Clinical Psychology Studies

Abstract Introduction and Objective: The present study aimed to investigate the mediating roles of rumination and health anxiety in the relationship between intolerance of uncertainty and both cyberchondria and obsessive–compulsive symptoms. The study was grounded in cognitive–emotional models that highlight the contribution of maladaptive beliefs and dysfunctional information-processing styles to the development of health-related psychological disorders. Research Methodology: This research employed a descriptive, correlational design. The statistical population consisted of all university students in Tabriz. A total of 414 participants were recruited using convenience sampling. Participants completed standardized self-report measures assessing intolerance of uncertainty, rumination, health anxiety, cyberchondria, and obsessive–compulsive symptoms. Structural equation modeling was conducted to test the hypothesized relationships among variables. Findings: The proposed structural model demonstrated a very good fit to the data (CFI = 0.94, TLI = 0.92, RMSEA = 0.08). The findings indicated that intolerance of uncertainty was indirectly associated with higher levels of cyberchondria and obsessive–compulsive symptoms through increased rumination and health anxiety. Both mediators significantly contributed to the strength of these indirect pathways. Conclusion: The results emphasize the critical role of maladaptive cognitive styles and emotion regulation processes in the development of health-related psychological difficulties. Targeting intolerance of uncertainty, rumination, and health anxiety may be essential in prevention and intervention programs addressing cyberchondria and obsessive–compulsive symptomatology.

Abstract Introduction and Objective: Adolescence is a critical developmental period marked by substantial biological, psychological, and social changes. These changes generate multiple challenges that may significantly affect adolescents’ physical and mental health. The present study aimed to develop a model of vulnerability factors among adolescent boys in coping with the challenges of adolescence.
Research Methodology: This qualitative study was conducted using a grounded theory approach. The sample consisted of 12 students from Allameh Tabataba’i University in Tehran in 2024, who were selected through purposive sampling based on the principle of theoretical saturation. Data were collected through semi-structured interviews and analyzed using the Strauss and Corbin method.
Findings: The findings yielded 42 open codes and 10 axial codes, including: lack of parental emotional support, informational guidance deficit, sexual challenges, emotional relationships with the opposite sex, unresolved struggles for autonomy, problem-solving–reducing coping strategies, exacerbating strategies, negative emotions and behaviors, feelings of guilt and confusion, and lack of self-acceptance.
Conclusion: The results indicated that lack of parental support, combined with insufficient environmental information, intensifies the pressures experienced by adolescent boys, leading to reduced self-acceptance and increased negative emotions and behaviors. It can therefore be concluded that inadequate parental support and limited awareness contribute significantly to the psychological and social vulnerability of adolescent boys.

Abstract Introduction and Objective: Substance use disorders, particularly heroin dependence, are frequently associated with heightened cue reactivity and altered pain perception, underscoring the need for evidence-based psychological interventions targeting these mechanisms. The present study aimed to compare the effectiveness of Acceptance and Commitment Therapy (ACT) and Mindfulness-Based Cognitive Therapy (MBCT) on drug cue–induced visual stimuli and pain perception among heroin users residing in the Karamat Rehabilitation Camp of Mobarakeh County during the 2023–2024 period.
Research Methodology: This study employed a quasi-experimental design with a mixed (between–within) repeated-measures approach, including pretest, posttest, and follow-up assessments. The statistical population consisted of approximately 400 heroin users undergoing a six-month residential treatment program. A total of 90 participants were selected through purposive sampling and randomly assigned to three groups (n = 30 per group): ACT, MBCT, and a control group. Inclusion criteria were an age range of 30–50 years, literacy sufficient for questionnaire completion, heroin use, the presence of physical pain, and commitment to a six-month residential stay. Exclusion criteria included concurrent use of multiple psychoactive substances, medication use during the study period, age below 30 or above 50 years, nonadherence to treatment protocols, participation in other psychotherapeutic interventions, and absence from more than two sessions. Data were collected using the McGill Pain Questionnaire (MPQ; 1977) and the Drug Cue–Induced Visual Stimuli Questionnaire (Ekhtiari, 2006). Statistical analyses were conducted using repeated-measures analysis of variance (ANOVA) with a mixed-design approach in SPSS version 24.
Findings: The results indicated that Acceptance and Commitment Therapy was significantly effective in reducing drug cue–induced visual stimuli, whereas Mindfulness-Based Cognitive Therapy significantly improved pain perception.
Conclusion: These findings suggest that MBCT is a more effective intervention for managing pain perception, while ACT is more effective in reducing drug cue reactivity among heroin users.

