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Johnson MS, Skjerdingstad N, Hoffart A, Ebrahimi OV, Johnson SU. Triggered by worry: A dynamic network analysis of COVID-19 pandemic-related anxiety and parental stress. J Affect Disord 2024; 346:329-337. [PMID: 37977301 DOI: 10.1016/j.jad.2023.10.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Major disruptions to daily life routines made families and parents particularly vulnerable to psychological distress during the COVID-19 lockdowns. However, the specific psychopathological processes related to within-person variation and maintenance of anxiety symptomatology and parental distress components in the parental population have been largely unexplored in the literature. METHODS In this preregistered intensive longitudinal study, a multilevel dynamic network was used to model within-person interactions between anxiety symptomatology, psychopathological processes, parental distress, and protective lifestyle components in a sample of 495 parents-each responding to daily assessments over a 40-day period. A total of 30,195 observations were collected across the subjects. RESULTS Extensive worry, threat monitoring, and uncontrollability of worry were identified as overreaching psychopathological processes related to the aggravation of other symptoms of anxiety and parental distress. A strong association was found between parental stress and parental burnout. Anger toward one's child was associated with both parental stress and parental burnout. Protective factors showed the lowest strength centrality, with few and weak connections to other symptoms and processes in the network. LIMITATIONS Associations may exist between the study variables on a different time scale; hence, different time lags should be used in future research. CONCLUSIONS Accessible, low-cost interventions that address worry, threat monitoring, and the uncontrollability of worry could serve as potential targets for reducing the symptom burden of anxiety and distress in the parental population.
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Affiliation(s)
- Miriam S Johnson
- Department of Behavioural Sciences, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Nora Skjerdingstad
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway
| | - Asle Hoffart
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway; Modum Bad Psychiatric Hospital, and Research Center, Vikersund, Norway
| | - Omid V Ebrahimi
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway; Modum Bad Psychiatric Hospital, and Research Center, Vikersund, Norway
| | - Sverre Urnes Johnson
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway; Modum Bad Psychiatric Hospital, and Research Center, Vikersund, Norway
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Semeraro C, Giofrè D, Coppola G, Verri V, Bottalico M, Cassibba R, Taurino A. The role of maladaptive personality traits on psychological stress the mediating effects of COVID-19-related worries and emotional dysregulation. Pers Individ Dif 2023; 213:112270. [PMID: 37333976 PMCID: PMC10229649 DOI: 10.1016/j.paid.2023.112270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 06/20/2023]
Abstract
There is increasing evidence that dysfunctional personality traits, related to psychological maladjustment and psychopathology, can play an important role in a person's ability to cope with major stressful events. Relatively little is known about the specific effect of the emotional component on the relationship between maladaptive personality traits and psychological stress. Therefore, the aim of the present study was to investigate the relationship between the maladaptive personality traits of psychoticism, detachment, and negative affect, and psychological stress, considering the effects of COVID-19-related worries and emotional dysregulation. An online survey was administered to 1172 adult participants. A series of path analysis models showed that maladaptive personality traits (psychoticism, detachment, and negative affect) are related to psychological stress. COVID-19-related worries and emotional dysregulation partially explained this association. The results suggest that in the early months of 2022, during the reduction of government restrictions, although the world population was no longer in nationwide lockdown, the COVID-19-related emotional component could still explain, at least in part, the association between maladaptive personality traits and psychological stress.
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Affiliation(s)
- Cristina Semeraro
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - David Giofrè
- Department of Educational Sciences, University of Genova, Italy
| | - Gabrielle Coppola
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Veronica Verri
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Morena Bottalico
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Rosalinda Cassibba
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Taurino
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
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Mohlman J, Basch CH, Bartoszek G, Magee S. Is a diverse sample of college students motivated by compassionate, neutral, or fear-inducing language in COVID-19 crisis messages? J Am Coll Health 2022:1-6. [PMID: 35834766 DOI: 10.1080/07448481.2022.2098032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 05/02/2022] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Objective: During public health emergencies such as the ongoing COVID-19 illness pandemic, it is essential to rapidly disseminate crisis messages which often contain embedded health directives. This study investigated which of three variants of the same messages (neutral tone, positive/compassionate tone, negative/fear-inducing tone) were most likely to motivate readers to engage in the health behavior proscribed in the message. Participants: Participants were 87 female and 41 male undergraduates at an urban university in the northeast U.S. Methods: A survey with three versions of eight different COVID messages containing health directives was administered. Results: Those who indicated stronger influence of positive/compassionate crisis messages (i.e., had higher Crisis Messages Survey scores) had higher adaptive health engagement scores, lower worry scores, and were likely to have had a past diagnosis of COVID-19. Moreover, a regression model including COVID-19 status and worry scores accounted for a significant proportion of variance in Crisis Messages Survey scores. Conclusions: Findings indicate that the use of neutral and compassionate language is optimal in motivating health behaviors embedded in university crisis messages.
