فهرست مطالب

Psychiatry and Behavioral Sciences - Volume:16 Issue: 1, Mar 2022
  • Volume:16 Issue: 1, Mar 2022
  • تاریخ انتشار: 1400/12/02
  • تعداد عناوین: 25
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  • Sepideh Soltanmohammadlou, Abbas Ramezani Farani, *, Samira Masoumian, Hooman Yaghmaie Zadeh, Babak Beigverdi Page 1
    Background

    Scrupulosity or religious obsession is a form of obsessive-compulsive disorder (OCD) and is recognized to be treatment-resistant. One of the most common treatments for treatment-resistant disorders is schema therapy.

    Objectives

    This study aimed to compare the early maladaptive schemas and schema modes of individuals with high and low scores in scrupulosity, as well as religious people with no disorder.

    Methods

    The population of this cross-sectional study consisted of all patients with OCD referred to Iran Psychiatric Hospital and the Clinic of Behavioral Sciences and Mental Health in Tehran, Iran, in 2019. The sample included 75 individuals with high score in scrupulosity, 75 individuals with low score in scrupulosity, and 75 religious people with no disorder. At first, all participants were evaluated with the structured clinical interview for DSM-5 disorders-clinical version (SCID-5-CV). Then, they completed the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS), Penn Inventory of Scrupulosity (PIOS), Young Schema Questionnaire-Short Form (YSQ-SF), and Schema Mode Inventory (SMI). Data were analyzed using the one-way analysis of variance (ANOVA) and Kruskal-Wallis test.

    Results

    Individuals with high scores in scrupulosity were significantly different from normal religious people in the "disconnection and rejection" and "impaired autonomy and performance" schema domains. However, there was no significant difference between individuals with high scores in scrupulosity and those with a low score in any of the schema domains. Also, individuals with a high score in scrupulosity scored higher in almost all schema modes compared to normal religious people. Finally, the "punitive and demanding parent modes" of individuals with a high score in scrupulosity was significantly different from that of individuals with a low score.

    Conclusions

    According to our results, it is essential to focus on "disconnection and rejection" and "impaired autonomy and performance" schema domains, as well as child and parent modes, especially the dysfunctional parent mode, to treat individuals with a high scrupulosity score. Due to limited literature, further research is needed to confirm our results.

    Keywords: Scrupulosity, Schema Modes, Religious, Obsessive Compulsive Disorder, Early Maladaptive Schemas
  • Ali Kheradmand, Anita Hosseini *, Abdollah Farhadinasab Page 2
    Background

    Aggressive behavior of patients in psychiatric wards is one of the main challenges faced by healthcare workers. Despite the abundance of research on the frequency of aggressive behavior, not enough attention has been paid to its severity. Furthermore, limited studies have evaluated the restraint methods used to manage aggressive behaviors.

    Objectives

    The current descriptive study aimed to compare the relationship between demographic characteristics, diagnosis of psychiatric illness, medical illness, and hospitalization characteristics with features of aggressive behavior in patients experiencing different types of restraint during hospitalization.

    Methods

    We evaluated subjects admitted to the adult psychiatric wards of Imam Hossein and Taleghani hospitals in Tehran, Iran, in 2018. The patients were controlled by various restraint methods during hospitalization. All the patients were evaluated for the severity of aggression, which was determined utilizing the Persian version of the Modified Overt Aggression Scale (MOAS). All the data along with demographic and clinical characteristics obtained from medical records were analyzed using the Mann-Whitney and Kruskal-Wallis nonparametric test (P-value = 0.05) and Spearman correlation coefficient to describe the factors affecting the aggressive behavior of patients.

    Results

    In this study, the prevalence of aggressive behavior was 11.7%. Among the demographic variables, gender (P-value = 0.003), education level (P-value = 0.05), and the history of aggressive behavior (P-value = 0.001) were significantly associated with the MOAS. Furthermore, as the hospitalization duration increased, the frequency of aggressive behavior decreased, and its severity intensified. Moreover, there was a significant relationship between aggression severity with admission type (P-value = 0.00), concurrent medical illness (P-value = 0.026), and substance abuse (P-value = 0.025).

    Conclusions

    Variables affecting aggressive behavior, such as male gender, involuntary admission, and a history of aggression, might aid in the early detection of patients who may exhibit more severe aggressive behavior.

    Keywords: Psychiatry Violence, Physical Restraint, Aggression
  • Elham Zare, Maryam Ghaffari, Fatemeh Nahidi *, Maliheh Nasiri, Abbas Masjedi Page 3
    Background

    Attachment between mother and fetus plays an important role in maternal identity, birth outcomes, growth, and development of a newborn. In addition, domestic violence, especially in pregnancy, has been regarded as a health priority in many societies.

    Objectives

    The study aimed to assess the relationship between domestic violence in pregnancy and maternal fetus attachment.

    Methods

    This descriptive correlational study was conducted on 200 pregnant mothers visiting the selected Healthcare Centers of Mashhad. The questionnaires were demographic information, Straus Violence Questionnaire and Cranley’s Mother-Fetus Attachment Questionnaire. Data were analyzed using descriptive and correlation coefficient and linear regression tests as well as SPSS v.21 software.

