Factors associated with prolonged COVID-related PTSD-like symptoms among adults diagnosed with mild COVID-19 in Poland.

COVID-19 has been considered a possible cause of post-traumatic stress disorder (PTSD) or similar conditions. However, what specific disease symptoms may contribute most to prolonged PTSD-like symptoms in COVID-19 survivors is unclear. The study aimed to present the factor structure of COVID-19 symptoms and identify which symptoms of COVID-19 best explain the subsequent presence of PTSD-like symptoms in mild COVID-19 survivors. COVID-positive adults (n = 341) completed online self-report scales at the baseline assessment (T1) and after approximately 4 months (T2), including The Patient Health Questionnaire Anxiety-Depression Scale; The Scale of Psychosocial Experience Related to COVID-19, The Primary Care PTSD Screen for DSM-5; and self-designed questionnaires evaluating the severity of COVID-related medical and neurocognitive symptoms and pre-pandemic variables. Exploratory factor analysis revealed five factors of COVID-19 symptoms: flu-like, respiratory, cold, neurological, and neurocognitive. Hierarchical logistic regression showed that besides selected control variables (anxiety and depression, presence of PTSD-like symptoms, COVID-related stigma in T1), neurocognitive symptoms of COVID-19 in T1 but not other symptoms of the disease were a significant predictor of the presence of PTSD-like symptom in T2. Findings suggest a need for a comprehensive neurocognitive assessment of people diagnosed with COVID-19 and prompt interventions targeting the prevention of potential risks for long-term PTSD-like states at the community level.

Positive experiences in the parent-child relationship during the COVID-19 lockdown in Poland: The role of emotion regulation, empathy, parenting self-efficacy, and social support.

Despite the impact of the COVID-19 outbreak being largely negative on parents and children, for some families, lockdown could also bring about some positive effects, for example, increased emotional closeness, and more time for joint activity. The aim of the current study was to investigate cross-sectionally the most important correlates of the positive experiences in the parent-child relationship among Polish mothers and fathers during the lockdown in the initial phase of the COVID-19 outbreak. In May 2020, 228 mothers and 231 fathers completed the Brief version of the Empathic Sensitivity Questionnaire, Difficulties in Emotion Regulation Scale Short Form, Social Support Scale, Parenting Self-Agency Measure, and Scale of Positive Experiences in Parent-Child Relationship during the COVID-19 lockdown. Our results showed that parenting self-efficacy and social support were the strongest correlates of positive experiences in the parent-child relationship in both mothers and fathers during the lockdown. Perspective-taking was positively related to the positive experiences in mothers, whereas personal distress was positively associated with the positive experiences in the parent-child relationship in fathers. Our results point to factors of potential importance in designing preventive and therapeutic interventions for mothers and fathers to enhance positive experiences in the parent-child relationship during the pandemic.

Depressive and anxiety symptom trajectories in Polish adolescents during the COVID-19 pandemic and the outbreak of war in Ukraine: uncovering the role of family relations.

INTRODUCTION: The aim of the study was to investigate longitudinal trajectories of change in anxiety and depression symptoms in Polish adolescents during the second year of the COVID-19 pandemic and after the outbreak of the war in Ukraine. Additionally, we aimed to identify risk/protective factors and outcomes associated with these trajectories. METHOD: We collected data in three waves between November 2021 and May 2022. Adolescents (N = 281 in the first wave) completed the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Filial Responsibility Scale for Youth, and questions related to the COVID-19 pandemic and war in Ukraine. RESULTS: We identified three trajectories of depressive symptoms: resilient with low, stable symptoms (71% of participants), chronically elevated symptoms (11%), and acute symptoms followed by recovery (18%). We distinguished two trajectories of anxiety symptoms: resilient (75%) and chronic (25%). Non-resilient trajectories were predicted by higher levels of familial unfairness (perceived lack of equality and reciprocity in the family), relationship difficulties at school and at home, older age, and poor socioeconomic status. Chronic depressive and anxiety symptoms were associated with higher war-related concerns. DISCUSSION: These findings can inform preventive and therapeutic interventions for at-risk adolescents to reduce negative long-term outcomes of social crises.

Misophonia in Children and Adolescents: Age Differences, Risk Factors, Psychiatric and Psychological Correlates. A Pilot Study with Mothers' Involvement.

Misophonia is a type of disorder characterized by decreased sound tolerance. While it typically begins in childhood, research on its characteristics in this population is limited. We assessed 90 children aged 7-18 with and without misophonia, along with their mothers, using interviews, questionnaires, and performance-based tests. Younger children with misophonia were more likely to use aggression in response to triggers than older, while adolescents largely reported self-harm during triggers. Children with misophonia did not differ from their peers in terms of ADHD, ODD, ASD, dyslexia, social and emotional competencies, head injuries, epilepsy, tinnitus, being prematurely born, or delivered via cesarean sections. However, they had significantly higher symptoms of anxiety and depression, more frequent occurrences of OCD, migraines, and psychosomatic complaints. Their mothers self-reported postpartum depression significantly more frequently than mothers in the control group. There is a need for further research on pediatric misophonia, with the involvement and assessment of parents.

Collective action mitigates the negative effects of COVID-19 threat and anti-abortion restrictions on mental health.

BACKGROUND: The COVID-19 pandemic changed our lives in many different domains, forcing people to adapt to countrywide lockdowns, school shutdowns, and business closures. The burden of the COVID-19 pandemic resulted also in deterioration of mental health. At the same time, political conflicts and social inequalities was reinforced and many people engaged in demonstrations to fight for their rights. This study examines whether collective acting for an important cause during the pandemic might mitigate the impact of both political tension related to anti-abortion restrictions and COVID-19 threats on mental health. METHODS: We conducted a two-wave study with a representative sample of the Polish population, investigating the effect of participating in Polish pro-choice demonstrations on depressive and anxiety symptoms. RESULTS: Participating in protests attenuated the negative effects of COVID-19 threat and anti-abortion restrictions on mental health. Moreover, we found that the feeling of solidarity with other demonstrators and sense of agency derived from such demonstrations led to lower levels of depressive and anxiety symptoms. CONCLUSION: The results of the study indicate that participating in meaningful and value-oriented collective action may serve as a buffer against the detrimental effects of social and health threats.

Predictors of pretraumatic stress during the COVID-19 pandemic in Poland.

BACKGROUND: Pretraumatic stress has the same symptoms as post-traumatic stress but instead pertains to anticipated threats. There is evidence that pretraumatic stress occurs among soldiers and pregnant people. OBJECTIVE: We analyzed correlates of pretraumatic stress concerning the threat of COVID-19 infection. METHOD: Our pilot study was cross-sectional (N = 74); our main study was longitudinal and consisted of three waves (N = 1067, N = 894, and N = 752 for Waves 1, 2, and 3, respectively). Our pilot study used correlation and multiple linear regression. Our main study used quadratic regression and a random intercept cross-lagged panel model. RESULTS: The pilot study found that pretraumatic stress was positively correlated with agreeableness (r = .24, p < .01) and negatively correlated with emotional stability (r = -.30, p < .01) and intellect/imagination (r = -.37, p < .01). The main study demonstrated that pretraumatic stress was positively correlated with other measures of mental health problems during the COVID-19 pandemic and with perceived positive aspects of the pandemic (r = .11, p < .01). There is evidence of a U-shaped relationship between pretraumatic stress and perceived positive aspects of the pandemic. A random intercept cross-lagged panel model analysis demonstrated that pretraumatic stress in Wave 2 was negatively predicted by levels of prosocial behavior in Wave 1 (B = -1.130, p < .01). CONCLUSION: Mental health professionals should take into account pretraumatic stress, not only as a possible consequence of the COVID-19 pandemic outbreak but more generally as a risk in situations that are new, difficult, and challenging for people.

Depressive symptoms and psychological pain experienced by Polish adults in the context of both the war in Ukraine and the COVID-19 pandemic.

