Mediating effect of symptom severity on the relationship between aggression, impulsivity and quality of life outcomes among patients with schizophrenia and related psychoses

AimsAggression and impulsivity among individuals with schizophrenia have been associated with poor clinical outcomes including worsening of symptoms and substance abuse which have been linked to a lower quality of life (QoL). The current study aimed to look at the mediating effect of symptom severity on the relationship between aggression, impulsivity and QoL among outpatients with schizophrenia and related psychoses in a multi-ethnic Asian population.MethodsData (n = 397) were collected from outpatients seeking treatment at the Institute of Mental Health. The World Health Organization quality of life-BREF (WHOQOL-BREF) scale, the symptoms checklist-90 revised (SCL-90-R), Buss Perry aggression questionnaire (BPAQ), and the Barratt impulsiveness scales (BIS) were used to assess subjective well-being, symptom severity, aggression, and impulsivity, respectively. Mediation analysis was performed using the PROCESS macro to understand the mediating effect of symptom severity.ResultsMotor impulsivity (MI) was indirectly associated with both the physical and psychological health domains of QoL while self-control was indirectly associated with the physical, psychological, and environmental health QoL domains through increased symptom severity.ConclusionThe significant indirect effect of symptom severity in our study highlights one potential pathway through which impulsivity impacts the QoL of individuals with schizophrenia and related psychoses. Elucidating other factors besides symptom severity that have an indirect effect on the QoL of individuals provides alternative approaches for treatment through which better clinical outcomes can be achieved

Why do we choose the color red for danger?

This study is concerned with the evolutionary significance of red and the effects of our sensitivity to red on danger related issues. According to past research, red has been linked to several evolutionary psychology concepts such as foraging, romance, aggression and dominance. Particularly, primate color vision evolved from dichromatic to trichromatic color vision for finding food in the forest (Surridge, Osorio, & Mundy, 2003) and subsequently, this ability to detect red was also adapted for attracting mates by noticing the appearance of red colorations on body parts such as the face and genitalia (Dubuc, Allen, Maestripieri, & Higham, 2014). Of specific interest to this study is the implicit red-danger association that has been suggested in prior studies. Yet, no study has been done thus far to investigate if red would invoke feelings of danger should there be an implicit red-danger association. Furthermore, some have questioned the possibility of the association of red and danger of having evolutionary roots. If it were true that we have evolved mechanisms to associate red with danger, the mere act of perceiving a red stimulus in contexts where negative outcomes are salient would enhance the perception of danger. Thus, this study sought to explore the significance of the color red in relation to danger. To achieve the aim of this research paper, three studies were conducted in total. 60 participants were involved in a pilot study (Study 1) that determined participant’s baseline for what qualifies as significantly dangerous situations. Out of five displayed contexts, participants considered car racing, glacier hiking and boxing significantly dangerous. These situations were then adapted into the questionnaire for the actual study (Study 2). Subsequently, 40 participants were recruited and they each participated in Study 2 and 3. Study 2 investigated the effects of the color red (versus blue) on perceptions of danger using the software Inquisit Lab 4. Results showed no significant difference between both conditions (red and blue) as an influence on the perception of danger. Study 3 on the other hand sought to extend the findings of Study 2 by investigating the function of the color red in relation to displayed signs. Participants were asked to choose the best color that would attract attention of viewers both towards warning and non-warning related signs on Adobe Photoshop. Results showed that the color red was the most selected color for both signs, regardless of the context (dangerous or not dangerous). Thus, on the whole, these findings suggest that red does not significantly enhance perceptions of danger where negative outcomes are salient. Instead, red functions to alert viewers of impending danger, given its salient characteristic. Thus it is commonly used in areas where more serious warning is needed such as on traffic warning signs, to prevent the effect of these serious warnings from being diluted by other signs if there were all to be red too (Leonard, 1999).Bachelor of Art

A reduced state of being: The role of culture in illness perceptions of young adults diagnosed with depressive disorders in Singapore.

