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فناوری‌های جدید، دورپزشکی و دور روانپزشکی E-Health, Telemedicine and Telepsychiatry 1 1 این مقاله نامه به سردبیر است و فاقد چکیده فارسی می باشد. Rapid technological progresses have affected different aspects of human life such as healthcare, and have resulted in formation of new medical terms such as “electronic health (e-health)” and “telemedicine”. E-health is providing healthcare services through electronic media, and “telemedicine” as one of the subsets of e-health, are those medical services which can be provided though live, interactive, and mutual televideo communication between the patient and the physician. The inclusion criteria have to be specified based on medical needs, applicability, cost-effectiveness, and the clinical condition of the patient. The allocated bandwidth, should also be considered. Researches have shown that effective optimal clinical care is the most important keyfactor in providing successful outcomes by telemedicine, and the role of updated equipment and facilities are insignificant in this regard. Telemedicine has also been successfully used in mental health care systems. “Telepsychiatry” is defined as the implication of telemedicine in mental health and psychiatric services, and “telepsychiatrist” is the psychiatrist who provides telepsychiatric services via electronic communication to residences of remote areas. Telepsychiatry is applicable in all age ranges and developmental and cognitive levels, and can be used in clinical evaluation and assessment, diagnosis, treatment, medical education, consultation, forensics, and emergency care, in a variety of mental disorders. Besides current barriers for implementing telemedicine in the mainstream of clinical practice, it seems that the rapid development of technology, will make the use of telemedicine in the medical and healthcare systems widespread and even inevitable. 2 Rapid technological progresses have affected different aspects of human life such as healthcare, and have resulted in formation of new medical terms such as “electronic health (e-health)” and “telemedicine”. E-health is providing healthcare services through electronic media, and “telemedicine” as one of the subsets of e-health, are those medical services which can be provided though live, interactive, and mutual televideo communication between the patient and the physician. The inclusion criteria have to be specified based on medical needs, applicability, cost-effectiveness, and the clinical condition of the patient. The allocated bandwidth, should also be considered. Researches have shown that effective optimal clinical care is the most important keyfactor in providing successful outcomes by telemedicine, and the role of updated equipment and facilities are insignificant in this regard. Telemedicine has also been successfully used in mental health care systems. “Telepsychiatry” is defined as the implication of telemedicine in mental health and psychiatric services, and “telepsychiatrist” is the psychiatrist who provides telepsychiatric services via electronic communication to residences of remote areas. Telepsychiatry is applicable in all age ranges and developmental and cognitive levels, and can be used in clinical evaluation and assessment, diagnosis, treatment, medical education, consultation, forensics, and emergency care, in a variety of mental disorders. Besides current barriers for implementing telemedicine in the mainstream of clinical practice, it seems that the rapid development of technology, will make the use of telemedicine in the medical and healthcare systems widespread and even inevitable. 266 269 2017/03/12 1395/12/22 2017/01/1 1395/10/12 الهام شیرازی Elham Shirazi روانپزشک، دانشیار، دانشکده علوم رفتاری و سلامت روان )انستیتو روانپزشکی تهران( مرکز تحقیقات بهداشت روان، دانشگاه علوم پزشکی و خدمات بهداشت یدرمانی ایران، تهران، ایران. ایران Email:shirazi.e@iums.ac.ir میترا حکیم شوشتری Mitra Hakim Shooshtari روانپزشک، دانشیار، دانشکده علوم رفتاری و سلامت روان )انستیتو روانپزشکی تهران( مرکز تحقیقات بهداشت روان، دانشگاه علوم پزشکی و خدمات بهداشت یدرمانی ایران، تهران، ایران. ایران محمدرضا شالبافان Mohammadreza Shalbafan روانپزشک، استادیار، مرکز تحقیقات بهداشت روان، دانشگاه علوم پزشکی و خدمات بهداشت یدرمانی ایران، تهران، ایران. ایران فاطمه هادی Fatemeh Hadi روانپزشک، استادیار، مرکز تحقیقات بهداشت روان، دانشگاه علوم پزشکی و خدمات بهداشت یدرمانی ایران، تهران، ایران. ایران رضا بیدکی Reza Bidaki روانپزشک، دانشیار، مرکز تحقیقات اعتیاد و علوم رفتاری، دانشگاه علوم پزشکی و خدمات بهداشت یدرمانی شهیدصدوقی یزد، یزد، ایران. ایران Telemedicine Telepsychiatry Telemedicine Televideo communication فناوری‌های جدید دورپزشکی و دور روانپزشکی 1.Hersh WR, Hickam DH, Severance SM, Dana TL, Krages KP, Helfand M. Diagnosis, access and outcomes: Update of a systematic review of telemedicine services. Journal of Telemedicine and Telecare. 2006; 12(2):3–31. doi: 10.1258/135763306778393117##2.Myers K, Cain S. Practice parameter for telepsychiatry with children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry. 2008; 47(12):1468–83. doi: 10.1097/chi.0b013e31818b4e13##3.Shore JH. Telepsychiatry: Videoconferencing in the delivery of psychiatric care. American Journal of Psychiatry. 2013; 170(3):256–62. doi: 10.1176/appi.ajp.2012.12081064##4.Brown NA. State medicaid and private payer reimbursement for telemedicine: An overview. Journal of Telemedicine and Telecare. 2006; 12(2):32–9. doi: 10.1258/135763306778393108##5.Hilty DM, Yellowlees PM, Cobb HC, Neufeld JD, Bourgeois JA. Use of secure e-mail and telephone: Psychiatric consultations to accelerate rural health service delivery. Telemedicine and E-Health. 2006; 12(4):490–5. doi: 10.1089/tmj.2006.12.490##6.Gibson KL, Coulson H, Miles R, Kakekakekung C, Daniels E, O'donnell S. Conversations on telemental health: Listening to remote and rural first nations communities. Rural and Remote Health. 2011; 11(2):1656-74.##7.Siemer CP, Fogel J, Van Voorhees BW. Telemental health and web-based applications in children and adolescents. Child and Adolescent Psychiatric Clinics of North America. 2011; 20(1):135–53. doi: 10.1016/j.chc.2010.08.012##8.Deslich S. Telepsychiatry in correctional facilities: Using technology to improve access and decrease costs of mental health care in underserved populations. Permanente Journal. 