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Although sleep disturbance is associated with suicide ideation, underlying cognitive-affective mechanisms that may explain this association are not well understood. The aim of the present study was to concurrently evaluate whether emotion regulation difficulties and distress tolerance explain this association among Iranian university students. A total of 679 Iranian university students (66.42% females; Mage = 24.34 years, SD = 4.86) completed a battery of online self-report questionnaire. Structural equation modeling was used to empirically explore the relations among variables. Sleep disturbance was positively associated with suicide ideation. Higher sleep disturbance symptoms were associated with higher levels of suicide ideation. Sleep disturbance was indirectly related to suicide ideation through both emotion regulation difficulties and distress tolerance. Findings expand knowledge of cognitive-emotional processes that may explain the sleep disturbance-suicide ideation association among Iranian university students. Iranian students experiencing sleep disturbance may benefit from intervention strategies targeting emotion regulation skills and distress tolerance to reduce suicide ideation. [ABSTRACT FROM AUTHOR]

Background: Anxiety disorders are highly prevalent and debilitating conditions that show high comorbidity rates in adolescence. The present article illustrates how Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Adolescents (UP-A) was adapted for Iranian adolescents with anxiety disorders. Methods: A total of 54 adolescents with comorbid anxiety disorders participated in a randomized, waitlist-controlled trial of group weekly sessions of either UP-A or waitlist control (WLC). Primary and process of change outcomes were assessed at baseline, posttreatment, and 1-month follow-up. Results: Significant changes were observed over time on major DSM-5 anxiety disorder symptoms (F (2, 51) = 117.09, p < 0.001), phobia type symptoms (F (2, 51) = 100.67, p < 0.001), and overall anxiety symptoms (F (2, 51) = 196.29, p < 0.001), as well as on emotion regulation strategies of reappraisal (F (2, 51) = 17.03, p < 0.001), and suppression (F (2, 51) = 21.13, p < 0.001), as well as on intolerance of uncertainty dimensions including prospective (F (2, 51) = 74.49, p < 0.001), inhibitory (F (2, 51) = 45.94, p < 0.001), and total intolerance of uncertainty (F (2, 51) = 84.42, p < 0.001), in favor of UP-A over WLC. Conclusion: Overall, results provide a cultural application of the UP-A and support the protocol as useful for improving anxiety disorders as well as modifying of emotion regulation strategies and intolerance of uncertainty dimensions in Iranian adolescents. Future directions and study limitations are discussed. [ABSTRACT FROM AUTHOR]

The majority of patients suffering from anxiety disorders in low- and middle-income countries do not receive evidence-based treatments. The Unified Protocol (UP) for the Transdiagnostic Treatment of Emotional Disorders is an evidence-based cognitive–behavioral intervention designed to treat the range of emotional disorders. Using a single-case experimental design five patients with panic disorder were assigned to a 3-week baselines assessment phase followed by eight sessions of UP treatment and 4-week follow-up phases. Multiple outcome measures of panic severity, anxiety sensitivity, affectivity, and overall anxiety severity and impairment were administered weekly during the baseline, intervention, and follow-up phases. At post treatment, all participants showed significant reductions in outcome measures, with changes functionally related to treatment and most improvements maintained at 4-week follow-up. Findings provide preliminary cross-cultural support for UP and add to the growing body of literature showing UP can be useful for patients with anxiety disorders in low- and middle-income countries with non-Western cultures. [ABSTRACT FROM AUTHOR]

Objective: The present study examined the psychometric properties of a Persian version of the Intolerance of Uncertainty Scale for Children (IUSC; Comer et al, 2009). Method: Participating youth (n = 346) 8 to 18 years of age were nonreferred community youth (n = 279) or youth who met diagnostic criteria for an anxiety disorder (n = 67) and their parents. Results: Across child- and parent-report data, confirmatory factor analysis supported a shortened 12-item version of the IUSC, and the confirmatory factor analysis also confirmed a theory-driven correlated two-factor structure of the IUSC-12. (i.e., prospective/inhibitory IU). Results further supported reliability and validity of parent- and child-reports of the Persian IUSC-12 via evidence of internal consistency, 4-week retest, significant associations with established measures of internalizing problems, and the ability of the measure to reliably distinguish the clinical sample from the community sample. Conclusion: Findings demonstrate sound psychometric properties of the Persian version of the IUSC-12 and provide additional support for the reliability and validity of the measure and its use in non-Western cultures. Findings are discussed in terms of implications for assessment, treatment, and study of anxiety and related internalizing problems in Iranian youth. [ABSTRACT FROM AUTHOR]

