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Changes in Psychic Life and Psychological Treatments during COVID-19 Pandemic

Special Issue Editors


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Guest Editor
Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy
Interests: therapeutic assessment; relational psychopathology models; epistemology of psychotherapy; psychotherapy process; comprehensive primary health care

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Guest Editor
1. ICREA - Catalan institution for Research and Advanced Studies, 08010 Barcelona, Spain
2. Medical Anthropology Research Center, DAFITS-Universitat Rovira i Virgili Av. Catalunya 35, ES-43002 Tarragona, Spain
Interests: medical anthropology; global mental health; medical humanities; neuroscience and society; sociology of diagnosis; global social medicine

E-Mail Website
Guest Editor
Department of Human and Social Sciences, University of Bergamo, 24129 Bergamo, Italy
Interests: violence; systemic therapy; family therapy; epistemology of complexity; epistemology of psychotherapy

Special Issue Information

Dear Colleagues, 

It has been almost two years since the COVID-19 outbreak changed the way humanity lives. The transformations in the way we think, feel, and relate have been and continue to be as many and as significant as those that have occurred in other areas of human life. We can say that, as human beings, we are no longer the same as we were two years ago. 

Among the many transformations that have occurred during this pandemic period, we find the core existential beliefs, the interpersonal relationships, the emotion regulation strategies, the perceptions of our mortality, time and space, the role of science and culture, and the sense of uncertainty and interdependence among human beings and between social groups and the environment. The extent and nature of these psychological and cultural changes have still to be studied in terms of the constraints and possibilities for improving social coexistence and for adapting psychological treatments in these changed conditions of life. 

This Special Issue aims to provide selected empirical, theoretical, and review contributions on the psychological changes and adaptations taking place in this pandemic period and on the necessary transformations of psychological interventions aimed at fostering well-being in different contexts (family, school, community, workplace, etc.). 

Potential topics include but are not limited to:

  • psychological aspects of long COVID syndrome
  • vaccine hesitancy, epistemic trust, and science conceptions
  • telepsychology and telepsychotherapy
  • effects of changes in psychotherapy setting
  • emotion regulation in quarantine and isolation
  • wellbeing and telework
  • relational changes in school and work setting
  • resilience, meaning making and post-traumatic growth
  • grieving in the pandemic
  • family relationships during pandemic
  • psychological treatment for health workers.

Dr. Attà Negri
Prof. Dr. Francisco Ortega
Dr. Arianna Barazzetti
Guest Editors

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Published Papers (23 papers)

