The prevalence of suicidal behaviour and its associated risk factors among school-going adolescents resident in the United Arab Emirates

Suicidal behaviour which includes suicidal ideation, having a plan to commit suicide and suicide attempts remains a global public health issue as it substantially impacts adolescent health and wellbeing. Suicidal behaviour, however, remains understudied in Middle Eastern contexts. This study analysed data from the 2016 Global School-based Student Health Survey collected in the United Arab Emirates (UAE). A sample of 5826 adolescents aged between 11 and 18 years were sampled. Potential risk factors associated with an elevated risk for engagement in suicidal behaviour were examined. These factors were stratified into categories for analysis (demographics, psychosocial, risky health, and socio-environmental). The age-adjusted prevalence of suicidal behaviour amongst the school-going adolescent population in the UAE was 54%. Analyses indicated that elevated risk was significantly associated with anxiety difficulties, the experience of loneliness, and amongst those who smoked tobacco. None of the socio-environmental factors emerged as significant. A dose-dependent relationship was evident in that the degree of risk that was evident appeared to compound as the number of adverse risk factors increased. The data suggest that suicidal behaviour may be highly prevalent in this location. Findings highlight the immense need to develop preventative interventions, some of which may be school-delivered and targeted at parents. Our findings provide initial indications as to which risk factors could be targeted for remediation in developing these interventions.

The association between depression and addictive social media use during the COVID-19 pandemic: The mediating role of sense of control

BACKGROUND

COVID-19 precipitated a plethora of mental health difficulties, particularly for those with pre-existing mental health concerns such as depression or addictive tendencies. For some, the distress that emanated from the experience of the pandemic prompted excessive engagement in the safety of online interactions on social media. The present study examined whether variation in individuals' sense of control explained the association between depression and addictive social media use.

METHOD

A sample of 1322 participants from two Middle Eastern nations provided data collected during the peak of the pandemic from February to May 2021. A combination of convenience and snowball sampling were used to recruit and collect data from college-aged students enrolled at two universities in Egypt and the United Arab Emirates, respectively. This study adopted a cross-sectional design in which participants completed a self-administered survey that consisted of measures that assessed depressive affect, sense of control, and addictive social media use.

RESULTS

Depression was significantly and positively associated with addictive SMU. Sense of control was negatively related to both depression and SMU and significantly mediated the association between these two variables (β = .62, SE = .03, 95%CI .56, .68).

CONCLUSION

This study identified a potential protective variable that could be targeted by psychological treatment to ameliorate the potential onset of addictive SMU in individuals with depressive symptoms under conditions of immense psychological distress such as a worldwide pandemic.

Body appreciation around the world: Measurement invariance of the Body Appreciation Scale-2 (BAS-2) across 65 nations, 40 languages, gender identities, and age

The Body Appreciation Scale-2 (BAS-2) is a widely used measure of a core facet of the positive body image construct. However, extant research concerning measurement invariance of the BAS-2 across a large number of nations remains limited. Here, we utilised the Body Image in Nature (BINS) dataset - with data collected between 2020 and 2022 - to assess measurement invariance of the BAS-2 across 65 nations, 40 languages, gender identities, and age groups. Multi-group confirmatory factor analysis indicated that full scalar invariance was upheld across all nations, languages, gender identities, and age groups, suggesting that the unidimensional BAS-2 model has widespread applicability. There were large differences across nations and languages in latent body appreciation, while differences across gender identities and age groups were negligible-to-small. Additionally, greater body appreciation was significantly associated with higher life satisfaction, being single (versus being married or in a committed relationship), and greater rurality (versus urbanicity). Across a subset of nations where nation-level data were available, greater body appreciation was also significantly associated with greater cultural distance from the United States and greater relative income inequality. These findings suggest that the BAS-2 likely captures a near-universal conceptualisation of the body appreciation construct, which should facilitate further cross-cultural research.

The Psychological Science Accelerator's COVID-19 rapid-response dataset

In response to the COVID-19 pandemic, the Psychological Science Accelerator coordinated three large-scale psychological studies to examine the effects of loss-gain framing, cognitive reappraisals, and autonomy framing manipulations on behavioral intentions and affective measures. The data collected (April to October 2020) included specific measures for each experimental study, a general questionnaire examining health prevention behaviors and COVID-19 experience, geographical and cultural context characterization, and demographic information for each participant. Each participant started the study with the same general questions and then was randomized to complete either one longer experiment or two shorter experiments. Data were provided by 73,223 participants with varying completion rates. Participants completed the survey from 111 geopolitical regions in 44 unique languages/dialects. The anonymized dataset described here is provided in both raw and processed formats to facilitate re-use and further analyses. The dataset offers secondary analytic opportunities to explore coping, framing, and self-determination across a diverse, global sample obtained at the onset of the COVID-19 pandemic, which can be merged with other time-sampled or geographic data.

