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Cognitive and mental health changes and their vulnerability factors related to COVID-19 lockdown in Italy.

ABSTRACT: The COVID-19 pandemic and government imposed social restrictions like lockdown exposed most individuals to an unprecedented stress, increasing mental health disorders worldwide. We explored subjective cognitive functioning and mental health changes and their possible interplay related to COVID-19-lockdown. We also investigated potential risk factors to identify more vulnerable groups. Across Italy, 1215 respondents completed our Qualtrics-based online-survey during the end of a seven to 10-week imposed lockdown and home confinement (from April 29 to May 17, 2020). We found subjective cognitive functioning and mental health severely changed in association with the lockdown. Under government regulations, cognitive complaints were mostly perceived in routine tasks involving attention, temporal orientation and executive functions-with no changes in language abilities. A paradoxical effect was observed for memory, with reduced forgetfulness compared to pre-lockdown. We found higher severity and prevalence of depression, anxiety disorders, abnormal sleep, appetite changes, reduced libido and health anxiety: with mild-to-severe depression and anxiety prevalence climbing to 32 and 36 percent, respectively, under restrictions. Being female, under 45 years, working from home or being underemployed were all identified as relevant risk factors for worsening cognition and mental health. Frequent consumers of COVID-19 mass media information or residents in highly infected communities reported higher depression and anxiety symptoms, particularly hypochondria in the latter. If similar restrictions are reimposed, governments must carefully consider these more vulnerable groups in their decisions, whilst developing effective global and long-term responses to the cognitive and mental health challenges of this type of pandemic; as well as implementing appropriate psychological interventions with specific guidelines: particularly regarding exposure to COVID-19 mass-media reports.

SUBMITTER: Fiorenzato E

PROVIDER: S-EPMC7840042 | biostudies-literature | 2021

REPOSITORIES: biostudies-literature

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Cognitive and mental health changes and their vulnerability factors related to COVID-19 lockdown in Italy.

Fiorenzato Eleonora E Zabberoni Silvia S Costa Alberto A Cona Giorgia G

PloS one 20210127 1

The COVID-19 pandemic and government imposed social restrictions like lockdown exposed most individuals to an unprecedented stress, increasing mental health disorders worldwide. We explored subjective cognitive functioning and mental health changes and their possible interplay related to COVID-19-lockdown. We also investigated potential risk factors to identify more vulnerable groups. Across Italy, 1215 respondents completed our Qualtrics-based online-survey during the end of a seven to 10-week ...[more]

PMID: 33503055

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Project description:This study aims at identifying the tools necessary for COVID-19 health emergency management, with particular reference to the period following the first lockdown, a crucial phase in which it was important to favor the maintenance of protective behaviors. It also aims at identifying the messages and sources that were most effective in managing communication correctly in such a crucial phase that is likely characterized by a fall in perceived health risk (due to the flattening of the epidemic curve) and a simultaneous rise in perceived economic and social risks (due to the enduring calamity). Knowing what source will be most effective to convey a specific message is fundamental in enabling individuals to focus on and comply with the rules. At the same time, it is necessary to understand how the message should be presented, and the relationships between messages, sources and targets. To meet these goals, data were collected through a self-administered online questionnaire submitted to a sample of undergraduate students from a University in Lombardy-the region most affected by the pandemic in the first wave- (Study 1), and to a national sample composed of Italian citizens (Study 2). Through our first manipulation which explored the effectiveness of social norms in relation to different sources, we found that, in the national sample, the injunctive norm conveyed by the government was the most effective in promoting behavioral intentions. By contrast, among the students, results showed that for the critical group with a lower risk perception (less inclined to adopt prevention behavior) descriptive norms, which implicitly convey the risk perception of peers, were as effective as the government injunctive norm. Our second manipulation, identical in Study 1 and 2, compared four types of communication (emotional, exponential growth, both of them, or neutral). The neutral condition was the most memorable, but no condition was more effective than the others. Across all message types there was a high intention to adopt protective behaviors. The results indicate possible applicative implications of the adopted communicative tools.

Project description:The COVID-19 emergency has severely affected the Italian population. During a pandemic, those with high health anxiety are at risk of adverse mental health outcomes, including peritraumatic distress and mood disturbance. No prior research has explored the role of psychological flexibility in protecting people at high risk of poorer mental health impacts due to health anxiety during a pandemic. Psychological flexibility is the cornerstone of psychological health and resiliency. According to acceptance and commitment therapy (ACT), it involves behaving consistently with one's chosen values even in the presence of emotional and mental discomfort. This study examined the mediating and moderating roles of psychological flexibility in the link between trait health anxiety and three mental health outcomes: COVID-19 peritraumatic distress, anxiety, and depression. We hypothesized that higher psychological flexibility would decrease the negative impacts of trait health anxiety on mental health outcomes. During the mandatory national lockdown (M = 35.70 days, SD = 8.41), 944 Italian adults (75.5% female, M = 38.86 years, SD = 13.20) completed an online survey consisting of standardized measures of psychological flexibility, trait health anxiety, COVID-19 distress, anxiety, and depression. Results indicated that psychological flexibility did not moderate the link between trait health anxiety and mental health outcomes. Rather, greater psychological flexibility mediated decreases in the adverse effects of trait health anxiety on COVID-19 distress, anxiety, and depression. In particular, two psychological flexibility processes, observing unhelpful thoughts rather than taking them literally (defusion) and values-based action (committed action), mediated decreases in the negative effects of trait health anxiety on all mental health outcomes. In contrast, the psychological flexibility process acceptance, which involves openness to inner discomfort, mediated increases in negative mental health outcomes. Overall, the combination of these processes mitigated the detrimental impacts of trait health anxiety on mental health during the emergency mandatory COVID-19 nationwide lockdown. Consistent with the ACT conceptualization of psychological flexibility, findings suggest embracing (rather than avoiding) inner discomfort and observing associated unhelpful thoughts, while also engaging in values-based action, increases resilience during adversity. Evidenced-based large-scale online public health interventions that target psychological flexibility in those experiencing health anxiety in the context of a pandemic are urgently needed. Many empirically-based ACT interventions are suited for this purpose.

Dataset Information

Cognitive and mental health changes and their vulnerability factors related to COVID-19 lockdown in Italy.

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Cognitive and mental health changes and their vulnerability factors related to COVID-19 lockdown in Italy.

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