Psychometric properties of the Arabic translation of the Dark Future Scale questionnaire in a non-clinical sample of Arabic-speaking young adults.

BACKGROUND: Through the years, studying negative behaviors of the worldwide population seized the spotlight from many researchers who focused on building scales in order the measure the level of worries, fear and even depression of such stressed individuals. By definition, "Future anxiety" (FA) is fueled by negative thoughts leading to intense fear of unknown future events. The Dark Future scale (DFS) measures the level of anxiety experienced towards the future. Our aim was to examine the psychometric properties of a novel Arabic translation of the DFS. METHODS: A sample of 684 Arabic-speaking young adults (65.6% women) filled the DFS, TEMPS-M (temperaments) and DASS-8 (psychological distress). RESULTS: Confirmatory factor analyses (CFA) supported a unidimensional model of the DFS score, with all 5 items retained. This scale had good reliability. Moreover, concurrent validity demonstrated significant associations between DFS scores and psychological distress, depressive, cyclothymic, irritable and anxious temperament. Scores achieved scalar invariance across gender, with women having greater exposure to anxiety about the future. CONCLUSION: Overall, these findings led to the conclusion that the Arabic DFS is a psychometrically valid tool for the assessment of FA. The DFS is a brief, reliable and easy to apply scale that would help researchers in psychology and psychiatry in assessing anxiety about future.

Psychometric properties of an Arabic translation of the meaning in life scale in a sample of young adults.

BACKGROUND: Young adults are in a constant phase of realizing their meaning in life while being in a constant pursuit of meaning. Meaning in life is a subjective, personal construct related to the perception of one's own life. Considering that there are no measures that study this construct within the Arab context, this study aimed to examine the psychometric properties of an Arabic translation of the Meaning in Life Questionnaire (MLQ) in the Lebanese context with a sample of young adults. METHODS: A sample of 684 Lebanese young adults was recruited for this study, having a mean age of 21.74 years, 65.6% of which were females. Through an online questionnaire, participants were requested to complete the Meaning in Life Questionnaire (MLQ), Depression, Anxiety and Stress Scale (DASS-8) and the Oviedo Grit Scale (EGO). RESULTS: CFA indicated that fit of the original bi-dimensional model of MLQ scores was inadequate. Items 9 and 10 cross-loaded to both MLQ factors. After removal of those 2 items, the final model displayed good fit indices. Reliability was good for the Search (ω = 0.89 / α = 0.89) and Presence (ω = 0.88 / α = 0.87) subscales. Additionally, across three levels of gender invariance (Configural, Metric and Scalar), no significant gender-based distinctions were observed in the MLQ scores. The Search subscale was significantly and positively associated with higher GRIT but not psychological distress, whereas the Presence subscale was significantly associated with higher GRIT and lower psychological distress. CONCLUSION: The results of this study contribute to the psychometric reliability and validity of the Arabic version of the MLQ and makes it available for dissemination among young adults within the Arab context. This allows for the implementation of new research that target construct of meaning in life, allowing for the accessibility of interventions that aim to foster the presence of and search for meaning in the lives of young adults within the Arab nations.

Psychometric properties of the Arabic versions of the long (27 items) and short (13 items) forms of the interpersonal mindfulness scale (IMS).