Anger and worry are related to problematic smartphone use: A cross-sectional examination of novel psychopathological constructs in a college-aged sample in the United Arab Emirates

Introduction

Problematic smartphone use (PSU) has consistently been shown to be associated with depression and anxiety. However, the association of PSU and psychological constructs beyond these two have rarely been subjected to examination. Worry and anger are transdiagnostic constructs that, given their conceptual similarity with depression and anxiety, may similarly evidence significant relationships with PSU.

Methods

To test these hypotheses, a sample of 264 college-aged students were recruited from a university in the United Arab Emirates. The sample ranged in age from 18 to 36 years (M = 21.51, SD = 2.99). Self-report measures of PSU, worry and anger were administered.

Results

Results revealed statistically significant associations with PSU, anger, and worry – these results were evident following correlational as well as regression analyses. Moreover, using a recommended cut-off score from the literature to identify participants scoring beyond the clinical threshold indicative of PSU, worry and anger scores were significantly higher in the clinical sub-group.

Conclusions

This study's results lend additional credibility to uses and gratifications theory and compensatory internet use theory as it appears that the excessive use of technologies may indeed serve the purpose of compensating for the management of emotional distress. Results are discussed within the context of these two theories.

The association between psychological burden related to COVID-19 and addictive social media use: Testing the mediational role of anxious affect

INTRODUCTION

The COVID-19 pandemic has had a substantial impact on the normalcy of life. Similarly, social media use (SMU) has increased exponentially. This study examined the association between individuals' perception of the psychological burden related to the pandemic and addictive SMU.

METHOD

A cross-sectional study was conducted between February and May 2021 in two national contexts, Egypt, and the United Arab Emirates. Data were gathered from a sample of 1322 participants drawn from a university population who completed measures of psychological burden related to COVID-19, anxious affect, and addictive SMU. Preliminary analyses of the potential association between the study variables were conducted using bivariate correlations followed by a pre-specified mediation model.

RESULTS

At a correlational level, all three study variables were positively associated with each other (r values ranged from .18 to .50 and all p values were < .05). A further mediation analysis confirmed that the total effect of psychological burden on addictive SMU was significant (β = .654, SE = .033, 95% CI .589-.720), and this relationship remained significant with inclusion of the mediator. Significant mediation was evident across the total sample as well as within each country-specific subsample.

CONCLUSION

These results provide insight into the factors that contribute to the development of addictive SMU in relation to the COVID-19 pandemic. Findings are discussed in relation to the emotion regulation function that SMU might play for individuals in the midst of emotional distress.

Cross-cultural measurement invariance of the Quality of Life Enjoyment and Satisfaction Questionnaire-Short form across ten countries: the application of Bayesian approximate measurement invariance

Background

The Quality of Life Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF) is the most frequently used generic quality of life (QOL) measure in many countries and cultures worldwide. However, no single study has been carried out to investigate whether this questionnaire performs similarly across diverse cultures/countries. Accordingly, this study aimed to assess the cross-cultural measurement invariance of the Q-LES-Q-SF across ten different countries.

Methods

The Q-LES-Q-SF was administrated to a sample of 2822 university students from ten countries: Bangladesh, Brazil, Croatia, India, Nepal, Poland, Serbia, Turkey, the United Arab Emirates, and Vietnam. The Bayesian approximate measurement invariance approach was used to assess the measurement invariance of the Q-LES-Q-SF.

Results

Approximate measurement invariance did not hold across the countries for the Q-LES-Q-SF, with only two out of 14 items being non-invariant; namely items related to doing household and leisure time activities.

Conclusions

Our findings did not support the cross-cultural measurement invariance of the Q-LES-Q-SF; thus, considerable caution is warranted when comparing QOL scores across different countries with this measure. Item rewording and adaptation along with calibrating non-invariant items may narrow these differences and help researchers to create an invariant questionnaire for reliable and valid QOL comparisons across different countries.

