Psychometric properties of an Arabic translation of the 10-item Connor-Davidson resilience scale (CD-RISC-10), the 8- and 10-item post-traumatic growth inventory-short form (PTGI-SF) scales.

BACKGROUND: Given their clinical significance and impact on stress response and their potential malleability, resilience and posttraumatic growth (PTG) should receive greater attention as relevant constructs in clinical and research practice in the Arab context. We aimed through the present study to test the psychometric properties of Arabic translations of the 10-item Connor-Davidson Resilience scale (CD-RISC-10), the 10-item and the 8-item Post-Traumatic Growth Inventory-Short Form (PTGI-SF) in a sample of Lebanese adults from the general population. METHODS: Three hundred eighty-seven Arabic-speaking participants (mean age = 26.17; 58.4% females) responded to a self-report web-based questionnaire. The forward and backward translation method was applied with the approval of the original developers of the scales. RESULTS: Confirmatory factor analysis indicated that fit of the one-factor model was acceptable, and all indices suggested that configural, metric, and scalar invariance was supported across gender for all the three scales. The CD-RISC-10, the 10-item and the 8-item PTGI-SF yielded a good internal consistency, with a McDonald's ω of .89, .95, and .93, respectively. Higher resilience and higher PTG were significantly and positively associated with greater cognitive reappraisal and lower emotion suppression, supporting convergent validity. CONCLUSION: We preliminarily suggest that these Arabic instruments are appropriate for use in Lebanese community adults to assess different positive responses after life crises, identify people with lack or low levels of resilience and growth who might need intervention, and monitor their response to therapy. Further cross-cultural validations should seek to extend their use in broader Arabic-speaking populations and settings.

Psychometric properties of an Arabic translation of the Big Three Perfectionism Scale-Short Form (BTPS-SF) in a community sample of adults.

BACKGROUND: Despite the high clinical relevance of the perfectionism construct as a transdiagnostic contributor to different mental health symptoms, and the recent burgeoning of research in this area across cultures in the past two decades, the Arab region was one of the cultural settings experiencing the slowest progress in this line of research. This study aimed to make a meaningful contribution to the literature by validating an Arabic-language version of the 16-item Big Three Perfectionism Scale-Short Form (BTPS-SF). In particular, we sought to examine structure and concurrent validity, internal consistency, and measurement invariance across gender groups. METHOD: A web-based, convenience sampling method was adopted to collect a sample of Arabic-speaking adults from the general population of Lebanon (N = 515; aged 27.55 ± 10.92 years; 69.9% females). The forward-backward method was applied in translating the Arabic version of the BTPS-SF. RESULTS: The examination of the internal structure, using Confirmatory Factor Analysis (CFA), demonstrated that the three-factor model (i.e., rigid, self-critical, and narcissistic perfectionism) fitted well to the data. All three factors of the Arabic 16-item BTPS-SF yielded excellent reliability estimates, with both Cronbach's alpha and McDonald's omega ranging from 0.83 to 0.86. Multi-group CFA revealed that fit indices showed no significant difference in model fit at the configural, metric, and scalar levels, thus suggesting that the factor loadings, pattern structure, and item intercepts are invariant across gender groups. Finally, BTPS-SF subscales scores correlated positively with psychological distress (i.e., depression, stress and anxiety), and inversely with subjective well-being, indicating an acceptable concurrent validity. CONCLUSION: The present findings allow us to conclude that the Arabic BTPS-SF permits to capture reliably and validly three main factors of perfectionism. We hope that providing this psychometrically sound scale will encourage its large use not only in empirical research, but also in clinical applications, including psychological screening and treatment monitoring.

Validation of the Arabic version of the cyberchondria severity scale 12 items (CSS-12-Ar) among a sample of Lebanese adults.

