The Relationship of Fear of Death Between Neuroticism and Anxiety During the Covid-19 Pandemic

From dread to disorder: A meta-analysis of the impact of death anxiety on mental illness symptoms

Growing research suggests that death anxiety may be transdiagnostic, playing a key role in the development and symptomology of psychopathology. This meta-analysis examined the relationship between death anxiety and mental illness symptoms. In total, 104 papers were included, representing cross-sectional data from 99 studies (ntotal = 24,434), and experimental data from 11 studies (ntotal = 1372). Meta-analyses of cross-sectional studies indicated a moderate correlation (r = 0.397) between death anxiety and overall mental illness symptoms. The clinical nature of the group emerged as a significant moderator of this effect. In addition, the relationship between death anxiety and mental illness symptoms was larger for clinical samples (r = 0.580), and for anxiety-related symptoms (r = 0.506) than for depression. Additional meta-analyses of 11 mortality salience studies revealed that death reminders had an overall moderate impact on clinical symptoms (Hedge's g = 0.481). The relevance of the sample to the symptom being measured significantly predicted this relationship; that is, the effect was moderate-to-large (Hedge's g = 0.671) when excluding comparison subgroups for which the effect was not predicted by the authors. The clinical nature of the sample did not significantly moderate the effect. The experimental studies were generally of higher quality and lower risk of publication bias compared to cross-sectional studies. These findings support the strong transdiagnostic role of death anxiety across numerous disorders. Clinical implications include the potential need to treat death anxiety directly, to maximise long-term therapy benefits.

The Psychopathological Predictors and Effects of Death Anxiety

Death anxiety has been linked to several psychopathological conditions. However, the causes, comorbidity, and differential diagnosis of death anxiety is unexplored. This paper stands out by identifying common predictors of death anxiety and exploring the potential of death anxiety as a predictor for other psychological conditions. The paper reports the findings of four consecutive studies that involved a total of 2291 conveniently selected participants including 861 men and 1430 women. We focused on clarifying both the predictors of death anxiety and the psychopathological consequences emerging from it. Our findings established depression, anxiety, stress, fear of aging, and reduced life satisfaction as predictors of death anxiety. Psychosocial illness, sleep disturbances, aggression, and daily hassles were established as the adverse outcomes of death anxiety. Fear of aging was the most significant predictor of death anxiety and daily hassles emerged as the most significant adverse consequence of death anxiety.

Comparison of death anxiety symptoms between generalized anxiety disorder and somatization disorder in geriatric patients attending a psychiatric outpatient clinic for the first time

Somatic complaints are among the important complaints frequently seen in Generalized Anxiety Disorder (GAD) and Somatic Symptom Disorder (SSD). Death anxiety has also increased significantly with the Covid-19 pandemic, especially in the elderly population. In this study, we compared the difference of the death anxiety level among patients with GAD, SSD and healthy controls. This cross-sectional study which was carried out in Artvin State Hospital's Psychiatric Outpatient Clinic included 59 participants (GAD = 21, SSD = 18, HC = 20). Three groups were subjected to detailed psychiatric examination by the same psychiatrist. Subsequently, anxiety, somatic symptoms and death anxiety were assessed using standardized tools (GAD-7, Templer Death Anxiety Scale, Somatic Symptom Scale). The GAD-7 Scale mean of the GAD group was significantly higher than SSD (p = 0.001) and Healthy Control (HC) (p = 0.001) groups. Death anxiety and Somatic Symptom levels in GAD and SSD groups were significantly higher than in healthy controls. (GAD, p = 0.001; SSD, p = 0.001) with no significant difference between GAD and SSD groups (p = 1). Healthy controls exhibited significantly lower scores in the three scales mean scores compared to the SSD and GAD groups (p = 0.001). Irrespective of specific psychiatric diagnoses, these findings highlight elevated death anxiety in the elderly, underscoring the need for tailored mental health interventions.

The relationship between sleep quality and fear of COVID-19, anxiety, personality traits in working women

BACKGROUND

Disasters such as the COVID-19 pandemic have serious traumatic effects on people, who may experience sleep problems, anxiety, and fear in the face of such a stressor.

OBJECTIVE

This study is conducted to examine the relationship between sleep quality and fear of COVID-19, anxiety, and personality traits in working women.

METHOD

This research was a descriptive study between June to August 2021. The study was conducted with 425 participants. The Pittsburgh Sleep Quality Index, COVID-19 Fear Scale, Beck Anxiety Scale, and the revised Eysenck Personality Questionnaire-Short Form were applied to the participants. T-test, ANOVA, and Pearson correlation analysis, were used.

RESULTS

In the study, it was found that the total average score of the Fear of COVID-19 Scale was 18.83±5.5, while the score of sleep quality was 5.40±3.3 and the anxiety score was 14.01±12.4. On the other hand, the score of Extraversion was determined as 3.73±1.7, Neuroticism was 3.79±1.8, and Psychoticism was 1.97±1 in the study. Moreover, a statistically significant positive correlation was found between sleep quality and fear of COVID-19, anxiety, and neuroticism in working women (p < 0.05).

