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  1. Pitil PP, Ghazali SR
    Psychol Rep, 2022 Dec 26.
    PMID: 36571322 DOI: 10.1177/00332941221149172
    Multiple studies have investigated the efficacy of acceptance and commitment therapy (ACT) in improving psychological flexibility among overweight and obese individuals. However, to date, no specific reviews have focused on ACT and weight-related difficulties in this population. This systematic review of the literature aims to identify and assemble all ACT interventions in randomized controlled trials (RCT) that address weight-related difficulties in the treatment of overweight and obese adults. The PRISMA 2020 framework was used for the systematic review, includes manual and computerized database searches. Five databases (Medline, PubMed, Scopus, PsycInfo, and Google) were utilized to gather all articles that: (a) published in English; (b) adopted the RCT design; (c) used ACT as an intervention; (d) included adult participants aged over 18 years with BMI of over 25 kg/m2, and (e) included weight-related difficulties and weight as outcome measures. The review identified seven studies comprising 698 overweight or obese participants of both genders. Improvements were reported in weight-related difficulties and percentage of weight loss in the ACT group and the non-ACT group. The present review supports ACT as an effective intervention that can help adults with weight-related difficulties and excess body weight. Further studies should be conducted in various overweight or obese populations with a more systematic RCT research design to establish the effectiveness of ACT in this area.
  2. Ghazali SR, Chen YY, Aziz HA
    J Child Adolesc Trauma, 2018 Jun;11(2):151-158.
    PMID: 32318145 DOI: 10.1007/s40653-017-0196-2
    Adolescents in the juvenile justice system are known to suffer from various psychological disorders. Less is known about how childhood psychological trauma is related to psychological disorders among delinquent adolescents in Malaysia. This study investigated the relationship between childhood maltreatment and depressive and Posttraumatic Stress Disorder (PTSD) symptoms. Of 327 adolescents 96% were exposed to at least one childhood victimization. Significant differences were found for all types of victimization (i.e. maltreatment, sexual abuse, severe assault, neglect, and family victimization) between delinquent and non-delinquent adolescents. Females were more likely to be involved in family victimization, while males were more likely to experience severe assault and crime victimization. Delinquent adolescents reported depressive and PTSD symptoms significantly more than non-delinquent adolescents. The prevalence of PTSD and depressive symptoms among delinquents was 20.8 and 52.7% respectively. Highly victimized delinquent adolescents and/or those victimized in family-related events were at significantly higher risk to develop psychiatric symptoms.
  3. Chen YY, Ghazali SR, Said A
    PMID: 39220240 DOI: 10.51866/oa.557
    INTRODUCTION: Exploring the connections between traumatic experiences and subsequent health outcomes is vital for informing clinical practices and public health policies. The study aimed to investigate the relationship between lifetime trauma exposure and posttraumatic stress disorder (PTSD), depressive and cardiovascular disease (CVD) symptoms.

    METHODS: A total of 171 patients who received treatment in a local heart centre were included in this study. Several questionnaires such as the Life Event Checklist-5, Posttraumatic Stress Disorder Checklist for DSM-5 and Patient Health Questionnaire-9 were used to measure their traumatic experiences and PTSD and depressive symptoms, respectively. Physiological measures were also examined. Data were analysed using SPSS.

    RESULTS: The chi-square test showed significant differences in the percentage of reported PTSD symptoms among the patients with CVD (24.0%), patients with kidney disease (4.3%) and patients with other health problems (7.1%). The patients with CVD reported having a significantly higher percentage of PTSD and depressive symptoms than the patients with other medical conditions. The patients with CVD who reported having PTSD symptoms had significant systolic blood pressure (SBP) and heart rate changes compared to the patients who did not. The patients who reported PTSD symptoms had a significantly shorter sleep duration than their counterparts. The SBP and diastolic blood pressure differed significantly between the patients with and without PTSD symptoms.

    CONCLUSION: Earlier detection, prevention and intervention related to trauma exposure and PTSD symptoms are suggested to reduce the CVD risk.

  4. Murphy S, Elklit A, Chen YY, Ghazali SR, Shevlin M
    Psychol Trauma, 2019 Mar;11(3):319-327.
    PMID: 29723027 DOI: 10.1037/tra0000355
    OBJECTIVE: Evidence has suggested there are sex differences in posttraumatic stress disorder (PTSD) symptom expression; however, few studies have assessed whether these differences are due to measurement invariance. This study aimed to examine sex differences in PTSD symptoms based on the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) using differential item functioning (DIF).

