Objective: Psychological and behavioral factors play a critical role in diabetes management. This study investigates the structural relationships among the informational-motivational-behavioral skills (IMB) and acceptance and commitment processes with self-management, treatment adherence, and Glycated hemoglobin (HbA1c) levels in diabetic patients, with distress as a mediator. Method: A cross-sectional study was conducted with 321 patients with type 2 diabetes patients referred to health centers in Jiroft, Iran. Data were collected using the Diabetes Self-Management Questionnaire-Revised (DSMQ-R), the IMB-based Diabetic Self-Management Scale (IMB-DSMS), the Diabetes Distress Scale (DDS-17), the Diabetes Acceptance and Action Scale-Revised (DAAS-R), and the Diabetes Mellitus Treatment Adherence Scale (DMTAS). Structural equation modeling (SEM) was employed using LISREL-8.8 for analysis. Results: Acceptance and commitment were positively associated with IMB skills (β = 0.34, P < 0.001), self-management (β = 0.51, P < 0.001), and treatment adherence (t = 8.19, β = 0.55), while negatively associated with distress (β = -0.24, P < 0.001). IMB skills were associated with increased self-management (β = 0.43, P < 0.001) and adherence (β = 0.46, P < 0.001), and also negatively associated with distress (β = -0.40, P < 0.001). Distress was also negatively associated with self-management (β = -0.22, P < 0.001) and adherence (β = -0.29, P < 0.001), and positively associated with HbA1c levels (β = 0.19, P < 0.001). Bootstrap results confirmed distress as a mediator between IMB skills, acceptance, and commitment, and self-management/adherence (P < 0.05). The model showed excellent fit (RMSEA = 0.046, χ²/df = 2.51). Conclusion: This cross-sectional study tested a structural model integrating acceptance-commitment and IMB frameworks. Findings highlight associations among psychological flexibility, IMB skills, reduced distress, and improved self-management. These relationships inform potential intervention targets. Longitudinal and experimental studies are required to evaluate causal effects and clinical implementation.
Objective: The Mentalizing Emotions Questionnaire (MEQ) assesses individuals' capacity to perceive, understand, and communicate emotional states across three dimensions: Self, Communicating, and Other. This study aimed to evaluate the psychometric properties of the Persian version of the MEQ. Method : Two independent samples of Iranian adults participated in this research (total N = 785; 71% female). Study 1 (N = 307) conducted an exploratory factor analysis (EFA) to examine the underlying structure of the scale. Study 2 (N = 478) performed a confirmatory factor analysis (CFA) to test the three-factor model. Internal consistency, test-retest reliability, convergent validity, and divergent validity were also assessed using established measures of mentalization, empathy, alexithymia, emotional beliefs, personality functioning, and emotion regulation. Results: The original three-factor structure (Self, Communicating, Other) was supported. Model fit indices indicated adequate-to-good fit (CFI = 0.92, RMSEA = 0.07, SRMR = 0.05, CMIN/df = 3.74). The Persian MEQ demonstrated strong internal consistency (α = 0.82-0.90) and excellent test-retest reliability (ICC = 0.89). Convergent validity was supported by positive correlations with mentalization and empathy measures (r = 0.20-0.35). Divergent validity was evidenced by negative correlations with alexithymia (r = -0.39), maladaptive emotional beliefs (r = -0.34), and personality functioning impairments (r = -0.31). Difficulty Describing Feelings showed a strong negative association with the Communicating dimension (r = -0.43). Cognitive reappraisal demonstrated a negative association with emotional mentalizing (r = -0.29). Conclusion: The Persian version of the MEQ demonstrates strong reliability and validity for assessing the mentalizing emotions in nonclinical Iranian populations. The findings also suggest potential cultural variations in the relationship between cognitive reappraisal and mentalizing emotions warranting further cross-cultural investigation.
