Journal of the Psychiatric Association of Thailand

The Association Between Parental and Peer Attachment and Anxiety in Children and Adolescents with Attention Deficit/Hyperactivity Disorder (ADHD) in King Chulalongkorn Memorial Hospital

Nathariya Bannalai, Jirada Prasartpornsirichoke, Nuttorn Pityaratstian — Fri, 27 Mar 2026 00:00:00 +0700

Objectives: This study aimed to examine the associations between parental attachment and anxiety among children and adolescents with ADHD, with peer attachment serving as a mediator variable. Furthermore, the study investigated the prevalence of anxiety among children and adolescents with ADHD receiving outpatient treatment in Child and Adolescent Psychiatry Unit at King Chulalongkorn Memorial Hospital.

Methods: This cross-sectional analytical study employed consecutive sampling to recruit children and adolescents aged 10–15 years who were diagnosed with ADHD and receiving outpatient treatment in Child and Adolescent Psychiatry Unit at King Chulalongkorn Memorial Hospital. Data were collected from medical records, a demographic questionnaire, the Inventory of Parent and Peer Attachment–Revised (IPPA-R), and the Thai version of the Screen for Child Anxiety Related Emotional Disorders (SCARED). The mediating role of peer attachment in the relationship between parental attachment and anxiety was analyzed using a mediation model. Indirect effects were evaluated using bootstrapping method with bias-corrected confidence intervals, implemented in SPSS version 30.0 PROCESS macro, controlling for sex, age, educational level, type of school, number of friends, presence of siblings, birth order, closeness with family members, and being raised by parents before the age of five.

Results: A total of 125 participants were included, of whom 97 (77.6%) were male. Eighty-one participants (64.8%) screened positive for anxiety, with 56 participants (44.8%) indicating a higher specificity for anxiety disorders. The majority screened positive for separation anxiety disorder (n = 84, 67.2%). The findings indicated that parental attachment was negatively associated with anxiety symptoms in children and adolescents with ADHD, showing a significant direct effect but no significant indirect effect (Direct effect = -0.531, 95%CI [-0.897,-0.165]), Indirect effect = 0.031, 95%CI [-0.082,0.181]). However, peer attachment did not mediate the relationship between parental attachment and anxiety.

Conclusion: The findings highlighted the crucial influence of parental attachment in alleviating anxiety symptoms in children and adolescents with ADHD. Peer attachment did not serve as a mediating factor in the relationship between parental attachment and anxiety. Therefore, promoting secure attachment between children and their parents may help reduce anxiety in this population.

Factors Associated with Depression, Suicidal Ideation, and Suicide Attempts in Adolescents: Modifying Effects of Well-being Based on the Positive Psychology Framework

Sirikanya Somboonying, Thanavadee Prachason, Pichaya Pojanapotha — Fri, 27 Mar 2026 00:00:00 +0700

Objective: This study aims to analyze factors associated with depression, suicidal ideation, and suicide attempts among adolescents in Chiang Mai - Thailand, as well as to examine the influence of well-being, as measured by the EPOCH framework developed from positive psychology, on these associations.

Methods: A descriptive analytical study was conducted among 240 students aged 10 - 18 years from three schools in Chiang Mai. Data were collected using a basic demographic questionnaire, the Patient Health Questionnaire for Adolescents (PHQ-A) to assess depression, and the EPOCH Measure of Adolescent Well-being. Univariate analyses using Pearson’s Chi-square and independent t-test were performed to identify factors associated with depression, suicidal ideation, and suicide attempts. Subsequently, multivariate analyses and interaction effect tests between well-being (EPOCH) and relevant factors were conducted using binary logistic regression.

Results: Univariate analysis showed that depression was significantly associated with LGBTQ (p < .001) and parents not living together (p = 0.034). Suicidal ideation was linked to LGBTQ (p < .001) and parents not living together (p = 0.015). Suicide attempts were associated with parents not living together (p = 0.004). Multivariate analysis revealed: Depression was associated with LGBTQ (OR 6.04, 95% CI 2.37 - 15.38, p < .001). Suicidal ideation was associated with LGBTQ (OR 15.78, 95% CI 5.61 - 44.37, p < .001) and parents not living together (OR 2.39, 95% CI 1.09 - 5.25, p = 0.030). Suicide attempts were associated with parents not living together (OR 4.42, 95% CI 1.62 - 12.11, p = 0.004). Regarding the interaction effects between EPOCH well-being and the associated risk factors, EPOCH did not significantly alter the relationships overall. However, there was a trend suggesting that Engagement may interact with LGBTQ in predicting depression (interaction OR 0.71, p = 0.061), and Connectedness may interact with parental status in predicting suicidal ideation (interaction OR 1.27, p = 0.056).

