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Journal ArticleDOI

Psychological, Behavioral, and Interpersonal Effects and Clinical Implications for Health Systems of the Coronavirus (COVID-19) Pandemic: A Call for Research

TL;DR: This call for research calls for studies that assess the specific effects of the COVID-19 pandemic on highly vulnerable populations such as children, adolescents, pregnant women, patients suffering from chronic and life-threatening conditions, healthcare workers, and elderly citizens.
Abstract: The novel coronavirus disease (COVID-19) emerged at the end of 2019 and was classified as a pandemic by the World Health Organization (WHO) on March 11, 2020. Both the COVID-19 emergency and the extraordinary measures to contain it have negatively affected the life of billions of people and have threatened individuals and nations. One of the main goals of clinical and health psychology during this pandemic is to investigate the behavioral, cognitive, emotional, and psychobiological responses to the COVID-19 emergency as well as to the preventive measures that have been imposed by governments to limit the contagion, such as social isolation. Psychological research has the responsibility to deliver sound empirical evidence to inform public health policies and to support and advise governments and policymakers in their introduction of sustainable, feasible, and cost-efficient prevention and intervention guidelines. Hence, the goal of this call for research is to stimulate theoretical discussions and empirical investigations on the bio-psycho-social impacts of COVID-19 for individuals, groups, and nations. We invite contributions that address the challenges that the COVID-19 emergency has imposed on couples, families, and social systems. In addition, we call for studies that assess the specific effects of the COVID-19 pandemic on highly vulnerable populations such as children, adolescents, pregnant women, patients suffering from chronic and life-threatening conditions, healthcare workers, and elderly citizens. Papers focusing on the impact of emotion regulation and coping strategies are encouraged. Original research, data reports, study protocols, single case reports and community case studies, theoretical perspectives, and viewpoints are invited to help improve our understanding of the COVID-19 pandemic.

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Journal ArticleDOI
TL;DR: Almost half of the Italian population had impaired sleep quality and sleep habits due to elevated psychological distress during the COVID-19 lockdown containment measures, and a multidisciplinary action should be undertaken in order to plan appropriate responses to the current crisis caused by the lockdown.
Abstract: Background Coronavirus disease 2019 (COVID-19) seriously affected the whole of Italy. The extreme virulence and the speed of propagation resulted in restrictions and home confinement. This change was immediately perceived by people who found themselves exposed to feelings of uncertainty, fear, anger, stress, and a drastic change in the diurnal but above all nocturnal lifestyle. For these reasons, we aimed to study the quality of sleep and its connection to distress levels and to evaluate how lifestyle changed in the Italian population during the lockdown. Methods By means of an Internet survey we recruited 6,519 adults during the whole of the COVID-19 lockdown (from March 10-1st phase to May 4-2nd phase). We investigated the sociodemographic and COVID-19-related information and assessed sleep quality using the Medical Outcomes Study-sleep scale (MOS-SS) and mental health with the short form of Depression, Anxiety, and Stress Scales-21 Items (DASS-21). Multiple logistic regression model was used to evaluate the multivariate association between the dependent variable (good sleeper vs. poor sleeper) and all the variables that were significant in the univariate analysis. Results A total of 3,562 (55.32%) participants reported poor sleep quality according to the MOS-Sleep Index II score. The multiple binary logistic regression results of poor sleepers revealed several risk factors during the outbreak restrictions: female gender, living in Central Italy, having someone close who died because of COVID-19, markedly changed sleep-wake rhythms characterized by earlier or postponed habitual bedtime, earlier habitual awakening time and reduced number of afternoon naps, and extremely severe levels of stress, anxiety, and depression. Conclusion This is the first study designed to understand sleep quality and sleep habits during the whole of the lockdown period in the Italian population that provides more than 6,000 participants in a survey developed specifically for the health emergency related to COVID-19. Our study found that more than half of the Italian population had impaired sleep quality and sleep habits due to elevated psychological distress during the COVID-19 lockdown containment measures. A multidisciplinary action should be undertaken in order to plan appropriate responses to the current crisis caused by the lockdown for the COVID-19 outbreak.