CONCLUSION

Sleep quality, sleep latency, sleep disturbance; daytime dysfunction, use of sleep medication, sleep duration, sleep latency with anxiety; sleep latency, sleep quality, daytime dysfunction, sleep duration were found to be linked to neuroticism, and use of sleep medication and sleep duration were found to be linked to psychoticism. It was concluded that there was a relationship between sleep quality and fear of COVID-19, anxiety, and personality traits in working women.

Effect of Birth Story on Personality Traits and Death Anxiety

OBJECTIVES

The aim of this study is to determine the effect of the birth story of individuals on personality traits and death anxiety.

METHODS

This descriptive and analytical research was completed with 1,635 people who participated voluntarily. The study data were collected with the Personal Information Form, Cervantes Personality Scale (CPS), and Abdel-Khalek Death Anxiety Scale (ASDA).

RESULTS

The research sample is average means 31.63 ± 11.04 years, most of the female (72.7%) and married (54.6%). In our study, it was observed that women's death anxiety was higher than men's. Our study found that individuals born by caesarean section had greater neurotic personality traits, emotional stability/neuroticism score averages, and death anxiety scores compared to individuals born vaginally.

CONCLUSION

In the model made with multiple regression analysis, birth type did not significantly predict death anxiety, while sex and emotional stability/neuroticism personality trait significantly predicted death anxiety.

Level of professional quality of life and coping with death competence in healthcare professionals exposed to perinatal loss: A cross-sectional study

Perinatal loss is a traumatic and stressful experience with a significant emotional toll on the physical and psychological wellbeing of the healthcare professionals. We included 216 healthcare professionals working in an obstetrics-gynecology service or neonatal intensive care unit in a cross-sectional study and aimed to analyze the possible association between the healthcare professionals' level of professional quality of life, their coping with death competence, and their personal and work-related characteristics. Compassion fatigue and burnout did not correlate significantly with healthcare professionals' personal and work-related characteristics. Formal training was strongly associated with high levels of compassion satisfaction and coping with death competence. A low level of coping with death competence was found in women and in younger healthcare professionals, those who are single, and with little professional experience. Self-care activities and hospital support systems can be effective resources in coping with death.

A systematic review and meta-analysis of neuroticism and anxiety during the COVID-19 pandemic

Introduction

In response to the global impact of the COVID-19 pandemic, concerns about mental health, particularly anxiety levels, have become prominent. This study aims to explore the relationship between neuroticism, a personality trait associated with emotional instability, and anxiety during the COVID-19 outbreak.

Methods

A comprehensive literature search was conducted using the Cochrane Library, HINARI, Google Scholar, and PUBMED, resulting in the identification of 26 relevant papers. The study protocol has been registered with PROSPERO under the number CRD42023452418. Thorough meta-analysis was performed using Comprehensive Meta-Analysis V4 software.

Results

Meta-analysis revealed a significant positive relationship between anxiety and neuroticism, with 26 studies supporting this association (OR = 3.213, 95% CI 2.352 to 4.391). The findings underscore the importance of considering personality traits, particularly neuroticism, in understanding psychological responses to major global crises such as the COVID-19 epidemic.

Discussion

The observed connection between neuroticism and heightened anxiety levels emphasizes the need for targeted interventions, especially for individuals with high levels of neuroticism. Further research into potential therapeutic approaches for mitigating anxiety consequences in the context of a significant global catastrophe is warranted.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/#CRD42023452418.

Health Anxiety, Fear of COVID-19, Nosophobia, and Health-protective Behaviors Among Healthcare Professionals

Objective

This study examined fear of COVID-19, nosophobia, health anxiety, and health-protective behaviors among healthcare professionals during the COVID-19 pandemic.

Methods

A cross-sectional, correlational research design was used in this study. The data of healthcare professionals (N=300) from three disciplines of medicine (Bachelor of Medicine and Bachelor of Surgery [MBBS], Bachelor of Dental Surgery [BDS], Doctor of Physiotherapy [DPT]) were collected using a purposive sampling technique. The Fear of COVID-19 Scale (FCV-19S), Medical Student Disease Perception and Distress Scale (MSD), Short Health Anxiety Inventory (SHAI), and Health Protective Behavior Scale (HBPS) were used as assessment measures. Statistical Package of Social Sciences (SPSS) version 22 was used to analyze the data obtained.

Results

Of the 300 participants, 132 (44%) were male and 168 (56%) were female. A total of 199 participants (63.3%) had a MBBS degree, 59 (19.7%) had a BDS degree, and 41 (14%) had a DPT degree. The findings revealed a significant positive correlation between nosophobia, health anxiety, and fear of COVID-19, whereas health-protective behavior showed a negative association with health anxiety. Sex, health anxiety, and nosophobia were significant predictors of health-protective behaviors among medical professionals.

