The aim of this study was to identify predictors of response to treatment for depression in Malaysia, using demographic and cognitive predictors. 113 patients, that were diagnosed with depression, were randomly assigned to the Treatment-As-Usual (TAU) (n=55), or TAU plus eight sessions of Group Cognitive Behaviour Therapy (TAU+GCBT; n=58). Pre-treatment using the Beck Hopelessness Scale (BHS), the Automatic Thoughts Questionnaire-Malay (ATQ-Malay), the Dysfunctional Attitude Scale-Malay (DAS-Malay), a quality of life scale, and demographic characteristics, were used in a series of multiple regression models, as potential predictors of the Beck Depression Inventory-Malay (BDI-Malay) post-assessment scores. Regression results revealed that age, the quality of life scale, and all three cognitive measures were significant predictors of outcomes in the Group Cognitive Behaviour Therapy (GCBT) group, showing that Beck's cognitive model for depression could be applied in Malaysia.
The aim of this study was to investigate the factor structure of the Malay version of the Dysfunctional Attitude Scale (DAS-Malay) in clinical and nonclinical populations. The DAS is a self-report inventory derived from Beck's cognitive theory of depression to measure beliefs constituting a predisposition to depression. The 40-item DAS-Malay was completed by 315 university students, 495 members of the general community, 167 medical patients, and 113 patients diagnosed with major depressive disorder. Through principal axis factoring, with varimax rotation, two factors were extracted; performance evaluation and self-control. Correlation with depression and other variables indicated that the DAS-Malay held good concurrent validity. In addition, sensitivity and specificity of the total scores of the DAS were evident in this study. The results showed that the DAS-Malay possesses satisfactory psychometric properties suggesting that this instrument is appropriate for use as a cognitive measure in a Malay cultural context although several issues require consideration.
This paper aimed to review the literature on depression that focused on its assessment and treatment in Malaysia. PsycINFO, Medline, local journals were searched, and 18 published articles were included in this paper. Results indicate that research on depression in Malaysia, particularly validation studies and psychotherapy research, was weak and fragmented, with minimal empirical evidence available. Pharmacotherapy still dominated the treatment for depression, and, in terms of psychotherapy, Cognitive Behavioural Therapy (CBT) was recently practiced, but only a few studies have reported on the treatment efficacy of CBT. Major limitations of studies were noted, and, consequently, the problems that are associated with the implementation and future direction of clinical and research on depression in Malaysia were discussed. In short, the contribution of empirical research on the assessment and treatment for depression remained inconsistent and fragmented and urgently in need of further empirical investigation.
The aim of this paper is to review the literature on suicide attempts in Malaysia. PsycINFO, PubMed, and Medline databases from 1845 to 2012 and detailed manual search of local official reports from the Ministry of Health and the Malaysian Psychiatric Association and unpublished dissertations from 3 local universities providing postgraduate psychiatric training were included in the current review. A total of 38 studies on suicide attempts in Malaysia were found and reviewed. Twenty-seven (76%) of the studies on suicide attempts were descriptive studies looking at sociodemographic data, psychiatric illnesses, and methods and reasons for suicide attempts. No study has been conducted on treatment and interventions for suicide attempts and the impact of culture was rarely considered. The review showed that in order for researchers, clinicians, and public health policy makers to obtain a better understanding of suicide attempts in Malaysia, more systematic and empirically stringent methodologies and research frameworks need to be used.
The aim of this paper was to review the literature on suicide ideation and intent in Malaysia. PsyINFO, PubMed, Medline databases from 1845 to 2012 and detailed manual search of local official reports from Ministry of Health, Malaysian Psychiatric Association and unpublished dissertations from 3 local universities providing postgraduate psychiatric training, were included in the current review. A total of 13 studies on suicide ideation and intent in Malaysia were found and reviewed. The review showed that research on suicide ideation and intent in Malaysia was fragmented and limited, at best. Approximately 50% of existing research on suicide ideation and intent simply focused on sociodemographic data. Fifty-four percent of the data were obtained from hospitals. No study has been conducted on treatment and interventions for suicide ideation and intent. None of the studies used validated suicide scales. The impact of culture was rarely considered. It was clear from the review that for researchers, clinicians and public health policy makers to gain a better understanding of suicide behavior especially suicide ideation and intent in Malaysia, more systematic and empirically stringent methodologies and research frameworks need to be used.
