Ponnusamy Subramaniam

An Exploration of the Indecisiveness Scale in Multiethnic Malaysia

This article examined the construct of indecisiveness, or the inability to make timely decisions, in a multiethnic sample from Malaysia. In all, 164 (84 women, 80 men) Malay participants and 150 (76 women, 74 men) Chinese participants completed a Malay version of Frost and Showss Indecisiveness Scale. Results showed that interitem reliabilities for both ethnic groups were high. Test-retest reliability with 21 participants after 10 days was also very high. The results of a confirmatory factor analysis testing the equivalency of a hypothesized single factorial structure for Malays and Chinese showed adequate fit for both ethnic groups. Based on single factorial structure, there were significant ethnic differences on overall indecisiveness scores (with Malays being more indecisive than Chinese) but no sex differences. These results are discussed in terms of previous cross-cultural work using the Indecisiveness Scale.

Suicide Attempts in Malaysia from the Year 1969 to 2011

The aim of this paper is to review the literature on suicide attempts in Malaysia. PsycINFO, PubMed, and Medline databases from 1845 to 2012 and detailed manual search of local official reports from the Ministry of Health and the Malaysian Psychiatric Association and unpublished dissertations from 3 local universities providing postgraduate psychiatric training were included in the current review. A total of 38 studies on suicide attempts in Malaysia were found and reviewed. Twenty-seven (76%) of the studies on suicide attempts were descriptive studies looking at sociodemographic data, psychiatric illnesses, and methods and reasons for suicide attempts. No study has been conducted on treatment and interventions for suicide attempts and the impact of culture was rarely considered. The review showed that in order for researchers, clinicians, and public health policy makers to obtain a better understanding of suicide attempts in Malaysia, more systematic and empirically stringent methodologies and research frameworks need to be used.

A Review of Risk Factors for Cognitive Impairment in Stroke Survivors

In this review, we aimed to identify the risk factors that may influence cognitive impairment among stroke survivors, namely, demographic, clinical, psychological, and physical determinants. A search from Medline, Scopus, and ISI Web of Science databases was conducted for papers published from year 2004 to 2015 related to risk factors of cognitive impairment among adult stroke survivors. A total of 1931 articles were retrieved, but only 27 articles met the criteria and were reviewed. In more than half of the articles it was found that demographical variables that include age, education level, and history of stroke were significant risk factors of cognitive impairment among stroke survivors. The review also indicated that diabetes mellitus, hypertension, types of stroke and affected region of brain, and stroke characteristics (e.g., size and location of infarctions) were clinical determinants that affected cognitive status. In addition, the presence of emotional disturbances mainly depressive symptoms showed significant effects on cognition. Independent relationships between cognition and functional impairment were also identified as determinants in a few studies. This review provided information on the possible risk factors of cognitive impairment in stroke survivors. This information may be beneficial in the prevention and management strategy of cognitive impairments among stroke survivors.

Psychometric properties and validation of the Positive and Negative Suicide Ideation (PANSI) inventory in an outpatient clinical population in Malaysia

The PANSI is a measure designed to assess the risk and protective factors related to suicidal behaviors. The present study evaluated the psychometric properties and factor structure of the Positive and Negative Suicide Ideation (PANSI) Inventory in a sample of clinical outpatients at a major hospital in Malaysia. In this study, 283 psychiatric patients and 200 medical (non-psychiatric) patients participated. All the patients completed the PANSI and seven other self-report instruments. Confirmative factor analysis supported the 2-factor oblique model. The internal consistency of the two subscales of PANSI-Negative and the PANSI-Positive were 0.93 and 0.84, respectively. In testing construct validity, PANSI showed sizable correlation with the other seven scales. Criterion validity was supported by scores on PANSI which differentiated psychiatric patients from medical patients. Logistic regression analyses showed PANSI can be used to classify the patients into suicidal or non-suicidal. The PANSI is a reliable and valid instrument to measure the severity of suicidal ideation among clinical outpatients in Malaysia.

Positive effects of Individual Cognitive Behavior Therapy for patients with unipolar mood disorders with suicidal ideation in Malaysia: A randomised controlled trial

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 (Cohens 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.

Weaving the non-pharmacological Alzheimer’s disease therapy into mobile personalized digital memory book application

Advances in mobile technology have lead to a more interesting and inspiring applications that could be used to help people with health problem. Together with rapid progress in mobile devices, new applications to support treatments have been developed tremendously. This technology has also been identified to assist patients with Alzheimer’s disease. This paper describes an application that was developed to improve the quality of life of a person who is suffering from Alzheimer’s disease. It was designed specifically for a patient with personalized contents. It was tested on an Android based mobile device where the patient could easily access the application at anytime and anywhere. Experts were interviewed to evaluate the usability and functionality of the system. The result from this study showed that the application is suitable for non-pharmacological therapy to assist Alzheimer’s patient. It can be used to enhance the reminiscent and stimulate cognitive function of the patient. The application is also being used as a support to improve the quality of life of the patient and encourage communication with the caretakers.