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The relations of internet and smartphone addictions to depression, anxiety, stress, and suicidality among public university students in Klang Valley, Malaysia

Wan Ismail WS, Sim ST, Tan KA, Bahar N, Ibrahim N, Mahadevan R, et al.

Perspect Psychiatr Care, 2020 Oct;56(4):949-955.
PMID: 32363648 DOI: 10.1111/ppc.12517

PURPOSE: This cross-sectional study examined the cyber-psychological correlates of depression, anxiety, stress, and suicidality among public university students in Klang Valley, Malaysia.
DESIGN AND METHODS: Participants were randomly selected using multi-stage sampling methods from three public universities in the study location. Participants completed measures of internet and smartphone addictions, depression, anxiety, stress, and suicidality, along with sociodemographic items.
FINDINGS: At bivariate level, both internet and smartphone addictions were found to have significant positive correlations with depression, anxiety, stress, and suicidality. At multivariate level, only internet addiction emerged as a consistent significant predictor for depression, anxiety, stress, and suicidality.
PRACTICE IMPLICATIONS: The present findings have implications for mental health professionals to routinely screen for psychological disturbance in young adults who have potential risks for internet addiction.
Fulltext Are Malaysian Youths Overdependent on the Internet?: A Narrative Review

Nik Jaafar NR, Bahar N, Ibrahim N, Baharudin A, Wan Ismail WS, Sim ST, et al.

Front Psychiatry, 2021;12:710790.
PMID: 34484002 DOI: 10.3389/fpsyt.2021.710790

Overdependence on the internet is a grave concern that has enveloped Malaysian youths which could lead to a variety of sequelae. This narrative review aims to determine the definition of internet overdependence and its associated factors, as well as the potential preventive and treatment strategies for internet overdependence. From the literature, internet overdependence is regarded as a 3-factor model encompassing salience, self-control failure, and serious consequences. Sociodemographic factors such as age, gender, and ethnicity, as well as psychosocial factors such as depression, anxiety, stress, and loneliness, were found to be associated with internet overdependence among Malaysian youths. A multimodal treatment approach is recommended by the implementation of various types of treatments, integrating disciplines such as pharmacology, psychotherapy, and family counseling. Despite various terminologies being used and unclear conceptualization of its nomenclature, overdependence on the internet is prevalent among youths in Malaysia. Future research should go toward establishing a clear definition of its terminology and attaining more robust evidence on treatment strategies.
The Dual Systems Model-Impulsivity and Narcissism as the Reflexive System and Self-Regulation as the Reflective System-of Smartphone Addiction

Tan KA, Nik Jaafar NR, Bahar N, Ibrahim N, Baharudin A, Wan Ismail WS, et al.

Cyberpsychol Behav Soc Netw, 2024 Feb;27(2):156-162.
PMID: 38232711 DOI: 10.1089/cyber.2023.0337

The exploration of underlying mechanisms leading to the development of smartphone addiction has been limited, with only a few studies incorporating theories to provide explanations. Drawing upon the Dual Systems Model, this study tested the hypothesis that the reflective system of self-regulation would mediate the relation between the reflexive system of impulsivity and narcissism, and smartphone addiction in a sample of 298 undergraduate students. Participants completed a self-administrated web-based questionnaire containing measures of impulsivity (the Barratt Impulsiveness Scale), narcissism (the Narcissistic Personality Inventory), self-regulation (the Self-Regulation Scale), and smartphone addiction (the Smartphone Addiction Inventory). The findings from structural equation modeling revealed that self-regulation served as a significant mediator between impulsivity and smartphone addiction, as well as between narcissism and smartphone addiction. These findings offer insights that can contribute to the development of interventions and strategies that target impulsivity and narcissism by enhancing self-regulation skills.
Fulltext Correction to: Effectiveness and sustainability of a structured group-based educational program (MEDIHEALTH) in improving medication adherence among Malay patients with underlying type 2 diabetes mellitus in Sarawak State of Malaysia: study protocol of a randomized controlled trial

Ting CY, Adruce SAZ, Hassali MA, Ting H, Lim CJ, Ting RS, et al.

Trials, 2019 05 10;20(1):267.
PMID: 31077233 DOI: 10.1186/s13063-019-3348-x

After publication of the original article [1], the authors have notified us that there are changes to the primary outcome of the study, instrument, subject's inclusion criteria, the funding and acknowledgements. These changes were made during the recruitment of participants and after approved by the Medical Research and Ethics Committee (MREC), National Institutes of Health Malaysia, on 16th November 2018.
Fulltext Effectiveness and sustainability of a structured group-based educational program (MEDIHEALTH) in improving medication adherence among Malay patients with underlying type 2 diabetes mellitus in Sarawak State of Malaysia: study protocol of a randomized controlled trial

Ting CY, Ahmad Zaidi Adruce S, Hassali MA, Ting H, Lim CJ, Ting RS, et al.

Trials, 2018 Jun 05;19(1):310.
PMID: 29871651 DOI: 10.1186/s13063-018-2649-9

BACKGROUND: Amidst the high disease burden, non-adherence to medications among patients with type 2 diabetes mellitus (T2DM) has been reported to be common and devastating. Sarawak Pharmaceutical Services Division has formulated a pharmacist-led, multiple-theoretical-grounding, culturally sensitive and structured group-based program, namely "Know Your Medicine - Take if for Health" (MEDIHEALTH), to improve medication adherence among Malay patients with T2DM. However, to date, little is known about the effectiveness and sustainability of the Program.
METHODS/DESIGN: This is a prospective, parallel-design, two-treatment-group randomized controlled trial to evaluate the effectiveness and sustainability of MEDIHEALTH in improving medication adherence. Malay patients who have underlying T2DM, who obtain medication therapy at Petra Jaya Health Clinic and Kota Samarahan Health Clinic, and who have a moderate to low adherence level (8-item Morisky Medication Adherence Scale, Malaysian specific, score <6) were randomly assigned to the treatment group (MEDIHEALTH) or the control group. The primary outcome of this study is medication adherence level at baseline and 1, 3, 6 and 12 months post-intervention. The secondary outcomes are attitude, subjective norms, perceived behavioural control, intention and knowledge related to medication adherence measured at baseline and 1, 6 and 12 months post-intervention. The effectiveness and sustainability of the Program will be triangulated by findings from semi-structured interviews with five selected participants conducted 1 month after the intervention and in-depth interviews with two main facilitators and two managerial officers in charge of the Program 12 months after the intervention. Statistical analyses of quantitative data were conducted using SPSS version 22 and Stata version 14. Thematic analysis for qualitative data were conducted with the assistance of ATLAS.ti 8.
DISCUSSION: This study provides evidence on the effectiveness and sustainability of a structured group-based educational program that employs multiple theoretical grounding and a culturally sensitive approach in promoting medication adherence among Malays with underlying T2DM. Both the quantitative and qualitative findings of this study could assist in the future development of the Program.
TRIAL REGISTRATION: National Medical Research Register, NMRR-17-925-35875 (IIR). Registered on 19 May 2017. ClinicalTrials.gov, NCT03228706 . Registered on 25 July 2017.