Journal of the Psychiatric Association of Thailand

Effect of Learning Types of Social Skills from a Board Game on the Non-Emotional Expression of the Learned Skills Among Students with Autism Spectrum Disorder at Autistic Research Center Khon Kaen University

Piyawan Srisuruk, Nittianate Kasicha, Korrawan Mongput, Suchat Paholpak — Thu, 20 Jun 2024 00:00:00 +0700

Objective: This study aimed to develop and evaluate the effectiveness of utilizing a board game for instructing 3 specific social skills (waiting, sharing, and emotional self-control (WSE) in kindergarten children with autism spectrum disorder (KwASD). The research also assessed the weekly frequency of the acquired WSE skills being expressed in daily life without accompanying irritability.

Methods: Conducted between May 1 and August 31, 2021, the research employed a purposive sampling approach, A - B model, within a single-subject design, involving 5 cases. Participants were KwASD aged 5 - 7 years from the Khon Kaen University Autistic Center. Ethical approval was obtained from the Human Research Ethics Committee at Khon Kaen University (HE643074). Research instruments included 1) a board game developed by the authors, emphasis on learning through social and experiential learning theory to impart each of WSE skills, underwent evaluation and approval by 3 experts in teaching and nursing KwASD and resulted in an item objective congruence (IOC) ranging from 0.67 to 1 for each assessment item; 2) An assessment form to appraise the weekly frequency of expression of the learned WSE without irritability, and underwent evaluation by the same expert panel, yielding IOC from 0.67 to 1 for each assessment item; and 3) a demographic data collection form. Statistical analysis involved enumerating item numbers, analyzing raw data changes, and creating single-subject design and baseline trend graphs using Microsoft Excel.

Results: Following structured teaching sessions with the board game, centered around events requiring WSE expression, all KwASD participants demonstrated increased expression of WSE in daily life, with reduced irritability compared to pre-learning levels. Subsequent teaching sessions consistently elevated all WSE scores above the baseline trend.

Conclusion: The findings suggested that a board game can effectively serve as a tool for instructing KwASD in acquiring and applying social skills, specifically focusing on waiting, sharing, and emotional self-control.

Prevalence and Associated Factors of Emotional and Behavioral Problems During COVID-19 Pandemic in Children and Adolescents with Autism Spectrum Disorder

Warisa Chulasen, Tikumporn Hosiri, Napat Sittanomai — Thu, 20 Jun 2024 00:00:00 +0700

Objective: To explore the prevalence and factors associated with emotional and behavioral problems among children and adolescents with autism spectrum disorder (ASD) during the COVID-19 pandemic who sought care at Siriraj Hospital from July 2022 to January 2023.

Methods: This descriptive cross-sectional study recruited children with ASD and their parents. Parents were required to complete three questionnaires; demographic data about children and their guardians, the Thai version of the Strengths and Difficulties Questionnaire (SDQ), and an assessment of the impact of the COVID-19 pandemic.

Results: The study included 167 participants. The prevalence of emotional and behavioral problems was 46.7%. Within each dimension, the prevalence rates were as follows: peer relationship problems at 85.6%, hyperactivity/inattention at 39.5%, conduct problems at 24.6%, and emotional symptoms at 15.0%. Emotional and behavioral problems were significantly associated with psychiatric comorbidities, quarantine measures affecting both children and family members due to COVID-19 risk, confirmed cases of COVID-19 among family members, disruptions to children’s daily routines, and sleep problems.

Conclusion: The prevalence of emotional and behavioral problems during the COVID-19 pandemic in children and adolescents with ASD was nearly half the total sample in the study. They may experience emotional and behavioral problems, which can be caused by both comorbidity psychiatric disorders and patient’s experiences. As such, it is important for physicians to closely monitor and assess any such issues in their ASD patients.

The Association Between Child Emotion Regulation, Child Mental Health Status, and Parental Competence in School-Aged Children in Bangkok, Thailand

Pimprapan Ooraikul, Parichawan Chandarasiri, Jirada Prasartpornsirichoke — Thu, 20 Jun 2024 00:00:00 +0700

Objective: This study aimed to examine the relationship between child emotion regulation, child mental health status, and parental competence in non-clinical 8 to 12-year-old children in a school in Bangkok, Thailand.

