مدل‌یابی معادلات ساختاری نشانه‌های اختلال استرس پس از سانحه (PTSD) ناشی از جنگ تحمیلی ۴۰ روزه بر پایه مؤلفه‌های نیازهای بین‌فردی (ادراک سربار بودن و تعلق از دست‌رفته) با نقش میانجی آمیختگی شناختی و گسلش شناختی در بزرگسالان

مجتبى پورآقا; آتیه  فلاحی بویه; فاطمه  قاسم پور; فاطمه  آمنه اقارب پرست; سهیلا  اسگندانی

Authors

Mojtaba Pouragha Department of Psychology, Ra.C., Islamic Azad University, Rasht, Iran Author https://orcid.org/0009-0001-2884-151X
Atiyeh Fallahi Bouyeh Department of Psychology, Ra.C., Islamic Azad University, Rasht, Iran Author https://orcid.org/0009-0007-5674-4139
Fatemeh Ghasempour Department of Psychology, Kho.C., Islamic Azad University, Khomeinishahr, Iran Author https://orcid.org/0009-0000-4411-6433
Fatemeh Ameneh Aghareb Parast Department of Psychology, Ka.C., Islamic Azad University, Karaj, Iran Author https://orcid.org/0009-0000-4411-6433
Soheila Esgandani Department of Psychology, WT.C., Islamic Azad University, Tehran, Iran Author https://orcid.org/0009-0000-4411-6433

Keywords:

Perceived burdensomeness, Thwarted belongingness, Cognitive fusion, Cognitive defusion, Posttraumatic stress disorder (PTSD), 40, day imposed war

Abstract

Objective: The present study aimed to model the structural relationships of posttraumatic stress disorder (PTSD) symptoms resulting from the 40-day imposed war based on interpersonal needs components, including perceived burdensomeness and thwarted belongingness, with the mediating role of cognitive fusion and cognitive defusion in adults.

Methodology: This study employed a descriptive-correlational design using structural equation modeling. The statistical population consisted of adult men and women aged 20 to 60 residing in Tehran, Isfahan, and Tabriz between March 2026 and April 2026. Initially, 513 participants were recruited through convenience sampling and completed electronic questionnaires. After screening based on the PTSD cutoff score, 374 individuals with moderate-to-severe PTSD symptoms were included in the final analysis. Research instruments included the Interpersonal Needs Questionnaire (INQ-10), the Cognitive Fusion Questionnaire (CFQ), and the PTSD Checklist for DSM-5 (PCL-5). Data were analyzed using SPSS-28 and AMOS-24 through Pearson correlation coefficients and structural equation modeling.

Findings: The findings demonstrated that the proposed model showed a satisfactory fit with the data. Perceived burdensomeness, thwarted belongingness, and cognitive fusion had significant positive direct effects on PTSD symptoms, whereas cognitive defusion showed a significant negative direct effect. Furthermore, perceived burdensomeness and thwarted belongingness positively predicted cognitive fusion and negatively predicted cognitive defusion. Bootstrap analyses also revealed that cognitive fusion functioned as a risk-enhancing mediator, while cognitive defusion acted as a protective mediator in the relationship between interpersonal needs and PTSD symptoms. Overall, perceived burdensomeness emerged as the strongest predictor of PTSD symptoms in the final structural model.

Conclusion: The results indicated that unmet interpersonal needs, particularly perceived burdensomeness, contribute substantially to the severity of PTSD symptoms through increasing cognitive fusion and weakening cognitive defusion among war-affected adults. Accordingly, interventions aimed at reducing cognitive fusion and strengthening cognitive defusion may serve as effective therapeutic approaches for alleviating war-related psychological consequences and improving posttraumatic adjustment.

Downloads

Download data is not yet available.

References

Abousaeidi Jirofti, S., Mahmoudaliloo, M., Neshat Gharemaleki, F., & Moaveni, H. (2024). The Mediating Role of Cognitive Fusion and Cognitive Defusion in the Relationship Between Rejection Sensitivity and Anorexia Nervosa in Young Girls. 13(11), 51-60.

American Psychiatric, A. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th , text rev. ed.). https://doi.org/10.1176/appi.books.9780890425787

Berisha Kida, E., Jahiu, G., & Karaj, T. (2025). Prevalence of Post-Traumatic Stress Disorder and Traumatic Exposure Among Teachers in Post-War Communities. Discover Mental Health, 5(1), 69. https://doi.org/10.1007/s44192-025-00194-6

Blain, R. C., Martin, C. E., Ehlinger, C. C., & Chard, K. M. (2023). Evidence Based Treatment for Posttraumatic Stress Disorder Decreases Suicidal Ideation by Reducing Perceived Burdensomeness Among Veterans in an Outpatient Program. Journal of Traumatic Stress, 36(6), 1138-1150. https://doi.org/10.1002/jts.23004

Darvishpour, Z., Kalanouri, Z., Oftadeh, Z., & Arbab Zehi, M. (2025). The Role of Psychological and Educational School Interventions in Improving Students' Psychological and Social Status After the 12-Day War. First International Conference of Leading Teachers in the Age of Transformative Research, Ahvaz. https://civilica.com/doc/2396597

Doosti, P., Khalatbari, J., Baseri, A., & Parvin Gonabadi, B. (2024). Designing an Indigenized Acceptance and Commitment Therapy Model and Its Effectiveness on Posttraumatic Stress Disorder. Quarterly Journal of Knowledge and Research in Applied Psychology, 25(96), 98-110.

