Nader Hajloo; Hasan Abdollahzadeh; Ali Salmani; Aysan Sharei; Negar Farhoudi
Abstract
Objective: Tension headache is known as the second most common chronic disease in the world. Tension headaches pose a significantly greater social burden than migraines, especially in chronic cases, and can have significant negative consequences on various aspects of an individual's well-being, including ...
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Objective: Tension headache is known as the second most common chronic disease in the world. Tension headaches pose a significantly greater social burden than migraines, especially in chronic cases, and can have significant negative consequences on various aspects of an individual's well-being, including physical, psychological, and social interactions. This type of headache has attracted the attention of many researchers and health professionals due to its prevalence and significant impact on quality of life. Therefore, designing a specific questionnaire can be an important step towards developing related research. The present study aimed to design and validate a tension headache questionnaire in the Iranian population. Method: The present study is a mixed qualitative-quantitative study. The qualitative part of the research was conducted in an inductive manner to extract the items used in developing the questionnaire. In the quantitative part, a descriptive method was used in the form of psychometric studies to examine the validity and reliability of the developed tool. In the qualitative part, the statistical population was all articles extracted from the scientific databases SID, Magiran, and Web of Science, PubMed, Scopus, Cochrane Library, Since direct, and Google scholar between 2000 and 2024. The statistical population of the research in the quantitative part consisted of all people with tension headaches based on the diagnostic criteria of the International Classification of Headache Disorders (ICHD-3) in 2025. The sample of the present study was 240 individuals from four cities selected by purposive sampling method and responded to the Tension Headache Questionnaire (2025), Questionnaire for Measuring Symptoms of Migraine Headache of Najarian (1997) and Psychological Well-Being Scale of Ryff (1989). Internal consistency coefficient, concurrent validity, exploratory and confirmatory factor analysis were used to analyze the data. The data were analyzed using SPSS.26 and LISREL.10.20 software. Results: The results of the internal consistency coefficient showed that this questionnaire and its subscales have adequate reliability (α>0.70). The results of the correlation coefficient showed that the positive relationship between the tension headaches variable and the severity of migraine symptoms (r=0.750, P<0.001) indicates appropriate convergent validity and the negative correlation coefficient between the psychological well-being variable (r=-0.155, P<0.05) indicates appropriate divergent validity. The fit indices of the confirmatory factor analysis model also confirmed the final model of this questionnaire with eight components of factors related to repetition, pain, time, environment, sensitivity, distress tolerance, pressure/tension, and mood (P<0.001). Conclusion: The results of this study showed that the tension headache questionnaire has acceptable validity and reliability in the Iranian society and is well-adapted to the cultural and indigenous characteristics of Iranian patients, which allows for a proper understanding of its items. Using this tool in diagnosing or assessing the severity of tension headaches can have a significant impact and is a suitable self-assessment scale for clinical and research situations.
Samane Ghadampour; Kourosh Amraei; Masoud Sadeghi
Abstract
Objective: Health anxiety, characterized by excessive worry about having a serious illness, leads to significant functional impairment. Its etiology involves complex cognitive-emotional mechanisms. This study proposes and tests a novel integrated mediation model to elucidate these pathways. We posit ...
