Effectiveness of a Theory-Based Digital Animated Video Intervention to Reduce Intention and Willingness to Sext Among Diploma Students: Cluster Randomized Controlled Trial.

BACKGROUND: Sexting refers to the exchange of sexually explicit digital content in the form of texts, photos, or videos. In recent years, sexting has become a public health concern. Surveys in Malaysia show a high prevalence of young adults engaged in sexting. Given that sexting is associated with sexual risk behavior, cyberbullying, and mental health issues, this behavior needs intervention to alleviate the resulting public health burden. However, there is a scarcity of theory-based intervention programs on the prevention of intention and willingness to sext among young adults. OBJECTIVE: This study aimed to develop and implement a sexting intervention module guided by the prototype willingness model (PWM), delivered using web-based animated video, and evaluate its effectiveness among diploma students from a public higher educational institution. The primary outcomes were intention and willingness to sext, while the secondary outcomes were knowledge, attitude, perceived norms, and prototype perceptions of sexting. METHODS: This 2-armed, parallel, single-blinded cluster randomized controlled trial was conducted in a public higher educational institution in the state of Melaka, Malaysia. Diploma students from 12 programs were randomly allocated into intervention and control groups. Both groups answered a self-administered web-based questionnaire assessing the outcomes at the baseline. The intervention group received a newly developed intervention module based on the PWM in the form of 5 animated videos posted on a private YouTube platform, while the control group was put on the waitlist. The intervention group was encouraged to discuss any issues raised with the researchers via WhatsApp private chat after viewing the videos. All participants were observed immediately and 3 months postintervention. Data analysis was performed with SPSS (version 26; IBM Corp). A generalized linear mixed model was used to determine the effectiveness of the intervention. RESULTS: There were a total of 300 participants with an attrition rate of 8.3% (n=25). After adjusting for age, sex, relationship status, and the amount of time spent on the web, there were significant differences in the intention to sext (ß=-.12; P=.002; Cohen d=0.23), willingness to sext (ß=-.16; P<.001; Cohen d=0.40), knowledge (ß=.12; P<.001; Cohen d=0.39), attitude (ß=-.11; P=.001; Cohen d=0.31), perceived norms (ß=-.06; P=.04; Cohen d=0.18), and prototype perceptions (ß=-.11; P<.001; Cohen d=0.35) between the intervention and control groups over 3 months. CONCLUSIONS: In this study, the sexting intervention module using the PWM that was delivered via web-based animated videos was effective in reducing intention and willingness to sext as well as in improving knowledge of sexting, attitudes, perceived norms, and prototype perceptions. Therefore, relevant agencies involved in the promotion of sexual and reproductive health among young adults in Malaysia can consider the implementation of this module. TRIAL REGISTRATION: Thai Clinical Trial Registry TCTR20201010002; https://www.thaiclinicaltrials.org/show/TCTR20201002001.

Development and validation of a medication non-adherence scale for Malaysian hypertensive patients: a mixed-methods study.