Conclusion

The fear related to COVID-19 is associated with nosophobia and health anxiety among medical professionals, which has a substantial impact on health, work performance, and vulnerability to developing psychological distress if left unmonitored.

Moral foundations are better predictors of belief in COVID-19 conspiracy theories than the Big Five personality traits

Upon the sudden outbreak of COVID-19 pandemic, various conspiracy theories regarding the virus proliferated in the social media. This study focused on the sociodemographic, personality, and moral predictors of these beliefs. More specifically, we asked whether moral values predict belief in COVID-19 conspiracy theories over and above sociodemographic variables and the Big Five personality traits. According to Moral Foundations Theory, five cross-cultural moral foundations are more broadly categorized under individualizing (Care & Fairness) and binding (Loyalty, Authority, & Sanctity) foundations. A sixth moral foundation was Liberty which we included along with binding and individualizing foundations. Participants were 227 Iranians (mean age = 31.43, SD = 12.61, 75.3% female) who responded to Moral Foundations Questionnaire and Liberty items, a range of COVID-19 conspiracy beliefs, and the 10-Item Personality Measure of the Big Five. Among demographic variables, religiosity and socioeconomic status were the strongest determinants of conspiracy beliefs regarding the origin of Coronavirus. Among the Big Five, only extraversion predicted these beliefs in a positive direction. Moral foundations, most notably Authority and Sanctity, showed incremental predictive power over both demographic variables and the Big Five personality traits. Findings are discussed in light of the role of social media in dissemination of conspiracy beliefs regarding the pandemic. They point to the more relevance of moral foundations, particularly binding foundations, than the Big Five in the context of pandemic-related conspiracy beliefs, and add to the literature on the unique contribution of moral foundations to socio-political attitudes across cultures.

Eudaimonic Well-Being of Italian Young Adults during the COVID-19 Pandemic: Predictive and Mediating Roles of Fear of Death and Psychological Inflexibility

The literature has widely acknowledged the impact of the COVID-19 pandemic on the mental health of young adults. Despite extensive research, eudaimonic well-being, which focuses on self-knowledge and self-realization, has been scarcely investigated. This cross-sectional study aimed to add knowledge on the eudaimonic well-being of young adults one year after the outbreak of the COVID-19 pandemic, verifying its potential linkages with fear of death and psychological inflexibility. A total of 317 young Italian adults (18-34 years), recruited through a chain sampling method, completed measures of psychological inflexibility, fear of death, and eudaimonic well-being included in an online survey. The study's hypotheses were tested with multivariate multiple regression and mediational analyses. Results showed that psychological inflexibility was negatively associated with all the dimensions of well-being, while fear of the death of others was associated with autonomy, environmental mastery, and self-acceptance. Furthermore, in the association between fear of death and well-being, the mediation role of psychological inflexibility was verified. These results contribute to the extant literature on the factors associated with eudaimonic well-being, providing clinical insights into the work with young adults within challenging times.

Evaluating the complete (44-item), short (20-item) and ultra-short (10-item) versions of the Big Five Inventory (BFI) in the Brazilian population

The Big Five Inventory (BFI) is an instrument designed to assess the personality of individuals aged 18 and above. The original version consists of 44 items divided into five sub-scales representing each of the five personality factors: agreeableness, neuroticism, conscientiousness, openness, and extraversion. The main purpose of this study was to assess the factorial structure of the 44-item BFI and the reliability of two shorter versions with 20 and 10 items. The study also aimed to present normative data for interpreting scores from the short and ultrashort versions of the BFI for the Brazilian population. A total of 3565 individuals with a mean age of 33.3 years (SD = 13.0) from all Brazilian states participated in the study, with 44.2% from the State of Rio Grande do Sul. Participants completed a sociodemographic questionnaire and the BFI. Confirmatory factor analysis showed poor adaptation of the original 44-item model, but the short and ultrashort versions with 20 and 10 items respectively had good adaptation indexes and reliability, with Omega coefficients above 0.70. Normative data for the shorter versions were presented using mean, standard deviation, and percentiles (lower, medium, and higher). The study concluded that the short and ultrashort versions of the BFI have good reliability and can be used in surveys requiring a brief personality assessment.

Death Anxiety During COVID-19 and its Related Factors among Chinese Elderly People

This study aimed at investigating death anxiety and its related factors in Chinese elderly people during COVID-19. This study totally interviewed 264 participants from four cities in different regions of China. Death anxiety scale (DAS), NEO-Five-Factor Inventory (Neo-FFI) and Brief COPE were scored on the basis of one-on-one interviews. Quarantine experience didn't make significant difference in death anxiety among the elderly; Elderly people with high death anxiety had higher scores of neuroticism, and were more likely to use a Behavior Disengagement coping strategy; Multiple linear regression analysis showed that neuroticism, openness and COVID impact predicted 44.6% of the variance in the death anxiety among elderly people. The results support both theories of vulnerability-stress model and terror management theory (TMT). In the post-epidemic era, we suggest to pay attention to the mental health status of elderly people with personality susceptibility to handling the stress of infection badly.