Background: This study sought to investigate the perceived influence of stressful events (i.e., the outbreak of the war in Ukraine, the political situation, and the COVID-19 pandemic) on the depressive symptoms and psychological pain experienced by Polish adults. The study also aimed to explore the association between experiential avoidance and emotional distress. Method: 110 Polish social media users aged 18-89 completed online the Patient Health Questionnaire-9, Psychache Scale and the Multidimensional Experiential Avoidance Questionnaire-30 and questions concerning perceived influence of stressful event on their emotional functioning. Results: More than half of the participants (52.7%) reported experiencing a subjective increase in their depressive symptoms since the outbreak of the war in Ukraine. Interestingly, a larger percentage of participants associated their emotional distress with the outbreak of the war (44.6%) and the overall political situation (39.2%) than with the COVID-19 pandemic (27.2%). In addition, experiential avoidance was found to be associated with subjective increases in the participants' depressive symptoms and emotional distress. Limitations: Cross-sectional character of the study, small sample size, and exclusive use of online data are main limitation of the study. Conclusions: Findings of our study can help planning preventive and therapeutic interventions for at-risk individuals to reduce negative long-term outcomes of the recent stressful life events in Poland.

Cognitive and Affective Empathy as Indirect Paths Between Heterogeneous Depression Symptoms on Default Mode and Salience Network Connectivity in Adolescents.

Depression amongst adolescents is a prevalent disorder consisting of heterogeneous emotional and functional symptoms-often involving impairments in social domains such as empathy. Cognitive and affective components of empathy as well as their associated neural networks (default mode network for cognitive empathy and salience network for affective empathy) are affected by depression. Depression commonly onsets during adolescence, a critical period for brain development underlying empathy. However, the available research in this area conceptualizes depression as a homogenous construct, and thereby miss to represent the full spectrum of symptoms. The present study aims to extend previous literature by testing whether cognitive and affective empathy indirectly account for associations between brain network connectivity and heterogeneous depression symptoms in adolescents. Heterogeneous functional and emotional symptoms of depression were measured using the child depression inventory. Our results indicate that cognitive empathy mediates the association between default mode network functional connectivity and emotional symptoms of depression. More specifically, that adolescents with a stronger positive association between the default mode network and cognitive empathy show lower emotional depression symptoms. This finding highlights the importance of cognitive empathy in the relationship between brain function and depression symptoms, which may be an important consideration for existing models of depression in adolescents.

Associations between symptoms of borderline personality disorder and suicidality in inpatient adolescents: The significance of identity disturbance.

Several studies report that borderline personality disorder (BPD) is a risk factor for suicidality in adults. However, this issue requires further research in adolescents, as it is not clear which individual BPD symptoms are significant correlates of suicidality in this age group. The main aim of the current study was to test which symptoms of BPD are associated with suicidality in adolescent inpatients, even when controlling for age, gender, and depressive symptoms. Inpatient adolescents (N = 339) aged 12-17 years completed the Childhood Interview for DSM-IV Borderline Personality Disorder, the Beck Depression Inventory-II, the Modified Scale for Suicidal Ideation, and reported their number of lifetime suicide attempts. Multivariable regression analyses showed that, after controlling for confounding variables, overall BPD symptom severity was positively related to suicidal ideation and suicide attempts. Of the individual BPD symptoms, identity disturbance, chronic emptiness, avoid abandonment, and transient paranoia were the most robust correlates of suicidal ideation intensity, and only identity disturbance was associated with the number of lifetime suicide attempts. To assess the risk of suicidality in youth, it is essential to assess for BPD symptoms; it is important to focus on adolescents' subjective feelings to assess the severity of identity disturbance and chronic emptiness.

Investigation of the Factor Structure of the Reflective Functioning Questionnaire (RFQ-8): One or Two Dimensions?

There is a need to have reliable and accessible screening measures of mentalizing ability to investigate the role of this capacity in social functioning and its development, emergence of psychopathological conditions, as well as to understand its role in psychotherapeutic processes. The 8-itemed Reflective Functioning Questionnaire (RFQ-8) has been developed for this purpose, however its factor structure and psychometric properties are unclear. The aim of the current study was to further investigate the factor structure of the RFQ-8 and explore its psychometric properties in a Polish sample. 538 participants aged 17-50 (M = 21.44, SD = 2.92) took part in the study. They were asked to complete the RFQ-8, Difficulties in Emotion Regulation Scale (DERS), General Health Questionnaire (GHQ-28), the Relationship Structures (ECR-RS) questionnaire and the Borderline Personality Inventory (BPI). Results of both exploratory and confirmatory analysis indicated that the RFQ-8 may be regarded as a scale measuring a unidimensional construct. Our results confirmed good construct validity for the unidimensional RFQ-8, suggesting that the one-dimensional RFQ specifically assesses uncertainty concerning mental states. Our findings highlight the need for further studies investigating the factor structure and psychometric properties of the RFQ-8.