BACKGROUND: Non-adherence to anti-hypertensive medications can lead to hypertension-related complications. One of the most effective preventive measures to mitigate these complications is to understand the underlying determinants of medication non-adherence using various scales. Unfortunately, existing scales for measuring non-adherence to anti-hypertensive medications have certain limitations, such as insufficient consideration of validity, dimensionality, and cultural adaptation. In response, the current study aimed to develop and validate a measure of non-adherence to anti-hypertensive medications-known as the Malaysian Anti-hypertensive Agent Non-Adherence Scale (MAANS)-for use in local hypertensive patients. METHODS: A two-phase mixed-methods approach was used. Phase 1 involved qualitative interviews with hypertensive patients from two health clinics in Kuala Lumpur, Malaysia. The themes extracted from these interviews were used to generate items for the MAANS. In Phase 2, data from 213 participants were analysed using exploratory factor analysis (EFA) to establish the scale's factor structure, thereby created the modified version of the MAANS. Confirmatory factor analysis (CFA) was then conducted on a separate dataset of 205 participants to confirm the factor structure, resulted in the final version of the MAANS. The reliability of the final MAANS version was assessed using Cronbach's alpha coefficient. The MAANS scores were used to predict subscales of the Malay version of the WHO Quality-of-Life (QOL) BREF, demonstrating the scale's predictive validity. RESULTS: Ten qualitative interviews yielded 73 items. The EFA produced a modified MAANS with 21 items grouped into five factors. However, the CFA retained three factors in the final scale: Perceived Non-Susceptibility, Poor Doctor-Patient Relationship, and Unhealthy Lifestyle. The final 14-item, 3-factor MAANS demonstrated moderate reliability (Cronbach's alpha coefficient = 0.64) and exhibited partial predictive validity, with the Poor Doctor-Patient Relationship and Unhealthy Lifestyle subscales significantly predicting Social QOL and Environmental QOL. CONCLUSION: The MAANS is a reliable, valid, and multidimensional scale specifically developed to evaluate non-adherence to anti-hypertensive medications in local clinical settings with the potential to further the advancement of research and practice in sociomedical and preventive medicine.

Relations between clinical characteristics and cognitive deficits among adult patients diagnosed with major depressive disorder.

OBJECTIVE: The present study examined the relations between clinical characteristics and cognitive deficits in adult patients with major depressive disorder (MDD) from a local outpatient psychiatric clinic in Malaysia. METHODS: The present sample included 110 participants aged 20-60 years old. Participants were invited to provide their information on sociodemographic variables (age, gender, and educational level) and clinical characteristics (age at onset of depression and duration of illness) and to complete a series of cognitive performance measures including the Trail Making Tests A (psychomotor speed) and B (executive function), the Digit Symbol Substitution Test (attention), and the Auditory Verbal Learning Test (immediate free recall, acquisition phase, and delayed recall). The Mini International Neuropsychiatric Interview Version 6.0 was used to confirm the diagnosis of MDD and the Montgomery-Åsberg Depression Rating Scale was used to assess illness severity. RESULTS: At the bivariate level, relations of age and educational level to all cognitive deficit domains were significant. At the multivariate level, only educational level and illness severity consistently and significantly predicted all cognitive deficits domains. CONCLUSIONS: Therapeutic modalities should be individualised whilst considering the impacts of cognitive deficits in an attempt to prevent further deterioration in psychosocial functioning of MDD patients.KEY POINTSCognitive deficits are an elemental component of Major Depressive Disorder (MDD) persisting during a current major depressive episode or during remission, altering individuals' ability to process information and changes the way they perceive and interact with the environment.Cognitive deficits in MDD are evident among the upper-middle income groups in South-Eastern Asian countries warranting more local research as such deficits could lead to functional decline and work performance such as absenteeism and presenteeism.Therapeutic modalities should be individualised by taking the impacts of cognitive deficits into consideration to promote psychosocial functioning of MDD patients.

Psychometric properties of the Malay version of the diabetes empowerment scale among hospital Serdang type 2 diabetes mellitus patients using exploratory factor analysis.

BACKGROUND: This study was initiated to examine the psychometric components of the Diabetes Empowerment Scale (DES) by translating and validating the scale into the Malay language (DES-M) which is the main language spoken in Malaysia. This study can determine the level of empowerment among diabetic patients towards diabetes management. In addition, the reliability and validity of the DES-M was also demonstrated. METHODS: A total of 151 patients with type 2 diabetes mellitus were recruited (between June 2016 and October 2016) to complete sets of questionnaires, which were DES-M, the Malay versions of the Diabetes Quality of Life (DQOL) for Adults and Summary of Diabetes Self Care Activities Questionnaire (SDSCA). Confirmatory and Exploratory factor analysis (CFA and EFA) were carried out to determine the factor structures of the DES-M. RESULTS: There were 100 males and 51 females with ages ranging from 19 to 81 years old (55 ± 13) included in this study. The instrument displayed good internal consistency (Cronbach's α =0.920) and the respective coefficients ranged from 0.65-0.84. Discriminant validity showed adequate correlations ranged from 0.257-0.744. Concurrent validity with SDSCA (Pearson's correlation = 0.313, p = 0.012). Predictive validity with DQOL (B = 0.27, p = 0.016). CFA indicated that four factor model of the DES-M has good fit to the data. CONCLUSION: This study indicates that the DES-M has a good internal consistency and validity. Therefore, it is a valid and reliable instrument for assessing empowerment score among patients with diabetes in Malaysia. TRIAL REGISTRATION: NMRR-16-805-30503 (IIR).

