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  Pre-, Peri-, and Neonatal Factors Associated with Autism Spectrum Disorder: Results of a Lebanese Case-control Study

  Rabbaa Khabbaz, Lydia; Hajj, Aline; Hallit, Souheil; El-Khatib, Rouba; External Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-07-01)

  Objective: The prevalence of autism spectrum disorder (ASD) in Lebanon is higher than what is reported by the World Health Organization (WHO), leading to the thought that the Lebanese population has some specific risk factors for ASD. Therefore, it is important to conduct more robust studies on this population. We conducted this study to identify pre-, peri-, and neonatal risk factors for ASD. Our ultimate goal was to detect and change some modifiable risk factors, thus reducing the incidence of ASD. Design: A case-control study was conducted using a random proportional sample of Lebanese children with ASD to explore whether risk factors, such as family history, pregnancy (including all medication and substances taken during pregnancy and infection history), gestational age, delivery, birth milestones, and the neonate's condition at birth could be associated with a higher prevalence of ASD. The local ethical committee approved the study (USJ-2016-91), and all parents gave their written consent. Results: A total of 66 children with ASD and 66 controls were included. The results of the multivariable analysis showed that a higher gestational weight gain (adjusted odds ratio [ORa]: 1.11) was significantly associated with higher odds of autism, whereas female sex (ORa: 0.13) and higher number of weeks of gestation (ORa: 0.76) were significantly associated with lower odds of autism. Conclusion: Such results are of great relevance, since many of the identified factors herein could be avoidable or modifiable, suggesting the need for implementing timely and appropriate public health strategies for disease prevention in pregnant women that could reduce ASD.
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  Menstrual symptoms variation among Lebanese women before and after the COVID-19 pandemic

  Hallit, Souheil; Issa, Rita; Obeid, Sahar; Sawma, Toni; Malaeb, Diana; No Collaboration; NA; 0; 0; Psychology; et al. (2022-07-20)

  Objectives: Pandemic diseases and the confinement measures due to COVID-19 infection have introduced acute and persistent psychosocial stressors for different individuals with a greater influence on females manifested through changes in the menstrual cycle. The objective of this study was to assess Lebanese female of reproductive age about their menstrual cycle, their mental health, and their lifestyle, throughout the COVID-19 pandemic, Beirut blast, and the economic crises. Methods: A cross-sectional online study conducted between October and December 2021, enrolled 398 Lebanese women using the snowball technique. The Menstrual Symptom Questionnaire (MSQ) was used to assess menstrual symptoms. A repeated measures ANOVA was used to assess factors associated with the variation in MSQ scores after vs before the pandemic. Results: Our results showed that a significantly higher number of days of menses, number of pads per day and total MSQ score were significantly found after the pandemic compared to before it. More distress (Beta=0.68), more post-traumatic stress disorder due to COVID-19 (Beta=0.19), a higher number of waterpipes smoked per week (Beta=1.20) and being infected by COVID-19 compared to not (Beta=3.98) were significantly associated with an increase in the MSQ score after the pandemic compared to before it. Conclusion: Our main findings indicate that females had irregular menstrual cycles, unpredictable bleeding pattern, and intense symptoms severity post COVID-19 pandemic. Furthermore, stress post COVID-19 and Beirut blast tended to be associated with increased menstrual symptoms. Thus, vulnerable women should be identified and offered appropriate care, information, and awareness regarding their menstrual period during a pandemic.
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  The nature, consequences, mechanisms, and management of sleep disturbances in individuals at-risk for psychosis

  Jahrami, Haitham; Hallit, Souheil; Fekih-Romdhane, Feten; Cheour, Majda; No Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-09-20)

