Smartphone addiction and personality traits among Lebanese adults: the mediating role of self-esteem.

Smartphone usage in Lebanon is increasing constantly. Lebanese population especially university students were described to be at a higher risk of smartphone addiction compared to the general population. To our knowledge there has been no study in the literature that investigated the mediating effect of self-esteem when assessing personality traits and smartphone addiction in young adults. The aim of our study was to assess factors associated with smartphone addiction and investigate the mediating role of self-esteem in the association between smartphone addiction and personality traits. A cross-sectional study was carried out between August and September 2020, during the lockdown period imposed by the government for the COVID-19 pandemic and that coincides with the summer season vacation for most Lebanese, using a sample of community-dwelling participants aged 18 to 29 years. The snowball technique was followed for participants' recruitment. The results showed that the mean age of the participants was 22.25 ± 2.87 years, with 70.9% females. The results showed that 216 (46.9%) of the participants had smartphone addiction. Higher negative emotionality (Beta = 0.17) was significantly associated with more smartphone addiction, whereas higher self-esteem (Beta = -0.37) and household crowding index (Beta = -1.58) were significantly associated with less smartphone addiction. Self-esteem mediated the association between negative emotionality and smartphone addiction. Lebanese young adults were found to be at a high risk of smartphone addiction. These results might serve as a first step towards implementing preventive measures to reduce smartphone addiction. Improving face to face communication, as well as setting specific time for cell phone usage might help reduce the development of addictive behaviors.

Work fatigue among Lebanese physicians and students during the COVID-19 pandemic: validation of the 3D-Work Fatigue Inventory (3D-WFI) and correlates.

BACKGROUND: Work fatigue is a work-related condition that affects physicians' health, work attitude safety and performance. Work fatigue affects not only medical workers but can also leave a negative impact on patients. With the burden of the COVID-19 pandemic as well as the economic crisis Lebanese doctors have been facing in the last 2 years, the aim of our study was to validate the 3D-Work Fatigue Inventory (3D-WFI) among Lebanese physicians and assess the rate and correlates of work fatigue (physical, mental and emotional). METHODS: A cross-sectional study was undertaken through an anonymous self-administered questionnaire between October 2020 and January 2021. The SPSS AMOS software v.24 was used to conduct confirmatory factor analysis (CFA). To validate the 3D-WFI, multiple indices of goodness-of-fit were described: the Relative Chi-square (χ2/df) (cut-off values:< 2-5), the Root Mean Square Error of Approximation (RMSEA) (close and acceptable fit are considered for values < 0.05 and < 0.11 respectively), the Tucker Lewis Index (TLI) and the Comparative Fit Index (CFI) (acceptable values are ≥0.90). RESULTS: A total of 401 responses was collected; 66.1, 64.8 and 65.1% respondents had an intermediate to high level of emotional, mental and physical work fatigue respectively. The fit indices obtained in the CFA of the 3D-WFI items fitted well: CFI =0.98, TLI =0.98, RMSEA = 0.05; 95% CI 0.046-0.063; pclose = 0.20) and χ2(136) = 295.76. The correlation coefficients between the three factors (Factor 1 = Physical work fatigue, Factor 2 = Mental work fatigue, Factor 3 = Emotional work fatigue) were adequate as well: Factor 1-Factor 2 (r = 0.70), Factor 1-Factor 3 (r = 0.52) and Factor 2-Factor 3 (r = 0.65). In addition, feeling pressured by long working hours during the pandemic, having more hours of night duty per month, more stressful events in life, and higher depression were significantly associated with more physical and mental work fatigue. Higher depression and having more stressful events in life were significantly associated with more emotional work fatigue. CONCLUSION: Work fatigue in Lebanese physicians seems to be associated with higher level of everyday stress, high work load and depression. Hospitals and local health authorities can use these results for early interventions that aim to reduce work fatigue and ensure the wellbeing of Lebanese physicians.

Knowledge, attitude and practice of Lebanese parents towards childhood overweight/obesity: the role of parent-physician communication.

BACKGROUND: Childhood overweight and obesity is one of the most challenging public health problems facing both developed and developing countries. Several studies carried worldwide assessed predisposing risk factors for childhood obesity, however, few addressed the Middle East region and particularly Lebanon. We aimed in our study to assess factors associated with knowledge, attitude and practice of Lebanese parents regarding childhood overweight, particularly the parent-physician communication. METHODS: This cross-sectional study conducted between September and December 2019. The questionnaire used was the standardized questionnaire of "Parent Questionnaire Curriculum" from the "We Can program" (Ways to Enhance Children's Activity and Nutrition). RESULTS: A higher parent-physician communication score (Beta = 0.05) was significantly associated with higher knowledge, whereas having a higher intermediate vs low income (Beta = -0.65) was significantly associated with lower knowledge. A higher knowledge global score (Beta = 1.25), a higher parent-physician communication score (Beta = 0.18), and having a university education level compared to illiterate/primary/complementary (Beta = 2.59) were significantly associated with better attitude. A better attitude (Beta = 0.92) and a higher global knowledge score (Beta = 0.6) were significantly associated with a better practice. CONCLUSION: This study found that a better parent-physician communication and higher knowledge were associated with better attitude and practice towards obesity. Given the rise in childhood obesity worldwide, identifying factors that help reduce childhood obesity, is becoming mandatory. Our results can open up to future studies addressing strategies to prevent childhood obesity in Lebanon.