Objective: Micronutrient deficiencies among university students may adversely influence their sleep quality, mental health, and memory function. The overarching purpose of this study was to evaluate the associations between dietary micronutrient intake and memory performance, mental health, and sleep quality among medical university students. Method: This was a cross-sectional study conducted on a sample of 985 university students. The Food Frequency Questionnaire, Prospective & Retrospective Memory Questionnaire, Depression, Anxiety and Stress Scale-21, and Pittsburgh Sleep Quality Inventory were used to assess dietary intake, memory function, mental health, and sleep quality, respectively. An undirected network was constructed via the EBICglasso model, and a directed acyclic graph was developed employing a Bayesian network. Results: The average age of the students was 22.44 ± 1.95 years. Among these participants, 500 (50.76%) were female and 485 (49.24%) were male. Assessments showed that 485 (49.20%) participants had depression symptoms, 490 (49.70%) had anxiety symptoms, 620 (62.90%) had stress, and 535 (54.30%) experienced sleep disturbances based on the cut-off scores of the questionnaires. Network analyses identified zinc, magnesium, B-group vitamins, vitamin D, and vitamin C as central nodes related to mental health, memory function, and sleep quality. Conclusion: Zinc, magnesium, vitamin B2, vitamin D, and vitamin C emerged as key micronutrients associated with mental health, memory function, and sleep quality. These micronutrients represent promising targets for future clinical studies.
Objective: The aim of this study was to investigate the occupational hazards faced by psychiatrists and their protective strategies against these challenges. Method: The research adopted a qualitative approach with a thematic analysis strategy. The study included 15 psychiatrists selected through purposive sampling until theoretical saturation was achieved. Data were collected using semi-structured interviews and analyzed with MAXQDA 2024 software. The analysis was conducted based on Attride-Stirling’s thematic network framework and involved systematic coding of meaning units and progressive abstraction into basic, organizing, and global themes. Results: Based on the analysis of interview transcripts, 73 basic themes, 11 organizing themes, and 3 global themes were identified for occupational hazards, along with 8 organizing themes for protective strategies. The global and organizing themes for hazards included: intrapersonal hazards (psychological stress, burnout, and clients’ social and cultural issues), interpersonal hazards (distress from patient interactions, domestic erosion, and lack of collegial cooperation), and Transpersonal hazards (organizational constraints, lost professional status, repetitive exhaustion under outdated infrastructure, and financial discrimination). The organizing themes for protective strategies encompassed psychological flexibility, passion for service, spiritual coping, professional growth, professional collaboration, restorative activities, therapeutic communication, and optimization of the treatment environment. Conclusion: This qualitative study identified psychiatrists’ occupational hazards across three dimensions -intrapersonal, interpersonal, and supra-personalwhile also highlighting critical protective strategies such as psychological flexibility and professional growth. The findings underscore the necessity for comprehensive support for psychiatrists’ mental health and the development of supportive resources. These results can serve as a foundation for future policy-making in the field of mental health. However, the findings should be interpreted in light of the study’s limited sample size and regional scope.
Objective: To determine levels of positive/negative religious coping and psychological resilience among mothers of children admitted to a pediatric intensive care unit (PICU) and to examine their associations with sociodemographic characteristics and perceived psychosocial support needs. Method : This descriptive, cross-sectional study was conducted between June and December 2025 in a pediatric intensive care unit; 100 mothers were recruited via face-to-face interviews. Data were collected using a sociodemographic form, the Brief RCOPE (positive/negative subscales), and the Brief Resilience Scale. Results: Scores for Positive religious coping were high (mean = 3.20 ± 0.60), negative religious coping was low (mean = 1.55 ± 0.50), and resilience scores were moderate (mean = 19.35 ± 5.18). Mothers who reported needing psychosocial support had higher positive and negative religious coping scores but lower resilience. Negative religious coping was negatively associated with resilience (r = -0.246, P = 0.014), whereas positive religious coping was not. Conclusion: The findings suggest that, in addition to psychosocial support, targeted spiritual care may be particularly important for mothers showing elevated negative religious coping during their child's PICU hospitalization.
