Body appreciation and mindful eating in Lebanese adults: the mediating role of psychological distress.

A gap in the literature exists about the associations between adaptive eating patterns like mindful eating, body appreciation and psychological distress within the Lebanese population. The current culture of acceptance and increased emphasis on wellbeing elicits interest in studying body acceptance and its correlates. The aim of the current study is to assess the mediating effect of psychological distress in the association between body appreciation and mindful eating behaviors among a sample of Lebanese adults. This cross-sectional study enrolled 465 participants. Men and women over the age of 18 were eligible to participate. Then, initial participants were asked to recruit other participants they know. Individuals who consented took an online questionnaire that contained the following scales: a section collecting sociodemographic information, Mindful Eating Behavior Scale, Depression Stress Anxiety Scale (DASS-8) and Body Appreciation (BAS-2). The results of the mediation analysis showed that psychological distress fully mediated the associations between body appreciation and eating with awareness/eating without distraction. Higher body appreciation was significantly associated with less psychological distress, whereas higher psychological distress was significantly associated with less eating with awareness/eating without distraction. However, body appreciation was not associated with eating with awareness/eating without distraction respectively. These findings could guide further research on different categories of adaptive eating patterns and positive body variables within the Lebanese population.

The moderating effect of psychological distress in the association between temperaments and dark future among young adults.

OBJECTIVE: The aim of the current study is to evaluate the moderating effect of psychological distress variables, depression, anxiety and stress on the relationship between affective temperaments and future anxiety, assessed with the Dark Future scale. METHODS: Lebanese adults from all districts/governorates of Lebanon participated in this cross-sectional study. The data was collected through a questionnaire including: a section about sociodemographic characteristics, the Dark Future scale (DFS), the Depression Anxiety Stress Scale (DASS-8) and the Affective Temperament Scale (TEMPS-M). RESULTS: The interaction irritable temperament by psychological distress (p = .007) was significantly associated with dark future; at low levels of psychological distress, more irritable temperament (Beta = 0.16) was significantly associated with more dark future. The interaction anxious temperament by psychological distress (p = .010) was significantly associated with dark future; at low (Beta = 0.34), moderate (Beta = 0.25) and high (Beta = 0.15) levels of psychological distress, more anxious temperament was significantly associated with more dark future. CONCLUSION: The nature of the associations among depression, anxiety and stress, specific temperaments and anxiety towards the future in a sample of Lebanese individuals was clarified. This is especially significant as Lebanese people live in circumstances that promote psychological distress and future anxiety such as dramatic economic and political crises, instability and lack of security in different aspects of life.

Caring for a Mentally Ill Patient at Home, Mental Health, Religiosity, and Spirituality and Their Association With Family Caregivers' Quality of Life in Lebanon.

Objective: To evaluate the effect of depression, anxiety, stress, insomnia, work fatigue, religiosity, and spirituality on quality of life (QOL) among family caregivers of people with mental Illness and those who care for family members without mental illness.Methods: A case-control study was conducted between July and September 2019 that enrolled 600 caregivers using a proportionate sample from all Lebanese governorates. Participants completed a 2-part questionnaire. The first part assessed sociodemographic and other characteristics and the second part comprised various scales including the Quality of Life 12-Item Short Form Health Survey, 9-Item Patient Health Questionnaire, Generalized Anxiety Disorder 7 Item, Perceived Stress Scale, Work Fatigue Inventory, Lebanese Insomnia Scale, Mature Religiosity Scale, and Spirituality Index of Well-Being.Results: Higher stress (P < .001), higher depression (P < .001), higher emotional work fatigue (P < .001), married parents compared to single (P = .026), having a child with an intellectual disability (P = .002), and sleep-wake disorders (P = .003) were significantly associated with lower physical QOL, whereas higher spirituality (P < .001) was associated with higher physical QOL. Higher insomnia (P = .01), higher anxiety (P = .017), higher mental work fatigue (P < .001), living with a patient having a mental psychiatric illness (P = .023), caregivers with a chronic disease (P = .040), and taking care of a child with depressive disorders (P = .027) were significantly associated with lower mental QOL, whereas higher spirituality was significantly associated with higher mental QOL.Conclusions: The care of a person with mental illness involves multiple challenges and problems, leading to negative impacts on the familial caregivers' mental health and magnified by the absence of sufficient support and awareness and training programs in Lebanon.Prim Care Companion CNS Disord 2023;25(4)22m03333. Author affiliations are listed at the end of this article.

