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Almarzouki AF. Impact of on-call shifts on working memory and the role of burnout, sleep, and mental well-being in trainee physicians. Postgrad Med 2024:1-6. [PMID: 38656827 DOI: 10.1080/00325481.2024.2347195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/22/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Optimal cognitive functions, including working memory (WM), are crucial to enable trainee physicians to perform and excel in their clinical practice. Several risk factors, including on-call shifts, poor mental health, burnout, and sleep problems, can impair clinical practice in trainee physicians, potentially through cognitive impairment; however, these associations have not been fully explored. OBJECTIVE This study investigated the effect of on-call shifts on WM among trainee physicians and its association with burnout, depression, anxiety, affect, and sleep. MATERIALS AND METHODS This cross-sectional study involved 83 trainee physicians (45% male). We measured demographic and training-related factors including on-call shifts and working hours. We also assessed depressive symptoms (PHQ-9), both state and trait anxiety (STAI total score), burnout (OLBI total score), positive and negative affect scores (PANAS), and sleep disturbances (PSQI total score). WM was evaluated using spatial working memory (SWM) strategy scores that reflected performance and total error counts. RESULTS Trainee physicians with more on-calls per month had significantly worse depressive symptoms, burnout scores, and sleep, as well as more negative affect. While controlling for covariates, being on-call more times per month was significantly associated with worse WM. Worse depressive symptoms and burnout scores were also significantly associated with impaired WM. CONCLUSION Working more on-call shifts is associated with compromised WM. Trainee physicians who experienced more depressive symptoms and burnout had worse WM.
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Affiliation(s)
- Abeer F Almarzouki
- Department of Clinical Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Almowalad E, Almarzouki AF, Alsalahi S, Aljanoubi F, Alzarah S, Alobeid O, Aldhafeeri M. Sleep patterns and awareness of the consequences of sleep deprivation in Saudi Arabia. Sleep Breath 2023; 27:1511-1518. [PMID: 36319929 DOI: 10.1007/s11325-022-02728-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/01/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Sleep deprivation is a growing challenge in modern society and places a burden on people's physical and mental well-being. However, only a few studies have investigated sleep patterns and awareness of the associated risks of sleep deprivation in Middle Eastern countries. This study aimed to explore these issues in adults in Saudi Arabia. METHODS This was a quantitative cross-sectional study. We collected information on the participants' demographic characteristics, sleep hours, and sense of feeling sleep-deprived over the previous 3 months regardless of sleep duration. Current knowledge of the health consequences associated with chronic sleep deprivation and attitudes toward seeking in-person health care for sleep deprivation symptoms were additionally assessed. RESULTS Among 1449 adults, only 41% of the participants slept for the recommended duration for adults of 7 h or more. However, 70% reported feeling sleep-deprived at least some of the time regardless of their sleep duration. Smokers, students, and those on sleep medications were more likely to report feeling sleep-deprived. Most participants (strongly) agreed that chronic sleep deprivation had a negative effect on their health (92%) and social (88%) and professional lives (91%), yet only 10% of our sample had visited a doctor for their sleep deprivation symptoms. CONCLUSIONS We found a high level of sleep deprivation among residents of Saudi Arabia and a strong awareness of the association between chronic sleep deprivation and negative consequences, yet a lower awareness of the association with specific medical comorbidities. Our findings also suggested a lack of health care engagement among sleep-deprived participants.