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Objective: Health anxiety, characterized by excessive worry about having a serious illness, leads to significant functional impairment. Its etiology involves complex cognitive-emotional mechanisms. This study proposes and tests a novel integrated mediation model to elucidate these pathways. We posit that Early Maladaptive Schemas (EMS)-deep-seated cognitive structures-predispose individuals to dysfunctional health interpretations. Building on schema and metacognitive theories, we hypothesize that EMS activate specific health-related metacognitive beliefs. These beliefs, in turn, are central in initiating maladaptive cognitive processes encapsulated by the Cognitive-Attentional Syndrome (CAS), which includes persistent worry, threat monitoring, and counterproductive coping, and its behavioral manifestation in online health-seeking, known as cyberchondria. Concurrently, emotion dysregulation is theorized to interact with and exacerbate these cognitive pathways, creating a vicious cycle that maintains health anxiety. The primary aim is to examine both direct and indirect associations between EMS and health anxiety, with health-related metacognitive beliefs, CAS, cyberchondria, and emotion dysregulation serving as sequential and parallel mediating variables. Testing this comprehensive model provides a holistic etiological framework for health anxiety, integrating predisposing vulnerabilities with maintaining factors. Confirmation of these pathways holds significant clinical implications, suggesting that effective interventions should target not only surface-level worries but also the underlying schemas,metacognitive beliefs, attentional processes, and emotion regulation strategies that perpetuate this debilitating condition. Method: This study employed a cross-sectional correlational design to examine the proposed model. The target population consisted of all single and married women aged 18 to 55 years in Tehran, Iran, with a clinically confirmed diagnosis of health anxiety, who had attended specialized or pain clinics at Shariati and Imam Khomeini Hospitals during the 2024 calendar year. A convenience sampling method was used to recruit an initial pool of 310 eligible participants. Following a comprehensive data screening procedure, which included checks for unengaged responding and multivariate outliers, data from 259 participants were retained for the final analysis, ensuring robust data quality. Participants completed a battery of validated self-report questionnaires, including: the Health Anxiety Inventory (HAI), the Schema Questionnaire—Short Form (YSQ-S3; Young, 2005), the Health-related Metacognitions Questionnaire (H-MCQ; Bailey & Wells, 2015), the Cognitive-Attentional Syndrome Scale (CAS-1; Wells., 2009), the Difficulties in Emotion Regulation Scale (DERS; Bjureberg et al,2016) and the Cyberchondria Severity Scale (McElroy et al., 2019). The hypothesized conceptual model, positing both direct and indirect pathways between early maladaptive schemas and health anxiety via multiple mediators, was tested using structural equation modeling (SEM). The analyses were conducted using two specialized statistical software packages, LISREL (version 8.80) and Mplus (version 7.4), to ensure the reliability and validity of the model fit indices and parameter estimates. Ethical approval for the study was obtained prior to data collection. Results: The structural equation modeling analysis revealed a differentiated pattern of significant and non-significant pathways within the hypothesized model. The following direct paths were not statistically significant: from the Vulnerability to Harm/Illness schema to Health Anxiety; from the Negativity/Pessimism schema to the Cognitive-Attentional Syndrome (CAS), Cyberchondria, and Health Anxiety; from the Insufficient Self-Control/Self-Discipline schema to CAS; and from Emotion Dysregulation to Health Anxiety. All other specified paths demonstrated significant coefficients. Regarding direct effects, the Vulnerability to Harm/Illness schema exerted significant, strong positive effects on Health-related Metacognitive Beliefs (β=0.59), CAS (β=0.68), Emotion Dysregulation (β=0.43), and Cyberchondria (β=0.72). The Negativity/Pessimism schema had significant, moderate positive effects on Metacognitive Beliefs (β=0.29) and Emotion Dysregulation (β=0.21). Conversely, the Insufficient Self-Control/Self-Discipline schema showed a significant but weak negative direct effect on Health Anxiety (β=-0.14), as well as negative effects on Metacognitive Beliefs (β=-0.14) and Cyberchondria (β=-0.13),alongside a positive effect on Emotion Dysregulation (β=0.21). Crucially, the mediating variables-Health-related Metacognitive Beliefs (β=0.33), CAS (β=0.25), and Cyberchondria (β=0.39)-all had significant positive direct effects on Health Anxiety. Analysis of indirect effects using bootstrapping was pivotal. For the Vulnerability to Harm/Illness schema, all specific indirect pathways to Health Anxiety were significant: via Metacognitive Beliefs (β=.194), via CAS (β=.168), and via Cyberchondria (β=.277), resulting in a significant total indirect effect (β=.640). In stark contrast, for the Negativity/Pessimism schema, none of the specific indirect pathways (via Metacognitive Beliefs: β=.096; via CAS: β=.009; via Cyberchondria: β = .030) nor the total indirect effect (β=.135) reached statistical significance. Similarly, for the Insufficient Self-Control schema, all specific indirect paths and the total indirect effect (β=-.069) were non-significant.Conclusion: This study provides evidence for a model of health anxiety, elucidating the pathways through which early maladaptive schemas contribute to the disorder. The findings demonstrate a direct effect of the insufficient self-control schema and an indirect effect of the vulnerability to harm schema, mediated by metacognitive processes and cyberchondria. These results advance our understanding of the underlying mechanisms of health anxiety.The results indicate that health anxiety is not a linear outcome of schema activation but rather the end product of a complex cognitive chain. Schemas require specific mediating factors namely, dysfunctional metacognitive beliefs and cyberchondric behaviors to manifest as clinical health anxiety symptoms. Consequently, therapeutic interventions for health anxiety, particularly in individuals with these schemas, should prioritize restructuring maladaptive metacognitive beliefs, modifying attentional biases, and reducing excessive online health-seeking behaviors (cyberchondria). Targeting these mediating processes is crucial for mitigating the influence of core cognitive schemas on the development and maintenance of health anxiety.
