Psychosocial dimensions of vaccine hesitancy: A systematic review.

Despite widely recognised effectiveness against the spread of COVID-19, vaccine hesitancy persists. This systematic literature review aimed to clarify the definition and the operationalisation of the term 'vaccine hesitancy' and disclose the various psychosocial factors underlying this phenomenon. The results of studies conducted in European countries and in the United States after the vaccines became available were taken into account. The review was conducted according to the Preferred Reporting Items for Systematic Review and Meta-Analyses statement. Twelve studies met the inclusion criteria and were reviewed. efinitions and measures of vaccine hesitancy differed across the studies, limiting their comparison. Nonetheless, by drawing on theoretical frameworks, we were able to identify several psychosocial variables in determining vaccine hesitancy. Our findings point to the need for a transdisciplinary approach to understanding the antecedents of vaccine hesitancy. A better understanding of the phenomenon may help to develop interventions and social policies to address a complex challenge such as vaccination hesitancy.

Performing Arts in Suicide Prevention Strategies: A Scoping Review.

Suicide is a leading cause of death all over the world. Suicide prevention is possible and should be pursued through a variety of strategies. The importance of the arts for positive health outcomes has been increasingly evidenced. This scoping review aimed to identify the possible role of the performing arts-defined as a type of art performed through actions such as music, dance, or drama executed alive by an artist or other participant in the presence of an audience,-in suicide prevention programs. PubMed, Embase, PsycINFO, CINAHL, ProQuest Psychology Database, Scopus, and Web of Science were searched using terms in English for publications of original studies that included performing arts in suicide prevention programs. Thirty-five studies conducted between 1981 and 2021 were identified, of which only five were randomized clinical trials and four quasi-randomized studies. Interventions used different performing arts to improve awareness, self-efficacy, and soft skills relevant to suicide prevention. Studies were addressed mainly to gatekeepers but also directly to at-risk populations. While the study designs do not allow inferences to be drawn about the effectiveness of performing arts in preventing suicide, the review found that performing arts have been successfully implemented in suicide prevention programs. Research to evaluate the possible therapeutic benefit is warranted.

Dyadic Predictors of Child Body Shame in a Polish and Italian Sample.

The present study aimed at assessing the predictors (related to the functioning of a parent-child dyad) of child body shame. Therefore, in the main analysis we examined relationships among child body shame, child perfectionism, child body dissatisfaction, parent body shame, parent perfectionism, and parent body dissatisfaction. In our main hypothesis we assumed that higher levels of the abovementioned parent functioning-related variables would be associated with higher child body shame after accounting for the effects of the foregoing child functioning-related variables. The analysis finally included complete data from 420 participants, i.e., a 115 Polish and 95 Italian parent-child dyad. Participants completed: (a) child: the Objectified Body Consciousness Scale for Youth, the Child-Adolescent Perfectionism Scale, the Children's Body Image Scale/the Figure Rating Scale; (b) parent: the Objectified Body Consciousness Scale, the Frost Multidimensional Perfectionism Scale, and the Contour Drawing Rating Scale. The results of a correlational analysis show that in both the Polish and Italian samples, the higher the level of child body shame, the higher the level of the following variables: child perfectionism, child body dissatisfaction, parent perfectionism, and parent body dissatisfaction. Interestingly, the only insignificant relationship in both samples is the association between body shame in both members of the child-parent dyad. Moreover, all steps of the regressions were significant in both Polish and Italian samples. It turned out that only in the Italian sample were all predictors significantly associated with a child's body shame (in the Polish sample there was no significant association between child's body shame and parent's perfectionism). To sum up, the above studies show the importance of considering the functioning of the parent-child dyad in understanding child body shame. These findings suggest that parents' attitudes toward their bodies and their beliefs about an ideal self should be taken into account when planning interventions to improve children's and adolescents' attitudes toward their bodies. This is so because it is possible for children to internalize their parents' beliefs about how to look and how critical one should be of themselves, which can result in strong body shame when they are not perfect enough against the internalized ideal. Therefore, it is also necessary to make parents aware that children's attitude toward their body is often a reflection of parents' attitude toward the body.

Emergency online school learning during COVID-19 lockdown: A qualitative study of adolescents' experiences in Italy.

The COVID-19 pandemic caused abrupt and profound changes to teaching and learning. The present study seeks to understand adolescents' experiences of the emergency adoption of online school learning (OSL) during the first national lockdown in Italy. Sixty-four students in their final two years of high school were interviewed and content analysis was performed. The findings describe students' views of the changes related to OSL according to structural, individual and relational dimensions. Schools' lack of organization, overwhelming demands, as well as experience of difficulties in concentration, stress and inhibited relationships with teachers and classmates were among the challenges evidenced in the transition. OSL, however, has also made it possible to experience a new flexibility and autonomy in the organization of learning. The study stresses the importance of fostering adaptation of teacher-student relationships and collaborative learning in order to improve schools' preparedness for digital transitions in and out of emergencies.

