Search Results (72)

Background: Juvenile fibromyalgia (JFM) is a chronic pain disorder characterised by widespread musculoskeletal pain, functional impairment, fatigue, and mood disturbances. Treatment remains challenging, considering the multifactorial nature of the condition and the limited high-quality evidence supporting pharmacological or non-pharmacological interventions. Objectives: This review aimed to critically appraise level I evidence from randomised controlled trials assessing the efficacy and safety of pharmacological and non-pharmacological treatments for adolescents with JFM. Methods: Seven published peer-reviewed clinical trials were examined, including studies investigating duloxetine, milnacipran, pregabalin, cognitive-behavioural therapy (CBT), and the integrated Fibromyalgia Integrative Training Teens (FIT) program, which combines CBT with neuromuscular training. Outcomes of interest included pain intensity, functional disability, depression symptoms, physical activity, and adverse events. Results: Pharmacological agents such as duloxetine, milnacipran, and pregabalin demonstrated modest improvements in pain, but failed to produce consistent benefits in function or mood, and were associated with a high incidence of adverse effects. CBT significantly improved functional disability and depression symptoms, yet it had a limited impact on pain reduction or objectively measured activity levels. The FIT Teens program showed superior outcomes in pain intensity and biomechanical function compared to CBT alone, suggesting a synergistic effect of combining psychological and physical reconditioning strategies. Conclusions: Current evidence supports the use of multimodal treatment approaches in JFM. Non-pharmacological interventions, particularly when integrated with structured exercise, offer meaningful benefits with minimal safety concerns. Larger, methodologically rigorous trials are needed to establish optimal treatment pathways and long-term outcomes for this complex and underserved paediatric population. Full article

Background: Tobacco use remains a major public health concern among young adults and is often complicated by co-occurring addictive behaviors. Objective: This study analyzed motivation for change, assessed with the decisional balance framework, in relation to multiple addictions among young smokers seeking treatment. Methods: Ninety-eight participants from the University of Granada enrolled in either an app-based cognitive–behavioral therapy (CBT) program (n = 35) or a traditional face-to-face CBT program (n = 63). Recruitment relied on self-identification and voluntary participation. Standardized instruments were applied to measure nicotine dependence (FTND), behavioral and substance-related addictions (MULTICAGE CAD-4), cannabis dependence (SDS), and motivation for change (DBQ). Logistic and stepwise regression analyses were conducted to identify predictors of treatment choice and motivational outcomes. Results: Younger participants and students were more likely to choose the app-based program. Compulsive buying was linked to perceiving more disadvantages of smoking, whereas sex addiction, cannabis dependence, and other substance addictions were associated with perceiving fewer disadvantages. Conclusions: Treatment preferences and motivational profiles differ according to age, academic status, and co-occurring addictions. These findings highlight the need to tailor smoking cessation strategies to individual profiles and support the role of mobile health tools in engaging digitally oriented populations. Full article

Attention-deficit/hyperactivity disorder (ADHD) presents unique challenges for middle school students, a population navigating heightened academic, social, and emotional demands. This review examines empirical literature on school-based interventions targeting ADHD in middle school populations, a group often under-represented in intervention research. This review synthesizes findings from studies on academic accommodations, organizational training (e.g., HOPS), self-management strategies, mental health supports (e.g., CBT), and integrated programs like STAND and the Challenging Horizons Program. Evidence suggests that targeted school-based interventions can improve executive functioning, task engagement, academic performance, and social–emotional outcomes. However, interventions vary in efficacy depending on implementations’ fidelity, individual differences, and contextual supports (such as family involvement and school resources). Although promising, many interventions are limited by scalability, sustainability, and a lack of rigorous longitudinal data. This paper identifies critical gaps in middle school-specific research and highlights the need for future studies on long-term outcomes, student self-advocacy, and the reduction of stigma. Overall, this review underscores the potential of multi-component, school-based approaches to mitigate academic and behavioral challenges in middle school students with ADHD. We also call for expanded efforts to tailor and sustain these interventions in real-world educational settings. Full article

