Search

Introduction: The current study aims to investigate the prevalence rates, associated factors, and predictors of anxiety disorders in Malaysia through a scoping review. Methods: PsycINFO and MEDLINE databases and a total of 28 local journals were used to search for published papers in this particular area. In this case, 37 out of 105 articles managed to meet the inclusion criteria and were subjected to review. A total of 17,673 respondents, which comprised university students, the general community, and numerous types of clinical patients, were included in the review. Results: The results showed that the prevalence rate of anxiety disorders was in the range between 1% and 67.6% for the mentioned populations. Moreover, various types of associated factors were found to be related to anxiety such as being divorced, widowed, or single; having a lower than tertiary level of education; being unemployed or retired; and having a low socioeconomic status. Meanwhile, there were also several predictors of anxiety such as having to deal with negative life events; domestic violence; family history of mental illness; severe psychological problems; and chronic physical illness. Conclusion: Generally, the prevalence of anxiety disorders is noticeable, and anxiety disorders may contribute to a decrease in the quality of life, an increase in social burden, reduced productivity, and increased utilization of health services. Therefore, awareness among community and health service providers regarding the prevalence rate of anxiety is believed to help in developing access to evidence-based psychological and pharmacological interventions.

Second-generation mindfulness-based interventions (SG-MBIs) align well with positive psychology philosophy and practices, but trials of SG-MBIs have largely focused on ill-being. This study developed a mindfulness-based positive psychology (MBPP) intervention integrating positive psychology with an SG-MBI to enhance well-being. A randomized control trial was performed to compare MBPP with a waitlist condition among 138 Chinese participants. The results showed that MBPP significantly reduced negative emotions for subjective well-being and significantly improved environmental mastery for psychological well-being. Improvements in self-compassion and negative attitudes but not avoidance, mediated changes in well-being. Changes in positive emotions, positive relations, and awareness were associated with the amount of meditation practice. These findings showed that MBPP is promising for improving well-being and that the positive psychology components play important roles. Broadly, the study illustrated that positive psychology and SG-MBIs can be effectively integrated, and it supported the further application of SG-MBIs from the positive psychology perspective.The online version contains supplementary material available at 10.1007/s10902-022-00525-2.

Attention bias contributes to the development and maintenance of test anxiety. However, little is known about the underlying mechanisms of attention bias, such as the relative contributions of the top-down and bottom-up cognitive processes. The bottom-up mechanism selects stimuli based on their physical salience, and regardless of the intention of observers. Besides, it remains unclear whether the attention bias in the test anxiety would extend in the visual search task in which numerous stimuli compete for attentional resources. Thus, the present research investigated these issues by combining the visual search task with eye-tracking techniques. The test-related pictures with varying threat levels may be the visual search target in the task-relevant condition, and be one of the distractors in the task-irrelevant condition. Thirty high and Thirty low test-anxious participants were required to attend a visual search task. Our results found that the low test-anxious group showed greater first fixation proportion and shorter dwell time towards test-related distractor within the target-absent condition. But we cannot find any effects of the high test-anxious group in the task-irrelevant condition. However, both groups showed a faster response and shorter target processing time of the test-related target, and the high test-anxious group had faster first fixation latency and greater first fixation proportion towards the high-threatening test-related target. These results suggested that the high test-anxious individuals showed early vigilance and improved processing efficiency towards the test-related target in a visual search task. Our findings indicated that ABs among numerous stimuli in test anxiety was not a completely bottom-up process.

The aims of this study were to examine (a) the effects of parental phubbing on teenagers' mobile phone dependency and (b) the mediating roles of subjective norm and dependent intention of underlying this relationship. We recruited 605 middle school students in Beijing, China and they completed the parental phubbing behaviors, subjective norm, dependency intention, and mobile phone dependency behavior questionnaires. The results of the structure equation modeling revealed that parental phubbing behaviors significantly increased teenager's mobile phone dependency behaviors in two indirect ways. First, parental phubbing reinforced teenagers' mobile phone dependency intention, which in turn increased the likelihood of mobile phone dependency. Second, parental phubbing enhanced the tendency of parental mobile phone dependence norm perceived by teenagers, and thus reinforced their mobile phone dependency intention, ultimately increasing mobile phone dependency. We concluded that parental phubbing is a significant indicator of teenager mobile phone dependency and that mobile phone dependency intention plays a mediation role between them. In addition, the perceived parental mobile phone dependency norm played a mediation role between parental phubbing and mobile phone dependency intention and indirectly influenced the level of mobile phone dependency behaviors through the mediation effect of mobile phone dependency intention.

Appreciative joy refers to feeling happy for others with appreciative and unenvious attitudes, which is a strength-like construct emphasized much more in Chinese than in Western culture. The current study provides an initial exploration of appreciative joy’s relationship with the strengths in the Values in Action (VIA) framework. Study 1 with 516 online participants showed that appreciative joy was positively correlated with the VIA strengths and provided an incremental explanation for subjective well-being and envy after controlling for the 24 VIA strengths. Study 2 recruited 559 readers of a Chinese novel (The Dream of the Red Chamber) and showed that appreciative joy was associated with the perception of the outstanding strength of characters in the novel after controlling for interpersonal strengths. These findings illustrate both similarities and differences between appreciative joy and strengths in VIA and hold multiple implications for research on appreciative joy, positive psychology and cultural diversity.

