How Has COVID-19 Affected Mental Health and Lifestyle Behaviors after 2 Years? The Third Step of a Longitudinal Study of Italian Citizens.

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.

The Role of Work Engagement in Facing the COVID-19 Pandemic among Mental Healthcare Workers: An Italian Study to Improve Work Sustainability during Emergency Situations

During the COVID-19 pandemic, healthcare workers faced an emergency that had significant psychological impacts on them. In this study, an investigation regarding work engagement as a protective factor for well-being was conducted on a sample of Italian healthcare workers in the field of mental health. Correlation and linear regression analyses were run on scores of standardized questionnaires about work engagement, burnout, resilience, stress, and coping strategies. Results indicate that work engagement is positively correlated with resilience, while it is negatively correlated with burnout and stress, particularly caused by personal attacks at work. As concerns the use of functional or dysfunctional coping strategies, negative correlations between work engagement and problem avoidance and emotional distress strategies were found. In conclusion, work engagement was confirmed to be an important protective factor that should be promoted among mental healthcare professionals to help them deal with health emergencies and to improve the psychological sustainability of the work.

Maternal verbal hostility amid the COVID-19 lockdown: The role of childhood verbal abuse, emotional stability and parental burnout

An increase of domestic violence is described since the beginning of the COVID-19 pandemic. Childhood maltreatment is a risk factor potentially predictive of negative parental behaviors. Parents with high levels of neuroticism and parental burnout could engage in child abuse. According to the literature, stressed parents could act the same abusive behaviors experienced in their childhood. An online survey was administered to a sample of 767 mothers during the first weeks of the lockdown, aiming at analyzing the association between parental early experiences of childhood verbal abuse and verbal hostility against their children during the lockdown, and the role of emotional stability and parental burnout. Findings support that childhood verbal abuse predicts maternal verbal hostility, and this relationship is mediated by neuroticism and parental burnout. (PsycInfo Database Record (c) 2022 APA, all rights reserved) (Italian) Dall'inizio del lockdown si e verificato un aumento di violenze familiari. Il maltrattamento infantile e un fattore di rischio che puo predire comportamenti genitoriali disfunzionali. Genitori con bassi livelli di stabilita emotiva e di burnout genitoriale possono compiere abusi sui figli. Secondo la letteratura, genitori emotivamente stressati possono ripetere i medesimi abusi esperiti nell'infanzia. Tramite una survey online somministrata durante le prime settimane di lockdown, abbiamo analizzato in un ampio campione di madri (N = 767) l'associazione tra esperienze precoci di abuso verbale subite, stabilita emotiva, burnout genitoriale e ostilita verbale verso i figli. I risultati mostrano che esperienze precoci di abuso verbale predicono l'adozione di comportamenti verbalmente abusanti verso i figli e che la stabilita emotiva e il burnout genitoriale mediano questa relazione. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

An Explainable Fake News Detector Based on Named Entity Recognition and Stance Classification Applied to COVID-19

Over the last few years, the phenomenon of fake news has become an important issue, especially during the worldwide COVID-19 pandemic, and also a serious risk for the public health. Due to the huge amount of information that is produced by the social media such as Facebook and Twitter it is becoming difficult to check the produced contents manually. This study proposes an automatic fake news detection system that supports or disproves the dubious claims while returning a set of documents from verified sources. The system is composed of multiple modules and it makes use of different techniques from machine learning, deep learning and natural language processing. Such techniques are used for the selection of relevant documents, to find among those, the ones that are similar to the tested claim and their stances. The proposed system will be used to check medical news and, in particular, the trustworthiness of posts related to the COVID-19 pandemic, vaccine and cure.

A Nationwide Survey of Psychological Distress among Italian People during the COVID-19 Pandemic: Immediate Psychological Responses and Associated Factors.

The uncontrolled spread of the coronavirus disease 2019 (COVID-19) has called for unprecedented measures, to the extent that the Italian government has imposed a quarantine on the entire country. Quarantine has a huge impact and can cause considerable psychological strain. The present study aims to establish the prevalence of psychiatric symptoms and identify risk and protective factors for psychological distress in the general population. An online survey was administered from 18-22 March 2020 to 2766 participants. Multivariate ordinal logistic regression models were constructed to examine the associations between sociodemographic variables; personality traits; depression, anxiety, and stress. Female gender, negative affect, and detachment were associated with higher levels of depression, anxiety, and stress. Having an acquaintance infected was associated with increased levels of both depression and stress, whereas a history of stressful situations and medical problems was associated with higher levels of depression and anxiety. Finally, those with a family member infected and young person who had to work outside their domicile presented higher levels of anxiety and stress, respectively. This epidemiological picture is an important benchmark for identifying persons at greater risk of suffering from psychological distress and the results are useful for tailoring psychological interventions targeting the post-traumatic nature of the distress.

