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OBJECTIVE: Online interventions hold promise in supporting the well-being of family caregivers and enhancing the quality of care they provide for individuals with long-term or chronic conditions. However, dropout rates from support programs among specific groups of caregivers, such as caregivers of people with dementia, pose a challenge. Focused reviews are needed to provide more accurate insights and estimates in this specific research area. METHODS: A meta-analysis of dropout rates from available online interventions for family caregivers of people with dementia was conducted to assess treatment acceptability. A systematic search yielded 18 studies involving 1,215 caregivers. RESULTS: The overall pooled dropout rate was 18.4%, with notable heterogeneity indicating varied intervention adherence. Interventions incorporating human contact, interactive features, and personalization strategies for specific types and stages of dementia predicted significantly lower dropout rates. Methodological assessment revealed variability in study quality. CONCLUSION: Findings support the effectiveness of social support, personalization strategies, and co-design in enhancing intervention adherence among dementia family caregivers. Further research is needed to explore factors influencing dropout rates and conduct robust trials to refine the implementation of future interventions.
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NSSI has recently been recognized as a significant health issue given its documented association with psychopathology and across a broad spectrum of psychiatric disorders. It has been found that individuals experiencing heightened emotions, which is referred to as an emotional cascade, are more likely to engage in self-injury behaviour due to low levels of distress tolerance (DT). The current meta-analysis using PRISMA guidelines sought to quantify the strength of the association between DT and lifetime frequency of NSSI using 22 eligible studies (N = 14,588; F = 60.7%; age = 23.35 ± 7.30), mainly from the United States. The correlation between emotional DT and NSSI was a small negative correlation (r = -.14), and it was non-significant for behavioural DT and NSSI (r = .02). Also, the effect-size was significant for studies that used interview-based measure of NSSI (r = -.24), and it was non-significant when self-report measures of NSSI (r = -.11) utilized. The association between DT and NSSI was significant and negative across the general population (r = -.47), university students (r = -.17), and inpatients (r = -.27); surprisingly, it was significant and positive among adolescents or high school students (r = .17). The observed effect-sizes were independent of publication year, mean age and its standard deviation, study quality, female proportion, DT, NSSI measures reliability, and clinical status. Future studies on NSSI should consider DT as a spectrum from distress intolerance to distress over-tolerance, given that it seems it has different functions when different samples (e.g., adolescents) are studied.
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Conducta Autodestructiva , Humanos , Conducta Autodestructiva/psicología , Conducta Autodestructiva/epidemiología , Distrés Psicológico , Femenino , Adulto , Masculino , Adulto Joven , AdolescenteRESUMEN
Current research indicates that anxiety disorders and elevated levels of trait anxiety are associated with biases and impairments when thinking of personally relevant future events, that is, future thinking. However, to date, little research has been conducted into how people with symptoms of clinical anxiety perceive the functions of future thinking. The current study presents a cross-sectional survey comparing individuals with elevated symptoms of generalized anxiety disorder (GAD) and related functional impact (N = 51, 43.1% female, Mage = 33.1, SD = 10.2) matched on age and gender with individuals with no clinically significant symptoms of GAD (N = 51, 43.1% female, Mage = 33.3, SD = 10.1) on self-reported functions of future thinking and a battery of items assessing the phenomenological characteristics. The results indicated various significant differences in the perceived functions of future thinking and its phenomenological characteristics in those with elevated GAD symptoms. Broadly, they indicate more frequent future thinking and more commonly for self-distraction or processing negatively valenced future events, and generally less adaptive mental representations that support current thinking on the psychopathological process of increased worry, anxious arousal and maladaptive cognition in clinical anxiety symptoms.
