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References

ORIGINAL RESEARCH ARTICLE


Front. Psychol., 21 October 2020 | https://doi.org/10.3389/fpsyg.2020.561536

https://www.frontiersin.org/articles/10.3389/
fpsyg.2020.561536/full
Ahorsu, D. K., Lin, C. Y., Imani, V., Saffari, M., Griffiths, M. D., and Pakpour,
A. H. (2020). The fear of COVID-19 scale: development and initial
validation. Int. J. Ment. Health Addict. 27, 1–9. doi: 10.1007/s11469-020-
00270278

CrossRef Full Text | Google Scholar

Aydın, E. (2020). Effect of Perfectionism, Social Competence and


Psychological Well-Being on Physical Activity of Students. Afr. Educat. Res.
J. 8, 90–95. doi: 10.30918/AERJ.81.20.020

CrossRef Full Text | Google Scholar

Banerjee, D. (2020). The other side of COVID-19: impact on obsessive


compulsive disorder (OCD) and hoarding. Psych. Res. 288:112966. doi:
10.1016/j.psychres.2020.112966

PubMed Abstract | CrossRef Full Text | Google Scholar

Berking, M., Neacsiu, A., Comtois, K. A., and Linehan, M. M. (2009). The
impact of experiential avoidance on the reduction of depression in treatment
for borderline personality disorder. Behav. Res. Ther. 47, 663–670. doi:
10.1016/j.brat.2009.04.011

PubMed Abstract | CrossRef Full Text | Google Scholar

Bond, F. W., Hayes, S. C., and Barnes-Holmes, D. (2006). Psychological


flexibility, ACT, and organizational behavior. J. Organizat. Behav. Manag. 26,
25–54. doi: 10.1300/j075v26n01_02
CrossRef Full Text | Google Scholar

Briggs, E. S., and Price, I. R. (2009). The relationship between adverse


childhood experience and obsessive-compulsive symptoms and beliefs: the
role of anxiety, depression, and experiential avoidance. J. Anx. Disor. 23,
1037–1046. doi: 10.1016/j.janxdis.2009.07.004

PubMed Abstract | CrossRef Full Text | Google Scholar

Brooks, S. K., Amlôt, R., Rubin, G. J., and Greenberg, N. (2020a).


Psychological resilience and post-traumatic growth in disaster-exposed
organisations: overview of the literature. BMJ Milit. Health 166, 52–56. doi:
10.1136/jramc-2017-000876

PubMed Abstract | CrossRef Full Text | Google Scholar

Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, S.,
Greenberg, N., et al. (2020b). The psychological impact of quarantine and how
to reduce it: rapid review of the evidence. Lancet 395, 912–920. doi:
10.1016/S0140-6736(20)3046030468

CrossRef Full Text | Google Scholar

Brown, T. A., Chorpita, B. F., Korotitsch, W., and Barlow, D. H. (1997).


Psychometric properties of the Depression Anxiety Stress Scales (DASS) in
clinical samples. Behav. Res. Ther. 35, 79–89. doi: 10.1016/s0005-
7967(96)00068-x

CrossRef Full Text | Google Scholar

Cribb, G., Moulds, M. L., and Carter, S. (2006). Rumination and experiential
avoidance in depression. Behav. Change 23, 165–176. doi:
10.1375/bech.23.3.165

PubMed Abstract | CrossRef Full Text | Google Scholar


Dalrymple, K. L., and Herbert, J. D. (2007). Acceptance and commitment
therapy for generalized social anxiety disorder. A pilot study. Behav.
Modificat. 31, 543–568. doi: 10.1177/0145445507302037

PubMed Abstract | CrossRef Full Text | Google Scholar

Deci, E. L., and Ryan, R. M. (2000). The “what” and “why” of goal pursuits:
human needs and the self-determination of behavior. Psychol. Inq. 11, 227–
268. doi: 10.1207/s15327965pli1104_01

CrossRef Full Text | Google Scholar

Doğan, T. (2015). Kısa psikolojik sağlamlık ölçeği’nin Türkçe uyarlaması:


geçerlik ve güvenirlik çalışması. J. Happiness Well Being 3, 93–102.

Google Scholar

Earvolino-Ramirez, M. (2007). Resilience: A concept analysis. In Nursing


forum, Vol. 42. Malden, USA: Blackwell Publishing Inc, 73–82.

Google Scholar

Ekşi, H., Kaya, Ç, and Kuşcu, B. (2018). Multıdımensıonal experıentıal


avoıdance questıonnaıre-30: adaptatıon and psychometrıc propertıes of the
Turkısh versıon. Annual Congress: ICRE. 483–487. Available online
at: https://www.academia.edu/37852402/Çok_Boyutlu_Yaşantısal_Kaçınma
_Ölçeği0_un_Türkçeye_uyarlanması_ve_psikometrik_Özellikleri_Multidim
ensional_Experiential_Avoidance_Questionnaire30_Adaptation_and_Psych
ometric_Properties_of_the_Turkish (accessed May 10, 2020).

Google Scholar

Garcia, R. (2017). Neurobiology of fear and specific phobias. Learn. Mem. 24,


462–471. doi: 10.1101/lm.044115.116

PubMed Abstract | CrossRef Full Text | Google Scholar


Greenberg, N., Docherty, M., Gnanapragasam, S., and Wessely, S. (2020).
Managing mental health challenges faced by healthcare workers during covid-
19 pandemic. BMJ 368:m1211. doi: 10.1136/bmj.m1211

PubMed Abstract | CrossRef Full Text | Google Scholar

Hayes, S. C., Strosahl, K. D., and Wilson, K. G. (2012). Acceptance and


commitment therapy: the process and practice of mindful change. New York:
Guilford Press.

Google Scholar

Hayes, S. C., Wilson, K. W., Gifford, E. V., Follette, V. M., and Strosahl, K.
(1996). Experiential avoidance and behavioral disorders: a functional
dimensional approach to diagnosis and treatment. J. Consul. Clin.
Psychol. 64, 1152–1168. doi: 10.1037/0022-006X.64.6.1152

PubMed Abstract | CrossRef Full Text | Google Scholar

Kashdan, T. B., and Rottenberg, J. (2010). Psychological flexibility as a


fundamental aspect of health. Clin. Psychol. Rev. 30, 865–878. doi:
10.1016/j.cpr.2010.03.001

PubMed Abstract | CrossRef Full Text | Google Scholar

Lovibond, P. F., and Lovibond, S. H. (1995). The structure of negative


emotional states: Comparison of the Depression Anxiety Stress Scales (DASS)
with the Beck Depression and Anxiety Inventories. Behav. Res. Ther. 33, 335–
343. doi: 10.1016/0005-7967(94)00075-u

CrossRef Full Text | Google Scholar

Luthans, F., Avey, J. B., Avolio, B. J., Norman, S. M., and Combs, G. M.
(2006). Psychological capital development: toward a micro-intervention. J.
Organizat. Behav. 27, 387–393. doi: 10.1002/job.373

CrossRef Full Text | Google Scholar


Machell, K. A., Goodman, F. R., and Kashdan, T. B. (2015). Experiential
avoidance and well-being: a daily diary analysis. Cogn. Emot. 29, 351–359.
doi: 10.1080/02699931.2014.911143

PubMed Abstract | CrossRef Full Text | Google Scholar

Mahaffey, B. L., Wheaton, M. G., Fabricant, L. E., Berman, N. C., and


Abramowitz, J. S. (2013). The contribution of experiential avoidance and
social cognitions in the prediction of social anxiety. Behav. Cogn.
Psychother. 41, 52–65. doi: 10.1017/S1352465812000367

PubMed Abstract | CrossRef Full Text | Google Scholar

Orcutt, H. K., Pickett, S., and Pope, E. (2005). Experiential avoidance and
forgiveness as mediators in the relation between traumatic life events and
PTSD symptoms. J. Soc. Clin. Psychol. 24, 1003–1029. doi:
10.1521/jscp.2005.24.7.1003

CrossRef Full Text | Google Scholar

Ornell, F., Schuch, J. B., Sordi, A. O., and Kessler, F. H. P. (2020). “Pandemic
fear” and COVID-19: mental health burden and strategies. Brazil. J. Psych. 42,
232–235. doi: 10.1590/1516-4446-20202028

CrossRef Full Text | Google Scholar

Ottenbreit, N. D., and Dobson, K. S. (2004). Avoidance and depression: the


construction of the cognitive-behavioral avoidance scale. Behav. Res. Ther. 42,
293–313. doi: 10.1016/S0005-7967(03)00140142

CrossRef Full Text | Google Scholar

Öz, P., and Yılmaz, E. B. (2009). A Significant Concept in Protecting Mental


Health: Resilience. Hacet. Unive. Facul. Health Sci. Nurs. J. 16, 82–89.

Google Scholar
Park, S. C., and Park, Y. C. (2020). Mental health care measures in response to
the 2019 novel coronavirus outbreak in Korea. Psych. Investig. 17, 85–86. doi:
10.30773/pi.2020.0058

PubMed Abstract | CrossRef Full Text | Google Scholar

Rawal, A., Park, R. J., and Williams, J. M. G. (2010). Rumination, experiential


avoidance, and dysfunctional thinking in eating disorders. Behav. Res.
Ther. 48, 851–859. doi: 10.1016/j.brat.2010.05.009

PubMed Abstract | CrossRef Full Text | Google Scholar

Reardon, S. (2015). Ebola’s mental-health wounds linger in


Africa. Nature 519, 13–15. doi: 10.1038/519013a

PubMed Abstract | CrossRef Full Text | Google Scholar

Rüsch, N., Schiel, S., Corrigan, P. W., Leihener, F., Jacob, G. A., and
Olschewski, M. (2008). Predictors of dropout from inpatient dialectical
behavior therpay among women with borderline personality disorder. J.
Behav. Ther. Exper. Psych. 39, 497–503. doi: 10.1016/j.jbtep.2007.11.006

PubMed Abstract | CrossRef Full Text | Google Scholar

Sahdra, B. K., Ciarrochi, J., Parker, P., and Scrucca, L. (2016). Using genetic
algorithms in a large nationally representative American sample to abbreviate
the Multidimensional Experiential Avoidance Questionnaire. Front.
Psychol. 7:189. doi: 10.3389/fpsyg.2016.00189

PubMed Abstract | CrossRef Full Text | Google Scholar

Santanello, A. W., and Gardner, F. L. (2007). The role of experiential


avoidance in the relationship between maladaptive perfectionism and
worry. Cogn. Ther. Res. 30, 319–332. doi: 10.1007/s10608-006-90009006

CrossRef Full Text | Google Scholar


Satici, B., Gocet-Tekin, E., Deniz, M. E., and Satici, S. A. (2020). Adaptation of
the Fear of COVID-19 Scale: its association with psychological distress and life
satisfaction in Turkey. Int. J. Ment. Health Addict. 2020, 1–9. doi:
10.1007/s11469-020-00294-0

PubMed Abstract | CrossRef Full Text | Google Scholar

Schumacker, R. E., and Lomax, R. G. (2004). A Beginner’s Guide to Structural


Equation Modeling, 2nd Edn. East Sussex: Psychology Press.

Google Scholar

Schwartz, D. A., and Graham, A. L. (2020). Potential maternal and infant


outcomes from (Wuhan) coronavirus 2019-nCoV infecting pregnant women:
lessons from SARS, MERS, and other human coronavirus
infections. Viruses 12:194. doi: 10.3390/v12020194

PubMed Abstract | CrossRef Full Text | Google Scholar

Seçer, İ (2015). Practical data analysis with SPSS and LISREL. Ankara: Anı


Press.

