محمود نجفی

Obsessive-compulsive disorder is one of the common disorders and there are many interventions for this disorder, but some patients do not get the desired results from the interventions. The aim of this research was to compare the effectiveness of acceptance and commitment therapy along with exposure and response prevention (ACT+ERP) with schema therapy along with exposure and response prevention (ST+ERP) of the intensity of obsessions and obsessive beliefs of patients with obsessive-compulsive disorder.

The research method was quasi-experimental having pre-test and post-test with a control group. The statistical population included all patients with obsessive-compulsive disorder in the year 2023 in Isfahan city. Sixty people were selected through convenience sampling and were randomly assigned to 2 experimental groups and one control group (20 people in each group). The experimental groups received eight 60-minute sessions of ACT+ERP and ST+ERP. In this research, Obsessional Beliefs Questionnaire -44 (Group of Experts Working on Obsessive-Obsessive Cognitions, 1997) and Yale-Brown Obsessive Compulsive Scale (Y-BOCS) (Goodman et al., 1989) were used. Multivariate analysis of covariance statistical tests was used to analyze the hypotheses.

compared to the control group, ACT+ERP and ST+ERP had significant effect on the intensity of obsessions and obsessive beliefs of patients (p<0.001).

Based on the research findings, ACT+ERP and ST+ERP are effective in reducing the severity of obsessions and obsessive beliefs of patients with obsessive-compulsive disorder. Also, ACT+ERP compared to ST+ERP had a greater effect on reducing the severity of obsessions and compulsions in patients with obsessive-compulsive disorder.

Obsessive Compulsive Disorder is one of the disorders that affects all aspect of life and leaves destructive effects in patients' lives in the long term. The aim of this study was to compare the effectiveness of acceptance and commitment therapy along with exposure and response prevention with schema therapy along with exposure and response prevention on perfectionism and experiential avoidance of patients with obsessive-compulsive disorder. It was semi-experimental research that had pre-test and post-test with a control group. The statistical population of the present study included all patients with obsessive-compulsive disorder in 2023 in Isfahan city. After the clinical interview, 60 people were selected by available sampling method and randomly assigned in two experimental groups and one control group (20 people in each group). The experimental groups received eight 60-minute sessions of acceptance and commitment therapy with exposure and response prevention and schema therapy with exposure and response prevention. Frost's perfectionism questionnaire and acceptance and action questionnaire second version were used in this research. The results were evaluated through the statistical method of multivariate analysis of covariance. The findings data showed that the effectiveness of both treatments on perfectionism and experiential avoidance were statistically significant. Schema therapy with exposure and response prevention is more effective on experiential avoidance and the effectiveness of both treatments on perfectionism was the same. It is suggested to use schema therapy or acceptance and commitment therapy along with exposure and response prevention.

This study aimed to investigate the relationship between childhood trauma and suicidal thoughts, considering the mediating roles of mentalization and mindfulness in a students. The research method was descriptive correlational (structural equations). The statistical population included all boy and geirl high school students in Mashhad during the 2023-2024 academic year, with 330 students selected as the sample using multi-stage cluster random sampling. To measure the research variables, the Childhood Trauma Questionnaire (2003), Beck's Suicide Ideation Scale (1998),Reflective Functioning Questionnaire (2016), and Five Facet Mindfulness Questionnaire (2006) were used. Data analysis was conducted using SPSS25 and AMOS24 software. The findings showed that childhood trauma (β= 0.21), mindfulness (β= -0.32 certainty   Mentalization factor (β= -0.25), and Uncertainty   Mentalization  factor (β=0.18) had a direct and significant effect on suicidal thoughts (P<0.01). Additionally, childhood trauma had a direct and significant effect on mindfulness (β=-0.85), certainty   Mentalization factor (β = -0.81), and Uncertainty Mentalization factor (β=0.81) (P< 0.01). Regarding the indirect effect, childhood trauma through mindfulness (β=0.27), certainty   Mentalization factor (β=0.20), and Uncertainty   Mentalization factor (β= 0.14) had an indirect effect on suicidal thoughts (P< 0.01). Planning to enhance mentalization capacity and mindfulness skills can reduce suicidal thoughts in this group of affected students.

