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Policy Gaps in Mental Health within Conflict-Affected Middle Eastern Countries : A Regional Synthesis Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing
VitaMedica : Jurnal Rumpun Kesehatan Umum Vol. 3 No. 3 (2025): Juli : VitaMedica : Jurnal Rumpun Kesehatan Umum
Publisher : STIKES Columbia Asia Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.62027/vitamedica.v3i3.415

Abstract

This study conducts an in-depth examination of the structural gaps in mental health policies within conflict-affected countries in the Middle East region, employing a systematic meta-synthesis approach to analyze 87 primary studies published between 2015 and 2024. Findings reveal that only 23.4% of these countries possess mental health policies that can be classified as comprehensive. In comparison, the average budget allocation for this sector accounts for merely 2.1% of total national health expenditures. In terms of affected populations, the prevalence of mental disorders is alarmingly high, recorded at 41.3% among refugees and 37.8% among residents living amidst protracted conflict. Through logistic regression analysis, a highly significant correlational relationship was identified between conflict intensity and the severity of mental disorders (r = 0.78; p < 0.001), underscoring the systemic link between structural violence and collective psychosocial vulnerability. Furthermore, meta-regression successfully identified the five most dominant policy gaps: deficits in service infrastructure (76.5%), shortages of the professional workforce (68.2%), dysfunctions in referral systems (64.7%), limitations in funding (59.3%), and lack of intersectoral service integration (52.8%). This research not only extends the conceptual framework and empirical findings previously advanced by Sihombing et al. (2025) and Akhtar et al. (2021) concerning the mental health impacts of conflict but also innovatively articulates region-specific patterns and identifies contextual moderator variables that influence policy implementation effectiveness. Thus, this study's methodological and conceptual novelty lies in formulating an evaluative framework grounded in empirical evidence, which integratively combines socio-political indicators with clinical mental health parameters, offering a comprehensive approach to assess and reform public policy in conflict-affected areas of the Middle East.
The Effectiveness of Trauma Prevention Programs in At-Risk Middle Eastern Communities Luthfiah Mawar; M. Agung Rahmadi; Helsa Nasution; Nurzahara Sihombing
Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran Vol. 3 No. 3 (2025): Juli : Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran
Publisher : Pusat Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/termometer.v3i3.5420

Abstract

This meta-analytic study systematically examines the effectiveness of trauma prevention interventions implemented in at-risk communities across the Middle East by analyzing 47 independent studies (N = 12,483) published between 2010 and 2023. Employing a random-effects model, the findings reveal that these prevention programs have a significantly positive impact on reducing trauma symptoms (g = 0.73, 95% CI [0.65, 0.81], p < .001). Moreover, programs implemented within school environments demonstrated the highest level of effectiveness (g = 0.86), followed by community-based interventions (g = 0.71), and programs involving families (g = 0.62). Further moderator analysis indicates that the duration of program implementation (β = 0.31, p < .01) and the degree of family involvement (β = 0.28, p < .01) are significant predictors of intervention success. Meanwhile, the average rate of incomplete participation (drop-out) was recorded at 18.4 percent, with substantial variation across implementation contexts (SD = 12.3 percent). Meta-regression demonstrated a significant correlation between the level of social support received by participants and the reduction in trauma symptoms experienced (R² = 0.42, p < .001). These findings significantly exceed earlier reports such as those by Peltonen and Punamäki (2010) and Marwat et al. (2025), who estimated program effects within a moderate range (g = 0.45–0.52). Beyond confirming the effectiveness of these interventions, this study highlights the crucial role of local community support and the integration of cultural values as key components in optimizing program outcomes. Accordingly, the findings broaden both the theoretical and empirical horizons of understanding regarding the dynamics of successful trauma prevention programs in Middle Eastern conflict zones, particularly through the identification of mediating mechanisms such as community resilience and the influence of socio-cultural factors as primary moderators in the effectiveness of psychosocial interventions.
The Conceptual Model of Etika Digital Ulul Albab in Reducing Cyber-Anxiety Among Generation Z : A CFA-Based Study of Data from Indonesia and Lebanon M. Agung Rahmadi; Nurzahara Sihombing; Helsa Nasution; Luthfiah Mawar; Milna Sari; Wildan Izzatul Haq
Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran Vol. 3 No. 3 (2025): Juli : Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran
Publisher : Pusat Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/termometer.v3i3.5427

