Iranian Journal of Psychiatry and Clinical Psychology
Year:2015 | Volume:21 | Issue:1 |Papers Count:14

Objectives: Domestic violence is a common phenomenon and also a health priority in all communities. Researches have shown that multiple biological, genetic, psychological, social, cultural and spiritual factors have key roles either in development or in prevention of domestic violence. Therefore, it is better to consider an integrated health care system which covers all influencing factors for preventive interventions and continuous and effective care. In recent years, several studies have been conducted about prevalence of domestic violence in Iran and also several interventions have been proposed by educational approach.Method: This research attempted to design and to implement an integrated community-based model for preventing domestic violence based on primary health care (PHC) system in Iran. In this article, the model resulted from this study has been presented.Findings: The model of “Intimate Partner Violence Prevention in Primary Health Care system” was designed by short-term training of the primary health care providers such as health workers, technicians, health professionals and family physicians in the level of small towns and rural societies for identifying the cases of intimate partner violence, communicating with people who are abused, recording the cases of violence and referring the victims of physical abuse. Also they can help these individuals to ameliorate their distress by counseling, supportive psychotherapy and some medications.Conclusion: By informing and sensitizing primary health care providers, this model could overcome all the limitations and shortcomings about unwillingness of the staff for cooperation in the program of the prevention of violence which has been reported in the study of Ramsey and colleagues, 2002. Also, it demonstrated that the medical section and primary health care system are valuable resources for assistance to perform the programs of violence prevention. However, this model has several limitations. Also some suggestions for removing the constraints in the national level and for interacting with other regional counties in terms of experiences have been provided.

Objectives: The present meta-analysis was aimed to evaluate the effectiveness of applied behavior analysis (ABA) on behavioral problems and difficulties in children with autism spectrum disorders in Iran. Method: A total of 142 studies published from 2005 to 2013 were reviewed and eight studies were selected for meta-analysis based on applying appropriate methodologies. The eight studies involved a total of 200 participants and since each study focused on multiple autism-related problems, 28 effect sizes were obtained. The research instrument was a checklist of content analysis.Results: The overall mean effect size was found to be r=0.83 (p<0.001). The highest effect size (r=0.926) was obtained in the research of Khorramabadi, et al. (for the variable of cognitive skills) and the lowest effect size (r=0.151) was seen in the study of Mashhadi, et al. (for the variable of social development).Conclusion: The results indicate a large effect size of ABA on decreasing the problems and difficulties of children with autism spectrum disorders in Iran. In addition, greater effects are found when this method is used in long-term and with higher intensity. Therefore, it seems that ABA can be used as an appropriate treatment method for children with autism spectrum disorders.

Objectives: The aim of this study was to evaluate the effectiveness of guided adolescent problem solving method on craving, attitudes toward drug abuse and coping strategies in adolescents with substance abuse.Method: In a quasi-experimental study with pretest/posttest design, 30 misdemeanor offending adolescents who were resident of a reformatory center (Tehran Correcting and Training Center) participated in this study and every pair of adolescents were randomly allocated in two experimental and control groups. All of these adolescents had history of drug abuse in the past year. The participants in both groups were assessed by Coping Strategies Questionnaire, Drug Belief Questionnaire, and Craving Abuse Questionnaire as well as urine toxicology tests. In the experimental group, guided adolescent problem solving was provided one session in each week for five successive weeks. In each session, 90 and 30 minutes were allocated to intervention and assessment, respectively. Three week after the last session of intervention, posttest was performed for both experimental and control groups. Reliable change index and covariance analysis were used for data analysis.Results: There were statistically significant difference between groups in terms of craving, believes related to drug abuse and verbal expression of emotions.Conclusion: Guided adolescent problem solving was effective on improving the coping strategies in adolescents with drug abuse. Expression of emotions has the key role in reducing the craving and attitude toward drug abuse in adolescents.

Objectives: To assess the attachment styles in obese patients and to compare it with a group of normal weight individuals.Method: In this study, attachment styles of 159 patients with obesity who referred to centers for management of obesity were compared with 183 subjects with normal weight. The attachment styles was assessed by Hazan and Shaver’s questionnaire, body mass index (BMI) as well as self-report demographic variables.Results: Total of 342 subjects (82% female) were assessed. Average age of these individuals was 34.8 years (SD=0.6). The frequencies of secure, avoidant and preoccupied attachment styles in persons with obesity were 66%, 17% and 15% respectively. There was not any significant statistical difference between the distribution of frequency of the attachment styles in obese people and persons with normal weight (p>0.05). There were significant lower medical comorbidities in subjects with secure attachment (p<0.01). In regression analysis, the determinant factors of higher body mass index (BMI) were increased age (p<0.05), the level of education under high school diploma (p<0.05), medication consumption (p<0.05), and also being housewife (p<0.05).Conclusion: Results of this study was closely aligned with the studies that have shown the association between many of psychosomatic disorders and insecure attachment styles.

