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Antoniou F, Alghamdi MH, Kawai K. The effect of school size and class size on school preparedness. Front Psychol 2024; 15:1354072. [PMID: 38596335 PMCID: PMC11002959 DOI: 10.3389/fpsyg.2024.1354072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 01/11/2024] [Indexed: 04/11/2024] Open
Abstract
The purpose of the present study was to understand students' school readiness as a function of student and teacher behaviors but also school size and class size using both linear and non-linear analytical approaches. Data came from 21,903 schools distributed across 80 countries as per the 2018 cohort of the PISA database. Results pointed to a preference for the Cusp model in that the relationship between school and class sizes with achievement proved to be best described by the non-linearity of the Cusp catastrophe model. The critical benchmarks were a school size of 801 students and a class size of 27 students for which increases beyond those thresholds were linked to nonlinearity and unpredictability in school readiness. For this reason, we suggest using the cusp catastrophe model from Nonlinear Dynamical Systems Theory (NDST) to understand more fully such complex phenomena.
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Affiliation(s)
- Faye Antoniou
- Department of Educational Studies, National and Kapodistrian University of Athens, Athens, Greece
| | - Mohammed H. Alghamdi
- Department of Self-Development Skills, King Saud University, Riyadh, Saudi Arabia
| | - Kosuke Kawai
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
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2
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Kira IA, Shuwiekh HA, Ashby JS, Elwakeel SA, Alhuwailah A, Sous MSF, Baali SBA, Azdaou C, Oliemat EM, Jamil HJ. The Impact of COVID-19 Traumatic Stressors on Mental Health: Is COVID-19 a New Trauma Type. Int J Ment Health Addict 2023; 21:51-70. [PMID: 34248442 PMCID: PMC8259553 DOI: 10.1007/s11469-021-00577-0] [Citation(s) in RCA: 41] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 02/07/2023] Open
Abstract
COVID-19 is a new type of trauma that has never been conceptually or empirically analyzed in our discipline. This study aimed to investigate the impact of COVID-19 as traumatic stress on mental health after controlling for individuals' previous stressors and traumas. We utilized a sample of (N = 1374) adults from seven Arab countries. We used an anonymous online questionnaire that included measures for COVID-19 traumatic stress, posttraumatic stress disorder, anxiety, depression, and cumulative stressors and traumas. We conducted hierarchical multiple regression, with posttraumatic stress disorder, depression, and anxiety as dependent variables. In the first step, in each analysis, we entered the country, gender, age, religion, education, and income as independent variables (Kira, Traumatology 7(2):73-86, 2001; Kira, Torture, 14:38-44, 2004; Kira, Traumatology, 2021, https://doi.org/10.1037/trm0000305). In the second step, we entered cumulative stressors and traumas as an independent variable. In the third step, we entered either COVID-19 traumatic stressors or one of its subtypes (fears of infection, economic, and lockdown) as an independent variable. Finally, we conducted structural equation modeling with PTSD, depression, and anxiety as predictors of the latent variable mental health and COVID-19 as the independent variable. Results indicated that COVID-19 traumatic stressors, and each of its three subtypes, were unique predictors of PTSD, anxiety, and depression. Thus, COVID-19 is a new type of traumatic stress that has serious mental health effects. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-021-00577-0.