Because of Covid-19 pandemic, psychological distress occurred worldwide. Servant leadership style is a supportive style that increases communication satisfaction, and communication satisfaction is an important factor in reducing psychological pressures. Therefore, it seems that factors such as choosing a servant leadership style and increasing social relations can help to reduce the psychological challenges. This study aims to investigate the mediating role of personal social capital between servant leadership behaviors and employee depression and social anxiety during the Covid-19 pandemic. This research is an applied and descriptive. Data gathering instrument is questionnaire. The statistical population consisted of 419 employees of Guilan Steel Complex, and the optimal sample was 221. Questionnaires were distributed among the employees using the simple random sampling method. The partial least squares method was used to analyze the data. The results revealed servant leadership behaviors has a positive relationship with personal social capital, and personal social capital has a negative relationship with depression. As well, servant leadership behaviors has relationship with depression. Therefore, personal social capital has a partial mediator role between servant leadership behaviors and depression. The findings also indicate the personal social capital has a negative relationship with social anxiety. However, servant leadership behaviors has no relationship with social anxiety. Hence, personal social capital has a full mediator role between servant leadership behaviors and social anxiety. Moreover, Servant leaders will lead to an increase in employees' desire for social interaction and a decrease in their psychological problems.

The aim of the present study was to determine the efficacy of mindfulness-based cognitive therapy on the components of shame and internal stigma in individuals with substance dependence undergoing methadone maintenance treatment.

A quasi-experimental study with a pre-test-post-test design with a control group was employed. The study population consisted of all individuals with substance dependence receiving methadone treatment at addiction treatment centers in Shahrood in 2024. From this population, 32 individuals were selected using the convenience sampling method and were randomly assigned to two groups: experimental (n=16) and control (n=16). Participants in both groups completed the external shame and internal stigma questionnaires in the pre-test and post-test. Mindfulness-based cognitive therapy was implemented in eight 90-minute sessions, once a week, to the experimental group. Data were analyzed using multivariate analysis of covariance.

The results indicated a significant difference between the two groups, and mindfulness-based cognitive therapy led to a reduction in the components of shame and improvement in internal stigma in individuals with substance dependence undergoing methadone maintenance treatment.

Based on the obtained results, addiction specialists can emphasize the improvement of shame and internal stigma components by using mindfulness-based cognitive therapy.

Bullying is a form of low-level violence that has recently attracted the attention of school psychologists. The purpose of this descriptive study is to determine child's self-esteem and child’s attitude toward parents in forecasting the bullying of boys /girls students at Bojnourd city public high school at the last year (92-93). A number of 400 students (200 boys and 200 girls) were selected by using a sampling area and answered to the adolescent peer relations questionnaire testing paradigm in 2000, Self-esteem Assessment Test published by Rosenberg in 1965, and Child’s Attitude toward Parents Test published by Walter D. Hudson in 1976. The Spss 18 software for data analysis could be used on two levels; the descriptive statistics using statistical indicators mean and standard and inferential statistics using Pearson correlation and regression analysis results presented. According to the results, there is significant relation between bullying, victimization, self-esteem and child’s attitude toward parents. The self-esteem and the child’s attitude toward parents can predict the bullying the victimization. It is proposed to use functional and practical training to upgrade the knowledge of teachers, parents and other school authorities to this phenomenon (bullying) and to help the children in this regard.

The purpose of this study was to investigate the mediating role of psychological flexibility in the relationship between emotional inadequacy and tendency to risky behaviors in adolescents. The descriptive research method was of the correlation type (structural equation model). The statistical population included the teenagers of Shahrood city in 2023, out of which 300 people were selected by available sampling method. The tools used in this research included risk-taking questionnaires of Iranian teenagers, emotional deficiency and psychological flexibility questionnaire. In order to analyze the research model, the structural equation model was used the findings showed that there is a positive and significant relationship between emotional inadequacy and the tendency to risky behaviors, and psychological flexibility plays a mediating role in the relationship between emotional insufficiency and the tendency to risky behaviors. Overall, the results showed that the model had a good fit. According to the obtained results, emotional inadequacy and psychological flexibility play an important role in predicting high-risk behaviors of adolescents. Emotional inadequacy and lack of psychological flexibility can increase the incidence and persistence of high-risk behaviors, including drug use, in teenagers. Therefore, the design of interventions based on improving emotional inadequacy and increasing psychological flexibility is suggested as a basis for reducing the high-risk behaviors of this group of people.