Empirical studies have shown that the Four Immeasurables Meditations (FIM) can enhance compassionate decisions towards others, such as helping victims being treated unfairly in economic games. However, research investigating how FIM affects individuals’ decisions when they themselves are victims is sparse. Thus, the current study utilized a randomized trial to scrutinize the causal influence of practicing FIM on people’s reactions towards unfairness that is directed at them. Meditation novices (N = 135) were randomly assigned to practice either a brief Appreciative Joy Meditation (AJM) or a matched neutral visualization. They then took part in the Ultimatum Game where they first acted as a proposer to propose an offer to another person, then acted as a responder to decide whether to accept a set of offers. The AJM group accepted significantly more unfair offers, but neither proposed a higher offer to others nor changed the perception of fairness, as compared with the neutral visualization control group. Furthermore, self-reported emotional changes during meditation practice could not predict behavior in the Ultimatum Game, but the Self-Transcendence dimension of the Appreciative Joy Scale, which reflects one’s ability to feel happy for others when one is in an inferior situation, predicted higher acceptance rate of unfair offers. This study provided a piece of causal evidence that a brief practice of AJM can make people more tolerable to unfairness directed against them. Broadly, this study also inspired more investigations on attitudes towards people in superior situations in future studies on FIM.

Gambling urges and gambling refusal self-efficacy beliefs play a major role in the development and maintenance of problem gambling. This study aimed to translate the Gambling Urge Scale (GUS) and the Gambling Refusal Self-Efficacy Questionnaire (GRSEQ) from English to Italian (GUS-I, GRSEQ-I) and to test their factor structure, internal consistency, construct validity, concurrent validity, and gender differences in 513 individuals from the Italian community. Factor structure and construct validity were tested through Confirmatory Factor Analysis, internal consistency through Cronbach’s alpha, concurrent validity through correlations with gambling-related cognitions (GRCS-I), probable pathological gambling (SOGS-I), and gambling functioning (GFA-R-I). Results confirmed that the 6 items of the GUS-I load highly on one dimension of Gambling Urge, and each of the 26 items of the GRSEQ-I load highly on their relevant sub-dimension, among the following: situations/thoughts, drugs, positive emotions, negative emotions. Both scales are internally consistent and show concurrent validity with gambling-related cognitions, probable pathological gambling, and gambling functioning. Males score higher than females at the GUS-I; females score higher than males at the GRSEQ-I. The findings from the present study suggest that the GUS-I and the GRSEQ-I are internally consistent and valid scales for the assessment of gambling urges and gambling refusal self-efficacy in Italian individuals from the community, with significant repercussions in terms of assessment, prevention, and intervention.

Forgiveness contributes to positive social relationships, which is critical for individual development, particularly for early adolescents. Most previous studies focused on the unique roles of cognitive factors (e.g., compromising thinking) and personality traits (e.g., self-esteem) in the process of developing forgiveness. However, sporadic research has examined their interactive effect on forgiveness from an integrated perspective. Given that forgiveness has been categorized into decisional and emotional forgiveness, this study aimed to examine the effects of compromising thinking on two types of forgiveness, and the moderating effects of self-esteem on the association between compromising thinking and forgiveness among early adolescents. A total of 1,009 Chinese primary and secondary school students (50.4% males; M age = 11.75, SD = 1.27) were recruited to complete three self-reported questionnaires. The results showed that compromising thinking predicted decisional forgiveness but not emotional forgiveness. Furthermore, self-esteem was identified to moderate the conditional effects of compromising thinking on decisional and emotional forgiveness. These findings advance a better understanding of the construct and mechanism of forgiveness, which can provide insights for targeted forgiveness interventions among early adolescents, such as compromising thinking instructions and self-esteem enhancement programs.

The Four Immeasurables Meditations (FIM) are a group of meditations rooted in Buddhism that cultivate pro-social attitudes. Previous studies have reported common difficulties during the practice of the FIM, yet there is no specific measure for those difficulties. The current study intended to develop the Difficulties during Meditation involving Immeasurable Attitudes Scale (DMIAS) to measure two aspects of common difficulties during the FIM practice: lack of concentration (LOC) and lack of pro-social attitudes (LOP). A total of 506 meditation novices were used in four studies. In study 1, exploratory factor analysis (EFA) with the data from a one-time practice of loving-kindness meditation was used to produce the 12-item DMIAS with two independent factors that were positively correlated (LOC and LOP). Studies 2, 3, and 4 validated the DMIAS in one-time practices of loving-kindness meditation, appreciative joy meditation, and compassion meditation, respectively. Across studies 2 to 4, confirmatory factor analyses supported the two-factor structure of the DMIAS, and both LOP and LOC had negative correlations with the other-focused positive emotions generated by the meditations. Although manipulations of the target to be blessed (study 3) and the length of practice (study 4) only had small impacts on the effects of meditation, the pattern of correlations between emotional outcomes and certain factors of the DMIAS was significantly different between the manipulated conditions. In summary, the DMIAS is a useful tool in understanding the difficulties during the FIM practice, and the current study also illustrated how technical details of the FIM influences the effects of the FIM practice.

This study tested Beck’s cognitive model of familial transmission of depression in a group of 187 pairs consisting of one parent and one offspring. The parents and offspring completed the Depressio...

Many studies support the beneficial effects of the “four immeasurable meditations” (FIM) that originate from Buddhism, but most psychological interventions adopt FIM that cultivate loving-kindness and compassion. The current study developed and evaluated a 4-week training program named “Heart of Joy” (HOJ) that is based on FIM that cultivate appreciative joy. Participants were randomly assigned to HOJ training (n = 59) or a wait-list condition (n = 42), and the final sample consisted of 41 participants in each condition. Satisfaction with life, appreciative joy, envy, emotions, and attitudes toward oneself and others were measured at pre-training, at post-training, and at a 1-month follow-up. The time × condition (M)ANOVA showed that HOJ participants had significantly higher low-arousal positive emotions and lower high-arousal and low-arousal negative emotions at both the post-training and follow-up assessments, as well as higher medium-arousal positive emotions at the post-training assessment only. HOJ participants also reported significantly higher life satisfaction at both the post-training and follow-up assessments and significantly lower envy at the follow-up assessment. The results had a medium effect size (Cohen’s d values ranging from 0.52 to 0.69). Appreciative joy, all attitudes, high-arousal positive emotions, and medium-arousal negative emotions did not show significant results. Further investigations revealed that changes in appreciative joy were more closely associated with changes in high-arousal than low-arousal positive emotions, and changes in envy were more closely associated with changes in attitudes toward oneself than attitudes toward others; this outcome indicates that appreciative joy and envy were impacted during this intervention. This study suggests that HOJ is a promising training program to improve subjective well-being and envy, and the implications for research were discussed.