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Trastornos de Ansiedad , Pensamiento , Humanos , Femenino , Masculino , Trastornos de Ansiedad/psicología , Adulto , Estudios Transversales , Predicción , Persona de Mediana Edad , Autoinforme , Encuestas y CuestionariosRESUMEN
Internet gaming disorder (IGD) is multifaceted and can have significant negative consequences. The present study examined the contribution of cognitive, metacognitive, motivational, and emotional factors as predictors for IGD severity. In a cross-sectional study, 703 Iranian adolescents (36.8% females, mean age = 16.98 years [SD = 1.23]) completed an online survey. Hierarchical regression analysis showed that the cognitive, metacognitive, motivational, and emotional factors predicted 7.8%, 17.4%, 1.4%, and 1.9% of the variance in IGD symptoms, respectively. The findings indicated that the cognitive factors including some maladaptive cognitions, such as cognitive salience, regret, and perfectionism, and metacognitive factors including some maladaptive metacognitions (negative metacognitions regarding the uncontrollability of online gaming and negative metacognitions regarding the dangers of online gaming) were significant predictors of IGD severity, highlighting their importance in understanding and predicting problematic gaming behaviors. Although contributing to the variance in IGD, motivational factors (escape, coping, and skill development) and emotional factors including emotion regulation (especially reappraisal) played relatively smaller roles compared to cognitive and metacognitive factors. Of the examined predictive factors, metacognitions were the most important predictor of IGD severity. Exploratory moderator analyses showed significant interactions between three predictors of IGD (reappraisal, negative metacognitions, and cognitive salience) with loneliness, stress, anxiety, and depressive symptoms. Reappraisal was the most frequent predictor and had a significant interaction with these variables. Other predictors independently impacted IGD irrespective of the level of loneliness, stress, anxiety, or depressive symptoms. Based on these findings, special attention to metacognitive, cognitive, emotional, and motivational factors is suggested in the treatment of IGD.
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Procrastination is the deliberate, unjustified postponing of an intended course of action despite its costs or unfavorable effects. The present study used a self-report online survey and collected data from a large convenience sample of the general adult population (N = 2,076; females = 55.73%; Mage = 35.1 years [SD ± 12.7]) with diverse demographics. Following the ring-curve distribution, the results indicated a 15.4% prevalence rate of procrastination among the Iranian community, which was significantly higher among women and divorced individuals and lower among nomadic individuals and those with higher academic degrees. A latent profile analysis demonstrated two distinct profiles, one for procrastinators (high scores on chronic procrastination, psychological distress, neuroticism, and extraversion; and low scores on general self-efficacy, self-esteem, satisfaction with life, openness, agreeableness, and conscientiousness) and one for non-procrastinators (demonstrating a reverse pattern compared to procrastinators). Moreover, additional network analysis suggested that the examined networks were invariant across procrastination status and gender. The results indicate that procrastination differs by demographic characteristics and is associated with a unique psychological profile. However, none of the aforementioned key study variables were considered a potential vulnerability for procrastinators due to the finding that all variables were peripheral and none were central in the examined networks. Therefore, relying on the differences in mean scores on psychometric scales does not appear to be an optimal way of determining the most important variables in a therapeutic context when treating procrastination.
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Impairments of auditory processing are among frequent findings in dyslexia. However, it is unclear how auditory signals are gated from brainstem to higher central processing stages in these individuals. The present study was done to investigate auditory sensory gating in children with developmental dyslexia (DD), and to determine whether sensory gating correlates with performance on behavioural tasks. Auditory sensory gating at P50, N1 and P2 waves was evaluated in two groups including 20 children with DD and 19 children with typical reading development (TRD). Behavioural tests were used to evaluate phonological working memory (PWM) and selective attention abilities. Sensory gating in children with DD was significantly less efficient than their peers at P50, N1 and P2 waves. Lower auditory evoked potential (AEP) amplitudes were found in the DD group. The children with TRD scored better in all the behavioural tests. Relationships were reported between sensory gating at P50, N1, P2 and behavioural performance in the two groups. Children with dyslexia had deficient sensory gating in comparison with controls. In addition, children with dyslexia experienced problems with PWM and selective attention tasks. The function of sensory gating was associated with attentional and PWM performances in this group.
