Corrigendum: Illness perceptions of COVID-19 in Europe: predictors, impacts and temporal evolution.

[This corrects the article DOI: 10.3389/fpsyg.2021.640955.].

The impact of government actions and risk perception on the promotion of self-protective behaviors during the COVID-19 pandemic.

INTRODUCTION: We aim to understand the factors that drive citizens of different countries to adhere to recommended self-protective behaviors during the COVID-19 pandemic. METHODS: Survey data was obtained through the COVID-19 Impact project. We selected countries that presented a sufficiently complete time series and a statistically relevant sample for running the analysis: Cyprus, Germany, Greece, Ireland, Latvia, Spain, Switzerland, the United Kingdom, and the United States of America. To identify country-specific differences in self-protective behaviors, we used previous evidence and change-point detection analysis to establish variations across participating countries whose effect was then assessed by means of interrupted series analysis. RESULTS: A high level of compliance with health and governmental authorities' recommendations were generally observed in all included countries. The level of stress decreased near the period when countries such as Cyprus, Greece or the United Kingdom relaxed their prevention behavior recommendations. However, this relaxation of behaviors did not occur in countries such as Germany, Ireland, or the United States. As observed in the change-point detection analysis, when the daily number of recorded COVID-19 cases decreased, people relaxed their protective behaviors (Cyprus, Greece, Ireland), although the opposite trend was observed in Switzerland. DISCUSSION: COVID-19 self-protective behaviors were heterogeneous across countries examined. Our findings show that there is probably no single winning strategy for exiting future health crises, as similar interventions, aimed to promote self-protective behaviors, may be received differently depending on the specific population groups and on the particular geographical context in which they are implemented.

Profiles and Risk Factors for Teen Dating Violence in Spain.

Teen dating violence (TDV) refers to a wide range of partner-directed harmful behaviors among adolescents. Since it was first documented in the 1980s, there is a growing interest in TDV due to its potentially devastating mid- and long-term consequences. Aiming at the early detection of TDV onset with prevention purposes, research has focused on the detection of typologies of perpetrators and/or victims as well as on identifying risk and protective factors for its occurrence. Research with Spanish adolescents, however, is very limited. To fill this gap, we recruited a total of 2,319 adolescents from different regions in Spain, out of which, 1,079 reported having had a romantic partner during the last year. These filled out measures of TDV (perpetration and victimization), school aggression, hostile and benevolent sexism, empathy, assertiveness, psychological inflexibility (general measures), and psychological inflexibility with prejudice thoughts. A cluster analysis revealed that adolescents could be divided into two clusters as a function of their TDV profile: Cluster 1, including close to 76% of the sample (boys and girls), presented low TDV perpetration and victimization; Cluster 2, including 24% of the sample (boys and girls), presented higher TDV perpetration and victimization. Regression analyses revealed that, as compared to those in Cluster 1, adolescents in Cluster 2 were more likely to be older boys who scored high in benevolent sexism, overt and relational school aggression, and personal distress, and low in behavior regulation skills, perspective taking, and practical personal ability. We discuss the implications of these findings for the design of evidence-based TDV prevention campaigns.

Psychological inflexibility and valuing happiness: Dangerous liaisons.

Previous evidence has shown that excessive valuing happiness may relate to lower psychological wellbeing across cultures. Considering the lack of data with Spanish population, we examined the relation between tightly holding happiness emotion goals and subjective wellbeing in a sample of Spanish women, and explored the mediation role exerted by psychological inflexibility components (namely, cognitive fusion and experiential avoidance) in the relation between valuing happiness and subjective wellbeing. A female adult sample (n = 168) filled out measures of excessive valuing happiness, psychological inflexibility, positive affect, negative affect, and life satisfaction. Valuing happiness only showed positive total effects on negative affect and strong direct effects on both cognitive fusion and experiential avoidance. Analyses revealed the mediating roles exerted by psychological inflexibility components, with experiential avoidance leading to lower pleasure; and cognitive fusion leading to greater displeasure and lower life satisfaction. Psychological inflexibility components explained between 40 and 80% of the total effect of valuing happiness on our outcome variables. Our findings highlight the need for further research on the benefits of hedonic vs. values-based approaches to happiness.