Illness perceptions form a key part of common-sense models which are used widely to explain variations in patient behaviours in healthcare. Despite the pervasiveness of depressive disorders worldwide and in young adults, illness perceptions of depressive disorders have not yet been well understood. Moreover, while a high proportion of cases of depressive disorders reside in South-east Asia, few have explored illness perceptions that are culturally relevant to this region. To address these limitations, this study aimed to understand illness perceptions of young adults diagnosed with depressive disorders. Face-to-face semi-structured interviews were conducted among Chinese, Malay, and Indian young adults aged 20 to 35 years old, who were seeking treatment at a psychiatric hospital. Data reached saturation after 33 interviews (10 to 12 interviews per ethnic group) and five themes emerged from the thematic analysis: 1) A reduced state of being experienced at a point of goal disengagement, 2) the accumulation of chronic stressors in a system that demands success and discourages the pursuit of personally meaningful goals, 3) a wide range of symptoms that are uncontrollable and disabling, 4) poor decision making resulting in wasted opportunities, with some positive takeaways, and 5) accepting the chronicity of depression. Young adults typically experienced depression as a reduced state of being and it was thought of cognitively as an entity that may be a part of or separate from the self. Over and beyond these aspects of cognitive representations was the emergence of themes depicting conflicts and dilemmas between the self and the social environment that threatened self-identity and autonomy. Addressing these conflicts in therapy would therefore be of utmost relevance for young adults recovering from depressive disorders in the local setting

Direct and moderating effects of personality on stigma towards mental illness

Abstract Background While many studies have explored the concept and correlates of stigma towards individuals with mental illness, few have investigated the role of personality in this process. In the current study, we firstly examined the relationship between personality and stigma towards mental illness; and then explored the moderating effects of personality traits on the relationship between contact experience/s and stigma. Methods Participants were recruited from public medical (N = 502) and nursing schools (N = 500) from April to September 2016 in Singapore for this cross-sectional survey, and they were randomly assigned to a vignette describing one of the following mental disorders: major depressive disorder, obsessive compulsive disorder, alcohol abuse, schizophrenia, and dementia. Stigma was measured by the ‘Personal and Perceived scales of the Depression Stigma Scale’ and the ‘Social Distance Scale’. These scales together had a 3-factor structure based on a previous national study in Singapore, namely ‘weak-not-sick’, ‘dangerous/unpredictable’ and ‘social distance’. Personality was measured by the 20-item short form of the International Personality Item Pool-five factor model measure. Results Regression suggested agreeableness and openness to experience were negatively associated with all three domains of stigma. ‘Weak-not-sick’ and extraversion were positively associated; and ‘social distance’ was positively associated with higher scores on conscientiousness and neuroticism. Both close- and non-close contact were associated with more positive attitudes towards mental illness among the participants. Openness to experience moderated the relationships of close contact experience with ‘weak-not-sick’ and ‘dangerous/unpredictable’, but in different directions. The association between close contact and ‘social distance’ were moderated by agreeableness. Conclusions Unlike non-close contact experience, close contact with people with mental illness worked differently on stigma for individuals with different personality traits. Future studies are needed to further explore the underlying mechanisms for such differences

Problematic drug use among outpatients with schizophrenia and related psychoses.

