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The associations between attachment relationships, negative automatic thoughts, and psychological problems are theoretically supported and well-entrenched in the literature. Based on the integration of the attachment theory and the cognitive theory, the current study investigated: (a) the mediation effect of negative automatic thoughts in the linkages between attachment relationships (maternal, paternal, and peer attachment) and psychological problems (depressive and anxiety symptoms); and (b) the moderating role of adolescent's gender in the mediation model. The data in this cross sectional study were collected from 936 Pakistani late adolescents (mean age = 17.79 years, SD = .69) studied in Rawalpindi district colleges, through multi-stage cluster sampling. Participants completed a set of questionnaires including Inventory of Parent and Peer Attachment-Urdu, Depression, Anxiety and Stress Scale and Automatic Thoughts Questionnaire. The models were tested through structural equation modelling. Results indicated that quality of maternal and peer attachments were indirectly linked with depressive and anxiety symptoms via negative automatic thoughts, paternal attachment was directly and indirectly associated with depressive symptoms, while parental attachment was indirectly related to anxiety symptoms. Additionally, the moderated mediation analysis showed that for females, quality of maternal, paternal, and peer attachment showed indirect association with depressive and anxiety symptoms. For males, only paternal and peer attachment had significant association with depressive and anxiety symptoms through negative automatic thoughts. The current study enhances our understanding of the distinct role of attachment security with mother, father and peers on the differential developmental outcomes of male and female adolescents. Implications are further discussed in the article., Author(s): Siddrah Irfan [sup.1] [sup.2] , Nor Sheereen Zulkefly [sup.1] Author Affiliations: (1) grid.11142.37, 0000 0001 2231 800X, Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, [...]

Background: Mental illness among Malaysian children is gradually reaching a fundamentally alarming point as it persistently shows increasing trend. The existing literature on the etiologies of children’s mental illness, highlights the most common cause to be ineffective or impaired parenting. Thus, efforts to combat mental illness in children should focus on improving the quality of parenting. Documented interventional studies focusing on this issue, particularly in Malaysia, are scarce and commonly report poor treatment outcomes stemming from inconvenient face-to-face instructions. Consequently, proposing an accessible online and digital-assisted parenting program is expected to reach a larger number of parents, as it can overcome substantial barriers. Hence, this study aims to develop a universal digital-assisted preventive parenting intervention called DaPI, that aims to enhance mental health of children in Malaysia. Methods: A total of 200 parents of children aged 10–14 years will be recruited and randomized into two groups either intervention or waitlist-control based on a 1:1 ratio for a duration of 8 weeks. Those in the intervention group will receive eight sessions of the DaPI program that focus mainly on parenting and children’s mental health. The primary outcome of this study will essentially focus on the changes in parent-reported parenting behavior and parental self-efficacy. The secondary outcome will be changes in children’s mental health (i.e., behavioral problems and emotional maladjustment). Assessments will be arranged pre- and post-intervention as well as at the 1-month follow-up. Analyses will be conducted using a paired t-test and multivariate analysis of covariance. Discussion: The expected outcome will be the establishment of DaPI in promoting children’s mental health by targeting changes in parenting behavior and parental self-efficacy in Malaysia. Findings from this study will be beneficial for policymakers to invest in parenting programs that could provide support to parents in enhancing their child’s overall development. [ABSTRACT FROM AUTHOR]

The present pilot study examined the associations between attachment relationships, psychological problems, and negative automatic thoughts among late adolescents in Rawalpindi, Pakistan. A total of 98 participants (male = 49, female = 49) were recruited from government colleges in Rawalpindi, Pakistan. The measures used to assess the research variables of this cross sectional study were the Inventory of Parent-Peer Attachment (IPPA-Urdu), Depression, Anxiety, and Stress Scale (DASS-Urdu), and the Automatic Thought Questionnaire (ATQ-Urdu). All of these measures had good reliabilities. Findings of the correlation analyses demonstrated that maternal, paternal and peer attachment relationships were negatively related to symptoms of depression and anxiety as well as to negative automatic thoughts. On the other hand, depressive and anxiety symptoms were positively associated with negative automatic thoughts. Additionally, findings suggested that future studies must investigate adolescents from two-parent households and exclude those with only one living parent. The results underscored the need for further investigations of the linkages between attachment relationships, negative automatic thoughts and psychological problems on larger samples. [ABSTRACT FROM AUTHOR]

