COVID-19 Pandemic in the Italian Population: Validation of a Post-Traumatic Stress Disorder Questionnaire and Prevalence of PTSD Symptomatology

Social-Single Prolonged Stress affects contextual fear conditioning in male and female Wistar rats: Molecular insights in the amygdala

Stress exposure can lead to post-traumatic stress disorder (PTSD) in male and female rats. Social-Single Prolonged Stress (SPS) protocol has been considered a potential PTSD model. This study aimed to pharmacologically validate the Social-SPS as a PTSD model in male and female rats. Male and female Wistar rats (60-day-old) were exposed to Social-SPS protocol and treated with fluoxetine (10 mg/Kg) or saline solution intraperitoneally 24 h before euthanasia. Two cohorts of animals were used; for cohort 1, male and female rats were still undisturbed until day 7 post-Social-SPS exposure, underwent locomotor and conditioned fear behaviors, and were euthanized on day 9. Animals of cohort 2 were subjected to the same protocol but were re-exposed to contextual fear behavior on day 14. Results showed that fluoxetine-treated rats gained less body weight than control and Social-SPS in both sexes. Social-SPS effectively increased the freezing time in male and female rats on day eight but not on day fourteen. Fluoxetine blocked the increase of freezing in male and female rats on day 8. Different mechanisms for fear behavior were observed in males, such as Social-SPS increased levels of glucocorticoid receptors and Beclin-1 in the amygdala. Social-SPS was shown to increase the levels of NMDA2A, GluR-1, PSD-95, and CAMKII in the amygdala of female rats. No alterations were observed in the amygdala of rats on day fourteen. The study revealed that Social-SPS is a potential PTSD protocol applicable to both male and female rats.

Identifying patterns of multidimensional self-compassion in Chinese young adults: implications for longitudinal mental health outcomes during the pandemic

BACKGROUND

Self-compassion (SC), reflecting self-attitude and self-connectedness, has proven to be a modifiable factor in promoting mental health outcomes. Increasingly, SC is recognized as a multidimensional construct consisting of six dimensions, rather than a single dimension.

OBJECTIVES

First, this study adopted a person-centered approach to explore profiles of SC dimensions in Chinese young adults. Second, the study examined the predictive effects of SC profiles on mental health outcomes.

METHODS

In February 2020, young adults (N = 1164) were invited to complete the 26-item Neff's Self-Compassion Scale online. Three months later, the same subjects (N = 1099) reported their levels of depressive symptoms, posttraumatic stress disorder (PTSD) symptoms, and posttraumatic growth (PTG).

RESULTS

After controlling for retrospective ACEs, four classes best characterized the profiles: self-compassionate (26.7%, N = 294), self-uncompassionate (12.3%, N = 135), average (55.9%, N = 614), and detached groups (5.1%, N = 56). Young adults in the self-compassionate group adjusted the best (with the highest level of PTG and the lowest levels of depressive and PTSD symptoms). Adults in the self-uncompassionate group demonstrated the poorest mental health outcomes (with the lowest level of PTG and the highest levels of depressive and PTSD symptoms). Young adults in the average group obtained more PTG than adults in the detached group (p < .01), but did not differ significantly in depressive and PTSD symptoms (p > .05).

CONCLUSION

The compassionate profile is the most adaptable for young adults among all groups. This study highlights the limitations of representing the relative balance of SC with a composite score.

Explosion of research on psychopathology and social media use after COVID-19: A scientometric study

BACKGROUND

Despite advances in research on psychopathology and social media use, no comprehensive review has examined published papers on this type of research and considered how it was affected by the coronavirus disease 2019 (COVID-19) outbreak.

AIM

To explore the status of research on psychopathology and social media use before and after the COVID-19 outbreak.

METHODS

We used Bibliometrix (an R software package) to conduct a scientometric analysis of 4588 relevant studies drawn from the Web of Science Core Collection, PubMed, and Scopus databases.

RESULTS

Such research output was scarce before COVID-19, but exploded after the pandemic with the publication of a number of high-impact articles. Key authors and institutions, located primarily in developed countries, maintained their core positions, largely uninfluenced by COVID-19; however, research production and collaboration in developing countries increased significantly after COVID-19. Through the analysis of keywords, we identified commonly used methods in this field, together with specific populations, psychopathological conditions, and clinical treatments. Researchers have devoted increasing attention to gender differences in psychopathological states and linked COVID-19 strongly to depression, with depression detection becoming a new trend. Developments in research on psychopathology and social media use are unbalanced and uncoordinated across countries/regions, and more in-depth clinical studies should be conducted in the future.

CONCLUSION

After COVID-19, there was an increased level of concern about mental health issues and a changing emphasis on social media use and the impact of public health emergencies.

Longitudinal Assessment of Hair Cortisol as a Predictor of Psychological Symptoms During COVID-19

BACKGROUND

There is a lack of evidence regarding enduring psychoneuroendocrine changes following an initial traumatic event, particular in the presence of an ongoing stressor. The coronavirus pandemic presents an opportunity to explore this matter. Consequently, the purpose of the present study was to investigate the impact of the ongoing pandemic (2021) on individuals, who experienced a first-time motor vehicle crash (MVC) at least 6 years earlier. To this end, we hypothesized that hair cortisol concentrations (HCC) following a first-time traumatic event positively predict symptoms of depression.

METHOD

We investigated N = 69 individuals (18 - 65 yrs.), who were victims of a MVC during 2010 - 2014. Hair strands were collected 10 days (t1) and 3 months after the MVC (t2), as well during the pandemic in 2021 (t3). To assess symptoms of depression, the participants filled out the Beck Depression Inventory at t1 - t3 and were additionally interviewed (Structured Clinical Interview for DSM-IV Axis I) at t1 and t2. Exclusion criteria conveyed a lifetime or acute mental disorder (incl. past trauma exposure).

RESULTS

Elevated pre-pandemic HCC following adversity (i.e., MVC) significantly predicted symptoms of depression in adults during the coronavirus pandemic (BDI: ß =.44, p =.010, R2 =.20), even after controlling for confounders. HCC significantly decreased over time, while in average psychological symptoms remained consistent.

CONCLUSION

Cortisol dysregulation in the past presents an enduring vulnerability to ongoing stress. In this regard, vulnerable groups may benefit from preventive measures. This finding validates the predictive power of HCC and extended past evidence in this regard, at the same time reinforcing the concept of the diathesis-stress model.

Impact of public health communication for prevention and personal resilience at the time of crisis. A pilot study with psychophysiological and self-report measures

Health communication promotes public and individual health. Psychophysiological indices can unveil the unconscious emotional variables that influence audience's representations of these communications. This study explored emotional and cognitive responses to health communications using implicit (psychophysiological) and explicit (self-report) measurements. Twelve communications (health prevention, personal health, public health, Covid-19) were shown to N = 19 participants, while psychophysiological (i.e. Heart Rate and Heart Rate Variability (HRV), skin conductance level and response (SCL and SCR)) and self-report (Semantic Differential and Self-Assessment Mannikin (SAM)) data were collected. Higher arousal and physiological engagement (SCL) were observed for health prevention, public and personal health communications. Lower HRV values were found for health prevention compared to crisis communication (Covid-19 stimuli), suggesting higher emotional reactions and concern for the first topic. Self-report results confirmed psychophysiological findings. Overall, using public health communication activates objective indicators about emotional reactions that have important implications for the effectiveness of the communication itself.

When time worsens framing: a longitudinal analysis of the psychological effects of the COVID-19 pandemic in women with an eating disorder and their healthy sisters

The COVID-19 pandemic has profoundly affected individuals with eating disorders (ED), leading to an exacerbation of symptoms worldwide in 2020. However, there is a lack of longitudinal analyses of the psychological burdens experienced by this population. This study aims to longitudinally assess the psychological effects of the COVID-19 pandemic in people with ED and their healthy sisters (HS) 1 and 2 years after the onset of the crisis. A sample of 148 individuals, consisting of 73 with ED and 45 HS, was evaluated in spring 2021 and spring 2022 regarding their current psychological and behavioral states. Participants were also asked to reflect on their feelings and behaviors during the 2020 lockdown. General psychopathology, eating disorders, and trauma-related symptoms were evaluated using validated questionnaires. Both groups showed an overall improvement in psychopathological symptoms with time. Individuals with ED exhibited greater improvement compared to their HS, which may be attributed to their initially higher burden. Individuals with ED reported a negative reframe, characterized by internalizing negative emotions and behaviors related to the 2020 lockdown. This longitudinal evaluation revealed two distinct and contrasting effects. Both ED patients and their HS demonstrated psychological improvement over time. However, people with ED experienced a negative reframe that affected their memory of specific life events, subsequently affecting their psychological well-being. These findings shed light on the clinical severity observed in people with ED during these pandemic years.

Covid-19 psychological pressures, depression and FOMO: the mediating role of online social support and emotional regulation

BACKGROUND

The spread of the coronavirus has led to significant anxiety among university students, resulting in various mental health problems that could potentially impact their academic performance.

