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Keenan E, Morris R, Vasiliou VS, Thompson AR. A qualitative feasibility and acceptability study of an acceptance and commitment-based bibliotherapy intervention for people with cancer. J Health Psychol 2024; 29:410-424. [PMID: 38158736 PMCID: PMC11005316 DOI: 10.1177/13591053231216017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
Self-directed bibliotherapy interventions can be effective means of psychological support for individuals with cancer, yet mixed findings as to the efficacy of these interventions indicate the need for further research. We investigated the experience of individuals with cancer after using a new self-help book, based on Acceptance and Commitment Therapy (ACT). Ten participants with cancer (nine females and one male, 40-89 years old) were given access to a bibliotherapy self-help ACT-based book and participated in post-intervention semi-structured interviews. Five themes were generated from reflexive thematic analysis: (1) The value of bibliotherapy (2) Timing is important (3) Resonating with cancer experiences (4) Tools of the book (5) ACT in action. The book was found to be acceptable (self-directed, accessible, understandable content, good responsiveness to exercises) and feasible (easy to use, ACT-consistent). Although not explicitly evaluated, participants' reports indicated defusion, present moment awareness, and consideration of values, as the ACT processes that contributed to adjustment, via helping them to regain control over their lives and become more present within the moment. Findings also indicate that the intervention may be best accessed following completion of initial medical treatment.
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Affiliation(s)
- Emma Keenan
- Cardiff and Vale University Health Board and Cardiff University
| | - Reg Morris
- Cardiff and Vale University Health Board and Cardiff University
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2
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Lyne SA, Yip K, Vasiliou VS, Katz DA, Richards P, Tieu J, Black RJ, Bridgewater S, Palmowski A, Beaton D, Maxwell LJ, Robson JC, Mackie SL, Goodman SM, Hill CL. Consensus of the definitions of the OMERACT glucocorticoid impact core domain set for people with rheumatic and musculoskeletal diseases. Semin Arthritis Rheum 2024; 64:152338. [PMID: 38134623 DOI: 10.1016/j.semarthrit.2023.152338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 12/24/2023]
Abstract
BACKGROUND The Outcome Measures in Rheumatology (OMERACT) Glucocorticoid (GC) Impact Working Group has been working to develop a core domain set to measure the impact of GCs on patients living with rheumatic and musculoskeletal diseases. The mandatory domains previously identified for inclusion in all clinical trials measuring the GC effects include infection, bone fragility, mood disturbance, hypertension, diabetes, weight, fatigue, and mortality. Before progressing to instrument selection, the Working Group sought to establish precise definitions of all mandatory domains within the core domain set. METHODS OMERACT methodology was applied with the use of evidence and consensus-based decision making of all stakeholder groups (patient research partners, health care professionals, clinician researchers, industry members and methodologists) to develop detailed definitions for the broad domain, target domain and domain components, taking into consideration sources of variability that could affect measurement of the domain. The working group synthesized prior qualitative studies, quantitative work, and results from Delphi rounds, to develop a rich definition of 'what' is to be measured. RESULTS Between 2021 and 2023, the OMERACT Working Group on GC Impact conducted virtual meetings to establish domain definitions. First, we mapped each domain onto an OMERACT Core Area. All domains were primarily represented within the Pathophysiological Manifestations Core Area, except from Fatigue which was primarily Life Impact and Weight which spanned both Core Areas. Sources of variability included cultural factors, age, gender, education level, socioeconomic status, personal experiences, emotional state, and language barriers. The domain definitions will form the foundation for instrument selection and the initial step of domain / concept match and content validity in the OMERACT pillar of 'truth' before moving on to feasibility and discrimination. CONCLUSION The OMERACT GC Impact Working Group has developed and agreed upon detailed domain definitions for core domains. Future steps of the working group are to select instruments and develop the core outcome measurement set for clinical trials measuring the impact of GC on patients with rheumatic and musculoskeletal diseases.
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Affiliation(s)
- Suellen A Lyne
- Rheumatology Unit, The Queen Elizabeth Hospital, Adelaide, Australia; Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Kevin Yip
- Division of Rheumatology, Hospital for Special Surgery, New York, NY, USA
| | | | | | | | - Joanna Tieu
- Rheumatology Unit, The Queen Elizabeth Hospital, Adelaide, Australia; Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Rachel J Black
- Rheumatology Unit, The Queen Elizabeth Hospital, Adelaide, Australia; Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Susan Bridgewater
- Rheumatology Research, Centre for Health and Clinical Research, University of the West of England, Bristol, UK
| | - Andriko Palmowski
- Department of Rheumatology and Clinical Immunology, Charité - Universitätsmedizin Berlin, Germany; Section for Biostatistics and Evidence-based Research, the Parker Institute, Frederiksberg and Bispebjerg Hospital, University of Copenhagen, Frederiksberg, Denmark
| | - Dorcas Beaton
- Institute for Work & Health, University of Toronto, Canada
| | - Lara J Maxwell
- Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Joanna C Robson
- Rheumatology Research, Centre for Health and Clinical Research, University of the West of England, Bristol, UK; Rheumatology Department, University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
| | - Sarah L Mackie
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK; Leeds Biomedical Research Centre, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Susan M Goodman
- Division of Rheumatology, Hospital for Special Surgery, New York, NY, USA
| | - Catherine L Hill
- Rheumatology Unit, The Queen Elizabeth Hospital, Adelaide, Australia; Adelaide Medical School, The University of Adelaide, Adelaide, Australia.
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Vasiliou VS, Philia I, Drosatou C, Mitsi E, Tsakonas I. LeadinCare: A Qualitative Informed Digital Training Platform Development to Increase Physicians' Soft Communication Skills After COVID-19. PSYCHOL HEALTH MED 2024; 29:39-54. [PMID: 37131299 DOI: 10.1080/13548506.2023.2206144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 04/17/2023] [Indexed: 05/04/2023]
Abstract
The post-COVID-19 pandemic era has placed new demands on physicians. One of these demands is the need to use targeted knowledge and soft communication skills, to address the psychosocial problems (e.g. vaccine hesitancy, fears) of individuals with Chronic Physical Illnesses (CPIs). Focusing on training physicians in targeted soft communication skills can help health care systems to address psychosocial-type problems. Yet, such training programs are rarely implemented, effectively.This study aimed to (a) understand physicians' implementation challenges when using soft communication skills during the COVID-19 pandemic; (b) identify beliefs, barriers, and facilitators that can influence physicians' behaviours to use soft communication skills; and (c) inform the content of the LeadinCare; a new digital training platform, designed to improve physicians' soft communication skills, by leveraging the TDF Theoretical Domain Framework (TDF).We conducted 14 in-depth semi-structured interviews with physicians in Greece, supporting non-COVID-19 cases with CPIs. We analyzed their data using inductive and deductive approaches.Physicians highlighted time, inability to see patients in person, absence of space for non-COVID-19 cases, and poor organizational procedures as barriers to using soft communication skills. Five TDF domains (beliefs) were identified as the most salient to inform the LeadinCare platform: (1) practical and well-organized knowledge; (2) skills that support patients and their relatives; (3) physicians' beliefs about capabilities to use the skills; (4) beliefs about consequences of using the skills (job satisfaction); and (5) the use of digital, interactive, and on-demand platforms (environmental context & resources). We mapped the domains in six narrative-based practices that informed the content of the LeadinCare.Physicians need skills that go beyond talking and towards cultivating resilience and flexibility.