Objectives: The present study was performed by the aim of qualitative evaluation of the experience of parents from the prepubescent period of their children with gender identity disorder.Method: This study was a qualitative research. By the available and targeted method of sampling, 10 parents of children with gender identity disorder who were referred to Tehran Psychiatric Institute in 2012 participated in a deep unstructured interview. After typing, the recorded interviews were encoded by the method of inductive content analysis.Results: The gathered findings were classified in four main categories as “similarities to the opposite sex / differences from the same sex”, “difficulties in school”, “the way of coping with the reality of gender identity issues”, and “parents’ feelings”. By the different ways, the parents had experienced the reality of the difficulties of gender identity in their child during his or her childhood, but they postponed coping with this event by using the various mechanisms such as negligence, overseeing, giving a promise, lack of seriously and procrastinating.Conclusion: The present study is the first research in our country in which the parents of children with gender identity disorder demonstrated their problems. With consider to the obtained findings from the present study, it is necessary not only to design the multi-dimensional programs which educate general public (include parents) and also experts for becoming familiar with gender identity but also to involve the parents of children with gender identity disorder in cooperation with primary healthcare providers for the process of diagnosis and treatment.

Objectives: Bipolar and unipolar depressions are different in terms of both biological or clinical sign and symptoms, so the available scales are not suitable for measuring the depression in bipolar disorder. The aim of the present study was to determine the psychometric features of the Persian Version of Bipolar Depression Rating Scale (BDRS).Method: A total of 368 participants, including 120 patients with bipolar disorder in the period of depression and 126 patients with major depressive disorder from the Medical Centers affiliated to Isfahan University of Medical Sciences, Iran, in the years of 2011-2012 and also 122 healthy individuals among relatives of patients and the staff of the sampling centers, were recruited in this study. Bipolar Depression Rating Scale (BDRS), Hamilton Depression Rating Scale (HAM-D), Young Mania Rating Scale (YMRS) and Beck Depression Inventory (BDI-II) were used for gathering the information. Data analysis was done by using of Pearson’s correlation coefficient, factorial analysis and discriminate analysis.Results: Bipolar Depression Rating Scale (BDRS) had high internal consistency in the population of Iran (α=0.81) and its validity was confirmed by robust correlation with Beck Depression Inventory (BDI-II) (r=0.61) and Hamilton Depression Rating Scale (HAM-D) (r=0.71). Correlation of the mixed subscale of BDRS with Young Mania Rating Scale (YMRS) was 0.69. Factor analysis identified three factors of psychological, physical and mixed depression; however, some of its items were different from original version. The most suitable clinical cutoff point was score of 18 with sensitivity and specificity of 93% and 94%, respectively.Conclusion: Persian version of the Bipolar Depression Rating Scale in Iranian population has provided the suitable and reliable psychometric features.

Objectives: To introduce a patient with bipolar disorder type1 who developed multiple paraphilic behavior.Case report: A 25 year old man with history of bipolar disorder type 1 along with paraphilic behaviors including frotteurism, fetishism, transvestism, voyeurism, and oppositional behaviors, lower than normal intelligence and possible history of attention deficit/hyperactivity disorder (ADHD) was referred and treated by valpiroic acid (Depakine), risoeridone, naltrexone, and finasteride.Conclusion: It is important to consider the psychiatric comorbidity of mood disorder and paraphilic disorders for proper evaluation and treatment of the patient and also for preventing the medication interactions.

Objectives: Considering and evaluation of suicidal thoughts in children.Case report: This report introduces a five years old child who presented with the signs and symptoms of threaten to suicide and homicide by knife, restlessness, verbosity, irritability, verbal and physical aggression toward others. This child has been treated with methylphenidate, due to symptoms of attention deficit / hyperactivity disorder (ADHD) for a short period of time. During the preparation of this report, he was hospitalized in the children’s psychiatric ward of Shahid Beheshti Hospital of Kerman for the second time after a short interval from the first-time hospitalization. Suicidal and homicidal thoughts of this child and his attempts for suicide or homicide were possibly due to non-abstract thinking related to his age without ability to think about consequences of these actions.Conclusion: Suicidal and homicidal thoughts or actions should be evaluated carefully even in the children, and also the appropriate interventions should be performed to reduce these behaviors.