Wellbeing, symptoms of trauma, and personal resources in Palestinian professional helpers: a cross-sectional quantitative survey.

BACKGROUND: Professional helpers working in adverse circumstances are at risk of developing psychosocial stress and signs of primary and secondary trauma (eg, anxiety and hyperarousal). We used modelling to investigate whether and to what extent personal resources (ie, post-traumatic growth, sense of coherence, and wellbeing) of Palestinian helpers affected their experience of psychological distress and trauma symptoms. METHODS: Eligible participants were professional health-care providers working in Gaza and the West Bank, occupied Palestinian territory, between June and October, 2018. We used the following quantitative measures: WHO Well Being Index (WHO-5), General Health Questionnaire (GHQ-12), Impact of Event Scale (IES-13), Sense of Coherence Scale (SOC-3), and Post-traumatic Growth Index (PTGI-10). Data were analysed by multivariate structural equation modelling with latent and empirical indicators to test the fit of these constructs to the empirical data. The model was specified to evaluate whether and to what extent mental resources may be interpreted as a set of protective factors mitigating risk factors. The study was approved by the ethics board of the University of Milano-Bicocca, Milan, Italy. Written consent was obtained from participants. FINDINGS: 181 participants were enrolled, ranging in age from 18 to 65 years (mean 31·1, SD 8·7). 135 (75%) were men. The mean GHQ-12 score was 17·7 (SD 7·5), revealing a medium to high degree of psychological trauma. 60 (33%) participants reported low mood (although not necessarily depression) on WHO-5. The structural model showed an excellent fit (χ2 [24] 31·8, p=0·132, root mean square error of approximation 0·043, 90% CI 0·019-0·077). Stronger personal resources were associated with lower levels of both psychological distress (ß=-0·25, p<0·01) and trauma (ß=-0·16, p<0·01). Personal resources were especially associated with reduced levels of anxiety (ß=-0·23, p<0·01) and intrusion symptoms (ß=-0·22, p<0·01). INTERPRETATION: Our integrated model showed that, despite heavy psychological burden, perceptions of post-traumatic growth, coherence, and wellbeing are associated with reduced psychological distress. Targeted training of health-care providers focused on self-awareness of their personal skills and survival resources could improve their psychological health. The study was limited by the cross-sectional research design, and the outcomes of the structural model should be read in terms of probabilistic associations rather than cause-effect relationships. A second limitation concerns the kind of data collected. All the research instruments yielded self-reported quantitative scores, meaning that the standardised ß weights in the model could potentially be an artifact of common method variance (ie, attributable to the measurement method rather than to the constructs themselves. FUNDING: None.

Measuring Traumatic Reactions in Palestinian Children: A Psychometric Assessment of the Children Revised Impact of Event Scale-Arabic Version (CRIES-13A).

The aim of the present study was to test the measurement model and measurement invariance of the Impact of Event Scale (Arabic version) in a large sample of Palestinian children. We estimated (Study 1; n = 610) the measurement model using confirmatory factor analysis. In Study 2 (n = 864), we conducted multigroup (girls and boys) tests of measurement invariance. We pooled the data collected from the participants in the first two studies (Study 3, N = 1474) to assess overall score reliability, as well as the IES' convergent and divergent validity vis-à-vis other measures of child wellbeing and mental health. The outcomes of the statistical analyses supported an invariant 13-item measurement model (intrusion, avoidance, and hyperarousal) for CRIES-13A. Intrusion and hyper-arousal together made up a first-order domain of symptoms (re-experiencing). The combined findings of these studies suggest that the CRIES-13A displays robust psychometric properties and may be used in contexts of military violence.

Social support, resilience, and mental health in a low-intensity warfare context: the effects of siege on university students in Gaza.

