Impact of Social Media Addiction and Internet Gaming Disorder on Sleep Quality: Serial Mediation Analyses.

Poor sleep quality is a concerning and prevalent consequence of social media addiction (SMA) and internet gaming disorder (IGD). Due to the lack of research examining how SMA and IGD lead to poor sleep quality, the current study aimed to understand the relationship between SMA and sleep quality, as well as that between IGD and sleep quality, through impulse control and bedtime procrastination. The study tested the hypotheses that higher levels of SMA and IGD would predict lower levels of impulse control, which would then predict higher levels of bedtime procrastination, leading to poorer sleep quality. A serial mediation analysis was performed with a sample of 221 participants (63.3% females, 34.4% males, and 2.3% prefer not to say) aged 18 to 53 years (M = 23.64, SD = 5.72). Participants completed questionnaires that assessed for social media addiction, internet gaming disorder, impulse control factor, bedtime procrastination, and sleep quality. There was a full serial mediation of impulse control and bedtime procrastination in the relationship between SMA and sleep quality, as well as that between IGD and sleep quality, providing support for the hypotheses. The findings provide the knowledge needed to develop and implement strategies that target impulse control issues and reduce bedtime procrastination to improve sleep quality.

Psychosocial risk factors of youth suicide in the Western Pacific: a scoping review.

INTRODUCTION:  The Western Pacific region accounts for 25% of global suicide rates globally. In the last decade, however, there is a rising concern over the rate of youth suicides in the region. In line with the regional vision of reducing the rate of non-communicable diseases by 2025, the study contributes to the literature by utilizing a scoping review approach to identify psychosocial risk factors associated with youth suicide in the region. METHOD: Publications on youth suicide in the Western Pacific region between 2010 and 2021 were reviewed. A total of 43 publications met the inclusion criteria and were read in full. RESULTS: Psychosocial risk factors associated with suicide in each publication were identified and thematically classified into five themes: interpersonal factors, history of abuse, academic factors, work factors, and minority status. DISCUSSION: Findings showed discrepancies in youth suicide research across member nations in the Western Pacific. Implications for regional policies on suicide prevention and future research were discussed.

Mortality Salience Effects of Critical Incidents - A Systematic Literature Review and Research Agenda.

Critical incidents (CI) trigger acute stress reactions and psychological trauma because of direct or vicarious exposure. These events include natural disasters, wars, terrorist attacks and pandemics, and usually result in deaths and serious physical injuries. Their life-threatening nature makes them reasonable candidates to induce mortality salience (MS). The current review aims to consolidate Terror Management Theory (TMT) research using CIs as MS. A systematic literature review was conducted. Overall, 74 articles with 113 studies were included. Through this review, strong support for MS effects of CI has been found. Consistent with TMT, CIs tend to trigger worldview defence, self-esteem enhancement and relationship seeking. CIs have also been found to impact negatively on individual well-being and organisational health. Recommendations specific to crisis interventions and well-being will be discussed. The review concludes with potential future research directions to strengthen and expand empirical knowledge in CI salience.

Big Data Analysis of Terror Management Theory's Predictions in the COVID-19 Pandemic.

The current study aimed to address the limitations of the terror management theory literature by using big data analysis to examine the theory's predictions in the COVID-19 pandemic. Specifically, Google Trends were examined before and after the first COVID-19 case was identified in Singapore. The results showed that there was a significant increase in mortality salience, intergroup conflict, and prosocial behavior, and a significant decrease in materialism after the first COVID-19 case was identified. However, no significant differences were found for anxiety. Limitations include the assumption that search terms reflect intentions that would eventually lead to a relevant behavior and the lack of data from other sources to corroborate with the results from Google Trends. Future research could use data from other sources to examine the effects of COVID-19 on theoretically relevant behaviors.

Mortality salience in an offline and online setting.

The current study aims to examine the effects of mortality salience effects on worldview defense in an offline and online setting. Participants were 146 (66 offline and 80 online) Singaporeans. Participants were randomly assigned to either the mortality salience condition or the control condition and after a delay completed a Worldview Defense Assessment. No significant mortality salience effects on worldview defense occurred in either setting. The results might be explained by the Asian sample, Singapore's culture of tolerance, and data collection during the Coronavirus Disease 2019 (COVID-19) pandemic. Future research directions include examining the effects of COVID-19 in activating worldview defense.

