Iranian Journal of Psychiatry

Mental Health Consequences of War: Lessons from Recent Conflicts and Implications for All, Specifically Iranians

2025-09-17T11:43:30+00:00

The Article Abstract is not available.

The Real Deviance: Misrepresentation of Science and the Persistence of Homophobic Ideology - A Rebuttal to Daftari and Khaleghi

2025-09-17T11:43:29+00:00

The Article Abstract is not available.

Science Beyond Consensus: Defending Open Inquiry in Sensitive Scientific Debates

2025-09-17T11:43:28+00:00

The Article Abstract is not available.

Can Replacing Screen Time with Social-Media and Mobile Apps Enhance Social Skills in Autistic Children?

2025-09-17T11:43:27+00:00

Objective: This study aimed to assess the impact of reducing screen time and replacing it with social media platforms and assistive technologies on the development of social and communication skills in children with autism spectrum disorder (ASD).

Method: A total of 30 children aged 4 to 8 years with a confirmed diagnosis of ASD were selected and randomly assigned to either an experimental group (n = 15) or a control group (n = 15). Over the course of eight weeks, the experimental group engaged in activities using social media apps and assistive technologies designed to enhance communication and social skills, while the control group continued with their regular screen time activities. Pre-test, post-test, and follow-up (four-week after post-test) assessments were conducted to measure the children's progress in social and communication skills.

Results: The experimental group showed significant improvements in communication and social skills, with communication scores increasing from a pre-test mean of 21.2 (SD = 3.1) to a post-test mean of 14.1 (SD = 2.4), and maintaining at 13.9 (SD = 2.5) during follow-up. Social skills improved from a pre-test mean of 31.2 (SD = 4.0) to a post-test mean of 14.1 (SD = 3.0), remaining stable at 14.0 (SD = 3.2) at follow-up. In contrast, the control group showed minimal changes in both communication (pre-test: 20.9, post-test: 20.5, follow-up: 20.3) and social skills (pre-test: 30.9, post-test: 30.7, follow-up: 30.6). Analysis of covariance (ANCOVA) results indicated significant differences between the groups in communication (F (1, 28) = 8.47, P = 0.006, η² = 0.32) and social skills (F (1, 28) = 7.21, P = 0.010, η² = 0.28). Paired samples t-tests in the experimental group also revealed significant improvements from pre-test to post-test for both communication (mean difference = 10.21, t = 5.67, P < 0.001) and social skills (mean difference = 9.89, t = 5.43, P = 0.002), with effects maintained during follow-up.

Conclusion: These findings emphasize the potential of using social media and assistive technologies as effective tools in fostering social and communication skill development in children with ASD.

Designing and Compiling a Special Parenting Package to Use Digital Technology in Iranian Children and Adolescents

2025-09-17T11:43:26+00:00

Objective: This study aimed to design and validate a culturally tailored educational package for Iranian parents of children and adolescents aged 0 to 18. The package addresses the safe and effective use of a range of digital technologies, including social media, online games, and educational applications. It focuses on enhancing parents’ knowledge, monitoring capabilities, and strategies to mitigate digital risks, with consideration of Iranian cultural values and family dynamics.

Method: The content was developed through a review of literature across multiple English and Persian databases, including PubMed, Scopus, Web of Science, Iran Medex, Magiran, and SID. Relevant keywords and MeSH terms related to parenting, digital technology, and cultural adaptation were used. Cultural appropriateness was ensured through consultations with a panel of experts in psychiatry, child development, and digital education, along with qualitative input from Iranian parents via focus groups and interviews.

Results: The finalized educational package comprises 12 well-structured chapters covering topics such as digital literacy, online safety, parental supervision, balancing screen time, effective family communication, and related legal and ethical issues contextualized for Iranian society. The package achieved high content validity, with all chapters scoring above 0.79 on the Content Validity Index (CVI) and Content Validity Ratio (CVR).

Conclusion: This culturally adapted package offers an evidence-based resource that empowers Iranian parents by increasing their awareness, sharpening their supervisory and communication skills, and supporting the healthy and responsible use of digital technologies among their children. Future steps include pilot testing and evaluating the package’s effectiveness and scalability in real-world settings.