The fear of COVID-19 scale: Its structure and measurement invariance across 48 countries

Coronavirus disease (COVID-19) has been a source of fear around the world. We asked whether the measurement of this fear is trustworthy and comparable across countries. In particular, we explored the measurement invariance and cross-cultural replicability of the widely used Fear of COVID-19 scale (FCV-19S), testing community samples from 48 countries (N = 14,558). The findings indicate that the FCV-19S has a somewhat problematic structure, yet the one-factor solution is replicable across cultural contexts and could be used in studies that compare people who vary on gender and educational level. The validity of the scale is supported by a consistent pattern of positive correlations with perceived stress and general anxiety. However, given the unclear structure of the FCV-19S, we recommend using latent factor scores, instead of raw scores, especially in cross-cultural comparisons. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Association of Internet gaming disorder symptoms with anxiety and depressive symptoms and substance use: an international cross-sectional study

Background

Problematic Internet gaming is an increasingly recognized global mental health problem. This multicultural cross-sectional study examined the association between Internet gaming disorder (IGD) symptoms and anxiety and depressive symptoms and substance use within a sample of young Internet users. In total, 3529 college/university students (1260 (35.7%) males; mean age 21 ± 3 years) were surveyed online. We assessed online gaming patterns using the Internet Gaming Disorder Self-report for College/University Students (ICMH-IGD), symptoms of depression using the Patient Health Questionnaire-9, and symptoms of anxiety using the Generalized Anxiety Disorder scale-7.

Results

IGD symptoms were associated with symptoms of depression, anxiety, and substance use, independent of time spent online, psychiatric diagnosis, culture, or sociodemographic characteristics. For males, more significant IGD symptoms were associated with more extended Internet browsing per day time and higher levels of anxiety and depressive symptoms, while for females, with more extended Internet browsing per day time, marihuana use, and higher levels of depressive symptoms.

Conclusions

Our study found that more overt symptoms of IGD were associated with higher levels of anxiety and depressive symptoms and substance use. Still, these associations differed among males and females, suggesting that gender differences should be considered when planning specific treatments.

Supplementary Information

The online version contains supplementary material available at 10.1186/s43045-022-00180-6.

Measuring anxiety related to COVID-19: Factor analysis and psychometric properties of the Arabic Coronavirus Anxiety Scale

Literature reports that fear and anxiety related to the coronavirus (COVID-19) pandemic may be a significant factor in promoting adherence to health-protective behaviours. This study aimed to validate an Arabic version of the Coronavirus Anxiety Scale (CAS). Participants aged 18 to 58 years of age were recruited from a university population (students and staff) as well as via social media from 22 June to 18 July 2020 when the United Arab Emirates was under a partial government-instituted lockdown. They completed Arabic versions of the CAS and the Fear of COVID-19 Scale. A confirmatory factor analysis produced a unidimensional structure and all items satisfactorily loaded onto this single factor (i.e., the physiological symptoms of fear and anxiety related to coronavirus). The Arabic CAS was internally consistent and concurrently valid. These preliminary findings suggest that the Arabic CAS is a valid and reliable instrument to employ in the assessment of dysfunctional anxiety related to coronavirus. The availability of this validated measure will enable the further conduct of a variety of mental health studies in relation to the COVID-19 pandemic. It also holds clinical utility as a potential screening measure for those afflicted by anxiety symptomology during the pandemic.

The Association Between Depressive Symptomology, Psychological Burden Related to COVID-19, and Engagement in Physical Exercise Among College Students

Introduction: The coronavirus (COVID-19) pandemic has resulted in substantial changes to the normalcy of daily life. Research conducted in Western Europe point to elevated levels of depression, rumination and worry as well psychological burden. These in turn impact the capacity of individuals to adhere to lockdown measures and health-protective behaviours. Investigations of these pandemic-related mental health constructs in the Middle East appears sparse. Moreover, there is an immense need to investigate the potential for simple strategies that might be used by individuals whilst in lockdown to combat the onset of mental health difficulties. Regular physical exercise may prove valuable in this regard. Objective: To investigate the potential mediational role of engagement in physical exercise on the association between depression and psychological burden related to COVID-19. Method: A sample of 1,322 participants (mage = 19.50 years, SD = 1.54) completed measures of depression and psychological burden related to COVID-19 and self-reported their frequency of physical exercise. Data were collected between February and May 2021 in Egypt and the United Arab Emirates. Results: Analyses revealed statistically significant associations between depression and psychological burden as well as between elevated depression and reduced physical exercise. Mediation analyses in which the potential mediational role of physical exercise was examined were not significant. Conclusions: Depression and psychological burden related to the pandemic appear to be prevalent in these Middle Eastern locations. Whilst physical exercise appears to be beneficial in combating depression, it does not appear to be a sufficient strategy for impeding the experience of psychological burden. Investigation of the contribution of additional strategies is required.

