Intrusive Thoughts Research Articles

Psychological impact of COVID-19 on nursing personnel: A regional online survey.

AimsThis study investigated mental health reactions to dealing with COVID‐19 in a population of nurses working in a variety of settings. The study attempted to expand our current understanding of the psychological reactions unique to nurses working during the highly stressful period of the COVID‐19 pandemic.DesignThe study used an online questionnaire design.MethodsNurses were recruited using social media via an electronic link between July and September 2020. Of them, 112 nursing professionals completed the 66‐item questionnaire.ResultsSignificant findings included the presence of moderate or greater levels of anxiety (62%), depression (31%), and posttraumatic stress disorder (15%) and with significantly greater intrusive thoughts and memories for nurses who provided direct patient care than those who did not. Nurses with a prior history of anxiety or depression were found to be at greater risk for psychological distress. Results further highlighted concerns and fears related to coronavirus in both their daily personal and professional lives.ConclusionThe use of standard, commonly used, measures of psychological disorders allow for a more precise comparison among studies both for this population at the time of the survey and over a period of time.ImpactSuggestions for helping nursing professionals identify nurses at risk and improved ways to cope and deal with adverse psychological effects are discussed.

Mapping frontoinsular cortex from diffusion microstructure.

We developed a novel method for mapping the location, surface area, thickness, and volume of frontoinsular cortex (FI) using structural and diffusion magnetic resonance imaging. FI lies in the ventral part of anterior insular cortex and is characterized by its distinctive population von Economo neurons (VENs). Functional neuroimaging studies have revealed its involvement in affective processing, and histopathology has implicated VEN loss in behavioral-variant frontotemporal dementia and chronic alcoholism; however, structural neuroimaging of FI has been relatively limited. We delineated FI by jointly modeling cortical surface geometry and its coincident diffusion microstructure parameters. We found that neurite orientation dispersion in cortical gray matter can be used to map FI in specific individuals, and the derived measures reflect a range of behavioral factors in young adults from the Human Connectome Project (N=1052). FI volume was larger in the left hemisphere than the right (31%), and the percentage volume of FI was larger in women than men (15.3%). FI volume was associated with measures of decision-making (delay discounting, substance abuse), emotion (negative intrusive thinking and perception of hostility), and social behavior (theory of mind and working memory for faces). The common denominator is that larger FI size is related to greater self-control and social awareness.

Coping styles and mental health outcomes of community members affected by black summer 2019-20 bushfires in Australia.

The aim of this study was to investigate coping styles, posttraumatic stress, and mental health symptoms among a sample of community members affected by 2019-20 Australian bushfires. Using a convenience sampling approach, an online survey was used to assess a range of coping strategies, posttraumatic stress and symptoms of depression, anxiety, and stress among the affected community members of Black Summer bushfires. The results revealed that study participants reported moderate symptoms of depression and stress, and severe levels of anxiety. Additionally, participants reported use of both approach and avoidance coping strategies following the bushfire event as well as experiencing symptoms of posttraumatic stress, such as having intrusive thoughts and symptoms of avoidance and hyperarousal. Despite the durability of many individuals, others remain affected by the event and there is evidence there may be longer term mental health consequences of the bushfires for some people. Given these findings, it is imperative that mental health services be readily available for people in the bushfire-affected areas. Mental health nurses have an important role to play in supporting individuals affected by disasters. Awareness of the short- and long-term impacts of disasters on the mental health of people is paramount for mental health nurses.

Understanding psychological factors influencing ecosystem conservation behaviours of forest professionals

This study was embarked upon to assess forest guards’ Knowledge, Attitude and Practice (KAP) behavioural change sequences in Nigeria lowland forest reserves using a structural equation modelling approach. Two research questions were raised and corresponding hypotheses were tested. From the data analysed, it was revealed that both knowledge and attitude variables significantly predicted the behaviour of the forest guards’ towards the management of the forest and its resources. Although the attitude variable on its own did not significantly predict the forest guards’ behaviours (t = 1.401, P > 0.05), it can be stated that the knowledge of the forest guards towards the forest is a better predictor to their environmental behaviours and their behavioural change sequence (AKP) is inclined towards developing affinity to the forest. Hence seminar and symposiums should be organized for all forest guards with the objectives of having better efforts and persistence, preparation for action, better visualization of success, reduce stressors, and fewer intrusive negative thoughts in managing the forest and its resources. This will help boost their affinity to the forest and self-efficacy as the study revealed that the Attitude-Knowledge-Practice (AKP) sequence explains better the behaviour of the forest guards in protecting the forest reserves.

