Inventory of Sources of Stress During Medical Education - Further Validation

Introduction: The Inventory of Academic Sources of Stress in Medical Education (IASSME) evaluates the presence and intensity of the main sources of academic stress for Portuguese Medicine students in five dimensions: Course demands/CD, Human demands/HD, Lifestyle/LS, Academic competition/AC, and Academic adjustment/AA. Objective(s): To further validate the ISSME using Confirmatory Factor Analysis and to analyze[ATP1] the psychometric properties of a new version including additional sources of stress. Method(s): Participants were 666 Portuguese medicine (82.6%) and dentistry (17.4%) students (81.8% girls);they answered an online survey including the ISSME and other validated questionnaires: Maslach Burnout Inventory - Students Survey (MBI-SS) and Depression Anxiety and Stress Scales (DASS). Result(s): Confirmatory Factor Analysis showed that the second order model composed of five factors (the original structure by Loureiro et al. 2008), but excluding item 11 (loading=.371), presented good fit indexes (chi2 /df=3.274;RMSEA=.0581, p<.001;CFI=.917;TLI=.904, GFI=.919). The Cronbach's alfas were alpha=.897 for the total and from alpha=.669 (F2-HD) to alpha=.859 (F1-CD) for the dimensions. The expanded version, including two additional items related to lack of interest in medicine/dentistry (F6, alpha=.543) and two additional COVID-19 stress-related-items (F7, alpha=.744) also showed acceptable fit indexes (chi2 /df=3.513;RMSEA=.061, p<.001;CFI=.88.;TLI=.866, GFI=.892). This new version's alpha was of .896. Pearson correlations between ISSME and the other measures were significant (p<.01) and high: >.55 with DASS and >.50 with MBI-SS. Girls presented significantly higher ISSME scores. F6 score was significantly higher in dentistry students. Conclusion(s): This further validation study underlines that IASSME presents good validity (construct and convergent) and reliability.

COVID-19 Pandemic: Another Source of Stress for Medical Students

Introduction: The COVID-19 pandemic has completely changed the experience of higher education with potentially negative consequences for students' wellbeing. Objective(s): To compare medicine/dentistry students' depression/ anxiety/stress levels before versus during the pandemic and to analyse the role of COVID-19-related stressors in their psychological distress. Method(s): Students from the Faculty of Medicine University of Coimbra answered socio-demographic and personality questionnaires and the Depression, Anxiety and Stress Scale/DASS before (academic years 2016-2017-2018-2019 - SAMPLE1;n=1000) and during (September-December 2020 and January-March 2021 - SAMPLE2;n=650) the COVID-19 pandemic. Mean age (21.12+/-3.75), personality traits scores, and gender proportions (75% girls) did not significantly differ between samples. SAMPLE2 also filled in the Fear of COVID-19 Scale and a new version of the Inventory of Sources of Stress During Medical Education/ISSDME, containing a COVID-19 -related dimension (restrictions on training and on socializing with friends/colleagues). Result(s): SAMPLE2 presented significantly higher mean scores of depression (3.89+/-3.55vs.3.33+/-3.34), anxiety (3.27+/-4.08vs.2.86+/-3.29), stress (7.07+/-5.72vs.6.18+/-4.59) and total DASS (12.28+/-10.55vs.13.65+/-11.13) than SAMPLE1 (all p<.05). Fear of COVID-19 was a significant predictor of DASS score (adjusted R2=2.9%, p<.001). COVID-19-related stressors continued explaining significant increments of DASS variance after controlling for each of the ISSDME dimensions: Course demands (R2 Change=1.8%), Human demands (2.5%), Lifestyle (2.3%), Academic competition (5.5%), and Academic adjustment (5.2%) (all p<.001). Conclusion(s): This study adds to the evidence of the negative impact of COVID-19 on students and emphasizes its pernicious role on medical students' psychological distress, which is already higher due to the individual and academic stressors to which they are more exposed.

Adherence to the Recommendations from the Portuguese General Directorate of Health (GDH) during the COVID-19 pandemic: fear or prosocial behaviour?