A multi-country test of brief reappraisal interventions on emotions during the COVID-19 pandemic

The COVID-19 pandemic has increased negative emotions and decreased positive emotions globally. Left unchecked, these emotional changes might have a wide array of adverse impacts. To reduce negative emotions and increase positive emotions, we tested the effectiveness of reappraisal, an emotion-regulation strategy that modifies how one thinks about a situation. Participants from 87 countries and regions (n = 21,644) were randomly assigned to one of two brief reappraisal interventions (reconstrual or repurposing) or one of two control conditions (active or passive). Results revealed that both reappraisal interventions (vesus both control conditions) consistently reduced negative emotions and increased positive emotions across different measures. Reconstrual and repurposing interventions had similar effects. Importantly, planned exploratory analyses indicated that reappraisal interventions did not reduce intentions to practice preventive health behaviours. The findings demonstrate the viability of creating scalable, low-cost interventions for use around the world. PROTOCOL REGISTRATION: The stage 1 protocol for this Registered Report was accepted in principle on 12 May 2020. The protocol, as accepted by the journal, can be found at https://doi.org/10.6084/m9.figshare.c.4878591.v1.

Problematic Internet Use, Psychopathology, Defense Mechanisms, and Coping Strategies: a Cross-Sectional Study from the United Arab Emirates

A number of studies point to a demonstrated relationship between problematic Internet use (PIU) and psychopathological variables. However, explorations of PIU in relation to defense mechanisms and coping strategies remain rare. The present study sought to determine the extent of PIU among a sample of college-aged young adults resident in the United Arab Emirates. The relationship of PIU to two psychopathological variables (depression and low self-esteem) and two psychological variables (defense mechanisms and coping strategies) were examined. A sample of 697 Emirati participants aged between 18 and 33 years of age completed assessments of PIU, socio-demographic, psychopathological, and psychological variables. A total of 67.3% exhibited PIU. Problematic users produced higher scores for maladaptive coping strategies and for the use of immature, neurotic, and autistic fantasy defenses. Regression analyses revealed that PIU was predicted by the mature, immature, and autistic fantasy defenses as well as, negatively by adaptive coping, and positively by maladaptive coping. These differed when the analyses were repeated on gender-stratified samples. Given that this initial prevalence estimation suggests that PIU may be a substantial issue in this region of the world, future research should examine the mental health risk factors related to PIU, particularly their causal relationships.

An investigation of the association between body appreciation, need for self-expression, and interest in cosmetic enhancing procedures

PURPOSE

To examine the association between body appreciation and three factors reflective of individuals' need for self-expression: uniqueness, investment in a distinctive appearance, and interest in cosmetic enhancements.

DESIGN AND METHODS

Cross-sectional, correlational design. Participants (N = 256) completed measurements of body appreciation, interest in cosmetic enhancements, need for uniqueness, and investment in a distinctive appearance.

FINDINGS

Body appreciation was associated with the need for uniqueness and a distinctive appearance investment. Only a generalized need for uniqueness was associated with a greater tendency to use cosmetic enhancing procedures.

IMPLICATIONS

Body appreciation appears to be related to established markers of positive striving for uniqueness. Thus, the use of cosmetic enhancements may serve to promote a unique sense of self and, potentially, a more positive body image.

The Breast Size Satisfaction Survey (BSSS): Breast size dissatisfaction and its antecedents and outcomes in women from 40 nations

The Breast Size Satisfaction Survey (BSSS) was established to assess women's breast size dissatisfaction and breasted experiences from a cross-national perspective. A total of 18,541 women were recruited from 61 research sites across 40 nations and completed measures of current-ideal breast size discrepancy, as well as measures of theorised antecedents (personality, Western and local media exposure, and proxies of socioeconomic status) and outcomes (weight and appearance dissatisfaction, breast awareness, and psychological well-being). In the total dataset, 47.5 % of women wanted larger breasts than they currently had, 23.2 % wanted smaller breasts, and 29.3 % were satisfied with their current breast size. There were significant cross-national differences in mean ideal breast size and absolute breast size dissatisfaction, but effect sizes were small (η² = .02-.03). The results of multilevel modelling showed that greater Neuroticism, lower Conscientiousness, lower Western media exposure, greater local media exposure, lower financial security, and younger age were associated with greater breast size dissatisfaction across nations. In addition, greater absolute breast size dissatisfaction was associated with greater weight and appearance dissatisfaction, poorer breast awareness, and poorer psychological well-being across nations. These results indicate that breast size dissatisfaction is a global public health concern linked to women's psychological and physical well-being.

