Iranian Journal of Psychiatry and Behavioral Sciences
Volume:14 Issue: 2, Jun 2020

Coping strategies can predict breast cancer patients’ emotional well-being.

The aim of this systematic scoping review was to investigate the effect of coping strategies-oriented interventions on coping skills in breast cancer women.

A systematic scoping review was conducted using a broad search across PubMed, Scopus, Springer, Elsevier, Cochrane Library, Science Direct, Web of Science, Magiran, Scientific Information Database, and Google scholar from 2009 - 2018.

Clinical or quasi-experimental trials using interventions and control groups on the coping strategies-oriented interventions in breast cancer women in English or Persian were included.

Two independent researchers selected the final papers. In the case of a disagreement, the third researcher made the final decision. The quality of the included studies was assessed using the Jadad scale.

The coping strategies-oriented interventions were classified into four main categories: psychological interventions, such as cognitive-behavioral therapy, mindfulness, coping therapy, self-management, and psychoeducation; spiritual-religious interventions; social interventions, such as family therapy; and complementary interventions, such as acupuncture. Most interventions improved the coping skills of the studied women. Based on the Jadad scale, only two studies had good quality.

Considering that most interventions improved the coping skills of breast cancer women, it is suggested that healthcare providers be proficient in examination techniques that maximize the patient’s coping skills. However, there remains a need for further culture-based research to adopt the best interventions and make changes in policy.

The rapid growth of psychiatric disorders requires psychiatric consultations to be provided on a greater scale, particularly for hospitalized patients.

The aim of this study was to evaluate the extent of psychiatric consultation requests in general hospitals and to identify potential gaps in the literature.

This scoping review was based on relevant research published in Web of Science, Scopus, PubMed, Embase, and Cochrane (1977- Dec 2019). The collected literature was closely examined prior to selecting the applicable studies by means of peer review. Data were summarized within a framework of themes comprised of psychiatric consultation, prevalence of psychiatric disorders, hospital departments, diagnosis of psychiatric disorders, and nature of research prior to theoretical classification and tabulation.

Ultimately, 22 studies were included in this scoping review. Requests for psychiatric consultations were highest in Austria and Italy, with 22.6% and 13.6% of cases, respectively. The majority of requests were from internal and surgical departments. Consultations were requested more frequently for female patients compared to male patients. mood disorders and substance use disorder were the most diagnostic reports.

Taking into consideration the prevalence of psychiatric disorders in patients suffering from physical illnesses, the referral rate results were considerably low. Although the frequency of psychiatric consultation reports vary widely between countries. As we limited the review to articles written in English, this may be due to selection bias. In this review, we identified that methodological differences and the use of different diagnostic criteria are major gaps that limit a definitive statistical comparison between studies.

Body image shame considerably contributes to the development and persistence of eating and body image disorders.

The current study was done to determine the psychometric properties of the body image shame scale and introduce a suitable measure for researchers and therapists in the field of psychological health.

In this study, 409 (136 men and 273 females) individuals who referred to cosmetic surgery clinics in Tehran were chosen. The construct validity of the body image shame was assessed using confirmatory factor analysis and divergent and convergent validity. To assess the divergent and convergent validity of the body compassion scale, appearance anxiety inventory, dysmorphic concern questionnaire and Forms of Self-Criticizing/Attacking and Self-Reassuring Scale were used. Internal Consistency and testretest reliability (4 weeks’ interval) were used to evaluate reliability. LISREL V8.80 and SSPS V20 were used for data analysis.

The results of confirmatory factor analysis showed that the two-factor model (internal and external body image shame) fitted the data (RMSEA = 0.07, NFI = 0.94, CFI = 0.92). Body image shame scale had a positive, significant correlation with dysmorphic concern, appearance anxiety, and self-criticism, and a negative, significant correlation with body compassion (P < 0.05). Also, Cronbach’s alpha coefficient, for the whole of scale, internal body image shame, and external body image shame were 0.85, 0.79, and 0.82, respectively.