154 citations

Journal ArticleDOI
TL;DR: In this article, the authors examined depression, anxiety, and stress among the Italian general population during the phase characterized by lockdown, and investigated the role of resilience as a potential predictor.
Abstract: Background The COVID-19 outbreak is severely affecting the overall mental health with unknown psychological consequences. Although a strong psychological impact is possible, scant evidence is available to date. Past studies have shown that resilience decreases the negative effects of stress. This study aimed to examine depression, anxiety, and stress among the Italian general population during the phase characterized by lockdown, and to investigate the role of resilience as a potential predictor. Methods A total sample of 6,314 Italian people participated in this study. Participants were recruited between March 29 and May 04 2020 through an online survey. The Depression Anxiety Stress Scales-21 (DASS-21) and the Resilience Scale (RS) were administered. Demographic data and lockdown related information were also collected. A correlational analysis was carried out to examine relationships between psychopathological domains and resilience. Three hierarchical regression analyses were conducted using the depression, anxiety, and stress as dependent variables and the resilience as independent variable controlling for age, gender, and education. COVID-19 specific variables were also included in the three regression analyses. A further exploratory analysis was carried out to examine which aspects of resilience predict depression, anxiety, and stress. Results The prevalence of moderate to extremely severe symptoms among participants was 32% for depression, 24.4% for anxiety, and 31.7% for stress. The sample mean scores on depression, anxiety, and stress were higher than the normal scores reported in the literature. Results of correlational analysis showed that resilience factors, such as meaningfulness, self-reliance, existential aloneness, and equanimity, are inversely associated with depression, anxiety, and stress. Results of regression analyses indicated that resilience was statically significant in predicting depression, anxiety, and stress. Geographic area of residence and infected acquaintances were also significant predictors. Regarding the resilience factors, results revealed that meaningfulness, perseverance, and equanimity were statistically significant in predicting all the DASS-21 scales. Conclusion About a third of respondents reported moderate to extremely severe depression, anxiety, and stress. The present study suggests that psychological resilience may independently contribute to low emotional distress and psychological ill-being. These findings can help explain the variability of individual responses during the COVID-19 outbreak.

68 citations

Journal ArticleDOI
TL;DR: In this article, the authors investigate the relationship between the COVID-19 phobia experienced by school administrators and their work-family conflict, family-work conflict, and life satisfaction.
Abstract: This study aims to investigate the relationships between the COVID-19 phobia experienced by school administrators and their work–family conflict, family–work conflict, and life satisfaction. This descriptive research, designed according to the relational survey model, was conducted with the participation of 356 school administrators. The study data were collected through online questionnaires, and then t-test, ANOVA, correlation analysis, and simple linear regression analysis were employed for the statistical analyses. The results revealed that female school administrators experienced greater levels of COVID-19 phobia than their male peers and that COVID-19 phobia is felt more intensely in the psychological and social sub-dimensions. However, female school administrators’ life satisfaction levels were significantly higher than those of male school administrators. In the current study, it was determined that school administrators in the younger age group experienced greater levels of COVID-19 phobia and family–work/work–family conflict than their peers from other age groups. The results of this study revealed a positive and moderate relationship between school administrators’ COVID-19 phobia and their levels of both work–family and family–work conflict. The findings of the study offer significant implications for policy makers in education, showing the importance of developing strategies that will reduce the effects of the pandemic for a more sustainable and efficient employee performance.

67 citations

Journal ArticleDOI
TL;DR: In this paper, the authors investigated the link, state, and differences of negative emotional symptoms, happiness, and work-life balance among university students during the COVID-19 pandemic.
Abstract: Background and Aims: Malaysia's first Movement Control Order (MCO) or "lockdown" was in place for 6 weeks to curb the spread of coronavirus disease (COVID-19). Consequently, all universities were forced to close temporarily with abrupt changes to teaching and learning activities. However, there has been a lack of consensus regarding students' actual psychological status and mental health during the MCO implementation. This study investigates the link, state, and differences of negative emotional symptoms, happiness, and work-life balance among university students during the COVID-19 pandemic. Methodology: This study recruited 1,005 university students across Malaysia. Data was collected online using Qualtrics to measure negative emotional symptoms (The Depression, Anxiety, and Stress Scale), happiness (The Oxford Happiness Inventory), and work-life balance (Work-Family Conflict Scale). All data was analyzed using SPSS version 25 and AMOS version 26 using T-test, ANOVA, logistic regression analyses, and path analysis method. Findings: Findings indicated that 22, 34.3, and 37.3% of the university students scored moderate to extremely severe levels of stress, anxiety, and depression symptoms, respectively. Half scored rather happy or very happy (50%) for happiness levels. Meanwhile, 50.4 and 39.4% scored high to very high levels of work-to-family and family-to-work conflict. Significant differences in stress, anxiety, depression, happiness, work-family conflict, and family-work conflict were recorded across different demographic factors. Happiness was found to be a protective factor with a lesser likelihood of experiencing severe stress (OR = 0.240, 95% CI: 0.180, 0.321), anxiety (OR = 0.336, 95% CI: 0.273, 0.414), and depression (OR = 0.121, 95% CI: 0.088, 0.165) with higher happiness levels. Higher score of work-to-family conflict contributes to greater odds of having severe levels of anxiety (OR = 1.453, 95% CI: 1.161, 1.818). While greater likelihood of developing severe stress (OR = 1.468, 95% CI: 1.109, 1.943) and severe anxiety (OR = 1.317, 95% CI: 1.059, 1.638) under increasing score of family-to-work conflict. Besides, happiness is found to negatively linked with lower negative emotional symptoms, while work-family conflict and family-work conflict are positively linked with higher negative emotional symptoms. Conclusion: Lockdown implementation during the COVID-19 pandemic appears to have a significant impact on university students' negative emotional symptoms, happiness, and work-life balance. Happiness was found to be a protective factor while the state of work-life balance is a risk factor that can predict students' negative emotional symptoms.

