The Effect of Attentional Avoidance, Attentional Focusing, and Mindfulness on the Frequency of Voice-Hearing and Associated Distress in People with Schizophrenia: A Randomized Controlled Trial.

Objective: The objective of this study was to determine the most effective coping mechanism to deal with auditory hallucinations that reduces the frequency of voice-hearing and associated distress. In the present randomized controlled trial, each of the three coping mechanisms of attentional avoidance, attentional focusing, and mindfulness were used in one group and the fourth group was the control group. Method : A total of 64 patients with schizophrenia, categorized in three groups of attentional avoidance, attentional focusing and mindfulness and one control group, were asked to listen to an ambiguous auditory task depending on the type of their coping mechanism. After determining the baseline of distress, the task was performed in duplicate for each group. After playing the auditory task for the first time, participants were asked to rate out the level of their distress and compliance with instructions, and they were asked to estimate the likely number of words they had heard. After the second time, they were asked to note the words they hear during the task and rate out their distress and compliance with instructions again at the end of the task. Results: There was a significant difference between groups in terms of distress with a medium effect size of 0.47. The post hoc analysis revealed that mindfulness group reported less distress compared to the attentional focusing group (P = 0.017) and the control group (P = 0.027). Also, a significant difference existed between groups in terms of the frequency of the identified words, with a moderately strong effect size of 0.59, and a very good statistical power of 0.99. The post hoc analysis showed that attentional avoidance (P = 0.013) and attentional focusing (P = 0.011) groups heard fewer words than the control group. Conclusion: Attention is a good target for treating psychotic patients with auditory hallucinations. Also, manipulation of attention can affect the frequency of auditory hallucinations and associated distress.

Belief in an Afterlife Influences Altruistic Helping Intentions in Alignment With Adaptive Tendencies.

Evolutionary definitions of altruism are only concerned with reproductive consequences and not motives or other psychological mechanisms, making them ideal for generalization to all forms of organisms. Hamilton's inclusive fitness theory explains altruistic behavior toward genetic relatives and has generated extensive empirical support. Trivers' theory of reciprocal altruism helps explain patterns of helping among non-kin, and other research has demonstrated that human helping intentions follow fitness consequences from age-based reproductive value on altruism. The current study examines a novel psychological factor, belief in the afterlife, which may influence altruistic helping intentions. Belief in the afterlife was incorporated into a previous study design assessing the effects of a target's genetic relatedness and age-based reproductive value. The influences of inclusive fitness and target age were reproduced in a non-Western sample of participants (N = 300) in Iran. Belief in the afterlife predicted the overall confidence of risking one's life to save another across all targets, and also moderated the effects of genetic relatedness and target age. Rather than promoting altruism equitably or advantaging those favored by adaptive tendencies, higher belief in an afterlife aligned with these tendencies in promoting further favoritism toward close kin and younger targets with higher reproductive value.

A preliminary study: designing and validating projective images of Young's early maladaptive schema (EMS) domains.

BACKGROUND: This study aims to design and validate ten projective images of Young's Early Maladaptive Schema (EMS) domains. For this purpose, two questions are to be addressed. (1) How is the factorial structure of the projective images of EMS domains? (2) Do the images designed in the domains of disconnection and rejection, impaired autonomy and performance, impaired limits, other-directedness, and over-vigilance and inhibition have sufficient validity? METHODS: This is an applied mixed-methods exploratory study, in which the statistical population consisted of psychologists from Tehran Province in the qualitative section (n = 8) as well as other individuals aged between 18 and 65 years (mean age = 33) from Qazvin in the quantitative section (n = 102) in 2018. The research questions were analyzed through principal axis factoring with a varimax rotation, confirmatory factor analysis, Pearson correlation coefficient, and Cronbach's alpha. RESULTS: According to the results, ten images and five domains of Young's EMSs contribute to a simple structure. Accounting for 70.35% of the total variance of EMSs, the five dimensions include disconnection and rejection, impaired autonomy and performance, impaired limits, other-directedness, and over-vigilance and inhibition. CONCLUSIONS: The results indicated that the designed projective images yielded acceptable construct validity.

