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  1. Ahmadi A, Mustaffa MS, Udin A, Haghdoost A
    Trends Psychiatry Psychother, 2016 03 18;38(1):14-22.
    PMID: 27007941 DOI: 10.1590/2237-6089-2015-0027
    INTRODUCTION: Pediatric anxiety disorders are the most common mental health disorders in the middle-childhood age group. The purpose of this study is to assess anxiety disorder symptoms, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV), in a large community sample of low socioeconomic level rural children and to investigate some of the psychometric properties (internal consistency, construct and convergent validity and items rated as often or always experienced) of the Malay version of the Spence Children's Anxiety Scale - Child version (SCAS-C).

    METHOD: Six hundred children aged 9-11 and 424 of their parents completely answered the child or parent versions of the SCAS.

    RESULTS: Results indicated that the internal reliability of subscales were moderate to adequate. Significant correlations between child and parent reports supported the measure's concurrent validity. Additionally, anxiety levels in this Malaysian sample were lower than among South-African children and higher than among their Western peers. There were both similarities and differences between symptom items reported as often or always experienced by Malaysian students and by children from other cultures. Confirmatory factor analysis provided evidence of the existence of five inter-correlated factors for anxiety disorders based on SCAS-C.

    CONCLUSION: Although some of the instrument's psychometric properties deviated from those observed in some other countries, it nevertheless appears to be useful for assessing childhood anxiety symptoms in this country.

  2. Ahmadi A, Mustaffa MS, Haghdoost A, Khan A, Latif AA
    Trends Psychiatry Psychother, 2015 4 11;37(1):37-41.
    PMID: 25860565 DOI: 10.1590/2237-6089-2014-0038
    INTRODUCTION: Anxiety among children has increased in recent years. Culturally adapted questionnaires developed to measure the level of anxiety are the best screening instruments for the general population. This study describes the scientific translation and adaptation of the Spence Children's Anxiety Scale (SCAS) into the Malay language.

    METHOD: The process of scientific translation of this selfreport instrument followed the guidelines of the Task Force for Translation and Cultural Adaptation of the International Society for Pharmacoeconomics and Outcomes Research (ISPOR).

    RESULTS: The Malay version and its adaptation for a new cultural context are described.

    CONCLUSION: The Malay version achieved the aims of the original version and its conceptual and operational equivalence. It may be used as the first Malay instrument to measure anxiety among children in research and in clinical and community settings.

  3. Ang CS
    Trends Psychiatry Psychother, 2020 4 23;42(1):7-15.
    PMID: 32321081 DOI: 10.1590/2237-6089-2018-0109
    OBJECTIVE: Use of the Screen for Child Anxiety Related Emotional Disorders (SCARED) has increased significantly since its publication. Although the validity of the SCARED is well established, most of the samples investigated primarily comprised Caucasian children and, where available, people from Asian cultures such as China. Furthermore, the instrument's utility for screening use in community samples has yet to be validated, although it is commonly advocated for this use. The present study addressed the psychometric properties of the SCARED in a community sample of Malaysian children and adolescents.

    METHOD: A total of 386 participants from an urban area, aged between 8 and 17, completed the 41-item SCARED. Confirmatory factor analysis and exploratory factor analysis were performed to investigate the factor structure of the SCARED.

    RESULTS: Internal consistency ratings for the SCARED's total and subscale scores were good, except for School Avoidance. The validity of the SCARED was further demonstrated through a significant correlation with the Internalizing subscale of the Strength and Difficulties Questionnaire (SDQ). In contrast with the five-factor structure proposed for primarily Caucasian samples, factor analysis revealed a four-factor structure for this Malaysian sample.

    CONCLUSIONS: These research findings support the validity of the SCARED and its utility as a screening tool in a community sample of Malaysian children and adolescents.

  4. Ahmadi A, Mustaffa MS, Haghdoost AA, Mansor SMS
    Trends Psychiatry Psychother, 2017 7 13;39(2):88-97.
    PMID: 28700038 DOI: 10.1590/2237-6089-2016-0047
    Introduction: Anxiety disorders in primary school-aged children negatively affect their mental health and psychological development. Available non-medical treatments for these conditions are time-consuming and expensive. In this context, eclectic therapy is a therapeutic approach that incorporates some therapeutic techniques and philosophies to create the ideal treatment. In this study, eclectic therapy consisted of art therapy and cognitive-behavioral therapy designed for children suffering from high level of anxiety in their middle childhood years. The therapy also included group guidance sessions for their mothers. The effectiveness of this intervention was examined in the study.

