Objective: To investigate the prevalence of parental stress and psychological wellbeing among parents with autistic children and their associations with dimensions of support system.
Methods: This is a preliminary cross sectional study which randomly selected parents with clinically diagnosed autistic children. Those parents who attended psycho-education session on management of autistic children at Health Psychology Unit were randomly selected to enroll in the study. Psychological wellbeing, parental stress and dimensions of support system were assessed by using the General Health Questionnaire (GHQ-28), the Parenting Stress Index (PSI) and the Provision Social Relation (PSR), respectively.
Results: Of 52 parents with autistic children (34 female and 18 male), about 90.4% of parents had significant parenting stress, and 53.8% of parents showed clinical disturbance in psychological wellbeing. Gender (t=1.67, p=0.02) and occupation (F=4.78, p=0.01) showed statistically significant association with psychological wellbeing. No association found between other socio-demographic factors, parental stress and psychological wellbeing with dimensions of support system among parents with autistic children.
Conclusion: Parents with autistic children have high prevalence of stress and psychological disturbances. Interactions of various factors need to be acknowledged and considered in order to reduce the burden of parents with autistic children.
Objective: This descriptive cross-section, community-based study examined the prevalence of psychiatric morbidity and quality of life (QOL) and the associated factors among family caregivers of hospice patients with cancer. Methods: Subjects were 50 family caregivers of cancer patients under the care of Hospice Malaysia homecare. Home visits were done in Klang Valley. Psychiatric morbidity was detected using GHQ-30 English and Bahasa Malaysia versions, and the QOL was assessed by the Short Form 36 items (SF-36) questionnaire. Results:The study results showed that 54% of respondents had psychiatric morbidity. The educational status and the relationship between family caregivers and the cancer patients were statistically significant (p
Objective: To investigate the prevalence of genital arousal disorder and the potential risk
factors that may impair genital arousal among women at a primary care setting in Malaysia.
Methods: A validated questionnaire for sexual function was used to assess genital arousal
function. A total of 230 married women aged 18–70 years old participated in this study. Their sociodemographic and marital profiles were compared between those who had genital arousal disorder and those who did not. The risk factors were examined. Results: The prevalence of genital arousal disorder in the primary care population was 50.4% (116/230). Women with genital arousal disorder were found to be significantly higher in groups of more than 45 years old (p55) (p=.001), those having 4 children or more (p=.028), those having less sexual intercourse (less than 1–2 times a week) (p=.001), and those at post-menopausal state (p=.002). There was no significant difference between these two groups in term of salary (p=.29), suffering from medical problems (p=.32), dysmenorrhea (p=.95), menarche (p=.5) and hormonal replacement therapy (p=.6). Conclusion: Women with infrequent sexual intercourse are less likely to be sexually aroused (OR=0.29, 95% CI: 0.11-0.74).
Introduction: To date, there are limited published literatures addressing behaviors of Attention Deficit and Hyperactive Disorder (ADHD) children and their parents’ psychological
characteristics. It is also crucial to know the relationship between characteristics of ADHD
behaviors on their parental psychological impacts. Objective: To determine the level of stress, anxiety and depressive among mothers of ADHD children compared to control group and also to determine the associations between domains of children’s behaviors (externalizing or internalizing) that gives most impact to these maternal psychological aspects. Method: This is a cross-sectional study. Seventy mothers of ADHD children who came to Child and Adolescent Clinic, Universiti Kebangsaan Malaysia Hospital completed self-rating questionnaires of Child Behavior Checklist (CBCL), Parenting Stress Index (PSI) and Hospital Anxiety and Depressive Scale (HADS). Seventy mothers of asthmatic children were recruited as a control group. Results: Mothers with ADHD children are more anxious, depressed and stressed (p
Objective: Self-esteem is an important component of psychological health. In Malaysia, Rosenberg’s self-esteem scale remained the single most popular utilized scale for studying global self-esteem. This study aims to design a language, culture and illness specific self-esteem questionnaire. Methods: The study consisted of 2 phases. The first phase was to generate items for the new self-esteem questionnaire (SSES) in Bahasa Malaysia. Literature review on the concept of selfesteem and its’ content was conducted. This was followed by expert opinion from professional care-givers. The items were qualitatively validated by healthy subjects and patients with schizophrenia from the same locality, culture and language. The second phase consists of quantitative validation of the items. Items in the new scale were analyzed based on the responses from 165 stable schizophrenia outpatients. The validated Malay version of Rosenberg Self-Esteem scale (RSES) was used concurrently as a comparison. Results: The SSES displayed good internal consistency for its two domains
(Cronbach’s alpha=0.88, 0.81) and test-retest reliability (ICC), ranged from 0.44 to 0.87. Its construct validity was confirmed by confirmatory factor analysis. The concurrent validity of SSES and RSES using Pearson correlation was 0.77. The Cronbach’s alpha for the validated Malay version of RSES is 0.67. Conclusion: This study presents a new self-esteem questionnaire (SSES) which has high concurrent validity with the standard RSES and confirms the reliability and validity of SSES in Malay patients with Schizophrenia.
