Resilience Contributes to Low Emotional Impact of the COVID-19 Outbreak Among the General Population in Italy

Abstract

Background The COVID-19 outbreak is severely affecting the overall mental health with unknown psychological consequences. Although a strong psychological impact is possible, scant evidence is available to date. Past studies have shown that resilience decreases the negative effects of stress. This study aimed to examine depression, anxiety, and stress among the Italian general population during the phase characterized by lockdown, and to investigate the role of resilience as a potential predictor. Methods A total sample of 6,314 Italian people participated in this study. Participants were recruited between March 29 and May 04 2020 through an online survey. The Depression Anxiety Stress Scales-21 (DASS-21) and the Resilience Scale (RS) were administered. Demographic data and lockdown related information were also collected. A correlational analysis was carried out to examine relationships between psychopathological domains and resilience. Three hierarchical regression analyses were conducted using the depression, anxiety, and stress as dependent variables and the resilience as independent variable controlling for age, gender, and education. COVID-19 specific variables were also included in the three regression analyses. A further exploratory analysis was carried out to examine which aspects of resilience predict depression, anxiety, and stress. Results The prevalence of moderate to extremely severe symptoms among participants was 32% for depression, 24.4% for anxiety, and 31.7% for stress. The sample mean scores on depression, anxiety, and stress were higher than the normal scores reported in the literature. Results of correlational analysis showed that resilience factors, such as meaningfulness, self-reliance, existential aloneness, and equanimity, are inversely associated with depression, anxiety, and stress. Results of regression analyses indicated that resilience was statically significant in predicting depression, anxiety, and stress. Geographic area of residence and infected acquaintances were also significant predictors. Regarding the resilience factors, results revealed that meaningfulness, perseverance, and equanimity were statistically significant in predicting all the DASS-21 scales. Conclusion About a third of respondents reported moderate to extremely severe depression, anxiety, and stress. The present study suggests that psychological resilience may independently contribute to low emotional distress and psychological ill-being. These findings can help explain the variability of individual responses during the COVID-19 outbreak.

Psychological outcomes after hospitalization for COVID-19: data from a multidisciplinary follow-up screening program for recovered patients

“…Referring to past outbreaks, a worse psychological impact was associated with younger age (Brooks et al ., 2020 ), as younger people were found to be particularly vulnerable and cope less well with the consequences of an epidemic (Taylor, Agho, Stevens & Raphael, 2008 ). Similar findings were found in the general population in Italy (Lenzo et al , 2020 ; Mazza et al , 2020 ). It could be hypothesized that younger patients may think of themselves as invulnerable and did not expect the disease, with a consequent shock and a severe impact on anxiety symptoms.…”

“…Similar high prevalence of anxiety, depression, posttraumatic stress, were found in the general population in Italy (Franceschini et al , 2020 ; Lenzo et al , 2020 ; Mazza et al , 2020 ; Rossi et al , 2020 ). For example, Lenzo and colleagues ( 2020 ) reported an overall prevalence of moderate- to-extremely severe anxiety, depression, and stress among general population during the lockdown (24.4%, 32%, and 31.7% respectively). Preliminary studies on patients diagnosed with COVID-19 highlighted their risk of developing psychopathologies (Tomasoni et al , 2020 ; Bo et al , 2020 ), as they may have experienced the disease and the hospitalization as traumatic events.…”

“…lockdown, stay-at-home orders, and physical distancing) was necessary to reduce the spread of the virus and to alleviate the pressure on the health care system (Remuzzi & Remuzzi, 2020 ). Some studies have highlighted the psychological strain caused by the pandemic among the general population in Italy, reporting high or very high levels of distress, fear of being infected, anxiety and depression (Franceschini et al , 2020 ; Lenzo et al , 2020 ; Mazza et al , 2020 ; Rossi et al , 2020 ).…”

Expressive Flexibility and Dispositional Optimism Contribute to the Elderly’s Resilience and Health-Related Quality of Life during the COVID-19 Pandemic

“…Psychological resilience consists of the positive strength to overcome and adapt to difficulties or stressful situations; additionally, it is proved to be a relevant factor able to contribute to reduce emotional distress and to improve psychological wellbeing during the COVID-19 outbreak [ 30 , 31 ]. Previous studies on elderly subjects have highlighted that high levels of psychological resilience predict better psychological wellbeing, improve social relationships and favor health-oriented behaviors [ 15 ].…”

“…The COVID-19 pandemic has severely affected the HRQoL of people worldwide, including Italy [ 30 , 31 ]; in this emergency, the elderly were denoted as one of the most vulnerable populations. In line with these theoretical conceptualizations, we might hypothesize that dispositional optimism and expressive flexibility might differently contribute to the HRQoL of elderly subjects, jointly with common age-related clinical factors such as cognitive status and frailty.…”