  There is strong evidence that sleep disturbances are commonly experienced by people with psychosis. Evidence has also shown that sleep disturbances are present since the very early stages of the disease, even during the pre-diagnostic phase. More recently, research involving young individuals at ultra-high risk (UHR) for psychosis documented frequent occurrence of sleep disturbances in this group. The very early onset of sleep disturbances in the course of psychosis has drawn attention to the possible links between sleep parameters and the risk of psychosis. To date, the nature of sleep disturbances characterizing the UHR stage remains unclear, with available studies having yielded mixed findings. In this regard, we performed this review to update the body of literature on the nature of sleep disturbances, their underlying mechanisms, their clinical and functional consequences, the prevention and intervention strategies in the at-risk for psychosis population. Our findings provided further support to the presence of disturbed sleep in UHR individuals as evidenced by subjective and objective sleep measures such as polysomnography, sleep electroencephalograms, and actigraphy. Reviewing the possible mechanisms underlying the relationship between sleep and psychosis emphasized its complex and multifactorial nature which is yet to be determined and understood. Further research is warranted to determine which facets of sleep disturbances are most detrimental to this specific population, and to what extent they can be causal factors or markers of psychosis.
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  Maladaptive Cognitive Schemas as Predictors of Disordered Eating: Examining the Indirect Pathway through Emotion Regulation Difficulties

  Obeid, Sahar; Hallit, Souheil; Gerges, Sarah; Malaeb, Diana; External Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-09-15)

  eating patterns. Moreover, no prior study has considered the potential role of difficulties in negative emotion regulation when disentangling the complex correlations between early maladaptive schemas and disturbed eating habits. Our study aimed at exploring the distinct relationships between early maladaptive schemas and disordered eating, while investigating the indirect role of emotion regulation difficulties within these associations. We collected data from 982 Lebanese young adults (18-30 years old), distributed across the five Lebanese governorates, who completed the Eating Attitudes Test (EAT-26), the Young Schema Questionnaire-Short Form 3 (YSQ-SF3), and the Difficulties in Emotion Regulation Scale-16 Item Version (DERS-16). The results showed that the disconnection and rejection schema domain, under which the early maladaptive schema of mistrust was the most predictive of disordered/inappropriate eating attitudes. All the remaining maladaptive schema domains (i.e., the impaired autonomy/performance, impaired limits, other-directedness, and overvigilance/inhibition schema domains) exerted significant indirect effects on disordered eating attitudes through difficulties in emotion regulation. Our findings gave prominence to a potential intrinsic mechanism through which maladaptive cognitive schemas are linked to disordered eating behaviors, emphasizing the role of emotion dysregulation as a cardinal actor within this model. They sustain the surmise that cognitively and emotionally vulnerable individuals exhibit stronger propensities for inappropriate dietary patterns, as a means to offset their inner weakness. This study broadens the medical community's insights into the underpinning processes behind eating disorder psychopathology and could therefore make a step towards the adoption of innovative therapeutic approaches that promote emotion regulation skills in the context of schema therapy.
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  Association between cognition and color discrimination among Lebanese patients with schizophrenia

  Hallit, Souheil; Oussama, Dahdouh; Solh, Tala; Lahoud, Corinne; Haddad, Chadia; No Collaboration; NA; 0; 0; Psychology; et al. (2022-09-12)

  Background: Patients with schizophrenia (SCZ) exhibit poorer color discrimination than normal individuals. Although retinal abnormalities, as well as cortical and subcortical alterations, found in patients with SCZ have been suggested to cause this poor color discrimination, the impact of cognitive impairment remains to be determined. Dopamine (DA) and glutamate (Glu), known to be disrupted in SCZ, are also suggested to play a role in color discrimination. Our objective was to investigate the contribution of cognitive impairment to color discrimination deficits in SCZ and to examine if these deficits are correlated to SCZ symptoms. Methods: This study includes 127 patients with SCZ between July and September 2021. The participants completed several questionnaires, specifically the Positive and Negative Syndrome Scale (PANSS), the Montreal Cognitive Assessment (MoCA) test, and the Farnsworth D-15 test, to assess the extent of SCZ symptoms, cognition, and color discrimination respectively. Results: Higher cognition (Beta = - 0.279) was significantly associated with a lower total error score (TES). Moreover, a higher positive PANSS score (Beta = 0.217) was significantly associated with a higher TES. A multinomial regression analysis taking the type of color blindness as the dependent variable showed that female sex (ORa = 5.46) was significantly associated with a certain type of color blindness. Conclusion: Color discrimination deficits in patients with SCZ may be due to the effect of cognitive impairment and/or SCZ itself.
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  A consensus document on definition and diagnostic criteria for orthorexia nervosa

