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Fulltext Online Behavior of Iranian Adolescents Living in Malaysia: A Qualitative Study of Parents' Viewpoints

Mirzaei F, Mohammadzadeh M

Iran J Public Health, 2021 Jul;50(7):1497-1498.
PMID: 34568194 DOI: 10.18502/ijph.v50i7.6647
Diet and Mental Health: What Should Be Done for Malaysian Adolescents

Tajik E, Javadi M, Mohammadzadeh M

Iran J Public Health, 2017 Jul;46(7):992-994.
PMID: 28845413
Mental health stigma among Middle Eastern adolescents: A protocol for a systematic review

Mohammadzadeh M, Awang H, Mirzaei F

J Psychiatr Ment Health Nurs, 2020 Dec;27(6):829-837.
PMID: 32170971 DOI: 10.1111/jpm.12627

WHAT IS KNOWN ON THE SUBJECT?: Four out of every five people with mental health disorders face stigma. Mental health and, consequently, mental health stigma are very common among youth living in the Middle East countries. Several studies have investigated mental health among adolescents in the Middle East, but studies on stigma are very scattered. There is no systematic review on stigma among adolescents with mental disorders across all the Middle East countries despite the common historical roots, similar cultural backgrounds, and recent widespread problems in the area. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This paper will aim to review and analyse the studies on stigma among adolescents with mental disorders in the Middle East countries, from different aspects such as the age rang, kind of stigma and risk factors of stigma. The study will cover studies on all kinds of stigma among Middle Eastern adolescents up to 18 years old published between 2000 and 2019. The study terms are generally focused on four categories: (a) kinds of Stigma, (b) Mental health problems, (c) Age range and (d) Region of study population. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Increasing understanding and awareness of different angles of mental health stigma among adolescents may be helpful for better coping with this challenge. Understanding the nature of stigma may give adolescents the ability of ignoring it and avoid starting self-stigma and/or stopping to seek help. ABSTRACT: Introduction Although many epidemiological and interventional investigations regarding improving mental health among youth in the Middle East have been performed, there is no systematic review specifically analysing the studies on stigma among adolescents with mental disorders (A-MDs) across all Middle East countries despite their common historical roots, similar cultural backgrounds, and recent widespread problems in the area. Purpose We will aim to systematically review and analyse the English language studies on stigma among A-MDs in the Middle East published between 2000 and 2019. Method The Web of Knowledge, Science Direct, PsycINFO and MEDLINE are electronic databases that will be included in this study. Furthermore, the bibliography lists of eligible articles will be manually searched for additional included articles. Descriptive statistics will be represented by mean score and standard deviation for continuous data and number/percentage for categorical data. Discussion This study may act as a resource for future studies attempting to assess and/or reduce stigma among children and adolescents with mental health issues specifically in the Middle East. Implications It is important for healthcare providers, including nursing professional, to improve their knowledge and vision towards stigma in their community. The outcomes of this study can be a shortcut reaching this information.
Life Skills Needs Assessment among Iranian Immigrant Students in Malaysia

Mohammadzadeh M, Awang H, Tajik E

Iran J Public Health, 2017 Jan;46(1):143-145.
PMID: 28451544
Improving coping mechanisms of Malaysian adolescents living in orphanages through a life skills education program: A multicentre randomized controlled trial

Mohammadzadeh M, Awang H, Ismail S, Shahr HK

Asian J Psychiatr, 2020 Feb;48:101892.
PMID: 31864126 DOI: 10.1016/j.ajp.2019.101892

The current study amid to determine whether a life skills-based education could improve coping skills among adolescents in Malaysian orphanages. It was a randomized controlled trial comprising intervention and control groups which were randomly selected to receive the life skills, or the Placebo education programmes. The DASS21 and Brief COPE were used as the study instruments. Results showed the mean scores of self-distraction, active coping, use of emotional support, use of instrumental support, positive reinterpretation, planning and acceptance, at post-test, were significantly increased compared to the pre-test values. Denial, substance abuse, behavioural disengagement and self-blame significantly decreased. The findings provide an opportunity to assess the effects of participation in a life skills education programme on behavioural health in Malaysia orphanages.
Emotional Health and Self-esteem Among Adolescents in Malaysian Orphanages

Mohammadzadeh M, Awang H, Kadir Shahar H, Ismail S

Community Ment Health J, 2018 01;54(1):117-125.
PMID: 28315972 DOI: 10.1007/s10597-017-0128-5