Trauma-focused cognitive-behavioral therapy (TF-CBT), broadly, is one of the leading evidence-based treatments for youth with posttraumatic stress disorder (PTSD). Generally, few culturally adapted TF-CBT interventions have been examined among war trauma-affected populations in low- and middle-income countries. Using a randomized clinical trial design, a total of 48 war trauma-exposed women in Iraq, Mage (SD) = 32.91 (5.33), with PTSD were randomly assigned to either TF-CBT or wait-list control (WLC) conditions. The intervention group received 12 individual weekly sessions of a culturally adapted TF-CBT intervention. Significant reductions in PTSD symptom severity were reported by women in the TF-CBT condition from pre- to posttreatment. Women in the TF-CBT condition reported significantly greater reductions in PTSD symptoms compared to WLC at 1-month follow-up. Additionally, levels of depression, anxiety, stress, and use of maladaptive emotion regulation strategies were significantly lower in the TF-CBT condition at posttreatment and 1-month follow-up, compared to the WLC condition. Women in the TF-CBT condition also reported significant improvements in various domains of quality of life at posttreatment and 1-month follow-up. This clinical trial provides preliminary cross-cultural support for the feasibility and efficacy of TF-CBT for the treatment of PTSD symptoms among women in non-Western cultures. Future directions and study limitations are discussed. [ABSTRACT FROM AUTHOR]

Childhood maltreatment (CM) and insecure attachment styles may partly explain grief severity following romantic breakup. Empirical studies examining the factors that could possibly explain this association, however, remain sparse. The present study tested whether the relations among CM, attachment styles, and romantic breakup grief severity could be explained by emotional suppression in Iranian college students. In a cross-sectional study, 239 Iranian college students (ages 18–45; M = 24.11, SD = 15.29; 50.6% women) with a recent romantic breakup experience were recruited from University of Tabriz. Participants completed a diagnostic interview and self-report battery, including the Persian version of the Child Abuse Self-Reported Scale, Revised Adult Attachment Scale, Romantic Breakup Grief Inventory, and Weinberger Adjustment Inventory. Structural equation modeling was used to empirically explore the relations among variables. Results indicated that those who reported higher levels of CM also reported higher levels of romantic breakup grief. Attachment closeness showed a significant negative and direct effect on romantic breakup grief severity. However, attachment anxiety was positively associated with greater levels of romantic breakup grief. Bootstrapping results showed that CM might affect romantic breakup grief severity via emotional suppression. Furthermore, attachment closeness and attachment anxiety exerted indirect effects on romantic breakup grief severity through emotional suppression. Clinical and empirical implications are discussed. [ABSTRACT FROM AUTHOR]

This study compared the effects of adding acceptance and commitment therapy (ACT) or exposure and response prevention (ERP) to adults diagnosed with obsessive compulsive disorder (OCD) already on an optimal and stable dose of selective serotonin reuptake inhibitors (SSRIs). Forty adults on SSRIs who were diagnosed with OCD participated in a randomized controlled trial in Iran of 12 individual weekly sessions of either ACT+SSRI, ERP+SSRI, or continued SSRI only. The results showed significant reductions in OCD symptom severity in ACT+SSRI and ERP+SSRI conditions at posttreatment with significantly greater reductions in both conditions compared to SSRI-only at follow-up. Additionally, psychological inflexibility and use of thought control strategies significantly decreased in the ACT+SSRI condition at posttreatment and follow-up compared to the ERP+SSRI and SSRI conditions. Both conditions led to decreases in perceived importance of stop signals. Results provide cross-cultural support for the treatment of OCD using ACT and ERP as adjuncts to SSRI and modest process of change differences between ACT and ERP. Future directions and study limitations are discussed. [ABSTRACT FROM AUTHOR]

