Fereshteh Jannatifard’s research while affiliated with Tehran University of Medical Sciences and other places

Objective: Excessive sugar consumption is a growing public health concern, with research suggesting it may function as an addictive substance. However, the lack of standardized tools to assess sugar addiction, particularly across cultures, remains a challenge. This study aims to validate the Persian version of the Sugar Addiction Questionnaire (SAQ) for use in Iran. Method: In this cross-sectional psychometric validation study, 504 Persian-speaking adults (59.1% female, mean age = 29.8 ± 19.5 years) were recruited using convenience sampling from Tehran health centers. Participants completed the SAQ and Yale Food Addiction Scale (YFAS 2.0), and participated in DSM-5-based semi-structured interviews for sugar addiction. Factor analysis and reliability measures (Cronbach’s alpha, test-retest, split-half) were used to assess the SAQ's validity and reliability. Results: The Persian SAQ demonstrated strong psychometric properties. Factor analysis revealed a five-factor structure explaining 45.08% of the variance. Concurrent validity was confirmed by significant correlations with the YFAS 2.0 (r = 0.51, P < 0.001) and BMI (r = 0.55, P < 0.001). The scale showed a good model fit (CFI = 0.91, RMSEA = 0.08), with acceptable reliability (Cronbach’s alpha = 0.79) and a test-retest correlation of 0.54. The optimal cutoff for diagnosing sugar addiction was 9, with the Area-Under-the-Curve (AUC) of 98%. Conclusion: The Persian version of the SAQ is a reliable and valid tool for assessing sugar addiction in Iran. This validated instrument can improve the diagnosis and understanding of sugar-related behavioral issues, supporting better public health strategies for managing excessive sugar consumption.

Background: COVID-19 had a destructive effect on human’s life. People with COVID-19 experienced high levels of depression, anxiety, and low Quality of Life (QOL). The aim of this study was to investigate the effect of the cognitive-behavioral intervention package on reducing stress, depression, and anxiety, as well as improving the QOL of patients with COVID-19. Methods: In this randomized controlled trial, 60 patients with COVID-19 who entered the isolation ward were included and randomly divided into control and experimental groups. The experimental group entered the intervention sessions once a week for 45 minutes for eight consecutive weeks. The intervention consisted of 8 sessions of CBT which was implemented for the experimental group. Patients in the control group received routine care during this period. DASS21, the Symptom Checklist (SCL-90), Fear of COVID-19 Scale (FCV-19S), and WHO-QOL were used to measure patients’ mental health and QOL. Data analysis was performed with ANCOVA using SPSS24 software. Results: There was no significant difference between groups in terms of DASS21, SCL-90 and QOL before intervention (p<0.05). After intervention, depression symptom and QOL were significantly improved in the experimental group compared to control group (p< 0.05). Accordingly, the findings stated the session of intervention was effective in improving the QOL (p<0.05) and mental illnesses (p<0.05) in patients with COVID-19. Conclusion: Our designed cognitive-behavioral intervention package can enhance the awareness and mental health of patients with COVID-19. This package as an auxiliary treatment can reduce anxiety/depression and improve QOL in patients with COVID-19. Therefore, our intervention package can serve as a useful solution for clinical settings to reduce mental health problems during crisis.

We attempted to conduct a two-year prospective cohort study on patients with COVID-19 and healthy peers as a control group to estimate the odds and risks of being diagnosed with psychiatric disorders as a result of infection by corona virus. In this prospective cohort study, 1186 subjects, including 865 patients with COVID-19 and 321 healthy individuals as the control group, were recruited from the community and clinics. During and two years after the acute phase of COVID-19, participants completed the demographic questionnaire, the World Health Organization Quality of Life-BREF (WHO-QOL-BREF), and the psychiatric interview using the Structured Clinical Interview for DSM-5 (SCID-5). Adjusted odds ratios (AOR) with 95% confidence intervals (CI) and Risk Ratio (RR) were calculated using the Statistical Package for the Social Sciences (SPSS) and Statistic and Data Analysis (Stata) software. Uninfected people experienced substantially better QOL compared to infected people (P < 0.05). The results showed that COVID-19 disease affected QOL and its sub scales (P < 0.05). In addition, the incidence of psychiatric disorders among infected people was significantly higher than that of uninfected people (P < 0.05). Infection with COVID-19 increased the risk of depressive disorders (AOR = 1.2), substance use disorder (AOR = 2.31), panic disorder (AOR = 1.11), obsessive compulsive disorder (AOR = 1.11), adjustment disorder (AOR = 2.1) and insomnia (AOR = 1.57). We found a high incidence of psychiatric illness among COVID-19 survivors during the two years following the acute phase of the pandemic. These survivors also reported a lower quality of life. It is crucial to utilize our findings to increase awareness about the elevated risk of psychiatric and psychological illnesses among COVID-19 survivors. Additionally, it is essential to integrate psychological care as a key component of post-acute COVID-19 healthcare programs.

