Cognition, Emotions, and Language in Front-Line Healthcare Workers: Clinical and Ethical Implications for Assessment Measures

Keywords: clinical psycholinguistics, linguistic markers, words-associations, psychological stress, ethics, depression, anxiety, resilience, healthcare staff, LIWC.

Abstract

Objectives. The article aims to reveal language-based markers of stressful experiences in healthcare workers in terms of their cognitions and emotions.  The following research questions were formulated for the current study: (1) Are risk and protective factors for psychological stress in healthcare staff, working with patients with COVID-19 aligned with anxiety, depression and resilience? (2) Are there any language-based indicators for emotional distress in healthcare staff, working with patients with COVID-19? (3) What are the key cognitions, emotions, and behavioral patterns are expressed in healthcare workers’ staff language? (4) What are words-associations in the Ukrainian Associative Dictionary aligned with language-based indicators of professional ethics in healthcare staff?

Materials and Methods. The study applies Beck’s Depression Inventory (BDI-II), Beck’s Anxiety Inventory (BAI), the Brief Resilient Coping Scale (BRCS), the Psychological Stress Scale (PSM-25), and the Linguistic Inquiry and Word Count (LIWC 2015).

Results. Results show that healthcare staff demonstrates a low level of psychological stress, depression and anxiety, and a medium level of resilience. The results of multiple linear regression indicate that the only significant negative predictor of stress is resilience. The psycholinguistic analysis of healthcare staff's narrative on their professional experience treating COVID-19 patients shows the key meaningful categories, namely social contacts, cognitive processes, and time. Social contacts are primarily represented by the category family. The word-associations from the Ukrainian Associative Dictionary indicate that feeling of guilt related to professional ethics in healthcare staff is more expressed in men compared with women.

Conclusion. The insights gained from this study may be of assistance to developing effective interventions for healthcare staff during a pandemic, primarily focusing on protective factors and weakening feelings of guilt to prevent moral injury. The study also raises some issues of the clinical psycholinguistic approach to examining emotional distress. This approach would be a fruitful area for further work.

Downloads

Download data is not yet available.

References

Alnazly, E., Khraisat, O.M., Al-Bashaireh, A.M., & Bryant, C. L. (2021). Anxiety, depression, stress, fear, and social support during COVID-19 pandemic among Jordanian healthcare workers. Plos One, 16(3), Article e0247679. https://doi.org/10.1371/journal.pone.0247679

Bai, Y., Lin, C. C., Lin, C. Y., Chen, J. Y., Chue, C. M., & Chou, P. (2004). Survey of stress reactions among health care workers involved with the SARS outbreak. Psychiatric Services, 55(9), 1055–1057. https://doi.org/10.1176/appi.ps.55.9.1055

Shah, K., Kamrai, D., Mekala, H., Mann, B., Desai, K., & Patel, R. S. (2020). Focus on mental health during the coronavirus (COVID-19) pandemic: applying learnings from the past outbreaks. Cureus, 12(3), Article e7405. http://doi.org/10.7759/cureus.7405

Beck, A.T., Epstein, N., Brown, G., & Steer, R.A. (1988a). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology, 56(6), 893. https://psycnet.apa.org/doi/10.1037/0022-006X.56.6.893

Beck, A.T., Steer, R.A., & Garbin, G.M. (1988b). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100. https://dx.doi.org/10.1186%2F1753-2000-1-8

Bedi, G., Cecchi, G.A., Slezak, D.F., Carrillo, F., Sigman, M., & De Wit, H. (2014). A window into the intoxicated mind? Speech as an index of psychoactive drug effects. Neuropsychopharmacology, 39(10), 2340–2348. https://psycnet.apa.org/doi/10.1038/npp.2014.80

Bifulco, A. (2021). Childhood trauma in women and fragmented interview narratives – some interdisciplinary methodological and clinical implications. East European Journal of Psycholinguistics, 8(1), 12–27. https://doi.org/10.29038/eejpl.2021.8.1.bif

Carbajal, A.B., Boluarte, A.S., Boluarte, A.R., & Soto, C.M. (2020). Working conditions and emotional impact in healthcare workers during COVID-19 pandemic. Journal of Healthcare Quality Research, 35(6), 401. https://doi.org/10.1016/j.jhqr.2020.08.002

Krantz, A.M., & Pennebaker, J.W. (2007). Expressive dance, writing, trauma, and health: When words have a body. In I.A. Serlin, J. Sonke-Henderson, R. Brandman, & J. Graham-Pole (Eds.), Whole person healthcare (Vol. 3: The arts and health), (pp. 201–229). Praeger Publishers.

Leigh, J., Fitzgerald, G., Garcia, E., & Moon, S. (2018). Global epidemics: how well can we cope? British Medical Journal, 8, Article 362:k3254. https://doi.org/10.1136/bmj.k3254

Lemyre, L., & Tessier, R. (2003). Measuring psychological stress. Concept, model, and measurement instrument in primary care research. Canadian Family Physician, 49, 1159–1168.