Relationships of Attitudes toward Eating and Eating Behaviors with Invalidating Childhood Environment in Adults: The Mediating Role of Self-Compassion, Distress Tolerance, and Impulsivity

2025-09-17T11:43:25+00:00

Objective: Eating disorders (EDs) are prevalent in adulthood and often originate in adolescence, influenced by various psychological factors, including childhood experiences. This research investigated how self-compassion, distress tolerance, and impulsivity function as mediators between early experiences of emotional invalidation during childhood and individuals’ eating patterns and attitudes in adulthood.

Method: The study involved 1,217 students (86.2% female), recruited through convenience sampling. Participants completed standardized questionnaires assessing eating behaviors, eating attitudes, self-compassion, distress tolerance, and impulsivity. The proposed model was tested using structural equation modeling (SEM).

Results: Impulsivity and self-compassion significantly mediated the relationship between childhood invalidation and both eating behavior (β = 0.161, P < 0.05) and eating attitude (β = 0.077, P < 0.01). Distress tolerance did not serve as a significant mediator in the model. Invalidating childhood environment was directly related to impulsivity (β = 0.303, P < 0.001) and self-compassion (β = -0.350, P < 0.001). Self-compassion and impulsivity were significant predictors of eating behavior and attitudes.

Conclusion: Childhood experiences of invalidation contribute to maladaptive eating behaviors and attitudes through the mediating roles of impulsivity and self-compassion. Notably, impulsivity had a stronger indirect effect on both outcomes compared to self-compassion. The results indicate that fostering self-compassion and managing impulsive tendencies may serve as important focal points for interventions designed to prevent or treat eating disorders.

Investigation of Relationship with God among Adolescents with Conduct Disorder: A Qualitative Content Analysis

2025-09-17T11:43:24+00:00

Objective: Conduct disorder is characterized by aggressive behavior, cheating or theft, destruction of property, and serious violation of laws before the age of 18. Relationship with God is probably one of the factors that can play a role in preventing delinquent behaviors in individuals with conduct disorder through internal self-control. In this research, we intended to explore the relationship with God among adolescents with conduct disorder.

Method: In this study, we used a directed qualitative content analysis research method. We interviewed 9 boys aged 12-17 years who had conduct disorder with or without substance use disorder at a correctional facility in Tehran. We collected the data using a purposive sampling method and continued until data saturation. All interviews were recorded and then transcribed verbatim. The interviews were analyzed using a content analysis method.

Results: The boys' relationship with God was analyzed. Three themes were extracted from the interviews: 1) Perception of God, 2) Image of God, and 3) Worship.

Conclusion: This study highlighted three main themes: Perception of God, Image of God, and Worship, which shape how adolescents with conduct disorder relate to spirituality. These findings can contribute to the development of culturally appropriate, faith-based therapeutic interventions.

The Emergence of Suicidal Ideation: Testing the Three-Step Theory in Iranian Adolescents

2025-09-17T11:43:23+00:00

Objective: Suicide is a global public health problem with significant adverse effects on individuals and society, especially among adolescents. Klonsky’s three-step theory (3ST) of suicide explains suicidal ideation through three factors, namely hopelessness, psychological pain, and connectedness in two steps. No study has investigated connectedness (step 2) in combination with psychological pain and hopelessness (step 1) in prediction of suicidal ideation among adolescents. Thus, we empirically tested the first two steps of the 3ST in a sample of Iranian adolescents.

Method: A total of 466 adolescents aged 12 to 20 years (356 females and 110 males) were recruited using convenience sampling. This cross-sectional study was conducted between September to November 2024. The participants completed self-report questionnaires on suicidal ideation, hopelessness, psychological pain, and connectedness. Hierarchical linear regression analysis was conducted to explore the impact of the interaction of hopelessness and psychological pain on suicidal ideation. In addition, we explored whether connectedness reduced the escalation of suicidal ideation in adolescents experiencing high psychological pain and hopelessness levels.