Objective: Smartphone is an important technology device in our lifestyle. It has an important part of our daily lives, but it also has a negative effect, such as cell phone dependency. This research aimed to evaluate the psychometric properties of mobile phone abuse (MPA) in the Iranian population. Method: In this study, data were chosen from 1100 participants who were studying in Tehran universities. The principal version of the scale was translated into Persian using the back translation method. All attendees completed Demographic Questionnaire, MPA Questionnaire, and Mobile Phone Problematic Use Scale (MPPUS). Eventually, a clinical interview (based on the fifth version of DSM) was done for all the participants. For data analysis, internal and external consistency, factor analysis, construct validity and confirmatory factor analysis (CFA) were used. Statistically, less than 0.05 were considered to be ‎ significant.‎ Results: According to expert judgments, content validity index was satisfactory. Furthermore, the reliability of the questionnaire was confirmed with Cronbach’s α of 0.90 and test-retest reliability of 0.56 after 3 weeks. The best cutoff point for this questionnaire (MPA) was 46. Also, 4 factors were extracted by principal components method and varimax rotation: “excessive use of cell phone,” “addictive use of social networks,” “mood modification,” and “preoccupation” for both male and female students. Conclusion: MPA could be used in studies on the evaluation of mobile phone addiction. This can be a stepping stone towards the identification of problems and improvement of students’ mobile phone abuse.

Introduction: Internet addiction disorder has reportedly become an important cause of health and social problems. The aim of this study was to investigate the effectiveness of cognitive-behavioral group therapy for internet addiction symptoms, quality of life, and mental health of students with internet addiction. Methods: This was a quasi-experimental study with pretest-posttest measures and a control group. The statistical population of the study consisted of all students at Tehran universities in the academic year of 2018-19. The target group was selected through an internet addiction test and a clinical interview using a targeted sampling method and was divided into experimental and control groups by randomization. The experimental group participated in fifteen 90-minute cognitive-behavioral group therapy sessions. Before, immediately after, and 3 months after the treatment, the internet addiction symptoms of both groups were evaluated to assess mental health with the IAT, quality of life (QOL), and SCL-90-R questionnaires. Data were analyzed with ANCOVA analysis using SPSS Statistics 20 software. Results: After treatment, cognitive-behavioral therapy groups showed reductions in internet addiction scores (p < 0.05). Results showed that the cognitive-behavioral group therapy was effective for improving quality of life (p < 0.05) and mental illnesses (p < 0.05) in students with internet addiction. Conclusions: Cognitive-behavioral group therapy can enhance awareness and mental health of students with internet addiction. Therefore, this intervention can be used as a beneficial treatment to reduce internet addiction symptoms and improve the condition of people with behavioral addictions such as internet dependency.

Objective: COVID 19 is having a devastating effect on mankind’s life. Individuals with COVID-19 will experience high levels of stress, depression, anxiety, and low quality of life. The goals the of present study were to investigate the effect of brief crisis intervention package on stress, depression, anxiety, and quality of life in patient with COVID-19. Method : In this randomized controlled clinical trial, 30 patients were randomly selected and divided into control and experimental groups. The experimental group was examined in four 60-minute sessions for one month. During this period, the control group received only routine treatment and therapy. Before and after the intervention, DASS21, the Symptom Checklist (SCL-25), and WHO-QOL were used to measure and record patient mental health and quality of life. Finally, data were analyzed using SPSS 24 software. Results: The average mental health score was assessed with WHO-QOL, DASS21, and SCL-25 before intervention and was not statistically significant (P = > 0.05), and the mean score of stress, anxiety, depression, WHO-QOL, SCL-25 after intervention was statistically significant (P < 0.001). Therefore, results showed the brief crisis intervention package was effective in improving the quality of life (P < 0.05) and mental illnesses (P < 0.05) in patients with COVID-19. Conclusion: The brief crisis intervention package can reduce the negative effect of patients with COVID-19. Therefore, this intervention can be used as a beneficial treatment to improve mental disorder symptoms and to improve the condition of people who suffer from COVID-19.