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Dislexia , Humanos , Niño , Dislexia/complicaciones , Potenciales Evocados Auditivos/fisiología , Lectura , Cognición , Filtrado SensorialRESUMEN
In Greece, the COVID-19 pandemic was associated with social isolation, economic crisis, considerable unemployment, and an escalation of psychological distress. Given the potential of COVID-19 to engender a long-lasting impact on mental health, validating the COVID-19 Anxiety Syndrome Scale (C-19ASS) may be beneficial in determining if fear-based behaviors may persist post-pandemic. This is a psychometric study examining the C-19ASS features across a general sample of Greeks (n = 912; female = 78%; mean age = 32.35, ±9.25). The Greek C-19ASS demonstrated a two-factor structure consistent with the original scale's perseveration and avoidance subscales. This structure was supported by confirmatory factor analysis, which demonstrated a strong fit and robust reliability along with good divergent and convergent validity evidenced by correlational analyses. The incremental validity test revealed that the Greek C-19ASS predicted functional impairment and COVID-19 anxiety independently of health anxiety, generalized anxiety, and depressive symptoms, the Big Five personality traits, pandemic-related factors, and demographic variables. The findings were discussed using a self-regulatory executive function model as a theoretical background to discuss this pandemic-related phenomenon.
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Coronavirus disease-19 (COVID-19) has led to the demise of millions of people worldwide; additionally, it has resulted in a significant economic and mental health burden. Since the onset of the COVID-19 pandemic, various measures have been constructed to evaluate pandemic-related fear and anxiety. The COVID-19 Anxiety Syndrome Scale (C-19ASS) is a promising measure that assesses coping strategies (e.g., avoidance, checking, worrying and threat monitoring), termed 'COVID-19 Anxiety Syndrome', in response to COVID-19 fear and anxiety. The measure has been broadly welcomed, leading to its use in Brazil (Portuguese), China, Greece, Indonesia, the Philippines, Iran (Farsi), Italy, Saudi Arabia (Arabic), Turkey, the United Kingdom and the United States. To gain a better understanding of the relevance of the COVID-19 Anxiety Syndrome, we conducted a systematic review and meta-analysis to explore the psychological correlates and psychometric properties of the C-19ASS. Through the analysis of a total of 17,789 individuals (age range 19-70; female = 33%-85%), the C-19ASS demonstrated a consistent factor structure, measurement invariance across gender and acceptable reliabilities. Furthermore, a significant association with COVID-19 anxiety, depressive symptoms, generalized anxiety, health anxiety, psychological distress and functional impairment (work and social adjustment) during the COVID-19 pandemic was observed. When considering the Big Five personality traits, the C-19ASS and its subscales were only significantly and negatively associated with extraversion; only the total score on the measure was associated with neuroticism. The observed effect sizes ranged from very small to medium. Given that all included studies (K = 24) were cross-sectional, and due to the nature of the COVID-19 Anxiety Syndrome, which may well persist after the pandemic ends, it is recommended to continue screening society for the persistence of this syndrome.
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COVID-19 , Humanos , Femenino , Estados Unidos , Adulto Joven , Adulto , Persona de Mediana Edad , Anciano , SARS-CoV-2 , Pandemias , Psicometría , Depresión/psicología , Ansiedad/diagnóstico , Ansiedad/psicologíaRESUMEN
BACKGROUND: Poor sleep quality is associated with a broad range of psychopathology and is a common problem among college students. This study aimed to investigate the mediating role of metacognitive beliefs related to sleep, emotion regulation and a negative cognitive style related to anxiety (looming cognitive style) in the relation between neuroticism and reported sleep quality. PARTICIPANTS: Participants were 343 undergraduates from three universities in Tehran (56.3% females, Mean age = 22.01 ± 2.74 years). METHOD: Data were gathered with a questionnaire packet that included the Pittsburgh Sleep Quality Index (PSQI), Metacognitions Questionnaire-Insomnia (MCQ-I), Emotion Regulation Questionnaire (ERQ), Looming Maladaptive Style Questionnaire (LMSQ) and Neuroticism subscale of NEO-PI-R. RESULTS: Structural equation modeling analyses supported a proposed model (R2 = 37%) which proposed that neuroticism both directly and indirectly linked to reported sleep quality through metacognitions related to sleep, cognitive reappraisal and looming cognitive style (χ2 = 1194.87, p < .001; CFI = 0.93, NFI = 0.90, RMSEA = 0.065, GFI = 0.92, SRMR = 0.069, IFI = 0.93). CONCLUSIONS: The results provide evidence for the impact of neuroticism on reported sleep quality through metacognitive, cognitive and emotional factors. The result suggest that special attention should be paid to these factors in the treatment and psychopathology of sleep quality.
