Psychological Outcomes Associated with Stay-at-Home Orders and the Perceived Impact of COVID-19 on Daily Life

Online Social Connection as a Buffer of Health Anxiety and Isolation During COVID-19

Abstract COVID-19 has given rise to a myriad of social, psychological, and health-related complications. The specific mental health implications of COVID-19 are still being uncovered, but we know that there are likely to be negative outcomes for many people. This is particularly the case for vulnerable members of the community, such as those with high health anxiety, and under conditions where individuals feel isolated or disconnected from others. The objective of this study was to examine whether the level of socially motivated Internet use acts as a buffer of the relationship between health anxiety, isolation behaviors, and depression. Participants (N = 473; 67.3 percent female; M_age = 23.03, SD = 7.50) from Australia completed self-report measures during the height of the national pandemic restrictions (April-May 2020). A regression analysis revealed positive relationships between health anxiety and isolation behaviors on depression and highlighted a three-way interaction effect. Specifically, health anxiety was significantly negatively associated with depression when participants engaged in fewer isolation behaviors. However, at higher levels of isolation behaviors, the relationship between health anxiety and depression was attenuated for participants with greater levels of online social connection. The findings suggest that online social connection buffered the negative effects of health anxiety under conditions of isolation. These results offer promising avenues to mitigate against vulnerabilities during the pandemic and highlight the need to promote alternate social support mechanisms in the absence of face-to-face connection.

Loneliness Among College Students: The Influence of Targeted Messages on Befriending

The objective of the current research was to examine the influence of targeted messages in increasing helping behaviors towards lonely individuals. Previous research on loneliness interventions typically focuses on the lonely individual and working to reduce feelings of loneliness. The current study expands on this research by targeting individuals around lonely others to notice and consider helping those who might be lonely. Five targeted messages, based on Latané and Darley's (1970) bystander intervention model, were utilized. These messages included a "notice" condition (increasing awareness of lonely others), an "assume responsibility" condition (awareness and responsibility towards helping lonely others), a "decide" condition (awareness, responsibility, and steps to reach out to lonely others), and two control conditions. Participants in the "decide" condition were significantly more likely to report feeling prepared to help lonely others in the future. Those in the "assume responsibility" and "decide" conditions also reported more awareness of lonely individuals during a one-week follow-up. Overall, findings indicate that it might be advantageous to approach reducing loneliness from the perspective of those around lonely individuals. Future research and implications of these findings are discussed.

Relations between Child and Parent Fears and Changes in Family Functioning Related to COVID-19

In adults, higher anxiety level related to COVID-19 has been associated with having a pre-existing medical or mental health condition and poor sleep quality. However, no study yet has looked at these links in children. The present study's main aim was to assess family changes associated with child and parent fears and concerns about COVID-19. We conducted a cross-sectional study among 144 families with children aged 9-12 years during the COVID-19 lockdown period. Families came from Quebec, Canada, and the survey was done in the early stages of the lockdown (April-May 2020). A phone-based survey assessed parent and child COVID-19-related fears and concerns, family-related changes and health issues. Results showed the more fears parents have about COVID-19, the more fears their child also has. Moreover, changes in family sleep habits were associated with parental and child fears and concerns about COVID-19. Reduced access to health services was associated with parental concerns about COVID-19. If another lockdown was to be put in place in the future, it would be important to inform families on the importance of sleep schedules and to maintain or increase health appointments when possible.

Cohort profile: the COVID-19 Coping Study, a longitudinal mixed-methods study of middle-aged and older adults' mental health and well-being during the COVID-19 pandemic in the USA

PURPOSE

The COVID-19 pandemic, beginning in early 2020, has resulted in massive social, economic, political and public health upheaval around the world. We established a national longitudinal cohort study, the COVID-19 Coping Study, to investigate the effects of pandemic-related stressors and changes in life circumstances on mental health and well-being among middle-aged and older adults in the USA.

PARTICIPANTS

From 2 April to 31 May 2020, 6938 adults aged ≥55 years were recruited from all 50 US states, the District of Columbia and Puerto Rico using online, multi-frame non-probability-based sampling.

FINDINGS TO DATE

Mean age of the baseline sample was 67.3 years (SD: 7.9 years) and 64% were women. Two in three adults reported leaving home only for essential purposes in the past week (population-weighted proportion: 69%; 95% CI: 68% to 71%). Nearly one in five workers aged 55-64 years was placed on a leave of absence or furloughed since the start of the pandemic (17%; 95% CI: 14% to 20%), compared with one in three workers aged ≥75 years (31%; 95% CI: 21% to 44%). Nearly one-third of adults screened positive for each of depression (32%; 95% CI: 30% to 34%), anxiety (29%; 28% to 31%) and loneliness (29%; 95% CI: 27% to 31%), with decreasing prevalence of each with increasing age.

FUTURE PLANS

Monthly and annual follow-ups of the COVID-19 Coping Study cohort will assess longitudinal changes to mental health, cognitive health and well-being in relation to social, behavioural, economic and other COVID-19-related changes to life circumstances. Quantitative and in-depth qualitative interview data will be collected through online questionnaires and telephone interviews. Cohort data will be archived for public use.

Life Satisfaction during Forced Social Distancing and Home Confinement Derived from the COVID-19 Pandemic in Spain

Life satisfaction is one of the main dimensions of well-being related to psychological factors, being essential for a person to adjust to difficult circumstances. The restrictive measures adopted to minimize the diffusion of the coronavirus disease (COVID-19) could alter the subjective dimension of well-being, so the objective of this study was to determine the factors related to life satisfaction of the Spanish population during forced home confinement derived from the COVID-19 pandemic. A cross-sectional study was designed, based on an online survey, and disseminated through the main social networks, which included the Satisfaction with Life Scale (SWLS) and sociodemographic and COVID-19-related variables. The possible relationships between the different variables were studied using univariate and multivariable regression analyses. A total of 3261 subjects participated in the study. Factors associated with greater personal life satisfaction were fewer days of home confinement (β = (-0.088); p ≤ 0.001), the perception of having received enough information (β = 0.076; p ≤ 0.001), having private access to the outside (β = 0.066; p ≤ 0.001), being employed (β = 0.063; p ≤ 0.001), being male (β = 0.057; p = 0.001) and not having been isolated (β = 0.043; p = 0.013). The results of this study provide novel information about the profiles of people related to greater well-being and life satisfaction during forced social distancing and home confinement, but more studies are needed to help to understand and complement these findings.

The unbearable loneliness of COVID-19: COVID-19-related correlates of loneliness in South Africa in young adults

This is the first study to examine the association between COVID-19 related variables and loneliness among young adults in South Africa during COVID-19. Participants (N=337) were university students who completed the UCLA Loneliness Scale and five selected subscales of the WHO COVID-19 Behavioural Insights Tool. The mean loneliness scores were significantly higher than previous studies in other contexts as well as studies conducted in the time of COVID-19. Correlational analysis found that greater perceived risk of infection, limited perceived knowledge of COVID-19 and lower appraisals of resilience were associated with increased loneliness. In a regression analysis, when all COVID-19 variables were considered simultaneously, only resilience, self-rated knowledge, and risk perception emerged as significant correlates of loneliness. These findings suggest that loneliness is a significant public health concern in South Africa in the time of COVID-19. It also suggests that self-efficacy and resilience can potentially be reinforced by public health campaigns that focus on enhancing COVID-19-related knowledge and preparedness.

The burden of loneliness: Implications of the social determinants of health during COVID-19

This study sought to examine if mental health issues, namely depression and anxiety symptoms, and loneliness were experienced differently according to various demographic groups during the COVID-19 pandemic (i.e., a societal stressor). An online survey, comprising demographic questions and questionnaires on depression, anxiety and loneliness symptoms, was distributed in Canada during the height of social distancing restrictions during the COVID-19 pandemic. Respondents (N=661) from lower income households experienced greater anxiety, depression and loneliness. Specifically, loneliness was greater in those with an annual income <$50,000/yr versus higher income brackets. Younger females (18-29yr) displayed greater anxiety, depressive symptoms and loneliness than their male counterparts; this difference did not exist among the other age groups (30-64yr, >65yr). Moreover, loneliness scores increased with increasing depression and anxiety symptom severity category. The relationship between loneliness and depression symptoms was moderated by gender, such that females experienced higher depressive symptoms when encountering greater loneliness. These data identify younger females, individuals with lower income, and those living alone as experiencing greater loneliness and mental health challenges during the height of the pandemic in Canada. We highlight the strong relationship between loneliness, depression and anxiety, and emphasize increased vulnerability among certain cohorts.

