Health Nexus

Background: Chronic pain is a persistent biopsychosocial condition in which pain-related thoughts, behavioral avoidance, emotional distress, and perceived coping ability can interact to maintain disability and suffering. Acceptance and Commitment Therapy (ACT) is designed to increase psychological flexibility and help individuals engage in valued action even when pain and distress are present. Objective: This study examined the effectiveness of ACT on pain catastrophizing, pain self-efficacy, and psychological flexibility in adults with chronic pain. Methods: A quasi-experimental pretest-posttest control group design with a two-month follow-up was used. Thirty adults with chronic pain were recruited through online platforms and purposively selected according to eligibility criteria. Participants were randomly assigned to an ACT group (n = 15) or a control group (n = 15). The ACT group received eight weekly 90-minute online group sessions, whereas the control group received no intervention during the active study period. Measures included the Pain Catastrophizing Scale, Pain Self-Efficacy Questionnaire, and Acceptance and Action Questionnaire-II. Data were analyzed using repeated-measures ANOVA and Bonferroni comparisons. Results: The ACT group showed marked improvement from pretest to posttest and follow-up. Pain catastrophizing decreased from 37.80 to 26.07 at posttest and 26.80 at follow-up. Pain self-efficacy increased from 30.40 to 42.27 at posttest and 43.47 at follow-up. Psychological flexibility improved as AAQ-II scores decreased from 31.33 to 19.80 at posttest and 19.20 at follow-up. Significant time, group, and time by group effects were reported for all outcomes. Conclusion: ACT was associated with sustained reductions in pain catastrophizing and improvements in pain self-efficacy and psychological flexibility among individuals with chronic pain. Larger randomized trials with active controls and longer follow-up periods are recommended.

Emotion regulation is a central developmental capacity during childhood and is closely related to children’s psychological adjustment, interpersonal functioning, and behavioral adaptation. Parents play a major role in children’s emotional development through modeling, emotional communication, parenting responses, and the emotional climate of the family. Parental emotional intelligence may therefore be associated with children’s ability to understand, manage, and regulate emotional experiences. This study examined the relationship between parental emotional intelligence and emotion regulation in children aged 6–12 years. Specifically, it investigated whether the main components of parental emotional intelligence—self-awareness, self-regulation, self-motivation, empathy, and social skills—were positively associated with children’s emotion regulation. This applied, descriptive, cross-sectional survey study was conducted among parents of children aged 6–12 years in Tehran, Iran. Based on Cochran’s formula for an unlimited population, 384 parents were included. Data were collected using the Schering Emotional Intelligence Questionnaire and the Cognitive Emotion Regulation Questionnaire developed by Garnefski and Kraaij. Internal consistency coefficients for the parental emotional intelligence components ranged from .76 to .80 in the present sample. Data were analyzed in SPSS using descriptive statistics, bivariate correlation coefficients, and multiple regression model summary statistics. The findings showed positive and statistically significant associations between all parental emotional intelligence components and child emotion regulation. The strongest reported correlation was observed for parental self-awareness (r = .50), followed by parental social skills (r = .45), self-motivation (r = .41), self-regulation (r = .38), and empathy (r = .37). The combined model showed a multiple correlation of R = .470. Because the originally reported R² value was not mathematically compatible with the reported R value, R² was corrected to .221, indicating that the parental emotional intelligence components jointly explained approximately 22.1% of the variance in children’s emotion regulation. The results suggest that higher parental emotional intelligence is associated with better emotion regulation in children aged 6–12 years. The findings support the importance of strengthening parents’ emotional skills as part of family-based educational and preventive mental health programs.

