The Depression Anxiety Stress Scale 8-Items Expresses Robust Psychometric Properties as an Ideal Shorter Version of the Depression Anxiety Stress Scale 21 Among Healthy Respondents From Three Continents

The 9-item Academic Self-Efficacy (ASE) scale: validity, reliability and measurement invariance across sexes and six Arab nations

Academic self-efficacy (ASE), the belief in one's ability to succeed in academic tasks, plays a crucial role in student motivation, learning, and performance. Reliable measurement of this construct is essential for identifying students' strengths and areas for improvement. This study aims to translate and validate the Academic Self-Efficacy Scale for use among university students from six different Arab countries. Using the Snowball sampling technique, participants (n = 2131), university students six Arab countries (i.e., KSA, UAE, Egypt, Lebanon, Oman, and Kuwait), answered the demographic questions and completed the Arabic Academic Self-Efficacy Scale, the Depression Anxiety Stress Scale-8, and the Multidimensional Social Support Scale. Confirmatory Factor Analysis proved a one-factor solution for the ASE scale. Adequate composite reliability was found (ω =.96; α =.96). Convergent and concurrent validity was assessed and proven by a negative correlation with measures of psychological distress and positive correlation with measures of social support. Our translation of the ASE scale was invariant across sexes and countries, with females scoring significantly higher than males. Our Arabic version of the ASE scale is a validated and reliable tool for assessing ASE in Arabic speaking populations, and shall provide means for assessing students' confidence in their academic abilities and help improve student support.

Loneliness among dementia caregivers: evaluation of the psychometric properties and cutoff score of the Three-item UCLA Loneliness Scale

Introduction

Dementia is a chronic progressive syndrome, with an entire loss of function in the late stages. The care of this demanding condition is primarily provided by family members, who often suffer from chronic burnout, distress, and loneliness. This instrumental study aimed to examine the factor structure, reliability, convergent validity, criterion validity, and cutoff scores of a short loneliness measure: the Three-Item version of the University of California, Los Angeles, Loneliness Scale (UCLALS3) in a convenience sample of dementia family caregivers (N = 571, mean age = 53 ±12 years, 81.6% females).

Methods

Exploratory and confirmatory factor analyses were used to examine the structure of the UCLALS3 while receiver-operating characteristic (ROC) curve, including caregiving burden and emotional distress as outcomes, was used to examine its cutoff.

Results

One factor accounted for 79.0% of the variance in the UCLALS3; it was perfectly invariant across genders but variant at the metric level across countries. The scale had adequate internal consistency (alpha = 0.87), high item-total correlations (0.69 - 0.79), reduced alpha if item deleted (0.77 - 0.86), and strong positive correlations with caregiving burden and psychological distress scores (r = 0.57 & 0.74, p values = 0.01). Percentile scores and the ROC curve suggested two cutoffs (≥6 and ≥6.5), which classified 59.3 and 59.4% of the participants as having higher levels of loneliness-comparable to global levels of loneliness among informal caregivers. The Mann-Whitney test revealed significantly high levels of caregiving burden and distress in caregivers scoring ≥6.5 on the UCLALS3.

Conclusion

The UCLALS3 is a valid short scale; its cutoff ≥6.5 may flag major clinically relevant symptoms in dementia caregivers, highlighting the need for tailored interventions that boost caregivers' individual perception of social relationships. More investigations are needed to confirm UCLALS3 invariance across countries.

Psychometric properties of the Arabic versions of the perceived social competence scale and the prosociality scale

BACKGROUND

Prosocial behaviors refer to a variety of voluntary actions intended to benefit others and the society. They have consistently proven their capacity to promote individuals' well-being and personal development. Nevertheless, these constructs remain largely underexplored in the Arab world. Providing validated measures of prosocial behaviors in the Arabic language for the Lebanese population could direct research attention towards assessing these behaviors and their promoting factors, thereby enhancing positive psychology. In this regard, we aimed to psychometrically validate the Standard Arabic-translated versions of the Perceived Social Competence scale (PSCS) and Prosociality Scale (PS) among a sample of Lebanese adults.

METHODS

A total of 403 Lebanese adults (27% men and 73% women) completed an online questionnaire containing the PSCS and PS, as well as the Buss-Perry aggression questionnaire-short form, the Jong-Gierveld loneliness scale, and the depression anxiety stress scale.

RESULTS

Both of the PSCS and PS yielded a unidimensional factor structure and demonstrated high levels of composite reliability, with McDonald ω values of 0.83 and 0.95, respectively. The analysis also supported configural, metric, and scalar invariance across gender for the two scales. Convergent validity was evidenced by a high correlation between the PSCS and PS, both measuring prosocial behaviors. In addition, weak and/or non-significant relations between prosocial behaviors and non-theoretically relevant variables (i.e., aggression, loneliness, and psychological distress) provided evidence for the divergent validity of both scales.

CONCLUSION

Our study cautiously suggested that the Standard Arabic versions of the PSCS and PS are psychometrically valid for measuring prosocial behaviors. This study should prompt further research in the field of social competence/prosocial behaviors for the sake of promoting positive psychological interventions in Lebanon. Future research should prioritize the inclusion of more diverse samples, encompassing a wider range of sociodemographic characteristics, in order to enhance the generalizability of these findings to the broader Lebanese population.

Relationship between parental perfectionism and child's disordered eating: mediating role of parental distress and validation of the arabic version of the eating disorders examination questionnaire-short-parent version (EDE-QS-P)

BACKGROUND

Eating disorders are an emerging global health crisis, with significant implications for both physical and psychological well-being. Disordered eating behaviors in childhood can serve as precursors to more severe eating disorders if left untreated. Previous literature evidences a strong association between perfectionism, as well as parental control and eating disorders, highlighting perfectionism as a significant factor in the development and maintenance of ED symptoms. Early intervention during this critical developmental period is essential to address these risks, prevent the progression to clinical eating disorders, and support healthier long-term outcomes for children. This study aimed to assess the mediating role of parental psychological distress in the association between perfectionism in parents and disordered eating in children. As a secondary objective, the study intended to validate the Arabic version of the Eating Disorders Examination Questionnaire-Short Parent Version (EDE-QS-P).

METHODS

A diverse sample of Lebanese parents of children aged 6-11 years (N = 502; mean age of 36.24 ± 8.29 years, 74.5% of mothers) were recruited from schools, community centers, and healthcare facilities into this cross-sectional study. One parent per child completed all the questionnaires, which assessed disordered eating in children, parental perfectionism, and psychological distress. The instruments used included the Eating Disorder Examination Questionnaire-Short Parent Version (EDE-QS-P) for disordered eating, the Big Three Perfectionism Scale - Short Form (BTPS-SF) for parental perfectionism, and the Depression, Anxiety, and Stress Scale-8 Items (DASS-8) for parental psychological distress. The SPSS software v.25 was used for statistical analysis. To examine the factor structure of the EDE-QS-P, we conducted a Confirmatory Factor Analysis (CFA) using SPSS AMOS v.28 software. The mediation analysis was conducted using PROCESS MACRO v.3.4 model 4.

RESULTS

The Arabic EDE-QS-P showed a unidimensional factor structure, strong internal consistency reliability and high convergent validity. Higher child's disordered eating scores were reported by fathers compared to mothers (8.32 ± 9.12 vs. 5.62 ± 7.69, t (500) = 3.01, p = 0.003). Parental distress mediated the association between parental perfectionism and child's disordered eating (indirect effect: Beta = 0.14; Boot SE = 0.02; Boot CI 0.11; 0.18). More parental perfectionism was significantly associated with more parental distress, and higher parental distress was significantly associated with more child's disordered eating. Higher parental perfectionism was significantly and directly associated with more child's disordered eating.

CONCLUSION

This study successfully validated the Arabic version of the EDE-QS-P in Lebanon, confirming its validity and reliability for assessing parental-reported disordered eating in children in Arab contexts. Elevated parental perfectionism correlates with increased child disordered eating, mediated by parental distress. This suggests that healthcare providers should be alert to signs of perfectionism and psychological distress in parents and provide appropriate interventions, such as cognitive-behavioral therapy or stress management techniques, to alleviate these issues and lower the risk of eating disorders in children.

Prevalence and Correlates of (Internet) Gaming Disorder among Young Adults in Singapore

There is a lack of estimates of prevalence rates of Internet gaming disorder (IGD) and gaming disorder (GD) among young adults in Singapore. Consequently, the current study aimed to examine the prevalence rates of IGD and GD, and their relationships with known correlates. Participants were a representative sample of 1008 young adults in Singapore. They completed instruments that assess IGD, GD, gaming motivations, negative emotional states, and sleep quality. The results showed a prevalence rate of 10.3% for IGD and 5.0% for GD. Males had a higher IGD and GD prevalence rate (14.6% and 7.2%) than females (6.2% and 2.8%). Furthermore, participants with IGD or GD reported higher gaming time, and higher scores on gaming motivations, negative emotional states, and sleep quality than their counterparts with no IGD or GD. The higher prevalence rates in this study compared to other global studies suggest that problematic gaming is a social issue in Singapore. Known correlates relating to gender, gaming time, motivations, and emotions were confirmed in the current study. The finding that participants with IGD or GD had better sleep quality was inconsistent with previous studies and could be due to the use of a single item to assess sleep quality. Limitations include the use of a cross-sectional correlational design. Future research could develop and evaluate prevention programs or intervention programs to alleviate the symptoms and negative consequences of problematic gaming.

Validation of the shortest version of the eating attitude test (EAT-7) as a screening tool for disordered eating in patients with first-episode schizophrenia

BACKGROUND

Individuals diagnosed with schizophrenia have a two to five-fold higher risk of developing obesity and up to threefold higher risk of developing disordered eating behaviors relative to the general population. Over the past decades, the Eating Attitude Test (EAT) has been well-recognized and widely used in clinical practice. However, only little psychometric information is available on the EAT for researchers and clinicians who deal with patients with schizophrenia, and it is still unclear whether the scale could fulfill measurement needs and help clinical and research decision-making in the context of psychotic disorders. This study aimed to investigate the psychometric properties of the shortest version of the EAT (EAT-7) among newly-diagnosed patients with schizophrenia who had minimal exposure to antipsychotics at the start of the study.

