Validation of the inventory of Callous-Unemotional Traits among school-going adolescents in Malaysia.

A key component in the study of antisocial behaviour among adolescents is the presence of callous-unemotional (CU) traits. Among the established tools available to measure CU traits is the Inventory of Callous-Unemotional traits (ICU). To date, there is no validated questionnaire to assess CU traits for the local population. Therefore, there is a need to validate the Malay version of the ICU (M-ICU) so that research can be conducted to explore CU traits among adolescents in Malaysia. The aim of the study is to validate the M-ICU. Two phases of cross-sectional study involving 409 (phase 1 -exploratory factor analysis (EFA), n = 180; phase 2-confirmatory factor analysis (CFA), n = 229) adolescents aged between 13 to 18 years old were conducted from July until October 2020 at six secondary schools in Kuantan district. Participants were selected via multistage random sampling. The ICU was initially translated into Malay language using forward-backward translation procedure by a group of bilingual researchers. Study participants completed the final version of the M-ICU questionnaire and socio-demographic questionnaire. Data was analysed using SPSS version 26 and MPlus software for factor structure validity by performing EFA and CFA. Initial EFA revealed three factors with two items deleted. A further EFA with two factors resulted in the deletion of unemotional factor items. Cronbach's alpha for overall scale improved from 0.70 to 0.74. CFA supported a two-factor solution with 17 items compared to the original English version that has three factors with 24 items. The findings revealed acceptable fit indices (RMSEA = 0.057, CFI = 0.941, TLI = 0.932, WRMR = 0.968). The study revealed that a two-factor model with 17 items of the M-ICU has good psychometric properties. The scale is valid and reliable to measure CU traits among adolescents in Malaysia.

Predictors of Mental Health Literacy among Parents, Guardians, and Teachers of Adolescents in West Malaysia.

Parents, guardians, and teachers are the informal sources of mental health support that adolescents rely on. Nevertheless, limited mental health knowledge limits their ability and confidence in providing appropriate assistance. This study aims to (1) evaluate the relationship between the roles of parents/guardians and teachers and their responses to discover the common misconceptions on mental health among those providing informal support to adolescents and (2) determine which demographic factors would act as the strongest predictor influencing their mental health literacy (MHL) status. The cross-sectional study recruited 867 parents, guardians, and teachers of adolescents from 24 government secondary schools' parent-teacher associations via multistage stratified random sampling. Parents, guardians, and teachers' MHL were evaluated using the Mental Health Knowledge Schedule-Malay Version (MAKS-M). The collected data were analyzed using Pearson's Chi-squared test to investigate the association between the respondents' roles and responses. Multiple Regression analysis was used to determine the predictors of MHL. The score of MAKS-M for the current study sample is 73.03% (M = 43.82, SD = 4.07). Most respondents responded incorrectly on Items 1 (employment), 6 (help-seeking), 8 (stress), and 12 (grief). Teachers provided more favorable responses on several items than parents and guardians. Finally, younger age, higher income, knowing someone with mental disorders, and having experience of attending formal training on mental health first aid were the significant predictors of MHL. MHL interventions in Malaysia should cater to older adults of lower socioeconomic status and lesser experience in mental health, specifically highlighting the stigmas on mental health help-seeking behaviors, treatment, and employment concerns, plus the recognition of various mental health diagnoses.

The Malay Literacy of Suicide Scale: A Rasch Model Validation and Its Correlation with Mental Health Literacy among Malaysian Parents, Caregivers and Teachers.

The 27-item Literacy of Suicide Scale (LOSS) is a test designed to measure the respondent's suicide knowledge. The purpose of this study is to examine the psychometric properties of the Malay-translated version of the LOSS (M-LOSS) and its association to sociodemographic factors and mental health literacy. The 27-item LOSS was forward-backward translated into Malay, and the content and face validities were assessed. The version was distributed to 750 respondents across West Malaysia. Rasch model analysis was then conducted to assess the scale's psychometric properties. The validated M-LOSS and the Malay version of the Mental Health Knowledge Schedule (MAKS-M) were then distributed to 867 respondents to evaluate their level of suicide literacy, mental health literacy, and their correlation. Upon Rasch analysis, 26 items were retained. The scale was found to be unidimensional, with generally satisfying separation and reliability indexes. Sex, socio-economic status, and experience in mental health were found to significantly impact the mean score for mental health literacy. This study also found a significant mean difference for suicide literacy across school types. Furthermore, while this study observed a weak but significant negative correlation between age and suicide literacy, no correlation was found between mental health and suicide literacy.

Callous-Unemotional Traits are Associated With Child-to-Parent Aggression.

This study examined the relations between callous-unemotional traits and perpetration of aggression toward parents in two separate studies, while also considering motivation for aggression and parenting styles experienced among young people. Study 1 involved 60 parents of children aged between 11 and 17 years old. The online study found high callous-unemotional traits, as reported by parents, to be associated with aggression toward both parents. Both types of motivation (proactive and reactive, as reported by parents) were associated with aggression toward parents. Study 2 involved 42 youths from an alternative education sample (between 11 and 16 years old). Youths with higher self-reported callous-unemotional traits reported more aggression toward both parents. Both studies, which had different reporters and different samples, showed youths with higher callous-unemotional traits were more aggressive toward their parents. In discussing the results, we note the importance of including callous-unemotional traits in future research on parent-directed aggression and in studies on domestic violence more broadly.

Adolescents as perpetrators of aggression within the family.

Although family violence perpetrated by juveniles has been acknowledged as a potentially serious form of violence for over 30years, scientific studies have been limited to examining the incidence and form of home violence. The present study examined the prevalence of family aggression as perpetrated by youths; we examined groups drawn from clinic-referred and forensic samples. Two audits of case files were conducted to systematically document aggression perpetrated by referred youths toward their family members. The purpose of the first audit was fourfold: i) to identify the incidence of the perpetration of family aggression among clinical and forensic samples; ii) to identify whether there were any reports of weapon use during aggressive episodes; iii) to identify the target of family aggression (parents or siblings); and iv) to identify the form of aggression perpetrated (verbal or physical). The second audit aimed to replicate the findings and to show that the results were not due to differences in multiple deprivation indices, clinical diagnosis of disruptive behavior disorders, and placement into alternative care. A sampling strategy was designed to audit the case notes of 25 recent forensic Child and Adolescent Mental Health Service (CAMHS) cases and 25 demographically similar clinic-referred CAMHS cases in the first audit; and 35 forensic cases and 35 demographically similar clinic-referred CAMHS cases in the second audit. Using ordinal chi-square, the forensic sample (audit 1=64%; audit 2=82.9%) had greater instances of family violence than the clinical sample (audit 1=32%; audit 2=28.6%). They were more likely to use a weapon (audit 1=69%; audit 2=65.5%) compared to the clinical sample (audit 1 and 2=0%). Examining only the aggressive groups, there was more perpetration of aggression toward parents (audit 1, forensic=92%, clinical=75%; audit 2, forensic=55.17%, clinical=40%) than toward siblings (audit 1, forensic=43%, clinical=50%; audit 2, forensic=27.58%, clinical=30%). Based on these findings, we would urge professionals who work within the child mental health, particularly the forensic area, to systematically collect reports of aggression perpetrated toward family members.