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Affiliation(s)
- Vasilis S Vasiliou
- Postdoctoral Research Associate in Clinical and Health Psychology, Cardiff University, Cardiff, UK
- Clinical Psychologist & Postdoctoral Mixed Methods Research Associate, University of Oxford, Oxford, UK
| | - Issari Philia
- Department of Psychology, Laboratory for Qualitative Research in Psychology and Psychosocial Well-Being, National and Kapodistrian University of Athens, Athens Greece
| | - Constantina Drosatou
- Department of Psychology, Laboratory for Qualitative Research in Psychology and Psychosocial Well-Being, National and Kapodistrian University of Athens, Athens Greece
| | - Efi Mitsi
- Department of Psychology, Laboratory for Qualitative Research in Psychology and Psychosocial Well-Being, National and Kapodistrian University of Athens, Athens Greece
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Powell LD, Vasiliou VS, Thompson AR. An ACT self-help intervention for adults with a visible difference in appearance: A pilot feasibility and acceptability randomized controlled study. Body Image 2023; 47:101637. [PMID: 37839287 DOI: 10.1016/j.bodyim.2023.101637] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 09/14/2023] [Accepted: 10/06/2023] [Indexed: 10/17/2023]
Abstract
Individuals living with a visible difference in appearance experience high levels of social anxiety, yet self-help interventions for this heterogeneous population are not available. We conducted a pilot trial of a novel Acceptance and Commitment Therapy (ACT) based self-help intervention.Individuals with anxiety about having a visible difference in appearance (n = 284) were randomized to an ACT-based four-week intervention (n = 145) or a waitlist control condition (n = 139). We collected pre and follow-up (four-weeks after the completion of the intervention) data. Primary outcomes included social anxiety and impairments in functioning. Psychological flexibility (PF) was also examined. ANCOVAs, controlling for pre scores, indicated significant improvements in functioning by the intervention group. No significant differences were observed for anxiety and PF between conditions at follow-up. Drop out was 68% for the intervention and 41% for the control group, with no differences in the groups in age, origin, gender, or type of visible difference. Participants in the intervention group found the intervention almost equally, useful (77%) and helpful (73%). An ACT-based self-help intervention can alleviate distress related to visible difference in appearance. More sophisticated designs are needed now, to collect idiographic and longitudinal data and examine personalized changes across time in this population.
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Affiliation(s)
| | - Vasilis S Vasiliou
- South Wales Clinical Psychology Training, Cardiff University, 11th Floor, Tower Building, 70 Park Place, Cardiff CF10 3AT, Wales, UK; Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Andrew R Thompson
- University of Sheffield, School of Psychology, Sheffield, UK; South Wales Clinical Psychology Training, Cardiff University, 11th Floor, Tower Building, 70 Park Place, Cardiff CF10 3AT, Wales, UK.
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Dias Neto D, Nunes da Silva A, Roberto MS, Lubenko J, Constantinou M, Nicolaou C, Lamnisos D, Papacostas S, Höfer S, Presti G, Squatrito V, Vasiliou VS, McHugh L, Monestès JL, Baban A, Alvarez-Galvez J, Paez-Blarrina M, Montesinos F, Valdivia-Salas S, Ori D, Lappalainen R, Kleszcz B, Gloster A, Karekla M, Kassianos AP. Corrigendum: Illness perceptions of COVID-19 in Europe: predictors, impacts and temporal evolution. Front Psychol 2023; 14:1227506. [PMID: 37384172 PMCID: PMC10299725 DOI: 10.3389/fpsyg.2023.1227506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/30/2023] Open
Abstract
[This corrects the article DOI: 10.3389/fpsyg.2021.640955.].
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Affiliation(s)
- David Dias Neto
- ISPA - Instituto Universitário, Lisboa, Portugal
- Applied Psychology Research Center Capabilities & Inclusion, Lisboa, Portugal
| | | | | | - Jelena Lubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiņš University, Riga, Latvia
| | - Marios Constantinou
- Department of Social Sciences (Cyprus), School of Humanities and Social Sciences, University of Cyprus, Nicosia, Cyprus
| | - Christiana Nicolaou
- Department of Nursing (Cyprus), Cyprus University of Technology, Limassol, Cyprus
| | - Demetris Lamnisos
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Savvas Papacostas
- The Cyprus Institute of Neurology and Genetics, The University of Nicosia Medical School, Nicosia, Cyprus
| | - Stefan Höfer
- Medical University Innsbruck, Innsbruck, Austria
| | - Giovambattista Presti
- Department of Human and Social Sciences, Kore University Behavioral Lab (KUBeLab), Kore University of Enna, Enna, Italy
| | - Valeria Squatrito
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | | | - Louise McHugh
- School of Psychology (Ireland), University College Dublin, Dublin, Ireland
| | | | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cádiz, Spain
| | | | | | | | - Dorottya Ori
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | | | - Andrew Gloster
- Division of Clinical Psychology & Intervention Science, Department of Psychology, University of Basel, Basel, Switzerland
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Angelos P. Kassianos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Department of Applied Health Research, University College London (UCL), London, United Kingdom
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Vasiliou VS, Russell H, Cockayne S, Coelho GLDH, Thompson AR. A network analysis of psychological flexibility, coping, and stigma in dermatology patients. Front Med (Lausanne) 2023; 10:1075672. [PMID: 37261125 PMCID: PMC10227518 DOI: 10.3389/fmed.2023.1075672] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 04/25/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction Despite the negative effects of stigma in individuals with skin conditions, interventions to address its effects are rare. This might be in part due to a continued lack of understanding as to how individuals respond to stigma. Methods In this study, we employed a step-case analytic method, using traditional regression, moderation, and network analyses, to examine the role of psychological flexibility (PF) with stigmatized experiences, and stigma-related outcomes. We run a cross-sectional study (n = 105 individuals with various skin conditions) and analyzed stigma-related variables. We included variables examining perceived stigmatization (PSQ), anxiety (GAD-7), depression (PHQ-9), well-being (EQ5D5L), and variables stemming from the PF model (CompACT), presented as three coping with stigma responses, namely "open," "aware," and "active.". Results Using network analysis, the most influential or central variables that contributed to stigma were generalized anxiety, perceived stigmatization, and valued actions. In relation to PF, being open to the experience of stigma (as opposed to avoidance), keeping a distance from stigmatized thoughts (as opposed to self-stigmatizing), and bringing attention to value-based committed actions (as opposed to passivity) were all found to contribute to less stigmatized experiences. Discussion The results indicate that two of the three skills of the PF model ("open" and "active") may be important targets for interventions targeting stigma in people living with skin conditions.
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Affiliation(s)
- Vasilis S. Vasiliou
- School of Psychology, South Wales Clinical Psychology Doctorate, Cardiff and Vale University Health Board, Cardiff University, Cardiff, United Kingdom
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Hellen Russell
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Sarah Cockayne
- Department of Dermatology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | | | - Andrew R. Thompson
- School of Psychology, South Wales Clinical Psychology Doctorate, Cardiff and Vale University Health Board, Cardiff University, Cardiff, United Kingdom
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
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Chong YY, Chien WT, Cheng HY, Lamnisos D, Ļubenko J, Presti G, Squatrito V, Constantinou M, Nicolaou C, Papacostas S, Aydin G, Ruiz FJ, Garcia-Martin MB, Obando-Posada DP, Segura-Vargas MA, Vasiliou VS, McHugh L, Höfer S, Baban A, Neto DD, da Silva AN, Monestès JL, Alvarez-Galvez J, Blarrina MP, Montesinos F, Salas SV, Őri D, Kleszcz B, Lappalainen R, Ivanović I, Gosar D, Dionne F, Merwin RM, Gloster AT, Kassianos AP, Karekla M. Predictors of changing patterns of adherence to containment measures during the early stage of COVID-19 pandemic: an international longitudinal study. Global Health 2023; 19:25. [PMID: 37069677 PMCID: PMC10106884 DOI: 10.1186/s12992-023-00928-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 04/04/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Identifying common factors that affect public adherence to COVID-19 containment measures can directly inform the development of official public health communication strategies. The present international longitudinal study aimed to examine whether prosociality, together with other theoretically derived motivating factors (self-efficacy, perceived susceptibility and severity of COVID-19, perceived social support) predict the change in adherence to COVID-19 containment strategies. METHOD In wave 1 of data collection, adults from eight geographical regions completed online surveys beginning in April 2020, and wave 2 began in June and ended in September 2020. Hypothesized predictors included prosociality, self-efficacy in following COVID-19 containment measures, perceived susceptibility to COVID-19, perceived severity of COVID-19 and perceived social support. Baseline covariates included age, sex, history of COVID-19 infection and geographical regions. Participants who reported adhering to specific containment measures, including physical distancing, avoidance of non-essential travel and hand hygiene, were classified as adherence. The dependent variable was the category of adherence, which was constructed based on changes in adherence across the survey period and included four categories: non-adherence, less adherence, greater adherence and sustained adherence (which was designated as the reference category). RESULTS In total, 2189 adult participants (82% female, 57.2% aged 31-59 years) from East Asia (217 [9.7%]), West Asia (246 [11.2%]), North and South America (131 [6.0%]), Northern Europe (600 [27.4%]), Western Europe (322 [14.7%]), Southern Europe (433 [19.8%]), Eastern Europe (148 [6.8%]) and other regions (96 [4.4%]) were analyzed. Adjusted multinomial logistic regression analyses showed that prosociality, self-efficacy, perceived susceptibility and severity of COVID-19 were significant factors affecting adherence. Participants with greater self-efficacy at wave 1 were less likely to become non-adherence at wave 2 by 26% (adjusted odds ratio [aOR], 0.74; 95% CI, 0.71 to 0.77; P < .001), while those with greater prosociality at wave 1 were less likely to become less adherence at wave 2 by 23% (aOR, 0.77; 95% CI, 0.75 to 0.79; P = .04). CONCLUSIONS This study provides evidence that in addition to emphasizing the potential severity of COVID-19 and the potential susceptibility to contact with the virus, fostering self-efficacy in following containment strategies and prosociality appears to be a viable public health education or communication strategy to combat COVID-19.
