Perceived social support, perceived stress, and quality of sleep among COVID-19 patients in Iran: assessing measurement invariance of the multidimensional scale of perceived social support across gender and age.

Background: Perceived social support (PSS) plays a considerable role in mental health. The Multidimensional Scale of Perceived Social Support (MSPSS) is one of the most widely used scales, leading to much research evidence. The present study investigated its measurement model, equivalence across gender (male and female) and age groups (older patients= above 60 and non-older patients= below 60), and concurrent validity. Methods: A cross-sectional survey was conducted between March and October 2020, on patients hospitalized due to COVID-19 in Tehran, Iran. The scales were administered to 328 COVID-19 patients (54.6% male, aged 21 to 92) from two general hospitals; participants completed MSPSS (including friends, family, and significant others subscales), Pittsburgh Sleep Quality Index (PSQI, include sleep latency, subjective sleep quality, habitual sleep efficiency, sleep duration, use of sleep medication, daytime dysfunction, and sleep disturbances subscales), and the Perceived Stress Scale-10 (PSS-10, to assess patients' appraisal of stressful conditions). Results: The MSPSS three-factor structure was confirmed among COVID-19 patients by Confirmatory Factor Analysis (CFA). The results support the MSPSS internal consistency and configural, metric, and scalar invariance across gender and age groups. Nevertheless, small but significant differences were found across ages based on the latent factor mean of the MSPSS from friends, with a lower mean level in older patients. The coefficients of Cronbach's alpha (ranging from.92 to.96), the ordinal theta (ranging from.95 to.98), and Omega (ranging from.93 to.97) suggested high internal consistency of MSPSS. The concurrent validity of MSPSS was evidenced by its significant negative correlation with PSS-10 (τb = -.13, p <.01) and also subjective sleep quality (τb = -.22, p <.01), sleep disturbances (τb = -.26, p <.001), and daytime dysfunction (τb = -.26, p <.001). Conclusions: The MSPSS was valid and reliable for measuring individuals' perception of social support between males and females and older and non-older COVID-19 patients.

Promoting electricity conservation through behavior change: A study protocol for a web-based multiple-arm parallel randomized controlled trial.

BACKGROUND AND AIMS: As a part of the framework of the EU-funded Energy efficiency through Behavior CHANge Transition (ENCHANT) project, the present paper intends to provide a "Research Protocol" of a web-based trial to: (i) assess the effectiveness of behavioral intervention strategies--either single or in combination--on electricity saving, and (ii) unravel the psychological factors contributing to intervention effectiveness in households across Europe. METHODS AND MATERIALS: Six distinct interventions (i.e., information provision, collective vs. individual message framing, social norms, consumption feedback, competitive elements, and commitment strategies) targeting electricity saving in households from six European countries (i.e., Austria, Germany, Italy, Norway, Romania, and Türkiye) are evaluated, with an initial expected samples of about 1500 households per country randomly assigned to 12 intervention groups and two control groups, and data is collected through an ad-hoc online platform. The primary outcome is the weekly electricity consumption normalized to the last seven days before measurement per person per household. Secondary outcomes are the peak consumption during the last day before measurement and the self-reported implementation of electricity saving behaviors (e.g., deicing the refrigerator). The underlying psychological factors expected to mediate and/or moderate the intervention effects on these outcomes are intentions to save electricity, perceived difficulty of saving energy, attitudes to electricity saving, electricity saving habit strength, social norms to save electricity, personal norms, collective efficacy, emotional reaction to electricity consumption, and national identity. The intervention effectiveness will be evaluated by comparing psychological factors and consumption variables before and after the intervention, leading to a 14 (groups including 2 control groups) × 6 (time) mixed factorial design, with one factor between (group) and one factor within subjects (time)-6 measurements of the psychological factors and 6 readings of the electricity meters, which gives then 5 weeks of electricity consumption. RESULTS: Data collection for the present RCT started in January 2023, and by October 2023 data collection will conclude. DISCUSSION: Upon establishing feasibility and effectiveness, the outcomes of this study will assist policymakers, municipalities, NGOs, and other communal entities in identifying impactful interventions tailored to their unique circumstances and available resources. Researchers will benefit from a flexible, structured tool that allows the design, implementation and monitoring of complex interventions protocols. Crucially, the intervention participants will benefit from electricity saving strategies, fostering immediate effectiveness of the interventions in real-life contexts. TRIAL REGISTRATION: This trial was preregistered in the Open Science Framework: https://osf.io/9vtn4.

