Iranian Journal of Psychiatry and Behavioral Sciences
Year:2016 | Volume:10 | Issue:4|Papers Count:17

Background: It is estimated that there are 180, 000 people who inject drugs (PWID) in Iran. To reduce HIV-related high-risk behaviours among PWID, primary needle and syringe programs (NSPs) are delivered through drop-in centres (DICs) in Iran since 2002, but there is a paucity of research on the differential effectiveness of psychosocial components of NSPs on high-risk injection and sexual behaviours of drug users. Objectives: The current study aimed to examine the effectiveness of adding-on a brief skill-based HIV prevention psychoeducation on HIV-related high-risk behaviours among clients of two drop-in centres (DICs) in Tehran, Iran. Materials and Methods: One hundred and twenty consecutive clients with the mean age of 34 years who met diagnostic and statistical manual of mental disorders, 4th edition, text revision (DSM-IV-TR) criteria for opioid dependence were selected and randomly assigned into intervention and control groups. Demographic data, history of drug abuse, high-risk sexual behaviours and drugrelated behaviours were gathered using a researcher-made questionnaire. The intervention group received two brief sessions of skill-based HIV prevention psychoeducation added on routine needle and syringe program; while the control group received routine services. The two groups were followed in months one and three, respectively. Results: The intervention group showed significantly more reduction in high risk injecting behaviours including average number of daily injections (F = 4. 32, P < 0. 05), number of injections during the last month (F = 11. 45, P < 0. 05), and number of times using syringes used by another person (F = 4. 27, P < 0. 05). The intervention group showed significantly greater reductions on some measures of sexual behaviours compared to the control group. These measures included the number of sex partners (F = 4. 43, P < 0. 05), the number of sex partners whom they had unprotected sex with (F = 3. 20, P < 0. 05) and the number of new sex partners (F = 3. 58, P < 0. 05). Conclusions: The study results indicated that adding-on a brief skill-based HIV prevention psychoeducation consisted of two individual sessions to routine NSP could significantly increase its effectiveness. The importance of integration of HIV prevention psychoeducation programs within routine harm reduction services was discussed.

Background: During pregnancy, due to special hormonal and physiological changes that occur in the body, sleep disorders are very prevalent; therefore, positive psychological states and emotions can have major impacts on overall sleep quality among pregnant women. Objectives: The aim of this study was to examine the effect of 15 positive psychological states (trust in God, optimism, a sense of efficacy, accepting responsibilities, a sense of control, purposefulness, hope, meaningfulness in life, life satisfaction, positive mood and happiness, being social, self-esteem and self-worth, a sense of peace, appreciation, and forgiveness) on predicting sleep quality among pregnant women. Materials and Methods: This descriptive study followed a correlational-predictive design. The statistical population of this study included all pregnant women referred to health care centers in Khash in the first half of 2015, which included 890 individuals. The sampling method was multistage cluster sampling. Overall, 268 questionnaires were distributedamongpregnant women, whohad the inclusion criteria of the current study, in order to be answer freely and voluntarily. Moreover, to collect data, two questionnaires including positive psychological states (PPS) and the Pittsburgh sleep quality index (PSQI) were used. Results: The results of the correlation coefficient indicated that optimism, purposefulness, hope, meaningfulness in life, life satisfaction, positive mood and happiness, a sense of peace, trust in God and forgiveness were significantly related to high sleep quality (P  0. 01). However, sleep quality was not correlated with a sense of efficacy, accepting responsibilities, a sense of control, being social, and a sense of self-esteem and self-worth (P  0. 05). Additionally, the results of stepwise regression analysis showed that positives mood, meaningfulness in life and hope together predicted 0. 47 of the variance in sleep quality among pregnant women (P 0. 01). Conclusions: Since psychological states and emotions have great impacts on sleep quality of pregnant women, paying attention to women’ s psychological states and emotions, especially in the last trimester of pregnancy, seems essential.

