stress disorders

Prolonged exposure to chronic stressors, such as the ongoing COVID‑19 pandemic, heightens the likelihood of experiencing various physical and mental health complications, including developing posttraumatic stress disorder (PTSD). The objective of the current study was to assess the prevalence of PTSD and examine its association with health beliefs among students enrolled in the Shahroud University of Medical Sciences.

This cross‑sectional study was conducted in 2022 and involved 350 students from diverse medical sciences. The participants were selected using a multistage stratified random sampling method. The study utilized health belief and PTSD questionnaires to collect data. The data were analyzed using analysis of variance (ANOVA), Chi‑square, and multiple regression models.

The average PTSD score among students was 43.3 ± 13.1. It was shown that 81 (23.8%) individuals had a lower score of PTSD. Furthermore, 161 (47.3%) were determined to have moderate levels of PTSD, while 99 (29%) had severe levels of PTSD. The average health beliefs score was 97.4 ± 15.0 out of 184, indicating moderate health views. The findings show a correlation between more outstanding total scores on health behaviors and a lower average score on PTSD. Regarding variables, it was discovered that Ph.D. and professional doctorate students had higher PTSD ratings than undergraduate students. Individuals with weaker economic means had a 4.6‑point higher average PTSD score than those with a monthly income exceeding $300. Furthermore, people with moderate to high anxiety levels due to COVID‑19 had a considerably higher average PTSD score, roughly 13.3 higher, than those who experienced lower stress levels.

The findings indicate a negative correlation between the total score of health behaviors and the average score of PTSD. Furthermore, the variables of educational level, impoverished economic status, and anxiety induced by the COVID‑19 pandemic emerged as significant predictors of elevated scores on the PTSD scale. In order to increase psychological health and reduce PTSD in students, this research suggests teaching health principles in the context of COVID‑19. 

Postpartum depression (PPD) is a significant mental health concern affecting many women worldwide. While various factors contribute to PPD, the role of perceived stress and marital satisfaction remains underexplored. This research aimed to investigate the mediating role of marital satisfaction in the relationship between perceived stress and PPD among postpartum women in Ahvaz.

A cross-sectional study utilizing structural equation modeling examined the relationships among perceived stress, marital satisfaction, and PPD. A convenience sample of 319 postpartum women who visited healthcare centers in Ahvaz, southern Iran, in 2023 was recruited. Data were collected using the Edinburgh Postnatal Depression Scale, the Perceived Stress Scale, and the Marital Satisfaction Scale. Data analysis was performed using structural equation modeling with SPSS-26 and AMOS-26 software.

The findings indicated a significant negative correlation between perceived stress and marital satisfaction (β = -0.45, P < 0.001). Both marital satisfaction (β = -0.31, P = 0.008) and perceived stress (β = 0.20, P = 0.028) were significantly related to PPD. Bootstrapping results also confirmed a significant indirect effect of perceived stress on PPD via marital satisfaction (β = 0.17, P = 0.027).

The interplay between perceived stress, marital satisfaction, and PPD is complex and multifaceted. This research highlights the potential importance of marital satisfaction as a critical factor in understanding the pathway between stress and PPD. Future interventions might consider incorporating strategies to enhance marital quality to reduce the risk of PPD.

Shift workers usually undergo circadian misalignment, which appears when the feeding and sleep-wake cycles are desynchronized with the temporal framework organized by the internal biological clock. People differ considerably in their tolerance to shift work depending on their chronotype. This research aimed to obtain information about circadian disorders and chronotype (as a mediating variable) on consequent mental states such as impulsivity, depression, anxiety, stress, addiction potential, and boredom in students of a medical university in northeastern Iran. We studied the mental state of individuals with circadian misalignment and compared it with the healthy control group.

The study design is a double-blind, randomized, controlled clinical trial. Thirty-five participants were randomly assigned to circadian alignment/misalignment protocols. Subjects completed questionnaires as baseline data (pre-test) and the end of the interventions (post-test). The study instruments were the multidimensional state boredom scale (MSBS), addiction potential scale, depression, anxiety, and stress scale-21, and Barratt impulsiveness-11 (BIS-11). To analyze outcomes, we categorized participants based on chronotype as mediate variable within each group (circadian aligned and misaligned condition).

