Emotional distress in COVID-19 patients in Maldives

BACKGROUND AND OBJECTIVES

Researchers are exploring the epidemiology, clinical characteristics, treatment, vaccination and the challenges faced by healthcare authorities. However less focus is being paid towards the impact of COVID-19 on mental health of the patients. This study is a cross-sectional study, measuring the prevalence of emotional distress among patients with COVID-19 in the Maldivian population.

METHODS

This study was conducted in Maldivian nations above 18 of age with COVID-19 who were admitted in isolation facilities. Patients who were on treatment for any other chronic medical conditions, severe and critical COVID-19 disease were excluded. This study was conducted over a period of 2 months by administering a local translated version of DASS21 questionnaire.

RESULTS

The total of 195 patients were included in this study. The mean age of the patients was 40 (CI at 95% 38-42) years. The respondents were 48.7% men and 51.3% women. Overall, 9% of patients with COVID-19 had depression while 23% of patients had anxiety and 12% of the patients had stress. There was a statistically significant relationship between gender and depression, anxiety and stress (p < 0.01). Symptomatic cases had a significantly higher level of stress than asymptomatic patients (p < 0.05), but no significant association was observed with symptomatic status and anxiety or depression.

CONCLUSION

The management of patients with COVID-19 should be multi-disciplinary with special focus on the mental wellbeing of our patients. We should aim to establish proper communication with the patients in order to identify emotional distress and provide appropriate mental health care.

Greenspace and park use associated with less emotional distress among college students in the United States during the COVID-19 pandemic

The COVID-19 pandemic has negatively affected many people's psychological health. Impacts may be particularly severe among socially vulnerable populations such as college students, a group predisposed to mental health problems. Outdoor recreation and visits to greenspaces such as parks offer promising pathways for addressing the mental health challenges associated with COVID-19. During the early stages of the pandemic (March-May 2020), we surveyed 1280 college students at four large public universities across the United States (U.S.) to assess how, and why, outdoor recreation and park use changed since the emergence of COVID-19. We also measured students' self-reported levels of emotional distress (a proxy for psychological health) and assessed potential demographic and contextual correlates of distress, including county-level per capita park area and greenness, using generalized linear models. We found that 67% of students reported limiting outdoor activities and 54% reported reducing park use during the pandemic. Students who reduced their use of outdoor spaces cited structural reasons (e.g., lockdowns), concerns about viral transmission, and negative emotions that obstructed active lifestyles. Students who maintained pre-pandemic park use levels expressed a desire to be outdoors in nature, often with the explicit goal of improving mental and physical health. Emotional distress among students was widespread. Models showed higher levels of emotional distress were associated with reducing park use during the pandemic and residing in counties with a smaller area of parks per capita. This study of U.S. college students supports the value of park-based recreation as a health promotion strategy for diverse populations of young adults during a time of crisis.

Children's fear and distress during a hospital-based family flu vaccine clinic: A parent survey

The aim of this study was to evaluate parents' perception of their child(ren)'s distress before, during, and after influenza (flu) vaccination, and their perceived effectiveness of pain and distress management strategies used during the vaccination process. This is a cross-sectional survey of parents attending Children's Hospital of Eastern Ontario's 2018 family flu clinic. After vaccination, parents completed a paper-based survey concerning demographics, fear and distress levels, and use and perceived effectiveness of pain/distress management interventions provided before and during the vaccination process. All survey data were entered into Research Electronic Data Capture (REDCap). Quantitative data were analyzed using descriptive statistics; qualitative data were analyzed using content analysis. A total of 164 parents completed the survey, reporting data on 327 children aged 6 months to 18 years (83% of children were vaccinated). Of 327 children, nearly half (n = 142, 44%) were reported to be moderately to severely distressed before, during, or after the vaccination process. The parents reported that 268 (82%) children received pain/distress management strategies during vaccination. Over half (n = 138, 57%) of the parents reported that the strategies used were very effective. Despite frequent use and parents' perceived effectiveness of pain/distress management interventions, nearly half of the children were perceived by parents as moderately to severely distressed during the vaccination process.