Sleep disorders in a sample of Lebanese children: the role of parental mental health and child nutrition and activity.

BACKGROUND: Sleep habits are an important component of a child's health and it is affected by parent-child relationship. Also, child's diet and nutrition appear to be an important factor affecting sleep health. Few studies have addressed the effect of parental emotional disturbance that can leave on children's sleep. Therefore, the objective of our study was to assess the prevalence of sleep disorders in pre- and school-aged children and evaluate its relation with parental mental health and child's nutrition and activity. METHODS: A cross-sectional study, conducted between October 2020 and January 2021, which enrolled 402 Lebanese parents from all over Lebanon. The questionnaire was distributed online using the snowball technique. The Pediatric Sleep Questionnaire (PSQ) was used to assess pediatric sleep behaviors and the Family Nutrition and physical activity questionnaire was used to assess parental behaviors that might predispose children for obesity. RESULTS: A total of 76 (19%) children had sleep disorders (PSQ scores of 8 or more). The multivariable analysis showed that higher paternal depression (Beta = 0.079, p = 0.010), maternal depression (Beta = 0.089, p = 0.001) and higher anxiety in the father (Beta = 0.064, p = 0.021) were significantly associated with higher PSQ scores (worse sleep) in the child. Higher Family Nutrition and Physical Activity Screening Tool scores in the child (Beta = -0.161, p < 0.001) was significantly associated with lower PSQ scores (better sleep). CONCLUSION: Paternal anxiety and depression, as well as maternal depression, were factors associated with children's sleeping disorders. Future studies are needed to assess parental influence on child's development.

Binge eating, orthorexia nervosa, restrained eating, and quality of life: a population study in Lebanon.

OBJECTIVES: To assess the implication of disordered eating behaviors (DEBs) on the quality of life (QOL) of a sample of the Lebanese population, after adjustment over sociodemographic characteristics of those participants. Secondary objective aimed to assess the role of body dissatisfaction (BD) in the association of DEBs and QOL. METHODS: This cross-sectional study was done between January and May 2018 and enrolled 811 participants from the community. A proportionate random sample technique was used to select the sample from all Lebanese Mohafazat. The World Health Organization Quality-of-life (WHOQOL)-BREF was used to assess the QOL and it includes four domains: physical health, psychological health, social relations, and environment. RESULTS: Body dissatisfaction was found to be a major confounding factor contributing to psychological and environmental HQOL impairments in patient with restrained eating. Nevertheless, orthorexia nervosa was associated with QOL impairments in its physical and environmental domains, regardless of body dissatisfaction that was shown to be a major contributor for QOL impairments. Similarly, ON was directly correlated with QOL of life impairment in its physical and environmental domains, independently of all other risk factors. CONCLUSION: When adding body dissatisfaction as a confounding variable, restrained eating and orthorexia nervosa remained significantly associated with quality-of-life impairments. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Factors influencing women's sex work in a Lebanese sample: results of a case-control study.

BACKGROUND: Many constituents contribute to the rise of sex work in Lebanon such as the socio-economic situation in the country (poverty, increased unemployment rates, and religious divisions), as well as the political and social instability. Several emotional and psychological factors such as depression, stress, anxiety, low self-esteem, emotional abuse, may force some people to rely on trading sex as a coping strategy for persevering. Therefore, it was deemed interesting to explore and understand factors that are correlated with sex work in Lebanon where no study, to our knowledge, has been written on this critical point. The objective of the study was to assess factors (such as trauma, child abuse, partner abuse, depression, anxiety, and stress) associated with women joining sex work among a sample of the Lebanese population. METHODS: A case-control study was conducted on a group of women (60 sex workers recruited from a prison for women) involved in sex work matched for age and sex with a control group (60 non-sex workers). Controls were chosen from the same prison population as the sex workers. RESULTS: A logistic regression was conducted, taking being a sex worker vs not as the dependent variable; independent factors were sociodemographic characteristics, child (psychological, neglect, physical and verbal) and inter partner violence (physical and non-physical), depression, anxiety and stress. Higher anxiety (aOR = 1.08) and higher inter partner physical violence (aOR = 1.02) were altogether related with higher chances of being a sex worker. CONCLUSION: This study proposes an association between child abuse, inter partner violence, alcohol consumption, anxiety, and sex work. Future research may also need to contemplate other factors not examined here, including parental substance use, personality traits, and many others.

Personality Traits and Online Pornography Use Among Lebanese Adults.