Acceptance of COVID-19 Vaccination in the Elderly: A Cross-Sectional Study in Southern Italy.

In Italy, at the end of 2020, a voluntary immunization plan against COVID-19 was introduced, involving elderly among the first target categories. The aim of this study was to assess, through an online questionnaire, the acceptance of COVID-19 vaccination in a sample of older adults from southern Italy. Of a total of 1041 respondents (41.7% males, mean age 76.6 ± 6.5), 965 (92.7%) were vaccinated or willing to be vaccinated against COVID-19, although less than half of the sample was favorable to vaccinations and agreed with mandatory immunization. Acceptance of COVID-19 vaccination was found to be positively related with higher educational level (OR = 1.875, CI95% = 1.113-3.161; p = 0.018) and having social/mass media as a main source of information (OR = 2.415 CI95% = 1.358-4.296, p = 0.003). On the contrary, an inverse relationship was found between acceptance of COVID-19 vaccination and having fulfilled the questionnaire after the introduction of green pass (OR = 0.218, CI95% = 0.129-0.369; p < 0.001). Therefore, although this evidence needs to be further confirmed, it is possible to agree with previous studies reporting that compulsory measures, such as green pass implementation, must be accompanied by effective education and information strategies of the target population.

Knowledge and Lifestyle Behaviors Related to COVID-19 Pandemic in People over 65 Years Old from Southern Italy.

BACKGROUND: Control measures adopted during the COVID-19 pandemic had a considerable impact on human daily life and lifestyles. Adherence to the recommended measures is influenced by knowledge and attitudes towards the disease. This cross-sectional study aimed to assess the level of knowledge regarding COVID-19, the related control measures, and lifestyle behaviors adopted during the pandemic in a sample of elderly Italian people. METHODS: A web-based questionnaire investigating socio-demographic characteristics, knowledge of COVID-19, the related preventive measures, and lifestyle changes that occurred during the pandemic, were distributed to ≥65 years old people living in South Italy. RESULTS: A satisfactory level of knowledge about COVID-19 and the related control measures has been found in the enrolled sample. However, a decrease in physical activity, as well as worsening sleeping and dietary habits, were found in roughly 60% of participants. Females were impacted greater by these lifestyle changes. CONCLUSIONS: Participants in this study showed a good level of knowledge regarding COVID-19 and its prevention. Nevertheless, they reported an increase in unhealthy habits that may have important health consequences in the long term and should be addressed by public health interventions targeted at older people.

When "Stay at Home" Can Be Dangerous: Data on Domestic Violence in Italy during COVID-19 Lockdown.

The global pandemic caused by a new strain of Coronavirus has brought the Italian government to adopt quarantine, isolation, and lockdown strategies as restrictive measures to reduce the virus spread. Being forced to stay at home could significantly increase the likelihood of episodes of home-based violence and could also be accompanied by a limited possibility of complaints or defense by the victim. The present study aimed to document, through the use of newspaper articles, the characteristics of domestic violence during the lockdown period related to COVID-19 in Italy (from 9 March 2020 up to 18 May 2020) and compare the results with the same period in 2019. The results showed an increase in domestic violence during the lockdown period compared to the same period the year before and highlighted the differences between the dynamics and violent behavior between the two periods examined. The results and limitations of this research are discussed with reference to the literature.

Development of a Decision Support System Framework for Cultural Heritage Management

Decision support systems (DSSs) have been traditionally identified as useful information technology tools in a variety of fields, including the context of cultural heritage. However, to the best of our knowledge, no prior study has developed a DSS framework that incorporates all the main decision areas simultaneously in the context of cultural heritage. We fill this gap by focusing on design-science research and specifically by developing a DSS framework whose features support all the main decision areas for the sustainable management of cultural assets in a comprehensive manner. The main decision-making areas considered in our study encompass demand management, segmentation and communication, pricing, space management, and services management. For these areas, we select appropriate decision-making supporting techniques and data management solutions. The development of our framework, in the form of a web-based system, results in an architectural solution that is able to satisfy critical requirements such as ease of use and response time. We present an application of the innovative DSS framework to a museum and discuss the main managerial implications and future improvements.

Personality and Lockdown: A Study on Italian Undergraduates During the COVID-19 Pandemic.