Adjustment to COVID-19 Lockdown Among Italian University Students: The Role of Concerns, Change in Peer and Family Relationships and in Learning Skills, Emotional, and Academic Self-Efficacy on Depressive Symptoms.

In Italy strict containment measures against COVID-19 pandemic were implemented from March to May 2020 with home confinement and schools and universities closed. Students shifted to remote learning, experienced a forced isolation from peers and an increased sharing of time and spaces with the family. The influence of these aspects on the psychological adjustment of university students is largely unexplored. This paper was aimed at investigating the role of some correlates of depressive symptoms specific to the lockdown condition experienced by young university students, namely contagion concern, perceived worsening of family, and peer relationships and perceived worsening of learning skills. Moreover, the possible mediating effects of emotional and academic self-efficacy in these relationships were examined. Data were collected from 296 Italian university students (aged 18-25 years; 83% female students) through an online survey by means of a snowball sampling methodology in May 2020. Significant depressive symptoms were reported by 67% of participants. Contagion concerns were related to depressive symptoms through the mediating effect of emotional self-efficacy. Worsening of learning skills was related to depressive symptoms through the mediating effect of academic self-efficacy. Depressive symptoms were directly related to worsening of family relationships but unrelated to worsening of peer relationships. Results are discussed in relation to the need of preventive interventions for this specific population in view of academic activities planning in the post-COVID 19 period.

Self-efficacy, subjective well-being and positive coping in adolescents with regard to Covid-19 lockdown.

The study is aimed at examining the relationship between emotional and self-regulated learning self-efficacy, subjective well-being (SWB) and positive coping among adolescents and youths, during the COVID-19 pandemic lockdown. 485 Italian students (74% girls; mean age 19.3) filled in an online questionnaire during the lockdown period. The hypothesized model in which both the forms of self-efficacy were predictors of SWB and positive coping, and SWB partially mediated the relation between self-efficacy measures and positive coping was tested by means of Structural equation modeling. Results largely supported the hypothesized relationships and suggested paying special attention to adolescents' self-efficacy in regulating basic negative emotions, in order to promote positive coping strategies to face challenges coming from everyday life and from non-normative events.

Social Media, Depressive Symptoms and Well-Being in Early Adolescence. The Moderating Role of Emotional Self-Efficacy and Gender.

The study of the psychological effects of social media use on adolescents' adjustment has long been the focus of psychological research, but results are still inconclusive. In particular, there is a lack of research on the positive and negative developmental outcomes and on possible moderating variables, especially concerning early adolescence. To fill these gaps in literature, the present study longitudinally investigated the relationships between social media use, depressive symptoms, affective well-being and life satisfaction, as well as the moderating role of emotional self-efficacy and gender. The study involved 336 Italian early adolescents (mean age = 13, sd = 0.3; 48% girls) who completed an anonymous self-report questionnaire twice within a year. Main results showed that higher social media use was related to higher depressive symptoms, lower affective well-being and lower life satisfaction among girls with lower emotional self-efficacy. Conversely, high social media use was related to higher affective well-being and higher life satisfaction for girls with higher emotional self-efficacy. Results are discussed in relation to their implications for risk prevention and health promotion among early adolescents. In particular, our results suggest that promoting emotional self-efficacy can be very helpful in making the use of social media an opportunity for well-being and life satisfaction rather than a developmental risk.

School Achievement and Depressive Symptoms in Adolescence: The Role of Self-efficacy and Peer Relationships at School.

Depressive symptoms are common during adolescence. Failure at school often relates to low self-efficacy that, in turn, is associated with depressive symptoms. Several studies have supported the role of friends in counteracting depression in adolescence. The present study tested a mediation model in which the indirect effect between school achievement and depressive symptoms, mediated by perceived self-efficacy, was moderated by peer relationships at school. Self-report questionnaires were administered to 1004 adolescents aged 14 to 18 years (M = 15.5; SD = 1.2). The moderated mediation model showed that the mediation of self-efficacy in the relation between school achievement and depressive symptoms was moderated by peer relationships. Higher self-efficacy was associated to lower depressive symptoms, in particular in adolescents with more school friends. Conversely, the magnitude of this association is weaker for those with fewer school friends. Programs aimed at reducing psychological malaise should focus on fostering positive relationships among classmates.