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Affiliation(s)
- Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Demetris Lamnisos
- Department of Health Sciences, European University Cyprus, 1516, Nicosia, Cyprus
| | - Jeļena Ļubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiņš University, Riga, Latvia
| | - Giovambattista Presti
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | - Valeria Squatrito
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | - Marios Constantinou
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Nicosia, Cyprus
| | | | | | - Gökçen Aydin
- Department of Psychological Counseling and Guidance, Faculty of Education, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Francisco J Ruiz
- Department of Psychology, Fundación Universitaria Konrad Lorenz, Bogotà, Colombia
| | | | | | | | | | - Louise McHugh
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Stefan Höfer
- Department of Psychiatry II, Innsbruck Medical University, Innsbruck, Austria
| | - Adriana Baban
- Department of Psychology, Babeş-Bolyai University (UBB), Cluj-Napoca, Romania
| | - David Dias Neto
- ISPA - Instituto UniversitárioAPPsyCI - Applied Psychology Research Center Capabilities & Inclusion, Lisbon, Portugal
| | - Ana Nunes da Silva
- Faculdade de Psicologia da Universidade de Lisboa, Lisbon, Portugal
- CICPSI - Centro de Investigação Em Ciência Psicológica. Alameda da Universidade, Universidade de Lisboa, Lisbon, Portugal
| | | | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cadiz, Spain
| | | | | | | | - Dorottya Őri
- Department of Mental Health, Heim Pal National Pediatric Institute, Budapest, Hungary
| | | | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Iva Ivanović
- Clinic for Psychiatry, Clinical Center of Montenegro, Podgorica, Montenegro
| | - David Gosar
- Department of Child, Adolescent and Developmental Neurology, University Children's Hospital, University Medical Center Ljubljana, Ljubljana, Slovenia
| | - Frederick Dionne
- Département de Psychologie, Université du Québec À Trois-Rivières, Trois-Rivières, Québec, G9A 5H7, Canada
| | - Rhonda M Merwin
- Department of Psychiatry and Behavioral Science, Duke University, Durham, NC, USA
| | - Andrew T Gloster
- Division of Clinical Psychology and Intervention Science, University of Basel, 4001, Basel, Switzerland
| | - Angelos P Kassianos
- Department of Psychology, University of Cyprus, 1678, Nicosia, Cyprus
- Department of Nursing, Cyprus University of Technology, 3036, Limassol, Cyprus
| | - Maria Karekla
- Department of Psychology, University of Cyprus, 1678, Nicosia, Cyprus
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Alvarez-Galvez J, Anastasiou A, Lamnisos D, Constantinou M, Nicolaou C, Papacostas S, Vasiliou VS, McHugh L, Lubenko J, Ruiz FJ, Paez-Blarrina M, Montesinos F, Valdivia-Salas S, Merwin RM, Karekla M, Gloster AT, Kassianos AP. The impact of government actions and risk perception on the promotion of self-protective behaviors during the COVID-19 pandemic. PLoS One 2023; 18:e0284433. [PMID: 37068083 PMCID: PMC10109472 DOI: 10.1371/journal.pone.0284433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 03/23/2023] [Indexed: 04/18/2023] Open
Abstract
INTRODUCTION We aim to understand the factors that drive citizens of different countries to adhere to recommended self-protective behaviors during the COVID-19 pandemic. METHODS Survey data was obtained through the COVID-19 Impact project. We selected countries that presented a sufficiently complete time series and a statistically relevant sample for running the analysis: Cyprus, Germany, Greece, Ireland, Latvia, Spain, Switzerland, the United Kingdom, and the United States of America. To identify country-specific differences in self-protective behaviors, we used previous evidence and change-point detection analysis to establish variations across participating countries whose effect was then assessed by means of interrupted series analysis. RESULTS A high level of compliance with health and governmental authorities' recommendations were generally observed in all included countries. The level of stress decreased near the period when countries such as Cyprus, Greece or the United Kingdom relaxed their prevention behavior recommendations. However, this relaxation of behaviors did not occur in countries such as Germany, Ireland, or the United States. As observed in the change-point detection analysis, when the daily number of recorded COVID-19 cases decreased, people relaxed their protective behaviors (Cyprus, Greece, Ireland), although the opposite trend was observed in Switzerland. DISCUSSION COVID-19 self-protective behaviors were heterogeneous across countries examined. Our findings show that there is probably no single winning strategy for exiting future health crises, as similar interventions, aimed to promote self-protective behaviors, may be received differently depending on the specific population groups and on the particular geographical context in which they are implemented.
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Affiliation(s)
- Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cadiz, Spain
| | - Andreas Anastasiou
- Department of Mathematics and Statistics, University of Cyprus, Nicosia, Cyprus
| | - Demetris Lamnisos
- Department of Health Sciences, European University of Cyprus, Nicosia, Cyprus
| | | | - Christiana Nicolaou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | | | - Vasilis S Vasiliou
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, United Kingdom
| | - Louise McHugh
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Jelena Lubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradings University, Riga, Latvia
| | | | | | | | | | - Rhonda M Merwin
- Department of Psychiatry and Behavioral Science, Duke University, Durham, North Carolina, United States of America
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Andrew T Gloster
- Division of Clinical Psychology & Intervention Science, Department of Psychology, University of Basel, Basel, Switzerland
| | - Angelos P Kassianos
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
- Department of Applied Health Research, University College London, London, United Kingdom
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9
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Haller E, Lubenko J, Presti G, Squatrito V, Constantinou M, Nicolaou C, Papacostas S, Aydın G, Chong YY, Chien WT, Cheng HY, Ruiz FJ, García-Martín MB, Obando-Posada DP, Segura-Vargas MA, Vasiliou VS, McHugh L, Höfer S, Baban A, Dias Neto D, da Silva AN, Monestès JL, Alvarez-Galvez J, Paez-Blarrina M, Montesinos F, Valdivia-Salas S, Ori D, Kleszcz B, Lappalainen R, Ivanović I, Gosar D, Dionne F, Merwin RM, Karekla M, Kassianos AP, Gloster AT. To Help or Not to Help? Prosocial Behavior, Its Association With Well-Being, and Predictors of Prosocial Behavior During the Coronavirus Disease Pandemic. Front Psychol 2022; 12:775032. [PMID: 35222147 PMCID: PMC8877810 DOI: 10.3389/fpsyg.2021.775032] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 12/21/2021] [Indexed: 01/10/2023] Open
Abstract
The coronavirus disease (COVID-19) pandemic fundamentally disrupted humans’ social life and behavior. Public health measures may have inadvertently impacted how people care for each other. This study investigated prosocial behavior, its association well-being, and predictors of prosocial behavior during the first COVID-19 pandemic lockdown and sought to understand whether region-specific differences exist. Participants (N = 9,496) from eight regions clustering multiple countries around the world responded to a cross-sectional online-survey investigating the psychological consequences of the first upsurge of lockdowns in spring 2020. Prosocial behavior was reported to occur frequently. Multiple regression analyses showed that prosocial behavior was associated with better well-being consistently across regions. With regard to predictors of prosocial behavior, high levels of perceived social support were most strongly associated with prosocial behavior, followed by high levels of perceived stress, positive affect and psychological flexibility. Sociodemographic and psychosocial predictors of prosocial behavior were similar across regions.
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Affiliation(s)
- Elisa Haller
- Clinical Psychology and Intervention Science, Department of Psychology, University of Basel, Basel, Switzerland
- *Correspondence: Elisa Haller,
| | - Jelena Lubenko
- Department of Health Psychology and Pedagogy, Riga Stradiņš University, Riga, Latvia
| | - Giovambattista Presti
- Kore University Behavioral Lab, Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | - Valeria Squatrito
- Kore University Behavioral Lab, Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | - Marios Constantinou
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Nicosia, Cyprus
| | | | | | - Gökçen Aydın
- Department of Psychological Counseling and Guidance, Faculty of Education, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Francisco J. Ruiz
- Department of Psychology, Fundación Universitaria Konrad Lorenz, Bogotá, Colombia
| | | | | | | | - Vasilis S. Vasiliou
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, United Kingdom
| | - Louise McHugh
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Stefan Höfer
- Department of Medical Psychology, Innsbruck Medical University, Innsbruck, Austria
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University (UBB), Cluj-Napoca, Romania
| | - David Dias Neto
- ISPA—Instituto Universitário, APPsyCI—Applied Psychology Research Center Capabilities and Inclusion, Lisbon, Portugal
| | - Ana Nunes da Silva
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisbon, Portugal
| | | | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cadiz, Spain
| | | | | | | | - Dorottya Ori
- Department of Mental Health, Heim Pal National Pediatric Institute, Budapest, Hungary
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | - Bartosz Kleszcz
- Bartosz Kleszcz Psychotherapy and Training, Sosnowiec, Poland
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Iva Ivanović
- Department of Child Psychiatry, Institute for Children’s Diseases, Clinical Centre of Montenegro, Podgorica, Montenegro
| | - David Gosar
- Department of Child, Adolescent and Developmental Neurology, University Children’s Hospital, University Medical Center, Ljubljana, Slovenia
| | - Frederick Dionne
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Rhonda M. Merwin
- Department of Psychiatry and Behavioral Science, Duke University, Durham, CA, United States
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | | | - Andrew T. Gloster
- Clinical Psychology and Intervention Science, Department of Psychology, University of Basel, Basel, Switzerland
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10
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Kassianos AP, Georgiou A, Kyprianidou M, Lamnisos D, Ļubenko J, Presti G, Squatrito V, Constantinou M, Nicolaou C, Papacostas S, Aydin G, Chong YY, Chien WT, Cheng HY, Ruiz FJ, Garcia-Martin MB, Obando D, Segura-Vargas MA, Vasiliou VS, McHugh L, Höfer S, Baban A, Neto DD, da Silva AN, Monestès JL, Alvarez-Galvez J, Blarrina MP, Montesinos F, Salas SV, Őri D, Kleszcz B, Lappalainen R, Ivanović I, Gosar D, Dionne F, Merwin RM, Chatzittofis A, Konstantinou E, Economidou S, Gloster AT, Karekla M, Constantinidou A. Mental Health and Adherence to COVID-19 Protective Behaviors among Cancer Patients during the COVID-19 Pandemic: An International, Multinational Cross-Sectional Study. Cancers (Basel) 2021; 13:6294. [PMID: 34944913 PMCID: PMC8699048 DOI: 10.3390/cancers13246294] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 11/22/2021] [Accepted: 12/07/2021] [Indexed: 12/23/2022] Open
Abstract
A population-based cross-sectional study was conducted during the first COVID-19 wave, to examine the impact of COVID-19 on mental health using an anonymous online survey, enrolling 9565 individuals in 78 countries. The current sub-study examined the impact of the pandemic and the associated lockdown measures on the mental health, and protective behaviors of cancer patients in comparison to non-cancer participants. Furthermore, 264 participants from 30 different countries reported being cancer patients. The median age was 51.5 years, 79.9% were female, and 28% had breast cancer. Cancer participants reported higher self-efficacy to follow recommended national guidelines regarding COVID-19 protective behaviors compared to non-cancer participants (p < 0.01). They were less stressed (p < 0.01), more psychologically flexible (p < 0.01), and had higher levels of positive affect compared to non-cancer participants. Amongst cancer participants, the majority (80.3%) reported COVID-19, not their cancer, as their priority during the first wave of the pandemic and females reported higher levels of stress compared to males. In conclusion, cancer participants appeared to have handled the unpredictable nature of the first wave of the pandemic efficiently, with a positive attitude towards an unknown and otherwise frightening situation. Larger, cancer population specific and longitudinal studies are warranted to ensure adequate medical and psychological care for cancer patients.
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Affiliation(s)
- Angelos P. Kassianos
- Department of Psychology, University of Cyprus, Nicosia 2109, Cyprus; (A.P.K.); (M.K.)
- Department of Applied Health Research, University College London, London WC1E 6BT, UK
| | - Alexandros Georgiou
- Bank of Cyprus Oncology Centre, Nicosia 2006, Cyprus; (A.G.); (E.K.); (S.E.)
| | - Maria Kyprianidou
- Department of Psychology, University of Cyprus, Nicosia 2109, Cyprus; (A.P.K.); (M.K.)
| | - Demetris Lamnisos
- Department of Health Sciences, European University of Cyprus, Nicosia 2109, Cyprus;
| | - Jeļena Ļubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradins University, LV-1007 Riga, Latvia;
| | - Giovambattista Presti
- Human and Social Sciences Department, University of Enna Kore, 94100 Enna, Italy; (G.P.); (V.S.)
| | - Valeria Squatrito
- Human and Social Sciences Department, University of Enna Kore, 94100 Enna, Italy; (G.P.); (V.S.)
| | | | - Christiana Nicolaou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol 3041, Cyprus;
| | | | - Gökçen Aydin
- Department of Psychological Counseling and Guidance, Hasan Kalyoncu University, Gaziantep 27010, Turkey;
| | - Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; (Y.Y.C.); (W.T.C.); (H.Y.C.)
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; (Y.Y.C.); (W.T.C.); (H.Y.C.)
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; (Y.Y.C.); (W.T.C.); (H.Y.C.)
| | - Francisco J. Ruiz
- Department of Psychology, Universidad de La Sabana, Chia 140013, Colombia; (F.J.R.); (M.B.G.-M.); (D.O.); (M.A.S.-V.)
| | - Maria B. Garcia-Martin
- Department of Psychology, Universidad de La Sabana, Chia 140013, Colombia; (F.J.R.); (M.B.G.-M.); (D.O.); (M.A.S.-V.)
| | - Diana Obando
- Department of Psychology, Universidad de La Sabana, Chia 140013, Colombia; (F.J.R.); (M.B.G.-M.); (D.O.); (M.A.S.-V.)
| | - Miguel A. Segura-Vargas
- Department of Psychology, Universidad de La Sabana, Chia 140013, Colombia; (F.J.R.); (M.B.G.-M.); (D.O.); (M.A.S.-V.)
| | - Vasilis S. Vasiliou
- School of Applied Psychology, University College Cork (UCC), T23 XE10 Cork, Ireland;
| | - Louise McHugh
- School of Psychology, University College Dublin, D04 V1W8 Dublin 4, Ireland;
| | - Stefan Höfer
- Department of Medical Psychology, Medical University Innsbruck, 6020 Innsbruck, Austria;
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, 400015 Cluj-Napoca, Romania;
| | - David Dias Neto
- ISPA—Instituto Universitário, 1149-041 Lisboa, Portugal;
- Applied Psychology Research Center Capabilities & Inclusion, 1149-041 Lisbon, Portugal
| | - Ana Nunes da Silva
- Department of Psychology, University of Lisbon, 1649-013 Lisbon, Portugal;
| | | | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, 11009 Cadiz, Spain;
| | | | - Francisco Montesinos
- Instituto ACT, 28049 Madrid, Spain; (M.P.B.); (F.M.)
- Department of Psychology, Universidad Europea de Madrid, 28049 Madrid, Spain
| | | | - Dorottya Őri
- Department of Mental Health, Heim Pal National Pediatric Institute, H-1089 Budapest, Hungary;
- Institute of Behavioral Sciences, Semmelweis University, H-1089 Budapest, Hungary
| | | | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, 40014 Jyväskylä, Finland;
| | - Iva Ivanović
- Department of Child Psychiatry, Institute for Children’s Diseases, Clinical Centre of Montenegro, 81000 Podgorica, Montenegro;
| | - David Gosar
- Department of Child, Adolescent and Developmental Neurology, University Children’s Hospital Ljubljana, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia;
| | - Frederick Dionne
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC G8Z 4M3, Canada;
| | - Rhonda M. Merwin
- Department of Psychiatry and Behavioral Science, Duke University, Durham, NC 27708, USA;
| | | | | | - Sofia Economidou
- Bank of Cyprus Oncology Centre, Nicosia 2006, Cyprus; (A.G.); (E.K.); (S.E.)
| | - Andrew T. Gloster
- Division of Clinical Psychology & Intervention Science, Department of Psychology, University of Basel, 4055 Basel, Switzerland;
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia 2109, Cyprus; (A.P.K.); (M.K.)
| | - Anastasia Constantinidou
- Bank of Cyprus Oncology Centre, Nicosia 2006, Cyprus; (A.G.); (E.K.); (S.E.)
- Medical School, University of Cyprus, Nicosia 1678, Cyprus;
- Cyprus Cancer Research Institute, Nicosia 2109, Cyprus
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11
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Nicolaou C, Menikou J, Lamnisos D, Lubenko J, Presti G, Squatrito V, Constantinou M, Papacostas S, Aydın G, Chong YY, Chien WT, Cheng HY, Ruiz FJ, Segura-Vargas MA, Garcia-Martin MB, Obando-Posada DP, Vasiliou VS, McHugh L, Höfer S, Baban A, Neto DD, da Silva AN, Monestès JL, Alvarez-Galvez J, Paez-Blarrina M, Montesinos F, Valdivia-Salas S, Ori D, Kleszcz B, Lappalainen R, Ivanović I, Gosar D, Dionne F, Merwin RM, Kassianos AP, Karekla M, Gloster AT. Mental Health Status of Healthcare Workers During the COVID-19 Outbreak. European Journal of Psychology Open 2021. [DOI: 10.1024/2673-8627/a000010] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Abstract. Background: The COVID-19 pandemic is a massive health crisis that has exerted enormous physical and psychological pressure. Mental healthcare for healthcare workers (HCWs) should receive serious consideration. This study served to determine the mental-health outcomes of 1,556 HCWs from 45 countries who participated in the COVID-19 IMPACT project, and to examine the predictors of the outcomes during the first pandemic wave. Methods: Outcomes assessed were self-reported perceived stress, depression symptom, and sleep changes. The predictors examined included sociodemographic factors and perceived social support. Results: The results demonstrated that half of the HCWs had moderate levels of perceived stress and symptoms of depression. Half of the HCWs ( n = 800, 51.4%) had similar sleeping patterns since the pandemic started, and one in four slept more or slept less. HCWs reported less perceived stress and depression symptoms and higher levels of perceived social support than the general population who participated in the same project. Predictors associated with higher perceived stress and symptoms of depression among HCWs included female sex, not having children, living with parents, lower educational level, and lower social support. Discussion: The need for establishing ways to mitigate mental-health risks and adjusting psychological interventions and support for HCWs seems to be significant as the pandemic continues.
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Affiliation(s)
- Christiana Nicolaou
- Department of Nursing, School of Health Sciences, Cyprus University of Technology, Limassol, Cyprus
| | - Joanna Menikou
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Demetris Lamnisos
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Jelena Lubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiņš University, Riga, Latvia
| | - Giovambattista Presti
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, Italy
| | - Valeria Squatrito
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, Italy
| | - Marios Constantinou
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Cyprus
| | | | - Gokcen Aydın
- Department of Psychological Counseling and Guidance, Faculty of Education, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Francisco J. Ruiz
- Faculty of Psychology, Fundación Universitaria Konrad Lorenz, Bogotá, Colombia
| | | | | | | | | | - Louise McHugh
- School of Psychology, University College Dublin, Ireland
| | - Stefan Höfer
- Department of Medical Psychology, Medical University Innsbruck, Austria
| | - Adriana Baban
- Department of Psychology, Babeş-Bolyai University (UBB), Cluj-Napoca, Romania
| | - David Dias Neto
- ISPA – Instituto Universitário; APPsyCI – Applied Psychology Research Center Capabilities & Inclusion, Lisboa, Portugal
| | - Ana Nunes da Silva
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, Lisboa, Portugal
| | | | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Spain
| | | | | | | | - Dorottya Ori
- Department of Mental Health, Heim Pal National Pediatric Institute, Budapest, Hungary
| | | | | | - Iva Ivanović
- Clinical Centre of Montenegro, Institute for Children’s diseases, Department for Child Psychiatry, Podgorica, Montenegro
| | - David Gosar
- Ljubljana University Medical Centre, Ljubljana, Slovenia
| | - Frederick Dionne
- Department of Psychology, Université du Québec à Trois-Rivières, Canada
| | - Rhonda M. Merwin
- Department of Psychiatry and Behavioral Science, Duke University, Durham, NC, USA
| | - Angelos P. Kassianos
- Department of Applied Health Research, University College London, United Kingdom
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Andrew T. Gloster
- Division of Clinical Psychology & Intervention Science, Department of Psychology, University of Basel, Switzerland
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12
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Vasiliou VS, Karademas EC, Christou Y, Papacostas S, Karekla M. Mechanisms of change in acceptance and commitment therapy for primary headaches. Eur J Pain 2021; 26:167-180. [PMID: 34375444 DOI: 10.1002/ejp.1851] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 07/31/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Despite the demonstrated effectiveness of behavioural headache interventions, it is not yet known which intervention processes account for treatment responses. Acceptance and commitment therapy (ACT), an emerging behavioural intervention for headaches, proposes psychological flexibility (PF) processes as the mechanisms via which intervention change occurs. This is the first study examining these processes of change variables on headache-related disability and quality of life (treatment outcome). METHODS Data originated from a Randomized Clinical Trial evaluating the efficacy of ACT for primary headaches. Ninety-four individuals with primary headaches (M = 43 y; 84% females; M headache frequency/month = 9.30) were randomized to either an ACT-based or a Wait-list control group (N = 47 in each). Participants completed questionnaires related to their headache experiences and PF processes at pre- (T1), post-treatment (T2), and 3-month follow-up (T3). RESULTS Following a bootstrapped cross product of coefficients approach, results demonstrated mediating effects of headache acceptance, cognitive defusion, avoidance of headache, and mindfulness in the ACT group compared to control on parameters of headache-related disability and quality of life at post and 3-month follow-ups. CONCLUSIONS These findings demonstrate that changes in certain PF processes lower disability and improve quality of life in headache sufferers, supporting that ACT works via its proposed mechanisms of change. Interventions for headache management may be optimized if they target increases in headache acceptance, defusion from thoughts, and mindfulness. SIGNIFICANCE Psychological flexibility (PF) guides the ACT approach, an emerging behavioral headache intervention that focuses on optimizing head pain adjustment via flexible responses to pain. It targets at increasing daily functioning rather than preventing or controlling headache episodes. Pain acceptance, cognitive defusion, and mindfulness act as processes of functional change in ACT, lowering disability and increasing daily functioning and quality of life. These components can upgrade the established effectiveness of behavioral headache interventions with personalized, modularized therapeutic targets that can help headache sufferers re-establish optimal daily functioning even in fluctuating and persistent headache episodes. TRIAL REGISTRATION clinical trials.gov registry (NCT02734992).
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Affiliation(s)
- Vasilis S Vasiliou
- Department of Applied Psychology, University College Cork, Cork, Ireland
| | | | - Yiolanda Christou
- Neurology Clinic B', The Cyprus Institute of Neurology and Genetics, Egkomi, Cyprus
| | - Savvas Papacostas
- Neurology Clinic B', The Cyprus Institute of Neurology and Genetics, Egkomi, Cyprus
| | - Maria Karekla
- Department of Psychology, ACTHealthy Laboratory, University of Cyprus, Nicosia, Cyprus
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13
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Zacharia M, Ioannou M, Theofanous A, Vasiliou VS, Karekla M. Does Cognitive Fusion show up similarly across two behavioral health samples? Psychometric properties and invariance of the Greek–Cognitive Fusion Questionnaire (G-CFQ). Journal of Contextual Behavioral Science 2021. [DOI: 10.1016/j.jcbs.2021.01.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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14
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Vasiliou VS, Dockray S, Dick S, Davoren MP, Heavin C, Linehan C, Byrne M. Reducing drug-use harms among higher education students: MyUSE contextual-behaviour change digital intervention development using the Behaviour Change Wheel. Harm Reduct J 2021; 18:56. [PMID: 34011370 PMCID: PMC8136195 DOI: 10.1186/s12954-021-00491-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/31/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Digital harm-reduction interventions typically focus on people with severe drug-use problems, yet these interventions have moderate effectiveness on drug-users with lower levels of risk of harm. The difference in effectiveness may be explained by differences in behavioural patterns between the two groupings. Harnessing behavioural theories to understand what is at the core of drug-use behaviours and mapping the content of new interventions, may improve upon the effectiveness of interventions for lower-risk drug-users. To the best of our knowledge, this is the first study to systematically apply the Behaviour Change Wheel (BCW) approach to understand the components, influencing capabilities, opportunities, and motivations (COM-B) of higher education students to change their drug-use behaviors. It is also the first study which identifies specific patterns of behaviours that are more responsive to harm reduction practices through the use of the Theoretical Domain Framework (TDF). METHODS We employed an explanatory sequential mix-method design. We first conducted an on-line survey and a Delphi exercise to understand the factors influencing COM-B components of higher education students to change their drug-use. Subsequently, we mapped all evidence onto the COM-B components and the TDF domains to identify clusters of behaviours to target for change, using a pattern-based discourse analysis. Finally, a series of multidisciplinary group meetings identified the intervention functions-the means by which the intervention change targeted behaviours and the Behavioural Change Techniques (BCTs) involved using the behaviour change technique taxonomy (v.1). RESULTS Twenty-nine BCTs relevant to harm-reduction practices were identified and mapped across five intervention functions (education, modelling, persuasion, incentivization, and training) and five policy categories (communication/marketing, guidelines, regulation, service provision, and environmental/social planning). These BCTs were distributed across eight identified saturated clusters of behaviours MyUSE intervention attempts to change. CONCLUSIONS The BCTs, identified, will inform the development of a digitally delivered behaviour change intervention that focuses on increasing mindful decision-making with respect to drug-use and promotes alternatives to drug-use activities. The findings can also inform implementation scientists in applying context-specific harm-reduction practices in higher education. We present examples of how the eight identified clusters of target behaviours are mapped across the COM-B components and the TDF, along with suggestions of implementation practices for harm reduction at student population level.