Psychometric properties of the persian version of the body image shame scale were confirmed in this study. Therefore, it can be used as a valid instrument in research and clinical works in populations with concerns about body image.

Although growing studies support features of co-rumination as a vulnerability factor in internalizing symptoms and positive factor in friendship, little attention has been paid to the psychometric properties of the Co-Rumination Questionnaire (CRQ).

This study aimed to determine the psychometric properties of the Persian version of this questionnaire.

This research is a descriptive-exploratory study and 550 high school students who were selected by random cluster sampling from schools in Tehran. They completed CRQ, Beck depression inventory-II (BDI-II), and ruminative response scale (RRS) from winter 2014 to summer 2015. Construct validity, internal consistency reliability, and factor structure were investigated.

The factor analysis identified two interpretable factors with the eigenvalue higher than 2. The results from concurrent validity measurement in the current study showed that co-rumination has a positive correlation with depression signs (P < 0.01) and rumination response style (P < 0.01). The CRQ validity was determined using the half-split method employing Spearman-Brown (0.82) and Guttman correlation test (0.81) and internal consistency (0.90). According to these values, this questionnaire has acceptable internal consistency reliability.

The Persian version of CRQ has reliability and validity for assessing co-rumination among adolescent participants. This study provides primary evidence on the applicability of the Persian version of the CRQ in the Iranian population.

Chronic renal disease is a worldwide concern. The number of patients on hemodialysis increases every year. These patients have several physiological and psychological problems like sexual dysfunction that can affect their mental health and treatment course.

This study first aimed to assess the prevalence of sexual dysfunction in end-stage renal disease (ESRD) patients on hemodialysis compared to healthy people. Then, it evaluated factors associated with sexual dysfunction in both groups.

This cross-sectional study recruited a total of 142 participants in two groups selected by a convenience sampling method. Group one included 71 ESRD patients from two hemodialysis centers in Zahedan, Southeast of Iran, recruited between September 2018 and September 2019. Group two included 71 healthy individuals matched for age, weight, and educational status. The two groups were assessed based on psychiatric interviews, the International Index of Erectile Function (IIEF), and the index of female sexual function (IFSF). The SPSS 24 software was used for data analysis. The bivariate Pearson correlation test, Cramer V, and independent-t-test were used to analyze the data.

All female patients and 90% of healthy females had various levels of sexual dysfunction, and there was no significant difference between them (P = 0.21). However, 84.6% of male patients and 33.3% of healthy males had various levels of sexual dysfunction and there was a significant difference between the two groups (P < 0.001). The duration of hemodialysis was not correlated with sexual dysfunction. Age, weight, educational status, and marriage duration showed the most correlations with sexual dysfunction, especially in females.

As the findings showed, sexual dysfunction had a high prevalence among hemodialysis patients. As many of these patients must be on hemodialysis for long periods, we need to pay attention to sexual dysfunction when assessing and planning for their treatment.

The Body Image Acceptance and Action Questionnaire (BI-AAQ) assesses cognitive flexibility and acceptance of body image.

This study was done to assess the validity and reliability of the Persian version of BI-AAQ, as an instrument to measure body image flexibility, in patients with somatic symptom and related disorders.

This descriptive psychometric study was done in 2017 on 357 patients with somatic symptom and related disorders selected through a convenient sampling method from Kashan University of Medical Sciences clinics. They responded to the BI-AAQ, Depression, Anxiety, and Stress Scale (DASS), Acceptance and Action Questionnaire-II (AAQ-II), and Freiburg Mindfulness Inventory (FMI). The reliability of the BI-AAQ was calculated using Cronbach’s alpha coefficient. To assess its validity, the exploratory and confirmatory factor analyses were used. The gathered data were analyzed via SPSS-22 and Amos-22 software.

This version retained a one-factor structure, similar to the original version of the questionnaire, which explained 42.55% of the variance. It had high internal consistency (0.84), split-half method (0.77), and correlates with AAQ (0.45), mindfulness (0.39) and correlates contrastingly with stress (0.11), anxiety (0.36) and depression (0.43).