Derived generalization of attentional bias for laboratory-induced threat: Yes but.

There is laboratory evidence that fear conditioning underlies the emergence of attentional bias (AB) for threat. Our main objective was to test, for the first time, whether derived or symbolic responding contributes to the generalization of AB across non-conditioned stimuli. Participants were all university students (N = 86) with no pre-existing conditions. We first employed an exogenous cueing paradigm with two color slides (i.e., A1 or to-be CS+, and A2 or to-be CS-) serving as cues, and loud white noise serving as unconditioned stimulus during conditioning trials. We then employed a match-to-sample procedure to establish a derived equivalence relation between color A1 and arbitrary shape C1 as well as between color A2 and arbitrary shape C2. Next, we investigated the transfer of AB across non-conditioned stimuli: participants performed the same spatial cueing task with non-conditioned C1 and C2 stimuli serving as cues. Results replicated previous findings on the conditioning basis of AB, and most importantly, showed preliminary evidence of AB transfer: those participants who appraised C1 and not C2 as a signal of impending noise showed AB toward C1. This is the first laboratory demonstration that AB may generalize to stimuli physically unrelated to directly conditioned threats. Unfortunately, the small number of participants showing this effect calls for cautious considerations.

Illness Perceptions of COVID-19 in Europe: Predictors, Impacts and Temporal Evolution.

Objective: Illness perceptions (IP) are important predictors of emotional and behavioral responses in many diseases. The current study aims to investigate the COVID-19-related IP throughout Europe. The specific goals are to understand the temporal development, identify predictors (within demographics and contact with COVID-19) and examine the impacts of IP on perceived stress and preventive behaviors. Methods: This was a time-series-cross-section study of 7,032 participants from 16 European countries using multilevel modeling from April to June 2020. IP were measured with the Brief Illness Perception Questionnaire. Temporal patterns were observed considering the date of participation and the date recoded to account the epidemiological evolution of each country. The outcomes considered were perceived stress and COVID-19 preventive behaviors. Results: There were significant trends, over time, for several IP, suggesting a small decrease in negativity in the perception of COVID-19 in the community. Age, gender, and education level related to some, but not all, IP. Considering the self-regulation model, perceptions consistently predicted general stress and were less consistently related to preventive behaviors. Country showed no effect in the predictive model, suggesting that national differences may have little relevance for IP, in this context. Conclusion: The present study provides a comprehensive picture of COVID-19 IP in Europe in an early stage of the pandemic. The results shed light on the process of IP formation with implications for health-related outcomes and their evolution.

Academic Competence, Teacher-Student Relationship, and Violence and Victimisation in Adolescents: The Classroom Climate as a Mediator.

School violence is a serious social and public health problem prevalent worldwide. Although the relevance of teacher and classroom factors is well established in the literature, few studies have focused on the role of teacher perceptions in school violence and victimisation and the potential mediational role of classroom climate in this relationship. A total of 2399 adolescents (50% girls), aged between 11 and 18 years (M = 14.65, SD = 1.78) and enrolled in five Spanish Secondary Compulsory Education schools completed measures of classroom climate, school violence towards peers and perception of peer victimisation, and their teachers informed about their academic competence and the teacher-student relationship. Correlational analyses revealed that whereas academic competence perceived by the teacher was negatively related to overt violence and victimisation, its relationship with pure relational violence was positive. Structural equation modelling analyses showed that variables of classroom climate (involvement, affiliation, and teacher support) perceived by the students functioned as partial mediators between teacher perceptions of academic competence and of teacher-student relationship and violence and victimisation. In the mediational model, teacher perception of academic competence acted as a direct protective factor against violence and victimisation, and teacher perception of teacher-student relationship acted as a direct risk for violence, as well as an indirect protective factor through classroom climate for victimisation. The interpretation of these results points to the importance of the teacher's subjective perceptions in the prevention of violence and victimisation problems and their practical implications for the classroom climate perceived by students.

