The impact of pandemic-related stress on attentional bias and anxiety in alexithymia during the COVID-19 pandemic.

The COVID-19 pandemic had negative consequences for mental health, yet it is unknown how and to what extent the psychological outcomes of this stressful event are moderated by individual traits. Alexithymia is a risk factor for psychopathology, and thus likely predicted individual differences in resilience or vulnerability to stressful events during the pandemic. This study explored the moderating role of alexithymia in the relationships of pandemic-related stress with anxiety levels and attentional bias. The participants were 103 Taiwanese individuals who completed a survey during the outbreak of the Omicron wave. Additionally, an emotional Stroop task including pandemic-related or neutral stimuli was used to measure attentional bias. Our results demonstrate that pandemic-related stress had a lesser impact on anxiety in individuals with a higher level of alexithymia. Moreover, we found that in individuals with higher exposure to pandemic-related stressors, a higher level of alexithymia indicated less attentional bias toward COVID-19-related information. Thus, it is plausible that individuals with alexithymia tended to avoid pandemic-related information, which could temporarily relieve stressors during the pandemic.

How are the youth? A brief-longitudinal study on symptoms, alexithymia and expressive suppression among Italian adolescents during COVID-19 pandemic.

Studies documented the negative consequences on adolescents' mental health of the stay-at-home measures adopted in reaction to the COVID-19 outbreak. However, few contributions focused on the psychopathological trajectories after the end of these stressful measures or investigated the moderating role of this context in the relationship linking psychological symptoms with emotion regulation. This brief longitudinal study was performed with two measurement times: during the severe lockdown (T1), and when the restrictive measures were relaxed (T2). Ninety-three community adolescents (45% boys; Mage  = 14.94 years, SD = 1.64) completed the Youth Self Report, the Social Media Disorder Scale, the Binge Eating Scale, the Emotion Regulation Questionnaire and the Toronto Alexithymia Scale 20 items. Except for binge eating and externalising symptoms, all variables significantly decreased between T1 and T2. The relationship between expressive suppression and binge eating scores significantly decreased across time whereas the link between alexithymia and internalising symptoms increased with time. The study supported the idea that low-risk adolescents experienced psychological relief from the relaxation of stay-at-home measures. Results suggest the importance of considering contextual factors when explaining the role of expressive suppression and alexithymia in binge eating and internalising symptoms among adolescents.

The relations between the alexithymia levels and social media addictions of nursing students.

PURPOSE: The present study was conducted in a cross-sectional and descriptive design to examine the relations between alexithymia levels and social media addictions of nursing students. METHOD: The study population consisted of nursing department students, and the sampling consisted of 202 students who had social media accounts and who volunteered to participate in the study. The study data were collected online between November 01, 2020 and November 08, 2020 with the questionnaire, Social Media Addiction Scale-Adult Form, and Toronto Alexithymia Scale. The data were evaluated with the Student's t, one-way analysis of variance, Kruskal-Wallis, Mann-Whitney U, and correlation analysis. RESULTS: It was found that 75.2% of the students were female, 57.9% were in the 18-20 age group, 60.3% of them spent 2-3 h a day on social media; social media addiction mean score was 64.81 ± 5.80 alexithymia mean score was 71.27 ± 8.62, and 46.03% were completely alexithymic. It was also found that there was a statistically positive and significant relation between the social media addiction and alexithymia scores of the students (p < 0.05). CONCLUSION AND RECOMMENDATIONS: It was determined that the mean alexithymia and social media addiction scores of the students were high, and they affected each other. In this respect, it is recommended that students be given training on limiting the use of social media. PRACTICE IMPLICATIONS: Social media addiction average score was found to be high in nursing department students. The alexithymia score averages of the nursing department students were found to be high. It was determined that the COVID pandemic nursing department students increased the time they use social media.

Impact of the COVID-19 Pandemic on the Mental Health of Adolescent Students in Daegu, Korea.