Preliminary investigation of the association between COVID-19 and suicidal thoughts and behaviors in the U.S

Evidence suggests that the negative consequences of COVID-19 may extend far beyond its considerable death toll, having a significant impact on psychological well-being. Despite work highlighting the link between previous epidemics and elevated suicide rates, there is limited research on the relationship between the COVID-19 pandemic and suicidal thoughts and behaviors. Utilizing an online survey, the current study aimed to better understand the presence, and extent, of the association between COVID-19-related experiences and past-month suicidal thoughts and behaviors among adults in the United States recruited via Amazon Mechanical Turk (n = 907). Results support an association between several COVID-19-related experiences (i.e., general distress, fear of physical harm, effects of social distancing policies) and past-month suicidal ideation and suicide attempts. Further, a significant proportion of those with recent suicidal ideation explicitly link their suicidal thoughts to COVID-19. Exploratory analyses highlight a potential additional link between COVID-19 and suicidal behavior, suggesting that a portion of individuals may be intentionally exposing themselves to the virus with intent to kill themselves. These findings underscore the need for suicide risk screening and access to mental health services during the current pandemic. Particular attention should be paid to employing public health campaigns to disseminate information on such services to reduce the enormity of distress and emotional impairment associated with COVID-19 in the United States.

Beliefs and Risk Perceptions About COVID-19: Evidence From Two Successive French Representative Surveys During Lockdown

BACKGROUND

The outbreak of COVID-19 has been a major interrupting event, challenging how societies and individuals deal with risk. An essential determinant of the virus' spread is a series of individual decisions, such as wearing face masks in public space. Those decisions depend on trade-offs between costs (or benefits) and risks, and beliefs are key to explain these.

METHODS

We elicit beliefs about the COVID-19 pandemic during lockdown in France by means of surveys asking French citizens about their belief of the infection fatality ratio (IFR) for COVID-19, own risk to catch the disease, risk as perceived by others, and expected prevalence rate. Those self-assessments were measured twice during lockdown: about 2 weeks after lockdown started and about 2 weeks before lockdown ended. We also measured the quality of these beliefs with respect to available evidence at the time of the surveys, allowing us to assess the calibration of beliefs based on risk-related socio-demographics. Finally, comparing own risk to expected prevalence rates in the two successive surveys provides a dynamic view of comparative optimism with respect to the disease.

RESULTS

The risk perceptions are rather high in absolute terms and they increased between the two surveys. We found no evidence for an impact of personal experience with COVID-19 on beliefs and lower risk perceptions of the IFR when someone in the respondent's family has been diagnosed with a disease. Answers to survey 1 confirmed this pattern with a clear indication that respondents were optimistic about their chances to catch COVID-19. However, in survey 2, respondents revealed comparative pessimism.

CONCLUSION

The results show that respondents overestimated the probabilities to catch or die from COVID-19, which is not unusual and does not necessarily reflect a strong deviation from rational behavior. While a rational model explains why the own risk to catch COVID-19 rose between the two surveys, it does not explain why the subjective assessment of the IFR remained stable. The comparative pessimism in survey 2 was likely due to a concomitant increase in the respondents' perceived chances to catch the disease and a decreased expected prevalence rate.

Cognitive and mental health changes and their vulnerability factors related to COVID-19 lockdown in Italy

The COVID-19 pandemic and government imposed social restrictions like lockdown exposed most individuals to an unprecedented stress, increasing mental health disorders worldwide.

We explored subjective cognitive functioning and mental health changes and their possible interplay related to COVID-19-lockdown. We also investigated potential risk factors to identify more vulnerable groups. Across Italy, 1215 respondents completed our Qualtrics-based online-survey during the end of a seven to 10-week imposed lockdown and home confinement (from April 29 to May 17, 2020). We found subjective cognitive functioning and mental health severely changed in association with the lockdown. Under government regulations, cognitive complaints were mostly perceived in routine tasks involving attention, temporal orientation and executive functions—with no changes in language abilities. A paradoxical effect was observed for memory, with reduced forgetfulness compared to pre-lockdown. We found higher severity and prevalence of depression, anxiety disorders, abnormal sleep, appetite changes, reduced libido and health anxiety: with mild-to-severe depression and anxiety prevalence climbing to 32 and 36 percent, respectively, under restrictions. Being female, under 45 years, working from home or being underemployed were all identified as relevant risk factors for worsening cognition and mental health. Frequent consumers of COVID-19 mass media information or residents in highly infected communities reported higher depression and anxiety symptoms, particularly hypochondria in the latter. If similar restrictions are reimposed, governments must carefully consider these more vulnerable groups in their decisions, whilst developing effective global and long-term responses to the cognitive and mental health challenges of this type of pandemic; as well as implementing appropriate psychological interventions with specific guidelines: particularly regarding exposure to COVID-19 mass-media reports.

Altered Meanings of Home Before and During COVID-19 Pandemic

Home came into focus immediately upon learning that COVID-19 is highly contagious and spread by human contact. Precautions people can take to safeguard themselves included physical distancing, social isolation, and staying at home. Despite phases of loosening or tightening precautions in most parts of the world, home retained its safe space status, almost irrespective of geographical location. Recent studies have shown that safety, security, and familiarity are the most referred positive attributes of home. Challenging this attenuation by scholars, negative or mixed meanings of home were highlighted in literary work and critics. Based on our integrative perspective bringing scientific and literary work together, we argue that pandemic might lead to changes in the meaning of home both in positive and negative directions simultaneously, inducing an ambiguous experience or even engendering a situated ambivalence. In this regard, we retrospectively inquired about the changes in home’s meaning in its social, personal, and symbolic attributes. A data set of 66 participants from 15 cities in Turkey revealed that there are not only alterations in the existing connotations of home but also additional ones, in positive, negative, and both directions. Results obtained in the pandemic context were discussed in the light of home studies through a constructionist perspective.

Associations Between Change in Outside Time Pre- and Post-COVID-19 Public Health Restrictions and Mental Health: Brief Research Report

The novel coronavirus disease 2019 (COVID-19) and associated pandemic has resulted in systemic changes to much of life, affecting both physical and mental health. Time spent outside is associated with positive mental health; however, opportunities to be outside were likely affected by the COVID-19 public health restrictions that encouraged people not to leave their homes unless it was required. This study investigated the impact of acute COVID-19 public health restrictions on outside time in April 2020, and quantified the association between outside time and both stress and positive mental health, using secondary analyses of cross-sectional data from the COVID and Well-being Study. Participants (n = 3,291) reported demographics, health behaviors, amount of time they spent outside pre/post COVID-19 public health restrictions (categorized as increased, maintained, or decreased), current stress (Perceived Stress Scale-4), and positive mental health (Short Warwick-Edinburgh Mental Well-being Scale). Outside time was lower following COVID-19 restrictions (p < 0.001; Cohen's d = −0.19). Participants who increased or maintained outside time following COVID-19 restrictions reported lower stress (p < 0.001, 5.93 [5.74–6.12], Hedges' g = −0.18; p < 0.001, mean = 5.85 [5.67–6.02], Hedges' g = −0.21; respectively) and higher positive mental health (p < 0.001, 24.49 [24.20–24.77], Hedges' g = 0.21; p < 0.001, 24.78 [24.52–25.03], Hedges' g = 0.28) compared to those who decreased outside time. These findings indicate that there are likely to be negative stress and mental health implications if strategies are not implemented to encourage and maintain safe time outside during large-scale workplace and societal changes (e.g., during a pandemic).

The Ups and Downs of Daily Life During COVID-19: Age Differences in Affect, Stress, and Positive Events

Objective

Past research has linked older age with greater emotional well-being and decreased reactivity to stressors, but it is unknown whether age-related advantages in emotional well-being are maintained in the wake of COVID-19. We examined age differences in exposure and affective reactivity to daily stressors and positive events in the first several weeks of the COVID-19 outbreak.

Method

In March and April 2020, 776 adults from Canada and the U.S. ages 18-91 (mean age 45) reported COVID-19 threats at baseline, then completed nightly surveys for one week about their daily stressors, positive events, and affect.

Results

Younger age predicted more concerns about the threat of COVID-19 across multiple domains, in addition to lower positive affect, higher negative affect, and less frequent positive events. Younger adults had more non-COVID-19 daily stressors and higher perceived control over stressors, but lower perceived coping efficacy than older adults. There were no age differences in the frequency of COVID-19 daily stressors nor perceived stressor severity. Younger adults had greater reductions in negative affect on days when more positive events occurred and greater increases in negative affect on days when non-COVID-19 stressors occurred. Age moderation was attenuated for negative affective reactivity to COVID-19 stressors. Age did not moderate positive affective reactivity to daily events.

