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Background: Substance use is prevalent among medical students and could affect their academic performance. This study aimed to determine whether a relationship exists between quality of life and substance use among medical students in Lebanon. Methods: This cross-sectional study was conducted on 465 medical students in Lebanon during the academic year 2022–2023. It was based on an online questionnaire about quality of life, and dependence on alcohol, nicotine, waterpipe, and cannabis. Results: Alcohol was the most used substance by medical students (83.2%) followed by cigarettes (27.5%), waterpipe (18.1%), and cannabis (16.1%). We reported alcohol dependence in 14%, cannabis use disorder in 4.1%, high nicotine dependence in 23.4%, and waterpipe dependence in 11% of students. Physical and mental health scores were below average. Poor physical health was associated with higher dependence on nicotine and waterpipe. Conclusion: Medical students in Lebanon have poor mental and physical health and engage in substance use. Awareness campaigns promoting better mental and physical quality of life are needed. [ABSTRACT FROM AUTHOR]

A limited amount of studies exists today on the prevalence of orthorexia nervosa (ON) and associated factors in adolescents. The aim of the current study is to evaluate the correlation of body dissatisfaction, self-esteem, anxiety and depression with ON tendencies and behaviors among a sample of Lebanese adolescents (15 to 18 years old), suggesting body dissatisfaction and self-esteem as co-moderators among these factors. This cross-sectional study, conducted between May and June 2020, enrolled 555 Lebanese adolescents, using a proportionate sample from all Lebanese governorates. The results of a first linear regression, taking the ON score as the dependent variable, showed that more anxiety, following a diet to lose weight, starving oneself to lose weight and feeling pressured by media to lose weight were significantly associated with more ON. When entering the interaction body dissatisfaction by depression/anxiety as independent variables, the results showed that following a diet to lose weight, starving oneself to lose weight and feeling pressured by media to lose weight were significantly associated with more ON, whereas higher body dissatisfaction and more depression were significantly associated with less ON. Moreover, the interaction depression by body dissatisfaction showed significance with ON; in patients with high depression, high body dissatisfaction was significantly associated with higher ON. In this study, a significant strong and equivocal interactive correlation was found between ON and different demographic, sociocultural and psychological factors. Although the obtained findings remain preliminary, being taken from a limited sample from one Arabic country, they may still add to the scarcity of the literature about ON and its screening tools, as well as they may pave a way for future research in the field of the eating psychology. [ABSTRACT FROM AUTHOR]

The main objectives were to associate between social media news consumption during these unstable times and depression, as well as suicidal ideation among a sample of Lebanese adults, in addition to associate between fear of Covid-19, depression and suicidal ideation. Secondary objectives aimed to check the mediating effect of depression in the association between time spent on social media to get the news and the presence of suicidal ideation. This is a cross-sectional study executed between April and May 2021. It involved 402 Lebanese citizens aged 18 years and above, selected randomly from all Lebanese districts. Having cancer (Beta = 0.20) or lung disease (Beta = 0.27), more fear of COVID-19 (Beta = 0.16), a higher time spent on social media for news (Beta = 0.13) and a higher household crowding index (Beta = 0.29) were significantly associated with more depression, whereas having a pet in the house (Beta = -0.13) and working in the medical field (Beta = -0.17) were significantly associated with less depression. Higher depression (aOR = 1.19) was significantly associated with higher odds of having suicidal ideation, whereas more fear of COVID-19 (aOR = 0.84) and older age (aOR = 0.96) were significantly associated with less odds of having suicidal ideation. Depression did not mediate the association between time spent on social media to get the news and suicidal ideation. This study showed that more time spent on social media reading the news is associated with higher depression but not suicidal ideation. Fear of Covid-19 is associated with more depression, but less suicidal ideation. Further studies are needed to identify the causality between social media news consumption, depression and suicidal ideation. Moreover, awareness campaigns should be organized to teach people how to consume social media news in a responsible way, without letting it affect their emotions directly, which may cause psychological disorders. [ABSTRACT FROM AUTHOR]

