Associations between Adverse Childhood Experiences and Gambling Severity in Youth Online Gamblers: The Mediating Roles of Internalizing, Attention and Externalizing Problems.

BACKGROUND: This study examined the association between Adverse Childhood Experiences (ACEs) and Gambling Severity (gambling severity), considering the mediating roles of internalizing, externalizing, and attention among youth online gamblers. METHODS: 762 youth (agemean±SD= 15.03 ± 2.40; agerange = 10-18 years; 75.3% boys) completed the Persian Gambling Disorder Screening Questionnaire (GDSQ-P), Pediatric Symptom Checklist - Youth Report (Y-PSC), and Behavioral Risk Factor Surveillance System Questionnaire (ACE's section, modified by authors). The analysis was done using the SMART PLS software. RESULTS: The reliability and discriminant validity of the provided model were assessed using Partial Least Squares-Structural Equation Modeling (PLS-SEM). According to the results of the PLS-SEM analysis, the present model demonstrated suitable levels of reliability and validity. Adverse Childhood Experiences (ACEs) significantly affected attention, internalizing, externalizing problems, and gambling severity. Additionally, the level of gambling was directly correlated with ACEs. Moreover, the indirect influence of the independent variable on the dependent variable via the mediators was found to be statistically significant (P < .001).These findings suggest that externalizing behaviors, attention problems, and internalizing symptoms mediate the effect of ACEs on gambling severity. Lastly, fitness indices indicated that our proposed model fit the data well (SRMR = 0.06, d_ULS = 1.15, Chi-square = 1291.461, and NFI = 0.71). CONCLUSION: Our study found that ACEs significantly influence gambling severity among youth online gamblers, with internalizing, externalizing, and attention problems mediating this relationship. Practical implications include integrating ACE screening and targeted interventions for associated mental health issues into youth gambling prevention programs to mitigate the risk of problematic gambling behavior.

Prediction of Suicidal Thoughts and Suicide Attempts in People Who Gamble Based on Biological-Psychological-Social Variables: A Machine Learning Study.

Recent research has shown that people who gamble are more likely to have suicidal thoughts and attempts compared to the general population. Despite the advancements made, no study to date has predicted suicide risk factors in people who gamble using machine learning algorithms. Therefore, current study aimed to identify the most critical predictors of suicidal ideation and suicidal attempts among people who gamble using a machine learning approach. An online survey conducted a cross-sectional analysis of 741 people who gamble (mean age: 25.9 ± 5.56). To predict the risk of suicide attempts and ideation, we employed a comprehensive set of 40 biological, psychological, social, and socio-demographic variables. The predictive models were developed using Logistic Regression, Random Forest (RF), robust eXtreme Gradient Boosting (XGBoost), and ensemble machine learning algorithms. Data analysis was performed using R-Studio software. Random Forest emerged as the top-performing algorithm for predicting suicidal ideation, with an impressive AUC of 0.934, sensitivity of 0.7514, specificity of 0.9885, PPV of 0.9473, and NPV of 0.9347. Across all models, dissociation, depression, and anxiety symptoms consistently emerged as crucial predictors of suicidal ideation. However, for suicide attempt prediction, all models exhibited weaker performance. XGBoost showed the best performance in this regard, with an AUC of 0.663, sensitivity of 0.78, specificity of 0.8990, PPV of 0.34, NPV of 0.984, and accuracy of 0.8918. Depressive symptoms and rumination severity were highlighted as the most important predictors of suicide attempts according to this model. These findings have important implications for clinical practice and public health interventions. Machine learning could help detect individuals prone to suicidal ideation and suicide attempts among people who gamble, assisting in creating tailored prevention programs to address future suicide risks more effectively.

The Psychological Flexibility in Epilepsy Questionnaire (PFEQ): Psychometric properties of the Persian version.

