Subjective cognitive failures and their psychological correlates in a large Italian sample during quarantine/self-isolation for COVID-19

How social support and resilience impact mental health: The moderating role of time in isolation during the COVID-19 pandemic

During the COVID-19 pandemic, quarantines effectively prevented the spread of COVID-19 but also caused people to develop mental health problems. We thus aimed to verify the impact of social support and resilience on mental health and to uncover the moderating role played by time in isolation during the post-pandemic era. We administered a cross-sectional survey to 510 college students. The results found that social support directly and negatively predicted mental health problems, and this relationship was mediated by resilience. Through multigroup analysis, resilience partially mediated the relationship between social support and mental health during period of isolation 1 (PI1) and fully mediated this relationship during period of isolation 2 (PI2) and period of isolation 3 (PI3). Moreover, the path coefficient of resilience to mental health at T3 was significantly higher than that at T2. Thus, the effect of resilience on mental health increases with the duration of time in isolation.

Psychometric properties and normative data of the Italian version of the Cognitive Function at Work Questionnaire: a screening tool for detecting subjective cognitive complaints at work

INTRODUCTION

Considering the extension of working life due to socioeconomic and political factors, many people may experience cognitive complaints (CC) at their workplace, with severe consequences on their quality of life. The identification of workers reporting significative SCC is crucial to eventually address them to an objective neuropsychological evaluation and implement cognitive interventions to guarantee workers' well-being. Since no Italian questionnaires for detecting CC were designed for occupational settings, the aim of the study was to validate the Italian version of the Cognitive Function at Work Questionnaire (CFWQ) and to provide its normative data.

MATERIALS AND METHODS

Internal consistency, convergent and divergent validity, and factorial structure of the CFWQ were evaluated. A regression-based procedure served to compute percentiles of CFWQ and its subscales.

RESULTS

Four hundred twenty-one participants without psychiatric and/or neurological disorders completed the survey. We found that the Italian CFWQ included 26 items, with a good internal consistency (Cronbach's alpha = 0.897) and a six-factor structure (memory, language, processing speed, abstract thinking/behavioral control, behavioral inertia, planning ability). CFWQ score did not correlate with empathy but correlated strongly with memory scores and moderately with anxiety and depression scores.

CONCLUSIONS

The Italian CFWQ showed good psychometric properties, in analogy with the original English scale. Therefore, it can be successfully employed in organizational contexts to possibly identify workers with CC and therefore with possible co-occurrent psychological, behavioral, and cognitive consequences.

Cognitive and neuroscientific perspectives of healthy ageing

With dementia incidence projected to escalate significantly within the next 25 years, the United Nations declared 2021-2030 the Decade of Healthy Ageing, emphasising cognition as a crucial element. As a leading discipline in cognition and ageing research, psychology is well-equipped to offer insights for translational research, clinical practice, and policy-making. In this comprehensive review, we discuss the current state of knowledge on age-related changes in cognition and psychological health. We discuss cognitive changes during ageing, including (a) heterogeneity in the rate, trajectory, and characteristics of decline experienced by older adults, (b) the role of cognitive reserve in age-related cognitive decline, and (c) the potential for cognitive training to slow this decline. We also examine ageing and cognition through multiple theoretical perspectives. We highlight critical unresolved issues, such as the disparate implications of subjective versus objective measures of cognitive decline and the insufficient evaluation of cognitive training programs. We suggest future research directions, and emphasise interdisciplinary collaboration to create a more comprehensive understanding of the factors that modulate cognitive ageing.

Social Support, Resilience, and Mental Health Among Three High-Risk Groups in Hong Kong: A Mediation Analysis

Objectives

To compare the prevalence of anxiety/depression, resilience, and social support among nurses, foreign domestic helpers (FDHs), and residents living in subdivided units (SDUs), and to examine their associations in these high-risk groups in Hong Kong during Omicron waves.

Methods

We recruited 1,014 nurses, 621 FDHs, and 651 SDU residents from December 2021 to May 2022 in this cross-sectional survey. The depression, anxiety, social support, and resilience levels were measured by the validated scales. The multivariate binary logistic regression and causal mediation analysis were applied to examine the associations.

Results

We observed a prevalence of 17.7% in anxiety and 21.6% in depression which were the highest in SDU residents, followed by FDHs, and lowest in nurses. Social support was associated with increased resilience levels and decreased risks of anxiety/depression. The association of social support with mental disorders was partly mediated by resilience, accounting for 30.9% and 20.9% of the total effect of social support on anxiety and depression, respectively.

Conclusion

Public health strategies should target improving social support and providing resilience-promoting interventions to help reduce mental disorders in vulnerable groups.

