Background: Infertility represents a significant crisis in married life, leading to serious intrapersonal and interpersonal challenges, with many infertile women experiencing psychological and marital difficulties. Objectives: In Iran, few studies have examined communication factors influencing infertility stress. This study aimed to better understand the variables affecting infertility stress and to test the mediating role of relational resilience in the relationship between dyadic coping and infertility stress among women undergoing infertility treatment in Kashan. Methods: A correlational study using structural equation modeling (SEM) was conducted. The statistical population comprised infertile women who attended an infertility center in Iran in 2023. A total of 218 participants were selected through purposive sampling and completed the Relational Resilience Questionnaire, Dyadic Coping Inventory (DCI), and Fertility Problems Inventory (FPI). Data were analyzed using AMOS 24 and SPSS 24. Results: The final mediation model demonstrated good fit indices (all > 0.90). Dyadic coping positively influenced relational resilience (β = 0.67, P < 0.001), which in turn negatively affected infertility stress (β = -0.51, P < 0.001), indicating full mediation. Subscale analyses confirmed these relationships: Relational resilience and dyadic coping were positively associated with their respective dimensions, while infertility stress was positively linked to social, relational, sexual concerns, and the need for parenthood. These results suggest that dyadic coping among infertile women and their husbands can enhance relational resilience, thereby reducing infertility-related stress. Conclusions: Although infertility stress affects multiple aspects of a couple's life, positive dyadic coping and relational resilience play a protective role. The findings provide valuable insights for therapists working with infertile couples, highlighting the importance of strengthening dyadic coping and relational resilience to mitigate stress.

Background: While a significant body of research has utilized general clinical manuals, a thorough literature review revealed a notable absence of studies using the Busch et al. (2016) manual — one of the few manuals grounded in the psychoanalytic concept of narcissistic vulnerability as a core mechanism in depression. This study is the first to empirically examine this foundational yet underexplored perspective. Objectives: This study investigates the efficacy of a 24-session manualized short-term dynamic psychotherapy (STDP), adapted from Busch et al.'s (2016) work, in reducing moderate to severe depressive symptoms. The manual identifies narcissistic vulnerability, conflicted anger, and perfectionism as key dynamics in depression. The primary aim of this intervention is to improve problematic relational patterns linked to narcissistic vulnerability, such as insecure attachment, egocentricity, social incompetence, and alienation. It is hypothesized that the intervention's effectiveness stems from targeting narcissistic vulnerability as a central feature of depression. Methods: A single-subject design was employed with five participants diagnosed with major depressive disorder (MDD). Changes in depressive symptoms, daily functioning, and quality of object relations were assessed across baseline, intervention, and follow-up phases using the Hamilton Depression Rating Scale (HDRS), the Sheehan Disability Scale (SDS), and the Bell Object Relations Inventory (BORRI), respectively. The Reliable Change Index (RCI) and visual trend analysis were used to evaluate outcomes. For more nuanced analysis, the intervention phase was divided into two halves. The treatment phase comprised 24 twice-weekly sessions, followed by a 4-week follow-up phase. Results: The intervention demonstrated significant effectiveness in reducing depressive symptoms throughout treatment and follow-up. Scores on the HDRS significantly decreased post-intervention. Mediation analysis supported the intervention’s role in mitigating depression by improving relational patterns, particularly through a significant reduction in insecure attachment. Additionally, scores on the SDS indicated improvements in daily functioning. Conclusions: These findings suggest that brief dynamic psychotherapy targeting narcissistic vulnerability as a core depressive feature holds promise for treating depression and informing the development of novel interventions.