    Results

    Here, 54% of members had experienced domestic violence. In general, there was a reversed and significant correlation between all aspects of domestic violence and mother-fetus attachment. Moreover, 89% of research centers reported fetal attachment as good, 10% as average, and 1% as weak. Based on the linear regression test, physical violence was able to predict the variance of maternal attachment score of 4.14% in mothers.

    Conclusions

    As a result of this article, regarding lower maternal-fetal attachment in violated women in pregnancy, much more sensitive screening should be considered for domestic violence so that adverse outcomes are prohibited.

    Keywords: Violence in Pregnancy, Maternal Fetus Attachment, Domestic Violence
  • Hoshang Amirian, Nasrin Jaberghaderi *, MohammadReza Mohammadi, Ali Khaleghi, Zahra Hooshyari, Leila Almasi, Sahar Moradi, Samad Khoramnia, Mohsen Mohammadpour, Sahar Pouyanfard Page 4
    Background

    This study is part of the national survey of the epidemiology of psychiatric disorders in Iranian children and adolescents (IRCAP), aiming to survey the prevalence of child and adolescent psychiatric disorders in Kermanshah and its outskirts.

    Objectives

    This study aimed to assess the child and adolescent mental health status in the Kermanshah Province of Iran.

    Methods

    A representative randomized sample of 993 urban and rural children aged 6 to 18 (349 aged 6 - 9 years, 333 aged 10 - 14 years, and 311 aged 15 - 18 years) participated in a cross-sectional study to be screened for psychiatric disorders using the Persian version of K-SADS-PL. In addition, a demographic questionnaire was completed by the participant's parents.

    Results

    According to DSM-IV, out of 993 participants, 114 (11.5%) had at least a kind of childhood psychiatric disorder. The highest rate of psychiatric disorders was in 10 to 14-year-old children (n = 43; 12.9%; 95% CI = 9.7 - 16.9). The most common psychiatric disorders were anxiety disorders (n = 65; 6.5%; 95% CI = 5.2 - 8.3), followed by behavioral disorders (n = 30; 3%; 95% CI = 2.1 - 4.3), neurodevelopmental disorders (n = 22; 2.2%; 95% CI = 1.1 - 2.7), and depressive disorders (n = 17; 1.7%; 95% CI = 1.1 - 2.7).

    Conclusions

    Compared to other pediatric diseases, the psychiatric disorder's prevalence is pretty high among the youths of Kermanshah Province. Therefore, child and adolescent mental health should be a priority for the youth healthcare system in Kermanshah.

    Keywords: Psychiatric Disorders, Mental Health, Kermanshah, Epidemiology, Adolescents Children
  • Seyed Hamzeh Hosseini, Forouzan Elyasi, Mahmood Moosazadeh, Ideh Ghafour * Page 5
    Backgrounds

    The COVID-19 epidemic has affected people's mental health around the world. According to previous epidemics, an increase in post-traumatic stress disorder (PTSD) has been seen until one year later.

    Objectives

    Due to the importance of psychological issues secondary to COVID-19, in this study, the frequency of PTSD symptoms in the follow-up of patients with COVID-19 who were hospitalized in Sari was evaluated.

    Methods

    In this cross-sectional study, 199 patients diagnosed with COVID-19 who were hospitalized in Sari were identified, and patients’ records were recorded. PTSD criteria were assessed based on the PTSD Checklist for DSM 5 (PCL-5). Data were analyzed using SPSS 16.

    Results

    In the present study, the overall prevalence of PTSD was 19.1% (38 patients). The frequency of PTSD was higher in women, married people, people with children, and those aged 20-44 years. The prevalence of PTSD was higher in 29 patients (38.2%) with higher education.

    Conclusions

    This study showed that PTSD has a high prevalence in people with a history of COVID-19, and it is necessary for these patients to undergo psychiatric evaluations.

    Keywords: Psychiatric Complications, Post-traumatic Stress Disorder, COVID-19
  • Fatemeh Jafari, Maryam Mobini, Siavash Moradi, Saeed Dashti Dargahloo, Ideh Ghafour, Forouzan Elyasi * Page 6
    Background

    Fibromyalgia syndrome (FMS) is a chronic musculoskeletal condition, which can reduce the quality of life (QoL).

    Objectives

    This study aimed to evaluate the impact of FMS on health-related quality of life (HRQoL) and the possible related factors such as sociodemographic and psychological variables.

    Methods

    In this cross-sectional study, 150 women patients with FMS were included who visited a psychosomatic clinic at a referral center in northern Iran. The samples were selected in a consecutive procedure from April 2019 to March 2019. Sociodemographic variables, HRQoL score [36-Item Short Form (SF-36) Health Survey], and the Pittsburgh Sleep Quality Index (PSQI) were recorded. Data were analyzed using the SPSS Statistics software (ver. 24). The quantitative data were reported as mean ± SD, and the qualitative variables were presented as frequency and percentage. Also, analysis was performed using analytical tests such as chi-square test (χ2). P < 0.05 was considered to be significant.

