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Background Drug abuse in juveniles is one of the most serious problems which lead to different physical, social and educational damages and outcomes. Objectives The aim of the present study is to predict the addiction Potential in youths by their early maladaptive schemas. Materials and Methods The research sample included students of the University of Sistan and Baluchistan, Zahedan, Iran, with average age of 19-24 years. Participants were 260 undergraduate students (159 girls and 101 boys) that were selected by probability proportional cluster random sampling. The instruments were the Addiction Potential Scale (APS) and Early Maladaptive Schemas SQ-SF (short form questionnaires). Results The result showed that there are positive and significant relationships among early maladaptive schemas include Disconnection/ Rejection, Impaired autonomy / Performance, Impaired Limits, Other-Directedness and Over vigilance / Inhibition, and addiction Potential. Also, results of regression showed the highest Addiction Potential predicted by the following schemas: Disconnection / Rejection, impaired autonomy and performance other-Directedness. Conclusions Therefore, Addiction Potential is one of the areas which can be used in planning and preventive activities, through identifying the groups with Early Maladaptive Schemas.

Background: due to its progressive nature in all aspects of life, addiction endangers the health of individuals, families and the society. Objectives: The purpose of this study was to determine the role of self-regulation and affective control in predicting interpersonal reactivity of drug addicts. Materials and Methods: This research is a correlation study. The statistical population of this study includes all drug addicts who were referred to addiction treatment centers of Ardabil in 2011 of whom 160 addicts were selected through convenience sampling. A self-regulation questionnaire, interpersonal reactivity questionnaire and affective control scale were used for data collection. Results: Research results showed that self-regulation (r = -0.40) and affective control (r = -0.29) have a significant relationship with interpersonal reactivity of addicts (P < 0.001). The results of the multiple regression analysis indicated that 19 percent of interpersonal reactivity can be predicted by self-regulation and affective control. Conclusion: These results suggest that self-regulation and affective control play an important role in exacerbating as well as reducing interpersonal reactivity of addicts.

Background: Research shows that parents have an immense influence over their children's behavior during adolescence. Adolescents who grow up with parents who are addicted to drugs and alcohol are more likely to turn to self-destructive behaviors such as suicide attempts. Because addiction in Iran is a primarily masculine phenomenon and in traditional Iranian culture, the father is responsible for family affairs and is recognized as the family provider, paternal addiction affects adolescent children. However, the impact of this type of parental addiction on adolescent suicide attempts has received little attention. Objectives: This study was conducted to assess the impact of paternal addiction on adolescent suicide attempts. Patients and Methods: This was a qualitative study that used a grounded theory approach. Thirteen participants, from two hospitals in Shiraz (southern Iran), were interviewed. We used purposeful sampling, followed by theoretical sampling. Data were collected from in-depth semi-structured interviews. Data analysis was done using Strauss and Corbin's (1998) approach, followed by the constant comparative method. Results: The mean age of the adolescents was 15.75 ± 1.83, and all of them were single. Five main themes were extracted from the data: mental health problems, relationship problems, financial problems, family problems, and imitation of risky behaviors. Conclusions: The findings suggest that in addition to the need to consider paternal addiction in health care plans, it is also necessary to pay attention to other family members, including the adolescents themselves. Health care providers, including nurses, can use the findings from this study for the purposes of prevention and education. Keywords: Adolescent; Addiction; Qualitative Research; Suicide Attempts Language: en

Background: Addiction is characterized differently among women and men, and they begin using drugs for different reasons and motives. Objectives: The aim of the study was to explore the gendered experiences and patterns of illicit drug use initiation in an Iranian context. Patients and Methods: A total of 29 participants (15 men and 14 women) took part in in-depth interviews conducted at a HIV triangulation clinic (for men and women) and drop-in-center for women in Kerman in 2011. Results: The results of the study suggest that patterns of drug use are different among among Iranian men and women. Men often transit to drug use from cigarette smoking, whereas women’s drug use practices often begins with opium. Unlike women, men who used drugs were often single at their drug use debut. Conclusions: Different patterns of first exposure to drug use among men and women highlight the role of gendered expectations and socio-cultural norms in shaping drug use experiences of people who use drugs and call for gender-specific harm reduction interventions.