Objective The goal of this study was to examine the factor structure of Young Schema Questionnaire-short form (YSQ-SF) in a sample of Chinese adolescents, and to explore which maladaptive schemas were associated with anxiety symptoms.& para;& para;Methods YSQ-SF was administered to 983 nonclinical Chinese adolescents aged 13-17 years. Confirmatory factor analyses with weighted least squares means and variance adjusted estimation were conducted to examine the factor structure of YSQ-SE. Stepwise regression analyses were performed to identify schemas associated with anxiety symptoms.& para;& para;Results A bifactor model with 15 correlated factors fitted the data better than other priori defined models. Stepwise regressions showed Vulnerability to harm, Abandonment, Emotional inhibition, Subjugation, and Unrelenting standards schemas were associated with anxiety symptoms. Furthermore, different anxiety symptoms were associated with common and distinctive schemas.& para;& para;Conclusion Maladaptive schemas were already stably formed in Chinese adolescents, however there's no robust evidence for the existence of domain. The explanatory value of maladaptive schemas for understanding psychopathology of anxiety in adolescence is discussed.

The aim of this study was to investigate the effectiveness of Individual Cognitive Behavior Therapy (ICBT) in treating patients with mood disorders with suicidal ideation. A total of 69 patients (48 females, 21 males) with the diagnoses above were randomly allocated to either the group of Treatment As Usual (TAU)+ICBT (n=33) or the TAU group (n=36). All participants completed the Beck Depression Inventory (BDI), Beck Scale for Suicide Ideation (BSS), Positive and Negative Suicide Ideation Inventory (PANSI), Beck Hopelessness Scale (BHS), and Depression Anxiety Stress Scale-21 (DASS-21). These questionnaires were administered at pre-treatment, midway through treatment (week 4), post-treatment (week 8), and at follow-ups after three months (week 20) and six months (week 32). Factorial ANOVA results showed that the TAU+ICBT patients improved significantly and at faster rate as compared to the TAU group, which showed improvement only from pre to mid treatment on DASS-D and BHS-T measures. The effect size (Cohen's d), for the TAU+ICBT group showed large effect (1.47) for depressive symptoms and suicidal ideation (1.00). These findings suggest that ICBT used in addition to the TAU, was effective in enhancing treatment outcome of patients with unipolar mood disorders as well as, reducing risk for suicide behavior.

Appreciative joy, as one of the four immeasurables in Buddhism, refers to feeling happy for people, and it is cultivated by appreciative joy meditation (AJM). There is a debate regarding whether appreciative joy is conceptually the same as positive empathy (empathy for others’ positive experiences); thus, this report empirically tests the similarities and differences between appreciative joy and positive empathy. Study 1 recruited a sample of 317 general participants using an online survey and evaluated the similarities and differences between the Appreciative Joy Scale (AJS) and the Positive Empathy Scale (PES) on the outcome variables of altruism, envy, and subjective well-being. Confirmatory factor analyses showed that the AJS and PES were independent of one another, and hierarchical multiple regressions indicated that AJS accounted for more variances on altruism than the PES. Study 2 recruited 119 participants in an experiment in a laboratory setting and compared the effects of AJM and the psychological operation of positive empathy in a matched setting on self-reported emotions and interpersonal attitudes. The analysis of variance (ANOVA) demonstrated that AJM generated significantly more other-focused positive emotions (e.g., love) in comparison with the positive empathy condition. These two studies supported that the concept and psychological operation of positive empathy differ from appreciative joy and AJM in Buddhism. In particular, the results in terms of altruism and other-focused positive emotions supported the conceptual analysis that appreciative joy directly involves kind intentions toward the target, whereas positive empathy does not necessarily do so.

The four immeasurables meditations (FIMs) cultivate four different attitudes in Buddhism. However, in psychological research, these meditations have been combined and their differences have not been directly evaluated. The current study provided the first comparison between appreciative joy meditation (AJM) and compassion meditation (CM). Ninety college students were allocated to three groups which included AJM, CM, and neutral facial visualization in a laboratory setting. The students were asked to practice corresponding meditations for friends followed by that for strangers. The self-reported emotions were measured before and after the meditations for different targets, and the emotional Stroop task was administered following the meditation for friends. The major findings included the following: (1) AJM and CM for strangers enhanced other-focused positive emotions (e.g., love) compared with the control group, indicating both AJM and CM promote pro-socialness. (2) Compared with the other conditions, CM for friends and for strangers increased sadness and CM for friends decreased happiness and overall positive emotional valence, whereas AJM for strangers enhanced happiness and overall positive emotional valence, suggesting that the two FIMs had different effects on emotional valence. (3) There were no significant interactions for self-focused positive emotions (e.g., pride) or interpersonal negative emotions (e.g., envy), but AJM exhibited a potential effect on the suppression of interpersonal negative emotions compared with the other conditions. (4) No significant interaction was found for low arousal positive emotions (e.g., calm) and overall arousal. (5) Findings from the Stroop task indicated that AJM tended to result in longer reaction times compared with the other groups, and daily appreciative joy also affected the reaction times. These findings indicate that FIMs should be differentiated in psychological research because of their different effects. The potential mechanisms underlying the effects of FIMs and their implications for research and practice of FIMs were also discussed.

