Multidimensional Assessment of COVID-19-Related Fears (MAC-RF): A Theory-Based Instrument for the Assessment of Clinically Relevant Fears During Pandemics

Covid-19 Anxiety Scale (CAS): A Validity and Reliability Study

In this study, our aim was to develop a valid and reliable scale to determine the social anxiety level of people regarding COVID-19. A total of 420 people participated in the research. Explanatory and confirmatory factor analyses were used to test the validity and reliability of the scale. As a result of the explanatory factor analysis, it was determined that the scale consisted of 22 items and four sub-dimensions. These sub-dimensions were named "negative thinking", "sociability", "fear" and "vaccination". In examination of the fit indices obtained from the confirmatory factor analysis results, it was seen that the four-factor scale structure was high and acceptable. Based on these results, we concluded that the COVID-19 social anxiety scale (CAS) was valid and reliable for examining the level of social anxiety of people during the pandemic periods.

Interplay of Dyadic Consensus, Reflective Functioning, and Perinatal Affective Difficulties in Modulating Fear of COVID-19 among First-Time Mothers: A Mediation Analysis

BACKGROUND

The COVID-19 pandemic has exacerbated fears and anxieties, potentially influencing maternal perinatal mental health. This study addresses a gap in the literature on fear of COVID-19 in pregnant women, aiming to identify contributing factors.

METHOD

Participants were 401 primiparous women with an average age of 34 years (SD = 4.56) who were recruited through the National Health System during birth support courses. They completed a series of self-reported instruments via an online survey, providing information on their levels of reflective functioning, dyadic consensus, perinatal maternal affectivity, and fear of COVID-19. Pearson's correlation and mediation analysis via a generalized linear model were implemented to analyze the collected data.

RESULTS

The relationship between dyadic consensus and fear of COVID-19 was significant and negative. Furthermore, a significant parallel mediation involving perinatal maternal affectivity and reflective functioning was found to the extent that, when these factors were inserted into the model, the direct association between dyadic consensus and fear of COVID-19 became non-significant (total mediation).

CONCLUSIONS

The results highlight the importance of dyadic adjustment in alleviating maternal COVID-19 fear, emphasizing interventions promoting couple functioning, mentalization, and addressing affective difficulties. Such approaches are vital for supporting expecting mothers during challenging times like the COVID-19 pandemic.

Emotional experiences and study motivation among Italian university students during the second wave of COVID-19

Objective: This study aimed to investigate the relationships between emotional experiences and study motivation in a group of nonworking and never-infected university students, during the second wave of the COVID-19 pandemic. Participants: Participants (N = 353; aged M = 21.5; SD = 2.8) were mostly female (76.2%) Italian university students. Methods: They completed an online assessment that included self-report measures of fear during the second wave of the COVID-19 pandemic, intolerance of uncertainty, optimism, and study motivation. Results: Our findings showed that older students were more optimistic than younger students. Besides, fear of COVID-19, intolerance of uncertainty, and pessimism predicted worse study motivation. Conclusions: Greater psychological support should be reserved for younger students to prevent emotional experiences that might affect the learning goal.

The self and our perception of its synchrony - Beyond internal and external cognition

The self is the core of our mental life which connects one's inner mental life with the external perception. Since synchrony is a key feature of the biological world and its various species, what role does it play for humans? We conducted a large-scale psychological study (n = 1072) combining newly developed visual analogue scales (VAS) for the perception of synchrony and internal and external cognition complemented by several psychological questionnaires. Overall, our findings showed close connection of the perception of synchrony of the self with both internal (i.e., body and cognition) and external (i.e., others, environment/nature) synchrony being associated positively with adaptive and negatively with maladaptive traits of self. Moreover, we have demonstrated how external (i.e., life events like the COVID-19 pandemic) variables modulate the perception of the self's internal-external synchrony. These findings suggest how synchrony with self plays a central role during times of uncertainty.

Validity and reliability of the COVID-19 Anxiety Syndrome Scale in Canadian dentists

BACKGROUND

The COVID-19 pandemic has resulted in a high level of mental health problems for the population worldwide including healthcare workers. Several studies have assessed these using measurements for anxiety for general populations. The COVID-19 Anxiety Syndrome Scale (C-19ASS) is a self-report measure developed to assess maladaptive forms of coping with COVID-19 (avoidance, threat monitoring and worry) among a general adult population in the United States. We used it in a prospective cohort study of COVID-19 incidence rates in practising Canadian dentists. We therefore need to ensure that it is valid for dentists in French and English languages. This study aimed to evaluate the validity of the C-19ASS in that population.

METHODS

Cross-sectional data from the January 2021 monthly follow-up in our prospective cohort study were used. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were performed.

RESULTS

The results of EFA revealed a 2-factor structure solution that explained 47% of the total variance. The CFA showed a good model fit on the data in both English and French languages. The Cronbach's alpha indicated acceptable levels of reliability. Furthermore, the C-19ASS showed excellent divergent validity from the Generalized Anxiety Disorder-7 (GAD-7) scale.

CONCLUSIONS

The C-19ASS is valid and reliable instrument to measure COVID-19-related anxiety in English and French among Canadian dentists.

PRACTICAL IMPLICATIONS

This validated measure will contribute to understanding of the mental health impact of the pandemic on dentists in Canada and enable the dental regulatory authorities and organizations to intervene to help dentists.

Do Italian people still wear masks? Analysis of personality and dispositional correlates of facemask use in post Covid-19 scenario

Face mask wearing is a low-cost preventative measure for the Covid-19 pandemic. In Italy, face masks are no longer mandatory indoors from the 1st of May 2022. Some research focused on factors that influence the choice of using masks, but less is known about mask-wearing when non-mandatory. The present study aims to compare those who were still wearing masks indoors when non-mandatory and those who were not, in personality traits, anxiety, depression, and trust in healthcare professions, in Italy, in 2022. Furthermore, we analyze if resilience, reactance, political orientation, and Covid-19 vaccinations moderate between negative affectivity and the choice of wearing masks. 1151 adults, aged 18-64, were recruited. Using the Qualtrics platform, participants filled in a socio-demographic interview, and self-report questionnaires. Results showed that people who were still wearing a mask indoors had higher levels of psychoticism and negative affectivity, worse mental health, greater trust in healthcare professions, and worries about the pandemic. Moreover, resilience partially moderates the relationship between negative affectivity and the choice of wearing a mask. These findings provide a better understanding of individuals' responses to post-pandemic changes, identifying the personal and contextual aspects that can make people struggle with the process of returning to normality.

Does the COVID-19 pandemic condition the delusional content of patients with psychosis? An observational study

INTRODUCTION

The primary objective is to analyse the impact of the COVID-19 pandemic on the triggers of psychopathology and on the delusional content of patients with psychotic symptoms treated during the first three months of the pandemic in a tertiary hospital in Madrid.

METHODS

We conducted a cross-sectional, observational and retrospective study of all patients attending the psychiatric emergency room (ER) between 11th March and 11th June 2020. Sociodemographic and clinical variables were included. The chi-squared test or Fisher's exact test were performed to compare categorical variables. The level of statistical significance was set at P<.05.

RESULTS

In the first month of the pandemic, COVID-19 conditioned the delirious content of 38.5% of the admitted patients and acted as a direct trigger for 46.2% of consultations. In the second week it affected 100.0% of the patients in both cases. Subsequently, a progressive and significant decrease was observed, with COVID-19 being the triggering factor for 17.6% and 11.5% of consultations in the second and third months of the pandemic respectively. Similarly, it was the main determinant of the delusional content in 13.7% and 3.8% of cases respectively.

CONCLUSIONS

The current pandemic affects delirium's pathoplasty. The delusional content of patients admitted with psychotic symptoms is quickly conditioned, which may be related to the radical change in their life, without transition or prior preparation. The patient's environmental context and events have a huge impact on the dynamics and characteristics of mental disorders.

Prevalence of fear of COVID-19, depression, and anxiety among undergraduate students during remote classes

BACKGROUND

During the coronavirus disease 2019 (COVID-19) pandemic, undergraduate students were exposed to symptoms of psychological suffering during remote classes. Therefore, it is important to investigate the factors that may be generated and be related to such outcomes.

OBJECTIVE

To investigate the association between fear of COVID-19, depression, anxiety, and related factors in undergraduate students during remote classes.

METHODS

This cross-sectional study included 218 undergraduate students (60.6% women and 39.4% men). Students answered a self-administered online questionnaire designed to gather personal information, pandemic exposure, physical activity level, fear of COVID-19 using the 'Fear of COVID-19 Scale', symptoms of depression using the Patient Health Questionnaire-9, and anxiety using General Anxiety Disorder-7.

