ABSTRACT
The goal is to test the validity of the "Will to exist-live and survive (WTELS) as a master motivator that activates executive functions. A sample of 262 adults administered different measures that included WTELS and executive functions. We conducted hierarchical regressions with working memory deficits (WMD) and inhibition deficits (ID) as dependent variables. We entered in the last steps resilience and WTELS as independent variables. We conducted path analysis with WTELS as independent variables and WMD and ID as outcome variables and resilience and social support as mediating variables. WTELS accounted for the high effect size for lower working memory deficits and medium effect size for lower inhibition deficits. In path analysis, the effects of WTELS on decreased WMD were direct, while its effects on the ID were indirect. PROCESS analysis indicated that WTELS was directly associated with lower depression, anxiety, PTSD, and COVID-19 traumatic stress, and its indirect effects were mediated by lower executive function deficits (Kira et al., Psych 12:992-1024 2021c, Kira et al., in press). The path model discussed was generally superior to the alternative models and was strictly invariant across genders (male/ female). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12144-021-02078-8.
ABSTRACT
COVID-19 challenged the current paradigms of traumatic stress. Although there are diagnostic taxonomies of mental disorders such as Diagnostic and Statistical Manual of Mental Disorders and International Statistical Classification of Diseases and Related Health Problems, the taxonomy of stressors and traumas that contribute significantly to such disorders is lacking. The current article tried to fill parts of this gap by proposing an update and refinement of the development-based taxonomy of stressors and traumas from a life-course perspective. We discussed the different trends in defining trauma and their limitations considering the recent empirical data that provided evidence for the limited predictive validity of the current posttraumatic stress disorder model and when confronting serious real-life events such as the COVID-19 pandemic. The updated taxonomy presented in this paper included preidentity (complicated birth, attachment disruptions, early childhood adversities), identity traumas (physical, personal, and social), interdependence (primary, secondary, and tertiary), and aging stressors and traumas, with the severity of stressors, is categorized on a scale from I to III. We identified 4 primary sources and pathways of these development-based stressors: intrapersonal, interpersonal, systemic, and environmental. The systemic sources are further divided into systemic "A," including traumas perpetrated by groups, institutions, or governments, and systemic "B," traumas such as recessions and global warming. The environmental sources and pathways are further divided into environmental "A" (physical), traumas such as earthquakes and hurricanes, and environmental "B" (biological/pathogenic), traumas such as pandemics. The macrodynamics of accumulation and proliferation and the interaction among preidentity, identity, and postidentity stressors and traumas determine their total mental health impact from a life-course perspective. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
ABSTRACT
COVID-19 is a new type of trauma that has never been conceptually or empirically analyzed in our discipline. This study aimed to investigate the impact of COVID-19 as traumatic stress on mental health after controlling for individuals' previous stressors and traumas. We utilized a sample of (N = 1374) adults from seven Arab countries. We used an anonymous online questionnaire that included measures for COVID-19 traumatic stress, posttraumatic stress disorder, anxiety, depression, and cumulative stressors and traumas. We conducted hierarchical multiple regression, with posttraumatic stress disorder, depression, and anxiety as dependent variables. In the first step, in each analysis, we entered the country, gender, age, religion, education, and income as independent variables (Kira, Traumatology 7(2):73-86, 2001; Kira, Torture, 14:38-44, 2004; Kira, Traumatology, 2021, https://doi.org/10.1037/trm0000305). In the second step, we entered cumulative stressors and traumas as an independent variable. In the third step, we entered either COVID-19 traumatic stressors or one of its subtypes (fears of infection, economic, and lockdown) as an independent variable. Finally, we conducted structural equation modeling with PTSD, depression, and anxiety as predictors of the latent variable mental health and COVID-19 as the independent variable. Results indicated that COVID-19 traumatic stressors, and each of its three subtypes, were unique predictors of PTSD, anxiety, and depression. Thus, COVID-19 is a new type of traumatic stress that has serious mental health effects. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11469-021-00577-0.
ABSTRACT
There is a need to accurately assess the specific impacts of the various traumatic stressors caused by COVID-19 on mental health. The goal was to evaluate the impact of different types of COVID-19 stressors (infection fears, lockdown, and economic stressors) on mental health and cognitive functioning. We used a sample of 262 Turkish adults. We administered an online questionnaire that included measures of COVID-19 traumatic stressors, PTSD, depression, anxiety, executive function deficits, and cumulative stressors and traumas (CST). The analyses included correlations, hierarchical regression, path analysis, and PROCESS mediation analysis. All COVID-19 traumatic stressors types and their cumulative load predicted PTSD, depression, anxiety, and executive function deficits after controlling for previous cumulative stressors and traumas and COVID-19 infection. COVID-19 lockdown's stressors were the strongest predictors, compared to COVID-19 fears and economic stressors. Path analysis and PROCESS mediation results indicated that COVID-19 traumatic stressors had direct effects on working memory deficits, direct and indirect effects on PTSD, depression, and anxiety, and indirect effects on inhibition deficits. Anxiety, depression, and inhibition deficits mediated its indirect effects on PTSD. The results have conceptual and clinical implications. COVID-19 continuous posttraumatic stress syndrome that includes comorbid PTSD, depression, anxiety, and executive function deficits is different and does not fit within the current trauma frameworks. There is a need for a paradigm shift in current stress and trauma frameworks to account for the COVID-19 continuous global stressors and for clinical innovations in intervention to help its victims. Supplementary Information: The online version contains supplementary material available at 10.1007/s12144-021-01743-2.
