Mental health among Syrian immigrants in Iraq
Abstract
Background: The migration of Syrian citizens to many parts of the world began after civil war in Syria. Many migrants lost their homes, friends and relatives as a result ofthe civil war. Millions of Syrians have been refugeesto European countries and especially to neighboring countries such as Libya, Turkey and Iraq. They have experienced housing, safety and cultural gap problems, which may put their mental health at risk. Many present signs of physical and mental illness, such as an insomnia, a weakened immune system, drug addiction,self-harm, and aggression, making their social adjustment more and more difficult. Despite facing the same conditions, other immigrants succeed to adjust with the new environment. It is necessary to understand factorsthat may optimize immigrants’social adjustment. Objectives: The aim of the present study is to evaluate to what extend some characteristics of Syrian immigrantsin Iraq,such as cultural intelligence, emotional intelligence are related to their social adjustment, and the role of mental health upon that relationship. Methods: Participants are Syrian immigrants who live in Erbil – Iraq. Data collection was held in 2017. Were randomly included 288 subjects (50% female). All participants completed 4 questionnaires translated from Persian version to Arabic language: Cultural and Emotional Intelligence Questionnaires (CI and EI), a Social Adjustment scale (SA) and a Mental Health Questionnaire (MH). Results: This study presents an empirical study into the mental health of immigrants. More specific, based on collected questionnaire data an explanatory model for mental health and social adjustment is established on the basis of emotional- and cultural intelligence. A better mental health is associated with better social adjustment. Emotional and cultural intelligence are significantly and positively and significantly and positively associated to social adjustment. Cultural intelligence issignificantly and positively related to mental health, while emotional intelligence has no significant relation with mental health, when simultaneous effects are analyzed. Conclusions: The present results suggest that mental health may have an intermediate role in the relationship between cultural intelligence and social adjustment, but no intermediate role in the relationship between emotional intelligence and social adjustment. Results convey an important message to public policies, highlighting the importance of preserving both cultural and emotional intelligence among Syrian immigrant in Iraq, as a measure to assure their mental health and social adjustment.
Full text
ACTA PSYCHOPATHOLOGICA ISSN 2469-6676 2019 Vol.5 No.2:1 1 iMedPub Journals Research Article www. i m e dpub. c om DOI: 10.4172/2469-6676.100183 © Under License of Creative Commons Attribution 3.0 License | This article is available from: www.psychopathology.imedpub.com Firouzeh Sepehrianazar1, Sara Qader Tilee1 and Margarida Gaspar de Matos2* 1 Urmia University, Urmia, Iran 2 FacultyofHumanMedicine,Institute of Environmental Health, University of Lisbon, Portugal *Corresponding author: Margarida Gaspar de Matos mmat[email protected]; margarida.gaspar[email protected]om Professor, Faculty of Human Medicine, Institute of Environmental Health, WFH/ University of Lisbon, Estrada da Costa 1495688 Cruz Quebrada, Portugal. Tel: + 351-21-414-91-52 Citation: Sepehrianazar F, Tilee SQ, Matos MGD (2019) Mental Health among Syrian Immigrants in Iraq. Acta Psychopathol Vol.5 No.2:1 Mental Health among Syrian Immigrants in Iraq Abstract Background: ThemigrationofSyriancitizenstomanypartsoftheworldbegan aftercivilwarinSyria.Manymigrantslosttheirhomes,friendsandrelativesasa resultofthecivilwar.MillionsofSyrianshavebeenrefugeestoEuropeancountries and especially to neighboring countries such as Libya, Turkey and Iraq. They have experienced housing, safety and cultural gap problems, which may put their mental health at risk. Many present signs of physical and mental illness, such as an