Developing a Scale to Investigate the Dissatisfaction with the Face and Body

The purpose of this study was to develop a psychometric scale to measure dissatisfaction with one’s face. In Study 1, 1,002 people aged 17–42 years using a 7-point Likert scale for a draft scale. Exploratory factor analysis revealed that the scale consisted of 27 items and a 3-factor structure (Avoidance, Fear, and Obsessive thinking), named Face Dissatisfaction Scale (FDS). Study 2 examined sex differences in dissatisfaction with the face and body. The results showed that females were more dissatisfied with faces than males; however, there was no sex difference in body dissatisfaction. Males were more dissatisfied with bodies than faces; however, there was no difference in females. We found that face dissatisfaction was positively associated with dysmorphic concerns and obsessive-compulsive tendencies. Moreover, the FDS showed high goodness-of-fit, reliability, and validity. The study suggests that FDS is a useful psychometric tool to seek unsatisfied people with their faces.

Recognition rates, treatment recommendations and stigma attributions for clients presenting with taboo intrusive thoughts: A vignette‐based survey of psychotherapists

AbstractIntroductionObsessive compulsive disorder (OCD) is a prevalent mental health disorder which is characterised by high levels of morbidity. Most individuals with OCD do not receive adequate psychotherapeutic intervention. Research suggests that taboo intrusive thoughts are less likely to be recognised as OCD in comparison to more recognisable forms. Stigma attributions are higher for individuals with taboo intrusive thoughts. The aim of this study is to examine psychotherapists' capacity to recognise different forms of OCD, their recommendations for psychotherapeutic intervention, and stigma attributions towards clients with OCD symptoms.MethodologyFive hundred fourteen psychotherapists in Ireland were randomly assigned a vignette describing a client with different OCD presentations—paedophilia, aggressive, religious, homosexuality, contamination and symmetry. Participants gave their interpretations of the presenting symptoms, their therapy recommendations and rated their confidence in their responses. Perceived dangerousness and willingness to work with the client were also investigated.ResultsThe taboo intrusive thoughts vignettes were significantly less likely to be recognised as OCD than the contamination and symmetry vignettes. Participants attributed greater levels of stigma to clients with aggressive and paedophilia intrusive thoughts. Recommendations for evidence‐based therapies were low. Participants who recognised OCD were significantly more likely to recommend an evidence‐based therapy. Confidence was a poor predictor of OCD identification and evidence‐based therapy recommendation.ConclusionsThe results suggest a lack of awareness of certain types of OCD presentation amongst psychotherapists, the meaning of the symptoms and of evidence‐based psychotherapeutic interventions for OCD. The implications of this, and possible applications of these results, are discussed.

The Maternal Disintegrative Responses Scale (MDRS) and its associations with attachment orientation and childhood trauma

BackgroundThe Maternal Disintegrative Responses Scale (MDRS), which examines intrusive thoughts and dissociative experiences among mothers in the postpartum period, has recently been developed and initially validated. ObjectiveIn this series of two studies, we sought to further examine the validity and psychometric properties of the MDRS by confirming its factor structure and investigating its associations with insecure attachment and childhood trauma. Participants and settingTwo convenience samples were recruited through social media. Participants in Study 1 consisted of 249 women aged 19 to 43 (M = 30.10, SD = 4.90) whose infants were up to 12 months old. Participants in Study 2 consisted of 637 women aged 20 to 46 (M = 31.43, SD = 4.81) whose infants were up to 16 weeks old. MethodThe participants completed a set of self-report questionnaires. In Study 1 we assessed trait anxiety, attachment orientation, the MDRS, and a background inventory. In Study 2 we assessed psychological distress, childhood trauma, the MDRS, and a background inventory. ResultsIn both studies, the factor structure of the MDRS was confirmed. In addition, insecure attachment and childhood trauma were both related to the MDRS factors, above and beyond the woman's background characteristics and current level of anxiety or distress. ConclusionsThe studies indicate the value of the MDRS as a promising, valid, and theory-based questionnaire for mothers following childbirth.