The present study aimed to evaluate the psychometric properties of a Persian version of the Psychological Flexibility Epilepsy Questionnaire (P-PFEQ). Transcultural adaptation and validation of the Persian version of the PFEQ were performed using translation and back-translation with pilot testing (on 17 patients) and expert evaluation. Participants in the current study involved 100 patients with an EEG-verified epilepsy diagnosis and an average age of 30.96 years (SD ±â€¯6.46) (63% were female). Data collection included a sociodemographic questionnaire, epilepsy-specific questionnaire, the Depression-Anxiety-stress scale (DASS-21), the Insomnia Severity Index (ISI), the 31-item Quality-of-Life questionnaire in Epilepsy (QOLIE-31), the Acceptance and Action Questionnaire (AAQ), the Committed Action Questionnaire (CAQ), and the short form of the Freiburg Mindfulness Inventory (FMI). Descriptive and inferential analyses were conducted by SPSS software V.26. The P-PFEQ demonstrated semantic, conceptual, and content validity in equivalence with the Swedish version. Based on Exploratory Factor Analysis (EFA), five items were eliminated and unidimensional scale of PFEQ with 12 items, explaining 50.38% of the total variance, was accepted. The scale showed good reliability through internal consistency (Cronbach's α of 0.9) and temporal stability on retest (n = 85, Intraclass correlation = 0.92). Convergent and divergent validity findings were acceptable for the P-PFEQ. The findings show that the P-PFEQ is a reliable and valid scale for assessing psychological flexibility in the Iranian patients with epilepsy. Also, it can be confidently recommended as a useful instrument in clinical practice.

Online Gambling in Iranian Social Media Users: Prevalence, Related Variables and Psychiatric Correlations.

The exponential increase in Internet use has been associated with dangers and harms. Recently, the prevalence of online gambling is increasing in various countries. Online gambling can be a prelude to gambling disorder. No study has been conducted in this field in Iran yet. The aim of this study was to investigate the prevalence of online gambling (without disorder and pathological), and its relationship with demographic variables and psychiatric symptoms. 3252 people participated in this study online. Research tools included gambling disorder screening questionnaire-Persian (GDSQ-P), brief symptom inventory (BSI), Young's addiction questionnaire, and Demographic questionnaire. The prevalence of online gambling was 8.9%. 26.6% of online gamblers experience moderate to severe degrees of pathological gambling. 74.7% of online gamblers were male. Online gamblers have a lower mean age than non-online gamblers (p < 0.001). Online gamblers were equally from all economic classes. The most common methods of gambling were CRASH game and sports betting. Online gamblers had no significant difference in the rate of face-to-face (physical) gambling history, compared to non-online gamblers (6.9% vs 5.6%), (p > 0.05). In BSI-assessed psychiatric symptoms, online gamblers showed higher scores on anxiety and obsession, and lower scores on paranoid ideation, compared to the control group (p < 0.05). Also, Internet addiction and daily use of the Internet as entertainment were significantly higher in online gamblers than non-online gamblers (p < 0.05). Also, a positive and significant correlation was found between the severity of gambling and the severity of Internet addiction, severity of depression, severity of anxiety, and severity of obsession in online gamblers (p < 0.05). Overall, online gambling is common in Iran and is associated with psychiatric problems. Health professionals and the government should pay special attention to online gambling and its related problems.

Predicting the quality of life based on pain dimensions and psychiatric symptoms in patients with Painful diabetic neuropathy: a cross-sectional prevalence study in Iranian patients.

BACKGROUND: This study aimed to predict the quality of life (QOL) in patients with Painful Diabetic Neuropathy (PDN) based on pain severity, pain catastrophizing, pain acceptance, depression, anxiety, and sleep disturbance. Also, this study was aimed to assess the prevalence of psychiatric symptoms in Iranian patients with PDN. METHOD: 1120 patients (mean age, 53.6 ± 12.6 years) participated in the research. Data were collected by the Quality of life questionnaire (NeuroQoL); Beck Depression Inventory, Beck Anxiety Inventory, the visual analog scale for pain severity, Pain Catastrophizing Scale (PCS), Chronic Pain Acceptance Questionnaire (CPAQ) and Pittsburgh Sleep Quality Index (PSQI). Finally, the data were analyzed using SPSS-26 by multiple regression analysis. RESULTS: The results showed the regression models' significance, and the dependent variables predicted 42% of total changes in the QOL. The most significant predicting factors were depression, pain catastrophizing, pain acceptance, pain severity, sleep disturbance, and anxiety in order. In patients with PDN, the prevalence of sleep disturbances, depression, and anxiety were 85.5%, 68.2%, and 62.1%, respectively. Also, comorbid depression and anxiety were found in 47% of patients. CONCLUSION: Results demonstrated a significant relationship between pain-related and psychiatric dimensions with QOL. Thus, it is suggested to design more specific psychological-based rehabilitation interventions in which these variables are considered. They should focus on more significant variables (such as depression and pain catastrophizing) to reach better treatment outcomes. Furthermore, this research shows a high level of anxiety, depression, and sleep disturbance in Iranian patients with PDN. Thus, experts and clinicians are suggested to focus on reducing these psychiatric symptoms.

