Iranian Journal of Psychiatry and Behavioral Sciences
Volume:13 Issue: 2, Jun 2019

Policies, in general, determine the approach of interventions in society and, in turn, they are supposed to be influenced by theories. Theories are based on evidence and data; therefore, the methodology used to produce evidence and data plays a decisive influence on the final theory. In the field of addiction, addiction theories rely on the product of studies conducted on different individual, group, and environmental levels. Addiction, however, is a multi-dimensional (biological, psychological, and sociological) phenomenon. In this review article, we argue the pieces of evidence by which we build up a matrix structure in the theoretical model in order to provide a comprehensive understanding of this phenomenon. One axis of the matrix consists of the biological, psychological, and sociological dimensions of addiction, while the other axis, consists of individual, group, and environmental levels. We further discuss how such a multilevel and multi-dimensional approach does not exist in most addiction theories, and each of the theories has only explained single or limited elements of this matrix. This mono-level approach to the phenomenon of addiction can lead to major fallacies in the research and studies of the addiction.

Suicide is one of the leading causes of death around the world. The hypothalamic-pituitary-adrenal (HPA) axis disorder is involved in the pathophysiology of suicidal behavior. Acupuncture by regulating the activity of the HPA axis could regulate the secretion of cortisol. This study aimed to evaluate the effectiveness of auricular acupuncture in the reduction of cortisol level and suicidal ideation in dysthymic patients with comorbid opiate use disorders enrolled in methadone maintenance treatment (MMT). In a randomized, double-blind, sham-controlled trial (TCTR20180328001), from December 2015 to June 2016, 24 patients (mean age = 24 years) with persistent depressive disorder (dysthymia) under methadone maintenance treatment who referred to Bijan Center for Substance Abuse Treatment in Tehran were selected through respondent-driven sampling (RDS). After 28 days of evaluation, the participants were randomized into two active or sham continuous groups. Auricular acupuncture was performed twice a week for four weeks for the experimental group while the control group received the sham acupuncture. Assessments were carried out before treatment (baseline) and every week for four weeks. Salivary cortisol was considered the primary outcome and the suicide ideation was the secondary outcome. The data were analyzed by the generalized estimation equation (GEE) model and the chi-square test. The qualitative data were analyzed using ATLAS/TI 5 software. Acupuncture had a significant effect on the cortisol level, as the primary outcome, during the four weeks of treatment. Moreover, there was a significant reduction in suicidal ideation as the secondary outcome (all P values < 0.01). Acupuncture as an alternative method could reduce the cortisol level and significantly decrease suicidal ideation.

Iranian parents consider themselves responsible for the behavior and actions of their children and think that the mistreatment of children is a sign of their defect and impropriety. The main purpose of this research was to develop and validate the parent abuse scale (girl-mother version), including construct validity, convergent validity, and internal consistency. The study population was all students’ mothers from high school and their adolescent daughters. Two samples were used in this study. In the first sample, 409 people were selected for exploratory factor analysis and in the second stage, a random sample of 188 mothers was selected as a multi-stage cluster sampling for confirmatory factor analysis. Mothers and their daughters have completed parent abuse questionnaire (girl-mother) and attitude scale of the child toward mother, respectively. The results of the exploratory factor analysis showed that this scale consisted of both physical and emotional parent abuse scale factors. The confirmatory factor analysis results confirmed the two-factor structure of this scale. Convergent validity of parent abuse scale was calculated by correlating it with child attitude scale toward her mother. The correlation coefficient of mean in subjects in parent abuse scale was significant with child attitude toward her mother scale. The internal consistency of the parent-mother scale and its factors were calculated according to Cronbach’s alpha coefficients and confirmed with the correlation coefficients of 0.93 and 0.75. According to the results, the parent abuse scale had sufficient validity and reliability in Iranian samples.

Drug abuse is a major problem in Iran with a huge social burden. Methadone maintenance treatment (MMT) is offered as a harm reduction program to decrease the consequences of opioid drug dependence. Single nucleotide polymorphisms (SNPs) in the ABCB1 gene, encoding P-glycoprotein, have shown associations with drug uptake in the central nervous system (CNS). We aimed to identify the frequency of ABCB1 SNPs and haplotypes in Iranian opioid-dependent patients and the link between ABCB1 haplotypes and P-glycoprotein function. We randomly selected 400 patients undergoing methadone treatment from the MMT clinics in Shahroud, Iran. Of these, 320 people qualified for the study were sorted according to their dose requirement. Individuals with a dose of greater than 100 mg/day and less than 60 mg/day were selected and divided into two groups. Blood samples were taken from 83 high-dose dependent (HDD) and 86 low-dose dependent (LDD) individuals. DNA was extracted and ABCB1 SNPs at the C1236T, C3435T, A61G, G1199A, and G2677T loci were detected using polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP). The haplotypes were obtained by the use of SNP analyzer version 2.0 software. No significant differences were observed in allele and genotype frequencies of the SNPs between HDD and LDD groups. Eleven unique haplotypes were obtained, of which only the TTAGG haplotype showed a significant difference between the two populations (P = 0.030557, χ2 = 4.678). Linkage disequilibrium was observed at 1199, 1236, and 3435 loci. There were no significant differences in methadone dose requirement between different haplotypes or genotypes. Here, for the first time, we reported the frequency of ABCB1 SNPs in opioid-dependent people in Iran. Regarding the results, it seems that the use of these SNPs is not beneficial to predict and optimize the amount of drug requirement in Iranian society. However, further genotyping studies are required to decipher the impact of genetic variability on methadone dependence.