BACKGROUND: In February 2020, as coronavirus disease 2019 (COVID-19) spread rapidly in Daegu, South Korea, students in that region experienced many emotional difficulties. In this study, we analyzed the stress and emotional crisis experienced by students during the COVID-19 pandemic, its causative factors, and the factors that affect negative emotions. METHODS: We identified the demographic information related to the experiences of unbearable stress and emotional crisis and their causal factors at three points in time: before the pandemic, during its peak, and at the time of the survey (2-3 months after the peak). In addition, we analyzed the factors related to depression and anxiety experienced by students during the COVID-19 pandemic. The Korean version of the Patient Health Questionnaire 9 and the Korean version of the Generalized Anxiety Disorder 7 was used to assess for depressive and anxiety symptoms in the subject students, respectively. RESULTS: A total of 8,177 students participated in the analysis, with 4,072 boys (49.8%), 4,105 girls (50.2%), and 4,463 middle school students (54.6%) and 3,177 high school students (45.4%). The percentage of students who experienced unbearable stress was 9% before the COVID-19 pandemic, increased to 16% at the peak of the COVID-19 pandemic, then decreased to 12.7% at the time of the survey. Stress was experienced more by girls (18.1% versus 13.8% in boys; χ² = 28.159, P < 0.001) and high school students (19.0% versus 13.5% in middle school students; χ² = 45.437, P < 0.001). Overall, 7.6% experienced emotional crises during the COVID-19 pandemic, which was more prevalent in girls (10.1% versus 5.2% in boys; χ² = 71.025, P < 0.001) and in high school students (8.8% versus 6.7% in middle school students; χ² = 12.996, P < 0.001). Depression and anxiety was seen in 19.8% and 12.3% of students during the COVID-19 pandemic, respectively. The risk factors for depression and anxiety included unbearable stress before the COVID-19 pandemic (P < 0.001), mental health (P = 0.044), and age (P = 0.040), whereas resilience was identified as a protective factor for depression and anxiety (P = 0.001). CONCLUSION: Students in Daegu experienced lots of mental difficulties since the COVID-19 pandemic. It will be necessary to improve stress management and resilience to improve students' mental health in disasters such as the COVID-19 pandemic.

Relationship between stress and alexithymia, emotional processing and negative/positive affect in medical staff working amid the COVID-19 pandemic.

The psychological burden of the COVID-19 pandemic may have a lasting effect on emotional well-being of healthcare workers. Medical personnel working at the time of the pandemic may experience elevated occupational stress due to the uncontrollability of the virus, high perceived risk of infection, poor understanding of the novel virus transmission routes and unavailability of effective antiviral agents. This study used path analysis to analyze the relationship between stress and alexithymia, emotional processing and negative/positive affect in healthcare workers. The sample included 167 nurses, 65 physicians and 53 paramedics. Sixty-two (21.75 %) respondents worked in COVID-19-designated hospitals. Respondents were administered the Toronto Alexithymia Scale-20, Cohen's Perceived Stress Scale, Emotional Processing Scale, and the Positive and Negative Affect Schedule. The model showed excellent fit indices (χ2 (2)=2.642, p=0.267; CFI=0.999, RMSEA=0.034, SRMR=0.015). Multiple group path analysis demonstrated physicians differed from nurses and paramedics at the model level (X2diff (7)=14.155, p<0.05 and X2diff (7)=18.642, p<0.01, respectively). The relationship between alexithymia and emotional processing was stronger in nurses than in physicians (difference in beta=0.27; p<0.05). Individual path χ2 tests also revealed significantly different paths across these groups. The results of the study may be used to develop evidence-based intervention programs promoting healthcare workers' mental health and well-being.

Late Adolescents' Attachment to Parents and Peers and Psychological Distress Resulting from COVID-19. A Study on the Mediation Role of Alexithymia.