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Affiliation(s)
- Jan Mohlman
- Psychology, William Paterson University, Wayne, NJ, USA
- Public Health, William Paterson University, Wayne, NJ, USA
| | | | | | - Sofia Magee
- Psychology, William Paterson University, Wayne, NJ, USA
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Feng Y, Krahé C, Koster EH, Lau JY, Hirsch CR. Cognitive processes predict worry and anxiety under different stressful situations. Behav Res Ther 2022. [DOI: 10.1016/j.brat.2022.104168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 07/14/2022] [Accepted: 07/22/2022] [Indexed: 11/19/2022]
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Meng ZQ, Leng Q, Wang X, Xu CH, Xu J, Liu Y. Comparative analysis of anxiety/depression scores in COVID-19 patients with disease severity, sleep patterns, and certain laboratory test results. Arch Med Sci 2022; 18:1262-1270. [PMID: 36160342 PMCID: PMC9479708 DOI: 10.5114/aoms/136111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 04/26/2021] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Coronavirus disease 2019 (COVID-19) is associated with severe emotional changes. This research aims to investigate the prevalence of anxiety and depression in COVID-19 patients and its relationship with disease severity, sleep patterns, lifestyle, and specific laboratory test results. MATERIAL AND METHODS An observational study of 52 Chinese patients with COVID-19 was conducted to assess the relation between anxiety and depression (evaluated with the Hospital Anxiety and Depression Scale) and laboratory findings (lymphocytes, C-reactive proteins, leukocytes, alanine aminotransferase, aspartate aminotransferase). The relationships between the severity of COVID-19 in patients, the Insomnia Severity Index (ISI) score, and the Hospital Anxiety and Depression Scale (HADS) score were also investigated. RESULTS There were statistically significant associations between disease, smoking, and HADS-A scores (p = 0.011/0.020). The HADS-D score of patients with the disease was higher than in those without a past medical history (p = 0.008). The difference in C-reactive protein (CRP) between different lung infections, the HADS-A and HADS-D scores between different ages and ISI groups, and the correlation between the two scores were statistically significant. CONCLUSIONS Anxiety and depression are associated with poor sleep quality, smoking, and past medical history in patients with COVID-19. Additionally, anxiety and depression were seen to coexist, and there was a positive correlation between them. Further, the inflammatory index CRP was significantly increased in bilateral lung infections.
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Affiliation(s)
- Zi-Qiang Meng
- Department of Hepatology, Xixi Hospital of Hangzhou, Hangzhou, China
| | - Qi Leng
- Department of Geriatrics, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, China
| | - Xu Wang
- Department of Ophthalmology, Xixi Hospital of Hangzhou, Hangzhou, China
| | - Chun-Hai Xu
- Department of Infection, The Second Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Jing Xu
- Department of Hepatology, Xixi Hospital of Hangzhou, Hangzhou, China
| | - Yan Liu
- Department of Hepatology, Xixi Hospital of Hangzhou, Hangzhou, China
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Kancherla N, Garlapati SKP, Raparla YK, Jamil M, Jamil J, Mannava SM. Survey of Stress in COVID Patient Post Treatment: A Qualitative Research. J Pharm Bioallied Sci 2021; 13:S1646-S1649. [PMID: 35018047 PMCID: PMC8686895 DOI: 10.4103/jpbs.jpbs_376_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Revised: 05/16/2021] [Accepted: 05/21/2021] [Indexed: 11/30/2022] Open
Abstract
AIM The purpose of our study was to examine the mental health status of patients with coronavirus disease-19 (COVID-19) who were hospitalized. METHODOLOGY In this cross-sectional study, 106 inpatients with COVID-19 who had stable clinical conditions were evaluated psychologically by questionnaire: Depression, anxiety, and stress scales-21 (DASS-21). RESULTS About one-third of patients had comorbidities. In totality, 97.2% of patients with COVID-19 had some grade of depression. Extent of depression, assessed with the help of the DASS questionnaire, was 85.8%. All patients (100%) had serious (0.9%) and grave level of (99.1%) anxiety. Regarding to stress levels, 97.1% of patients had some degree of stress. In the worsening of stress category, 84.9% of patients had high-stress levels. CONCLUSION The presence of such increased prevalence and seriousness of psychiatric disorders among hospitalized patients with COVID-19 underlines the necessity for serious consideration to the mental health standing of these patients.