BACKGROUND: There is a lack of measures and data on interpersonal mindfulness from non-Western cultures, which can hinder advances in our understanding of the construct, its conceptual representation, and its effects on human connection and relationships within different cultural settings. To fill this gap and help spark future research in this area in the Arab world, the current study aimed to examine the psychometric properties of an Arabic translation of the 27-item and the 13-item versions of the interpersonal Mindfulness Scale (IMS) in a sample of Arabic-speaking adolescents from the general population. METHODS: A web-based survey was conducted in a sample of 527 Lebanese community adolescents (Mean age = 15.73 ± 1.81 years; 56% females). The IMS was translated from English into Arabic using the forward-backward translation method. Participants completed the long and short forms of the IMS, as well as the Buss-Perry Aggression Questionnaire-Short Form (BPAQ-SF), and the 5-item Brief Irritability Test. RESULTS: Confirmatory factor analyses provided support to the four-factor structure of both the 27-item and the 13-item IMS (i.e., Presence, Awareness of Self and Others, Nonjudgmental Acceptance, and Nonreactivity). The original and the short form versions of the IMS yielded excellent internal consistency in our sample, with a Cronbach's α coefficients of 0.95 and 0.90, and McDonald's omega coefficients of 0.95 and 0.90, respectively. Multigroup comparisons suggested the factorial invariance of the Arabic 27-item and 13-item IMS between male and female participants at the metric, configural, and scalar levels. Finally, the concurrent validity of both full-length and short form of the IMS appeared to be good and comparable, as attested by patterns of correlations in expected directions with outcome variables (i.e., aggression, anger, hostility, and irritability). CONCLUSION: The present findings provide support for the good psychometric qualities of the Arabic translation of the IMS in both long and short forms, suggesting that these scales are suitable for use to measure interpersonal mindfulness in Arabic-speaking youth, at least in Lebanon. We expect that the IMS, in particular its shortest form, will prompt more systematic investigation of interpersonal mindfulness in the Arabic-speaking populations, especially with regard to enhancing healthy communications with others and building effective social relationships.

The mediating effect of dysmorphic concern in the association between avoidant restrictive food intake disorder and suicidal ideation in adults.

BACKGROUND: Reflecting on the existing literature on suicidal ideation and Avoidant/Restrictive Food Intake Disorder (ARFID), this article investigates the complex relationship between them, hypothesizing about the possibility of dysmorphic concerns, being a mediator linking ARFID to suicidal ideation. METHODS: Using a snowball sampling approach, a survey was created on Google Forms and circulated across messaging applications and social media networks (WhatsApp, Instagram, Messenger). The sample involved 515 participants recruited between February and March 2023. The questionnaire included the following scales: Nine-items Avoidant/Restrictive Food Intake Disorder screen (NIAS), Dysmorphic Concern Questionnaire (DCQ), and Columbia-Suicide Severity Rating Scale (C-SSRS). When filling the questionnaire, respondents were warned that they can experience distress when answering certain questions and received information about mental health services. Five hundred fifteen adults participated in this study, with a mean age of 27.55 ± 10.92 years and 60.1% females. RESULTS: After adjusting over potential confounders (i.e., age, education, marital status, and household crowding index), analyses showed that dysmorphic concerns fully mediated the association between avoidant restrictive eating and suicidal ideation. Higher avoidant restrictive eating was significantly associated with more dysmorphic concerns, and higher dysmorphic concerns were significantly associated with the presence of suicidal ideation. Finally, avoidant restrictive eating was not significantly associated with suicidal ideation. CONCLUSION: This study highlights the potential indirect link between ARFID and suicidal ideation mediated by dysmorphic concerns. While no direct connection was observed between ARFID and suicidal ideation, the presence of dysmorphic concerns appeared to be a crucial factor in amplifying the risk of suicidal ideation in individuals with ARFID. This emphasizes the importance of addressing dysmorphic concerns alongside ARFID treatment to enhance mental health interventions and outcomes.

Moderating effect of self-esteem between perfectionism and avoidant restrictive food intake disorder among Lebanese adults.