Prevalence of Orthorexic Tendencies and Their Correlates Among Lebanese Patients with Cancer.

Individuals with cancer face daily challenges regarding diet and healthy lifestyle behaviors that may lead them to better health. This quest for improved health can be exaggerated in unhealthy ways if it is not approached with moderation as occurs with a condition called orthorexia nervosa (ON). Our aim in this study was to determine the prevalence of ON tendencies and their behavioral correlates among Lebanese adults with cancer. This was a monocentric cross-sectional study, conducted between December 2021 and February 2022, involving 366 patients. We collected data via telephone and recorded answers online on a Google form. We used the Düsseldorf Orthorexia Scale (DOS) to assess orthorexic behaviors, and we checked for behavioral correlates of orthorexia through a linear regression model using the DOS score as the dependent variable. On the DOS scale, we found that 9% of these participants showed possible ON tendencies, whereas 22.2% had definite ON tendencies. Factors associated with having more ON tendencies were (a) receipt of hormonotherapy, (b) being female and (c) having breast cancer. Having prostate cancer was significantly associated with fewer ON tendencies. Our results should help improve the management of patients with cancer through programs to increase patient awareness and education.

Association Between Personality Traits and Procrastination and the Mediating Effect of Emotional Intelligence in Lebanese Medical Students.

Objective: To investigate the relationship between personality traits and procrastination and the mediating role of emotional intelligence (EI) among a sample of Lebanese medical students.Methods: This cross-sectional study was conducted between June and December 2019. A total of 296 students filled out a questionnaire that consisted of sociodemographic characteristics and the following scales: Procrastination Assessment Scale for Students, Big Five Personality Test, and Quick Emotional Intelligence Self-Assessment Scale.Results: Since no bivariate associations were found between sociodemographic variables, they were not included in the mediation analysis. EI mediated the association between neuroticism and procrastination. Neuroticism was significantly associated with lower EI (P < .01) and lower procrastination (P < .001), whereas higher EI was significantly associated with lower procrastination (P < .001). EI mediated the association between openness to experience and procrastination. Openness to experience was significantly associated with higher EI and higher procrastination (P < .001), whereas higher EI was significantly associated with lower procrastination (P < .001).Conclusions: The results emphasize the role of EI in personality and procrastination and highlight its importance in clinical settings. It is important for clinicians, especially school and university counselors, to identify risk factors beyond low levels of adaptive personality traits such as EI within the clinical setting to reduce irrational procrastination and improve academic performance.

The moderating effect of emotion regulation in the association between coping strategies and resilience in Lebanese adults.

OBJECTIVES: To evaluate the psychometric properties of the Coping Strategies Inventory-Short Form and investigate the relationship between coping strategies and resilience, taking into consideration the moderating role of emotion regulation. METHODS: This cross-sectional study was carried out between May and July 2022. A total of 387 participants was recruited through convenience sampling through several areas in Lebanon governorates. The data was collected through an online questionnaire containing the following sections: sociodemographic information about the participants, Connor-Davidson Resilience Scale (CD-RISC), Emotion Regulation Questionnaire and Coping Strategies Inventory-Short Form. RESULTS: The confirmatory factor analysis results confirmed the four-factor structure of the Coping Strategies Inventory-Short Form, with no measurement invariance across gender. In individuals with high problem-focused engagement and emotion-focused engagement, lower expressive suppression was significantly associated with more resilience. In individuals with high problem-focused disengagement, having high expressive suppression was significantly associated with less resilience. CONCLUSION: The current study provides novel and distinct findings regarding the relationship between emotion regulation, coping strategies and resilience in all of their dimensions. Furthermore, the present results provide insight on how a population under extreme stress receives and reacts to its reality.