Introduction: During a public health crisis, preventive measures are essential. However, to make them effective, all citizens must be engaged. Objective(s): To analyse the differential role of individual and contextual variables in the adherence to public health recommendations. Method(s): 1376 adults (70.5% female;mean age=35.55+/-14.27) completed a survey between September/2020 and May/2021 with: Adherence Scale to the Recommendations during COVID-19 (ASR-COVID19;evaluates three dimensions of adherence), Fear of Covid-19 Scale (FC19S) and Toronto and Coimbra Prosocial Behaviour Questionnaire (ProBeQ;assesses empathy and altruism). Result(s): Adherence did not differ between individuals with or without personal or family history of COVID-19 infection. ASRCOVID19 and all dimensions were positively correlated to ProBeQ's altruism and empathy (from r=.32 to r=.54);FCV19S correlated positively to total adherence score and house sanitation (from r=.18 to r=.26;all p<.01). Linear regressions revealed that altruism and empathy (first model), as well as fear of Covid-19 (second model), were significant predictors of adherence;however, while the first model explained ffi28% of its variance, the second (FCV19S as independent variable) only explained ffi3%. Regression models performed in a subsample of participants with personal or family history of COVID-19 revealed that only empathy, but not altruism, was a significant predictor of adherence;in this subsample, fear was no longer a significant predictor of adherence, except for lockdown and use of teleservices. Conclusion(s): Based on our results, we suggest health care providers and public health campaigns should take into consideration social solidarity and altruism, as well as previous experiences, when appealing to public's engagement in health behaviour.

From Perceived Vulnerability to Disease to Psychological Distress in times of COVID19 pandemic

Introduction: Perceived vulnerability to disease/PVD may influence psychological reactions to COVID-19 pandemic. Objective(s): To analyse the role of PVD in psychological distress/PD during the COVID-19 pandemic, testing whether it is mediated by perceived risk of COVID-19, fear of COVID-19 and repetitive negative thinking/RNT. Method(s): Participants (N=413 adults;69.2% women) were recruited from September until December 2020, via social networks. They completed the following self-report validated questionnaires: Perceived Vulnerability to Disease Questionnaire/ PVDQ;Perceived Risk of COVID-19 Scale, Fear of COVID-19 Scale;Perseverative Thinking Questionnaire and Depression Anxiety and Stress Scale. As women had significantly higher levels of PVD, COVID-19 perceived risk and fear, RNT, and psychological distress/PD, gender was controlled in mediation analysis (using PROCESS macro for SPSS;Hayes 2018). Result(s):All the variables significantly (p<.01), moderately (r>.20) and positively correlated. The serial mediation model 6 with the three sequential mediators resulted in significant total effect (c=.326, se=.0791, p<.001, CI:.1702-.4814), non-significant direct effect (c'=.111, se=.065, p=.087, CI:-.0162 to .2380), significant total indirect effect (.2149, se=.065, CI:.1079-.3278);most indirect effects were significant, including the indirect 7 (.0144, se=.0077, CI=.0017-.0320), that goes through all mediators (PVD->COVID19 perceived risk->COVID19 fear->RNT->PD), meaning full mediation. Conclusion(s): The effect of PVD on psychological distress operates by increasing the perception of risk and the fear of COVID-19, which intensify related worries and ruminations in times of pandemic. People with high perceived threat, aversion and discomfort in situations associated with increased risk of infection should be helped to decrease dysfunctional cognitive contents and processes in times of pandemic.

Relationship between personality, adherence to (mental) health behaviours and psychological distress during the COVID-19 pandemic

Introduction: Public health authorities around the world have been disseminating messages to support mental health and psychosocial well-being during the COVID-19 pandemic. Based on the Portuguese guidelines, we have developed the Adherence Scale to the RecommendationsforMental Health during the COVID-19 Pandemic (ASR-MH-COVID19) to better understand this health behaviour. Objective(s): To analyse the relationship between sociodemographics, personality traits, Adherence (to the Recommendations for Mental Health during the COVID-19 Pandemic) and psychological distress. Method(s): 413 individuals (69.2% female;mean age=31.02+/-14,272) completed an on-line survey, in September-December 2020, including sociodemographic questions, ASR-MH-COVID19, NEO-FFI-20 and Depression Anxiety Stress Scale (DASS-21) and Health Perception Scale. Result(s):Adherence scores did not significantly differ by gender, age and years of education. Women presented higher DASS and Neuroticism scores (p<.01). Adherence were negatively correlated with Neuroticism (r=-.247) and with Depression/Anxiety/Stress (all r.- 200), positively with Openness to Experience (r=.174), Conscientiousness (r=.194) and Perceived Health (Physical, r=.173 and Psychological, r=.215) (all p<.01). Mediation analysis (Hays' Macro Process - Model 4) revealed that Adherence is a partial mediator between Openness and DASS and Conscientiousness and DASS;when considering Neuroticism, only the direct effect was significant. The effect of Perceived Health (both Physical and Psychological) on DASS was also mediated by Adherence. Conclusion(s): The Health Behaviour Model proposes a pathway linking personality and health that applies to these results about adherence and psychological distress during the COVID-19 pandemic. Personality and perceived health (also a trait) influence both adherence to mental health behaviours and psychological distress. Understanding personality is vital for health care providers.