Repetitive Negative Thinking and Sexual Functioning in Portuguese Men and Women: A Cross-Sectional Study

Objective: Repetitive negative thinking (RNT) is a transdiagnostic process involved in the development and maintenance of emotional disorders that negatively affect sexual functioning. However, empirical evidence for the role of RNT on sexual functioning is still lacking. The current study aimed to investigate the role of RNT on sexual functioning in men and women by examining differences in RNT between men and women and between individuals with and without subclinical sexual difficulties. It also aimed to investigate the predictive role of RNT on sexual function indices in men and women. Methods: A total of 424 participants (270 women) completed online a sociodemographic questionnaire and Portuguese versions of the Persistent and Intrusive Negative Thoughts Scale, the Female Sexual Functioning Index, and the International Index of Erectile Function. Results: The main findings showed that women scored significantly higher than men on the RNT. Similarly, individuals with subclinical sexual difficulties scored significantly higher on the RNT compared with individuals without sexual difficulties. RNT was a statistically significant and negative predictor of sexual functioning in women and men. The role of RNT on sexual functioning in women and men was found, with men and women with subclinical sexual difficulties more likely to express persistent and intrusive negative thoughts compared with men and women without sexual difficulties. Conclusions: In summary, RNT appears to be a negative predictor of sexual functioning in both women and men, suggesting that individuals with more intrusive and negative persistent thoughts also have more difficulty in their sexual response.

Hand Washing: When Ritual Behavior Protects! Obsessive-Compulsive Symptoms in Young People during the COVID-19 Pandemic: A Narrative Review.

The Coronavirus Disease 2019 (COVID-19) pandemic had a profound impact on the lifestyles and mental health of young people. It has been hypothesized that the focus on hygiene and the fear of contamination/infection during the pandemic may have exacerbated obsessive–compulsive (OC) symptoms in this population. OC symptoms are widespread in the general population, with varying degrees of intensity. At their most extreme, they manifest in obsessive–compulsive disorder (OCD), which is characterized by obsessive thoughts and compulsive behaviors. The present narrative review aimed at evaluating the relationship between the COVID-19 pandemic and OCD and OC symptoms in young people, especially children and adolescents with and without OCD, focusing on vulnerability and risk factors and the impact of lockdown measures. Of the six studies identified, four examined clinical samples diagnosed with OCD and two looked at community-based adolescent samples. Five of the six studies found that OC symptoms increased during the pandemic. Additionally, vulnerability to anxiety may constitute a risk condition and the lockdown measures and personal stressful life events can constitute potential triggers of OC symptoms, while ongoing treatment for OCD had a protective effect. The results suggest that, during the COVID-19 pandemic, obsessive and compulsive behavior (e.g., hand washing) in young people at the greatest risk should be monitored, and the intervention of mental health services should be maintained. More research is needed in this area.

Perceived need of psychological support for taboo obsessions in new parents: A cross-sectional survey

Research has shown that many new parents experience taboo obsessions, which can lead to increased anxiety, depression, negative impact on parental function and quality of life. Many parents do not seek help due to shame or stigma. This cross-sectional survey study with self-recruited parents of infants and toddlers in Sweden explored: 1) the frequency and 2) impact of taboo obsessions, 3) whether negative appraisals could be a relevant factor for intervention, and 4) the perceived need for an intervention for taboo obsessions in this population. A total of 594 new parents filled out an online survey about taboo obsessions and the perceived need for psychological support. Fifty six percent reported currently experiencing or having previously experienced taboo obsessions and 54% responded that the taboo obsessions had a negative impact on their self-image. Additionally, 18–19% reported that the obsessions were difficult to control and/or had a negative impact on the relationship to the child. Importantly, 51% responded that they would absolutely or probably like to try online treatments for these intrusive thoughts. Keeping the limitations of a non-probabilistic online survey in mind, the results suggest that an online intervention targeting taboo obsessions in new parents could be well received.

