Middle Eastern Journal of Disability Studies

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Introduction: The aim of this study was to determine the efficacy of modular cognitive- Behavioral Therapy of anxiety (localized version) in reducing of anxiety and depression symptoms in children and adolescent.

Method: The method used in this research was pre-test and post- test with control and matching group. The research population was all 6 to 13 year-old girls in Urumiya. Out of 280 female students who completed the revised scale of children's anxiety and depression and three-part test of anxiety and depression test, 24 people who had high scores in the anxiety inventory were first matched and then randomly assigned to the experimental and alternative test group.

Results: The results of multivariate covariance analysis indicated that the treatment was effective in reducing panic disorder, social anxiety, depression, separation anxiety, general anxiety, and obsessive compulsive disorder. Also, the treatment is effective in reducing negative emotions and physiological excitation as well as increasing positive affect.

Conclusion: Ttreatment of anxiety and depression disorders with modular approach (Localized version) can be used to reduce the types of anxiety and depression disorders (P<0/05) due to the emphasis on common high level factors.

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Background: Students are considered as the main sources for sustainable development of any country. Therefore, paying attention to mental health is very important in them. The aim of this study was to investigate the effect of relaxation in Dohsa- hou method on depression, stress and social anxiety among dormitory students of Zahedan University of Medical Sciences in 2018.
Methods: This is a quasi-experimental study with pre-test and post-test. This study was performed on 100 female dormitory students living in Zahedan University of Medical Sciences in 208. Students randomly (lottery) were placed in two groups of intervention and control in envelopes that were sampled. Then they completed the demographic questionnaire and depression, stress and social anxiety in the pre-test. After the pre-test, the relaxation method was performed individually by a researcher trained on the student. Three sessions per week and a session duration of 45 minutes. After treatment, the data were analyzed by SPSS-21 software.
Results: Independent t-test showed that there is a significant difference between the two intervention and control groups in terms of stress, depression and social anxiety (p = 0.001). The level of depression, stress and social anxiety of the intervention group with a decrease in mental retardation was significantly lower than the control group.
Conclusion: In fact, the Dohsa-Hou method, by reducing stress and depression, stabilizes individuals emotionally and enhances social activity and leads to more attention and awareness of one's own body.

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Background &Objectives: Depression is the most common psychiatric disorder. The disorder lasts for at least two weeks, during which  there is a feeling of depressed mood, apathy, or loss of pleasure in almost all areas. Psychological capital intervention is a model derived from Luthanschr('39') psychological capitals, which emphasizes the construction and creation of components, the existence of each of  them can be used as a powerful tool strengthens individual against the storms of life. An important principle in psychological capital intervention is that the intervention should help people to be able to guide the path of growth and prosperity by increasing psychological capital in addition to reducing the symptoms of their disorder and pain; They can live a fuller, happier and richer life. In most intervention models, the role of positive psychological components such as hope, optimism, self-efficacy and resilience is less considered. The aim of this study was to compare the effectiveness of psychological capital intervention and cognitive-behavioral intervention on depression in patients with mild to moderate depression.
Methods: The present study was a quasi-experimental design of pre-test-post-test and follow-up with a control group. The population of this study consisted of all people with mild to moderate depression who were referred to Aftab Counseling Center in Najafabad, Isfahan in the first half of 2018. Tools study was Beck Depression Inventory-II. Among depressed patients applying for training sessions based on inclusion and exclusion criteria, 45 clients who had a score of 14 to 28 in the Depression Inventory were randomly assigned to two experimental groups and a control group. For patients in one experimental group, psychological capital intervention was conducted in 8 sessions of 90 minutes in a group manner. For the other experimental group, the cognitive-behavioral intervention session was held in 8 sessions of 90 minutes in a group manner. The control group did not receive any intervention. After the training sessions, all three groups were re-evaluated for depression. Two months after the end of the training sessions (post-test), the subjects were re-evaluated in the follow-up phase. To analyze the data, descriptive statistics such as frequency distribution, mean and standard deviation and to analyze  data in inferential statistics repeated measures analysis of variance test were used by SPSS version 24.
Results: The results of the group comparison showed that both psychological capital intervention and cognitive behavior intervention led to a reduction in depressive symptoms (p <0.001). Eta square showed that the main effect of the group caused about 29% changes. Also, in examining the effect of time, the results showed that there was a significant difference between the depression scores of psychological capital intervention groups and cognitive-behavior intervention with the control group at each stage of the measurement time (p <0.001). Eta squared also showed that the effect of time caused 76% changes in the mean scores. The interaction between the measurement stage and the group on the mean scores of depression was also significant, which shows that the effect of the group varies according to the time of measurement (p <0.001). The size of the interaction between time and group was 59%. The results of pairwise comparison tests showed that the scores of both cognitive-behavioral intervention group and psychological capital intervention group in post-test and follow-up were significantly different from the control group (p <0.01). The results also showed psychological capital intervention was more effective in reducing mild to moderate depressive syndrome compared to cognitive-behavior intervention (5 p <0.04).
Conclusion: psychological capital intervention by creating strengths of hope, self-efficacy, resilience and optimism over time is more effective than cognitive-behavioral intervention in reducing mild to moderate depressive symptoms.