arezoo moradi tavalaei; Imanollah Bigdeli; Ali Mashhadi; Mahdi Razmara; mohammad Jafferany
Abstract
Objective: Alopecia areata (AA) is a complex autoimmune condition with non-scarring alopecia, and it occurs in approximately 2% of the global population. Although its pathogenesis includes both genetic and immunological factors, mounting evidence supports the significance of psychological determinants ...
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Objective: Alopecia areata (AA) is a complex autoimmune condition with non-scarring alopecia, and it occurs in approximately 2% of the global population. Although its pathogenesis includes both genetic and immunological factors, mounting evidence supports the significance of psychological determinants in inducing as well as exacerbating the condition. The transdiagnostic approach, which is a method characterizing key psychological processes underlying greater than one disorder, offers a new paradigm to study AA's psychosocial determinants. The current research analyzes how transdiagnostic factors, particularly neuroticism, anxiety sensitivity, emotion regulation, mindfulness, and experiential avoidance, correlate with severity of AA and emotional comorbidities in an Iranian clinical sample. Our research contributes to closing relevant gaps in extant research in that: (1) the variables are compared simultaneously, not separately, and (2) a full mediation model is considered to shed light on personality-outcome pathways. Method: We performed a cross-sectional survey of 200 AA patients (123 men, 77 women; mean age=29.93±7.93 years) enrolled from clinics of dermatology of Imam Reza Hospital, Mashhad. Candidates were confirmed by board-certified dermatologists for AA diagnosis, while disease severity was measured using the Alopecia Areata Severity Index (AASI). All participants completed validated Persian versions of Multidimensional Emotional Disorder Inventory (MEDI) for emotional disorders, Anxiety Sensitivity Index-16 (ASI-16), Freiburg Mindfulness Inventory-Short Form (FMI-SF), Gross & John Emotion Regulation Questionnaire (ERQ), Multidimensional Experiential Avoidance Questionnaire (MEAQ). Structural Equation Modeling (SEM) through Smart-PLS 3.0 examined direct/indirect associations between transdiagnostic variables, with mediation testing through bootstrapping (5000 samples). The research was ethically approved in ethical commite of ferdowsi university of Mashhad (IR.UM.REC.1402.174). Results: Key findings of this study are: Neuroticism had the highest correlation with emotional disorders (β=0.819, p<0.001), explaining 67.1% variance. High neuroticism predicted lower mindfulness (β=-0.560) and higher disease severity (β=0.206). Mindfulness mediated 38.7% of neuroticism's effect on emotional disorders (β=-0.206, p<0.001) and reduced experiential avoidance (β=-0.687). Anxiety sensitivity had direct effects on emotional disorders (β=0.280) and emotion dysregulation (β=-0.393), but indirect effects through avoidance were nonsignificant (p=0.818). Counter hypotheses, emotion dysregulation, and experiential avoidance could not mediate psychological effects (p>0.05). The demographic variable of age/sex showed few effects of moderation (all p>0.10). Conclusion: This study provides the first evidence for transdiagnostic mechanisms in AA, identifying neuroticism and mindfulness as pivotal treatment targets. We suggest for: Revised AA management guidelines incorporating psychological assessments, Development of brief mindfulness interventions tailored for dermatology settings, Increased collaboration between dermatologists and psychologists. These innovations could transform AA from a purely dermatological condition to a biopsychosocial model of care, potentially improving treatment adherence and reducing relapse rates.