Communicating emotional distress experienced by adolescents between adolescents and their mothers: Patterns and links with adolescents' emotional distress

This research proposes the construct of Communication Patterns of adolescents' emotional distress (CPAED) between adolescents and their parents, describing situations in which open or defective dialog about adolescents' emotions following distressful events are formed between adolescents and their parents. By addressing adolescents' perceptions of CPAED in adolescents and their mothers, we developed a valid and reliable scale to assess the hypothesized CPAED theoretical framework. Factor analyses in Study 1 (EFA; N = 257, M_age = 15.66 years old, SD = 0.35) and Study 2 (CFA; initial N = 684; M_age = 14.08, SD = 0.45) suggested three factors: a) Active and Reactive Emotion Sharing (ARES), referring to adolescents' active sharing of emotion or reactive sharing in the face of maternal inquiry; b) Lack of Solicitation by mothers (LS), tracking mothers' avoidance of communication; and c) Lack of Response by adolescents (LR), describing adolescents' avoidance of communication even when asked by mothers. Moreover, Study 2 documented that CPAED were linked to maternal emotion socialization practices (i.e., emotion expressivity and responses to adolescents' negative emotions) and adolescents' negative emotion expression. Study 2 found that ARES predicted decreased emotional distress in adolescents, whereas LS and LR predicted increased emotional distress accordingly; and the three factors of CPAED incrementally predicted adolescents' emotional distress over and beyond other theoretically relevant predictors.

Psychosocial profiles of risk and resiliency in neurofibromatoses: a person-centered analysis of illness adaptation

OBJECTIVES

We sought to characterize psychosocial profiles of adaptation to neurofibromatosis (NF).

METHODS

Participants (N = 224) completed self-report measures of psychosocial functioning, including risk (i.e., perceived stress, depression, anxiety) and resiliency (i.e., gratitude, optimism, coping, social support, mindfulness, empathy). We used a TwoStep hierarchical cluster analysis to determine clusters reflecting adaptation to NF.

RESULTS

The analysis revealed two distinct groups, with the "Low Adaptation" group defined by high emotional distress and low resiliency (n = 130; 57% of participants), and the "High Adaptation" group defined by low emotional distress and high resiliency (n = 85; 37% of participants). Clusters differed significantly across nearly all criterion variables, as well as quality of life and pain interference.

CONCLUSION

Both risk and resiliency factors are important for understanding psychosocial adaptation to NF. Findings suggest that clinical providers should prioritize screening and intervention methods targeting these variables to promote positive adaptation to NF.

TRIAL REGISTRATION

ClinicalTrials.gov NCT03406208; https://clinicaltrials.gov/ct2/show/NCT03406208 (Archived by WebCite at http://www.webcitation.org/72ZoTDQ6h ).

Spirituality, Personality, and Emotional Distress During COVID-19 Pandemic in Croatia

This study examined the association between spiritual quality of life (QoL), spiritual coping, emotional distress, and personality during the COVID-19 pandemic lockdown in a convenience sample of Croatian adults (n = 2,860, 80.6% women). Participants completed an online questionnaire that collected information on sociodemographic characteristics, distress (the Depression, Anxiety, and Stress Scale 21), spiritual coping and spiritual QoL (the WHO Quality of Life-Spirituality, Religiousness, and Personal Beliefs), and personality (the International Personality Item Pool). The hierarchical regression analysis demonstrated that personality traits, especially emotional stability, were the most significant predictors of mental health outcomes. Spiritual coping styles were a predictor of worse, while spiritual QoL of better psychological outcomes. Results demonstrate the complex relations between different aspects of spirituality/religiosity with personality and emotional outcomes and suggest that distress motivates the engagement of spiritual coping in times of disaster.

Childhood maltreatment and emotional distress: The role of beliefs about emotion and psychological inflexibility

The current study aimed to investigate the mediating role of negative beliefs about emotion and psychological inflexibility on the relationship between childhood maltreatment and emotional distress. A total of 519 participants completed the Childhood Trauma Questionnaire (CTQ), Depression Anxiety Stress Scale-21 (DASS-21), the Leahy Emotional Schema Scale II (LESS-II), and the Acceptance and Action Questionnaire-II (AAQ-II). All scales were significantly correlated. Two mediation analyses were tested. In the first model negative beliefs about emotion and psychological inflexibility mediated the relationship between childhood maltreatment and emotional distress measured by DASS-21 total score. In the second model, negative beliefs about emotion and psychological inflexibility mediated the relationship between childhood maltreatment and depression, anxiety, and stress measured by the subscales of DASS-21. Results suggest that maltreatment in childhood is associated with the individuals' approaches, plans and strategies in response to emotions, and psychological inflexibility which together further determine emotional distress.

