Abstract
Background: The 2019 coronavirus disease (COVID-19) outbreak is currently putting a strain on the mental health resilience of the world's population. Specifically, it is likely to elicit an intense response to fear and to act as a risk factor for the onset of posttraumatic stress disorder (PTSD). Some individuals may be more at risk than others, with pathological personality variables being a potential candidate as a central vulnerability factor. In addition, the pathways that lead the pathological personality to PTSD and intense fear responses to COVID-19 are likely to be explained by poor emotion regulation capacities, as well as by dissociative mechanisms.Aims: This study aimed to shed light on vulnerability factors that may account for the onset of PTSD and intense responses of fear in response to COVID-19 outbreak and to test the mediating role of emotion dysregulation and dissociation proneness in these pathways.Methods: We used a longitudinal design of research administered to a sample of community individuals (N = 308; meanage = 35.31, SD = 13.91; 22.7% were male). Moreover, we used self-report questionnaires to measure pathological personality, emotion regulation capacities, dissociative proneness at the beginning of the lockdown, and PTSD symptoms and fear of COVID-19 at the end of the Italian lockdown (from March 9 to May 18, 2020). Structural equation modeling was used to test the hypotheses.Results: We found that pathological personality levels longitudinally predicted PTSD and fear of COVID-19 levels. Moreover, the associations between emotion dysregulation and dissociation were shown to significantly and totally mediate the relationship between pathological personality and PTSD, whereas no significant mediation effects were observed in relation to fear of COVID-19.Conclusions: Individuals with pathological personality traits may be more vulnerable to the onset of negative psychological consequences related to COVID-19 outbreak, such as PTSD symptomatology and fear levels. Emotion regulation capacities appear to be relevant targets of interventions for PTSD symptomatology. Future research should explore the mediating variables linking pathological personality to intense fear responses to COVID-19.
Highlights
According to the World Health Organization [1], the new coronavirus disease (COVID-19), which appeared at the end of the 2019, is responsible for more than 1,633,941 deaths and 73,453,006 confirmed cases (December 15, 2020)
This serious scenario could be worsened by an amplification of fear [3], by media or social networks, spreading panic or fake news, or by false-positive diagnosis
Especially for subjects with previous psychopathological vulnerability, such as pathological personality traits: studies examining basic biological mechanisms support the idea that emotion dysregulation increases fear levels [4], through the connection between emotional dysregulation and lack of tolerance
Summary
According to the World Health Organization [1], the new coronavirus disease (COVID-19), which appeared at the end of the 2019, is responsible for more than 1,633,941 deaths and 73,453,006 confirmed cases (December 15, 2020). It seems reasonable to suggest that this situation may have induced relational and social difficulties [2] This serious scenario could be worsened by an amplification of fear [3], by media or social networks, spreading panic or fake news, or by false-positive diagnosis (for instance, in India, a family man committed suicide to protect his family following a false-positive diagnosis of COVID-19). The pathways that lead the pathological personality to PTSD and intense fear responses to COVID-19 are likely to be explained by poor emotion regulation capacities, as well as by dissociative mechanisms
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