Objective: Given the importance of mental health during adolescence and the considerable prevalence of psychological problems among this age group, along with the limited epidemiological data available in South Khorasan province, Iran, the present research focused on determining the prevalence of internalizing and externalizing problems in regional school-aged adolescents and analyzing related demographic characteristics. Method: This descriptive cross-sectional study included 1,152 adolescents aged 12 to 19 years (mean age = 15.42, SD = 1.65) from Birjand City. A multistage random sampling method was employed to select the participants. Data were collected using the self-report version of the Strengths and Difficulties Questionnaire (SDQ), which measures internalizing and externalizing problems. To analyze the data, descriptive statistics were computed and comparative analyses were performed. Demographic variables such as age, gender, academic performance, school grade, and school type were also included in the analysis. Results: The prevalence of internalizing problems among the participants was 36.8% (95% confidence interval: 34.0 to 39.6), whereas externalizing problems were identified in 15.2% (95% CI: 13.0 to 17.4). Internalizing problems were significantly more prevalent among girls (40.1%) than boys (32%). However, no significant gender difference was found in externalizing problems (girls: 14.5%, boys: 15.8%). Emotional problems (28.6%) and hyperactivity (10.4%) were significantly more common in girls, while peer problems (61.7%) and conduct problems (17.5%) were higher in boys (P < 0.01). Adolescents with poor academic performance and those attending public schools reported higher levels of psychological problems (P < 0.01). Conclusion: Internalizing problems are more common than externalizing problems among adolescents. The main risk factors include being female, poor academic performance, and attending public schools. Mental health programs and interventions should prioritize these high-risk subgroups to enhance preventive and therapeutic outcomes.
Objective: Childhood trauma and attachment styles are critical factors influencing prolonged grief symptoms in bereaved adults. This study investigates the relationship between childhood trauma, attachment styles, and prolonged grief symptoms considering the mediating role of mentalization, shame, and guilt in bereaved adults. Method: The present research is a cross-sectional descriptive study with a correlational design utilizing path analysis. The statistical population of this study includes bereaved individuals, selected by the convenience sampling method. A total of 311 participants completed to the PG-13-R, CTQ, RAAS, RFQ, and SSGS questionnaires. SPSS 24 and PLS 3 were employed for data analysis using path analysis modeling. PLS-SEM, a variance-based approach suitable for non-normal and complex models with multiple mediators, was used for path analysis modeling. Results: The study results demonstrated a significant direct relationship of childhood trauma (β = 0.29, P = 0.006) and attachment styles (β = 0.23, P = 0.020) with prolonged grief symptoms. The critical finding in this research concerns the mediating variables. According to the results, shame significantly mediated the overall model (β = 0.10, P = 0.042), specifically between between attachment styles and prolonged grief symptoms (β = 0.10, P = 0.044), while mentalization and guilt were not significant mediators. In total, 60% of the variance in prolonged grief symptoms can be explained by predictive variables (R² = 0.609), including childhood trauma, attachment style, mentalization, shame, and guilt. Conclusion: These findings emphasize the role of shame in the prolonged grief symptoms among adults with childhood trauma histories and insecure attachments. Therefore, the findings suggest that interventions targeting shame could be effective in reducing prolonged grief symptoms.
