فرح لطفی کاشانی

The purpose of the present study was to study the mediating role of the transdiagnostic factors in the relationship between stressful events and panic disorders.. The present study was conducted through the casual non-experimental method. The students of the public universities in Tehran affiliated with the Ministry of Science and Technology was research population.This research conducted in 2020. The number of 700 students were selected by a convenience sampling method. To gather the data the Severity Measure for Panic Disorder of APA (2013), Freestone et al.’s distress intolerance scale (1994), the Cognitive Emotion Regulation Questionnaire of Garnefski and Kraaij (2006), the Acceptance and Action questionnaire of Bond et al. (2011), Paykel‘s stressful life events (1971) and Cartwright-Hatton and Wells’s Meta-Cognitive Beliefs Questionnaire Wales and Carteret-Hawton (2004). The analyzing the data was done using the Amos software and the structural equation modeling. The results showed that the indirect effect of stress events on the symptoms of panic disorder is significant by mediating role of transdiagnostic factors (p<0.05). According to the findings obtained from the data analysis, it can be said that transdiagnostic factors has a mediating role in the relationship between stressful events and panic disorder. Therefore, it is important to pay attention to transdiagnostic factors in the treatment of patients suffering from panic disorder.

 This study aimed to compare the effectiveness of cognitive therapy and mindfulness on depression in women with gestational diabetes.

 This study was quasi-experimental. The statistical population consisted of women with gestational diabetes who referred to the Rey Health and Treatment Network. Using convenience sampling, 45 individuals were selected and randomly assigned to three groups: mindfulness, cognitive therapy, and control. The pre-test included the administration of the Edinburgh Postnatal Depression Scale. The mindfulness and cognitive therapy groups each received eight 60-minute sessions, held twice a week. The post-test was conducted immediately after the interventions, followed by a one-month follow-up test. The inclusion criteria were: age between 18 and 35 years, pregnancy term of 24 to 28 weeks, and a minimum ability to read and write. The exclusion criteria included: absence from more than two therapy sessions, use of psychotropic medication, simultaneous or recent (within one year) psychotherapy, and exposure to significant and unpredictable stressors. Data were analyzed using analysis of variance (ANOVA) with SPSS 25 software.

 The results of ANOVA indicated a significant difference between the three groups in the post-test and follow-up phases (p < 0.01). Bonferroni post-hoc analysis revealed that cognitive therapy was more effective in reducing depression compared to mindfulness (p < 0.01). Additionally, both mindfulness (p < 0.01) and cognitive therapy (p < 0.01) were effective in improving depression, and these effects persisted in the follow-up phase (p < 0.01).

 Cognitive therapy demonstrated greater effectiveness in improving depression in women with gestational diabetes compared to mindfulness. However, both approaches were effective in reducing depression.

University students are a vulnerable group mental health problems. The aim of this study to design, develop and validate a training self-esteem by McKay and Fanning and its effectiveness on emotional repression in students

The present research was conducted in two stages. In the first stage, cognitive techniques of McKay and Fanning (2016), self-esteem sessions were developed. Then, 8 psychology experts determined the content validity of the sessions. In the second stage, a semi-experimental design with pre-test, post-testand with a control group and follow-up 2 months was used. The statistical population was female students at Hadith College of Tehran City in the winter of 2024 and was evaluated by twostage sampling. In the first stage, screening was done based on subjective sampling. In the second stage, based on the simple random method, 30 people were selected from among female students with the inclusion and exclusion criteria of the study and were randomly replaced in an experimental group (15 people) and a control group (15 people). The self-esteem sessions were administered to the experimental group for 16 sessions, and after 2 months, was followed up. The self-esteem sessions was administered to the experimental group for 16 sessions, and after 2 month, was followed up. Data was collected using Weinberger adjustment inventory short form (WAI-SF) of Weinberger & Schwartz (1990). Data analysis was performed using SPSS-28 software with analysis of variance with repeated measures and Bonferroni.

The results indicated that self-esteem sessions have acceptable content validity. Furthermore, the results of training intervention showed that tarning self-esteem significantly reduced the distress (F=18.306 and p-value =0.001), inhibition (F=0.46 and p-value=0.001), defensiveness (F=11.89 and p-value =0.001) and total score emotional repression (F=93.90 and p-value =0.001) and this effect was significant in the follow-up phase.

Tarning self-esteem can be considered as a valid and effective program for reduced the symptoms of emotional repression by university counseling centers and psychological services for female students.

