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PLoS One ; 16(10): e0258294, 2021.
Article in English | MEDLINE | ID: covidwho-1477532


Individuals are dependent on institutions (e.g., universities, governments, healthcare systems) to protect their safety and advocate for their needs. When institutions harm the individuals who depend on them, they commit institutional betrayal, which has been associated with numerous negative outcomes in prior research. Throughout the COVID-19 pandemic, students have entrusted universities to protect both their health and their educational opportunities. However, many universities have failed to meet these expectations, and it is likely that many students experience COVID-19-related institutional betrayal. In two similar studies, we examined the prevalence and correlates of institutional betrayal among undergraduate students at a large, public university in the Northwest United States during the fall 2020 and winter 2021quarters. In both studies, more than half of students endorsed at least one type of COVID-19-related institutional betrayal, and higher institutional betrayal ratings were significantly correlated with both current trauma symptoms and COVID-19-related avoidance and intrusion cognitions. In Study 2, the relationship between COVID-19-related institutional betrayal and current trauma symptoms remained significant, even when controlling for gender, personal and familial COVID-19 infection, and past trauma history. These results indicate that COVID-19 institutional betrayal is common and may be uniquely associated with distress among undergraduate students. We suggest it would behoove university institutions to reduce COVID-19-related institutional betrayal.

Betrayal/psychology , COVID-19 , Psychological Trauma , SARS-CoV-2 , Students/psychology , Adolescent , Adult , COVID-19/epidemiology , COVID-19/psychology , Female , Humans , Male , Northwestern United States/epidemiology , Psychological Trauma/epidemiology , Psychological Trauma/psychology , Universities
Eur J Psychotraumatol ; 12(1): 1964197, 2021.
Article in English | MEDLINE | ID: covidwho-1467268


Background: The COVID-19 pandemic exposes individuals to multiple stressors, such as quarantine, physical distancing, job loss, risk of infection, and loss of loved ones. Such a complex array of stressors potentially lead to symptoms of adjustment disorder. Objective: This cross-sectional exploratory study examined relationships between risk and protective factors, stressors, and symptoms of adjustment disorder during the first year of the COVID-19 pandemic. Methods: Data from the first wave of the European Society of Traumatic Stress Studies (ESTSS) longitudinal ADJUST Study were used. N = 15,563 participants aged 18 years and above were recruited in eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. Associations between risk and protective factors (e.g. gender, diagnosis of a mental health disorder), stressors (e.g. fear of infection, restricted face-to-face contact), and symptoms of adjustment disorder (ADNM-8) were examined using multivariate linear regression. Results: The prevalence of self-reported probable adjustment disorder was 18.2%. Risk factors associated with higher levels of symptoms of adjustment disorder were female gender, older age, being at risk for severe COVID-19 illness, poorer general health status, current or previous trauma exposure, a current or previous mental health disorder, and longer exposure to COVID-19 news. Protective factors related to lower levels of symptoms of adjustment disorder were higher income, being retired, and having more face-to-face contact with loved ones or friends. Pandemic-related stressors associated with higher levels of symptoms of adjustment disorder included fear of infection, governmental crisis management, restricted social contact, work-related problems, restricted activity, and difficult housing conditions. Conclusions: We identified stressors, risk, and protective factors that may help identify individuals at higher risk for adjustment disorder.