ّFereshteh Naeimi; mahdie salehi; fateme golshani
Abstract
Objective: Spiritual health, as an individual and social dimension, plays an important role in both individual life and society and has received increasing attention in psychological research. Therefore, the aim of the present study was to model spiritual health based on hope and religious orientation, ...
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Objective: Spiritual health, as an individual and social dimension, plays an important role in both individual life and society and has received increasing attention in psychological research. Therefore, the aim of the present study was to model spiritual health based on hope and religious orientation, with the mediating roles of emotion regulation and distress tolerance, and the moderating role of gender among university students. Method: The present study was descriptive–correlational and applied in nature. The statistical population consisted of 4,000 male and female students of Islamic Azad University, Central Tehran Branch, from whom 352 students were selected using stratified random sampling. The research instruments included Allport’s (1950) Religious Orientation Questionnaire, Snyder’s (1991) Hope Scale, Ellison’s (1982) Spiritual Health Questionnaire, Gross and John’s (2001) Emotion Regulation Questionnaire, and Simmons and Gaher’s (2005) Distress Tolerance Questionnaire. Data analysis included descriptive statistics, and structural equation modeling was used in the inferential section using SmartPLS 4 software. Results: Based on the statistical results, the total effect of hope on spiritual health mediated by emotion regulation was positive in male students (β = 0.389) and negative in female students (β = −0.181). In addition, the total effect of religious orientation on spiritual health mediated by emotion regulation was positive in male students (β = 0.369) and negative in female students (β = −0.085). Moreover, the total effect of hope on spiritual health mediated by distress tolerance was positive in male students (β = 0.415) and negative in female students (β = −0.189). Furthermore, the total effect of religious orientation on spiritual health mediated by distress tolerance was positive in male students (β = 0.324) and negative in female students (β = −0.105). In the present model, the SRMR value in the male student group was 0.071 and in the female student group was 0.060, both of which are smaller than the recommended cutoff value of 0.08. In addition, the NFI value in the male student group was 0.715 and in the female student group was 0.657, which are considered acceptable and indicate adequate measurement model fit in both groups. Moreover, the t-values for the direct and indirect effects of all research variables were smaller than 1.96. Therefore, it can be concluded that, at the 95% confidence level, gender did not moderate the indirect effects among the research variables. In other words, there was no significant difference in the effectiveness of the examined psychological constructs between male and female students. Conclusion: Based on the results obtained from the present study, the total effect of hope on spiritual health mediated by emotion regulation was statistically significant and positive in male students and negative in female students. Studies by Ruggins et al. (2022) indicate that hope, as a cognitive factor, can help individuals achieve success. This construct reflects individuals’ capacity to generate multiple pathways and strategies to attain goals, needs, and desires (McNamara et al., 2023), and it can function as a coping strategy against stressful life events while enhancing resilience and flexibility. Furthermore, Taghavi and Amiri (2023) showed that individuals with a spiritual orientation accept life realities more effectively and experience higher levels of hope, which is consistent with the findings of the present study. Based on the results of the study, the total effect of religious orientation on spiritual health mediated by emotion regulation was statistically significant and positive in male students and negative in female students. In this regard, Allport (1968) conceptualized religion as a unifying philosophy of life and considered it an important factor in mental health. He emphasized the relationship between intrinsic religious orientation and mental health, suggesting that intrinsic religiosity, in contrast to extrinsic religiosity, promotes psychological well-being. Similarly, Abbasi (2023) found a relationship between emotional stability and religious orientation, indicating that as