Background: Suicide and suicide attempts are significant public health challenges worldwide. In Iran, particularly in Ilam province, this issue has become increasingly prominent, necessitating effective prevention strategies. Prior research highlights the efficacy of educational and therapeutic interventions, including psychological training and counseling, in reducing suicidal behaviors. Objectives: The present study aimed to evaluate the effectiveness of a structured educational-therapeutic intervention program implemented in comprehensive health centers across Ilam. Methods: Using an applied, community-based participatory approach, this interventionist-analytical study was conducted over 12 months (December 2019 to January 2021). The target population included service recipients at health centers across Ilam. Interventions were delivered at general, selective, and indicated levels, encompassing suicide prevention training, psychological counseling, and systematic screening for at-risk individuals. Data were extracted from quarterly and annual center reports and analyzed using SPSS with descriptive and inferential statistics. Results: Findings demonstrated a significant reduction in suicide and suicide attempts in Ilam city following the intervention, particularly among individuals aged 15 - 24 and 25 - 34 years. There was also a notable increase in the identification and treatment of depression and anxiety disorders. However, in some areas like Darehshahr and Dehloran, an increase in suicide attempts was observed, highlighting the need for localized assessment. Conclusions: Educational-therapeutic programs in health centers of Ilam effectively reduced suicidal behaviors. Expanding such interventions nationally and further investigating regional outcome disparities is strongly recommended.

Background: Type 1 diabetes (T1D) is a chronic condition that significantly impacts the psychological health of adolescents. Objectives: This study aimed to examine the effect of acceptance and commitment therapy (ACT) on anxiety and emotion regulation in adolescents with T1D. Methods: In this randomized controlled trial, 40 adolescents aged 13 - 18 were randomly assigned to an ACT group (n = 20) or a control group (n = 20). The intervention included eight weekly 60-minute group sessions. Participants completed the Beck Anxiety Inventory (BAI) and the Emotion Regulation Questionnaire (ERQ) at pre-test, post-test, and three-month follow-up. The data were analyzed using multivariate analysis of variance (MANOVA) with a repeated measurement design and through SPSS-22 statistical software. Results: The ACT significantly reduced anxiety (-8.10 ± 4.65, ηp2 = 0.81) and improved both reappraisal (+7.75 ± 4.56, ηp2 = 0.87) and suppression in emotion regulation (-3.30 ± 3.14, ηp2 = 0.28) compared to the control group (P < 0.001), with effects maintained at follow-up. Conclusions: The findings indicate that psychological treatment methods, including ACT, significantly enhance the effectiveness of medical treatments, especially for adolescents with T1D.

Background: Nomophobia, the fear of being without mobile phone connectivity, is increasingly prevalent among university students, particularly nursing students who face rigorous academic and clinical demands. Objectives: This study examines the prevalence of nomophobia and its associations with sleep quality, communication skills, and perceived stress in nursing students to inform targeted interventions for their well-being and professional competencies. Methods: A cross-sectional study was conducted from March to May 2025 with 208 undergraduate nursing students from two universities in Kashan, Iran, using stratified sampling. Participants completed validated Persian versions of the Nomophobia Questionnaire (NMP-Q), Pittsburgh Sleep Quality Index (PSQI), Communication Skills Attitude Scale (CSAS), and Stress Index in Nursing Students (SINS). Data were collected via paper-based questionnaires during class and clinical sessions. Descriptive statistics, Pearson correlations, hierarchical regression, and Bayesian regression with a Jeffreys-Zellner-Siow (JZS) prior were used to analyze relationships between nomophobia and study variables, controlling for demographics. The sample size was calculated using G*Power, targeting a minimum of 200 participants for adequate power. Results: The mean NMP-Q score indicated moderate-to-high nomophobia levels. Participants reported poor sleep quality (mean PSQI = 7.91) and elevated stress (mean SINS = 82.38). Nomophobia was positively correlated with poor sleep quality (R = 0.42, P < 0.001) and stress (R = 0.51, P < 0.001), and negatively correlated with positive communication attitudes (R = -0.26, P < 0.001). Hierarchical regression showed that stress (β = 0.39, P < 0.001) and poor sleep quality (β = 0.28, P < 0.001) were the strongest predictors of nomophobia, with positive communication attitudes offering a protective effect (β = -0.16, P = 0.014). Bayesian analysis confirmed these findings (BF10 = 142.6). Daily smartphone use was not significant after controlling for psychosocial variables. The cross-sectional design limits causal inference. Conclusions: Nomophobia is prevalent among nursing students and significantly associated with poor sleep quality and high stress, while positive communication attitudes mitigate its impact. These findings suggest the possibility of interventions targeting stress management, sleep hygiene, and communication skills to reduce nomophobia. Future longitudinal studies should explore causality and evaluate intervention efficacy to support nursing students’ well-being.