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Affiliation(s)
- Neeraj Kancherla
- MBBS Interns, King George Hospital, Visakhapatnam, Andhra Pradesh, India
| | | | | | - Maria Jamil
- Intern, Tawam Hospital, Gulf Medical University, Al Jurf, Ajman, United Arab Emirates
| | - Javairia Jamil
- Sheikh Shakhbout Medical Center (SSMC), Gulf medical University, Al Jurf, Ajman, United Arab Emirates
| | - Sai Mahitha Mannava
- Kamineni Institute of Medical Sciences, Narketpally, Nalgonda District, Telangana, India
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Georgiades J, Cusworth K, MacLeod C, Notebaert L. The relationship between worry and attentional bias to threat cues signalling controllable and uncontrollable dangers. PLoS One 2021; 16:e0251350. [PMID: 33984007 PMCID: PMC8118555 DOI: 10.1371/journal.pone.0251350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 04/24/2021] [Indexed: 11/18/2022] Open
Abstract
People vary in the frequency with which they worry and there is large variation in the degree to which this worry disrupts their everyday functioning. Heightened tendency to experience disruptive worry is characterised by an attentional bias towards threat. While this attentional bias is often considered maladaptive, it can be adaptive when it concerns threat cues signalling dangers that can be mitigated through personal action. In this case, the resulting worry may increase the likelihood of this action being taken, with beneficial rather than disruptive consequences for everyday functioning. Thus, depending on its focus, attentional bias to threat could potentially drive worry that is high or low in disruptiveness. The current study addressed this possibility, by testing the novel hypothesis that the degree to which worry is disruptive is a function of the degree to which this attentional bias concerns all threat cues, rather than being restricted to threat cues signalling controllable dangers. Participants completed a novel probe task assessing their attention to threat cues signalling a future danger that could be controlled on some blocks, but not on others. Thus, the task revealed the degree to which their selective attention to threat cues was ‘aligned’ with danger controllability, by being more evident on blocks that permitted participant control of the danger signalled by the threat cues. The results indicate, contradicting the hypothesis under test, participants who reported high levels of disruptive worry demonstrated alignment of attentional bias to variations in danger controllability, whereas this was not the case for participants who reported high levels of non-disruptive worry. While caution is needed in the interpretation of the results due to methodological limitations, this study provides a new conceptual and methodological framework for future research on the attentional basis of individual differences in the tendency to experience disruptive vs non-disruptive worry.
