Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item The association between negative experiences during childhood and social anxiety disorder: A cross-sectional study among Sri Lankan university students(Sri Lanka Medical Association, 2023) de Silva, B.G.R.; De Zoysa, P.T.; Pathmeswaran, A.; Williams, S.S.INTRODUCTION: Social Anxiety Disorder (SAD) demonstrates early-onset, chronic course, and impairment in all social spheres. OBJECTIVES: The study objective was to explore the association between negative childhood experiences among a university student sample that indicated a high prevalence of SAD. METHODS: A cross-sectional study was conducted among 1137 students from five state universities. The Liebowitz Social Anxiety Scale – Sinhala version, and a correlates questionnaire including a culturally adapted Adverse Childhood Events Questionnaire and contextually appropriate parenting-related questions, were used as instruments. The analysis included chi-square tests for independence, spearman’s r correlations, and binary logistic regressions. RESULTS: Within the sample, 52.2% were female, and 66% were between 21-23 years. All faculties were represented with 27.5% from engineering. 32.2% of participants were first years. Bivariate analyses identified that being an eyewitness towards violence towards mother, feeling unsafe, feeling mistreated by family, experiencing physical abuse, experiencing sexual abuse, experiencing emotional abuse, experiencing parental dissatisfaction, and parental overcontrol to be significantly (p<0.05) associated with SAD. Continuous variables of Parent dissatisfaction (AOR=1.07, 95% CI 1.01-1.13, p<0.05), parent overcontrol (AOR=1.08, 95% CI 1.02-1.15, p<0.01) and experiences of emotional abuse (AOR=1.31, 95%CI 1.11-1.54, p=0.001) remained independently associated with SAD on regression analysis. CONCLUSIONS: Findings from this study corroborate the literature on the association between childhood experiences and parenting-related factors and SAD. The findings also highlight for the first time that Sri Lankan university students are no exception. An urgent need for awareness and prevention of adverse experiences within the family context, and early intervention to prevent the development of SAD are crucial.Item Randomized Controlled Trial Investigating the Effectiveness of Cognitive Behaviour Group Therapy Compared to a Waitlist Control in the Treatment of University Students with Social Phobia(Sri Lanka Medical Association, 2020) Hapangama, A.; de Silva, B.G.R.; de Zoysa, P.T.; Kuruppuarachchi, K.A.L.A.; Ravindran, A.; Wickremasinghe, A.R.; Williams, S.S.INTRODUCTION AND OBJECTIVES: Social phobia causes significant impairment in a person’s personal and professional life. However, individually delivered cognitive behavioural therapy (CBT) is costly, limited by the number of trained therapists and not scalable to meet the need for such therapy in the population. In this context, cognitive behavioral group therapy (CBGT) is the viable option. Objective was to determine the treatment effectiveness of CBGT as compared to a waitlist control of university students with social phobia. METHOD: A single-blind randomized controlled trial consisting of an 8-week treatment phase of CBGT versus a waitlist control was conducted among university students with social phobia. The Liebowitz Social Anxiety Scale –Self Rated Sinhala version (LSAS-SR) was administered at screening, baseline, four weeks and eight weeks of the trial. A culturally adapted CBGT was delivered in Sinhala to the intervention group by a trained clinical psychologist. RESULTS: Thirty university students (15 in each arm) with a mean age of 22, meeting DSM IV criteria for Social Anxiety Disorder were included. Repeated measure analysis of the total scores of the LSAS-SR in the CBGT arm showed statistically significant (p<0.001) reduction in the total scores (13.3) as compared to the waitlist arm after controlling for age and gender. CONCLUSION: CBGT is superior to waitlist control in university students with social phobia.Item Cognitive behavioral therapy for university students with social phobia: A method to culturally adapt group therapy(Sri Lanka Medical Association, 2016) de Silva, B.G.R.; de Zoysa, P.; Williams, S.S.INTRODUCTION AND OBJECTIVES: Social phobia is a debilitating anxiety disorder with negative social implications. University students in Sri Lanka appear to have high prevalence rates of social phobia according to preliminary studies. Establishing a methodology by which interventions such as, Cognitive Behavioral Group Therapy (CBGT) could be culturally adapted is the objective of this study. METHOD: The gold standard CBGT was used to construct the structure of the intervention. CBGT interventions that have been modified to suit university student participant groups in the West were reviewed to revise the structure of the therapy. Existing cross-cultural therapy adaptation models were identified to derive factors to be taken in to consideration within this adaptation process. A study of other mental health intervention programs that have been cross-culturally adapted in diverse cultural settings was carried out. RESULTS: The methodology obtained constituted of three steps. The intervention program was initially reviewed by a panel of clinical psychologists to assess for appropriateness of content. Thereafter, the finalized layout, including activity worksheets were translated to Sinhala Language, and re-translated to English to test for accuracy. Finally, the translated documents were assessed by a panel of mental health experts in Sri Lanka and consensus was reached. CONCLUSIONS: A practical methodology to cross-culturally adapt psychological therapy for social phobia in the Sri Lankan context was developed