insomnia,aweakenedimmunesystem,drugaddiction,self-harm,andaggression, makingtheirsocialadjustmentmoreandmoredifficult.Despitefacingthesame conditions,otherimmigrantssucceedtoadjustwiththenewenvironment.Itis necessarytounderstandfactorsthatmayoptimizeimmigrants’socialadjustment. Objectives: The aim of the present study is to evaluate to what extend some characteristicsofSyrianimmigrantsinIraq,suchasculturalintelligence,emotional intelligence are related to their social adjustment, and the role of mental health uponthatrelationship. Methods: Participants are Syrian immigrants who live in Erbil – Iraq. Data collectionwasheldin2017.Wererandomlyincluded288subjects(50%female). All participants completed 4 questionnaires translated from Persian version to Arabiclanguage:CulturalandEmotionalIntelligenceQuestionnaires(CIandEI),a SocialAdjustmentscale(SA)andaMentalHealthQuestionnaire(MH). Results: This study presents an empirical study into the mental health of immigrants.Morespecific,basedoncollectedquestionnairedataanexplanatory model for mental health and social adjustment is established on the basis of emotional- and cultural intelligence. A better mental health is associated with bettersocialadjustment.Emotionalandculturalintelligencearesignificantlyand positivelyandsignificantlyandpositivelyassociatedtosocialadjustment.Cultural intelligenceissignificantlyandpositivelyrelatedtomentalhealth,whileemotional intelligence has no significant relation with mental health, when simultaneous effectsareanalyzed. Conclusions: The present results suggest that mental health may have an intermediate role in the relationship between cultural intelligence and social adjustment, but no intermediate role in the relationship between emotional intelligence and social adjustment. Results convey an important message to public policies,highlightingtheimportanceofpreservingbothculturalandemotional intelligence among Syrian immigrant in Iraq, as a measure to assure their mental health and social adjustment. Keywords: Immigrants; Cultural intelligence; Emotional intelligence; Mental health; Social adjustment Received: December 19, 2018; Accepted: April 09, 2019; Published: April17,2019
2019 ACTA PSYCHOPATHOLOGICA ISSN 2469-6676 Vol.5 No.2:1 2This article is available from: www.psychopathology.imedpub.com intelligence. Tabatabaeimozabadi [15] claimed that there is a significantcorrelationbetweenEmotionalIntelligence&Cultural Intelligence. Emotional intelligence is one of the factors that affect cultural intelligence, although Ang, Van Dyne, Koh, Templer, Tay & Chandrasekar [16] argued that cultural intelligence is conceptually and empirically different from emotional intelligence. Emotional intelligence is the appropriate processing of the data which has emotional load. Various scholarssuchasBar-On[17],Sepehrianazar[18]andGoleman [19] have been working on conceptualizing emotional intelligence. Mayer, Salovey & Caruso [20] believe that people with high emotional intelligence can control own emotions and others’. According to their theory, emotional intelligence consists of four different abilities: perception of emotion, emotional facilitation, understanding emotions, and managementofemotions.Parsamehr&Heddat[21]showed a direct þrelationship þbetween þemotional þintelligence þand þsocial þadjustment among407 þ þstudents þof þYazd þUniversity,Iranand,accordingtoSepehrianazar’sstudy[22]. Emotional intelligence has significant effects on psychological healthandontheindividuals’behaviours. Theaimofthepresentstudyistoevaluatetowhatextendsome characteristics of Syrian immigrants in Iraq, such as cultural intelligence, emotional intelligence are related to their social adjustment,andtheroleofmentalhealthuponthatrelationship. Methods The aim of the present study is to evaluate to what extend somecharacteristicsofimmigrants,suchasculturalintelligence, emotional intelligence and mental health, are related to their social adjustment in the host country and the role of mental healthuponthatrelationship A diagrammed model (Figure 1) was designed to propose a conceptual working model