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Affiliation(s)
- Enas Almowalad
- Internal Medicine & Critical Care Department, Faculty of Medicine, King Abdullah Bin Abdulaziz University Hospital, Riyadh, Saudi Arabia
| | - Abeer F Almarzouki
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
| | - Shifaa Alsalahi
- Internal Medicine Department, King Saud Medical City, Riyadh, Saudi Arabia
| | - Flwah Aljanoubi
- Internal Medicine Department, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Sarah Alzarah
- Internal Medicine Department, King Khalid University Hospital, Riyadh, Saudi Arabia
| | - Obada Alobeid
- Internal Medicine Department, Al-Habib Hospital, Al Qassim, Riyadh, Saudi Arabia
| | - Maha Aldhafeeri
- Pediatric Department, Al-Iman General Hospital, Riyadh, Saudi Arabia
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Almarzouki AF, Bellato A, Al-Saad MS, Al-Jabri B. COGMED working memory training in children with Attention Deficit/Hyperactivity Disorder (ADHD): A feasibility study in Saudi Arabia. Appl Neuropsychol Child 2023; 12:202-213. [PMID: 35549563 DOI: 10.1080/21622965.2022.2070020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Working memory training has been proven effective for improving cognitive functioning in patients with Attention Deficit/Hyperactivity Disorder (ADHD). However, the feasibility of this type of training for children in Saudi Arabia has not been previously explored. We investigated the feasibility of implementing Cogmed Working Memory Training (CWMT) in a sample of 29 Saudi children with ADHD. We found no significant demographic or clinical differences between compliant and noncompliant children. Although compliant children were initially better at following instructions and reported better improvements in working memory and math skills compared to those who did not complete the CWMT, all children who participated in the program showed improvements in performing the CWMT tasks. Most parents found the Cogmed training feasible for their children, were satisfied and keen to continue with the program, and felt the training helped them to address their problems. Most children did not encounter any difficulties in using the software, and many families were, therefore, likely to continue using the techniques from the program. We conclude that CWMT for children with ADHD is feasible in Saudi Arabia. Larger case-controlled studies are needed to thoroughly investigate the effects of CWMT compared to other interventions in Saudi children with ADHD.
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Affiliation(s)
- Abeer F Almarzouki
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Alessio Bellato
- Institute of Psychology, Psychiatry and Neuroscience (IoPPN), King's College London, London, UK
- School of Psychology, University of Nottingham Malaysia, Semenyih, Malaysia
| | - Maha S Al-Saad
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- General Directorate of Health Affairs in Najran, Ministry of Health, Najran, Saudi Arabia
| | - Basma Al-Jabri
- Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
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Almarzouki AF, Mandili RL, Salloom J, Kamal LK, Alharthi O, Alharthi S, Khayyat N, Baglagel AM. The Impact of Sleep and Mental Health on Working Memory and Academic Performance: A Longitudinal Study. Brain Sci 2022; 12:1525. [PMID: 36358451 PMCID: PMC9688482 DOI: 10.3390/brainsci12111525] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 11/01/2022] [Accepted: 11/07/2022] [Indexed: 04/06/2024] Open
Abstract
Sleep and mental health can affect cognition and academic performance. The present study aimed to investigate the relationships between sleep, mental health, working memory, and academic performance. We collected demographic data from university students during the non-academic summer period and the academic term. We also measured academic performance (GPA), sleep (PSQI), depression (PHQ-9), anxiety (GAD-7), and disordered social media use (SMDS). Working memory was assessed by the Cambridge Neuropsychological Test Automated Battery (CANTAB). We assessed 83 students (42.2% male) with a mean age of 21 years. Compared to the non-academic summer period, students had significantly worse sleep and distress scores in the academic term. Anxiety, depression, and distress scores were significantly correlated with worse sleep quality. Despite worse mental health and sleep in the academic term, working memory improved compared to the non-academic summer period and was also correlated with a higher GPA. However, a higher GPA was significantly associated with longer sleep latency, increased sleep disturbances, and increased use of sleep medication. Students experiencing poor sleep suffered from poor mental health, although they maintained high GPA and working memory scores. Cognitive resilience, including higher working memory, may mask poor sleep quality and mental health among university students.
