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      Psychological health of mothers and siblings of children with autism spectrum disorder during COVID-19 pandemic: New evidence in Italian families

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          Abstract

          Background and aim:

          Psychological challenges are well recognized in families with a child with Autism Spectrum Disorder (ASD). Instead, less is known about the effects of traumatic scenarios, such as COVID-19, on the psychological health of these families. The main aim of this study was to examine the psychological health of both mothers and typically developing (TD) siblings of children with ASD during the COVID-19 pandemic. We also investigated the relationship between mothers’ psychological resources and their children’s psychological well-being.

          Method:

          The sample included 52 mothers and their children: 15 mothers with one child with ASD and at least one TD child (ASD-siblings group) and 37 mothers with one or more TD children (TD control group). The data were collected using an online platform; four standardized questionnaires (GAD-7, BDI-II, CD-RISC 25 and CBCL) were administered.

          Results:

          The analyses revealed more internalizing and total behavioral symptoms in the siblings of children with ASD, compared to the TD control group. Regarding the mothers, we did not find differences in depression and anxious symptoms between the two groups. However, the mothers of children with ASD showed a lower resilience than mothers of TD children. Moreover, the psychological well-being of the children was related with the mothers’ anxiety in the ASD-siblings group.

          Conclusions:

          Overall, our data show that the COVID-19 outbreak may have been particularly challenging for siblings of children with ASD, and highlight the importance of intensifying the psychological support to these families. (www.actabiomedica.it)

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          Most cited references73

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          A brief measure for assessing generalized anxiety disorder: the GAD-7.

          Generalized anxiety disorder (GAD) is one of the most common mental disorders; however, there is no brief clinical measure for assessing GAD. The objective of this study was to develop a brief self-report scale to identify probable cases of GAD and evaluate its reliability and validity. A criterion-standard study was performed in 15 primary care clinics in the United States from November 2004 through June 2005. Of a total of 2740 adult patients completing a study questionnaire, 965 patients had a telephone interview with a mental health professional within 1 week. For criterion and construct validity, GAD self-report scale diagnoses were compared with independent diagnoses made by mental health professionals; functional status measures; disability days; and health care use. A 7-item anxiety scale (GAD-7) had good reliability, as well as criterion, construct, factorial, and procedural validity. A cut point was identified that optimized sensitivity (89%) and specificity (82%). Increasing scores on the scale were strongly associated with multiple domains of functional impairment (all 6 Medical Outcomes Study Short-Form General Health Survey scales and disability days). Although GAD and depression symptoms frequently co-occurred, factor analysis confirmed them as distinct dimensions. Moreover, GAD and depression symptoms had differing but independent effects on functional impairment and disability. There was good agreement between self-report and interviewer-administered versions of the scale. The GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research.
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            The psychological impact of quarantine and how to reduce it: rapid review of the evidence

            Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.
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              Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

              Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.
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                Author and article information

                Journal
                Acta Biomed
                Acta Biomed
                Acta Bio Medica : Atenei Parmensis
                Mattioli 1885 (Italy )
                0392-4203
                2531-6745
                2023
                17 October 2023
                : 94
                : 5
                : e2023199
                Affiliations
                [1 ] Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Reggio Emilia, Italy
                [2 ] AUT AUT Modena APS Association, Modena, Italy
                [3 ] Research Coordination and Support Service, Istituto Superiore di Sanità, Rome, Italy
                [4 ] Division of Clinical Psychology AUSL Modena, Modena, Italy
                Author notes
                Correspondence: Michela Camia Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia, Campus San Lazzaro, Padiglione De Sanctis, Reggio Emilia, Italy E-mail: michela.camia@ 123456unimore.it
                Article
                ACTA-94-199
                10.23750/abm.v94i5.14522
                10644939
                37850771
                611742ac-e630-4ea9-9fbb-4fd95e421643
                Copyright: © 2023 ACTA BIO MEDICA SOCIETY OF MEDICINE AND NATURAL SCIENCES OF PARMA

                This work is licensed under a Creative Commons Attribution 4.0 International License

                History
                : 27 March 2023
                : 31 May 2023
                Categories
                Original Article

                autism spectrum disorder,mothers,siblings,covid-19,psychological health

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