METHODS

This is an observational, cross-sectional survey that was carried out in the department of psychiatry at Razi Hospital, Manouba, Tunisia. The study took place between January and June 2024, and involved clinically-stabilized outpatients with schizophrenia who have had < 3 months of treatment with antipsychotics (N = 112; mean age of 24.44 ± 5.41 years).

RESULTS

In terms of factor analysis, the EAT-7 presented a one-dimensional structure. All seven items strongly loaded on a single factor, with all indices of the CFA suggesting a good fit to the data. In addition, the EAT-7 yielded excellent reliability coefficients, with both a McDonald's ω and a Cronbach's α of 0.88. Measurement invariance of the EAT-7 across sex groups was tested using multi-group CFA, and established at the configural, scalar, and metric levels. No significant differences in EAT-7 scores between males and females were found. Finally, EAT-7 scores positively correlated with scores of depression and anxiety, supporting concurrent validity of the scale.

CONCLUSION

The shortness, items' clarity and conciseness of the EAT-7 make it an efficient tool appropriate as a first-step screening tool to detect disordered eating in patients with schizophrenia at low cost and burden. We hope that this study will facilitate the widespread application of the EAT-7 in routine assessment and monitoring of disordered eating in patients with schizophrenia, in both clinical and research practices.

Food addiction and associated factors in newly diagnosed patients with schizophrenia: a cross-sectional comparison with siblings and healthy controls

BACKGROUND

Despite the potential clinical and treatment relevance of food addiction (FA) among individuals with schizophrenia, the scientific literature on its characteristics and correlates within this population is sparse. Limited knowledge on FA in patients with schizophrenia may impede progress in developing effective treatments for pathological eating patterns and the common obesity and metabolic syndrome problems in this population. Considering these research gaps, the present study aimed to compare the nature and prevalence of FA symptoms among patients with first-episode schizophrenia, their siblings, and healthy controls. As a secondary objective, this study sought to examine the psychopathological correlates of FA in the patients' group.

METHODS

A cross-sectional study was conducted in Razi Hospital, Tunis, Tunisia, from January to June 2024. A total of 112 newly diagnosed, clinically stabilized patients with first-episode schizophrenia, 77 of their unaffected siblings and 78 healthy controls were included. FA was assessed using the modified version of the Yale Food Addiction Scale (mYFAS 2.0). The Metacognitions Questionnaire (MCQ-30) and the Emotion Regulation Questionnaire were administered to the patients' group.

RESULTS

Findings showed a higher prevalence of FA in the patient group (32.1%) compared to both siblings (13.0%) and controls (9.0%). Siblings had higher FA scores compared to controls (16.12 ± 4.95 versus 15.00 ± 6.09; p < 0.001). After Bonferroni correction for multiple testing, higher FA scores were significantly associated with less cognitive self-consciousness (Beta = - 0.54), older age (Beta = 0.45), and higher psychological distress (Beta = 0.63).

CONCLUSION

Our findings suggest that people with first-episode schizophrenia are likely to present with co-occurring FA, and experience associated distress. Findings also provide initial support for a possible connection between dysfunctional metacognitive beliefs and FA in patients with schizophrenia, suggesting that cognitive self-consciousness may be a fundamental cognitive process in FA in this population. This may lend some theoretical and clinical implications for alleviating FA symptoms in schizophrenia.

Psychometric properties of an Arabic translation of the 13-item short mood and feelings questionnaire- parent version (SMFQ-P) to screen for depression in children

BACKGROUND

Understanding the connection between parental wellbeing and its impact on childhood depression is crucial in order to develop targeted interventions and support systems that can mitigate potential long-term effects on mental health. This study focuses on examining the properties of an Arabic translation of a questionnaire called Short Mood and Feelings Questionnaire Parent Version (SMFQ-P) as a preliminary step toward validating a culturally relevant screening tool for childhood depression in Lebanon.

METHODS

A total of 502 parents, recruited through a snowball method, took part in the survey with an age of 36.24 years (SD ± 8.29). Among them 74.5% were females 88.8% were married and 72.9% had completed university level education. The children's mean age was 7.95 ± 1.14 years. The SMFQ-P was evaluated using confirmatory factor analysis (CFA), reliability measures, and correlations with parental distress using the Depression Anxiety Stress Scale-8 (DASS-8).

RESULTS

Confirmatory factor analysis (CFA) demonstrated an excellent fit for the one-factor model of SMFQ-P scores (RMSEA = 0.059, 90% CI [0.049, 0.070]; SRMR = 0.034; CFI = 0.967; TLI = 0.960), with standardized factor loadings ranging from 0.58 to 0.82. Male parents reported more depression in their child than female parents (p = .016). Parental distress levels (r = .60, p < .001) correlated strongly with SMFQ-P scores, suggesting indirect concurrent validity.

CONCLUSION

The SMFQ-P shows promise as a screening tool for childhood depression, offering preliminary evidence of its reliability and validity in the Lebanese context. Limitations, including reliance on parent-reported distress and the lack of a direct child-report validation, should be addressed in future studies.

Psychometric properties of the Arabic Stress Numerical Rating Scale (SNRS-11) in adolescents

Meta-analytic results have revealed a significant influence of stress on a wide array of psychological and behavioral markers, underscoring its considerable clinical importance. Providing a simple and cost-effective tool assessing stress for the Arabic-speaking population would be immensely beneficial. Therefore, our research objective was to examine the psychometric properties of an Arabic version of the Stress Numerical Rating Scale-11 (Arabic SNRS-11), including its reliability, and construct validity. 763 adolescents were recruited during November 2023. An anonymous self-administered Google Forms link was distributed via social media networks. The results of the EFA revealed two factors, which explained 66.43% of the common variance. When adding the SNRS-11, Bartlett's test of sphericity, χ2(55) = 4127.1, p < 0.001, and KMO (0.88) remained adequate. The two-factor solution obtained explained 63.28% of the variance. The same structure was obtained in both males and females separately. McDonald's ω and Cronbach's α were very good for all models. Both PSS and Arabic SNRS-11 scores correlated significantly and positively with each other, as well as with higher depression, anxiety and stress scores. Finally, no significant difference was found between males and females in terms of PSS (27.08 ± 6.43 vs. 27.72 ± 6.06; p = 0.163; Cohen's d = 0.102) and Arabic SNRS-11 (4.68 ± 2.56 vs. 4.97 ± 2.52; p = 0.125; Cohen's d = 0.113) scores. The findings indicate that the Arabic SNRS-11 is a cost-effective, valid, and reliable tool for assessing stress. Therefore, it is recommended to use this single item to assess momentary or day-to-day stress among Arabic-speaking adolescents in Arab clinical and research settings. To evaluate the practical effectiveness of the Arabic SNRS-11 and to further enhance the data on its construct validity, future studies should assess the measure in diverse contexts and among specific populations.

Is a picture worth the same emotions everywhere? Validation of images from the Nencki affective picture system in Malaysia

Several validated image sets, such as NAPS, IAPS, GAPED, and OASIS, have been developed to elicit affective states. However, these image sets were primarily validated on Western populations within European and American contexts, and none have been fully validated in a Southeast Asian sample, where emotional restraint may also be valued similarly to the East Asian contexts. This study aimed to validate and provide norms for the Nencki Affective Picture System (NAPS; Marchewka et al., 2014) within a Malaysian sample. Subsets from the 1356 NAPS images consisting of five image categories (faces, people, objects, landscapes, animals) were presented sequentially to 409 Malaysian adults aged 18 and above, who rated images for valence, arousal and approach/avoidance on a 9-point Likert scale. Valence, arousal and approach/avoidance norms were compared against the original European sample. Malaysian men and women rated images with lower valence and motivation than Europeans, but Malaysian men showed higher arousal ratings compared to European men, while Malaysian women exhibited the opposite pattern, with lower arousal ratings than European women. A linear regression was found instead of a classic 'boomerang' shaped quadratic regression previously observed in Western samples, suggesting that emotional suppression may be at play, in line with social norms. The Malaysian normative ratings will be freely available to all researchers.

Body appreciation and mindful eating in Lebanese adults: the mediating role of psychological distress

A gap in the literature exists about the associations between adaptive eating patterns like mindful eating, body appreciation and psychological distress within the Lebanese population. The current culture of acceptance and increased emphasis on wellbeing elicits interest in studying body acceptance and its correlates. The aim of the current study is to assess the mediating effect of psychological distress in the association between body appreciation and mindful eating behaviors among a sample of Lebanese adults. This cross-sectional study enrolled 465 participants. Men and women over the age of 18 were eligible to participate. Then, initial participants were asked to recruit other participants they know. Individuals who consented took an online questionnaire that contained the following scales: a section collecting sociodemographic information, Mindful Eating Behavior Scale, Depression Stress Anxiety Scale (DASS-8) and Body Appreciation (BAS-2). The results of the mediation analysis showed that psychological distress fully mediated the associations between body appreciation and eating with awareness/eating without distraction. Higher body appreciation was significantly associated with less psychological distress, whereas higher psychological distress was significantly associated with less eating with awareness/eating without distraction. However, body appreciation was not associated with eating with awareness/eating without distraction respectively. These findings could guide further research on different categories of adaptive eating patterns and positive body variables within the Lebanese population.

Psychometric evaluation of DASS versions among Spanish and Chinese teachers using exploratory structural equation modeling (ESEM)

BACKGROUND

Teachers in demanding work environments are prone to anxiety, depression, and stress. Validated measures across different cultural contexts are required. The present study evaluated the psychometric properties of the 21-item Depression, Anxiety and Stress Scale (DASS-21) and DASS-12 and DASS-8 among Spanish and Chinese primary school teachers.

METHODS

A total of 3930 primary school teachers were recruited, comprising samples from Spain (n = 1350) and China (n = 2580). Scale structure was analyzed using confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM). Model comparisons were conducted to identify the best-fitting factor structure. Convergent and discriminant validity were examined, and concurrent validity was assessed using emotional exhaustion as a criterion variable. Optimal diagnostic thresholds were established through latent profile analysis (LPA) and receiver operating characteristic (ROC) analysis.

