Background: The COVID-19 pandemic represents one of the most stressful events of recent times. Among the population, healthcare professionals who treat COVID-19 patients are most likely to develop psychological distress and posttraumatic stress symptoms (PTSS). The present study thus aimed to investigate the psychological impact of the COVID-19 outbreak on Italian healthcare workers. Methods: The responses of 145 healthcare workers (72 medical doctors and 73 nurses) were included in the final dataset. Participants were asked to provide sociodemographic and clinical information, and to complete: (a) quality of life and health-related Visual Analogue Scales, (b) State-Trait Anxiety Inventory-Form Y1, (c) Beck Depression Inventory, and (d) PTSD Checklist for DSM-5. Results: A comparison between healthcare professionals working in COVID-19 wards and other units revealed that the former reported higher levels of both depressive symptoms and PTSS. Moreover, the results of regression analyses showed that in healthcare professionals working with COVID-19 patients, gender and marital status, and gender and age significantly predicted depressive symptoms and PTSS, respectively. Particularly, being female and not in a relationship were found to be associated with higher levels of depressive symptoms, whereas being female and older were found to be related to higher levels of PTSS. Conclusions: The current findings suggest that specific predisposing factors could identify healthcare workers who are at high risk of developing mental health symptoms when faced with COVID-19 patients.

The disease caused by respiratory syndrome coronavirus 2 (SARS-CoV-2) called COVID-19 resulted in a pandemic that has demanded extraordinary physical and mental effort from healthcare workers. This review provides an overview of studies that have explored traumatic stress in healthcare workers and associated factors between January and May 2020. The focus is on the most relevant literature investigating the prevalence of traumaand stressor-related symptoms. Articles were selected from PubMed and PsycINFO databases using the search terms, "healthcare workers," "COVID-19," and "posttraumatic stress" in different combinations and with various synonyms. Among the seven studies that fulfilled our criteria, five assessed traumatic stress response, one assessed acute stress symptoms, and one focused on vicarious traumatization. Overall, the available findings highlight the presence of trauma-related stress, with a prevalence ranging from 7.4 to 35%, particularly among women, nurses, frontline workers, and in workers who experienced physical symptoms. Future studies should clarify the long-term effects of the COVID-19 pandemic on the mental health of healthcare workers, with particular focus on posttraumatic stress disorder.

This a preprint and has not been peer reviewed. Data may be preliminary.

The first case of COVID-19 in Italy emerged at the end of January 2020. 1 Following a series of increasingly severe restrictions, a new decree on March 9, 2020, imposed home lockdown on the entire nation. 2 The COVID-19 outbreak, similarly to previous epidemics, can trigger psychological disorders such as anxiety, depression, and post-traumatic stress disorder (PTSD) in exposed individuals in the short as well as in the long-term. 3 This study aimed to investigate the prevalence of posttraumatic stress symptoms (PTSS) in the general Italian population and to explore the variables such as sociodemographic features, COVID-19-related aspects, quality of life, and health-related aspects that could predict the likelihood of PTSS occurrence. Moreover, anxiety and depressive symptoms, often observed in people exposed to highly stressful events, were evaluated. Data were collected using an anonymous online survey from March 19, 2020, to April 5, 2020. A snowball sampling strategy was employed, wherein the participants were initially recruited via online advertisements and were encouraged to pass the survey link to others. Responses of 1,321 participants were included in the final data set. Participants were asked to provide sociodemographic information and complete (1) COVID-19-related questions, (2) quality of life and health-related visual analogue scales, (3) State-Trait Anxiety Inventory-Form Y1, (4) Beck Depression Inventory (BDI-II), and (5) PTSD Checklist for DSM-5 (PCL-5) in order to assess PTSS. This study was approved by the University of Turin ethics committee and was conducted in accordance with the Declaration of Helsinki. All participants provided written informed consent. The total sample had a mean age of 35.1 (SD 14) years; 69% (922) of participants were females, and 71% (933) were from Northern Italy. Most of the participants had a degree or

This study examined the relationships between posttraumatic growth (PTG) and posttraumatic depreciation (PTD) across 10 countries and assessed the factorial invariance of the standardized inventory assessing PTG and PTD, the PTGDI-X, the expansion of the PTGI-X (Tedeschi et al., 2017). We also investigated the roles of social and cognitive factors in PTG and PTD. Data were collected from participants who identified that their most stressful life experience met the definition of trauma in Australia,

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Background: Post-traumatic growth (PTG) is considered a positive outcome of struggling with a traumatic event, distinct, and opposite from negative outcomes, i.e., psychological distress. The present study aimed to shed light on the relationship between potentially relating factors (i.e., coping strategies, perceived social support, and attachment style) and both positive and negative psychological outcomes. Methods: A total of 123 breast cancer survivors were recruited, who completed a battery of self-report questionnaires, assessing PTG, psychological distress, coping strategies, perceived social support, and attachment style. Three regression analyses were run to evaluate whether relating factors were significant predictors of the positive and negative psychological outcomes. Results: The regression analyses showed that the “Fatalism” coping strategy and perceived social support were two significant predictors of PTG. Instead, the “Helpless-Hopeless” and “Anxious Preoccupation” coping strategies, as well as an insecure attachment style, were significant predictors of depression, while the “Anxious Preoccupation” coping strategy and an insecure attachment style were significant predictors of anxiety. Conclusions: The present findings showed that the factors underlying a positive or negative outcome are different and specific. While perceived social support and a fatalistic attitude seem to play a key role in the positive outcome, dysfunctional coping strategies, together with an insecure attachment style, appear to be related with negative psychological outcome. Considering these factors in clinical practice would help patients to give meaning to their traumatic experience, enhancing psychological growth.

Pain in fibromyalgia (FM) is accompanied by a heterogeneous series of other symptoms, which strongly affect patients’ quality of life and interfere with social and work performance. The present study aimed to evaluate the effects of alexithymia on both the physical and the psychosocial components of the health-related quality of life (HRQoL) of FM patients, controlling for the concomitant effects of depression, anxiety, and pain. In particular, given the strong interconnection between depression and alexithymia, the relationship between alexithymia and HRQoL as mediated by depressive symptoms was further investigated. Data were collected on a consecutive sample of 205 female patients with a main diagnosis of FM. The results showed that about 26% of the patients showed the presence of alexithymia, as assessed by the Toronto Alexithymia Scale (TAS-20). Clinically relevant levels of depressive and anxiety symptoms were present in 61 and 60% of the patients, respectively. The results of the hierarchical multiple regression analyses showed that pain intensity (PI) and depressive symptoms explained the 45% of the variance of the physical component of HRQoL (p < 0.001). Regarding the mental component of HRQoL, depressive and anxiety symptoms, alexithymia, and PI significantly explained 61% of the variance (p < 0.001). The mediation analyses confirmed that alexithymia had a direct effect on the mental component of HRQoL and showed a statistically significant indirect effect on both the physical and the mental components, through the mediation of depressive symptoms. In conclusion, the results of the present study suggested the presence of both a direct and an indirect effect of alexithymia, in particular of the difficulty identifying feeling, on the HRQoL of patients with FM. Indeed, even though the concomitant presence of depressive symptoms is responsible of an indirect effect, alexithymia per se seems to directly contribute to worsen the impact that this chronic pain pathology has on the patients’ quality of life, especially regarding the psychosocial functioning.