Published online Aug 19, 2022. doi: 10.5498/wjp.v12.i8.1088
Peer-review started: March 20, 2022
First decision: May 30, 2022
Revised: June 13, 2022
Accepted: July 16, 2022
Article in press: July 16, 2022
Published online: August 19, 2022
Processing time: 150 Days and 21.9 Hours
There is mounting empirical evidence of the detrimental effects of the coronavirus disease 2019 (COVID-19) outbreak on mental health. Previous research has underscored the effects of similar destabilizing situations such as war, natural disasters or other pandemics on acute stress levels which have been shown to exacerbate current and future psychopathological symptoms.
To explore the role of acute stress responses (intrusive, avoidance and hyper
A sample of 439 participants from a university community in Spain (age: mean ± SD: 36.64 ± 13.37; 73.1% females) completed several measures assessing their fear of COVID-19, acute stress responses and emotional dysfunction syndromes through an online survey. Data collection was carried out from the start of home confinement in Spain until May 4, 2020, coinciding with initial de-escalation measures. Processing of the dataset included descriptive and frequency analyses, Mann-Whitney U Test of intergroup comparisons and path analysis for direct and indirect effects. This is an observational, descriptive-correlational and cross-sectional study.
The prevalence of clinical symptoms in our sample, reported since the beginning of the pandemic, reached 31.44%. The female group presented higher scores although the effect size was small. Overall, the participants who exceeded the clinical cut-off points in emotional problems showed higher levels of fear of COVID-19 and of cognitive, motor and psychophysiological responses of acute stress, unlike the group with normative scores. In addition, the results show significant mediated effects of hyperarousal stress among fear of COVID-19 and emotional dysfunction psychopathology. However, the clinical syndromes most related to the consequences of the pandemic (e.g., social contact avoidance or frequent hand washing), such as agoraphobia and obsessive-compulsive symptoms, were in fact predicted directly by fear of COVID-19 and/or the acute stress response associated with the pandemic and had a greater predictive power.
The present study illustrates a clearer picture of the role of acute stress on several forms of psychopathology during the COVID-19 crisis and home confinement.
Core Tip: This study provides the prevalence of emotional dysfunction which reached 30% during the confinement stage in Spain. Our results point to higher levels of fear of coronavirus disease 2019 (COVID-19) and acute stress in participants with purely clinical symptoms compared with the normative group. We found clinically relevant associations between emotional dysfunction, fear of COVID-19 and acute stress. The mediated role of a psychophysiological activation response to explain indirect effects from fear of COVID-19 on various clinical syndromes is emphasized. These results support the need to include a therapeutic component of acute stress management in prevention and psychological intervention strategies in the face of exceptional events of a traumatic nature.