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.

Did Cognitive Attentional Syndrome Symptoms Predict Stress- and Trauma-Related Symptoms in the Initial Phase of the COVID-19 Pandemic? Results from a Two-Wave Study on a Sample of Polish Internet Users.

BACKGROUND: According to metacognitive theory, Cognitive Attentional Syndrome (CAS) is a transdiagnostic factor and a main mechanism of psychopathology maintenance. The main goal of this study is to examine whether CAS predicted stress- and trauma-related symptomatology in the first months of the COVID-19 pandemic and three months later. METHODS: Initially, 1792 participants were recruited online via social media; the data were collected at two time points. The measures included the Cognitive Attentional Syndrome Questionnaire, the Adjustment Disorder-New Module 20, the International Trauma Questionnaire, and additional measures. RESULTS: Structural equation modeling was conducted in order to determine the relations between the reported stressors, CAS, and symptomatology. At both time points, CAS was a significant mediator between the stressors and symptoms of adjustment disorder. Despite the decrease in the intensity of adjustment disorder symptoms between waves, it was a significant predictor of other psychopathologies at both time points, except for traumatic stress. CONCLUSIONS: The findings confirm the assumption that CAS is a transdiagnostic factor of psychopathology and has a mediating role in the relationship between stressors and adjustment disorder and co-occurring symptomatology. The effect was particularly significant in the initial phase of the pandemic, which was highly stressful for many people.

Psychometric properties of the Patient Health Questionnaire-4 (PHQ-4) in 9230 adults across seven European countries: Findings from the ESTSS ADJUST study.

BACKGROUND: The four-item Patient Health Questionnaire-4 (PHQ-4) is a widely used screening measure for depression and anxiety. OBJECTIVES: This study aimed to test factor structure and measurement invariance in an adult sample of the general population across seven European countries. METHOD: A total sample of 9230 adults, 71.3 % female, Mage = 44.35 (SD = 14.11) from seven countries (Austria, Croatia, Georgia, Germany, Lithuania, Portugal, and Sweden) participated in the study. We applied confirmatory factor analysis (CFA) to examine the factor structure and measurement invariance testing to evaluate measurement equivalence across countries, gender, and age groups. RESULTS: The CFA yielded that a two-factor PHQ-4 model with separate depression and anxiety factors had the best fit. Partial scalar measurement invariance was established across different groups based on gender, age, and country. CONCLUSIONS: The PHQ-4 is a valid and reliable measure that can be applied to screen for depression and anxiety in the general population. LIMITATIONS: The limitation of the study includes the sampling, which resulted in the sample structure with the majority of females, predominantly of high education and from urban communities.

Factors Associated With Suicide Ideation in Lithuania and Poland Amid the COVID-19 Pandemic.

Background: The COVID-19 pandemic had an impact on many risk and protective factors associated with suicide. Aims: The aim of this study was to identify pandemic-related factors associated with suicidal ideation in the two European countries, Lithuania and Poland, amid the COVID-19 pandemic. Method: The sample comprised 2,459 participants in both countries; 57.2% of the respondents were female. The Mage of the participants was 43.45 years (SD = 15.91). Pandemic-related stressors and adjustment problems were measured to assess associations with suicidal ideation. Results: High levels of adjustment problems, loneliness, and burden due to staying at home more during the COVID-19 pandemic were significantly associated with suicide ideation in both Lithuania and Poland. Limitations: This was a cross-sectional online study with different recruitment approaches in the two countries. Conclusion: Adjustment problems, loneliness, and stressors related to staying at home more could be important targets for suicide prevention amid the pandemic.

Polish Validation of the Internet Gaming Disorder-20 (IGD-20) Test. / Badanie walidacyjne polskiej wersji kwestionariusza Zaburzenie Grania w Internecie-20 (Internet Gaming Disorder-20, IGD-20).