According to the results of the current research, the BI-AAQ is a reliable instrument with valid psychometric properties to measure the body image acceptance of individuals in Iranian patients with somatic symptom and related disorders.

Immigration can be accompanied by many psychological outcomes for emigrant families.

The present study aimed to compare family drawing test indices and behavioral problems among Iranian and Afghan emigrant children.

The research design was a comparative and cross-sectional study. We included 550 Iranian and Afghan students aged 7 - 11 years in Isfahan Province from April to June 2017. Achenbach Behavioral Problem questionnaire (2001) was sent to their mothers for filling, and Drawing Family Test was conducted. After reducing the number of dropout students, the final sample reached 282 students (including 174 Iranian students and 108 Afghan immigrants)., SPSS-23 software and chi-square tests as well as multivariate analysis of variance were used for analyzing data.

The results of the chi-square test showed that there was a significant difference in some of the drawing indices, including size, rhythm, location of drawing, valuation, removal of person, and distances between two groups of Iranian students and Afghan migrants (P < 0.05). Also, the results of multivariate analysis of variance indicated that there was a significant difference among mean scores of behavioral problems and dimensions of somatization, thinking problems and anti-social problems in the two groups (P < 0.05). There was no significant difference in other variables.

According to the results, the children of the Afghan refugee group have more both behavioral problems and drawing indices than the Iranian group.

The breakup of a romantic relationship imposes considerable grief to individuals and is actually a psychological and psychiatric challenge. The current study is a clinical trial of a pharmacologic agent reducing post-relationship grief. 90 female patients with the mean age of 29.55 ± 4.65 years were divided into two groups as an intervention group (n = 45) and the control group (n = 45). All patients were experiencing a diagnosed depression due to a romantic breakup during the last six months. The control group received a standard pharmacotherapy for depression, which was 50 mg sertraline daily. The intervention group received an additional 0.05 mg Clonidine daily. The treatment was continued for 8 weeks, and the visual analog scale evaluated the subjective report of the patients for grief and intensity of love. Comparison of pre-treatment and post-treatment grief and intensity of love were analyzed using ANOVA. Clonidine induced a significant decrease in the post-breakup grief with no significant change in the intensity of love. This pharmacotherapy is suggested for better management of romantic breakup.

Pregnancy and childbirth are natural phenomena in a women’s life, associated with stress and anxiety, leading to adverse effects in the mother and fetus. Using complementary medicine, such as aromatherapy, music, light radiation, and aquariums in an environment that engage a person’s multiple senses can make mothers relax through mental deviations.

The aim of this study was to evaluate the effects of a Snoezelen room on fear, anxiety, and satisfaction of childbirth’s nulliparous women.

This randomized clinical trial was carried out on 130 eligible women in a selected hospital affiliated to the Iran University of Medical Sciences in Tehran. One hundred thirty women were randomly assigned to the intervention (n = 65) and control (n = 65) groups using six modes blocks using the convenient sampling method. The delivery room was designed to distract women’s minds in the intervention group. Data were collected using a demographic characteristics form, Harman’s Childbirth Attitude questionnaire (CAQ), Visual Analogue scale (VAS) to measure childbirth anxiety, and the Mackey Childbirth Satisfaction Rating scale. Data were analyzed by SPSS version 16 using independent t-test, repeated measures analysis of variance, and Bonferroni and chi-square tests.

The results showed a significant reduction in fear in the active phase and postpartum in the intervention group compared with the control group (P < 0.001 and P < 0.001, respectively). Anxiety showed a significant difference and was lower at dilatation of 6 to 7 and 7 to 8 cm, and after childbirth in the interventional group. The satisfaction of childbirth significantly increased in the interventional group (P < 0.001).

These results confirmed the importance of a Snoezelen room in the childbirth of nulliparous women, which can promote vaginal childbirth.

In many societies, transgender is a marginal minority that experience deprivation and isolation in cultural discourse, and find many social and psychological problems.