  Lombardo, Caterina; Hallit, Souheil; Donini, Lorenzo; Obeid, Sahar; External Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-12-20)

  Purpose: Since the term orthorexia nervosa (ON) was coined from the Greek (ὀρθός, right and ὄρεξις, appetite) in 1997 to describe an obsession with "correct" eating, it has been used worldwide without a consistent definition. Although multiple authors have proposed diagnostic criteria, and many theoretical papers have been published, no consensus definition of ON exists, empirical primary evidence is limited, and ON is not a standardized diagnosis. These gaps prevent research to identify risk and protective factors, pathophysiology, functional consequences, and evidence-based therapeutic treatments. The aims of the current study are to categorize the common observations and presentations of ON pathology among experts in the eating disorder field, propose tentative diagnostic criteria, and consider which DSM chapter and category would be most appropriate for ON should it be included. Methods: 47 eating disorder researchers and multidisciplinary treatment specialists from 14 different countries across four continents completed a three-phase modified Delphi process, with 75% agreement determined as the threshold for a statement to be included in the final consensus document. In phase I, participants were asked via online survey to agree or disagree with 67 statements about ON in four categories: A-Definition, Clinical Aspects, Duration; B-Consequences; C-Onset; D-Exclusion Criteria, and comment on their rationale. Responses were used to modify the statements which were then provided to the same participants for phase II, a second round of feedback, again in online survey form. Responses to phase II were used to modify and improve the statements for phase III, in which statements that met the predetermined 75% of agreement threshold were provided for review and commentary by all participants. Results: 27 statements met or exceeded the consensus threshold and were compiled into proposed diagnostic criteria for ON. Conclusions: This is the first time a standardized definition of ON has been developed from a worldwide, multidisciplinary cohort of experts. It represents a summary of observations, clinical expertise, and research findings from a wide base of knowledge. It may be used as a base for diagnosis, treatment protocols, and further research to answer the open questions that remain, particularly the functional consequences of ON and how it might be prevented or identified and intervened upon in its early stages. Although the participants encompass many countries and disciplines, further research will be needed to determine if these diagnostic criteria are applicable to the experience of ON in geographic areas not represented in the current expert panel.
• Assessment of Antimicrobial Utilization among Cancer Patients with Febrile Neutropenia at the Lebanese Hospitals

  Salameh, Pascale; Hallit, Souheil; Cherri, Sarah; Shouman, Lamis; External Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-06-20)

