Psychology of Woman Journal

Comparison of the Effectiveness of Existential Therapy and Schema Therapy in Reducing Death Anxiety among Women with Multiple Sclerosis

Liah Aqa Ali Akbari iD , Mahdieh Rahmanian ^* iD , Amin Rafieipour iD

Objective: This study aimed to compare the effectiveness of existential therapy and schema therapy in reducing death anxiety among married women with multiple sclerosis (MS).

Methods and Materials: This quasi-experimental study employed a pretest–posttest design with a control group. The statistical population comprised all married women diagnosed with multiple sclerosis in Tehran during the first six months of 2026 whose diagnosis had been confirmed by a specialist physician and who were receiving support from the Tehran Multiple Sclerosis Society. Using purposive sampling, 45 eligible women were selected and assigned to three groups of 15 participants: existential therapy, schema therapy, and control. Participants in the two intervention groups received the corresponding therapeutic programs, whereas the control group received no psychological intervention during the study period. Death anxiety was assessed at the pretest and posttest stages using the Templer Death Anxiety Scale. Data were analyzed using repeated-measures analysis of variance to examine changes in death anxiety across measurement occasions and differences among the three study groups.

Findings: Repeated-measures analysis of variance demonstrated a statistically significant reduction in death anxiety following psychological intervention. Both existential therapy and schema therapy produced significant improvements in death anxiety compared with the control condition, indicating that each intervention was effective in reducing death-related anxiety among women with multiple sclerosis. The between-group comparison of the two active interventions further revealed a significant difference in their therapeutic effectiveness. Existential therapy produced a greater reduction in death anxiety than schema therapy, demonstrating its comparatively stronger effect on death-related psychological distress in the study population.

Conclusion: Both existential therapy and schema therapy appear to be effective psychological interventions for reducing death anxiety among married women with multiple sclerosis; however, existential therapy may provide greater therapeutic benefits.

Comparing the Effectiveness of Mindfulness-Based Cognitive Therapy and Positive Psychology Interventions on Self-Acceptance in Women with Chronic Tension-Type Headache

Maedeh Mirzaei Malati iD , Elnaz Ahmadi Saravani ^* iD , Negin Amirardehjani iD

Objective: This study aimed to compare the effectiveness of mindfulness-based cognitive therapy (MBCT) and positive psychology interventions (PPI) in improving self-acceptance among women with chronic tension-type headache.

Methods and Materials: This quasi-experimental study employed a pretest–posttest design with a two-month follow-up and a control group. The study population comprised women diagnosed with chronic tension-type headache in Tehran, Iran, in 2025. Sixty participants were recruited through convenience sampling and assigned to three groups: MBCT (n = 20), PPI (n = 20), and control (n = 20). Both interventions were administered in eight 120-minute sessions, conducted twice weekly, while the control group received no intervention. Self-acceptance was measured using the Beck Self-Concept Test at pretest, posttest, and follow-up. Data were analyzed using mixed repeated-measures analysis of variance and Bonferroni-adjusted pairwise comparisons in SPSS version 23.

Findings: Mixed repeated-measures analysis of variance revealed statistically significant main effects of time and group and a significant time-by-group interaction on self-acceptance. Bonferroni-adjusted comparisons demonstrated significant improvements from pretest to posttest and from pretest to follow-up in both intervention groups, whereas changes in the control group were nonsignificant. Both MBCT and PPI produced significantly higher self-acceptance scores than the control condition at posttest and follow-up (p < .001). Furthermore, PPI demonstrated significantly greater effectiveness than MBCT at both posttest and follow-up assessments (p < .001), indicating a comparative advantage maintained over the two-month follow-up period.

Conclusion: Both MBCT and PPI were effective in improving self-acceptance among women with chronic tension-type headache, with PPI demonstrating superior and sustained outcomes. These findings suggest that positive psychology interventions may represent a promising psychological approach for enhancing self-acceptance in this population. Further randomized studies with longer follow-up periods are recommended to establish the durability and clinical significance of these improvements.

The Relationship Between Sense of Coherence and Post-Traumatic Growth in Breast Cancer Survivors: The Mediating Roles of Stress-Related Benefit Finding and Positive Changes in Attitudes Toward Life

Ghazal Taghavirad ^* iD , Mina Sheykh iD , Mahsa Talebi Eshkalak iD , Nazanin Fahimi iD , Kamran Pourmohammad Ghouchani iD

Objective: This study aimed to investigate the relationship between sense of coherence and post-traumatic growth in breast cancer survivors, with stress-related benefit finding and positive changes in attitudes toward life as mediating variables.