BACKGROUND: Avoidant Restrictive Food Intake Disorder (ARFID) is a new diagnosis added to the DSM-5 characterized by pathological eating habits without body image disturbances. Previous findings demonstrated a general association between high levels of perfectionism and low levels of self-esteem in association with general eating disorders. However, research is scant when it comes to ARFID specifically. Subsequently, although self-esteem is seen to moderate the association between perfectionism and general eating disorders, this research study aims to explore the same moderation but with ARFID specifically. METHODS: For this study, 515 Lebanese adults from the general Lebanese population were recruited from all over Lebanon, 60.1% of which were females. The Arabic version of the Big Three Perfectionism Scale- Short Form (BTPS-SF) was used to measure self-critical, rigid and narcissistic perfectionism; the Avoidant/Restrictive Food Intake Disorder screen (NIAS) was used to score the ARFID variable; the Arabic-Single Item Self-Esteem (A-SISE) was the scale used to measure self-esteem. RESULTS: Across the different perfectionism types, self-esteem was seen to moderate the association between narcissistic perfectionism and ARFID (Beta = - 0.22; p =.006). At low (Beta = 0.77; p <.001), moderate (Beta = 0.56; p <.001) and high (Beta = 0.36; p =.001) levels of self-esteem, higher narcissistic perfectionism was significantly associated with higher ARFID scores. CONCLUSION: This study brought to light some crucial clinical implications that highlight the need for interventions that help in the enhancement of self-esteem in patients with high perfectionism and ARFID. This study suggests that clinicians and healthcare professionals should focus more on risk factors influencing the development and maintenance of ARFID-like symptoms.

Stressors in hospitalized patients and their associations with mental health outcomes: testing perceived social support and spiritual well-being as moderators.

BACKGROUND: Although hospitalization can be a burdensome experience for all patients, research into the sources of this distress and potential protective factors has so far been scattered, specifically among the broad hospitalized population across all disease types and inpatient units. The present study explores the frequency and nature of the foremost experienced hassles among a sample of Lebanese hospitalized patients, tracing their correlations with depression and anxiety while also investigating positive coping (i.e., perceived social support and spiritual well-being) as potential moderator of these relationships. METHODS: A total of 452 Lebanese inpatients from all medical units filled a survey composed of a list of 38 stressors experienced during hospitalization and other measures assessing depression, anxiety, perceived social support, and spiritual well-being. RESULTS: Pain was the most common stressor experienced by the patients (88.9%), followed by the feeling of being overwhelmed (80.3%). When conducting a factor analysis, 18 stressors loaded on 4 distinct factors, hence yielding 4 main stressor groups (i.e., Illness Apprehension, Hopelessness/Uselessness, Social Isolation, and Spiritual Concerns). The multivariable analysis showed that increased illness apprehension (Beta = 0.69) and hopelessness (Beta = 1.37), being married (Beta = 1.17) or divorced (Beta = 1.38) compared to single, being admitted in a two-bed room compared to one-bed (Beta = 1.59), higher financial burden (Beta = 0.24), and lower socio-economic status (Beta = 1.60) were significantly associated with higher anxiety. Additionally, increased hopelessness (Beta = 0.82) and being married (Beta = 0.79) compared to single were significantly associated with higher depression. However, among patients experiencing high levels of stressors, those with high spiritual well-being and perceived social support had lower depressive/anxiety symptoms. CONCLUSION: Our study characterized the principal stressors encountered during hospitalization, underscoring their associations with Lebanese inpatients' mental health. On the other hand, as perceived social support and spiritual well-being acted as negative moderators of these associations, intervention programs aimed at enhancing such adaptive coping techniques are strongly called upon to palliate the psychological distress of patients in hospital settings.

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.

The indirect role of orthorexia nervosa and eating attitudes in the association between perfectionism and muscle dysmorphic disorder in Lebanese male University students - results of a pilot study.

