people do not always pretend or act like what they actually are since they desire more approval from others . social desirability is the tendency of one to have a socially and culturally desirable manner , so he / she can be viewed positively by other people or seems consistent with social and cultural norms and expectations . that is why people with high social desirability might want to present themselves with their best behaviours for a better feeling of satisfaction . therefore , social desirability is an important , yet often neglected issue in the investigation of mental disorders . minor psychiatric disorder ( mpd ) is one of mental health problems that have long been associated with work . however , the high social desirability can directly influence coping with mpd ( e.g. work stress ) . nurses like other health professionals are under a lot of pressure due to the type of their job . various factors , such as shift work , sleep disorder , lack of time , repeated exposure to suffering and patient s death , lack of support , and professional responsibility can affect the mental health of nurses . the prevalence of mpd among health care personnel is higher than other groups of workers . the responsibility they take for people s health and the long times they spend with patients make their working environment highly stressful . the prevalence of mpd among nurses in different countries has been reported to be between 34% and 41% . one of the factors among personality characteristics that can affect the level of mpd among nurses is social desirability . nurses , because of having a persistent contact with patients and their families , are strongly influenced by them . social desirability may affect different aspects of people s life and in particular their mental health . since health is something valuable for health care providers , nurses with high social desirability are expected to have fewer mental disorders . on the other hand , nurses have a very important role in clinical and health related programs and paying attention to their mental health has been of great concern in the recent decades . scant studies so far have evaluated the relationship between social desirability and mpd . however , this relationship has not been considered among nurses . this study aimed at investigating the relationship between social desirability and mpd among nurses in southern iran . however , there might be some variables confounding this relationship and we aimed to take them into consideration during the analysis . this was a cross - sectional study conducted in fars and bushehr provinces of iran from april to july 2014 . after expressing the purpose of the study by actuaries to the nurses and obtaining fully informed verbal consent from them , they were asked to fill in the structured questionnaire anonymously . participants were selected randomly using multi - stage sampling . at first , of 39 cities , 20 were selected randomly ( 29 in fars province and 10 in bushehr province ) . 25 hospitals out of 60 were taken as a sample in shiraz which is the largest city in the south of iran . in those cities with more than one hospital , the number of nurses in each hospital was selected by using probability proportional to sampling size , based on various wards and total number of nurses in each ward . in order to gain confidential issues , moreover , they were assured that their information would not be used for any purpose other than this research . simulation studies show that the sample size depends on the number of the predictor variables and the data distribution , and studies with sample sizes with more than 500 have enough power to fit the model . primary inclusion criteria included the ability and willingness of nurses to participate and having at least one year of work experience . distortion of the questionnaire , employment in another job at the same time , and part - time employment were the exclusion criteria in this study . the 12-item general health questionnaire ( ghq-12 ) is a useful screening tool for assessment of individual s mpd over their past few weeks . the most common scoring methods of ghq-12 are bi - modal ( all items coded 0 - 0 - 1 - 1 , ranging from 0 to 12 ) and four - point scale likert scoring system ( all items coded 0 - 1 - 2 - 3 , ranging from 0 to 36 ) . a lower score indicates the absence of mpd and a better mental health . in this study , the likert scoring method was used because , firstly , the likert scale has different values for each item , while in bi - modal 1 - 2 and 3 - 4 options , scoring is the same . secondly , in the robust regression , the likert scoring method has a better fit since the dependent variable ( i.e. sum of ghq-12 ) must be of quantitative form . marlowe - crowne social desirability scale ( mc - sds ) questionnaires is one of the most widely used scales for detecting social desirability . mc - sds consists of 33 items in which respondents are asked to choose true or false . negatively phrased items were reversed and the total score was calculated which is the sum of all scores and ranges from zero to 33 ; scores between 0 to 8 , 9 to 19 , and 20 to 33 indicate low , moderate , and high level of social desirability , respectively . those who score high on this scale have a tendency to present themselves in a socially acceptable manner which conforms to others expectations . to translate mc - sds questionnaire items from english into persian language , the questionnaire was translated into farsi independently by two fluent bilingual experts in the field of psychology and mental health . next , it was back - translated into english by two other independent translators , and finally the coordinator provided the persian version of the mc - sds by comparing and adapting these translations . the goodness - of - fit of mc - sds was demonstrated using the store - bentler scaled chi - square ( 1200.954 ) , x2/df ( 2.426 ) , root mean square error of approximation ( 0.043 ) , adjusted goodness - of - fit index , normed fit index ( 0.888 ) , and goodness - of fit index ( 0.901 ) . internal consistency reliability of the mc - sds questionnaire was assessed using the kuder - richardson formula 20 ( kr-20 ) coefficient , which measures the appropriateness for testing dichotomous variables ( yes / no ) . confirmatory factor analysis ( cfa ) with a maximum likelihood method of estimation was used to examine the construct validity of the questionnaire . the shapiro - wilks test revealed that both ghq and social desirability scores depart significantly from normality , so mann  whitney and kruskal  