Parallel with the rapid growth of smartphone users among the youth, its problematic use has received attention due to adverse outcomes. The psychometric properties of smartphone addiction inventory (SPAI) have been studied among Italian and Taiwanese university students. The aim of this study was to investigate the psychometric properties of the SPAI among Iranian university students. We recruited 402 undergraduate university students in the study from February to March 2017. The SPAI and young’s Internet addiction test (IAT) were completed for them. The AMOS statistical software (version 21) was used to test the five-factor model proposed in the original SPAI. The results of the goodness-of-fit index showed an ambiguous solution. For more appropriate trimming of the SPAI factorial structure, an exploratory-confirmatory cross-validation strategy was followed. The SPAI showed excellent internal consistency (Cronbach’s α = 0.92). Cronbach’s α values of the five subscales varied from 0.53 to 0.84. The results supported a five-factor solution consisting of sleep interference, craving, daily life inference, compulsivity, and time spent (chi-square = 1105.445; P < 0.000; CFI = 0.902; TLI = 0.91; RMSEA = 0.09), which showed good convergent validity with the IAT scores. Moreover, the SPAI showed high factor correlations. Given the increasing trend of smartphone users in the country, the Persian version of the SAPI could be a useful tool for further investigation of smartphone problematic use among Iranian university students.

Ethnicity is one of many intrinsic factors influencing the drug response and its severity in patients with schizophrenia. In North Sumatera, Indonesia, information is very limited on the effect of divalproex sodium in Batak and non-Batak tribes. The study aimed to investigate differences in positive and negative syndrome scale (PANSS) scores between Batak and non-Batak males with schizophrenia receiving risperidone treatment alone or in combination with divalproex sodium. This open trial experimental study was conducted on 60 Batak and non-Batak male subjects with schizophrenia. The doses of divalproex sodium and risperidone were 1500 mg and 6 mg, respectively. The sample was obtained from Prof. Dr. M. Ildrem Psychiatric Hospital, North Sumatra, Indonesia, in a span of six months from September 2017 to February 2018. The mini international statistical classification of diseases-10 (Mini ICD-10) structured interviews were used for diagnosis. There were no differences between the Batak and Non-Batak groups in the PANSS positive subscale score (P = 0.766), PANSS negative subscale score (P = 0.789), and PANSS total score (P = 0.673) in six weeks of observation. There were no significant differences in the PANSS scores between males with schizophrenia from Batak and non-Batak tribes who received risperidone monotherapy or combined with divalproex sodium.

Concurrent use of stimulants during opioid maintenance treatments (OMTs) negatively impacts the treatment outcomes. The aim of this study is to evaluate the prevalence and correlation of amphetamine and methamphetamine use among OMT clients in Golestan province-Northeast of Iran. In a cross-sectional study, 750 OMT clients were recruited through a two-stage cluster sampling. Face-to-face interviews were conducted to complete the study questionnaire. Urine samples were also taken to perform rapid drug testing for morphine, amphetamine, methamphetamine, tramadol, cannabis, and benzodiazepines. Survey analysis command in STATA was used to estimate the prevalence of drug use among the target population. In this study, 8.1% (95% CI: 3.6 to 12.6) of the participants had positive urine sample for amphetamine or methamphetamine. Also, 41.8% (95% CI: 34.4 to 49.1) of the clients had positive samples for morphine. The urine positivity rate of morphine was significantly higher among those who had positive urine sample for amphetamines (68.3%; 95% CI: 51.7 to 84.9 versus 39.4% 95% CI: 31.3 to 47.6). In multivariate analysis, lifetime alcohol consumption (adjusted OR: 2.8, 95% CI 1.5 to 5.5) and history of imprisonment (adjusted OR: 2.2, 95% CI: 1.0 to 4.6) were associated with positive urine sample for amphetamines. Simultaneous use of amphetamines among clients of OMTs was considerable. It is recommended to regularly test all OMT clients for concurrent use of stimulants. This is particularly important for clients with past history of alcohol consumption or imprisonment.