Antecedentes: La pandemia de COVID-19 expone a las personas a múltiples factores estresantes, como la cuarentena, el distanciamiento físico, la pérdida del trabajo, el riesgo de infección, y la pérdida de seres queridos. Esta compleja serie de factores estresantes puede potencialmente conducir a síntomas del trastorno de adaptación.Objetivo: Este estudio exploratorio transversal examinó las relaciones entre los factores de riesgo y de protección, los factores estresantes, y los síntomas del trastorno de adaptación durante el primer año de la pandemia de COVID-19.Métodos: Se utilizaron datos de la primera ola del estudio longitudinal ADJUST de la Sociedad Europea de Estudios de Estrés Traumático (ESTSS en su sigla en inglés). N = 15.563 participantes de 18 años o más fueron reclutados en once países (Austria, Croacia, Georgia, Alemania, Grecia, Italia, Lituania, Países Bajos, Polonia, Portugal, y Suecia) de junio a noviembre de 2020. Se examinaron mediante regresión lineal multivariante las asociaciones entre los factores de riesgo y de protección (p. ej., género, diagnóstico de un trastorno de salud mental), factores estresantes (p. ej., miedo a la infección, contacto restringido cara a cara), y síntomas del trastorno de adaptación (ADNM-8 en su sigla en inglés).Resultados: La prevalencia del trastorno de adaptación probable autoinformado fue del 18,2%. Los factores de riesgo asociados con niveles más altos de síntomas del trastorno de adaptación fueron género femenino, edad avanzada, riesgo de enfermedad grave por COVID-19, peor estado de salud general, exposición a un trauma actual o anterior, un trastorno de salud mental actual o anterior, y una exposición más prolongada a las noticias de COVID-19. Los factores de protección relacionados con niveles más bajos de síntomas del trastorno de adaptación fueron mayores ingresos, estar jubilado, y tener más contacto cara a cara con sus seres queridos o amigos. Los factores estresantes relacionados con la pandemia que se asociaron con niveles más altos de síntomas del trastorno de adaptación incluyeron miedo a la infección, manejo gubernamental de crisis, contacto social restringido, problemas relacionados con el trabajo, actividad restringida, y condiciones de vivienda difíciles.Conclusiones: Identificamos factores estresantes, de riesgo, y protectores que pueden ayudar a identificar a las personas con mayor riesgo de trastorno de adaptación.

Adjustment Disorders/psychology , COVID-19/psychology , Psychological Trauma/psychology , Adjustment Disorders/epidemiology , Adult , Aged , Aged, 80 and over , COVID-19/epidemiology , Cross-Sectional Studies , Europe/epidemiology , Female , Humans , Male , Middle Aged , Pandemics , Protective Factors , Psychological Trauma/epidemiology , Quarantine/psychology , Risk Factors , SARS-CoV-2 , Surveys and Questionnaires
J Anal Psychol ; 66(3): 443-462, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1299075


This paper explores how the deadly shadow of COVID-19 passing over the Earth constitutes a collective trauma that frequently opens up or 'triggers' un-remembered personal trauma, and it provides clinical examples of these intersections. The paper further explores how the human imagination, which we normally utilize to make meaning out of traumatic experience, can be hijacked by fear - leading to avoidance of suffering and to illusory formulations and alternative realities such as conspiracy theories. Alternatively, the imagination can be employed in more realistic and creative ways - leading through conscious suffering to healing and wholeness. Which path the imagination takes is shown to depend on the capacity of individuals to feel the full reality of the human condition in general and the exquisite vulnerability of our existence as fragile human beings at this moment in history. Ernest Becker's analysis of our 'denial of death' and his urgency to embrace our common human vulnerability is explored in relation to Jung's early tendency to deny the body. The author proposes that the more creative uses of the imagination, connected to a more humble and realistic apprehension of our common destiny, may be seen in the 'Black Lives Matter' movement that swept the world in the aftermath of the COVID-19 outbreak.

Cet article explore comment l'ombre de mort de la COVID-19, passant sur la terre, constitue un traumatisme collectif qui souvent ouvre ou ravive un traumatisme personnel non-remémoré. L'article fournit des exemples cliniques de telles intersections. Il explore comment l'imagination humaine, que nous utilisons normalement pour donner du sens à nos expériences traumatiques, peut être détournée par la peur. Ceci mène à l'évitement de la souffrance et à des formulations illusoires ou réalités alternatives telles que les théories du complot. Mais l'imagination peut aussi être employée de manières plus réalistes et créatives, nous guidant à travers une souffrance consciente à la guérison et la complétude. Nous montrerons que le choix du chemin que l'imagination emploie dépend de la capacité des personnes à éprouver la pleine réalité de la condition humaine en général et la vulnérabilité magnifique de notre existence en tant qu'êtres humains fragiles à ce moment de l'histoire. L'analyse que fait Ernest Becker de notre 'déni de la mort' et son insistance à épouser notre vulnérabilité humaine commune est étudiée et mise en relation avec la tendance de Jung, au début de son œuvre, à renier le corps. L'auteur propose que les utilisations plus créatives de l'imagination, reliées à une appréhension plus humble et plus réaliste de notre destinée commune, peuvent se retrouver dans le mouvement Black Lives Matter, mouvement qui a balayé le monde à la suite de la flambée de COVID-19.