2013; 17(3):80–6. doi: 10.7812/tpp/12-123##9.Chakrabarti S. Usefulness of telepsychiatry: A critical evaluation of videoconferencing-based approaches. World Journal of Psychiatry. 2015; 5(3):286.-304.##10.Hilty DM, Ferrer DC, Parish MB, Johnston B, Callahan EJ, Yellowlees PM. The effectiveness of telemental health: A 2013 review. Telemedicine and E-Health. 2013; 19(6):444–54. doi: 10.1089/tmj.2013.0075## 11.Mazhari S, Bahaedin Beigi K. [Telepsychiatry and its application in Iran (Persian)]. Iranian Journal of Psychiatry and Clinical Psychology. 2012; 17(4):336-8.##12.Clarke G, Yarborough BJ. Evaluating the promise of health IT to enhance/expand the reach of mental health services. General Hospital Psychiatry. 2013; 35(4):339–44. doi: 10.1016/j.genhosppsych.2013.03.013##13.Gros DF, Morland LA, Greene CJ, Acierno R, Strachan M, Egede LE, et al. Delivery of evidence-based psychotherapy via video telehealth. Journal of Psychopathology and Behavioral Assessment. 2013; 35(4):506–21. doi: 10.1007/s10862-013-9363-4.##14.Shirazi E. Telemedicine in child and adolescent psychiatry. Paper presented at: The Iranian 6th International Congress of Child and Adolescent Psychiatry. 17-19 September 2013; Tabriz, Iran.##15.Boydell KM, Volpe T, Pignatiello A. A qualitative study of young people’s perspectives on receiving psychiatric services via televideo. Journal of the Canadian Academy of Child and Adolescent Psychiatry. 2010; 19(1):5–11. PMCID: PMC2809440##16.Williams TL, May CR, Esmail A. Limitations of patient satisfaction studies in telehealthcare: A systematic review of the literature. Telemedicine Journal and E-Health. 2001; 7(4):293–316. doi: 10.1089/15305620152814700##17.Hyler SE, Gangure DP, Batchelder ST. Can telepsychiatry replace in-person psychiatric assessments? A review and meta-analysis of comparison studies. 2005; 10(5):403–15. doi: 10.1017/s109285290002277x.##18.Cuevas CDL, Arredondo MT, Cabrera MF, Sulzenbacher H, Meise U. Randomized clinical trial of telepsychiatry through video## 19.conference versus face-to-face conventional psychiatric treatment. Telemedicine and E-Health. 2006; 12(3):341–50. doi: 10.1089/tmj.2006.12.34## ##

نقش ذهن آگاهی، تنظیم هیجانی، تحمل پریشانی و ارتباط مؤثر با دیگران در پیش بینی نشانه های وسواسی جبری The Role of Mindfulness, Emotion Regulation, Distress Tolerance and Interpersonal Effectiveness in Predicting Obsessive-Compulsive Symptoms 1 1 اهداف: هدف پژوهش حاضر، بررسی نقش پیش‌بینی‌کننده ذهن‌آگاهی، تنظیم هیجانی، تحمل پریشانی و ارتباط مؤثر با دیگران (از طریق کنترل اثر متغیرهای جمعیت‌شناختی، افسردگی و اضطراب)، به‌طور اختصاصی برای انواع نشانه‌های وسواسی‌جبری بود. مواد و روش ها: این پژوهش با استفاده از روش همبستگی انجام شد. 240 نفر از دانشجویان دانشگاه علوم پزشکی تهران به روش نمونه‌گیری طبقه‌ای نسبی در این پژوهش شرکت کردند. داده‌ها از طریق پرسش‌نامه‌های پنج‌وجهی ذهن‌آگاهی (FFMQ)، تحمل پریشانی (DTS)، دشواری‌های تنظیم هیجان (DERS)، هوش هیجانی بار- ان (BEQI)، اضطراب، افسردگی و استرس (DASS-21)، وسواسی‌جبری (OCI-R) و اطلاعات جمعیت‌شناختی گردآوری شدند. داده‌ها با روش‌های همبستگی و رگرسیون سلسله مراتبی و با استفاده از نسخه 19 نرم‌افزار SPSS تحلیل شدند. یافته ها: بیشترین ضرایب همبستگی بین وسواس فکری با نمره کل ذهن‌آگاهی (r=-0/47)، نمره کل تنظیم هیجان (r=0/56)، نمره کل خرده‌مقیاس جذب از مؤلفه تحمل پریشانی (r=-0/38)، نمره کل ارتباط مؤثر با دیگران (r=-0/43)، نمره کل افسردگی (r=0/49) و نمره کل نشانه‌های وسواسی‌جبری با اضطراب (r=0/50) بود. نتایج تحلیل رگرسیون نشان داد که متغیرهای کنترل و پیش‌بین پژوهش توانستند 43درصد از واریانس نمره کل نشانه‌های وسواسی جبری، 27درصد از واریانس وسواس شست‌وشو، 49درصد از واریانس وسواس فکری، 22درصد از واریانس وسواس انباشت، 8درصد از واریانس وسواس نظم‌وترتیب، 32درصد از واریانس وسواس وارسی و 45درصد از واریانس وسواس خنثی‌سازی را تبیین کنند. نتیجه گیری :متغیرهای پیش‌بین و کنترل، در پیش‌بینی نمره کل نشانه‌های وسواسی جبری و انواع وسواس نقش داشتند. اگرچه در انواع وسواس، متغیرهای متفاوتی نقش داشتند که حاکی از آسیب‌شناسی متفاوت در انواع وسواس است. بیشترین ارتباط همبستگی و درصد واریانس تبیین‌شده توسط این متغیرها، در مورد وسواس فکری بود. همچنین نتایج این پژوهش نقش قابل توجه اضطراب و افسردگی را در پیش‌بینی انواع وسواس نشان داد، به‌طوری‌که درصد وزنی آن‌ها در مدل‌های رگرسیون انواع وسواس، از متغیرهای پیش‌بین بالاتر بود که ضرورت توجه به این متغیرها در پژوهش و درمان اختلال و نشانه‌های وسواس را برجسته می‌کند. 2 Objectives: The aim of present study was to investigate the predictive role of Mindfulness, Emotion regulation, Distress tolerance, Interpersonal effectiveness (by controlling the effects of demographic variables, depression and anxiety). Methods: The study design was correlational. A total of 240 students of Tehran University of Medical Sciences were selected using stratified proportional sampling method. Data were collected using five facet mindfulness questionnaire (FFMQ), Distress Intolerance scale(DTS), Difficulties in Emotion Regulation Scale (DERS), Bar-On Emotional Quotient Inventory (BEQI), Depression, Anxiety and Stress Scale -21 (DASS -21), Obsessive- Compulsive Inventory – Revised (OCI-R) and demographic data questionnaire. The gathered data was analyzed using Pearson correlation and hierarchical regression Results: The highest correlation relationships was between obsession sub-type with total score of mindfulness (r=-0.47), total score of emotion regulation (r=0.56), absorption sub-scale of distress tolerance (r=-0.38), total score of interpersonal effectiveness (r=-0.43), total score of depression (r=0.49), and total score of obsessive-compulsive symptoms with anxiety (r=0.5). The results of regression analysis indicated that control and predictive variables account for 43% of obsessive-compulsive symptoms variance, 27% of washing variance, 49% of obsessing variance, 22% of hoarding variance, 8% of ordering variance, 32% of checking variance, and 45% of neutralizing variance. So that their weight percentages in models of all OCDs were higher than the predictor variables. This highlights the necessity of considering these variables in research and treatment of the symptoms of obsessive-compulsive disorder. Theoretical and clinical implications of the results have been discussed in detail. Conclusions :Control and predictive variables play a role in the prediction of the total score of obsessive-compulsive symptoms and all sub-types. However, different variables involved in sub-types may be considered as distinctive pathology among sub-types. The highest correlation relationship and accounted variance through study variables were in the case of obsessing. The results also indicate the noticeable role of depression and anxiety in the prediction of all sub-types. 