Methods: This cross-sectional study was conducted in a demonstrative school in Bangkok from March to May 2023 using an anonymous survey. Measurements consisted of demographic data, ERQ-CA/HIF for child emotion regulation, self-rated and parent-rated SDQ for child mental health status, and PSOC for parental competence. All available children aged 8 - 12 years and their primary caregivers were included, then children with neurodevelopmental disorder(s) and academic disadvantages were excluded. Parents with major psychiatric disorder(s) were also excluded. Informed consent was given, and ethical approval was granted. The relationship between factors was analyzed using Pearson's correlation. Dependent T-test, independent T-test, and one-way ANOVA were used to compare groups with different demographics.

Results: A total of 306 child-parent dyads were eligible for the study. The mean age of the children and the parents were 9.8 and 44.9 years respectively. Most of the participants had high household income and high parental education. No association between child emotion regulation and parental competence was found. However, there were weak to moderate negative associations between child emotion regulation and all psychological symptoms (r = -.19 to -.31); negative emotions and parental competence (r = -.16 to -.19); and parental competence and parent-rated psychological symptoms (r = -.12 to -.29). Weak to moderate positive associations between child emotion regulation and prosocial behaviors (r = .12 to .24) were also found, whereas negative emotions were moderately associated with emotional problems (r = .62), and weakly with all other psychological symptoms (r = .23 to .30).

Conclusion: This study found that emotion regulation is positively associated with prosocial behavior and negatively associated with mental health problems, while parental competence is associated with child's mental health outcomes, particularly prosocial behaviors and attention problems. However, no association between child emotion regulation and parental competence was found which raised an urgent question of whether parents realize their important role in coaching their child's emotion regulation. There were several limitations. More research is needed to better understand the relationship between emotion regulation, mental health, and perceived parental competence in Thai culture, with improvements for the future as suggested.

Correlation Between Smartphone Addiction and Depression in Secondary School Children

Thu, 20 Jun 2024 00:00:00 +0700

Objective: To study the correlation between smartphone addiction and depression in secondary school children and related factors associated with depression in secondary school children.

Method: A cross-sectional study was conducted in secondary school children. The data was collected by using demographic questionnaire, Smartphone Addiction Scale-Thai Shot Version (SAS-SV-TH), Children’s Depression Inventory (CDI)-Thai version. The data was analyzed by descriptive analysis for general information. Analytical statistics, chi-square and Spearman’s correlation, were used to explore the relationship between smartphone addiction and depression. Logistic regression in both bivariate and multivariable analyses was applied to investigate the association between various factors and depression.

Results: Among the 290 children who were included in the study, 51% were female, smartphone addiction was statistical significantly associated with depression in secondary school children (p<0.001). Factor associated with depression in secondary school children were educational level (Adj. OR 0.19, 95%CI: 0.08 - 0.43 for grade 8, Adj. OR 0.46, 95%CI: 0.23 - 0.92, p<0.001 for grade 3), academic achievement (grade point average) (Adj. OR 0.47 95% CI: 0.26 - 0.84, p = 0.011), screen time (Adj. OR 1.10, 95%CI: 1.002 - 1.21, p = 0.045) and smartphone addiction (Adj. OR 2.92, 95%CI: 1.63 - 5.23, p<0.001).

Conclusion: The study revealed a statistically significant association between smartphone addiction and depression among secondary school children. Other factors associated with depression in secondary school children were educational level, academic achievement and screen time.

The Effect of a Parent Management Training Program on Parents’ Mental Health, Family Relationships, Positive Parenting, and Behaviors of Children with Attention Deficit Hyperactivity Disorder

Kanchamon Seehapanya, Choochart Wong-Anuchit — Thu, 20 Jun 2024 00:00:00 +0700

Objective: To compare scores of parents’ mental health, family relationships, positive parenting, and behaviors of children with attention deficit hyperactivity disorder (ADHD) between the experimental and control groups of parents after participating in a Parent Management Training (PMT) Program.

