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.

Mindfulness meditation and psychedelics: potential synergies and commonalities.

There has been increasing scientific and clinical interest in studying psychedelic and meditation-based interventions in recent years, both in the context of improving mental health and as tools for understanding the mind. Several authors suggest neurophysiological and phenomenological parallels and overlaps between psychedelic and meditative states and suggest synergistic effects of both methods. Both psychedelic-assisted therapy and meditation training in the form of mindfulness-based interventions have been experimentally validated with moderate to large effects as alternative treatments for a variety of mental health problems, including depression, addictions, and anxiety disorders. Both demonstrated significant post-acute and long-term decreases in clinical symptoms and enhancements in well-being in healthy participants, in addition. Postulated shared salutogenic mechanisms, include, among others the ability to alter self-consciousness, present-moment awareness and antidepressant action via corresponding neuromodulatory effects. These shared mechanisms between mindfulness training and psychedelic intervention have led to scientists theorizing, and recently demonstrating, positive synergistic effects when both are used in combination. Research findings suggest that these two approaches can complement each other, enhancing the positive effects of both interventions. However, more theoretical accounts and methodologically sound research are needed before they can be extended into clinical practice. The current review aims to discuss the theoretical rationale of combining psychedelics with mindfulness training, including the predictive coding framework as well as research findings regarding synergies and commonalities between mindfulness training and psychedelic intervention. In addition, suggestions how to combine the two modalities are provided.

Long-lasting effects of World War II trauma on PTSD symptoms and embodiment levels in a national sample of Poles.

The main aim of this study was to investigate the long-lasting influences of World War II (WWII) trauma in a national sample of Poles, based on Danieli's (1998) survivors' post-trauma adaptational styles (fighter, numb, victim) and their link with current post-traumatic stress disorder (PTSD) symptoms and embodiment level among participants. We also sought to investigate whether the level of knowledge about WWII trauma among ancestors could moderate that association. The study was conducted among a representative sample of 1598 adult Poles obtained from an external company. Participants filled out the Danieli Inventory of Multigenerational Legacies of Trauma, the knowledge about traumatic World War II experiences in the family questionnaire, the Posttraumatic Diagnostic Scale-5, and the Experience of Embodiment Scale. We observed a positive relationship between all survivors' post-trauma adaptational styles and current levels of PTSD symptoms among participants. In addition, PTSD level mediated the relationships between those adaptational styles and embodiment intensity; that mediation was additionally moderated by a lack of knowledge about WWII trauma among ancestors in our participants. Our study adds to the literature on intergenerational trauma by highlighting the importance of evaluating embodiment in understanding the mechanisms of trauma transmission. Furthermore, it highlights the moderating effect of knowledge of family history in this mechanism and the need to share family histories with subsequent generations.

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.

Exposure to self-reported traumatic events and probable PTSD in a national sample of Poles: Why does Poland's PTSD prevalence differ from other national estimates?

BACKGROUND: There is a lack of studies on trauma exposure and PTSD prevalence in Poland on representative samples. Available data from studies on convenient samples show very high rates of probable PTSD compared with relevant estimates in other countries. OBJECTIVE: This study aimed to measure the exposure to self-report traumatic events (PTEs) and to estimate the current rate of prevalence of probable posttraumatic stress disorder (PTSD) in accordance with DSM-5 criteria in a population-based sample of Poles. Additionally, the link between PTSD intensity and level of life satisfaction was investigated. METHOD: A representative sample of 1,598 adult Poles was recruited. Probable PTSD was assessed with the Posttraumatic Diagnostic Scale for DSM-5 (PDS-5) and the Satisfaction with Life Scale (SWLS) was also used. RESULTS: The findings showed that 60.3% of Poles had experienced at least one PTE and 31.1% of those who had been exposed to trauma reported symptoms of PTSD. At the level of the entire sample, the obtained rate for probable PTSD was 18.8%. The traumatic events with the highest probabilities of PTSD symptoms were child abuse and sexual assault. Levels of life satisfaction were significantly lower in the group of participants with probable PTSD. CONCLUSIONS: We found that the current prevalence of probable PTSD in Poland is intriguingly high relative to rates reported in comparable representative samples from other countries across the world. Possible mechanisms are discussed, including a lack of social acknowledgement of WWII and other traumas as well as poor access to trauma-focused care. We hope that this research may inspire more studies investigating cross-national differences in PTSD and trauma exposure.

Coping styles with stress and its relations to psychiatric and clinical symptoms in patients with sarcoidosis: A latent profile analysis.

