مقالات رزومه دکتر امرالله ابراهیمی

Migraine headaches are one of the psychosomatic disorders that severely impair patients' quality of life and general functioning by mediating psychological problems. The aim of this study was to investigate the mediating role of pain intensity in the relationship between psychosomatic components on quality of life in these patients.

Methods and Materials:

 In this cross-sectional study, 250 patients with migraine were selected based on inclusion and exclusion criteria among people with migraine referred to the Pain and Neurology Clinic affiliated to Isfahan Medical Sciences in 2020 through available sampling. In the appropriate psychological situation, after justifying the goals of the research, the World Health Organization Quality of Life Questionnaire (SF-26), Von Korff’s Pain Intensity Scale (PIS) and also the Diagnostic criteria for psychosomatic research Questionnaire (DCPR) were completed.

The results showed that there was no significant correlation between pain intensity and other variables and only psychosomatic components had a significant negative correlation with quality of life dimensions and Also, in the path analysis model, no significant direct and indirect relationship was found between psychosomatic components and pain intensity with different dimensions of quality of life, although the proposed path analysis model showed a good fit.

The findings of this study suggest the development of psychological intervention packages based on the explanatory model for the correction of Alexithymia, irritable mood, health anxiety and type A behavior in order to improve the quality of life of migraine patients.

In the past decades, a group of diseases have been classified under the title of psychosomatic complaints and it has been reported that the diagnostic problems and their differentiation from other diseases have caused an increase in paraclinical and diagnostic costs in the patients of this group of patients. Psychosomatic diseases are a class of diseases in which a person suffers from physical and physical signs and symptoms that are caused by psychological factors or may be intensified under the influence of psychological characteristics and stressors. It seems that in addition to biological mechanisms, psychological and emotional factors are involved in the occurrence of these diseases. In this way, different levels of feelings of hostility, depression, and anxiety can be seen as the predominant basic factors of psychosomatic complaints. According to this, the present study was conducted to investigate the efficacy of mindfulness-based cognitive therapy on cognitive fusion and alexithymia in students with psychosomatic disorders.
 

The research method was quasi-experimental with pretest, posttest, control group, and two-month follow-up period design. The statistical population included secondary high school students with psychosomatic disorder in Khomeini Shahr in the academic year 2020-21. 37 students with signs of psychosomatic disorder were selected through the purposive sampling method and randomly accommodated into experimental and control groups (18 in the experimental and 19 in the control group). The experimental group received eight seventy-five-minute sessions of mindfulness-based cognitive therapy intervention during two months. The applied questionnaires in this study included a psychosomatic complaints scale (Takata & Sakara, 2004), a Cognitive fusion questionnaire (Gillanders et al., 2014), and an alexithymia (Takata & Sakara, 2004) questionnaire (Bagby et al., 1994). The data from the study were analyzed through mixed ANOVA via SPSS23 software.
 

The results showed that mindfulness-based cognitive therapy has a significant effect on cognitive fusion and alexithymia in students with psychosomatic disorder (p<0.001). Also, the results showed that this effectiveness remained stable in the two-month follow-up period. Descriptive findings also indicated that cognitive therapy based on mindfulness was able to reduce the average scores of cognitive fusion and alexithymia of students with psychosomatic complaints.
 

According to the findings of the present study, it can be concluded that mindfulness-based cognitive therapy can be used as an efficient therapy to decrease cognitive fusion and alexithymia in students with psychosomatic disorder through mindful activities and attitudes and addressing feelings and problem-making emotions. In addition, cognitive therapy based on mindfulness by applying practical mechanisms (such as body awareness and cognitive and emotional re-evaluation), can reduce the cognitive and emotional avoidance of students with psychosomatic complaints. On the other hand, by accepting signs and symptoms, students reduce overthinking about symptoms and learn that these are part of the body's defense mechanisms against stress that they have to deal with. This process improves the skill of regulating, managing, and expressing emotions and reduces alexithymia and cognitive fusion.

In the COVID-19 pandemic, nurses were subjected to stressful conditions, which necessitated the need for psychological-supportive interventions. The aim of this study was to determine the effectiveness of the educational-therapeutic package based on psychological flexibility on the quality of work life and general health of COVID-19 nurses.

