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Fulltext Mental Health Conceptualization and Resilience Factors in the Kalasha Youth: An Indigenous Ethnic and Religious Minority Community in Pakistan

Choudhry FR, Khan TM, Park MS, Golden KJ

Front Public Health, 2018;6:187.
PMID: 30065918 DOI: 10.3389/fpubh.2018.00187

The Kalasha are a religious, ethnic, and linguistic minority community in Pakistan. They are indigenous people living in remote valleys of the Hindu Kush Mountains in northern Pakistan, neighboring Afghanistan. The Kalasha are pastoral, as well as agricultural people to some extent, although they are increasingly facing pressures from globalization and social change, which may be influencing youth and community development. Their traditional world view dichotomizes and emphasizes on the division of the pure (Onjeshta) and the impure (Pragata). There remains a scarcity of literature on mental health and resilience of indigenous communities in South Asia and Pakistan generally, and the polytheistic Kalasha community specifically. Thus, the current study was conducted with the aim to explore the cultural protective factors (resilience) of the Kalasha youth (adolescents and emerging adults) and to explore their perceived etiological understandings and preferred interventions for mental health support systems. The theoretical framework of Bronfenbrenner's (1, 2) ecological systems model was used. Interpretative Phenomenological Analysis (IPA) was conducted, considering the advantage of its idiographic approach and the "double hermeneutic" analytic process. This methodology was consistent with the aim to understand and make sense of mental health and resilience from the Kalasha indigenous perspective. A total of 12 in-depth interviews were conducted with adolescents and emerging adults (5 males, 7 females), along with ethnographic observations. The analysis revealed 3 superordinate themes of mental health perceptions and interventions, each with more specific emergent themes: (1) Psychological Resilience/Cultural Protective Factors Buffering Against Mental Health Problems (Intra-Communal Bonding & Sharing; Kalasha Festivals & Traditions; Purity Concept; Behavioral Practice of Happiness and Cognitive Patterns); (2) Perceived Causes of Mental Health Issues (Biological & Psychosocial; Supernatural & Spiritual; Environmental); and (3) Preferred Interventions [Shamanic Treatment; Ta'awiz (Amulets); Communal Sharing & Problem Solving; Medical Treatment; Herbal Methods]. The overall findings point to the need for developing culturally-sensitive and indigenous measures and therapeutic interventions. The findings highlighted the Kalasha cultural practices which may promote resilience. The findings also call for indigenous sources of knowledge to be considered when collaboratively designing public health programs.
Fulltext Communication, the Heart of a Relationship: Examining Capitalization, Accommodation, and Self-Construal on Relationship Satisfaction

De Netto PM, Quek KF, Golden KJ

Front Psychol, 2021;12:767908.
PMID: 34966329 DOI: 10.3389/fpsyg.2021.767908

The study of processes that enrich positive relationships has been an under-researched area within positive psychology practice. The way an individual responds during couple conflicts (accommodation response) and toward the disclosure of good news of a partner (capitalization response) has been linked to relationship quality. Although the accommodation and capitalization communication processes are part and parcel of our everyday lives, the two processes have been examined separately and dominated by the Western perspectives in past research. Prior work has suggested that Western and Asian cultures differ in expressing and perceiving beneficial communication behaviors. Yet, it is still unclear which accommodation and capitalization responses matter the most from an Asian lens. To date, there is no research examining these interconnected variables simultaneously in Asia, specifically in Malaysia. In this study, two forms of communication processes, namely, (1) accommodation and (2) capitalization, were explored concurrently to disentangle the unique associations and influence on relationship satisfaction. This study also sought to understand the moderating effects of culture in terms of interdependent self-construal on the link between these two communication processes and relationship satisfaction. Responses of 139 Malaysians in dating relationships between the age of 18 and 30 years (M age = 23.15) were collected through online surveys. An active and constructive reaction was captured as the most favorable response through both the capitalization and accommodation processes. Prominently, an active-constructive capitalization response bore the strongest influence on relationship satisfaction above and beyond other responses. A passive and constructive response was revealed only fruitful for disclosures of positive news and not during conflicts. Conversely, in the destructive paradigm, passive-destructive responses were the most detrimental factor in relationships compared to other destructive responses. The results also uncovered that interdependent self-construal did not moderate the two forms of communication processes. However, the findings discovered unexpected individual and cultural variations. This pioneering study is a noteworthy addition to the positive psychology literature from an Asian standpoint. It highlights the significance of not only protecting relationships through better conflict management but also enriching relationships by capitalizing on the positive aspects across the lives of the couple, ultimately providing a greater holistic insight into cultivating flourishing lives.
Religiosity and Healthy Lifestyle Behaviours in Malaysian Muslims: The Mediating Role of Subjective Well-Being and Self-Regulation

