Browsing by Author "Alkhamees, Abdulmajeed A."
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- Cardiometabolic Morbidity (Obesity and Hypertension) in PTSD: A Preliminary Investigation of the Validity of Two Structures of the Impact of Event Scale-RevisedPublication . Ali, Amira Mohammed; Al-Dossary, Saeed A.; Laranjeira, Carlos; Atout, Maha; Khatatbeh, Haitham; Selim, Abeer; Alkhamees, Abdulmajeed A.; Aljaberi, Musheer A.; Pakai, Annamária; Al-Dwaikat, TariqBackground: Posttraumatic stress disorder (PTSD) and/or specific PTSD symptoms may evoke maladaptive behaviors (e.g., compulsive buying, disordered eating, and an unhealthy lifestyle), resulting in adverse cardiometabolic events (e.g., hypertension and obesity), which may implicate the treatment of this complex condition. The diagnostic criteria for PTSD have lately expanded beyond the three common symptoms (intrusion, avoidance, and hyperarousal). Including additional symptoms such as emotional numbing, sleep disturbance, and irritability strengthens the representation of the Impact of Event Scale-Revised (IES-R), suggesting that models with four, five, or six dimensions better capture its structure compared to the original three-dimensional model. Methods: Using a convenience sample of 58 Russian dental healthcare workers (HCWs: mean age = 44.1 ± 12.2 years, 82.8% females), this instrumental study examined the convergent, concurrent, and criterion validity of two IES-R structures: IES-R3 and IES-R6. Results: Exploratory factor analysis uncovered five factors, which explained 76.0% of the variance in the IES-R. Subscales of the IES-R3 and the IES-R6 expressed good internal consistency (coefficient alpha range = 0.69–0.88), high convergent validity (item total correlations r range = 0.39–0.81, and correlations with the IES-R’s total score r range = 0.62–0.92), excellent concurrent validity through strong correlations with the PTSD Symptom Scale-Self Report (PSS-SR: r range = 0.42–0.69), while their criterion validity was indicated by moderate-to-low correlations with high body mass index (BMI: r range = 0.12–0.39) and the diagnosis of hypertension (r range = 0.12–0.30). In the receiver-operating characteristic (ROC) curve analysis, all IES-R models were perfectly associated with the PSS-SR (all areas under the curve (AUCs) > 0.9, p values < 0.001). The IES-R, both hyperarousal subscales, and the IES-R3 intrusion subscale were significantly associated with high BMI. Both avoidance subscales and the IES-R3 intrusion subscale, not the IES-R, were significantly associated with hypertension. In the two-step cluster analysis, five sets of all trauma variables (IES-R3/IES-R6, PSS-SR) classified the participants into two clusters according to their BMI (normal weight/low BMI vs. overweight/obese). Meanwhile, only the IES-R, PSS-SR, and IES-R3 dimensions successfully classified participants as having either normal blood pressure or hypertension. Participants in the overweight/obese and hypertensive clusters displayed considerably higher levels of most trauma symptoms. Input variables with the highest predictor importance in the cluster analysis were those variables expressing significant associations in correlations and ROC analyses. However, neither IES-R3 nor IES-R6 contributed to BMI or hypertension either directly or indirectly in the path analysis. Meanwhile, age significantly predicted both health conditions and current smoking. Irritability and numbing were the only IES-R dimensions that significantly contributed to current smoking. Conclusions: The findings emphasize the need for assessing the way through which various PTSD symptoms may implicate cardiometabolic dysfunctions and their risk factors (e.g., smoking and the intake of unhealthy foods) as well as the application of targeted dietary and exercise interventions to lower physical morbidity in PTSD patients. However, the internal and external validity of our tests may be questionable due to the low power of our sample size. Replicating the study in larger samples, which comprise different physical and mental conditions from heterogenous cultural contexts, is pivotal to validate the results (e.g., in specific groups, such as those with confirmed traumatic exposure and comorbid mood dysfunction).
