Journal of Police Medicine

fa پیش‌بینی آمادگی به اعتیاد در بیماران مبتلا به سرطان بر اساس ادراک حمایت اجتماعی با میانجی‌گری خودکارآمدی درد و پذیرش درد Prediction of Addiction Readiness in Cancer Patients Based on the Perception of Social Support with the Mediation of Pain Self-Efficacy and Pain Acceptance روان‌شناسی انتظامی Police Related Psychology پژوهشی اصيل Original Research <div style="text-align: justify;">اهداف: درد سرطان، افکار و باورهای منفی در بیماران ایجاد می‌کند که می‌تواند سطح کارکرد و تحمل درد را در این بیماران تحت تأثیر قرار دهد. در چند دهه‌ اخیر، مصرف مواد مخدر برای تسکین درد در بیماران دارای سرطان به‌طور چشمگیری بالا رفته است. پژوهش حاضر با هدف بررسی نقش میانجی پذیرش ‌درد و خودکارآمدی درد در ارتباط بین ادراک حمایت اجتماعی و آمادگی به اعتیاد انجام شد. مواد و روش‌ها: جامعه آماری این پژوهش توصیفی-همبستگی، زنان و مردان دارای سرطان شهر اراک در سال 1400-1399 بود. 201 بیمار دارای سرطان مراجعه‌کننده به بیمارستان‌های شهر اراک به روش نمونه‌گیری در دسترس (97 زن و 104 مرد) انتخاب شدند. تمامی نمونه‌ها مقیاس حمایت اجتماعی ادراک‌شده Zimet و همکاران (1988)، پرسش‌نامه خودکارآمدی درد Nicholas (1980)، پرسش‌نامه درد مزمن vowels و همکاران (2004) و پرسش‌نامه آمادگی اعتیاد Wade و Butcher (1992) را تکمیل کردند. برای تحلیل داده‌ها از روش تحلیل مسیر با استفاده از نرم‌افزارSPSS 25  و Amos 24 استفاده شد. یافته‌ها: 201 بیمار با میانگین سنی 10/38±53/46 سال در این پژوهش شرکت کردند. نتایج حاکی از برازش مطلوب مدل پژوهش بود. نتایج نشان داد که میان ادراک حمایت اجتماعی، پذیرش درد و خودکارآمدی درد با آمادگی به اعتیاد همبستگی منفی معنادار (0/001p<) و میان ادراک حمایت اجتماعی با پذیرش درد و خودکارآمدی درد همبستگی مثبت معنادار (0/001p<) وجود داشت. در مسیر غیرمستقیم، مدل میانجی ادراک حمایت اجتماعی میان خودکارآمدی درد و پذیرش درد با آمادگی اعتیاد در سطح معناداری 0/001 و ضریب استاندارد (0/30-) معنادار بود. نتیجه‌گیری: تقویت شبکه حمایت اجتماعی افراد، در کنار توسعه احساس خودکارآمدی و پذیرش جنبه‌های غیرقابل کنترل، می‌تواند به عنوان اهداف و برنامه‌های درمانی پیشگیرانه از حرکت بیماران به سوی مصرف مواد مخدر برای تسکین درد مدنظر قرار گیرد.</div>   <div style="text-align: justify;"> Aims: Cancer pain creates negative thoughts and beliefs in patients, which can affect the level of functioning and pain tolerance in these patients. In recent decades, the use of drugs for pain relief in cancer patients has increased dramatically. The present study was conducted with the aim of investigating the mediating role of pain acceptance and pain self-efficacy in the relationship between the perception of social support and readiness for addiction. Materials and Methods: The statistical population of this descriptive-correlation study was men and women with cancer in Arak city in 2020-2021. A total of 201 cancer patients referred to Arak hospitals were selected by available sampling method (97 women and 104 men). Perceived Social Support Questionnaire of Zimet et al. (1988), Pain Self-Efficacy Questionnaire of Nicholas (1980), Chronic Pain Questionnaire of Vowels et al. (2004) and Addiction Readiness Questionnaire by Wade and Butcher (1992) were completed by all the samples. For data analysis, path analysis method was used using SPSS 25 and Amos 24 software. Findings: Out of 215 participants, 14 were excluded from the analysis due to incomplete completion of the questionnaires, and the final analysis was performed on 201 people. Of these, 104 were men (51.75%), and 97 were women (48.25%). The average age of the participants in the research was 53.46±10.38 years, and 34.82% had a middle school diploma (70 people), 24.37% had a high school diploma (49 people), 30.84% had a bachelor's degree (62 people), and 9.95% had a master's degree or higher (20 people). Nineteen people (9.45%) were single, and 165 (82.08%) were married. Thirty-one (15.4%) of the participants had breast cancer, 29 (14.4%) had prostate cancer, 36 (17.9%) had stomach cancer, 33 (16.4%) had colon cancer, 26 people (12.9%) had bladder cancer, 25 people (12.4%) had skin cancer, nine people (4.5%) had uterine cancer, and 12 people (6.0%) had thyroid cancer. The value of kurtosis and skewness of the variables was in the range of -2 to +2, so the data had a normal distribution and the default of data analysis was followed (Table 1). There was a negative and significant correlation between the perception of social support and potential for addiction (r=-0.389). Also, there is a positive and significant relationship between the perception of social support and pain acceptance (r=0.486), a positive and significant correlation between the perception of social support and pain self-efficacy (r=0.462), and a negative and significant correlation between pain acceptance and potential for addiction (r=-0.511). Moreover, there was a negative and significant relationship between pain self-efficacy and potential for addiction (r=-0.414). After descriptive data analysis, path analysis defaults were checked and confirmed. The multicollinearity of the variables was investigated using the tolerance statistic and variance inflation factor, and the results showed no multicollinearity between the variables. Path analysis was used to examine the relationship between the variables of perception of social support, pain acceptance, pain self-efficacy, and potential for addiction. Figure 1 shows the path analysis diagram of the final model, and Table 3 shows the fit indices of the final model in the target sample. The fit indices of the final model include the chi-square index (X²/Df=2.94), comparative fit index (CFI=0.99), incremental fit index (IFI=0.99), Tucker-Lewis fit index (TLI=0.93), and the root mean square deviation of approximation (RMSEA=0.09) indicated the optimal fit of the final model. The results of the direct effect of social support perception on pain acceptance, social support perception on pain self-efficacy, pain acceptance on addiction, and pain self-efficacy on addiction and the standard indirect coefficient of social support perception on addiction with the mediating role of pain acceptance and pain self-efficacy was equal to -0.30 (Table 4). The result of the Sobel test for the significance of the mediating variable of pain acceptance was equal to 3.40 and for the variable of pain efficiency was equal to 2.39. Since the z-value was