Hamidin Awang

Unhealthy diet practice and symptoms of stress and depression among adolescents in Pasir Gudang, Malaysia

BACKGROUND/OBJECTIVE Missing main meals and an unhealthy snacking pattern can lead to poor diet quality and consequently to the presence of chronic diseases among which mental disorder is no exception. Since there is little research on diet, skipping meals and psychological status in Asian countries, this study tries to determine eating behaviour and predicting symptoms of stress and depression of adolescents in Pasir Gudang, Malaysia. SUBJECTS AND METHODS A cross-sectional study was conducted among Form 1 secondary school-going adolescents (n 1565, response rate: 90%) in southern Malaysia from April to May 2013. A self-administered structured and validated questionnaire (socio-demographic, eating behaviour questionnaire, and depression, anxiety and stress scales (DASS-21)) was used for data collection. RESULTS Among respondents, 803 (51.3%) were female, 1125 were Malay (71.9%) with a mean age of 13.7 (SD=0.8) years. Logistic regression analysis indicated that students who were underweight (OR=3.07, 95% CI 1.21, 7.76), obese (OR=2.64, 95% CI 1.01, 6.87), used to eat out of home (OR=1.37, 95% CI 1.28, 2.13), eat dinner (>4 days/week) (OR=1.59, 95% CI 1.04, 2.43) were more likely to have depression or stress symptoms. Moreover, participants with 4-7 days/week eating breakfast (OR=0.88, 95% CI 0.21, 0.89) were less likely to be at mild/moderate stress. CONCLUSIONS Findings underscore the effect of unhealthy eating practices among adolescents on mental health. Targeted education should be implemented to improve psychological well-being.

Testing comparison models of DASS-12 and its reliability among adolescents in Malaysia

OBJECTIVE The 21-item Depression, Anxiety and Stress Scale (DASS-21) is frequently used in non-clinical research to measure mental health factors among adults. However, previous studies have concluded that the 21 items are not stable for utilization among the adolescent population. Thus, the aims of this study are to examine the structure of the factors and to report on the reliability of the refined version of the DASS that consists of 12 items. METHOD A total of 2850 students (aged 13 to 17 years old) from three major ethnic in Malaysia completed the DASS-21. The study was conducted at 10 randomly selected secondary schools in the northern state of Peninsular Malaysia. The study population comprised secondary school students (Forms 1, 2 and 4) from the selected schools. RESULTS Based on the results of the EFA stage, 12 items were included in a final CFA to test the fit of the model. Using maximum likelihood procedures to estimate the model, the selected fit indices indicated a close model fit (χ(2)=132.94, df=57, p=.000; CFI=.96; RMR=.02; RMSEA=.04). Moreover, significant loadings of all the unstandardized regression weights implied an acceptable convergent validity. Besides the convergent validity of the item, a discriminant validity of the subscales was also evident from the moderate latent factor inter-correlations, which ranged from .62 to .75. The subscale reliability was further estimated using Cronbachs alpha and the adequate reliability of the subscales was obtained (Total=76; Depression=.68; Anxiety=.53; Stress=.52). CONCLUSION The new version of the 12-item DASS for adolescents in Malaysia (DASS-12) is reliable and has a stable factor structure, and thus it is a useful instrument for distinguishing between depression, anxiety and stress.

Emotional Health and Self-esteem Among Adolescents in Malaysian Orphanages

This study aimed to assess the prevalence and risk factors of depression, anxiety, stress and low self-esteem among institutional Malaysian adolescents. This cross-sectional descriptive study included 287 adolescents aged 12–18 years living in six selected orphan homes. Study’s instruments included Socio-demographic questionnaire, validated Malay version of Depression Anxiety Stress Scale-21 and Rosenberg Self-Esteem Scale. The findings revealed that 85.2, 80.1 and 84.7% of participants had depression, anxiety and stress respectively. Females were more likely to be depressed. Furthermore, anxiety was significantly associated with race and age but no significant associations between stress and the demographic factors were found. The study also showed that 70.8% of males and 69.2% of females had low self-esteem and the self-esteem was associated with depression, anxiety and stress.Therefore, mental health problems are very common among adolescents in Malaysian orphanages. Results reveal the urgency of immediate actions to reduce the mental health problems among Malaysian institutional adolescents.