El presente trabajo explora como la sombra mortal del COVID-19 pasando sobre la tierra constituye un trauma colectivo que frecuentemente abre o 'activa' trauma personal no recordado. Se proveen ejemplos clínicos de estas intersecciones. El escrito además explora cómo la imaginación humana, la cual normalmente utilizamos para encontrar sentido a partir de experiencias traumáticas, puede ser apropiada por el miedo - conduciendo a la evitación del sufrimiento y a formulaciones ilusorias y realidades alternativas tales como las teorías conspirativas. Alternativamente, la imaginación puede ser empleada en modos más realistas y creativos - conduciendo a través del sufrimiento consciente a la sanación y a la integridad. Cual camino toma la imaginación, se muestra que depende de la capacidad de los individuos para sentir la realidad plena de la condición humana en general y la exquisita vulnerabilidad de nuestra existencia como frágiles seres humanos en este momento de la historia. El análisis de nuestra 'negación de la muerte' de Ernest Becker y su urgencia por acoger nuestra común vulnerabilidad humana es explorada con relación a la temprana tendencia en Jung de negar el cuerpo. El autor propone que los usos más creativos de la imaginación, conectados a una aprehensión más humilde y realista de nuestro destino común, puede ser vista en el movimiento Black Lives Matter que recorrió el mundo en las postrimerías del estallido del COVID-19.

COVID-19 , Fear/psychology , Imagination , Political Activism , Psychoanalytic Therapy , Psychological Trauma/psychology , Racism , Adult , Humans , Professional-Patient Relations , Telemedicine
J Anal Psychol ; 66(3): 561-582, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1298409


Fear and grief caused by the pandemic have produced a powerful unconscious narrative in the collective psyche that the coronavirus is driven by an innately evil, and possibly divine, force. The resulting archetypal dimension of fear causes an extra layer of psychological suffering in individuals. This paper discusses how and why this narrative was created and why it is so compelling by looking at 1) the myth-making nature of the human psyche, 2) the psychodynamics of fear that drive the narrative, 3) the properties of the coronavirus and the pandemic that activate negative poles of some archetypes, in particular, archetypes of evil, and 4) asking how analytical psychology can help ease psychological suffering caused by these negative narratives, where one possibility is to invoke the transcendent function. The author's personal experiences as both biochemist and analytical psychologist elucidate how the transcendent function can promote healing.

La peur et la douleur causées par la pandémie ont produit un puissant récit inconscient dans la psyché collective, à savoir que le coronavirus est dirigé par une force intrinsèquement maléfique ou éventuellement divine. La dimension archétypale de peur qui en résulte produit une couche supplémentaire de douleur psychologique chez les individus. Cet article étudie comment et pourquoi ce récit est créé et pourquoi il est si convaincant. L'article procède en examinant 1) la nature de la psyché humaine qui tend à fabriquer des mythes, 2) les dynamiques psychanalytiques de la peur qui motivent le récit, 3) les propriétés du coronavirus et de la pandémie qui activent les pôles négatifs de certains archétypes, et en particulier l'archétype du mal, et 4) comment la psychologie analytique peut aider à soulager la douleur psychologique produite par ces récits négatifs. Une possibilité est d'invoquer la fonction transcendante. Les expériences personnelles de l'auteur à la fois en tant que biochimiste et en tant que psychologue analytique éclairent comment la fonction transcendante peut promouvoir la guérison.

El miedo y el dolor causado por la pandemia han producido una poderosa narrativa inconsciente en la psique colectiva, significando que el coronavirus es producido por una fuerza divina, innata del mal. La resultante dimensión arquetípica del miedo causa un estrato extra de sufrimiento psicológico en los individuos. El presente trabajo examina cómo y porqué ha sido creada esta narrativa y porqué resulta tan atractiva, prestando atención a: 1) la naturaleza creadora de mitos de la psique humana, 2) los psico-dinamismos del miedo que impulsan dicha narrativa, 3) las propiedades del coronavirus y de la pandemia que activan los polos negativos de ciertos arquetipos, en particular arquetipos del mal, y 4) pregunta cómo la psicología analítica puede ayudar a aliviar el sufrimiento psicológico causado por estas narrativas negativas, donde una posibilidad es invocar la función trascendente. Las experiencias personales de la autora como bioquímica y psicóloga analítica elucidan como la función trascendente puede promover la curación.