This study evaluated the psychometric properties of the Persian version of the Obsessive–Compulsive Inventory–Child Version (OCI-CV) in clinical and community samples. Factor structure (confirmatory factor analysis), validity (convergent/discriminant, and predictive), and reliability (internal consistency, and 4-week retest) of the Persian version of the OCI-CV were investigated in a sample of 391 children and adolescents 7–17 years comprised of two groups: a clinical sample of youth with OCD (n = 62), and a community sample (n = 329). Participants completed the OCI-CV, Multidimensional Anxiety Scale for Children (MASC), Children's Depression Inventory (CDI), and Child Behavior Checklist (CBCL). Similar to the English version of the OCI-CV, the Persian version of the scale demonstrated a stable six-factor structure, good convergent and discriminant validity through its correlations with other specific measures of pediatric psychopathology, acceptable sensitivity and specificity for the detection of OCD, and good reliability in terms of internal consistency and temporal stability. These findings suggest that the OCI-CV is a valid and reliable measure to assess obsessive–compulsive symptom dimensions in Iranian youth. Findings provide cross cultural support on the utility of OCI-CV as a self-report measure of obsessive–compulsive symptomology. [ABSTRACT FROM AUTHOR]

Given the high prevalence and adverse outcomes associated with generalized anxiety disorder (GAD), development and expansion of effective treatment modalities are important. The present study compared the effectiveness of cognitive behavior therapy targeting intolerance of uncertainty (CBT-IU) and selective serotonin reuptake inhibitors (SSRIs) for treating GAD. A total of 30 Iranian patients with GAD (Mage = 25.16 ± 6.73) were randomised to receive either CBT-IU (n = 15) or SSRI (n = 15). Measures included the Structured Clinical Interview for DSM-5 (SCID-5), Penn State Worry Questionnaire (PSWQ), Why Worry-II (WW-II), Intolerance of Uncertainty Scale (IUS), and Negative Problem Orientation Questionnaire (NPOQ). Repeated measures analysis of variance tested differential treatment outcomes. The results of intention-to-treat (ITT) analysis indicated that although both CBT-IU and SSRI were effective treatments for GAD, CBT-IU produced significantly better results than SSRI at post-treatment. This clinical trial provides preliminary cross-cultural support for the treatment of GAD using CBT-IU, with findings suggesting that this non-medication intervention reduces GAD symptoms. [ABSTRACT FROM AUTHOR]

According to the DSM-5 dimensional approach and evidence-based assessments classification, the Children's Florida Obsessive Compulsive Inventory (C-FOCI) is a promising instrument for the dimensional assessment of both the presence of obsessive–compulsive symptoms and their severity in youth. The aim of this study was to evaluate the reliability (internal consistency, and four-week retest), validity (convergent and predictive), and factor structure (confirmatory factor analysis) of a Persian version of the C-FOCI across clinical and community samples of youth. Participating youth (N = 391) from 7–17 years of age included non-referred community youth (n = 329) or youth who met diagnostic criteria for OCD (n = 62). Similar to the original English version of the C-FOCI, the Persian version of the scale demonstrated a two independent factor structure, good convergent and discriminant validity through its correlations with other specific measures of pediatric psychopathology, good reliability in terms of internal consistency and temporal stability, and acceptable sensitivity/specificity for the detection of pediatric OCD caseness. These results suggest sound psychometric properties of the Persian version of the C-FOCI. Findings add to the literature and provide cross cultural support on the utility of C-FOCI as a dimensional measure for assessing both obsessive–compulsive symptoms and their severity in clinical and research settings. [ABSTRACT FROM AUTHOR]

Since the beginning of the coronavirus disease-2019 (COVID-19) outbreak, individuals worldwide have shown different anxiety-related reactions. Several vulnerability factors may play a role in individuals' psychological reactions to the COVID-19 pandemic. Such factors include pathological personality traits which have been shown to contribute to the development of anxiety-related conditions. Consequently, the present study investigated the relationships between DSM-5 pathological personality domains and COVID-19-related anxiety symptoms. Using an online data portal, the relationships between DSM-5 pathological personality domains and COVID-19-related anxiety symptoms among a mixed university student and community sample (N = 612) were studied. The results showed that there was a positive and significant relationship between all DSM-5 pathological personality domains and COVID-19-related anxiety. The results of multiple linear regression analysis showed that DSM-5 pathological personality domains explained 21% of COVID-19-related anxiety variance. Based on standardized coefficients, the Personality Inventory for DSM-5 (PID-5) negative affect domain had the main role in COVID-19-related anxiety. The findings suggest that pathological personality domains can be predictors in the symptoms of anxiety in a viral outbreak. The novel findings add to the literature on individual differences in domains of personality in response to pandemic situations. Implications for future clinical applications and research investigations are discussed. [ABSTRACT FROM AUTHOR]

