Does cognitive flexibility change the nature of the relationship between intolerance of uncertainty and psychological symptoms during the COVID-19 outbreak in Turkey?

The COVID-19 pandemic has significantly affected the mental health of the general population worldwide. The study aimed to determine the associations of the intolerance of uncertainty (IU) and cognitive flexibility (CF) with a variety of psychological symptoms and to examine the impact of IU on psychological symptoms through the moderating role of CF. The Brief Symptom Inventory, Intolerance of Uncertainty Scale-12, and Cognitive Control and Flexibility Questionnaire were applied to a sample of 3004 adults living in Turkey. The results of the analysis indicated that CF moderated the effect of IU on psychology symptoms. The slope analysis revealed a weakening association between IU and psychological symptoms with the introduction of a high CF level introduced to the model. The findings highlighted the importance of IU as a potential risk factor for developing psychological symptoms while CF appears as a potential protective factor during the COVID-19 pandemic.

Cognitive training using a mobile app as a coping tool against COVID-19 distress: A crossover randomized controlled trial.

BACKGROUND: The COVID-19 pandemic has been suggested to constitute a broad base stressor with severe mental health consequences. mHealth applications are accessible self-help tools that can be used to reduce psychological distress during the pandemic. This randomized controlled trial evaluated the effects of mobile-based cognitive training exercises on COVID-19 related distress and maladaptive cognitions. METHODS: Following initial screening (n = 924), participants scoring 1 standard deviations above the mean of the COVID-19 Distress Scale were randomized into two groups. Participants in the immediate-app group (iApp; n = 25) started using the application at baseline (T0) for 12 days (from T0 to T1). Participants in the delayed-app group (dApp; n = 22) started using the mobile application at T1 (crossover) and used it for the following 12 days (T1 to T2). RESULTS: Intention to treat analyses indicated that the iApp group exhibited lower COVID-19 distress, lower depression, fewer intolerance of uncertainty and obsessive beliefs than the dApp group at T1. In addition, using the app for 12 consecutive days was associated with large effect-size reductions (Cohen's d ranging from 0.81 to 2.35) in COVID-19 distress and related maladaptive cognitions in the iApp group (from T0 to T1) and the dApp group (from T1 to T2). Moreover, these reductions were maintained at the follow-up. LIMITATIONS: This study was a crossover trial with a relatively limited sample size and mainly female participants. CONCLUSION: Our findings underscore the usefulness of brief, low-intensity, portable interventions in alleviating the negative effects of the pandemic on mental health.

Obsessive beliefs prospectively predict adherence to safety behaviours related to COVID-19 through obsessive-compulsive symptoms and COVID-19 distress: A serial multiple mediator analysis.

Obsessive-compulsive tendencies may render individuals vulnerable to elevated distress and over-adherence to safety behaviours during illness outbreaks. The present study investigated obsessive beliefs as a predictor of obsessive-compulsive symptoms, COVID-19 distress and the exercise of safety behaviours related to COVID-19 in a community sample. Four hundred seventy-nine participants responded to a questionnaire battery in March 2020 and 218 individuals participated in a follow-up assessment in September 2020. Results indicated that baseline obsessive beliefs predicted the exercise of baseline safety behaviours through obsessive-compulsive symptoms and COVID-19 distress. In addition, the relationship between baseline obsessive beliefs and safety behaviour adoption 6 months later was mediated by later obsessive-compulsive symptoms and COVID-19 distress. Findings extended prior research on the association between obsessive-compulsive phenomena and psychological changes related to illness outbreaks. The implications for prevention and treatment strategies are discussed.

Cognitive Training via a Mobile Application to Reduce Obsessive-Compulsive-Related Distress and Cognitions During the COVID-19 Outbreaks: A Randomized Controlled Trial Using a Subclinical Cohort.

Obsessive-compulsive disorder (OCD) is a persistent psychiatric disorder causing significant impairment in functioning. The COVID-19 pandemic has exacerbated OCD-related symptoms and interrupted access to treatment. Recent research suggests mHealth apps are promising tools for coping with OCD symptoms. This randomized controlled trial evaluated the effects of a CBT-based mobile application designed to reduce OCD symptoms and cognitions in community participants considered at high risk of developing OCD symptoms. Following initial screening (n = 924), fifty-five community participants scoring 2 standard deviations above the OCI-R mean were randomized into two groups. In the immediate-app use group (iApp; n = 25), participants started using the application at baseline (T0), 4 min a day, for 12 days (T0-T1). Participants in the delayed-app group (dApp; n = 20) started using the mobile application at T1 (crossover) and used the app for the following 12 consecutive days (T1-T2). Intention to treat analyses indicated that using the app for 12 consecutive days was associated with large effect-size reductions (Cohen's d ranging from .87 to 2.73) in OCD symptoms and maladaptive cognitions in the iApp group (from T0 to T1) and dApp group (from T1 to T2). These reductions were maintained at follow-up. Our findings underscore the usefulness of brief, low-intensity, portable interventions in reducing OCD symptoms and cognitions during the pandemic.