270 283 2017/03/122017/03/12 1395/12/22 2017/01/12017/01/1 1395/10/12 علی حسین اسفندزاد Ali Hosein Esfand Zad گروه روانپزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی تهران ایران E-mail: aliesfandzad@gmail.com گیتی شمس Giti Shams گروه روانپزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی تهران ایران علی پاشا میثمی Ali Pasha Meysami گروه پزشکی اجتماعی، دانشکده پزشکی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی تهران ایران عارفه عرفان Arefeh Erfan گروه روانپزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی تهران ایران Obsessive-compulsive symptoms Mindfulness Emotional regulation Distress tolerance Interpersonal effectiveness تحمل پریشانی تنظیم هیجان ارتباط مؤثر با دیگران ذهن آگاهی نشانه های وسواسی جبری Sadock B, Sadock V, Ruiz P. Kaplan and Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry. 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کارکرد خانواده ادراک شده و افکار خودکشی دانشجویان: نقش تعدیل کننده ناامیدی Perceived Family Functioning and Suicidal Ideation Among University Students: Hopelessness as a Moderator 1 1 هدف پژوهش حاضر به دنبال پاسخگویی به این پرسش است که بر اساس رابطه موجود میان کارکرد خانواده و افکار خودکشی از یک سو و رابطه کارکرد خانواده و ناامیدی از سوی دیگر، آیا می‌توان فرض کرد در رابطه میان کارکرد خانواده و افکار خودکشی ناامیدی به شکل تعدیل‌کننده عمل می‌کند؟ روش روش پژوهش حاضر از نوع همبستگی است. جامعه آماری شامل دانشجویان ساکن خوابگاه در دانشگاه شهیدبهشتی در سال 1393 است که از میان آن‌ها 373 دانشجو به‌صورت در دسترس انتخاب و با استفاده از ابزارهای خودگزارش‌دهی سنجیده شدند. پس از اجرای پرسش‌نامه‌های ابزار سنجش خانواده (FAD)، مقیاس ناامیدی بک (BHS) و مقیاس افکار خودکشی بک (BSS)، داده‌های به‌دست‌آمده با استفاده از نسخه 19 نرم‌افزار SPSS و به روش همبستگی و رگرسیون سلسله‌مراتبی چندگانه تحلیل شد. یافته ها نتایج این تحلیل نشان داد که بین ادراک کارکرد کلی خانواده و ناامیدی (001/0,P≤ 40/0=r)، ادراک کارکرد کلی خانواده و افکار خودکشی (001/0،P≤43/0=r) و بین ناامیدی و افکار خودکشی دانشجویان (001/0،P≤ 63/0=r) همبستگی مثبت معناداری وجود دارد. یافته مهم دیگر این پژوهش، تأیید نقش تعدیل‌کننده ناامیدی است. نتیجه گیری رابطه ادراک کارکرد کلی خانواده و افکار خودکشی در سطوح بالای ناامیدی بیشتر می‌شود، درحالی‌که در سطوح پایین ناامیدی این رابطه چشمگیر نیست. 2 Objectives: The present study aims to determine whether the association between family function and suicidal ideation on one hand and correlation of family functions and hopelessness on the other hand can be supposed that hopelessness acts as a moderator in the association between family functions and suicidal ideation. Methods: For this, 373 accessible Shahid Beheshti students were selected and measured with self-reporting means. After performing Family Assessment Devices, Beck Hopelessness Scale and Beck scale for suicidal ideation, the gathered data were analyzed through simple correlation and hierarchical regression by SPSS 19. Results: There are significant positive correlations between understanding total family function and hopelessness, family function and suicidal ideation and also between hopelessness and suicidal ideation of students. Therefore, hopelessness has a moderating role in the association between understanding family function and suicidal ideation. Conclusions: The association between family function and suicidal ideation increases at higher levels of hopelessness while in lower levels of hopelessness, this association is not significant. 284 291 2017/03/122017/03/122017/03/12 1395/12/22 2017/01/12017/01/12017/01/1 1395/10/12 اسدالله اکبری Asadollah Akbari گروه روانشناسی بالینی دانشکده علوم تربیتی و روانشناسی، دانشگاه شهیدبهشتی ایران لیلی پناغی Leili Panaghi پژوهشکده خانواده، دانشگاه شهیدبهشتی ایران E-mail: panaghi@sbu.ac.ir مجتبی حبیبی Mojtaba Habibi دانشکده علوم رفتاری و سلامت روان (انستیتو روانپزشکی تهران) ایران منصوره سادات صادقی Mansoure Alsadat Sadeghi پژوهشکده خانواده، دانشگاه شهیدبهشتی ایران Suicidal ideation Family function Hopelessness افکار خودکشی کارکرد خانواده ناامیدی Greenberger E, McLaughlin CS. Attachment, coping and explanatory Style in late adolescence. Journal of Youth and Adolescence. 1998; 27(2):121-139. doi: 10.1023/a:1021607627971##McCarthy CJ, Moller NP, Fouladi RT. Continued attachment to parents: Its relationship to affect regulation and perceived stress among college students. Measurement & Evaluation in Counselling and Development. 2001; 33(4):198-212.##Chang EC. Cultural differences, perfectionism, and suicidal risk in a college population: Does social problem solving still matter? Cognitive Therapy & Research. 1998; 22(3):237-254. doi: 10.1007/s10608-015-9711-7##Panaghi L, Ahmadabadi Z, Peiravi H, Abolmasoomi FZ. [Suicide trend in university students during 2003 to 2008 (Persian)]. Iranian Journal of Practice in Clinical Psychology. 2010; 16(2):87-98##Westefeld JS, Range LM, Rogers JR, Maples MR, Bromley JL, Alcorn J. Suicide: An Overview. Counselling Psychologist. 2000; 28(4):445-510. doi: 10.1177/0011000000284002##Kwok SY. Perceived family functioning and suicidal ideation: Hopelessness as mediator or moderator. Nursing Research. 2011; 60(6):422-429. doi: 10.1097/nnr.0b013e31823585d6##Dour HJ, Cha CB, Nock MK. Evidence for an emotion–cognition interaction in the statistical prediction of suicide attempts. Behaviour Research & Therapy. 2011; 49(4):294–8. doi: 10.1016/j.brat.2011.01.010##Wagner BM, Silverman MA, Martin CE. Family factors in youth suicidal behaviors. American Behavioral Scientist. 2003; 46(9):1171-91. doi: 10.1177/0002764202250661##Beck AT, Steer RA, Kovacs M, Garrison B. Hopelessness and eventual suicide: A 10-year prospective study of patients hospitalized with suicidal ideation. American Journal of Psychiatry. 