A longitudinal study of risk and protective factors for symptoms of adjustment disorder during the COVID-19 pandemic.

Background: The COVID-19 pandemic caused multiple stressors that may lead to symptoms of adjustment disorder.Objective: We longitudinally examined relationships between risk and protective factors, pandemic-related stressors and symptoms of adjustment disorder during the COVID-19 pandemic, as well as whether these relationships differed by the time of assessment.Method: The European Society for Traumatic Stress Studies (ESTSS) ADJUST Study included N = 15,169 participants aged 18 years and above. Participants from 11 European countries were recruited and screened three times at 6-month intervals from June 2020 to January 2022. Associations between risk and protective factors (e.g. gender), stressors (e.g. fear of infection), and symptoms of adjustment disorder (AjD, ADNM-8) and their interaction with time of assessment were examined using mixed linear regression.Results: The following predictors were significantly associated with higher AjD symptom levels: female or diverse gender; older age; pandemic-related news consumption >30 min a day; a current or previous mental health disorder; trauma exposure before or during the pandemic; a good, satisfactory or poor health status (vs. very good); burden related to governmental crisis management and communication; fear of infection; restricted social contact; work-related problems; restricted activity; and difficult housing conditions. The following predictors were associated with lower AjD levels: self-employment or retirement; working in healthcare; and face-to-face contact ≥ once a week with loved ones or friends. The effects of the following predictors on AjD symptoms differed by the time of assessment in the course of the pandemic: a current or previous mental disorder; burden related to governmental crisis management; income reduction; and a current trauma exposure.Conclusions: We identified risk factors and stressors predicting AjD symptom levels at different stages of the pandemic. For some predictors, the effects on mental health may change at different stages of a pandemic.

We longitudinally examined predictors of symptoms of adjustment disorder in 15,563 adults during the COVID-19 pandemic.We found stressors, risk, and protective factors predicting adjustment disorder symptom levels at different stages of the pandemic.For some predictors, the effects appear to change in different phases of a pandemic.

Risk and protective factors, stressors, and symptoms of adjustment disorder during the COVID-19 pandemic - First results of the ESTSS COVID-19 pan-European ADJUST study.

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.

Stressors, coping and symptoms of adjustment disorder in the course of the COVID-19 pandemic - study protocol of the European Society for Traumatic Stress Studies (ESTSS) pan-European study.

BACKGROUND: During the current COVID-19 pandemic, the people in Europe are exposed to self-isolation, quarantine, job loss, risk of contracting COVID-19, or grief of loved ones. Such a complex array of stressors may lead to symptoms of adjustment disorder or posttraumatic stress disorder. This research protocol describes a study launched by the European Society of Traumatic Stress Studies (ESTSS) to investigate the impact of the COVID-19 pandemic on symptoms of adjustment disorder across European countries. OBJECTIVE: The longitudinal online cohort study aims (1) to explore psychosocial reactions to the COVID-19 pandemic across ten European countries; (2) to examine the relationships between risk and resilience factors, stressors and symptoms of adjustment disorder during the pandemic; and (3) to investigate whether these relationships are moderated by coping behaviours. METHOD: In ten countries (Austria, Croatia, Georgia, Germany, Italy, Lithuania, Netherlands, Poland, Portugal, and Sweden), between 1,000 and 2,000 participants will be recruited, depending on the size of the country. Participants will be assessed at two timepoints with a six-month interval. Following a conceptual framework based on the WHO's social framework of health, an assessment of risk and resilience factors, COVID-19 related stressors and pandemic-specific coping behaviours will be measured to estimate their contribution to symptoms of adjustment disorder. The Adjustment Disorder New Module 8 (ADNM-8) will be used to assess symptoms of adjustment disorder. As a secondary measure, symptoms of posttraumatic stress disorder will be measure using the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). DATA ANALYSIS: The relative contribution of risk factors, resilience factors, and stressors on symptoms of adjustment disorder or symptoms of posttraumatic stress disorder will be estimated using multilevel analysis. To determine the moderating effects of different types of coping behaviours on these relationships, a multilevel mediation analysis will be carried out.