Methods and Materials: This descriptive-correlational study employed structural equation modeling. The statistical population consisted of breast cancer survivors in Mashhad, Iran, from whom 400 participants were selected using convenience sampling. Data were collected using Antonovsky’s 29-item Sense of Coherence Questionnaire (1987), Tedeschi and Calhoun’s 21-item Post-Traumatic Growth Inventory (1996), Park’s 17-item Stress-Related Benefit-Finding Questionnaire (1998), and Wallace and Wright’s 24-item Attitude Toward Life Questionnaire (2005). Data were analyzed using SPSS for preliminary statistical analyses and AMOS version 24 for testing the measurement and structural models. Direct and indirect relationships among the study variables were examined, and bootstrap analysis was used to assess the significance of the mediating effects.

Findings: Structural equation modeling indicated that sense of coherence had a positive and statistically significant direct relationship with post-traumatic growth. Stress-related benefit finding significantly mediated the relationship between sense of coherence and post-traumatic growth. Positive changes in attitudes toward life also demonstrated a statistically significant independent mediating effect in this relationship. Furthermore, bootstrap analysis confirmed that the simultaneous indirect effect of stress-related benefit finding and positive changes in attitudes toward life on the association between sense of coherence and post-traumatic growth was statistically significant. The final structural model also demonstrated an acceptable overall fit, supporting the hypothesized relationships among the study variables.

Conclusion: Sense of coherence appears to facilitate post-traumatic growth among breast cancer survivors both directly and through adaptive psychological processes involving benefit finding and positive reconstruction of attitudes toward life.

Developing a Model of Codependency Based on Addictive Behaviors Among Women in Families Affected by Addiction

Fatemeh Masoudinia iD , Hossein Davoudi ^* iD , Fariba Arjmandi iD

Objective: This study aimed to develop and explain a comprehensive model of codependency based on addictive behaviors among women in families affected by addiction and to identify its principal antecedents, contextual and intervening factors, coping strategies, and psychological and interpersonal consequences.

Methods and Materials: This applied qualitative study employed qualitative content analysis. Participants were experts in psychology, counseling, psychiatry, addiction, and related clinical fields who were selected through purposive sampling until theoretical saturation was achieved. Data were collected using semi-structured interviews lasting approximately 30–40 minutes. The interview transcripts were repeatedly reviewed and analyzed through open, axial, and selective coding using constant comparison. Credibility, transferability, dependability, and confirmability criteria were used to establish the trustworthiness of the qualitative findings.

Findings: Qualitative analysis identified codependency based on addictive behaviors as a multidimensional, interactive, and cyclical phenomenon. Causal conditions included low self-esteem, negative self-concept, emotional dependency, insecure attachment, dysfunctional beliefs regarding responsibility and self-sacrifice, and adverse developmental experiences. The central phenomenon was characterized by excessive emotional dependency, pathological focus on the person exhibiting addictive behaviors, controlling behaviors, excessive rescuing, self-neglect, and tolerance of emotional harm. Contextual conditions comprised cultural, familial, and economic factors, whereas psychological, therapeutic, and social-support factors functioned as intervening conditions. Coping responses ranged from maladaptive control, monitoring, emotional suppression, and conflict avoidance to adaptive boundary setting, self-care, treatment seeking, and identity reconstruction. Major consequences included depression, chronic anxiety, psychological exhaustion, reduced self-esteem and differentiation of self, disturbed emotional intimacy, marital conflict, impaired trust, and reproduction of the codependency cycle.

Conclusion: Codependency among women in families affected by addiction is best understood as a complex process produced by interactions among individual vulnerabilities, family dynamics, sociocultural pressures, and available psychological and social resources.

Predicting Psychological Distress Based on Psychological Flexibility, Attachment Needs, and Alexithymia in Infertile Women Following Unsuccessful IVF

Somayeh Esmaili iD , Azarmidokht Rezaei ^* iD , Maryam Zarnaghash iD , Forouzan Esmaielzadeh iD

Objective: The present study aimed to predict psychological distress based on psychological flexibility, attachment needs, and alexithymia among infertile women who had experienced unsuccessful in vitro fertilization (IVF).