This study was a single-blind clinical trial. Based on the clinical interview, 30 people were selected from the population of 120 nurses working in Isa Bin Maryam Center for Covid-19 Hospital in Isfahan city in the winter of 2019 and were randomly assigned to two control and intervention groups. The study tools were Walton's Quality of Work Life Questionnaire and General Health Questionnaire (PHQ) and psychological safe exposure educational-therapeutic package based on psychological flexibility. The data were analyzed in SPSS 24 statistical software with univariate analysis of covariance method.

The average scores of the quality of life and general health of the two groups before the study had no statistically significant difference (p>0.05). After the intervention, the average quality of life scores of the experimental and control groups were 74.7 and 72.6, respectively, which did not have a statistically significant difference, but the average scores of the general health of the experimental and control groups were 31.7 and 38.8, respectively, which was a statistically significant difference.

the application of the therapeutic educational package based on psychological flexibility has been able to have a positive and significant effect on the general health components of nurses; Therefore, it is suggested to pay attention to these educational packages in educational planning and nursing management policies.

Depression and blood pressure are the common disorders in the elderly and are effective in beginning and intensifying each other, so that mental disorders are the fourth main cause of death in the world. The aim of this study was to determine the structural model of the relationship between depression and blood pressure with the mediation of nutritional habits in the elderly.

This research was a descriptive study based on structural equation modeling (SEM). The research population included all the elderly people who referred to the health center of Falavarjan City, Iran, in 2019-2020, and 360 of them were selected by convenience sampling. Research tools included nutritional habits questionnaire, elderly depression questionnaire, and the Integrated Health System (SIB). Data analysis was done using descriptive and inferential statistics tests in AMOS and SPSS software.

According to the regression coefficient of -0.266 and the critical value of -3.57 and P = 0.051, the variable of nutritional habits can play the role of a mediating variable between the predictor variable of depression and the criterion variable of blood pressure and can explain it. In fact, the model had the ability to predict and fit.

According to the results of this research based on the relationship between depression, blood pressure, and nutritional habits in the elderly, simultaneous attention to somatic and psychological problems is necessary. Therefore, planning to diagnose and treat depression and its factors on time can be effective in improving health in the elderly, especially improving their mental health.

Irritable bowel syndrome (IBS) is a functional disorder in the intestinal-gastric system that is defined by specific intestinal-gastric symptoms without an organic cause. The aim of the research was to investigate the effectiveness of acceptance and commitment therapy on treatment compliance and pain intensity in patients with irritable bowel syndrome.

The present study was a semi-experimental research method of pre-test-post-test design with a control group and a 2-month follow-up group. The statistical population of this research was all the patients with irritable bowel syndrome in Isfahan city in 2017, 15 people were selected by the available sampling method and randomly divided into an intervention group using the acceptance and commitment treatment method and a control group. Data were collected using Seyed Fatemi et al. treatment adherence questionnaire (TAQ) (2017) and Durkin et al. pain questionnaire (SF-MPQ-2) (2009). The intervention of acceptance and commitment therapy was carried out during 8 sessions of 90 minutes once a week; But the control group did not receive any intervention. The research data was analyzed by variance analysis with repeated measurements.

The findings showed that the acceptance and commitment treatment method is effective on the treatment compliance of patients with irritable bowel syndrome (p<0.05). Also, the treatment method of acceptance and commitment of pain severity in patients with irritable bowel syndrome was effective (P<0.05).

It can be concluded that acceptance and commitment therapy is effective on treatment adherence and pain intensity.

The present study investigated the effectiveness of mindfulness-based cognitive therapy on perceived stress and psychosomatic symptoms in students with psychosomatic disorders. The study employed a quasi-experimental design with a pre- and post-test, a control group, and a two-month follow-up period. In the academic year 2020-21, the statistical population included secondary high school students with psychosomatic disorder in the city of Khomeini Shahr. Using a method of purposive sampling, 37 students with psychosomatic disorder symptoms were selected and randomly assigned to experimental and control groups (18 in the experimental group and 19 in the control group). Over the course of two months, the experimental group received eight 75-minute mindfulness-based cognitive therapy sessions. This study utilized the psychosomatic complaints scale (PCS) and perceived stress scale (PSS) as questionnaires. The study’s data were analyzed using mixed ANOVA and SPSS-23 software. The results showed that mindfulness-based cognitive therapy has a significant impact on perceived tension and psychosomatic symptoms in students with psychosomatic disorder (p<0.001). Based on the findings of the present study, it can be concluded that mindfulness-based cognitive therapy can be used as an effective therapy to reduce perceived stress and psychosomatic symptoms in students with psychosomatic disorder through mindful activities and attitudes, as well as by addressing problematic feelings and emotions.