Transactional Links between Teacher-Adolescent Support, Relatedness, and Aggression at School: A Three-Wave Longitudinal Study.

This study examines the reciprocal effects between two school-based relationships within the classroom-namely, perceived teacher support and relatedness with classmates-and school aggression (overt and relational) across two courses of secondary education. Participants were 654 adolescents (48% boys), who were assessed in three waves: first, at the beginning of the academic year (T0), second, at the end of the same academic year (T1), and third, at the beginning of the next academic year (T2) (Mage wave 1 = 13.98 years). Autoregressive cross-lagged modeling was applied. Results show a protective effect of relatedness against relational aggression in both genders. Moreover, we observed a protective effect of perceived teacher support at the beginning of the course for later school aggression as well as a risk effect if this perceived teacher support is maintained throughout the course. These effects were observed in relation with gender-atypical forms of aggression (overt in girls and relational in boys). Finally, aggression had negative consequences for relatedness in girls and for teacher support through the mediation of relatedness in boys. Gender differences and practical implications of these findings are discussed.

School Violence towards Peers and Teen Dating Violence: The Mediating Role of Personal Distress.

School violence towards peers and teen dating violence are two of the most relevant behaviour problems in adolescents. Although the relationship between the two types of violence is well established in the literature, few studies have focused on mediators that could explain this empirical relationship. We departed from the evidence that relates anger, emotional distress and impaired empathy to teen dating violence and juvenile sexual offending, to explore the role of personal distress, i.e., a self-focused, aversive affective reaction to another's emotion associated with the desire to alleviate one's own, but not the other's distress; as a possible mechanism linking school violence towards peers and teen dating violence in a sample of Spanish adolescents. We also explored the prevalence of emotional and physical teen dating violence, both occasional and frequent, and the differences between boys and girls. A total of 1055 adolescents (49.2% boys and 50.8% girls) aged between 11 and 17 years (M = 14.06, SD = 1.34) who had had at least one romantic relationship within the last year, completed measures of school violence towards peers, teen dating violence, and personal distress. Statistical analyses revealed that occasional and frequent teen dating violence (both physical and emotional) was more frequent in girls than in boys, and that personal distress functioned as a partial mediator, with an overall model fit higher for boys than girls: in boys, partial mediation occurred for both physical and emotional teen dating violence; in girls, partial mediation occurred only for physical violence. The interpretation of the results is tentative given the novel nature of the study, and points to the evidence of the emotional costs of school violence and the importance of emotion and behavior regulation to undermine the social costs of personal distress.

To Help or Not to Help? Prosocial Behavior, Its Association With Well-Being, and Predictors of Prosocial Behavior During the Coronavirus Disease Pandemic.

The coronavirus disease (COVID-19) pandemic fundamentally disrupted humans' social life and behavior. Public health measures may have inadvertently impacted how people care for each other. This study investigated prosocial behavior, its association well-being, and predictors of prosocial behavior during the first COVID-19 pandemic lockdown and sought to understand whether region-specific differences exist. Participants (N = 9,496) from eight regions clustering multiple countries around the world responded to a cross-sectional online-survey investigating the psychological consequences of the first upsurge of lockdowns in spring 2020. Prosocial behavior was reported to occur frequently. Multiple regression analyses showed that prosocial behavior was associated with better well-being consistently across regions. With regard to predictors of prosocial behavior, high levels of perceived social support were most strongly associated with prosocial behavior, followed by high levels of perceived stress, positive affect and psychological flexibility. Sociodemographic and psychosocial predictors of prosocial behavior were similar across regions.

Impact of COVID-19 pandemic on mental health: An international study.