Abstinence from social media use, subjective well-being, stress, and loneliness

PURPOSE

Studies with experimental designs in which the association between participants' subjective well-being and their use of social media is studied remain rare. This study tested the effect of abstaining from social media use on participants' well-being, affect, perceived stress, and sense of perceived loneliness.

DESIGN AND METHODS

Randomized, controlled design. Sixty-eight participants were randomized to one of two conditions.

FINDINGS

Those who abstained from social media use, compared with those in the control group, evidenced a decline in life satisfaction, an increase in negative affect, and an increase in loneliness.

PRACTICE IMPLICATIONS

Excessive social media use poses deleterious consequences for users, but abstinence may not necessarily exact positive changes; this outcome is dependent on the functions for which social media are used.

Correlates of Problematic Internet Use among college and university students in eight countries: An international cross-sectional study

BACKGROUND AND AIMS

Internet use has increased worldwide exponentially over the past two decades, with no up-to-date cross-country comparison of Problematic Internet Use (PIU) and its correlates available. The present study aimed to explore the pattern and correlates of PIU across different countries in the European and the Asian continent. Further, the stability of factors associated with PIU across different countries were assessed.

MATERIALS AND METHODS

An international, cross-sectional study with a total of 2749 participants recruited from universities/colleges of eight countries: Bangladesh, Croatia, India, Nepal, Turkey, Serbia, Vietnam, and United Arab Emirates (UAE). Participants completed the Generalized Problematic Internet Use Scale -2 (GPIUS2) assessing PIU, and the Patient Health Questionnaire Anxiety-Depression Scale (PHQ-ADS) assessing the depressive and anxiety symptoms.

RESULTS

A total of 2643 participants (mean age 21.3 ± 2.6; 63% females) were included in the final analysis. The overall prevalence of PIU for the entire sample was 8.4% (range 1.6% to 12.6%). The mean GPIUS2 standardized scores were significantly higher among participants from the five Asian countries when compared to the three European countries. Depressive and anxiety symptoms were the most stable and strongest factors associated with PIU across different countries and cultures.

DISCUSSION AND CONCLUSIONS

The PIU is an important emerging mental health condition among college/university going young adults, with psychological distress being the strongest and most stable correlate of PIU across different countries and cultures in this study. The present study highlighted the importance of screening university and college students for PIU.

The factor structure and psychometric properties of an Arabic-translated version of the Body Appreciation Scale-2

PURPOSE

The conduct of body image studies with Arab populations is hindered by a lack of psychometrically sound assessment measures. We examined the psychometric properties of an Arabic translation of the most frequently employed measure of body appreciation, the Body Appreciation Scale-2 (BAS-2).

DESIGN AND METHODS

A sample of college-aged women from the United Arab Emirates (UAE) (n = 256) completed the Arabic BAS-2, and measures of aesthetic and functional body image, authentic body pride, and self-reported body mass index (BMI).

RESULTS

Exploratory factor analysis revealed that the Arabic BAS-2 had a one-dimensional factor structure. BAS-2 scores were positively correlated with body image and body pride, but not with BMI.

PRACTICE IMPLICATIONS

A psychometrically sound BAS-2 may now facilitate the conduct of cross-cultural work that includes the Arabic-speaking population, an often-neglected ethnic group in most body image studies.

