Iranian Journal of Psychiatry and Clinical Psychology
Year:2017 | Volume:23 | Issue:3|Papers Count:12

Kraepelin was the first who recognized the phenomenon of cycling in bipolar disorder in 1913. The term rapid cycling was proposed by Dunner and Fieve in 1974. Later on, Kramlinger and Post defined ultra-rapid cycling and ultradian cycling in 1996. Frequent rapid mood switches are an inherent characteristic of bipolar disorder, and rapid cycling is included as a course specifier for bipolar disorder in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Although the terms cycle and episode are commonly used to delineate discrete periods of mood disorders, literature still suffers from the inconsistent and indistinct definition for them. Therefore, the reported prevalence of rapid cycling bipolar disorder shows a wide variability across studies, which ranges from 15% to 53.6% in adults, and 41.8% to 87.1% in children. Moreover, studies have used different definitions for rapid, ultra-rapid, and ultra-ultra-rapid/ultradian cycling, which has reduced the comparability of data across studies. However, the higher prevalence of rapid, ultra-rapid, and ultra-ultra-rapid/ultradian cycling reported in children with bipolar disorder, compared to adults, may make the pattern of cycling a key criterion in the diagnosis of early-onset bipolar disorder. Obviously, there is a significant need to stabilize a distinct specific definition for each of the terms episode, cycle, rapid cycling, ultra-rapid cycling, and ultra-ultra-rapid/ultradian cycling, based on the consensus of experts in bipolar disorder, in children and adults. In addition to increasing the value of research, using common terminologies and definitions enables comparison between studies and improves diagnostic criteria of rapid cycling bipolar disorder and its therapeutic and management plans in both the early- and adult-onset types.

Objectives: This study was conducted to design Individual Differences intervention based on parents’ expressed emotion and its impact on children’s social skills with high-functioning autism disorder.Methods: The first part of this study is comparative-causal and the second part is a semi-experimental study. In order to design Floortime treatment plan based on parents’ expressed emotion, first in an Embedded Design Mixed Research Method by means of researcher’s questionnaire for qualitative measurement and family questionnaire for quantitative part of emotional state of mothers with autistic children were measured.Accordingly, the treatment plan with 23 meetings was codified. Finally, 20 children with high-functioning autism were selected from the autism centers by available sampling. Out of them, 10 children were put into the experimental group and they were provided designed intervention plan in addition to the ABA intervention, and the other 10 children formed the control group, who merely received Applied Behavior Analysis (ABA) intervention. Tools used were Family Questionnaire, ASSQ test, Stanford-Binet intelligence test, and Gilliam and Vineland social compatibility tests.Results: Results show that there are significant differences in mother’s expressed emotion in case of normal and autistic children. The expressed emotion of mothers of autistic children is high in terms of the total score of expressed emotion, criticism, and Emotional Over-Involvement (EOI). After the intervention, no significant difference was observed in the social compatibility and communication skills between the two groups of children who were under the ABA intervention and who were under Floortime intervention. But after the intervention, the experimental group had a better score in relation variable.Conclusion: Given the high level of excitement expressed by parents of children with autism, various interventions have to reduce their excitement. You can also use social interventions such as floortime intervention to increase the association of children with high performance autism disorder.

Objectives: The current study investigated the structural relationship between autistic traits, the components of social problem-solving deficiencies and depressive-anxiety symptoms.Methods: The study was conducted in 2015-2016 consisting of 336 students (male and female) with their age ranging from 18 to 35 years old. They were selected by using the convenience sampling method, and were assessed on Autism Spectrum Quotient (AQ), social problem-solving (SPSI-SF), and depression and anxiety symptoms (BAI and BDI-II). For data analysis, Pearson conduct coefficient, structural equation modeling, and boot stooping methods were conducted.Results: The results of the analysis revealed that the deficit in social problem-solving component has an intermediary role in assessing the relationship between the severity of autistic traits, and depression-anxiety symptoms. All other hypothetical fitness indices model were in the appropriate range of positive cross-correlation (0.45³r³0.25) between autistic traits, problem-solving deficiencies component, and depression- anxiety, All relations were found to be statistically significant (P<0.01).Conclusion: The findings from the current study provide further support to the structural relationship between the components of the problem-solving deficiencies, severity of depressive - anxiety symptoms, and autistic traits. The understanding of how they are related to depressive - anxiety symptoms will hopefully help in informing about the future attempts for adopting an effective problem-solving programs for individuals with autistic traits.

