Designing and determining the effectiveness of a suicide intervention package for psychologists working in the primary health care system.

Aims: Suicide is a major public health problem around the world. The present study aimed to design and determine the effectiveness of a suicide intervention package for psychologists working in the primary health care system in Hormozgan Province. Materials and Methods: This study was conducted in two phases: qualitative and quantitative phases. In the qualitative phase, it was a thematic analysis type, and in the quantitative phase, it was quasi-experimental type with pretest-posttest in two groups of intervention and comparison. To standardize the suicide intervention package, Delphi method was used, and for quantitative content validity, content validity index (CVI) and content validity ratio (CVR) were used. In the quantitative phase of the study, the statistical population of the study included 270 people who had suicidal ideations and had no history of suicide attempt. Among them, 135 people were included in the intervention group and 135 people were included in the comparison group using a convenience sampling method. They were selected among those referred to eight comprehensive rural and urban health service centers in eight cities of Hormozgan Province. The results were analyzed by MANCOVA statistical test. Results: CVR was more than 0.75 and CVI was more than 0.87. In the quantitative phase, the results showed a significant difference between the means before and after the intervention for the variables of psychological distress, suicidal ideation, and hopelessness (P < 0.01). Conclusion: It seems that psychological suicide preventive interventions in the primary health care system are effective in reducing psychological distress,suicidal thoughts and hopelessness.

Prevalence of externalising disorder comorbidities in adolescents: a systematic review and meta-analysis protocol.

INTRODUCTION: Externalising disorders are some of the most prevalent problems in childhood and particularly during adolescence that can change into more severe psychopathology in adulthood if left unattended. In the research literature, these disorders include attention deficit/hyperactivity disorder, oppositional/defiant disorder, conduct disorder and substance use disorders. The comorbidity prevalence of these disorders is significant and cannot be considered a random factor. The dimensional structure of psychopathology has always been studied by researchers to address disorder comorbidities and aetiology. There has always been controversy over the number of spectra and the lower levels. Currently, the new top-down, Hierarchical Taxonomy of Psychopathology model conceptualising psychopathology is being used, which is a dimensional classification system for the different spectra of psychopathology based on a combination of conceptual modelling and factor analysis of symptoms. This systematic review investigates the comorbidity prevalence of spectra of externalising disorders to provide valuable information and feedback on this model. METHODS AND ANALYSIS: This systematic review will include all the studies conducted from 1/1/1990 to 1/12/2020 to examine the prevalence and comorbidity of each of the externalising disorders in the general population, schools and outpatients using any instrument (questionnaires or interviews). There will be no language restrictions in selecting the studies. The studies are age restricted and must be conducted on adolescents only, but there are no restrictions on the gender and nationality of the participants. ETHICS AND DISSEMINATION: This systematic review is based on previously published articles and therefore will not require ethical approval. The results of the systematic review will be disseminated as publication in a peer-reviewed journal and conference presentation. PROSPERO REGISTRATION NUMBER: CRD42022327629.

Psychometric Properties of the Posttraumatic Cognitions Inventory-9 items in an Iranian sample.

INTRODUCTION: The Posttraumatic Cognitions Inventory is a largely used measure to assess negative posttraumatic cognitions that are common among individuals with trauma-related disorders. There was a need to have a valid and reliable short form of it in Persian. OBJECTIVE: This study aimed to translate the Posttraumatic Cognitions Inventory-9 item (PTCI-9) into Persian, and evaluate its characteristics and psychometric properties. METHODS: This was a cross-sectional psychometric study using the translation and back-translation technique, experts assessed the content validity of the scale. Participants were 207 Iranian individuals recruited from the general population and 151 of them were trauma-exposed. Participants completed the Persian version of the PTCI-9, Beck Depression Inventory (BDI-II), and the WHO Quality of Life (WHO-QOL) scale. The psychometric properties of the Persian version of PTCI-9 were assessed using Exploration and Confirmatory factor analysis methods. Cronbach's α coefficient and Pearson's analysis were calculated, as well. RESULTS: Factor analyses supported a 3-factor model including the Self, World, and Self-blame subscales. The Cronbach's alpha of the Persian version of PTCI-9 (α=0.74) and its subscales (0.76, 0.82, 0.78) demonstrated its acceptable reliability. The Persian PTCI-9 also had strong test-retest reliability (r=0.79). The correlation between the Persian version of PTCI-9 and the BDI-II (r=0.60), and WHO-QOL (r=-0.54) indicated the convergent validity of the scale. CONCLUSION: The Persian version of PTCI-9 showed acceptable psychometric properties. It is a brief and pragmatic measure that can be used in Iranian trauma-exposed patients for research and clinical purposes.