Investigating the Role of Anger and Cognitive Malfunction in Mental Health: A Cross-Sectional Exploration Paving the Way for a Subsequent Experiment

The functional outcomes associated with subjective well-being (SWB) and the detrimental aspects of psychological distress (PD) make it essential to explore contributing factors. The present study investigated a model about the existing gap in the determining role of trait anger (TA), state anger (SA), cognitive reappraisal (CR), rumination and cognitive failure (CF) as predictors of SWB and PD. The study contributes by exploring the interaction of dispositional, situation factors and emotional regulation strategies in shaping SWB and PD in the Indian Sample. A cross-sectional survey design was employed wherein 600 young adults aged 18-40 (Mage = 22.13, SDage = 4.06) were recruited from Uttar Pradesh, India using a multi-level cluster sampling method. The data were collected using questionnaires in the field setting during August-December 2021. Regression and path analysis revealed that the proposed predictors explained significant variance in SWB and PD, i.e., R2 = 0.24, F (5, 594) = 38.03, p < 0.01, Cohen f2 =0.31 and R2 = 0.35, F (5, 594) = 66.40, p < 0.01, Cohen f2 = 0.53, respectively. The models also fit well with the statistical indices. Except CR, all predictors emerged as significant risk factors. The findings suggest that the interventions to reduce PD and enhance SWB may consider inculcating CR and reducing higher levels of TA, SA, rumination and CF to enhance an individual's adaptive functioning. The findings pave the way for conducting a pre-planned experiment to study the outcomes of various levels of TA in regulating incidental anger (SA) employing CR and rumination.

Loneliness during the post-confinement period: The significance of social living conditions for stress biomarkers and memory

In the aftermath of the COVID-19 lockdown, concerns about the impact of loneliness and reduced social interactions on mental health have arisen. This study explored the repercussions of post-lockdown social restrictions across psychological (loneliness, perceived stress, and depressive symptoms), biological (hair cortisol and cardiovascular activity), and cognitive dimensions (subjective memory complaints and working, declarative, and prospective memory), with a specific emphasis on perceived loneliness and the living situation. The study included 45 students: 23 (mean age = 25.69 years) in the Alone Group (AG), who experienced significant family changes and international relocation, and 22 (mean age = 25.50 years) in the Not Alone Group (NAG), who maintained their nuclear family and did not move from their home country. We assessed heart rate variability (HRV) before, during, and after immediate memory evaluations using time-domain (the square root of the mean, RMSSD) measures. The analysis revealed no significant group differences in telematic contact with family and friends, perceived stress, or depression. However, the AG participants reported fewer face-to-face interactions and greater perceived loneliness compared to the NAG. Additionally, the AG group exhibited slightly higher hair cortisol levels and worse working memory (WM) and prospective memory (PM) performance. Importantly, no significant associations were observed between memory outcomes and stress biomarkers. However, a significant interaction effect of loneliness in the relationship between hair cortisol levels and PM was found. That is, hair cortisol concentrations were negatively related to PM when participants perceived high and moderate loneliness. This interaction was absent in the working and declarative memory domains. In summary, these findings underscore the intricate interplay between loneliness, cortisol, and memory, emphasizing the need for comprehensive research on the complex mechanisms governing these multifaceted relationships.

Longitudinal study of disease severity and external factors in cognitive failure after COVID-19 among Indonesian population

The COVID-19 infection is assumed to induce cognitive failure. Identifying the relationship between COVID-19, the effect of vaccination and medication, and accommodating non-COVID-19 factors to cognitive failure is essential. This study was conducted in Indonesia from September 2021 to January 2023. Demographic information, clinical data, comorbidities, vaccination, and medication during COVID-19 were obtained, as well as a 6-month cognitive assessment with Cognitive Failures Questionnaire/CFQ, Fatigue Severity Score, and Generalized Anxiety Disorder (GAD-7). A Structural Equation Model explains the relationship between potential predictors and cognitive failure. The average score of CFQ after 6 months was 45.6 ± 23.1 out of 100. The severity of the disease, which was associated with vaccination status, age, previous infection, and unit of treatment (p < 0.05), was not related to cognitive failure (p = 0.519), although there is a significant direct impact of worst vaccination status to cognitive failure(p < 0.001). However, age, fatigue, and current anxiety were associated with higher cognitive failure (p < 0.001), although comorbidities and recent headaches were not significant in other models (p > 0.05). This study concludes that cognitive failure after COVID-19 is a multifactorial event and does not solely depend on COVID-19 severity. It is crucial to re-address the factors related to the long-term efficacy of vaccination and medication and focus on non-health factors affecting cognitive failure.Trial Registration: NCT05060562.