BACKGROUND: To the best of our knowledge, the Cyberchondria Severity Scale-12 (CSS-12) has not been translated into Arabic; therefore, our objective was to assess the psychometric properties of the Arabic version of the CSS (CSS-12-Ar) among a sample of Lebanese adults. METHODS: Participants were enrolled in January 2021. A confirmatory factor analysis (CFA) was carried out using the MPlus software v.7.2, reporting several goodness-of-fit indicators: Relative Chi-square (χ2/df), Root Mean Square Error of Approximation (RMSEA), Comparative Fit Index (CFI) and Tucker Lewis Index (TLI). To evaluate measurement invariance across gender, we conducted higher-order multiple group confirmatory analysis using lavaan software. RESULTS: 449 participants enrolled in this study (mean age: 24.34 ± 8.22 years, 70.6% females). Since the correlations between the four-factor model were very high (r > 0.8), we ran the higher-order CFA in which all first-order latent variables were loading a general factor. The analyzed model was well-fitted to the data χ2(50) = 173.34; p < 0.001; CFI = 0.926; RMSEA = 0.074 [0.062, 0.086]. The Cronbach's alpha values were good for the total score (0.92), as well as for excessiveness (0.80), distress (0.77), reassurance (0.81) and compulsion (0.76). The results provided evidence of full scalar invariance across gender. The comparison of latent mean scores revealed no significant differences across gender, in either the cyberchondria total score or its facets. The CSS-12 score was positively associated with anxiety (r = 0.10; p = 0.003) (convergent validity), OCD (r = 0.11; p = 0.016) and stress (r = 0.35; p < 0.001) (concurrent validity). CONCLUSION: The CSS-12-Ar was deemed a suitable scale to measure the severity of cyberchondria among Lebanese university students. We hope that researchers and clinicians can benefit now from this scale.

Psychometric properties of an Arabic translation of the Nine Item Avoidant/Restrictive Food Intake Disorder Screen (NIAS) in a community sample of adults.

BACKGROUND: No epidemiological data is yet available on Avoidant/Restrictive Food Intake Disorder (ARFID) in Arab countries, which may in part be due to the lack of measures available in Arabic language. This constitutes a major obstacle to further progress of our understanding of the nature, aetiology, course, treatment, and prevention of ARFID, especially as some evidence suggested that ARFID may vary across cultures and food environments. We aimed to contribute to the literature in the eating disorders field by examining the psychometric properties of an Arabic translation of the Nine Item ARFID Screen (NIAS). METHOD: This was a cross-sectional, web-based study. A total of 515 Lebanese community adults (mean age of 27.55 ± 10.92 years, 69.9% females) participated. The forward-backward method was adopted to translate the NIAS from English to Arabic. RESULTS: Confirmatory Factor Analyses provided evidence for the adequate fit indices for the three-factor model (i.e., Picky eating, Fear, and Appetite) and the 9-item version of the NIAS. An adequate reliability of the Arabic NIAS was achieved, with McDonald's ω ranging from .75 to .90 for the total score and all three subscores. Multi-group analyses demonstrated measurement invariance by sex (males vs. females) and weight groups (underweight/healthy weight [BMI ≤ 25] vs. overweight/obese [BMI > 25]) at the configural, metric, and scalar levels. Adequate patterns of correlations between the NIAS and measures of disordered eating symptoms, psychological distress and well-being were seen. In particular, fear was significantly associated with non-ARFID disordered eating symptoms. Appetite and Picky eating, but not Fear, were inversely correlated with well-being. All three NIAS subscores and the total score were positively correlated with psychological distress. CONCLUSION: Findings provided evidence that the Arabic NIAS is a short, valid and reliable self-report measure to screen for ARFID symptoms. In light of these findings, we recommend its use for clinical and research purposes among Arabic-speaking adults.

Avoidant/restrictive food intake disorder (ARFID) is an eating disorder characterized by food avoidance or dietary restriction associated with at least one of four consequences­­weight loss, nutritional deficiency, nutritional supplement dependence, and/or psychosocial impairment. The Nine Item ARFID Screen (NIAS) was developed as a screening measure to detect ARFID symptoms and has nine items with three subscales that map onto symptoms of each ARFID presentation. The NIAS have been translated into multiple languages but not yet validated in Arabic. To that end, we aimed to translate and validate the Arabic version of the NIAS in the present study, which would in turn facilitate improved research and clinical practices related to ARFID in Arabic-speaking nations. The present findings provide support for the psychometric properties of the Arabic version of the NIAS in examining ARFID in Arabic-speaking adults in Lebanon.

Psychometric properties of an Arabic translation of the multidimensional social support scale (MSPSS) in a community sample of adults.

