Latefa Ali Dardas

Psychosocial Correlates of Parenting a Child with Autistic Disorder

Background: The lifelong experience of raising a child with a complex developmental disability such as autistic disorder is considered one of the most significant parenting stressors, with the potential to spill over into various areas of the life of parents. Therefore, studying the psychological functioning for parents of children with developmental disabilities requires the consideration of multiple factors acting and interacting concurrently. Purpose: The purpose of this study was to examine the relationship between two sets of variables in a sample of parents of children with autistic disorder. The first set was composed of the parents’ characteristics and the coping strategies used. The second set was composed of three stress subscales—parental distress (PD), parent–child dysfunctional interaction (PCDI), and difficult child (DC)—and the parental quality of life (QOL). Methods: Canonical correlation multivariate analysis was used to examine the relationship between the sets of variables in 184 Jordanian parents of children with autistic disorder. Results: The analyses revealed that the parents who have higher incomes, use diverse problem-solving strategies, exhibit less escape–avoidance, and exhibit less responsibility acceptance behavior tended to report lower PD, PCDI, and DC scores and a higher QOL score. The analyses also revealed that being an older parent, having more time since the child’s autistic diagnosis, and using more distancing coping strategies were associated with lower PD scores, higher PCDI and DC scores, and better QOL. Conclusions: This study is the first to investigate a wide range of parental psychosocial impacts as well as several sociodemographic factors that are possibly associated with raising a child with autistic disorder. The results indicate that health professionals working with parents of children with autistic disorder need to consider holistically the factors that can potentially affect the parents’ health and well-being and provide care that focuses on the parents as both clients and caregivers.

The stigma of mental illness in Arab families: a concept analysis

Accessible summary The stigma of mental illness varies significantly from culture to culture and from person to person. To date, little is known about how mental illness stigma manifests within the Arab community. This study aimed at bringing clarity to the concept of ‘mental illness stigma’ as it applies to Arab families. Nursings holistic and patient-centered approach is integral to helping Arab patients and their families appropriately incorporate individual values, beliefs, and cultural perspectives into treatment plans. This study establishes a scientific alert for professionals at all levels to avoid making false generalizations about a specific culture that are not based on specific research findings from that culture. Abstract Accessing mental health services is a critical step towards reducing the burden of mental illness. The stigma of mental illness is one of the most common reasons for not seeking mental health care leading to negative health consequences and undue suffering for many individuals and their families. Stigma is embedded in its social context. What may be considered acceptable in one society may be considered unacceptable and open to stigmatization in other societies. Arabs have a shared set of values, beliefs, and traditions that are substantially different from those of Westerners. Further, in most Arab countries, formal mental health resources are scarce and people with mental illness experience the compounded disadvantages of poverty and illness stigma. To date, little is known about how mental illness stigma manifests within the Arab community making it difficult to design and test interventions that support Arab individuals with mental illness and their families in treatment seeking and adherence. Using Rodgers concept analysis method, we examined how ‘mental illness stigma’ operates within an Arab context as a first step towards elucidating culturally competent approaches to treatment. This analysis provides a foundation for future work in the areas of mental illness diagnosis, education, and treatment that reflect the unique characteristics of Arab culture.

Cancer Prevention and Care: a National Sample from Jordan

This survey was designed to enhance cancer prevention and care in a sample from the Arab world. A descriptive survey research design was adopted. A representative sample of 3,196 individuals from the three main regions of Jordan (north, middle, and south) was used. Data were collected through interviews. The tool for the study included the following aspects: identification and background information; health status; participant’s lifestyle; general beliefs about cancer prevention; screening and early detection; and communication channels and seeking information about cancer. The participants believed that the three greatest factors related to cancer specifically in Jordan were active cigarette smoking, exposure to radiation, and exposure to chemicals. The majority of the participants agreed that getting regular cancer checkup helps diagnose the disease early with a good prognosis. Interestingly, cancer checkup was about seven times greater among females than males. Married individuals performed checkup four times more than singles. The findings indicate that knowledge gaps and improper practices toward cancer existed among the participants and, if corrected, could facilitate the care, prevention, and early detection of cancer. The findings help in defining key areas that should be addressed in national cancer policies in Jordan.

Psychometric Properties of the Parenting Stress Index with Parents of Children with Autistic Disorder.