METHOD

To examine the mediating role of emotional regulation and online social support in the relationships between COVID-19 psychological pressures, depression, and the fear of missing out (FoMO) among young adult university students, a cross-sectional research design was employed using an online survey. The sample consisted of 521 full-time university students from China, currently enrolled in undergraduate and postgraduate programs.

RESULTS

Findings revealed that more than half (55.09%, n=287) of the university students experienced COVID-19 psychological pressures. These pressures directly contributed to increased levels of depression (β = 0.339, p < .001) and fear of missing out (β = 0.236, p < .001). Moreover, online social support and emotional regulation exhibited partial mediating effects on the association between COVID-19 psychological pressures, depression, and the fear of missing out. The results indicated that COVID-19 psychological pressures were linked to higher levels of depressive symptoms and a greater fear of missing out among university students.

CONCLUSIONS

However, the provision of timely and adequate online social support, as well as the implementation of emotional regulation strategies, mitigated the negative effects of the pandemic on students' social and emotional well-being. Consequently, this led to reduced levels of depression and fear of missing out.

Polysomnography and Neuropsychological Analysis of Patients With Post-Traumatic Stress Disorder Two Years After the COVID-19 Pandemic in Wuhan

OBJECTIVE

We used polysomnography (PSG) monitoring and neuropsychological scales to explore the characteristics of coronavirus disease-2019 (COVID-19) patients diagnosed with post-traumatic stress disorder (PTSD) in Wuhan, two years after the onset of the COVID-19 pandemic.

METHODS

A total of 42 patients in the Sleep Medicine Center were diagnosed with insomnia between December 2021 and May 2022; they were divided into the PTSD group (patients with PTSD diagnosed with insomnia after COVID-19 infection) and the non-PTSD group (patients with insomnia without PTSD). A healthy control group was simultaneously included.

RESULTS

The PTSD group was more significant than the non-PTSD group in partial manifestations of sleep disorders, neuropsychological clinical symptoms, and partial PSG data. Patients with different COVID-19 subtypes showed significant differences in the course of disease, sleep disorders, neuropsychological clinical symptoms, relevant scale scores, and PSG data analysis.

CONCLUSION

The emotional anxiety and depression of COVID-19 patients diagnosed with PTSD two years after the COVID-19 pandemic in Wuhan are more significant, and will not be self-alleviated with the passage of time. It is necessary to continue to pay attention to the PTSD symptoms and sleep psychology of COVID-19 infected patients, and take appropriate measures. Patients with severe and critical COVID-19 have more severe sleep and mental disorders, and there is a significant correlation between the duration of the disease and the severity of mental and mental disorders and sleep disorders after recovery.

Insights into attention and memory difficulties in post-COVID syndrome using standardized neuropsychological tests and experimental cognitive tasks

The COVID-19 pandemic has given rise to post-acute cognitive symptoms, often described as 'brain fog'. To comprehensively grasp the extent of these issues, we conducted a study integrating traditional neuropsychological assessments with experimental cognitive tasks targeting attention control, working memory, and long-term memory, three cognitive domains most commonly associated with 'brain fog'. We enrolled 33 post-COVID patients, all self-reporting cognitive difficulties, and a matched control group (N = 27) for cognitive and psychological assessments. Our findings revealed significant attention deficits in post-COVID patients across both neuropsychological measurements and experimental cognitive tasks, evidencing reduced performance in tasks involving interference resolution and selective and sustained attention. Mild executive function and naming impairments also emerged from the neuropsychological assessment. Notably, 61% of patients reported significant prospective memory failures in daily life, aligning with our recruitment focus. Furthermore, our patient group showed significant alterations in the psycho-affective domain, indicating a complex interplay between cognitive and psychological factors, which could point to a non-cognitive determinant of subjectively experienced cognitive changes following COVID-19. In summary, our study offers valuable insights into attention challenges faced by individuals recovering from COVID-19, stressing the importance of comprehensive cognitive and psycho-affective evaluations for supporting post-COVID individuals.

Exploring the Interplay of Working Memory, Apathy, and Mood/Emotional Factors

BACKGROUND

Previous investigations on healthy humans showed conflicting evidence regarding the impact of mood on working memory performance. A systematic investigation of how mood affects apathy levels in healthy participants is currently missing.

METHODS

We administered a visuospatial (VS) and a numerical (N) n-back task to a sample of 120 healthy individuals. In these participants, using a series of questionnaires, we also evaluated apathy, mood, working memory, perceived stress, PTSD symptoms caused by the COVID-19 pandemic outbreak, and general psychiatric symptoms. Successively, we investigated their performance in the n-back task as a function of scores to these questionnaires.

RESULTS

Participants performed better in the N block than in the VS one. Their accuracy decreased as a function of the n-back difficulty. We reported no differences in working memory performance or apathy as a function of mood, stress, or PTSD symptoms. We found that phobic anxiety negatively predicted accuracy to the numerical n-back task and that subjects with greater anxiety and difficulty in regulating emotions also showed higher levels of withdrawal from the task.

CONCLUSION

The study's results suggest that while mood did not significantly affect working memory performance, strong associations were found between WMQ scores and working memory capabilities.

Prevalence of post-traumatic stress disorder risk post-COVID-19 in 12 countries in Latin America: a cross-sectional survey

Introduction

Latin America was the region most affected by COVID-19 in the second quarter of 2020, and consequently, the impact on mental health requires evaluation. The aim of this study was to assess the risk of post-traumatic stress disorder (PTSD) caused by bereavement due to COVID-19 in 12 countries in Latin America.

Methods

The current study was an analytical cross-sectional study. Validated tests were applied for PTSD, depression, anxiety, and stress (DASS-21), questions about the respondent's condition or their environment, and demographic questions, as well as the length of the mourning period of suffering.

Results

The outcomes demonstrated that the PTSD risk increased for women (p < 0.001), when a friend or acquaintance had COVID-19 (p = 0.002), when a close relative died from COVID-19 (p = 0.010), having severe depression (p <0.001), severe anxiety (p  <0.001), severe stress (p  <0.001), residing in Chile (p  <0.001), Paraguay (p  <0.001), Bolivia (p  <0.001), Costa Rica (p  <0.001) or El Salvador (p  = 0.005). On the other hand, there was less risk of PTSD at an older age (p  <0.001) or if respondents had a sentimental partner (p  = 0.025). In the case of severe PTSD, there was a greater gender risk for women (p  <0.001), a close relative dying from COVID-19 (p  = 0.017), having severe depression (p  <0.001), severe anxiety (p  <0.001), severe stress (p  <0.001), residing in Chile (p  <0.001), Paraguay (p  <0.001), Bolivia (p  <0.001) and Costa Rica (p  = 0.002). It was also observed that there was less risk of severe PTSD at an older age demographic (p  <0.001).

Discussion

It can be concluded that the percentages of PTSD are high in its clinical presentation as severe, especially among Latin American women.

Posttraumatic stress disorder symptoms in systemic autoimmune rheumatic disease patients during the early COVID-19 pandemic

AIM

Given reports of increased prevalence of PTSD symptoms at COVID-19 pandemic onset, we aimed to assess the prevalence of posttraumatic stress disorder (PTSD) symptoms at pandemic onset in individuals with and without systemic autoimmune rheumatic disease (SARD).

METHODS

In May 2020, we invited 6678 patients to complete the Brief Trauma Questionnaire and the Posttraumatic Stress Disorder Checklist (PCL-5), validated PTSD symptom screenings. We compared responses from patients with and without SARD using multivariable logistic regression.

RESULTS

We received 1473 responses (22% response rate) from 5/2020 to 9/2021 (63 with prior PTSD diagnoses, 138 with SARD history). The SARD population was more female (p .0001) and had a higher baseline prevalence of stress disorders (56% vs. 43%, p .004). SARD subjects reported more experiences with life-threatening illness, 60%, versus 53% among those without SARD (p .13), and more antidepressant or anxiolytic medication use pre-pandemic (78% vs. 59%, p .0001). Adjusting for pre-pandemic PTSD diagnosis, younger age and history of stress disorder were the most significant predictors of PCL-5 positivity. There were no significant differences in PCL-5 score or positivity among those with or without SARD.

CONCLUSION

In this population, patients with SARD had a higher pre-COVID-19 prevalence of stress-related conditions, but it was not the case that they had an increased risk of PTSD symptoms in the early pandemic. Younger individuals, those with baseline depression, anxiety, or adjustment disorders, and those taking antidepressant or anxiolytic medications were more likely to have PTSD symptoms in the first waves of the COVID-19 pandemic.

Development and initial psychometric evaluation of a COVID-related psychosocial experiences questionnaire for cancer survivors

BACKGROUND

Cancer survivors are at elevated risk of psychological problems related to COVID-19, yet no published measure adequately assesses their psychosocial experiences during the pandemic.

PURPOSE

Describe the development and factor structure of a comprehensive, self-report measure (COVID-19 Practical and Psychosocial Experiences questionnaire [COVID-PPE]) assessing the pandemic's impact on US cancer survivors.

METHODS

The sample (n = 10,584) was divided into three groups to assess COVID-PPE factor structure by conducting: (1) initial calibration/exploratory analysis of the factor structure of 37 items (n = 5070), (2) confirmatory factor analysis of the best-fitting model (36 items after item removal; n = 5140), and (3) post-hoc confirmatory analysis with an additional six items not collected in the first two groups (42 items; n = 374).