Barriers and facilitators of willingness to vaccinate against COVID-19: Role of prosociality, authoritarianism and conspiracy mentality. A four-wave longitudinal study.

AIM: We investigated longitudinal relations between individual willingness to undergo vaccination against COVID-19 and three social factors: conspiracy mentality, prosociality, and authoritarianism. METHOD: This longitudinal study comprised four measurement points. The first wave sample included 1130 responses and was representative of the Polish population in terms of gender, age, and place of residence. Analyses were performed using random intercept cross-lagged panel models. RESULTS: We observed bidirectional positive cross-lagged relationships between prosociality and willingness to undergo vaccination in the first three waves of measurement. Authoritarianism and conspiracy mentality translated into a lower willingness to vaccinate between the third and fourth points of measurement when the vaccination became a near-term possibility. CONCLUSIONS: Eliciting prosocial motivation to vaccinate can be paramount in overcoming vaccine hesitancy. Because conspiracy thinking may be a crucial barrier to willingness to be vaccinated, it is critical to focus on planning interventions and campaigns undermining conspiracy theories about COVID-19.

Relations between multidimensional attitude toward death and psychological distress in firefighters.

To investigate firefighters' multidimensional attitude toward death and psychological distress, 60 firefighters completed the Death Attitude Profile-Revised and the General Health Questionnaire-28. As predicted, fear of death and escape acceptance were positively related to severe depression and anxiety/insomnia. However, contrary to predictions, neutral acceptance and death avoidance were not associated with psychological distress. Our results indicate that it would be advisable to examine the effectiveness of preventive and therapeutic interventions for firefighters aimed at reducing the fear of death and escape acceptance.

Factors associated with burnout in Polish healthcare workers during the COVID-19 pandemic.

Introduction: The COVID-19 pandemic has placed the healthcare system under substantial strain that has caused elevated psychological distress among healthcare workers (HCWs). Previous studies have found a high prevalence of burnout among HCWs exacerbated by the COVID-19 pandemic and have delineated some associated factors, but further research is needed. Little is known, for example, whether the economic status of HCWs or experiencing negative and positive emotions contribute to burnout. The present study was meant to fill this gap. Methods: A total of 412 HCWs (i.e.: nurses - 47%, physicians-28%, psychologists-14%, and other healthcare professionals-11%), aged 21-69 years (M = 36.63; SD = 11.76) participated in a web-based cross-sectional study. Data was collected from June to November 2020. The participants filled out measures assessing two dimensions of burnout (Exhaustion and Disengagement), depression, generalized anxiety, positive and negative emotions, along with the survey evaluating organizational aspects of their work during the pandemic. Results: Burnout thresholds were met by 54 and 66% of respondents for Disengagement and Exhaustion, respectively, which is high but comparable to levels found in other countries during the pandemic. Similarly to previous work, depression and anxiety were high in HCWs, with 24 % of them being in the risk group for clinical severity of depression and 34% in the risk group for a clinical generalized anxiety disorder (GAD). Regression analysis showed that the intensity of negative emotions was the strongest predictor of Exhaustion, whereas the intensity of positive emotions was the strongest predictor of Disengagement. Depression and GAD symptoms were positively related to Exhaustion, and economic status was inversely related to Disengagement. Discussion: These results suggest that distress in HCWs during the pandemic was related to symptoms of burnout, whereas higher income and experiencing positive emotions were associated with reduced burnout levels. Our findings call for the development of burnout intervention programs that could build capacities for dealing with depression and other negative emotions and at the same time teach skills on how to increase positive emotions in HCWs.

Risk of Developing Post-traumatic Stress Disorder in Severe COVID-19 Survivors, Their Families and Frontline Healthcare Workers: What Should Mental Health Specialists Prepare For?