New technologies in neuroscience like neurofeedback (NFB) is one of the growing and challenging issues. The aim of present study was to determine the effectiveness of NFB on the severity of gastrointestinal (GI) symptoms, depression, anxiety, stress and quality of life in irritable bowel syndrome (IBS).

This study is a double-blind clinical trial with a control group. Initial screening included 160 patients with IBS who were referred by the gastroenterologist. Thirty patients were randomly assigned to three groups of NFB intervention; placebo (Pseudo-NFD) and control group (GI drugs only). The groups completed the IBS Severity Scale (IBS-SSS), Depression, Anxiety and Stress Scale (DASS-42) and IBS Quality of Life Questionnaire (QOL-IBS) before and after the intervention. Data were analyzed using ANOVA.

The results showed that NFB and placebo had a greater and significant effect on reducing depressive symptoms and IBS severity compared to the drug alone (P < 0.05). The placebo group with the drug showed an increase in higher quality of life scores than the other groups (P < 0.05). There was no significant difference between the groups in stress and anxiety.

Findings support the use of NFB along with medication for IBS patients, which is associated with appropriate therapeutic relationship, to enhance the effectiveness of interdisciplinary interventions.

Musculoskeletal pain is one of the most common pains in patients referred to medical centers which may have a psychological basis. The aim of this study was to develop a structural model to explain the mediating role of catastrophizing pain, depression and anxiety between psychological flexibility and pain self-efficacy in patients with musculoskeletal pain.

In a cross-sectional study, 200 patients with chronic musculoskeletal pain were selected by convenience sampling method from those referred to medical centers affiliated to Isfahan University of Medical Sciences in 2020-2021. Eligible participants filled out: Chronic Pain Acceptance Questionnaire (CPAQ), Cognitive Fusion Questionnaire (CFQ), Self-Experience Questionnaire (SEQ), Value-based Life Questionnaire (VLQ), Committed Action Questionnaire (CAQ-8), Pain Self-Efficacy Questionnaire (PSEQ) and the Mindful Attention Awareness Scale (MAAS), Pain Catastrophizing Scale (PCS), and Hospital Anxiety and Depression Scale (HADS). Then the data were analyzed using SPSS-24 and AMOS software and statistical methods of regression analysis and structural equations.

The results showed that the direct effect coefficient of pain catastrophizing, anxiety, depression and psychological flexibility on pain self-efficacy is (0.357), (0.255), (0.127) and (0.849) respectively. The total relationship between psychological flexibility and pain self-efficacy is (0.346). To test the suitability of the models, NFI, TLI, CFI and IFI indices were used, which were within acceptable limits.

The psychological flexibility variable predicts pain self-efficacy mediated by catastrophic pain, depression and anxiety (P < 0.01, r = 0.85) and it appears that predicting pain catastrophe, depression, anxiety and psychological resilience can increase pain self-efficacy. Ultimately, the improvement of these psychological factors may affect the process of better disease management.

The aim of this study was to evaluate the effectiveness of acceptance and commitment therapy on emotional regulation and perception of the disease in women with irritable bowel syndrome.

The quasi-experimental research method was a pretest-posttest design with a control group with follow-up. The statistical population of this study was all female patients with irritable bowel syndrome in Isfahan in 2018 who were selected by available sampling method, 30 patients were selected and randomly divided into an intervention group by acceptance and commitment therapy and a control group that finally, after falling, 28 remained (experimental group 13 and control group 15). The experimental group underwent 8 90-minute sessions of acceptance and commitment according to the protocol of Hayes, Orsillo, & Roemer (2010) and the control group remained on the waiting list. Data were collected based on the Disease Perception Questionnaire (Broadbent et al., 2002) and the Emotion Regulation Questionnaire (Gross and John, 2003) and repeated measures analysis of variance was used using SPSS software.