This study examined the psychometric properties of a Persian translation of the Body and Appearance Self-conscious Emotions Scale. A total of 393 university students from Iran completed the Body and Appearance Self-conscious Emotions Scale, along with measures of depression, self-esteem, affect, body appreciation, physical self-perceptions, personality, obsessive-compulsive disorder, and body dysmorphic disorder. Confirmatory factor analysis indicated that the four-factor structure had adequate fit. Further analyses indicated that the Body and Appearance Self-conscious Emotions Scale scores evidenced internal consistency, convergent validity, and test–retest reliability. These results suggest that scores on the Persian version of the Body and Appearance Self-conscious Emotions Scale show evidence of reliability and validity in the Iranian population and can be used in the field of research and treatment. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of acceptance and commitment therapy (ACT) on depressive symptoms in physically disabled persons. Design: Randomized controlled trial. Setting: State welfare organization in Kamyaran, Kurdistan, Iran. Participants: Fifty-two physically disabled participants with a primary diagnosis of depression were randomly assigned to either ACT or control groups. Interventions: Participants in the ACT group (n = 23) received eight weekly 90-minute group sessions based on standard ACT protocol for depression. Participants in the control group (n = 29) received psychoeducation regarding depression. Main measures: Measures were recorded at baseline, eight weeks (end of treatment), and 16 weeks (follow-up). The outcomes were the change in the depressive symptoms, measured by Beck Depression Inventory-II (BDI-II), psychological flexibility, emotion regulation, and psychological well-being measured by Acceptance and Action Questionnaire-II (AAQ-II), Emotion Regulation Questionnaire (ERQ), and Scales of Psychological Well-Being (SPWB), respectively. Results: After eight weeks, significant changes in depressive symptoms was observed in the experimental group (ACT –10.39 ± 0.79 vs control 0.66 ± 0.68, P < 0.001). Compared to the control group, the experimental group also showed significant improvement in psychological flexibility (ACT 8.13 ± 0.52 vs control –0.03 ± 0.51, P < 0.001), adaptive emotion regulation strategies (ACT 10.74 ± 0.62 vs control 0.03 ± 1.03, P < 0.001), and psychological well-being (ACT 66.95 ± 4.01 vs control –1.90 ± 1.04, P < 0.001). Conclusion: Compared with control group, ACT significantly reduced the participants' depression, and changed psychological flexibility, emotion regulation, and psychological well-being in persons with physical disability. [ABSTRACT FROM AUTHOR]

Pregnant women are at high risk of mood and anxiety disorders, and options for non-pharmacological treatment are limited. Mindfulness-based cognitive therapy (MBCT) has strong evidence among people with mood and anxiety disorders, but limited studies reported the effectiveness of MBCT on perinatal comorbid conditions. This study aimed to examine the effects of an 8-week MBCT intervention on pregnant women with comorbid depression and anxiety. In this randomized controlled study, 38 pregnant women with a diagnosis of depression and varying levels of comorbid anxiety disorders were randomly assigned to either MBCT or a control group. Scores on the Beck Depression Inventory-II, Beck Anxiety Inventory, Emotion Regulation Questionnaire, and Scales of Psychological Wellbeing were used as outcome measures at baseline, after MBCT, and through 1-month follow-up. Intent to treat analyses provided preliminary evidence that MBCT can be effective in reducing depressive and anxiety symptoms and in enhancing the use of adaptive emotion regulation strategies and psychological well-being. Improvements in outcomes were maintained 1 month. Results provide cross-cultural support for MBCT as a treatment for depression and anxiety in pregnant women. This brief and non-pharmacological treatment can be used to improve maternal psychological health. [ABSTRACT FROM AUTHOR]