    Results

    The mean (SD) age was 42.35 (11.73) years. The mean physical and mental health scores were 33.45 (16.22) and 48.99 (18.19), respectively. Moreover, 88% of patients had moderate-to-severe sleep disorder, and those who did not, had a better physical and mental health status [42.7 (14.1) vs. 32.2 (16.1), P-value = 0.009 and 62.2 (16.3) vs. 47.2 (17.7), P-value = 0.001, respectively]. History of depression according to self-reporting was associated with worse mental health subscale scores [44.4 (16.8 Vs. 52.4 (18.5), P-value = 0.007], and lower scores in social functioning and emotional well-being (P-value = 0.012, P-value = 0.001, respectively). Being postmenopausal was associated with a lower physical health quality (P-value = 0.049). Body Mass Index (BMI) reversely correlated with HRQoL subscales (r = -0.163, P-value = 0.046), but the subscales were not affected by the level of income (P-value = 0.644, P-value = 0.170, respectively).

    Conclusions

    Patients with fibromyalgia report a considerable significant impact on their quality of life and impaired sleep quality. Assessment of sleep quality and QoL are needed in patients with fibromyalgia.

    Keywords: Sleep Disorders, Health-Related Quality of Life, Fibromyalgia, Depression
  • Marjan Hajfiroozabadi, Jamileh Mohtashami *, Foroozan Atashzadeh Shoorideh Page 7
    Background

    Borderline personality disorder (BPD) is associated with a high risk of suicide. Limited information is available on the individual factors underlying suicidal behaviors, especially suicide attempts (SAs), in Iranian patients with BPD.

    Objectives

    This study aimed to analyze the individual factors underlying suicidal behaviors in patients with BPD.

    Methods

    This was a qualitative descriptive study that was conducted from May 2020 to February 2021 in Tehran and Karaj, Iran, on 23 participants, including 14 patients with BPD and seven mental health professionals, as well as two members of their families. The research environment included psychiatric inpatient wards, psychiatric emergencies, and psychiatric clinics. Participants were selected through purposive sampling. Data were collected using semi-structured interviews and were analyzed using conventional content analysis.

    Results

    Data analysis revealed five main themes and 15 sub-themes related to the individual factors underlying the identification and prediction of the risk for suicidal behaviors and SAs. The extracted themes included “psychological pain and loneliness”, “defects in the distinction and integration of emotions”, “unconventional behavior and emotion”, “pervasive incompatibility”, and “breakdown of the self-integrity”.

    Conclusions

    The BPD is a complex and challenging disorder in which patients with BPD usually tend to engage in suicidal behaviors, and with the emergence of individual factors underlying the occurrence of such behaviors, appropriate preventive measures and interventions can be taken to reduce suicide-related behaviors such as suicidal thoughts and planning, as well as SAs.

    Keywords: Suicide, Self-Injurious Behavior, Suicidal Behavior, Qualitative Research, Individual Factors, Borderline Personality Disorder
  • Maryam Khoshkhui, Maedeh Kamrani, Maryam Emadzadeh, Zahra Jafari, Farhad Faridhosseini * Page 8
    Background

    Considering the psychobiological aspects of various dermatological diseases and the role of personality traits in the development of chronic skin diseases such as chronic urticaria, the present study aimed to assess the personality traits of patients with chronic spontaneous urticaria (CSU) compared to healthy individuals.

    Methods

    In this cross-sectional study during 2016 - 2018, all patients with CSU who referred to Immunology and Allergy Clinic of Ghaem hospital, the Center of reference and excellence in urticaria (UCARE), considered as research community; 100 patients with CSU were selected using the convenience sampling method. Moreover, 100 healthy participants were selected as the control group. Research instruments were Temperament and Character Inventory (TCI) and a demographic checklist. Data were analyzed using descriptive statistics, t-test, and chi-square test using SPSS Software version 23.

    Results

    The patients had higher scores in novelty-seeking (P = 0.041) and harm avoidance (P = 0.015), while the healthy individuals had higher scores in self-directedness (P = 0.003) and cooperativeness (P = 0.001). Moreover, male patients had higher scores in novelty-seeking (P = 0.006) and reward dependence (P = 0.013); however, female patients had higher scores in self-transcendence (P = 0.001) and cooperativeness (P = 0.019). Furthermore, there was a correlation between the disease duration of with reward dependence, self-directedness, and self-transcendence.

    Conclusions

    Personality traits seem to be associated with CSU. In this regard, patients with CSU had higher scores in novelty-seeking and harm avoidance and lower scores in self-directedness and cooperativeness than healthy individuals.

    Keywords: Trait, Temperament, Personality, Chronic Spontaneous Urticaria (CSU)
  • Elieh Abasi, Narjes Sadat Borghei, Maryam Farjamfar, Shahrbanoo Goli, Afsaneh Keramat * Page 9
    Background

    The involvement of husbands during pregnancy within the Iranian culture is one of the challenging topics. In this context, efforts to encourage male involvement in the maternal health issues can strengthen family bonds and consequently improve the relationships between men and women in societies.