BACKGROUND: The COVID-19 pandemic triggered vast governmental lockdowns. The impact of these lockdowns on mental health is inadequately understood. On the one hand such drastic changes in daily routines could be detrimental to mental health. On the other hand, it might not be experienced negatively, especially because the entire population was affected. METHODS: The aim of this study was to determine mental health outcomes during pandemic induced lockdowns and to examine known predictors of mental health outcomes. We therefore surveyed n = 9,565 people from 78 countries and 18 languages. Outcomes assessed were stress, depression, affect, and wellbeing. Predictors included country, sociodemographic factors, lockdown characteristics, social factors, and psychological factors. RESULTS: Results indicated that on average about 10% of the sample was languishing from low levels of mental health and about 50% had only moderate mental health. Importantly, three consistent predictors of mental health emerged: social support, education level, and psychologically flexible (vs. rigid) responding. Poorer outcomes were most strongly predicted by a worsening of finances and not having access to basic supplies. CONCLUSIONS: These results suggest that on whole, respondents were moderately mentally healthy at the time of a population-wide lockdown. The highest level of mental health difficulties were found in approximately 10% of the population. Findings suggest that public health initiatives should target people without social support and those whose finances worsen as a result of the lockdown. Interventions that promote psychological flexibility may mitigate the impact of the pandemic.

Spanish Validation of the Emotion Regulation Questionnaire for Children and Adolescents (ERQ-CA): Introducing the ERQ-SpA.

Research on emotion regulation is now extensive and shows the benefits of the adaptive management of emotions for social functioning and psychological well-being. Our purpose was to test the psychometric properties of the Emotion Regulation Questionnaire for Children and Adolescents with a sample of nonclinical Spanish adolescents. A total of 462 secondary education students (223 girls, mean age = 13.89 years, SD = 1.38) participated. The instrument proved to be two-factor and gender-invariant. Results revealed the temporal stability of both emotion regulation strategies, while the predictive validity study revealed that depressive symptoms were negatively related to cognitive reappraisal, and positively related to expressive suppression. Our findings support the use of the ERQ-SpA in Spanish adolescents.

Psychological Flexibility With Prejudices Increases Empathy and Decreases Distress Among Adolescents: A Spanish Validation of the Acceptance and Action Questionnaire-Stigma.

Empathy is an emotional response that may facilitate prosocial behavior and inhibit aggression by increasing empathic concern for others. But the vicarious experience of other's feelings may also turn into personal distress when the person has poor regulation skills and holds stigmatizing beliefs. In thinking about the processes that may trigger the experience of personal distress or empathic concern, research on the influence of psychological flexibility and inflexibility on stigma is showing promising results. Both processes are assessed with the Acceptance and Action Questionnaire-Stigma (AAQ-S). The current study sought to carry out a validity study of a Spanish version of the AAQ-S with a sample of adolescents aged 11-17 years. The study included an expanded test of its predictive validity with measures at three times to evaluate the role of psychological flexibility and inflexibility as risk or protective variables for the development of personal distress and/or empathic concern in the stigmatizer. Statistical analyses confirmed a two-correlated-factor solution, the adequate reliability of both factors, and their construct and predictive validity in the expected direction. The stigmatizer's inflexible reaction to their stigmatizing thoughts predicted the occurrence of personal distress, whereas the stigmatizer's flexible reaction to their stigmatizing thoughts predicted the occurrence of empathic concern for others. These findings confirm the importance of considering the role of regulatory skills in the experience of empathic concern or personal distress in the presence of stigmatizing thoughts, with possible implications for the promotion of prosocial behavior and the reduction of aggressive behavior among adolescents.