The present study aimed to investigate the relationship between Mathematical Self-Efficacy and Academic Motivation with emphasis on the role of gender in students. The research method was descriptive correlation. The statistical population included all undergraduate students of Islamic Azad Universities of Tehran province in the academic year 1398-1399. 300 participants were selected as a sample by multi-stage cluster random sampling method. Instruments included self-made Mathematical Self-efficacy Questionnaire and Academic Motivation Scale (AMS) (Vallerand et.al, 1992). The results showed that all four components of The self-made Questionnaire were positively correlated with the Intrinsic and Extrinsic Motivation components in Vallerand Questionnaire and negatively correlated with Amotivation at the %1 level. The results of fisher test showed that gender significantly moderated the relationship between the components of Mathematical Self-Efficacy and Mathematical Self-Efficacy Stress and Extrinsic Academic Motivation. The type of academic discipline significantly modulated the link between the components of Mathematical Stress, General Mathematical Self-Efficacy, and Mathematical Anxiety with Extrinsic Academic Motivation

The present study was to investigate the efficacy of acceptance and commitment therapy in the context of infertile women’s emotional expression and sexual function. The study was a quasi-experimental design with pretest-posttest and control group design, with a two-month follow-up period. The statistical population included infertile women who submitted referrals to the infertility clinics at Mother and Child Hospital and Samar infertility clinic in Shiraz during the winter of 2021. The experimental and control groups were randomly assigned to 36 infertile women who were selected through the voluntary sampling procedure. Over the course of two and a half months, the experimental group was subjected to ten sessions of acceptance and commitment therapy. In this study, the Emotional Expression Questionnaire (EEQ) (King, Emmons, 1990) and the Sexual Function Questionnaire (Keraskian, Mojembari, and Kaiballah, 2014) were implemented. The SPSS23 software was used to analyze the collected data using mixed ANOVA. The findings indicated that acceptance and commitment therapy has a substantial impact on the emotional expression and sexual function of infertile women (p<0.001). Through the development of psychological resilience and mental acceptance, acceptance and commitment therapy can be employed as an effective approach to enhance the emotional expression and sexual function of infertile women, as indicated by the study’s results.

Interventions based on mindfulness are considered to be one of the cognitive-behavioral treatments, the inclusion of which in patients reduces the psychological stress resulting from such diseases as breast cancer in patients. Therefore, the present study aimed to assess the effectiveness of mindfulness-based stress reduction training on the catastrophizing of cancer pain and the tolerance of helplessness caused by the treatment of breast cancer patients.

The present research was an interventional study. The statistical population included all patients with breast cancer treated at Shahada Tajrish Hospital Cancer Center in 2023. A total of 30 patients were selected based on the inclusion criteria and randomly assigned to two groups: experimental (n=15) and control (n=15). Based on Ashrafi's training package, the experimental group received eight 120-minute sessions of stress reduction training based on mindfulness; nonetheless, the control group did not receive any intervention. The standard questionnaires on pain catastrophizing by Sullivan, Bishop, and Pewick and tolerance of helplessness by Simmons and Gaher were used to collect data. Data were analyzed using multivariate covariance analysis in SPSS software (version 26).

The mean age scores of subjects in the experimental and control groups were 36.26±6.04 and 47.5±7.59 years, respectively, and there was no significant relationship between the two groups in terms of age (P=0.689). The findings pointed out that a mindfulness-based stress reduction program was effective in reducing pain catastrophizing and tolerance of helplessness among women with breast cancer (P<0.05). Therefore,  mindfulness-based stress reduction training reduced pain catastrophizing and increased tolerance of helplessness in women with breast cancer in the experimental group.

As evidenced by the results of this study, the use of cognitive behavioral therapy integrated with mindfulness can be an effective treatment in reducing perceived pain and catastrophizing and increasing pain self-efficacy. Therefore, it is suggested that this treatment method be taught to psychologists by experts in different hospital centers.

The present study was conducted to analyze the focal relationship of the contribution of mental adaptation to cancer, health literacy, and perceived threat in predicting the early diagnosis of breast cancer.

This study was a descriptive correlational research. The statistical population of the present study included all women with breast cancer under treatment at Shohadaye Tajrish Hospital Cancer Treatment Center in 2023, and 310 people were determined to participate in the research using G*Power software and the available sampling method. They responded to Williams, Templin, and Hines's breast cancer literacy questionnaires, Champion's perceived threat questionnaire, Watson's mental adaptation to cancer and early diagnosis questionnaire. The data were also analyzed using a focal correlation test and multiple regression.

The results showed that there is a significant relationship between the contribution variables of mental adaptation, perceived threat, and health literacy with the components of early cancer diagnosis (knowledge, attitude, and actions) (P ≤ 0.01). Also, the results showed that health literacy was 4.8%, mental compatibility was 3.4 percent and perceived threat 18.7% alone predicted the variance of early diagnosis of breast cancer. The perceived threat share is 38.9%, higher than all other variables.

Based on the statistical results, it can be said that increasing mental adaptability, perceived threat, and health literacy play a role in early disease diagnosis, and the importance of perceived threat is more significant than mental adaptability and health literacy, which should be considered.

Interpersonal and social rhythm therapy (IPSRT) is a type of psychotherapy that was initially designed to improve the mood and prevent the relapse of people with bipolar disorder, and for this purpose, understanding and working with biological and social rhythms and training interpersonal skills It is focused. The present study was conducted with the aim of investigating the effectiveness of IPSRT in combination with motivational interviewing (MI) on reducing the symptoms of major depression with anxiety distress, which is one of the most common and debilitating mental disorders.

