Health Nexus

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.

This study compared the effectiveness of cognitive behavioral therapy (CBT) and emotion-focused therapy (EFT) for improving mindfulness and psychological flexibility in women with generalized anxiety disorder (GAD). A quasi-experimental pretest-posttest design with a control group and follow-up assessment was used. Forty-five women with GAD who attended counseling and psychological service centers in Tehran in 2025 were selected through purposive sampling and then randomly assigned to three groups (n = 15 per group): CBT, EFT, and control. Interventions were delivered online in 12 weekly 90-minute sessions. Measures included the Generalized Anxiety Disorder Scale (GAD-7), the Five Facet Mindfulness Questionnaire (FFMQ-15), and the Acceptance and Action Questionnaire-II (AAQ-II). Data were analyzed using repeated-measures analysis of variance in SPSS version 26. Both active treatments produced significant improvements compared with the control group, but CBT showed the strongest effects. For mindfulness, the CBT group increased from M = 31.46 (SD = 5.12) at pretest to M = 54.06 (SD = 5.00) at posttest and M = 55.53 (SD = 8.41) at follow-up, whereas the EFT group increased from M = 32.73 (SD = 4.51) to M = 47.73 (SD = 4.72) and M = 47.20 (SD = 4.75). For AAQ-II scores, where lower scores indicate greater psychological flexibility, the CBT group improved from M = 33.80 (SD = 3.23) to M = 17.60 (SD = 4.08) and M = 18.26 (SD = 4.31), while the EFT group improved from M = 36.06 (SD = 3.43) to M = 23.40 (SD = 3.45) and M = 22.93 (SD = 4.69). The repeated-measures ANOVA showed significant time, group, and time × group effects for both mindfulness and psychological flexibility (all p < .001). Both CBT and EFT were effective in women with GAD, but CBT yielded greater gains in mindfulness and psychological flexibility and maintained these gains at follow-up.

Sexual assault during adolescence is associated with profound psychological sequelae, particularly post-traumatic stress disorder (PTSD), yet traumatic exposure may also be followed by post-traumatic growth (PTG). This study evaluated whether Acceptance and Commitment Therapy (ACT) could simultaneously reduce PTSD symptoms and strengthen PTG in adolescent survivors of sexual assault. The study used a randomized controlled, pre-test/post-test/follow-up design. Forty-two adolescent girls aged 13–18 years who met diagnostic criteria for PTSD after sexual assault were recruited from counseling centers, forensic medicine clinics, and welfare-related services in Tehran and randomly assigned to ACT or treatment as usual (TAU). The ACT condition involved 12 weekly 90-minute sessions adapted for trauma-exposed adolescents and focused on acceptance, cognitive defusion, present-moment awareness, self-as-context, values clarification, and committed action. Outcomes were assessed using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), the Child PTSD Symptom Scale for DSM-5 (CPSS-5), and the Posttraumatic Growth Inventory for Children–Revised (PTGI-C-R). Data were analyzed with mixed-design analysis of variance. Thirty-nine participants completed the study (ACT, n=19; TAU, n=20). A significant Time × Group interaction was found for PTSD symptoms, F(2,74)=45.32, p<0.001, ηp2=0.55, showing a marked reduction in the ACT group from pre-test to post-test that was maintained at follow-up. A similarly significant Time × Group interaction emerged for PTG, F(2,74)=38.91, p<0.001, ηp2=0.51, indicating substantial gains in growth-related outcomes in the ACT group, with further improvement at the two-month follow-up. The control group showed no significant change in either outcome. ACT appears to be an effective intervention for adolescent survivors of sexual assault. Beyond symptom reduction, it may also support constructive post-traumatic adaptation by helping adolescents respond more flexibly to trauma-related thoughts and emotions and re-engage with personally meaningful life directions.

Behavioral problems during adolescence can disrupt academic performance, social adjustment, and long-term wellbeing. Sport and physical activity have been proposed as modifiable school-based factors that may support healthier psychosocial development. This study examined the association between sports activity level and behavioral maladjustment among male secondary school students in Tehran Province, Iran. The study used an applied, descriptive-survey design. The statistical population comprised 20,513 male students from selected counties of Tehran Province. Using two-stage cluster sampling with proportional allocation based on the Krejcie and Morgan table, 377 students were required; 400 questionnaires were distributed and 361 were analyzed. Data were collected using a researcher-developed questionnaire that included demographic and sports-activity items and a behavioral maladjustment scale. Face validity was confirmed by 10 experts in psychology and sport management, and internal consistency was acceptable (Cronbach’s alpha = 0.81). Students were classified into four groups: no sports activity, low activity, moderate activity, and high activity. One-way analysis of variance (ANOVA) and Tukey post hoc tests were used. More than half of the students (52.9%) were in the low-activity group, whereas 15.0% were in the high-activity group and 6.4% reported no sports activity. Football was the most common preferred sport, followed by bodybuilding. Mean behavioral maladjustment scores differed markedly across activity levels: no activity 3.20 ± 0.85, high activity 2.02 ± 0.41, moderate activity 2.27 ± 0.32, and low activity 3.62 ± 0.62. The between-group difference was statistically significant, F(3, 357) = 190.54, p < 0.001. Tukey comparisons showed that the high-activity group had significantly lower maladjustment scores than the no-activity, moderate-activity, and low-activity groups. Higher sports activity was associated with lower behavioral maladjustment scores among male secondary school students. The findings support strengthening school-based opportunities for regular sport participation, while future research should use standardized behavioral instruments and longitudinal designs to clarify causality.