The current study aimed at increasing our understanding of the psychological impact of the COVID-19 lockdown on undergraduate students, particularly with respect to the association between personality traits; defense mechanisms (DMs); depression, anxiety, and stress symptoms (DASSs); and compliance with the government recommended health measures. A sample of 1,427 Italian undergraduate students were administered the Personality Inventory for the DSM-5-Brief Form; the Defense Style Questionnaire-40; and the Depression, Anxiety and Stress Scale-21. Compliance with the COVID-19 behavioral recommendations was measured through a 10-item survey measure. Results showed that immature DMs and internalizing personality traits (i.e., detachment, negative affect, psychoticism) were risk factors of DASSs. Furthermore, subjects with higher levels of DASSs appeared less compliant with the health measures recommended by the Italian government. Experts may use these results to identify and subsequently support (via the Internet) young subjects at greater risk of mental health problems as a result of the COVID-19 pandemic.

Knowledge and Acceptance of COVID-19 Vaccination among Undergraduate Students from Central and Southern Italy.

At the end of 2020, the Italian Ministry of Health launched a national vaccination campaign to counteract the COVID-19 pandemic. The present study aimed at appraising levels of knowledge about and acceptance of COVID-19 vaccination in a sample of Italian undergraduates during the first phase of the immunization plan. A web-based questionnaire was administered to students attending universities in Bari, Naples, and Rome during the period February-April 2021. Of the total of 3226 participants, 91.9% were keen to receive a COVID-19 vaccination. More than 80% gave correct answers to questions about COVID-19 vaccine administration, functioning, and effects on community health. However, only 63.8% identified the correct composition of the available vaccines. Knowledge was found to be related to sociodemographic features and COVID-19 vaccination acceptance (p < 0.05). COVID-19 vaccination acceptance was found to be related to having a previous vaccination against influenza (OR 3.806, CI 95% 1.181-12.267; p = 0.025) and knowledge (OR 4.759, CI 95% 2.106-10.753; p = 0.000). These results show a good level of awareness about COVID-19 vaccination in this population, which may indicate the effectiveness of communication strategies accompanying the COVID-19 immunization campaign in Italy.

The COVID-19 Outbreak and Psychological Distress in Healthcare Workers: The Role of Personality Traits, Attachment Styles, and Sociodemographic Factors

The COVID-19 outbreak has exposed healthcare professionals (HPs) to increased workloads and a high risk of contagion. The present study aimed at examining the effects of the COVID-19 outbreak on the mental health of HPs in Italy, investigating the role of attachment style, personality traits, and sociodemographic variables. An online survey was administered from 18 to 22 March 2020. Respondents were 296 HPs (77% female, 23% male;aged 21–77 years). The measures employed were a sociodemographic questionnaire, the Personality Inventory for DSM-5-BF (PID-5-BF), the Attachment Style Questionnaire (ASQ), and the Depression, Anxiety and Stress Scale–21 (DASS-21). The findings showed that PID-5-BF Negative Affect, female gender, and ASQ Preoccupation with Relationships predicted high levels of stress, anxiety, and depression, respectively. Furthermore, PID-5-BF Detachment predicted higher psychological distress, as captured in the DASS-21 total score and DASS-21 Depression score, and having an infected loved one was associated with high psychological distress. Overall, the results suggest that HPs are experiencing high rates of psychological distress during the pandemic, and that specific attachment styles and personality traits might be useful in identifying those at greatest risk for developing mental health symptoms.

The COVID-19 lockdown and psychological distress among Italian parents: Influence of parental role, parent personality, and child difficulties.

The Italian lockdown following the spread of COVID-19 exposed residents to a long and unexpected period of managing offspring at home. Throughout this time, most parents continued to work remotely. The present research aimed at assessing multiple sociodemographic and psychological variables for parental well-being during the lockdown. An online survey was administered from 6 to 11 April 2020. Respondents were 917 parents aged 23-67 years with up to six children, aged 3-13 years. The measures employed were: 14 demographic questions, the Big Five Inventory (BFI-10), the Emotional Symptoms and Hyperactivity-Inattention subscales of the Strength and Difficulties Questionnaire (SDQ-P), and the General Health Questionnaire (GHQ-12). Multiple moderated linear regression analyses were performed. Motherhood, higher levels of education, higher neuroticism, lower extroversion, and more child emotional and hyperactivity-inattention symptoms were found to be significant predictors of parent distress. Furthermore, a significant two-way interaction between child emotional problems and parent extroversion was found. Overall, parents showed high rates of psychological distress, signalling severe difficulties during the lockdown. Families with a child suffering from emotional and behavioural difficulties should immediately be detected by social services to activate support interventions to prevent chronic and amplified manifestations of these problems.