Background: Problematic use of social networks is a widespread problem that may exert deleterious impacts on cognitive functions. Moreover, studies have added an important link between loneliness and its harmful effect on cognitive functions. Other studies have also revealed that problematic use of social networks among teenagers has a pejorative influence on their social interactions, leading to increased social isolation. Therefore, the goal of our research was to investigate the link between problematic use of social networks and cognitive function in a group of Lebanese adolescents while also taking into consideration the indirect role of loneliness in this relationship. Methods: This cross-sectional study, which was carried out between January and April 2022, included 379 teenagers (aged between 13 and 17 years), from all Lebanese governorates. The PROCESS SPSS Macro version 3.4, model four was used to compute three pathways. Pathway A determined the regression coefficient for the effect of problematic use of social networks on loneliness; Pathway B examined the association between loneliness and cognitive function, and Pathway C' estimated the direct effect of problematic use of social networks on cognitive function. Results: Higher negative social comparison, addictive consequences of problematic use of social networks, and loneliness were significantly associated with worse cognitive function. Loneliness mediated the association between negative social comparison and worse cognitive function, as well as between addictive consequences of problematic use of social networks and worse cognitive function. In addition, higher financial burden was significantly correlated with worse cognitive function, whereas higher physical activity was related to better cognitive function. Conclusion: In sum, the current study supports that problematic use of social networks is negatively associated with adolescents' cognitive function, where loneliness seems to play a pivotal role in this equation. The results thus endorse the importance of helping Lebanese adolescents to overcome problematic use of social networks and recover from their loneliness, to achieve a better cognitive/academic performance. [ABSTRACT FROM AUTHOR]

Background: Recently, there has been a blooming focus on "eating healthy and clean", with the ideal of being healthy becoming a popular lifestyle trend. Previous research suggested the presence of two forms of orthorexia: Orthorexia Nervosa (OrNe) and Healthy Orthorexia (HeOr). Taking into consideration that orthorexia thoughts are led by the desire to reach an optimal physical health, the dedication to a healthy living may require healthy lifestyle habits: smoking cessation, moderate alcohol intake, and increased physical activity. The main study aim was to determine, among Lebanese adolescents, the association between healthy behaviors and the two likely forms of orthorexia (OrNe and HeOr), given that the adolescent phase is a risky period in the development of eating disorders. Methods: A cross-sectional study, conducted between January and April 2022, enrolled 444 adolescents aged between 14 and 18 years, with an equitable random sample from all the Lebanese governorates (mean age 16.23 ± 1.15 years; 60.1% females). The Teruel Orthorexia Scale (TOS) was used to assess orthorexic eating tendencies. The Lebanese Waterpipe Dependence Scale, the Fagerström Test for Nicotine Dependence and the Alcohol Use Disorder Identification Test scales, all validated in adolescents, were used to evaluate the association between orthorexia and healthy behaviors. Results: Higher TOS OrNe scores were significantly and highly correlated with the TOS HeOr scores (r = 0.68; p < 0.001). In the bivariate analysis, waterpipe smoking was weakly but significantly associated with more OrNe, whereas more physical activity was significantly and moderately associated with more HeOr. After adjusting over all sociodemographic characteristics, other behaviors and the other dimension of orthorexia, more alcohol use disorder was significantly but strongly associated with higher OrNe, whereas more physical activity remained significantly associated with higher HeOr. Conclusion: In light of our results, OrNe and HeOr might be considered as different entities, mainly in their associations with alcohol consumption and physical activity. This supports the hypothesis of OrNe being a new form of eating disorder, whereas HeOr possibly showing protective characteristics. Orthorexia is still a topic of controversy, especially in the probable presence of two facets that are still difficult to differentiate. [ABSTRACT FROM AUTHOR]

Background: Binge eating disorder is a common eating disorder among the adolescent population. The available literature in the Middle East in general, and Lebanon specifically, is relatively scarce and/or outdated. The objectives of this study were to (1) validate the Binge Eating Scale (BES) for use in Lebanese adolescents, and (2) assess correlates of binge eating behavior among this population. Methods: A cross-sectional study conducted between May and June 2020, enrolling 555 adolescents between the ages of 15–18 years old from all Lebanese governorates. The Binge Eating Scale was used to screen for the presence/absence of binge eating. Results: A confirmatory factor analysis revealed that the one-factorial model fits the data best. The results of a linear regression, taking the binge eating score as the dependent variable, showed that higher body dissatisfaction, more alcohol use disorder, higher depression, vomiting to lose weight and starving to lose weight were significantly associated with more binge eating. Higher self-esteem was significantly associated with less binge eating. Conclusion: The Arabic Version of the BES scale seems to be a reliable tool to be used in Lebanese adolescents for the assessment of binge eating. More body dissatisfaction, lower self-esteem, increased depressive symptoms were associated with more binge eating. We hope this tool will be a reliable one to be used in epidemiological studies and research about eating behaviors/disorders. Plain English summary: The results showed that higher body dissatisfaction, higher depression, vomiting to lose weight and starving to lose weight were significantly associated with more binge eating. Our study also showed that the Binge Eating Scale is an adapted and validated tool to be used among Lebanese adolescents for the assessment of binge eating. We hope that the study results will help clinicians in the screening and management of Binge Eating behaviors among Lebanese adolescents. [ABSTRACT FROM AUTHOR]