Early nutrition, growth and cognitive development of infants from birth to 2 years in Malaysia: a study protocol.

BACKGROUND: The first 2 years of life is a critical period of rapid growth and brain development. During this period, nutrition and environmental factors play important roles in growth and cognitive development of a child. This report describes the study protocol of early nutrition, growth and cognitive development of infants from birth to 2 years of age. METHODS/DESIGN: This is a prospective cohort study of mothers and infants recruited from government health clinics in Seremban district in Negeri Sembilan, Malaysia. Infants are followed-up at 6, 12, 18 and 24 months of age. Pre-natal factors that include mother's pre-pregnancy body mass index, gestational weight gain, blood glucose and blood pressure during pregnancy, infant's gestational age, birth weight and head circumference at birth are obtained from patient card. Post-natal factors assessed at each follow-up are feeding practices, dietary intake, anthropometric measurements and cognitive development of infants. Iron status is assessed at 6 months, while infant temperament and home environment are assessed at 12 months. Maternal intelligence is assessed at 18 months. DISCUSSION: Early life nutritional programming is of current interest as many longitudinal studies are actively being conducted in developed countries to investigate this concept. The concept however is relatively new in developing countries such as Malaysia. This study will provide useful information on early nutrition and infant development in the first two years of life which can be further followed up to identify factors that track into childhood and contribute to growth and cognitive deviations.

Effects of Brief Psychoeducational Program on Stigma in Malaysian Pre-clinical Medical Students: A Randomized Controlled Trial.

OBJECTIVE: If presented with serious mental illness (SMI), individuals' low help-seeking behaviors and poor adherence to treatment are associated with negative stereotypes and attitudes of healthcare providers. In this study, we examined the effects of a brief psychoeducational program on reducing stigma in pre-clinical medical students. METHODS: One hundred and two pre-clinical medical students (20-23 years old) were randomly assigned to face-to-face contact + educational lecture (n = 51) condition or video-based contact + educational lecture (n = 51) condition. Measures of pre-clinical medical students' mental illness-related stigma using the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) were administered at pre-, post-treatment, and 1-month follow-up. RESULTS: A 2 (condition: face-to-face contact + educational lecture, video-based contact + educational lecture) by 3 (time: pre-treatment, post-treatment, and 1-month follow-up) mixed model MANOVA was conducted on the Attitudes, Disclosure and Help-Seeking, and Social Distance OMS-HC subscales. Participants' scores on all subscales changed significantly across time, regardless of conditions. To determine how participants' scores changed significantly over time on each subscale, Bonferroni follow-up comparisons were performed to access pairwise differences for the main effect of time. Specifically, pairwise comparisons produced a significant reduction in Social Distance subscale between pre-treatment and post-treatment and between pre-treatment and 1-month follow-up, and a significant increase between post-treatment and 1-month follow-up, regardless of conditions. With respect to the Attitudes and Disclosure and Help-Seeking subscales, pairwise comparisons produced a significant reduction in scores between pre-treatment and post-treatment and a significant increase between post-treatment and 1-month follow-up. CONCLUSIONS: Our findings provide additional evidence that educational lecture on mental illness, coupled with either face-to-face contact or video-based contact, is predictive of positive outcomes in anti-stigma programs targeting future healthcare providers.