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Affiliation(s)
- Vasilis S. Vasiliou
- School of Applied Psychology, University College Cork, N Mall, Kilbarry Enterprise Centre, Cork Enterprise Centre, Cork, Ireland
| | - Samantha Dockray
- School of Applied Psychology, University College Cork, N Mall, Kilbarry Enterprise Centre, Cork Enterprise Centre, Cork, Ireland
| | - Samantha Dick
- School of Public Health, University College Cork, Fourth Floor, Western Gateway Building, Cork, Ireland
| | - Martin P. Davoren
- School of Public Health, University College Cork, Fourth Floor, Western Gateway Building, Cork, Ireland
- Cork Sexual Health Centre, 16 Peter’s Street, Centre, Cork, Ireland
| | - Ciara Heavin
- Cork University Business School, University College Cork, West Wing, Main Quadrangle, Cork, Ireland
| | - Conor Linehan
- School of Applied Psychology, University College Cork, N Mall, Kilbarry Enterprise Centre, Cork Enterprise Centre, Cork, Ireland
| | - Michael Byrne
- Student Health Department, University College Cork, Ardpatrick College Road, Cork, Ireland
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15
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Chong YY, Chien WT, Cheng HY, Lamnisos D, Ļubenko J, Presti G, Squatrito V, Constantinou M, Nicolaou C, Papacostas S, Aydin G, Ruiz FJ, Garcia-Martin MB, Obando-Posada DP, Segura-Vargas MA, Vasiliou VS, McHugh L, Höfer S, Baban A, Neto DD, da Silva AN, Monestès JL, Alvarez-Galvez J, Blarrina MP, Montesinos F, Salas SV, Őri D, Kleszcz B, Lappalainen R, Ivanović I, Gosar D, Dionne F, Merwin RM, Gloster AT, Karekla M, Kassianos AP. Patterns of Psychological Responses among the Public during the Early Phase of COVID-19: A Cross-Regional Analysis. Int J Environ Res Public Health 2021; 18:4143. [PMID: 33919888 PMCID: PMC8070933 DOI: 10.3390/ijerph18084143] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Revised: 04/05/2021] [Accepted: 04/08/2021] [Indexed: 12/16/2022]
Abstract
This study aimed to compare the mediation of psychological flexibility, prosociality and coping in the impacts of illness perceptions toward COVID-19 on mental health among seven regions. Convenience sampled online survey was conducted between April and June 2020 from 9130 citizens in 21 countries. Illness perceptions toward COVID-19, psychological flexibility, prosociality, coping and mental health, socio-demographics, lockdown-related variables and COVID-19 status were assessed. Results showed that psychological flexibility was the only significant mediator in the relationship between illness perceptions toward COVID-19 and mental health across all regions (all ps = 0.001-0.021). Seeking social support was the significant mediator across subgroups (all ps range = <0.001-0.005) except from the Hong Kong sample (p = 0.06) and the North and South American sample (p = 0.53). No mediation was found for problem-solving (except from the Northern European sample, p = 0.009). Prosociality was the significant mediator in the Hong Kong sample (p = 0.016) and the Eastern European sample (p = 0.008). These findings indicate that fostering psychological flexibility may help to mitigate the adverse mental impacts of COVID-19 across regions. Roles of seeking social support, problem-solving and prosociality vary across regions.
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Affiliation(s)
- Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (W.T.C.); (H.Y.C.)
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (W.T.C.); (H.Y.C.)
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China; (W.T.C.); (H.Y.C.)
| | - Demetris Lamnisos
- Department of Health Sciences, European University Cyprus, 1516 Nicosia, Cyprus;
| | - Jeļena Ļubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiņš University, LV-1007 Riga, Latvia;
| | - Giovambattista Presti
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (G.P.); (V.S.)
| | - Valeria Squatrito
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, 94100 Enna, Italy; (G.P.); (V.S.)
| | - Marios Constantinou
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, 2417 Nicosia, Cyprus;
| | - Christiana Nicolaou
- Department of Nursing, Cyprus University of Technology, 3036 Limassol, Cyprus;
| | | | - Gökçen Aydin
- Department of Psychological Counseling and Guidance, Faculty of Education, Hasan Kalyoncu University, Gaziantep 27010, Turkey;
| | - Francisco J. Ruiz
- Department of Psychology, Fundación Universitaria Konrad Lorenz, Bogotà 110231, Colombia; (F.J.R.); (M.A.S.-V.)
| | - Maria B. Garcia-Martin
- Faculty of Psychology, University of La Sabana, Chía 53753, Colombia; (M.B.G.-M.); (D.P.O.-P.)
| | - Diana P. Obando-Posada
- Faculty of Psychology, University of La Sabana, Chía 53753, Colombia; (M.B.G.-M.); (D.P.O.-P.)
| | - Miguel A. Segura-Vargas
- Department of Psychology, Fundación Universitaria Konrad Lorenz, Bogotà 110231, Colombia; (F.J.R.); (M.A.S.-V.)
| | - Vasilis S. Vasiliou
- School of Applied Psychology, University College Cork, T12 YN60 Cork, Ireland;
| | - Louise McHugh
- School of Psychology, University College Dublin, D04 V1W8 Dublin, Ireland;
| | - Stefan Höfer
- Department of Medical Psychology, Innsbruck Medical University, 6020 Innsbruck, Austria;
| | - Adriana Baban
- Department of Psychology, Babeş-Bolyai University (UBB), 400095 Cluj-Napoca, Romania;
| | - David Dias Neto
- ISPA—Instituto Universitário, APPsyCI—Applied Psychology Research Center Capabilities & Inclusion, 1149-041 Lisbon, Portugal;
| | - Ana Nunes da Silva
- Faculdade de Psicologia, Alameda da Universidade, Universidade de Lisboa, 1649-013 Lisbon, Portugal;
| | | | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, 11003 Cadiz, Spain;
| | | | | | | | - Dorottya Őri
- Heim Pal National Pediatric Institute, Department of Mental Health, 1089 Budapest, Hungary;
| | - Bartosz Kleszcz
- Bartosz Kleszcz Psychotherapy and Training, ul. Aleja Zwycięstwa 31/8, 41-200 Sosnowiec, Poland;
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, FI-40014 Jyväskylä, Finland;
| | - Iva Ivanović
- Clinic for Psychiatry, Clinical Center of Montenegro, 81110 Podgorica, Montenegro;
| | - David Gosar
- Department of Child, Adolescent and Developmental Neurology, University Children’s Hospital, University Medical Center, 1000 Ljubljana, Slovenia;
| | - Frederick Dionne
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada;
| | - Rhonda M. Merwin
- Department of Psychiatry and Behavioral Science, Duke University, Durham, NC 27708, USA;
| | - Andrew T. Gloster
- Division of Clinical Psychology and Intervention Science, University of Basel, 4001 Basel, Switzerland;
| | - Maria Karekla
- Department of Psychology, University of Cyprus, 1678 Nicosia, Cyprus; (M.K.); (A.P.K.)
| | - Angelos P. Kassianos
- Department of Psychology, University of Cyprus, 1678 Nicosia, Cyprus; (M.K.); (A.P.K.)