Google Scholar

Seçer, İ, and Ulaş, S. (2020a). The Mediator Role of Academic Resilience in


the Relationship of Anxiety Sensitivity, Social and Adaptive Functioning, and
School Refusal With School Attachment in High School Students. Front.
Psychol. 11:557. doi: 10.3389/fpsyg.2020.00557

PubMed Abstract | CrossRef Full Text | Google Scholar

Seçer, İ, and Ulaş, S. (2020b). An Investigation of the Effect of COVID-19 on


OCD in Youth in the Context of Emotional Reactivity, Experiential Avoidance,
Depression and Anxiety. Int. J. Ment. Health Addict. 13, 1–14. doi:
10.1007/s11469-020-00322-z

PubMed Abstract | CrossRef Full Text | Google Scholar


Shigemura, J., Ursano, R. J., Morganstein, J. C., Kurosawa, M., and Benedek,
D. M. (2020). Public responses to the novel 2019 coronavirus (2019-nCoV) in
Japan: mental health consequences and target populations. Psych. Clin.
Neurosci. 74, 281–282. doi: 10.1111/pcn.12988

PubMed Abstract | CrossRef Full Text | Google Scholar

Shin, L. M., and Liberzon, I. (2010). The neurocircuitry of fear, stress, and
anxiety disorders. Neuropsychopharmacology 35, 169–191. doi:
10.1038/npp.2009.83

PubMed Abstract | CrossRef Full Text | Google Scholar

Shultz, J. M., Cooper, J. L., Baingana, F., Oquendo, M. A., Espinel, Z.,
Althouse, B. M., et al. (2016). The role of fear-related behaviors in the 2013-
2016 West Africa Ebola virus disease outbreak. Curr. Psych. Rep. 18:104. doi:
10.1007/s11920-016-0741-y

PubMed Abstract | CrossRef Full Text | Google Scholar

Smith, B. W., Dalen, J., Wiggins, K., Tooley, E., Christopher, P., and Bernard,
J. (2008). The brief resilience scale: assessing the ability to bounce back. Int.
J. Behav. Med. 15, 194–200. doi: 10.1080/10705500802222972

CrossRef Full Text | Google Scholar

Tabachnick, B., and Fidell, L. (2013). Using multivariate statistics, 6th Edn.


Boston: Pearson.

Google Scholar

Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., et al. (2020). Immediate
psychological responses and associated factors during the initial stage of the
2019 coronavirus disease (covid-19) epidemic among the general population
in China. Int. J. Environ. Res. Publ. Health 17, 1729. doi:
10.3390/ijerph17051729
PubMed Abstract | CrossRef Full Text | Google Scholar

World Health Organization [WHO] (2020). Coronavirus disease (COVID-


2019): Situation report-54. Available online
at: https://www.who.int/docs/default-source/coronaviruse/situation-
reports/20200314-sitrep-54-covid-19.pdf?sfvrsndcd46351_2.2 (accessed May
5, 2020).

Google Scholar

Xiang, Y. T., Yang, Y., Li, W., Zhang, L., Zhang, Q., Cheung, T., et al. (2020).
Timely mental health care for the 2019 novel coronavirus outbreak is urgently
needed. Lancet Psych. 7, 228–229. doi: 10.1016/S2215-0366(20)30046-8

CrossRef Full Text | Google Scholar

Yılmaz, O., Boz, H., and Arslan, A. (2017). The validity and reliability of
depression stress and anxiety scale (DASS-21) Turkish short form. Res.
Financ. Econom. Soc. Stud. 2, 78–91.

Google Scholar
Keywords: fear of COVID-19, psychological adjustment, experiential avoidance, psychological
resilience, healthcare professionals
Citation: Seçer İ, Ulaş S and Karaman-Özlü Z (2020) The Effect of the Fear of COVID-19 on
Healthcare Professionals’ Psychological Adjustment Skills: Mediating Role of Experiential
Avoidance and Psychological Resilience. Front. Psychol. 11:561536. doi:
10.3389/fpsyg.2020.561536
Received: 12 May 2020; Accepted: 23 September 2020;
Published: 21 October 2020.
Edited by:
Eduardo Salas, Rice University, United States
Reviewed by:
Beth Milliard, York Regional Police, Canada
Paula Odriozola-González, University of Valladolid, Spain
https://www.frontiersin.org/articles/10.3389/fpsyg.2020.02065/full
BRIEF RESEARCH REPORT ARTICLE
Front. Psychol., 13 August 2020 | https://doi.org/10.3389/fpsyg.2020.02065

References
Agrigoroaei, S., and Lachman, M. E. (2010). “Personal control and aging: how
beliefs and expectations matter,” in Praeger Perspectives. Aging in America,
Vol. 1, eds J. C. Cavanaugh, and R. West (Santa Barbara, CA: Praeger) 177–201

Google Scholar

Aspinwall, L. G., Sechrist, G. B., and Jones, P. R. (2005). Expect the best and
prepare for the worst: anticipatory coping and preparations for Y2K. Motiv.
Emot. 29, 353–384. doi: 10.1007/s11031-006-9008-y

CrossRef Full Text | Google Scholar

Aspinwall, L. G., and Taylor, S. E. (1997). A stitch in time: self-regulation and


proactive coping. Psychol. Bull. 121, 417–436. doi: 10.1037/0033-
2909.121.3.417

PubMed Abstract | CrossRef Full Text | Google Scholar

Bai, Y., Lin, C. C., Lin, C. Y., Chen, J. Y., Chue, C. M., and Chou, P. (2004).
Survey of stress reactions among health care workers involved with the SARS
outbreak. Psychiatr. Serv. 55, 1055–1057. doi: 10.1176/appi.ps.55.9.1055

PubMed Abstract | CrossRef Full Text | Google Scholar

Bandura, A. (1977). Self-efficacy: toward a unifying theory of behavioral


change. Psychol. Rev. 84, 191–215. doi: 10.1037/0033-295X.84.2.191

PubMed Abstract | CrossRef Full Text | Google Scholar

Bokszczanin, A. (2012). Social support provided by adolescents following a


disaster and perceived social support, sense of community at school, and
proactive coping. Anxiety Stress Coping 25, 575–592. doi:
10.1080/10615806.2011.622374
PubMed Abstract | CrossRef Full Text | Google Scholar

Cameron, S. J., Armstrong-Stassen, M., Orr, R. R., and Loukas, A. (1991).


Stress, coping, and resources in mothers of adults with developmental
disabilities. Couns. Psychol. Q. 4, 301–310. doi: 10.1080/09515079108254438

CrossRef Full Text | Google Scholar

Centers for Disease Control (2020). Characteristics of health care personnel


with COVID-19 — United States, February 12–April 9. MMWR Morb. Mortal.
Wkly. Rep. 69, 477–481. doi: 10.15585/mmwr.mm6915e6

CrossRef Full Text | Google Scholar

Chen, Q., Liang, M., Li, Y., Guo, J., Fei, D., Wang, L., et al. (2020). Mental
health care for medical staff in China during the COVID-19 outbreak. Lancet
Psychiatry 7, e15–e16. doi: 10.1016/S2215-0366(20)30078-X

CrossRef Full Text | Google Scholar

Chew, N. W., Lee, G. K., Tan, B. Y., Jing, M., Goh, Y., Ngiam, N. J., et al.
(2020). A multinational, multicentre study on the psychological outcomes and
associated physical symptoms amongst healthcare workers during COVID-19
outbreak. Brain Behav. Immun. 88, 559–565. doi: 10.1016/j.bbi.2020.04.049

PubMed Abstract | CrossRef Full Text | Google Scholar

Cruz, J. P., Cabrera, D. N., Hufana, O. D., Alquwez, N., and Almazan, J.
(2018). Optimism, proactive coping and quality of life among nurses: a cross-
sectional study. J. Clin. Nur. 27, 2098–2108. doi: 10.1111/jocn.14363

PubMed Abstract | CrossRef Full Text | Google Scholar

De Raedt, R., and Hooley, J. M. (2016). The role of expectancy and proactive
control in stress regulation: a neurocognitive framework for regulation
expectation. Clin. Psychol. Rev. 45, 45–55. doi: 10.1016/j.cpr.2016.03.005

PubMed Abstract | CrossRef Full Text | Google Scholar


Dyrbye, L. N., West, C. P., Satele, D., Boone, S., Tan, L., Sloan, J., et al. (2014).
Burnout among US medical students, residents, and early career physicians
relative to the general US population. Acad. Med. 89, 443–451. doi:
10.1097/ACM.0000000000000134

PubMed Abstract | CrossRef Full Text | Google Scholar

Godderis, L., Boone, A., and Bakusic, J. (2020). COVID-19: a new work-
related disease threatening healthcare workers. Occup. Med. 70, 315–316. doi:
10.1093/occmed/kqaa056

PubMed Abstract | CrossRef Full Text | Google Scholar

Gold, J. A. (2020). Covid-19: adverse mental health outcomes for healthcare


workers. BMJ. 5:m1815. doi: 10.1136/bmj.m1815

PubMed Abstract | CrossRef Full Text | Google Scholar

Goulia, P., Mantas, C., Dimitroula, D., Mantis, D., and Hyphantis, T. (2010).
General hospital staff worries, perceived sufficiency of information and
associated psychological distress during the A/H1N1 influenza
pandemic. BMC Infect. Dis. 10:322. doi: 10.1186/1471-2334-10-322

PubMed Abstract | CrossRef Full Text | Google Scholar

Greenberg, N., Docherty, M., Gnanapragasam, S., and Wessely, S. (2020).


Managing mental health challenges faced by healthcare workers during covid-
19 pandemic. BMJ. 26:m1211. doi: 10.1136/bmj.m1211

PubMed Abstract | CrossRef Full Text | Google Scholar

Greenglass, E., Fiksenbaum, L., and Eaton, J. (2006). The relationship


between coping, social support, functional disability and depression in the
elderly. Anxiety Stress Coping 19, 15–31. doi: 10.1080/14659890500436430

CrossRef Full Text | Google Scholar


Guerin, J. M., Copersino, M. L., and Schretlen, D. J. (2018). Clinical utility of
the 15-item geriatric depression scale (GDS-15) for use with young and
middle-aged adults. J. Affect. Disord. 1, 59–62. doi: 10.1016/j.jad.2018.07.038

PubMed Abstract | CrossRef Full Text | Google Scholar

Johnston, D., Bell, C., Jones, M., Farquharson, B., Allan, J., Schofield, P., et al.
(2016). Stressors, appraisal of stressors, experienced stress and cardiac
response: a real-time, real-life investigation of work stress in nurses. Ann.
Behav. Med. 50, 187–197. doi: 10.1007/s12160-015-9746-8

PubMed Abstract | CrossRef Full Text | Google Scholar

Kang, L., Li, Y., Hu, S., Chen, M., Yang, C., Yang, B. X., et al. (2020). The
mental health of medical workers in Wuhan, China dealing with the 2019
novel coronavirus. Lancet Psychiatry. 7:e14. doi: 10.1016/S2215-
0366(20)30047-X

CrossRef Full Text | Google Scholar

Kumar, S. (2016). Burnout and doctors: prevalence, prevention and


intervention. Healthcare 4:37. doi: 10.3390/healthcare4030037

PubMed Abstract | CrossRef Full Text | Google Scholar

Lachman, M. E., and Firth, K. M. (2004). The Adaptive Value of Feeling in


Control during Midlife. Chicago, III: University of Chicago Press.

Google Scholar

Lachman, M. E., and Weaver, S. L. (1998a). Sociodemographic variations in


the sense of control by domain: findings from the MacArthur studies of
midlife. Psychol. Aging 13, 553–562. doi: 10.1037/0882-7974.13.4.553

PubMed Abstract | CrossRef Full Text | Google Scholar


Lachman, M. E., and Weaver, S. L. (1998b). The sense of control as a
moderator of social class differences in health and well-being. J. Pers. Soc.
Psychol. 74, 763–773. doi: 10.1037/0022-3514.74.3.763

PubMed Abstract | CrossRef Full Text | Google Scholar

Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., et al. (2020). Factors
associated with mental health outcomes among health care workers exposed
to coronavirus disease 2019. JAMA Netw. Open 3:e203976. doi:
10.1001/jamanetworkopen.2020.3976

PubMed Abstract | CrossRef Full Text | Google Scholar

Lazarus, R. S. (2006). A New Synthesis: Stress and Emotion. New York, NY:


Springer Publishing Company.

Google Scholar

Lee, A. M., Wong, J. G., McAlonan, G. M., Cheung, V., Cheung, C., Sham, P. C.,
et al. (2007). Stress and psychological distress among SARS survivors 1 year
after the outbreak. Canad. J. Psychiatry 52, 233–240. doi:
10.1177/070674370705200405

PubMed Abstract | CrossRef Full Text | Google Scholar

Liu, S., Yang, L., Zhang, C., Xiang, Y. T., Liu, Z., Hu, S., et al. (2020). Online
mental health services in China during the COVID-19 outbreak. Lancet
Psychiatry 7, e17–e18. doi: 10.1016/S2215-0366(20)30077-8

CrossRef Full Text | Google Scholar

Maunder, R., Hunter, J., Vincent, L., Bennett, J., Peladeau, N., Leszcz, M., et
al. (2003). The immediate psychological and occupational impact of the 2003
SARS outbreak in a teaching hospital. CMAJ 168, 1245–1251.