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Background and purpose: The mental health of people in any society is one of the necessities of that society, and one of the important indicators of mental health is the level of depression and life satisfaction. These mental health indicators are becoming increasingly important especially in the youth period. Therefore, the present research was conducted with the aim of investigating the mediating role of pleasurable experiences in the relationship between family functioning and depression and life satisfaction of young people.
Research method: The descriptive research method was a correlation type, which was carried out using the path analysis method. The statistical population included all young people aged 18 to 25 in Shiraz. 300 people were selected using available sampling method. The measurement tools included the family functioning scale (Garnefsky, Craig and Spinhaven, 2001), the pleasurable experiences scale (Connor and Davidson, 2003), the life satisfaction questionnaire (Foures and Olson, 1993) and the depression scale (Bashart, 2010). The collected data were analyzed at two descriptive levels (using mean, standard deviation and correlation coefficient) and inferential (using structural equation modeling method with Amos-21 software). The significance level for all statistical tests was α=0.05.
Results: The results showed that family functions have a direct and significant effect on enjoyable experiences (β = 0.42, P < 0.0001) and life satisfaction (β = 0.37, P < 0.0001). In addition, the results indicated that pleasant experiences (β = 0.33, P < 0.0001) had a direct and significant effect on life satisfaction and depression. In addition, the results indicated that the variable of pleasurable experiences played a mediating role in the relationship between family functioning and depression and life satisfaction of young people.
Conclusion: Based on the findings of the research, it can be concluded that pleasurable experiences play a mediating role in the relationship between family functioning and depression and life satisfaction of young people.
 

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Abstract
Background and objective: high blood pressure can cause insufficiency in people or even be associated with cardiovascular diseases, which is actually one of the health problems in industrialized and developing countries. The present study was conducted with the aim of investigating the effectiveness of dialectical group therapy on the improvement of psychological symptoms and quality of life of patients with high blood pressure.
Methods: The present study was applied in terms of purpose and in a semi-experimental manner with a pre-test-post-test design with a control group, out of 87 volunteers, 30 patients were assigned to two groups based on random sampling. The tools used are Beck Depression Questionnaire (1960), Beck Anxiety Questionnaire (1990), and Dialectical Behavior Therapy Protocol (Linehan, 1993). A one-way analysis of the covariance test was used to test the hypotheses. Data analysis was done through the spss-22 program.
Results: The results indicated a significant difference between the two groups on 