The present study aimed to examine the mediational role of maladaptive cognitive schema in the association between stressful life events, which are operationalised as major (i. e. negative life events) and minor (i. e. daily hassles) life stressors, and depressive symptoms among adolescents. A cross-sectional correlational study was conducted to recruit participants across four selected states of Kedah, Kelantan, Melaka and Selangor in Peninsular Malaysia. This study involved a total of 1,032 adolescents from 25 government secondary schools, identified using probability proportional to size cluster sampling technique. Data were collected through a self-report questionnaire. Using structural equation modelling analyses, findings revealed a full mediation effect of maladaptive cognitive schema between negative life events and depressive symptoms, and a partial mediation effect between daily hassles and depressive symptoms. This study provided valuable insights about the significance of maladaptive cognitive schema as a mediator in the stress-depression association and advanced the understanding of mechanism underlying development of depressive symptoms among adolescents in Malaysia. Findings also benefit the clinical practice in the development of targeted depression prevention and intervention programs. [ABSTRACT FROM AUTHOR]

We conducted a study with the aims of examining adolescents' perceptions of their mother's and father's parenting behavior and developing a new Malaysian Parenting Behavior Inventory (MPBI). In Phase One, we recruited 903 adolescents using the proportionate to size sampling technique. The results of the exploratory factor analyses of the MPBI Mother and Father scales revealed four underlying factor structures: Warmth, Monitoring, and Harsh Discipline were somewhat similar to those in past findings and theory, and Indigenous centered on religious and cultural values in parenting. In Phase Two, using an independent sample of adolescents, we replicated the factor structure of Study One with confirmatory factor analysis, resulting in strong model fit estimates. We conclude that the MPBI has good initial psychometric properties and is culturally influenced. The MPBI may be useful for prevention and intervention programs in clinical and non-clinical settings, including providing valuable information on factors pertinent to parent-adolescent interactions. [ABSTRACT FROM AUTHOR]

Depressive symptomatology is a serious mental health problem that has been observed among Malaysian adolescents. Hence, we conducted a cross-sectional study to identify the risk and protective factors for adolescent depressive symptoms. Specifically, we hypothesized that stressful life events, parental verbal aggression, and parental warmth are significantly associated with adolescent depressive symptoms. A sample of 1092 adolescents (13-19 years old; 447 boys and 645 girls) was recruited using probability proportional to size cluster sampling from 20 secondary schools in four states across Malaysia. Results of the multivariable logistic regression analysis revealed that stressful life events and maternal verbal aggression had significant main effects on depressive symptoms. In the moderation analyses, paternal warmth alleviated the influence of paternal verbal aggression on depressive symptoms. In contrast, both paternal and maternal warmth exacerbated the depressogenic impact of maternal verbal aggression. Such findings could improve prevention and intervention programs for combatting depressive symptoms in Malaysian adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Early onset of externalizing behaviour may increase the likelihood of extensive maladaptation in future life. Recently, there has been a growing research undertaken on the role of religiosity on externalizing behaviour among Muslim adolescents. However, the mechanism underlying this relationship is still poorly understood. This study sets out to examine the relationships between adolescent religiosity, self-control, and externalizing behaviours (rule-breaking and aggressive behaviours) of Muslim juveniles in rehabilitation centre. Methods: Questionnaire assessments of adolescent religiosity, self-control, rule-breaking behaviour, and aggressive behaviour were collected from 427 Muslim adolescents aged between 13 to 18 years old in eight Tunas Bakti Schools (STB). Results: Structural equation modeling analysis indicated adolescent religiosity was negatively associated with externalizing behaviour, both directly and indirectly. The indirect association was mediated by self-control. This study suggests that greater adolescent religiosity was associated with higher self-control, which in turn lowers both rule-breaking and aggressive behaviour. Conclusion: The results highlight the important role of religiosity and self-control in preventing externalizing behaviour among Muslim adolescents. Further step towards designing preventative strategy may need to consider integrating both Islamic-based program and self-control input to enhance mental health and behavioural adjustment of Muslim adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Negative automatic thoughts refer to subconscious thinking patterns in response to irrational and self-defeating stimuli. Individuals who are depressed tend to have biased negative automatic thoughts. Therefore, there is a need to refine our understanding of what contributes to the development of adolescent depressive symptoms. The current study examined the mediating role of negative automatic thoughts in the link between maternal attachment and depressive symptoms among late adolescents in Pakistan. Methods: This cross-sectional study focused on 936 (males=423, females=513) students aged 17 to 19 years old, who were selected through multistage cluster sampling technique. Respondents answered self-report questionnaires which assessed maternal attachment, depressive symptoms, and negative automatic thoughts. Structural equation modelling was utilised to analyse the relationships among the research variables. Results: The findings indicated that 39.3% had negative automatic thoughts; whereas, 5.6% experienced severe depressive symptoms. Correlational analysis showed that maternal attachment had a negative association with depressive symptoms and negative automatic thoughts. In contrast, depressive symptoms were positively related to negative automatic thoughts. Structural analysis revealed that negative automatic thoughts partially mediated the association of maternal attachment with depressive symptoms among late adolescents. Findings specifically demonstrated that those with insecure maternal attachment tend to have negative automatic thoughts, which subsequently lead to depressive symptoms. Conclusion: In conclusion, findings highlight the importance of secure attachment to the mother and positive automatic thoughts in combating depressive symptoms; thus ensuring a healthy psychological development for adolescents. [ABSTRACT FROM AUTHOR]