Objectives: Attributing the intention to others’ behavior is one important factor in the theory of mind development. This study aimed to assess validity of the "Moving shapes" paradigm in a group of Iranian school-aged children to evaluate their understanding the intention of others’ behavior.Methods: Through randomized cluster sampling, students at grades 3 to 5 were recruited among the mainstream schools in Tehran. Parents completed the Child Behavior Checklist (CBCL). After using the Ishihara test to rule out color-blindness, the "Moving shapes" paradigm was performed for all participants. Data were analyzed using descriptive methods, T test, linear regression, and Pearson’s correlation analysis.Results: The mean age of the participants was 9.96 (SD=0.916) years, and 49.2% of them were male. There was no association between age and gender with intentionality score. All variables of the paradigm were significantly correlated with each other (P<0.05). The correlation coefficient for intentionality score and number of metallizing terms was 0.612 (P=0.01). There was no significant association between the CBCL subscale scores and animated variables.Conclusion: The "Moving shapes paradigm" can be used as a valid test for evaluation of the intentionality in Iranian school-aged children.

Objectives: This study was done to evaluate the clinical characteristics, function, quality of life, and premorbid adjustment of inpatient children and adolescents with First-Episode Psychosis (FEP) at Roozbeh psychiatric hospital.Methods: During a two-year cohort study (2013-2014), all admissions in the child and adolescent psychiatric ward were evaluated. Diagnoses were made using clinical assessment and the Kiddie Schedule for Affective Disorder and Schizophrenia-Present and Lifetime Version-Persian Version (K-SADS-LV-PV). The Positive and Negative Symptoms Scale (PANSS), Premorbid Adjustment Scale (PAS), Clinical Global Assessment Scale (CGAS), and WHO-Quality of Life-Brief (WHOQOL-Brief) were used to assess the related variables.Results: Among 44 participants (47.7% boys) with a mean age of 193.11 (21.5) months, 68.3% were suffering from Bipolar Disorder (BD) and 15.9% from Schizophrenia. Poor premorbid adjustment before the emergence of psychosis was indirectly related with academic level and directly consistent with suicidal risk and duration of psychotic disorder (P<0.05). The level of premorbid global functioning was higher than 80% only in 7% of the participants. This score was less than 40% in 95% of the participants during admission.Conclusion: Bipolar disorder was the most common diagnosis among the child and adolescent inpatients with FEP. FEP was consistent with poor premorbid adjustment and severe global functioning impairment. These findings confirm the need for prevention and early interventions in at-risk individuals.

Objectives: The aim of this study is to investigate the mediating role of rumination in relation to the attachment styles and depression symptoms.Methods: This is an expost facto study with causal design. Around 175 students of Iranian University answered to Beck Depression Inventory-II (BDI-II), Ruminative Responses Scale (RRS), and the Adult Attachment Questionnaire (AAQ), which were analyzed using variance analysis, regression, and mediation analysis.Results: The study results showed that attachment orientation is related to rumination (P<0.001) and depression (P<0.0005). Specifically, avoidance index of attachment system is strongly associated with brooding (P<0.002). Our results also supported the mediating role of brooding in between avoidance index and depression symptoms (P<0.0005).Conclusion: Brooding mediate in between avoidance index and depression symptoms. The study findings also emphasize the role of caregiver-child relationship in the formation of rumination and depression, and recommend implementing preventive programs in order to restrain the development of such dysfunctional construct.

Objectives: Aim of this study is to investigate the self-narration of patients with schizophrenia.Methods: The study was done by narrative analysis and the statistical sample consisted of nine patients with schizophrenia, who were selected through purposive sampling. Research instruments used were Mental Status Examination form (MSE) and McAdams life story interview. Structural analysis and content analysis methods were used for analyzing data.Results: Results showed that the narrations of these patients began with an unstable situation in which there were some clues of a great chaos. This chaos is usually caused due to schizophrenia that totally impacts the narrator’s life. According to content analysis the main theme of the narrations of patients with schizophrenia was be sacrificed. Rejection, insecurity, loneliness, shame, and guilt were other important themes in their narrations. The absence of a father and an over-involved mother were also the themes of the narration.Conclusion: Data showed that the self-perception of patients with schizophrenia was self-centered perception and the illness had a critical role to play in that.