The primary objective of this study was to explore the mediating role of perfectionism in the ‎connection between Insecure attachment and depression symptoms.‎‏ ‏ In the current research, a ‎descriptive and correlational approach was employed, and the proposed model introduced within the study was ‎assessed through the application of structural equation modeling‏.‏‎ The statistical population for this study ‎comprised second-grade high school students from Delijan city, enrolled in the 1401-1402 academic year. A ‎total of 550 students were selected using random cluster sampling. Data collection for this study incorporated ‎multiple instruments, including the attachment scale (Collins and Reed, 1990),‎‏ ‏perfectionism scale ‎‎(Hewitt‏ ‏and Flett, 1991), and the depression subscale of DASS-21 (Lovibond & Lovibond, 1995). The ‎results indicated that the structural model presented in this research fits the collected data. There was a direct ‎positive relationship between depression and avoidant attachment, anxious attachment, and perfectionism‏ ‏‎(p = ‎‎0/001). Furthermore, the indirect relationship of depression with avoidant attachment‏ ‏‎(p = 0/002) and anxious ‎attachment‏ ‏‎(p = 0/001)‎‏ ‏mediated by perfectionism, was also significant.‎‏ ‏ The findings highlighted ‎the mediating role of perfectionism in the relationship between avoidant and anxious attachment styles‏ ‏with ‎depression. Consequently, enhancing the quality of interpersonal relationships could be achieved through ‎educational initiatives aimed at increasing awareness among parents, students, and educational authorities ‎regarding ineffective perfectionism and detrimental attachment styles. Moreover, these research outcomes ‎hold potential significance in the realms of psychopathology and the development of treatment protocols, ‎particularly by emphasizing the intermediary influence of perfectionism.‎

The purpose of this research was to determine the mediating role of metacognitive beliefs between anxiety sensitivity, responsibility and obsessive-compulsive symptoms in the general population living in Tehran. The descriptive research method was correlation type (path analysis). 300 people from among the general population living in Tehran city were selected through an internet call, according to the entry criteria in the accessible sampling method. The tools used in this research include the Revised Obsession Scale (OCI-R); (Foua et al., 2002), Anxiety Sensitivity Inventory (ASI) (Rice et al., 1986), Responsibility Attitude Scale (RAS); (Salkovskis et al., 2000) and metacognitive beliefs questionnaire (MCQ-30); (Wells, 1997). The data showed that anxiety sensitivity and responsibility have a direct and significant relationship with obsessive-compulsive symptoms, and metacognitive beliefs have a mediating role in the relationship between anxiety sensitivity and responsibility with obsessive-compulsive symptoms, and the indirect effect of metacognitive beliefs in the relationship between anxiety sensitivity, Responsibility and obsessive-compulsive symptoms were significant.In general it can be concluded that anxiety sensitivity and responsibility can cause the emergence and continuation of obsessive-compulsive symptoms by increasing metacognitive beliefs. According to the research results and the mediating role of metacognitive beliefs in relation to obsessive-compulsive symptoms, planning to improve people's education in the field of anxiety sensitivity and responsibility can play an important role in reducing obsessive-compulsive symptoms through metacognitive beliefs.

The purpose of this research was to compare personality traits, attachment style, and life satisfaction in women without children and women with children. Current research was of the causal-comparative type. The socio-statistics of this research included all women without children and women with children in the city of Mashhad in 1402.

The sample size included two groups of voluntary childless women (50 people) and women with children (50 people), who were selected through available sampling. Questionnaires of personality traits, attachment styles and life satisfaction questionnaires were used to collect data. The research data was analyzed using a multivariate analysis of variance test.

The results showed that the scores of the subscales of personality traits, attachment style and life satisfaction were significantly different between the two groups of voluntary childless women and women with children. Based on this, women without children had higher life satisfaction, insecure attachment and openness to experience and lower extroversion, agreeableness and secure attachment than women with children.

The results indicate that personality plays a significant role in influencing people towards becoming parents or away from. The findings emphasize the need of attention to the personality characteristics, attachment style and life satisfaction of women without children.

 Although several treatments have been designed for obsessive-compulsive disorder, they are not effective enough in all patients. Hence, obsession therapists are looking for multidimensional treatments. The aim of the current research is to design a behavioral spiritual-emotional protocol for the treatment of obsessive-compulsive disorder.

 Given the purpose of the research, the effective treatment packages developed in previous researches should be analyzed in behavioral, emotional and spiritual axes, and effective goals and techniques should be selected and integrated in the emotional-spiritual behavioral treatment package according to the Islamic context. The statistical population of this research included articles and theses related to behavioral, emotional and spiritual treatments of obsessive compulsive disorder in Farsi and English. These researches were collected and analyzed into components, techniques and mechanisms. Then, the effective components, techniques and mechanisms with good theoretical support and research evidence were integrated into the behavioral- emotional-spiritual protocol. The final package was approved and confirmed by experts in the field. In the present study, all ethical considerations were observed and the authors reported no conflict of interests.

 The behavioral-emotional-spiritual protocol for the treatment of obsessive compulsive disorder includes 15 sessions: establishing a therapeutic relationship and explaining the treatment, secondary positive spiritual evaluation of negative thoughts, acceptance of doubts, self-soothing, reducing the fusion of thought and action, exposure and response prevention therapy, acceptance of doubts and behavior management, spiritual mindfulness, removing obstacles, increasing the quality of life and modifying the lifestyle.

