Chemotherapy-induced cognitive impairment in breast cancer survivors: A systematic review of studies from 2000 to 2021

BACKGROUND

Studies have indicated that apart from enhancing patient survival, chemotherapy has adverse side effects on the psychological, social, and cognitive functions of breast cancer survivors.

AIMS

This study was conducted to understand chemotherapy's impact on breast cancer survivors' cognitive functions.

METHODS AND RESULTS

Our study is a systematic review based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We searched English databases, including PubMed/MEDLINE, PsycINFO, and Web of Science, and Persian databases, such as Irandoc and Elmnet, using Persian keywords of cancer, breast cancer, chemotherapy, cognitive functions, executive functions, and neuropsychological functions. Two reviewers independently evaluated the full text of the articles according to predefined criteria. Among the 937 available studies, 26 were selected based on the inclusion and exclusion criteria, of which 17 (65%) were longitudinal and 9 (35%) were cross-sectional. The findings indicated a significant relationship between the use of chemotherapy and cognitive impairments, most notably attention, working and short-term memory, and executive functions. However, the studies differed in their findings regarding the long-term persistence of cancer-related cognitive impairment (CRCI), which could be due to the wide range of tools used, different methods to measure cognitive functions, and the difference in the sample size of the studies.

CONCLUSION

Chemotherapy, affecting cortical and subcortical brain structures, causes a set of cognitive impairments that can lead to impairments in social responsibility acceptance, daily functioning, and quality of life of women. Therefore, rigorous and extensive research design is required to understand the causes and consequences of CRCI using standardized and sensitive measures of cognitive functions. Specifically, studies comparing the effects of different chemotherapy regimens on cognition and potential mechanisms and/or moderators of CRCI would be instrumental in designing more effective therapy regimens and evaluating the efficacy and cost-effectiveness of cognitive rehabilitation and supportive care programs.

Culture as an effective frame of reference in clinical decision-making: A comparison of Iranian, American, and Canadian psychotherapists

The therapeutic communication between psychotherapist and client is highly dependent on their socio-cultural background. The purpose of this study was to examine the effects of culture on decision-making style of psychotherapists in three dimensions of decision-making: expedience vs. realism, individualism vs. collectivism, and long-term orientation vs. short-term orientation. The sample of this study consisted of 144 psychotherapists (40 Iranians educated in Iran, 33 Iranians educated in the west, 36 Americans, and 35 Canadians). Each of the participants were presented with three scenario that involved clinical challenging situations. For each area of decision-making a statement was considered and the psychotherapist was requested to rate them based on importance in his/her clinical decision-making. Findings indicated that the groups differed significantly on all dimensions with few exceptions when American and Canadian psychotherapists were compared. The decision-making style of Iranian psychotherapists was more with expediency, collectivism and long-term orientation, while the decision-making style of American and Canadian psychotherapists was more with realism, individualism, and short-term orientation. According to the results of current study, socio-cultural background of psychotherapists, as a frame of reference, significantly influenced their clinical decision-making style.

Examining the Link Between Character Strengths and Positive and Negative Mental Health Indicators in Iranian Adolescents

Character strengths are an important foundation for positive development and thriving in adolescence. Most research on character strengths has been conducted with youths in Western cultures. We examined character strengths in relation to positive and negative well-being indicators in a sample of Iranian youths. We investigated the reliability and validity of the Farsi version of the Values in Action Inventory of Strengths for Youth (VIA Y-96)—a self-report survey commonly used in Western contexts. Participants were adolescents in Iran ( N = 1,359; 48.5% female; M age = 13.54, SD = 1.00) who completed the VIA Y-96 and questionnaires assessing life satisfaction, positive/negative experiences, depression, anxiety, and stress. We found that reliability coefficients were acceptable for most of the VIA subscales. A confirmatory factor analysis (CFA), as well as a second-order CFA, supported the construct validity of the Farsi VIA Y-96. Correlations between the character strengths and positive and negative well-being indicators supported convergent validity. Measurement invariance for the VIA Y-96 was established in this study comparing boys’ and girls’ response patterns. Sex and grade level differences were found for some of the subscales. Overall, the Farsi VIA Y-96 had acceptable psychometric properties, suggesting that it can be used in research on character strengths with Iranian youths.

Cultural differences in conceptual representation of "Privacy": A comparison between Iran and the United States

Culture consists of shared conceptual representations in an individual's cognition. Thus, there may be cultural differences in the representation of a concept. To assess this possibility, we compared the subjective semantic structure of "privacy" in Iran and the United States. Participants were 200 adults, 100 from Iran and 100 from the United States. In the first phase of the experiment, using the associative terms task, we detected nine of the most frequent terms that were associated with the concept of "privacy" in each culture. In the second phase, using the judged-similarity task, we asked participants to rate the degree to which each of the nine terms from the previous phase was associated with every other term and with the concept of "privacy." Results from a correspondence analysis model suggest similarities in the mapping of terms related to "privacy" along the dichotomous dimension of physical vs. informational concerns. However, cultural differences emerged in a second dimension, the extent to which individualism vs. collectivism was stressed. While "personal privacy" and an individual's relationship with the government was important for American adults, the main focus for Iranian adults was "familial privacy" and family-centered living.

