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Emotion Regulation and COVID-Related Stress Management

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Mental Health".

Deadline for manuscript submissions: closed (12 April 2023) | Viewed by 49617

Special Issue Editors


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Guest Editor
Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56126 Pisa, Italy
Interests: COVID-19; emotion regulation; defense mechanisms; assessment; personality

E-Mail Website
Guest Editor
Department of Surgical, Medical and Molecular Pathology, Critical and Care Medicine, University of Pisa, 56126 Pisa, Italy
Interests: COVID-19; emotion regulation; mindfulness; adjustment; stress
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

One year after the World Health Organization declared the COVID-19 a pandemic (March 2020), people are still experiencing the worst global crisis since the 2nd World War. Direct and indirect consequences are innumerable, and its unpredictable evolution makes the restoration of normalcy extremely difficult. Human well-being is being seriously affected by COVID-19. Besides the massive loss of lives, research has demonstrated the dramatic impact of the current outbreak on people’s mental health. Although risk factors have been extensively studied, less is known about the protective role of emotion regulation in mitigating the effects of this pandemic on psychological wellbeing. 

Emotion regulation is a psychological resource that serves to mitigate distress through the modification of intensity, duration, and type of the experienced emotion. Through the use of implicit and explicit emotion regulation strategies (e.g., defense mechanisms, somatization, meditation, and coping strategies), individuals can reduce negative feelings and anxiety associated with an emotionally impactful experience by positively change the quality of an emotional response. On the other hand, failures in emotional regulation may contribute to the development, maintenance, and exacerbation of psychological psychopathology. 

This Special Issue aims to explore the key role of emotion regulation in the management of COVID-19-related distress. We will consider for publication theoretical and empirical studies highlighting the importance of systematic assessment of emotion-regulation strategies, their contribution to protecting against psychological distress, and the need to tailor treatments to enhance emotion regulation during the ongoing global health crisis.

Dr. Mariagrazia Di Giuseppe
Prof. Dr. Ciro Conversano
Guest Editors

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Keywords

  • COVID-19
  • emotion regulation
  • stress
  • resilience
  • assessment
  • personality
  • defense mechanisms
  • mindfulness
  • adjustment
  • quality of life

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Published Papers (12 papers)