Comparison of the effects of transcranial direct current stimulation and mindfulness-based stress reduction on mental fatigue, quality of life and aggression in mild traumatic brain injury patients: a randomized clinical trial.

BACKGROUND: The rate of traumatic brain injuries (TBIs) due to the accidents is high around the world. Patients with mild TBIs may suffer from some psychological disorders, including aggression, and mental fatigue, and thus their quality of life decreased. Among different treatments for TBI, two treatments, namely transcranial direct current stimulation (tDCS), and mindfulness-based stress reduction (MBSR) have shown to be effective. Therefore, this study aimed to compare the effects of these two treatments on mental fatigue, aggression and quality of life in mTBI patients. MATERIALS AND METHODS: This randomized controlled trial study was conducted on 48 TBI patients referred to emergency and neurosurgery departments of Shahid Beheshti Hospital, Kashan, Iran. They were selected using the convenience sampling method. Data were collected using the mental fatigue scale, the World Health Organization Quality of Life-BREF (short version), and the Buss-Perry Aggression Questionnaires. Then, the data were analyzed using a Mixed Repeated Measures ANOVAs, and the Levene and Kolmogorov-Smirnov tests by SPSS-23 software. RESULTS: The mean age of patients in the three groups of MBSR, tDCS and control were 69.38 + 6.11 (25% male), 25.40 + 12.11 (25% male) and 69.37 + 0.2 (18.8% male), respectively. There was no significant difference between the three groups in terms of mental fatigue, quality of life and aggression (P < 0.05). In addition, the results showed that there was a significant difference between the main effect of time and the interaction between time and group (P < 0.001). CONCLUSIONS: Both MBSR and tDCS methods are effective in reducing the mental fatigue and aggression and increasing quality of life of mTBI patients; MBSR treatment, as indicated in the present study, can be more effective than tDCS in patients with mTBI. TRIAL REGISTRATION: Thailand Registry of Clinical Trials, TCTR20180827003 Registered on August 24, 2018.

Evaluation of the psychometric indicators of the Comprehensive Autistic Trait Inventory in Iranian adults.

BACKGROUND: The DSM-5's Comprehensive Autism Traits Inventory (CATI) was a useful diagnostic tool for the general population because it covered all the critical aspects of autism. However, its reliability and validity in the overall Iranian population still need to be investigated. PURPOSE: We reviewed the inventory and estimated the validity and reliability of the Iranian version of CATI among 1800 adults. METHODS: The Persian version of CATI (CATI-I) was administered to 1800 Iranian adults using the online Star Questionnaire system. Internal consistency, convergent validity, discriminant validity, test-retest reliability, and measurement invariance across genders were calculated. RESULTS: The Correlated social & non-social bifactor model showed the best fit in the Iranian community (CFI=.966; TLI=.947; RMSEA=.045; SRMR=.028). Ultimately, the CATI-I scale in the Iranian community consisted of 39 items across six factors and two higher-order constructs. Additionally, the CATI-I scale's convergent validity and reliability values were acceptable. CONCLUSION: The CATI-I demonstrates satisfactory reliability and validity in measuring autism traits. It is an appropriate model for the second-order social and non-social factors, and it also shows measurement invariance across genders.

