Putting into Words the COVID-19 Lockdown Experience: Psychological Symptoms and the Referential Process
Abstract
:1. Introduction
- Based on previous research, we expected to find a significant positive correlation between psychopathology and logical and reflective language, as a measure of the defense mechanisms of intellectualization and rationalization.
- We expected to find a significant positive correlation between somatization, depressive symptoms, somatic language and negative effects, as measures of verbal expression of body parts, symptoms and negative feelings.
2. Materials and Methods
2.1. Procedure
2.2. Participants
2.3. Measures
2.3.1. Sociodemographic Questionnaire
2.3.2. The Symptoms Checklist-90-Revised (SCL-90-R)
2.3.3. Italian Discourse Attributes Analysis Program (IDAAP) and Linguistic Measures of the Referential Process
- The Italian Weighted Referential Activity Dictionary (I-WRAD) contains 9596 words and represents the computerized measure of RA. The scale ranges between 0 and 1, with 0.5 as the neutral value. The most frequent words depicting a low IWRAD score are associated with a subjective focus. Instead of pointing to external objects and describing situations, the focus is on the present rather than the past tense. High scores represent a high level of referential activity.
- The Italian Reflection Dictionary (IREF) is composed of abstract words concerning how people think and communicate their thoughts. This dictionary includes basic logic words and words referring to cognitive or logical functions or the failures of these functions.
- The Italian Sensory Somatic Dictionary (ISensD) is composed of words related to the body and bodily activities. The number of ISensD words in a speech sample measures the sub-symbolic activation.
- The Italian Sum Affect Dictionary (ISAffD) concerns how people feel and communicate their feelings. It includes words indicating an emotional response, either positive or negative. ISAffD is composed of three sub-dictionaries: positive affect (IAffP), negative affect (IAffN), and neutral affect without a specific valence (IAffZ).
- The Italian Weighted Reflection and Reorganization List (IWRRL) refers to the reorganization and reflection function, where the speaker is trying to recognize and understand the emotional value of an event or set of events. It is not an abstract reflection, but rather, an individual’s reasoning related to a vivid experience. High scores for this measure represent high reflection/reorganization.
2.4. Statistics
3. Results
3.1. Demographics and Descriptives
3.2. Psychological Symptoms and Linguistic Measures
3.3. Narrative Vignettes
3.3.1. Low Group
3.3.2. High Group
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- ISS Working Group Mental Health and Emergency COVID-19. Indications for an Intervention Program of the Mental Health Departments for the Management of the Impact of the COVID-19 Epidemic on Mental Health. Rapporto ISS COVID-19 n. 23/2020, Version 6 May 2020. Available online: https://www.iss.it/rapporti-covid-19/-/asset_publisher/btw1J82wtYzH/content/rapporto-iss-covid-19-n.-23-2020-indicazioni-di-un-programma-di-intervento-dei-dipartimenti-di-salute-mentale-per-la-gestione-dell-impatto-dell-epidemia-covid-19-sulla-salute-mentale.-versione-del-6-maggio-2020 (accessed on 6 May 2020).
- Masiero, M.; Mazzocco, K.; Harnois, C.; Cropley, M.; Pravettoni, G. From Individual to Social Trauma: Sources of Everyday Trauma in Italy, the US and UK during the Covid-19 Pandemic. J. Trauma Diss. 2020, 21, 513–519. [Google Scholar] [CrossRef]
- Vindegaard, N.; Benros, M.E. COVID-19 pandemic and mental health consequences: Systematic review of the current evidence. Brain Behav. Immun. 2020, 89, 531–542. [Google Scholar] [CrossRef]
- Cellini, N.; Canale, N.; Mioni, G.; Costa, S. Changes in sleep pattern, sense of time and digital media use during COVID-19 lockdown in Italy. J. Sleep Res. 2020, 29, 13074. [Google Scholar] [CrossRef] [PubMed]
- Velotti, P.; Rogier, G.; Beomonte, Z.S.; Castellano, R.; Tambelli, R. Loneliness, Emotion Dysregulation, and Internalizing Symptoms During Coronavirus Disease 2019: A Structural Equation Modeling Approach. Front. Psychiatry 2021, 11, 1498. [Google Scholar] [CrossRef] [PubMed]
- Dunn, J.; Coupe, T.; Adams, B. Measuring Linguistic Diversity during COVID-19. In Proceedings of the Fourth Workshop on Natural Language Processing and Computational Social Science of Association for Computational Linguistics, Online, 20 November 2020; Available online: https://aclanthology.org/2020.nlpcss-1.1.pdf (accessed on 20 November 2020).