wallis test were used to compare mc - sds and ghq-12 scores on demographic variables . because of non - normality and the presence of outliers in the ghq-12 score , robust regression method was used for discovering the relationship between social desirability and other factors with the level of mpd . in general , ordinary least squares estimation is used for the classical multiple regressions . if the assumptions for regression do not hold , the inference about parameter estimation and the results will be misleading . if outliers are present in the data , the assumption of normality is violated ; then , the least squares regression may not be the most powerful technique and might have an adverse effect on the estimation of parameters . therefore it can be used to detect outliers and to provide resistant results in the presence of outliers . this was a cross - sectional study conducted in fars and bushehr provinces of iran from april to july 2014 . after expressing the purpose of the study by actuaries to the nurses and obtaining fully informed verbal consent from them , they were asked to fill in the structured questionnaire anonymously . participants were selected randomly using multi - stage sampling . at first , of 39 cities , 20 were selected randomly ( 29 in fars province and 10 in bushehr province ) . 25 hospitals out of 60 were taken as a sample in shiraz which is the largest city in the south of iran . in those cities with more than one hospital , the number of nurses in each hospital was selected by using probability proportional to sampling size , based on various wards and total number of nurses in each ward . in order to gain confidential issues , moreover , they were assured that their information would not be used for any purpose other than this research . simulation studies show that the sample size depends on the number of the predictor variables and the data distribution , and studies with sample sizes with more than 500 have enough power to fit the model . primary inclusion criteria included the ability and willingness of nurses to participate and having at least one year of work experience . distortion of the questionnaire , employment in another job at the same time , and part - time employment were the exclusion criteria in this study . the 12-item general health questionnaire ( ghq-12 ) is a useful screening tool for assessment of individual s mpd over their past few weeks . the most common scoring methods of ghq-12 are bi - modal ( all items coded 0 - 0 - 1 - 1 , ranging from 0 to 12 ) and four - point scale likert scoring system ( all items coded 0 - 1 - 2 - 3 , ranging from 0 to 36 ) . a lower score indicates the absence of mpd and a better mental health . in this study , the likert scoring method was used because , firstly , the likert scale has different values for each item , while in bi - modal 1 - 2 and 3 - 4 options , scoring is the same . secondly , in the robust regression , the likert scoring method has a better fit since the dependent variable ( i.e. sum of ghq-12 ) must be of quantitative form . marlowe - crowne social desirability scale ( mc - sds ) questionnaires is one of the most widely used scales for detecting social desirability . mc - sds consists of 33 items in which respondents are asked to choose true or false . negatively phrased items were reversed and the total score was calculated which is the sum of all scores and ranges from zero to 33 ; scores between 0 to 8 , 9 to 19 , and 20 to 33 indicate low , moderate , and high level of social desirability , respectively . those who score high on this scale have a tendency to present themselves in a socially acceptable manner which conforms to others expectations . to translate mc - sds questionnaire items from english into persian language , we used the standard forward - backward procedure . at the first step , the questionnaire was translated into farsi independently by two fluent bilingual experts in the field of psychology and mental health . next , it was back - translated into english by two other independent translators , and finally the coordinator provided the persian version of the mc - sds by comparing and adapting these translations . the goodness - of - fit of mc - sds was demonstrated using the store - bentler scaled chi - square ( 1200.954 ) , x2/df ( 2.426 ) , root mean square error of approximation ( 0.043 ) , adjusted goodness - of - fit index , normed fit index ( 0.888 ) , and goodness - of fit index ( 0.901 ) . internal consistency reliability of the mc - sds questionnaire was assessed using the kuder - richardson formula 20 ( kr-20 ) coefficient , which measures the appropriateness for testing dichotomous variables ( yes / no ) . confirmatory factor analysis ( cfa ) with a maximum likelihood method of estimation was used to examine the construct validity of the questionnaire . the shapiro - wilks test revealed that both ghq and social desirability scores depart significantly from normality , so mann  whitney and kruskal  wallis test were used to compare mc - sds and ghq-12 scores on demographic variables . because of non - normality and the presence of outliers in the ghq-12 score , robust regression method was used for discovering the relationship between social desirability and other factors with the level of mpd . in general , ordinary least squares estimation is used for the classical multiple regressions . if the assumptions for regression do not hold , the inference about parameter estimation and the results will be misleading . if outliers are present in the data , the assumption of normality is violated ; then , the least squares regression may not be the most powerful technique and might have an adverse effect on the estimation of parameters . therefore , statistical methods that are able to handle or detect outliers have been developed . it can be used to detect outliers and to provide resistant results in the presence of outliers . the mean age of the participants was 32.086.29 years old and the mean work experience was 7.755.80 years . low , moderate and high levels of social desirability were observed in 1.2% , 41.2% and 57.6% of the participants , respectively . the ghq-12 scores in sum , for men and for women were 13.025.64 , 12.585.35 and 13.265.78 , respectively . men had lower ghq-12 score and better mental health than women , but the difference was not statistically significant by mann kruskal - wallis test showed that the scores of ghq-12 and mc - sds differed in the levels of education . mann - whitney and kruskal - wallis test showed that the scores of ghq-12 and mc - sds did not differ in