(1) Background: This study aimed to identify baseline demographic, clinical, and psychosocial predictors of treatment response in adolescents with anorexia nervosa (AN) undergoing an intensive 20-week enhanced cognitive behavioral therapy (CBT-E) program, which included inpatient and day patient phases. Treatment outcomes were assessed at the end of intensive treatment (EOIT) and at a 20-week follow-up. (2) Methods: A prospective cohort of 68 adolescents under the age of 16 consecutively admitted to intensive CBT-E was evaluated. Baseline measures included body mass index (BMI)-for-age percentiles, percentage of expected body weight (%EBW), eating disorder psychopathology (EDE-Q), general psychopathology, and functional impairment. (3) Results: Of those who began treatment, 83.4% completed the program and 70.2% were available for follow-up assessment. Based on intent-to-treat analysis, 94.1% achieved a “good BMI outcome” and 73.5% met criteria for “full response” at EOIT. At follow-up, 64.7% maintained a good BMI and 55.9% sustained a full response. Completers’ analysis indicated that baseline body weight, clinical impairment, general psychopathology, and weight regain influenced treatment outcomes. However, no baseline demographic or clinical variables predicted treatment completion or outcome at either time point at intention-to-treat analysis, except that younger age at admission was linked to higher eating disorder psychopathology at follow-up. (4) Conclusions: In treatment completers, certain baseline clinical factors and weight regain influenced outcomes, while in the full sample, younger age predicted greater residual psychopathology at follow-up. These findings, if confirmed, emphasize the need for early intervention, focused support for weight regain, and potential adaptations of CBT-E for early adolescents. Full article

Objectives: This study assessed the effectiveness of a cognitive behavioral therapy (CBT)-based fine dust education program, grounded in the Health Belief Model (HBM), on elementary students’ fine dust knowledge, related behaviors, and mental health (depression, anxiety, stress, sleep quality). Methods: From September to November 2024, 95 students (grades 4–6) living near a coal-fired power plant in midwestern South Korea were assigned to either an intervention group (n = 44) or a control group (n = 51). The intervention group completed a three-session CBT-based education program; the control group received stress management education. Assessments were conducted at weeks 1, 2, 4, and 8 using standardized mental health and behavior scales (PHQ: Patient Health Questionnaire, GAD: Generalized Anxiety Disorder Assessment, PSS: Perceived Stress Scale, ISI: Insomnia Severity Index). Results: A chi-square test was conducted to compare pre- and post-test changes in knowledge and behavior related to PM2.5. The intervention group showed significant improvements in seven fine dust-related knowledge and behavior items (e.g., PM2.5 awareness rose from 33.3% to 75.0%; p < 0.05). The control group showed limited gains. Regarding mental health, based on a mixed-design ANCOVA, anxiety scores significantly declined over time in the intervention group, with group and interaction effects also significant (p < 0.05). Depression scores showed time effects, but group and interaction effects were not significant. No significant changes were observed for stress, sleep, or group × PM2.5 interactions. Conclusions: The CBT-based education program effectively enhanced fine dust knowledge, health behaviors, and reduced anxiety among students. It presents a promising, evidence-based strategy to promote environmental and mental health in school-aged children. Full article

Maternal mental illness significantly impacts caregiving, influencing both mothers and their children. This narrative review examines the challenges faced by mothers with conditions such as depression, anxiety, bipolar disorder, and schizophrenia, which often disrupt caregiving routines, emotional stability, and social integration. These difficulties can hinder secure attachments and contribute to adverse developmental outcomes in children, including heightened risks of anxiety, depression, behavioral issues, and cognitive impairments. Children of mothers with mental illnesses are 1.8 times more likely to develop emotional or behavioral problems and face a 2.7 times higher risk of suicidal ideation during adolescence. Intergenerational transmission of mental illness is also prevalent, with affected children showing a 2.5 times greater likelihood of developing mental illnesses in adulthood. Effective interventions include cognitive behavioral therapy (CBT), family-based approaches, and community programs integrating parenting education and mental health resources. These strategies have demonstrated improvements in maternal well-being and child resilience. The review highlights the need for comprehensive policies addressing maternal mental health, early intervention for children, and culturally sensitive support systems to break cycles of intergenerational mental illness. Future research should prioritize evaluating long-term intervention effectiveness and exploring innovative tools like digital mental illnesses solutions to support affected families. Full article

