Journal of School of Public Health and

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Background and Aim: Internet has become an effective medium to transfer new scientific and research findings, knowledge and information in educational processes across the world. It also facilitates essential communication among millions of people globally and offers users plenty of entertainment for their leisure time. However, excessive computer use interferes with daily life and carries a risk of addiction. Therefore, the concept of internet addiction is now considered a social problem. This study was conducted to determine the association between internet addiction and general health among dormitory students of Tehran University of Medical Sciences in 2010.

Materials and Methods: This cross-sectional study, conducted in 2010, included 125 female- and 110 male-students from dormitories of Tehran University of Medical Sciences, selected by stratified random sampling. The instruments for data collection were two standard questionnaires - YANG Internet Addiction and Goldberg's General Health (GHQ). Data were analyzed by SPSS-19, the statistical tests being Kolmogorov-Smirnov, Mann-Whitney U, Chi-square, correlation coefficient, and multivariate regression.

Results: The results showed that, based on the YANG classification, 34% of the students were addicted to the internet. In comparison with ordinary users, the general health of the internet-addicted users was at a higher risk (p<0.001). The two groups were also different with regard to anxiety and depression (p<0.001), but not with regard to physical function or social function.                     

Conclusion: Internet addiction among dormitory students is a cause for concern. Well-designed programs focusing on education, counseling and behavioral intervention are needed to reduce internet addiction amongst vulnerable students.

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  Background and Aim: Addiction behaviors have been established among high risk behaviors among different age groups in Iran. This study aimed to investigate the effects of a designed educational program on high risk behaviors of a sample of addicts in Qom, Iran.

  Materials and Methods: Totally, 128 men with addiction history in self help groups referred to health centers in Qom were studied. The instruments used to collect data were a self administered demographic questionnaire and the designed scale high risk behavior based on Health Belief Model (HBM).

  Results: The mean age of participants was 32.4 years. There were no significant difference between two groups at baseline in terms of all demographic data and all HBM constructs. The mean scores of HBM constructs, improved significantly in comparison with baseline. (p < 0.05).

  Conclusions: This study indicated that designed educational program could improve all HBM constructs after intervention. Additionally, behavior intention might be changed after intervention significantly.

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  Background and Aim: The community assessment is the basis of strategic policies for health professionals and managers. The aim of community assessment is collection of the data that relating to public health problems, data analysis and concludes about necessary capacities for providing the necessary resources to resolve problems.

  Materials and Methods: In this study the databases of Scientific Information Database, MagIran, MEDLINE, Google Scholar, and IranMedex were searched up to April 2014 (farvardin1393). All papers of community assessment in the country according to our standard community assessment model were included in this study.

  Results: Overall 11 studies were evaluated and the common feature of all research is to identify problems of society and local problems. The drug addiction was classified in 3 of the studies as a main problem and in 7 of studies was classified in the ten major problems. Poverty and unemployment are allocated to the next priority, the second priority in 2 studies, the third priority in 3 studies and the fourth priority in 3 studies. Environmental health problems and socio-cultural problems were the next priorities.

  Conclusion: The proposed model can be used to suggest new health services with due consideration of community problems, as well as develop suitable, effective intervention strategies. This type of community study should not be conducted only once. Rather, it should be repeated periodically in any community, results compared and used for policy-making.

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Background and Aim: Both the cognitive and functional processes in an individual can be influenced directly by the central nervous system. Considering the widespread use of narcotics, an exact knowledge of the different dimensions of addiction and its relationship with the brain executive functions can help find strategies for its treatment and promote effectiveness of current intervention programs and optimization of functional activities and, ultimately, promotion of well-being and psychological dimensions in these patients. The purpose of this study was to compare the brain executive functions in two groups of addicts ─ those who have and those have not resumed using narcotics.      

Materials and Methods: The study population consisted of all the male-addicts consulting the addiction recovery/treatment centers in Tehran in 2013, who had used the narcotic methamphetamine (glass) in the past and had taken action to quit, as well as those who had, after quitting, resumed using narcotics. The sample in each group included 30 male-addicts who had given their consent. They were selected by the available sampling method. Diagnosis of addiction and classification of mental disorders in the subjects was based on a). the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR), and b). assessment by specialists in the addiction recovery centers. The “Wisconsin Card" and "Stroop test" were used to collect data, and one-way analysis of variance test (ANOVA) was used for data analysis.