Discussion

In the early weeks of the pandemic, older adults showed better emotional well-being and less reactivity to stressors but did not differ from younger adults in their exposure to COVID-19 stressors. Additionally, younger adults benefited more from positive events.

Psycho-social factors associated with mental resilience in the Corona lockdown

The SARS-CoV-2 pandemic is not only a threat to physical health but is also having severe impacts on mental health. Although increases in stress-related symptomatology and other adverse psycho-social outcomes, as well as their most important risk factors have been described, hardly anything is known about potential protective factors. Resilience refers to the maintenance of mental health despite adversity. To gain mechanistic insights about the relationship between described psycho-social resilience factors and resilience specifically in the current crisis, we assessed resilience factors, exposure to Corona crisis-specific and general stressors, as well as internalizing symptoms in a cross-sectional online survey conducted in 24 languages during the most intense phase of the lockdown in Europe (22 March to 19 April) in a convenience sample of N = 15,970 adults. Resilience, as an outcome, was conceptualized as good mental health despite stressor exposure and measured as the inverse residual between actual and predicted symptom total score. Preregistered hypotheses (osf.io/r6btn) were tested with multiple regression models and mediation analyses. Results confirmed our primary hypothesis that positive appraisal style (PAS) is positively associated with resilience (p < 0.0001). The resilience factor PAS also partly mediated the positive association between perceived social support and resilience, and its association with resilience was in turn partly mediated by the ability to easily recover from stress (both p < 0.0001). In comparison with other resilience factors, good stress response recovery and positive appraisal specifically of the consequences of the Corona crisis were the strongest factors. Preregistered exploratory subgroup analyses (osf.io/thka9) showed that all tested resilience factors generalize across major socio-demographic categories. This research identifies modifiable protective factors that can be targeted by public mental health efforts in this and in future pandemics.

Effects of previous exposure to psychotherapeutic strategies on depression and anxiety symptoms during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has seen an increase in depression and anxiety among those with and without a history of mental illness. Commonly used forms of psychological therapy improve mental health by teaching psychotherapeutic strategies that assist people to better manage their symptoms and cope with life stressors. Minimal research to date has explored their application or value in managing mental health during significant broad-scale public health crises.

AIMS

To determine which psychotherapeutic strategies people who have previously received therapy use to manage their distress during the COVID-19 pandemic, and whether the use and perceived helpfulness of these strategies has an effect on symptoms of depression and anxiety.

METHOD

Data (N = 857) was drawn from multiple waves of a representative longitudinal study of the effects of COVID-19 on the mental health of Australian adults, which includes measures of anxiety, depression and experiences with psychotherapy and psychotherapeutic strategies.

RESULTS

Previous engagement in therapy with psychotherapeutic strategies had a protective effect on depressive but not anxiety symptoms. Common and helpful strategies used by respondents were exercise, mindfulness and breathing exercises. Using mindfulness and perceiving it to be helpful was associated with lower levels of depression and anxiety symptoms. No other strategies were associated with improved mental health.

CONCLUSIONS

Prior knowledge of psychotherapeutic strategies may play a role in managing mental health during unprecedented public health events such as a global pandemic. There may be value in promoting these techniques more widely in the community to manage general distress during such times.

Spatial Temporal Analysis of Traffic Patterns during the COVID-19 Epidemic by Vehicle Detection Using Planet Remote-Sensing Satellite Images

The spread of the COVID-19 since the end of 2019 has reached an epidemic level and has quickly become a global public health crisis. During this period, the responses for COVID-19 were highly diverse and decentralized across countries and regions. Understanding the dynamics of human mobility change at high spatial temporal resolution is critical for assessing the impacts of non-pharmaceutical interventions (such as stay-at-home orders, regional lockdowns and travel restrictions) during the pandemic. However, this requires collecting traffic data at scale, which is time-consuming, cost-prohibitive and often not available (e.g., in underdeveloped countries). Therefore, spatiotemporal analysis through processing periodical remote-sensing images is very beneficial to enable efficient monitoring at the global scale. In this paper, we present a novel study that utilizes high temporal Planet multispectral images (from November 2019 to September 2020, on average 7.1 days of frequency) to detect traffic density in multiple cities through a proposed morphology-based vehicle detection method and evaluate how the traffic data collected in such a manner reflect mobility pattern changes in response to COVID-19. Our experiments at city-scale detection, demonstrate that our proposed vehicle detection method over this 3 m resolution data is able to achieve a detection level at an accuracy of 68.26% in most of the images, and the observations’ trends coincide with existing public data of where available (lockdown duration, traffic volume, etc.), further suggesting that such high temporal Planet data with global coverage (although not with the best resolution), with well-devised detection algorithms, can sufficiently provide traffic details for trend analysis to better facilitate informed decision making for extreme events at the global level.

Assessing the Transitional Impact and Mental Health Consequences of the COVID-19 Pandemic Onset

In this article, we report the results of a survey of North American adults (n = 1,215) conducted between March 24 and 30, 2020 at the onset of the COVID-19 pandemic. Respondents completed the COVID-TIS (Transitional Impact Scale-Pandemic version) and the 21-item Depression, Anxiety, and Stress Scale (DASS), indicated their level of COVID-infection concern for themselves and close others, and provided demographic information. The results indicated: (a) during its early stage, the pandemic produced only moderate levels of material and psychological change; (b) the pandemic produced mild to moderate levels of psychological distress; (c) respondents who lost their jobs as a result of the pandemic experienced more change and more psychological distress than those who did not, and (d) younger respondents and less well-educated ones experienced more psychological distress than older respondents. Unexpectedly, (e) respondents indicated that they were more concerned that friends and family members would become infected with COVID-19 than that they would be. We conclude by speculating that these results are driven less by the immediate changes brought about by the pandemic and more by uncertainty concerning its long-term economic and social impact.

The COVID-19 epidemic in Poland and its influence on the quality of life of university students (young adults) in the context of restricted access to public spaces

Aim

The aim of this study was to determine the impact of social distancing, self-isolation and limited access to public spaces during the COVID-19 pandemic on the quality of life and psychological well-being of young people.

Subject and methods

The coronavirus disease 2019 (COVID-19) pandemic caused by the SARS-CoV-2 virus posed a new global challenge in 2020. The new coronavirus emerged locally, but it rapidly spread to all continents and also reached Poland. On 24 March, the Polish Ministry of Health enforced self-isolation measures to contain the transmission of the disease. The new regulations imposed restrictions on civic freedoms, including access to public spaces. These measures significantly affected the daily lives of Polish citizens. Public spaces play a fundamental role in catering to the citizens' basic needs. Access to public spaces is directly correlated with the quality of life, human relations and spontaneous interactions. Young people are highly socially active, and they are frequent users of public spaces. University students (young adults) who transitioned to online learning on 12 March were surveyed remotely with the Microsoft Forms online tool. The questionnaire contained several questions to elicit demographic information about the respondents, as well as 25 closed-ended questions relating to university students' quality of life and access to public spaces during the epidemic. The survey was carried out during the first Polish lockdown in April 2020. The study group was composed of 132 respondents who were university students aged 19-26.

Results

The results revealed a strong correlation between the severity of lockdown measures during the epidemic and the students' activity levels in public spaces, a considerable deterioration in their physical and psychological well-being, and the overall quality of life.

Conclusion

The respondents were significantly affected by the absence of direct social interactions which, in their opinion, can be only partially compensated for by remote contact.

Mental health consequences of COVID-19 media coverage: the need for effective crisis communication practices

During global pandemics, such as coronavirus disease 2019 (COVID-19), crisis communication is indispensable in dispelling fears, uncertainty, and unifying individuals worldwide in a collective fight against health threats. Inadequate crisis communication can bring dire personal and economic consequences. Mounting research shows that seemingly endless newsfeeds related to COVID-19 infection and death rates could considerably increase the risk of mental health problems. Unfortunately, media reports that include infodemics regarding the influence of COVID-19 on mental health may be a source of the adverse psychological effects on individuals. Owing partially to insufficient crisis communication practices, media and news organizations across the globe have played minimal roles in battling COVID-19 infodemics. Common refrains include raging QAnon conspiracies, a false and misleading "Chinese virus" narrative, and the use of disinfectants to "cure" COVID-19. With the potential to deteriorate mental health, infodemics fueled by a kaleidoscopic range of misinformation can be dangerous. Unfortunately, there is a shortage of research on how to improve crisis communication across media and news organization channels. This paper identifies ways that legacy media reports on COVID-19 and how social media-based infodemics can result in mental health concerns. This paper discusses possible crisis communication solutions that media and news organizations can adopt to mitigate the negative influences of COVID-19 related news on mental health. Emphasizing the need for global media entities to forge a fact-based, person-centered, and collaborative response to COVID-19 reporting, this paper encourages media resources to focus on the core issue of how to slow or stop COVID-19 transmission effectively.