The Cognitive Function at Work Questionnaire (CFWQ): A new scale for measuring cognitive complaints in occupational population

Cognitive functioning is a relevant work and health related topic, however, validated methods to assess subjective cognitive complaints (SCC) at work are lacking. We introduce the Cognitive Function at Work Questionnaire (CFWQ) for measuring SCC in occupational settings. 1-year follow-up data of 418 employees from a Finnish public media service company was analyzed. Participants completed web-based CFWQ, cognitive tests and a broad set of questionnaires for evaluating depression, anxiety, insomnia, daytime sleepiness, burnout, stress, mental job burden, work ability, cognitive errors, and perceived health. The factor analysis yielded a model with the CFWQ subdomains: Memory, Language, Executive Function, Speed of Processing, Cognitive Control and Name Memory. The internal consistency (Cronbach's alpha = .87) and the test-retest constancy (ICC = .84) reflected good reliability. Correlation between the CFWQ and cognitive errors at work ranged from .25 to .64 indicating adequate concurrent validity. Employees with depression, insomnia and burnout symptoms had higher (p < .001) CFWQ scores than participants without these symptoms. Depression and burnout symptom severity as well as accumulation of mood, sleep, and psychosocial stressors were associated with higher CFWQ scores (p < .001 in all). The CFWQ appears psychometrically sound measure for the assessment of SCC in occupational population.

Poorer decision making among college students during the COVID-19 pandemic: Evidence for "pandemic-brain"

OBJECTIVE

Did living through the COVID-19 pandemic cause healthy college students to experience "pandemic-brain," a phenomenon characterized by difficulties with various cognitive abilities? Did students shift from deliberative to more impulsive decision making?

PARTICIPANTS

We compared a pre-pandemic sample of 722 undergraduate students to 161 undergraduate students recruited in Fall 2020, during the COVID-19 pandemic.

METHOD

We compared scores on the Adult Decision Making Competence scale among participants who completed the task pre-pandemic or across two time points in Fall 2020, during the pandemic.

RESULTS

Decision making was less consistent and more reliant on gain/loss framing during the pandemic compared to pre-pandemic, but college students were no less confident in their decisions. No significant changes in decision making occurred during the pandemic.

CONCLUSIONS

These decision making changes could increase the risk of making an impulsive choice with negative health consequences affecting demands on student health centers and imperiling learning environments.

Coping styles with stress and its relations to psychiatric and clinical symptoms in patients with sarcoidosis: A latent profile analysis

OBJECTIVE

Although stress and styles of coping with it can have a major impact on one's health and can determine the course and management of chronic diseases, no previous studies have evaluated coping strategies and their relation to emotional distress and clinical symptoms in sarcoidosis.

METHODS

In two consecutive studies, we investigated differences in coping styles of sarcoidosis patients in comparison to healthy control subjects and the association of identified profiles to an objective measurement of disease (Forced Vital Capacity) and symptoms such as dyspnoea, pain, anxiety and depressive symptoms in 36 patients with sarcoidosis (study 1) and 93 patients with sarcoidosis (study 2).

RESULTS

Across two studies we found that patients with sarcoidosis used emotion-focused and avoidant coping significantly less often than healthy individuals, and that in both groups the profile with dominant problem (task)-focus style was the most beneficial in terms of mental health. Further, the profile of sarcoidosis patients characterized by the lowest intensity of all coping strategies was found to be superior in terms of physical health status (dyspnoe, pain and FVC level).

CONCLUSION

These findings suggest that successful management of sarcoidosis should include coping styles assessment and call for a multidisciplinary approach in diagnosis and treatment of sarcoidosis patients.

Cognitive and psychological outcomes and follow-up in severely affected COVID-19 survivors admitted to a rehabilitation hospital

BACKGROUND

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) represents the most recent severe pandemic resulting in coronavirus disease 2019 (COVID-19). COVID-19 can damage the central nervous system, requiring admission to intensive care units (ICU) and aggressive treatments (long-term ventilatory assistance and sedation) to stabilize vitals. Most post-COVID-19 patients experience cognitive impairments and mood or stress disorders. We aimed to study the frequency of cognitive deficits in COVID-19 survivors, the relationship between clinical factors in the acute phase and cognitive outcomes, affective states, and quality of life. We explored cognitive reserve (CR) role, as a post-COVID-19 resilience factor.

METHODS

Twenty-nine COVID-19 inpatients were assessed using a neuropsychological battery, mood scales, quality of life, and social integration questionnaires. Twenty-five were retained through telephone follow-up to monitor cognitive sequelae, affective states, and reintegration levels roughly 8 months after hospital discharge. We administered the Cognitive Reserve Index questionnaire.

RESULTS

We found most patients display no cognitive deficits. When they did, multi-domain impairment occurred most frequently, especially involving executive functions. Results revealed a significant correlation between depression levels and the interval between ICU admission and tracheal tube removal. We found increased levels of depression and anxiety at follow-up, a significant relationship between resuming daily life activities, high CR, and executive functions.