Effectiveness of mindful self-compassion therapy on psychopathology symptoms, psychological distress and life expectancy in infertile women treated with in vitro fertilization: a two-arm double-blind parallel randomized controlled trial.

OBJECTIVES: Infertility is a prominent problem affecting millions of couples worldwide. Recently, there has been a hightened emphasis on elucidating the subtle linkages between infertility treatment leveraging assisted reproductive technology and the complex realm of psychological challenges, as well as efforts in implementation of psychological interventions.The Mindful Self-Compassion (MSC) program seeks to improve self-compassion, compassion for others, mindfulness, and life satisfaction while reducing depression, anxiety, and stress. In the current study, an MSC intervention was performed on infertile women (IW) undergoing in vitro fertilization (IVF) to assess the effectiveness of this intervention in reducing psychological distress and psychopathological symptoms and enhancing life expectancy. METHODS: Fifty-seven IW undergoing IVF were randomly allocated to two groups: MSC (n = 29) or treatment as usual (TAU; n = 28). Participants in MSC met once a week for two hours for eight weeks and attended a half-day meditation retreat. The Synder's Hope questionnaire and the Revised 90-Symptom Checklist (SCL-90-R) were used as the primary outcome measures. Data were obtained before the intervention, immediately after the intervention, and two months post-intervention. Repeated measures of ANCOVA and paired t-tests in all assessment points were used to compare the MSC and the TAU groups in outcomes. RESULTS: In the MSC group, hopelessness, anger-hostility, anxiety, interpersonal sensitivity difficulties, and depression were significantly reduced compared with the TAU group, and those improvements persisted at the two-month follow-up. Reliable change index revealed that the MSC group's gains were both clinically significant and durable. CONCLUSIONS: MSC can facilitate higher life satisfaction and mental well-being for IW undergoing IVF by reducing psychological distress, psychopathological symptoms, and hopelessness. These encouraging findings call for more research into the effectiveness of mindfulness-based therapies in addressing psychological problems among IW undergoing IVF.

Corrigendum: Confirmatory factor analysis and gender invariance of the Persian version of psychological control scale: association with internalizing and externalizing behavior problems.

[This corrects the article DOI: 10.3389/fpsyg.2023.1128264.].

Corrigendum: The 18-item Swedish version of Ryff's psychological wellbeing scale: psychometric properties based on classical test theory and item response theory.

[This corrects the article DOI: 10.3389/fpsyg.2023.1208300.].

The effectiveness of mobile-based ecological momentary motivational enhancement therapy in reducing craving and severity of cannabis use disorder: Study protocol for a randomized controlled trial.

Objective: This study aims to investigate the effectiveness of Ecological Momentary Motivational Enhancement Therapy (EM-MET) in reducing craving and severity of Cannabis Use Disorder (CUD) among young adults. Methods: This multicenter, single-blinded randomized controlled trial (RCT) will be conducted over a period of 11 weeks. Eighty patients with CUD will be randomly assigned to two equal-sized parallel groups, either the Motivational Enhancement Therapy (MET) group or the EM-MET group. All participants will receive four individual face-to-face sessions of MET (twice a week). The MET group will not receive any other treatments after these sessions; however, in the EM-MET group, the top triggers of patients will be assessed using mobile-based Ecological Momentary Assessment (EMA) five times a day within three weeks (after face-to-face sessions) and they will receive a call from the therapist who provides them with EM-MET (in the form of an emergency telephone helpline) as soon as they report experiencing triggers of cannabis use that are assessed using EMA in their everyday lives. Primary outcomes including CUD severity and the severity of craving will be evaluated using the Leeds Dependence Questionnaire and the Self-efficacy and Temptation Scale, respectively. These assessments will be conducted at pre-treatment, post-treatment, and a six-week follow-up. Discussion: If proven feasible and effective, the results of this study will offer clinicians an evidence-based treatment approach to address craving and dependency in patients with CUD. Moreover, these patients will receive effective treatment in real time and in real life, when and where it is most needed. However, it is important to consider the limitations of this study, such as the specific population studied in Tehran, Iran, which may affect the generalizability of the results. Nevertheless, the implementation of Ecological Momentary Interventions (EMIs) in real-life settings holds promise for timely and effective treatment.Trial registration: This trial was registered in the Iranian Registry of Clinical Trials on 21 February 2023. Registry No. IRCT20221224056908N1.