BACKGROUND: The literature highly concentrates on disorders related to body image among women but only minimally when it comes to the male population; hence, in order to provide general practitioners, and primary care physicians in general, and psychiatrists in particular, with additional information concerning muscle dysmorphia among male university students in Lebanon, this study seemed essential, and was therefore conducted to (1) identify the prevalence of MDD, and (2) evaluate the indirect effect of eating attitudes in general and orthorexia nervosa in particular, in the association between perfectionism and muscle dysmorphic disorder (MDD) among a sample of male university students. METHODS: In this cross-sectional study conducted between September 2021 and May 2022, 396 male university students from multiple universities in Lebanon filled the online Arabic questionnaire. RESULTS: The results showed that 26 (6.6%) of the participants had MDD. Orthorexia nervosa and eating attitudes mediated the association between perfectionism and MDD; higher perfectionism was significantly associated with higher ON and more inappropriate eating; higher ON and more inappropriate eating were significantly associated with higher MDD, whereas perfectionism had a significant total direct effect on MDD. The high prevalence of MDD among male university students in Lebanon implies further investigation on the national level in the country. CONCLUSION: Awareness campaigns among the university students could be adopted at the national level to increase the level of knowledge on the concepts of obsessive self-destructive perfectionism, orthorexia nervosa and muscle dysmorphia.

Psychometric properties of an Arabic translation of the short 9-item drive for muscularity scale (DMS-9).

BACKGROUND: After the original 15-item Drive for Muscularity Scale developed by McCreary et al. in 2004, a more theoretically based scale that replicates the original DMS subscales with a better conceptual clarity and a shorter number of items, i.e., the DMS-9, has recently been developed by Chaba et al. in 2018. We sought to contribute to the literature especially under the Arab context, by investigating the psychometric properties of an Arabic translation of the DMS-9 in a sample of Arabic-speaking Lebanese university students of both genders. METHODS: University students (N = 402; 55.2% females) from multiple universities in Lebanon were invited to fill the survey in this cross-sectional designed study (December 2022 and January 2023). Our sample was chosen using the snowball technique; a soft copy of the questionnaire was created using google forms software, and an online approach was conceived to proceed with the data collection. RESULTS: Using an Exploratory Factor Analysis-to- Confirmatory Factor Analysis strategy, we found that the original two-factor model of the DMS proposed in the parent study was adequately replicated in our sample. The two DMS-9 factor scores showed very good McDonald's omega values (ω > 0.8). Findings also showed that gender invariance was achieved at the configural, metric, and scalar levels. Additionally, drive for muscularity scores correlated in the expected way with other study variables, providing support for the convergent and divergent validity of the Arabic DMS-9. Specifically, we found that greater drive for muscularity attitudes and behaviors significantly correlated with more severe muscle dysmorphic symptoms, inappropriate eating attitudes, muscle bias internalization, and lower body appreciation. CONCLUSION: Findings preliminarily suggest that the Arabic DMS-9 is psychometrically sound and suitable tool to assess the drive for muscularity construct among Arabic-speaking community adults. Making the Arabic DMS-9 available will hopefully benefit the scientific community working in Arab settings, promote local and international research in this area, and offer descriptive data on how drive for muscularity may interfere with health indicators in the general Arab population.

Psychometric properties of an Arabic translation of the external and internal shame scale (EISS).

BACKGROUND: The concept of shame in Arab societies displays multiple differences when compared to Western societies in terms of nature, sources, types, and correlates. Surprisingly, we could not find any study investigating this increasingly important construct in Arab countries or the broad Arabic-speaking communities. This may likely be due to the lack of valid instruments assessing shame in the Arabic language. To address this major gap and contribute to the international literature, we sought to examine the psychometric properties of an Arabic translation of the External and Internal Shame Scale (EISS) among a community sample of Arabic-speaking adults from Lebanon. METHODS: An online survey was conducted among Lebanese adults between July and August 2022. A total of 570 Lebanese adults completed the EISS, as well as Depression Anxiety Stress Scales, Other as shamer scale, and the Standardized Stigmatization Questionnaire. Exploratory-to-confirmatory (EFA-CFA) factor analyses were conducted. RESULTS: Exploratory and confirmatory factor analyses supported a unidimensional model of EISS scores, with all eight items retained. Scores achieved scalar invariance across gender, with no significant difference reported between females and males. EISS scores were found to have adequate composite reliability (McDonald's ω = 0.88 for the total score); as well as adequate patterns of correlations with depression, anxiety and stress symptoms, as well as stigmatization scores. Finally, our analyses provide support to the concurrent validity of the Arabic version of the scale, by showing that the EISS total scores strongly correlated with the external shame measure "other as shamer". CONCLUSION: Although further validations are necessary before our findings could be generalized, we preliminarily suggest that this is a short, easy-to-use, self-report scale that enables a reliable and valid measure of the shame construct among Arabic-speaking people.

