E-ISSN: 2981-2569 Editor-in-Chief: Dr. Hadi Nobari Owner: KMAN Research Institute Publisher: KMAN Publication Inc. (KMANPUB) Contact emails: healthnexus@kmanpub.com / healthnexusjournal@gmail.com Open access: YES Peer-review: Yes (Open Peer-review) Health Nexus is a multidisciplinary journal dedicated to publishing and disseminating groundbreaking research in human health. This journal uniquely focuses on the synergistic relationship among four key areas: sports sciences, psychology, public health, and emerging technologies in health. By embracing this diverse yet interconnected scope, Health Nexus serves as a dynamic platform for researchers to present their latest findings and contribute significantly to the enhancement of human health and well-being. The journal invites a wide array of submissions, including original research articles, comprehensive reviews, insightful meta-analyses, theoretical explorations, and practical applications. These contributions are expected to advance knowledge and understanding in each of the journal's core areas: sports sciences' role in physical and mental health, psychological perspectives on wellness, public health strategies for community and global health improvement, and the transformative impact of emerging technologies in healthcare. Health Nexus is committed to fostering the development of evidence-based practices and interventions. By integrating research from sports sciences, psychology, public health, and emerging technologies in health, the journal aims to offer a holistic view of human health. This approach ensures the promotion of well-being in all aspects of life, encouraging innovative solutions to health challenges in today's rapidly evolving world. About the Publisher Publisher: KMAN Publication Inc. Publisher Office: Unit 5‑10825 Yonge St, Richmond Hill, Ontario, Canada, L4C 3E3 https://journals.kmanpub.com Email: kmanpu@kmanpub.com Telegram: +1 (647) 656‑4401 | WhatsApp: +1 (437) 429‑3507 Germany Office: Dratelnstrasse, Wohnung A60, 21119 Hamburg, Germany (+4915207720487)
The effectiveness of trauma-focused mentalization-based group therapy on psychological distress and cognitive errors in women with war experience
War-related experiences can create persistent psychological consequences for women, including elevated psychological distress and maladaptive cognitive processing. The present study examined the effectiveness of trauma-focused mentalization-based group therapy in reducing psychological distress and cognitive errors among women with war experience. This applied quasi-experimental study used a pre-test-post-test design with a control group and a follow-up phase. The sample consisted of 40 eligible women with war experience in Tabriz who were selected through purposive sampling and randomly assigned to an experimental group and a control group, with 20 participants in each group. The experimental group received trauma-focused mentalization-based group therapy in ten weekly 90-minute sessions, whereas the control group received no intervention. Psychological distress was measured using the Kessler Psychological Distress Scale, and cognitive errors were measured using the Cognitive Errors Questionnaire. Data were analyzed using multivariate analysis of covariance, univariate analysis of covariance, and paired-sample t-tests. Psychological distress in the experimental group decreased from 32.85 +/- 5.21 at pre-test to 21.40 +/- 4.86 at post-test and remained stable at follow-up (22.10 +/- 4.71). Cognitive errors decreased from 131.60 +/- 18.35 at pre-test to 94.25 +/- 15.80 at post-test and remained stable at follow-up (96.10 +/- 16.22). The multivariate effect of group was significant, Wilks Lambda = 0.43, F(2, 35) = 23.49, p = .001, partial eta squared = .57. Univariate analyses also showed significant group effects for psychological distress, F(1, 36) = 48.72, p = .001, partial eta squared = .58, and cognitive errors, F(1, 36) = 44.56, p = .001, partial eta squared = .55. Post-test-follow-up differences in the experimental group were not significant for psychological distress, t = 1.31, p = .20, or cognitive errors, t = 1.15, p = .26. Trauma-focused mentalization-based group therapy was effective in reducing psychological distress and cognitive errors among women with war experience, and the treatment effects were maintained at follow-up.
trauma-focused mentalization-based therapy; group therapy; psychological distress; cognitive errors; women; war experience.
Copyright (c) 2025 Nahid Yousefpour (Corresponding Author)
Modeling Elementary Teachers' Work Engagement Based on Job Crafting and Emotional Creativity: The Mediating Role of Critical Thinking
Teacher work engagement is a key psychological and occupational factor in educational quality. The present study examined a structural model in which job crafting and emotional creativity were associated with elementary teachers' work engagement, both directly and indirectly through critical thinking. This applied, descriptive-correlational survey used structural equation modeling. The population consisted of all elementary school teachers in Barkhar, Iran. Because the population was limited, census sampling was used, and 270 teachers were included. Data were collected using standardized self-report instruments measuring emotional creativity, job crafting, critical thinking, and work engagement. Data were analyzed using SPSS and SmartPLS 3. Descriptive statistics showed mean scores of 63.62 for emotional creativity, 55.38 for critical thinking, 42.87 for job crafting, and 22.79 for work engagement. All direct structural paths were positive and statistically significant. Job crafting was positively associated with work engagement (beta = 0.138, t = 2.762, p = .006) and critical thinking (beta = 0.478, t = 8.566, p < .001). Emotional creativity was positively associated with work engagement (beta = 0.191, t = 3.944, p < .001) and critical thinking (beta = 0.384, t = 6.601, p < .001). Critical thinking was the strongest direct predictor of work engagement (beta = 0.623, t = 14.366, p < .001). The indirect effects through critical thinking were also supported: emotional creativity -> critical thinking -> work engagement (indirect beta = 0.239) and job crafting -> critical thinking -> work engagement (indirect beta = 0.298). The findings suggest that job crafting and emotional creativity are relevant correlates of elementary teachers' work engagement and that critical thinking may partly explain these associations.