Dementia is a neurocognitive disorder that affects a person's abilities in daily functioning. Anxiety and depression symptoms are common among persons with dementia. Cognitive behavioural therapy (CBT) has been tested to manage their depression and anxiety symptoms. However, the purpose of CBT in managing these symptoms is unclear. Therefore, this paper aims to clarify whether CBT can be used to reduce depression and anxiety symptoms in persons with dementia. The electronic databases PubMed, PsycINFO, MEDLINE, and CINAHL were used to locate relevant studies. Eleven studies, which involved a total of 116 older adults, were identified. The findings suggest that CBT can be effective in reducing depression and anxiety symptoms. Based on our current review, the findings from previous studies form a promising foundation on which to conduct a major randomized controlled trial with a larger sample size. This review discusses some of the most important considerations in applying CBT to persons with dementia, and these may be beneficial for future studies that explore this area and seek more conclusive evidence on the use of CBT.
The Reasons For Living Inventory has been shown to have good psychometric properties in Western populations for the past three decades. The present study examined the psychometric properties and factor structure of English and Malay version of the Reasons For Living (RFL) Inventory in a sample of clinical outpatients in Malaysia. The RFL is designed to assess an individual's various reasons for not committing suicide. A total of 483 participants (283 with psychiatric illnesses and 200 with non-psychiatric medical illnesses) completed the RFL and other self-report instruments. Results of the EFA (exploratory factor analysis) and CFA (confirmatory factor analysis) supported the fit for the six-factor oblique model as the best-fitting model. The internal consistency of the RFL was α=.94 and it was found to be high with good concurrent, criterion and discriminative validities. Thus, the RFL is a reliable and valid instrument to measure the various reasons for not committing suicide among psychiatry and medical outpatients in Malaysia.
Study site: Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM)
The majority of prevention and intervention research in problem gambling (PG) has focused on identifying negative risk factors. However, not all at-risk individuals go on to develop anticipated disorders and many thrive in spite of them. In healthcare settings, PG and other disorders are typically conceptualized from the biomedical perspective that frame disorders as something negative residing within the individual and reduction in negativity is seen as success. Indeed, this problem-focused conceptualization may be adequate in many cases as reducing PG behaviour is undoubtedly an important outcome, but the focus on negativity alone is too narrow to capture the complexity of human behaviour. Hence, this study attempts to bridge the gap in literature by providing an evaluation of the predictive ability of the positive dispositions on problem gambling severity, gambling-related cognitions, and gambling urges. The positive psychological dispositions examined were curiosity, gratitude, hope, personal growth initiative, and mindfulness. Participants consisted of 801 Taiwanese Chinese students and community individuals (Mean age = 25.36 years). Higher levels of gratitude and hope have been found to predict lower PG, gambling-related cognitions, or gambling urges. Meanwhile, higher mindfulness predicted lower PG, but only among Chinese males. However, lower personal growth initiative predicted lower PG, gambling-related cognitions, and gambling urges. These analyses have small to medium effect sizes with significant predictions. Findings of this study have essential implications in understanding and treating Chinese problem gamblers. These positive dispositions should be addressed by mental health professionals in preventative and treatment programs among Chinese individuals. Further implications and suggestions for future research are discussed.
The influence of an individuals' belief in their ability to resist drinking alcohol has recognised importance in understanding the pattern of drinking behaviours among Caucasian samples. Measures used to investigate this construct, such as the drinking refusal self-efficacy questionnaire-revised (DRSEQ-R; [Oei, T. P. S., Hasking, P. A., & Young, R. M. (2005). Drinking refusal self-efficacy questionnaire-revised (DRSEQ-R): A new factor structure with confirmatory factor analysis. Drug and Alcohol Dependence, 78, 297-307.]) have been widely used and have established psychometric properties. However, the exploration of the utility of this questionnaire with samples of different ethnicity, religion and living in different countries remains scarce. In the current study, Arab Muslim samples living in the United Arab Emirates and Oman (n=356) and Asian predominately Muslim samples living in Malaysia and Indonesia (n=256) were used. Exploratory and confirmatory factor analysis demonstrated that the DRSEQ-R has a three factor structure. Internal consistency ranged from alpha .96 to alpha .86 and validity was good. This study offers evidence of the utility of this measure with Arab and Asian samples.
