Enhancing Knowledge of Anxiety Disorders in Primary School Students Through Jigsaw Puzzle Activity

Authors

  • Charles Ganaprakasam Sekolah Kebangsaan Taman Selasih
  • Tinagaran Selvarajah Sekolah Jenis Kebangsaan (Tamil) Telok Panglima Garang
  • Tatchayani Santreseker Sekolah Kebangaan Air Merah
  • Muralitharan Shanmugam Sekolah Kebangsaan Jalan Panglima Bukit Gantang

DOI:

https://doi.org/10.33736/jcshd.5589.2023

Keywords:

anxiety-related disorders, mental health literacy, jigsaw puzzle

Abstract

The study aims to develop an Anxiety-Related Disorders Jigsaw Puzzle (ADJP) as an intervention tool and to determine its effectiveness in enhancing children's mental health literacy on anxiety-related disorders. The ADJP contained four modules defining anxiety-related disorders, symptoms, risk factors, and prevention strategies. Seven subject-matter experts and participants evaluated these modules, and feedback was used to improve the tool further. A one-group pretest-posttest quasi-experimental design was then used to test the ADJP's efficacy in enhancing knowledge of anxiety-related disorders among primary school students (N=35). The results showed significant differences in anxiety literacy (A-Lit) scores between the intervention and control groups, implying that the ADJP intervention effectively enhanced the knowledge of anxiety-related disorders among study participants. Findings suggest the tool could be used as a mental health literacy resource for classroom activities to improve students' awareness of anxiety-related disorders.

 

References

Aga Mohd Jaladin, R., Fernandez, J. A., Muhamad, A. S., Mohammad Roose, A. R., & Sipon, S. (2023). Development of a Cognitive Therapy Module To Enhance Self-Esteem for Youth With Physical Disabilities in Malaysia. Journal of Health and Translational Medicine, 26(1), 16–26. https://doi.org/10.22452/jummec.vol26no1.5

Ahmadi, N. A., Muhd Yusoff, F., Ratnasingam, S., Mohamed, F., Nasir, N. H., Mohd Sallehuddin, S., Mahadir Naidu, B., Ismail, R., & Aris, T. (2015). Trends and factors associated with mental health problems among children and adolescents in Malaysia. International Journal of Culture and Mental Health, 8(2), 125–136.

Alexander, E. R., Savitz-Romer, M., Nicola, T. P., Rowan-Kenyon, H. T., & Carroll, S. (2022). "We Are the Heartbeat of the School": How School Counselors Supported Student Mental Health During the COVID-19 Pandemic. Professional School Counseling, 26(1b), 2156759X2211055. https://doi.org/10.1177/2156759x221105557

Amado-Rodríguez, I. D., Casañas, R., Mas-Expósito, L., Castellví, P., Roldan-Merino, J. F., Casas, I., Lalucat-Jo, L., & Fernández-San Martín, M. I. (2022). Effectiveness of Mental Health Literacy Programs in Primary and Secondary Schools: A Systematic Review with Meta-Analysis. Children (Basel, Switzerland), 9(4), 480.

Amirah, S. N., Husna, H., Muhamad Afnan, A., Suriani, I., & Ahmad Iqmer Nashriq, M. N. (2020). Sociodemographic factors of mental health literacy among homemakers living in low-cost apartments in Puchong, Selangor, Malaysia. Malaysian Journal of Medicine and Health Sciences, 16(1), 121–125.

Ang, C. S. (2020). Anxiety in Malaysian children and adolescents: Validation of the Screen for Child Anxiety Related Emotional Disorders (SCARED). Trends Psychiatry Psychother, 42(1),7–15.

Azad, N., Shahid, A., Abbas, N., Shaheen, A., & Munir, N. (2017). Anxiety And Depression In Medical Students Of A Private Medical College. Journal of Ayub Medical College, 29(1), 123–127

Azham, A. A., & Janon, N. S. (2021). The relationship between parental anxiety, child's behavioural inhibition and child anxiety. Southeast Asia Early Childhood Journal, 10(1), 50–61. https://doi.org/10.37134/saecj.vol10.1.5.2021

Baughman, N., Prescott, S. L., Rooney, R. (2020). The Prevention of Anxiety and Depression in Early Childhood. Frontier. Psychology, 11. https:/doi.org/10.3389/fpsyg.2020.517896

Borza L. (2017). Cognitive-behavioural therapy for generalized anxiety. Dialogues in Clinical Neuroscience, 19(2), 203–208.