Antecedentes: Durante la actual pandemia de COVID-19, las personas en Europa están expuestas a autoaislamiento, cuarentena, pérdida de empleo, riesgo de contraer COVID-19 o duelo de sus seres queridos. Un conjunto tan complejo de factores estresantes puede provocar síntomas de trastorno de adaptación o trastorno de estrés postraumático. Este protocolo de investigación describe un estudio lanzado por la Sociedad Europea de Estudios de Estrés Traumático (ESTSS) para investigar el impacto de la pandemia COVID-19 en los síntomas del trastorno de adaptación en países europeos.Objetivo: El estudio longitudinal de cohorte en línea tiene como objetivo (1) explorar las reacciones psicosociales a la pandemia de COVID-19 en diez países europeos; (2) examinar las relaciones entre los factores de riesgo y resiliencia, estresores y síntomas de trastorno de adaptación durante la pandemia; e (3) investigar si estas relaciones son moderadas por comportamientos de afrontamiento.Método: En diez países (Austria, Croacia, Georgia, Alemania, Italia, Lituania, Países Bajos, Polonia, Portugal y Suecia) serán reclutados entre 1,000 y 2,000 participantes, dependiendo del tamaño del país. Los participantes serán evaluados en dos momentos con un intervalo de seis meses. Siguiendo un marco conceptual basado en el marco social de salud de la OMS, una evaluación de los factores de riesgo y resiliencia, factores estresantes relacionados con COVID-19 y el comportamiento de afrontamiento específico de la pandemia serán medidos para estimar su contribución a los síntomas de trastorno de adaptación. El nuevo módulo de trastorno de adaptación 8 (ADNM-8) se utilizará para medir los síntomas del trastorno de adaptación. Como medida secundaria, se evaluarán síntomas de trastorno de estrés postraumático usando el cribaje de TEPT en atención primaria para DSM-5 (PC-PTSD-5).Análisis de datos: La contribución relativa de los factores de riesgo, factores de resiliencia y los estresores sobre los síntomas de trastorno de adaptación o síntomas de trastorno de estrés postraumático se estimará mediante análisis multinivel. Para determinar los efectos moderadores de diferentes tipos de conductas de afrontamiento en estas relaciones, se llevará a cabo un análisis de mediación multinivel.

Alexithymia and attachment insecurities in impulsive aggression.

The aims of this study were to develop a new measure of impulsive aggressiveness, and to assess whether this measure was associated with deficits in mentalized affectivity and adult attachment styles in a sample of 637 non-clinical participants. Extending Fonagy and Bateman's (2004) hypothesis, the mediating role of poor affectivity mentalization in the relationship between insecure attachment styles and impulsive aggression was also evaluated. Selected insecure attachment styles (R2(adjusted) = .18, p < .001) and deficits in mentalized affectivity (R(2)(adjusted) = .25, p < .001) were significantly associated with impulsive aggressiveness. The overall regression model accounted for roughly 33% of the variance in impulsive aggressiveness. Mentalization deficits significantly mediated the effects of attachment styles on impulsive aggressiveness, although effect size measures suggested that only partial mediation occurred.

Psychometric properties of an adolescent version of the Barratt Impulsiveness Scale-11 for a sample of Italian high school students.

The purpose of this study was to extend the development of the Italian version of the Barratt Impulsiveness Scale for use with adolescents. The analyses which led to the development of this version were based on data from 563 high school students. The internal consistency was good (Cronbach alpha=.78). A confirmatory factor analysis identified six first-order factors which converged into two second-order factors, a General Impulsiveness factor and a Nonplanning Impulsiveness factor. The General Impulsiveness factor included motor and attention or cognition items. The second-order factors differed from those obtained with the adult Italian version as well as the American version. Possible reasons for these differences are discussed. The new version correlated significantly with self-report measures of aggression and Attention-Deficit/Hyperactivity Disorder as well as with frequency of alcohol use and cigarette smoking.