 Behavioral-emotional-spiritual Protocol for Obsessive Compulsive Disorder Treatment has collected and integrated the effective components and techniques of behavioral, emotional and spiritual treatments. In this therapeutic package, emphasis was placed on the value of religion and religiosity, as well as the differences between a religious individual and an individual with obsessive-compulsive disorder (OCD). Some new techniques were developed, such as distinguishing between voluntary negative thoughts and involuntary negative thoughts, with the latter being considered as obsessive thoughts and not sinful. Additionally, secondary positive evaluation techniques were formulated, whereby enduring intrusive negative thoughts was conceptualized as a step towards seeking closeness to God.

The present study was conducted with the aim of determining the mediating role of stress and fear of corona in the relationship between obsessive beliefs and obsessive-compulsive symptoms. The descriptive research method was correlation type. Among the general population, 391 people were selected through an internet call in 2021, according to the entry criteria in the accessible sampling method. The tools used in this research include the revised practical Foua obsessive-compulsive scale, obsessive beliefs, Ahorso Corona fear scale and Taylor Corona stress. To analyze the data Pearson correlation and structural equation modeling (SEM) were conducted. The findings showed that obsessive beliefs have a direct and significant relationship with stress and fear of corona and obsessive-compulsive symptoms, and stress and fear of corona have a mediating role in the relationship between obsessive beliefs and obsessive-compulsive symptoms. Overall, the results showed that the model had a good fit. This finding can be used to design an intervention to reduce fear and stress during the outbreak of infectious diseases. Therefore, it can be said that planning to reduce stress and obsessive beliefs has an effective role in reducing obsessive-compulsive symptoms and is essential.

The purpose of this research was to investigate the effectiveness of cognitive empowerment of mental states on the mind reading ability of substance dependent people. The current study was a quasi-experimental type with a pretest-posttest design with a control group. 30 drug addicts with the same conditions in terms of age, education, occupation, etc. were selected and randomly assigned to two experimental and control groups (15 people in each group). The participants responded to the eye reading test (Baron-Cohen test) in the pretest and posttest. The experimental group was subjected to the intervention of the cognitive empowerment program (Terme program) and the control group did not receive any intervention. The results of covariance analysis showed that cognitive empowerment (Terme program) is effective on the ability to read minds (theory of mind) in drug dependent people. In fact, the Terme program has improved the ability to read minds through the eyes in drug dependent people. Based on the results of the present research, it is possible to use the cognitive empowerment program (Terme program) in the ability to read minds through the eyes for drug dependent people.

The Purpose of the present study was to investigate the effectiveness of integrated behavioral -emotional spiritual therapy on scrupulosity and rumination in patients with obsessive-compulsive disorder. The current research method was a randomized trial with pre-test, post-test and follow-up. In this research, 40 patients with obsessive-compulsive disorder, who were randomly divided into two groups of 20 people, experimental and control. The experimental group received behavioral emotional-spiritual therapy as a group in 15 ninety-minute sessions, and the control group did not receive any intervention. The data collection tools included a semi-structured interview based on DSM5 (SCID-I), the Obsessive compulsive Questionnaire, the scrupulosity Questionnaire and the Rumination Questionnaire, which the participants answered at the beginning and end of the treatment and two months after the end of the treatment. The data was analyzed using the analysis of covariance test in SPSS-22 software. The findings of the research showed that behavioral emotional-spiritual therapy significantly reduces scrupulosity and rumination in patients with obsessive-compulsive disorder (P<0.001) and the gains of the treatment are maintained two months after the end of the treatment. According to the findings of the research, behavioral-emotional spiritual therapy can be used to reduce rumination and scrupulosity, and therapists can use this method to reduce rumination and scrupulosity of people with obsessive-compulsive disorder.

The present study was conducted with the aim of determining the mediating role of anxiety and depression in the relationship between childhood maltreatment and obsessive-compulsive symptoms. The research method was descriptive and of the correlation type (structural equation modeling). From among the general population of social media users in 2022, 350 people were selected according to the entry criteria by voluntary sampling method. The tools used in this research included the Revised scale of obsessive–compulsive Syndrome (Foa and et al), Childhood Trauma Questionnaire (Bernstein & Stein), Beck Anxiety Inventory & Beck Depression Inventory-II. Pearson's correlation test and structural equation modeling were used to analyze the data. The results showed that childhood abuse has a direct and significant relationship with obsessive-compulsive symptoms, and anxiety and depression play a mediating role in the relationship between childhood abuse and obsessive-compulsive symptoms, and overall, the results show that the model fits well. According to the obtained results, it can be said that childhood trauma, anxiety and depression play an important role in the formation of obsessive-compulsive symptoms. In general, it can be concluded that childhood trauma can cause obsessive-compulsive symptoms by affecting anxiety and depression.