The mean age of the participants was 21.66 years (range: 18-25 years). One-way analysis of variance to compare research variables in groups based on chronotype (evening, intermediate type, and morning types) showed a significant difference between the three chronotype groups in the total and non-planning impulsivity, as well as active and passive addiction potential (P<0.001). The Bonferroni post hoc test was used to compare the mean of variables in the chronotype groups about total and non-planning impulsivity scores, as well as active and passive addiction. The results showed that non-planning (P<0.01) and active addiction (P<0.001) in people with evening and intermediate types were significantly lower than in people with morning type (P=0.02).

Alterations in diurnal profiles of activity, sleep, and feeding time, based on chronotype related to impulsiveness and boredom, and such circadian misalignment were associated with addiction potential.

The prevalence of type 2 diabetes represents a significant public health challenge, and effective disease management is essential for improving patient outcomes. Perceived social support and self-care are critical factors in the health of individuals with type 2 diabetes.

This study aimed to explore the relationship between social support, perceived stress, and self-care behaviors in patients with type 2 diabetes in Rasht.

In this cross-sectional descriptive study, 384 participants were selected from a population of 40,000 people with type 2 diabetes in Rasht city, using the Karjesi and Morgan table. Tobert’s self-care questionnaires, the Perceived Social Support Scale by Zimmet, Dalhem, Zimmet, and Farley, and the Perceived Stress Scale by Cohen, Kamark, and Mermelstein were utilized for data collection. The data obtained from field investigations were analyzed using descriptive and analytical statistical tests, including Pearson correlation and linear regression, at a significance level of 0.01 and a confidence interval of 0.99, in SPSS software version 16.

The results of the study revealed a positive correlation between perceived social support and self-care (r = 0.35), family support and self-care (r = 0.25), friends’ support and self-care (r = 0.33), and support from significant individuals and self-care (r = 0.37). Conversely, a negative relationship was observed between perceived stress and self-care (r = -0.22).

These findings can assist healthcare providers in expanding existing knowledge and designing diabetes self-care management education programs tailored to the psychosocial and cultural needs of adults in the study region.

Iranian youth encounter numerous stressors, including accidents, suicide, and unemployment, heightening their risk for posttraumatic stress disorder (PTSD). It's crucial to assess, diagnose, and treat PTSD in this demographic.

This study aimed to evaluate the factor structure and validate the Post-Traumatic Symptom Scale (PTSS).

A cross-sectional approach was employed for the validation of the PTSS in Bandar Abbas, 2022, with a sample of 901 young residents selected via random cluster sampling. Data were gathered using the PTSS and the Mississippi Scale for Posttraumatic Stress Disorder (MSPSS). Validation of the scale encompassed content validity, concurrent validity, and factor analysis. Reliability assessments included internal consistency, test-retest, and split-half reliability. The optimal cut-off point was identified through receiver operating characteristic (ROC) curve analysis and the Youden Index.

The PTSS demonstrated robust face and content validity, evidenced by impact factor (1.6 < impact factor< 3.6), content validity ratio (CVR = 0.68 to 0.91), and Content Validity Index (CVI = 0.70 to 0.94). The PTSS's concurrent validity with the MSPSS was positively strong (r = 0.64, P < 0.001). Factor analyses, both exploratory (EFA) and confirmatory (CFA), substantiated a four-factor model of the PTSS, accounting for 56.288% of the variance (19% for arousal and reactivity, 14% for negative alterations in cognitions and mood, 11% for avoidance, and 11% for intrusion). The scale's overall Cronbach's alpha was 0.87, with subscales ranging from 0.77 to 0.88. Test-retest reliability stood at 0.81 (P < 0.01), and split-half reliability at 0.81. The PTSS's optimal cut-off for PTSD diagnosis was 60, delivering a sensitivity of 0.70, specificity of 0.99, and Youden Index of 0.69.

The PTSS proves to be a reliable and valid instrument for assessing posttraumatic stress symptoms among young Iranians, offering a useful resource for researchers and practitioners in the prevention and treatment of PTSD.

Given the inherent nature of their job, law enforcement staff regularly confront major stressors.

The prevalence of post-traumatic stress disorder (PTSD) among law enforcement staff is about twice that of the general population. We conducted this study to assess PTSD risk factors among this population.

This prospective case-control study was conducted on patients with PTSD working as law enforcement staff as the case group, and their comrades with no PTSD as the control group. We used a questionnaire, including possible factors contributing to the development of PTSD, to gather the data. Binomial logistic regression was used to calculate the odds ratio (OR) and 95% confidence intervals.