Methods: This quasi-experimental research used a pretest-posttest design. The parents of children with ADHD were randomly assigned to an experimental (n=25) or control group (n=25). The experimental group participated in the PMT program and usual care for 6 weeks; the control group received usual care only. In addition to demographic characteristics, four instruments were used to collect data: the 21-item Depression Anxiety Stress Scale 21 (DASS-21), the 10-item Family Relationship Questionnaire, the 16-item Positive Parenting Questionnaire, and the 10-item Modified IOWA Conners Rating Scale. Health outcomes of this study were (1) three individual mental health (stress, anxiety, and depression), (2) family relationship, (3) positive parenting, and (4) parents’ ratings of the behaviors of their children with ADHD. Descriptive statistics independent t-test, and paired t-test were used for data analysis.

Results: After participating in the PMT program, the scores of parents’ three mental health (stress, anxiety, and depression) and parents’ ratings of behaviors of children with ADHD were significantly lower than parents in the control group (p < .05). The scores of family relationships and positive parenting in the experimental group were significantly higher than those in the control group (p < .05).

Conclusion: The PMT Program is suitable for training parents’ skills and also results in reducing behavioral problems of children with ADHD

Family Functioning and Caregiver Stress in Attention-Deficit/ Hyperactivity Disorder (ADHD) Comparing to Non-Chronic Physical Illness

Nicha Janprasert, Nida Limsuwan — Thu, 20 Jun 2024 00:00:00 +0700

Objective: To specifically investigate the family functioning and caregiver stress in the family with ADHD comparing to the family with non-chronic physical illness.

Method: A cross-sectional study consisted of 97 subjects in ADHD group and 101 subjects in non-chronic physical illness group.

Results: The comparison of the family functioning between ADHD and non-chronic physical illness group demonstrated significantly poorer family functioning in ADHD group than physical illness group on difficulties, communication and the general family functioning. Moreover, higher caregiver stress in ADHD group than physical illness group was demonstrated. In addition, the significant associations between clinical groups, difficulties, communication, general family functioning and caregiver stress were reported. Furthermore, the positive associations between all dimensions of family functioning, general family functioning and caregiver stress were significant.

Conclusion: ADHD group had poorer family functioning and higher caregiver stress level than physical illness group. Family interventions potentially have benefits for ADHD population.

Validity and Reliability of the Thai Version of the Family Resilience Assessment Scale (FRAS-Thai)

Tanaporn Sangpongsanon, Thanvaruj Booranasuksakul, Jirada Prasartpornsirichoke — Thu, 20 Jun 2024 00:00:00 +0700

Objective: To translate the Family Resilience Assessment Scale (FRAS) into Thai and to evaluate the validity and reliability of the Thai version of the Family Resilience Assessment Scale (FRAS-Thai) in both Thai children aged 11 - 18 and their parents.

Methods: This research adopts a descriptive cross-sectional design, wherein the Family Resilience Assessment Scale (FRAS-Thai) underwent a translation process into Thai through conventional forward-backward method. The Thai version underwent scrutiny to ascertain its content validity. Subsequently, the study enrolled a cohort of 130 pairs of parent-child aged 11 - 18, sourced from both a high school in Bangkok and patients aged 13 - 18 from a hospital. The data was collected from July to November 2023.

Results: The FRAS-Thai exhibited 1 robust item-objective congruence (IOC) of 0.75 - 1.00 Internal consistency, as measured by Cronbach’s Alpha, was notably high at 0.95 for the children group and 0.95 for the parent group, underscoring the instrument’s commendable content validity and reliability. In comparison to the Thai family resilience tool, Pearson's correlation analysis unveiled a moderate correlation, with coefficients of 0.69 and 0.68 for the children and the parent groups respectively. Additionally, the correlation between the scores of the FRAS-Thai in the children and parent groups showed a coefficient of 0.38.

Conclusion: The Thai version of the Family Resilience Assessment Scale demonstrated good content validity and reliability. It can be effectively used to assess family resilience in the Thai population, both among children aged 11 - 18 and parents.

Mental Health of Psychiatric Patients’ Caregivers at Psychiatric Outpatient Department in Pattani Hospital

Hatairat Kuneepant, Emnasree Mintrasak — Thu, 20 Jun 2024 00:00:00 +0700

Objective: To determine the prevalence and associated factors of mental health problem among caregivers of psychiatric patients at Pattani Hospital

Method: A cross-sectional descriptive study was conducted in 400 caregivers of psychiatric patients who had attended the outpatient clinic at Pattani hospital during 1 December 2023, to 31 December 2023. Participants were assessed by demographic questionnaires and Thai General Health Questionnaire-28. The data were analyzed using descriptive and inferential statistics such as Chi-square or Fisher's exact test and Stepwise Multiple Regression.