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Affiliation(s)
- Jessie Georgiades
- School of Psychological Science, Centre for the Advancement of Research on Emotion, The University of Western Australia, Perth, Western Australia, Australia
- * E-mail:
| | - Kelly Cusworth
- School of Psychological Science, Centre for the Advancement of Research on Emotion, The University of Western Australia, Perth, Western Australia, Australia
| | - Colin MacLeod
- School of Psychological Science, Centre for the Advancement of Research on Emotion, The University of Western Australia, Perth, Western Australia, Australia
| | - Lies Notebaert
- School of Psychological Science, Centre for the Advancement of Research on Emotion, The University of Western Australia, Perth, Western Australia, Australia
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Shanok NA, Meltzer K, Frank C, Lugo V, Jones NA. Computerized inhibitory control training reduces anxiety in preadolescent students. Appl Neuropsychol Child 2021; 11:455-470. [PMID: 33605177 DOI: 10.1080/21622965.2021.1884984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The study examined the relationship between anxiety, inhibitory control (IC), and resting-state electroencephalography (EEG) in a critical age-range for social and emotional development (8-12-year-olds). The participants were assigned to 4 weeks of either an emotional IC training program, a neutral IC training program, or a waitlisted control, and were tested using cognitive, emotional, and EEG measures. The training was computerized and completed remotely. At baseline, IC accuracy scores were negatively related to both anxiety and depression levels (N = 42). Additionally, increased right lateral frontal alpha asymmetry was predictive of increased anxiety/depression scores. A series of multivariate analyses of covariance and post-hoc tests were conducted to compare effects in the participants that completed the full 16 sessions of training (N = 32). Overall the emotional and neutral training conditions showed similar improvements in IC accuracy, as well as reductions in anxiety compared to the waitlist condition. Minimal neurophysiological changes occurred from pre-to-post; however, lateral frontal asymmetry shifted leftward in the emotional training group. These findings highlight the potential of computerized IC training for mitigating negative emotional functioning in preadolescents. Future research is necessary to determine the long-term effects of IC training and whether longer training intervals facilitate persisting impacts.
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Affiliation(s)
- Nathaniel A Shanok
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
| | - Kelsey Meltzer
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
| | - Colin Frank
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
| | - Victoria Lugo
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
| | - Nancy Aaron Jones
- Behavioral Sciences Department, Florida Atlantic University, Boca Raton, Florida, USA
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Roma P, Monaro M, Muzi L, Colasanti M, Ricci E, Biondi S, Napoli C, Ferracuti S, Mazza C. How to Improve Compliance with Protective Health Measures during the COVID-19 Outbreak: Testing a Moderated Mediation Model and Machine Learning Algorithms. Int J Environ Res Public Health 2020; 17:E7252. [PMID: 33020395 PMCID: PMC7579153 DOI: 10.3390/ijerph17197252] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 09/29/2020] [Accepted: 09/30/2020] [Indexed: 12/23/2022]
Abstract
In the wake of the sudden spread of COVID-19, a large amount of the Italian population practiced incongruous behaviors with the protective health measures. The present study aimed at examining psychological and psychosocial variables that could predict behavioral compliance. An online survey was administered from 18-22 March 2020 to 2766 participants. Paired sample t-tests were run to compare efficacy perception with behavioral compliance. Mediation and moderated mediation models were constructed to explore the association between perceived efficacy and compliance, mediated by self-efficacy and moderated by risk perception and civic attitudes. Machine learning algorithms were trained to predict which individuals would be more likely to comply with protective measures. Results indicated significantly lower scores in behavioral compliance than efficacy perception. Risk perception and civic attitudes as moderators rendered the mediating effect of self-efficacy insignificant. Perceived efficacy on the adoption of recommended behaviors varied in accordance with risk perception and civic engagement. The 14 collected variables, entered as predictors in machine learning models, produced an ROC area in the range of 0.82-0.91 classifying individuals as high versus low compliance. Overall, these findings could be helpful in guiding age-tailored information/advertising campaigns in countries affected by COVID-19 and directing further research on behavioral compliance.
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Affiliation(s)
- Paolo Roma
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (P.R.); (M.C.); (E.R.); (S.B.); (S.F.)
| | - Merylin Monaro
- Department of General Psychology, University of Padova, 35131 Padova, Italy;
| | - Laura Muzi
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome, 00185 Rome, Italy;
| | - Marco Colasanti
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (P.R.); (M.C.); (E.R.); (S.B.); (S.F.)
| | - Eleonora Ricci
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (P.R.); (M.C.); (E.R.); (S.B.); (S.F.)
| | - Silvia Biondi
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (P.R.); (M.C.); (E.R.); (S.B.); (S.F.)
| | - Christian Napoli
- Department of Medical Surgical Science and Translational Medicine, Sapienza University of Rome, 00189 Rome, Italy;
| | - Stefano Ferracuti
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (P.R.); (M.C.); (E.R.); (S.B.); (S.F.)