A meta-analytic review of Internet gaming disorder and the Big Five personality factors.

Two systematic reviews have been conducted to summarize the literature on Internet Gaming Disorder (IGD) and personality. However, the data was not synthesized statistically, imposing a limit to their conclusions. The current study aimed to extend on the two reviews by conducting a series of five meta-analyses, one for each of the Big Five personality factors, to examine their relationships with IGD. A comprehensive search was conducted on the databases PsycArticles, PsycInfo, and Web of Science from inception to 29 July 2021. The data was analyzed using Meta-Essentials and the random effects model was used to obtain the pooled estimate of the effect size. A total of 12 articles were included (n = 145 to 3389). IGD was not significantly correlated with openness to experience (r = -0.05). However, IGD was negatively correlated with conscientiousness (r = -0.29), extraversion (r = -0.15), and agreeableness (r = -0.17), and positively correlated with neuroticism (r = 0.20). Age moderated the relationships between IGD and openness to experience and conscientiousness. The results were broadly consistent with the DSM-5 IGD criteria and the Big Five personality framework. Future research directions might include examining age as moderator variables, and using appropriate instruments based on the DSM-5 IGD criteria.

A Guide to Nature Immersion: Psychological and Physiological Benefits.

Nature exposure has been renowned for its positive physiological and psychological benefits. Recent years have seen a rise in nature immersion programs that make use of Guided Forest Therapy walks in a standard sequence of sensory awareness activities to expose participants to natural environments in a safe but effective manner. The study aimed to compare the efficacy of guided versus unguided nature immersion, upon three dependent variables of mood, nature connectedness and heartrate. 51 participants were assigned to either guided or unguided nature immersion. Nature connectedness (Connectedness to Nature Scale, CNS), Environmental Identity Scale, EID short form) and mood (Positive and Negative Affect Scale, PANAS) were assessed before and after nature immersion, while heart rate was tracked continuously by a wristwatch heart rate tracker throughout the 2-h experience. Demographics and general health practice (GHP) information were also collected. A mixed model ANOVA revealed that nature connectedness and mood (but not heart rate) improved post-immersion for all participants. Comparing the guided/unguided conditions, there were no significant differences in the change in nature connectedness, mood or heart rate. Comparing within the five segments within the standard sequence in the guided condition, the third and fifth segments revealed a significantly lower heart rate compared to the baseline heart rate.

Prevalence of Internet Addiction and Gaming Disorders in Southeast Asia: A Meta-Analysis.

This meta-analytic review aimed to examine the pooled prevalence rates of Internet addiction and gaming disorders in Southeast Asia. Several databases including PubMed, MEDLINE, PsycINFO, Web of Science, Embase, and Cochrane Central were searched and a total of 24 studies were included in this study. The selection of studies was conducted in accordance to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Two meta-analyses were conducted to examine data on Internet addiction and gaming disorders separately. A random-effects model was employed to derive the pooled prevalence rate. Mixed-effects meta-regression and subgroup analyses were performed to examine the moderators of the between-study heterogeneity. Publication bias was tested using the Egger's regression test and funnel plot. Only seven out of the 11 Southeast Asian countries were represented in the literature. All except for two of the included studies were cross-sectional in nature. The findings revealed a pooled prevalence rate of 20.0% (95% confidence interval: 14.5%-27.0%) and 10.1% (95% confidence interval: 7.3%-13.8%) for Internet addiction and gaming disorders respectively. Mean age and study population were significant moderators of the between-study heterogeneity in the prevalence rates of gaming disorders such that samples involving older participants showed higher prevalence rate than those involving younger individuals. Country of study was found to be significant moderator of the between-heterogeneity for both Internet addiction and gaming disorders, however the findings should be interpreted with caution due to the small and unbalanced sample sizes. There was no significant publication bias. Such epidemiology research should be extended to the Southeast Asian countries that have not been studied or are under-studied. Given that the prevalence rates appear to be higher in Southeast Asia than in other world regions, future research should also explore the factors behind these inter-regional differences. Further longitudinal studies should also be conducted to examine the trajectories of such disorders.

Smartphone Application in Postgraduate Clinical Psychology Training: Trainees' Perspectives.

