Prevalence, Demographic Correlates, and Medical Correlates of Cognitive Impairment Among Iranian People Living With HIV: A Cross-sectional Survey Study.

ABSTRACT: While taking antiretroviral therapy, 30%-60% of people living with HIV (PLWH) experience neurocognitive impairment (NCI). To determine NCI prevalence among Iranian PLWH, by the computerized Vienna Test System, 63 adults living without HIV and 63 Iranian PLWH aged 18-50 years ( M = 35.3, SD = 7.9) were assessed for cognitive function. NCI was determined by receiver operating characteristic curve cutoff points based on the adults living without HIV. Associations between demographics, HIV serostatus markers, and mean T-scores were investigated. Performance differences were tested by including significant covariates in an analysis of covariance. NCI prevalence rates were 57.14% in PLWH and 19.05% in adults living without HIV. Global neurocognitive performance and all cognitive domains were significantly different between the groups, except for visual memory and selective attention. In Iran, NCI prevalence parallels that reported in PLWH worldwide. There should be a strategy to screen Iranian PLWH for NCI.

The Effect of Violent and Melodrama Movies on Risky Decision-making and Behavioral Inhibition in Adolescents.

Introduction: Brain functional performance is a collection of outstanding mental processing that provides a framework for achieving goals based on targeted behaviors. Disorders in executive functions make it difficult for a person to perform everyday tasks. One of the phenomena highlighted in various media is the violence that adolescents welcome with the production of violent movies. This study aimed to investigate the effect of violent movies on risky decision-making and behavioral inhibition of adolescents and compare the effects of violence with melodrama movies. Methods: This quasi-experimental study was conducted with a pretest-posttest design with a control group among 60 adolescents (30 girls and 30 boys) living in Tehran City, Iran. They were selected using the available sampling method. For this purpose, neurological tests of Iowa Gambling and go-no go were used. Results: The results showed that violent movies caused a significant increase in risky decision-making (P<0.05). In addition, these types of movies caused a significant decrease in behavioral inhibition among adolescents (P<0.05). Conclusion: Movies with ill-mannered stories and content that glorify violence harm adolescents' decision-making and deterrence, leading them to make risky decisions and weaken their inhibition power.

Further Support for the Psychometric Properties of the Farsi Version of Perth Alexithymia Questionnaire.

Alexithymia is defined as the lack of words to describe emotions and is associated with different psychopathologies. Various tools have been developed for measuring alexithymia; each has its limitations. A new questionnaire, Perth Alexithymia Questionnaire (PAQ), was developed to simultaneously assess positive and negative dimensions. Validation of such a tool in different cultures allows cross-cultural health psychology studies and facilitates knowledge transfer in the field. We aimed to examine the psychometric features of the PAQ in the Farsi-speaking population in Iran. Four-hundred-twenty-nine university students were asked to complete the PAQ, the Toronto Alexithymia Scale (TAS-20), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), and emotion regulation questionnaire (ERQ). Concurrent validity, discriminant validity, internal consistency, and test-retest reliability and factor structure were investigated. Confirmatory factor analysis showed a five-factor model identical to the original questionnaire. The questionnaire indicated good internal consistency (0.82 < α < 0.94). Test-retest reliability was acceptable for all subscales. The correlations between PAQ and its subscales with BDI-II, BAI, and TAS, and expression suppression subscale of ERQ were strong for concurrent validity. Concerning the discriminant validity, PAQ and its subscales were not correlated with reappraisal subscales of ERQ. The present findings suggest that the Farsi version of PAQ has strong psychometric properties and is appropriate for use in the Farsi-speaking population.

Attachment and joint attention in infants: The role of expectation.

Previous research highlighted the correlation between parent-infant's attachment quality and joint attention skills. However, the underlying mechanisms of this relationship are still unclear. The aim of this study was to assess whether it is by mediating the expectation component in Internal Working Models that the quality of attachment style can affect joint attention. At first, 12- to 20-month-old infants were classified into secure and insecure groups using the Strange Situation Procedure. On a following day, using a violation-of-expectation paradigm, infants were habituated to two joint attention videos. Finally, the mean looking time duration of secure and insecure infants were compared with each other between two "divergent attention" and "joint attention" videos. Infants looked longer for divergent attention videos suggesting they did have expectation regarding the appropriate response in triadic interactions. In line with our main hypothesis, secure infants, but not insecure ones, looked longer in the divergent attention situation when an attachment-related context was present, revealing the possible mediating role of "expectations" in the correlation between attachment and joint attention.

Internet-Delivered Versus Face-to-Face Cognitive Behavior Therapy for Anxiety Disorders: Systematic Review and Meta-Analysis.