Google Scholar
Maunder, R. G., Lancee, W. J., Balderson, K. E., Bennett, J. P., Borgundvaag,
B., Evans, S., et al. (2006). Long-term psychological and occupational effects
of providing hospital healthcare during SARS outbreak. Emerg. Infect. Dis. 12,
1924–1932. doi: 10.3201/eid1212.060584

PubMed Abstract | CrossRef Full Text | Google Scholar

Miao, M., Zheng, L., and Gan, Y. (2017). Meaning in life promotes proactive
coping via positive affect: a daily diary study. J. Happiness Stud. 18, 1683–
1696. doi: 10.1007/s10902-016-9791-4

CrossRef Full Text | Google Scholar

Musliner, K. L., Munk-Olsen, T., Laursen, T. M., Eaton, W. W., Zandi, P. P.,
and Mortensen, P. B. (2016). Heterogeneity in 10-year course trajectories of
moderate to severe major depressive disorder: a danish national register-
based study. JAMA Psychiatry 1, 346–353.

Google Scholar

Neupert, S. D., Almeida, D. M., and Charles, S. T. (2007). Age differences in


reactivity to daily stressors: the role of personal control. J. Gerontol. Ser. B
Psychol. Sci. Soc. Sci. 62, 216–225. doi: 10.1093/geronb/62.4.P216

PubMed Abstract | CrossRef Full Text | Google Scholar

Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., and
Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia
among healthcare workers during the COVID-19 pandemic: a systematic
review and meta-analysis. Brain Behav. Immun. 88, 901–907. doi:
10.1016/j.bbi.2020.05.026

PubMed Abstract | CrossRef Full Text | Google Scholar

Pearlin, L. I., and Schooler, C. (1978). The structure of coping. J. Health Soc.
Behav. 19, 2–21. doi: 10.2307/2136319
CrossRef Full Text | Google Scholar

Pearman, A., Hughes, M. L., Smith, E. L., and Neupert, S. D. (2020). Age
differences in risk and resilience factors in COVID-19-related stress. J.
Gerontol. B Psychol. Sci. Soc. Sci. doi: 10.1093/geronb/gbaa120 [Epub ahead
of print].

CrossRef Full Text | Google Scholar

Polk, M. G., Smith, E. L., Zhang, L. R., and Neupert, S. D. (2020). Thinking
ahead and staying in the present: implications for reactivity to daily
stressors. Pers. Individ. Differ. 15:109971. doi: 10.1016/j.paid.2020.109971

CrossRef Full Text | Google Scholar

Rajkumar, R. P. (2020). COVID-19 and mental health: a review of the existing


literature. Asian J. Psychiatr. 10:102066. doi: 10.1016/j.ajp.2020.102066

PubMed Abstract | CrossRef Full Text | Google Scholar

Sareen, J., Cox, B. J., Afifi, T. O., de Graaf, R., Asmundson, G. J., ten Have, M.,
et al. (2005). Anxiety disorders and risk for suicidal ideation and suicide
attempts: a population-based longitudinal study of adults. Arch. Gen.
Psychiatr. 62, 1249–1257. doi: 10.1001/archpsyc.62.11.1249

PubMed Abstract | CrossRef Full Text | Google Scholar

Shanafelt, T., Ripp, J., and Trockel, M. (2020). Understanding and addressing
sources of anxiety among health care professionals during the COVID-19
pandemic. JAMA 323, 2133–2134. doi: 10.1001/jama.2020.5893

PubMed Abstract | CrossRef Full Text | Google Scholar

Shechter, A., Diaz, F., Moise, N., Anstey, D. E., Ye, S., Agarwal, S., et al.
(2020). Psychological distress, coping behaviors, and preferences for support
among New York healthcare workers during the COVID-19 pandemic. Gen.
Hosp. Psychiatry 66, 1–8. doi: 10.1016/j.genhosppsych.2020.06.007
PubMed Abstract | CrossRef Full Text | Google Scholar

Smereka, J., and Szarpak, L. (2020). COVID 19 a challenge for emergency


medicine and every health care professional. Am. J. Emerg. Med. doi:
10.1016/j.ajem.2020.03.038 Online ahead of print

PubMed Abstract | CrossRef Full Text | Google Scholar

Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., and Jacobs, G. A.
(1983). Manual for the State-Trait Anxiety Inventory. Palo Alto, CA:
Consulting Psychologists Press.

Google Scholar

Stauder, A., Cserháti, Z., and Thege, B. K. (2018). Decreasing the negative
effects of work-related stress in unchanged working environments. Eur. J.
Ment. Health. 13, 163–183. doi: 10.5708/EJMH.13.2018.2.4

CrossRef Full Text | Google Scholar

Stauder, A., Nistor, K., Zakor, T., Szabó, A., Nistor, A., Ádám, S., et al. (2017).
Quantifying multiple work-related psychosocial risk factors: proposal for a
composite indicator based on the COPSOQ II. Int. J. Behav. Med. 24, 915–
926. doi: 10.1007/s12529-017-9651-6

PubMed Abstract | CrossRef Full Text | Google Scholar

The Lancet (2020). COVID-19: protecting health-care


workers. Lancet 395:922. doi: 10.1016/S0140-6736(20)30644-9

CrossRef Full Text | Google Scholar

Vernon, L. L., Dillon, J. M., and Steiner, A. R. (2009). Proactive coping,


gratitude, and posttraumatic stress disorder in college women. Anxiety Stress
Coping 22, 117–127. doi: 10.1080/10615800802203751

PubMed Abstract | CrossRef Full Text | Google Scholar


World Health Organization (2020). Coronavirus disease (COVID-19)
Situation Report 115. Available online at: https://www.who.int/docs/default-
source/coronaviruse/situation-reports/20200514-covid-19-sitrep-115.pdf?
sfvrsn=3fce8d3c_6 (accessed June 15, 2020)

Google Scholar

Yates, M. E., Tennstedt, S., and Chang, B. H. (1999). Contributors to and


mediators of psychological well-being for informal caregivers. J. Gerontol. Ser.
B Psychol. Sci. Soc. Sci. 54, 12–22. doi: 10.1093/geronb/54B.1.P12

PubMed Abstract | CrossRef Full Text | Google Scholar

Yesavage, J. A. (1988). Geriatric depression scale. Psychopharmacol. Bull. 24,


709–711.

Google Scholar
Keywords: health care professionals, pandemic (COVID-19), stress and coping, depression,
anxiety
Citation: Pearman A, Hughes ML, Smith EL and Neupert SD (2020) Mental Health Challenges
of United States Healthcare Professionals During COVID-19. Front. Psychol. 11:2065. doi:
10.3389/fpsyg.2020.02065
Received: 13 May 2020; Accepted: 27 July 2020;
Published: 13 August 2020.
Edited by:
Andrew E. P. Mitchell, University of Chester, United Kingdom
Reviewed by:
Stefano Eleuteri, Sapienza University of Rome, Italy
Reina Granados, University of Granada, Spain
Lennart Reifels, The University of Melbourne, Australia

References
Adriaenssens, J., de Gucht, V., and Maes, S. (2012). The impact of traumatic
events on emergency room nurses: findings from a questionnaire survey. Int.
J. Nurs. Stud. 49, 1411–1422. doi: 10.1016/j.ijnurstu.2012.07.003

PubMed Abstract | CrossRef Full Text | Google Scholar


Aisling, M., Aisling, D., and David, C. (2016). An assessment of psychological
need in emergency medical staff in the Northern Health and Social Care Trust
Area. Ulster Med. J. 85, 92–98.

Google Scholar

American Psychiatric Association (2013). Diagnostic and Statistical Manual


of Mental Disorders (DSM-5). Washington, DC: American Psychiatric
Association.

Google Scholar

Argentero, P., and Setti, I. (2011). Engagement and vicarious traumatization in


rescue workers. Int. Arch. Occup. Environ. Health 84, 67–75. doi:
10.1007/s00420-010-0601-8

PubMed Abstract | CrossRef Full Text | Google Scholar

Bandura, A. (1997). Self-Efficacy: The Exercise of Control. New York, NY: W.


H. Freeman.

Google Scholar

Barleycorn, D. (2019). Awareness of secondary traumatic stress in emergency


nursing. Emerg. Nurse 27, 19–22. doi: 10.7748/en.2019.e1957

PubMed Abstract | CrossRef Full Text | Google Scholar

Beck, C. (2011). Secondary traumatic stress in nurses: a systematic


review. Arch. Psychiatr. Nurs. 25, 1–10. doi: 10.1016/j.apnu.2010.05.005

PubMed Abstract | CrossRef Full Text | Google Scholar

Bellelli, G., and Di Schiena, R. (2012). Emozioni e Decisioni. Come la


Psicologia Spiega il Conflitto tra Ragione e Sentiment. Bologna: IL Mulino.

Google Scholar
Benight, C. C., and Harper, M. L. (2002). Coping self-efficacy perceptions as a
mediator between acute stress response and long-term distress following
natural disasters. J. Trauma Stress 15, 177–186. doi:
10.1023/A:1015295025950

CrossRef Full Text | Google Scholar

Birinci, G. G., and Erden, G. (2016). Yardım çalışanlarında üstlenilmiş travma,


ikincil travmatik stres ve tükenmişliğin değerlendirilmesi [Evaluation of
vicarious trauma, secondary traumatic stress and burnout in aid
workers]. Turk. J. Psychol. 31, 10–26.

Google Scholar

Bohlken, J., Schömig, F., Lemke, M. R., Pumberger, M., and Riedel-Heller, S.
G. (2020). COVID-19-Pandemie: belastungen des medizinischen Personals
[COVID-19 pandemic: stress experience of healthcare workers – a short
current review]. Psychiatr. Prax. 47, 190–197. doi: 10.1055/a-1159-5551

PubMed Abstract | CrossRef Full Text | Google Scholar

Bosmans, G., Hofland, H. W., De Jong, A. E., and Van Loey, N. E. (2015).
Coping with burns: the role of coping self-efficacy in the recovery from
traumatic stress following burn injuries. J. Behav. Med. 38, 642–651. doi:
10.1007/s10865-015-9638-1

PubMed Abstract | CrossRef Full Text | Google Scholar

Brown, J., Mulhern, G., and Joseph, S. A. (2002). Incident-related stressors,


locus of control, coping, and psychological distress among firefighters in
Northern Ireland. J. Trauma Stress 15, 161–168. doi:
10.1023/A:1014816309959

CrossRef Full Text | Google Scholar

Cai, H., Tu, B., Ma, J., Chen, L., Fu, L., Jiang, Y., et al. (2020). Psychological
impact and coping strategies of frontline medical staff in Hunan between
January and March 2020 during the outbreak of coronavirus disease 2019
(COVID-19) in Hubei, China. Med. Sci. Monit. 26, e924171-1–e924171-16. doi:
10.12659/MSM.924171

PubMed Abstract | CrossRef Full Text | Google Scholar

Chamberlin, M. J. A., and Green, H. J. (2010). Stress and coping strategies


among firefighters and recruits. J. Loss Trauma 15, 548–560. doi:
10.1080/15325024.2010.519275

CrossRef Full Text | Google Scholar

Chan, A. O., and Huak, C. Y. (2004). Psychological impact of the 2003 severe
acute respiratory syndrome outbreak on healthcare workers in a medium size
regional general hospital in Singapore. Occup. Med. 54, 190–196. doi:
10.1093/occmed/kqh027

PubMed Abstract | CrossRef Full Text | Google Scholar

Chang, C. M., Lee, L. C., Connor, K. M., Davidson, J. R. T., Jeffries, K., and
Lai, T. J. (2003). Posttraumatic distress and coping strategies among rescue
workers after an earthquake. J. Nerv. Ment. Dis. 191, 391–398. doi:
10.1097/01.nmd.0000071588.73571.3d

CrossRef Full Text | Google Scholar

Chesney, M. A., Neilands, T. B., Chambers, D. B., Taylor, J. M., and Folkman,
S. (2006). A validity and reliability study of the coping self-efficacy scale. Br.
J. Health Psychol. 11, 421–437. doi: 10.1348/135910705X53155

PubMed Abstract | CrossRef Full Text | Google Scholar

Coetzee, S. K., and Klopper, H. C. (2010). Compassion fatigue within nursing


practice: a concept analysis. Nurs. Health Sci. 12, 235–243. doi:
10.1111/j.1442-2018.2010.00526.x

PubMed Abstract | CrossRef Full Text | Google Scholar


Connor-Smith, J. K., and Flachsbart, C. (2007). Relations between personality
and coping: a meta-analysis. J. Pers. Soc. Psychol. 93, 1080–1107. doi:
10.1037/0022-3514.93.6.1080

PubMed Abstract | CrossRef Full Text | Google Scholar

Del Missier, F., Bonini, N., and Rumiati, R. (2008). Psicologia del Giudizio e
Della Decisione. Bologna: IL Mulino.

