Iranian Journal of Psychiatry

A Closer Look at Adolescent Mental Health: Prevalence of Internalizing and Externalizing Problems Across Educational and Gender Groups

2026-03-10T11:55:47+0330

Objective: Given the importance of mental health during adolescence and the considerable prevalence of psychological problems among this age group, along with the limited epidemiological data available in South Khorasan province, Iran, the present research focused on determining the prevalence of internalizing and externalizing problems in regional school-aged adolescents and analyzing related demographic characteristics.

Method: This descriptive cross-sectional study included 1,152 adolescents aged 12 to 19 years (mean age = 15.42, SD = 1.65) from Birjand City. A multistage random sampling method was employed to select the participants. Data were collected using the self-report version of the Strengths and Difficulties Questionnaire (SDQ), which measures internalizing and externalizing problems. To analyze the data, descriptive statistics were computed and comparative analyses were performed. Demographic variables such as age, gender, academic performance, school grade, and school type were also included in the analysis.

Results: The prevalence of internalizing problems among the participants was 36.8% (95% confidence interval: 34.0 to 39.6), whereas externalizing problems were identified in 15.2% (95% CI: 13.0 to 17.4). Internalizing problems were significantly more prevalent among girls (40.1%) than boys (32%). However, no significant gender difference was found in externalizing problems (girls: 14.5%, boys: 15.8%). Emotional problems (28.6%) and hyperactivity (10.4%) were significantly more common in girls, while peer problems (61.7%) and conduct problems (17.5%) were higher in boys (P < 0.01). Adolescents with poor academic performance and those attending public schools reported higher levels of psychological problems (P < 0.01).

Conclusion: Internalizing problems are more common than externalizing problems among adolescents. The main risk factors include being female, poor academic performance, and attending public schools. Mental health programs and interventions should prioritize these high-risk subgroups to enhance preventive and therapeutic outcomes.

Religious Coping Styles and Psychological Resilience Among Mothers of Children Hospitalized in a Pediatric Intensive Care Unit: A Cross-Sectional Study

2026-02-24T09:41:33+0330

Objective: To determine levels of positive/negative religious coping and psychological resilience among mothers of children admitted to a pediatric intensive care unit (PICU) and to examine their associations with sociodemographic characteristics and perceived psychosocial support needs.

Method: This descriptive, cross-sectional study was conducted between June and December 2025 in a pediatric intensive care unit; 100 mothers were recruited via face-to-face interviews. Data were collected using a sociodemographic form, the Brief RCOPE (positive/negative subscales), and the Brief Resilience Scale.

Results: Scores for Positive religious coping were high (mean = 3.20 ± 0.60), negative religious coping was low (mean = 1.55 ± 0.50), and resilience scores were moderate (mean = 19.35 ± 5.18). Mothers who reported needing psychosocial support had higher positive and negative religious coping scores but lower resilience. Negative religious coping was negatively associated with resilience (r = −0.246, P = 0.014), whereas positive religious coping was not.

Conclusion: The findings suggest that, in addition to psychosocial support, targeted spiritual care may be particularly important for mothers showing elevated negative religious coping during their child’s PICU hospitalization.

Investigating the Relationship between Childhood Trauma and Attachment Styles with Prolonged Grief Symptoms

2026-02-21T12:36:10+0330

Objective: Childhood trauma and attachment styles are critical factors influencing prolonged grief symptoms in bereaved adults. This study investigates the relationship between childhood trauma, attachment styles, and prolonged grief symptoms considering the mediating role of mentalization, shame, and guilt in bereaved adults.

Method: The present research is a cross-sectional descriptive study with a correlational design utilizing path analysis. The statistical population of this study includes bereaved individuals, selected by the convenience sampling method. A total of 311 participants completed to the PG-13-R, CTQ, RAAS, RFQ, and SSGS questionnaires. SPSS 24 and PLS 3 were employed for data analysis using path analysis modeling. PLS-SEM, a variance-based approach suitable for non-normal and complex models with multiple mediators, was used for path analysis modeling.