Depression is frequently maintained by repetitive negative thinking, particularly rumination, and by deeper maladaptive cognitive structures that shape how individuals interpret themselves, their emotions, and life events. This quasi-experimental study examined the effectiveness of schema-reconstruction-based cognitive behavioral therapy (CBT) in reducing depressive symptoms and rumination components among patients with depression. Thirty patients with depression who attended treatment clinics in Isfahan, Iran, in 2025 were selected from eligible volunteers and allocated to an experimental group (n = 15) and a control group (n = 15). Participants completed the Beck Depression Inventory and the Ruminative Response Scale before and after the intervention. The experimental group received eight 45-minute group sessions of schema-reconstruction-based CBT, while the control group received no psychological intervention during the active study period. The intervention focused on psychoeducation, identification of automatic thoughts, recognition of early maladaptive schemas, links between schemas and developmental experiences, cognitive restructuring, emotional and cognitive exposure to schemas, behavioral practice, and relapse prevention. Data were analyzed using one-way analysis of covariance in SPSS version 22. Compared with the control group, the experimental group showed lower posttest scores for depression, distraction, reflection, and brooding/absorption in thought. Group effects were significant for depression, F = 52.74, p <= .01; distraction, F = 10.73, p <= .01; reflection, F = 15.75, p <= .01; and brooding/absorption in thought, F = 16.89, p <= .01. Schema-reconstruction-based CBT was associated with meaningful reductions in depressive symptoms and all measured components of rumination. The findings support the value of targeting deeper cognitive schemas when treating depression characterized by repetitive negative thinking. Larger trials with follow-up assessments are recommended.

Background: Extramarital relationships can produce a severe relational rupture that weakens trust, emotional accessibility, marital commitment, intimacy, and the capacity to forgive. Emotionally Focused Couple Therapy (EFT) is an attachment-oriented intervention designed to restructure negative interaction cycles and restore emotional responsiveness between partners. Objective: This study examined the effectiveness of EFT on marital commitment, marital intimacy, and marital forgiveness among couples affected by extramarital relationships. Methods: A quasi-experimental pretest-posttest design with an experimental group and a control group was used. Thirty-two participants who had attended family counseling clinics in Tehran because of distress related to a spouse's extramarital relationship were selected through purposive sampling and assigned equally to an EFT intervention group or a control group. The intervention group received eight 90-minute EFT sessions, whereas the control group received no EFT intervention during the study period. Data were collected using the Marital Commitment Questionnaire, the Walker-Thompson Marital Intimacy Scale, and the Rye Forgiveness Scale. Descriptive statistics, assumption testing, multivariate analysis of covariance, and follow-up univariate analyses of covariance were applied. Results: After controlling for pretest scores, a significant multivariate difference was observed between groups at posttest, Wilks' Lambda = .489, F = 37.49, p = .008, partial eta squared = .56. Follow-up analyses indicated significant posttest improvements in marital commitment, marital intimacy, and marital forgiveness in the EFT group compared with the control group. Conclusion: EFT appears to be a useful intervention for couples experiencing injury after extramarital relationships, particularly when clinical work targets attachment needs, emotional disclosure, responsiveness, and reconstruction of safe interaction cycles.

Parental death during childhood is a major developmental adversity that may disrupt emotion regulation, executive functioning, autonomic regulation, and grief adaptation. Because children depend heavily on surviving caregivers for co-regulation, family-based interventions may be especially important for reducing prolonged grief symptoms and supporting recovery of cognitive and physiological functioning. This quasi-experimental pretest-posttest study evaluated an eight-session Emotion Regulation and Parental Support (ERPS) program among 60 bereaved children aged 8-12 years. Participants were allocated to an intervention group (n = 30) or waitlist control group (n = 30). Outcomes included executive functioning (Stroop interference), working memory (Digit Span Backward), physiological arousal (systolic and diastolic blood pressure and resting heart rate), emotion regulation (Emotion Regulation Checklist), and prolonged grief symptoms (PG-13-C total score). Analysis of covariance (ANCOVA) was used to compare posttest outcomes between groups while controlling for baseline scores. The intervention group showed substantially greater improvement than the control group across all outcome domains. Significant adjusted between-group effects were found for Stroop interference, F(1, 57) = 68.42, p < .001, η² = .55; Digit Span Backward, F(1, 57) = 32.18, p < .001, η² = .36; systolic blood pressure, F(1, 57) = 14.55, p < .001, η² = .20; diastolic blood pressure, F(1, 57) = 11.20, p = .001, η² = .16; resting heart rate, F(1, 57) = 19.85, p < .001, η² = .26; ERC emotion regulation, F(1, 57) = 95.40, p < .001, η² = .63; ERC lability/negativity, F(1, 57) = 58.30, p < .001, η² = .51; and prolonged grief symptoms, F(1, 57) = 82.10, p < .001, η² = .59. Reductions in Stroop interference were correlated with reductions in resting heart rate (r = .48, p < .01), and improvements in Digit Span Backward were correlated with reductions in grief symptoms (r = -.52, p < .01). The findings suggest that a structured parental support and emotion regulation program can improve neurocognitive, physiological, and psychological outcomes in bereaved children. The results support the clinical value of caregiver-inclusive interventions that target co-regulation and adaptive grief processing.