of the direct and indirect effects of theabove-mentionedvariables,thepattern(s)ofrelationship(s), andtheeffectofmentalhealth. Participants ParticipantsareSyrianimmigrantswholiveinErbilcityofIraq Country, in 2017. Were included 288 subjects (50% female) randomlyselectedwithintheimmigrants‘group.Participantsage rangedfrom20tomorethan40,(42%/n=121)hadagesbetween 20and30;40%(n=115)hadagesbetween31and40yearsold, and18%(n=52)wereolderthan40(Meanage,45.4yearsold, SD,3.77).47.5%(n=116)oftheseparticipantshadschoolingup tosecondaryschool,and52.5%(n=128)hadauniversitydiploma. Data collection All participants volunteer to participate in the study and have completedfourquestionnaires.Datacollectionwasanonymous. Studyfollowedallusualethicsguidelinesforresearchinhumans. Thestudywascarriedoninthecontextofanacademicresearch supervisedbyUrmiaUniversityandclearanceofethicsissueswas obtained at the University level. Background Eachyearmillionsofpeoplechangetheirlifeworlds,eitheragainst theirwillorvoluntarily,andnowadays,duetofasterandmore sophisticated communication tools and conditions, the world witnesses the increasing rise in immigration [1]. Immigration is one of the social behaviors issues [2] that cause changes in populationstructure,culturalandscientifictransfer,andalltypes ofvoluntaryorcompulsoryimmigrationfacedifferentchallenges inacross-culturalenvironment,whileexperiencingthechange from a familiar environment to an unfamiliar [3]. ThemigrationofSyriancitizenstomanypartsoftheworldbegan aftercivilwarinSyria.Migrantsareingeneralcitizenswholost their homes, relatives and friends, as a result of the civil war. Millions of Syrians have been refugees to European countries and especially to neighboring countries such as Libya, Turkey and Iraq.MostofSyriaRefugeestoIraqwhoareKurdish,liveinIraqi Kurdistan, Erbil [4]. They have experienced s problems, such as living in tents, limited facilities and cultural differences. There are signs of physical and mental illness among them, such as an insomnia,aweakenedimmunesystem,drugaddiction,self-harm, andaggression,makingtheiradjustmentwiththeenvironment moreandmoredifficult[4].Despitefacingthesameconditions, someimmigrantssucceedtoadjustwiththenewenvironment.It isnecessarytounderstandfactorsthatmayoptimizeimmigrants’ social adjustment. Theoretical Background Adjustment refers to all strategies that a person uses to handle life stressful situations [5]. Social adjustment differs from society to society, according to the culture and the beliefs of the community. According George, Thamson, Chaze & Guruge [6] mentalhealthispivotaltoholistichealthandwellbeing.Mental health is a dynamic state of mental satisfaction and a feeling that one can cope with the community and enjoy personal situationsandsocialcharacteristics[7,8],quotingthehumanistic psychologists,believethatthelove,approvalandpositivenonconditionalattentionofthechildisessentialforthedevelopment of a person's mental health. Cultural Intelligence, which refers to the ability to effectively interact with cultures, is a concept that was first introduced by Early & Ang [9] and comes into play in the analysis and adaptationtodifferentcultures.Theydefineculturalintelligence as the person’s ability to successfully adapt to new cultural environments,usuallydifferentfromone'sownculturalcontext. TheresultsofGuomundsottir’s[10]studyshowedthatthereisa significantcorrelationbetweenagreatergeneraladjustmentand greater meta-cognitive and motivational cultural intelligence. Cultural intelligence enables the individual to recognize culturaldifferencesandtobehaveproperlyindifferentcultural environments[11].Early&Mosakowski[12]presentedcultural intelligence has having three dimensions: cognitive, physical / behavioral, and motivational, and Thomas [13] considered three components: cultural knowledge, cultural attention and cultural skills. Harris, Lievens, [14] associated this concept withothertypesofintelligence,includingemotionalandsocial