Adherence Scale to the Recommendations for Mental Health during the COVID-19 pandemic from the Portuguese General Directorate of Health (ASR-MHCOVID19) - Development and validation

Introduction: The COVID-19 crisis has generated an increasing stress throughout the population. Objective(s): To develop and validate the Adherence Scale to the Recommendations for Mental Health during the COVID-19 pandemic from the Portuguese General Directorate of Health (GDH) (ASR-MH-COVID19). Method(s): The items content was based on the GDH guides for the prevention of mental health and psychosocial well-being of the general population during the COVID-19 outbreak. After content and facial validity analysis, the preliminary version of the ASR-MHCOVID19 (8 items to be answered on a Likert scale) was completed by 413 individuals (69.2% female;mean age=31.02+/-14,272), in September-December 2020 (Sample1) and then by 967 (70.9% female;mean age=34.02+/-14,272), in February-May 2021 (Sample2). Sample1 was randomly divided in two sub-samples. Sample1A was used for exploratory factor analysis/EFA and Sample1B for confirmatory factor analysis/CFA;CFA was then replicated with Sample2. The online surveys also included the Adherence Scale to the Recommendations of Portuguese GDH to minimize the impact of COVID-19 (ASR-COVID-19;Pereira et al. 2020). Result(s): CFAs were informed by EFA and showed that the unidimensional model presented acceptable-good fit indexes (Sample1B: chi2 /df=2.747;RMSEA=.0980, p<.001;CFI=.973;TLI=.918, GFI=.972;Sample2: chi2 /df=3.327;RMSEA=.0490, p<.001;CFI=.993;TLI=.983, GFI=.990). Cronbach's alfas were alpha<.850. Pearson correlations between ASR-MH-COVID19 and ASR-COVID19 were significant (p<.01) and moderate-high for the total (r=.753) and dimensional scores (Distance and respiratory hygiene, r=.739;House and personal hygiene, r=.584;Use of remote services and isolation r=.425). Conclusion(s): The new ASR-MH-COVID19 has shown validity and reliability, allowing the investigation of this (mental) health behaviour.

Grief during the COVID-19 pandemic: A crosssectional online survey in university students

Introduction: Almost 5 million people worldwide have lost their lives due to SARS-CoV-2 (source: WHO coronavirus (COVID-19) dashboard, data of 1.10.2021;https://covid19.who.int/) and therefore, globally, there is an increase of people in grief due to the death of a significant other. Objective(s): To study psychological correlates of grief during the COVID-19 pandemic. Method(s): 591 university students, with a mean age of 23.84+/-7.95 years (range 18-65 years;76.8% women;91.2% Portuguese) completed an online questionnaire during the second COVID-19 confinement (from 15.02 to 13.03.2021), with sociodemographic questions, the Pandemic Stress Index, the Mental Health Inventory, Insomnia Scale, questions on physical/ psychological health, and social isolation. Result(s): Students bereaving the death of a significant other (n=93, 15.7%;n=25, 26.9% reported cause was SARS-CoV-2;time since death: < 3 months to 1-year), compared to those who did not (n= 498;84.3%), described poorer psychological health, higher psychological distress (depression, anxiety, lack of control) and sleep difficulties, higher levels of stress (higher impact of COVID pandemic in daily life, and higher behavior changes in response to COVID-19) and more social isolation. Conclusion(s): COVID-19 pandemic-related stress is a source of additional stress for bereaved students. Grief is also associated with social isolation, poor mental health (depression, anxiety, lack of control) and sleep difficulties. Screening efforts, guidance, and counseling from professionals of mental health care, primary health care, and universities health care services during and after the COVID-19 pandemic could be extremely beneficial for bereaved students, particularly for those at higher risk of developing prolonged grief disorder.

