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Insecure attachment style as a vulnerability factor for depression: recent findings in a community-based study of Malay single and married mothers

Abdul Kadir NB, Bifulco A

Psychiatry Res, 2013 Dec 30;210(3):919-24.
PMID: 24075307 DOI: 10.1016/j.psychres.2013.08.034

The role of marital breakdown in women's mental health is of key concern in Malaysia and internationally. A cross-sectional questionnaire study of married and separated/divorced and widowed women examined insecure attachment style as an associated risk factor for depression among 1002 mothers in an urban community in Malaysia. A previous report replicated a UK-based vulnerability-provoking agent model of depression involving negative evaluation of self (NES) and negative elements in close relationships (NECRs) interacting with severe life events to model depression. This article reports on the additional contribution of insecure attachment style to the model using the Vulnerable Attachment Style Questionnaire (VASQ). The results showed that VASQ scores were highly correlated with NES, NECR and depression. A multiple regression analysis of depression with backward elimination found that VASQ scores had a significant additional effect. Group comparisons showed different risk patterns for single and married mothers. NES was the strongest risk factor for both groups, with the 'anxious style' subset of the VASQ being the best additional predictor for married mothers and the total VASQ score (general attachment insecurity) for single mothers. The findings indicate that attachment insecurity adds to a psychosocial vulnerability model of depression among mothers cross-culturally and is important in understanding and identifying risk.
Vulnerability, life events and depression amongst Moslem Malaysian women: comparing those married and those divorced or separated

Abdul Kadir NB, Bifulco A

Soc Psychiatry Psychiatr Epidemiol, 2011 Sep;46(9):853-62.
PMID: 20556355 DOI: 10.1007/s00127-010-0249-4

INTRODUCTION: The experiences of married and single mothers were compared in an investigation of psychosocial vulnerability, stress and depression in a community-based study of Moslem mothers in Malaysia. For the first time, a model of vulnerability-provoking agent originally developed by Brown et al. in the UK was tested in a Malaysian context.
METHODS: A cross-sectional study was carried out in the district of Johor Bahru, Malaysia. Of the 1,200 women approached from membership of community associations, 1,002 (84%) completed the questionnaires. Severe life events Recent Life Events Questionnaire (Brugha and Cragg in Acta Psychiatr Scand 82:77-81, 1990) and psychosocial vulnerability (VDQ) (Moran et al. in Br J Clin Psychol 40:411-427, 2001) were used to measure vulnerability factors. Depression was measured by the General Health Questionnaire (GHQ-30) (Havenaar et al. in Soc Psychiatry Psychiatr Epidemiol 43:209-215, 2008).
RESULTS: Single mothers had significantly higher rates of depression than those married (60.5 vs. 39.5%), as well as higher rates of severe life events and Negative Elements in Close Relationships (lack of support and conflict with children). However, married mothers had greater Negative Evaluation of Self. The two vulnerability factors were correlated to each other and to severe life events and social adversity. Logistic regression showed an interaction between severe life events in the material and relationship domains and joint vulnerability for depression outcome. The results are discussed in relation to the low recognition of psychosocial risks for depression in single mothers in Malaysia, as well as lack of appropriate services.
Malaysian Moslem mothers' experience of depression and service use

Abdul Kadir NB, Bifulco A

Cult Med Psychiatry, 2010 Sep;34(3):443-67.
PMID: 20549550 DOI: 10.1007/s11013-010-9183-x

Standard psychiatric criteria for depression developed in the United States and United Kingdom are increasingly used worldwide to establish the prevalence of clinical disorders and to help develop services. However, these approaches are rarely sensitive to local and cultural expressions of symptoms or beliefs about treatment. Mismatch between diagnostic criteria and local understanding may result in underreporting of depression and underutilization of services. Little such research has been conducted in Malaysia, despite the acknowledged high rate of depression and low access to services. This study examines depression in Moslem Malay women living in Johor Bahru, Southern Peninsular Malaysia, to explore depression symptoms using the Structured Clinical Interview for DSM-IV. The 61 women interviewed were selected on the basis of high General Health Questionnaire scores from a large questionnaire survey of 1,002 mothers. The illustrative analysis looks at descriptions of depressed mood, self-depreciation and suicidal ideation, as well as attitudes toward service use. The women gave full and open descriptions of their emotional symptoms, easily recognizable by standard symptom categories, although somatic symptoms were commonly included, and the spiritual context to understanding depression was also prevalent. However, few women had knowledge about treatment or sought medical services, although some sought help from local spiritual healers. Attending to such views of depression can help develop services in Malaysia.
Fulltext The 5Cs of Positive Youth Development, Purpose in Life, Hope, and Well-Being Among Emerging Adults in Malaysia

