The Effectiveness of Acceptance and Commitment Therapy on Anxiety, Depression, and Stress in Patients with Spinal Cord Injuries

Background: Since the number of patients with spinal cord injuries is increasing, paying attention to these patients’ psychological problems is a priority. This study aimed to evaluate the effect of acceptance and commitment therapy on anxiety, depression, and stress in patients with spinal cord injuries.Methods: The present study had utilized a single-subject approach in the form of multiple baseline design. The samples were selected using purposive sampling based on convenience sampling method. The statistical population included all patients in Hamadan city with spinal cord injuries who referred to the Shahid Beheshti hospital in this city. The total numbers of them were 181 people in 2016. The researchers informed the patients about the research and presented them with informed consent forms. Among 50 screened patients, five patients (4 males and one female) selected and entered the treatment process: anxiety, depression, and stress measured by Depression Anxiety Stress Scales (DASS-21). Acceptance and commitment therapy conducted in 8 treatment sessions on anxiety, depression, and stress in patients with spinal cord injuries.Results: The results of the graphic and chart analysis, reliable change index (RCI) and the percentage of recovery showed that acceptance and commitment therapy affected anxiety, depression, and stress in the patients with spinal cord injuries.Conclusion: Findings indicated that acceptance and commitment therapy improved people’s mental health by working on acceptance and mindfulness processes and behavior change processes. This therapy decreased anxiety, depression, and stress in patients with spinal cord lesion

The Effectiveness of Schema Therapy in Reducing Aggression and Social Anxiety in Adolescents of Hamedan city aged 17 to 18 years

Introduction: This study aimed to investigate the effect of schema therapy in reducing aggression and social anxiety in adolescents aged 17 to 18 years. Method: This is a semi-experimental study with multistage cluster sampling method. The population of the study consisted of 3,000 secondary school students in District 1 of Hamadan. In the first stage of sampling, between the two regions of education in the city of Hamadan one was randomly selected. In the next phase, of all secondary schools in the area one was randomly selected and 32 patients were selected from among the students of this school. The Buss-Perry Aggression Scale and the Social Anxiety Scale of adolescents was conducted on students. 16 students were placed in the experimental group and control group and the experimental group received the independent variable (Schema Therapy) for 10 sessions. Each session was 60 minute long. Findings: The results showed that schema therapy was an effective way to reduce physical aggression (P=0/05, F=20/3), verbal aggression (P=0/05, F=16/6), anger (P=0/05, F=104/5), hostility (P=0/05, F=7/2) and social anxiety (P=0/05, F=8/9) in adolescents aged 17 to 18 years in Hamadan city. Conclusion: result show the significant effect schema therapy on aggression and social anxiety in adolescents aged 17 to 18 years

Comparison of the Effectiveness of Schema Therapy and Dialectical Behavior Therapy on Temperament and Character Dimensions and Cognitive Emotion Regulation Strategies in Patients with HIV

There are many social concerns towards HIV disease and people feel irrational fears of infection and modes of virus transmission. These factors might affect the temperament and character dimensions, as well as cognitive emotion regulation strategies. Accordingly, psychological therapies can be used as beneficial tools to identify the disease and to mitigate the related concerns. This study aimed at comparing the effectiveness of Schema Therapy (ST) and Dialectical Behavior Therapy (DBT) on temperament and character (TC) dimensions and cognitive emotion regulation (CER) strategies in patients with HIV. In terms of methodology, this was an experimental study based on the pretest-posttest and control group. Also, this was applied research in terms of objective. The statistical population comprised all patients with HIV who were under treatment in behavioral disorders clinics of Health Centers in Hamedan, Iran, during 2019-2020. Of them, 45 subjects were chosen by using simple random sampling then were assigned to three groups (n=15), including two intervention groups and one control group. To assess the considered variables, the Temperament and Character Inventory (TCI) designed by Cloninger (1994), and the Cognitive Emotion Regulation Questionnaire (CERQ) (2001) were used. According to ANCOVA results, ST and DBT affected temperament and character dimensions and there was a significant difference between the two groups. Therefore, although both therapies had effectiveness in surveyed variables, ST had higher effectiveness rather than DBT

Burden of disease scenarios for 204 countries and territories, 2022–2050: a forecasting analysis for the Global Burden of Disease Study 2021

