Background: Empathy is an important factor in patient-physician relationship that has beneficial effects in medical practice. Jefferson Scale of Empathy (JSE) has been specifically designed to assess empathy in health professionals (HP-version) and related students (S-version). Few validation studies have been performed on S-version of the scale. Aims: To examine empathy in a large sample of Iranian medical students, and also to study factor structure and psychometric properties of the Persian translation of the S-version of the JSE. Method: 1187 medical students (759 female) from 16 universities around the country participated in the study during 2009. Independent sample t-test, multivariate analysis of variance, and confirmatory factor analysis (CFA) were performed to analyze the data. Results: Female students outscored male students in empathy. The trend for empathy had a negative relationship with years of education. JSE showed an acceptable internal consistency and test re-test reliability. CFA upheld the original three-factor structure -Perspective Taking, Compassionate Care, and Standing in the Patient's Shoes -consisting 20 items. Conclusion: The decrease in empathy during medical education is consistent with previous studies. The Persian version of JSE is a valid and reliable measure to tap empathy in a Persian-speaking medical student.

Background:Selective serotonin reuptake inhibitors (SSRIs) and exposure with response prevention for treatment of obsessive-compulsive disorder (OCD) have demonstrated empirical support; however, a substantial number of patients remain with clinically significant OCD symptoms after such treatments. Objectives:The aim of this study was to compare the effectiveness of acceptance and commitment therapy (ACT), selective serotonin reuptake inhibitors (SSRIs) and combination of ACT and SSRIs in the treatment of adults with obsessive-compulsive disorder (OCD).Patients and Methods:Thirty-two outpatients meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria for OCD were randomly assigned to one of the three treatment conditions: ACT, SSRIs and combined treatment. The Yale-Brown Obsessive-Compulsive Scale and Acceptance and Action Questionnaire were administered at pre-treatment and post-treatment. Twenty-seven patients completed the study. Data was analyzed using one-way analysis of variance (ANOVA) and one-way analysis of covariance (ANCOVA), clinically significant change (CSC) and complete remission status.Results:ANCOVA revealed that patients treated with ACT and combined treatment experienced a significantly greater improvement in obsessive-compulsive (OC) symptoms and experiential avoidance (EA) at post-treatment compared to those treated with SSRIs alone. However, there were no significant differences between ACT and combined treatment on OC symptoms and EA. CSC and complete remission status results showed that unlike SSRI, ACT and combined treatment led to more improvement in OC symptoms.Conclusions:ACT and combined treatment are more effective than SSRIs alone in treating OC symptoms and EA. However, it appears that adding SSRIs to ACT does not increase the effectiveness of ACT in the treatment of adults with OCD in the short-term.

Background: Based on historical viewpoint, relationship among depression, anxiety and stress attracted clinical and theoretical consideration. Despite the relative overlap of these psychological disorders in general, these three syndromes are distinctive in terms of theoretically and conceptually aspects.

Background This systematic review aimed to investigate the psychometric properties of the school health’s assessment tools in primary schools through COSMIN Risk of Bias checklist. We examined the studies that have addressed the measurement properties of school-health instruments to give a clear overview of the quality of all available tools measuring school health in primary schools. This systematic review was registered in PROPERO with the Registration ID: CRD42020158158. Method Databases of EBSCOhost, PubMed, ProQuest, Wily, PROSPERO, and OpenGrey were systematically searched without any time limitation to find all full-text English journal articles studied at least one of the COSMIN checklist measurement properties of a school-health assessment tool in primary schools. The instruments should be constructed based on a school health model. The eligible studies were assessed by COSMIN Risk of Bias checklist to report their quality of methodology for each measurement property and for the whole study by rating high, moderate or low quality. Results At the final screening just seven studies remained for review. Four studies were tool development, three of them were rated as “adequate” and the other study as “very good”; five studies examined the content validity, three of them were appraised as “very good”, and the two remaining as “inadequate”. All seven studies measured structural validity, three of them were evaluated as “very good”, three other were scored as “adequate”, and the last study as “inadequate”. All the seven studies investigated the internal consistency, five of them were assessed as “very good”, one was rated as “doubtful”, and the last one as “inadequate”. Just one study examined the cross-cultural validity and was rated as “adequate”. Finally, all seven studies measured reliability, two of them were rated as “very good” and the rest five studies were appraised as “doubtful”. All rating was based on COSMIN checklist criteria for quality of measurement properties assessment. Conclusion The number of studies addressing school health assessment tools was very low and therefore not sufficient. Hence, there is a serious need to investigate the psychometric properties of the available instruments measuring school health at primary schools. Moreover, the studies included in the present systematic review did not fulfill all the criteria of the COSMIN checklist for assessing measurement properties. We suggest that future studies consider these criteria for measuring psychometric properties and developing school health assessment tools.