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19 pages, 408 KiB  
Article
Cognitive and Relational Processes Associated to Mental Health in Italian High School Students during COVID-19 and Russian–Ukrainian War Outbreaks
by Attà Negri, Arianna Barazzetti, Alice Rinzivillo, Rachele Mariani and Cinzia Di Monte
Int. J. Environ. Res. Public Health 2024, 21(4), 508; https://doi.org/10.3390/ijerph21040508 - 19 Apr 2024
Viewed by 1414
Abstract
The negative impact of the COVID-19 pandemic on mental health has been widely demonstrated; however, few studies have investigated the psychological processes involved in this impact, including core beliefs violation, meaning-making disruption, interpersonal support, or one’s relational functioning. This study explored the mental [...] Read more.
The negative impact of the COVID-19 pandemic on mental health has been widely demonstrated; however, few studies have investigated the psychological processes involved in this impact, including core beliefs violation, meaning-making disruption, interpersonal support, or one’s relational functioning. This study explored the mental health of 215 Italian adolescents during the COVID-19 pandemic and the subsequent outbreak of the Russian–Ukrainian war. By administering a set of questionnaires, several cognitive and emotional variables were investigated, including core belief violation, meaning attribution to the pandemic and war, attachment, and emotion regulation, social media addiction, and relationships with significant others and teachers. We conducted some descriptive, mean difference, correlational, and predictive analyses that revealed a significant association between core belief violation caused by war and pandemic, ability to integrate war and pandemic within personal meaning universe, the relational support received, and mental health. The relationship with teachers during these challenging periods improved significantly according to the respondents’ opinion, becoming both more authoritative and empathic. This study offers insights into what cognitive and relational processes are useful to intervene on to reduce the distress of adolescents who are facing significant moments of crisis due to events that challenge their cognitive and emotional balance. Full article
12 pages, 334 KiB  
Article
Exploring Factors Influencing COVID-19 Vaccine Hesitancy and Refusal: A Study in Italy during the Vaccine Rollout
by Arianna Barazzetti, Stefano Milesi and Attà Negri
Int. J. Environ. Res. Public Health 2024, 21(3), 331; https://doi.org/10.3390/ijerph21030331 - 12 Mar 2024
Viewed by 2213
Abstract
The availability of an effective vaccine against COVID-19 virus marked a crucial moment in the fight against its pandemic spread. Although distribution of the vaccine began in December 2020, high acceptance rates and repeated administrations are needed to achieve widespread immunization, but hesitation [...] Read more.
The availability of an effective vaccine against COVID-19 virus marked a crucial moment in the fight against its pandemic spread. Although distribution of the vaccine began in December 2020, high acceptance rates and repeated administrations are needed to achieve widespread immunization, but hesitation toward the vaccine persists to this day. To identify psychological variables and other factors associated with vaccine hesitancy, we conducted a study from August 2021 to October 2022. An Internet-based survey gathered data from 137 Italian adults, exploring attitudes, sociodemographic characteristics, psychological variables, and immunization behavior. The results analysis showed that gender (69.2% of vaccine-adverse people were males), education (years of education was negatively correlated with vaccine hesitancy), and religion (not declaring oneself religious or atheist was more likely to be associated with hesitancy toward the vaccine) were the variables influencing attitudes toward the vaccine. Other psychological variables differentiated people with opposite attitudes toward the vaccine: high scores on the Conspiracy Mentality Questionnaire (CMQ) and Core Belief Inventory (CBI) were positively correlated with vaccine hesitancy, indicating that individuals with more pronounced core belief violation, due to the pandemic, tend to express higher levels of vaccine hesitancy. Finally, a linear regression analysis confirmed the role of participants’ conspiracy mentality as a valid predictor for vaccine hesitancy. Full article
19 pages, 542 KiB  
Article
Organizational Learning in Healthcare Contexts after COVID-19: A Study of 10 Intensive Care Units in Central and Northern Italy through Framework Analysis
by Maddalena Gambirasio, Demetrio Magatti, Valentina Barbetta, Silvia Brena, Giordano Lizzola, Chiara Pandolfini, Francesca Sommariva, Anna Zamperoni, Stefano Finazzi and Silvia Ivaldi
Int. J. Environ. Res. Public Health 2023, 20(17), 6699; https://doi.org/10.3390/ijerph20176699 - 1 Sep 2023
Viewed by 1448
Abstract
The rapid spread of the SARS-CoV-2 virus has forced healthcare organizations to change their organization, introducing new ways of working, relating, communicating, and managing to cope with the growing number of hospitalized patients. Starting from the analysis of the narratives of healthcare workers [...] Read more.
The rapid spread of the SARS-CoV-2 virus has forced healthcare organizations to change their organization, introducing new ways of working, relating, communicating, and managing to cope with the growing number of hospitalized patients. Starting from the analysis of the narratives of healthcare workers who served in the intensive care units of 10 hospitals in Central and Northern Italy, this contribution intends to highlight elements present during the pandemic period within the investigated structures, which are considered factors that can influence the birth of organizational learning. Specifically, the data collected through interviews and focus groups were analyzed using the framework analysis method of Ritchie and Spencer. The conducted study made it possible to identify and highlight factors related to aspects of communication, relationships, context, and organization that positively influenced the management of the health emergency, favoring the improvement of the structure. It is believed that the identification of these factors by healthcare organizations can represent a valuable opportunity to rethink themselves, thus becoming a source of learning. Full article
19 pages, 382 KiB  
Article
Impact of COVID-19 Pandemic on Well-Being, Social Relationships and Academic Performance in a Sample of University Freshmen: A Propensity Score Match Evaluation Pre- and Post-Pandemic
by Chiara Buizza, Clarissa Ferrari, Giulio Sbravati, Jessica Dagani, Herald Cela, Giuseppe Rainieri and Alberto Ghilardi
Int. J. Environ. Res. Public Health 2023, 20(15), 6485; https://doi.org/10.3390/ijerph20156485 - 31 Jul 2023
Cited by 1 | Viewed by 2061
Abstract
The COVID-19 pandemic has impacted freshmen, compromising their mental health, lifestyles, and academic performance. There are few studies that have investigated changes in the health status and lifestyles of freshmen before and after the pandemic. The aims of this study were: (1) to [...] Read more.