This study aimed to assess the prevalence and risk factors of depression, anxiety, stress and low self-esteem among institutional Malaysian adolescents. This cross-sectional descriptive study included 287 adolescents aged 12-18 years living in six selected orphan homes. Study's instruments included Socio-demographic questionnaire, validated Malay version of Depression Anxiety Stress Scale-21 and Rosenberg Self-Esteem Scale. The findings revealed that 85.2, 80.1 and 84.7% of participants had depression, anxiety and stress respectively. Females were more likely to be depressed. Furthermore, anxiety was significantly associated with race and age but no significant associations between stress and the demographic factors were found. The study also showed that 70.8% of males and 69.2% of females had low self-esteem and the self-esteem was associated with depression, anxiety and stress.Therefore, mental health problems are very common among adolescents in Malaysian orphanages. Results reveal the urgency of immediate actions to reduce the mental health problems among Malaysian institutional adolescents.
Influence of coping mechanisms on emotional problems among adolescents in Malaysian orphanages

Mohammadzadeh M, Awang H, Ismail S, Kadir Shahar H

Asia Pac Psychiatry, 2017 12;9(4).
PMID: 29193714 DOI: 10.1111/appy.12288
Stress and coping mechanisms among adolescents living in orphanages: An experience from Klang Valley, Malaysia

Mohammadzadeh M, Awang H, Ismail S, Kadir Shahar H

Asia Pac Psychiatry, 2018 Mar;10(1).
PMID: 29417729 DOI: 10.1111/appy.12311

INTRODUCTION: Health issues often differ from one population to another. Assessing different aspects of the health condition is a vital step toward developing and designing appropriate prevention and treatment programs to reduce health problems in any group or population. This study aimed to assess both the prevalence of stress and the coping mechanisms as well as identify the predictors of stress levels among adolescents in Malaysian orphanages.
METHODS: Overall, 307 male and female adolescents (aged 13-18 y old) living in 9 private orphanages located in Klang Valley, Malaysia, participated in this cross-sectional study. Brief COPE scale and Depression, Anxiety and Stress Scale-21 were used as the main instruments in the current study.
RESULTS: The results of the current study showed female adolescents and participants with a higher level of education were more likely to experience stress. The results also showed significant differences between boys and girls in using of coping mechanisms in self-distraction (t = -2.39, P = .01), substance use (t = 2.12, P = .03), use of emotional support (t = -2.70, P = .001), humor (t = 2.28, P = .02), and religion (t = -2.19, P = .02). Denial, venting, religion, humor, planning, and active coping were identified as predictors of stress among participants.
DISCUSSION: The results showed a high prevalence of stress and a negative coping pattern among participants. The finding of the current study also showed the urgency of taking immediate action to reduce stress and improve coping methods among Malaysian institutional adolescents.
Emotional health and coping mechanisms among adolescents in Malaysian residential foster care homes: A comparative study with adolescents living with families

Mohammadzadeh M, Tajik E, Awang H, Latiff LA

Asian J Psychiatr, 2018 Feb;32:156-158.
PMID: 29278817 DOI: 10.1016/j.ajp.2017.12.011
Fulltext Improving emotional health and self-esteem of Malaysian adolescents living in orphanages through Life Skills Education program: A multi-centre randomized control trial

Mohammadzadeh M, Awang H, Ismail S, Kadir Shahar H

PLoS One, 2019;14(12):e0226333.
PMID: 31877163 DOI: 10.1371/journal.pone.0226333

Generally speaking, institutionalised children and adolescents are at greatly increased risk of serious mental and behavioural problems, up to seven times more than their peers. Life skills- based interventions using peer enforcement have been introduced as effective program to improve adolescents' emotional and behavioral health. Therefore, the current randomized control study aimed to determine, if a life skills-based intervention could improve the emotional health and self-esteem among Malaysian adolescents in orphanages. Overall, 271 male and female adolescents (13-18 years old) from 8 orphanages in Klang valley, Malaysia participated in the study. Comparing the intervention to control group within 3 points of time, the finding of the study showed that immediately after finishing the interventional sessions (post-test), the mean scores of depression (F = 33.80, P<0.001, η2 = 0.11), anxiety (F = 6.28, P = 0.01, η2 = 0.02), stress (F = 32.05, P<0.001, η2 = 0.11) and self-esteem (F = 54.68, P<0.001, η2 = 0.17) were significantly decreased compared to the pre-test values. However, there was no significant difference between two groups in the depression mean scores (F = 2.33, P = 0.13). Regarding to the interaction between group and test a significant change was seen in the mean score of all 4 variables including depression (F = 31.04, P<0.001, η2 = 0.10), anxiety (F = 14.21, P<0.001, η2 = 0.05), stress (F = 15.67, P<0.001, η2 = 0.06) and self-esteem (F = 13.29, P<0.001, η2 = 0.05). Furthermore, except depression (Δmean = -1.37, P<0.001), no significant difference was seen between study variables' mean scores between post- and follow-up test (p>0.001). These results provide preliminary approve for LSE to enhance emotional health and self-esteem in orphanages.
Life Skills Education for Malaysian Institutionalised Adolescents: Knowledge, Needs and Priorities: A Qualitative Pilot Study