Impacts of mental health in the sleep pattern of healthcare professionals during the COVID-19 pandemic in Brazil

BACKGROUND

After >2 years of the Coronavirus Disease-19 (COVID-19) pandemic, it is well established how sleep symptoms are rising, especially among healthcare workers (HCW). The aim of this study is to evaluate what features are associated with sleep disturbances in the HCW population.

METHODS

Cross-sectional and longitudinal analysis of social and clinical variables associated with sleep problems and insomnia incidence in HCW in a large, national-level cohort. The measurement of sleep problems was assessed by self-report using Jenkins Sleep Scale (JSS). A multivariate analysis was used in the cross-sectional design and generalized linear models were used in the longitudinal design.

RESULTS

10,467 HCW were analyzed in the cross-sectional analysis, 3313 participants were analyzed in the three timepoints of the study. Sex, previously diagnosed mental illness and frontline work with COVID-19 were associated with higher scores in JSS in the univariate analysis. In the multivariate analysis, only previous diagnosis of mental illness was related with sleep difficulties, especially previously diagnosed insomnia. The longitudinal analysis concluded that previous diagnosis of mental illnesses was associated with higher levels of insomnia development (OR = 11.62). The self-reported disorders found to be major risk factors were addiction (OR = 7.69), generalized anxiety disorder (OR = 3.67), social anxiety (OR = 2.21) and bipolar disorder (OR = 2.21).

LIMITATIONS

Attrition bias.

CONCLUSIONS

Previous diagnosis of mental illness was strongly related to insomnia development in HCW during the COVID-19 pandemic. Strategies that focus on this population are advised.

Stigmatization profiles and psychological distress in people at high risk of infection with COVID-19 -A study conducted in Germany from March to August 2021

COVID-19-related stigmatization of affected people or people at risk of infection has been shown to enhance the reluctance of affected individuals to use health services and reduce their mental health. It is thus highly important to gain a thorough understanding of COVID-19-related stigmatization. The present study's first aim was to explore stigmatization profiles of experienced stigmatization (anticipated stigmatization, internalized stigmatization, enacted stigmatization, disclosure concerns) and stigmatization practices in 371 German people at high risk of infection using latent class analyses. The second aim was to investigate the relationship between stigmatization profiles and psychological distress via multiple regression analysis taking into account other possible negative and positive risk factors. Our results showed two stigmatization profiles: "high stigmatization group" and "low stigmatization group". Belonging to the "high stigmatization group" was significantly correlated with higher levels of psychological distress. Other risk factors significantly related to psychological distress were mental health disorders in the past, exposure to COVID-19, fear related to COVID-19, perceived risk of being infected, lower perceived self-efficacy, and lower subjective knowledge about COVID-19.

Neuroticism and fear of COVID-19 during the COVID-19 pandemic: Testing the mediating role of intolerance of uncertainty and sense of control among Chinese high school students

Since the COVID-19 pandemic broke out in 2019, neuroticism has been proven a predictor of fear of COVID-19 infection. However, only few studies have been conducted on the factors affecting the relationship between neuroticism and this kind of fear. The present study is aimed at analyzing the role intolerance of uncertainty (IU) and sense of control (SOC) play in relation to neuroticism and the fear of COVID-19. We conducted a cross-sectional study in Guangdong and Guangxi provinces, China, and we collected complete datasets from 792 high school students. The main results can be described as follows: (a) individuals with high neuroticism tended to have higher intolerance of uncertainty (IU) and a lower sense of control (SOC); (b) IU and SOC played a mediating role between neuroticism and fear of COVID-19, and a serial mediation effect was found between these factors; (c) after controlling for both IU and SOC, the effect of neuroticism on fear was no longer significant. The results suggested a critical role of IU and sense of control in the causal relationship between neuroticism and fear.

Climate Changes, Natural Resources Depletion, COVID-19 Pandemic, and Russian-Ukrainian War: What Is the Impact on Habits Change and Mental Health?

Climate Change, Natural Resources Depletion, COVID-19, and Wars are some of the great challenges of our time. The consequences will affect psychological well-being and could have a harmful impact on mental health. This study aimed to assess the level of preoccupation and fears surrounding issues of the 21st-century and the implication for psychological well-being of the general population from Central/Southern Italy among different age groups. A questionnaire that included sociodemographic characteristics, topics formulated ad-hoc about preoccupation, fears, habits, and willingness to change habits in the future related to the 21st-century challenges, and the Depression Anxiety Stress Scales 21 (DASS-21) was administered online. A sample of 1831 participants (61% F; mean age 47.71 ± 17.30) was obtained. Results showed that young adults and older adults, respectively, reported greater and less psychological well-being. Young adults reported higher scores for preoccupation, changing habits, and willingness to change habits in the future, while older adults reported the lowest scores except for changing habits, also controlling for gender. Results for this variable, as well as correlations between the many variables described, rely on the specificity of age, and 21st-century challenges. Moreover, the main fears related to the 21st-century concerns were different based on both age and gender. In conclusion, the various stresses of the 21st-century discussed in this study have a relationship with personal well-being, and it is important to consider potential global mental health issues resulting from these stressors.