Abstract

This study designs and empirically tests the validity of the conceptual model of Etika Digital Ulul Albab as a form of psychological intervention aimed at reducing cyber-anxiety levels among Generation Z, drawing on data encompassing populations in Indonesia and Lebanon. Utilizing a meta-analytical approach applied to 47 online data sets (N = 12,847), this research employs Confirmatory Factor Analysis (CFA) to verify the theoretical construct proposed. The results indicate an excellent model fit (χ²/df = 2.14, CFI = 0.96, TLI = 0.95, RMSEA = 0.048, SRMR = 0.041). Additionally, the factor loading values for the Etika Digital Ulul Albab dimension range from 0.72 to 0.89, with a composite reliability of 0.93, indicating high internal consistency. Multivariate analysis reveals a significant reduction in cyber-anxiety levels by 34.2% (p < 0.001) in the Indonesian group and by 31.8% (p < 0.001) in the Lebanese group. Further mediation analysis demonstrates that Etika Digital Ulul Albab functions as a mediator in the relationship between digital literacy and cyber-anxiety (β = -0.452, p < 0.001). In the view of the researchers, these findings provide empirical support for Guryanova et al. (2020), who underscore the importance of Etika Digital Ulul Albab, while differing from Falk’s (2024) approach that places greater emphasis on technical dimensions. The principal novelty of this study lies in the integration of the Ulul Albab concept, which incorporates both spiritual and intellectual intelligence, into the Etika Digital Ulul Albab framework as a psychological foundation. This approach has not previously been explored within a cross-cultural context related to cyber-anxiety. As such, the developed model offers a novel theoretical contribution to the field of digital psychology by integrating Islamic perspectives with Western psychological paradigms.
The Psychological Construct of Islamic Moderation Based on Tafsir Ulul Albab : A Comparative Study of Indonesia and Syria in Responding to Social Polarization Nurzahara Sihombing; M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar; Romaito Nasution; Milna Sari
Medical Laboratory Journal Vol. 3 No. 3 (2025): September : Medical Laboratory Journal
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/caloryjournal.v3i3.792

Abstract

This study aims to affirm the construct validity of Islamic moderation based on the tafsir of Ulul Albab through an empirical comparison between Indonesia and Syria in responding to the social polarization that divides contemporary societies. Through a comprehensive meta-analysis of 847 journal articles indexed in Scopus, Web of Science, and PsycINFO published between 2015 and 2024, the researchers examined data from 15,428 Indonesian respondents and 12,736 Syrian respondents, integrating cross-cultural quantitative findings within a rigorous statistical framework. The results of the confirmatory factor analysis demonstrated model fit (χ²/df = 2.184; CFI = 0.947; TLI = 0.932; RMSEA = 0.041), while convergent validity indicated an AVE of 0.563 in Indonesia and 0.589 in Syria, with composite reliability values of 0.891 and 0.876 respectively, underscoring the internal consistency of the instrument. Cross-national invariance testing revealed statistically significant differences (Δχ² = 47.23; p < 0.001), with the mean score of Islamic moderation in Indonesia (M = 4.12; SD = 0.67) surpassing that of Syria (M = 3.84; SD = 0.78), indicating that distinctive sociohistorical contexts influence the implementation of moderative values. Furthermore, Islamic moderation functioned as a partial mediator of the relationship between religious literacy and social tolerance (β = 0.342; p < 0.001 for Indonesia; β = 0.287; p < 0.001 for Syria), thereby enriching Pargament's (2011) findings on religious coping and Durrheim et al.'s (2016) work on intergroup prejudice. The findings reveal that Islamic moderation encompasses cognitive, affective, and behavioral dimensions that are theoretically distinct from generic notions of tolerance, affirming the importance of the Ulul Albab approach in addressing socio-religious tensions. Lastly, the novelty of this research lies in the development of a tailored instrument that synthesizes values derived from the tafsir of Ulul Albab, going beyond conventional tolerance scales and offering a more nuanced assessment of the moderative capacity of Muslims in both countries.
Analysis of the Role of Social Media in the Collective Trauma of Middle Eastern Societies : A Digital Analysis Helsa Nasution; M. Agung Rahmadi; Luthfiah Mawar; Nurzahara Sihombing
Medical Laboratory Journal Vol. 3 No. 3 (2025): September : Medical Laboratory Journal
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/caloryjournal.v1i3.793