In this study, IPSRT was combined with MI in the form of a single-case study design with multiple baselines. The subjects included 2 people (one male and one female) with low vision suffering from major depressive disorder with anxiety distress who were selected by the purpose-based accessible sampling method in September 2022 from among the members of the Mashhad welfare student WhatsApp group. After the stability of the research variables in the baseline, the subjects underwent 12 weekly 1-hour therapy sessions with a follow-up period of 2, 1, and 3 months. Beck's depression and anxiety questionnaires were used to evaluate changes in baseline, treatment and follow-up. Data analysis was done with the help of stable change index, effect size, improvement percentage and visual analysis of the graph.

The results showed that this treatment has made clinically and statistically significant changes (P<0.005) in reducing symptoms of depression and accompanying anxiety.

Findings support that IPSRT in combination with MI is effective in reducing symptoms of major depression and associated anxiety.

The impact of cultural context on the psychological adaptation of women to breast cancer (BC) has been recognized as significant. Consequently, the primary objective of this study was to gain insight into women's life experiences, taking into account the role of culture in forming BC-related experiences.

This research was conducted with a qualitative phenomenological design to detect the experiences of women living with BC. The statistical population of this research included Iranian women with BC who referred to educational and oncology centers affiliated with the medical sciences universities in Iran and were members of the Tehran BC virtual group. The samples were selected using purposeful and snowball sampling methods. The required data were collected by holding semi-structured and in-depth interviews with 11 women in stages 1, 2, and 3 of BC in the age range of 29 to 51 years. The interview guide was semi-structured questions.

The main concepts indicating cultural factors affecting BC adaptation were extracted. In this regard, the challenges of women with BC were as follows: fear of cancer, financial and occupational problems, changes in motherhood role, perceived concerns about the unpredictability of social conditions, unhealthy sympathy from relatives and community members, and the issue of cancer as a taboo. Moreover, some strategies were adopted to cope with the threatening conditions of this disease: Spirituality, perceived support, maintaining individual abilities, and emotional expression.

Individuals' culture affects the formation of their experiences and adaptation to BC. Interventions culturally tailored to individuals’ needs can play a more effective role by using a common language (i.e., culture).

One of the most common psychological disorders among children, adolescents and adults, is anxiety disorders. These disorders include a complex of disorders that their common features are fear, anxiety, and behavioral distress. Various causes and factors are involved in appearance of the disorder. The aim of this study was to examine the mediating role of transdiagnostic factors in relationship between stressful events and generalized anxiety.

Methods and Materials: 

The research method was non-experimental causal. The statistical population was all students of public universities of science and technology ministry in Tehran. Among them 700 students were selected by convenience sampling. And the data were gathered through internet-based questionnaires. The instruments included generalized anxiety scale (short-form) (2006), Freeston’s intolerance of ‎uncertainty (1994), cognitive emotion regulation questionnaire (short-form) (2006), acceptance and action questionnaire (2011), life events scale (1971), and meta-cognitive beliefs questionnaire. To analyze the data structural equation modeling (SEM) was used through Amos software version 26.

The results showed that the indirect effect of stressful events on generalized anxiety disorder by mediating role of transdiagnostic factors is significant (p<0.05). The estimates of the findings indicated that intolerance of uncertainty has equal coefficients in mediating of stressful events and generalized anxiety (p<0.05). Also, results revealed that compatible and incompatible emotion regulation, experiential avoidance, and metacognitive beliefs as transdiagnostic factors have significant role in mediating in relationship between stressful events and generalized anxiety (p<0.05).

Regarding the obtained findings based on analyzing data, it can be mentioned that transdiagnostic factors has a mediating role between stressful events and generalized anxiety. Therefore, it is highly important to pay attention to transdiagnostic factors in treatment of patients suffering from generalized anxiety disorder.

 Although sexual function (SF) and sexual satisfaction (SS) are the essential factors influenced negatively by infertility and may be associated with delaying or disrupting infertility treatment, no systematic review has assessed the results of these studies so far.

 The present study aimed to systematically review published interventional research regarding SF and SS among infertile individuals.

 In this systematic review, the databases of PubMed, MEDLINE, Web of Science, Scopus, ScienceDirect, Cochrane Library, PsycInfo, Google Scholar, and SID were searched to retrieve the relevant studies in Persian and English languages up to August 2021.  

 23 interventional studies were included in this systematic review, of which only 2 were low quality based on the critical appraisal skills programme checklist. The interventions of the included studies were classified into 2 main categories: educational and psychological interventions for increasing the SF and SS among infertile women or couples. 

 There was no clear evidence to understand the most effective method for increasing SF and satisfaction among couples with infertility. Based on the results of the included studies, all of them showed the effectiveness of the various interventions performed on sexual health dimensions among couples with infertility. This systematic review showed that most SF studies were educational, whereas the SS were more psychologically interventional. Conducting standardized and high-quality randomized controlled trials focusing on SF and SS is recommended.

