Volume & Issue: Volume 33, Issue 1 - Serial Number 35, April 2026 
Clinical Psychology

The Communicator Path of Insecure Attachment and Childhood Emotional Abuse With Interpersonal Problems in Individuals With Cluster B Personality Disorders: The Mediating Role of Frustration Tolerance

https://doi.org/10.22055/psy.2024.48134.3325

Somayeh Rostampour Khorfkore, Ali Asghar Hosseinzadeh, Bahram Mirzaian

Abstract Introduction
Cluster B personality disorders represent a significant public health concern across various age and gender groups. These disorders are marked by complex and severe symptoms, including dramatic, emotional, erratic, and unpredictable behaviors. Given the poor quality of interpersonal relationships and the associated adverse clinical outcomes, there is a pressing need to conduct studies on psychopathology to gain a deeper understanding of the interpersonal relationship issues prevalent in this cluster. Accordingly, this study aimed to evaluation of the communicator path of insecure attachment and childhood emotional abuse with interpersonal problems in individuals with cluster B personality disorders through the mediating role of frustration tolerance.

Method
This research utilized a descriptive correlational method and path analysis within a cross-sectional design. The target population for this study included individuals seeking outpatient and inpatient psychotherapy services at the neuropsychiatric department of Zare Hospital in Sari, as well as at specialized psychiatric clinics in the central Mazandaran province during 2019. Among them 200 applicants were selected through purposive sampling. The inclusion criteria for participants in this study were as follows: informed consent, possessing a minimum literacy level in Persian, being between the ages of 18 and 50, and having a diagnosis of cluster B personality disorders based on DSM-5 diagnostic criteria, the Millon Clinical Multiaxial Inventory-III (MCMI-III), and assessment of a psychiatrist. The research instruments included the Adult Attachment Scale (Hazan & Shaver, 1987), the Childhood Trauma Questionnaire (Bernstein et al., 2003), the Frustration Discomfort Scale (Harrington, 2005), and the Interpersonal Problems Questionnaire-Short Form (Barkham et al., 1996). Data analysis was performed using path analysis method with AMOS-23 software.

Results
The path analysis results revealed that both insecure-avoidant and insecure-ambivalent attachment styles, along with childhood emotional abuse and frustration tolerance, had a significant positive direct effect on the participants' interpersonal problems. Additionally, the findings indicated that frustration tolerance plays a significant mediating role in the relationship between insecure attachment styles, childhood emotional abuse, and interpersonal problems in individuals with cluster B personality disorders. The evaluation of the path analysis model quality in this study confirmed that the goodness of fit indices specifically the Goodness of Fit Index (GFI), Adjusted Goodness of Fit Index (AGFI), Standardized Fit Index (NFI), and Comparative Fit Index (CFI), all were above the standard value of 0.9. Also, the root mean square error of approximation (RMSEA) was less than the standard value of 0.08, which confirmed that the final model of this study has a good fit and is considered acceptable.

Discussion
The findings of this study confirm that insecure attachment styles, childhood emotional abuse, and low frustration tolerance are significant factors in understanding the psychopathology associated with interpersonal problems in cluster B personality disorders. As such, these elements should be taken into account in both clinical and non-clinical settings to enhance prevention, diagnosis, and treatment within mental health programs. Furthermore, this study contributes to the existing theoretical frameworks concerning the psychopathology of interpersonal issues in high-risk populations with cluster B personality disorders.

Family Psychology

Investigating the prediction model of emotional blackmail based on the difficulty in emotion regulation and cognitive fusion with the mediation of authenticity in relationship in married women

https://doi.org/10.22055/psy.2024.47052.3271

parisa karshenas najafabadi, hamid kazemi zahrani

Abstract Introduction
As the smallest social institution, the family is effective in improving the mental health of the society. Husband and wife are the main cores in the formation, advancement and improvement of family goals, and the way they interact is effective in achieving these goals. Women are half of the society's population and as one of the important members of the family system and society. A woman as a wife provides a warm and loving environment for the health and growth of other family members. Therefore, it is necessary to have mental health to play such a role.Therefore, the present study was conducted in order to investigate the prediction model of emotional blackmail based on the difficulty of emotion regulation and cognitive fusion with the mediation of authenticity in relationship in married women. This research is one of the structural equation modeling correlation researches.

Method
This research is one of the structural equation modeling correlation researches. The statistical population of the research is the married women of Najaf Abad city in 1402. A sample of 220 people was selected using the accessible method and the questionnaires of emotional blackmail (Rahmat, sodagar, gamhari, 2018), difficulty in regulating emotions (Gratz and Roemer, 2004), cognitive fusion (Gillanders et al, 2014) and Authenticity in the relationship (Lopez and Rice, 2006) were completed. The obtained data were analyzed with SPSS26 and AMOS24 software using the structural equation model with the maximum likelihood method.

Results
The results showed that there is a positive and significant relationship between the difficulty of emotion regulation and cognitive fusion with emotional blackmail (P<0.05). There is a negative and significant relationship between the difficulty of emotion regulation and cognitive fusion with authenticity in the relationship (P<0.05). Authenticity mediates the relationship between emotion regulation difficulty and cognitive fusion with emotional blackmail (P<0.05).

Discussion
Based on the study, it seems that in order to overcome the trap of emotional blackmail, it is necessary to pay attention to the authenticity in the relationship as a mediator of the relationship between emotional blackmail with the difficulty of emotion regulation and cognitive fusion.

Family Psychology

The effectiveness of emotional schema therapy on sexual self-esteem, marital relationship quality, communication patterns and emotional dyslexia in conflicted couples referring to family counseling centers in Qom

https://doi.org/10.22055/psy.2023.44837.3120

Mahbobeh Abbasi Ghomi, Hasan Heydari, Mojtaba Mahamodi

Abstract The aim of this study was to compare the effectiveness of emotion-oriented schema therapy and combined behavioral therapy on sexual self-esteem, quality of marital relationship, communication patterns and emotional narcissism in conflicting couples referred to counseling centers in Qom. The family is the main core of every society and the center of maintaining people's health and mental health, and it is not the only place to meet the emotional, material, developmental and spiritual needs of its members, but the origin of human emotions and the center of the most intimate relationships and interactions. It is also interpersonal. The concept of family and the value of this social institution is considered as the basic work for every government and society, and every society, according to its values, first goes to the family to help its society from within. For this reason, the family is one of the first institutions that must change in society. Therefore, the foundation of the family is formed based on the marriage contract between the husband and wife so that they can experience a peaceful and happy life together, but unfortunately, abundant evidence indicates that couples in today's society Establishing and maintaining intimate and friendly relationships have severe and difficult problems. One of the common problems in couples' relationships that has attracted the attention of therapists is couples' conflicts. Conflict in relationships occurs when a person's behavior does not match the other person's expectations. All over the world, there is an increasing concern about increasing the level of marital conflict and its serious effect on the functioning and stability of the family.

