Risk Factors and Psychosocial Correlates of Emotionally Negative Dreams in Patients Referred to a Cardiac Rehabilitation Centre

@#Introduction: Dream, as a kind of mental activity, includes various functions such as mood regulation, adjustment and integration of new information with the available memory system. The study was done for assessing the relationship between physiological and psychological components of cardiac diseases with emotionally negative dreams in cardiac rehabilitation. Methods: At the baseline of this cross-sectional study, 156 patients from Western Iran participated during April–November 2016. People 20 years–80 years able to recall the emotional content of dreams after cardiac surgery entered the study. The Beck depression inventory (BDI), Beck anxiety inventory (BAI), Buss and Perry’s aggression questionnaire (BPAQ) and Schredl’s dream emotions manual were used for collecting data. A binary logistic regression analysis used for the study of the relationship between risk factors and emotionally negative dreams. Results: The mean age of participants was 59 (SD = 9) years (men: 64.1%). The results showed that 25% of patients have negative emotional content. After adjustment for demographic variables, the results showed that increased anxiety [adjusted odds ratio (adj OR) = 1.08 [1.01– 1.16], P = 0.020] and anger (adj OR = 1.03 [1.00–1.06], P = 0.024) and hypertension (adj OR = 2.71 [1.10–6.68], P = 0.030) can predict the dreams with negative content significantly. Conclusion: The increasing rates of anxiety and anger and history of hypertension are related to increasing dreams with the negative emotional load. The control of risk factors of dreams with negative emotional load can be the target of future interventions.

The Mediator Role of Aggression in the Relationship between Marital Stress and Depression among Patients with Coronary Artery Disease

@#Background: Depression is one of the most important consequences of cardiovascular diseases (CVDs), and to control and treat it, it is necessary to identify its direct and indirect triggers and underlying factors. Therefore, the current study aims to evaluate and investigate the mediator role of aggression in the relationship between marital stress and depression. Methods: The sample of current cross-sectional study includes 212 patients with coronary artery disease (CAD) in Iran evaluated from Jan to Jun 2017. The required data were gathered using Beck’s Depression Inventory (BDI) questionnaire, Buss and Perry’s Aggression Questionnaire (BPAQ), and Hudson’s Marital Satisfaction Index (HMSI). The data were analysed using Pearson’s correlation coefficient and structural equation modeling (SEM) using SPSS20 and AMOS software. Results: The mean age of participants (68.4% male) was 58.5 ± 8.9. The results show that there is a significant positive relationship between all the variables (P < 0.05). The results of the model show that marital stress cannot directly predict depression (P = 0.586). However, through aggression, marital stress can significantly predict 18% of the variance of depression (P < 0.001). Conclusions: Not directly, but indirectly through aggression, marital stress can significantly predict increased depression among patients with CAD. The physiological and psychological pathways of the findings can be discussed.

Inequalities in access to hospitals: a case study in the Islamic Republic of Iran 1997–2012

Background: Nowadays, the significance of applying Geographic information system (GIS) to survey accessibility to hospitals and understanding disparities in this regard has increased.

Aims: The main aim of this descriptive–analytical research was to study the spatial accessibility of the population of Kermanshah for 3 years 1997 (n=693157), 2007 (n=794863), and 2012 (n=851 405) to hospitals based on age and gender groups through GIS.

Methods: The study was conducted based on network analysis models, mean centre, and standard distance in the environment of Arc/GIS. A standard radius of 1500 metres was set for the medical centres, and a 25-minute walking span was set for the distance of each person from home to the nearest hospital.

Results: The results of the network analysis demonstrated that the hospitals were inaccessible to the populations according to our criteria, and their geographical access to hospitals measured 68.80%, 64.23% and 66.20% in 1997, 2007, and 2012, respectively. Women aged 65 years and above were more at risk in this regard.

Conclusions: Over the total period under study, the results revealed that hospitals were concentrated in the central and southern areas of Kermanshah

Mediator role of experiential avoidance in relationship of perceived stress and alexithymia with mental health

This cross-sectional study investigated the mediatory role of experiential avoidance in the relationship between perceived stress and alexithymia with mental health. We enrolled 440 students [age 18-30 years] at Kermanshah University of Medical Sciences through stratified random sampling method. The study tools were demographic checklist, GHQ-28, Toronto Alexithymia Scale-20 and Perceived Stress Scale. Data were analysed by SPSS-18 and AMOS-18 using Pearson correlation, hierarchical regression analysis and structural equation modelling [SEM]. There was a significant positive correlation between perceived stress and experiential avoidance, and alexithymia and mental health problems [P < 0.001]. SEM showed that the relationship between perceived stress and mental health problems by experiential avoidance was 0.19 [[beta = 0.19; standard error [SE] = 0.09; P = 0.001], and the relationship between alexithymia and mental health problems through experiential avoidance was 0.09 [beta = 0.09; SE = 0.43; P = 0.01]. The mediatory role of experiential avoidance was confirmed in such a way that the effects of alexithymia and perceived stress decreased

Attachment Style and Resiliency in Patients with Obsessive-Compulsive Personality Disorder / 가정의학회지