- Department of Applied Health Research, University College London, London WC1E 6BT, UK
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16
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Dias Neto D, Nunes da Silva A, Roberto MS, Lubenko J, Constantinou M, Nicolaou C, Lamnisos D, Papacostas S, Höfer S, Presti G, Squatrito V, Vasiliou VS, McHugh L, Monestès JL, Baban A, Alvarez-Galvez J, Paez-Blarrina M, Montesinos F, Valdivia-Salas S, Ori D, Lappalainen R, Kleszcz B, Gloster A, Karekla M, Kassianos AP. Illness Perceptions of COVID-19 in Europe: Predictors, Impacts and Temporal Evolution. Front Psychol 2021; 12:640955. [PMID: 33935893 PMCID: PMC8079952 DOI: 10.3389/fpsyg.2021.640955] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 03/12/2021] [Indexed: 12/23/2022] Open
Abstract
Objective: Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impacts of IP on perceived stress and preventive behaviors. Methods: This was a time-series-cross-section study of 7,032 participants from 16 European countries using multilevel modeling from April to June 2020. IP were measured with the Brief Illness Perception Questionnaire. Temporal patterns were observed considering the date of participation and the date recoded to account the epidemiological evolution of each country. The outcomes considered were perceived stress and COVID-19 preventive behaviors. Results: There were significant trends, over time, for several IP, suggesting a small decrease in negativity in the perception of COVID-19 in the community. Age, gender, and education level related to some, but not all, IP. Considering the self-regulation model, perceptions consistently predicted general stress and were less consistently related to preventive behaviors. Country showed no effect in the predictive model, suggesting that national differences may have little relevance for IP, in this context. Conclusion: The present study provides a comprehensive picture of COVID-19 IP in Europe in an early stage of the pandemic. The results shed light on the process of IP formation with implications for health-related outcomes and their evolution.
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Affiliation(s)
- David Dias Neto
- ISPA - Instituto Universitário, Lisboa, Portugal.,Applied Psychology Research Center Capabilities & Inclusion, Lisboa, Portugal
| | | | | | - Jelena Lubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiṇš University, Riga, Latvia
| | - Marios Constantinou
- Department of Social Sciences (Cyprus), School of Humanities and Social Sciences, University of Cyprus, Nicosia, Cyprus
| | - Christiana Nicolaou
- Department of Nursing (Cyprus), Cyprus University of Technology, Limassol, Cyprus
| | - Demetris Lamnisos
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Savvas Papacostas
- The Cyprus Institute of Neurology and Genetics, The University of Nicosia Medical School, Nicosia, Cyprus
| | - Stefan Höfer
- Medical University Innsbruck, Innsbruck, Austria
| | - Giovambattista Presti
- Department of Human and Social Sciences, Kore University Behavioral Lab (KUBeLab), Kore University of Enna, Enna, Italy
| | - Valeria Squatrito
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | | | - Louise McHugh
- School of Psychology (Ireland), University College Dublin, Dublin, Ireland
| | | | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
| | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cádiz, Spain
| | | | | | | | - Dorottya Ori
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | | | - Andrew Gloster
- Division of Clinical Psychology & Intervention Science, Department of Psychology, University of Basel, Basel, Switzerland
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
| | - Angelos P Kassianos
- Department of Psychology, University of Cyprus, Nicosia, Cyprus.,Department of Applied Health Research, University College London (UCL), London, United Kingdom
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17
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Gloster AT, Lamnisos D, Lubenko J, Presti G, Squatrito V, Constantinou M, Nicolaou C, Papacostas S, Aydın G, Chong YY, Chien WT, Cheng HY, Ruiz FJ, Garcia-Martin MB, Obando-Posada DP, Segura-Vargas MA, Vasiliou VS, McHugh L, Höfer S, Baban A, Dias Neto D, Nunes da Silva A, Monestès JL, Alvarez-Galvez J, Paez-Blarrina M, Montesinos F, Valdivia-Salas S, Ori D, Kleszcz B, Lappalainen R, Ivanović I, Gosar D, Dionne F, Merwin RM, Kassianos AP, Karekla M. Impact of COVID-19 pandemic on mental health: An international study. PLoS One 2020; 15:e0244809. [PMID: 33382859 PMCID: PMC7774914 DOI: 10.1371/journal.pone.0244809 10.1371/journal.pone.0244809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic triggered vast governmental lockdowns. The impact of these lockdowns on mental health is inadequately understood. On the one hand such drastic changes in daily routines could be detrimental to mental health. On the other hand, it might not be experienced negatively, especially because the entire population was affected. METHODS The aim of this study was to determine mental health outcomes during pandemic induced lockdowns and to examine known predictors of mental health outcomes. We therefore surveyed n = 9,565 people from 78 countries and 18 languages. Outcomes assessed were stress, depression, affect, and wellbeing. Predictors included country, sociodemographic factors, lockdown characteristics, social factors, and psychological factors. RESULTS Results indicated that on average about 10% of the sample was languishing from low levels of mental health and about 50% had only moderate mental health. Importantly, three consistent predictors of mental health emerged: social support, education level, and psychologically flexible (vs. rigid) responding. Poorer outcomes were most strongly predicted by a worsening of finances and not having access to basic supplies. CONCLUSIONS These results suggest that on whole, respondents were moderately mentally healthy at the time of a population-wide lockdown. The highest level of mental health difficulties were found in approximately 10% of the population. Findings suggest that public health initiatives should target people without social support and those whose finances worsen as a result of the lockdown. Interventions that promote psychological flexibility may mitigate the impact of the pandemic.
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Affiliation(s)
- Andrew T. Gloster
- Division of Clinical Psychology & Intervention Science, Department of Psychology, University of Basel, Basel, Switzerland
- * E-mail:
| | - Demetris Lamnisos
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Jelena Lubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiņš University, Riga, Latvia
| | - Giovambattista Presti
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | - Valeria Squatrito
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | - Marios Constantinou
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Nicosia, Cyprus
| | | | | | - Gökçen Aydın
- Department of Psychological Counseling and Guidance, Faculty of Education, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Francisco J. Ruiz
- Department of Psychology, Fundación Universitaria Konrad Lorenz, Bogotà, Columbia
| | | | | | | | | | - Louise McHugh
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Stefan Höfer
- Medical University Innsbruck, Innsbruck, Austria
| | - Adriana Baban
- Department of Psychology, Babeş-Bolyai University (UBB), Cluj-Napoca, Romania
| | - David Dias Neto
- Instituto Superior de Psicologia Aplicada (ISPA), Instituto Universitário; APPsyCI—Applied Psychology Research Center Capabilities & Inclusion, Lisboa, Portugal
| | - Ana Nunes da Silva
- Faculdade de Psicologia, Alameda da Universidade, Universidade de Lisboa, Lisboa, Portugal
| | | | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cadiz, Spain
| | | | | | | | - Dorottya Ori
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | | | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Iva Ivanović
- Clinic for Psychiatry, Clinical Center of Montenegro, Podgorica, Montenegro
| | - David Gosar
- Ljubljana University Medical Centre, Ljubljana, Slovania
| | - Frederick Dionne
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Rhonda M. Merwin
- Department of Psychiatry and Behavioral Science, Duke University, Durham, North Carolina, United States of America
| | | | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
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18
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Gloster AT, Lamnisos D, Lubenko J, Presti G, Squatrito V, Constantinou M, Nicolaou C, Papacostas S, Aydın G, Chong YY, Chien WT, Cheng HY, Ruiz FJ, Garcia-Martin MB, Obando-Posada DP, Segura-Vargas MA, Vasiliou VS, McHugh L, Höfer S, Baban A, Dias Neto D, Nunes da Silva A, Monestès JL, Alvarez-Galvez J, Paez-Blarrina M, Montesinos F, Valdivia-Salas S, Ori D, Kleszcz B, Lappalainen R, Ivanović I, Gosar D, Dionne F, Merwin RM, Kassianos AP, Karekla M. Impact of COVID-19 pandemic on mental health: An international study. PLoS One 2020; 15:e0244809. [PMID: 33382859 PMCID: PMC7774914 DOI: 10.1371/journal.pone.0244809] [Citation(s) in RCA: 266] [Impact Index Per Article: 66.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 12/16/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic triggered vast governmental lockdowns. The impact of these lockdowns on mental health is inadequately understood. On the one hand such drastic changes in daily routines could be detrimental to mental health. On the other hand, it might not be experienced negatively, especially because the entire population was affected. METHODS The aim of this study was to determine mental health outcomes during pandemic induced lockdowns and to examine known predictors of mental health outcomes. We therefore surveyed n = 9,565 people from 78 countries and 18 languages. Outcomes assessed were stress, depression, affect, and wellbeing. Predictors included country, sociodemographic factors, lockdown characteristics, social factors, and psychological factors. RESULTS Results indicated that on average about 10% of the sample was languishing from low levels of mental health and about 50% had only moderate mental health. Importantly, three consistent predictors of mental health emerged: social support, education level, and psychologically flexible (vs. rigid) responding. Poorer outcomes were most strongly predicted by a worsening of finances and not having access to basic supplies. CONCLUSIONS These results suggest that on whole, respondents were moderately mentally healthy at the time of a population-wide lockdown. The highest level of mental health difficulties were found in approximately 10% of the population. Findings suggest that public health initiatives should target people without social support and those whose finances worsen as a result of the lockdown. Interventions that promote psychological flexibility may mitigate the impact of the pandemic.