Objective: To evaluate the association between personality traits and online pornography use among a sample of Lebanese adults.Methods: This cross-sectional study was carried out between October and November 2020 and enrolled participants from all Lebanese districts through an online survey following a snowball technique. Participants (N = 653) completed a self-administered questionnaire, which included questions from the Cyber-Pornography Use Inventory and the Big 5 Inventory.Results: Higher extroversion (adjusted odds ratio [aOR] = 1.06) and agreeableness (aOR = 1.05), as well as having a secondary (aOR = 1.82) or university (aOR = 2.18) level of education compared to a primary/complementary level were significantly associated with more porn-addictive patterns. Females had lower porn-addictive patterns compared to males (aOR = 0.67). Alcohol consumption (aOR = 2.26), higher agreeableness (aOR = 1.04), and having a secondary (aOR = 1.58) or university (aOR = 1.80) level of education compared to a primary/complementary level were significantly associated with more guilt regarding online porn use. Finally, alcohol drinking (aOR = 2.28) was significantly associated with more online sexual behavior, whereas female gender (aOR = 0.34) and more agreeableness (aOR = 0.94) were significantly associated with less online sexual behavior.Conclusions: The study highlights that some personality traits (agreeableness and extroversion) and other factors (alcohol consumption, gender, and education level) are associated factors with online pornography use. Further research is needed to assess different factors associated with pornography viewing.

Personality Traits and Mental Health among Lebanese Medical Students: The Mediating Role of Emotional Intelligence.

Medical students face daily challenges such as large workload, time commitment and clinical environment pressure leading to a higher risk of psychological distress. The aim of our study was to assess the relationship between personality traits and depression, anxiety, and stress among Lebanese medical students and to evaluate the mediating role of emotional intelligence (EI) in this association. This cross-sectional study was conducted between June and December of 2019. Participants were from seven medical schools in Lebanon. Higher extraversion (B = -0.11), higher neuroticism (B = -0.28) and higher emotional intelligence (B = -0.03) were significantly associated with lower depression. Higher neuroticism (B = -0.29) and higher emotional intelligence (B = -0.03) were significantly associated with lower anxiety. Higher openness to experience (B = 0.07) and higher agreeableness (B = 0.08) were significantly associated with higher stress, whereas higher neuroticism (B = -0.05) was associated with lower stress. EI mediated the association between extraversion and depression and openness to experience and depression. EI mediated the association between extraversion and anxiety and openness to experience and anxiety. The results of this study were different from those previously cited in the literature. This could be secondary to the mediating role of emotional intelligence. This study consequently opens up the possibility of new studies highlighting the role of emotional intelligence in the possible preservation of medical students' mental health.

Investigating the Relationship Between the Use of Problematic Social Networks and Emotional Intelligence in a Sample of Lebanese Adults.

Objective: To show the impact of problematic social media use (PSMU) on the 4 domains of emotional intelligence (emotional management, emotional awareness, social emotional awareness, and relationship management) among the Lebanese population.Methods: This cross-sectional study enrolled 466 adults (January-May 2019). The Social Media Disorder Scale and Quick Emotional Intelligence Self-Assessment were used to assess problematic social media use and emotional intelligence, respectively.Results: Higher PSMU was significantly associated with lower emotional management scores (ß = -0.13), but not emotional awareness, social emotional awareness, relationship management, or total emotional intelligence scores. Female sex and older age were associated with higher social emotional awareness (ß = 2.63 and ß = 0.10, respectively) and relationship management (ß = 2.12 and ß = 0.13, respectively) scores.Conclusions: This study showed that higher PSMU was related to lower emotional intelligence. Future prospective studies are needed to gain an understanding of the relationship between PSMU and each component of emotional intelligence, as well as the mediating factors in such associations.

Alexithymia, aggressive behavior and depression among Lebanese adolescents: A cross-sectional study.

BACKGROUND: For a long time, Lebanon has been considered an unstable country. This can have a negative impact on Lebanese adolescents that consequently face secondary emotional stress, leading to more mental health problems such as anxiety, depression, and alexithymia. The objective of this study was to assess the association between alexithymia, depression and aggressive behavior in a sample of Lebanese adolescents. METHODS: This is a cross-sectional study, conducted between September 2018 and February 2019, which enrolled 568 young adolescents aged between 15 and 18 years using a proportionate sample from two Lebanese governorates. Out of 750 questionnaires distributed, 568 (75.73%) were completed and collected back. RESULTS: The mean age was 15.87 ± 0.82 years, with 302 (53.2%) females; 180 (31.7%) were alexithymic, 193 (34.0%) and 181 (31.9%) had moderate (scores between (89 and 111) and high (scores ≥ 112) aggression respectively, whereas 176 (31.0%) and 149 (26.2%) had moderate (scores between 3 and 4) and high (scores ≥ 5) depression respectively. Higher levels of alexithymia were significantly associated with higher depression (Beta = 0.44), higher total aggression (Beta = 0.78), higher physical aggression (Beta = 0.24), higher verbal aggression (Beta = 0.14), higher anger (Beta = 0.22), and higher hostility (Beta = 0.19). CONCLUSION: The prevalence of alexithymic behaviors, as well as aggression and depression in Lebanese students appears to be very high in comparison with students worldwide. Alexithymia was significantly associated with higher depression, physical and verbal aggression, anger and hostility among adolescents. Factors underlying the high level of alexithymia remain not fully elucidated.