Objective: Positive mental health is a distinct dimension of population health. Despite the validation of the Persian Mental Health Continuum-Short Form (MHC-SF), population-based estimates for adult municipal surveillance in Iran are limited. To describe MHC-SF score distributions, internal consistency, and demographic gradients among adults in Mashhad. Method : A population-based cross-sectional survey (May 2024-March 2025) used stratified cluster sampling across five health districts (50 clusters; Kish-grid household selection). Adults aged ≥ 18 years completed the 14-item Persian MHC-SF indexing emotional well-being (EWB), social well-being (SWB), and psychological well-being (PWB). Results: Among 2,066 adults (57.6% women), the overall mean (SD; median) MHC-SF score was 61.55 (13.21; 63), with domain scores of 28.99 (6.19; 30) for PWB, 19.01 (5.63; 19) for SWB, and 13.54 (4.11; 14) for EWB. Men scored slightly higher than women on the total scale, EWB, and PWB (all P < 0.001; small effect sizes), while the SWB difference was not statistically significant (p = 0.075). Age showed weak positive associations with total, EWB, and SWB scores (ρ = 0.060-0.069; P ≤ 0.006), but not PWB (ρ = 0.018; P = 0.408). Item-level contrasts suggested higher male endorsement of agency/meaning indicators and higher female endorsement of benevolence/collective optimism; both sexes reported high levels of warm, trusting relationships. In a multivariable linear regression adjusting for age and sex simultaneously, demographic predictors accounted for < 1% of outcome variance, with male sex independently associated with higher total, EWB, and PWB scores, and age independently associated with slightly higher total, EWB, and SWB scores. Conclusion: In this representative urban population-based study, positive mental health was moderately high; PWB ranked highest, while SWB lagged. Demographic gradients were small: men slightly exceeded women, and older adults reported marginally higher EWB and SWB. For surveillance, the MHC-SF total score appears suitable as a summary indicator, while the SWB profile may help identify community-level levers (e.g., social capital and trust) to strengthen social connectedness in Mashhad, Iran.
Objective: To assess levels of self-esteem, social anxiety, and affective lability among pediatric nursing students; to examine their associations with academic achievement; and to test whether social anxiety and affective lability mediate the self-esteem–achievement relationship. Method: A descriptive cross-sectional study was conducted among 370 nursing students aged 17-24 years using purposive sampling. Instruments included the Coopersmith Self-Esteem Scale (self-esteem), the Liebowitz Social Anxiety Scale-Self-Report (LSAS-SR), the Affective Lability Scale (ALS-18), and academic achievement records from the pediatric nursing course. Sociodemographic variables were also collected. Data were analyzed using Pearson correlations and mediation analysis with Hayes PROCESS Model 4. Results: Students demonstrated moderate self-esteem, mild-to-moderate social anxiety, and clinically notable affective lability (mean ALS-18 = 42.3 ± 11.7; scores > 40 indicate clinically notable emotional dysregulation). Self-esteem showed a significant positive correlation with academic achievement (r = 0.42, P < 0.01). Social anxiety (r = -0.38, P < 0.01) and affective lability (r = -0.36, P < 0.01) were each negatively correlated with both self-esteem and academic achievement. Mediation analysis revealed that social anxiety and affective lability partially mediated the relationship between self-esteem and academic achievement (indirect effect = 0.19, 95% CI: 0.08 to 0.33), accounting for 41% of the total association between self-esteem and academic achievement (proportion mediated = 0.41). No significant associations were found between sociodemographic variables and self-esteem. Conclusion: Self-esteem is positively associated with academic achievement among pediatric nursing students. Cross-sectional mediation analysis indicates that this association is statistically consistent with a model in which social anxiety and affective lability together account for 41% of the total association. However, causal interpretation requires longitudinal replication. Psychiatric screening for emotional dysregulation and social anxiety using validated tools such as the ALS-18 and LSAS may help identify at-risk students, but experimental studies are needed to test whether interventions targeting these constructs improve academic outcomes.
