Narratives of the worst experiences associated with peritraumatic distress during the COVID-19 pandemic: a mixed method study in the USA and Italy

Figures & data

Figure 1. Cumulative number of new confirmed cases (top) and deaths (bottom) per million people in the US and Italy during the first wave of COVID-19 pandemic.

Table 1. Demographic and clinical information.

	M (SD) US	M (SD) Italy	M (SD) Total
Age (years)	44.40 (15.89)	39.44 (16.03)	42.8 (16.1)
PDI* total score	23.13 (10.18)	20.04 (9.68)	22.1 (10.1)
	N (%) US	N (%) Italy	N (%) Total
Gender
Male	155 (20.92)	92 (25.77)	247 (22.5)
Female	569 (76.79)	259 (72.55)	828 (75.4)
Other/won’t disclose	17 (2.29)	6 (1.68)	23 (2.1)
Marital status
Single	191 (25.78)	92 (25.77)	283 (25.8)
Dating without co-habitating	60 (8.10)	90 (25.21)	150 (13.7)
Co-habitating/married	435 (58.70)	154 (43.14)	589 (53.6)
Separated/Divorced/Widowed	55 (7.42)	21 (5.88)	76 (6.9)
Occupation
Healthcare workers	68 (9.18)	56 (15.69)	124 (11.3)
General workers (manual workers, professional workers, self-employed, etc.)	315 (42.51)	121 (33.89)	436 (39.7)
Unemployed (students, retired, unemployed)	197 (26.59)	122 (34.17)	319 (29.1)
Other	161 (21.73)	58 (16.25)	219 (19.9)
Education
Pre-university	33 (4.45)	82 (22.97)	115 (10.5)
Undergraduate level	229 (30.90)	121 (33.89)	350 (31.9)
Graduate level	479 (64.64)	154 (43.14)	633 (57.7)

Note: N = 1098, US (N = 741) and Italy (N = 357).

*The Peritraumatic Distress Inventory (PDI) ranges from 0 (no symptom) to 52.

Table 2. Frequency of themes endorsed in the worst experiences narratives and comparison by country.

	Total sample N (%)	USA (N = 741)	Italy (N = 358)	Chi-square	P-value
Anxiety	117 (10.7%)	69 (9.3%)	48 (13.4%)	4.32	.049
Threat	449 (40.9%)	337 (45.5%)	112 (31.4%)	19.84	<.001
Threat self	231 (21%)	178 (24%)	53 (14.8%)	12.28	<.001
Threat others	294 (26.8%)	221 (29.8%)	73 (20.4%)	10.80	<.001
Threat world	15 (1.4%)	5 (0.7%)	10 (2.8%)	8.08	.004
Loss	235 (21.4%)	175 (23.6%)	60 (16.8%)	6.64	.010
Guilt/shame	83 (7.6%)	57 (7.7%)	26 (7.3%)	0.058	.810
Helplessness	59 (5.4%)	44 (5.9%)	15 (4.2%)	1.43	.232
Loss experienced by self	70 (6.4%)	51 (6.9%)	19 (5.3%)	0.98	.321
Loss experienced by others	65 (5.9%)	54 (7.3%)	11 (3.1%)	7.65	.006
Anger	137 (12.5%)	99 (13.4%)	38 (10.6%)	1.63	.202
Anger with others	90 (8.2%)	70 (9.4%)	20 (5.6%)	4.732	.030
Anger with government	90 (8.2%)	39 (5.3%)	21 (5.9%)	0.18	.672
Stress and distress	273 (24.9%)	157 (21.2%)	116 (32.5%)	16.48	<.001
Stress	205 (18.7%)	115 (15.5%)	90 (25.1%)	14.90	<.001
Exposure to threatening information/event	78 (7.1%)	50 (6.7%)	28 (7.8%)	0.44	.508
Constriction	330 (30.1%)	213 (28.7%)	117 (32.8%)	1.86	.173
Social isolation	180 (16.4%)	110 (14.8%)	70 (19.6%)	3.99	.046
Deprivation of resources	148 (13.5%)	107 (14.4%)	41 (11.5%)	1.80	.179
Being trapped in an intolerable situation	30 (2.7%)	10 (1.3%)	20 (5.6%)	16.40	<.001
Absence of negative effects	32 (2.9%)	12 (1.6%)	20 (5.6%)	13.51	<.001
Positive effects	5 (0.5%)	1 (0.1%)	4 (1.1%)	5.162	.023
Coping strategies	47 (4.3%)	28 (3.8%)	19 (5.3%)	1.40	.237

Figure 2. Classification and regression tree (CART) analysis of COVID-19 experiences predicting clinically significant levels of peritraumatic distress.