The COVID-19 pandemic has impacted freshmen, compromising their mental health, lifestyles, and academic performance. There are few studies that have investigated changes in the health status and lifestyles of freshmen before and after the pandemic. The aims of this study were: (1) to carry out a pre–post-COVID-19 pandemic comparison between two freshmen samples, in order to detect differences in their socio-demographic characteristics and in some clinical variables; (2) to assess the effect of the COVID-19 pandemic on the social and academic lives of the second sample of freshmen. The samples recruited in 2019 and 2022, matched by propensity score procedure (N = 553), were mostly female (57.3% vs. 55.3%); the mean age was 22.9 and 20.9 years, respectively. The freshmen recruited after the pandemic had less psychological distress and substance use than freshmen recruited before the pandemic. Seventy-eight percent of the freshmen stated that the pandemic had an impact on their social relationships. This effect was greater for females and Italian students. Forty-seven percent reported that the pandemic has worsened their academic performance, while 60% stated that pandemic has improved their grades. The results of this study can provide valuable insights into the impact of the pandemic on freshmen, in order to implement interventions to mitigate the consequences of the pandemic in some subgroups of this target population. Full article
17 pages, 1431 KiB  
Article
Mental Health Issues as a Consequence of the Pandemic: Group Psycho-Educational Intervention to Support Patients Recovered from COVID-19 Infection
by Denise Vagnini, Nicolò Lamperti, Sara Molgora, Francesca Barile, Federica Facchin, Umberto Mazza and Emanuela Saita
Int. J. Environ. Res. Public Health 2023, 20(12), 6105; https://doi.org/10.3390/ijerph20126105 - 12 Jun 2023
Cited by 2 | Viewed by 1854
Abstract
Common psycho-physical symptoms have emerged in patients who were previously recovered for COVID-19 infection, including traumatic experience and enduring emotional disturbances. A group psycho-educational intervention of seven weekly sessions and a follow-up after three months was proposed to all Italian-speaking patients formally discharged [...] Read more.
Common psycho-physical symptoms have emerged in patients who were previously recovered for COVID-19 infection, including traumatic experience and enduring emotional disturbances. A group psycho-educational intervention of seven weekly sessions and a follow-up after three months was proposed to all Italian-speaking patients formally discharged from a public hospital in northern Italy and physically recovered from infection. Eighteen patients were recruited and divided into four age-homogenous groups, each led by two facilitators (psychologists and psychotherapists). The group sessions followed a structured format with thematic modules, including main topics, tasks, and homework assignments. Data were collected through recordings and verbatim transcripts. The objectives of the study were twofold: (1) to analyze the emerging themes and gain insight into the significant aspects of the participants’ lived experience of COVID-19, and (2) to examine changes in how participants approached these themes throughout the intervention process. Semantic-pragmatic text analyses, specifically thematic analysis of elementary context and correspondence analysis, were conducted using T-LAB software. Linguistic analysis revealed a congruence between the intervention’s objectives and the participants’ experiences. The study highlighted an evolution in the narratives, as participants transitioned from a passive and concrete perspective on the disease to a more comprehensive cognitive and emotional elaboration of their personal illness stories. These findings hold potential relevance for healthcare services and professionals working in this field. Full article
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16 pages, 792 KiB  
Article
The Up-Side of the COVID-19 Pandemic: Are Core Belief Violation and Meaning Making Associated with Post-Traumatic Growth?
by Marco Castiglioni, Cristina Liviana Caldiroli, Rossella Procaccia, Federica Conte, Robert A. Neimeyer, Claudia Zamin, Anna Paladino and Attà Negri
Int. J. Environ. Res. Public Health 2023, 20(11), 5991; https://doi.org/10.3390/ijerph20115991 - 29 May 2023
Cited by 8 | Viewed by 1910
Abstract
The negative impact of the COVID-19 pandemic on mental health has been extensively documented, while its possible positive impact on the individual, defined as Post-Traumatic Growth (PTG), has been much less investigated. The present study examines the association between PTG and socio-demographic aspects, [...] Read more.
The negative impact of the COVID-19 pandemic on mental health has been extensively documented, while its possible positive impact on the individual, defined as Post-Traumatic Growth (PTG), has been much less investigated. The present study examines the association between PTG and socio-demographic aspects, pre-pandemic psychological adjustment, stressors directly linked to COVID-19 and four psychological factors theoretically implicated in the change processes (core belief violation, meaning-making, vulnerability and mortality perception). During the second wave of the pandemic 680 medical patients completed an online survey on direct and indirect COVID-19 stressors, health and demographic information, post-traumatic growth, core belief violation, meaning-making capacity, feelings of vulnerability and perceptions of personal mortality. Violation of core beliefs, feelings of vulnerability and mortality, and pre-pandemic mental illness positively correlated with post-traumatic growth. Moreover, the diagnosis of COVID-19, stronger violation of core beliefs, greater meaning-making ability, and lower pre-existing mental illness predicted greater PTG. Finally, a moderating effect of meaning-making ability was found. The clinical implications were discussed. Full article
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18 pages, 443 KiB  
Article
Linguistic Predictors of Psychological Adjustment in Healthcare Workers during the COVID-19 Pandemic
by Marco Castiglioni, Cristina Liviana Caldiroli, Attà Negri, Gian Mauro Manzoni and Rossella Procaccia
Int. J. Environ. Res. Public Health 2023, 20(5), 4482; https://doi.org/10.3390/ijerph20054482 - 2 Mar 2023
Cited by 6 | Viewed by 2495
Abstract
COVID-19 broke out in China in December 2019 and rapidly became a worldwide pandemic that demanded an extraordinary response from healthcare workers (HCWs). Studies conducted during the pandemic observed severe depression and PTSD in HCWs. Identifying early predictors of mental health disorders in [...] Read more.
COVID-19 broke out in China in December 2019 and rapidly became a worldwide pandemic that demanded an extraordinary response from healthcare workers (HCWs). Studies conducted during the pandemic observed severe depression and PTSD in HCWs. Identifying early predictors of mental health disorders in this population is key to informing effective treatment and prevention. The aim of this study was to investigate the power of language-based variables to predict PTSD and depression symptoms in HCWs. One hundred thirty-five HCWs (mean age = 46.34; SD = 10.96) were randomly assigned to one of two writing conditions: expressive writing (EW n = 73) or neutral writing (NW n = 62) and completed three writing sessions. PTSD and depression symptoms were assessed both pre- and post-writing. LIWC was used to analyze linguistic markers of four trauma-related variables (cognitive elaboration, emotional elaboration, perceived threat to life, and self-immersed processing). Changes in PTSD and depression were regressed onto the linguistic markers in hierarchical multiple regression models. The EW group displayed greater changes on the psychological measures and in terms of narrative categories deployed than the NW group. Changes in PTSD symptoms were predicted by cognitive elaboration, emotional elaboration, and perceived threat to life; changes in depression symptoms were predicted by self-immersed processing and cognitive elaboration. Linguistic markers can facilitate the early identification of vulnerability to mental disorders in HCWs involved in public health emergencies. We discuss the clinical implications of these findings. Full article
13 pages, 555 KiB  
Article
Threat Appraisal, Resilience, and Health Behaviors in Recovered COVID-19 Patients: The Serial Mediation of Coping and Meaning-Making