BACKGROUND: There is a lack of methodologically strong measure to assess perceived social support among Arabic-speaking populations. Our main objective was therefore to examine the psychometric properties of an Arabic translation of the Multidimensional Social Support Scale (MSPSS) in a sample of Arabic-speaking Lebanese adults from the general population. METHODS: We adopted a cross-sectional design involving a convenience sample of 387 non-clinical Lebanese adults aged 26.17 ± 11.47 years (58.4% females). Participants were administered a web-based anonymous questionnaire containing the MSPSS, the 10-item Connor-Davidson Resilience Scale, and the Post traumatic growth Inventory-Short Form. The forward-backward translation method was applied. Confirmatory factor analysis (CFA) and gender invariance in the MSPSS were examined. McDonald's ω coefficients were calculated as internal consistency indicators. RESULTS: The Arabic MSPSS and its subscales have a high internal consistency with McDonald's ω values between 0.94 and 0.97. CFA indicated that fit of the three-factor model was acceptable. All indices suggested that configural, metric, and scalar invariance was supported across gender. Both genders exhibited no significant difference in all MSPSS dimensions. Convergent validity was supported by showing that all three MSPSS sub-scores and total score correlated significantly and positively with resilience and posttraumatic growth scores. CONCLUSION: Although further cross-cultural validations involving other Arab countries and communities are still needed, we preliminarily suggest that this scale is applicable to the broad Arabic-speaking people for the measurement of perceived social support in clinical and research contexts.

Validation of the Arabic version of the 35-item TEMPS-M in a community sample of adults.

BACKGROUND: To our knowledge, no brief version of the Temperament Evaluation in Memphis Pisa and San Diego (TEMPS-M) is available so far in the Arabic language, which might have resulted in limited research in this field from Arab countries. We aimed through this study to validate the 35-item TEMPS-M into the Arabic language in a sample of non-clinical Lebanese adults. METHODS: We used an online cross-sectional survey targeting non-clinical Lebanese adults from the general population. A confirmatory factor analysis was conducted to test the factorial structure of the TEMPS-M. RESULTS: All five temperament subscales achieved good/very good internal consistencies in the present study (depressive: α = 0.78, cyclothymic: α = 0.86, hyperthymic: α = 0.83, irritable: α = 0.87, and anxious: α = 0.87). The five-factor solution of the TEMPS-M displayed a good CFI of 0.94, TLI of .94 and a GFI of .95, but a poor RMSEA of .10 [90% CI .10, .11]. The five affective temperaments showed positive correlations with personality dysfunction domains, thus attesting for convergent validity. In addition, positive correlations between all affective temperament dimensions and anxiety/depression scores were found. We also tested for gender invariance, and found that configural, metric, and scalar invariance were supported across gender. CONCLUSION: Our data suggest that the psychometric properties of the Arabic TEMPS-M are good. Making this scale available in Arabic will hopefully encourage Arab researchers to investigate this under-explored topic in their countries, and advance knowledge on how culture impacts the prevalence, development and course of temperament.

Factors associated with posttraumatic growth: gratitude, PTSD and distress; one year into the COVID-19 pandemic in Lebanon.

Almost one year since the COVID-19 was declared a global pandemic, mental distress remains elevated with high prevalence of post-traumatic stress disorder (PTSD). Yet studies suggest these challenging circumstances might be conducive of post-traumatic growth (PTG). This study aims to investigate the factors associated with growth after the original trauma. A sample of 252 Lebanese adults filled an online survey to determine levels of PTG, PTSD and gratitude using validated self-rating scales. Participants also subjectively evaluated the sources of their distress such as the COVID-19 pandemic, the Beirut port explosion and/or their deteriorating financials. The PTGi-SF evaluated dimensions of growth while the IES-R_22 measured the degree of distress post-trauma. The GQ-6 was used to measure the proneness to experience gratitude daily. Results indicated 41% of participants scored above the cutoff for PTSD symptomatology. Yet, PTSD was positively correlated, alongside gratitude and accumulated subjective distress, with higher levels of PTG. A forward linear regression taking PTG scores as the dependent variable further showed that more gratitude (Beta = 0.57), a higher impact of events (Beta = 0.16), and knowing anyone who died from COVID-19 (Beta = 3.93) were significantly associated with more growth. The study highlights elevated levels of PTSD symptoms in a context of a global pandemic worsened by financial and socio-political instabilities. It mostly identifies personal factors, including high initial symptomatology post-trauma and gratitude, related to the capacity for growth in spite of these accumulating hardships. As such, it advocates the need to investigate and bolster silver linings amidst unprecedented traumas.

