Turky H. Almigbal

Background: The Leary Impostorism Scale (LIS) is a brief established instrument designed to assess impostorism; however, no validated Arabic version is currently available. This study aimed to translate, culturally adapt, and evaluate the psychometric properties of the Arabic LIS among university students. Methods: A cross-sectional validation study was conducted among Arabic-speaking university students in Saudi Arabia. Participants completed the Arabic LIS and comparator measures of impostorism, self-efficacy, and perfectionism. Psychometric evaluation included internal consistency, exploratory and confirmatory factor analyses, construct and concurrent validity, and test–retest reliability. Results: A total of 185 participants with complete LIS data were included in the psychometric analyses. The Arabic LIS demonstrated excellent internal consistency (Cronbach’s α = 0.93; McDonald’s ω = 0.93). Factorability indices supported factor analysis [KMO = 0.90; Bartlett’s χ ² (21) = 1536.59, p < 0.001]. Exploratory factor analysis based on polychoric correlations supported a single-factor structure, with factor loadings ranging from 0.81 to 0.94 and an eigenvalue of 5.45. Confirmatory factor analysis showed statistically significant freely estimated loadings ( p < 0.001), with standardized loadings ranging from 0.78 to 1.00; global fit indices were χ ² (14) = 105.39, CFI = 0.91, TLI = 0.87, RMSEA = 0.19 (90% CI [0.16, 0.22]), and SRMR = 0.06. Strong positive correlations were observed with the CIPS-20 ( r = 0.76), CIPS-10 ( r = 0.77), and IPSS-3 ( r = 0.66), whereas weaker correlations were found with general self-efficacy ( r = 0.20) and perfectionism ( r = 0.16–0.18). Test–retest reliability was moderate among 14 participants retested after 1–4 weeks (Pearson r = 0.65; ICC = 0.65). Conclusion: The Arabic LIS demonstrated high internal consistency and promising initial evidence of validity as a brief measure of impostorism among Arabic-speaking university students. Further evaluation of its factor structure and temporal stability in a broader population is warranted.

Background/aim: Physical inactivity remains widespread globally, with most adults not achieving recommended physical activity levels. Exercise motives and goals, central to Self-Determination Theory, strongly influence sustained participation. The Bernese Motive and Goal Inventory (BMZI) is a validated tool to assess exercise motivation; however, no Arabic version exists. This study aimed to translate, culturally adapt, and validate the BMZI for Arabic-speaking adults. Methods: A web-based cross-sectional study was conducted in Saudi Arabia between September and October 2025 among native Arabic-speaking adults via social media and community networks. The survey included sociodemographic data, the Arabic version of the Bernese Motive and Goal Inventory (Ar-BMZI), the Sport Motivation Scale (SMS), and the SF-12 Health Survey. Reliability was assessed through Cronbach’s α, McDonald’s ω, and ICC for test–retest consistency; construct validity via exploratory and confirmatory factor analysis; and convergent validity by correlating Ar-BMZI with the Arabic-SMS and Arabic-SF-12 physical component. Results: A total of 680 participants were included, with a mean age of 30.4 ± 12.9 years. Most were female (61.6%) and held a bachelor’s degree (73.5%). Nearly half (50.9%) reported a low monthly income. The Ar-BMZI demonstrated strong overall psychometric performance. Internal consistency was excellent (Cronbach’s α = 0.883; ω = 0.868), and test–retest reliability indicated high stability over time (ICC = 0.870, 95% CI = 0.786–0.933). Convergent validity was supported by a moderate correlation with the Arabic Sport Motivation Scale (r = 0.613, p < 0.001) and a weak correlation with the SF-12 physical health domain (r = 0.098, p = 0.011), which supported discriminant validity. Exploratory principal component analysis with Varimax rotation identified a five-factor structure explaining 69.2% of the total variance, and confirmatory factor analysis further supported this structure, demonstrating an excellent model fit. Conclusions: The Ar-BMZI demonstrates high reliability and good validity, supporting its use among Arabic-speaking adults.