Association between desire thinking and problematic social media use among a sample of Lebanese adults: The indirect effect of suppression and impulsivity.

BACKGROUND: Desire thinking, impulsivity and suppression are psychological variables that are intricately related to behavioral addictions. Bearing in mind the scarcity of data on desire thinking, impulsivity, thought suppression and pathological social media use in developing countries such as Lebanon, with the existing literature suggesting a heightened mental health burden associated with this problematic social media use, it becomes all the more important to elucidate their relationship. Our study aims at investigating the association between desire thinking and problematic social media use specifically, and to further test the effect of impulsivity and thought suppression in mediating the relation between the two distinct facets of desire thinking and problematic social media use. METHODS: A cross-sectional study was carried out between November 2021 and March 2022 using a sample of 414 community-dwelling participants aged above 18 years from all Lebanese districts. The data was collected through an online questionnaire including a section about sociodemographic information, the Desire Thinking Questionnaire (DTQ), Impulsive Behavior Scale (S-UPPS-P), White Bear Suppression Inventory (WBSI) and Social Media Disorder Short Form (SMD). The tests used in the bivariate analysis to assess correlates of SMD were the Student t test to compare two means and the Pearson test to correlate two continuous scores. The PROCESS SPSS Macro version 3.4, model four was used to conduct the mediation analysis. RESULTS: Desire thinking was shown to correlate with increased social media use. Moreover, we found that suppression and lack of premeditation mediated the association between verbal perseveration and social media use disorder whereas suppression and urgency mediated the association between imaginal prefiguration and social media use disorder. CONCLUSION: This study provides new insight on a topic of increasing public health concern. Although understudied to date, suppression and impulsivity differentially mediate the influence of both facets of desire thinking on problematic social media use disorder. The current findings point to the highly pervasive issue of social media use disorder and the need to investigate underlying psychological factors that aggravate it to better profile and support individuals struggling with it.

Does self-esteem mediate the association between perfectionism and mindfulness among Lebanese university students?

OBJECTIVES: To evaluate the associations between mindfulness, self-esteem and perfectionism in a Lebanese sample of university students, as well as the indirect effect of self-esteem between mindfulness and perfectionism was investigated. METHODS: This cross-sectional study was carried out between July and September 2021. A total of 363 university students were recruited through convenience sampling through several universities in Lebanon's governorates. An online survey that included a part that collected sociodemographic information, the Freiburg Mindfulness Inventory to assess mindfulness, the Rosenberg Self-Esteem Scale to assess self-esteem and the Big Three Perfectionism Scale to assess perfectionism was completed by participants. RESULTS: Higher self-esteem (Beta = 1.30) was significantly associated with more mindfulness, whereas higher self-critical perfectionism (Beta = - 0.61) was significantly associated with less mindfulness. Self-esteem mediated the association between self-critical and narcissistic perfectionism and mindfulness. More perfectionism was significantly and directly associated with less mindfulness and lower self-esteem, whereas higher self-esteem was significantly associated with more mindfulness. CONCLUSION: This study provides valuable findings that enable practitioners to effectively identify people needing interventions to improve psychological health through mindfulness, self-esteem and perfectionism. The conclusions that can be deduced from this study can help educational psychologists and counselors guide university students towards effective mindfulness practices that can increase self-esteem levels and balance maladaptive perfectionism that can cause distress and impairment in the social and academic settings.

Association of Social Media Use Disorder and Orthorexia Nervosa Among Lebanese University Students: The Indirect Effect of Loneliness and Factor Structure of the Social Media Use Disorder Short Form and the Jong-Gierveld Loneliness Scales.