Google Scholar

Dominguez-Gomez, E., and Rutledge, D. N. (2009). Prevalence of secondary


traumatic stress among emergency nurses. J. Emerg. Nurs. 35, 199–204. doi:
10.1016/j.jen.2008.05.003

PubMed Abstract | CrossRef Full Text | Google Scholar

Du, J., Dong, L., Wang, T., Yuan, C., Fu, R., Zhang, L., et al. (2020).
Psychological symptoms among frontline healthcare workers during COVID-
19 outbreak in Wuhan. Gen. Hosp. Psychiatry doi:
10.1016/j.genhosppsych.2020.03.011 [Epub ahead of print].

CrossRef Full Text | PubMed Abstract | Google Scholar

Duffy, E., Avalos, G., and Dowling, M. (2015). Secondary traumatic stress
among emergency nurses: a cross-sectional study. Int. Emerg. Nurs. 23, 53–
58. doi: 10.1016/j.ienj.2014.05.001

PubMed Abstract | CrossRef Full Text | Google Scholar

El-Hage, W., Hingray, C., Lemogne, C., Yrondi, A., Brunault, P., Bienvenu, T.,
et al. (2020). Health professionals facing the coronavirus disease 2019
(COVID-19) pandemic: what are the mental health risks? Encephale 46, S73–
S80. doi: 10.1016/j.encep.2020.04.008

PubMed Abstract | CrossRef Full Text | Google Scholar

Favretto, G. (2005). Le Forme del Mobbing. Milano: Raffaello Cortina.


Google Scholar

Figley, C. R. (1995). “Compassion fatigue as secondary traumatic stress


disorder: an overview,” in Compassion Fatigue: Coping with Secondary
Traumatic Stress Disorder in Those Who Treat the Traumatized, ed. C. R.
Figley (New York, NY: Brunner-Routledge), 1–20. doi:
10.1097/njh.0000000000000126

CrossRef Full Text | Google Scholar

Fraccaroli, F., and Balducci, C. (2011). Stress e Rischi Psicosociali Nelle


Organizzazioni. Bologna: IL Mulino.

Google Scholar

Fullerton, C. S., Ursano, R. J., and Wang, L. (2004). Acute stress disorder,
posttraumatic stress disorder, and depression in disaster or rescue
workers. Am. J. Psychiatry 161, 1370–1376. doi: 10.1176/appi.ajp.161.8.1370

PubMed Abstract | CrossRef Full Text | Google Scholar

Howlett, M., Doody, K., Murray, J., LeBlanc-Duchin, D., Fraser, J., and
Atkinson, P. R. (2015). Burnout in emergency department healthcare
professionals is associated with coping style: a cross-sectional survey. Emerg.
Med. J. 32, 722–727. doi: 10.1136/emermed-2014-203750

PubMed Abstract | CrossRef Full Text | Google Scholar

Huang, L., Xu, F. M., and Liu, H. (2020). Emotional responses and coping
strategies of nurses and nursing college students during COVID-19
outbreak. MedRxiv [Preprint] doi: 10.1101/2020.03.05.20031898

CrossRef Full Text | Google Scholar

Huang, J. Z., Han, M. F., Luo, T. D., Ren, A. K., and Zhou, X. P. (2020).
Mental health survey of medical staff in a tertiary infectious disease hospital
for COVID-19. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 38, 192–
195. doi: 10.3760/cma.j.cn121094-20200219-00063

PubMed Abstract | CrossRef Full Text | Google Scholar

Kerai, S. M., Khan, R., Islam, M., Asad, N., Razzak, J., and Pasha, O. (2017).
Post-traumatic stress disorder and its predictors in emergency medical service
personnel: a cross-sectional study from Karachi, Pakistan. BMC Emerg.
Med. 17:26. doi: 10.1186/s12873-017-0140-7

PubMed Abstract | CrossRef Full Text | Google Scholar

Khalid, I., Khalid, T. J., Qabajah, M. R., Barnard, A. G., and Qushmaq, I. A.
(2016). Healthcare workers emotions, perceived stressors and coping
strategies during a MERS-CoV outbreak. Clin. Med. Res. 14, 7–14. doi:
10.3121/cmr.2016.1303

PubMed Abstract | CrossRef Full Text | Google Scholar

Kucmin, T., Kucmin, A., Turska, D., Turski, A., and Nogalski, A. (2018).
Coping styles and dispositional optimism as predictors of post-traumatic
stress disorder (PTSD) symptoms intensity in paramedics. Psychiatr. Pol. 52,
557–571. doi: 10.12740/PP/68514

PubMed Abstract | CrossRef Full Text | Google Scholar

Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., et al. (2020). Factors
associated with mental health outcomes among healthcare workers exposed to
coronavirus disease 2019. JAMA Netw. Open 3:e203976. doi:
10.1001/jamanetworkopen.2020.3976

PubMed Abstract | CrossRef Full Text | Google Scholar

Lazarus, R. S., and Folkman, S. (1984). Stress, Appraisal, and Coping. New


York, NY: Springer.

Google Scholar
Lee, S. M., Kang, W. S., Cho, A. R., Kim, T., and Park, J. K. (2018).
Psychological impact of the 2015 MERS outbreak on hospital workers and
quarantined hemodialysis patients. Comp. Psychiatry 87, 123–127. doi:
10.1016/j.comppsych.2018.10.003

PubMed Abstract | CrossRef Full Text | Google Scholar

Li, L., Ai, H., Gao, L., Zhou, H., Liu, X., Zhang, Z., et al. (2017). Moderating
effects of coping on work stress and job performance for nurses in tertiary
hospitals: a cross-sectional survey in China. BMC Health Serv. Res. 17:401.
doi: 10.1186/s12913-017-2348-3

PubMed Abstract | CrossRef Full Text | Google Scholar

Li, Z., Ge, J., Yang, M., Feng, J., Qiao, M., Jiang, R., et al. (2020). Vicarious
traumatization in the general public, members, and non-members of medical
teams aiding in COVID-19 control. Brain Behav. Immun. 88, 916–919. doi:
10.1016/j.bbi.2020.03.007

PubMed Abstract | CrossRef Full Text | Google Scholar

Loo, G. T., DiMaggio, C. J., Gershon, R. R., Canton, D. B., Morse, S. S., and
Galea, S. (2016). Coping behavior and risk of post-traumatic stress disorder
among federal disaster responders. Disaster Med. Public Health Prep. 10,
108–117. doi: 10.1017/dmp.2015.141

PubMed Abstract | CrossRef Full Text | Google Scholar

Matud, M. P. (2004). Gender differences in stress and coping styles. Pers.


Individ. Dif. 37, 1401–1415. doi: 10.1016/j.paid.2004.01.010

CrossRef Full Text | Google Scholar

Matud, M. P., Bethencourt, J. M., and Ibáñez, I. (2015). Gender differences in


psychological distress in Spain. Int. J. Soc. Psychiatry 61, 560–568. doi:
10.1177/0020764014564801
PubMed Abstract | CrossRef Full Text | Google Scholar

Matud, M. P., and Garcia, M. C. (2019). Psychological distress and social


functioning in elderly Spanish people: a gender analysis. Int. J. Environ. Res.
Public Health 16:341. doi: 10.3390/ijerph16030341

PubMed Abstract | CrossRef Full Text | Google Scholar

Maunder, R. G., Lancee, W. J., Balderson, K. E., Bennett, J. P., Borgundvaag,


B., Evans, S., et al. (2006). Long-term psychological and occupational effects
of providing hospital healthcare during SARS outbreak. Emerg. Infect. Dis. 12,
1924–1932. doi: 10.3201/eid1212.060584

PubMed Abstract | CrossRef Full Text | Google Scholar

Mealer, M., and Jones, J. (2013). Posttraumatic stress disorder in the nursing
population: a concept analysis. Nurs. Forum 48, 279–288. doi:
10.1111/nuf.12045

PubMed Abstract | CrossRef Full Text | Google Scholar

Missouridou, E. (2017). Secondary posttraumatic stress and nurses’ emotional


responses to patient’s trauma. J. Trauma Nurs. 24, 110–115. doi:
10.1097/JTN.0000000000000274

PubMed Abstract | CrossRef Full Text | Google Scholar

Morrison, L. E., and Joy, J. P. (2016). Secondary traumatic stress in the


emergency department. J. Adv. Nurs. 72, 2894–2906. doi: 10.1111/jan.13030

PubMed Abstract | CrossRef Full Text | Google Scholar

Nydegger, R., Nydegger, L., and Basile, F. (2011). Post-traumatic stress


disorder and coping among career professional firefighters. Am. J. Health
Sci. 2, 11–20. doi: 10.19030/ajhs.v2i1.4365

CrossRef Full Text | Google Scholar


Oh, N., Hong, N., Ryu, D. H., Bae, S. G., Kam, S., and Kim, K. Y. (2017).
Exploring nursing intention, stress, and professionalism in response to
infectious disease emergencies: the experience of local public hospital nurses
during the 2015 MERS outbreak in South Korea. Asian Nurs. Res. 11, 230–
236. doi: 10.1016/j.anr.2017.08.005

PubMed Abstract | CrossRef Full Text | Google Scholar

Ornell, F., Halpern, S. C., Kessler, F. H. P., and Narvaez, J. C. (2020). The
impact of the COVID-19 pandemic on the mental health of healthcare
professionals. Cad. Saúde Pública 36:e00063520. doi: 10.1590/0102-
311x00063520

PubMed Abstract | CrossRef Full Text | Google Scholar

Ozbay, F., Johnson, D. C., Dimoulas, E., Morgan, C. A., Charney, D., and
Southwick, S. (2007). Social support and resilience to stress: from
neurobiology to clinical practice. Psychiatry 4, 35–40.

Google Scholar

Park, C. L., Folkman, S., and Bostrom, A. (2001). Appraisals of controllability


and coping in caregivers and HIV+ men: testing the goodness-of-fit
hypothesis. J. Consult. Clin. Psychol. 69, 481–488. doi: 10.1037/0022-
006X.69.3.481

PubMed Abstract | CrossRef Full Text | Google Scholar

Placentino, A., and Scarcella, C. (2001). Risorse Umane ed Emergenza di


Massa. Processi di Aiuto e di Auto Aiuto. Firenze: Cesvot.

Google Scholar

Roden-Foreman, J. W., Bennett, M. M., Rainey, E. E., Garrett, J. S., Powers,


M. B., and Warren, A. M. (2017). Secondary traumatic stress in emergency
medicine clinicians. Cogn. Behav. Ther. 46, 522–532. doi:
10.1080/16506073.2017.1315612
PubMed Abstract | CrossRef Full Text | Google Scholar

Rodríguez-Rey, R., Palacios, A., Alonso-Tapia, J., Pérez, E., Álvarez, E., Coca,
A., et al. (2019). Burnout and posttraumatic stress in paediatric critical care
personnel: prediction from resilience and coping styles. Aust. Crit. Care 32,
46–53. doi: 10.1016/j.aucc.2018.02.003

PubMed Abstract | CrossRef Full Text | Google Scholar

Sakuma, A., Takahashi, Y., Ueda, I., Sato, H., Katsura, M., Abe, M., et al.
(2015). Post-traumatic stress disorder and depression prevalence and
associated risk factors among local disaster relief and reconstruction workers
fourteen months after the Great East Japan Earthquake: a cross-sectional
study. BMC Psychiatry 15:58. doi: 10.1186/s12888-015-0440-y

PubMed Abstract | CrossRef Full Text | Google Scholar

Sasangohar, F., Jones, S. L., Masud, F. N., Vahidy, F. S., and Kash, B. A.
(2020). Provider burnout and fatigue during the COVID-19 pandemic: lessons
learned from a high-volume intensive care unit. Anesth. Analg. 131, 106–111.
doi: 10.1213/ANE.0000000000004866

PubMed Abstract | CrossRef Full Text | Google Scholar

Sbattella, F. (2009). Manuale di Psicologia Dell’emergenza. Milano: Franco


Angeli.

Google Scholar

Setti, I., and Argentero, P. (2012). Vicarious trauma: a contribution to the


Italian adaptation of the Secondary Traumatic Stress Scale in a sample of
ambulance operators. Appl. Psychol. Bull. 264, 58–64.