Mohammadzadeh M, Awang H, Kadir Shahar H, Ismail S

Iran J Public Health, 2017 Dec;46(12):1739-1741.
PMID: 29259951
Fulltext Relationship between Attachment Styles and Risk Behavior (Smoking and Bullying) among Secondary School Students: An Experience from Hulu Langat, Malaysia

Mohammadzadeh M, Awang H, Jun CY, Hashim NF, Premkumar A

Iran J Public Health, 2020 Oct;49(10):2006-2008.
PMID: 33346208 DOI: 10.18502/ijph.v49i10.4708
Fulltext Effect of online intervention based on life skills for mental health, self-efficacy and coping skills among Arab adolescents in the Klang Valley, Malaysia: A cluster randomised controlled trial protocol

Sherif Y, Fattah Azman AZ, Said SM, Siddiqah Alimuddin A, Awang H, Mohammadzadeh M

PLoS One, 2024;19(2):e0298627.
PMID: 38394185 DOI: 10.1371/journal.pone.0298627

BACKGROUND: Migrant children and adolescents face a significantly increased risk of mental health issues. Focusing on this population's mental health issues is fundamental and requires more attention to detect and reduce these burdens in adulthood. Nevertheless, life skills intervention can improve mental health. Its effects on Arab migrant adolescents have not been tested. Here, an evaluation protocol of the effect of an online life skills-based intervention for improving depression, anxiety, stress, self-efficacy, and coping skills among Arab adolescents in Malaysia will be examined.
MATERIAL AND METHODS: This cluster randomised controlled trial (RCT) will involve 207 Arab students (14-18 years old) from 12 Arabic schools in the Klang Valley. The schools will be assigned randomly to an intervention (online life skills programme) or control group at a 1:1 ratio. The researcher will deliver eight one-hour sessions to the intervention group weekly. The control group will receive the intervention at the evaluation end. Both groups will complete assessments at baseline, and immediately and three months after the intervention. The primary outcome is anxiety, depression, and stress [Depression Anxiety and Stress Scale-21 (DASS-21)]. The secondary outcomes are self-efficacy (General Self-Efficacy Scale) and coping skills (Brief COPE Inventory). Data analysis will involve the Generalised Estimation Equation with a 95% confidence interval. P < .05 will indicate significant inter- and intra-group differences.
DISCUSSION: This will be the first cluster RCT of an online life skills education programme involving Arab adolescent migrants in Malaysia. The results could support programme effectiveness for improving the participants' mental health problems (depression, anxiety, stress), increasing their self-efficacy, and enhancing their coping skills. The evidence could transform approaches for ameliorating migrant children and adolescents' mental well-being.
TRIAL REGISTRATION: The study is registered with the Clinical Trial Registry (Identifier: NCT05370443).
Fulltext Effectiveness of Life Skills Intervention on Depression, Anxiety and Stress among Children and Adolescents: A Systematic Review

Sherif Y, Azman AZF, Awang H, Mokhtar SA, Mohammadzadeh M, Alimuddin AS

Malays J Med Sci, 2023 Jun;30(3):42-59.
PMID: 37425380 DOI: 10.21315/mjms2023.30.3.4

Children and adolescents are at a significantly high risk of mental health problems during their lifetime, among which are depression and anxiety, which are the most common. Life skills education is one of the intervention programmes designed to improve mental well-being and strengthen their ability to cope with the daily stresses of life. This review aimed to identify and evaluate the effect of life skills intervention on the reduction of depression, anxiety and stress among children and adolescents. Following the Population, Intervention, Comparison and Outcome (PICO) model and the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2009 checklist, eight databases (Academic Search Complete, CINAHL, Cochrane, MEDLINE, Psychology and Behavioural Sciences Collection, PubMed, Scopus and Web of Science) were systematically reviewed from 2012 to 2020. The search was limited to English papers only. It included published experimental and quasi-experimental studies addressing the effect of life skills interventions on the reduction of at least one of the following mental health disorders: depression, anxiety and stress among children and adolescents (from the age of 5 years old to 18 years old). We used the Joanna Briggs Institute checklist for experimental and quasi-experimental studies to evaluate the quality of the included studies. This study was registered in PROSPERO [CRD42021256603]. The search identified only 10 studies (three experimental and seven quasi-experimental) from 2,160 articles. The number of the participants was 6,714 aged between 10 years old and 19 years old. Three studies in this review focused on depression and anxiety, whereas one study investigated depression and the other anxiety. Three studies targeted only stress and two examined the three outcomes, namely, depression, anxiety and stress. Almost in all studies, the life skills intervention positively impacted mental disorders, considering the differences among males and females. The overall methodological quality of the findings was deemed to be moderate to high. Our results clearly indicated the advantages of life skills programmes among adolescents in different settings and contexts. Nonetheless, the results highlight some important policy implications by emphasising the crucial roles of developers and policymakers in the implementation of appropriate modules and activities. Further research examining life skills intervention with a cultural, gender perspective, age-appropriate and long-term effect is recommended.