RESULTS

Among the tested factor structures (unidimensional, oblique three-factor, ESEM, bifactor, and bifactor ESEM models), the ESEM model demonstrated superior fit indices, supporting acceptable factorial validity among both Spanish and Chinese samples. The DASS versions in the ESEM structure exhibited strong convergent, discriminant, and concurrent validity in the Spanish sample, while showing relatively weaker validity indices among the Chinese sample. Notably, the empirically derived cutoff scores for DASS-21 sub-dimensions among teachers were substantially higher than the originally recommended thresholds.

CONCLUSION

The three DASS versions effectively assessed three types of psychological distress among Spanish teachers, while among the Chinese teachers, the DASS instruments appeared useful for assessing distress, though caution is recommended when using individual subscale scores.

Mediating effect of depression between self-esteem, physical appearance comparison and intuitive eating in adults

The first aim of the study is to clarify the associations between intuitive eating, self-esteem, physical appearance and psychological distress; and second, to assess the mediating effect of psychological distress on the relationship between self-esteem/physical appearance comparison and intuitive eating. A total of 359 Lebanese participants from several Lebanese governorates were enrolled in this cross-sectional study between September and November 2022. The data was collected through an online questionnaire that included the following scales: Intuitive Eating Scale‑2, Depression Anxiety Stress Scale, Rosenberg Self-Esteem Scale, and Physical Appearance Comparison Scale. The results of the mediation analysis showed that depression partially mediated the association between self-esteem / physical appearance comparison and intuitive eating. Higher self-esteem was significantly associated with lower depression; higher depression was significantly associated with more intuitive eating. Also, higher self-esteem was directly and significantly associated with more intuitive eating. On another hand, higher physical appearance comparison was significantly associated with higher depression; higher depression was significantly associated with more intuitive eating. Finally, higher physical appearance comparison was directly and significantly associated with less intuitive eating. The current study shows how significantly intuitive eating, an adaptive eating pattern, and psychological variables are interrelated and possibly affect each other. It helps shed light on intuitive eating, a somewhat unfamiliar eating pattern within the Lebanese population. These findings allow practitioners to promote healthy eating behaviors and psychological health by educating and guiding patients and clients about intuitive eating.

Arabic validation of the parental stress scale (PSS) in a population-based sample of Lebanese parents

BACKGROUND

Parental stress significantly impacts the well-being of families, and necessitates culturally sensitive tools for its assessment. The Parental Stress Scale, widely used in diverse cultural settings, lacks a validated Arabic version suitable for the Lebanese context, where unique sociopolitical and economic factors might influence parental stress differently. This study aimed to translate, culturally adapt, and validate the scale in Arabic among a Lebanese sample.

METHODS

Following the Snowball sampling method, participants (n = 502) were adult Lebanese parents who answered demographic questions and completed the Arabic version of the Parental Stress Scale and the Depression, Anxiety, and Stress Scale-8.

RESULTS

Confirmatory Factor Analysis showed a two-factor model of the Parental Stress Scale (CFI = 0.956). We found adequate composite reliability for both the 'Parental Stress' (ω = 0.91/α = 0.91) and 'Parental satisfaction' (ω = 0.94/α = 0.94) subscales. Convergent validity and concurrent validity were demonstrated through positive correlations with measures of depression, anxiety and stress. Our translation of the scale was shown to be invariant across sexes, with fathers scoring significantly higher than mothers.

CONCLUSION

Our validated Arabic version of the Parental Stress Scale offers a culturally sensitive instrument for assessing parental stress in Lebanon. This tool enables healthcare providers and researchers to identify stressors affecting Lebanese families, facilitating the development of targeted interventions to support parental mental health.

The impact of cancer prevention education on the mental health of college students based on the difference-in-differences method

Background and objective

Cancer, as the second leading cause of death worldwide, poses significant challenges to human health and socio-economic development. In recent years, the incidence of cancer has shown a trend toward younger populations, drawing attention to cancer prevention education among college students. However, research on the specific impact of cancer prevention education on the mental health of college students is limited. This study aims to explore the impact of cancer prevention education on the mental health of college students, revealing the mediating role of disease awareness and the moderating roles of psychological resilience and cultural differences.

Methods

A difference-in-differences (DID) approach was used, involving 1,670 freshmen from a Chinese university, divided into an experimental group (n = 835) and a control group (n = 835). The experimental group received a semester-long cancer prevention education program. Data were collected monthly from November 2022 to June 2023 using the Depression Anxiety Stress Scales (DASS-21) and a custom Disease Awareness Scale.

Results

The study found a significant improvement in mental health scores among the experimental group, with an average increase of 14.738 points on the DASS-21 scale (p < 0.001), representing a 23% reduction in stress, anxiety, and depression levels compared to the control group. Disease awareness in the experimental group improved by 17%, as measured by the Disease Awareness Scale, with a mediation effect of 3.563 points (p < 0.001). Furthermore, psychological resilience and cultural differences moderated the impact of the education program, with those scoring higher in resilience showing an additional 8% improvement in mental health scores (moderation effect = 0.892, p < 0.001), and cultural differences accounting for a 5% variance (moderation effect = 0.756, p < 0.001) in the outcomes.

Conclusion

This study demonstrates that systematic and scientific cancer prevention education has a significant positive impact on the mental health of college students. Universities should promote comprehensive and personalized health education strategies to improve disease awareness, foster psychological resilience, and emphasize cultural differences, thereby enhancing the overall physical and mental health of college students and promoting their holistic development. This finding provides important empirical support and theoretical basis for the design and implementation of health education in universities.

Validation of the Working Ability, Location, Intensity, Days of Pain and Dysmenorrhea (WaLIDD) Scale in Arabic-Speaking Young Female Adults

Background

Dysmenorrhea, characterized by painful menstrual cramps, significantly impacts the well-being of women globally. Despite its prevalence and adverse effects, dysmenorrhea is often underdiagnosed and inadequately treated. This study aims to validate the Arabic version of the Working ability, Location, Intensity, Days of pain, and Dysmenorrhea (WaLIDD) scale among Lebanese female university students aged 18-45.

Methods

This cross-sectional study, involving 729 participants, utilized a translated WaLIDD scale and the Depression, Anxiety, and Stress Scales (DASS-8).

Results

Confirmatory Factor Analysis (CFA) confirmed the one-factor structure of the WaLIDD scale, demonstrating excellent fit indices, with good internal reliability. Concurrent validity analysis revealed significant associations between higher WaLIDD scores and elevated levels of depression, anxiety, and stress. The prevalence of dysmenorrhea in the study was estimated at 7.3%.

Conclusion

The study underscores the importance of the WaLIDD scale as a reliable and valid tool for assessing dysmenorrhea among Arabic-speaking populations. The successful validation of the Arabic version facilitates its application in Lebanon and potentially other Arab regions, providing a universal tool to predict and assess dysmenorrhea and its impact. Further research is encouraged to explore the scale's applicability in clinical settings and tailor interventions for improved women's well-being.

Psychometric properties of the Arabic version of the Nightmares Distress Questionnaire (NDQ-AV) in a community sample of adolescents

BACKGROUND

The Nightmare Distress Questionnaire (NDQ), known and commonly used for its adequate psychometric properties, is the most widely used instrument for the measurement of nightmare distress. This study aimed to assess the psychometric properties of a newly translated Arabic version of the Nightmare Distress Questionnaire (NDQ-AV).

METHODS

A total of 546 Lebanese adolescents was recruited for this study and completed the NDQ-AV, the Insomnia Severity Index (ISI), and the eight-item Depression, Anxiety and Stress Scale (DASS-8).

RESULTS

The results of the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) supported both a one-factor model and a two-factor model of the NDQ-AV, with the latter consisting of seven items within both factors. The first factor was referred to as the "general nightmare distress and coping" while the second was named "nightmare impact and perception". The reliability of the scale was excellent (α = 0.930 and ω = 0.915). Moreover, measurement invariance was shown across gender, demonstrating that this measure performs consistently for both men and women. Additionally, the NDQ-AV scores exhibited excellent reliability alongside factorial and concurrent validity.

CONCLUSION

In conclusion, these results support the psychometric validity of the Arabic version of the NDQ. The availability of the NDQ-AV is expected to facilitate the understanding of nightmare distress within the Lebanese context.

Mediating and moderating factors between economic pressure and turnover intention among school teachers in Lebanon during the ongoing crisis era

Background

The Lebanese ongoing crisis has exposed big challenges for the education system, including low teachers' salaries and their desire to leave their jobs. Identifying key contributing factors to teacher turnover intention may help policymakers develop and implement appropriate and informed retention strategies aiming at preserving the struggling Lebanese educational system and saving costs. The present study aimed to examine the mediating role of three potential factors, i.e. job satisfaction, work-related fatigue, and psychological distress, and the moderating role of employment sector, in the relationship between economic pressure and turnover intention among teachers who work in Lebanon during the economic crisis.

Methods

We carried-out a cross-sectional, web-based study targeting a nationally-representative sample of Lebanese teachers (N = 3779, mean age = 38.33 years, 86.7 % females).

Results

The results of mediation analyses showed that physical/emotional/mental work fatigue, psychological distress and job satisfaction mediated the relationship between perceived economic pressure and turnover intentions among Lebanese teachers. Economic pressure was significantly associated with higher work fatigue, more distress, less job satisfaction and more turnover intentions. Also, more work fatigue, higher distress levels and less job satisfaction were significantly associated with higher turnover intentions. Finally, more economic pressure was significantly associated with more turnover intentions. On the other hand, the moderating effect of teachers' sector of employment (Private versus Public) was not significant.

Conclusion

This is among the first studies to link economic pressure, job satisfaction, work fatigue, psychological distress and turnover intentions in the teachers' psychology literature. This is also the first study on this topic in Lebanon, a country that offers a unique context and opportunity to understand the link between teachers' economic pressure and turnover intentions. The results expand on past research by showing that work-related fatigue, job satisfaction and psychological distress are three factors that underline the cross-sectional relationship between economic pressure and teachers' turnover intention. This implies that further attention of policy makers and school officials should be paid to enhance job satisfaction, decrease work fatigue and prevent psychological distress in order to retain and attract teachers at schools in Lebanon.