  Background: Febrile neutropenia is a prevalent oncologic complication. Initiating rapid treatment with empirical antimicrobials in febrile neutropenia patients reduces mortality due to infections. Objectives: The study aims to evaluate antimicrobial utilization among FN patients in Lebanon in terms of drug choice, dose, and duration of treatment. Setting: This is a retrospective, multicenter, observational study was conducted at three different Lebanese university hospitals (in which the Infectious Diseases Society of America (IDSA) guidelines are adopted), between February 2014 and May 2017. Methods: Adult cancer patients aged 18 years and older with febrile neutropenia were included in the study. Using the IDSA guidelines as a reference, patients were assessed whether they received the antimicrobial regimen in consistent to the IDSA reference or not. Statistical analysis was performed using the Statistical Package for the Social Science software (SPSS version 22.0). Main outcome measure: The adherence to guidelines for the indication and doses of antibiotics and anti-fungal in patients with febrile neutropenia. Results: A total of 124 patients with a mean age of 54.43±17.86 years were enrolled in the study. Leukemia (29.7%) was the most prevalent cancer and the most common infection was sepsis (20.2%). Combination antibiotic lactams being the most prescribed antibiotics (86.8%). Only 94 (86.23%) patients were given the antibiotic therapy appropriate for choice, dose, and duration. Empirical antifungal therapy was initiated in 63.7% of the patients and fluconazole was the most used antifungal (36.3%). In contrast to antibiotics, the majority of antifungal choices were not selected according to the recommendations and they were considered inappropriate for doses and for the required treatment duration as proposed by (IDSA). Fifty-eight percent of patients received antivirals, even though it is not recommended as empirical treatment. Conclusion: In conclusion, this study reveals a non-consistent antimicrobial utilization practice at the involved sites with respect to FN treatment. Inappropriateness was encountered in drug selection, dose and duration of treatment with antifungals and antivirals.
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  Factors associated with knowledge and awareness of stroke among the Lebanese population: A cross-sectional study

  Malaeb, Diana; Hallit, Souheil; Dia, Nada; Hosseini, Hassan; External Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-07-11)

  Background: Evaluation of the knowledge about stroke in the general population is extremely vital as it prevents stroke development, limits complications, and achieves better quality of life. We assume that the general Lebanese population lacks awareness about stroke and its associated complications. This study aims to evaluate stroke knowledge and determine the factors associated with stroke awareness among the general Lebanese population. Methods: This cross-sectional study assessed respondents' sociodemographic characteristics and the identification of risk factors, warning signs, stroke consequences, and early response to stroke symptoms. A total of 551 Lebanese adults without a history of stroke filled in an online self-reported questionnaire publicly shared on social applications. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. Results: Among the 551 participants enrolled, 403 (74.2%) were females and 312 (56.7%) were under 30 years of age. Females compared to males and employed compared to unemployed had significantly higher odds of identifying at least one risk factor (OR=4.3 [95%CI=1.1;16.8] and 6 [95%CI=1.2;29.6], respectively). Also, when compared to unemployed, employed participants had significantly higher odds of recognizing at least one of the early stroke symptoms (OR=3.3 [95%CI=1.2;8.9]) and identifying at least one of the stroke consequences (OR=5.3 [95%CI=1.1;25.9]). Reaching a university level of education compared to a school level was associated with significantly higher odds (OR=2.3 [95%CI=1.1;4.8]) of taking a patient to a hospital. Conclusion: Well-educated, employed, and female participants were more knowledgeable about stroke. Tailored interventions focusing on individuals with inadequate stroke literacy are needed. Further studies, more representative of the general Lebanese population with a larger sample size, are necessary to confirm our findings.
• Association Between Personality Traits/Dimensions and Fear of No Mobile Phone Connectivity (nomophobia): Results of a Lebanese National Study

  Obeid, Sahar; Hallit, Souheil; Dib, Joseph; Hallit, Rabih; External Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-09-13)

  Objective: To study nomophobia in a large sample of Lebanese adults and its relationship with personality traits and other sociodemographic factors that may contribute to the diagnosis such as sex, parental status, and smoking. Methods: This cross-sectional study was conducted between January and July 2019. A total of 2,260 residents randomly selected from districts in Lebanon completed a questionnaire about sociodemographic characteristic and smoking. Respondents also completed the Nomophobia Questionnaire, Personality Inventory for DSM-5, and NEO Five-Factor Inventory. Results: The results of a linear regression, taking the nomophobia score as the dependent variable, showed that higher neuroticism (B = 0.648), number of waterpipes smoked per week (B = 0.749), and disinhibition (B = 0.706) were significantly associated with higher nomophobia, whereas more agreeableness (B = -0.535) and detachment (B = -0.594) were significantly associated with lower nomophobia. Conclusions: This study assessed the variation of inherent personality traits using 2 validated personality questionnaires and their association with nomophobia. As digital use becomes more prevalent within personal and professional aspects of life, nomophobia might become an anxiety risk. Future studies should focus on preventive and treatment measures in the form of awareness campaigns.
• Association Between Computer Vision Syndrome, Insomnia, and Migraine Among Lebanese Adults: The Mediating Effect of Stress