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Abstract
                                                                                                                             
Background & Objectives : All people need skills to prevent mental disorders such as depression as well as increase and improve their mental health. Regulation of emotions through cognition is one of the basic necessities of every person's life, which helps him to regulate his emotions or feelings in the face of a threatening and stressful event. A person's beliefs that he can express his emotions at appropriate times or control them, or that he has the ability to manage his positive and negative emotions is called self-efficacy in emotional regulation. Therefore, a person's thoughts and cognition play a very important role in the ability to manage. Regulation and control of feelings and emotions after experiencing a stressful event.On the other side Communication skills play an important role in improving a person's cognitive, emotional and practical abilities to interact with others and achieve success and happiness in life. Human capabilities grow in the shadow of interpersonal relationships, and the result is poor communication, family, educational, occupational problems, low self-efficacy, and worsening of depression symptoms. Therefore, the purpose of this research was to determine the effectiveness of communication skills training on cognitive regulation of emotion and self-efficacy in people with Mild-depression.
Method: The research method was quasi-experimental with a pretest-posttest with a control group. The statistical population included people with mild depression in Tehran in 2020. From the above population, 20 people werw selectedby the available sampling method and randomly assigned to the experimental(10 people) and control (10 people)groups.. The intervention (communication skills training) which was conducted in accordance with the World Health Organization's educational guidelines The expermintal group underwent Communication Skills Training for 8 sessions of ninety minutes and two sessions per week and the control group received no intervention.
Measuring instruments In this research, Beck's depression test was used as one of the most suitable measuring criteria that can reflect the depressive states in people in order to identify people with mild depression. Meta-analyses reported the correlation coefficient between clinical assessment of depression and BDI as 0.72 for psychiatric patients and 0.60 for healthy people were Cognitive Emotion Regulation Questionnaire (CERQ) developed by Garnefski to evaluate the way of thinking after experiencing life-threatening events. The validity of the scale has been calculated through Cronbach's alpha for positive strategies 0.91, negative strategies 0.87 and the whole questionnaire 0.93.
- The self-efficacy questionnaire (GSE) of this scale has a maximum score of 85 and a minimum score of 17, with higher scores indicating stronger self-efficacy. The reliability coefficient through Cronbach's alpha for general self-efficacy was 0.86.
Data analysis was done using descriptive (mean,standard deviation) and inferential statistics (analysis of covariance) in SPSS version 16. The significance level of statistical tests was set at 0.05.
Results : The results indicated that communication skills training is significantly effective in increasing emotionally cognitively adapted strategies, reducing maladaptive cognitive-emotional strategies and increasing the self-efficacy on individuals with mild depression. The Effectiveness of communication skills training intervention on people suffering from depression who were in the experimental group, in the order of priority for rumination strategies (P=0.002) 45%, blaming others (P=0.002) 43%, catastrophizing Making (P=0.020) 28% and self-blame (P=0.032) decreased by 24%, respectively, preference for replanning strategies (P=0.004) 40%, compromise re-evaluation (P=0.012) P=0) 32%, renewed attention (P=0.029) 29%, event acceptance (P=0.026) 26% and perspective taking (P=0.025) 25% increased. Also, in the self-efficacy, the difference between the averages in the test and control groups in the post-test after removing the effect of the pre-test was statistically significant (P<0.001). The Effectiveness of communication skills training intervention on the variable of self-efficacy in people with mild depression who were trained in the experimental group, approximately 41% increased in self-efficacy compared to the control group who were not trained.
Conclusion: Considering the importance of communication skills training for all people and its obvious effect in controlling adaptive and maladaptive cognitive emotion strategies and self-efficacy on individuals, communication skills training was necessary.
Key words : Self-Efficacy, Cognitive Emotion Regulation, communication skills training, Depression.
 