Psychometric properties of the ultra-brief self-report Patient Health Questionnaire-4 (PHQ-4) to assess anxiety and depression in Arabic-speaking adults

BACKGROUND

Anxiety and depression are psychiatric disorders that often coexist and share some features. Developing a simple and cost-effective tool to assess anxiety and depression in the Arabic-speaking population, predominantly residing in low- and middle-income nations where research can be arduous, would be immensely beneficial. The study aimed to translate the four-item composite Patient Health Questionnaire - 4 (PHQ-4) into Arabic and evaluate its psychometric properties, including internal reliability, sex invariance, composite reliability, and correlation with measures of psychological distress.

METHODS

587 Arabic-speaking adults were recruited between February and March 2023. An anonymous self-administered Google Forms link was distributed via social media networks. We utilized the FACTOR software to explore the factor structure of the Arabic PHQ-4.

RESULTS

Confirmatory factor analysis (CFA) indicated that fit of the two-factor model of the PHQ-4 scores was modest (χ2/df = .13/1 = .13, RMSEA = .001, SRMR = .002, CFI = 1.005, TLI = 1.000). Internal reliability was excellent (McDonald's omega = .86; Cronbach's alpha = .86). Indices suggested that configural, metric, and scalar invariance were supported across sex. No significant difference was found between males and females in terms of the PHQ-4 total scores, PHQ-4 anxiety scores, and PHQ-4 depression scores. The total score of the PHQ-4 and its depression and anxiety scores were significantly and moderately-to-strongly associated with lower wellbeing and higher Depression Anxiety and Stress Scale (DASS) total and subscales scores.

CONCLUSION

The PHQ-4 proves to be a reliable, valid, and cost-effective tool for assessing symptoms related to depression and anxiety. To evaluate the practical effectiveness of the Arabic PHQ-4 and to further enhance the data on its construct validity, future studies should assess the measure in diverse contexts and among specific populations.

Translation and validation to the Arabic language version of the climate change anxiety scale (CCAS)

BACKGROUND

The Arab world is one of the global regions the most directly concerned by, and suffering from climate change's adverse consequences. As such, there appears to be a strong need for an understanding of how Arab people may emotionally respond to climate change. Providing valid and reliable measures of climate change anxiety (CCA) can help gain a clear overview of the situation in Arab countries, and allow to intervene timely and effectively to mitigate any adverse effects on Arab people's mental health. To this end, the present study sought to validate the Arabic language version of the Climate Change Anxiety Scale (CCAS) in a sample of native Arabic-speaking adults from the general population of Lebanon.

METHODS

This study adopted a cross-sectional approach and enrolled 763 adults between July and September 2023.

RESULTS

A confirmatory analysis of the one-factor model showed poor fit indices as follows: CFI = 0.90, GFI = 0.83, SRMR = 0.048 and RMSEA 0.131 [90% CI 0.123, 0.138). The two-factor model showed a satisfactory fit with a high CFI of and a GFI of 0.91 and a SRMR of 0.04 and RMSEA of 0.05 [90% CI 0.04, 0.06]. Both McDonald's omega and Cronbach alpha values were high for the overall CCAS score (α = 0.96 and ω = 0.96) in the whole sample. Configural, metric and scalar invariance across gender was demonstrated. No significant difference was found between males and females in terms of total CCAS scores (24.53 ± 10.59 vs. 26.03 ± 11.17, t(761) = -1.82, p = .069). Higher CCA, functional impairment and cognitive impairment scores were significantly associated with higher depression, anxiety and stress.

CONCLUSION

The reliability and validity of the CCAS in its Arabic version were proven. The availability of this self-report measure could offer a chance to assess CCA among Adults speaking Arabic, and to spread its future use for screening and research purposes.

Translation, transcultural adaptation, and convergent validity of the Arabic version of the Mukbang addiction scale

INTRODUCTION

The present study evaluated the psychometric properties of the Arabic translation of the Mukbang Addiction Scale (MAS) among Arabic-speaking adults from the general population. Specifically, it aimed to assess the factorial structure through a confirmatory factor analysis, determine the composite reliability through Cronbach alpha and McDonald's omega scores, assess gender invariance, and evaluate the convergent validity by examining its correlation to eating addiction and psychological distress.

METHODS

A total of 370 individuals with a mean age of 21.94 ± 2.29 years participated in this study, which was conducted using an online platform. The participants were surveyed on demographic information, mukbang addiction, food addiction, and psychological distress. Translation was conducted using the forward and backward technique.

RESULTS

The findings demonstrated excellent internal consistency of the Arabic MAS (McDonald's omega coefficient = 0.93). Confirmatory factor analyses validated the one-factor structure of the scale, while establishing measurement invariance across sex at the configural, metric, and scalar levels. No sex differences were observed in the Mukbang addiction levels. Lastly, the MAS scores were significantly and positively correlated with food addiction and psychological distress, supporting their convergent validity.

CONCLUSION

The current research provides evidence supporting the reliability and validity of the Arabic version of the MAS as a self-report method for assessing addictive Mukbang watching. While further validations are needed to corroborate the present findings, this measure can be effectively utilized across different fields, including schools, mental health centers, and researchers aiming to understand this global phenomenon. Mukbang refers to individuals or hosts consuming large quantities of food while interacting with their audiences through recorded video or a live stream. The Mukbang phenomenon has gained substantial popularity among young individuals over the past years, rising concerns about its potential impact on their eating habits and health, especially when overconsumed. Overconsumption of mukbang content, or Mukbang addiction, aligns with the core features of addiction, including compulsive engagement, tolerance, and withdrawal symptoms, making it comparable to other addictive behaviors. Mukbang addiction can lead to detrimental effects on mental and physical health, including neglect of balanced nutrition, disordered eating habits, obesity, feelings of guilt, shame, poor self-esteem, distorted self-images, body dissatisfaction, heightened anxiety or depression, and social isolation. Given these significant impacts, valid and reliable tools are crucial to enable an accurate assessment of Mukbang addiction. This study proposes to translate, adapt and examine the psychometric properties of the Mukbang Addiction Scale (MAS) in a sample of Arabic-speaking individuals from the general population. Findings showed that the six MAS items loaded on a single factor with strong internal consistency and good convergent validity, preliminarily indicating its potential validity and reliability for assessing addictive mukbang-watching among Arabic-speaking individuals.

Psychometric properties of the arabic translation of the Physical Appearance Comparison Scale-Revised (PACS-R) in adults

BACKGROUND

Physical comparison may be a factor in body dissatisfaction and related issues, like eating disorders and depression. The Physical Appearance Comparison Scale-Revised (PACS-R) is a scale developed to assess the frequency of physical comparison. Because there is no validated scale for body comparison in Arabic, this study aims to address this gap by validating the PACS-R in the Arabic language.

METHODS

The PACS-R was translated to Arabic following a conventional forward-backward translation procedure, and was administered to a sample of 359 Lebanese adults along with The Depression Anxiety Stress Scale, and the Rosenberg self-esteem scale (RSES) for convergent validity. The factor structure was studied by confirmatory factor analysis (CFA), and composite reliability was assessed using McDonald's omega and Cronbach's alpha.

RESULTS

Results suggested a one-factor structure of the Arabic PACS-R, with good internal consistency (McDonald's ω = 0.97 / Cronbach α = 0.97). Measurement invariance was established across sex groups, with no significant difference being reported between males and females in terms of PACS-R scores (15.42 ± 10.64 vs. 13.16 ± 11.88; t(357) = 1.84; p = .066). Finally, adequate convergent validity was tested and found to be adequate, with PACS-R scores found to be correlated negatively with self-esteem and positively with psychological distress.

CONCLUSION

The present findings preliminarily establish the Arabic PACS-R as an effective instrument for researchers and practitioners aiming to explore the physical comparison among Arabic-speaking populations, thus contributing to research and clinical work in the Arabic community.

Psychometric properties of the Arabic translation of the Dark Future Scale questionnaire in a non-clinical sample of Arabic-speaking young adults

BACKGROUND

Through the years, studying negative behaviors of the worldwide population seized the spotlight from many researchers who focused on building scales in order the measure the level of worries, fear and even depression of such stressed individuals. By definition, "Future anxiety" (FA) is fueled by negative thoughts leading to intense fear of unknown future events. The Dark Future scale (DFS) measures the level of anxiety experienced towards the future. Our aim was to examine the psychometric properties of a novel Arabic translation of the DFS.

METHODS

A sample of 684 Arabic-speaking young adults (65.6% women) filled the DFS, TEMPS-M (temperaments) and DASS-8 (psychological distress).

RESULTS

Confirmatory factor analyses (CFA) supported a unidimensional model of the DFS score, with all 5 items retained. This scale had good reliability. Moreover, concurrent validity demonstrated significant associations between DFS scores and psychological distress, depressive, cyclothymic, irritable and anxious temperament. Scores achieved scalar invariance across gender, with women having greater exposure to anxiety about the future.

CONCLUSION

Overall, these findings led to the conclusion that the Arabic DFS is a psychometrically valid tool for the assessment of FA. The DFS is a brief, reliable and easy to apply scale that would help researchers in psychology and psychiatry in assessing anxiety about future.