RESULTS

Undergraduate students had a high prevalence of depression and anxiety (83.0% and 76.1%, respectively) but a low prevalence of fear of COVID-19 (28.9%) during remote classes. Multivariate analysis revealed that women who reported health status as neither good nor bad and who had lost a family member from COVID-19 had the highest levels of fear. For depression and anxiety, the main related factors found were female gender, bad health status, insufficiently active, and complete adherence to the restriction measures.

CONCLUSION

These findings may be used to develop actions to manage symptoms of anxiety and depression among students, with interventions through physical activity programmes to improve mental health.

In Between the Psychological and Physiological Self - The Impact of Covid-19 Pandemic on the Neuro-Socio-Ecological and Inflammatory Mind-Body-Brain System

The COVID-19 pandemic has had a profound impact on individuals' sense of self perturbating the sense of connectedness with the others, touching upon deep existential fears and deep intersubjective and cultural layers, emphasizing the importance of a neuro-socio-ecological alignment for the sense of security of psychological self. We can still observe after years how social distancing measures, quarantines, and lockdowns have disrupted social connections and routines, leading to feelings of isolation, anxiety and depressive symptomatology. Furthermore, from a physiological perspective, some people continue to experience health problems long after having COVID-19, and these ongoing health problems are sometimes called post-COVID-19 syndrome or post-COVID conditions (PASC). In this complex scenario, through the operationalization of the sense of self and its psychological and physiological baseline, our aim is to try to shed some new light on elements of resilience vs. vulnerability. Here we intend the self and its baseline as the crossroads between psychology and physiology and we show how COVID-19 pandemic, especially in post-COVID-19 syndrome (PACS), left traces in the mind-body-brain system at a neuro-socio-ecological and inflammatory level.

Unveiling the influence of the Italian mafia as a Dark Triad threat on individuals' affective states and the power of defense mechanisms

The present research investigated whether the Italian mafia as a Dark Triad threat increased threat-related affective states and explored how thinking about defense mechanisms may help to reduce these states. For this, we conducted a multi-method experimental study with Italians (N = 253). The quantitative results show that the mafia as a threat manipulation increased threat-related affective states in terms of higher behavioral inhibition (BIS) and lower behavioral activation (BAS). The qualitative results further depict proximal and distal defense mechanisms to reduce this threat, which can be categorized into models of threat and defense. Exploratory analyses indicate that naming distal defenses positively affected the increase of BAS. Additionally, when participants had higher levels of BIS after the threat, naming more defenses and proximal defenses positively affected the decrease of BIS. Further qualitative results provide valuable information on effective personal and societal buffers for the perceived threat of the Italian mafia.

After the first lockdown due to the COVID-19 pandemic: Perceptions, experiences, and effects on well-being in Italian people

Background

Since the COVID-19 pandemic and the subsequent measures of containment, multiple studies have been conducted aimed at assessing the impacts on people's psychophysical well-being; however, few studies have investigated the general population's perceptions, experiences, and effects by adopting a mixed-method approach.

Methods

A total of 855 Italian participants completed an online survey, conducted in the period following the first lockdown in Italy. Psychological well-being, perceived stress and COVID-19-related fears were assessed by standardized questionnaires (Psychological General Well-Being Index-Short version, Perceived Stress Scale 10, and Multidimensional Assessment of COVID-19-Related Fears). The process of sense-making of the experience during the lockdown period was also evaluated by means of an open-ended question.

Results

Participants reported a lower level of general well-being, and a higher level of both perceived stress and COVID-19-related fear during the lockdown period compared to the time of the survey (1 month after the resumption of activities). The thematic analysis of responses to the open-ended question revealed two factors and five clusters, which explain the thematic variance among the narratives: the first factor refers to the type of experience (emotional states and feelings vs. objective descriptions of daily activities), while the second concerns positive or negative connotations of the experiences reported.

Conclusions

This study explored the psychological impact of the first lockdown on people's well-being, and described the process of making sense of the experience during the lockdown 1 month after going back to previous habits. Results highlighted the effectiveness of the mixed-method approach for an in-depth and exhaustive investigation of people's psychological condition during and after the first lockdown.

An exploration of happiness, anxiety symptoms, and depressive symptoms among older adults during the coronavirus pandemic

The COVID-19 pandemic has affected millions of people worldwide. Because of the challenges associated with the pandemic, universal levels of happiness have likely depleted. We know little about how those with prior existing mental health concerns have responded to the pandemic. Using cross-sectional (study 1; N = 1,366) and longitudinal (study 2; N = 262) data, we utilized a stress and resilience perspective to explore mental health symptoms and happiness among older adults before and after the declaration of the pandemic. Results for both studies indicated higher levels of depression and anxiety symptoms predicted lower levels of happiness; however, for those who indicated higher levels of mental health symptoms, post-pandemic declaration happiness levels were higher than pre-pandemic happiness levels. Findings suggest that resilience may be learned throughout a lifetime, and that experiences from prior stressors may show benefits in responding to future ones, even among vulnerable populations.

Predictors of Cyberchondria during the COVID-19 pandemic: A cross-sectional study using supervised machine learning

BACKGROUND

Cyberchondria is characterized by repeated and compulsive online searches for health information, resulting in increased health anxiety and distress. It has been conceptualized as a multi-dimensional construct fueled by both anxiety and compulsivity-related factors and described as a "transdiagnostic compulsive behavioral syndrome" which is associated with health anxiety, problematic internet use and obsessive-compulsive symptoms. Cyberchondria is not included in the ICD-11 or the DSM-5, and its defining features, etiological mechanisms and assessment continue to be debated.

OBJECTIVE

This study aimed to investigate changes in the severity of cyberchondria during the pandemic and identify predictors of cyberchondria at this time.

METHODS

Data collection started on May 4, 2020 and ended on June 10, 2020, which corresponds to the first wave of the COVID-19 pandemic in Europe. At the time the present study took place, French-speaking countries in Europe (France, Switzerland, Belgium and Luxembourg) all implemented lockdown or semi-lockdown measures. The survey consisted of a questionnaire collecting demographic information (sex, age, education level and country of residence) and information on socioeconomic circumstances during the first lockdown (e.g., economic situation, housing and employment status), and was followed by several instruments assessing various psychological and health-related constructs. Inclusion criteria for the study were being at least 18 years of age and having a good understanding of French. Self-report data were collected from 725 participants aged 18 to 77 years (mean 33.29, SD 12.88 years), with females constituting the majority (416/725, 57.4%).

RESULTS

The results show that the COVID-19 pandemic affected various facets of cyberchondria: cyberchondria-related distress and interference with functioning increased (distress z=-3.651, P<.001; compulsion z=-5.697, P<.001), whereas the reassurance facet of cyberchondria decreased (z=-6.680, P<.001). Also, COVID-19-related fears and health anxiety emerged as the strongest predictors of cyberchondria-related distress and interference with functioning during the pandemic.

CONCLUSIONS

These findings provide evidence about the impact of the COVID-19 pandemic on cyberchondria and identify factors that should be considered in efforts to prevent and manage cyberchondria at times of public health crises. Also, they are consistent with the theoretical model of cyberchondria during the COVID-19 pandemic proposed by Starcevic and his colleagues in 2020. In addition, the findings have implications for the conceptualization and future assessment of cyberchondria.

The role of defense styles and psychopathological symptoms on adherence to conspiracy theories during the COVID-19 pandemic

Due to the unpredictability of the COVID-19 pandemic situation, individuals felt uncertain and insecure. As a consequence, conspiracy theories flourished and quickly spread. In the current study, we examine the relationship between general and COVID-19-related conspiracy theories, cognitive reflection, psychopathological symptoms, and defense styles in a sample of Italian adults. A total of 450 participants (50.2% male; mean age = 40.89 years, SD = 12.15) took part in an online survey. Two linear regression models on the general (explained variance 22.6%) and COVID-19-related (explained variance 33.0%) conspiracy theories have been tested. Among the predictive factors, older age, mania symptoms, and immature defenses facilitate adherence to conspiracy theories; on the opposite side, higher education, cognitive reflection, and mature defenses protected from adherence to conspiracy theories. The study provides some novel findings about factors that are significantly associated with general and COVID-19-related conspiracy theories, and highlights the pivotal role of individuals' psychological defenses in conspiracy theories.