The Role of Mindfulness in Predicting Pain Interference in Patients with Primary Headache.

BACKGROUND: Primary headaches are one of the most troubled chronic diseases. Headaches interfere within the various dimensions of the patient's life. Coping strategies that aim to be attention focused (e.g., mindfulness) may moderate pain-related emotional and physical interference. OBJECTIVES: This investigation examined the relationship between mindfulness and pain intensity with physical and emotional interference and the subsequent aim was to analyze the role of mindfulness and headache severity combination in the prediction of pain-related interference. METHODS: This correlational study was conducted during years 2017 to 2018 at Imam Hossein Hospital of Tehran province. Eighty-five patients (56 females and 29 males), who had one type of primary headache were selected through purposive sampling after the diagnosis by a neurologist. The data were collected through the brief pain inventory (BPI) and the mindful attention awareness scale (MAAS). All data were analyzed using descriptive statistics. Bivariate correlation matrix and hierarchical stepwise linear regression statistics were used. RESULTS: The correlational analysis of the results indicated significant association between mindfulness (MAAS) and pain severity (BPI) (P < 0.01) as well as the findings of the study point to the significant relationship between mindfulness and both physical and emotional pain-related interference (P < 0.01). The results of stepwise linear regression indicated that pain severity explains only 1% of the total score in emotional pain-related interference (P = 0.003 and ΔF (1 and 83) = 9.22, ΔR2 = 0.11). Adding mindfulness to the model led to a 43% increase of the explained variance (R2 Change = 0.34). In physical interference, although pain severity was able to predict pain interference (P = 0.01 and ΔF (1 and 83) = 7.09, ΔR2 = 0.07), a combination model justifies 10% of the interference variance that was not statistically meaningful (P = 0.08, ΔR2 = 0.103). CONCLUSIONS: This result is a further support that Mindful Awareness contributed to emotional pain-related interference prediction. This result can explain the role of attention focused and mindful awareness in primary headache pain adjustment.

Use of Mindfulness-based Cognitive Therapy to Change Pain-related Cognitive Processing in Patients with Primary Headache: A Randomized Trial with Attention Placebo Control Group.

BACKGROUND: Mindfulness-based interventions have shown to be efficient in managing chronic pain. Cognitive factors play a prominent role in chronic pain complications and negative cognitive contents about pain are often the first issues targeted in cognitive-based therapies, which are known as first-line treatment of chronic pain over the past decades. Little, however, is known about the manner of thinking about pain or pain-related cognitive processing. OBJECTIVES: Therefore, the purpose of this study was to investigate the effect of mindfulness-based cognitive therapy (MBCT) on pain-related cognitive processing and control of chronic pain in patients with primary headache. METHODS: A clinical trial was conducted in 2017 - 2018 on 85 Persian language patients with one type of primary headache selected through purposive sampling in Emam Hossein Hospital in Tehran province. To measure the variables of the study, we used the Brief Pain Inventory (BPI) and Pain-related Cognitive Processing Questionnaire (PCPQ). All data were analyzed by independent t-test and chi-square and longitudinal data were analyzed using linear mixed model analysis. RESULTS: Statistically significant time × group interactions were found in pain intensity (P < 0.001), pain interference (P < 0.001), as well as in three cognitive processing subscales including pain focus, pain distancing, and pain openness (P < 0.001). However, the results of pain diversion were not meaningful. CONCLUSIONS: MBCT is a potentially efficacious approach for individuals with headache pain. Regulation and correction of cognitive processing are considered as effective cognitive coping strategies in MBCT treatment.

Cognitive Processing Styles and Mindfulness on Pain Intensity Prediction in People with Primary Headache.