Emotional distress and coping strategies in COVID-19 anxiety

The present study aims to identify psychological factors affected by the COVID-19 pandemic given the information we have about reactions during previous pandemics, which documented features of anxiety, depression and post-traumatic stress disorder. We investigated the relationship between health anxiety, symptoms of depression, anxiety and stress, and coping mechanisms in the general population and among students. The study was conducted on Romanian population (n = 759), aged between 18-70 years old (M = 33.24), general population (n = 485), and students (n = 274). The results showed that the general population is more anxious when confronted with the new virus compared to students (t (757) = 1.902, p < .05, p = .029). Following the analysis of the hierarchical regression, the results revealed that when controlling the health anxiety variable, a high level of anxiety symptoms and stress, and a low level of depression symptoms could predict anxiety for COVID-19 (R 2  = .070, F change (3, 754) = 16.759, p ˂ .001). Also, we found that maladaptive strategies are the ones which explain the relationship between health anxiety and COVID-19-related anxiety (95% CI = .011 - .057). The results of this study bring extra knowledge and shed new light on the psychological aspects of the current sanitary crisis and contribute to the understanding of the way people relate to this disease.

The Financial and Psychological Impact of Identity Theft Among Older Adults

Background and Objectives

Society's growing reliance on technology to transfer private information has created more opportunities for identity thieves to access and misuse personal data. Research on identity theft specifically among adults aged 65 and older is virtually nonexistent, yet research focusing on victims of all ages indicates a positive association between age, minority status, and more severe economic and psychological consequences.

Research Design and Methods

Identity theft measures come from a sample of more than 2,000 self-reported victims aged 65 and older from the nationally representative National Crime Victimization Survey Identity Theft Supplements administered in 2014 and 2016. Regression was used to examine how socioeconomic status, demographic characteristics, and incident-specific factors relate to how much money is stolen, the likelihood of experiencing out-of-pocket costs, and emotional distress among older identity theft victims.

Results

Older Black identity theft victims were more likely to have greater amounts of money stolen and were more likely to feel distressed by the incident than older White victims. The most disadvantaged older adults living at or below the federal poverty level were significantly more likely to suffer out-of-pocket costs. The length of time information was misused, experiencing subsequent financial problems and problems with friends/family, and the hours spent resolving identity theft were positively associated with emotional distress. Among those aged 65 and older, age was not significantly associated with losses or emotional distress.

Discussion and Implications

Older adults living in poverty need more resources to assist with recovery and reporting identity theft to law enforcement. Limiting the extent of losses from identity theft and reducing the length of time information is misused may reduce the emotional toll of identity theft on older victims.

Exploring the Heterogeneity and Trajectories of Positive Functioning Variables, Emotional Distress, and Post-traumatic Growth During Strict Confinement Due to COVID-19

COVID-19 pandemic-related confinement may be a fruitful opportunity to use individual resources to deal with it or experience psychological functioning changes. This study aimed to analyze the evolution of different psychological variables during the first coronavirus wave to identify the different psychological response clusters, as well as to keep a follow-up on the changes among these clusters. The sample included 459 Spanish residents (77.8% female, M_age = 35.21 years, SD_age = 13.00). Participants completed several online self-reported questionnaires to assess positive functioning variables (MLQ, Steger et al. in J Loss Trauma 13(6):511-527, 2006. 10.1080/15325020802173660; GQ-6, McCullough et al. in J Person Soc Psychol 82:112-127, 2002. 10.1037/0022-3514.82.1.112; CD-RISC, Campbell-Sills and Stein in J Traum Stress 20(6):1019-1028, 2007. 10.1002/jts.20271; CLS-H, Chiesi et al. in BMC Psychol 8(1):1-9, 2020. 10.1186/s40359-020-0386-9; SWLS; Diener et al. in J Person Assess, 49(1), 71-75, 1985), emotional distress (PHQ-2, Kroenke et al. in Med Care 41(11):1284-1292, 2003. 10.1097/01.MLR.0000093487.78664.3C; GAD-2, Kroenke et al. in Ann Internal Med 146(5):317-325, 2007. 10.7326/0003-4819-146-5-200703060-00004; PANAS, Watson et al. in J Person Soc Psychol 47:1063-1070, 1988; Perceived Stress, ad hoc), and post-traumatic growth (PTGI-SF; Cann et al. in Anxiety Stress Coping 23(2):127-137, 2010. 10.1080/10615800903094273), four times throughout the 3 months of the confinement. Linear mixed models showed that the scores on positive functioning variables worsened from the beginning of the confinement, while emotional distress and personal strength improved by the end of the state of alarm. Clustering analyses revealed four different patterns of psychological response: "Survival", "Resurgent", "Resilient", and "Thriving" individuals. Four different profiles were identified during mandatory confinement and most participants remained in the same cluster. The "Resilient" cluster gathered the largest number of individuals (30-37%). We conclude that both the heterogeneity of psychological profiles and analysis of positive functioning variables, emotional distress, and post-traumatic growth must be considered to better understand the response to prolonged adverse situations.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10902-021-00469-z.

