مجله روانپزشکی و روانشناسی بالینی ایران
سال شانزدهم شماره 3 (پیاپی 62، پاییز 1389)

To address the weaknesses and shortcomings of the mentally disordered patients’ charter and presenting suggestions for its improvement, the opinions of doctors, nurses and inpatients about the necessity and feasibility of patients’ charter were sought. The study was a cross-sectional survey carried out on 71 doctors, 97 nurses, and 105 inpatients in Roozbeh, Iran, Imam Hossein and Rasoul hospitals. Data were gathered through a self-performed questionnaire which was collected from Patients Rights Charter (Ministry of Health and Medical Education), the proposed patients’ rights cases and mental health care law (World Health Organization1382). Data were analyzed using descriptive statistics and Kruskal-Wallis test. All three groups agreed with “the possibility of treatment withdrawal by patients against the medical team’s advice” and the “possibility of leaving the hospital against medical advice”. The three groups agreed upon keeping patients against their will in instances when the patient “poses a threat to others”, “is not able to take care of his/her personal needs and his/her health is endangered” or “has attempted suicide”. Patients disagreed with physical constraint of the patient and using physical force in treatment. The present Patients’ Rights Charter in Iran cannot totally cover the needs of mentally ill patients.

To assess the reliability and validity of the abridged version of the Farsi version of Scale to Assess Unawareness of Mental Disorders (SUMD), as well as examining the change in insight among patients with psychotic mania in the course of recovery.

In a cross-sectional study, 36 patients with psychotic mania were evaluated for inter-rater reliability by researchers. Subsequently, 60 patients with psychotic mania were evaluated using SUMD (Abridged), Young Mania Rating Scale (YMRS), and Global Assessment of Functioning (GAF) scale in two steps: first in the beginning of admission (acute phase) and then during discharge (recovery phase).

Inter-rater reliability was calculated using intra-class correlation to be 0.73-0.93. Improvement of patients’ insight during the acute and recovery phases (p<0.01) indicated the validity of the scale.

Farsi translation of abridged version of SUMD has proper reliability and validity.

The aim of this study was to assess the symptoms of Posttraumatic Stress Disorder (PTSD) and the comorbidity of depression, anxiety, anger and dissociation with PTSD based on gender difference between two groups of earthquake-stricken boys and girls in the city of Bam and comparing it with normal adolescents in Tehran. One thousand 11-16 year old students (300 boys and 700 girls) in the city of Bam selected using multi-step cluster sampling in two educational levels as the experimental group, and 3042 eleven to sixteen year old students from Tehran as the control group were examined. Data were gathered using Syndrome Checklist for Children (form A) and Interview form of Post Trauma Stress Scale (interview form). Data were then analyzed using correlation, independent t, chi-square (c2), and Kruskal Wallis. Adolescents who had experienced the traumatic events showed higher levels of depression, anxiety, posttraumatic stress, anger and dissociation in comparison with normal adolescents (p<0.01). In the group with PTSD, frequency of all PTSD symptoms except anger symptoms was higher in girls than in boys. However, the frequency of pathological syndromes (T>65) was more evident in boys than in girls, but was non-significant. The prevalence of PTSD in the experimental group was 20%. There is a high comorbidity between symptoms of PTSD and other symptoms, which leads to a higher report of PTSD prevalence. Even though psychological vulnerability was higher in boys than in girls, it seems that gender role expectance in the expression of emotions and the method of describing the symptoms play a role in this issue.

Evaluating the association of other types of violence with sexual violence in Iranian couples, as well as assessing the relation of sexual violence and marital attitudes of abused women. 200 couples were selected via a multi-cluster sampling method and completed the Marital Attitude Survey and Conflict Tactic Scale Revised. The experience of physical or psy-chological violence increased the likelihood of sexual coercion especially in women (p<0.001). Female victims of sexual coercion cited lower attribution of problems to one's own behavior, lower expectations of improvement and perceived ability to change (p<0.05). The probability of experiencing sexual coercion escalates in cases of confronting other kinds of violence, especially in women. Incomplete marital attitudes play a significant role in the development and maintenance of sexual violence.

The aim of this research was to investigate the effect of stress on visual selective (focused) attention regarding the moderating effect of personality factor of conscientiousness.

60 subjects were chosen by multi-stage random sampling method with respect to personality and neuropsychological criteria of the research and were placed in three equal groups (two experimental groups and one control group; each group consisted of 20 subjects). Cognitive stressor tasks were first administered to the subjects in both experimental groups, and their visual selective attention was assessed subsequently. The control group’s visual selective attention was assessed without administrating any cognitive stressor tasks. Two indexes were used to assess the visual selective attention: counting error and classification error. The research data were analyzed by t-test for two independent samples.

The results showed that stress significantly increases the rate of both counting error and classification error (p<0.0001). It was also shown that conscien-tiousness contributes in stress effect and causes additional significant increase in both counting and classification errors (p<0.0001).

The research results revealed that stress significantly reduces visual selective (focused) attention to neutral stimuli and conscien-tiousness accentuates this negative effect.