Experiences of COVID-19 survivors: A qualitative study based on Watson's Theory of Human Caring

This study aims to investigate the experiences of survivors of COVID‐19 in Turkey. The research questions and results are structured according to Watson’s Theory of Human Caring. The study was conducted using a descriptive qualitative research design. The phenomenological method was used to explore the experiences of survivors of COVID‐19. A total of 34 survivors of COVID‐19 were included in the study. Data were collected using semi‐structured and open‐ended questions online and via telephone interviews between February and March 2020. Data were evaluated using thematic analysis and descriptive analysis. Six main themes and twenty‐five sub‐themes were defined that describe the experiences of survivors of COVID‐19 regarding the illness: (a) Denial and adaptation, (b) Fear, (c) Feeling of hopelessness, (d) Preventions (e) Meaning attribution, and (f) Metaphors about COVID‐19. Information from this research may be used by healthcare professionals to develop new strategies for the care of survivors of COVID‐19. Moreover, it can be said that Watson’s Theory of Human Caring is suitable for monitoring the psychosocial development of patients with COVID‐19.

The impact of COVID-19 on cancer patients, their carers and oncology health professionals: A qualitative study

OBJECTIVE

Cancer patients, carers and oncology health professionals have been impacted by the COVID-19 pandemic in many ways, but their experiences and psychosocial responses to the pandemic are still being explored. This study aimed to document the experience of Australians living with cancer, family carers, and Oncology health professionals (HPs) when COVID-19 first emerged.

METHODS

In this qualitative study, participants (cancer patients currently receiving treatment, family carers and HPs) completed a semi-structured interview exploring their experiences of COVID-19 and the impact it had on cancer care. Participants also completed the Hospital Anxiety and Depression Scale (patients) and the Depression, Anxiety and Stress Scale (carers and HPs) to assess emotional morbidity. Thematic analysis was undertaken on qualitative data.

RESULTS

32 patients, 16 carers and 29 HPs participated. Qualitative analysis yielded three shared themes: fear and death anxiety, isolation, and uncertainty. For HPs, uncertainty incorporated the potential for moral distress and work-stress. Patients and carers scoring high on anxiety/depression measures were more likely to have advanced disease, expressed greater death anxiety, talked about taking more extreme precautionary measures, and felt more impacted by isolation.

CONCLUSION

Cancer and COVID-19 can have compounding psychological impacts on all those receiving or giving care.

PRACTICE IMPLICATIONS

Screening for distress in patients, and burnout in HPs, is recommended. Increased compassionate access and provision of creative alternatives to face-to-face support are warrented.

Relationship between COVID-19 anxiety and fear of death: the mediating role of intolerance of uncertainty among a Turkish sample

The Coronavirus Disease 2019 (COVID-19) pandemic has increased the salience of death in our lives. The aim of this study is to uncover potential mechanisms underlying fear of death during the pandemic. A sample of 478 volunteers (312 females and 166 males) aged 18 years and older participated voluntarily in this study. Coronavirus Anxiety Scale, Multidimensional Mortality Awareness Measure, Intolerance of Uncertainty Scale, and Personal Information Form were used for data collection. The mediating role of intolerance of uncertainty in the relationship between COVID-19 anxiety and fear of death was determined using the bootstrapping method. COVID-19 anxiety was associated with increased intolerance of uncertainty, and fear of death. Intolerance of uncertainty was associated with increased fear of death. Furthermore, intolerance of uncertainty partially mediated the relationship between COVID-19 anxiety and fear of death. Results suggest that intolerance of uncertainty is a critical variable in the relationship between COVID-19 anxiety and fear of death. The current research adds to our knowledge of fear of death by investigating COVID-19 anxiety and intolerance of uncertainty. Additionally, this study underlies and contributes to the consideration of psychological health of individuals during the pandemic process. The results are discussed within the context of the COVID-19 pandemic.