The Portuguese adapted version of the fear of covid-19 scale for the postpartum period

Introduction: The Portuguese version of the Fear of COVID-19 Scale (FCV-19S;Cabacos et al. 2021), composed of seven items, presented good validity and reliability to be used in general population. To be used within perinatal context, specifically in the postpartum period, we have added an item related to the baby (item 8 - "I'm afraid my baby will be infected with coronavirus-19"). Objective(s): To analyze the psychometric properties of Portuguese adapted version of the Fear of COVID-19 Scale for the postpartum period (FCV-19SP), namely construct validity, internal consistency, and convergent validity. Method(s): 207 women (mean age= 33.51 +/- 5.23 years) recruited in the postpartum period (9,06 +/- 8,52 months after delivery) fill in a set of self-reported validated questionnaires: Perinatal Depression Screening Scale (PDSS), Perinatal Anxiety Screening Scale (PASS) and Coronavirus-19 Fear Scale for the postpartum period (FCV-19SP). Result(s): CFA revealed that the unifactorial model composed of eight items presented good fit indexes (X2 /df=1.508;CFI=.991;GFI=.974;TLI=.983;p[RMSEA<=.01] = .049), better than those of the seven items version (X2 /df=3.963;CFI=.957;GFI=.909;TLI=.905;p[RMSEA<=.01] =.219). Cronbach alpha for the FCV-19SPP was alpha=.880. The total score significantly (p<.01) and moderately correlated with PDSS (r=.262) and PASS (r=.371). Conclusion(s): The FCV-19SP is a valid and reliable questionnaire to assess fear of COVID-19 in women in the postpartum period.

Worries during the COVID-19 pandemic - which were the most prevalent and disturbing?

Introduction: The COVID-19 pandemic has brought additional worries and challenges to people's lives, with potential implications for psychological well-being. Objective(s): To understand which worries and life changes have affected most the Portuguese general population during the COVID-19 pandemic and to analyse which contents are associated with higher levels of repetitive negative thinking/RNT and psychological distress/PD. Method(s): In September-December 2020, 413 Portuguese adults (69.2% female;Mean age= 31.02+/-14.272) were asked one open questions, with reference to the COVID-19 pandemic period: "what was your biggest worry?" the answers were independently categorized by two researchers. Participants also filled the validated Depression Anxiety and Stress Scale and the Perseverative Thinking Questionnaire. Result(s): The most prevalent worries were about: 1) fear of contamination (oneself and others-48.7%;2) physical and mental health and well-being (self and others)-27.2%;3) studies and profession-13.3%;4) uncertainty about the future-7.7%;5) economic-financial issues-6.5%;6) miscellaneous-3.3%;7) no worries-0.7%. Participants who had worries of the theme 4 had the highest RNT and PD mean scores, followed by themes 3 and 5, and then themes 2 and 1. These thematic groups significantly (p<.01) differ between each other (except 3-5) and from the other groups. RNT was a significant predictor of PD (R2 =37.0%, beta=.609, p<.001). Conclusion(s): People who worry about the future uncertainties, occupational activities and finances should be systematically assessed with regard to their levels of anxiety, depression and stress and they can learn to deal with the RNT as a way to reduce their psychological suffering in times of pandemic.

