Zahedan Journal of Research in Medical Sciences
Volume:14 Issue: 9, 2012 Nov

Drug craving is considered as one of the main cores of drug dependency and addiction. Multidimensionality of drug craving, its cultural-bounded features and its intra individual rapidly changing nature makes it difficult to be measured. Nowadays, regarding different psychometric approaches, there are various instruments available for measurement of different aspects of drug craving but mainly for Latin-based languages in North America and European countries. High prevalence and special conditions, and unique subcultures in substance abuse and addiction in many countries, like Iran, make the design of culturally validated instruments for drug craving assessment priority. Comprehensive review on drug craving measurement instruments for Persian speaking subjects have been performed by searching in databases (ELSEVIER, Science Direct and Scientific Information Database (SID)) and investigating of related documents on regional experiences. In this article seven main categories of drug craving instruments have been reviewed focusing on validated versions in Persian language including: self-reports, reinforcement “proxies”, drug self administration, psycho physiological responding, neurobiological responding, cognitive processing and expressive methods. Reviewing on weak and strength points of each instrument group and national and regional experiences shows that designing and validating a new series of ecologically-validated instruments for multidimensional measurement of drug craving in different addiction subcultures should be prioritized to cover current methodological gaps in substance abuse studies in Iran.

This study has been carried out in order to investigate the effect of musical activities on attention of schizophrenic patients. Since April 2010, 55 patients from members of the Association of Schizophrenic Patients (Ahba) were screened using available sampling method. They randomly divided into two groups which were consisted of experimental group (30) and control group (25). The experimental group participated in 24 sessions of the music therapy, which were provided in the place of Ahba association in June and July of the same year. Data were collected using Stroop test, continuous performance test and Lezak letter cancellation test in pre-test and post-test stages. In the experimental group, average scores of processing speed, before and after intervention had significant difference and music affected this group (p< 0.05) but no significant deference was observed between and within the groups in other variables. Music therapy can be effective on elevating of maintenance of attention in schizophrenic patients, but a considerable influence on this group needs more studies.

The living skills of schizophrenic patients are disrupted due to cognitive, perceptual, sensory-motor, psychological, and psychosocial problems. Therefore, the identification of some aspects of living skills that require medical intervention is essential in these patients. Accordingly, in this study, the living skills of schizophrenic patients were investigated with the Kohlman Evaluation of Living Skills. This study was conducted by using the cross-sectional descriptive and analytic approach in which 35 hospitalized and 51 outpatient schizophrenic patients and 35 healthy individuals were compared and the areas of living skills that needed help were determined. According to the Kruskal-Wallis test, there was a significant difference between the mean scores of healthy, hospitalized and outpatients subjects, whereas the difference in the means scores was not significant between the two groups of patients (p=0.693). Schizophrenic patients showed more than 50% requirement for help in the following subscales; appearance, awareness of dangerous household situations, appropriate action for sickness and accidents, obtaining and maintaining a source of income, budgeting their monthly income, and leisure activities. Employment had a direct effect on the living skills of the subjects and the test mean scores of employed people (2.409) was better than unemployed persons (7.083). The living skills of schizophrenic patients are damaged in some areas through the course of the disease and its symptoms. Based on the Kohlman Evaluation of Living Skills, these people require most help in self-care, safety health, money management, and leisure activities.

The hospitalization of premature newborns in neonatal intensive care unit causes the family to experience a sense of loss and to disturb the emotional connection of the mother with the newborn. The present study aimed to determine the effect of empowerment programs on mother-infant interaction and the weight gain of premature infants hospitalized in neonatal intensive care unit. In this clinical trial, after obtaining written consent, a total of 140 mothers with infants hospitalized in neonatal intensive care units were randomly divided into two experimental and control groups. The empowerment program was performed on mothers of the experimental group and then mother-infant interaction was assessed through the observation form of attachment behavior and the measurement of neonate weight in both groups and the data were analyzed by SPSS-16 software. The mean of the total maternal attachment behaviors in the experimental and control groups were 52.01±6.65 and 36.28±28.09, respectively. The result of the independent t-test (p=0.001) showed that there was statistically a significant difference between the two groups and the mean weight of infants two months after the intervention were 3620±877.31 and 3200±824.85 grams in experimental and control groups, respectively. The result of the independent t-test (p=0.005) showed that there was statistically a significant difference between the experimental and the control groups. Regarding the increase of mother-infant interaction and the weight gain of premature infants, it is recommended to provide the necessary training to parents, especially to mothers, in order to appropriately confront and communicate with the newborn and to empower mothers in order to care for premature neonates.

The Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE) is a 104-item tool made based on the factor analysis of 15 available scales to measure schizotypy. This research aims to investigate the psychometric properties of Oxford-Liverpool Inventory of Feelings and Experiences. Conducted as an ex-post facto survey, this study is a descriptive cross–sectional research. A sample of 482 patients was selected and assessed through stratified random sampling from different faculties of Shahid Madani University of Azarbaijan. Data were analyzed using exploratory factor analysis method by means of the Principal Component Analysis method. Factor analysis using the Principal Component Analysis method extracted five principal factors, which were named cognitive disorganization, impulsive nonconformity, unusual experiences/magical thinking, introvertive anhedonia, and isolation. In addition, two other types of validity (concurrency and correlation of subscales with the total scale and each other) and three types of reliability (test-retest, half-splitting, and internal consistency) were reported. According to the findings of the present study, O-LIFE has favorable psychometric properties in the Iranian society and is applicable in psychiatric and psychologic researches as a valid tool.

This research aims to study previous findings about interpersonal ambivalence in people with obsessive compulsive disorders that shows itself as hidden aggression, excessive responsibility, feelings of guilt, and reverse reaction formations. In this correlational study, 60 individuals (33 women and 27 men) with obsessive-compulsive disorders who were referred to psychologist's offices and clinics of the city of Shiraz were selected through available sampling. Participants completed the Padua Inventory, Spielberger’s State-Trait Anger Inventory, the Responsibility Attitude Scale, the Guilt Inventory, and the Defense Mechanisms Inventory. SPSS-16 software was used to analyze the data. The results showed that the Pearson correlation coefficient was significant between excessive responsibility, hidden aggression, feelings of guilt, and reverse reaction formations with the severity of obsessive-compulsive symptoms. Based on the results of the regression analysis, feelings of guilt were the strongest predictor of obsessive-compulsive symptoms (β=0.388). Also, the results of path analysis suggest that hidden aggression had predicted feelings of guilt (β=0.47), which was also a predictor of excessive responsibility (β=0.30). According to the results, it seems that a high interpersonal ambivalence exists among people with obsessive-compulsive disorders. Therefore, this structure has the eligibility to be considered in research, especially in the treatment.

The aim of the present study was to investigate psychometric properties and the Standardization of Simpson’s Hope Scale (1999) in Iranian university students. In this descriptive-survey research, 1000 students with age range of 18 to 34 and with the mean age of 23.9±5.13 were selected via the categorical cluster sampling method from different universities. Then they answered the Snyder’s Hope Scale, Oxford Happiness Scale, the Ahwaz Hardiness Scale, the Beck Hopelessness Inventory, Riff’s Psychological Well-being Scale, as well as Sympson’s (1999) Hope Scale (with little change). Coefficients of Cronbach’s alpha (0.94), split-half (0.85), convergent validity with Hardiness (0.40), Happiness (0.64), Psychological Well-being scales (0.47), divergent validity (Beck Hopelessness, -0.25) criterion validity (Snyder’s Hope 0.55) were calculated, which were significant at p<0.01 level. The exploratory factor analysis showed that the 40-item Hope Scale for adults is saturated with five factors (social, academic, family, occupational, and leisure hope) that explain 56% of the scale’s variance. Second-order confirmatory factor analysis indicated that the five mentioned factors are well loaded on a principal factor, and therefore, the six-factor model was well fitted with the data (AGFI=0.93, RMSEA= 0.037, NFI=0.98). The results showed that this test has high reliability and validity and can be used in other studies.

The activity level of Narcotics Anonymous group (NA) is expanding in many countries, including Iran. Some research has confessed the benefits of 12-step NA approach compared with similar methods. In the present study, the role of regular participation of opioid addicts in the NA group was studied in terms of abstinence rate and compared with routine program of detoxification centers of the person Welfare Organization and Medical Sciences University. All addicts who attempted to quit in self-introducer clinical centers of Medical Sciences University and the Welfare Organization of Rafsanjan were suggested to participate and not to participate in NA, based on even and odd numbers, respectively. Among them, two equal 120-person (NA and control) groups were selected, then evaluated every three months and followed up for 12 months. Their status was assessed through questionnaires, interviews, and morphine tests. The purity rate of NA group with 8.49 months was significantly different with normal addicts in 5.19 months (p=0.001). The recurrence rate at 12 months was significantly lower in the NA group compared with the control group, calculated through independent t-test (p=0.001). Quitting history and addiction duration in the NA group was significantly higher than control group. The findings of the research support a better prognosis for participants of NA group. Further researches are recommended to provide useful clinical information for patients and professionals.