The Cognitive Model of Negative Symptoms in Schizophrenia: A Hierarchical Component Model With PLS-SEM.

The cognitive model of negative symptoms suggests that some dysfunctional beliefs mediate the relationship between neurocognitive deficits and negative symptoms and disability. This study tested the hypothesis that dysfunctional performance beliefs mediate neurocognitive deficits, negative symptoms, and disability. We used a hierarchal component model with 85 men patients diagnosed with chronic schizophrenia. Results showed a moderate to strong correlation between dysfunctional performance beliefs, neurocognitive deficits, negative symptoms, and disability. These results support the Hierarchal component model (HCM) of the cognitive model of negative symptoms. Our results indicated that the disability in schizophrenia is mediated through dysfunctional performance beliefs, neurocognitive deficits, and negative symptoms pathway. Further, dysfunctional performance beliefs have a crucial role in this pathway. Therefore, targeting this vicious cycle of dysfunctional beliefs can improve disability in patients with schizophrenia.

Mixed-methods study protocol for explanation of pregnant women's concerns about antenatal anomaly screening process: Designing, implementing and evaluation of intervention.

AIM: This study aims to investigate the concerns of Iranian pregnant women in the antenatal anomaly screening process (AASP) and propose an intervention to reduce these concerns. DESIGN: This exploratory sequential mixed-methods study is conducted in three stages (qualitative, intervention design and quantitative), in Tehran. METHODS: A qualitative study is carried out to collect pregnant women's concerns during the AASP. Then, a two-step procedure is implemented. In the first step (expert session), the concerns extracted in the qualitative part are prioritized. Next, the interventions used to reduce the concerns of pregnant women in the AASP are reviewed by considering the priority determined in the previous stage. The information obtained from this step is used to design intervention. Ultimately, a randomized controlled trial is used to evaluate the effectiveness of the intervention. DISCUSSION: The results can be used for framing policies in health systems to address pregnant women's concerns in the AASP and to promote their mental health.

Validity and Reliability of Youth Anxiety Measure for DSM-5 in Iranian Non-Clinical Children and Adolescents.

The present study aimed to explore the validity and reliability of the Persian version of the Youth Anxiety Measure for DSM-5 (YAM-5). Two groups of non-clinical children and adolescents were recruited. The first group (n = 520) was recruited via 4 schools of Tehran, Iran, and only completed the YAM-5. The second group (n = 557) was recruited via 4 schools of Tabriz, Iran. In addition to the YAM-5, they completed another anxiety scale and a depression scale. The exploratory factor analysis of data of the first group revealed a five factor model similar to the original model of the scale. The confimatory factor analysis showed that the five factor model fit with the data of second group. Also, the convergent validity was supported. The current findings, thus, provide support for validity and reliability of Persian version of the YAM-5 in a nonclinical sample of children and adolescents in Iran.

Effect of "motivational interviewing" and "information, motivation, and behavioral skills" counseling interventions on choosing the mode of delivery in pregnant women: a study protocol for a randomized controlled trial.