- Wolohan, J.T. Estimating the Effect of COVID-19 on Mental Health: Linguistic Indicators of Depression during a Global Pandemic. Available online: https://aclanthology.org/2020.nlpcovid19-acl.12.pdf (accessed on 12 April 2020).
- Wu, P.; Zhao, N.; Li, S.; Liu, Z.; Wang, Y.; Liu, T.; Liu, X.; Zhu, T. Exploring the Psychological Effects of COVID-19 Home Confinement in China: A Psycho-Linguistic Analysis on Weibo Data Pool. Front. Psychol. 2021, 12, 2087. [Google Scholar] [CrossRef] [PubMed]
- Guerrini, C.J.; Schneider, S.C.; Guzick, A.G.; Amos Nwankwo, G.N.; Canfield, I.; Fedson, S.; Gutierrez, A.M.; Sheu, J.C.; Song, A.Y.; Villagran, A.M.; et al. Psychological Distress Among the U.S. General Population During the COVID-19 Pandemic. Front. Psychiatry 2021, 12, 810. [Google Scholar] [CrossRef] [PubMed]
- Testoni, I.; Zanellato, S.; Iacona, E.; Marogna, C.; Cottone, P.; Bingaman, K. Mourning and Management of the COVID-19 Health Emergency in the Priestly Community: Qualitative Research in a Region of Northern Italy Severely Affected by the Pandemic. Front. Public Health 2021, 9, 45. [Google Scholar] [CrossRef] [PubMed]
- Li, I.; Li, Y.; Li, T.; Alvarez-Napagao, S.; Garcia-Gasulla, D.; Suzumura, T. What Are We Depressed About When We Talk About COVID-19: Mental Health Analysis on Tweets Using Natural Language Processing. In Proceedings of the Artificial Intelligence XXXVII (SGAI), Cambridge, UK, 15–17 December 2020; Lecture Notes in Computer Science. Bramer, M., Ellis, R., Eds.; Springer: Cham, Switzerland, 2020; Volume 12498. [Google Scholar] [CrossRef]
- Mota, N.B.; Weissheimer, J.; Ribeiro, M.; de Paiva, M.; Avilla-Souza, J.; Simabucuru, G.; Chaves, M.F.; Cecchi, L.; Cirne, J.; Cecchi, G.; et al. Dreaming during the Covid-19 pandemic: Computational assessment of dream reports reveals mental suffering related to fear of contagion. PLoS ONE 2020, 15, e0242903. [Google Scholar] [CrossRef]
- Pennebaker, J.W. The Secret Life of Pronouns: What Our Words Say about Us; Bloomsbury: New York, NY, USA, 2011. [Google Scholar]
- Javier, R.A.; Marcos, L.R. The role of stress on the language-independence and code-switching phenomena. J. Psycholinguist. Res. 1989, 18, 449–472. [Google Scholar] [CrossRef]
- Galbusera, L.; Fellin, L. The intersubjective endeavor of psychopathology research: Methodological reflections on a second-person perspective approach. Front. Psychol. 2014, 5, 1150. [Google Scholar] [CrossRef] [Green Version]
- Baddeley, J.L.; Daniel, G.R.; Pennebaker, J.W. How Henry Hellyer’s use of language foretold his suicide. Crisis 2011, 32, 288–292. [Google Scholar] [CrossRef]
- Dove, G. Thinking in words: Language as an embodied medium of thought. Top. Cogn. Sci. 2014, 6, 371–389. [Google Scholar] [CrossRef]
- Bucci, W. The development of emotional meaning in free association: A multiple code theory. In Hierarchical Concepts in Psychoanalysis, 1st ed.; Wilson, A., Gedo, J.E., Eds.; Guilford: New York, NY, USA, 1993; pp. 3–47. [Google Scholar]
- Bucci, W. Symptoms and symbols: A multiple code theory of Somatization. Psychoanal. Inq. 1997, 17, 151–172. [Google Scholar] [CrossRef]
- Bucci, W. Emotional Communication and Therapeutic Change Understanding Psychotherapy through Multiple Code Theory, 1st ed.; Cornell, W.C., Ed.; Routhledge: London, UK, 2021. [Google Scholar]
- Negri, A.; Christian, C.; Mariani, R.; Belotti, L.; Andreoli, G.; Danskin, K. Linguistic features of the therapeutic alliance in the first session: A psychotherapy process study. Res. Psychother. 2019, 22, 374. [Google Scholar] [CrossRef] [Green Version]