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Research

14 pages, 865 KiB  
Article
Coping with COVID-19: Can a Sense of Coherence and Social Support Play a Protective Role in the Perception of COVID-19 by Polish Women Football Players? A Cross-Sectional Study
by Anna Ussorowska-Krokosz, Jan Blecharz, Malgorzata Siekanska and Monika Grygorowicz
Int. J. Environ. Res. Public Health 2023, 20(13), 6308; https://doi.org/10.3390/ijerph20136308 - 6 Jul 2023
Cited by 1 | Viewed by 1739
Abstract
Introduction: Athletes have demonstrated a significant increase in anxiety and stress connected to the COVID-19 pandemic. Drawing on the theory of salutogenesis, this study examined the relationship between the sense of coherence and social support and competitive elite-level athletes’ perception of the COVID-19 [...] Read more.
Introduction: Athletes have demonstrated a significant increase in anxiety and stress connected to the COVID-19 pandemic. Drawing on the theory of salutogenesis, this study examined the relationship between the sense of coherence and social support and competitive elite-level athletes’ perception of the COVID-19 pandemic situation. Materials and Methods: The perceived secondary gains associated with the pandemic were analysed with a quasi-qualitative research methodology. The sample consisted of 204 competitive elite-level female football players aged 14–36 (M = 17.61, SD = 4.42) who completed the Sense of Coherence Questionnaire (SOC-29), the Berlin Social Support Scales (BSSS), and the researchers’ own questionnaire to assess the perception of the COVID-19 situation. Results: The results confirmed a relationship between a sense of coherence and coping better with the difficult situation caused by the coronavirus pandemic. No protective role of social support in the adaptive perception of the pandemic situation was identified. Conclusions: The data from the quasi-qualitative study testify to the use of the adversity of the pandemic to grow in many areas of female football players’ lives. The sense of coherence was a protective factor in mitigating the negative consequences of the COVID-19 pandemic situation. Full article
(This article belongs to the Special Issue Emotion Regulation and COVID-Related Stress Management)
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19 pages, 1083 KiB  
Article
Mental Disorders and Level of Resilience in Eight High-Altitude Cities of Peru during the Second Pandemic Wave: A Multicenter Population-Based Study
by J. Pierre Zila-Velasque, Pamela Grados-Espinoza, Naomi Coba-Villan, Jocelyn Quispe-Chamorro, Yesenia F. Taipe-Guillén, Estefany Pacheco, Laura Ccasa-Valero, Virgilio E. Failoc-Rojas, Cristian Díaz-Vélez and Mario J. Valladares-Garrido
Int. J. Environ. Res. Public Health 2023, 20(1), 519; https://doi.org/10.3390/ijerph20010519 - 28 Dec 2022
Cited by 3 | Viewed by 3388
Abstract
COVID-19 has led us to take preventive measures, such as social isolation, to reduce the high transmissibility of the disease. This could have affected the mental health of various population groups and the development of resilience as a mitigator. A cross-sectional analytical study [...] Read more.
COVID-19 has led us to take preventive measures, such as social isolation, to reduce the high transmissibility of the disease. This could have affected the mental health of various population groups and the development of resilience as a mitigator. A cross-sectional analytical study was conducted with 700 participants from eight cities. The dependent variables were depression, anxiety, and post-traumatic stress disorder (PTSD). The independent variable was resilience. Generalized logistic regressions were used to identify the associations between the variables. The population consisted mostly of university students (65.0%); the rest of the population was distributed among workers of public or private institutions, housewives, and others (35.0%). High prevalences of anxiety (72.7%), depression (64.1%), and PTSD (15.1%) were found, as well as a median (interquartile range) resilience score of 24 points was determined. Factors associated with a high prevalence of PTSD were having lost employment and having a family member who died from COVID-19. For depression, associated factors were severe food insecurity and hypersomnia. For anxiety, associated factors were were having a deceased family member with COVID-19 and mild food insecurity. Our results show that, during the pandemic, the general population had a higher prevalence of mental disorders. In addition, anxiety was the most prevalent of the dependent variables. Special attention should be paid to the factors influencing the development of mental disorders and mental health prevention and promotion programs should be established. Full article
(This article belongs to the Special Issue Emotion Regulation and COVID-Related Stress Management)
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20 pages, 2404 KiB  
Article
You Do Not Have to Get through This Alone: Interpersonal Emotion Regulation and Psychosocial Resources during the COVID-19 Pandemic across Four Countries
by Olenka Dworakowski, Zilla M. Huber, Tabea Meier, Ryan L. Boyd, Mike Martin and Andrea B. Horn
Int. J. Environ. Res. Public Health 2022, 19(23), 15699; https://doi.org/10.3390/ijerph192315699 - 25 Nov 2022
Cited by 3 | Viewed by 2244
Abstract