Conclusion: The study indicates that LGBTQ and family structure (parents not living together) significantly increase risks of depression, suicidal ideation, and suicide attempts among adolescents. The positive psychology components, particularly Engagement and Connectedness, may play a preventive role in this vulnerable group, which warrants further investigation for future applications in mental health prevention and treatment.

The Psychometric Properties of The Bullying and Cyberbullying Scale for Adolescents (BCS-A-Thai version)

Supawadee Charoenwanit, Preeyaporn Prayongkul — Fri, 27 Mar 2026 00:00:00 +0700

Objective: To examine the psychometric properties of the Bullying and Cyberbullying Scale for Adolescents (BCS-A-Thai version).

Methods: This cross-sectional study aimed to examine the psychometric properties of the Bullying and Cyberbullying Scale for Adolescents (BCS-A-Thai version), including its reliability and construct validity. Data were collected from Thai university students aged 18 - 25 years (n = 1,200) across five regions of Thailand using an online questionnaire via Google Forms.

Results: The Bullying and Cyberbullying Scale for Adolescents (BCS-A-Thai version) demonstrated high reliability. Both Form A (victim version) and Form B (perpetrator version) showed Cronbach’s alpha coefficients of .92. The construct validity assessed through exploratory factor analysis revealed that both forms consisted of four factors-cyber, physical, verbal, and relational bullying-which were consistent with the original scale. Form A accounted for 85.89% of the total variance, while Form B accounted for 83.23% of the total variance. These findings indicate that the BCS-A-Thai version possesses good reliability and construct validity, suggesting its suitability for use in research among Thai youths.

Conclusion: The Thai version of the Bullying and Cyberbullying Scale for Adolescents demonstrated acceptable reliability and construct validity, comparable to the original instrument. It is considered suitable for use among adolescents aged 18 - 25 years and can be effectively applied in studies addressing bullying and cyberbullying, which are significant issues among adolescents and youths in the modern era.

Prevalence of Self-stigma and Its Association with Coping Strategies among Psychiatric Outpatients

Nattapat Sornvech, Karn Jumroonrojana — Fri, 27 Mar 2026 00:00:00 +0700

Objective: This study aimed to examine the prevalence of self-stigma and its association with coping strategies among psychiatric outpatients in Thailand.

Methods: A cross-sectional descriptive study was conducted among 387 psychiatric outpatients at the psychiatric clinic of Ramathibodi Hospital. The Thai version of the Internalized Stigma of Mental Illness Scale (ISMI) was used to assess self-stigma, and the Thai version of the Brief COPE inventory was used to assess coping strategies. Data were analyzed using descriptive statistics, correlation analysis, and multiple regression analysis.

Results: Of the 387 participants, 355 (91.73%) provided valid responses. The majority were female (71.8%) with median age of 35 years. The prevalence of high self-stigma was 13.52%. Self-stigma correlated negatively with adaptive coping strategies, particularly positive reframing (r = -0.357, p < 0.001), acceptance (r = -0.320, p < 0.001), and humor (r = -0.279, p < 0.001), and positively correlated with maladaptive coping strategies, especially self-blame (r = 0.558, p < 0.001) and behavioral disengagement (r = 0.477, p < 0.001). Multiple regression analysis revealed that humor, self-blame, and behavioral disengagement remained significantly associated with self-stigma, after adjusting for sociodemographic and clinical variables.

Conclusion: This study found that the prevalence of self-stigma among psychiatric patients was lower than that reported in international studies. However, certain coping strategies were significantly associated with levels of self-stigma. These findings underscore the importance of promoting adaptive coping and reducing maladaptive coping, which may help mitigate self-stigma and enhance patients’ coping capacity.

Mental Health Problems and Related Factors of Covid-19 Patients at Field Hospital of Songkhla Rajanagarindra Psychiatric Hospital

Fri, 27 Mar 2026 00:00:00 +0700

Objective: To examine mental health outcomes and associated factors among COVID-19 patients admitted to the field hospital of Songkhla Rajanagarindra Psychiatric Hospital by analyzing secondary data from the institutional Mental Health Check-In database.

Methods: This retrospective study utilized secondary data collected through the Mental Health Check-In system. The dataset included demographic characteristics and results from standardized mental health screening instruments, assessing resilience quotient, burnout, stress, depression, and suicide risk.