A Network Analysis Study to Evaluate Obsessive-Compulsive Beliefs/Dimensions and Personality Beliefs in Patients with Obsessive-Compulsive Disorder (OCD): A Cross-Sectional Study in Two Common OCD Subtypes.

Objective: Obsessive-Compulsive Disorder (OCD) has been considered a heterogeneous psychiatric disorder. Identifying this heterogeneity can lead to better diagnosis and treatment. The two most common OCD subtypes include contamination/cleaning and danger/checking. This study aimed to identify the network structure of OCD symptoms, personality, and obsessive beliefs in these OCD subtypes. Method : 333 patients with OCD were included in the study (156 patients with the danger/check subtype and 177 patients with the contamination/cleaning subtype). In addition, 276 healthy individuals participated in this study. We used a network analysis approach to determine the OCD central symptoms [nodes]. The Personality Beliefs Questionnaire-Short Form [PBQ-SF], Obsessive-Compulsive Inventory-Revised [OCI-R], and Obsessional Beliefs Questionnaire-44 [OBQ-44] were used for network estimation. Results: The results indicated that the network structure in healthy individuals was different from the network structure in patients with obsessive-compulsive disorder [PwOCD]. In healthy individuals, "obsessive" personality belief and "danger" obsessive belief were the most strength nodes and formed the core of the central communication between symptoms in these subjects. Regarding the contamination/cleaning subtype, the most central symptoms include "washing" obsessive symptom, "danger" obsessive belief, and "wash" obsessive symptom. However, "perfect" obsessive beliefs, "check" obsessive symptoms, and "avoidant" personality beliefs were the most central symptoms in the danger/check subtype. These results demonstrated that each of the studied groups had a unique network structure, which is consistent with the heterogeneous nature of OCD. Conclusion: Different OCD subtypes have different cognitive-behavioral network structures. According to the results of this study, these symptoms should be given priority in OCD theoretical models and treatment strategies.

Estimate the prevalence of daily caffeine consumption, caffeine use disorder, caffeine withdrawal and perceived harm in Iran: a cross-sectional study.

One of the informal diagnoses in DSM-5 is Caffeine Use Disorder (CUD). CUD and high levels of caffeine consumption could impact mental health conditions. This study aimed to estimate the prevalence of CUD, caffeine consumption, caffeine-related harms, and related psychiatric symptoms in Iran. A cross-sectional survey with a convenience sample of 1228 adults were conducted in Iran. Caffeine consumption was assessed across 20 products in Iran. Caffeine Use Disorder Questionnaire (CUDQ), Caffeine Withdrawal Symptoms Questionnaire (CWSQ), 14-item Caffeine-related Harm Screening (CHS), and Symptom Checklist-25 (SCL-25) were used in the present study. We used SPSS (desktop version 26.0) to analyze the data using descriptive statistics, chi-square, and the least significant difference (LSD) post hoc test. The daily average caffeine consumption was 146.67 mg. The prevalence of CUD and caffeine withdrawal (C.W.) were estimated at 19.5% and 46.62%, respectively. Also, 12.9% of responders received CUD and C.W.s simultaneously. The prevalence of CUD was higher in men than females (25.08% vs. 13.93%). 95% of participants (n = 1166) reported using at least one caffeine product yesterday. Moreover, the most reported caffeine-related harms were the desire for sugar (42.9%), insomnia (39.3%), and caffeine dependence (38.3%). Age significantly correlates with CUD (- 0.07) and daily caffeine intake (0.08). Moreover, all SCL-90 subscales had a significant correlation with daily caffeine intake. Finally, responders at younger ages reported higher levels of CUD and caffeine consumption than older adults(P < 0.05). High rates of C.W. and CUD in the Iranian population suggest that it is necessary to develop evidence-based treatments.

A Study of the Psychometric Properties of the Persian Version of the Online Gambling Symptom Assessment Scale in the Iranian Population.

