مجله روانپزشکی و روانشناسی بالینی ایران
سال هفدهم شماره 3 (پیاپی 66، پاییز 1390)

This study was conducted to compare the efficacy of metacognitive therapy (MCT), fluvoxamine and the combination of MCT with fluvoxamine, in improving thought control strategies and stop signal criteria in patients with obsessive-compulsive disorder (OCD). Twenty one individuals among outpatients with OCD presenting to clinics in Tehran were selected and randomly divided into three groups: metacognitive therapy, fluvoxamine (50-300 mg/d) and combined therapy. All groups received 10 days of treatment. The Thought Control Questionnaire (TCQ) and Stop Signal Questionnaire (SSQ) were administered pre-treatment and post-treatment to all subjects. Kruskal Wallis test, Mann-Whitney U-test, and ANCOVA were used to analyze data. In comparison with fluvoxamine, MCT and combined treatment led to significant improvements in worry, self-punishment and reappraisal strategies of thought control and stop signal criteria (p<0.01). There was no significant difference between MCT and combined therapy. MCT and combined treatment are more effective than fluvoxamine (50-300 mg/d) in improving thought control strategies and stop signal criteria in patients with OCD. Adding medication to MCT does not improve the patients’ outcome

According to Beck's cognitive theory, dysfunctional core beliefs are developed by stressful life experiences. In addition, depressive episodes could be considered as stressful events. Thus, it is assumed that patients with depressive disorder experience beliefs about depression and its outcome, due to repeated episodes of depression. The aim of this study was to develop an instrument for measuring maladaptive beliefs about depression and assess its psychometric features. A three stage approach was used. In the first stage an item pool was developed and its face validity was approved by a focus group. Subsequently, 698 students of Ghazvin University completed Beck Depression Inventory-II and Depression Beliefs Scale (DBS), developed in the previous stage. 433 subjects completed the DBS again after 14 days. In the third stage, in order to assess discriminant validity, 93 subjects in three groups of patients with recurrent major depressive disorder (N=34), patients with first episode of major depressive disorder (N=29), and non-clinical subjects (N=30) participated in sad mood induction task and then completed DBS. Exploratory factor analysis and Varimax rotation identified four factors related to depression, described as "lack of control on depression", " Catastrophizing", " worthlessness", and "incapability". Also, DBS and its subscales showed satisfactory discriminant validity, convergent validity, internal consistency and test-retest reliability. Identified subscales in DBS reflect concepts of Beck's cognitive theory and Teasdale's differential activation hypothesis about relapse in depression. Also, these results provide preliminary evidence about desirable validity and reliability of DBS. However, psychometric properties of the scale should be assessed in patients with other types of depressive disorders such as dysthymia.

To develop and evaluate the validity and reliability coefficients of Iranian Adolescents Risk-taking Scale (IARS) and its subscales was the aim of the current study. After reviewing the proposed instruments in this field, and with considering the cultural features and circumstances of the Iranian society, the Iranian Adolescents Risk-taking Scale (IARS) was developed in 38 items. 1204 students were selected from Tehran high schools using multistage sampling, and all subjects completed IARS. Data were analyzed using exploratory factor analysis and goodness of fit index. Exploratory factor analysis indicated that IARS is a 7 dimensional scale, which explains 64.84% of the overall risk variance. The Cronbach’s alpha for the total scale and subscales were 0.94 and 0.74-0.93 respectively. The psychometric properties of IARS are consistent with the cultural indices of Iranian society.

This study aims to evaluate the cultural adaptation, validity and reliability of the Persian version of Experience of Caregiving Inventory (ECI) in families of patients with severe mental disorders. After the translation and cultural adaptation of ECI, 225 family members of patients with severe mental disorders completed the ECI, the General Health Questionnaire (GHQ-28) and a demographic questionnaire. The Split half test was used to assess reliability. To determine internal consistency, Cronbach’s alpha test and the concurrent validity was calculated by Pearson’s correlation between the GHQ-28 and the ECI total negative score. Reliability of the Inventory as assessed by the Spearman-Brown correlation coefficient was 0.80. The range of the Cronbach’s alpha for each subscale, total negative score and total positive score was 0.51 to 0.90. Pearson’s correlation between the GHQ-28 score and the total negative score was 0.37 (p<0.01). The Persian version of the ECI has good reliability and validity for family members of patients with severe mental disorders.