Background: Substance abuse is a chronic phenomenon that affects many physical, psychological, social, familial and economic elements. Abusers are left with severely reduced interaction both with other individuals and society. Objectives: The aim of this study was to compare the spiritual health of addicts and people with a normal quality of life in the city of Birjand, Iran. Patients and Methods: The sample consisted of 100 non-addicted subjects and 100 patients who were drug addicts in treatment centers and rehabilitation facilities both public and private in Birjand. Normal sampling measures were used to find subjects of the same age and gender. The subjects completed a spiritual health questionnaire and the short form of the world health organization’s (WHO) Quality of life questionnaire, and the data were analyzed using multivariate ANOVA. Results: The results of ANOVA showed significant differences between addicted and non addicted individual on spiritual well-being subscales. Conclusions: The strengthening of spiritual and religious attitudes among drug users encourages them to engage in and justify actions that are relevant to their health. When this happens, their quality of life increases significantly.

Background: Drug abuse is a chronic and enduring phenomenon, which is among the important challenging public health problems. One of the main aspects in drug abuse is the relapse. Objectives: The aims of this study were to estimate the time to relapse (survival rate) and to evaluate some of its associated variables by survival analysis. Patients and Methods: This research was conducted in four addiction treatment centers on 140 self-referred addicts in Ilam city, Iran, in 2012. Cluster sampling method was used for selecting the samples and data were collected by interview and referring to the subjects’ records. The gathered data were analyzed through the life table, Kaplan-Meier analysis, log rank test, and Cox regression. Results: The relapse rate was 30.42%, mean and median of the time to relapse (survival time) were 27.40 ± 1.63 months (CI 95%: 24.19 - 30.60) and 25 ± 2.25 months (CI 95%: 22.5 - 27.5), respectively. In the first six months, the cumulative survival rate was 83%, while in the 24th month it was 46% and the following time was consistent. Job status (OR = 2.64), marital status (OR = 1.55), family size (OR = 1.20) and age (OR = 0.23) were statistically significant in Cox regression model. Conclusions: In the initial treatment, it seems necessary to supervise and monitor the treatment process through staff in addiction treatment centers together with the company of the addicts’ families to reduce relapse rate.

BACKGROUND: There is a great deal of medical literature suggesting that substance use disorder is a serious clinical concern, affecting general population and associated with considerable economic, societal, and personal costs. OBJECTIVES: This study sought to clarify the relationship between early trauma, dissociative experience, and suicide ideation as predictive factors of active and passive addiction potential (A/PAP) in high-school students. PATIENTS AND METHODS: Three hundred students with the mean age of 15.72 y were selected via multistage random sampling. All participants were asked to complete Iranian addiction potential scale, early trauma inventory, dissociative experiences scale, and Beck's suicide ideation scale. Analyzing data was done using canonical correlation. RESULTS: Structural coefficients showed that the pattern of high scores in A/PAP correlates with the pattern of high scores in early trauma, dissociative experience and suicide ideation. The findings of the study showed that the combination of low A/PAP can probably decrease the likelihood of early trauma, dissociative experience and suicide ideation. CONCLUSIONS: Early trauma, dissociative experience, and suicide ideation can predict A/PAP and explain the considerable variance of survival index. Language: en