The necessity revealed by COVID-19 pandemic: Paradigm shift of Iran's healthcare system

Background

COVID-19 pandemic has resulted in drastic changes around the world, revealing vulnerable aspects of healthcare systems. This study aimed to explore how Iranian healthcare system experienced the paradigm shift during the pandemic and determine the aspects that need improvement during the pandemic era.

Method

This qualitative study was conducted in 2021. A framework analysis approach was used to analyze the content of the 19 semi-structured interviews with the healthcare system experts from Shiraz University of Medical Sciences (SUMS). The interviews' audio files changed into transcript after each session and data was saturated at the 19 interview. To increase the trustworthiness of the study, Guba and Lincoln's criteria including credibility, transferability, dependability, and confirmability were used. Goldsmith's five-step framework analysis was used applying MAX QDA version 10 software.

Result

Eight main themes and 20 subthemes were explored. The main themes included "strengthening the electronic health infrastructure," "research for evidence-based decision making," "dedicated financing to the pandemic," "prevention of disruption in the effective provision of services and medicines," "enriching the authority of the Ministry of Health by focusing on interactions," "recruiting, managing and empowering health human resources with attention to financial and non-financial incentives," "reforming educational approaches in training students in medical universities," as well as "lessons learned from neglected aspects."

Conclusion

To be ready to respond to a possible future pandemic and for a paradigm shift, bold steps must be taken to make fundamental changes in various aspects of the healthcare system including e-health development, evidence-based decision making, dedicated budgets for pandemics, reinforcement of interactions at the national and international level, as well as sufficient attention to healthcare workers from all financial, non-financial and educational aspects.

Influence of fear of COVID-19 on depression: The mediating effects of anxiety and the moderating effects of perceived social support and stress perception

Objective

Explore the influence of fear of COVID-19 on depression, with anxiety as a mediator and perceived social support and stress perception as moderates.

Methods

From February to March 2020, 1,196 valid data were collected online through questionnaire by cluster sampling method. Fear of COVID-19 Questionnaire, the Patient Health Questionnaire 9-Item Scale (PHQ-9), the Generalized Anxiety Disorder 7-Item Scale (GAD-7), the Perceived Social Support Scale (PSSS) and the10-item Perceived Stress Scale (PSS-10) were used as the survey instrument, and the participants were female undergraduates from a liberal arts college of a Chinese university. Common method bias was assessed using Harman's single-factor test in SPSS and confirmatory factor analysis in AMOS. The levels of participants' anxiety, depression and perceived social support were described using frequency and percentage, Pearson Correlation test was used to measure the correlation between the variables. The PROCESS macro for SPSS (Model 1, Model 4, and Model 21) were applied to examine the mediating effect and moderating effect of the model.

Results

Fear of COVID-19 can positively influence depression, anxiety plays a mediating role between fear of COVID-19 and depression, perceived social support negatively moderates the relationship between fear of COVID-19 and anxiety, and stress perception positively moderates the relationship between anxiety and depression. These five variables can form a moderated mediating effect model.

Conclusion

Fear of COVID-19, anxiety and stress perception are risk factors for depression, perceived social support is a protective factor for depression. Reducing the fear of COVID-19, anxiety and stress perception and enhancing perceived social support are beneficial to reduce the level of depression.

The psychometric properties and gender invariance of the Italian version of the Perceived Vulnerability to Disease Questionnaire (I-PVDQ) during the COVID-19 pandemic

BACKGROUND

The Perceived Vulnerability to Disease Questionnaire (PVDQ) measures beliefs associated with personal susceptibility to infectious diseases and behaviors or perceptions in the presence of potential risk of pathogen transmission. Given the onset of the Severe Acute Respiratory Syndrome Coronavirus 2 global pandemic, otherwise known as the COVID-19 pandemic, the construct being measured may function differently based on affective, behavioral, and cognitive changes along with the need to change norms and lifestyles in a global context. The present study aims to test the psychometric properties and the gender invariance of the Italian adaptation of the PVDQ to confirm that the scale can be used with Italian-speaking people, and that it functions effectively during a pandemic.

METHODS

A total of 509 participants filled out an online questionnaire including the Italian version of the I-PVDQ (I-PVDQ) and several measures of psychological constructs. Reliability and factor analyses (single and multigroup) were conducted. Bayesian correlation tests and Bayesian independent sample t-tests were used to assess the validity of I-PVDQ.

RESULTS

Exploratory factor analysis supported the two-factor structure of the I-PVDQ, and factor loadings loaded appropriately onto perceived infectability (PI) and germ aversion (GA). In terms of invariance, the scale showed configural, metric, scalar, and strict invariance across genders. Decisive evidence in favor of correlation with the measure of COVID-19 related fears for both PI and GA was found. There was strong evidence for observed correlations with COVID-19 related constructs such as intolerance to uncertainty, psychological inflexibility, resilience, stress, and anxiety. Women showed higher GA than men, while there were no gender differences in PI.

CONCLUSIONS

Taken together, these results suggest that the I-PVDQ confirms the psychometric properties of the original version and that can be used to detect PVD when it is affected by environmental circumstances since its functioning is preserved during a pandemic.

A longitudinal investigation on problematic Facebook use, psychological distress and well-being during the second wave of COVID-19 pandemic

The social isolation and the subsequent, increased use of Social Networking Sites due to the COVID-19 pandemic have had an impact on subjective well-being around the world. The present longitudinal study examined whether changes in psychological distress and well-being during the Italian second wave of the pandemic differ among people with different levels of Problematic Facebook Use (PFU). A total of 493 participants (M_age = 24.55 ± 7.25; 80.3% females) completed measures of passive use of Facebook, social comparison orientation on Facebook, fear of missing out, psychological distress (depressive symptoms and fear of COVID-19 pandemic) and well-being across three waves. Latent class analysis (LCA) categorized participants into three groups with different PFU levels: healthy users, moderate PFU users, and high PFU users. Hierarchical linear modeling (HLM) showed that the between-person level (class membership) accounted for most of the variability in psychological distress and well-being. No significant changes were found in psychological distress and well-being over time, but the High PFU users showed greater levels of psychological distress and lower levels of well-being at each time point. The findings of this study suggest that the relationship between PFU, psychological distress and well-being may reflect trait-like time-invariant differences between individuals rather than state-like changes.

Examination of individuals' depression, anxiety, and stress levels during the COVID-19 pandemic in Turkey

PURPOSE

This research was conducted to determine the depression, anxiety, and stress levels of individuals during the COVID-19 epidemic. In addition, the compatibility of the Depression-Anxiety-Stress Scale (DASS-21) scale results with the participants' feeling depressed, anxious, and stressed were examined.

DESIGN AND METHODS

The sample of the study consisted of 870 individuals over the age of 18 between May-August 2021. The data of the study were collected online, using the personal information form and DASS-21.

RESULTS

In our study, it was observed that 22.3 % of the participants were severely depressed, 19.0 % were highly anxious and 14.3 % were highly stressed. In addition, a relationship was determined between many sociodemographic variables and depression, anxiety, and stress levels. It was found that individuals who were not vaccinated, did not receive health care, and were not satisfied with health care were more depressed, anxious, and stressed. The agreement between all DASS-21 sub-dimensions and participants' feeling is poor in terms of Cohen's kappa. The agreement is poor in the anxiety sub dimension, but moderate in the other sub-dimensions in terms of Gwet's AC1.

PRACTICE IMPLICATIONS

It is recommended that nurses develop new care and evaluation strategies for the psychosocial field in order to protect and maintain the health of individuals during the COVID-19 pandemic process, as well as more practices promoting the COVID-19 vaccine in our country.

Panic Food Purchasing amid COVID-19 Pandemic: Does the Impact of Perceived Severity, Anxiety and Self-Isolation Really Matter?

This research examines the influences of perceived severity, anxiety, and self-isolation intention, amid the coronavirus disease of 2019 (COVID-19), on panic food purchasing. The research adopted a quantitative approach using a pre-examined instrument, which was self-administered by the research team (with support from a data collection-specialised company) to consumers who were urgently shopping for food in the Kingdom of Saudi Arabia (KSA). The results of structural equation modelling (SEM) using analysis of a moment structures (AMOS) software showed a significant positive impact of perceived severity on consumers' anxiety and self-isolation intention amid the COVID-19 pandemic. Self-isolation intention was found to have a significant positive impact on the anxiety of consumers amid the pandemic. Additionally, perceived severity, anxiety, and self-isolation have a significant positive impact on panic food purchasing. Both anxiety and self-isolation were found to have partial mediating effects in the link between perceived severity and panic purchasing intention. The results of the current research contribute to a better understanding of factors that influence panic purchasing behaviour, especially amid a pandemic. This will help policymakers to deal with this behaviour when such issues arise in the future. Other implications for scholars and policy makers are discussed.

