The Coping Circumplex Model: An Integrative Model of the Structure of Coping With Stress

The relationship between coping styles and family burden in chronic schizophrenic and bipolar type I patients’ caregivers

Background

Caregivers play an essential role in caring of patients with psychiatric disorders. It is important to focus on family burden and coping styles of chronic psychiatric disorders’ caregivers. In this survey, the aim was to measure coping styles’ of schizophrenic and bipolar type I patients’ caregivers, their burden and its relationship between these scales. In this cross-sectional study, 100 main caregivers of patients (50 schizophrenic patients, 50 bipolar type I patients) from both Razi psychiatric hospital were enrolled in the study in 2014. The instruments were family burden interview schedule (FBIS) and Weintraub coping orientations to problems experienced (COPE). Chi-square, Pearson correlation coefficient, and independent t-test were used for data analysis.

Results

There was inverse correlation between burden and problem-focused coping strategy about caregivers of both groups (r = − 0.29, P < 0.01). There was a direct correlation between burden and emotional-oriented and less benefit and not effective coping strategies, but it was not significant. The independent t-test demonstrated caregivers’ burden is not significantly different between bipolar mood disorder and schizophrenia.

Conclusions

Social support and health services to caregivers of chronic schizophrenia and bipolar disorder are necessary. Training effective coping style reduces perceived caring burden.

Causal Model Analysis of the Effect of Formalism, Fear of Infection, COVID-19 Stress on Firefighters' Post-Traumatic Stress Syndrome and Insomnia

As the front line of epidemic prevention, firefighters are responsible for the transportation of infected cases. Firefighters are under a lot of stress from the new COVID-19, especially the fear that they may contract the virus at work and spread the virus to their families. In particular, the framework of this study incorporates Riggs' formalism variables. When firefighters think that the epidemic prevention regulations are inconsistent with the actual epidemic prevention, it will increase their work pressure on COVID-19. In this study, firefighters from all over Taiwan were used as the respondents, and a total of 453 respondents were obtained. This study uses confirmatory factor analysis and structural equation modeling to test the established hypotheses. The findings confirm that formalism, fear of self and family infection are positively influencing COVID-19 stress. COVID-19 stress positively affects PTSD and insomnia. COVID-19 stress negatively affects problem-focused strategies. Problem-focused strategies negatively affect post-traumatic stress disorder.

Coping Strategies Adopted by Motor Vehicle Accident Survivors from a Hilly State of North India

BACKGROUND

Dealing with trauma has always been challenging for people from all walks of life. Moreover, traumas like Motor Vehicle Accidents (MVA) are sudden and can be life-threatening, which further raises the concern and thus requires healthy adaptation. Considering the lack of data on the coping strategies of accident survivors in India, this study was undertaken to assess the coping strategies adopted by MVA survivors.

METHODS

Cross-sectional survey was conducted at tertiary care institution in Uttarakhand (India) during 2019-2020. A total of 250 MVA survivors were selected through total enumerative sampling and assessed for posttraumatic stress disorder (Posttraumatic Stress Disorder Checklist (PCL)-5), depression (Zung self-rating depression scale), and coping strategies (Brief COPE questionnaire).

RESULTS

The mean score was highest for emotion-focused coping mechanism (32.84 ± 5.18) and lower for dysfunctional (26.18 ± 10.59) and problem-focused (18.47 ± 3.12) coping mechanisms. Religion (96.87%) and emotional support (87.25%) were among the frequently adopted coping styles, whereas denial and self-blame were the least adopted. A high correlation was found between depression and the three coping mechanisms (r = 0.83 [emotion-focused coping], 0.68 [problem-focused coping], 0.62 [dysfunctional coping]). Among the participants, 133 crossed the threshold for PTSD and/or depression.

CONCLUSIONS

A commonly adopted coping strategy among MVA survivors is emotion-focused coping mechanism. Religion and emotional support are most prevalent because of family dynamics prevalent in countries like India.