3 © Under License of Creative Commons Attribution 3.0 License 2019 Vol.5 No.2:1 ACTA PSYCHOPATHOLOGICA ISSN 2469-6676 Measures Besides demographics, participants answered the following questionnaires: 1) Cultural Intelligence Questionnaire (CIQ) ofEarley&Ang[9],(Lugo[23],translated toPersianlanguage byAzemonyarInstitute [24]);2)Schutte Self-ReportEmotional IntelligenceTest(EIQ)(SSEIT)(Schutte,1998translatedtoPersian language by Hossaini [25]); 3) the Social Adjustment Scale– Self-Report (SAS) of (Weissman & Bothwell, 1999, translated to Persian language by Azemonyar Institute [24]), the Mental HealthQuestionnaire(GHQ)ofGoldberg(Goldberg,Hillier[26], translatedtoPersianlanguagebyNazifi,Mokarami,Akbaritabar, FarajiKujerdi,Tabrizi&Rahi[27].Persianversionofalltestswere translated into Arabic and Kurdish language. All the translated instrumentshavefollowedinternationalguidelinesforaccuracy (QuestionnairesweretranslatedfromPersianversiontoArabic language by two independent bilingual researchers and backtranslatedforfinalcheck). Data analysis Descriptiveandcorrelationalanalyseswereconducted,followed byStructuralEquationModelling (SEM), to find the pattern of relationshipbetweenEIandCIwithSocialAdjustmentinthehost country while taking into account Mental Health. Significance levelwassetatp<.05 Results Cultural Intelligence Questionnaire (CIQ) (Azemonyar Institute [24]),isa20 items questionnairerangingfrommin20to max 140.ThegoodnessoffitindicesfortheCIQonthisstudysample are adequate X2 / df = 1.89; SRMS =0.06; GFI=0.94 and AGFI= 0.91).EmotionalIntelligenceQuestionnaire(EIQ)(Hossaini[25]), is a 33 items questionnaire ranging from min 33 to max 165. ThegoodnessoffitindicesfortheEIQonthisstudysampleare adequate X2 /df=2.43;SRMS=0.07;GFI=0.92andAGFI=0.89). SocialAdjustmentScale(SAS)(AzemonyarInstitute[24])isa54 items.Forthisstudy,students'questionsweredeletedandonly 26questionswereused.Togetthetotaltestscore,summingthe scores of all items and dividing by the number of items actually scored. The goodness of fit indices for the SAS on this study sample are adequate X2 / df = 2.81; SRMS =0.07; GFI=0.91 and AGFI=0.88),andtheMentalHealthQuestionnaire(MHQ/GHQ) (Nazifietal.,[27])isa28itemsquestionnairerangingfrommin0 tomax84.ThegoodnessoffitindicesfortheMHQ/GHQonthis study sample are adequate X2 /df=2.39;SRMS=0.07;GFI=0.93 andAGFI=0.90) InwhatconcernsCulturalIntelligenceandEmotionalIntelligence higher results correspond to more cultural or emotional intelligence respectively, while considering the Mental Health andSocialAdjustment,higherscorescorrespondrespectivelyto loworpoorMentalHealthandpoorSocialAdjustment. Bivariate analysis Descriptive analysis of the variables included in the study is presented (Table 1).Skewnessandkurtosisindicessuggestedthe normalityofdatadistribution. The correlations between research variables were calculated using Pearson’s correlation coefficients (Table 2). All variables present significant correlations, emotional and cultural intelligence are significantly and positively correlated. Social adjustment is significantly and positively correlated to Mental Health. Accordingtothepresentresultsthereisanegativeandsignificant correlationamongEmotionalIntelligenceandCulturalIntelligence and Mental Health, and a negative and significant correlation between Emotional Intelligence and Cultural Intelligence and SocialAdjustment.BecauselowerscoresonMentalHealthand SocialAdjustmentcorrespondtorespectivelytoabetterMental Health status and to a better Social Adjustment, this result must be read as an higher Emotional Intelligence and higher Cultural Intelligence being significantly associated to a better Mental Health, and an higher Cultural Intelligence and an higher EmotionalIntelligencebeingsignificantlyassociatedtoabetter Social Adjustment. Structural equations modeling A structural equations model was carried out in order to test simultaneous direct effects. In order to investigate Goodness ofFitindexintheresearchmodelthreeindiceswereusedone absolute, one comparative and another parsimonious (Kline [28]).Inthecurrentresearch,Nikoie’sGoodnessofFitindex(GFI), Nikoie’sAdjustedGoodnessofFitIndex(AGFI)andStandardized Root Mean Squared Residual (SRMR), and (X2/df)squarefreedom ConceptualworkingModel-relationshipamongthestudyvariables. Figure 1 Emotional Intelligence Cultural Intelligence Mental Health Social Adjustment