The aim of this study was to compare Intolerance of uncertainty, Cyberchondria and Health anxiety in obsessive-compulsive disorder, general anxiety disorder, depressive disorder and normal people. The method of the present study was causal-comparative. For this purpose, a sample was selected from 50 eligible patients with obsessive-compulsive disorder and 50 patients with general anxiety disorder and 50 patients depressive disorder to 505 Army Psychiatric Hospital in Tehran and 50 hospital staff (normal group). Were selected by available sampling method Research instruments include the The IUS-12(intolerance of uncertainty The Short version)CSS-12 (Cyberchondria Severity Scale) and the health anxiety Inventory . Descriptive statistics (mean and standard deviation) and inferential statistics (multivariate analysis of variance)were used to measure and to analyze the findings. Findings showed that there is a significant difference between the Intolerance of uncertainty, Cyberchondria and Health anxiety in the four groups. The mean score of people with general anxiety disorder in all components of Intolerance of uncertainty is higher than other groupe. Also All components of Cyberchondria, Health anxiety in the group of obsessive-compulsive groupe is higher than other groupe.Conclusion The results indicate the importance and necessity of paying attention to the Intolerance of uncertainty, Cyberchondria and Health anxiety in obsessive-compulsive disorder, general anxiety disorder, depressive disorder.

The present research aimed to predict high-risk behaviors based on positive youth development and positive psychological capital in adolescents.

This study was descriptive-correlational. The statistical population consisted of adolescents in the city of Tehran in 2020, from which 298 people were selected using the convenience sampling method. The tools used in this research included the questionnaires of Iranian adolescents' risk-taking, positive youth development, hope, resilience, self-efficacy, and optimism. Pearson's correlation and stepwise regression were used to analyze the data.

The results showed that the dimensions of positive youth development and positive psychological capital were significantly associated with high-risk behaviors and attitude towards substance use in adolescents. The results of the regression analysis also indicated that the components of positive youth development and psychological capital explained 45% of the variance of high-risk behaviors.

According to the obtained results, positive youth development and positive psychological capital (hope, resilience, self-efficacy, and optimism) play an important role in predicting high-risk behaviors in adolescents. Positive youth development and positive psychological capital can reduce the occurrence and continuation of the tendency to high-risk behaviors in adolescents. Therefore, the design of interventions based on the improvement of these characteristics is suggested as a basis for reducing high-risk behaviors in this group of people.

Previous research has highlighted the potential role of inferential confusion in the development and maintenance of obsessive- compulsive disorder symptoms. In some of these studies, the factors predicting obsessive-compulsive disorder symptoms, including fear of self and obsessive beliefs, have been identified, but the mediating mechanisms of this relationship have not been identified yet.

The purpose of the present study was to investigate the mediating role of fear of self and obsessive beliefs in the relationship between inferential confusion and obsessive-compulsive disorder symptoms.

The research method was correlational and structural equation medeling. The statistical population of the study included all social network users in mashhad in year 2022, from which 300 subjects  participated were selected by available sampling method. To collect research data, measures of Obsessive-Compulsive Insentory-Revised (Foa et al., 2002), Feared Self Questionnaire (Aardema et al., 2013), Obsessive Beliefs Questionnaire (OCCWG, 1997), and Inferential Confusion Questionnaire (Aardema et al., 2010) were used. Data analysis done through structural equation modeling using path analysis method by SPSS26 and AMOS22 softwares.

The results showed that inferential confusion (β=0.19), fear of self (β=0.23) and obsessive beliefs (β=0.55) had a positive and significant effect on obsessive-compulsive disorder symptoms (P<0.01). Also, the direct effect of inferential confusion on fear of self (β=0.60) and obsessive beliefs (β=0.58) was significant (P<0.01). Regarding the indirect effect, inferential confusion had a significant effect on obsessive-compulsive disorder symptoms through the mediating variable of obsessive beliefs (β=0.31) and fear of self (β=0.13) (P<0.05).

Acording to the role of fear of self and obsessive beliefs in the relationship between inferential confusion and obsessive-compulsive disorder symptoms, planning to reduce fear of self and obsessive beliefs can reduce the effect of inferential confusion on obsessive-compulsive disorder symptoms.

The objective of this study was to assess the mediating role of attachment styles and negative affect in the association between childhood trauma and obsessive-compulsive symptoms.