Objective: This umbrella review synthesizes findings from existing systematic, scoping, and narrative reviews on psycho-spiritual processes and interventions that influence well-being following trauma and adversity. Method: Following umbrella review methodology, we searched major databases (PsycINFO, PubMed, CINAHL, etc.) for reviews published between 2015 and 2025. Methodological quality was assessed using the AMSTAR-2 tool. Only reviews scoring above the predefined threshold of > 8/16 were included. All 18 included reviews scored 14–16 out of 16, indicating high methodological quality. Eighteen reviews met the inclusion criteria, encompassing diverse populations including veterans, cancer survivors, disaster victims, and survivors of abuse. Results: The synthesis reveals three core psycho-spiritual pathways: 1) The Meaning-Making Pathway, where spirituality facilitates posttraumatic growth (PTG), identity reconstruction, and spiritual well-being (SWB); 2) The Pathway of Spiritual Struggle, where existential conflict, moral injury, and a loss of meaning exacerbate psychological distress; and 3) The intervention Pathway, where psycho-spiritually integrated therapies showed positive effects. However, effect sizes, confidence intervals, and heterogeneity were inconsistently reported across the 18 included reviews, precluding a single pooled estimate. Effect sizes from meta‑analyses ranged from small to moderate: for depression (Cohen’s d = 0.42, 95% CI [0.21, 0.63]), for anxiety (SMD = 0.31–0.58), and for spiritual well‑being (SMD = 0.47, 95% CI [0.29, 0.65]). Heterogeneity was moderate to high (I² = 54–72%). Key facilitators include person-centered, trauma-informed care that validates spiritual concerns, while a primary barrier is the clinician's lack of training in addressing existential and spiritual dimensions. Conclusion: Psycho-SWB is a pivotal, multifaceted outcome of trauma recovery. Effective support requires a nuanced approach that acknowledges both the potential for growth and the reality of existential pain. Clinical practice must integrate evidence-based psycho-spiritual interventions, while research should prioritize longitudinal designs, diverse populations, and standardized measures of psycho-spiritual constructs.
Objective: Mothers of children suffering with autism spectrum disorder (ASD) and intellectual disability (ID) experience substantial psychological challenges that may affect their perceived self-efficacy. While psychological well-being and spiritual health are considered important protective factors, their relative contributions to general self-efficacy in this population remain insufficiently explored in Iran. This study aimed to investigate whether psychological well-being and spiritual health are correlated with the general self-efficacy of mothers of children with ID or ASD in Qom, Iran. Method: This was a correlational cross-sectional study involving the participation of 100 mothers of children with ID (n = 49) and ASD (n = 51) who were enrolled via multi-stage cluster sampling method. The participants completed the Spiritual Health Questionnaire for the Iranian Population, the Ryff Psychological Well-Being Questionnaire, and the Sherer Self-Efficacy Questionnaire. Data were analyzed using Pearson correlation coefficients and stepwise multiple regression analysis in SPSS version 22, with the significance level set at P < 0.05. Results: The study revealed that psychological well-being was positively and significantly correlated with general self-efficacy in both mothers of children with ASD (r = 0.62, P < 0.001) and mothers of children with ID (r = 0.65, P < 0.001). In contrast, spiritual health showed no significant association with general self-efficacy in either group (P > 0.05). Regression analyses showed that psychological well-being explained 38% of the variance in general self-efficacy among mothers of children with ASD and 42% among mothers of children with ID (P < 0.001). Conclusion: The findings highlight the importance of psychological well-being as a substantial predictor of general self-efficacy among mothers of children with ID and ASD. Thus, interventions to strengthen maternal self-efficacy are recommended to be considered a means of promoting self-efficacy, while the role of spiritual health requires further study.
Objective: Somatic-type delusional disorder is characterized by fixed false beliefs related to bodily changes or illness. This report describes an unusual early-onset case associated with significant functional decline and compares its features with previously published cases. Method: Clinical information was collected through psychiatric assessment, family interviews, physical and neurological examinations, laboratory investigations, and six months of follow-up. A narrative review of relevant English-language case reports published between 2003 and 2025 was also undertaken. Results: A 22-year-old woman developed a persistent belief that self-inflicted cuts on her feet had permanently altered her joints and skin. Despite repeated reassurance and normal medical findings, she remained convinced of the perceived deformity. The condition was associated with depressed mood, social isolation, poor self-care, reduced food intake, and academic impairment. Investigations did not identify an underlying medical cause. Treatment with olanzapine, psychoeducation, supportive psychotherapy, and family counselling resulted in gradual improvement. During follow-up, delusional conviction decreased substantially, accompanied by better self-care, social interaction, and academic functioning. Review of the literature indicated that severe impairment and early onset are relatively uncommon in somatic-type delusional disorder. Conclusion: Early-onset somatic delusions can lead to marked psychosocial dysfunction and may differ from the traditionally described pattern of preserved functioning. Comprehensive assessment, ongoing diagnostic review, and combined pharmacological and psychosocial interventions are important for achieving favorable outcomes.
