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Alnemr L, Salama AH, Abdelrazek S, Alfakeer H, Ali Alkhateeb M, Torun P. Prevalence of social anxiety disorder and its associated factors among foreign-born undergraduate students in Türkiye: A cross-sectional study. PLOS GLOBAL PUBLIC HEALTH 2024; 4:e0003184. [PMID: 39078858 PMCID: PMC11288422 DOI: 10.1371/journal.pgph.0003184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 07/09/2024] [Indexed: 08/02/2024]
Abstract
Social anxiety disorder (SAD) is prevalent among university students, yet data on its severity among foreign-born international undergraduate students in Türkiye remains limited. This study aims to determine the prevalence of SAD and its associated factors within this population. A cross-sectional study was conducted using a Google Form survey distributed across various universities from September 17, 2023, to February 1, 2024. The survey comprised two sections: sociodemographic information and 17 items of the Social Phobia Inventory (SPIN), which measures the frequency and intensity of social anxiety symptoms. Data analysis included descriptive statistics and inferential analysis, multiple regression, and binomial logistic regression. Out of 506 participants, 455 were included in the study. Results revealed that 39.1% exhibited no or very mild symptoms of SAD, while 23.7% experienced mild symptoms, 21.3% faced moderate symptoms, and 11.6% and 4.2% presented with severe to very severe symptoms, respectively. Factors such as gender (p < 0.0001), previous academic failures (p = 0.013), family history of mental health issues (p = 0.009), exercise frequency (p < 0.0001), and perceptions of relationships with classmates (p < 0.0001) were significantly associated with SAD. Females showed a higher probability of SAD compared to males (OR = 1.976). Individuals engaging in over 90 minutes of exercise per week were less likely to have SAD (OR = 0.383), and occasional smokers had a lower risk of SAD compared to non-smokers (OR = 0.422). Our study uncovered a notably elevated prevalence of Social Anxiety Disorder (SAD) among foreign-born undergraduate students in Türkiye. Factors such as being female, having a family history of mental illnesses, studying in a stressful environment, experiencing academic failure, and engaging in less frequent exercise were associated with noticeable symptoms of SAD. These findings emphasize the urgent need for heightened efforts in recognizing and addressing SAD within this population.
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Affiliation(s)
- Lujain Alnemr
- Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Türkiye
| | - Abdelaziz H. Salama
- Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Türkiye
- School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Salma Abdelrazek
- Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Türkiye
| | - Hussein Alfakeer
- Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Türkiye
| | - Mohamed Ali Alkhateeb
- Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Türkiye
| | - Perihan Torun
- Department of Public Health, Hamidiye International School of Medicine, University of Health Sciences, Istanbul, Türkiye
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Fekih-Romdhane F, Rogoza R, Hallit R, Malaeb D, Sakr F, Dabbous M, Sawma T, Obeid S, Hallit S. Psychometric properties of an Arabic translation of the Big Three Perfectionism Scale-Short Form (BTPS-SF) in a community sample of adults. BMC Psychiatry 2023; 23:932. [PMID: 38082387 PMCID: PMC10712120 DOI: 10.1186/s12888-023-05427-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Despite the high clinical relevance of the perfectionism construct as a transdiagnostic contributor to different mental health symptoms, and the recent burgeoning of research in this area across cultures in the past two decades, the Arab region was one of the cultural settings experiencing the slowest progress in this line of research. This study aimed to make a meaningful contribution to the literature by validating an Arabic-language version of the 16-item Big Three Perfectionism Scale-Short Form (BTPS-SF). In particular, we sought to examine structure and concurrent validity, internal consistency, and measurement invariance across gender groups. METHOD A web-based, convenience sampling method was adopted to collect a sample of Arabic-speaking adults from the general population of Lebanon (N = 515; aged 27.55 ± 10.92 years; 69.9% females). The forward-backward method was applied in translating the Arabic version of the BTPS-SF. RESULTS The examination of the internal structure, using Confirmatory Factor Analysis (CFA), demonstrated that the three-factor model (i.e., rigid, self-critical, and narcissistic perfectionism) fitted well to the data. All