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.

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

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

The relationship between cyberbullying perpetration/victimization and suicidal ideation in healthy young adults: the indirect effects of positive and negative psychotic experiences.

BACKGROUND: Even though not all cyber bullies or victims think of (or consider) suicide, they clearly appear to be at an increased risk. One possible strategy to reduce suicide risk is to decrease cyberbullying occurrence; but this approach has its limitations, as it is certainly an illusion to believe that cyberbullying could be controlled or eliminated in a digitalized world. Another alternative and interesting strategy is to consider mediating factors that may indirectly affect suicidality. To this end, our purpose was to test the hypothesis that positive and negative psychotic experiences (PEs) mediate the relationship from cyberbullying perpetration/victimization to suicidal ideation (SI). METHOD: The study followed a cross-sectional design, and was conducted during the period from June to September 2022. A total of 3103 healthy community participants from Lebanon were included (mean age 21.73 ± 3.80 years, 63.6% females). RESULTS: After adjusting over potential confounders, mediation analysis models showed that both positive and negative PEs partially mediated the associations between cyberbullying victimization/perpetration and SI. Higher cyberbullying perpetration and victimization were significantly associated with greater positive and negative PEs; more severe positive and negative PEs were significantly associated with higher levels of SI. Higher cyberbullying victimization and perpetration were significantly and directly associated with higher levels of SI. CONCLUSION: In light of our preliminary findings, there appears to be an urgent need for a new focus on carefully assessing and addressing attenuated psychotic symptoms in healthy individuals engaged in cyberbullying either as victims or bullies and who present with SI. It is important that school counselors and decision-makers consider a holistic approach taking into account both external/environmental (bullying) and internal/individual (PEs) factors in their suicide prevention programs. Future longitudinal research in larger samples are still required to confirm our findings and further elucidate the mechanisms underlying the relationship between cyberbullying and suicide.

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.

Translation and validation to the Arabic language version of the climate change anxiety scale (CCAS).

BACKGROUND: The Arab world is one of the global regions the most directly concerned by, and suffering from climate change's adverse consequences. As such, there appears to be a strong need for an understanding of how Arab people may emotionally respond to climate change. Providing valid and reliable measures of climate change anxiety (CCA) can help gain a clear overview of the situation in Arab countries, and allow to intervene timely and effectively to mitigate any adverse effects on Arab people's mental health. To this end, the present study sought to validate the Arabic language version of the Climate Change Anxiety Scale (CCAS) in a sample of native Arabic-speaking adults from the general population of Lebanon. METHODS: This study adopted a cross-sectional approach and enrolled 763 adults between July and September 2023. RESULTS: A confirmatory analysis of the one-factor model showed poor fit indices as follows: CFI = 0.90, GFI = 0.83, SRMR = 0.048 and RMSEA 0.131 [90% CI 0.123, 0.138). The two-factor model showed a satisfactory fit with a high CFI of and a GFI of 0.91 and a SRMR of 0.04 and RMSEA of 0.05 [90% CI 0.04, 0.06]. Both McDonald's omega and Cronbach alpha values were high for the overall CCAS score (α = 0.96 and ω = 0.96) in the whole sample. Configural, metric and scalar invariance across gender was demonstrated. No significant difference was found between males and females in terms of total CCAS scores (24.53 ± 10.59 vs. 26.03 ± 11.17, t(761) = -1.82, p = .069). Higher CCA, functional impairment and cognitive impairment scores were significantly associated with higher depression, anxiety and stress. CONCLUSION: The reliability and validity of the CCAS in its Arabic version were proven. The availability of this self-report measure could offer a chance to assess CCA among Adults speaking Arabic, and to spread its future use for screening and research purposes.

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.

Psychometric properties of an Arabic translation of the long (12 items) and short (7 items) forms of the Violent Ideations Scale (VIS) in a non-clinical sample of adolescents.