Given the high mortality of the coronavirus disease 2019 (COVID-19), having severe COVID-19 may be a life-threatening event, especially for individuals at high risk of complications. Therefore, in the article we try to answer two questions that are relevant to public mental health: Can we define groups who are at higher risk of developing pandemic-related PTSD? How can health specialists prepare for it? Given the results of previous research on PTSD in epidemic (e.g., SARS) survivors, we suggest that mental health professionals in countries touched by the pandemic should prepare for an increase in the PTSD prevalence, specifically in: individuals who have had severe COVID-19; family members of these patients and of patients who have died; and frontline healthcare workers witnessing COVID-19 patients' sudden deaths, or numerous life-threatening situations. We postulate that these groups at risk should be routinely screened for PTSD in primary medical and pediatric care. Mental health services should prepare for providing therapeutic interventions for individuals with PTSD in the vulnerable groups, and support to their families, especially children.

Dynamic relationships between different types of conspiracy theories about COVID-19 and protective behaviour: A four-wave panel study in Poland.

RATIONALE: Conspiracy theories about COVID-19 pose a serious threat to public health by providing false information and undermining official health recommendations. However, existing studies rarely employed longitudinal designs, precluding the determination of the directionality between endorsement of conspiracy theories and its societal consequences. Also, relatively little research examined whether the association between protective health behaviour and the endorsement of conspiracy theories is affected by the content of a given theory. METHODS: A four-wave longitudinal panel survey on the association between belief in a wide range of conspiracy theories about COVID-19 and protective behaviour was carried out on a representative sample of Polish citizens (T1 = 1130, T2 = 971, T3 = 818, T4 = 688). Analyses were performed using Random Intercept Cross-Lagged Panel Models. RESULTS: The results showed a reciprocal, bidirectional association between conspiracy mentality and protective behaviour. The same effect was also observed between protective behaviour and threat of authoritarianism. We did not find evidence that specific COVID-19 related conspiracy theories directly (and differently) predict within-person changes in protective behaviour over time. CONCLUSIONS: Our results showed that the association between various conspiracy-related variables and anti-pandemic COVID-19 variables differs at within- and between-person levels. Changes in the adherence to pro-health measures were negatively predicted by conspiracy mentality and a feeling of threat that the solutions introduced by the government may limit civil rights. Specific conspiracy beliefs were significantly related to protective behaviour only at the between-person level.

The Relations Between Identity Disturbances, Borderline Features, Internalizing Disorders, and Suicidality in Inpatient Adolescents.

Previous studies have demonstrated positive associations between identity disturbances and suicidality in adolescents; however, mechanisms underlying these relationships are not well understood. The authors propose that borderline features and various internalizing disorders may mediate these relations. The aim of this study was to test a multiple mediation model of the associations between these constructs using structural equation modeling. Ninety-six inpatient adolescents aged 12-17 years completed the Assessment of Identity Development in Adolescents, the Childhood Interview for DSM-IV Borderline Personality Disorder, the Youth Self-Report, and the Columbia-Suicide Severity Rating Scale. Findings partly confirmed the theoretical model. Borderline features mediated the positive effect of identity disturbances on suicidal ideation severity. Mediations of withdrawn/depression and anxiety/depression on the effect of identity disruption on suicidal ideation intensity were demonstrated. Identity disruptions and borderline and depressive symptoms could be possible targets for interventions for youth experiencing suicidal ideation.

Generalized anxiety and depressive symptoms in various age groups during the COVID-19 lockdown in Poland. Specific predictors and differences in symptoms severity.