Neuropathy is the mostly prevalent of complications and the major cause of amputation, pain and disability in patients with diabetes. The purpose of this study was to investigate the role of individual, psycho-social, and disease-related risk factors in neuropathy of type 2 diabetes patients. In this retrospective cross-sectional study, 271 patients with type 2 diabetes were selected by convenience sampling in diabetic outpatient clinics of Tehran University of Medical Sciences and the Iranian Diabetic Association. The data were collected by demographical and disease characteristics questionnaires and DASS-42, QOLS, DSMS, and DKS scales. Then, the data were analyzed by r binary logistic regression along with PASW software. Socio-economic status, glycosylated hemoglobin, body mass index, diabetes self-management, depression, quality of life, diabetes knowledge, and diabetes duration were significantly able to differentiate diabetic patients with neuropathy from diabetic patients without neuropathy (p<0.001). Gender, treatment type and patient age were not significantly able to differentiate two groups (p>0.05). The total regression model explained that 95.2% of cases were classified correctly. Inappropriate socio-economic status, glycosylated hemoglobin over 9%, being overweight and obesity, poor diabetes self-management, clinical depression, low quality of life, poor diabetes knowledge, and longer diabetes duration contribute to the incidence of neuropathy in patients with type 2 diabetes and attention must be paid to them for neuropathy prevention.

According to the Bowen Family System Theory, the differentiation level is associated with lower anxiety. The aim of this study was to evaluate more broadly the relationship between differentiation and other indicators of public health (anxiety, depression, physical discomforts, and social dysfunction) in Iranian culture. This descriptive-correlation study was conducted on third-grade boy and girl high school students in district 5, Tehran. The study sample consisted of 320 third grade high school students randomly selected from the four geographical corners of this district (160 girls and 160 boys). The subjects completed the 28-item version of the Goldberg General Health Questionnaire and the Differentiation Inventory designed by Skowron. The results were analyzed by SPSS-14 statistical software through Pearson correlation, multivariate regression analysis, and t-test statistical methods. The results of regression analysis in the t-test showed a significant relationship between differentiation level and general health of students at the level of 0.99. People with higher differentiation (emotional reactivity, fusion with others, less emotional cutoff, and clearer I-position) have better general health. The findings confirm the Bowen System Theory.

Early maladaptive schemas are self-defeating emotional and cognitive patterns that develop early in life and repeat during the life cycle. They may cause a lot of psychological disorders including anxiety, depression, and drug abuse. Regarding to the importance of the prevention and treatment of addiction and regarding to obscurity of schemas about addiction, we compared the schemas of addicted and non-addicted men. In this cross-sectional study, 205 addicted and non-addicted men were selected in the city of Kerman through cluster sampling. To collect information, a questionnaire with acceptable validity and reliability consisting of demographic information and early maladaptive schemas was used. Data analysis was performed with SPSS-17 software. Totally, 96 addicted and 106 non-addicted men with a mean age of 33.3±9.8 years participated in the study. There were significant differences between early maladaptive schemas in two groups of addicted and non-addicted men (p=0.001). Logistic regression analysis showed that enmeshment, emotional deprivation, and vulnerability to harm or illness maladaptive schemas can predict addiction (p=0.001). According to this study, the most important schemas for addicted men are emotional deprivation, self-sacrifice, emotional inhibition, unrelenting standards, entitlement, insufficient self-control/self-discipline, and disconnection as well as enmeshment, vulnerability to harm or illness, and emotional deprivation predictor schemas that require special notion from related institutions and addiction therapist for addiction rehabilitation and prevention.

With no effective vaccine for prevention or a definite cure for treatment, health education is considered the most effective intervention against HIV. Using a valid tool to evaluate the effect of health education interventions is an inevitable necessity. The aim of this study was to design a tool and to assess its validity and reliability based on native culture characterization in order to evaluate the health belief model constructs about AIDS. 480 women covered by health bases of the city of Zanjan, in the age group of 20-30 years, married, and with at least first middle school education participated in this cross-sectional study. After reviewing the literature, the tool was designed and its validity and reliability was approved based on psychometric processes and feedback from the target group and a panel of experts through calculating the content validity ratio, content validity index, exploratory factor analysis, and determining internal consistency. The validity of 37 items were assessed and selected through calculating the index score of the item effect above 1.5, content validity index ratio greater than 0.49, and content validity index higher than 0.79 and by using exploratory factor analysis with a special value greater than 1; seven factors and 34 items were kept and classified into five categories based on literature review and content items. The reliability of the research tool was calculated with Cronbach’s alpha equal to 0.82. The results of this study provide appropriate evidence about the strength of structural factors and the reliability of the assessment tool for structures of health belief models about AIDS, and the creation of accessibility to a reliable tool for assessing the structures of health belief model.