Problematic drug use is common among psychiatric patients and is linked with poorer course and outcomes of illness. The aim of this study is to assess the prevalence of problematic drug use, and to explore its sociodemographic correlates and associations with health behaviors and outcomes among outpatients with schizophrenia and related psychoses in Singapore. Data from 397 individuals who were aged 21-65 years and were seeking treatment for schizophrenia and related psychoses in the outpatient clinics of a tertiary psychiatric hospital were analyzed. The Drug Abuse Screening Test (DAST-10) was used to assess problematic drug use. Information on sociodemographics, smoking status, alcohol use, symptoms severity and quality of life were collected. Multivariable logistic regressions were conducted to explore correlates and associations of problematic drug use. The prevalence of problematic drug use was 5.8% ( = 23) in the sample, and 10.6% ( = 42) of the participants reported having problematic drug use and/or problematic alcohol use. More males than females reported having problematic drug use ( = 0.021), and also problematic drug and/or alcohol use ( = 0.004). Significant associations were observed between problematic drug use and smokers with nicotine dependence, and with physical health domain of quality of life. Individuals with greater symptom severity were approximately twice as likely to have problematic drug use and/or alcohol use. While the prevalence of problematic drug use in this sample population is relatively lower compared to other countries, there is a considerable number who might be at risk. Routine screening and close monitoring of drug use is recommended as part of psychiatric assessment, particularly among males and patients with nicotine dependence

A qualitative study on negative experiences of social media use and harm reduction strategies among youths in a multi-ethnic Asian society

PURPOSE: This study aimed to expand and inform the emerging body of research on the negative experiences of social media use among youths and how youths deal with them, in an Asian setting, using a qualitative approach. METHODS: Data were collected using 11 focus group discussions (FGDs) and 25 semi-structured interviews (SIs) among youths aged 15 to 24 years residing in Singapore who were recruited via purposive sampling. Data were analysed using thematic analysis. RESULTS: The salient negative effects mentioned by participants include the development of negative reactions and feelings from upward comparisons with others (e.g., others\u27 achievements and lifestyle), receiving hurtful comments, exposure to controversial content (e.g., political events and social movements), as well as the perpetuation of negative feelings, behaviours, and sentiments (e.g., rumination, unhealthy eating behaviour, and self-harm). Participants also described strategies which they have employed or deemed to be useful in mitigating the negative effects of social media use. These include filtering content and users, taking breaks from social media, cognitive reframing, and self-affirmation, where they identify and change stress-inducing patterns of thinking by setting realistic social, physical, and lifestyle expectations for themselves, and focusing on self-development. CONCLUSION: The current results highlight that while youths experience negative effects of social media use, they have high media literacy and have employed strategies that appear to mitigate the negative effects of social media use. The findings can inform various stakeholders involved in helping youths navigate the harms of social media use or provide directions for intervention studies aimed at reducing the harms of social media use

The impact of having foreign domestic workers on informal caregivers of persons with dementia: Findings from a multi-method research in Singapore

Singapore Ministry of Health’s National Medical Research Counci

Data_Sheet_1_Mediating effect of symptom severity on the relationship between aggression, impulsivity and quality of life outcomes among patients with schizophrenia and related psychoses.pdf

AimsAggression and impulsivity among individuals with schizophrenia have been associated with poor clinical outcomes including worsening of symptoms and substance abuse which have been linked to a lower quality of life (QoL). The current study aimed to look at the mediating effect of symptom severity on the relationship between aggression, impulsivity and QoL among outpatients with schizophrenia and related psychoses in a multi-ethnic Asian population.MethodsData (n = 397) were collected from outpatients seeking treatment at the Institute of Mental Health. The World Health Organization quality of life-BREF (WHOQOL-BREF) scale, the symptoms checklist-90 revised (SCL-90-R), Buss Perry aggression questionnaire (BPAQ), and the Barratt impulsiveness scales (BIS) were used to assess subjective well-being, symptom severity, aggression, and impulsivity, respectively. Mediation analysis was performed using the PROCESS macro to understand the mediating effect of symptom severity.ResultsMotor impulsivity (MI) was indirectly associated with both the physical and psychological health domains of QoL while self-control was indirectly associated with the physical, psychological, and environmental health QoL domains through increased symptom severity.ConclusionThe significant indirect effect of symptom severity in our study highlights one potential pathway through which impulsivity impacts the QoL of individuals with schizophrenia and related psychoses. Elucidating other factors besides symptom severity that have an indirect effect on the QoL of individuals provides alternative approaches for treatment through which better clinical outcomes can be achieved.</p