by Dariusz Krok, Ewa Telka, Małgorzata Szcześniak and Adam Falewicz
Int. J. Environ. Res. Public Health 2023, 20(4), 3649; https://doi.org/10.3390/ijerph20043649 - 18 Feb 2023
Cited by 6 | Viewed by 2265
Abstract
Research indicates that both cognitive appraisal and personal resources can noticeably influence health behaviors, as individuals modify their health convictions and practices on the basis of threat appraisal, personality, and meaning. The aim of the current study was to investigate whether coping strategies [...] Read more.
Research indicates that both cognitive appraisal and personal resources can noticeably influence health behaviors, as individuals modify their health convictions and practices on the basis of threat appraisal, personality, and meaning. The aim of the current study was to investigate whether coping strategies and meaning-making can serially mediate the relationship of threat appraisal and resilience with health behaviors in recovered COVID-19 patients. Self-report measures of threat appraisal, resilience, coping, meaning-making, and health behaviors were completed by 266 participants (aged 17 to 78, 51.5% female) who had recovered from COVID-19. The serial mediation analysis showed that the relationship of threat appraisal and resilience with health behaviors was mediated by problem-focused coping, meaning-focused coping, and meaning-making, but not by emotion-focused coping. These results suggest that associations among threat perception, resilience, and health behavior depend to some extent on the interplay of coping and meaning-making, which reveals their unique role in the process of recovery from COVID-19, with potential implications for health interventions. Full article
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15 pages, 637 KiB  
Article
Social Environment and Attitudes toward COVID-19 Anti-Contagious Measures: An Explorative Study from Italy
by Alessandro Gennaro, Matteo Reho, Tiziana Marinaci, Barbara Cordella, Marco Castiglioni, Cristina Liviana Caldiroli and Claudia Venuleo
Int. J. Environ. Res. Public Health 2023, 20(4), 3621; https://doi.org/10.3390/ijerph20043621 - 17 Feb 2023
Cited by 7 | Viewed by 1779
Abstract
Social and cultural aspects (i.e., political decision making, discourses in the public sphere, and people’s mindsets) played a crucial role in the ways people responded to the COVID-19 pandemic. Framed with the Semiotic-Cultural Psychological Theory (SCPT), the present work aims to explore how [...] Read more.
Social and cultural aspects (i.e., political decision making, discourses in the public sphere, and people’s mindsets) played a crucial role in the ways people responded to the COVID-19 pandemic. Framed with the Semiotic-Cultural Psychological Theory (SCPT), the present work aims to explore how individual ways of making sense of their social environment affected individuals’ perception of government measures aimed at managing the pandemic and the adherence to such measures. An online survey was administered from January to April 2021 to the Italian population. Retrieved questionnaires (N = 378) were analyzed through a Multiple Correspondence Analysis (MCA) to detect the factorial dimensions underpinning (dis)similarities in the respondents’ ways of interpreting their social environment. Extracted factors were interpreted as markers of Latent Dimensions of Sense (LDSs) organizing respondents’ worldviews. Finally, three regression models tested the role of LDSs in supporting the individual satisfaction with the measures adopted to contain the social contagion defined at national level, individual adherence to the containment measures and the perception of the population’s adherence to them. Results highlight that all the three measures are associated with a negative view of the social environment characterized by a lack of confidence in public institutions (health system, government), public roles and other people. Findings are discussed on the one hand to shed light on the role of deep-rooted cultural views in defining personal evaluations of government measures and adherence capacity. On the other hand, we suggest that taking into account people’s meaning-making can guide public health officials and policy makers to comprehend what favors or hinders adaptive responses to emergencies or social crises. Full article
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13 pages, 373 KiB  
Article
Learner Experience of an Online Co-Learning Model to Support Mental Health during the COVID-19 Pandemic: A Qualitative Study
by Catherine Briand, Regis Hakin, Julio Macario de Medeiros, Francesca Luconi, Brigitte Vachon, Marie-Josée Drolet, Antoine Boivin, Catherine Vallée and Sarah Montminy
Int. J. Environ. Res. Public Health 2023, 20(3), 2498; https://doi.org/10.3390/ijerph20032498 - 31 Jan 2023
Cited by 4 | Viewed by 2018
Abstract
The COVID-19 pandemic has had a negative impact on the mental health of the population such as increased levels of anxiety, psychological distress, isolation, etc. Access to mental health services has been limited due to the “overflow” of demands. The Recovery College (RC) [...] Read more.
The COVID-19 pandemic has had a negative impact on the mental health of the population such as increased levels of anxiety, psychological distress, isolation, etc. Access to mental health services has been limited due to the “overflow” of demands. The Recovery College (RC) model, an education-based approach, has addressed this challenge and provided online well-being and mental health courses to at-risk populations. The RC model proposes a co-learning space in an adult education program where learners from diverse backgrounds collectively learn and empower themselves to better address psychological well-being and mental health issues. The aim of this study was to document the experience of learners who participated in online RC courses during the COVID-19 pandemic and the perceived impact of these courses on their mental health. A qualitative interpretative descriptive study design was employed, and Miles and Huberman’s stepwise content analysis method was used to mine the data for themes. Fourteen structured online interviews were conducted with a sample representative of the diversity of learners. Five categories of themes emerged: (1) updating and validating your mental health knowledge, (2) taking care of yourself and your mental health, (3) improving and modifying your behaviors and practices, (4) changing how you look at yourself and others, and (5) interacting and connecting with others. Results suggest that online RC courses can be an effective strategy for supporting individual self-regulation and empowerment, breaking social isolation, and reducing the effects of stress in times of social confinement measures and limited access to care. Full article
19 pages, 574 KiB  
Article
Risk Perception, Perceived Government Coping Validity, and Individual Response in the Early Stage of the COVID-19 Pandemic in China
by Tao Xu, Mengyuan Shao, Ruiquan Liu, Xiaoqin Wu and Kai Zheng
Int. J. Environ. Res. Public Health 2023, 20(3), 1982; https://doi.org/10.3390/ijerph20031982 - 21 Jan 2023
Cited by 5 | Viewed by 2042
Abstract
As a major crisis event, the COVID-19 pandemic has affected the global economy, threatened the lives of the public, and caused varying degrees of impact on the public. Previous studies have shown that risk perception and government response had different impacts on the [...] Read more.