BACKGROUND: Gaza has long been enduring a quasi-total siege that significantly undermines quality of life in the region. Gazan youth are particularly affected by the ongoing economic recession, a disrupted environment, and health and food insecurity. These critical circumstances are worsened by the ongoing conflict between Palestine and Israel, which is a cause of death and destruction. AIMS: This cross-sectional study investigated the effects of living under protracted siege conditions on mental distress, resilience, and social support among a sample of Palestinian university students living on the Gaza Strip. METHODS: Five hundred fifty Palestinian university students were recruited at four universities in Gaza. They completed a battery of instruments, including the Gaza Siege Checklist, Depression, Anxiety and Stress Scale (DASS), Resilience Scale (RS), and Berlin Social Support Scales (BSSS). We used structural equation modelling (SEM) to test a conceptual model of social support and resilience as protective factors against the impact on mental distress of living under siege. RESULTS: Our findings indicate that living under siege has direct adverse effects, leading to increased mental distress in the form of anxiety, depression, and acute stress. Enduring siege conditions compromises resilience and sources of social support, thereby increasing subjects' risk of developing psychological distress.

Factor structure and psychometric proprieties of the COVID-19 prevention behaviours (COV19-PB) scale.

We sought to test the COVID19-PB scale's psychometric properties and its dimensionality in a sample composed of 1107 Italian adults aged from 18 to 80 years (M = 39.59; SD = 16.36), 75% (n = 830) females, and 25% (n = 277) males. Exploratory, Confirmatory factor analysis and parallel analysis were used to validate the instrument that resulted from the Ebola Virus protective behaviours scale adaptation. Fear of covid-19 and a 1-item level of adherence to the Covid-19 protection scale were used to test the measure's convergent validity. A four-factor structure emerged from exploratory and confirmatory factor analysis: direct avoidance, avoidance of public spaces, avoidance of social interaction, and talking about the virus as protection. COVID-19 PB was a valuable measure to assess individuals' competencies in assuming correct behaviours during the pandemic.

Promoting prosocial behavior in toddlerhood: A conversation-based intervention at nursery.

The awareness that prosocial skills begin to develop during the early years, with lasting implications for social lives, underpins increasing efforts to find ways of promoting prosocial behavior in children. Nevertheless, few such intervention studies have been conducted with toddlers in educational settings. Following the line of inquiry that examines the role of conversation about inner states in the early development of socioemotional competence, the current study makes an original contribution by evaluating the efficacy of a conversational intervention (TEPP, Toddlers Empathy Prosociality Program) in fostering prosocial conduct in young children. A total of 142 toddlers (Mage = 29.78 months, range = 22-36) participated in a 2-month program during which specially trained teachers read prosocial stories to small groups of children and then involved the children in conversations about inner states and prosocial behavior (Condition 1), in conversations about concrete actions and physical states (Condition 2), or in free play activities (Condition 3). Children in Condition 1 were found to outperform their peers in Conditions 2 and 3 on both direct and indirect measures of prosocial behavior. Gender had a further slight influence on the study outcomes. Overall, the results confirmed that intervention based on conversation about inner states and prosocial actions can enhance the development of prosocial skills in toddlers, encouraging the implementation of early education programs targeting prosociality among peers.

An Exploratory Cross-Sectional Study on the Relationship between Dispositional Mindfulness and Empathy in Undergraduate Medical Students.

THEORY: There is a growing interest in identifying the psychological variables that promote and sustain empathy in medical students during their studies. Dispositional mindfulness has been shown to be empirically associated with socio-demographic characteristics and empathy among the general population. This research aimed to assess dispositional mindfulness in a sample of undergraduate medical students and to investigate its association with gender, age, and empathy. Hypotheses: It is hypothesized that male medical students would show, on average, higher dispositional mindfulness than their female counterparts, and that older students would exhibit higher dispositional mindfulness than younger ones. Dispositional mindfulness was also expected to be positively associated with the ability to feel compassion for others and to adopt their perspective, and negatively associated with the personal distress in tense interpersonal settings. Method: An exploratory cross-sectional study was conducted. Data were gathered from a large sample (N = 933) of Italian non-meditating second- and fifth-year medical students. Dispositional mindfulness and empathy were assessed using the Five-Facet Mindfulness Questionnaire and the Interpersonal Reactivity Index, respectively. Gender and age differences in dispositional mindfulness scores were calculated by analyses of variance, whereas hierarchical multiple regression models were used to assess the association between dispositional mindfulness and empathy scores. RESULTS Female medical students were more able to Act with Awareness than males, whereas males had higher levels than females of Describing and Nonreactivity to their feelings. When compared to their older counterparts, younger students scored higher on Observing and lower on Nonreactivity facets. Dispositional mindfulness facets correlated differently with both emotional and cognitive empathy dimensions, beyond the effects of gender and age. Medical students who displayed higher dispositional mindfulness appeared to be less emotionally distressed in tense interpersonal settings and more able to take others' cognitive perspective. Conclusions: The findings support the notion that dispositional mindfulness is related to empathy and may have implications for the design of mindfulness-based training for use in the medical educational setting. Tailored interventions that cultivate specific dispositional mindfulness facets may be implemented along the medical curriculum to prevent the emotional distress in tense interpersonal settings and to sustain the cognitive capability to take others' viewpoints among medical students.