Interoceptive awareness in a Norwegian population: psychometric properties of the Multidimensional Assessment of Interoceptive Awareness (MAIA) 2.

BACKGROUND: Interoception plays a vital role in human cognition and emotion and is an increasingly important part of clinical studies of mind-body approaches and mental health. Interoceptive awareness (IA) encompasses numerous mind-body components and can be assessed by employing a self-report measure such as the Multidimensional Assessment of Interoceptive Awareness (MAIA), which has been adapted and validated across several countries and is used in experimental and clinical settings. In this study, the MAIA-2, which was developed due to the psychometric shortages of MAIA, was thoroughly translated, and its psychometric features were examined in a sample of 306 Norwegian-speaking participants (81% females, ages 16 through 66 plus). METHODS: The participants completed the MAIA-2 Norwegian version (MAIA-2-N) and the COOP/WONCA Functional Assessment Charts measuring psychological, physical, and overall health. The following psychometric qualities of the MAIA-2 were investigated: factor structure, internal consistency, and the moderating role of gender. RESULTS: Confirmatory Factor Analysis (CFA) revealed that an 8-factor model of MAIA-2-N provided the best fit. Also, a bifactor model revealed a proper fit. Good internal consistency and a moderating role of gender, age, and education on the relationships between certain MAIA-2-N factors and health were observed. CONCLUSIONS: The MAIA-2-N is an adequate measure of IA in Norwegian-speaking individuals. The factor-structure corresponds with the original MAIA-2 and it shows good internal consistency. Some moderating effects of gender were observed, particularly related to the relationship between IA and physical and psychological state, with the physical state/fitness more closely linked to IA in males and psychological state in females.

Construct validity of the General Health Questionnaire (GHQ-12) in patients with COVID-19 and its demographic and medical correlates.

Introduction: The present cross sectional study aimed to evaluate the construct and criterion validity, reliability, and gender and age differences of the 12-item General Health Questionnaire (GHQ-12) among hospitalized patients with COVID-19 in 2020. The criterion validity was assessed via its link with perceived stress, sleep quality, daily life activities, and demographic and medical characteristics. Methods: A total of 328 COVID-19 patients (55.8% men; Mage = 50.49, SD = 14.96) completed the GHQ-12, the Perceived Stress Scale (PSS), the Pittsburgh Sleep Quality Index (PSQI), the Activities of Daily Life (ADL)-Katz Scale, and the Lawton Instrumental Activities of Daily Living Scale (IADL). Results: Among 13 factorial models, the three-factor model (successful coping, self-esteem, and stress) was shown to have the best fit. GHQ-12 was positively associated with PSQI, PSS, Hyperlipidemia, psychiatry disorders, hospitalization duration, the change in sleep time, and use of sleeping pills, and negatively correlated with educational level, and the number of family members. The GHQ-12 also had a negative correlation with ADL and IADL in over 60 years of age group. Females scored higher on total GHQ-12 scores, compared to males. Finally, the hospitalization duration was longer for patients over 60 (mean = 8.8 days, SD = 5.9) than patients under 60 (mean = 6.35 days, SD = 5.87). Discussion: Overall, the findings provided evidence that mental distress in patients with COVID-19 is correlated with high perceived stress, low sleep quality, low ADL and IADL, and a range of demographic features and medical conditions. Designing psychological interventions for these patients that target the aforementioned correlates of mental distress is warranted.