The current study aims to examine the relationship between Social Media Use Disorder (SMUD) and Orthorexia Nervosa (ON), and evaluate the indirect effect of loneliness in this association. This cross-sectional study was carried out between July and September 2021. A total of 363 university students were recruited through convenience sampling through several universities in Lebanon's governorates. Data about information about the social media applications mostly used (Instagram, Facebook, Twitter, etc.), the number of times of entry to social media applications, the time spent on these applications, ON, loneliness and SMUD, were also collected. The Mplus v.7.2 software was used to estimate categorical confirmatory factor analyses (CFA) of the SMD and loneliness scales. The one-factorial model of the SMD scale fitted well according to χ2/df (69.71/27 = 2.58), TLI (.967), CFI (.956), and RMSEA values (.066; CI [.047-.085]; pclose = .079). The one-factorial model of the loneliness scale fitted well according to χ2/df (10.30/5 = 2.06) TLI (=0.97), CFI (=0.98), and RMSEA values (=0.054; CI [0.000-0.101]; pclose = 0.379). When entering the social media applications and time spent on these applications as independent variables in a first regression model, using Instagram (Beta = 2.73), using Tumblr (Beta = 3.22), spending 30-60 minutes per day on social media apps compared to less than 30 minutes (Beta = 2.33), higher physical activity index (Beta = 0.04) and loneliness (Beta = 0.67) were significantly associated with more ON. When entering the SMUD score as an independent variable in a second regression model, the results showed that higher SMUD (Beta = 0.50) was significantly associated with more ON. Also, loneliness played a partial indirect role in the association between SMUD and ON (by 16%). The current results can help mental health professionals better detect these potential psychological disorders and might help improve future treatment of issues related to ON and SMUD.

Association between impulsivity and healthy orthorexia: any moderating role of personality traits?

The study objectives were to investigate correlates of healthy orthorexia (HeOr), its relation with impulsivity, and the moderating role of adaptive personality traits among a Lebanese adult sample. The sample was recruited from seven community pharmacies, from the five districts in Lebanon, chosen from a list provided by the Lebanese Order of Pharmacists in a convenient way. The questionnaire included the Teruel Orthorexia Scale (TOS) to measure HeOr, Big Five Inventory (BFI) to assess adaptive personality traits, and the I-8 scale for impulsivity. Higher extraversion (B = -4.31) was significantly associated with lower healthy orthorexia. The interaction perseverance by extraversion was associated with higher healthy orthorexia; in those with higher perseverance, higher extraversion was associated with more healthy orthorexia. Our study presents findings that could be of significant clinical relevance in the future, especially with the interest increase in Orthorexia Nervosa prevalence, which subsequently prompts more research and intrigue about HeOr. Furthermore, it places healthy eating and consistent commitment to a healthy diet within a clearly defined scientific frame, on which further investigation can be based.

Is problematic social media use associated with higher addictions (alcohol, smoking, and waterpipe) among Lebanese adults?

PURPOSE: To evaluate the correlation between problematic social media use, alcohol use disorder, and smoking addiction through both cigarettes and waterpipe, among a sample of Lebanese adults. METHODS: This cross-sectional study was carried out between January and April 2019. It enrolled 461 residents of the community randomly selected from Lebanon's districts in a proportionate rate. RESULTS: Higher problematic social media use was significantly associated with more waterpipe addiction but not cigarette dependence and alcohol use disorder.

Association between impulsivity and orthorexia nervosa: any moderating role of maladaptive personality traits?

OBJECTIVES: To explore the possible moderating relation between impulsive behavior and maladaptive personality traits in regards to orthorexia nervosa (ON). METHODS: This cross-sectional study was conducted between July and December 2019 and recruited 519 Lebanese adults from seven community pharmacies randomly selected from a list provided by the Lebanese Order of Pharmacists. The Teruel Orthorexia Scale (TOS) was employed to assess orthorexic eating tendencies, the I-8 measured impulsivity and the Personality Inventory for DSM-5 (PID) evaluated maladaptive personality traits. RESULTS: Our results showed that, for I-8 subscales, only higher perseverance (B = 0.31) was significantly associated with higher ON. In regard to PID-5 subscales, only higher negative affect (B = - 0.34) was significantly associated with lower ON. Furthermore, significant interactions were found between personality traits and impulsivity to predict TOS-ON. CONCLUSION: The current results show that female gender, maladaptive personality traits and impulsivity present contributing factors regarding orthorexic eating. Certain impulsivity dimensions were confirmed to interact with personality traits in the prediction of orthorexic eating thereby highlighting possible risk factors and psychopathological mechanisms. LEVEL OF EVIDENCE: Level V, cross-sectional descriptive study.