Effects of Fear of COVID-19 on Mental Well-Being and Quality of Life among Saudi Adults: A Path Analysis

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic has been very disruptive, and thus is likely to result in substantial challenges to mental health.

OBJECTIVES

This study aimed to investigate the effects of fear of COVID-19 on the mental well-being and quality of life among Saudi adult population and to evaluate the impact of perceived social support.

MATERIALS AND METHODS

This cross-sectional study used an anonymous online survey, where participants were administered the Fear of COVID-19 Scale, Hospital Anxiety and Depression Scale, European Health Interview Survey-Quality of Life and Medical Outcomes Study Social Support Survey. A path analysis was used to investigate the proposed theoretical domain structure linking fear of COVID-19 with perceived social support, mental well-being and quality of life.

RESULTS

A total of 1029 Saudi adults with a mean age of 33.7 years (SD 11.5) responded to the survey. Descriptive analysis showed that this sample was fearful of COVID-19, anxious and depressed but, at the same time, reported high quality of life and perceived social support scores. Path analysis indicated that increased fear of COVID-19 was directly associated with diminished mental well-being, which in turn was associated with lower quality of life. The beneficial effects of perceived social support were stronger on quality of life than on mental well-being. No direct link was found between fear of COVID-19 and quality of life.

CONCLUSION

These findings emphasize the importance of having effective social systems in place to minimize the impact of the COVID-19 pandemic on mental well-being and quality of life.

Impulsivity and Difficulties in Emotional Regulation as Predictors of Binge-Watching Behaviours

Recently, the question about the potentially problematic characteristics of binge-watching behaviours has been raised in the contemporary literature. Binge-watching is a highly popular behaviour that involves watching multiple episodes of TV series in one sitting. Studies show that binge-watching can be both an entertaining, but also a potentially problematic, behaviour. Therefore, this research aimed to answer the question about how impulsivity, difficulties in emotional regulation, and one's motivations around why they want to watch a TV series predict problematic binge-watching among a group of Polish young adults. The research group consisted of 645 participants. The following tools were then used to measure the study variables: the Impulsive Behaviour Scale, the Difficulties in Emotion Regulation Scale, the Viewing Motivation Scale, and the Questionnaire of Excessive Binge-watching. Furthermore, a regression analysis was performed on the responses to each measure in order to answer our research questions. Our results show that a lack of premeditation, impulse control difficulties, and having an escapist motivation are all significant predictors of problematic binge-watching behaviours. Furthermore, one's motivations around dealing with loneliness, their motivations around how to best spend their free time, as well as their informative and entertaining motivations were also found to be significant predictors of problematic binge-watching behaviours.

Cross-cultural comparisons of psychosocial distress in the USA, South Korea, France, and Hong Kong during the initial phase of COVID-19

The COVID-19 crisis has resulted in disruption of everyday life worldwide but the impact and response to the pandemic have not been uniform. Many countries rapidly deployed physical-distancing mandates to curb the spread of the virus; others did not. Social distancing strategies are necessary to reduce the transmission of the virus but there may be unintended consequences. We examined psychological distress in four societies with distinct public health strategies (South Korea, Hong Kong, France and the United States) to identify common and region-specific factors that may contribute to mental health outcome during the pandemic. From March to July of 2020, a survey of demographics, general health, mental health, loneliness and social networks was conducted. Overall, younger age, greater concern for COVID, and more severe loneliness predicted worse psychological outcome but the magnitudes of these effects varied across the four regions. Objective measures of social isolation did not affect mental health. There were also notable differences in psychological outcome; Hong Kong, with very strict social distancing protocols plus ongoing political unrest, suffered the most drastic deterioration of mental health. To prepare for an impending mental health crisis, concerted efforts to reduce loneliness should be integrated into a comprehensive public health strategy.

Suppression May Improve Adaptation to Worry When Facing Uncertainty: Studying COVID-19 Pandemic

The COVID-19 pandemic has been associated with increased uncertainty, fear and worry in everyone's life. The effect of changes in daily life has been studied widely, but we do not know how emotion-regulation strategies influence adaptation to a new situation to help them overcome worry in the face of uncertainty. Here, 1,064 self-selected Farsi speaking participants completed an online battery of questionnaires that measured fear of virus and illness, worry, intolerance of uncertainty, and emotion regulation (two subscales: reappraisal, suppression). We also documented the number of daily COVID-19 cases and deaths due to COVID-19 on the day in which participants completed the questionnaire. Our findings suggest a correlation between contamination fear and the number of daily-confirmed cases (r = 0.11), and the number of reported deaths due to COVID-19 (r = 0.09). Worry mediated the relationship between intolerance of uncertainty and fear of virus and illness (b = 0.16, 0.1141 < CI < 0.2113). In addition, suppression moderated the relationship between intolerance of uncertainty and worry (p < 0.01). Our results suggest that suppression (at least in the short term) can be an adaptive response to the worry associated with uncertainty. Suppression can reduce worry, which in turn can decrease fear of contamination and improve adaptation to social distancing requirements. Although, the observed correlations were significant, but considering the sample size, they are not strong, and they should be interpreted cautiously.

Increased meaningful activity while social distancing dampens affectivity; mere busyness heightens it: Implications for well-being during COVID-19

Social distancing measures have been implemented in many countries to limit the spread of COVID-19. Emerging literature reveals that fear of acquiring COVID-19 has detrimental psychological ramifications. However, it seems likely that social distancing will have a further negative impact on well-being. The focus of this study was therefore to investigate whether changes in behaviour as a result of social distancing would predict changes in well-being. Participants (n = 95) rated their level of well-being as it was both during social distancing and retrospectively one month before beginning social distancing. Participants also indicated how much time they spent engaged in various activities both during social distancing and one month before social distancing and nominated how important each of these activities was for them. These measures employed scales created specifically for the present study. In addition, participants completed the Big Five Inventory–2 Extra-Short Form and the nine-item version of the Personal Optimism and Self-Efficacy Optimism Scale. We found that affectivity–both positive and negative–decreased with increased engagement in meaningful activities and that affectivity increased with increased activity in general. While both sorts of activity appear to improve some aspects of well-being, it appears that meaningful activity regulates psychological homeostasis while busyness in general does not.

Emotional Well-Being Under Conditions of Lockdown: An Experience Sampling Study in Austria During the COVID-19 Pandemic

The coronavirus (COVID-19) pandemic and attendant lockdown measures present serious threats to emotional well-being worldwide. Here, we examined the extent to which being outdoors (vs. indoors), the experience of loneliness, and screen-time are associated with emotional well-being during the COVID-19 pandemic using an experiencing sampling method. In April 2020, Austrian adults (N = 286, age M = 31.0 years) completed a 21-day experience sampling phase in which they reported their emotional well-being (i.e., happiness), whether they were indoors or outdoors, and loneliness at three random time-points each day, as well as their daily screen-time. Results indicated that being outdoors was associated with higher emotional well-being, whereas greater loneliness and greater daily screen-time were associated with poorer well-being. Additionally, the impact of loneliness on well-being was weaker when participants were outdoors than indoors. These results have health policy implications for the promotion of population well-being during pandemics.

Emotional Well-Being Under Conditions of Lockdown: An Experience Sampling Study in Austria During the COVID-19 Pandemic

The coronavirus (COVID-19) pandemic and attendant lockdown measures present serious threats to emotional well-being worldwide. Here, we examined the extent to which being outdoors (vs. indoors), the experience of loneliness, and screen-time are associated with emotional well-being during the COVID-19 pandemic using an experiencing sampling method. In April 2020, Austrian adults (N = 286, age M = 31.0 years) completed a 21-day experience sampling phase in which they reported their emotional well-being (i.e., happiness), whether they were indoors or outdoors, and loneliness at three random time-points each day, as well as their daily screen-time. Results indicated that being outdoors was associated with higher emotional well-being, whereas greater loneliness and greater daily screen-time were associated with poorer well-being. Additionally, the impact of loneliness on well-being was weaker when participants were outdoors than indoors. These results have health policy implications for the promotion of population well-being during pandemics.