  Hallit, Souheil; Akiki, Maria; Hallit, Rabih; Obeid, Sahar; Malaeb, Diana; External Collaboration; NA; 0; 0; Psychology; et al. (2022-08-11)

  Objective: Computer vision syndrome (CVS) refers to a group of ocular and extraocular symptoms due to prolonged digital device screen use. The objective of this study was to assess the correlation between CVS, insomnia, and migraine, taking into consideration stress as a mediating factor between these 3 variables. Methods: This cross-sectional study was conducted between August 2020 and April 2021 using an online questionnaire filled out by 749 participants. Participants were enrolled using a snowball sampling technique. The link to the Arabic questionnaire was sent to the individuals by WhatsApp and by e-mail. Results: The prevalence of CVS among participants was 70.5%. The presence of CVS (β = 3.26) was significantly associated with higher insomnia. The presence of CVS (adjusted odds ratio [aOR] = 1.66) and higher stress (aOR = 1.09) was significantly associated with higher odds of having migraine. Stress fully mediated the association between CVS and migraine by 52.76% and between CVS and insomnia by 79.99%. Conclusion: CVS was significantly associated with insomnia and migraine. Stress mediated the relationship between CVS and insomnia, and between CVS and migraine. The precise mechanisms behind these associations were not evaluated in this study, with the hope that future research will provide more information on this topic.
• Association of the time spent on social media news with depression and suicidal ideation among a sample of Lebanese adults during the COVID-19 pandemic and the Lebanese economic crisis

  Soufia, Michel; El Frenn, Yara; Hallit, Souheil; Obeid, Sahar; External Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-05-13)

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

  Obeid, Sahar; Fahs, Iqbal; Hallit, Souheil; Kheir, Nelly; External Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-07-01)

  Background: With the well-known serious effects of alcohol and nicotine dependence on adolescents' well-being, and knowing that males are more exposed to violent video gaming, this study was conducted to examine the association between exposure to violent video gaming and alcohol, cigarette, and waterpipe dependence among male Lebanese adolescents. Methods: This was a cross-sectional observational study conducted with Lebanese male students (13-17 years old) between October and December 2019. The Video Game Questionnaire was utilized to assess the content of violence in video games. For the assessment of alcohol, cigarette, and waterpipe dependence, the Alcohol Use Disorders Identification Test scale (AUDIT), Fagerström Test for Nicotine Dependence (FTND), and Lebanese Waterpipe Dependence Scale (LWDS) were used, respectively. Log transformation was used for the three addiction scores. Four linear regressions were performed taking the AUDIT, FTND, LWDS, and violent video gaming scores as dependent variables. Results: From the 388 students enroled (mean age= 15.83 ± 1.93 years), 190 (48.8%) were classified as having violent video gaming. Older age (beta=0.049) and more violent video gaming (beta=0.006) were significantly associated with more cigarette dependence. More violent video gaming (beta=0.003) was significantly associated with more waterpipe dependence. Older age (beta=-0.090) was significantly associated with lower alcohol use disorder, whereas more violent video gaming (beta=0.005) was significantly associated with more alcohol use disorder. Conclusion: The study supports an association between higher exposure to violent video game and higher alcohol and smoking dependence among male teenagers in Lebanon. Hence, support and guidance should be implemented to raise awareness and protect teenagers.
• A National Study of the Association of Attachment Styles With Depression, Social Anxiety, and Suicidal Ideation Among Lebanese Adolescents