Heart disease is one of the most common diseases in the world. The aim of the current research was the efficacy of written emotional expression training on adherence to treatment in heart patients.
The present study was practical and quasi-experimental with a pre-test-post-test design and a two-month follow-up with a control group. The statistical population included all patients with heart problems in the west of Tehran city, 40 of whom were selected by available sampling method and randomly assigned to experimental and control groups. They completed Medanlo adherence to treatment questionnaire (2013). The data was analyzed using the repeated measurement variance analysis method with the help of SPSSV19 software.
The results showed that there was a significant difference in the adherence to treatment variable and all its components (F=7.332 and P<0.01). After the intervention in the variables of interest in treatment (F=7.694 and P<0.01), willingness to participate (F=6.959 and P<0.01), ability to adapt (F=14.113 and P<0.01), integration of treatment with life (F=9.953 and P<0.01), adherence to treatment (F=6.891 and P<0.01), commitment to treatment (F=6.892 and P<0.01), doubt in implementing the treatment (F=19.877 and P<0.01) and adherence to treatment (F=43.134 and P<0.01) of the group.
Finally, it can be concluded that the use of written emotional expression training has elevated the adherence to treatment and its components in heart patients. Therefore psychologists, counselors, cardiologists, and clinical and health professionals can benefit from this training in order to improve the adherence to treatment of heart patients.

Objective (s): Breast cancer is one of the most common cancers in women, which seriously affects patients’ psychological wellbeing. There are many interventions to deal with psychological impact of the disease. This study aimed to review the effectiveness of spiritual therapy in breast cancer patient. The secondary aim was to review studies that compared the effectiveness of spiritual therapy with others psychological interventions.

This scoping review examined studies published in Persian language with related keywords, including ‘spiritual therapy’ and ‘breast cancer’ in Google Scholar up to July 2023. The data were extracted and tabulated to summarize evidence.

Overall, 554 article were retrieved. After excluding unrelated articles, 27 articles (18 articles reporting effectiveness of spiritual therapy and 9 articles comparing effectiveness of the spiritual therapy with others psychological interventions) were selected for final review. All studies confirmed the effectiveness of spiritual therapy on improved quality of life, resilience and hope. It also reduced anxiety, stress, depression, fear of the cancer among breast cancer patients. The findings showed that spiritual therapy is more effective than other psychological interventions except 2 studies that showed other psychological interventions are more effective.

The findings showed that spiritual therapy was effective on improving the quality of life, resilience, hope and decreasing the fear of cancer, anxiety, stress and depression.

Propose: The present study was conducted to investigate the efficacy of unified trans-diagnostic treatment on the infertility stress and Cognitive fusion in infertile women’s.

It was a quasi-experimental study with pretest-posttest and control group design. Two-month follow-up period was administered too. The statistical population included infertile women who referred to infertility clinic at Mother and Child Hospital and Samar infertility clinic in the city of Shiraz in the winter of 2021. 36 infertile women were selected through voluntary sampling method and randomly accommodated into experimental and control groups. The experimental group received ten sessions of unified trans-diagnostic treatment during two-and-a-half-months. The applied questionnaires in this study included Infertility stress Questionnaire (Newton, Sherrard, Glavac, 1999) and Cognitive fusion Questionnaire (Gillanders et al, 2010). The collected data were analyzed through mixed ANOVA via SPSS23 software.

The results showed that unified trans-diagnostic treatment has significant effect on the infertility stress (F=50.03; Eta=0.59; P<0001) and Cognitive fusion (F=91.36; Eta=0.72; P<0001) in infertile women’s.

According to the findings of the present study it can be concluded that unified trans-diagnostic treatment can be used as an efficient intervention to improve infertility stress and Cognitive fusion in infertile women’s through employing techniques such as identify emotions, emotional awareness, cognitive reassessment, and identify patterns of emotion avoidance.

The present study was conducted to investigate the effectiveness of unified trans-diagnostic treatment on the emotional expression and sexual function of the infertile women. It was a quasi-experimental study with pretest, posttest and control group design. Two-month follow-up period was administered too. The statistical population included infertile women who referred to Infertility Clinic at Mother and Child Hospital and Samar Infertility Clinic in the city of Shiraz in the winter of 2021. Thirty six infertile women were selected through voluntary sampling method and randomly accommodated into experimental and control groups. The experimental group received ten sessions of unified trans-diagnostic treatment during two-and-a-half-months. The applied questionnaires in this study included Emotional Expression Questionnaire (EEQ) (King, Emmons, 1990) and Sexual Function Questionnaire (Keraskian, Mojembari and Kaiballah, 2014). The collected data were analyzed through mixed ANOVA via SPSS23 software. The results showed that unified trans-diagnostic treatment has significant effect on the emotional expression (F=39.82; Eta=0.54; P<0001) and sexual function (F=31.88; Eta=0.49; P<0001) in the infertile women. According to the findings of the present study it can be concluded that unified trans-diagnostic treatment can be used as an efficient therapy to improve emotional expression and sexual function in the infertile women through employing techniques such as identifying emotions, emotional awareness, cognitive reassessment, and identifying patterns of emotion avoidance.