Results: The findings showed that the interaction of hopelessness and psychological pain accounted for 59% of the variance in suicidal ideation (P < 0.001). Connectedness was found as a protective factor for suicidal ideation in adolescents who experience high levels of both psychological pain and hopelessness (r = 0.24, P < 0.001).

Conclusion: These findings support the applicability of the first two steps of the 3ST for Iranian adolescents. Future research should examine all three steps of this theory in a clinical sample of adolescents.

The Mediating Role of Alexithymia in the Relationship between Maladaptive Object Relations Patterns and Depression

2025-09-17T11:43:22+00:00

Objective: Depression is a prevalent psychological condition that severely impacts quality of life. Psychodynamic theories highlight early interpersonal experiences and maladaptive object relations as key factors in vulnerability to psychopathology. Alexithymia, characterized by difficulty identifying and expressing emotions, is a transdiagnostic risk factor strongly linked to depression. This study examines the mediating role of alexithymia in the relationship between maladaptive object relations and depression.

Method: This cross-sectional study used a path-analysis method. A total of 245 dormitory students (145 males and 100 females) from Iran University of Medical Sciences were selected via two-stage cluster sampling. Data were collected using the Bell Object Relations and Reality Testing Inventory (BORRTI), Toronto Alexithymia Scale (TAS-20), and Beck Depression Inventory–Short Form (BDI-S). Pearson correlation, regression analysis, and the Sobel test were conducted using SPSS version 20.

Results: Path analysis showed significant direct effects of maladaptive object relations (alienation, insecure attachment, egocentricity, social incompetence) on both alexithymia (β = 0.395–0.444, P < 0.001) and depression (β = 0.365–0.562, P < 0.001). Alexithymia also directly affected depression (β = 0.176–0.287, P ≤ 0.003). Indirect effects of alexithymia in the relationship between object relations and depression ranged from 0.077 to 0.113, with all paths significant per the Sobel test.

Conclusion: Alexithymia significantly mediates the relationship between maladaptive object relations and depression, suggesting that early unhealthy relational patterns may foster depression by impairing emotional awareness. Therapeutic interventions should focus on enhancing emotional processing to promote sustainable recovery

Embodied Self and Metaphor Comprehension Predict Comprehension of Boundary Concept in Patients with Schizophrenia

2025-09-17T11:43:21+00:00

Objective: The embodied self refers to the sense of self intertwined with the physical body and its experiences, which is impaired in schizophrenia. Comprehension of metaphors that are cognitive tools to help the comprehension of abstract ideas is also impaired in patients with schizophrenia. The Conceptual Metaphor Theory (CMT) links embodied experiences and metaphors to boundaries, indicating that these disruptions may lead to difficulties in understanding boundaries in schizophrenia. This study explores the role of embodied self and metaphor comprehension in predicting boundary concept comprehension in patients with schizophrenia.

Method: This study employed a cross-sectional correlational design to examine the relationships among variables. The current study recruited 85 Male patients who were diagnosed with schizophrenia (mean age = 47.84 years, SD = 7.58) through a convenience sampling method. All participants completed the Embodied Sense of Self scale, the Montreal Evaluation of Communication (MEC) Metaphor subtest, and a researcher-developed questionnaire assessing comprehension of the boundary concept. Multiple linear regression analyses were applied to assess the associations between the embodied self, metaphor comprehension, and understanding of the boundary concept.

Results: The suggested Model predicts 50% of the total variance (P < 0.01, R2 = 0.50). Metaphor comprehension predicts boundary concept understanding (β = 0.67, P ≤ 0.01, R2 = 0.50), while the embodied self (β = -0.13, P = 0.1, R2 = 0.50) does not.

Conclusion: Our findings indicate that impairments in metaphor comprehension are significantly related to the understanding of boundary concepts in schizophrenia, while no such relationship was observed with the embodied self. These results highlight the role of metaphorical cognitions in boundary perception, potentially extending to issues with the self-other boundary and representing relations of self-other boundary disturbances and Metaphorical cognition.

Psychometric Properties of the Persian Version of the Comprehensive Autism Trait Inventory (CATI)

2025-09-17T11:43:20+00:00

Objective: The present study aimed to culturally adapt and psychometrically evaluate the Comprehensive Autism Trait Inventory (CATI) for use within the Iranian society, thereby facilitating cross-cultural research on autistic traits.