How to Improve Compliance with Protective Health Measures during the COVID-19 Outbreak: Testing a Moderated Mediation Model and Machine Learning Algorithms.

In the wake of the sudden spread of COVID-19, a large amount of the Italian population practiced incongruous behaviors with the protective health measures. The present study aimed at examining psychological and psychosocial variables that could predict behavioral compliance. An online survey was administered from 18-22 March 2020 to 2766 participants. Paired sample t-tests were run to compare efficacy perception with behavioral compliance. Mediation and moderated mediation models were constructed to explore the association between perceived efficacy and compliance, mediated by self-efficacy and moderated by risk perception and civic attitudes. Machine learning algorithms were trained to predict which individuals would be more likely to comply with protective measures. Results indicated significantly lower scores in behavioral compliance than efficacy perception. Risk perception and civic attitudes as moderators rendered the mediating effect of self-efficacy insignificant. Perceived efficacy on the adoption of recommended behaviors varied in accordance with risk perception and civic engagement. The 14 collected variables, entered as predictors in machine learning models, produced an ROC area in the range of 0.82-0.91 classifying individuals as high versus low compliance. Overall, these findings could be helpful in guiding age-tailored information/advertising campaigns in countries affected by COVID-19 and directing further research on behavioral compliance.

The Effect of Parent Psychological Distress on Child Hyperactivity/Inattention During the COVID-19 Lockdown: Testing the Mediation of Parent Verbal Hostility and Child Emotional Symptoms.

The coronavirus disease 2019 (COVID-19) health crisis is strongly affecting the psychological well-being of the general population. According to a very recent literature, the imposed lockdown and social distancing measures have generated a series of negative outcomes, including fear of the future, anxiety, and somatization symptoms. Few studies have investigated the impact of the COVID-19 pandemic on the well-being of parents and children, and still fewer studies have assessed the relationship between the psychological health of parents and children. The present study aimed at understanding the effect of parents' psychological distress and verbal aggression on behavioral and emotional symptoms of children during the COVID-19 lockdown. Using an online survey administered in the first weeks of the lockdown in Italy, we explored the mediating effects of parent verbal hostility and child emotional symptoms on the relationship between parent distress and child hyperactivity/inattention in a sample of 878 Italian parents (87.4% mothers; meanage = 40.58). Two hypotheses were proposed: (1) parent distress would significantly predict child hyperactivity/inattention, and (2) parent verbal hostility and child emotional symptoms would mediate the association between parent distress and child hyperactivity/inattention. The serial mediated model confirmed both hypotheses, suggesting that higher rates of psychological distress in parents were associated with higher levels of hyperactivity/inattention in children. Parent verbal hostility and child emotional problems were also found to positively mediate this relation. Our results may be used to improve sociopsychological interventions in the general population in the near future. They may also contribute to the clinical definition of therapeutic paths for parents and families.

Psychological and Emotional Impact of Patients Living in Psychiatric Treatment Communities during Covid-19 Lockdown in Italy.

Most studies on well-being during the COVID-19 pandemic have focused on the mental health of the general population; far less attention has been given to more specific populations, such as patients with mental illness. Indeed, it is important to examine the psychiatric population, given its vulnerability. The present study aimed at assessing the psychological and emotional impact of isolation on patients in Residential Rehabilitation Communities, compared to healthy controls. A questionnaire was administered cross-sectionally on an online survey platform and both psychiatric patients and healthy controls accessed via a designed link. The results showed significant differences between psychiatric patients and controls on Anxiety, Stress, Worry, and Risk Perception variables. Psychiatric patients scored lower on Stress compared to healthy controls and higher on Anxiety, Perceived Risk of getting infected with COVID-19 and Worry about the emergency situation. The results showed that, during the Italian lockdown, psychiatric patients living in residential communities received unbroken support from peers and mental health professionals, maintained their usual medication treatment, and were informed of COVID-19 consequences. This finding provides insight into the differences between residential and healthy populations and highlights the importance of continuous support for psychiatric patients, especially during stressful situations such as a pandemic.

Weight Gain in a Sample of Patients Affected by Overweight/Obesity with and without a Psychiatric Diagnosis during the Covid-19 Lockdown.