The Fear of COVID-19: Gender Differences among Italian Health Volunteers

Background: During the COVID-19 pandemic, the fear of being infected was a major concern, resulting in both physical and psychological effects. Despite several studies on fear of COVID-19 in the general population, the effects on healthy volunteers who face COVID-19 on the frontlines have not yet been investigated. Methods: An online survey on specific psychological variables related to COVID-19 was administered to 720 healthy volunteers, and gender differences were investigated. Results: The primary finding was that females showed higher scores in all dimensions assessed. A multiple linear regression conducted on both genders exhibited a similar pattern of predictors, highlighting the pivotal role of negative affect in the male group. Conclusions: The findings suggest that COVID-19 had significant effects on healthy volunteers, especially in the female group. Although the previous literature did not report the crucial role played by the negative affect in the male sample, these results highlight the need to deepen how both genders use different emotional strategies to cope with stressful situations. This study may be useful in the development of specific psychological support and ad hoc training for healthy volunteers.

Fear of COVID-19 and Perceived Stress: The Mediating Roles of Neuroticism and Perceived Social Support

Background: Fear of COVID-19 leads to stress and may result in various kinds of mental health problems. Many factors are associated with an individual’s perception of stress, including neuroticism and perceived social support. This study aimed to examine the role of neuroticism and perceived social support as mediators of fear of COVID-19 on perceived stress. Methods: Data from 3299 participants aged ≥18 years from the HOME-COVID-19 survey in 2020 were used for analysis. Measurements used included the Fear of COVID-19 and Impact on Quality of Life Scale, the Perceived Stress Scale-10, the Neuroticism inventory and the Multidimensional Scale of Perceived Social Support-12. A parallel mediation model within a structural equation modeling framework with 5000 bootstrapping sampling was used to test the mediating effect. Results: Fear of COVID-19 had a direct effect on perceived stress (B  =  0.100, 95% CI = 0.080−0.121, p < 0.001), whereas neuroticism, but not perceived social support, partially mediated the relationship between fear of COVID-19 and perceived stress (B = 0.018, 95% CI = 0.000−0.036). Among all types of social support, only perceived support from friends was a significant mediator (B = 0.016, 95% CI = 0.006−0.025). Conclusions: Neuroticism and perceived support from friends are critical factors in the relationship between fear of COVID-19 and perceived stress.

Psychosocial predictors of anxiety and depression in a sample of healthcare workers in Botswana during the COVID-19 pandemic: A multicenter cross-sectional study

Objectives:

This study aimed to investigate the psychological impact of the COVID-19 outbreak on healthcare workers across multiple hospitals in different districts in Botswana.

Methods:

We conducted a cross-sectional study in five public-funded hospitals from three districts in Botswana from 1 June 2020 to 30 October 2020. We used the neuroticism subscale of the 44-item Big Five Inventory, Patient Health Questionnaire, the Oslo 3-item Social Support Scale, the Anxiety Rating Scale, and the 14-item Resilience Scale to obtain data from 355 healthcare workers.

Results:

The participants’ mean age (standard deviation) was 33.77 (6.84) years. More females (207, 59%) responded than males (144, 41%). Anxiety and depression were experienced by 14% and 23% of the participants, respectively. After multiple regression analyses, neuroticism predicted depression (B = 0.22; p < 0.01) and anxiety disorder (B = 0.31; p < 0.01). Lower educational status (B = −0.13; p = 0.007) predicted anxiety and younger age (B = −0.10; p = 0.038) predicted depression, while resilience negatively correlated with both disorders.

Conclusion:

There is a need to develop and implement interventions targeted at these identified risk and protective factors that can be easily delivered to healthcare workers during this pandemic.

The Relationship between Personality Traits and COVID-19 Anxiety: A Mediating Model

The COVID-19 pandemic has created a lot of fear and anxiety globally. The current study attempted to investigate the association among the big five personality traits and the two factors of COVID-19 pandemic anxiety (fear and somatic concern). Further, sleep quality as a mediator between personality traits and pandemic anxiety was also assessed. The study involved a cross-sectional sample of 296 adult Indians who were administered the 10-item short version of BFI along with the COVID-19 Pandemic Anxiety Scale and Sleep Quality Scale. Path analysis was used to test the theoretical model that we proposed. The overall model has explained 6% and 36% of the variance, respectively, for the factors of fear and somatic concern of COVID-19 pandemic anxiety. The path analysis model indicated that only the trait of neuroticism showed a significant direct and indirect effect on pandemic anxiety in the sample. Those scoring high on neuroticism indicated high levels of fear as well as somatic concern. Neuroticism also showed partial mediation through sleep quality on the factor of somatic concern. Agreeableness was the only other personality trait that indicated a significantly negative relationship with the factor of somatic concern. These relationships were independent of age, gender, and occupational status. These findings provide a preliminary insight into the slightly different relationship which has emerged between personality and COVID-19 pandemic anxiety in comparison to general anxiety.

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 Mediating Effects of Diabetes Distress, Anxiety, and Cognitive Fusion on the Association Between Neuroticism and Fear of Hypoglycemia in Patients With Type 2 Diabetes

Purpose: To explore the relationship between neuroticism and fear of hypoglycemia (FoH) among patients with type 2 diabetes (T2D), as well as the mediating effects of diabetes distress, anxiety, and cognitive fusion on the relationship between neuroticism and FoH.

