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      Pathway linking attachment styles to post-traumatic growth among recovered COVID-19 patients: testing the mediating role of coping styles Translated title: Ruta que vincula los estilos de apego con el crecimiento postraumático en pacientes recuperados de COVID-19: probando el papel mediador de los estilos de afrontamiento

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          ABSTRACT

          Background: Research on post-disaster mental health shows that people have unique resources to undergo positive changes like posttraumatic growth (PTG) after facing adversities.

          Objective: This study aimed to investigate the relationship between attachment styles and PTG in COVID-19 survivors, with a focus on exploring the mediating role of coping strategies. Through examining these dynamics, the study seeks to contribute to deeper understanding of the psychological processes underlying growth in individuals recovering from the pandemic.

          Method: A total of 210 participants were enrolled from the hospitals in Tabriz, Iran, in January 2021, and completed self-report questionnaires. PTG, attachment styles, and coping strategies were assessed using Posttraumatic Growth Inventory (PTGI), Revised Adult Attachment Scale (RAAS), and Coping Inventory for Stressful Situations (CISS). Structural equation modelling (SEM) was used to assess the mediation models.

          Results: The direct effects of secure (β = 0.22, p < .001), and ambivalent-anxious attachment (β = −0.22, p < .001) on PTG were significant. Also, task-oriented coping significantly predicted PTG (β = .60, p < .001). The direct path from secure (β = 0.16, p < .05) and ambivalent-anxious attachment (β = −0.38, p < .001) to task-oriented coping was significant, as was direct impact of secure (β = −0.18, p < .01) and ambivalent-anxious attachment (β = 0.37, p < .001) to emotion-oriented coping. The association between secure attachment and PTG is significantly mediated by task-oriented coping (β = 0.1, (95% CI: 0.01–0.18)). Also, task-oriented coping was a significant negative mediator between ambivalent-anxious attachment and PTG (β = −0.24, (95% CI: −0.33 – −0.15)).

          Conclusions: Results support the mediating role of coping strategies in the relationship between attachment styles and PTG. It emphasizes the importance of interventions for improving coping resources in individuals with life-threatening illnesses, focusing on improving problem-focused coping and reducing maladaptive strategies.

          HIGHLIGHTS

          • Individuals with secure attachment styles demonstrate significant positive posttraumatic growth following COVID-19 recovery.

          • Problem focused coping plays a significant mediating role in the relationship between secure attachment style and posttraumatic growth in people who recovered from COVID-19.

          • The findings suggest the importance of developing interventions to enhance coping resources for traumatized populations to facilitate posttraumatic growth.

          Translated abstract

          Antecedentes: La investigación en salud mental después de un desastre muestra que las personas tienen recursos únicos para experimentar cambios positivos como el crecimiento postraumático (CPT) después de enfrentarse a adversidades.

          Objetivo: Este estudio tiene como objetivo investigar la relación entre los estilos de apego y el CPT en los sobrevivientes de COVID-19, centrándose en explorar el papel mediador de las estrategias de afrontamiento. A través del examen de estas dinámicas, el estudio pretende contribuir a una comprensión más profunda de los procesos psicológicos subyacentes al crecimiento en individuos que se recuperan de la pandemia.

          Método: Un total de 210 participantes se inscribieron en los hospitales de Tabriz, Irán, en enero de 2021, y completaron cuestionarios de autoinforme. El CPT, los estilos de apego y las estrategias de afrontamiento se evaluaron mediante el Inventario de Crecimiento Postraumático (PTGI en su sigla en inglés), la Escala Revisada de Apego Adulto (RAAS en su sigla en inglés) y el Inventario de Afrontamiento de Situaciones Estresantes (CISS en su sigla en inglés). Se utilizó un modelo de ecuaciones estructurales (SEM en su sigla en inglés) para evaluar los modelos de mediación.

          Resultados: Los efectos directos del apego seguro (β = 0.22, p < .001), y ansioso-ambivalente (β = −0.22, p < .001) sobre el CPT fueron significativos. Asimismo, el afrontamiento orientado a la tarea predijo significativamente el CPT (β = 0.60, p < .001). La vía directa del apego seguro (β = 0.16, p < .05) y ansioso-ambivalente (β = −0.38, p < .001) sobre el afrontamiento orientado a la tarea fue significativa, al igual que el impacto directo del apego seguro (β = −0.18, p < .01) y ansioso-ambivalente (β = 0.37, p < .001) sobre el afrontamiento orientado a la emoción. La asociación entre el apego seguro y el CPT está significativamente mediada por el afrontamiento orientado a la tarea (β = 0.1, (IC 95%: 0.01–0.18)). Asimismo, el afrontamiento orientado a la tarea fue un mediador negativo significativo entre el apego ansioso-ambivalente y el CPT (β = −0.24, (IC 95%: −0.33 – −0.15)).