Method
Semi-experimental research method with pretest design - Post-test with two experimental groups and a control group and the statistical population, including all women with marital conflicts referred to counseling centers in Qom province in 2021. From this population, 21 couples were selected by sampling method and randomly divided into three groups: emotion-oriented schema therapy (7 couples), integrated behavior (7 couples) and control (7 couples). Both experimental groups received ten 60-minute training sessions. Subjects were examined before the intervention, at the end of the intervention, and at the follow-up stage for three months using the Toronto Alexithymia Questionnaire (1986), Schwartz (1996) Sexual Self-Esteem Questionnaire, the quality of subsequent marital relationships, et al. (1995), and Christ's age and relationship patterns. Salavi (1984) Assessing Assistance. The data were analyzed with the help of SPSS software and multivariate covariance analysis method.

Results
The findings showed a significant difference between the experimental and control groups in sexual self-esteem, marital relationship quality, constructive communication patterns, and emotional ataxia in the post-test phase. The results showed that emotional schema therapy increased the results of three variables: self-esteem, quality of marital relationship, and mutual constructive communication, and decreased the three variables of withdrawal expectation, mutual communication, and emotional dyslexia. Emotional-centered couple therapy is effective on emotional apathy, relationship quality, sexual self-esteem, and communication patterns among conflicting couples. In explaining the above results, it can be said: the goal of couple therapy based on schema-emotional therapy is to change emotional patterns that are linked to communication problems.

Discussion
Therefore, according to the research, it can be concluded that emotion-oriented schema therapy can increase sexual self-esteem, the quality of relationships and communication patterns, and reduce Alexithymia. In the model of emotional schemas, people differ from each other in terms of the interpretation and evaluations they make of their emotional experience, and they may try to deal with their emotions with different strategies such as experiential avoidance, ineffective cognitive strategies, social support, or other strategies. to deal with, which causes mental disorders and on the one hand, the formation of high conflicts between couples, but during the process of treatment with various techniques, including cognitive reconstruction, couples with problems are changed or adjusted, and this model is based on this principle. It is established that emotional disorders are caused by beliefs, interpretations and strategies used to deal with emotions. Therefore, interventions related to emotional schemas can be effective on marital satisfaction and marital problems, and subsequently reduce conflicts in couples.

Social Pathology

Comparison of Temparement and Character dimensions in Older Adults with and without Experience of Abuse

https://doi.org/10.22055/psy.2024.46817.3257

Niloofar Zahedi Bialvayi, Abbas Abolghasemi, Mousa Kafi

Abstract Introduction
Elder abuse is a very common phenomenon that currently exists in societies, and despite its many physical and psychological effects, less attention has been paid to it. The research literature indicates that some characteristics and behavioral patterns in the elderly, increase the risk of them being placed in abusive situations and it provides the ground for mistreatment of the elderly. It is also possible that these characteristics are the result of frequent mistreatment of them. Although the studies show differences in the characteristics of the elderly with and without the experience of abuse, there are challenges between the studies. Also, it seems necessary to study the dimensions of personality, which have received less attention in researches. Therefore, according to the existing gap, the present study was conducted with the aim of comparing the dimensions of temperament and character in the elderly with and without the experience of abuse.

Method
The method of the present research was casual-comprative. The statiscal population of the study consisted of the elderly who referred to the retirement centers of Rasht, Iran in 2022-2023. The participant of this study were 164 elderly people (72 elders with experience of abuse and 92 elders without experience of abuse) who were selected by the available sampling method (based on the cut-off score of 4 in Hwlek-Sengstock’s elder abuse screening test and the elder abuse clinical interview). Data were collected using short version of the Temparement and Character Inventory (TCI-56). The inclution criteria included elders aged between 65 and 74 years, having at least a middle school education, with informed and voluntary consent. The exclusion criteria included non-cooperation and regretion, chronic physical or mental illness such as dementia, speech disorder and hearing impairment. The data collection process was carried out by the researcher and under her supervision and lasted for almost 4 months. The data were analyzed by Multivariate Analysis of Variance (MANOVA) in SPSS-24 software.

Results
The resaults indicated that there is a significant difference between dimentions of Temparement such as Harm Avoidance, Novelty Seeking and Persistence (except for dimention of Reward Dependence) and Character such as Self-directedness, Co-operativeness and Self-transcendence in the elderly of the two groups (P<0/001). So that the elderly with the experience of abuse had different dimentions of Temparement (lower level of Persistence component and higher level of Novelty Seeking and Harm Avoidance) and lower level of all dimensions of Character. The level of dimention of Reward Dependence was also lower in elderly with the experience of abuse, but the difference in the groups was not significant (P>0/001).

Discussion
These findings state that some personality traits, that is different levels of Temparement dimensions and low levels of Character dimensions, as a risk factor can provide the basis for elder abuse and increase vulnerability of the elderly to abuse situations. It is also possible that repeated experience of abuse has destructive effects on the personality of the elderly, especially the dimensions of Character which is the part of the personality created by the environment. The findings of this research show more details of personality dimensions and their relationship with elder abuse. Therefore, it is necessary to pay attention to these variables in the design of prevention programs. So that we able to prevent elder abuse experiences or design more appropriate intervention programs for each eldely person. The lack control of gender effect, the use of available sampling method and the use of self-reporting tools in data collection were the limitations of this research that was not possible to control them. It is suggested to control these factors in future studies.

Addiction

The mediating role of resilience in the relationship between physical activity and students' phone addiction