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Background & Objectives: Coronavirus disease 2019, also called COVID-19, is a sickness caused by a virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 first broke out in Wuhan, China, on 31 December 2019, and it was later declared an international public health emergency by the World Health Organization (WHO). Many people with COVID-19 have mild to moderate symptoms and can recover on their own. But COVID-19 can serious illness and lead to death in some people. People at higher risk include older adults and the risk increases with age. Also at higher risk for serious illness are people with existing medical conditions. COVID-19 has brought physical risks as well as psychological challenges to the whole world. Stressful events and diseases are potent adverse environmental factors that can predispose individuals to psychiatric disorders, in particular depression. During an epidemic outbreak, the public experiences negative emotional responses, such as anxiety and depression symptoms. COVID-19 causes moderate-to-severe symptoms of anxiety and depression in people. Generalized Anxiety Disorder (GAD) is one of the most common disorders characterized by persistent, excessive, and unrealistic concerns about everyday issues. Depression is a common mental disorder that involves a depressed mood or loss of pleasure or interest in activities for long periods. Therefore, this study aimed to examine the association of GAD and depression among high school female students during the COVID-19 pandemic in Shiraz.
Methods: The present study was a cross–sectional and correlational. The study's statistical population included all high school female students living in Shiraz City, Iran, in 2020. The study participants included 395 high school female students who were selected by convenience sampling method. The inclusion criteria were as follows: being teenagers (12–18 years old), living in Shiraz City, having full consent to participate in the plan, and not using drugs and psychotropic drugs. The exclusion criterion was the incomplete completion of the questionnaires. To collect the data, the Generalized Anxiety Disorder (GAD-7) (Spitzer et al., 2006), and the Patient Health Questionnaire (PHQ-9) (Kroenke et al., 2001) were used. In statistical analysis, the symptom scores for GAD, and depression were dichotomized into binary variables, guided by their designated cut-off scores. A score of GAD-7 ≥10 and a score of PHQ-9 ≥14 marked the threshold for potential GAD and depression cases, respectively. The Pearson correlation coefficient was used to analyze the data using SPSS software version 24 at a significance level of 0.05.
Results: The prevalence rates of GAD and depression symptoms among high school students during the COVID-19 pandemic in Shiraz were 55.69 % and 42.27 %, respectively. The results of the Pearson correlation coefficient showed a significant positive relationship between symptoms of GAD, and depression (r=0.56, p<0.001).
Conclusion: The prevalence of generalized anxiety disorder and depression is considerably high in high school female students during the COVID-19 pandemic in Shiraz. Furthermore, a compressive approach, including management policies, psychosocial interventions, and training, is critical to reducing generalized anxiety disorder and depression symptoms in high school female students during the COVID-19 pandemic as well as during any outbreaks of other infectious diseases in the future.

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Objective: This research was planned to evaluated depression in nursing students at Azad University of Yasouj
Materials & Methods: This study is a descriptive and an instrument used was Beck Inventory scale for depression. All undergraduate nursing students at Azad university of Yasouj (200 people) were tested with Persian language version of Beck Depression Inventory (BDI).for analysis of information we used SPSS & Excel. The main statistical method for data analysis was independent T test.
Results: Data analysis showed 60٪ of men are normal and 40٪ showed degree depression. Our study showed mild depression in 29.33٪, moderate depression in 8٪, and severe depression in 2.67 ٪ of this group. In woman group we found 45.5٪ are normal and 55.5٪ are depressed. We found mild depression in 44٪, moderate depression in 7.2٪, and severe depression in 3.2 ٪ of this group. On the whole we found that 51٪ of subjects were normal and 49٪ were depressed .In depressed group our study showed mild depression in 38.5٪, moderate depression in 7.5٪, and severe depression in 3٪ of students
Using a factor analysis test (T test), it was revealed that two factors (sex and depression). The results of analysis showed significant difference between males and females. T test for depression was showed significantly different between female (19.2) and male (14.88) subjects.
Conclusions: This research shows that is a high proportion of nursing students have depression. We have suggested some recommendations in order to prevent and control the sources of the depression.

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Abstract Introdouction: The aime of this research was to determine the effectiveness of child- centered play therapy with approach Axline training on mood change (Depression) in children with learning Disabilities . Method: The method of this research was quasi experimental(pre test- post test with control groups).The population of this research was all of students (boys and girls ) with learning disabilities in yazd. 30 students 7- 8 referred to learning disabilities shahied Namdar center in the yazd, were selected by purposeful sampling method and were assignment in to group (15 experimental and 15 control). The experimental group received 8 sessions in two time(twice weekly )of child- centered play therapy with approach Axline training and the control group which did not receive any intervention. The Instruments of this research was interview clinical interview and child Depression Inventory (CDI). data were analyzed by ANCOVA analysis. Results: The results if the analysis of covariance showed that effectiveness of child- centered play therapy with approach Axline training on mood change (Depression) in children with learning Disabilities . Conclusion. Findings generally showed that the child- centered play therapy training to reduce mood change (Depression) in children with learning Disabilities(p<0/001).