M-learning refers to the learning that takes advantage of mobile technologies. Although research shows enhanced educational outcomes from m-learning in some Asian countries, the generalizability to postgraduate clinical psychology training in Singapore remains unclear. Current professional standards in clinical psychology training emphasize the importance of attainment of clinical competencies in trainees. Although learning theories indicated potential for m-learning to be incorporated into the local clinical psychology curriculum, trainees' perspectives have not been adequately explored on m-learning. The study aimed to address this gap by exploring the use of m-learning via a novel smartphone application in clinical psychology training using mixed-methods design. Eight clinical psychology trainees between the ages of 26 to 43 years old (mean age of 31.75, SD = 5.49) enrolled in a relevant coursework subject were recruited. Participants were randomly allocated to the experimental and control groups. The experimental group accessed the novel application weekly, from week 1 to week 6, and participants in the control group accessed the application after week 6. Participants from both groups completed a brief demographic questionnaire, and the following scales New General Self-Efficacy Scale adapted for Education (NGSES-E) and self-reported scale of learning outcomes (SLO). The qualitative study explored how participants perceived and experienced the novel application. Participants from the experimental group were invited to provide open-ended responses about the novel application. Data were analyzed using thematic analysis. Results from the qualitative analysis yielded four themes of: Convenience, preferred learning style, building confidence, and putting theory into practice. Findings from the qualitative study were consistent with previous studies about advantages of m-learning: That the e-platform was convenient, the learning style was engaging, which helped to build confidence, and facilitate practical learning of skills. The qualitative results were helpful in understanding the users' perspectives and experience of the novel application, indicating that future research in this innovative area is necessary. However, the quantitative outcomes were not significant, limitations would be discussed, and recommendations made for future research.

Clinical assessment of suicide risk and suicide attempters' self-reported suicide intent: A cross sectional study.

This study explored medical doctors' clinical assessment of suicide risk and suicide attempters' self-reported suicide intent. Three years of archival assessment records related to suicide attempters who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to analysis. Records related to 460 suicide attempters (70.4% females; 28.6% males) were analysed using logistic regressions. Their ages ranged from 12 to 85 (M = 29.08, SD = 12.86). The strongest predictor of suicide intent was habitual poor coping, followed by serious financial problems, and expressed regret. The strongest predictor of suicide risk was hiding the attempt followed by prior planning. The findings were discussed in regards to implications in clinical assessments and suicide prevention efforts.

Health-Related Quality of Life in Pediatric Patients with Leukemia in Singapore: A Cross-Sectional Pilot Study.

There has been a paradigm shift in health service delivery to a more holistic approach, which considers Quality of Life (QoL) and overall functioning. Health-Related Quality of Life (HRQoL) is a multidimensional construct that encompasses physical functioning as well as psychosocial aspects of emotional and social functioning. This study explored factors related to HRQoL in Asian pediatric patients with leukemia in Singapore. The available variables included: age, treatment duration, household income, gender, ethnicity, religion, diagnosis, and phase of treatment. It is hypothesized that the relationships will be significant. In the current study, there were 60 patients (60% males) with leukemia; their ages ranged from 1 to 21 years (Mean = 8.03, Standard Deviation = 4.55). The hypothesis was partially supported. Age had a significant positive relationship with physical functioning, r(60) = 0.28, p < 0.05, physical health, r(60) = 0.28, p < 0.05, and the total HRQoL score, r(60) = 0.29, p < 0.05. Treatment duration had a positive relationship with school functioning, r(60) = 0.28, p < 0.05. All other correlations were statistically non-significant. The effects of the available psychosocial variables of gender, ethnicity, and religion were examined on scores from the Pediatric Quality of Life Inventory (PedsQL). Ethnicity had a significant effect on social functioning, U = 292.00, p < 0.05, r = 0.3 (medium effect size). Specifically, Chinese (Median = 85.00, n = 33) had significantly higher scores on social functioning than others (Median = 70.00, n = 27). The remaining comparisons were statistically non-significant. The current findings added to QoL research, and provided an impetus for more research in the area of HRQoL for children with leukemia in Singapore.

Controlling Noncommunicable Diseases in Transitional Economies: Mental Illness in Suicide Attempters in Singapore-An Exploratory Analysis.