Background: The primary objective of the current paper was to assess the psychometric attributes of the Persian version of the Online Gambling Symptom Assessment Scale (P-OGSAS) within the Iranian population. Methods: The current study was conducted through a convenient sampling method between September and November 2021, involving 187 participants who had experienced online gambling at least once a month for the last 3 months. OGSAS was translated from English into Persian using the forward-backward translation method. Cronbach's alpha coefficient and principal component analysis (PCA) were employed to evaluate the reliability and validity of the scale, respectively. Participants were administered a battery of assessments, including P-OGSAS, Persian Gambling Disorder Screening Questionnaire (GDSQ-P), Patient Health Questionnaire-9 Items (PHQ-9), and Generalized Anxiety Disorder Questionnaire (GADQ-7), to assess validity and reliability. Findings: The results showed that the 3-factor model of this scale provides the highest level of predictability. The 3-factor model accounts for 54.8% of the square load. With a Cronbach's alpha coefficient of 0.807, P-OGSAS demonstrated satisfactory reliability. Finally, OGSAS has a significant correlation with other scales, and as a result, this scale has suitable convergent validity. Conclusion: P-OGSAS can adequately assess the symptoms and severity of online gambling. Therefore, clinicians could use this scale to evaluate the problems related to online gambling in the Iranian population.

The Mediating Roles of Self-compassion and Emotion Regulation in the Relationship among Alexithymia, Gambling Frequency, Risky Decision-Making, and Gambling Severity in Online Gamblers.

Background: The research literature about the relationship between alexithymia, risky decision-making, and gambling severity has been contradictory and limited. Besides, there is no study on the mediating roles of self-compassion and emotion regulation in online gambling. Moreover, the role of these mediators in gambling frequency has not been studied. Thus, the present study aimed to investigate the relationship between alexithymia, risky decision-making, and gambling frequency by considering the mediating role of self-compassion and emotion regulation in online gamblers. Methods: A total of 319 Iranians who gambled online at least once a week in the past three months were investigated using an online survey including Farsi Toronto Alexithymia Scale-20 (FTAS-20), Difficulties in Emotion Regulation Scale (DERS), and Gambling Disorder Screening Questionnaire-Persian (GDSQ-P). Statistical analyses were conducted by SPSS 26.0 for Windows. The relationships between the variables were analyzed using correlation analysis. In cases where significant relationships were observed, the hypotheses of the regression model were tested. Findings: The mean age of the participants was 24.6±6.06 and 253 participants (73.9%) were male. Furthermore, no significant differences were observed between men and women in terms of risky decision-making (P=0.051), gambling severity (P=0.59), and age (P=0.293). Conclusion: Alexithymia had both a direct and indirect relationship with gambling severity through the mediating roles of emotion regulation and self-compassion. Moreover, alexithymia was significantly associated with risky decision-making and gambling frequency, through the mediating role of difficulties in emotion regulation, both directly and indirectly.

Exploring the structure of the university-students obsessive-compulsive tendency scale in Iranian university students: a network analysis study.

INTRODUCTION: A risk factor for developing obsessive-compulsive disorder (OCD) in non-clinical samples is obsessive-compulsive tendencies (OCT). An OCT scale has recently been developed for university students (UOC) and showed promising psychometric properties. However, no validated Persian language scale evaluates OCT in non-clinical samples. Accordingly, this study aimed to validate the Persian version of the UOC in Iranian university students. METHODS: Three hundred sixty-eight university students (54.6% females, mean ages: 22.4 ± 4.51) entered the study. The Persian version of UOC was evaluated concerning the structure of Exploratory Factor Analysis (EFA), Confirmatory factor analysis (CFA), and Exploratory graph analysis (EGA). Regarding the construct validity, the concurrent validity was assessed between the UOC and The Obsessive-Compulsive Inventory-Revised (OCI-R), Kessler Psychological Distress Scale (K10), and Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). We calculated Cronbach's alpha to evaluate the reliability of the UOC. All statistical calculations were done in R programming language (in R-Studio Desktop version 4.2.1). RESULTS: The Persian version of UOC showed a convenient internal consistency with Cronbach's alpha coefficient for the total scale 0.88. UOC scores were significantly correlated with OCI-R, K-10, and YBOCS. The EFA and EGA showed four and three-factor solutions with 25 and 28 items, respectively. Also, CFA showed that these two solutions were reliable, and the three-factors solution showed higher fit indexes. Finally, the results showed that item-27 was the most central item in the UOC network structure. CONCLUSION: The findings from the present study indicated that the Persian version of UOC has acceptable psychometric properties. So, this scale can be used for examining obsessive-compulsive tendencies in Iranian university students.