The Role of Identity Motives on Quality of Life and Depressive Symptoms: A Comparison Between Young Adults With Multiple Sclerosis and Healthy Peers.

The diagnosis of a chronic illness during young adulthood represents a non-normative life transition influencing the identity definition process, as well as the individual psychological adjustment. The study examined if relationships between identity motives (self-esteem, efficacy, continuity, distinctiveness, belonging, and meaning), health-related quality of life, and depressive symptoms differ between healthy young adults and young adults diagnosed with multiple sclerosis (MS). Two hundred one people (101 MS patients and 100 healthy controls), aged 18-35 years, completed a self-report questionnaire. Young adults with MS reported lower health-related quality of life and lower efficacy motive than their healthy peers. Among MS patients, high meaning was related to lower depressive symptoms, whereas high continuity and high belonging were related to higher health-related quality of life than in healthy controls. The study highlights the relevance of identity motives for the adjustment to MS and has implications for psychological interventions with young patients.

Adjustment to multiple sclerosis and identity satisfaction among newly diagnosed women: what role does motherhood play?

The present study aimed to describe the levels of depressive symptoms, affective well-being and identity satisfaction in a group of women recently diagnosed with multiple sclerosis (MS), accounting for differences in age, motherhood, and disease duration. Moreover, the role of identity satisfaction in depressive symptoms and affective well-being was evaluated, examining the moderating effect of motherhood. The study involved 74 women, aged between 19 and 57 years (Mean = 37.7 years, SD = 10.7 years). Thirty-two women (43.2%) had children, aged between 2 and 29 years. All women had relapsing-remitting multiple sclerosis (RRMS) and mild to moderate disability. Mothers experienced greater depressive symptoms than childless women. Moreover, motherhood moderated the effect of disease duration on adjustment, with mothers reporting greater depressive symptoms, less affective well-being and less identity satisfaction than childless women as time passed since the diagnosis. Finally, greater identity satisfaction was related to less depressive symptoms and greater affective well-being, with a moderating effect of motherhood. The results outline the relevance of the process of identity redefinition for women's adjustment to MS early in the illness. Moreover, the results underscore the need to take into account the additional burden of motherhood when promoting women's adjustment to MS.

Empathy and Depression Among Early Adolescents: The Moderating Role of Parental Support.

Early adolescence is a period of development of emotional competence, but also of increasing vulnerability for the onset of depressive symptoms. While literature underscored that empathy promotes social relationships and psychological well-being over the life course, the possible role of high empathy levels as a risk factor for depression has been under investigated, especially among early adolescents. Moreover, although parenting practices are known to influence both empathy and depression in adolescence, few studies investigated if parenting moderates the relationship between empathy and depression. Therefore, the aims of the study were: (1) to investigate the relationships between affective and cognitive empathy and depression; (2) to investigate the moderating role of perceived paternal and maternal support on the associations between affective and cognitive empathy and depression; (3) to examine if the relationships among affective and cognitive empathy, maternal and paternal support and depression vary as a function of early adolescents' gender. The study involved 386 Italian students aged between 12 and 14 (M age = 13, SD = 0.3, 47.9% girls) who completed an anonymous self-report questionnaire, including measures of cognitive and affective empathy, paternal and maternal support and depression. Results showed that with a mean level of affective and cognitive empathy, higher maternal support was related to lower depression for girls, whereas higher paternal support was related to lower depression for both boys and girls. Both maternal and paternal support moderated the relation between empathy and depression. In particular, maternal support moderated the non-linear relation between affective empathy and depression and the relation was further moderated by early adolescents' gender: boys with low affective empathy reported lower depression in a context of high maternal support. Paternal support moderated the linear relation between cognitive empathy and depression, independently of early adolescents' gender: boys and girls with high cognitive empathy reported higher depression in a context of low paternal support. The results of the study suggested that high empathy might be a risk factor for depression during early adolescence and mothers and fathers have a differential moderating role in relation to the affective and cognitive dimensions of empathy, also in relation to early adolescents' gender.

Young adults' adjustment to a recent diagnosis of multiple sclerosis: The role of identity satisfaction and self-efficacy.