Tey SE, Park MS, Golden KJ

J Relig Health, 2018 Dec;57(6):2050-2065.
PMID: 28647911 DOI: 10.1007/s10943-017-0420-2

Past research on healthy lifestyle behaviours has been primarily conducted within Western or Judeo-Christian contexts, while non-Western or Muslim contexts remain under-represented. This study examined predictors of healthy lifestyle behaviours (religiosity, goal-setting, impulse control, and subjective well-being) in Malaysian Muslims and explored the mechanisms underlying the relationship between religiosity and healthy lifestyle behaviours. Self-report survey responses from 183 healthy adults (M age = 28.63 years, 18-50 years) were analysed using regression and multiple mediation analyses. The results indicated that subjective well-being emerged as the strongest predictor, followed by goal-setting. Furthermore, subjective well-being and goal-setting mediated the religiosity-healthy lifestyle behaviour relationship. The findings provide guidance for future health-promoting interventions.
Fulltext Risk and Resilience Among Mothers and Fathers of Primary School Age Children With ASD in Malaysia: A Qualitative Constructive Grounded Theory Approach

Ilias K, Cornish K, Park MS, Toran H, Golden KJ

Front Psychol, 2018;9:2275.
PMID: 30670992 DOI: 10.3389/fpsyg.2018.02275

Little is known about the coping and resilience experiences of parents of children with autism spectrum disorder (ASD) in the Malaysian cultural context. This study utilized a qualitative methodological approach adopting constructive grounded theory. The study sought to address the lack of research to date exploring the risk and protective experiences that contribute to parental stress and resilience for parents of primary school age children with ASD in the Malaysian setting. Twenty-two parents of children with ASD (13 mothers and 9 fathers) participated in semi-structured interviews. A strength of the study was the inclusion of both mother and father participant perspectives. The interviews lasted 50-80 min (mean: 67.5 min). The 22 parents had a total of 16 children (12 males; 4 females) formally diagnosed with ASD. Child age ranged between 5 and 12 years (mean age: 8.44). Overall, analysis of the 22 interviews revealed four prominent themes - "initial reaction to child's ASD symptoms and diagnosis," "family life affected by a child with ASD," "awareness about ASD in Malaysia," and "coping strategies, wellbeing, and becoming resilient." The first three themes revolved around stress and adversity, and, the adaptability and acceptance of the parents. These processes illustrated the risks experienced by the parents of children with ASD in Malaysia. The last theme especially highlighted the strengths and determination of the parents and illustrated the protective experiences and processes that helped parents to develop and enhance resilience. Overall, the findings revealed that resilience develops synergistically and dynamically from both risk and protective experiences across different levels - individual, family, community, society and government. The findings motivated the development of our theoretical model of resilience that can help health and education professionals tailor assessment and interventions for parents of children with ASD in the Malaysian context. Clinical, policy, and research suggestions were discussed.
Fulltext A Cross-Cultural Examination of SNS Usage Intensity and Managing Interpersonal Relationships Online: The Role of Culture and the Autonomous-Related Self-Construal

Lee SL, Kim JA, Golden KJ, Kim JH, Park MS

Front Psychol, 2016;7:376.
PMID: 27148100 DOI: 10.3389/fpsyg.2016.00376

Perception of the autonomy and relatedness of the self may be influenced by one's experiences and social expectations within a particular cultural setting. The present research examined the role of culture and the Autonomous-Related self-construal in predicting for different aspects of Social Networking Sites (SNS) usage in three Asian countries, especially focusing on those aspects serving interpersonal goals. Participants in this cross-cultural study included 305 university students from Malaysia (n = 105), South Korea (n = 113), and China (n = 87). The study explored specific social and interpersonal behaviors on SNS, such as browsing the contacts' profiles, checking for updates, and improving contact with SNS contacts, as well as the intensity of SNS use, hypothesizing that those with high intensity of use in the Asian context may be doing so to achieve the social goal of maintaining contact and keeping updated with friends. Two scales measuring activities on other users' profiles and contact with friends' profiles were developed and validated. As predicted, some cross-cultural differences were found. Koreans were more likely to use SNS to increase contact but tended to spend less time browsing contacts' profiles than the Malaysians and Chinese. The intensity of SNS use differed between the countries as well, where Malaysians reported higher intensity than Koreans and Chinese. Consistent with study predictions, Koreans were found with the highest Autonomous-Related self-construal scores. The Autonomous-Related self-construal predicted SNS intensity. The findings suggest that cultural contexts, along with the way the self is construed in different cultures, may encourage different types of SNS usage. The authors discuss study implications and suggest future research directions.
Parenting Stress and Resilience in Parents of Children With Autism Spectrum Disorder (ASD) in Southeast Asia: A Systematic Review