An increasing number of mobile phone users check their phones at any time and place, even during in-person interactions. Such behaviors that interrupt social interactions have been described as phubbing. The present study focused on phubbing behaviors within the context of parent-child households and aimed to examine the associations among parents' phubbing, the parent-child relationship, children's self-esteem, and problematic mobile phone use (PMPU) by adolescents. The structural equation model results based on the data collected from 1,721 secondary students revealed that parents' phubbing was not only directly associated with children's PMPU but also indirectly associated with PMPU through the mediating roles of the parent-child relationship and children's self-esteem after gender and age were controlled. These findings suggest a possible underlying mechanism for the relationship between parents' phubbing and children's PMPU, and could thus inform interventions to prevent or decrease PMPU among adolescents. Limitations and implications are discussed.

The Four Immeasurables Meditations (FIM) intervention have been shown as a promising intervention for reducing depressive symptoms. The current study is a systematic review of FIM intervention effects on depressive symptoms. Among 192 empirical research articles on FIM published before May 2019, 40 independent trials from 35 records measured depressive symptoms. The meta-analysis included 21 randomized controlled trials (RCT; n = 1468) and 16 uncontrolled trials (n = 376). The results supported overall effectiveness of FIM on depressive symptoms (d = 0.38 for RCT and d = 0.87 for uncontrolled trials). Moderator analysis indicated the effects differed across protocols, and effects were smaller in RCT using active control groups. No significant differences were observed for participant type, measures, intervention length, or intervention components. Individual studies found no direct association between meditation practice time and effects, and mindfulness and self-compassion were widely supported as mechanisms of change. Current evidence supports FIM as an effective intervention for reducing depressive symptoms, but additional studies with more rigorous designs using active control groups are needed. Further investigation should be encouraged regarding specific protocols and participants, the contribution of meditation practice, and other mechanisms such as positive emotions.

The roles of culture in understanding gambling and gambling disorder (GD) as well as the prevention and treatment of problem gambling (PG) are systematically presented. Relevant academic databases as well as other academically grounded published articles, government reports and conference papers accessed via online searches from 1975 to 2016 were used. Our review showed that although there were mixed findings in relation to the rate of gambling, there were strong evidences for higher rates of GD among culturally and linguistically diverse (CALD) samples compared to Caucasians or the general population. Cultural factors—such as ethnic, familial and national cultures—implicated in the maintenance of problem gambling are important considerations for future theoretical and practical developments in our increasingly globalised populations. Building cultural competencies and openness among various stakeholders (governmental, treatment providers, communities and academia) is a promising pathway in effective remediation and engagement with recovering or help-seeking gamblers and family members. Designing and implementing effective and culturally sensitive prevention and treatment programmes with the assistance of key community and/or religious leaders as well as family members will help minimise gambling among at-risk members, attract CALD problem gamblers (PGs) to treatment as well as treat and retain CALD PGs in treatment. Finally, although it is important to consider the impact of culture on PG, clinicians need to acknowledge CALD clients’ individual differences when devising prevention and treatment plans, and researchers need to acknowledge the fluidity of the concept of culture in their investigations.

Appreciative joy (or sympathetic joy) refers to feeling happiness for others and is one of the four prosocial attitudes (“four immeasurables”) cultivated by loving-kindness meditation in Buddhism. The current study included 1622 participants and developed a scale to measure appreciative joy for friends in daily life. Both an exploratory factor analysis and confirmatory factor analysis resulted in an appreciative joy scale consisting of three components: sense of joy, positive interpersonal bias, and self-transcendence (study 1). The appreciative joy scale exhibited high correlations with measurements for interpersonal relationships and four immeasurables. The scale also shows incremental contributions to positive emotions, satisfaction with life, trait happiness, and peace of mind after controlling for interpersonal relationships or the four immeasurables (studies 2 and 3). The scale exhibited higher scores among Buddhists than among individuals with no religious belief, and its structure was maintained across English and Chinese samples (study 4); in addition, it demonstrated good test-retest reliability (study 5). Overall, the current study validated the scale as a useful tool for measuring appreciative joy, and certain findings also highlighted directions for future research on appreciative joy, including causal relationships with positive emotions, comparisons with compassion, and effects on envy.

This study examined the psychometric properties of the school engagement measure (SEM) in Singapore. The sample consisted of 1,027 students from a multi-ethnic Singapore adolescent community. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) confirmed that the two-factor solution, namely, (a) Emotional and (b) Cognitive Engagement, was the best fit for the data. Reliability for the 11-item SEM as well as its Emotional and Cognitive subscales was good. Concurrent validity was assessed using correlations between Emotional Engagement, Cognitive Engagement, SEM Total scores, and the measure of aggression and delinquency. Statistically significant negative correlations were found between SEM scores with aggression and delinquency. Taken together, the findings suggest that the SEM is a useful instrument for assessing school engagement among Asian students, in particular in Singapore.

Depression is a problem among college students in China. Yet the use of preventative group cognitive-behavioral (CB) intervention is rare. One hundred and eighty Chinese college students who were identified as being at risk for depression were randomly assigned to three groups: 1) a brief group cognitive–behavioral (CB) intervention, 2) a supportive group (SG) intervention, and 3) a wait-list control condition. The Zung Self-Rating Depression Scale (SDS), the Zung Self-Rating Anxiety Scale (SAS), and the Chinese College Student Adjustment Scale (CCSAS) were administered at pre-test, post-test, and six-month follow-up. Analysis of variance (ANOVA) conducted among the three groups revealed that the CB group demonstrated significantly less increase in measures of primary symptoms of anxiety and depression than the wait-list controls at post-test and six-month follow-up. The prevention effect of the SG group was significant only at the six-month follow-up. CB participants also showed significantly greater improvements in social adjustment than did SG participants and controls at the post-test and six-month follow-up.