  Obeid, Sahar; Hallit, Souheil; Fattouh, Nour; Hallit, Rabih; Soufia, Michel; External Collaboration; NA; 0; 0; Psychology; et al. (2022-05-19)

  Objective: In Lebanon, depression and social phobia are prevalent, as is suicidal ideation. Consistent violence in Lebanon may cause distress and even mental illness among some children and adolescents. The objective of this study was to generate the first general population-based survey estimates on the association between insecure attachment styles (fearful, preoccupied, and dismissing), mental health disorders (depression and social anxiety), and a clinical manifestation of some mental/psychiatric disorders (suicidal ideation) among Lebanese adolescents. Methods: This cross-sectional study was conducted between January and May 2019. Of 2,250 questionnaires distributed, 1,810 (80.44%) were completed and collected. Participants were enrolled in the study using a proportionate random sample of schools from all Lebanese governates (Beirut, Mount Lebanon, North, South, and Bekaa). Results: The results showed that a secure attachment style was significantly associated with less fear (β = 5.966), depression (β = -0.319), and suicidal ideation (β = -0.583). Insecure attachment styles (preoccupied, fearful, and dismissing) were significantly associated with more fear and avoidance, depression, and suicidal ideation; more preoccupied attachment style was significantly associated with higher fear (β = 5.639) and avoidance (β = 9.974). Higher fearful attachment style was significantly associated with more avoidance (β = 4.605) and depression (β = 0.980). Finally, more dismissing attachment style was significantly associated with more fear (β = 8.508), avoidance (β = 10.689), and suicidal ideation (β = 0.528). Conclusions: The study results revealed that insecure attachment styles are associated with higher levels of depression, suicidal ideation, and social phobia. Future research is necessary to confirm the findings.
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  Parental divorce and smoking dependence in Lebanese adolescents: the mediating effect of mental health problems

  Hallit, Souheil; Azzi, Vanessa; Iskandar, Katia; Obeid, Sahar; External Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-08-04)

  Background: Lebanon has the highest prevalence estimates among Middle Eastern countries and Arab women regarding cigarette smoking, with 43% of men and 28% of women involved in such trends. Marital disruption is a tremendous source of irritability and discomfort that may hinder a child's healthy development, creating perturbing distress and increasing disobedience that may exacerbate smoking addiction. Additionally, Lebanese adolescents are inflicted by high emotional and economic instability levels, rendering increased susceptibility to distress and propensity to engage in addictive behavior. This study aims to investigate the association between parental divorce and smoking dependence among Lebanese adolescents, along with exploring the potential mediating effect of mental health disorders of such correlation. Methods: A total of 1810 adolescents (14 and 17 years) enrolled in this cross-sectional survey-based study (January-May 2019). Linear regressions were conducted to check for variables associated with cigarette and waterpipe dependence. PROCESS v3.4 model 4 was used to check for the mediating effect of mental health disorders between parental divorce and smoking dependence. Results: Higher suicidal ideation and having divorced parents vs living together were significantly associated with more cigarette and waterpipe dependence. Higher anxiety was significantly associated with more waterpipe dependence. Insomnia and suicidal ideation played a mediating role between parental divorce and cigarette/waterpipe dependence. Conclusion: Our results consolidate the results found in the literature about the association between parental divorce and smoking addiction and the mediating effect of mental health issues. We do not know still in the divorce itself or factors related to it are incriminated in the higher amount of smoking in those adolescents. Those results should be used to inspire parents about the deleterious effect of divorce on their children to lower their risk of smoking addiction. Further longitudinal studies are needed to better understand the complexity of such associations and to see whether the divorce experience by itself or the factors that accompany it are involved in the increased smoking addiction among adolescents.
• Validation of the Arabic version of the Assessing Emotions Scale measuring emotional intelligence in a Lebanese sample

  Obeid, Sahar; Azzi, Vanessa; Schutte, Nicola; Fekih-Romdhane, Feten; Hallit, Souheil; External Collaboration; NA; 0; 0; Psychology; et al. (2023-02-05)