2011; 142(5):559-63. doi: 10.1176/ajp.142.5.559##Durant T, Mercy J, Kresnow MJ, Simon T, Potter L, Hammond WR. Racial differences in hopelessness as a risk factor for a nearly lethal suicide attempt. Journal of Black Psychology. 2006; 32(3):285-302. doi: 10.1177/0095798406290468##Rotheram-Borus MJ, Trautman PD. Hopelessness, depression, and suicidal intent among adolescent suicide attempters. Journal of the American Academy of Child & Adolescent Psychiatry. 1988; 27(6):700-704. doi: 10.1097/00004583-198811000-00006##Van Heeringen C, Audenaert K, Van Laere K, Dumont F, Slegers G, Mertens J, Dierckx RA. Prefrontal 5-HT< sub> 2a</sub> receptor binding index, hopelessness and personality characteristics in attempted suicide. Journal of Affective Disorders. 2003; 74(2):149-158. doi: 10.1016/s0165-0327(01)00482-7##Shek, DTL. Assessment of family functioning in Chinese adolescents: The Chinese version of the Family Assessment Device. Research on Social Work Practice. 2002; 12(4):502-524. doi: 10.1177/1049731502012004003##King CA, Segal HG, Naylor M, Evans T. Family functioning and suicidal behavior in adolescent inpatients with mood disorders. Journal of the American Academy of Child & Adolescent Psychiatry. 1993; 32(6):1198-1206.‌ doi: 10.1097/00004583-199311000-00013##Garrison CZ, Addy CL, Jackson KL, McKeown RE, & Waller JL. 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[Family function of AD/HD children (Persian)] [PhD thesis]. Tehran: University of Social Welfare & Rehabilitation Sciences; 2003.##Beck AT, Weissman A, Lester D, Trexler L. The measurement of pessimism: The hopelessness scale. Journal of Consulting & Clinical Psychology. 1974; 42(6):861-65. PMID: 4436473##Beck AT, Steer RA. Manual for the Beck hopelessness scale. San Antonio, TX: Psychological Corporation; 1988.##Perczel Forintos D, Sallai J, Rózsa. Adaptation of the Beck Hopelessness Scale in Hungary. Psychological Topics. 2010; 19(2):307-321.‌##Hanna D, White R, Lyons K, McParland J, Shannon C, Mulholland C. The structure of the Beck Hopelessness Scale: A confirmatory factor analysis in UK students. Personality and Individual Differences. 2011; 51(1):17-22. doi: 10.1016/j.paid.2011.03.001##Steed L. Further validity and reliability evidence for Beck Hopelessness Scale scores in a nonclinical sample. 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ارتباط بین ابعاد فرزندپروری ادراکشده و سبکهای هویتی با شدت افسردگی در نوجوانان Relationship Between Perceived Parenting Styles and Identity Styles With Intensity of Depression in Adolescents 1 1 هدف :پژوهش حاضر با هدف بررسی رابطه ابعاد فرزندپروری ادراک‌شده و سبک‌های هویتی با شدت افسردگی نوجوانان انجام شده است. روش  :در این پژوهش دانش آموزان مقطع دبیرستان شهرستان‌های استان تهران در قالب یک طرح همبستگی به شیوه مقطعی، 200 نفر از نوجوانان با سن 14 تا 18 سال به شیوه نمونه‌گیری خوشه‌ای انتخاب شدند. از شرکت‌کنندگان خواسته شد به مقیاس‌های افسردگی بک-2(BDI-II) و سیاهه سبک هویتی(ISI) و ابعاد فرزندپروری ادراک‌شده ((PSQ) ) پاسخ دهند. برای تحلیل آماری داده‌ها از از نرم افزار SPSS نسخه 20 و همبستگی پیرسون و رگرسیون گام‌به‌گام استفاده شد. یافته ها: نتایج نشان داد ابعاد فرزندپروری ادراک‌شده و سبک‌های هویتی با شدت افسردگی در نوجوانان رابطه معناداری دارد. به‌طوری‌که متغیرهای پیش‌بین تعهد هویت و بُعد فرزندپروری پذیرش یا طرد و بُعد فرزندپروری کنترل آزادی با ضریب همبستگی 50/0 در ارتباط با شدت افسردگی در نوجوانان توانست در مجموع 25/0 از واریانس شدت افسردگی نوجوانان را تبیین کند (25/0=R2). نتیجه گیری: به نظر می‌رسد تعهد هویت و سبک فرزندپروری مبتنی بر پذیرش والدین دو متغیر مهم در پیشگیری از افسردگی در نوجوانان است. از آنجا که شیوه‌های فرزندپروری و ارتباط والد و نوجوان مهارتی قابل آموزش است و آسیب‌های ناشی از افسردگی در نوجوانان نیز بسیار زیاد است، توجه به آموزش این موضوع در سطح کاربردی اهمیت خاصی دارد. 2 Objectives: The aim of this study was to examine the relationship between identity styles and dimensions of perceived parenting with the intensity of depression in adolescents. Methods: In a correlation design, 200 (100 girls and 100 boys) students aged 14-18 years were selected from Tehran high schools using cluster sampling. Participants were asked to complete Beck Depression Inventory-2 (BDI-2), Parenting Style Questionnaire (PSQ) and Identity Styles Inventory (ISI) questionnaires. Data were analyzed using Pearson correlation and step-by-step regression (stepwise). Results: Significant relationship was found to exist among the dimensions of perceived parenting and identity style along with depressive intensity. Additionally, predictor variables including identity commitment, dimensions of acceptance, and control parenting with correlation (r=0.50) could predict 0.25 percent of depressive intensity among adolescents (25.0=2R). Conclusions: It seems that identity commitment and parenting style based on parent acceptance among adolescents are two important variables in preventing depressive symptoms. Parenting style and adolescent parent communication are acceptable skills. In addition, the pathology resulting from depression among the adolescents was high, so it is important to address this problem practically. 292 299 2017/03/122017/03/122017/03/122017/03/12 1395/12/22 2017/01/12017/01/12017/01/12017/01/1 1395/10/12 امین سهراب زاده فرد Amin Sohrabzadeh Fard گروه روانشناسی بالینی، دانشکده علوم رفتاری و سلامت روان، دانشگاه علوم پزشکی ایران ایران بنفشه غرایی Banafsheh Gharraee گروه روانشناسی بالینی، دانشکده علوم رفتاری و سلامت روان(انستیتو روانپزشکی تهران)، دانشگاه علوم پزشکی ایران ایران E-mail: gharraee.b@iums.ac.ir علی اصغر اصغرنژاد فرید Ali Asghar Asgharnejad Farid گروه روانشناسی بالینی، دانشکده علوم رفتاری و سلامت روان(انستیتو روانپزشکی تهران)، دانشگاه علوم پزشکی ایران ایران اسماء عاقبتی Asma Aghebati گروه روانشناسی بالینی، دانشکده علوم رفتاری و سلامت روان(انستیتو روانپزشکی تهران)، دانشگاه علوم پزشکی ایران ایران Parenting Identity Depressive Adolescent فرزندپروری سبکهای هویتی افسردگی نوجوانان Yap MBH, Pilkington PD, Ryan SM, Jorm AF. 