    Objectives

    This qualitative study aimed to elucidate the involvement of husbands in maternal-fetal attachment (MFA).

    Methods

    Using a qualitative approach and conventional content analysis, 11 pregnant women referring to the health care centers in Sari, Iran were interviewed from March 2020 to February 2021. The participants met the maximum diversity criteria in terms of age, level of education, occupation, and socioeconomic status. Deep and unstructured interviews were utilized to obtain the research data. All the interviews were then transcribed verbatim and analyzed using the qualitative content analysis method developed by Graneheim and Lundman in MAXQDA Software.

    Results

    A total of 350 codes emerged from the data. We identified a main theme entitled ‘husband support’, which included four categories and 11 sub-categories. The main categories were: (1) empathic response, (2) emotional support, (3) continued support, and (4) attention to fetus.

    Conclusions

    Interventions to enhance husband support could increase MFA. Planning to promote male participation in pregnancy process is essential to promote maternal and child health.

    Keywords: Qualitative Research, Involvement, Husbands, Attachment
  • Mohsen Karimi, Fatemeh Narenji Thani, Zahra Naqhsh *, Tahereh Ghazaghi Page 10
    Background

    Multiple sclerosis (MS) is a chronic, common, and progressive disease of the nervous system, and the affected individuals suffer from its complications throughout their lives and experience different physical and emotional disorders.

    Objectives

    The present study aimed to compare the effectiveness of acceptance and commitment therapy (ACT) and cognitive-behavioral ‎therapy (CBT) in enhancing resiliency and quality of life among MS patients.

    Methods

    This randomized clinical trial was carried out on 30 MS patients referred to the Department of Neurology in Baqiyatallah Hospital (Tehran, Iran) during February 19 to September 1, 2017. The patients were randomly assigned to three groups: (1) ACT (n = 10, 8 sessions, 90-minute weekly‎ sessions), (2) CBT (n = 10, 10 sessions, 90-minute weekly‎ sessions), and (3) control group (n = 10, no sessions). The resilience and quality of life were measured in pre-test and post-test phases and 1.5 months after treatment using the Connor-Davidson Resilience and Multiple Sclerosis Impact Scales, respectively. Repeated measurement ANOVA and SPSS Software (version 24) were used in this study to analyze the collected data.

    Results

    The study sample consisted of 30 MS patients (mean age = 31.7 ± 5.7, 60% female and 57% married). The three groups were homogeneous in terms of demographic and baseline variables. The results demonstrated that both ACT and CBT had the same effectiveness in increasing resiliency (mean difference in CBT = 0.9 vs ACT = 0.8 (P = 0.882); CBT = 0.9 vs. Control = -1.4 (P = 0.004); ACT = 0.8 vs. Control = -1.4 (P = 0.0041)) and quality of life (mean difference in CBT = 2.9 vs ACT = 3.1 (P = 0.051); CBT = 2.9 vs. Control = 0.6 (P = 0.002); ACT = 3.1 vs. Control = 0.6 (P = 0.014)) among the MS patients so that the participants’ post-test and follow-up scores increased significantly compared to the pretest scores.

    Conclusions

    The present study results indicate that ACT and CBT can equally enhance resiliency and quality of life among MS patients.

    Keywords: Quality of Life, Psychological Resilience, Multiple Sclerosis, Cognitive-Behavioral ‎Therapy, Acceptance, Commitment Therapy
  • Sareh Keshvardoost, Elaheh Shafiei, Sadrieh Hajesmaeel Gohari, *, Mostafa Hosseini Golkar, Kambiz Bahaadinbeigy Page 11

    Context: Schizophrenia is one of the most severe mental disorders that affect all aspects of a patient's lives. Telemedicine can be helpful for this population.

    Objectives

    This study aimed to review the studies for investigating the applications and outcomes of telemedicine in providing healthcare services for patients with schizophrenia.

    Evidence Acquisition

    We searched PubMed and Scopus databases to find relevant studies in July 2020. The combination of two “Schizophrenia” AND “Telemedicine” keywords were used to search databases. Original observational and interventional studies, which have used a telemedicine service in schizophrenia disease, were included in this review.

    Results

    Of 309 gathered studies, 26 studies were entered into this research. The synchronous modality (58%) and videoconference communication (38.5%) were used in most studies. Most studies (84.5%) have shown that telemedicine was a beneficial method. More than half of the studies (58%) had therapeutic goals. The rest of the studies were for diagnostic (19%), educational (11.5%), and both therapeutic and educational (11.5%) purposes. Only one study (4%) showed that telemedicine was not cost-effective. In nine studies (34.5%), users were satisfied with the use of telemedicine services.

    Conclusions

    Telemedicine is a useful method for the management of patients with schizophrenia, especially to improve treatment adherence and prevent relapse. It would be better to pay more attention to the educational issues because of the positive impact on adherence to treatment and prevent relapse.