36 citations

Journal ArticleDOI
TL;DR: Castelnuovo et al. as discussed by the authors investigated the effect of the COVID-19 pandemic on the level of physical activity among Swiss office workers, with no evidence for a decrease in the three types of activity: walking, moderate intensity activity, and vigorous intensity activity.
Abstract: Purpose: The COVID-19 lockdown interrupted normal daily activities, which may have led to an increase in sedentary behavior (Castelnuovo et al, 2020) The aim of this study was to investigate the effect of the COVID-19 pandemic on the level of physical activity among Swiss office workers Methods: Office workers from two Swiss organizations, aged 18-65 years, were included Baseline data from January 2020 before the COVID-19 pandemic became effective in Switzerland were compared with follow-up data during the lockdown phase in April 2020 Levels of physical activity were assessed using the International Physical Activity Questionnaire Paired sample t-tests or Wilcoxon signed-rank test were performed for statistical analysis Results: Data from 76 participants were analyzed Fifty-four participants were female (711%) The mean age was 427 years (range from 218 to 627) at baseline About 75% of the participants met the recommendations on minimal physical activity, both before the COVID-19 pandemic and during the lockdown Weak statistical evidence for a decline in total physical activity in metabolic equivalent of task minutes per week (MET min/week) was found (estimate = -292, 95% CI from - ∞ to 74, p-value = 009), with no evidence for a decrease in the three types of activity: walking (estimate = -189, 95% CI from - ∞ to 100, p-value = 028), moderate-intensity activity (estimate = -200, 95% CI from - ∞ to 30, p-value = 022) and vigorous-intensity activity (estimate = 80, 95% CI from - ∞ to 460, p-value = 074) Across the three categories "high," "moderate," and "low" physical activity, 17% of the participants became less active during the lockdown while 29% became more active Conclusion: The COVID-19 pandemic did not result in a reduction in total physical activity levels among a sample of Swiss office workers during the first weeks of lockdown Improved work-life balance and working times may have contributed to this finding Clinical Trial Registration: wwwClinicalTrialsgov, NCT04169646 Registered 15 November 2019 - Retrospectively registered, https://clinicaltrialsgov/ct2/show/NCT04169646

17 citations

References
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Journal ArticleDOI
TL;DR: The 2019 novel coronavirus (2019-nCoV) pneumonia, believed to have originated in a wet market in Wuhan, Hubei province, China at the end of 2019, has gained intense attention nationwide and globally and a range of measures has been urgently adopted.

2,447 citations

Journal ArticleDOI

1,356 citations


"Psychological, Behavioral, and Inte..." refers background in this paper

  • ...Online mental health services could provide cheap and feasible solutions, taking into account the enormous bio-psycho-social costs of the pandemic (Duan and Zhu, 2020; Liu et al., 2020; Xiang et al., 2020)....

    [...]

Journal ArticleDOI
TL;DR: The coronavirus disease 2019 (COVID-19) epidemic has now spread across China for over a month, and Xiang and colleagues, claim that the mental health needs of patients with confirmed CO VID-19, patients with suspected infection, quarantined family members, and medical personnel have been poorly handled.

1,244 citations

Journal ArticleDOI
TL;DR: This article highlights key requirements for telehealth uptake, including flexible funding arrangements, training and accrediting the health workforce, to become a routinely used part of the health system.
Abstract: The current coronavirus (COVID-19) pandemic is again reminding us of the importance of using telehealth to deliver care, especially as means of reducing the risk of cross-contamination caused by close contact. For telehealth to be effective as part of an emergency response it first needs to become a routinely used part of our health system. Hence, it is time to step back and ask why telehealth is not mainstreamed. In this article, we highlight key requirements for this to occur. Strategies to ensure that telehealth is used regularly in acute, post-acute and emergency situations, alongside conventional service delivery methods, include flexible funding arrangements, training and accrediting our health workforce. Telehealth uptake also requires a significant change in management effort and the redesign of existing models of care. Implementing telehealth proactively rather than reactively is more likely to generate greater benefits in the long-term, and help with the everyday (and emergency) challenges in healthcare.

1,146 citations

Journal ArticleDOI
TL;DR: Experiences based on the work of the Shanghai Medical Team are outlined, which suggest greater attention should be paid to psychological crisis intervention (PCI) among affected populations for the timely prevention of inestimable damage from a secondary psychological crisis.
Abstract: Since the middle of December 2019, human-to-human transmission of novel coronavirus pneumonia (NCP) has occurred among close contacts. At the same time, greater attention should be paid to psychological crisis intervention (PCI) among affected populations, for the timely prevention of inestimable damage from a secondary psychological crisis. PCI has been initiated via remote (telephone and internet) and onsite medical services to help medical workers, patients, and others affected to overcome any psychological difficulties. This paper outlines experiences based on the work of the Shanghai Medical Team.

129 citations


"Psychological, Behavioral, and Inte..." refers background in this paper

  • ...According to Jiang et al. (2020), the psychological needs of various groups could differ: “the guiding principles divide the population affected by NCP (new coronavirus pneumonia) into 4 levels and require the first-level population to be the focus of PCI (psychological crisis intervention)…...

    [...]

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