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Objective: Depression is a common symptom in patients with Multiple sclerosis (MS). Several reasons contribute to depression in these patients, such as motor disability and inability to perform activities of daily living; while the balance is one of the most important effective factors. So, the aim of this study is to investigate the relationship between balance and depression in patients with multiple sclerosis.

Methods: This study was performed using descriptive-analysis, cross-sectional method. People with MS who refer to Isfahan hospitals participate in the study. Convenience sampling was conducted for participants. Based on inclusion and exclusion criteria, only 35 among 95 clients were selected. After recording the demographic information, Beck Depression Inventory and Berg Balance Scale were used to assess depression and balance, respectively. Statistical analysis was performed via SPSS-18 software and Spearman correlation test was used at 5% error level (p<0.05).

Results: The subjects participated in this study consisted of 21 women and 14 men aged 20-60 (32±8.92). The Mean score for Berg Scale was 45.14±10.12 and mean score for Beck Inventory was 17.74±9.65. Statistical analysis of data showed that there is a significant correlation between balance and depression (r= -0.485, p=0.004).

Conclusion: Since the balance and depression problems were seen in the samples of this study, as well as its negative effects on different aspects of life in patients with MS, the existence of balance and depression assessment for comprehensive planning treatment and rehabilitation program seems necessary.

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Abstract
Background and objective: Acceptance and Commitment Therapy (ACT) is a method of third wave therapies that emphasizes on changing thoughts and feelings rather than their transformation, content or frequency. It seems that in disorders such as depression, the transformation of thoughts and feelings take place faster and easier than change in their form and content particularly when the depression is co-morbid with another disorder such as drug abuse. The aim of the present study is to survey the effectiveness of Acceptance and Commitment Therapy on reducing co-morbid depression in drug-dependent individuals.
Methods: This study is semi-experimental with pre-test, post-test and control group. The population includes all drug users referred to Addiction Treatment Center (Tavalod Dobare) in Tehran who were asked to fill Beck's Depression Inventory as well as those individuals who had high depression. Of these people 40 subjects were selected and randomly divided into experimental and control groups consisted of 20 persons.
Results: The results of covariance analysis show that Acceptance and Commitment Therapy for addicted people have significant effect on reducing depression.
Conclusion: The Results obtained in this study suggest that Acceptance and Commitment Therapy can be effective in treating depression in people with addictions.
 

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Abstract
Objective: The focus of this study is on early psychological interventions for parents with children with developmental disorders to minimize adverse effects due to the special circumstances of the family. As such, it investigated effects of stress coping strategy instruction to mothers of deaf children on stress and depression reduction.
Methods: This study was a two-group pretest-posttest quasi-experimental one. The participants were 24 mothers with deaf children recruited through convenience sampling, who were divided into control and experimental groups. Both groups filled out Parenting Stress Index and Beck Depression Inventory. In the next step, the experimental group received stress coping strategy instruction in 10 ninety-minute sessions while the mothers in control group went on their normal procedures. At the end of the instructional sessions, both groups filled out the aforementioned questioners as the post-test. Covariance analysis was used for analyzing the data. 
Result: The results of the analysis of covariance showed that stress management methods reduced both parenting stress (p<0.05) depression scores (p<0.05) among mothers in the experimental group in comparison with the control group.
Conclusion: It is concluded that stress coping strategy instruction is an effective way to help reduce parents' psychological problems. The method is suggested because of its high efficiency specially when administered in groups as it is cheap and accepted by families.