Work engagement; job crafting; emotional creativity; critical thinking; elementary teachers; structural equation modeling
Copyright (c) 2026 Hajar Moeini korbekandi, Reza Borji Bodaghi, Hossein Aalamdarian (Author); Rasul Rezaei Mollajegh (Corresponding Author)
Analyzing Coaches' Behaviors in the Relationship Between Motivational Climate and Performance Satisfaction Among Table Tennis Athletes
This qualitative phenomenological study analyzed coaches' behaviors in the relationship between motivational climate and performance satisfaction among developing table tennis athletes. Coaches are central social agents in youth sport, because their feedback, leadership style, goal-setting practices, and interpersonal behavior shape athletes' perceptions of competence, autonomy, relatedness, and achievement. Seven table tennis coaches and 25 developing athletes aged 14-18 years were recruited through snowball sampling. Data were collected through semi-structured interviews and analyzed using reflexive thematic analysis. The findings were organized into two complementary perspectives. From the coaches' accounts, five overarching themes were identified: coaching philosophy, social support behavior, leadership style, motivational climate, and goal setting. From the athletes' accounts, four overarching themes emerged: coaches' philosophy from the athletes' viewpoint, performance climate, skill climate, and goal setting. The integrated interpretation showed that supportive communication, positive feedback, emotional support, adaptive leadership, mastery-oriented climates, and individualized goal setting were perceived as facilitating athletes' motivation and satisfaction with performance. Conversely, excessive control, punishment for mistakes, rigid outcome emphasis, and social comparison were described as potentially reducing intrinsic motivation and psychological safety. The study contributes to coaching science by showing how coaching behaviors are experienced simultaneously as technical, ethical, relational, and motivational practices in table tennis. Practical implications are offered for coach education, particularly the need to train coaches in reflective self-regulation, autonomy-supportive communication, constructive feedback, and goal-setting methods that support both performance development and athlete well-being.
coaching behavior; motivational climate; performance satisfaction; table tennis; self-determination theory; qualitative research
Copyright (c) 2026 Hamidreza Sarafrazian (Author); Zohreh Meshkati (Corresponding Author); Rokhsareh Badami, Zahra Serjooi (Author)
Comparing the Effectiveness of Young's Schema Therapy and Intensive Short-Term Dynamic Psychotherapy on Psychological Resilience in Kidney Patients
In addition to physical problems, kidney patients face several psychological difficulties, including reduced psychological resilience. Objective: This study aimed to compare the effectiveness of Young's schema therapy and intensive short-term dynamic psychotherapy on psychological resilience in kidney patients. This quasi-experimental study used a pretest-posttest design with a three-month follow-up and a control group. The statistical population consisted of kidney patients in Mashhad, Iran, in 2023. Forty-five participants were selected through convenience sampling and allocated to three equal groups of 15 participants: two experimental groups and one control group. The first experimental group received Young's schema therapy in eight sessions, and the second experimental group received intensive short-term dynamic psychotherapy in fifteen sessions. The control group received no intervention during the study period. Psychological resilience was assessed using the Connor-Davidson Resilience Scale. Data were analyzed using repeated-measures analysis of variance and Bonferroni post hoc tests. Both therapeutic approaches were effective in increasing psychological resilience in kidney patients compared with the control group, and the effects remained stable at the three-month follow-up. Comparison of the two treatments showed no significant difference between Young's schema therapy and intensive short-term dynamic psychotherapy in psychological resilience; both approaches were equally effective (P < 0.001 for treatment effects; P > 0.05 for between-treatment comparison). The findings suggest that, within the limits of a small feasibility-based quasi-experimental design, both Young's schema therapy and intensive short-term dynamic psychotherapy were associated with sustained improvements in self-reported psychological resilience among kidney patients.
Intensive short-term dynamic psychotherapy; Kidney patients; Psychological resilience; Young's schema therapy
Copyright (c) 2025 Shirin Esmaili (Author); Mustafa Bolghan-Abadi (Corresponding Author); Ahmad Mansouri (Author)
Comparison of Electromyographic Activity Patterns of Gluteus Maximus, Biceps Femoris, and Tensor Fasciae Latae During Treadmill Walking in Individuals with Piriformis Syndrome
Piriformis syndrome is a common neuromuscular disorder characterized by gluteal pain and sciatic nerve irritation, which may alter gait patterns and lower-limb muscle activation. Understanding these alterations can help identify compensatory mechanisms and guide effective rehabilitation strategies. This study aimed to compare the electromyographic activity patterns of the gluteus maximus, biceps femoris, and tensor fasciae latae during treadmill walking in individuals with piriformis syndrome versus healthy controls. In this case-control study, 14 male participants (7 with piriformis syndrome and 7 healthy controls), aged 20–40 years with normal BMI, were recruited. Surface electromyography was recorded from the gluteus maximus, biceps femoris, and tensor fasciae latae of both lower limbs using the ME6000 system during treadmill walking at each participant's preferred speed. Signal processing included band-pass filtering (20–450 Hz), notch filtering at 50 Hz, full-wave rectification, and RMS envelope extraction. Activation onset, activation offset, minimum amplitude, and maximum amplitude were determined from three consecutive gait cycles. Independent t-tests were used for statistical analysis with a significance level of p < 0.05. The piriformis syndrome group showed delayed onset and earlier offset across all three muscles. The gluteus maximus demonstrated significantly higher minimum amplitude and lower maximum amplitude in both limbs (p < 0.05). The biceps femoris showed significant temporal alterations in both limbs, with reduced maximum amplitude only in the left limb (p = 0.018). The tensor fasciae latae demonstrated significant temporal alterations in both limbs, with increased minimum amplitude only in the right limb (p = 0.019). The findings suggest that individuals with piriformis syndrome demonstrate altered muscle activation timing and amplitude during gait. However, due to the cross-sectional case-control design, causal relationships and underlying neuromuscular mechanisms cannot be definitively established. Rehabilitation should incorporate neuromuscular control exercises to restore proper activation timing and coordination.