While experiencing the unpredictable events of the COVID-19 pandemic, we are likely to turn to people in order to regulate our emotions. In this research, we investigate how this interpersonal emotion regulation is connected to affective symptoms, above and beyond intrapersonal emotion [...] Read more.
While experiencing the unpredictable events of the COVID-19 pandemic, we are likely to turn to people in order to regulate our emotions. In this research, we investigate how this interpersonal emotion regulation is connected to affective symptoms, above and beyond intrapersonal emotion regulation. Furthermore, we explore whether perceived psychosocial resources moderate these associations, i.e., if individuals reporting healthier social connections benefit differently from interpersonal emotion regulation. N = 1401 participants from the USA, UK, Germany, and Switzerland completed an online survey that included text samples. Affective symptoms (depression, adjustment disorder, fear of COVID-19) were examined based on self-reported as well as language-based indicators. As psychosocial resources, we examined social support, loneliness, attachment style, and trust. We defined latent variables for adaptive and maladaptive interpersonal emotion regulation and analyzed how they were associated with affective symptoms controlling for intrapersonal emotion regulation. Further, we analyzed how they interacted with psychosocial resources. Maladaptive interpersonal emotion regulation strategies were associated with affective symptoms. With lower psychosocial resources, the associations between interpersonal emotion regulation and depressive symptoms were more pronounced. The results highlight that maladaptive interpersonal emotion regulation is associated with worse mental health. These effects are not buffered by more psychosocial resources and are stronger for people with low psychosocial resources. Full article
(This article belongs to the Special Issue Emotion Regulation and COVID-Related Stress Management)
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7 pages, 298 KiB  
Article
Psychological Impact of Cancellation of Elective Surgeries for Ophthalmic Patients during COVID-19 Pandemic
by Stephanie K. Y. Chu, David T. C. To, Candice C. H. Liu, Tony Wong and Kenneth K. W. Li
Int. J. Environ. Res. Public Health 2022, 19(22), 14852; https://doi.org/10.3390/ijerph192214852 - 11 Nov 2022
Viewed by 1487
Abstract
The COVID-19 pandemic has disrupted routine hospital services globally. The cancellation of elective surgeries placed a psychological burden on patients. A questionnaire study was conducted to identify the psychological impact of canceling cataract operations on patients at Kowloon East Cataract Center, Tseung Kwan [...] Read more.
The COVID-19 pandemic has disrupted routine hospital services globally. The cancellation of elective surgeries placed a psychological burden on patients. A questionnaire study was conducted to identify the psychological impact of canceling cataract operations on patients at Kowloon East Cataract Center, Tseung Kwan O Hospital, Hong Kong, from April to June 2020. In total, 99 participants aged 59 years old and above, who had their cataract surgeries postponed or as scheduled, were studied using the standardized patient health questionnaire (PHQ-9) and generalized anxiety disorder questionnaire (GAD-7). None of the patients who had their cataract surgeries rescheduled reached the cutoff score for major depression in PHQ-9, whereas, according to GAD-7, five patients had mild symptoms of anxiety, and one had severe symptoms. There was no significant psychosocial impact of the cancellation of cataract surgeries on patients. Full article
(This article belongs to the Special Issue Emotion Regulation and COVID-Related Stress Management)
12 pages, 370 KiB  
Article
Factors Associated with Anxiety, Depression, and Stress in Peruvian University Students during the COVID-19 Pandemic
by Palmer J. Hernández-Yépez, Carlos O. Muñoz-Pino, Valeria Ayala-Laurel, Pavel J. Contreras-Carmona, Fiorella Inga-Berrospi, Víctor J. Vera-Ponce, Virgilo E. Failoc-Rojas, César Johan Pereira-Victorio and Mario J. Valladares-Garrido
Int. J. Environ. Res. Public Health 2022, 19(21), 14591; https://doi.org/10.3390/ijerph192114591 - 7 Nov 2022
Cited by 13 | Viewed by 3687
Abstract
During the COVID-19 pandemic, university students have adopted measures that completely transformed their educational environment, and this has generated an increase in psychological stress. The present study aimed to identify the factors associated with anxiety, depression, and stress in students at a university [...] Read more.
During the COVID-19 pandemic, university students have adopted measures that completely transformed their educational environment, and this has generated an increase in psychological stress. The present study aimed to identify the factors associated with anxiety, depression, and stress in students at a university in Peru during the COVID-19 pandemic in 2020. We conducted a cross-sectional analytical study in students in Lima, Peru. The DASS-21 scale was used to measure levels of depression, anxiety, and stress and associate it with socio-educational and COVID-19-related variables using generalized linear models with Poisson distribution, log link, and robust variance. Of 400 students surveyed, 19.2%, 23.2% and 17.2% of students presented depression, anxiety, and stress, respectively. The frequency of depression (PR = 0.91, 95%CI: 0.84–0.99), anxiety (PR = 0.90, 95%CI: 0.83–0.99) and stress (PR = 0.92, 95%CI: 0.86–0.99) was lower in women. The students of the engineering and business faculty presented a higher frequency of anxiety (PR = 1.11, 95%CI: 1.00–1.22). There was a greater frequency of presenting anxiety, depression and stress in students who worked in a different area of health or did not work. Our results suggest the importance of promoting mental health awareness campaigns in university students due to the constant academic load they have. Full article