Association between impulsivity and orthorexia nervosa / healthy orthorexia: any mediating effect of depression, anxiety, and stress?

BACKGROUND: There is a lack of studies investigating the possible mediating role of psychological factors, such as depression, anxiety and stress on orthorexic eating behaviors. Given that personality attributes might affect the manifestation of psychological disorders, it was hypothesized that depression, anxiety and stress mediate the relationship between impulsivity-related traits and orthorexic eating, noting that previous research had evaluated the role of depression as a mediator between impulsivity and other pathological eating behaviors. The study objectives were to explore the mediating effect of depression, anxiety, and stress, on impulsivity and orthorexia nervosa, and healthy orthorexia. METHODS: This cross-sectional study conducted between July and December 2019 recruited 519 Lebanese adults from seven community pharmacies randomly selected from a list provided by the Lebanese Order of Pharmacists. RESULTS: Our results showed that depression and anxiety were positively correlated with ON. We also found a notable gender difference in findings: higher anxiety and female gender were significantly associated with higher TOS healthy orthorexia, while higher stress was associated with lower TOS healthy orthorexia. Finally, higher urgency was associated with lower TOS healthy orthorexia, while higher perseverance was significantly associated with higher TOS healthy orthorexia. Depression and anxiety partially mediated the association between perseverance and ON while anxiety and stress partially mediated the association between urgency and healthy orthorexia. CONCLUSION: Our study suggests that depression, anxiety and stress play a mediating role between impulsivity and orthorexia nervosa/healthy orthorexia. Our findings provide a ground for future investigations of impulsive behaviors, psychopathology, and orthorexia in different populations.

Correlates of bullying perpetration among Lebanese adolescents: a national study.

BACKGROUND: Presently, 1 in 4 Lebanese adolescents is involved in bullying, with 12% being perpetrators. In Lebanon, around 90% of bullying incidents occur in schools. Given the lack of studies tackling bullying perpetration in Lebanon, this study aims to identify and target risk factors of bullying perpetration among Lebanese adolescents, which would serve future prevention and intervention programs. METHODS: This cross-sectional study took place between January and May 2019 in a proportionate random sample of schools from all Lebanese districts. A total of 1810 (90.5%) out of 2000 students accepted to participate. RESULTS: Results showed that 831 (49.1%, CI: 0.46-0.51) participants had bullied other people. A stepwise linear regression, using as the dependent variable the bullying perpetration score, showed that higher psychological (ß = 0.12; 95% CI 0.083-0.176), sexual (ß = 0.26; 95% CI 0.128-0.411), neglect (ß = 0.08; 95% CI 0.051-0.120), physical abuse (ß = 0.13; 95% CI 0.036-0.235), higher internet addiction (ß = 0.07; 95% CI 0.057-0.097), higher social fear (ß = 0.10; 95% CI 0.075-0.140), and having separated parents (ß = 1.60; 95% CI 0.561-2.650) were significantly associated with more bullying perpetration. Higher social avoidance (ß = - 0.03; 95% CI -0.062- -0.003) was significantly associated with less bullying perpetration. CONCLUSION: The results revealed that bullying perpetration is significantly associated with parental status, child abuse, internet addiction, and social fear. Educational and relevant governmental institutions could use our findings to develop and implement efficient bullying prevention and intervention programs for all involved parties.

Association of characters and temperaments with cigarette and waterpipe dependence among a sample of Lebanese adults.