Inventory of Sources of Stress During Medical Education - Further Validation

Introduction The Inventory of Academic Sources of Stress in Medical Education (IASSME) evaluates the presence and intensity of the main sources of academic stress for Portuguese Medicine students in five dimensions: Course demands/CD, Human demands/HD, Lifestyle/LS, Academic competition/AC, and Academic adjustment/AA. Objectives To further validate the ISSME using Confirmatory Factor Analysis and to analyze the psychometric properties of a new version including additional sources of stress. Methods Participants were 666 Portuguese medicine (82.6%) and dentistry (17.4%) students (81.8% girls);they answered an online survey including the ISSME and other validated questionnaires: Maslach Burnout Inventory – Students Survey (MBI-SS) and Depression Anxiety and Stress Scales (DASS). Results Confirmatory Factor Analysis showed that the second order model composed of five factors (the original structure by Loureiro et al. 2008), but excluding item 11 (loading=.371), presented good fit indexes (χ2/df=3.274;RMSEA=.0581, p<.001;CFI=.917;TLI=.904, GFI=.919). The Cronbach’s alfas were α=.897 for the total and from α=.669 (F2-HD) to α=.859 (F1-CD) for the dimensions. The expanded version, including two additional items related to lack of interest in medicine/dentistry (F6, α=.543) and two additional COVID-19 stress-related-items (F7, α=.744) also showed acceptable fit indexes (χ2/df=3.513;RMSEA=.061, p<.001;CFI=.88.;TLI=.866, GFI=.892). This new version’s α was of .896. Pearson correlations between ISSME and the other measures were significant (p<.01) and high: >.55 with DASS and >.50 with MBI-SS. Girls presented significantly higher ISSME scores. F6 score was significantly higher in dentistry students. Conclusions This further validation study underlines that IASSME presents good validity (construct and convergent) and reliability. Disclosure No significant relationships.

Levels of depressive and anxious symptoms of pregnant women before vs. during the COVID-19 pandemic

IntroductionThe effects on the population’s mental health due to the rapid global spread of COVID-19 are even greater for specific groups such as pregnant women.ObjectivesTo compare levels of depressive and anxiety symptoms of pregnant women before vs. during the COVID-19 pandemic and to analyze the role of COVID-19 fear in perinatal psychological disorder.Methods200 Brazilian women evaluated during the pandemic in May-June 2020 (Sample-1) with the Brazilian Covid-19 Fear Scale for the Perinatal Period (Barros et al. 2020) and Screening for Perinatal Depression and the Perinatal Anxiety Crawl Scale, both with α> .90. Sample-1 was compared with a sample of 300 Portuguese women;these responded to the same questionnaires, before the pandemic, in 2017 and 2018 (Sample-2).ResultsSample-1 had significantly higher mean scores of depression (52.73 ± 20.26 vs. 35.87 ± 16.98, t = 10.77, p <.001) and anxiety (36.58 ± 18.23 vs. 18.50 ± 13.71, t = 11.94, p <.001) and correlated significantly (p <.05) and moderate (r.30) with the fear of COVID-19. Hierarchical regression analyzes showed that, even after controlling for the effect of risk factors for PPP (Pereira et al. 2020), fear of COVID-19 is a significant predictor of depressive symptomatology levels (increments of 2-5%) and anxious (10-15%) during the pandemic.ConclusionsThe Sample-1 being from a different country may be a confusing factor, however, the magnitude of differences in PPP levels and the relevant role of fear in COVID-19, alert us to be aware of perinatal mental health.

Brazilian version of the postpartum depression screening scale-24

IntroductionThe PDSS-24 is a Portuguese short version of the Postpartum Depression Screening Scale (Beck and Gable, 2002). Items were selected on the basis of exploratory factor analysis (those with loadings >.60). The PDSS-24 proved to be superior to the 35-items PDSS in reliability, validity and screening ability (Pereira et al. 2013).ObjectivesTo analyze the psychometric properties (construct validity using Confirmatory Factor Analysis, discriminant validity and reliability) of the Brazilian preliminary version of PDSS-24MethodsAfter confirming the items semantic equivalence and slightly adapt two adjectives from European to Brazilian Portuguese, 350 pregnant women (Mean age: 30.01±5.452;Mean gestation weeks=25.17±6.55), with uncomplicated pregnancies, completed the PDSS-24 and the Brazilian recently validated versions of Profile of Mood States-25 (PoMS;Barros et al. 2021). SPSS and AMOS software were used.ResultsAfter some errors were correlated the multidimensional second-order model of PDSS-24 presented an aceptable fit (χ2=3.448;RMSEA=.099;CFI=.817, TLI=.886, GFI=.886). The PDSS Cronbach’s alpha for the total was α=.90. Cronbach alpha was .90 for the total and >.75 for the dimensions. Appling the Portuguese validated cut-off score for Major Depression/DSM-5 (>42) to this sample 224 (64.0%) participants presented clinical relevant depressive symptoms.ConclusionsThe Brazilian PDSS-24 has acceptable validity and reliability. The percentage of women with high depressive symptomatology is three times higher than the figures reported in Portuguese Studies. This can be partly explained by the fact that data collection was done during the COVID19 pandemic. It is important to determine the PDSS cut-offs to screen for perinatal depression in Brazil.