    Keywords: Telepsychiatry, Telemedicine, Schizophrenia, Review
  • Zabihollah Abbaspour *, Parisa Souri Laki, Gholamreza Rajabi Page 12
    Background

    Domestic violence, including child abuse, spousal abuse, elder abuse, and parent abuse, is a common issue in the modern world. Parent abuse is one of the phenomena that has been the focus of attention in recent decades due to its negative effects on the family system.

    Objectives

    This study aimed to investigate the predictors of parent abuse in boy students.

    Methods

    This present study was a correlational study. The statistical population was all second-grade boy high school students and their mothers in Kuhdasht-Iran in 2020. In this regard, 380 students were selected by multi-stage cluster sampling. Instruments were the parent abuse scale (boy version), child exposure to domestic violence (CEDV), parent marital conflict, parenting style inventory (PSI), Rosenberg Self-esteem Scale, and Samani Family Cohesion Questionnaire. The students and their mothers completed the instruments. The data were analyzed with Pearson correlation and regression.

    Results

    The findings showed that there was a positive and significant relationship between domestic violence, marital conflict, authoritarian and permissive parenting styles with parent abuse, and there was a significant negative relationship between family coherence, authoritative parenting style, and students' self-esteem with parent abuse. The results from stepwise regression showed that domestic violence, authoritative and permissive parenting styles, and self-esteem were the strongest predictors of parent abuse.

    Conclusions

    According to our findings, the negative interactions and the children’s exposure to violence within the family are basic triggers for the occurrence of mother abuse.

    Keywords: Self-esteem, Parenting Styles, Mother Abuse, Marital Conflict, Family Coherence, Domestic Violence
  • Zeinab Mohammadzadeh, Elham Maserat, Somayeh Davoodi * Page 13
    Context

    The demand for remote psychologist services increased during the COVID-19 outbreak due to the emergence of multiple mental health problems. Many countries have applied telemental health approaches to managing and treating mental disorders. This review study aimed to investigate the role of information technology, especially telemental health, in managing psychological problems during the COVID-19 pandemic.

    Evidence Acquisition

    This study was conducted in four phases: Identification, screening, eligibility, and inclusion. Keywords were selected from MeSH to search the principal medical databases. Finally, important information was extracted from nine selected papers, including the author names, study setting, purpose, technology, method, intervention, and results.

    Results

    Some studies provided telepsychiatry to people whose mental problems developed during COVID-19. Another study explained the telepsychological service for patients with mental illness before the epidemic. Most articles signified the influential role of telehealth in screening and reducing social contacts. Besides, this technology played a significant role in providing mental health services.

    Conclusions

    The study showed that telemental health and telepsychiatry approaches effectively promote the mental health and well-being of participants with various mental problems. In implementing these approaches, some items such as allocating sufficient funds, preparing appropriate infrastructure, providing training for users, defining suitable evaluation methods, and considering confidentiality and privacy need to be considered.

    Keywords: Telepsychiatry, Telemental Health, Telebehavioral, COVID-19
  • Zohreh Hashemi *, Sanaz Eyni, Matineh Ebadi Page 14
    Background

    The comorbidity of substance use, mood disorders, and anxiety has been proven in various studies, leading to many clinical implications.

    Objectives

    This study aimed to evaluate the effectiveness of acceptance and commitment therapy (ACT) in depression and anxiety in individuals with substance use disorder.

    Methods

    This quasi-experimental study utilized a pretest-posttest design with a control group. The statistical population consisted of all people with substance abuse in Urmia in 2019, including 220 subjects. The sample consisted of 50 individuals with substance use disorders selected by purposive sampling and randomly assigned to experimental and control groups. The experimental group was trained in eight sessions, each lasting 90 min, based on the ACT protocol by Hayes et al. (2004), while the control group did not receive any intervention. The data were obtained using the Beck Depression Inventory and Beck Anxiety Inventory. Pretest and posttest were performed in both groups. The collected data were analyzed by multivariate analysis of covariance (MANCOVA) using SPSS23 software.

    Results

    The results showed that after controlling for the pretest effects, a significant difference was observed between the mean posttest scores of the two groups in both depression and anxiety (P < 0.05).

    Conclusions

    Acceptance and commitment therapy is an appropriate strategy to effectively improve depression and anxiety in people with substance use disorder.

    Keywords: Substance Use Disorders, Depression, Anxiety, Acceptance Commitment Therapy
  • Mana Goodarzi, Mohammad Noori *, Maryam Aslzakerlighvan, Imaneh Abasi Page 15
    Background

    Body dysmorphic disorder (BDD) and social anxiety are two concepts related to body dissatisfaction. These concepts have been linked to sociocultural attitudes to appearances and painful experiences in interpersonal relationships.

    Objectives

    The present study examines the relationship between childhood traumas with social appearance anxiety (SAA) and BDD through the mediating role of sociocultural attitudes toward appearance (SATA).

    Methods

    This cross-sectional study was conducted on 415 university students in Tehran, Iran using the convenience sampling method in 2019 - 2020. Data were analyzed using SPSS version 24 and Amos version 21 software.