The results showed that the method of acceptance and commitment treatment had an effect on emotional regulation (F=24.09, P<0.001) and disease perception (F=10.91, P<0.001) in patients with irritable bowel syndrome. The results also showed that the method of acceptance and commitment treatment on emotional regulation and perception of the disease in patients with irritable bowel syndrome was durable at the follow-up stage.

Therefore, based on the findings of the study, it can be said that the method of acceptance and commitment treatment is an effective model in patients with irritable bowel syndrome and can be used as one of the treatment or educational methods in patients' programs.

Metabolic disorders and depression are common problems in old age that can affect the onset and exacerbation of each other. The aim of this study was to investigate the mediating role of body mass index in the relationship between metabolic diseases (diabetes and hyperlipidemia) and depression in the elderly.

The research method was descriptive and structural equation modeling. The study population comprised of all the elderly who were referred to Falavarjan health center in 2019-2020. On total, 360 old aged individuals were selected by simple random sampling using their electronic records. The research tools included body mass questionnaire, elderly depression questionnaire (Cronbach’s alpha) and apple system (integrated health system).

The results showed that there was a correlation between depression in the elderly and diabetes index, Body mass index (BMI), and blood cholesterol 0.81, 0.59, and 0.36 respectively, depicting a significant relationship. Also, body mass variable can play the role of mediating variable between depression and metabolic diseases. The explained model also had a good fit.

According to the research findings, metabolic diseases are directly and indirectly related to depression in the elderly through body mass, so in programs related to lifestyle modification and improving the health of the elelderly, interventions for physical and psychological factors should be considered as well.

Frontal lobe epilepsy (FLE) is associated with cognitive dysfunction that may adversely affect the quality of life (QoL) before and after surgery for epilepsy. This study aimed to find cognitive factors that may predict QoL in patients with FLE whose seizures had been controlled by surgery for epilepsy.

Methods and Materials: 

Twenty-four patients with FLE who underwent epilepsy surgery from June 2014 to June 2019 were recruited. The seizure outcome was assessed with modified Engel classification. All of the patients were assessed by Wechsler Adult Intelligence Scale-Revised, Wechsler Memory Scale, Color Trails Test, Tower of London Test, Persian Aphasia Naming Test, and Persian Diagnostic Aphasia Battery. The QoL was evaluated with the QoL in Epilepsy Inventory with 89 items. Repeated measures analysis of variance and Generalized Linear Models (GLM) was used for statistical analysis.

The results showed that there was a significant difference between the scores of working memory (p = 0.01), general intelligence (p <0.001), and functional intelligence (p <0.001) before and after surgery. GLM regression model showed that color errors in part 2 of CTT by -18.43 and higher indexed scores of verbal memory by -1.28, both before surgery, predicted decreased total QOLIE score.

Working memory and executive functioning were neuropsychological factors that may predict QoL in after surgery for FLE.

Patients who suffered coronary artery disease (CAD) experience a lower quality of life.This study aimed to investigate the mediating role of the illness perception variable in the relationship between mentalization and personality type D with quality of life in patients with coronary heart disease.

The present study was performed using correlation modeling using structural equation modeling. Based on Cohen's sample size determination table, 210 patients with coronary heart disease were enrolled by random sampling method. Questionnaires of personality type D, quality of life (SF-36), mentalization (Ment S) and disease perception (IPQ) were used to gather data for this study which were completed by the patients themselves. After data collection, the relationship between the two variables with Pearson correlation and the interactive relationship in the structure of the theoretical model drawn in this study was evaluated using structural equation modeling.

The final research model had a very good fit. The results showed a direct effect of D personality type and disease perception on quality of life but the direct effect of mentalization on quality of life was not significant. Also, the indirect effect of personality type D and mentalization through disease perception on quality of life was statistically significant.

Cognitive and emotional representation of the disease, which is the illness perception, can mediate the relationship between psychological and personality variables with quality of life. Therefore, in improving the perception of the disease to improve the quality of life of patients, personality, behavioral and psychological variables can serve as targets of intervention.