It was discovered that the relation between certain personality traits and nicotine dependence differs among ethnicities and cultures; therefore, this study was conducted to determine which temperaments and personality traits are associated with smoking dependence in order to contribute to the development of effective and targeted interventions for smoking dependence within the Lebanese population. A cross-sectional study was carried out between March and April 2020 among a sample of Lebanese adults from all Lebanese governorates. The sample included (N = 501) divided as follows: 62 (12.4%) nonsmokers, 37 (7.4%) cigarette smokers, 266 (53.1%) waterpipe smokers, and 136 (27.1%) mixed smokers. Higher cooperativeness (B = - 0.03) was significantly associated with lower waterpipe dependence. High vs. low education level (B = - 0.97), female gender compared to males (B = - 1.07), higher cooperativeness (B = - 0.01), and higher self-transcendence (B = - 0.01) were significantly associated with lower cigarette dependence, whereas higher age (B = 0.03) was significantly associated with higher cigarette dependence. A multinomial regression analysis, taking the smoking group as the dependent variable, showed that higher harm avoidance (aOR = 0.97) and novelty seeking (aOR = 0.97) were significantly associated with lower cigarette smoking. A high level of education vs. a low one (aOR = 8.85) was significantly associated with higher cigarette smoking. Higher self-transcendence was significantly associated with lower mixed smoking. Being married vs. single (aOR = 2.46) was significantly associated with higher odds of being a mixed smoker, whereas female gender compared to males (aOR = 0.41) was significantly associated with lower odds of being a mixed smoker. These results are pivotal in understanding the relationship between personality and smoking dependence.

Problematic social media use and mental health (depression, anxiety, and insomnia) among Lebanese adults: Any mediating effect of stress?

PURPOSE: To examine the association between problematic social media use with depression, anxiety, insomnia, and stress in a sample of young Lebanese adults. METHODS: This cross-sectional study was achieved between January and May 2019; 466 out of 600 adults completed the questionnaire. RESULTS: Higher problematic social media use was significantly associated with higher depression, anxiety, and insomnia, but not stress. Stress mediated the relation between depression, anxiety, insomnia, and problematic social media use. PRACTICAL IMPLICATIONS: This study showed that problematic social media use was associated with psychological disorders. Additional research is needed to identify and describe the potential causality between the use of social media and various mental health issues and the interplay between the social media network and other mental health factors.

Bullying victimization among Lebanese adolescents: The role of child abuse, Internet addiction, social phobia and depression and validation of the Illinois Bully Scale.

BACKGROUND: Both bullying victimization and perpetration were associated with depression, social phobia, physical and psychological child abuse and Internet addiction in Lebanon. The prevalence of bullying in Lebanon is alarming, with 50% of school-aged children and adolescents reporting being bullied at some point. The high rate of both bullying victimization can be reflective of the inefficacy of current prevention and intervention policies in targeting associated problematic individual and contextual factors. The objective of the present study was to analyze factors associated with bullying victimization and validate the Illinois Bully Scale among Lebanese adolescents. METHODS: This is cross-sectional study that took place between January and May 2019. We enrolled 1810 adolescents between 14 and 17 years of age. The Illinois Bully scale was used to measure bullying victimization. In order to ensure the adequacy of the sample with values greater than 0.8 - an indicator that component or factor analysis was useful for these variables - we used Kaiser-Meyer-Olkin (KMO) measurement. Statistical significance considered if the p-value < 0.05. RESULTS: The results showed that 841 (46.5%, CI: 44.1% - 48.7%) participants were classified as having been previously bullied. None of the bullying scale items was removed. Items on the bullying scale converged on a two-factor solution with Eigenvalues greater than 1, accounting for a total of 73.63% of the variance (Factor 1: bullying victimization; Factor 2: bullying perpetration; KMO = 0.899, Bartlett's sphericity test p < 0.001; αCronbach = 0.955). Having a separate parents (ORa = 3.08), Mild (ORa-4.71) to moderate (ORa = 3.84) internet addiction test, higher social fear (ORa = 1.50), higher psychological abuse (ORa = 3.59), higher child neglect (ORa = 2.21) and physical (ORa = 4.55) abuse were significantly associated with higher odds of being bullied. However, higher social avoidance (ORa = 0.49), poor (ORa = 0.20), fair (ORa = 0.94) and very good (ORa = 0.04) physical activity as compared to sedentary were significantly associated with lower odds of being bullied. CONCLUSIONS: Our findings attest that bullying victimization is likely to be associated with certain factors such as child abuse of all forms, Internet addiction, social fear and avoidance. In addition, the Illinois Bully Scale was validated in Lebanon. More attention should be paid to students vulnerable to bullying victimization, such as those with environmental or domestic problems, and adolescents with psychological disorders such as behavioral addictions.