https://doi.org/10.22055/psy.2024.47420.3285

Nasser Bay, Zahra Gholami Far

Abstract Using a mobile phone is considered a necessity for today's modern life, and this smart tool has a special place in the technological revolution created. Beyond their main function, smart phones provide entertainment opportunities such as online games, surfing the web and browsing social media, and have made life easier by having a variety of applications. Despite the many advantages of smartphones, attention to their threats has become a new and attractive field of research for researchers. Addiction to smartphones is considered one of the potential threats in the use of this electronic device. Addiction to smartphones is a growing phenomenon, especially among young people, due to factors such as the increase in the number of social networks, the increase in the capabilities of smartphones and the development of the skills of users to use this modern tool, as well as the Corona epidemic. With the increase in the disorders caused by the addiction to the use of smartphones, efforts have been made to do interventions to reduce the amount of use of this smart tool. Many researches mention physical activity as an effective factor for reducing mental and behavioral disorders such as smartphone addiction. Physical activity also has similar capabilities as using smartphones. Recreational, social, entertainment and educational functions of physical activity can satisfy people's psychological needs in different ways, which can replace physical activity with the use of mobile phones and thus reduce the frequency of using smartphones. Also, the recreational, competitive and open features of physical activities provide a suitable environment for the development of psychological resilience of people such as students, and students who have more psychological resilience achieve more academic success. Parallel to the increase in the access of different age groups to mobile phones in Iran, its use has also increased greatly. Despite the increase in the number of mobile phone users, not much scientific research has been done on its negative consequences such as addiction in the country. Encouraging students to do physical activity can be used as an important strategy in this regard, but little research has been done in this regard, which highlights the necessity of doing this research. According to the mentioned cases, the main aim of the research was to study the mediating role of resilience in the relationship between physical activity and students' phone addiction. Accordingly, the main objective of this research is to study the mediating role of resilience in the relationship between physical activity and students' phone addiction.
Method
This applied research used a descriptive correlational method. The statistical population consisted of all female high school students in Ramian City in the academic year 2023 (291 students). The census method was used to select the research sample, and finally, 259 questionnaires were collected. Data collection tools included three questionnaires: Physical Activity (Hagger et al), Psychological Resilience (Van Der Meer et al), and Mobile Phone Addiction (Kown et al). Descriptive statistics and structural equation modeling were used to analyze the data, with SPSS version 25 and Smart PLS version 3 software.
Results
The results showed a positive and significant relationship between physical activity and psychological resilience among female students. Additionally, the results indicated a negative and significant relationship between physical activity and mobile phone addiction among students. Finally, the findings showed that the relationship between physical activity and mobile phone addiction among female students is significantly mediated by psychological resilience.
Discussion
Increasing the motivation of female students to engage in regular physical activity can lead to outcomes such as increased psychological resilience and reduced mobile phone use. Based on the results, it is recommended to encourage female students to engage in regular physical activity in schools and to consider attractive sports programs for these students in extracurricular activities.

Health Psychology

Investigating Attachment Styles as an Antecedent of Health-Promoting Behaviors with the Mediating Role of Psychological Well-Being in Medical Students

https://doi.org/10.22055/psy.2024.47923.3306

Akram Heidary Harzavily, Isaac Rahimian-Boogar

Abstract Introduction
Health-promoting behaviors are increasingly important to increase health and reduce diseases. On the other hand, the health of the medical staff plays an important role in improving the health of the society. Considering the limited research evidence regarding health-promoting behaviors in intern medical students, more research is needed to formulate appropriate interventions to improve psychological dimensions and health-related behaviors for them. Attachment styles play a role directly and indirectly through other protective psychological factors such as well-being on health-promoting behaviors. Attachment style influences healthy or risky behaviors by determining the interaction with health care providers and some individual characteristics. Psychological well-being is also an important factor in healthy behaviors by strengthening positive individual characteristics. Examining the relationships between attachment styles, psychological well-being and health-promoting behaviors in an integrated model among intern medical students is important. Therefore, the present study was conducted with the aim of examining the fit of the model in the relationship between attachment styles and health-promoting behaviors with the mediating factor of psychological well-being.

Method
The current study was a cross-sectional descriptive study in which structural relationships between variables were investigated using the structural equation model. The statistical population of the study included all medical students of Gilan and Qazvin provinces who completed their internship during the Corona epidemic and its subsequent strains. Among this population, 550 medical students were selected by conveniance sampling during May 2022 to February 2023. The age mean and standard deviation of the participants were 25.02 and 2.3, respectively. After obtaining written informed consent and explaining the objectives of the study to the participants, Adult Attachment Questionnaire (Hazan & Shaver, 1987), Psychological Well-Being Scale (Ryff, 1989) and Health Promotion Lifestyle Profile-II (Walker et al., 1987) were completed by the participants. In addition, the research ethical code obtained from the National Ethics Committee in Biomedical Research (ID: IR.SEMUMS.REC.1401.205) and the study was conducted in compliance with other ethical considerations, including the protection of the participants' rights, confidentiality and freedom of action in participating in the research. The descriptive statistics (mean, standard deviation, correlation, and tests of statistical presumptions) were used for data analysis with SPSS-25 software and inferential statistics (structural equation modeling) was used with LISREL 7.8 software to exmine the research hypothesis. The significance level of the data was considered as P<0.05.

Results
The findings showed that attachment styles have a direct and significant relationship with health-promoting behaviors, and psychological well-being mediates the relationship between attachment styles and health-promoting behaviors (P<0.001). According to the indices obtained in the examined model (df=ϰ^2⁄2.09, CFI=0.94, GFI=0.92, AGFI=0.91, RMSEA=0.05, NNFI=0.96, (NFI = 0.96), the model has a good fit (P<0.05). Based on the Bootstrop test, the mediating role of psychological well-being in the relationship between attachment styles and health-promoting behaviors is confirmed (P<0.05). The results of the Sobel test were also obtained to investigate the mediating role of psychological well-being in the relationship between attachment styles and health-promoting behaviors, respectively, 2.85 to 3.21, which confirmed the results of the bootstrap result.

Discussion
According to the results, attachment styles play a significant role in health-related behaviors, and psychological well-being plays a mediating role in the relationship between attachment styles and health-promoting behaviors. These results contain implications in providing and formulating appropriate interventions to promote health-related behaviors based on various attachment styles and psychological well-being. It is suggested that future researches focus on developing mixed designs (quantitative-qualitative studies) and expand these results to develop tailored interventions to promote health-related behaviors based on these factors. The strengthening secure attachment and promoting psychological well-being is necessary in order to maintain and improve health-promoting behaviors of medical students.

Cognitive psychology

The effect of sleep deprivation on memory functions in the night sleep pattern

https://doi.org/10.22055/psy.2025.47222.3277

somayeh lorestani, leila alizadeh, hamdolah Jayervand

Abstract Introduction
Considering the importance and necessity of sleep and memory, the present research was conducted with the aim of identifying the preferred sleep patterns and different schedules of students and investigating its relationship with memory. Also, considering the daily conditions of today's world, this research sought to find the answer to the question of whether insomnia will have negative effects on memory, Sleep is one of the most important functions of the body that can increase or decrease mental functions in humans. Therefore, paying attention to the issue of sleep should be considered as one of the important psychological issues. Sleep not only provides the necessary opportunity for physical rest and regeneration, but also is effective in learning and strengthening memory. In fact, many studies have shown a deep connection between sleep and memory. and if this research and various researches done in this field are examined, it will be possible to answer the mentioned questions and find a way. It made the solutions to this problem more accessible. And by solving this problem, we can address the factors that strengthen memory and improve its performance.
Method
The current research method is semi-experimental with a pre-test-post-test design and a control group. The current research population consisted of 200 female dormitory students who were selected by available sampling, then the morning-evening sleep questionnaire was distributed among the sample and according to the research objectives, 35 people were completely evening sleep type (according to the questionnaire instructions which indicates the sleep type of people) were diagnosed. After declaring the consent of these people to participate in the research and also having the right to withdraw from the research at any time, and fully complying with the principles of ethical code of psychology, the sample people were randomly assigned to 2 experimental and control groups. Then, during a session, the purpose of the research was explained to the subjects of the experimental group, and before the intervention, a pre-test of the subjects was carried out in such a way that the Wechsler adult memory test was performed on the subjects of the experimental and control groups, and then the intervention of the research to One night of sleep deprivation was performed on the subjects of the experimental group. The intervention method was such that the subjects were asked to be present at the place of the research at the designated time and they were deprived of sleep for one night by watching movies and group discussions. In the end, to analyze the data in the descriptive statistics section, the mean and standard deviation were calculated, and in the inferential statistics section, the multivariate covariance analysis method was used by Spss software.