Treating COVID-19 patients with EMDR: A pilot study

The threatening and unpredictable nature of the coronavirus disease (COVID-19) pandemic presents unprecedented mental-health challenges worldwide. For those directly affected by the disease, the stress of facing potential death and overcoming fear can overwhelm their personal coping resources and can lead to symptoms of posttraumatic stress disorder and anxiety and depression. The objective of our study was to investigate the effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy to reduce anxio-depressive symptoms, distress and fear of the unknown in COVID-19 patients hospitalized for intensive care. A pilot study was conducted with 21 participants hospitalized for COVID-19 (11 women and 10 men) who were treated with EMDR therapy and assessed for anxio-depressive symptoms (Hospital Anxiety and Depression Scale, HADS), intensity of distress (Subjective Units of Disturbance, SUD scale), and levels of experienced fear (i.e., fear of the unknown) (Multidimensional Assessment of COVID-19-Related Fears, MAC-RF). After the 4-session treatment, the EMDR therapy showed to be effective in reducing all of the evaluated symptoms in all patients and allowed for stabilization. All patients maintained improved psychological states for one week following the four sessions. EMDR therapy has been shown to be an effective strategy for helping patients process exposure to adverse events by relieving symptoms of acute stress and trauma. EMDR is a focused approach that with as few as 4 sessions can strengthen adaptive coping strategies for dealing with an ongoing situation, restore optimism and can rapidly prevent the onset of potentially long-lasting psychological disorders.

Does COVID-19 related symptomatology indicate a transdiagnostic neuropsychiatric disorder? - Multidisciplinary implications

The clinical presentation that emerges from the extensive coronavirus disease 2019 (COVID-19) mental health literature suggests high correlations among many conventional psychiatric diagnoses. Arguments against the use of multiple comorbidities for a single patient have been published long before the pandemic. Concurrently, diagnostic recommendations for use of transdiagnostic considerations for improved treatment have been also published in recent years. In this review, we pose the question of whether a transdiagnostic mental health disease, including psychiatric and neuropsychiatric symptomology, has emerged since the onset of the pandemic. There are many attempts to identify a syndrome related to the pandemic, but none of the validated scales is able to capture the entire psychiatric and neuropsychiatric clinical presentation in infected and non-infected individuals. These scales also only marginally touch the issue of etiology and prevalence. We suggest a working hypothesis termed Complex Stress Reaction Syndrome (CSRS) representing a global psychiatric reaction to the pandemic situation in the general population (Type A) and a neuropsychiatric reaction in infected individuals (Type B) which relates to neurocognitive and psychiatric features which are part (excluding systemic and metabolic dysfunctions) of the syndrome termed in the literature as long COVID. We base our propositions on multidisciplinary scientific data regarding mental health during the global pandemic situation and the effects of viral infection reviewed from Google Scholar and PubMed between February 1, 2022 and March 10, 2022. Search in-clusion criteria were "mental health", "COVID-19" and "Long COVID", English language and human studies only. We suggest that this more comprehensive way of understanding COVID-19 complex mental health reactions may promote better prevention and treatment and serve to guide implementation of recommended administrative regulations that were recently published by the World Psychiatric Association. This review may serve as a call for an international investigation of our working hypothesis.

Changes in Touch Avoidance, Stress, and Anxiety During the COVID-19 Pandemic in Italy

In the present study we analyzed how attitudes toward touch have changed during the COVID-19 pandemic in an Italian sample, through two different studies: in the first we contacted participants of the Italian validation study of the Touch Avoidance Questionnaire, asking them to take part in a follow-up study (N = 31, 64.5% women, age 42.58 ± 15.15); in the second we recruited a new sample of 717 people (73.92% women, age 34.25 ± 13.11), comparing it to the full validation sample of the Touch Avoidance Questionnaire (N = 335, 64.48% women, age = 35.82 ± 14.32) to further investigate the relationship between the pandemic, stress responses, fear of contagion, anxiety, and attitudes toward touch. Overall, we found higher post-pandemic scores for touch avoidance toward strangers and family members and lower scores in touch avoidance toward friends of either gender, along with a slight increase in anxiety and stress. Touch avoidance was also positively related to anxiety and/or stress levels except for touch avoidance toward same-sex friends, for which the relationship with anxiety was negative. Surprisingly, we found that young people were the most anxious, despite older people being more at-risk of dying from COVID-19. Women were slightly more stressed out. COVID-19-related fears were significant predictors of touch avoidance toward partners, friends and strangers, but not of touch avoidance toward family. The results suggest that touch avoidance increased during the pandemic (except toward same-sex friends), together with anxiety and stress levels, but the change was relatively small.

Fear of COVID-19 and its association with mental health-related factors: systematic review and meta-analysis

BACKGROUND

The severity of COVID-19 remains high worldwide. Therefore, millions of individuals are likely to suffer from fear of COVID-19 and related mental health factors.

AIMS

The present systematic review and meta-analysis aimed to synthesize empirical evidence to understand fear of COVID-19 and its associations with mental health-related problems during this pandemic period.

METHOD

Relevant studies were searched for on five databases (Scopus, ProQuest, EMBASE, PubMed Central, and ISI Web of Knowledge), using relevant terms (COVID-19-related fear, anxiety, depression, mental health-related factors, mental well-being and sleep problems). All studies were included for analyses irrespective of their methodological quality, and the impact of quality on pooled effect size was examined by subgroup analysis.

RESULTS

The meta-analysis pooled data from 91 studies comprising 88 320 participants (mean age 38.88 years; 60.66% females) from 36 countries. The pooled estimated mean of fear of COVID-19 was 13.11 (out of 35), using the Fear of COVID-19 Scale. The associations between fear of COVID-19 and mental health-related factors were mostly moderate (Fisher's z = 0.56 for mental health-related factors; 0.54 for anxiety; 0.42 for stress; 0.40 for depression; 0.29 for sleep problems and -0.24 for mental well-being). Methodological quality did not affect these associations.

CONCLUSIONS

Fear of COVID-19 has associations with various mental health-related factors. Therefore, programmes for reducing fear of COVID-19 and improving mental health are needed.

Fear of Becoming Infected and Fear of Doing the Wrong Thing - Cross-Cultural Adaptation and Further Validation of the Multidimensional Assessment of COVID-19-Related Fears (MAC-RF)

Background

With the COVID-19 infection speeding around the world, many experience fear and anxiety. To detect those at risk of psychopathology and provide treatment, valid instruments are needed. The aim of this study was to cross-culturally validate the theory-based instrument Multidimensional Assessment of COVID-19-Related Fears (MAC-RF) in Croatian and to further examine the scale's validity by exploring its relationship with relevant constructs.

Method

A total of 477 participants completed an online survey during a rapid rise in new daily COVID-19 cases in Croatia and while new restrictions were being imposed.

Results

MAC-RF had a stronger association with health anxiety, cyberchondria, and anxiety sensitivity compared to depression, attesting to its convergent and divergent validity. However, a 2-factor structure was revealed in this sample: Fear of infection and Fear of using an inadequate strategy in dealing with pandemic. Fear of infection had a stronger association with health anxiety and COVID-19 anxiety and was a better predictor of COVID-19 related protective health behaviors. Fear of choosing an inadequate strategy had a stronger association with cyberchondria, fear of consequences of the epidemic on mental health, as well as financial consequences, and loss of civil liberties.

Conclusion

Fear of infection captures negative emotional states due to feared consequences on personal somatic health and the health of loved ones, while Fear of choosing an inadequate strategy in dealing with the pandemic reflects a metacognitive aspect. Treatments may have to target both aspects of COVID-19 related fear.

Pandemic paranoia, general paranoia, and their relationships with worry and beliefs about self/others - A multi-site latent class analysis

BACKGROUND

During the COVID-19 pandemic, an increase in paranoid thinking has been reported internationally. The development of the Pandemic Paranoia Scale (PPS) has provided a reliable assessment of various facets of pandemic paranoia. This study aimed to (i) identify classes of individuals with varying levels of general paranoia and pandemic paranoia, and (ii) examine associations between classification and worry, core beliefs, and pro-health behaviours.