RESULTS

The final COVID-PPE was divided into two sets of subscales, conceptualized as Risk Factors and Protective Factors. The five Risk Factors subscales were labeled Anxiety Symptoms, Depression Symptoms, Health Care Disruptions, Disruptions to Daily Activities and Social Interactions, and Financial Hardship. The four Protective Factors subscales were labeled Perceived Benefits, Provider Satisfaction, Perceived Stress Management Skills, and Social Support. Internal consistency was acceptable for seven subscales (αs = 0.726-0.895; ωs = 0.802-0.895) but poor or questionable for the remaining two subscales (αs = 0.599-0.681; ωs = 0.586-0.692).

CONCLUSIONS

To our knowledge, this is the first published self-report measure comprehensively capturing psychosocial impact-both positive and negative-of the pandemic on cancer survivors. Future work should evaluate predictive utility of COVID-PPE subscales, particularly as the pandemic evolves, which may inform recommendations for cancer survivors and facilitate identification of survivors most in need of intervention.

Childhood adversity during the post-apartheid transition and COVID-19 stress independently predict adult PTSD risk in urban South Africa: A biocultural analysis of the stress sensitization hypothesis

OBJECTIVES

The COVID-19 pandemic in South Africa introduced new societal adversities and mental health threats in a country where one in three individuals are expected to develop a psychiatric condition sometime in their life. Scientists have suggested that psychosocial stress and trauma during childhood may increase one's vulnerability to the mental health consequences of future stressors-a process known as stress sensitization. This prospective analysis assessed whether childhood adversity experienced among South African children across the first 18 years of life, coinciding with the post-apartheid transition, exacerbates the mental health impacts of psychosocial stress experienced during the 2019 coronavirus (COVID-19) pandemic (ca. 2020-2021).

MATERIALS AND METHODS

Data came from 88 adults who participated in a follow-up study of a longitudinal birth cohort study in Soweto, South Africa. Childhood adversity and COVID-19 psychosocial stress were assessed as primary predictors of adult PTSD risk, and an interaction term between childhood adversity and COVID-19 stress was calculated to evaluate the potential effect of stress sensitization.

RESULTS

Fifty-six percent of adults exhibited moderate-to-severe PTSD symptoms. Greater childhood adversity and higher COVID-19 psychosocial stress independently predicted worse post-traumatic stress disorder symptoms in adults. Adults who reported greater childhood adversity exhibited non-significantly worse PTSD symptoms from COVID-19 psychosocial stress.

DISCUSSION

These results highlight the deleterious mental health effects of both childhood trauma and COVID-19 psychosocial stress in our sample and emphasize the need for greater and more accessible mental health support as the pandemic progresses in South Africa.

Thinking about it: the impact of COVID-19-related stimuli on prospective memory

Background

Since 2020, information regarding COVID-19 has been a constant presence in the news, in our conversations and thoughts. Continuous exposure to this type of stimuli could have an impact on cognitive processes essential for our everyday activities, such as prospective memory (PM). PM is the ability to remember to perform an intention at a specific point in the future, like remembering to take prescribed medicines at a specific time or to turn off the stove after cooking. Do COVID-related stimuli affect our ability to perform a PM task?

Methods

To answer this question, we proposed a novel version of the classical paradigm used to investigate PM. Namely, this paradigm includes a baseline condition, in which an ongoing task is presented alone, and a PM condition in which the same task is proposed again together with a second (prospective) task. In this study, a short video clip was presented between the baseline and the PM condition. The video clip displayed either neutral, negative, or COVID-related content. Additionally, participants were asked to respond to two questionnaires and a series of questions regarding their well-being and experience with the pandemic. Namely, the DASS-21 scale (evaluating depression, anxiety, and stress), and the COVID-19-PTSD questionnaire (a questionnaire evaluating post-traumatic stress disorder symptoms related to the pandemic experience) were administered. Participants' performance and responses were analyzed using a linear mixed effect (LME) model approach, and correlation analyses were run to highlight possible correlations between participants' scores in the DASS-21, the COVID-19-PTSD, and the additional questions on their personal experience with the pandemic.

Results

The LME models revealed significant effects of the displayed video on performance: in line with previous studies, the clip displaying standard negative contents led to impaired accuracy in the ongoing task in the PM condition, compared to the Baseline. In contrast, participants who saw the COVID-related clip showed improved accuracy in the ongoing task compared to the other participants, selectively in the block performed after the video clip was displayed (PM condition). Furthermore, the explanatory power of the LME model calculated on accuracy to the ongoing trials was enhanced by the inclusion of the scores in the anxiety subscale of the DASS-21, suggesting a detrimental role of anxiety. Altogether, these results indicate a different effect of the exposure to classical negative contents (associated with a cost in terms of accuracy in the ongoing task between the baseline and the PM condition) and the pandemic-related one, which was instead characterized by a higher accuracy to ongoing trials compared to the other video clips. This counterintuitive finding seems to suggest that COVID-related stimuli are processed as "acute stressors" rather than negative stimuli, thus inducing a state of increased alertness and responsivity.

Pandemic Stressors and Adaptive Responses: A Longitudinal Analysis of the Quality of Life and Psychosocial Dynamics among Urothelial Cancer Patients

The 2019 coronavirus disease (COVID-19) pandemic has had a profound influence on different sectors of society, including health. This study hypothesized a significant impact of the pandemic on the quality of life and psychosocial well-being of urothelial cancer patients, specifically anticipating a decrease in anxiety and depression scores as the pandemic progressed. The primary objectives were to assess longitudinal changes in quality of life indexes, evaluate Healthcare Anxiety and Depression Scale (HADS) score trends over three years (2020-2022), and identify any correlational patterns between the progression of the pandemic and anxiety, depression, and stress levels among this cohort. A cross-sectional analysis was conducted on Eastern Cooperative Oncology Group (ECOG) 1 and Tumor Node Metastasis (TNM) stage 1 bladder cancer patients from the Timis County Emergency Clinical Hospital in Romania. Sixty patients were evaluated each year from 2020 to 2022, utilizing a detailed selection process involving the review of both the hospital database and paper records. Key data included demographic information, medical history, and responses to the Patient Health Questionnaire (PHQ-9), Short Form (SF-36), HADS, and Generalized Anxiety Disorder (GAD-7) questionnaires. A total of 163 completed questionnaires were analyzed, providing insight into various aspects of patients' experiences during the pandemic. Notably, the mean hospitalization days ranged from 3.6 ± 2.1 days in 2020 to 4.0 ± 2.4 days in 2022 (p = 0.663). Concerns that current symptoms might be pandemic-related spiked to 63.5% in 2021, but reduced to 50.9% in 2022, with this fluctuation being significant (p = 0.026). The perception of decreased quality of or accessibility to medical care was significant over the years, with a decline to 52.7% in 2022 (p = 0.033). Quality of life assessments demonstrated an upward trend, from an average score of 55.9 ± 8.9 in 2020 to 59.3 ± 8.8 in 2022 (p = 0.049). Interestingly, anxiety levels, as indicated by the HADS survey, revealed a significant decline from a score of 7.8 in 2020 to 6.5 in 2022 (p = 0.008). On the other hand, GAD-7 scores displayed a downward trend over the years, potentially indicative of developed coping strategies (p = 0.034). This study provides a comprehensive insight into the fluctuating dynamics of psychosocial factors and quality of life among urothelial cancer patients during the pandemic years. It underscores a potential adaptive response, as evidenced by the decrease in anxiety levels and an upward trend in the quality of life scores over the period. These findings highlight the resilience and adaptability of this patient cohort amidst the challenges posed by the pandemic, potentially guiding future interventions and supports in similar health crises.

Dean Y, Kishk RM, Elsaid NMAB, Salem A, Shah J, Aiash H, Eida M. Assessment of post-traumatic stress disorder and health-related quality of life among patients recovered from mild-to-moderate COVID-19 and their close contacts: A cross-sectional study

The pandemic of COVID-19 is a traumatic event with distressing implications for mental health and several aspects of life. This study aimed to assess Post-traumatic Stress Disorder (PTSD) and Health-Related Quality of Life (HRQoL) among patients who experienced mild-to-moderate COVID-19 and their household contacts. This cross-sectional descriptive study was conducted between May 2020 and November 2020, in Ismailia and Suez governorates. A convenient sampling method was used. The sample size was calculated according to the prevalence of PTSD in COVID-19 patients to be 200 adult participants from both sexes, 100 patients with history of recent COVID-19 infection (up to 2 months after recovery) and their close family. COVID-19 was confirmed by a nasal swab sample tested by PCR in addition to suggestive symptoms and/or positive computed tomography lung findings. Data was collected by using the Arabic version of the Post-Traumatic Stress disorder checklist 5 (PCL5-PTSD) and the Arabic version of Health-Related Quality of Life (HRQoL). The questionnaire was collected through interviews at the Endemic and Infectious diseases and Family medicine outpatient clinics. Of the 200 studied participants, evidence of PTSD was found in 112 (56%) participants; all COVID-19 cases and 12 of their close-contact relatives. Impaired HRQoL was evident in 107 (53.5%) participants; all the COVID-19 cases and 7 contacts. The mean values total scores of the PTSD and HRQoL and its domains were significantly higher among cases compared to their contacts. The most frequently impaired domain was social (55%), psychological (54.5%), impairment (53.5%) followed by physical (48.5%) and the least was health perception (33.5%). The mean values of PTSD, HRQoL and their domains were significantly higher among participants who recalled respiratory symptoms and who had comorbid illness. The odds ratio of PTSD and HRQoL was 0.27 (95% CI: 0.2-0.36) and 0.3 (95% CI: 0.23-0.39) in participants who had more than a case of COVID-19 within their families. All the studied COVID-19 participants showed PTSD and impaired HRQoL, compared to 12% and 7% of their contacts, respectively. Past COVID-19 was associated with impairment of all domains of HRQoL and the most affected were the physical, psychological and impairment domains.

