Displaying all 12 publications

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  1. Rosli AN, Wan Ismail WS
    Case Rep Psychiatry, 2015;2015:136835.
    PMID: 26483984 DOI: 10.1155/2015/136835
    We report a case of a girl with a history of obsessive-compulsive disorder (OCD) subsequently exhibiting psychosis. She never attained remission since the outset. Initially she seemed to be resistant to most antipsychotics, namely, risperidone, haloperidol, paliperidone, quetiapine, and clozapine. However, she later responded remarkably better to risperidone after it was reintroduced for the second time. Recognizing and understanding the various pathogenesis of OCD or obsessive-compulsive symptoms (OCS) in schizophrenia are vital in laying out plan to manage the patient effectively.
  2. Wan Ismail WS, Nik Jaafar NR, Sidi H, Midin M, Shah SA
    Compr Psychiatry, 2014 Jan;55 Suppl 1:S114-20.
    PMID: 23763872 DOI: 10.1016/j.comppsych.2013.05.002
    INTRODUCTION: To determine sociodemographic and psychological factors associated with bullying behavior among young adolescents in Malaysia.
    METHODS: This is a cross-sectional study of four hundred ten 12-year-old adolescents from seven randomly sampled schools in the Federal Territory of Kuala Lumpur, Malaysia. Sociodemographic features of the adolescents and their parents, bullying behavior (Malaysian Bullying Questionnaire), ADHD symptoms (Conners Rating Scales), and internalizing and externalizing behavior (Child Behaviour Checklist) were obtained from adolescents, parents and teachers, respectively.
    RESULTS: Only male gender (OR=7.071, p=0.01*, CI=1.642-30.446) was a significant sociodemographic factor among bullies. Predominantly hyperactive (OR=2.285, p=0.00*, CI=1.507-3.467) and inattentive ADHD symptoms reported by teachers (OR=1.829, p=0.03*, CI=1.060-3.154) and parents (OR=1.709, p=0.03*, CI=1.046-2.793) were significant risk factors for bullying behavior while combined symptoms reported by young adolescents (OR=0.729, p=0.01*, CI=0.580-0.915) and teachers (OR=0.643, p=0.02*, CI=0.440-0.938) were protective against bullying behavior despite the influence of conduct behavior (OR=3.160, p=0.00*, CI=1.600-6.241). Internalizing behavior, that is, withdrawn (OR=0.653, p=0.04*, CI=0.436-0.977) and somatic complaints (OR=0.619, p=0.01*, CI=0.430-0.889) significantly protect against bullying behavior.
    DISCUSSIONS: Recognizing factors associated with bullying behavior, in particular factors distinctive to the local population, facilitates in strategizing effective interventions for school bullying among young adolescents in Malaysian schools.
  3. Wan Ismail WS, Nik Jaafar NR, Mohd Daud TI, Shah SA, Ismail A, Shafiee Z
    ASEAN Journal of Psychiatry, 2010;11(1):79-86.
    MyJurnal
    Objective: School bullying in Malaysia is on the rise. While efforts are put together to combat the problem, the psychiatric aspect has been neglected. This is a cross-sectional study aimed to determine the association between the symptoms of ADHD and bully/victim problems among Malaysian sixthgraders attending primary schools in Kuala Lumpur.
    Methods: A total of 410 sixth-graders from seven randomly selected schools were assessed with regards to bully/victim problems and ADHD symptoms using self-reported questionnaires. Malaysian Bullying Questionnaire was used to rate bully/victim problems while ADHD symptoms were assessed using ConnersWells’ Adolescent Self-report Scale (CASS). Teachers and parents also assessed students’ ADHD symptoms using Conner’s Teachers Rating Scale (CTRS) and Conner’s Parents Rating Scale (CPRS), respectively.
    Results: Self-reported questionnaires showed that 61.2% of the children were involved in bully/victim problems. The ADHD symptoms were found significant in relation to bully/victim problems as tested by multiple logistic regression. Only students and parents reported significant ADHD symptoms among the bully/victim groups. The ADHD symptoms reported by students were significant among bullies(OR=0.59,CI=0.42-0.83, p
  4. Jaafar NRN, Bahar N, Ibrahim N, Wan Ismail WS, Baharudin A
    Curr Opin Psychiatry, 2017 Jul;30(4):260-267.
    PMID: 28426547 DOI: 10.1097/YCO.0000000000000336
    PURPOSE OF REVIEW: There are considerable gender differences in youth engaging in excessive internet use (EIU). This review provides updates based on the recent literature focusing on the EIU in young women to describe its implications including what it constitutes of, its correlates, sequelae and preventive and/or treatment strategies.