The present inquiry aims is to study transgender’s interactive- mental experiences.

A qualitative method is used to study the lived experiences of transgender. Twenty five transgender in the cities of Yazd, Mashhad, and Tehran were selected through snowball sampling for an in-depth interview. The transcripts of interviews were analyzed through theoretical coding.

The analysis of interviews showed mental distress as the main phenomenon of transgenders. The results indicated that transgender’s life experiences consisted of gender-mental dimensions (duality of gender self-concept, duality of gender presentation and dual gender performance) and gender-interaction dimension (family, friends, school interaction, and lack of social opportunities). Transgender’s strategies in such situations are often removing sex organs, anonymity, and isolation. Other consequences include sexual abuse, drug addiction, and suicide.

In the current research, the constructed meanings of these people suggest that transgender is experiencing complex, insecure, and difficult life world. So educating the families, society, and media can play an effective role in reducing and managing their problems.

As one of the most enjoyable life experiences, pregnancy may be accompanied by many physiological and psychological changes that make women susceptible to developing mental disorders such as anxiety. Non-pharmacological methods such as writing therapy are among the ways to deal with anxiety.

The present study aimed to determine the effect of writing therapy on anxiety in women during pregnancy.

This randomized controlled trial was conducted on 70 pregnant women with a gestational age between 28 - 31 weeks. The participants were assigned to an intervention group and a control group using a randomized block design. The intervention group received three in-person writing therapy-based counseling sessions and two telephone calls between the sessions, while the control group received routine pregnancy care. The Beck anxiety inventory was completed before and six weeks after the intervention. Independent t-test and ANCOVA were used for data analysis.

There was no significant difference between the two groups in terms of socio-demographic variables and baseline anxiety scores. Based on ANCOVA with baseline score adjustment, the mean score of anxiety was significantly lower in the intervention group than in the control group after the intervention (adjusted mean difference = -6.8; 95%CI = -4.5 to -9.1; P < 0.001).

According to the results, writing therapy can reduce anxiety in pregnant women; however, further studies are needed before a definitive conclusion. 

Community Mental Health centers (CMHCs) have been successful in the on-time diagnosis and treatment of psychiatric disorders worldwide.

The study aimed to evaluate the efficiency of the Community Mental Health Center (CMHC) affiliated with Shahid Beheshti University of Medical Sciences in the on-time diagnosis and treatment of psychiatric patients who go to the general physicians. Evidence suggests that such a diagnosis and treatment can help reduce the burden of disease on society.

This descriptive cross-sectional study was conducted from January 2014 to September 2016. Fourteen general physicians and case managers in the catchment area of CMHC cooperated with the study. General physicians began to diagnose and treat psychiatric disorders based on therapeutic guides. The descriptive statistics were used for data analysis.

One thousand and four hundred and eighty seven patients were diagnosed by the general practitioners, 730 (49.09%) of whom suffered from depression, and 544 (36.58%) suffered from anxiety. As the physicians reported, 15/74% of the total number of visits was related to psychiatric disorders. Based on the telephone follow-ups, 94/34% of the patients reported improvement. Untreated patients were followed up or taken to a psychiatrist.

This study demonstrates the importance of on-time diagnosis of psychiatric patients and the provision of specialized services that can decrease the load of prevalent psychiatric disorders if continued.

Mental health status of the parents and children are associated.

The aim of the present study was to compare the psychopathology of parents of children with epilepsy with healthy children in an Iranian sample.

A total of 288 parents of children with epilepsy attending the Pediatric Neurology Clinic of Tabriz University of Medical Sciences, Northwest of Iran, were matched with 154 parents of normal children and evaluated using the Millon Clinical Multiaxial Inventory-III.

Parents of children with epilepsy scored higher in all subscales, except for dependent personality pattern. Mothers of children with epilepsy scored higher in all clinical syndrome scales. The same pattern was observed for fathers of the children with epilepsy.

A high rate of psychiatric disorders was observed in Iranian parents of children with epilepsy. This pattern was not limited to mothers but was applicable to fathers, as well.