A total of 84 participants were included in the study. We found that some factors could be protective against PTSD, including marriage (OR: 0.270, 95% CI: 0.087 - 0.839, P-value: 0.024), having an academic degree (OR: 0.333, 95% CI: 0.114 - 0.978, P-value: 0.045), higher income (R2: 0.081; OR: 0.849, 95% CI: 0.721 - 1.000, P-value: 0.050), and receiving satisfactory family support (OR: 0.413, 95% CI: 0.171 - 0.999, P-value: 0.050). Furthermore, logistic regression showed that a positive psychological history (OR: 2.562, 95% CI: 1.025 - 6.406, P-value: 0.044), a positive familial psychological history (OR: 2.667, 95% CI: 1.099 - 6.406, P-value: 0.030), and encountering trauma (aside from the current trauma) after 18 years of age (OR: 2.643, 95% CI: 1.038 - 6.731, P-value: 0.041) are risk factors for PTSD.

Our results showed that marriage, having an academic degree, higher income, and receiving satisfactory family support are protective factors. In addition, the risk factors for PTSD include a positive psychological history, a positive familial psychological history, and encountering trauma (aside from the current trauma) after 18 years of age. However, given our limitations, further studies should be conducted before drawing solid conclusions.

Health care provided by youth can support homebound and bedridden older adults. The purpose of this study was to develop a program for homebound and bedridden older adults in rural areas of northeastern Thailand.

The methodology was a mixed method, including 1) exploration of the current situation through qualitative method, 2) development of a training program, and 3) implementation and evaluation of the program developed through a quasi-experimental method from February to June 2020 in Ta-Muang Subdistrict, Selaphum District, Roi Et Province, Thailand. Data were collected through focus group discussions, in-depth interviews, Thai version of the brief form of the World Health Organization Quality of Life (WHOQOL-BREF-THAI), and Srithanya Stress Test (ST-5) questionnaires. Quantitative data were analyzed using percentages, means, SDs, and paired t tests, while qualitative data were analyzed using content analysis.

The qualitative method showed 4 major themes, including 1) lack of caregivers, 2) lack of knowledge, 3) loneliness and stress, and 4) under the poverty line. The training program involved 6 activities: 1) providing knowledge in caring for older adults to educate and support youth, 2) demonstrating and practicing in caring for older adults to educate and support youth, 3) caring for older adults with love and care, 4) providing hygiene care to older adults, 5) promoting self-worth and self-confidence in youth, and 6) enhancing community participation. The quantitative method showed after the implementation of this training program.  Findings showed that quality of life had higher mean scores, and stress had lower mean scores compared to the prior implementation.

This training program could promote bonding among youth and homebound and bedridden older adults through peer support from health volunteers.

Opioid abuse is one of the most critical problems today, and individuals struggling with this issue often experience stress, anxiety, and depression disorders. This study aimed to investigate the effects of software-based cognitive bias modification on stress, anxiety, and depression disorders among patients receiving methadone maintenance treatment. This double-blind clinical trial was conducted in 2022. Eighty-four participants were selected through convenience sampling from individuals undergoing methadone maintenance treatment for opioid abuse at an addiction treatment center in Isfahan city. They were then randomly assigned to either the intervention group (n=42) or the control group (n=42). The intervention involved a four-week program utilizing software-based cognitive bias modification through the dot-probe task, with two sessions per week. Participants in both groups completed DASS21 questionnaires before, immediately after, and two months following the intervention. The repeated-measures ANOVA test revealed statistically significant differences in the mean scores of stress (P<0.001), anxiety (P<0.001), and depression (P<0.001) disorders in the intervention group before, immediately after, and two months post-intervention. The findings of this study suggest that software-based cognitive bias modification can lead to a reduction in stress, anxiety, and depression disorders among patients undergoing methadone maintenance treatment. Therefore, incorporating this program alongside other treatment methods for individuals in methadone maintenance treatment is recommended.

This study investigates the effect of virtual training on the stress of mothers of children with febrile seizures.

This quasi-experimental research was conducted on 64 mothers of children with febrile seizures in Shahrekord in 2022. The samples were randomly distributed into intervention and control groups. The intervention group received WhatsApp training during three individual and 3 group sessions, and the control group received routine training. Mothers' stress was measured using the Pediatric Inventory for Parents (PIP) questionnaire, completed by two groups before, immediately, and two months after the intervention. Data analysis was done using the SPSS 18 version, descriptive statistics, repeated measure analysis of variance, independent t-test, chisquare, and Fisher tests.

