ABSTRACT
Background: Although symptoms of posttraumatic stress disorder (PTSD) have been associated with the COVID-19 pandemic experiences, no study has explored yet the association of specific COVID-19 narratives with peritraumatic distress, the precursor of PTSD. Objective: To explore the worst experiences associated with peritraumatic distress during the first wave of the COVID-19 pandemic. Method: Adult residents (N = 1098), from the US (n = 741) and Italy (n = 357), completed an online survey including socio-demographic data, COVID-19-related experiences, the Peritraumatic Distress Inventory and an open question on their worst experiences during the first period of the COVID-19 pandemic (April–May 2020). A thematic content analysis (TCA) was conducted on the answers to the open question and a classification and regression tree (CART) analysis was used to identify the themes that best predicted the clinical levels of peritraumatic distress. Results: The main TCA themes related to participants’ worst COVID-19 experiences were anxiety, threat, loss, anger, stress and constriction. Threat was the most prevalent theme and correlated with experiences such as being quarantined, being infected and a loved one receiving the diagnosis. US participants’ descriptions of their worst experiences related more to life-threat and loss, while Italians reported more threat to the world, stress, social isolation, and feeling trapped. In the CART analysis, the main predictor (79.9%) was perceiving negative effects from the COVID-19 crisis. Among them, a COVID-related threat to self-experience was the most robust predictor. In its absence, being deprived of resources or experiencing high levels of anxiety were other robust predictors. Conclusions: The study provided evidence of the utility of a mixed-method approach in conceptualizing experiences associated with the COVID-19 pandemic and the risk of traumatic symptoms. Its findings may inform healthcare interventions and policies for tackling the new challenges posed by the COVID-19 pandemic. HIGHLIGHTS Clinically significant levels of peritraumatic distress symptoms were prevalent during the COVID-19 pandemic. Clinically significant levels of peritraumatic distress during the COVID-19 pandemic were related to experiences of life-threat, resource deprivation, and anxiety, cross-cutting the themes articulated by the thematic content analysis of anxiety, threat, loss, anger, stress and constriction. The US and Italian participants’ descriptions of their worst experiences differed in subtle but important ways, with Americans reporting more life-threat and losses compared to Italians reporting more threat to the world, stress, social isolation, and feelings of being trapped.
ABSTRACT
Background: Although symptoms of posttraumatic stress disorder (PTSD) have been associated with the COVID-19 pandemic experiences, no study has explored yet the association of specific COVID-19 narratives with peritraumatic distress, the precursor of PTSD. Objective: To explore the worst experiences associated with peritraumatic distress during the first wave of the COVID-19 pandemic. Method: Adult residents (N = 1098), from the US (n = 741) and Italy (n = 357), completed an online survey including socio-demographic data, COVID-19-related experiences, the Peritraumatic Distress Inventory and an open question on their worst experiences during the first period of the COVID-19 pandemic (April-May 2020). A thematic content analysis (TCA) was conducted on the answers to the open question and a classification and regression tree (CART) analysis was used to identify the themes that best predicted the clinical levels of peritraumatic distress. Results: The main TCA themes related to participants' worst COVID-19 experiences were anxiety, threat, loss, anger, stress and constriction. Threat was the most prevalent theme and correlated with experiences such as being quarantined, being infected and a loved one receiving the diagnosis. US participants' descriptions of their worst experiences related more to life-threat and loss, while Italians reported more threat to the world, stress, social isolation, and feeling trapped. In the CART analysis, the main predictor (79.9%) was perceiving negative effects from the COVID-19 crisis. Among them, a COVID-related threat to self-experience was the most robust predictor. In its absence, being deprived of resources or experiencing high levels of anxiety were other robust predictors. Conclusions: The study provided evidence of the utility of a mixed-method approach in conceptualizing experiences associated with the COVID-19 pandemic and the risk of traumatic symptoms. Its findings may inform healthcare interventions and policies for tackling the new challenges posed by the COVID-19 pandemic. HIGHLIGHTS Clinically significant levels of peritraumatic distress symptoms were prevalent during the COVID-19 pandemic.Clinically significant levels of peritraumatic distress during the COVID-19 pandemic were related to experiences of life-threat, resource deprivation, and anxiety, cross-cutting the themes articulated by the thematic content analysis of anxiety, threat, loss, anger, stress and constriction.The US and Italian participants' descriptions of their worst experiences differed in subtle but important ways, with Americans reporting more life-threat and losses compared to Italians reporting more threat to the world, stress, social isolation, and feelings of being trapped.