COVID-19 , Fear/psychology , Health Knowledge, Attitudes, Practice , Imagination , Psychological Trauma/psychology , Adult , Humans
PLoS One ; 16(6): e0252603, 2021.
Article in English | MEDLINE | ID: covidwho-1259244


BACKGROUND: In the fight against the COVID-19 pandemic, frontline healthcare providers who are engaged in the direct diagnosis, treatment, and care of patients face a high risk of infection yet receive inadequate protection from contamination and minimal support to cope with overwork, frustration, and exhaustion. These problems have created significant psychological and mental health concerns for frontline healthcare providers. This study aimed to compare the levels of vicarious traumatization between frontline and non-frontline healthcare providers in response to the COVID-19 pandemic. METHODOLOGY: All the subjects who met the inclusion criteria were recruited for this comparative cross-sectional study, which was conducted from May to July 2020 in two hospitals in Kelantan, Malaysia. A self-administered questionnaire, namely, the Malay-version Vicarious Traumatization Questionnaire and the Medical Outcome Study Social Support Survey were utilized. A descriptive analysis, independent t-test, and analysis of covariance were performed using SPSS Statistics version 26. RESULTS: A total of 160 frontline and 146 non-frontline healthcare providers were recruited. Vicarious traumatization was significantly higher among the non-frontline healthcare providers (estimated marginal mean [95% CI]: 79.7 [75.12, 84.30]) compared to the frontline healthcare providers (estimated marginal mean [95% CI]: 74.3 [68.26, 80.37]) after adjusting for sex, duration of employment, and social support. CONCLUSION: The level of vicarious traumatization was higher among non-frontline compared to frontline healthcare providers. However, the level of severity may differ from person to person, depending on how they handle their physical, psychological, and mental health. Hence, support from various resources, such as colleagues, family, the general public, and the government, may play an essential role in the mental health of healthcare providers.

COVID-19 , Compassion Fatigue , Health Personnel , Mental Health , Pandemics , Psychological Trauma , SARS-CoV-2 , Surveys and Questionnaires , Adult , COVID-19/epidemiology , COVID-19/psychology , Compassion Fatigue/epidemiology , Compassion Fatigue/psychology , Female , Humans , Malaysia/epidemiology , Male , Middle Aged , Psychological Trauma/epidemiology , Psychological Trauma/psychology
J Psychiatr Ment Health Nurs ; 28(5): 777-782, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1084517


WHAT IS KNOWN ON THE SUBJECT?: With the ongoing and possible evolving use of face coverings as a public health protection measure against the transmission of COVID-19, this is likely to be an ongoing challenge for those who find their use challenging. The wearing of face coverings following trauma is likely to be of ongoing relevance, making this an area that would benefit from further research. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: The authors present their personal and professional experiences as a means of highlighting the difficulties that can be faced as a result of the use of face coverings. The window of tolerance helps to understand the difficulties that can be caused by wearing face coverings and provides a visual means of conceptualizing the cognitive, behavioural, physiological and emotional reactions that can occur as a result of their use. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: This paper provides an awareness of the link between trauma and the wearing of face coverings, and how their use could be re-traumatizing for those accessing services. This topic is relevant across all sectors where it is only just beginning to be acknowledged that for many, particularly those with experiences of interpersonal trauma, difficulties can arise due to the use of face coverings. The sharing of grounding techniques and an introduction to the window of tolerance provides a means of collaboratively developing skills and developing a shared understanding of the difficulties associated with the use of face coverings.

COVID-19 , Masks , Psychological Trauma , COVID-19/prevention & control , Humans , Masks/adverse effects , Psychological Trauma/psychology
Eur J Psychotraumatol ; 12(1): 1860356, 2021.
Article in English | MEDLINE | ID: covidwho-1069186