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Affiliation(s)
- Abeer F. Almarzouki
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Rahaf L. Mandili
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Joud Salloom
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Lujain K. Kamal
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Omimah Alharthi
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Samah Alharthi
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Nusaiba Khayyat
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
| | - Alaa M. Baglagel
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
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Almarzouki AF, Alghamdi RA, Nassar R, Aljohani RR, Nasser A, Bawadood M, Almalki RH. Social Media Usage, Working Memory, and Depression: An Experimental Investigation among University Students. Behav Sci (Basel) 2022; 12:bs12010016. [PMID: 35049627 PMCID: PMC8772695 DOI: 10.3390/bs12010016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 02/01/2023] Open
Abstract
Social media usage (SMU) and its relationship with working memory (WM) and academic performance remain unclear, and there is a lack of experimental evidence. We investigated whether WM mediates the association between SMU and academic performance, including the roles of depression, anxiety, and disordered social media use as possible contributors. A sample of 118 undergraduate students aged 19 to 28 from Saudi Arabia performed a WM test twice; for one assessment, participants were required to interact with social media before the test, and the other test was preceded by painting online. We also measured grade point average (GPA), habitual social media usage (SMU), depression (PHQ-9), anxiety (GAD-7), and disordered social media usage (SMDS). There was no significant difference between WM scores in the social media condition compared to the control condition, but when solely considering at least moderately depressed participants, social media use predicted significantly more errors in the social media condition compared to the control condition. Furthermore, higher SMDS scores were significantly predicted by higher PHQ-9 scores and more hours of habitual SMU. GPA scores were not predicted by WM performance or SMU. The present study is one of the first experimental attempts to compare the relationship between SMU and WM and highlights the priming effect of depression on the relationship between SMU and WM.
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Affiliation(s)
- Abeer F. Almarzouki
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Correspondence:
| | - Renad A. Alghamdi
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (R.N.); (R.R.A.); (A.N.); (M.B.); (R.H.A.)
| | - Roaa Nassar
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (R.N.); (R.R.A.); (A.N.); (M.B.); (R.H.A.)
| | - Reem R. Aljohani
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (R.N.); (R.R.A.); (A.N.); (M.B.); (R.H.A.)
| | - Abdulrahman Nasser
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (R.N.); (R.R.A.); (A.N.); (M.B.); (R.H.A.)
| | - Manar Bawadood
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (R.N.); (R.R.A.); (A.N.); (M.B.); (R.H.A.)
| | - Rawan H. Almalki
- Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia; (R.A.A.); (R.N.); (R.R.A.); (A.N.); (M.B.); (R.H.A.)
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Al-Saad MSH, Al-Jabri B, Almarzouki AF. A Review of Working Memory Training in the Management of Attention Deficit Hyperactivity Disorder. Front Behav Neurosci 2021; 15:686873. [PMID: 34366803 PMCID: PMC8334010 DOI: 10.3389/fnbeh.2021.686873] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 06/28/2021] [Indexed: 11/17/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders among children. Working memory deficits underlie many of the behavioural symptoms of ADHD. Alongside psychostimulant medications, strategies to improve working memory may play an important adjuvant role in the management of ADHD. In this study, we review the role of working memory deficits in ADHD, the evidence surrounding working memory training strategies in the management of the condition, and the factors affecting the success of these strategies in alleviating ADHD symptoms. More specifically, we review several non-pharmacological interventions that target working memory deficits in ADHD, with special emphasis on cognitive working memory training. We conclude that the development of evidence-based interventions such as computerised cognitive training (CCT) could provide an alternative or adjunct to the use of psychostimulants, especially in cases where side effects are a major issue.
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Affiliation(s)
- Maha Saleh Habsan Al-Saad
- Faculty of Medicine, Department of Clinical Physiology, King Abdulaziz University, Jeddah, Saudi Arabia.,Public Health Sector, General Directorate of Health Affairs in Najran, Ministry of Health, Najran, Saudi Arabia
| | - Basma Al-Jabri
- Faculty of Medicine, Department of Pediatrics, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abeer F Almarzouki
- Faculty of Medicine, Department of Clinical Physiology, King Abdulaziz University, Jeddah, Saudi Arabia
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Brown CA, Almarzouki AF, Brown RJ, Jones AKP. Neural representations of aversive value encoding in pain catastrophizers. Neuroimage 2018; 184:508-519. [PMID: 30243959 DOI: 10.1016/j.neuroimage.2018.09.052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 08/14/2018] [Accepted: 09/18/2018] [Indexed: 02/08/2023] Open
Abstract
Chronic pain is exacerbated by maladaptive cognition such as pain catastrophizing (PC). Biomarkers of PC mechanisms may aid precision medicine for chronic pain. Here, we investigate EEG biomarkers using mass univariate and multivariate (machine learning) approaches. We test theoretical notions that PC results from a combination of augmented aversive-value encoding ("magnification") and persistent expectations of pain ("rumination"). Healthy individuals with high or low levels of PC underwent an experimental pain model involving nociceptive laser stimuli preceded by cues predicting forthcoming pain intensity. Analysis of EEG acquired during the cue and laser stimulation provided event-related potentials (ERPs) identifying spatially and temporally-extended neural representations associated with pain catastrophizing. Specifically, differential neural responses to cues predicting high vs. low intensity pain (i.e. aversive value encoding) were larger in the high PC group, largely originating from mid-cingulate and superior parietal cortex. Multivariate spatiotemporal EEG patterns evoked from cues with high aversive value selectively and significantly differentiated the high PC from low PC group (64.6% classification accuracy). Regression analyses revealed that neural patterns classifying groups could be partially predicted (R2 = 28%) from those neural patterns classifying the aversive value of cues. In contrast, behavioural and EEG analyses did not provide evidence that PC modifies more persistent effects of prior expectation on pain perception and nociceptive responses. These findings support the hypothesis of magnification of aversive value encoding but not persistent expression of expectation in pain catastrophizers. Multivariate patterns of aversive value encoding provide promising biomarkers of maladaptive cognitive responses to chronic pain that have future potential for psychological treatment development and clinical stratification.