An examination of problematic mobile phone use in the United Arab Emirates: Prevalence, correlates, and predictors in a college-aged sample of young adults

Despite a number of benefits, mobile phones can carry many deleterious effects. We aimed to determine the extent of problematic mobile phone use in a sample of college-aged young adults in the United Arab Emirates. We also examined whether a number of factors were correlated with and predicted problematic use. We conducted a cross-sectional, correlational study in which a sample of 350 young adults (M = 20.70, SD = 2.14, range: 18–33 years) completed a survey that included socio-demographic variables, and measures of problematic mobile phone use (MPPUS-10), depression, and low self-esteem. One third of the sample evidenced scores indicative of problematic mobile phone use (M = 47.14, SD = 19.98). Logistic regression identified female gender, increasing daily time using the mobile phone, and elevated depressive symptomology predicted higher MPPUS-10 scores. The MPPUS-10 evidenced acceptable reliability and validity in this sample. The prevalence of problematic mobile phone use was considerable in this sample, higher in comparison to previous reports from Europe and the Far East.

•

Excessive mobile phone use is pervasive in the UAE.

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Elevated depression scores and increasing time of use predicted problematic phone use.

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The MPPUS-10 evidenced acceptable reliability and validity.

Public stigma and attitudes toward psychological help-seeking in the United Arab Emirates: The mediational role of self-stigma

PURPOSE

Scholars argue that public stigma is predictive of self-stigma, and self-stigma is a primary predictor of attitudes toward seeking psychological help (ATPH). This assertion remains undetermined outside of the United States. This study examines a potential mediational model in which internalized stigma was hypothesized to mediate the relationship between public stigma and ATPH using a sample in the United Arab Emirates.

DESIGN AND METHODS

Cross-sectional, correlational design; 114 students completed measures of public stigma, self-stigma, and ATPH.

FINDINGS

Full mediation occurred. The sample exhibited high levels of both public stigma and self-stigma. Psychology students manifested diminished levels of stigma and more favorable ATPH. Results are discussed in relation to the prevalent cultural and contextual factors.

PRACTICE IMPLICATIONS

Stigma reduction campaigns in this locale should target internalized stigma and its associated socio-cultural nuances.

A comparative description of perceived stress and coping strategies among psychology and nonpsychology students in the United Arab Emirates

PURPOSE

This study describes perceived stress and coping strategies as they occur within a college-aged population from an Arab background. Variables were compared between psychology students and their peers from other faculties.

DESIGN AND METHODS

A cross-sectional, correlational design was used for this study. A total of 114 students completed the Brief COPE questionnaire, the Perceived Stress Scale, and a measure of our own design to assess sources of psychosocial support.

FINDINGS

The complete sample engaged in help-seeking behavior, though distinct differences between groups were evident. Perceived stress was pervasive. Students employed a range of coping strategies but showed a clear preference for emotion-focused strategies.

PRACTICE IMPLICATIONS

Training institutions carry the responsibility for developing supportive interventions to promote students' throughput, and ensure the graduation of competent and ethically sound clinicians.

The ‘revolving door’: a profile of acute admissions at a South African psychiatric hospital

This paper reports admission rates within the acute service at a major South African tertiary psychiatric facility, Lentegeur Psychiatric Hospital (LPH) in Cape Town.

Randomized controlled trial of a book-sharing intervention in a deprived South African community: effects on carer-infant interactions, and their relation to infant cognitive and socioemotional outcome

BACKGROUND

Consistent with evidence from high-income countries (HICs), we previously showed that, in an informal peri-urban settlement in a low-middle income country, training parents in book sharing with their infants benefitted infant language and attention (Vally, Murray, Tomlinson, & Cooper, ). Here, we investigated whether these benefits were explained by improvements in carer-infant interactions in both book-sharing and non-book-sharing contexts. We also explored whether infant socioemotional development benefitted from book sharing.

METHODS

We conducted a randomized controlled trial in Khayelitsha, South Africa. Carers of 14-16-month-old infants were randomized to 8 weeks' training in book sharing (n = 49) or a wait-list control group (n = 42). In addition to the cognitive measures reported previously, independent assessments were made at base line and follow-up of carer-infant interactions during book sharing and toy play. Assessments were also made, at follow-up only, of infant prosocial behaviour in a 'help task', and of infant imitation of doll characters' nonsocial actions and an interpersonal interaction. Eighty-two carer-infant pairs (90%) were assessed at follow-up. (Trial registration ISRCTN39953901).

RESULTS

Carers who received the training showed significant improvements in book-sharing interactions (sensitivity, elaborations, reciprocity), and, to a smaller extent, in toy-play interactions (sensitivity). Infants in the intervention group showed a significantly higher rate of prosocial behaviour, and tended to show more frequent imitation of the interpersonal interaction. Improvements in carer behaviour during book sharing, but not during toy play, mediated intervention effects on all infant cognitive outcomes, and tended to mediate intervention effects on infant interpersonal imitation.