Background: The current COVID-19 pandemic is associated with a variety of stressors. Preliminary research has demonstrated that general public are experiencing a range of psychological problems, including stress-related disturbances. However, to date, there is not much research on the prevalence of adjustment disorder during the current pandemic. Objectives: This study aimed to assess the prevalence and severity of symptoms of adjustment disorder compared to posttraumatic symptoms, depression and generalized anxiety in a large sample of adult Poles, in the first phase of the current pandemic. Method: Self-report data from a web-based sample (N = 1,742) was collected between March 25 and April 27, just after the introduction of nationwide quarantine measures in Poland. Results: The current COVID-19 pandemic was a highly stressful event for 75% of participants and the strongest predictor of adjustment disorder. Increased symptoms of adjustment disorder were reported by 49%, and they were associated with female gender and not having a full-time job. However, after exclusion of co-occurring symptomatology, 14% of the sample were finally qualified as meeting diagnostic criteria of adjustment disorder. A substantial proportion of the sample screened also positive for generalized anxiety (44%) and depression (26%); the rate for presumptive PTSD diagnosis was 2.4%. Conclusions: High rates of negative mental health outcomes were found in the Polish population in the first weeks into the COVID-19 pandemic and lockdown measures. They indicate the intense current stress-related symptoms in the early phase of the pandemic and warrant further monitoring on population's mental health.

Antecedentes: La actual pandemia de COVID-19 está asociada con una variedad de estresores. Investigaciones preliminares han demostrado que la población general está experimentando una variedad de problemas psicológicos, incluyendo trastornos relacionados con el estrés. Sin embargo, hasta la fecha no hay mucha investigación acerca de la prevalencia de trastornos de adaptación durante la actual pandemia.Objetivos: Este estudio tuvo como objetivo evaluar la prevalencia y severidad de los síntomas del trastorno adaptativo comparado con los síntomas postraumáticos, depresión y ansiedad generalizada en una gran muestra de adultos polacos, en la primera fase de la actual pandemia.Método: Se recolectó información auto-reportada de una muestra basada en la web (N=1.742) entre el 25 de marzo y el 27 de Abril, justo después de la introducción de medidas de cuarentena a nivel nacional en Polonia.Resultados: La pandemia actual de COVID-19 fue un evento altamente estresante para el 75% de los participantes y el predictor más poderoso de trastorno de adaptación. 49% informó un aumento de síntomas de trastorno de adaptación, y se asociaron con género femenino y no tener trabajo de tiempo completo. Sin embargo, después de la exclusión de la sintomatología concurrente, 14% de la muestra cumplía los criterios para diagnóstico de trastorno de adaptación. Una proporción importante de la muestra tambien resultó positiva para ansiedad generalizada (44%) y depresión (26%): la tasa de diagnóstico presuntivo de TEPT fue de 2,4%.Conclusiones: Se encontraron altas tasas de consecuencias negativas de salud mental en la población Polaca en las primeras semanas de pandemia y medidas de confinamiento por COVID-19. Indican los intensos síntomas actuales relacionados con el estrés en la fase inicial de la pandemia y justifican un mayor seguimiento de la salud mental de la población.

Adjustment Disorders/epidemiology , COVID-19/psychology , Psychological Trauma/epidemiology , Adjustment Disorders/psychology , Adult , Anxiety Disorders/epidemiology , Anxiety Disorders/psychology , COVID-19/epidemiology , Depression/epidemiology , Depression/psychology , Female , Humans , Male , Pandemics , Poland/epidemiology , Psychological Trauma/psychology , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Surveys and Questionnaires
Semin Perinatol ; 44(7): 151279, 2020 11.
Article in English | MEDLINE | ID: covidwho-1044689


The pandemic, and the associated changes to pregnancy and postpartum experiences, can lead to profound psychological reactions including panic, hyperarousal, sleep disturbance, anxiety, depression, and traumatic stress disorders. Providers face compassion fatigue and shared trauma. In this article, we describe the mental health outcomes known to date in regard to the novel coronavirus disease 2019 pandemic for obstetric patients and their providers as well as therapeutic approaches, including our novel embedded mental health service, to address these mental health needs.