Study site: Psychiatric clinic, Hospital Universiti Sains Malaysia (HUSM), Kelantan and Hospital Kota Bharu, (HKB), Kelantan
Objective: This study examined the symptoms of PTSD among survivors of the December 26th 2004 Malaysian tsunami disaster, as well as differences among sexes in terms of coping styles and availability of social support. Methods: A total of 64 (28 males and 36 females) respondents from several affected districts of Kuala Muda and Langkawi in Kedah and Batu Maung, Pulau Pinang were recruited through purposive sampling. The Detailed Assessment of Posttraumatic Stress (DAPS) was used to measure the posttraumatic stress disorder/symptoms, while the Social Support Questionnaire and Significant Others Scale (Form A) were used to measure the quality and quantity of social support. The COPE Questionnaire was used to measure two coping styles; adaptive and maladaptive coping. Results: Fifty two (81%) respondents did not fulfill the DAPS-PTSD criteria while only 12 (19%) fulfilled the criteria. There was no significant difference between men and women in terms of posttraumatic stresstotal, and the quantity and quality of social support. However, there is a significant difference in adaptive and maladaptive coping styles among victims who fulfill the PTSD diagnosis and those who did not. It was also found that there is no relationship between PTSD symptoms and emotional support, whereas there is a significant
relationship between PTSD symptoms and practical support. Conclusion: This research showed that only a small number of respondents fulfilled the diagnosis of PTSD following their experience of a disaster. There were no difference between genders in terms of PTSD symptoms and social support. Among victims who fulfill the PTSD diagnosis and those who do not, there is a significant difference in the adaptive and maladaptive coping styles. As for the relationship between PTSD symptoms and social support, there is a significant
relationship between PTSD symptoms and practical support but not with emotional support.
Objective: To investigate the correlation between sexual desire and sexual arousal among Malaysian women in a primary care setting. Methods: The Malay Version of Female Sexual Function Index (MVFSI) was used to assess low sexual desire and lack of sexual arousal among the respondents. A total of 230 married women aged 18 – 70 years old participated in this study. Their sociodemographic, marital profiles and correlation between low sexual desire and lack of sexual arousal were examined. Results: More than 60% respondents with low sexual desire have co-exist low sexual arousal and 94.4% respondents with high sexual desire do have high sexual arousal ( χ²= 79.6, p
Objective: This study aims to determine the quality of life (QOL) of Malaysian women based on their physical and mental scores and correlates with age and cervical disease severity. Methods: This is a cross-sectional study from Nov 2006 till Dec 2007 from participating
Gynecology-Oncology outpatient and in patient’s wards. QOL interviews used the SF-36 questionnaires. Main domains were the Physical Composite Scores (PCS) and the Mental Composite Scores (MCS). Results: A total of 396 participated in the study. Mean respondents age were 53.31 ± 11.21 years, educated till secondary level (39.4%), Malays (44.2%) with mean marriage duration of 27.73 ± 12.12 years. Among pre-invasive diseases, the cervical intra epithelial neoplasia (CIN) 1 was the highest in percentage of cases
(8.1%). Among invasive cancer, stage 1 cancer was highest (31.1%), followed with stage 2 (28.3%), stage 3 (7.3%) and stage 4 cancers (5.8%). PCS scores are highest among the pre-invasive and stage 1 cancer (F=4.357; p
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
Objective: The aim of this study was to identify depression among HIVinfected patients attending Infectious Disease Clinic in University Malaya Medical Centre (UMMC). Methods: This is a cross sectional study on HIVinfected patients attending Infectious Disease Clinic, UMMC. Those who fulfilled inclusion criteria were recruited and interviewed. Sociodemographic characteristics and clinical conditions such as mode of transmission, year of diagnosis, CD4+ counts, drug treatment and clinical stage were collected. The patients were then subjected to self-administered questionnaires, Patient Health Questionnaire, (PHQ-9) and Hospital Anxiety & Depression Scale (HADS). Results: 89 patients were recruited. Scores from PHQ9 showed 32% of depression rate while scores from HADS showed 19% of depression rate among the respondents. Non-self financial supporter, nonalcoholic drinkers and females were more likely to be depressed (P