BACKGROUND: Primary headaches are the most common cause of absence from work and school and one of the most common reasons for referring to the neurologists. OBJECTIVES: The present study was designed to investigate the relationship of cognitive processing style and mindfulness with pain intensity and the ultimate aim was to provide the role of pain-related cognitive processes and mindfulness in the prediction of headache intensity. METHODS: The study was conducted descriptively by using the correlation method. The statistical population of this study was composed of 85 patients (56 females and 29 males) with one type of primary headache, which were selected through purposive sampling after the diagnosis of a headache by a neurologist at Imam Hossein Hospital in Tehran province. To measure the variables of the study, the numeric pain rating scale (NRS) and the pain-related cognitive processes questionnaire (PCPQ) were used. All data were analyzed using descriptive statistics (frequency and percentages). Bivariate correlation matrix and hierarchical stepwise linear regression statistics were used. RESULTS: The results showed that there was a significant and negative association between pain intensity (NRS) and mindfulness (P < 0.01) and all pain-related cognitive processes, except pain focus (P < 0.01). The results of stepwise linear regression indicated that mindfulness only explains 39% of total score changes in pain intensity (P < 0.05 and ΔF (1 and 83) = 53.63, ΔR = 0.385). Adding cognitive processing styles to the model led to an 18% increase of the explained variance (R2 change = 0.179). In total, the present research model justifies 54% of the severity of headache variance (P < 0.01, ΔR = 0.54). CONCLUSIONS: The results suggest that pain-related cognitive processes and mindfulness are effective on pain intensity prediction. In other words, this result can explain the role of mindfulness and adaptive cognitive processing in primary headache pain management.

Effectiveness of resilience training versus cognitive therapy on reduction of depression in female Iranian college students.

Depression is the most common mental illness among women. Its prevalence in women is two to three times that of men. The purpose of the present study was to evaluate the effectiveness of resilience training on the reduction of depression in female college students. This semi-empirical study was carried out with two experimental groups and one control group. The research sample was women with symptoms of depression who were 18-22 years of age and living in a college dormitory. One experimental group was given eight 90-minute resilience training sessions, while the other received eight 90-minute cognitive therapy sessions. The control group didn't receive any interventions. The three groups under study were evaluated using the Beck II depression inventory before and after the interventions and two months after the treatment had ended. The three groups didn't have significant differences in age, marital status, or depression scores on the pretest. The resilience training group and cognitive therapy group showed a significant decrease in the average depression score from pretest to posttest and from pretest to follow-up. The main effect of groups, stage, and interaction between groups and stage also were significant (all were p < 0.001). There was no significant difference between effectiveness of resilience training and cognitive therapy on depression but there was a significant difference between these two treatment groups and the control group. The effectiveness of resilience training was just as good as the effectiveness of cognitive therapy. The effects of resilience training on depression remained stable from the posttest to the follow-up, like that of cognitive therapy.

Reality Testing in Children with Childhood-Onset Schizophrenia and Normal Children: A Comparison using the Ego Impairment Index on the Rorschach.

OBJECTIVE: The aim of this study was to examine reality testing in schizophrenic children and compare it with normal children using minus responses subcomponent in ego impairment index of the Rorschach test. METHODS: In a descriptive design, 20 accidentally sampled children, including 10 schizophrenic and 10 normal children, were recruited in to two groups and were compared in terms of reality testing subcomponent of Ego Impairment Index (EII). After initial interview, the Rorschach inkblot test was administered on the two groups, and Distorted Quality responses (FQ-) were calculated. The results were then analyzed by independent t-test and Cohen's d for effect size. RESULTS: The result of independent t-test revealed that the mean of minus responses in schizophrenic children was significantly higher than that of normal children. In addition, the usefulness of the Rorschach ego impairment index (EII) in evaluating reality testing in schizophrenic children was confirmed. In addition, it was found that defect in reality testing is one of the prominent characteristics of schizophrenic children. CONCLUSION: The higher minus responses in schizophrenic children indicate that schizophrenic children have weaker functioning in reality testing compared with normal children.

Effectiveness of compassionate mind training on depression, anxiety, and self-criticism in a group of Iranian depressed patients.