Dimensions of Identity Development Scale: Confirmatory factor analysis, gender invariance, and external validity of the Persian version.

The present study was conducted to examine the psychometric properties and gender invariance of the Iranian version of the Dimensions of Identity Development Scale (DIDS). A total of 1453 adolescents (50.8% female; 14-18 years old, mean = 15.48) participated in a cross-sectional study and completed the DIDS and the Youth Self-Report of behavior problems. The Confirmatory Factor Analysis supported the six-factor model of the DIDS, echoing past studies showing the original 5th factor (Exploration in Depth) being divided into Exploration in Depth and Reconsidering the Commitment. The invariance testing showed comparable measurement properties of the DIDS across males and females (strict measurement invariance). Further, behavior problems were associated positively with Ruminative Exploration and negatively with Commitment Making, Identification with Commitments, Exploration in Depth, and Reconsideration of Commitments, whereas the opposite was true for academic performance. A six-factor DIDS was shown to be a valid and reliable measure for the assessment of identity development dimensions among Iranian adolescents. Future studies in the Iranian context evaluating the identity clusters derived from identity dimensions and their gender differences are warranted.

Characterization of functioning in breast cancer survivors: an interpretive descriptive analysis study based on the International Classification of Functioning, Disability, and Health (ICF) and the Item-Perspective Classification Framework.

PURPOSE: Breast cancer survivors may experience a variety of disabilities that could potentially compromise their independent functioning. This study aimed to examine their perspectives and experts on their functioning and interpret concepts with the International Classification of Functioning, Disability, and Health (ICF) and the Item-Perspective Classification Framework (IPF). METHODS: Interpretive descriptive methods were used with in-depth interviewing with 16 breast cancer survivors and 22 experts using a semi-structured interview guide. The interviews were recorded, transcribed, and qualitatively analyzed using thematic analysis. The extracted data were linked to the ICF Core Set for Breast cancer and were interpreted by the IPF. RESULTS: Four main themes emerged to define the functioning of breast cancer survivors: body functioning, physical functioning, social functioning, and mental functioning. Three other factors were also categorized as modifiers of functioning personal, emotional, and environmental. The 592 extracted meaningful concepts were linked to 38 (47%) categories from the ICF: 16 Body Functions, 14 Activities and Participation, and 8 Environmental Factors. The IPF classified all the extracted concepts, and most rational appraisals fell in the biological (B) domain. The concepts that required emotional appraisal were classified in Psychology (P). CONCLUSION: Psychological and emotional factors were pivotal in defining functioning in patients with BC.

Rehabilitation specialists need to consider a holistic approach to breast cancer survivor care that addresses physical functioning and social, emotional, and environmental factors that may affect their overall well-being.The findings suggest that rehabilitation interventions that aim to improve the functioning of breast cancer survivors should target a range of areas, including body functioning, physical functioning, social functioning, and mental functioning.It is important for rehabilitation professionals to consider personal, emotional, and environmental factors that influence the functioning of breast cancer survivors when designing interventions.Using the ICF Core Set for Breast Cancer and the IPF can help rehabilitation specialists better understand the functioning of breast cancer survivors and develop more effective interventions.

Pathways from childhood trauma to suicidal ideation: mediating through difficulties in emotion regulation and depressive symptoms.