Copyright (c) 2026 Arsham Sarvi (Author); Mohammad Ali Seyed Hoseini (Corresponding Author)
Latency-Aware Breast Cancer Detection in Mammography Images Using a Fog-Cloud Framework Based on Stacked Transfer Learning and PSO-Optimized XGBoost
Breast cancer is one of the most important public health challenges worldwide, and the quality of its early detection is directly associated with reduced mortality, lower treatment costs, and improved care pathways. Mammography remains one of the principal screening tools; however, the interpretation of mammographic images is affected by human error and infrastructural limitations in the presence of tissue density, noise, similarities between benign and malignant lesions, and variations in imaging protocols. This paper presents an automated breast cancer detection framework focused on reducing processing latency-aware deployment and increasing diagnostic reliability within a fog-cloud architecture. At the fog layer, mammographic images are standardized through resizing, intensity normalization, noise reduction, and lightweight preparation to reduce data-transmission volume and initial response time. At the cloud layer, three transfer-learning models—ResNet50, DenseNet121, and EfficientNetB7—are employed to extract deep features. The probabilistic outputs of these models are integrated in a three-level stacked ensemble architecture, with XGBoost used as the final meta-classifier. To reduce dependence on manual tuning and control overfitting, the key hyperparameters of the base models and the meta-classifier are optimized using particle swarm optimization. Evaluation was conducted on the public CBIS-DDSM dataset using stratified cross-validation. The results showed that the proposed model achieved an accuracy of 97.5% on the test subset, balanced performance across the two classes, a recall of 98.0% for the benign class, and 96.9% for the malignant class. The findings indicate that combining near-source preprocessing, transfer-based feature extraction, stacked ensembling, and metaheuristic optimization can provide a promising decision-support framework for distributed healthcare environments; however, clinical deployment requires external validation, explicit latency benchmarking, and prospective assessment.
breast cancer, mammography, fog computing, transfer learning, stacked ensemble, XGBoost, particle swarm optimization, CBIS-DDSM
Copyright (c) 2026 Zahraa Abdulmajeed Ibrahim Al-Mohammed (Author); Esmaeil Bagheri (Corresponding Author); Ameer Hussein Mohammed Ali, Mehdi Hamidkhani (Author)
Effects of Eight Weeks of Integrated Neuromuscular Training on Static and Dynamic Balance, Flexibility, and Landing Errors in Male Football Players Aged 18–20 Years
Football requires neuromuscular control, postural stability, flexibility, and safe jump-landing mechanics. Deficits in these components may impair performance and contribute to hazardous lower-limb movement patterns. This randomized controlled study examined the effects of eight weeks of integrated neuromuscular training on static and dynamic balance, flexibility, and landing errors in male football players aged 18–20 years. Methods: Thirty male football players were randomly allocated to an integrated neuromuscular training group or an active control group (n = 15 per group). The experimental group completed a progressive multicomponent program three times weekly for eight weeks, including balance, strength, plyometric, core-stability, landing-technique, and reactive-agility exercises. The control group continued usual football training. Dynamic balance, static balance, flexibility, and landing quality were assessed before and after the intervention. Analysis of covariance was used with baseline values entered as covariates. Results: After the intervention, the experimental group showed significantly greater improvements in static balance, dynamic balance, flexibility, and landing quality than the control group (p < .001). Large effects were observed for dynamic balance (partial η² = .656) and landing errors (partial η² = .492). The experimental group showed an adjusted 35.9-cm improvement in dynamic balance and a 1.55-error reduction in Landing Error Scoring System scores, corresponding to an approximate 27.6% reduction in landing errors. Exploratory mediation analysis suggested that improved dynamic balance statistically explained part of the reduction in landing errors. Conclusion: Eight weeks of integrated neuromuscular training improved postural control, flexibility, and landing mechanics in young male football players. The program may be used as a structured warm-up strategy in football settings, although larger trials with injury follow-up are required.
integrated neuromuscular training; dynamic balance; static balance; flexibility; Landing Error Scoring System; football players; postural control
Copyright (c) 2026 Mohammed Abdulhamza Ismael Mohsin (Author); Lotfali Bolboli (Corresponding Author); Reza Farzizadeh (Author)
The Effectiveness of the Floortime Method on Sensory Processing Sensitivity, Theory of Mind, and Social Skills in Children with High-Functioning Autism
This study examined the effectiveness of the Floortime method on sensory processing sensitivity, theory of mind, and social skills in children with high-functioning autism. A quasi-experimental pretest-posttest design with a control group was used. The statistical population consisted of children with high-functioning autism who attended autism rehabilitation centers in District 5 of Tehran in spring 2025. Thirty-six children were selected by convenience sampling and then allocated to experimental and control groups, with 18 participants in each group. Data were collected using the Sensory Profile School Companion, the Theory of Mind Test, and the Autism Social Skills Profile. The experimental group received twelve 75-minute Floortime sessions over six weeks, whereas the control group received no Floortime intervention during the study period. Data were analyzed using multivariate analysis of covariance and analysis of covariance in SPSS version 23. After controlling for pretest scores, the Floortime method significantly increased sensory registration, theory of mind, and social skills and significantly decreased sensory sensitivity and sensory avoiding. The intervention did not produce a statistically significant change in sensory seeking. The findings suggest that Floortime can support sensory regulation, social-cognitive understanding, and adaptive social behavior in children with high-functioning autism when implemented in a structured and developmentally responsive format.
