The associations between metacognition problems, childhood trauma and internalizing symptoms in healthcare workers working directly with patients infected with COVID-19

Healthcare workers (HCWs) providing medical support while facing one of the highest levels of adverse and potentially fatal outcomes due to COVID-19 are put in a vulnerable position leading to the development of mental health problems. The development of any prevention and intervention programs to reduce this risk is possible with better understanding and knowledge of possible vulnerability factors. The aim of the present study is to investigate psychological effect of working directly with patients infected with COVID-19 (WD) and possible individual vulnerability factors for the development of psychological problems in HCWs. The data used in this cross-sectional study were collected using online self-reported questionnaires from 290 HCWs aged 21-61 years old. The mean score of the scales of 145 HCWs-WD and 145 HCWs not WD (HCWs-NWD) were compared by independent sample t test. Associations between childhood traumas, metacognitive dysfunctional beliefs and internalizing symptoms were analyzed using structural equation modelling (SEM). The depression, anxiety, stress symptoms levels, somatization and sleep problem levels were found to be higher in HCWs-WD compared to HCWs-NWD. SEM revealed that childhood trauma levels was associated with the increased risk of internalizing problems, and metacognitive dysfunctional beliefs had a partial mediator role between childhood traumas and internalizing symptoms in HCWs-WD. Improving metacognitive abilities may hence need to be considered in prevention programs for the HCWs. The findings can also be used to set up further research on the specific interventions on the HCWs who are at a risk as their profession entails them being in such traumatic situations.