Measuring agency in children: The development and validation of the War Child Agency Assessment Scale - Palestinian version (WCAAS-Pal).

In the present article, we aimed at construing a new quantitative measure of children's agency in Palestine. Within a socio-ecological and culturally and contextually informed perspective, the study introduces the development of a new instrument to investigate and evaluate children's agentic practices within their living contexts and their daily lives. First, we evaluated the model of measurement of WCAAS-Pal using a sequential exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). Following the principles of testing a quantitative measure in the context of the dual-frame sampling method, the process of validating the quantitative measure was conducted on a group of 1166 Palestinian children aged 9 to 14 years (m = 11.58, sd = 1.54). Second, a sample of 251 Palestinian children aged between 9 and 14 years (m = 11.82, sd = 1.53) was used to compute the reliability of the instrument along with both convergent and divergent validity using the Children Hope Scale and the Children Revised Impact of Event Scale-Arabic Version measures, respectively. The results of the EFA suggested a baseline seven-factor structure to be further assessed via CFA. a complex web of agency domains that might contribute to the child psychological functioning when forced to leave in conditions of ongoing threat and military violence emerged from the analysis.

Quality of life, primary traumatisation, and positive and negative affects in primary school students in the Gaza Strip.

BACKGROUND: Many researchers have reported that exposure to war and ongoing political violence increases mental health problems in children. Results of studies have also shown a high prevalence (58-80%) of post-traumatic stress disorder in war-affected children living in the occupied Palestinian territory. The aim of this study was to estimate the direct and indirect effects of perceived life satisfaction on the consequences of children's exposure to trauma and the balance of positive and negative affect. METHODS: Palestinian children were recruited from primary schools in four refugee camps in the Gaza Strip (Bureij, Gaza Beach Camp, Jabalia, Rafah). All children had been involved in or witnessed one or more episodes of violence involving other people in the 2 months prior to the study (the 2012 Gaza War). We used the Multidimensional Students Life Satisfaction Scale (peers, self, living environment, school, family), the Positive and Negative Affect Scale for Children, and the revised Children Impact of Events scale (intrusion and avoidance symptoms) to test (through structural equation modelling) the moderation effect of life satisfaction on war trauma via positive emotions. FINDINGS: 1276 Palestinian children were enrolled in this study. The model tested with structural equation modelling was robust. Children's life satisfaction influenced both the intrusion (ß=-0·48; p=0.003) and avoidance (ß=-11; p=0·021) effects of primary traumatisation. The consequences of primary traumatisation by intrusion (ß=0·34; p=0·008) and avoidance (ß=0·27; p=0.011) contributed to increasing negative affect. Finally, perceived life satisfaction had direct effects on affective experience, specifically increasing positive affect and diminishing negative affect. INTERPRETATION: Perceived quality of life in children has a role in controlling war-related traumas. Life satisfaction contributes both directly and indirectly to change affectivity. When children perceive themselves to be highly satisfied with their home and school environment, living conditions, and relationships with peers and parents, the effects of trauma are less severe. FUNDING: None.

Teaching in conflict contexts: dimensions of subjective wellbeing in Palestinian teachers living in Israel and the occupied Palestinian territory.