Introduction: Depressive symptoms are major public health issues with significantly increasing rates during adolescence. Specific factors and mechanisms associated with depressive symptoms still need to be identified. The present study aimed to examine direct relationships between paternal attachment and negative life events (NLE) to depressive symptoms. Indirect effect of automatic thoughts on the relationships was also examined. Methods: A sample of 1030 adolescents aged between 13 and 19 years (mean=15.36) was recruited using probability proportional to size cluster sampling from selected states in Peninsular Malaysia to complete self-report measures on the study variables. Results: Structural equation modelling indicated that paternal attachment in terms of secure, approachability and anxious fearful were directly associated to depressive symptoms. Broadly, increases in secure and approachability attachments followed by decreases in depressive symptoms. Adolescents who experienced anxious fearful attachment seemed to be more vulnerable to depressive symptoms. Moreover, results from mediation analyses revealed that automatic thoughts mediated the effect of two attachment variables (i.e., anxious fearful and responsiveness) and NLE to depressive symptoms. Conclusion: These findings shed light on the concurrent effects of attachment and life events on depressive symptoms, providing evidence on how to reduce depressive symptoms among adolescents. The current study also expands knowledge on the role of automatic thoughts as potentially relevant mediator. Intervention and prevention programs aimed at preventing adolescents from the deleterious effects of depressive symptoms should involve both parents and adolescents in order to promote optimal attachment relationships and minimize depressive cognitions in adolescents. [ABSTRACT FROM AUTHOR]

Objectives: Distortions in autobiographical memory have been implicated in major depressive disorder (MDD). Those with MDD demonstrate a ‘depressogenic’ autobiographical life structure. Research has not examined how culture influences this process. We investigated whether Malay individuals (members of an interdependent culture) with MDD demonstrated a ‘depressogenic’ autobiographical life structure similar to that of British individuals (members of an independent culture) with MDD. Design: A 2 (Culture; Malay, British) × 2 (Mood; depressed, control) cross‐sectional design using a card sort task and self‐report measures was used. Methods: Malay individuals with MDD or no history of MDD completed the life‐structure card‐sorting task, which provided a novel method for investigating organizational structure of the life narrative. These data were compared to previously collected data in which British individuals with MDD or without MDD had completed the same task within the same experimental protocol. Results: Pan‐culturally those with MDD had greater negativity (i.e., used more negative attributes), negative redundancy (i.e., used the same negative attributes repeatedly across life chapters) and negative emodiversity (i.e., had greater variety and relative abundance of negative attributes), and reduced positive redundancy (i.e., used the same positive attributes repeatedly across chapters) in their structuring relative to controls. While the British MDD group had greater compartmentalization (i.e., the negative and positive attributes were clustered separately across different chapters) than British controls, the Malay MDD group had lower levels of compartmentalization than Malay controls. Conclusions: The findings suggest culture may shape aspects of the autobiographical life structure in MDD. Practitioner points: The majority of the literature investigating depression pertains to individuals from European Western cultures, despite recognition that depression ranks as one of the most debilitating diseases worldwide. This raises questions as to whether current depression models and interventions can be applied universally or whether they are limited to European Western groups. The current study found that pan‐culturally those with MDD had similar structuring of their life story relative to controls. However, there were some cultural differences that need to be considered (e.g., Malay individuals provided less detailed, less elaborate and less emotionally diverse life stories and while the British MDD group had greater compartmentalization than British controls, the Malay MDD group had lower levels of compartmentalization than Malay controls). Limitations of the study included group differences in gender and mood at the time of testing. Cultural differences in the number of attributes used may have influenced findings. Only the Malay group completed the individualism–collectivism measure. [ABSTRACT FROM AUTHOR]

