Abstract
Pandemics and government-mandated quarantining measures have a substantial impact on mental health. This study investigated the psychological impact of the coronavirus disease 2019 (COVID-19) crisis on Italian residents during the first week of government-imposed lockdown and the role of defense mechanisms as protective factors against distress. In this cross-sectional study, 5,683 Italians responded to an online survey assessing socio-demographics, overall psychological distress, post-traumatic symptoms, and defense mechanisms using validated measures as the Symptom Checklist-90 (SCL-90), the Impact of Event Scale-Revised (IES-R), and the Defense Mechanisms Rating Scale-Self-Report-30 (DMRS-SR-30). Data were collected from March 13 to March 18, within the first week of lockdown in Italy. Results showed that younger age and female gender were associated with increased psychological distress. Having positive cases nearby, more days on lockdown, and having to relocate were also associated with greater distress. Higher overall defensive functioning (ODF) was associated with lower levels of depression (r = −.44, 95% CI −0.48, −0.40), anxiety (r = −.38, 95% CI −0.42, −0.35), and post-traumatic stress symptoms (PTSS) (r = −.34, 95% CI −0.38, −0.30). Conversely, less adaptive defensive functioning was related to greater affective distress across all domains. Each increased unit of ODF decreased the chances of developing post-traumatic stress symptoms (PTSS) by 71% (odds ratio = 0.29, p < 0.001, 95% CI.026,.032). The psychological impact of COVID-19 among Italians during the early weeks of government lockdown has been significant. The pandemic continues to have extraordinary mental health impact as it moves across the globe. Given the salience of defensive functioning in psychological distress, consideration of interventions that foster the use of more adaptive defenses may be an important component of building resilience amidst a pandemic.
Highlights
In March 2020, the World Health Organization declared coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a pandemic
Among Italians responding during the COVID-19 outbreak, this study sought to 1) examine the prevalence of symptoms of psychological distress and identify predictors of distress; and 2) evaluate different associated emotion regulation strategies that might impact the relationship between stress and distress
Participants with Impact of Event Scale-Revised (IES-R) scores falling in the PTSD range showed significantly lower overall defensive functioning (ODF) (M = 5.21; SD = 0.62; p = .000) and Global Severity Index (GSI) (M = 1.24; SD = 0.53; p = .000)
Summary
In March 2020, the World Health Organization declared coronavirus disease 2019 (COVID-19), the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a pandemic. At the time of conducting this study only few countries registered positive cases and deaths for COVID-19, with Italy being the first hit European country [1]. The rapid spread and devastating impact of COVID-19 has resulted in social distancing, self-quarantining, and government-enforced lockdown of citizen movement. On March 9, 2020, the Italian government expanded local lockdown efforts to include all localities, requiring more than 60 million people to stay at home. The aim of this study was to assess psychological effects associated with the pandemic and their relationship to demographic and COVID-19 impact variables
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