          Conclusiones: Los resultados apoyan el papel mediador de las estrategias de afrontamiento en la relación entre los estilos de apego y el CPT. Se enfatiza la importancia de las intervenciones para mejorar los recursos de afrontamiento en individuos con enfermedades potencialmente mortales, centrándose en mejorar el afrontamiento centrado en el problema y reducir las estrategias maladaptativas.

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          Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China

          Summary Background A recent cluster of pneumonia cases in Wuhan, China, was caused by a novel betacoronavirus, the 2019 novel coronavirus (2019-nCoV). We report the epidemiological, clinical, laboratory, and radiological characteristics and treatment and clinical outcomes of these patients. Methods All patients with suspected 2019-nCoV were admitted to a designated hospital in Wuhan. We prospectively collected and analysed data on patients with laboratory-confirmed 2019-nCoV infection by real-time RT-PCR and next-generation sequencing. Data were obtained with standardised data collection forms shared by WHO and the International Severe Acute Respiratory and Emerging Infection Consortium from electronic medical records. Researchers also directly communicated with patients or their families to ascertain epidemiological and symptom data. Outcomes were also compared between patients who had been admitted to the intensive care unit (ICU) and those who had not. Findings By Jan 2, 2020, 41 admitted hospital patients had been identified as having laboratory-confirmed 2019-nCoV infection. Most of the infected patients were men (30 [73%] of 41); less than half had underlying diseases (13 [32%]), including diabetes (eight [20%]), hypertension (six [15%]), and cardiovascular disease (six [15%]). Median age was 49·0 years (IQR 41·0–58·0). 27 (66%) of 41 patients had been exposed to Huanan seafood market. One family cluster was found. Common symptoms at onset of illness were fever (40 [98%] of 41 patients), cough (31 [76%]), and myalgia or fatigue (18 [44%]); less common symptoms were sputum production (11 [28%] of 39), headache (three [8%] of 38), haemoptysis (two [5%] of 39), and diarrhoea (one [3%] of 38). Dyspnoea developed in 22 (55%) of 40 patients (median time from illness onset to dyspnoea 8·0 days [IQR 5·0–13·0]). 26 (63%) of 41 patients had lymphopenia. All 41 patients had pneumonia with abnormal findings on chest CT. Complications included acute respiratory distress syndrome (12 [29%]), RNAaemia (six [15%]), acute cardiac injury (five [12%]) and secondary infection (four [10%]). 13 (32%) patients were admitted to an ICU and six (15%) died. Compared with non-ICU patients, ICU patients had higher plasma levels of IL2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNFα. Interpretation The 2019-nCoV infection caused clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus and was associated with ICU admission and high mortality. Major gaps in our knowledge of the origin, epidemiology, duration of human transmission, and clinical spectrum of disease need fulfilment by future studies. Funding Ministry of Science and Technology, Chinese Academy of Medical Sciences, National Natural Science Foundation of China, and Beijing Municipal Science and Technology Commission.
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            Clinical Characteristics of Coronavirus Disease 2019 in China

            Abstract Background Since December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients. Methods We extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death. Results The median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission. Conclusions During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)
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              Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives

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                Author and article information

                Journal
                Eur J Psychotraumatol
                Eur J Psychotraumatol
                European Journal of Psychotraumatology
                Taylor & Francis
                2000-8066
                23 September 2024
                2024
                23 September 2024
                : 15
                : 1
                : 2398917
                Affiliations
                Department of Psychology, Faculty of Education and Psychology, University of Tabriz , Tabriz, Iran
                Author notes
                [CONTACT ] Mostafa Zarean zareanpsy2020@ 123456gmail.com

                Supplemental data for this article can be accessed online at https://doi.org/10.1080/20008066.2024.2398917.

                Author information
                https://orcid.org/0000-0002-6032-3851
                https://orcid.org/0000-0003-3451-9292
                https://orcid.org/0000-0002-5015-2585
                Article
                2398917
                10.1080/20008066.2024.2398917
                11421159
                39311771
                753139aa-6f6e-41c4-b490-affa7e76424e
                © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.

                History
                Page count
                Figures: 1, Tables: 2, Equations: 0, References: 85, Pages: 13, Words: 7344
                Categories
                Basic Research Article
                Research Article

                Clinical Psychology & Psychiatry
                posttraumatic growth,attachment styles,coping strategies,covid-19,crecimiento postraumático,estilos de apego,estrategias de afrontamiento

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