Prevalence of Late Onset Stress Symptomatology (LOSS) in geriatric combat veterans and its relation with dementia: A Pilot Study

IntroductionLate onset stress symptomatology (LOSS) is a relatively new concept in combat veterans, which includes repeated but not intrusive thoughts about combat-related experiences, irritability, or nightmares that do not cause impairment of daily functioning.ObjectivesThe objectives of this study were to identify the LOSS phenomenon in geriatric combat veterans and to establish a correlation between LOSS and cognitive deficit ± major stressors.MethodsThe electronic database was searched for the last 2 years from starting the study with the hypothesis that the LOSS phenomenon has been diagnosed with sleep, anxiety, trauma-related, or impulse control related disorders. Records were examined for trauma-related symptoms, excluding major symptoms of trauma-related stressors. The veterans were assessed objectively using LOSS, PCL-5 (PTSD checklist for DSM-5), social readjustment rating scales, and MOCA (Montreal Cognitive Assessment scale) for cognitive screening.ResultsWe reviewed 1329 patient records and identified 35 potential LOSS subjects. Four veterans were diagnosed with PTSD not otherwise specified, 2 with anxiety disorder unspecified, and 1 veteran with nightmare disorder. The majority (85%) of the veterans scored >40 in PCL-5, and only one veteran fulfilled the criteria for LOSS, who scored 67 on the LOSS scale. All the veterans scored ≤25 on MOCA with a significant deficit in recent recall.ConclusionsOur study shows new onset stress-related symptoms are strongly associated with significant cognitive deficits and higher individual stress levels. The onset of PTSD symptoms in older combat veterans might have been correlated with the onset of cognitive deficits, as suggested by several other studies.DisclosureNo significant relationships.

A Qualitative Research to Examine Experiences of Turkish Women with Breast Cancer

IntroductionBreast cancer is a serious public health problem and one out of every 4 women diagnosed with cancer is breast cancer. Although the survival rate has increased due to advances in diagnosis and treatment, getting a cancer diagnosis is a highly stressful life event and seriously affects the lives of patients.ObjectivesTherefore, the aim of this qualitative study is to explore the experiences of women with breast cancer.MethodsData were gathered using semi-structured forms, in-depth interviews with 7 patients aged between 29 and 64 who had been diagnosed with breast cancer in 2017 and after. All interviews were tape-recorded and the themes have resulted in analyzing the content of the recorded data.ResultsIt has been determined that women have difficulties in getting information from healthcare professionals, emotional supports from their partners and family members, dealing with losses in roles and femininity, and coping with intrusive thoughts. However, it has been highlighted that women have experienced some positive changes in certain areas such as deeper interpersonal relationships with others, appreciating health and life.ConclusionsAs a result of the study, it has been thought that it is important to reduce the distress level of women with breast cancer related to their needs and difficulties and to encourage their positive changes. Besides, working in cooperation with healthcare professionals responsible for their treatment will be beneficial to reduce the distress level of the women.DisclosureNo significant relationships.

Antidepressant treatment in premenstrual dysphoric disorder, case report

IntroductionPremenstrual dysphoric disorder (PMDD) is included for the first time in the last edition of DSM within affective disorders. It is necessary that 5 of a list of 11 symptoms (lability, irritability, depressed mood, anxiety, lethargy, being out of control or physical symptoms among others) appear in the majority of menstrual cycles but must be only present during the week before menstruation improving after its onset. It has a prevalence of 1,8-5,8% and it is associated to significant functional impairment. SSRIs are indicated as first-line treatment in severe symptoms.ObjectivesTo review about premenstrual dysphoric disorder and its psychopharmacological treatment.MethodsWe carry out a literature review about premenstrual dysphoric disorder, accompanied by a clinical description of one patient treated with sertraline.Results44 years old female referred to our outpatient mental health service due to anxious and depressive symptoms. She had presented abdominal pain, anxiety, obsessive thoughts, sadness, emotional lability, apahty, anergy, uncontrolled impulse, irritability and vociferous attitude with verbal agressiveness only the week before menstruation during several years. These symptoms interfered negatively in her relationships. We started sertraline treatment with ad integrum clinical recovery after two menstrual cycles. 6 months later we indicated to take sertraline only the week before menstruation, maintaining stability.Conclusions1) It is important to consider premenstrual dysphoric disorder as a possible diagnosis in women with premenstrual discomfort symptoms. 2) It might be consider as a depressive disorder. 3) Antidepressant treatment should be considered in women with disabling symptoms.DisclosureNo significant relationships.