Floortime; DIR model; sensory processing; theory of mind; social skills; high-functioning autism
Copyright (c) 2025 Farideh Rahpeymay Nargesi (Author); MohamadParsa Azizi (Corresponding Author); Fateme BagherMoradi, Majid Ebrahimpour (Author)
Maternal Early Maladaptive Schemas and Parenting Styles Associated with Maladaptive Cognitive Emotion Regulation Strategies in Girls Aged 9-11 Years
Maladaptive cognitive emotion regulation strategies, including self-blame, rumination, catastrophizing, and blaming others, may place children at increased risk for emotional and behavioral difficulties. Maternal early maladaptive schemas and parenting styles are family-related factors that may be associated with these strategies. This cross-sectional correlational study was conducted among 181 girls aged 9-11 years and their mothers in the second educational district of Kerman, Iran. Participants were recruited from five elementary schools using multistage cluster sampling. The girls completed the Cognitive Emotion Regulation Questionnaire, and mothers completed Young's Early Maladaptive Schema Questionnaire and Baumrind's Parenting Style Questionnaire. Maladaptive cognitive emotion regulation was calculated as the sum of the CERQ maladaptive subscales: self-blame, rumination, catastrophizing, and blaming others. Data were analyzed using Pearson correlation and exploratory simultaneous multiple regression in SPSS version 26. Maladaptive cognitive emotion regulation was positively correlated with all maternal early maladaptive schemas and with authoritarian and permissive parenting styles, and it was negatively correlated with authoritative parenting. The simultaneous regression model was statistically significant, F(21, 159) = 34.04, p < .001, R = .904, R2 = .818, adjusted R2 = .794. Variables with significant positive independent associations were mistrust / abuse, defectiveness / shame, failure, dependence / incompetence, vulnerability to harm or illness, subjugation, negativity / pessimism, punitiveness, authoritarian parenting, and permissive parenting. Authoritative parenting showed a significant negative independent association. The findings suggest that girls' maladaptive cognitive emotion regulation strategies are associated with both mothers' cognitive-emotional schema patterns and maternal parenting styles. Because of the cross-sectional design, school-clustered sampling, lack of covariate adjustment, and relatively large number of predictors, the findings should be interpreted as exploratory associations rather than causal or definitive predictive evidence.
maladaptive cognitive emotion regulation
Copyright (c) 2025 Shirin Alsadat (Corresponding Author); Farshid Khosropour, Hasan Mohamadtehrani (Author)
Embodied Cognition in Sport Expertise: A Thematic Exploration of Sensorimotor Awareness in Professional Athletes
The objective of this study was to explore and interpret the lived experiences of professional athletes to identify the core thematic dimensions of sensorimotor awareness within the framework of embodied cognition. This study employed a qualitative research design using thematic analysis grounded in an interpretivist paradigm. Participants consisted of twenty-four professional athletes from Canada, representing both individual and team sports with a minimum of five years of elite-level experience. Data were collected through semi-structured in-depth interviews, complemented by reflective journals and researcher field notes to enhance contextual richness and triangulation. Interviews focused on athletes’ perceptions of bodily awareness, decision-making processes, and integration of sensory feedback during performance. All interviews were audio-recorded, transcribed verbatim, and analyzed following a six-phase thematic analysis procedure, including familiarization, coding, theme generation, review, and refinement. Rigor was ensured through member checking, peer debriefing, and maintenance of an audit trail. The analysis revealed four overarching themes: heightened bodily awareness, embodied decision-making, sensorimotor calibration, and embodied emotional regulation. The findings indicated that perception–action coupling and motor refinement through repetition were universally experienced and constituted the core of expertise. Athletes demonstrated strong reliance on pre-reflective, intuitive processes for rapid decision-making, particularly in dynamic environments. Interoceptive and proprioceptive awareness emerged as critical mechanisms supporting performance optimization and emotional regulation. Variations across sport types suggested that closed-skill sports emphasized precision and bodily control, whereas open-skill sports prioritized adaptability and anticipatory action. Overall, sensorimotor awareness functioned as an integrative system linking cognitive, physical, and affective domains. The findings support the central role of embodied cognition in sport expertise, demonstrating that high-level performance is grounded in the integration of sensory perception, motor execution, and emotional regulation. Sensorimotor awareness operates as a dynamic and multidimensional construct that enables athletes to adapt efficiently to complex and changing environments.
Copyright (c) 2025 Ali Seghatoleslami, Nicola Luigi Bragazzi (Author)
Effectiveness of Hydrotherapy on Low Back Pain: A Systematic Review and Meta-analysis
The aim of this study was to determine and compare the effects of hydrotherapy on pain and functional disability in patients with low back pain. This systematic review and meta-analysis was conducted based on randomized controlled trials. A comprehensive search was performed in PubMed, Cochrane Library, ScienceDirect, Scopus, and Google Scholar databases, yielding a total of 1,144 records. After removing duplicates, 920 studies remained for title and abstract screening, of which 850 were excluded due to irrelevance to the study objective. Ultimately, 6 eligible study reports, representing 5 independent randomized trial samples, were included in the systematic review. Six reports were included in the exploratory composite meta-analysis; however, two reports appeared to arise from the same parent trial sample and therefore the pooled estimate should not be interpreted as six fully independent trial effects. The results indicated that although several individual studies reported improvements in pain and functional outcomes following hydrotherapy, the pooled effect estimate from the random-effects model showed a non-significant effect in favor of hydrotherapy compared with control interventions (pooled effect size = -2.44; 95% CI: -5.88 to 1.00). Because the included studies used different pain and disability instruments, the pooled estimate should be interpreted as a composite effect estimate rather than a raw mean difference on a single clinical scale. Considerable heterogeneity was observed among the included studies (I² = 98.1%), indicating substantial variability in study populations, intervention protocols, treatment duration, and outcome measures. Egger's test (P = 0.07), Begg's test (P = 0.43), and visual inspection of the funnel plot did not show clear evidence of publication bias; however, because only 6 reports were included, these tests have limited power and cannot exclude undetected publication bias. Overall, although individual studies suggested potential improvements in pain and function among patients receiving hydrotherapy, the final meta-analysis did not demonstrate a statistically significant overall effect.