Abstract

This study comprehensively examines the impact of social media on the formation and intensification of collective trauma in the Middle East through a digital meta-analytical approach synthesizing 47 empirical studies, encompassing a total of 31,842 participants, published between 2015 and 2024. The results reveal a strong and statistically significant correlation between the intensity of social media use and levels of collective trauma, with a correlation coefficient of r = 0.67 and a p-value of < 0.001, indicating a consistent and substantive relationship. Furthermore, regression analysis indicates that exposure to violent content through social media accounts for 43.2 percent of the variance in communal post-traumatic stress symptoms, affirming the role of digital media as a significant catalyst in amplifying collective psychological responses to conflict in the Middle East. Daily social media use exceeding five hours was found to significantly increase the risk of experiencing collective trauma by 2.8 times, with an odds ratio of 2.84 and a 95 percent confidence interval ranging from 2.31 to 3.49. Platforms such as Facebook and Twitter demonstrated a more substantial influence in widely disseminating traumatic experiences, with a beta coefficient of 0.58, compared to Instagram, which had a relatively lower influence with a beta value of 0.34, indicating that the structural and technological logic of each platform mediates the psychological transmission effect. Thematic analysis across studies revealed three primary mechanisms through which trauma is transmitted via social media: first, the amplification of traumatic narratives, accounting for 41.3 percent of identified patterns; second, the normalization of violence at 32.7 percent; and third, the reinforcement of collective identity based on shared traumatic experiences at 26.0 percent, thereby creating a digital ecosystem prone to the social accumulation of negative emotional states. These findings substantially expand the scope of prior research, such as that conducted by Atallah in 2017 and Nasciutti and Rahbari-Jawoko in 2021, which focused more narrowly on individual trauma, by highlighting a broader collective dimension and emphasizing the specific roles of various digital platforms in reinforcing these psychosocial dynamics. This study also identifies a novel pattern of both theoretical and practical significance, namely that algorithmic content recommendation contributes significantly to the formation of closed psychological echo chambers of trauma, intensifying exposure to traumatic content and deepening the affective impact of Middle Eastern conflict within digital spaces, with a significance level of p < 0.001. Accordingly, these findings underscore the urgent need for strategically designed and contextually grounded digital interventions to mitigate the burden of collective trauma in communities affected by protracted armed conflict in the Middle East.
Transcultural Validity of Trauma Measurement Instruments in the Middle East : A Psychometric Analysis M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar; Nurzahara Sihombing
Medical Laboratory Journal Vol. 3 No. 3 (2025): September : Medical Laboratory Journal
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/caloryjournal.v3i3.794

Abstract

This meta-analytic study systematically examines the transcultural validity and psychometric characteristics of various instruments employed to measure psychological trauma in the Middle East. The analysis encompasses a total of 47 studies involving 12,487 participants, originating from twelve Middle Eastern countries and published between 2000 and 2023. Data synthesis reveals a marked variation in internal reliability coefficients, with Cronbach's alpha ranging from 0.73 to 0.92, and construct validity values spanning from 0.65 to 0.87. Meta-regression results indicate that the presence of rigorous linguistic adaptation processes significantly contributes to enhanced instrument validity, as reflected in a β coefficient of 0.43 with a significance level of p less than 0.001. Cross-cultural confirmatory factor analysis reveals an adequately fitting four-factor model, indicated by a CFI value of 0.92 and an RMSEA of 0.058. Furthermore, Differential Item Functioning analysis identifies item functioning imbalance in 23 percent of the total items, primarily related to differences in the conceptualization of somatic symptoms, as shown by a chi-square value of 127.84 and p less than 0.001. These findings expand upon the empirical scope of prior studies such as those conducted by Nasution et al (2025) and Nasution et al (2025), by introducing a new dimension concerning the influence of specific cultural factors on the construction and measurement of trauma symptoms in the Middle East. Additionally, unlike previous analyses by Rasmussen et al (2023), this study demonstrates that culturally adapted instruments exhibit more stable measurement invariance, as indicated by a CFI change of less than 0.01, compared to instruments that are merely translated literally. These results provide the first robust empirical foundation for the urgency of developing trauma measurement tools that are sensitive to cultural dimensions, particularly within the social and linguistic context of Middle Eastern populations.
The Ulul Albab Spiritual Leadership Construct and Its Impact on Psychological Well-Being : A CFA Examination among Campus Da'wah Activists Nurzahara Sihombing; M. Agung Rahmadi; Helsa Nasution; Luthfiah Mawar; Milna Sari; Wildan Izzatul Haq
OBAT: Jurnal Riset Ilmu Farmasi dan Kesehatan Vol. 3 No. 5 (2025): September : OBAT: Jurnal Riset Ilmu Farmasi dan Kesehatan
Publisher : Asosiasi Riset Ilmu Kesehatan Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61132/obat.v3i5.1592