COVID-19 , Compassion Fatigue/psychology , Obstetrics , Physicians/psychology , Pregnancy Complications/psychology , Pregnant Women/psychology , Psychological Trauma/psychology , Anxiety/psychology , Anxiety/therapy , Compassion Fatigue/therapy , Depression/psychology , Depression/therapy , Female , Humans , Mental Health , Mental Health Services , Organizational Policy , Pregnancy , Pregnancy Complications/therapy , Psychological Trauma/therapy , Psychotherapy , Psychotherapy, Group , SARS-CoV-2 , Sleep Wake Disorders , Stress Disorders, Post-Traumatic/psychology , Stress Disorders, Post-Traumatic/therapy , Stress Disorders, Traumatic, Acute/psychology , Stress Disorders, Traumatic, Acute/therapy , Telemedicine , Visitors to Patients
BMJ Open ; 10(12): e043949, 2020 12 16.
Article in English | MEDLINE | ID: covidwho-983653


OBJECTIVES: To gain insight into the experiences and concerns of front-line National Health Service (NHS) workers while caring for patients with COVID-19. DESIGN: Qualitative analysis of data collected through an anonymous website (www.covidconfidential) provided a repository of uncensored COVID-19 experiences of front-line NHS workers, accessed via a link advertised on the Twitter feed of two high profile medical tweeters and their retweets. SETTING: Community of NHS workers who accessed this social media. PARTICIPANTS: 54 healthcare workers, including doctors, nurses and physiotherapists, accessed the website and left a 'story'. RESULTS: Stories ranged from 1 word to 10 min in length. Thematic analysis identified common themes, with a central aspect being the experience and psychological consequence of trauma. Specific themes were: (1) the shock of the virus, (2) staff sacrifice and dedication, (3) collateral damage ranging from personal health concerns to the long-term impact on, and care of, discharged patients and (4) a hierarchy of power and inequality within the healthcare system. CONCLUSIONS: COVID-19 confidential gave an outlet for unprompted and uncensored stories of healthcare workers in the context of COVID-19. In addition to personal experiences of trauma, there were perceptions that many operational difficulties stemmed from inequalities of power between management and front-line workers. Learning from these experiences will reduce staff distress and improve patient care in the face of further waves of the pandemic.

COVID-19/therapy , Health Personnel/psychology , Occupational Stress/psychology , Psychological Trauma/psychology , Adult , Female , Health Personnel/organization & administration , Hospital Administration , Humans , Male , Mental Health , Middle Aged , Nurses/psychology , Physical Therapists/psychology , Physicians/psychology , Qualitative Research , SARS-CoV-2 , Social Media , State Medicine/organization & administration , United Kingdom , Young Adult
Psychol Trauma ; 12(S1): S73-S75, 2020 Aug.
Article in English | MEDLINE | ID: covidwho-867504


As a result of the COVID-19 pandemic, many school districts have closed for the remainder of the academic year. These closures are unfortunate because, for many students, schools are their only source of trauma-informed care and supports. When schools reopen, they must develop a comprehensive plan to address the potential mental health needs of their students. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Coronavirus Infections , Mental Health Services , Pandemics , Pneumonia, Viral , Psychological Trauma , School Health Services , Students , Academic Success , Adolescent , COVID-19 , Child , Child, Preschool , Coronavirus Infections/ethnology , Coronavirus Infections/psychology , Humans , Pneumonia, Viral/ethnology , Pneumonia, Viral/psychology , Psychological Trauma/psychology , Psychological Trauma/therapy , Schools , Students/psychology
J Psychiatr Res ; 132: 23-31, 2021 01.
Article in English | MEDLINE | ID: covidwho-842479


Trauma survivors who suffer from posttraumatic stress disorder (PTSD) symptoms may be particularly vulnerable when facing the COVID-19 pandemic. Yet trauma exposure may also lead to salutogenic outcomes, known as posttraumatic growth (PTG). Nevertheless, the implications of PTG attributed to prior trauma, for trauma survivors' adjustment when facing additional stressors, are unclear. Addressing this gap, 528 Israeli trauma survivors were assessed for PTG and PTSD symptoms attributed to prior trauma, as well as peritraumatic stress symptoms related to the pandemic, as part of an online survey. Analyses revealed that being younger, female, quarantined, negatively self-rating one's health status, and suffering from PTSD symptoms were associated with elevated peritraumatic stress symptoms. Furthermore, PTG attributed to prior trauma made a significant contribution in explaining elevated intrusion, avoidance, and hyperarousal symptoms. The present results point to the need for clinicians to take into account reports of PTG attributed to prior trauma when treating trauma survivors during the current pandemic.