Copyright (c) 2025 Marzieh Dowlatshahi, Shaghayegh Rastgoo, Javad salami, Raziyeh Chabok, masoumeh sadat mousavi (Author); Fatemeh Naseri (Corresponding Author); Shaghayegh Rastgoo (Author)
Effect of Telerehabilitation-Based Dynamic Neuromuscular Stabilization Exercises on Cardiorespiratory Fitness and Strength in Overweight and Obese Older Women
The present study aimed to investigate the effect of a six-week telerehabilitation-based Dynamic Neuromuscular Stabilization (DNS) exercise program on cardiorespiratory fitness and upper and lower extremity strength in overweight and obese older women. This research was a quasi-experimental study with a pretest-posttest design including a control group. The statistical population consisted of overweight and obese older women living in Mashhad, Iran. The research sample included 30 participants aged 60 to 75 years with a body mass index above 25 kg/m², who were selected using convenience sampling and randomly assigned to two groups: experimental (n = 15) and control (n = 15). The experimental group received a six-week DNS exercise protocol (six sessions per week, including three supervised remote sessions and three home sessions) via telerehabilitation. Cardiorespiratory fitness was assessed using the 2-Minute Step Test. Upper extremity strength was measured separately for the left and right arms using the 30-Second Arm Curl Test. Lower extremity strength was assessed using the 30-Second Chair Stand Test. All measurements were conducted at pretest and posttest stages. Analysis of covariance was used for data analysis at a significance level of p < 0.05. The results showed a significant difference between the experimental and control groups for cardiorespiratory fitness (F = 586.88, p = 0.001, η² = 0.95). A significant difference was also observed for lower extremity strength (F = 267.00, p = 0.001, η² = 0.90). However, no significant differences were found between the two groups for left upper extremity strength (F = 0.350, p = 0.550, η² = 0.002) or right upper extremity strength (F = 0.12, p = 0.770, η² = 0.005). A six-week telerehabilitation-based Dynamic Neuromuscular Stabilization exercise program may be an effective and practical intervention for improving cardiorespiratory fitness and lower extremity strength in overweight and obese older women. However, this protocol did not significantly improve upper extremity strength, highlighting the principle of training specificity. Telerehabilitation-based DNS may provide an accessible home-based exercise option for enhancing selected physical fitness outcomes in this population.
Copyright (c) 2025 Forough Nikghadam Dalouei (Author); Nasser Mohammad Rahimi (Corresponding Author)
Comparative Effects of Continuous and Interval Aerobic Training on Cellular Respiration Indices (OCR) and ATP Content in Skeletal Muscle of Rats with Type 2 Diabetes
Type 2 diabetes impairs skeletal muscle energy metabolism, partly through mitochondrial respiratory dysfunction and reduced ATP-generating capacity. This experimental study compared the effects of continuous and interval aerobic training on cellular respiration indices and ATP content in the gastrocnemius muscle of male Wistar rats with type 2 diabetes. Male Wistar rats were allocated to six groups: healthy control, healthy + continuous training, healthy + interval training, diabetic control, diabetic + continuous training, and diabetic + interval training (n = 8 per group). Type 2 diabetes was induced using a high-fat diet followed by intraperitoneal streptozotocin injection. The exercise interventions were performed for eight weeks. After the intervention, gastrocnemius muscle samples were collected for analysis of mitochondrial respiratory indices, including basal respiration, ATP-linked respiration, maximal respiration, spare respiratory capacity, proton leak, coupling efficiency, and tissue ATP content. Data were analyzed using two-way analysis of variance followed by Tukey post hoc tests. Diabetes reduced mitochondrial respiratory indices, spare respiratory capacity, coupling efficiency, and ATP content. Both aerobic training protocols improved respiratory function and ATP content in diabetic rats. The interval training protocol produced larger improvements than continuous training in maximal respiration, spare respiratory capacity, and ATP content. Eight weeks of aerobic training partially restored diabetes-related impairments in skeletal muscle mitochondrial function. Interval aerobic training appeared to produce stronger respiratory adaptations than continuous training. These findings provide preclinical evidence for the role of exercise intensity structure in mitochondrial adaptation under diabetic conditions.
Copyright (c) 2025 Elham Fanaei (Author); ‌Elham Eftekhari Gheinani (Corresponding Author); Jamshid Banaei Borojeni (Author)
Regulation of the GLUT4 Translocation Pathway in Diabetic Skeletal Muscle: Comparative Effects of Aerobic and Resistance Training on AS160 and GLUT4 Gene Expression in Type 2 Diabetic Mice
Background: Impaired glucose transport into skeletal muscle is a central mechanism in insulin resistance and type 2 diabetes mellitus. AS160 (TBC1D4) and glucose transporter type 4 (GLUT4) are key molecular components of the insulin-dependent glucose transport pathway. Exercise training is an established non-pharmacological intervention for improving glucose homeostasis; however, the comparative effects of aerobic and resistance training on AS160 and GLUT4 gene expression in diabetic skeletal muscle remain insufficiently clarified. Objective: This study compared the effects of aerobic and resistance training on AS160 and GLUT4 gene expression in the soleus and extensor digitorum longus (EDL) muscles of type 2 diabetic mice. Methods: Fifty male C57BL/6 mice were assigned to five groups: healthy control, sham, diabetic control, diabetic plus aerobic training, and diabetic plus resistance training. Type 2 diabetes was induced using a high-fat diet followed by low-dose streptozotocin injection. The training protocols were performed for 8 weeks, 5 sessions per week. AS160 and GLUT4 gene expression in the soleus and EDL muscles was measured by real-time polymerase chain reaction and normalized to GAPDH using the 2^-ΔΔCt method. Data were analyzed using two-way mixed analysis of variance with Bonferroni post hoc comparisons. Results: Diabetes reduced AS160 and GLUT4 expression in both muscles. Both exercise modalities increased the expression of the two genes compared with the diabetic control group. The GLUT4 response was stronger than the AS160 response, and aerobic training produced a larger increase in GLUT4 expression than resistance training. The soleus muscle showed a stronger metabolic response than the EDL muscle. Conclusion: Exercise training, particularly aerobic training, partially restored defects in the skeletal muscle glucose transport pathway in type 2 diabetic mice. These findings support structured exercise as a molecularly relevant strategy for improving insulin sensitivity in diabetes.