The aim of this research was to study the predictive role of self-efficacy, belief of treatment effectiveness, social support and doctor-patient relationship on diabetes Mellitus self-management. 500 type II diabetes outpatients (245 men and 255 women) presenting to Shariati Hospital in Tehran were selected by convenience sampling. The subjects completed the scales related to diabetic self-care, self-efficacy, belief of treatment effectiveness, social support and doctor-patient relationship. Data were analyzed using Pearson correlation coefficient and multiple regression analysis. There was a significant and positive relationship between self-efficacy, belief of treatment effectiveness, doctor-patient relationship, social support and diabetes self-management (p<0.001). Self-efficacy, belief of treatment effectiveness and social support were capable of predicting diabetes self-management variance significantly (F=1.326, df=3 and 310, p<0.001) and explain 89% of diabetes self-management. Belief of treatment effectiveness, social support and especially, self-efficacy, are important self-management activities in diabetes Mellitus. Therefore, provision of improvement and enrichment programs for self-efficacy, are helpful for the improvement of self-care behaviors and the reduction of diabetes Mellitus associated harm.

The aim of the present study was to examine the sensitivity level of Behavioral Approach System (BAS) and Behavioral Inhibition System (BIS) as probable predisposing factors for substance abuse. To this end, the difference of sensitivity levels of BAS and BIS were assessed in substance abusers, cigarette smokers, and normal individuals. The present causal-comparative study compared the sensitivity levels of approach and inhibition behavioral systems in the following three groups: substance abusers (n=43), cigarette smokers (n=45) and normal individuals (n=55), using BIS/BAS scales. Data were analyzed using c2 distribution, one way analysis of variance, multivariate analysis of variance, and follow-up tests. The scores of BAS subscale in substance abusers and cigarette smokers were higher than that of normal individuals (p≥0.05), but there was no difference in this regard between substance abusers and smokers. In the BIS subscale, the cigarette smokers scored higher than the other two groups (p≥0.05). Substance abusers and smokers have a more sensitive BAS than normal individuals, which predisposes them to appetitive behaviors. These findings are in line with the Reinforcement Sensitivity Theory, which predicts a relation between BAS, appetitive behaviors and substance abuse.

The goal of the present study was to describe the experience of female psychiatric inpatients, of couple-family relationships. The method of phenomenology was used in this qualitative study. The subjects comprised female patients hospitalized in Noor Psychiatric Hospital in Isfahan. Fourteen subjects were selected using purpose-oriented sampling, up to reaching data saturation. Data were collected using an unstructured interview and Colaizzi’s seven stage process was used for data analysis. The findings were classified in 847 conceptual codes. Subsequent to the fourth level coding, the data were divided into two main groups: (1) causes of the illness and their aggravating factors (behavior of spouse, behavior of spouse’s family, behavior of subject, miscellaneous factors and childhood and adolescence period), and (2) subjects’ reactions (to the behavior of spouse, toward continuing to live and to sexual relation with spouse). Women experience many negative events in their marital life, with undesired effects on mental health. Taking these issues into consideration and providing families and couples with related education could have significant effects in improving mental health among women.

The aim of the present study was to assess the knowledge and attitude of patients with gender identity disorder (GID), presenting to Tehran Psychiatric Institute, toward Acquired immunodeficiency Syndrome (AIDS).

58 patients with gender identity disorder (41 female-to-male and 17 male-to-female) were selected using convenience sampling. The subjects completed the questionnaire proposed by Family Health Organization. Subsequent to determining the distribution by statistical methods, data were analyzed using parametric and non-parametric tests suitable for group comparison.

About 70% of the subjects believed that an apparently healthy individual could be infected with human immunodeficiency virus (HIV). Only five subjects (8.6%) considered themselves to be at risk for HIV infection. With regard to routes of transmission, 70% believed anal sex carries lower risk than vaginal sex.

Subjects had a low level of knowledge regarding sexually transmitted diseases. Therefore, all individuals with GID should be provided with sufficient information about AIDS and sexually transmitted diseases.