METHODS

An international sample of adults (N = 2510) across five sites completed the Revised-Green Paranoid Thoughts Scale and the PPS. Latent class analysis (LCA) was conducted using these two paranoia variables. Classes were compared on trait worry (Penn State Worry Questionnaire), beliefs about self/others (Brief Core Schema Scales), and pro-health behaviour.

RESULTS

Three latent classes emerged: Class 1 with low R-GPTS and PPS scores, Class 2 with a high R-GPTS score and a moderate PPS score, and Class 3 with high R-GPTS and PPS scores. Compared to Class 1, Classes 2-3 were associated with more worry and negative self- and other-beliefs. Class 3 was further characterised by greater positive-self beliefs and less engagement in pro-health behaviours. Engagement in pro-health behaviours was positively correlated with interpersonal mistrust and negatively correlated with paranoid conspiracy and persecutory threat.

CONCLUSIONS

Individuals with a general paranoia tendency were more likely to respond to the global health threats in a suspicious and distrusting way. Our findings suggested that worry and negative self/other beliefs may contribute to not just general paranoia but also pandemic paranoia. The preliminary finding of a link between pro-health behaviours and interpersonal mistrust warrants further examination.

The Thought of Death in a Pandemic Era: Can Anxiety Determine the Nexus between the Accessibility, Availability and Use of Personal Protective Equipment (PPE) for COVID-19 and Work Behaviour among Aviation Workers?

Since the emergence of COVID-19, the aviation sector has been one of the numerous industries which have been affected the most. In this present paper, the thought of death among aviation workers as an indicator of anxiety at a time when the availability, access to, and use of Personal Protective Equipment (PPE) remains paramount to the survival of work in the line of duties and its influence on different work behaviors was assessed. The theoretical foundation of the study was built on the process efficiency theory, attentional interference theory, and the terror management theory (TMT), which focuses on both the psychological and emotional responses exhibited by people due to fear or worry about a specific situation. The study adopted an exploratory study design that incorporates a cross-sectional and self-reported survey among 646 frontline workers across 12 international airlines and the Ghana Airport Company Limited (GACL), Accra, Ghana using simple random sampling and convenient sampling techniques. After all the preliminary tests were performed, the path analysis estimated by Structural Equation Modelling (SEM) indicated that anxiety has a significant influence on workers’ stress-adaptive performance and task performance, but recorded no significant causal link with interpersonal performance. The findings indicated that all three proxies of employee work behaviours, which focus on both adaptive and task performance, were significantly related to workers’ access, availability, and use of PPE (APPE). The association between anxiety and APPE was also found to be significant. Bootstrapping mediation analysis shows that anxiety partially mediates the influence APPE has on both stress-adaptive performance and task performance, but did not show any mediating effect on the association between APPE and interpersonal performance. Among the three dimensions of death anxiety, both the fear of death (FDE) and death intrusion (DINT) indicated a significant partial mediating effect on the influence APPE has on all three multidimensional constructs of work behaviours. The findings literally prove that worrying about the fatality risk associated with COVID-19 is highly predictive.

The Relationship Between Resilience and Sleep Quality During the Second Wave of the COVID-19 Pandemic: A Longitudinal Study

PURPOSE

Previous studies showed poor sleep quality during the first Italian lockdown consequent to the quick spread of the virus. Poor sleep quality remained stable during the so-called "second wave", which started in Autumn 2020. This study aimed to compare sleep quality between the two waves of contagions and to examine the effect of resilience, together with sociodemographic and COVID-related variables, on sleep quality during the second wave.

PATIENTS AND METHODS

A total of 648 participated in this longitudinal study through an online survey during the first lockdown consequent to the COVID-19 and during the second wave. The Medical Outcomes Study-Sleep Scale (MOS-SS) and the Resilience Scale (RS) were administered. Sociodemographic and COVID-related information were also collected.

RESULTS

The results showed sleep quality slightly increased in the second wave, even though with a small effect size. Correlational analysis showed that resilience is inversely correlated with sleep quality measured in the two waves. Sleep quality during the second wave was positively correlated with sleep quality in the first lockdown. Likewise, the results of multiple regression revealed that the sleep quality in the first lockdown and resilience were significant predictors of sleep quality during the second wave.

CONCLUSION

These findings highlighted that the prevalence of poor sleepers remained high during the second wave. Together with the sleep quality in the first lockdown, resilience represents an important factor related to sleep quality during the second wave. Interventions to improve sleep quality among the general population should take into account these findings.

Potential markers for predicting delayed encephalopathy in patients with acute carbon monoxide poisoning

BACKGROUND

Acute carbon monoxide poisoning (ACOP) commonly results in delayed neuropsychiatric sequelae (DNS). Currently, there are no reliable predictors. The aim of this article is to establish a practical model for predicting the development of delayed encephalopathy clinically.

METHODS

Retrospective analysis of clinical data were performed at a single institution for the past 6 years. 107 patients with ACOP were recruited, of who 67 developed DNS and 40 did not. Clinical characteristics of the patients were analyzed between the two groups. The risk factors associated with DNS development were screened to identify the potential markers for predicting DNS. A predictive model was then built, and the receiver operating characteristic (ROC) curve analysis was used to assess its predictive ability.

RESULTS

There were significant differences in 13 clinical features between the two groups. Four potential markers were identified. They were age, source of CO, Glasgow Coma Scale score and the initiation of HBOT. The potential predictive model showed an area under the curve (AUC) of 0.93 in the training set and 0.97 in the testing set.

CONCLUSIONS

Our model could calculate the probability of DNS after acute CO poisoning.

COVID-19 Related Fears of Patients Admitted to a Psychiatric Emergency Department during and Post-Lockdown in Switzerland: Preliminary Findings to Look Ahead for Tailored Preventive Mental Health Strategies

Background and Objectives: While the impact on mental health of 2019 coronavirus (COVID-19) has been extensively documented, little is known about its influence on subjective fears. Here, we investigate the COVID-19 impact and its related restrictions on fears of patients admitted to a psychiatric Emergency Department (ED) during and post-lockdown. Materials and Methods: A retrospective study on 1477 consultations at the psychiatric ED of the University Hospital of Geneva (HUG) was performed using a mixed-methods analysis. The first analysis section was qualitative, aiming to explore the type of fears, while the second section statistically compared fears (i) during lockdown (16 March 2020–10 May 2020) and (ii) post-lockdown (11 May 2020–5 July 2020). Fears were also explored among different patient-age sub-groups. Results: 334 patients expressed one/more fears. Both in lockdown and post-lockdown, fears mostly pertained to “containment measures” (isolation, loneliness). When compared lockdown vs. post-lockdown, fears about “work status” (deteriorating, losing work) prevailed in lockdown (p = 0.029) while “hopelessness” (powerless feeling, inability to find solutions) in post-lockdown (p = 0.001). “Self around COVID-19” (dying, getting sick) fear was relatively more frequent in youth (p = 0.039), while “hopelessness” in the elderly (p < 0.001). Conclusions: Collectively, these findings highlight that lockdown/post-lockdown periods generated temporally and demographically distinct COVID-19 related fears patterns, with special regard to youth and elderly, two particularly vulnerable populations when faced with sudden and unexpected dramatic events. For this reason, the particular ED “front-line service” status makes it a privileged observatory that can provide novel insights. From a mental health perspective, these latter can be translated into pragmatic, more personalized prevention strategies to reinforce specific resilience resources and mitigate the current and long-term pandemic’s impact.

Influence of COVID-19 Pandemic Uncertainty in Negative Emotional States and Resilience as Mediators against Suicide Ideation, Drug Addiction and Alcoholism

This research uses structural equation modeling to determine the influence of uncertainty due to the COVID-19 pandemic as an independent variable in the negative emotional states and resilience (as mediating variables) vs. drug addiction, alcoholism, and suicide ideation as dependent variables in 5557 students from a public state university in Northern Mexico. The five variables are related through eight hypotheses and tested using partial least squares. We used an adapted questionnaire sent by email in May 2020. Findings show that uncertainty facing the COVID-19 pandemic had a direct and significant influence on negative emotional states and a significant inverse effect on resilience; in the trajectory, drug addiction and alcoholism, and suicide ideation are explained.

Prevalence of depression and anxiety among male patients with COVID-19 in Lebsayyer Field Hospital, Qatar

BACKGROUND

Depression and anxiety are major health problems found to be associated with various conditions. COVID-19 is a global pandemic that has a substantial effect on the worldwide population. This study aimed to assess the prevalence of depression and anxiety among male patients with COVID-19 and explore their relationship with participants' characteristics.