2019 ACTA PSYCHOPATHOLOGICA ISSN 2469-6676 Vol.5 No.2:1 4This article is available from: www.psychopathology.imedpub.com degree were calculated and are adequate X2 / df = 2.06; SRMS =0.03;GFI=0.91andAGFI=0.87). According to the present results, direct effect of Emotional IntelligenceonSocialAdjustmentissignificantlynegative(-0.55). MentalHealthdirecteffectonSocialAdjustmentissignificantly positive (.15). Cultural Intelligence has a low, yet significant negative direct effect on social adjustment (-0.08). Cultural IntelligencedirecteffectonMentalHealthissignificantlynegative (-.35). Emotional Intelligence hasn’t direct significant effect (-0.08)onMentalHealth.EmotionIntelligencedirectseffecton Cultural Intelligence is significantly positive [29]. As has been statedbefore,becauselowerscoresonMentalHealthandSocial AdjustmentcorrespondtorespectivelytoabetterMentalHealth statusandtoabetterSocialAdjustment,resultsmustbereadas anhigherCulturalIntelligencebeingsignificantlyassociatedtoa betterMentalHealth,andanhigherCulturalIntelligenceandan higherEmotionalIntelligencebeingsignificantlyassociatedtoa betterSocialAdjustment(Table 3). EmotionalIntelligence,CulturalIntelligenceandMentalHealth explained 36% of Social Adjustment variance. Emotional Intelligence and Cultural Intelligence explained 14% of Mental Healthvariance.EmotionalIntelligenceexplained8%ofCultural Intelligence. A diagrammed model (Figure 2)wasdesignedpresentthedirect and indirect effects of the above-mentioned variables, the pattern(s)ofrelationship(s),andtheeffectofmentalhealth. Discussion Atabivariatelevelallvariablespresentedsignificantcorrelations: emotional and cultural intelligence are significantly and positivelycorrelated,andsocial adjustment is significantlyand Variable min. max mean SD skewness kurtosis EmotionalIntelligence(EI) 38 149 102.27 22.60 -0.56 0.19 Cultural Intelligence (CI) 30 134 84.54 22.36 -0.87 -0.57 Mental health (MH) 28 108 58.01 17.30 0.94 0.39 Social adjustment (SA) 32 122 67.83 20.33 0.78 0.05 Table 1:Summaryofdescriptiveanalysisofthevariablesincludedinthestudy. Variable EI CI MH SA EmotionalIntelligence(EI) 1 Cultural Intelligence (CI) 0.30** 1 Mental Health (MH) -0.17** -0.38** 1 Social Adjustment (SA) -0.49** -0.15** 0.22** 1 Table 2:Summaryofcorrelationalanalysisofthevariablesincludedinthestudy. Path direct effect t p Towardsocialadjustment(SA)by: EI CI Mental health (MH) -0.55 -0.02 0.15 -5.35 -0.22 2.28 0.001 0.02 0.02 Towardmentalhealth(MHQ)by: EI CI -0.08 -0.35 -1.06 -4.61 0.28 0.001 Towardculturalintelligence(CI)by: EI 0.29 3.52 0.001 Table 3:Predictionofdirecteffectvalues. StructuralModel-Directeffectsoftherelationshipamongstudyvariables. Figure 2 -0.55** -0.08 ns 0.29** 0.15Ύ * -0.35** -0.02* *p<0.05, **p<0.01 Emotional Intelligence Cultural Intelligence Mental Health Social Adjustment
5 © Under License of Creative Commons Attribution 3.0 License 2019 Vol.5 No.2:1 ACTA PSYCHOPATHOLOGICA ISSN 2469-6676 positively correlated to mental health, Higher emotional and cultural intelligence are associated to a better mental health, and higher emotional and cultural intelligence are associated toabettersocialadjustment,assuggestedbyEarly&Ang[9], Guomundsottir[10]andTriandhs[11]. Howeverotherauthorsreferredamulti-dimensionalaspectof culturaladjustment(Early,&Mosakowski,[12]andThomas[13] that could not be analyzed in the present study. At a multi-variated structural level, emotional intelligence has direct positive effect on cultural intelligence, as suggested by Tabatabaeimozabadi[15].HoweverasAngetal.