ABSTRACT
Background The Posttraumatic Stress Disorder Checklist (PCL-5) is the most widely used screening tool in assessing posttraumatic stress disorder symptoms, based on the Diagnostic and Statistical Manual of Mental disorders (DSM-5) criteria. This study aimed to evaluate the psychometric properties of the newly translated Bangla PCL-5. Methods A cross-sectional survey was carried out among 10,605 individuals (61.0% male;mean age: 23.6 ± 5.5 [13–71 years]) during May and June 2020, several months after the onset of the COVID-19 outbreak in Bangladesh. The survey included the Bangla PCL-5 and the PHQ-9 depression scale. We used confirmatory factor analysis to test the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor hybrid model. Results The Bangla PCL-5 displayed adequate internal consistency (Cronbach’s alpha = 0.90). The Bangla PCL-5 score was significantly correlated with scores of the PHQ-9 depression scale, confirming strong convergent validity. Confirmatory factor analyses indicated the models had a good fit to the data, including the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor hybrid model. Overall, the seven-factor hybrid model exhibited the best fit to the data. Conclusions The Bangla PCL-5 appears to be a valid and reliable psychometric screening tool that may be employed in the prospective evaluation of posttraumatic stress disorder in Bangladesh.
ABSTRACT
BACKGROUND: The Posttraumatic Stress Disorder Checklist (PCL-5) is the most widely used screening tool in assessing posttraumatic stress disorder symptoms, based on the Diagnostic and Statistical Manual of Mental disorders (DSM-5) criteria. This study aimed to evaluate the psychometric properties of the newly translated Bangla PCL-5. METHODS: A cross-sectional survey was carried out among 10,605 individuals (61.0% male; mean age: 23.6 ± 5.5 [13-71 years]) during May and June 2020, several months after the onset of the COVID-19 outbreak in Bangladesh. The survey included the Bangla PCL-5 and the PHQ-9 depression scale. We used confirmatory factor analysis to test the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor hybrid model. RESULTS: The Bangla PCL-5 displayed adequate internal consistency (Cronbach's alpha = 0.90). The Bangla PCL-5 score was significantly correlated with scores of the PHQ-9 depression scale, confirming strong convergent validity. Confirmatory factor analyses indicated the models had a good fit to the data, including the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor hybrid model. Overall, the seven-factor hybrid model exhibited the best fit to the data. CONCLUSIONS: The Bangla PCL-5 appears to be a valid and reliable psychometric screening tool that may be employed in the prospective evaluation of posttraumatic stress disorder in Bangladesh.
Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Adolescent , Adult , Anhedonia , Checklist , Cross-Sectional Studies , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Male , Psychometrics , Reproducibility of Results , Stress Disorders, Post-Traumatic/diagnosis , Young AdultABSTRACT
Compelling evidence proved that coronavirus disease (COVID-19) disproportionately affects minorities. The goal of the present study was to explore the effects of intersected discrimination and discrimination types on COVID-19, mental health, and cognition. A sample of 542 Iraqis, 55.7% females, age ranged from 18 to 73, with (M = 31.16, SD = 9.77). 48.7% were Muslims, and 51.3% were Christians (N = 278). We used measures for COVID-19 stressors, executive functions, intersected discrimination (gender discrimination, social groups-based discrimination, sexual orientation discrimination, and genocidal discrimination), posttraumatic stress disorder (PTSD), depression, anxiety, status and death, existential anxieties, and health. We conducted independent samples t test between Muslims and Christians. We conducted hierarchical regression analyses using the Christian minority subsample to see if intersected discrimination is predictive of COVID-19 hospitalization. We conducted two-path analyses, one with intersected discrimination as an independent variable and the second with the different discrimination types as independent variables. Intersected discrimination predicted COVID-19 hospitalization. The primary discrimination type for Christians was genocidal discrimination. Christians had higher existential anxiety about status and death than Muslims. Intersected discrimination and discrimination types had a significant association with mental health, health, and cognition variables, with intersected discrimination, had a higher impact than each. Existential anxiety about the person's social and economic status was the critical outcome of intersected discrimination that trickles down to other variables. COVID-19 stressors had significant effects on depression, PTSD, generalized anxiety, and Status existential annihilation anxiety (EAA). COVID-19 hospitalization and stressors are associated with inhibition and working memory deficits. We discussed the conceptual and clinical implications of the results. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
Subject(s)
COVID-19 , Anxiety/psychology , Female , Humans , Iraq , Male , Mental Health , SARS-CoV-2ABSTRACT