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Affiliation(s)
- Ibrahim A. Kira
- grid.256304.60000 0004 1936 7400Center for Cumulative Trauma Studies, Stone Mountain, GA, & Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, 4906 Woodhurst Way, Stone Mountain Atlanta, GA 30088 USA
| | | | - Jeffrey S. Ashby
- grid.256304.60000 0004 1936 7400Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA USA
| | | | | | | | | | | | - Enas. M. Oliemat
- grid.33801.390000 0004 0528 1681Hashemite University, Zarqa, Jordan
| | - Hikmet J. Jamil
- grid.17088.360000 0001 2150 1785Department of Family Medicine, Michigan State University, Lansing, MI USA
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3
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Moore HE, Hill B, Tanser F, Siriwardena AN, Gussy M, Cutts M, Spaight R. Characterizing Unusual Spatial Clusters of Male Mental Health Emergencies Occurring During the First National COVID-19 "Lockdown" in the East Midlands Region, UK: A Geospatial Analysis of Ambulance 999 Data. Am J Mens Health 2022; 16:15579883221097539. [PMID: 35579400 PMCID: PMC9118447 DOI: 10.1177/15579883221097539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 04/08/2022] [Accepted: 04/12/2022] [Indexed: 12/05/2022] Open
Abstract
The widespread psychological effects of contagion mitigation measures associated with the novel coronavirus disease 2019 (COVID-19) are well known. Phases of "lockdown" have increased levels of anxiety and depression globally. Most research uses methods such as self-reporting that highlight the greater impact of the pandemic on the mental health of females. Emergency medical data from ambulance services may be a better reflection of male mental health. We use ambulance data to identify unusual clusters of high rates of male mental health emergencies occurring in the East Midlands of the United Kingdom during the first national "lockdown" and to explore factors that may explain clusters. Analysis of more than 5,000 cases of male mental health emergencies revealed 19 unusual spatial clusters. Binary logistic regression analysis (χ2 = 787.22, df = 20, p ≤ .001) identified 16 factors that explained clusters, including proximity to "healthy" features of the physical landscape, urban and rural dynamics, and socioeconomic condition. Our findings suggest that the factors underlying vulnerability of males to severe mental health conditions during "lockdown" vary within and between rural and urban spaces, and that the wider "hinterland" surrounding clusters influences the social and physical access of males to services that facilitate mental health support. Limitations on social engagement to mitigate effects of the pandemic are likely to continue. Our approach could inform delivery of emergency services and the development of community-level services to support vulnerable males during periods of social isolation.
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Affiliation(s)
| | - Bartholomew Hill
- Water WISER CDT, University of Loughborough, Loughborough, Leicestershire, UK
| | - Frank Tanser
- Lincoln Institute for Rural Health, University of Lincoln, Lincoln, UK
| | | | - Mark Gussy
- Lincoln Institute for Rural Health, University of Lincoln, Lincoln, UK
| | - Morgan Cutts
- Department of Geography, University of Lincoln, Lincoln, UK
| | - Robert Spaight
- East Midlands Ambulance Service NHS Trust, Nottingham, UK
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Kira IA, Rice K, Ashby JS, Shuwiekh H, Ibraheem AB, Aljakoub J. Which Traumas Proliferate and Intensify COVID-19 Stressors? The Differential Role of Pre- and Concurrent Continuous Traumatic Stressors and Cumulative Dynamics in Two Communities: USA and Syria. JOURNAL OF LOSS & TRAUMA 2022. [DOI: 10.1080/15325024.2022.2050067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA, & Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
| | - Kenneth Rice
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
| | - Jeffery S. Ashby
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
| | - Hanaa Shuwiekh
- Department of Psychology, Fayoum University, Fayoum, Egypt
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Moore HE, Siriwardena AN, Gussy M, Hill B, Tanser F, Spaight R. Exploring the Impact of the COVID-19 Pandemic on Male Mental Health Emergencies Attended by Ambulances During the First National "Lockdown" in the East Midlands of the United Kingdom. Am J Mens Health 2022; 16:15579883221082428. [PMID: 35246002 PMCID: PMC8902032 DOI: 10.1177/15579883221082428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic and associated mitigation strategies such as “lockdown” are having widespread adverse psychological effects, including increased levels of anxiety and depression. Most research using self-reported data highlights the pandemic’s impact on the psychological well-being of females, whereas data for mental health emergency presentations may reflect the impact on male mental health more accurately. We analyzed records of male mental health emergencies occurring in the East Midlands of the United Kingdom during the first national “lockdown.” We computed two binary logistic regression models to (a) compare male mental health emergencies occurring during “lockdown,” 2020 (5,779) with those occurring in the same period in 2019 (N = 4,744) and (b) compare male (N = 5,779) and female (N = 7,695) mental health emergencies occurring during “lockdown.” Comparisons considered the characteristics of mental health emergencies recorded by ambulance clinicians (Primary Impressions), and the socioeconomic characteristics of communities where emergencies use the Index of Multiple Deprivation. We found that during “lockdown,” male emergencies were more likely to involve acute anxiety (odds ratio [OR]: 1.42) and less likely to involve intentional drug overdose (OR: 0.86) or attempted suicide (OR: 0.71) compared with 2019. Compared with females, male emergencies were more likely to involve acute behavioral disturbance (OR: 1.99) and less likely to involve anxiety (OR: 0.67), attempted suicide (OR: 0.83), or intentional drug overdose (OR: 0.76). Compared with 2019, and compared with females, males experiencing mental health emergencies during “lockdown” were more likely to present in areas of high deprivation. Understanding the presentation of male mental health emergencies could inform improved patient care pathways.