gender , marital status , age , and work experience . result of non - parametric tests for comparison of mc - sds and ghq-12 in demographic characteristics table 2 shows the relationship between covariates and the level of mpd using robust regression . robust regression could reveal the effect of an independent variable ( i.e. mc - sds score ) on a dependent variable ( i.e. ghq-12 score ) while controlling for the other covariates ( i.e. gender , marital status , education , age , and work experience ) . in this study , we used robust regression to assess the relationship between social desirability and mpd in southern iran . according to the results , the meansd of ghq score in iranian nurses was 13.025.64 and based on cut - off point of 9 from a previous study , 27.3% of the nurses had mpd . the meansd of mc - sds score in this study among nurses was 20.174.76 which is classified as high . based on previous studies , the mean of social desirability among the general population was 20.032.99 , and no significant difference was found in the mean of social desirability between the general population and iranian nurses ( t - value=0.33 , p=0.741 ) . although there was no similar studies evaluating social desirability in nurses by mc - sds-33 , in other populations using the short version of mc - sds , the meansd of mc - sds among chinese nurses was 7.021.74 based on the cut - off point of 5 ( for mcsds-10 ) , indicating a high level of social desirability , among respondents from 20 to 35 years old in romanian sample was 15.485.14 , and among bariatric surgery candidates in southeastern u.s academic medical center was 22.035.74 . the non - parametric result showed that mpd did not differ significantly across gender , age , education , work experience and marital status and the total social desirability scores were different in various levels of education . mc - sds scores did not differ significantly across gender , age , work experience and marital status . in most of the previous studies , it is reassuring for users of the mc - sds to know that there is no need to treat mc - sds scores for men and women or for different levels of education , marital status , work experience and age differently . this finding is in line with earlier studies which showed that respondents who had 4 or more years of college education had lower social desirability scores than those with less than 4 years experience of attendance at the university . our results from the robust regression represented a statistically significant effect of gender and social desirability on mpd . according to these findings , the nurses mpd was inversely affected by social desirability while controlling the socio - demographic factors like gender , age , marital status , education and work experience , i.e. nurses with higher scores on social desirability had reported lower mpd . the mc - sds has been found to have a negative association with symptoms of poor mental health , a finding that has failed to be fully reported as an undesirable state for those with a high need for approval . however , there was no similar study on nurses , but this was consistent with a study that was done on bariatric surgery candidates , showing a significant inverse relationship between social desirability and the factors such as anxiety and depression . before controlling social desirability variable ( non - parametric result ) , the nurses mpd was not statistically significant among men and women . after controlling for social desirability variable using robust regression , the nurses gender was a statistically significant predictor of mpd . the reason why gender was not significant in non - parametric tests could be the fact that women had significantly higher social desirability scores than men . from a statistical point of view , one limitation of the present study is that the sample size was unequal between men and women , and this could confound the results of non - parametric tests . our findings were consistent with previous studies which have reported that women are more likely to have mental disorders than men . based on a research , prevalence of mental disorders among women one possible cause is that women , because of their distinct physical and psychological conditions , are exposed to more sources of mental disorders than men . in summary , it appears that nurses social desirability has a significant effect on their mpd . however , further studies among different nations and cultures are required to provide a better insight into the relationship between social desirability and mpd . also , other factors such as social support , job satisfaction , and job performance should be taken into consideration while evaluating the connection between social desirability and mpd . moreover , this is essential to assess the relationship between social desirability and the factors mentioned above . our findings can provide a guideline for senior decision makers in health policy organizations in order to identify the factors affecting mpd in nurses for development of strategic plans to improve their mental health . according to the results , if one is interested in evaluating mpd among nurses , social desirability should be considered as an effective factor .
background : social desirability may affect different aspects of people s quality of life . one of the impressive dimensions of quality of life is mental health . the prevalence of minor psychiatric disorders ( mpd ) among health care workers is higher than other health workers . 
 this article aims at evaluating the relationship between social desirability and mpd among nurses in southern iran.method:a cross - sectional study was carried out on 765 nurses who had been employed in hospitals in the southern provinces of iran . the 12-item general health questionnaire ( ghq-12 ) and marlowe - crowne social desirability scale ( mc - sds ) 
 were used for evaluating the mpd and social desirability in nurses , respectively . 
 the robust regression was used to determine any quantified relationship between social desirability and the level of mpd with adjusted age , gender , work experience , marital status , and level of education.result:the mean scores of ghq-12 and mc - sds were 13.025.64 ( out of 36 ) and 20.174.76 ( out of 33 ) , respectively . 
 the result of robust regression indicated that gender and social desirability were statistically significant in affecting mpd.conclusion:the prevalence of mpd in female nurses was higher than males . 
 nurses with higher social desirability scores had the tendency to report lower levels of mpd .