The structured clinical interview for DSM-5 has recently been revised to reflect the new findings in the diagnostic criteria of psychological disorders.

The present study aimed to evaluate the reliability and validity of the Persian translation of structured clinical interview for diagnostic and statistical manual of mental disorders-fifth edition (DSM-5)-research version (SCID-5-RV) on Iranian adult population.

In the current diagnostic accuracy study a total of 305 clinical samples were admitted to fifteen adult clinical settings and a subsample of these participants (n = 50, with a mean age of 34.31 and a standard deviation of 11.96) was recruited to evaluate test-retest reliability, and 40 non-clinical participants were recruited to examine construct validity. All participants completed the Millon Clinical Multiaxial inventory-III (MCMI-III) and Brief Symptom inventory (BSI).

SCID psychometric properties indicated an acceptable range for internal consistency (0.95 - 0.99), test-retest reliability (0.60 - 0.79), and Kappa reliability (0.57 - 0.72). Further, the agreement between interviewer and psychiatrist diagnoses was assessed using the Kappa index, and the result was satisfactory. The current diagnostic accuracy study used sensitivity and specificity indexes to assess the diagnostic validity of SCID by positive predictive value and also negative predictive value under the “likelihood ratio” domain. Specificity values for most psychiatric disorders were high; the sensitivity values were to somewhat lower. Furthermore, SCID-5-RV categorical diagnoses demonstrated an acceptable construct validity based on the significant differences between the clinical and non-clinical samples in all subscales of BSI except for phobia as well as all clinical subscales of MCMI-III.

In general, the Persian translation of SCID-5-RV represented acceptable reliability and validity for various categorical diagnoses in different clinical settings.

Emotional reactivity is a key construct for understanding psychopathology. Examining the psychometric properties of the instruments in societies with different cultures can help with their external validity.

The current study aimed at standardization and validation of the Perth emotional reactivity scale (PERS) in Iranian university students.

The Persian version of the PERS was produced through forward translation, reconciliation, and back-translation. A total of 302 (169 males and 133 females) nonclinical students were selected by convenience sampling method, and completed a set of questionnaires, including the PERS, weight efficacy lifestyle questionnaire-short form (WEL-SF), eating attitude test-16 (EAT-16), selfesteem scale (SES), difficulties in emotion regulation scale-16 (DERS-16), and self-compassion scale (SCS) short-form. The construct validity of the PERS was assessed using confirmatory factor analysis and divergent and convergent validity. Internal consistency and test-retest reliability (a 2-weeks interval) were used to evaluate the reliability. Data analysis was performed using LISREL (version 8.8) and SSPS (version 22) software.

All PERS scales and subscales were found with good internal consistency and test-retest reliability in a nonclinical population. The convergent validity and divergent validity were also found good. The results of this study provides the support for the applicability of the six-factor (RMSEA = 0.06, NFI = 0.94, NNFI = 0.96, and CFI = 0.97) and two-factor (RMSEA = 0.07, NFI = 0.94, NNFI = 0.96, and CFI = 0.96) models of the PERS.

The PERS showed good validity and reliability and can be useful in assessing emotional reactivity in the Iranian population. The PERS can be promising as a measure to use in emotional-based studies and clinical settings.

Job stress, which undermines productivity and physical and mental health, has been reported to be high among military personnel.

The present study aimed to explore the role of character strengths, emotions, and resilience in predicting job stress in a sample of Iranian military personnel.

This cross-sectional study recruited a total number of 146 military personnel via convenience sampling and administered the Health and Safety Executive Stress Questionnaire, Conner-Davidson Resilience Scale, Values in Action Inventory of Strengths, and Positive and Negative Affect Schedule. The correlation analysis and stepwise linear regression were performed using SPSS22.

Job stress was negatively associated with resilience, positive emotions, and character strengths and positively associated with negative emotions (P < 0.001). Regression analysis revealed that three variables, including resilience, courage, and negative emotions could predict 57% of the variance in job stress (Adj. R2 = 0.57, P < 0.001).