BACKGROUND: Cesarean section is an important surgical procedure, when normal vaginal delivery imposes a risk to mother and/or baby. The World Health Organization states the ideal rate for Cesarean section to be between 10 and 15% of all births. In recent decades, the rate has been increased dramatically worldwide. This paper explains the protocol of a randomized controlled trial that aims to compare the effect of "motivational interviewing" and "information, motivation, and behavioral skills" counseling interventions on choosing mode of delivery in pregnant women. METHODS: A four-armed, parallel-design randomized controlled trial will be conducted on pregnant women. One hundred and twenty women will be randomly assigned to four groups including three intervention groups and one control group. The intervention groups included the following: (1) motivational interviewing; (2) face-to-face information, motivation, and behavioral skills model; and (3) information, motivation, and behavioral skills model provided using a mobile application. The inclusion criteria include being literate, being in gestational age from 24 to 32 weeks, being able to speak Persian, having no complications in the current pregnancy, having no indications for Cesarean section, and having enough time to participate in the intervention. The primary outcome of the study is the mode of delivery. The secondary outcomes are women's intention to undergo Cesarean section and women's self-efficacy. DISCUSSION: The interventions of this protocol have been programmed to reduce unnecessary Cesarean sections. Findings may contribute to a rise in normal vaginal delivery, and the effective intervention may be extended for use in national Cesarean section plans. TRIAL REGISTRATION: Iran Randomized Clinical Trial Center IRCT20151208025431N7 . Registered on December 07, 2018.

Psychometric Properties of the Farsi Version of Eyberg Child Behavior Inventory (F-ECBI) in Iranian Population.

Objective: Eyberg Child Behavior Inventory (ECBI) is one of the most frequently used tools for measuring behavioral problems; however, no research has been done to evaluate its psychometric properties in Iran. Method : The present study sought for exploring the factor structure and psychometric properties of the F-ECBI in an Iranian sample. A total of 495 mothers (mean age = 33.83 years; SD = 4.78) who reported behavioral problems in their children aged 3 to 12 years (mean age = 6.36 years; SD = 2.66) were selected via convenience sampling in 2018-2019. The psychometric properties of F-ECBI, including reliability (Cronbach's alpha) and validity (exploratory and confirmatory factor analysis, and convergent validity) were assessed using SPSS version 25 and LISREL 8.80. Results: By performing EFA on the first sample part (n = 360), the examination of scree plot supported a 3-factor or 4-factor solution, and pattern matrix resulted in a 3-factor structure. The factors were called as "behavioral problems related to oppositional defiant", "behavioral problems related to inattentive", and "behavioral problems related to conduct", according to their content and the research. CFA was performed on the second part of the sample (n = 135) to test the fitness of the 3-factor solution. According to CFI (0.91), NFI (0.91), NNFI (0.90), IFI (0.91), PNFI (0.77), GFI (0.75) AGFI (0.70), PGFI (0.62) and chi-square (540.31) indexes, the model had acceptable fitness. Cronbach's alpha was employed to measure the internal consistency and it revealed to be at a good to excellent level (behavioral problems related to oppositional defiant = 0.88; behavioral problems related to inattentive = 0.84; behavioral problems related to conduct = 0.74). The 3-factors subscales were associated with total difficulties, internalizing and externalizing SDQ, indicating the good convergent validity of F-ECBI. Conclusion: The F-ECBI has good psychometric properties in Iran and can be employed as a useful instrument for measuring children's behavioral problems.

The Effect of Counseling on Breast Cancer Awareness in Rural Iranian Women: a Randomized Controlled Clinical Trial.

In a community such as Iran where late presentation is predominant and the majority of breast cancer patients are diagnosed at advanced stages of the disease, there is an urgent need for improving the level of awareness about breast cancer and early detection measures. Given that rural residents are at higher risk for late diagnosis of breast cancer because they have less education, income, and access to advanced screening technologies, this study was conducted to determine the effect of counseling on breast cancer awareness of rural Iranian women. This randomized clinical trial was conducted on 60 rural women from the Abish Ahmad area in northwestern Iran in 2017. The randomized cluster method was used for sampling. From 20 rural health houses and centers, about one third were selected randomly. From the six selected clusters, three were randomly allocated as the control group and three as the intervention group. Using convenience sampling, 30 women between the ages of 40 and 69 were selected from the control group and 30 from the intervention group. The intervention group attended six group counseling sessions. Data was gathered using a demographic and obstetrical information questionnaire and breast cancer awareness measures. The chi-square, independent t test and ANCOVA by controlling for the baseline scores were used to analyze the data. After counseling, the mean knowledge about breast cancer score was significantly higher in the intervention group than in the control group (adjusted mean difference, 17.02; confidence interval (CI) 95%, 15.44 to 18.59; p < 0.001). The mean barriers to breast cancer screening score showed a significant decrease in the intervention group compared to the control group (AMD, - 1.74; 95% CI - 3.12 to - 0.36, p < 0.001). After intervention, the frequency of breast self-exam showed a significant difference between groups (p < 0.001); but for confidence about noticing breast changes, no significant difference was observed between groups (p = 0.08). Group counseling had a significant effect on enhancing breast cancer awareness of rural Iranian women, except for confidence about noticing breast changes.