This study compared deficits in executive functioning in psychiatric outpatients with anxiety and depression to neurologically impaired patients and a community sample using a cross-sectional design. Anxious, depressed and neurologically impaired patients were compared for executive dysfunction using the revised Dysexecutive Questionnaire. A large sample of 663 community individuals, 39 mood disordered, 121 anxiety disordered and 120 neurologically impaired outpatients participated. Anxious and depressed patients exhibited significantly greater executive dysfunction than neurological patients and healthy controls. Anxiety patients reported the greatest executive dysfunction than all other groups including greater total problems and specific deficits in inhibiting responses and in acting with volition. Problems with inhibition reflect difficulties of anxiety patients in preventing automatic responses. Problems with volition reported by anxiety patients were attributed to comorbid depression, consistent with anxiety patients reporting the highest levels of depressive as well as anxious symptomology. Depressed patients reported greater problems with volition than community members, reflecting problems with planning and motivation. Neurologically impaired individuals reported a comparable level of executive dysfunction to the general community. This was attributed mainly to the poor ability of neurologically impaired individuals to report their own deficits. We discuss the relevance of executive functioning to anxiety and depression, and the implications of using the DEX-R with clinical samples.

The Catastrophic Cognitions Questionnaire-Modified (CCQ-M) is a common instrument for measuring catastrophic thoughts. In some countries, however, CCQ-M still poses concerns following the lack of appropriate validation among their populations. The current study aimed to examine the factor structure of the CCQ-M, the reliability, and the validity in community samples in Malaysia. The Malay version of CCQ-M and additional measures assessing the symptoms and cognitions relevant to anxiety disorders were completed by 682 university students and general community. Exploratory factor analysis revealed a two-factor structure accounting for 62.2% of the total variance. Confirmatory factor analysis confirmed the two-factor model by deleting four items. The Cronbach's alpha coefficients for the total and the two subscales were .94, .90, and .92, respectively. Test-retest reliability analysis was conducted on 82 university students in the interval period of 14 days, and the result was r = .58. Evidence supported the concurrent, convergent, and discriminant validity. In conclusion, the 17-item CCQ-M-Malaysia is a valid and reliable instrument for assessing catastrophic cognitions among Malaysian populations. Copyright © 2015 John Wiley & Sons, Ltd.

Medical students often experience heightened psychological distress that may undermine their training experience. This study evaluated the effects of a 4-week mindfulness-based intervention program on psychological health among medical students and whether the effects were mediated by changes in mindfulness. The study also examined whether trait mindfulness moderated the effectiveness of the intervention. One hundred thirty-nine medical students participated in the study. They completed measures of mindfulness and psychological symptoms at pre- and post-intervention. Analysis showed that the intervention group reported significantly greater improvements in depressive symptoms, anxiety, general psychiatric symptoms, perceived stress, subjective happiness, and satisfaction with life compared to the control group. Low trait mindfulness at baseline predicted greater improvements on depressive and anxiety symptoms. Changes in mindfulness mediated several outcomes. The findings show that a brief mindfulness-based intervention program is efficacious in reducing psychological symptoms among medical students. Mindfulness may be a key mechanism of change of the intervention.

Objectives: Problem Gambling (PG) has been linked to several socio-cognitive risk and protective factors; However, knowledge on their impact on problem gamblers in Asia remains limited. This study compares gambling risk and protective factors between clinical problem gamblers and community individuals in Singapore.Methods: Data on gambling risk and protective factors, and PG severity were collected from 150 clinical problem gamblers and 150 community individuals through paper surveys.Results: Clinical problem gamblers scored significantly higher in PG severity, gambling-related negative thoughts and urge and psychological distress, and scored significantly lower in gambling refusal self-efficacy, hope, resilience and life satisfaction, than community participants. There were also more significant relationships between risk and protective factors among clinical than community participants.Conclusion: Gambling-related protective factors are relevant to clinical problem gamblers in the Singapore context, which could be further leveraged upon to inform and refine existing PG rehabilitation efforts.

In this study the effectiveness of the condensed Dialectical Behavior Therapy Skills Training Group (DBTSTG) was compared to the Cognitive Therapy Group (CTG) in reducing depression and suicide reattempt and modifying emotion regulation strategies among those with borderline personality disorder (BPD). A total of 82 depressed BPD college students with a suicidal history within the past 6-months were randomly allocated to DBTSTG or CTG. Both groups had similar reductions in suicide reattempts and depression after the intervention and 6-month follow-ups. However, the CTG showed improvements in cognitive errors, but the DBTSTG revealed increases in acceptance and decreases in suppression scores. Both groups were effective in decreasing depression and suicide reattempt in BPD college students, probably through increasing adaptive antecedent-focused or response-focused strategies of emotion regulation, respectively.

Interpersonal needs are associated with suicide. However, no interpersonal needs questionnaire has been validated in Asia. The psychometric properties of the Interpersonal Needs Questionnaire were examined in a sample of 340 young male adults in Singapore. This questionnaire measures proximal causes of desire for suicide using the extent to which individuals believe that they are a burden to others (perceived burdensomeness) and the extent to which they believe their needs are not met (thwarted belongingness). Confirmatory factor analysis found that a two-factor model of perceived burdensomeness and thwarted belongingness provided an adequate fit for the data. Internal consistency was excellent. Concurrent, convergent, predictive, and discriminant validity was demonstrated. The findings showed that the Interpersonal Needs Questionnaire provides a valid measure of interpersonal needs in young Asian males. Thus, the instrument can be utilized to test the interpersonal psychological theory of suicidal behavior.

Currently, cognitive behavioral therapies appear to be one of the most studied treatments for gambling problems and studies show it is effective in treating gambling problems. However, cognitive behavior models have not been widely tested using statistical means. Thus, the aim of this study was to test the validity of the pathways postulated in the cognitive behavioral theory of gambling behavior using structural equation modeling (AMOS 20). Several questionnaires assessing a range of gambling specific variables (e.g., gambling urges, cognitions and behaviors) and gambling correlates (e.g., psychological states, and coping styles) were distributed to 969 participants from the community. Results showed that negative psychological states (i.e., depression, anxiety and stress) only directly predicted gambling behavior, whereas gambling urges predicted gambling behavior directly as well as indirectly via gambling cognitions. Avoidance coping predicted gambling behavior only indirectly via gambling cognitions. Negative psychological states were significantly related to gambling cognitions as well as avoidance coping. In addition, significant gender differences were also found. The results provided confirmation for the validity of the pathways postulated in the cognitive behavioral theory of gambling behavior. It also highlighted the importance of gender differences in conceptualizing gambling behavior.