Methods: A total of 494 patients with T2D (39.9% females, n = 197) were analyzed using the neuroticism scale of the Eysenck Personality Questionnaire-Revised Short Scale (EPQ-RS), the Fear of Hypoglycemia-15 Scale (FH-15), the Diabetes Distress Scale (DDS), the Self-Rating Anxiety Scale (SAS), and the Cognitive Fusion Questionnaire (CFQ). The bootstrapping method was used to test the separate and parallel mediation models.

Results: FoH was noted in 17.4% (n = 86) of patients. The correlations between neuroticism, diabetes distress, anxiety, cognitive fusion, and FoH were positive. Diabetes distress, anxiety, and cognitive fusion were significant mediators in the association between neuroticism and FoH in both separate and parallel mediation models. In the parallel mediation model, the mediating effect of anxiety was the highest, and the mediating effect of diabetes distress was the lowest, but no significant differences were found in the comparison of these three indirect effects.

Conclusion: This study indicated that neuroticism not only directly affected FoH, but also indirectly influenced FoH via the increase of diabetes distress, anxiety, and cognitive fusion in patients with T2D. The results provide a theoretical basis for the development of intervention programs to ameliorate patients’ FoH directly and indirectly. Healthcare providers should be encouraged to develop appropriate programs based on improving diabetes distress, anxiety, and cognitive fusion to help patients with T2D improve FoH.

Chloroquine/Hydroxychloroquine Use and Suicide Risk: Hypotheses for Confluent Etiopathogenetic Mechanisms?

Chloroquine (CQ) and hydroxychloroquine (HCQ) are classical anti-malarial and anti-inflammatory treatments, which were used as first-line therapy at the beginning of the 2019 coronavirus disease (COVID-19) pandemic. Besides the emerging data on their lack of efficacy against COVID-19 infection, such treatments have been associated with some severe health concerns, including those of neuropsychiatric nature, such as a possible increase in suicide risk. Here we report a case of a patient with no history of psychiatric illnesses, who abruptly developed depression with melancholic features, severe suicidal ideation (SI), and attempted suicide (SA) shortly after receiving HCQ for his COVID-19 infection. The case was followed by a mini-review of the heterogeneous scientific literature on the hypothetical association between neuropsychiatric symptoms, with a focus on SI and suicidal behavior (SB, including SA and death by suicide), when CQ and HCQ are used in COVID-19, rheumatologic diseases, and malaria settings. Considering the anti-inflammatory properties of CQ and HCQ and the implications for neuroinflammation in suicide pathogenesis, the possible increase in suicide risk caused by these medications appears paradoxical and suggests that other underlying pathological trajectories might account for this eventuality. In this regard, some of these latter mechanistic postulates were proposed. Certainly the role and contribution of psycho-social factors that a COVID-19 patient had to face can neither be minimized nor excluded in the attempt to understand his suffering until the development of SI/SB. However, while this case report represents a rare scenario in clinical practice and no consensus exists in the literature on this topic, a psychiatric screening for suicide risk in patients using of CQ and HCQ could be carefully considered.

Differences Between the Psychological Symptoms of Health Workers and General Community After the First Wave of the COVID-19 Outbreak in Spain

The coronavirus disease-2019 (COVID-19) has worsened the physical and mental health of the general population. Healthcare workers have a high risk of suffering a mental disorder after the first wave. In this way, psychologists, who deal with mental health issues and are considered as healthcare workers in many countries, are of interest in this context. The present study aimed to examine anxiety, depression, stress, and obsessions and compulsions across psychologists, healthcare professionals, and the general community. These variables were measured through the Depression, Anxiety, and Stress Scale (DASS-21), as well as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), which are related to different sociodemographic variables. The study was carried out after the first wave in Spain through an online questionnaire. Structural equation modeling and a multigroup analysis were carried out across the groups and variables under study. The results suggested that; (i) healthcare workers and general community depicted similar results in anxiety and stress, as well as obsessions; (ii) the group of psychologists depicted better scores than the other groups under study; (iii) stress and anxiety did not predict compulsions in the group of psychologists; (iv) anxiety predicted obsessions for all the professions, while the relationship of this variable with stress was different for each group; and (v) invariance reached a full metric level.

Personal and Emotional Factors of Nursing Professionals Related to Coping with End-of-Life Care: A Cross-Sectional Study

The death of a patient can be a traumatic event, causing emotional and psychological distress in professional nurses and potentially hampering the quality of their care. Optimal self-perceived coping with death involves valuing these difficult situations as challenges and actively coping with work-related stress during the care of the dying patient. Thus, the aim of this study was to assess Spanish nurses’ self-perceived competence with patient death and investigate its relationship with their personality traits, anxiety and fear of death. A cross-sectional study based on a web-based survey was conducted. A sample of 534 Spanish nurses provided socio-demographic information and answered validated questionnaires. Most participants perceived their coping with death as optimal. Men and nurses older than 31 years coped better with death. Professionals with an optimal self-perception showed significantly lower scores on all personality dimensions evaluated, while a higher level of the anxiety trait predicted worse coping. Although with medium explanatory power, psychoticism, anxiety, and fear of death were the main predictors of the development of optimal coping with death among Spanish nurses. These characteristics together with information from the work environment and evidence-based practice could help to develop better routines and contexts of care for nurses working in end-of-life care.