As a major crisis event, the COVID-19 pandemic has affected the global economy, threatened the lives of the public, and caused varying degrees of impact on the public. Previous studies have shown that risk perception and government response had different impacts on the public, but they revealed more about the independent impact of risk perception and government response on the public. This study will comprehensively consider the impacts of these two factors on the behavior of the public in the early stage of the epidemic. We analyzed data from an online survey in the early days of the COVID-19 pandemic in China and categorized individual behaviors into three dimensions: entertainment and travel, work, and the stockpile of supplies. In addition, we defined the risk perception variables by two dimensions: knowledge of the epidemic itself and knowledge of the consequences of the epidemic. At the same time, we used an exploratory factor analysis to construct the variable of perceived government coping validity and then adopted the ordinal logit model for analysis. The results showed that in terms of entertainment and travel, people would not be affected even if they fully understood the epidemic itself; once they were aware of the negative social consequences of the epidemic, people would suspend entertainment and travel to prevent the spread of the virus. As for work or employment, people would not stop working or employment even if they realized the infectivity and harmfulness of the disease and its social consequences. Furthermore, fear of COVID-19 and the perception of uncontrolled COVID-19 significantly positively affected people’s material stockpiling behavior. These results indicate that different risk perceptions had different effects on individual responses, and individual behaviors reflected different coping logics. In addition, the government’s effective response to the epidemic would significantly reduce the negative impacts of the epidemic on the three dimensions of people’s responses. These conclusions have certain policy implications for preventing and responding to outbreaks in other countries. Full article
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15 pages, 1513 KiB  
Article
How the COVID-19 Pandemic Affects the Provision of Psychotherapy: Results from Three Online Surveys on Austrian Psychotherapists
by Stefanie Winter, Andrea Jesser, Thomas Probst, Yvonne Schaffler, Ida-Maria Kisler, Barbara Haid, Christoph Pieh and Elke Humer
Int. J. Environ. Res. Public Health 2023, 20(3), 1961; https://doi.org/10.3390/ijerph20031961 - 20 Jan 2023
Cited by 6 | Viewed by 2263
Abstract
This study aimed to assess patient numbers and the format in which psychotherapy was delivered by Austrian psychotherapists during different time points of the COVID-19 pandemic and to explore psychotherapists` experiences on pandemic-associated changes in their psychotherapeutic work as well as their wishes [...] Read more.
This study aimed to assess patient numbers and the format in which psychotherapy was delivered by Austrian psychotherapists during different time points of the COVID-19 pandemic and to explore psychotherapists` experiences on pandemic-associated changes in their psychotherapeutic work as well as their wishes for support in their professional activities. Three cross-sectional online surveys were conducted between March 2020 and May 2022. The total number of participating psychotherapists was n = 1547 in 2020, n = 238 in 2021, and n = 510 in 2022. The number of patients treated was highest in 2022 and lowest at the beginning of the pandemic (p < 0.001). During the lockdown in 2020, only 25.0% of patients were treated in personal contact. This proportion increased in the following years, reaching 86.9% in 2022 (p < 0.001). After a substantial increase in the proportion of patients treated via the telephone and internet during the first lockdown, both proportions decreased during the pandemics’ second and third year (p < 0.001). However, a larger proportion of patients were treated via the internet in 2022 compared to pre-pandemic times (p < 0.001). Psychotherapists reported that the pandemic affected mainly the setting in which psychotherapy was provided (29.6%), the working conditions and workload (27.1%), as well as the demand for psychotherapy (26.9%). About one-third of psychotherapists expressed support wishes for their psychotherapeutic work. Results suggest that the pandemic went along with a partial shift in the provision of psychotherapy towards psychotherapy via the internet but not the telephone. The increase in patient numbers and psychotherapists` reports of increased workload suggest a rise in the demand for mental health care during and in the aftermath of the pandemic. Full article
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14 pages, 929 KiB  
Article
Gender Differences in Coping and Psychological Adaptation during the COVID-19 Pandemic
by Rosann Cholankeril, Ellen Xiang and Hoda Badr
Int. J. Environ. Res. Public Health 2023, 20(2), 993; https://doi.org/10.3390/ijerph20020993 - 5 Jan 2023
Cited by 20 | Viewed by 4357
Abstract
This population-based study investigated gender differences in the use of coping strategies and their relationship to anxiety symptoms during the initial COVID-19 lockdown period in the United States. A national online survey was administered between 13 April 2020 and 8 June 2020. The [...] Read more.
This population-based study investigated gender differences in the use of coping strategies and their relationship to anxiety symptoms during the initial COVID-19 lockdown period in the United States. A national online survey was administered between 13 April 2020 and 8 June 2020. The study sample comprised 1673 respondents (66% women). Overall, 46% reported high levels of anxiety, and women experienced significantly (p < 0.001) higher levels of anxiety than men. Women were significantly (p < 0.05) more likely to use acceptance, self-distraction, positive reframing, and emotional support than men. Significant interactions between gender and coping strategies were also identified. Women engaging in high (+1SD) vs. low (−1SD) levels of active coping were not found to have significantly different anxiety levels. In contrast, men reported higher levels of anxiety when they engaged in high levels of active coping and lower levels of anxiety when they engaged in low levels of active coping (b2 = 0.88, t = 3.33, p = 0.001). Additionally, women engaging in high levels of acceptance and positive reframing reported significantly lower anxiety levels than when engag-ing in low levels of acceptance (b1 = −1.03, t = −4.58, p < 0.001) and positive reframing (b1 = −0.72, t = −3.95, p < 0.001). No significant associations between acceptance and positive reframing levels and anxiety levels were found with men. Overall, these findings extend our understanding of the nature of gender differences in stress responsivity during periods of high psychological distress and can inform the development of mental health interventions to respond to the COVID-19 pandemic and future infectious disease outbreaks. Full article
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16 pages, 2288 KiB  
Article
Teachers during the COVID-19 Era: The Mediation Role Played by Mentalizing Ability on the Relationship between Depressive Symptoms, Anxious Trait, and Job Burnout
by Annalisa Levante, Serena Petrocchi, Federica Bianco, Ilaria Castelli and Flavia Lecciso
Int. J. Environ. Res. Public Health 2023, 20(1), 859; https://doi.org/10.3390/ijerph20010859 - 3 Jan 2023
Cited by 13 | Viewed by 2634
Abstract
Background: The COVID-19 outbreak caused severe changes in school activities over the past two years. Teachers underwent a re-planning of their teaching approaches, shifting from face-to-face teaching formats to remote ones. These challenges resulted in high levels of burnout. The identification of risk/protective [...] Read more.
