Clinical Psychology Studies

Abstract This study explored how the Picture Exchange Communication System (PECS) impacts social skills in children aged 7 to 10 years with autism spectrum disorder (ASD). Using a single-case experimental design (A-B-C), four children with ASD were selected through convenience sampling from a rehabilitation center in Tehran. Their cognitive and social skills were assessed with Raven’s Colored Progressive Matrices (RCPM) and the Autism Social Skills Profile (ASSP), respectively. Each child participated in twelve individual PECS sessions, each lasting 45 minutes. After the intervention, assessments were repeated with the ASSP, and follow-up evaluations were conducted one month later. Data analysis included visual analysis, recovery percentages, and Cohen’s D effect size, using SPSS version 24. Results showed significant improvements in social skills due to PECS, with instructor-reported effect sizes of 1.6, 1.4, 1.2, and 1.6. Notably, gains were observed in social reciprocity (effect sizes: 1.4, 1.08, 0.98, 1.6) and social participation (effect sizes: 1.91, 1.77, 1.56, 1.73), while detrimental social behaviors decreased (effect sizes: 1.07, 1.1, 1.4, 1.2). Parental reports confirmed these improvements, highlighting enhanced social skills and fewer negative behaviors. Overall, the study suggests that PECS is an effective tool for improving social skills and reducing problematic behaviors in children with ASD, supporting their vital social development.

Abstract Abstract
Objective The present study aimed to investigate the effectiveness of Group Behavioral Activation Therapy (BA) on reducing hopelessness and suicidal ideation in adolescents diagnosed with Major Depressive Disorder (MDD).
Research Methodology: This quasi-experimental study utilized a pre-test, post-test, and two-month follow-up design with a control group. The sample (N=40) consisted of adolescents aged 12 to 19 in Kermanshah, diagnosed with MDD, who were selected via purposive sampling and randomly assigned to the experimental (n=20) or control (n=20) group. The mean age of participants was approximately 14.4 years. The experimental group received ten 90-minute weekly group sessions of BA, while the control group received no intervention. Research instruments included the Hopelessness Scale for Children (HSC) and the Beck Scale for Suicide Ideation (BSSI). Data were analyzed using Mixed-Design Analysis of Variance (Mixed ANOVA).
Findings: The results indicated a statistically significant Group × Time interaction for both variables, confirming the effectiveness of the BA intervention. BA significantly reduced levels of hopelessness (F=11.18,p<0.001,η2=0.22) and suicidal ideation (F=29.92,p<0.001,η2=0.37) compared to the control group. Furthermore, post-hoc analysis confirmed that the therapeutic gains achieved were maintained at the two-month follow-up. The intervention had a stronger effect on reducing suicidal ideation (η2=0.37) than on hopelessness (η2=0.22).
Conclusion: The findings suggest that Behavioral Activation is an effective, evidence-based, and cost-effective intervention for reducing the core symptoms of depression and exerting a profound therapeutic impact on high-risk constructs like hopelessness and suicidal ideation in adolescents. The study underscores the importance of implementing BA in clinical and educational settings.
Keywords:
Adolescents;Behavioral Activation; Hopelessness; Major Depressive Disorder; Suicidal Ideation

Abstract Introduction and Objective: Learning disabilities are often associated with difficulties in information processing, concentration, and attentional control. The present study aimed to compare the effectiveness of a physical–motor literacy promotion program and Computer-assisted rehabilitation on selective attention in children with learning disabilities. Method: This experimental study employed a pretest–posttest design with a control group. The statistical population consisted of boys and girls aged 7–15 years with learning disabilities in Shahrood during the academic year 2022–2023.45 participants were selected through convenience sampling and randomly assigned to three groups: physical–motor literacy enhancement program, computer-based cognitive rehabilitation, and control (15 children per group). The instruments were physical–motor literacy enhancement program, Captain’s Log cognitive rehabilitation software (2018), the Stroop Test software (developed by Sina Psychological Equipment Center), and the Marathon pedometer. Data were analyzed using analysis of covariance (ANCOVA) and Bonferroni post hoc tests. Results: The results showed no significant difference between the effectiveness of the physical–motor literacy promotion program and the computer-based cognitive rehabilitation in improving attention scores. the physical–motor literacy promotion program, by providing an integrated understanding of human nature, was able to fill the gap of previous motor-based programs and demonstrated comparable therapeutic effectiveness to computer-based cognitive rehabilitation. Conclusion: Both the physical–motor literacy promotion program and computer-based cognitive rehabilitation can be beneficial in improving attention in children with learning disabilities. However, limitations such as the absence of follow-up on treatment persistence and the influence of moderating variables (e.g., weight, age, gender) highlight the need to address these constraints in future research.