OBJECTIVE: Suicidal ideation is a clinical exigency heightening the risk of suicide at different levels of suicidal behavior. This study sought to explore crucial correlates of this phenomenon with a structural equation modeling approach. Accordingly, the mediating role of depressive symptoms and difficulties in emotion regulation between childhood trauma and suicidal ideation were explored. METHOD: The sample consisted of 372 university students (57.3% females, M = 20.75, SD = 2.25) who completed self-report measures examining experiences of childhood trauma, depressive symptoms, difficulties in emotion regulation, and suicidal ideation. Structural equation modeling was employed, and mediation analysis was conducted. Confirmatory factor analysis was used to test the measurement model of each construct before evaluating the conceptual mediated model. RESULTS: Findings indicate that depressive symptoms with difficulties in emotion regulation had the strongest association (r = 0.60, P = 0.001), then depressive symptoms and suicidal ideation (r = 0.58, P = 0.001), suicidal ideation with difficulties in emotion regulation (r = 0.45, P = 0.001) then suicidal ideation with childhood trauma (r = 0.39, P = 0.001), difficulties in emotion regulation with childhood trauma (r = 0.36 P = 0.001) and finally depressive symptoms and childhood trauma (r = 0.35, P = 0.001). Regarding indirect paths, difficulties in emotion regulation and depression function together (in a sequential path) to mediate the association between childhood trauma and suicidal ideation ( χ2(68) = 216.86, P < 0.01, CFI = 0.95, TLI = 0.93, RMSE = 0.077, CI [0.066 to 0.089], SRMR = 0.049). CONCLUSION: Results demonstrate that childhood trauma, depressive symptoms, and difficulties in emotion regulation are linked to suicidal ideation, highlighting the necessity of recognizing and addressing suicidal ideation as well as the factors that contribute to suicidal ideation. Emotion regulation interventions can be effective in reducing the negative effects of childhood trauma and lowering the risk of suicide. These interventions can help in reducing depressive symptoms and improve overall mental well-being, leading to a lower risk of suicide.

The contribution of transdiagnostic vulnerability factors in patients with chronic insomnia.

Introduction: Various transdiagnostic factors have been associated with insomnia severity. The current study aimed to predict insomnia severity based on a group of transdiagnostic factors including neuroticism, emotion regulation, perfectionism, psychological inflexibility, anxiety sensitivity, and repetitive negative thinking after controlling for depression/anxiety symptoms and demographic characteristics. Methods: Two hundred patients with chronic insomnia disorder were recruited from a sleep disorder clinic. Participants completed the Insomnia Severity Index (ISI), Clinical Perfectionism Questionnaire (CPQ), Acceptance and Action Questionnaire-II (AAQ-II), Anxiety Sensitivity Index-3 (ASI-3), Repetitive Thinking Questionnaire (RTQ-10), Big Five Inventory (BFI-10), Emotion Regulation Questionnaire (ERQ), and Depression Anxiety Stress Scale (DASS-21). Results: After controlling for the confounding variables (depression/anxiety symptoms and demographic characteristics), hierarchical multiple linear regression suggested the significant association of neuroticism (BFI), cognitive reappraisal (ERQ), personal standards (CPQ), evaluative concerns (CPQ), physical concerns (ASI), cognitive concerns (ASI), and repetitive negative thinking (RTQ) with insomnia severity. Discussion: The findings support the role of transdiagnostic factors, especially physical concerns, repetitive negative thinking, and neuroticism in chronic insomnia. Future research using longitudinal designs is required to verify the causal status of transdiagnostic variables.

Social skills and symptoms of anxiety disorders from preschool to adolescence: a prospective cohort study.

BACKGROUND: Prior research, mostly cross-sectional or prospective studies with short follow-up periods, has indicated that childhood anxiety is associated with difficulties with social interaction. However, the etiological role of social skills in the development of anxiety in childhood remains unknown. Moreover, it is not known whether childhood anxiety impedes the development of age-appropriate social skills. METHODS: The relation between anxiety and social skills was, therefore, examined in two birth cohorts of children who were assessed biennially from the ages of 4 to 14 years (n = 1,043). Semistructured psychiatric diagnostic interviews of children (from age 8) and parents were used to measure symptoms of separation, generalized, and social anxiety disorders as well as specific phobias. Social skills were measured through the parent-reported Social Skills Rating System. A random intercept cross-lagged panel model was used to analyze the data, adjusting for observed time-variant covariates (emotion regulation, secure attachment, bullying victimization, and global self-esteem) and all unobserved time-invariant confounding effects. RESULTS: Reduced social skills predicted increased symptoms of anxiety at ages 8, 10, and 12 (ß = -.26, ß = -.17, and ß = -.15, respectively), whereas an increased number of anxiety symptoms did not forecast changes in social skills. CONCLUSIONS: The findings suggest that reduced social skills may be involved in the development of anxiety symptoms in middle childhood and should, therefore, be considered in efforts to prevent and treat childhood anxiety.