Polygamy is a social reality that results from different sociocultural factors and can alter familial functional harmony and relations, leaving changes in the familial system. The purpose of the present research was to compare polygamous and monogamous families in variables of the senior wife’s stress, father’s power and performance. It also determined the extent of relationships between father’s power, performance, and wife’s stress. The current research was a survey study. The statistical population of the study composed of 400 married females above the age of 16, including 150 senior woman from polygamous families and 250 from monogamous families in Zahedan, Iran in 2018. Participants were assessed using the Cohen, Kamarck, and Mermelstein’s perceived stress scale (PSS) and Mahdavi, Sabouri power scale (PS). Father’s performance scale used by combined McMaster’s functioning scale and Olson’s marital satisfaction scale. Results of mean stress of senior women in polygamous marriages showed significantly more stress mean than their counterparts in monogamous marriages (P < 0.001). In addition, women from polygamous families had more problems than women belong to monogamous families (P < 0.001). The data, as shown, confirm that fathers in polygamous families are more powerful than fathers in monogamous families (P < 0:001). There was a correlation between father’s power and wife’s stress (0.56) and also father’s performance and wife’s stress (-0.67) with 99% confidence level. This study shows that polygamous families confront more problems than monogamous families. The article calls on public policy and social service personnel to increase public awareness of the significance of proper understanding of marital roles and interactions for families well being.

When the spouses are aware of the fact that each one has emotional needs that must be fulfilled, it will lead to decrease the marital satisfaction, such as the lack of awareness which will lead to marriage burnout in a long-term period. The aim of this study was to examine the impacts of the spouses’ age, years of marriage, and the nature of marriage burnout dimensions, especially the emotional exhaustion. The researcher of the present study applied a Maslach burnout inventory (MBI) scale to 392 families whose ages were within the range of (23 - 67) years. Those spouses were married for (1 - 35) years and had children. Descriptive statistics showed a higher marriage burnout level among the spouses who work in a full-time job and the ones who do not work in comparison to the ones who work in a part-time job. Emotional exhaustion is mostly influenced by the increase in the spouses’ ages and years of marriage. Although there was no impact for the years of marriage on depersonalization, personal accomplishment and depersonalization were mostly influenced by the spouses’ nature of work. Marriage burnout is a painful state of emotional exhaustion and physical and emotional depletion experienced by spouses. This state results from emotional exhaustion, work exhaustion, and failure to fulfill the requirements of their marital relationships, especially the emotional requirements. Spouses having children are more exposed to experience marriage burnout.

Post-partum depression (PPD) is the most prevalent mental problem associated with childbirth. Studies are inconsistent as to whether geographical location is linked with the risk of post-partum depression. The current study examined and compared the prevalence and risk factors for post-partum depression in urban and rural areas. A prospective cohort study was conducted on 2279 pregnant women in Mazandaran based urban and rural areas. Edinburgh postnatal depression scale (EPDS) and other validated instruments were applied to assess the similarities and differences between depression prevalence rate within 12 postpartum weeks and two women groups’ characteristics. Logistic regression model was used to distinguish PPD risk factors in urban and rural residents. PPD prevalence rate was slightly higher among the urban women (20.1%) than that of the rural ones (17.8%) with no significant difference. Although the established PPD risk factors such as prenatal depression and lack of parental self-efficacy were associated with PPD in both groups of women, the rural-specific risk factors such as socio-demographic and health problems were related to PPD in rural areas and social isolation predisposed urban women to PPD. PPD is a significant health problem among women regardless of their place. The increased PPD risk in each residence is associated with unique risk factors requiring specific interventions.

Fruit and vegetable consumption is associated with improvements in mental health, but few studies examined this relationship longitudinally. The current study aimed at assessing the effect of fruit and vegetable consumption on mental-health-related quality of life, major depressive disorder, and generalized anxiety disorders. The study analyzed four waves of longitudinal trial data collected from 442 temple members with prehypertension and/or prediabetes, randomly selected from 12 Buddhist temples in Nakhon Pathom province from 2016 to 2018. The longitudinal associations between fruit and vegetable consumption and three mental-health-measures were calculated using generalized estimating equations (GEE). Results of GEE predicting mental-health-related quality of life indicated that more frequent fruit consumption (P = 0.485) was not, but more frequent vegetable consumption (P = 0.027) was in the fully adjusted model associated with greater mental-health-related quality of life. Fruit and vegetable consumption (P = 0.033) was associated with greater mental-health-related quality of life only in the unadjusted model. More frequent fruit (P = 0.566 and P = 0.751, respectively), vegetable (P = 0.173 and P = 0.399), and fruit and vegetable consumption (P = 0.252 and P = 0.634, respectively) did not significantly reduce the risk of major depression and generalized anxiety disorder. The current longitudinal study did not find evidence that more frequent fruit and vegetable consumption was associated with mental-health-related quality of life, depression, and anxiety. However, more frequent vegetable consumption was associated with greater mental-health-related quality of life.