CONCLUSIONS

These findings suggest the importance of psychological support in the long term and the modulating role of cognitive reserve in quality of life after infection.

Cognitive Deficits in the Acute Phase of COVID-19: A Review and Meta-Analysis

This meta-analysis was conducted to quantify the risk of patients exhibiting cognitive deficits in the acute phase of COVID-19 at the time of the first variants (i.e., before the vaccine) and quantify the potential vulnerability of older patients and those who experienced more severe respiratory symptoms. To this end, we searched the LitCovid and EMBASE platforms for articles, including preprints, and included all studies (n = 48) that featured a measurement of cognition, which encompassed 2233 cases of COVID-19. Of these, 28 studies reported scores on global cognitive efficiency scales administered in the acute phase of COVID-19 (up to 3 months after infection). We were able to perform a meta-analysis of proportions on 24 articles (N_patients = 943), and a logistic regression on 18 articles (N_patients = 518). The meta-analysis for proportion indicated that 52.31% of patients with COVID-19 exhibited cognitive deficits in the acute phase. This high percentage, however, has to be interpreted taking in consideration the fact that the majority of patients were hospitalized, and some presented neurological complications, such as encephalopathy. A bootstrap procedure with random resampling revealed that an age of 59 was the threshold at which one would be more prone to present cognitive deficits. However, the severity of respiratory symptoms did not influence the scores on a global cognitive efficiency scale. Overall, our results indicated that neuropsychological deficits were a major consequence of the acute phase of the first forms of COVID-19.

Effects of personal relative deprivation on the relationship between anger rumination and aggression during and after the COVID-19 pandemic lockdown: A longitudinal moderated network approach

INTRODUCTION

Several studies have demonstrated a directional link between rage rumination and aggression. However, recent research suggests that this relationship is bidirectional. The current study examined the complex relationships between anger rumination and aggression using a moderated network approach in a longitudinal design while considering personal relative deprivation.

METHOD

A total of 665 participants (59.25% female, age_mean±SD  = 19.01 ± 1.25) were enrolled at two-time points. Assessments included self-report measures of the Anger Rumination Scale, Buss-Perry Aggression Questionnaire, and Relative Deprivation Scale. A Moderated Network Model (MMN) was used to test the complex links among anger rumination, aggression, and personal relative deprivation.

RESULTS

The analysis revealed that the link between anger rumination and aggression was complex and bidirectional. Notably, as the level of personal relative deprivation increased, verbal aggression had a positive conditional effect on anger afterthoughts in Wave 2, and thoughts of revenge had a positive conditional effect on verbal aggression in Wave 2. Moreover, as the first discovery, anger afterthoughts and anger had a negative conditional effect on each other across levels of personal relative deprivation in Wave 2. In addition, network comparison indicates that the MNMs structure was significantly different across timepoints, implying that anger rumination and aggression were inextricably linked in college students during isolation and that this complicated relationship was weakened after isolation.

CONCLUSIONS

This study deepens our understanding of the bidirectional relationships between anger rumination and aggression and recognizes the moderating role of personal relative deprivation.

What makes us more susceptible to false memories in the era of COVID-19? A focus on vaccines and Green Pass

INTRODUCTION

The coronavirus disease 2019 (COVID-19) pandemic was accompanied by an overabundance of fake news increasing the risk of developing false memories (FMs). Previous studies have shown that the relationship between fake news and FMs could be mediated by some individual variables, including attitudinal biases. We explored the role of these variables in true memories (TMs) and FMs formation, with special emphasis on vaccine- and Green Pass (GP)-related topics.

METHOD

We set up a large online survey exploring several constructs including media usage, attitude toward vaccines and GP, perceived (PK) and objective knowledge (OK) about COVID-19-related information, fear of the disease, depression and anxiety symptoms, coping mechanisms, and reasoning skills. Then, we asked participants whether they remembered certain news (true or fake), providing confidence ratings.

RESULTS

Data from 289 respondents (198 females) from the general population were analyzed. Participants with positive attitude reported a greater fear that their loved ones contracted the COVID-19, a more frequent use of traditional media, and a higher PK when compared with respondents with negative attitude. On the whole sample, participants reported higher confidence levels when required to judge their memory of true than fake news; however, participants with positive attitude reported a higher confidence for both true and fake news. The relationship between attitude and TM confidence was mediated by the PK, whereas the relationship between attitude and FM confidence was probably affected by OK.

CONCLUSION

Attitude can modulate individual behaviors in the context of health issues. The PK and OK may interact with attitude in the memory formation.