OBJECTIVES: The purpose of the present study was to validate the Polish version of the Internet Gaming Disorder-20 (IGD-20) Test that is consistent with DSM-5 diagnostic criteria. METHODS: A total of 652 game players took part in the validation study. Confirmatory factor analysis was used to check the scale structure. Questionnaires measuring symptoms of psychopathology and desire thinking were used to estimate construct validity of the IGD-20. The analysis also considered the game genres most frequently chosen by players. RESULTS: Confirmatory factor analysis confirmed a5-factor structure of the Polish version of IGD-20 questionnaire, which is consistent with previous findings in other language versions. Fit indices were evaluated collectively, indicating that the model has agood fit: χ2(142)=690.059; p <0.001; RMSEA=0.077 (90% CI: 0.071-0.083); CFI =0.950; TLI=0.940; SMRR =0.053. Internal consistency is high (McDonald's ω =0.93). Analysis also showed significant correlations between problem gaming, symptoms of psychopathology, and desire thinking. Participants reported that they spent the least amount of time playing educational games, compared to other game genres; the frequency of educational games selection negatively correlated with the intensity of problematic gaming symptoms. CONCLUSIONS: The validation study of the Polish version of the IGD-20 questionnaire has confirmed the good psychometric properties of the tool and its internal structure. Further research should focus on examination of gender differences and psychometric properties in the clinical sample of players.

Adjustment disorder, traumatic stress, depression and anxiety in Poland during an early phase of the COVID-19 pandemic.

Background: The current COVID-19 pandemic is associated with a variety of stressors. Preliminary research has demonstrated that general public are experiencing a range of psychological problems, including stress-related disturbances. However, to date, there is not much research on the prevalence of adjustment disorder during the current pandemic. Objectives: This study aimed to assess the prevalence and severity of symptoms of adjustment disorder compared to posttraumatic symptoms, depression and generalized anxiety in a large sample of adult Poles, in the first phase of the current pandemic. Method: Self-report data from a web-based sample (N = 1,742) was collected between March 25 and April 27, just after the introduction of nationwide quarantine measures in Poland. Results: The current COVID-19 pandemic was a highly stressful event for 75% of participants and the strongest predictor of adjustment disorder. Increased symptoms of adjustment disorder were reported by 49%, and they were associated with female gender and not having a full-time job. However, after exclusion of co-occurring symptomatology, 14% of the sample were finally qualified as meeting diagnostic criteria of adjustment disorder. A substantial proportion of the sample screened also positive for generalized anxiety (44%) and depression (26%); the rate for presumptive PTSD diagnosis was 2.4%. Conclusions: High rates of negative mental health outcomes were found in the Polish population in the first weeks into the COVID-19 pandemic and lockdown measures. They indicate the intense current stress-related symptoms in the early phase of the pandemic and warrant further monitoring on population's mental health.

Antecedentes: La actual pandemia de COVID-19 está asociada con una variedad de estresores. Investigaciones preliminares han demostrado que la población general está experimentando una variedad de problemas psicológicos, incluyendo trastornos relacionados con el estrés. Sin embargo, hasta la fecha no hay mucha investigación acerca de la prevalencia de trastornos de adaptación durante la actual pandemia.Objetivos: Este estudio tuvo como objetivo evaluar la prevalencia y severidad de los síntomas del trastorno adaptativo comparado con los síntomas postraumáticos, depresión y ansiedad generalizada en una gran muestra de adultos polacos, en la primera fase de la actual pandemia.Método: Se recolectó información auto-reportada de una muestra basada en la web (N=1.742) entre el 25 de marzo y el 27 de Abril, justo después de la introducción de medidas de cuarentena a nivel nacional en Polonia.Resultados: La pandemia actual de COVID-19 fue un evento altamente estresante para el 75% de los participantes y el predictor más poderoso de trastorno de adaptación. 49% informó un aumento de síntomas de trastorno de adaptación, y se asociaron con género femenino y no tener trabajo de tiempo completo. Sin embargo, después de la exclusión de la sintomatología concurrente, 14% de la muestra cumplía los criterios para diagnóstico de trastorno de adaptación. Una proporción importante de la muestra tambien resultó positiva para ansiedad generalizada (44%) y depresión (26%): la tasa de diagnóstico presuntivo de TEPT fue de 2,4%.Conclusiones: Se encontraron altas tasas de consecuencias negativas de salud mental en la población Polaca en las primeras semanas de pandemia y medidas de confinamiento por COVID-19. Indican los intensos síntomas actuales relacionados con el estrés en la fase inicial de la pandemia y justifican un mayor seguimiento de la salud mental de la población.