The Depression Anxiety Stress Scale 8: investigating its cutoff scores in relevance to loneliness and burnout among dementia family caregivers

The global trend of advanced aging comes at the cost of amplified onset of age-related diseases. Dementia is a common multifactorial age-related neurodegenerative disorder, which manifests with progressive declines in cognitive functioning and ability to perform activities of daily living. As polices discourage institutionalized care, family members act as primary caregivers and endure increased vulnerability to physical and mental health problems secondary to care-related changes in life routine and relationships. Targeting clinically significant distress at earlier stages through valid brief measures may promote caregivers' wellbeing and dementia care continuity/quality. This study aimed to determine the optimal cutoff score of the Depression Anxiety Stress Scale 8-items (DASS-8) in a convenience sample of 571 European caregivers (Mean age = 53 ± 12 years, Italian = 74.4%, Swiss = 25.6%) through three methods. K-means clustering classified the sample into high- and low-distress clusters based on DASS-8 score of 19. Receiver operator curve (ROC) analysis using 48 and 7 cutoffs of the Zarit Burden Interview (ZBI) and the Three-Item University of California, Los Angeles, Loneliness Scale-version 3 (UCLALS3), revealed two DASS-8 cutoffs (12.5 and 14.5, area under the curve (AUC) = 0.85 and 0.92, p values < .001, 95% CI 0.82-0.88 and 0.89 to 0.94, sensitivity = 0.81 and 0.78, specificity = 0.76 and 0.89, Youden index = 0.57 and 0.67, respectively). Decision modeling produced two DASS-8 cutoffs (9.5 and 14.5) for predicting low and high caregiving burden and loneliness, respectively. According to the median of all DASS-8 cutoffs (14.5) the prevalence of mental distress was 50.8%. Distress correlated with key mental problems such as burnout and loneliness-in path analysis, DASS-8 scores were predicted by the ZBI, UCLALS3, care dependency, and receiving help with care, especially among older, female, and spouse caregivers. Further diagnostic workup should follow to confirm psycho-pathogenicity among caregivers with DASS-8 scores above 14.5. Investigations of the DASS-8 in other countries/populations may confirm the validity of this cutoff score.

Psychometric properties of an Arabic translation of the meaning in life scale in a sample of young adults

BACKGROUND

Young adults are in a constant phase of realizing their meaning in life while being in a constant pursuit of meaning. Meaning in life is a subjective, personal construct related to the perception of one's own life. Considering that there are no measures that study this construct within the Arab context, this study aimed to examine the psychometric properties of an Arabic translation of the Meaning in Life Questionnaire (MLQ) in the Lebanese context with a sample of young adults.

METHODS

A sample of 684 Lebanese young adults was recruited for this study, having a mean age of 21.74 years, 65.6% of which were females. Through an online questionnaire, participants were requested to complete the Meaning in Life Questionnaire (MLQ), Depression, Anxiety and Stress Scale (DASS-8) and the Oviedo Grit Scale (EGO).

RESULTS

CFA indicated that fit of the original bi-dimensional model of MLQ scores was inadequate. Items 9 and 10 cross-loaded to both MLQ factors. After removal of those 2 items, the final model displayed good fit indices. Reliability was good for the Search (ω = 0.89 / α = 0.89) and Presence (ω = 0.88 / α = 0.87) subscales. Additionally, across three levels of gender invariance (Configural, Metric and Scalar), no significant gender-based distinctions were observed in the MLQ scores. The Search subscale was significantly and positively associated with higher GRIT but not psychological distress, whereas the Presence subscale was significantly associated with higher GRIT and lower psychological distress.

CONCLUSION

The results of this study contribute to the psychometric reliability and validity of the Arabic version of the MLQ and makes it available for dissemination among young adults within the Arab context. This allows for the implementation of new research that target construct of meaning in life, allowing for the accessibility of interventions that aim to foster the presence of and search for meaning in the lives of young adults within the Arab nations.

Perceived social competencies as moderators: examining the relationship between psychological distress and aggression, hostility, and anger in Lebanese adults

INTRODUCTION

The majority of people experience anger at some point in their lives when confronted with unpleasant situations. In social settings, anger can lead to aggressive and hostile in the absence of adequate social competences. Our study aims to examine the moderating role of perceived social competences in the association between psychological distress and anger expression (trait anger, hostility, physical aggression, and verbal aggression) among a sample of Lebanese adults.

METHODS

403 participants above 18 years (the mean age was 24.56 ± 8.46) were enrolled in the cross-sectional study with 73% female participants. The candidates were asked to complete a structured questionnaire including the following scales: (1) Buss-Perry Aggression Questionnaire-Short Form (BPAQ-SF), (2) the Depression Anxiety Stress Scale (DASS-8), (3) Perceived Social Competencies (PSC), and (4) The De Jong-Gierveld Loneliness Scale.

RESULTS

The interaction psychological distress by perceived social competence was not significantly associated with physical aggression, verbal aggression, or hostility but was significantly associated with anger. After adjusting the results over variables that showed a p <.25 in the bivariate analysis, this association was significant at low (Beta = 0.24; p <.001), moderate (Beta = 0.20; p <.001) and high (Beta = 0.16; p <.001) levels of perceived social competencies, where higher psychological distress was significantly associated with more anger. On another note, with higher perceived social competence, we find a decrease in levels of psychological distress in our sample.

CONCLUSION

This study provided evidence that perceived social competencies such as communication skills, empathy and prosocial behaviors act as moderators in the association between psychological distress and anger. In future works, investigating and building advanced program in order to develop social competences of individuals might prove important. It is crucial to implement such strategies and projects in schools: this educational setting could be fruitful in a way that social skills could be instilled during childhood and anger-aggressive behaviors could be managed throughout adulthood.

Psychometric properties of the Arabic version of the intolerance of uncertainty scale: a multinational study

INTRODUCTION

It is common for people to experience anxiety when contemplating their unknown future. Studies have shown that those who tend to worry more about their future are more likely to be intolerant of uncertainty. In order to study the way people from the Middle East tackle uncertainty, a valid and reliable scale is needed. In this context, the present study aimed to examine the psychometric properties of the Arabic version of the 12-item Intolerance of Uncertainty Scale (IUS-12) in a community sample of native Arabic-speaking participants from Lebanon, Egypt, and Kuwait.

METHODS

A sample of 2038 university students answered the survey, with a mean age of 22.30 ± 4.15 years and 77.5% females. A Google Form link was dissipated among participants that included some demographic questions, the IUS-12 and the Depression, Anxiety and Stress Scale (DASS-8).

RESULTS

Following the confirmatory factor analysis (CFA), a bi-dimensional model of the Arabic version of the IUS-12 was found. The scale showed an excellent internal reliability for the prospective anxiety (ω = 0.85 / α = 0.85) and inhibitory anxiety (ω = 0.87 / α = 0.87). Additionally, the results illustrated configural, metric, and scalar invariance across genders and countries. Furthermore, Egypt and Lebanon were seen to have statistically significant higher levels of inhibitory anxiety compared to Kuwait, while only Egypt showed statistically significant higher prospective anxiety compared to Kuwait. Finally, higher psychological distress was significantly and positively associated with higher prospective and inhibitory anxiety.

CONCLUSION

The results of this study provide support for the psychometric reliability and validity of the Arabic version of the IUS-12, allowing for its generalizability and suitability for use among individuals from different Arabic-speaking nations.

Association between textual and pictorial warnings on tumbac (waterpipe tobacco) boxes and motivation to quit waterpipe smoking among Lebanese and Iraqi adolescents

BACKGROUND

Waterpipe tobacco smoking has increased tremendously at a global level among all age groups, particularly young people. Previous studies have examined the impact of waterpipe tobacco pictorial health warnings on adults but scarce studies were done on adolescents. The aim of this study was to assess the association of textual versus pictorial warnings on tumbac boxes and the motivation to quit waterpipe smoking among adolescents located in two Eastern Mediterranean countries Lebanon and Iraq.

METHODS

A cross-sectional study was conducted between May and November 2022, involving 294 adolescents waterpipe smokers from Lebanon and Iraq. The questionnaire included the Lebanese Waterpipe Dependence Smoking-11, the Depression, Anxiety and Stress Scale, the Waterpipe Harm Perception Scale, Waterpipe Knowledge Scale, Waterpipe Attitude Scale, the Fagerstrom Test for Nicotine Dependence, and the Motivation to Stop Scale.

RESULTS

When adjusting the results over confounding variables, the results showed that compared to finding the warnings to stop smoking not efficacious at all, adolescents who find the warnings moderately (aOR = 2.83) and very (aOR = 6.64) efficacious had higher motivation to quit. Compared to finding the warnings not increasing their curiosity for information about how to stop waterpipe smoking at all, participants who confessed that warnings increased their curiosity a little (aOR = 2.59), moderately (aOR = 3.34) and very (aOR = 3.58) had higher motivation to quit. Compared to not considering changing the tumbac brand if the company uses pictorial warnings, adolescents who would consider changing the tumbac brand (aOR = 2.15) had higher motivation to quit.

CONCLUSION

Pictorial and textual warnings on waterpipe packs were associated with higher motivation to stop waterpipe smoking. Public health education programs for this purpose seem warranted.

Mediating effect of psychological distress and mindful eating behaviors between orthorexia nervosa and academic self-efficacy among Lebanese university female students

OBJECTIVES

This study examined the mediating effect of psychological distress and mindful eating behaviors between orthorexia nervosa and academic self-efficacy among Lebanese university female students.

METHODS

A total of 769 female participants enrolled in this cross-sectional study (mean age 21.58 ± 3.20 years). A self-administered questionnaire was distributed among university female students. The questionnaire consisted of Mindful Eating Behaviors Scale, ORTO-R, Depression Anxiety Stress Scale, and Arabic version of Academic Self-Efficacy Scale.

RESULTS

The results showed that psychological distress fully mediated the association between orthorexia nervosa and academic self-efficacy; higher orthorexia nervosa was significantly associated with less psychological distress (β= -0.31, p =.05), with more psychological distress significantly associated with lower academic self-efficacy (β= -0.32, p =.09). Focused eating fully mediated the association between orthorexia nervosa and academic self-efficacy; higher orthorexia nervosa was significantly associated with less focused eating (β=-0.09, p =.04), with more focused eating significantly associated with better academic self-efficacy (β = 1.40, p =.10). Orthorexia nervosa was not directly associated with academic self-efficacy in both models.

CONCLUSION

This study shed light on important connections between orthorexia nervosa, psychological distress, mindful eating behaviors, and academic self-efficacy within the Lebanese context. The findings will have practical implications for both educational institutions and healthcare providers striving to support young female adults' overall well-being and academic success.

Psychometric properties of an Arabic translation of the short entrapment scale in a non-clinical sample of young adults

BACKGROUND

Entrapment is the feeling of wanting to leave an unbearable situation but believing that there are no options to do so. An Arabic entrapment Scale will assist healthcare professionals in the region in the prevention of suicide as the tool is tailored to the specific sociocultural context, which would enhance entrapment detection.