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تبیین علل کاهش پاسخگویی رضایتبخش جنسی در زنان متأهل در سنین باروری: یک تحقیق کیفی Exploring the Reducing Satisfactory Response in Married Women of Reproductive Age: Qualitative Study 1 1 هدف:  رابطه جنسی تعاملی دوطرفه است که برای ارتقای کیفیت آن، تعامل بهینه هر دو طرف رابطه نیاز است. یکی از مشکلات در روابط جنسی زوج‌ها، عدم رضایتمندی زن به رابطه است. نارضایتی در صورتی است که انتظار و درخواست صرفاً از جانب مرد مطرح شود. هدف این مقاله تبیین علل کاهش پاسخگویی رضایت‌بخش جنسی زنان متأهل در مقابل درخواست جنسی همسر است. مواد و روش‌ها: در این پژوهش برای تبیین و تحلیل رفتارهای جنسی زنان متأهل در سنین باروری از روش کیفی و رویکرد تحلیل محتوا استفاده شده است. جامعه پژوهش شامل تمام زنان متأهل در سنین باروری در شهرهای رفسنجان و اصفهان بودند. نمونه‌های پژوهش به روش نمونه‌گیری هدفمند انتخاب شدند. 52 نفر از گروه هدف در شهرهای رفسنجان و اصفهان بودند که در 4 مصاحبه فردی عمیق و 8 گروه متمرکز متشکل از 48 شرکت‌کننده به‌طور داوطلبانه شرکت کردند. اطلاعات حاصل از مصاحبه‌های نیمه‌ساختاریافته، ضبط و تایپ شد. داده‌ها به روش تحلیل محتوای قراردادی به سبک گرانهایم تجزیه‌وتحلیل شد. یافته‌ها: از داده‌های تحقیق درباره علل کاهش پاسخگویی رضایت‌بخش جنسی زنان، سه معنای اصلی پیش‌نیاز توجه و محبت و انحراف از معیارهای طرح‌واره جنسی و خواست‌های فردی استخراج شد. نتیجه‌گیری: برای ارتقای سلامت جنسی زنان و به‌ویژه ارتقای کیفیت زندگی زناشویی لازم است که متخصصان حوزه سلامت جنسی به تغییرات رفتارهای جنسی زنان و توقعات وانتظارات و اقتدار جنسی آنان توجه کنند. پیشنهاد می‌شود این‌ نکات در آموزش‌های جنسی قبل و حین ازدواج برای زنان و مردان لحاظ شوند. 2 Objectives: Sexual relationship is a mutual interaction, which its promotion requires appropriate contribution of both  partners. Given the complaints of lack of female contribution in sexual relationships where the male is the initiator, this article aims at exploring the roots of not being responsive toward male sexual request in married women. Methods: This was a qualitative study with content analysis approach for exploring the concept of sexual behavior in married women of reproductive age. In-depth interviews and focus group discussions were conducted with 52 Iranian women in Rafsanjan and Isfahan. Fifty-two subjects from target group were in Rafsanjan and Isfahan cities that voluntarily took part in 4 individual deep interviews and 8 focused group consisted of 48 participants. All sessions and discussions were recorded and transcripted verbatim. Inspired by the Graneheim approach, content analysis was adopted to extract the meanings and perceptions. Results: From study data, we extracted three main themes: “attention and affection prerequisite,” “deviation from sexual script” and “individual wishes.” Conclusions: With respect to sexual and marital life quality promotion in women, it is essential for caregivers to take care of women expectations and sexual authority. We suggest these contents be mentioned in premarital consult. 300 307 2017/03/122017/03/122017/03/122017/03/122017/03/12 1395/12/22 2017/01/12017/01/12017/01/12017/01/12017/01/1 1395/10/12 زهره قرشی Zohreh Ghorashi دکترای بهداشت باروری، استادیار، گروه مامایی، دانشکده پرستاری و مامایی، دانشگاه علوم پزشکی رفسنجان، رفسنجان، ایران. ایران E-mail: zghorashi@yahoo.com عفت السادات مرقاتی خویی Effat Merghati Khoei دکترای سلامت جنسی، استادیار، مرکز تحقیقات ضایعات مغزی نخاعی، پژوهشکده علوم اعصاب، دانشگاه علوم پزشکی تهران، تهران، ایران. ایران Sexual responsiveness Married women in reproductive age Qualitative study پاسخگویی جنسی زنان متأهل سنین باروری تحقیق کیفی Maines RP. 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London: UCL Press; 1999.##Westheimer R. Human Sexuality: A Psychosocial Perspective. 2nd edition. Philadelphia: Williams & wilkins; 2004.##Sims KE, Meana M. Why did passion wane? A qualitative study of married women’s attributions for declines in sexual desire. Journal of Sex & Marital Therapy. 2010; 36(4):360-80. doi: 10.1080/0092623x.2010.498727##Regan P, Berscheid E. Gender differences in beliefs about the causes of male and female sexual desire. Personal Relationships. 1995; 2:345-58. doi: 10.1111/j.1475-6811.1995.tb00097.x##Sigusch V, Schmidt G, Reinfeld A, Wiedemann-Sutor I. Psychosexual stimulation: Sex differences. Journal of Sex Research. 1970; 6(1):10-24. doi: 10.1080/00224497009550639##Reed JP, Reed RS. Pornography research using direct erotic stimuli. Journal of Sex Research. 1972; 8(3):237-46. doi: 10.1080/00224497209550756##Petersen JL, Hyde JS. A Meta-Analytic Review of research on gender differences in sexuality, 1993-2007. 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ساختار عاملی پرسش‌نامه شخصیتی PID-5) DSM-5) در نمونه ایرانی Factor Structure of Personality Inventory for DSM-5 (PID-5) in an Iranian Sample 1 1 هدف: این پژوهش با هدف ترجمه و بررسی ساختار عاملی پرسش‌نامه شخصیتی 5-DSM (5-PID) در زبان فارسی انجام شد. مواد و روش ها :در این پژوهش مقطعی، جامعه آماری به روش در دسترس از بین دانشجویان پزشکی دانشگاه علوم پزشکی ایران انتخاب شد. پس از برگرداندن 5-PID به فارسی و ترجمه مجدد به انگلیسی، پرسش‌نامه روی 217 نفر (114 دانشجوی سالم و 103 بیمار مبتلا به اختلالات شخصیت) اجرا شد. داده‌های به‌دست‌آمده به روش تحلیل عاملی اکتشافی با استفاده از نسخه 22 نرم‌افزار آماری SPSS و روش تحلیل اجزای اصلی و چرخش مایل سنجیده، بار عاملی هر وجه مرتبط با هرکدام از عوامل پنج‌گانه استخراج شد. یافته ها :در تحلیل عاملی پنج عامل استخراج شد. عامل اول شامل گویه‌های «بی‌لذتی»، «مضطرب‌بودن»، «افسردگی‌پذیری»، «حواس‌پرتی»، «ناپایداری هیجانی»، «تکانش‌گری»، «ناامنی در جدایی» و «سلطه‌پذیری»؛ عامل دوم شامل «توجه‌جویی»، «سنگ‌دلی»، «فریب‌کاری»، «خودبزرگ‌بینی»، «خصومت» و «دغل‌کاری»؛ عامل سوم شامل «گریز از صمیمیت»، «عاطفه‌پذیری محدود»، «انزوا» و «شکاکیت»، عامل چهارم شامل «درجازدگی»، «کمال‌طلبی نامنعطف»، «تکانش‌گری»، «مسئولیت‌ناپذیری» و «خطرپذیری» و عامل پنجم شامل «غرابت»، «کژتنظیمی ادراکی»، «باورها» و «تجارب نامعمول» می‌شود. نتیجه گیری: نسخه فارسی پرسش‌نامه از نظر روایی‌سازه، وضعیت قابل قبولی دارد و با تأیید روایی و پایایی، قابلیت دارد که بین مخاطبان ایرانی فارسی‌زبان به عنوان ابزاری برای بررسی اختلالات شخصیتی، کاربری بالینی داشته باشد. 2 Objectives: The study was performed to determine the factor structure of the Persian translation of Personality Inventory for DSM-5 (PID 5). Methods: After translation and back translation of PID-5, it was performed on 217 subjects, including 114 healthy students and 103 patients with personality disorders. Exploratory factor analysis was done using principal component analysis and direct oblimin rotation to determine the main factors of the inventory and factor loading of the facets. We used SPSS 20 for data analyses. Results: Using direct oblimin rotation, 5 factors were extracted. The 1st factor Depression-Anxiety includes 8 facets: anhedonia, anxiousness, depressivity, distractibility, emotional lability, impulsiveness, separation insecurity and submissiveness. The 2nd factor Antagonism includes 6 facets: attention seeking, callousness, deceitfulness, grandiosity, hostility and manipulativeness. The 3rd factor Detachment includes 4 facets: intimacy avoidance, restricted affectivity, withdrawal and suspiciousness. The 4th factor includes 5 facets: preservation, rigid perfectionism, impulsiveness, irresponsibility and risk taking. Finally, eccentricity, perceptual dysregulation, unusual beliefs, and experiences were categorized under the 5th factor Conclusions: The Persian version of PID-5 has acceptable construct validity and could be used as an assessment tool for personality disorders in Iranian samples, if other types of validity and reliability of the tool are proved to be satisfactory. 