BACKGROUND: Subjective wellbeing can be defined in terms of good mental state, including positive and negative evaluations that people make of their affect and lives. The aim of this study was to identify specific domains of wellbeing that are salient to Palestinian teachers living in three different contexts (West Bank, Gaza Strip, and Israel) and to map how components of subjective wellbeing vary between the three cohorts. METHODS: Data were gathered from interviews of teachers participating in 16 focus groups and from 36 key informants (including psychologists, counsellors, school principals, lawyers). Participants were divided into three groups according to their working locations. Data were analysed by using a mixed-method approach. We used thematic textual analysis, and data were cross-validated with results of statistical significance of lexical specificities (ie, domain-specific terms extracted from specific participants' lexicon) and semantic network analysis. FINDINGS: We interviewed 104 teachers. First-order hierarchical categorisation of thematic analysis revealed four dimensions of subjective wellbeing: psychosocial, professional-related, economic issues, and contextual factors. Some second-order subcategories were quality of teaching work, personality aspects, emotional dimensions, political dimensions, and psychological dimensions. Analysis of lexical specificities and results of semantic network analysis revealed that the importance of different components of subjective wellbeing varied across geographical cohorts. Overall, the results of qualitative and quantitative data analysis showed a clear relationship between the teachers' subjective wellbeing and the places they lived. INTERPRETATION: General themes were common in all populations, but the three cohorts differed in terms of the relative salience of each theme. The prominent themes for the Gazan group were quality of teaching, social dimensions, and religion. The key themes for the West Bank group were economic, social dimensions, and recognition. Salient themes for the Arab-Israeli group were professional, emotional, and social dimensions. Despite some differences between the diasporic Palestinian populations in the occupied Palestinian territories and Israel, the categories of wellbeing are supported in all cohorts. FUNDING: None.

Metaphors of adolescence during COVID-19 pandemic: a mixed-method analysis in relation to well-being and alexithymia.

Introduction: During the pandemic, young people experienced a general increase in stress levels in their home and school environments and in their relationships with peers and family, largely due to restrictions on freedom of movement and social isolation. The ability to identify sources of stress and respond positively to them, using both personal and environmental resources, seems to be key to maintaining an acceptable level of well-being. This study investigates the association between alexithymic traits, self-perceived well-being, and self-representations in adolescents as expressed via narrative metaphors during the COVID-19 epidemic. Methods: The sample comprised 229 Italian adolescents (51.1% females, mean age = 16.64). The research design was based on an exploratory, parallel, mixed-method approach. A semi-structured online interview was used as the major data gathering tool including both standardized quantitative questionnaire and open-ended questions. Data were analyzed by means of descriptive statistics, quantitative textual analysis and multidimensional co-word correspondence analysis. Results: Main findings reveal a general low level of perceived well-being associated with alexithymia, affecting adolescents' lexical choices for their metaphors. Alexithymia-related low levels of well-being correspond to metaphors in which confusion and overpowering emotions predominate. Vivid pictures indicating vitality and a bright view on the future is often correlated with high levels of well-being. Discussion: Overall, these novel findings appear to show an interactive effect of perceived well-being and alexithymia on adolescents' ability to identify and describe their own condition. Furthermore, metaphors emerge as powerful tools for investigating well-being in adolescents since closely related to inner states.

A mixed-method study on adolescents' well-being during the COVID-19 syndemic emergency.

In this study, we set out to investigate adolescents' levels of perceived well-being and to map how they went about caring for their well-being during the COVID-19 syndemic. Participants were 229 Italian adolescent high school students (48.9% males, mean age = 16.64). The research design was based on an exploratory, parallel, mixed-method approach. A multi-method, student-centered, computer-assisted, semi-structured online interview was used as the data gathering tool, including both a standardized quantitative questionnaire on perceived well-being and an open-ended question about how adolescents were taking charge of their well-being during the COVID-19 health emergency. Main findings reveal general low levels of perceived well-being during the syndemic, especially in girls and in older adolescents. Higher levels of well-being are associated with more affiliative strategies (we-ness/togetherness) whereas low levels of well-being are linked with more individualistic strategies (I-ness/separatedness) in facing the health emergency. These findings identify access to social support as a strategy for coping with situational stress and raise reflection on the importance of balancing the need for physical distancing to protect from infection, and the need for social closeness to maintain good mental health.

Trajectories of quality of life and mental health during the Covid-19 lockdown and six months after in Italy. A longitudinal exploration.