    Methods: 61 students aged 9-12 years with high levels of anxiety participated in the study. Intervention A (n = 20) consisted of 9-hour eclectic therapy for children with 3-hour group guidance sessions for their mothers. Intervention B (n = 20) consisted of 9-hour eclectic therapy for children. There was also a control group (n = 21).

    Results: Teacher ratings of children's mental health difficulties and self-report ratings of anxiety disorders indicated a significant difference from pretest to posttest, revealing a large effect size between the two interventions. Higher levels of pretest scores significantly predicted higher posttest scores for all domains of anxiety and mental health difficulties. Furthermore, age, gender, mothers working a 15-hour day, mother's educational level, parental divorce rates, parental death, and family monthly income predicted therapy outcomes.

    Conclusion: Results provide support for the effectiveness of eclectic art and CBT to improve children's mental health and reduce anxiety through changing thoughts, beliefs, emotions, and behaviors that may cause fear and anxiety.

  5. Ransing R, de la Rosa PA, Pereira-Sanchez V, Handuleh JIM, Jerotic S, Gupta AK, et al.
    PMID: 34735077 DOI: 10.47626/2237-6089-2021-0263
    INTRODUCTION: Varying public views on cannabis use across countries may explain the variation in the prevalence of use, policies and research in individual countries, and global regulation of cannabis. This paper aims to describe the current state of cannabis use, policies, and research across sixteen countries.

    METHODS: PubMed and Google Scholar were searched for published studies from 2010 to 2020. Searches were conducted by using the relevant country of interest as a search term (e.g. "Iran"), as well as relevant predefined keywords such as "cannabis", "marijuana", "hashish", "bhang "dual diagnosis", "use", "addiction", "prevalence", "co-morbidity", "substance use disorder", "legalization" or "policy" (English and non-English). These keywords were used in multiple combinations to create the search string in studies records' titles and abstracts. Official websites of respective governments and international organizations were also searched in English and non-English (national language country) languages to identify the current state of cannabis use, policies, and research in each of those countries.

    RESULTS: Inconsistent and heterogeneous reporting of cannabis use, variation in policies (e.g., legalization), and intervention strategies across the reviewed countries were the main findings. European countries have dominated cannabis research output in PubMed, as compared to Asian countries (Thailand, Malaysia, India, Iran and Nepal).

    CONCLUSIONS: Although global cannabis regulation is ongoing, the existing heterogeneities across countries in terms of policies and epidemiology can increase the burden of cannabis use disorders disproportionately and unpredictably. There is an urgent need to develop global strategies to address these cross-country barriers to improve early detection, prevention, and interventions for cannabis use and related disorders.

  6. Pang NTP, Tio VCS, Singh ASB, Tseu MWL, Shoesmith WD, Abd Rahim MA, et al.
    Trends Psychiatry Psychother, 2023 Feb 17;44:e20200172.
    PMID: 34392668 DOI: 10.47626/2237-6089-2020-0172
    INTRODUCTION: COVID-19 has trickle-down psychological effects on multiple strata of society, particularly university students. Apart from the worry of contracting or spreading COVID-19, Malaysian university students were also locked down on their campuses, suffering significant psychological distress. Hence, an online mindfulness intervention was proposed to alleviate psychological distress and improve psychological flexibility and mindfulness.

    METHODS: This was a quasi-experimental study with university students as participants. Intervention group participants were instructed to complete online questionnaires which covered basic demographics and instruments assessing depression, anxiety, stress, mindfulness, psychological flexibility, and fear of COVID-19 before and after the one-hour intervention. The control group also completed before and after questionnaires and were subsequently crossed over to the intervention group. Repeated measures ANOVA was conducted to assess time*group effects.

    RESULTS: 118 participants were involved in this study. There were significant differences in anxiety (F(1,116) = 34.361, p < 0.001, partial eta-squared = 0.229) and psychological flexibility between the two groups (F(1,116) = 11.010, p = 0.001, partial eta-squared = 0.087), while there were no differences in depression, stress, mindfulness, or fear of COVID-19.

    CONCLUSION: The results of this study corroborate the efficacy of online single-session mindfulness therapy as a viable short-term psychological intervention under financial and time constraints. Since university students are in the age group with the highest incidence of depressive and anxiety disorders, it is crucial to utilize resources to address as many students as possible to ensure maximum benefit.

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