Results
The findings of covariance analysis showed that sleep deprivation has an effect on memory functions in the night sleep type and causes disturbances in memory functions (P<0.001). Finally, the results showed that sleep deprivation causes memory dysfunction and it can be concluded that sleep plays an important role in memory.

Discussion
Sleep deprivation directly affects thinking and feeling. Chronic lack of sleep can increase the long-term risk of physical and mental problems. According to research, one of the important factors in maintaining health is paying attention to healthy and correct sleep patterns, because sleep can affect the nervous system and function, and any sleep disorder can cause people to face cognitive, behavioral, and emotional problems and in the long run, these problems can lead to various disorders and deeper problems that will be difficult to treat and address.. Several factors can cause or contribute to lack of sleep, including poor sleep hygiene, lifestyle choices, and other medical conditions, and not having the right amount of sleep can lead to various health problems such as lack of concentration, fatigue, reduced ability, and bring memory function. All these initial symptoms can eventually cause serious complications. Sleep plays an important role in memory consolidation and consolidation, which leads to disturbances during encoding, consolidation and retrieval of memories and this, as proven by numerous studies, can cause serious problems throughout the entire life process of people.

Family Psychology

The Mediating Role of Body Image in the Relationship Between Parental Bonding and Eating Disorders in Adolescent Girls

https://doi.org/10.22055/psy.2024.47234.3279

Kowsar Hosseinian Langouri Sorkhi, Abbas Bakhshipour Rodsari, Mohammad Shadbafi, Mahsa Pishkar Ahrab

Abstract Introduction
During adolescence, individuals experience significant changes in behaviors related to eating and body weight, often accompanied by concerns about weight, body shape, and dissatisfaction with body image. These changes, which commonly manifest during puberty, may indicate the onset of eating disorders. Eating disorders encompass a complex category of clinical conditions characterized by abnormal eating patterns, excessive concerns about body shape, and distorted perceptions of body image, significantly impairing both physical and psychological functioning. The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes these disorders into three diagnostic classifications: anorexia nervosa, bulimia nervosa, and binge-eating disorder, providing a deeper description and understanding of each. These disorders primarily affect adolescent girls and young women, typically impacting individuals aged 13 to approximately 25-30 years. Non-clinical samples indicate that eating disorders affect 7.5% of adolescent girls and 2.1% of adolescent boys. Therefore, examining risk factors associated with eating disorders, particularly during the sensitive adolescent period, is of paramount importance for preventive interventions. Among these, parent-child relationships play a crucial role, influencing the psychological and social well-being of adolescents, often explored through attachment theory or parental bonding framework. The aim of the current study was to investigate the mediating role of body image in the relationship between parental bonding and eating disorders among female students.

Method
The present research was descriptive and correlational in nature. For this purpose, a sample of 215 female second-year high school students was selected from Babolsar city in the winter of the academic year 1403-02 using a multi-stage cluster random sampling method. To measure the variables, the following questionnaires were employed: Parker Parental Bonding Instrument (Parker et al., 1979), Body Image Questionnaire (Littleton et al., 2005), and Eating Disorder Diagnosis Scale (Stice et al., 2000). Data analysis was conducted using SPSS version 24 and AMOS version 24 software.
Results
The findings of the research indicated that maternal bonding can predict eating disorders both directly (β = -0.19, p < 0.05) and through the mediating role of body image (β = -0.11, p < 0.01). No direct effect was found for paternal bonding on eating disorders; however, paternal bonding can indirectly predict eating disorders (β = -0.09, p < 0.01).

Discussion
Based on the research findings, it appears that weak maternal bonding can independently predict eating disorders. Additionally, weak bonding with both mother and father can create vulnerabilities in body image development, thereby setting the stage for the onset of eating disorders. Therefore, from a practical standpoint, intervention and empowerment programs can be designed for parents and at-risk individuals to improve body image and prevent eating disorders.


Discussion
Based on the research findings, it appears that weak maternal bonding can independently predict eating disorders. Additionally, weak bonding with both mother and father can create vulnerabilities in body image development, thereby setting the stage for the onset of eating disorders. Therefore, from a practical standpoint, intervention and empowerment programs can be designed for parents and at-risk individuals to improve body image and prevent eating disorders.

Family Psychology

Comparing the effectiveness of Acceptance and commitment therapy and Solution-focused (brief) therapy on internal coherence and self-control in women with marital conflict

https://doi.org/10.22055/psy.2024.46770.3256

Maryam Moshtaghi, Mohammad Javad Asghari Ebrahimabad, Mohammad Reza Saffarian Toosi, Hamid Nejat

