Facing Pediatric Rheumatic Diseases: The Role of Disease Activity and Parental Emotion Regulation Strategy in Parents' and Children's Psychological Adjustment.

BACKGROUND: Pediatric rheumatic diseases (PRDs) are a group of chronic disorders that start in childhood and are characterized by periodic exacerbations and remissions of symptoms, with limitations in family, school, and social activities. The aim of this study was to detect differences in parents' psychological adjustment and emotion regulation strategies, and parent-reported children's adjustments in families of children with active and inactive PRDs. METHODS: Fifty-four parents (38 mothers and 16 fathers) of children with PRD were recruited from a pediatric unit. Disease activity was evaluated by their pediatric rheumatologist, while parents' depressive and anxiety symptoms, emotion regulation strategies, and children's emotional difficulties and hyperactivity-inattention symptoms were assessed through a web-based survey. RESULTS: Parents of children with active PRDs reported higher levels of their child's emotional difficulties and hyperactivity-inattention symptoms. Linear regression analysis demonstrated that having a child in the active phases of PRD and lower use of cognitive reappraisal lead to higher children's emotional symptoms, while active disease, low use of cognitive reappraisal, and greater expressive suppression were associated with higher hyperactivity-inattention symptoms. Our study highlights that children with PRDs and their parents may be at increased risk for psychological problems, especially during the active disease phase, highlighting the importance of a multidisciplinary approach.

Maternal Cancer and Perception of Child Psychological Adjustment: The Role of Mother's Anxiety, Depression, and Parenting Stress.

A mother's cancer diagnosis may have consequences for all family members, particularly for children, since it makes a parent less physically and emotionally available, with effects on the relationship with the child and his/her development. The main aim of this study was to analyze children's psychological adjustment in the context of maternal cancer by considering factors related to the child (i.e., age and sex), the mother (psychological adjustment), and cancer (i.e., time elapsed from the diagnosis and current oncological treatment). Self-report questionnaires investigating mothers' parenting stress, depression, anxiety, and children's emotional and behavioral problems were administered to 124 mothers (mean age = 44.52 years; SD = 7.22) diagnosed with cancer. A hierarchical regression analysis highlighted that time since diagnosis and mothers' anxiety and parenting stress accounted for almost 44% of the variance of the children's difficulties. Maternal depression, current oncological treatment, and the child's age and sex were not statistically significant. Higher mothers' parenting stress and anxiety and a longer time elapsed since the first diagnosis predicted higher levels of children's emotional and behavioral problems. These findings highlight the need to identify precursors of childhood distress in the context of maternal cancer and to develop structured programs to support both mothers and children.

Mothers' and Children's Mental Health During the COVID-19 Pandemic Lockdown: The Mediating Role of Parenting Stress.

The present study, carried out during the first peak of the COVID-19 outbreak in Italy, aimed at investigating the mental health of mothers and children during the nationwide lockdown. More specifically, the study investigated children's depression and mothers' individual distress and parenting stress, in comparison with normative samples. The mediating effect of mothers' parenting stress on the relationship between mothers' individual distress and children's depression was also explored. Finally, the study analyzed whether children's biological sex and age moderated the structural paths of the proposed model. A sample of 206 Italian mothers and their children completed an online survey. Mothers were administered self-report questionnaires investigating individual distress and parenting stress; children completed a standardized measure of depression. Mothers' individual distress and parenting stress and children's depression were higher than those recorded for the normative samples. Mothers' parenting stress was found to mediate the association between mothers' individual distress and children's depression. With respect to children, neither biological sex nor age emerged as significant moderators of this association, highlighting that the proposed model was robust and invariant. During the current and future pandemics, public health services should support parents-and particularly mothers-in reducing individual distress and parenting stress, as these are associated with children's depression.

COVID-19 and chronic disease patients: Perceived stress, worry, and emotional regulation strategies.

OBJECTIVE: The current study aimed at investigating the perceived impact of the COVID-19 pandemic on Italian individuals with a preexisting medical condition. Specifically, the study analyzed: (a) if different conditions were associated with different levels of distress, different levels of worry, and different emotion regulation strategies (i.e., cognitive reappraisal, expressive suppression); and (b) if distress levels were associated with levels of worry about COVID-19, emotion regulation strategies, and changes to medical treatment due to the pandemic. METHOD: This cross-sectional study involved 124 individuals (79.8% female; mean age = 48.88 years; SD = 14.95) with a diagnosis of chronic disease. The questionnaires, administered during the peak of the first wave of the COVID-19 pandemic in Italy (April-May 2020), comprised the Perceived Stress Scale, the Emotion Regulation Questionnaire, a COVID-19 worry questionnaire, and a questionnaire designed to collect anamnestic and sociodemographic data. RESULTS: Higher levels of expressive suppression and worries related to COVID-19, and changes to medical treatment due to the pandemic, were associated with higher perceived stress in patients with a preexisting chronic disease. No differences emerged in the study variables according to the type of chronic disease. CONCLUSIONS: The results highlight the importance of considering expressive suppression, levels of worry about COVID-19, and changes to scheduled medical treatment. Screening procedures based on these factors may be useful for identifying individuals with a preexisting medical condition at higher risk of distress, in order to offer them specific and remotely delivered psychological support. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Uncertainty following an inconclusive result from the BRCA1/2 genetic test: A review about psychological outcomes.