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.

Prevalence of adjustment disorder in Poland during the COVID-19 pandemic and its association with symptoms of anxiety and depression.

Purpose: Due to the current COVID-19 pandemic, many new stressors have arisen, which is associated with an increased risk of mental disorders. The purpose of this article is to assess the prevalence of adjustment disorder and symptoms of anxiety and depression in the Polish population, on the basis of two studies conducted during the pandemic. Methods: Two online survey studies were conducted at different time points: the first in March 2020 on a N = 1742 sample, the second in June 2020, on the sample of N = 567. In both cases, the same self-description questionnaires were used to measure adjustment disorder, depression and generalized anxiety. Results: In Study I, 75% of participants considered the COVID-19 pandemic to be highly stressful and 43% declared they met the criteria for adjustment disorder. When anxiety and depression were excluded 8.4% of participants met the criteria. On the other hand, in Study II, the criteria for this disorder (without the exclusion of other disorders) were met by 52%. In both studies, significant positive correlations were observed between the symptoms of adjustment disorder and those of anxiety and depression. Conclusions: The research provides important data on the mental health of Poles during the pandemic. The proportion of people who have potentially met the criteria for adjustment disorder, as well as for depression and anxiety, seems very high. It is advisable to continue monitoring the occurrence of these disorders, depending on developments in the changing context of the pandemic.

Psychometric properties of the Polish version of the desire thinking questionnaire in a sample of Internet game players.

The Desire Thinking Questionnaire (DTQ) is the main instrument used to measure desire thinking, which is the voluntary cognitive elaboration of a desired target on a verbal or imaginal level. Research has shown that this pattern of thinking occurs in different addictive behaviors. This study aimed to adapt the DTQ for use in research on gaming behavior (DTQ-G) and to validate the Polish version of the DTQ-G in a sample of Internet game players. A sample of 635 gamers were examined via the internet. The psychometric analyses of the DTQ-G yielded good results. The questionnaire proved to be a reliable tool for measuring desire thinking related to gaming. Confirmatory factor analysis provided support for the two-factor solution, with both factors (imaginal prefiguration and verbal perseveration) achieving good internal consistency. The Polish version of the DTQ-G has good psychometric properties and can be considered comparable to the original version.

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.

Adverse childhood experiences, dissociation, and anxious attachment style as risk factors of gaming disorder.

INTRODUCTION: The aim of this study was to explore the relationship between adverse childhood experiences (ACEs), attachment styles, dissociation, and symptoms of gaming disorder (GD). Methods: The total sample of the survey was 1288 gamers who completed a set of questionnaires via the Internet; they included questions on ACEs, attachment styles (anxious and avoidance styles in intimate relationships), symptoms of dissociation, and GD. Structural equation modeling (SEM) was performed to examine the detailed relationships between variables. RESULTS: In the hypothesized model, ACEs, dissociation, and the scales of avoidance and anxiety were considered predictors of gaming disorder. Only the avoidance subscale proved to be statistically insignificant; the model without this variable fit the data and had good psychometric properties. CONCLUSIONS: To conclude, this study showed a link between adverse childhood experiences, dissociation, and anxiety experienced in relationships as significant risk factors for symptoms of gaming disorder.