Background: The Altman Self-rating Mania Scale (ASRM) is a brief instrument used for screening, repeated symptom monitoring, and research purposes. Objectives: This study aimed to translate, adapt, and validate the Persian version of the ASRM to address the lack of self-assessment tools for mania in Iran. Methods: This cross-sectional study, conducted using a convenience sampling method, involved 200 participants who were selected to take part in the study. The ASRM underwent forward-backward translation by bilingual experts. Participants completed the ASRM, 32-item Hypomania Checklist (HCL-32), and Patient Mania Questionnaire-9 (PMQ-9) during a single session. Psychometric testing included assessments of reliability, validity, and factor structure. Results: The Persian ASRM demonstrated strong psychometric properties in our clinical sample (N = 200). The scale showed good internal consistency (Cronbach’s α = 0.74) and excellent test-retest reliability [intraclass correlation coefficient (ICC) = 0.82] over a one-week interval. Convergent validity was established through significant correlations with established measures: The PMQ-9 (R = 0.43, P < 0.001) and HCL-32 (R = 0.43, P < 0.001). Discriminant validity was confirmed by a non-significant correlation with the Spontaneous Use of Mental Imagery Scale (SUIS; R = 0.08, P = 0.61). Factor analysis revealed a unidimensional structure explaining 41.7% of the variance [Kaiser-Meyer-Olkin (KMO) = 0.72; Bartlett’s χ2 = 114.6, P < 0.001], consistent with the construct of the original scale. All items showed adequate item–total correlations (0.33 - 0.47) and contributed meaningfully to the total score. Conclusions: The ASRM serves as a reliable self-report tool, offering both validity and reliability in identifying and measuring the intensity of manic symptoms. The Altman Scale represents a validated self-assessment instrument with demonstrated reliability in screening for and measuring the severity of manic symptoms. It enables quick and straightforward evaluations of patients’ conditions and is suitable for research, clinical, and screening purposes. Its practical design supports brief yet effective assessments, allowing for versatile use in research settings, clinical evaluations, and screening programs.

Background: Diabetic foot disease often leads to below-knee amputation (BKA), with substantial consequences for health-related quality of life (HRQoL). Identifying associated psychological and sociodemographic factors is crucial for optimizing post-operative care. Objectives: To assess HRQoL, anxiety, and depression among diabetic foot patients following BKA, and explore their associations with sociodemographic factors. Methods: A cross-sectional study was conducted among 112 amputated patients admitted to Firoozgar Hospital (Tehran) between 2022 and early 2023. Participants completed the short form health survey (SF-36) and the Hospital Anxiety and Depression Scale (HADS). Variables assessed included age, sex, education level, income, and history of surgical site infection (SSI). Statistical analyses involved descriptive and inferential methods. Results: Higher educational levels were significantly associated with improved SF-36 scores (P < 0.05) and lower HADS anxiety/depression levels (P < 0.05). Older age showed negative correlations with physical functioning (R = -0.72, P < 0.001) and general health (R = -0.03, P = 0.790). While most HRQoL differences between sexes were statistically non-significant, female participants reported slightly lower scores in vitality, general health, and emotional role domains. The presence of SSI tended to lower physical functioning scores, though differences did not reach statistical significance. Conclusions: Age and education significantly influence post-amputation HRQoL. These findings underscore the need for tailored psychosocial support and rehabilitation strategies targeting vulnerable subgroups.