The development and preliminary validation of a brief scale of emotional distress in young people using combined classical test theory and item response theory approaches: The Brief Emotional Distress Scale for Youth (BEDSY)

Reliable, valid, and brief measures are important for identifying young people in community contexts who experience mental health problems. This paper reports the development and preliminary validation of the Brief Emotional Distress Scale for Youth (BEDSY), a measure based on anxiety and depression symptoms that load strongly upon the general construct of emotional distress. Participants, aged 11-17 years, included 2663 from a community population and 281 referred anxious youth. From a pool of 20 items, eight were selected for the final scale using methods from classical test theory, followed by item response theory (IRT). The final eight items met the pre-specified criteria for skewness and kurtosis, item-total correlations, IRT characteristics, and discrimination between referred vs. community samples. Exploratory structural equation modeling for a bi-factor model indicated that 81% of total variance was explained by the general emotional distress factor. The 8-item BEDSY showed strong internal consistency, good construct validity, and acceptable sensitivity and specificity in discriminating between a community sample vs anxious youth, and between youth with and without high levels of depressive symptoms. As such the scale has strong potential as a brief screen for identifying emotionally distressed young people in community contexts.

Mental health and substance use by sexual minority status in high school students who experienced sexual violence

PURPOSE

To examine the association between sexual minority status and the prevalence of emotional distress and substance use among a nationally-representative sample of youth who reported sexual violence victimization.

METHODS

Data were from the 2017 National Youth Risk Behavior Survey, a biennial school-based survey. We restricted the sample to youth who reported any past-year sexual violence victimization. We estimated prevalence ratios using modified Poisson regression with robust error variance to examine associations of sexual minority status with depressive symptomology, suicidality, and substance use.

RESULTS

Among the 1364 (9.7%) students who experienced sexual violence, 78% were girls. Relative to heterosexual youth, sexual minority youth had higher prevalence estimates for the emotional distress outcomes and marijuana use. Sexual minority status was associated with depressive symptomology (adjusted prevalence ratio [aPR] 1.33, 95% confidence interval 1.22-1.44), suicidal ideation (aPR: 1.91, 1.66-2.20), medically treated suicide attempt (aPR: 2.74, 1.53-4.93), and past 30-day marijuana use (aPR: 1.29, 1.06-1.57).

CONCLUSIONS

Among youth who experience sexual violence, sexual minorities may experience more emotional distress and substance use outcomes than heterosexuals. Rape crisis programs and other tertiary interventions should attend to the unique needs of sexual minorities who have been sexually victimized.

Barriers and benefits of primary caregivers' involvement in children's education during COVID-19 school closures

School closures during the COVID-19 pandemic have forced many children around the world to spend unprecedented amounts of time at home, and the responsibility for educating children, especially young ones, has largely fallen to parents and caregivers. Using a sample of 764 households with preschool children in Wuhan, China, where the pandemic started, this study examined the impact of the pandemic on primary caregivers' involvement in their children's education at home, and the barriers and benefits of such involvement for preschool children's learning and well-being. The results showed that primary caregivers were generally less involved in their children's education at home during the pandemic than they were prior to it. Having younger children, a lower socioeconomic status (i.e., parents' lower levels of education and less prestigious occupations), poorer physical health, and higher levels of household chaos were associated with lower frequencies of home-based involvement exhibited by caregivers. Finally, caregivers' home-based involvement during the pandemic was beneficial to preschool children's learning behavior and emotional health. The findings highlight the importance of understanding the barriers and benefits of caregivers' home-based involvement for designing interventions and policies to mitigate the negative impact of the pandemic on children and their families.