Background: Orthorexia Nervosa (ON) is defined as a pathological preoccupation characterized by obsessive beliefs and compulsive behaviors regarding 'pure' eating behaviors. Many scales have been established and display good results regarding reliability and validity measures, including but not limited to ORTO-R (revised version of ORTO-15), Eating Habits Questionnaire, Teruel Orthorexia Scale (TOS) and the Düsseldorf Orthorexia Scale (DOS). Among these, the DOS seems to be a promising measure for multiple reasons. The current paper aims to validate the DOS, a measure of ON, in a non-Western population of Lebanese adolescents. Methods: This was a cross-sectional designed study, conducted between May and June 2020, which enrolled 555 adolescents (15–18 years old; 75.7% females). Due the coronavirus pandemic outbreak, the data were gathered through snowball sampling using an online questionnaire. The DOS, TOS and ORTO-R scales were used in this study to screen for orthorexic tendencies and behaviors. Results: We tested four competing structural models of the DOS assessing its factorial validity. The results of the current investigation revealed that the one-factorial model is the best one to represent the structure of the questionnaire. We provided evidence for validity for the DOS through demonstrating that it correlates significantly with other measures of orthorexic behaviours (Teruel Orthorexia Scale and ORTO-R). Finally, we have gathered evidence that the orthorexic behaviours as measured by DOS are not associated with age (r = −.02; p =.589), household crowding index (r =.02; p =.578), and Body Mass Index (r =.04; p =.297). Yet, females as compared to males achieved higher scores (M = 20.07, SD = 6.38 vs M = 18.29, SD = 6.37; p =.005; d =.28). Conclusion: The Arabic version of the DOS seems to be a structurally valid and internally consistent questionnaire measuring orthorexic eating behavior in a sample of Lebanese adolescents. This tool may be useful for psychologists, psychiatrists, dietitians and other clinicians in the assessment and the treatment of the multidimensional nature of ON. [ABSTRACT FROM AUTHOR]

Background: Restrained eating disorder is prevalent worldwide across both ethnic and different cultural groups, and most importantly within the adolescent population. Additionally, comorbidities of restrained eating present a large burden on both physical and mental health of individuals. Moreover, literature is relatively scarce in Arab countries regarding eating disorders, let alone restrained eating, and among adolescent populations; hence, the aim of this study was to (1) validate the Dutch Restrained Eating Scale in a sample of Lebanese adolescents and (2) assess factors correlated with restrained eating (RE), while taking body dissatisfaction as a moderator between body mass index (BMI) and RE.Methods: This cross-sectional study, conducted between May and June 2020 during the lockdown period imposed by the Lebanese government, included 614 adolescents aged between 15 and 18 years from all Lebanese governorates (mean age of 16.66 ± 1.01 years). The scales used were: Dutch Restrained Eating Scale, body dissatisfaction subscale of the Eating Disorder Inventory-Second version, Rosenberg Self-Esteem Scale, Beirut Distress Scale (for psychological distress), Hamilton Anxiety Rating Scale and Patient Health Questionnaire (for depression).Results: The factor analysis yielded a one-factor solution with Eigen values > 1 (variance explained = 59.65 %; αCronbach = 0.924). Female gender (B = 0.19), higher BMI (B = 0.49), higher physical activity index (B = 0.17), following a diet to lose weight (B = 0.26), starving oneself to lose weight (B = 0.13), more body dissatisfaction (B = 1.09), and higher stress (B = 0.18) were significantly associated with more RE, whereas taking medications to lose weight (B=-0.10) was significantly associated with less RE. The interaction body mass index (BMI) by body dissatisfaction was significantly associated with RE; in the group with low BMI, higher body dissatisfaction was significantly associated with more RE.Conclusions: Our study showed that the Dutch Restrained Eating scale is an adapted and validated tool to be used among Lebanese adolescents and revealed factors associated with restrained eating in this population. Since restrained eating has been associated with many clinically-diagnosed eating disorders, the results of this study might serve as a first step towards the development of prevention strategies targeted towards promoting a healthy lifestyle in Lebanese adolescents. [ABSTRACT FROM AUTHOR]

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 (β = 0.12; 95% CI 0.083-0.176), sexual (β = 0.26; 95% CI 0.128-0.411), neglect (β = 0.08; 95% CI 0.051-0.120), physical abuse (β = 0.13; 95% CI 0.036-0.235), higher internet addiction (β = 0.07; 95% CI 0.057-0.097), higher social fear (β = 0.10; 95% CI 0.075-0.140), and having separated parents (β = 1.60; 95% CI 0.561-2.650) were significantly associated with more bullying perpetration. Higher social avoidance (β = - 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. [ABSTRACT FROM AUTHOR]

Supplementary Information Reference 1 Boulos Nakhoul T, Mina A, Soufia M. Restrained eating in Lebanese adolescents: scale validation and correlates. Michel Soufia, Sahar Obeid and Souheil Hallit are last co-authors. [Extracted from the article]