Improving the Cognitive Flexibility (CF) of Adolescent Students Through Differentiated Instructions in Indonesia

Continuous renal replacement therapy (CRRT) is the primary treatment for severe sepsis and has been shown to reduce patient mortality. Patients with severe sepsis who receive CRRT frequently experience significant physical and psychological distress, manifesting as shame, social withdrawal, and abnormal cognitive moods. This study aimed to explore the relationship between psychological resilience, cognitive flexibility, and post-traumatic growth (PTG) levels in patients with severe sepsis treated with CRRT. From January to October 2024, patients with severe sepsis who were treated with CRRT in our hospital were selected by convenience sampling as the research object. The Connor-Davidson Resilience Scale (CDRISC), Cognitive Flexibility Scale, and Post-Traumatic Growth Inventory (PTGI) were used to evaluate patients' psychological resilience, cognitive flexibility, and PTG levels. Statistical methods included the independent sample t test, Pearson analysis, and linear regression analysis. The total scores of CDRISC, cognitive flexibility scale and PTGI in 205 patients was (42.98 ± 6.13), (95.04 ± 17.98) and (49.77 ± 9.92), respectively. There was a significant positive correlation between psychological resilience, cognitive flexibility, and PTG levels in patients with severe sepsis treated with CRRT (p < 0.05). Psychological resilience and cognitive flexibility had positive predictive effects on PTG, and there were significant positive predictive effects between psychological resilience and cognitive flexibility (p < 0.05). Psychological resilience directly and positively predicted PTG (β = 0.538, p < 0.05). The indirect effect of psychological resilience on cognitive flexibility was significant (β = 0.677, p < 0.05), and the indirect effect of cognitive flexibility on PTG was significant (β = 0.165, p < 0.05). The chain-mediating effect between psychological resilience, cognitive flexibility, and PTG was significant (β = 0.112, p < 0.05). Psychological resilience can affect the PTG level of patients with severe sepsis treated with CRRT and can also indirectly affect PTG levels through direct chain mediation of cognitive flexibility. Targeted intervention strategies should be formulated to improve mental health and promote clinical prognosis.

This study investigates the impact of a nature experience-based environmental education module program on preschool children’s environmental awareness. A mixed-methods design was employed, incorporating a case study as the qualitative component and a one-group pretest–posttest experimental design as the quantitative component. The study group consisted of ten children (four girls and six boys) aged 60–72 months, enrolled in a kindergarten and previously not received any formal environmental education. The program was implemented over nine weeks, with weekly one-day sessions conducted in a designated forest area. Data were collected through a semi-structured interview form developed by the researcher and the Children’s Environmental Scale developed by Koçak Tümer and Temel (2021). Qualitative data were analyzed using content analysis, while quantitative data were examined using a paired-samples t-test to compare pretest and posttest results. The findings revealed that, following participation in the program, children demonstrated increased knowledge and awareness regarding concepts such as the environment, environmental pollution, environmental protection, living beings, and recycling. Moreover, the posttest mean scores were found to be significantly higher than the pretest mean scores. These results indicate that the nature experience-based environmental education program positively influenced preschool children’s environmental awareness, suggesting that nature-based learning activities can effectively foster environmental consciousness in early childhood education. In an era where children are increasingly disconnected from nature and tend to perceive the environment as an abstract concept, there is a pressing need for experiential learning environments that enable direct interaction with nature and nurture both environmental affection and awareness. Therefore, environmental education should extend beyond classroom walls, providing children with opportunities to explore, experience, and appreciate their surroundings. The nature-loving child of today will become the environmentally responsible adult of tomorrow, thereby laying the foundation for a sustainable future.