Psychometric evaluation of the Malay version of the Montgomery- Asberg Depression Rating Scale (MADRS-BM).

BACKGROUND: This study examines the psychometric properties of the Malay version of the Montgomery-Ǻsberg Depression Rating Scale (MADRS-BM). METHODS: A total of 150 participants with (n = 50) and without depression (n = 100) completed the self-rated version of the Montgomery-Ǻsberg Depression Rating Scale (MADRS-S), the Malay versions of the MADRS-BM, the Beck Depression Inventory-II (BDI-II-M), the General Health Questionnaire-12 (GHQ-12), and the Snaith-Hamilton Pleasure Scale (SHAPS-M). RESULTS: With respect to dimensionality of the MADRS-BM, we obtained one factor solution. With respect to reliability, we found that internal consistency was satisfactory. The scale demonstrated excellent parallel form reliability. The one-week test-retest reliability was good. With respect to validity, positive correlations between the MADRS-BM, BDI-II-M, and the GHQ and negative correlation between the MADRS-BM and SHAPS-M provide initial evidence of MADRS-BM's concurrent validity. After adjusting for age, gender, ethnicity, educational level, and marital status, individuals with depression significantly reported higher MADRS-BM scores than did individuals without depression. Hence, there is additional evidence for concurrent validity of the MADRS-BM. Cut-off score of 4 distinguished individuals with depression from individuals without depression with a sensitivity of 78 % and a specificity of 86 %. CONCLUSIONS: The MADRS-BM demonstrated promising psychometric properties in terms of dimensionality, reliability, and validity that generally justifies its use in routine clinical practice in Malaysia.

The effects of connectedness on health-promoting and health-compromising behaviors in adolescents: evidence from a statewide survey.

Using a social ecological perspective, we examined the effects of connectedness in multiple domains on health-promoting and health-compromising behaviors among Asian American (AA), Pacific Islander (PI), and Caucasian/White American (WA) adolescents in California. After adjusting for age, gender, and socioeconomic status, the following consistent results emerged across the three ethnic groups: (a) community connectedness increased the odds of physical activity; (b) internal, family, and school connectedness decreased, whereas friend connectedness increased, the odds of substance use; and (c) internal and family connectedness decreased the odds of violent behavior. We also found specific ethnic variations pertaining to the effects of connectedness. Friend connectedness increased the odds of violent behavior for AAs and WAs, but not for PIs. Meanwhile, community connectedness increased the odds of substance use and violent behavior for AAs and PIs, but decreased the odds of these behaviors for WAs. Findings for healthy dietary behavior were inconsistent across ethnic groups and connectedness domains. Our overall findings suggest that the effects of connectedness were more salient for health-compromising behaviors than for health-promoting behaviors. Health prevention and intervention efforts in adolescents could target the role of their connectedness to their multiple social domains.

The linguistic and construct validity of the Malay version of the Coping Self-Efficacy Scale (CSES-My): Evidence from a sample of Malaysian parents of children with leukemia or lymphoma.

Background: Parents of children with hematological cancers such as leukemia and lymphoma need to cope with stress related to their child's diagnosis. The Coping Self-Efficacy Scale is a widely used and validated tool to measure an individual's confidence in dealing with stressful situations. Appropriate translation and validation are needed to produce a localized language version suitable for Malaysian contexts. Objective: The study aimed to examine the linguistic and construct validity of the Malay version of the Coping Self-Efficacy Scale (CSES-My) among parents of children with hematological cancer. Methods: The CSES-My was created through a sequential series of steps, starting with the translation of the original English version, followed by cultural adaptation, and then cognitive interviewing. The 26-item CSES-My was self-administered in a sample of parents of children with leukemia and lymphoma from October 2021 until February 2022. They were recruited via online or face-to-face methods. Exploratory factor analysis was performed to examine the construct validity of the CSES-My. Results: A total of 165 complete responses were analyzed. The scale has two factors, including Personal Coping and Social Coping, accounting for 58.3% of the variance. Personal Coping (19 items, Cronbach's alpha = 0.958) represented the respondents' self-efficacy for independently executing coping strategies, whether through solving problems or changing the way they think about the situation. Social Coping (6 items, Cronbach's alpha = 0.867) represented their confidence in executing coping strategies, which involved using social resources such as seeking external support, distraction, and avoiding loneliness. Conclusions: The CSES-My had reliable and valid psychometric properties, providing evidence for its utility in evaluating coping self-efficacy among parents of children with leukemia or lymphoma in Malaysia. The CSES-My is a valuable tool for nurses and other healthcare professionals investigating coping self-efficacy in Malay-speaking populations, and it may also aid in the development of future coping interventions.