Abdul Kadir NB, Mohd RH

Front Psychol, 2021;12:641876.
PMID: 34335359 DOI: 10.3389/fpsyg.2021.641876

A substantial body of evidence supports Lerner and colleagues' 5Cs model of positive youth development (PYD) in the United States (U.S.). Nonetheless, it remains unclear whether the 5Cs can be used to identify positive development in the under-researched Asian contexts, such as Malaysia. Thus, this study examined the 5Cs of PYD (competence, confidence, character, connection, and caring) and their importance to purpose in life, hope, and well-being in a sample of emerging adult undergraduate university students in Malaysia. Data were collected from 400 participants from 15 Malaysian universities (132 males, 268 females; ages ranged from 18 to 26 years old, M = 22). A hierarchical multiple regression analysis indicated that two of the 5Cs of PYD (confidence and connection) as well as hope were important to explaining variation in well-being. The findings imply that there are strong links between PYD, especially confidence and connection, and well-being, while purpose in life and hope were indirectly related to the 2Cs (confidence and connection) of PYD and well-being. Therefore, mental health professionals are encouraged to review and redefine their treatment design to include confidence, connection, purpose in life and hope when working with Malaysian emerging adult university students.
Fulltext Developmental assets, creativity, thriving, and mental health among Malaysian emerging adults

Abdul Kadir NB, Rusyda HM

Front Psychol, 2022;13:944238.
PMID: 36148118 DOI: 10.3389/fpsyg.2022.944238

This study was part of a larger cross-national research project at the Norway's University of Bergen, which involved participants from over 30 countries. This undertaking delves into developmental assets, creativity, and thriving, and the part they play in determining mental health. Thus, this study examined the developmental assets (internal assets: support, empowerment, boundaries, and expectations and creative use of time; external assets: commitment to learning, positive identity, positive values, and social competencies), creativity, thriving, and their importance to mental health in a sample of Malaysian emerging adults. This study was based on a sample of 394 undergraduate students, comprising 264 females and 130 males, ranging between the ages of 18 and 26 years (M = 21.5). Two subscales of the Reisman diagnostic creativity assessment (RDCA) were used to measure creativity (originality and fluency). Meanwhile, thriving indicators of Search Institute were used to measure thriving while the short form of the mental health continuum (MHC-SF) for adolescents was used to measure mental health. An online Google form was used to collect data from university students enrolled in both public and private universities. The correlation analysis results revealed that all the variables were positively correlated to each other and that the relationship between development assets, creativity, thriving, and mental health ranged from weak to moderate. Multiple regression (stepwise) analysis produced four models that indicated that positive identity, support, creativity, and thriving have a significant influence on mental health among emerging adults. Further, analyses using the PROCESS procedure demonstrated significant indirect effects of positive identity and support on mental health through its effects on creativity and thriving. As such, it is our recommendation that mental health practitioners tailor their treatment approach to include positive identity, support, creativity, and thriving in their sessions with Malaysian emerging adults.
Knowledge, Self-Efficacy, and Preventive Behavior of COVID-19 Outbreak Among Community in Malaysia

Ab Malik N, Mohd RH, Abdul Kadir NB

Asia Pac J Public Health, 2021 07;33(5):674-675.
PMID: 33938242 DOI: 10.1177/10105395211012542
Fulltext The role of social support and spiritual wellbeing in predicting suicidal ideation among marginalized adolescents in Malaysia

Ibrahim N, Che Din N, Ahmad M, Amit N, Ghazali SE, Wahab S, et al.