METHODS

This cross-sectional study was conducted among expatriate male patients with COVID-19 admitted to Lebsayyer Field Hospital in Qatar with mild COVID-19 (according to World Health Organization classification) from July till August 2020. The sample size was calculated using Cochran's formula based on disease prevalence. All eligible patients were invited to participate until reaching 400 participants, who then completed an anonymous survey of sociodemographic questions, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 questionnaire, which are validated screening tools for depression and anxiety, respectively.

RESULTS

Of the 400 participants, 148 (37.0%) and 77 (19.3%) reported depressive and anxiety symptoms, respectively. Depression was more prevalent among those 40-49 years old (p = 0.029), while anxiety was more prevalent among people aged  ≥ 50 (p = 0.456). Both depression (p = 0.009) and anxiety (p = 0.042) were more prevalent among Bangladeshi, followed by Filipino participants. Depression was more prevalent among those with the highest income (> 15,000 QR; p = 0.004), in contrast to anxiety, which was more prevalent among those with the lowest monthly income ( <  2,000 QR; p = 0.039).

CONCLUSION

The prevalence of depressive and anxiety symptoms is high among the study participants. Associated factors identified by the study were unsteady income, poor self-rated health, living with family, Southeast Asian ethnicity, and age group of 40-49 years.

Assessing online gaming and pornography consumption patterns during COVID-19 isolation using an online survey: Highlighting distinct avenues of problematic internet behavior

Background and aim

The Coronavirus (COVID-19) pandemic has required drastic safety precautions to contain virus spread, involving a protracted self-isolation period. Those with greater perceived or actual life stress are vulnerable to develop problematic internet behaviors. Thus, we assessed how COVID-19 social isolation affected online gaming (OG) and pornography viewing (PV) in the general population.

Methods

We developed an online cross-sectional survey, Habit Tracker (HabiT), completed by 1,344 adults (≥18 years). HabiT was released internationally with individuals from 80 countries participating; a majority residing in the United States and United Kingdom. We measured changes in OG (IGDS9-SF) and PV (CYPAT) behaviors before and during the COVID-19 quarantine period. We also assessed psychiatric factors such as anxiety, depression (HADS), and impulsivity (SUPPS-P). The primary outcome measures were change in amount of, and current OG and PV severity during quarantine. These measures were related to ten COVID-19-related stress factors.

Results

Overall, we observed a large increase in OG and a minor increase in PV. Those who increased OG (63%) and PV (43%) during quarantine were younger individuals, males, those who left the quarantine household infrequently, those who reported low frequency or poor quality social interactions, and those with higher depression, anxiety, and urgency impulsivity.

Discussion

Our findings highlight similarities between forms of problematic internet behaviors driven by stress, depression, anxiety; while highlighting distinct avenues which these behaviors can manifest.

Conclusion

We emphasize the relevance of identifying those in need of emotional regulation interventions, to mitigate problematic internet behaviors in the context of COVID-19 isolation.

Measuring anxiety related to COVID-19: Factor analysis and psychometric properties of the Arabic Coronavirus Anxiety Scale

Literature reports that fear and anxiety related to the coronavirus (COVID-19) pandemic may be a significant factor in promoting adherence to health-protective behaviours. This study aimed to validate an Arabic version of the Coronavirus Anxiety Scale (CAS). Participants aged 18 to 58 years of age were recruited from a university population (students and staff) as well as via social media from 22 June to 18 July 2020 when the United Arab Emirates was under a partial government-instituted lockdown. They completed Arabic versions of the CAS and the Fear of COVID-19 Scale. A confirmatory factor analysis produced a unidimensional structure and all items satisfactorily loaded onto this single factor (i.e., the physiological symptoms of fear and anxiety related to coronavirus). The Arabic CAS was internally consistent and concurrently valid. These preliminary findings suggest that the Arabic CAS is a valid and reliable instrument to employ in the assessment of dysfunctional anxiety related to coronavirus. The availability of this validated measure will enable the further conduct of a variety of mental health studies in relation to the COVID-19 pandemic. It also holds clinical utility as a potential screening measure for those afflicted by anxiety symptomology during the pandemic.

Making sense of the COVID-19 pandemic: A qualitative longitudinal study investigating the first and second wave in Italy

The COVID-19 pandemic further highlighted the crucial role of people's compliance for the success of measures designed to protect public health. Within the frame of Semiotic Cultural Psycho-social Theory, we discuss how the analysis of people's ways of making sense of the crisis scenario can help to identify the resources or constraints underlying the ways the citizens evaluate and comply with the anti-covid measures. This study aimed to examine how Italian adults interpreted what was happening in the first wave of the pandemic and how the interpretation varied in the period up to the beginning of the second wave. Diaries were collected for six months, from 11 April to 3 November 2020. Participants were periodically asked to talk about their life 'in the last few weeks'. A total number of 606 diaries were collected. The Automated Method for Content Analysis (ACASM) procedure was applied to the texts to detect the factorial dimensions - interpreted as the markers of latent dimensions of meanings- underpinning (dis)similarities in the respondents' discourses. ANOVA were applied to examine the dissimilarities in the association between factorial dimensions and production time. Findings show that significant transitions occurred over time in the main dimensions of meaning identified. Whereas the first phase was characterized by a focus on one's own daily life and the attempt to make sense of the changes occurring in the personal sphere, in the following phases the socio-economic impact of the crisis was brought to the fore, along with the hope to returning to the "normality" of the pre-rupture scenario. We argued that, despite the differences, a low sense of the interweaving between the personal and public sphere emerged in the accounts of the pandemic crisis throughout the sixth months considered; a split that, we speculate, can explain the "free for all" movement that occurred at the end of the first wave and the beginning of the second wave.

Psychometric Validation of the Arabic Fear of Illness and Virus Evaluation

Global infectious pandemics can affect the psychology and behavior of human beings. Several tools were developed to evaluate the psychological impact of such outbreaks. The present study aimed to examine the psychometric properties of the Arabic translated version of Fear of Illness and Virus Evaluation scale (FIVE). FIVE is a 35-item tool consisting of four subscales that measure Fears about Contamination and Illness, Fears about Social Distancing, Behaviors Related to Illness and Virus Fears and Impact of Illness and Virus Fears. The tool was translated into Arabic by using a forward-backward translation. The online questionnaire contained the following sections: demographics, FIVE, Fear of COVID-19 Scale (FCV-19S) and face validity questions. Non-probability convenient sampling technique was used to recruit participants via a mobile instant messaging application. Reliability, concurrent validity, face validity and factor analysis were examined. The data consisted of 509 adult participants who reside in Saudi Arabia. The internal consistency of the Arabic FIVE subscales was high (0.84-0.91) with strong concurrent validity indicated by positive correlations of FIVE subscales with FCV-19S. Factor analysis suggested slightly different factor structures (Fears of Getting Sick, Fears that Others Get Sick, Fears of the Impact on Social Life and Behaviors Related to Illness and Virus Fears). Our data showed a better fit using the proposed structures. The Arabic version of the FIVE showed robust validity and reliability qualities to assess fear of COVID-19 on Arabic adult population.

[Does the COVID-19 pandemic condition the delusional content of patients with psychosis? An observational study]

Introduction: The primary objective is to analyse the impact of the COVID-19 pandemic on the triggers of psychopathology and on the delusional content of patients with psychotic symptoms treated during the first three months of the pandemic in a tertiary hospital in Madrid.Methods: We conducted a cross-sectional, observational and retrospective study of all patients attending the psychiatric emergency room (ER) between 11th March and 11th June 2020. Sociodemographic and clinical variables were included. The chi-squared test or Fisher's exact test were performed to compare categorical variables. The level of statistical significance was set at p<0.05.Results: In the first month of the pandemic, COVID-19 conditioned the delirious content of 38.5% of the admitted patients and acted as a direct trigger for 46.2% of consultations. In the second week it affected 100.0% of the patients in both cases. Subsequently, a progressive and significant decrease was observed, with COVID-19 being the triggering factor for 17.6% and 11.5% of consultations in the second and third months of the pandemic respectively. Similarly, it was the main determinant of the delusional content in 13.7% and 3.8% of cases respectively.Conclusions: The current pandemic affects delirium's pathoplasty. The delusional content of patients admitted with psychotic symptoms is quickly conditioned, which may be related to the radical change in their life, without transition or prior preparation. The patient's environmental context and events have a huge impact on the dynamics and characteristics of mental disorders.