I won't comply because it is a hoax: Conspiracy beliefs, lockdown compliance, and the importance of psychological flexibility

The COVID-19 pandemic has brought unprecedented situations (government lockdowns, quarantines, etc.) and stressors (a seemingly “phantom” virus that can be lurking anywhere) causing uncertainty for the future, uncontrollable and unpredictable situations. It appears that especially during times of uncertainty and high stress, conspiracy theories flourish and these can affect the way individuals behave, especially in response to governmental recommendations for social isolation and quarantine. Psychological flexibility, we hypothesized, may act as a protective factor in the relation between COVID-19 distress, conspiracy theory beliefs and consequent behaving. In this respect, the aim of this paper was to examine how conspiracy theory beliefs, COVID-19 distress, adherence behavior, and psychological flexibility interact. Participants were 1001 individuals (802 women; Mage = 35.59years, SD = 10.07), who completed an online survey approximately one month after the first governmental measures of self-isolation and quarantine were enforced. Psychological flexibility was found to mediate the relation between conspiracy theory beliefs and compliance behavior. Further, being highly stressed appeared to increase the probability that a person will believe conspiracy theories, while such beliefs influenced whether a person would follow public health recommendations. Psychological flexibility appeared to be a protective factor at low and moderate distress levels. However, at high levels of COVID-19 distress, individuals prone to conspiracy theory beliefs would be less likely to conform to governmental public health recommendations irrespective of their psychological flexibility levels.

Comorbidity, Functional Impairment, and Emotional Distress: A Coping Mediation Model for Persons With Cancer

BACKGROUND

Comorbid disease in cancer patients can substantially impact medical care, emotional distress, and mortality. However, there is a paucity of research on how coping may affect the relationship between comorbidity and emotional distress.

PURPOSE

The current study investigated whether the relations between comorbidity and emotional distress and between functional impairment and emotional distress were mediated by three types of coping: action planning (AP), support/advice seeking (SAS), and disengagement (DD).

METHODS

Four hundred and eighty-three persons with cancer completed a measure of functional impairment (Sickness Impact Profile), the Checklist of Comorbid Conditions, the Brief COPE, the Hospital Anxiety and Depression Scale, the Quality of Life Assessment for Cancer Survivors (Negative Feelings Scale), and the Distress Screening Schedule (Emotional Distress Scale). The latter three measures were used to form a latent construct representing the outcome, emotional distress.

RESULTS

Model comparison analysis indicated that the model with DD as a mediator had a better fit than models containing AP and SAS. DD mediated the relationship between functional impairment and emotional distress, so that engaging in DD was associated with greater distress. In addition, comorbidity and functional impairment were directly and positively related to emotional distress, but the relation between comorbidity and distress was not mediated by coping type.

CONCLUSIONS

Both comorbidity and functional impairment may be associated with distress, but disengagement coping only mediated the relation involving functional impairment and was positively associated with distress. Future studies can investigate whether teaching active coping or adaptive coping (e.g., through mindfulness exercises) can decrease distress in cancer patients, despite functional impairments.

Colorectal cancer survival: prevalence of psychosocial distress and unmet supportive care needs

Purpose

The aim of this study was to determine the prevalence of distress and unmet supportive care needs in post-treatment colorectal cancer (CRC) survivors. Also, to explore the association between both variables and to identify potential associated sociodemographic and cancer-related risk factors.

Methods

A cross-sectional study of 200 CRC survivors who at least 1 month before had completed the primary treatment for CRC was conducted. The Brief Symptom Inventory-18 (BSI-18) and the Spanish version of Cancer Survivors’ Unmet Needs (S-CaSUN) were used.

Results

One in five CRC survivors showed clinical distress and 86% expressed at least one unmet need. Distress was positively associated with the prevalence of needs in all domains. All comprehensive care and information needs were expressed by at least 20% of survivors and some by more than 50%. Other needs also mentioned by 20% of survivors were financial support, ongoing case manager, and concerns about cancer recurrence. The risk factors associated were lower socioeconomic status, younger age, and a primary treatment that includes more than surgery.

Conclusions

The findings highlight the relevance of extending psychosocial care beyond the CRC primary medical treatment. A person-centered approach that addresses informational, emotional, social, and physical needs can increase satisfaction with care and also prevent psychological morbidity in CRC survivors.