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Affiliation(s)
| | | | - Mark Gussy
- Lincoln Institute of Rural Health, University of Lincoln, Lincoln, UK
| | | | - Frank Tanser
- Lincoln Institute of Rural Health, University of Lincoln, Lincoln, UK
| | - Robert Spaight
- East Midlands Ambulance Service NHS Trust, Nottingham, UK
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Kira IA, Aljakoub J, Al Ibraheem B, Shuwiekh HAM, Ashby JS. The Etiology of Complex PTSD in the COVID-19 and Continuous Traumatic Stressors Era: A Test of Competing and Allied Models. JOURNAL OF LOSS & TRAUMA 2022. [DOI: 10.1080/15325024.2022.2028094] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, Georgia, USA
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, Georgia, USA
| | | | | | | | - Jeffrey S. Ashby
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, Georgia, USA
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Kira IA, Rihan Ibrahim ES, Shuwiekh HAM, Ashby JS. Does Intersected Discrimination Underlie the Disproportionate Impact of COVID-19 Infection and Its Severity on Minorities? An Example from Jordan. JOURNAL OF LOSS & TRAUMA 2021. [DOI: 10.1080/15325024.2021.1992224] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA, USA
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
| | | | | | - Jeffrey S. Ashby
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
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Moore HE, Siriwardena AN, Gussy M, Tanser F, Hill B, Spaight R. Mental health emergencies and COVID-19: the impact of 'lockdown' in the East Midlands of the UK. BJPsych Open 2021; 7:e139. [PMID: 34308824 PMCID: PMC8314071 DOI: 10.1192/bjo.2021.973] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The most immediate response of the research community to COVID-19 has been a focus on understanding the effects, treatment and prevention of infection. Of equal and ongoing importance is elucidating the impact of mitigation measures, such as lockdown, on the well-being of societies. Research about mental health and lockdown in the UK has predominately involved large surveys that are likely to encounter self-selection bias. Further, self-reporting does not constitute a clinical judgement. AIMS To (a) compare the age, gender and ethnicity of patients experiencing mental health emergencies prior compared with during lockdown, (b) determine whether the nature of mental health emergencies has changed during compared with before lockdown, (c) explore the utility of emergency medical service data for identifying vulnerability to mental health emergencies in real time during a pandemic. METHOD A total of 32 401 clinical records of ambulance paramedics attending mental health emergencies in the East Midlands of the UK between 23 March and 31 July 2020 and the same period in 2019 were analysed using binary logistic regression. RESULTS People of younger age, male gender and South Asian and Black ethnicity are particularly vulnerable to acute mental health conditions during lockdown. Patients with acute cases of anxiety have increased during lockdown whereas suicide and intentional drug overdose have decreased. CONCLUSIONS Self-reported data may underrepresent the true impact of lockdown on male mental health and ethnic minority groups. Emergency medical data can be used to identify vulnerable communities in the context of the extraordinary circumstances surrounding the current pandemic, as well as under more ordinary circumstances.