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Affiliation(s)
- Christopher A Brown
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom; Human Pain Research Group, School of Biological Sciences, University of Manchester, Salford Royal NHS Foundation Trust, Salford, United Kingdom.
| | - Abeer F Almarzouki
- Physiology Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Richard J Brown
- School of Psychological Sciences, University of Manchester, Manchester, United Kingdom
| | - Anthony K P Jones
- Human Pain Research Group, School of Biological Sciences, University of Manchester, Salford Royal NHS Foundation Trust, Salford, United Kingdom
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Almarzouki AF, Brown CA, Brown RJ, Leung MHK, Jones AKP. Negative expectations interfere with the analgesic effect of safety cues on pain perception by priming the cortical representation of pain in the midcingulate cortex. PLoS One 2017; 12:e0180006. [PMID: 28665973 PMCID: PMC5493341 DOI: 10.1371/journal.pone.0180006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 06/08/2017] [Indexed: 12/23/2022] Open
Abstract
It is well known that the efficacy of treatment effects, including those of placebos, is heavily dependent on positive expectations regarding treatment outcomes. For example, positive expectations about pain treatments are essential for pain reduction. Such positive expectations not only depend on the properties of the treatment itself, but also on the context in which the treatment is presented. However, it is not clear how the preceding threat of pain will bias positive expectancy effects. One hypothesis is that threatening contexts trigger fearful and catastrophic thinking, reducing the pain-relieving effects of positive expectancy. In this study, we investigated the disruptive influence of threatening contexts on positive expectancy effects while 41 healthy volunteers experienced laser-induced heat pain. A threatening context was induced using pain-threatening cues that preceded the induction of positive expectancies via subsequent pain-safety cues. We also utilised electroencephalography (EEG) to investigate potential neural mechanisms underlying these effects. Lastly, we used the Fear of Pain Questionnaire to address whether the disruptive effect of negative contexts on cued pain relief was related to the degree of fear of pain. As predicted, participants responded less to pain-safety cues (i.e., experienced more pain) when these were preceded by pain-threatening cues. In this threatening context, an enhancement of the N2 component of the laser-evoked potential was detected, which was more pronounced in fearful individuals. This effect was localised to the midcingulate cortex, an area thought to integrate negative affect with pain experience to enable adaptive behaviour in aversive situations. These results suggest that threatening contexts disrupt the effect of pain relief cues via an aversive priming mechanism that enhances neural responses in the early stages of sensory processing.
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Affiliation(s)
- Abeer F. Almarzouki
- Physiology Department, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- * E-mail:
| | - Christopher A. Brown
- Department of Psychological Sciences, Institute of Psychology, Health and Society, University of Liverpool, Liverpool, United Kingdom
| | - Richard J. Brown
- School of Psychological Sciences, University of Manchester, Manchester, United Kingdom
| | | | - Anthony K. P. Jones
- Human Pain Research Group, Division of Neuroscience and Cognitive Psychology, University of Manchester, Salford Royal NHS Foundation Trust, Salford, United Kingdom
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