OBJECTIVES: This review aims to provide recent reports of best practices for the treatment of OCD in the ASEAN region . METHODS: Thirty nine treatment articles between 1990 & 2002 were randomly selected and comparisons were made with regards to types of treatment and their successes . RESULTS: Cognitive and Behavior Therapies , especially Exposure and Response Prevention were found to be favourable methods in the treatment of OCD, in a comparison to other methods of psychological interventions . CONCLUSIONS: Psychological therapies for OCD are essential in the maintenance of gains , especially when combined with pharmocotheraphy . Further clinical studies in Asia are needed to supplement the growing demands in psychological intervention of OCD.
OBSESSIVE-COMPULSIVE DISORDER

Objective: To investigate the prevalence of parental stress and psychological wellbeing among parents with autistic children and their associations with dimensions of support system. Methods: This is a preliminary cross sectional study which randomly selected parents with clinically diagnosed autistic children. Those parents who attended psycho-education session on management of autistic children at Health Psychology Unit were randomly selected to enroll in the study. Psychological wellbeing, parental stress and dimensions of support system were assessed by using the General Health Questionnaire (GHQ-28), the Parenting Stress Index (PSI) and the Provision Social Relation (PSR), respectively. Results: Of 52 parents with autistic children (34 female and 18 male), about 90.4% of parents had significant parenting stress, and 53.8% of parents showed clinical disturbance in psychological wellbeing. Gender (t=1.67, p=0.02) and occupation (F=4.78, p=0.01) showed statistically significant association with psychological wellbeing. No association found between other socio-demographic factors, parental stress and psychological wellbeing with dimensions of support system among parents with autistic children. Conclusion: Parents with autistic children have high prevalence of stress and psychological disturbances. Interactions of various factors need to be acknowledged and considered in order to reduce the burden of parents with autistic children

Objective: To investigate the prevalence of parental stress and psychological wellbeing among parents with autistic children and their associations with dimensions of support system. Methods: This is a preliminary cross sectional study which randomly selected parents with clinically diagnosed autistic children. Those parents who attended psycho-education session on management of autistic children at Health Psychology Unit were randomly selected to enroll in the study. Psychological wellbeing, parental stress and dimensions of support system were assessed by using the General Health Questionnaire (GHQ-28), the Parenting Stress Index (PSI) and the Provision Social Relation (PSR), respectively. Results: Of 52 parents with autistic children (34 female and 18 male), about 90.4% of parents had significant parenting stress, and 53.8% of parents showed clinical disturbance in psychological wellbeing. Gender (t=1.67, p=0.02) and occupation (F=4.78, p=0.01) showed statistically significant association with psychological wellbeing. No association found between other socio-demographic factors, parental stress and psychological wellbeing with dimensions of support system among parents with autistic children. Conclusion: Parents with autistic children have high prevalence of stress and psychological disturbances. Interactions of various factors need to be acknowledged and considered in order to reduce the burden of parents with autistic children.

Children with Autism Spectrum Disorder (ASD) have significant challenges in their daily life including social communication and interaction, emotional awareness and management, as well as behavioural issues. Many interventions are conducted based on theoretical backgrounds and past literature. There is lack of research study that interview and explore the real psychological needs of children with ASD in Malaysia. It is a significant component as their needs may vary depending on the cultural background, lifestyle, and social norms. Besides, there is a need to develop standardised intervention module to enhance intervention fidelity and replication of future study. The current study aims to scrutinise the psychological needs of children with ASD in Malaysia, develop a standardised group intervention module based on the identified needs, and then examine the feasibility of the developed module. Nine children with moderate to high functioning of ASD (7 to 12 years old) and their parents from Kuala Lumpur and Sarawak participated in the study. Result from the focus group interview suggests that children with ASD have three major psychological needs which are sociocommunication, awareness of danger, and emotions. The group intervention module was designed to fulfil these needs. The feasibility result shows that the designed module is practical, useful, and understandable for the participants. In view of this, future study may explore the effectiveness of the module. Once the module is proven effective, it can be patented and utilised to improve the psychological functioning of children with ASD in Malaysia.
Autism Spectrum Disorder ; children ; group intervention ; feasibility ; psychological needs.