The psychological impact of COVID-19 pandemic lockdowns: a review and meta-analysis of longitudinal studies and natural experiments

Lockdowns to control the spread of the coronavirus disease 2019 (COVID-19) have had profound effects on everyday life worldwide, but their effect on mental health remains unclear because available meta-analyses and reviews rely mostly on cross-sectional studies. We conducted a rapid review and meta-analysis of longitudinal studies and natural experiments investigating the relationship between COVID-19 lockdowns and mental health. A total of 25 studies involving 72 004 participants and 58 effect sizes were analyzed. Using a random effects model, we found that lockdowns had small effects on mental health symptoms, g = 0.17, s.e. = 0.05, 95% CI (0.06-0.24), p = 0.001, but the effects on positive psychological functioning, g = -0.12, s.e. = 0.11, 95% CI (-0.33 to 0.09), p = 0.27, were not significant. Multivariate analysis of effect sizes revealed significant and relatively small effect sizes for anxiety and depression, while those for social support, loneliness, general distress, negative affect, and suicide risk were not significant. The results indicated substantial heterogeneity among studies, but meta-regression analyses found no significant moderation effects for mean age, gender, continent, COVID-19 death rate, days of lockdown, publication status or study design. The psychological impact of COVID-19 lockdowns is small in magnitude and highly heterogeneous, suggesting that lockdowns do not have uniformly detrimental effects on mental health and that most people are psychologically resilient to their effects.

Change in Physical Activity, Sleep Quality, and Psychosocial Variables during COVID-19 Lockdown: Evidence from the Lothian Birth Cohort 1936

(1) Objectives: The COVID-19 pandemic has disproportionately affected the lives of older people. In this study, we examine changes in physical activity, sleep quality, and psychosocial variables among older people during COVID-19 lockdown. We build on cross-sectional studies on this topic by assessing change longitudinally. We also examined whether participant characteristics including demographic, cognitive, personality, and health variables were related to more positive or negative changes during lockdown. (2) Methods: 137 older participants (mean age 84 years) from the Lothian Birth Cohort 1936 study were included in the analysis. They completed the same questionnaires assessing physical activity, sleep quality, mental wellbeing, social support, loneliness, neighbourhood cohesion, and memory problems before (mostly 2 years earlier) and again during national lockdown. (3) Results: On average, levels of physical activity were reduced (those doing minimal physical activity increased from 10% to 19%) and perceived social support increased during lockdown (effect size drm = 0.178). More positive change in the psychosocial and behavioural outcome variables during lockdown was associated with personality traits (greater intellect, emotional stability, and extraversion) and having a higher general cognitive ability. Participants with a history of cardiovascular disease, more symptoms of anxiety, or who lived alone were more likely to experience negative changes in the outcome variables during lockdown. (4) Discussion: These results provide further insight into the experiences of older people during the COVID-19 pandemic and could help to identify those at greatest risk of negative psychosocial or behavioural changes during this time.

Cross-sectional analysis to explore the awareness, attitudes and actions of UK adults at high risk of severe illness from COVID-19

OBJECTIVES

This study explored the impact of COVID-19 on people identified as at high risk of severe illness by UK government, and in particular, the impact of lockdown on access to healthcare, medications and use of technological platforms.

DESIGN

Online survey methodology.

SETTING

UK.

PARTICIPANTS

1038 UK adults were recruited who were either identified by UK government as at high risk of severe illness from COVID-19 or self-identified as at high risk with acute or other chronic health conditions not included in the UK government list. Participants were recruited through social media advertisements, health charities and patient organisations.

MAIN OUTCOMES MEASURES

The awareness, attitudes and actions survey which explores the impact of COVID-19, on including access to healthcare, use of technology for health condition management, mental health, depression, well-being and lifestyle behaviours.

RESULTS

Nearly half of the sample (44.5%) reported that their mental health had worsened during the COVID-19 lockdown. Management of health conditions changed including access to medications (28.5%) and delayed surgery (11.9%), with nearly half of the sample using telephone care (45.5%). Artificial Intelligence identified that participants in the negative cluster had higher neuroticism, insecurity and negative sentiment. Participants in this cluster reported more negative impacts on lifestyle behaviours, higher depression and lower well-being, alongside lower satisfaction with platforms to deliver healthcare.

CONCLUSIONS

This study provides novel evidence of the impact of COVID-19 on people identified as at high risk of severe illness. These findings should be considered by policy-makers and healthcare professionals to avoid unintended consequences of continued restrictions and future pandemic responses.

Social distancing during the COVID-19 pandemic as a predictor of daily psychological, social, and health-related outcomes

In the context of the COVID-19 pandemic, striking public health measures have been implemented to encourage physical distancing in order to slow the spread of disease. However, the impact of these measures on health and wellbeing is not well understood. In the current study a daily diary methodology was used to investigate the effects of social isolation due to the COVID-19 pandemic on a variety of outcomes with 230 undergraduate students. Participants completed an online diary for 3 days, reporting on daily social distancing behaviors, psychological wellbeing/resources, social/interpersonal connection with others, health behaviors, and health outcomes. Overall, daily social distancing (close adherence to social distancing guidelines) was associated with decreases in psychological wellbeing/resources, less social/interpersonal connection with others (including technology-mediated communication), fewer positive health behaviors, and increased reports of stress-related physical illness symptoms. Discussion centers on implications of these findings as well as the importance of identifying ways to mitigate the effects of these necessary but costly measures on health and wellbeing.

COVID-19 as 'Game Changer' for the Physical Activity and Mental Well-Being of Augmented Reality Game Players During the Pandemic: Mixed Methods Survey Study

BACKGROUND

Location-based augmented reality (AR) games, such as Pokémon GO and Harry Potter: Wizards Unite, have been shown to have a beneficial impact on the physical activity, social connectedness, and mental health of their players. In March 2020, global social distancing measures related to the COVID-19 pandemic prompted the AR games developer Niantic Inc to implement several changes to ensure continued player engagement with Pokémon GO and Harry Potter: Wizards Unite. We sought to examine how the physical and mental well-being of players of these games were affected during the unprecedented COVID-19 restriction period as well as how their video game engagement was affected.

OBJECTIVE

The aims of this study were to examine the impact of COVID-19-related social restrictions on the physical and mental well-being of AR game players; to examine the impact of COVID-19-related social restrictions on the use of video games and motivations for their use; and to explore the potential role of AR games (and video games in general) in supporting well-being during COVID-19-related social restrictions.

METHODS

A mixed methods web-based self-reported survey was conducted in May 2020, during which COVID-19-related social restrictions were enforced in many countries. Participants were recruited on the web via four subreddits dedicated to Pokémon GO or Harry Potter: Wizards Unite. Data collected included quantitative data on demographics, time spent playing video games, physical activity, and mental health; qualitative data included motivations to play and the impact of video games on mental health during COVID-19 lockdown.

RESULTS

We report results for 2004 participants (1153/1960 male, 58.8%, average age 30.5 years). Self-reported physical activity during COVID-19-related social restrictions significantly decreased from 7.50 hours per week on average (SD 11.12) to 6.50 hours (SD 7.81) (P<.001). More than half of the participants reported poor mental health (925/1766, 52.4%; raw World Health Organization-5 Well-Being Index score <13). Female gender, younger age, and reduced exercise were significant predictors of poor mental health. Participants reported a significant increase in video game play time from 16.38 hours per week on average (SD 19.12) to 20.82 hours (SD 17.49) (P<.001). Approximately three quarters of the participants (n=1102/1427, 77.2%) reported that playing video games had been beneficial to their mental health. The changes made to Pokémon GO and Harry Potter: Wizards Unite were very well received by players, and the players continued to use these games while exercising and to maintain social connection. In addition to seeking an escape during the pandemic and as a form of entertainment, participants reported that they used video games for emotional coping and to lower stress, relax, and alleviate mental health conditions.

CONCLUSIONS

AR games have the potential to promote physical and mental health during the COVID-19 pandemic. Used by populations under isolation and distress, these games can improve physical and mental health by providing virtual socialization, sustained exercise, temporal routine, and mental structure. Further research is needed to explore the potential of AR games as digital behavioral interventions to maintain human well-being in the wider population.