Schizophrenia which is perhaps the most disabling and puzzling form of a mental disorder is often conceptualized as 'gila' (lunacy or madness) by the Malaysian society. The debilitating nature of the disorder and recurrent relapse of its psychotic episodes have often been misunderstood and lead to confusion among the family members, who play the role as primary caregivers. While expressed emotion (EE) has been widely studied in the Western world, it is not well understood in Malaysia.
Currently, cognitive behavioral therapies appear to be one of the most studied treatments for gambling problems and studies show it is effective in treating gambling problems. However, cognitive behavior models have not been widely tested using statistical means. Thus, the aim of this study was to test the validity of the pathways postulated in the cognitive behavioral theory of gambling behavior using structural equation modeling (AMOS 20). Several questionnaires assessing a range of gambling specific variables (e.g., gambling urges, cognitions and behaviors) and gambling correlates (e.g., psychological states, and coping styles) were distributed to 969 participants from the community. Results showed that negative psychological states (i.e., depression, anxiety and stress) only directly predicted gambling behavior, whereas gambling urges predicted gambling behavior directly as well as indirectly via gambling cognitions. Avoidance coping predicted gambling behavior only indirectly via gambling cognitions. Negative psychological states were significantly related to gambling cognitions as well as avoidance coping. In addition, significant gender differences were also found. The results provided confirmation for the validity of the pathways postulated in the cognitive behavioral theory of gambling behavior. It also highlighted the importance of gender differences in conceptualizing gambling behavior.
The PANSI is a measure designed to assess the risk and protective factors related to suicidal behaviors. The present study evaluated the psychometric properties and factor structure of the Positive and Negative Suicide Ideation (PANSI) Inventory in a sample of clinical outpatients at a major hospital in Malaysia. In this study, 283 psychiatric patients and 200 medical (non-psychiatric) patients participated. All the patients completed the PANSI and seven other self-report instruments. Confirmative factor analysis supported the 2-factor oblique model. The internal consistency of the two subscales of PANSI-Negative and the PANSI-Positive were 0.93 and 0.84, respectively. In testing construct validity, PANSI showed sizable correlation with the other seven scales. Criterion validity was supported by scores on PANSI which differentiated psychiatric patients from medical patients. Logistic regression analyses showed PANSI can be used to classify the patients into suicidal or non-suicidal. The PANSI is a reliable and valid instrument to measure the severity of suicidal ideation among clinical outpatients in Malaysia.
Study site: Psychiatric clinic, Medical clinic, Ear, Nose and Throat (ENT) clinic, Ophthalmology clinic and orthopedic clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
Scale, Questionnaire and Device: Positive and Negative Suicide Ideation Inventory (PANSI), Depression Anxiety Stress Scale (DASS-21), Reasons for Living Inventory (RFL), Beck Hopelessness Scale (BHS), Provision of Social Relations (PSR), Satisfaction with Life Scale (SWLS), Rosenberg Self Esteem Scale (RSE), The Adult Trait Hope Scale (ATHS)
The present study evaluated the psychometric properties and factor structure of the Satisfaction With Life Scale (SWLS) in a sample of clinical outpatients in Malaysia. The SWLS is a measure designed to assess subjective life satisfaction. Four hundred eighty-three participants (283 with psychiatric illnesses and 200 with other medical illnesses) completed the SWLS and other self-report instruments. Results of the EFA and CFA supported the fit for the one-factor model as the best-fitting model. The internal consistency of the SWLS (α=0.86) was found to be high. Correlational analyses showed that SWLS had adequate concurrent validity. Scores on SWLS, which differentiated psychiatric patients and medical patients, supported criterion validity. The logistic regression analyses showed good discriminative validity of SWLS. The SWLS is a reliable and valid instrument to measure the satisfaction with life among psychiatry and clinical outpatients in Malaysia.
Study site: medical and psychiatric clinics, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia