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Ali AM, Alkhamees AA, Hallit S, Al-Dwaikat TN, Khatatbeh H, Al-Dossary SA. The Depression Anxiety Stress Scale 8: investigating its cutoff scores in relevance to loneliness and burnout among dementia family caregivers. Sci Rep 2024; 14:13075. [PMID: 38844485 PMCID: PMC11156668 DOI: 10.1038/s41598-024-60127-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/19/2024] [Indexed: 06/09/2024] Open
Abstract
The global trend of advanced aging comes at the cost of amplified onset of age-related diseases. Dementia is a common multifactorial age-related neurodegenerative disorder, which manifests with progressive declines in cognitive functioning and ability to perform activities of daily living. As polices discourage institutionalized care, family members act as primary caregivers and endure increased vulnerability to physical and mental health problems secondary to care-related changes in life routine and relationships. Targeting clinically significant distress at earlier stages through valid brief measures may promote caregivers' wellbeing and dementia care continuity/quality. This study aimed to determine the optimal cutoff score of the Depression Anxiety Stress Scale 8-items (DASS-8) in a convenience sample of 571 European caregivers (Mean age = 53 ± 12 years, Italian = 74.4%, Swiss = 25.6%) through three methods. K-means clustering classified the sample into high- and low-distress clusters based on DASS-8 score of 19. Receiver operator curve (ROC) analysis using 48 and 7 cutoffs of the Zarit Burden Interview (ZBI) and the Three-Item University of California, Los Angeles, Loneliness Scale-version 3 (UCLALS3), revealed two DASS-8 cutoffs (12.5 and 14.5, area under the curve (AUC) = 0.85 and 0.92, p values < .001, 95% CI 0.82-0.88 and 0.89 to 0.94, sensitivity = 0.81 and 0.78, specificity = 0.76 and 0.89, Youden index = 0.57 and 0.67, respectively). Decision modeling produced two DASS-8 cutoffs (9.5 and 14.5) for predicting low and high caregiving burden and loneliness, respectively. According to the median of all DASS-8 cutoffs (14.5) the prevalence of mental distress was 50.8%. Distress correlated with key mental problems such as burnout and loneliness-in path analysis, DASS-8 scores were predicted by the ZBI, UCLALS3, care dependency, and receiving help with care, especially among older, female, and spouse caregivers. Further diagnostic workup should follow to confirm psycho-pathogenicity among caregivers with DASS-8 scores above 14.5. Investigations of the DASS-8 in other countries/populations may confirm the validity of this cutoff score.
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Affiliation(s)
- Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Smouha, 21527, Alexandria, Egypt
| | | | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
| | - Tariq N Al-Dwaikat
- Department of Community and Mental Health, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Haitham Khatatbeh
- Department of Nursing, Faculty of Nursing, Jerash University, Jerash, Jordan
| | - Saeed A Al-Dossary
- Department of Psychology, College of Education, University of Ha'il, 1818, Ha'il, Saudi Arabia
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Alduraidi H, Al Karmi F, Mustafa A, Alzu'bi M, Odeh N, Alrawabdeh J, Alzyoud M. The Impact of War Trauma and Housing Environment on Mental Wellbeing of Syrian Refugees in Jordan: A Comparison between In-Camp and Urban Populations. Issues Ment Health Nurs 2024; 45:186-195. [PMID: 38301172 DOI: 10.1080/01612840.2023.2297306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2024]
Abstract
The aim of this study is to compare mental wellbeing and levels of post-trauma distress between Syrian refugees who live inside camps and those who live outside camps in Jordan through a survey-based cross-sectional design, where data were collected from 240 adult Syrian refugees in Jordan. The Arabic versions of the Mental Health Continuum Short Form (MHC-SF), and the Impact of Event Scale-Revised (IES-R) were used to quantitatively measure variables through descriptive statistics and multiple comparative analysis tests. Despite having no significant correlation with residence, findings of the MHC-SF showed significance for mental wellbeing with employment status and income. Whereas IES-R showed that camp refugees fared significantly better in terms of trauma effect than urban refugees. It can be concluded that Syrian refugees living inside camps were disadvantaged in terms of mental wellbeing but slightly less affected by war in comparison to those living in urban areas. Improved programs and policies are needed to uplift the mental wellbeing of Syrian refugees in Jordan and to minimize the destructive traumatic effects of the Syrian war on their wellness.
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Affiliation(s)
| | - Feras Al Karmi
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Anas Mustafa
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Marah Alzu'bi
- School of Medicine, The University of Jordan, Amman, Jordan
| | - Nada Odeh
- School of Medicine, The University of Jordan, Amman, Jordan
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Millard LA, Wittkowski A. Compassion focused therapy for women in the perinatal period: a summary of the current literature. Front Psychiatry 2023; 14:1288797. [PMID: 38179247 PMCID: PMC10766363 DOI: 10.3389/fpsyt.2023.1288797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/28/2023] [Indexed: 01/06/2024] Open
Abstract
Introduction Compassion focused therapy (CFT) is emerging as an effective psychological intervention to treat those experiencing mental health difficulties. CFT was adapted for women who are mothers during the perinatal period (from conception to 2 year postpartum). Although CFT is being delivered in NHS perinatal mental health services in the United Kingdom (UK), its current evidence-base for the treatment of women's mental health problems is unclear. As part of this Mini Review, we aimed to identify the current findings relating to CFT for women in the perinatal period (with or without a mental health condition) in order to identify any associated future research and clinical implications. Method A systematic search of two databases was undertaken. Included studies were required to meet the following criteria: (1) offered an intervention using CFT or perinatal CFT (P-CFT), (2) participants were women in the perinatal period, and (3) studies used a pre- and post-intervention study design. No language restrictions were used. A narrative synthesis was then conducted. Results Five studies, dating from 2018 to 2023, met the inclusion criteria. A total of 1,258 participants were included across those studies. Significant improvements in compassion-based outcomes (i.e., self-compassion, self-criticism/self-reassurance) were observed. However, these findings were primarily derived from non-clinical samples (n = 4) and could only be seen as preliminary. Conclusion Although these results are encouraging for mothers presenting with sub-clinical mental health symptoms, further research is clearly warranted to determine whether CFT/P-CFT may benefit mothers, including those presenting with more significant perinatal mental health difficulties.
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Affiliation(s)
- Leah Alice Millard
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
| | - Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, United Kingdom
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
- Manchester Academic Health Science Centre, Manchester, United Kingdom
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Sabah A, Aljaberi MA, Hajji J, Fang CY, Lai YC, Lin CY. Family Communication as a Mediator between Family Resilience and Family Functioning under the Quarantine and COVID-19 Pandemic in Arabic Countries. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1742. [PMID: 38002833 PMCID: PMC10670761 DOI: 10.3390/children10111742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 11/26/2023]
Abstract
The coronavirus pandemic has become an unprecedented world crisis in which we have struggled against the most potent threat of the twenty-first century. This pandemic has had a profound impact on individuals and families. Therefore, the study aimed to examine family communication as a mediator of the relationship between family resilience and family functioning under the quarantine and coronavirus pandemic in Algeria and Iraq. This study was conducted among individuals in Iraq and Algeria (N = 361). The respondents completed the Family Communication Scale (FCS), Walsh Family Resilience Questionnaire (WFRQ), and Family Functioning Scale (FFS). Structural equation modeling (SEM) with the bootstrapping method was used to conduct the mediated effects of family communication. Using the bootstrapping method in SEM, family resilience and communication significantly affected family functioning (coefficient = 0.808). Moreover, the direct effect and indirect effect (via family functioning) of family resilience on family functioning were both significant, with coefficients of 0.682 and 0.126. In addition, numerous groups from Iraq and Algeria have been analyzed as a sample and have shown no differences in the relationships between family resilience, family communication, and family functioning. In conclusion, the results showed that family communication mediated the relationship between family resilience and family functioning. Moreover, the type of this mediation seemed to be partial because of the significant direct relationship between family resilience and family functioning. According to the findings, healthcare providers should consider improving family resilience and communication to achieve good family functioning.
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Affiliation(s)
- Aiche Sabah
- Faculty of Human and Social Sciences, Hassiba Benbouali University of Chlef, Chlef 02076, Algeria
| | - Musheer A. Aljaberi
- Faculty of Medicine and Health Sciences, Taiz University, Taiz 6803, Yemen;
- Department of Community Health, Faculty of Medicine & Health Sciences, Universiti Putra Malaysia, Serdang 43300, Malaysia
- Faculty of Nursing and Applied Sciences, Lincoln University College, Petaling Jaya 47301, Malaysia
| | - Jamel Hajji
- Higher Institute of Sport and Physical Education of Gafsa, Gafsa University, Gafsa 2100, Tunisia;
- Faculty of Human and Social Sciences of Tunis, University of Tunis, Tunis 1007, Tunisia
| | - Chuan-Yin Fang
- Division of Colon and Rectal Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 621, Taiwan;
| | - Yu-Chen Lai
- Division of Colon and Rectal Surgery, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 621, Taiwan;
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan;
- Faculty of Social Sciences, Media and Communication, University of Religions and Denominations, Qom 37491-13357, Iran
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Tang Y, He W. Depression and academic engagement among college students: the role of sense of security and psychological impact of COVID-19. Front Public Health 2023; 11:1230142. [PMID: 37601170 PMCID: PMC10436546 DOI: 10.3389/fpubh.2023.1230142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 07/24/2023] [Indexed: 08/22/2023] Open
Abstract
Background The negative consequences of depression in college students have garnered global attention, especially in relation to academic achievement during the COVID-19 pandemic, which need critical assessment. Aim This study investigated whether a sense of security mediated the relationship between depression and academic engagement among college students during the pandemic and whether the moderating psychological impact of COVID-19 has a moderating effect on this relationship. Methods In this cross-sectional study, we recruited 466 college students from 30 provincial-level administrative regions in China via the Internet and used established scales to measure depression, academic engagement, a sense of security, and the psychological impact of COVID-19. The mediating and moderating effects were tested using the bootstrap method. Results Depression was found to negatively influence academic engagement, with a sense of security partially mediating this relationship. Moreover, the psychological impact of COVID-19 was shown to have a moderating effect on this mediating process. Conclusion This study could aid in crafting pertinent strategies to mitigate the adverse effects of depression on learning amid unexpected public health crises and foster better mental health among college students.
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Affiliation(s)
| | - Weiguang He
- College of Social Sciences, Shenzhen University, Shenzhen, China
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Poirson L, Robin M, Shadili G, Lamothe J, Corruble E, Gressier F, Essadek A. Male Victims of Sexual Abuse: Impact and Resilience Processes, a Qualitative Study. Healthcare (Basel) 2023; 11:1868. [PMID: 37444703 DOI: 10.3390/healthcare11131868] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Revised: 06/19/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
The increasing prevalence of sexual abuse calls for exceptional awareness of its multidimensional impact on the mental, sexual, and social wellbeing of male adults. This study aims to deepen the overall understanding of sexual abuse consequences; to highlight some common resilience factors; and to strengthen therapeutic and social support. In this qualitative research, we conducted seven semi-structured interviews with male victims of sexual violence. The data were analysed with the interpretative phenomenological analysis. They shed light on the great suffering linked to sexual violence, and on seven themes which are seemingly pillars of resilience: bond to others, bond to the body, making sense of things, expression, rediscovering oneself, institutions, and finally, learning and commitment. The exploration of these themes reveals several avenues for adjusting care, most of which imply the importance of raising awareness so that spaces receiving the victims' word can emerge.
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Affiliation(s)
- Léa Poirson
- Interpsy Laboratory, University of Lorraine, 54015 Nancy, France
| | - Marion Robin
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, 75014 Paris, France
- CESP, INSERM U1178, Team PsyDev, University Paris-Saclay, UVSQ, 94275 Gif-sur-Yvette, France
- Faculty of Health, University Paris Cité, 75006 Paris, France
| | - Gérard Shadili
- Department of Adolescent and Young Adult Psychiatry, Institut Mutualiste Montsouris, 75014 Paris, France
- Faculty of Health, University Paris Cité, 75006 Paris, France
| | - Josianne Lamothe
- School of Social Work, Sherbrooke University, Sherbrooke, QC J1K 2R, Canada
| | - Emmanuelle Corruble
- Department of Psychiatry, Bicêtre University Hospital, Assistance Publique Hôpitaux de Paris APHP, Hôpitaux Universitaires Paris Saclay, 94275 Le Kremlin Bicêtre, France
- CESP, INSERM U1018, Moods Team, Faculté de Médecine Paris Saclay, University Paris-Saclay, 94275 Le Kremlin Bicêtre, France
| | - Florence Gressier
- Department of Psychiatry, Bicêtre University Hospital, Assistance Publique Hôpitaux de Paris APHP, Hôpitaux Universitaires Paris Saclay, 94275 Le Kremlin Bicêtre, France
- CESP, INSERM U1018, Moods Team, Faculté de Médecine Paris Saclay, University Paris-Saclay, 94275 Le Kremlin Bicêtre, France
| | - Aziz Essadek
- Interpsy Laboratory, University of Lorraine, 54015 Nancy, France
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Ali AM, Al-Dossary SA, Almarwani AM, Atout M, Al-Amer R, Alkhamees AA. The Impact of Event Scale-Revised: Examining Its Cutoff Scores among Arab Psychiatric Patients and Healthy Adults within the Context of COVID-19 as a Collective Traumatic Event. Healthcare (Basel) 2023; 11:healthcare11060892. [PMID: 36981549 PMCID: PMC10048280 DOI: 10.3390/healthcare11060892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 02/18/2023] [Accepted: 03/12/2023] [Indexed: 03/30/2023] Open
Abstract
The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD). It has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its determined six subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as a probable ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 & 0.91, p values = 0.001, 95% CI: 0.80-0.92 & 0.87-0.94, sensitivity = 0.85 & 0.87, specificity = 0.73 & 0.83, Youden index = 0.58 & 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by pandemic-related irritability expressed a stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability/dysphoric mood evolved as a direct and indirect effect of key PTSD symptoms (intrusion, hyperarousal, and numbing). The irritability dimension of the IES-R directly predicted the traumatic symptoms of sleep disturbance in both samples while sleep disturbance did not predict irritability. The findings suggest the usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/co-morbidities (e.g., sleep disturbance) in both healthy and diseased groups.
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Affiliation(s)
- Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria 21527, Egypt
| | - Saeed A Al-Dossary
- Department of Psychology, College of Education, University of Ha'il, Ha'il 55476, Saudi Arabia
| | - Abdulaziz Mofdy Almarwani
- Department of Psychiatric Nursing, College of Nursing, Taibah Univesity, Janadah Bin Umayyah Road, Tayba, Medina 42353, Saudi Arabia
| | - Maha Atout
- School of Nursing, Philadelphia University, Amman 19392, Jordan
| | - Rasmieh Al-Amer
- Faculty of Nursing, Isra University, Amman 11953, Jordan
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW 2751, Australia
| | - Abdulmajeed A Alkhamees
- Department of Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah 52571, Saudi Arabia
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Psychometric evaluation of the Depression Anxiety Stress Scale 8 among women with chronic non-cancer pelvic pain. Sci Rep 2022; 12:20693. [PMID: 36450770 PMCID: PMC9712382 DOI: 10.1038/s41598-022-15005-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 06/16/2022] [Indexed: 12/05/2022] Open
Abstract
Psychiatric comorbidity and abusive experiences in chronic pelvic pain (CPP) conditions may prolong disease course. This study investigated the psychometrics of the Depression Anxiety Stress Scale 8 (DASS-8) among women with CPP (N = 214, mean age = 33.3 ± 12.4 years). The DASS-8 expressed excellent fit, invariance across age groups and menopausal status, good know-group validity (differentiating women with psychiatric comorbidity from those without comorbidity: U = 2018.0, p = 0.001), discriminant validity (HTMT ratios < 0.85), excellent reliability (alpha = 0.90), adequate predictive and convergent validity indicated by strong correlation with the DASS-21 (r = 0.94) and high values of item-total correlations (r = 0.884 to 0.893). In two-step cluster analysis, the DASS-8 classified women into low- and high-distress clusters (n = 141 and 73), with significantly higher levels of distress, pain severity and duration, and physical symptoms in cluster 2. The DASS-8 positively correlated with pain severity/duration, subjective symptoms of depression/anxiety, experiences of sexual assault, fatigue, headache severity, and collateral physical symptoms (e.g., dizziness, bloating, fatigue etc.) at the same level expressed by the parent scale and the DASS-12, or even greater. Accordingly, distress may represent a target for early identification of psychiatric comorbidity, CPP severity, experiences of sexual assault, and collateral physical complaints. Therefore, the DASS-8 is a useful brief measure, which may detect mental distress symptoms among women with CPP.
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Chang JG, Ha EH, Lee W, Lee SY. Cognitive impairments in patients with subacute coronavirus disease: Initial experiences in a post-coronavirus disease clinic. Front Aging Neurosci 2022; 14:994331. [PMID: 36437985 PMCID: PMC9681802 DOI: 10.3389/fnagi.2022.994331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 10/21/2022] [Indexed: 11/11/2022] Open
Abstract
Background A significant number of patients experience persistent cognitive impairment after coronavirus disease (COVID-19). This study aimed to investigate the cognitive function of patients in the subacute phase of COVID-19 and to identify the clinical factors associated with cognitive sequelae. Materials and methods Data from patients who visited the psychiatric department of our post-COVID clinic between March and May 2022 were analyzed. The results of neuropsychiatric function tests, including the digit span forward (attention/processing speed) and backward (working memory) tests, the trail making test part A (attention/processing speed) and part B (executive functioning), and the Stroop word color interference test (executive functioning), as well as clinical data from 40 patients in the subacute phase of COVID-19 were analyzed. We calculated the frequency of impairments in each cognitive measure, defined as a z-score of ≤−1.5 standard deviations below measure-specific age- and sex-adjusted norms. Results Of the participants, 72.5% (n = 29) had impairments in at least one cognitive domain. Impairment in executive function was the most frequent (64.9%), followed by impairments in processing speed/attention (52.5%) and working memory (42.5%). Age was inversely correlated with T scores in all cognitive function tests. Conclusion Regular examination of cognitive function is needed, especially in elderly individuals, regardless of the subjective symptom manifestations.
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Affiliation(s)
- Jhin Goo Chang
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang-si, South Korea
| | - Eun-Hye Ha
- Division of Pulmonary and Critical Care Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang-si, South Korea
| | - Wangjun Lee
- Office of the Chief Executive Officer and Chairman, Myongji Hospital, Goyang-si, South Korea
| | - Su Young Lee
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Goyang-si, South Korea
- *Correspondence: Su Young Lee,
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Ali AM, Alameri RA, Hendawy AO, Al-Amer R, Shahrour G, Ali EM, Alkhamees AA, Ibrahim N, Hassan BH. Psychometric evaluation of the depression anxiety stress scale 8-items (DASS-8)/DASS-12/DASS-21 among family caregivers of patients with dementia. Front Public Health 2022; 10:1012311. [PMID: 36388286 PMCID: PMC9641276 DOI: 10.3389/fpubh.2022.1012311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/26/2022] [Indexed: 01/27/2023] Open
Abstract
Patients with dementia express a set of problematic and deteriorating symptoms, along with self-care dependency. Over time, the mental health of family caregivers of persons with dementia may be affected, putting them at a high risk for psychopathology, which may be associated with endangered wellbeing of people with dementia. This cross-sectional instrumental design study examined the psychometric properties of the Depression Anxiety Stress Scale 8-items (DASS-8), DASS-12, and DASS-21 in a convenient sample of 571 caregivers from northern Italy and southern Switzerland (mean age = 53 years, SD = 12, range = 24-89 years). A bifactor structure of the three measures had the best fit; some items of the DASS-12/DASS-21 failed to load on their domain-specific factors. The three-factor structure was invariant across various groups (e.g., gender and education), expressed adequate reliability and convergent validity, and had strong positive correlation with the three-item UCLA Loneliness Scale (UCLALS3). Distress scores did not differ among carers of different types of dementia (Alzheimer's disease vs. other types, e.g., vascular dementia). However, distress scores were significantly high among female individuals, adult children caregivers, those caring for dependent patients, and those who received help with care. For 54.9 and 38.8% of the latter, care was provided by relatives and health professionals, respectively. Since the DASS-8 expresses adequate psychometrics comparable with the DASS-21, it may be used as a brief measure of distress in this population.
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Affiliation(s)
- Amira Mohammed Ali
- Department of Psychiatric Nursing and Mental Health, Faculty of Nursing, Alexandria University, Alexandria, Egypt
| | - Rana Ali Alameri
- Fundamentals of Nursing Department, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amin Omar Hendawy
- Department of Animal and Poultry Production, Faculty of Agriculture, Damanhour University, Damanhour, Egypt
| | - Rasmieh Al-Amer
- Faculty of Nursing, Isra University, Amman, Jordan
- School of Nursing and Midwifery, Western Sydney University, Penrith, NSW, Australia
| | - Ghada Shahrour
- Jordan University of Science and Technology, Faculty of Nursing, Irbid, Jordan
| | - Esraa M. Ali
- Department of Basic and Educational Sciences, Faculty of Education for Early Childhood, Alexandria University, Alexandria, Egypt
| | - Abdulmajeed A. Alkhamees
- Department of Medicine, Unayzah College of Medicine and Medical Sciences, Qassim University, Unayzah, Saudi Arabia
| | - Nashwa Ibrahim
- Psychiatric and Mental Health Nursing Department, Faculty of Nursing, Mansoura University, Mansoura, Egypt
| | - Bothaina Hussein Hassan
- Department of Nursing, College of Applied Medical Sciences, King Faisal University, Al-Ahsa, Saudi Arabia
- Department of Gerontological Nursing, Faculty of Nursing, Alexandria University, Alexandria, Egypt
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Faretta E, Maslovaric G, Garau MI, Marmondi G, Piras L, Rezzola S, Incerti A, Nardoni A, Pagani M, Gallina E. The psychological impact of the COVID emergency on Italian nursing homes staff and the effectiveness of eye movement desensitization and reprocessing. Front Psychol 2022; 13:969028. [PMID: 36312101 PMCID: PMC9605733 DOI: 10.3389/fpsyg.2022.969028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/27/2022] [Indexed: 11/18/2022] Open
Abstract
Residential nursing homes were particularly badly affected by the first wave of COVID-19, with large numbers of their frail person getting infected with COVID-19 and dying. The staff in these structures were catapulted into a reality very different from what they were used to. They had to adapt the way they used to take care of their patients in a very short space of time and in a scenario that was continually changing. In this manuscript we describe the subjective experience of staff in a number of Italian nursing homes during the first wave of the COVID-19 pandemic; and we report data showing the effectiveness of the Eye Movement Desensitization and Reprocessing (EMDR) treatment provided to support them during this Pandemic.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Eugenio Gallina
- Centro di Ricerca e Studi in Psicotraumatologia, Milan, Italy
- *Correspondence: Eugenio Gallina,
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Aljaberi MA, Lee KH, Alareqe NA, Qasem MA, Alsalahi A, Abdallah AM, Noman S, Al-Tammemi AB, Mohamed Ibrahim MI, Lin CY. Rasch Modeling and Multilevel Confirmatory Factor Analysis for the Usability of the Impact of Event Scale-Revised (IES-R) during the COVID-19 Pandemic. Healthcare (Basel) 2022; 10:1858. [PMID: 36292305 PMCID: PMC9602035 DOI: 10.3390/healthcare10101858] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 09/20/2022] [Accepted: 09/21/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Several instruments are currently used to assess Coronavirus Disease 2019 (COVID-19) -induced psychological distress, including the 22-item Impact of Event Scale-Revised (IES-R). The IES-R is a self-administered scale used to assess post-traumatic stress disorder (PTSD). The current study aimed to examine the construct validity of the IES-R, based on the Rasch model, with COVID-19-related data, as well as to test the multilevel construct validity of the IES-R within and among countries during the pandemic crisis. METHODS A multi-country web-based cross-sectional survey was conducted utilizing the 22-item IES-R. A total of 1020 participants enrolled in our survey, of whom 999 were included in the analyses. Data were analyzed using Rasch modeling and multilevel confirmatory factor analysis (MCFA). RESULTS The Rasch modeling results of the IES-R demonstrated that the IES-R is a satisfactory instrument with the five-point Likert scale, asserting that its 22 items are significant contributors to assessing PTSD as a unidimensional construct covered by the items of the IES-R. The MCFA confirmed that the 22-item IES-R, with its three factors, including intrusion, avoidance, and hyperarousal, demonstrates adequate construct validity at the within- and among-country levels. However, the results of the Akaike information criterion (AIC) model determined that the 16-item IES-R is better than the 22-item IES-R. CONCLUSION The results suggested that the 22-item IES-R is a reliable screening instrument for measuring PTSD related to the COVID-19 pandemic, and can be utilized to provide timely psychological health support, when needed, based on the screening results.