OBJECTIVE

In the current study, we aim to evaluate the psychometric properties of a translated Arabic version of the Entrapment Scale Short Form (E-SF).

METHODS

Three hundred eighty-nine Lebanese citizens were enrolled in this cross-sectional study.

RESULTS

The mean age of participants was 23.03 years (SD = 2.93), 69.4% being women. To examine the factor structure of the entrapment scale, we used an exploratory-to-confirmatory factor analysis (EFA-to-CFA) strategy. EFA and CFA results indicated that the fit of the unidimensional model of the Arabic Entrapment Scale (A-ES) was generally acceptable. Composite reliability of scores was adequate in the total sample (ω = .87). All indices suggested that configural, metric, and scalar invariance was supported across genders. Entrapment was positively and significantly correlated with suicidal ideation, alcohol use disorder, psychological distress, and orthorexia nervosa, suggesting convergent and divergent validity.

CONCLUSION

The A-ES was found to be a valid and reliable tool to assess the degree of entrapment in Lebanese young adults. The A-ES will assist healthcare professionals in the region in the prevention of suicide as the tool is tailored to the specific sociocultural context, which would enhance entrapment detection.

The moderating effect of psychological distress in the association between temperaments and dark future among young adults

OBJECTIVE

The aim of the current study is to evaluate the moderating effect of psychological distress variables, depression, anxiety and stress on the relationship between affective temperaments and future anxiety, assessed with the Dark Future scale.

METHODS

Lebanese adults from all districts/governorates of Lebanon participated in this cross-sectional study. The data was collected through a questionnaire including: a section about sociodemographic characteristics, the Dark Future scale (DFS), the Depression Anxiety Stress Scale (DASS-8) and the Affective Temperament Scale (TEMPS-M).

RESULTS

The interaction irritable temperament by psychological distress (p = .007) was significantly associated with dark future; at low levels of psychological distress, more irritable temperament (Beta = 0.16) was significantly associated with more dark future. The interaction anxious temperament by psychological distress (p = .010) was significantly associated with dark future; at low (Beta = 0.34), moderate (Beta = 0.25) and high (Beta = 0.15) levels of psychological distress, more anxious temperament was significantly associated with more dark future.

CONCLUSION

The nature of the associations among depression, anxiety and stress, specific temperaments and anxiety towards the future in a sample of Lebanese individuals was clarified. This is especially significant as Lebanese people live in circumstances that promote psychological distress and future anxiety such as dramatic economic and political crises, instability and lack of security in different aspects of life.

Burden, Anxiety, and Depression Among Caregivers of Parkinson's Disease Patients

Background

Parkinson's disease (PD) is a disabling neurodegenerative movement disorder. Most PD patients are looked after by caregivers who are close to them regardless of their relationship. Caregivers may experience a notable impact on their mental health as they dedicate a significant amount of time to the patient while observing the progression of the disease.

Objective

The aim of this study was to evaluate the level of burden, depression, anxiety, and stress among caregivers of PD patients.

Methods

We conducted a cross-sectional analysis between July and September 2023 among caregivers of PD patients following in the Movement Disorders Clinic at King Khalid University Hospital in Riyadh, Saudi Arabia, and through the Saudi Parkinson's Society. The data collection was done anonymously through an electronic self-administered questionnaire. Caregiver burden was assessed by using the validated Arabic version of the Zarit Burden Interview (ZBI) scale, and the Depression Anxiety Stress Scale (DASS) was used to assess the presence and level of anxiety and depression.

Results

There were 118 caregivers (53.39% female, 33.9% aged between 35- 45 years, and 73.73% were sons/daughters) caring for 118 patients (57.63%, male, 38.98% aged between 66- 76). The ZBI score was highest among sibling caregivers. Moreover, burden scores were higher among those who provided care more frequently than others.

Conclusions

Our study revealed that PD caregivers face a high risk of care burden, especially those who are siblings and spend longer periods in patient care. Additionally, female caregivers reported higher rates of depression, anxiety, and stress.

Psychometric properties of an Arabic translation of the Big Three Perfectionism Scale-Short Form (BTPS-SF) in a community sample of adults

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.

Cut-off scores of the Depression Anxiety Stress Scale-8: Implications for improving the management of chronic pain

AIM

Mental distress, non-specific symptoms of depression and anxiety, is common in chronic pelvic pain (CPP). It contributes to poor recovery. Women's health nurses operate in multidisciplinary teams to facilitate the assessment and treatment of CPP. However, valid cut-off points for identifying highly distressed patients are lacking, entailing a gap in CPP management.

DESIGN

This instrumental cross-sectional study identified a statistically derived cut-off score for the Depression Anxiety Stress Scale-8 (DASS-8) among 214 Australian women with CPP (mean age = 33.3, SD = 12.4, range = 13-71 years).

METHODS

Receiver operator characteristic curve, decision trees and K-means clustering techniques were used to examine the predictive capacity of the DASS-8 for psychiatric comorbidity, pain severity, any medication intake, analgesic intake and sexual abuse. The study is prepared according to the STROBE checklist.

RESULTS

Cut-off points resulting from the analysis were ordered ascendingly. The median (13.0) was chosen as an optimal cut-off score for predicting key outcomes. Women with DASS-8 scores below 15.5 had higher analgesic intake.

CONCLUSION

CPP women with a DASS-8 score above 13.0 express greater pain severity, psychiatric comorbidity and polypharmacy. Thus, they may be a specific target for nursing interventions dedicated to alleviating pain through the management of associated co-morbidities.

IMPLICATIONS FOR PATIENT CARE

At a cut-off point of 13.0, the DASS-8 may be a practical instrument for recommending a thorough clinician-based examination for psychiatric comorbidity to facilitate adequate CPP management. It may be useful for evaluating patients' response to nursing pain management efforts. Replications of the study in different populations/countries are warranted.

The General Mattering Scale, the Anti-Mattering Scale, and the Fear of Not Mattering Inventory: Psychometric Properties and Links with Distress and Hope Among Chinese University Students

Purpose

Mattering is essential to university students' mental health. Feeling valued by others or unimportant can affect their overall well-being. However, most measures for assessing mattering have been developed and tested in Western countries, with limited evaluation of the measures when administered to university students in other regions. This study evaluated the reliability and validity of three mattering-related instruments - the General Mattering Scale (GMS), Anti-Mattering Scale (AMS), and Fear of Not Mattering Inventory (FNMI) among Chinese university students using classical test theory and Rasch analysis.

Methods

The study comprised 3594 university students from 19 universities across 13 provinces in mainland China, with a balanced gender distribution of 47.2% females and 52.8% males. Participants' ages ranged from 18 to 37, averaging 20.02 years. Most (78.4%) were in four-year programs, with the rest in three-year programs. The majority were freshmen (54.2%), and 86.3% had siblings. The predominant major was engineering (43.4%), followed by roughly equal representations in science, social science, and literature/art.

Results

The three scales showed high reliability and factorial validity, with Rasch analysis confirming their unidimensionality and monotonicity, although 2 of 15 items (one GMS item and one FNMI item) had lower fit. There were no substantial differences in item functioning between male and female respondents. Further analyses indicated that mattering, anti-mattering, and fear of not mattering all explained significant unique variance in levels of hope and distress.

Conclusion

All three mattering-related instruments are suitable for assessing Chinese students' mattering, anti-mattering, and fear of not mattering and changes in levels of these mattering dimensions. Moreover, each measure represents a unique element of the mattering construct in terms of associations with levels of hope and distress assessed in during the COVID-19 pandemic.

Validation of the Arabic version of the resilience scale for adolescents (READ)

INTRODUCTION

Adolescents react differently to challenging negative life events. Resilience, a dynamic characteristic of individuals, was studied to be a protective factor against such events. In order to study the resilience among Arabic-speaking adolescent populations, age-appropriate measures that are fully apprehended by younger respondents are needed. In this context, the present study aimed to examine the psychometric properties of an Arabic translation of the Resilience Scale for Adolescents (READ) in a community sample of native Arabic-speaking adolescents aged 13-18 years.

METHODS

A sample of 546 community Arabic-speaking adolescents from Lebanon was recruited (n = 328 females, with a mean age of 15.76 ± 1.65 years). Through an online questionnaire, participants were requested to complete the READ, Depression, Anxiety and Stress Scale (DASS-8) and the 13-item Children's Impact of Event Scale (CRIES-13).

RESULTS

Following the exploratory and confirmatory factor analysis (EFA-to-CFA) strategy, a unidimensional model of the Arabic version of the READ was met after 10 items were removed from the scale, and showed strong internal consistency (Cronbach's alpha of 0.943). Additionally, the one-factor solution of the Arabic version of the READ was identical across male and female adolescents at the three levels of invariance (Configural, Metric and Scalar). Finally, higher resilience scores were significantly correlated with lower levels of psychopathology, namely depression, anxiety, stress and PTSD, thus attesting to the concurrent validity of the Arabic READ.

CONCLUSION

Findings lend support to the psychometric reliability and validity of the Arabic version of the READ, and therefore its suitability for use among Arabic-speaking adolescents. The availability of this tool facilitates the implementation of interventions that foster resilience, especially in adolescents who have faced a number of negative life events.

Evaluating the psychometric properties of the Chinese Depression Anxiety Stress Scale for Youth (DASS-Y) and DASS-21

BACKGROUND

In recognizing the need for a reliable and valid instrument to assess psychological distress among children and adolescents, the present study translated the newly developed Depression Anxiety Stress Scale for Youth (DASS-Y) into Chinese, while also comparing its psychometric properties with those of the well-established DASS-21 within a primary and middle school demographic.

METHODS

Utilizing a combination of convenience sampling and purposive sampling, a cohort comprising 1,507 primary and 1,131 middle school students was recruited. Rasch analysis, confirmatory factor analysis (CFA), and structural equation modeling (SEM) were used in the data analysis.