greater than 1.96, the significance of the influence of mediating variables was confirmed. Conclusion: Strengthening the social support network of individuals, along with developing a sense of self-efficacy and acceptance of uncontrollable aspects, can be considered as preventive treatment goals and plans for patients' tendency to use drugs for pain relief. CLINICAL & PRACTICAL TIPS in POLICE MEDICINE By providing a platform to increase the social network of individuals and by emphasizing holding training courses that are fundamental factors in the formation of an independent and coherent identity when facing life-threatening diseases, psychologists and counselors of military institutions can promote patients’ acceptance and self-efficacy in order to increase the mental health of police forces in the society. Acknowledgments: We appreciate all the patients who participated in this study. CONFLICT of INTEREST: The authors stated that there is no conflict of interest in the present study. AUTHORS CONTRIBUTION: First author, ideation, study design, data collection, data analysis; second author, study design, data collection, data analysis; third and fourth authors, study design and data analysis. All the authors participated in the initial writing of the article and its revision, and all accept the responsibility for the accuracy and correctness of the article's contents with the final approval of this article. FUNDING SOURCES This research had no financial support.</div>   <div style="text-align: center;">Table 1) Mean, kurtosis and skewness of research variables</div> <table align="center" class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Variable</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">M±SD</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Kurtosis</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Skewness</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Pain acceptance</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">45.20±5.78</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.97</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.38</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Pain self-efficacy</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">30.66±6.19</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-0.09</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.08</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Potential for addiction</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">76.68±8.03</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-0.04</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-0.060</td> </tr> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">Perception of social support</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">33.38±3.64</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">1.19</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">1.60</td> </tr> </tbody> </table> <div style="text-align: center;"> <div aria-label="Page Break" class="cke_pagebreak" contenteditable="false" data-cke-display-name="pagebreak" data-cke-pagebreak="1" style="page-break-after:always" title="Page Break"></div>Table 2) Correlation matrix of research variables</div> <table align="center" class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Variable</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">1</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">2</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">3</td> <td style="border-bottom: 1px solid black; width: 27px; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">4</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Pain acceptance</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">1</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;"></td> </tr> </tbody> </table> <table align="center" class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;"></td> </tr> </tbody> </table> <table align="center" class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;"></td> </tr> </tbody> </table> <table align="center" class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;"></td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;"></td> </tr> </tbody> </table> <table align="center" class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;"></td> <td style="border-width: initial; border-style: none; border-color: initial; width: 27px; padding: 0cm 2px; text-align: center;"></td> </tr> </tbody> </table> <table align="center" class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-width: initial; border-style: none; border-color: initial; width: 27px; padding: 0cm 2px; text-align: center;"></td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 4px; text-align: center;">Pain self-efficacy</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 4px; text-align: center;">0.448**</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 4px; text-align: center;">1</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 4px; text-align: center;"></td> </tr> </tbody> </table> <table align="center" class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 4px; text-align: center;"></td> <td style="border-width: initial; border-style: none; border-color: initial; width: 27px; padding: 0cm 2px; height: 4px; text-align: center;"></td> </tr> </tbody> </table> <table align="center" class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-width: initial; border-style: none; border-color: initial; width: 27px; padding: 0cm 2px; height: 4px; text-align: center;"></td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 4px; text-align: center;">Potential for addiction</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 4px; text-align: center;">-0.511**</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 4px; text-align: center;">-0.414**</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; height: 4px; text-align: center;">1</td> <td style="border-width: initial; border-style: none; border-color: initial; width: 27px; padding: 0cm 2px; height: 4px; text-align: center;"></td> </tr> </tbody> </table> <table align="center" class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-width: initial; border-style: none; border-color: initial; width: 27px; padding: 0cm 