The current study aimed to explore how COVID-19-traumatized populations cope using a coping model based on wills to exist, live, and survive (WTELS) that leads to positive coping and posttraumatic growth (PTG). We used data from 11 Arab countries (N = 2732), including Egypt (N = 831), and included measures for COVID-19 stressors (COVID-fear, economic, lockdown, and grief stressors), WTELS, resilience, religiosity, spirituality, social support, and PTG. We conducted ANOVA on the main sample to explore the differences between Arab countries, hierarchical regressions, and path analysis on the Egyptian subsample to test a model of the effects on WTELS. In the path model, WTELS was the independent variable. Other coping strategies were mediating variables, and COVID-19 stressor types were outcome variables. ANOVA on the main sample indicated that Egypt was the highest on COVID-19 stressors (infection fears, economic, lockdown, and grief stressors), actual infection, and WTELS. Hierarchical regression indicated that social support, resilience, and WTELS were positive predictors of PTG, with WTELS had the highest effect size (ß = .41) and WTELS being a negative predictor of COVID-19 stressors, while resilience and social support were not. Path analysis indicated that WTELS predicted higher religiosity, spirituality, social support, resilience, and lower COVID-19 stressors. Religiosity predicted higher spirituality, social support, and resilience and lower COVID-19 stressors. Interfaith spirituality predicted higher resilience and lower COVID-19 grief stressors. The results validated the central role of WTELS. Results helped to identify potentially effective interventions with COVID-19 victims that focus on WTELS, spirituality, and religiosity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11469-021-00712-x.
ABSTRACT
The purpose of this study was to test if coronavirus disease 2019 (COVID-19) traumatic stress predicts posttraumatic stress disorder (PTSD) symptoms after cumulative trauma and whether there is a three-way interaction between COVID-19 traumatic stress, cumulative trauma, and race in the prediction of PTSD. Using a cross-sectional design, a diverse sample of 745 participants completed measures of cumulative trauma, COVID-19 traumatic stress, and PTSD. COVID-19 traumatic stress accounted for a significant amount of the variance in PTSD above and beyond cumulative trauma. A significant interaction effect was found, indicating that the effect of COVID-19 traumatic stress in predicting PTSD varied as a function of cumulative trauma and that the effects of that interaction were different for Asians and Whites. There were generally comparable associations between COVID-19 traumatic stress and PTSD at low and high levels of cumulative trauma across most racial groups. However, for Asians, higher levels of cumulative trauma did not worsen the PTSD outcome as a function of COVID Traumatic Stress but did at low levels of cumulative trauma.
Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Cross-Sectional Studies , Humans , Stress Disorders, Post-Traumatic/diagnosis , White PeopleABSTRACT
COVID-19 presents continuous cumulative multilayered traumatic stressors that have a significant mental health impact on refugees and especially Syrian refugees. A sample of 417 Syrian refugees in Turkey participated in an online survey that included measures for COVID-19 traumatic stress (COVID-19TS), cumulative stressors and traumas, posttraumatic stress disorder (PTSD), depression, generalized anxiety, and existential death and status anxieties. We conducted an independent samples t test between those hospitalized due to COVID-19 infection (N = 47) and the others. Further, we conducted path analysis supplemented by PROCESS macro to identify the mediators. The path model included cumulative stressors and traumas and COVID-19TS as independent variables, existential status and death anxieties as mediating variables, and PTSD, depression, and anxiety as outcome variables. We conducted multigroup invariance to test the path model equivalence across genders and tortured and nontortured groups. Results indicated that the participants are highly traumatized and include a relatively high number of torture survivors (N = 102). Being tortured was a decisive risk factor for being hospitalized for COVID-19, with over 75% of the hospitalized been torture survivors. The sample participants have high rates of PTSD, depression, and anxiety, especially among those hospitalized due to COVID-19 and those with a history of torture. COVID-19TS has the highest association with its economic trauma. COVID-19TS is directly associated with elevated PTSD, depression, and anxiety comorbid symptoms and indirectly via existential death and status anxieties as mediators. The path model was strictly invariant across genders and tortured and nontortured groups. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
ABSTRACT