Results: The study found that 57 out of the 400 caregivers of patients studied had mental health problem, accounting for 14.3%. When assessing each aspect of mental health, it was observed that 16.0% exhibited physical symptoms, 14.7% experienced anxiety and insomnia, 13.0% faced social impairments, and 6% suffered from severe depression. The analysis of factors influencing the mental health status of caregivers of psychiatric patients revealed several significant findings. Specifically, caregivers in the age group of 31 - 40 years (Adj.OR=0.13, p = 0.006), 41 - 50 years old (Adj.OR=0.07, p = 0.001), 51 - 60 years old (Adj.OR=0.04, p < 0.001), relationship factors with the patient as a child (Adj.OR=0.35, p = 0.034), relatives (Adj.OR=0.16, p < 0.001) and education level factor Bachelor's degree or higher (Adj.OR=0.40, p = 0.045) were less likely to experience mental health problem. Divorced/separated (Adj.OR=4.83, p = 0.002), having family income in debt (Adj.OR=2.06, p = 0.032), and having had bad experiences with patients (Adj.OR=2.40, p = 0.033) were identified as significant factors contributing to mental health problem among caregivers of psychiatric patients at the 0.05 significance level.

Conclusion: Divorce/separated status, debt and having had bad experiences with the patient. As a result, caregivers of psychiatric patients have mental health problems. Therefore, caregivers who meet the above qualifications should be screened. To provide psychological care and close counseling.

Factors Associated with Anxiety and Depression of Teachers During the Covid-19 Pandemic

Seepanna Suwannagird, Patcharin Seree, Komsan Kiatrungrit — Thu, 20 Jun 2024 00:00:00 +0700

Objective: To examine the factors associated with anxiety and depression in teachers and to investigate the anxiety and depression of teachers during the COVID-19 pandemic.

Methods: This research presented a cross-section descriptive study. The teacher samples were selected from various government schools, private schools, and demonstration schools. Total 437 teachers in primary and secondary classes in Thailand were tested recruited from 2020 to 2022 by Stratified sampling. Data collection happened via Google Forms platform from April 5th to April 19th, 2023. Questionnaires were used to collect the general information, factors, Generalized Anxiety Disorder; GAD7 (Thai Version) and Patient Health Questionnaire; PHQ-9 (Thai Version). The collected data was analyzed using Pearson’s Chi-Square test and Binary logistic regression. This human research study was approved and monitored by Human Research Ethics Protocol No. IPRS-IRB-2023-042

Results: The factors that significantly affected anxiety were age (p = 0.026), while age (p = 0.029) and teaching experience (p = 0.043) significantly affected depression. The levels of anxiety achieved (low, moderate, and severe) were 36.84%, 8.92%, and 4.58%, respectively, whereas depression achieved 22.20%, 7.78%, and 6.18%, respectively.

Conclusion: This study shows that some teachers faced and coped with mental health issues during the COVID-19 pandemic situation. School administrators and relevant agencies must plan strategies and provide interventions to assist teachers who have been experiencing anxiety and depression for the purpose of improving mental well-being. These include establishing preventive measures for potential mental health problems among teachers, such as providing school psychologists or psychiatrists to impart knowledge and counseling to teachers regarding coping mechanisms, managing expectations, and anxiety management. Additionally, annual mental health screenings for teachers should be conducted, along with organizing meetings for teachers to discuss and exchange their teaching experiences with each other in the school.

Factors Influencing Mindfulness Practice in Patients with Mild Cognitive Impairment: A Qualitative Research Study

Nawan Rachatan, Karn Jumroonrojana, Daochompu Daochompu Nakawiro — Thu, 20 Jun 2024 00:00:00 +0700

Objective: To study the factors influencing mindfulness training and suitable mindfulness practice model for patients with mild cognitive impairment (MCI)

Methods: This qualitative study included 10 participants, comprising healthcare professionals with at least 1 year of mindfulness training experience and experience treating patients with MCI (5 participants) and patients with MCI who had undergone mindfulness practice for at least 6 months at Ramathibodi Hospital (5 participants). Data was collected through semi-structured interviews, and subsequently, content analysis was employed to analyze the gathered information.