  The objective of this study was to assess the psychometric characteristics of the Arabic version of the Assessing Emotions Scale (AES-Ar) among a sample of Lebanese young adults. A total of 402 Lebanese university students and their contacts were recruited for the study. A confirmatory factor analysis (CFA) investigated the structure of the scale. The CFA for investigating a four-factor solution using all items showed the fit indices were acceptable (χ2 /df = 1803.15/489 = 3.69; RMSEA = 0.082 [0.078-0.086]; CFI = 0.88; TLI = 0.87) but the loading of the negatively worded items 5, 28 and 33 were low on their respective factors. When testing the four-factor model after removing items 5, 28 and 33, the results improved further with good fit indices of the model (χ2 /df = 1383.184/399 = 3.46, RMSEA = 0.078 [0.074-0.0832], CFI = 0.91 and TLI = 0.90) and good factor loading of each item on each factor, respectively. No measurement invariance was found between genders. The AES-Ar Cronbach's α was excellent (0.976). Higher Assessing Emotions Scale-Ar scores, based on the 30 positively worded items, were significantly associated with greater self-esteem (r = .547; p < .001), and less depression (r = -.295; p < .001). Our results suggest that the AES-Ar is appropriate for use to measure emotional intelligence in Arabic-speaking populations.
• Child abuse and aggressiveness in individuals diagnosed with schizophrenia in Lebanon

  Hallit, Souheil; Fekih-Romdhane, Feten; Haddad, Georges; Abboud, Cedric; External Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-10-01)

  Objectives: To identify individual and clinical risk factors of aggressiveness, including exposure to different forms of childhood trauma, in a sample of Lebanese patients with schizophrenia. Methods: A total of 131 patients diagnosed with schizophrenia participated in this cross-sectional study. Results: Higher physical (Beta = 0.24, p < 0.001) and sexual (Beta = 0.29, p = 0.003) abuse, alcohol drinking (Beta = 1.46, p = 0.008), having a history of head trauma (Beta = 1.10, p = 0.041), and male gender (Beta = -1.59, p = 0.009) were significantly associated with higher mean aggression scores. Practical implications: Our investigation of the factors linked to aggressiveness in patients with schizophrenia complement those of earlier findings, showing that the relationship between interacting individual and environmental risk factors and later aggressiveness is quite complex, and needs further longitudinal and prospective studies.
• Prevalence and Associated Factors of Social Anxiety Among Lebanese Adolescents

  Hallit, Souheil; Obeid, Sahar; Hallit, Rabih; Soufia, Michel; External Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-06-16)

  Objective: To determine the prevalence of social anxiety among Lebanese adolescents and assess its association with bullying and child abuse. Methods: This cross-sectional investigation conducted between January and May 2019 recruited 1,810 adolescents aged 14 to 17 years selected randomly from private schools from all Lebanese governates (Beirut, Mount Lebanon, North, South, and Bekaa). Participants completed a questionnaire that included items from the Liebowitz Social Anxiety Scale, the Childhood Abuse Self-Report Scale, and the Illinois Bully Scale. Results: The results showed that 73.2% (95% CI, 71.02-75.31) of the participants had social anxiety. Higher mean scores on the psychological, neglect, physical, and sexual abuse scales and bullying and victimization scales were significantly associated with higher total social anxiety, fear, and avoidance scores (P < .05 for all). The multivariate analysis showed that having separated parents (β = 11.16), as well as higher child psychological abuse (β = 0.69), neglect (β = 0.52), physical abuse (β = 1.71), and sexual abuse (β = 1.56) were significantly associated with higher total social anxiety. The same results were found for social fear and avoidance, with bullying victimization being significantly associated with higher social fear only (P = .042). Conclusions: This study showed high social anxiety among adolescents in Lebanon. Having separated parents and child abuse were related to social anxiety among adolescents. Future studies are needed to explore the effects of specific forms of childhood abuse in individuals with certain vulnerabilities.
• Presence of a psychiatric patient at home and work fatigue in family caregivers: The moderating effect of spirituality

