Iranian Journal of Psychiatry

Structural Effect of Informational-Motivational-Behavioral Skills and Acceptance-Commitment in Self-Management, Adherence, and HbA1c in Diabetes: The Mediating Role of Distress

Zahra Heidari Archandani, Isaac Rahimian-Boogar — Wed, 18 Mar 2026 11:23:00 +0330

Objective: Psychological and behavioral factors play a critical role in diabetes management. This study investigates the structural relationships among the informational-motivational-behavioral skills (IMB) and acceptance and commitment processes with self-management, treatment adherence, and Glycated hemoglobin (HbA1c) levels in diabetic patients, with distress as a mediator.

Method: A cross-sectional study was conducted with 321 patients with type 2 diabetes patients referred to health centers in Jiroft, Iran. Data were collected using the Diabetes Self-Management Questionnaire-Revised (DSMQ-R), the IMB-based Diabetic Self-Management Scale (IMB-DSMS), the Diabetes Distress Scale (DDS-17), the Diabetes Acceptance and Action Scale-Revised (DAAS-R), and the Diabetes Mellitus Treatment Adherence Scale (DMTAS). Structural equation modeling (SEM) was employed using LISREL-8.8 for analysis.

Results: Acceptance and commitment were positively associated with IMB skills (β = 0.34, P < 0.001), self-management (β = 0.51, P < 0.001), and treatment adherence (t = 8.19, β = 0.55), while negatively associated with distress (β = -0.24, P < 0.001). IMB skills were associated with increased self-management (β = 0.43, P < 0.001) and adherence (β = 0.46, P < 0.001), and also negatively associated with distress (β = -0.40, P < 0.001). Distress was also negatively associated with self-management (β = -0.22, P < 0.001) and adherence (β = -0.29, P < 0.001), and positively associated with HbA1c levels (β = 0.19, P < 0.001). Bootstrap results confirmed distress as a mediator between IMB skills, acceptance, and commitment, and self-management/adherence (P < 0.05). The model showed excellent fit (RMSEA = 0.046, χ²/df = 2.51).

Conclusion: This cross-sectional study tested a structural model integrating acceptance-commitment and IMB frameworks. Findings highlight associations among psychological flexibility, IMB skills, reduced distress, and improved self-management. These relationships inform potential intervention targets. Longitudinal and experimental studies are required to evaluate causal effects and clinical implementation.

Repurposing Vinpocetine: A Potential Management Strategy for Selective Serotonin Reuptake Inhibitors (SSRI)-Induced Sexual Dysfunction

Zahra Nazari Taloki — Tue, 17 Mar 2026 00:00:00 +0330

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

Sadegh Jafarzadeh, Arash Ziaee, Mohammad Khajedaluee, Mahdi Gholian-Aval — Sun, 15 Mar 2026 00:00:00 +0330

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

Fri, 13 Mar 2026 00:00:00 +0330

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, Ahmad Khamesan, Hadi Samadieh, Mohammad Hossein Sorbi — Tue, 10 Mar 2026 00:00:00 +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.