Cardiovascular disease is a part of the chronic diseases that cause of the death of many people annually. It is vital to consider different psychological treatments in these patients. Therefore, this study aimed to investigate the effectiveness of mindfulness-based therapy on chronic stress and disease perception in heart patients.

The current study was a quasi-experimental study with a pre-test-post-test design with a two-month follow-up and a control group. From among all the heart patients in West Tehran, 40 people were selected by convenience sampling and assigned in two groups (Experimental and Control). In the pre-test, post-test and follow-up stages, the participants completed Wheaton's (1991) Chronic Stress Questionnaires and Brodbent et al.'s (2006) disease Perception Questionnaires. Then the experimental group received mindfulness treatment. The data were analyzed by analysis of variance and repeated measure and with the help of SPSSV19 software.

The results illustrated that there is a significant difference between the groups in the variables of chronic stress (F=5.91) and illness perception (F=10.72) (P<0.05). In the experimental group, after the experimental intervention, a significant decrease in chronic stress and an increase in the illness perception was reported.

According to the results, mindfulness intervention has led to a reduction of chronic stress and an increase in disease perception in heart patients. Therefore, the knowledge of counselors, psychologists, cardiologists and clinical and health professionals about these variables can help in reducing chronic stress and increasing disease perception in heart patients.

Autoimmune and chronic diseases cause many psychological problems by directly and indirectly affecting the nervous system. Lupus is one of the autoimmune diseases that, in addition to the problems caused by the nature of the disease itself, the side effects of its drugs also cause emotional and mental disturbances. The prevalence of lupus in women is about 9 times higher than in men, and the patients are usually between 15 and 45 years old. In Iran, according to a study conducted by the Rheumatology Research Center of Tehran University of Medical Sciences, lupus has a prevalence of 40 in 100,000, that is, 1 person per 2,500 Iranians is diagnosed with lupus. People with lupus Erythematosus experience many skin ulcers, joint pains, periodicity of the disease, side effects of medications, and stressful events. In the framework of psychological interventions for people with lupus, in recent years acceptance-based therapy (ACT) and commitment is a non-pharmacological strategy and among the effective treatment lines for patients with physical diseases. This therapeutic approach is part of the third wave of behavioral therapies, which aims to help clients achieve a more valuable and satisfying life by increasing psychological flexibility and not focusing solely on cognitive reconstructions. Research has emphasized the effectiveness of cognitive functions and attention management and executive function by ACT in patients with chronic diseases. For example, Menshi et al showed in their research in 2015 that ACT can improve people's executive function by adjusting incompatible schemas, however, no research was found regarding the effectiveness of this treatment method in people with lupus. In addition to ACT, another psychological approach and non-pharmacological strategies that have been proposed to improve psychological and functional variables such as attention and executive function in people with lupus is short-term intensive dynamic psychotherapy (ISTDP). The goal of ISTDP or psychoanalysis is to help clients achieve a full experience of repressed emotions and the fantasies and memories that are repressed by these emotions. By clarifying defenses and challenging them, ISTDP focuses on experiencing unconscious feelings and emotions to increase awareness. It is a psychological process that can help you change how you react to life's inevitable hardships. The review of the literature showed that even though several studies on the effectiveness of ACT and also the ISTDP approach have been conducted separately on different populations, no study compares these two treatment approaches in patients with lupus Erythematosus. The present study was conducted to compare the effectiveness of ACT and ISTDP on attention and executive function in lupus Erythematosus patients.

The current research was a semi-experimental single-subject type with multiple baseline designs. The participants of this study were 6 people with lupus, members of the Lupus Patients Support Association in Tehran, who were selected as available and randomly assigned to two groups of three. The tools used in the research included the Wisconsin Card Sorting Test and the Stroop Test. The subjects of the first group received ACT and the subjects of the second group (ISTDP) individually in 8 sessions of 90 minutes. To analyze the data, the effect size was used.

Regarding effect size calculations in Stroop dimensions between treatment groups, the results generally showed that the ACT method had a more significant effect than ISTDP in the extent of reaction time. In terms of reducing the number of errors in the error of the first stage, the effect size in the ACT group is medium and in the ISTDP group, slightly too high, in the second and third stages, both are high, but the magnitude of the effect is higher in the second stage in the ISTDP and in the third stage in the ACT group. Regarding the calculation of effect size and index of stable change in Wisconsin dimensions between treatment groups, the results of the study also showed that the average effect size in the residual error of the first and second stages of the Wisconsin test in the ACT group is higher than the average effect of the ISTDP group. In terms of increasing the number of correct answers in the first and second stages, the effect size in the ACT group is lower than in the ISTDP group.