Abstract Introduction and Objective: Complex childhood trauma can lead to significant psychological consequences in adulthood, among which distress tolerance is particularly important. Accordingly, the present study aimed to compare the effectiveness of Emotion-Focused Therapy (EFT) and Integrated Spiritual Therapy on distress tolerance in individuals with complex trauma. Research Methodology: The study employed a quasi-experimental design with a pretest–posttest control group and a two-month follow-up. Participants were selected from clients with a history of complex trauma (emotional and physical neglect, and emotional, physical, and sexual abuse) who had been assessed at the Kish Health Center in 2023. Sample size was estimated using Cohen’s table with an effect size of 0.5, statistical power of 0.80, and α = 0.05, resulting in three groups. Among eligible participants, 36 individuals were selected and randomly assigned to two experimental groups and one control group (Experimental 1, Experimental 2, and Control), with 12 participants in each group. Initially, the Difficulties in Emotion Regulation Questionnaire was administered to all groups. Experimental Group 1 received ten 90-minute sessions of Emotion-Focused Therapy, while Experimental Group 2 received ten 90-minute sessions of Integrated Spiritual Psychotherapy. The control group received no intervention. After completion of the interventions, all groups completed the Distress Tolerance Questionnaire as a posttest. Findings: The findings indicated that Emotion-Focused Therapy was more effective than Integrated Spiritual Therapy in increasing distress tolerance among individuals with complex trauma. Furthermore, the effects of the interventions remained stable at the follow-up stage (p < 0.01). Conclusion: Based on the findings, Emotion-Focused Therapy can be considered a valuable intervention for managing distress in patients with complex trauma and may be recommended for use in clinical and psychological treatment centers.

Abstract Introduction and Objective: Bipolar disorder is a chronic and progressive mood disorder that leads to severe problems in a person's social and occupational functioning. The purpose of this research was to investigate the effect of the group cognitive behavioral therapy on the cognitive emotion regulation and the quality of life of women with bipolar I.
Research Methodology: The research design was semi-experimental with pre-test and post-test with experimental and unmathched control groups. The statistical population of the present study included all female suffering from bipolar I disorder. Using the purposeful sampling method, there were 30 people in two experimental groups (15 people) and control (15 people) were completely randomly replaced. Subjects completed cognitive emotion regulation Garnefsky (2006) and WHO quality of life questionnaire (1989). The experimental group received 8 sessions cognitive behavioral therapy group. Both groups completed the questionnaires in two stages before and after the intervention. Unitivariate Analysis of Covariance was used to analyze the data.
Findings: The findings indicated that group cognitive-behavioral therapy had a significant effect on the Improving adaptive and reducing maladaptive strategies of cognitive emotion regulation (p<0.01), also, it had a significant effect on quality of life of the people with bipolar disorder type 1 (p<0.05).
Conclusion: The result of this study showed that cognitive behavioral therapy group training is effective in terms of cognitive regulation of emotions and quality of life of people with bipolar disorder type 1 and this treatment method can be used to improve emotional regulation and increase the quality of life of bipolar patients.

Abstract Introduction and Objective: The present study aimed to investigate the role of Cognitive abilities in predicting rational decision-making among adolescents, considering the mediating role of emotional intelligence and moral judgment. Rational decision-making, as one of the key processes of cognitive development in adolescence, plays a crucial role in personal, social, and academic adjustment. Given that adolescence is accompanied by extensive biological, cognitive, and emotional changes, identifying underlying factors influencing rational decision-making is of particular importance.
Research Methodology: This study employed a quantitative, correlational design using structural equation modeling (SEM). The statistical population consisted of lower secondary school students in Yazd during the 2024–2025 academic year, from which a sample was selected through cluster random sampling. Research instruments included the General Decision-Making Styles Questionnaire (GDMS), the Cognitive Functions Questionnaire, the Trait Emotional Intelligence Questionnaire–Short Form (TEIQue-SF), and the Moral Judgment Questionnaire. Data were analyzed using AMOS-24 software.
Findings: Findings indicated that Cognitive abilities directly predicted rational decision-making (β=0.17, P<0.05). Furthermore, emotional intelligence and moral judgment significantly mediated this relationship (β=0.308, P<0.002). In other words, adolescents with higher Cognitive abilities also demonstrated higher levels of emotional intelligence and moral judgment, which in turn contributed to the enhancement of their rational decision-making.
Conclusion: The results highlight the importance of an integrated approach to cognitive, emotional, and moral processes in understanding adolescent decision-making and may provide a basis for designing educational and counseling interventions aimed at improving adolescents’ decision-making skills.