Aim: Covid-19 pandemic and its relative containment measures have affected populations' quality of life and psychological well-being worldwide. The fear related to the pandemic and the imposed containment measures has acted as a trigger causing a global increase in negative mental health states. Thus, we aimed to explore the relationship between fear of covid-19 and mental health via QoL (the first and the second lockdown in Italy, 2020). Subject and methods: Through a quantitative cross-lagged path model research design, the study investigates people's fear of Covid-19, quality of life, and negative mental states in a population of 444 Italian adults (Mean=40.7; Standard Deviation=16.9; 80% women), in the period between the first and the second waves of the pandemic. Results: Results show that participants' Covid-19 fear decreased between waves, contributing to a decrease in negative mental states (stress, anxiety and depression), thus improving the perceived quality of life. Furthermore, quality of life emerged as able to buffer the impact of fear of Covid on people's psychological distress in short and medium terms, confirming its central role in regulating mental distress. Conclusion: The study suggests important guidelines for developing interventions to support the populations' well-being and mental health.

The role of teachers' socio-emotional competence in reducing burnout through increased work engagement.

Introduction: Research has highlighted the relevance of socio-emotional competence in buffering the harmful impacts of perceived stress on the psychological facets of the teaching profession. The purpose of this paper is to innovatively investigate the relationships between perceived stress, work engagement, and burnout in a single comprehensive model, when considering the potential role that socio-emotional competence plays in mitigating the adverse impact of perceived stress on burnout. Methods: A total of 276 Italian in-service teachers (mean age = 46.6 ± 9.9 years) completed quantitative self-report measures of perceived stress, socio-emotional competence, work engagement, and burnout. Data were analyzed by using a structural equation modeling (SEM) approach. Results: All fit indexes supported the model's full acceptance and suggested that teachers' socio-emotional competence reduced the effect of perceived stress on the risk of burnout by increasing their level of work engagement. Discussion: The implications of the findings are discussed in terms of promoting interventions that target not only stress reduction but also foster teachers' socio-emotional competence in order to maintain a good level of work engagement and reduce the effect of stress on burnout.

Validation of Italian students' self-ratings on the SSIS SEL brief scales.

Introduction: Despite increasing interest in measuring social and emotional learning (SEL), there is a lack of European-validated tools for assessing the efficacy of SEL programs. The aim of this study was to validate an Italian version of the social skills improvement system (SSIS) SEL brief scales-student form. Methods: Participants were 1,175 students (mean age: 11.02 years; SD: 2.42; range: 8-16 years; males: 46.8%) recruited at schools in Northern Italy. Statistical analyses and results: Initial confirmatory factor analysis encountered a series of challenges, implying non-convergence of the original five-factor measurement model (self-awareness, self-management, social awareness, relationship skills, and responsible decision-making) based on the Collaborative on Academic Social Emotional Learning (CASEL) competency framework established with students in the United States. Further exploratory and confirmatory analyses supported a four-factor model that remained partially invariant across gender groups. The Italian version of the SSIS SEL brief scales was thus shown to be an efficient measurement tool for estimating social and emotional learning in students. Discussion: We discuss the implications of findings in relation to selecting valid and reliable instruments for assessing children's and adolescents' SEL competencies, while considering the culturally-situated nature of the constructs under study.

Psychological distress, professional burnout, and trauma in Palestinian health care helpers: A two-wave quantitative longitudinal study.

OBJECTIVE: The aim of this longitudinal study was to model the cumulative network of associations between trauma-related symptoms, professional burnout, and psychological distress in health care practitioners working in emergency settings. METHOD: The research was conducted with Palestinian health care helpers (N = 60) operating in Gaza and the West Bank. The study variables were evaluated via repeated quantitative self-report questionnaires collected in two waves and the associations among them were estimated using structural equation modeling, bootstrap methods, and Monte Carlo simulation. RESULTS: The longitudinal structural model offered a good fit for the data (χ²(114) = 161.4, p = .02, NC = 1.42, nonnormed fit index [NNFI] = .950, comparative fit index [CFI] = .951, root mean square error of approximation [RMSEA] = .079), in support of the notion that trauma-related outcomes and professional burnout may be associated with mental health across different professional groups. Specifically, trauma-related symptoms wielded a direct effect on professional burnout (ß = .28) and psychological distress (ß = .11) at T0. Trauma-related symptoms were found to be more strongly associated with professional burnout (ß = .40) than with psychological distress (ß = .03) at T1. CONCLUSION: Emergency workers operating in an environment marked by instability and ongoing risk need to draw on sources of resistance and resilience to protect their mental health. We discuss both the clinical implications of these findings and future lines of inquiry. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Virtual Reality Applications in Medicine During the COVID-19 Pandemic: Systematic Review.