Use of aripiprazole in an obsessive compulsive disorder case with associated motor tics

IntroductionObsessive compulsive disorder (OCD) is a pathology represented by thoughts, images, impulses or feelings that generate great anxiety and discomfort, as well as the development of compulsive acts and rituals that cause great dysfunction.The comorbidity of different psychiatric disorders with OCD is known, such as impulse control disorder and tic disorder.ObjectivesThe objective of this study is to describe the clinical characteristics, comorbidities and the treatment used in a patient with an OCD diagnosis and motor tics.MethodsDescription of a clinical case of motor tics associated with OCD in an adult patient.ResultsA 29-year-old man begins mental health follow-up for presenting, as a result of a choking episode, obsessive thoughts with significant emotional and behavioral repercussions, to the point of restricting his diet and losing several kilos of weight. He also manifested checks and rituals in order to avoid possible choking.Treatment with sertraline and clonazepam was started, without evidence of improvement in symptoms. Months later, bucolingual and guttural tics, difficult to control by the patient and which caused bite lesions in the mouth and tongue, were added to the described clinic. Oral aripiprazole was associated to the treatment and then prolonged- release intramuscular administration was used, achieving improvement in obsessive symptoms and motor tics.ConclusionsThe usefulness of adjuvant treatment with atypical antipsychotics has been demonstrated in adults with OCD who present an insufficient response to an SSRI. Injectable prolonged-release antipsychotics can help improve long-term prognosis by ensuring adherence.DisclosureNo significant relationships.

Unhealthy fantasizing of a loved person who does not exist in reality

IntroductionObsessive-compulsive disorder is a disorder in which recurring, intrusive, unwanted thoughts, ideas or sensations cause them to feel driven to do something repetitively. The repetitive behaviors can significantly interfere with a person’s daily activities and social interactions. Not performing the behaviors commonly causes great distress.ObjectivesClinical trials are required for proper assessment and management of this group of patients.MethodsMrs. X, a 28 year old female coming for psychiatric consultation with the complaints of self talking, irritability and aggression, insomnia.She fantasizes a man publicly, whom she loves but he has no existence in reality. She tries to solve all kinds of problems by talking to that fantasy man. If anyone interrupts her, she becomes irritable, shouts and breaks things. But for the last 3 months she realized that its a problem. Because, she can’t eat, sleep and concentrate on her household chores for this fantasy. Even she can’t take care of her child and feeling low sexual affection for her husband. On personal history, she said that she had poor attachment with her parents.ResultsAfter thorough assessment, her consultant Psychiatrist told that she was sufering from unhealthy fantasy obsession or Obsessive Compulsive Disorder.ConclusionsIt is very important and urgent to assess and manage this group of patients, because this has a devastating impact on relationships, specially on the conjugal life. Psychoeducation about the ilness and Psychotherapy along with pharmacotherapy should be the mode of treatment.DisclosureNo significant relationships.