International Prevalence and Correlates of Psychological Stress during the Global COVID-19 Pandemic

This study reports perceived stress and associated sociodemographic factors from an international sample of adults, during the COVID-19 pandemic. The Perceived Stress Scale (PSS-10) along with socio-demographic questions were conducted between 8 April 2020 and 11 May 2020. The survey was translated from English into five languages. Recruitment was conducted worldwide using social media. A total of 1685 survey responses were collected across 57 countries with eleven countries (≥30 responses/country) included in the sub-analyses. Overall, the mean PSS-10 score was 19.08 (SD = 7.17), reflecting moderate stress compared to previously reported norms. Female gender was associated with a higher PSS score (3.03, p < 0.05) as well as four-year degree holders (3.29, p < 0.05), while adults over 75 years (-7.46, p < 0.05) had lower PSS scores. Personal care composite score (including hours of sleep, exercise, and meditation) was associated with lower PSS scores (-0.39, p < 0.01). Increases in personal care and changes in work expectations were associated with lower PSS scores (-1.30 (p < 0.05) and -0.38 (p < 0.01), respectively). Lower total PSS scores were reported in Germany (-4.82, p < 0.01) compared to the global response sample mean. This information, collected during the initial period of global mitigation orders, provides insight into potential mental health risks and protective factors during crises.

Factors associated with the mental health status of medical students during the COVID-19 pandemic: a cross-sectional study in Japan

OBJECTIVE

The COVID-19 pandemic had a substantial impact on university students, including those in medical schools, with disruption in routine education causing significant psychological distress. The objective of this study was to evaluate the factors associated with psychological distress among medical students during the period of enforced home quarantine from March through May 2020.

DESIGN

A cross-sectional study.

SETTING

One Japanese medical school.

PARTICIPANTS

571 medical students.

PRIMARY AND SECONDARY OUTCOME MEASURES

Self-administered electronic questionnaires including the K-6 scale for psychological distress, the Rosenberg Self-Esteem Scale (RSES) for self-esteem and the General Self-Efficacy Scale (GSES) for self-efficacy were distributed. To assess the determinant factor for psychological distress, variables such as sex, grade in school, living conditions, and RSES and GSES scores were evaluated in regression analysis.

RESULTS

163 respondents (28.5%) scored ≥5 on the K-6 scale, indicating a significant degree of psychological distress. Logistic regression revealed that a higher score on RSES (p<0.001) and GSES (p<0.01) was an independent factor associated with lower levels of psychological distress. Multiple regression analysis focusing on students with a K-6 score ≥5 revealed that higher scores on RSES correlated with lower levels of psychological distress. By contrast, those with higher GSES scores also scored higher for indicators of psychological distress.

CONCLUSIONS

This study identified that self-efficacy and self-esteem were both influential factors for predicting psychological distress during the current COVID-19 pandemic. Medical schools should provide support for mental health and educational initiatives directed at enhancing self-esteem and self-efficacy, with a focus on improving personal resilience. In emergency situations, such as that faced in response to the COVID-19 pandemic, initial programmes might target students with higher levels of self-efficacy. By contrast, under routine situations, these efforts should be directed towards students with lower self-esteem as primary means to prevent depression.

Epidemics among perceived impacts on Latvia before and during COVID-19: emerging threats versus stability

BACKGROUND

In the time of global challenges, perception of the ongoing change at different levels of social systems modulates individual expectations, decisions, and emotional health. A previous study in Latvia revealed that perceived threats, globalization, political power, and personal control form the latent structure of perceived impacts on the country. The present study assessed the stability of this structure, comparing a relatively favorable situation and the situation of the COVID-19 emergency in Latvia.

PARTICIPANTS AND PROCEDURE

Two successive independent samples included 254 and 171 university students in 2019 and 2020, respectively. Participants assessed the impact of 15 factors on Latvia: personal impact, parents and relatives, friends, people of Latvia, political parties and leaders, Saeima (the parliament of Latvia), the government of Latvia, the European Union, the United States, other countries, global economic crises, war and military conflicts, terrorism, epidemics, and natural disasters.

RESULTS

A series of confirmatory factor analyses established partial invariance of the model. During the COVID-19 emergency, a significant shift in the perceived impact of epidemics, natural disasters, and global economic crises combined with the relative stability of personal, meso-, and macro-level factors.

CONCLUSIONS

This stability indicates possible resources for balancing perceived threats in the situation of successful coping with COVID-19 in Latvia in Spring 2020.

Safe but Lonely? Loneliness, Anxiety, and Depression Symptoms and COVID-19

Background

The COVID-19 pandemic has led governments worldwide to implement unprecedented response strategies. While crucial to limiting the spread of the virus, “social distancing” may lead to severe psychological consequences, especially in lonely individuals.

Methods

We used cross-sectional (n = 380) and longitudinal (n = 74) designs to investigate the links between loneliness, anxiety, and depression symptoms (ADS) and COVID-19 risk perception and affective response in young adults who implemented social distancing during the first 2 weeks of the state of epidemic threat in Poland.

Results

Loneliness was correlated with ADS and with affective response to COVID-19’s threat to health. However, increased worry about the social isolation and heightened risk perception for financial problems was observed in lonelier individuals. The cross-lagged influence of the initial affective response to COVID-19 on subsequent levels of loneliness was also found.

Conclusion

The reciprocal connections between loneliness and COVID-19 response may be of crucial importance for ADS during the COVID-19 crisis.

The “stay at home” orders effect on mental health of Egyptian adults during the COVID-19 pandemic partial lockdown

Purpose

Mental health is one of the aspects seriously affected by the COVID-19 pandemic. Governmental preventive measures worldwide disturbed people’s daily routine, social activities, access to education and even impacted their working environment. The present work aims at screening the expected negative effects on mental and psychological wellbeing.

Design/methodology/approach

An online survey was introduced through an internet-based platform to assess mental wellbeing (MW) and stress among Egyptian adults using SHORT Warwick-Edinburgh Mental Wellbeing Scale and Falsification of Type Scale, respectively. Socio-demographics were also collected. Data from 150 respondents through the period from May 25 till June 1 were tabulated and statistical analyses were performed.

Findings

More than 70% of respondents declared jobs being affected by the pandemic. Females showed deteriorated state of mental health, together with the youth (≤44 years) and those who lost their jobs or suffered reduced income. In conclusion, mental health as expressed by MW and stress showed to be affected among the Egyptian adults due to the “stay at home” orders. Prompt actions are highly recommended to save vulnerable populations at the time being and from the aggravation of their mental problems in the long term.

Originality/value

The study is the first in Egypt figuring out affected populations and vulnerable categories that need extra care in the future. It provides valuable data and expresses reasonable explanations to the obtained findings. The study also introduces recommendations and highlights hot topics for future research.

"Oh, this is actually okay": Understanding how one state child welfare training system adapted to the COVID-19 pandemic

BACKGROUND

Training for new and existing child protection system (CPS) caseworkers is critical to developing and maintaining a competent workforce that effectively works towards safety, permanency, and wellbeing outcomes for children in the system. The COVID-19 pandemic required a shift to virtual training to continue training CPS professionals safely.

OBJECTIVE

The purpose of our project was to determine if there were differences in learning outcomes between learners who completed training in the usual delivery methods (Pre-COVID) and the fully virtual delivery methods (Post-COVID). We also sought to understand any factors that facilitated or impeded successful virtual training during the pandemic.

PARTICIPANTS AND SETTING

Caseworkers-in-training completed learning and satisfaction assessments through standard continuing quality improvement efforts. Training facilitators, course developers, and leadership completed qualitative interviews.

METHODS

We assessed quantitative differences in one US state in learner knowledge, satisfaction, and behaviors before and during the COVID-19 pandemic and conducted a qualitative thematic analysis of interviews with training system employees.

RESULTS

Overall, there were limited differences in learner outcomes before and after the transition to virtual training delivery. Across the employee interviews, three main themes emerged: organizational culture facilitated the transition, external constraints caused challenges during the transition, and there were opportunities to evolve training practices positively.

CONCLUSIONS

The shift to a virtual learning environment had little impact on learner knowledge or satisfaction. Employee perspectives indicated that the pre-COVID investment in organizational culture has substantial dividends for performance during the crisis.