Methods and Materials: This quantitative, cross-sectional, descriptive-correlational study was conducted using structural equation modeling. The statistical population comprised infertile women receiving treatment in infertility centers in Shiraz, Iran, during 2025–2026 who had experienced at least one unsuccessful IVF cycle. A total of 280 eligible women were selected through purposive non-probability sampling. Data were collected using the Depression Anxiety Stress Scales-21 (Lovibond & Lovibond, 1995), Cognitive Flexibility Inventory (Dennis & Vander Wal, 2010), Marital Attachment Needs Scale (Samani et al., 2023), and Toronto Alexithymia Scale-20. Data were analyzed using Pearson correlations and structural equation modeling with SPSS 26 and AMOS 24.

Findings: Structural analyses showed that psychological flexibility significantly predicted psychological distress (β = .58, p < .001). Attachment needs were also a significant predictor of psychological distress (β = .48, p < .001). In addition, alexithymia significantly predicted psychological distress (β = .43, p < .001). Correlation analysis further showed significant associations between psychological distress and psychological flexibility (r = −.17, p < .01), attachment needs (r = −.47, p < .05), and alexithymia (r = .65, p < .01).

Conclusion: Psychological flexibility, attachment needs, and alexithymia are important psychological factors associated with distress following unsuccessful IVF. Assessment of these variables may help identify women at greater psychological risk and support the development of targeted psychological interventions alongside infertility treatment.

Comparison of the Effectiveness of a Sexual Intelligence Psychoeducational Counseling Package for Women with Marital Conflicts and Johnson’s Emotionally Focused Therapy on Sexual Relationship

Zahra Jalali Asil iD , Seyed Hamid Atashpour ^* iD , Hadi Farhadi iD

Objective: Marital conflict can reduce emotional intimacy and the quality of sexual relationships. The present study aimed to compare the effectiveness of a sexual intelligence psychoeducational counseling package package and Johnson’s Emotionally Focused Therapy (EFT) in improving sexual relationships among women experiencing marital conflict.

Methods and Materials: This study employed a quasi-experimental three-group pretest–posttest design with a two-month follow-up. A total of 54 married women experiencing marital conflict who sought services at counseling centers in Shahrekord were selected using convenience sampling and randomly assigned to three groups: sexual intelligence education–counseling, Johnson’s Emotionally Focused Therapy, and control (18 participants per group). The two intervention groups received 10 weekly two-hour intervention sessions, whereas the control group received no intervention. Data were collected using the Sexual Relations subscale of the Hurlbert Index of Sexual Assertiveness (HISA; Hurlbert, 1992) and analyzed using repeated-measures analysis of variance (ANOVA) and the Bonferroni post hoc test in SPSS version 23.

Findings: The results of the repeated-measures ANOVA indicated that the main effect of time (p < .001), the time × group interaction effect (p = .048), and the between-group effect (p = .041) were statistically significant for sexual relationships. The Bonferroni post hoc test further showed that a statistically significant difference existed only between the sexual intelligence education–counseling group and the control group. In contrast, the difference between the Emotionally Focused Therapy group and the control group, as well as the difference between the two intervention groups, was not statistically significant (p > .05).

Conclusion: The sexual intelligence psychoeducational counseling package package significantly improved sexual relationships among women experiencing marital conflict, whereas Johnson’s Emotionally Focused Therapy did not produce a statistically significant effect. The implementation of the sexual intelligence psychoeducational counseling package package in family counseling centers is recommended as an intervention for improving the quality of couples’ sexual relationships.

Effectiveness of Group Narrative Therapy on Hope, Marital Forgiveness, and Marital Intimacy in Women Affected by Marital Infidelity

Mona Aghababaei iD , Zekrollah Morovati ^* iD , Jafar Houshyari iD

Objective: This study aimed to investigate the effectiveness of group narrative therapy in improving hope, marital forgiveness, and marital intimacy among women affected by marital infidelity.

Methods and Materials: This quasi-experimental study employed a pretest–posttest control-group design with a three-month follow-up. Participants were 30 women affected by marital infidelity who attended counseling centers in District 5 of Tehran, Iran, in 2025. Participants were selected through purposive sampling and randomly assigned to a group narrative therapy condition (n = 15) or a control condition (n = 15). The intervention consisted of ten weekly 90-minute group narrative therapy sessions based on the narrative approach of White and Epston. Data were collected using the Miller Hope Scale, Marital Offence-Specific Forgiveness Scale, and Marital Intimacy Needs Questionnaire. Data were analyzed using repeated-measures analyses and Bonferroni-adjusted comparisons.