Objective: Literatures on factors influencing performance of the Stroop interference have been elusive on coping styles. Past investigations of coping influence on Stroop test have been indirect and inconclusive due to variability of multidimensional coping models and application of different Stroop test. The concept of constricted versus flexible or broad cognitive style have linked personality and coping styles to Stroop performance. The objective of this study was to determine the associations of coping styles with Stroop resistance towards interference (Stroop RI) and subsequently determine the predictors of Stroop performance. Methods: This was a cross-sectional community research design study with purposive sampling. In this study, the self-administered Brief COPE inventory questionnaires and Stroop Test were performed among 205 undergraduate medical students. Results: Findings revealed that behavioural disengagement (r=-0.361), dysfunctional coping (r=-0.355), self-blame (r = 0.222), and substance abuse (r = -0.173) showed negative correlation and proven strong association with Stroop RI. Further multiple regression analyses identified behavioural disengagement (R2 = 0.13), and dysfunctional coping (R2 = 0.024) as significant predictors for interference. Conclusion: Coping styles have implication on Stroop test exhibited in varied cognitive styles. Integrating coping styles factor on Stroop test has glimpsed the future direction of other neuropsychological assessment batteries on the importance of profiling individualistic baseline norms. ASEAN Journal of Psychiatry, Vol. 16 (1): January – June 2015: XX XX.
Objective: Transition of people with cognitive impairment to nursing home is often an option when their disease progresses and their needs become too complex. The aim of this study was to identify the needs of people with cognitive impairment living in nursing homes and factors associated with higher level of needs.
Methods: A cross sectional survey involving 110 respondents with cognitive impairment aged ≥60 was carried out. Respondents were assessed using the Short Mini Mental State Examination (SMMSE), Camberwell Assessment of Needs for Elderly (CANE), Barthel Index (BI), Friendship Scale (FS), and Geriatric Depression Scale (GDS).
Results: Respondents with cognitive impairment had a mean of 2.81 (SD=3.72) for unmet needs and 11.95 (SD=3.14) for the met needs, with higher mean suggesting a better outcome measure. The most frequent unmet needs were intimate relationships (66.40%), company (40.00%), and daytime activity (34.50%). Unmet needs were significantly associated with depression, social isolation, and cognitive impairment.
Conclusion: Most of the needs of people with cognitive impairment in nursing homes were fulfilled, except in social area. Therefore, attention should be given in improving the care system, which emphasizes collaboration between people with cognitive impairment, family members, community, and government in helping to reduce the risk of loneliness in those with cognitive impairment.
Objectives: The aim of this study is to validate the Malay version of the Aggression Questionnaire (AQ) for the purpose of the future study related to aggression. Furthermore, the study seeks to identify types of aggression hold by the female inmates.
Methods: A cross-sectional study was designed involving 90 Malaysian female prisoners. The analyses include descriptive analysis, confirmatory factor analysis, and reliability testing. After one-week interval, a test-retest was conducted.
Results: The preliminary analysis confirmed that factor analysis was appropriate for the Malay-translated version of the AQ. The four factors structure was assessed but the factor loadings are remarkable different from the original versions. The total Cronbach's alpha coefficients is very high (α= 0.91). The Pearson's correlation however is low (r = 0.48) but acceptable for the instrument. Reliability of the subscales and the factors were also found satisfactory. Consequently, anger and hostility were identified as the most common types of aggression among the participants, followed by verbal aggression. In contrast, physical aggression was the least scored type of aggression.
Conclusion: The Malay-translated version of the AQ was found to be valid and reliable to be used in future studies.
Objective: The MINI International Neuropsychiatric Interview (MINI) is a short, structured diagnostic interview compatible with the Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV). It was designed for clinical practice, research in psychiatric, primary care settings and epidemiological surveys. This preliminary study aims to evaluate the reliability and validity of the Malaysian Version of MINI for Major Depressive Disorder and Generalized Anxiety Disorder symptoms criteria only.