308 317 2017/03/122017/03/122017/03/122017/03/122017/03/122017/03/12 1395/12/22 2017/01/12017/01/12017/01/12017/01/12017/01/12017/01/1 1395/10/12 شیوا ثریا Shiva Soraya گروه روانپزشکی، دانشکده علوم رفتاری و سلامت روان، دانشگاه علوم پزشکی ایران ایران لیلا کمال زاده Leila Kamalzadeh گروه روانپزشکی، دانشکده علوم رفتاری و سلامت روان، دانشگاه علوم پزشکی ایران ایران وحیده نیری Vahideh Nayeri گروه روانپزشکی، دانشکده علوم رفتاری و سلامت روان، دانشگاه علوم پزشکی ایران ایران عصمت بیات Esmat Bayat گروه روانشناسی عمومی، مرکز تحقیقات بهداشت روان، دانشگاه علوم پزشکی ایران ایران کاوه علوی Kaveh Alavi گروه روانپزشکی، مرکز تحقیقات بهداشت روان، دانشکده علوم رفتاری و سلامت روان(انستیتو روانپزشکی تهران)، دانشگاه علوم پزشکی ایران ایران سید وحید شریعت Seyed Vahid Shariat گروه روانپزشکی، مرکز تحقیقات بهداشت روان، دانشکده علوم رفتاری و سلامت روان(انستیتو روانپزشکی تهران)، دانشگاه علوم پزشکی ایران ایران E-mail: vahid.shariat@gmail.com Personality disorder validity Factor analysis Inventory اختلال شخصیت روایی تحلیل عاملی پرسش‌نامه Sadock BJ, Sadock VA. 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مدلسازی معادله های ساختاری نگرشهای ناکارآمد و افسردگی: بررسی نقش واسطه ای سبک پاسخ نشخوار Structural Equation Modeling of Dysfunctional Attitudes and Depression Symptoms: Investigation of the Mediation Role of Ruminative Response Style 1 1 هدف: مطالعه حاضر با هدف بررسی معادله‌های ساختاری نگرش‌های ناکارآمد با علائم افسردگی و بررسی نقش واسطه‌ای سبک پاسخ نشخوار برای تبیین علائم افسردگی انجام شد. روش: پژوهش توصیفی‌همبستگی حاضر با حضور 200 نفر (99 دختر و 101 پسر)، به روش نمونه‌گیری در دسترس از بین دانشجویان دانشگاه شیراز در مقطع کارشناسی در سال تحصیلی 1392-1391 انجام شد. برای اندازه‌گیری متغیرهای پژوهش از فرم تجدیدنظرشده مقیاس افسردگی و فرم کوتاه‌شده مقیاس نگرش‌های ناکارآمد و مقیاس سبک پاسخ نشخوار استفاده شد. برای بررسی فرضیه‌های پژوهش از رگرسیون چندگانه هم‌زمان مطابق مراحل بارون و کنی (1986) و از الگویابی معادلات ساختاری استفاده شد. برای بررسی برازش مدل پیشنهادی از شاخص‌های مطلق و ایجازی و تطبیقی، و برای تعیین معناداری تأثیر غیرمستقیم متغیر واسطه‌ای از روش نمونه‌گیری‌های مکرر (خودراه‌انداز) به‌وسیله نسخه 16 نرم‌افزار SPSS و Amos graphic استفاده شد. یافته ها: نتایج نشان داد نگرش‌های ناکارآمد، هم به‌طور مستقیم و هم به‌واسطه سبک پاسخ نشخوار، پیش‌بینی‌کننده منفی و معنادار علائم افسردگی هستند. نتایج شاخص‌های برازش مطلق 06/0=RMSEA و ایجازی 91/0=AGFI و تطبیقی 97/0=CFI نشان داد مدل طراحی‌شده با داده‌های نمونه برازش مناسب و ارتباط نزدیکی با فرض‌های نظری دارد. نتیجه گیری: نگرش‌های ناکارآمد به‌واسطه سبک پاسخ نشخوار با علائم افسردگی رابطه دارد و این مدل می‌تواند تبیین و سبب‌شناسی نشانه‌های افسردگی را تسهیل کند. 2 Objectives: The aim of this study was to investigate the mediation role of ruminative response style in the relationship between dysfunctional attitudes and depression symptoms. Methods: This correlational and descriptive study was conducted on 200 undergraduate students (99 females and 101 males) who were selected by convenience sampling method out of Shiraz University students in academic year 2012-2013. To measure the study variables, the revised form of depression scale, short form of dysfunctional attitudes scale and ruminative response style scale were used. To examine the study hypotheses, the simultaneous multiple regression model according to Baron and Kenny (1986) and structural equation modelling were used.  To study the fitness of the proposed model, the absolute, adjusted and comparative fit indices and to determine the significance of indirect effect of moderate variable, the snowball sampling were used by SPSS16 and Amos graphic. Results: The results showed that dysfunctional attitudes were negative and significant predictor of depression symptoms both directly and indirectly through ruminative response style. Moreover, the results of the absolute (RMSEA= 0.06), comparative (CFI =0.97) and adjusted (AGFI=0.91) fit indices showed that the proposed model had a close relationship with data of fitness sample and the theoretical assumptions. Conclusions: Finally, the model parameters matched the model in terms of optimal fit. 318 329 2017/03/122017/03/122017/03/122017/03/122017/03/122017/03/122017/03/12 1395/12/22 2017/01/12017/01/12017/01/12017/01/12017/01/12017/01/12017/01/1 1395/10/12 حمیدرضا گلزار Hamid Reza Golzar گروه روانشناسی بالینی، دانشکده علوم تربیتی و روانشناسی، دانشگاه شیراز ایران E-mail: Hamidrezagolzar65@gmail.com عبدالعزیز افلاک سیر Abdolaziz Aflakseir گروه روانشناسی بالینی، دانشکده علوم تربیتی و روانشناسی، دانشگاه شیراز ایران جواد ملازاده Javad Molazadeh گروه روانشناسی بالینی، دانشکده علوم تربیتی و روانشناسی، دانشگاه شیراز ایران Dysfunctional attitudes Depression Symptoms Ruminative response style Structural equation modeling افسردگی نگرشهای ناکارآمد سبک پاسخ نشخوار معادله های ساختاری Barlow DA. Clinical handbook of psychological disorders: A step-by-step treatment manual. New York: Guilford Publications Inc.; 2006.##Riskind JH, Alloy LB. The cognitive vulnerability to depression (CVD) Project: Current findings and future directions. In Alloy LB, Rishkind JH, editors. Cognitive Vulnerability to Emotional Disorders. New Jersey: Paulist Press; 2006.##Ingram RE, Atchley RA, Segal ZV. Vulnerability to depression: From cognitive neuroscience to prevention and treatment. New York: Guilford Publications Inc.; 2011.