Findings: Group narrative therapy significantly improved all primary outcomes compared with the control condition. Significant between-group differences were observed for hope (mean difference = 8.48, p = .001), total marital forgiveness (mean difference = 9.40, p = .001), and total marital intimacy (mean difference = 19.60, p = .001). Improvements were also evident across the dimensions of marital forgiveness and marital intimacy. The pattern of follow-up scores indicated that treatment gains were largely maintained three months after the intervention.

Conclusion: Group narrative therapy appears to be an effective intervention for enhancing hope, marital forgiveness, and marital intimacy among women affected by marital infidelity. The intervention may facilitate both psychological and relational recovery by promoting meaning reconstruction, personal agency, and alternative narratives following betrayal.

Psychometric Evaluation and Validation of the Persian Version of the Screen for Adult Anxiety Related Disorders (SCAARED) in a Sample of Iranian Mothers

Alireza Nalaie iD , Zahra Bagherzadeh Golmakani ^* iD , Ahmad Mansouri iD , Mustafa Bolghan-Abadi iD

Objective: This study aimed to evaluate the psychometric properties and validate the Persian version of the Screen for Adult Anxiety Related Disorders (SCAARED) in a sample of Iranian mothers.

Methods and Materials: This descriptive-correlational psychometric study was conducted among mothers of lower-secondary school students in Mashhad, Iran, during the 2024–2025 academic year. The target population comprised approximately 110,000 mothers, of whom 296 were selected using multistage cluster sampling. Following forward and backward translation of the SCAARED, its face and content validity were evaluated by 15 experts in anxiety disorders. Construct validity was assessed through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Internal consistency and construct reliability and validity were examined using Cronbach’s alpha, composite reliability, average variance extracted (AVE), the Fornell–Larcker criterion, and the heterotrait–monotrait (HTMT) ratio.

Findings: The content validity ratio (CVR) values for all 44 items ranged from 0.60 to 1.00, while item-level content validity index (I-CVI) values ranged from 0.87 to 1.00. EFA supported a four-factor structure accounting for 58.3% of the total variance. CFA further confirmed the adequacy of the four-factor model. The Cronbach’s alpha coefficient for the total scale was 0.807, indicating satisfactory internal consistency. The AVE was 0.586, supporting adequate convergent validity. Furthermore, the Fornell–Larcker criterion and HTMT matrix demonstrated satisfactory discriminant validity among the identified factors.

Conclusion: The Persian version of the SCAARED demonstrated satisfactory reliability, content validity, construct validity, convergent validity, and discriminant validity. Accordingly, it can be considered a valid and reliable instrument for screening anxiety disorders among Iranian mothers and may be used in both research and clinical settings.

Psychology of Woman Journal

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Comparing the Effectiveness of Emotion-Focused Therapy and Transactional Analysis Therapy on Interpersonal Problems in Conflicted Women Seeking Divorce

Comparison of the Effectiveness of Relational Imagery Therapy and Acceptance and Commitment Therapy on Communication Patterns in Women Experiencing Marital Infidelity

Predicting Anxiety Sensitivity Based on Fatigue and Occupational Stress Among Female Law Enforcement Employees

Comparison of the Effectiveness of Time Perspective and Emotional Efficacy-Based Interventions on Social-Emotional Loneliness and Self-Concealment in Single Women in the Climacteric Period

Gendered Experiences of Workplace Discrimination: A Qualitative Analysis of Women in Leadership Positions

The Relationship Between Childhood Trauma and Personality Traits with Attitudes Toward Childbearing in Married Women Aged 25–45

Comparison of the Effectiveness of Emotion-Focused Therapy and the Existential–Spiritual Reconstruction Protocol in Enhancing Quality of Life Among Women Attending Healthcare Centers in Bushehr City

Effectiveness of Schema Therapy on Emotion Regulation and Anxiety Sensitivity in Women with Borderline Personality Disorder

Can Self-Repair Training Help Women with Symptoms of Borderline Personality Disorder? A Quasi-Experimental Study

Prediction of Attitudes Toward Marital Infidelity Based on Thinking Styles and Mindfulness with the Mediating Role of Emotional Attachment in Women

Artificial Neural Network Prediction of Psychological Well-Being Among Women Using Emotional, Cognitive, and Social Features

Predicting Body Dissatisfaction Among Young Women Using Random Forest Based on Social Media, Appearance, and Self-Evaluation Features

Identifying Individual, Family, and Social Factors Contributing to Psychological Empowerment Among Women

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