Methods: Six hours of MINI training was given as part of a National Health Morbidity Survey training program for layman interviewers (n=229) and three videos were prepared by an expert psychiatrist for inter-rater reliability purposes. Meanwhile, for validity purposes, the MINI was administered to patients with Major Depressive Disorder (n=30), Generalized Anxiety Disorder (n=20) and to a normal population (n=60), to conform against the Diagnostic and Statistical Manual of Mental Disorder (DSM-IV) that was administered by psychiatrists.
Results: Overall the inter-rater reliability was satisfactory (0.67 to 0.85) and the concordance between the MINI’s and expert diagnoses was good, with kappa values of greater than 0.88.
Conclusions: The Malay version of the MINI is adjusted to the clinical setting and for the assessment of positive cases in a community setting. Modifications were highlighted to correct any identified problems and to improve the reliability of the MINI for future research and clinical use.
Objective: Living with epilepsy imposes great challenges on both patients and their family caregivers but most researchers only explored the impact on patients, with less attention given to family caregivers. Our study intended to explore the needs and problems of epilepsy family caregivers of epilepsy patients encountered during the caregiving process. Methods: Respondents were recruited from the Neurology Clinic of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu. A semi-structured interview was conducted using openended and broad questions asking about their general experience in caregiving, daily routine activities, caregiving effects, caregiving difficulties and caregivers’ needs. The interviewed data were later transcribed into verbatim before further analysis using the QSR International’s NVivo10 software. Results: Fifteen Malay Muslim family caregivers between the age of 19 and 66 years participated. Most were females (53%), married (67%), with education level at secondary school or equivalent (73%) and were homemakers (40%). In particular, respondents expressed the need for extra support from their family members and experts in terms of physical (care relief), mental, and financial aspects. In addition, the major caregiving problems identified included: (i) emotional disturbances (sad, angry, depressed, and anxious); (ii) care giving challenges (family adjustments, physical burden, psychological burden, and time management); and (iii) financial issues (not working and limited family income). Some advantages in caregiving were also reported. Conclusion: In conclusion, their experiences while taking care of their loved ones in terms of feelings, beliefs and needs exposed the difficulties in caregiving, causing substantial emotional pressure which could later lead to poor quality of caregiving. ASEAN Journal of Psychiatry, Vol. 16 (1): Januray – June 2015: XX XX.
Study site: Neurology Clinic of Hospital Sultanah Nur Zahirah (HSNZ), Kuala Terengganu.
Objective: Type D personality, tendency trait to experience increased NA (Negative Affect) and SI (Social Inhibition) has been associated with negative psychological conditions linked to heart disease. This study aimed to examine the psychometric properties of the Malay version of Type D personality scale (DS14) among Malaysian patients with coronary artery disease (CAD). Methods: In this cross-sectional study 195 patients diagnosed with CAD were selected from National Heart Institute, Kuala Lumpur. They completed the questionnaire including demographic information and the Malay version of DS14 and Hospital Anxiety and Depression Scale (HADS). Results: The structural validity, as demonstrated by exploratory factor analysis of the DS14 was acceptable. The Cronbach's α coefficient for the NA and SI subscales were 0.876 and 0.732, respectively. With the standardized cut-off of NA ≥ 10 and SI ≥ 10, 28.2% of the patients with CAD were defined as having a Type D personality. Anxiety was significantly higher among patients with Type D personality. Conclusion: The results indicate that the Type D personality (DS14) questionnaire is a valid and reliable tool in the Malaysian population. The prevalence of Type D personality in Malaysia falls close to what has been found in Western countries, at least for CAD patients. This study indicates also that it is possible to use the DS14 among the Malaysian population in future cross-cultural studies. ASEAN Journal of Psychiatry, Vol. 15 (2): July - December 2014: 186-195.