OBJECTIVE: Although stress and styles of coping with it can have a major impact on one's health and can determine the course and management of chronic diseases, no previous studies have evaluated coping strategies and their relation to emotional distress and clinical symptoms in sarcoidosis. METHODS: In two consecutive studies, we investigated differences in coping styles of sarcoidosis patients in comparison to healthy control subjects and the association of identified profiles to an objective measurement of disease (Forced Vital Capacity) and symptoms such as dyspnoea, pain, anxiety and depressive symptoms in 36 patients with sarcoidosis (study 1) and 93 patients with sarcoidosis (study 2). RESULTS: Across two studies we found that patients with sarcoidosis used emotion-focused and avoidant coping significantly less often than healthy individuals, and that in both groups the profile with dominant problem (task)-focus style was the most beneficial in terms of mental health. Further, the profile of sarcoidosis patients characterized by the lowest intensity of all coping strategies was found to be superior in terms of physical health status (dyspnoe, pain and FVC level). CONCLUSION: These findings suggest that successful management of sarcoidosis should include coping styles assessment and call for a multidisciplinary approach in diagnosis and treatment of sarcoidosis patients.

Brain activity during meditation in first-time meditators.

AIM OF THE STUDY: The electrophysiological correlates of meditation states in both short and long-term meditators have been increasingly documented; however, little is known about the brain activity associated with first-time meditation experiences. The goal of this study was to investigate the electrophysiological correlates of a single guided mindfulness meditation session in subjects with no previous meditation experience. MATERIALS AND METHODS: We analyzed electroencephalogram (EEG) changes in signal power, hemispheric asymmetry, and information flow between EEG channels, in 16 healthy subjects who were new to meditation practice. RESULTS: Our results show that information flow decreases in the theta (4-8 Hz) and alpha ranges (8-13 Hz) during mindfulness meditation exercise as compared to control: a passive listening condition. These changes are accompanied by a general trend in the decrease of alpha power over the whole scalp. One possible interpretation of these results is that there is an increased level of alertness/vigilance associated with the meditation task rather than reaching the target state. CONCLUSIONS: Our study expands on the existing body of knowledge concerning neural oscillations during breathing meditation practice by showing that in participants with no previous meditation training, EEG correlates are different from the electrophysiological signatures of mindfulness meditation found in studies of more advanced practitioners.

Assessment of Neurocognitive Functions, Olfaction, Taste, Mental, and Psychosocial Health in COVID-19 in Adults: Recommendations for Harmonization of Research and Implications for Clinical Practice.

OBJECTIVE: To propose a set of internationally harmonized procedures and methods for assessing neurocognitive functions, smell, taste, mental, and psychosocial health, and other factors in adults formally diagnosed with COVID-19 (confirmed as SARS-CoV-2 + WHO definition). METHODS: We formed an international and cross-disciplinary NeuroCOVID Neuropsychology Taskforce in April 2020. Seven criteria were used to guide the selection of the recommendations' methods and procedures: (i) Relevance to all COVID-19 illness stages and longitudinal study design; (ii) Standard, cross-culturally valid or widely available instruments; (iii) Coverage of both direct and indirect causes of COVID-19-associated neurological and psychiatric symptoms; (iv) Control of factors specifically pertinent to COVID-19 that may affect neuropsychological performance; (v) Flexibility of administration (telehealth, computerized, remote/online, face to face); (vi) Harmonization for facilitating international research; (vii) Ease of translation to clinical practice. RESULTS: The three proposed levels of harmonization include a screening strategy with telehealth option, a medium-size computerized assessment with an online/remote option, and a comprehensive evaluation with flexible administration. The context in which each harmonization level might be used is described. Issues of assessment timelines, guidance for home/remote assessment to support data fidelity and telehealth considerations, cross-cultural adequacy, norms, and impairment definitions are also described. CONCLUSIONS: The proposed recommendations provide rationale and methodological guidance for neuropsychological research studies and clinical assessment in adults with COVID-19. We expect that the use of the recommendations will facilitate data harmonization and global research. Research implementing the recommendations will be crucial to determine their acceptability, usability, and validity.

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.

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.

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.

Mindfulness-based cognitive therapy reduces clinical symptoms, but do not change frontal alpha asymmetry in people with major depression disorder.

OBJECTIVES: Mindfulness-based cognitive therapy (MBCT) has demonstrated to be successful in the reduction of relapse rates in patients with recurrent major depressive disorder (MDD). Little is known if MBCT is effective for treating individuals with current MDD episode and about underlying psychophysiological mechanisms of symptoms reduction. The aim of the present study was to assess effects of MBCT on depressed individuals in terms of reduction of depressive and anxiety symptoms and to evaluate if this therapeutic improvement would be reflected on neurophysiological level by shift in frontal alpha asymmetry (FAA). PARTICIPANTS: We studied 20 individuals with current MDD. DESIGN: Participants were randomly assigned either to waiting list or 8-week MBCT. Before and after the treatment we have assessed depression, anxiety, and FAA in resting-state electroencephalogram (EEG) - an indicator of approach vs. withdrawal-related response dispositions and a vulnerability factor of MDD. RESULTS: In line with previous findings, reduction of depressive and anxiety symptoms, but no change in mean values of FAA in MBCT group was found. CONCLUSIONS: These results provide a support for the beneficial effects of MBCT in current MDD treatment, however, they do not support the hypothesis on alpha asymmetry change as a neural correlate of MDD improvement.

A pilot study of mindfulness-based relapse prevention for compulsive sexual behaviour disorder.