Abstract The family is the main institution of a society and the relations of its members, especially couples, are of special importance. A good relationship between couples will bring more satisfaction fewer conflicts and a higher quality of married life (Hoseini Beheshtian & Attar, 2020). Various factors, including the lack of internal cohesion, affect the spouses' relationship and cause much damage to the family (Akbari et al. 2022). The sense of coherence helps manage marital conflicts and improves the marital relationship (Oei et al. 2021). Another factor that can affect couples' relationships is self-control. There is evidence that high levels of self-control are associated with constructive interpersonal behaviors that improve relationship quality and reduce conflict (Cheung et al. 2022).
One treatment approach is Acceptance and Commitment Therapy (ACT), which has been evaluated in more than 900 randomized trials (Hayes, 2022). In Iran, few studies conducted on the effectiveness of Acceptance and Commitment Therapy on the sense of coherence (Derakhshanjan et al. 2023; Rostami et al. 2023), and self-control (Babakhani, 2020). Also, Solution-Oriented Therapy is another psychological therapy that emphasizes the capabilities and abilities of people to create solutions (Ayar & Sabancioğullari, 2022) Few studies have been conducted on the effectiveness of solution therapy conducted in terms of the sense of coherence (Pourdel et al. 2021; Ismakhani Akbarinejad & Ebrahimi Sadr, 2022), and self-control (Mir Hashemi & Najafi, 2014).
Also, it should be noted that there has been no research on the effectiveness and comparison of acceptance and commitment-based therapy and solution-oriented therapy, specifically on self-control and internal cohesion in the subject of women with marital conflict. Considering the negative consequences of conflicts on the individual lives of couples and their children, the necessity of dealing with treatments that target marital conflicts is felt. Therefore, this study aims to investigate the effect of group therapy based on acceptance and commitment and solution-oriented therapy on the self-control and internal cohesion of women with marital conflicts.
Method:
The present study was a semi-experimental method and a pre-test-post-test-one-month follow-up design was used with the control group. The statistical population of this research included women with marital conflict referring to Ravan Plus Clinic in Mashhad in 2023. Among them, 45 women were selected purposefully and voluntarily and then randomly assigned into two experimental groups and one control group (15 subjects per group). To collect the data, the Internal Coherence Questionnaire (ICQ), Self-Control Tangney Questionnaire (SCQ), and Marital Conflict Questionnaire (MCQ). After explanations were given to the participants about the conditions of the research and the objectives of the study, the first group received the solution-focused therapy the second group received acceptance and commitment-based therapy (ACT), and the third group as a control group received no treatment during this time. Each group meeting was held once a week for 90 minutes in two months. Questionnaires were completed in three phases: pre-test, post-test, and one-month follow-up by three groups. To analyze the data, repeated measures analysis was used.
Results:
Findings showed that Acceptance and commitment therapy and Solution-focused (brief) therapy were effective as compared with the control group in terms of self-control and internal cohesion (P<0.001). The results also showed that there was no significant difference between the two experimental groups in terms of self-control and internal cohesion (P>0.05).
Discussion:
In sum, Acceptance and commitment therapy and Solution-focused (brief) therapy were effective in increasing the internal coherence and self-control of women with marital conflicts. It is suggested that future researches be conducted on couples to investigate the effectiveness of treatment on men as well. To increase the generalizability of the results, it is suggested that this research be carried out in different populations (divorced women, etc.).

Family Psychology

Predicting marital satisfaction based on mother's parenting stress with the mediating role of depression and marital conflict and moderating father's empathy tendency

https://doi.org/10.22055/psy.2024.43570.3015

Sara Ebrahimi, Seyedeh Elham Mousavian Khatir

Abstract Introduction
Although research findings indicated the adverse and negative effect of parenting stress on mothers' marital satisfaction, the internal mechanism of this relationship and the effect of father's behavior on marital problems have not been investigated. The importance of studying the father's behavior is because the problems of married life are related not only to the mother's behavior but also to the father's behavior. Also, considering that high levels of stress in raising children harms the mother's physical and mental health and endangers the normal functioning of the family, the present study aims to: First, provide research support for family studies by examining the relationship between mother's parenting stress and her marital satisfaction. Second, provide a model to investigate the mechanism of depression and marital conflict in the relationship between parenting stress and marital satisfaction. Third, past studies of couple relationships have ignored the possible effects of empathy. In this study, father's tendency instead of empathy ability was used as a moderator in the relationship between mother's parenting stress and marital satisfaction with the mediation of depression and marital conflict.
Method
The research method was descriptive and correlation type. The studied population included all the employed couples with children from Tehran in 1401, and 212 couples were selected as a sample using convenience sampling method. Mothers responded to the Parenting Stress Scale (Berry & Jones, 1995), Self-Rating Depression Scale (Zung, 1965), Conflict Behavior Scales (Rusbult et al., 1986 and Strauss, 1979) and Marital Satisfaction Scale (Olson et al., 1982) and fathers responded to the Basic Empathy Scale (Jolliffe & Farrington, 2006). In order to analyze the data, Pearson's correlation and multiple regression (models 6 and 85) were used in Hayes Process in SPSS24 software.
Results
The findings indicated that mother’s parenting stress has a negative correlation with their marital satisfaction, depression and marital conflict play a mediating role in the relationship between mother’s parenting stress and their marital satisfaction, and fathers' empathy tendency also moderates this relationship. This means that fathers can with empathy for mothers, reduce depression and marital conflicts caused by parenting stress and finally their low levels of marital satisfaction.
Conclusion
In sum, these findings highlighted the serious impact of mother’s parenting stress of in keeping and caring for their children on their mental health and quality of life together, as well as the important role of fathers' empathy in reducing these consequences. The results can be used to design an intervention and a comprehensive approach to improve the mental well-being of mothers.

Social Pathology

The mediating role of behavioral-emotional problems in the relationship between parental psychological control and Internet addiction in university students

https://doi.org/10.22055/psy.2024.45617.3181

Fatemeh Alidoosti, Maryam Salari, Vahideh Moafian, mahdieh bakhtiari

Abstract Introduction
Internet addiction refers to a feeling of compulsion and inability to control using the Internet. Due to its prevalence among university students, and considering the fact that it may be influenced by variables such as parents and behavioral-emotional problems, the present study was conducted to investigate the mediating role of behavioral-emotional problems in the relationship between parental psychological control and Internet addiction.
Method
The research method was a descriptive correlational type, and its statistical population consisted of all university students studying at Khayyam University in the academic year 1401-1402, of whom, according to Guilford's opinion about the sufficiency of 200 people for the sample, a sample of 244 people (180 girls and 64 boys) were selected by the convenience sampling method. In order to collect the research data, the Internet Addiction Test (IAT) by Young (1999), the Dependency-oriented and Achievement-oriented Psychological Control Scale (DAPCS) by Soenens et al (2010), and the Strengths and Difficulties Questionnaire (SDQ) by Goodman (2001) were used, and the data were analyzed utilizing SPSS and LISREL software. Statistical analysis was done based on descriptive statistics, the Pearson correlation test, and the path analysis method.
Results
The findings revealed that based on Pearson's correlation coefficients in line with examining the relationships between variables, parental psychological control has a positive and significant relationship with Internet addiction and behavioral-emotional problems, and also, behavioral-emotional problems have a positive and significant relationship with Internet addiction. Furthermore, in pursuance of answering the research question, the results of the modified model, considering parental psychological control as an exogenous variable and Internet addiction in university students as an endogenous variable, showed that among the types of behavioral-emotional problems that were placed as the mediating variables in the path analysis model, only emotional problems could play a significant mediating role for the relationship between parental psychological control and Internet addiction in university students.
Discussion
The present study's findings indicate a high correlation and by the same token, the importance of parental psychological control and behavioral-emotional problems in predicting Internet addiction in university students. Therefore, according to the obtained results, on one hand, parental psychological control directly causes Internet addiction in university students, and on the other hand, it can indirectly lead to the emergence or exacerbation of Internet addiction through the creation of emotional problems in university students. Based on this, on one side, Parents' use of appropriate and desirable communication methods, and on the other side, paying attention to the recognition and reduction of emotional problems to decrease Internet addiction in university students can be noteworthy.