[16]arguedthat culturalintelligencemayconceptuallyandempiricallydifferent from emotional intelligence, and this fact could better explain that, when analyzing simultaneous direct effects, emotional intelligence, hasn’t a significant effect on mental health while culturalintelligencehas.Alsoemotionalintelligencehasadirect effectonsocialadjustmentmuchstrongerthanthedirecteffect of cultural intelligence, as suggested by Parsamehr & Heddat [21].Inthecaseofemotionalintelligencetheresultssuggested that there is no mediational increase in the relation among emotional intelligence and social adjustment when mental health is considered. Cultural intelligence has a much lower (yet significant) direct effectonsocialadjustment.Furthermore,inlinewithAng’setal. [16]arguments,culturalintelligencehasasignificantdirecteffect on mental health (more cultural intelligence corresponding to a better mental health), opposite to the non-significant effect registeredbetweenmentalhealthandemotionalintelligence. According to Mayer, Salovey & Caruso [20] theory, emotional intelligence consists of four different abilities: perception of emotion, emotional facilitation, understanding emotions, and management of emotions. In the present study only a global measure was considered preventing detailed and partial sub scores to be analyzed. Mentalhealthhasdirectandsignificanteffectsocialadjustment, meaning that a better situation regarding mental health is associatedwithbetterthesocialadjustment,assuggestedbefore by Sepehrianazar [22]. Theresultsofthepresentstudyhighlightimportantimplications forinterventions,aimingatenhancingmentalhealthandsocial adjustmentofSyrianimmigrantsinIraq.Emotionalandcultural intelligencearesignificantlyrelated,yetfocusingdifferentaspects that allow the different association they present with mental health.Thisfactisquitetroublesomeandmaywellberelatedto thepoorstudyconditions,inveryvulnerableconditions.Itcould also be better understood if subscales were considered in the relatedquestionnaires.Butitcanalsobethecasethatstrong cultural bonds may be the key factor to increase resilience and leadtoabettermentalhealth,althoughnotsoefficientforsocial adjustment to new environments. On the opposite emotional intelligence, although not contributing to an enhanced mental health, could better suit for increased understanding of new environmentsthuspromotinganincreasesocialadjustment. Whenanalyzingsimultaneouseffects,abettermentalhealthis associated with better social adjustment, and both emotional and cultural intelligence are significantly associated to social adjustment, but only cultural intelligence is significantly associated to mental health. The present results suggest that mentalhealthmayhaveanintermediateroleintherelationship between cultural intelligence and social adjustment, but no intermediate role in the relationship between emotional intelligencewithsocialadjustment. Limitations and Future Questions Futureresearchmustincludequalitativemethodsinordertofully discusstheissuesraisedbythisstudywiththeimmigrants,trying toworkouttheirawarenessandunderstandingoftheseresults andtheirhealthimplications(Matos[3]).Alsoitwouldbepossible for a second analysis of this data in order to consider subscales, tobepossibletobemore analytical; identifying “which parts” ofbothemotionalandculturalintelligencecanbecontributing to that twofold pattern. A comparative grade/schooling level, genderandagegroupanalysisisalsounderpreparation. Conclusions Theauthorsaimwiththepublicationofthisworkcontributing to raise awareness and increase the well-being and social adjustment of Syrian immigrants, and in a very near future to beabletoprovidenationalgovernmentswithafewguidelines regardingtheirmentalhealthandsocialadjustmentpromotion. For the moment being the strongest conclusions are the relevance tofocusonSyrianimmigrants’mentalhealthasawaytoincrease their social adjustment. A second issue is that cultural and emotionalintelligenceapparentlyhavediverse(yetsignificant) effects on both mental health and social adjustment. Results conveyanimportantmessagetopublicpolicies,highlightingthe importanceofpreservingbothculturalandemotionalintelligence among Syrian immigrant in Iraq, as a measure to assure their mentalhealthandsocialadjustmentsituations. Funding Matos,M.G. receivedaSabbatical grantfromtheFoundation for Science and Technology (FCT) (SFRH/BSAB/135160/2017 - INSERM/ Université Paul Sabatier/ Toulouse/ France.