Previous studies have mostly examined cognitive and psychosocial variables that are critical to the cognitive behavioral conceptualization of Problem Gambling (PG) in community samples. This study aimed to assess whether cognitive and psychosocial variables (gambling refusal self-efficacy, gambling cognitions, gambling urges, comorbid negative psychological states, comorbid substance use/misuse, life satisfaction and quality of life) can predict gambling behaviour in a clinical sample. One hundred and thirty-nine volunteers for a PG self-help cognitive behaviour treatment program participated. Results showed that only perceived gambling refusal self-efficacy, cognitions of inability to stop gambling, hazardous drinking behaviors, and poor quality of life related to one’s environment, significantly predicted SOGS and/or CPGI scores. Significant interactions between gender and a number of variables including gambling cognitions (especially gambling expectancies), gambling refusal self-efficacy as well as quality of life related to physical or environmental health predicted gambling behaviour in this clinical sample.

This study examined psychological well-being and coping in parents of children with ASD and parents of typically developing children. 73 parents of children with ASD and 63 parents of typically developing children completed a survey. Parents of children with ASD reported significantly more parenting stress symptoms (i.e., negative parental self-views, lower satisfaction with parent-child bond, and experiences of difficult child behaviors), more depression symptoms, and more frequent use of Active Avoidance coping, than parents of typically developing children. Parents of children with ASD did not differ significantly in psychological well-being and coping when compared as according to child's diagnosis. Study results reinforced the importance of addressing well-being and coping needs of parents of children with ASD.

It has been widely reported that medical students face considerable stress in medical school. In Malaysia, a brief (four-session, 2 h per week) group Mindfulness-based Cognitive Therapy (b-GMBCT/Mindful-Gym) was developed to help medical students cope with stress. The aim of this study was to evaluate the feasibility and effectiveness of the program in reducing stress among medical students in a Malaysian university. This was a single-group, prospective study. A total of 135 year-four medical students in psychiatric postings participated in the program (conducted in seven batches over 2 years). The following outcome variables were measured pre- and post-intervention: mindfulness, perceived stress, and general psychological distress. Intention-to-treat analyses showed significant reductions in perceived stress (M = −3.85, SD = 5.70, 95 % CI, -2.88 to −4.82, p

Dementia is a neurocognitive disorder that affects a person's abilities in daily functioning. Anxiety and depression symptoms are common among persons with dementia. Cognitive behavioural therapy (CBT) has been tested to manage their depression and anxiety symptoms. However, the purpose of CBT in managing these symptoms is unclear. Therefore, this paper aims to clarify whether CBT can be used to reduce depression and anxiety symptoms in persons with dementia. The electronic databases PubMed, PsycINFO, MEDLINE, and CINAHL were used to locate relevant studies. Eleven studies, which involved a total of 116 older adults, were identified. The findings suggest that CBT can be effective in reducing depression and anxiety symptoms. Based on our current review, the findings from previous studies form a promising foundation on which to conduct a major randomized controlled trial with a larger sample size. This review discusses some of the most important considerations in applying CBT to persons with dementia, and these may be beneficial for future studies that explore this area and seek more conclusive evidence on the use of CBT.

The study aimed to strengthen the scarce literature on self-help treatments for Problem Gambling (PG) by comparing the effectiveness of a Self-Help Cognitive Behavioral Treatment (SHCBT) program (n = 23) with a 6-week Waitlist condition (n = 32) in problem gamblers. Participants were community volunteers with gambling problems and were randomly allocated to the Waitlist and treatment conditions. Results showed significant improvements at post-treatment in gambling behaviors including frequency of gambling, average amount gambled per day and PG symptoms as well as a number of gambling correlates including psychological states (e.g., depression, anxiety and stress), gambling cognitions, gambling urges, gambling related self-efficacy, satisfaction with life, and quality of life among those who completed the SHCBT program, when compared with the waitlist condition. The effect size (partial η 2) ranged from .25 to .57 for all assessed outcomes that showed significant improvement from pre- to post-treatment. It was concluded that a self-help CBT program can be beneficial for treating community problem gamblers.

Background and Objectives: Negative cognitive biases have been linked to anxiety and mood problems. Accumulated data from laboratory studies show that positive and negative interpretation styles with accompanying changes in mood can be induced through cognitive bias modification (CBM) paradigms. Despite the therapeutic potential of positive training effects, few studies have explored training paradigms administered via smartphones. The current study aimed to compare the effectiveness of three different types of training programmes (cognitive bias modification-attention, CBM-A; cognitive bias modification-interpretation, CBM-I; attention and interpretation modification, AIM) administered via smart-phones by using a control condition (CC). Methods: Seventy-six undergraduate participants with high social anxiety (Liebowitz Social Anxiety Scale, LSAS ≥ 30) were randomly assigned to four groups: CBM-A (n = 20), CBM-I (n = 20), AIM (n = 16) and CC (n = 20). Results: The results showed that the effects of CBM training, CBM-I training, or AIM training versus CC for attention yielded no significant differences in dot-probe attention bias scores. The CBM-I group showed significantly less threat interpretation and more benign interpretation than the CC group on interpretation bias scores. Conclusions: The present results supported the feasibility of delivering CBM-I via smartphones, but the effectiveness of CBM-A and AIM training via smartphones was limited.