Google Scholar
Shin, H., Park, Y. M., Ying, J. Y., Kim, B., Noh, H., and Lee, S. M. (2014).
Relationships between coping strategies and burnout symptoms: a meta-
analytic approach. Prof. Psychol. 45, 44–56. doi: 10.1037/a0035220

CrossRef Full Text | Google Scholar

Simione, L., and Gnagnarella, C. (2020). Differences between health workers


and general population in risk perception, behaviors, and psychological
distress related to COVID-19 spread in Italy. PsyArXiv [Preprint] doi:
10.31234/osf.io/84d2c

CrossRef Full Text | Google Scholar

Slottje, P., Huizink, A. C., Twisk, J. W., Witteveen, A. B., Van der Ploeg, H. M.,
Bramsen, I., et al. (2005). Epidemiological study air disaster in Amsterdam
(ESADA): study design. BMC Public Health 5:54. doi: 10.1186/1471-2458-5-54

PubMed Abstract | CrossRef Full Text | Google Scholar

Spoorthy, M. S. (2020). Mental health problems faced by healthcare workers


due to the COVID-19 pandemic: a review. Asian J. Psychiatr. 51:102119. doi:
10.1016/j.ajp.2020.102119

PubMed Abstract | CrossRef Full Text | Google Scholar

Strentz, T., and Auerbach, S. M. (1988). Adjustment to the stress of simulated


captivity: effects of emotion-focused versus problem-focused preparation on
hostages differing in locus of control. J. Pers. Soc. Psychol. 55, 652–660. doi:
10.1037/0022-3514.55.4.652

PubMed Abstract | CrossRef Full Text | Google Scholar

Tan, B. Y., Chew, N. W., Lee, G. K., Jing, M., Goh, Y., Yeo, L. L., et al. (2020).
Psychological impact of the COVID-19 pandemic on healthcare workers in
Singapore. Ann. Intern. Med. doi: 10.7326/M20-1083 [Epub ahead of print].

CrossRef Full Text | PubMed Abstract | Google Scholar


Theleritis, C., Psarros, C., Mantonakis, L., Roukas, D., Papaioannou, A.,
Paparrigopoulos, T., et al. (2020). Coping and its relation to PTSD in Greek
firefighters. J. Nerv. Ment. Dis. 208, 252–259. doi:
10.1097/NMD.0000000000001103

PubMed Abstract | CrossRef Full Text | Google Scholar

Vagni, M., Maiorano, T., Giostra, V., and Pajardi, D. (2020). Hardiness, stress
and secondary trauma in Italian healthcare and emergency workers during the
COVID-19 pandemic. Sustainability 12:5592. doi: 10.3390/su12145592

CrossRef Full Text | Google Scholar

Vitaliano, P. P., DeWolfe, D. J., Maiuro, R. D., Russo, J., and Katon, W.
(1990). Appraised changeability of a stressor as a modifier of the relationship
between coping and depression: a test of the hypothesis of fit. J. Pers. Soc.
Psychol. 59, 582–592. doi: 10.1037/0022-3514.59.3.582

PubMed Abstract | CrossRef Full Text | Google Scholar

Walton, M., Murray, E., and Christian, M. D. (2020). Mental health care for
medical staff and affiliated healthcare workers during the COVID-19
pandemic. Eur. Heart J. Acute Cardiovasc. Care 9, 241–247. doi:
10.1177/2048872620922795

PubMed Abstract | CrossRef Full Text | Google Scholar

Watson, R., Deary, I., Thompson, D., and Li, G. (2008). A study of stress and
burnout in nursing students in Hong Kong: a questionnaire survey. Int. J.
Nurs. Stud. 45, 1534–1542. doi: 10.1016/j.ijnurstu.2007.11.003

PubMed Abstract | CrossRef Full Text | Google Scholar

Witt, M., Stelcer, B., and Czarnecka-Iwańczuk, M. (2018). Stress coping styles
in firemen exposed to severe stress. Psychiatr. Pol. 52, 543–555. doi:
10.12740/PP/73837
PubMed Abstract | CrossRef Full Text | Google Scholar

Wolf, L. A., Pechats, C., Delao, A. M., Moon, M. D., Clark, P. R., and Zavotsky,
K. E. (2016). “It’s a burden you carry”: describing moral distress in emergency
nursing. J. Emerg. Nurs. 42, 37–46. doi: 10.1016/j.jen.2015.08.008

PubMed Abstract | CrossRef Full Text | Google Scholar

Wong, T. W., Yau, J. K., Chan, C. L., Kwong, R. S., Ho, S. M., Lau, C. C., et al.
(2005). The psychological impact of severe acute respiratory syndrome
outbreak on healthcare workers in emergency departments and how they
cope. Eur. J. Emerg. Med. 12, 13–18. doi: 10.1097/00063110-200502000-
00005

PubMed Abstract | CrossRef Full Text | Google Scholar

World Health Organization (2020). COVID-19 Preparedness and Response


Progress Report 1 February to 30 June 2020. Available online
at: https://www.who.int/publications/i/item/strategic-preparedness-and-
response-plan-for-the-new-coronavirus (accessed July 15, 2020).

Google Scholar

Xiao, H., Zhang, Y., Kong, D., Li, S., and Yang, N. (2020). The effects of social
support on sleep quality of medical staff treating patients with coronavirus
disease 2019 (COVID-19) in January and February 2020 in China. Med. Sci.
Monit. 26:e923549. doi: 10.12659/MSM.923549

PubMed Abstract | CrossRef Full Text | Google Scholar

Young, P. M., Partington, S., Wetherell, M. A., St Clair Gibson, A., and
Partington, E. (2014). Stressors and coping strategies of U.K. firefighters
during on-duty incidents. Stress Health 30, 366–376. doi: 10.1002/smi.261

CrossRef Full Text | Google Scholar


Zhu, Z., Xu, S., Wang, H., Liu, Z., Wu, J., Li, G., et al. (2020). COVID-19 in
Wuhan: immediate psychological impact on 5062 health workers. Medrxiv
[Preprint] doi: 10.1101/2020.02.20.20025338

CrossRef Full Text | Google Scholar


Keywords: COVID-19, stress, secondary trauma, healthcare workers, self-efficacy, coping
Citation: Vagni M, Maiorano T, Giostra V and Pajardi D (2020) Coping With COVID-19:
Emergency Stress, Secondary Trauma and Self-Efficacy in Healthcare and Emergency Workers
in Italy. Front. Psychol. 11:566912. doi: 10.3389/fpsyg.2020.566912
Received: 29 May 2020; Accepted: 13 August 2020;
Published: 03 September 2020.
Edited by:
Andrew E. P. Mitchell, University of Chester, United Kingdom
Reviewed by:
Beth Milliard, York Regional Police, Canada
Atreyee Bhattacharyya, University of Haifa, Israel
Emanuele Maria Giusti, Catholic University of the Sacred Heart, Italy

https://www.frontiersin.org/articles/10.3389/fpsyg.2020.566912/full
ORIGINAL RESEARCH ARTICLE
Front. Psychol., 03 September 2020 | https://doi.org/10.3389/fpsyg.2020.566912

Coping With COVID-19:


Emergency Stress, Secondary
Trauma and Self-Efficacy in
Healthcare and Emergency
Workers in Italy
References
Adriaenssens, J., de Gucht, V., and Maes, S. (2012). The impact of traumatic
events on emergency room nurses: findings from a questionnaire survey. Int.
J. Nurs. Stud. 49, 1411–1422. doi: 10.1016/j.ijnurstu.2012.07.003

PubMed Abstract | CrossRef Full Text | Google Scholar

Aisling, M., Aisling, D., and David, C. (2016). An assessment of psychological


need in emergency medical staff in the Northern Health and Social Care Trust
Area. Ulster Med. J. 85, 92–98.

Google Scholar

American Psychiatric Association (2013). Diagnostic and Statistical Manual


of Mental Disorders (DSM-5). Washington, DC: American Psychiatric
Association.

Google Scholar

Argentero, P., and Setti, I. (2011). Engagement and vicarious traumatization in


rescue workers. Int. Arch. Occup. Environ. Health 84, 67–75. doi:
10.1007/s00420-010-0601-8
PubMed Abstract | CrossRef Full Text | Google Scholar

Bandura, A. (1997). Self-Efficacy: The Exercise of Control. New York, NY: W.


H. Freeman.

Google Scholar

Barleycorn, D. (2019). Awareness of secondary traumatic stress in emergency


nursing. Emerg. Nurse 27, 19–22. doi: 10.7748/en.2019.e1957

PubMed Abstract | CrossRef Full Text | Google Scholar

Beck, C. (2011). Secondary traumatic stress in nurses: a systematic


review. Arch. Psychiatr. Nurs. 25, 1–10. doi: 10.1016/j.apnu.2010.05.005

PubMed Abstract | CrossRef Full Text | Google Scholar

Bellelli, G., and Di Schiena, R. (2012). Emozioni e Decisioni. Come la


Psicologia Spiega il Conflitto tra Ragione e Sentiment. Bologna: IL Mulino.

Google Scholar

Benight, C. C., and Harper, M. L. (2002). Coping self-efficacy perceptions as a


mediator between acute stress response and long-term distress following
natural disasters. J. Trauma Stress 15, 177–186. doi:
10.1023/A:1015295025950

CrossRef Full Text | Google Scholar

Birinci, G. G., and Erden, G. (2016). Yardım çalışanlarında üstlenilmiş travma,


ikincil travmatik stres ve tükenmişliğin değerlendirilmesi [Evaluation of
vicarious trauma, secondary traumatic stress and burnout in aid
workers]. Turk. J. Psychol. 31, 10–26.

Google Scholar

Bohlken, J., Schömig, F., Lemke, M. R., Pumberger, M., and Riedel-Heller, S.
G. (2020). COVID-19-Pandemie: belastungen des medizinischen Personals
[COVID-19 pandemic: stress experience of healthcare workers – a short
current review]. Psychiatr. Prax. 47, 190–197. doi: 10.1055/a-1159-5551

PubMed Abstract | CrossRef Full Text | Google Scholar

Bosmans, G., Hofland, H. W., De Jong, A. E., and Van Loey, N. E. (2015).
Coping with burns: the role of coping self-efficacy in the recovery from
traumatic stress following burn injuries. J. Behav. Med. 38, 642–651. doi:
10.1007/s10865-015-9638-1

PubMed Abstract | CrossRef Full Text | Google Scholar

Brown, J., Mulhern, G., and Joseph, S. A. (2002). Incident-related stressors,


locus of control, coping, and psychological distress among firefighters in
Northern Ireland. J. Trauma Stress 15, 161–168. doi:
10.1023/A:1014816309959

CrossRef Full Text | Google Scholar

Cai, H., Tu, B., Ma, J., Chen, L., Fu, L., Jiang, Y., et al. (2020). Psychological
impact and coping strategies of frontline medical staff in Hunan between
January and March 2020 during the outbreak of coronavirus disease 2019
(COVID-19) in Hubei, China. Med. Sci. Monit. 26, e924171-1–e924171-16. doi:
10.12659/MSM.924171

PubMed Abstract | CrossRef Full Text | Google Scholar

Chamberlin, M. J. A., and Green, H. J. (2010). Stress and coping strategies


among firefighters and recruits. J. Loss Trauma 15, 548–560. doi:
10.1080/15325024.2010.519275

CrossRef Full Text | Google Scholar

Chan, A. O., and Huak, C. Y. (2004). Psychological impact of the 2003 severe
acute respiratory syndrome outbreak on healthcare workers in a medium size
regional general hospital in Singapore. Occup. Med. 54, 190–196. doi:
10.1093/occmed/kqh027
PubMed Abstract | CrossRef Full Text | Google Scholar

Chang, C. M., Lee, L. C., Connor, K. M., Davidson, J. R. T., Jeffries, K., and
Lai, T. J. (2003). Posttraumatic distress and coping strategies among rescue
workers after an earthquake. J. Nerv. Ment. Dis. 191, 391–398. doi:
10.1097/01.nmd.0000071588.73571.3d

CrossRef Full Text | Google Scholar

Chesney, M. A., Neilands, T. B., Chambers, D. B., Taylor, J. M., and Folkman,
S. (2006). A validity and reliability study of the coping self-efficacy scale. Br.
J. Health Psychol. 11, 421–437. doi: 10.1348/135910705X53155

PubMed Abstract | CrossRef Full Text | Google Scholar

Coetzee, S. K., and Klopper, H. C. (2010). Compassion fatigue within nursing


practice: a concept analysis. Nurs. Health Sci. 12, 235–243. doi:
10.1111/j.1442-2018.2010.00526.x

PubMed Abstract | CrossRef Full Text | Google Scholar

Connor-Smith, J. K., and Flachsbart, C. (2007). Relations between personality


and coping: a meta-analysis. J. Pers. Soc. Psychol. 93, 1080–1107. doi:
10.1037/0022-3514.93.6.1080

PubMed Abstract | CrossRef Full Text | Google Scholar

Del Missier, F., Bonini, N., and Rumiati, R. (2008). Psicologia del Giudizio e
Della Decisione. Bologna: IL Mulino.