Intervención en el trastorno de ansiedad social a través de la terapia de aceptación y compromiso: una revisión sistemática / Acceptance and commitment therapy for social anxiety disorder: a systematic review

El objetivo de la presente revisión sistemática fue examinar la eficacia de la terapia de aceptación y compromiso (ACT) en el tratamiento del trastorno de ansiedad social (TAS). Se realizó una búsqueda exhaustiva en distintas bases de datos, incluyendo, tras la aplicación de diversos criterios, un total de ocho estudios realizados entre los años 2005 y 2016. En tres de ellos se mostró la eficacia de la ACT para reducir la sintomatología fóbica y la inflexibilidad psicológica. En los otros cinco, ensayos controlados aleatorizados, se demostró que la ACT y la terapia cognitivo conductual (TCC) producían efectos similares al final del tratamiento y en el seguimiento. En algunos casos también se observó que la ACT mejoraba los resultados de la TCC en adherencia al tratamiento y en la calidad de vida. El TAS muestra mejoras tras la aplicación de la ACT en todos los estudios analizados en esta revisión, en línea con revisiones anteriores. Se discuten las debilidades de las pruebas acumuladas hasta la fecha sobre la eficacia de la ACT para el tratamiento del TAS y se proponen líneas de trabajo futuro

The purpose of this systematic review was to examine the efficacy of acceptance and commitment therapy (ACT) applied to the treatment of social anxiety disorder (SAD). An exhaustive search was carried out in different databases. After the application of a number of inclusion and exclusion criteria, a total of eight studies conducted between 2005 and 2016 were obtained and then reviewed. In three of these studies, ACT proved efficacious in reducing phobic symptoms and psychological inflexibility. The remaining five, which employed randomized controlled trial design, showed that ACT and cognitive behavioral therapy (CBT) produce similar improvements both at post-treatment and during the follow-up. In some cases, ACT produced better treatment adherence and self-reported quality of life than CBT. All in all, every study included in this paper reported improvements in TAS after ACT, in line with previous evidence. Results are discussed in terms of the strengths and weaknesses of the evidence accumulated so far, and new directions for research are suggested

Spanish Validation of the Avoidance and Fusion Questionnaire for Youth (AFQ-Y).

Psychological inflexibility (PI) refers to the overarching and nonadaptive avoidance of thoughts and feelings. PI is a transdiagnostic process that is present in numerous psychopathologies, such as anxiety and mood disorders, addictive behaviors, and chronic pain, as presented by American adults and adolescents. Despite the high rates of depression and depressed mood among Spanish and Latino adolescents and the observed relation between PI and adjustment problems at this age, an instrument assessing PI in Spanish-speaking adolescents is lacking. In this study, we assessed the psychometric properties of a Spanish adaptation of the Avoidance and Fusion Questionnaire for Youth with 483 students from Spain (mean age 13.89 years). The Spanish Avoidance and Fusion Questionnaire for Youth proved to be a two-factor psychometrically sound instrument. Total PI scores correlated positively with depression and negatively with satisfaction with life. The predictive validity results showed cognitive fusion and experiential avoidance to be two interrelated but distinct processes that characterize PI.

Brief ACT Protocol in at-risk adolescents with conduct disorder and impulsivity

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The aim of this preliminary research is to explore the effect of a brief protocol based on acceptance and commitment therapy (ACT) applied to five adolescents (15-17 years old) with conduct disorder and impulsivity, who had received treatment for the last few years without positive results. Problematic behaviors were aggressive, impulsive, and oppositional reactions at school, home, and neighborhood (e.g., drugs or alcohol consumption, legal violations, oppositionist and defiant reactions, etc.). A brief ACT protocol was designed to functionally suit the presence of impulsivity and the absence of self-control repertory of these adolescents as well as the resistance to psychological treatment. The brief protocol was focused on four aspects: (a) to set a context between the therapist and the adolescents to promote the sense of personal responsibility, (b) to confront the adolescents with the effect of their behavior regulation (pros and cons) and the experience of creative hopelessness, (c) to clarify personally important valued directions, and (d) to promote defusion skills so that the adolescents could take charge of their private experiences and choose actions according to their values. Four 90-min, individual sessions were implemented over two weeks. Participants and teachers’ reports obtained before, during, and after the treatment implementation showed a high positive change. In addition, 1-year follow-up information showed an important change in a wide range of areas such as family, social relationships, school achievement, and occupational status. These results suggest that brief ACT protocols can have a great impact on at-risk population. Limitations were discussed (AU)

The relationship between perceived emotional intelligence and depressive symptomatology: the mediating role of perceived stress.