Background: Migraine, a chronic neurological disorder, significantly impacts women's quality of life through psychological distress. Acceptance and commitment therapy (ACT) enhances distress tolerance and cognitive flexibility by promoting acceptance and value-driven action. Compassion-focused therapy (CFT) fosters self-compassion, reducing self-criticism to alleviate distress and support cognitive flexibility. Objectives: The objective of this study was to compare the effectiveness of ACT and CFT in enhancing distress tolerance and cognitive flexibility in women with migraine. Methods: This quasi-experimental study employed a pre-test-post-test design with a 3-month follow-up and a control group. The statistical population included women diagnosed with migraine in Ahvaz, Iran, in 2023. A sample of 108 participants was selected via convenience sampling from patients attending the Labkhande Zendegi Counseling Center and randomly assigned to three groups (ACT, CFT, and waitlist control; n = 36 per group) using computer-generated random numbers. The experimental groups received 8 weekly 90-minute sessions of either ACT or CFT, while the control group remained on a waitlist. Data were collected using the Distress Tolerance Scale (DTS) and Cognitive Flexibility Inventory (CFI) and analyzed using repeated measures analysis of variance with a significance level of 0.05. Results: Both ACT and CFT significantly improved distress tolerance (ACT: From 29.70 ± 4.13 to 50.40 ± 4.72; CFT: From 30.00 ± 3.99 to 49.35 ± 4.25) and cognitive flexibility (ACT: From 46.06 ± 5.28 to 78.12 ± 5.88; CFT: From 46.60 ± 4.92 to 68.00 ± 5.43) compared to the control group (P &lt; 0.001), with effects maintained at follow-up. The ACT showed a significantly greater improvement in cognitive flexibility compared to CFT (mean difference: 10.12, P &lt; 0.001), but no significant difference was observed for distress tolerance (P = 0.325). Conclusions: The findings indicate that both ACT and CFT are effective in improving distress tolerance and cognitive flexibility in women with migraine, with ACT showing a relative advantage in enhancing cognitive flexibility. These results suggest that clinicians can select either approach based on patient needs, potentially improving psychological management of migraine-related distress.

The present study aimed to investigate the relationship between anxiety and self-efficacy with the mediating role of cognitive flexibility among female university students. This research was a fundamental and descriptive study using a path analysis method within a correlational design. The statistical population included all female students at the Islamic Azad University, Garmsar Branch, in 2024. Using purposive and convenience sampling, 295 valid questionnaires were collected. Data were gathered using the Sherer General Self-Efficacy Scale, the Beck Anxiety Inventory, and the Cognitive Flexibility Inventory by Dennis and Vander Wal. To analyze the data, Pearson correlation coefficients and multiple regression analyses within a structural equation modeling framework were conducted using SPSS version 25 and AMOS, with a significance level set at p &lt; .05. Pearson correlation results showed that anxiety had a significant negative correlation with both self-efficacy (r = -0.52, p &lt; .001) and cognitive flexibility (r = -0.46, p &lt; .001), while cognitive flexibility had a significant positive correlation with self-efficacy (r = 0.59, p &lt; .001). The structural model revealed that anxiety significantly and negatively predicted self-efficacy (β = -0.38, p &lt; .001) and cognitive flexibility (β = -0.36, p &lt; .001), whereas cognitive flexibility significantly and positively predicted self-efficacy (β = 0.47, p &lt; .001). The indirect effect of anxiety on self-efficacy through cognitive flexibility was also significant (β = -0.17, p &lt; .001), confirming the mediating role of cognitive flexibility. Model fit indices indicated a good fit (χ²/df = 1.96, GFI = 0.93, CFI = 0.96, RMSEA = 0.047). The findings highlight the critical role of cognitive flexibility in mitigating the negative impact of anxiety on self-efficacy. Enhancing cognitive flexibility in academic and clinical settings may serve as a valuable strategy to improve self-efficacy and reduce anxiety among female students.

The role of religion in human life is very important because it relates to a person's spiritual life with his belief in God. The role of religion is to be a guide in the effort to create a meaningful, peaceful and dignified life. Education is an effort so that humans can develop their potential through the learning process and or other ways that are known and recognized by the community. The development of contextual learning models that make students the center of learning in class can increase student interest in PAK subjects and other subjects because they do not rely on conventional methods, namely lecture methods that are generally mnoton and boring. In this study the design used is classroom action research. The data analysis technique used in this study is the first analysis technique with student participation in learning activities. Data on student participation were analyzed using descriptive statistics with percentage techniques. Second through learning outcomes. Data on learning outcomes obtained from the pretest and posttest results were analyzed by comparing the percentage and average results at the end of each cycle. The research resulted in the following conclusions: The development of contextual-based learning models has a positive impact on the potential of students as active, creative and innovative learning centers and teachers as facilitators, managers and mentors who can motivate learning and student achievement and competence and are able to motivate to interested in learning Christian Religious Education, especially at SD HKBP Maranatha 2019/2020. Secondly, based on existing studies, research and papers, the development of learning models through a contextual approach shows significant learning outcomes that are better than conventional learning models both quantitatively and qualitatively on PAK subject students.