Causal beliefs of mental illness and its impact on help-seeking attitudes : a cross-sectional study among university students in Singapore

Objectives: A considerable proportion of those who suffer from mental illnesses in Singapore do not seek any form of professional help. The reluctance to seek professional help could be due to misconceptions about the causes of mental illnesses. Research has shown that help-seeking attitudes can predict actual service use. As young adults are most at risk of developing mental illnesses, this study aims to elucidate the impact of causal beliefs about mental illness on help-seeking attitudes among university students in Singapore. Design: Prior to attending an anti-stigma intervention, data on the Causal Beliefs about Mental Illness, Inventory of Attitudes towards Seeking Mental Health services and questions pertaining to sociodemographic background were collected from participants using a self-administered questionnaire. Multiple linear regressions were performed to examine the relationship between causal beliefs and help-seeking, as well as their sociodemographic correlates. Settings: A university in Singapore. Participants: 390 students who were studying in a University in Singapore. Results: Younger age was associated with higher scores on psychosocial attribution, while prior social contact with individuals with mental illness was significantly associated with lower scores on personality attribution. With regard to help-seeking attitudes; being a male and personality attribution were significantly associated with lower scores on ‘Psychological Openness’ and ‘Indifference to Stigma’, while psychosocial attribution was significantly associated with higher scores on ‘Help-seeking Propensity’. Having prior social contact also predicted higher ‘Psychological Openness’, while being in Year 2 and 3 predicted lower scores on ’Indifference to Stigma’. Conclusion: Findings from this study suggest that help-seeking attitudes might be influenced by causal beliefs, with personality attribution being the most impairing. Hence, to reduce the wide treatment gap in Singapore, anti-stigma interventions targeting young people could focus on addressing beliefs that attribute mental illness to the personality of the individual.Singapore Totalisator Board (SingTOTE)Published versionThe study was funded by Tote Board, Singapore

Advancing research to eliminate mental illness stigma: an interventional study to improve community attitudes towards depression among university students in Singapore

Background: After decades of anti-stigma initiatives, the Advancing Research To Eliminate Mental Illness Stigma (ARTEMIS) intervention study is one of the first in Singapore to evaluate the effects of an anti-stigma intervention on attitudes towards depression in university students. Methods: 390 university students from a local university in Singapore were voluntarily recruited for the study. The ARTEMIS intervention comprises an educational and social contact component, as well as a question and answer (Q&A) session with experts in the area of mental health. The Community Attitudes towards Mental Illness (CAMI) scale was administered at baseline, post-intervention and at 3-months follow-up. A confirmatory factor analysis (CFA) was conducted. Results: The CFA identified a 3-factor model for the CAMI with a decent fit (RMSEA = 0.06, CFI = 0.93, TLI = 0.93, SRMR = 0.06). Favourable shifts in attitudes across the factors were observed immediately after the intervention (p < 0.001). Gender (β = − 1.19, 95% CI: − 2.10, − 0.27, p = 0.01) and nationality (β = − 1.23, 95% CI: − 2.35, − 0.11, p = 0.03) were identified as significant correlates for the community mental health ideology (CMHI) factor. Linear effects indicated that having a close social contact with mental illness observed a smaller decrease in authoritarianism scores from pre- to post-intervention (β = 0.85, 95% CI: 0.18, 1.53, p = 0.01); whereas quadratic effects found a greater decrease in scores from post-intervention to after 3-months for benevolence (β = − 0.34, 95% CI: − 0.52, − 0.16, p < 0.001) and CMHI (β = − 0.22, 95% CI: − 0.45, − 0.002, p = 0.048). Conclusion: The anti-stigma intervention shows promising short-term results across the CAMI dimensions even after adjusting for sociodemographic correlates. However, the intervention did not observe the sustained attitude shifts after 3-months. Recommendations for future anti-stigma interventions were also considered.Published versionThis study was supported by Tote Board (Grant No. 2016/11/051)