Background: Susanne Jaeggi developed the Dual N-Back task in 2003 and proved that dual tasks can improve the activation of Prefrontal cortex as the centre of executive functions. However, Gray and Thompson suggested that this effect is not long-lasting. Objectives: Fluid intelligence, working memory, and short-term memory are very important factors in the achievement of educational objectives. Neuropsychological training concentrates on achievements instead of educational intervention. We aimed to evaluate the effectiveness of collective cognitive training in an interventional study because collective components of training have been ignored at schools. We selected dual n-back task because it is a computerized task and the efficiency of the task has been demonstrated in previous studies. Materials and Methods: It was a quasi-experimental study. We performed the study in a middle school in Hamadan in 2014. There were a total of 66 teenage participantswhowere assigned to one of the two control and experimental groups. All of them completed a series of tests, namely Wechsler’ s memory subtest and Raven’ s progressive Advanced Matrices (RAPM), in pre-test, and post-tests as well as follow-up. Thirty six participants were trained in twelve sessions of collective training during three months. Results: Our results indicated that fluid intelligence, working memory, and short-term memory in the intervention group improved significantly than the control group even in the follow-up stage (P < 0. 01). However, the improvement of cognitive abilities did not have an influence on the general averages. Conclusions: Dual N-back task can improve working memory, short-term memory, and fluid intelligence, but the improvement of aforementioned cognitive skills does not promote educational achievement.

Background: Patients with schizophrenia have abnormal skin flush response to niacin. We aimed to evaluate the accuracy of niacin skin test in these patients. Objectives: We aimed to evaluate the accuracy of niacin skin test in these patients. Materials and Methods: This diagnostic trial with parallel-group design was conducted at the Noor university hospital in Isfahan (Iran) from January to September 2014. Participated Subjects were hospitalized schizophrenic adult and their first degree relatives, bipolar disorder patients and healthy controls (n = 25 in each group). Niacin skin test was performed using 0. 5 mL of 0. 1Mand 0. 01Mdiluted methyl nicotinate solutions applied every 5 minutes for a total of 20 minutes and graded from 0 (no redness) to 3 (extreme redness). Sensitivity, specificity, and positive and negative predictive values were calculated. Results: The time point at which there was no further significant change in the skin response was 10 minutes after the test. At this set point, schizophrenic patients had lower response to each solutions compared to others (P < 0. 001), but there was no difference between bipolar disorder patients and controls (P > 0. 05). A grade of  1 skin response to the 0. 01 M solution of methyl nicotinate would provide sensitivity, specificity, positive and negative predictive values of 80%, 93. 3%, 80%, and 93. 3%, respectively, in differentiating schizophrenic from other groups. Using 0. 1 M solution provide lower sensitivity (32%) and negative predictive value (81. 5%), but higher specificity (100%) and positive predictive value (100%). Conclusions: Niacin skin flush response is impaired in schizophrenic patients. This phenomenon may be used as a complementary diagnostic test in psychiatric workups.

Background: There is a growing body of literature in favor of cognitive therapy on anger in the world. Objectives: The aim of the present study was to evaluate the efficacy of cognitive-behavioral group therapy in the reduction of state-trait anger and increase of general health among female students of Khorasgan Azad University, Isfahan. Materials and Methods: This study was a quasi-experimental research. A number of 40 students from the humanity sciences faculty of Khorasgan Azad University, who accepted the invitation to the study, were selected and randomly assigned to the experimental (n = 20 participants) and control (n = 20 participants) groups. The group therapy, based on Reilly & Shropshire’ s model (2000), was held in 8 weekly sessions at Khorasgan Azad University. The participants were asked to fill out the Spielberger’ s state-trait and general health questionnaires in the pre-test, post-test and follow-up test (6 months later). Results: The results of multivariate analysis of covariance (MANCOVA) showed a significant difference between the groups in the mean scores of state anger, anxiety, social dysfunction, depression, and general health in the post-test (P < 0. 05). However, there was not a significant difference in the mean scores of trait anger and somatic symptom in this stage. In the follow-up stage, there was a significant difference in all the variables between the two groups (P < 0. 05). Conclusions: Cognitive-behavioral group therapy could be an appropriate approach in decreasing anger and improving general health among female students.

Objectives: This study aimed to unveil the effect of depression death and anxiety death on coping style among coronary heart disease (CHD) patients in Tabriz, a city in the Northwest of Iran. Materials and Methods: In this cross-sectional study, 293 coronary heart disease patients were recruited from three hospitals in Tabriz from January to July 2015. Socio-demographic characteristics and CHD clinical history were archived by a checklist. Validated self-administered questionnaires were used to measure death depression, death anxiety, and coping style. The association between death depression and death anxiety with coping style was evaluated, using multivariable linear regression. Results: In this study, the participants were 60 11 years of age. Death depression was most significantly influenced by occupation, and the death anxiety level was affected by the history of hospitalization with CHD. The coping style level was not statistically significant across sociodemographic and CHD clinical history characterises. In death depression, the third quartile was significantly and inversely associated with coping style, compared to reference category;  (95% CI);-1. 60 (-2. 97 to-0. 27), P value = 0. 02. Conclusions: AmongCHDpatients, death depression and death anxiety could be influenced by sociodemographic andCHDhistory background characteristics, respectively. Death depression could be considered as a determinant for coping style.