PURPOSE The purpose of this study was to examine the psychometric properties and the theoretical structure of the Parenting Stress Index-short form (PSI-SF) with Jordanian parents of children with autistic disorder. METHODS Using a cross-sectional design for data collection, the convenience sample of the study was composed of 184 Jordanian parents of children with autistic disorder. The factor structure for the PSI-SF was examined using confirmatory and exploratory factor analyses. RESULTS We found that the modified three-factor model (30 items) fits the data significantly better than the 36-item model. The results showed that the 12 items of the Parental Distress sub-scale support the original scale structure. However, items in the Parent-Child Dysfunctional Interaction and Difficult Child sub-scales did not show stability in their structure. The results in this study showed that the PSI-SF in its 30-item model has endorsed the necessary validity of the scale with parents of children with autistic disorder. The study provides information on the effects of Arab culture on the validity of PSI-SF. CONCLUSION It is recommended to use the new factors structure of the PSI-SF with the 30 items in the studies that intend to examine the stress among parents with children with autistic disorder in the Arab world.

Validation of the World Health Organization's Quality of Life Questionnaire with Parents of Children with Autistic Disorder

The World Health Organization’s Quality of Life Questionnaire-BREF (WHOQOL-BREF) has been used in many studies that target parents of children with Autistic Disorder. However, the measure has yet to be validated and adapted to this sample group whose daily experiences are considered substantially different from those of parents of children with typical development and parents of children with other disabilities. Therefore, this study was designed to examine the psychometric properties and the theoretical structure of the WHOQOL-BREF with a sample of 184 parents of children with Autistic Disorder. The factor structure for the WHOQOL-BREF was examined using exploratory and confirmatory factor analyses. Our analyses provided no evidence of a better model than the original 4-domain model. Nevertheless, some items in the measure were re-distributed to different domains based on theoretical meanings and/or clean loading criteria. The new model structure gained the measure’s required validity with parents of children with Autistic Disorder.

A pilot study of depression, stigma, and attitudes towards seeking professional psychological help among Arab adolescents

Abstract The Arab region has the largest proportion of young people in the world and many of the factors that contribute to the onset of depression. Yet, very little is known about the current situation of depression and its associated stigma in this region. The purpose of this pilot study was to obtain preliminary data examining clinically significant depressive symptoms, depression stigma, and attitudes towards seeking professional help for depression among a sample of Arab adolescents from Jordan. Cross-sectional data were collected from 88 adolescents attending public schools in Jordan using self-report questionnaires that were available in, or translated into, Arabic. Among the 88 adolescents, 22% reported scores suggesting mild depression and 19% reported scores suggesting moderate depression, while 24% reported scores suggesting severe depression. The most frequently reported depressive symptoms were changes in sleep patterns (76%), changes in appetite (63%), agitation (62%), and crying (61%). The majority (73%) had moderate depression stigma, and 43% had negative attitudes towards seeking professional help. Yet, 67% believed they would find relief in psychotherapy if they ever had a serious emotional crisis. Findings suggest that the prevalence of depressive symptoms may be high among Jordanian adolescents. Further, many of these adolescents may experience depression-related stigma that affects their attitudes and willingness to seek professional help. To determine the true scope of these issues, including the prevalence of depression among Jordanian adolescents, future research should obtain data from a nationally representative sample.

Adolescent Depression in the Arab Region: A Systematic Literature Review.

Adolescent depression is a primary cause of global disability and burden with considerable variability across countries in its prevalence, diagnosis, management, and prognosis. No systematic reviews have been published on adolescent depression in Arab countries despite the unique sociocultural background that can play a major role in shaping Arab depressed adolescents’ prognosis and response to treatment. The purpose of this study was to provide such a review with the goal of identifying the necessary foundations for culturally competent mental health care practices to address the unique needs of Arab adolescents and their families. We systematically reviewed PubMed, CINAHL, PsycINFO, and available Arabic databases. We adhered to the PRISMA statement to guide the process of identification, selection, and appraisal of the reviewed articles. No restrictions were applied on publication date. The search was completed in December 2015. A total of 199 unique articles met criteria for screening at the abstract level; 47 articles were selected for review in full text; and 27 articles were included in the final analysis. Four emerging themes were identified: (1) few robust prevalence estimates of adolescent depression are available in Arab countries; (2) depression varies based on the individual characteristics of Arab adolescents; (3) context influences Arab adolescents’ risk of experiencing depression; and (4) the stigma of depression negatively impacts help-seeking process among Arab adolescents. This review highlights the need for more community-based detection efforts that employ developmentally and culturally appropriate measurement instruments for adolescent depression. Furthermore, findings suggest the need for culturally competent care that integrates indigenous health practices into modern mental health systems. Nurses, who form the greatest proportion of health personnel in all Arab countries, are uniquely situated to help Arab adolescents experiencing depression restore, maintain, and/or promote their mental health and wellbeing.