A Case of Ruminative Hypomania Induced by High Dose Venlafaxine

IntroductionObsessive phenomena, when present, are usually seen in the depressive phase of bipolar disorder.ObjectivesThe peculiar case with aggravation in ruminative and obsessive thinking with simultaneous hypomania may widen our understanding of the phenomenology of antidepressant induced hypomanic symptoms.MethodsWe present a case of ruminative hypomania induced by high dose venlafaxine. Young Mania Rating Scale (YMRS), Hamilton Depression Rating Scale (HAM-D) and Yale Brown Obsessive Compulsive Scale (YBOCS) were used for symptom ratings.ResultsThe patient was 30 years old and she had treatment history of depression for 3 months. She had two consecutive suicide attempts with drugs in the week before she was hospitalized for suicidal risk. She was using venlafaxine 300 mg/day and olanzapin 2,5 mg/day; continuous ruminative thinking about the past and imaginary sexual affairs with former friends were apparent with an unremitting pattern, leading to intense psychomotor agitation and suicide attempts. Irritable mood, and increased energy was observed with continuous ruminations. She was diagnosed with bipolar-II-disorder, with mixed features and anxious distress (YMRS:17, HAM-D:22, YBOCS:34). After discontinuing venlafaxine and starting anti-manic treatment with haloperidol 10 mg/day in the first week, both affective symptoms and ruminations were improved (YMRS:2, HAM-D:4, YBOCS:8). Aripiprazol 20 mg/day and quetiapine 100 mg/day which were given for continuation treatment were also effective for preserving full remission.ConclusionsWhen prescribing high dose venlafaxine for treatment resistant depression, it should be remembered that this may induce hypomanic symptoms and prominent ruminative thinking which can be ameliorated with anti-manic treatment.DisclosureNo significant relationships.

The elephant in the room: the stressful psychological effects of COVID-19 pandemic in mental healthcare workers

IntroductionDespite the large amount of research concerning the impact of COVID-19 on health care workers, to date few targeted MHWs. Moreover, none has investigated the vulnerability due to exposure to previous traumatic events among health care workers.ObjectivesThis study aimed to investigate the psychological distress in MHWs after the first lockdown imposed by the COVID-19 pandemic in the more impacted regions of the North of Italy, to understand which COVID-19, sociodemographic and professional variables as well as previous stressful life experiences, could have had greater negative effects.MethodsThe online survey occurred from 28-June to 10-August 2020. This included questions regarding sociodemographic factors, professional information, COVID-19 exposure. Moreover, three validated self-report questionnaires were administered: Life Events Checklist for DSM-5 (LEC-5), Impact of Event Scale-Revised (IES-R), Depression Anxiety Stress Scales-21 (DASS-21).Results271 MHWs completed the survey. At least 20% had elevated levels of psychological distress with post-traumatic symptoms. Stratifying for professional roles, the nurses resulted the most affected, with significantly higher scores in terms of intrusive thoughts, hyperarousal and avoidance behaviors. Several variables affected psychological distress in MHWs, but stronger effects were done by age, professional roles, increased workload and worst working environment during COVID-19 pandemic, to had experienced the separation of family members, but also had experienced during their life of a severe human suffering (physical and/or psychological) on oneself or on a loved one.ConclusionsOur data underlying the importance of recent but also previous severe stressful events as risk factors to develop post-traumatic symptoms reducing the resilience of the subjects investigated.DisclosureNo significant relationships.

Adjunctive therapeutic strategies in Obsessive-Compulsive Disorder resistant to serotonin reuptake inhibitors: a literature review

Introduction Obsessive-Compulsive Disorder (OCD) is a common mental disorder and a major cause of disability worldwide. Typically, it has a chronic course, marked by recurrent intrusive thoughts (obsessions) and repetitive behaviors (compulsions). Its pharmacological first line of treatment has been well established for several years now, with the Serotonin Reuptake Inhibitors (SRIs). However, about half of the patients are resistant to this approach, representing a therapeutic challenge for clinicians. Evidence suggests that other medications can augment SRIs, enhancing its effects and achieving a bigger efficacy in these patients’ treatment. Also, there is an increasing interest in neurosurgical interventions in these patients.ObjectivesThe main goal of this work was to assess the clinical efficacy of adjunctive therapeutic strategies in patients with OCD resistant to SRIs.MethodsA literature review was conducted searching PubMed and ScienceDirect databases from the 1st of January 2000 to the 1st of September 2021 to identify clinical trials comparing an active drug/neurosurgical intervention with placebo as an adjunctive therapeutic strategy in SRI-resistant OCD.ResultsSixteen studies were selected for data extraction, including a total of 585 patients. Risperidone, aripiprazole, N-acetylcysteine, lamotrigine, pindolol, riluzole, memantine and methylphenidate were efficacious for augmenting SRIs in OCD. Ablative surgery (ABL) and deep brain stimulation (DBS) were equal effective in the treatment of refractory OCD.ConclusionsSeveral therapeutic options presented as potentially effective in OCD when it is resistant to SRIs, although this is still an area for further research.DisclosureNo significant relationships.