| | - Cristina Mazza
- Department of Neuroscience, Imaging and Clinical Sciences, University “G.d’Annunzio”, 66100 Chieti-Pescara, Italy
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Mazza C, Ricci E, Biondi S, Colasanti M, Ferracuti S, Napoli C, Roma P. A Nationwide Survey of Psychological Distress among Italian People during the COVID-19 Pandemic: Immediate Psychological Responses and Associated Factors. Int J Environ Res Public Health. 2020;17. [PMID: 32370116 PMCID: PMC7246819 DOI: 10.3390/ijerph17093165] [Citation(s) in RCA: 1109] [Impact Index Per Article: 277.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 01/14/2023]
Abstract
The uncontrolled spread of the coronavirus disease 2019 (COVID-19) has called for unprecedented measures, to the extent that the Italian government has imposed a quarantine on the entire country. Quarantine has a huge impact and can cause considerable psychological strain. The present study aims to establish the prevalence of psychiatric symptoms and identify risk and protective factors for psychological distress in the general population. An online survey was administered from 18–22 March 2020 to 2766 participants. Multivariate ordinal logistic regression models were constructed to examine the associations between sociodemographic variables; personality traits; depression, anxiety, and stress. Female gender, negative affect, and detachment were associated with higher levels of depression, anxiety, and stress. Having an acquaintance infected was associated with increased levels of both depression and stress, whereas a history of stressful situations and medical problems was associated with higher levels of depression and anxiety. Finally, those with a family member infected and young person who had to work outside their domicile presented higher levels of anxiety and stress, respectively. This epidemiological picture is an important benchmark for identifying persons at greater risk of suffering from psychological distress and the results are useful for tailoring psychological interventions targeting the post-traumatic nature of the distress.
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Pawluk EJ, Koerner N, Tallon K, Antony MM. Unique Correlates of Problem Solving Effectiveness in Individuals with Generalized Anxiety Disorder. Cogn Ther Res 2017; 41:881-90. [DOI: 10.1007/s10608-017-9861-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bulley A, Henry JD, Suddendorf T. Thinking about threats: Memory and prospection in human threat management. Conscious Cogn 2017; 49:53-69. [DOI: 10.1016/j.concog.2017.01.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 09/10/2016] [Accepted: 01/22/2017] [Indexed: 12/15/2022]
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Liao Q, Cowling BJ, Wu P, Leung GM, Fielding R, Lam WWT. Population Behavior Patterns in Response to the Risk of Influenza A(H7N9) in Hong Kong, December 2013-February 2014. Int J Behav Med 2016; 22:672-82. [PMID: 25622816 PMCID: PMC7090479 DOI: 10.1007/s12529-015-9465-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background A novel avian influenza A(H7N9) virus, first identified in Mainland China in February and March 2013, caused an outbreak in humans in April and May, 2013. Closure of live poultry markets in some affected cities dramatically reduced numbers of cases during summer of 2013, but the epidemic resurged during the winter 2013–14, increasing reported cases to 393 in Mainland China as of 30 March 2014. Purpose The study aimed to explore population behavior patterns responding to an epidemic of influenza A(H7N9) virus. Method Three cross-sectional surveys were conducted among 1000, 680, and 1011 respondents in December 2013, January 2014, and February 2014, with response rates of 68.0, 64.4, and 66.6 %, respectively, in Hong Kong. Adults were recruited and interviewed using random digit-dialing telephone survey. Latent class analysis was employed to explore heterogeneity in protective behavior patterns across the three surveys. Multinomial regression models were developed to determine factors associated with latent class membership. Results Three comparable latent classes were identified across the three surveys: Moderate hygiene compliance (Class 1), High hygiene compliance (Class 2), and Vigilance (Class 3). The prevalence of Class 1 was 48–52 % across the three surveys while Class 3 prevalence increased significantly from 13 % in the Dec-2013 survey to 20 % in the Feb-2014 survey. Compared with Class 1, Class 3 were more likely to be female, older, better educated, married, perceive higher susceptibility to H7N9, attribute greater severity to H7N9, report higher current worry, and anticipated worry about H7N9 infection. Conclusion The three classes reflect different levels of adoption of protection and thereby may have different levels of vulnerability toward contracting H7N9 infection. It appears that as the epidemic intensifies, Class 2 (Good hygiene compliance) members are likely to transfer to Class 3 (Vigilance) while Class 1 (Moderate hygiene compliance) could be unchanged. The young, mostly single males and those with lower educational achievement represent a group for whom public health messages need to be targeted.