Brook, C. A., & Schmidt, L. A. (2008). Social anxiety disorder: a review of environmental risk factors. Neuropsychiatric Disease and Treatment, 4(1), 123–143.

Brooks, H., Syarif, A. K., Pedley, R., Irmansyah, I., Prawira, B., Lovell, K., Opitasari, C., Ardisasmita, A., Tanjung, I. S., Renwick, L., Salim, S., & Bee, P. (2021). Improving mental health literacy among young people aged 11–15 in Java, Indonesia: the co-development of a culturally-appropriate, user-centred resource (The IMPeTUs Intervention). Child and Adolescent Psychiatry and Mental Health, 15(1), 1–18. https://doi.org/10.1186/s13034-021-00410-5

Cranmer, G. (Ed.) (2017). One-Group Pretest–Posttest Design. SAGE Publications, Vols. 1-4. Inc, https://doi.org/10.4135/9781483381411

Crescentini, C., Capurso, V., Furlan, S., & Fabbro, F. (2016). Mindfulness-oriented meditation for primary school children: Effects on attention and psychological well-being. Frontiers in Psychology, 7, 1–12. https://doi.org/10.3389/fpsyg.2016.00805

Cruz, E., Martins, P., & Diniz, P. (2017). Factors related to the association of social anxiety disorder and alcohol use among adolescents: a systematic review. Jornal de Pediatria, 93(5), 442–451.

Dewi, D. R., Lestari, A., & Vellyana, D. (2020). The Effect of Therapy Containing Puzzle on Decreasing Anxiety of Hospitalized Children Aged 3–6 Years. 27(ICoSHEET, 2019), 413–415. https://doi.org/10.2991/ahsr.k.200723.105

Fisak, B., Persad, L., Gallegos, J., & Barrett, P. (2019). Prevention of anxiety in preschool-aged children. In B. Fisak & P. Barrett (Eds.), Anxiety in preschool children: Assessment, treatment, and prevention (pp. 215–237). Routledge/Taylor & Francis Group.

Fissler, P., Küster, O. C., Laptinskaya, D., Loy, L. S., Von Arnim, C. A. F., & Kolassa, I. T. (2018). Jigsaw puzzling taps multiple cognitive abilities and is a potential protective factor for cognitive aging. Frontiers in Aging Neuroscience, 10, 1–11. https://doi.org/10.3389/fnagi.2018.00299

Ganaprakasam, C. & Selvaraja, T. (2020). Cognitive Behavioural Group Therapy on Test Anxiety among Primary School Students. Malaysian Journal of Social. Sciences and Humanities. 5, 61–67.

Ganaprakasam, C., Humayra, S., Ganasegaran, K., & Arkappan, P. (2021). Escalation of Suicide Amidst The COVID-19 Pandemic in Malaysia: Progressive Strategies for Prevention. Malaysian Journal of Social Sciences and Humanities, 6(10), 592–596.

Gimba, S. M., Harris, P., Saito, A., Udah, H., Martin, A., & Wheeler, A. J. (2020). The modules of mental health programs implemented in schools in low- and middle-income countries: findings from a systematic literature review. BMC Public Health, 20(1), 1581.

Gulliver, A., Griffiths, K. M., Christensen, H., Mackinnon, A., Calear, A. L., Parsons, A., Bennett, K., Batterham, P. J., & Stanimirovic, R. (2012). Internet-based interventions to promote mental health help-seeking in elite athletes: an exploratory randomized controlled trial. Journal of Medical Internet Research, 14(3), e69. https://doi.org/10.2196/jmir.1864

Jafar, A., Dollah, R., Sakke, N., Mapa, M. T., Hua, A. K., Eboy, O. V., Joko, E. P., Hassan, D., & Hung, C. V. (2022). Assessing the challenges of e-learning in Malaysia during the pandemic of Covid-19 using the geospatial approach. Scientific Reports, 12(1), 1–10. https://doi.org/10.1038/s41598-022-22360-4

Jorm, A. F., Korten, A. E., Jacomb, P. A., Christensen, H., Rodgers, B., & Pollitt, P. (1997). "Mental health literacy": a survey of the public's ability to recognise mental disorders and their beliefs about the effectiveness of treatment. The Medical Journal of Australia, 166(4), 182–186. https://doi.org/10.5694/j.1326-5377.1997.tb140071.