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Metacognición , Calidad del Sueño , Adulto , Trastornos de Ansiedad/psicología , Femenino , Humanos , Irán , Masculino , Neuroticismo , Encuestas y Cuestionarios , Adulto JovenRESUMEN
The association between distress tolerance (DT) and posttraumatic stress disorder (PTSD) is well established. This study aimed to provide an account of the magnitude of this effect across available studies. From the 2,212 records yielded by the initial search, 56 studies comprised 12,672 participants (Mage = 29.96, SD = 12.05; 44.94% women) were included in the investigation upon a priori criteria. Results demonstrated consistent negative associations between DT and PTSD symptoms, such that lower DT was associated with higher PTSD symptom severity and vice versa; the effect size (ES) was relatively small in magnitude (r = -0.335, 95% CI [-0.379, -0.289]). Moreover, ESs for the DT-PTSD association were significantly greater for studies which examined self-reported DT compared to those that examined behavioral DT. The number of traumatic event types experienced (trauma load) was the most consistent moderator of the DT and PTSD association. The clinical implications of the role of DT in PTSD are discussed.
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Trastornos por Estrés Postraumático , Femenino , Humanos , Masculino , Autoinforme , Trastornos por Estrés Postraumático/complicacionesRESUMEN
OBJECTIVES: Much of the research on hoarding is focused on cognition and behavior, with less focus on emotion and its regulation. METHOD: A comprehensive search yielded nine studies (out of 5581) from which to draw data for the current study. Across the eight studies (nine independent effect sizes) which provided data for 1595 total participants (Meanage = 34.46, SD = 8.78; 64.26% females). RESULTS: Emotion dysregulation had a medium association with hoarding symptoms (r = 0.43). The effect was strong (r = 0.61) in some populations and weaker (r = 0.19) in others. However, it was higher in nonclinical samples than in clinical samples. Also, the strength of the association between hoarding and emotion regulation differed by the type of hoarding measures adopted in the individual studies. Moreover, there were no statistically significant differences between emotion dysregulation facets and hoarding. CONCLUSION: The findings highlight the importance of studying emotions and emotion regulation in hoarding.
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Regulación Emocional , Trastorno de Acumulación , Acaparamiento , Adulto , Cognición , Emociones/fisiología , Femenino , Acaparamiento/psicología , Humanos , MasculinoRESUMEN
There is a potential for a long-lasting psychological and social impact from the COVID-19 pandemic. Recently, the COVID-19 Anxiety Syndrome Scale (C19-ASS) has been developed, which measures individuals' coping mechanisms in relation to the fear or threat of COVID-19. The C19-ASS was developed and has been used so far only in Western samples. Further psychometric evaluation is needed in ethnically diverse samples. Therefore, the current study sought to test the psychometric properties in a large sample of Iranians (n = 1429; female = 52.1%; Mean age = 35.83, ±12.89) who completed a cross-sectional survey. Exploratory factor analysis revealed that the Persian C19-ASS has a two-factor structure corresponding to the perseveration and avoidance subscales of the original scale. Confirmatory factor analyses also supported a two-factor solution, which showed a firm model fit and high internal consistencies. Furthermore, it showed excellent divergent validity from generalized anxiety, indicating that it is concerned explicitly with COVID-19, supported by correlational analyses and exploratory factor analysis. Test of incremental validity indicated the Persian C19-ASS explained more variance in functional impairment and COVID-19 anxiety than the gender, marital and educational status, generalized anxiety, neuroticism, openness, consciousness and having lost someone close due to COVID-19. Also, based on a mediation test, it was found that C19-ASS mediates the relationship between the Big Five personality traits (except openness and consciousness) and health anxiety, generalized anxiety, depression and COVID-19 anxiety. Overall, the current findings provide further evidence for the construct of the COVID-19 anxiety syndrome. The COVID-19 anxiety syndrome is discussed in light of the S-REF model that provides an explanatory framework for this pandemic-related construct.