BACKGROUND: Accurately measuring violent ideations would be of particular high relevance in Arab countries, which are witnessing an unprecedented increase in violence rates among adolescents because of the widespread social, economic and political unrest in the region. Therefore, the present study aimed to test the psychometric properties of an Arabic translation of the 12-item and the 7-item forms of the Violent Ideations Scale (VIS and VIS-SF) in a sample on non-clinical Arabic-speaking adolescents. METHODS: Five hundred seventy-seven community adolescents (mean age of 15.90 ± 1.73 years, 56.5% females) answered an anonymous online survey comprising an Arabic translation of the Violent Ideations Scale (VIS) and a measure of physical aggression. RESULTS: Confirmatory factor analyses (CFA) offered support for the single-factor structure of the Arabic VIS and the VIS-SF. Both the long and short forms of the scale yielded excellent internal consistency, with McDonald's ω coefficients of 0.96 and 0.94 and Cronbach's α coefficients of 0.96 and 0.94, respectively. Multi-group CFA established measurement invariance across gender groups. Finally, results revealed significant and positive correlations between the two forms of the VIS and physical aggression scores, thus supporting concurrent validity. CONCLUSION: Both the VIS and VIS-SF have demonstrated good psychometric properties in their Arabic versions, and suitability for sound assessment of violent ideations. We therefore expect that these measures assist clinicians in risk assessment and management of violence, and help foster research in this area in Arab countries.

Psychometric properties of the Arabic version of the Nightmares Distress Questionnaire (NDQ-AV) in a community sample of adolescents.

BACKGROUND: The Nightmare Distress Questionnaire (NDQ), known and commonly used for its adequate psychometric properties, is the most widely used instrument for the measurement of nightmare distress. This study aimed to assess the psychometric properties of a newly translated Arabic version of the Nightmare Distress Questionnaire (NDQ-AV). METHODS: A total of 546 Lebanese adolescents was recruited for this study and completed the NDQ-AV, the Insomnia Severity Index (ISI), and the eight-item Depression, Anxiety and Stress Scale (DASS-8). RESULTS: The results of the exploratory factor analysis (EFA) and the confirmatory factor analysis (CFA) supported both a one-factor model and a two-factor model of the NDQ-AV, with the latter consisting of seven items within both factors. The first factor was referred to as the "general nightmare distress and coping" while the second was named "nightmare impact and perception". The reliability of the scale was excellent (α = 0.930 and ω = 0.915). Moreover, measurement invariance was shown across gender, demonstrating that this measure performs consistently for both men and women. Additionally, the NDQ-AV scores exhibited excellent reliability alongside factorial and concurrent validity. CONCLUSION: In conclusion, these results support the psychometric validity of the Arabic version of the NDQ. The availability of the NDQ-AV is expected to facilitate the understanding of nightmare distress within the Lebanese context.

Psychometric properties of the ultra-brief self-report Patient Health Questionnaire-4 (PHQ-4) to assess anxiety and depression in Arabic-speaking adults.

BACKGROUND: Anxiety and depression are psychiatric disorders that often coexist and share some features. Developing a simple and cost-effective tool to assess anxiety and depression in the Arabic-speaking population, predominantly residing in low- and middle-income nations where research can be arduous, would be immensely beneficial. The study aimed to translate the four-item composite Patient Health Questionnaire - 4 (PHQ-4) into Arabic and evaluate its psychometric properties, including internal reliability, sex invariance, composite reliability, and correlation with measures of psychological distress. METHODS: 587 Arabic-speaking adults were recruited between February and March 2023. An anonymous self-administered Google Forms link was distributed via social media networks. We utilized the FACTOR software to explore the factor structure of the Arabic PHQ-4. RESULTS: Confirmatory factor analysis (CFA) indicated that fit of the two-factor model of the PHQ-4 scores was modest (χ2/df = .13/1 = .13, RMSEA = .001, SRMR = .002, CFI = 1.005, TLI = 1.000). Internal reliability was excellent (McDonald's omega = .86; Cronbach's alpha = .86). Indices suggested that configural, metric, and scalar invariance were supported across sex. No significant difference was found between males and females in terms of the PHQ-4 total scores, PHQ-4 anxiety scores, and PHQ-4 depression scores. The total score of the PHQ-4 and its depression and anxiety scores were significantly and moderately-to-strongly associated with lower wellbeing and higher Depression Anxiety and Stress Scale (DASS) total and subscales scores. CONCLUSION: The PHQ-4 proves to be a reliable, valid, and cost-effective tool for assessing symptoms related to depression and anxiety. To evaluate the practical effectiveness of the Arabic PHQ-4 and to further enhance the data on its construct validity, future studies should assess the measure in diverse contexts and among specific populations.