Background: Cognitive impairment is a chronic and disabling manifestation of schizophrenia. Objectives: This before-after study was conducted to examine the effect of a short course computer-assisted cognitive remediation on improving cognitive functions of patients with schizophrenia. Materials and Methods: Twenty patients with schizophrenia were enrolled into the study. The intervention consisted of 10 onehour sessions held 2-3 times a week, using the Cogpack software that includes tasks to improve attention, memory, and executive function. The patients’ cognitive functioning was assessed before and after the remediation, using tests in the CANTAB battery, including stop signal task (SST) and choice reaction time (CRT) to assess attention levels, pattern recognition memory (PRM) and Paired associate learning (PAL) to examine memory, and stocking of Cambridge (SOC) and intra-extra dimensional task (IED) to evaluate executive function. Results: IED and SOC revealed a statistically significant improvement in executive function after the intervention. PAL revealed a significantimprovementinmemory functioning inmostaspects after the intervention, whilePRMdid not. CRTshoweda significant improvement in some aspects of attention and concentration after the intervention, while SST did not. Conclusions: This before-after study revealed that a relatively short course of a computer-assisted cognitive remediation can be applied to improve several aspects of cognitive functioning in patients with schizophrenia. A randomized controlled trial is required to establish the effectiveness of the intervention.

Background: This study aimed to clarify the relationship between dissociation experience, and alexithymia and eating attitudes in female students of Ahvaz University. Materials and Methods: The present study had a cross sectional design. Overall, 325 female undergraduate students were selected by multi-phaserandomclusteringandcompleted the following rating scales; eating attitudes test-26 (EAT-26), alexithymia questionnaire (TAS-20), dissociative experiences scale (DES-28). Data analysis was done using the Pearson correlation and stepwise multiple regression analysis. Results: With the Pearson method, we found a correlation between alexithymia and eating attitudes (P = 11. 3), and a significant positive correlation between dissociative experiences and eating attitudes (P = 36. 8) was also found. The multi-variable correlation coefficient for alexithymia and dissociative experiences with eating attitudes in female students was respectively MR = 37. 0 and MR = 11. 3, and F ratio was respectively equal to 36. 7 and 2. 86, which was significant at P = 0. 001 and P = 0. 092. Conclusions: This study highlights the association between eating attitudes, and dissociation experiences and alexithymia, yet dissociation experiences were more relevant and a stronger predictor for eating attitudes.

Objectives: Eating disorders are important health issues of body image disturbances. These disorders are not limited to Western countries or females. The current study aimed to investigate the prevalence of eating disorders among Iranian male adolescents and the associated factors. Materials and Methods: This cross-sectional survey was conducted on 433 male high school students. The study assessed the effects of demographic characteristics, social pressures from family and friends, self-esteem, body satisfaction and media on eating disorders. Results are presented in terms of odds ratio (OR) and confidence interval (CI). P-values less than 0. 05 were considered as statistically significant. Results: About 15% of male adolescents had eating disorders. There were significant differences between the two groups (with and without eating disorders) in terms of social pressure, body dissatisfaction and body mass index (BMI). Body dissatisfaction (OR = 1. 23, 95% CI: 1. 01-1. 50) and BMI (OR = 1. 14, 95% CI: 1. 06-1. 21) were identified as predictive factors in eating disorders. Conclusions: The results indicated the need for more attention to eating disorders and predictive factors in Iranian adolescents as an example of Asian cultures.

Background: Brain-derived neurotrophic factor (BDNF) might involve in the pathogenesis of mental disorders. There are inconsistent reports related to the role of BDNF Val66Met in susceptibility to bipolar disorder (BD). Objectives: The aim of the present study was to investigate the role of BDNF Val66Met and its synergism with 5-HTT gene-linked polymorphic region (5-HTTLPR) variants in susceptibility to bipolar I disorder (BP-I) inWestern Iran. MaterialsandMethods: In this case-control study, 153 patients with BP-I and 146 age-and gender-matched healthy individuals were investigated for BDNF and 5-HTTLPR variants using PCR-RFLP method. Results: The frequency of BDNF A (Met) allele in patients (17. 7%) was slightly lower than that in controls (19. 9%, P = 0. 5). The concomitant presence of BDNF G (Val) and 5-HTTLPR S alleles tended to increase the risk of BP-I by 1. 41 times (P = 0. 064) compared to the combined presence of BDNF G and 5-HTTLPR L alleles. Also, interaction between BDNF G (Val) and 5-HTTLPR S tended to increase the risk of BP-I by 1. 28-fold (P = 0. 062) compared to the concomitant presence of BDNF A and 5-HTTLPR S alleles. Conclusions: This study, conducted for the first time on Kurdish population in Western Iran, did not indicate any association between BDNF Val66Met with BP-I. However, the interaction between BDNF and 5-HTTLPR variants tended to increase the susceptibility to BP-I.