Validation of the Arabic version of the brief irritability test (Ar-BITe) in non-clinical adolescents.

BACKGROUND: Despite the substantial clinical relevance of irritability in the development and maintenance of several mental disorders and its negative effects on functioning, no valid and reliable measures are available yet to identify the presence and consequences of irritability as a distinct construct among the Arabic-speaking populations. To bridge this gap, and help advance this field in the under-researched Arab region, we aimed to validate an Arabic-language version of the Brief Irritability Test (BITe). METHODS: Eligible participants were native Arabic-speaking non-clinical adolescents from Lebanon; 527 participants aged 15.73 ± 1.81 years (56% females) completed the survey. RESULTS: Utilizing the Confirmatory Factor Analysis approach, we found that the five items of the Arabic BITe loaded into a single factor structure. The scale showed excellent reliability, as both Cronbach's alpha and McDonald's omega coefficient values were of 0.88. Multi-group analyses showed invariance across sex groups in our sample at the configural, metric, and scalar levels. Female adolescents exhibited higher BITe scores than their male counterparts (14.01 vs. 13.25), but this difference did not reach the statistical significance. Good concurrent validity was supported based on positive correlations between irritability scores and measures of aggression, anger and hostility (r Pearson's coefficients ranging from 0.35 to 0.42), as well as positive correlations with insomnia symptoms scores. CONCLUSION: The present findings allow us to conclude that the Arabic version of the BITe is a unidimensional, reliable, valid, brief, and economic self-report measure of the irritability construct for both male and female Arabic-speakers. Providing an Arabic validated version of the BITe will hopefully foster the research efforts of the Arab scientific community in this area, and promote the implementation of timely, evidence-informed and culturally-sensitive mental health interventions that appropriately address irritability-related problems and consequences among Arab young populations.

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 resilience scale for adolescents (READ).

INTRODUCTION: Adolescents react differently to challenging negative life events. Resilience, a dynamic characteristic of individuals, was studied to be a protective factor against such events. In order to study the resilience among Arabic-speaking adolescent populations, age-appropriate measures that are fully apprehended by younger respondents are needed. In this context, the present study aimed to examine the psychometric properties of an Arabic translation of the Resilience Scale for Adolescents (READ) in a community sample of native Arabic-speaking adolescents aged 13-18 years. METHODS: A sample of 546 community Arabic-speaking adolescents from Lebanon was recruited (n = 328 females, with a mean age of 15.76 ± 1.65 years). Through an online questionnaire, participants were requested to complete the READ, Depression, Anxiety and Stress Scale (DASS-8) and the 13-item Children's Impact of Event Scale (CRIES-13). RESULTS: Following the exploratory and confirmatory factor analysis (EFA-to-CFA) strategy, a unidimensional model of the Arabic version of the READ was met after 10 items were removed from the scale, and showed strong internal consistency (Cronbach's alpha of 0.943). Additionally, the one-factor solution of the Arabic version of the READ was identical across male and female adolescents at the three levels of invariance (Configural, Metric and Scalar). Finally, higher resilience scores were significantly correlated with lower levels of psychopathology, namely depression, anxiety, stress and PTSD, thus attesting to the concurrent validity of the Arabic READ. CONCLUSION: Findings lend support to the psychometric reliability and validity of the Arabic version of the READ, and therefore its suitability for use among Arabic-speaking adolescents. The availability of this tool facilitates the implementation of interventions that foster resilience, especially in adolescents who have faced a number of negative life events.