This study investigated the mediating role of perceived stress in the relationship between perceived emotional intelligence and depressive symptoms in adolescence. A total of 661 high school Spanish students participated in the study. The analyses indicated that the effects of each of the perceived emotional intelligence sub-scales (namely, Attention, Clarity and Repair) on depressive symptomatology were partially mediated by perceived stress. Specifically, the mediating effect was negative for Clarity and Repair, but positive for attention. The analysis also showed that the direct effects were positive for all sub-scales. These results suggest that the promotion of stress management skills may be core in the development of prevention and treatment programs for depression in adolescents, and possibly more beneficial than the promotion of emotion regulation skills. Our findings, along with previous evidence, suggest that emotional attention, as measured in the present study, may be targeting a pathological type of attention.

A further Experimental Step in the Analysis of Hierarchical Responding

This study is a step forward in the difficult task of analyzing the transformation of functions via hierarchical relations. Eight participants underwent a computer task with five phases. During Phase 1, four stimuli were trained to become the following relational cues: INCLUDES, BELONGS TO, SAME, and DIFFERENT. In Phase 2, three equivalence classes were trained and tested (A1-B1-C1-D1; A2-B2-C2-D2; A3-B3-C3-D3). During Phase 3, inclusion relations were first established, by using the INCLUDES and BELONGS TO relational cues, between the to-be lower levels of the hierarchy, namely A1/B1, A2/B2, and A3/B3; and stimuli X.1, X.2, and Y.1, respectively. Then, the INCLUDES relational cue was used to establish inclusion relations between X.1/X.2 and X, and between Y.1 and Y, so that X and Y would become the most inclusive levels of two separate hierarchical networks. In Phase 4, X.1 was established as cold, D2 as heavy, and C3 as sweet. Lastly, in Phase 5 (Critical Test), seven stimuli from both hierarchical networks were tested for the transformation of functions. Five of the six participants who made it to this test responded correctly. Implications, limitations, and further research are discussed (AU)

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Treatment-seeking precipitators in problem gambling: analysis of data from a gambling helpline.

Although research on treatment precipitators for problem gambling is scarce, telephone surveys have consistently shown that financial and emotional problems resulting from problem gambling are the factors which recovered or active gamblers most frequently report as treatment precipitators. The present study sought to build on previous evidence by analyzing the demographic and gambling-related information provided by gamblers calling the helpline operated by the New Mexico Council on Problem Gambling and receiving a referral to private counseling. Specifically we examined the differences between the callers who initiated treatment with a private counselor after receiving the referral (n = 223), and those who were likewise referred to counseling but did not attend the first appointment (n = 231). The 2 groups could only be distinguished by the fact that the therapy-initiating group cited family or financial problems as the reason for calling the helpline. Further analyses revealed that helpline staff also had an influence on counseling initiation. These findings, along with other differences between groups call for further research on the most effective ways of targeting problem gamblers who call a helpline so as to facilitate their progression to the action stage of change.

Using panicogenic inhalations of carbon dioxide enriched air to induce attentional bias for threat: Implications for the development of anxiety disorders.

The tendency for anxious individuals to selectively attend to threatening information is believed to cause and exacerbate anxious emotional responding in a self-perpetuating cycle. The present study sought to examine the relation between differential interoceptive conditioning (IC) using carbon dioxide inhalation as a panicogenic unconditioned stimulus (US) and the development of Stroop colour-naming interference to various non-word conditioned stimuli (CSs). Healthy university students (N = 27) underwent the assessment of colour-naming interference to reinforced CS+ and non-reinforced CS- non-words prior to and following differential fear conditioning. Participants showed greater magnitude electrodermal and verbal-evaluative responses to the CS+ over the CS- non-word following IC, and demonstrated the expected slower colour-naming latencies to the CS+ compared to the CS- non-word from baseline to post-conditioning. We discuss the relation between fear learning and the emergence of attentional bias for threat to further understand the maintenance of anxiety disorders.