Antecedentes: Aunque los síntomas del trastorno de estrés postraumático (TEPT) se han asociado con las experiencias de la pandemia de COVID-19, ningún estudio ha explorado aún la asociación de las narrativas específicas de COVID-19 con el distres peritraumático, el precursor del TEPT.Objetivo: Explorar las peores experiencias asociadas al distres peritraumático durante la primera ola de la pandemia COVID-19.Método: Adultos residentes (N = 1098), de los EE.UU. (n = 741) e Italia (n = 357), completaron una encuesta en línea que incluía datos sociodemográficos, experiencias relacionadas con la COVID-19, el Inventario de Distrés Peritraumático y una pregunta abierta sobre sus peores experiencias durante el primer período de la pandemia de la COVID-19 (abril-mayo de 2020). Se realizó un análisis de contenido temático (TCA, en sus siglas en inglés) sobre las respuestas a la pregunta abierta y se utilizó un análisis de árbol de clasificación y regresión (CART, en sus siglas en inglés) para identificar los temas que mejor predecían los niveles clínicos de distres peritraumático.Resultados: Los principales temas del TCA relacionados con las peores experiencias de COVID-19 de los participantes fueron la ansiedad, la amenaza, la pérdida, la ira, el estrés y la constricción. La amenaza fue el tema más prevalente y se correlacionó con experiencias como estar en cuarentena, estar infectado y que un ser querido recibiera el diagnóstico. Las descripciones de los participantes estadounidenses de sus peores experiencias estaban más relacionadas con la amenaza a la vida y la pérdida, mientras que los italianos informaron más de la amenaza al mundo, el estrés, el aislamiento social y la sensación de estar atrapados. En el análisis CART, el principal predictor (79,9%) fue la percepción de efectos negativos de la crisis COVID-19. Entre ellos, la experiencia de amenaza a sí mismo relacionada con la COVID fue el predictor más sólido. En su ausencia, estar privado de recursos o experimentar altos niveles de ansiedad fueron otros predictores sólidos.Conclusiones: El estudio aportó pruebas de la utilidad de un abordaje de métodos mixtos para conceptualizar las experiencias asociadas a la pandemia de COVID-19 y el riesgo de síntomas traumáticos. Sus hallazgos pueden servir de base a las intervenciones y políticas sanitarias para afrontar los nuevos retos que plantea la pandemia de COVID-19.
Subject(s)
COVID-19 , Stress Disorders, Post-Traumatic , Adult , Anxiety/epidemiology , COVID-19/epidemiology , Humans , Pandemics , Quarantine , Stress Disorders, Post-Traumatic/epidemiology , United States/epidemiologyABSTRACT
BACKGROUND: Throughout the pandemic, the general population was encouraged to use media to be kept informed about sanitary measures while staying connected with others to obtain social support. However, due to mixed findings in the literature, it is not clear whether media use in such a context would be pathogenic or salutogenic. OBJECTIVE: Therefore, the associations between COVID-19-related stressors and frequency of media use for information-seeking on trauma- and stressor-related (TSR) symptoms were examined while also investigating how social media use for support-seeking and peritraumatic distress interact with those variables. METHODS: A path model was tested in a sample of 5913 adults who completed an online survey. RESULTS: The number of COVID-19-related stressors (ß=.25; P<.001) and extent of information-seeking through media (ß=.24; P=.006) were significantly associated with the severity of TSR symptoms in bivariate comparisons. Associations between levels of peritraumatic distress and both COVID-19-related stressors and information-seeking through media, and social media use for support- and information-seeking through media were found (ßCOVID-19 stressors: Peritraumatic Distress Inventory=.49, P<.001; ßseeking information: Peritraumatic Distress Inventory=.70, P<.001; ßseeking information-seeking support=.04, P<.001). CONCLUSIONS: Results suggest that exposure to COVID-19-related stressors and seeking COVID-19-related information through the media are associated with higher levels of peritraumatic distress that, in turn, lead to higher levels of TSR symptoms. Although exposure to the stress of the COVID-19 pandemic may be unavoidable, the frequency of COVID-19-related information consumption through various media should be approached with caution.
Subject(s)
COVID-19 , Social Media , Adult , COVID-19/epidemiology , Cross-Sectional Studies , Humans , Pandemics , SARS-CoV-2ABSTRACT
BACKGROUND: Posttraumatic stress disorder (PTSD) has been hailed by some as the emblematic mental disorder of the COVID-19 pandemic, assuming that PTSD's life-threat criterion was met de facto. More plausible outcomes like adjustment disorder (AD) have been overlooked. METHODS: An online cross-sectional survey was launched in the initial stage of the pandemic using a convenience sample of 5 913 adults to compare the prevalence of COVID-related probable PTSD versus probable AD. The abridged Impact of Event Scale - Revised (IES-6) assessed the severity of trauma- and stressor-related symptoms over the previous week. Demographic and pandemic-related data (e.g., receiving a formal diagnosis of COVID-19, job loss, loss of loved one, confinement, material hardship) were collected. A Classification and Regression Tree analysis was conducted to uncover the pandemic experiences leading to clinical 'caseness'. Caseness was defined by a score > 9 on the IES-6 symptom measure and further characterized as PTSD or AD depending on whether the Peritraumatic Distress Inventory's life-threat item was endorsed or not. RESULTS: The participants were predominantly Caucasian (72.8%), women (79.2%), with a university degree (85%), and a mean age of 42.22 (SD = 15.24) years; 3 647 participants (61.7%; 95%CI [60.4, 63.0]) met the threshold for caseness. However, when perceived life-threat was accounted for, only 6.7% (95%CI [6.1, 7.4]) were classified as PTSD cases, and 55% (95%CI [53.7, 56.2]) as AD cases. Among the AD cases, three distinct profiles emerged marked by the following: (i) a worst personal pandemic experience eliciting intense fear, helplessness or horror (in the absence, however, of any life-threat), (ii) a pandemic experience eliciting sadness/grief, and (iii) worrying intensely about the safety of significant others. CONCLUSIONS: Studies considering the life-threat criterion as met de facto during the pandemic are confusing PTSD for AD on most counts. This misconception is obscuring the various AD-related idioms of distress that have emerged during the pandemic and the actual treatment needs.