Psychometrics scales

Adapting the guilt about parenting scale (GAPS) to Iranian culture (validity and reliability study)

https://doi.org/10.22055/psy.2024.45630.3187

reyhaneh rokni, Azadeh Taheri

Abstract Introduction: The parental guilt scale is one of the few questionnaires designed to measure guilt in parents with normal children. In recent decades, the number of working mothers in Iran has increased, but the division of responsibilities in the family still remains traditional, and mothers are recognized as the main caregivers of children and fathers as the source of family income, so most mothers have to deal with work duties and the family themselves experience double pressure and as a result, parental guilt. Most mothers feel extra pressure to take care of their work and family duties, and as a result, they experience parental guilt. Parental guilt in working mothers can affect the work and family performance of mothers and the psychological well-being of family members, so the need for an efficient tool to measure parental guilt was felt. The present study was conducted to investigate the psychometric properties of parental guilt scale in Iranian mothers.
Method: The statistical population of the study was working mothers in Tehran who have children between 2 and 12 years old and worked at least 20 hours a week, who were selected through convenience sampling. Mothers answered the 10-item questionnaires of parental guilt, and... and...
To check construct validity (confirmatory factor analysis) and reliability of the questionnaire, spss 26 and amos24 software were used. Also, to check the concurrent validity of the questionnaire, its correlation coefficient with the questionnaires... and... was obtained.
Results: The results of the confirmatory factor analysis showed that the factor loading of all the items is more than 0.56 and all paths from the items to the main structure were significant at the 0.001 level. Also, the fit indices of the model (CMIN/DF=2.37, RMSE=0.073, GFI=0.93, CFI=0.93, IFI=0.95) were within acceptable range. Therefore, the said scale had an acceptable construct validity. The results of the reliability of the parental guilt questionnaire showed the value of Cronbach's alpha and acceptable construct reliability.
Discussion : In short, these findings provide evidence of face validity, content validity, construct reliability of parental guilt questionnaire in the sample of Iranian mothers.
In the concurrent validity evaluation, it was found that this scale had a significant positive correlation with the family-work conflict scale, which indicates that the family-work conflict in mothers often causes them to feel parental guilt. Also, this questionnaire showed a negative correlation with the Mindful Parenting Questionnaire, which means that the more conscious mothers behave in their parenting practices, the less parental guilt they experience. The research findings show that the parental guilt questionnaire in Iranian working mothers is an accurate and reliable tool.

Cognitive psychology

The Effect of Strengthening Working Memory on Alpha and Theta Brain Bands in the Prefrontal and Temporal Regions in Divergent Thinking in Right-Handed Students

https://doi.org/10.22055/psy.2025.46760.3252

Sepideh Shahmoradi, Mohammad Reza Zoghi Paydar, Mehran Farhadi, Shahriar Yarmohamadi Vasel

Abstract Introduction
Introduction
Divergent thinking reflects the ability to find different solutions to problems, break plans, and be as creative as possible. It is defined as a purposeful process that is supported by default, working memory, and executive systems. Researchers seem to agree that working memory plays a key role in effective complex cognitive processes such as reasoning, problem solving, decision making, and abstract thinking in general. In the last few years, with the advancement of computer technologies, the examination of the brain wave pattern in the form of quantitative brain wave analysis has been considered. Regarding the brain mechanisms behind thinking, creativity, and memory, there have been numerous studies; nevertheless, the neurological mechanisms underlying the improvement of divergent thinking are still debated. On this basis, the present study investigates the effect working memory enhancement on the pattern of alpha and theta brain bunds in the pre-frontal and temporal regions during divergent thinking tasks.

Method
The research design in the present study is quasi-experimental. The statistical population of the study consisted of graduate students in the field of psychology at Payam Noor University, Tehran-South branch, and cognitive sciences in Pardis Cognitive Science Research Institute in the academic year 2021-2022. Using purposeful sampling method, 32 students were selected (16 men, 16 women) and randomly assigned to two equal groups. Research instruments used in the current study included the Handedness Inventory, Creativity Test (CREE), Raven's Progressive Matrices Test, Quantitative Electroencephalography or Brain Mapping, Unusual Uses Task, Counting the Snakes task, Wechsler's Working Memory Test (WMT) and N-Back software. In this research, first, using the lateral superiority questionnaire, right-handed participants were selected. Then, considering the inclusion criteria, the sample group was selected. Then, the participants completed all the tests and inventories and they were randomly assigned to the groups based on the inclusion criteria. After recording the brain waves of all the participants, the participants in the experimental group were given memory training (N-back) in 20 sessions with each session lasting 20 minutes. However, memory training and the control group did not receive any intervention. Finally, the related tasks were presented to the experimental and control groups, and the brain bunds were recorded at the same time.

Results
The results regarding the within-subject's effects were significant in the case of alpha and theta bunds, which means that the observed changes in the variables can be explained by alpha and theta bunds. The results of between-subject effects also showed that the average alpha and theta bunds were different in the experimental and control groups. These results show that the strengthening the working memory on alpha and theta bunds in the prefrontal and temporal regions is significant in divergent thinking. The results of pairwise comparison of the wave averages in the pretest-posttest and pretest-follow-up phases revealed that the difference in the mean score of alpha and theta bunds in the prefrontal region of the brain was significant, but the difference in the mean score in the post-test-follow-up phase was not significant, indicating the stability of the results. Overall, the results showed that strengthening working memory led to an increase in the relative power of alpha and theta bunds in the prefrontal area (electrode locations F7 and F8) and in the temporal area (electrode locations T3 and T4) and this increase remained stable in the follow-up phase.

Discussion
It can be stated that in divergent thinking, the brain is involved in creative activities, the areas involved are focused on the internal function, and the increase in alpha and theta power in the divergent thinking condition is considered as an indicator of the depth of the ongoing processes of mental imagination, which represents a reliable indicator of specific cognitive processes associated with divergent thinking and creativity. This results of the present study can be used in line with cognitive empowerment (including divergent thinking) by using working memory enhancement and new techniques such as neurofeedback, Loretta neurofeedback, and transcranial direct current stimulation (TDCS), based on frequency bands and locations, specially to help the formation of more effective protocols to strengthen the brain's abilities.

Exceptional Children Psychology

اثربخشی واقعیت‌درمانی مبتنی بر پذیرش‌مثبت بی‌قید و شرط خود بر کیفیت ارتباط‌ والدین و ترس از ارزیابی‌منفی مادران دارای فرزند با اختلالات طیف‌اوتیسم

https://doi.org/10.22055/psy.2024.46768.3255

Maryam Ebrahimi, Mahboobe Taher, Abbasali Hossein Khanzadeh

Abstract Introduction
It is clear that in order to empower the family institution, measures should be taken to prevent its stagnation and stagnation. The dynamic and constructive nature of relationships within the family can be a suitable platform for the development and growth of family members, and one of the solutions presented in this regard has always been a component of education. By informing the audience and then changing their attitude, the educational institution can remove the tension-causing and unpleasant patterns and ultimately lead to the satisfaction of the couples. Therefore, it was inevitable to prepare a new educational package suitable for the characteristics of mothers with children with autism. In order to achieve this purpose, it was necessary to examine the factors that weaken and strengthen the family institution in the current conditions and design educational content accordingly. Based on this, the present study seeks to answer the question, is the reality therapy package based on unconditional positive self-acceptance effective on the quality of parents' communication, fear of negative evaluation of mothers with children with autism spectrum disorders?

