PUBLICATIONS
Published in Psychiatry Research (2007)
EMDR is listed by MOH (Singapore) for efficacy with trauma-related disorders
- Clinical practice guidelines for Anxiety Disorders
The Ministry of Health (MOH) has developed the clinical practice guidelines on Anxiety Disorders to provide doctors and patients in Singapore with evidence-based treatment for anxiety disorders. This article reproduces the introduction and executive summary (with recommendations from the guidelines) from the MOH clinical practice guidelines on anxiety disorders, for the information of SMJ readers. Chapters and page numbers mentioned in the reproduced extract refer to the full text of the guidelines, which are available from the Ministry of Health website: http://www.moh. gov.sg/content/moh_web/healthprofessionalsportal/doctors/guidelines/cpg_medical.html.
EMDR for nightmare processing
- Case report
A single client with depression and chronic nightmares was treated with 4 sessions of eye movement desensitization and reprocessing (EMDR) and showed a decrease in nightmares and improvement in general well-being. The client’s 2 nightmare images were resolved following Luber’s (2010) protocol for nightmare processing. Treatment effects were measured with the Outcome Rating Scale and showed a shift from the clinical range at pretreatment to the nonclinical range at the third session. The ready improvement and gains of this patient have served to highlight various aspects of the EMDR procedures which have worked well for the client, which included targeting the negative cognitions surrounding the theme of helplessness as well as adapting the positive cognition with a collectivistic orientation.
Personality profiling
- Australian and Singaporean psychiatric patients
The use of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) as a useful measure of psychopathology has been shown in extensive studies. However, there is limited research on the ability of the MMPI-2 to measure differences across diverse cultures. This study aims to extend the research on Caucasian–Chinese MMPI profiles to the countries of Singapore and Australia by examining cross-nation variations. Participants were recruited from psychiatric outpatient clinics and consisted of 70 and 107 patients from Singapore and Australia, respectively. It was predicted that similarities across the two cultures would be observable, with differences reflected on specific scales. The overall findings indicate that MMPI-2 profile comparisons are comparable between Australian and Singaporean subjects, with considerably more similarities than differences. However, there are significant differences on specific MMPI-2 subscales including the lie, hypochondriasis, Addiction Potential Scale, overcontrolled hostility, fears, health concerns and negative treatment indicators. It is suggested that the differences are a reflection of cultural and ethnic distinctions specific to each country, whereas the commonalities between the two nations indicate comparable overall profiles.
Published in Journal of EMDR Research and Practice (2014), 8(3), 129-134.
Masculininty and Femininty scales
- Gender constructs related to psychological health
Previous research measuring various biosocial factors such as age, sex, and marital status has found them to be essentially unrelated to measures of psychological health. Recent empirical studies have revealed that personality constructs may be more significant than demographic variables in the prediction of psychological well-being. The present study assessed the personality constructs of masculinity and femininity and hypothesized that the Gender-Masculine (GM) scale of the MMPI-2 would be more effective than the Gender-Feminine (GF) scale in predicting psychological well-being. This hypothesis stems from previous research that has indicated the dominance of the masculinity model. It is suggested that previous research supporting androgyny as a primary indicator of well-being was influenced by the masculinity component of this gender orientation. One hundred and seventy-seven psychiatric patients from Australia (N 5 107) and Singapore (N 5 70) completed the MMPI-2. Hierarchical multiple regression revealed significantly stronger masculinity effects, with significance achieved on measures of ego strength and low self-esteem. No significant relationship between psychological well-being and the GF variable was found. Similarly, androgyny did not add any further variance to the model when masculinity was controlled for. Overall, the results are consistent with an interpretation that GM is a better correlate of psychological well-being as compared to the GF scale.
Published in International Journal of Psychology (2006), 41(5), 413-422.
Published in Singapore Medical Journal(2015), 56(6), 310-316.
Sexual assaults in Singapore
- Comparative study of rapists and molesters
Sexual assaults vary in terms of severity from molestation, which involves touching, stroking, fondling or grabbing of any part of the victim's body, to rape, where victims have been known to suffer severe emotional trauma. The aim of the study is to compare molesters with rapists using hypotheses that molesters and rapists commit their offences at different times of the day, at differing locations and with differing relationships with their victims. The influence of alcohol on both groups was also studied.
Convicted molesters and rapists were given a semi-structured interview in prison. Demographic information and details of each offence were obtained from prison records. Comparisons were made of the demography, time, place, reasons for assault, relationship of offender to victims and the role of alcohol and drugs consumed by the perpetrators.
Molesters and rapists were of similar age and ethnicity, but differed in that rapists had attained a lower educational level and were more likely to be single. Rapists were more likely to report having drunk alcohol, committing rape after midnight and in secluded places. Molesters struck in the afternoon hours and usually in crowded places. Victims of molesters tended to be relatives whereas victims of rapists were more likely to be ex-spouses or ex-lovers. Molesters tended to give other reasons for their offences.
Differences between molesters and rapists could lead to intervention strategies chiefly targeting the issues of poor socialisation skills in molesters and alcohol counselling for rapists.
Published in Medicine, Science and the Law (2002), 42(4), 344-350.
Published in Singapore Medical Journal (1999), 40(9), 590-5.
Stress and workplace absenteeism
- Study done with civil service organisations in Singapore
BACKGROUND OF STUDY: Three hundred and sixty three subjects from various civil service organisations were administered the SCOPE-i (Stress, Coping and Personality Inventory) as part of the Institute of Mental Health's efforts to promote mental health in the workplace.
AIM OF STUDY:
This study examines the relationship between stress-related factors and absenteeism. Absenteeism is measured by the number of days of medical leave taken (MC) and self-report of minor illnesses (MI) which are not severe enough to warrant the coverage of a medical certificate.
RESULTS:
In this study, we are interested in the differences between MI and MC, and their respective relationships with stress-related factors. We hypothesised that MI, rather than MC, is more related to poor workplace conditions. The findings of this study support this hypothesis. Thus if workplace environment is stressful, people are still likely to come to work despite their illness. An interesting observation in this study is the different ways in which environmental stressors and psychosocial aspects of the workplace environment affect the MC variable. Individuals are more likely to take MC when the environmental stressors are high (i.e., poor lighting, uncomfortable temperatures, etc) as compared to poor psychosocial environmental conditions (e.g., work overload, high organisational tension, career limitations and high personal constraints). On the other hand, when faced with poor psychosocial environmental conditions, MI increases instead of MC.
CONCLUSION:
These findings have implications on the types of changes in a workplace which employers should make in order to decrease MC and improve physical well-being. In addition, the study shows the usefulness of MI in future studies as a dependent variable.
EMDR processing of chronic fatigue syndrome
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The understanding that chronic fatigue syndrome (CFS) or myalgic encephalomyelitis (ME) is precipitated by a viral infection advances the view that CFS/ME is a medical condition that requires medical interventions. The present case study advances the view that EMDR can process the negative memories related to the trigger situations that involve the fatigue and tiredness, the high level of interoceptive awareness, and to maladaptive thought patterns. These trigger situations are akin to the maintenance factors in the chronic pain literature that involve disability status, interoceptive awareness and maladaptive thought patterns. The subject improved on several indicators of physical and mental fatigue, as well as demonstrated by scores on the FAS (Fatigue Assessment Scale) and CIS-20 (Checklist of Individual Strengths). In conclusion, the results show that EMDR therapy can be an encouraging, non-invasive and relatively short strategy to the treatment of CFS.
Published in Journal of Psychology and Clinical Psychiatry (2017), 7(3).