The role of cognitive distraction in sexual dysfunction in female medical resident doctors

Introduction: Studies have shown a high prevalence of sexual dysfunction in Medical residents. Psychological, interpersonal, and sociocultural factors play an important role in sexual vulnerability. In addition, distraction or interference in the cognitive process of the erotic stimulus plays an important role in the development of sexual dysfunction. The aim of our study was to determine the prevalence of sexual dysfunctions among a sample of married female medical resident doctors and to explore its relation with cognitive distraction during sex. Subjects and methods: This was a cross-sectional study, which was carried out in October 2017 with 70 married female medical resident doctors. We used the Female Sexual Function Index (FSFI) for sexual functioning assessment and the cognitive distraction during sex scale. Results: The mean age of women was 30.52 years. They had been married for 6.04 years on the mean. The majority (74%) had children. According to the FSFI, 40% of resident doctors had sexual dysfunction. The mean cognitive distraction during sex score was 4.37. In our study, women with female sexual dysfunction reported significantly lower sexual desire score = 3.2 vs. 4.1 and p = 0.03) and arousal (score = 3.è vs. 4.7 and p = 10-3), decreased lubrication (score = 3.8 vs. 5.1; p = 10-3), less sexual satisfaction (score = 3.9 vs. 5.8; p = 10-3) and higher orgasm difficulties (score = 3.4 vs. 5.1; p = 10-3). Yet, our results highlighted that women with female sexual dysfunction presented significantly more cognitive distraction during sex (score = 3.9 vs. 4.6; p = 0.03). Conclusion: According to our study, it appears that the prevalence of FSD in medical resident doctors is considerable. Besides, intrusive thoughts and cognitive distraction during sexual intercourse are importantly associated with sexual functioning. Therefore, several measures should be implemented in this population to prevent or act on these factors.

Use of structural modeling to explain high school students obsessive beliefs based on symptoms of stress, anxiety, and depression, metacognitive beliefs, and self-esteem: The mediating role of inferential confusion

Introduction: Thoughts, impulses, or images that are distressing and intrusive characterize obsessive-compulsive disorder. On the other hand, obsessive beliefs are important in turning intrusive thoughts into obsessive thoughts. Aim: This study aimed to present a structural model to explain obsessive beliefs among high school students, based on the symptoms of stress, anxiety, and depression, metacognitive beliefs, and self-esteem, considering the mediating role of inferential confusion. Method: In this correlational study, the statistical population included all secondary high school students in Aligudarz, Lorestan Province, Iran, during the 2020-2021 academic years. A total of 300 individuals were selected using cluster sampling. Data were collected using the Obsessive Beliefs Questionnaire (OBQ-44), Depression, Anxiety, and Stress Scale (DASS-21), Metacognitions questionnaire-30 (MCQ-30), Inferential Confusion Questionnaire-Expanded Version (ICQ-EV), and Rosenberg Self-Esteem Scale (RSES). Data analysis was performed using structural equation modeling in SPSS-20 and AMOS-24. Results: The goodness of fit indices of the measurements model (2/df=3.12, RMSEA=0.084) supported the good fitness of the model. Also, the goodness of fit indices of the structural model (2/df=2.24, RMSEA=0.064) indicated the good fit of the model for the collected data. Conclusion: Based on the results, metacognitive beliefs, symptoms of stress, depression, and anxiety, and self-esteem are among factors affecting obsessive beliefs; inferential confusion plays a mediating role in their association with obsessive beliefs. Therefore, elimination or moderation of contributing factors is essential for correcting obsessive-compulsive beliefs.