Development and user evaluation of an online caregiver education resource for Malaysian parents of children with leukemia or lymphoma.

Objective: Malaysian parents of children diagnosed with leukemia or lymphoma stand to benefit from a comprehensive Malay-language online resource, complementing existing caregiver education practices. This study aimed to develop and assess the efficacy of e-Hematological Oncology Parents Education (e-HOPE), an online caregiver education resource in Malay, designed to enhance the knowledge of parents with children diagnosed with leukemia or lymphoma in Malaysia. Methods: A user profile and topic list were established based on previous needs analysis studies. Content was developed for each identified topic. An expert panel assessed the content validity of both informational content and activity sections. Subsequently, the contents were presented via a learning management system to parents of children newly diagnosed with leukemia or lymphoma. Parents evaluated the quality of e-HOPE using the Website Evaluation Questionnaire (WEQ) after an 8-week period. Results: The scale content validity index (S-CVI/Ave) achieved 0.996 for informational content and 0.991 for the activity section. Sixteen parents provided evaluations of e-HOPE after an 8-week usage period. Mean WEQ scores for various dimensions ranged from 4.23 for completeness to 4.88 for relevance. Conclusions: E-HOPE was meticulously designed and developed to offer Malaysian parents a Malay-language resource complementing current caregiver education practices. It exhibited strong content validity and received positive user ratings for quality. Further assessment is warranted to evaluate its effectiveness in supporting parents of children with leukemia or lymphoma. The resource is anticipated to enhance information accessibility and support for Malaysian parents facing hematological cancers in their children. Trial registration: Clinicaltrials.govNCT05455268.

The Dual Systems Model-Impulsivity and Narcissism as the Reflexive System and Self-Regulation as the Reflective System-of Smartphone Addiction.

The exploration of underlying mechanisms leading to the development of smartphone addiction has been limited, with only a few studies incorporating theories to provide explanations. Drawing upon the Dual Systems Model, this study tested the hypothesis that the reflective system of self-regulation would mediate the relation between the reflexive system of impulsivity and narcissism, and smartphone addiction in a sample of 298 undergraduate students. Participants completed a self-administrated web-based questionnaire containing measures of impulsivity (the Barratt Impulsiveness Scale), narcissism (the Narcissistic Personality Inventory), self-regulation (the Self-Regulation Scale), and smartphone addiction (the Smartphone Addiction Inventory). The findings from structural equation modeling revealed that self-regulation served as a significant mediator between impulsivity and smartphone addiction, as well as between narcissism and smartphone addiction. These findings offer insights that can contribute to the development of interventions and strategies that target impulsivity and narcissism by enhancing self-regulation skills.

Risk factors for early TB treatment interruption among newly diagnosed patients in Malaysia.

