Abstract
During April 2020, we conducted the first wave (T0) of an online survey to explore the psychological health of Italian adults after 1 month of isolation at home to contain the spread of COVID-19. Methods and symptoms at baseline have been published in detail in Amendola et al. (2021). Inclusion criterion was an age of 18 years or older, while living outside Italy during the national lockdown was an exclusion criterion. A snowball sampling technique was employed to recruit participants. To advertise the survey, social media platforms were used and university students at Sapienza University of Rome were encouraged to participate. Here, we present the results of the analysis regarding predictors of hopelessness among Italian adults who participated at the second wave (T1) of the study during the second half of June 2020. Between T0 and T1, the slowdown of the contagion process was remarkable. National lockdown restrictions were eased, and production activities were resuming.
Four hundred and twelve valid responses were obtained at T0, while 57 participants (78.9% females, n = 45) also responded at T1 (response rate at T1 was 13.8%). The mean age of participants at T1 was 33.72 (SD = 9.68). The online questionnaire included depression and anxiety subscales of the BSI (Derogatis, 1975), eight items of the BRIAN (Giglio et al., 2009), and the short version of the BHS (Dora et al., 2013) examining hopelessness at T1. All scales showed good internal consistency (α of the depression subscale was .85 and .83 at T0 and T1, respectively; α of anxiety was .91 at T0 and .86 at T1; α of the BRAIN was .82 at T0 and .80 at T1; α of the BHS was .83 at T1).
Individuals who participated both at T0 and T1 showed no difference compared to those who participated only at T0 for age, gender, education, depression, anxiety, and circadian rhythm at baseline.
Changes in depression, anxiety, and circadian rhythm over time were analyzed using linear mixed models. Although mean scores decreased (depression: T0 = 6.10 ± 5.06, T1 = 5.37 ± 4.54; anxiety: T0 = 6.0 ± 5.85, T1 = 5.37 ± 5.19; circadian rhythm: T0 = 16.86 ± 5.18, T1 = 16.09 ± 4.72) changes were non-significant.
Mean score at the short version of the BHS was 2.39 (SD = 2.32). Four participants (7.02%) obtained a total score of 6 or higher, indicating an individual at risk of suicide according to Dora et al. (2013).
The relationship between the variables of interest and hopelessness was explored using regression models. Initially, all predictors were fitted separately; in the final model, all significant predictors were fitted jointly to determine their unique relevance in predicting hopelessness. Findings of the final model indicated that anxiety at T0 and depression at T1 significantly predicted hopelessness at T1 (Table 1).
Results of regression analyses predicting hopelessness during the second survey wave (T1).
p < .05; **p < .01; ***p < .001.
The main limitation of the present study is related to the small sample size with high proportion of well-educated people (29.8% completed the high school, 70.2% university degree or higher). The response rate at T1 was slightly lower than those of approximately 20% observed in a previous study (Deutskens et al., 2004) but in line with recommended rates under liberal conditions (Nulty, 2008). A possible explanation for the low response rate obtained may be related to the absence of incentives for participation in the study. Furthermore, some participants may have been less motivated to fill out the battery of questionnaires and paying attention to their psychological distress during the second survey wave when national restrictions to counter the spread of the coronavirus were eased. However, participants who participated at T0 only and those who participated at both time points did not show differences for age, gender, education, depression, anxiety, and circadian rhythm at baseline. Importantly, our findings have clinical and public health implications. Symptoms of depression and anxiety during the COVID-19 pandemic positively predicted hopelessness after the easing of national measures of home isolation. In caring for their patients, clinicians should consider the relationship between internalizing symptoms, the risk of suicide, and the reason behind hopelessness. Current life events such as financial difficulties, job loss, illness, or the passing away of a loved one can all be linked to depressive symptoms and hopelessness. Additionally, social distancing and isolation may also increase feelings of worthlessness and lack of hope in the future. The public health systems should support interventions aimed at strengthening mental health programs across the countries or improving social connection of more vulnerable and isolated people during a pandemic event. The governments have the opportunity to recognize the importance of improving availability and accessibility of community based mental health services (Golechha, 2020). Finally, future research utilizing larger samples is needed to confirm our findings.
Footnotes
Acknowledgements
The authors would like to thank the individuals who generously shared their time and experience for the purposes of this project.
Availability of data
The data that support the findings of this study are available from the corresponding author, R.C., upon reasonable request.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards, and with the ethical standards of the Ethics Committee of the Department of Dynamic and Clinical Psychology, Sapienza University of Rome.
Funding
The author(s) received no financial support for the research, authorship, and/or publication of this article.
Informed consent
Informed consent was obtained from all individual participants included in the study.