Relationship between COVID-19 perceived risk and perfectionism – a preliminary study

IntroductionResearch following the Covid-19 pandemics has shown that psychological reactions to the pandemic and its constraints can vary significantly depending on personality. One of the traits that has not been studied yet, but can play a harmful role in the COVID-19 psychological impact is perfectionism. This trait, characterized by setting excessively high standards of performance and striving for flawlessness, has increased in recent years and is considered a transdiagnostic process involved in several (mental) health problems (Curran & Hill 2019).ObjectivesTo analyze the role of Perfectionism in the levels of fear of COVID19 and of perception of infection risk by COVID-19.Methods234 adults (75.6% women;mean age=29.53±12.51) completed an on-line survey with the Portuguese validated versions of Covid-19 Perceived Risk Scale (C19PRS;Pereira et al. 2020), Fear of COVID-19 Scale (FC19S;Cabaços et al. 2020) and Big Three Perfectionism Scale (BTPS;Garrido et al. 2020). SPSS was used to perform correlation and regression analysis.ResultsPerceived Risk and Fear of COVID-19 were significantly correlated with perfectionism (.243, .228, respectively) (both, p<.01). Perfectionism explains 5.5% (Adjusted R2) of the FC19S variance (Beta=.243, p<.001) and 4.8% of the C19PRS variance (Beta=.228, p=.01).ConclusionsThis study provides preliminary, but completely innovative evidence that perfectionism contribute to the psychological impact of Covid-19 pandemics. In the near future we will test the hypothesis that the nature of unpredictability and the limitations imposed by the global crisis may be exacerbating the already high levels of psychological distress that affect negative perfectionists.

Portuguese version of the COVID-19 perceived risk scale – psychometric study

IntroductionRisk perception of COVID-19 is potentially a significant determinant of the pandemic evolution and the public’s response to it. Acceptable levels of risk perception can be considered good for people to effectively fight the pandemic and adopt preventive health behaviors while high levels of risk perception may be damaging. Recently, Yıldırım&Güler (2020) developed the Covid-19 Perceived Risk Scale (C19PRS) to measure this construct.ObjectivesTo analyze the psychometric properties of the C19PRS Portuguese version, namely construct validity, internal consistency and convergent validity.MethodsA community sample of 234 adults (75.6% women;mean age= 29.53±12.51;range:16-71) completed an on-line survey with the Portuguese versions of the CPRS and the Fear of Covid-19 Scale (FCV-19S;Cabaços et al. 2020). The total sample was randomly divided in two sub-samples: sample A (n=117) was used to perform an exploratory factor analysis/EFA;sample B (n=117) to make a confirmatory factor analysis/CFA.ResultsEFA resulted in three components. CFA revealed that the second-order model with three factors presented good fit indexes (X2/df=1.471;CFI=.959;GFI=.948;TLI=.932;p[RMSEA≤.01]=.065). CPRS Cronbach alphas was α=.687;for F1 Worry, F2 Susceptibility to Covid-19 and F3 Susceptibility to Overall Morbimortality were α=.747, α=.813 and α=.543, respectively. The total and dimensional scores significantly correlated with FCV-19S (r>.30, p<.01).ConclusionsThis study provides evidence for the validity and reliability of the Portuguese version of CPRS, which will be used in an ongoing research project on the relationship between Covid-19 perceived risk, perfectionism, cognitive processes and adherence to public health measures to contain the pandemic.