Background/aim: Medical students often face intense pressure to excel, which can lead to imposterism, characterized by persistent self-doubt and fear of being exposed as inadequate, alongside high levels of perfectionism. This study aims to assess the prevalence of imposterism and perfectionism among medical students in Saudi Arabia and explore their potential implications for student well-being. Methods: A cross-sectional analytical study was conducted between October and December 2024 among female medical students in Saudi Arabia. Data were collected via an online survey, which included demographic questions, the validated Arabic versions of the Clance Impostor Phenomenon Scale (Ar-CIPS), the short form of the Big Three Perfectionism Scale (BTPS-SF), and the General Self-Efficacy Scale (GSES). Results: A total of 265 medical students (mean age 20.96 ± 1.44 years) participated. Most reported a monthly income of less than 2000 SR, and the majority had a GPA above 4.5. A 74.3% expressed moderate impostor experiences. The BTPS-SF revealed the highest scores in self-critical perfectionism, followed by narcissistic and rigid perfectionism. Higher impostor scores were significantly associated with greater perfectionism and lower self-efficacy (p < 0.05). In multivariable analysis, BTPS-SF scores positively predicted CIPS scores (β = 0.52, p < 0.001), whereas GSE scores predicted lower CIPS scores (β = −0.47, p = 0.001). Conclusions: This study revealed a high prevalence of impostor phenomenon and perfectionism among female medical students, with self-critical perfectionism being the most prominent. Imposterism was significantly associated with higher perfectionism and lower self-efficacy.

Background: Excessive sun exposure is a major modifiable risk factor for skin cancer, with ultraviolet (UV) radiation identified as a key contributor. Saudi Arabia’s high UV index and hot climate increase the risk of photo-induced skin damage among residents. Although awareness of sun protection is growing, inconsistent use of preventive measures persists, often due to misconceptions and limited knowledge. This study aimed to assess patterns of current and prior sun exposure across demographic groups in Saudi Arabia using the validated Arabic version of the Sun Exposure and Behaviour Inventory (Ar-SEBI). Methods: An analytical cross-sectional study was conducted between August 2024 and January 2025 across all five Saudi regions using non-probability quota sampling to ensure geographic representation. Sun-exposure practices and protective behaviours were measured using the Ar-SEBI. Data were collected via an online questionnaire and analysed using IBM SPSS Statistics 26. Normality was assessed via Shapiro–Wilk and Levene’s tests. Depending on the distribution, data were analysed using the Mann–Whitney U test, the Kruskal–Wallis H test, unpaired t-tests, or ANOVA. A p-value < 0.05 was considered statistically significant. Results: A total of 11,491 adults participated. Significant demographic and regional differences in sun-related behaviours were observed. Overall, 72.7% of participants were unaware of the SPF level of their sunscreen. Males and individuals under 30 years of age had significantly higher sun exposure scores than females and older adults, respectively (p < 0.001). Residents of the Southern region had the highest exposure and behaviour scores (p < 0.001), despite also reporting higher engagement in some protective measures. Additionally, sun exposure scores increased progressively with darker Fitzpatrick skin types (IV–VI) (p < 0.001), suggesting a common belief that darker skin confers adequate protection. Conclusions: This study reveals notable disparities in sun-protection practices across Saudi Arabia. Younger adults, males, and individuals with darker skin types reported greater sun exposure and indicators of lower protective awareness. These findings support the need for targeted, culturally tailored public health campaigns and policy measures to enhance sun safety and reduce long-term dermatological risks.

Background and aim: Patient satisfaction is a critical indicator of healthcare quality, shaping treatment adherence, continuity of care, and the allocation of resources. The Short Assessment of Patient Satisfaction (SAPS) is a brief, reliable tool that is widely used internationally, but no validated Arabic version currently exists. Therefore, this study aimed to translate, culturally adapt, and validate the SAPS into Arabic for use in primary care clinics. Methods: We conducted a cross-sectional validation study at general practice clinics of a tertiary academic hospital in Riyadh, Saudi Arabia (June–August 2025). Consecutive Arabic-speaking patients aged 18–80 were recruited post-visit and completed a self-administered electronic survey including the Arabic Short Assessment of Patient Satisfaction (Ar-SAPS), PSQ-18, and PDRQ-9, as well as demographic and visit variables. Psychometric testing included internal consistency, test–retest reliability, construct validity, and factor analysis. Results: A total of 273 participants enrolled in our study. The Ar-SAPS demonstrated good reliability (Cronbach’s α = 0.789; McDonald’s ω = 0.882) and moderate test–retest stability (ICC = 0.634, p < 0.0001). Factor analysis supported a primarily unidimensional structure, with the first factor explaining 60.2% of variance. Most inter-item correlations were moderate to strong, except for item 6. Convergent validity was supported by significant correlations with the Arabic PDRQ-9 (r = 0.623, p < 0.001, CI [0.532, 0.713]) and PSQ-18 (r = 0.662, p < 0.001, CI [0.531, 0.793]), confirming consistency with established measures of patient satisfaction. Furthermore, it demonstrated excellent discriminative ability, with areas under the curve of 0.965 for overall satisfaction and 0.955 for willingness to recommend. Conclusion: The Ar-SAPS is valid and reliable for use to assess patient satisfaction.