BACKGROUND: Virtual reality can play an important role during the COVID-19 pandemic in the health care sector. This technology has the potential to supplement the traditional in-hospital medical training and treatment, and may increase access to training and therapies in various health care settings. OBJECTIVE: This systematic review aimed to describe the literature on health care-targeted virtual reality applications during the COVID-19 crisis. METHODS: We conducted a systematic search of the literature on the PsycINFO, Web of Science, and MEDLINE databases, according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. The search string was as follows: "[(virtual reality)] AND [(COVID-19) OR (coronavirus) OR (SARS-CoV-2) OR (healthcare)]." Papers published in English after December 2019 in peer-reviewed journals were selected and subjected to the inclusion and exclusion criteria. We used the Mixed Methods Appraisal Tool to assess the quality of studies and the risk of bias. RESULTS: Thirty-nine studies met the inclusion criteria. Seventeen studies showed the usefulness of virtual reality during the COVID-19 crisis for reducing stress, anxiety, depression, and pain, and promoting physical activity. Twenty-two studies revealed that virtual reality was a helpful learning and training tool during the COVID-19 crisis in several areas, including emergency medicine, nursing, and pediatrics. This technology was also used as an educational tool for increasing public understanding of the COVID-19 pandemic. Different levels of immersion (ie, immersive and desktop virtual reality), types of head-mounted displays (ie, PC-based, mobile, and standalone), and content (ie, 360° videos and photos, virtual environments, virtual reality video games, and embodied virtual agents) have been successfully used. Virtual reality was helpful in both face-to-face and remote trials. CONCLUSIONS: Virtual reality has been applied frequently in medicine during the COVID-19 pandemic, with positive effects for treating several health conditions and for medical education and training. Some barriers need to be overcome for the broader adoption of virtual reality in the health care panorama. TRIAL REGISTRATION: International Platform of Registered Systematic Review and Meta-analysis Protocols (INPLASY) INPLASY202190108; https://inplasy.com/inplasy-2021-9-0108/.

Prosocial Behavior in Toddlerhood: The Contribution of Emotion Knowledge, Theory of Mind, and Language Ability.

While scholars have previously investigated the respective contributions of emotional knowledge and language ability to toddlers' prosociality, no studies to date have featured a battery of multiple direct measures assessing both of these abilities plus theory of mind on the one hand, and prosocial behavior on the other hand. In contrast, we conducted the present cross-sectional study with a view to evaluating the unique contributions of each of these three social cognition variables as antecedents of prosocial conduct during toddlerhood, measuring them via a series of individually administered standardized tasks. Furthermore, given that the existing literature documents mixed gender effects, we also set out to explore the role of gender in toddlers' prosociality. Finally, we also controlled for any effects of age on the patterns of association among the key variables. Participants were 127 children aged between 24 and 36 months (M = 29.2 months; SD = 3.5). We identified significant correlations among the variables under study. In addition, stepwise multiple regression analysis suggested that each of the social cognition (SC) abilities - i.e., emotion knowledge, theory of mind, and language - made a unique contribution to explaining variance in prosocial behaviors (PB). These findings show that SC is already associated with PB in toddlerhood and suggest the importance of fostering social cognition competence from the early years, with a view to increasing children's propensity to engage in prosocial conduct.

The Effects of Playing Video Games on Stress, Anxiety, Depression, Loneliness, and Gaming Disorder During the Early Stages of the COVID-19 Pandemic: PRISMA Systematic Review.