The association between objective cognitive measures and ecological-functional outcomes in COVID-19

Background

Cognitive dysfunctions, both subjective and detectable at psychometric testing, may follow SARS-CoV-2 infection. However, the ecological-functional relevance of such objective deficits is currently under-investigated. This study thus aimed at investigating the association between objective cognitive measures and both physical and cognitive, ecological-functional outcomes in post-COVID-19.

Methods

Forty-two COVID-19-recovered individuals were administered the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA). The Functional Independence Measure (FIM) was adopted to assess functional-ecological, motor/physical (FIM-Motor) and cognitive (FIM-Cognitive) outcomes at admission (T0) and discharge (T1).

Results

When predicting both T0/T1 FIM-total and-Motor scores based on MMSE/MoCA scores, premorbid risk for cognitive decline (RCD) and disease-related features, no model yielded a significant fit. However, the MoCA - but not the MMSE significantly predicted T0/T1 FIM-Cognitive scores. The MoCA was significantly related only to T0/T1 FIM-Cognitive Memory items.

Discussion

Cognitive measures are not associated with physical/motor everyday-life outcomes in post-COVID-19 patients. The MoCA may provide an ecological estimate of cognitive functioning in this population.

Is This All COVID-19's Fault? A Study on Trainees in One of the Most Affected Italian Cities

Many studies have investigated the state of the health of healthcare workers during the acute period of the pandemic. Yet, few studies have assessed the health of such professionals after the pandemic and in a less dramatic period. This study involved a particular sample represented by residents in anaesthesia-resuscitation and psychiatry at a university in northern Italy particularly affected by the pandemic. The objectives were to investigate some indicators of health and well-being and compare the two groups of trainees. Using Google Forms, the following tests were proposed: the General Health Questionnaire, Maslach Burnout Inventory, Subjective Happiness Scale, Satisfaction with Life Scale, Coping Inventory for Stressful Situations, Brief Resilience Scale, State-Trait Anxiety Inventory, as well as an ad hoc questionnaire. A qualifying element of the work was the discussion of the results with the trainees. Various strengths have emerged, such as high values of resilience and job satisfaction; a positive assessment of the support received from the work team; an articulate use of coping strategies; and good levels of happiness and satisfaction with life, in both specialities. However, a widespread anxiety also emerged, which appears to be more attributable to concerns about professional evaluation, rather than the pandemic itself. In summary, the trainees seem to have found a fair amount of personal balance, whereas the relationship with the patient seems to be more compromised. In the comparison between specialities, the only significant differences are the levels of depersonalisation and resilience, both of which are higher in anaesthetists.

Workforce and supply chain disruption as a digital and technological innovation opportunity for resilient manufacturing systems in the COVID-19 pandemic

During the SARS-CoV-2 pandemic (also known as COVID-19), workforce downsizing needs, safety requirements, supply chain breaks and inventory shortages affected manufacturing systems' and supply chain's responsiveness and resilience. Companies wandered in a disrupted scenario because recommended actions/strategies to survive - and thrive - were not available an improvised actions to keep their operations up and running. This paper analyzes the COVID-19 impacts on the workforce and supply resilience in a holistic manner. The following research questions are discussed: (i) how can manufacturing firms cope with urgent staff deficiencies while sustaining at the same time a healthy and safe workforce in the perspective of socially sustainable and human-centric cyber-physical production systems?; (ii) is remote working (cf. smart working) applicable to shop-floor workers?; (iii) is it possible to overcome supply chain breaks without stopping production? In the first part, we propose three Industry 4.0-driven solutions that would increase the workforce resilience, namely: (i) the Plug-and-Play worker; (ii) the Remote Operator 4.0; (iii) the Predictive Health of the Operational Staff. In the second part, the concepts of (i) Digital & Unconventional Sourcing, i.e. Additive Manufacturing, and (ii) Product/Process Innovation are investigated from a novel business continuity and integration perspective. We ultimately argue that forward-looking manufacturing companies should turn a disruptive event like a pandemic in an opportunity for digital and technological innovation of the workplace inspired by the principles of harmonic digital innovation (that places the human well-being at the center). These aspects are discussed with use cases, system prototypes and results from research projects carried out by the authors and real-world examples arising lessons learned and insights useful for scientists, researchers and managers.