    Results

    According to our results, while childhood traumas were not directly related to BDD (β = 0.059; SE = 0.31), SAA seemed to play a statistically significant mediating role (β = 0.17; SE = 0.005). Moreover, childhood trauma was related to SAA both directly (β = 0.24; SE = 0.001) and through the mediating role of SATA. In addition, SATA (β = 0.17; SE = 0.005) significantly predicted BDD (β = 0.27, P < 0.001). The assumed model was in good fit with the acquired data (CFI = 0.97, GFI = 0.95, NFI = 0.94, RMSEA = 0.046).

    Conclusions

    Children who have had traumatic experiences may experience anxiety and self-doubt. Thus, childhood traumas are ostensibly related to signs of BDD and SAA through the mediation of sociocultural attitudes. Childhood traumas can also predict susceptibility to rejection in interpersonal relationships. However, no results have been found to mediate rejection sensitivity concerning trauma with BDD and SAA.

    Keywords: Body Dysmorphic Disorder, Childhood Traumas, Social Appearance Anxiety, Sociocultural Attitudes Toward Appearance
  • Nour-Mohammad Bakhshani, Riehaneh Tafreshi *, Shahab Lotfinia Page 16
    Background

    Children with learning disabilities (LDs) may be at risk of social anxiety because they are less socially accepted and more anxious than their peers. Approximately 70% of students with LDs experience a high level of anxiety symptoms, and they have clinical symptoms of anxiety more than their peers.

    Objectives

    This study aimed to determine the effectiveness of social skills training on social anxiety disorder in students with LDs.

    Methods

    This randomized controlled trial study included a pretest-posttest control group. Data were collected using Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (SCID-5), Spence Children’s Anxiety Scale (SCAS), and Matson Evaluation of Social Skills with Youngsters (MESSY). In total, 30 participants with diagnosed LDs and high social anxiety were randomly assigned to intervention and control groups. The intervention group received a social skills treatment over 12 sessions of 90minutes. After collecting the data, SPSS version 24 was used with 95% CI for data analysis. The Levene test was used to assess the equality of variances, and analysis of covariance (ANCOVA) employed to assess the main effect of social skills intervention.

    Results

    The results of the ANCOVA test showed that social skills training reduced social anxiety in the intervention group (P < 0.01). The covariate (pretest of anxiety) was also significant (P < 0.01).

    Conclusions

    This study showed that social skills training could reduce social anxiety in children with LDs. This result can be a guideline for clinicians to provide the appropriate intervention for the emotional problems of students with LDs.

    Keywords: Child, Learning Disability, Social Anxiety, Social Skills
  • Esmaeil Mousavi Asl, Hamzeh Rostami, Amirali Moghadam Sadegh, Leila Abdi, Forouzan Behrouzian* Page 17
    Background

    Eating disorders (EDs) are prevalent in adolescents and young adults, leading to various psychiatric and physical complications that affect the quality of life and even mortality.

    Objectives

    The present study aimed to investigate the mediating role of self-efficacy and self-esteem in the relationship of perfectionism and negative reactivity with EDs.

    Methods

    This descriptive study was performed on 302 students selected from the University of Tehran during 2018 - 2019. The data collection tools were the ED Examination-Questionnaire Short form, Self-esteem Scale, Weight Efficacy Lifestyle Questionnaire-Short Form, ED Inventory-Perfectionism Scale, and Perth Emotional Reactivity Scale. Pearson’s correlation coefficient and structural equation modeling were used to analyze the data.

    Results

    The results showed that EDs had significant positive correlations with perfectionism (r = 0.4, P = 0.01) and general negative reactivity (r = 0.53, P = 0.01). On the other hand, these disorders had a significant negative correlation with self-esteem (r = -0.48, P = 0.01) and self-efficacy (r = 0.53, P=0.01). Self-esteem had a negative significant relationship with perfectionism (r = -0.12, P = 0.05) and negative reactivity (r = -0.68, P = 0.01). Moreover, self-efficacy had a negative significant relationship with perfectionism (r = -0.28, P = 0.01) and negative reactivity (r = -0.5, P = 0.01). The findings of path analysis showed that self-esteem and self-efficacy played mediating roles in the relationship of negative reactivity and perfectionism with EDs. Negative reactivity directly affected eating pathology (t = 1.27, ß = 0.13) but is not significant.

    Conclusions

    Our findings showed that self-esteem and self-efficacy are protective factors against the negative effects of perfectionism and negative reactivity. Therefore, self-esteem and self-efficacy can be considered as parts of prevention and treatment programs for EDs.

    Keywords: Eating Disorders, Emotional Reactivity, Perfectionism, Self-efficacy, Self-esteem
  • Ahad Solat Petloo, Shahram Vaziri*, Farah Lotfi Kashani Page 18
    Context

    Marital adjustment is necessary for ensuring the well-being and continuity of mutual relationships. It encompasses a wide range of experiences required for cohabitation, such as satisfaction, agreement, and expressing emotions. The importance of marital adjustment has been the focus of various therapeutic approaches, and it has been long considered by researchers in the context of communicative skills.