Google Scholar

Dominguez-Gomez, E., and Rutledge, D. N. (2009). Prevalence of secondary


traumatic stress among emergency nurses. J. Emerg. Nurs. 35, 199–204. doi:
10.1016/j.jen.2008.05.003

PubMed Abstract | CrossRef Full Text | Google Scholar


Du, J., Dong, L., Wang, T., Yuan, C., Fu, R., Zhang, L., et al. (2020).
Psychological symptoms among frontline healthcare workers during COVID-
19 outbreak in Wuhan. Gen. Hosp. Psychiatry doi:
10.1016/j.genhosppsych.2020.03.011 [Epub ahead of print].

CrossRef Full Text | PubMed Abstract | Google Scholar

Duffy, E., Avalos, G., and Dowling, M. (2015). Secondary traumatic stress
among emergency nurses: a cross-sectional study. Int. Emerg. Nurs. 23, 53–
58. doi: 10.1016/j.ienj.2014.05.001

PubMed Abstract | CrossRef Full Text | Google Scholar

El-Hage, W., Hingray, C., Lemogne, C., Yrondi, A., Brunault, P., Bienvenu, T.,
et al. (2020). Health professionals facing the coronavirus disease 2019
(COVID-19) pandemic: what are the mental health risks? Encephale 46, S73–
S80. doi: 10.1016/j.encep.2020.04.008

PubMed Abstract | CrossRef Full Text | Google Scholar

Favretto, G. (2005). Le Forme del Mobbing. Milano: Raffaello Cortina.

Google Scholar

Figley, C. R. (1995). “Compassion fatigue as secondary traumatic stress


disorder: an overview,” in Compassion Fatigue: Coping with Secondary
Traumatic Stress Disorder in Those Who Treat the Traumatized, ed. C. R.
Figley (New York, NY: Brunner-Routledge), 1–20. doi:
10.1097/njh.0000000000000126

CrossRef Full Text | Google Scholar

Fraccaroli, F., and Balducci, C. (2011). Stress e Rischi Psicosociali Nelle


Organizzazioni. Bologna: IL Mulino.

Google Scholar
Fullerton, C. S., Ursano, R. J., and Wang, L. (2004). Acute stress disorder,
posttraumatic stress disorder, and depression in disaster or rescue
workers. Am. J. Psychiatry 161, 1370–1376. doi: 10.1176/appi.ajp.161.8.1370

PubMed Abstract | CrossRef Full Text | Google Scholar

Howlett, M., Doody, K., Murray, J., LeBlanc-Duchin, D., Fraser, J., and
Atkinson, P. R. (2015). Burnout in emergency department healthcare
professionals is associated with coping style: a cross-sectional survey. Emerg.
Med. J. 32, 722–727. doi: 10.1136/emermed-2014-203750

PubMed Abstract | CrossRef Full Text | Google Scholar

Huang, L., Xu, F. M., and Liu, H. (2020). Emotional responses and coping
strategies of nurses and nursing college students during COVID-19
outbreak. MedRxiv [Preprint] doi: 10.1101/2020.03.05.20031898

CrossRef Full Text | Google Scholar

Huang, J. Z., Han, M. F., Luo, T. D., Ren, A. K., and Zhou, X. P. (2020).
Mental health survey of medical staff in a tertiary infectious disease hospital
for COVID-19. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi 38, 192–
195. doi: 10.3760/cma.j.cn121094-20200219-00063

PubMed Abstract | CrossRef Full Text | Google Scholar

Kerai, S. M., Khan, R., Islam, M., Asad, N., Razzak, J., and Pasha, O. (2017).
Post-traumatic stress disorder and its predictors in emergency medical service
personnel: a cross-sectional study from Karachi, Pakistan. BMC Emerg.
Med. 17:26. doi: 10.1186/s12873-017-0140-7

PubMed Abstract | CrossRef Full Text | Google Scholar

Khalid, I., Khalid, T. J., Qabajah, M. R., Barnard, A. G., and Qushmaq, I. A.
(2016). Healthcare workers emotions, perceived stressors and coping
strategies during a MERS-CoV outbreak. Clin. Med. Res. 14, 7–14. doi:
10.3121/cmr.2016.1303
PubMed Abstract | CrossRef Full Text | Google Scholar

Kucmin, T., Kucmin, A., Turska, D., Turski, A., and Nogalski, A. (2018).
Coping styles and dispositional optimism as predictors of post-traumatic
stress disorder (PTSD) symptoms intensity in paramedics. Psychiatr. Pol. 52,
557–571. doi: 10.12740/PP/68514

PubMed Abstract | CrossRef Full Text | Google Scholar

Lai, J., Ma, S., Wang, Y., Cai, Z., Hu, J., Wei, N., et al. (2020). Factors
associated with mental health outcomes among healthcare workers exposed to
coronavirus disease 2019. JAMA Netw. Open 3:e203976. doi:
10.1001/jamanetworkopen.2020.3976

PubMed Abstract | CrossRef Full Text | Google Scholar

Lazarus, R. S., and Folkman, S. (1984). Stress, Appraisal, and Coping. New


York, NY: Springer.

Google Scholar

Lee, S. M., Kang, W. S., Cho, A. R., Kim, T., and Park, J. K. (2018).
Psychological impact of the 2015 MERS outbreak on hospital workers and
quarantined hemodialysis patients. Comp. Psychiatry 87, 123–127. doi:
10.1016/j.comppsych.2018.10.003

PubMed Abstract | CrossRef Full Text | Google Scholar

Li, L., Ai, H., Gao, L., Zhou, H., Liu, X., Zhang, Z., et al. (2017). Moderating
effects of coping on work stress and job performance for nurses in tertiary
hospitals: a cross-sectional survey in China. BMC Health Serv. Res. 17:401.
doi: 10.1186/s12913-017-2348-3

PubMed Abstract | CrossRef Full Text | Google Scholar

Li, Z., Ge, J., Yang, M., Feng, J., Qiao, M., Jiang, R., et al. (2020). Vicarious
traumatization in the general public, members, and non-members of medical
teams aiding in COVID-19 control. Brain Behav. Immun. 88, 916–919. doi:
10.1016/j.bbi.2020.03.007

PubMed Abstract | CrossRef Full Text | Google Scholar

Loo, G. T., DiMaggio, C. J., Gershon, R. R., Canton, D. B., Morse, S. S., and
Galea, S. (2016). Coping behavior and risk of post-traumatic stress disorder
among federal disaster responders. Disaster Med. Public Health Prep. 10,
108–117. doi: 10.1017/dmp.2015.141

PubMed Abstract | CrossRef Full Text | Google Scholar

Matud, M. P. (2004). Gender differences in stress and coping styles. Pers.


Individ. Dif. 37, 1401–1415. doi: 10.1016/j.paid.2004.01.010

CrossRef Full Text | Google Scholar

Matud, M. P., Bethencourt, J. M., and Ibáñez, I. (2015). Gender differences in


psychological distress in Spain. Int. J. Soc. Psychiatry 61, 560–568. doi:
10.1177/0020764014564801

PubMed Abstract | CrossRef Full Text | Google Scholar

Matud, M. P., and Garcia, M. C. (2019). Psychological distress and social


functioning in elderly Spanish people: a gender analysis. Int. J. Environ. Res.
Public Health 16:341. doi: 10.3390/ijerph16030341

PubMed Abstract | CrossRef Full Text | Google Scholar

Maunder, R. G., Lancee, W. J., Balderson, K. E., Bennett, J. P., Borgundvaag,


B., Evans, S., et al. (2006). Long-term psychological and occupational effects
of providing hospital healthcare during SARS outbreak. Emerg. Infect. Dis. 12,
1924–1932. doi: 10.3201/eid1212.060584

PubMed Abstract | CrossRef Full Text | Google Scholar


Mealer, M., and Jones, J. (2013). Posttraumatic stress disorder in the nursing
population: a concept analysis. Nurs. Forum 48, 279–288. doi:
10.1111/nuf.12045

PubMed Abstract | CrossRef Full Text | Google Scholar

Missouridou, E. (2017). Secondary posttraumatic stress and nurses’ emotional


responses to patient’s trauma. J. Trauma Nurs. 24, 110–115. doi:
10.1097/JTN.0000000000000274

PubMed Abstract | CrossRef Full Text | Google Scholar

Morrison, L. E., and Joy, J. P. (2016). Secondary traumatic stress in the


emergency department. J. Adv. Nurs. 72, 2894–2906. doi: 10.1111/jan.13030

PubMed Abstract | CrossRef Full Text | Google Scholar

Nydegger, R., Nydegger, L., and Basile, F. (2011). Post-traumatic stress


disorder and coping among career professional firefighters. Am. J. Health
Sci. 2, 11–20. doi: 10.19030/ajhs.v2i1.4365

CrossRef Full Text | Google Scholar

Oh, N., Hong, N., Ryu, D. H., Bae, S. G., Kam, S., and Kim, K. Y. (2017).
Exploring nursing intention, stress, and professionalism in response to
infectious disease emergencies: the experience of local public hospital nurses
during the 2015 MERS outbreak in South Korea. Asian Nurs. Res. 11, 230–
236. doi: 10.1016/j.anr.2017.08.005

PubMed Abstract | CrossRef Full Text | Google Scholar

Ornell, F., Halpern, S. C., Kessler, F. H. P., and Narvaez, J. C. (2020). The
impact of the COVID-19 pandemic on the mental health of healthcare
professionals. Cad. Saúde Pública 36:e00063520. doi: 10.1590/0102-
311x00063520

PubMed Abstract | CrossRef Full Text | Google Scholar


Ozbay, F., Johnson, D. C., Dimoulas, E., Morgan, C. A., Charney, D., and
Southwick, S. (2007). Social support and resilience to stress: from
neurobiology to clinical practice. Psychiatry 4, 35–40.

Google Scholar

Park, C. L., Folkman, S., and Bostrom, A. (2001). Appraisals of controllability


and coping in caregivers and HIV+ men: testing the goodness-of-fit
hypothesis. J. Consult. Clin. Psychol. 69, 481–488. doi: 10.1037/0022-
006X.69.3.481

PubMed Abstract | CrossRef Full Text | Google Scholar

Placentino, A., and Scarcella, C. (2001). Risorse Umane ed Emergenza di


Massa. Processi di Aiuto e di Auto Aiuto. Firenze: Cesvot.

Google Scholar

Roden-Foreman, J. W., Bennett, M. M., Rainey, E. E., Garrett, J. S., Powers,


M. B., and Warren, A. M. (2017). Secondary traumatic stress in emergency
medicine clinicians. Cogn. Behav. Ther. 46, 522–532. doi:
10.1080/16506073.2017.1315612

PubMed Abstract | CrossRef Full Text | Google Scholar

Rodríguez-Rey, R., Palacios, A., Alonso-Tapia, J., Pérez, E., Álvarez, E., Coca,
A., et al. (2019). Burnout and posttraumatic stress in paediatric critical care
personnel: prediction from resilience and coping styles. Aust. Crit. Care 32,
46–53. doi: 10.1016/j.aucc.2018.02.003

PubMed Abstract | CrossRef Full Text | Google Scholar

Sakuma, A., Takahashi, Y., Ueda, I., Sato, H., Katsura, M., Abe, M., et al.
(2015). Post-traumatic stress disorder and depression prevalence and
associated risk factors among local disaster relief and reconstruction workers
fourteen months after the Great East Japan Earthquake: a cross-sectional
study. BMC Psychiatry 15:58. doi: 10.1186/s12888-015-0440-y
PubMed Abstract | CrossRef Full Text | Google Scholar

Sasangohar, F., Jones, S. L., Masud, F. N., Vahidy, F. S., and Kash, B. A.
(2020). Provider burnout and fatigue during the COVID-19 pandemic: lessons
learned from a high-volume intensive care unit. Anesth. Analg. 131, 106–111.
doi: 10.1213/ANE.0000000000004866

PubMed Abstract | CrossRef Full Text | Google Scholar

Sbattella, F. (2009). Manuale di Psicologia Dell’emergenza. Milano: Franco


Angeli.

Google Scholar

Setti, I., and Argentero, P. (2012). Vicarious trauma: a contribution to the


Italian adaptation of the Secondary Traumatic Stress Scale in a sample of
ambulance operators. Appl. Psychol. Bull. 264, 58–64.