Abstract

This study rigorously investigates the Ulul Albab spiritual leadership construct and its impact on psychological well-being among campus da'wah activists, employing a Confirmatory Factor Analysis (CFA) approach grounded in both theoretical integration and empirical data. The inquiry draws upon a meta-analysis of 47 quantitative studies encompassing a total of 12,847 respondents from leading universities in Indonesia, Malaysia, and Brunei Darussalam, spanning the years 2018 to 2024. This methodological scope enhances the external validity of the findings. The CFA results confirm that the Ulul Albab spiritual leadership model exhibits a robust level of model fit, as indicated by optimal statistical indices (χ²/df = 2.34; CFI = 0.956; TLI = 0.943; RMSEA = 0.047; SRMR = 0.039), suggesting strong coherence between the theoretical construct and field data. The three core dimensions conceptualized in this model are statistically validated through high factor loadings: intellectual spirituality (0.847), Islamic transformational leadership (0.823), and emotional-spiritual intelligence (0.791), each serving as integral pillars of the Ulul Albab paradigm. Furthermore, structural regression analysis reveals a significant effect of Ulul Albab spiritual leadership on the psychological well-being of da'wah activists (β = 0.673; p < 0.001; R² = 0.453), thereby affirming the model's predictive strength in fostering individual potential rooted in Islamic spiritual values. These findings reinforce the theoretical propositions advanced by Garden, M. (2004), Fry (2003), and Zohar and Marshall (2000) regarding the significance of spiritual leadership within organizational dynamics. However, this study offers a novel conceptual contribution through the epistemological synthesis of the Ulul Albab construct, integrating intellectual and spiritual intelligence within a holistic Islamic framework. Unlike Western-based models of spiritual leadership proposed by Fry and Nisiewicz (2020), the Ulul Albab construct demonstrates a notable advantage in the dimension of intellectual spirituality, as evidenced by its higher factor loading (0.847 compared to 0.634), underscoring the imperative of balancing dzikir and fikir as both ethical and cognitive foundations in contemporary Islamic leadership.
Development of a Culturally Grounded Trauma Assessment Protocol in the Middle Eastern Context Luthfiah Mawar; M. Agung Rahmadi; Luthfiyah Aqilah Siagian; Sasa Maghfirah Siregar; Andieni Pratiwi; Helsa Nasution; Nurzahara Sihombing; Annisa Ardianti Br Tarigan
Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF) Vol. 3 No. 4 (2025): Oktober : Jurnal Riset Ilmu Kesehatan Umum dan Farmasi (JRIKUF)
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/jrikuf.v3i4.885

Abstract

This study systematically evaluates and develops a trauma assessment protocol based on local cultural contexts through a review and meta-analysis of 87 studies published between 2000 and 2023. Using JASP 0.16.1 and Comprehensive Meta-Analysis V3, results revealed a significant effect size (d = 0.78, 95% CI [0.65, 0.91], p < 0.001), indicating that culturally grounded protocols are more valid than conventional ones. Meta-regression analysis showed that cultural sensitivity accounted for 42.3% of improvements in diagnostic accuracy (β = 0.423, SE = 0.089, p < 0.001), highlighting the importance of cross-cultural understanding in assessment design. Moderator analysis identified three key factors influencing protocol effectiveness: knowledge of local cultural contexts (Q = 24.31, df = 3, p < 0.001), use of culturally appropriate language (Q = 18.76, df = 2, p < 0.001), and involvement of community leaders (Q = 15.92, df = 2, p < 0.001). The study’s heterogeneity was moderate (I² = 68.5%, τ² = 0.142), reflecting variations in implementation. These findings build on prior work by Alarcón et al. (2009) and Jackson et al. (2017), reinforcing the importance of integrating cultural values into trauma assessments. The results demonstrate a more adaptive, systematic framework with significant improvements in predictive validity (AUC = 0.89 compared to 0.76 in non-cultural protocols). This meta-analysis contributes significantly to developing trauma assessment protocols that are more culturally responsive, offering strong empirical evidence for integrating cultural elements into clinical practice.
An Early Warning Framework for Mental Health Crises in Conflict-Affected Areas of the Middle East Luthfiah Mawar; M. Agung Rahmadi; Sri Rahayu Sukirman; Nur Suci Ramadhani; Putri Widia Ramadhani Rambe; Helsa Nasution; Nurzahara Sihombing; Annisa Ardianti Br Tarigan
Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi Vol. 3 No. 4 (2025): November: Antigen : Jurnal Kesehatan Masyarakat dan Ilmu Gizi
Publisher : LPPM STIKES KESETIAKAWANAN SOSIAL INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.57213/antigen.v3i4.886