BMC Public Health, 2019 Jun 13;19(Suppl 4):553.
PMID: 31196009 DOI: 10.1186/s12889-019-6861-7

BACKGROUND: The high number of adolescents and young adults harbouring suicidal ideation, as reported by the Ministry of Health Malaysia, is alarming. This cross-sectional study aims to examine the association between social support and spiritual wellbeing in predicting suicidal ideation among Malaysian adolescents.
METHODS: A total of 176 adolescents in selected urban areas in the states of Wilayah Persekutuan and Selangor were selected. The Suicide Ideation Scale (SIS) was used to measure the level of severity or tendency of suicidal ideation. The Multidimensional Scale of Perceived Social Support (MSPSS) was used to measure the perceived social support received by the respondent while the Spiritual Wellbeing Scale (SWBS) was used to measure the religious wellbeing (RWB), the existential wellbeing (EWB) and the overall score of spiritual wellbeing (SWB).
RESULTS: The study found that both RWB and EWB showed significant negative correlation with suicidal ideation. Similarly, support from family and friends also showed a negative correlation with suicidal ideation. Further analysis using multiple regressions showed that RWB and SWB, and family support predict suicidal ideation in adolescents.
CONCLUSION: Spiritual wellbeing in combination with family support plays a major role in predicting suicidal ideation. Therefore, intervention for encompassing spirituality and family support may contribute to a more positive outcome in suicidal adolescents.
Fulltext Reliability and Validity of the Malay Mindful Eating Questionnaire (MEQ-M) among Overweight and Obese Adults

Abdul Basir SM, Abdul Manaf Z, Ahmad M, Abdul Kadir NB, Ismail WNK, Mat Ludin AF, et al.

Int J Environ Res Public Health, 2021 01 24;18(3).
PMID: 33498903 DOI: 10.3390/ijerph18031021

The Mindful Eating Questionnaire is a reliable tool for the assessment of mindful eating behavior among the general population. This study aimed to determine the reliability and validity of The Malay Mindful Eating Questionnaire (MEQ-M) in a sample of overweight and obese adults. This is a cross-sectional survey which involved 144 overweight and obese adults in a selected public university. After linguistic validation of the Malay version of the MEQ, exploratory factor analysis (EFA) with varimax rotation was performed on the scale constructs. The psychometric properties of the MEQ were assessed through Cronbach's alpha and intraclass correlation coefficient (ICC) analysis. The EFA of the MEQ produced a seven-dimensional model (58.8% of overall variances). The concurrent validity analysis between total MEQ scores and total Mindfulness Attention Awareness Scale (MAAS) scores indicated a weak non-significant correlation (p = 0.679). The internal consistency reliability of the MEQ was reasonable (Cronbach's α = 0.64). The agreement stability of the MEQ over eight weeks was poor (ICC = 0.10). In conclusion, the psychometric properties of the Malay-translated MEQ are acceptable through construct validity and internal consistency reliability tests. This instrument may be used for assessing mindful eating habits in the Malaysian population, especially among overweight and obese adults.
Fulltext Criterion Validity and Psychometric Properties of a Malay Version of the Short Multidimensional Inventory Lifestyle Evaluation-Confinement (SMILE-C) in a Sample of University Staff with Weight Problems

Abdul Kadir NB, Ismail WNK, Abdullah NA, Helma R, Abdul Jalil SJ, Che Kasim A, et al.

Int J Environ Res Public Health, 2021 Oct 03;18(19).
PMID: 34639710 DOI: 10.3390/ijerph181910410

The aim of this study was to validate the Short Multidimensional Inventory Lifestyle Evaluation-Confinement (SMILE-C) in a Malaysian context. The SMILE-C, which is a respondent-generated instrument, was used to ask participants questions on their lifestyle during the COVID-19 pandemic. The indices of seven sub-scores were then calculated. A total of 121 university staff members completed the Malay version of the SMILE-C as well as instruments for measuring well-being, family life satisfaction, mindfulness and awareness, work engagement, and quality of life. The Cronbach's alpha values and Pearson correlation coefficients were satisfactory in this initial validation of the instrument. The SMILE-C showed positive correlations with all the variables being studied. The results supported the criterion-related validity and psychometric properties of the Malay version of the SMILE-C as an instrument for assessing lifestyle changes during the COVID-19 pandemic.
Fulltext Factors Associated with Health-Related Quality of Life amongst Employees in a Malaysian Public University

Abdul Manaf MR, Mohammed Nawi A, Mohd Tauhid N, Othman H, Abdul Rahman MR, Mohd Yusoff H, et al.