The present study aimed at identifying psychological and psychosocial variables that might predict weight gain during the COVID-19 lockdown in patients affected by overweight/obesity with and without a psychiatric diagnosis. An online survey was administered between 25 April and 10 May 2020, to investigate participants' changes in dietary habits during the lockdown period. 110 participants were recruited and allocated to two groups, 63 patients had no psychiatric diagnosis; there were 47 patients with psychiatric diagnosis. ANOVA analyses compared the groups with respect to psychological distress levels, risk perception, social support, emotion regulation, and eating behaviors. For each group, a binary logistic regression analysis was conducted, including the factors that were found to significantly differ between groups. Weight gain during lockdown was reported by 31 of the participants affected by overweight/obesity without a psychiatric diagnosis and by 31 patients with a psychiatric diagnosis. Weight gain predictors were stress and low depression for patients without a psychiatric diagnosis and binge eating behaviors for patients with a psychiatric diagnosis. Of patients without a psychiatric diagnosis, 60% reported much more frequent night eating episodes. The risk of night eating syndrome in persons affected by overweight/obesity with no psychiatric diagnosis should be further investigated to inform the development of tailored medical, psychological, and psychosocial interventions.

A 2-Month Follow-Up Study of Psychological Distress among Italian People during the COVID-19 Lockdown.

The spread of coronavirus disease 2019 (COVID-19) has called for unprecedented measures, including a national lockdown in Italy. The present study aimed at identifying psychological changes (e.g., changes in depression, stress, and anxiety levels) among the Italian public during the lockdown period, in addition to factors associated with these changes. An online follow-up survey was administered to 439 participants (original sample = 2766), between 28 April and 3 May 2020. A paired sample t-test tested for differences in stress, anxiety, and depression over the period. Multivariate regression models examined associations between sociodemographic variables, personality traits, coping strategies, depression, and stress. Results showed an increase in stress and depression over the lockdown, but not anxiety. Negative affect and detachment were associated with higher levels of depression and stress. Higher levels of depression at the start of the lockdown, as well as fewer coping strategies and childlessness, were associated with increased depression at follow-up, whereas higher levels of stress at the start of the lockdown and younger age were associated with higher stress at follow-up. These results may help us to identify persons at greater risk of suffering from psychological distress as a result lockdown conditions, and inform psychological interventions targeting post-traumatic symptoms.

Predicting Perceived Stress Related to the Covid-19 Outbreak through Stable Psychological Traits and Machine Learning Models.

The global SARS-CoV-2 outbreak and subsequent lockdown had a significant impact on people's daily lives, with strong implications for stress levels due to the threat of contagion and restrictions to freedom. Given the link between high stress levels and adverse physical and mental consequences, the COVID-19 pandemic is certainly a global public health issue. In the present study, we assessed the effect of the pandemic on stress levels in N = 2053 Italian adults, and characterized more vulnerable individuals on the basis of sociodemographic features and stable psychological traits. A set of 18 psycho-social variables, generalized regressions, and predictive machine learning approaches were leveraged. We identified higher levels of perceived stress in the study sample relative to Italian normative values. Higher levels of distress were found in women, participants with lower income, and participants living with others. Higher rates of emotional stability and self-control, as well as a positive coping style and internal locus of control, emerged as protective factors. Predictive learning models identified participants with high perceived stress, with a sensitivity greater than 76%. The results suggest a characterization of people who are more vulnerable to experiencing high levels of stress during the COVID-19 pandemic. This characterization may contribute to early and targeted intervention strategies.

Parenting-Related Exhaustion During the Italian COVID-19 Lockdown.

OBJECTIVE: Worldwide, the coronavirus disease 2019 (COVID-19) pandemic has generated significant worry, uncertainty, anxiety, sadness, and loneliness. In Italy, these effects have been particularly pronounced. While research on the COVID-19 outbreak has mainly focused on the clinical features of infected patients and the psychological impact on the general population and health professionals, no investigation has yet assessed the psychological impact of the pandemic on parents. In the present research, we conducted a web-based survey of Italian parents to examine the prevalence of parenting-related exhaustion-and to identify its associated risk and protective factors-4 weeks into the lockdown. METHODS: A total of 1,226 parents provided their consent to participate in the study and completed a demographic questionnaire, information relating to particular COVID-19 experiences, and measures of emotional exhaustion, parental resilience, social connections, and psychological distress during the lockdown. RESULTS: Seventeen percent of our sample experienced significant parenting-related exhaustion, with mothers more severely affected. Multiple regression analyses showed that greater parenting-related exhaustion was predicted by psychological distress, lower parental resilience, motherhood, fewer perceived social connections, and being single, as well as having a child with special needs, having a large number of children, and having younger children. CONCLUSION: The findings add further support to the call for preventive programs to support parents throughout the COVID-19 pandemic. Mental health professionals and social workers should be warned of the effects of lockdown and social distancing on parenting and, consequently, the well-being of children.