The growing rate of smoking cigarettes among the youths necessitates examining its contributing factors. Accordingly, we aimed to compare smoking and nonsmoking university students in their attachment styles, perceived loneliness, and psychological well-being. To this end, we recruited 100 current smokers and 100 nonsmoking students by using a convenience sampling method from Shahid Beheshti University, Tehran, Iran. All participants completed the Adult Attachment Scale, Loneliness Scale, and General Health Questionnaire. Data analysis indicated that compared to nonsmokers, smokers had a more anxious attachment style and they felt lonelier. Moreover, current results showed that smokers suffered from higher rates of psychological problems than nonsmokers. These results suggest that smoking is influenced by a set of psychological factors and therefore, prevention and treatment programs targeting these factors may be effective in reducing the rate of smoking cigarettes among university students.

Objectives Tuning in to Kids (TIK) is a group parenting program that targets parent emotion socialization (emotional awareness and regulation, meta-emotion and emotion coaching skills) to improve children's functioning. The aim of this pilot study was to investigate the effectiveness of this program when used with parents of anxious preschool children. Methods The study used a randomized controlled design. Fifty-six mothers of children who scored one standard deviation above the mean on the parent report of the Preschool Anxiety Scale (PAS) were selected from 358 families who expressed interest in participating in a parenting program. Selected participants were randomly assigned to intervention (n = 30) or control (n = 26) conditions. Participants in the intervention condition attended the 6 session TIK program followed by two booster sessions at monthly intervals thereafter. Post-intervention and 6-months later the PAS was re-administered to participants in both conditions. Results Mixed Repeated Measure ANOVA analysis showed a significant difference between participants in the two conditions on parent-reported anxiety at post-test and 6-month follow-up. Clinical significance analyses showed 69% of the intervention group in comparison to 18% of the control group had parent-reported change into the normal range for anxiety scores. These changes remained stable at 6-month follow-up (60% compared to 23%). ConclusionThe study suggests that the TIK program shows preliminary effectiveness when used in Iran with preschool children with anxiety.

Australian, Iranian and Portuguese university students (N = 967) completed University Students Depression Inventory (USDI; Khawaja & Bryden, 2006) in English, Persian, and Portuguese languages respectively. A series of MANOVA were used to examine differences in depression symptoms as an effect of the country and demographic variables. Interactions were also examined. The results indicated that country, gender, and year level had some impact on the depressive symptoms of the university students. Australian students were more depressed than the Iranian and Portuguese students, while Iranian students were more depressed than the Portuguese students. Subscales of USDI: Lethargy, Motivation, and Cognitive/Emotional were also used to compare the depressive symptoms of students. The Australian female students reported a significantly higher level of lethargy than their male counterparts. Similarly, the first year male students from Iran were significantly more lethargic than the first year Iranian female students. Iranian and Portuguese male students, compared to the female students of these countries, experienced a lower level of motivation. The Australian and Iranian students, compared to the Portuguese students, reported a significantly higher level of cognitive and affective symptoms. The scores on the Cognitive/Emotional subscale increased with the year level. Differences among students' depression are described and implications discussed.

This study was designed to evaluate the psychometric properties of a Persian version of the Self-Efficacy Questionnaire for Children (SEQ-C) among Iranian adolescents. The scale was translated into Persian and administered to 946 high school students (49.8% girls, ages 14 through 19). Participants also completed the Child Depression Inventory, Social Avoidance and Distress Scale, and Spielberger’s State–Trait Anxiety Inventory. Finally, participants’ grade point averages were collected. Confirmatory factor analysis upheld the original 3-factor structure: social, academic, and emotional self-efficacy. Findings supported the Persian version of the SEQ-C’s internal consistency and test–retest reliability. The SEQ-C was related to other constructs in empirically and theoretically expected ways. With respect to gender, there was some noninvariance in factor structure and mean-level gender differences. Other results indicated that girls reported higher social and academic self-efficacy, but lower emotional self-efficacy, relative to boys. The Persian version of the SEQ-C was found to be a valid and reliable measure of self-efficacy among Persian adolescents.