Current Status and Future Trends of Acceptance and Commitment Therapy (ACT) for Smoking Cessation: A Narrative Review with Specific Attention to Technology-Based Interventions.

Background: During recent decades, it has become evident that cigarette smoking has led to an increase in cancer, risk of death, and economic problems or sanitation issues worldwide. Acceptance and commitment therapy (ACT), as a third-wave behavioral therapy, has devoted significant attention to smoking cessation. However, this treatment has been utilized in different formats and protocols. Moreover, addressing its challenges and progress needs examination and integration. Accordingly, the primary aim of this study was to present a narrative review for summarizing and integrating the current data on the effectiveness of ACT on smoking cessation. This study also aimed to investigate the challenges and the future of this field. Methods: The publications from January 1, 2010 to October 9, 2021 were identified by searching MEDLINE, Embase, Scopus, PsycINFO, and Web of Science electronic databases. The search was performed with the following keywords: "Acceptance AND Commitment Therapy" OR "Acceptance" AND "smoking" OR "tobacco" OR "cigarette" OR "smoker" OR "Nicotine". The inclusion criterion was studies with interventions aimed at reducing smoking cessation in smokers. Findings: A total of 17 articles were analyzed in this study. The results showed that this treatment has significant effectiveness in smoking cessation and psychiatric comorbidities. Moreover, the role of experiential avoidance in smoking cessation was discussed in detail. Conclusion: ACT is a suitable psychotherapy module for smoking cessation. However, it needs some upgrades regarding technology. To this end, smartphone applications and AVATAR therapy technologies were discussed with their advantages and solvable disadvantages.

The story of memory and executive functions in obsessive-compulsive disorder: a case-control study.

OBJECTIVE: Neuropsychological findings in obsessive-compulsive disorder (OCD) are mainly clustered around the role of memory and executive functions. However, outcomes vary across different OCD populations. In addition, the extent to which each of these factors can distinguish patients with OCD (PwOCD) from healthy individuals remains uncertain and attracts great attention. The present study aims to investigate the above issues. METHOD: This was a cross-sectional study of 182 individuals (90 PwOCD and 92 matched healthy controls). After screening for inclusion and exclusion criteria, the participants were administered neuropsychological tests including, the Wechsler Memory Scale-III (WMS-III), the Wisconsin Card Sorting Test (WCST), and the Stroop Color-Word Test (SCWT). Data were analyzed to test the study hypotheses using comparison of means and regression analysis methods. RESULTS: The results showed that PwOCD had poorer performance than the control group in Immediate Memory, General Memory, and Working Memory and also according to response inhibition indexes. The results also showed that General Memory and Reaction Time2 from the SCWT index could be predictive variables for discriminating between PwOCD and controls. CONCLUSION: The findings of this study support the prior assumptions that PwOCD would have impaired memory dimensions and response inhibition, but did not support worse set-shifting performance. We also present an initial model for the predictive role of these neuropsychological variables in discriminating OCD from healthy individuals and increasing diagnostic accuracy.

A pilot randomized controlled trial of dialectical behavior therapy (DBT) for reducing craving and achieving cessation in patients with marijuana use disorder: feasibility, acceptability, and appropriateness.