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Abstract
Objective: Leisure as one of the most important aspects of life among people with multiple sclerosis may be influenced by several factors. This study examined the effects of fatigue, depression and cognitive impairment on the individual's leisure.
Methods: This is an analytical cross – sectional study. Convenience sampling was used to recruit 35 participants with multiple sclerosis aged 21-55 from among the patients treated at an occupational therapy clinic in Hamadan. The research instruments were Tondnevis leisure Questionnaire, Fatigue Severity Scale, Beck Depression Inventory test and Mini-Mental Status Examination. SPSS software was used to analyze the data.
Results: A significant relationship was found between leisure time and depression (r=0.385) and fatigue (r=0.499), but no significant relationship was found between leisure and cognitive dysfunction (r=0.226).
Conclusions: Results suggested a strong positive association between depression, fatigue and Leisure, indicating that elevated levels of fatigue and depression reduce leisure time among patients with multiple sclerosis.
 

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Abstract
Background & objective: Aging is a progressive physiological change in an organism that leads to a decline of biological functions and of the organism's ability to adapt to stress.  The World Health Organization has pointed out that a world-wide revolution is taking place in demography. Looking at the statistics and figures, the depth, intensity and importance of this issue become more apparent. There are about 600 million older people over 60 in the world, this figure will double by 2025 and will rise to 2 billion by 2050. One of the most debilitating and prevalent diseases in the elderly is blood pressure, which imposes enormous costs on the government. High blood pressure is one of the most common chronic diseases that afflicts a large population and is one of the most serious Psycho-physiological disorders which has attracted a lot of thoughts. In several studies, psychological factors such as depression and anxiety were introduced as risk factors for blood pressure. Depression is one of the most common psychiatry diagnoses that has created a major problem for mental health with its growing trend and prevalence. Among the effective therapies for depression and anxiety due to physical illnesses, stress management via cognitive-behavioral approach has been successfully applied to combine anxiety reduction methods such as muscle relaxation, cognitive rehabilitation, effective coping training, exerting training and anger management to treat emotional and physical problems such as anxiety and depression, insomnia, diabetes, high blood pressure, heart disease, arthritis, AIDS and cancer. Therefore, this study was conducted to evaluate the effectiveness of training cognitive-behavioral stress management techniques on anxiety, depression and blood pressure in elderly people.
Methods: The design of this study was quasi-experimental with pre-test and post-test and control group. The study population consisted of all the elderly people living in the nursing home of district 5 in Tehran, that were in the elderly group list in the year 1395. The sample consisted of 30 people from nursing home living in Mehrban Nursing Home, who were selected by simple random sampling method. In other words, after accessing the centers, due to the extensive aging centers of Tehran, one of the elderly centers of District 5 of Tehran (the Mehrban nursing Center) was selected, which was also the place of study. The following tools were used to collect data: Beck Depression Inventory (BDI-II) and Cattel's Anxiety Scale. The experimental group was trained in cognitive-behavioral stress management approach, and the control group received no intervention. The duration of the treatment sessions consisted of 10 sessions of 60 minutes, performed as a group once a week in the Mehrban nursing home. Single Variable-Covariance Analysis (ANCOVA) was used to test the research hypotheses.
Results: Based on the results of the Ancova test, after neutralizing the pre-test scores, stress management training has a meaningful effect on the anxiety (p<0.001, F(27,1)=16.099), and depression (p<0.001, F(27,1)=66.69) and blood pressure (p<0.001, F(27,1)=23.062).There is a meaningful difference in average moderated scores of anxiety, depression and blood pressure between stress management training groups via cognitive-behavioral approach and in the control group. In other words, these findings indicate a decrease in anxiety, depression and blood pressure in the experimental group compared with the control group. The extent of this effect was 45% for anxiety, 61% for depression and 50% for blood pressure.
Conclusion: A series of training courses presented in form of stress management in a cognitive-behavioral approach have significant positive effects on the reduction of anxiety and depression in the elderly and thereby protecting them from the numerous side-effects of anxiety and depression. Therefore, it can be used as a useful intervention to reduce the components of depression and anxiety and benefit from it in educational and health centers.
 

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