Objective: The involvement of families in assisting health professionals in providing care for their family members who suffer a stroke during hospitalization is common in Malaysia. Family caregivers are accountable in providing for the first-ever stroke survivor’s needs, including maintaining functional improvements gained in rehabilitation and the long-term well-being of the stroke survivors. The objective of this study was to determine the predictors of life satisfaction among family caregivers of hospitalized first-ever stroke patients. Methods: This was a cross-sectional community research design study with purposive sampling. It involved 102 family caregivers of hospitalized first-ever stroke patients of two tertiary hospitals in Kelantan. The Bakas Caregiving Outcomes Score (BCOS) was used to measure life satisfaction. Multiple linear regression was used to determine the predictors of life satisfaction. Results: Out of 102 respondents, 21 were males and 81 were females with age range of 16 to 76 years. Significant predictors of life satisfaction of caregivers while caring for their hospitalized first-ever stroke family members were caregivers’ health (β: -2.875, 95%CI: -5.725, -0.025, p = 0.048), patients’ age (β: - 4.251, 95% CI: - 6.379, -2.123, p
Objective: A sizable body of criminology literature has suggested that personality factors are critical to the development of aggressive behaviour. While research on personality focusing on aggression often revolves on "Eynseck Three Factor Model" and "Big Five Model", research on "Alternative Five Factor Model" (AFFM) is rather inadequate. Objective: The present study aimed to examine the association between five types of personality traits and subscales of aggression. Methods: This observational cross-sectional study was conducted in two prisons in Peninsular Malaysia among 198 Malay adult male inmates. The participants were selected based on the purposive sampling method from those who were convicted for various types of crime. Two psychometric instruments adapted to the Malaysian context were used: Malay version of Zuckerman-Kuhlman Personality Questionnaire-40-Cross Culture (ZKPQ-M-40-CC) and Aggression Questionnaire (AQ-M). Pearson correlation coefficient test was conducted to determine the association between five types of personality traits and subscales of aggression. Results: The results showed that there was a significant association between certain types of personality traits and subscales of aggression. The results were discussed in relation to theory and the context of crime. Conclusion: There is evidence that personality traits are linked to aggressive behaviour which may lead a person to commit offenses. ASEAN Journal of Psychiatry, Vol. 15 (2): July - December 2014: 176-185.
There are a number of validated questionnaires available for the screening of Post-Traumatic Stress Disorder (PTSD), and the PTSD Checklist for Civilians is one of them. However, none was translated into the Malay Language and validated for use in the Malaysian population. The aim of this study is to translate and validate the Malay PTSD Checklist for Civilians (MPCL-C). Methods: The PCL-C was translated into the Malay Language and back-translated. The reliability and validity of the MPCL-C were then determined by administering them to those who presented at the emergency department for motor vehicle accident at least one month before. Results: The MPCL-C has good face and content validity. In terms of reliability, it is also good, with Chronbach’s alpha values of 0.90, 0.77, 0.75 and 0.74 for the full scale, re-experiencing, avoidance and arousal domains respectively. Conclusions: The MPCL-C is a valid and reliable instrument to screen for PTSD in motor vehicle accident victims for the studied population.
The evaluation of mental health among older adults has become increasingly important in health and social science. Although this has been studied in developed countries, there are also issues for emerging countries, which have aging populations. The aims of this study were to determine the prevalence of loneliness/social isolation and late-life depression among older adults with cognitive impairment living in institutional care. Methods: A cross sectional survey involving residents of four government nursing homes in West Malaysia was carried out. All residents aged 60 years old and above with cognitive impairment were included in the study. Participants were assessed by the Short Mini Mental State Examination (SMMSE), Friendship Scale (FS) and Geriatric Depression Scale (GDS). Results: The prevalence of depression and loneliness/social isolation were 85.5% and 95.5% respectively. Depression was strongly associated with age, education attainment, financial conditions, health, cognitive impairment and loneliness/social isolation. Loneliness/social isolation was strongly associated to depression and relationship satisfaction with children. Conclusion: There was high prevalence of depression and loneliness/social isolation among older adults with cognitive impairment living in institutional care. Depression and loneliness/social isolation are interrelated and influence each other and these problems need to be addressed to improve their quality of life.
Device, Questionnaire & Scale: Mini Mental State Examination (MMSE-12); Friendship Scale (FS); Geriatric Depression Scale (GDS-15)
Objective: This study was conducted to assess the effects of Methadone Maintenance Therapy (MMT) and buprenorphine-naloxone Maintenance Therapy (BNX) on the Quality of life (QoL) of opiate abusers. Methods: The QoL status of opioid-dependent patients was assessed using the WHOQOL-BREF questionnaire. It is a cross-sectional study involving a total of 108 patients who received MMT or BNX therapy in Malaysia from May 2011 to September 2011. Results: A statistically significant difference in the overall QoL and psychological aspect among patients on MMT was observed. On the contrary, the scores of overall QoL and quality of social relationship for BNX group were higher in patients with lower dosage. Conclusion: The comparison between patients on high dose MMT and high dose BNX exhibited significant difference in the overall QoL especially in psychological, social relationship and environment domains, with the high dose MMT group having better mean score. ASEAN Journal of Psychiatry, Vol. 15 (2): July - December 2014: 131-139.