(This article belongs to the Special Issue Emotion Regulation and COVID-Related Stress Management)
10 pages, 366 KiB  
Article
Mindfulness and Defense Mechanisms as Explicit and Implicit Emotion Regulation Strategies against Psychological Distress during Massive Catastrophic Events
by Mariagrazia Di Giuseppe, Graziella Orrù, Angelo Gemignani, Rebecca Ciacchini, Mario Miniati and Ciro Conversano
Int. J. Environ. Res. Public Health 2022, 19(19), 12690; https://doi.org/10.3390/ijerph191912690 - 4 Oct 2022
Cited by 19 | Viewed by 3787
Abstract
Emotion regulation is an important aspect of psychological functioning that influences subjective experience and moderates emotional responses throughout the lifetime. Adaptive responses to stressful life events depend on the positive interaction between explicit and implicit emotion regulation strategies, such as mindfulness and defense [...] Read more.
Emotion regulation is an important aspect of psychological functioning that influences subjective experience and moderates emotional responses throughout the lifetime. Adaptive responses to stressful life events depend on the positive interaction between explicit and implicit emotion regulation strategies, such as mindfulness and defense mechanisms. This study demonstrates how these emotion regulation strategies predict psychological health during the early phase of the COVID-19 pandemic. A convenience sample of 6385 subjects, recruited via snowball sampling on various social media platforms, responded to an online survey assessing psychological reaction to social restrictions imposed to limit the spread of COVID-19 in Italy. Psychological distress, post-traumatic stress symptoms, mindfulness, and defense mechanisms were assessed using SCL-90, IES-R, MAAS, and DMRS-30-SR, respectively. Higher mindfulness was significantly associated with higher overall defensive maturity and a greater use of high-adaptive defenses (p < 0.0001). Both mindfulness and defense mechanisms acted as good predictors of psychological health (R2 = 0.541) and posttraumatic symptoms (R2 = 0.332), confirming the role of emotion regulation in protecting against maladaptive responses to stressful situations. Full article
(This article belongs to the Special Issue Emotion Regulation and COVID-Related Stress Management)
12 pages, 697 KiB  
Article
Cognitive Emotion Regulation Strategies as Mediators between Resilience and Stress during COVID-19 Pandemic
by Andreea Ursu and Cornelia Măirean
Int. J. Environ. Res. Public Health 2022, 19(19), 12631; https://doi.org/10.3390/ijerph191912631 - 3 Oct 2022
Cited by 14 | Viewed by 5229
Abstract
(1) Background: Although there is accumulating evidence for the associations between resilience, emotion regulation and stress, little is known about the mechanisms of these relations. To extend the existing research, the present study examined cognitive emotion regulation strategies as one potential mechanism between [...] Read more.
(1) Background: Although there is accumulating evidence for the associations between resilience, emotion regulation and stress, little is known about the mechanisms of these relations. To extend the existing research, the present study examined cognitive emotion regulation strategies as one potential mechanism between trait resilience and perceived stress during the COVID-19 pandemic. (2) Methods: Young adults (N = 266; M = 20.05; SD = 3.93) were invited to fill out questionnaires that assessed trait resilience, cognitive emotion regulation strategies and perceived stress. (3) Results: The results showed that resilience was negatively associated with perceived stress and with self-blame, catastrophizing and rumination, and positively associated with positive reappraisal, focus on planning, positive refocus and putting into perspective. Stress was positively associated with self-blame, catastrophizing, rumination, other-blame and acceptance, and negatively associated with positive reappraisal and positive refocus. Moreover, positive refocus, rumination, catastrophizing and self-blame partially explained the associations between trait resilience and perceived stress during the COVID-19 pandemic. (4) Conclusions: These findings highlight the potential utility of targeting cognitive emotion regulation strategies in the development and implementation of preventive interventions for reducing stress during highly challenging situations. Full article
(This article belongs to the Special Issue Emotion Regulation and COVID-Related Stress Management)
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16 pages, 856 KiB  
Article
The ‘Myth of Zero-COVID’ Nation: A Digital Ethnography of Expats’ Survival Amid Shanghai Lockdown during the Omicron Variant Outbreak
by Benjamin H. Nam, Hans-Jörg Luitgar Weber, Yuanyuan Liu and Alexander Scott English
Int. J. Environ. Res. Public Health 2022, 19(15), 9047; https://doi.org/10.3390/ijerph19159047 - 25 Jul 2022
Cited by 21 | Viewed by 3444
Abstract