Ilias K, Cornish K, Kummar AS, Park MS, Golden KJ

Front Psychol, 2018;9:280.
PMID: 29686632 DOI: 10.3389/fpsyg.2018.00280

Background: This paper aimed to review the literature on the factors associated with parenting stress and resilience among parents of children with autism spectrum disorder (ASD) in the South East Asia (SEA) region. Methods: An extensive search of articles in multiple online databases (PsycNET, ProQuest, PudMed, EMBASE, CINAHL, Web of Science, and Google Scholar) resulted in 28 papers that met the inclusion criteria (i.e., conducted in the SEA region, specific to ASD only, published in a peer-reviewed journal, full text in English). Studies found were conducted in the following countries: Brunei, n = 1; Indonesia, n = 2; Malaysia, n = 12; Philippines, n = 5; Singapore, n = 5, Thailand, n = 2; and Vietnam, n = 1, but none from Cambodia, East Timor, Laos, and Myanmar were identified. Results: Across the studies, six main factors were found to be associated with parenting stress: social support, severity of autism symptoms, financial difficulty, parents' perception and understanding toward ASD, parents' anxiety and worries about their child's future, and religious beliefs. These six factors could also be categorized as either a source of parenting stress or a coping strategy/resilience mechanism that may attenuate parenting stress. Conclusion: The findings suggest that greater support services in Western countries may underlie the cultural differences observed in the SEA region. Limitations in the current review were identified. The limited number of studies yielded from the search suggests a need for expanded research on ASD and parenting stress, coping, and resilience in the SEA region especially in Cambodia, East Timor, Laos, and Myanmar. The identified stress and resilience factors may serve as sociocultural markers for clinicians, psychologists, and other professionals to consider when supporting parents of children with ASD.
Fulltext Impact of the COVID-19 Lockdown in Malaysia: An Examination of the Psychological Well-Being of Parent-Child Dyads and Child Behavior in Families With Children on the Autism Spectrum

Fong HX, Cornish K, Kirk H, Ilias K, Shaikh MF, Golden KJ

Front Psychiatry, 2021;12:733905.
PMID: 34721108 DOI: 10.3389/fpsyt.2021.733905

Background: The COVID-19 pandemic lockdowns have adversely impacted children on the autism spectrum and their families, especially in Malaysia where this population is often marginalized. The current quantitative research aimed to investigate the impact of the Malaysian COVID-19 lockdown on the behavior and psychological distress of children formally diagnosed with an autism spectrum condition (ASC) as well as the psychological distress and well-being of their parents, in comparison with a typically developing (TD) control group. Methods: The children's ages ranged between 5 and 17 years. The sample included 72 ASC parent-child dyads and 62 TD parent-child dyads. The primary caregiver completed an online survey including the following: demographic and diagnostic information; ASC symptoms; children's inattention, hyperactivity/impulsivity, perceived stress, depression, and anxiety; parents' perceived stress, depression, anxiety, and well-being based on their experience pre- and mid-lockdown (March 18th to June 9th 2020) in Malaysia. Results: Among the ASC group, no significant pre- and mid-lockdown change was found in ASC symptoms (p > 0.05). There were no significant gender differences (boys/girls) in all the child scales. The 2 [diagnosis (ASC, TD)] × 2 [lockdown (pre-lockdown, mid-lockdown)] mixed-model ANOVAs revealed main effects of lockdown on children's attention, hyperactivity/impulsivity, anxiety, and parents' perceived stress, depression, and psychological well-being (p < 0.005). There was a main effect of diagnosis in all child and parent variables, except parents' perceived stress (p >0.005). However, there was no significant interaction effect between diagnosis and lockdown (p >0.005). All child behavior (inattention and hyperactivity/impulsivity) and child psychological distress (anxiety, depression, and perceived stress) were significantly correlated in both the ASC and TD groups (p < 0.005). On the other hand, only some of the parent variables were significantly correlated with child variables (p < 0.0045) in the ASC group while none of the parent variables were significantly correlated with the child variables (p > 0.005) in the TD group. Conclusion: The results provide preliminary evidence indicating negative effects of the Malaysian lockdown on both children on the autism spectrum and TD children, as well as their parents. These quantitative results will be triangulated with the qualitative interview data to provide a holistic understanding of the impact of the pandemic, informing translational policy and practice recommendations.
Fulltext Predicting probable Alzheimer's disease using linguistic deficits and biomarkers