TB treatment interruption has resulted in delayed sputum conversion, drug resistance, and a high mortality rate and a prolonged treatment course, hence leading to economic and psychosocial affliction. To date, there are limited studies investigating the physico-social risk factors for early treatment interruptions. This prospective multicenter cohort study aimed to investigate the risk factors for early treatment interruption among new pulmonary tuberculosis (TB) smear-positive patients in Selangor, Malaysia. A total of 439 participants were recruited from 39 public treatment centres, 2018-2019. Multivariate Cox proportional hazard analyses were performed to analyse the risk factors for early treatment interruption. Of 439 participants, 104 (23.7%) had early treatment interruption, with 67.3% of early treatment interruption occurring in the first month of treatment. Being a current smoker and having a history of hospitalization, internalized stigma, low TB symptoms score, and waiting time spent at Directly Observed Treatment, Short-course centre were risk factors for early treatment interruption. An appropriate treatment adherence strategy is suggested to prioritize the high-risk group with high early treatment interruption. Efforts to quit smoking cessation programs and to promote stigma reduction interventions are crucial to reduce the probability of early treatment interruption.

Evaluating the Change Process of a Brief Cognitive Behavior Therapy Workshop for Psychological Distress Among Primary Care Self-Referrals in Selangor, Malaysia.

Despite the high prevalence of psychological distress in primary care, only a limited number of individuals can benefit from early and evidenced-based psychological approach. Barriers to help-seeking attributable to stigma, lack of proper care pathway to evidence-based psychological interventions, and a high volume of primary care attendees are among the factors that contribute to the inadequate psychological treatments. This study examined the implementation of a change process using a brief cognitive behavioral therapy (b-CBT) workshop as a potential approach in managing psychological distress among 73 primary care self-referrals using purposive sampling. One-way repeated-measures multivariate analysis of variance (ANOVA) was used to analyze changes in psychological distress within a non-randomized quasi-experimental study. Results revealed significant differences in psychological distress using Depression, Anxiety, and Stress Scale-21 items at three time points (pre-intervention, post-intervention, and 1-month follow-up). Implementation of the b-CBT workshop showed positive changes for psychological distress, suggesting the possibility of integrating brief, non-stigmatized, and evidence-based psychological approach at the primary care level. However, the self-referral characteristics of the attendees remain unknown. Factors such as potential feasibility, participant's usability and satisfaction, and implementation of b-CBT workshop to improve psychological distress are discussed in this study.

Translation and Validation of the Malay Version of the WHO-5 Well-Being Index: Reliability and Validity Evidence from a Sample of Type 2 Diabetes Mellitus Patients.

The translation and validation process of the WHO-5 Well-Being Index (WHO-5) into Malay is still not yet available. This study is the first psychometric evaluation of the Malay version of the WHO-5 in a sample of 127 primary care patients with type 2 diabetes mellitus. We evaluated the internal consistency and 5-week test-retest reliability of the WHO-5 Malay, and three aspects of its validity-first, the factorial validity in relation to the factor structure of the WHO-5 Malay; second, the concurrent validity in relation to depression and diabetes-related distress; and third, the convergent validity in relation to diabetes management self-efficacy and diabetes self-care behaviors. This study had two phases. Phase 1 involved the translation of the WHO-5 into Malay language following established procedures, whereas Phase 2 involved the validation of the WHO-5 Malay. Excellent internal consistency and 5-week test-retest reliability estimates were obtained. The factorial validity of the WHO-5 was found to be unidimensional. As for concurrent validity, the WHO-5 Malay was found to be negatively correlated with depression and diabetes-related distress. The WHO-5 was found to be correlated with diabetes management self-efficacy and diabetes self-care behaviors, thereby establishing convergent validity. The WHO-5 Malay has reliable and valid psychometric properties and represents a promising tool that informs healthcare providers in making effective and holistic diabetes management.

Development and Validation of a Caregiving Knowledge Questionnaire for Parents of Pediatric Leukemia and Lymphoma Patients in Malaysia.