Google Scholar

Shin, H., Park, Y. M., Ying, J. Y., Kim, B., Noh, H., and Lee, S. M. (2014).
Relationships between coping strategies and burnout symptoms: a meta-
analytic approach. Prof. Psychol. 45, 44–56. doi: 10.1037/a0035220

CrossRef Full Text | Google Scholar

Simione, L., and Gnagnarella, C. (2020). Differences between health workers


and general population in risk perception, behaviors, and psychological
distress related to COVID-19 spread in Italy. PsyArXiv [Preprint] doi:
10.31234/osf.io/84d2c

CrossRef Full Text | Google Scholar

Slottje, P., Huizink, A. C., Twisk, J. W., Witteveen, A. B., Van der Ploeg, H. M.,
Bramsen, I., et al. (2005). Epidemiological study air disaster in Amsterdam
(ESADA): study design. BMC Public Health 5:54. doi: 10.1186/1471-2458-5-54

PubMed Abstract | CrossRef Full Text | Google Scholar


Spoorthy, M. S. (2020). Mental health problems faced by healthcare workers
due to the COVID-19 pandemic: a review. Asian J. Psychiatr. 51:102119. doi:
10.1016/j.ajp.2020.102119

PubMed Abstract | CrossRef Full Text | Google Scholar

Strentz, T., and Auerbach, S. M. (1988). Adjustment to the stress of simulated


captivity: effects of emotion-focused versus problem-focused preparation on
hostages differing in locus of control. J. Pers. Soc. Psychol. 55, 652–660. doi:
10.1037/0022-3514.55.4.652

PubMed Abstract | CrossRef Full Text | Google Scholar

Tan, B. Y., Chew, N. W., Lee, G. K., Jing, M., Goh, Y., Yeo, L. L., et al. (2020).
Psychological impact of the COVID-19 pandemic on healthcare workers in
Singapore. Ann. Intern. Med. doi: 10.7326/M20-1083 [Epub ahead of print].

CrossRef Full Text | PubMed Abstract | Google Scholar

Theleritis, C., Psarros, C., Mantonakis, L., Roukas, D., Papaioannou, A.,
Paparrigopoulos, T., et al. (2020). Coping and its relation to PTSD in Greek
firefighters. J. Nerv. Ment. Dis. 208, 252–259. doi:
10.1097/NMD.0000000000001103

PubMed Abstract | CrossRef Full Text | Google Scholar

Vagni, M., Maiorano, T., Giostra, V., and Pajardi, D. (2020). Hardiness, stress
and secondary trauma in Italian healthcare and emergency workers during the
COVID-19 pandemic. Sustainability 12:5592. doi: 10.3390/su12145592

CrossRef Full Text | Google Scholar

Vitaliano, P. P., DeWolfe, D. J., Maiuro, R. D., Russo, J., and Katon, W.
(1990). Appraised changeability of a stressor as a modifier of the relationship
between coping and depression: a test of the hypothesis of fit. J. Pers. Soc.
Psychol. 59, 582–592. doi: 10.1037/0022-3514.59.3.582
PubMed Abstract | CrossRef Full Text | Google Scholar

Walton, M., Murray, E., and Christian, M. D. (2020). Mental health care for
medical staff and affiliated healthcare workers during the COVID-19
pandemic. Eur. Heart J. Acute Cardiovasc. Care 9, 241–247. doi:
10.1177/2048872620922795

PubMed Abstract | CrossRef Full Text | Google Scholar

Watson, R., Deary, I., Thompson, D., and Li, G. (2008). A study of stress and
burnout in nursing students in Hong Kong: a questionnaire survey. Int. J.
Nurs. Stud. 45, 1534–1542. doi: 10.1016/j.ijnurstu.2007.11.003

PubMed Abstract | CrossRef Full Text | Google Scholar

Witt, M., Stelcer, B., and Czarnecka-Iwańczuk, M. (2018). Stress coping styles
in firemen exposed to severe stress. Psychiatr. Pol. 52, 543–555. doi:
10.12740/PP/73837

PubMed Abstract | CrossRef Full Text | Google Scholar

Wolf, L. A., Pechats, C., Delao, A. M., Moon, M. D., Clark, P. R., and Zavotsky,
K. E. (2016). “It’s a burden you carry”: describing moral distress in emergency
nursing. J. Emerg. Nurs. 42, 37–46. doi: 10.1016/j.jen.2015.08.008

PubMed Abstract | CrossRef Full Text | Google Scholar

Wong, T. W., Yau, J. K., Chan, C. L., Kwong, R. S., Ho, S. M., Lau, C. C., et al.
(2005). The psychological impact of severe acute respiratory syndrome
outbreak on healthcare workers in emergency departments and how they
cope. Eur. J. Emerg. Med. 12, 13–18. doi: 10.1097/00063110-200502000-
00005

PubMed Abstract | CrossRef Full Text | Google Scholar

World Health Organization (2020). COVID-19 Preparedness and Response


Progress Report 1 February to 30 June 2020. Available online
at: https://www.who.int/publications/i/item/strategic-preparedness-and-
response-plan-for-the-new-coronavirus (accessed July 15, 2020).

Google Scholar

Xiao, H., Zhang, Y., Kong, D., Li, S., and Yang, N. (2020). The effects of social
support on sleep quality of medical staff treating patients with coronavirus
disease 2019 (COVID-19) in January and February 2020 in China. Med. Sci.
Monit. 26:e923549. doi: 10.12659/MSM.923549

PubMed Abstract | CrossRef Full Text | Google Scholar

Young, P. M., Partington, S., Wetherell, M. A., St Clair Gibson, A., and
Partington, E. (2014). Stressors and coping strategies of U.K. firefighters
during on-duty incidents. Stress Health 30, 366–376. doi: 10.1002/smi.261

CrossRef Full Text | Google Scholar

Zhu, Z., Xu, S., Wang, H., Liu, Z., Wu, J., Li, G., et al. (2020). COVID-19 in
Wuhan: immediate psychological impact on 5062 health workers. Medrxiv
[Preprint] doi: 10.1101/2020.02.20.20025338

CrossRef Full Text | Google Scholar


Keywords: COVID-19, stress, secondary trauma, healthcare workers, self-efficacy, coping
Citation: Vagni M, Maiorano T, Giostra V and Pajardi D (2020) Coping With COVID-19:
Emergency Stress, Secondary Trauma and Self-Efficacy in Healthcare and Emergency Workers
in Italy. Front. Psychol. 11:566912. doi: 10.3389/fpsyg.2020.566912
Received: 29 May 2020; Accepted: 13 August 2020;
Published: 03 September 2020.
Edited by:
Andrew E. P. Mitchell, University of Chester, United Kingdom
Reviewed by:
Beth Milliard, York Regional Police, Canada
Atreyee Bhattacharyya, University of Haifa, Israel
Emanuele Maria Giusti, Catholic University of the Sacred Heart, Italy
https://www.frontiersin.org/articles/10.3389/
fpsyg.2020.01684/fullORIGINAL RESEARCH ARTICLE
Front. Psychol., 10 July 2020 | https://doi.org/10.3389/fpsyg.2020.01684

The Psychological Impact of


the COVID-19 Outbreak on
Health Professionals: A
Cross-Sectional Study
Emanuele Maria Giusti ,  1,2*
Elisa Pedroli ,  3,4
Guido E. D'Aniello ,  2

Chiara Stramba Badiale ,  3


Giada Pietrabissa ,  1,2
Chiara Manna , 
1,2

Marco Stramba Badiale ,  5


Giuseppe Riva , 
1,3
Gianluca Castelnuovo  and 1,2

Enrico Molinari 1,2

References
Bai, Y. M., Lin, C. C., Lin, C. Y., Chen, J. Y., Chue, C. M., and Chou, P. (2004).
Survey of stress reactions among health care workers involved with the SARS
outbreak. Psychiatr. Serv. 55, 1055–1057. doi: 10.1176/appi.ps.55.9.1055

PubMed Abstract | CrossRef Full Text | Google Scholar

Bianchi, R. (2015). What is “severe burnout” and can its prevalence be


assessed? Intens. Care Med. 41:166. doi: 10.1007/s00134-014-3534-y

PubMed Abstract | CrossRef Full Text | Google Scholar


Bottesi, G., Ghisi, M., Altoè, G., Conforti, E., Melli, G., and Sica, C. (2015). The
Italian version of the depression anxiety stress scales-21: factor structure and
psychometric properties on community and clinical samples. Compr.
Psychiatry 60, 170–181. doi: 10.1016/j.comppsych.2015.04.005

PubMed Abstract | CrossRef Full Text | Google Scholar

Boukhris, M., Hillani, A., Moroni, F., Annabi, M. S., Addad, F., Ribeiro, M. H.,
et al. (2020). Cardiovascular implications of the COVID-19 pandemic: a global
perspective. Can. J. Cardiol. doi: 10.1016/j.cjca.2020.05.018. [Epub ahead of
print].

PubMed Abstract | CrossRef Full Text | Google Scholar

Chan, A. O. M., and Huak, C. Y. (2004). Psychological impact of the 2003


severe acute respiratory syndrome outbreak on health care workers in a
medium size regional general hospital in Singapore. Occup. Med. 54, 190–196.
doi: 10.1093/occmed/kqh027

PubMed Abstract | CrossRef Full Text | Google Scholar

Cheng, S. K. W., and Wong, C. W. (2005). Psychological intervention with


sufferers from severe acute respiratory syndrome (SARS): lessons learnt from
empirical findings. Clin. Psychol. Psychother. 12, 80–86. doi:
10.1002/cpp.429

CrossRef Full Text | Google Scholar

Dipartimento della Protezione Civile (2020). COVID-19 Scheda Regioni


20200523. Available online
at: https://github.com/pcm-dpc/COVID-19/blob/master/schede-
riepilogative/regioni/dpc-covid19-ita-scheda-regioni-20200523.pdf

Friedman, J., Hastie, T., and Tibshirani, R. (2010). Regularization paths for
generalized linear models via coordinate descent. J. Stat. Softw. 33:1. doi:
10.18637/jss.v033.i01
PubMed Abstract | CrossRef Full Text | Google Scholar

Fusaroli, P., Balena, S., and Lisotti, A. (2020). On the death of 100 + Italian
doctors from COVID-19. Infection 1–2. doi: 10.1007/s15010-020-01436-1.
[Epub ahead of print].

PubMed Abstract | CrossRef Full Text | Google Scholar

Giordano, G., Blanchini, F., Bruno, R., Colaneri, P., Di Filippo, A., Di Matteo,
A., et al. (2020). Modelling the COVID-19 epidemic and implementation of
population-wide interventions in Italy. Nat. Med. 26, 855–860. doi:
10.1038/s41591-020-0883-7

PubMed Abstract | CrossRef Full Text | Google Scholar

Giorgi, G., Fiz Perez, F. S., Castiello D'Antonio, A., Mucci, N., Ferrero, C.,
Cupelli, V., et al. (2015). Psychometric properties of the Impact of Event Scale-
6 in a sample of victims of bank robbery. Psychol. Res. Behav. Manag. 8, 99–
104. doi: 10.2147/PRBM.S73901

PubMed Abstract | CrossRef Full Text | Google Scholar

Henry, J. D., and Crawford, J. R. (2005). The short-form version of the


depression anxiety stress scales (DASS-21): Construct validity and normative
data in a large non-clinical sample. Br. J. Clin. Psychol. 44, 227–239. doi:
10.1348/014466505X29657

PubMed Abstract | CrossRef Full Text | Google Scholar

Ho, C. S., Chee, C. Y., and Ho, R. C. (2020). Mental health strategies to combat
the psychological impact of covid-19 beyond paranoia and panic. Ann. Acad.
Med. Singapore 49, 155–160.

PubMed Abstract | Google Scholar

Huang, J. Z., Han, M. F., Luo, T. D., Ren, A. K., and Zhou, X. P. (2020).
Mental health survey of 230 medical staff in a tertiary infectious disease
hospital for COVID-19. Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za
Zhi 38, 192–195. doi: 10.3760/cma.j.cn121094-20200219-00063

PubMed Abstract | CrossRef Full Text | Google Scholar

Khalid, I., Khalid, T. J., Qabajah, M. R., Barnard, A. G., and Qushmaq, I. A.
(2016). Healthcare workers emotions, perceived stressors and coping
strategies during a MERS-CoV outbreak. Clin. Med. Res. 14, 7–14. doi:
10.3121/cmr.2016.1303

PubMed Abstract | CrossRef Full Text | Google Scholar

Kim, J. S., and Choi, J. S. (2016). Factors influencing emergency nurses'


burnout during an outbreak of middle east respiratory syndrome Coronavirus
in Korea. Asian Nurs. Res. 10, 295–299. doi: 10.1016/j.anr.2016.10.002

PubMed Abstract | CrossRef Full Text | Google Scholar

Kuhn, M. (2015). caret: Classification and Regression Training. Astrophysics


Source Code Library. Available online
at: https://ui.adsabs.harvard.edu/abs/2015ascl.soft05003K (accessed May
03, 2020).

