Clinical psychology is a specialised field of professional psychology that is much needed with regards to the treatment of mental disorders, behaviour problems and learning difficulties. The field of clinical psychology has been integrated into the health system, especially the mental health and education system, in many western countries. In Malaysia, clinical psychology is still a new concept and has yet to be accepted into the medical and health systems in Jurnal Sains Kesihatan Malaysia 5 (1) 2007: 59-6660 general. This preliminary study looks at the awareness of 199 medical and health sciences professional with regards to clinical psychology. Results of this survey found that only 13.6% of the respondents demonstrated basic knowledge of what clinical psychology is. The awareness of clinical psychology as a clinical profession, and its benefits within the health system is still very much lacking among medical and health sciences professionals. The need to improve awareness of clinical psychology as a clinical profession as well as a health science discipline is very important as clinical psychology services are able to contribute to more holistic treatment of health problems in Malaysia.Implications of this study includes the need for the awareness of clinical psychology to be improved.
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.
Women participating in a wide range of competitive sports are at higher risk of developing eating disorders, menstrual irregularities and osteoporosis, which are generally referred to as the 'female athlete triad'. The objective of this study was to determine the prevalence of female athlete triad and factors associated with this condition among athletes participating in different sports. A total of 67 elite female athletes aged between 13-30 years participated in the study and were subdivided into the 'leanness' and 'non-leanness' groups. Eating disorders were assessed using a body image figure rating and the Eating Disorder Inventory (EDI) with body dissatisfaction (BD), drive for thinness (DT), bulimia (B) and perfectionism (P) subscales. Menstrual irregularity was assessed with a self-reported menstrual history questionnaire. Bone quality was measured using a quantitative ultrasound device at one-third distal radius. Prevalence of the female athlete triad was low (1.9%), but the prevalence for individual triad component was high, especially in the leanness group. The prevalence of subjects who were at risk of menstrual irregularity, poor bone quality and eating disorders were 47.6%, 13.3% and 89.2%, respectively, in the leanness group; and 14.3%, 8.3% and 89.2%, respectively, in the non-leanness group. Since the components of the triad are interrelated, identification of athletes at risk of having any one component of the triad, especially those participating in sports that emphasise a lean physique, is an important aid for further diagnosis.
The aim of this study was to investigate the relationship between gender, birth weight, nutritional status, and iron status of children with their academic performance and cognitive function.
Nutrition is an important factor in mental development and, as a consequence, in cognitive performance. Malnutrition is reflected in children's weight, height and BMI curves. The present cross-sectional study aimed to evaluate the association between anthropometric indices and cognitive performance in 6746 school-aged children (aged 6-12 years) of four Southeast Asian countries: Indonesia; Malaysia; Thailand; Vietnam. Cognitive performance (non-verbal intelligence quotient (IQ)) was measured using Raven's Progressive Matrices test or Test of Non-Verbal Intelligence, third edition (TONI-3). Height-for-age z-scores (HAZ), weight-for-age z-scores (WAZ) and BMI-for-age z-scores (BAZ) were used as anthropometric nutritional status indices. Data were weighted using age, sex and urban/rural weight factors to resemble the total primary school-aged population per country. Overall, 21% of the children in the four countries were underweight and 19% were stunted. Children with low WAZ were 3·5 times more likely to have a non-verbal IQ < 89 (OR 3·53 and 95% CI 3·52, 3·54). The chance of having a non-verbal IQ < 89 was also doubled with low BAZ and HAZ. In contrast, except for severe obesity, the relationship between high BAZ and IQ was less clear and differed per country. The odds of having non-verbal IQ levels < 89 also increased with severe obesity. In conclusion, undernourishment and non-verbal IQ are significantly associated in 6-12-year-old children. Effective strategies to improve nutrition in preschoolers and school-aged children can have a pronounced effect on cognition and, in the longer term, help in positively contributing to individual and national development.
CONTEXT: Few randomized controlled trials (RCTs) of interventions for the treatment of childhood obesity have taken place outside the Western world.
AIM: To test whether a good practice intervention for the treatment of childhood obesity would have a greater impact on weight status and other outcomes than a control condition in Kuala Lumpur, Malaysia.
METHODS: Assessor-blinded RCT of a treatment intervention in 107 obese 7- to 11-year olds. The intervention was relatively low intensity (8 hours contact over 26 weeks, group based), aiming to change child sedentary behavior, physical activity, and diet using behavior change counselling. Outcomes were measured at baseline and six months after the start of the intervention. Primary outcome was BMI z-score, other outcomes were weight change, health-related quality of life (Peds QL), objectively measured physical activity and sedentary behavior (Actigraph accelerometry over 5 days).
RESULTS: The intervention had no significant effect on BMI z score relative to control. Weight gain was reduced significantly in the intervention group compared to the control group (+1.5 kg vs. +3.5 kg, respectively, t-test p < 0.01). Changes in health-related quality of life and objectively measured physical activity and sedentary behavior favored the intervention group.
CONCLUSIONS: Treatment was associated with reduced rate of weight gain, and improvements in physical activity and quality of life. More substantial benefits may require longer term and more intensive interventions which aim for more substantive lifestyle changes.
The dual burden of malnutrition reportedly coexists in Malaysia; however, existing data are scarce and do not adequately represent the nutritional status of Malaysian children. The Nutrition Survey of Malaysian Children was carried out with the aim of assessing the nutritional status in a sample of nationally representative population of children aged 6 months to 12 years. A total of 3542 children were recruited using a stratified random sampling method. Anthropometric measurements included weight, height, mid-upper arm circumference, and waist and hip circumferences. Blood biochemical assessment involved analyses of Hb, serum ferritin, and vitamins A and D. Dietary intake was assessed using semi-quantitative FFQ, and nutrient intakes were compared with the Malaysian Recommended Nutrient Intakes (RNI). The prevalence of overweight (9·8%) and obesity (11·8%) was higher than that of thinness (5·4%) and stunting (8·4%). Only a small proportion of children had low levels of Hb (6·6%), serum ferritin (4·4%) and vitamin A (4·4%), but almost half the children (47·5%) had vitamin D insufficiency. Dietary intake of the children was not compatible with the recommendations, where more than one-third did not achieve the Malaysian RNI for energy, Ca and vitamin D. The present study revealed that overnutrition was more prevalent than undernutrition. The presence of high prevalence of vitamin D insufficiency and the inadequate intake of Ca and vitamin D are of concern. Hence, strategies for improving the nutritional status of Malaysian children need to consider both sides of malnutrition and also put emphasis on approaches for the prevention of overweight and obesity as well as vitamin D insufficiency.