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.

Profiles of intuitive eating in adults: the role of self-esteem, interoceptive awareness, and motivation for healthy eating.

OBJECTIVE: Intuitive eating is an eating behavior that has recently come to use mainly in the young population. Knowing that the Lebanese cultural diet differs from other countries, the purpose of this study was to investigate if there is a relationship between self-esteem, interoceptive awareness, and motivation for healthy eating in a sample of Lebanese adults using a Latent Profile Analysis approach. DESIGN: Cross-sectional study. SETTING: Lebanese governorates. PARTICIPANTS: 359 Lebanese participants enrolled in this study (mean age: 22.75 ± 7.04 years, 40.1% males), through convenience sampling in several Lebanese governorates. Participants were asked to fill anonymously the following scales: The Intuitive Eating Scale (IES-2), the Rosenberg Self-Esteem Scale, the Multidimensional Assessment of Interoceptive Awareness Scale (MAIA), and the Motivation for Healthy Eating Scale (MHES). RESULTS: Our findings revealed four profiles: profile 1 (n = 67; 18.66%) characterized by high SE and intermediate interoceptive awareness and motivation for healthy eating; profile 2 (n = 86; 23.97%) presented high SE, interoceptive awareness, and motivation for healthy eating; profile 3 (n = 86; 23.96%) characterized by high SE, interoceptive awareness, and motivation for healthy eating; class 4 (n = 108; 30.08) described by low SE, intermediate interoceptive awareness, and motivation for healthy eating One-way analysis of variance did not observe a significant difference between the four profiles based on intuitive eating (F = 1.810; p = 0.145; ɳp2 = 0.015). CONCLUSIONS: Among a sample of Lebanese people, four profiles of interoceptive awareness, motivation for healthy eating, and self-esteem were observed, with no difference concerning intuitive eating.

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.

Mediating effect of suicidal ideation in the association between child abuse and premenstrual syndrome among female adults.

INTRODUCTION: Premenstrual symptoms encompass a range of physical, emotional, and behavioral changes that cyclically occur before menstruation. Childhood abuse has been associated with subsequent mental health challenges, yet its relationship with exacerbating premenstrual symptoms remains an understudied area. Furthermore, suicidal ideation often emerges from traumatic backgrounds such as child abuse, creating another layer of complexity. Given the rising suicide rates in Lebanon, and the concurrent increase in reported child abuse cases, this research focuses on the role of suicidal ideation as a mediator between child abuse and premenstrual syndrome. METHODS: This cross-sectional study involved 915 female university students in Lebanon. Participants completed an online questionnaire encompassing demographic details, health lifestyle, the Premenstrual Symptoms Screening Tool (PSST), Columbia-Suicide Severity Rating Scale (C-SSRS), and Child Abuse Self Report Scale (CASRS-12). The mediation analysis was conducted using PROCESS MACRO v3.4 model 4; three pathways derived from this analysis: pathway A from the independent variable to the mediator, pathway B from the mediator to the dependent variable, Pathway C indicating the direct effect from the independent to the dependent variable. RESULTS: The results of the mediation analysis showed that suicidal ideation mediated the association between all types of child abuse and the presence of PMS. Higher psychological (Beta = 0.21; p < 0.001), neglect (Beta = 0.02; p = 0.017), physical (Beta = 0.19; p < 0.001) and sexual (Beta = 0.20, p < 0.001) child abuse were significantly associated with higher suicidal ideation, which was significantly associated with the presence of PMS (Beta = 0.38, p = 0.001; Beta = 0.57, p < 0.001; Beta = 0.45, p < 0.001; and Beta = 0.50, p < 0.001) respectively. Finally, higher psychological (Beta = 0.17, p < 0.001), physical (Beta = 0.11, p = 0.024), but not sexual (Beta = 0.07, p = 0.198) child abuse was directly and significantly associated with the presence of PMS, whereas higher neglect (Beta = -0.06, p = 0.007) was significantly associated lower odds of having PMS. CONCLUSION: This study highlights the mediating role of suicidal ideation in the complex association between different types of childhood abuse and premenstrual symptoms. The findings emphasize the need for trauma-informed care and tailored interventions to address the diverse impact of these factors. Recognizing the intricate relationships between child abuse, suicidal ideation, and PMS can aid healthcare providers in comprehensively addressing young women's mental and reproductive well-being. Trauma-informed care, tailored interventions and awareness of potential connections between childhood maltreatment are essential in managing these complex challenges.

