The Effectiveness of Dialectical Behavior Therapy on Health Anxiety, Perfectionism, and Identity Crisis among 15- to 18-Year-Old Students in Selective and Gifted Schools

Abstract

This study aimed to investigate the effectiveness of dialectical behavior therapy in reducing health anxiety, perfectionism, and identity crisis among 15- to 18-year-old male students enrolled in selective public and gifted schools. This applied, quasi-experimental study employed a pretest-posttest control-group design with a one-month follow-up. The statistical population consisted of approximately 1,500 male students aged 15-18 years attending selective public and gifted schools in Kermanshah, Iran, during the 2024-2025 academic year. Using convenience sampling and predetermined inclusion criteria, 40 eligible students were selected and randomly assigned to an experimental group and a control group, with 20 participants in each. Data were collected using the Ahmadi Identity Crisis Questionnaire, Hill Perfectionism Questionnaire, and Short Health Anxiety Inventory. The experimental group received eight 60-minute group-based dialectical behavior therapy sessions delivered twice weekly over one month, whereas the control group received no intervention. Assessments were conducted at pretest, posttest, and one-month follow-up. Data were analyzed using repeated-measures analysis of variance and Bonferroni-adjusted comparisons in SPSS version 27. Significant time-by-group interaction effects were observed for total health anxiety (F=5.418, p=.010, η²=.125), illness likelihood (F=9.257, p=.001, η²=.196), and negative consequences (F=7.840, p=.002, η²=.171), whereas general health concern was not significant (p=.252). Significant interaction effects were also found for total perfectionism (F=12.735, p=.001, η²=.251), interpersonal sensitivity (F=5.631, p=.005), striving for excellence (F=14.009, p=.001), organization (F=6.730, p=.002), purposefulness (F=4.874, p=.010), and high standards for others (F=3.890, p=.025), while perceived parental pressure was not significant (p=.943). Identity crisis also showed a significant time-by-group interaction (F=7.659, p=.001, η²=.168). Bonferroni comparisons confirmed significantly lower total health anxiety, total perfectionism, and identity crisis scores in the experimental group. Dialectical behavior therapy was effective in reducing health anxiety, most dimensions of perfectionism, and identity crisis among male students in selective and gifted schools, with effects generally maintained at one-month follow-up.