The present study aimed to compare the effectiveness of schema therapy and intensive short-term dynamic psychotherapy (ISTDP) on resilience, emotion regulation, and self-compassion in women with a history of trauma. The study employed a quasi-experimental design with pre-test, post-test, and three-month follow-up, including a control group. The statistical population consisted of women aged 20 to 45 years in Hamadan, Iran, in 2025. A total of 60 participants were initially selected using purposive sampling and assigned to three groups (schema therapy, ISTDP, and control), each consisting of 20 participants. Due to attrition, the final sample included 49 participants. The experimental groups received 15 sessions of intervention (90 minutes each), while the control group received no intervention. Data were collected using the Connor–Davidson Resilience Scale (CD-RISC; Connor & Davidson, 2003), the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004), and the Self-Compassion Scale–Short Form (SCS-SF; Raes et al., 2011). Data were analyzed using mixed-design repeated-measures analysis of variance. The results indicated that both schema therapy and ISTDP significantly improved resilience, emotion regulation, and self-compassion compared to the control group (p < .001). Additionally, the interaction effect of time and group was significant for all variables, indicating different patterns of change across groups. The findings also showed that ISTDP was more effective than schema therapy in improving emotion regulation, while no significant difference was observed between the two treatments in resilience and self-compassion. Overall, the findings suggest that both schema therapy and ISTDP are effective interventions for improving psychological functioning in women with trauma. However, ISTDP may be particularly beneficial for enhancing emotion regulation.

Internalizing and externalizing behavioral disorders are common problems during adolescence and may adversely affect students’ executive functions. The present study compared the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) and neurofeedback on executive functions in female upper secondary school students with internalizing and externalizing behavioral disorders in Tehran. This applied study used a quasi-experimental pretest-posttest design with a one-month follow-up and included two experimental groups and one control group. The study population comprised female upper secondary school students in Tehran during the 2024-2025 academic year. Forty-five students were selected through convenience sampling and randomly assigned to three groups: EMDR, neurofeedback, and control. Data were collected using the Child Behavior Checklist (CBCL) and the Behavior Rating Inventory of Executive Function (BRIEF). Data were analyzed using repeated-measures analysis of variance and post hoc tests in SPSS version 27. Both EMDR and neurofeedback significantly improved executive functions compared with the control group, and these improvements remained stable at follow-up. No statistically significant difference was observed between the two intervention groups in the post hoc comparisons, although both interventions outperformed the control group. These findings suggest that both EMDR and neurofeedback are effective interventions for enhancing executive abilities in students with behavioral disorders and may be considered in therapeutic and educational programs.

The aim of this study was to develop a model for designing therapeutic environments for patients with schizophrenia based on familiar cognitive patterns and to examine its effect on reducing patient anxiety. This study was conducted using a mixed-methods approach (quantitative–qualitative). In the quantitative phase, 30 hospitalized patients with schizophrenia at Omid Farda Center were interviewed and were asked to report their level of anxiety, based on the Hamilton Anxiety Rating Scale, after viewing images of designed environments. In the qualitative phase, in-depth interviews were conducted with 20 architecture experts. The results of statistical analysis indicated that environmental design incorporating familiar cognitive elements such as lighting, color, furniture, and surface materials had a significant effect on reducing patients’ anxiety. The findings suggest that an environmental psychology-based approach can contribute to the development of effective and human-centered therapeutic environments for psychiatric patients.