OBJECTIVE: The purpose of this study was to examine the effectiveness of compassionate mind training (CMT) on symptoms of depression and anxiety in Iranian depressed sufferers. METHOD: Nineteen depressed patients aged 20 to 40 (Beck Depression Inventory value ≥ 20) were randomly assigned into two groups. The experimental group participated in 12 sessions of group therapy based on Paul Gilbert's manual of CMT. The control group was given no intervention. The participants were assessed by Beck Depression Inventory-II (BDI-II), Anxiety Scale (AS), and Levels of Self-Criticism (LSCS) questionnaires at the beginning and immediately after the intervention. To follow-up the therapeutic effect of CMT, the three questionnaires were answered again by participants two months after the end of the intervention. Data were analyzed by independent samples t-test. RESULTS: The results revealed that CMT significantly decreases depression (P < 0.05) and anxiety score (P < 0.05) in the follow-up study, but not immediately after the intervention. Although CMT decreased self-criticism, this effect was marginally insignificant. CONCLUSION: The findings indicated that CMT could alleviatedepression and anxiety in a group of Iranian depressed patients.

The effectiveness of group hope therapy on hope and depression of mothers with children suffering from cancer in tehran.

BACKGROUND: Researches mainly focus on patients who suffer from cancer. Families and parents have been neglected in these researches although they experience levels of stress, depression and anxiety. This research aims at studying the effectiveness of Hope Therapy based on group therapy on hope and depression of mothers with children suffering from cancer in Aliasghar Children's Hospital, Tehran (2010). METHODS: In this applied and semi-experimental research, 20 mothers were selected based on Snyder Hope Scale and Beck Depression Inventory (pre-test). They were randomly assigned into two groups of experimental and control. Intervention based on Hope Therapy protocol was executed on the experimental group for eight weeks (eight sessions, each lasted for 2 hours). Afterwards, post-test was performed for both groups. After eight weeks, the experimental group completed questionnaires and the follow up phase. RESULTS: Results demonstrated that Hope Therapy increases hope (p<0.05), and decreases depression in mothers of children with cancer (p<0.001). CONCLUSION: Covariance analysis indicated that Hope Therapy significantly decreases depression and increases hope of mothers whose children suffer from cancer. Follow up results showed no significant changes in hope of this group of mothers in the two months after post-test, but depression was decreased significantly during this period. It was concluded that effectiveness of Hope Therapy may be continued during the follow up phase.

The effectiveness of emotion regulation training and cognitive therapy on the emotional and addictional problems of substance abusers.

OBJECTIVES: The purpose of this study was to investigate the effectiveness of emotional regulation training group therapy, based on Dialectical Behavioral Therapy (DBT) and Cognitive Therapy, on improving emotional regulation and distress tolerance skills and relapse prevention in addicts. METHOD: In a quasiexperimental study, 39 patients with the diagnosis of opioid dependence based on DSM-IV criteria were randomly assigned in to two experimental and one control groups. The experimental groups took 10 ninety-minute sessions of group therapy. The subjects were evaluated using the Opiate Treatment Index (OPI), General Health Questionnaire-28 (GHQ-28), and Distress Tolerance and Difficulties in Emotion Regulation Scales prior to the start of treatment, and at the sixteenth session. The control group did not take group therapy and was merely treated with naltrexone. Data were analyzed using repeated measures ANOVA and χ2 test. RESULTS: Scheffe test showed that both emotion regulation training and cognitive therapy were more effective than naltrexone increasing distress tolerance, emotion regulation enhancement, and decreasing the amount of drug abuse, health improvement, social functioning, somatic symptoms, anxiety, social dysfunction and depression enhancement (P<0.05). In addition, emotion regulation training was more effective than cognitive therapy, increasing distress tolerance and emotional regulation enhancement (p<0.05). CONCLUSION: It seems that DBT skill training increase the effectiveness of pharmacotherapy and is more effective than cognitive therapy.