    Evidence Acquisition

    Due to the inter-theoretical and multi-dimensional nature of marital communication and adaptation, this study was conducted to investigate the effectiveness of integrative therapies based on the regulation of the cognitive, emotional, and behavioral mediators on marital adaptation. Data Sources: In this systematic review, English articles published from March 2005 to March 2021 in databases including Google Scholar, ScienceDirect, PubMed, Web of Science, and Cochrane Library were extracted. Also, to find the articles published in Persian, databases including Scientific Information Database (SID) and Magiran were searched from January 2021 to April 2021.

    Results

    A total of 20 studies were included for analysis. The results of the systematic review showed the usefulness of integrative couple therapies with the continuation of therapeutic effects in more than two months of follow-up.

    Conclusions

    Although the effectiveness of integrative approaches in improving the couple’s adaptation and communication components were confirmed in the reviewed studies, most of the studies provided no evidence regarding the effective variables in the therapeutic interventions and the related procedure. Therefore, more precise studies are required to make a more accurate judgment on their credibility

    Keywords: Communication, Couples Therapy, Emotional Self-regulation, Psychological Adaptation
  • Asieh Sadat Baniaghil, Fateme Abedi *, Mahbobeh Faramarzi, Mohammadali Vakili, ParvanehMirabi Page 19
    Background

    Parenthood can reduce marital satisfaction (MS). Problem-solving skill (PSS) training enables couples to solve family problems and improve MS.

    Objectives

    We aimed to evaluate the effectiveness of PSS training on MS of primigravida breastfeeding mothers.

    Methods

    The research design of this randomized controlled field trial study was pretest-posttest with a control group done on 68 primigravida breastfeeding mothers who attended healthcare centers affiliated to Babol University of Medical Sciences, Iran. They were allocated to two experimental (34 individual) and control (34 individual) groups using the blocked randomized allocation technique based on pretest scores of MS. The small group program (10 - 11 women) of PSS training was performed for six 80-minute sessions for the experimental group. The control group did not receive the intervention. All participants completed the ENRICH inventory three times, namely before, immediately after, and one month after the intervention by self-report. The level of significance was 0.05.

    Results

    Total MS score in the experimental group increased from 164.24 ± 22.85 before intervention to 181.84 ± 20.5 immediately after, and 184.41 ± 20.36 one month after the intervention significantly. Moreover, except for the score of the idealistic distortion dimension, the mean scores of the other dimensions of the ENRICH increased significantly over time in the experimental group.

    Conclusions

    PSS training can be used as an effective method to improving MS in primigravida breastfeeding mothers. Therefore, this intervention is recommended as an effective program for improving MS.

    Keywords: Problem-solving, Marital Satisfaction, Breastfeeding Mothers
  • Abbas Shafiei, Jalal Younesi *, Mohammad Saeed Khanjani, Manouchehr Azkhosh, Samaneh Hossainzadeh Page 20
    Background

    Mothers of children with intellectual disability often face many challenges and stressors related to their children’s problems. This can negatively affect their marital relationship and satisfaction and cause marital conflict.

    Objectives

    This study aimed to investigate the effects of schema therapy on marital satisfaction and marital conflict in mothers of children with intellectual disability.

    Methods

    This quasi-experimental study had a pretest-posttest, control group design. The statistical population included all mothers of children with intellectual disability covered by the Social Welfare Organization of Qarchak, Iran. A total of 30 women were randomly selected and allocated into two equal groups of experimental and control (n = 15 in each group). While schema therapy was presented to the experimental group through holding ten 2-hour sessions, mothers in the control group did not receive any intervention. To collect data, we used the Enrich Marital Satisfaction Questionnaire by Olson (1998) and the Marital Conflict Questionnaire by Barati and Sanai. Data were analyzed using paired samples t-test and analysis of covariance.

    Results

    The results showed that schema therapy significantly improvedmarital satisfaction andmitigatedmarital conflict inmothers of children with intellectual disability (P < 0.001).

    Conclusions

    Schema therapy increased marital satisfaction and reduced marital conflict in mothers of children with intellectual disability.

    Keywords: Children with Intellectual Disability, Marital Conflict, Marital Satisfaction, Mothers, Schema Therapy
  • Vahid Akbari Farkhani* Page 21
  • Maryam Amini Fasakhoudi, Zorieh Abbasi*, Abbas Bakhshipour Roudsari, Maryam Mazaheri Page 22
    Background

    The present study aimed to determine the relationship of anxious attachment style with catastrophizing, fear of pain, and hypervigilance.

    Methods

    The study sample consisted of 210 students at Tabriz University, Iran, with recent acute pain or the lack of pain experience selected by the convenience sampling method. The subjects responded to the Relationship Scales Questionnaire, Pain Catastrophizing Scale, Fear of Pain Questionnaire, and Pain Vigilance and Awareness Questionnaire. Data were analyzed by Pearson’s correlation coefficient and structural equation modeling.

    Results

    The findings indicated a significant positive relationship between the subscale of anxious attachment and the variables of catastrophizing, fear of pain, and vigilance to pain, as well as a relationship among the variables. Moreover, the modeling showed a structural relationship between anxious attachment and studied variables.