BACKGROUND: Previous studies carried out in different countries have indicated that young adults experienced higher levels of emotional distress, in the form of depressive and anxiety symptoms, than older age groups during the COVID-19 pandemic. However, little is known about which pandemic-related difficulties and factors may contribute to these forms of emotional distress in various age groups. PURPOSE: The aim of the current study was to investigate: (i) differences in levels of depressive and generalized anxiety symptoms in four age groups in the Polish population during the COVID-19 lockdown; (ii) differences in perceived difficulties related to the pandemic in these groups; and (iii) which factors and difficulties related to the pandemic are the best predictors of generalized anxiety and depressive symptoms in various age groups during the COVID-19 lockdown. METHOD: A total of 1115 participants (aged 18-85) took part in the study. The sample was representative of the Polish population in terms of sex, age, and place of residence. Participants completed the following online: the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, a Scale of Perceived Health and Life Risk of COVID-19, a Social Support Scale, and a Scale of Pandemic-Related Difficulties. RESULTS: Younger age groups (18-29 and 30-44) experienced higher levels of depressive and generalized anxiety symptoms than older adults (45-59 and 60-85 years). Household relationship difficulties were among the most significant predictors of depressive and generalized anxiety symptoms in all age groups. Fear and uncertainty related to the spread of the virus was one of the most important predictors of emotional distress in all the groups apart from the adults between 18 and 29 years, whereas difficulties related to external restrictions were one of the most significant predictors of depressive and anxiety symptoms exclusively in the youngest group. CONCLUSIONS: The youngest adults and those experiencing difficulties in relationships among household members are the most vulnerable to depressive and generalized anxiety symptoms during the COVID-19 lockdown. It is important to plan preventive and therapeutic interventions to support these at-risk individuals in dealing with the various challenges related to the COVID-19 pandemic.

Neuropsychological disorders after COVID-19. Urgent need for research and clinical practice.

Purpose: Numerous studies suggest that infection with coronavirus SARS-CoV-2, which causes acute respiratory distress syndrome and COVID-19 illness, can lead to changes in the central nervous system (CNS). Consequently, some individuals with SARS-CoV-2 infection may also present the symptoms of neuropsychological disorders. The goals of this literature review is the synthesis of various perspectives and up-to-date scientific knowledge as well as the formulation of initial recommendations for clinical practice. Views: According to current state of knowledge, numerous SARS-CoV-2 infection-specific and nonspecific risk factors exist for brain damage, which might lead to neuropsychological impairments in individuals who have recovered from COVID-19. The emerging evidence suggests significant behavioral and cognitive deficits in COVID-19 survivors, which are present in the early phase after recovery and persist for several months. Neuropsychological disturbances can potentially include a wide spectrum of disorders, yet deficits of attention, memory, executive functions, language and visuospatial orientation are among most commonly identified. The relationship between cognitive impairment, emotional disturbances and severity of COVID-19 symptoms needs to be submitted to further research. Conclusions: The scientific knowledge resulting from neuropsychological empirical studies during the COVID-19 pandemic allows for a postulate of an urgent evidence-based systematic neuropsychological research to be conducted among COVID-19 survivors. More than anything, the recovered individuals must be provided with adequate neuropsychological help in the form of neuropsychological diagnosis, monitoring and rehabilitation.

The relations between childhood maltreatment, shame, guilt, depression and suicidal ideation in inpatient adolescents.

BACKGROUND: Previous studies demonstrated positive relations between various forms of maltreatment and suicidal ideation in youth; however, mechanisms underlying these relationships are not well understood. We propose that the experience of maltreatment in childhood may lead to high levels of generalized guilt and shame, resulting in an increase of depressive symptoms and suicidal thoughts in adolescents. The aim of the current study was to test our model of relations between these constructs using path analysis. METHODS: 112 inpatient adolescents aged 12-17 years completed the Childhood Trauma Questionnaire to measure various types of maltreatment, the Personal Feelings Questionnaire to evaluate generalized guilt and shame, the Beck Depression Inventory-II to assess depressive symptoms, and the Columbia-Suicide Severity Rating Scale to assess suicidal ideation. RESULTS: Findings partly confirmed the theoretical model. Indirect positive effects of sexual and emotional abuse, as well as emotional and physical neglect on suicidal ideation via generalized self-conscious emotion and/or depression were demonstrated. In contrast to our predictions, indirect negative effects of physical abuse on suicidal thoughts via generalized guilt and shame and depression were found. LIMITATIONS: Sample characterized by predominately Caucasian inpatient adolescents from financially stable and well-educated environments, over-reliance on self-report measures and the lack of a longitudinal design were main limitations of the study. CONCLUSIONS: The study provides novel information on the potential mechanisms underlying the association between childhood maltreatment and suicidal ideation in adolescents. Generalized guilt and/or shame could be possible targets for interventions for victims of some forms of maltreatment to reduce depressive symptoms and suicidal ideation.