Self-critical perfectionism mediates the relationship between self-esteem and satisfaction with life in Lebanese university students.

BACKGROUND: The psychological mechanisms that underlie the relationship between self-esteem and life satisfaction remain unclear and not well-understood. We sought through the present study to test the hypothesis that perfectionism plays a significant mediating role in the association between self-esteem and satisfaction with life among Lebanese university students. METHODS: A cross-sectional study was performed in a sample of 363 students (61.7% females, mean age = 22.65 ± 3.48 years). Three research instruments were used: satisfaction with life scale, Rosenberg self-esteem scale and big three perfectionism scale. RESULTS: Higher self-esteem was significantly associated with lower self-critical perfectionism (Beta = - 0.47), whereas higher self-critical perfectionism was significantly associated with lower satisfaction in life (Beta = - 0.29). Finally, higher self-esteem was significantly and directly associated with higher satisfaction with life (Beta = 0.48). CONCLUSION: The present preliminary findings point to the role of self-critical perfectionism as a buffer between self-esteem and satisfaction with life, suggesting the roles of self-esteem and perfectionism as promising avenues for promoting satisfaction with life in adolescent students.

Association between Experiences in Life and Quality of Life among Lebanese University Students in a Collapsing Country: The Moderating Role of Religious Coping and Positivity.

(1) Background: No goal can be more important than optimal individual quality of life (QOL); life experiences, religious coping, and positivity play pivotal roles in achieving this goal. The aim is to assess the correlation between positive/negative experiences in life and QOL, taking into consideration the moderating role of positivity and positive/negative religious coping among a sample of Lebanese university students. (2) Methods: This cross-sectional study was carried out between November and December 2021, and enrolled 333 university students, aged between 18 and 30 years, from various areas in Lebanon's governorates. The 12-item Short Form Health Survey, the brief religious coping methods scale, and the Scale of Positive and Negative Experience were included in the questionnaire. Forward linear regressions were conducted to check for correlates associated with physical and mental QOL scores. All variables that showed a correlation or effect size > |0.24| were entered in the multivariable and moderation models as independent ones. Significance was set at a p < 0.05. (3) Results: A linear regression, taking the physical QOL score as the dependent variable, showed that living in rural areas compared to urban and more positivity were significantly associated with a better physical QOL, whereas more negative religious coping was significantly associated with a lower physical QOL. More positivity and more positive religious coping were significantly associated with a better mental QOL. The moderation analysis showed that in people with high positive experiences, those with higher negative religious coping had lower mental QOL. (4) Conclusions: In a society as deeply religious as Lebanon, it is crucial to organize awareness programs to help in discriminating between religious coping mechanisms. Across order to stop further detrimental effects on QOL, our findings may serve as a solid foundation for future studies of QOL with additional variables, in other groups and nations.

The psychological impact of COVID-19 in a socio-politically unstable environment: protective effects of sleep and gratitude in Lebanese adults.

BACKGROUND: The COVID-19 global pandemic initiated an unprecedented medico-psychological turmoil. Our study investigates the psychological impact of the viral spread and austere lockdown, and focuses mostly on potential protective factors in a politically and economically unstable society. METHODS: A cross-sectional design was used to evaluate rates of mental distress in a sample of 348 Lebanese adults. Participants filled questionnaires of perceived stress (PSS), depression (PHQ-9), anxiety (GAD-7), PTSD (IES-22), as well as sleep (PSQi) and gratitude (GQ-6) immediately after 3 months of strict quarantine. Demographics included gender, age, employment and infection statuses. Correlations and regression models were used. RESULTS: Results indicated a very high prevalence of mental distress, in addition to major alterations in sleep quality and quantity. Younger age and unemployment correlated with more severe symptoms. Sleep was found to be a protective factor against all studied psychological distress, and gratitude further mitigated effects of depression. CONCLUSIONS: Mental health significantly degrades post-COVID lockdown, even in the absence of direct viral threat. Yet simple behavioral and cognitive changes like sleep and attitude of gratitude could provide protective factors against these psychological distresses. Such changes should be further explored and advocated as cost-efficient self-care practices to buffer this devastating public health burden, especially in unstable socio-political environments.

Development and validation of a shortened version of the Child Abuse Self Report Scale (CASRS-12) in the Arabic language.