Use and self-perceived effects of social media before and after the COVID-19 outbreak: a cross-national study

To (i) examine the use of social media before and after the COVID-19 outbreak; (ii) examine the self-perceived impact of social media before and after the outbreak; and (iii) examine whether the self-perceived impacts of social media after the outbreak varied by levels of mental health. A cross-national online survey was conducted in Norway, UK, USA and Australia. Participants (n = 3810) reported which social media they used, how frequently they used them before and after the COVID-19 outbreak, and the degree to which they felt social media contributed to a range of outcomes. The participants also completed the 12-item General Health Questionnaire. The data were analyzed by chi-square tests and multiple linear regression analysis. Social media were used more frequently after the pandemic outbreak than compared to before the outbreak. Self-perceived effects from using social media increased after the COVID-19 outbreak, and in particular stress and concern for own and others’ health. Emotional distress was associated with being more affected from using social media, in particular in terms of stress and concern for own or others’ health. The use of social media has increased during the coronavirus outbreak, as well as its impacts on people. In particular, the participants reported more stress and health concerns attributed to social media use after the COVID-19 outbreak. People with poor mental health appear to be particularly vulnerable to experiencing more stress and concern related to their use of social media.

The ethical implications of verbal autopsy: responding to emotional and moral distress

Background

Verbal autopsy is a pragmatic approach for generating cause-of-death data in contexts without well-functioning civil registration and vital statistics systems. It has primarily been conducted in health and demographic surveillance systems (HDSS) in Africa and Asia. Although significant resources have been invested to develop the technical aspects of verbal autopsy, ethical issues have received little attention. We explored the benefits and burdens of verbal autopsy in HDSS settings and identified potential strategies to respond to the ethical issues identified.

Methods

This research was based on a case study approach centred on two contrasting HDSS in Kenya and followed the Mapping-Framing-Shaping Framework for empirical bioethics research. Data were collected through individual interviews, focus group discussions, document reviews and non-participant observations. 115 participants were involved, including 86 community members (HDSS residents and community representatives), and 29 research staff (HDSS managers, researchers, census field workers and verbal autopsy interviewers).

Results

The use of verbal autopsy data for research and public health was described as the most common potential benefit of verbal autopsy in HDSS. Community members mentioned the potential uses of verbal autopsy data in addressing immediate public health problems for the local population while research staff emphasized the benefits of verbal autopsy to research and the wider public. The most prominent burden associated with the verbal autopsy was emotional distress for verbal autopsy interviewers and respondents. Moral events linked to the interview, such as being unsure of the right thing to do (moral uncertainty) or knowing the right thing to do and being constrained from acting (moral constraint), emerged as key causes of emotional distress for verbal autopsy interviewers.

Conclusions

The collection of cause-of-death data through verbal autopsy in HDSS settings presents important ethical and emotional challenges for verbal autopsy interviewers and respondents. These challenges include emotional distress for respondents and moral distress for interviewers. This empirical ethics study provides detailed accounts of the distress caused by verbal autopsy and highlights ethical tensions between potential population benefits and risks to individuals. It includes recommendations for policy and practice to address emotional and moral distress in verbal autopsy.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12910-021-00683-7.

The emotional impact of the COVID-19 outbreak on cancer outpatients and their caregivers: results of a survey conducted in the midst of the Italian pandemic

Introduction

The study investigates the emotional discomfort of cancer patients and their caregivers, who need to access the oncology day hospital to receive treatment during the COVID-19 pandemic in Italy.

Methods

This is a single-institution, prospective, cross-sectional study. From May to June 2020, the points of view of both patients and caregivers were compared through 2 different multiple-choice questionnaires, enquiring demographic characteristics, changes in emotional status, interpersonal relationships with health professionals (HCPs) and self-perception of treatment outcomes.

Results

Six hundred twenty-five patients and 254 caregivers were enrolled. Females were prevalent and patients were generally older than caregivers. Forty percent of patients and 25.6% of caregivers thought they were at a greater risk of contagion because lived together with a cancer patient or accessed the hospital. Both patients (86.3%) and caregivers (85.4%) considered containment measures a valid support to avoid the spread of infection. People with a lower education level were less worried about being infected with SARS-COV-2. Waiting and performing visits/treatments without caregivers had no impact on the emotional status of patients (64.4%), but generated in caregivers greater anxiety (58.8%) and fear (19.8%) of not properly managing patients at home. The majority of patients (54%) and caregivers (39.4%) thought the pandemic does not influence treatment outcomes. The relationship with HCPs was not negatively impacted for majority of patients and caregivers.

Conclusions

Starting from these data, we can better understand the current psychological distress of patients and their families in order to develop potential strategies to support them in this strenuous period of crisis.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00520-021-06489-y.

Unpacking Racial/Ethnic Disparities in Emotional Distress Among Adolescents During Witnessed Police Stops

PURPOSE

This study aimed to investigate racial/ethnic disparities in emotional distress during witnessed police stops among a national sample of urban-born youth.