RESULTS

Significant differences were observed between the DASS-Y and the DASS-21, notably within the anxiety subscale. The proportions of individuals with clinical mood disorders identified by the two scales demonstrated a significant disparity. Both scales, following an adjustment of responses, exhibited satisfactory internal consistency and convergent validity, with the acceptance of a three-factor structure. Furthermore, the DASS-Y showed superior discriminant validity relative to the DASS-21, providing more compelling evidence regarding concurrent validity.

CONCLUSION

Overall, the Chinese version of the DASS-Y demonstrated superior robustness to the DASS-21 in terms of psychometric properties. The findings provide initial evidence for the psychometric properties of the DASS-Y from another culture.

Psychometric properties of an Arabic translation of the Nine Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS) in a community sample of adults

BACKGROUND

No epidemiological data is yet available on Avoidant/Restrictive Food Intake Disorder (ARFID) in Arab countries, which may in part be due to the lack of measures available in Arabic language. This constitutes a major obstacle to further progress of our understanding of the nature, aetiology, course, treatment, and prevention of ARFID, especially as some evidence suggested that ARFID may vary across cultures and food environments. We aimed to contribute to the literature in the eating disorders field by examining the psychometric properties of an Arabic translation of the Nine Item ARFID Screen (NIAS).

METHOD

This was a cross-sectional, web-based study. A total of 515 Lebanese community adults (mean age of 27.55 ± 10.92 years, 69.9% females) participated. The forward-backward method was adopted to translate the NIAS from English to Arabic.

RESULTS

Confirmatory Factor Analyses provided evidence for the adequate fit indices for the three-factor model (i.e., Picky eating, Fear, and Appetite) and the 9-item version of the NIAS. An adequate reliability of the Arabic NIAS was achieved, with McDonald's ω ranging from .75 to .90 for the total score and all three subscores. Multi-group analyses demonstrated measurement invariance by sex (males vs. females) and weight groups (underweight/healthy weight [BMI ≤ 25] vs. overweight/obese [BMI > 25]) at the configural, metric, and scalar levels. Adequate patterns of correlations between the NIAS and measures of disordered eating symptoms, psychological distress and well-being were seen. In particular, fear was significantly associated with non-ARFID disordered eating symptoms. Appetite and Picky eating, but not Fear, were inversely correlated with well-being. All three NIAS subscores and the total score were positively correlated with psychological distress.

CONCLUSION

Findings provided evidence that the Arabic NIAS is a short, valid and reliable self-report measure to screen for ARFID symptoms. In light of these findings, we recommend its use for clinical and research purposes among Arabic-speaking adults.

Irritable bowel syndrome (IBS) among Lebanese adults: unidentified IBS and associated factors

BACKGROUND

Irritable bowel syndrome (IBS) is one of the most frequent functional gastrointestinal disorders, but the condition is still underdiagnosed. The high of rate of unidentified IBS by patients can be related to different factors. The aim of this study is to assess the rate of unidentified IBS among Lebanese adults and investigate the role of socio-demographic factors, anxiety, depression, insomnia and eating attitudes on IBS diagnosis.

METHODS

A cross-sectional study was conducted among Lebanese adults older than 18 years between June 2022 and December 2022, using a self-reporting questionnaire distributed via social media.

RESULTS

A total of 425 participants was enrolled in the study with around 184 (46.8%) having a possible unidentified IBS. Higher psychological distress (aOR = 1.07) and insomnia severity (aOR = 1.08) were significantly associated with higher odds of having possible unidentified IBS whereas a higher household crowding index (aOR = 0.67) was significantly associated with lower odds of having possible IBS. The correlation of eating attitudes with cigarette smoking (aOR = 1.33; p = .025; 95% CI 1.04; 1.70) and insomnia severity with cigarette smoking (aOR = .89; p = .023; 95% CI .80; .98) were significantly associated with the presence of possible IBS. In nonsmokers, higher psychological distress (aOR = 1.07) and insomnia severity (aOR = 1.10) were significantly associated with higher odds of having possible IBS. In smokers, higher BMI (aOR = .78) was significantly associated with lower odds of having possible IBS, whereas higher eating attitudes scores (more inappropriate eating) (aOR = 1.40) were significantly associated with higher odds of having possible IBS.

CONCLUSION

The study highlighted the implication of raising awareness about IBS among the Lebanese population to promote early diagnosis and minimize the rate of unidentified IBS by patients. Initiation of appropriate treatment plans, tailored symptomatic management approach, and diet programs should be highly encouraged.

Understanding and Fostering Mental Health and Well-Being among University Faculty: A Narrative Review

In recent years, there has been increasing recognition of mental health concerns in academia, with stress, burnout, anxiety, and depression being reported among faculty members. The demanding work environment, the need to balance personal and professional duties, and the constant pressure of productivity while navigating multiple tasks of teaching, research, mentorship, professional development, and service all impact the mental health and overall well-being of faculty. Higher education institutions have structurally changed as has the research landscape. These changes as well as faculty-specific and student-specific factors coupled to the effect of the COVID-19 pandemic have led to profound effects on the mental health of academics. This paper is a narrative review of the pertinent literature describing faculty mental health and well-being. It summarizes the available evidence on factors influencing faculty mental health and shows the prevalence of anxiety, depression, stress, and burnout among faculty from various academic fields and along the whole academic ladder. Using a suggested framework that collates the efforts of leaders and faculty, the paper concludes by exploring strategies that promote work-life balance among academics and suggesting effective interventions to improve their mental health outcomes.

Examining correlates of aggression and mediating effect of psychological distress between exposure to media violence and aggression in lebanese adults

BACKGROUND

Violent media is the most consumed type of media in Lebanon. Many studies have linked exposure to media violence to increased aggression and psychological distress. As Lebanon is going through socio-political turmoil, we aimed to [1] explore the correlates of aggression (i.e., sociodemographic factors, BMI, loneliness, social competence, and psychological distress) in a sample of Lebanese adults from the general population, and [2] to examine the mediating effect of psychological distress in the association between exposure to media violence and aggression in this sample.

METHODOLOGY

Adults were recruited through online convenience sampling. We employed scales to assess content-based media exposure (C-ME), aggression (BPAQ-SF), psychological distress (DASS-8), loneliness (JGLS), and perceived social competence (PSCS).

RESULTS

Exposure to media violence was associated with all four aggression subtypes (verbal, physical, hostility, and anger). Psychological distress partially mediated all these associations; higher exposure to media violence was significantly associated with more psychological distress, which was significantly associated with higher levels of all types of aggression. Moreover, higher exposure to media violence was significantly associated with higher levels of all types of aggression.

CONCLUSION

In the sociopolitical context of Lebanon, violent media could be considered a public hazard. Psychological distress likely potentiates the association between exposure to violent media and aggression. Future research should focus on determining what components of psychological distress underpin this mediation.

Revised Chinese resident health literacy scale for the older adults in China: simplified version and initial validity testing

Objective

This study aimed to develop a short version of the Chinese Resident Health Literacy Scale focused on older adults in China, and further assess the reliability and validity of this short version.

Methods

The data was from a cross-sectional community-based older adults health survey conducted in 2020. The total of 5,829 older adults were randomly divided into two parts using for the simplification and assessment of the scale, respectively. Item Response Theory (IRT) and Differential Item Functioning (DIF) were used for item analysis and scale simplification. Cronbach's alpha and McDonald's omega were used to assess the reliability and three factors Confirmatory Factor Analysis (CFA) was used to assess the validity, which were compared to the original version. Moreover, Multi-group Confirmatory Factor Analysis (MCFA) was used to test the model invariance of the short version across groups of gender, age groups, level of education, and cognitive status.

Results

The simplified version consisted of 27 items taken from 50 original items, of them 11 items from the dimension of knowledge and attitudes, 9 items from the dimension of behavior and lifestyle, and 7 items from the dimension of health-related skills. The overall Cronbach's alpha and McDonald's omega were both 0.87 (95%CI: 0.86-0.88). The goodness-of-fits of CFA in simplified version were still acceptable in CFI, TLI, GFI, and RMSEA, even improved in CFI, TLI, and GFI compared to those of original version. Also, the model was stable and invariant in MCFA across gender, cognitive status, and educational level groups.

Conclusion

In this study, we formed a simplified instrument for measuring health literacy focused on older adults in China. This short version might be more suitable for the priority recommendation in extended tracking of the dynamic changes on the levels of health literacy in the whole life cycle in public health settings. Further research might be to identify the cut-off values to distinguish the older adults with different levels of health literacy.

The moderating effect of emotion regulation in the association between social support and religiosity and psychological distress in adults

BACKGROUND

Lebanese adults face daily obstacles due to their numerous responsibilities and non-ending external pressures to the extent that Lebanon has been ranked second among highest negative experiences countries worldwide. A sparse number of international studies showed that positive social support, religiosity and cognitive reappraisal would decrease psychological distress, but none in Lebanon. This study aimed to evaluate the association between social support, religiosity and psychological distress among Lebanese adults, taking into consideration the moderating role of emotion regulation.

METHODS

387 adult participants enrolled in this cross-sectional study between May and July 2022. Participants were chosen from five different governorates in Lebanon, using the snowball sampling technique, and were asked to complete a structured questionnaire, which included the following scales: the Mature Religiosity Scale, the Emotional Regulation Scale, the Depression Anxiety Stress Scale, and the Multidimensional Scale of Perceived Social Support.

RESULTS

The interaction social support by cognitive reappraisal was significantly associated with psychological distress; at high levels of cognitive reappraisal and low levels of expressive suppression, higher social support (Beta = - 0.07; p = .007) was significantly associated with lower psychological distress. The same was found at high levels of cognitive reappraisal and moderate levels of expressive suppression (Beta = - 0.08; p = .021). Social support alone was not significantly associated with psychological distress in the model (Beta = 0.15; t = 1.04; p = .300; 95% CI - 0.14; 0.44).

CONCLUSION

This cross-sectional study has provided evidence that the adequate use of emotional regulation skills such as high level of cognitive reappraisal and low level of expressive suppression with presence of social support would remarkably decrease psychological distress. This result casts a new light on clinical approaches to tackle this association between the emotional regulation of a patient in interpersonal psychotherapy.