    Conclusions

    Anxious attachment style acts as a vulnerability factor and a predictor of chronic pain in individuals without pain experience. It means that facing catastrophic pain in people with anxious attachment styles can lead to the fear of pain and hypervigilance.

    Keywords: Anxious Attachment Style, Catastrophizing, Fear of Pain, Hypervigilance
  • Esmail Soltani *, Sadegh Izadi, Pardis Sharifi, Maryam Poursadeghfard Page 23
    Background

    Cognitive fusion is a substantial variable of acceptance and commitment therapy (ACT). Recently, various instruments have been developed to assess cognitive fusion, including a version relevant to medical illness referred to as the Cognitive Fusion Questionnaire-Chronic Illness (CFQ-CI).

    Objectives

    This study aimed to assess the validity and reliability of the Persian version of CFQ-CI in multiple sclerosis (MS) patients.

    Methods

    In a cross-sectional study, the Persian version of CFQ-CI and several other measures that assessed self-compassion, depression, and social anxiety symptoms were administered on 195 MS patients in Shiraz Emam Reza Clinic. Exploratory factor analysis (EFA), internal consistency, and convergent validity were used for data analysis.

    Results

    EFA revealed a 1-factor model. The Cronbachα was 0.92. As to the convergent validity, CFQ-CI had positive associations with measures of depression and social anxiety and negative associations with self-compassion.

    Conclusions

    Overall, this research supports the psychometric properties of the Persian version of CFQ-CI.

    Keywords: Acceptance, Commitment Therapy, Chronic Illness, Cognitive Fusion, Validity, Reliability
  • Mahnaz Azmodeh, Rastegar Hoseini*, Ehsan Amiri Page 24
    Background

    The preventative measures to reduce the incidence of coronavirus disease 2019 (COVID-19) have reduced the physical activity level (PAL) that might also affect physical and mental health.

    Objectives

    The present study investigated the relationship between self-perception of fitness (SPF) and PAL in COVID-19-recovered individuals (CRI).

    Methods

    The population of this descriptive-analytical study included all CRI (men and women, in the age range of 20 to 70 years) in Kermanshah. In the present study, 890 volunteers (438 men and 452 women) were sampled using a multistage cluster sampling method. The International Physical Activity Questionnaire (IPAQ-SF) was used to assess the PAL and the Delignières et al. questionnaire to assess the SPF. The Pearson correlation coefficient test and independent t-test were used to analyze the data using SPSS version 24 software.

    Results

    The results showed low PAL (men: 876.11 ± 40.23; women: 739.27 ± 8.02) and poor SPF (men: 6.64 ± 1.62; women: 5.27 ± 1.39) in CRI. Also, there was a significant positive relationship between high and moderate PAL and SPF in men (r = 0.67, P = 0.032; r = 0.77, P = 0.018, respectively) and women (R = 0.56, P = 0.041; r = 0.66, P = 0.035, respectively), while there was a significant inverse relationship between low PAL and SPF among men (r = -0.85, P = 0.001) and women (r = -0.89, P = 0.001).

    Conclusions

    Based on the results, wrong SPF in individuals with low PAL might be one reason for being insufficiently active. Thus, a proper understanding of PAL could be the first step of a regular physical activity schedule to enhance the immune system.

    Keywords: Self-assessment, Physical Fitness, Mental Health, COVID-19
  • Fatemeh Zargar, Mahin Rabiei *, Zohre Naderi, Mohammad Javad Tarrahi Page 25
    Background

    Asthma is a common respiratory disorder that negatively affects quality of life (QOL) and mood status.

    Objectives

    The purpose of this study was to investigate the efficacy of group acceptance and commitment therapy (ACT) on the symptom control, QOL, and mood status of asthmatic patients.

    Methods

    This randomized clinical trial study was conducted on 32 asthmatic patients randomly allocated to the case group (underwent group ACT plus medical therapy; n = 15) and the control group (who were medically treated only in 2019; n = 17). The case group participated in 8 sessions of 90-minute group ACT. Spirometry was performed for both groups at baseline and at the end of the intervention. The Asthma Control Questionnaire (ACQ) to assess symptom control status, Hospital Anxiety and Depression Scale (HADS) to assess mood status, and Asthma Quality of Life Questionnaire (AQLQ) to assess QOL were filled out by the patients at baseline and at the end of the intervention.

    Results

    The measurements regarding the trend of changes in the case group over the time were significant in all of the evaluated entities, including ACQ, depression and anxiety subscales of HADS, and AQLQ scores (P < 0.05), while nonsignificant alterations were observed in the controls (P > 0.05). The comparison of the 2 groups revealed significant differences in all the assessed entities (P > 0.05). The spirometry variables were statistically significant in the control group at baseline (P < 0.05), while the post-intervention assessments revealed a nonsignificant difference (P > 0.05).

    Conclusions

    Group ACT can efficiently reduce the asthma symptoms in asthmatic patients, along with the remarkable improvement in mood and QOL. Further evaluations with a longer period of intervention are strongly recommended.

    Keywords: Acceptance, Commitment Therapy, Anxiety, Asthma, Depression, Quality of life