Iranian Journal of Psychiatry

Difficulties in Accepting the Past as a Mediator between Perfectionism and Symptoms of Depression among University Students in Yazd

Milad Zare, Marjan Poshtmashhadi, Hamid Poursharifi — Mon, 10 Nov 2025 10:15:05 +0330

Objective: The Existential Model of Perfectionism and Depressive Symptoms (EMPDS) assumes that difficulties in accepting the past explains why socially prescribed perfectionism (SPP) is linked to depressive symptoms. Prior research on EMPDS relies on homogeneous samples and cross-sectional designs, limiting our understanding of EMPDS. More importantly, SPP may be affected by different cultural norms, and no study to date has examined this model in Iran. This study aimed to test EMPDS in Iran using a moderated mediation framework, a heterogeneous sample, and a longitudinal design with two waves.

Method: This study used a two-wave longitudinal design in a diverse sample of unmarried undergraduate and graduate Iranian students (N = 251; 117 men and 134 women) studying at universities in Yazd province. We collected the data in February and March 2023. The analysis was moderated mediation analysis. In the first wave, a link to the survey was distributed, which included demographic questions, the SPP scale, and baseline measure of depressive symptoms. One month later, participants who had completed wave 1 were recontacted to complete the Difficulties in Accepting the Past questionnaire and depressive symptoms scale.

Results: SPP predicted depressive symptoms through difficulties in accepting the past (b = 0.64, SE = 0.09, 95% CI = [0.46; 0.83]), and depressive symptoms were also linked to past acceptance (b = 0.35, SE = 0.05, 95% CI = [0.25; 0.45]). A bootstrapping analysis confirmed a significant mediation effect (b = 0.72, 95% CI = [0.27; 2.53]). However, the interaction between SPP and acceptance of the past was not significant (b = -0.007, SE = 0.006, 95% CI = [-0.017; 0.007]).

Conclusion: These findings suggest that psychotherapists treating clients with SPP should consider interventions facilitating meaning-making and acceptance of the past. The study also highlights the importance of accounting for cultural influences when applying EMPDS.

The Effects of Cognitive Behavioral Therapy Interventions on Emotional Disorders in Iranian Studies: A Systematic Review and Meta-Analysis

Leila Mirzaei, Zahra Golizade, Abolfazl Farid — Sun, 09 Nov 2025 11:41:40 +0330

Objective: This study systematically integrates and reviews the results of Iranian studies on the effectiveness of cognitive behavioral therapy (CBT) for emotional disorders.

Method: To ensure a comprehensive review, relevant Iranian studies from 2001 to 2024 were identified from databases such as Google Scholar, Web of Science, Scopus, PubMed, SID, Noormags, and MagIran using keywords including CBT, emotional disorders, anxiety, depression, OCD, PTSD, and stress.

Results: Based on the inclusion criteria, 93 effect sizes from 65 Iran-based studies were selected for analysis. The random-effects model revealed a significant overall effect size of CBT on emotional disorders, with g = 1.07, p < 0.001, and a 95% confidence interval ranging from 0.95 to 1.20. The primary analysis indicated that CBT effectively improved various emotional disorders, including anxiety (g = 1.04), depression (g = 1.09), OCD (g = 1.19), PTSD (g = 0.39), and stress (g = 1.27). Subgroup analysis showed no significant gender differences in the effectiveness of CBT, whereas meta-regression revealed a significant association between the effect size of CBT and the age of Iranian participants.

Conclusion: The CBT intervention method has been an effective treatment for emotional disorders and has significantly improved anxiety, depression, OCD, and PTSD in Iranian populations; however, its effect on stress was not statistically significant in this study.

Non-Pharmacological Strategies for Postpartum Depression: A Network Meta-Analysis of Randomized Controlled Trials

Sat, 08 Nov 2025 12:21:42 +0330

Objective: Postpartum depression (PPD) has a significant impact on the mother, child and family. Pharmacologic therapy in breastfeeding mothers often causes side effects, so non-pharmacologic alternatives are needed. This study aims to systematically review and synthesize evidence from randomized controlled trials (RCTs) on the effectiveness of non-pharmacological interventions for PPD through a network meta-analysis.