COVID-19 , Health Status , Posttraumatic Growth, Psychological , Psychological Trauma/psychology , Quarantine/psychology , Stress Disorders, Traumatic/psychology , Survivors/psychology , Adolescent , Adult , Aged , COVID-19/prevention & control , Diagnostic Self Evaluation , Female , Humans , Israel , Male , Middle Aged , Young Adult
Int J Eat Disord ; 53(11): 1855-1862, 2020 11.
Article in English | MEDLINE | ID: covidwho-734194


OBJECTIVE: the aim of this longitudinal study was to evaluate the impact of COVID-19 epidemic on Eating Disorders (EDs) patients, considering the role of pre-existing vulnerabilities. METHOD: 74 patients with Anorexia Nervosa (AN) or Bulimia Nervosa (BN) and 97 healthy controls (HCs) were evaluated before lockdown (T1) and during lockdown (T2). Patients were also evaluated at the beginning of treatment (T0). Questionnaires were collected to assess psychopathology, childhood trauma, attachment style, and COVID-19-related post-traumatic symptoms. RESULTS: A different trend between patients and HCs was observed only for pathological eating behaviors. Patients experienced increased compensatory exercise during lockdown; BN patients also exacerbated binge eating. Lockdown interfered with treatment outcomes: the descending trend of ED-specific psychopathology was interrupted during the epidemic in BN patients. Previously remitted patients showed re-exacerbation of binge eating after lockdown. Household arguments and fear for the safety of loved ones predicted increased symptoms during the lockdown. BN patients reported more severe COVID-19-related post-traumatic symptomatology than AN and HCs, and these symptoms were predicted by childhood trauma and insecure attachment. DISCUSSION: COVID-19 epidemic significantly impacted on EDs, both in terms of post-traumatic symptomatology and interference with the recovery process. Individuals with early trauma or insecure attachment were particularly vulnerable.

Coronavirus Infections/prevention & control , Feeding and Eating Disorders/psychology , Pandemics/prevention & control , Pneumonia, Viral/prevention & control , Quarantine/psychology , Adolescent , Adult , COVID-19 , Case-Control Studies , Exercise/psychology , Feeding Behavior/psychology , Feeding and Eating Disorders/therapy , Female , Humans , Italy , Longitudinal Studies , Middle Aged , Object Attachment , Psychological Trauma/psychology , Stress Disorders, Post-Traumatic/etiology , Stress Disorders, Post-Traumatic/psychology , Surveys and Questionnaires , Young Adult
Cogn Neuropsychiatry ; 25(5): 348-363, 2020 09.
Article in English | MEDLINE | ID: covidwho-733444


INTRODUCTION: One route to advancing psychological treatments is to harness mental health science, a multidisciplinary approach including individuals with lived experience and end users (e.g., Holmes, E. A., Craske, M. G., & Graybiel, A. M. (2014). Psychological treatments: A call for mental-health science. Nature, 511(7509), 287-289. doi:10.1038/511287a). While early days, we here illustrate a line of research explored by our group-intrusive imagery-based memories after trauma. METHOD/RESULTS: We illustrate three possible approaches through which mental health science may stimulate thinking around psychological treatment innovation. First, focusing on single/specific target symptoms rather than full, multifaceted psychiatric diagnoses (e.g., intrusive trauma memories rather than all of posttraumatic stress disorder). Second, investigating mechanisms that can be modified in treatment (treatment mechanisms), rather than those which cannot (e.g., processes only linked to aetiology). Finally, exploring novel ways of delivering psychological treatment (peer-/self-administration), given the prevalence of mental health problems globally, and the corresponding need for effective interventions that can be delivered at scale and remotely for example at times of crisis (e.g., current COVID-19 pandemic). CONCLUSIONS: These three approaches suggest options for potential innovative avenues through which mental health science may be harnessed to recouple basic and applied research and transform treatment development.