Prevalence of post-traumatic stress disorder among residents of Shanghai standardized training programs during the COVID-19 outbreak: a cross-sectional study

Background

The COVID-19 pandemic may have increased the prevalence of psychiatric disorders, such as anxiety, depressive disorders, and post-traumatic stress disorder (PTSD), among healthcare workers.

Purpose

This study aims to investigate the prevalence of PTSD and its risk factors among residents in the standardized residency training programs (SRTPs) in Shanghai during the COVID-19 outbreak.

Participants and methods

An online cross-sectional survey was conducted between December 17, 2021, and January 7, 2022, among SRPT residents from 15 hospitals in Shanghai, China. Questionnaires comprising general information, medical-related traumatic event experiences, the PTSD Checklist (PCL-5), and the perceived social support scale (PSSS) were distributed to the participants using the online Questionnaire Star electronic system.

Results

We included 835 valid responses for the analysis. In total, 654 residents (78.3%) had experienced at least one traumatic event, and 278 residents (33.3%) were found to have PTSD symptoms. The age 26-30 years old, female sex, and increased resident working hours were identified as the risk factors for PTSD (p < 0.05), and perceived social support had a significant negative association with PTSD (p < 0.05).

Conclusion

During the COVID-19 pandemic, there was a high prevalence of PTSD among SRTPs residents in Shanghai. The age 26-30 years old, female sex, and increased resident working hours were identified as risk factors for PTSD, while perceived social support was identified as a protective factor against PTSD. The present findings can be applied in STRPs management and provide useful information for designing special interventions and protocols for SRTPs residents.

Psychological state and predictors of psychiatric morbidity in COVID-19 patients six weeks after discharge

To be able to detect possible psychological distress and long-term deterioration caused by COVID-19, following the patient, who has recovered, is crucial. Therefore, this study (i); aims to examine the ongoing fear-loss of control, the rate of anxiety, depression, and post-traumatic stress disorder levels following the 6th week after discharge; (ii) to examine the effect of post-traumatic stress disorder on anxiety, and depression and (iii) within the same context to reveal the developmental markers of psychiatric morbidity and the risk group. The study includes 180 patients who were hospitalized with COVID-19 diagnosis. Sociodemographic Data Form, the Hospital Anxiety Depression Scale and the Impact of Event Scale-Revised were used in the current study. High rates of symptoms of anxiety, depression, and PTSD were reported by the inpatients, as more than one-third scored above the anxiety and depression cut-off scores of borderline abnormal and abnormal. Also, 37.22 % of the participants reported the likely presence of PTSD symptoms. Anxiety and depression were significantly positively related to the symptoms of PTSD. The results suggest that there is psychiatric morbidity in anxiety, depression, and post-traumatic stress disorder and that especially posttraumatic stress poses a risk for other psychopathologies.

Post-traumatic stress symptoms and benefit finding: a longitudinal study among Italian health workers during the COVID-19 pandemic

PURPOSE

Research has highlighted that the exposure of healthcare professionals to the COVID-19 pandemic for over two years can lead to the development and persistence of symptoms characteristic of Post-Traumatic Stress Disorder (PTSD), with serious consequences on both the individual well-being and the quality of care provided. The present study was aimed at investigating the role of benefit finding in moderating post-traumatic stress symptoms (PTSS) over time.

METHODS

The longitudinal study, conducted between April and October 2020, involved 226 Italian health workers (44.7% nurses and midwives, 35% doctors, 20.3% technical and rehabilitation professionals), who filled out an online survey at the beginning of the study (T1), after three months (T2), and after six months (T3). Participants (77.4% women; mean age = 41.93, SD = 12.06) completed the PTSD Checklist for DSM-5 (PCL-5) and Benefit Finding, a 17-item questionnaire measuring the perceived level of positive consequences derived from stressful experiences. A hierarchical regression analysis highlighted the moderating effect of benefit finding (T2) on the association between PTSS values at T1 and T3.

RESULTS

A buffering effect was observed, with higher benefit finding levels reducing the magnitude of the bivariate association between PTSS assessed at the beginning and at the end of the study.

CONCLUSION

Findings suggest the potential mental health related benefits of interventions allowing health professionals to identify positive aspects in the experience of working under prolonged emergency circumstances, such as the pandemic ones.

Psychosocial status and risk perception among Iranian healthcare workers during the fifth wave of the COVID-19 pandemic

BACKGROUND

Healthcare workers (HCWs) are essential resources, and their health and wellbeing are key not only for offering constant and useful care facilities to clients, but also for maintaining the safety of the workforce and patients. The risk of severe mental health problems among HCWs may have increased during large outbreaks of COVID-19. To evaluate the psychosocial status and risk perception of HCWs who participated in treating COVID-19 patients in Northern Iran, we performed a web-based cross-sectional study.

METHODS

The web-based cross-sectional design was applied between June 27 and September 2, 2021. Using convenience sampling, 637 HCWs were recruited from hospitals in Northern Iran (Mazandaran). The HCWs completed self-report questionnaires that included a sociodemographic information form, the 12-item General Health Questionnaire, Impact of the Event Scale-Revised, Risk Perception Questionnaire, and Anxiety Stress Scale-21. The data were analyzed via descriptive and inferential statistics and univariate/multivariate logistic regression to assess the risk factors linked to each psychosocial consequence.

RESULTS

The results reveal that the COVID-19 pandemic had an adverse psychosocial influence on HCWs, which was already apparent 1.5 years after the crisis began. Based on the results, 71.6%, 55.6%, and 32.3% of HCWs reported having anxiety, depression, and stress symptoms, respectively, since the outbreak of this disease. The logistic regression models displayed that marital status, having children, and working hours with patients were all risk factors of psychosocial impairment.

CONCLUSIONS

The outbreak of COVID-19 can be considered an important experience of a bio-disaster resulting in a significant rate of psychiatric problems in HCWs. There is a need for designing and promoting supportive programs to help HCWs cope and to improve their psychosocial state, and the present study has detected for whom psychosocial support may be effective and practical 1.5 years after the primary outbreak. Moreover, detecting and managing concerns and reducing infection-related embarrassment/stigma are essential for improving HCWs' mental health.

Seeking and Providing Social Support on Twitter for Trauma and Distress During the COVID-19 Pandemic: Content and Sentiment Analysis

BACKGROUND

The COVID-19 pandemic can be recognized as a traumatic event that led to stressors, resulting in trauma or distress among the general population. Social support is vital in the management of these stressors, especially during a traumatic event, such as the COVID-19 pandemic. Because of the limited face-to-face interactions enforced by physical distancing regulations during the pandemic, people sought solace on social media platforms to connect with, and receive support from, one another. Hence, it is crucial to investigate the ways in which people seek and offer support on social media for mental health management.

OBJECTIVE

The research aimed to examine the types of social support (eg, emotional, informational, instrumental, and appraisal) sought and provided for trauma or distress on Twitter during the COVID-19 pandemic. In addition, this study aimed to gain insight into the difficulties and concerns of people during the pandemic by identifying the associations between terms representing the topics of interest related to trauma or distress and their corresponding sentiments.

METHODS

The study methods included content analysis to investigate the type of social support people sought for trauma or distress during the pandemic. Sentiment analysis was also performed to track the negative and positive sentiment tweets posted between January 1, 2020, and March 15, 2021. Association rule mining was used to uncover associations between terms and sentiments in tweets. In addition, the research used Kruskal-Wallis and Mann-Whitney U tests to determine whether the retweet count and like count varied based on the social support type.

RESULTS

Most Twitter users who indicated trauma or distress sought emotional support. Regarding sentiment, Twitter users mostly posted negative sentiment tweets, particularly in January 2021. An intriguing observation was that wearing masks could trigger and exacerbate trauma or distress. The results revealed that people mostly sought and provided emotional support on Twitter regarding difficulties with wearing masks, mental health status, financial hardships, and treatment methods for trauma or distress. In addition, tweets regarding emotional support received the most endorsements from other users, highlighting the critical role of social support in fostering a sense of community and reducing the feelings of isolation during the pandemic.