The results of the study showed that despite the effectiveness of ISTDP on the attention and executive function of patients with lupus Erythematosus, ACT had more effectiveness than ISTDP on the attention and executive function of patients with lupus Erythematosus, hence this approach along with other approaches The existing treatment is recommended as a suitable option to improve attention and executive function in people with lupus Erythematosus. It is also suggested that health therapists pay attention to the findings of this research and the discussion of executive functions to enrich their diagnostic formulation, and if they find a symptom in executive functions, they should use cognitive interventions in this direction. Due to the problems in collecting samples from patients with lupus Erythematosus, the available sampling method was used in this research. Therefore, the selected sample group is less representative of the entire society and the results cannot be generalized. Also, this research was considered without a control group and follow-up stage. The same researcher and therapist in ACT may also increase the possibility of bias in the results. Also, in this research, the effect of moderating variables such as gender was not investigated, which may have distorted the results.

Transgender people are vulnerable to a high risk of mental health problems. These people face many problems in accessing health services. There is very little information about the needs of transgender people for health care and their concerns in this regard. This study aimed to examine the mental health services and needs of transgender people and their attitudes and experiences.

To select English-related studies in the databases of Science Direct, Google Scholar, Web of Science, PubMed, Scopus, Psych Info, Psych Lit, and Sociological Abstracts, the English keywords Trans, Transgender, Transphobia, Gender Dysphoria, Mental health, and Mental health service were searched from 2010 to 2022. Also, for Persian articles, the equivalent Persian keywords were searched in internal databases of the University Jihad Scientific Database (SID), Comprehensive Humanities, and Civilica Portal.  Finally, out of 231 studies, 12 articles were selected for review.

This study highlights the main challenges of transgender people. The results of this study showed that some of these challenges include access to health services tailored to the needs of transgender people and the need to develop mental health services for these people.

We can conclude that there are no medical services that meet the needs of transgender people and to improve the quality of life of these people, there is a need to develop mental health services and train specialists.

Breast cancer, as the most common cancer, is the cause of death of millions of people around the world. Given that psychological status can be effective in responding to treatment by affecting the immune system, the aim of this study was to present a model for predicting the status of the immune system through personality type D mediated by defense mechanisms in patients with breast cancer.

The statistical population of the present study included all women with breast cancer in Tehran and Gilan in 1398, from which 250 were selected by purposive sampling. Data were collected using a Type D personality, Questionnaire Defense Style Questionnaire and Warning Signs of Immunodeficiency. Pearson correlation coefficient and structural equation modeling were used to analyze the data using AMOS and SPSS software version 22.

The results showed that there was a significant and direct correlation between the status of the immune system and the neurotic defense mechanism, undeveloped defense mechanism and personality type D and a significant and inverse correlation between the status of the immune system and the developed defense mechanism. Also, defense mechanisms played a mediating role in the relationship between personality type D and immune system status in breast cancer patients.

Accordingly, in patients with breast cancer, the status of the immune system can be predicted through defense mechanisms and personality type D. Therefore, therapists and health professionals can help these people overcome their disease by designing interventions based on modifying defense mechanisms and personality type D. Thus, the more an individual uses the immature defense mechanism, the weaker the immune system is, and the use of the developed defense mechanism is associated with a stronger immune system. Based on the findings, it can be said that designing psychological interventions based on modifying defense mechanisms and changing personality type D, can help a patient with breast cancer to manage and treat the disease.

Every year, in Iran and the world, many researches are conducted in the field of stress, anxiety and depression, especially in the field of treatment, and on the other hand, the lives of people who are involved with these problems are greatly disturbed and the inefficiencies caused by these problems make their lives miserable. It seriously affects and in general due to the very high prevalence of these disorders, huge time, energy and costs are imposed on individuals and governments every year, both in the field of treatment and in the field of research. Mental disorders have gained special importance due to the current tense world, which among mental disorders, anxiety, stress and depression have a long history and high prevalence and have attracted the attention of researchers. Anxiety, stress and depression have been considered throughout the history of psychology due to their unfortunate consequences and high prevalence. Knowing the causes of these disorders and effective treatment solutions for these disorders have always been considered, and therefore, many researches have been conducted in this field and a large amount of financial and human resources have been allocated to them. Although a lot of money has been spent on these issues, the results of the conducted research are not consistent and even sometimes contradictory results are obtained in the research. Therefore, the application of contradictory research results, publication, interpretation, evaluation and recognition of their weak points requires a solution based on the correct review and analysis of the research background, the use of conflicting evidence and the use of a combined method. For this reason, we take help from meta-analysis for this matter. In fact, meta-analysis is a method that can be used to infer the differences in the conducted research and to combine the results of various and numerous researches and extract new and coherent results and remove what causes bias in the final results and to solve problems and reach it contributes to more accurate results. The result of the research that has been done in order to present and improve the treatment methods is a very high volume of studies that have contradictory and scattered results. Therefore, this issue makes it difficult for researchers and therapists to draw conclusions and provide treatment services. Therefore, the application and use of meta-analysis research method can play a significant role in organizing the scattered results and resolve the contradictions in the data. Statistically, meta-analysis discovers the relationships between characteristics and research findings by converting the results of previous research into a common scale. The necessity of this research and meta-analysis research in general is due to the low sample size studied in intervention studies. The results of such studies are estimated to be biased compared to studies with larger samples. In these cases, the meta-analysis method by combining related studies and calculating the effect size of the investigated hypotheses is actually evaluated with larger samples. The findings of this type of research will be fruitful both in the field of science and research development and in the field of application and treatment and will bring many advantages. Researchers, professors and students can use the information and results of the research to choose the exact and correct area of their research, in other words, by determining the areas that need more research, it becomes possible to expand the theoretical area, also if the results are, show the ineffectiveness of treatment, a research field will be provided so that those interested in that field of treatment can review and make effective changes in the treatment protocol and in future research, they can improve and improve treatment methods. Therefore, the aim of the current research is to analyze the results of the research conducted in the field of the effectiveness of integrative treatment approaches on the occurrence of depression symptoms by using the meta-analysis technique.