The study was a descriptive-correlational approach, utilizing structural equation modeling. Among the general population, 363 people were selected through an internet survey, based on the inclusion criteria and using the convenience sampling method. The tools used in this research included the Obsessive-Compulsive Inventory-Revised (Foa et al., 2002), the Childhood Trauma Questionnaire (Bernstein et al., 2003), the Positive and Negative Affect Scale (Watson et al., 1988), and the Experiences in Close Relationships Questionnaire (Brennan and Morris, 1997). Structural equation modeling was used to analyze the research model.

The results indicated that childhood trauma had a significant and direct link to obsessive-compulsive symptoms. In addition, attachment styles and negative affect significantly mediated the relationship between childhood trauma and obsessive-compulsive symptoms. Overall, the results showed that the model had good fit.

According to the results, individuals with a history of childhood trauma and insecure attachment styles typically experience negative emotions. It is also likely for these individuals to exhibit obsessive symptoms. In general, childhood trauma, insecure attachment styles, and negative emotions are factors that can play an important role in relation to obsessive-compulsive symptoms. Therefore, these factors should be considered when planning prevention methods and treatment programs.

Obsessive Compulsive Disorder (OCD) is a common and exhausting disease. The present study aimed to investigate the effect of integrated behavioral-emotional spiritual therapy on obsessive-compulsive disorder, obsessive beliefs, and fusion of thought and action in patients with obsessive-compulsive disorder. The study used a controlled trial with pre-test, post-test, and two-month follow-up design. In this study, 40 people suffering from OCD participated and were divided into two groups experimental and control. The experimental group received emotional-spiritual behavioral therapy in 15 ninety-minute sessions, and the control group did not receive any intervention. The data collection tools included a semi-structured interview based on DSM5 (SCID-I), the Obsessive-Compulsive Questionnaire, the Obsessive Beliefs Questionnaire, and the Questionnaire on the Fusion of Thought and Action. The participants answered to the scales at the beginning and end of the treatment and two months after the treatment. The data were analyzed using the analysis of the covariance test. The findings of the research showed that emotional-spiritual behavioral therapy significantly reduced obsessive-compulsive disorder, and obsessive beliefs including extreme responsibility, perfectionism, control of thoughts, and fusion of thought and action. According to the findings of the research, emotional-spiritual behavioral therapy was effective in reducing obsessive-compulsive disorder, obsessive beliefs, and fusion and action.
Obsessive Compulsive Disorder is characterized by obsessive thoughts or compulsive behaviors or both. Obsessions include recurrent and persistent thoughts, desires, or perceptions that are experienced in an intrusive and obnoxious manner. Compulsions are experienced in two ways of overt behaviors and hidden behaviors. Overt compulsions are like frequent hand washing, extreme order, and checking, hidden compulsions are repetitive mental activities such as counting and slowly repeating words (Najafi et al., 2022). Obsessive beliefs and fusion of thought and action are factors that perpetuate obsessive-compulsive disorder. Obsessive beliefs and fusion of thought and action are factors that perpetuate OCD. 
Cognitive-behavioral therapy and exposure and response prevention therapy are among the most important treatments for OCD. However, each of these treatments has shortcomings. Nowadays, therapists are looking to combine the effective components of different treatments and increase their efficiency to solve shortcomings. Paying attention to different and numerous variables in the explanation of OCD leads to a deeper and more comprehensive look at the dimensions of OCD and as a result, more efficient treatment formulation (Fisher et al., 2020). The past research has shown a positive relationship between religiosity and mental health (Borghei et al., 2020). Today, a wide range of therapists believe that to increase the effectiveness of psychotherapy for religious people, positive religious and spiritual attitudes and feelings should be combined with psychotherapy (Fox et al., 2020). Therefore, the question of this research was: What is the effectiveness of behavioral-emotional-spiritual therapy in reducing OCD symptoms, obsessive beliefs, and fusion of thought and action in obsessive-compulsive patients?
 
The design of the present study was a randomized controlled trial with pre-test-post-test and follow-up. The statistical population included all people suffering from OCD in the city of Qom. The sample consisted of 40 people who were selected and randomly and equally placed in two experimental and control groups based on the variables of age, marital status, education, and history of OCD.
The participants in the experimental group received the spiritual-emotional behavioral protocol in the form of 15 group therapy sessions, and the control group remained in the waiting line and received obsessive-compulsive therapy due to ethical issues after the research. The behavioral emotional-spiritual protocol for the treatment of OCD includes 15 sessions: establishing a therapeutic relationship and explaining the logic of the treatment, secondary positive spiritual evaluation of negative thoughts, accepting doubts, self-soothing, reducing the fusion of thought and action, exposure and response prevention, Acceptance of doubt and behavior management, mindfulness skills mixed with spirituality, removing barriers to exposure and response prevention therapy, increasing quality of life and modifying lifestyle.
All participants completed the research questionnaires. Analysis of variance, multivariate analysis of covariance (MANCOVA), and univariate analysis of covariance were used to analyze the data with SPSS-24 software. 
 