Stress and coping mechanisms among adolescents living in orphanages: An experience from Klang Valley, Malaysia

Health issues often differ from one population to another. Assessing different aspects of the health condition is a vital step toward developing and designing appropriate prevention and treatment programs to reduce health problems in any group or population. This study aimed to assess both the prevalence of stress and the coping mechanisms as well as identify the predictors of stress levels among adolescents in Malaysian orphanages.

Association between perceived parental style and depressive symptoms among adolescents in Hulu Langat District, Malaysia

Abstract Depression among adolescents is increasing and worrying because of its morbidity and mortality from suicide. It has been found to be associated with negative parental styles. The objective of this study was to determine the relationship between perceived negative parental styles and depressive symptoms among adolescents in Hulu Langat District, Selangor, Malaysia. A cross-sectional study was carried out on 1769 secondary school students by using a multistage cluster sampling method. Data were collected by using a set of validated, pre-tested and standardized questionnaires which included the Measures of Parental styles (MOPS) and modified Depression, Anxiety and Stress Scale 12 (DASS-12) for adolescents. Data were analyzed by using the chi-square test, Pearson’s correlation coefficient and independent t-tests. Out of 1800, 1769 completed the questionnaire giving a response rate of 98.3%. The prevalence of severe depressive symptoms was about 14% while 18.0% and 36.1% of respondents have moderate and mild depressive symptoms, respectively. There were significantly moderate and positive correlations between perceived indifferent parents (Father: r = 0.367; Mother: r = 0.340, p < 0.05), perceived abusive parents (Father: r = 0.338; Mother: r = 0.331, p < 0.05) and depressive symptoms among the respondents. While perceived over control parents shows a significantly positive but weak correlation (Father: r = 0.206; Mother: r = 0.244, p < 0.05) with depressive symptoms among respondents. All types of parental styles in this study were significantly different among respondents with different categories of depressive symptoms (p < 0.008). Perceived negative parental styles have significant influence on adolescents’ depressive symptoms. Intervention on modifying parental style is needed to reduce depressive symptoms.

Influence of coping mechanisms on emotional problems among adolescents in Malaysian orphanages

Psychological problems are increasing dramatically among children and adolescents living in orphanages (Mohammadzadeh, Awang, K. S, & Ismail, 2017; Polihronakis, 2008). This study aimed to assess the influence of coping mechanisms on emotional problems in Malaysian orphanages. Using the validated Malay versions of DASS21 and Brief COPE scale, 287 adolescents (aged 13‐17) from 8 orphanages in Klang Valley, 2015, participated in this study. The study was approved by the ethical committee of the Unversiti Putra Malaysia and a written consent form was obtained from all the respondents and caregivers. The results showed that stress was significantly predicted by denial, venting, religion, humor, planning, and active coping. Only denial had a positive association with stress. Results of logistic regression showed participants using denial were 2.37 times (P = .001) more likely to be stressful. The participants using venting, humor, planning, and active coping were 0.61 (P = .01), 0.59 (P = .02), 0.56 (P = .01), and 0.39 times (P = .001) less likely to be stressful. Denial, self‐blame, planning, and humor had significant impact on depression. Participants using denial, self‐blame, and humor were, respectively, 1.70 (P = .01), 1.58 (P = .02), and 1.38 times (P = .03) more likely to be depressed. The participants using planning were 1.41 times (P = .03) less likely to be depressed. Meanwhile, substance use and self‐distraction have positive significant impact on anxiety. Participants using substance use method (P = .001) and self‐distraction (P = .04) were 1.78 and 1.31 times more likely to be anxious, respectively. As understanding the risk factors of emotional problems is a vital step to develop appropriated programs for reducing mental issues in