CONCLUSIONS

This study demonstrates the potential of social media as a platform to exchange social support during challenging times and to identify the specific concerns (eg, wearing masks and exacerbated symptoms) of individuals with self-reported trauma or distress. The findings provide insights into the types of support that were most beneficial for those struggling with trauma or distress during the pandemic and may inform policy makers and health organizations regarding better practices for pandemic response and special considerations for groups with a history of trauma or distress.

A decline in perceived social status leads to post-traumatic stress disorder symptoms in adults half a year after the outbreak of the COVID-19 pandemic: consideration of the mediation effect of perceived vulnerability to disease

Background/purpose

In December 2019, Wuhan, Hubei, China firstly reported the existence of the COVID-19 virus. It is crucial to prioritize the psychological well-being of citizens in lockdown cities and make more strides in the academic field of post-traumatic stress disorder (PTSD) to prepare for the post-pandemic era.

Methods

We took the cognitive-relational theory as our basis and collected Hubei province-level data (N = 3,465) to examine the impact of perceived social status decline on the prevalence of PTSD symptoms, and checked the mediating effect of perceived vulnerability to disease (PVD) during the period of psychological adjustment.

Results

Using propensity score matching, we estimate the average treatment effect of perceived social status decline on PTSD level, and we robustly regress the two with weight adjustment generated in matching. We found that more decline in perceived social status is associated with a worse degree of PTSD symptoms, and confirmed PVD's buffering role although the mediating effect was not as high as hypothesized.

Conclusion and implications

Our study confirmed the decisive role of subject social status in health prediction compared to traditional socioeconomic measures, which extends the cognitive-relational in examining socioeconomic status and contributes to the dialog on socioeconomic inequality. We also suggested providing more social support at the community level and enhancing individuals' positive understanding to protect mental health.

Psychological consequences of experiencing the COVID-19 coronavirus pandemic: early maladaptive schemas and mental health and quality of life

The research presented here aimed to determine the psychological consequences of experiencing Poland's coronavirus disease 2019 (COVID-19) pandemic. We focused on changes in mental health (anxiety and depression symptoms, morbid thoughts, and suicidal ideation) and quality of life. Our retrospective study included 499 adults comprising 316 women and 173 men (aged 18-72, Me = 27, SD = 12.48). We employed the following research tools: the General Health Questionnaire (GHQ-30), the shortened version of the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), and the abridged version of the Harkavy Asnis Suicide Survey (HASS-BREF) scale to assess the severity of suicidal ideations and behaviors, as well as the Young Schema Questionnaire (YSQ-S3-PL). The questionnaires' instructions for the subjects were modified to obtain information for three specific periods: before the pandemic, at the most difficult time of the pandemic for individuals, and in the last two weeks (the time period preceding data collection; January/February 2021). It emerged that both mental health and quality of life had deteriorated significantly in the studied population. In addition, early maladaptive schemas (Abandonment, Vulnerability to Harm, and Insufficient Self-Control) were likely predictors of mental health deterioration at the most difficult time of the COVID-19 pandemic. The schema of Defectiveness was likely predictor of a lower severity of symptoms of mental health disturbances. If psychological diagnosis covered the identification of thinking patterns typical of maladaptive schemas, which may be a risk factor for mental health deterioration, psychologists could better adapt forms and ways of psychological assistance to the patient's needs.

[A Structural Equation Model for Posttraumatic Growth among Cured Patients with COVID-19]

PURPOSE

This study aimed to develop and test a model for posttraumatic growth among cured patients with COVID-19. This model was based on Calhoun and Tedeschi's Posttraumatic Growth model and a literature review.

METHODS

The participants comprised 223 patients cured from COVID-19 who were ≥ 19 years of age. The data were collected through an online questionnaire from March 21 to 24, 2022. The assessment tools included the Impact of Event Scale: Revised Korean version, the Connor-Davidson Resilience Scale, the Distress Disclosure Index, the Multidimensional Scale of Perceived Social Support, the Korean version of the Event-related Rumination Inventory, and the Korean version of the Post-traumatic Growth Inventory. Data were analyzed using the IBM SPSS version 24.0 and IBM AMOS 26.0.

RESULTS

The modified model showed appropriate goodness of fit (χ² = 369.90, χ²/degree of freedom = 2.09, SRMR = .09, RMESA = .07, CFI = .94, TLI = .93). The post-traumatic growth of cured patients with COVID-19 was explained through distress perception, self-disclosure, and deliberate rumination, with the explanatory power being 70.0%.

CONCLUSION

This study suggests preparing a disaster psychology program involving experts who can activate deliberate rumination is necessary. Further, this study may serve as basic data for developing a program to enhance the post-traumatic growth of patients cured from COVID-19.

Daily stress, family functioning and mental health among Palestinian couples in Israel during COVID-19: A moderated mediation model

The COVID-19 pandemic created a range of stressors, among them difficulties related to work conditions, financial changes, lack of childcare, and confinement or isolation due to social distancing. Among families and married individuals, these stressors were often expressed in additional daily hassles, with an influence on mental health. This study examined two moderated mediation models based on Bodenmann's systemic-transactional stress model. Specifically, the models tested the hypothesis that intra-dyadic stress mediates the association between extra-dyadic stress and mental health, while two measures of family functioning, cohesion and flexibility, moderate the relationship between extra and intra-dyadic stress. Participants were 480 Palestinian adults in Israel who completed self-report questionnaires. All were in opposite-sex marriages and identified as either cisgender women or cisgender men. The results showed partial mediation patterns supporting both models, indicating that family cohesion and flexibility weakened the mediating effect of intra-dyadic stress on the relationship between extra-dyadic stress and mental health. These findings increase our understanding of the variables that affected mental health during the pandemic, and suggest that when faced with extra-dyadic stress, married individuals with good family environments are less likely to experience high levels of intra-dyadic stress, which is in turn associated with preserved mental health. Limitations and implications for planning interventions for couples and families during the pandemic are discussed.

Primacy Effect of Dynamic Multi-Sensory Covid ADV Influences Cognitive and Emotional EEG Responses

Advertising uses sounds and dynamic images to provide visual, auditory, and tactile experiences, and to make the audience feel like the protagonist. During COVID-19, companies modified their communication by including pandemic references, but without penalizing multisensorial advertising. This study investigated how dynamic and emotional COVID-19-related advertising affects consumer cognitive and emotional responses. Nineteen participants, divided into two groups, watched three COVID-19-related and three non-COVID-19-related advertisements in two different orders (Order 1: COVID-19 and non-COVID-19; Order 2: non-COVID-19 and COVID-19), while electrophysiological data were collected. EEG showed theta activation in frontal and temporo-central areas when comparing Order 2 to Order 1, interpreted as cognitive control over salient emotional stimuli. An increase in alpha activity in parieto-occipital area was found in Order 2 compared to Order 1, suggesting an index of cognitive engagement. Higher beta activity in frontal area was observed for COVID-19 stimuli in Order 1 compared to Order 2, which can be defined as an indicator of high cognitive impact. Order 1 showed a greater beta activation in parieto-occipital area for non-COVID-19 stimuli compared to Order 2, as an index of reaction for painful images. This work suggests that order of exposure, more than advertising content, affects electrophysiological consumer responses, leading to a primacy effect.

Initial Psychological Reactions to COVID-19 of Middle Adolescents in Portugal

In its early stage, the COVID-19 pandemic and the subsequent public health measures brought several challenges to people in general, with adolescents being one of the most affected groups. To assess the psychological reactions of Portuguese adolescents in that early phase of the COVID-19 pandemic, we conducted an online survey that was filled by a sample of 340 (67.6% female and 32.4% male) middle adolescents (aged 16 and 17 years). Using the Impact Event Scale-Revised and the Depression, Anxiety, and Stress Scale, we found that most participants reported a normal score for depression, anxiety, and stress. However, 47.1% reported some level of pandemic-related traumatic distress, and 25.6% reported high severity values. The girls' levels of depression, anxiety, stress, and traumatic distress were significantly higher than those of the boys. Regression models showed that gender, number of symptoms experienced in the past days, self-reported health status, and concern with family were significant predictors of these mental health indicators. Our findings underscore the need for future research on the long-term traumatic psychological impact of the COVID-19 pandemic in adolescents, and on the gender differences in this group. This will allow the development of strategies to identify and address at-risk adolescents, since the promotion of mental health and the prevention of pathology are imperative for the health of current and future generations.

Implicit IAT Measures and Neurophysiological fNIRS Markers in Response to High-Engagement Advertising

Self-report measures partially explain consumers' purchasing choices, which are inextricably linked to cognitive, affective processes and implicit drives. These aspects, which occur outside of awareness and tacitly affect the way consumers make decisions, could be explored by exploiting neuroscientific technology. The study investigates implicit behavioural and neurovascular responses to emotionally arousing and high-engagement advertisements (COVID-19 content). High-engagement advertisements and control stimuli were shown in two experimental sessions that were counterbalanced across participants. During each session, hemodynamic variations were recorded with functional Near-Infrared Spectroscopy (fNIRS) of the prefrontal cortex (PFC), a neurophysiological marker for emotional processing. The implicit association task (IAT) was administered to investigate the implicit attitude. An increase in the concentration of oxygenated haemoglobin (O2Hb) was found for the high-engagement advertising when this category of stimuli was seen first. Specular results were found for deoxygenated haemoglobin (HHb) data. The IAT reported higher values for highly engaging stimuli. Increased activity within the PFC suggests that highly engaging content may be effective in generating emotional arousal and increasing attention when presented before other stimuli, which is consistent with the higher IAT scores, indicating more favourable implicit attitudes. This evidence suggests that the effectiveness of highly engaging advertising-related messages may be constrained by the order of advertisement administration.