Dear Editor, Addiction is a complex behavior (1). Acquisition, development, and maintenance of addictive behaviors are resulted from the interplay between many interacting factors (2) including the psychological and/or biological predispositions of the individual (e.g. genetic, attitudinal, belief and personality factors, unconscious motivations, etc.), the social environment in which the individual lives (i.e. situational characteristics), and the activity itself (i.e. structural characteristics) (3). This ‘global’ view of addiction highlights various integrative processes which interplay between these individual, situational and structural differences. Depending upon the type of addiction, these various overarching influences (i.e. individual, situational, and structural) can be subdivided even further. Addiction can be therefore conceptualized as a complicated and integrated jigsaw. The paper by Bakhshi Bojed and Nikmanesh (4) provided another piece in the ‘addiction’ jigsaw by demonstrating that specific individual differences (in this case, early maladaptive schemas developed in adolescence, i.e. disconnection/rejection; impaired autonomy and performance; impaired limits; other-directedness; over-vigilance/inhibition) show a significant positive correlation with addictive potential. Despite the highly significant positive correlational relationship, the study showed that even with three of the maladaptive schemas (i.e. disconnection/rejection; impaired autonomy and performance; other-directedness) added to the stepwise regression model, it still only explained 18% of the variance for addictive potential. Although these results appear to confirm the findings of other studies which have shown a positive correlation between early maladaptive schemas and drug addictions (5, 6), the study findings also revealed that vast majority of the addictive potential among adolescents is explained by many other influencing factors. To paraphrase Burglass and Shaffer (7), two of the most important questions in the addiction field are ‘why do people become addicted to some things and not others?’ and ‘why some people become addicted and not others?’ (of which, findings of Bakhshi Bojed and Nikmanesh contribute empirical evidence to the second question) (4). In a paper by Larkin and colleagues (8) examining the nature of addiction, responses to these two critical questions have been somewhat impeded because of two common misconceptions about such behavior: Addiction somehow resides within a particular type of individual. Addiction resides in a particular substance (in the case of chemical addictions) or activity (in the case of behavioral addictions). Put more simply, the misconception is that some individuals are already ‘diseased,’ or that some activities or substances cause the disease, or both. Findings of Bakhshi Bojed and Nikmanesh (like those investigating other factors such as influence of parents or the media) (9, 10) suggest that strategies are highly needed to prevent the addiction occurring in the first place. Majority of researchers have identified vulnerable groups with predispositions to developing addictions. As Bakhshi Bojed and Nikmanesh asserted, we need to create suitable preventive and therapeutic strategies based on the results of empirical work. Researchers should also be aware that addictions and dependencies are not just restricted to those who are involved with ingestion of a psychoactive substance. Research into maladaptive schemas could also be adapted for research into other addictions including behavioral addictions such as gambling, video game, exercise and shopping addictions (11). The complex systems model, as formulated by Griffiths and Larkin (1), corresponds well to the bio-psychosocial approach to addiction and can incorporate any addiction risk factor, including maladaptive schemas. Griffiths and Larkin have (1, 12) also argued for a complex systems model of addiction. ‘Complex’ for the obvious reason that addictive behavior is complex, and ‘systems’ based on the research of Davies (13), who proposed that alternative explanations for addictive behavior require "development of a ‘system’ within which drug usage is conceived as an activity carried out for positive reasons, by people who make individual decisions about their substance usage and who may take drugs competently as well as incompetently" (p.163). Based on the observations made by Polkinghorne, the paper by Griffiths and Larkin (1) argued that the complex systems model (which they contended that was a more theoretically flexible approach) goes “some way towards bridging the epistemological gap” (p. 101). Griffiths and Larkin also contended that the complex systems approach was descended from previous writings which take a multi-factorial approach in explaining addictive behaviors (14). It is also possible to consider the interplay between common and unique elements of any particular individual’s situation and across the lifespan utilizing the complex systems model (including adolescence as highlighted in the paper by Bakhshi Bojed and Nikmanesh) (4). This includes many factors (i.e. physiological, social, psychological, and cultural) that may be specific to an individual person. Additionally, such an approach is all-inclusive and can include both the psychopharmacological properties of specific psychoactive substance addictions as well as the psychologically reinforcing properties of behavioral addictions such as pathological gambling. However, it such a model is not a return to locating the property of ‘addictiveness’ within a particular substance or within a particular activity, although those in the field need be aware of the effects (eg, physiological, psychological, social), that share commonalities with specific kinds of activities or substances, but not with others. It is clear that many research paradigms are insular and inadequate in explaining addiction. Development of maladaptive schemas on their own cannot and do not fully explain addictive behavior. Addictions are multi-faceted behaviors, cannot be explained by a single parsimonious theory, and can be strongly influenced by contextual factors (2). Research into (and treatment of) addictive behavior needs to be rooted within an interdisciplinary bio-psychosocial perspective, which eclectically incorporates the best theoretical approaches of contemporary biology, psychology, and sociology. According to Griffiths, a successful explanatory theory of addictive behaviors should contain a number of core components (1). More specifically, such a theory must “ Synthesize pharmacological, cultural, situational and personality factors, Account for the varying nature of addiction across cultures, individuals and time, Account for commonalities between all addictions, and Be faithful to lived human experience” (p. 196). The paper by Bakhshi Bakhshi Bojed and Nikmanesh contributes further evidence for (and to) the multi-faceted nature of addiction (4).