COVID-19 challenges the known traditional coping skills of the individual. New innovative concepts are evolving that may help fill some gaps in our knowledge of intrinsic human strengths to cope with the COVID-19 pandemic, such as the "will-to exist-live, and survive" (WTELS) and striving for higher standards of perfectionism. The current study tested a model of coping to 3 main COVID-19 traumatic stressors: fears of infection, economic traumas, and lockdown (related isolation/disturbed routines, and social difficulties). We used a sample of 1,377 participants from 7 Arab countries and measures of COVID-19 traumatic stressors, WTELS, striving for high standards (perfectionism), resilience, social supports, socioeconomic status, and well-being. We conducted structural equation (SEM) analysis to test whether WTELS as an independent variable predicts COVID-19 stressors as a latent variable (with three observed COVID-19 stressors types: fears, economic, and lockdown stressors) and whether this relationship is mediated in part by resilience, striving for high standards, social support, socioeconomic status, and well-being. WTELS indirectly and indirectly via the mediating variables had significant effects on lowering COVID-19 traumatic stress and its 3 stressor types. Alternative models did not fit as well with the data. In addition, the model was strictly invariant across genders. We discuss the conceptual and clinical implications of the results. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
ABSTRACT
The current research aims to test the new measurement model of COVID-19 stressors which includes four stressor types: infection fears, lockdown, economic, and grief in one second-order factor. Using a sample of 2732 from 11 Arab countries and measures for COVID-19 stressors, PTSD, depression, anxiety, and executive function, we conducted exploratory and confirmatory factor analyses, multigroup invariance, and correlations. A second-order factor with four first-order factors model fit the data well. All factors were significantly correlated with PTSD, depression, anxiety, working memory, and inhibition deficits. The measure and its four subscales have robust psychometrics and were invariant across genders. [ABSTRACT FROM AUTHOR] Copyright of Journal of Loss & Trauma is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
ABSTRACT
COVID-19 challenged the current paradigms of traumatic stress. Although there are diagnostic taxonomies of mental disorders such as Diagnostic and Statistical Manual of Mental Disorders and International Statistical Classification of Diseases and Related Health Problems, the taxonomy of stressors and traumas that contribute significantly to such disorders is lacking. The current article tried to fill parts of this gap by proposing an update and refinement of the development-based taxonomy of stressors and traumas from a life-course perspective. We discussed the different trends in defining trauma and their limitations considering the recent empirical data that provided evidence for the limited predictive validity of the current posttraumatic stress disorder model and when confronting serious real-life events such as the COVID-19 pandemic. The updated taxonomy presented in this paper included preidentity (complicated birth, attachment disruptions, early childhood adversities), identity traumas (physical, personal, and social), interdependence (primary, secondary, and tertiary), and aging stressors and traumas, with the severity of stressors, is categorized on a scale from I to III. We identified 4 primary sources and pathways of these development-based stressors: intrapersonal, interpersonal, systemic, and environmental. The systemic sources are further divided into systemic "A," including traumas perpetrated by groups, institutions, or governments, and systemic "B," traumas such as recessions and global warming. The environmental sources and pathways are further divided into environmental "A" (physical), traumas such as earthquakes and hurricanes, and environmental "B" (biological/pathogenic), traumas such as pandemics. The macrodynamics of accumulation and proliferation and the interaction among preidentity, identity, and postidentity stressors and traumas determine their total mental health impact from a life-course perspective. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
ABSTRACT
COVID-19 pandemic's mental health impact on Arab countries is under-researched. The goal of this investigation was to study the differential impact of COVID-19 on the mental health of Arab countries. A questionnaire including measures of COVID-19 traumatic stress, PTSD, depression, anxiety, and cumulative stressors and trauma was distributed anonymously online in seven Arab countries (Egypt (N = 255), Kuwait (N = 442), Jordan (N = 216), Saudi Arabia (N = 212, Algeria (N = 110), Iraq and Palestine (N = 139)). We used ANOVA and stepwise regression to analyze the data. For each country, regression, PTSD, depression, and anxiety were dependent variables; we entered in the first-step, gender, age, religion, education, and income. In the second step, we entered "cumulative stressors and traumas." In the third step, we entered COVID-19 traumatic stress. The ANOVA results indicated that the differences in COVID19 traumatic stress, PTSD, depression, and anxiety between the countries were significant. Post-hoc analysis indicated that Egypt is significantly higher than all the other Arab countries in COVID-19 traumatic stress, PTSD, anxiety, and depression. The subsample from Palestine and Iraq had a significantly higher cumulative trauma load than the other Arab countries but did not have higher levels of COVID-19 traumatic stress or PTSD. Stepwise regression indicated that COVID-19 traumatic stress accounted for significant variance above and beyond the variance accounted for by previous cumulative stressors and traumas for anxiety in all countries and PTSD and depression in all countries except for Algeria. We discussed the implications for these results for the urgent mental health needs of Arab countries.