During this Covid-19 pandemic, the Petrokimia Gresik Volleyball Club’s female athletes have to do training from home (TFH). Unfortunately, this prolonged TFH has caused the athletes experiencing a decrease in motivation and lose of training goals. This community service aimed to increase the athletes’ achievement motivation through a Virtual Goal-Setting Training (VGST). The VGST was designed and carried out in 4 sessions: introduction to goal-setting, goal identification, goal self-efficacy, goal commitment. The VGST’s effectiveness was tested using a one-group pretest-posttest experimental design, and measured by the Achievement Motivation Scale for Specialists of the Sport for All (AMSSSA) which consists of 30 items, as well as by observation and interviews. The results of this community service activity showed a significant increase in achievement motivation between pretest and posttest results (p&lt;0.01). In conclusion, a structured design of VGST can be an alternative to increase achievement motivation for athletes during the Covid-19 pandemic.

ABSTRACTThis study investigated the relationships between school resilience strength, cognitive flexibility, emotion regulation, and school engagement in high school students. A hypothetical model test was conducted for this purpose. This study was designed according to a predictive correlational model. Through convenience sampling, this study collected data from 456 (58.6% females; mean age = 16.04, SD = 1.154) high school students (studying in Ankara province. The school resilience scale, cognitive flexibility scale, emotional regulation scale for adolescents, and school engagement scale were used. The relationships between the variables were examined by testing the theoretical serial mediation model. The study showed that emotion regulation and school resilience had multiple serial mediating roles in cognitive flexibility and school engagement. Another finding was that cognitive flexibility predicts emotion regulation, emotion regulation predicts school resilience, and school resilience predicts school engagement. This study revealed that factors such as cognitive flexibility and emotional regulation affect high school students’ ability to recover at school and their school engagement regardless of the school climate. It also shows how emotion regulation and school resilience mediate the relationship between cognitive flexibility and school engagement. Mental health professionals such as school counselors and psychologists can focus on emotion regulation and cognitive flexibility to develop school resilience and school engagement in student clients. In addition, more studies can be conducted on the extent to which both individual factors and environmental factors such as school climate simultaneously affect school engagement.

Purpose: The purpose of this study was to identify the impact of cognitive flexibility and e-learning digital literacy on the learning flow of nursing students who had experienced e-learning. Methods: The research design for this study was a descriptive survey using convenience sampling. Data were collected using online questionnaires completed by 134 nursing students in A city and P city. The data were analyzed using percentages, mean values, standard deviations, Pearson‘s correlation coefficients, and multiple regression with SPSS for Windows version 22.0. Results: Positive correlations were found between learning flow and e-learning digital literacy (r = .43, p &lt; .001), between learning flow and cognitive flexibility (r = .52, p &lt; .001), and between e-learning digital literacy and cognitive flexibility (r = .65, p &lt; .001). In the multiple regression analysis, cognitive flexibility (β = .42, p &lt; .001) was a significant predictor that explained 27% of variance in learning flow. Conclusion: The results of this study show that cognitive flexibility is a factor influencing learning flow in nursing students. Based on the results of the study, educational programs aiming to improve learning flow should include methods that improve cognitive flexibility.

Background: This research aims to compare corona disease anxiety (CDA) based on cognitive emotion regulation (CER) strategies and cognitive flexibility between people with COVID-19 experience and normal individuals in Hamedan. Objectives: The primary question of this study is whether there is a difference between people with a history of COVID-19 and normal individuals in Hamedan in comparing CDA based on the strategies of CER and cognitive flexibility. Methods: This cross-sectional descriptive-analytical research was conducted in the first half of 1401 in Hamedan. The population consisted of people from Hamedan, with 420 individuals (210 with a history of COVID-19 and 210 normal individuals) selected by convenience sampling. The tools used in this research were the demographic information questionnaire and questionnaires on coronavirus anxiety, cognitive regulation of emotion, and cognitive flexibility. Results: Based on the results obtained from this research, according to the F and P-values (F = 7.222, P &lt; 0.00), there is a significant difference in terms of CDA, CER strategies, and cognitive flexibility between people with COVID-19 experience and normal individuals. Conclusions: The present study showed that the level of anxiety about contracting a virus such as COVID-19 and people's psychological coping mechanisms are influenced by their personality and psychological preparations. People with a history of COVID-19 experience have different CER strategies and cognitive flexibility related to CDA compared to normal individuals. The CDA and cognitive flexibility were higher in normal individuals, while the non-adaptive CER strategies were higher in people with a history of COVID-19.