BACKGROUND: An inconclusive result from BRCA1/2 genetic testing indicates that a genetic variant of uncertain significance is detected. This case constitutes the majority of genetic test results, but studies specifically addressing the psychological adjustment of people with inconclusive results are scarce. AIM: To examine psychological outcomes of receiving an uninformative BRCA1/2 test result. METHODS: PubMed, PsychInfo, and Cochrane Central Register of Controlled Trials were screened for studies focusing on distress, anxiety, and depression levels in individuals with inconclusive genetic test results. This review is based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses method. RESULTS: Studies on psychological outcomes of inconclusive BRCA1/2 focused on general and specific distress, anxiety, and depression. Overall, they produced mixed results. These inconsistent findings are probably due to the uncertainty caused by this type of result, that may also influence the decisions of individuals about surveillance and prophylactic options, reducing their compliance. In addition, this review highlights specific risk and protective factors that affect psychological adjustment in individuals with an inconclusive genetic testing result. CONCLUSION: Individuals with inconclusive genetic test results need specific educational programs and support to better understand the meaning of their results in order to be able to make decisions about surveillance and prophylactic options.

Psychological Adjustment of Healthcare Workers in Italy during the COVID-19 Pandemic: Differences in Stress, Anxiety, Depression, Burnout, Secondary Trauma, and Compassion Satisfaction between Frontline and Non-Frontline Professionals.

Emergency situations have been associated with negative psychological adjustment outcomes in healthcare professionals, although studies on the impact of the Coronavirus Disease 2019 (COVID-19) pandemic amongst Italian health workers are limited. The main aim of this study was to investigate the psychological adjustment of healthcare professionals during the peak of the COVID-19 pandemic, evaluating differences according to working or not with patients affected by COVID-19 and in areas with a more severe spread of this pandemic. Healthcare professionals' attitudes toward psychological support were analyzed. The levels of anxiety, depression, psychological stress, and professional quality of life (compassion satisfaction, burnout, and compassion fatigue) and attitudes toward psychological support were measured among 627 Italian healthcare workers (mean age = 40.55 years; SD = 11.49; range: 27-72). Significantly higher levels of stress, burnout, secondary trauma, anxiety, and depression were observed among professionals working with COVID-19 patients. Higher levels of stress and burnout and lower levels of compassion satisfaction were detected in professionals working in areas with higher rates of contagion. No interaction effects were found between working (or not) with patients affected by COVID-19 and working (or not) in areas with a more severe diffusion of this pandemic. Finally, in the group of professionals who worked with COVID-19 patients, the percentage of professionals who thought to ask for psychological support was twice that of the group that did not work with COVID-19 patients. The overall findings indicate that the mental health of frontline healthcare workers requires further consideration and that targeted prevention and intervention programs are necessary.

Psychological effects of the COVID-2019 pandemic: Perceived stress and coping strategies among healthcare professionals.

Starting from China, the coronavirus disease (COVID-19) contagion spread unexpectedly and quickly all over the world, particularly affecting Italy. In the early stages of the epidemic, healthcare professionals have been in the front-line to manage the infection. The current study aimed to analyse the impact of COVID-19 outbreak on healthcare professionals and to detect some risk and protective factors of their distress levels, with regard to socio-demographic variables, direct exposure to COVID-19 and the coping strategies used to deal with stress. The data were collected during the peak of the infection. A total of 595 healthcare professionals enrolled in the study and completed the measures of socio-demographical and professional data, perceived stress (PSS) and coping strategies (COPE- NVI-25). Overall, we found that a positive attitude towards the stressful situation was the main protective factor, while female gender, seeking social support, avoidance strategies and working with COVID-19 patients were risk factors. Economic status, problem solving ability and turning to religion were not associated with stress levels. This study, one of the first on this topic, highlighted the main coping strategies used by healthcare professionals in facing the highly stressful situation caused by the pandemic.