Higher resilience and courage are associated with lower job stress. Also, negative emotions such as anger, guilt, and anxiety would contribute to higher job stress. Providing training courses to develop and boost resilience and courage and manage negative emotions can offset the negative effects of job stress on military personnel. Also, considering these factors as recruitment criteria would lead to the enlistment of cadets who may be more resilient to stress.

Concerns about body image among male adolescents has become increasingly prevalent, leading to a need for muscularity. It is well known that psychological factors play a role in the development of these concerns.

The aim of the current study was to predict the drive for muscularity based on psychological factors, including selfesteem, maladaptive perfectionism, and interpersonal sensitivity.

This cross-sectional study was conducted in 2019. Using a convenience sampling method, 150 adolescent male students from district 14 of Tehran, Iran, were selected to participate in the study. Data was collected by utilizing the following measures: drive for Muscularity scale, Rosenberg Self-Esteem scale, Almost Perfect scale-revised, and Interpersonal Sensitivity measure. Data were analyzed using the Pearson correlation coefficient and the Enter Regression method.

High scores in the Drive forMuscularity scale were significantly associated with higher levels of maladaptive perfectionism, interpersonal sensitivity, and lower levels of self-esteem. Moreover, the results of the multiple regression analysis revealed that predivariables could explain 52% in the variance of the drive for muscularity.

Findings indicated that the psychological factors investigated in this study were risk factors for masculinity among adolescents. We suggest that clinicians take these factors into account in order to make preventive and therapeutic programs more effective.

In recent years, suicide in Iran has become a growing concern. Although stressful life events (SLEs) are increasing as a global prevalence, suicide attempters (SAs) and the impact and association between suicide and SLEs are poorly understood.

This study aimed at examining the role and effect of SLEs in suicides and SAs.

This descriptive-analytical study was performed during 2014 to 2016 based on 186 records (through random quota sampling) of suicidal behaviors (SBs), including 154 SAs and 32 suicide cases in Malekan County, East Azerbaijan, Iran. A valid semistructured Life Event questionnaire (LEQ) with 43-items of common types of SLEs in the last year before SBs was used by trained interviewers through single sitting and face to face interviews. The point-biserial correlation and multiple logistic regression analysis were utilized to estimate the adjusted odds ratios and confidence intervals for suicide risk.

A significant correlation was found between SLEs scores and suicide (R = 0.739). Comparing SLEs types between the two groups of SAs and suicides, it was revealed that the highest odds ratios were related to financial problems (OR = 11.9; 95% CI = 4.00 - 35.85), early marriage (OR = 4.97; 95% CI = 1.68 - 14.65), exposure to new conditions (OR = 8.79; 95% CI = 1.3 - 59.22), and family conflicts (OR = 2.53; 95% CI = 1.23 - 6.53), respectively.

SLEs are most strongly associated with committing suicide. Suicide determinants are different from SA. SLEs management by health systems is imperative to improve life skills in suicide prevention.

Substance use disorders (SUD) are serious social problems that cause physiological and psychological disorders. Adolescents and youth are known as high-risk groups for SUD.

The present study aimed to investigate the pattern, prevalence, incidence, and etiology of SUD among all students studying at the Ilam University of Medical Sciences, Ilam (Iran), during the academic year 2018 - 2019.

In a cross-sectional study, a multistage random sampling method was used to select the participants. A self-administered questionnaire was used to collect data. This questionnaire was designed to collect information about the participant’s demographic data, social data, medical and behavioral data. Data were analyzed using descriptive and inferential statistics in SPSS 16 software.

Participants’ ages mean ± SD was 23.5 ± 3.2 years old. The incidence of substance abuse was higher among men compared to women. The main observed pattern of SUD was Marijuana among consumers. The curiosity and increased memory had the highest and lowest incidence, respectively.

The incidence of SUD is high among Iranian students, and most of them have begun SUD in adolescence and because of curiosity. It is necessary to augment adolescents’ and young people’s awareness of the SUD and addiction consequences.