Background/aim: Statin medications (hydroxymethylglutaryl-CoA reductase inhibitors) are the agents most commonly used to lower lipids in people with dyslipidemia but are well known to exert unfavorable side effects such as myalgia, which may result in medication discontinuation. In this study, we aimed to assess the relationship between statin use and the development of gastric acid reflux symptoms. Methods: An analytical cross-sectional study was conducted between October 2022 and December 2023 at King Saud University Medical City in Riyadh, Saudi Arabia, among individuals diagnosed with dyslipidemia who had used statin medications regularly for a minimum of 3 months. A simple random sampling technique was utilized. Patients were asked for demographic information, statin type, dose, duration, past medical history, and gastroesophageal reflux symptoms using the Ar-GerdQ tool. Results: A total of 386 participants enrolled in our study. Participants’ mean age and standard deviation was 55.4 ± 13.4 years, and the most used statin medication was atorvastatin (69.9%). The total mean GerdQ score was 6.40 (standard deviation 1.90), whereas only 11.4% of participants had gastric reflux symptoms. Different statin types, intensity, and duration were not statistically significantly correlated with gastric reflux symptoms (all P > 0.05). In comparison with those not using proton pump inhibitors, those who were using proton pump inhibitors were more frequently predicted to have an increased risk of developing gastroesophageal reflux disease (adjusted odds ratio = 2.991; 95% confidence interval: 1.359–6.585; P = 0.007). Conclusion: Statin medications were not associated with gastroesophageal symptoms, regardless of the statin type, dose, or intensity. Multicenter studies on a national level are warranted to affirm this conclusion further.

Introduction and importance: Severe hypertriglyceridemia is increasingly leading to referrals to endocrinology clinics. Patients commonly present with clinical manifestations such as recurrent abdominal pain, acute pancreatitis, and eruptive xanthomas. Case presentation: We report the case of a young male patient with over 30 recurrent episodes of acute pancreatitis and extremely elevated triglyceride levels. Genetic testing identified a heterozygous pathogenic mutation in the 1-acylglycerol-3-phosphate-o-acetyltransferase 2 (AGPAT2) gene. Further deletion/duplication analysis of the AGPAT2 gene was negative. The clinical presentation closely resembled type I hyperlipoproteinemia. Clinical discussion: Despite the typical presentation of type I hyperlipoproteinemia, the identification of a heterozygous AGPAT2 mutation suggests a potential novel genetic contributor to familial hypertriglyceridemia. This finding highlights the importance of genetic analysis in understanding atypical presentations of hyperlipoproteinemia and underscores the need to explore this mutation’s inheritance patterns and pathophysiological implications. Conclusion: The heterozygous AGPAT2 mutation may represent a novel genetic factor in familial hypertriglyceridemia. Further research is needed to clarify its clinical significance and inheritance mechanisms.