A functional magnetic resonance imaging (fMRI) study was conducted on 4 healthy male and female subjects to investigate brain activation during passive and active listening. Two different experimental conditions were separately used in this study. The first condition requires the subjects to listen to a simple arithmetic instruction (e.g. one-plus-two-plus-three-plus-four) – passive listening. In the second condition, the subjects were given the same series of arithmetic instruction and were required to listen and perform the calculation – active listening. The data were then analysed using the Statistical Parametric Mapping (SPM5) and the MATLAB 7.4 (R2007a) programming softwares. The results obtained from the fixed (FFX) and random effects analyses (RFX) show that the active-state signal intensity was significantly higher (p < 0.05) than the resting-state signal intensity for both conditions. The results also indicate significant differences (p < 0.001) in brain activation between passive and active listening. The activated cortical regions during passive listening, as obtained from the FFX of the first condition is symmetrical in the left and right temporal and frontal lobes covering the cortical auditory areas. However, for the second condition, which was active listening, more activation occurs in the left hemisphere with a reduction in the number of activated voxels and their signal intensity in the right hemisphere. Activation mainly occurs in the middle temporal gyrus, precentral gyrus, middle frontal gyrus, superior temporal gyrus and several other areas in the frontal lobes. The point of maximum signal intensity has been shifted to a new coordinates during active listening. It is also observed that the magnetic resonance signal intensity and the number of activated voxel in the right and left superior temporal lobes for the second condition have been reduced as compared to that of the first condition. The results obtained strongly suggest the existence of functional specialisation. The results also indicate different networks for the two conditions. These networks clearly pertain to the existence of functional connectivity between activation areas during listening and listening while performing a simple arithmetic task.

Stress is a common problem among university students and studies showed that involvement in exercise could help in reducing stress. However, information regarding the effect of high intensity progressive resistance training (PRT) using a resistant tube on stress among inactive and moderate active young male university students is limited. Hence, the aim of this study is to examine the effect of high intensity PRT using a resistant tube on psychological stress level, cortisol, DHEA and physical fitness in this population. A total of 30 male university students were participated in this quasi-experiment study. Intervention group (n = 14, age: 21.50 ± 1.37 yr) was participaned to carry out high intensity PRT by using resistant tube 3 times per week for 10 weeks; control group (n = 16, age: 21.29 ± 1.86 yr) was asked to continue their current lifestyle as usual. Before and after 10 weeks of intervention, psychological stress was measured by using PSS and SLSI questionnaires; cortisol and DHEA level were measured by using ELISA method. Timed up-and-go (TUG) used to examine dynamic balance and handgrip strength test used to measure muscle strength. Findings showed that the increased of DHEA level after 10 weeks of intervention was significantly difference between control and intervention groups (p < 0.05). There was no significant group difference in changes over time in anthropometric and body composition measurements, stress scores, cortisol level and physical fitness. High intensity PRT using resistant tube may be beneficial in increasing DHEA level among young male adults, which can act as a stress biochemical indicator.
Stress, Psychological

Background: Most women are reluctant to undergo breast cancer screenings due to the pain and anxiety they experience. Sectional three-dimensional (3-D) breasttomosynthesis was introduced to improve cancer detection, but breast compression is still used for the acquisition of images. This study was conducted to investigate the effects of reduced compression force on pain, anxiety and image quality in digital breast tomosynthesis (DBT). Methods: A total of 130 women underwent screening mammography using convenience sampling with standard and reduced compression force at the breast clinic. A validated questionnaire of 20 items on the state anxiety level and a 4-point verbal rating scale on the pain level were conducted after the mammography. Craniocaudal (CC) and mediolateral oblique (MLO) projections were performed with standard compression, but only the CC view was performed with reduced compression. Two independent radiologists evaluated the images using image criteria scores (ICS) and the Breast Imaging-Reporting and Data System (BI-RADS). Results: Standard compression exhibited significantly increased scores for pain and anxiety levels compared with reduced compression (P < 0.001). Both radiologists scored the standard and reduced compression images as equal, with scores of 87.5% and 92.5% for ICS and BI-RADS scoring, respectively. Conclusions: Reduced compression force in DBT reduces anxiety and pain levels without compromising image quality.