Method
This is a semi-experimental research of pre-test-post-test type and a 2-month follow-up period, with a control group. The statistical population of the research was made up of all mothers with children with autism in the city of Sari in 2021-2022. A number of 30 mothers were selected based on the entry and exit criteria with available sampling method. The sample size using G Power software and with criteria such as the expected effect size of 0.25, alpha level equal to 0.05, z rate equal to 1.96, test power equal to 0.80, the number of effect levels within A subject equal to 3 and the number of effect levels between subjects were selected equal to 3, and then they were randomly assigned to two experimental and control groups. Also, analysis of variance with repeated measurements was used to check the research hypothesis. Statistical results were analyzed using SPSS-26 statistical software.
Results
The findings showed that the reality therapy package based on unconditional positive acceptance has sufficient content validity in the opinion of experts. Also, this package has a significant effect on the quality of parents' communication, fear of negative evaluation of mothers of children with autism spectrum disorders (P<0.05).

Discussion
The findings showed that the reality therapy package based on unconditional positive acceptance leads to an increase in the quality of parents' communication and a decrease in the fear of negative evaluation of mothers of children with autism spectrum disorders. And these changes have continued until the follow-up stage. Reality therapy based on unconditional positive self-acceptance helps mothers of children with autism spectrum disorders to be able to make more effective decisions and by accepting responsibility, identify dysfunctional behaviors that do not help to meet their needs and replace them with more effective options. to solve their emotional problems responsibly and improve their marital relationship by choosing their behaviors and thus become closer to each other, so as to increase the quality of their marital relationships and reduce their conflicts. Ultimately, it leads to the feeling in the person that, contrary to his negative and distorted thoughts, he is a person who is good enough and no longer worries about others' evaluation of him, reduces his negative and distorted thoughts and negative perceptions of himself and is less than Before, he is worried about people who think about him inappropriately and evaluate and judge him negatively; Therefore, by creating self-confidence and a pleasant feeling in people, it reduces the fear of negative evaluation by others.

Cognitive psychology

Comparison of effects of 3D puzzles and painting on executive functions and visual memory of preschool children

https://doi.org/10.22055/psy.2024.46852.3262

Faride Radpoor, Farideh Sadat Hosseini, Seyed Mousa Golestaneh, tayebeh ahmadshahi

Abstract Introduction
Preschool education can act as a protective factor in children's development. High quality preschool education can moderate the impact of potential risks on cognitive development. In this age range, the cognitive development of children goes through its fastest possible state; And the quality of the educational products of this course is of great importance and it is the cornerstone for their future education. Play therapy and art therapy are among the intervention methods that are widely used in today's societies to promote the cognitive development of children. The reason for using this method is that children may not yet be fully prepared from a developmental point of view, and since these methods are liked by children, it seems appropriate to use them as learning methods for children. Considering the importance of growth and promotion of various cognitive processes in preschool period and emphasizing the positive effect of indirect methods in this age period, the focus of the research is on the effectiveness of Lego therapy and painting therapy. Therefore, this research was conducted with the aim of comparing Lego therapy and painting therapy on the executive functions and visual memory of preschool children.

Method
The research method was semi-experimental with a pre-test, post-test and follow-up plan with a control group. The statistical population includes all the preschool children of Ahram city and the statistical sample was 27 preschool children in the age range of 4.5-6.5 years old, who were selected using the accessible method, but how they were placed in the experimental and control groups was random. Three weeks after the research, the follow-up period was done. The painting therapy protocol sessions were based on the Mohammadi protocol (2007) and there were 10 sessions of 40 minutes per session and two sessions were held every week. Also, the Lego therapy protocol sessions were ten sessions based on Asal and Asadian's protocol (2014), and each session lasted for 40 minutes, and two sessions were held weekly. Andre Ray's visual memory test (1942) and Ridley's Stroop test (1935) were used to collect data.
Results
The research findings indicate that drawing therapy and lego therapy have an effect on children's visual memory and executive functions (P<0.05). There is no significant difference between the two methods in terms of impact on visual memory and executive functions
Discussion
Painting therapy and lego therapy interventions can develop cognitive processes in children in preschool age and can be used as two useful tools. These two methods are considered as new educational interventions that can be used to improve intellectual and mental foundations as well as talent identification of children in preschool age. Executive functions, whose major growth occurs in childhood, if well developed, can create appropriate problem-solving ability and mental flexibility in facing events in adulthood. Helping to develop visual memory also improves students' behavior and flexibility.

Family Psychology

Comparing the effectiveness of positive-oriented resilience training and mentalization-based training in improving the components of parent-child interaction in mothers of mentally retarded children.

https://doi.org/10.22055/psy.2024.47033.3266

Bamdad Shadi Zavareh, Masoumeh Azmoudeh, Babak Kashefimehr, Javad Mesrabadi

Abstract Introduction
Parent-child interaction plays a crucial role in child development, particularly among children with intellectual disabilities. Effective interventions targeting parent-child interactions can have significant implications for the well-being and development of both parents and children in these families. This study aimed to compare the effectiveness of two distinct training approaches—positive resilience training and mentalization-based training—in enhancing parent-child interaction components among mothers of children with intellectual disabilities.

Method
This research employed a quasi-experimental design, incorporating pre-test and post-test assessments along with a control group. The study population consisted of mothers of children with intellectual disabilities in Tabriz, totaling 4,500 individuals. Initially, a cluster sampling method was used to select one of the five welfare centers in Tabriz. To improve data quality and select mothers whose children with intellectual disabilities aligned most closely with the research objectives, purposive sampling was employed. In this stage, 45 mothers were selected based on specific criteria (inclusion and exclusion criteria) and were randomly assigned to two experimental groups and one control group.
The data collection instrument utilized in this study was the Pianta Parent-Child Interaction Questionnaire (1994), a well-established tool for evaluating various dimensions of parent-child relationships, including closeness, dependence, and conflict. Statistical analyses, including multivariate covariance analysis (MANCOVA) and Bonferroni post-hoc tests, were conducted using SPSS software version 26 to assess the specific impact of the training interventions on parent-child interaction components.

