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Abstract Aim and Background: Evidences show that both negative and positive affects play role in tendency to use substances, giving this issue, the current study was conducted in other to investigate relationships between distress tolerance, negative and positive urgency with severity of dependence and craving in people with substance dependency. Methods and Materials: The method of this research was correlation. The whole people with substance dependency were referring to Ardabil centers of addiction treatment, comprised statistical society of this research. One hundred and thirty people were selected by cluster sampling method from this society. Having conducting clinical interview, they responded to questionnaires of demographic characteristics, distress tolerance, negative and positive urgency, severity of dependence and craving. Collected data were analyzed by SPSS 18 with tests of Pearson correlation and multiple regression via inter method. Findings: The results showed that severity of substance dependency related negatively to rate of tolerance (r=-0.33; P≤0.002), absorption(r=-0.26; P≤ 0.01), and total score of distress tolerance (r=-0.25; P≤ 0.02), but positively to negative urgency (r=0.23; P≤ 0.04). Craving also correlated negatively with tolerance(r=-0.35; P≤0.001), appraisal(r=-0.30; P≤0.001), absorption (r=-0.34; P≤0.001), regulation (r=-0.23; P≤0.03), and total score of distress tolerance(r=-0.45; P≤ 0.001), but positively to positive(r=0.26; p≤ 0.03), and negative urgency(r=-0.29; P≤ 0.01). The results of regression analyses also reveled that 31 percent of variance of craving was explained with distress tolerance reversely Conclusions: According to results of this study and importance of craving as a central factor in addiction relapse, training the coping skills with negative affect, especially increasing coping power with distress were suggested for addicted clients along with typical therapies substance abuse and dependency.

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Aim and Background : The aim of the present study was to examine the role of cognitive emotion regulation strategies and distress tolerance in high-risk behaviors among students. Methods and Materials : In a correlational study, from among all students of various schools of Kharazmi University in 2014-2015, 240 students (146 women and 94 men) were selected using multistage cluster sampling. The participants completed the Cognitive Emotion Regulation Questionnaire, Distress Tolerance Questionnaire, and Iranian Adolescents Risk-Taking Scale. Data analysis was performed using the Pearson correlation coefficient and multiple regression analysis (stepwise). Findings : The correlation coefficients showed that adaptive strategies (acceptance, positive refocusing, refocusing on planning, positive reappraisal, and putting into perspective) had a significant negative relationship with some risky behaviors (dangerous driving, violence, cigarette smoking, substance abuse, alcohol consumption, and relationship with the opposite sex). The non-adaptive strategies of blaming others and catastrophizing had a significant positive relationship with the risky behaviors of dangerous driving, violence, cigarette smoking, substance abuse, and sexual relationship and behavior. These results also indicated that components of distress tolerance (tolerance, absorption, and appraisal) had a significant negative relationship with some risky behaviors (dangerous driving, violence, cigarette smoking, substance abuse, and sexual relationship and behavior). The results of multiple regression analysis showed that among the five adaptive strategies, strategies of acceptance, positive refocusing, refocusing on planning, and positive reappraisal had predictive power for some risky behaviors. In addition, among the four non-adaptive strategies, strategies of catastrophizing, and blaming others had predictive power for some risky behaviors. Moreover, among the components of distress tolerance, appraisal and absorption components had predictive power for some risky behaviors. Overall, among other predictors, the two strategies of refocusing on planning and positive reappraisal, with explanation of 11% of variance in violence scores, had the highest coefficient for high-risk behaviors. Conclusions : From the findings of this study, it can be inferred that cognitive emotion regulation strategies and distress tolerance were important predictors of risky behaviors in students. Therefore, in educational programs for the prevention and reduction of risky behaviors among students, cognitive emotion regulation strategies and distress tolerance require more attention.

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Aim and Background: Migraine is one of the most common neurological diseases and one of the factors that reduce the overall quality of life of patients. On the other hand, various factors such as psychological characteristics and emotional problems are important in determining the severity of problems caused by this disorder. Two important factors are the emotion regulation and distress tolerance. The aim of this study was to compare the quality of life, emotion regulation and distress tolerance in migraine and non-migraine individuals.
Methods and Materials: The study was a causal-comparative study. The statistical population consisted of all individuals with migraine referring to neurosurgical clinics in Kashan in spring and summer of 2018 as well as non-migraine individuals from the general population. Two groups of 40 individuals, one group of migraine sufferers and the other group of non-disabled individuals, were selected from the statistical population. Participants completed these instruments: World Health Organization Quality of Life Scale (WHOQOL-BREF), Difficulties in Emotion Regulation Scale (DERS) and Distress Tolerance Scale (DTS). Data analyzed using SPSS-19 software and independent t-test.
Findings: There was a significant difference between the two groups in the quality of life (t=-7.56), emotion dysregulation (t= 9.19) and distress tolerance (t=-3.42).
Conclusions: People with migraine reported lower quality of life and distress tolerance compared to non-migraine patients. They also had more difficulty adjusting their emotions. These patients are unable to tolerate distress because they cannot relieve their pain. As a result, migraine, as a chronic pain, disrupts daily activities and decreases quality of life.