Background and Objectives: Psychological distress is a pervasive yet often undertreated aspect of the cancer experience, contributing to reduced quality of life, poorer treatment adherence, and worse health outcomes. This systematic review and meta-analysis evaluated the efficacy of non-pharmacological, evidence-based psychological interventions on distress, depression, anxiety, coping capacity, and quality of life in adult cancer patients. Interventions were grouped into three domains: structured psychotherapeutic therapies (e.g., Cognitive Behavioral Therapy [CBT], Acceptance and Commitment Therapy [ACT], Meaning-Centered Psychotherapy [MCP]); mindfulness and stress reduction programs (e.g., Mindfulness-Based Stress Reduction [MBSR], Mindfulness-Based Cognitive Therapy [MBCT]); and coping and resilience-enhancing modalities (e.g., Promoting Resilience in Stress Management [PRISM], expressive writing). Materials and Methods: Following PRISMA guidelines, 42 randomized controlled trials published between 2015 and 2025 were included. A stratified meta-analytic approach calculated pooled standardized mean differences for each intervention class and outcome. Heterogeneity, subgroup, and moderator analyses explored drivers of effect variability. Results: Structured psychotherapeutic interventions yielded the largest effects, especially for depression. Mindfulness-based interventions produced moderate but significant improvements in distress and emotional regulation. Coping and resilience programs provided smaller yet statistically significant gains in adaptive coping. Between-study heterogeneity was moderate, partly explained by intervention type, delivery modality, and cancer subtype. Conclusions: These findings support integrating psychosocial care into standard oncology protocols and endorse its routine implementation as a core component of comprehensive cancer treatment. Full article

Background/Objectives: Cystic fibrosis (CF) is a chronic genetic disease that impacts both physical and psychological health, increasing vulnerability to anxiety, depression, and reduced quality of life (QoL). Psychological interventions, particularly cognitive behavioral therapy (CBT), have demonstrated promising results in enhancing emotional resilience, treatment adherence, and QoL. This systematic review aims to evaluate the role and effectiveness of psychological interventions in improving the QoL among individuals with CF. Methods: A comprehensive literature search was conducted across the PubMed, Scopus, and PsycINFO databases for studies published between 2014 and 2024, in line with PRISMA guidelines and a registered PROSPERO protocol. Out of 162 initially identified articles, six clinical studies met the inclusion criteria. Intervention included cognitive behavioral therapy-based interventions, employing several digital or telehealth formats such as fibrosis-specific cognitive behavioral therapy (CF-CBT) and the coping and learning to manage stress (CALM) program, often delivered via telehealth. Results: Most interventions demonstrated significant reductions in depression, anxiety, and perceived stress, alongside improvements in coping self-efficacy and vitality. Cohen’s d-effect sizes ranged from moderate to large for core psychological outcomes. QoL measures, particularly vitality and emotional functioning, were significantly enhanced in most studies. Conclusions: Psychological interventions, particularly CBT and ACT, significantly improve mental health and QoL in individuals with CF, supporting their integration into routine care. Full article

Cognitive behavioral therapy (CBT) has proven effective in addressing the psychological and emotional challenges of cancer. This study evaluated the impact of a self-esteem enhancement intervention integrated into a standard CBT protocol on the quality of life and self-esteem of women with colorectal cancer. Conducted at Spitalul Județean Clinic Bihor (Romania) between August 2020 and March 2024, the study included 67 women aged 32 to 66 years undergoing chemotherapy or combined chemotherapy and radiotherapy. This study aimed to evaluate the impact of a self-esteem enhancement intervention integrated into a standard CBT protocol on the quality of life and self-esteem of women with colorectal cancer. Participants were assigned to a CBT group, receiving eight weekly sessions based on the Simonton Program, or a control group on a psychotherapy waiting list. Quality of life was assessed using the EORTC QLQ-C30 questionnaire, and self-esteem was measured through actual and ideal self-perceptions. A repeated measures ANOVA analyzed changes in both outcomes. Results showed a significant improvement in quality of life (F = 6.33, df = 1, 65, p < 0.05) and self-esteem (F = 4.46, df = 1, 65, p < 0.05) in the CBT group, whereas no improvements were observed in the control group. Self-esteem was enhanced through reduced discrepancies between actual and ideal self-perceptions, especially in cognitive and emotional dimensions. Physical functioning improved but was less pronounced, influenced by disease progression and treatment stage. No significant changes were observed in social functioning, suggesting that longer-term interventions may be needed. These findings highlight CBT as a valuable complementary intervention in oncology care, supporting its integration into standard treatment to enhance patients’ psychological well-being and quality of life. Full article