Results: A total of 2,282 individuals were included in the analysis, comprising 64.4 percent female and 35.4 percent male participants, with a mean age of 46.50 ± 16.72 years (range 18 - 86 years). The majority were residents of Songkhla province. Mental health screening revealed that 10.8% exhibited low resilience, while 4.7% experienced stress, 2.1% reported burnout, 1.4 % were at risk of depression, and 0.5% were at risk of suicide. Overall, 15.3% of participants had at least one mental health problem. Logistic regression analysis found that participants aged ≥60 years had significantly lower odds of mental health problems than those aged 18 - 39 years (adjusted odds ratio [aOR] = 0.566; 95% CI = 0.405 - 0.791). Regarding the duration of field hospital operations, the latter 5-month period (September 2021 - January 2022) had significantly lower odds of mental health problems than the first 5-month period (April 2021 - August 2021) (aOR = 0.349; 95% CI = 0.271 - 0.449). Sex was not associated with mental health problems.

Conclusion: COVID-19 patients admitted to the field hospital of Songkhla Rajanagarindra Psychiatric Hospital demonstrated a considerable prevalence of mental health issues, with low resilience being the most frequently reported condition. These findings underscore the importance of early psychological intervention during outbreaks of emerging infectious diseases, in order to mitigate adverse mental health outcomes.

Prevalence of Binge Drinking and Its Association with Depression in University Students

Sirapop Wangvanitchaphan, Rujira Tuangpermsub, Tiraya Lerthattasilp — Fri, 27 Mar 2026 00:00:00 +0700

Objective: This study aims to examine (1) the prevalence of binge drinking in undergraduate students and associated factors and (2) association of binge drinking and depression

Methods: A cross-sectional study was conducted among Thammasat University undergraduate students. Online questionnaires consisted of 1) demographic data 2) alcohol use and associated behaviors 3) Patient Health Questionnaire-9 (PHQ-9) and 4) Comprehensive Effects of Alcohol (CEOA). Fisher's Exact Test was used to analyze the association between binge drinking and depression. Logistic regression analysis was used to analyze association with other associated factors.

Results:Among the 282 participants, the prevalence of binge drinking is 48.58%. No statistically significant relationship was found with depression. Factors associated with increased behavior are being male gender (OR = 2.993, 95% CI 1.190 - 7.529), smoking (OR = 11.220, 95% CI 2.898 - 43.448), and expectation in sociability (OR = 1.183, 95% CI 1.088 - 1.287). Factors associated with decreased behavior are living at home (OR = 0.260, 95% CI 0.081 - 0.839), having sufficient monthly income without savings (OR = 0.208, 95% CI 0.491 - 0.883), and expectation in sexuality (OR = 0.803, 95% CI 0.699 - 0.923).

Conclusion: Prevalence of binge drinking in Thammasat University students is higher than normal population in similar. However, the result couldn’t conclude that binge drinking is associated with depression.

The Relationship between Smoking/E-cigarettes and The Influence of Religious Beliefs among Secondary School Students in Yala Province

Insanee Kado, Sirichai Hongsanguansri — Fri, 27 Mar 2026 00:00:00 +0700

Objective: To examine the lifetime prevalence of cigarette smoking and e-cigarette use and their associations with religious beliefs–related factors and school type among secondary school students in Yala Province.

Methods: This descriptive cross-sectional study was conducted in January 2025 using an online questionnaire. The study sample consisted of 368 students in grades 7 - 12 from four schools in Yala Province: two general secondary schools and two private Islamic religious schools (Pondok schools). Associations between cigarette smoking and e-cigarette use with religious beliefs and school type were analyzed.

Results: Among the 368 participants, the mean age was 14.7 ± 2.0 years; 219 were male (59.5%) and 136 were female (37.0%). The lifetime prevalence of cigarette smoking was 36.4%, and e-cigarette use was 25.3%. Students from Pondok schools had a significantly higher prevalence of cigarette smoking than those from general schools (75.4% vs. 15.1%, p < 0.001), as well as a higher prevalence of e-cigarette use (54.6% vs. 9.2%, p < 0.001). Among Muslim students, strict adherence to religious teachings was significantly associated with cigarette smoking and e-cigarette use (p = 0.048 and p = 0.020, respectively). Other factors associated with cigarette smoking and e-cigarette use included family structure, parental advice, daily allowance, and academic performance.

Conclusion: Students attending Pondok schools had higher rates of cigarette smoking than those in general schools, and strict adherence to religious teachings showed a statistically significant association with cigarette smoking and e-cigarette use. Therefore, smoking and e-cigarette prevention campaigns in Yala Province should focus on students in Pondok schools, particularly those with poor academic performance.