##Kooshki S, Jamali M, Salehi M, Akbari H. [The effectiveness of stress reduction strategies based on mindfulness and dysfunction attitudes in a group of patients with heart disease (Persian)]. Psychol Studies. 2012; 15(4):93-112.##Halvorsen M, Wang CE, Eisemann M, Waterloo K. Dysfunctional attitudes and early maladaptive schemas as predictors of depression: A 9-year follow-up study. Cognitive Therapy & Research. 2009; 34(4):368–79. doi: 10.1007/s10608-009-9259-5##Thomas J, Altareb B. Cognitive vulnerability to depression: An exploration of dysfunctional attitudes and ruminative response styles in the United Arab Emirates. Psychology & Psychotherapy: Theory, Research & Practice. 2011; 85(1):117–21. doi: 10.1111/j.2044-8341.2011.02015.x##Kërqeli A, Kelpi M, Tsigilis N. Dysfunctional attitudes and their effect on depression. Procedia - Social & Behavioral Sciences. 2013; 84:196–204. doi: 10.1016/j.sbspro.2013.06.534##Nolen-Hoeksema S. Sex differences in unipolar depression: Evidence and theory. Psychological Bulletin. 1987; 101(2):259–82. doi: 10.1037/0033-2909.101.2.259##Nolen-Hoeksema S. Responses to depression and their effects on the duration of depressive episodes. Journal of Abnormal Psychology. 1991; 100(4):569–82. doi: 10.1037/0021-843x.100.4.569##Nolen-Hoeksema S, Morrow J, Fredrickson BL. Response styles and the duration of episodes of depressed mood. Journal of Abnormal Psychology. 1993;102(1):20–28. doi: 10.1037/0021-843x.102.1.20##Wiersma JE, van Oppen P, van Schaik DJF, van der Does AJW, Beekman ATF, Penninx BWJH. Psychological Characteristics of Chronic Depression. Journal of Clinical Psychiatry. 2011; 72(3):288–94. doi: 10.4088/jcp.09m05735blu##Hilt LM, McLaughlin KA, Nolen-Hoeksema S. Examination of the response styles theory in a community sample of young adolescents. Journal of Abnormal Child Psychology. 2010; 38(4):545–56. doi: 10.1007/s10802-009-9384-3##Bagherinezhad M, Salehi Fadradi J, Tabataba'i M. [The relationship between rumination and depression in a sample of Iranian students (Persian)]. Studies in Education & Psychology. 2010; 11(1):21-38.##Hankin BL, Abramson LY. Development of gender differences in depression: An elaborated cognitive vulnerability-transactional stress theory. Psychological Bulletin. 2001; 127(6):773–96. doi: 10.1037/0033-2909.127.6.773##Beck A. T, Steer R.A, Brown G. K. Beck Depression Inventory –2nd edition manual. San Antonio: The Psychological Corporation; 1996.##Kapci EG, Uslu R, Turkcapar H, Karaoglan A. Beck Depression Inventory II: Evaluation of the psychometric properties and cut-off points in a Turkish adult population. Depression & Anxiety. 2008; 25(10):104–110. doi: 10.1002/da.20371##Ghassemzadeh H, Mojtaba'i R, Karamghadiri N, Ebrahimkhani N. Psychometric properties of a Persian-language version of the Beck Depression Inventory-Second edition: BDI-II-PERSIAN. Depression & Anxiety. 2005; 21(4):185-92. doi: 10.1002/da.20070##Carmody DP. Psychometric characteristics of the Beck Depression Inventory-II with college students of diverse ethnicity. International Journal of Psychiatry in Clinical Practice. 2005; 9(1):22–8. doi: 10.1080/13651500510014800##Rajabi GhR, Karjoo Kasmaei S. [Psychometric properties Beck Depression Inventory-Second edition (BDI-II-Persian) (Persian)]. 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میزان عدم پیگیری درمان در درمانگاه سرپایی بیمارستان روزبه: پیگیری یکساله Dropout in Outpatient Psychiatric Clinic, Roozbeh Hospital: One Year Follow-Up 1 1 هدف: اختلالات روان‌پزشکی در میان جمعیت عمومی و مراجعان درمانگاه‌های سرپایی شایع هستند، ولی فقط بخشی از افرادی که نیازمند درمان‌های روان‌پزشکی هستند، برای بررسی تشخیصی و درمان به روان‌پزشک مراجعه می‌کنند. از بین این مراجعه‌کنندگان نیز تعداد اندکی درمان را پیگیری می‌کنند و بقیه افراد درمان را ادامه نمی‌دهند. این پژوهش با هدف تعیین میزان ریزش  (عدم مراجعه) بیماران به درمانگاه سرپایی بیمارستان روزبه و تعیین عوامل مرتبط با آن انجام شده است. روش:  پرونده 400 بیمار مراجعه‌کننده به درمانگاه سرپایی بیمارستان روزبه در سال 1392 بررسی شد و اطلاعات لازم در چک‌لیستی که جمعی از متخصصان طراحی کرده بودند، یادداشت شد. داده‌ها به روش آزمون خی دو و رگرسیون لجستیک و با استفاده از نسخه 16 نرم‌افزار spss تحلیل شده است. یافته ها: میزان ریزش در درمانگاه سرپایی 8/57 درصد بود. این میزان در درمانگاه افراد بزرگ‌سال 58درصد و در درمانگاه کودک‌ونوجوان 8/43درصد به‌دست آمده است. بیماران با سن کمتر از 18 سال 11درصد از ریزش و بیماران 18 تا 65 سال 8/41درصد از ریزش و بیماران بیشتر از 65 سال 5درصد از ریزش را تشکیل می‌دادند. بیماران مرد 5/33درصد از ریزش و بیماران زن 3/24درصد از ریزش را به خود اختصاص می‌دادند. بین سن، سطح تحصیلات، وضعیت شغلی بیماران، منبع ارجاع و نوع تشخیص با میزان ریزش رابطه معنادار وجود داشت، اما رابطه بین جنسیت و وضعیت تأهل بیماران با میزان ریزش معنادار نبود. نتیجه گیری:ریزش و عدم پیگیری درمان مشکلی شایع در روند درمان سرپایی بیماران مراجعه‌کننده به روان‌پزشک است که در بیماران بزرگ‌سال میزان آن بیشتر است. به همین دلیل برنامه‌ریزی برای انجام مداخلات لازم برای کاهش میزان ریزش بیماران ضروری به نظر می‌رسد. 2 Objectives: Mental illnesses are common among outpatient clinics, but only some of these patients receive adequate treatments and attend. The purpose of this study is to evaluate the dropout rate and identify the predictors of dropouts in outpatient clinics in Roozbeh Psychiatric Hospital. Methods: A questionnaire designed by expert psychiatrists was filled. The questionnaire consists of information collected from medical records of 400 patients who consulted outpatient clinics of Roozbeh Psychiatric Hospital. The data were analyzed using SPSS16. Results: The total dropout rate was 57.8% (males: 33.5% and females: 24.3%). The dropout rates in adult and child and adolescent clinics were 58% and 43.8%, respectively. A total of 11% of total dropout rate was in patients under 18 years, 41.8% was in patients aged 18 to 65 years, and 5% was in patients aged 65 years and over. There were  significant relationships between drop out rate and variables of patients' age, educational degrees, occupation, referral point, and type of diagnosis. However, no significant relationships were found between drop out rate and gender or marital status of the patients. Conclusions: Dropout is a common barrier in delivering outpatient psychiatric treatments. There need to be proper interventions to reduce such dropouts. 