CONCLUSIONS

Training in book sharing, a simple, inexpensive intervention that has been shown to benefit infant cognitive development in a low-middle income country, also shows promise for improving infant socioemotional outcomes in this context. Benefits are mediated by improvements in carer-infant interactions, particularly in book-sharing contexts.

The impact of dialogic book-sharing training on infant language and attention: a randomized controlled trial in a deprived South African community

BACKGROUND

Dialogic book-sharing is an interactive form of shared reading. It has been shown in high income countries (HICs) to be of significant benefit to child cognitive development. Evidence for such benefit in low and middle income countries (LMICs) is scarce, although a feasibility study of our own produced encouraging findings. Accordingly, we aimed to establish the impact on child language and attention of providing training in dialogic booksharing to carers of infants in an impoverished South African community.

METHODS

We conducted a randomized controlled trial in Khayelitsha, an informal settlement in South Africa. Mothers of infants aged between 14 and 16 months were recruited and randomized to either 8 weeks of manualized training in dialogic book-sharing or a no-intervention control group. Independent assessments were made of infant language and attention at baseline and following training. The trial was registered (ISRCTN39953901).

RESULTS

Ninety one carer-infant dyads were recruited and randomized to the intervention group (n = 49) or the control group (n = 42), 82 (90%) of whom were available for follow-up assessments. On a standardized carer report of infant vocabulary, compared to those in the control group, carers who received the intervention reported a significantly greater increase in the number of words understood by their infants as well as a larger increase in the number of words that their infant understood and could vocalize. Intervention group children also showed substantially greater gains on a measure of sustained attention.

CONCLUSIONS

In line with evidence from HICs, a dialogic book-sharing programme delivered to an impoverished South African sample was shown to be of considerable benefit to the development of child language and focussed attention. The training programme, which is simple and inexpensive to deliver, has the potential to benefit child cognitive development in LMIC contexts where such development is commonly compromised.

The 'revolving door': a profile of acute admissions at a South African psychiatric hospital

This paper reports admission rates within the acute service at a major South African tertiary psychiatric facility, Lentegeur Psychiatric Hospital (LPH) in Cape Town.

HIV-associated neurocognitive disorders

HIV infection is associated with disturbances in brain function referred to as HIV-associated neurocognitive disorders (HAND). This literature review outlines the recently revised diagnostic criteria for the range of HAND from the earliest to the more advanced stages: (i) asymptomatic neurocognitive impairment; (ii) mild neurocognitive disorder; and (iii) HIV-associated dementia. Relevant literature is also reviewed regarding the differential impact upon component cognitive domains known to be affected in HAND, which in turn should ideally be targeted during clinical and neuropsychological assessments: psychomotor and information processing speed, learning and memory, attention and working memory, speech and language, executive functioning and visuospatial functioning. A discussion outlining the neuropsychological tools used in the diagnostic screening of HAND is also included. The central mechanisms of HAND appear to revolve primarily around psychomotor slowing and cognitive control over mental operations, possibly reflecting the influence of disrupted fronto-striatal circuits on distributed neural networks critical to cognitive functions. The accurate assessment and diagnosis of HAND depends on meeting the need for statistically sound neuropsychological assessment techniques that may be used confidently in assessing South African populations, as well as the development of relevant norms for comparison of test performance data.

Accuracy of the Raypex-4 and Propex apex locators in detecting horizontal and vertical root fractures: an in vitro study

Unforeseen root fractures during endodontic therapy are often difficult to diagnose and treat. Apex locators have been shown to be accurate in measuring the working lengths of root canals, and it was postulated whether they could also be used to determine the position of root fractures. This study was undertaken to assess the accuracy of two different apex locators in determining the position of fractures. One hundred single rooted teeth were randomly divided into two groups. One group had simulated horizontal fractures cut into them and the other group had vertical fractures. All fractures were detected in both groups using both a Propex (third generation) and a Raypex-4 (fourth generation) apex locator. The actual lengths of the fractures were then measured under 2.5 times magnification, and the results subjected to statistical analysis. Both locators produced similar results and were found to be very accurate, with measurements that correlated closely to the actual lengths. Clinically, treatment options for root fractures vary depending on their location. Thus apex locators may be a valuable aid in not only determining the presence of a root fracture, but also its exact location, which will help the clinician decide on the most appropriate management.