Objective: Despite the awareness of smartphone addiction, low findings and lack of validated standards have led to insufficient information in this area. This study aimed to examine the relationship between mobile phone dependency and mental disorders in students in Iran, while controlling for the impact of gender, age, educational levels, and marital status. Method: In this cross-sectional study, a sample of 1400 university students (445 males and 955 females) aged 18-35 years were selected from 3 cities of Tehran, Isfahan and Karaj. The participants filled out a set of questionnaires: Cell Phone Dependency Questionnaire (CPDQ), Millon Multiaxial Clinical Inventory, and participated in interviews. Data were analyzed using multiple logistic regression method via SPSS-22 software. Results: In terms of controlling the demographic variables, the results revealed that bipolar disorder, depression, anxiety, somatization, dependent personality disorder, and compulsive personality disorder could increase the possibility of mobile phone addiction by 4.2, 4.2, 1.2, 2.8, 3.1, and 3.2 folds, respectively (P < 0.05). However, other disorders and demographic characteristics did not have any significant effects on the equation. Conclusion: The results can help better understand the relationship between psychological syndromes and smartphone addiction and can also facilitate further studies in this field. In addition, those students with smartphone addiction should be provided with different preventative strategies. Moreover, a growing range of stimulating applications may trigger the risk of addiction.

Objective: Smart phones have rapidly become an integral, and for some, an essential communication device worldwide. The issue of identity has always been a subject of interest among psychologists. The present study was conducted to compare personal and national identity and their subscales between cell phone addicts and non-addicts. Method: In this cross-sectional study, 500 student cell phone users from various universities in Tehran were recruited using stratified sampling. Participants completed cell phone addiction questionnaires including Mobile Phone Problematic Use Scale (MPPUS), Cell Phone Dependency Questionnaire (CPDQ), Personal Identity Development Questionnaire, Extended Objective Measure of Ego Identity Status (EOMEIS) and National Identity Questionnaire. Then, the subscales of these instruments were analyzed using SPSS Version 20. Results: Results of this study revealed significant differences between cell phone addicts and non-addicts in the scores of national identity, personal identity, and most subscales, except for some subscales (P<0.05). In addition, a negative and significant relationship was found between personal and national identity and cell phone addiction (r=-0.35, -0.33, respectively).On the other hand, after controlling for the confounder variables, we found that national identity had an effect on cell phone addiction(OR=0.05, CI=0.92-0.98). Conclusion: The results of this study indicated that cell phone overuse may be correlated with defects in some aspects of national and personal identity.

Background The aim of this study was to evaluate the effect of variables such as personality traits, driving behavior and mental illness on road traffic accidents among the drivers with accidents and those without road crash. Methods In this cohort study, 800 bus and truck drivers were recruited. Participants were selected among drivers who referred to Imam Sajjad Hospital (Tehran, Iran) during 2013-2015. The Manchester driving behavior questionnaire (MDBQ), big five personality test (NEO personality inventory) and semi-structured interview (schizophrenia and affective disorders scale) were used. After two years, we surveyed all accidents due to human factors that involved the recruited drivers. The data were analyzed using the SPSS software by performing the descriptive statistics, t-test, and multiple logistic regression analysis methods. P values less than 0.05 were considered statistically significant. Results In terms of controlling the effective and demographic variables, the findings revealed significant differences between the two groups of drivers that were and were not involved in road accidents. In addition, it was found that depression and anxiety could increase the odds ratio (OR) of road accidents by 2.4- and 2.7-folds, respectively (P=0.04, P=0.004). It is noteworthy to mention that neuroticism alone can increase the odds of road accidents by 1.1-fold (P=0.009), but other personality factors did not have a significant effect on the equation. Conclusion The results revealed that some mental disorders affect the incidence of road collisions. Considering the importance and sensitivity of driving behavior, it is necessary to evaluate multiple psychological factors influencing drivers before and after receiving or renewing their driver’s license.

Objective: The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) classified mobile phone addiction disorder under "impulse control disorder not elsewhere classified". This study surveyed the diagnostic criteria of DSM-IV-TR for the diagnosis of mobile phone addiction in correspondence with Iranian society and culture. Method: Two hundred fifty students of Tehran universities were entered into this descriptive-analytical and cross-sectional study. Quota sampling method was used. At first, semi- structured clinical interview (based on DSM-IV-TR) was performed for all the cases, and another specialist reevaluated the interviews. Data were analyzed using content validity, inter-scorer reliability (Kappa coefficient) and test-retest via SPSS18 software. Results: The content validity of the semi- structured clinical interview matched the DSM-IV-TR criteria for behavioral addiction. Moreover, their content was appropriate, and two items, including "SMS pathological use" and "High monthly cost of using the mobile phone" were added to promote its validity. Internal reliability (Kappa) and test-retest reliability were 0.55 and r = 0.4 (p<0. 01) respectively. Conclusion: The results of this study revealed that semi- structured diagnostic criteria of DSM-IV-TR are valid and reliable for diagnosing mobile phone addiction, and this instrument is an effective tool to diagnose this disorder.