BACKGROUND AND AIMS: Compulsive sexual behaviour disorder (CSBD) is a medical condition that can impair social and occupational functioning and lead to severe distress. To date, treatment effectiveness studies of CSBD are under-developed; typically, treatment for CSBD is based on guidelines for substance or other behavioural addictions. Mindfulness-based relapse prevention (MBRP) is an evidence-based treatment for substance addiction aimed at, among other things, reducing craving and negative affect-i.e. processes that are implicated in the maintenance of problematic sexual behaviours. However, to our knowledge no prior research has been published evaluating mindfulness-based intervention (MBI) in the treatment of CSBD, except two clinical case reports. Therefore, the aim of the current pilot study was to examine whether MBRP can lead to clinical improvement in CSBD. Methods: Participants were 13 adult males with a diagnosis of CSBD. Before and after the eight-week MBRP intervention, participants completed a booklet of questionnaires including measurements of porn viewing, masturbation and emotional distress. Results: As expected, we found that after MBRP participants spent significantly less time engaging in problematic pornography use and exhibited a decrease in anxiety, depression and obsessive-compulsive (OC) symptoms. Discussion and Conclusions: The findings indicate that MBRP could be beneficial for CSBD individuals. Further clinical effectiveness studies with bigger sample sizes, delayed post-training measurements and randomised control trial design are warranted. In conclusion, MBRP leads to a decrease in time spent watching porn and a decrease in emotional distress in CSBD patients.

Manifestations of clinical depression in daily life: a daily diary study of descriptions of naturally occurring events.

In the present study, clinically depressed (n = 135) and non-depressed adults (n = 138) described the events that happened to them each day for two weeks, and these descriptions were content analysed. Participants also rated how stressful and how positive each event was. Multilevel analyses found that depressed individuals, compared to the non-depressed, used more negative emotion words and more pronouns and used fewer positive emotion words, and they rated events as more stressful and less positive. Stressfulness of events was positively related to the use of pronouns and negative emotion words and was negatively related to the use of positive emotion words. Relationships between positivity of events and word counts were in the opposite direction. Controlling for stressfulness or positivity of events eliminated differences between the depressed and non-depressed in word use, except for use of other-pronouns words. Compared to the non-depressed, depressed people may either experience a greater number of objectively stressful or less pleasant daily events or perceive naturally occurring daily events as more stressful and less positive, and they describe daily events in ways that are consistent with such differences.

Relationship between alexithymia and variability of blood pressure measured with ABPM in hypertensive patients.

OBJECTIVE: Studies indicates that dysregulation of emotions plays an important role in the etiology of elevated blood pressure (BP). One of the signatures of emotional dysregulation is alexithymia defined as an impaired ability to experience and express emotions. Previous work indicated that primary hypertension (HT) is marked by higher alexithymia, but little research examined the relationship between alexithymia and variability of evaluated BP with 24 h Ambulatory Blood Pressure Monitoring (ABPM) in HT patients. METHOD: Fifty-five participants diagnosed with hypertension and a matched group of thirty-nine healthy participants filled in The Toronto Alexithymia Scale (TAS-20), a clinical-demographic questionnaire, and were assessed with 24 h ABPM. RESULTS: After removing those with white coat HT, as expected, hypertensive individuals had a higher total score and all three alexithymia subscales. Furthermore, alexithymia was positively correlated with average values of systolic BP. CONCLUSION: These findings provided support for the contention that alexithymia is associated with elevated BP, the higher level of alexithymia the higher systolic BP in 24 h BP measurement. Future studies may examine the causal relationship between alexithymia and HT and evaluate the effectiveness of emotional regulation training interventions to reduce BP in people suffering from primary hypertension.

Attention to negative words predicts daily rumination among people with clinical depression: evidence from an eye tracking and daily diary study.

The present study examined relationships between attention to negative words and daily rumination and daily adjustment in a sample of clinically depressed individuals. We recorded eye movements of 43 individuals diagnosed with major depression while they were freely viewing dysphoric, threat-related, neutral, and positive words. Then, each day for one week, participants provided measures of their daily rumination and psychological adjustment. Multilevel analyses found that attention to dysphoric and threat-related words was positively related to daily rumination and attention to threat-related words was negatively related to daily adjustment. These findings suggest that the impaired ability to disengage from negative words is positively related to rumination in daily life and is negatively related to well-being, as defined in terms of Beck's Triad.

Cognitive-Behavioral (CBT) and Psychodynamic (PDT) Group Psychotherapy and Their Impact on Depressive Symptoms and Hostile Attributions.

This article examined how intensive group cognitive-behavioral therapy (GCBT) and group psychodynamic psychotherapy (GPDT) modified depressive symptoms and processing of social information (hostility attributions in a variety of ambiguous situations). The sample (N = 37) comprised individuals who were attending psychotherapy due to psychological distress (GCBT or GPDT). The study examined how group psychotherapy influences depression symptoms and social cognition. There was a decrease in depressive symptoms after three months of intensive CBGT, but PDGT did not significantly improve symptoms of depression. Moreover, in both psychotherapies, the authors noted a significant decrease in hostile attributions, mainly in situations involving people with whom one does not have a close relationship.