- Caretti, V.; Craparo, G. Disregolazione affettiva, trauma e dissociazione in un gruppo non clinico di adolescenti. Una prospettiva evolutiva. Inf. Adolesc. 2005, 3, 22–30. [Google Scholar] [CrossRef]
- Baddeley, J.L.; Pennebaker, J.W. The expressive writing method. In Studies in Writing. Research on Writing Approaches in Mental Health, 1st ed.; L’Abate, L., Sweeney, L.G., Eds.; Emerald Group Publishing: Bingley, UK, 2011; pp. 85–92. [Google Scholar] [CrossRef]
- Di Trani, M.; Mariani, R.; Renzi, A.; Greenman, P.S.; Solano, L. Alexithymia according to Bucci’s multiple code theory: A preliminary investigation with healthy and hypertensive individuals. Psychol. Psychother. 2018, 91, 232–247. [Google Scholar] [CrossRef]
- Bucci, W. Dissociation from the Perspective of Multiple Code Theory—Part II. Contemp. Psychoanal. 2007, 43, 305–326. [Google Scholar] [CrossRef]
- Lind, M.; Vanwoerden, S.; Penner, F.; Sharp, C. Narrative Coherence in Adolescence: Relations with Attachment, Mentalization, and Psychopathology. J. Personal. Assess. 2020, 102, 380–389. [Google Scholar] [CrossRef] [PubMed]
- Hambleton, G.; Russell, R.; Wandrei, M. Narrative Performance Predicts Psychopathology: A Preliminary Demonstration. J. Narrat. Life Hist. 1996, 6, 87–105. [Google Scholar] [CrossRef]
- Hashemi, B.; Shaw, R.J.; Hong, D.S.; Hall, R.; Nelson, K.; Steiner, H. Posttraumatic stress disorder following traumatic injury: Narratives as unconscious indicators of psychopathology. Bull. Menn. Clin. 2008, 72, 179–190. [Google Scholar] [CrossRef] [PubMed]
- Negri, A.; Bucci, W.; Maskit, B. Referential activity levels in the main clinical diagnoses. In Proceedings of the Third Joint Meeting of the SPR European and UK Chapters, Porto, Portugal, 10–13 October 2012. [Google Scholar]
- Mariani, R.; Di Trani, M.; Negri, A.; Tambelli, R. Linguistic analysis of autobiographical narratives in unipolar and bipolar mood disorders in light of multiple code theory. J. Aff. Disord. 2020, 273, 24–31. [Google Scholar] [CrossRef]
- Prunas, A.; Sarno, I.; Preti, E.; Madeddu, F.; Perugini, M. Psychometric properties of the Italian version of the SCL-90-R: A study on a large community sample. Europ. Psychiatry 2012, 27, 591–597. [Google Scholar] [CrossRef]
- Bucci, W. Overview of the Referential Process: The Operation of Language within and between People. J. Psychol. Res. 2021, 50, 3–15. [Google Scholar] [CrossRef]
- Maskit, B. Overview of Computer Measures of the Referential Process. J. Psychol. Res. 2021, 50, 29–49. [Google Scholar] [CrossRef] [PubMed]
- Mariani, R.; Maskit, B.; Bucci, W.; De Coro, A. Linguistic measures of the referential process in psychodynamic treatment: The English and Italian versions. Psychother. Res. 2013, 23, 430–447. [Google Scholar] [CrossRef] [PubMed]
- Negri, A.; Esposito, G.; Mariani, R.; Savarese, M.; Belotti, L.; Squitieri, B.; Bucci, W. The Italian weighted reflection and reorganization list (I-WRRL): A new linguistic measure detecting the third phase of the referential process. In Proceedings of the XII Congresso Nazionale della Società per la Ricerca in Psicoterapia SPR-Italia, Palermo, Italy, 5–6 October 2018; Pagepress: Pavia, Italy, 2018; p. 5. Available online: https://aisberg.unibg.it/retrieve/handle/10446/135501/291743/Abstract%20pubblicati%20su%20RIPPO.pdf (accessed on 5 October 2018).