The relationship of alexithymia to pain and other symptoms in fibromyalgia: A systematic review and meta-analysis.

BACKGROUND AND OBJECTIVE: People with fibromyalgia (FM) often report having difficulty with emotional identification and expression, and this "alexithymia" may contribute to their pain and other symptoms. Multiple studies have assessed alexithymia in FM, and we systematically reviewed and meta-analyzed this literature to: (a) describe the prevalence of alexithymia in people with FM; (b) compare the level of alexithymia in FM to both healthy controls and controls with other pain conditions; and (c) determine the association of alexithymia to pain intensity, depression, and anxiety in people with FM. DATABASES AND DATA TREATMENT: Following PRISMA guidelines, we searched multiple databases (Scopus, PubMed/MEDLINE, Embase, Web of Science, PsycINFO and Google Scholar) from inception to May 31, 2022. Study quality was assessed with The Joanna Briggs Institute (JBI) tools for cross-sectional studies, and STATA:17 was used for meta-analysis. A total of 32 studies met eligibility criteria and were included in meta-analyses. RESULTS: The prevalence of alexithymia in FM averaged 48%. People with FM had substantially higher alexithymia than healthy controls (SMD = 1.00; 95% CI: 0.79 to 1.22), as well people with other pain-related conditions (SMD = 0.35, 95% CI = 0.04 to 0.65), particularly rheumatoid arthritis (SMD = 0.49; 95% CI: 0.08-0.91). Alexithymia was positively associated with pain intensity (r = 0.24), anxiety (r = 0.50), and depression (r = 0.41) among people with FM. CONCLUSIONS: Due to the high level of alexithymia in people with FM and the positive relationship of alexithymia with pain and psychological distress, interventions to improve emotional awareness, expression, and processing in FM are recommended.

Corrigendum: Construct validity of the General Health Questionnaire (GHQ-12) in patients with COVID-19 and its demographic and medical correlates.

[This corrects the article DOI: 10.3389/fpsyg.2023.1132154.].

Confirmatory factor analysis and gender invariance of the Persian version of psychological control scale: association with internalizing and externalizing behavior problems.

Introduction: The current cross-sectional study aimed to examine the reliability, construct validity, gender invariance and concurrent validity of the psychological control scale-youth self-report (PCS-YSR) among Iranian adolescents. Methods: A total of 1,453 high school students (49.2% boys; Mage = 15.48, SD = 0.97), who aged between 14 and 18 years old completed the PCS-YSR and the youth self-report (YSR) scale of behavior problems. Results: Reliability was established using Cronbach's alpha and ordinal alpha for maternal and paternal psychological control. The confirmatory factor analysis (CFA) results supported the original unidimensional model of the PCS-YSR scale for both mother and father forms. Results also revealed that mother and father forms of PCS-YSR were invariant across adolescents' gender. When comparing the mean differences, mothers were more psychologically controlling toward their sons, compared to their daughters. The mother and father forms of PCS-YSR were found to have acceptable concurrent validity through their relationship to internalizing and externalizing behavioral problems. Discussion: Overall, our findings supported the psychometric properties of the Persian version of the Psychological Control Scale-Youth Self-Report among Iranian adolescents. This scale can be used as an efficient tool for parental psychological control among adolescents in Iran. The negative effect of the intrusive parenting behavior on child' negative outcomes in Iran, irrespective of culture, was shown.

Immediate and Long-Term Effects of a Computerized Cognitive Rehabilitation Therapy on Cognitive Function in People Living with HIV in Iran: A Single-Blind Two-Arm Parallel Randomized Controlled Trial.