BACKGROUND: The goal of the present study was to determine the relationships between attachment styles and resiliency in obsessive-compulsive personality disorder. METHODS: A random sample of 260 subjects was obtained from the population of undergraduate students of the Nour Branch of Islamic Azad University, which is located in Mazandaran, and these subjects were enrolled in this descriptive and correlational study. The collected data included the subjects' responses to an adult attachment style questionnaire, resilience scale, and obsessive-compulsive personality disorder questionnaire. The data were analyzed with Pearson correlation coefficient indices and multiple regressions. RESULTS: The results of the data analysis showed a positive correlation (relationship) between ambivalent/avoidant attachment styles and obsessive-compulsive personality disorder and a negative correlation between resilience and obsessive-compulsive personality disorder. Furthermore, these results demonstrated that attachment style and resiliency can predict obsessive-compulsive personality disorder. In addition, no significant relationships were found between the demographic variables (convertibles) and obsessive-compulsive personality disorder. CONCLUSION: These results suggested that attachment style and resiliency contribute to the development of obsessive-compulsive personality disorder.

Perceived Stress, Alexithymia, and Psychological Health as Predictors of Sedative Abuse / 가정의학회지

BACKGROUND: The harmful effects of sedative medications and substances in conjunction with limited research regarding predictive psychological constructs of drug abuse necessitate further investigation of associated factors. Therefore, the present study aimed to elucidate the roles of perceived stress, alexithymia, and psychological health as predictors of sedative abuse in medical students. METHODS: In this cross-sectional study, 548 students at Kermanshah University of Medical Sciences, Iran, were selected using stratified random sampling. The data were obtained using the Perceived Stress Scale, an alexithymia scale (Farsi version of the Toronto Alexithymia Scale-20), and a General Health Questionnaire to assess psychological health. Data were analyzed using discriminant analyses. RESULTS: The results demonstrated that the user and non-user of sedative substances groups had significantly different predictive variables (except for social function disorder) (P>0.05). Physical complaints, alexithymia, and perceived stress, which had standard coefficients of 0.80, 0.60, and -0.27, respectively, predicted sedative drug use. CONCLUSION: The results of the present study indicate that perceived stress, alexithymia, physical complaints, anxiety, and depression are associated with sedative drug abuse.

The Intervening Role of Alexithymia in the Relationship between Attachment Styles and Test Anxiety among Gifted High School Students / 가정의학회지

BACKGROUND: Given the importance of test anxiety among gifted students, the present study was conducted to assess the intervening role of alexithymia in the relationship between test anxiety and attachment styles. METHODS: By means of simple random sampling, 300 participants were selected out of all the students at two high schools in Khorramabad, which are affiliated with the Iranian National Organization for Development of Exceptional Talents (SAMPAD). Test anxiety, alexithymia, and attachment style questionnaires were used for data collection. Pearson correlation and path analysis tests were used to analyze the data. RESULTS: The results showed a positive relationship between test anxiety and avoidant and anxious attachment styles. Alexithymia and test anxiety were also positively related. Moreover, the results indicated that 12% of changes in test anxiety were explained by avoidant and anxious attachment styles as well as alexithymia. The relationship between the avoidant attachment style and test anxiety was 0.06 through alexithymia. However, no significant relationship between anxious attachment and test anxiety through alexithymia was found. CONCLUSION: The avoidant attachment style leads to test anxiety when the level of alexithymia increases in an individual.

Gender differences in patients' beliefs about biological, environmental, behavioral, and psychological risk factors in a cardiac rehabilitation program

Introduction: There are significant gender differences in the epidemiology and presentation of cardiovascular diseases [CVDs], physiological aspects of CVDs, response to diagnostic tests or interventions, and prevalence or incidence of the associated risk factors. Considering the independent influence of gender on early dire consequences of such diseases, this study was conducted to investigate gender differences in patients' beliefs about biological, environmental, behavioral, and psychological risk factors in a cardiac rehabilitation program

Materials and Methods: This study has cross sectional design. The sample was composed of 775 patients referred to cardiac rehabilitation unit in Imam Ali Hospital in Kermanshah, Iran. The data were collected using clinical interview and patients' medical records. The data were analyzed using descriptive statistics such as mean, standard deviation, and chi-square test. To do the statistical analysis, SPSS version 20 was utilized

Results: As the results indicated, there was a significant difference between the beliefs of men and women about risk factors of heart disease [X[2]= 48.36; P<0.01]. Men considered behavioral [55.1%] and psychological [33.7%] risk factors as the main causes of their disease, respectively. On the other hand, women regarded psychological [38.2%] and behavioral factors [26.6%] as the most common causes of cardiac conditions, respectively. Both men and women considered stress as the most important heart disease risk factor [21% and 22.3%, respectively]. Also, women were less aware of the risk factors, compared to men

Conclusion: From the patients' perspective, psychological and behavioral risk factors were the most important causes of cardiovascular diseases [CVDs]; moreover, stress was the most influential risk factor for developing cardiac diseases. Thus, learning to control and manage these risk factors can help to prevent the development of CVDs and reduce the occurrence of subsequent cardiac events