Background: Stroke is a primary cause of adult disability and often causes cognitive impairment. Rehabilitation interventions aim to enhance patients’ cognitive abilities, thereby addressing care needs, improving quality of life, and optimizing performance in compromised functions. Objective: To evaluate the impact of incorporating cognitive–behavioral training (CBT) into a selected exercise program on cortical reorganization and cognitive recovery in post-stroke patients. Methods: Thirty post-stroke patients of both sexes (27 male and 3 female) aged from 40 to 65 years were randomly divided into two groups: the study group (n = 15) received CBT combined with a selected exercise program including weight-bearing, balance, and aerobic exercises, while the control group (n = 15) underwent the selected exercise program only. All participants engaged in an 8-week intervention with three sessions per week. Cortical reorganization was measured using quantitative electroencephalography (QEEG) at electrode sites F3, F4, T5, and T6, and cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) and RehaCom, focusing on memory, attention, concentration, logical reasoning, and reaction behavior. Assessments were carried out for all patients before and after the 8-week treatment program. Results: Improvements were assessed through three key measures: QEEG, the MoCA, and RehaCom. Post-intervention, the study group demonstrated a significantly higher (alpha + beta)/(delta + theta) ratio at F3, F4, T5, and T6 (p < 0.01), indicative of enhanced cortical reorganization. MoCA scores increased by 16.98% in the study group compared to 7.40% in the control group (p < 0.01). Additionally, RehaCom assessments revealed marked improvements in memory, attention, logical reasoning, and reaction behavior in the study group (p < 0.01). Conclusions: Integrating cognitive–behavioral training with a selected exercise program significantly enhances cortical reorganization and cognitive recovery in post-stroke patients. These findings suggest that adding CBT to rehabilitation protocols can effectively address deficits in memory and attention, ultimately improving functional outcomes. Full article

Learn to Fly was developed between February 2022 and March 2023 with the goal of fostering greater social participation and intergenerational dialogue around the recognition and solution of pertinent social issues through the development of psychological flexibility and socioemotional competences in children at the start of their academic careers. Based on a participatory methodology and the concepts of the third generation of Cognitive Behavioral Therapies (CBTs) and ACT (Acceptance Commitment Therapy), the target audience included children of ages 5 and 6 (pre-school and first grade), their teachers, and their families. The Learn to Fly pilot initiative was implemented in eight partner institutions on the Portuguese mainland with the participation of 289 children, their families, and 22 educators. Learn to Fly was evaluated after 12 weeks of implementation using a combination of methodologies, including interviews, focus groups, and pre- and post-tests. Teachers emphasized that the initiative brought families closer to the school, thereby strengthening connections between the school and the community, when analyzing the impact of the project on the school community. Positive changes were observed in the children’s behaviors, particularly with respect to hyperactivity, relationship problems with colleagues, prosocial behavior, socioemotional skills, their perceptions of their participation in various scenarios (their city and country), and intergenerational dialogue with their parents. In addition to the teachers’ preconceived notions about child participation, they became more aware of the possibility of children having a say in decision-making and discovered that the program promoted this aspect. Presently equipped with resources, it is envisaged that teachers trained to implement Learn to Fly will play a significant role in promoting positive child development and social engagement. Full article

Background/Objectives: Although physical exercise provides numerous health benefits, it can occasionally become addictive, leading to negative consequences for physical and mental health. Specifically, the role of maladaptive schemas in the relationship between exercise addiction and self-esteem underscores the importance of addressing these cognitive patterns in therapeutic settings to develop practical interventions that enhance exercise with healthier self-perceptions. This study aims to analyze the role of early maladaptive schemas in the relationship between exercise addiction and self-esteem. Methods: The design of this study is non-experimental, correlational, and cross-sectional. The sample comprised 788 university women students (mean age 20.39 years, SD = 2.28). Results: Exercise addiction is negatively associated with self-esteem and shows positive but weak correlations with most early maladaptive schemas, except for Impaired Autonomy. A mediating effect was identified for Disconnection and Rejection (β = −0.08, p = 0.008), Impaired Limits (β = −0.03, p = 0.019), Other Directedness (β = −0.04, p = 0.032), and Over-Vigilance and Inhibition (β = −0.05, p < 0.001). Full mediation was observed for Disconnection and Rejection and Over-Vigilance and Inhibition, while Impaired Limits and Other Directedness showed partial mediation. Conclusions: These findings suggest that the decrease in self-esteem among individuals with exercise addiction could be explained by the activation of maladaptive schemas that influence exercise motivation, with Over-Vigilance and Inhibition standing out in particular. Furthermore, it is necessary to develop cognitive behavioral therapy (CBT)-based interventions focused on modifying early maladaptive schemas and strengthening self-esteem. Additionally, it would be advisable to implement educational programs in university and sports settings that promote well-being and enjoyment over the pursuit of external validation or obsession with body image. These strategies could help prevent exercise addiction and mitigate its negative effects on self-esteem. Full article