BACKGROUND: All available scales to screen for child abuse may be challenging to administer due to their length. Indeed, a higher number of items is associated with more administration time and less motivation to engage in responding. We aimed through this study to examine the psychometric properties of a brief Arabic version of the Child Abuse Self Report Scale (CASRS-12) in terms of factorial structure, internal consistency, divergent validity, and correlations with measures of bullying victimization, eating attitudes and perceived social support. METHODS: We performed a cross-sectional, web-based study among Community Lebanese adolescents; where two samples have been used (Sample 1: N = 852, aged 15.34 ± 1.18 years, 54.8% females; Sample 2: N = 404, aged 16.60 ± 1.51 years, 57.2% females). The construct validity was tested using both exploratory and confirmatory factor analyses. RESULTS: Results revealed that both EFA and CFA yielded a four-factor structure for the CASRS-12 that mirrors the original four factors captured by the original CASRS. The scale also showed a good internal consistency as evidenced through McDonald's ω values ranging from 0.87 to 0.93 for the four subscales; and configural, metric, and scalar invariance across gender. Finally, we found that all CASRS-12 dimensions were significantly and positively correlated with more inappropriate eating attitudes and lower social support; and that psychological, physical, and sexual abuse correlated with higher bullying victimization CONCLUSION: In light of these findings, we potentially encourage clinicians and researchers to use this scale as a valid and reliable measure of child abuse among Arabic-speaking populations.

"In-between orthorexia" profile: the co-occurrence of pathological and healthy orthorexia among male and female non-clinical adolescents.

BACKGROUND: The profile of adolescents with orthorexic eating behaviors remains to be explored. This study is the first to explore the typology of Lebanese adolescents from a large non-clinical sample based on orthorexia nervosa (ON) and healthy orthorexia (HO). METHOD: A total of 555 adolescents (aged between 15 and 18 years) completed a set of questionnaires assessing orthorexic behaviors, self-esteem, stress, depressive and anxiety symptoms. Cluster analysis based on ON and HO scores was used to identify the typology of the sample. More precisely, this analysis was used to reveal and distinguish between naturally occurring subgroups of individuals with different orthorexic eating profiles, within the studied sample. Further, a series of one-way ANOVA was used to compare observed clusters based on their scores on used questionnaires. This analysis was used to capture the behavioral and psychological differences between previously yielded subgroups of individuals. RESULTS: Cluster analysis based on ON and HO scores yielded 3 distinct groups: "Low orthorexia", "Moderate in-between orthorexia" and "High in-between orthorexia". While the first group represented individuals with no particular (healthy or pathological) interest in healthy eating, the two latter groups represented those with respectively moderate and high degrees of an interest in healthy eating that has both pathological and healthy aspects. Significant differences between clusters regarding their levels of stress, depression, anxiety and self-esteem was observed, yet they were found to be negligible due to poor effect sizes. CONCLUSION: Findings from this study suggest that ON and HO can indeed co-occur among adolescents, that this co-occurrence can be experienced at different severity levels. Low effect sizes for ANOVA comparisons may suggest the possibility of the co-occurrence of ON and HO reducing the negative effects of ON behavior to some degree. The potential role of confusion around what constitutes "healthy eating" in the emergence of these "in-between orthorexia" profiles is put forward.

The profile of adolescents with orthorexic eating behaviors remains to be explored. Lebanese adolescents in this study were categorized into three groups: "Low orthorexia", "Moderate in-between orthorexia" and "High in-between orthorexia". Significant differences between clusters regarding their levels of stress, depression, anxiety, and self-esteem was observed, yet they were found to be negligible due to poor effect sizes. Findings from this study suggest that ON and HO can indeed co-occur among adolescents and that this co-occurrence can be experienced at different severity levels.

Work Addiction and Depression, Anxiety, and Stress: the Mediating Role of Food Addiction Among Lebanese Young Adult Workers.