Portuguese version of the fear of COVID-19 scale – psychometric study

IntroductionMore than in other conditions, fear is associated with infectious diseases, and is directly associated with its transmission rate, morbidity and mortality. High levels of fear can affect the individual’s ability to think clearly, react proportionately and make rational decisions in the context of COVID-19. Recently, Mertens et al. (2020) developed the Fear of Covid-19 Scale (FCV-19S) to measure this construct.ObjectivesTo analyse the psychometric properties of the FCV-19S Portuguese version, namely construct validity, internal consistency and convergent validity.MethodsA community sample of 234 adults (75.6% women;mean age= 29.53±12.51;range:16-71) completed an on-line survey with the Portuguese versions of the FCV-19S, the Covid-19 Perceived Risk Scale (CPRS) and the Depression Anxiety Stress Scale (DASS-21).The total sample was randomly divided in two sub-samples: sample A (n=117) was used to perform an exploratory factor analysis/EFA;sample B (n=117) to make a confirmatory factor analysis/CFA.ResultsEFA resulted in one component. CFA revealed that the unifactorial model presented acceptable fit indexes (X2/df=3.291;CFI=.977;GFI=.932;TLI=.919;p[RMSEA≤.01]=.091). Cronbach alpha was α=.855. The total score significantly correlated with Covid-19 Perceived Risk (r=.529, p<.01) and with anxiety from DASS-21 (r=.132, p<.05).ConclusionsThis study provides preliminary evidence for the validity and reliability of the Portuguese version of FCV-19S, which will be used in an ongoing research project on the relationship between fear of Covid-19, personality, cognitive processes and adherence to public health measures to contain the pandemic.

Relationship between fear of COVID-19 and individual factors – a preliminary study

IntroductionFear associated to infectious diseases is directly related with their transmission rate, morbidity and mortality. High levels of fear associated with COVID-19 can affect people’s ability to act and think rationally. In a time of pandemics, it is essential to understand individual factors that might be associated to higher vulnerability to stress and fear.ObjectivesTo analyse: a)correlations between Fear of Covid-19 and clinical and sociodemographic characteristics;b)the mediator role of repetitive negative thinking on the relationship between personality traits and Fear of Covid-19.Methods234 adults (75.6% women;mean age=29.53±12.51) completed an on-line survey with the Portuguese version of the Fear of Covid-19 Scale (FCV-19S) and other questionnaires to evaluate clinical and sociodemographic characteristics (years of education, perceived physical and mental health and infection by Covid-19), Personality (NEO-FFI-20) and Repetitive negative thinking (PTQ-15). SPSS and Process Macro (Hays, 2020) were used.ResultsFCV-19 mean scores were significantly higher in women and significantly correlated with years of education (r=-.14) (p<.05). History of previous/current Covid-19 infection did not significantly distinguish FCV-19 scores and they did not correlate with perceived health. FCV-19 correlated significantly with neuroticism and PTQ total and dimensional scores (r>.20, p<.01). Both Repetitive thinking and Cognitive interference were mediators of the relationship between neuroticism and fear of COVID, even after controlling for gender and education.ConclusionsThis study provides preliminary evidence on individual factors that might be associated to the emotional response to the Covid-19 pandemics, aiming to facilitate public health initiatives to ease people’s fears in a near future.

COVID-19 Fear Scale - Validation and adaptation for the perinatal period

Introduction: The comprehensive effects on the mental health of the population due to the rapid global spread of COVID-19 are even more harmful to specific groups of individuals, including pregnant women. Objective: To analyze the psychometric properties of the COVID-19 Fear Scale for Perinatal Period (EMC19-9). Methods: This is a cross-sectional study with 204 pregnant women. Participants were recruited online through social networks. The criteria for participation in the research were: pregnant and aged 18 years or older. An electronic form was filled out, which included the preliminary Portuguese version of the COVID-19 Fear Scale (EMC19), containing the seven items in the original version and the two additional items related to pregnancy and baby, socio-demographic, psychosocial and related to pregnancy, as well as the validated Brazilian versions of the Perinatal Depression Screening Scale and the Perinatal Anxiety Screening Scale. The SPSS version 26 statistical package was used. For parametric measures, Pearson’s coefficient and Student’s T and non-parametric - Mann Whitney’s U. And the magnitude of the correlation coefficients with perinatal anxiety and depression symptoms, Cohen’s criteria. AMOS 26.0 was used for confirmatory factor analysis. For internal consistency, Cronbach’s alpha. Results: The results indicate that EMC-19-9 is a onedimensional construct, has robust psychometric qualities, very good internal consistency of the questionnaire and shows convergent validity, has a moderate and significant correlation with perinatal anxiety and a significant, albeit slight, correlation with perinatal depression. Conclusion: the Covid-19 Fear Scale for the Perinatal Period (EMC-19-9) has robust psychometric qualities and convergent validity. EMC-19-9 is a reliable and valid tool to assess the severity of fear of COVID-19 among women in the perinatal period in Brazil. © The authors (2021), this article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.