Relationship between perceived social support and post-traumatic growth in coronavirus disease 2019 patients discharged from the hospital

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has affected mental health and physical health negatively in some individuals. Examining perceived social support and post-traumatic growth (PTG) in COVID-19 patients could facilitate our understanding of how patients maintain their mental health.

AIM

To examine the relationship between the level of perceived social support and PTG in COVID-19 patients discharged from the hospital.

METHODS

This descriptive study was carried out between August and September 2022 with patients who were hospitalized due to COVID-19 in a university hospital in Erzurum and who were discharged at least 3 mo prior to the beginning of the study. The study was completed by 196 patients. Study data were collected face-to-face using a personal information form, multidimensional scale of perceived social support and PTG inventory.

RESULTS

The total mean score of the multidimensional scale of perceived social support was 63.82 ± 15.72. The PTG inventory total mean score was 47.77 ± 19.85. In addition, a direct significant correlation was found between perceived social support in COVID-19 patients and PTG.

CONCLUSION

The study results showed that perceived social support variables affected PTG significantly. Therefore, it is recommended for healthcare professionals to implement interventions to promote social support from healthcare professionals and the patient’s family and friends. Considering the negative effects of the ongoing COVID-19 pandemic, it is very important and necessary to implement effective public health interventions to promote PTG to reduce mental health problems.

A confirmatory factor analysis of a cognitive model of COVID-19 related anxiety and depression

The mental health impact of the COVID-19 pandemic has been significant, with many regions across the globe reporting significant increases in anxiety, depression, trauma, and insomnia. This study aims to validate a potential cognitive model of maintenance factors of COVID-19 related distress by examining psychological predictors of distress, and their goodness-of-fit as a coherent model. Participants from the general population (n = 555) were recruited using a cross-sectional on-line survey design, assessing Demographic factors, Anxiety, Depression, Loneliness, COVID-19 related distress, Trauma Cognitions related to COVID-19, Rumination, Safety Behaviours, Personality Factors, and Mental Effort related to COVID-19. A series of stepwise linear regressions found that components of the model were significant and accounted for a large percentage of variance when examining Covid-19 related distress (R² = 0.447 Covid Stress Scale), Anxiety (R² = 0.536 DASS-Anxiety Subscale) and Depression (R² = 0.596 Depression DASS-subscale). In a confirmatory factor analysis, Loneliness, Post-Traumatic Cognitions about Self, Post-Traumatic Cognitions about the World, Emotional Stability, and Mental Effort related to COVID-19 loaded onto a single factor. The final model showed adequate fit (CFI = 0.990, TLI = 0.983, RMSEA = 0.053 (0.027-0.080), GFI = 0.986, SRMR = 0.0216, χ2 = 23.087, p = .006). The results highlight the importance of cognitive factors, such as post-traumatic cognitions, rumination, and mental effort in maintaining COVID-19 related distress.

Promoting Emotional and Psychological Well-Being During COVID-19 Pandemic: A Self-Help Virtual Reality Intervention for University Students

Mental health problems are very common among university students, and the situation worsened during the COVID-19 pandemic. The closure of universities, the restrictions imposed, and the reduction of social activities led to considerable changes in students' lives, thus posing new mental health and emotional challenges. Within this context, promoting university students' general well-being, in particular emotional and psychological well-being, becomes essential. In addition to the possibility of online interventions aimed at overcoming distance limitations and reaching people at their home, other advanced technologies such as virtual reality (VR) have demonstrated the potential to improve people's well-being, quality of life, and positive experiences. The study reported in this article is aimed at exploring the feasibility and preliminary effectiveness of a self-help VR intervention lasting 3 weeks in promoting emotional well-being in university students. Forty-two university students voluntarily participated in a six-session intervention. In each session, a different virtual scenario was presented: two relaxing experiences and four transformative experiences based on metaphors or metaphoric ones aimed at encouraging students to be aware of their emotions and positive resources. Students were randomly allocated to an experimental group and to a waiting list group that started the intervention after 3 weeks. Before and after the six sessions, participants completed an assessment by completing online questionnaires. Results showed a significant increase in both emotional well-being and psychological well-being in the experimental group compared to the waiting list group. The majority of participants said that they would recommend the experience to other students.

The Moderating Role of Self-Care Behaviors in Personal Care Aides of Older Adults during the COVID-19 Pandemic

The COVID-19 pandemic has brought new challenges and work changes for formal caregivers such as personal care aides with an impact on their quality of life (QoL). This cross-sectional study aims to analyze the relationships and contribution of sociodemographic and psychological variables towards QoL including the moderating role of self-care. This study included 127 formal caregivers from Portugal who were assessed on depression, anxiety and stress (DASS-21); professional self-care (SCAP); quality of life (SF-12); COVID-19 traumatic stress (COVID-19TSC) and preventive COVID-19 infection behaviors (PCOVID-19 IBS). Professional self-care was positively associated with QoL and also moderated the relationship between distress and QoL (p < 0.001). According to results, nursing homes should provide formal caregivers, such as personal care aides, with the professional support they need in order to promote their QoL and prevent burnout.

Postacute Sequelae of COVID-19 and Adverse Psychiatric Outcomes: Protocol for an Etiology and Risk Systematic Review

BACKGROUND

The postacute sequelae of COVID-19 (PASC) is a syndrome characterized by persistent COVID-19 symptoms or the onset of new symptoms following recovery from the initial or acute phase of the illness. Such symptoms often occur 4 or more weeks after being diagnosed with COVID-19. Although a lot of work has gone into understanding the long-term mental health effects of PASC, many questions related to the etiology and risk of this condition remain.

OBJECTIVE

This protocol is for a systematic review assessing the association between PASC and adverse psychiatric outcomes and whether people with PASC are at greater risk of developing an adverse psychiatric outcome than those without PASC.

METHODS

Various medical literature databases (eg, PubMed and EMBASE) will be searched for eligible articles, using predefined search criteria. Gray literature will also be explored. Epidemiological observational studies and secondary analyses of randomized controlled trials that report a quantitative relationship between PASC and at least one adverse psychiatric outcome will be included. The Population, Exposure of interest, Comparator, and Outcome framework will be used as a standardized framework for the inclusion criteria. The Joanna Briggs Institute critical appraisal tools will be used to assess methodological quality and critically appraise the risk of bias in included studies. A random-effects meta-analysis will be conducted if possible. A formal narrative synthesis will be performed if a meta-analysis is impossible due to substantial heterogeneity across studies. The Grading of Recommendations Assessment, Development and Evaluation approach will be used to rate the cumulative certainty of the evidence for all outcomes. Ethical approval is not required. The study results will be published in a peer-reviewed journal.

RESULTS

This study documents and addresses etiology, risk factors, and long-term symptoms of COVID-19 among people with PASC. It focuses on a key priority area for new evidence syntheses on the clinical management of COVID-19 and pandemic-related conditions. It will include evidence on nonhospitalized and hospitalized patients with a history of PASC.

CONCLUSIONS

Substantial heterogeneity across studies may limit the ability to perform a meta-analysis. Findings will inform disease prevention, decision-making, health care policy, and clinical research (Reviewed by the Plan P #PeerRef Community).

TRIAL REGISTRATION

PROSPERO CRD42022308737; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=308737.

Association between Social and Emotional Competencies and Quality of Life in the Context of War, Pandemic and Climate Change

The present context, with an ongoing pandemic situation, war and climate change, seems to play a critical role in both the peoples’ perception of their quality of life, and the acquisition and development of social and emotional competencies. In this study, our goal was to assess the relationship between social and emotional competencies and peoples’ quality of life in a Portuguese sample. Participants were 1139 individuals living in Portugal, aged between 16 and 85 years old, who were mostly (73%) female. An online protocol for data acquisition was used, which included sociodemographic characterization, the Portuguese version of the scale of Social and Emotional Competencies (SEC-Q) and the World Health Organization Quality of Life (WHOQOL-BRIEF). Correlation analysis and a canonical correlation were performed, with results showing a high association between the dimensions of social and emotional competencies and peoples’ quality of life. Two significant canonical roots were extracted, and the results show that the first is characterized by internal factors, linking psychological health and self-management and motivation, and the second root evidences the external factors, linking social relations and environment with social awareness and pro-social behavior.

Posttraumatic stress disorder symptoms among Chinese college students following the COVID-19 outbreak

Objective

This study examined the prevalence of posttraumatic stress disorder (PTSD) symptoms in college students 1 month after the lockdown of Wuhan to identify possible risk factors for PTSD symptoms in a cross-sectional study.