The Effectiveness of Mindfulness-Based Cognitive Therapy on Iranian Female Adolescents Suffering From Social Anxiety.

BACKGROUND: Social anxiety is one of the most common psychological disorders that exists among children and adolescents, and it has profound effects on their psychological states and academic achievements. OBJECTIVES: The aim of this study was to determine the effectiveness of mindfulness-based cognitive therapy (MBCT) on diminishing social anxiety disorder symptoms and improving the self-esteem of female adolescents suffering from social anxiety. PATIENTS AND METHODS: Semi-experimental research was conducted on 30 female students diagnosed with social anxiety. From the population of female students who were studying in Tehran's high schools in the academic year of 2013 - 2014, 30 students fulfilling the DSM-5 criteria were selected using the convenience sampling method and were randomly assigned to control and experimental groups. The experimental group received eight sessions of MBCT treatment. The control group received no treatment. All participants completed the social phobia inventory (SPIN) and Rosenberg self-esteem scale (RSES) twice as pre- and post-treatment tests. RESULTS: The results from the experimental group indicated a statistically reliable difference between the mean scores from SPIN (t (11) = 5.246, P = 0.000) and RSES (t (11) = -2.326, P = 0.040) pre-treatment and post-treatment. On the other hand, the results of the control group failed to reveal a statistically reliable difference between the mean scores from SPIN (t (12) = 1.089, P = 0.297) and RSES pre-treatment and post-treatment (t (12) = 1.089, P = 0.000). CONCLUSIONS: The results indicate that MBCT is effective on both the improvement of self-esteem and the decrease of social anxiety. The results are in accordance with prior studies performed on adolescents.

Effectiveness of motivational interviewing in promoting hand hygiene of nursing personnel.

BACKGROUND: Motivational interviewing (M.I.) is an option for modifying an individual's behavior. It is used as an educational method in recent years. The aim of our study was to indicate whether or not education, using lecture alone and lecture with M.I., would affect the performance of nursing personnel regarding their hand hygiene. If so, which of these two methods were most effective for this purpose? METHODS: This was an interventional study conducted in Bahrami Pediatric Hospital in Tehran. The study population consisted of all nursing personnel in the hospital. Considering the responsibilities of different nurses and their educational status, we divided them into three classes. The participants of each class were randomly assigned to either the control or experiment groups training lecture alone or lecture with M.I., respectively. We used Independent-t, Paired-t, Mann-Whitney U and Wilcoxon signed ranks tests for analysis. RESULTS: Education using lecture alone improved the hand hygiene performance of nursing personnel only in the first and third classes (P = 0.002 and P = 0.001, respectively). Similarly, lecture combined with M.I. improved the hand hygiene performance of personnel in the first and third classes (P < 0.001 and P = 0.004, respectively). The latter method was more effective compared to lecture alone in the first and third classes (P < 0.001 and P = 0.013, respectively). CONCLUSIONS: Education based on lecturing improves hand hygiene performance among nursing personnel. It will be more effective if combined with M.I.

Personality and chronic fatigue syndrome: The role of the five-factor model.

The aim of this study was to examine the relationships between personality factors and the symptomatology of fatigue among people with chronic fatigue syndrome (CFS), and compare them to people from the general population. Seventy-seven CFS patients (47 women, 30 men) were compared with 72 healthy individuals (44 women, 28 men) to investigate whether personality factors are related to the symptomatology of fatigue. All participants were asked to complete the NEO Five Factor Inventory (NEO-FFI), the Modified Fatigue Impact Scale (MFIS), the Fatigue Severity Scale (FSC), and the Mental Health Inventory (MHI). The results revealed that the CFS group reported higher levels of neuroticism and conscientiousness than the control group. These two personality factors were significantly related to fatigue symptoms, impact, and severity in both groups. These findings suggest that personality factors of neuroticism and conscientiousness may play an important role in the development and perpetuation of fatigue symptoms.