BACKGROUND: Over the last 20 years, internet-delivered cognitive behavior therapy (ICBT) has been tested in a large number of randomized controlled trials, often with positive results. However, it is not widely known about the efficacy of ICBT as compared to face-to-face cognitive behavior therapy (CBT). METHODS: In the present systematic review and meta-analysis, ICBT for treatment of anxiety disorders was directly compared to face- to-face CBT within the same trial. This study aimed to reinvestigate the effect of ICBT compared to face-to-face CBT for anxiety disorders. A total of 8 studies out of the 236 articles screened met all the inclusion criteria. The included studies targeting five different anxiety disorders, social anxiety disorder, adolescent anxiety, panic disorder, spider phobia, and fear of public speaking, had been carried out in Australia, Spain, and Sweden. The total number of participants was 348 in ICBT and 316 in face-to-face conditions. RESULTS: The results of our meta-analysis are interesting both from theoretical and practical standpoints, which showed a pooled effect size posttreatment with Hedges' g = 0.01 (95% CI: -0.16 to 0.18). CONCLUSIONS: ICBT and face-to-face CBT created equivalent overall effects. in treatment of anxiety disorders. Since there have been similar systematic reviews about anxiety disorders so far, and in majority of them, ICBT has not been compared against face-to-face treatment. More research is needed to establish the general equivalence of the two treatment formats. Also, understanding what makes ICBT work is a challenge for future research.

Rotational and Collic Vestibular-Evoked Myogenic Potential Testing in Normal Developing Children and Children With Combined Attention Deficit/Hyperactivity Disorder.

OBJECTIVES: Vestibular dysfunction in childhood can have a major effect on a child's developmental process. Balance function has been reported to be poorer in children with attention deficit and hyperactivity disorder (ADHD) than in their typically developing peers. Due to contradictory available evidence and the paucity of research on vestibular function specifically in children with combined ADHD (cADHD), we designed this aged-matched study to assess vestibular function in children with cADHD. DESIGN: We enrolled 30 typically developing children (15 boys and 15 girls; mean age, 9 years 6 months; range, 7 to 12 years) and 33 children (19 boys and 14 girls; mean age, 9 years 0 months; range, 7 to 12 years) with cADHD diagnosed by our research psychiatrist. Typically developing controls were used to obtain normative data on vestibular testing and to examine the impact of age on the vestibular response parameters, and these results were compared with those of the cADHD group. All children underwent the sinusoidal harmonic acceleration subtype of the rotary chair test (0.01, 0.02, 0.08, 0.16, and 0.32 Hz) and the cervical vestibular-evoked myogenic potential (cVEMP) test. RESULTS: At all five frequencies in the sinusoidal harmonic acceleration test, there was no significant correlation between age and any of the following rotary chair response parameters in typically developing children: vestibulo-ocular reflex (VOR) gain, phase, asymmetry, and fixation index. Furthermore, there was no significant correlation between age and any of the following cVEMP parameters for the right and left ears of control group: p1 and n1 latency, amplitude, threshold, and amplitude ratio. Significantly higher VOR gains were observed for children with cADHD at frequencies of 0.01 (p = 0.001), 0.08 (p < 0.001), 0.16 (p = 0.001), and 0.32 (p = 0.003) Hz, when compared with the control group. Furthermore, fixation abilities were significantly lower in the cADHD group than in the control group at 0.16 (p < 0.001) and 0.32 (p < 0.001) Hz. cVEMP parameters showed no significant differences between the two groups. CONCLUSIONS: Our results showed higher VOR gains and poorer fixation abilities in children with cADHD compared with typically developing children. Cerebellar dysfunction in patients with ADHD has been well documented in the literature, and our findings of cVEMP and rotary chair tests for these children showed impaired vestibular function in these children, based on increased VOR gain values and decreased fixation capabilities. Because VOR gain is mediated through the inferior olive and controlled by the cerebellum, our results suggest that central inhibition of vestibular function may be deficient in children with cADHD, resulting in higher VOR gains. Also, there is general agreement that failure of fixation suppression indicates a central lesion. The lesion can originate from the parietal-occipital cortex, the pons, or the cerebellum. However, failure of fixation suppression is most prominent in lesions involving the midline cerebellum that could be counted for children with cADHD. We believe that this contribution is theoretically and practically relevant as high VOR gains and decreased suppression capabilities may result in symptoms of reading and writing difficulties, learning disabilities, vertigo, and motion sickness in these children. Therefore, assessment of vestibular function in children with cADHD at a young age must be considered when developing rehabilitation protocols for these children.

Preliminary evidence of improved cognitive performance following vestibular rehabilitation in children with combined ADHD (cADHD) and concurrent vestibular impairment.