Methods

Out of 10,502 who responded, 9,274 students impacted by the COVID-19 pandemic were included in our study. PTSD symptoms was evaluated by the Impact of Event Scale-revised (IES-R). Anxiety/depression symptoms were evaluated by the Kessler Psychological Distress Scale (K10). Personality traits, coping style, and social support were assessed by the Eysenck Personality Questionnaire-Revised Short Scale for Chinese (EPQ-RSC), the Simplified Coping Style Questionnaire (SCSQ), and the Social Support Rating Scale (SSRS). Logistic regression analysis was utilized to further explore risk factors for PTSD symptoms.

Results

More than 1 month after the COVID-19 outbreak, 13.1% of college students developed PTSD symptoms, indicating that COVID-19 associated stressful experiences were connected with PTSD symptoms. After the COVID-19 outbreak, subjects with symptomatologic PTSD symptoms were more likely to experience strained relationships with their family, to have close contact with COVID-19 patients and to drop out of college. The logistic regression model demonstrated the association factors of PTSD symptoms. Neuroticism, psychoticism and an avoidant coping style were associated with increased risk for PTSD symptoms, while an active coping style was protective against PTSD symptoms during this pandemic.

Conclusion

The results showed that PTSD symptoms was prevalent in Chinese college students 1 month after the COVID-19 outbreak. Effective psychological support work should be carried out accordingly.

The traumatic impact of the COVID-19 pandemic: the possible role of rumination and uncertainty

The COVID-19 pandemic has caused some traumatic injuries to individuals due to the isolation, loneliness, and uncertainty it has created. Ruminative thoughts and uncertain situations are known to affect trauma. It aimed to evaluate the traumatic effect of the pandemic based on the ruminative thoughts and intolerance of uncertainty in the study. The sample for the descriptive and cross-sectional study consisted of 402 participants. Data were collected by using the questionnaire form, the Post Traumatic Stress Disorder Scale (PTSD), the Ruminative Reactions Scale (RRS), and the Intolerance of Uncertainty Scale (IUS). A positive correlation was discovered between the PTSD mean scores of the study participants and their RRS and IUS scores (p < .05). Furthermore, RRS (β = 0.280) was identified as a variable that primarily affected PTSD (p < .05). It was concluded that both ruminative thoughts and intolerance of uncertainty were predictors of post-traumatic stress disorder in the COVID-19 pandemic. Considering the possible effects of the pandemic, it is recommended to reduce the intolerance to uncertainty, to rework the ruminative thought content with appropriate and effective methods, and to create some programs for gaining problem-solving skills.

"Unprecedented Times:" Experiences of Social Work and Public Health Professionals during Times of Public Crises

Social workers and public health professionals in the U.S. were profoundly impacted by COVID-19, systemic racism, and the 2020 U.S. presidential election. This study examined their external job support, burnout, and job satisfaction in the context of these circumstances. The findings suggest respondents, who had graduate degrees in social work or public health, overemphasized their job satisfaction and underemphasized their burnout. While social work and public health professionals felt satisfied with their labor, not acknowledging burnout limits the amount of support they may access to effectively continue the work. Interestingly, participants who had more administrative functions reported higher job satisfaction scores and lower burnout scores. Traditionally, those in administrative positions have more control over their schedule and work responsibilities. Findings suggest that more training, opportunities for self-care, and discussions about safety and systemic racism are needed in the workplace for social workers and public health professionals.

When Staying Home Is Not Safe: An Investigation of the Role of Attachment Style on Stress and Intimate Partner Violence in the Time of COVID-19

Intimate partner violence (IPV) is a major public health concern, with increasing rates of IPV being seen around the world during the COVID-19 pandemic. Previous research has linked the perpetration of IPV and other forms of sexual violence to aspects of romantic attachment psychology, with insecure anxious/preoccupied attachment most often linked to higher rates of IPV. Stressful events typically activate the attachment system and may either aggravate or disrupt its regulatory functioning. In the present study, we investigated whether COVID-related PTSD and depressive symptoms were associated with increased IPV perpetration and whether this relationship was moderated by levels of attachment security. Our findings indicated that higher COVID-related PTSD was significantly associated with increased IPV perpetration in securely attached individuals, whereas depressive symptoms was significantly associated with decreased IPV perpetration in securely attached individuals. IPV perpetration by insecure individuals was consistently high regardless of COVID-related PTSD or depressive symptoms. These findings suggest that COVID-related PTSD may erode adaptive attachment functioning, particularly among the previously secure, which can have important consequences for secure individuals and their intimate partners. The present findings may explain some of the recent increase in IPV cases worldwide and serve to raise awareness and motivate clinical interventions to more efficiently help both victims and perpetrators of IPV stay safe while staying home.

COVID-19 and Eating Problems in Daily Life: The Mediating Roles of Stress, Negative Affect and Posttraumatic Stress Symptoms

Background The COVID-19 pandemic poses a challenge to individuals' mental health. People worldwide are experiencing increased stress, negative affect, and posttraumatic stress symptoms, which may lead to eating problems. The purpose of this study was to explore the impact of the perceived severity of COVID-19 on eating problems and the mediating effects of stress/negative affect/posttraumatic stress symptoms both at the personal level and interpersonal level. Methods: During the COVID-19 outbreak, a total of 108 college students were recruited to report their perceived severity of COVID-19, stress, negative affect, posttraumatic stress symptoms, and eating problems three times a day for seven consecutive days using Ecological Momentary Assessment. Results: State perceived severity of COVID-19 predicted fewer subsequent eating problems in daily life at the personal level. Both state negative affect and posttraumatic stress symptoms were positively associated with eating problems in daily life. At the interpersonal level, trait-like perceived severity of COVID-19, stress, negative affect, and posttraumatic stress symptoms were positively associated with overall eating problems. There were no mediating effects of stress/negative affect/posttraumatic stress symptoms on the relations between perceived severity of COVID-19 and eating problems at the personal/interpersonal level. Conclusions: The perceived severity of COVID-19, stress, negative affect, and posttraumatic stress symptoms might increase the risk of eating problems.

Causal Model Analysis of the Effect of Formalism, Fear of Infection, COVID-19 Stress on Firefighters' Post-Traumatic Stress Syndrome and Insomnia

As the front line of epidemic prevention, firefighters are responsible for the transportation of infected cases. Firefighters are under a lot of stress from the new COVID-19, especially the fear that they may contract the virus at work and spread the virus to their families. In particular, the framework of this study incorporates Riggs' formalism variables. When firefighters think that the epidemic prevention regulations are inconsistent with the actual epidemic prevention, it will increase their work pressure on COVID-19. In this study, firefighters from all over Taiwan were used as the respondents, and a total of 453 respondents were obtained. This study uses confirmatory factor analysis and structural equation modeling to test the established hypotheses. The findings confirm that formalism, fear of self and family infection are positively influencing COVID-19 stress. COVID-19 stress positively affects PTSD and insomnia. COVID-19 stress negatively affects problem-focused strategies. Problem-focused strategies negatively affect post-traumatic stress disorder.

Has the COVID-19 Pandemic Worsened Health-Related Quality of Life of Patients with Inflammatory Bowel Disease? A Longitudinal Disease Activity-Controlled Study

The present longitudinal study aimed to investigate the burden of disease activity change on health-related quality of life (HRQoL) of patients with inflammatory bowel disease (IBD) during the two different pandemic waves in 2020 and 2021. A sample of 221 IBD patients (recruited during March-May 2020 for T0 and March-May 2021 for T1) was included. The psychological impact of the COVID-19 pandemic (Impact of Event Scale-Revised (IES-R)) and HRQoL (Inflammatory Bowel Disease Questionnaire (IBDQ)) were assessed. Post-traumatic COVID-19-related symptoms (IES-R) were not significantly different across the disease activity-related groups. Conversely, IBDQ was consistently higher in patients with persistent, quiescent disease activity compared to the other groups, as expected. Even after controlling for baseline IES-R, repeated-measures ANCOVA showed a non-significant main effect of time (p = 0.60) but a significant time-per-group interaction effect with a moderate effect size (η2 = 0.08). During the two different phases of pandemic restrictions, IBD-specific HRQoL was modified by disease-related factors such as disease activity, rather than by the post-traumatic symptoms of COVID-19. This lends further weight to the need for developing an evidence-based, integrated, biopsychosocial model of care for patients with IBD to identify subjective and objective factors that affect the burden of disease.

Mental health status and psychosocial issues during Nationwide COVID-19 quarantine in Iran in 2020: A cross-sectional study in Mazandaran Province

The coronavirus disease 2019 (COVID-19) pandemic is spreading rapidly, and its psychosocial impact remains a big challenge. In this respect, quarantine has been recommended, as a significant practice, to prevent the given condition. Therefore, the present study was to determine the prevalence rates of depression, anxiety, and stress and to reflect on the impact of COVID-19, as a traumatic stressor event, on individuals. This web-based survey was fulfilled via an online questionnaire, completed by respondents selected through the cluster sampling technique, from March 24 to April 10, 2020, living in Mazandaran Province, Northern Iran. Accordingly, the data regarding demographic characteristics, physical health status, quarantine compliance, contact with COVID-19, and additional information were collected. The psychosocial impact of the pandemic was then assessed by the Impact of Event Scale-Revised (IES-R), and the respondents' mental health status was evaluated using the Depression, Anxiety, and Stress Scale-21 (DASS-21). Data analysis was further performed by linear regression. The study findings, from 1075 respondents, revealed that 22.5% of the cases had moderate-to-severe depression, 38.5% of the individuals were suffering from moderate-to-severe anxiety, and 47.2% of the participants were experiencing moderate-to-severe stress. In 14.5% of the respondents, the psychosocial impact of COVID-19 also varied from the possibility of post-traumatic stress disorder (PTSD) to immunosuppression (p < 0.01). With the high prevalence rates of depression, anxiety, and stress, mental health professionals are suggested to develop psychosocial interventions and support plans for the general population to reduce the impact of the COVID-19 pandemic on public mental health status.