In view of the existing methodological drawbacks in the previous investigations of NEO-Personality Inventory-Revised, the present study aimed at reinvestigating the construct validity of this inventory in Iran. 334 students 231 female and 98 male, 5 not specified) with a mean age of 23.1 were selected via convenience sampling from Tehran, Elm-o-Farhang and Shahid Beheshti Universities, and completed NEO-Personality Inventory-Revised. Inclined rotation and parallel analysis was used for exploratory and confirmatory factor analysis. Exploratory factor analysis resulted in the extraction of five factors, which altogether accounted for 59.25 percent of the total variance of the data. As a result of exploratory factor analysis, a noticeable number of cross-loads and wrongly loaded subscales were observed. Confirmatory factor analysis also resulted in weak to moderate fit indexes. Considering the results of the present study and with regard to the medium and weak alpha coefficients in the Garousi Farshi study, the primary applicability of this questionnaire in the Iranian culture is questionable. It seems that factor analysis at the level of characteristics could be helpful.

To design a short questionnaire on subjective well-being and the assessment of its validity and reliability. Using references, a set of questions was gathered and constructed, and was assessed in two phases. In the first phase, it was randomly administered to 70 Mobarake Steel Complex personnel in Isfahan, Iran, and in the second phase it was administered to 40 personnel who had referred to a counseling center subsequent to a diagnosis of depressive disorder and anxiety via interview-as well as 166 non-referred personnel in a random manner. Internal consistency, content validity, diagnostic validity, reliability, cut-off points, sensitivity and specificity of the questionnaire and its measurement error were calculated using correlation, analysis of variance, independent t, discriminate analysis and factor analysis. The results of factor analysis showed four sub-scales: vitality, life determination, neuroses, and stress-depression. Cronbach’s alpha for these four subscales was higher than 0.8. The difference between the normal and the patient group (p<0.0001) indicated the validity of the questionnaire. Cut-off point, sensitivity and specificity of this questionnaire were 1.9%, 67.5%, and 78% respectively. Considering its favorable psychometric features, this questionnaire could be used for research, diagnostic and treatment purposes.

This study investigated the validity, reliability and standardization of Reasons For Living Inventory (Linehen, Goodstin, Chiles & Nilsen, 1983) in Iranian adults.

500 adults (420 from group normal, 80 from group suicide attempters) was selected through multi-stage sampling method (for normal group) and random sampling method (for suicide group) and administered the RFL, Persian version of Beck Scale of Suicide Ideation (BSSI) and Oxford Happens Inventory (OHI).

The results based on item total correlation and dis-crimination degree showed Cornbach's alpha and test-retest coefficient for the scale was 0.95 & 0.93 respectively. The result of principle component analysis (PC) and Promx rotation suggested the stricture of the scale in Iranian population (deleting 1 item without the factor loads) contains 4 factors (Survival and Coping Beliefs and Responsibility to Family, Fear of Suicide, Moral Objections and Child Related Concerns).

Goodness of fit indices of confirmatory factor analysis confirmed the 4 extracted factors. The positive correlation coefficients between the factors of RFL and Oxford Happens Inventory confirmed the convergent validity of the scale and the negative correlation coefficients between the factors of RFL and Beck Scale of Suicide Ideation confirmed the congruent validity of the scale. Also differential validity of RFL showed it can discriminate suicide group from non-suicide group.

There is a dearth of empirical research on physician empathy despite its mediating role in patient-physician relationships and clinical outcomes. Due to a lack of a single definition and a precise measurement tool, research in this area had been limited until recently; and to the best of our knowledge, this is the first research carried out on this subject in Iran. In this study, the level of empathy in medical residents was assessed using the Jefferson Scale of Physician Empathy. The study sample consisted of 251 residents in hospitals affiliated to Iran University of Medical Sciences in 2008. The retest reliability and internal consistency of the questionnaire was first tested on 20 residents, which resulted in acceptable figures. Psychiatry residents had a mean empathy score of 114.2, which was higher than residents of other specialties were. This was followed by scores of residents of anesthesiology, surgery, pathology, emergency medicine, obstetrics and gynecology, internal medicine, ENT, radiology, orthopedics, pediatrics, ophthalmology, and dermatology. Mean empathy score in psychiatry residents had significant difference with those of orthopedics, pediatrics, ophthalmology and dermatology. There was no significant difference in mean empathy score with regard to age, marital status and sex. Even though the present study showed an appropriate face validity and reliability, the results were different in some aspects with those of other countries. This could be due to the lack of sufficient attention to humanistic aspects of doctor-patient relationship in the educational context of medicine in Iran, the mismatch between residents’ medical career and their true preferences, as well as cultural differences.

Understanding the nature and types of stressful events in life of school age children. In this qualitative study, using an open interview, the description of stressful life events by 29 schoolchildren in Tabriz, Iran, were recorded and analyzed. 223 stressful events derived from the interviews, were classified into 17 basic categories. In the end, four themes were assumed for these categories: 1- non-supplied demands, 2- loss, 3- threatening events, 4- stimulating events. The categorization derived from this study was similar to other categorizations. Due to their developmental stage and cognitive level, childhood stressful life events are different from adulthood stressful life events to some extent.