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Affiliation(s)
| | | | - Mark Gussy
- Lincoln Institute for Rural Health, University of Lincoln, UK
| | - Frank Tanser
- Lincoln Institute for Rural Health, University of Lincoln, UK
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Kira IA, Alpay EH, Ayna YE, Shuwiekh HAM, Ashby JS, Turkeli A. The effects of COVID-19 continuous traumatic stressors on mental health and cognitive functioning: A case example from Turkey. CURRENT PSYCHOLOGY 2021; 41:7371-7382. [PMID: 33897228 PMCID: PMC8057920 DOI: 10.1007/s12144-021-01743-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2021] [Indexed: 12/12/2022]
Abstract
There is a need to accurately assess the specific impacts of the various traumatic stressors caused by COVID-19 on mental health. The goal was to evaluate the impact of different types of COVID-19 stressors (infection fears, lockdown, and economic stressors) on mental health and cognitive functioning. We used a sample of 262 Turkish adults. We administered an online questionnaire that included measures of COVID-19 traumatic stressors, PTSD, depression, anxiety, executive function deficits, and cumulative stressors and traumas (CST). The analyses included correlations, hierarchical regression, path analysis, and PROCESS mediation analysis. All COVID-19 traumatic stressors types and their cumulative load predicted PTSD, depression, anxiety, and executive function deficits after controlling for previous cumulative stressors and traumas and COVID-19 infection. COVID-19 lockdown’s stressors were the strongest predictors, compared to COVID-19 fears and economic stressors. Path analysis and PROCESS mediation results indicated that COVID-19 traumatic stressors had direct effects on working memory deficits, direct and indirect effects on PTSD, depression, and anxiety, and indirect effects on inhibition deficits. Anxiety, depression, and inhibition deficits mediated its indirect effects on PTSD. The results have conceptual and clinical implications. COVID-19 continuous posttraumatic stress syndrome that includes comorbid PTSD, depression, anxiety, and executive function deficits is different and does not fit within the current trauma frameworks. There is a need for a paradigm shift in current stress and trauma frameworks to account for the COVID-19 continuous global stressors and for clinical innovations in intervention to help its victims.
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Affiliation(s)
- Ibrahim A Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA USA.,Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA USA
| | - Emre Han Alpay
- Department of Psychology, Mersin University, Mersin, Turkey
| | | | | | - Jeffrey S Ashby
- Center for Stress, trauma, and Resiliency, Georgia State University, Atlanta, GA USA
| | - Aras Turkeli
- Department of Psychology, Mersin University, Mersin, Turkey
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Kira IA, Alpay EH, Turkeli A, Shuwiekh HAM, Ashby JS, Alhuwailah A. The Effects of COVID-19 Traumatic Stress on Executive Functions: The Case of Syrian Refugees in Turkey. JOURNAL OF LOSS & TRAUMA 2021. [DOI: 10.1080/15325024.2020.1869444] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA
- Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
| | - Emre Han Alpay
- Department of Psychology, Eastern Mediterranean University, Famagusta, North Cyprus
| | - Aras Turkeli
- Department of Psychology, Mersin University, Mersin, Turkey
| | | | - Jeffrey S. Ashby
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
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11
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Kira IA, Shuweikh H, Al-Huwailiah A, El-Wakeel SA, Waheep NN, Ebada EE, Ibrahim ESR. The direct and indirect impact of trauma types and cumulative stressors and traumas on executive functions. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:1078-1094. [PMID: 33245250 DOI: 10.1080/23279095.2020.1848835] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The goal was to measure the effects of trauma types, cumulative trauma, posttraumatic stress disorder (PTSD), existential annihilation anxiety (EAA), and posttraumatic growth (PTG) on executive functions. The study sample consists of 1155 from Egypt and Kuwait. Measures included adults working memory deficits (WMD) and inhibition deficits (ID), and cumulative stressors and traumas (CST) and trauma types, PTSD, EAA, and PTG. We used Stepwise regression and PROCESS macro to analyze the data. Results indicated that survival and cumulative traumas have direct effects on a lower WMD and ID, attachment traumas and gender discrimination by parents have direct impacts on higher WMD and ID, while personal identity, status identity, secondary trauma, gender discrimination by society, community violence do not have any direct effects on WMD or ID. All traumas have indirect effects on higher WMD or/and ID via PTSD. Gender discrimination by society, community violence, and CST has an additional indirect higher impact on WMD and ID via EAA. There were indirect trajectories from survival trauma, personal identity, status identity trauma, secondary trauma, gender discrimination by society, and CST on lower WMD or/and ID via PTG. Attachment trauma, gender discrimination by parents, perpetration traumas, and community violence were not associated with PTG and its trajectories of lower WMD or/and ID. We discussed the research and clinical implication for these results.