- Effects of Hormonal Replacement Therapy and Mindfulness-Based Stress Reduction on Climacteric Symptoms Following Risk-Reducing Salpingo-OophorectomyPublication . Ali, Amira Mohammed; Al-Dossary, Saeed A.; Laranjeira, Carlos; Amer, Faten; Hallit, Souheil; Alkhamees, Abdulmajeed A.; Aljubilah, Aljawharah Fahad; Aljaberi, Musheer A.; Alzeiby, Ebtesam Abdullah; Fadlalmola, Hammad Ali; Pakai, Annamaria; Khatatbeh, HaithamBreast Cancer Associated Susceptibility Proteins Type 1/2 (BRCA1/2) promote cellular functioning by modulating NRF2-mediated antioxidant signaling. Redox failure in women with BRCA1/2 insufficiency increases the risk for breast/ovarian/uterine cancers. Risk-reducing salpingo-oophorectomy (RRSO) is a prophylactic surgery of the reproductive organs, which is frequently conducted by the age of 40 to lower the occurrence of cancer in women with BRCA1/2 mutations. However, abrupt estrogen decline following RRSO causes ovarian failure, which implicates various cellular physiological processes, resulting in the increased release of free radicals and subsequent severe onset of menopausal symptoms. Comfort measures (e.g., hormonal replacement therapy (HRT) and mindfulness-based stress reduction (MBSR)) may improve chronological menopause-related quality of life, but their specific effects are not clear in women with gene mutations. Aiming to fill the gap, this study used path analysis to examine the effects of HRT and MBSR on menopausal symptoms among RRSO patients (N = 199, mean age = 50.5 ± 6.7 years). HRT directly alleviated the levels of urogenital symptoms (β = −0.195, p = 0.005), which mediated its indirect significant effects on the somatic–vegetative and psychological symptoms of menopause (β = −0.046, −0.067; both p values = 0.004, respectively), especially in BRCA2 carriers and in women who were currently physically active, premenopausal at the time of RRSO, had a high BMI, and had no history of breast cancer. It increased the severity of urogenital symptoms in women with a history of cancer. MBSR, on the other hand, was associated with indirect increases in the intensity of the somatic–vegetative and psychological symptoms of menopause (β = 0.108, 0.029; p = 0.003, 0.033, respectively). It exerted positive direct effects on different menopausal symptoms in multigroup analysis. The results suggest that young women undergoing recent RRSO may benefit from HRT at an individual level, while their need for extensive measures to optimize their psychological wellbeing is ongoing. The adverse effects of MBSR, which are captured in the present study, imply that MBSR may interfere with redox sensitivity associated with estradiol fluctuations in BRCA1/2 carriers. Investigations are needed to test this hypothesis and elaborate on the underlying mechanisms in these women.
- Psychometric evaluation of the Arabic version of the Eight-item Center for Epidemiological Studies Depression Scale (CESD-8): Specific cultural considerations for the assessment of depressionPublication . Ali, Amira M.; Al-Dossary, Saeed A.; Fekih-Romdhane, Feten; Alameri, Rana Ali; Laranjeira, Carlos; Khatatbeh, Haitham; Zoromba, Mohamed Ali; Alkhamees, Abdulmajeed A.; Aljaberi, Musheer A.; Pakai, Annamaria; El-Gazar, Heba EmadBackground Despite extensive evaluations of the Center for Epidemiological Studies Depression Scale (CESD), its shortest version, the Eight-Item version (CESD-8), is less investigated, with absolute lack of information on its psychometric properties in the Arab world. Methods To fill the gap, data collected via an anonymous online survey from Saudi samples of students (N = 979, 422) and employees (N = 314), were analyzed through exploratory factor analysis, confirmatory factor analysis, and multigroup analysis to examine the structure and measurement invariance of the CESD-8. Convergent validity and internal consistency tests involved correlating the CESD-8 with its subscales, item analysis measures, and intra class correlations. Criterion validity tests involved correlating the CESD-8 and its subscales with a single-item measure of happiness. Results Exploratory factor analysis produced two factors (negative affect and positive affect) with eigen values >1, which explained 86.4 % of the variance. In confirmatory factor analysis, the crude exploratory factor analysis model had good fit while the fit of the unidimensional CESD-8 and another two-factor structure (depressed affect and somatic complaints) was improved by correlating the residuals of the items of positive affect (CESD4 and CESD6). A three-factor model (depressed affect, somatic complaints, and positive affect) expressed the best fit in the absence of error correlations. This model was invariant across groups of students and employees, gender, and age. The scale and its three dimensions demonstrated adequate internal consistency (alpha coefficient range = 0.65–0.89), convergent validity (item total correlation range = 0.43–0.80 and range of correlations with the CESD-8 = -0.68–0.92), and criterion validity (range of correlations with happiness scores = -0.40–0.60). Conclusions The CESD-8 is a valid short scale for quick identification of people with depressive psychopathologies. Using the CESD-8 to detect heterogenous depressive symptoms, rather than assessing depression as a whole condition, may influence our understanding of the dynamics and treatments of depression in specific groups/cultures, with emphasis on absence of positive affect in the definition of depression among Arabs. Replications of the three-factor structure in different cultures are needed.