Introduction Validated tools to measure caregiving knowledge among parents of children with hematological cancers are needed to measure the clinical outcome of caregiver interventions. This study reports the development and validation of the Hematological Oncology Parents Education Caregiving Knowledge Questionnaire (HOPE-CKQ) among Malaysian parents of pediatric leukemia and lymphoma patients. Methods Initially, 60 items on caregiving knowledge were developed based on a qualitative needs assessment study. Content validity was evaluated using item content validity index (I-CVI) and scale content validity index (S-CVI/Ave). Parents of pediatric leukemia and lymphoma patients were invited to complete the 60-item version of the HOPE-CKQ. Exploratory factor analysis (EFA) using polychoric correlation resulted in an 18-item version of HOPE-CKQ. Confirmatory factor analysis (CFA) was used to verify the factor structure. Known-group validity was tested by comparing the scores among different levels of parent education. Results The I-CVI ranged from 0.83 to 1.00 whereas the S-CVI/Ave was 0.99, indicating good content validity. A total of 167 complete responses were analyzed for factor analysis. EFA using polychoric correlations resulted in a single-factor structure consisting of 18 items. CFA confirmed that the 18-item single-factor HOPE-CKQ model had a good fit for the data. The internal consistency reliability was good (α=0.80). Parents with tertiary education level had higher caregiving knowledge (M=12.61, SD=3.37) compared to parents with secondary education and below (M=10.33, SD=3.80) (t=3.58, p<0.001). Conclusions The 18-item HOPE-CKQ is valid and reliable for use to measure caregiving knowledge among pediatric leukemia and lymphoma parents. This tool may be considered to measure caregiving knowledge in future preventive and intervention programs.

Effectiveness of Online Mindfulness-Based Intervention (iMBI) on Inattention, Hyperactivity-Impulsivity, and Executive Functioning in College Emerging Adults with Attention-Deficit/Hyperactivity Disorder: A Study Protocol.

Attention-deficit/hyperactivity disorder (ADHD), a common neurodevelopmental disorder, often persists into adulthood. In Malaysia, the prevalence rate of hyperactivity symptoms is highest among Chinese Malaysians. There are limited evidence-based treatment options targeting the core symptoms of ADHD, as well as executive functioning. In addition, conventional psychotherapeutic approaches for adults with ADHD have been found to be highly labor-intensive. The present study will evaluate the effectiveness of an online mindfulness-based intervention to reduce inattention and hyperactivity-impulsivity and improve executive functioning among Chinese Malaysian college emerging adults with ADHD. Informed by established literature, we will design an 8-week online mindfulness-based intervention (i.e., iMBI). We will conduct a two-arm randomized controlled trial comparing an iMBI plus treatment-as-usual group (n = 54) and an enhanced treatment-as-usual control group (n = 54). Outcome measures of inattention, hyperactivity-impulsivity, and executive functioning will be collected at baseline, immediately post-intervention, and 1-month post-intervention. The findings of the present study will not only demonstrate the implementation of iMBI as a new treatment modality but also inform practitioners on the effectiveness of iMBI in reducing the burden of adults living with ADHD.

Psychometric Properties of the Malay Version of the Internet Gaming Disorder Scale-Short Form (IGDS9-SF-M): Evidence from a Sample of Malaysian Undergraduates.

In recent years, increased interest in Internet Gaming Disorder has led to the development of the Internet Gaming Disorder Scale-Short Form. Translation and subsequent validation of such a scale are important for cross-cultural use. The aim of the present study was to examine the psychometric properties (factor structure, reliability, and validity) of the Malay Version of the Internet Gaming Disorder Scale-Short Form using a sample of Malaysian undergraduates. The present sample included 137 Malaysian undergraduates. Participants completed a self-administered online survey containing demographic items, the Malay Version of the Internet Gaming Disorder Scale-Short Form, the Problematic Online Gaming Questionnaire-Short Form, and the Malay Version of the Internet Addiction Test. The present findings confirm the one-factor model of the Malay Version of the Internet Gaming Disorder Scale-Short Form. Good reliability, as measured by Cronbach alpha, was found for the Malay Version of the Internet Gaming Disorder Scale-Short Form. The Malay Version of the Internet Gaming Disorder Scale-Short Form has demonstrated concurrent validity by significantly correlating with the Problematic Online Gaming Questionnaire-Short Form as well as demonstrated convergent validity with respect to the Malay Version of the Internet Addiction Test. The Malay Version of the Internet Gaming Disorder Scale-Short Form is a reliable and valid tool for assessing Internet Gaming Disorder in Malaysian undergraduates. As more research is still needed to confirm the status of Internet Gaming Disorder as a formal disorder, it is hoped that the Malay Version of the Internet Gaming Disorder Scale-Short Form can facilitate future research examining antecedents and consequences of Internet Gaming Disorder in a Malaysian setting.