Method: This cross-sectional survey included 1,013 Iranian adults (70.1% female), aged 15 to 50 years (M = 24.91, SD = 5.47), recruited through convenience sampling. The translation of the CATI into Persian was developed based on a carefully implemented forward and backward translation procedure through bilingual experts. Discrepancies were resolved by a panel of psychologists and psychometricians to ensure semantic and conceptual equivalence. The broad autism phenotype questionnaire (BAPQ), a tool designed to measure traits associated with the broad autism phenotype, was also administered to measure convergent validity. In order to assess internal consistency, Cronbach’s alpha was calculated, while construct validity was evaluated through confirmatory factor analysis (CFA) and Pearson correlations with BAPQ scores.

Results: CFA confirmed that all items aligned meaningfully with their intended factors, supporting the persian CATI’s six-factor structure and indicating a good model fit (CFI = 0.93; RMSEA = 0.047; χ² / df = 3.25; GFI = 0.90; SRMR = 0.059). The average variance extracted (AVE) was 0.45 for both the components and the overall scale. Correlations between CATI subscales and the BAPQ ranged from 0.03 to 0.40, demonstrating acceptable convergent and divergent validity. The reliability of the six-factor model was verified by Cronbach’s alpha (0.84) and McDonald’s omega (0.82).

Conclusion: The Persian version of the CATI shows sound psychometric properties for evaluating autistic traits in the Iranian population. These findings support utility of CATI in research settings and highlight the importance of culturally adapted assessment tools for improving diagnosis and intervention across diverse contexts.

Climate Change Awareness, Eco-Anxiety, and Anger among Yemeni Medical Students.

2025-09-17T11:43:19+00:00

Objective: Climate change is increasingly recognized as a global health threat. However, awareness and psychological responses to climate risks may vary across populations, particularly in conflict-affected regions. This study aimed to assess the levels of climate change awareness, climate anxiety, and aggression among Yemeni medical students.

Method: A descriptive cross-sectional design was utilized for this study. The sample included 212 final-year students from all departments within the Faculty of Medicine and Health Sciences at Taiz University. Data were collected using validated scales for climate change awareness, the Climate Anxiety Scale, and the Buss–Perry Aggression Questionnaire. Descriptive statistics, group comparisons (t-tests and ANOVA), correlation analysis, and multiple linear regression were applied to identify significant relationships and predictors.

Results: More than 60% of the participants demonstrated poor awareness of climate change, and over 50% reported low levels of climate anxiety. Moderate aggression scores were observed in more than half of the respondents. While aggression showed significant associations with sex and climate anxiety, no statistically significant relationship was found between climate change awareness and anxiety.

Conclusion: Despite the environmental vulnerability of Yemen, medical students show limited awareness and low psychological response to climate change. This may reflect a focus on immediate survival needs in conflict-affected settings. Integrating climate-health education and psychological preparedness into medical curricula is essential to empower future healthcare providers in addressing climate-related health challenges.

Effectiveness of Digital Cognitive Behavioral Therapy for Insomnia: A Meta-Analysis of Randomized Controlled Trials

2025-09-17T11:43:18+00:00

Objective: This study aimed to evaluate the effectiveness of fully automated Digital Cognitive Behavioral Therapy for Insomnia (dCBT-I) interventions in reducing insomnia severity through a systematic review and meta-analysis of randomized controlled trials (RCTs).

Method: A systematic search was conducted across multiple databases, including PubMed, PsycINFO, Web of Science, Scopus, and Google Scholar, to identify RCTs evaluating fully automated dCBT-I. Eligible studies were included those assessing adults diagnosed with insomnia using validated criteria or scales, utilizing digital delivery platforms, and reporting quantitative insomnia severity outcomes. A meta-analysis was performed using a random-effects model, with standardized mean differences (SMDs) and 95% confidence intervals (CIs) as the primary effect measures. Subgroup and sensitivity analyses were conducted to explore sources of heterogeneity.