Mediating effect of psychological distress and mindful eating behaviors between orthorexia nervosa and academic self-efficacy among Lebanese university female students.

OBJECTIVES: This study examined the mediating effect of psychological distress and mindful eating behaviors between orthorexia nervosa and academic self-efficacy among Lebanese university female students. METHODS: A total of 769 female participants enrolled in this cross-sectional study (mean age 21.58 ± 3.20 years). A self-administered questionnaire was distributed among university female students. The questionnaire consisted of Mindful Eating Behaviors Scale, ORTO-R, Depression Anxiety Stress Scale, and Arabic version of Academic Self-Efficacy Scale. RESULTS: The results showed that psychological distress fully mediated the association between orthorexia nervosa and academic self-efficacy; higher orthorexia nervosa was significantly associated with less psychological distress (ß= -0.31, p =.05), with more psychological distress significantly associated with lower academic self-efficacy (ß= -0.32, p =.09). Focused eating fully mediated the association between orthorexia nervosa and academic self-efficacy; higher orthorexia nervosa was significantly associated with less focused eating (ß=-0.09, p =.04), with more focused eating significantly associated with better academic self-efficacy (ß = 1.40, p =.10). Orthorexia nervosa was not directly associated with academic self-efficacy in both models. CONCLUSION: This study shed light on important connections between orthorexia nervosa, psychological distress, mindful eating behaviors, and academic self-efficacy within the Lebanese context. The findings will have practical implications for both educational institutions and healthcare providers striving to support young female adults' overall well-being and academic success.

Mediating effect of depression and acute stress between exposure to Israel-Gaza war media coverage and insomnia: a multinational study from five arab countries.

BACKGROUND: In the context of persistent wars and conflicts worldwide, the impact of acute, excessive and constant exposure to media coverage of such events on mental health outcomes becomes a serious problem for public health, and requires therefore urgent investigation to inform an effective prevention and management response. The objective of the present study was to test the hypothesis that war-related media exposure is directly and indirectly associated with insomnia through depression and perceived stress among adults from the general population of different Arab countries. METHODS: A cross-sectional study was carried-out two weeks after the beginning of Israel-Gaza war on the 7th of October 2023. An anonymous online survey and a snowball sampling method were adopted to collect data. A sample of 2635 general population adults (mean age of 23.98 ± 7.55 years, 73.1% females) took part of this study. RESULTS: The results of the mediation analysis showed that, after adjusting over potential confounders, depression and perceived stress fully mediated the association between war media exposure and insomnia; higher war media exposure was significantly associated with higher depression (Beta = 0.13; p < .001) and perceived stress (Beta = 0.07; p < .001), whereas higher depression (Beta = 0.43; p < .001) and perceived stress (Beta = 0.31; p < .001) were significantly associated with higher insomnia. It is of note that war media exposure was not significantly and directly associated with insomnia (Beta = - 0.01; p = .178 and Beta = 0.02; p = .098 respectively). CONCLUSION: The present study is the first to provide evidence that more time spent viewing the horrors of war is significantly associated with insomnia. In addition, symptoms of stress and depression were present as early as two weeks following the beginning of the war, and played a significant role in mediating the association between war media coverage and insomnia. These findings suggest that timely screening for, and management of depression and stress symptoms in clinical and preventive programs might be beneficial for community adults who have been heavily and indirectly exposed to war through media, and present with insomnia.

Association between textual and pictorial warnings on tumbac (waterpipe tobacco) boxes and motivation to quit waterpipe smoking among Lebanese and Iraqi adolescents.