OBJECTIVE: Balance function has been reported to be worse in ADHD children than in their normal peers. The present study hypothesized that an improvement in balance could result in better cognitive performance in children with ADHD and concurrent vestibular impairment. This study was designed to evaluate the effects of comprehensive vestibular rehabilitation therapy on the cognitive performance of children with combined ADHD and concurrent vestibular impairment. METHODS: Subject were 54 children with combined ADHD. Those with severe vestibular impairment (n=33) were randomly assigned to two groups that were matched for age. A rehabilitation program comprising overall balance and gate, postural stability, and eye movement exercises was assigned to the intervention group. Subjects in the control group received no intervention for the same time period. Intervention was administered twice weekly for 12 weeks. Choice reaction time (CRT) and spatial working memory (SWM) subtypes of the Cambridge Neuropsychological Test Automated Battery (CANTAB) were completed pre- and post-intervention to determine the effects of vestibular rehabilitation on the cognitive performance of the subjects with ADHD and concurrent vestibular impairment. ANCOVA was used to compare the test results of the intervention and control group post-test. RESULTS: The percentage of correct trial scores for the CRT achieved by the intervention group post-test increased significantly compared to those of the control group (p=0.029). The CRT mean latency scores were significantly prolonged in the intervention group following intervention (p=0.007) compared to the control group. No significant change was found in spatial functioning of the subjects with ADHD following 12 weeks of intervention (p>0.05). CONCLUSION: The study highlights the effect of vestibular rehabilitation on the cognitive performance of children with combined ADHD and concurrent vestibular disorder. The findings indicate that attention can be affected by early vestibular rehabilitation, which is a basic program for improving memory function in such children. Appropriate vestibular rehabilitation programs based on the type of vestibular impairment of children can improve their cognitive ability to some extent in children with ADHD and concurrent vestibular impairment (p>0.05).

Oculomotor rehabilitation in children with dyslexia.

Background: Dyslexia is the most common learning disorder. Visual and oculomotor deficits in dyslexic children have been reported. The purpose of this study was to measure oculomotor parameters and analyze the effect of oculomotor rehabilitation strategies on dyslexia. Methods: Binocular eye movements were recorded by oculomotor subtype of videonystagmography (VNG) testing on 30 children with dyslexia and 20 typical reader children (aged 8-12) in both genders. Dyslexic children were diagnosed with DSM-V scale by experts in reading disorder centers. We studied those children with developmental dyslexia, who had deficits in eye movements recording. Dyslexic children were divided into 2 groups of case and control. Oculomotor rehabilitation (including fixation, saccade, and tracking training) was performed in case group for 1 hour, twice weekly for 8 weeks. Before the intervention, results of oculomotor tests were compared between 3 groups (healthy, case, and control). Then, to analyze the effect of the intervention, results of oculomotor tests were compared between case and control groups in pre- and post- intervention stage. Data were analyzed by independent and paired samples t tests, ANOVA, and repeated measures tests in SPSS v. 21. Results: There were significant differences in oculomotor characteristics of dyslexic children in comparison with those reported in typical children. Oculomotor rehabilitation intervention had a positive effect on improvement of oculomotor responses and eye movements in dyslexic children. Moreover, there was no statistically significant difference between dyslexic children and non-dyslexic children in oculomotor skills after the training. Conclusion: Our results showed the positive effects of oculomotor rehabilitation on eye movements. Primary oculomotor assessment in dyslexic children and early use of oculomotor rehabilitation combined with other treatments are highly recommended.

Association of blood antioxidants status with visual and auditory sustained attention.

OBJECTIVE: A low antioxidants status has been shown to result in oxidative stress and cognitive impairment. Because antioxidants can protect the nervous system, it is expected that a better blood antioxidant status might be related to sustained attention. However, the relationship between the blood antioxidant status and visual and auditory sustained attention has not been investigated. The aim of this study was to evaluate the association of fruits and vegetables intake and the blood antioxidant status with visual and auditory sustained attention in women. METHOD: This cross-sectional study was performed on 400 healthy women (20-50 years) who attended the sports clubs of Tehran Municipality. Sustained attention was evaluated based on the Integrated Visual and Auditory Continuous Performance Test using the Integrated Visual and Auditory (IVA) software. The 24-hour food recall questionnaire was used for estimating fruits and vegetables intake. Serum total antioxidant capacity (TAC), and erythrocyte superoxide dismutase (SOD) and glutathione peroxidase (GPx) activities were measured in 90 participants. RESULTS: After adjusting for energy intake, age, body mass index (BMI), years of education and physical activity, higher reported fruits, and vegetables intake was associated with better visual and auditory sustained attention (P < 0.001). A high intake of some subgroups of fruits and vegetables (i.e. berries, cruciferous vegetables, green leafy vegetables, and other vegetables) was also associated with better sustained attention (P < 0.02). Serum TAC, and erythrocyte SOD and GPx activities increased with the increase in the tertiles of visual and auditory sustained attention after adjusting for age, years of education, physical activity, energy, BMI, and caffeine intake (P < 0.05). DISCUSSION: Improved visual and auditory sustained attention is associated with a better blood antioxidant status. Therefore, improvement of the antioxidant status through an appropriate dietary intake can possibly enhance sustained attention.