type 2 diabetes mellitus; aerobic training; resistance training; AS160; GLUT4; glucose transport; skeletal muscle
Copyright (c) 2025 Reyhaneh Alizadeh Behbahani (Author); Saeed Keshavarz (Corresponding Author); Leila Sarrami, Jamshid B anaei Borojeni (Author)
The Effectiveness of an Integrated Emotion-Focused Therapy and Music Therapy Package in Reducing Stress, Anxiety, and Depression among Adults with High-Functioning Autism Spectrum Disorder
This study examined the preliminary effectiveness of an integrated therapeutic package combining emotion-focused therapy and music therapy in reducing stress, anxiety, and depression among adults with high-functioning autism spectrum disorder. A quasi-experimental pretest-posttest-follow-up design with a control group was used; after purposive eligibility screening, participants were allocated to groups using a simple random procedure. The population consisted of adults aged 18-45 years with autism spectrum disorder level 1, without intellectual disability, who attended psychological centers and private or semi-private clinics in Tehran, Iran, in 2025. Thirty adults were screened, and 27 eligible participants were selected through purposive sampling and allocated by simple random procedure to an experimental group (n = 14) or a control group (n = 13). The experimental group received 12 sessions of the integrated intervention over six weeks, with two 90-minute sessions per week; the control group received no study-delivered active psychological intervention during this period, while access to stable usual care was not restricted. Outcomes were measured using the Depression Anxiety Stress Scales-21 (DASS-21). Mixed-design repeated-measures analyses of variance showed significant time × group interactions for stress, F(1.018, 25.447) = 77.285, p < .001, partial eta squared = .756; anxiety, F(1.007, 25.177) = 24.007, p < .001, partial eta squared = .490; and depression, F(1.011, 25.277) = 35.964, p < .001, partial eta squared = .590. The experimental group showed substantial reductions from pretest to posttest, and these gains were observed at the six-month follow-up, although maintenance should be interpreted cautiously because treatments received during follow-up were not experimentally controlled. The findings suggest that an integrated emotion-focused and music-based intervention may be a useful structured approach for reducing internalizing symptoms in adults with high-functioning autism spectrum disorder.
high-functioning autismhigh-functioning autism
Copyright (c) 2026 Hossein Fayazmanesh (Author); Kourosh Amraei (Corresponding Author); Fatemeh Rezaei (Author)
The Effectiveness of Acceptance and Commitment Therapy on Non-Suicidal Self-Injury and Executive Functions in Patients with Borderline Personality Disorder
Borderline personality disorder (BPD) is a complex clinical condition characterized by affective instability, impulsivity, interpersonal dysregulation, identity disturbance, and recurrent self-harming behaviors. Non-suicidal self-injury (NSSI) is particularly important in BPD because it is often used as a short-term strategy for regulating painful emotions, yet it is associated with considerable clinical risk and functional impairment. Executive functions, including inhibition, planning, self-organization, emotional self-regulation, and self-motivation, are also frequently impaired in this population. Acceptance and Commitment Therapy (ACT) may be clinically useful because it targets experiential avoidance and promotes psychological flexibility, values-based action, and acceptance of difficult internal experiences. This quasi-experimental study used a pretest-posttest-follow-up design with a control group. The statistical population included patients diagnosed with BPD who attended psychological and psychiatric treatment centers in Shahrood, Iran, in 2022. Forty participants were selected by convenience sampling and were then randomly assigned to an ACT group (n = 20) or a waiting-list control group (n = 20). The ACT group received eight intervention sessions, while the control group received no psychological intervention during the study period. Outcomes were assessed using the Barkley Deficits in Executive Functioning Scale and the Inventory of Statements About Self-Injury. Assessments were conducted at pretest, posttest, and two-month follow-up. Repeated-measures analysis was used to examine group, time, and group-by-time effects. ACT significantly reduced both intrapersonal and interpersonal NSSI functions. Significant group-by-time effects were found for intrapersonal NSSI (F = 11.55, p < .001, partial η² = .23) and interpersonal NSSI (F = 15.02, p < .001, partial η² = .28). ACT also significantly improved executive-function domains, including time self-management, self-organization/problem-solving, self-restraint/inhibition, self-motivation, and emotional self-regulation. Pairwise comparisons showed significant improvements from pretest to posttest and from pretest to follow-up, whereas posttest-to-follow-up differences were not significant, suggesting maintenance of treatment gains. The findings suggest that ACT may be an effective psychological intervention for reducing NSSI behaviors and improving executive-function difficulties in patients with BPD. The results support the use of ACT as an adjunctive clinical approach for targeting emotional dysregulation, maladaptive self-injury functions, and executive dysfunction in this population. Further randomized clinical trials with larger samples and longer follow-up periods are recommended.
Copyright (c) 2026 Elahe Hatami (Corresponding Author); Ali Akbar Soleimanian, Hamid Darrodi (Author)
Effectiveness of Behavioral Therapy Based on Systematic Desensitization in Reducing Anxiety and Animal-Phobia Symptoms in Adolescents
Animal phobia is a common subtype of specific phobia and is often accompanied by marked anxiety, avoidance behavior, and functional impairment. Systematic desensitization is a behavioral intervention that combines relaxation training with gradual exposure to feared stimuli. This study examined the effectiveness of behavioral therapy based on systematic desensitization in reducing anxiety and animal-phobia symptoms among adolescents with animal phobia. A quasi-experimental pretest-posttest design with a wait-list control group was used. Twenty-seven adolescents aged 15-18 years were recruited from counseling centers in Mashhad, Iran, after a clinical screening interview guided by DSM-5 criteria for specific phobia and an elevated score on the animal-phobia item set of the Specific Phobia Questionnaire. Participants were randomly allocated to an experimental group (n = 13) or a wait-list control group (n = 14). The experimental group received eight weekly 60-minute sessions of systematic desensitization, whereas the control group received no active intervention during the study period. Outcomes were assessed using the Beck Anxiety Inventory and 10 animal-related items from the Specific Phobia Questionnaire. Data were analyzed using descriptive statistics and univariate analysis of covariance, controlling for pretest scores. After controlling for pretest scores, the experimental group showed significantly lower posttest anxiety than the control group, F(1, 24) = 64.37, p < .001, partial eta squared = .728. A significant intervention effect was also observed for animal-phobia symptoms, F(1, 24) = 28.98, p < .001, partial eta squared = .547. These findings suggest that systematic desensitization may be a useful structured intervention for reducing anxiety and animal-phobia symptoms in adolescents. However, the small sample size, reliance on self-report outcomes, lack of behavioral approach testing, and absence of follow-up assessment require cautious interpretation. Future studies with larger samples, active control conditions, clinician-rated outcomes, and follow-up assessments are recommended.