Background: Anxiety disorders which influence physical and psychological strength and the quality of individual and social life are afflicting great numbers of people both in the modern developed societies and in underdeveloped ones. As two cases of transdiagnostic factors influencing a wide range of psychological disorders, especially anxiety disorders, repetitive thinking (RT) and perfectionism are now receiving greater attention from psychologists and psychotherapists. Objectives: The current study was an attempt to investigate the mediating role of RT in predicting the relationship between perfectionism and severity of anxiety. Materials and Methods: For this purpose, 385 students of Azerbaijan Shahid Madani University were selected using cluster randomsampling and evaluated through the three inventories of depression and anxiety symptoms, repetitive thinking questionnaire (RTQ) and perfectionism questionnaires in 2015. Data were analyzed using SPSS software and hierarchical regression analysis. Results: Findings suggested that there were correlations among three variables of perfectionism, RT and anxiety; results also revealed that RT played a significant mediating role in predicting the relationship between perfectionism and anxiety. Conclusions: These findings canbeaneffective step toward designing plans to prevent different emotional disordersandtreatment protocols.

Background: Suicide behaviors cause a large portion of Disability adjusted life years worldwide. Objectives: The aim of this research was to study the trend, correlations and discrepancy of registered suicide incidents in Iran from 2009 to 2012 using data from the Iranian suicide registry. Materials and Methods: Suicide registry entries throughout the country between 2009 and 2012, including suicidal attempts and suicides, were collected. Data on age, gender, occupational, marital and residential status along with suicide method, history of previous attempt and history of medical or mental disorders were registered by health service provision staff at the service centers. Geographic mapping and statistical analysis were performed. Results: Amongst the 252911 attempted suicides during the period, we found suicide attempt and suicide rate of 30. 5-44. 8 and 1. 76-2. 23 per 100000 individuals, respectively, denoting overall suicide fatality rate of 2. 63%. The rate of suicide attempt in different provinces ranged between 0. 7 and 271. 1 and the rate of suicide between 0. 17 and 17. 7 per 100000 individuals. Attempted suicides showed more fatality in males, elderly, widow/widowers, divorced and unemployed subjects as well as in residents of rural areas. The most common attempt methods were medication overdose (84%), and the mostcommonsuicide methods were hanging (30. 3%), medications overdose (28. 1%) and self-burning (17. 9%); these methods are found at different rates in various parts of the world. Conclusions: While the registry could provide us the most valid data on suicide, the wide range of suicide and suicide attempt rates in different provinces not only could question this statement but also could highlight the importance of studying the ethnic/geographic variations in suicide epidemiology with improved suicide registry and surveillance systems.

Objectives: This study investigated the relationship between cognitive emotion regulation, emotional problems and attachment style among students in a causal model. Materials and Methods: The sample group included 285 bachelor students of Tabriz University that were selected randomly by multi-stage cluster sampling. The study instruments were revised adult attachment scale (RAAS), cognitive emotion regulation questionnaire and depression anxiety and stress scale (DASS 21). Results: The findings indicated that attachment dimensions predict negative and positive emotion regulation strategies. The cognitive emotion regulation mediated between attachment dimensions and emotional problems. Furthermore, attachment dimensions had a direct and indirect effect on emotional problems. Conclusions: Findings of the current study are consistent with previous findings and theoretical stance indicating the predictability of mental health indices from quality of attachment in student.

Background: Stress is an important occupational hazard in numerous occupations. The consequences of stress have been associated with a number of health conditions. Objectives: The aim of this study was to investigate whether nurses’ perceived levels of stress are associated to presenteeism and absenteeism. Materials and Methods: In a cross-sectional study, conducted at a public general hospital in Croatia, medical nurses filled the perceived stress scale (PSS-10) and short-form of theWorld health organization health and work performance questionnaire (WHO HPQ). Results: Nurses experiencing absenteeism (26, 53%) had a little higher levels of stress (X = 18. 85, SD = 7. 31) when compared to those without absenteeism (X = 17. 52, SD = 6. 63), t (144) = 1. 037, P = 0. 301. Nurses with presenteeism (15. 74%) had statistically significantly higher levels of stress (M = 21. 42, SD = 5. 62), compared to nurses without presenteeism (X = 17. 35, SD = 6. 84), t(144) = 2. 47, P = 0. 015. Linear regression (R2 = 0. 032, P = 0. 036) showed an association between presenteeism and stress (B = 3. 952, S. E. = 1. 26,  = 0. 069). No association was found between absenteeism and stress. Conclusions: Although there is an association between presenteeism and stress, we cannot draw a causal line from this finding.