Results: The results indicated that executive functions of the brain as regards design flexibility, response inhibition, and conceptualizing addiction, as well as its general executive functioning, were weaker in the groups who had resumed addiction. 

Conclusion: Based on the findings it can be concluded that narcotics can weaken the brain executive functions in addicts and make them lose hope for any improvement. The findings support results of previous work reported in the literature; however, further research is needed in this area to make it possible to draw definitive conclusions.

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Background and Aim: Substance abuse and risky sexual behaviors are intermingled. Both subjects, however, are highly sensitive issues culturally in some societies such as Iran, making assessment of sexual behaviors difficult and challenging. It is particularly difficult to assess and study risky sexual behaviors in the drug-using population. Thus, it seems essential to develop and validate a comprehensive native instrument specific for the Iranian drug-using population to screen their risky sexual behaviors and in treatment settings.

Materials and Methods: A thorough literature review was made to find a tool utilized in addiction treatment settings.  The Sex and Drug History Form (SDHF) was translated into Persian. Clients (n = 107) referred to the sexual health clinic in the Iranian National Center for Addiction Studies (INCAS) were selected randomly. Questionnaires were completed through face-to-face interviews by trained research assistants. Data analysis was done using the Cronbach`s alpha and exploratory factor analysis.

Results: Cronbach`s alpha was found to be 0.78. Using the principal component analysis, the Sex and Drug Screening Scale (SDSS) revealed 78.6 of the total variance in two main domains, namely, drug-use behaviors and sexual behaviors. The number of subscales in the original instrument, which was 3, increased to 6.

Conclusion: Substance abuse and addiction significantly affect one's sexual behaviors and safety. The Sex and Drug Screening Scale will enable health workers and therapists to assess the patients' sexual health and risky behaviors at admission, which will facilitate planning, implementing and evaluating intervention programs aiming at treating addiction.

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Background and Aim: Group therapy is one of the selective approacheseffective in addiction treatment, although it is not used extensively.Therefore, it is essential to assessthe current group therapy situation and determine its barriers andreinforcing factors inaddiction treatment settings.

Materials and Methods: This qualitative study was a rapid assessment designed and conducted in 2014-2015. Formal and informal data were collectedfrom 6 selectedcenters (n=55) bya multi-disciplinaryresearch team,using a systematic and semi-structuredapproach. Data were analyzed using thematic analysis.

Results: Based on dataanalysis a descriptive model was obtained with two main items, namely, structure and implementation of group therapy and effectiveness process. These two main items were found to be composed of four descriptive sub-items, including structural determinants and effective determinants in group therapy, contextual features, content, acceptabilityand desirability of treatment.

Conclusion: The findings show that application and effectiveness of group therapy is desirable, but it is not used as a routine approach in addiction treatment centers. Barriers to expansion of group therapy include insufficient content, lack of a structured protocol, and lack of professionalcapacity building. The study also revealsthat group therapy is quite acceptableamong patients who have had the experience of being treated with this approach but less acceptable among those who are not familiar with it.

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Background and Aim: This study aimed to investigate the association of Internet addiction and self-control with mental health among students of the University of Applied Sciences and Technology (UAST) in Ilam city, Iran.

Materials and Methods: Data collection tools included the Mental Health Goldenberg scale, Tanji Self-control Inventory and Young Internet Addiction questionnaires. The sample consisted of 101 UAST students in Ilam City, Iran.

Results: Analysis of the data showed a statistically significant negative relationship between internet addiction and mental health and a positive association between self-control and mental health in male- and female-students.

Conclusion: It can be concluded that he more a student uses the Internet, the more likely he/she is to be less healthy mentally, while if a student has more self-control, he/she is more likely to be healthier mentally.The use of the Internet among the new generation in the society is spreading, becoming an important part of life. It has been said that teenagers are at a high risk. Hence the responsible authorities should consider mental health as a factor preventing extreme behavior of young people.