- Kiefer, F.; Helwig, H.; Tarnaske, T.; Otte, C.; Jahn, H.; Wiedemann, K. Pharmacological Relapse Prevention of Alcoholism: Clinical Predictors of Outcome. Eur. Addict. Res. 2005, 11, 83–91. [Google Scholar] [CrossRef] [PubMed]
- Telch, C.F.; Agras, W.S. Obesity, binge eating and psychopathology: Are they related? Int. J. Eat. Disord. 1994, 15, 53–61. [Google Scholar] [CrossRef]
- Zhou, Y.; Maskit, B.; Bucci, W.; Fishman, A.; Murphy, S. Development of WRRL: A New Computerized Measure of the Reflecting/Reorganizing Function. J. Psycholinguist. Res. 2021, 50, 51–64. [Google Scholar] [CrossRef]
- Mariani, R.; Hoffman, L. Analytic Process and Linguistic Style: Exploring Analysts’ Treatment Notes in the Light of Linguistic Measures of the Referential Process. J. Psychol. Res. 2021, 50, 193–206. [Google Scholar] [CrossRef]
- Mariani, R.; De Coro, A. Study of a Short-term Treatment by Referential Activity Linguistic Measures. Res. Psychother. 2013, 16, 42–53. [Google Scholar] [CrossRef]
- Negri, A.; Andreoli, G.; Barazzetti, A.; Zamin, C.; Christian, C. Linguistic Markers of the Emotion Elaboration Surrounding the Confinement Period in the Italian Epicenter of COVID-19 Outbreak. Front. Psychol. 2020, 11, 568281. [Google Scholar] [CrossRef]
- Santana, M.; Zatti, C.; Spader, M.L.; Malgarim, B.G.; Salle, E.; Piltcher, R.; Ceresér, K.; Bastos, A.G.; Freitas, L.H. Acute stress disorder and defense mechanisms: A study of physical trauma patients admitted to an emergency hospital. Trends Psychiatry Psychother. 2017, 39, 247–256. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Marazziti, D.; Pozza, A.; Di Giuseppe, M.; Conversano, C. The psychosocial impact of COVID-19 pandemic in Italy: A lesson for mental health prevention in the first severely hit European country. Psychol. Trauma Theory Res. Pract. Policy 2020, 12, 531–533. [Google Scholar] [CrossRef] [PubMed]
- Di Giuseppe, M.; Zilcha-Mano, S.; Prout, T.A.; Perry, J.C.; Orrù, G.; Conversano, C. Psychological Impact of Coronavirus Disease 2019 Among Italians During the First Week of Lockdown. Front. Psychiatry 2020, 30, 576597. [Google Scholar] [CrossRef]
- Cohn, M.A.; Mehl, M.R.; Pennebaker, J.W. Linguistic markers of psychological change surrounding 11 September 2001. Psychol. Sci. 2004, 5, 10–15. [Google Scholar] [CrossRef] [PubMed]
IWRAD |
High weight: odore (smell); urla (scream); baciare (to kiss). Medium weight: il (the); capisci (you understand); io (I). Low weight: superficiali (superficial); ansiosa (anxious); carini (nice). |
IWRRL |
High weight: impedisce (prevent); spensierata (carefree); bisogni (needs). Medium weight: chiaramente (clearly); discorso (speech); logicamente (of course). Low weight: sapendo (understanding); nascosta (hidden); separazione (separation). |
IRefD |