Results
Both positive resilience training and mentalization-based training demonstrated significant effectiveness in improving parent-child interaction components, specifically in enhancing closeness, dependence, and reducing conflict within the parent-child relationship. The results indicated that both interventions significantly impacted these components (p < 0.01). However, notable differences were observed in the effectiveness of the two interventions, with mentalization-based training showing superior effectiveness in enhancing closeness and reducing conflict compared to positive resilience training (p < 0.001 vs. p < 0.01 in both comparisons).

Discussion
The findings highlight the importance of tailored interventions in supporting parent-child interactions among mothers of children with intellectual disabilities. Both positive resilience training and mentalization-based training offer valuable approaches for fostering positive parent-child dynamics, with mentalization-based training showing particular promise in enhancing closeness and reducing conflict within the relationship. These results underscore the potential of incorporating mentalization-based approaches into intervention programs aimed at improving parent-child interactions in challenging contexts, such as those involving children with intellectual disabilities.

Exceptional Children Psychology

The effectiveness of the lived experience program focused on the acceptance and commitment of positive and negative academic emotions of students with stuttering disorder: a single case study

https://doi.org/10.22055/psy.2024.47069.3267

Shahrooz Nemati, rahim badri, Shahram Vahedi, Mohammad Bardel

Abstract Introduction
Speech disorder, including stuttering, is a communication disorder that affects the production and fluency of speech. Stuttering is characterized by repetitions, stretching, pauses, or involuntary stuttering in sounds, syllables, and words. It is prevalent in about 5% of adolescents and 20% of the overall population. Stuttering can have a significant impact on communication abilities and may lead to psychological issues such as emotional disturbance, low cognitive flexibility, and perceptual speech problems. The current research aims to implement the "acceptance and commitment training" to determine its effectiveness on the academic emotions of students with stuttering disorder.
Method
The research used a single-subject design with different subjects, including 3 second-grade high school students with stuttering disorder. The students went through baseline, treatment, and follow-up stages. Student names were obtained from the social harms section of Khoi city's education management. Participants were second-year high school students with stuttering disorder, who hadn't received prior psychological intervention and met the entry and exit criteria. Participants with physical or sensory issues or who missed more than two sessions were excluded.
Results
A study was conducted with three student participants. Participant one is a 16-year-old boy in 11th grade with a history of late speech development. Participant two is a 17.5-year-old girl in 12th grade who struggles with speech fluency and accuracy. Participant three is a 15-year-old girl in 10th grade with speech problems and academic difficulties. The study includes detailed information about their backgrounds and the psychological assessments conducted. This information provides valuable insights for addressing their unique needs in the treatment process.
Discussion
The current study aimed to investigate the effectiveness of an acceptance and commitment therapy (ACT) program in improving positive and negative academic emotions among second-year high school students who stutter. The analysis revealed that the ACT intervention had a significant positive effect on enhancing both positive and negative academic emotions in the participants. The ACT-based therapy facilitated students' ability to replace negative academic emotions with more positive experiences in the classroom, moving away from cognitive avoidance. However, the researchers acknowledged the uncontrollable nature of factors influencing academic emotions, such as personality traits, school environment, and personal/cultural beliefs, as a limitation of the study. Future research should consider the impact of additional variables, including personality and religious factors, as well as the program's effectiveness with other neurodevelopmental populations and socioeconomic groups. Additionally, comparing the outcomes of individual counseling with parents to group-based education would provide valuable insights for the implementation of this therapeutic approach.

Psychotherapy

Comparison the Effectiveness of Acceptance and Commitment and Emotion Focused Therapies on Quality of Life of Patients with Type 2 Diabetes

https://doi.org/10.22055/psy.2024.47263.3281

Mojgan Zandi, Shahram Mohammad Khani, Mohammad Hatami

Abstract According to the World Health Organization (2023), approximately 95% of all adults with diabetes have type 2 diabetes. The quality of life of these patients is low. Considering that the psychological complications of type 2 diabetes are very costly, it is very important to pay attention to psychological therapies for its consequences, including the quality of life; The main question of the current research is “what extent is the effect of ACT and EFT on the quality of life of patients with type 2 diabetes”. This research was a quasi-experimental method with a pre-test, post-test, and follow-up design. The statistical population of the current study was all patients with type 2 diabetes living in Tehran who had visited the endocrinology clinics of Tehran University of Medical Sciences in 2018. Using the available sampling method, 45 patients with type 2 diabetes were replaced in three groups according to the entry and exit criteria. Quality of life (SF-36) was used to collect data. For the first experimental group, ACT was performed in 12 one-hour sessions, and for the second experimental group, EFT was performed based in 8 one-hour sessions. Finally, the data were analyzed using the paired sample t-test and repeated measure test. In addition, SPSS-26 software was used for the analysis.
The results of the one-sample t-test showed that in the ACT group, the difference between the pre-test and post-test scores of the quality of life and its dimensions (emotional health, mental health, lack of physical pain, general health) was significant; This means that these scores have increased in the post-test compared to the pre-test. In the EFT group, the difference between the pre-test and post-test scores of the quality of life and its dimensions (emotional health, lack of fatigue, social functioning, lack of physical pain) was significant; In other words, EFT had an effect on increasing scores in the post-test. But in the control group, no significant difference was observed between the pre-test and post-test scores. The results of the mixed variance analysis test showed that the effect of time and group on the quality of life of patients was significant; However, the group × time effect on the patients' quality of life was not significant; In other words, there is a difference between the levels of time (pre-test, post-test, and follow-up) in all study groups. Also, the results showed that ACT and EFT have almost the same effect on patients' quality of life. The results of the interaction effect of therapies and mechanism variables showed that ACT with the help of psychological flexibility and EFT with the help of emotional efficiency were effective in improving the quality of life of type 2 diabetes patients.
The results showed that ACT and EFT were effective on the quality of life of patients with type 2 diabetes and no significant difference was observed between the effectiveness of these two therapies on the quality of life. This result is consistent with previous findings. ACT seeks to increase psychological flexibility, which includes awareness and acceptance of one's thoughts and feelings while taking actions that are aligned with personal values; Therefore, increasing psychological flexibility, which has been confirmed to be related to quality of life, can help people with type 2 diabetes to deal with emotional challenges caused by this disease, such as hopelessness, anxiety, or depression, which can improve their quality of life. Regarding the effectiveness of EFT on the quality of life of patients with type 2 diabetes in the present study, it can be said that this finding is consistent with previous findings. In explaining this finding, it can be argued that living with type 2 diabetes often involves managing stress related to the disease itself and its treatment, and EFT can provide people with strategies to deal with stress more effectively, such as identifying and challenging unhelpful thoughts and developing healthy coping mechanisms; Therefore, it can have a positive effect on the quality of life of people with diabetes. Based on the findings, it is suggested that ACT and EFT use to improve the quality of life of type 2 diabetes patients.