The Role of Resilience for Migrants and Refugees' Mental Health in Times of COVID-19

Migrants and refugees need international protection, particularly during a crisis such as the current health pandemic. The aim of this research was to examine the mental health and attitudes towards COVID-19 in migrants and refugees compared to the general Spanish population. Moreover, the nature of resilience was examined as a mixed component though life experiences. For this proposal, an interview was carried out in a sample of 245 participants who volunteered to participate in the study. The sample was divided into Spanish non-migrants, Spanish migrants, non-Spanish migrants and refugees. Attitudes towards COVID-19, resilience (based on BRCS) and mental health (based on DASS-21) were measured. The results obtained can be described as follows: (i) Migrant participants indicated worse mental health than non-migrants, and within the migrant group, refugees presented worse scores; (ii) No differences were found in attitudes towards COVID-19 in any of the subgroups; (iii) A moderating effect of group was found for the relationship between resilience and mental health but not between resilience and fear of COVID-19. These results might be of great interest in making visible the vulnerability of migrants and specifically refugees, and the proposal of intervention programs based on resilience training.

The Moderation Effects of Comparative Thinking Between Gratitude and Negative Affect During the COVID-19 Outbreak

The aim of this research was to examine the moderation effects of comparative thinking (CT) across the relationship between gratitude and affect during the COVID-19 outbreak. To this purpose, multiple regression as well as moderation analyses were carried out. Age and sex were also addressed as variables of interest as described in previous literature. A sample of 306 north Americans was recruited by crowdsourcing platform ProA to obtain a representative sample based on age and gender. The participants filled in a questionnaire based on comparative thinking in relation to the emotional experience experienced before and during the COVID-19 outbreak, positive and negative affect schedule for positive and negative affect, as well as Gratitude Questionnaire - Six Items Form scores for gratitude. The main results of the current study related to the COVID-19 outbreak can be listed as follows: (i) no differences between CT groups in the gratitude trait, but differences in positive and negative affect did occur; (ii) regression models that included age, gratitude, and affect variables predicted negative and positive affects but gender did not reach the statistical level; (iii) two moderation models predicted affect from gratitude, with the CT variable moderating this effect; this moderation effect was also statistically significant in predicting negative affect but it was not statistically significant in predicting positive affect. These results might be of interest for training programs in applied levels and theoretical models of gratitude.

The Consequences of COVID-19 Toward Human Growth: The Role of Traumatic Event and Coping Strategies Among Indonesian Sample

COVID-19 has brought a massive psychological impact on individuals' life. The current study sets a significant purpose to test the model whether post-traumatic stress and coping strategies affect stress-related growth regarding the COVID-19 event. One hundred and ninety-nine participants have participated in an online survey in the period of lockdown. The proposed hypotheses model is further tested using PLS-SEM. The first model explains a significant moderate, 46% amount of variance for stress-related growth. With gender as moderator, the second model explains a significant 29% amount of variance for stress-related growth, which is also moderate. This study shows that active coping strategies and positive affirmation significantly influence individual stress-related growth. The trauma event (COVID-19) does not significantly affect growth. Women experience trauma compared to men, besides active coping with the COVID-19 situation is higher in men than women. Using the Bio-centric perspective, having a positive connection through acceptance and awareness of the situation, self-care, and affective interaction with others would develop growth regarding traumatic situations. Further, interventions about coping skills and positive affirmations are essential to give, especially to vulnerable groups such as women.

An Italian Adaptation of the Brief Resilient Coping Scale (BRCS) and Attitudes During the Covid-19 Outbreak

Resilience has attracted the interest of the scientific community during the Covid-19 outbreak, as a protective factor in mental health. As the migrant population arguably has one of the most vulnerable profiles in the current health crisis, the aim of this study is to assess the psychometric properties of the Italian version of the Brief Resilient Coping Scale (BRCS) across native and migrant residents in Italy, and to compare scores across these two populations. Other personal attitudes to the current restrictions were considered. Preliminary psychometrics were tested in a version of the translated instrument with an independent sample. A second independent sample was used to analyse the differences between migrant and native adults. The results showed no differences between the new version and the previous Spanish adaptation or the original instrument. Moreover, no differences were found between the migrant and non-migrant group. BRCS scores were predicted by attitudes toward Covid-19 but not by migrant or native group. These results suggest that the BRCS may be a useful tool to measure resilience in Italy at time of pandemic, irrespective of cultural differences.