    RECENT FINDINGS: Definition of EIU and its conceptualization still requires refinement. Recent studies indicate a changing trend towards female predominance of EIU. Women also differ in their internet use compared with men regarding their preference in the internet content and online activities, motives of use and factors related to access to the internet, including the device, sociocultural restrictions, etc. The correlates and sequelae of EIU encompass psychological, physical, biological, family and social domains that could form the basis of identifying individuals at risk and strategizing treatment.

    SUMMARY: The findings indicate the need for standardization in definition and measures of EIU for better recognition of EIU and identification of its at-higher-risk females. Effective preventive and treatment measures are still limited by various methodology flaws outlined here.

  5. Abd Latif MH, Wan Ismail WS, Abdul Manaf MR, Abdul Taib NI
    J Autism Dev Disord, 2023 Nov 21.
    PMID: 37987948 DOI: 10.1007/s10803-023-06155-8
    PURPOSE: Accepting and adapting to the child's diagnosis of Autism Spectrum Disorder (ASD) can be challenging for parents. We aimed to assess domains of parental adjustment namely despair, self-blame, and acceptance among parents whose children were diagnosed with ASD.

    METHODS: A cross-sectional study was conducted among 111 parents of children with autism who attended Child and Adolescent Psychiatry Unit (CAPU), in a university teaching hospital in Kuala Lumpur, Malaysia. Sociodemographic profiles of both parents and children were gathered. Parental adjustment focusing on parental self-blame, despair and acceptance were assessed using self-reported questionnaires namely Adjustment to the Diagnosis of Autism (ADA).

    RESULTS: Higher level of despair was associated with parents who have medical illness (β = 0.214, p = 0.016) and children who received antipsychotic medications (β = 0.329, p 

  6. Abd Rahman FN, Mohd Daud TI, Nik Jaafar NR, Shah SA, Tan SM, Wan Ismail WS
    Pediatr Int, 2013 Aug;55(4):422-7.
    PMID: 23617604 DOI: 10.1111/ped.12115
    There is a dearth of studies on behavioral and emotional problems in residential care children in Malaysia. This study describes the behavioral and emotional problems in a sample of children in a government residential care home and compares them with their classmates living with their birth parents.
  7. 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.

  8. 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.
  9. Nurkhairulnisa AI, Chew KT, Zainudin AA, Lim PS, Shafiee MN, Kampan N, et al.
    Obstet Gynecol Int, 2018;2018:9795681.
    PMID: 30116271 DOI: 10.1155/2018/9795681
    Objective: This study aims to describe the menstrual pattern and menstrual care of girls with intellectual disabilities and to evaluate the impact of menstruation and awareness of parents/guardians on girls with intellectual disabilities.

    Methodology: Parents/guardians of girls aged 9-17 years with known intellectual disabilities who attended a scheduled public forum and Paediatrics and Adolescent Gynaecology Clinic (PAC) were recruited in a questionnaire-based study.

    Results: A total of 123 parents/guardians with a mean age of 41.83 ± 5.45 years completed the questionnaire. The mean age of girls with intellectual disabilities was 12.28 ± 2.78 years, and the mean menarcheal age was 11.12 ± 1.76 years. Only 53 (43.1%) parents/guardians were aware of availability of menstrual suppression. Parents/guardians with lower family income (OR = 0.00; 95% CI = 0.00-0.20), unable to manage menses (OR = 0.03; 95% CI = 0.00-0.61), and moderate severity of menses (OR = 0.01; 95% CI = 0.00-1.21), were associated with seeking medical help on menstrual suppression. The factors associated with parents/guardians requesting for sterilization were lower family income (OR = 0.02; 95% CI = 0.00-0.36) and concern about sexual abuse (OR = 0.25; 95% CI = 0.06-0.39).

    Conclusion: Menstrual pattern in girls with intellectual disabilities is similar to those without disabilities. Parents/guardians' knowledge and awareness on menstrual suppression were still lacking.