Background/Objectives: Cognitive and psychological factors, such as eating disorder psychopathology, irrational food beliefs, and internalized weight stigma, have not been sufficiently explored in the context of obesity treatment. This study evaluated the role of these variables as predictors of weight loss in patients with severe obesity following a brief intensive cognitive–behavioral therapy for obesity (CBT-OB) program. Methods: A total of 400 patients (mean BMI: 41.9 kg/m²; mean age: 55.9 years) participated in a 21-day residential CBT-OB intervention, followed by a 12-month follow-up assessment. The Eating Disorder Examination Questionnaire, Weight Bias Internalization Scale, and Irrational Food Beliefs Scale were administered at admission and discharge. Body weight was also assessed at the 12-month follow-up. Results: Of the participants, 371 patients (92.2%) completed the intensive CBT-OB program, and 310 (81.1%) attended the follow-up. On average, completers achieved 9% weight loss at follow-up, accompanied by a significant reduction in binge-eating episodes. Cognitive factors, including lower baseline eating concern, higher baseline weight concern, and greater improvement in irrational beliefs (specifically self-deception about eating and weight control), significantly predicted weight loss at 12 months. However, internalized weight stigma did not predict weight loss in this cohort. Conclusions: This study underscores the importance of targeting specific cognitive factors in obesity treatment to enhance long-term outcomes. Addressing irrational food beliefs and promoting flexible dietary restraint may improve weight loss and maintenance in individuals with severe obesity. Further research is warranted to refine cognitive–behavioral interventions for personalized obesity management strategies. Full article

Type 1 Diabetes (T1D) is a progressive autoimmune disease often identified in childhood or adolescence, with early stages detectable through pre-diabetic markers such as autoantibodies and subclinical beta-cell dysfunction. The identification of the pre-T1D stage is critical for preventing complications, such as diabetic ketoacidosis, and for enabling timely interventions that may alter disease progression. This review examines the multifaceted approach to managing T1D risk in adolescents and teens, emphasizing early detection, nutritional interventions, beta-cell preservation strategies, and psychosocial support. Screening for T1D-associated autoantibodies offers predictive insight into disease risk, particularly when combined with education and family resources that promote lifestyle adjustments. Although nutritional interventions alone are not capable of preventing T1D, certain lifestyle interventions, such as weight management and specific nutritional choices, have shown the potential to preserve insulin sensitivity, reduce inflammation, and mitigate metabolic strain. Pharmacological strategies, including immune-modulating drugs like teplizumab, alongside emerging regenerative and cell-based therapies, offer the potential to delay disease onset by protecting beta-cell function. The social and psychological impacts of a T1D risk diagnosis are also significant, affecting adolescents’ quality of life, family dynamics, and mental health. Supportive interventions, including counseling, cognitive-behavioral therapy (CBT), and group support, are recommended for managing the emotional burden of pre-diabetes. Future directions call for integrating universal or targeted screening programs within schools or primary care, advancing research into nutrition and psychosocial support, and promoting policies that enhance access to preventive resources. Advocacy for the insurance coverage of screening, nutritional counseling, and mental health services is also crucial to support families in managing T1D risk. By addressing these areas, healthcare systems can promote early intervention, improve beta-cell preservation, and support the overall well-being of adolescents at risk of T1D. Full article

Background: Mental illnesses are pervasive amongst children and adolescents with intellectual disabilities (ID), particularly anxiety disorders. To date, there has been limited research on the use of cognitive behavior therapy (CBT) as a potential treatment for this population. Fearless Me! © is an adapted CBT program specifically designed to treat anxiety in children and adolescents with mild to moderate ID. Method: Three children, aged between ten and sixteen, participated in group delivery of the Fearless Me! © program. Measures of anxiety were completed pre- and post-treatment by both the children and the parents. Results: For one child, a significant reduction in anxiety was observed, whilst another child showed significant improvement in emotional competence. Conclusions: This case series highlights the need for additional research into the utility of the adapted CBT program, Fearless Me! © to reduce anxiety in children and adolescents with ID. Full article