Copyright (c) 2025 Homayun Rajabipour, Hossein Fayazmanesh (Author)
Comparison of the Effectiveness of Short-Term Psychodynamic Therapy and Integrated Acceptance and Commitment Therapy with Schema Therapy on Sleep Quality and Disability Caused by Tension-Type Headache in Insecurely Attached Nurses with Anxiety Symptoms
Nurses working in intensive, emergency, and oncology settings are exposed to persistent emotional, cognitive, and physical demands. In nurses with insecure attachment and anxiety symptoms, these demands may be expressed through sleep disturbance and disabling tension-type headache. This study compared the effectiveness of short-term psychodynamic therapy and an integrated acceptance and commitment therapy with schema therapy intervention on sleep quality and tension-type headache-related disability in insecurely attached nurses with anxiety symptoms. A quasi-experimental pre-test-post-test design with a wait-list control group and one-month follow-up was used. The population consisted of nurses employed in ICU, CCU, emergency, and oncology wards of Imam Reza Hospital, Mashhad, Iran, during the second half of 1403 SH. From 420 eligible nurses, 180 volunteered for screening; 70 had anxiety scores above the cut-off on DASS-21, 40 also showed predominant insecure attachment, and 30 met all inclusion criteria. Participants were randomly assigned to short-term psychodynamic therapy (n = 10), integrated acceptance and commitment therapy with schema therapy (n = 10), or wait-list control (n = 10). Both active interventions were delivered in eight 70-minute sessions. Outcome measures were the Pittsburgh Sleep Quality Index and the Headache Disability Inventory. Data were analyzed using multivariate and univariate analysis of covariance and Bonferroni post hoc tests. Results: After controlling for pre-test scores, the overall multivariate group effect was significant for sleep quality, Wilks' Lambda = .49, F(4, 50) = 5.43, p = .001, partial eta squared = .30, and for headache disability, Wilks' Lambda = .30, F(8, 44) = 4.50, p = .001, partial eta squared = .45. Group effects were significant for sleep quality at post-test and follow-up and for both emotional and functional dimensions of headache disability at post-test and follow-up. Adjusted Bonferroni comparisons indicated significant advantages of the psychodynamic group over the control group for sleep quality at post-test and follow-up, and significant advantages of both active interventions over control for headache disability. For headache disability, the adjusted pairwise comparisons indicated larger reductions in the psychodynamic condition than in the integrated treatment condition across post-test and follow-up. Both active interventions were associated with improvements in sleep quality and tension-type headache-related disability; however, the adjusted inferential results suggested a stronger effect of short-term psychodynamic therapy on headache-related disability in this sample. The findings support the clinical relevance of emotion-focused and schema/acceptance-based interventions for anxious, insecurely attached nurses, while emphasizing the need for replication with larger samples and longer follow-up.
intensive short-term dynamic psychotherapy
Copyright (c) 2025 Fatemeh Hassanezhad, Fatemeh Shahabizadeh, Jalil Jarrahi Feriz (Author)
Work Environment, Workload, and Mental Health Among Healthcare Staff in Critical Care Settings: A Systematic Review
Critical care settings such as intensive care units, emergency departments, anesthesia units, and crisis-response hospital wards expose healthcare staff to high task density, moral pressure, unpredictable clinical events, and emotionally demanding encounters with patients and families. These conditions can affect staff mental health, quality of life, professional functioning, and patient safety. This systematic review synthesizes evidence on the relationship between the work environment, workload, and mental health outcomes among healthcare staff working in critical care settings. The review was structured according to the main reporting principles of PRISMA 2020. English and Persian literature was searched and verified through PubMed, Google Scholar, journal websites, SID, Magiran, and related databases. Eligible studies examined healthcare workers in critical care or comparable crisis settings and reported work-environment factors, workload, job stress, burnout, depression, anxiety, sleep problems, quality of life, coping, or patient-safety-related outcomes. Given the heterogeneity of study designs, settings, instruments, and outcomes, findings were synthesized narratively rather than statistically. The evidence consistently shows that high workload, insufficient staffing, rotating or night shifts, limited decision latitude, poor team communication, inadequate physical environments, and repeated exposure to death or ethical dilemmas are associated with poorer mental health. Burnout, emotional exhaustion, depressive symptoms, anxiety, sleep disturbance, moral distress, reduced quality of life, and lower perceived patient-safety culture were the most commonly reported outcomes. Protective factors included supportive leadership, meaningful teamwork, supervisor and peer support, resilience, fair scheduling, structured reflection, access to psychological support, and organizational attention to rest, staffing, and safety culture. Mental health in critical care staff is not merely an individual vulnerability; it is a system-level outcome shaped by the interaction between job demands, job resources, organizational culture, and personal coping capacity. Sustainable interventions should therefore combine workload redesign, staffing adequacy, shift planning, supportive supervision, psychological services, team communication, and staff participation in decision-making.
Copyright (c) 2025 Fezeh Rezaeian (Author)
Prediction of Self-Harming Thoughts Based on Early Maladaptive Schemas and Mindfulness
Self-harming thoughts are among the most important psychological warning signs associated with emotional dysregulation, maladaptive coping, and vulnerability to self-injurious behaviors. The present study aimed to examine the predictive role of mindfulness and early maladaptive schemas in self-harming thoughts among adults referring to psychological clinics in Tehran. This applied study used a descriptive-correlational cross-sectional design. The statistical population consisted of individuals over 18 years of age who referred to private or public psychological clinics in Tehran during the third quarter of 2025 due to anxiety, depression, or other psychological difficulties. Using simple random sampling and based on the Krejcie and Morgan table, 300 participants were selected. Data were collected using the Kentucky Inventory of Mindfulness Skills, Young Schema Questionnaire–Short Form, and Beck Scale for Suicide Ideation. Data were analyzed using Pearson correlation coefficients and simultaneous multiple regression analysis in SPSS version 22. The results showed that total mindfulness was negatively and significantly associated with self-harming thoughts (r = −0.556, p = 0.001), whereas the total maladaptive schema score was positively and significantly associated with self-harming thoughts (r = 0.455, p = 0.002). In the regression analyses, the mindfulness model and schema model significantly predicted self-harming thoughts. Among mindfulness components, only describing without labeling remained a significant predictor (β = 0.244, p = 0.004). Among schema domains, only impaired autonomy and performance significantly predicted self-harming thoughts (β = 0.307, p = 0.002). In the simultaneous model, mindfulness and early maladaptive schemas together explained approximately 40% of the variance in self-harming thoughts (R² = 0.402). These findings suggest that self-harming thoughts are shaped by the combined effects of reduced mindfulness skills and dysfunctional cognitive-emotional schemas. Interventions that strengthen nonjudgmental description of internal experiences and modify autonomy-related maladaptive schemas may help reduce self-harming thoughts.