Abstract Introduction and Objective: Understanding the psychological mechanisms underlying somatic symptoms can clarify the processes involved in psychosomatic problems and facilitate the design of targeted therapeutic interventions. The present study aimed to examine the structural model of the effect of insecure attachment on somatic symptoms, with mentalization and difficulty in emotion regulation serving as mediating variables in adults.
Research Methodology: The research design was correlational and employed structural equation modeling (SEM). The statistical population included all individuals aged 18 or older living in Hamedan who had consulted a physician in 2024 with somatic symptoms. A sample of 295 individuals was selected using convenience sampling. Data were collected using several standardized assessment tools, including Fraley et al.’s Attachment Scale (2011), the Difficulties in Emotion Regulation Scale by Gratz & Roemer (2004), the Reflective Functioning Questionnaire by Fonagy and Luyten (2016), and the Somatic Symptom Disorder-B Criteria Scale by Toussaint et al. (2016).
Results: The results indicated that insecure attachment to close friends, mothers, fathers, and partners had a significant negative impact on mentalization (β = -0.12 to -0.39, p < 0.05) and a significant positive impact on somatic symptoms (β = 0.15 to 0.27, p < 0.01). The analysis revealed a significant indirect relationship between insecure attachment and somatic symptoms, mediated by mentalization and emotion regulation, across all models (p < 0.05). The fit indices for the four models, including RMSEA ≤ 0.066 and CFI > 0.96, indicated good fit.
Conclusion: Therefore, insecure attachment can lead to somatic symptoms by reducing mentalization capacity and increasing difficulties in emotion regulation. These results underscore the importance of addressing mentalization processes and emotion regulation skills in psychotherapeutic interventions for psychosomatic disorders.

Abstract Introduction and Objective: This study aims to compare the effectiveness of transcranial direct current stimulation (tDCS) and motivational interviewing in enhancing self-control, and reducing drug craving, among men addicted to narcotics.
Research Methodology: This is a quasi-experimental applied research that was conducted in 2025. The statistical population consisted of male drug addicts supported by the Imam Khomeini Relief Foundation in Alborz Province, specifically those referred to the Rose Clinic and the Article 16 Addiction Treatment Camp in Kalak, Karaj. A total of 60 participants were selected through convenience sampling and randomly assigned to four groups: 15 received tDCS, 15 underwent sham stimulation, 15 received motivational interviewing, and 15 served as a control group. The research instruments included the Drug Desire Questionnaire (DDQ) and the Self-Control Scale. Data analysis was conducted using descriptive statistics and repeated measures ANOVA via SPSS version 24.
Findings: Both tDCS and motivational interviewing significantly reduced drug craving (P ≤ 0.05). However, unlike motivational interviewing, tDCS did not show a significant effect on self-control. Follow-up analysis two months later revealed that the effects of motivational interviewing on craving were more enduring than those of tDCS.
Conclusion: Given the longer-lasting impact of motivational interviewing, it is recommended that specialized training programs be developed for psychologists and addiction treatment professionals to enhance their use of motivational interviewing in therapeutic settings.

Abstract The study aimed to examine effectiveness of cognitive-behavioral
therapy in combination with stress reduction based on mindfulness in
reducing anxiety and automatic thoughts and improving general health
of a patient with generalized anxiety disorder. The study used a singlesubject A-B design to determine the mixed effects of the interventions
on the subject. The subject completed Beck Anxiety Inventory (BAI),
Hamilton Anxiety Rating Scale (HARS), Automatic Thoughts
Questionnaire (ATQ) and General Health Questionnaire (GHQ) in
both phase A (baseline) and phase B (last treatment session). The
patient’s BAI score decreased from 45 in stage A to 30 in the fifth
session, 16 in the tenth session and 10 in the final phase. Results from
HARS, ATQ and GHQ also indicated significant decreases in the
patient’s scores. The study suggests that a mixed intervention
consisting of a cognitive-behavioral therapy combined with
mindfulness-based stress reduction can have positive effects on
treating generalized anxiety disorder.

Abstract The study aimed to make a comparison between effectiveness of
cognitive-behavioral therapy and mindfulness-based therapy in
improving quality of life of patients with irritable bowel syndrome
(IBS). The study followed a quasi-experimental design with three
groups a pre-test and a final test. Group sizes were decided
considering the fact that the study was a pilot project and that some
subjects might discontinue their participation. Thus, 36 patients (20
males and 16 females) with IBS (diagnosed using Rome III process)
were chosen using convenient sampling and then randomly divided
into two study and one control groups (each with 12 patients). The
IBS-QOL34 questionnaire was administered in the three groups as the
pre-test. The questionnaire was administered as the post-test in the
three groups two months later. All results were analyzed using
statistical methods. After results of the control group and influence of
the pretest were omitted, ANCOVA showed that there was a
significant difference between effects of the two therapy methods (p
<0/05). The LSD post-hoc test also showed a significant difference
between effectiveness of the mindfulness-based therapy compared to
that of the cognitive-behavioral therapy (p <0/05). It can be suggested
based on the basis of the results that the new method of psychotherapy
in treating patients with IBS should be considered, because the old
therapy is not always effective or even promising.
and it can thus be used as a new treatment method for individuals with
aviophobia.