METHODS

A national sample of urban-born youth in the U.S. from the most recent wave (2014-2017) of the Fragile Families & Child Wellbeing Study was used in the present study, with a particular focus on youth who report having witnessed police stops, despite not being directly stopped by the police (N = 1,488).

RESULTS

Significant racial/ethnic disparities in feeling angry and unsafe during witnessed police stops emerged, with multiracial, black, and Hispanic youth exhibiting the highest rates of these forms of emotional distress. In the case of Black and multiracial youth, officer intrusiveness and perceptions of procedural injustice collectively explain a large portion of disparities in emotional distress during witnessed stops.

CONCLUSIONS

Youth of color are more likely to report emotional distress during witnessed police stops, largely due to the officer intrusiveness and perceived injustices that characterize these stops. Moving forward, scholars should consider whether racial/ethnic disparities in witnessing police violence and injustice may be a significant driver of mental health inequities among urban-born youth.

The association between adult ADHD and food addiction: A mediation analysis

OBJECTIVES

The aim of this study was to investigate the association between food addiction severity (FA) and ADHD symptomatology. Furthermore, we investigated whether emotional distress, and the mentalization deficits could mediate this relationship.

METHODS

Three hundred eighty-five Italian adults (307 women and 78 men) participated in the study and completed the Italian versions of the Modified Yale Food Addiction Scale version 2.0, the Adult ADHD Self-Report Scale, the Depression Anxiety Stress Scales 21 and the Mentalization Questionnaire.

RESULTS

ADHD symptoms severity and general distress were significantly and independently associated with FA. Emotional distress partly mediated the relationship between FA and ADHD symptoms severity. In addition, mentalization deficits partly mediated this relationship only when evaluating the influence of FA on ADHD symptoms severity.

LIMITATIONS

This is a cross-sectional study and causal interpretations of the relationships among the variables are speculative.

CONCLUSIONS

It is important to assess emotional distress and mentalization deficits in individuals at risk of ADHD and FA because these conditions could increase the risk for the presence of disordered eating patterns.

The impact of the Covid-19 pandemic on mental and physical health in Denmark - a longitudinal population-based study before and during the first wave

BACKGROUND

In the continuation of the first wave of the Covid-19 outbreak in Denmark, unprecedented restrictions with great impact on the citizen's everyday life were implemented. The objectives of this study were to investigate the influence of the Covid-19 pandemic on mental and physical health in the Danish population during the spring 2020 first wave outbreak and lockdown.

METHODS

A sample from the adult Danish population (n = 2190) were included. Self-reported measures of illness worry (Whiteley-6-R), emotional distress (SCL-90), and physical symptom load (SLC-90) were obtained before and during the first wave of the pandemic and compared with Wilcoxon signed-rank tests. Impact of covariates on physical and mental health was evaluated with ordinal regression analyses. Results from a tailored questionnaire regarding the Covid-19 pandemic were presented to explore the direct impact of the pandemic.

RESULTS

We only found minor increases in illness worry, emotional distress and physical symptom load (0-1 points difference, p ≤ 0.007) during the Covid-19 pandemic compared to before the pandemic. Sex, age, education, and physical disease were not associated with illness worry, emotional distress, or physical symptom load. Overall, the participants were trustful in the authorities' recommendations and felt that they managed the pandemic and the restrictions to a great extent despite that some expected great/major future consequences of the pandemic.

CONCLUSIONS

This study suggested that the first wave of the Covid-19 pandemic only had minor impact on mental and physical health in the Danish general population. Future studies should address the impact of the second wave of the pandemic and the renewed implementation of the concomitant restrictions.

How are emotional distress and reassurance expressed in medical consultations for people with long-term conditions who were unable to receive curative treatment? A pilot observational study with huntington's disease and prostate cancer

Objective

It is unclear whether how people with long-term conditions express distress, and how clinicians respond, influences perceptions of consultation outcomes. The pilot study examined emotional distress and reassurance in consultations with people whose long-term conditions (at the time of consultations) were treated using active surveillance or symptom management (as no curative treatment was suitable).