The prevalence of sedentary lifestyles among children has increased significantly in recent decades, leading to higher rates of overweight, obesity, and reduced physical fitness. School-based exercise programs are considered an effective strategy to improve body composition and promote health in children. The purpose of the present study was to investigate the effects of a structured continuous aerobic training program on body composition among primary school boys aged 10–12 years in Shahriar County, Iran. This research employed a quasi-experimental design with pre-test and post-test measurements and included a control group. Twenty students were randomly assigned to two groups: a continuous training group (n=10) and a control group (n=10). Body composition variables, including body fat percentage, fat-free mass, and basal metabolic rate, were measured using a bioelectrical impedance analyzer (InBody 0.3, Korea). Anthropometric variables such as waist circumference, hip circumference, arm circumference, and thigh circumference were also recorded. The training program lasted 12 weeks and consisted of three weekly sessions with progressive intensity ranging from 60% to 75% of maximum heart rate. Statistical analysis was conducted using descriptive statistics, Kolmogorov–Smirnov tests for normality, and analysis of variance (ANOVA). Results showed a significant improvement in body composition in the training group compared with the control group (p = 0.002). Participants who completed the exercise intervention demonstrated reductions in body fat percentage and improvements in lean body mass. These findings suggest that continuous aerobic training programs implemented within school settings can effectively improve body composition and promote physical health in children. The results highlight the importance of integrating structured physical activity into school curricula to prevent childhood obesity and improve long-term health outcomes.

Psychosomatic disorders, particularly gastrointestinal complaints, are a major health concern among university students, as they can impair physical health, academic performance, psychological well-being, and social functioning. This study examined the mediating role of generalized anxiety disorder (GAD) symptoms in the relationship between stressful life events, childhood maltreatment, and gastrointestinal symptoms. This descriptive correlational study was conducted among undergraduate and graduate students of Islamic Azad University, Neyshabur Branch, during the 2024–2025 academic year. A total of 300 students were selected through convenience sampling. Data were collected using the Child Abuse Self-Report Scale, the GAD-7, the Stressful Life Events Screening Questionnaire, and the Gastrointestinal Symptom Rating Scale. Data were analyzed in SPSS 26 and AMOS using descriptive statistics, Pearson correlations, and structural equation modeling. The results showed significant associations among GAD symptoms, stressful life events, childhood maltreatment, and gastrointestinal symptoms. The structural model showed acceptable fit. Stressful life events positively predicted GAD symptoms (β = 0.28, p < 0.001) and gastrointestinal symptoms (β = 0.24, p < 0.01). Childhood maltreatment also positively predicted GAD symptoms (β = 0.36, p < 0.001) and gastrointestinal symptoms (β = 0.37, p < 0.01). GAD symptoms partially mediated these relationships.

Abstract

Structured play has been proposed as an effective approach to enhance both physical and psychological health in children; however, evidence from school-based interventions examining self-esteem, perceived physical competence, and psychological well-being simultaneously remains limited. This study examined the effects of an eight-week structured play intervention on self-esteem, perceived physical competence, and psychological well-being in children aged 8–11 years. In this quasi-experimental pretest–posttest study, 68 children were recruited from primary schools in Tehran, Iran, and conveniently allocated to a structured play intervention group (n = 34) or a control group (n = 34). The intervention comprised two 45-minute sessions per week for 8 weeks, including skill-based activities, cooperative games, and reflection periods. Outcomes were assessed using the Rosenberg Self-Esteem Scale (child-adapted), the Physical Self-Perception Profile for Children, and the KIDSCREEN-27 (total score). Pre- and post-intervention data were analyzed using ANCOVA, controlling for baseline scores, with effect sizes reported as partial eta squared (η²p). The results revealed significant intervention effects on all outcomes. Self-esteem improved significantly in the intervention group compared with controls (F(1, 65) = 18.42, p < 0.001, η²p = 0.22). Similarly, perceived physical competence (F(1, 65) = 32.15, p < 0.001, η²p = 0.33) and psychological well-being (F(1, 65) = 24.87, p < 0.001, η²p = 0.28) increased significantly. Paired-sample t-tests confirmed pre- to post-intervention improvements in the intervention group (all p < 0.001), whereas changes in the control group were non-significant. An 8-week structured play program delivered in schools was associated with meaningful improvements in self-esteem, perceived physical competence, and psychological well-being in children aged 8–11 years, supporting its potential for promoting holistic development in educational and community settings.

Keywords: Structured play; School-based intervention; Self-esteem; Physical competence; Psychological well-being; Children

Cognitive abilities such as working memory and processing speed play a significant role in students’ learning processes and academic performance. Deficits in these abilities are often associated with learning disorders such as dyslexia and mathematics learning disorder (dyscalculia). The present study aimed to compare working memory and processing speed among elementary school students with dyscalculia, dyslexia, and typically developing peers in Tehran. This study employed an ex post facto (causal–comparative) design. The sample consisted of 75 male and female students from Grades 1 to 5 of elementary school during the 2021–2022 academic year in Tehran. Participants were divided into three groups: students with dyscalculia, students with dyslexia, and typically developing students. The groups were matched in terms of age, gender, grade level, and intelligence quotient (IQ). Working memory and processing speed were assessed using subtests of the Wechsler Intelligence Scale for Children – Fourth Edition (WISC-IV), standardized by Abedi and colleagues. Data analysis was conducted using one-way analysis of variance (ANOVA). The results of the ANOVA indicated a significant difference among the three groups in both working memory and processing speed (p < .001, df = 2). Specifically, students with dyscalculia and dyslexia demonstrated weaker performance compared to typically developing students; however, no significant difference was observed between the dyscalculia and dyslexia groups. The findings suggest that deficits in working memory and processing speed represent common characteristics among students with learning disorders. Therefore, designing and implementing educational and rehabilitation programs that focus on strengthening these cognitive abilities may contribute to improving the academic performance of these students.