Google Scholar

Lee, A. M., Wong, J. G., McAlonan, G. M., Cheung, V., Cheung, C., Sham, P. C.,
et al. (2007). Stress and psychological distress among SARS survivors 1 year
after the outbreak. Can. J. Psychiatry 52, 233–240. doi:
10.1177/070674370705200405

PubMed Abstract | CrossRef Full Text | Google Scholar

Lee, S. M., Kang, W. S., Cho, A. R., Kim, T., and Park, J. K. (2018).
Psychological impact of the 2015 MERS outbreak on hospital workers and
quarantined hemodialysis patients. Compr. Psychiatry 87, 123–127. doi:
10.1016/j.comppsych.2018.10.003
PubMed Abstract | CrossRef Full Text | Google Scholar

Leocani, L., Diserens, K., Moccia, M., and Caltagirone, C. (2020). Disability
through COVID-19 pandemic: neurorehabilitation cannot wait. Eur. J.
Neurol. doi: 10.1111/ene.14320. [Epub ahead of print].

PubMed Abstract | CrossRef Full Text | Google Scholar

Liebensteiner, M. C., Khosravi, I., Hirschmann, M. T., Heuberer, P. R., Thaler,


M., Board of the AGA-Society of Arthroscopy Joint-Surgery, and Thaler, M.
(2020). Massive cutback in orthopaedic healthcare services due to the COVID-
19 pandemic. Knee Surg. Sports Traumatol. Arthrosc. 28, 1705–1711. doi:
10.1007/s00167-020-06032-2

CrossRef Full Text | Google Scholar

Liu, Q., Luo, D., Haase, J. E., Guo, Q., Wang, X. Q., Liu, S., et al. (2020). The
experiences of health-care providers during the COVID-19 crisis in China: a
qualitative study. Lancet Glob. Heal. 8, e790–e798. doi: 10.1016/S2214-
109X(20)30204-7

PubMed Abstract | CrossRef Full Text | Google Scholar

Lovibond, P. F., and Lovibond, S. H. (1995). The structure of negative


emotional states: comparison of the Depression Anxiety Stress Scales (DASS)
with the beck depression and anxiety inventories. Behav. Res. Ther. 33, 335–
343. doi: 10.1016/0005-7967(94)00075-U

PubMed Abstract | CrossRef Full Text | Google Scholar

Low, Z. X., Yeo, K. A., Sharma, V. K., Leung, G. K., McIntyre, R. S., Guerrero,
A., et al. (2019). Prevalence of burnout in medical and surgical residents: a
meta-analysis. Int. J. Environ. Res. Public Health 16:1479. doi:
10.3390/ijerph16091479

PubMed Abstract | CrossRef Full Text | Google Scholar


Manzoni, P., and Milillo, C. (2020). Covid-19 mortality in Italian doctors. J.
Infect. doi: 10.1016/j.jinf.2020.05.034. [Epub ahead of print].

PubMed Abstract | CrossRef Full Text | Google Scholar

Maslach, C., and Goldberg, J. (1998). Prevention of burnout: new


perspectives. Appl. Prev. Psychol. 7, 63–74. doi: 10.1016/S0962-
1849(98)80022-X

CrossRef Full Text | Google Scholar

Maslach, C., Jackson, S., and Leiter, M. (1997). “The Maslach burnout
inventory manual,” in Evaluating Stress: A Book of Resources (Palo Alto, CA:
Consulting Psychologists Press), 191–218.

PubMed Abstract | Google Scholar

Maunder, R. G., Lancee, W. J., Balderson, K. E., Bennett, J. P., Borgundvaag,


B., Evans, S., et al. (2006). Long-term psychological and occupational effects
of providing hospital healthcare during SARS outbreak. Emerg. Infect. Dis. 12,
1924–1932. doi: 10.3201/eid1212.060584

PubMed Abstract | CrossRef Full Text | Google Scholar

Ornell, F., Schuch, J. B., Sordi, A. O., and Kessler, F. H. P. (2020). “Pandemic
fear” and COVID-19: mental health burden and strategies. Braz. J.
Psychiatry 42, 232–235. doi: 10.1590/1516-4446-2020-0008

PubMed Abstract | CrossRef Full Text | Google Scholar

Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., and
Katsaounou, P. (2020). Prevalence of depression, anxiety, and insomnia
among healthcare workers during the COVID-19 pandemic: A systematic
review and meta-analysis. Brain. Behav. Immun. doi:
10.1016/j.bbi.2020.05.026. [Epub ahead of print].

PubMed Abstract | CrossRef Full Text | Google Scholar


Pedrabissi, L., and Santinello, M. (1989). Verifica della validità dello STAI
forma Y di Spielberger. [Verification of the validity of the STAI, Form Y, by
Spielberger.]. Giunti Organ. Spec. 191–192, 11–14.

Google Scholar

Portoghese, I., Galletta, M., Coppola, R. C., Finco, G., and Campagna, M.
(2014). Burnout and Workload among health care workers: the moderating
role of job control. Saf. Health Work 5, 152–157. doi:
10.1016/j.shaw.2014.05.004

PubMed Abstract | CrossRef Full Text | Google Scholar

Ran, L., Chen, X., Wang, Y., Wu, W., Zhang, L., and Tan, X. (2020). Risk
Factors of Healthcare Workers with Corona Virus Disease 2019: A
Retrospective Cohort Study in a Designated Hospital of Wuhan in China. Clin.
Infect. Dis. ciaa287. doi: 10.1093/cid/ciaa287. [Epub ahead of print].

PubMed Abstract | CrossRef Full Text | Google Scholar

Salvagioni, D. A. J., Melanda, F. N., Mesas, A. E., González, A. D., Gabani, F.


L., and Andrade, S. M. de (2017). Physical, psychological and occupational
consequences of job burnout: a systematic review of prospective studies. PLoS
ONE 12:e0185781–e0185781. doi: 10.1371/journal.pone.0185781

PubMed Abstract | CrossRef Full Text | Google Scholar

Schaufeli, W. B., and Van Dierendonck, D. (1995). A cautionary note about the
cross-national and clinical validity of cut-off points for the Maslach Burnout
Inventory. Psychol. Rep. 76, 1083–1090. doi: 10.2466/pr0.1995.76.3c.1083

PubMed Abstract | CrossRef Full Text | Google Scholar

Sirigatti, S., Stefanile, C., and Menoni, E. (1988). Per un adattamento italiano
del Maslach Burnout Inventory (MBI) [Toward an Italian version of the
Maslach Burnout Inventory (MBI)]. Boll. di Psicol. Appl. 187–188, 33–39.
Google Scholar

Spielberger, C., Gorsuch, R., Lushene, R., Vagg, P. R., and Jacobs, G.
(1983). Manual for the State-Trait Anxiety Inventory (Form Y1 – Y2). Palo
Alto, CA: Consulting Psychologists Press.

Tam, C. W. C., Pang, E. P. F., Lam, L. C. W., and Chiu, H. F. K. (2004). Severe
acute respiratory syndrome (SARS) in Hongkong in 2003: stress and
psychological impact among frontline healthcare workers. Psychol. Med. 34,
1197–1204. doi: 10.1017/S0033291704002247

PubMed Abstract | CrossRef Full Text | Google Scholar

Tan, B. Y. Q., Chew, N. W. S., Lee, G. K. H., Jing, M., Goh, Y., Yeo, L. L. L., et
al. (2020a). Psychological impact of the COVID-19 pandemic on health care
workers in Singapore. Ann. Intern. Med. M20–M1083. doi: 10.7326/M20-
1083

CrossRef Full Text | Google Scholar

Tan, W., Hao, F., McIntyre, R. S., Jiang, L., Jiang, X., Zhang, L., et al. (2020b).
Is returning to work during the COVID-19 pandemic stressful? A study on
immediate mental health status and psychoneuroimmunity prevention
measures of Chinese workforce. Brain. Behav. Immun. 87, 84–92. doi:
10.1016/j.bbi.2020.04.055

PubMed Abstract | CrossRef Full Text | Google Scholar

Thoresen, S., Tambs, K., Hussain, A., Heir, T., Johansen, V., and Bisson, J.
(2009). Brief measure of posttraumatic stress reactions: Impact of Event
Scale-6. Soc. Psychiatry Psychiatr. Epidemiol. 45, 405–412. doi:
10.1007/s00127-009-0073-x

PubMed Abstract | CrossRef Full Text | Google Scholar

Tran, B. X., Ha, G. H., Nguyen, L. H., Vu, G. T., Hoang, M. T., Le, H. T., et al.
(2020). Studies of Novel Coronavirus Disease 19 (COVID-19) pandemic: a
global analysis of literature. Int. J. Environ. Res. Public Health. 17:4095. doi:
10.3390/ijerph17114095

PubMed Abstract | CrossRef Full Text | Google Scholar

Wang, C., Horby, P. W., Hayden, F. G., and Gao, G. F. (2020a). A novel
coronavirus outbreak of global health concern. Lancet 395, 470–473. doi:
10.1016/S0140-6736(20)30185-9

PubMed Abstract | CrossRef Full Text | Google Scholar

Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., et al. (2020b). A
longitudinal study on the mental health of general population during the
COVID-19 epidemic in China. Brain. Behav. Immun. 87, 40–48. doi:
10.1016/j.bbi.2020.04.028

CrossRef Full Text | Google Scholar

Weiss, D. S. (2007). “The impact of event scale: revised BT,” in Cross-Cultural


Assessment of Psychological Trauma and PTSD, eds J. P. Wilson and C. S.
Tang (Boston, MA: Springer US, 219–238.

Google Scholar

Wiederhold, B. K., Cipresso, P., Pizzioli, D., Wiederhold, M., and Riva, G.
(2018). Interventions for physician burnout: a systematic review of systematic
reviews. Int. J. Prev. Med. 9, 253–263. doi: 10.1515/med-2018-0039

CrossRef Full Text | Google Scholar

Wilder-Smith, A., and Freedman, D. O. (2020). Isolation, quarantine, social


distancing and community containment: pivotal role for old-style public
health measures in the novel coronavirus (2019-nCoV) outbreak. J. Travel
Med. 27:taaa020. doi: 10.1093/jtm/taaa020

PubMed Abstract | CrossRef Full Text | Google Scholar


Woo, T., Ho, R., Tang, A., and Tam, W. (2020). Global prevalence of burnout
symptoms among nurses: a systematic review and meta-analysis. J. Psychiatr.
Res. 123, 9–20. doi: 10.1016/j.jpsychires.2019.12.015

PubMed Abstract | CrossRef Full Text | Google Scholar

World Health Organization (2020a). Coronavirus Disease 2019 (COVID-19)


Situation Report - 116. Available online
at: https://www.who.int/docs/default-source/coronaviruse/situation-
reports/20200515-covid-19-sitrep-116.pdf

Google Scholar

World Health Organization (2020b). WHO Characterizes COVID-19 as A


Pandemic. World Health Organ.

Xiang, Y. T., Yang, Y., Li, W., Zhang, L., Zhang, Q., Cheung, T., et al. (2020).
Timely mental health care for the 2019 novel coronavirus outbreak is urgently
needed. Lancet Psychiatry 7, 228–229. doi: 10.1016/S2215-0366(20)30046-8

PubMed Abstract | CrossRef Full Text | Google Scholar

Zhang, C., Yang, L., Liu, S., Ma, S., Wang, Y., Cai, Z., et al. (2020). Survey of
insomnia and related social psychological factors among medical staff
involved in the 2019 novel coronavirus disease outbreak. Front. Psychiatry.
11:306. doi: 10.3389/fpsyt.2020.00306

PubMed Abstract | CrossRef Full Text | Google Scholar

Zou, H., and Hastie, T. (2005). Regularization and variable selection via the
elastic net. J. R. Stat. Soc. Ser. B 67, 301–320. doi: 10.1111/j.1467-
9868.2005.00503.x

CrossRef Full Text | Google Scholar


Keywords: COVID-19, burnout, depression, anxiety, post-traumatic stress, predictors, clinical
psychology, cross-sectional study
Citation: Giusti EM, Pedroli E, D'Aniello GE, Stramba Badiale C, Pietrabissa G, Manna C,
Stramba Badiale M, Riva G, Castelnuovo G and Molinari E (2020) The Psychological Impact of
the COVID-19 Outbreak on Health Professionals: A Cross-Sectional Study. Front.
Psychol. 11:1684. doi: 10.3389/fpsyg.2020.01684
Received: 29 May 2020; Accepted: 22 June 2020;
Published: 10 July 2020.
Edited by:
Konstantinos Papazoglou, Yale University, United States
Reviewed by:
Roger C. Ho, National University of Singapore, Singapore
Cristina Queiros, University of Porto, Portugal

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