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COVID-19 , Ansiedad/diagnóstico , Ansiedad/psicología , Estudios Transversales , Femenino , Humanos , Irán , Pandemias , Psicometría , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
Non-adherence to medical regimens among patients with diabetes is a well-recognized concern in health care. Modified information, motivation, behavioural skills (IMB) model by adding an emotion component to it was tested to explore predictors of treatment adherence among 1,125 Iranian patients with diabetes type I (T1D) and type II (T2D) and due to other medical conditions. The modified IMB model explained 35% of the treatment adherence with large effect-sizes f2 = 0.56 to 0.69. Self-compassion and interpersonal communication between staff and patients (ICSP) were significant predictors of treatment adherence among patients with T1D, T2D and diabetes due to other medical conditions, while both outperformed the other significant predictors of treatment adherence, i.e., illness perception and social support in all groups. Distress intolerance was a significant predictor of treatment adherence only in patients with T2D. In addition, patients, based on their type of diabetes, exhibited different patterns of illness perception in predicting treatment adherence. Among T2D patients and those with diabetes due to other medical conditions, gender (male; only in T2D) and being single were significant predictors of treatment adherence, while age and diabetes duration were not. Finally, the model demonstrated that above and beyond demographic features, self-compassion, interpersonal communication between patients and health care staff, distress intolerance, perceived social support and illness perception were significant predictors of treatment adherence among patients with diabetes.
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Diabetes Mellitus Tipo 1 , Diabetes Mellitus Tipo 2 , Humanos , Masculino , Motivación , Irán , Cumplimiento y Adherencia al Tratamiento , Diabetes Mellitus Tipo 2/terapia , Diabetes Mellitus Tipo 2/psicologíaRESUMEN
This study aimed to develop fortified dairy desserts containing Lactobacillus casei and evaluate the physicochemical, sensory, and microbiological characteristics of the product during 28 days of storage. Seven dairy desserts were formulated by date extract (8%), whey protein (1.56%), inulin (4%(, folic acid (0.00066%), vitamin D (0.002%) and gluconate calcium (0.66%). The addition of date extract and inulin increased total solids while whey protein incorporation into dairy desserts led to the improvement of protein and phosphorous content. Furthermore, all fortified dairy desserts showed higher antioxidant activity and total phenolic content. Fortification of dairy desserts had no negative effect on the sensory acceptability and syneresis was not observed. In addition, the pH reduction and increased acidity did not adversely affect the count of L. casei, which remained above 8 log CFU g-1 during storage. Consequently, the fortified dairy dessert developed in this research is an innovative food product with good acceptability and high nutritional quality.
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The global COVID-19 outbreak has put the human race's distress tolerance abilities to the test. And, the distress experienced getting worse with each pandemic wave; however, the more flexible the person, the greater the chance of surviving. Thus, the current study aimed to examine the mediating role of personalized psychological flexibility (PPF) in the link between distress intolerance to psychological distress during the fourth wave of the pandemic in Iran. A total of 576 individuals (Meanage 34.80, ±10.9, females 55.6%) took part in the online survey. In this national sample, PPF partially played a role in mediating the association mentioned above. Interestingly, this mediation was independent of demographic factors (age, gender, marital status, and educational level) and fear of COVID-19, mindfulness, and satisfaction with life. So, despite the mentioned variables, accepting and using unpleasant emotions as fuel to achieve valued goals rather than avoiding them would mitigate the psychological distress during the pandemic. Consequently, public health services can aim to provide psychological flexibility enhancing interventions to decay COVID-19-related mental distress.
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COVID-19 , Distrés Psicológico , Femenino , Humanos , Irán/epidemiología , Pandemias , SARS-CoV-2RESUMEN
The current study aimed to investigate the mediating role of metacognitions, intolerance of uncertainty and emotion regulation in the relationship between fear of COVID-19 (FC-19) and health anxiety, among families with COVID-19 infected. Participants were 541 individuals from family members of patients with COVID-19 (F = 52.3%, mean age = 41.3 ± 13.2 years). Data were collected with a packet including sociodemographic and risk factors, the Fear of COVID-19 Scale, the Short Health Anxiety Inventory, the Metacognitions Questionnaire 30, the Intolerance of Uncertainty Scale-12 and the Emotion Regulation Questionnaire. Structural equation modelling analyses revealed a full mediation of metacognitions (i.e., positive beliefs about worry, negative beliefs about thoughts concerning uncontrollability and danger, cognitive confidence and beliefs about the need to control thoughts), intolerance of uncertainty and expressive suppression in the relation between FC-19 and health anxiety. Moreover, the strongest indirect links were found between FC-19 and health anxiety through negative beliefs about thoughts concerning uncontrollability and danger and intolerance of uncertainty. These associations were independent of gender and risk status. The final model accounted for 71% of the variance of health anxiety. These findings suggest that particularly metacognitions, intolerance of uncertainty and expressive suppression play a full mediational role in the relation between FC-19 and health anxiety.