Results: A total of 49 RCTs involving 20,118 participants were included. Fully automated dCBT-I significantly reduced insomnia severity compared to control conditions (WMD: -3.42; 95% CI: -4.35 to -2.48; P < 0.001). Subgroup analyses revealed greater effectiveness in studies using rigorous diagnostic criteria, as well as among U.S.-based populations. Despite substantial heterogeneity (I² > 98%), sensitivity analyses confirmed the robustness of findings. Funnel plot asymmetry suggested minor potential publication bias, though Egger’s test did not confirm significant bias (P = 0.494).

Conclusion: Fully automated dCBT-I programs effectively reduce insomnia severity, offering a scalable, accessible solution to overcome barriers in traditional CBT-I delivery. However, variability in study methodologies and the predominance of studies from high-income countries highlight the need for further research. Future directions include incorporating objective sleep measures, assessing long-term outcomes, and adapting interventions to diverse cultural and economic contexts. Fully automated dCBT-I holds transformative potential for addressing insomnia on a global scale.

Mapping Two Decades of Childhood Emotional Abuse Research: A Global Bibliometric Analysis (2005–2024)

2025-09-17T11:43:16+00:00

Objective: Child emotional abuse (CEA) is associated with a wide range of detrimental consequences, both in childhood and adulthood. Despite its widespread prevalence and long-term impact, it has historically received less scholarly attention compared to physical and sexual abuse. To address this gap, his study presents the first global bibliometric analysis of CEA research from 2005–2024, mapping its evolution, thematic trends, and geographical distribution.

Method: Using Scopus and PubMed, 1,040 articles and reviews in English were analyzed via the R-based Bibliometrix package. Descriptive, network, and thematic analyses identified publication patterns, collaboration networks, and conceptual trends.

Results: Publications on CEA have risen sharply since 2018, with psychology, medicine, and psychiatry dominating the field. The United States, China, and Canada are the most productive countries, while many Low- and Middle-Income Countries (LMICs) remain underrepresented (e.g., Iran 0.96%). Trend analyses reveal a thematic shift from immediate psychological distress toward developmental mechanisms, transdiagnostic constructs (e.g., early maladaptive schemas), and culturally contextual factors. Thematic mapping shows underdeveloped core areas (e.g., depression, child trauma), well-developed motor themes (e.g., early maladaptive schemas, meta-analysis), and niche/emerging topics (e.g., fMRI, gene–environment interaction).

Conclusion: CEA research is expanding toward integrative, culturally informed, and mechanism-focused frameworks, but definitional, methodological, and geographical gaps persist. Targeted investment in LMIC research, validated and culturally adapted tools, interdisciplinary collaboration, and prevention-oriented strategies are urgently needed.

Environmental Risk Factors of Conduct Disorder: An Overview of Meta-Analyses

2025-09-17T11:43:15+00:00

Objective: Conduct disorder is one of the most common disorders of childhood and adolescence. This disorder imposes high costs on the individual, family and community. Understanding the risk factors associated with conduct disorder can provide a comprehensive picture of the disorder. Therefore, the aim of this study is to investigate the risk factors related with conduct disorder.

Method: We included meta-analyses that reported one or more risk factors of conduct disorder. We searched PubMed and Scopus until July 19, 2025. One author assessed the quality of the included studies using the ROBIS, and two authors extracted relevant data independently.

Results: We found 12 articles that met the inclusion criteria, from which data pertaining to 17 meta-analyses were extracted. The risk factors identified by the meta-analyses were as follows: severe psychiatric disorders in parents, postnatal exposure to second-hand smoke, atopic dermatitis, being children of alcoholics, prenatal alcohol exposure, maternal smoking during pregnancy, maternal alcohol use during pregnancy, overweight/obesity, maternal perinatal depression, preconception overweight, and preconception obesity.

Conclusion: Drawing on 17 meta-analyses, this study provides a comprehensive synthesis of the risk factors associated with conduct disorder. The findings can inform policymakers and healthcare professionals to develop targeted interventions, such as public health campaigns and support programs for at-risk families, to mitigate these risks. Furthermore, this study highlights the gaps in the existing literature, including the reliance on older studies and methodological limitations, paving the way for future research to address these shortcomings and strengthen the evidence base.