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Schizophrenia relapse in Kuala Lumpur, Malaysia: do relatives' expressed emotion and personality traits matter?

Roseliza-Murni A, Oei TP, Fatimah Y, Asmawati D

Compr Psychiatry, 2014 Jan;55(1):188-98.
PMID: 23374905 DOI: 10.1016/j.comppsych.2012.12.026

Schizophrenia which is perhaps the most disabling and puzzling form of a mental disorder is often conceptualized as 'gila' (lunacy or madness) by the Malaysian society. The debilitating nature of the disorder and recurrent relapse of its psychotic episodes have often been misunderstood and lead to confusion among the family members, who play the role as primary caregivers. While expressed emotion (EE) has been widely studied in the Western world, it is not well understood in Malaysia.
Fulltext Adolescent Connectedness: Testing Confirmatory Factor Analysis of the Hemingway: Measure of Adolescent Connectedness-Bahasa Melayu Version (HMAC-BM)

Mohd Khatib NA, Roseliza-Murni A, Mohd Hoesni S, Manap J

Int J Environ Res Public Health, 2022 Sep 26;19(19).
PMID: 36231492 DOI: 10.3390/ijerph191912189

Measuring the factors that underlie adolescent connectedness has become a prominent focused issue in past studies across many disciplines. Thus far, the Hemingway: Measure of Adolescent Connectedness (HMAC) is the first research-based measure of adolescent's relationship and sense of belonging with other people and their surroundings. The current study aimed to examine the measurement model of the Hemingway: Measure of Adolescent Connectedness which has been translated into Bahasa Melayu (HMAC-BM) in order to check for its feasibility among Malaysian adolescents. A total of 377 adolescents aged 16 years old were recruited from the Federal Territory of Kuala Lumpur. Three factors, namely connectedness to family, school, and neighbors with seven sub-factors of the HMAC-BM, were analyzed by Confirmatory Factor Analysis (CFA) using the IBM SPSS Amos 23.0 (23.0, IBM Technology, Armonk, NY, USA). Results of the CFA supported the second-order factor of the HMAC-BM structures. The overall HMAC-BM scale and its subscales have higher factor loadings ranging from 0.60 to 0.79. Cronbach's alpha coefficients ranged from 0.78 to 0.95 for the three subscales and 0.84 for the total scale. Results also revealed seven sub-factors with forty-one factors-solution that accounted for 0.89% of total variance explained for adolescent connectedness. Findings provide empirical support for the feasibility of HMAC-BM in explaining Malaysian adolescents' social connectedness. Hence, the HMAC-BM is a promising measure that can be used on Malaysian adolescents. The findings have important implications which provide a clear picture of HMAC-BM as an accurate instrument to measure adolescent's social connectedness toward enhancing prosocial attitudes and well-being.
Fulltext Predictors of Mortality within Prison and after Release among Persons Living with HIV in Indonesia

Culbert GJ, Crawford FW, Murni A, Waluyo A, Bazazi AR, Sahar J, et al.