Psychological variables play a major role in adaptation and quality of life among heart patients. This study was conducted to investigate the mediating role of illness perception in the relationship between psychological flexibility and quality of life in patients with coronary artery disease.

In the present cross-sectional study, 220 patients with coronary artery disease referred to Isfahan's Shahid Chamran Specialist Hospital were selected based on inclusion and exclusion criteria. For data collection, demographic information questionnaire, Brief Illness Perception Questionnaire (B-IP), quality of life questionnaire (SF-36), Bond acceptance and action questionnaire (AAQ-II), Gillanders Cognitive defusion Questionnaire (CFQ), and the Cluster Value-Driven Life Questionnaire (VLQ) were used. The gathered data was analysed using structural equation modeling method.

The results of study revealed a direct relationship between PF and QOL (r = -0.505), also significant negative relationship was found between IP and QOL (r = 0.285). In addition, the intensity of general relationship between QOL and PF through mediating role of IP was estimated at (r < 0.603). IP significantly mediates the relationship between acceptance and practice, values, fusion, on illness duration (0.028, 0.56, -0.094, and 0.50).

It seems that, Illness perception as a mediacing variable between psychological flexibility and quality of life plays a significant role. Thus, considering this for treatment and rehabilitation purposes has been emphasized.

Migraine headaches are one of the psychosomatic disorders that severely impair patients' quality of life and general functioning by mediating psychological problems. The aim of this study was to investigate the mediating role of pain anxiety in the relationship between psychosomatic components on quality of life in these patients.

In this cross-sectional study, using available sampling method, 250 patients with migraine were selected based on inclusion and exclusion criteria among people with migraine referred to the Pain and Neurology Clinic affiliated to Isfahan Medical Sciences, Isfahan, Iran, in year 2020. In the appropriate psychological situation, after justifying the goals of the research, the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), McCracken Pain Anxiety Questionnaire (PASS-20) and also the Diagnostic Criteria for Psychosomatic Research Questionnaire (DCPR) were completed.

There was a negative correlation between the components of psychosomatic and pain anxiety with the dimensions of quality of life. Moreover, there was an indirect relation between the components of psychosomatic with the dimensions of quality of life, a direct relation between pain anxiety and the dimensions of quality of life. Besides, the proposed model of path analysis of variables had a good fit.

The findings of this study explain the contribution of some underlying psychological factors in the occurrence and persistence of headache. Moreover, this study suggests the development of psychological intervention packages based on an explanatory model to improve the quality of life of patients with migraine.

The aim of this study was to determine the effectiveness of cognitive-behavioral therapy on the perception of disease and psychological capital of patients with type 2 diabetes in Shahrekord in 1398. In this quasi-experimental study, pre-test-post-test design and control group were used. For this purpose, 30 people with type 2 diabetes who had a file in the Shahrekord Diabetes Association were selected using purposive sampling using the inclusion and exclusion criteria of the study and randomly assigned to the experimental and control groups (15 people in each group). Data collection tools included Disease Perception Questionnaire (Bradbent et al., 2006) and Psychological Capital (McGee, 2011) which were completed by the participants. Then the experimental group underwent 8 sessions of 90 minutes of cognitive-behavioral therapy and finally the data using the method Analysis of covariance was analyzed. The results showed that cognitive-behavioral therapy improved the perception of the disease in patients with type 2 diabetes (p <5%). The results also showed that cognitive-behavioral therapy increased psychological capital and its components in patients with type 2 diabetes (p <5%). The cognitive-behavioral group intervention with the protocol used in this study was effective in increasing the perception of disease and psychological capital in the population with diabetes and this method can be used along with drug therapies for patients with type 2diabetes. One of the limitations of this study is the limited sample of patients with type 2 diabetes, which can not be a good and sufficient indicator for the community. Therefore, generalizing the results only to the target community is logical and possible, and for other levels we must do so with caution. Data were prepared using self-report questionnaires that may have response biases.

The aim of this study was to compare the effectiveness of cognitive behavioral therapy and acceptance and commitment therapy on quality of life and self-care of patients with type 2 diabetes in Shahrekord Diabetes Association in 2018.