three factors of the Arabic 16-item BTPS-SF yielded excellent reliability estimates, with both Cronbach's alpha and McDonald's omega ranging from 0.83 to 0.86. Multi-group CFA revealed that fit indices showed no significant difference in model fit at the configural, metric, and scalar levels, thus suggesting that the factor loadings, pattern structure, and item intercepts are invariant across gender groups. Finally, BTPS-SF subscales scores correlated positively with psychological distress (i.e., depression, stress and anxiety), and inversely with subjective well-being, indicating an acceptable concurrent validity. CONCLUSION The present findings allow us to conclude that the Arabic BTPS-SF permits to capture reliably and validly three main factors of perfectionism. We hope that providing this psychometrically sound scale will encourage its large use not only in empirical research, but also in clinical applications, including psychological screening and treatment monitoring.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi hospital, Manouba, 2010, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Radoslaw Rogoza
- University of Economics and Human Sciences in Warsaw, Warsaw, Poland
- Department of Psychology, University of Lleida, Lleida, Spain
| | - Rabih Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Department of Infectious Disease, Bellevue Medical Center, Mansourieh, Lebanon
- Department of Infectious Disease, Notre Dame des Secours University Hospital, Postal code 3, Byblos, Lebanon
| | - Diana Malaeb
- College of Pharmacy, Gulf Medical University, Ajman, United Arab Emirates
| | - Fouad Sakr
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Toni Sawma
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Effat University, Jeddah, 21478, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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Fekih-Romdhane F, El Tawil N, El Zouki CJ, Jaalouk K, Obeid S, Hallit S. Psychometric properties of an Arabic translation of the shortest version of the Central Religiosity Scale (CRS-5) in a sample of young adults. BMC Psychol 2023; 11:400. [PMID: 37980533 PMCID: PMC10657561 DOI: 10.1186/s40359-023-01431-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 11/06/2023] [Indexed: 11/20/2023] Open
Abstract
BACKGROUND There is a dearth of research on religiosity in Arabic-speaking populations, partly due to a lack of universal, standardized and valid instruments to assess this construct. We sought through this study to establish the psychometric properties of an Arabic translation of the shortest version of the Central Religiosity Scale (CRS-5), a widely used measure of religiosity that can be applicable to most religious traditions, thus allowing for worldwide cultural and trans-religious comparisons. METHOD A total of 352 Lebanese young adults enrolled in this study with a mean age of 25.08 years (SD = 9.25) and 73.3% women. The forward-backward method was adopted to translate the original English version of the CRS-5 to Arabic. RESULTS We ran an Exploratory Factor Analysis for the CRS-5 to test whether the expected dimensionality is suitable for the subsequent Confirmatory Factor Analysis (CFA). The model found replicates the originally proposed five items and one-factor model. Our findings demonstrated that the Arabic CRS-5 achieved good levels of composite reliability, with a McDonald's ω coefficient of .85. A multi-group CFA was modelled for the examination of measurement invariance of the Arabic CRS-5 across gender at the metric, configural, and scalar levels. Between-gender comparisons revealed no significant differences between males and females regarding CRS-5 scores. Finally, we found that religiosity was positively correlated with positive mental health aspects (i.e., social support) and inversely correlated with negative mental health aspects (i.e., suicidal ideation, depression, social anxiety and entrapment); thus attesting for the convergent validity of the CRS-5 as a measure of centrality of religiosity. CONCLUSION Pending further validations with larger and more representative populations, we preliminarily suggest that the Arabic CRS-5 is psychometrically sound, and can be recommended for use for research and clinical purposes in Arabic-speaking people of various religions and cultures.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Nathalie El Tawil
- Faculty of Arts and Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Christian-Joseph El Zouki
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- UFR de Médecine, Université de Picardie Jules Verne, 1 Rue des Louvels, Amiens, 80037, France
- Faculté d'Ingénierie et de Management de la Santé, 42 rue Ambroise Paré, Loos, 59120, France
| | | | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon.