Marmar, C.R., Brown, A.D., Qian, M., Laska, E., Siegel, C., Li, M., ... & Vergyri, D. (2019). Speech-based markers for posttraumatic stress disorder in US veterans. Depression and Anxiety, 36(7), 607–616. https://doi.org/10.1002/da.22890

Martinek, S., & Mitkov, S. (2021). Ukrainskyi asotsiatyvnyi slovnyk [The Ukrainian Associative Dictionary]. (Vol. 3). Lviv: PAIS.

Matsumoto, D.E. (2009). The Cambridge dictionary of psychology. Cambridge University Press.

Ozbay, F., Johnson, D.C., Dimoulas, E., Morgan III, C.A., Charney, D., & Southwick, S. (2007). Social support and resilience to stress: from neurobiology to clinical practice. Psychiatry (Edgmont), 4(5), 35–40.

Pennebaker, J.W., Boyd, R.L., Jordan, K., & Blackburn, K. (2015). The development and psychometric properties of LIWC2015. Austin, TX: University of Texas at Austin.

Sahebi, A., Nejati, B., Moayedi, S., Yousefi, K., Torres, M., & Golitaleb, M. (2021). The prevalence of anxiety and depression among healthcare workers during the COVID-19 pandemic: An umbrella review of meta-analyses. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 110247. https://dx.doi.org/10.1016%2Fj.pnpbp.2021.110247

Schiff, M., Zasiekina, L., Pat-Horenczyk, R., & Benbenishty, R. (2021). COVID-related functional difficulties and concerns among university students during COVID-19 pandemic: A binational perspective. Journal of Community Health, 46(4), 667–675. https://dx.doi.org/10.1007%2Fs10900-020-00930-9

Sinclair, V.G., & Wallston, K.A. (2004). The development and psychometric evaluation of the Brief Resilient Coping Scale. Assessment, 11(1), 94–101.

Tausczik, Y. R., & Pennebaker, J. W. (2010). The psychological meaning of words: LIWC and computerized text analysis methods. Journal of Language and Social Psychology, 29(1), 24–54. https://psycnet.apa.org/doi/10.1177/0261927X09351676

Uphoff, E. P., Lombardo, C., Johnston, G., Weeks, L., Rodgers, M., Dawson, S., ... & Churchill, R. (2021). Mental health among healthcare workers and other vulnerable groups during the COVID-19 pandemic and other coronavirus outbreaks: A rapid systematic review. PloS One, 16(8), Article e0254821. https://doi.org/10.1371/journal.pone.0254821

van den Broek, E. L., van der Sluis, F., & Dijkstra, T. (2011). Telling the story and re-living the past: How speech analysis can reveal emotions in post-traumatic stress disorder (PTSD) patients. In J. Westerink, M. Krans, & M. Ouwerkerk (Eds.), Sensing Emotions: The impact of context on experience measurements (pp. 153–180). (Philips Research Book Series; Vol. 12). Springer. https://doi.org/10.1007/978-90-481-3258-4_10

Walton, M., Murray, E., & Christian, M. D. (2020). Mental health care for medical staff and affiliated healthcare workers during the COVID-19 pandemic. European Heart Journal: Acute Cardiovascular Care, 9(3), 241–247. https://doi.org/10.1177/2048872620922795

Zasiekin, Serhii (2021). Cognition, Emotions, and Language in Front-Line Healthcare Workers: Clinical and Ethical Implications. Mendeley Data, V1, https://doi.org/10.17632/xcy46g2wvr.1 or https://data.mendeley.com/datasets/xcy46g2wvr/1

Zasiekina, L., Hordovskya, T., & Kozihora, M. (2020). Understanding Language and Speech in the Voice of Collective Trauma. In: L.O. Kalmykova, N.V. Kharchenko, & I.V. Mysan (Eds.), Proceedings of the XV International Scientific and Practical Conference “Psycholinguistics in a Modern World – 2020” (Pereiaslav-Khmelnytskyi, 22-23 October, 2020). (Vol. 15, pp. 84–88). https://doi.org/10.31470/10.31470/2706-7904-2020-15-84-88

Zhang, J., Pan, Z., Gui, C., Xue, T., Lin, Y., Zhu, J., & Cui, D. (2018). Analysis on speech signal features of manic patients. Journal of Psychiatric Research, 98, 59–63. https://doi.org/10.1016/j.jpsychires.2017.12.012


Abstract views: 503
PDF Downloads: 266
Published
2021-10-24
How to Cite
Zasiekina, L., Pastryk, T., Kozihora, M., Fedotova, T., & Zasiekin , S. (2021). Cognition, Emotions, and Language in Front-Line Healthcare Workers: Clinical and Ethical Implications for Assessment Measures. PSYCHOLINGUISTICS, 30(1), 8-25. https://doi.org/10.31470/2309-1797-2021-30-1-8-25