330 339 2017/03/122017/03/122017/03/122017/03/122017/03/122017/03/122017/03/122017/04/12 1396/1/23 2017/01/12017/01/12017/01/12017/01/12017/01/12017/01/12017/01/12017/01/1 1395/10/12 زهرا میرسپاسی Zahra Mirsepassi روه روانپزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی تهران ایران E-mail: z-mirsepassi@sina.tums.ac.ir جواد علاقبندراد Javad Alaghband Rad دانشکده پزشکی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی تهران ایران ونداد شریفی Vandad Sharifi گروه روانپزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی تهران ایران والنتین آرتونیان Valentine Artounian گروه روانپزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی تهران ایران پروانه فرهاد بیگی Parvaneh Farhad Beigi ، پژوهشکده علوم شناختی ایران فتانه عبدی ماسوله Fattaneh Abdi گروه روانپزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی تهران ایران عمران محمد رزاقی Omran Mohammad Razaghi گروه روانپزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی تهران ایران حمیدرضا نقوی Hamidreza Naghavi گروه روانپزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی تهران ایران همایون امینی Homayoun Amini Psychosomatic Research Center, Tehran University of Medical Sciences ایران سارا جعفری Sara Jafari گروه روانپزشکی، دانشکده پزشکی، دانشگاه علوم پزشکی و خدمات بهداشتی درمانی تهران ایران Dropout Continuity of care Outpatient Psychiatric clinic ریزش عدم مراجعه درمانگاه سرپایی روانپزشکی Baumeister H, Härter M. Prevalence of mental disorders based on general population surveys. Social Psychiatry & Psychiatric Epidemiology. 2007; 42(7):537–46. doi: 10.1007/s00127-007-0204-1 ##Sharifi V, Daliri S, Amini A, Mohammadi M. [Psychiatric Problems in General Outpatient Clinics: Prevalence and Reasons for Help Seeking (Persian)]. Iranian Journal of Psychiatry Clinical Psychology. 2011; 16(4):484–489.##Sharifi V, Amin-Esmaeili M, Hajebi A, Motevalian A, Radgoodarzi R, Hefazi M, et al. Twelve-month prevalence and correlates of psychiatric disorders in Iran: The Iranian Mental Health Survey, 2011. Archive of Iranian Medicine. 2015; 18(2):76–84. doi: 015182/AIM.004##Sharifi V, Daliri S, Amini H, Mohammadi M. [Psychiatric problems in general outpatient clinics: Prevalence and reasons for help seeking (Persian)]. Iranian Journal of Psychiatry & Clinical Psychology. 2011; 16(4):484-489 ##Codony M, Alonso J, Almansa J, Bernert S, de Girolamo G, de Graaf R, et al. 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بررسی رابطه ابعاد رفتاری و شناختی اضطراب اجتماعی در دوره نوجوانی با جنسیت و نقشهای جنسیتی Investigations of the Relation Between Social Anxiety, Cognitive and Behavioral Aspect of It and Sex and Gender-Rolein Adolescence 1 1 اهداف :مطالعات نشان می‌دهد اضطراب اجتماعی یکی از اختلالات شایع دوره نوجوانی است. از میان عوامل اثرگذار بر این اختلال، بررسی جنس (مذکر یا مؤنث) نتایج متناقضی را نشان می‌دهد؛ درحالی‌که رابطه نقش جنسیتی با برخی از اختلالات اضطرابی تأیید شده است. ازاین‌رو هدف مطالعه حاضر مقایسه اضطراب اجتماعی و ابعاد شناختی و رفتاری آن در انواع جنس و نقش جنسیتی (زنانه، مردانه، آندروژنی و نامتمایز) بود. مواد و روش ها: نمونه‌های این پژوهش را 277 نفر از دانش‌آموزان 12 تا 13 تشکیل می‌دادند. این افراد با استفاده از روش نمونه‌گیری خوشه‌ای انتخاب شدند و پرسش‌نامه‌های اضطراب اجتماعی نوجوانان (SASA) و نقش جنسی کودکان (CSRI) را تکمیل کردند. یافته ها :نتایج براساس آزمون همبستگی تی و تحلیل واریانس نشان داد زنانگی با اضطراب اجتماعی و ابعادشناختی و رفتاری آن رابطه مثبت معنی‌دار و مردانگی با این متغیرها رابطه منفی معنادار دارد (05/0>P). همچنین میانگین نمره‌های اضطراب اجتماعی و ابعاد شناختی و رفتاری آن در گروه دارای سنخ جنسیتی زنانه به‌طورمعنی‌داری بیش‌از گروه‌های دیگر (مردانه و آندروژن و نامتمایز) بود (05/0>P). این درحالی است که نمرات اضطراب اجتماعی و ابعاد شناختی و رفتاری آن در دو جنس (مذکر و مؤنث) تفاوت معناداری نداشت. نتیجه گیری :طرح‌واره‌های نقش جنسیتی می‌تواند به عنوان عوامل مرتبط با اضطراب اجتماعی و ابعاد شناختی و رفتاری آن در نوجوانانی مدنظر قرار گیرد. 2 Objectives: Social anxiety is one of the most common disorders of adolescence. Among the factors affecting the disorder to determine the sex (female or male) reported conflicting results, while the relationship between gender role consistent with some anxiety disorders. The aim of this study was to compare social anxiety and its cognitive (AFNE) and behavioral (TISC) aspects based on different sex and gender roles (femininity, masculinity, androgyny and indistinct). Methods: Students (N=277) aged 12 to 13 years were selected using cluster sampling. They were asked to complete research questionnaires including Social Anxiety Scale for Adolescents (SASA) and Child Sexual Role Inventory (CSRI). Results: The results of T-test, correlation analysis and variance analysis showed significant positive relationships between femininity and social anxiety and its cognitive and behavioral aspects. Significant negative relationships between masculinity and these variables (P<0.5) were also found. More significant mean scores were observed for social anxiety and its cognitive and behavioral aspects in the group by feminine gender-role in comparison with other groups (masculine, androgen and indistinct). However,there was no significant difference in the scores of social anxiety and its cognitive and behavioral aspects in both sexes. Conclusion: The gender-role schema can be considered as a factor associated with social anxiety and its cognitive and behavioral aspects in adolescents. 340 347 2017/03/122017/03/122017/03/122017/03/122017/03/122017/03/122017/03/122017/04/122017/03/12 1395/12/22 2017/01/12017/01/12017/01/12017/01/12017/01/12017/01/12017/01/12017/01/12017/01/1 1395/10/12 مهناز علی اکبری دهکردی Mahnaz Aliakbari Dehkordi گروه روانشناسی، دانشکده علوم انسانی، واحد تهران جنوب، دانشگاه پیام نور ایران حسین زارع Hossein Zare گروه روانشناسی تربیتی، دانشکده علوم انسانی، واحد تهران جنوب، دانشگاه پیام نور. ایران علی اصغر اصغرنژاد فرید Aliasghar Asgharnejad Farid گروه روانشناسی، دانشکده علوم رفتاری و سلامت روان، دانشگاه علوم پزشکی ایران ایران راضیه هاشمیان Razieh Hashemian گروه روانشناسی، دانشکده علوم انسانی، واحد تهران جنوب، دانشگاه پیام نور. ایران E-mail: ahashemian70@gmail.com Social anxiety Gender role Sex Adolescence اضطراب اجتماعی نقش جنسیتی جنس نوجوانی American Psychiatric Association. 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