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Affiliation(s)
- Musheer A. Aljaberi
- Faculty of Medicine and Health Sciences, Taiz University, Taiz 6803, Yemen
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43300, Malaysia
- Faculty of Nursing and Applied Sciences, Lincoln University College, Petaling Jaya 47301, Malaysia
| | - Kuo-Hsin Lee
- Department of Emergency Medicine, E-Da Hospital, I-Shou University, No. 1, Yi-Da Road, Yanchao District, Kaohsiung City 824, Taiwan
- School of Medicine, I-Shou University, No. 8, Yi-Da Road, Jiao-Su Village, Yan-Chao District, Kaohsiung City 824, Taiwan
| | - Naser A. Alareqe
- Department of Educational Psychology, Faculty of Education, Taiz University, Taiz 6803, Yemen
| | - Mousa A. Qasem
- Department of Pharmaceutical Technology, Faculty of Pharmacy, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Abdulsamad Alsalahi
- Department of Pharmacology, Faculty of Pharmacy, Sana’a University, Mazbah District, Sana’a 1247, Yemen
| | - Atiyeh M. Abdallah
- Department of Biomedical Sciences, College of Health Sciences, QU-Health, Qatar University, Doha 2713, Qatar
| | - Sarah Noman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43300, Malaysia
| | - Ala’a B. Al-Tammemi
- Migration Health Division, International Organization for Migration (IOM), Amman 11953, Jordan
| | | | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
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Collazo-Castiñeira P, Rodríguez-Rey R, Garrido-Hernansaiz H, Collado S. Prediction of post-traumatic growth in the face of the COVID-19 crisis based on resilience, post-traumatic stress and social participation: A longitudinal study. Front Psychol 2022; 13:985879. [PMID: 36059760 PMCID: PMC9430662 DOI: 10.3389/fpsyg.2022.985879] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 07/21/2022] [Indexed: 11/13/2022] Open
Abstract
The COVID-19 crisis has generated a severe and negative psychological impact worldwide. Despite this, it is also possible to experience post-traumatic growth (PTG). This study aimed to longitudinally explore the prevalence of PTG in the Spanish population and test a predictive model for PTG from resilience, post-traumatic stress symptoms (PTSS), and participation in social activities. Data were collected longitudinally in March, July, and November 2020 via an online survey. About 20% of the sample showed moderate-high levels of PTG, with no significant differences over time. The predictive model explained 19% of the variance in PTG, showing that the inverse relation between resilience and PTG was mediated by PTSS. Additionally, participation in social activities acted as a predictor of PTG. Women, young people, those who had lost their job and people who had experienced COVID-19 symptoms or the loss of a loved one presented higher PTG. Thus, people have experienced positive changes (PTG), but these did not protect them from adverse symptomatology (PTSS).
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Affiliation(s)
- Paula Collazo-Castiñeira
- Department of Psychology, Faculty of Human and Social Sciences, Universidad Pontificia Comillas, Madrid, Spain
- Department of Geriatrics, Hospital Universitario Ramón y Cajal (IRYCIS), Madrid, Spain
| | - Rocío Rodríguez-Rey
- Department of Psychology, Faculty of Human and Social Sciences, Universidad Pontificia Comillas, Madrid, Spain
| | - Helena Garrido-Hernansaiz
- Department of Education and Psychology, Centro Universitario Cardenal Cisneros, Alcalá de Henares, Spain
| | - Silvia Collado
- Department of Psychology and Sociology, Faculty of Social and Human Sciences, University of Zaragoza, Teruel, Spain
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Shim M, Hwang HJ, Lee SH. Impaired functional cortical networks in the theta frequency band of patients with post-traumatic stress disorder during auditory-cognitive processing. Front Psychiatry 2022; 13:811766. [PMID: 36032254 PMCID: PMC9403077 DOI: 10.3389/fpsyt.2022.811766] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 07/19/2022] [Indexed: 11/29/2022] Open
Abstract
Impaired cognitive function related to intrusive memories of traumatic experiences is the most noticeable characteristic of post-traumatic stress disorder (PTSD); nevertheless, the brain mechanism involved in the cognitive processing is still elusive. To improve the understanding of the neuropathology in PTSD patients, we investigated functional cortical networks that are based on graph theory, by using electroencephalogram (EEG). EEG signals, elicited by an auditory oddball paradigm, were recorded from 53 PTSD patients and 39 healthy controls (HCs). Source signals in 68 regions of interests were estimated using EEG data for each subject using minimum-norm estimation. Then, using source signals of each subject, time-frequency analysis was conducted, and a functional connectivity matrix was constructed using the imaginary part of coherence, which was used to evaluate three global-level (strength, clustering coefficient, and path length) and two nodal-level (strength and clustering coefficients) network indices in four frequency bands (theta, alpha, low-beta, and high-beta). The relationships between the network indices and symptoms were evaluated using Pearson's correlation. Compared with HCs, PTSD patients showed significantly reduced spectral powers around P300 periods and significantly altered network indices (diminished strength and clustering coefficient, and prolonged path length) in theta frequency band. In addition, the nodal strengths and nodal clustering coefficients in theta band of PTSD patients were significantly reduced, compared with those of HCs, and the reduced nodal clustering coefficients in parieto-temporo-occipital regions had negative correlations with the symptom scores (Impact of Event Scale-Revises, Beck Depression Inventory, and Beck Anxiety Inventory). The characterization of this disrupted pattern improves the understanding of the neuropathophysiology underlying the impaired cognitive function in PTSD patients.