Objective: This study aimed to assess the impact of online psychoeducational training on reducing the psychological burden of caregivers of patients with moderate to severe dementia. Caring for such patients, especially by non-professional caregivers, poses significant mental and physical challenges. Internet-based interventions offer a practical and innovative solution to help alleviate this burden. Method: This clinical trial was conducted in 2023 in Kashan, Iran, with 84 caregivers of patients with moderate to severe dementia. Participants were divided into two groups: an intervention group (n = 42) and a control group (n = 42). The intervention group received a 20-session online psychoeducational program over eight weeks, while the control group received routine care. Caregiver burden was measured using the Zarit Burden Interview (ZBI) before, immediately after, and three months after the intervention. Data analysis included independent t-tests and repeated measures ANOVA. Results: Baseline characteristics of caregivers in both groups were homogeneous in most variables, except for education level, which differed significantly (P = 0.006). Repeated measures of the general linear model (GLM) analysis revealed a significant reduction in caregiver burden in the intervention group (P = 0.014). Within-group analysis showed that the burden significantly decreased immediately after the training. Although a slight increase was observed at the three-month follow-up, it remained lower than the baseline (P < 0.001). Conclusion: Online psychoeducational training significantly reduces the psychological burden of dementia patient caregivers, with sustained effectiveness over a three-month follow-up. These findings support the integration of digital psychoeducation as a viable alternative or complement to traditional interventions, particularly in resource-limited or high-need settings.
Objective: The prevalence of Neurodevelopmental Disorders (NDDs), including Autism Spectrum Disorder (ASD), is increasing globally, driven largely by evolving diagnostic criteria, diagnostic substitution, and increased public awareness. While children with NDDs frequently visit Emergency Departments (EDs) for medical, non-psychiatric complaints, acute care environments are often ill-equipped to meet their unique sensory and communicative needs. This mismatch frequently leads to behavioral escalation, increased use of restraint, and caregiver dissatisfaction. Method: This narrative review synthesizes current literature to examine the challenges facing pediatric clients with NDDs in non-psychiatric settings and identifies evidence-based strategies to optimize their management. Results: Analysis reveals that the chaotic nature of the ED, characterized by sensory overload and unpredictable routines, acts as a significant barrier to care. Clinicians frequently report higher procedural difficulty for these clients, as measured by tools such as the Task Completion Index (TCI). Evidence indicates these patients are five times more likely to have difficulty with vital signs and eight times more likely to undergo physical or pharmacological restraint compared to neurotypical peers. Key management strategies identified include the implementation of “Health Passports” for communicating baseline needs, early identification via EMR flagging, and environmental modifications such as “Low-Stimulation Rooms” and sensory toolkits. Furthermore, adopting behavioral pain scales (e.g., r-FLACC) and “Tell-Show-Do” techniques are essential for accurate assessment and procedural success. Conclusion: Current acute care models are often reactive rather than proactive regarding neurodiversity. Bridging the gap requires a systemic shift towards “support-first” methodologies. By integrating sensory-friendly protocols, leveraging caregiver expertise, and prioritizing staff training, healthcare systems can significantly reduce the reliance on coercive measures and improve clinical outcomes for this vulnerable population, which should be considered a core competency in pediatric emergency medicine.
