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Fulltext Evaluation of an Online Gottman's Psychoeducational Intervention to Improve Marital Communication among Iranian Couples

Deylami N, Hassan SA, Alareqe NA, Zainudin ZN

Int J Environ Res Public Health, 2021 08 25;18(17).
PMID: 34501535 DOI: 10.3390/ijerph18178945

Amounting evidence indicates that insufficient knowledge of marital communication skills leads to destructive interactions and poor marital adjustments in couples, especially during stressful situations. Despite the high effectiveness of Gottman's psychoeducational intervention, there is a lack of study on the online Gottman's psychoeducation intervention (O-GPI) to improve marital communication and dyadic adjustments. The aim of this study was to evaluate the effectiveness of O-GPI on the improvement of marital communication patterns among Iranian couples.
METHOD: The study followed a single-blind parallel group in a randomized controlled trial using an experimental longitudinal design, comprising 72 heterosexual couples living in Shiraz, Iran, with a 1-7-year marital age and no severe marital problems. The experimental group received eight consecutive O-GPIs via the Zoom platform, while the control group received information related to parenting skills via email. The outcome measures were the three patterns of communication: (i) constructive communication; (ii) demand-withdraw communication; and (iii) mutual avoidance communication-the screening measure was the dyadic adjustment scale.
RESULTS: The findings indicated that O-GPI could improve couples' constructive communication significantly (45% for husbands and 40% wives) and decrease their total demand-withdrawal (51% for husbands and 65% wives) and mutual avoidance communication (60% for husbands and 62% wives).
LIMITATIONS: Due to the homogenous nature of the sample, generalizations should be made with caution.
CONCLUSIONS: This study demonstrates the feasibility and effectiveness of the online Gottman's psychoeducational intervention to improve couples' communication patterns.
Fulltext Universality and Normativity of the Attachment Theory in Non-Western Psychiatric and Non-Psychiatric Samples: Multiple Group Confirmatory Factor Analysis (CFA)

Alareqe NA, Roslan S, Taresh SM, Nordin MS

Int J Environ Res Public Health, 2021 May 27;18(11).
PMID: 34072158 DOI: 10.3390/ijerph18115770

This study tests for the first time the validity of universality and normativity assumptions related to the attachment theory in a non-Western culture, using a novel design including psychiatric and non-psychiatric samples as part of a comprehensive exploratory and advanced confirmatory framework. Three attachment assessments were distributed to 212 psychiatric outpatients and 300 non-psychiatric samples in Yemen. The results of the fourteen approaches of exploratory factor analysis (EFA) produce a similar result and assertion that the psychiatric outpatients tend to explore attachment outcomes based on multi-methods, while the non-psychiatric samples suggest an attachment orientation based on multi-traits (self-other). The multiple group-confirmatory factor analysis (MG-CFA) demonstrates that the multi-method model fits the psychiatric samples better than the non-psychiatric samples. Equally, the MG-CFA suggests that the multi-traits model also fits the psychiatric samples better than the non-psychiatric samples. Implications of the results are discussed.
Fulltext Effects of Group and Individual Culturally Adapted Cognitive Behavioral Therapy on Depression and Sexual Satisfaction among Perimenopausal Women

Khoshbooii R, Hassan SA, Deylami N, Muhamad R, Engku Kamarudin EM, Alareqe NA

Int J Environ Res Public Health, 2021 07 20;18(14).
PMID: 34300161 DOI: 10.3390/ijerph18147711

AIMS: Previous research has shown the efficacy of culturally adapted Cognitive Behavioral Therapy (CA-CBT) in reducing depression, yet its effect on increasing sexual satisfaction is not well documented. In this study, an embedded randomized controlled trial design was used to examine the effect of group and individual CA-CBT on depression and sexual satisfaction among perimenopausal women.
METHOD: A total of 64 depressed Iranian perimenopausal women were randomly assigned to two formats of treatments; sixteen sessions of group CA-CBT and eight sessions of individual CA-CBT, as well as a waitlist control group. Depression and sexual satisfaction were measured using BDI-II and ENRICH, respectively, at T1 (pre-treatment), T2 (post-treatment) and T3 (follow-up).
RESULTS: Repeated measures ANOVA indicated that the women who underwent both group and individual CA-CBT had effectively reduced depression and increased sexual satisfaction between pre-treatment and post-treatment, and it was sustained after six months of follow-ups with large effect sizes of significant differences (p < 0.001), but the control group did not.
CONCLUSION: The results showed promising evidence for the efficacy of both treatment groups of CA-CBT for depression and sexual satisfaction among perimenopausal women. The population mental health burden among perimenopausal women may likely be reduced by propagating this effective treatment.
Fulltext Psychometric Properties of the Millon Clinical Multiaxial Inventory-III in an Arabic Clinical Sample Compared With American, Italian, and Dutch Cultures