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Aim and Background: Based on the theories of etiology of self-injury behaviors, several psychological and social multivariate models have been investigated to predict self-injury behaviors in adolescents. This study aimed to investigate the mediating role of self–criticism and distress tolerance in relationship between attachment styles and non-suicidal self-injury behaviors in adolescents.

Methods and Materials: This study was a descriptive-correlational study with structural equation modeling approach. The statistical population consisted of all high school students in Kashmar city in the years 2018-2019. Initially, a sample of 700 students was selected among all high school students were selected by multistage cluster sampling, but the final analysis was performed on 292 students who reported at least one experience of non-suicidal self-injury behaviors. Data were collected using Deliberate Self–Harm Inventory (DSHI), Childhood Attachment to Each Parent Scale (CAEPS), Distress Tolerance Scale (DES) and Forms of-Self–Criticism/Attacking & Self-Reassuring (FSCRS) and were analyzed in SPSS and LISREL software by using structural equation modeling.

Findings: The results showed that the relationship between attachment styles and non-suicidal self-injury behaviors mediated by self-criticism and distress tolerance. The amount of fit indices of GFI, CFI, NFI, IFI, NNFI, AGFI, RFI and RMSEA were equal to 0.94, 0.93, 0.90, 0.93, 0.90, 0.90, 0.89 and 0.071, respectively. The results indicate that the proposed model fits the data well. The findings of the study showed that 34% of the observed variance in non-suicidal self-injury behaviors can be explained through a combination of parent attachment, self-criticism and distress tolerance.

Conclusions: The findings of this study confirmed the mediating role of self-criticism and distress tolerance in the relationship between attachment styles and non-suicidal self-injury behaviors. Thus, it seems necessary for experts, therapists and planners when working with adolescents and specifically in counseling and treatment centers to consider the role of these mediating variables.

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Aim and Background: Suicide as one of the leading causes of death worldwide is a major public health concern; however, few studies have examined the factors influencing it in families on the verge of divorce. To determine the prediction of tendency to suicide based on the difficulty of emotional regulation, cognitive flexibility, family flexibility, and distress tolerance in adolescents and young families on the eve of divorce in Isfahan.
Methods and Materials: The present study was a descriptive correlation that was performed in the statistical population of all adolescents and young families on the eve of divorce in Isfahan in the second six months of 2019-2020. According to the Cochran's formula, 373 people were selected and answered Beck scale for suicide ideation, difficulties in emotion regulation scale, cognitive flexibility inventory, family flexibility questionnaire and distress tolerance scale. Data collected by Pearson correlation coefficient and stepwise regression were analyzed using SPSS-24 software.
Findings: The research findings showed that difficulty in emotion regulation a positive and significant relationship with the tendency to suicide. Cognitive flexibility, family flexibility and distress tolerance have a negative and significant relationship with tendency to suicide (P<0/01). Data from stepwise regression analysis also showed that cognitive flexibility and difficulty in emotion regulation have a combined ability to predict 17% of variance changes in tendency to suicide (P<0/01).
Conclusions: The results of the present study showed that difficulty in emotion regulation and cognitive flexibility play an important role in the tendency to suicide in adolescents and young families on the eve of divorce.

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Aim and Background: Cerebral palsy is a non-progressive movement and postural disorder that occurs following nerve damage in the early years and causes motor and neurological disabilities. Disorders in daily life activities, heavy medical expenses and severe dependence on others affect the functioning of the family, especially mothers. Therefore, the present study was conducted to compare the effectiveness of self-compassion therapy and psychological capital training on the tolerance of anxiety and emotional self-regulation of mothers of children with cerebral palsy.
Methods and Materials: The present study was a quasi-experimental study with pre-test, post-test and follow-up design. The statistical population of the study included mothers with children with cerebral palsy in rehabilitation centers under the supervision of Shahrekord Welfare in 2019 (270 subjects) of which a sample of 45 subjects were selected and randomly divided into three groups (two experimental and a control group) were assigned. Individuals in both experimental groups participated in 10 sessions of 90 minutes in self-compassion and psychoanalytic courses. Participants answered the Simmons and Gaher (2005) Emotional Distress Tolerance Questionnaire and the Emotional Self-Regulation Questionnaire (2010) in three stages. Research data were analyzed using repeated measures analysis of variance and independent t-test.
Findings: The results showed that self-compassion training and psychological capital training have increased the stress tolerance of mothers with children with cerebral palsy in the same and effective way(p<0.05) and among the two intervention methods, only psychological capital training was able to improve mothers' emotional self-regulation (p<0.001).
Conclusions: Based on the results of the present study, it can be said that two methods of self-compassion training intervention and psychological capital training can be used as effective intervention options to improve anxiety tolerance and self-regulation of mothers of children with cerebral palsy.