Objective: Persistent negative symptoms in chronic schizophrenia often show limited responsiveness to antipsychotic therapy. The present study evaluated whether supplementation with vitamin B12 and folic acid improves negative symptoms as the primary endpoint, while also examining effects on positive symptoms and global cognitive functioning as secondary outcomes. Method: In this randomized, double-blind, placebo-controlled trial, 88 inpatients with chronic schizophrenia receiving stable risperidone therapy were assigned to one of four groups: vitamin B12 (1 mg/day), folic acid (1 mg/day), combined vitamin B12 plus folic acid (1 mg/day each), and placebo for eight weeks. Negative symptoms were measured using the Scale for the Assessment of Negative Symptoms (SANS), positive symptoms using the Scale for the Assessment of Positive Symptoms (SAPS), and cognitive function using the Mini-Mental State Examination (MMSE). Serum concentrations of vitamin B12 and folate were assessed at baseline and after the intervention. Results: Supplementation with vitamin B12 and/or folic acid led to significant increases in serum concentrations of the corresponding vitamins (P < 0.001). All supplementation groups demonstrated significant and clinically meaningful reductions in negative symptom severity compared with placebo, with large effect sizes. In contrast, no significant changes were detected in positive symptoms or global cognitive performance. Conclusion: Adjunctive vitamin B12 and folic acid supplementation significantly reduced negative symptom severity in chronic schizophrenia, without affecting positive symptoms or global cognition. Targeted correction of vitamin deficiencies may represent a valuable adjunctive approach for persistent negative symptoms.
Objective: Grief is a response to significant loss that may become prolonged and develop into prolonged grief disorder (PGD). Sociocultural factors can influence this process. This scoping review examined studies on sociocultural determinants of PGD. Method: Databases searched included PubMed, Web of Science, Scopus, PsycINFO, and ProQuest. Studies published between January 2012 and December 2025 were screened in accordance with PRISMA-ScR guidelines and analyzed descriptively. Results: From 877 identified papers, 19 met the inclusion criteria. Four key sociocultural factors emerged: religious beliefs, mourning customs, cultural beliefs, and social support. Religious beliefs functioned as both risk and protective factors depending on the context and coping style. Mourning customs promoted healing when upheld and intensified grief when disrupted; moreover, in some contexts, rituals may also maintain grief. Cultural beliefs shaped grief expression and understanding, sometimes conflicting with diagnostic criteria. Social support, especially when culturally congruent, moderated grief outcomes, while social withdrawal or isolation also emerged as an important predictor of prolonged grief (PG) symptoms. Conclusion: The findings underscore the importance of culturally sensitive interventions in PGD. Understanding these sociocultural dynamics is essential for developing culturally tailored prevention and treatment strategies for PGD
Objective: This study systematically integrates and reviews the results of Iranian studies on the effectiveness of cognitive behavioral therapy (CBT) for emotional disorders. Method: To ensure a comprehensive review, relevant Iranian studies from 2001 to 2024 were identified from databases such as Google Scholar, Web of Science, Scopus, PubMed, SID, Noormags, and MagIran using keywords including CBT, emotional disorders, anxiety, depression, OCD, PTSD, and stress. Results: Based on the inclusion criteria, 93 effect sizes from 65 Iran-based studies were selected for analysis. The random-effects model revealed a significant overall effect size of CBT on emotional disorders, with g = 1.07, p < 0.001, and a 95% confidence interval ranging from 0.95 to 1.20. The primary analysis indicated that CBT effectively improved various emotional disorders, including anxiety (g = 1.04), depression (g = 1.09), OCD (g = 1.19), PTSD (g = 0.39), and stress (g = 1.27). Subgroup analysis showed no significant gender differences in the effectiveness of CBT, whereas meta-regression revealed a significant association between the effect size of CBT and the age of Iranian participants. Conclusion: The CBT intervention method has been an effective treatment for emotional disorders and has significantly improved anxiety, depression, OCD, and PTSD in Iranian populations; however, its effect on stress was not statistically significant in this study.
