Trauma-spectrum symptoms among the Italian general population in the time of the COVID-19 outbreak

Abstract

Background: Recent evidence showed adverse mental health outcomes associated with the COVID-19 pandemic, including trauma-related symptoms. The Global Psychotrauma Screen (GPS) is a brief instrument designed to assess a broad range of trauma-related symptoms with no available validation in the Italian population. Aims: This study aimed to examine the factor structure of the Italian version of the GPS in a general population sample exposed to the COVID-19 pandemic and to evaluate traumarelated symptoms in the context of COVID-19 related risk factors associated with lockdown measures. Methods: We conducted a cross-sectional web-based observational study as part of a longterm monitoring programme of mental health outcomes in the general population. Eighteen thousand one hundred forty-seven participants completed a self-report online questionnaire to collect key demographic data and evaluate trauma-related symptoms using the GPS, PHQ-9, GAD-7, ISI, and PSS. Validation analyses included both exploratory and confirmatory factor analysis and correlation analyses. The relation with putative COVID-19 related risk factors was explored by multivariate regression analysis. Results: Exploratory factor analyses supported a two-factor model. Confirmatory factor analysis showed that the best fitting model was a three-factor solution, with core Posttraumatic Stress Symptoms (PTSS) (re-experiencing, avoidance, hyperarousal), Negative Affect (symptoms of depressed mood, anxiety, irritability), and Dissociative symptoms. GPS Risk factors and specific COVID-19 related stressful events were associated with GPS total and the three factor scores. Conclusions: Our data suggest that a wide range of trauma-spectrum symptoms were reported by a large Italian sample during the COVID-19 pandemic. The GPS symptoms clustered best in three factors: Negative Affect symptoms, Core PTSS, and Dissociative symptoms. In particular, high rates of core PTSS and negative affect symptoms were associated with the COVID-19 pandemic in Italy and should be routinely assessed in clinical practice. Síntomas del espectro traumático en la población general italiana en el tiempo del brote de COVID-19Antecedentes: Evidencias recientes revelaron resultados adversos para la salud mental asociados con la pandemia de COVID-19, incluyendo síntomas relacionados con el trauma. El Mapeo Global de Psicotrauma (GPS, en sus siglas en inglés) es un breve instrumento diseñado para evaluar una amplia gama de síntomas relacionados con el trauma, sin validación disponible en la población italiana. Objetivos: El objetivo de este estudio fue examinar la estructura de factores de la versión italiana del GPS en una muestra de la población general expuesta a la pandemia de COVID-19 y evaluar los síntomas relacionados con el trauma en el contexto de los factores de riesgo relacionados con COVID-19 asociados con las medidas de confinamiento. Métodos: Realizamos un estudio observacional transversal basado en la web como parte de un programa de vigilancia a largo plazo de los resultados de ...

COVID-19: An Urgency to Address Mental Health Consequences

“…Most studies about trauma-spectrum symptoms of COVID-19 involved the general population (Karatzias et al, 2020;Hyland et al, 2020;Rodriguez-Rey et al, 2020;Rossi et al, 2021), which appeared under a high risk of suffering from stress-related disorders, depression, and anxiety during the lockdown. In essence, the COVID-19 risk factors upon people's mental health could be summarise as follow: first, the lockdown status imposed upon the entire population in particular country or area, mandatory being under quarantine or self-isolated had a significant impact on people's mental health.…”

“…Some working activities and employments were discontinued which some employees saw similar as being fired at work. (Rossi et al, 2021) reports different (multiple) mental health outcomes on general population due to lockdown: 23% reported symptoms of adjustment disorder, 37% reported PTSD, 22% high perceived stress, 21% anxiety, and 17% depression. In the survey based on self-report assessment, the majority of respondents (75.8%, n = 1320) indicated that the COVID-19 pandemic was a stressful event for them.…”

“…Studies (Karatzias et al, 2020;Rossi et al, 2021) also found that, due to COVID-19, alongside the classic PTSD core symptoms (hyperarousal, re-experiencing, and avoidance), people also suffer the Disturbances in Self-Organisation (DSO):…”

“…The sole focus on physical health should be overcome by including impact upon mental health with the short-and long-term effects of the COVID-19 pandemic. This is in particular as studies (Hyland et al, 2020;Javakhishvili et al, 2020;Karatzias et al, 2020;Rossi et al, 2021) suggest that within a substantial proportion of the younger population the COVID-19 pandemic leads to the mental health problems (depression, anxiety, stress-related issues, withdrawal, aggressiveness), which require long-term strategy to deal with.…”

Semantic adaptation of the Global Psychotrauma Screen for children and adolescents in the United States

“…By adapting the GPS (Olff et al, 2020a ), as opposed to creating new instruments, we aimed to provide a tool for longitudinal screening of the symptom dynamics and treatment outcomes as children grow, and cross-sectional screening of symptoms of intergenerational trauma in families who live in chronically traumatic contexts. The GPS has a potential for a more comprehensive screening of trauma because in addition to PTSD, it includes Disturbances in Self-Organization (DSO) as part of Complex PTSD, the symptoms of anxiety, depression, sleep problems, self-harm, dissociation, other physical, emotional, and social problems, substance abuse, the risk and protective factors, and functioning (Frewen, McPhail, Schnyder, Oe, & Olff, 2021 ; Oe et al, 2020 ; Olff et al, 2020b ; Rossi et al, 2021 ).…”