The global prevalence of overweight and obesity among children has increased rapidly in the recent decades, includingin Malaysia. Thus, development of effective interventions to prevent childhood obesity in Malaysia is urgently needed.This paper describes the study design of a 12-week multi-component, school-based nutrition education programme aimedat managing childhood obesity. The objective of Juara Sihat™ is to determine the effectiveness of a nutrition educationprogramme in improving anthropometric status, knowledge, attitude and practice (KAP) of nutrition, eating habits andphysical activity level among overweight and obese children. This quasi-experimental study involves two primary schoolsin Kuala Lumpur with similar demographic characteristics. Eligibility criteria of research participants are overweightand obese children aged 9 to 11 years. The main components of the Juara Sihat™ intervention are nutrition educationclasses on healthy eating and active lifestyle; physical activity sessions; and active involvements of parents and teachers.The control school does not receive any interventions. The primary outcome is BMI-for-age z-score, while other outcomesinclude waist circumference, body fat percentage, KAP of nutrition score, dietary intake, physical activity level, sedentarybehaviour and biochemical profile. Outcome measures will be assessed at three intervals: baseline, post-intervention 1(3-month follow-up), and post-intervention 2 (6-month follow-up). The Juara Sihat™ programme represents a promisingapproach to examining the effectiveness of a school-based childhood obesity intervention with strong empowerment ofParents’ and Teachers’ Association (PTA). We anticipate that this study may provide insights towards the development ofmore effective strategies in formulating childhood obesity interventions.

Chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) is associated with adverse effects. However, NSAIDs are among the most popular pain killers and easily available over the counter. This study aimed to determine the prevalence of NSAIDs use in Malaysian adults and among those with chronic diseases such as arthritis, kidney disease, hypertension, heart disease and asthma. It also examined the factors associated with NSAIDs use. Data from the National Health Morbidity Survey (NHMS) 2011, a nation-wide survey was analysed. A total of 18231 respondents aged 18 years and above responded to this module. Multivariate logistic regression was used to investigate the association between NSAIDs use and associated factors. The overall prevalence of NSAIDs use among Malaysian adults was 14.2% (95%CI 13.3-15.1). Of the respondents, 4.2% (95%CI 3.8-4.7) took NSAIDs once daily. NSAIDs use was highly associated with those who were ever-told to have arthritis (aOR: 3.03; 95%CI 2.60-3.52) and have difficulty of performing daily activities or work (aOR: 2.06; 95%CI 1.86-2.28). Those who were ever-told to have kidney disease (aOR: 2.36; 95%CI 1.74-3.20), ever-told to have asthma (aOR: 1.36; 95%CI 1.17-1.58), ever-told to have heart disease (aOR: 1.34; 95%CI 1.08-1.65), known hypertension (aOR: 1.22; 95%CI 1.08-1.37) also were associated with NSAIDs use. By socio-demographic profiles, NSAIDs use was positively associated with those who have government benefit scheme or private health insurance (aOR: 1.44; 95%CI 1.31-1.58), higher education level (aOR: 1.35; 95%CI 1.20-1.51), higher household income (aOR: 1.26; 95%CI 1.11-1.44, aOR: 1.12; 95%CI 1.02-1.24), currently working (aOR: 1.25; 95%CI 1.13-1.39) and female (aOR: 1.17; 95%CI 1.07-1.28). NSAIDs use was less likely among those aged 60 years and above (aOR: 0.83; 95% CI 0.72-0.97), Chinese (aOR: 0.41; 95% CI 0.36-0.47) and ‘Others’ ethnicity (aOR: 0.82; 95% CI 0.67-0.99) compared to Malay ethnicity. NSAIDs use is prevalent in Malaysian adults and associated with co-morbidities and higher socio-demographic status, thus appropriate awareness should be promoted and highlighted in the community.
non-steroidal anti-inflammatory drugs ; NSAIDs use ; NHMS ; prevalence ; Malaysia.

Children with Specific Learning Disorder (SLD) faces challenges in academic areas and are often negatively labelled. The learning problems in SLD children were mainly due to poor phonological skill but not much was known about the contribution of visuospatial difficulties. Therefore, this study aims to determine the relationship between phonological awareness skills and global visual-spatial abilities among Malay speaking children with SLD, and to compare children with SLD and typical readers on intellectual functioning, phonological awareness and global visual-spatial ability. An equal number of typical readers (n = 36) and children with SLD were recruited. Data were coded and analysed using Kendall’s Tau-b, independent samples t-test and Mann-Whitney U test. Results showed phonological skills have strong negative correlation with global visual-spatial ability (r = .55). The typical readers have significantly higher IQ and better phonological skills and better global visual-spatial skills as compared to the group with SLD. However, there is no conclusive evidence due to specificity of more than one area measured by the assessment tools. Nevertheless, it provides a direction for future research to look into global visual-spatial aspects of SLD to aid in educational instruction in the future, in addition to the long-standing phonology deficit theory.
Specific Learning Disorders ; dyslexia ; phonological awareness, global visual-spatial ability, intellectual functioning