The Cross-Sectional Relations of COVID-19 Fear and Stress to Psychological Distress among Frontline Healthcare Workers in Selangor, Malaysia.

Previous pandemics have demonstrated short and long-term impacts on healthcare workers' mental health, causing knock-on effects on patient care and professional functioning. Indeed, the present COVID-19 pandemic has created unprecedented disruption in social interactions and working conditions. Malaysia has been under the Recovery Movement Control Order since June 2020; however, with the upsurge of cases, healthcare workers face pressure not only from working in resource-deprived settings but also from the increasing patient load. The primary objective of the present study was to examine the cross-sectional relationship of COVID-19 fear and stress to psychological distress (operationalized as anxiety and depression) in healthcare workers. The present sample included 286 frontline healthcare workers from three hospitals in Selangor, Malaysia. Self-administered questionnaires containing sociodemographic and occupational items, the Malay versions of the Coronavirus Stress Measure scale, the Fear of Coronavirus-19 scale, the Generalized Anxiety Disorder-7, and the Patient Health Questionnaire-9 were distributed via online platforms. Hierarchical multiple regression findings suggest that age, shift work, and COVID-19 stress consistently predicted anxiety and depression among frontline healthcare workers after adjusting for sociodemographic and occupational variables. The present findings suggest that frontline healthcare workers are not only inoculated against COVID-19 itself but also against the psychological sequelae of the pandemic.

Are Malaysian Youths Overdependent on the Internet?: A Narrative Review.

Overdependence on the internet is a grave concern that has enveloped Malaysian youths which could lead to a variety of sequelae. This narrative review aims to determine the definition of internet overdependence and its associated factors, as well as the potential preventive and treatment strategies for internet overdependence. From the literature, internet overdependence is regarded as a 3-factor model encompassing salience, self-control failure, and serious consequences. Sociodemographic factors such as age, gender, and ethnicity, as well as psychosocial factors such as depression, anxiety, stress, and loneliness, were found to be associated with internet overdependence among Malaysian youths. A multimodal treatment approach is recommended by the implementation of various types of treatments, integrating disciplines such as pharmacology, psychotherapy, and family counseling. Despite various terminologies being used and unclear conceptualization of its nomenclature, overdependence on the internet is prevalent among youths in Malaysia. Future research should go toward establishing a clear definition of its terminology and attaining more robust evidence on treatment strategies.

Relations of Bedtime Mobile Phone Use to Cognitive Functioning, Academic Performance, and Sleep Quality in Undergraduate Students.

The present cross-sectional study examined the relations of bedtime mobile phone use to cognitive functioning, academic performance, and sleep quality in a sample of undergraduate students. Three hundred eighty-five undergraduate students completed a self-administered questionnaire containing sociodemographic variables, bedtime mobile phone use, the Pittsburgh Sleep Quality Index, and the Cambridge Neuropsychological Test Automated Battery (attention and verbal memory). At bivariate level, increased scores in bedtime mobile phone use were significantly correlated with decreased scores in academic performance and sleep quality. Our multivariate findings show that increased scores in bedtime mobile phone use uniquely predicted decreased scores in academic performance and sleep quality, while controlling for gender, age, and ethnicity. Further untangling the relations of bedtime mobile phone use to academic performance and sleep quality may prove complex. Future studies with longitudinal data are needed to examine the bidirectional effect that bedtime mobile phone use may have on academic performance and sleep quality.