  Obeid, Sahar; Hallit, Souheil; Zeitoun, Abeer; Sfeir, Michel; External Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-10-01)

  Objectives: To assess the association between the mental health of caregivers having a psychiatric patient at home and work fatigue, and if this association is moderated by spirituality. Methods: This case-control study enrolled 600 caregivers (July-September 2019). Results: Stress, anxiety, insomnia and the presence of a psychiatric patient at home were associated with higher levels of physical, mental, and emotional work fatigue. In the case of caregivers who have a psychiatric patient at home, those with low spirituality had more mental and emotional work fatigue. Practical implications: Healthcare professionals should enlighten caregivers more on the risks and the consequences of their job, assist them with information on what to expect, and teach them how to normalize feelings that they may face.
• Psychometric properties of an Arabic translation of the Functionality Appreciation Scale (FAS) in Lebanese adults

  Hallit, Souheil; Obeid, Sahar; Todd, Jennifer; Malaeb, Diana; External Collaboration; NA; 0; 0; Psychology; 0; et al. (2022-09-01)

  The Functionality Appreciation Scale is a widely used instrument for the measurement of an individual's appreciation of their body for what it can do and is capable of doing (i.e., functionality appreciation). Here, we examined the psychometric properties of a novel Arabic translation of the FAS. A sample of 826 Lebanese adults completed the FAS, as well as previously validated measures of body appreciation, disordered eating attitudes, orthorexia, and self-esteem. Exploratory and confirmatory factor analyses supported a unidimensional model of FAS scores, with all 7 items retained. Scores achieved scalar invariance across gender, with women reporting significantly greater functionality appreciation than men. FAS scores were found to have adequate composite reliability and adequate patterns of convergent and criterion-related validity. Additionally, functionality appreciation predicted self-esteem once the effects of all other variables had been accounted for, supporting incremental validity. Overall, these results suggest that the Arabic FAS is a psychometrically valid tool for the assessment of functionality appreciation. The availability of the Arabic FAS should facilitate improved understanding of the effectiveness of existing interventions designed to promote greater physical activity in the Lebanese context.
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  Attachment styles and their association with aggression, hostility, and anger in Lebanese adolescents: a national study

  Obeid, Sahar; Hallit, Souheil; Haddad, Chadia; External Collaboration; NA; 0; 0; Psychology; 0; Maalouf, Elise (2022-04-22)

  Background: The idea that attachment styles can affect the level of anger in an individual educes a reason why people develop anger issues and behavioral problems in adolescence that escalate into adulthood. Lebanon suffers from a shortage of data pertaining to insecure attachment styles and the affective and cognitive aspects of anger and behavioral anger expression among the Lebanese youth population. This study aimed to investigate the association between attachment dimensions and anger expression (trait anger, hostility, physical aggression, and verbal aggression) among a sample of Lebanese adolescent participants. Methods: This cross-sectional study was performed between January and May 2019 among 1810 Lebanese high-school students aged 12-18 and used two validated measures, the Adolescent-Relationship Questionnaire (A-RQ) and The Buss-Perry Aggression Questionnaire (BPAQ). The A-RQ assessed attachment behaviors, while the BPAQ evaluated aggression. Results: Higher fearful and dismissing attachment styles, and higher physical activity index were significantly associated with higher physical and verbal aggression. A higher fearful attachment style was significantly associated with more anger. A higher secure attachment style was significantly associated with less anger. Higher preoccupied and dismissing attachment styles were significantly associated with higher hostility. Conclusion: Our findings revealed a significant relationship between both insecure attachment dimensions and the tripartite model of anger expression. This study adds to the anger literature by providing a more informed understanding of how variations in anger expression are linked to the processing of interpersonal interactions, which are the hidden facets of attachment systems.

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