Before the intervention, the average total score of stress in frequency level in intervention and control groups was 117.29 ± 20/70 and 122.50 ± 24.69 and in difficulty level in intervention and control groups were 122.21 ± 25.32 and 129.83 ± 3.24. There was no statistically significant difference on the two levels between the groups (P = 0.363) and (P = 0.285). Immediately after the intervention, the average total score on the two levels in the intervention group was significantly lower than the control group (P = 0.001) and (P = 0.003). Two months after the intervention, the average score on two levels in the intervention group was lower than the control group (P < 0.001).

Using virtual training is suggested as an effective method to reduce the stress of mothers of children with febrile seizures.

Like becoming a mother, becoming a father is a new and important role that entails several responsibilities and expectations for men. This study aimed to investigate the relationship between psychological status and perceived social support in men during their wives’ pregnancy.

This cross-sectional study investigated 372 Iranian men in the third trimester of their wives' pregnancy using multistage cluster sampling from May 2014 to February 2015 in Tabriz, Iran. The self-administered questionnaires used included demographic questionnaire, Personal Resource Questionnaire (PRQ-85-part2), and short form of depression, anxiety, and stress (DASS-21). The statistical tests including Spearman correlation, Mann-Whitney, Kruskal Wallis and linear regression model were used for data through SPSS v. 21.

 Perceived social support was negatively correlated with anxiety (r=-0.390, P<0.001), depression (r= -0.277, P<0.001), and stress in men (r= -0.290, P<0.001). Based on the results of multiple linear regression, the father's education, mother's occupation, income, and fetus gender by ultrasound were significantly related to the anxiety of fathers. Moreover, mother's age was significantly correlated with men's depression.

Based on the results, social support affects the psychological status of men in the third trimester of pregnancy of their wives and the levels of anxiety, depression and stress decrease in men with increasing of social support.  Healthcare providers should pay more attention to the increasing public awareness, stress management and communication skills training, and support of men during their wife’s pregnancy.

 Infertility disrupts the life of infertile couples and causes violence against women. Women who experience violence must deal with the painful memories of that stressful event. Those who go through events beyond normal experience may develop post-traumatic stress disorder (PTSD).

 The present study aimed to determine the relationship between perceived violence and PTSD in infertile women.

 This case-control study was conducted on 148 infertile women with PTSD and 148 infertile women without PTSD who had attended Milad Infertility Treatment Center in Mashhad, Iran. A score above 50 from the PTSD checklist-civilian version (PCL-C) was considered for the diagnosis of PTSD, and the mean score of violence was compared between the groups of subjects with and without PTSD.

 The results showed a significant relationship between PTSD and violence against infertile women (P < 0.001). The mean violence score was 59.22 ± 7.31 in subjects with PTSD and 41.10 ± 13.33 in the group of subjects without PTSD. Moreover, the risk of violence was 1.11 times higher in subjects with PTSD than in the healthy group (OR = 1.11, CI 95%: 1.08 - 1.14).

 The results of this study showed that the risk of violence was higher in subjects with PTSD than in women without this disorder. Therefore, necessary measures must be taken to help infertile women affected by violence.

The clinical environment always has been the most stressful course of nursing education. Personality traits can be influential factors in stress resources and responding to stress. The present study investigates the correlation between personality traits and nursing students’ stress resources in the clinical environment.

This descriptive correlational study was planned and performed on Zanjan University of Medical Sciences nursing students. The research population was 215 students selected by stratified random sampling method from all nursing students in the third to eighth semesters. We used an electronic questionnaire for data gathering, including three sections: demographic characteristics, NEO personality traits, and stress resources in the clinical environment. The data were analyzed using descriptive and inferential statistics.

The most and least stressful resources were related to the score of unpleasant emotions and interpersonal relationships. We found a significant positive correlation between neuroticism personality traits and all four stress resources (p < 0.05). The results also showed a significant correlation between all scores of personality traits and perceived stress from unpleasant emotions except the openness to experience trait (p < 0.05). Furthermore, the relationship between age, gender, semester, interest, and stress resources in the clinical environment was statistically significant (p < 0.05).

Paying attention to the nursing student’s clinical performance to maintain the patient’s health is vital and unavoidable. Therefore, more than ever in the preclinical course of nursing education, improving the psychological readiness and simulation training method can reduce the harmful effects of the clinical environment’s stress resources on their clinical performance.

Research capacity building and self-efficacy are essential skills for medical students that greatly help them to participate in research. The present study aimed to investigate the relationship between academic stress and research self-efficacy in medical students through the mediating role of research spirit.
Materials &

This descriptive-correlational study used path analysis to examine the relationships between the variables. The statistical population was all postgraduate medical students in Ilam in the academic year 2022-2023, of whom 301 students were selected using convenience sampling. They completed the Research Self-Efficacy Scale, the Academic Stress Scale, and the Research Spirit Questionnaire. Evaluation of the proposed model was done using path analysis.