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Background and Aim: The Internet is a strong and multimedia technology that meets the most basic needs of human beings; however, this new technology can have great negative effects on people's lives. This study aimed to determine the prevalence of Internet addiction and its relationship with quality of sleep and quality of life among students of Zahedan University of Medical Sciences.          
Materials and Methods: This descriptive-analytical cross-sectional study was conducted in Zahedan in 2017.The study population included all the students of Zahedan University of Medical Sciences. A sample of 340 students were selected through stratified random sampling. Data were collected using three World Health Organization questionnaires, namely, quality of sleep, Internet addiction and quality of life questionnaires, and analyzed using SPSS (v22), the statistical tests being ANOVA and linear regression test and T-test.
Results:  Data analysis showed that Internet addiction and the quality of life among the students were mild (43 ± 15) and desirable (78.4± 1.6), respectively. However, the sleep Quality Index for 282 students (82.9%) was not desirable. There were statistically significant associations (p<0.05) between the place of residence on the one hand and Internet addiction, quality of sleep and quality of life on the other.
Conclusion: Based on the findings it can be concluded that Internet addiction has a negative effect on the quality of sleep and quality of life of the students. The students need to pay more attention to the use of the Internet. It is also recommended that behavioral and cognitive intervention be designed and implemented aiming at teaching the students proper use of the computer and the Internet.

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Background and Aim: Considering that meta-cognitive beliefs play a very important role in the prevention, preservation and continuity of addiction, this study aimed to determine the effectiveness of meta-cognitive group therapy (MCT) on the extent of addiction-proneness in male university students.
Materials and Methods: This study was a quasi-experimental project with pretest-posttest, a control group and follow-up. The statistic population consisted of all the male Bachelor's students of the Mashhad Ferdowsi University, Iran in the academic year 2016-17. The sample was 30 students selected and assigned randomly to an experimental or control group. Data were collected using a meta-cognition questionnaire (MCQ-30) and the addiction potential scale (APS). Statistical tests included analysis of covariance and the dependent t-test.
Results: Covariance and post-test addictive potential scores showed that MCT could desirably affect the addiction-proneness of university male students (p<0.01).
Conclusion: Based on the findings it can be concluded that metacognitive therapy can reduce the addiction proneness of male university student, the effect lasting for three months.  Therefore, it is recommended that responsible authorities in the health sector use meta-cognitive therapy for addiction prevention and resumption.

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Background and Aim: The “Package for mental and social health promotion and drug abuse prevention” was developed in response to the importance of, and concerns relate to, the mental and social health in the population. Since any policy and plan needs to be assessed to find its weaknesses, strengths and challenges to ensure its successful implementation, this study aimed to find and explain the executive leadership challenges of this service package from the service provider's perspective.
Materials and Methods: This study was a qualitative research, the data being collected through interviews and reviewing the relevant documents. The research population included experts from Kerman University of Medical Sciences, Kerman, Iran, those in charge of the package implementation, urban community health center officials and health care providers. The interviewees were selected using a targeted sampling method.
Results: Based on the interviews, the findings were categorized into four main themes: low public cooperation, difficulty in communication, missing links in design and implementation of packages, and methods of payment to service providers. In addition, the findings based on reviewing the documents were grouped as objectives, plans, activities, target groups, and interventions related to this service package.
Conclusion: Based on the findings of this study, it can be concluded that the implementation challenges of the mental health care package fall into three categories, namely, policy-making, facilities, and personal challenges. Proper changes and reforms at the public policy-making level, creating individual awareness and providing proper facilities for the implementation of the package can help overcome these challenges.

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Background and Aim: Internet addiction means excessive and unnecessary use of the Internet. The aim of this study was to investigate the role of brain-behavioral systems in Internet addiction among university students.
Materials and Methods: This was a descriptive and correlational research. The statistical population was all the students of Islamic Azad University, Karaj Branch in the academic year 1397-98. A sample of 162 students were selected, based on the Tabachnick & Fidell formula, using the multi-phase cluster sampling technic. The tools used to collect data were the harmful Internet use and the brain and behavioral system questionnaires.
Results: Based on the multivariate regression analysis, 66.7% of Internet addiction among the students could be explained by brain-behavioral systems.  Active avoidance and approach, as components of the behavioral activation system, could predict Internet addiction negatively, while passive avoidance and extinction, as components of the behavioral inhibition system, and fight and flight from the components of the fight/flight system, could predict Internet addiction positively.
Conclusion: Purposeful communication and information search (pleasant unconditional stimuli), tedium and constant logic dominating the internet environment (unpleasant unconditional stimuli) have their own conditional cues on the Internet that indicate the degree of susceptibility of brain-behavioral systems to internet addiction.