Internet use has been receiving increasing attention from researchers and clinicians. However, few theoretical models of problematic internet use have been tested empirically, especially in Asia where a considerably high number of internet users have been documented. This study proposed variations of and tested Davis’s [1] modified cognitive-behavioural model of problematic internet use in an Asian sample. The participants were 296 university students (60.8% female, 39.2% male) between 17 and 49 years of age in Singapore. The results from path analyses did not support Davis’s model as a whole. However, significant pathways were found between psychopathology and maladaptive cognitions, as well as between maladaptive cognitions and generalised problematic internet use. Implications for research foci in the future were discussed.

Interventions using the "Four Immeasurables Meditations" (FIM) are effective for various outcomes; however, whether increased meditation practice in these interventions leads to better results has not been well investigated. This systematic review included 22 FIM interventions that reported associations between the amount of meditation practice and its outcomes. Despite the heterogeneity in intervention components and outcome variables, there were generally few significant associations between amount of meditation practice and its outcomes. Specifically, only five studies reported that more than half of the calculated results were significant. In comparison with correlations between total amount of practice and overall outcomes, the short-term influence of meditation practice was evaluated in fewer studies; however, it had a better association with outcomes. More studies are required that address the underlying mechanisms that elucidate how meditation practice leads to outcome changes in daily life. In this study, two promising mechanisms with initial evidence were discussed. This review also summarized common methodological issues including a lack of experimental manipulation and inaccurate measuring of meditation practice.

The aim of this study was to investigate the efficacy of an Internet-based cognitive behavioural therapy program (I-CBT) for the treatment of problem gambling, when compared to a waitlist control and an active comparison condition consisting of monitoring, feedback, and support (I-MFS). Participants (N = 174) were randomly allocated to the three conditions. Variables of interest were gambling outcome and related mental health measures. Participants in the active conditions (I-CBT and I-MFS) completed six online modules. Both I-CBT and I-MFS conditions resulted in significant treatment gains on gambling severity. However, I-CBT was also associated with reductions in a range of other gambling-related and mental health outcomes. Compared with I-MFS, I-CBT produced greater effects across seven outcomes measures, relating to gambling urges, cognitions, stress, and life satisfaction. I-CBT participants also rated the program as significantly more satisfactory. Treatment gains observed for both active conditions were found to be stable through to 12 month follow up. The results indicate that the benefits of I-CBT were more than simply the non-specific effects of engaging in online treatment or receiving motivation, feedback, and support. Online treatments for gambling may be a valuable tool in increasing help-seeking and treatment engagement in this population, and be integrated as part of stepped care approaches to treatment.

Background and aims: abnormal cognitions are among the most salient domain-specific features of gambling disorder. The aims of this study were: (a) to examine and validate a Spanish version of the Gambling-Related Cognitions Scale (GRCS; Raylu & Oei, 2004) and (b) to examine associations between cognitive distortion levels, impulsivity, and gambling behavior. Methods: this study first recruited a convenience sample of 500 adults who had gambled during the previous year. Participants were assessed using the Spanish version of GRCS (GRCS-S) questionnaire, the UPPS-P impulsivity questionnaire, measures of gambling behavior, and potentially relevant confounders. Robust confirmatory factor analysis methods on half the sample were used to select the best models from a hypothesis-driven set. The best solutions were validated on the other half, and the resulting factors were later correlated with impulsivity dimensions (in the whole n = 500 factor analysis sample) and clinically relevant gambling indices (in a separate convenience sample of 137 disordered and non-disordered gamblers; validity sample). Results: this study supports the original five-factor model, suggests an alternative four-factor solution, and confirms the psychometric soundness of the GRCS-S. Importantly, cognitive distortions consistently correlated with affect-or motivation-driven aspects of impulsivity (urgency and sensation seeking), but not with cognitive impulsivity (lack of premeditation and lack of perseverance). Discussion and conclusions: our findings suggest that the GRCS-S is a valid and reliable instrument to identify gambling cognitions in Spanish samples. Our results expand upon previous research signaling specific associations between gambling-related distortions and affect-driven impulsivity in line with models of motivated reasoning.

This study examined the psychometric properties of the self-report measure, Anxious Self-Statements Questionnaire (ASSQ), in an Asian context. The sample consisted of 434 community participants from Singapore, who were predominantly ethnic Chinese. Exploratory factor analysis (EFA) and Confirmatory Factor analysis (CFA) confirmed that the 3 factors solution, namely (1) Self-Doubt, (2) Inability to Maintain Coping, and (3) Negative Thinking/ Worry, was the best fit for the data. Internal consistency was good for the total scale and the factor scales derived from the three-factor model. Concurrent and discriminant validities of the ASSQ - Asia (ASSQ-A) were also good, hence suggesting that the ASSQ-A is a valid and reliable instrument for assessing anxiety-related cognitive content or anxious self-talk among Asians, in particular in Singapore.

This study explored the moderating and mediating influences of self-acceptance and tolerance to others in the relationship between mindfulness and subjective well-being. In total, 301 (130 males) university students completed the Five-Facet Mindfulness Questionnaire, Index of Well-being, Self-acceptance Questionnaire, and Tolerance Scale. The results showed that the positive link between mindfulness and subjective well-being was significantly mediated by self-acceptance only. Tolerance played a moderating role. The implications of the results for relevant research and mindfulness training were discussed.

Background: This study aimed to explain how quality of life changes during psychotherapy, using a cognitive-behavioural theoretical framework, and examined whether changes in symptoms or changes in cognitions were more influential with regard to quality of life change. Three different hypotheses were tested that might explain the mechanisms by which quality of life changes during group cognitivebehaviour therapy (CBT) for anxiety and depression. Methods: 127 outpatients with anxiety and/or depression enrolled in a four-week group CBT programme participated. Measures of anxiety and depression symptoms, cognitive change, and quality of life were administered at baseline and post-treatment. Baseline to post-treatment change scores were calculated and entered into multiple regression analyses. Results: Reductions in anxiety and depression symptoms were related to increases in quality of life, whereas cognitive changes were not consistently related to changes in quality of life. Limitations: The main limitation was that the study's design was not able to assess whether changes in cognitions or symptoms preceded changes in quality of life, as all variables were measured at the same two points in time. Conclusions: These results provided evidence that quality of life changes as a result of or, simultaneously with, symptom change. It appears that group CBT does not improve quality of life through strategies designed to change patients' cognitions.