2px; height: 4px; text-align: center;"></td> </tr> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; height: 4px; border-top: none; border-right: none; border-left: none; text-align: center;">Perception of social support</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; height: 4px; border-top: none; border-right: none; border-left: none; text-align: center;">0.486**</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; height: 4px; border-top: none; border-right: none; border-left: none; text-align: center;">0.462**</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; height: 4px; border-top: none; border-right: none; border-left: none; text-align: center;">-0.389**</td> <td style="border-bottom: 1px solid black; width: 27px; padding: 0cm 2px; height: 4px; border-top: none; border-right: none; border-left: none; text-align: center;">1</td> </tr> </tbody> </table> <div style="text-align: center;">Significant at the p<0.01 level** <div aria-label="Page Break" class="cke_pagebreak" contenteditable="false" data-cke-display-name="pagebreak" data-cke-pagebreak="1" style="page-break-after:always" title="Page Break"></div>  <img alt="" src="./files/site1/images/image-20230411090312-1.png" style="width: 435px; height: 303px;" > Figure 1) The output model of the role of mediation in the relationship between the perception of social support and potential for addiction <div aria-label="Page Break" class="cke_pagebreak" contenteditable="false" data-cke-display-name="pagebreak" data-cke-pagebreak="1" style="page-break-after:always" title="Page Break"></div> Table3) final model suitability indices</div> <table align="center" class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Fit index</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Df</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">X2/Df</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">RMSEA</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">CFI</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">IFI</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">TLI</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Acceptable value</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">+</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Less than 3</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Less than 0.10</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">More than 90</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">More than 90</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">More than 90</td> </tr> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">The final model</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">1</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">2.94</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.09</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.99</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.99</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.93</td> </tr> </tbody> </table> <div style="text-align: center;"><div aria-label="Page Break" class="cke_pagebreak" contenteditable="false" data-cke-display-name="pagebreak" data-cke-pagebreak="1" style="page-break-after:always" title="Page Break"></div> Table 4) The effect of direct and indirect relationship in the final model</div> <table align="center" class="MsoTableGrid" style="border-collapse:collapse; border:none"> <tbody> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Direction</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">Standard beta</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: 1px solid black; border-right: none; border-left: none; text-align: center;">p</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Perception of social support >>> acceptance of pain</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.48</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.001</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Perception of social support >>> pain self-efficacy</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.46</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.001</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Acceptance of pain >>> potential for addiction</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-0.40</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.001</td> </tr> <tr> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">Pain self-efficacy >>> potential for addiction</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">-0.23</td> <td style="border-width: initial; border-style: none; border-color: initial; padding: 0cm 2px; text-align: center;">0.001</td> </tr> <tr> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">Perception of social support >>> pain acceptance* pain self-efficacy >>> addiction</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">-0.30</td> <td style="border-bottom: 1px solid black; padding: 0cm 2px; border-top: none; border-right: none; border-left: none; text-align: center;">0.001</td> </tr> </tbody> </table> <div style="text-align: center;"></div> <div style="text-align: center;"></div>    اعتیاد,درد سرطان,حمایت اجتماعی,خودکارآمدی,درد, Addiction,Cancer Pain,Social Support,Self-Efficacy,Pain, 1 14 http://jpmed.ir/browse.php?a_code=A-10-1274-1&slc_lang=fa&sid=1 Sarah Behzad سارا بهزاد sarah.behzad@gmail.com 100319475328460013988 100319475328460013988 No Department of Psychology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran گروه روان‌شناسی، واحد سنندج، دانشگاه آزاد اسلامی، ، سنندج، ایران yahya yarahmadi یحیی یاراحمدی yyarahmadi@gmail.com 100319475328460013989 100319475328460013989 Yes Department of Psychology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran گروه روان‌شناسی، واحد سنندج، دانشگاه آزاد اسلامی، ، سنندج، ایران Farshad Bahari فرشاد بهاری fbahari20277@yahoo.com 100319475328460013990 100319475328460013990 No Department of Psychology, Arak Branch, Islamic Azad University, Arak, Iran گروه روان‌شناسی، واحد اراک، دانشگاه آزاد اسلامی، اراک، ایران Hamzeh Ahmadian حمزه احمدیان ahmadian2012@gmail.com 100319475328460013991 100319475328460013991 No Department of Psychology, Sanandaj Branch, Islamic Azad University, Sanandaj, Iran گروه روان‌شناسی، واحد سنندج، دانشگاه آزاد اسلامی، ، سنندج، ایران