BACKGROUND: Waterpipe tobacco smoking has increased tremendously at a global level among all age groups, particularly young people. Previous studies have examined the impact of waterpipe tobacco pictorial health warnings on adults but scarce studies were done on adolescents. The aim of this study was to assess the association of textual versus pictorial warnings on tumbac boxes and the motivation to quit waterpipe smoking among adolescents located in two Eastern Mediterranean countries Lebanon and Iraq. METHODS: A cross-sectional study was conducted between May and November 2022, involving 294 adolescents waterpipe smokers from Lebanon and Iraq. The questionnaire included the Lebanese Waterpipe Dependence Smoking-11, the Depression, Anxiety and Stress Scale, the Waterpipe Harm Perception Scale, Waterpipe Knowledge Scale, Waterpipe Attitude Scale, the Fagerstrom Test for Nicotine Dependence, and the Motivation to Stop Scale. RESULTS: When adjusting the results over confounding variables, the results showed that compared to finding the warnings to stop smoking not efficacious at all, adolescents who find the warnings moderately (aOR = 2.83) and very (aOR = 6.64) efficacious had higher motivation to quit. Compared to finding the warnings not increasing their curiosity for information about how to stop waterpipe smoking at all, participants who confessed that warnings increased their curiosity a little (aOR = 2.59), moderately (aOR = 3.34) and very (aOR = 3.58) had higher motivation to quit. Compared to not considering changing the tumbac brand if the company uses pictorial warnings, adolescents who would consider changing the tumbac brand (aOR = 2.15) had higher motivation to quit. CONCLUSION: Pictorial and textual warnings on waterpipe packs were associated with higher motivation to stop waterpipe smoking. Public health education programs for this purpose seem warranted.

Does mindfulness moderate the association between impulsivity and well-being in Lebanese university students?

Limited evidence showed that impulsivity is negatively related to life satisfaction and wellbeing; however, the mechanisms underlying this relationship remain unclear. We aimed through this work to investigate the relationship between impulsivity dimensions and well-being and to explore the moderator role of mindfulness on this relationship in a sample of Lebanese university students. This cross-sectional study was carried out among 363 university students recruited through convenience sampling through several universities in Lebanon's governorates. Higher mindfulness was significantly associated with better wellbeing in the models that considered urgency and sensation seeking as independent variables. A lack of premeditation and a lack of perseverance were both inversely associated with well-being. The interaction lack of perseverance by mindfulness was significantly associated with wellbeing; for students who were low in mindfulness, more lack of perseverance was significantly associated with a lower wellbeing. Our study suggested that mindfulness practice may offer a promising avenue for implementing strategies aiming at improving the well-being of students with high levels of impulsivity.

Association between work fatigue and cognitive function among Lebanese health-care professionals: the moderating effect of emotional intelligence.

The aim of this study was to assess the association between work-related fatigue and cognitive impairment among Lebanese health-care professionals with a closer look into the moderating role of emotional intelligence. This cross-sectional study was conducted between November 2021 and January 2022; 406 Lebanese health-care professionals were recruited through convenience sampling. Moderate analysis showed that with low levels of emotional intelligence, more physical, mental, or emotional work fatigue was significantly associated with lower cognitive function scores. These scores get better in people with moderate and high emotional intelligence for the same levels of work fatigue. Health-care workers, especially in Lebanon, are subject to a decline in their cognitive function when faced to high work fatigue loads in all its types, physical, mental, and emotional, along with the country's stressors. Here comes the role of emotional intelligence, where for the same level of fatigue, professionals with high emotional intelligence tend to have better cognitive functioning.

Path analysis of the role of coping strategies between emotional intelligence and lifestyle habits during COVID-19 lockdown.

The relationship between Emotional Intelligence (EI) and lifestyle choices during the COVID-19 pandemic is obscure and not very well understood. To clarify the mechanisms underlying this relationship, we proposed to test the hypothesis that different coping styles (avoidant and approach) have an indirect effect on the association between EI and many types of lifestyle habits. A cross-sectional study was conducted between December 2020 and January 2021. Our target sample consisted of Lebanese adults from the general population. In path analysis, approach coping mediated the association between EI and different lifestyle habits (rest, nutrition, general physical conditions), but not exercise. Furthermore, avoidant coping did mediate the association between EI and general physical conditions, but not between EI and other lifestyle choices (namely rest, exercise, and nutrition). To conclude, individuals with high EI, and that are users of approach coping strategies to deal with stressors, have increased rest time, healthy nutrition and general physical conditions. This cautiously implies that fostering approach coping may help improve the positive effects of EI on healthy lifestyles during crises such as this pandemic.

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

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