Objectives: The purpose of the present study was to investigate some psychometric characteristics of Secondary Trauma Questionnaire (STQ) in the wives of warfare victims.Methods: Children of warfare victims living in Yazd, Esfahan, Shiraz, and Ahvaz and studying at Shahed and Isargar Schools of present in these cities in 2011-12 academic year were the target population for this study. Of this population, 379 subjects were selected by cluster sampling method. Secondary Trauma Questionnaire (STQ), Secondary Traumatic Stress Scale (STSS), Mississippi PTSD Scale, and Depression Anxiety Stress Scale (DASS) were used to collect the data. Confirmation factor analysis, Pearson correlation, and independent samples t-test were used to analyze the data.Results: Findings of confirmation factor analysis revealed that STQ, similar to the one approved by the developers of this scale had a one-factor structure in Iranian samples. Face validity of STQ using item impact method and content validity of this scale using Content Validity Index (CVI) and Content Validity Ratio (CVR) were confirmed. There were significantly high correlations among the STQ scores of participants and STSS, PTSD Scale, and DASS that approved the convergent validity of the scale (P<0.01). By using STQ, we were able to discriminate the group of subjects with high mental health from those with low mental health (discriminant validity).Conclusion: The Farsi version of secondary trauma scale was valid and reliable for the wives of Iranian warfare victims.

Objectives: The Stanford Hypnotic Susceptibility Scale: Form C (SHSS: C) was first introduced by Weitzen-hoffer and Hilgard in 1952 and then revised and completed in 1962. The given scale mainly measures behavioral compliance and suggestibility within a whole range of hypnotic phenomena (movements as well as examples of imagination and cognitive distortions) in a short time. Thus, the purpose of this study was to investigate the psychometric properties of SHSS: C in a non-clinical population.Methods: This descriptive study was conducted on 300 students from different schools of Kermanshah University of Medical Sciences in Iran selected by multi-stage cluster random sampling method and tested via research instruments such as SHSS: C, the Hypnotic Induction Profile (HIP), the Harvard Group Scale of Hypnotic Susceptibility by Spiegel, and the NEO Five-Factor Inventory (NEO-FFI). The data obtained were analyzed using descriptive statistics, correlation coefficient, exploratory factor analysis, Cronbach’s alpha coefficient, and Guttman’s split-half coefficient using the SPSS software version 22.Results: Factor analysis using varimax rotation from the principal component analysis extraction method for the SHSS: C could lead to the extraction of three factors of hypnotic susceptibility talents of perceptive-cognitive abilities, sensory-motor phenomena, cognitive distortions, and post-hypnotic effects. The reliability coefficients (alpha, test-retest, and internal consistency) were also equal to 0.80, 0.75, and 0.74, respectively. Moreover, three types of validity (concurrent, criterion, and correlation between subscales and total scale and inter-correlations) for the HIP, the Harvard Group Scale of Hypnotic Susceptibility by Spiegel, and the NEO-FFI were reported to be 0.89, 0.84, and 0.68, respectively.Conclusion: The results showed that the SHSS: C was endowed with desirable psychometric properties in an Iranian population, and it could be used in research studies on psychology and psychiatry.

Objectives: In 1974, Iraj Siasisi and Ahmad Mohit decided to open a psychiatry/mental health institute in Iran. They aimed to radically change mental health, addiction prevention, and mental rehabilitation training, as well as national mental health research and services in Iran. To this end, two years later in 1976, Tehran Institute of Psychiatry was founded in Tehran. Then in 2013, its name changed to School of Behavioral Sciences and Mental Health. This paper reports the process of developing the Institute and mental health services in Iran and Eastern Mediterranean Region.Methods: This report is the last section of a three-part report published in this journal in 2017. The study method was an in-depth interview with the present director of the Institute and literature/ document analysis. The author at first recorded and documented the interview and then reviewed its content and relevance to academic literature.Results: The main purpose of establishing Tehran Institute of Psychiatry was to decentralize the services of psychiatry, clinical psychology, and mental health from state and big psychiatric hospitals to small medical centers in Iran. This important step resulted in an evolution in mental hospitals care facilities and decentralization care in many small/ general hospitals all over Iran. This center integrated mental health into the primary health cares in Iran, created a platform to develop mental health program for the country, and became responsible for implementing it, as well. Furthermore, every year a lot of experts in relevant areas of knowledge are being trained in this institute and many national research has been undertaking in it.Conclusion: History of mental health and addiction prevention, decentralization of psychiatric services, and integration of mental health in primary health care in Iran and some other countries are immensely devoted to Tehran Institute of Psychiatry: School of Behavioral Sciences and Mental Health.