Parents and caregivers of children with ASD have reported significant stress and challenges in caregiving. However, stress coping research in parents and caregivers of children remains limited. This review attempted to close this gap. For this review, 37 studies investigating the (1) underlying themes, (2) contributing factors, and (3) psychological outcomes of ASD-related parental and caregiver coping, were selected from the literature. Results revealed that the two most useful coping resources, i.e., problem-focused coping (45.9 %) and social support (37.8 %), were supported by parental stress coping studies. Parents’ and caregivers’ use of coping strategies was also influenced by (1) demographical characteristics (i.e., gender, age, education, income, language) and psychological attributes (i.e., personality, cultural values, optimism, sense of coherence, benefit-finding and sense-making abilities, emotional health, coping styles), (2) child characteristics (i.e., age, gender, medical conditions, cognitive and adaptive functioning abilities, language difficulties, and behavior problems) and (2) situational variables (i.e., treatment availability, family function, and clinician referrals to support resources). Finally, methodological limitations in past studies were discussed. This review emphasized the importance of further examination on the coping mechanisms of parents/caregivers of children with ASD.

Background: Clinical depression is often preceded by social withdrawal, however, limited research has examined whether depressive symptoms are alleviated by interventions that increase social contact. In particular, no research has investigated whether social identification (the sense of being part of a group) moderates the impact of social interventions. Method: We test this in two longitudinal intervention studies. In Study 1 (N¼52), participants at risk of depression joined a community recreation group; in Study 2 (N¼92) adults with diagnosed depression joined a clinical psychotherapy group. Results: In both the studies, social identification predicted recovery from depression after controlling for initial depression severity, frequency of attendance, and group type. In Study 2, benefits of social identification were larger for depression symptoms than for anxiety symptoms or quality of life. Limitation: Social identification is subjective and psychological, and therefore participants could not be randomly assigned to high and low social identification conditions. Conclusions: Findings have implications for health practitioners in clinical and community settings, suggesting that facilitating social participation is effective and cost-effective in treating depression.

This study examined the relationships between risk (i.e., gambling cognitions, gambling urges, psychological distress) and protective factors (i.e., life satisfaction, resilience, gambling refusal self-efficacy) and problem gambling among 310 Singaporeans aged between 18 and 73 years. Data on demographics, risk and protective factors, and gambling behavior were collected through electronic and paper surveys. Hierarchical multiple regression was employed to assess the contributions of the risk and protective factors in predicting problem gambling. Three risk factors (i.e., gambling cognitions, gambling urges, psychological distress) and two protective factors (i.e., resilience, gambling refusal self-efficacy) were found to significantly and uniquely predict problem gambling. Furthermore, the risk factors significantly interacted with the protective factors to moderate gambling severity. Gambling refusal self-efficacy shows significant protective effects against problem gambling, while the effects of resilience on gambling vary across settings. Both factors need to be taken into account in the understanding of problem gambling.

The present study evaluated the psychometric properties and factor structure of the Satisfaction With Life Scale (SWLS) in a sample of clinical outpatients in Malaysia. The SWLS is a measure designed to assess subjective life satisfaction. Four hundred eighty-three participants (283 with psychiatric illnesses and 200 with other medical illnesses) completed the SWLS and other self-report instruments. Results of the EFA and CFA supported the fit for the one-factor model as the best-fitting model. The internal consistency of the SWLS (α = 0.86) was found to be high. Correlational analyses showed that SWLS had adequate concurrent validity. Scores on SWLS, which differentiated psychiatric patients and medical patients, supported criterion validity. The logistic regression analyses showed good discriminative validity of SWLS. The SWLS is a reliable and valid instrument to measure the satisfaction with life among psychiatry and clinical outpatients in Malaysia.

Background Schizophrenia which is perhaps the most disabling and puzzling form of a mental disorder is often conceptualized as ‘gila’ (lunacy or madness) by the Malaysian society. The debilitating nature of the disorder and recurrent relapse of its psychotic episodes have often been misunderstood and lead to confusion among the family members, who play the role as primary caregivers. While expressed emotion (EE) has been widely studied in the Western world, it is not well understood in Malaysia. Objectives This study aimed at investigating the predictive role of relatives’ EE index and components as well as personality traits in relapse among schizophrenia patients in Kuala Lumpur and Klang Valley, Malaysia. Methods A total of 160 subjects consisting of 80 patients diagnosed with chronic schizophrenia and 80 relatives were recruited to participate in Phase 1 of the study. Only patient-participants were followed-up 6 months later for Phase 2 of the study in order to check for possible relapse. The Family Questionnaire (FQ) and the short scale Eysenck Personality Questionnaire-Revised (EPQ-R) were administered to measure relatives’ EE and personality traits, respectively. Patients’ were considered to relapse if they were readmitted into psychiatric wards 6 months post-hospital discharge. Results The findings revealed that the odds for patients to relapse were increased by 8 times when relatives demonstrated high-EE level. Relatives’ critical comments (CC) turned out to be the strongest predictor with the odds to relapse increased by 12% when they demonstrated an increase in CC level. Relatives’ personality traits particularly the extraversion trait also turned out to be the significant direct predictor to patients’ relapse. Our results showed that a unit decrease in extraversion trait score predicted the odds for patients to relapse by 23%. Discussions Our findings supported the Western findings on the significant role of relatives’ high-EE level particularly the CC scale on the course of schizophrenia. The novelty of the current finding was demonstrated in the significant role of relatives’ extraversion trait that directly predicted patients’ relapse. Results also indicated the feasibility of EE in predicting relapse among schizophrenia patients in Klang Valley, Malaysia.