The scientific literature has shown the key role played by attachment to parents and peers and difficulties in recognizing, processing, and regulating emotions (i.e., alexithymia) in the (mal-)adaptive psychological response to the COVID-19 pandemic during late adolescence. No study has yet explored the complex interplay between these variables. We recruited a sample of 454 late adolescents (Mage = 22.79, SD = 2.27) and assessed attachment to parents and peers, alexithymia, and peritraumatic distress due to COVID-19 through self-report instruments. Attachment to fathers and peers, but not to mothers, and alexithymia significantly predicted levels of peritraumatic distress. Alexithymia fully and partially mediated the effect of, respectively, attachment to mothers and attachment to peers on peritraumatic distress due to COVID-19. These findings suggested that intervention programs focused on the promotion of peer social relationships, supportive parent-adolescent relationships, and the ability to recognize and discriminate one's own and others' emotions are needed in helping late adolescents to face the current health emergency and preventing short- and long-term psychopathological consequences related to the COVID-19 pandemic.

COVID-19 lockdown has altered the dynamics between affective symptoms and social isolation among older adults: results from a longitudinal network analysis.

The COVID-19 lockdown has drastically limited social interactions and brought about a climate of fear and uncertainty. These circumstances not only increased affective symptoms and social isolation among community dwelling older adults but also alter the dynamics between them. Using network analyses, we study the changes in these dynamics before and during the lockdown. Community-dwelling older adults (N = 419) completed questionnaires assessing depression, anxiety, and social isolation, before the COVID-19 pandemic, as part of a cohort study, and during the lockdown period. The total scores of these questionnaires were compared across time. For the network analyses, partial correlation networks were constructed using items in the questionnaires as nodes, separately at both timepoints. Changes in edges, as well as nodal and bridge centrality were examined across time. Depression and anxiety symptoms, and social isolation had significantly increased during the lockdown. Significant changes were observed across time on several edges. Greater connectivity between the affective and social isolation nodes at lockdown was observed. Depression symptoms have become more tightly coupled across individuals, and so were the anxiety symptoms. Depression symptoms have also become slightly decoupled from those of anxiety. These changing network dynamics reflect the greater influence of social isolation on affective symptoms across individuals and an increased vulnerability to affective disorders. These findings provide novel perspectives and translational implications on the changing mental health context amidst a COVID-19 pandemic situation.

The Level of Ruminative Thought and Alexithymia of People in the COVID-19 Pandemic Process.

OBJECTIVE: The COVID-19 pandemic process caused many physiological and psychological effects on individuals. This study aims to examine the ruminative thinking and alexithymia levels of people in the COVID-19 pandemic process. METHODS: The descriptive, cross-sectional, and the correlational designed study was conducted with 852 people in ?stanbul\Turkey during the COVID-19 pandemic process between March and May 2020. The data of the research was collected with the Sociodemographic Form Toronto Alexithymia Scale and Ruminative Thought Style Questionnaire. RESULTS: It was found that the average of ruminative thought score of the people was 92.49±19.89 and the alexithymia score average was 71.76±13.70. A positive and significant relationship was found between the Ruminative Thought Style Questionnaire and the Toronto Alexithymia Scale and subscale scores (p<0.05). According to the results, ruminative thinking levels were affected by 12% alexithymia level and 9% time spent on conversation. A statistically significant relationship was found between rumination, alexithymia, and its sub-dimensions and the number of times people spend for conversation during the day and the number of people they live with (p<0.05). It was determined that those living with family/friends were lower than those who were alone, and those with good communication in relationships had lower rumination and alexithymia (p<0.05). CONCLUSION: Care should be taken against alexithymia and rumination during the COVID-19 pandemic process, and attention should be given to interpersonal relationships, conversation, and communication in the quarantine process.

Emotional eating during COVID-19 in the United Kingdom: Exploring the roles of alexithymia and emotion dysregulation.