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Psychology Department, College of Humanities, Efat University, Jeddah, 21478, Saudi Arabia.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
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Sfeir M, Rahme C, Obeid S, Hallit S. The mediating role of anxiety and depression between problematic social media use and bulimia nervosa among Lebanese university students. J Eat Disord 2023; 11:52. [PMID: 36991483 PMCID: PMC10052263 DOI: 10.1186/s40337-023-00776-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 03/20/2023] [Indexed: 03/30/2023] Open
Abstract
Background Bulimia nervosa (BN) is a disorder that is characterized by binge eating and inappropriate compensatory behavior to control weight. The aim of this study was to evaluate the mediating role of anxiety and depression between problematic social media use (PSMU) and BN among a sample of Lebanese university students. Methods This cross-sectional study was carried out between July and September 2021; a total of 363 university students was recruited through convenience sampling. The PROCESS SPSS Macro version 3.4, model four was used to test the indirect effect and calculate three pathways. Pathway A determined the regression coefficient for the effect of PSMU on mental health issues (depression/anxiety); Pathway B examined the association between mental health issues on BN, and Pathway C’ estimated the direct effect of PSMU on BN. Pathway AB was used to calculate the indirect effect of PSMU on BN via depression/anxiety. Results Results showed that depression and anxiety partially mediated the association between PSMU and BN. Higher levels of PSMU were associated with more depression and anxiety; higher depression and anxiety were associated with more BN. PSMU was directly and significantly associated with more BN. When entering anxiety (M1) then depression (M2) as consecutive mediators in a first model, the results showed that only depression mediated the association between PSMU and bulimia. When taking depression (M1) then anxiety (M2) as consecutive mediators in a second model, the results showed that the mediation PSMU → Depression → Anxiety → Bulimia was significant. Higher PSMU was significantly associated with more depression, which was significantly associated with more anxiety, which was significantly associated with more bulimia. Finally, higher PSMU was directly and significantly associated with more bulimia Conclusion The current paper highlights the relationship that social media use has on BN and other aspects of mental health such as anxiety and depression in Lebanon. Future studies should replicate the mediation analysis conducted in the current study while taking into account other eating disorders. Additional investigations of BN and its correlates must strive to improve the comprehension of these associations’ pathways through designs that allow to draw temporal frameworks, in order to efficiently treat this eating disorder and prevent its negative outcomes. Bulimia nervosa, an eating disorder, is characterized by an impulsive consumption of food in a short period of time, followed by behaviors that compensate the eating such as vomiting or excessive exercise in order to avoid weight gain. Individuals with problematic social media use were found to have higher levels of bulimia symptoms. Symptoms of bulimia can also be associated with both depression and anxiety. The aim of the current study was to examine the mediating role of anxiety and depression between problematic social media use and bulimia nervosa. The results of our study found that problematic social media use was directly associated with more bulimia nervosa and also associated with higher depression and anxiety, both of which were associated with bulimia nervosa. Tackling associated disorders may help reduce symptoms of bulimia nervosa. Clinicians should carefully examine these associations while assessing and implementing treatment plans.