The method of this research is quasi-experimental and for data collection, pre-test-post-test design (three groups) with two experimental groups, a control group and a follow-up group have been used. The statistical population of the study consisted of all patients with type 2 diabetes of Shahrekord Diabetes Association, from which 45 people were selected by available sampling method and randomly divided into two experimental groups (15 people in each group) and one control group (15 people) were appointed. The experimental group of cognitive-behavioral therapy was trained for 9 sessions of 60 minutes and the treatment group based on acceptance and commitment were trained for 8 sessions of 60 minutes and the control group remained on the waiting list. The instruments used in the present study included quality of life of diabetic patients (Thomas et al., 2004) and self-care (Tubert et al., 2000) which were used in two stages of pre-test and post-test. The analysis of the information obtained from the implementation of the questionnaire was performed through spss24 software in two descriptive and inferential sections (repeated analysis of variance).

The results showed that cognitive-behavioral therapy and acceptance and commitment therapy did not have a significant effect on patientschr('39') quality of life. The results also showed that both interventions used in this study could significantly improve self-care (p <0.05), with the difference that the intervention based on acceptance and commitment therapy had a greater impact on patientschr('39') self-care. The follow-up phase continued.

Based on the results of this study, acceptance and commitment based therapy can increase the level of self-care of patients with type 2 diabetes.

The aim of this study was to investigate the effect of schema therapy on Pain Acceptance, Pain Self-Efficacy, pain intensity and emotion regulation in spinal column surgery patients suffering from pain in Milad hospital.

In this study semi-experimental with pretest-posttest control group design was used, 96 male peopel who were eligible for inclusion criteria and underwent spinal surgery assigned to experimental and control groups by chance and the experimental ones received interventional therapy. This study was to analyze the data from the test ANCOVA.

Results showed that schema therapy is effective and ipmroved Pain Acceptance and Pain Self- Efficacy and reducing amount of pain Intensity and emotion management.

The results revealed that schema therapy focuses on challenge and change process to create improvement and is appropriate for post operation pain management in patients with such a surgeries . According to the result of this study the schema therapy can be used as secondary prevention of pain consequences in these patients.

Nowadays, flexibility is the subject of special attention in the field of mental health and the scope of related research is increasing every day. The purpose of the present study was to construct and investigate the psychometric properties and factor structure of the adolescents' psychological flexibility scale. Four-hundred-sixty students were selected from six schools from the eighth and ninth grades (with emphasis on the ninth grade) by the multistage sampling method from six schools in Isfahan city. The instruments were Acceptance and Action Questionnaire (AAQ-II) and General Health Questionnaire (GHQ). In factor analysis, the three factors of commitment, lack of perfectionism, and openness to experience were effective in forming themental flexibility variable. The obtained results showed that the present scale is a tool that has appropriate reliability (stability, internal consistency) and validity for measuring psychological flexibility. The results of exploratory and confirmatory factor analyses in this study confirmed the appropriate construct validity of this scale.

Irritable bowel syndrome (IBS) is one of the most common functional gastrointestinal disorders in which stress plays a central role. The aim of this study was to investigate the effectiveness of compassion-focused therapy (CFT) on severity of perceived stress in patients with IBS.

 The research was performed in the form of a pretest-posttest quasi-experimental design with control and experimental groups. Statistical population included all patients with IBS referred to the functional Gastroenterology Clinic of Psychosomatic Research Center of Isfahan University of Medical Sciences, Isfahan, Iran, in 2016. Based on the research purpose, 30 patients with IBS were selected through available sampling method, and then randomly divided into two equal experimental and control groups. CFT were held for the experimental group in 8 sessions that any session consisted of 90 minutes. Patients in control group were in waiting list, and they only received routine medical treatment. In order to assess perceived severity of stress, Cohen Perceived Stress Scale-14 items (PSS 14) was used. Data were analyzed using analysis of covariance (ANCOVA) method via SPSS software.

 CFT with medication had more effect on perceived stress reduction in patients with IBS than mere drug treatment (F =5.031; P < 0.01).

 CFT can be used to reduce perceived stress in patients with IBS, and this approach is justified for the Iranian population.