Khesht-Masjedi, M. F., Shokrgozar, S., Abdollahi, E., Habibi, B., Asghari, T., Ofoghi, R. S., & Pazhooman, S. (2019). The relationship between gender, age, anxiety, depression, and academic achievement among teenagers. Journal of Family Medicine and Primary Care, 8(3), 799–804. https://doi.org/10.4103/jfmpc.jfmpc_103_18

Krass I. (2016). Quasi-experimental designs in pharmacist intervention research. International Journal of Clinical Pharmacy, 38(3), 647–654. https://doi.org/10.1007/s11096-016-0256-y

Larun, L., Nordheim, L. V., Ekeland, E., Hagen, K. B., & Heian, F. (2006). Exercise in the prevention and treatment of anxiety and depression among children and young people. The Cochrane Database of Systematic Reviews, 3(3), CD004691.

Len, N., Madihie, A., & Yusoff, S. M. (2020). Development of Cognitive Therapy Group Intervention ( CTGI ) on Resilience among Adolescents. Journal of Cognitive Sciences and Human Development, 6(2), 1–10.

Lewinsohn, P. M., Holm-Denoma, J. M., Small, J. W., Seeley, J. R., & Joiner, T. E., Jr (2008). Separation anxiety disorder in childhood as a risk factor for future mental illness. Journal of the American Academy of Child and Adolescent Psychiatry, 47(5), 548–555.

Mahfar, M., Noah, S. M., & Senin, A. A. (2019). Development of Rational Emotive Education Module for Stress Intervention of Malaysian Boarding School Students. SAGE Open, 9(2). https://doi.org/10.1177/2158244019850246

Malaysia Ministry of Education. (2023). Panduan Pelaksanaan Program Minda Sihat Kalendar Akademik Sesi 2023/2024. https://shorturl.at/hiHY7

McGuire, J. F., Lewin, A. B., & Storch, E. A. (2014). Enhancing exposure therapy for anxiety disorders, obsessive-compulsive disorder and post-traumatic stress disorder. Expert Review of Neurotherapeutics, 14(8), 893–910.

Mohamad, N. E., Sidik, S. M., Akhtari-Zavare, M., & Gani, N. A. (2021). The prevalence risk of anxiety and its associated factors among university students in Malaysia: a national cross-sectional study. BMC Public Health, 21(1), 1–12. https://doi.org/10.1186/s12889-021-10440-5

National Health and Morbidity Survey (NHMS). Ministry of Health Malaysia. 2020. https://iku.moh.gov.my/nhms (accessed on 10 September 2022).

National Institute of Mental Health. (2018). Anxiety disorder. https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder

Neni, W. S., Jagathisswary, G., Anderson, A. E., Norshafarina, S. K., Afiq, Z. M., Irwanto, Ariafandi, A., Isnaeni, A. A., Nadzirah, T. I. T. I., & Haliza, B. (2021). Development of Puzzle-Based Intervention for Adolescents to Enhance the Knowledge on Depression Management. Malaysian Journal of Public Health Medicine, 21(2), 149–161. https://doi.org/10.37268/mjphm/vol.21/no.2/art.877

Noah, S. M., & Ahmad, J. (2005). Module development: How to develop training modules and academic modules. Serdang: Universiti Putra Malaysia

Phoa, P. K. A., Ab Razak, A., Kuay, H. S., Ghazali, A. K., Ab Rahman, A., Husain, M., Bakar, R. S., & Abdul Gani, F. (2023). Predictors of Mental Health Literacy among Parents, Guardians, and Teachers of Adolescents in West Malaysia. International Journal of Environmental Research and Public Health, 20(1), 825. https://doi.org/10.3390/ijerph20010825

Renwick, L., Pedley, R., Johnson, I., Bell, V., Lovell, K., Bee, P., & Brooks, H. (2022). Mental health literacy in children and adolescents in low- and middle-income countries: a mixed studies systematic review and narrative synthesis. European Child and Adolescent Psychiatry, 10.1007/s00787-022-01997-6.