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Affiliation(s)
- Qiuyan Liao
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Benjamin J Cowling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China.
| | - Peng Wu
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Richard Fielding
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China
| | - Wendy Wing Tak Lam
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, China
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Williams MO, Mathews A, Hirsch CR. Verbal worry facilitates attention to threat in high-worriers. J Behav Ther Exp Psychiatry 2014; 45:8-14. [PMID: 23906509 DOI: 10.1016/j.jbtep.2013.05.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2013] [Revised: 05/01/2013] [Accepted: 05/30/2013] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Worry is predominantly a verbal-linguistic process with relatively little imagery. This study investigated whether the verbal nature of worry contributes to the maintenance of worry by enhancing attention to threat. It was hypothesised that verbal worry would lead to greater attentional bias to threat than imagery-based worry. METHODS Fifty high-worriers were randomly assigned to one of two groups, one in which they were instructed to worry in a verbal way and one in which they worried in an imagery-based way, before completing a dot probe task as a measure of attention to threat-related words. RESULTS Those who worried in verbal form demonstrated greater attentional bias to threat than did those who worried in imagery-based form. These findings could not be accounted for by group differences in personal relevance of or distress associated with worry topics, state mood following worry, levels of the relatedness of participants' worries to stimuli on the dot probe task, trait anxiety, general propensity to worry, nor adherence to the worry training. LIMITATIONS The present study only included word stimuli in the dot probe task; inclusion of images would allow for firmly rejecting the hypothesis that the attention effects observed following verbal worry were merely a result of priming verbal threat representations. Also, future studies could include a further control group that does not engage in any form of worry to ascertain that verbal worry increased attentional bias rather than imagery decreasing pre-existing attentional bias. CONCLUSIONS Possible mechanisms underlying this effect of verbal worry on attention to threat are discussed, together with clinical implications of the current findings.
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Abstract
Worry, characterized by repetitive and involuntary aversive thoughts about perceived concerns, is a central mental health complaint known to negatively impact quality of life of individuals facing perceived threats to health or well-being. Although empirical focus on worry has escalated over the past three decades, there has been less attention to current research trends and knowledge development related to this important phenomenon in nursing. This article presents a biobehavioral conceptual framework of worry for nursing application that is derived from a concept synthesis of biological, behavioral, clinical, and cognitive psychology sources.Databases including CINAHL, EBM Review, Health & Wellness Resource Center, PsycINFO, and PubMed were systematically reviewed for the years 2000–2012. The adapted conceptual framework describes relationships among perceived threat; process, structure, and content worry attributes; and outcomes of worry. The framework may be applied in clinical environments as a resource to better understand and care for patients facing perceived threats to health and well-being. The framework contributes a foundation to build empirical knowledge for nursing practice, theory, and research that has potential to improve patient well-being and health-related quality of life outcomes.
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Beckwé M, Deroost N, Koster EHW, De Lissnyder E, De Raedt R. Worrying and rumination are both associated with reduced cognitive control. Psychological Research 2014; 78:651-60. [DOI: 10.1007/s00426-013-0517-5] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 09/23/2013] [Indexed: 11/25/2022]
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Abstract
We present an evidence-based model of pathological worry in which worry arises from an interaction between involuntary (bottom-up) processes, such as habitual biases in attention and interpretation favouring threat content, and voluntary (top-down) processes, such as attentional control. At a pre-conscious level, these processes influence the competition between mental representations when some correspond to the intended focus of attention and others to threat distracters. Processing biases influence the probability of threat representations initially intruding into awareness as negative thoughts. Worry in predominantly verbal form then develops, influenced by conscious processes such as attempts to resolve the perceived threat and the redirection of attentional control resources to worry content, as well as the continuing influence of habitual processing biases. After describing this model, we present evidence for each component process and for their causal role in pathological worry, together with implications for new directions in the treatment of pathological worry.
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