OBJECTIVE: To conduct a pilot RCT investigating the feasibility, acceptability, and preliminary efficacy of dialectical behavioral therapy (DBT) for marijuana cessation and craving reduction. METHODS: Sixty-one patients with marijuana use disorder diagnoses were randomly assigned to a DBT group or a control group (psycho-education). Patients completed measures at pre-intervention, post-intervention, and at two-month follow-up. The Marijuana Craving Questionnaire (MCQ) and marijuana urine test kits were used to assess craving and abstinence respectively. RESULTS: The feasibility of DBT was significantly higher than control group feasibility. In the DBT 29/30 participants completed all sessions (96% retention) and 24/31 control group participants completed all sessions (77% retention) (χ2 = 4.95, p = 0.02). Moreover, 29/30 (96%) participants in the DBT group completed the two-month follow-up and 20/31 (64.5%) control group members completed the two-month follow-up (χ2 = 9.97, p = 0.002). The results showed that patients in the DBT group had significantly higher intervention acceptability rates (16.57 vs. 9.6) than those in the control group. This pattern was repeated for appropriateness rates (p < 0.05). The overall results for craving showed that there was no significant difference between the groups (F = 3.52, p > 0.05), although DBT showed a significant reduction in the "emotionality" subscale compared to the control group (F = 19.94, p < 0.05). To analyze cessation rates, DBT was compared to the control group at the posttest (46% vs. 16%) and follow-up (40% vs. 9.5%) and the results confirmed higher effectiveness in the DBT group for cessation (p < 0.05). Furthermore, among those who had lapsed, participants in the DBT group had fewer consumption days than those in the control group (p < 0.05). CONCLUSIONS: DBT showed feasibility, acceptability, and promising efficacy in terms of the marijuana cessation rate. CLINICAL TRIAL REGISTRATION: Thailand Registry of Clinical Trials, TCTR20200319007.

The synergistic effect of vitamin D supplement and mindfulness training on pain severity, pain-related disability and neuropathy-specific quality of life dimensions in painful diabetic neuropathy: a randomized clinical trial with placebo-controlled.

PURPOSE: This study aimed to examine the synergistic effect of Vitamin D (VD) Supplement and mindfulness on neuropathic pain severity, Pain-Related Disability and Neuropathy-Specific Quality of Life (QOL) dimensions in painful diabetic neuropathy. METHODS: In this randomized controlled trial, 225 patients with painful diabetic neuropathy were randomly allocated to five groups: (1) mindfulness and placebo, (2) placebo, (3) mindfulness, (4) VD, and (5) mindfulness and VD. Mindfulness training includes twelve sessions, and VD patients received a daily four thousand IU oral dosage (four capsules) with 28,000 IU vitamin D weekly for 12 weeks. Laboratory analyses, Sun exposure time, Vitamin D intake, BMI and physical activity were measured in pre-test and post-test. Pain-Related Disability measured with The Pain Disability Index (PDI). For other outcome variables, Neuropathy, a Specific QOL questionnaire and Neuropathic pain severity scale were utilized. Data were analyzed using one-way repeated-measures analysis of variance (ANOVA), Scheffe Post-hoc test and paired sample t-test. RESULTS: In baseline, measures were not different among the groups. At the end-of-treatment, results showed improvement in all groups except the "placebo only" group for outcome variables. There was no difference between VD and mindfulness groups (within and not combined with placebo) in posttest. However, "VD + mindfulness" has a greater improvement rather than VD and mindfulness groups (P < 0.05). Moreover, both protocols have no significant effects on FBS, BMI and energy intakes (P > 0.05). CONCLUSION: Combining VD and mindfulness can reduce pain severity and pain-related disability, so with these changes, patients experience improve in their quality of life.

Psychometric properties of the Persian versions of acceptance and action diabetes questionnaire (AADQ) and the diabetes acceptance and action scale (DAAS), in Iranian youth with type 1 diabetes.