The study method was meta-analysis, and its statistical population included Persian studies, which were searched for Persian language articles in the databases of specialized Persian journals with keywords integrative, integrative approach, integrative treatment, integrative therapeutic approaches, integrative group therapy, integrative positive psychotherapy and Depression, separately and in combination, were searched. As a result of the search process, 16 articles related to the topic were obtained and after the process of removing studies based on inclusion and exclusion criteria, 7 articles were removed and 9 articles were found suitable for this meta-analysis. CMA2 software was used for data analysis.

Examining the questions showed that the effect size of integrative treatment approaches on depression is equal to 62.3%.

In general, it can be said that this research can greatly help therapists in the field of depression, and therapists using the results can make their patients' recovery more effective and efficient by choosing the correct method of treatment and implementing it effectively. Accelerate the treatment process and reduce the suffering of their patients. In the above explanation, it can be said that depressed people also suppress positive emotions. Strengthening the capabilities of gratitude, hope and vitality probably play a role in increasing positive emotions. It can be said that in the etiology of depression, the reduction of positive emotions indirectly helps the occurrence of depression symptoms through the increase of negative emotions. In this way, in addition to increasing positive emotions, strengthening the mentioned capabilities is also effective in regulating negative emotions. On the other hand, the increase in personality abilities may lead to the improvement of coping strategies in depressed people. Depressed people generally suffer from a sense of emptiness and meaninglessness in life. In the integrative therapeutic approach, various strategies are used to strengthen emotional regulation. For example, to strengthen the ability to forgive, the therapist helps clients identify negative emotions such as anger and hatred and express them during the therapy session. Also, in these meetings, clients face painful events from the past and reframe them if necessary. In the critical thinking sessions, ineffective cognitions related to negative emotions are identified and replaced with efficient cognitions. In this way, the client can better accept his inner experiences such as negative thoughts, anger and hatred. It can be said that by relying on an integrated program of treatment and introducing emotions to people, tracking mood and activity level, familiarizing with creating small behavioral changes and evaluating them, teaching common mental traps, preparing a list of pleasurable activities and other stages and steps presented in the research; There was a significant difference in the depression of people before and after the implementation and it has been effective in reducing depression. Also, with the effort that takes place in the integrative treatment approach for behavioral acceptance of the existing situation, and in practice, more patience and tolerance occurs in the relationship between the patient and his spouse, the platform for positive social exchange is provided, which is one of the platforms and areas for strengthening social capital.

Breast cancer, as the most common cancer, is the cause of death of millions of people around the world. The aim of this study was to present a model for predicting the status of the immune system through coping strategies with stress and personality type D mediated by defense mechanisms in patients with breast cancer.

The statistical population of the present study included all women with breast cancer in Tehran and Gilan in 2019, from which 250 were selected by purposive sampling. Data were collected using a checklist of warning signs of immunodeficiency, a questionnaire of defense mechanisms, a questionnaire of personality type D and a questionnaire of coping strategies. The data were analyzed using structural equation method and smart-PLS- v3 software was analyzed.

The results showed that coping strategies did not have a significant direct effect on immune status scores. The direct effect of personality type D on immune status scores was significant. Defense mechanisms did not mediate the relationship between coping styles with stress and personality type D with immune status scores.

In general, it can be concluded that in patients with breast cancer, personality type D has a significant effect on the state of the immune system, and therefore therapists and health professionals can design interventions based on the correction of personality type D, Help these people overcome their illness.

Narrative therapy (NT) and Good Enough Sex Model (GESM) are models for promoting mental and sexual health in marital identity. The present study examines and compares the effectiveness of these two treatments on the dimensions of sexual attitudes in infertile couples.

