Iranian Journal of Psychiatry

Population Well-Being in Mashhad: Mental Health Distribution and Demographic Gradients

Sadegh Jafarzadeh — 2026-03-15

Objective: Positive mental health is a distinct dimension of population health. Despite the validation of the Persian Mental Health Continuum–Short Form (MHC-SF), population-based estimates for adult municipal surveillance in Iran are limited. To describe MHC-SF score distributions, internal consistency, and demographic gradients among adults in Mashhad.

Method: A population-based cross-sectional survey (May 2024–March 2025) used stratified cluster sampling across five health districts (50 clusters; Kish-grid household selection). Adults aged ≥ 18 years completed the 14-item Persian MHC-SF indexing emotional well-being (EWB), social well-being (SWB), and psychological well-being (PWB).

Results: Among 2,066 adults (57.6% women), the overall mean (SD; median) MHC-SF score was 61.55 (13.21; 63), with domain scores of 28.99 (6.19; 30) for PWB, 19.01 (5.63; 19) for SWB, and 13.54 (4.11; 14) for EWB. Men scored slightly higher than women on the total scale, EWB, and PWB (all P < 0.001; small effect sizes), while the SWB difference was not statistically significant (p = 0.075). Age showed weak positive associations with total, EWB, and SWB scores (ρ = 0.060–0.069; P ≤ 0.006), but not PWB (ρ = 0.018; P = 0.408). Item-level contrasts suggested higher male endorsement of agency/meaning indicators and higher female endorsement of benevolence/collective optimism; both sexes reported high levels of warm, trusting relationships. In a multivariable linear regression adjusting for age and sex simultaneously, demographic predictors accounted for < 1% of outcome variance, with male sex independently associated with higher total, EWB, and PWB scores, and age independently associated with slightly higher total, EWB, and SWB scores.

Conclusion: In this representative urban population-based study, positive mental health was moderately high; PWB ranked highest, while SWB lagged. Demographic gradients were small: men slightly exceeded women, and older adults reported marginally higher EWB and SWB. For surveillance, the MHC-SF total score appears suitable as a summary indicator, while the SWB profile may help identify community-level levers (e.g., social capital and trust) to strengthen social connectedness in Mashhad, Iran.

Psychometric Properties of the Persian Version of the Mentalizing Emotions Questionnaire

Ali Rahim Hallaj — 2026-03-13

Objective: The Mentalizing Emotions Questionnaire (MEQ) assesses individuals’ capacity to perceive, understand, and communicate emotional states across three dimensions: Self, Communicating, and Other. This study aimed to evaluate the psychometric properties of the Persian version of the MEQ.

Method: Two independent samples of Iranian adults participated in this research (total N = 785; 71% female). Study 1 (N = 307) conducted an exploratory factor analysis (EFA) to examine the underlying structure of the scale. Study 2 (N = 478) performed a confirmatory factor analysis (CFA) to test the three-factor model. Internal consistency, test–retest reliability, convergent validity, and divergent validity were also assessed using established measures of mentalization, empathy, alexithymia, emotional beliefs, personality functioning, and emotion regulation.

Results: The original three-factor structure (Self, Communicating, Other) was supported. Model fit indices indicated adequate-to-good fit (CFI = 0.92, RMSEA = 0.07, SRMR = 0.05, CMIN/df = 3.74). The Persian MEQ demonstrated strong internal consistency (α = 0.82–0.90) and excellent test–retest reliability (ICC = 0.89). Convergent validity was supported by positive correlations with mentalization and empathy measures (r = 0.20–0.35). Divergent validity was evidenced by negative correlations with alexithymia (r = −0.39), maladaptive emotional beliefs (r = −0.34), and personality functioning impairments (r = −0.31). Difficulty Describing Feelings showed a strong negative association with the Communicating dimension (r = −0.43). Cognitive reappraisal demonstrated a negative association with emotional mentalizing (r = −0.29).

Conclusion: The Persian version of the MEQ demonstrates strong reliability and validity for assessing the mentalizing emotions in nonclinical Iranian populations. The findings also suggest potential cultural variations in the relationship between cognitive reappraisal and mentalizing emotions warranting further cross-cultural investigation.

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

Farzin Malakooti — 2026-03-10

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

Taner Adıgüzel — 2026-02-24

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

Fatemeh Serjouie — 2026-02-21

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.