The Moderating Role of Caregiving on Fear of COVID-19 and Post-Traumatic Stress Symptoms

Caregiving has been associated with increased levels of fear and post-traumatic stress symptoms (PTSS) during COVID-19 pandemic. However, there is a lack of studies that analyze when the relationship between fear and PTSS occur, using informal caregiving as a moderator variable. To explore this moderating role, we conducted a cross-sectional online study between November 2020 and January 2021. A total of 503 men and women from the Spanish general population completed the survey. Sociodemographic and Covid-19-related data, fear of COVID-19, PTSS symptoms, and current psychological history were assessed. Prevalence of informal caregiving in the sample was 16.5%. Increased levels of fear and PTSS were found in caregivers compared to non-caregivers. Female gender and high number of COVID-19 related risk factors was also associated with fear and PTSS severity. The moderation analyses showed an interaction effect between caregiving and fear of COVID-19 when predicting PTSS symptoms. Particularly, results showed that informal caregivers reported greater PTSS symptoms, when compared to non-caregivers with same levels of fear of COVID-19. This evidence suggests that being a caregiver could increase the fear's impact on PTSS severity in the context of pandemics. Further studies with larger samples are needed to confirm these findings.

COVID-19 related mental health issues: a narrative review of psychometric properties of scales and methodological concerns in scale development

OBJECTIVES

The global crisis of COVID-19 and its consequential strict public health measures placed around the world have impacted mental health. New scales and tools have been developed to measure these mental health effects. This narrative review assesses the psychometric properties of these scales and tools and methodological aspects of their development.

METHODS

PubMed, PubMed Central, and Google Scholar were searched for articles published from 15 May 2020 to 15 August 2020. This search used three groups of terms ("tool" OR "scale" AND "mental" OR "psychological"; AND "COVID-19" OR "coronavirus"). The identified scales were further evaluated for their psychometric properties and methodological aspects of their development.

RESULTS

Though the studies developing these scales (n = 12) have demonstrated their robust psychometric properties, some methodological concerns are noteworthy. Most of the scales were validated using internet-based surveys, and detailed descriptions of the mode of administration, sampling process, response rates, and augmentation strategies were missing.

CONCLUSIONS

The heterogeneous and inadequate reporting of methods adopted to evaluate the psychometric properties of the identified scales can limit their utility in clinical and research settings. We suggest developing guidelines and checklists to improve the design and testing, and result in reporting of online-administered scales to assess the mental health effects of the COVID-19 pandemic.

Psychosocial impact of Covid-19 outbreak on Italian asthmatic children and their mothers in a post lockdown scenario

Italy was the first European country to fight the Covid-19 outbreak. To limit the transmission of the virus, the Italian Government imposed strict domestic quarantine policies and temporary closure of non-essential businesses and schools from March 10th,2020. Although more and more literature is exploring the impact of the pandemic on non-referred children and families, only a few studies are focused on the psychosocial impact of Covid-19 in chronically ill children and their caregivers. The present study investigates asthma control and children and mothers' psychological functioning (i.e.: psychological well-being, fear of contagion, and mothers' Covid-19 related fears) in 45 asthmatic children aged 7-to-14, compared to a control sample. The subjects were administered an online survey after the lockdown (from 28th May to 23rd August 2020). The analysis shows that asthmatic children presented higher concern in relation to contagion, however, no difference in psychological functioning was displayed between the two cohorts. Mothers reported more Covid-19 related fears, and greater worries according to the resumption of their children's activities. Moreover, they indicated a global worsening of their psychological well-being during the lockdown. Furthermore, regarding the clinical sample, the multivariate regression model showed that a worsening of mothers' psychological and children's physical well-being was associated with a worsening of children's psychological well-being during the lockdown. The results of this study indicate that mothers of asthmatic children can be more prone to experience psychological fatigue in a pandemic scenario. Special programs should be developed to support caregivers of chronically ill children.

Perceived Strain Due to COVID-19-Related Restrictions Mediates the Effect of Social Needs and Fear of Missing Out on the Risk of a Problematic Use of Social Networks

The occurrence of the COVID-19-virus led to drastic short-term measures to reduce its spread and influence. Regulations such as "physical distancing," mentioned as "social distancing," and the closure of public facilities during the lockdown could be perceived as burdensome especially by individuals who feel a strong need for social exchange and belonging. These components such as need to belong and the fear of missing out also play a major role in the development and maintenance of a problematic use of social networks. Researchers have argued recently that an increase of addictive (online) behaviors may be a likely consequence of subjectively experienced restrictions in the context of the COVID-19 pandemic. The current study investigates the interplay of perceived strain due to COVID-19-related restrictions and the fear of missing out (FoMO) as well as of symptoms of problematic social-networks use. We hypothesized that perceived strain due to COVID-19-related restrictions mediates the effect of specific predisposing variables related to social needs on the symptom severity of a problematic use. To assess the perceived strain due to COVID-19-related restrictions, we developed a specific questionnaire asking for perceived COVID-19-related strain in several domains of everyday-life. An exploratory factor analysis identified five factors: perceived strain related to restrictions of (1) social contacts, (2) travel, (3) childcare, (4) work, and (5) own health. In a sample of 719 German participants and data collection during the first COVID-19 lockdown (March 30th until April 3rd 2020), a structural equation model was calculated showing that higher levels of need to belong and FoMO increase perceived COVID-19-related strain, which is related to symptoms of a problematic social-networks use. The effect of need to belong on problematic social-networks use is mediated by experienced COVID-19-related strain and FoMO-online. Even if the use of social networks is not pathological per se, it may be associated with suffering for a vulnerable part of users. We conclude that specific needs and fear-associated predisposing variables contribute to experiencing physical distance and other pandemic-related restrictions as more stressful, which may increase problematic social-networks use and potentially other addictive behaviors as well in the context of the COVID-19-related lockdown.

Instruments to measure fear of COVID-19: a diagnostic systematic review

BACKGROUND

The COVID-19 pandemic has become a source of fear across the world. Measuring the level or significance of fear in different populations may help identify populations and areas in need of public health and education campaigns. We were interested in diagnostic tests developed to assess or diagnose COVID-19-related fear or phobia.

METHODS

We performed a systematic review of studies that examined instruments diagnosing or assessing fear or phobia of COVID-19 (PROSPERO registration: CRD42020197100). We utilized the Norwegian Institute of Public Health's Live map of covid-19 evidence, a database of pre-screened and pre-categorized studies. The Live map of covid-19 evidence identified references published since 1 December 2019 in MEDLINE, Embase, and the Centers for Disease Control and Prevention. Following biweekly searches, two researchers independently categorized all studies according to topic (seven main topics, 52 subordinate topics), population (41 available groups), study design, and publication type. For this review, we assessed for eligibility all studies that had been categorized to the topic "Experiences and perceptions, consequences; social, political, economic aspects" as of 25 September 2020, in addition to hand-searching included studies' reference lists. We meta-analyzed correlation coefficients of fear scores to the most common reference tests (self-reports of anxiety, depression, and stress), and reported additional concurrent validity to other reference tests such as specific phobias. We assessed study quality using the QUADAS-2 for the minority of studies that presented diagnostic accuracy statistics.

RESULTS

We found 18 studies that validated fear instruments. Fifteen validated the Fear of COVID-19 scale (FCV-19S). We found no studies that proposed a diagnosis of fear of COVID-19 or a threshold of significant/clinical versus non-significant/subclinical fear. Study quality was low, with the most common potential biases related to sampling strategy and un-blinded data analysis. The FSV-19S total score correlated strongly with severe phobia (r = 0.703, 95%CI 0.634-0.761) in one study, and moderately with anxiety in a meta-analysis.

CONCLUSIONS

The accuracy of the FSV-19S needs to be measured further using fear-related reference instruments, and future studies need to provide cut-off scores and normative values. Further evaluation of the remaining three instruments is required.