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Affiliation(s)
- Andrew T. Gloster
- Division of Clinical Psychology & Intervention Science, Department of Psychology, University of Basel, Basel, Switzerland
| | - Demetris Lamnisos
- Department of Health Sciences, European University Cyprus, Nicosia, Cyprus
| | - Jelena Lubenko
- Psychological Laboratory, Faculty of Public Health and Social Welfare, Riga Stradiņš University, Riga, Latvia
| | - Giovambattista Presti
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | - Valeria Squatrito
- Kore University Behavioral Lab (KUBeLab), Faculty of Human and Social Sciences, Kore University of Enna, Enna, Italy
| | - Marios Constantinou
- Department of Social Sciences, School of Humanities and Social Sciences, University of Nicosia, Nicosia, Cyprus
| | | | | | - Gökçen Aydın
- Department of Psychological Counseling and Guidance, Faculty of Education, Hasan Kalyoncu University, Gaziantep, Turkey
| | - Yuen Yu Chong
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Wai Tong Chien
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Ho Yu Cheng
- The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Francisco J. Ruiz
- Department of Psychology, Fundación Universitaria Konrad Lorenz, Bogotà, Columbia
| | | | | | | | | | - Louise McHugh
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Stefan Höfer
- Medical University Innsbruck, Innsbruck, Austria
| | - Adriana Baban
- Department of Psychology, Babeş-Bolyai University (UBB), Cluj-Napoca, Romania
| | - David Dias Neto
- Instituto Superior de Psicologia Aplicada (ISPA), Instituto Universitário; APPsyCI—Applied Psychology Research Center Capabilities & Inclusion, Lisboa, Portugal
| | - Ana Nunes da Silva
- Faculdade de Psicologia, Alameda da Universidade, Universidade de Lisboa, Lisboa, Portugal
| | | | - Javier Alvarez-Galvez
- Department of Biomedicine, Biotechnology and Public Health, University of Cadiz, Cadiz, Spain
| | | | | | | | - Dorottya Ori
- Vadaskert Child and Adolescent Psychiatric Hospital, Budapest, Hungary
| | | | - Raimo Lappalainen
- Department of Psychology, University of Jyväskylä, Jyväskylä, Finland
| | - Iva Ivanović
- Clinic for Psychiatry, Clinical Center of Montenegro, Podgorica, Montenegro
| | - David Gosar
- Ljubljana University Medical Centre, Ljubljana, Slovania
| | - Frederick Dionne
- Département de Psychologie, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Rhonda M. Merwin
- Department of Psychiatry and Behavioral Science, Duke University, Durham, North Carolina, United States of America
| | | | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
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19
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Dick S, Vasiliou VS, Davoren MP, Dockray S, Heavin C, Linehan C, Byrne M. A Digital Substance-Use Harm Reduction Intervention for Students in Higher Education (MyUSE): Protocol for Project Development. JMIR Res Protoc 2020; 9:e17829. [PMID: 32851980 PMCID: PMC7484779 DOI: 10.2196/17829] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Revised: 05/08/2020] [Accepted: 05/27/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Digital interventions have been identified as a possible tool for reducing the harm caused by illicit drug use among students attending higher education (ie, college students). However, the success of interventions in this area has been hampered by a lack of user involvement and behavior change theory in their design. The My Understanding of Substance use Experiences (MyUSE) project combines a rigorous user-centered design (UCD) methodology and a robust behavioral change framework to develop a digitally delivered harm reduction intervention for illicit drug use among students in higher education. OBJECTIVE This project aims to design and develop a digital intervention that targets drug use-related harm among students in higher education. METHODS The MyUSE project will take place over 3 phases. The first phase was exploratory in nature, involving 3 systematic reviews, a large survey, and student workshops to gather a comprehensive evidence base to guide the project. The second phase is the development stage of the project, involving the use of the Behavior Change Wheel theoretical framework to determine the behavior change techniques of the intervention and the use of the UCD methodology to guide the development of the digital intervention. The third phase is the evaluation stage, whereby the intervention will undergo a 5-stage evaluation process to comprehensively evaluate its impacts. RESULTS The exploratory phase 1 of the MyUSE project was completed in December 2018. Phase 2 is currently underway, and phase 3 is due to begin in September 2020. CONCLUSIONS Higher education institutions (HEIs) are ideally placed to intervene and support students in the area of illicit drug use but are constrained by limited resources. Current digital interventions in this area are sparse and have several weaknesses. The MyUSE project combines a UCD approach with a robust behavior change framework to develop a digitally delivered intervention that is economically viable, effective in changing behavior, usable and acceptable to students, and able to sustain long-term implementation in HEIs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/17829.
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Affiliation(s)
- Samantha Dick
- School of Public Health, University College Cork, Cork, Ireland
| | | | - Martin P Davoren
- School of Public Health, University College Cork, Cork, Ireland
- Sexual Health Centre, Cork, Ireland
| | - Samantha Dockray
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Ciara Heavin
- Health Information Systems Research Centre, Cork University Business School, University College Cork, Cork, Ireland
| | - Conor Linehan
- School of Applied Psychology, University College Cork, Cork, Ireland
| | - Michael Byrne
- Student Health Department, University College Cork, Cork, Ireland
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20
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Vasiliou VS, Michaelides MP, Kasinopoulos O, Karekla M. Psychological Inflexibility in Pain Scale: Greek adaptation, psychometric properties, and invariance testing across three pain samples. Psychol Assess 2019; 31:895-904. [PMID: 30896210 DOI: 10.1037/pas0000705] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The success of acceptance and commitment therapy (ACT) in improving life functioning among chronic pain patients is followed by an interest in investigating mechanisms of action via which it unfolds and validating measures to assess its key constructs. The Psychological Inflexibility in Pain Scale (PIPS-II) assesses pain avoidance and fusion. This is the first study to examine the measurement models of this instrument's Greek adaptation (G-PIPS-II) in patients with different pain localizations (i.e., chronic and headache). A community heterogeneous sample of chronic pain sufferers (N = 156) and two clinical samples comprising treatment-seeking chronic pain patients (N = 149) and treatment-seeking headache patients (N = 89) were recruited from nongovernmental chronic pain support organizations and primary care centers. Exploratory and confirmatory factor analyses demonstrated an acceptable model fit of the G-PIPS-II yielding a two-factor model: avoidance (8 items) and cognitive fusion (4 items). Moderate to high correlations with theoretically related measures supported its construct validity; reliability was high for the total scale and the Avoidance subscale and medium for the Cognitive Fusion subscale. Weak measurement invariance was established across the three pain groups, suggesting that regardless of pain localization, chronic pain and headache patients understand the two latent factors in a similar way. G-PIPS-II is a psychometrically sound instrument assessing two constructs targeted for change within ACT and is deemed a conceptually meaningful scale with items having similar meanings for patients with different pain localization. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Maria Karekla
- Department of Psychology, ACTHealthy Laboratory, University of Cyprus
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21
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Vasiliou VS, Karekla M, Michaelides MP, Kasinopoulos O. Construct validity of the G-CPAQ and its mediating role in pain interference and adjustment. Psychol Assess 2018; 30:220-230. [DOI: 10.1037/pas0000467] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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22
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Karademas EC, Karekla M, Flouri M, Vasiliou VS, Kasinopoulos O, Papacostas SS. The impact of experiential avoidance on the relations between illness representations, pain catastrophising and pain interference in chronic pain. Psychol Health 2017; 32:1469-1484. [DOI: 10.1080/08870446.2017.1346193] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
| | - Maria Karekla
- Department of Psychology, University of Cyprus, Nicosia, Cyprus
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