There was a negative correlation between academic stress and research spirit (p<0.001). There was a significant positive correlation between research spirit and research self-efficacy (p<0.001), whereas there was no significant correlation between the direct path of academic stress to research self-efficacy. Also, there was a significant correlation between the indirect path connecting academic stress and research self-efficacy through research spirit (p<0.01).

Based on the results, the proposed model shows a good fit and is a major step toward identifying factors influencing research self-efficacy among medical students.

As one of the primary causes of confusion and decline in mental health, stress can be the source of considerable negative effects on student performance. The present study aimed to investigate the effectiveness of stress management training in academic optimism and hope of university entrance exam applicants.
Participants &

This was a quasi-experimental study based on a pretest-posttest design with a follow-up. The statistical population consisted of all university entrance exam applicants in Ahvaz, Iran, in 2022. Thirty applicants, who met the inclusion criteria, were selected as the sample using convenience sampling and randomly assigned to the treatment and control groups (15 participants per group). The participants in the treatment group attended eleven 120-minute sessions of cognitive-behavioral stress management (CBSM) training program, whereas those in the control group received no intervention. The Academic Optimism Scale and Adult Hope Scale were used to collect data. Data were analyzed using descriptive statistics (mean and standard deviation) and inferential statistics (analysis of covariance).

The results showed that the stress management training program improved the academic optimism (F=117.24, P=0.001) and hope (F=66.33, P=0.001) of the participants in the treatment group.

It can be concluded that stress management training in stressful situations, such as the university entrance exam can boost candidates' academic optimism and hope.

The desire to attain ideal body dimensions determined by the society causes internal pressure and negative emotional intensity in young people, and this leads to mood disorders. It was aimed to examine the relationship between university students' perceived body weights and their depression, anxiety, and stress levels.

This cross-sectional, descriptive study was conducted with 950 university students at Uskudar University in Istanbul, Turkey during the 2021-2022 academic year. The Information Form and the Depression, Anxiety and Stress Scale (DASS-42) were administered online through a structured questionnaire created in Google Forms. IBM SPSS v26® software was used in the analysis of the data.

74.4% of the students were female. The mean age was 19.17±1.11 years, and the mean body mass index (BMI) was 22.12±3.87 kg/m2. The prevalence of participants’ mood disorders as ‘severe’ and ‘extremely severe’ depression was 91.2%, anxiety was 62.2% and stress was 62.3%. According to BMI, 26.1% of ‘underweight’ students and 31.5% of ‘overweight’ students perceived themselves as normal weight. And also, 23.8% of the students misjudged their body weight. Students who misjudged their body weight had higher depression levels (P=0.008).

There was a strong relationship between perceived body weight and depression, 1 of every 4 students misjudged their body weight. Body perception of participants who were ‘underweight’ according to BMI was in the perceptional direction of obesity and who were ‘overweight’ was in the perceptional direction of thinness. Students who were ‘normal weight’ according to BMI have a healthier body image.

Mental disorders have become especially important in the current stressful world. Among these disorders, anxiety, and depression are highly prevalent. Stress is also a very common phenomenon. Given the teachers’ prominent roles in the education department and the importance of their mental health, the present study aimed to determine stress, anxiety, and depression among teachers during the COVID-19 Pandemic in 2020. This cross-sectional study examined 210 primary school teachers in district 3 of Isfahan province in Iran, using multi-stage random sampling. Data were collected by the Depression, Anxiety, and Stress Scale- 42 Items (DASS-42). Also, the obtained data were analyzed using SPSS Statistics 20 and conducting pearson test, t-test, ANOVA, and linear regression. The results indicated a high level of stress, anxiety, and depression among the teachers. Findings also showed that teachers’ depression was significantly associated with their age, work experience, type of housing, and student behavior (P<0.05). Further, teachers’ anxiety was significantly associated with their work experience and student behavior (P<0.05). Moreover, teachers’ stress was significantly associated with their history of mental diseases (P<0.05). Teachers’ depression, anxiety, and stress were not significantly correlated with their marital status, spouse’s job, education level, and Relationship with other colleagues (P>0.05). Given that stress, anxiety, and depression affect teachers’ mental health, and consequently the quantity and quality of their work, holding training courses and sessions to discuss teachers’ problems, provides practical and effective solutions, and offers them administrative and organizational support, can be an effective step towards improving their mental health.