Attenzione (attention), capire (to understand), decisione (decision), ragione (reason), razionalità (rationality), ricordo (memory). |
ISenSD |
Ammalato (sick), digerire (digest), disorientamento (disorientation), dolore (pain), ridere (to laugh), sintomi (symptoms), vomitare (to throw up). |
ISAffD: |
Positive—abbracci (hugs), affidabile (reliable), felice (happy); negative—abbandonato (abandoned), depresso (depressed), impaurito (frightened); neutral—attesa (expectation), bisogno (need), coinvolto (involved) |
SCL-90-R 1 | Linguistic Measures 2 | |||||||
---|---|---|---|---|---|---|---|---|
IWRAD | IRef | IWRRL | IAffN | IAffP | IAffS | IAffZ | ISensS | |
SOM | −0.062 | 0.207 | −0.043 | 0.151 | −0.138 | −0.092 | −0.092 | 0.109 |
OC | −0.176 | 0.372 ** | −0.343 * | 0.226 | −0.059 | −0.012 | −0.080 | −0.055 |
IS | −0.138 | 0.309 * | −0.278 | 0.171 | −0.084 | −0.035 | −0.125 | −0.184 |
DEP | −0.207 | 0.339 * | −0.347 * | 0.182 | −0.099 | −0.036 | 0.000 | −0.053 |
ANX | −0.151 | 0.367 * | −0.338 * | 0.265 | −0.095 | 0.010 | 0.158 | −0.050 |
HOS | −0.178 | 0.520 ** | −0.193 | 0.126 | −0.204 | −0.158 | 0.009 | −0.105 |
PHO | −0.104 | 0.133 | −0.236 | 0.147 | −0.009 | 0.054 | 0.146 | −0.149 |
PAR | −0.065 | 0.367 * | −0.237 | 0.187 | −0.093 | −0.037 | −0.104 | −0.080 |
PSY | −0.125 | 0.281 | −0.136 | 0.144 | −0.072 | −0.027 | −0.065 | −0.046 |
GSI | −0.170 | 0.358 * | −0.290 * | 0.205 | −0.116 | −0.049 | −0.051 | −0.064 |
AGE | 0.283 | −0.010 | 0.208 | −0.104 | 0.290 * | 0.244 | −0.075 | −0.018 |
Linguistic Measures 1 | High Group (N = 25) | Low Group (N = 23) | t | Sign | ||
---|---|---|---|---|---|---|
M | SD | M | SD | |||
IWRAD | 0.824 | 0.059 | 0.861 | 0.073 | 1.94 | 0.047 * |
IRef | 0.043 | 0.030 | 0.025 | 0.016 | −2.62 | 0.012 * |
IWRRL | 0.730 | 0.089 | 0.793 | 0.078 | 2.59 | 0.013 * |
IAffP | 0.021 | 0.031 | 0.071 | 0.206 | 1.18 | 0.241 |
IAffN | 0.044 | 0.056 | 0.029 | 0.042 | −1.03 | 0.307 |
IAffS | 0.073 | 0.069 | 0.102 | 0.201 | 0.67 | 0.505 |
IAffZ | 0.008 | 0.015 | 0.002 | 0.006 | −1.62 | 0.111 |
ISenS | 0.065 | 0.041 | 0.057 | 0.044 | −0.638 | 0.527 |
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Mariani, R.; Monaco, S.; Di Trani, M. Putting into Words the COVID-19 Lockdown Experience: Psychological Symptoms and the Referential Process. Healthcare 2021, 9, 1100. https://doi.org/10.3390/healthcare9091100
Mariani R, Monaco S, Di Trani M. Putting into Words the COVID-19 Lockdown Experience: Psychological Symptoms and the Referential Process. Healthcare. 2021; 9(9):1100. https://doi.org/10.3390/healthcare9091100
Chicago/Turabian StyleMariani, Rachele, Silvia Monaco, and Michela Di Trani. 2021. "Putting into Words the COVID-19 Lockdown Experience: Psychological Symptoms and the Referential Process" Healthcare 9, no. 9: 1100. https://doi.org/10.3390/healthcare9091100