Objectives: Most of the women around the globe experience low back pain which often has a psychological overlay. Acceptance and Commitment Therapy (ACT) can enhance psychological condition and subsequently improve mental health. Thereby the quality of life of individuals with chronic low back pain gets improved. The study rationale aimed to assess the effectiveness of ACT on quality of life, severity and duration of pain in women with chronic low back pain. Methods:Twenty subjects (women aged between 23 to 34 years) with chronic low back pain from a rehabilitation clinic in Rasht city in the year 2016 were included in the study by convenience sampling method. They were then randomly divided into experimental and control groups (in each group, n=10). Data were collected by a three-part checklist containing demographic characters, World Health Organization Quality of Life questionnaire and McGill Pain Questionnaire. The rehabilitation interventions were based on ACT carried out for eight sessions of one hour each, twice a week. The collected data were analyzed by SPSS software via Paired t-test and independent t-test method.Results: There was a significant increase in all subscales of quality of life (P<0.001) except subscale of physical health (P<0.38) in experimental group. Independent t-test showed a significant decline in mean severity and duration of pain in the experimental group compared to control group. Discussion:The effects of ACT rehabilitation technique on women with chronic low back pain were impressive, which augmented the quality of life. Hence this method can be used as a rehabilitation tool for women with chronic low back pain. A B S T R A C T

Background: Multiple sclerosis (MS) is considered a chronic disease in which physical and mental disorders are common among these patients. This study aimed to evaluate the effectiveness of the Lazarus multimodal approach intervention on psychological distress, working memory, and anxiety in patients with MS. Methods: A quasi-experimental research method with pre-test, post-test, and follow-up and a control group was used in this study. The statistical population of the study included the patients who were members of the "MS Patient Support Society" in Tehran who had been referred to this center during January and March 2017. The sample consisted of 32 people selected by the convenience sampling method from the members of the MS community. The data were obtained through the Kessler psychological distress scale (K10), the Wechsler’s Working Memory Index, and the Beck Anxiety Inventory. The experimental group underwent the Lazarus multimodal approach in ten 90-minute sessions of two sessions per week for one and a half months. The control group received no intervention. The follow-up was performed three months after the post-test. The repeated measurement method and SPSS 22 were used to analyze the data. Results: The findings showed that the Lazarus multimodal approach had a significant effect on decreasing anxiety (P<0.001), psychological distress (P<0.001), and increasing working memory (P<0.001). Conclusion: It can be concluded that Lazarus’ multimodal approach was effective on anxiety, psychological distress, and working memory and can be employed to reduce psychological problems in patients with MS.

Background and Objectives: Fatigue and pain are the common complications in patients suffering from multiple sclerosis (MS), which is influenced by the patients' psychological status as well as stress. The current study aimed at investigating the protective mediating role of sense of coherence in the relationship of perceived stress with fatigue and pain in Iranian MS patients. Methods:This cross-sectional study was carried out in 2019. The study population consisted of patients who were members of the Iranian MS association in Tehran, Karaj, and Qom, Iran. The sampling was performed via the convenience sampling method using a multi-center design in MS centers in Tehran, Karaj, and Qom, Iran. In total, 452 patients with a mean age of 38.45±9.36 years were included in the study. The data were collected using the Orientation to Life Questionnaire (OLQ-13, Antonovsky, 1978), Perceived Stress Scale (PSS, Cohen et al., 1983), and Visual Analogue Scale for fatigue and pain (VAS-F and VAS-P, Hayes and Patterson, 1921). The mediation analysis was carried out via PROCESS macro in SPSS software. A pvalue less than 0.05 was considered statistically significant.Results: Pain and fatigue showed significant positive and negative relationships with perceived stress and sense of coherence, respectively (P<.001). Furthermore, the sense of coherence could reduce 25% of the total effect of perceived stress on fatigue and pain; however, the results remained significant in the presence of gender, education level, employment status, and illness duration only for fatigue (indirect effect = -0.07, [0.01, 0.14]). Conclusion:Sense of coherence reduces the effect of perceived stress on fatigue in MS patients. However, it does not affect the relationship between perceived stress and pain among these patients.

Background:Although very few studies have investigated the association of narcissistic symptoms and aggressive driving, very little is known about association of narcissism and serious traffic outcomes such as crash and serious violation of traffic laws. The aim of this study was to determine whether there is an association between the narcissistic symptoms of professional bus drivers and high risk driving records or crash.Methods: A total of 200 outer-city bus drivers were enrolled in 2018 from Tehran origin of trips.The narcissistic symptoms of drivers were assessed using the Narcissistic Personality Inventory-16 (NPI-16). The traffic police databases were searched for records of crashes or recorded negative traffic scores during a 3-year period prior to time of interviews. Data were analyzed using Stata 14 statistical software package.Results: Mean age of the participants was 44.4 years with a standard deviation of 9.3 years.Fourteen drivers (7%) had a crash history over the past three years. Mean normalized narcissism score was 22.3 among those without a crash history over the past three years versus 18.8 among those with a crash history without statistical significance. Forty-four drivers (22%) had a negative traffic scoring record due to high risk traffic violations registered in police database over the past three years. Mean normalized narcissism score was 22 among those without negative score record over the past three years versus 22.3 among those with a negative score history.However, the difference was not found to be statistically significant. Conclusion:The findings of present study does not support an association between crash risk or being a recorded high risk driver and narcissism levels. However, considering the complex risk profile of road traffic crashes, much larger studies are needed to rule it out.