Is Watching TV Series an Adaptive Coping Strategy During the COVID-19 Pandemic? Insights From an Italian Community Sample

Social distancing and lockdown due to the COVID-19 pandemic substantially impacted individuals' daily habits and well-being. Within such a context, digital technology may provide a welcome source of alternative forms of connection and entertainment. Indeed, streaming services showed a remarkable increase in membership subscriptions throughout the period considered. However, excessive involvement in watching TV series has recently become a subject of scholarly concern as it may represent an emerging form of addictive behavior with the features of what has been labeled as "binge-watching" (i.e., watching multiple episodes of TV series in a single session). The current study aimed to assess TV series watching behaviors and related motivations, as well as their relationships with depression, stress and anxiety, in a sample of Italian adults during the COVID-19 lockdown. Specifically, we aimed to explore which patterns of motivations and emotional states influenced either a high but healthy engagement in watching TV series, or promoted problematic and uncontrolled watching behavior under such circumstances. A total of 715 adults (M = 31.70, SD = 10.81; 71.5% female) from all over Italy were recruited (from 1st to 30th April 2020) through advertisements via social media platforms of Italian university communities and other online groups. Two multiple hierarchical regression analyses were performed with non-problematic and problematic TV series watching set as dependent variables. Results showed that people spent more time watching TV series during the pandemic lockdown, especially women who also reported higher levels of anxiety and stress than men. Moreover, both non-problematic (R 2 = 0.56; p < 0.001) and problematic (R 2 = 0.33; p < 0.001) TV series watching behaviors were equally induced by anxiety symptoms and escapism motivation, thereby suggesting that watching TV series during the COVID-19 lockdown probably served as a recovery strategy to face such a stressful situation. Finally, our findings also suggest that enrichment motives may protect from uncontrolled and potentially addictive watching behaviors. These findings, therefore, hold important implications, particularly for avoiding the over-pathologization of excessive involvement in online activities emerging as a result of specific distressing situations.

The mechanisms between illness representations of COVID-19 and behavioral intention to visit hospitals for scheduled medical consultations in a Chinese general population

Testing the Common-Sense Model, this random telephone survey examined the associations between illness representations of COVID-19 and behavioral intention to visit hospitals for scheduled medical consultations (BI-VHSMC), and the mediations via coping and fear of nosocomial infection among 300 Chinese adults. The prevalence of BI-VHSMC was 62.3%. Mediation analysis found that maladaptive coping (rumination and catastrophizing) and fear of nosocomial infection mediated the associations between various dimensions of illness representations of COVID-19 (e.g. consequence and controllability) and BI-VHSMC, both indirectly and serially. Illness representations, coping, and fear should be considered when planning related health promotion during the COVID-19 pandemic.

Historical reflection on Taijin-kyōfushō during COVID-19: a global phenomenon of social anxiety?

Although fear and anxiety have gradually become a shared experience in the time of COVID-19, few studies have examined its content from historical, cultural, and phenomenological perspectives concerning the self-awareness and alterity. We discuss the development of the ubiquitous nature of Taijin-kyōfushō (TKS), a subtype of social anxiety disorder (SAD) originated and considered culturally-bound in the 1930s Japan involving fear of offending or displeasing other people. Considering the historical processes of disease classification, advances in cognitive neurosciences, and the need to better understand the content of suffering, psychiatric nosology for SAD still appears controversial and requires further investigations.

Psychological distress associated with the COVID-19 lockdown: A two-wave network analysis

BACKGROUND

Although preliminary research has evidenced negative psychological consequences of the COVID-19 pandemic among the general population, little research has been carried out examining the interplay among the broader dimensions and correlates of individual distress. Via network analysis, the current study investigated the pathways that underlie some components of psychological distress and their changes over time (during and post COVID-19-related lockdown).

METHODS

1,129 adult participants (79.1% women) completed a two-wave online survey during and after the lockdown, and reported on variables such as depression, anxiety, stress, fear of COVID, intolerance of uncertainty, emotion regulation and social support. The networks were estimated via Gaussian Graphical Models and their temporal changes were compared through the centrality measures.

RESULTS

Depression, stress, anxiety and fear of COVID formed a spatially contiguous pattern, which remained unchanged in both the two waves. After the lockdown, the fear of COVID node reduced its strength in the network, whereas inhibitory intolerance of uncertainty and emotion suppression were associated with depression. Emotion regulation was connected to depression, but not to stress and anxiety during both waves. Perceived emotional support had few connections to the other nodes.

LIMITATIONS

Only 32.7% of participants provided complete responses for both waves.

CONCLUSION

The COVID-19 outbreak has had a significant psychosocial impact on adults. In the context of the network approach, depressive symptoms had the highest strength and their associations to other dimensions of individual distress may be key factors in understanding the influence of exposure to the COVID-19 outbreak on mental health.

Anxiety, Health Self-Perception, and Worry About the Resurgence of COVID-19 Predict Fear Reactions Among Genders in the Cuban Population

The resurgence of COVID-19 could deepen the psychological impacts of the pandemic which poses new challenges for mental health professionals. Among the actions that should be prioritized is the monitoring of the groups that have shown greater psychological vulnerability during the first stage of the pandemic. The first aim of our study is to explore the fear reactions to COVID-19 between genders during the second wave of the outbreak in Cuba. Second, establish possible predictors of fear of COVID-19 in relation to gender. Specifically, we will evaluate how anxiety related to COVID-19, health self-perception, and worry about the resurgence of COVID-19 predict fear reactions among women and men in the Cuban population. A cross-sectional online study was designed. The research was conducted between August 16 and October 18, 2020. A total of 373 people completed the online survey. A socio-demographic questionnaire, the Fear of COVID-19 Scale and the Coronavirus Anxiety Scale were used. An independent-samples t-test was conducted to compare the fear, worry, anxiety and self-perceived health scores, between genders. The relationship between those variables and fear of COVID-19, was investigated using Pearson correlation coefficient. Finally, multiple linear regression was used to evaluate the possible associations (predictors) related to fear of COVID-19. In our study, women, compared to men, presented greater fear reactions, greater concern about resurgence of COVID-19 and poorer self-perceived health. Anxiety reactions in our sample showed no differences between genders. In women, anxiety of COVID-19, worry about resurgence of COVID-19, and self-perceived health are associated with fear reactions to COVID-19. In the case of men, the self-perceived health showed no associations with fear reactions. Our results confirm the results of several related investigations during the first wave of the pandemic where women have shown greater psychological vulnerability compared to men. However, we cannot rule out that the real impact of the pandemic on mental health in men is much greater than that described by the studies conducted to date. Additional studies are needed on the psychological impact of COVID-19 on men.

Maladaptive Daydreaming in an Adult Italian Population During the COVID-19 Lockdown

During the COVID-19 outbreak, individuals with or without mental disorders may resort to dysfunctional psychological strategies that could trigger or heighten their emotional distress. The current study aims to explore the links between maladaptive daydreaming (MD, i.e., a compulsive fantasy activity associated with distress and psychological impairment), psychological symptoms of depression, anxiety, and negative stress, and COVID-19-related variables, such as changes in face-to-face and online relationships, during the COVID-19 lockdown in Italy. A total of 6,277 Italian adults completed an online survey, including socio-demographic variables, COVID-19 related information, the 16-item Maladaptive Daydreaming Scale (MDS-16), and Depression, Anxiety, and Stress Scales-21 Items (DASS-21). Based on an empirically derived cut-off score, 1,082 participants (17.2%) were identified as probable maladaptive daydreamers (MDers). A binary logistic regression revealed that compared to controls, probable MDers reported that during the COVID-19 lockdown they experienced higher levels of anxiety and depression, decreased online social relationships, and, surprisingly, stable or increased face-to-face social relationships. Given the peculiar characteristics of the pandemic context, these findings suggest that the exposure to the risk of contagion had probably exacerbated the tendency of probable MDers to lock themselves inside their mental fantasy worlds, which in turn may have contributed to further estrangement from online social relationships and support, thus worsening their emotional distress.

The relationship between fear of COVID-19 and mental health problems: A meta-analysis

The coronavirus disease-2019 (COVID-19) pandemic has caused physical and mental health problems among individuals around the world. Recent studies have reported various mental health problems among both health-care workers and the general population. In this meta-analysis, evidence is provided concerning the relationships between the Fear of COVID-19 Scale. The fear of COVID-19 scale: Development and initial validation. International Journal of Mental Health and Addiction] - the most widely used, translated, and validated scale - and mental health problems including, anxiety, stress, depression, distress, post-traumatic stress, and sleep problems among the general population. We searched for relevant studies on Web of Science, Google Scholar, PubMed, and ERIC databases and conducted a meta-analysis with selected studies in accordance with the inclusion criteria. A total of 33 studies met the inclusion criteria. The results demonstrated that fear of COVID-19 was strongly related to anxiety (r = 0.55, n = 19,578), traumatic stress (r = 0.54, n = 8,752), distress (r = 0.53, n = 11,785) as well as being moderately related to stress (r = 0.47, n = 4,340) and depression (r = 0.38, n = 23,835). The correlation with insomnia (r = 0.27, n = 2,114) was modest. These results demonstrate that fear of COVID-19 is associated a wide range of mental health problems among the general population.