The Effectiveness of Cognitive Behavioral Therapy on Body Image Concern, Rejection Sensitivity, and Peer Relationships in Girls with Precocious Puberty: A Semi-Experimental Study

Abstract

The present study aimed to investigate the effectiveness of cognitive behavioral therapy on body image concern, rejection sensitivity, and peer relationships in girls with precocious puberty. This study employed a semi-experimental pretest–posttest design with a control group. The statistical population consisted of 11- to 13-year-old girls with precocious puberty who were referred to a pediatric endocrinology clinic in Tehran in 2025. From approximately 400 eligible individuals, 30 participants were selected purposively and randomly assigned to experimental and control groups. The experimental group received eight weekly sessions of cognitive behavioral therapy, while the control group received no intervention. Data collection instruments included the Body Image Concern Inventory developed by Littleton et al., the Rejection Sensitivity Questionnaire by Downey and Feldman, and the Peer Relationship Index by Hudson. Data were analyzed using multivariate and univariate analyses of covariance in SPSS version 26. The results of multivariate covariance analysis demonstrated that cognitive behavioral therapy had a significant effect on the combined dependent variables of body image concern, rejection sensitivity, and peer relationships (P<0.001). Univariate analyses further indicated that body image concern significantly decreased in the experimental group after the intervention, with an effect size of 0.45. Rejection sensitivity also showed a significant reduction compared with the control group, with an effect size of 0.66. In addition, peer relationships significantly improved in the experimental group, with an effect size of 0.76. These findings suggest that cognitive behavioral therapy effectively reduced maladaptive cognitions, negative self-evaluations, and interpersonal difficulties while enhancing social functioning and emotional adjustment among girls with precocious puberty. The findings indicate that cognitive behavioral therapy is an effective intervention for reducing body image concern and rejection sensitivity and for improving peer relationships in girls with precocious puberty. Therefore, integrating this psychological intervention alongside medical treatments may contribute substantially to enhancing psychological well-being and social adjustment in this population.