Work addiction is considered a public health concern, as it can lead to negative and harmful health outcomes. However, patterns leading from work addiction to mental health concerns remain so far largely unknown and under-studied. We aimed to verify whether the relationship between work addiction and psychological distress (i.e., depression, anxiety, and stress) is mediated by food addiction among young adult workers in the context of Lebanese culture. The second objective was to validate the Arabic version of the Bergen Work Addiction Scale (BWAS). The online cross-sectional survey was conducted among 1268 Lebanese young adult workers (65.1% females, mean age 26.18 years) using the Bergen Work Addiction Scale, the Depression Anxiety and Stress Scale, the Yale Food Addiction Scale, and the Three-Factor Eating Questionnaire. The PROCESS SPSS Macro version 3.4, model four, was used to compute the mediation analysis. Findings revealed that 175 (13.8%) were presented as work-addicted individuals, and 226 (17.8%) exhibited addictive-like eating behaviors. Bivariate analyses showed that higher degree of work addiction and food addiction was significantly associated with higher levels of depression, anxiety, and stress. The results of the mediation analysis showed that the association between work addiction and depression, anxiety, and stress was mediated by food addiction. In light of our findings, we cautiously suggest that the link of work addiction to psychological distress via food addiction implies that strategies targeting food addiction might mitigate the harmful effects of work addiction on workers' mental health.

The influence of family functioning on the severity of fear of cancer recurrence: A cross-sectional study in a sample of breast cancer survivors of Lebanese women.

OBJECTIVE: To explore the links between family functioning-in terms of cohesion, flexibility, and communication-and the fear of cancer recurrence (FCR) in a sample of breast cancer survivors of Lebanese women. METHODS: This was a cross-sectional study among 62 Lebanese adult women (mean age: 51.0 ± 8.29 years; years since diagnosis: 7.19 ± 7.06) in remission, included via convenience and snowball sampling. A multicomponent questionnaire, encompassing socio-demographic and medical questions, the "Family Adaptability and Cohesion Evaluation Scale," the "Family communication scale," and the "Family satisfaction scale" (FACES IV) and the short version of the "Fear of Cancer Recurrence Inventory" (FCRI-SF), was used. Descriptive, bivariate, and multivariate analyses were conducted. A p-value<0.01 was used to indicate statistical significance. RESULTS: On average, FCR was clinically non-significant (12.31 ± 7.76). The sample had a low disengagement (20.01 ± 4.83), very low enmeshment (19.68 ± 4.57), very low rigid operation (21.7 ± 4.26), very low chaotic functioning (16.43 ± 4.48), high family communication level (38.78 ± 7.96), connected balanced cohesion (28.18 ± 5.47), very flexible balanced flexibility (26.81 ± 4.56), and low level of family satisfaction (34.53 ± 8.04). A very low chaotic functioning in the family (B = -11.37, Beta = -0.49, 99%CI = -19.54, -3.19), very high and low communication (B = -6.04, Beta = -0.33, 99%CI = -11.42, -0.67; B = -11.85, Beta = -0.46, 99%CI = -20.13, -3.58, respectively), very flexible balanced flexibility (B = -10.36, Beta = -0.67, 99%CI = -15.77, -4.94) and younger age (B = -0.31, Beta = -0.37, 99%CI = -0.59, -0.04) predicted a lower FCR score. CONCLUSION: Balanced flexibility and the quality of communication within the family were associated with a decreased FCR, while chaotic family functioning increased FCR severity. Cohesion, disengagement, enmeshment, and family satisfaction did not impact the severity of FCR.

Menstrual symptoms variation among Lebanese women before and after the COVID-19 pandemic

Objectives: Pandemic diseases and the confinement measures due to COVID-19 infection have introduced acute and persistent psychosocial stressors for different individuals with a greater influence on females manifested through changes in the menstrual cycle. The objective of this study was to assess Lebanese female of reproductive age about their menstrual cycle, their mental health, and their lifestyle, throughout the COVID-19 pandemic, Beirut blast, and the economic crises. Methods: A cross-sectional online study conducted between October and December 2021, enrolled 398 Lebanese women using the snowball technique. The Menstrual Symptom Questionnaire (MSQ) was used to assess menstrual symptoms. A repeated measures ANOVA was used to assess factors associated with the variation in MSQ scores after vs before the pandemic. Results: Our results showed that a significantly higher number of days of menses, number of pads per day and total MSQ score were significantly found after the pandemic compared to before it. More distress (Beta=0.68), more post-traumatic stress disorder due to COVID-19 (Beta=0.19), a higher number of waterpipes smoked per week (Beta=1.20) and being infected by COVID-19 compared to not (Beta=3.98) were significantly associated with an increase in the MSQ score after the pandemic compared to before it. Conclusion: Our main findings indicate that females had irregular menstrual cycles, unpredictable bleeding pattern, and intense symptoms severity post COVID-19 pandemic. Furthermore, stress post COVID-19 and Beirut blast tended to be associated with increased menstrual symptoms. Thus, vulnerable women should be identified and offered appropriate care, information, and awareness regarding their menstrual period during a pandemic. (AU)

The association between sense of coherence and quality of life: a cross-sectional study in a sample of patients on hemodialysis.