Assessing Interpersonal Proximity Evaluation in the COVID-19 Era: Evidence From the Affective Priming Task

Social proximity has since ever been evaluated as positive. However, the outbreak of the COVID-19 pandemic has dramatically reduced our social relations to avoid spreading the contagion. The present study aims to investigate people's current assessment of social proximity by using an affective priming paradigm (APP). We hypothesized that if our evaluation of social proximity is positive, then words with positive valence (e.g., relaxed) should be processed faster when preceded by images of social proximity than social distancing. On the contrary, if our evaluation of social proximity is turning negative, then words with a negative valence (e.g., sad) should be processed faster when preceded by images of social proximity than social distancing. To this end, we presented participants with prime images showing line drawings representing humans in situations of proximity or distancing and asked them to evaluate the valence (i.e., positive or negative) of a subsequent target word. In a follow-up session, the same participants evaluated the prime images as being positively or negatively valenced. Results showed that a large subset of participants who rated the prime images of social proximity as positive also processed positive words faster when these were preceded by images of social proximity than social distancing. Conversely, a smaller subset of participants who rated the prime images of social proximity as less positive processed negative words faster when these were preceded by images of social proximity than social distancing. These results suggest individual differences in the assessment of social proximity likely driven by the pandemic.

Risk and Protective Factors of Psychological Distress in Patients Who Recovered From COVID-19: The Role of Cognitive Reserve

Recent studies reported the development of psychological distress symptoms in patients who recovered from COVID-19. However, evidence is still scarce and new data are needed to define the exact risk and protective factors that can explain the variability in symptoms manifestation. In this study, we enrolled 257 patients who recovered from COVID-19 and we evaluated the levels of psychological distress through the Symptoms Checklist-90-R scale. Data concerning illness-related variables were collected from medical records, while the presence of subjective cognitive difficulties, both before and after the illness, as well as the level of the cognitive reserve (CR), were assessed over a clinical interview. Results revealed that being female and reporting the presence of subjective cognitive difficulties after COVID-19 were associated with higher levels of psychological distress. At the same time, being admitted to the hospital and having a high CR were protective factors. Adding new information to this emerging research field, our results highlight the importance of a complete psychological and cognitive assessment in patients with COVID-19.

Italian telephone-based Mini-Mental State Examination (Itel-MMSE): item-level psychometric properties

Background

The Italian telephone-based Mini-Mental State Examination (Itel-MMSE), despite being psychometrically sound, has shown relevant ceiling effects, which may negatively impact the interpretation of its scores. In address to overcome such an issue, this study aimed at providing item-level insights on the Itel-MMSE through Item Response Theory (IRT) analyses.

Methods

Five-hundred and sixty-seven healthy Italian adults (227 males, 340 females; mean age: 51 ± 17 years, range 18–96; mean education: 13.31 ± 4.3 years). A two-parameter logistic IRT model was implemented to assess item discrimination and difficulty of the Itel-MMSE. Construct unidimensionality, statistical independence of items, and model and item fit were tested. Informativity levels were also assessed graphically.

Results

With respect to the Itel-MMSE total score, ceiling effects were found in 92.7% of participants. Unidimensionality was violated; both model and item fit were poor; a few items showed statistical dependence. Both the whole test and its items proved to be scarcely informative, especially for medium-to-high levels of ability, except for attention and spatial orientation subtests, which consistently yielded the highest discriminative capability.

Discussion

The Itel-MMSE appears to be most informative in low-performing healthy individuals. However, the present findings should not lead practitioners to aprioristically equate ceiling effects/low informativity to clinical uselessness. Items assessing attention and, to a lesser extent, spatial orientation appear to be the most informative.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40520-021-02041-4.

Cognitive reserve and coping strategies predict the level of perceived stress during COVID-19 pandemic: A cross-sectional study

The COVID-19 pandemic and the measures to avert contagion heavily impacted individuals' mental health. In the present cross-sectional study, we investigate the relationship between cognitive reserve, coping modalities and the perceived stress during a chronic stage of COVID-19 pandemic by online administration of three standardized questionnaires in a sample of healthy volunteers covering a large lifespan (18–85 years). We found that positive orientation to problems and higher levels of cognitive reserve were associated with lower levels of stress. Conversely, coping strategies involving negation, substance consumption, and appeal to other people and religion to face everyday life, together with higher education, were associated with higher levels of stress. These results shade light on the long-term psychological consequences of COVID-19 and call for the development of psychological interventions improving coping and cognitive reserve, to preserve and restore mental health following the pandemic.

Telephone Interview for Cognitive Status (TICS): Italian adaptation, psychometrics and diagnostics

BACKGROUND

Telephone-based cognitive screening (TBCS) is crucial to telehealth care of neurological patients, prevention campaigns, and epidemiological studies on cognitive impairment. The Telephone Interview for Cognitive Status (TICS) is one of the most widespread and psychometrically/diagnostically sound TBCS test, with several versions developed worldwide (e.g., with and without a delayed recall item). In Italy, only attempts of adaptation and preliminary evidence of its statistical features have been provided so far. This study thus aimed at (1) developing an Italian version of the TICS and assessing its (2) psychometric and (3) diagnostic properties.