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Affiliation(s)
- Ibrahim Aref Kira
- Center for Cumulative Trauma Studies, Stone Mountain, GA, USA.,Affiliate of the Center of Stress Trauma and Resiliency, Georgia State, University, Atlanta, GA
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12
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Shuwiekh HAM, Kira IA, Sous MSF, Ashby JS, Alhuwailah A, Baali SBA, Azdaou C, Oliemat EM, Jamil HJ. The differential mental health impact of COVID-19 in Arab countries. CURRENT PSYCHOLOGY 2020; 41:5678-5692. [PMID: 33162726 PMCID: PMC7605480 DOI: 10.1007/s12144-020-01148-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2020] [Indexed: 11/29/2022]
Abstract
COVID-19 pandemic’s mental health impact on Arab countries is under-researched. The goal of this investigation was to study the differential impact of COVID-19 on the mental health of Arab countries. A questionnaire including measures of COVID-19 traumatic stress, PTSD, depression, anxiety, and cumulative stressors and trauma was distributed anonymously online in seven Arab countries (Egypt (N = 255), Kuwait (N = 442), Jordan (N = 216), Saudi Arabia (N = 212, Algeria (N = 110), Iraq and Palestine (N = 139)). We used ANOVA and stepwise regression to analyze the data. For each country, regression, PTSD, depression, and anxiety were dependent variables; we entered in the first-step, gender, age, religion, education, and income. In the second step, we entered “cumulative stressors and traumas.” In the third step, we entered COVID-19 traumatic stress. The ANOVA results indicated that the differences in COVID19 traumatic stress, PTSD, depression, and anxiety between the countries were significant. Post-hoc analysis indicated that Egypt is significantly higher than all the other Arab countries in COVID-19 traumatic stress, PTSD, anxiety, and depression. The subsample from Palestine and Iraq had a significantly higher cumulative trauma load than the other Arab countries but did not have higher levels of COVID-19 traumatic stress or PTSD. Stepwise regression indicated that COVID-19 traumatic stress accounted for significant variance above and beyond the variance accounted for by previous cumulative stressors and traumas for anxiety in all countries and PTSD and depression in all countries except for Algeria. We discussed the implications for these results for the urgent mental health needs of Arab countries.
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Affiliation(s)
| | - Ibrahim A Kira
- Center for Cumulative Trauma Studies, 4906 Woodhurst Way, Stone Mountain, GA 30088 USA.,Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA USA
| | | | - Jeffrey S Ashby
- Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA USA
| | | | | | | | | | - Hikmet J Jamil
- Department of Family Medicine, Michigan State University, Lancing, Michigan USA
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Kira IA, Shuwiekh HAM, Rice KG, Ashby JS, Elwakeel SA, Sous MSF, Alhuwailah A, Baali SBA, Azdaou C, Oliemat EM, Jamil HJ. Measuring COVID-19 as Traumatic Stress: Initial Psychometrics and Validation. JOURNAL OF LOSS & TRAUMA 2020. [DOI: 10.1080/15325024.2020.1790160] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
- Ibrahim A. Kira
- Center for Cumulative Trauma Studies, Stone Mountain, Georgia, USA
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, Georgia, USA
| | | | - Kenneth G. Rice
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, Georgia, USA
| | - Jeffrey S. Ashby
- Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, Georgia, USA
| | | | | | | | | | - Chafika Azdaou
- Department of Psychology, University of Algiers, Algiers, Algiers
| | - Enas. M. Oliemat
- Department of Special Education, Hashemite University, Zarqa, Jordon
| | - Hikmet J. Jamil
- School of Medicine, Wayne State University, Detroit, Michigan, USA
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Kira I, Barger B, Shuwiekh H, Kucharska J, Al-Huwailah A. The Threshold Non-linear Model for the Effects of Cumulative Stressors and Traumas: A Chained Cusp Catastrophe Analysis. ACTA ACUST UNITED AC 2020. [DOI: 10.4236/psych.2020.113025] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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