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BACKGROUND: Conducted researches show that psychological factors may have a very important role in the etiology, continuity and consequences of coronary heart diseases. This study has drawn the psychological risk and protective factors and their effects in patients with coronary heart diseases (CHD) in a structural model. It aims to determine the structural relations between psychological risk and protective factors with quality of life in patients with coronary heart disease. MATERIALS AND METHODS: The present cross-sectional and correlational studies were conducted using structural equation modeling. The study sample included 398 patients of coronary heart disease in the university referral Hospital, as well as other city health care centers in Isfahan city. They were selected based on random sampling method. Then, in case, they were executed the following questionnaires: Coping with stressful situations (CISS- 21), life orientation (LOT-10), general self-efficacy (GSE-10), depression, anxiety and stress (DASS-21), perceived stress (PSS-14), multidimensional social support (MSPSS-12), alexithymia (TAS-20), spiritual intelligence (SQ-23) and quality of life (WHOQOL-26). RESULTS: The results showed that protective and risk factors could affect the quality of life in patients with CHD with factor loadings of 0.35 and -0.60, respectively. Moreover, based on the values of the framework of the model such as relative chi-square (CMIN/DF = 3.25), the Comparative Fit Index (CFI = 0.93), the Parsimony Comparative Fit Index (PCFI = 0.68), the Root Mean Square Error of Approximation (RMSEA = 0.07) and details of the model (significance of the relationships) it has been confirmed that the psychocardiological structural model of the study is the good fitting model. CONCLUSION: This study was among the first to research the different psychological risk and protective factors of coronary heart diseases in the form of a structural model. The results of this study have emphasized the necessity of noticing the psychological factors in primary prevention by preventive programs and in secondary prevention by rehabilitation centers to improve the quality of life of the people with heart diseases.
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BACKGROUND: According to Beck theory, dysfunctional attitude has a central role in emergence of depression. The aim of this study was to determine contributions of dysfunctional attitude and general health index to depression. METHODS: In this case-control study, two groups of subjects participated. The first group consisted of 65 patients with major depression and dysthymic disorder, who were recruited from Noor and Navab Safavi Psychiatry Clinics in Isfahan. The control group was consisted of 65 non-patient individuals who were accompanied or relatives of the patients and was matched with them based on age, sex and education. Both groups completed 26-item Dysfunctional Attitude Scale (DAS-26) and 28-item General Health Questionnaire (GHQ-28). Logistic regression and correlation methods were applied for statistical analysis. RESULTS: Logistic regression analysis showed that by an increase of one level in categorized DAS-26 scores and one score in the physical symptoms, anxiety, social dysfunction and depression subscales of GHQ-28 the risk of depression increase by 6.8, 1.6, 1.9, 3.7, 4.78 times, respectively. CONCLUSIONS: Capability of dysfunctional attitude and general health subscales to predict depression supports the Beck's cognitive diathesis stress theory of depression that dysfunctional attitude may be a predisposing risk factor for depression.
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BACKGROUND: Although psychological factors are now recognized as playing a significant and independent role in the development of coronary heart disease (CHD) and its complications, many of these factors are correlated with each other. The present study is aimed at examining the association between alexithymia and anxiety depression, stress, quality of life, and social support in CHD patients. MATERIALS AND METHODS: In this research 398 patients with coronary heart disease (166 females and 232 males) from the city of Isfahan were selected using random sampling. The tools used included depression, anxiety, and stress scale (DASS-21), Health-related to Quality Of Life (HRQOL-26), Multiple Scale Perceived Social Support (MSPSS-12), and the Toronto Alexithymia Scale (TAS-20). The data were analyzed using structural equation modeling by using the Statistical Package for Social Science (SPSS21) (IBM Corp: Armonk, New York.U.S.) and Asset Management Operating System (AMOS21) SPSS, an IBM Company: Chicago, U.S. Software. RESULTS: Results of the structural equation model showed an acceptable goodness of fit, for the explanation alexithymia that was significantly associated with lower HRQOL and social support and increasing anxiety, depression, and stress. CONCLUSIONS: Alexithymia may increase anxiety, depression, and stress and can be a predisposing factor to poorer HRQOL and social support.
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BACKGROUND: Research on attachment has shed new light on understanding one of the underlying mechanisms of psychopathology in children. The aim of this study was to investigate the therapeutic efficacy of attachment-based intervention in a pediatric sample with obsessive-compulsive disorder (OCD). METHODS: Twelve participants, 10-12 years of age, were treated across an eight-week period. They had not been treated with either pharmacotherapy or psychotherapy previously and remained medication-free during the attachment-based therapy. This study comprised two groups of children: The experimental group, who received attachment-based intervention, and the control group, who did not receive treatment. All participants were assessed in terms of severity of OCD symptoms by administrating the Children's Yale-Brown Obsessive-Compulsive Scale before and after the experimental group had received the therapeutic sessions. The children were assessed again one month later. The level of children's depression, and attachment insecurity, as well as their mothers' depression, OCD symptoms, and attachment insecurity, were statistically controlled in this study. RESULTS: Multivariate analysis of covariance (MANCOVA) indicated that the OCD symptoms in children decreased significantly over the course of the therapy, and this gain was maintained at follow-up. The results of this study demonstrated that the attachment-based intervention was efficacious in alleviating the OCD symptoms. CONCLUSION: It is suggested that parental instruction in attachment-based relationships may help prevent young children from developing OCD symptoms in middle-childhood and adulthood.