Methods

An observational pilot study was conducted involving consultations between people with long-term conditions and their respective clinician. Consultations between three clinicians (two Huntington’s Disease; one Prostate Cancer) and 22 people with long-term conditions (11 Huntington’s Disease; 11 Prostate Cancer) were audio-recorded. Participants also completed an expanded Consultation and Relational Empathy (CARE) Measure. Two researchers coded sessions using Verona Coding Definitions of Emotional Sequences (VR-CoDES/VR-CoDES-P). Code frequencies were calculated, t tests performed between conditions, and Pearson’s correlations performed for associations between CARE responses and clinician utterances.

Results

People with long-term conditions expressed emotional distress on average 4.45 times per session, averaging 1.09 Concern and 3.36 Cue utterances. Clinicians responded with more explicit (2.59) and space-providing (3.36), than non-explicit (1.86) and space-reducing (1.09), responses per session. Clinicians expressed spontaneous reassurance on average 5.18 times per session, averaging 3.77 Cognitive and 1.5 Affective reassurance utterances. Huntington’s Disease consultations featured significantly more 'Cues', 'Concerns' and 'Overall' 'Emotional Distress', and 'Cognitive' and 'Overall' ‘Reassurance'.

Conclusion

Emotional distress was expressed more using hints than explicit concern utterances. Clinicians predominantly explicitly explored distress rather than providing information/advice and provided advice using spontaneous cognitive reassurance. People with Huntington’s Disease expressed more concerns and received more reassurance, indicating different needs between conditions. Future research is required to explore emotional distress and reassurance in a larger sample of participants and long-term condition types, and how the practical implications of these findings may be used to enhance outcomes of consultations.

Trial registration

N/A.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40814-021-00833-z.

The Relationship Between Sexual Compulsivity, Emotional and Spiritual Distress of Religious and Non-religious Internet Pornography Users

This study sought to examine the relationship between the sexual compulsivity, emotional and spiritual distress of religious and non-religious adults who sought assessment for pornography addiction on the Internet. Religious (n = 350) and non-religious (n = 114) data were analyzed separately with a one-way between-subjects multivariate analysis of variance. The Kalichman Sexual Compulsivity Scale was used to divide the religious and non-religious into three groups: non-sexually compulsive (NCs); moderately sexually compulsive and sexually compulsive (SCs). All of the dependent variables, except age, were significantly higher for SCs than NCs for the religious. For the non-religious, all of the dependent variables, except age and time spent viewing Internet pornography (IP), were significantly higher for SCs than NCs. The non-religious spent significantly more time viewing IP than the religious. Yet, the religious were significantly more sexually compulsive. Emotional distress and spiritual distress were found to be significantly higher for SCs than the NCs regardless of religiosity. The non-religious were significantly more anxious and stressed than the religious. Specific religious affiliations did not have any significant bearing on the degree of sexual compulsivity. Religious practice, being associated with less viewing of IP, suggests the likelihood that moral reasons may provide some rationale for not viewing IP. At the same time, religious practice might reinforce shame in the addiction cycle thus religious individuals may be more at-risk to developing a compulsive pattern of viewing IP. The implications of the findings and suggestions for future research are presented.

Is neuroticism differentially associated with risk of Alzheimer's disease, vascular dementia, and frontotemporal dementia?

This study examines whether neuroticism is differentially associated with risk of incident Alzheimer's disease (AD), vascular dementia (VD), and frontotemporal dementia (FTD) using a prospective study design. Participants from the UK Biobank (N = 401,422) completed a self-report neuroticism scale in 2006-2010 and incident all-cause dementia, AD, VD, and FTD were ascertained using electronic health records or death records up to 2018. During an average follow-up of 8.8 years (3,566,123 person-years), there were 1798 incident of all-cause dementia, 675 AD, 376 VD, and 81 FTD. Accounting for age and sex, compared to individuals in the low quartile, individuals in the top quartile of neuroticism had higher risk of all-cause dementia (HR = 1.70; 95% CI: 1.49-1.93), AD (HR = 1.42; 1.15-1.75), VD (HR = 1.73; 1.30-2.29), but not FTD (HR = 0.89; 0.49-1.63). The associations with AD and VD were attenuated but remained significant after further accounting for education, household income, deprivation index, diabetes, hypertension, stroke, heart attack, ever smoker, physical activity, obesity, hemoglobin A1c, C-reactive protein, and low-density lipoprotein. The associations were not moderated by socioeconomic status. The findings were consistent in analyses that excluded cases that occurred within the first 5 years of follow-up. In conclusion, neuroticism is a robust predictor of incident AD and VD, but not FTD. This pattern suggests that the affective symptoms that distinguish dementia types may partly reflect premorbid differences in trait neuroticism.