Social Estrangement and Psychological Distress before and during the COVID-19 Pandemic: Patterns of Change in Canadian Workers

This article argues that the COVID-19 pandemic and associated social distancing measures intended to slow the rate of transmission of the virus resulted in greater subjective isolation and community distrust, in turn adversely impacting psychological distress. To support this argument, we examine data from the Canadian Quality of Work and Economic Life Study, two national surveys of Canadian workers-one from late September 2019 (N = 2,477) and the second from mid-March 2020 (N = 2,446). Analyses show that subjective isolation and community distrust increased between the two surveys, which led to a substantial rise in psychological distress. Increases in subjective isolation were stronger in older respondents, resulting in a greater escalation in psychological distress. These findings support a Durkheimian perspective on the harm to social integration and mental health caused by periods of rapid social change but also illustrate how a life course context can differentiate individual vulnerability to disintegrative social forces.

Adverse effects of COVID-19-related lockdown on pain, physical activity and psychological well-being in people with chronic pain

Countries across the world imposed lockdown restrictions during the COVID-19 pandemic. It has been proposed that lockdown conditions, including social and physical distancing measures, may disproportionately impact those living with chronic pain and require rapid adaptation to treatment and care strategies. Using an online methodology, we investigated how lockdown restrictions in the United Kingdom impacted individuals with chronic pain (N = 431) relative to a healthy control group (N = 88). Data were collected during the most stringent period of lockdown in the United Kingdom (mid-April to early-May 2020). In accordance with the fear-avoidance model, we hypothesised lockdown-related increases in pain and psychological distress, which would be mediated by levels of pain catastrophising. Responses indicated that people with chronic pain perceived increased pain severity, compared to their estimation of typical pain levels prior to lockdown (p < .001). They were also more adversely affected by lockdown conditions compared to pain-free individuals, demonstrating greater self-perceived increases in anxiety and depressed mood, increased loneliness and reduced levels of physical exercise (p ⩽ .001). Hierarchical regression analysis revealed that pain catastrophising was an important factor relating to the extent of self-perceived increases in pain severity during lockdown (β = .27, p < .001) and also mediated the relationship between decreased mood and pain. Perceived decreases in levels of physical exercise also related to perceptions of increased pain (β = .15, p < .001). Interestingly, levels of pain intensity (measured at two time points at pre and during lockdown) in a subgroup (N = 85) did not demonstrate a significant change. However, individuals in this subgroup still reported self-perceived pain increases during lockdown, which were also predicted by baseline levels of pain catastrophising. Overall, the findings indicate that people with chronic pain suffer adverse effects of lockdown including self-perceived increases in their pain. Remote pain management provision to target reduction of pain catastrophising and increase health behaviours including physical activity could be beneficial for this vulnerable population.

Effectiveness of Innovation Media for Improving Physical Distancing Compliance during the COVID-19 Pandemic: A Quasi-Experiment in Thailand

To flatten the curve of COVID-19 infections, with no effective pharmacological interventions or vaccine available in the imminent future, public health responses must continue to rely on non-pharmacological interventions. We developed three innovation media to promote physical distancing compliance (i.e., a fearful picture, a red one-way arrow sign, and a norm-speech sticker). This study aimed to compare physical distancing compliance between our interventions and conventional interventions. Our study was a quasi-experiment, and we observed a representative sample of university canteen customers via closed-circuit television (CCTV). Each intervention was monitored over non-prime-time hours, per day, on 6–9 August 2020. Among the 400 participants (100 participants in each group), their age group, gender, and physical distancing practices were observed in a university canteen. The number of failures of physical distancing ranged between 93.8% and 17.6%, and on average between 84.2% and 34.2%, dependent on the intervention and the marking point. There were no statistically significant differences in promoting physical distancing compliance between our interventions compared with conventional interventions. However, the participants tended to practice physical distancing at the back of the queue more than at the front, regardless of the interventions.

Psychological Effects of Social Isolation Due to Quarantine in Chile: An Exploratory Study

As we all know, COVID-19 has impacted the entire world. Quarantine disrupts people's lives, with high levels of stress and negative psychological impacts. Studies carried out mostly in the Far East, Europe, or the United States have started to provide evidence on survivors, frontline healthcare workers, and parents. The present study is the first survey to be carried out in Latin America (in Santiago, the capital of Chile). It aims to (a) explore the perceived psychological impact and future concerns; (b) evaluate vulnerability factors; (c) describe the perceived psychological impacts on participants whose psychological help and actual online psychotherapy was interrupted; and (d) explore the future need for psychological help. Procedure: An online survey was carried out (the first 2 weeks of lockdown in Santiago), which included sociodemographic data, perceived psychological impact, future concerns, and questions about psychological support. Participants: A total of 3,919 subjects answered, mostly women (80%). Results: The main perceived psychological impacts were concern (67%) and anxiety (60%). Future concerns were: general health (55.3%), employment (53.1%), and finances (49.8%). Younger participants had a greater perceived psychological impact (p's < 0.01) and concerns about employment, finances, mental health, stigma, and general health (p's < 0.001). Women reported more perceived psychological impact than men (p's < 0.05). Men reported mainly boredom (χ2 = 11.82, gl = 1, p < 0.001). Dependent employees experienced more boredom, anxiety, distress, sleep problems, an inability to relax, and a lack of concentration than the self-employed (p's < 0.05). While the latter reported future concerns about employment and finances (p's < 0.001), dependent employees reported them on their general and mental health (p's < 0.001). Regarding psychological support, 22% of participants were receiving it before lockdown. They showed more perceived psychological impact than those who were not (p's < 0.01), and 7% of them had online psychotherapy, reporting excellent (32.1%) or odd but working (65.2%) results. Finally, of the total sample, almost half of the participants (43.8%) felt they would need emotional support after this pandemic, and these are the ones that also showed higher perceived psychological impact (p's < 0.001). This study confirms the presence of perceived negative emotional impact and concerns about the future. Also, there are vulnerable groups, such as women, younger people, the self-employed, and people with psychological processes that were interrupted.

Perceived Impact of Covid-19 Across Different Mental Disorders: A Study on Disorder-Specific Symptoms, Psychosocial Stress and Behavior

The recent outbreak of the coronavirus disease (Covid-19) has plunged countries across the world into crisis. Both in the general population and in specific subgroups such as infected people or health care workers, studies have reported increased symptoms of anxiety, depression and stress. However, the reactions of individuals with mental disorders to Covid-19 have largely been neglected. The present study therefore aimed to investigate the perceived impact of Covid-19 and its psychological consequences on people with mental disorders. In this online survey, participants were asked to evaluate their disorder-specific symptoms, perceived psychosocial stress and behaviors related to Covid-19 in the current situation and retrospectively before the spread of Covid-19. The study included participants with self-identified generalized anxiety disorder (GAD), panic disorder and agoraphobia (PA), illness anxiety disorder (IA), social anxiety disorder (SAD), depression (DP), obsessive–compulsive disorder (OCD), body dysmorphic disorder (BDD), eating disorders (ED), schizophrenia spectrum and other psychotic disorders (SP), other non-specified mental disorder (other) as well as mentally healthy controls (HC). The results of bayesian parameter estimation suggest that the symptom severity of DP, GAD, IA and BDD has deteriorated as a reaction to Covid-19. Across all mental disorders and HC, self-reported psychosocial stress levels were higher during the outbreak of Covid-19 compared to before. A reduced frequency of social contacts and grocery shopping was found for all participants. People with self-identified mental disorders showed higher personal worries about Covid-19 and a higher fear of contagion with Covid-19 than did HC. According to our findings, Covid-19 may reinforce symptom severity and psychosocial stress in individuals with mental disorders. In times of pandemics, special support is needed to assist people with mental disorders and to prevent symptom deterioration.

[Health care and care for the elderly in the future : Insights from the corona pandemic]

Gesundheitsversorgung und die Pflege alter Menschen sind durch die Corona-Pandemie massiv unter Druck geraten. Dabei zeigen sich strukturelle Defizite und Schwachstellen, die nicht wirklich neu sind, durch Covid-19 aber wieder ins Blickfeld rücken und an Aktualität gewinnen. Im Versorgungssystem stellen sich angesichts der aktuellen Herausforderungen neue Fragen und in der Sicherung der Pflege alter Menschen werden Lücken und Herausforderungen sichtbar – teilweise spezifisch auf einen Bereich bezogen, zum größeren Teil aber sektorenübergreifend.

Auf der Basis nationaler und internationaler einschlägiger Studien und Veröffentlichungen und explizit aus der Perspektive der Sozialen Gerontologie wird in diesem Beitrag schwerpunktmäßig auf die aktuelle Situation in der Pflege in Deutschland in Zeiten des SARS-CoV-2-Virus fokussiert. Aus dieser Situationsanalyse werden mögliche Denkanstöße abgeleitet und es wird skizziert, wie eine Neuorientierung mit Blick in die Zukunft aussehen und welcher mögliche Erkenntnisgewinn aus der Corona-Pandemie gezogen werden kann.