BACKGROUND: Although multiple sclerosis (MS) is often diagnosed during young adulthood (18-30 years), there is a lack of knowledge on the psychological adjustment to the illness among recently diagnosed young adult patients. OBJECTIVE/HYPOTHESIS: The aims of the study were to describe the adjustment to MS (depression, positive and negative affect) in a group of young adult patients and to investigate the role of identity satisfaction and self-efficacy in MS on adjustment. We hypothesized that the relationship between identity satisfaction and adjustment was mediated by self-efficacy (goal setting and symptom management). METHODS: The cross-sectional study involved 66 patients (63.6% women) with a mean age of 25.2 years (SD = 3.4) who had been diagnosed for no more than three years. Patients completed measures of identity satisfaction (Identity Motives Scale), Self-efficacy in MS (SEMS), Depression (CESD-10), Positive and Negative Affect (PANAS). Data were analyzed through factorial ANOVAs and hierarchical regression analysis. RESULTS: Thirty-eight percent of patients reported depressive symptoms and negative affect mean score was higher than in the general population. Higher identity satisfaction was directly related to lower depression. Self-efficacy in goal setting partially mediated the relationship between identity satisfaction and positive affect, whereas self-efficacy in symptom management totally mediated the effect of identity satisfaction on negative affect. All results were significant at p < 0.05. CONCLUSIONS: The results suggest the usefulness of addressing identity redefinition and self-efficacy in psychological interventions aimed at promoting young adults' adjustment to MS in an early phase of the illness.

Exploring change in a group-based psychological intervention for multiple sclerosis patients.

PURPOSE: The study is focused on a group-based cognitive behavioral intervention aimed at promoting the quality of life and psychological well-being of multiple sclerosis patients. The study investigates how the group intervention promoted change among participants and fostered their adjustment to the illness. MATERIALS AND METHODS: The intervention involved six groups of patients (a total of 41 patients) and included four consecutive sessions and a 6-month follow-up. To explore change, verbatim transcripts of the intervention sessions were analyzed using a mixed-methods content analysis with qualitative data combined with descriptive statistics. The categories of resistance and openness to change were used to describe the process of change. RESULTS: Resistance and openness to change coexisted during the intervention. Only in the first session did resistance prevail over openness to change; thereafter, openness to change gradually increased and stabilized over time, and openness to change was then always stronger than resistance. CONCLUSIONS: The study builds on previous research on the effectiveness of group-based psychological interventions for multiple sclerosis patients and gives methodological and clinical suggestions to health care professionals working with multiple sclerosis patients. Implications for rehabilitation The study suggests that a group-based cognitive behavioral intervention for multiple sclerosis patients focused on the promotion of identity redefinition, a sense of coherence and self-efficacy in dealing with multiple sclerosis fosters the process of change and may be effective in promoting patients' adjustment to their illness. Health care professionals leading group-based psychological interventions for multiple sclerosis patients should be aware that resistance and openness to change coexist in the process of change. The study suggests that the duration of the intervention is a crucial factor: a minimum of three sessions appears to be necessary for group participants to develop greater openness to change and follow-up sessions should be implemented to maintain positive changes among participants. The use of qualitative instruments to evaluate group interventions captures the complexity of processes and gives useful indications to health professionals to improve rehabilitation programs.

Coping strategies and adjustment to multiple sclerosis among recently diagnosed patients: the mediating role of sense of coherence.

OBJECTIVE: To examine the relationship between coping strategies (problem solving, emotional release, and avoidance) and adjustment (health-related quality of life, depression, and affective well-being) in a group of recently diagnosed multiple sclerosis patients (up to three years since diagnosis), and to explore the mediating role of sense of coherence between coping strategies and adjustment. DESIGN: Cross-sectional. SETTING: Multiple Sclerosis Clinic Centre. SUBJECTS: A total of 102 patients (61.8% women; age (years): M = 35.8, SD = 11.9; 95% with a relapsing-remitting form of multiple sclerosis; Expanded Disability Status Scale score, between 1 and 4). INTERVENTIONS: Not applicable. MAIN MEASURES: Coping with multiple sclerosis (problem solving, emotional release, and avoidance), sense of coherence, health-related quality of life (SF-12), depression (CES-D), and affective well-being (PANAS). RESULTS: Problem solving was linked to higher mental health ( ß = 0.28) and higher affective well-being ( ß = 0.36), emotional release was related to lower depression ( ß = -0.22); avoidance was associated to higher mental health ( ß = 0.25), higher affective well-being ( ß = 0.24), and lower depression ( ß = -0.29 ) (all betas were significant at p < 0.05). Sense of coherence mediated the relationship between emotional release and depression (Sobel z-value = -2.00; p < 0.05) and the relationship between avoidance and all the indicators of adjustment (mental health: Sobel z-value = 1.97; depression: Sobel z-value = -2.02; affective well-being: Sobel z-value= 2.05; p < 0.05). CONCLUSIONS: Emotional and avoidant coping strategies seem to be adaptive among recently diagnosed multiple sclerosis patients. A mediating role between coping strategies and adjustment is played by sense of coherence.