Measuring public attitudes towards people living with chronic diseases in Arabic-speaking populations: adaptation and development of the Social Stigma Scale of Chronic Diseases (SSS-CD).

BACKGROUND: A large proportion of the population in Arab countries suffer from chronic diseases. According to the statistics by the Global Health Estimates, chronic illnesses contribute by 71% to total deaths in the Arab region. While chronic illnesses have been demonstrated to carry high levels of social stigma, it is only recently that little research attention has been given to this topic in the Arab world. It is well-established that the social stigma construct is culturally-dependent. Therefore, the lack of an Arabic measure highlighted the urgent need for developing a culturally adapted and valid instrument to assess social stigma toward people living with chronic diseases. In this study, we aimed to examine the psychometric properties of the Arabic translation, adaptation and development of "the Social Stigma Scale of Chronic Diseases" (SSS-CD). METHOD: Fifteen items derived from the literature and assessing social stigma towards chronic diseases have been administered to 570 Arabic-speaking adults from the Lebanese general population (aged 24.59 ± 6.75years; 68.6% women). Items were translated into Arabic using a forward-backward translation method. Exploratory factor analysis (EFA) using a principal-axis EFA on the first split-half subsample, followed by a confirmatory factor analysis (CFA) tested on the model extracted from the EFA on the second split-half subsample, were conducted to examine the construct validity of the SSS-CD. Fit indices were deemed adequate if the normed model chi-square (χ²/df) ≤ 3, the Steiger-Lind root mean square error of approximation (RMSEA) ≤ 0.08, the Tucker-Lewis Index (TLI) and the comparative fit index (CFI) ≥ 0.90. RESULTS: Findings revealed that the 10-item SSS-CD has a unidimensional factor structure, with the following fit indices: χ2/df = 92.95/34 = 2.73, RMSEA = 0.077 (90% CI 0.059, 0.096), SRMR = 0.062, CFI = 0.939, TLI = 0.919. A good internal consistency was demonstrated by a McDonald's omega value of 0.73 for the total score. Findings also supported invariance across gender, with men exhibiting higher levels of social stigma attached to chronic diseases than women. All three dimensions of stigmatization (social, psychological and evolutionary stigmatization) were positively correlated with SSS-CD scores (Social self-interest [r = .40; p < .001], Evolutionary self-interest [r = .37; p < .001], Psychological self-interest [r = .42; p < .001]), demonstrating relatively strong convergent validity. CONCLUSION: Our findings suggest that the SSS-CD has robust psychometric qualities. We thus preliminarily suggest that the scale is valid, reliable and suitable for use among Arabic-speaking people from the general population to measure public attitudes towards people living with chronic diseases. Providing this psychometrically sound measure will hopefully enable to foster research in this area in order to draw a clear overview of the prevalence and characteristics of social stigma attached to chronic diseases in Arabic-speaking communities. However, given that this was the first study to examine the psychometric properties of the SSS-CD, the present findings and conclusions should be considered tentative pending future cross-national validation studies.

Irritable bowel syndrome (IBS) among Lebanese adults: unidentified IBS and associated factors.