Participants were 48 married individuals who referred to the urology, gynecology and sexual health clinics in Tehran with infertility, which was selected thorugh convenience sampling method and were randomly assigned into three groups of 16 individuals such as NT, GESM and Control groups. The content of NT and GESM was performed separately for the experimental groups during 4 sessions of 90 minutes. To collect data, the demographic and Dehghani'  sexual attitude questionnaires, was used.  Data analysis was performed using SPSS software 26 and descriptive statistics tests and analysis of univariate and multivariate covariance, Bonferroni and mixed analysis of variance.

The result of covariance test was significant for all three emotional, cognitive and behavioral variables at 99% confidence level (p<0.01) and both treatments had a significant effect on improving the cognitive and emotional dimensions of infertile married sexual attitude in the post-test phase (p˂0.05) and only NT were effective in the behavioral dimension of sexual attitude (p˂0.05) but GESM not make a significant difference in the behavioral dimension (P>0.05). Also NT has been more successful in promoting the emotional dimension of sexual attitude and in the cognitive dimension, both interventions have acted similarly.

Both treatments can be used to enhance the emotional and cognitive dimensions of the sexual attitude in infertile couples.

Marital satisfaction is one of the essential components of family stability. The present study aimed to determine the effect of couple therapy with a self-regulation approach on marital satisfaction.

This was a quasi-experimental study. Participants were sixty clients referred to psychological and counseling centers in Karaj, Iran with marital problems; selected by convenience sampling method. They were randomly assigned into two groups of fifteen pairs: experimental and control groups. The marital satisfaction questions from Spanier Dyadic Adjustment Scale (DAS), were used for data collection. Couples in the experimental group received self-regulation therapy for eight sessions. Marital satisfaction was assessed at three points in time: baseline, immediately after the couple therapy, and two-months follow-up. Independent t-tests, one-way ANOVA with repeated measures, and LSD post hoc test was used. The significance level was considered less than 0.05.

The mean age of the experimental and control group was 32.46 and 33.43 years, respectively. Marital satisfaction score in three times assessments in the experimental group was 29.23, 40.50, and 39.1 (P<0.05), and in the control group it was 29.03, 29.20, and 25.3 respectively (P>0.05). The difference in the marital satisfaction score in the post-test and follow-up assessments between the two groups also showed a significant difference (P<0.05).

Couple therapy with a self-regulation approach improves marital satisfaction.

Infertility targets marital identity and can disrupt the natural course of a couple's sex life. Narrative Therapy (NT) and Good Enough Sex Model (GESM) are specific methods to promote mental-sexual health. The aim of this study was to investigate and compare the effectiveness of these two methods on the attitude and sexual satisfaction of infertile couples.

This was a quasi-experimental study using pretest- posttest design with a control group. Forty-eight clients referred to urology and genecology office in Tehran, Iran, with primary infertility problem were studied. They were selected through convenience sampling method and randomly assigned to three groups of 16 individuals such as NT, GESM and control groups. The content of NT and GESM was performed separately for the experimental groups for 4 sessions of 90 minutes. To collect data, the demographic questionnaire, Dehghani’ attitude questionnaire and Hudson’ sexual satisfaction questionnaire, was used. Data analysis was performed by SPSS software version 26 and descriptive statistics and analysis of covariance, Bonferroni post hoc test and mixed analysis of variance were used.

The results of analysis of covariance showed that both treatments had a significant effect on sexual attitude in the post-test compared to the control group (P <0.001). Bonferroni test indicates the superiority of NT over the GESM in promoting sexual attitude (P <0.05), and the greater impact of the GESM than the NT in promoting sexual satisfaction of infertile couples was observed (P <0.05). The results of repeated measures analysis also showed the persistence of effects in the follow-up stage (P <0.05).

The findings showed that the narrative therapy and the good enough sex model, are two appropriate interventional program to promote attitude and sexual satisfaction in infertile married people.

Considering the suicide is one of the most important public health issues, the present study investigates the comparison between comparison of the effectiveness of two therapeutic approaches Integrative and Acceptance and Commitment Therapy ACT on integrative self- knowledge among people with suicide attempts.

The current research is a quasi-experimental with pre-experimental-post-experimental study with a follow up design. The statistical population of the present study included all people with suicide attempts in North Khorasan who were hospitalized in 2020. The sample of the study included 24 subjects who selected through random sampling as well as inclusion criteria and assigned randomly into two experimental groups (12 people in each group). ACT package and integrated treatment protocol accomplished in eight 90-minutes sessions individually every week. The research tool was Integrative self- knowledge scale Ghorbani et al. (2008). Data were collected in four stages before the intervention, fourth session, at the end of the intervention and after two months. Data were analyzed using of mixed multivariate variance and by SPSS-26 software.

The results showed that both treatments effect on integrative self- knowledge (F = 120.346, P < 0.001, eta = 0.860). In Experiential self- awareness and to integrate there isn’t significant difference between the two treatments but in Reflective self- knowledge integrated treatment was more effective.

In order to increase the level of integrative self-knowledge in people with suicide attempts, more attention should be paid to the use of integrated approach treatment and acceptance and commitment therapy.