BACKGROUND: Psychological flexibility has considerable effects on medical and psychosocial outcomes in youth with type 1 diabetes mellitus (T1DM). This study aimed to evaluate the psychometric properties of the Persian versions of the Acceptance and Action Diabetes Questionnaire (AADQ) and the Diabetes Acceptance and Action Scale for children and adolescents (DAAS), the measures of diabetes-specific psychological flexibility. METHODS: 196 youth with T1DM completed the DAAS, AADQ (youth-report), Child and Adolescent Mindfulness Measure (CAMM), Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA), and the Avoidance and Fusion Questionnaire for Youths (AFQ-Y8). Also, their parents completed AADQ (parent-report). Data analyzed by SPSS V.26 and LISREL 8.8. RESULTS: The mean and standard deviation of participants' age was 14.7 ± 2.08.The internal consistency due to Cronbach's alpha method was 0.87, 0.8, 0.84, and 0.83 for DAAS total scores, avoidance, values impairment, and fusion, respectively. The internal consistency of AADQ (both parent-report and youth report) was above 0.8. Test-retest reliability (from 45 participants) with a one-week interval was assessed by the interclass correlation coefficient (ICC). The DAAS, AADQ-parent report, and AADQ-youth report's reliability coefficients were 0.93, 0.82, and 0.92, respectively. The AADQ (both forms) and DAAS evidence good content validity based on correlations with other measures. Confirmatory factor analysis (CFA) and Exploratory Factor Analysis (EFA) showed DAAS has the three-factor model, which strongly a suitable model is fitting. EFA also verified the AADQ model fitting. CONCLUSIONS: In general, these results support the psychometric properties of the Persian versions of DAAS and AADQ among the Iranian youth patients with T1DM. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40200-021-00796-1.

Clarification the optimal cut-off values for Persian-language versions of depression screening tools in Iranian patients with type 2 diabetes.

INTRODUCTION: Depression is the most common psychiatric disorder in patients with type 2 diabetes. There are many questionnaires to measure depression symptoms. These tools are generally used with the same cut-off points in different medical diseases. The present study investigates the optimal cut-off points of these tools in patients with type 2 diabetes in the Iranian diabetic population. The original version of this tool is prepared in Persian. METHOD: Two-hundred and forty four patients with a diagnosis of diabetes were selected to participate in the study. The gold standard for diagnosing depression was the Structured Mini-International Neuropsychiatric Interview. We applied the cut-off points of the Persian versions of the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI), Depression in Diabetes Self-Rating Scale (DDS-RS), Problematic Areas in Diabetes Survey (PAID), Hamilton Depression Rating Scale (HDRS) and Depression in Diabetes Self-Rating Scale (DDS-RS). RESULTS: 23.8% of patients were diagnosed with depression. Depressed patients had higher levels of HbA1c and physical complaints than non-depressed patients. In all tools, the sum of Sensitivity and Specificity of our proposed cut-off points was better than the conventional cut-off points. In HADS, the results showed that this questionnaire performed better and more efficiently than other tools. CONCLUSION: In patients with type 2 diabetes, it is better to use the proposed cut-off point's specific to this disorder in the Iranian population. These cut-off points have a higher ability to identify depressed and non-depressed cases.

Effectiveness of acceptance and commitment therapy (ACT) on depression and sleep quality in painful diabetic neuropathy: a randomized clinical trial.

BACKGROUND: Neuropathic pain is a complicated phenomenon in patients with diabetes. These patients have many problems, especially depression and Sleep disturbance. This study aimed to assess the effectiveness of Acceptance and Commitment Therapy on depression and Sleep disturbance in patients with painful diabetic neuropathy. METHODS: The current paper was conducted according to the clinical trial method with 50 participants. Participants were separated into intervention and control groups randomly. Based on the diagnosis of neurologists, all participants received standard medications to regulate neuropathic pain. The intervention group received ACT for eight sessions. The results were evaluated in the pre-test, post-test, and follow-up. The tools used were the Pittsburgh sleep quality index (PSQI) and Beck's depression inventory. Statistical analysis includes descriptive statistics, and repeated-measures (ANOVA) conducted by SPSS (version 26) software. Results: Results showed that in the intervention group, the treatment led to improved depressive symptoms (F = 6.81, P < 0.05). Besides, for sleep quality, treatment in all subscales, except for the Hypnotic medicine subscale, significantly improved the intervention group's situations. It was also observed that the overall quality of sleep in the ACT group showed a more significant improvement (P < 0.05). All the above results remained the same until the end of the follow-up period (P < 0.05). CONCLUSION: ACT, as a complementary treatment, can improve the psychiatric symptoms and problems in people with neuropathic pain. Therefore, it is necessary to include psychotherapy services along with medical treatment in outpatient and hospitalization units. TRIAL REGISTRATION NUMBER: IRCT201802050388630N4. Registered in 02/05/2018.