BACKGROUND: Patients on hemodialysis universally experience detriments in their general quality of life (QOL). Sense of coherence (SOC) is a long-standing factor that affects QOL. Nevertheless, the association between SOC and QOL in patients on hemodialysis was seldom investigated. Our research aims to study this association in a sample of Lebanese adult patients on hemodialysis. METHODS: In this cross-sectional study, SOC was measured using the short version of the "Orientation of Life" scale (SOC-13). QOL was assessed using the Kidney Disease Quality of Life- Short Form (KDQOL-SF). The association between SOC and QOL and its submodalities was first explored using Pearson Correlation and multivariate linear regression analyses, controlling for sociodemographic variables and medical variables. RESULTS: 157 patients on hemodialysis (mean(SD) age: 62.1(13.81) years; 58.6% males) were included. Mean QOL score was 51.65 and that of SOC was 48.06. SOC was strongly corrected with the total QOL (r = 0.832; p value < 0.001), as well as its physical functioning (r = 0.767; p value < 0.001), emotional functioning (r = 0.757; p value < 0.001), cognitive functioning (r = 0.740; p value < 0.001), and social functioning (r = 0.773; p value < 0.001) submodailties. SOC was moderately correlated with professional functioning submodality of QOL (r = 0.618; p value < 0.001), but not correlated with the satisfaction with the quality of care (r = 0.052; p = 0.520). Within the regression models accounting for sociodemographic and medical variables, SOC was significantly associated with the total QOL (unstandardized B = 0.803; 95% CI 0.714, 0.893), physical functioning (unstandardized B = 0.761; standardized B = 0.763; 95% CI 0.661, 0.861), emotional functioning (unstandardized B = 1.205; standardized B = 0.757; 95% CI 1.037, 1.372), professional functioning (unstandardized B = 1.142; standardized B = 0.498; 95% CI 0.843, 1.442), cognitive functioning (unstandardized B = 1.239; standardized B = 0.739; 95% CI 1.058, 1.420), and social functioning (unstandardized B = 0.912; standardized B = 0.768; 95% CI 0.790, 1.034). CONCLUSIONS: In a sample of adult patients on hemodialysis, SOC was positively significantly associated with QOL and its submodalities, expect the satisfaction with the quality of care. The confirmation of the general hypothesis that relates the SOC with the QOL encourages more salutogenic research among this patient population.

Menstrual symptoms variation among Lebanese women before and after the COVID-19 pandemic.

Objectives: Pandemic diseases and the confinement measures due to COVID-19 infection have introduced acute and persistent psychosocial stressors for different individuals with a greater influence on females manifested through changes in the menstrual cycle. The objective of this study was to assess Lebanese female of reproductive age about their menstrual cycle, their mental health, and their lifestyle, throughout the COVID-19 pandemic, Beirut blast, and the economic crises. Methods: A cross-sectional online study conducted between October and December 2021, enrolled 398 Lebanese women using the snowball technique. The Menstrual Symptom Questionnaire (MSQ) was used to assess menstrual symptoms. A repeated measures ANOVA was used to assess factors associated with the variation in MSQ scores after vs before the pandemic. Results: Our results showed that a significantly higher number of days of menses, number of pads per day and total MSQ score were significantly found after the pandemic compared to before it. More distress (Beta=0.68), more post-traumatic stress disorder due to COVID-19 (Beta=0.19), a higher number of waterpipes smoked per week (Beta=1.20) and being infected by COVID-19 compared to not (Beta=3.98) were significantly associated with an increase in the MSQ score after the pandemic compared to before it. Conclusion: Our main findings indicate that females had irregular menstrual cycles, unpredictable bleeding pattern, and intense symptoms severity post COVID-19 pandemic. Furthermore, stress post COVID-19 and Beirut blast tended to be associated with increased menstrual symptoms. Thus, vulnerable women should be identified and offered appropriate care, information, and awareness regarding their menstrual period during a pandemic.