Fekih-Romdhane, F. (2026). A Mediation Model on How PTSD Symptoms Are Related to Psychotic Experiences in Survivors of the Ongoing Gaza War 2023-2024. Conflict and Health, 20(1), 7. https://doi.org/10.1186/s13031-025-00744-3

Fischer, I. C., Na, P. J., Harpaz-Rotem, I., & Pietrzak, R. H. (2024). Prevalence, Correlates, and Burden of Subthreshold PTSD in US Veterans. The Journal of Clinical Psychiatry, 85(4), 24m15465. https://doi.org/10.4088/JCP.24m15465

Hapenny, J. E., & Fergus, T. A. (2017). Cognitive Fusion, Experiential Avoidance, and Their Interactive Effect: Examining Associations With Thwarted Belongingness and Perceived Burdensomeness. Journal of Contextual Behavioral Science, 6(1), 35-41. https://doi.org/10.1016/j.jcbs.2016.11.003

Ito, D., Watanabe, A., & Osawa, K. (2023). Mindful Attention Awareness and Cognitive Defusion Are Indirectly Associated With Less PTSD-Like Symptoms via Reduced Maladaptive Posttraumatic Cognitions and Avoidance Coping. Current Psychology, 42, 1182-1192. https://doi.org/10.1007/s12144-021-01521-0

Joiner, T. (2005). Why People Die by Suicide. Harvard University Press.

Mahboubi Matbou, M., Ahmadi, V., Soleimannejad, H., & Jafari Mehdiabad, A. (2024). Presenting a Model of Suicidal Behavior Based on Anxiety With the Mediation of Interpersonal Needs in Suicide Attempters. Journal of Health Promotion Management, 13(3), 89-100.

Martin, C. E., Pukay-Martin, N. D., Blain, R. C., Dutton-Cox, C., & Chard, K. M. (2021). Suicidal Ideation in a Veterans Affairs Residential Posttraumatic Stress Disorder Treatment Setting: The Roles of Thwarted Belongingness and Perceived Burdensomeness. Journal of Traumatic Stress, 34(6), 1188-1198. https://doi.org/10.1002/jts.22540

Morabito, D. M., Boffa, J. W., Bedford, C. E., Chen, J. P., & Schmidt, N. B. (2020). Hyperarousal Symptoms and Perceived Burdensomeness Interact to Predict Suicidal Ideation Among Trauma-Exposed Individuals. Journal of psychiatric research, 130, 218-223. https://doi.org/10.1016/j.jpsychires.2020.07.029

Namusoke, J., Mayengo, N., Nakanwagi, C. C., Omech, B., Kibedi, H., Ssenyonga, J., Amone-P'Olak, K., & Meiser-Stedman, R. (2025). Cognitive Appraisal as a Mediator of the Relations Between War Experiences and PTSD in the Formerly Abducted Youth in Northern Uganda: Findings From the WAYS Study. Psychological Trauma: Theory, Research, Practice, and Policy. https://doi.org/10.1037/tra0001944

Short, L. B., Xia, R., & O'Brien, W. H. (2025). Post-Traumatic Stress, Cognitive Fusion, and Intolerance of Uncertainty as Longitudinal Predictors of Post-Traumatic Growth From the COVID-19 Pandemic. Journal of Contextual Behavioral Science, 36, 100894. https://doi.org/10.1016/j.jcbs.2025.100894

Tanhaye Rashvanloo, F., Karshki, H., & Amin Yazdi, S. A. (2021). Psychometric Properties of the Interpersonal Needs Questionnaire Based on Classical Test Theory and Item Response Theory. Journal of Behavioral Sciences Research, 19(2), 328-341.

Tinsae, T., Shumet, S., Tadesse, G., Takelle, G. M., Rtbey, G., Melkam, M., Andualem, F., Nakie, G., Segon, T., Koye, S., Fentahun, S., & Alemu, W. G. (2024). Post-Traumatic Stress Disorder in the Ethiopian Population Dwelling in War-Affected Communities: A Systematic Review and Meta-Analysis. Frontiers in Psychiatry, 15, 1399013. https://doi.org/10.3389/fpsyt.2024.1399013

Varmaqani, H., Fathi Ashtiani, A., & Poursharifi, H. (2018). Psychometric Properties of the Persian Version of the PTSD Checklist for DSM-5. Applied Psychological Research Quarterly, 8(9), 131-142.

Wojcik, K. D., Cox, D. W., Kealy, D., & Zumbo, B. D. (2024). The Effect of Cognitive Fusion on Change in PTSD and Depression Symptom Severity in Veterans Engaged in Group Psychotherapy. Journal of Cognitive Psychotherapy, 38(2), 169-184. https://doi.org/10.1891/JCP-2022-0035

Zeydabadinejad, M. M., Nouri, N., Fatehi Khoshknab, L., Malekmohammadi, S., & Poursadegh Gavgani, Z. (2025). The Effectiveness of Mindfulness-Based Cognitive Therapy on Cognitive Fusion and Interpersonal Needs in Students With Suicidal Thoughts. Cognitive Psychology Quarterly, 13(2), 1-15.