Background/objectives: Cognitive flexibility is the mental skill that allows a person to shift between different ideas or concepts and think about several concepts simultaneously. A commonly used tool to assess cognitive flexibility is the Cognitive Flexibility Scale (CFS). This study focused on translating and validating the CFS into Arabic, given the lack of existing Arabic tools for assessing cognitive flexibility. Methods: Conducted at King Saud University, Riyadh, between April and June 2024, the study employed random sampling and involved 529 participants, including 419 students and 110 patients. Results: The average participant age was 25.8 years, with females making up 56.9% of the sample. Participants completed the Arabic CFS, along with the Emotion Regulation Questionnaire (ERQ) and the Perceived Stress Scale (PSS), at two time points 3–6 weeks apart. Reliability was evaluated through internal consistency (Cronbach’s alpha = 0.8) and test–retest reliability (intraclass correlation coefficient = 0.82). Item analysis indicated that removing any single item did not significantly impact overall reliability, and inter-item correlations were strongest between items 4 and 6 (0.55) and items 6 and 7 (0.51). Validity was assessed through face, content, and construct validity, with factor analysis revealing a dominant single component accounting for 34.4% of the variance, confirming the scale’s unidimensionality. Content validity indices for all items exceeded 0.9 in terms of relevance, importance, simplicity, and clarity. The Arabic CFS demonstrated good construct validity, showing significant correlations with the ERQ’s reappraisal and suppression dimensions and the PSS. Conclusion: In conclusion, the Arabic version of the CFS is a valid and reliable tool for assessing cognitive flexibility in Arabic-speaking populations. This tool will be valuable in both clinical and research settings within Saudi Arabia, offering a robust instrument for evaluating cognitive flexibility.

As a result of the increasing global incidence of obesity and related diseases, this study aims to investigate the prevalence of obesity and its correlation with eating disorder (ED) screening among medical students to develop effective prevention strategies and provide better outcomes for these students. We conducted a quantitative analytical cross-sectional study at the College of Medicine at King Saud University between November 2023 and February 2024. A stratified random sampling technique was utilized, enrolling a net number of 415 participants. Participants were asked several questions, including demographic information, weight, height, and past medical history, and were given a validated screening tool for EDs. Participants’ mean age was 21.4 ± 1.67 years, and 17.6% were considered obese. The prevalence of positive screening for EDs was 27.7%; it was more common in females (p = 0.013) and those who earned more than 1000 SAR per month (p = 0.011). Female students also exhibited almost twice the odds of having EDs than males (AOR = 1.957; 95% CI = 1.218–3.146; p = 0.006). Furthermore, non-obese students showed decreased odds of having EDs compared with obese students by at least 48% (AOR = 0.517; 95% CI = 0.287–0.929; p = 0.027). Our study revealed a concerning prevalence of ED symptoms and obesity among medical students, suggesting profound implications. Therefore, multicenter studies are needed to assess the generalizability of the results and apply the findings to targeted national campaigns and interventions tailored specifically to medical students.

Purpose: Smartphone addiction is prevalent among medical students, and there is a concern that the coronavirus disease 2019 (COVID-19) pandemic fueled a rise in smartphone addiction. Earlier studies suggest a link between excessive smartphone usage and negative outcomes such as depression, stress, and reduced academic achievement. However, there is a dearth of both local studies in Saudi Arabia and studies conducted during the COVID-19 pandemic exploring the prevalence of smartphone addiction and its association with academic performance, depression, and perceived stress, which is the purpose of the current study. Methods: In 2021, a cross-sectional research project took place among medical students at King Saud University and the Vision Colleges located in Riyadh, Saudi Arabia. An online self-administered questionnaire consisting of demographic variables, grade point average (GPA), the Patient Health Questionnaire-9 (PHQ-9), the Perceived Stress Scale-4 (PSS-4), and the Smartphone Addiction Scale—Short Version (SAS-SV) was deployed. Results: Three hundred and fifteen students participated. Around 47.9% of students reported smartphone addiction, and the mean SAS-SV score was 32.31 ± 12.01 points. Both PHQ-9 and PSS-4 scores showed a significant positive correlation with the SAS-SV score (r = 0.216, p < 0.001 and r = 247, p < 0.001, respectively), while GPA did not (r = −0.027, p = 0.639). An adjusted analysis showed that the PSS-4 score was positively associated with the SAS-SV score (odds ratio (OR) = 1.206, p < 0.001), while the PHQ-9 score was not (OR = 102, p = 0.285). Conclusions: Smartphone addiction is prevalent among medical students and associated with perceived stress. Additional research is required to gain a deeper comprehension of this issue and to assess the success of intervention initiatives aimed at encouraging healthy smartphone usage, particularly in times of crisis like the COVID-19 pandemic.