Background: The COVID-19 outbreak caused severe changes in school activities over the past two years. Teachers underwent a re-planning of their teaching approaches, shifting from face-to-face teaching formats to remote ones. These challenges resulted in high levels of burnout. The identification of risk/protective factors contributing to burnout is crucial in order to inform intervention programs. Thus, we hypothesized a mediation role of teachers’ mentalizing ability (processing of emotions, a component of mentalized affectivity) on the relationship between depression, anxiety, and depersonalization (burnout dimension). Two reverse models were computed. Job satisfaction, teachers’ age and gender, school grade, and length of teaching experience served as covariates. Methods: 466 (M(sd) = 46.2 (10.4) years) online questionnaires were completed by Italian teachers of primary (n = 204) and middle (n = 242) schools. Measures of burnout, depression, anxiety, and mentalization were administered. Results: The findings corroborated our hypotheses: in all models, processing emotions served as a mediator on the relationship between depression, anxiety, and depersonalization, and on the reciprocal one. Job satisfaction positively impacted processing emotion, and negatively impacted depression and depersonalization; women teachers reported high levels of the anxious trait. Conclusions: Overall, it can be concluded that the ability to mentalize has a beneficial impact on teachers’ well-being. Policymaking, clinical, and research implications were discussed. Full article
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16 pages, 971 KiB  
Article
How Has COVID-19 Affected Mental Health and Lifestyle Behaviors after 2 Years? The Third Step of a Longitudinal Study of Italian Citizens
by Cristina Mazza, Eleonora Ricci, Marco Colasanti, Alessandra Cardinale, Francesca Bosco, Silvia Biondi, Renata Tambelli, Alberto Di Domenico, Maria Cristina Verrocchio and Paolo Roma
Int. J. Environ. Res. Public Health 2023, 20(1), 759; https://doi.org/10.3390/ijerph20010759 - 31 Dec 2022
Cited by 8 | Viewed by 2157
Abstract
The COVID-19 pandemic and its protective measures had a tremendous effect on the general population’s mental health and deeply affected their lifestyle. The present study carried out a longitudinal analysis to evaluate the long-lasting psychological effects of the pandemic and its impact on [...] Read more.
The COVID-19 pandemic and its protective measures had a tremendous effect on the general population’s mental health and deeply affected their lifestyle. The present study carried out a longitudinal analysis to evaluate the long-lasting psychological effects of the pandemic and its impact on the general population’s day-to-day routine. Three points in time were considered: the initial period of the lockdown (T1; n = 2766; March 2020), the final period of the lockdown (T2; n = 439; May 2020) and two years after the lockdown (T3; n = 268; July 2022). Frequency analyses were carried out to examine which behavioral changes were maintained following the COVID-19 pandemic and lockdown; furthermore, a repeated measures ANOVA test was run to measure differences in depression, stress, and anxiety levels between the three periods considered; lastly, multivariable ordinal logistic regression analyses were carried out to examine which variables were associated with psychological distress more than two years after the lockdown. The results highlighted that depression at T3 was associated with depression at T2 and negative affect, whereas stress at T3 was associated with stress at T2 and detachment. The psychological effects and lifestyle changes are also discussed. Full article
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21 pages, 1321 KiB  
Article
The Impact of Mixed Emotions on Consumer Improvisation Behavior in the Environment of COVID-19: The Moderating Effect of Tightness-Looseness Culture
by Xiaozhi Huang, Xiaojie Zhang and Heng Zhang
Int. J. Environ. Res. Public Health 2022, 19(24), 17076; https://doi.org/10.3390/ijerph192417076 - 19 Dec 2022
Cited by 2 | Viewed by 1981
Abstract
Organizations and individuals are unprepared for an unexpected outbreak of COVID-19. While most of the literature focuses on improvised reactions at the organizational level, this paper focuses on understanding improvised reactions at the individual level. This paper draws on previous research applying improvisation [...] Read more.
Organizations and individuals are unprepared for an unexpected outbreak of COVID-19. While most of the literature focuses on improvised reactions at the organizational level, this paper focuses on understanding improvised reactions at the individual level. This paper draws on previous research applying improvisation to the field of consumer behavior and introduces consumer knowledge acquisition as a mediating variable and tightness-looseness culture as a moderating variable from the perspective of mixed emotions of awe and anxiety to explain the mechanism of consumers with mixed emotions of awe and anxiety on improvisation behavior based on the environment of a COVID-19 outbreak. Data from 330 participants in Study 1 examined the effect of mixed emotions of awe and anxiety on improvisation behavior through knowledge acquisition, and data from 434 participants in Study 2 examined the moderating effect of relaxed culture. The findings suggest that consumers with mixed emotions report a higher willingness to acquire knowledge and report higher levels of improvisational behavior. Consumers behaved differently in different environments. Consumers with mixed emotions responded more strongly to improvisation in the loose-culture environment than in the tight-culture environment, and the mixed emotions of awe and anxiety had a positive effect on individual consumers’ improvisational behavior through the mediating role of knowledge acquisition. Full article
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17 pages, 674 KiB  
Article
Unusual Experience in the COVID-19 Pandemic: Young Children’s Readjustment from Home to Preschool following School Closures in Different Risk Regions
by Xiumin Hong, Sijie Zhao and Qianqian Liu
Int. J. Environ. Res. Public Health 2022, 19(24), 16785; https://doi.org/10.3390/ijerph192416785 - 14 Dec 2022
Cited by 1 | Viewed by 1561
Abstract
Children’s readjustment to preschool following long-term school closures during the COVID-19 pandemic merits special attention. This study examined children’s preschool readjustment using a survey of 1008 teachers in a high-risk region and 1399 teachers in a fluctuating-risk region of China. Results found are [...] Read more.
Children’s readjustment to preschool following long-term school closures during the COVID-19 pandemic merits special attention. This study examined children’s preschool readjustment using a survey of 1008 teachers in a high-risk region and 1399 teachers in a fluctuating-risk region of China. Results found are as follows. (1) children’s preschool readjustment was at a medium level after the long-term school closures. However, children’s preschool readjustment scores in the fluctuating-risk region were significantly lower than those in the high-risk region. (2) Children in both regions were divided into four profiles based on their preschool readjustment: low-level, middle-level, upper-middle-level, and high-level groups. (3) Preschool transition practices and teachers’ turnover intention are common factors relating to preschool readjustment in both regions. Teachers’ professional development support impacted children’s preschool readjustment only in the high-risk region. The findings inform the design of targeted interventions to help children readjust to preschool across different risk regions. Full article
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10 pages, 344 KiB  
Article
Effects of Yoga and Mindfulness Programs on Self-Compassion in Medical Professionals during the COVID-19 Pandemic: An Intervention Study
by Tomoko Miyoshi, Hiromi Ida, Yoshito Nishimura, Soichiro Ako and Fumio Otsuka