The assumptions of the analysis of the covariance test were checked. Multivariate covariance analysis was performed and the results in the post-test were in the Pillai's Trace (F(5,26)=0.661, p <0.001), Wilks' Lambda (F(5,26) =0.339, p <0.001), Hotelling's Trace (F(5,26) =1.950, p <0.001), the Roy's Largest Root (F(5,26) =1.950, p <0.001) showed that the difference between the two experimental and control groups in the total variables of obsessive compulsiveness, a fusion of thought and action and obsessive beliefs was 66% significant (p<0.001). Also, the results in the follow-up test in the Pillai's Trace (F(5,26) =0.612, p <0.001), Wilks' Lambda (F(5,26) =0.388, p <0.001), and the Hotelling's Trace(F(5,26) =1.576, p <0.001), the Roy's Largest Root (F(5,26) =1/576, p<0.001) showed that the difference between the two experimental and control groups in total variables is significant by 61% (p<0.001). To determine the variables in which the post-test had a significant difference from the pre-test, a univariate analysis of the covariance test was performed. The results are presented in Table 1.
 
 
Table 1
The Results of Univariate Analysis of Covariance (ANCOA) In the Post-Test and Follow-Up with Pre-Test




Source of changes


The dependent variable


Time


Degrees of freedom


mean square


F


P


Eta squared




group


obsessive compulsive


Posttest


1


1280.796


22.69


0.001


0.400




Follow-up test


1


282.620


40.484


0.001


0.544




obsession


Posttest


1


320.280


19.187


0.001


0.361




Follow-up test


1


73.436


30.855


0.001


0.476




compulsion


Posttest


1


319.313


22.693


0.001


0.400




Follow-up test


1


62.781


24.025


0.001


0.414




Thought action fusion


Posttest


1


781.421


16.214


0.001


0.323




Follow-up test


1


608.212


6.639


0.014


0.163




likelihood thought-action fusion


Posttest


1


152.582


16.580


0.001


0.328




Follow-up test


1


101.048


4.950


0.013


0.131




Moral thought action fusion


Posttest


1


266.897


9.553


0.004


0.219




Follow-up test


1


219.149


3.916


0.014


0.123




Extreme sense of responsibility


Posttest


1


3083.484


16.750


0.001


0.330




Follow-up test


1


1844.798


12.935


0.001


0.276




Perfectionism


Posttest


1


4218.571


14.475


0.001


0.299




Follow-up test


1


2263.043


9.965


0.003


0.227




Thought control


Posttest


1


1828.083


25.772


0.001


0.431




Follow-up test


1


1661.643


22.671


0.001


0.400




*P<0.05     ** P<0.01  

The results of Table 1 shows that the participants in the behavioral-emotional spiritual group had significantly more reductions in OCD, fusion of thought and action, and obsessive beliefs in the post-test and follow-up test than the participants in the control group.
 
The research showed that behavioral-emotional spiritual therapy significantly reduced OCD and the fusion of thought and action and obsessive beliefs, and the achievements of the treatment were maintained two months after the treatment. In explaining this finding, it can be said that in religious people suffering from obsession, psychological and spiritual issues are intertwined in such a way that they cannot be separated. The behavioral-emotional spiritual therapy pays special attention to the spiritual aspects of OCD. This treatment pays attention to a person's religious values and differentiates between religious values and obsessive beliefs. It increases the client's insight into obsessional doubts and teaches him that avoidant, safe-keeping, and reassurance-seeking behaviors may be revealed in the religious context and are different from healthy religious practices and cause the persistence of obsessions. On the other hand, by reviewing the purpose of life and conceptualizing OCD as an opportunity to get closer to God, this treatment creates a sense of meaning in the person and strengthens his motivation to do exposure and response prevention exercises.
In this treatment, OCD is conceptualized as a psychological injury like a physical injury. The difference between obsessive thoughts, which are involuntary and accompanied by suffering and voluntary thoughts accompanied by pleasure, which is a kind of moral vice, was explained. Spiritual anxiety, which is due to a little faith in God, is separated from psychological anxiety, which is due to problems with hormones and neurotransmitters. Patience over doubts and trying to do exercises is conceptualized as an opportunity to get closer to God. It is explained to the person that striving in the way of God increases the capacity of existence and when a person performs his academic, job, family, and social activities despite the obsessive discomfort, he gets more reward and spiritual growth than healthy people. Creating these positive spiritual attitudes reduces obsessive beliefs.
 