BACKGROUND: Irritable bowel syndrome (IBS) is one of the most frequent functional gastrointestinal disorders, but the condition is still underdiagnosed. The high of rate of unidentified IBS by patients can be related to different factors. The aim of this study is to assess the rate of unidentified IBS among Lebanese adults and investigate the role of socio-demographic factors, anxiety, depression, insomnia and eating attitudes on IBS diagnosis. METHODS: A cross-sectional study was conducted among Lebanese adults older than 18 years between June 2022 and December 2022, using a self-reporting questionnaire distributed via social media. RESULTS: A total of 425 participants was enrolled in the study with around 184 (46.8%) having a possible unidentified IBS. Higher psychological distress (aOR = 1.07) and insomnia severity (aOR = 1.08) were significantly associated with higher odds of having possible unidentified IBS whereas a higher household crowding index (aOR = 0.67) was significantly associated with lower odds of having possible IBS. The correlation of eating attitudes with cigarette smoking (aOR = 1.33; p = .025; 95% CI 1.04; 1.70) and insomnia severity with cigarette smoking (aOR = .89; p = .023; 95% CI .80; .98) were significantly associated with the presence of possible IBS. In nonsmokers, higher psychological distress (aOR = 1.07) and insomnia severity (aOR = 1.10) were significantly associated with higher odds of having possible IBS. In smokers, higher BMI (aOR = .78) was significantly associated with lower odds of having possible IBS, whereas higher eating attitudes scores (more inappropriate eating) (aOR = 1.40) were significantly associated with higher odds of having possible IBS. CONCLUSION: The study highlighted the implication of raising awareness about IBS among the Lebanese population to promote early diagnosis and minimize the rate of unidentified IBS by patients. Initiation of appropriate treatment plans, tailored symptomatic management approach, and diet programs should be highly encouraged.

Knowledge, attitudes, and practices of Lebanese university students related to sexually transmitted diseases: a cross-sectional study.

AIM: To appraise Lebanese university students' knowledge, attitudes, and practices related to sexually transmitted diseases (STDs). METHODS: This cross-sectional study was conducted in March and April 2020. A total of 402 students (67.9% women) from ten universities located in different Lebanese regions were recruited through convenient sampling. RESULTS: Pursuing a major in non-health sciences compared with a major in health sciences (adjusted odds ratio [aOR]=0.08) was significantly associated with lower odds of having better knowledge of STDs. Older age (aOR=1.09) was significantly associated with higher odds of having better knowledge of STDs. Having good vs poor knowledge (aOR=3.88) was significantly associated with higher odds of having favorable attitudes toward STDs, whereas pursuing a major in non-health sciences compared with a major in health sciences (aOR=0.28) was significantly associated with lower odds of having favorable attitudes toward STDs. Women compared with men (aOR=2.21) had higher odds of having healthier practices related to STDs. Attitude did not mediate the association between knowledge and practice. CONCLUSION: Attitude did not significantly mediate the association between knowledge and practice. Therefore, educational programs and awareness campaigns should be implemented in secondary schools and among vulnerable non-medical students. Such efforts can help students identify the symptoms of STDs, seek medical attention, and make informed decisions to protect themselves.

Validation of the Arabic version of the Eating Attitude Test in Lebanon: a population study.

OBJECTIVES: To validate an Arabic version of the Eating Attitude Test (EAT-26) and identify factors (such as depression, stress, anxiety and body dissatisfaction) that might be associated with disordered eating among a sample of the Lebanese population. DESIGN: Cross-sectional study. SETTING: All Lebanese governorates. PARTICIPANTS: A total of 811 participants randomly selected participated in this 5-month study (January-May 2018). RESULTS: The EAT-26 scale items converged over a solution of six factors that had an eigenvalue over 1, explaining a total of 60·07 % of the variance (Cronbach's α = 0·895). The prevalence of disordered eating attitudes was 23·8 %. Higher EAT-26 scores (disordered eating attitudes) were significantly associated with higher depression (ß = 0·325), higher emotional eating (ß = 0·083), daily weighing (ß = 3·430), higher physical activity (ß = 0·05), starving to reduce weight (ß = 4·94) and feeling pressure from TV/magazine to lose weight (ß = 3·95). CONCLUSIONS: The Arabic version of EAT-26 can be a useful instrument for screening and assessing disordered eating attitudes in clinical practice and research. Some factors seem to be associated with more disordered eating attitudes among participants for whom psychological counseling may be needed. Yet, our findings are considered preliminary, and further studies are warranted to confirm them.