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Affiliation(s)
- Miseon Shim
- Industry Development Institute, Korea University, Sejong, South Korea
- Department of Electronics and Information Engineering, Korea University, Sejong, South Korea
| | - Han-Jeong Hwang
- Department of Electronics and Information Engineering, Korea University, Sejong, South Korea
- Interdisciplinary Graduate Program for Artificial Intelligence Smart Convergence Technology, Korea University, Sejong, South Korea
| | - Seung-Hwan Lee
- Psychiatry Department, Ilsan Paik Hospital, Inje University, Goyang, South Korea
- Clinical Emotion and Cognition Research Laboratory, Goyang, South Korea
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15
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Faretta E, Garau MI, Gallina E, Pagani M, Fernandez I. Supporting healthcare workers in times of COVID-19 with eye movement desensitization and reprocessing online: A pilot study. Front Psychol 2022; 13:964407. [PMID: 36003099 PMCID: PMC9393610 DOI: 10.3389/fpsyg.2022.964407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/11/2022] [Indexed: 11/29/2022] Open
Abstract
We report the results of a pilot study regarding the adaptation of the group eye movement desensitization and reprocessing (EMDR) protocol for the treatment online, for the management of trauma associated with the COVID-19 Pandemic in Italy. The target group were healthcare workers in a nursing home (Residenza sanitaria assistita, RSA) who decided to live and stay on site during the most acute phase of the Pandemic in order to protect the residents of the home. Scores for perceived post traumatic stress disorder (PTSD) symptoms and quality of emotional experience improved significantly following participation in the therapy programme. These preliminary results confirm the innovative potential of the EMDR protocol when used online on early intervention, to prevent the development of later psychological disturbances.
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Affiliation(s)
- Elisa Faretta
- Eye Movement Desensitization and Reprocessing (EMDR) Italy Association, Varedo, Italy
| | - M. Ignazia Garau
- Eye Movement Desensitization and Reprocessing (EMDR) Italy Association, Varedo, Italy
| | - Eugenio Gallina
- Centro di Ricerca e Studi in Psicotraumatologia (CRSP), Milan, Italy
- *Correspondence: Eugenio Gallina,
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies, Consiglio Nazionale delle Ricerche, Rome, Italy
| | - Isabel Fernandez
- Eye Movement Desensitization and Reprocessing (EMDR) Italy Association, Varedo, Italy
- Centro di Ricerca e Studi in Psicotraumatologia (CRSP), Milan, Italy
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16
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Malakoutikhah A, Zakeri MA, Koenig HG, Dehghan M. The psychometric properties of the Persian version of the moral injury symptoms scale-health care professionals version. Front Psychol 2022; 13:978572. [PMID: 35992473 PMCID: PMC9389154 DOI: 10.3389/fpsyg.2022.978572] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/18/2022] [Indexed: 11/17/2022] Open
Abstract
BackgroundHealth care professionals face a number of problems during crises, such as the COVID-19. Studies addressed the prevalence of moral injury among healthcare professionals during the COVID-19 outbreak. Lack of a valid standard of moral injury among health care professionals is one of the factors that has made it difficult to identify and treat this complication. This study aimed to evaluate the psychometric properties of the Moral Injury Symptoms Scale-Health Care Professionals (MISS-HP) among health care professionals in Iran.MethodsThis study was conducted to evaluate the validity and reliability of the MISS-HP. The sample included 455 healthcare professionals working in four teaching hospitals in Kerman, who were in direct contact with patients. In this study, face validity, content validity, construct validity (structural and convergent), and internal reliability of the MISS-HP were evaluated. Demographic information questionnaire, the Moral Injury Symptoms Scale-HealthCare Professionals (MISS-HP), General Health Questionnaire (GHQ), and Impact of Event Scale (IES) were administered to study participants.ResultsThe MISS-HP was evaluated using translation-back translation technique. The content validity index of the items (I-CVI) and the scale (S-CVI) were 0.9 and 0.99, respectively. Exploratory factor analysis showed a three-factor structure in the MISS-HP that explained 57.49% of the variance. Confirmatory factor analysis indices were acceptable. The cut-off point of the questionnaire was 36.5. There was a positive and moderate correlation between the Persian version of MISS-HP, GHQ (r = 0.34), and IES-R (r = 0.40). The Cronbach’s alpha coefficient of the Persian version of MISS-HP was 0.70.ConclusionThis study found that the MISS-HP is a concise, comprehensive, valid and reliable scale for assessing moral injury among health care professionals in clinical or research settings. This scale will be helpful for managers and researchers to identify and plan health policies and improve the psychological state of health care professionals.