Ethical Consideration
Compliance with Ethical Guidelines: All ethical issues were compiled based on ethical committee of Semnan University.
Authors’ Contributions: All authors contributed to the study. The first author administered behavioral emotional-spiritual therapy to the participants and written the first draft of the manuscript. The second author edited the manuscript.Conflict of Interest: The authors declare no conflict of interest for this study.
Funding: The study had no financial support.Acknowledgment: The authors would like to thank all participants for their time and contribution to the study.

The present study was conducted with the aim of comparing the effectiveness of cognitive-behavioral(CBT) therapy and metacognitive therapy(MCT) on psychological distress (stress, anxiety and depression) in drug addicts. The research method was a quasi-experiment with pre-test and post-test control group and the statistical population were all drug addicts in Semnan city in the year 2021. Participants were assigned by random sampling into three groups, two experimental groups(cognitive- behavioral therapy and metacognitive therapy) and one control group. The research tool was Laviband and Laviband (1995) depression, anxiety and stress scale. Data analysis was done by multivariate covariance analysis. The findings showed that both interventions were effective in improving psychological distress in drug dependent people. Also, there was no significant difference between the effectiveness of the two treatments (p<0.01). According to the results of the research, cognitive-behavioral therapy and meta-cognitive therapy can be used to improve the mental health of substance dependent people.

The purpose of the present study was to investigate the mediating role of psychological distress (depression, anxiety and stress) in the relationship between inferential confusion and obsessive-compulsive symptoms. The research method was descriptive-correlational (path analysis) and the statistical population of the study was all Social network users (between 20 to 50 years old) in mashhad in year 2022. Using the available sampling method, 345 subjects participated in the research through an online survey. The instruments used in this study include Obsessive-Compulsive Insentory-Revised (OCI-R), Depression, Anxiety, and Stress Scale (DASS-21), and Inferential Confusion Questionnaire (ICQ-EV). Data analysis done through Pearson correlation coefficient and path analysis. The findings showed that inferential confusion has a direct and significant relationship with obsessive-compulsive symptoms. Also, psychological distress had a mediating role in the relationship between inferential confusion and obsessive-compulsive symptoms and the model has a good fit. According to the research results and the mediating role of psychological distress in the relationship between inferential confusion and obsessive-compulsive symptoms, In condition of high psychological distress, the relation of inferential confusion with obsessive-compulsive symptoms is stronger than when the components of depression, anxiety and stress are low. Also, planning to reduce psychological distress can be effective in reducing the effect of inferential confusion on obsessive-compulsive symptoms.

The goal of the present paper is to gain an optimal intensity of ultrasound to achieve required pressure field generated by the collapsing bubble in blood to break down blood clots. Due to the direct relationship between the pressure caused by the collapse of bubbles caused by ultrasound and the intensity of the waves, determining the optimal intensity of the ultrasound is of great importance. For this purpose, the collapse pressure within the bubble has been calculated using Rayleigh–Plesset (RP) equation. Moreover, a coupling simulation of the flow and clot structure is performed using the full Navier-Stokes equations, which governs the blood domain, and linearized discrete equations for the clot medium to calculate the desired bubble collapsing pressure necessary to break down the clots, which has immense importance in medical applications. Using the obtained parameters for the minimum pressure pulse required to deform the clot and the ultrasound intensity required to create the minimum pressure, simulations have been performed and it has been shown that the clot’s shape changes when confronted with the the applied pressure which confirms the effectiveness of the proposed method.

This study seeks to know the different types of behavior of managers in facing the psychological challenges of employees during Covid-19 in order to help the organization achieve its goals by creating coordination with other components. For this purpose, 21 managers were interviewed using the narrative research method and 507 primary codes were extracted. Then, using theme analysis, 74 concepts for employees' psychological challenges and 130 concepts for managers' behavior in facing these challenges were discovered, and finally 18 final categories for employees' psychological challenges and 30 final categories for managers' behavior were identified. In the typology section, the final categories of managers' behavior were classified in two dimensions of Accepting the manager's behavior (high/low) and employee morale (strong/weak) and four main types were obtained based on these two dimensions. Types of managers' behavior were identified with the titles of developing, motivating, directing and moderating behaviors. By choosing the appropriate behaviors and paying attention to the morale and acceptance of the employees in choosing these behaviors, in addition to maintaining the morale of the employee, managers also gain more influence over the employees and can accompany the employees to reduce psychological challenges and achieve organizational success.