The effects of COVID-19 continuous traumatic stressors on mental health and cognitive functioning: A case example from Turkey

Ibrahim A Kira; Emre Han Alpay; Yunus Emre Ayna; Hanaa A M Shuwiekh; Jeffrey S Ashby; Aras Turkeli

doi:10.1007/s12144-021-01743-2

The effects of COVID-19 continuous traumatic stressors on mental health and cognitive functioning: A case example from Turkey

Curr Psychol. 2022;41(10):7371-7382. doi: 10.1007/s12144-021-01743-2. Epub 2021 Apr 21.

Authors

Ibrahim A Kira^{1

2}, Emre Han Alpay³, Yunus Emre Ayna⁴, Hanaa A M Shuwiekh⁵, Jeffrey S Ashby⁶, Aras Turkeli³

Affiliations

¹ Center for Cumulative Trauma Studies, Stone Mountain, GA USA.
² Affiliate of Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA USA.
³ Department of Psychology, Mersin University, Mersin, Turkey.
⁴ Psychology Department, Dicle University, Diyarbakır, Turkey.
⁵ Fayoum University, Fayoum, Egypt.
⁶ Center for Stress, trauma, and Resiliency, Georgia State University, Atlanta, GA USA.

Abstract

There is a need to accurately assess the specific impacts of the various traumatic stressors caused by COVID-19 on mental health. The goal was to evaluate the impact of different types of COVID-19 stressors (infection fears, lockdown, and economic stressors) on mental health and cognitive functioning. We used a sample of 262 Turkish adults. We administered an online questionnaire that included measures of COVID-19 traumatic stressors, PTSD, depression, anxiety, executive function deficits, and cumulative stressors and traumas (CST). The analyses included correlations, hierarchical regression, path analysis, and PROCESS mediation analysis. All COVID-19 traumatic stressors types and their cumulative load predicted PTSD, depression, anxiety, and executive function deficits after controlling for previous cumulative stressors and traumas and COVID-19 infection. COVID-19 lockdown's stressors were the strongest predictors, compared to COVID-19 fears and economic stressors. Path analysis and PROCESS mediation results indicated that COVID-19 traumatic stressors had direct effects on working memory deficits, direct and indirect effects on PTSD, depression, and anxiety, and indirect effects on inhibition deficits. Anxiety, depression, and inhibition deficits mediated its indirect effects on PTSD. The results have conceptual and clinical implications. COVID-19 continuous posttraumatic stress syndrome that includes comorbid PTSD, depression, anxiety, and executive function deficits is different and does not fit within the current trauma frameworks. There is a need for a paradigm shift in current stress and trauma frameworks to account for the COVID-19 continuous global stressors and for clinical innovations in intervention to help its victims.

Supplementary information: The online version contains supplementary material available at 10.1007/s12144-021-01743-2.

Keywords: Anxiety; COVID-19 traumatic stressors; Depression; Executive functions; PTSD.