Russell, J. D. (1974). Modular instruction: A guide to the design, selection, utilization and evaluation of modular materials. Minneapolis, MN: Burgess Publishing.

Scaini, S., Rossi, F., Rapee, R.M., Bonomi, F., Ruggiero, G.M., Incerti, A., 2022. The Cool Kids as a School-Based Universal Prevention and Early Intervention Program for Anxiety: Results of a Pilot Study. International Journal of Environmental Research and Public Health, 19(2), 941. https://doi.org/10.3390/ijerph19020941

Selamat, N. W., Gobu, J., Irwanto, Sary, D. D., Kamaruddin, N. S., Zaki, M. A., Selamat, A., Selamat, A. I., Idris, T. I. N. T., & Baharudin, H. (2021). Enhancement of knowledge and attitude level on depression via knowledge, depression and adolescents (Kda) puzzles. Journal of Indian Association for Child and Adolescent Mental Health, 17(4), 182–199. https://doi.org/10.1177/0973134220210412

Shum, A. K., Lai, E. S., Leung, W. G., Cheng, M. N., Wong, H. K., So, S. W., Law, Y. W., & Yip, P. S. (2019). A Digital Game and School-Based Intervention for Students in Hong Kong: Quasi-Experimental Design. Journal of Medical Internet Research, 21(4), e12003. https://doi.org/10.2196/12003

Simkiss, N. J., Gray, N. S., Malone, G., Kemp, A., & Snowden, R. J. (2020). Improving mental health literacy in year 9 high school children across Wales: a protocol for a randomized control treatment trial (RCT) of a mental health literacy programme across an entire country. BMC Public Health, 20(1), 727. https://doi.org/10.1186/s12889-020-08736-z

Singh, S., Zaki, R. A., & Farid, N. D. N. (2018). Mental Health Literacy Among Young Adolescents in Selangor. Malaysian Journal of Youth Studies, 2(11), 68–97.

Singh, S., Zaki, R. A., & Farid, N. D. N. (2020). Adolescent mental health literacy and its association with depression. ASM Science Journal, 13(5), 207–216.

Singh, S., Zaki, R. A., Farid, N. D. N., & Kaur, K. (2022). The Determinants of Mental Health Literacy among Young Adolescents in Malaysia. International Journal of Environmental Research and Public Health, 19(6), 3242. https://doi.org/10.3390/ijerph19063242

Singh, S., Zaki, R. A., Farid, N. D. N., & Kaur, K. (2022). The Determinants of Mental Health Literacy among Young Adolescents in Malaysia. International Journal of Environmental Research and Public Health, 19(6), 3242. https://doi.org/10.3390/ijerph19063242

Tuckman, B. W., & Waheed, M. A. (1981). Evaluating an Individualized Science Programme For Community College Students. Journal of Research in Science Teaching, 18, 489-495

Tuijnman, A., Kleinjan, M., Hoogendoorn, E., Granic, I., & Engels, R. C. (2019). A Game-Based School Program for Mental Health Literacy and Stigma Regarding Depression (Moving Stories):Protocol for a Randomized Controlled Trial. JMIR Research Protocols, 8(3), e11255. https://doi.org/10.2196/11255

Yu, Y., Oh, Y., Kounios, J., & Beeman, M. (2022). Dynamics of hidden brain states when people solve verbal puzzles. NeuroImage, 255, 119202. https://doi.org/10.1016/j.neuroimage.2022.119202

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Published

2023-09-30

How to Cite

Ganaprakasam, C., Selvarajah, T. ., Santreseker , T. ., & Shanmugam, M. (2023). Enhancing Knowledge of Anxiety Disorders in Primary School Students Through Jigsaw Puzzle Activity. Journal of Cognitive Sciences and Human Development, 9(2), 186–208. https://doi.org/10.33736/jcshd.5589.2023