extrinsic religious orientation increases, emotional instability also increases, whereas greater intrinsic religious orientation is associated with enhanced emotional stability, which is consistent with the results of the present study. Moreover, based on the results of the study, the total effects of hope and religious orientation on spiritual health mediated by distress tolerance were statistically significant and positive in male students and negative in female students. Simmons and Gaher (2005) conceptualized distress tolerance as an individual capacity that is challenged in difficult and stressful life situations and defined it as the ability to experience and tolerate negative emotional states. Distress tolerance is an individual-differences variable that reflects the capacity to experience and withstand emotional distress and provides a basis for individuals’ adaptation across various environments, which is consistent with the findings of the present study.The results also showed that hope and religious orientation play important roles in individuals’ spiritual health, and that gender does not have a moderating role in this process. No significant differences were found between male and female students in the impact of the examined psychological variables on spiritual health. Therefore, based on the results obtained, it is suggested that more extensive research on this topic be conducted in other social groups, including employees of organizations and companies. In addition, training programs may be implemented through universities, municipalities, and counseling centers to enhance individuals’ knowledge and skills related to emotion regulation, distress tolerance, hope, religious orientation, and spiritual health. A limitation of the present study is the limited generalizability of the findings to populations beyond university students.
Narges Raoofi Adegani; Maryam Zarnaghash; Majid Barzegar; Nadere Sohrabi Shegefti
Abstract
Objective: Cancer is one of the most important health problems worldwide. Childhood cancer is a leading cause of death worldwide, and the leading cause of death in children and adolescents. The World Health Organization (2021) estimates that the number of new cases of cancer will increase to 26 million ...
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Objective: Cancer is one of the most important health problems worldwide. Childhood cancer is a leading cause of death worldwide, and the leading cause of death in children and adolescents. The World Health Organization (2021) estimates that the number of new cases of cancer will increase to 26 million worldwide by 2040, increasing the global burden of cancer. Despite significant advances in the treatment of this chronic disease, this diagnosis is still devastating for family members of children and causes major changes in their lives. The changes in the child's condition, the impact of the side effects of the medication used, and the disease on his physical condition will cause severe psychological problems in mothers. Parental burnout is a significant psychological concern that can adversely affect parenting quality, particularly in mothers who care for children with chronic illnesses such as cancer. These mothers often experience elevated levels of psychological distress due to the emotional, physical, and financial demands of caring for a child with a life-threatening condition. Exposure of parents to prolonged stress related to childcare leads to parental burnout, a state of intense and overwhelming fatigue related to the parental role, in which parents become emotionally distant from their children and, unlike in the past, doubt their capacities as effective and good parents. In recent years, attachment theory and mindfulness have emerged as critical psychological constructs that may influence how individuals cope with stress and caregiving demands. According to Bowlby's attachment theory, the early emotional bonds between the child and the mother (caregiver) are internalized in the form of mental models and are generalized to the child's wider range of interpersonal relationships in the future. The mental model creates a set of expectations and beliefs about the self and others and the relationships between them. Which arouses the individual's emotions in stressful situations. The pattern of these relationships, in the form of attachment style, remains relatively constant throughout the individual's life. Bowlby described three types of attachment in childhood: secure, avoidant, and anxious (ambivalent). This has also been confirmed in adulthood. Mindfulness is defined