Studying Depression Among Arab Adolescents: Methodological Considerations, Challenges, and Lessons Learned From Jordan.

The purpose of this study was to evaluate the methodology for research examining depression severity, depression sigma, and attitudes toward seeking professional help for depression among Jordanian adolescents aged 12 to 17 years. Because this was a novel area of research in the Arab countries generally, and Jordan specifically, we aimed to (a) assess the feasibility of collaboration with recruitment sites, (b) evaluate the sampling method and recruitment strategies, and (c) confirm the utility of the measures translated from English to Arabic, namely, the Depression Stigma Scale (DSS; Griffiths, Christensen, & Jorm, 2008) and the Attitudes Toward Seeking Professional Psychological Help Scale (ASPPH; Fischer & Farina, 1995). Cross-sectional data were collected using self-report questionnaires from 88 adolescents attending public schools in Jordan. Active parental consents and adolescent assents were obtained as required by an American institutional review board (IRB), which was 1 of 2 entities providing approval for the study protocol. Depression was evaluated using a validated Arabic version of the Beck Depression Inventory II (BDI-II; Beck, Steer, & Brown, 1996). A systematic translation procedure was utilized for the DSS and ASPPH scales. Feasibility of collaboration with recruitment sites was established. However, the active consent procedure reduced the response rate and influenced sample characteristics. Both the BDI-II and the DSS showed adequate reliability. Reliability of the ASPPH scale was questionable. Conducting cross-cultural research requires careful considerations of all ethical, methodological, cultural, linguistic, and logistical issues that might potentially affect the validity and reliability of collected data. This study taps a significant gap in the literature, and provides important recommendations on how to address the potential impacts of the consent process on subjects’ decision to participate or opt out of studies addressing stigmatizing issues, such as mental illness.

The hidden patients: Fathers of children with autism spectrum disorder

Abstract Background There has been a noticeable upsurge of scholarly writing and policy interest in the quality of life (QoL) of fathers raising children with autism spectrum disorder (ASD). However, there remains a scarcity of studies investigating the complex role of the psychological and sociodemographic characteristics of those fathers in shaping their QoL. This study intended to develop the necessary understanding of the characteristics of fathers of children with ASD that can potentially predict their QoL. Methods Cross-sectional data collected from 101 fathers through self-administered questionnaires were utilised. Standard simultaneous regression was used for modelling the relationship between QoL as a dependent variable and 7 independent variables (parental distress, parent–child dysfunctional interaction, difficult child characteristics, fathers’ level of education, family income, childs gender, and childs age). Results Family income, childs age, and parent–child dysfunctional interaction were not significant predictors for the QoL of fathers of children with ASD. However, the remainder of the variables added significantly to the explained variance of QoL. Conclusion The current research-based data can contribute to a better understanding of the QoL of fathers raising children with ASD. It may assist health policymakers to design support programs that holistically consider the psychological health and socioeconomic backgrounds of fathers of children with ASD to better influence the outcomes of their parenting experience.

Colorectal cancer in Jordan: prevention and care

The aim of this study was to describe the knowledge, attitudes, and practices toward colorectal cancer prevention and care in Jordan. A survey was designed to produce reliable estimates for the population’s knowledge, attitudes, and practices in all 12 governorates of Jordan by using stratified random sampling. A representative sample of the adult population in Jordan completed a comprehensive tool which explored participants’ knowledge about the risk factors associated with colorectal cancer, cancer prevention through lifestyle changes, and early cancer diagnosis and screening. According to the participants (n = 3196), colorectal cancer had the second highest percentage of screening recommendation (12.6%) after breast cancer (57.3%). Only 340 individuals (11%) reported ever screening for cancer. About 20% of the participants had heard of one of the screening tests for colorectal cancer. In fact, only 290 (9.1%) participants had performed the colorectal cancer screening tests. This study provides data that will help colorectal cancer prevention and treatment programs and may enhance the efficiency of colorectal cancer-controlling programs. The findings confirm the necessity of starting colorectal screening intervention that targets the most vulnerable individuals.