Int. J. Environ. Res. Public Health 2022, 19(19), 12523; https://doi.org/10.3390/ijerph191912523 - 30 Sep 2022
Cited by 8 | Viewed by 3990
Abstract
Stress among healthcare workers (HCWs) increased during the coronavirus disease 2019 pandemic. We aimed to determine whether a yoga and mindfulness program could alleviate burnout and other psychological and physical distress in HCWs, and how this might affect their empathy for patients. A [...] Read more.
Stress among healthcare workers (HCWs) increased during the coronavirus disease 2019 pandemic. We aimed to determine whether a yoga and mindfulness program could alleviate burnout and other psychological and physical distress in HCWs, and how this might affect their empathy for patients. A weekly one-hour yoga and mindfulness program was conducted for three months in 2021. Participants were 18 consenting HCWs and, the final analysis included 13 participants. They responded to online questionnaires before and after the program. We measured salivary cortisol levels before and after the program on the first and last days. Self-measured pulse rates (PRs) were taken before and after each session, which decreased significantly in both cases (before, after the first program: 72, 65 bpm, p < 0.05; before, after the last program: 75, 66, p < 0.05), but salivary cortisol levels did not change. No significant changes were observed in Patient Health Questionnaire-9, Maslach Burnout Inventory, Sense of Coherence, Connor-Davidson Resilience Scale, Self-compassion Scale, or Jefferson Scale of Empathy. However, common humanity, a subscale of self-compassion, increased significantly (before the first program: 5.6, after the last program: 6.5, p < 0.05), and over-identification decreased significantly (7.9, 6.7, p < 0.01). Yoga and mindfulness programs may help improve the sense of common humanity and reduce over-identification in HCWs. Full article
19 pages, 545 KiB  
Article
Mediating Role of Intra-Team Conflict between Paternalistic Leadership and Decision-Making Quality among China University’s CMT during COVID-19
by Kenny S. L. Cheah, Zuraidah Abdullah and Min Xiao
Int. J. Environ. Res. Public Health 2022, 19(18), 11697; https://doi.org/10.3390/ijerph191811697 - 16 Sep 2022
Cited by 1 | Viewed by 2221
Abstract
Universities across China have set up crisis management teams (CMTS) to deal with the crisis brought on by the COVID-19 pandemic. This study focuses on how the paternalistic leadership practices of a Chinese university CMT influence crisis strategic decisions by managing conflict. These [...] Read more.
Universities across China have set up crisis management teams (CMTS) to deal with the crisis brought on by the COVID-19 pandemic. This study focuses on how the paternalistic leadership practices of a Chinese university CMT influence crisis strategic decisions by managing conflict. These relationships were verified using hierarchical regression analysis on 312 samples from the surveyed university during the pandemic and found the following: benevolent leadership and moral leadership have positive effects on decision quality. However, unlike most studies on paternalistic leadership, in crisis situations, the negative effects of authoritarian leadership disappear under the mediating effect of affective conflict. This means that affective conflict within CMT fully mediates the relationship between authoritarian leadership and decision quality, and partially mediates the relationship between moral leadership and decision quality, while cognitive conflict partially mediates the relationship between benevolent leadership and crisis decision quality. It indicates that a CMT must stimulate and maintain a certain level of cognitive conflict while suppressing affective conflict to achieve high-quality crisis decision-making. This state can be achieved by practicing lower levels of authoritarian leadership and maintaining high levels of moral and benevolent leadership practices. Full article
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18 pages, 633 KiB  
Article
Predictive Factors of Anxiety, Depression, and Health-Related Quality of Life in Community-Dwelling and Institutionalized Elderly during the COVID-19 Pandemic
by Stefania Pascut, Susanna Feruglio, Cristiano Crescentini and Alessio Matiz
Int. J. Environ. Res. Public Health 2022, 19(17), 10913; https://doi.org/10.3390/ijerph191710913 - 1 Sep 2022
Cited by 10 | Viewed by 3263
Abstract
The COVID-19 health emergency and restrictive measures have increased psychological problems, particularly anxiety and depression, in the general population. However, little is known about mental health conditions and the possible risk and protective factors of specific population groups, such as institutionalized vs. community-dwelling [...] Read more.
The COVID-19 health emergency and restrictive measures have increased psychological problems, particularly anxiety and depression, in the general population. However, little is known about mental health conditions and the possible risk and protective factors of specific population groups, such as institutionalized vs. community-dwelling elderly. We investigated the abovementioned aspects in a sample of 65–89-year-old people during the third wave of COVID-19 in Italy. We employed a sociodemographic survey and four questionnaires on health-related quality of life (SF-36), loneliness (UCLA), spirituality (FACIT-Sp), and anxiety/depression (HADS). Our findings suggest that the physical, psychological, and spiritual well-being of the elderly had not been seriously impaired by the events related to the pandemic, although most of the participants reported a worsening of their social life and a moderate/high fear of COVID-19. In regression analyses, these two latter aspects turned out to be predictors of higher anxiety, while spiritual well-being and the possibility to get out of the house/institution emerged as protective factors against anxiety and for preserving quality of life, respectively. Our findings help refine the picture of the condition of the elderly in the aftermath of the pandemic, giving some hints about how to continue supporting their well-being and quality of life. Full article
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11 pages, 410 KiB  
Article
How Did People with Functional Disability Experience the First COVID-19 Lockdown? A Thematic Analysis of YouTube Comments
by Karen A. E. Hall, Blanca Deusdad, Manuel D’Hers Del Pozo and Ángel Martínez-Hernáez
Int. J. Environ. Res. Public Health 2022, 19(17), 10550; https://doi.org/10.3390/ijerph191710550 - 24 Aug 2022
Cited by 10 | Viewed by 2477
Abstract
People with functional disability endure barriers to health and other services and to full participation in social life. In the context of COVID-19, this discrimination has been intensified worldwide. We examine how the experience of COVID-19 lockdown was depicted in comments to a [...] Read more.
People with functional disability endure barriers to health and other services and to full participation in social life. In the context of COVID-19, this discrimination has been intensified worldwide. We examine how the experience of COVID-19 lockdown was depicted in comments to a video about functional disability and COVID published on VICE’s YouTube channel. We analysed the first 100 comments on the video, which was posted in spring 2020, during the first COVID-19 lockdown (roughly from March to June 2020, with some variations around the world). We identified four themes: lack of access to care and services, isolation and lifestyle changes, mental health consequences, and peer support. Legal regulations regarding COVID-19 and people with functional disability have not been sufficient in most countries. The COVID-19 pandemic has exposed inadequate care systems, even in Western countries with advanced social protection policies. Full article