as paying attention on purpose in the present moment, without judgment. In other words, mindfulness is adopting a non-judgmental attitude toward personal experiences. It is an ongoing, moment-to-moment process that allows the individual to be less reactive and more accepting of these experiences. Mothers with children with chronic diseases, especially cancer, are at serious risk of developing parental burnout syndrome. And so far, parental burnout has not been studied in this at-risk and care-seeking community. Therefore, examining the present conceptual model will be necessary to improve local knowledge about parental burnout in Iranian mothers, especially the sensitive community of mothers with children with cancer, and also to create a perspective to reduce this distressing experience by cultivating awareness in them. Understanding how maternal attachment styles and mindfulness interact to influence parental burnout can contribute to the development of targeted interventions for at-risk mothers. Method: The present study aimed to examine a causal model of parental burnout based on maternal attachment, with the mediating role of mindfulness, in mothers of children diagnosed with cancer. This study employed a descriptive-correlational design using structural equation modeling (SEM) to test the hypothesized relationships among variables. The statistical population included all mothers of children with cancer who were referred to pediatric oncology units of Omid Hospital in Esfahan, Iran, in 2024. Using convenience sampling, 250 mothers were selected and asked to complete three standardized questionnaires: the Parental Burnout Assessment (PBA), the Adult Attachment Scale (Collins & Read, 1990), and the Five Facet Mindfulness Questionnaire (FFMQ). Results: The data were analyzed using SPSS version 26 and AMOS version 24. The structural model showed a good fit to the data (χ²/df =3.89, RMSEA=0.078, CFI=2.963). The findings indicated that the direct relationship between secure attachment (β=-0.213, p<0.05), avoidant attachment style (β = 0.256, p<0.05), anxious attachment style (β=0.137, p<0.05), and mindfulness (β=-0.66, p<0.05) had significant direct relationships with parental burnout. Nonetheless, the indirect effects of all three attachment styles (secure, anxious, avoidant) on parental burnout through mindfulness as a mediator were found to be significant (p<0.001). Conclusion: This study aimed to investigate the causal model of parenting burnout in mothers of children with cancer based on maternal attachment with the mediating role of maternal mindfulness. The results supported the direct relationship between secure attachment style and avoidant attachment style negatively, anxious attachment style positively, and maternal mindfulness negatively with parenting burnout. The results showed that maternal mindfulness has a mediating role in parenting burnout based on attachment styles (secure, avoidant, anxious). The study's findings showed that a secure attachment style is negatively associated with burnout among mothers. This means that mothers with secure attachment style experience less parenting burnout. These findings support the theoretical proposition that mindfulness acts as a protective factor against parental burnout and that secure attachment fosters adaptive coping strategies through increased present-moment awareness and emotion regulation. The results emphasize the need for preventive and therapeutic interventions that focus on promoting secure attachment and enhancing mindfulness in mothers of children with cancer. Mindfulness-based parenting programs and attachment-informed counseling could be particularly effective in reducing parental stress and burnout in this high-risk group. In conclusion, this study contributes to the growing body of literature highlighting the interplay between attachment, mindfulness, and psychological well-being among caregiving mothers. It underscores the importance of incorporating psychological factors into pediatric cancer care, not only for the child but also for the primary caregiver. Future research may explore longitudinal designs and intervention studies to establish causal links and practical applications.
Minoo Irani; Hossein Zare; Mohammad Oraki; Ezatallah Kordmirza Nikoozadeh; Amin Rafieipoor
Abstract
Objective: One of the autoimmune diseases is Systematic Lupus Erythematosus (SLLE) (Riaz et al., 2022). Lupus is a chronic autoimmune disease affecting multiple systems and organs at different times and incurring extensive damage to the patient (Chen et al., 2022). Lupus can affect various aspects of ...