METHODS

A back-translated and culturally adapted version of the TICS was developed. Three-hundred and sixty-five healthy individuals from different regions of Italy (147 males, 216 females; age: 53.2 ± 16 years; education: 13 ± 4.5 years) were administered the TICS and the Italian telephone-based Mini-Mental State Examination (Itel-MMSE). Validity was tested by convergence and at the structure level, whereas reliability as internal consistency, test-retest, and inter-rater. Diagnostic accuracy, item difficulty, and discrimination were also examined.

RESULTS

The TICS featured a single component and its score converged with that of the Itel-MMSE (rs = .37). Reliability was excellent as inter-rater (ICC = .94), good as test-retest (ICC = .78), and acceptable as internal consistency (Cronbach's α = .63). Accuracy was high as tested against the Itel-MMSE (AUC = .83) and did not improve when adding the delayed recall. Backward subtraction was the most difficult and discriminative task.

DISCUSSION

The Italian TICS is a valid, reliable, and diagnostically accurate TBCS test. The original format of the TICS can be thus adopted in both clinical and research settings.

Does social distancing affect the processing of brand logos?

Social distancing and isolation have been imposed to contrast the spread of COVID-19. The present study investigates whether social distancing affects our cognitive system, in particular the processing of different types of brand logos in different moments of the pandemic spread in Italy. In a size discrimination task, six different logos belonging to three categories (letters, symbols, and social images) were presented in their original format and spaced. Two samples of participants were tested: one just after the pandemic spread in Italy, the other one after 6 months. Results showed an overall distancing effect (i.e., spaced stimuli are processed slower than original ones) that interacted with the sample, revealing a significant effect only for participants belonging to the second sample. However, both groups showed a distancing effect modulated by the type of logo as it only emerged for social images. Results suggest that social distancing behaviors have been integrated in our cognitive system as they appear to affect our perception of distance when social images are involved.

Psychosocial Effects of COVID-19 Measures on (Pre-)Dementia Patients During Second Lockdown

BACKGROUND

The COVID-19 pandemic poses enormous social challenges, especially during lockdown. People with cognitive decline and their caregivers are particularly at risk of lockdown consequences.

OBJECTIVE

To investigate psychosocial effects in (pre-)dementia patients and caregivers during second lockdown and compare effects between first and second lockdown.

METHODS

We included n = 511 (pre-)dementia patients and n = 826 caregivers from the Amsterdam Dementia Cohort and via Alzheimer Nederland. All respondents completed a self-designed survey on psychosocial effects of COVID-19. We examined relations between experienced support and psychosocial and behavioral symptoms using logistic regression. In a subset of patients and caregivers we compared responses between first and second lockdown using generalized estimating equation.

RESULTS

The majority of patients (≥58%) and caregivers (≥60%) reported that family and friends, hobbies, and music helped them cope. Support from family and friends was strongly related to less negative feelings in patients (loneliness: OR = 0.3[0.1-0.6]) and caregivers (loneliness: OR = 0.2[0.1-0.3]; depression: OR = 0.4[0.2-0.5]; anxiety: OR = 0.4[0.3-0.6]; uncertainty: OR = 0.3[0.2-0.5]; fatigue: OR = 0.3[0.2-0.4]; stress: OR = 0.3[0.2-0.5]). In second lockdown, less psychosocial and behavioral symptoms were reported compared to first lockdown (patients; e.g., anxiety: 22% versus 13%, p = 0.007; apathy: 27% versus 8%, p < 0.001, caregivers; e.g., anxiety: 23% versus 16%, p = 0.033; patient's behavioral problems: 50% versus 35%, p < 0.001). Patients experienced more support (e.g., family and friends: 52% versus 93%, p < 0.001; neighbors: 28% versus 66%, p < 0.001).

CONCLUSION

During second lockdown, patients and caregivers adapted to challenges posed by lockdown, as psychosocial and behavioral effects decreased, while patients experienced more social support compared to first lockdown. Support from family and friends is a major protective factor for negative outcomes in patients and caregivers.

Age- and gender-related differences in the evolution of psychological and cognitive status after the lockdown for the COVID-19 outbreak: a follow-up study

OBJECTIVE

Individuals experienced psychological symptoms in response to quarantine for the COVID-19 pandemic. Therefore, we aimed to investigate the possible effect of age and gender on the evolution of mental health status after the quarantine in the Italian population and the baseline predictors of post-traumatic stress symptoms.

METHODS

An online follow-up questionnaire including an assessment of depression, anxiety, anger, post-traumatic stress, subjective cognitive failures, resilience, and coping style was completed by participants 2 months after the end of the quarantine (n = 758).

RESULTS

Individuals experienced psychological symptoms also 2 months after the end of the quarantine. No decrease in depression and anxiety scores emerged, but younger individuals and females experienced more severe symptoms. Anger symptoms decreased in young adults, whereas they increased in older adults. Moreover, individuals reported more cognitive failures at follow-up. No changes were observed in resilience, whereas participants reported adopting fewer coping strategies at follow-up. Finally, post-traumatic stress symptoms 2 months after the end of the lockdown were associated with more severe psychological symptoms and more fear of getting infected at baseline.