Betacoronavirus , Coronavirus Infections/therapy , Imagery, Psychotherapy/trends , Mental Health/trends , Pneumonia, Viral/therapy , Psychological Trauma/therapy , Stress Disorders, Post-Traumatic/therapy , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/psychology , Emotions/physiology , Humans , Imagery, Psychotherapy/methods , Pandemics , Pneumonia, Viral/epidemiology , Pneumonia, Viral/psychology , Psychological Trauma/epidemiology , Psychological Trauma/psychology , SARS-CoV-2 , Stress Disorders, Post-Traumatic/epidemiology , Stress Disorders, Post-Traumatic/psychology , Thinking/physiology
Psychol Trauma ; 12(6): 582-584, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-706406


India enforced one of the world's largest lockdowns in the last quarter of March 2020 to minimize the impact of the COVID-19 pandemic. This commentary focuses on the mental health implications of the ongoing pandemic as well as the lockdown that lasted for more than two months and is still in place in certain areas. Whereas loneliness, stress, anxiety, and depression have been widespread, vulnerable sections of the population, including daily wage workers, migrant laborers, religious minorities, women and children, and the elderly, have been facing various forms of economic, sociopolitical, and familial stigma, racism, and violence. By and large, the COVID-19 pandemic has widened all forms of societal disparities in India. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Adaptation, Psychological , Betacoronavirus , Coronavirus Infections/psychology , Health Status Disparities , Pneumonia, Viral/psychology , Psychological Trauma/psychology , Quarantine/psychology , Vulnerable Populations/psychology , COVID-19 , Coronavirus Infections/complications , Humans , India , Pandemics , Pneumonia, Viral/complications , Psychological Trauma/etiology , SARS-CoV-2
Psychol Trauma ; 12(6): 585-587, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-695966


This article reviews the psychological impact of the COVID-19 pandemic in India. Specifically, social, psychological, and systemic factors that have adverse implications are discussed. Identifying and addressing these factors have implications for the development of policies and interventions. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Betacoronavirus , Coronavirus Infections/complications , Coronavirus Infections/psychology , Mental Disorders/complications , Mental Disorders/psychology , Pneumonia, Viral/complications , Pneumonia, Viral/psychology , COVID-19 , Humans , India , Pandemics , Psychological Trauma/complications , Psychological Trauma/psychology , SARS-CoV-2
J Affect Disord ; 277: 75-84, 2020 12 01.
Article in English | MEDLINE | ID: covidwho-695635


BACKGROUND: Mental health of the population during COVID-19 quarantine could be at risk. Previous studies in short quarantines, found mood-related and anxiety symptomatology. Here we aimed to characterize the subtypes of psychological distress associated with quarantine, assess its prevalence, explore risk/protective factors, and possible mechanisms. METHODS: Online cross-sectional data (n = 4408) was collected during the Argentine quarantine, between 1st-17th April 2020 along a small replication study (n = 644). Psychological distress clusters were determined using latent profile analysis on a wide-range of symptoms using the complete Brief-Symptom Inventory-53. Multinomial and Elastic-net regression were performed to identify risk/protective factors among trait-measures (Personality and Resilience) and state-measures (COVID-19 related fear and coping-skills). RESULTS: Three latent-classes defined by symptom severity level were identified. The majority of individuals were classified in the mild (40.9%) and severe classes (41.0%). Participants reported elevated symptoms of Phobic-Anxiety (41.3%), Anxiety (31.8%), Depression (27.5%), General-Distress (27.1%), Obsession-Compulsion (25.1%) and Hostility (13.7%). Logistic-regressions analyses mainly revealed that women, young individuals, having a previous psychiatric diagnosis or trauma, having high levels of trait-neuroticism and COVID-related fear, were those at greater risk of psychological distress. In contrast, adults, being married, exercising, having upper-class income, having high levels of trait-resilience and coping-skills, were the most protected. Mediation analysis, showed that state-measures mediated the association between trait-measures and class-membership. CONCLUSIONS: Quarantine was associated intense psychological distress. Attention should be given to COVID-19-related fear and coping-skills as they act as potential mediators in emotional suffering during quarantine.

Anxiety/psychology , Depression/psychology , Psychological Distress , Quarantine/psychology , Adaptation, Psychological , Adolescent , Adult , Aged , Aged, 80 and over , Argentina , Betacoronavirus , COVID-19 , Coronavirus Infections , Cross-Sectional Studies , Exercise/psychology , Fear/psychology , Female , Humans , Income , Latent Class Analysis , Male , Marital Status , Mental Disorders/psychology , Mental Health , Middle Aged , Neuroticism , Pandemics , Personality , Pneumonia, Viral , Protective Factors , Psychological Trauma/psychology , Resilience, Psychological , Risk Factors , SARS-CoV-2 , Stress, Psychological/psychology , Young Adult