Res Rep Trop Med, 2017;8:25-35.
PMID: 29238241 DOI: 10.2147/RRTM.S126131

Objectives: HIV-related mortality is increasing in Indonesia, where prisons house many people living with HIV and addiction. We examined all-cause mortality in HIV-infected Indonesian prisoners within prison and up to 24 months post-release.
Materials and Methods: Randomly selected HIV-infected male prisoners (n=102) from two prisons in Jakarta, Indonesia completed surveys in prison and were followed up for 2 years (until study completion) or until they died or were lost to follow-up. Death dates were determined from medical records and interviews with immediate family members. Kaplan-Meier and Cox proportional hazards regression models were analyzed to identify mortality predictors.
Results: During 103 person-years (PYs) of follow-up, 15 deaths occurred, including ten in prison. The crude mortality rate within prison (125.2 deaths per 1,000 PYs) was surpassed by the crude mortality rate in released prisoners (215.7 deaths per 1,000 PYs). HIV-associated opportunistic infections were the most common probable cause of death. Predictors of within-prison and overall mortality were similar. Shorter survival overall was associated with being incarcerated within a specialized "narcotic" prison for drug offenders (hazard ratio [HR] 9.2, 95% confidence interval [CI] 1.1-76.5; P=0.03), longer incarceration (HR 1.06, 95% CI 1.01-1.1; P=0.01), and advanced HIV infection (CD4+ T-cell count<200cells/μL; HR 4.8, 95% CI 1.2-18.2; P=0.02). Addiction treatment was associated with longer survival (HR 0.1, 95% CI 0.01-0.9; P=0.03), although treatment with antiretroviral therapy (ART) or methadone was not.
Conclusions: Mortality in HIV-infected prisoners is extremely high in Indonesia, despite limited provision of ART in prisons. Interventions to restore immune function with ART and provide prophylaxis for opportunistic infections during incarceration and after release would likely reduce mortality. Narcotics prisons may be especially high-risk environments for mortality, emphasizing the need for universal access to evidence-based HIV treatments.
Intervening factors between risk of violence and aggressive behaviours among forensic inpatients: a scoping review

Ahmad Badruddin N, Roseliza-Murni A, Kamaluddin MR, Ahmad Badayai AR, Munusamy S

BMC Psychol, 2024 Mar 15;12(1):155.
PMID: 38491550 DOI: 10.1186/s40359-024-01649-1

BACKGROUND: Risk of violence is closely associated with aggression propensity. However, there is a lack of research to explain the mechanisms behind this association, especially among the patients of forensic secure facilities. This review aimed to identify and synthesize the available literature concerning the intervening factors (mediating or moderating factors) in the relationship between the risk of violence and aggressive behavior in forensic secure facilities.
METHODS: Two electronic academic databases were searched: Scopus and Web of Science (WoS) using specific keywords as search terms derived from the PCC framework with no specific time limit. The search strategy was developed based on the JBI Manual for Evidence Synthesis and utilised the PRISMA-ScR guidelines. Data on the risk of violence, intervening factors, and aggressive behavior were extracted from the included studies. Further analysis was performed whereby similar data were grouped and synthesised together.
RESULTS: The initial search produced 342 studies. However, only nine studies fulfilled the inclusion criteria. The nine studies included 1,068 adult forensic inpatients from various psychiatric hospitals. Only mediation studies reported significant mechanisms of influence between the risk of violence and aggressive behavior. It is postulated that the human agency factor may be the underlying factor that influences a person's functioning and the subsequent series of events between the risk of violence and aggression.
CONCLUSIONS: In light of the paucity of evidence in this area, a generalised conclusion cannot be established. More studies are warranted to address the gaps before conclusive recommendations can be proposed to the relevant stakeholders.
Fulltext The Influence of Medication Attitudes on Utilization of Antiretroviral Therapy (ART) in Indonesian Prisons

Culbert GJ, Bazazi AR, Waluyo A, Murni A, Muchransyah AP, Iriyanti M, et al.

AIDS Behav, 2016 05;20(5):1026-38.
PMID: 26400080 DOI: 10.1007/s10461-015-1198-4

Negative attitudes toward HIV medications may restrict utilization of antiretroviral therapy (ART) in Indonesian prisons where many people living with HIV (PLH) are diagnosed and first offered ART. This mixed-method study examines the influence of medication attitudes on ART utilization among HIV-infected Indonesian prisoners. Randomly-selected HIV-infected male prisoners (n = 102) completed face-to-face in-depth interviews and structured surveys assessing ART attitudes. Results show that although half of participants utilized ART, a quarter of those meeting ART eligibility guidelines did not. Participants not utilizing ART endorsed greater concerns about ART efficacy, safety, and adverse effects, and more certainty that ART should be deferred in PLH who feel healthy. In multivariate analyses, ART utilization was independently associated with more positive ART attitudes (AOR = 1.09, 95 % CI 1.03-1.16, p = 0.002) and higher internalized HIV stigma (AOR = 1.03, 95 % CI 1.00-1.07, p = 0.016). Social marketing of ART is needed to counteract negative ART attitudes that limit ART utilization among Indonesian prisoners.