CONCLUSIONS

Our findings demonstrate that the long-term psychological impact and the cognitive consequences of quarantine differ according to age and gender. The identification of more vulnerable groups allows the implementation of interventions to reduce psychological symptoms and the risk for cognitive impairment.

Objective Knowledge Mediates the Relationship between the Use of Social Media and COVID-19-Related False Memories

The exposure to relevant social and/or historical events can increase the generation of false memories (FMs). The Coronavirus Disease 2019 (COVID-19) pandemic is a calamity challenging health, political, and journalistic bodies, with media generating confusion that has facilitated the spread of fake news. In this respect, our study aims at investigating the relationships between memories (true memories, TMs vs. FMs) for COVID-19-related news and different individual variables (i.e., use of traditional and social media, COVID-19 perceived and objective knowledge, fear of the disease, depression and anxiety symptoms, reasoning skills, and coping mechanisms). One hundred and seventy-one university students (131 females) were surveyed. Overall, our results suggested that depression and anxiety symptoms, reasoning skills, and coping mechanisms did not affect the formation of FMs. Conversely, the fear of loved ones contracting the infection was found to be negatively associated with FMs. This finding might be due to an empathy/prosociality-based positive bias boosting memory abilities, also explained by the young age of participants. Furthermore, objective knowledge (i) predicted an increase in TMs and decrease in FMs and (ii) significantly mediated the relationships between the use of social media and development of both TMs and FMs. In particular, higher levels of objective knowledge strengthened the formation of TMs and decreased the development of FMs following use of social media. These results may lead to reconsidering the idea of social media as the main source of fake news. This claim is further supported by either the lack of substantial differences between the use of traditional and social media among participants reporting FMs or the positive association between use of social media and levels of objective knowledge. The knowledge about the topic rather than the type of source would make a difference in the process of memory formation.

A Standardized Prospective Memory Evaluation of the Effects of COVID-19 Confinement on Young Students

The restriction imposed worldwide for limiting the spread of coronavirus disease 2019 (COVID-19) globally impacted our lives, decreasing people’s wellbeing, causing increased anxiety, depression, and stress and affecting cognitive functions, such as memory. Recent studies reported decreased working memory (WM) and prospective memory (PM), which are pivotal for the ability to plan and perform future activities. Although the number of studies documenting the COVID-19 effects has recently blossomed, most of them employed self-reported questionnaires as the assessment method. The main aim of our study was to use standardized tests to evaluate WM and PM in a population of young students. A sample of 150 female psychology students was recruited online for the administration of two self-reported questionnaires that investigated psychological wellbeing (DASS-21), prospective, and retrospective memory (PRMQ). Subjects were also administered two standardized tests for WM (PASAT) and PM (MIST). We found increased anxiety, depression, and stress and decreased PM as measured by self-reports. The perceived memory failures agreed with the results from the standardized tests, which demonstrated a decrease in both WM and PM. Thus, COVID-19 restriction has strongly impacted on students’ mental health and memory abilities, leaving an urgent need for psychological and cognitive recovery plans.

Mental health status of Italian elderly subjects during and after quarantine for the COVID-19 pandemic: a cross-sectional and longitudinal study

BACKGROUND

The elderly are more vulnerable to COVID-19 and therefore need to adopt long-term social distancing measures. The duration of quarantine impacts the psychological status of the general population. However, until now no study has explored the psychological impact of the pandemic and quarantine together with longitudinal changes in the mental health status of Italian elderly.

METHODS

An online questionnaire including an assessment of depression, anxiety, anger, post-traumatic stress, subjective cognitive failures, resilience, coping style, and other dimensions related to the pandemic was completed by participants during (T0) and two months after the end (T1) of the quarantine.

RESULTS

The sample recruited at T0 included 334 elderly participants. About 45% of the participants experienced depression, anxiety, or anger. Moreover, more fear of getting infected was related to more severe depression, anxiety, and anger, but resilience was found to mediate these relationships. More severe depressive and anger symptoms were related to more severe cognitive failures. No significant difference was observed in mental health scores between T0 and T1. Finally, more severe depression at T0 was associated with the development of post-traumatic stress symptoms at T1.

CONCLUSIONS

The fear of getting infected, probably due to perceived vulnerability to disease, seems to play a crucial role in the development of psychological symptoms in the elderly, but resilience seems to mediate the impact of fear. The presence of long-term psychological consequences and the possible risk of developing PTS symptoms in the elderly suggest the need for targeted interventions to reduce possible long-term psychological and cognitive consequences.