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Aim and Background: Researchers are interested in facilitating mechanisms in therapeutic interventions, including cultural mechanisms, therefore this study was conducted to compare the effectiveness of cognitive-behavioral therapy using Mowlana's parables and anecdotes and acceptance and commitment therapy in distress tolerance in mothers of children with cerebral palsy.
Methods and Materials: This applied study was conducted using a mixed method (using qualitative-quantitative data). The quantitative part of the research consisted of comparative content analysis and the quantitative phase consisted of a quasi-experiment with pretest-posttest design using intervention and control groups. Participants consisted of 48 mothers of children with cerebral palsy who were selected using purposeful sampling and were randomly allocated to two intervention and one control groups. To collect data, the Distress Tolerance Scale (Simmons and Gaher, 2005) were used. Data were analyzed in SPSS 23 using the repeated measures ANOVA and Bonferroni's post-hoc test.
Findings: The results showed that the difference in the effect of the two treatment methods on the components of tolerance (p=0.020), evaluation (p=0.037) and, accordingly, the total distress tolerance score (p=0.016) is significant, so that the treatment based on acceptance and commitment has increased the average scores of the two components of tolerance and evaluation more in addition to the total score of distress tolerance compared to cognitive behavioral therapy using Rumi's parables and anecdotes.
Conclusions: It can be concluded that the treatment based on acceptance and commitment is a more effective method to increase distress tolerance in mothers of children with cerebral palsy compared to cognitive behavioral therapy using Rumi's parables and anecdotes.

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Aim and Background: Breast cancer is the most common malignancy in women, and despite medical advances and the development of treatments, this disease continues to cause psychological and physical effects on the life dimensions of many affected people, such as the attitude to death and tolerance of distress, which should be taken into account. Therefore, the aim of this research was the effectiveness of emotional schema therapy on attitude towards death and distress tolerance of breast cancer patients.
Methods and Materials: The research method is semi-experimental with a pre-test-post-test design and follow-up with a control group. The statistical population included all patients diagnosed with breast cancer in government cancer treatment centers located in Isfahan. The sample consisted of 36 patients with breast cancer from Seyed al-Shohda Hospital (AS) in Isfahan and Alaa Cancer Prevention and Control Center, who were selected through targeted sampling and randomly divided into two experimental groups (18 people) and control groups (18 people). The experimental group was treated with emotional schema. The data in this research was collected The Death Attitude Profile (DAP-R) –Revised (Wang, Racker & Gasser,1994) and the Distress Tolerance Scale (DTS) by (Simons& Gaher, 2005), in three stages: pre-test, post-test and follow-up, and it was done using proportional statistical tests and SPSS-26 software.
Findings: The results of the analysis of variance with repeated measurements showed that emotional schema therapy improved the attitude towards death and distress tolerance of the experimental group at a significant level (P<0.05).
Conclusions: The results of the present study showed that the effectiveness of emotional schema therapy can have a significant impact on the psychological characteristics of breast cancer patients, including the attitude towards death and distress tolerance, so it is suggested that this type of treatment be used to help breast cancer patients.

 

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Aim and Background: Chronic and incurable diseases, such as celiac disease, significantly impact the quality of life of patients and their families. The diagnosis of celiac disease in a child can pose a threat to the mental well-being of their caregivers, especially their mothers, as these individuals often endure considerable anxiety and psychological stress. Therefore, the aim of the present study is to compare the effectiveness of solution focused therapy and narrative therapy on distress tolerance in mothers of children diagnosed with celiac disease.
Methods and Materials: The present study is a semi-experimental intervention research with a pre-test, post-test, and three-month follow-up design, consisting of two experimental groups and one control group. The statistical population included mothers with at least one child diagnosed with celiac disease who are members of the Celiac Association of Iran in Isfahan. Among them, 60 individuals were selected through purposive sampling and randomly assigned to two experimental groups and one control group (20 participants in each group). The first experimental group received solution-focused therapy, while the second experimental group underwent narrative therapy in the form of eight90-minute sessions. The control group received no intervention. Data were collected using the Distress Tolerance Questionnaire by Gaher and Simon (2005). The data were analyzed in SPSS version26 using repeated measures ANOVA and Bonferroni post-hoc tests.
Findings: Both interventions led to a significant increase in distress tolerance among mothers of children with celiac disease (P<0.01). Additionally, there was no significant difference in the effectiveness of the two interventions on distress tolerance between the two experimental groups at the post-test stage. These results remained stable during the follow-up phase (P<0.01).
Conclusions: Both solution-focused therapy and narrative therapy can be utilized as beneficial interventions to enhance distress tolerance in mothers of children with celiac disease