Int J Environ Res Public Health, 2021 10 17;18(20).
PMID: 34682645 DOI: 10.3390/ijerph182010903

The current academic landscape has overwhelmed faculties and with demands to adopt tech-savvy teaching modes and accelerate scholarly works, administrative duties, and outreach programs. Such demands have deteriorated the health-related quality of life (HRQoL) among university employees. This study aimed to determine the factors associated with HRQoL among university employees in a Malaysian public university. This cross-sectional study was conducted among 397 employees from the Universiti Kebangsaan Malaysia (UKM) between April and June 2019. A self-administered questionnaire that consisted of socio-demographic items, risky health behaviors, health-related information, and validated scales for measuring employees' physical inactivity, psychological states, and HRQoL was utilized. Descriptive and inferential statistics were calculated using SPSS version 23.0. Hierarchical multiple linear regression models were yielded to determine the factors associated with different domains of HRQoL. Mediation analysis was conducted using PROCESS MACRO (Model 4). Statistical significance was set to p < 0.05. Physical HRQoL scored the highest, while environmental HRQoL had the lowest score among the employees. Physical HRQoL was influenced by age, service duration, comorbid conditions, BMI, chronic diseases, and anxiety. Factors associated with psychological HRQoL were age, service duration, depression, and stress. Age, service duration, and chronic diseases affected employees' social relationship HRQoL, while environmental HRQoL was associated with age, occupation type, chronic diseases, and depression. Socio-demographics, risky health behaviors, health profiles, and psychological attributes were significantly associated with employees' HRQoL. Age was the only positively correlated factor across all HRQoL domains, while other factors deteriorated employees' HRQoL.
The Coronavirus Anxiety Scale: Cross-national measurement invariance and convergent validity evidence

Jovanović V, Rudnev M, Abdelrahman M, Abdul Kadir NB, Adebayo DF, Akaliyski P, et al.

Psychol Assess, 2024 Jan;36(1):14-29.
PMID: 38010780 DOI: 10.1037/pas0001270

Coronavirus Anxiety Scale (CAS) is a widely used measure that captures somatic symptoms of coronavirus-related anxiety. In a large-scale collaboration spanning 60 countries (Ntotal = 21,513), we examined the CAS's measurement invariance and assessed the convergent validity of CAS scores in relation to the fear of COVID-19 (FCV-19S) and the satisfaction with life (SWLS-3) scales. We utilized both conventional exact invariance tests and alignment procedures, with results revealing that the single-factor model fit the data well in almost all countries. Partial scalar invariance was supported in a subset of 56 countries. To ensure the robustness of results, given the unbalanced samples, we employed resampling techniques both with and without replacement and found the results were more stable in larger samples. The alignment procedure demonstrated a high degree of measurement invariance with 9% of the parameters exhibiting noninvariance. We also conducted simulations of alignment using the parameters estimated in the current model. Findings demonstrated reliability of the means but indicated challenges in estimating the latent variances. Strong positive correlations between CAS and FCV-19S estimated with all three different approaches were found in most countries. Correlations of CAS and SWLS-3 were weak and negative but significantly differed from zero in several countries. Overall, the study provided support for the measurement invariance of the CAS and offered evidence of its convergent validity while also highlighting issues with variance estimation. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Trust in government moderates the association between fear of COVID-19 as well as empathic concern and preventive behaviour

Karakulak A, Tepe B, Dimitrova R, Abdelrahman M, Akaliyski P, Alaseel R, et al.

Commun Psychol, 2023 Dec 15;1(1):43.
PMID: 39242865 DOI: 10.1038/s44271-023-00046-5

With the COVID-19 pandemic, behavioural scientists aimed to illuminate reasons why people comply with (or not) large-scale cooperative activities. Here we investigated the motives that underlie support for COVID-19 preventive behaviours in a sample of 12,758 individuals from 34 countries. We hypothesized that the associations of empathic prosocial concern and fear of disease with support towards preventive COVID-19 behaviours would be moderated by trust in the government. Results suggest that the association between fear of disease and support for COVID-19 preventive behaviours was strongest when trust in the government was weak (both at individual- and country-level). Conversely, the association with empathic prosocial concern was strongest when trust in the government was high, but this moderation was only found at individual-level scores of governmental trust. We discuss how motivations may be shaped by socio-cultural context, and outline how findings may contribute to a better understanding of collective action during global crises.

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