Background and Aims Bilingualism is increasingly recognized as a dynamic cognitive experience shaped by continuous interaction with two language systems. While several studies have explored the effects of bilingualism on cognitive abilities, such as working memory and cognitive flexibility, findings have been inconsistent. Factors, such as age of second language acquisition, cultural background, language proficiency, and demographic characteristics, are believed to influence these cognitive outcomes. This study aimed to investigate whether Persian-Turkish bilingualism results in differences in working memory capacity and cognitive flexibility among university students in Tehran. Methods This study employed a descriptive-analytical design with a causal-comparative approach, due to the non-manipulable nature of bilingualism as a naturally occurring variable. The research sample consisted of 120 university students (60 Persian-Turkish bilinguals and 60 Persian monolinguals), aged between 18 and 32 years, selected via convenience sampling from universities in Tehran during the 2022–2023 academic year. Working memory was assessed using the auditory version of the n-back task (1-back and 2-back conditions), and cognitive flexibility was evaluated using the wisconsin card sorting test (WCST). Data were analyzed using SPSS software, version 27, including Levene’s test for homogeneity of variances and independent samples t-tests. Results Statistical analysis revealed no significant differences in working memory performance between bilingual and monolingual groups. In the one-back task, the Mean±SD accuracy for monolinguals was 106.23±12.92, while for bilinguals it was 106.20±13.99, t(118)=0.014, P=0.98. Similarly, in the two-back task, monolinguals scored a Mean±SD of 89.77±17.54, and bilinguals scored 84.55±21.11, t(118)=1.472, P=0.14. Regarding cognitive flexibility, most WCST indicators showed no significant differences between the groups. For example, in the number of completed categories, monolinguals Mean±SD 5.97±0.18 compared to bilinguals with 5.92±0.42, t(118)=-0.841, P=0.40. However, a significant difference was observed in task completion time, where bilinguals took longer 153.55±32.68 than monolinguals 132.45±37.31, t(118)=3.295, P=0.001. Conclusion The findings of this study indicated that bilingualism in adults (Persian–Turkish bilinguals) does not necessarily lead to significant differences in working memory (as measured by the visual version of the n-back task) or cognitive flexibility. It should be noted that working memory in this research was assessed exclusively using visual stimuli, and no auditory version was administered; thus, results might differ in auditory or combined modalities. Furthermore, given the participants’ educational background, limited familiarity with other languages, such as English or Arabic, is possible, which could influence their cognitive performance. These factors should be considered when interpreting the results, and future research should examine them using more controlled designs and multimodal stimuli.

Objective: The current study aimed to determine the fit of the proposed model of Iranian immigrants' general health based on cognitive flexibility, resilience, and perfectionism mediated by acculturation stress. Methods and Materials: The research method was correlational. The population included all Iranian immigrants residing legally in Western Europe, North America, or Oceania. Using convenience sampling, 224 participants were selected and responded to Goldberg’s General Health Questionnaire (1979), Dennis and Vander Wal’s Cognitive Flexibility Inventory (2010), Connor and Davidson’s Resilience Scale (2003), Hill et al.'s Perfectionism Scale (2004), and Havighurst and King’s Cultural Stress Scale (1996). Data analysis was conducted using structural equation modeling with LISREL software 8.80. Findings: The results showed that the proposed model of general health for Iranian immigrants based on cognitive flexibility, resilience, and perfectionism mediated by acculturation stress was a good fit. The findings also indicated that cognitive flexibility had a negative inverse effect on general health (β = -0.46; p &lt; 0.01); resilience had a negative inverse effect on general health (β = -0.42; p &lt; 0.01); overall perfectionism had a negative inverse effect on general health (β = -0.42; p &lt; 0.01). Acculturation stress had a direct positive effect on general health (β = 0.76; p &lt; 0.01). Cognitive flexibility mediated by acculturation stress had an indirect effect on general health (β = -0.67; p &lt; 0.01); resilience mediated by acculturation stress had an indirect effect on general health (β = -0.74; p &lt; 0.01); and perfectionism mediated by acculturation stress had an indirect effect on the general health of Iranian immigrants (β = -0.65; p &lt; 0.01). Conclusion: It can be concluded that increasing cognitive flexibility and resilience, along with reducing maladaptive perfectionism, leads to a decrease in acculturation stress and an improvement in the general health of immigrants. Therefore, it is recommended that self-help groups, special information sessions, and stress management psychological workshops for immigrants be organized, emphasizing perfectionism, acculturation, and coping strategies to reduce the physical and psychological health impacts of acculturation stress.