Development of Children in Iran: A Systematic Review and Meta-Analysis

Background:

In order to gain a better perspective of the developmental status of children in different regions of Iran, this study was carried out to determine the prevalence and the factors impacting child development in Iranian studies.

Materials and Methods:

Articles published in Iranian and international journals indexed in the SID, PubMed, Scopus and Magiran databases from 2001-2015 were systematically reviewed using standard and sensitive keywords. After evaluating the quality of 155 articles in the initial search, 26 articles were analyzed according to the inclusion criteria. After investigations, meta-analysis was done for six studies and the results were combined using Random Effects model, and the heterogeneity of studies was evaluated using the I² index. Data analysis was performed using STATA version 11.2.

Results:

Eagger & Beggs tests, respectively with 0/273 & 0/260 did not confirm the probability of publication bias in the data, but heterogeneity in studies was confirmed (p<0/001). On such basis, the pooled prevalence of developmental disorder based on Random Effect model was calculated to be 0.146, CI (0/107-0/184). The prevalence of developmental disorders in children in the studies reviewed was reported between 7 to 22.4%. The most important risk factors were in SES (Socio Economic Status) and Prenatal, Perinatal, Neonatal &Child groups.

Conclusion:

More extensive studies and early intervention with respect to causes of developmental delay in children seems necessary.

Relationship of Mothers' Psychological Status with Development of Kindergarten Children

OBJECTIVE

Given the importance of children's development and the role of psychological status of mothers in this regard, this study investigated the relationship of mothers' psychological status (stress, anxiety and depression) with the development of children aged 36-60 months.

MATERIALS & METHODS

This descriptive study was performed on 1036 mothers and their children, aged 36 to 60 months, in different kindergartens in Tehran City, Iran, in 2014-2015. Participants were selected through multi-stage random sampling. The following instruments were used in this study: A demographic and obstetric specification questionnaire, children specification questionnaire, the Beck Depression Inventory, Spiel Berger Test, Perceived stress questionnaire and the Ages and Stages Questionnaire to determine the status of the children's development. Data were analyzed using SPSS20 software, Mann-Whitney; independent t-test and logistic-Regression model were used.

RESULTS

The prevalence of developmental delay in children aged 36-60 months was 16.2%. The independent t-test showed a relationship between maternal stress and developmental delay in children. The Mann-Whitney test revealed a significant relation between mothers' depression level and developmental delay in their children. There was a significant relation between trait anxiety and developmental delay in children. Moreover, a significant relation was found between maternal stress and developmental delay in fine motor skills. The logistic regression model showed a significant relationship of child gender, economic and social states with developmental delay.

CONCLUSION

This study showed mothers' psychological status probably is an effective factor in developmental delay. The assessment of mothers' psychological status is suggested for early interventions.

Parental self-efficacy as a determining factor in healthy mother-child interaction: a pilot study in iran

OBJECTIVE

Parental self-efficacy is associated with increasing mental health in children. There is a paucity of research in Iran on the role of parental self-efficacy in increasing mental health status of children. In this preliminary study, we studied the effectiveness of the World Health Organization international child development program (2002) for children aged 3 years and younger in increasing positive interaction between child and mother as an important component of mental health.

METHODS

Forty mothers from a central hospital child-caring center in Mashhad participated in the study and were randomly divided into an experimental group (n = 20) and a control group (n = 20). The experimental group received the World Health Organization international child development program for 6 consecutive weeks while the control group remained without manipulation. The Parenting Self-Agency Measure (PSAM) was administered at pre-test, post-test and at 1-month follow-up.

RESULTS

The study findings indicated that parental efficacy in the experimental group increased after 6 consecutive weeks of training and remained unchanged after 1 month of follow-up while the control group showed no difference regarding scores obtained at three stages of the study.

CONCLUSION

International programs such as the World Health Organization international child development program can increase positive child-mother interaction as an important factor which contributes to mental health in early years of life but further studies with larger samples in longer terms and with more follow-up periods in Iran are suggested.

DECLARATION OF INTEREST

None. Clinical Trial Registration-URL: http://www.irct.ir. Unique identifier: IRCT2012073010445N1.

Forgiveness in Relation to Attachment Style and Consanguine Marriage in Iranian Married Individuals

The aim of this study was to compare forgiveness in secure and insecure Iranian married couples. Whether marriage had occurred within the family (consanguine) or not (non-consanguine) was also considered. 400 married participants completed the Family Forgiveness Scale and the Adult Attachment Questionnaire. Analysis of reported forgiveness within the marital family showed that, although there was no significant difference between secure and insecure participants in overall forgiveness, secure participants rated “reparation” and “resolution” higher, whereas insecure participants rated “realization” and “recognition” higher. Comparing the experience of forgiveness in the family of origin, securely attached couples not only reported significantly more overall forgiveness but reported more “realization” and “resolution” while forgiving. Some interesting sex differences were also found, as individuals in consanguine vs non-consanguine couples differed in mean “recognition” in the forgiveness process.