نادر منیرپور

Objective: Due to unpleasant consequences of depression in patients suffering from cardiac diseases, such as increase in mortality rate during the first year, especially after undergoing a surgery; this study addresses structural relationships between cognitive and behavioral variables including illness perception and coping strategies in predicting depression after undergoing Coronary Artery Bypass Grafting (CABG) and Percutaneous Coronary Intervention (PCI). Besides, one of the cognitive models for assessing psychological adaptation with chronic medical diseases was outlined for the first time. Method: The sample comprised 245 coronary patients confronted with the diagnosis for the first time, who had undergone PCI and CABG interventions. They were chosen and interviewed through convenience sampling following one month of initiating treatment process. For this purpose, Beck Depression Inventory for Primary Care (BDI-PC), Coping Inventory for Stressful Situations (CISS-21) and the short format of Disease Perception Questionnaire were administered. Data was analyzed using structural equations modeling (LISREL software). Results: findings indicated that applying emotion-focused coping strategies determined 40% of depression variance in these patients, whereas problem-focused strategies determined 4.5% of it and avoidant coping strategy didn’t have a significant role in depression. On the other hand, illness perception as a cognitive variable, could directly determine 26% of depression and 4.5% of it through emotion-focused strategies and 0.25% by means of problem-focused strategies. Also illness perception, could meaningfully determine 50% of emotion-focused coping variance, 7% of problem-focused variance and 8% of avoidance variance. Conclusion: Overall results of this study supported Leventhal’s theoretical model of self-regulation and verified the role of cognitive variables (illness perception) and behavioral ones (coping strategy) in emerging depression. Therefore it is recommended that much attention be drawn to the process of developing patient’s illness perception through personal or group trainings and if necessary, offering effective cognitive and behavioral treatments by practitioners.

Purpose : Most couples have communication problems in their married life, the existence of chaotic relationships has destructive effects on formation of emotional divorce among couples: purpose of this study was to present a model of emotional divorce based on differentiation with mediating role of attachment styles and experience of we-ness. Methodology : the research method was descriptive-correlational and the statistical population included all parents of students referring to counseling and guidance centers of association of parents and educators of Tehran in 2020 that their number was1836 people.the statistical sample size was considered based on Sample Power statistical software (350 people),and sampling method was multi-stage random.research tools included, Guttman (2008) Emotional Divorce Scale, Skorn and Friedlander (1989) Differentiation inventory, Collins and Reed(1990)Attachment Styles Scale, Vedes, Nussbeck,Bodenman (2013) Experience of We-ness Questionnaire,in this study, data analysis was performed using SPSS software and Smartpls Structural Equations. Findings : the results showed,presenting the model of emotional divorce based on differentiation with mediating role of attachment styles and experience of we-ness, accordance with the theoretical model and has a good fit,also,the study of direct path showed that there is asignificant negative relationship between the components of differentiation, attachment styles and experience of we-ness with emotional divorce and the results of the indirect path also showed that differentiation has a significant negative relationship with mediating role of attachment styles and experience of we-ness with emotional divorce and intensity of desired effect. Conclusion : Inordertocreate cohesion and create asatisfying marital relationship based on recognizing the emotions of each couple and modifying the attachment style and type of differentiation of couples,we can confront the psychological elements to improve the relationship between couples during medical considerations