Copyright (c) 2025 Shohrehalsadat Filsouf, Tayebe Ardi, Elham Mahmodiyan, Sevin Esmaelzadeh, Hanieh Forghani Heris (Author)
Effectiveness of Acceptance and Commitment Therapy on Pain Catastrophizing, Pain Self-Efficacy, and Psychological Flexibility in Individuals with Chronic Pain: A Quasi-Experimental Study
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.
Acceptance and Commitment Therapy; chronic pain; pain catastrophizing; pain self-efficacy; psychological flexibility; online intervention
Copyright (c) 2025 Fatemeh Moqbeli, Fateme Mohebi Rezaei, Elnaz Seyyedbaglou, Parisa Fatahi, Javad Adeldoust (Author); Mohammad Amin Roustaei Hossein Abad (Corresponding Author)
Parental Emotional Intelligence and Emotion Regulation in Children Aged 6–12: A Cross-Sectional Study
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.
emotional intelligence; emotion regulation; parents; children; family; psychological adjustment
Copyright (c) 2025 Milad Nik Andish, Nafise Kianersi, Ghazaleh Mohammadkhani, Horie Asadzade, Elham Kalantari (Author)
The Effectiveness of Schema-Reconstruction-Based Cognitive Behavioral Therapy on Rumination in Patients With Depression: A Quasi-Experimental Study
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.
cognitive behavioral therapy; schema reconstruction; rumination; depression; Beck Depression Inventory; Ruminative Response Scale
Copyright (c) 2025 Elahe Ghorbani, Arezoo Zarei, Zeinab Panahian, Zohreh Nazemi (Author); Mahdieh Abdollahi Vand Nodeh (Corresponding Author)
The Effectiveness of Emotionally Focused Couple Therapy on Marital Commitment, Marital Intimacy, and Marital Forgiveness Among Couples Affected by Extramarital Relationships: A Quasi-Experimental Study
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.
Emotionally Focused Couple Therapy; extramarital relationships; marital commitment; marital intimacy; marital forgiveness; attachment injury; infidelity
Copyright (c) 2025 Saba Sadat Basirat (Author); Mohammad Sina Yaghoubnejad (Corresponding Author); Mehdi Basirt (Author)
The Role of Parental Support in Restoring Neurocognitive and Physiological Regulation Following Childhood Grief: An Emotion-Regulation-Based Interventional Study
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.
childhood bereavement; parental support; emotion regulation; prolonged grief; executive function; autonomic regulation; family intervention
Copyright (c) 2025 Hanieh Abbasi (Author); Fakhri Sadat Hosseini (Corresponding Author); Nastaran Madankan, Elham Dehghan, Zahra Sadat Mohseni Nia (Author)
Effects of Schema Therapy and ISTDP on Resilience, Emotion Regulation, and Self-Compassion in Women with a History of Trauma
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.
schema therapy, intensive short-term dynamic psychotherapy, resilience, emotion regulation, self-compassion, trauma, women
Copyright (c) 2025 Alireza Ahangaran (Author); Pardis Tadayon (Corresponding Author); Mohammad Reza Zoghi Paidar , Hossein Mohagheghi , Javad Moshfeghi Vahed , Fatemeh Mirzai (Author)
Comparative Effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) and Neurofeedback on Executive Functions in Female Senior High School Students with Internalizing and Externalizing Behavioral Disorders
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.
EMDR; neurofeedback; executive functions; internalizing disorders; externalizing disorders; adolescents
Copyright (c) 2026 Seyedeh Golzar Razavi (Author); Ali Zadehmohammadi (Corresponding Author); Mohammadreza Bigdeli, Hossien Bigdeli (Author)
Modeling the Design of Therapeutic Environments for Patients with Schizophrenia Based on Environmental Cognitive Patterns and Its Effect on Anxiety Reduction
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.
therapeutic design, schizophrenia, anxiety, environmental psychology, healing architecture, cognitive patterns
Copyright (c) 2026 Mohammad Kaveh Baghbahadorani, Hamidreza Ameri Siyahoyi, Vahdaneh Fooladi, Mastooreh Sedaghat (Author)
Comparing the Effectiveness of Cognitive Behavioral Therapy and Emotion-Focused Therapy on Mindfulness and Psychological Flexibility in Generalized Anxiety Disorder
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.
generalized anxiety disorder, cognitive behavioral therapy, emotion-focused therapy, mindfulness, psychological flexibility
Copyright (c) 2025 Alireza Ahangaran, Hasan Fathi, Negin Sadat Azimi, Aliyeh Ghorbani (Author)
The Effectiveness of Acceptance and Commitment Therapy on Reducing Post-Traumatic Stress Disorder Symptoms and Enhancing Post-Traumatic Growth in Adolescent Survivors of Sexual Assault
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.
acceptance and commitment therapy; post-traumatic stress disorder; post-traumatic growth; sexual assault; adolescence; trauma therapy.
Copyright (c) 2025 Mahboubeh Abdollahzade Ata Abadi, Seyedeh Nafiseh Mohseni Mansour, Zeinab Es’haqian, Mehdi Babajanzadeh Barforoushi, Nasim Samadifard (Author)