This study presents a digital ethnography of expats’ survival amid the Shanghai lockdown during the Omicron variant outbreak. This study drew insights from studies on resilience and secondary coping within the context of global migration to comprehend the diverse emotional challenges faced by [...] Read more.
This study presents a digital ethnography of expats’ survival amid the Shanghai lockdown during the Omicron variant outbreak. This study drew insights from studies on resilience and secondary coping within the context of global migration to comprehend the diverse emotional challenges faced by expats in a series of lockdowns and persistent nucleic acid amplification tests. Thus, this study asks what the major emotional challenges expats faced and what sources of social support they could draw from citizens in their host country during the Shanghai lockdown. Accordingly, this study collected WeChat group conversations to draw empirical findings, promoted scholarly conversations about fundamental survival necessity, and traced the process for establishing intercultural collective resilience with citizens from their host country. Overall, this study emphasized the significance of host country members who can promote certain coping mechanisms for their visitors in the specific regional and geographical context of China. Full article
(This article belongs to the Special Issue Emotion Regulation and COVID-Related Stress Management)
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13 pages, 523 KiB  
Article
The Impact of COVID-19 on Anxious and Depressive Symptomatology in the Postpartum Period
by Daniela Pereira, Brigite Wildenberg, Andreia Gaspar, Carolina Cabaços, Nuno Madeira, António Macedo and Ana Telma Pereira
Int. J. Environ. Res. Public Health 2022, 19(13), 7833; https://doi.org/10.3390/ijerph19137833 - 26 Jun 2022
Cited by 5 | Viewed by 2339
Abstract
Background: Women in the postpartum period may be particularly vulnerable to the psychological effects of the COVID-19 pandemic. The aim of our study was to evaluate the impact of the coronavirus pandemic on postpartum depression and anxiety levels and the role of the [...] Read more.
Background: Women in the postpartum period may be particularly vulnerable to the psychological effects of the COVID-19 pandemic. The aim of our study was to evaluate the impact of the coronavirus pandemic on postpartum depression and anxiety levels and the role of the fear of COVID-19 in its development. Methods: Women who delivered at the Bissaya Barreto Maternity Hospital, between 16 March and 16 June 2020 (Group 1: Birth in COVID-19 period, n = 207), recruited in the postpartum period, filled in a set of self-reported validated questionnaires: Perinatal Depression Screening Scale, Perinatal Anxiety Screening Scale, Profile of Mood States, Perseverative Thinking Questionnaire, Dysfunctional Beliefs Towards Maternity Scale, and the Fear of COVID-19 Scale. Levels of depressive and anxious symptomatology, negative affect, negative repetitive thinking, and the dysfunctional beliefs towards motherhood of these women were compared with data from samples of previous studies that included women whose delivery had occurred at the same Maternity Hospital before the COVID-19 pandemic period (Group 2: Birth before the COVID-19 period, n = 212). Results: Based on the cutoff points of the screening scales, the prevalence of clinically relevant depressive and anxious symptoms in Group 1 was 40.1% and 36.2%, respectively. Women in Group 1 had significantly higher levels of anxious and depressive symptoms, negative affect, negative repetitive thinking, and dysfunctional beliefs towards motherhood than women in Group 2 (p < 0.05). Fear of COVID-19 in the postpartum period was a predictor of depressive (ß = 0.262) and anxious (ß = 0.371) symptoms, explaining 6.9% and 13.7% of their variability, respectively (p < 0.001). Conclusion: During the COVID-19 pandemic, women in the postpartum period present greater depressive and anxious symptomatology, as well as increased risk factors. Full article
(This article belongs to the Special Issue Emotion Regulation and COVID-Related Stress Management)
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15 pages, 1749 KiB  
Article
The Moderating Effect of Compassionate Mindfulness on the Psychological Needs and Emotions of Generation Y in the 21st Century in Taiwan
by Hui-Li Lin, Fang-Suey Lin, Ling-Chen Liu and Wen-Hsin Liu
Int. J. Environ. Res. Public Health 2022, 19(9), 5458; https://doi.org/10.3390/ijerph19095458 - 29 Apr 2022
Cited by 2 | Viewed by 1935
Abstract
During the 2020 COVID-19 pandemic in Taiwan, 6.5% of Generation Y required medical treatment for emotional and stress-related mental disorders. This study explores the moderating effect of mindfulness training on psychological needs and emotions to propose effective measures to promote the mental health [...] Read more.