High rates of comorbid depression and anxiety often complicate psychological interventions. The current preliminary study was designed to examine the efficacy of a unified and transdiagnostic model based on emotion regulation skills for patients with comorbid depression and anxiety. Forty-three participants with a diagnosis of major depression and varying levels of comorbid anxiety symptoms were randomly assigned to either a unified and transdiagnostic treatment group (UP; n = 20) or a wait-list control group ( n = 23). The treatment group received 14 weekly UP sessions. Scores on the Beck Depression Inventory-II, Beck Anxiety Inventory, and Emotion Regulation Questionnaire were used as outcome measures. Data provided preliminary evidence that UP can be effective in reducing depressive and anxiety symptoms and in improving the use of effective emotion regulation strategies up to 3 months. Present results support the implementation of UP as a beneficial group treatment for patients with comorbid depressive and anxiety symptoms. [ABSTRACT FROM AUTHOR]

Background: The high incidence and prevalence rates of depression among students identify them as a vulnerable population and make the case for the development of cost-effective treatments. Aims: We aimed to examine the comparative effects of brief group metacognitive therapy (MCT) versus behavioural activation (BA) treatments for depression, anxiety, and emotion regulation in university students. Method: All participants (25 women, 16 men; age range: 18–30 years) fulfilled criteria for major depression and were randomly assigned to MCT (n = 15), BA (n = 15), or a wait-list control group (n = 15). The treatment groups received 8 weekly MCT or BA sessions. Scores on the Beck Depression Inventory, Beck Anxiety Inventory, and Cognitive Emotion Regulation Questionnaire were used as outcome measures. Results: This pilot study showed that both treatments were equally effective for depressive and anxiety symptoms. However, therapeutic techniques differed with regards to their effects on specific facets of emotion regulation, such as Positive Reappraisal and Catastrophizing, with MCT being more effective compared to BA. BA also showed a stronger relapse at follow-up with regards to Acceptance and Refocus on Planning. Conclusions: Results suggest that groups MCT and BA may be implemented as cost-effective treatments for students with moderate depression. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) pandemic and its consequences may impact individuals' mental health. Objectives: The present study aimed to investigate the psychological status of individuals during the COVID-19 outbreak in Iran following the government's social distancing plan. Methods: Data from 1,524 people were collected using a cross-sectional web-based survey via social media. Demographic variables and psychological status were evaluated using the General Health Questionnaire, Stress Response Inventory, and BrunelMoodScale. Results: Individuals reported that their mental health decreased during the pandemic. Four factors were associated with increased stress: (1) Fear of getting sick; (2) indefinite quarantine duration; (3) impaired daily activities; and (4) reduced social communication. One-third of the participants reported physical symptoms (32.7%), 47% anxiety, 72% social dysfunction, and 28.3% depression. Approximately half of the participants (52.2%) reported mental health disorder symptoms. Detrimental mental health characteristics were higher among females, younger people, and singles. Conclusions: Health policies should be implemented to help reduce the psychological burden during and after the Iranian government's SDP, especially among females, singles, and younger people. [ABSTRACT FROM AUTHOR]

Due to the excessive amount of counterfeit goods in the Third World countries and the losses caused by the sale of these goods, this study attempts to investigate the relationship between personality characteristics (neuroticism, extroversion, openness, conscientiousness and agreeableness) and attitudes toward purchase of counterfeit goods. This study is a cross-sectional type. The statistical population comprised graduate and undergraduate students of Hamadan University of Medical Sciences. The sample included 700 people, selected randomly by simple sampling manner and response to the attitude toward purchase of counterfeit goods questionnaire and NEO Personality Inventory. The SPSS16 software, independent t-test and Pearson correlation were used to analyze the data. Results indicated that there is a significant relationship between extroversion, openness and agreeableness with attitude toward counterfeited goods purchasing. The results also indicated that the mean difference of attitude toward counterfeit goods purchasing between gender, marital status and educational level were significant. Results indicated that personality characteristics affected consumers' attitude toward counterfeit goods purchasing and these personality characteristics can play a role in the reduction of counterfeit goods purchasing. [ABSTRACT FROM AUTHOR]