Background: Couple burnout results from plethora of non-realistic expectations, irrational thoughts, past awareness and understanding of each other’ s needs and wide difference of couples past expectations and reality. Objectives: The present research was conducted to investigate the effectiveness of solution-focused therapy on couple burnout among couples referred to Shahryar city court for divorce. Materials and Methods: The population included all couples referred to this court during the month of May, 2014. The sample consisted of 20 couples, who were selected via convenience method and then randomly assigned to two groups for this study. The instrument used in this study was Pines’ couple burnout scale. The design of this study was pretest-posttest with a control group. All subjects answered the scale, and then the experimental group received intervention of Solution-focused therapy for eight, ninetyminute sessions. At posttest stage, the two groups answered the scale again. Data of this research were analyzed by the method of multiple covariance analysis. Results: The result of this study showed that solution-focused therapy decreased couple burnout of the experimental group compared with the control group. Conclusions: Solution-focused therapy decreased couple burnout among couple referred to Shahriar city court for divorce.

Background: Both capital punishment and euthanasia are highly disputed practices that are considered justified by their proponents. Emotional component of attitude has been ignored in the scales developed to assess attitude on capital punishment and euthanasia. Objectives: This development study aimed to develop an assessment tool to evaluate emotional attitude (ignored by previous scales) toward capital punishment and euthanasia that are considered justified by their proponents in 2015. The scale, as defined by the authors, measures individuals’ attitude revealing their sense of self or non-self, although lawis in no condition to tackle the exception either crime or euthanasia. After assessing face validity with two psychologists, a clinical psychologist and a psychometric expert at the school of behavioral sciences and mental health, a justified death attitude scale (JDAS) was performedon571 students of national universities of Tehran to evaluate construct validity of the scale. Data were analyzed using the exploratory factor analysis, chi-square, and multivariate analysis of variance. Materials and Methods: The justified death attitude scale included 59 items; other than the first 4 warm-up questions, each item included a scenario inwhicha decision should bemadeby the subjectonlife of the personage. Scenarios are related to rape, adultery, murder, drug trafficking, and active and passive euthanasia. The aforementioned scenarios and items are developed based on social interviews. Results: The justified death attitude scale showed an acceptable reliability and included eight factors that could explain 80. 56 variance of the scale. A comparison with warm-up items and main items indicated that poll did not assess euthanasia attitude (P > 0. 05), but it could assess death penalty attitude (P < 0. 05). Conclusions: The justified death attitude scale has acceptable validity and reliability in emotional attitude assessment of capital punishment and euthanasia.

Background: Hardiness as one of the personality traits is an important factor in predisposing risky behaviors including addiction. Objectives: This research examines the relationship between hardiness and addiction potential and identifies socio-economic determinants of hardiness and tendency to addiction among medical students in Iran. Materials and Methods: In this study, 577 medical students selected based on the convenience sampling method were examined. They were selected from five faculties of Qazvin University of Medical Sciences. Data were collected on hardiness scale, addiction potential scale and demographic variables. Data analysis included descriptive and inferential statistics powered by SPSS (v. 22). Results: Research results showed that there was a negative relationship between hardiness and addiction potential (r =-227, P < 0. 001). Males had a higher level of hardiness (P < 0. 05) and lower addiction potential than females (P < 0. 01). Respondents who had an addicted person in their family showed a lower addiction potential than those who did not have an addicted family member (P < 0. 01). Being in a family with cold relationships was associated with higher levels of hardiness; they showed less addiction potential compared to persons who enjoyed a warm family with friendly relationships (P < 0. 01), but lower levels of hardiness. Conclusions: Hardiness had a significant negative relationship with tendency to addiction. Regarding demographic factors that were found to be the predictors of hardinessandaddiction potential, a consistent patternwasobserved inwhichthosewhohadhigh tendency for addition were low in hardiness. This is not surprising since hardiness is a shield that provides a defense mechanism for coping behavior when a person is faced with negative life events or adverse life conditions. Based on the results, individuals high in hardiness are perhaps less likely to resort to drugs. However, further researches are recommended on this subject.