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Affiliation(s)
- Alireza Malakoutikhah
- Student Research Committee, School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Ali Zakeri
- Non-Communicable Diseases Research Center, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
- Social Determinants of Health Research Centre, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Harold G. Koenig
- Department of Psychiatry and Behavioral Sciences, and Department of Medicine, Duke University Medical Center, Durham, NC, United States
| | - Mahlagha Dehghan
- Department of Critical Care Nursing, Razi Faculty of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
- *Correspondence: Mahlagha Dehghan, ,
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Emotional Reaction to the First Dose of COVID-19 Vaccine: Postvaccination Decline in Anxiety and Stress among Anxious Individuals and Increase among Individuals with Normal Prevaccination Anxiety Levels. J Pers Med 2022; 12:jpm12060912. [PMID: 35743695 PMCID: PMC9224616 DOI: 10.3390/jpm12060912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 05/26/2022] [Accepted: 05/28/2022] [Indexed: 02/07/2023] Open
Abstract
Although vaccination has been adopted by the WHO to limit worldwide transmission of COVID-19, people’s worries about COVID-19 vaccines may suppress their desire for vaccination despite vaccine availability. This study aimed to investigate anxiety and stress symptoms among 250 Jordanians (mean age = 43.18 ± 6.34 years, 72% females) who received their first vaccine dose. The respondents completed the anxiety and stress subscales of the Depression Anxiety and Stress scale 21 (DASS-21) before and after vaccination. The respondents expressed more moderate–severe levels of stress before than after vaccination (20.8% and 13.2%, respectively). Meanwhile, 37.2% and 45.2% of the respondents expressed moderate–severe anxiety before and after vaccination, respectively. Wilcoxon signed-rank test revealed that the drop in the level of stress from before- (median (IQR) = 5 (1–8)) to after vaccination (median (IQR) = 3 (1–7)) was statistically significant (z = −3.81, p = 0.001, r = 0.17) while the increase in anxiety was not. Anxiety significantly dropped postvaccination among individuals experiencing mild to severe anxiety before vaccination. Similarly, stress and anxiety significantly increased among individuals expressing normal anxiety before vaccination (z = −3.57 and −8.24, p values = 0.001, r = 0.16 and 0.37, respectively). Age positively correlated with postvaccination anxiety among respondents with mild prevaccination anxiety, and it negatively correlated with the prevaccination level of stress in the normal-anxiety group. Gender, marital status, respondents’ level of education, and history of COVID-19 infection had no significant correlation with anxiety or stress at either point of measurement. Overcoming their hesitancy to receive COVID-19 vaccines, individuals with normal levels of anxiety experienced a rise in their distress symptoms following immunization. On the contrary, vaccination seemed to desensitize anxious individuals. Policymakers need to formulate a population-specific plan to increase vaccine preparedness and promote psychological well-being over all during the pandemic.
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Alzahrani NS, Almarwani AM, Asiri SA, Alharbi HF, Alhowaymel FM. Factors influencing hospital anxiety and depression among emergency department nurses during the COVID-19 pandemic: A multi-center cross-sectional study. Front Psychiatry 2022; 13:912157. [PMID: 35990067 PMCID: PMC9387387 DOI: 10.3389/fpsyt.2022.912157] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 07/13/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The emergency department (ED) is a highly stressful environment, which exposes nurses to infection. ED nurses handle life-threatening conditions, endure long working hours, and deal with anxious patients and their families. AIM This study aimed to examine factors, which may influence anxiety and depression levels among ED nurses during the coronavirus disease 2019 (COVID-19) pandemic. METHODS A cross-sectional design was used with 251 participants from six hospitals in Saudi Arabia (mean age = 32.7 ± 6.59, range = 21-54 years, 70.5% females). Data were collected using the Hospital Anxiety and Depression Scale (HADS), and the analysis was conducted using structural equation modeling (SEM). RESULTS Based on the HADS scores, 29.1 and 25.5% of ED nurses were identified as doubtful cases for depression and anxiety, respectively. Additionally, 34.7 and 43.3% of ED nurses were identified as definite cases for depression and anxiety, respectively. Higher anxiety levels were observed among female nurses, nurses with lower physical activity levels, and nurses who worked in urban areas. Low physical activity levels and more than 6 years of work experience correlated with a higher level of depression. None of the hypothesized paths in the anxiety and depression models were significant, except for two observed variables-namely, work location and physical exercise in the anxiety model and physical exercise in the depression model. CONCLUSION Emergency department nurses expressed high levels of anxiety and depression during the COVID-19 pandemic, which may negatively affect their performance and reduce care quality. Therefore, health care leaders should implement specialized mental health education programs focused on nursing occupational safety and support to improve ED nurses' psychological well-being. Specific attention should be paid to ED female nurses who work in urban areas, especially those with more than 6 years of experience.
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Affiliation(s)
- Naif S Alzahrani
- Department of Medical Surgical Nursing, College of Nursing, Taibah University, Medina, Saudi Arabia
| | | | - Saeed A Asiri
- Department of Medical Surgical Nursing, College of Nursing, King Saud University, Riyadh, Saudi Arabia
| | - Hanan F Alharbi
- Department of Maternity and Child Health Nursing, College of Nursing, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Fahad M Alhowaymel
- Department of Nursing, College of Applied Medical Sciences, Shaqra University, Shaqra, Saudi Arabia
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