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Objective: One of the autoimmune diseases is Systematic Lupus Erythematosus (SLLE) (Riaz et al., 2022). Lupus is a chronic autoimmune disease affecting multiple systems and organs at different times and incurring extensive damage to the patient (Chen et al., 2022). Lupus can affect various aspects of patients' lives and their psychological and physical health and lead to impairing their quality of life (Hanly et al., 2019). The study done by Wang et al. (2022) in a group of lupus patients reported that the majority of patients expressed problems such as feelings of depression, anxiety and psychological distress, stress and inability to accept changes in mental image. The results of the research by Hanley et al. (2022) indicated that lupus, with its effects on the central nervous system, brings about significant psychological distress and anxiety in such patients. By reviewing the research cases performed in this area, psychological interventions on this disease can improve the secondary disease relevant symptoms and even help with biological therapies for individuals (Irani et al. 2019, Nabi et al. 2020, Oreki et al. 2021). Consistent with psychological interventions, one of such interventions is compassion-focused therapy(CFT), which has appealed modern therapists for unique diseases (Rezaei et al. 2021). Another intervention run among the affected patients is acceptance and commitment therapy(ACT). The aspects under the influence of SLE, which are one of its most important aspects, are often overlooked and little research has been done on it, and considering domestic research, few studies have been conducted on psychological interventions in SLE suffering patients. Pursuant to the performed studies, the effectiveness of compassion-focused therapy in the patients with lupus has not been much studied. On the other hand, in the performed studies, the component of social acceptance in SLE patients has received less attention and improving social acceptance in such patients requires training. As a result, it seems that concentrating on the patient's own psychological issues (such as reducing or controlling stress, focusing on their self-care, and social acceptance) is one of the best treatment methods for the patient. Regarding the above stated statements, the current study was developed and implemented targeting to compare the effectiveness of acceptance and commitment-based therapy training and a compassion-focused therapy on enhancing the psychological, social and biological indicators in the patients with systematic lupus erythematosus(SLE) in public hospitals covered by Tehran University of Medical Sciences. Method: This study was applied in terms of goal and experimental in terms of method with a pre-and post-test design, a control group and a two-month follow-up. Once the research topic was selected and approved and the relevant code of ethics (IR.PNU.REC.1403. 666) and the due permits were granted by the authorities, 45 patients who referred to the hospital were interviewed with their consent, and this interview was held in a separate room for convenience and thanks to the relevant authorities. In the interview, all the conditions of the subjects were checked according to the pre-designed items and the relevant questionnaires were handed to them simultaneously for being completed. Next, the subjects were randomly assigned to three 15-person groups, including the experimental groups (the ACT and CFT training and the control group) by drawing lots. Subsequently, the subjects in the two experimental groups attended eight 90-minute sessions of acceptance and commitment therapy(ACT) and compassion-focused therapy(CFT), while the control group did not undergo training during the intervention and were merely in the consultation sessions with their therapist. Finally, all three experimental and control groups took the post-test. Results: The results of one-way ANOVA in the psychological and social indicators in the two groups based on CFT and ACT indicated a statistically significant difference between the mean scores of post-test and considering the effect of time in the variables of depression (P<0.001, F=41.95, η2=0.666), anxiety (P<0.001, F=44.38, η2=0.679) and quality of life (P<0.001, F=110.342, η2=0.840). The results of one-way ANOVA with repeated measures in the psychological and social indicators in the two groups based on CFT and ACT revealed a statistically meaningful difference between the mean scores of post-test and considering the effect of time in the variables of depression (P<0.001, F=28.42, η2=0.668), anxiety (P<0.001, F=38.42, η2=0.759), and quality of life (P<0.001, F=35.124η2=0.856). pursuant to results of the Cochrane’s Q test, a tangible difference was observed between the three groups in terms of Antinuclear Antibody (ANA) Test immediately after the intervention (Mean rank = 1.83, p=0.0001). Conclusion: The present study was done to compare the effectiveness of acceptance and commitment-based therapy and compassion-focused therapy on enhancing the biological, psychological and social indicators in female patients with SLE in Tehran. The findings displayed that both training methods were effective in improving the psychological, social and biological indicators of women with lupus and no significant difference was reported between these two educational methods. Overall, it indicated that acceptance and commitment therapy and compassion-focused therapy were equally effective on the biological, psychological and social indicators of the SLE suffering women. This result can demonstrate the key role of interventions such as ACT-based and CFT in enhancing the biological, psychological and social indicators. This finding can be a basis for developing educational programs for the women with lupus and can also help psychologists and counselors to use this educational plan to promote women's health. Like any other research, this study has its own limitations, which include short-term follow-up of the effect of the implemented educational program, small sample size, data collection through questionnaires, and failure to hold a follow-up phase due to lack of access to patients living in different regions. Therefore, it is recommended to conduct follow-up periods to address the effect of this intervention during a long-term period and to add others.
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