Browsing by Author "Zoromba, Mohamed Ali"
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- The Arabic Version of the Patient Health Questionnaire‐2 (PHQ‐2): Psychometric Evaluation Among Mothers of Children With Intellectual DisabilitiesPublication . Ali, Amira Mohammed; Al-Dossary, Saeed A; Aljaberi, Musheer A.; El-Gazar, Heba Emad; Laranjeira, Carlos; Khatatbeh, Haitham; Zoromba, Mohamed Ali; Alamer, Rasmieh; Amer, Faten; Pakai, Annamaria; Fekih-Romdhane, Feten; Lidoriki, EiriniAim: Mothers of children with intellectual disabilities are particularly vulnerable to mental distress due to demanding and exhausting caregiving. However, in the Arab world, they are seldom screened for depression because of limited diagnostic resources. Addressing the urgent need for brief and reliable screening tools, this study evaluated the psychometric properties of the Arabic version of the Patient Health Questionnaire-2 (PHQ-2) among 85 Saudi mothers. Design: A cross-sectional study. Methods: The construct, convergent, and divergent validity of the PHQ-2 was examined through a latent variable model (LVM), while its cutoff score was examined through receiver-operating characteristic (ROC) curve analysis. Results: The unidimensional PHQ-2 (item loadings > 0.7) was positively predicted by stress and negatively predicted by high mood and happiness, supporting its convergent and divergent validity. The PHQ-2 effectively predicted low mood, poor sleep quality, nightmares, high stress, low general physical health, and willingness to join a psychological support program (area under the curve [AUC] range = 0.72–0.84, p values < 0.001). The best balance between sensitivity and specificity was achieved at the PHQ-2 threshold ≥ 2.5, while the cutoff ≥ 3.5 demonstrated a higher positive predictive value (PPV) for all outcomes (range = 30.0–78.8 vs. 23.0–70.8). Conclusions: The PHQ-2 is a brief, valid tool, which at cutoffs ≥ 2.5 and ≥ 3.5 can reliably detect clinically significant depression and related psychological and physical adverse effects. Mothers scoring ≥ 3.5 may require a clinician-based examination for depression, and they may benefit from specific mental health literacy interventions. However, the results should be interpreted with caution given convenience sampling, a small sample size, and elevated distress levels in the current population. These limitations highlight the need to replicate the study with larger, randomly selected samples from more diverse populations. Implications for Practice: Nurses can efficiently screen for depression and its mental/physical sequelae, as well as monitor response to treatment using only two items. The study provided two well-interpreted cutoffs of the PHQ-2, with real-world implications for mental health screening in under-resourced settings. Reporting Method: The study adhered to STROBE guidelines. Patient or Public Contribution: No patient or public contribution. Copyright © 2025 Amira Mohammed Ali et al. Nursing Research and Practice published by John Wiley & Sons Ltd.
- 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.