Results: Factors which promote mindfulness practice were categorized into internal and external factors. Internal factors included intention and having a positive attitude towards mindfulness, while external factors encompassed social support, suitable training methods, and a conducive environment. These factors could either support or hinder mindfulness practice. Other external factors which promoted mindfulness practice included social roles, religion, or personal beliefs. Other external factors that served as obstacles to mindfulness practice included lack of training skills, poor socioeconomic status, poor health, and fatigue from daily routines.

Conclusion: To promote mindfulness practice in individuals with MCI, encouraging a strong intention to practice mindfulness is crucial. This involves fostering a positive mindset, emphasizing the importance and benefits of mindfulness, and highlighting the control it provides over one’s behavior. Consistent and clear goal-setting for mindfulness practice is essential. Additionally, social support from friends, family, influential individuals in the community, and government support can play a significant role in motivating individuals to engage in mindfulness practice together. Creating supportive environments for mindfulness practice, simplifying and adapting mindfulness techniques to daily life, will make it more accessible for individuals with MCI, enabling them to engage in regular mindfulness practice.

The Prevalence and Associated Factors of Metabolic Syndrome in Psychiatric Patients at Thammasat University Hospital

Nuttaya Chartchua, Winitra Nuallaong, Muthita Phanasathit — Thu, 20 Jun 2024 00:00:00 +0700

Objective: To determine the prevalence and associated factors of metabolic syndrome in psychiatric patients

Methods: A descriptive cross-sectional study was conducted among psychiatric outpatients at mental health clinic, between August 1, 2022 and July 31, 2023. The sample consisted of 299 psychiatric outpatients diagnosed with the following principle disorders: psychotic disorders, bipolar disorders, depressive disorders, and anxiety disorders. Metabolic syndrome was diagnosed based on the International Diabetes Federation criteria (IDF, 2005). Data were analyzed and tested for associations between various factors using multivariate logistic regression analysis.

Results: The prevalence of metabolic syndrome was 51.17%. Age, education level, occupation, economic status, current alcohol consumption, use of antidiabetic, antihypertensive, and hypolipidemic agents, duration of psychiatric disease, and antipsychotics were significantly correlated with metabolic syndrome. The duration of psychiatric disease was a risk factor for metabolic syndrome (adjusted odds ratio = 1.055, 95%CI = 1.006 - 1.106), while exposure to agomelatine, bupropion, deanxit, tianeptine, trazodone, and vortioxetine was a protective factor for metabolic syndrome (adjusted odds ratio = 0.405, 95%CI = 0.213 - 0.772).

Conclusion: The prevalence of metabolic syndrome in this group of psychiatric patients was high. These findings support the importance of assessing and monitoring metabolic syndrome in psychiatric patients who are continuously exposured to antipsychotic every year by measuring body mass index, blood pressure, waist circumference, fasting plasma glucose, HDL cholesterol, and triglycerides.

Predicting Factors of Six Months Retention in Methadone Maintenance Therapy at Prachuap Khiri Khan Hospital

Vinn Jinanarong, Pavarud Puangsri — Thu, 20 Jun 2024 00:00:00 +0700

Objective: To examine the characteristics of patients who are undergoing long-term methadone treatment at Prachuap Khiri Khan Hospital and to determine which factors predict patient retention in the system for more than six months.

Methods: A descriptive study was conducted on 153 patients. The sample population consisted of patients undergoing long-term methadone treatment at Prachuap Khiri Khan Hospital. Data were collected between January 1, 2020, and January 1, 2023. The demographic data, substance use histories, and treatment histories were collected and analyzed.

Results: The study revealed that more than one-third of patients remained in treatment for over six months (37.3 percent), with an average stay of 6.3 months. Patients over the age of 16, receiving methadone via take-home or drop-off at a nearby hospital, and living outside the hospital district were found to be significantly more likely to stay in the system for more than six months.

Conclusion: The results should be used to increase caution when treating young patients with opioid use disorder and patients who live in the suburbs and increase the number of methadone drop-off units.