During the initial phases of the COVID-19 pandemic, playing video games has been much more than just a pastime. Studies suggested that video games for many individuals have helped to cope with such difficult life experience. However, other research indicates that gaming may have had harmful effects. Within this context, this systematic review aimed to describe the literature on the effects of video games during the early stages of the COVID-19 crisis on stress, anxiety, depression, loneliness, and gaming disorder (GD), examining the study characteristics and outcomes. A systematic search of the literature was made following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. It was preregistered in the International Platform of Registered Systematic Review and Meta-Analysis Protocols (INPLASY)-INPLASY202180053. The search databases were PsycINFO, Web of Science, and Medline. The search string was: [("video game*") OR ("computer game*") OR ("gaming")] AND [("COVID-19")]. Twenty-four studies met the inclusion criteria. Four research explored the effects of playing video games during the COVID-19 pandemic on stress, anxiety, and depression. Four studies investigated loneliness, while 18 research investigated game disorder. Video games, especially augmented reality and online multiplayer ones, mitigated stress, anxiety, depression, and loneliness among adolescents and young adults during stay-at-home restrictions. However, in the case of at-risk individuals (i.e., particularly male youths), playing video games had detrimental effects.

A virtual reality home-based training for the management of stress and anxiety among healthcare workers during the COVID-19 pandemic: study protocol for a randomized controlled trial.

BACKGROUND: Healthcare workers represent one of the most affected categories by the adverse effects of the COVID-19 pandemic on mental health. Excessive stress and anxiety are critical factors that could compromise work performance. Besides, high levels of stress and anxiety may have long-term physical and psychological consequences. Recent studies investigated virtual reality to reduce stress and anxiety among healthcare workers during the COVID-19 pandemic. However, the proposed virtual reality interventions have important limitations related to their location (i.e., research lab and hospitals) and content (i.e., virtual experiences only for relaxation). Within this context, this randomized controlled trial aims to investigate the efficacy and acceptability of a brief home-based virtual reality training for managing stress and anxiety during the COVID-19 crisis in a sample of Italian healthcare workers. METHODS: The study is a randomized controlled trial. It includes two groups of 30 individuals recruited from healthcare workers: (1) the experimental group and (2) the control group. Participants in the experimental group will receive a training consisting of three home sessions performed in a week. In each session, participants will try through an immersive virtual reality standalone system (i.e., Oculus Quest 2) a virtual psychoeducation experience on stress and anxiety (i.e., MIND-VR). Subsequently, they will try the virtual relaxation content (i.e., The Secret Garden). The control group will receive no training and will be reassessed one week and one month after the initial evaluation. DISCUSSION: If the proposed brief home-based virtual reality training will result helpful and easy to use, it could become an empirically assessed viable option for protecting healthcare workers' mental health both during the COVID-19 pandemic and once it will be over. Furthermore, the intervention might be easily adapted for other categories of people who need support in managing stress and anxiety. TRIAL REGISTRATION: ClinicalTrials.gov NCT04611399 .

Commercial Off-The-Shelf Video Games for Reducing Stress and Anxiety: Systematic Review.

BACKGROUND: Using commercial off-the-shelf video games rather than custom-made computer games could have several advantages for reducing stress and anxiety, including their low cost, advanced graphics, and the possibility to reach millions of individuals worldwide. However, it is important to emphasize that not all commercial video games are equal, and their effects strongly depend on specific characteristics of the games. OBJECTIVE: The aim of this systematic review was to describe the literature on the use of commercial off-the-shelf video games for diminishing stress and anxiety, examining the research outcomes along with critical variables related to computer game characteristics (ie, genre, platform, time of play). METHODS: A systematic search of the literature was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. The search databases were PsycINFO, Web of Science, Medline, IEEExplore, and the Cochrane Library. The search string was: [("video game*") OR ("computer game*")] AND [("stress") OR ("anxiety") OR ("relaxation")] AND [("study") OR ("trial") OR ("training")]. RESULTS: A total of 28 studies met the inclusion criteria for the publication period 2006-2021. The findings demonstrate the benefit of commercial off-the-shelf video games for reducing stress in children, adults, and older adults. The majority of the retrieved studies recruited young adults, and fewer studies have involved children, middle-aged adults, and older adults. In addition to exergames and casual video games, other genres of commercial off-the-shelf games helped to reduce stress and anxiety. CONCLUSIONS: Efficacy in reducing stress and anxiety has been demonstrated not only for exergames and casual video games but also for other genres such as action games, action-adventure games, and augmented reality games. Various gaming platforms, including consoles, PCs, smartphones, mobile consoles, and virtual reality systems, have been used with positive results. Finally, even single and short sessions of play had benefits in reducing stress and anxiety. TRIAL REGISTRATION: International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY202130081; https://inplasy.com/?s=INPLASY202130081.