    METHOD: Confirmatory factor analysis was conducted on the DSM-5 model of PTSD, followed by a multiple indicators multiple causes (MIMIC) model to examine possible DIF using the PTSD Checklist for DSM-5. Data were analyzed from a Malaysian adolescent sample (n = 481) of which 61.7% were female, with a mean age of 17.03 years.

    RESULTS: The results indicated the presence of DIF for 2 of 20 PTSD criteria. Females scored significantly higher on emotional cue reactivity (B4), and males reported significantly higher rates of reckless or self-destructive behavior (E2) while statistically controlling for the latent variables in the model. However, the magnitude of these item-level differences was small.

    CONCLUSION: These findings indicate that despite the presence of DIF for 2 DSM-5 symptoms, this does not provide firm support for nonequivalence across sex. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

  5. Ghazali SR, Elklit A, Balang RV, Sultan MA, Kana K
    Asian J Psychiatr, 2014 Oct;11:45-9.
    PMID: 25453696 DOI: 10.1016/j.ajp.2014.05.008
    The objective of this study is to determine the prevalence of lifetime exposure to traumatic events and its relation to PTSD symptoms.
  6. Majani AF, Ghazali SR, Yoke Yong C, Pauzi N, Adenan F, Manogaran K
    Psychol Rep, 2023 Aug;126(4):1605-1619.
    PMID: 35084251 DOI: 10.1177/00332941221075246
    Multiple exposures to life-threatening events may lead to various mental health issues and indirectly affect the marriage of those affected. Very few studies have investigated trauma exposure, posttraumatic stress disorder (PTSD), depressive symptoms, and marital conflicts among firefighters, a group that faces such exposure occupationally. The present study explores the relationship between trauma exposure, PTSD, and depression in relation to marital conflicts among firefighters in Sarawak, adopting a cross-sectional research design. Different marital status reported significant PTSD and depressive symptoms. The widowed scored higher PTSD and depressive symptoms than the married and single groups. Firefighters with PTSD and depressive symptoms reported having more problems in aggression family history of distress, sexual dissatisfaction, and problem solving communication than those without. Regression analysis showed that problem solving communication (t (212) = 2.59, p = .01) and global distress scores (t (212) = 2.17, p < .05) in type of marital conflicts served as a significant predictor for depressive symptoms. The present study suggests that proper planning for treatment and intervention is needed to improve psychological well-being among firefighters and other high-risk professions following multiple exposures to traumatic events in carrying their job duty. Proper intervention programs also should be initiated for spouses of firefighters dealing with traumatized partners.
  7. Mohamed NF, Ghazali SR, Yaacob NA, Rahim AAA, Maskon O
    Sultan Qaboos Univ Med J, 2018 Nov;18(4):e494-e500.
    PMID: 30988969 DOI: 10.18295/squmj.2018.18.04.011
    Objectives: Heart failure (HF) is a common clinical syndrome with an enormous impact on prognosis and lifestyle. Accordingly, rehabilitation measures need to be patient-specific and consider various sociocultural factors so as to improve the patient's quality of life (QOL). This study aimed to develop and validate a HF-specific QOL (HFQOL) questionnaire within a multicultural setting.

    Methods: This study took place at the National Heart Institute and Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia, between March 2013 and March 2014. A self-administered 75-item HFQOL questionnaire was designed and administrated to 164 multi-ethnic Malaysian HF patients. Exploratory factor analysis was performed to assess the instrument's construct validity. Cronbach's alpha coefficients were used to determine internal consistency.

    Results: A total of 33 out of 75 items were retained in the final tool. The HFQOL questionnaire had three common factors-psychological, physical-social and spiritual wellbeing-resulting in a cumulative percentage of total variance of 44.3%. The factor loading ranges were 0.450-0.718 for psychological wellbeing (12 items), 0.394-0.740 for physical-social wellbeing (14 items) and 0.449-0.727 for spiritual wellbeing (seven items). The overall Cronbach's alpha coefficient of the questionnaire was 0.82, with coefficients of 0.86, 0.88 and 0.79 for the psychological, physical-social and spiritual wellbeing subdomains, respectively.

    Conclusion: The HFQOL questionnaire was found to be a valid and reliable measure of QOL among Malaysian HF patients from various ethnic groups. Such tools may facilitate cardiac care management planning among multi-ethnic patients with HF.

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