During the 2020 COVID-19 pandemic in Taiwan, 6.5% of Generation Y required medical treatment for emotional and stress-related mental disorders. This study explores the moderating effect of mindfulness training on psychological needs and emotions to propose effective measures to promote the mental health of Generation Y. This study was carried out by questionnaire, using the data of respondents born in 1980–1999, collected in three different periods for quantitative analysis with compassionate mindfulness as the main variable. The results show that the compassionate mindfulness effect on emotion regulation varies greatly among different educational levels. However, it still plays a positive role in the psychological needs of Generation Y. Most members of Generation Y who receive compassionate mindfulness training have fewer basic needs and more interpersonal trust. They pay more attention to individual-oriented self-realization. Compassionate mindfulness has a greater positive moderating effect on the mental health of women aged 30–39 and those who are highly educated. Compassionate mindfulness has a more positive moderating effect on the psychological needs of members of Generation Y who were born more recently. During the COVID-19 pandemic, providing compassionate mindfulness has a significant positive effect on the prevention of mental disorders of Generation Y in Taiwan. Full article
(This article belongs to the Special Issue Emotion Regulation and COVID-Related Stress Management)
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10 pages, 328 KiB  
Article
Prevalence of Psychological Distress and Associated Factors in Nursing Students during the COVID-19 Pandemic: A Cross-Sectional Study
by Fumiya Tanji and Yuki Kodama
Int. J. Environ. Res. Public Health 2021, 18(19), 10358; https://doi.org/10.3390/ijerph181910358 - 1 Oct 2021
Cited by 14 | Viewed by 3347
Abstract
Little is known about psychological distress and its associated factors during the COVID-19 pandemic among nursing students, especially during the initial spread. The present study aimed to investigate the prevalence of psychological distress among Japanese nursing students after the first semester of 2020 [...] Read more.
Little is known about psychological distress and its associated factors during the COVID-19 pandemic among nursing students, especially during the initial spread. The present study aimed to investigate the prevalence of psychological distress among Japanese nursing students after the first semester of 2020 with shifted classes and practice online. Furthermore, we examined whether factors such as health issues and resilience were associated with psychological distress. The data were obtained from a cross-sectional, self-administered questionnaire survey at a Japanese nursing college from September to November 2020 (n = 289). We collected data such as sociodemographic variables, medical history, insomnia, and resilience (Bidimensional Resilience Scale). Psychological distress was measured using the K6 scale (scores ≥ 5). The prevalence of psychological distress was 58.5%. The multivariate Poisson regression analysis found a negative association between innate resilience factors, and positive associations between medical history, insomnia, and psychological distress. The present study showed that more than half of the study participants experienced high levels of psychological distress. Our results suggest the importance of monitoring mental health among nursing students, focusing not only on health issues, but also personality components such as innate resilience during the prolonged COVID-19 pandemic. Full article
(This article belongs to the Special Issue Emotion Regulation and COVID-Related Stress Management)
12 pages, 337 KiB  
Article
Stress, Burnout, and Resilience among Healthcare Workers during the COVID-19 Emergency: The Role of Defense Mechanisms
by Mariagrazia Di Giuseppe, Gianni Nepa, Tracy A. Prout, Fabrizio Albertini, Stefano Marcelli, Graziella Orrù and Ciro Conversano
Int. J. Environ. Res. Public Health 2021, 18(10), 5258; https://doi.org/10.3390/ijerph18105258 - 14 May 2021
Cited by 89 | Viewed by 15196
Abstract
The experience of working on the frontlines of the COVID-19 healthcare crisis has presented a cumulative traumatic experience that affects healthcare professionals’ well-being. Psychological resources such as resilience and adaptive defense mechanisms are essential in protecting individuals from severe stress and burnout. During [...] Read more.
The experience of working on the frontlines of the COVID-19 healthcare crisis has presented a cumulative traumatic experience that affects healthcare professionals’ well-being. Psychological resources such as resilience and adaptive defense mechanisms are essential in protecting individuals from severe stress and burnout. During September 2020, 233 healthcare workers responded to an online survey to test the impact of demographic variables, COVID-19 exposure, and psychological resources in determining stress and burnout during the COVID-19 emergency. Frontline workers reported higher scores for stress, emotional exhaustion, and depersonalization (p < 0.001) as compared to colleagues working in units not directly serving patients with COVID-19. Mature defensive functioning was associated with resilience and personal accomplishment (r = 0.320; p < 0.001), while neurotic and immature defenses were related to perceived stress and burnout. Stress and burnout were predicted by lower age, female gender, greater exposure to COVID-19, lower resilience, and immature defensive functioning among healthcare professionals (R2 = 463; p < 0.001). Working on the frontlines of the COVID-19 pandemic appears to provoke greater stress and burnout. On the other hand, resilience and adaptive defense mechanisms predicted better adjustment. Future reaction plans should promote effective programs offering support for healthcare workers who provide direct care to patients with COVID-19. Full article
(This article belongs to the Special Issue Emotion Regulation and COVID-Related Stress Management)
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