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COVID-19 , Regulación Emocional , Metacognición , Adulto , Ansiedad , Miedo , Humanos , Persona de Mediana Edad , SARS-CoV-2 , Encuestas y Cuestionarios , IncertidumbreRESUMEN
INTRODUCTION: Tinnitus is the most common symptom of auditory system disorders. It affects the quality of life of millions of people, but it is still incurable in most cases. Vagus nerve stimulation (VNS) therapy is a potential new treatment for subjective tinnitus. In this study, transcutaneous vagus nerve stimulation (tVNS) combined with tones was utilized to treat salicylate-induced tinnitus since salicylate is a reliable and convenient approach for rapidly inducing tinnitus. METHODS: Wistar rats were divided into acoustic stimulation alone (AS, n = 6), tVNS alone (n = 6), and tVNS with AS (n = 6) groups for behavioral and electrophysiological tests. They were assessed by auditory brainstem response (ABR), prepulse inhibition (PPI), gap prepulse inhibition of the acoustic startle (GPIAS), social interactions, and aggressive behavior tests at baseline and seven days' post-salicylate (175 mg/kg, twice a day) injection. RESULTS: The inhibition percentage of the GPIAS test was significantly reduced post-salicylate injection in the tVNS and AS alone groups, while it was not significant in the tVNS with AS group. There was no significant difference in the mean percentage of the GPIAS test between the tVNS groups (with or without AS) after salicylate injections. Social interactions were significantly different in the AS alone group pre- and post-salicylate injections, but they were not significant in other groups. Moreover, the results of aggressive behavior tests showed significantly increased post-salicylate injections in the AS alone group, while they were not significant in the tVNS groups (with or without AS). CONCLUSIONS: The current study revealed that the application of tVNS alone produced improved social interaction and mood and alleviated salicylate-induced tinnitus severity. Moreover, combining tVNS with acoustic stimulation can prevent salicylate-induced tinnitus.
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Acúfeno , Estimulación Eléctrica Transcutánea del Nervio , Estimulación del Nervio Vago , Humanos , Ratas , Animales , Acúfeno/inducido químicamente , Acúfeno/terapia , Salicilatos/farmacología , Estimulación del Nervio Vago/métodos , Calidad de Vida , Ratas Wistar , Nervio VagoRESUMEN
Aripiprazole is an efficacious treatment for both the positive and negative symptoms of schizophrenia and is also commonly used as a mood stabilizer. It is associated with better tolerability compared with other antipsychotics. However, there are reports of patients who experience problem gambling, hypersexuality, obsessive-compulsive symptoms, and other impulsive and/or compulsive behaviors as a result of aripiprazole administration and/or dosage increase. We aimed to do a systematic review of case reports published in this regard. After screening more than 6000 titles and abstracts in ten scientific search engines, we found 35 related records comprising 59 cases. The majority of cases (n = 42, 71.18%) were male, the mean age was 33.83 years (± 13.40), and the average daily dose of aripiprazole was 11.63 mg (± 6.94). The results of our review showed that the most frequently published impulsivity adverse effect of aripiprazole is gambling, followed by hypersexuality, obsessive-compulsive symptoms/disorder, problem eating, trichotillomania, problem shopping, and kleptomania. These symptoms were experienced both by patients who had previous problems in these areas and those who did not. In the majority of cases, the symptoms appeared within 30 days after aripiprazole administration started and ceased within 30 days of its discontinuation and/or dose decrease. Clinicians should be aware of impulsivity adverse effects, monitor them, and educate both patients and the family about them.