Abstract Diabetes refers to complex chronic metabolic conditions that are
characterized by elevated levelsof blood glucose if untreated.
Diabetes is one of the biggest health problems faced with many people
living in Yazd. The disease rate in Yazd is twice as high as the
country’s average rate. Patient's self-care behaviors have a major role
in diabetes management. Such self-care activities can be exceedingly
demanding and often require fundamental lifestyle changes. The
purpose of this study was to examine the impact of cognitive factors in
controlling and treating type 2 diabetes. The statistical society of the
study included 4990 diabetic patients who referred to Yazd Diabetes
Research Center. A sample of 256 patients was selected using
Cochran’s formula and simple random sampling. Subjects then had
structured interviews. Data were analyzed using one-way ANOVA, ttest, Pearson’s correlation coefficient and stepwise regression.
Significant correlations were found between self-efficacy, outcome
expectancies, duration of the disease and adherence to self-care.
Adherence to self-care activities was greater among older, moreeducated and upper-income patients. Also, a total of 27% of variance
in self-care behavior can be explained by duration of diabetes and selfefficacy.

Abstract Mental disability of children is a source of stress which threatens
mental health of the family and affects different aspects of the family
life. Various methods have been developed for helping affected
families, among which psychological interventions have a special
place. The present study aimed to offer a meta-analysis of
effectiveness of psychological interventions in mental health of
families who have children with mental disabilities. The method used
was meta-analysis. Twenty five papers were reviewed and 11selected
for the analysis, the total number of subjects in which was 712. Based
on the results, the effect size was 0.25, which indicates a below
average rate according to Cohen’s table. It can therefore be suggested
that psychological interventions have a positive effect on mental
health of families who have children with mental disabilities, and that
the interventions can be used as a method for improving mental health
of such families. The interventions, however, need to be supplemented
by other support interventions.

Abstract Abstract
The present study aims at investigating the effectiveness of
prevention and relationship enhancement program (PREP) on
increasing marital intimacy. To do so, 24 couples who referred to state
and private counseling centers to enhance their marital intimacy were
selected. They were then randomly divided into two groups including
prevention and relationship enhancement program (12 couples), and
control group (12 couples). The type of the research was semiexperimental (pretest-posttest with control design). Educational
intervention (prevention and relationship enhancement program)
including 11 sessions (1.5 hours) was applied on the experiment
group. Results indicated that the intervention (prevention and
relationship enhancement program) had a significant effect on marital
intimacy. Furthermore, the prevention and relationship enhancement
program had positive and significant effect on nine component of
marital intimacy including emotional, intellectual, physical, social,
communicational, spiritual, psychological, sexual, and total intimacy.

Abstract Due to the dramatic rise in divorce rate in recent years, many scholars have attempted to unravel the factors involved in this increasing phenomenon. The present paper aimed at a qualitative phenomenological study of the divorce contexts in the city of Rasht. In so doing, 25 divorced people who were selected through purposeful sampling were included in the study. Semi-structured interviews were used to collect data. The collected data were analyzed through thematic analysis. The data analysis showed 9 sub-themes which were merged into the four main themes, namely, large, medium, small and interactive themes. These findings indicate that the phenomenon of divorce is systemic in its aspects, its factors are cyclical, and there are structural relations among its contexts. It is concluded that these systemic quality, cyclical factors and structural relations should be taken into consideration for prevention programs, counseling and crisis interventions.

Abstract Abstract
The aim of the study was to examine effectiveness of group
logotherapy on reducing depression and increasing hope in elderly
with empty nest syndrome living in city of Ghorveh. The study
employed a quasi-experimental design with pretest and posttest and a
control group. The statistical population included all men and women
living in Ghorveh whose children had left them. The sample group
consisted of 24 individuals who were selected using convenient
sampling. Data were collected using the 21-item Beck Depression
Inventory (BDI II) and Snyder’s Adult Hope Scale (AHS). The data
were analyzed using descriptive and inferential statistics (covariance
analysis). The results showed that the average posttest depression
score was significantly lower in the experimental group than the
control group, and that the average posttest hope score was
significantly higher in the experimental group. The findings suggest
that group logotherapy has positive effects in reducing depression and
increasing hope in elderly with empty nest syndrome