Background: Globally, traumatic brain injury (TBI) is recognized as one of the most significant contributors to mortality and disability. Most of the patients who have experienced TBI will be discharged home and reunited with their families or primary caregivers. The degree of severity of their reliance on caregivers varies. Therefore, the task of delivering essential care to the patients becomes demanding for the caregivers. A significant proportion of caregivers expressed considerable burden, distress, and discontentment with their lives. Therefore, it is critical to comprehend the dynamic of TBI and caregivers to optimize patient care, rehabilitation, and administration. The effectiveness of the Brain Injury Family Intervention (BIFI) program tailored for caregivers of patients with TBI has been widely proven in Western countries. However, the impact is less clear among caregivers of patients with TBI in Malaysia., Objective: This study aims to assess the effectiveness of BIFI in reducing emotional distress and burden of care, fulfilling the needs, and increasing the life satisfaction of caregivers of patients with TBI at government hospitals in Malaysia., Methods: This is a 2-arm, single-blinded, randomized controlled trial. It will be conducted at Hospital Rehabilitasi Cheras and Hospital Sungai Buloh. In total, 100 caregivers of patients with TBI attending the neurorehabilitation unit will be randomized equally to the intervention and control groups. The intervention group will undergo the BIFI program, whereas the control group will receive standard treatment. Caregivers aged ≥18 years, caring for patients who have completed >3 months after the injury, are eligible to participate. The BIFI program will be scheduled for 5 sessions as recommended by the developer of the module. Each session will take approximately 90 to 120 minutes. The participants are required to attend all 5 sessions. A total of 5 weeks is needed for each group to complete the program. Self-reported questionnaires (ie, Beck Depression Inventory, Positive and Negative Affect Schedule, Caregiver Strain Index, Satisfaction With Life Scale, and Family Needs Questionnaire) will be collected at baseline, immediately after the intervention program, at 3-month follow-up, and at 6-month follow-up. The primary end point is the caregivers' emotional distress., Results: The participant recruitment process began in January 2019 and was completed in December 2020. In total, 100 participants were enrolled in this study, of whom 70 (70%) caregivers are women and 30 (30%) are men. We are currently at the final stage of data analysis. The results of this study are expected to be published in 2024. Ethics approval has been obtained., Conclusions: It is expected that the psychological well-being of the intervention group will be better compared with that of the control group after the intervention at 3-month follow-up and at 6-month follow-up., Trial Registration: Iranian Registry of Clinical Trials IRCT20180809040746N1; https://irct.behdasht.gov.ir/trial/33286., International Registered Report Identifier (irrid): RR1-10.2196/53692., (©Siti Aminah Omar, Nor Sheereen Zulkefly, Firdaus Mukhtar. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 14.03.2024.)

Objectives: The present pilot study examined the associations between attachment relationships, psychological problems, and negative automatic thoughts among late adolescents in Rawalpindi, Pakistan., Subjects: A total of 98 participants (male = 49, female = 49) were recruited from government colleges in Rawalpindi, Pakistan., Methods: The measures used to assess the research variables of this cross sectional study were the Inventory of Parent-Peer Attachment (IPPA-Urdu), Depression, Anxiety, and Stress Scale (DASS-Urdu), and the Automatic Thought Questionnaire (ATQ-Urdu)., Results: All of these measures had good reliabilities. Findings of the correlation analyses demonstrated that maternal, paternal and peer attachment relationships were negatively related to symptoms of depression and anxiety as well as to negative automatic thoughts. On the other hand, depressive and anxiety symptoms were positively associated with negative automatic thoughts. Additionally, findings suggested that future studies must investigate adolescents from two-parent households and exclude those with only one living parent., Conclusion: The results underscored the need for further investigations of the linkages between attachment relationships, negative automatic thoughts and psychological problems on larger samples., (© 2020 Siddrah Irfan and Nor Sheereen Zulkefly, published by De Gruyter, Berlin/Boston.)

Objectives: The present study aimed to examine the mediational role of maladaptive cognitive schema in the association between stressful life events, which are operationalised as major (i. e. negative life events) and minor (i. e. daily hassles) life stressors, and depressive symptoms among adolescents., Methods: A cross-sectional correlational study was conducted to recruit participants across four selected states of Kedah, Kelantan, Melaka and Selangor in Peninsular Malaysia. This study involved a total of 1,032 adolescents from 25 government secondary schools, identified using probability proportional to size cluster sampling technique. Data were collected through a self-report questionnaire., Results: Using structural equation modelling analyses, findings revealed a full mediation effect of maladaptive cognitive schema between negative life events and depressive symptoms, and a partial mediation effect between daily hassles and depressive symptoms., Conclusions: This study provided valuable insights about the significance of maladaptive cognitive schema as a mediator in the stress-depression association and advanced the understanding of mechanism underlying development of depressive symptoms among adolescents in Malaysia. Findings also benefit the clinical practice in the development of targeted depression prevention and intervention programs., (© 2020 Walter de Gruyter GmbH, Berlin/Boston.)