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Antipsicóticos , Trastornos Disruptivos, del Control de Impulso y de la Conducta , Humanos , Masculino , Femenino , Adulto , Aripiprazol/efectos adversos , Antipsicóticos/efectos adversos , Conducta Impulsiva , Conducta Compulsiva/inducido químicamente , Trastornos Disruptivos, del Control de Impulso y de la Conducta/inducido químicamenteRESUMEN
Acceptance and commitment therapy (ACT) for obsessive-compulsive disorder (OCD) has been found efficacious in randomized clinical trials (RCTs), but the two widely known RCTs were conducted within the United States with predominantly White samples. Research that evaluates treatments like ACT for OCD outside the typical Western cultures is needed. The current scoping review summarizes the key characteristics and findings from 18 RCTs that evaluated ACT for OCD in Iran. These RCTs are largely unknown in the broader scientific literature despite representing the vast majority of ACT for OCD trials, in part because the majority are published in Persian. The preponderance of RCTs treated participants in groups, and most protocols did not include exposure exercises. Of 18 trials, 5 were single sex. Use of selective serotonin reuptake inhibitors (SSRIs) was common with all participants on stable doses at pretreatment in many of the trials. Methodological quality was low to medium. ACT was inconsistent against nontraditional comparison conditions, slightly favorable to empirically validated treatments, and favorable compared with the waitlist and SSRIs. The process of change data indicated that ACT increased the psychological flexibility more than cognitive behavior therapy or SSRIs. These results highlight that findings on ACT for OCD from Western populations replicate and generalize to individuals in Iran. These findings also offer insights gained from studying ACT in Iran and significantly expand the literature based on ACT for OCD that can be integrated into scholarship by all researchers.
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Terapia de Aceptación y Compromiso , Trastorno Obsesivo Compulsivo , Trastorno Obsesivo Compulsivo/terapia , Humanos , Irán , Ensayos Clínicos Controlados Aleatorios como Asunto , Inhibidores Selectivos de la Recaptación de Serotonina/uso terapéuticoRESUMEN
Chronic stress (CS) is critically involved in the Alzheimer's disease (AD) pathogenesis resulting in cognitive disturbance. Also, amyloid precursor protein (APP) related gens, pro-inflammatory cytokines, and stress increases AD-related pathogenesis through increasing APP, all are important players in the development of AD. Herein, we explore the possible neuroprotective and anti-amnestic effect of quercetin (QUER) on cognitive deficits induced by scopolamine (SCOP) in stressed rats. Stress induction was performed by exposed of rats to 2-h chronic restraint stress for 10 days. Then rats were supplemented with QUER (25 mg/kg/day oral gavage, for 1 month). Ratswere submitted to intraperitoneal (i.p.) injection of SCOP (1 mg/kg) during the final 9 days of QUER supplementation to induce dementia like condition. Following the interventions, behavioral tests [elevated plus maze (EPM) and novel object recognition memory (NORM)] was examined to analysis the cognitive functions. Meanwhile, prefrontal cortex (PFC) and hippocampus of brain were used for gene expression and biochemical studies. Also, the plasma corticosterone (CORT) level was measured. We established that administration of QUER ameliorated the SCOP-related memory impairment. Also, QUER decreased stress related anxiety like behaviors in the EPM. QUER also altered the interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) levels in both PFC and hippocampus of SCOP treated rats in stress and non-stress conditions. We found that QUER increased APP and amyloid precursor-like protein 2 (APLP2) mRNA expression in both non-stress and stressed rats. Also, our findings imply that QUER suppress the effect of SCOP on cognitive functions. Moreover, decreased APP mRNA expression in the hippocampus were observed following pretreatment of rats with QUER in both stress and non-stress groups. Given that decreased amyloid beta (Aß) expression in the hippocampus of stressed rats, it can be proposed that elevations in APP mRNA expression by QUER activates non-amyloidogenic pathways leading to reduction in Aß levels. However, our findings indicate that QUER can be a therapeutic candidate, which exerts an anti-amnesic property against SCOP-induced memory decline. On the other hand, prior QUER administration in stress condition could be a promising approach against AD prevention.