Attitudes of Lebanese adults regarding COVID-19 vaccination.

BACKGROUND: COVID-19 was first detected in Lebanon on February 21, 2020; it reached its peak in January 2021, with a total number of 418,448 confirmed cases and 5380 deaths (until March 15, 2021). Gaining insight into factors regarding willingness or refusal for vaccination might guide our goals in raising the awareness and target efforts to increase acceptance of the COVID-19 vaccine and maximize the uptake. Therefore, this study aims to assess the intent to receive the COVID-19 vaccine among Lebanese adults and the factors associated with vaccine refusal. METHODS: We conducted a cross-sectional study during November-December 2020 among Lebanese adults from all Lebanese regions using a survey tool with closed-ended questions that included sociodemographic data and questions about vaccine hesitancy, knowledge, attitude, practice, and fear of COVID-19. We used the snowball technique to collect the data because of the COVID-19 imposed lockdown. RESULTS: Of the 579 participants, 21.4% were willing to receive the vaccine, 40.9% refused, and the remainder were unsure of their response. More vaccine hesitancy (adjusted odds ratio (aOR) = 1.06; 95% CI 1.03-1.09) was significantly associated with more odds of disagreeing/ strongly disagreeing on receiving the COVID-19 vaccine compared to being neutral. More vaccine hesitancy (aOR = 0.95; 95% CI 0.91-0.99), female gender compared to males (aOR = 0.53; 95% CI 0.32-0.87), and being married compared to single (aOR = 0.53; 95% CI 0.29-0.98) were significantly associated with lower odds of agreeing/strongly agreeing on receiving the COVID-19 vaccine compared to being neutral. CONCLUSION: Overall, our findings revealed a high percentage of people (40%) who strongly disagreed with receiving the vaccine, mainly females, married participants, and those who have a general vaccine hesitancy. Moreover, no significant association was found with knowledge, attitude, or prevention practice regarding COVID-19. Targeted efforts are necessary to increase acceptance of a COVID-19 vaccine among the Lebanese population to control the COVID-19 pandemic. Further studies with a larger sample size are warranted to validate our results and provide better insights into the underlying reasons for refusing vaccination.

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 between parental divorce and mental health outcomes among Lebanese adolescents: results of a national study.

BACKGROUND: In Lebanon, divorce rates have jumped from nearly 7000 in recent years to 8580 in 2017, an increase of 22.5%, with North Lebanon recording the highest number, followed by Beirut, likely resulting in increased behavioral problems in the offspring of divorced parents. Furthermore, one out of two Lebanese adolescents whose biological parents were divorced, separated, or deceased has a psychiatric disorder. More information regarding the impact of divorce on the mental health of Lebanese adolescents is still missing. The objective of this study was to explore the association between divorce and mental health outcomes, particularly depression, anxiety, and suicidal ideation among Lebanese adolescents. METHODS: A cross-sectional study conducted between January and May 2019 enrolled 1810 adolescents aged 14 to 17 years, using a simple randomization method to choose schools. A proportionate number of schools was selected from each of the five Lebanese Mohafazat (Beirut, Mount Lebanon, North, South, and Beqaa), based on the list of the Ministry of Education and Higher Education. A total of 18 private schools were approached; two declined, and 16 accepted to participate. RESULTS: The mean age of participants was 15.42 ± 1.14 years, with 53.3% females. After adjustment for the covariates (age, sex, and house crowding index), the results showed that adolescents whose parents are separated compared to living together had more social fear (Standardized Beta (SB = 0.270) and avoidance (SB = 0.188), higher depression (SB = 0.045), and higher suicidal ideation (SB = 0.370). CONCLUSION: Our findings reveal that teens with divorced parents had higher social fear and avoidance, depression, and suicidal ideation, highlighting the need for adequate prevention programs to support both children and parents during this emotionally difficult period.