2019 ACTA PSYCHOPATHOLOGICA ISSN 2469-6676 Vol.5 No.2:1 6This article is available from: www.psychopathology.imedpub.com References 1 Guedes F, Gaspar T, Tome G, Cerqueira A, Matos MG (2019) Os adolesentes portugeuses e a igualdade de oportunidades dos migrantes (Portuguese adolescents and equity among immigrants). J Child Adolesc Psychol 1: 95-106. 2 ZanjaniH(2001)Immigration,Tehran:SAMTpublisher. 3 MatosMG (2019)Dream teens:Navigating lifelike aprotagonist, Saarbrucken: Lambert Academic Publishing. 4 TileeSQ(2017) Mental health among syrian immigrants in Iraq, nonpublisheddissertationpresentedatUrmiaUniversity,Urmia,Iran. 5 SadockB,SadockV,KaplanH(2003)Kaplan&sadock'ssynopsisof psychiatry:behavioralsciences/clinicalpsychiatry.Philadelphia,Pa.: LippincottWilliams&Wilkins. 6 George U, Thamson M, Chaze F, Guruge S (2015) Immigrant mental health.Apublichealthissue:lookingbackandmovingforward.IntJ Environ Res Public Health 12: 13624-13648. 7 Milanifar B (2010) Mental health tehran: gomes. 11th Edn. 8 Shfiabadi A, Naseri G (2017) Theories of counseling and psychotherapy.Tehran:universitypublicationcenter(persian). 9 EarlyPC,AngS(2003)Culturalintelligence:individualinteractions across cultures. Stanford, CA: stanford university press. 10 GuomundsottirS(2015)NordicexpatriatesintheUS:therelationship betweenculturalintelligenceand adjustment.Int JIntercult Relat 47:175-186. 11 Triandhs HC (2006) Cultural intelligence in organizations. Group Organ Manag 31: 20-26. 12 EarlyPC,MosakowskiE(2004)Culturalintelligence.HarvBusRev 82: 139-146. 13 ThomasC(2006)Cultureintelligencepeopleskillsforaglobalwork place.ConsultingtoManagement16:70-80. 14 Harris MM, Lievens F (2005) Selecting employees for global assignments: can assessment centers measure cultural intelligence? InA.Rahim&R.T.Golembiewski(Eds.)CurrTopManag 10: 221-240. 15 Tabatabaeimozabadi SM (2016) Study the role of emotional intelligenceandculturalintelligenceinthefieldsoforganizational transformationtends. JournalofInnovationandEntrepreneurship 3: 105-116. 16 AngS,VanDyneL,KohC,TemplerKJ,TayC,etal.(2007)Cultural intelligence: Its measurement and effects on cultural judgment and decision making, cultural adaptation and task performance. ManagementandOrganizationReview3:335-371. 17 Bar-OnR(2000)Emotionalandsocialintelligence:insightsfromthe emotionalquotientinventory.In:Bar-OnR,ParkerJDA,editors.The HandbookofEmotionalIntelligence.SanFrancisco:JosseyBassPp: 363-388. 18 SepehrianazarF (2015)Emotional intelligence,fromIQ toEQand SQ. Iran: Jahad Daneshgahy Publications, 3rd Edn, ISBN: 978-9646032-70-5. 19 GolemanD(1998)Workingwithemotionalintelligence.NewYork: Bantam. Pp: 13-32. 20 MayerJD,SaloveyP,CarusoDR(2008)Emotionalintelligence:new abilityoreclectictraits? 21 AmPsychol63:503-517. 22 Parsamehr M, Heddat E (2017) The þrelationship þbetween þemotionalþintelligenceþandþsocialþadjustmentþofþstudents. J Soc Dev 11: 65-69. 23 Sepehrianazar F (2012) Emotional intelligence as a predictor for academic performance in university, J Educ Sci Psychol, Romania 2: 36-44. 24 LugoM(2007)Anexaminationofculturalandemotionalintelligences in the development of global transformational leadership skills. Unpublisheddoctoraldissertation,WaldenUniversity. 25 AzemonyarInstitute(2011)SocialAdjustmentscale (SAS). 26 HossainiN(2009)Researchquestionnaireonpsychology,counseling, educationscienceandsociology.Tehran:Sokhanpublisher. 27 GoldbergDP,HillierVF(1979)Ascaledversionofthegeneralhealth questionnaire. Psychol Med 9: 139-145. 28 Nazifi M, Mokarami H, Akbaritabar A, Faraji Kujerdi M, Tabrizi R, et al. (2013) Reliability, validity and factor structure of the persian translationofgeneralhealthquestionnaire(ghq-28)inhospitalsof kerman university of medical sciences. J Fasa University of Med Sci 3: 336-342. 29 Kline RB (2011) Principles and practice of structural equation modeling. 2ndEdn,NewYork:TheGuilfordPress.