Orimaye SO, Wong JS, Golden KJ, Wong CP, Soyiri IN

BMC Bioinformatics, 2017 Jan 14;18(1):34.
PMID: 28088191 DOI: 10.1186/s12859-016-1456-0

BACKGROUND: The manual diagnosis of neurodegenerative disorders such as Alzheimer's disease (AD) and related Dementias has been a challenge. Currently, these disorders are diagnosed using specific clinical diagnostic criteria and neuropsychological examinations. The use of several Machine Learning algorithms to build automated diagnostic models using low-level linguistic features resulting from verbal utterances could aid diagnosis of patients with probable AD from a large population. For this purpose, we developed different Machine Learning models on the DementiaBank language transcript clinical dataset, consisting of 99 patients with probable AD and 99 healthy controls.
RESULTS: Our models learned several syntactic, lexical, and n-gram linguistic biomarkers to distinguish the probable AD group from the healthy group. In contrast to the healthy group, we found that the probable AD patients had significantly less usage of syntactic components and significantly higher usage of lexical components in their language. Also, we observed a significant difference in the use of n-grams as the healthy group were able to identify and make sense of more objects in their n-grams than the probable AD group. As such, our best diagnostic model significantly distinguished the probable AD group from the healthy elderly group with a better Area Under the Receiving Operating Characteristics Curve (AUC) using the Support Vector Machines (SVM).
CONCLUSIONS: Experimental and statistical evaluations suggest that using ML algorithms for learning linguistic biomarkers from the verbal utterances of elderly individuals could help the clinical diagnosis of probable AD. We emphasise that the best ML model for predicting the disease group combines significant syntactic, lexical and top n-gram features. However, there is a need to train the diagnostic models on larger datasets, which could lead to a better AUC and clinical diagnosis of probable AD.
Fulltext Factor Structure of Urdu Version of the Flourishing Scale

Choudhry FR, Al-Worafi YM, Akram B, Ahmed MA, Anwar Ul Haq M, Khan TM, et al.

Front Psychol, 2018;9:1513.
PMID: 30283370 DOI: 10.3389/fpsyg.2018.01513

Background: A great deal of research has been carried out on the assessment of the eudaimonic perspective of psychological well-being and the hedonic perspective of subjective well-being. The Flourishing Scale (FS) has been extensively used in research and practice, as it assesses the fundamental aspects of social psychological functioning. Nevertheless, the psychometric properties of Urdu versions of eudaimonic measures, such as the FS, have not yet been ascertained. The translation and validation of the FS in the Urdu language was not available, and hence this study was planned with the aim to validate the Urdu version of the FS. Methods: We assessed the psychometric properties of the FS in a sample of adults aged 18 years and above in Pakistan (N = 130) using exploratory factor analysis based on principal component analysis with varimax rotation and confirmatory factor analysis. Results: The exploratory factor analysis confirmed the unidimensional nature of the 8-item FS. We assessed that the Urdu version of the FS showed a high internal consistency reliability (α = 0.914) with a significant intraclass correlation coefficient (ICC), p < 0.001). In our study, the Kaiser-Mayer-Olkin value was 0.915 with a chi-square test value (χ2) of 637.687, and Bartlett's test of sphericity was significant (df = 28, p < 0.001). The intraclass correlation coefficients (ICCs) at test-retest for all domains were statistically significant (p < 0.001) and showed excellent agreement for all the items. The revised confirmatory factor analysis revealed a good-fit model, but with item 8-"People respect me"-removed due to its lower factor loading. Conclusions: The findings suggest that the FS is a psychometrically sound instrument for assessing social psychological functioning among adults in Pakistan. Therefore, the validated Urdu version of the FS may be used in future studies of well-being in clinical psychology and positive psychology.