Dear Editor, The use of psychoactive drugs is a wide spread phenomenon which occurs in virtually all cultures of the world. Most people who consume psychoactive substances may control their consumption well over their whole life span and even draw benefits from it (1). In a minority of the users, however, controlled drug use can make a transition to drug addiction. This is a psychiatric disorder which requires treatment, or even better, prevention. Although drug use is the ‘conditio sine qua none’ of developing drug addiction, there are additional factors that contribute significantly to the risk. There are genetic (2) and epigenetic factors (3, 4), and there are environmental factors. These environmental factors may be further distinguished in passively incurred and actively developed factors (5). Passively incurred factors may be the experience of a natural disaster or a major private loss, which may then trigger the escalation of drug consumption. But there are also actively developed environmental factors. One group of them is the schemas that people form. These are patterns of beliefs and thoughts about oneself, others, and the environment, which shape how we perceive our environment, how we form memories and how we generate behavior. These schemas are acquired starting in early life. They can be helpful or maladaptive. Young et al. (6) had identified eighteen maladaptive schemas which were grouped in five areas: 1) disconnection/rejection, 2) impaired autonomy/performance, 3) impaired limits, 4) other directedness and 5) over vigilance/inhibition. These schemas are believed to foster negative experiences in life and produce a rather insufficient coping with psychological pressure. Positive schemas, in contrast, allow people to experience more positive experiences and allow for a better coping with stressful life events. Previous studies have shown that an enhanced rate of early established maladaptive schemas is found in drug users (7, 8). While genetic, epigenetic and also passively incurred environmental factors can only explain a small proportion of the addiction risk, it is currently unclear which role actively developed factors might play. Bakhshi Bojed and Nikmanesh asked in their study whether the establishment of maladaptive schemas increases addiction potential of young people and whether these early maladaptive schemas can predict addiction potential. To address this question they investigated 260 students (159 females, 101 males) of the University of Sistan and Baluchestan in the year 2011-12. They were all young adults 19-25 years of age. All subjects were administered the Addiction Potential Scale questionnaire to evaluate current addiction potential. In order to measure early maladaptive schemas, the young schema questionnaire – short form was used. The main finding of this study was a significant positive correlation between addiction potential and all of the five areas of early maladaptive schemas (disconnection/rejection, impaired autonomy and performance, Impaired limits, other-directedness and over vigilance/inhibition). In a regression analysis the authors identified the schema of disconnection/rejection as the most influential factor, which alone determined already 0.16 of the variance in the addiction potential. Together with the schemas ‘impaired autonomy’ and ‘other-directedness’ it explained 0.19 of the variance (9). These findings clearly suggest that there is a strong relationship between early maladaptive schemas and the addiction potential in young adults. Maladaptive schemas are established early in life often by family interactions. In fact, offspring copies the schemas of parents, family members or even peers. This may explain why there is a high inheritance of the addiction risk (10), but only a small part of it appears genetically or epigenetically transmitted. As the present study shows, an increasingly big role might be played by inherited schemas, where children simply copy maladaptive schemas of their parents. Maladaptive schemas not only predict addiction as it was shown in previous studies (7, 8), but already the addiction potential. Thus, they may well suit as screening instruments to identify people at increased risk of addiction and may allow focusing prevention programs in the future.

Background: Addiction for narcotics is a dangerous reality, especially in teenagers and young persons, and is one of the most important socioeconomic and health problems, threatens the human society and leads to social stagnancy in various aspects. Objectives: The present study aimed at determining Meta-cognitive relationship with addiction potential tendency in students and determining the distribution of each Meta-cognitive dimension in predicting addiction potential tendency. Materials and Methods: The descriptive-correlative method was used for conducting this research. The research target population included all students of Ardebil Mohaghegh University. A sample of 380 subjects was selected randomly from this demographic population by cluster multistage sampling. We used Weed and colleagues’ questionnaire of addiction to assess addiction potential tendency, and the Meta-cognitive scale of Wells and colleagues for evaluating Meta-cognition. Data gathered were analyzed by multifold Regression via simultaneous entrance method. Results: The rate of students’ addiction potential tendency can be predicted by having characteristics of their Meta-cognition. It also appeared that among the five parameters of Meta-cognition, the role of three parameters required for controlling thoughts, uncontrollability and risk, and positive beliefs about anxiety were of great importance in predicting addiction potential tendency in students. Conclusions: The results of this research have important implications regarding the attention of students’ counselors to Meta-cognitive dimensions in order to prevent students’ tendency for addiction.