Alareqe NA, Roslan S, Nordin MS, Ahmad NA, Taresh SM

Front Psychol, 2021;12:562619.
PMID: 34566736 DOI: 10.3389/fpsyg.2021.562619

Millon Clinical Multiaxial Inventory MCMI-III is a multidimensional measure of psychopathology with excellent construct validity, test-retest reliability as well as internal consistency. Factor analysis of the MCMI-III has produced mixed results, extracting parsimonious three-factor solutions, or replicating the original four-factor solution in psychiatric samples from Western countries. However, little work has been done on the psychometric properties of the MCMI-III, using non-Western psychiatric samples. Outpatients (N = 212) completed the MCMI-III during a semi-structured interview. Eight exploratory factor analysis (EFA) methods were used to explore the underlying structure of MCMI-III. Skewness, kurtosis, and descriptive statistics confirmed that scales of MCMI-III were normally distributed. High-internal consistency was found. The eight EFA methods applied to the 24 clinical scales identified a consensual three-factor solution: factor I (internalizing psychopathology; 18 scales), factor II (externalizing psychopathology; 4 scales) and factor III (psychological disturbance; 2 scales), accounting for a total of 72% of the common variance. Regarding the cross-cultural equivalence of the MCMI-III structure, Tucker's congruence coefficient (Φ) was used and confirmed that internalizing (F1) and externalizing psychopathology (F2) factors obtained in this study are similar to high vs. low psychopathology and emotional constraint factors provided by American study of Haddy et al. (2005) (Φ was 0.86 and 0.97). These two factors are also similar to the general adjustment and antisocial acting out factors provided by the American study of Craig and Bivens (1998) (Φ was 0.82 and 0.96). The first two factors in this study also reflect high similarity with the factor solutions obtained with the Italian and Dutch versions of MCMI-III (Rossi et al., 2007; Pignolo et al., 2017). Despite using a psychiatric sample from a non-Western culture, the two factors identified for this MCMI-III Arabic version were similar to those reported on studies with MCMI-III, using primarily Western samples (Craig and Bivens, 1998; Rossi et al., 2007).
Fulltext Rasch Modeling and Multilevel Confirmatory Factor Analysis for the Usability of the Impact of Event Scale-Revised (IES-R) during the COVID-19 Pandemic

Aljaberi MA, Lee KH, Alareqe NA, Qasem MA, Alsalahi A, Abdallah AM, et al.

Healthcare (Basel), 2022 Sep 24;10(10).
PMID: 36292305 DOI: 10.3390/healthcare10101858

BACKGROUND: Several instruments are currently used to assess Coronavirus Disease 2019 (COVID-19) -induced psychological distress, including the 22-item Impact of Event Scale-Revised (IES-R). The IES-R is a self-administered scale used to assess post-traumatic stress disorder (PTSD). The current study aimed to examine the construct validity of the IES-R, based on the Rasch model, with COVID-19-related data, as well as to test the multilevel construct validity of the IES-R within and among countries during the pandemic crisis.
METHODS: A multi-country web-based cross-sectional survey was conducted utilizing the 22-item IES-R. A total of 1020 participants enrolled in our survey, of whom 999 were included in the analyses. Data were analyzed using Rasch modeling and multilevel confirmatory factor analysis (MCFA).
RESULTS: The Rasch modeling results of the IES-R demonstrated that the IES-R is a satisfactory instrument with the five-point Likert scale, asserting that its 22 items are significant contributors to assessing PTSD as a unidimensional construct covered by the items of the IES-R. The MCFA confirmed that the 22-item IES-R, with its three factors, including intrusion, avoidance, and hyperarousal, demonstrates adequate construct validity at the within- and among-country levels. However, the results of the Akaike information criterion (AIC) model determined that the 16-item IES-R is better than the 22-item IES-R.
CONCLUSION: The results suggested that the 22-item IES-R is a reliable screening instrument for measuring PTSD related to the COVID-19 pandemic, and can be utilized to provide timely psychological health support, when needed, based on the screening results.
Fulltext A cross-sectional study on the impact of the COVID-19 pandemic on psychological outcomes: Multiple indicators and multiple causes modeling

Aljaberi MA, Alareqe NA, Alsalahi A, Qasem MA, Noman S, Uzir MUH, et al.

PLoS One, 2022;17(11):e0277368.
PMID: 36350838 DOI: 10.1371/journal.pone.0277368

Although the psychological impact of coronavirus disease 2019 (COVID-19) has been evaluated in the literature, further research is needed, particularly on post-traumatic stress disorder (PTSD) and psychological outcomes, is needed. This study aims to investigate the effect of the COVID-19 pandemic on psychological outcomes (depression, anxiety, and insomnia). A cross-sectional study using an online survey was conducted using the following instruments: Impact of Event Scale-Revised (IES-R), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder (GAD-7), and Insomnia Severity Index (ISI). Confirmatory factor analysis (CFA), structural equation model (SEM), multiple indicators and multiple causes (MIMIC) modeling, and differential item functioning (DIF) were performed to analyze the collected data. According to the results, participants with PTSD (n = 360) showed a higher level of depression, anxiety, and insomnia than those without PTSD (n = 639). Among the participants, 36.5% experienced moderate to severe symptoms of depression, and 32.6% had mild depressive symptoms. Moreover, 23.7% of participants experienced moderate to severe anxiety symptoms, and 33.1% had mild anxiety symptoms. In addition, 51.5% of participants experienced symptoms of insomnia. In conclusion, the PTSD caused by COVID-19 is significantly associated with depression, anxiety, and insomnia at the level of latent constructs and observed variables.