Emotional eating, generally defined as (over)-eating in response to negative emotions, has been associated with poor physical and psychological outcomes. During a time of heightened negative affect, it is important to understand the impact of the COVID-19 pandemic and associated lockdown measures on eating behaviours, and further elucidate the ways in which emotional eating is related to emotion dysregulation and impaired abilities to identify emotions (i.e. alexithymia). The aims of this study were to explore perceived changes in eating behaviours in relation to self-reported negative affect during the pandemic and to examine direct and indirect effects of alexithymia on emotional eating. An online questionnaire measured these constructs in the general population of the United Kingdom (n = 136). Findings demonstrated that those who reported changes to their eating behaviours during the pandemic also reported greater levels of depression during the same time frame. Mediation analyses revealed that difficulties identifying and describing feelings both predicted emotional eating indirectly via emotion dysregulation. Findings contribute to the understanding of the mechanisms underpinning the relationship between alexithymia and emotional eating and describe changes to eating behaviours during COVID-19. We discuss how these findings should be applied, and recommendations for future research.

Increased emotional eating during COVID-19 associated with lockdown, psychological and social distress.

Due to the spread of COVID 2019, the Italian government imposed a lockdown on the national territory. Initially, citizens were required to stay at home and not to mix with others outside of their household (Phase 1); eventually, some of these restrictions were lifted (Phase 2). To investigate the impact of lockdown on emotional and binge eating, an online survey was conducted to compare measures of self-reported physical (BMI), psychological (Alexithymia), affective (anxiety, stress, and depression) and social (income, workload) state during Phase 1 and Phase 2. Data from 365 Italian residents showed that increased emotional eating was predicted by higher depression, anxiety, quality of personal relationships, and quality of life, while the increase of bingeing was predicted by higher stress. Moreover, we showed that higher alexithymia scores were associated by increased emotional eating and higher BMI scores were associated with both increased emotional eating and binge eating. Finally, we found that from Phase 1 to Phase 2 binge and emotional eating decreased. These data provide evidence of the negative effects of isolation and lockdown on emotional wellbeing, and, relatedly, on eating behaviour.

Impact of lockdown due to COVID-19 pandemic in changes of prevalence of predictive psychiatric disorders among children and adolescents in Bangladesh.

Lockdown, isolation, quarantine and social distancing are proved to be only effective measures to prevent and tackle COVID-19 till date. Unfortunately, these measures have caused physical, economical and mental health problems. Children and adolescents are not immune to the adverse mental health effect due to the new changes. Research around the globe shows children and adolescents are suffering from an increased number of depressive symptoms, clinginess, inattention, irritability and worry. This cross-sectional online-based survey type study was aimed to get a snapshot of the prevalence of predictive psychiatric disorders in the child and adolescent population in Bangladesh before and during lockdown. Validated Bangla parent version of Strengths and Difficulties Questionnaire was used to assess the psychopathology among subjects. Total sample was 552 aged from 4-17 years. Boy-girl ratio was 1.3:1. Prevalence of any predictive psychiatric disorder before lockdown was 20.5 % and within lockdown was 39.7 % and the difference was highly significant (P < 0.001). Prevalence of emotional, conduct disorder and hyperactivity were also increased significantly during the lockdown period than before. Conduct disorder and hyperactivity were more prevalent among boys both before and within lockdown. In contrast, prevalence of emotional disorder was higher among girls before lockdown but within the lockdown period, the boy-girl prevalence was almost the same. This study shows the new extreme measures to tackle COVID-19 has a disaster impact on mental health of children and adolescents. Subsequent studies and support should be developed to prevent conditions getting worse.

Emotional reactions and subjective health status during the COVID-19 pandemic in Israel: the mediating role of perceived susceptibility.