BackgroundFuture trends in disease burden and drivers of health are of great interest to policy makers and the public at large. This information can be used for policy and long-term health investment, planning, and prioritisation. We have expanded and improved upon previous forecasts produced as part of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) and provide a reference forecast (the most likely future), and alternative scenarios assessing disease burden trajectories if selected sets of risk factors were eliminated from current levels by 2050.MethodsUsing forecasts of major drivers of health such as the Socio-demographic Index (SDI; a composite measure of lag-distributed income per capita, mean years of education, and total fertility under 25 years of age) and the full set of risk factor exposures captured by GBD, we provide cause-specific forecasts of mortality, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) by age and sex from 2022 to 2050 for 204 countries and territories, 21 GBD regions, seven super-regions, and the world. All analyses were done at the cause-specific level so that only risk factors deemed causal by the GBD comparative risk assessment influenced future trajectories of mortality for each disease. Cause-specific mortality was modelled using mixed-effects models with SDI and time as the main covariates, and the combined impact of causal risk factors as an offset in the model. At the all-cause mortality level, we captured unexplained variation by modelling residuals with an autoregressive integrated moving average model with drift attenuation. These all-cause forecasts constrained the cause-specific forecasts at successively deeper levels of the GBD cause hierarchy using cascading mortality models, thus ensuring a robust estimate of cause-specific mortality. For non-fatal measures (eg, low back pain), incidence and prevalence were forecasted from mixed-effects models with SDI as the main covariate, and YLDs were computed from the resulting prevalence forecasts and average disability weights from GBD. Alternative future scenarios were constructed by replacing appropriate reference trajectories for risk factors with hypothetical trajectories of gradual elimination of risk factor exposure from current levels to 2050. The scenarios were constructed from various sets of risk factors: environmental risks (Safer Environment scenario), risks associated with communicable, maternal, neonatal, and nutritional diseases (CMNNs; Improved Childhood Nutrition and Vaccination scenario), risks associated with major non-communicable diseases (NCDs; Improved Behavioural and Metabolic Risks scenario), and the combined effects of these three scenarios. Using the Shared Socioeconomic Pathways climate scenarios SSP2-4.5 as reference and SSP1-1.9 as an optimistic alternative in the Safer Environment scenario, we accounted for climate change impact on health by using the most recent Intergovernmental Panel on Climate Change temperature forecasts and published trajectories of ambient air pollution for the same two scenarios. Life expectancy and healthy life expectancy were computed using standard methods. The forecasting framework includes computing the age-sex-specific future population for each location and separately for each scenario. 95% uncertainty intervals (UIs) for each individual future estimate were derived from the 2·5th and 97·5th percentiles of distributions generated from propagating 500 draws through the multistage computational pipeline.FindingsIn the reference scenario forecast, global and super-regional life expectancy increased from 2022 to 2050, but improvement was at a slower pace than in the three decades preceding the COVID-19 pandemic (beginning in 2020). Gains in future life expectancy were forecasted to be greatest in super-regions with comparatively low life expectancies (such as sub-Saharan Africa) compared with super-regions with higher life expectancies (such as the high-income super-region), leading to a trend towards convergence in life expectancy across locations between now and 2050. At the super-region level, forecasted healthy life expectancy patterns were similar to those of life expectancies. Forecasts for the reference scenario found that health will improve in the coming decades, with all-cause age-standardised DALY rates decreasing in every GBD super-region. The total DALY burden measured in counts, however, will increase in every super-region, largely a function of population ageing and growth. We also forecasted that both DALY counts and age-standardised DALY rates will continue to shift from CMNNs to NCDs, with the most pronounced shifts occurring in sub-Saharan Africa (60·1% [95% UI 56·8–63·1] of DALYs were from CMNNs in 2022 compared with 35·8% [31·0–45·0] in 2050) and south Asia (31·7% [29·2–34·1] to 15·5% [13·7–17·5]). This shift is reflected in the leading global causes of DALYs, with the top four causes in 2050 being ischaemic heart disease, stroke, diabetes, and chronic obstructive pulmonary disease, compared with 2022, with ischaemic heart disease, neonatal disorders, stroke, and lower respiratory infections at the top. The global proportion of DALYs due to YLDs likewise increased from 33·8% (27·4–40·3) to 41·1% (33·9–48·1) from 2022 to 2050, demonstrating an important shift in overall disease burden towards morbidity and away from premature death. The largest shift of this kind was forecasted for sub-Saharan Africa, from 20·1% (15·6–25·3) of DALYs due to YLDs in 2022 to 35·6% (26·5–43·0) in 2050. In the assessment of alternative future scenarios, the combined effects of the scenarios (Safer Environment, Improved Childhood Nutrition and Vaccination, and Improved Behavioural and Metabolic Risks scenarios) demonstrated an important decrease in the global burden of DALYs in 2050 of 15·4% (13·5–17·5) compared with the reference scenario, with decreases across super-regions ranging from 10·4% (9·7–11·3) in the high-income super-region to 23·9% (20·7–27·3) in north Africa and the Middle East. The Safer Environment scenario had its largest decrease in sub-Saharan Africa (5·2% [3·5–6·8]), the Improved Behavioural and Metabolic Risks scenario in north Africa and the Middle East (23·2% [20·2–26·5]), and the Improved Nutrition and Vaccination scenario in sub-Saharan Africa (2·0% [–0·6 to 3·6]).InterpretationGlobally, life expectancy and age-standardised disease burden were forecasted to improve between 2022 and 2050, with the majority of the burden continuing to shift from CMNNs to NCDs. That said, continued progress on reducing the CMNN disease burden will be dependent on maintaining investment in and policy emphasis on CMNN disease prevention and treatment. Mostly due to growth and ageing of populations, the number of deaths and DALYs due to all causes combined will generally increase. By constructing alternative future scenarios wherein certain risk exposures are eliminated by 2050, we have shown that opportunities exist to substantially improve health outcomes in the future through concerted efforts to prevent exposure to well established risk factors and to expand access to key health interventions.FundingBill & Melinda Gates Foundation.</p