BACKGROUND: Mental illness is a pertinent risk factor related to suicide. However, research indicates there might be underdiagnosis of mental illness in Asian suicide attempters; this phenomenon is concerning. This study explored prediction of diagnosis of mental illness in suicide attempters in Singapore using available variables. METHODS: Three years of medical records related to suicide attempters (N = 462) who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to analysis. Of the sample, 25% were diagnosed with mental illness; 70.6% were females and 29.4% were males; 62.6% were Chinese, 15.4% Malays, and 16.0% Indians. Their age ranged from 12 to 86 (M = 29.37, SD = 12.89). All available variables were subjected to regression analyses. FINDINGS: The full model was significant in predicting cases with and without diagnosis of mental illness and accurately classified 79% of suicide attempters with diagnosis of mental illness. CONCLUSIONS: The findings were discussed in regard to clinical implications in diagnosis and primary prevention.

Effect of Cardiac Rehabilitation on Quality of Life, Depression and Anxiety in Asian Patients.

This study explored the effect of cardiac rehabilitation on quality of life, depression, and anxiety in Asian patients in Singapore. Out of the 194 patients who were recruited into the study, 139 patients (71.6%) completed both the pre- and post-cardiac rehabilitation questionnaires. Their ages ranged from 28 to 80 (M = 56.66, SD = 8.88), and 103 patients (74.1%) were males and 21 patients (15.1%) were females. As hypothesized, there was a statistically significant difference between the pre- and post-cardiac rehabilitation scores on the combined dependent variables, F (4, 135) = 34.84, p < 0.001; Wilks' Lambda = 0.49; partial eta squared = 0.51. An inspection of the mean scores indicated that patients reported higher levels of physical and mental quality of life and lower levels of depression post-cardiac rehabilitation. The findings were discussed in regards to implications in cardiac rehabilitation in Singapore.

Suicide Precipitants Differ Across the Lifespan but Are Not Significant in Predicting Medically Severe Attempts.

An important risk factor for suicide assessment is the suicide precipitant. This study explores suicide attempt precipitants across the lifespan. Three years of medical records related to suicide attempters who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to analysis. These cases were divided into three age groups: Adolescence, Early Adulthood, and Middle Adulthood. A total of 540 cases were examined (70.9% females; 63.7% Chinese, 13.7% Malays, 15.9% Indians), whose ages ranged from 12 to 62. There were eight cases above the age of 65 years which were excluded from the analysis. Significant differences were found in precipitants for suicide attempts across the lifespan. Middle adults had relatively fewer relationship problems, and adolescents had comparatively fewer financial and medical problems. The models to predict medically severe attempts across the age groups using suicide precipitants were not significant. The findings were discussed in regards to implications in suicide assessment and primary prevention in Singapore, as well as limitations and recommendations for future research.

An examination of the internal consistency and structure of the Statistical Anxiety Rating Scale (STARS).

The purpose of the current study was to examine the internal consistency and structure of the English version of the Statistical Anxiety Rating Scale (STARS). Participants were 202 (79% females) psychology undergraduates was recruited from James Cook University's Singapore (71%) and Australia (29%) campuses. Acceptable internal consistency reliabilities, ranging from .81 to .94, were found in this sample. Approximate fit indices suggest that a correlated six first-order factor model best describes the data in contrast to theoretical considerations suggesting that a six factor model with two correlated superordinate factors (i.e., statistics anxiety and attitudes toward statistics) best describes the data. Researchers are recommended to use part one of the STARS to assess statistics anxiety and part two to assess attitudes toward statistics.

Quality of Life in Patients With a Major Mental Disorder in Singapore.

Background: There has been a paradigm shift in mental health service delivery, from a focus on reducing symptoms to a more holistic approach, which considers Quality of Life (QoL). Method: This study aimed to explore prediction of Quality of Life (QoL) in Asian patients with a major mental disorder i.e., depression or schizophrenia in Singapore. In the current study, there were 43 patients (65.1% females) with depression. Their ages ranged from 18 to 65 (M = 44.63, SD = 12.22). The data were combined with the data on patients with schizophrenia, where there were 43 patients (65.1% females) with schizophrenia, their ages ranging from 18 to 65 (M = 44.60, SD = 12.19). Results: The components of QoL were examined i.e., Physical Component Summary (PCS) and Mental Component Summary (MCS). For all patients, social support and age accounted for 17.3% of the variance in PCS, F (2, 83) = 8.66, p < 0.001. For patients with depression, disorder severity, age, and duration of treatment accounted for 48.3% of the variance in PCS, F (3, 39) = 12.15, p < 0.001. For patients with schizophrenia, education (Primary or Lower vs. Post-Secondary or Higher) and emotional coping accounted for 21.3% of the variance in PCS, F (2, 40) = 5.40, p < 0.01. For all patients, self-efficacy and age accounted for 27.0% of the variance in MCS, F (2, 83) = 15.37, p < 0.001. For patients with depression, disorder severity accounted for 45.6% of the variance in MCS, F (1, 41) = 34.33, p < 0.001. For patients with schizophrenia, number of hospitalizations accounted for 18.5% of the variance in MCS, F (1, 41) = 9.29, p < 0.01. Conclusion: The findings were discussed in regards to implications in interventions to enhance QoL of patients with schizophrenia and depression in Singapore.