Improving the quality of life and psychological well-being of recently diagnosed multiple sclerosis patients: preliminary evaluation of a group-based cognitive behavioral intervention.

PURPOSE: The study evaluated a group-based cognitive behavioral intervention aimed at promoting the quality of life and the psychological well-being of recently diagnosed multiple sclerosis (MS) patients (up to 3 years since the diagnosis). METHOD: The study involved 85 patients [59% women; mean age 37, SD = 12.3; 94% with relapsing-remitting MS; Expanded Disability Status Scale (EDSS) between 1 and 4]. A quasi-experimental study design was applied; 54 patients (intervention group) participated in five group sessions, a 6-month post-intervention and a 1-year follow-up; 31 patients (comparison group) participated in activities routinely provided to recently diagnosed MS patients. Measures of Quality of Life (SF-12), Depression (CESD-10), Affective well-being (PANAS) and Optimism (LOT-R) were assessed. RESULTS: At the 6-month post-intervention, mental health increased in the intervention group and decreased in the comparison group, whereas negative affect decreased in the intervention group and increased in the comparison group. At the 1-year follow-up, mental health and optimism increased in the intervention group and decreased in the comparison group. CONCLUSIONS: Preliminary evidence suggests that the proposed intervention fosters the quality of life and the psychological well-being of recently diagnosed MS patients by reducing negative affect and promoting mental health and optimism, particularly in the long term. Implications for Rehabilitation Preliminary evidence suggests that a group-based cognitive behavioral intervention focused on identity redefinition, sense of coherence and self-efficacy promotes the quality of life (increased mental health) and psychological well-being (decreased negative affect and increased optimism) of recently diagnosed MS patients (up to 3 years since the diagnosis). The first years following the MS diagnosis should be considered a good time for a psychological intervention aimed at promoting the patient's adjustment to the illness. Strategies should be found to increase the participation of recently diagnosed MS patients in psychological interventions.

Adolescent risk behaviours and protective factors against peer influence.

This study examined the relationships between protective factors and involvement in risk behaviour of Italian adolescents with friends involved in risk. Protective factors were drawn from models of peers and from individual skills (perceived regulatory self-efficacy, intolerant attitudes about deviance) and orientation (to health, school, religion). The data are from two waves, 1 year apart, of a questionnaire survey of adolescents in northwestern Italy. Participants were 908 adolescents (42% boys) ages 14-16 years. Results of a hierarchical regression revealed that religiosity is a protective factor and that friends' models for conventional behaviours and positive attitude about health can mitigate the influence of deviant friends on adolescent risk behaviour 1 year later, even after controlling for prior levels of risk behaviour. Possible implications of this study suggest the importance of implementing preventive interventions by involving the peer group, especially at about 16 years, and working with heterogeneous (deviant and nondeviant) groups.

The effects of a group-based cognitive behavioral therapy on people with multiple sclerosis: a randomized controlled trial.

OBJECTIVE: To evaluate the effectiveness of a cognitive behavioral group-based intervention aimed at reducing depression and fostering quality of life and psychological well-being of multiple sclerosis patients through the promotion of identity redefinition, sense of coherence, and self-efficacy. DESIGN: A randomized controlled trial. SETTING: Non-medical setting, external to the Multiple Sclerosis Clinic Centre. SUBJECTS: Eighty-two patients: 64% women; mean age 40.5, SD = 9.4; 95% with relapsing-remitting multiple sclerosis; Expanded Disability Status Scale (EDSS) between 1 and 5.5 were included in the study. INTERVENTIONS: Patients were randomly assigned to an intervention group (five cognitive behavioral group-based sessions, n = 41) or to a control group (three informative sessions, n = 41). MAIN MEASURES: Depression (CES-D), Quality of life (MSQOL revised), Psychological well-being (PANAS), Identity Motives Scale, Sense of Coherence (SOC), and Self Efficacy in Multiple Sclerosis. RESULTS: Quality of life increased in the intervention group compared with the control at 6-months follow-up (mean change 0.72 vs. -1.76, p < 0.05). Well-being in the intervention group increased for males and slightly decreased for females at 6-months follow-up (mean change 6.58 vs. -0.82, p < 0.05). Contrasts revealed an increase in self-efficacy in the intervention group at posttreatment compared with the control (mean change 2.95 vs. -0.11, p < 0.05). Depression tended to lower, while identity and coherence increased in the intervention group compared with the control, though the differences were not significant. CONCLUSIONS: Preliminary evidence suggests that intervention promotes patients' quality of life and has an effect on psychological well-being and self-efficacy.