According to threat anticipation cognitive model, anxiety is the main causal factor for Paranoia. The study was designed to answer the question of whether anxiety-based cognitive behavioral therapy can reduce paranoid ideations. During a six-month period (April to September 2017) the female students of Mashhad Universities, Iran voluntarily participated in this study, of which 30 subjects with subclinical paranoid ideations were selected based on SCID-I, scoring 1 > in the SCL-90 questionnaire, and scoring 40 > in Paranoia scale. Fifteen subjects were determined for each group based on Cohen table and the probability of dropout. They were divided into two groups. Finally, eighteen participants completed all therapy and assessment sessions. Before and after the intervention, paranoid scale and work and social adjustment scale were used to assess paranoid ideations and performance impairments. This study indicated a reduction in paranoid ideation (P = 0.000) and an improvement in general function (P = 0.001). This study could be promising research to design specific protocols for Paranoia in a non-clinical population.

Stress is an important part of a college student’s life. Psycho-technology has greatly helped students cope more effectively with stress. The aim of the present study was to compare the effectiveness of three methods of intervention for stress management in students based on mindfulness-based stress reduction, including blended therapy, smartphone mobile application, and face-to-face therapy. A quasi-experimental study was designed with pretests, posttests, and follow-ups for a month on randomly selected students. The first group was treated by the Aramgar application only, the second group by both the face-to-face therapy and Aramgar application, and the third group by the face-to-face therapy only. The DASS-21 was utilized for both pretest and posttest administration. The ANOVA and post hoc tests were applied to analyze the data. The mean age of the participants was 24.29 ± 3.21 years. There was a significant difference in the mean score reduction of depression, stress, and anxiety between the three groups (P < 0.001). The post hoc test showed that the blended therapy group had the greatest mean score reduction on stress, depression, and anxiety among the three groups. The blended approach could improve the mental health of students more than the two other approaches. Therefore, the use of mobile platforms of new technologies is highly suggested along with face-to-face interventions in clinics to support people within their daily routine.

With the advent of the third wave of cognitive-behavioral therapies, compassion and self-compassion were taken into consideration. Self-compassion serves as a protective factor against psychopathology. Shame, perfectionism, and negative affect are among the risk factors of body dysmorphic disorder (BDD). Self-compassion may decrease the negative effects of these factors on the dysmorphic concern. The aim of the current study was to examine the protective effect of self-compassion against perfectionism, negative affect, and external shame in relation to concern about body dysmorphia. A convenience sampling method was used to select 210 students (103 males and 107 females) studying at Shahid Beheshti University of Medical Sciences. The dysmorphic concern questionnaire, self-compassion scale (short-form), external shame scale, negative affect scale, and perfectionism scale were applied as study tools. Pearson correlation coefficient and the path analysis of structural equation modeling were employed to analyze the data. External shame, perfectionism, and negative affect had significant positive relationships with concern about body dysmorphia. Accordingly, there was a significant negative relationship between self-compassion and concern about body dysmorphia. Moreover, the results of path analysis showed that self-compassion played a mediating role in the relationship of concern about body dysmorphia with perfectionism and negative affect. However, it did not have a significant mediating role in the relationship between external shame and concern about body dysmorphia. Self-compassion can serve as a protective factor against perfectionism and negative affect to decrease the negative effects of these risk factors.

Today there is an increased risk of suicide among young people throughout the world. Due to the high prevalence of suicide in Iran and its important psychological and social effects, the epidemiology of suicide death and its associated factors were evaluated in Ilam as a deprived area of Iran. A Longitudinal study was conducted in Ilam, Iran, during a five-year period from 2012 - 2016. The basic data were recorded through the registration centers of legal medicine and governmental medical centers in Ilam, Iran. The suicide death ratio was calculated based on the number of suicide deaths per 100,000 populations each year. Data analysis was carried out with IBM SPSS for Windows vesion 20.0 using descriptive and inferential statistics. A P value less than 0.05 was considered as significant level. In total, there were 475 suicide deaths, with 41.1% being female and 58.9% male. The highest rate of suicide deaths is found in 2012 at 20 per 100,000. More than half of the suicide deaths occurred in individuals between the ages of 21 - 40. 78.9% of all suicide deaths occurred in individuals without an income and 21.1% in individuals with a personal income. A substantial number of all suicide deaths occurred in individuals without a personal income. Most likely, individuals who are financially dependent will experience lower self-esteem and a higher risk of mental disorders. All of these factors increased the risk of suicide.