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Affiliation(s)
- Michel Sfeir
- grid.8364.90000 0001 2184 581XDepartment of Clinical Psychology, University of Mons, Mons, Belgium
- grid.9851.50000 0001 2165 4204Institute of Psychology (IP), Faculty of Social and Political Sciences, University of Lausanne, Lausanne, Switzerland
| | - Clara Rahme
- grid.512933.f0000 0004 0451 7867Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Sahar Obeid
- grid.411323.60000 0001 2324 5973Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- grid.512933.f0000 0004 0451 7867Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- grid.411423.10000 0004 0622 534XApplied Science Research Center, Applied Science Private University, Amman, Jordan
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Merhy G, Moubarak V, Hallit R, Obeid S, Hallit S. The indirect role of orthorexia nervosa and eating attitudes in the association between perfectionism and muscle dysmorphic disorder in Lebanese male University students - results of a pilot study. BMC Psychiatry 2023; 23:55. [PMID: 36670380 PMCID: PMC9854036 DOI: 10.1186/s12888-023-04549-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 01/16/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The literature highly concentrates on disorders related to body image among women but only minimally when it comes to the male population; hence, in order to provide general practitioners, and primary care physicians in general, and psychiatrists in particular, with additional information concerning muscle dysmorphia among male university students in Lebanon, this study seemed essential, and was therefore conducted to (1) identify the prevalence of MDD, and (2) evaluate the indirect effect of eating attitudes in general and orthorexia nervosa in particular, in the association between perfectionism and muscle dysmorphic disorder (MDD) among a sample of male university students. METHODS In this cross-sectional study conducted between September 2021 and May 2022, 396 male university students from multiple universities in Lebanon filled the online Arabic questionnaire. RESULTS The results showed that 26 (6.6%) of the participants had MDD. Orthorexia nervosa and eating attitudes mediated the association between perfectionism and MDD; higher perfectionism was significantly associated with higher ON and more inappropriate eating; higher ON and more inappropriate eating were significantly associated with higher MDD, whereas perfectionism had a significant total direct effect on MDD. The high prevalence of MDD among male university students in Lebanon implies further investigation on the national level in the country. CONCLUSION Awareness campaigns among the university students could be adopted at the national level to increase the level of knowledge on the concepts of obsessive self-destructive perfectionism, orthorexia nervosa and muscle dysmorphia.
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Affiliation(s)
- Georges Merhy
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Verginia Moubarak
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Rabih Hallit
- grid.444434.70000 0001 2106 3658School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon ,Infectious Disease Department, Notre Dame des Secours University Hospital Center, Street 93, Byblos, Postal Code 3, Lebanon ,Infectious Disease Department, Bellevue Medical Center, Mansourieh, Lebanon
| | - Sahar Obeid
- grid.411323.60000 0001 2324 5973Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon. .,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon. .,Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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Fekih-Romdhane F, Sawma T, Obeid S, Hallit S. Self-critical perfectionism mediates the relationship between self-esteem and satisfaction with life in Lebanese university students. BMC Psychol 2023; 11:4. [PMID: 36611220 PMCID: PMC9825007 DOI: 10.1186/s40359-023-01040-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 01/04/2023] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The psychological mechanisms that underlie the relationship between self-esteem and life satisfaction remain unclear and not well-understood. We sought through the present study to test the hypothesis that perfectionism plays a significant mediating role in the association between self-esteem and satisfaction with life among Lebanese university students. METHODS A cross-sectional study was performed in a sample of 363 students (61.7% females, mean age = 22.65 ± 3.48 years). Three research instruments were used: satisfaction with life scale, Rosenberg self-esteem scale and big three perfectionism scale. RESULTS Higher self-esteem was significantly associated with lower self-critical perfectionism (Beta = - 0.47), whereas higher self-critical perfectionism was significantly associated with lower satisfaction in life (Beta = - 0.29). Finally, higher self-esteem was significantly and directly associated with higher satisfaction with life (Beta = 0.48). CONCLUSION The present preliminary findings point to the role of self-critical perfectionism as a buffer between self-esteem and satisfaction with life, suggesting the roles of self-esteem and perfectionism as promising avenues for promoting satisfaction with life in adolescent students.
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Affiliation(s)
- Feten Fekih-Romdhane
- The Tunisian Center of Early Intervention in Psychosis, Department of Psychiatry "Ibn Omrane", Razi Hospital, 2010, Manouba, Tunisia
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - Toni Sawma
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Sahar Obeid
- Social and Education Sciences Department, School of Arts and Sciences, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
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