Method: This network meta-analysis synthesizes evidence from RCTs evaluating non-pharmacological interventions for PPD. We reviewed 13 articles from PubMed, Science Direct, Scopus, and Cochrane Library. Network Meta-Analysis was performed using RStudio with a random effects model, while Rob 2.0, RoB-ME, and CINeMA were used to assess the risk of bias.

Results: The analysis showed that Therapy-Assisted Internet Cognitive Behavioral Therapy (TA-iCBT) had the highest benefit with a Mean Difference (MD) of 6.90 [95% CI 5.35 to 8.45], p = 0.005, as well as the highest effectiveness (P-score 0.891) and very low heterogeneity (I² = 0%). Qualitatively, other alternative therapies are also safe for the mother, but need to be tailored to the patient's needs.

Conclusion: In conclusion, TA-iCBT is the most effective non-pharmacological therapy for PPD and can be the main choice in the psychiatric treatment of PPD patients.

Experiential Avoidance, Perfectionism, and Self-Compassion in Maladaptive Versus Adaptive Daydreaming: A Comparative Study in Iran

Maryam Pourmoazzen, Hoda Doosalivand, Malek Bastami, Amir Sam Kianimoghadam — Mon, 27 Oct 2025 00:00:00 +0330

Objective: This study aimed to compare experiential avoidance, perfectionism, and self-compassion between individuals with maladaptive and adaptive daydreaming tendencies within Iranian cultural context.

Method: The study utilized an online survey distributed via social media to a convenience sample of Iranian adults. The final sample consisted of 428 participants, who were divided into an MD group (n = 210) and a normative group (n = 218). This classification was based on a conservative cutoff score of ≥ 50 on the Maladaptive Daydreaming Scale-16 (MDS-16). Participants also completed the Self-Compassion Scale (SCS), the Multidimensional Perfectionism Scale (MPS–H), and the Brief Experiential Avoidance Questionnaire (BEAQ). A series of multivariate one-way analyses of variance (MANOVAs) were conducted to compare the groups.

Results: The MANOVA revealed a significant overall statistical difference between the groups. Compared to the normative group, individuals with MD reported significantly higher levels of experiential avoidance. The MD group also scored significantly higher on the negative components of self-compassion, including self-judgment, isolation, and over-identification, and scored significantly lower on the positive component of mindfulness. Furthermore, maladaptive daydreamers scored significantly higher on other-oriented and socially-prescribed perfectionism. No significant differences were found for self-oriented perfectionism, self-kindness, or common humanity.

Conclusion: This study provides empirical evidence that, within an Iranian sample, MD is associated with higher levels of experiential avoidance, other-oriented and socially-prescribed perfectionism, and deficits in self-compassion. These findings highlight crucial psychological factors potentially involved in the maintenance of MD. Therapeutic approaches may be enhanced by fostering self-compassion, addressing maladaptive perfectionistic beliefs, and employing strategies to reduce experiential avoidance.

The Genetic Landscape of Autism in Iran: A Systematic Review

Sun, 26 Oct 2025 00:00:00 +0330

Objective: Autism is a genetic disorder involving various genes. This study aims to investigate the role of genetic factors in Iranian patients with autism to help in more accurate diagnosis of this disease by identifying genes involved in Iranian patients.

Method: This study was conducted as a systematic review on patients with autism in Iran, including design and search strategy, systematic collection and review of articles, and quality assessment of studies for data extraction. The search strategy included databases such as PubMed, Scopus, and Web of Science using relevant keywords, and autism diagnosis was based on DSM-IV and DSM-5 criteria.

Results: In this study, genes RORA, MTRR, MTR, Reelin, VDR, VMAT1, ACE I/D, MOCOS, HOTAIR, ANRIL, RIT2, MMP-9, GRM7, FOXP3, and GRIN2B showed significant relationships with the occurrence of autism.

Conclusion: Given the dispersion and lack of coherence in studies on autism genetics in Iran, the definitive impact of each polymorphism in the Iranian population cannot be conclusively determined, and further studies are needed.