ABSTRACT: Up to 50% of people with HIV (PWH) experience neurocognitive impairments (NCIs) that can interfere with everyday functioning and reduce quality of life. To address this problem, this study examined the immediate and long-term efficacy of computerized cognitive rehabilitation therapy (CCRT) on cognitive function in PWH in Tehran, Iran. Thirty PWH with NCI engaged in 24 biweekly 90-min CCRT sessions. A control group of 30 PWH and NCI received treatment-as-usual, but no CCRT. The cognitive rehabilitation protocol focused on attention, visual memory, nonverbal learning, and planning. Pretest, posttest, and follow-up cognitive measurements showed that the designed CCRT protocol was effective in improving performance in selected cognitive domains along with the global neurocognitive performance scores of PWH. These findings suggest that this CCRT protocol be considered as part of a treatment plan to address cognitive impairment for PWH. Implications for clinical practice and research are provided.

Psychopathology and Poor Clinical Insight in Psychotic Patients: Does the Diagnosis Matter?

ABSTRACT: Poor clinical insight is one of the most common features of schizophrenia spectrum disorders and plays a critical role in prognosis and treatment. Considering the biological and phenomenological overlap between schizophrenia and bipolar I disorder with psychotic features (BID) and increasing incidents of methamphetamine-induced psychotic disorder (MIPD) patients in Iran, it is necessary to have a clear picture of insight among these three groups. The aim of the present study was to compare clinical insight and other aspects of illness among three different disorders: schizophrenia, BID, and MIPD. In addition, we sought to examine the relationship of the severity of psychotic symptoms with clinical insight in each group. A total of 115 male inpatients, including 48 persons diagnosed with schizophrenia, 35 persons diagnosed with BID, and 32 persons diagnosed with MIPD, were selected. All participants completed the Scale to Assess Unawareness of Mental Disorder and the Positive and Negative Syndrome Scale. The results of analysis of variance indicated that schizophrenia patients reported higher rates of illness duration and number of hospital admissions in comparison to the MIPD and BID groups. In addition, persons diagnosed with BID reported more of these outcomes than MIPD groups. However, the three groups showed similar patterns in terms of age of onset and educational, marital, and occupational statuses. The results also revealed that awareness of the disorder was more impaired in schizophrenia patients compared with BID and MIPD patients and in MIPD compared with BID groups. However, the level of awareness of the effect of medication, the awareness of social consequences, and the total score of clinical insight were similar across the three diagnostic groups. As expected, poor clinical insight was correlated with high levels of positive, negative, and cognitive symptoms in the schizophrenia group; with high levels of positive, cognitive, and depressive symptoms in the BID group; and with high levels of positive and excitement symptoms in MIPD. In addition, hierarchical linear regression analyses revealed that only cognitive symptoms in the schizophrenia group and excitement symptoms in the MIPD group significantly predicted the overall score of clinical insight. In the BID group, both cognitive and depressive symptoms significantly predicted clinical insight. These findings suggest that there are differing levels of poor clinical insight in schizophrenia, MIPD, and BID and that poor clinical insight found within each group may have different antecedents.

The Explanation of Adolescent Delinquent Behaviors Based on Jessor's Problem Behavior Theory (PBT) in Iran: The Role of Individual Vulnerability, Opportunity Risk Availability, and Perceived Support.

This study tested the generality of Problem Behavior Theory (PBT) in explaining adolescents' problem behavior in Iran. Data were collected from 392 adolescents (Mage = 15.97, SD = 1.12, 55.4% girls) who completed the Adolescent Health and Development Questionnaire (AHDQ) to assess the individual vulnerability, opportunity risk availability, perceived support, and delinquent behaviors. Results indicated that individual vulnerability and opportunity risk availability had a significant relationship with delinquent behaviors and a significant interaction with perceived support in their influence on delinquent behaviors. Further, perceived support was negatively associated with delinquent behaviors. Our results were consistent with PBT's explanatory model for adolescents' problem behavior in Western countries and are informative about problem behavior involvement among Iranian adolescents and the design of interventions.