Development of Self-help Workbook for Enhancing Motivation and Promoting Behavioral Change in Alcohol Dependent Patients

Kawintip Tippimanchai, Pichai Saengcharnchai, Wanida Rattanasumawong — Fri, 27 Mar 2026 00:00:00 +0700

Objective: Alcohol consumption and related beverages remain a major public health concern in Thailand, leading to physical, psychological, and social consequences. Although several treatment approaches exist, barriers such as limited accessibility and stigma remain significant challenges. This study aimed to develop and evaluate the effectiveness of a self-help workbook designed to enhance motivation and promote behavioral change in alcohol consumption.

Methods: The self-help workbook was developed using CBT and MI principles and validated by experts prior to testing. A randomized controlled trial (RCT) was conducted. Based on the sample size calculation, 60 participants were planned; however, a total of 30 inpatients (n = 30) diagnosed with alcohol use disorder were enrolled and randomly allocated into two groups. The intervention group received the self-help workbook (n = 15), while the control group received alcohol education leaflet (n = 15). Research instruments included the University of Rhode Island Change Assessment Scale (URICA), the Alcohol Abstinence Self-Efficacy Scale (AASE), and the Timeline Follow-Back interview (TLFB). Outcomes were assessed at baseline, week 1, week 4, and week 12.

Results: The results showed that the experimental group who received the self-help workbook (WB) tended to have greater improvement in motivation to quit drinking compared with the control group who received the health education leaflet on alcohol (HE) at week 12, although the difference was not statistically significant (p = 0.338). However, the level of self-control in high-risk situations among participants in the WB group was significantly higher than that of the HE groups at week 12 (p = 0.024). Both groups demonstrated a reduction in average alcohol consumption and improvement in drinking behaviors throughout the follow-up period, with no significant differences between groups.

Conclusion: The self-help workbook may have the potential to enhance motivation and certain aspects of drinking behaviors, particularly self-efficacy in resisting high-risk situations for relapse, although its effectiveness among inpatients with alcohol use disorder requires further investigation.

Prevalence and Associated Factors of Quality of Life and Sleep Quality among Personnel in a Community Hospital, Ubon Ratchathani Province

Fri, 27 Mar 2026 00:00:00 +0700

Objective: To investigate the prevalence and factors associated with quality of life and sleep quality among personnel in a community hospital in Ubon Ratchathani Province.

Methods: This is a cross-sectional descriptive study conducted among personnel who had been working in a community hospital in Ubon Ratchathani for at least three months between December 2024 and February 2025. Data were collected using a general information questionnaire, the Thai version of the World Health Organization Quality of Life –Brief (WHOQOL-BREF-THAI), and the Thai version of the Pittsburgh Sleep Quality Index (PSQI). Factors associated with quality of life and sleep quality were analyzed using multivariable linear regression and multivariable logistic regression.

Results: The study included 182 participants, mostly female (72%), with an average age of 35.5 years. The majority worked 9 - 16 hours per day (51.6%), with occupational groups being clinical core (40.7%) and clinical allied (40.7%). Most participants perceived their work environment as good (74.2%) and reported a moderate level of quality of life (54.9%). The prevalence of poor sleep quality was 50.5% (n = 92). Factors significantly associated with quality of life (p < 0.05) were exercise (coefficient = 4.87, 95% CI = 0.96 - 8.77, p = 0.015), caffeine consumption (coefficient = 4.34, 95% CI = 0.24 - 8.45, p = 0.038), and a good work environment (coefficient = 6.93, 95% CI = 2.50 - 11.37, p = 0.002), while high work-related fatigue was associated with lower quality of life (coefficient = -7.04, 95% CI = -12.69 to -1.39, p = 0.015). Factors significantly associated with poor sleep quality included increasing age (AOR = 1.15, 95% CI = 1.03 - 1.29, p = 0.016), working in the clinical core occupational group (AOR = 4.40, 95% CI = 1.39 - 13.96, p = 0.012), and working 9 - 16 hours per day (AOR = 2.73, 95% CI = 1.16 - 6.41, p = 0.021). Conversely, the perception of a good work environment was associated with 60% lower odds of poor sleep quality (AOR = 0.40, 95% CI = 0.16 - 1.00, p = 0.049).

Conclusion: Exercise, caffeine consumption, and a good work environment were associated with a higher quality of life, whereas high work-related fatigue was associated with a lower in quality of life. Work-related factors (occupational group and working hours) and personal factors (age) were associated with increased odds of poor sleep quality. A good work environment was significantly associated with a higher quality of life and lower odds of poor sleep quality among hospital personnel.