Today, the Internet has become a part of our everyday life and online communications have made it easy for people to develop interpersonal relationships. However, certain problems and difficulties have arisen from this issue. One of these problems, which have been prevalent among couples and families, is extramarital internet relationships or internet infidelity. The present research has been done to study people's attitudes towards this phenomenon. A 43-item Internet Infidelity Questionnaire (IIQ) was presented on a website designed for this purpose. 481 Iranian users who were members of Farsi language forums and chat rooms were selected through available community sampling and enrolled in the study. To analyze research data, descriptive statistics and the t-test were used. The results showed that either women or men considered online sexual activities of their partners as traitorous compared with friendly and emotional activities in cyberspace. In addition, women in comparison with men had a more negative attitude towards their partners’ internet activity (especially online sexual activities). This study expanded our understanding of the traditional concept of infidelity that had merely limited it to face-to-face sexual and emotional behavior. The results also showed that women had more negative attitudes towards such activities compared to men.

Patients with tinnitus encounter many problems, including depression, anxiety, insomnia, increased sensitivity to sound, and negativity. The aim of this study was to evaluate the efficacy of hypnotherapy on the depression, anxiety, and insomnia caused by tinnitus. This study was a pilot research with a pretest-posttest and control design. The statistical population included individuals who suffered from tinnitus and its associated symptoms. Twenty patients with tinnitus were selected through available sampling. The subjects were divided randomly into two experimental and control groups. Both groups completed the Beck Depression Inventory, Spielberger's State-Trait Anxiety Inventory, and the Pittsburgh Sleep Quality Index in both pretest and post-test phases. Only the experimental group received 10 sessions of hypnotherapy. In this study, independent and dependent t-tests were used to obtain the data. The two groups were similar in terms of tinnitus severity and age range. The results of independent and dependent t-tests at p=0.05 level in all three variables of depression, anxiety, and insomnia showed a significant difference between the scores of pretest and post-test as well as the post-test scores of control and experimental groups. The results indicated the effectiveness and usefulness of hypnotherapy in the reduction and treatment of the depression, anxiety, and insomnia caused by tinnitus in the experimental group.

Fatigue is one of the most common and disabling symptoms of multiple sclerosis (MS) disease. Since fatigue can cause a great deal of problems it create can cause a variety of psychological symptoms particularly depression, anxiety and stress as well, that quality of daily lives, endanger. Thus, the objective of this study was to determine the relation between fatigue severity and psychological symptoms and quality of life in patients with MS. In this descriptive-correlational study, 76 patients with MS with a mean age of 34.02±9.42 (16-58 year), a member of Guilan province MS association, were selected consecutively. At first, all patients completed the questionnaire of demographic information, and then they were evaluated by the Fatigue Severity Scale (Fatigue Severity Scale), depression, anxiety, Stress Scale (depression, anxiety, stress scale-21) and Quality of Life questionnaire (Short Form-36). Correlational analyses indicated a significant association between fatigue severity and patient's age, depression, anxiety and stress (p<0.05) and quality of life (p<0.01), While there were no significant relations between fatigue severity and duration of MS. The results of multiple stepwise regression analysis showed that only the factor of quality of life as a selected variable in final model could explain 27% of the shared variance of fatigue severity results (p=0.002). The findings showed that regardless of other variables, the levels of quality of life are predictor of fatigue severity in patients with MS. Therefore it is suggested in these patients psychotherapy based on improvement of quality of life for decrease of the levels of fatigue be set as the central aim of psychological interventions.

The present study focused on investigation perceived social support in predicting physical well-being after bone marrow transplantation (BMT) in patients with acute leukemia. Pre-BMT, psychosocial data were gathered on 58 patients (38 men and 20 women) between 18-45 years that selected during 13 months via census procedure. Then, physical well-being was followed up one, two and three months post-BMT. Results showed that some of dimensions of perceived social support predicted physical well-being after BMT. In general, Attention to psychosocial factors prior to BMT and during recovery appears critical for physical well-being.