Prediction of Quality of Life in Asian Patients with Schizophrenia: A Cross-sectional Pilot Study.

BACKGROUND: There has been a shift in mental health services from an emphasis on treatment focused on reducing symptoms to a more holistic approach involving quality of life (QOL) and overall well-being. Many psychosocial variables are associated with QOL but a parsimonious framework is needed to deepen our understanding about the contribution of psychosocial factors in influencing the QOL of Asian patients with schizophrenia in Singapore. The study aimed to address the current gap in literature by analysis of QOL using available predictors in Asian patients with schizophrenia in Singapore. METHODS: 43 Singaporean patients diagnosed with schizophrenia were recruited at a large teaching hospital in Singapore from January to May 2010 and were invited to complete questionnaires. Of the sample, 65.1% were females, ages ranged from 18 to 65 (M = 44.60, SD = 12.19). Available variables were subjected to regression analysis. FINDINGS: The data were analyzed using SPSS Version 23 with the alpha level set at 0.05. The final model with five predictors was significant in predicting QOL. Positive Re-appraisal, Social Support, Avoidant Coping, Duration of Hospitalization, and Education accounted for 47.2% of the variance (Adjusted R2 = 40.0%) in QOL, F (5, 37) = 6.60, p < 0.001. Those with post-secondary or higher education had higher QOL than those with secondary or lower education. Duration of hospitalization negatively predicted QOL. CONCLUSION: The findings were discussed in regards to clinical implications for informing interventions to enhance QOL in patients with schizophrenia.

What predicts medical lethality of suicide attempts in Asian youths?

This study explores youth suicide attempts in Singapore using multiple databases of comprehensive archival records. Three years of medical records related to suicide attempters (N=666) who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to retrospective analysis. Compared to other age groups, a peak in suicide attempts (n=207) was observed in youths aged between 15 and 24 years old (76.3% females; 23.7% males, mean age=19.30, SD=2.89). The model using recognized risk and protective factors was significant in predicting medical lethality, and correctly classified 62.8% of high lethality cases. Only resolution of precipitant made a unique statistical significant contribution. Analysis was separately conducted for males and females. Implications of the findings are discussed.

Does ethnicity matter in risk and protective factors for suicide attempts and suicide lethality?

This study explored ethnic differences in risk and protective factors for suicide attempts, for the major ethnic groups in Singapore, and ethnic differences in prediction of lethality. Three years of medical records related to suicide attempters (N = 666) who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to analysis. Of the sample, 69.2% were female, 30.8% male; 63.8% Chinese, 15.8% Indian, and 15.0% Malay. Indians were over-represented in this sample, as compared with the ethnic distribution in the general population. Ages ranged from 10 to 85 years old (M = 29.7, SD = 16.1). Ethnic differences were found in risk and protective factors, and perceived lethality of suicide attempts. All available variables were subjected to regression analyses for Chinese, Indian and Malay attempters to arrive at parsimonious models for prediction of perceived lethality. The findings were discussed in regards to implications in assessment of suicide risk and primary prevention for the multiethnic society in Singapore.

Statistics Anxiety Update: Refining the Construct and Recommendations for a New Research Agenda.

Appreciation of the importance of statistics literacy for citizens of a democracy has resulted in an increasing number of degree programs making statistics courses mandatory for university students. Unfortunately, empirical evidence suggests that students in nonmathematical disciplines (e.g., social sciences) regard statistics courses as the most anxiety-inducing course in their degree programs. Although a literature review exists for statistics anxiety, it was done more than a decade ago, and newer studies have since added findings for consideration. In this article, we provide a current review of the statistics anxiety literature. Specifically, related variables, definitions, and measures of statistics anxiety are reviewed with the goal of refining the statistics anxiety construct. Antecedents, effects, and interventions of statistics anxiety are also reviewed to provide recommendations for statistics instructors and for a new research agenda.