Psychometric properties of an Arabic translation of the external and internal shame scale (EISS)

BACKGROUND

The concept of shame in Arab societies displays multiple differences when compared to Western societies in terms of nature, sources, types, and correlates. Surprisingly, we could not find any study investigating this increasingly important construct in Arab countries or the broad Arabic-speaking communities. This may likely be due to the lack of valid instruments assessing shame in the Arabic language. To address this major gap and contribute to the international literature, we sought to examine the psychometric properties of an Arabic translation of the External and Internal Shame Scale (EISS) among a community sample of Arabic-speaking adults from Lebanon.

METHODS

An online survey was conducted among Lebanese adults between July and August 2022. A total of 570 Lebanese adults completed the EISS, as well as Depression Anxiety Stress Scales, Other as shamer scale, and the Standardized Stigmatization Questionnaire. Exploratory-to-confirmatory (EFA-CFA) factor analyses were conducted.

RESULTS

Exploratory and confirmatory factor analyses supported a unidimensional model of EISS scores, with all eight items retained. Scores achieved scalar invariance across gender, with no significant difference reported between females and males. EISS scores were found to have adequate composite reliability (McDonald's ω = 0.88 for the total score); as well as adequate patterns of correlations with depression, anxiety and stress symptoms, as well as stigmatization scores. Finally, our analyses provide support to the concurrent validity of the Arabic version of the scale, by showing that the EISS total scores strongly correlated with the external shame measure "other as shamer".

CONCLUSION

Although further validations are necessary before our findings could be generalized, we preliminarily suggest that this is a short, easy-to-use, self-report scale that enables a reliable and valid measure of the shame construct among Arabic-speaking people.

Association between endometriosis and sexual satisfaction among a sample of lebanese women

BACKGROUND

Endometriosis is a complex disease that affects approximately 10% of women of childbearing age. It is characterized by the presence of endometrial-like tissue outside the uterus and often results in symptoms such as pelvic pain and infertility. This condition may disturb mental health and decrease both the mental and physical health related quality of life of women. The aim of this study was to assess the emotional state and the intimate relational aspect of life in Lebanese women living with endometriosis.

METHODS

This is a case-control study that included 317 women (65 participants with endometriosis and 252 controls (1:3 ratio)). Participants completed an online survey that included questions related to endometriosis, Sexual Satisfaction Scale for Women, Couple Satisfaction Index, Perceived Partner Responsiveness Scale and the Depression, Anxiety and Stress Scale.

RESULTS

A significantly higher mean sexual satisfaction score was found in women without endometriosis compared to those with endometriosis (90.83 vs. 83.42; p = 0.006). No significant difference was found in terms of couple satisfaction, depression, anxiety, stress, and perceived partner responsiveness between the two groups. Higher couple satisfaction (Beta = 1.30) and perceived partner responsiveness (Beta = 0.16) were significantly associated with higher sexual satisfaction, whereas higher depression (Beta=-1.70) and having endometriosis compared to not (Beta=-6.51) were significantly associated with lower sexual satisfaction.

CONCLUSION

This study validated the link between endometriosis and sexual satisfaction and invalidated the association between endometriosis and emotional state, as well as couple satisfaction and perceived partner responsiveness. Greater sexual satisfaction was, however, linked to greater perceived partner responsiveness and greater couple satisfaction, as well as decreased signs of depression, anxiety, and stress. More research is warranted to better understand how Lebanese women are coping with the disease and how clinicians may help them further.

The Impact of Event Scale-Revised: Examining Its Cutoff Scores among Arab Psychiatric Patients and Healthy Adults within the Context of COVID-19 as a Collective Traumatic Event

The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD). It has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its determined six subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as a probable ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 & 0.91, p values = 0.001, 95% CI: 0.80-0.92 & 0.87-0.94, sensitivity = 0.85 & 0.87, specificity = 0.73 & 0.83, Youden index = 0.58 & 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by pandemic-related irritability expressed a stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability/dysphoric mood evolved as a direct and indirect effect of key PTSD symptoms (intrusion, hyperarousal, and numbing). The irritability dimension of the IES-R directly predicted the traumatic symptoms of sleep disturbance in both samples while sleep disturbance did not predict irritability. The findings suggest the usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/co-morbidities (e.g., sleep disturbance) in both healthy and diseased groups.

The co-moderating effect of social support and religiosity in the association between psychological distress and coping strategies in a sample of lebanese adults

BACKGROUND

Coping involves attempts to mitigate the negative repercussions of stressful situations including psychological distress. The aim of this study was to assess factors affecting coping and examine the role of social support and religiosity in moderating the association between psychological distress and coping strategies in a sample of Lebanese adults.

METHODS

A cross-sectional study was carried out between May and July 2022, enrolling 387 participants. The study participants were asked to complete a self-administered survey containing the Multidimensional Scale of Perceived Social Support Arabic Version, the Mature Religiosity Scale, the Depression Anxiety Stress Scale, and the Coping Strategies Inventory-Short Form.

RESULTS

Higher levels of social support and mature religiosity were significantly associated with higher problem- and emotion-focused engagement scores and lower problem- and emotion-focus disengagement scores. In people experiencing high psychological distress, having low mature religiosity was significantly associated with higher problem-focused disengagement, seen at all levels of social support. In people experiencing high psychological distress, having moderate mature religiosity was significantly associated with higher problem-focused disengagement, seen at both moderate and high levels of social support.

CONCLUSION

Our findings provide novel insight into the moderating effect of mature religiosity in the association between psychological distress and coping strategies affecting adaptive behavior to stress.

Translation and validation of the mindful eating behaviour scale in the Arabic language

BACKGROUND

There has been a drastic increase in the prevalence of obesity and its related diseases in the Arabic-speaking countries during the last decades along with a lack of public awareness about this awareness about this public health problem. This calls for the development of novel prevention and intervention strategies that are based on new approaches, including mindful eating. In this context, we aimed through this study to explore the factor structure, composite reliability, measurement invariance across sex, convergent and divergent validity of an Arabic translation of the Mindful Eating Behaviour Scale (MEBS).

METHODS

A cross-sectional study carried out between September and November 2022, and enrolled 359 participants, all aged above 18 years old and recruited from all Lebanon governorates. The questionnaire used included socio-demographic questions, and the following scales: The Mindful Eating Behavior Scale (MEBS), Rosenberg Self-Esteem Scale (RSES), Intuitive Eating Scale-2, and Depression Anxiety Stress Scale (DASS-8).

RESULTS

McDonald's ω values ranged from .82 to .95 or the four mindful eating domains, indicating the excellent internal consistency reliability of the scale. Our study also showed that fit indices from the confirmatory factor analysis confirmed the original four-factor structure model of the MEBS. Furthermore, our analyses suggested that configural, metric, and scalar invariance was supported across sex. Our results found no sex difference in all MEBS subscales scores. Finally, we found positive correlations between Focused eating, Hunger and satiety cues on one hand, and intuitive eating on the other hand. Moreover, greater Hunger and satiety cues scores were correlated with higher self-esteem and lower body mass index.

CONCLUSION

Our findings support the psychometric reliability and validity of the Arabic MEBS. We suggest, accordingly, that the scale will be of high clinical and research utility, and will help in the development of information-based interventions focused on mindful eating that are aimed to combat eating disorders and obesity in the Arab world.

Psychometric evaluation of the Depression Anxiety Stress Scale 8 among women with chronic non-cancer pelvic pain

Psychiatric comorbidity and abusive experiences in chronic pelvic pain (CPP) conditions may prolong disease course. This study investigated the psychometrics of the Depression Anxiety Stress Scale 8 (DASS-8) among women with CPP (N = 214, mean age = 33.3 ± 12.4 years). The DASS-8 expressed excellent fit, invariance across age groups and menopausal status, good know-group validity (differentiating women with psychiatric comorbidity from those without comorbidity: U = 2018.0, p = 0.001), discriminant validity (HTMT ratios < 0.85), excellent reliability (alpha = 0.90), adequate predictive and convergent validity indicated by strong correlation with the DASS-21 (r = 0.94) and high values of item-total correlations (r = 0.884 to 0.893). In two-step cluster analysis, the DASS-8 classified women into low- and high-distress clusters (n = 141 and 73), with significantly higher levels of distress, pain severity and duration, and physical symptoms in cluster 2. The DASS-8 positively correlated with pain severity/duration, subjective symptoms of depression/anxiety, experiences of sexual assault, fatigue, headache severity, and collateral physical symptoms (e.g., dizziness, bloating, fatigue etc.) at the same level expressed by the parent scale and the DASS-12, or even greater. Accordingly, distress may represent a target for early identification of psychiatric comorbidity, CPP severity, experiences of sexual assault, and collateral physical complaints. Therefore, the DASS-8 is a useful brief measure, which may detect mental distress symptoms among women with CPP.

Psychometric evaluation of the depression anxiety stress scale 8-items (DASS-8)/DASS-12/DASS-21 among family caregivers of patients with dementia

Patients with dementia express a set of problematic and deteriorating symptoms, along with self-care dependency. Over time, the mental health of family caregivers of persons with dementia may be affected, putting them at a high risk for psychopathology, which may be associated with endangered wellbeing of people with dementia. This cross-sectional instrumental design study examined the psychometric properties of the Depression Anxiety Stress Scale 8-items (DASS-8), DASS-12, and DASS-21 in a convenient sample of 571 caregivers from northern Italy and southern Switzerland (mean age = 53 years, SD = 12, range = 24-89 years). A bifactor structure of the three measures had the best fit; some items of the DASS-12/DASS-21 failed to load on their domain-specific factors. The three-factor structure was invariant across various groups (e.g., gender and education), expressed adequate reliability and convergent validity, and had strong positive correlation with the three-item UCLA Loneliness Scale (UCLALS3). Distress scores did not differ among carers of different types of dementia (Alzheimer's disease vs. other types, e.g., vascular dementia). However, distress scores were significantly high among female individuals, adult children caregivers, those caring for dependent patients, and those who received help with care. For 54.9 and 38.8% of the latter, care was provided by relatives and health professionals, respectively. Since the DASS-8 expresses adequate psychometrics comparable with the DASS-21, it may be used as a brief measure of distress in this population.