Emerging Materials, Wearables, and Diagnostic Advancements in Therapeutic Treatment of Brain Diseases

Among the most critical health issues, brain illnesses, such as neurodegenerative conditions and tumors, lower quality of life and have a significant economic impact. Implantable technology and nano-drug carriers have enormous promise for cerebral brain activity sensing and regulated therapeutic application in the treatment and detection of brain illnesses. Flexible materials are chosen for implantable devices because they help reduce biomechanical mismatch between the implanted device and brain tissue. Additionally, implanted biodegradable devices might lessen any autoimmune negative effects. The onerous subsequent operation for removing the implanted device is further lessened with biodegradability. This review expands on current developments in diagnostic technologies such as magnetic resonance imaging, computed tomography, mass spectroscopy, infrared spectroscopy, angiography, and electroencephalogram while providing an overview of prevalent brain diseases. As far as we are aware, there hasn't been a single review article that addresses all the prevalent brain illnesses. The reviewer also looks into the prospects for the future and offers suggestions for the direction of future developments in the treatment of brain diseases.

Post-pandemic stress of COVID-19 among high-risk groups: A systematic review and meta-analysis

BACKGROUND

Post-Traumatic Stress Disorder (PTSD) is considered as a prevalent outcome of the COVID-19 pandemic. This study aimed to present a global picture of the prevalence of PTSD in high-risk groups for COVID-19 (HRGs-COVID19) and determine its risk factors.

METHODS

Cross-sectional studies published between March 11, 2020, and October 11, 2021, in English, were searched in seven databases on the prevalence of PTSD in HRGs-COVID19. After screening the retrieved records, their quality was assessed, and the required data were extracted. R-4.1.3 software and random effect model with 95 % confidence interval (CI) were used to synthesize and analyze the data.

RESULTS

The pooled prevalence of PTSD in HRGs-COVID19 was 30 % (95 % CI: 21-39 %). The pooled prevalence of PTSD was significantly different in terms of the variables of data collection during the lockdown, gender, and data collection season (P < 0.05). Subgroup analyses could not identify sources of heterogeneity.

LIMITATIONS

The included studies did not cover all HRGs-COVID19 such as smokers and the elderly.

CONCLUSION

Considering the higher pooled prevalence of PTSD in HRGs-COVID19 than the general population, COVID-19 patients, and health care workers, prioritizing this subgroup for prevention and treatment of psychological outcomes is highly recommended. Predicting and implementing psychological interventions early in the pandemic is more critical when applying restrictive measures and among HRGs-COVID19 women.

Predictors of Students' Mental Health during the COVID-19 Pandemic: The Impact of Coping Strategies, Sense of Coherence, and Social Support

Young people and women seem to suffer more from social restrictions due to the COVID-19 pandemic than do others. Findings from pre-pandemic surveys identified students as a specific risk group for developing anxiety and depressive symptoms. Recent studies have indicated that students especially denoted a decrease in mental health during the pandemic. In a sample of n = 1938 university students (67.6% female), we investigated protective factors that are associated with mental health (defined as the absence of any mental disorder) and more specifically, the absence of major depression during the pandemic despite social restrictions. Investigated protective factors were social support, sense of coherence and situational coping strategies. The results of the multiple logistic regression analyses revealed that male gender, high sense of coherence and specific coping strategies could be identified to be associated with mental health in general and the absence of major depression. Protective coping strategies that were related to mental health in general were lower substance use, lower behavioral disengagement, higher positive reframing and lower self-blame. Protective coping strategies that were associated with the absence of major depression specifically were higher use of instrumental support, lower substance use, lower behavioral disengagement, higher positive reframing, higher emotional support, lower self-blame and lower humor. Social support was related to the absence of major depression, but not to mental health in general. Higher age in university students was associated with better mental health, but not with the absence of major depression specifically. These findings indicate that sense of coherence and situational coping strategies can buffer the adverse effect of social restrictions on mental health and thus, can serve as important resilience factors. Moreover, they highlight the political relevance of promoting specific coping strategies to foster mental health in students encompassing adverse events and social restrictions.

Prevalence of long COVID-19 among healthcare workers: a systematic review and meta-analysis protocol

INTRODUCTION

A proportion of those who survive the acute phase of COVID-19 experience prolonged symptoms, commonly known as long COVID-19. Given that healthcare workers (HCWs) face an elevated risk of acute COVID-19 compared with the general population, the global burden of long COVID-19 in HCWs is likely to be large; however, there is limited understanding of the prevalence of long COVID-19 in HCWs, or its symptoms and their clustering. This review will aim to estimate the pooled prevalence and the symptoms of long COVID-19 among HCWs infected with SARS-CoV-2 globally, and investigate differences by country, age, sex, ethnicity, vaccination status and occupation.

METHODS AND ANALYSIS

A systematic review and meta-analysis will be conducted. Medline (via Ovid), CINAHL (via EBSCO), Embase (via Ovid), PsycINFO (via EBSCO), OpenGrey (grey literature) and medRxiv (preprint server) will be searched from the 31 December 2019 onward. All research studies and preprint articles reporting any primary data on the prevalence and/or the symptoms of long COVID-19 among adult HCWs will be included. Methodological quality will be assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Outcomes are anticipated to be the prevalence of long COVID-19 among HCWs around the world and trajectory of symptoms. Data synthesis will include random-effect meta-analysis for studies reporting prevalence data of long COVID-19 following SARS-CoV-2 infection among HCWs. The results will be presented with a 95% CI as an estimated effect across studies. Heterogeneity will be assessed using I² statistic. Where meta-analysis is inappropriate, a narrative synthesis of the evidence will be conducted.

ETHICS AND DISSEMINATION

Ethical approval is not needed as data will be obtained from published articles. We will publish our findings in a peer-reviewed journal and disseminate the results of our review at conferences.

PROSPERO REGISTRATION NUMBER

CRD42022312781.

An Exploratory Mixed-method Descriptive Analysis of Youth Coping during the First Wave of the COVID-19 Pandemic in Quebec

This study presents an exploratory mixed-method descriptive analysis of psychological distress, challenges encountered and coping strategies of youth during the first wave of COVID-19. A total of 4 914 Quebec youth, aged 14 to 25 recruited through social media completed an online survey on the impact of the pandemic on their daily life, psychological distress and post-traumatic growth. They were also invited to answer two open-ended questions regarding the difficulties they experienced and their coping strategies. Overall, 26.6% of youth showed serious psychological distress and 20.3% displayed probable PTSD symptoms related to the COVID-19. Comparative analyses revealed that youth identifying as gender and sexual minorities were more vulnerable to distress during the first wave of the pandemic. While few sociodemographic variables distinguish youth reporting post-traumatic growth from those who do not, the former group was more likely to seek and receive social support. Qualitative data highlighted difficulties that were common to many respondents including lack of social contacts, the lockdown itself, and problems related to disruptions of educational and academic activities. Youth also mentioned three main strategies they used to cope: maintaining social contacts, engaging in leisure activities and physical exercise. While many youths have encountered compelling challenges during the lockdown of the first wave of COVID-19, some report having relied on efficient coping strategies to deal with the situation. Support services should be implemented to help the youth cope with the pandemic while considering their diverse needs.

A Multicenter Network Analysis Examining the Psychological Effects of the COVID-19 Pandemic on Patients with Eating Disorders versus Their Healthy Siblings

(1) Background: The impact of the COVID-19 pandemic on individuals with eating disorders (EDs) has been recorded all over the world; the traumatic effects of COVID-19 have exacerbated specific and general psychopathologies in those with EDs. Comparing patients' and their healthy siblings' responses might help one evaluate whether there are significant differences between healthy individuals and those struggling with EDs in regard to posttraumatic psychological symptoms. (2) Methods: A sample of 141 ED patients and 99 healthy siblings were enrolled in this study in two different centers specializing in ED treatment. All participants completed the posttraumatic stress disorder (PTSD) checklist and an eating and general psychopathological self-report questionnaire. Network analysis was then applied to evaluate the differences between the populations. (3) Results: No significant differences emerged between the network structures despite the significant differences between patients and their healthy siblings in regard to posttraumatic symptoms, eating, and general psychopathology. (4) Conclusion: The complex nature of the interaction between environmental and personal factors should be evaluated further in individuals with EDs due to how they respond to traumatic events, which exacerbate patients' psychopathology.