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Background and Aim: Considering the harms and dangers of addiction and the fact that many people are trapped in it every day, it is important to identify the variables that affect it. The aim of this study was to predict the tendency to addiction among university students based on initial maladaptive schemas and cognitive emotion regulation.
Materials and Methods: This was a cross-sectional descriptive-analytical study. The statistical population consisted of all the 3548 students of Gonbad Kavous Payame-Noor University in the academic year 2019-20, from among whom a sample of 384 students was selected using the one-stage cluster random sampling method. The data collection tools were the following 3 questionnaires: early maladaptive schema (Young, 2005), cognitive emotion regulation (Garnefski & Kraaij, 2001) and addiction tendency (Wade and Butcher, 1992). Pearson correlation coefficient and multiple linear regression were used to analyze the data using the SPSS software version 22 at a statistical significance level of 0.05.
Results: Data analysis showed correlations between addiction and the following variables: excessive ringing in the ears (r = 0.491, p = 0.001), being guided by others (r = 0.523, p = 0.001), disturbed constraints (0.001 >, r = 0.426 p), impaired function (r = 0.389, p = 0.001), discontinuation (r = 0.406, p <0.001) and cognitive emotion regulation (p> 475, <0.001). 0r =). In addition, the results of multiple linear regression analysis showed the following: excessive ringing (β= 0.203, p = 0.001), being guided by others (β= 0.274, p = 0.001), disturbed constraints (β= 0.261, p = 0.001), impaired function (β= 0.229, p = 0.001), discontinuation (β= 0.193, p <0.001) and cognitive emotion regulation (β= 0.315, p = 0.001). 
Conclusion: Based on the findings of this study, the average tendency to addiction among university students can be predicted by changing the initial maladaptive schemas and improving the cognitive emotional regulation.
 

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Background and Aim: In recent decades, the use of the Internet as a suitable and affordable means of communication has become increasingly popular among people, especially young people. However, the excessive use of this technology has led to negative physical, behavioral and psychological consequences, causing concern in many families and even in authorities involved in the educational system. Therefore, the purpose of this study was to investigate the association of family emotional atmosphere, self-control and sleep quality with Internet addiction in teenagers.

Materials and Methods: This research was a cross-sectional and descriptive correlational study. The statistical population was all the 300 male students in the 4th to 6th grades of two non-governmental high schools in Rasht city, Iran in the academic year of 1401-1401. A sample of 169 was selected based on the Morgan's Krejci table and using the available sampling method. The data collection tools were the Young's internet addiction, Pittsburgh sleep quality, Tanji self-control and Nodargah family emotional atmosphere questionnaires.

Results: The analysis of the data showed that there is a significant positive correlation between Internet addiction and family emotional atmosphere (r=0.597) and sleep quality (r=0.331), while a negative and significant correlation exists between self-control and Internet addiction (r=0.668). Furthermore, the regression test results showed that all the three variables, namely family emotional atmosphere, self-control and sleep quality, can predict the changes in the internet addiction variable, such that per one standard deviation change in the familial emotional atmosphere, self-control and sleep quality a change of 0.163,  ̶ 0.382 and 0.375 deviation occurs in Internet addiction. Finally, simultaneous regression analysis showed that 51% of the students' internet addiction level can be explained by family emotional atmosphere, self-control and the students' sleep quality.
Conclusion: Based on the findings it is concluded that the variables family emotional atmosphere and sleep quality have a direct positive, while self-control has an inverse negative, relationship with Internet addiction. In addition, the family emotional atmosphere, high self-control and good sleep quality are effective in managing the use of the Internet by teenagers, which would mean that the proper awareness of parents and school counselors of the subject can help prevent internet addiction in teenagers.
 

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Background and Aim: Social health is one of the most basic criteria of social well-being and an effective factor in improving the quality of life of any society. .In Iran, the Office of Mental Health, Social Health and Addiction (OMSHA) is responsible for planning, implementing, monitoring and evaluating social health programs. The purpose of this research was to criticize and assess the contents of the social health component of the primary health care (PHC) system in an attempt to revise the contents.
Materials and Methods: The method used in this study was the deconstruction method. The research environment was all the contents of the social health component provided by OMSHA, and in order to obtain precise data the entire statistical population was taken as the study sample.
Results: In general, data analysis indicated the following: inappropriate screening, cultural adaptation, unidimensionality, role and responsibility adaptation, the preference of treatment to prevention, updating, comprehensiveness and adequacy of basic contents, and comprehensiveness and adequacy of practical suggestions.
Conclusion: It can be concluded that revision of the contents of the social health component of the Office of Mental health, Social Health and Addiction is a necessity in order to improve the delivery of mental health services..