Objective: Intense emotions following physical, psychological, and cognitive changes in adolescents may lead to aggression. Aggressive adolescents, due to negative experiences in relationships, are at risk for multiple psychological problems. Therefore, the present study aimed to investigate the effectiveness of dialectical behavior therapy on cognitive flexibility and alexithymia in aggressive adolescents. Methods and Materials: This quasi-experimental study employed a pre-test, post-test design with a control group. The statistical population included all high school students (grades 1 and 2) in Shahdad County during the 2021-2022 academic year. Thirty students were selected using convenience sampling from these schools, having scored higher than 78 on the Buss-Perry Aggression Questionnaire. Out of these, 30 students were randomly assigned to experimental (n=15) and control (n=15) groups. The research instruments included the Cognitive Flexibility Inventory (Dennis &amp; Vander Wal, 2010), the Toronto Alexithymia Scale (1994), and the Buss-Perry Aggression Questionnaire. Multivariate analysis of covariance (MANCOVA) was used to analyze the data using SPSS-26 software. Findings: The findings indicated that dialectical behavior therapy had a significant effect on cognitive flexibility and alexithymia in aggressive adolescents (p&lt;0.005). Conclusion: Considering the effectiveness of dialectical behavior therapy on cognitive flexibility and alexithymia in aggressive adolescents, the implementation of intervention methods based on dialectical behavior therapy, particularly for emotional regulation and increasing cognitive flexibility, is recommended in schools and for high school students.

Cognitive flexibility is a term encompassing three basic domains and meaning the ability to adjust individuals’ cognition depending on varying circumstances. Problematic internet use may be related to psychological structures. In addition, studies have shown that the internet is both a stress-making tool and a safe haven in which individuals can seek to cope with stress. Taken all together, the purpose of the study was to observe the mediating role of coping with stress in the relationship between problematic internet use and cognitive flexibility. Chosen by convenient sampling, the participants were 706 volunteered secondary school pupils from Turkey. All data were collected with Cognitive Flexibility Scale, Strategies for Coping with Stress Scale and Young Internet Addiction Test-Short Form. As the study results revealed, problematic internet use had a negative significant effect on cognitive flexibility without the inclusion of strategies for coping with stress. Accordingly, the prediction effect of problematic internet use on cognitive flexibility became non-significant after the inclusion of strategies for coping with stress.

Irritable bowel syndrome (IBS) is one of the most common brain-gut interaction disorders, characterized by chronic abdominal pain, altered bowel habits, and heightened stress responses that significantly affect patients' psychological functioning and quality of life. Given that chronic stress plays a central role in the onset and maintenance of IBS symptoms, identifying psychological resources that promote adaptation and well-being is crucial. The present study aimed to examine the mediating role of resilience in the relationship between cognitive flexibility and psychological well-being among patients with IBS. This descriptive-correlational study employed a structural equation modeling approach. The statistical population included all IBS patients who referred to the Gastrointestinal Health Center at Al-Zahra Hospital in Isfahan in 2024. A sample of 300 patients was selected using convenience sampling. Data were collected using the Psychological Well-Being Scale, Cognitive Flexibility Inventory, and Connor-Davidson Resilience Scale, and analyzed using SPSS and AMOS version 28. Results showed that cognitive flexibility and resilience significantly predicted psychological well-being, and that resilience mediated the relationship between cognitive flexibility and psychological well-being. These findings highlight the importance of resilience and cognitive flexibility as protective psychological resources that help patients manage stress and improve well-being in the context of IBS.

Objective: The present study aimed to determine the effectiveness of neurofeedback therapy on executive functions in 11- and 12-year-old adolescent boys with anxiety disorder. Methods and Materials: This quasi-experimental study employed a pretest-posttest-follow-up design with a control group. The participants were 34 adolescent boys diagnosed with anxiety disorders, selected through convenience sampling from three psychotherapy clinics in Tehran in 2022. They were randomly assigned to experimental and control groups. The experimental group received 20 sessions of neurofeedback therapy, each lasting 45 minutes. The cognitive abilities of participants were assessed using Nejati's (2013) Cognitive Abilities Questionnaire, which evaluates executive functions across seven domains. Data were analyzed using repeated measures ANOVA to compare changes in executive functions across the pretest, posttest, and follow-up stages. Findings: The results indicated that neurofeedback therapy had a significant positive effect on executive functions, including memory, inhibitory control, decision-making, planning, sustained attention, social cognition, and cognitive flexibility (p = 0.001). Improvements were observed in the experimental group across all stages compared to the control group, suggesting that neurofeedback therapy effectively enhanced cognitive performance in adolescents with anxiety disorders. Conclusion: Neurofeedback therapy was found to be an effective intervention for improving the executive functions of adolescents with anxiety disorders. The therapy’s ability to regulate brain activity led to significant cognitive enhancements, providing a promising non-invasive treatment option. Future studies should explore the long-term effects and broader applications of neurofeedback in different populations.