  10. Ibrahim MF, Wan Ismail WS, Nik Jaafar NR, Mohd Mokhtaruddin UK, Ong HY, Abu Bakar NH, et al.
    Front Psychiatry, 2022;13:913067.
    PMID: 35757216 DOI: 10.3389/fpsyt.2022.913067
    INTRODUCTION: Depression is a prevalent mental health condition worldwide and in Malaysia. Depression among adolescents has been steadily increasing. Self-esteem has been known to be associated with depression. It has been postulated that a poor lifestyle among adolescents is associated with depression. This paper aims to study the correlation of self-esteem, lifestyle (eating behavior, physical activity, and internet usage) with depression among Malaysian youth.

    METHODOLOGY: This is a cross-sectional study among secondary school children from 5 random schools in an urban city of Kuala Lumpur, Malaysia. Those with intellectual disability and/or difficulty to comprehend Malay language, and without parental consent and assent, were excluded. Students from randomly selected classes aged 13-year-old to 17-year-old were invited to fill in these questionnaires: Socio-demographic Questionnaire, Rosenberg Self-esteem Questionnaire, Physical Activity Questionnaire (PAQ-A), Eating Disorder Examination Questionnaires (EDE-Q), Internet Addiction Test Scale (IAT), and Children's Depression Inventory (CDI).

    RESULT: 461 students participated in the study. 21.5% of the participating students were found to have depression (n = 99). Younger age and Chinese race showed significant association with adolescent depression with a p-value of 0.032 and 0.017 respectively. Other significant correlations with depression were self-esteem (p = 0.013), disordered eating (p = 0.000), lower physical activity (p = 0.014) and problematic internet usage (p = 0.000).

    DISCUSSION: The prevalence of depression among adolescents in this study (21.5%) is in line with previous prevalence studies in Malaysia. Self-esteem is postulated to be a moderating factor for depression hence explaining the significant association. A sedentary lifestyle may increase the risk of developing depression, The causal relationship between problematic internet usage and depression is complex and difficult to establish. This is similar to the relationship between problematic eating behavior and depression as well.

    CONCLUSION: There is still a need to explore the causal relationship between lifestyle factors and depression among youth. Despite that, the results from this paper have accentuated the gravity of the importance of a healthy lifestyle among adolescents. An appropriate preventive measure is governmental strategies and policies aiming at improving a healthier lifestyle in this age group.

  11. 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.
  12. Ahmad Basri MAF, Wan Ismail WS, Kamal Nor N, Mohd Tohit N, Ahmad MN, Mohamad Aun NS, et al.
    PLoS One, 2024;19(4):e0301517.
    PMID: 38574084 DOI: 10.1371/journal.pone.0301517
    The use of virtual reality in social skills training for high functioning autism spectrum disorder (HFASD) youth has been found to be engaging and enjoyable. Despite the promising results, previous literature indicates that there has been no consensus on the social skills target in the training content. There is also limited research on how evidence-based strategies like cognitive and behaviour techniques are instantiated into the VR environment to teach social skills. The aim of this study is to determine the key components to design a social skills training content using virtual reality for youths with HFASD. The Fuzzy Delphi method (FDM) was used to obtain expert consensus on social skills difficulties and cognitive behavioral techniques included in the content in three phases. In phase 1, a questionnaire was developed from in-depth interviews and scientific literature review. The in-depth interviews were conducted with 13 HFASD youth, 7 parents and 6 experts. In phase 2, 3 experts rated the relevance of the items in the questionnaire using an item-level content validity index (I-CVI) assessment. In phase 3, the questionnaire was distributed to 10 experts to rate their level of agreement on each component using a 7-point Likert scale. Components that received a value above 75%, threshold value (d) ≤ 0.2, fuzzy score (A) ≥ α - cut value = 0.5 and higher rank based on defuzzification score were prioritized to be included in the content. Items that received higher expert consensus on social skills difficulties included assessing non-verbal responses, initiating, maintaining, and leaving conversations, emotional difficulties and difficulties in perspective taking. Cognitive and behavioral techniques that received higher expert consensus were psychoeducation, modelling, relaxation techniques, reinforcements, and perspective-taking questions. These key components can be used as a framework for the development of virtual learning content for social skills training in future studies.
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