Results: The study results demonstrated a significant direct relationship of childhood trauma (β = 0.29, P = 0.006) and attachment styles (β = 0.23, P = 0.020) with prolonged grief symptoms. The critical finding in this research concerns the mediating variables. According to the results, shame significantly mediated the overall model (β = 0.10, P = 0.042), specifically between between attachment styles and prolonged grief symptoms (β = 0.10, P = 0.044), while mentalization and guilt were not significant mediators. In total, 60% of the variance in prolonged grief symptoms can be explained by predictive variables (R² = 0.609), including childhood trauma, attachment style, mentalization, shame, and guilt.

Conclusion: These findings emphasize the role of shame in the prolonged grief symptoms among adults with childhood trauma histories and insecure attachments. Therefore, the findings suggest that interventions targeting shame could be effective in reducing prolonged grief symptoms.

Psychiatrists Under Pressure: Exploring Occupational Risks and Protective Strategies

2026-02-18T11:11:43+0330

Objective: The aim of this study was to investigate the occupational hazards faced by psychiatrists and their protective strategies against these challenges.

Method: The research adopted a qualitative approach with a thematic analysis strategy. The study included 15 psychiatrists selected through purposive sampling until theoretical saturation was achieved. Data were collected using semi-structured interviews and analyzed with MAXQDA 2024 software. The analysis was conducted based on Attride-Stirling’s thematic network framework and involved systematic coding of meaning units and progressive abstraction into basic, organizing, and global themes.

Results: Based on the analysis of interview transcripts, 73 basic themes, 11 organizing themes, and 3 global themes were identified for occupational hazards, along with 8 organizing themes for protective strategies. The global and organizing themes for hazards included: intrapersonal hazards (psychological stress, burnout, and clients’ social and cultural issues), interpersonal hazards (distress from patient interactions, domestic erosion, and lack of collegial cooperation), and Transpersonal hazards (organizational constraints, lost professional status, repetitive exhaustion under outdated infrastructure, and financial discrimination). The organizing themes for protective strategies encompassed psychological flexibility, passion for service, spiritual coping, professional growth, professional collaboration, restorative activities, therapeutic communication, and optimization of the treatment environment.

Conclusion: This qualitative study identified psychiatrists’ occupational hazards across three dimensions -intrapersonal, interpersonal, and supra-personalwhile also highlighting critical protective strategies such as psychological flexibility and professional growth. The findings underscore the necessity for comprehensive support for psychiatrists’ mental health and the development of supportive resources. These results can serve as a foundation for future policy-making in the field of mental health. However, the findings should be interpreted in light of the study’s limited sample size and regional scope.

Dietary Micronutrient Intake and Its Associations with Memory Function, Mental Health, and Sleep Quality among Medical University Students: A Network Analysis

2026-02-14T09:22:39+0330

Objective: Micronutrient deficiencies among university students may adversely influence their sleep quality, mental health, and memory function. The overarching purpose of this study was to evaluate the associations between dietary micronutrient intake and memory performance, mental health, and sleep quality among medical university students.

Method: This was a cross-sectional study conducted on a sample of 985 university students. The Food Frequency Questionnaire, Prospective & Retrospective Memory Questionnaire, Depression, Anxiety and Stress Scale-21, and Pittsburgh Sleep Quality Inventory were used to assess dietary intake, memory function, mental health, and sleep quality, respectively. An undirected network was constructed via the EBICglasso model, and a directed acyclic graph was developed employing a Bayesian network.

Results: The average age of the students was 22.44 ± 1.95 years. Among these participants, 500 (50.76%) were female and 485 (49.24%) were male. Assessments showed that 485 (49.20%) participants had depression symptoms, 490 (49.70%) had anxiety symptoms, 620 (62.90%) had stress, and 535 (54.30%) experienced sleep disturbances based on the cut-off scores of the questionnaires. Network analyses identified zinc, magnesium, B-group vitamins, vitamin D, and vitamin C as central nodes related to mental health, memory function, and sleep quality.

Conclusion: Zinc, magnesium, vitamin B2, vitamin D, and vitamin C emerged as key micronutrients associated with mental health, memory function, and sleep quality. These micronutrients represent promising targets for future clinical studies.