The Up-Side of the COVID-19 Pandemic: Are Core Belief Violation and Meaning Making Associated with Post-Traumatic Growth?

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.

Linguistic Predictors of Psychological Adjustment in Healthcare Workers during the COVID-19 Pandemic

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.

Linguistic Predictors of Psychological Adjustment in Healthcare Workers during the COVID-19 Pandemic.

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.

Psychological Factors Explaining the COVID-19 Pandemic Impact on Mental Health: The Role of Meaning, Beliefs, and Perceptions of Vulnerability and Mortality.

This study tested an expanded version of the explanatory model of the negative impact of the COVID-19 pandemic on mental health proposed by Milman and colleagues. Participants (N = 680) completed an online survey on demographic variables associated with poor pandemic mental health, COVID-19 stressors, mental health symptoms, and pandemic-related psychological processes we hypothesized as mediating mechanisms explaining the negative mental health effects of the COVID-19 stressors. Results indicated that these psychological processes (core belief violation, meaning made of the pandemic, vulnerability, and mortality perception) explained the severity of mental health symptoms to a far greater extent than COVID-19 stressors and demographics combined. In addition, these psychological processes mediated the impact of COVID-19 stressors on all mental health outcomes. Specifically, COVID-19 stressors were associated with increased core belief violation, decreased meaning making, and more intense perceived vulnerability and mortality. In turn, those whose core beliefs were more violated by the pandemic, who made less meaning of the pandemic, and who perceived a more pronounced vulnerability and mortality experienced a worse mental health condition. This study's results suggest some possible ways of intervention in pandemic-like events useful for limiting such impact at the individual, group, social and political levels.

Changes in Clinical Process as a Result of Online Therapy: Findings from a Single Case Study.

Introduction: This study examined changes in the clinical interaction in a single clinical dyad between sessions conducted in person and sessions conducted remotely, applying linguistic indicators based on multiple code and referential process theory. Methods: Sessions from an ongoing psychotherapy of a male patient in his late 30s were audio-recorded and transcribed. Linguistic indicators, including the Weighted Referential Activity Dictionary (WRAD), were scored, and graphed using the Discourse Attributes Analysis Program (DAAP). The sessions included 8 sessions immediately before online work, 10 sessions immediately following the implementation of online work, and 12 sessions collected several months after the clinical dyad had been working remotely. Results: A comparison of in-person sessions to telehealth sessions shows that the patient spoke more in post-telehealth sessions but with decreased emotional engagement, as evidenced by a decrease in WRAD. The therapist appeared to be working harder to communicate that he was listening as evidenced by an increase in the measure of non-turn vocalizations (interjections such as hmm). Discussion: It appears that both patient and therapist were working harder to remain connected and communicate that they were present but with limited emotional engagement. This pattern remained unaltered at a 2-month followup. The findings address empirically the subjective experience of many clinicians who have switched to remote treatment. Implications for the future of remote therapy are discussed.

Linguistic Markers of the Emotion Elaboration Surrounding the Confinement Period in the Italian Epicenter of COVID-19 Outbreak.

The expressive writing method has rarely been proposed in contexts of large-scale upheavals that affect large populations. In this study this method was applied as an intervention and tool of investigation during the confinement period in the Lombardy region, the Italian Epicenter of COVID-19 outbreak. Sixty-four participants took part in an online expressive writing project, and a total of 167 writings were collected together with some self-report evaluations on emotions and physical sensations. A linguistic analysis through two different sets of computerized linguistic measures was conducted on the collected writings in order to study the linguistic markers of emotion regulation and elaboration. Results indicated that online expressive writing has helped respondents to get more in touch with the intense emotions that were experienced following the upheavals they witnessed. Writing even only once or twice helped, particularly those respondents who had at least one COVID-19 patient among close friends or relatives. Their writings showed an intense emotional involvement together with the ability to reflect and reorganize the personal meaning of the events and emotions experienced. This study shows that expressive writing can be used in the context of a psychological emergency, both as a powerful instrument to investigate and detect the complex psychodynamic processes underpinning the distress, and as a useful intervention to reduce the negative impact of traumatic events.