Over the past decades a large amount of research has been done on body image of adolescents. The motivation for this new surge is based on its effect on their functions and behaviors. The aim of this study was to investigate relationship between body image and adjustment in both sexes. The subjects of the study included 400 male and female students of high school selected by cluster sampling. Information was gathered using Physical Self-Description Questionnaire and Bell Adjustment Inventory. Data were analyzed using Pearson correlation coefficient and stepwise regression analysis. Results indicated that there was significant relationship between body image and adjustment in both sexes. In general, findings demonstrate that positive body image lead to high self worth and adjustive behaviors in both sexes.

The purpose of this research was to study the attitudes of pregnant women with intention of elective cesarean section, based on the theory of planned behavior. This cross-sectional study was carried out on 150 pregnant women in their third trimester of pregnancy with an intention or decision to elective cesarean section, who were selected through probability sampling. The collection tool of information was a questionnaire based on the theory of planned behavior. In a majority of women, the attitude and the control of perceived behavior was weak or intermediate. The ANOVA test showed a significant statistical correlation between the means scores of attitude with education level and the control of perceived behavior with type of previous labor. Obedience incentive was based on physicians, mothers, and spouses’ decisions, respectively. Continuous classes for training psychological skills and the preparation of mothers for delivery should be established to decrease the interest of pregnant women toward elective cesarean section.

The aim of this study was to evaluate the quality of life after cardiac surgery and to compare quality of life before and after open heart surgery. 49 patients participated in this study. The data were then analyzed by SPSS-13 statistical software. Three months after the operation, life quality score increased (p=0.001), but unlike the improvement of physical status, mood improvement was not observed 3 months after surgery. According to the mental status of patients, it is recommended to perform necessary actions.

The aim of this study was to compare the self-esteem and social support of the elderly residing in boarding centers and living in their homes. In this causal-comparative study, 120 elderly individuals residing in boarding facilities and living he their homes in the city of Shiraz were selected through available sampling and responded to demographic, social support, and self-esteem questionnaires. The findings show that there was a significant difference between self-esteem and social support in both groups of the elderly residing in their homes and those living in boarding centers. The elderly living at home have greater self-esteem and social support than the elderly residing in boarding facilities.

Multiple sclerosis (MS) is a demyelinating disease of the central nervous system that causes many problems in patients. Since training should be done in according to the educational needs, this study is performed to assess the educational needs of MS patients. This is a descriptive cross-sectional study, and its tool was a questionnaire on the educational needs of MS patients. Fifty patients referred to the MS society were selected through simple sampling. Based on the obtained results, 60% of patients were female, 52% were single, and 16% were high school undergraduates. Seventy-eight percent of the patients needed training about disease nature, 82% about treatment and care, 46% about nutrition, and 32% about physical activity. The findings showed that patients need more education about treatment and self-care.

The purpose of this study was to investigate the relation of optimism with mental health and the affectivity of optimism training on mental health and its components on Yazd University students. Fifty new students of the 2008-2009 academic years were randomly selected. The General Health Questionnaire (GHQ-28) and the optimism scale were completed by them. Thirty persons of these students, who had the highest psychological problems based on the general health questionnaire, were divided into two case and control groups through random assignment. The case group was trained for one month, in two 90-minute sessions per week. Pre-tests and follow-up tests were performed in both groups. The results of Pearson correlation coefficients showed that optimism had a negative and significant relationship with mental health, anxiety, social function, and depression scores (p< 0.0001). However, no significant relationship was seen with somatic symptoms (p >0.005). Multivariate analysis of covariance showed that optimism training had significant impact on mental health and its components in the case group, compared with the control group (p< 0.0001). In general, the findings of this research suggest the relationship between optimism and mental health and the effectiveness of optimism training on mental health. This method can be used to treat and prevent mental health problems.

Smoking hookah is a traditional method of tobacco smoking which is common in Middle East and Arabic countries. The Hormozgan province is in the second rank of hookah use after Bushehr in Iran. This research is seeking to study the factors affecting hookah smoking in a sample of rural community of the Hormozgan province. From the total population of the Hormozgan province villages, 310 residents were selected through multistage sampling. The data were analyzed in a logistic regression model. The prevalence of hookah smoking was 36.5%; 28.4% in men and 45.16% in women. Marital Status and Job are associated with Hookah smoking (p<0.05), age (OR=1.04), gender (OR=4.43), cigarette smoking (OR=5.16), having a hookah smoker in the family (OR=1.9), and education (OR=0.34) were effective in hookah smoking. Considering the high prevalence of hookah smoking, appropriate educational programs should be designed in order to qualitatively study the reasons of region’s people tendency toward the hookah.