Other

Jump to: Research

15 pages, 901 KiB  
Systematic Review
Caring for People with Rare Diseases: A Systematic Review of the Challenges of, and Strategies for Dealing with, COVID-19
by Elena Faccio, Matteo Bottecchia and Michele Rocelli
Int. J. Environ. Res. Public Health 2023, 20(19), 6863; https://doi.org/10.3390/ijerph20196863 - 29 Sep 2023
Cited by 1 | Viewed by 2084
Abstract
The COVID-19 pandemic took a toll on everyone’s lives, and patients with rare diseases (RDs) had to pay an even higher price. In this systematic review, we explored the impact of the COVID-19 pandemic on individuals with RDs from a psychological perspective. Using [...] Read more.
The COVID-19 pandemic took a toll on everyone’s lives, and patients with rare diseases (RDs) had to pay an even higher price. In this systematic review, we explored the impact of the COVID-19 pandemic on individuals with RDs from a psychological perspective. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we retrieved articles from the Google Scholar, Scopus, and PubMed databases focusing on ‘COVID-19,’ ‘psychology,’ and ‘rare diseases.’ Seventeen primary articles were identified (mainly from continental Europe). The results revealed the psychological effects of the pandemic on rare disease patients, including increased anxiety, stress, and depressive moods. This review also highlighted the increased vulnerability and reduced quality of life of rare disease patients during the pandemic, as well as the importance of telecare and psychological support as critical interventions for improving their well-being. There is an urgent need for multidisciplinary research and stronger healthcare systems to meet the unique challenges of rare disease patients, who represent 3.5–5.9% of the global population. Full article
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7 pages, 293 KiB  
Case Report
Provision of Psychological Support to a 31-Year-Old Man with SARS-CoV2-Induced Pneumonia during and after Hospitalization: A Clinical Case Report
by Edward Callus
Int. J. Environ. Res. Public Health 2023, 20(1), 757; https://doi.org/10.3390/ijerph20010757 - 31 Dec 2022
Cited by 1 | Viewed by 1580
Abstract
A 31-year-old man hospitalized during the first wave of the pandemic in 2020 suffering from severe psychological distress, requested psychological assistance as his condition progressively worsened, eventually requiring intubation. After being referred to the clinical psychology service by a ward physician, the patient [...] Read more.
A 31-year-old man hospitalized during the first wave of the pandemic in 2020 suffering from severe psychological distress, requested psychological assistance as his condition progressively worsened, eventually requiring intubation. After being referred to the clinical psychology service by a ward physician, the patient was assisted remotely for two months for a total of 22 sessions during hospitalization and after discharge. A psychometric evaluation was carried out when the patient was close to discharge and longitudinally, for a total of four times, for depression (Patient Health Questionnaire-9 (PHQ-9)), anxiety (Generalized Anxiety Disorder Scale-7 (GAD-7)), post-traumatic stress disorder (Impact of Event Scale—Revised (IES-R)) and insomnia (Insomnia Severity Index (ISI)). Support was provided remotely, mainly through audio and video calls, and text chats were also utilized when possible and as required. The initial psychometric evaluation indicated moderate depression, severe anxiety, the presence of post-traumatic stress disorder and sleep problems. Psychological distress decreased until reaching a situation of no distress in the final evaluation. Psychological interventions from which the patient benefitted were stress reduction and breathing techniques, empathic support, elaboration of the possibility of grief and cognitive restructuring regarding fears relative to his condition. Psychological support provided remotely and the monitoring of psychological status after discharge are highly advisable in pandemic emergency situations. The CARE checklist of information to include when writing a case report was utilized in the writeup of this case report. Full article
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