The general consensus is that COVID-19, the virus spreading rapidly across the globe, affects physical health but also mental health and mental well-being. This study aimed to assess the associations among emotional reactions toward COVID-19, knowledge about COVID-19, perceived susceptibility to this disease, and subjective health status. This study was a cross-sectional study conducted among 1,085 Israeli adults who completed an online survey between April 23 and May 5, 2020. The self-administered questionnaire included questions about emotional reactions to COVID-19, knowledge about COVID-19, perceived susceptibility, subjective health status, and sociodemographic variables. Participants (aged 18-96) reported high levels of emotional reactions to COVID-19. Most respondents were worried (77.4%), afraid (62.8%) or stressed (55.3%). Emotional reaction scores were higher among women than among men. In the regression model, emotional reactions were higher for older participants, those who rated their subjective health status as poorer, and those who were employed, with the final model explaining 11.6% of the variance in emotional reactions. Perceived susceptibility significantly mediated the relationship between subjective health status and emotional reactions. The high prevalence of emotional responses among women, older people and those with lower subjective health ratings points to the need for intervention programs primarily targeting these groups.

Mental health of pregnant women during the COVID-19 pandemic: A longitudinal study.

Several studies have reported the susceptibility of pregnant women to emotional instability and stress. Thus, pregnancy may be a risk factor that could deepen the already negative effects of the current COVID-19 pandemic. Therefore, the aim of this study is to analyze longitudinally the psychopathological consequences of the pandemic in pregnant women, and to explore differences with non-pregnant women. The participants in this study were 102 pregnant women, and a control group of 102 non-pregnant women (most of them reported having university studies and little financial impact from the pandemic). They completed the Beck Depression Inventory-II, the State-Trait Anxiety Inventory, and the Positive and Negative Affect Schedule, in three different times (2, 14, and 47 days after the start of the lockdown). In a time range of 50 days of quarantine, all women showed a gradual increase in psychopathological indicators and a decrease in positive affect. Pregnant women showed a more pronounced increase in depression, anxiety and negative affect than the non-pregnant women did. In addition, pregnant women showed a more pronounced decrease in positive affect. It is important for institutions dedicated to perinatal health care to count on empirical information to optimize the provision of their services.

Emotional exhaustion among the South Korean workforce before and after COVID-19.

Since the outbreak of the COVID-19 pandemic in South Korea in January 2020, many South Korean employees have been experiencing work stressors, threats of job insecurity, and feelings of isolation, which together lead to emotional exhaustion. The present study aimed to compare the emotional exhaustion of South Korean employees before and after the pandemic, as well as to examine how the demographic characteristics of employees affected their emotional exhaustion. We administered surveys to 276 employees before the COVID-19 pandemic (from July to October 2019) and 301 employees after its onset (from March to April 2020). A series of t-tests demonstrated that both employee samples were similar demographically. Hierarchical regression analyses revealed that even when controlling for baseline emotions, the employees assessed after the COVID-19 experienced significantly higher emotional exhaustion than those assessed before. Furthermore, in reaction to COVID-19, female employees felt more emotionally exhausted than their male counterparts. Finally, after the COVID-19 pandemic, younger and short-tenured employees reported higher emotional exhaustion than older and more experienced employees. These findings provide insight into managing the mental health of employees during the COVID-19 crisis. PRACTITIONER POINTS: The emotional exhaustion of the South Korean workforce increased after the COVID-19 pandemic. After the pandemic, female employees experienced a higher level of emotional exhaustion than their male counterparts. After the pandemic, younger and short-tenured employees experienced a higher level of emotional exhaustion than older and long-tenured employees.

Loneliness: A signature mental health concern in the era of COVID-19.

In response to the COVID-19 pandemic, most communities in the United States imposed stay-at-home orders to mitigate the spread of the novel coronavirus, potentially leading to chronic social isolation. During the third week of shelter-in-place guidelines, 1,013 U.S. adults completed the UCLA Loneliness Scale-3 and Public Health Questionnaire (PHQ-9). Loneliness was elevated, with 43% of respondents scoring above published cutoffs, and was strongly associated with greater depression and suicidal ideation. Loneliness is a critical public health concern that must be considered during the social isolation efforts to combat the pandemic.