Rehabilitation services lockdown during the COVID-19 emergency: the mental health response of caregivers of children with neurodevelopmental disabilities

BACKGROUND

The present study investigated the impact of the COVID-19-related rehabilitation services lockdown on the mental health of caregivers of children with neurodevelopmental disabilities.

METHODS

Between 26 March and 11 May 2020, 84 caregivers filled out ad-hoc and standardized questionnaires through an online survey in order to measure their psychological response to the emergency and lockdown as well as their levels of parenting stress, anxiety and depression.

RESULTS

Worries about COVID-19 contagion and concerns for the child left without rehabilitation programs were the greatest sources of mental health burden for caregivers. Nonetheless, only the concerns for the child were significantly associated with caregivers' reports of stress, depressive and anxious symptoms.

DISCUSSION

These findings highlight the burden faced by caregivers of children with neurodevelopmental disabilities during the COVID-19 emergency in Italy. These families should be considered as a high-risk population that requires dedicated healthcare attention, such as promoting continuity of care by investing in tele-rehabilitation programs. Implications for rehabilitation Caregivers of children with disability reported symptoms of anxiety and depression during COVID-19 emergency. Major concerns regarded COVID-19 contagion risk and child development during rehabilitation lockdown. Caregivers' psychological symptoms were associated with concerns for child development during the lockdown. Parents of children with disability may face relevant stress during and after COVID-19 psychological burden. During COVID-19 recovery, policy-makers and clinicians should dedicate specific care actions for families of children with disability.

Impact of COVID-19 Lockdown Measures on Spanish People with Chronic Pain: An Online Study Survey

The corona virus disease 2019 (COVID-19) pandemic is one of the most important healthcare and societal challenges to have emerged in the last century. It may have effects on both physical and psychosocial health, but studies considering the impact on vulnerable populations, such as people with chronic pain, are needed. In this cross-sectional study, an online survey of relevant chronic pain domains, coping strategies, triggers and potential related variables was answered by 502 Spanish individuals with chronic pain. Participants were mainly women (88%) with longstanding chronic pain and moderate to high pain intensity and disability. The perception of pain aggravation and the most pain-related outcomes were observed. Contextual variables such as job insecurity, worries about the future, people cohabiting, being close to someone who had passed away, or being potentially infected with COVID-19 were related to worse outcomes. More than half the participants altered their pain management style (e.g., increased medication intake) and several changes occurred with respect to pain triggers (cognitions, feelings of insecurity and loneliness, and sleeping problems were more frequently reported as triggers during lockdown). Our preliminary results highlight the negative effects of lockdown on patients with chronic pain as well as the need to make available cost-effective and remotely accessible healthcare resources for counteracting them.

Impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists

OBJECTIVES

To evaluate the impact of COVID-19 on clinical practice, income, health and lifestyle behavior of Brazilian urologists during the month of April 2020.

MATERIALS AND METHODS

A 39-question, web-based survey was sent to all urologist members of the Brazilian Society of Urology. We assessed socio-demographic, professional, health and behavior parameters. The primary goal was to evaluate changes in urologists' clinical practice and income after two months of COVID-19. We also looked at geographical differences based on the incidence rates of COVID-19 in different states.

RESULTS

Among 766 urologists who completed the survey, a reduction ≥ 50% of patient visits, elective and emergency surgeries was reported by 83.2%, 89.6% and 54.8%, respectively. An income reduction of ≥ 50% was reported by 54.3%. Measures to reduce costs were implemented by most. Video consultations were performed by 38.7%. Modifications in health and lifestyle included weight gain (32.9%), reduced physical activity (60.0%), increased alcoholic intake (39.9%) and reduced sexual activity (34.9%). Finally, 13.5% of Brazilian urologists were infected with SARS-CoV-2 and about one third required hospitalization. Urologists from the highest COVID-19 incidence states were at a higher risk to have a reduction of patient visits and non-essential surgeries (OR=2.95, 95% CI 1.86 - 4.75; p< 0.0001) and of being infected with SARS-CoV-2 (OR=4.36 95%CI 1.74-10.54, p=0.012).

CONCLUSIONS

COVID-19 produced massive disturbances in Brazilian urologists' practice, with major reductions in patient visits and surgical procedures. Distressing consequences were also observed on physicians' income, health and personal lives. These findings are probably applicable to other medical specialties.

Coping with COVID-19 and movement control order (MCO): experiences of university students in Malaysia

This study examined how university students in Malaysia coped with the psychological impact of the COVID-19 pandemic and restrictions on movement (also known as MCO). A total of 983 students participated in a survey conducted online between April 20 and May 24, 2020. The psychological impact was measured using Zung's Self-Rating Anxiety Scale (SAS). The students were assessed on the usage of adaptive (humanitarian and seeking social support) and maladaptive coping strategies (acceptance and mental disengagement). The results showed that the students used maladaptive coping strategies more than adaptive coping strategies to deal with anxiety caused by the pandemic and the effect of restriction of movement. Seeking social support and acceptance coping strategies were significantly associated with the level of anxiety. The student's gender, age, ethnicity, level and type of study, and living arrangement were associated with coping strategies. The students' selection of coping strategies mirrors typical Asian culture, that is, submissiveness. The study proposes several practical and professional suggestions to address students' mental health issues.

Mental health outcomes associated with the COVID-19 pandemic: Prevalence and risk factors in a southern US state

The COVID-19 pandemic has had a dramatic effect on the functioning of individuals and institutions around the world. This cross-sectional registry-based study examined some of the burdens of the pandemic, the prevalence of mental health difficulties, and risk factors for psychosocial morbidity among community residents in Arkansas. The study focused on a period of gradual reopening but rising infection rates. The investigation included validated screening measures of depressive symptoms (PHQ-9), generalized anxiety (GAD-7), trauma-related symptoms (PCL-5), and alcohol use (AUDIT-C). A notable percentage of participants reported elevated symptoms on each of these outcomes. In separate multivariable analyses that accounted for a number of demographic and pandemic-related covariates, individuals who reported greater pandemic-related disruption in daily life, and those with a prior history of mental health concerns, were more likely to screen positive for depressive, anxiety and trauma-related symptoms. Findings illuminate burdens experienced by community residents during a period of phased reopening, and offer a foundation for future screening and intervention initiatives.

Lockdown, quarantine measures, and social distancing: Associations with depression, anxiety and distress at the beginning of the COVID-19 pandemic among adults from Germany

The COVID-19 pandemic is suggested to have a negative impact on mental health. To prevent the spread of Sars-CoV-2, governments worldwide have implemented different forms of public health measures ranging from physical distancing recommendations to stay-at-home orders, which have disrupted individuals' everyday life tremendously. However, evidence on the associations of the COVID-19 pandemic and public health measures with mental health are limited so far. In this study, we investigated the role of sociodemographic and COVID-19 related factors for immediate mental health consequences in a nationwide community sample of adults from Germany (N = 4335). Specifically, we examined the effects of different forms and levels of restriction resulting from public health measures (e.g. quarantine, stay-at-home order) on anxiety and depression symptomatology, health anxiety, loneliness, the occurrence of fearful spells, psychosocial distress and life-satisfaction. We found that higher restrictions due to lockdown measures, a greater reduction of social contacts and greater perceived changes in life were associated with higher mental health impairments. Importantly, a subjectively assumed but not an officially announced stay-at-home order was associated with poorer mental health. Our findings underscore the importance of adequate risk communication and targeted mental health recommendations especially for vulnerable groups during these challenging times.

Mental health during the COVID-19 pandemic: Effects of stay-at-home policies, social distancing behavior, and social resources

Social distancing is the most visible public health response to the COVID-19 pandemic, but its implications for mental health are unknown. In a nationwide online sample of 435 U.S. adults, conducted in March 2020 as the pandemic accelerated and states implemented stay-at-home orders, we examined whether stay-at-home orders and individuals' personal distancing behavior were associated with symptoms of depression, generalized anxiety disorder (GAD), intrusive thoughts, insomnia, and acute stress. Stay-at-home order status and personal distancing were independently associated with higher symptoms, beyond protective effects of available social resources (social support and social network size). A subsample of 118 participants who had completed symptom measures earlier in the outbreak (February 2020) showed increases in depression and GAD between February and March, and personal distancing behavior was associated with these increases. Findings suggest that there are negative mental health correlates of social distancing, which should be addressed in research, policy, and clinical approaches to the COVID-19 pandemic.