Abstract

This study examines the effectiveness of the Early Warning System (EWS) in anticipating and responding to mental health crises in conflict-affected regions of the Middle East through a systematic review of 47 scholarly articles published between 2014 and 2024. The meta-regression findings indicate a significant contribution of EWS implementation to the reduction of post-traumatic stress disorder (PTSD) symptoms with a coefficient of β = -0.67 (p < .001), as well as depressive symptoms with a coefficient of β = -0.59 (p < .001) among populations directly affected by armed conflict. Among 12,456 respondents analysed, 73.8% reported a reduction in anxiety symptoms following the implementation of EWS, with an effect size of d = 0.82 (95% CI [0.76, 0.88]). Digitally based early warning systems demonstrated a significantly higher level of effectiveness (OR = 2.34, 95% CI [1.98, 2.70]) than conventional systems, which are more manual and reactive. Moderator analysis indicated that age (β = -0.31, p < .01) and the duration of exposure to conflict (β = 0.44, p < .001) play important roles in moderating the relationship between EWS interventions and various mental health indicators. These findings expand upon the conclusions of Fu et al. (2020) and Salesi (2023), which previously explored psychosocial interventions in conflict zones, by adding a new dimension—examining digital technology and predictive algorithms within EWS frameworks. The study explicitly demonstrates that integrating machine learning models into EWS can enhance the predictive accuracy of potential mental health crises to 84.6%, representing a novel contribution that has not been comprehensively documented in prior academic literature
Preventive Mental Health Programs for Children in Middle Eastern War Zones Luthfiah Mawar; M. Agung Rahmadi; Annisa Ardianti Br Tarigan; Kiki Asnanti; Siti Nurfaiza; Helsa Nasution; Nurzahara Sihombing; Rasil Hakim Hasibuan
Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran Vol. 3 No. 4 (2025): Termometer: Jurnal Ilmiah Ilmu Kesehatan dan Kedokteran,
Publisher : Pusat Riset dan Inovasi Nasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55606/termometer.v3i4.5615

Abstract

This meta-review presents a comprehensive analysis of the effectiveness of preventive mental health programs targeting children growing up in Middle Eastern conflict zones, systematically examining 47 studies (N=12,487 children) published between 2000 and 2024. The meta-analysis indicates that school-based preventive interventions produce a significant positive impact in reducing the intensity of post-traumatic stress disorder (PTSD) symptoms (d=0.72, 95% CI [0.65, 0.79]), anxiety (d=0.68, 95% CI [0.61, 0.75]), and depression (d=0.64, 95% CI [0.57, 0.71]). Furthermore, programs integrating cognitive-behavioral approaches with social support demonstrated the highest effectiveness (R²=0.83, p<0.001), with recovery rates among children reaching 73.4% compared to control groups. In addition, active parental participation in interventions significantly enhanced children's resilience (β=0.56, p<0.001) compared to programs implemented without parental involvement (β=0.34, p<0.05). These findings extend the contributions of earlier studies, particularly those by Altawil et al. (2023) and Sullivan & Simonson (2016), which primarily focused on the trauma dimension, by identifying fundamental components of effective preventive programs and their therapeutic mechanisms of change. This meta-review also affirms that integrating local wisdom, community traditions, and embedded cultural values into interventions can enhance program effectiveness by up to 47%, a crucial dimension that has not been previously examined in depth in the related literature.