Psychological Distress in Healthcare Workers between the First and Second COVID-19 Waves: The Role of Personality Traits, Attachment Style, and Metacognitive Functioning as Protective and Vulnerability Factors.

Loredana Cena,Alberto Stefana,Alice Trainini,Jessica Janos,Matteo Rota,Stefano Calza

doi:10.3390/ijerph182211843

Abstract

The COVID-19 pandemic has impacted the mental health of healthcare workers (HCWs) since its outbreak, but little attention has been paid to person-level vulnerability and protective factors. This study aims to determine the prevalence of both general and pandemic-related psychological distress among HCWs between the first and second COVID-19 waves in Italy and analyze associations between psychological distress and personality traits, attachment style, and metacognitive functioning. Between June and October 2020, 235 Italian HCWs completed questionnaires concerning psychological stress, personality traits, attachment style, and metacognitive functioning; 26.5% of respondents presented with moderate to extremely severe levels of general psychological distress and 13.8% with moderate to extremely severe levels of pandemic-related psychological distress. After controlling for demographic and occupational variables, significant associations emerged among high emotional stability as a personality trait and both general (aOR: 0.58, 95% CI: 0.41–0.79) and pandemic-related psychological stress (aOR: 0.62, 95% CI: 0.41–0.90). Additionally, higher scores regarding one’s ability to understand others’ emotional states were associated with lower odds of developing psychological distress (aOR: 0.78, 95% CI: 0.63–0.93). Lastly, when comparing those with fearful attachment styles to those with secure attachments, the aOR for psychological distress was 4.73 (95% CI: 1.45–17.04). These results highlight the importance of conducting baseline assessments of HCWs’ person-level factors and providing regular screenings of psychological distress.

Highlights

In the light of the above, this study focuses on the role of personality traits, attachment styles, and metacognitive functioning as vulnerability or protective factors for both general and pandemic-related psychological distress in healthcare workers (HCWs)
Most worked in community-based facilities (69.4%), while the remaining worked in hospitals (30.6%); 39.1% of participants had more than 16 years of work experience as a healthcare professional, while 30.6% had 6–15 years and
Regarding factors related to psychological distress, we found significant differences in symptomatology levels between people who had different attachment styles (p = 0.001), different levels of ability to understand others’ emotional states (p < 0.001) and to understand causal relationships (p < 0.001) as well as between different scores for two dimensions of the structure of personality, emotional stability (p < 0.001), and extraversion (p = 0.013)

Summary

Introduction

During the ongoing global public health emergency, there has been a rapidly growing number of studies aimed at investigating the psychological impact of the COVID-19 pandemic, including vulnerabilities and protective factors in the general population [1–3]. As well as in specific populations [4–7] and health care services [8]. Among these specific populations, healthcare workers (HCWs) experience much higher pressure than usual due to increased workload and risk of infection [9,10], in addition to the risk factors experienced by the general population [11,12]. HCWs face an increased risk of onset or worsening of mental health issues such as stress, anxiety, depression, rage, denial, somatization, and sleep disturbance [13,14] that may compromise the quality of their care.

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