Coping and post-traumatic stress disorder symptoms among Chinese youth in the peak and remission periods of COVID-19

The COVID-19 pandemic has exposed emergent vulnerability to adolescents' mental health. This longitudinal study investigated the association between coping at the peak of the COVID outbreak (T1) and Post-Traumatic Stress Disorder (PTSD) symptoms concurrently, and at the remission periods of COVID in China three months (T2) and six months (T3) later in a sample of 6th to 12th-grade students (N = 782). The results showed that forward-focus coping was negatively associated with PTSD symptoms across all three timepoints and predicted reduced risk for more PTSD symptoms at T2, and trauma-focus coping was positively associated with PTSD symptoms across all three timepoints and predicted higher risk of PTSD symptoms both at T2 and T3. There was an interaction effect of trauma-focus coping and T1 symptoms on later symptoms (T3) - trauma-focus coping was more detrimental for those who had more initial symptoms. The results showed the beneficial effects of future-oriented coping and harmful effects of trauma-focus coping for Chinese youth during the epidemic. Clinical implications of the results were discussed.

Key Predictive Factors in the Mental Health of Chinese University Students at Home and Abroad

The prevalence of reported mental health problems among university students has increased at alarming rates in recent years. While various negative life events (from personal events such as relationship breakdowns to more global events such as COVID-19 [SARS-CoV-2] pandemic) have been found to be important predictors of poor mental health in this population, some individuals have been found robustly to fare better than others in confronting such events. Identifying factors that predict these individuals' mental health, along with the specific coping strategies they utilize may have significant practical implications when confronted by adverse events such as COVID-19. This study investigated relationships between the impact of the COVID-19 pandemic on 828 (453 females, 374 males, and one "Other") Chinese university students' mental health, and their internal strengths, personality characteristics, and demographic profiles. We also investigated whether students' use of specific coping strategies mediated these relationships. Stepwise multiple regression analyses (MRAs) and a path analysis revealed that students who resided in their home country, had higher levels of internal strengths, a lower level of neuroticism and a higher level of agreeableness and reported fewer negative mental health changes than did other respondents during COVID-19 in the second half of 2020. Self-regulation and withdrawal coping strategies were both important mediators of these relationships. These findings have important implications for universities in identifying and assisting students in the face of adverse events such as COVID-19.

Psychosocial Influences on Coping and Wellbeing during the Covid-19 Lockdown in the Early Days of the Pandemic: A Mixed Methods Research

This study focuses on the psychosocial impacts of COVID-19 restrictions on wellbeing and uses a mixed methods design to develop a more profound understanding about adaptive coping during stressful situations. The quantitative phase of this study examined the association between psychological capital, perceived stress, coping and wellbeing. The online survey was conducted in May 2020 and had 257 participants. The Structural Equation Modelling (SEM) results showed that the hypothesized model had an adequate fit [χ2(306, N = 257) = 547.185, p = 0.00]; and that both psychological capital and perceived stress were significant predictors of wellbeing. Significantly, young people reported a more negative impact on their wellbeing during the lockdowns. In the subsequent qualitative phase, in-depth interviews with 21 voluntary participants (14 females and 7 males) suggested that individuals could reappraise stressful situations and use coping strategies for psychosocial adaptation. From this research, it was identified that especially the younger age group is at risk, and that that psychosocial resources, such as psychological capital, could be developed to enhance coping and wellbeing with the ongoing impacts of the pandemic.

Patterns of the physical, cognitive, and mental health status of older individuals in a real-life primary care setting and differences in coping styles

Background

Physical frailty and cognitive decline are two major consequences of aging and are often in older individuals, especially in those with multimorbidity. These two disorders are known to usually coexist with each other, increasing the risk of each disorder for poor health outcomes. Mental health disorders, anxiety and depression, are common in older people with multimorbidity, in particular those with functional or sensory deficits, and frailty.

Purpose

The aim of this study was to show how physical frailty, cognitive impairments and mental disorders, cluster in the real life setting of older primary care (PC) patients, and how these clusters relate to age, comorbidities, stressful events, and coping strategies. Knowing that, could improve risk stratification of older individuals and guide the action plans.

Methods

Participants were older individuals (≥60, N = 263), attenders of PC, independent of care of others, and not suffering from dementia. For screening participants on physical frailty, cognitive impairment, and mental disorders, we used Fried‘s phenotype model, the Mini-Mental State Examination (MMSE), the Geriatric Anxiety Scale (GAS), and the Geriatric Depression Scale (GDS). For testing participants on coping styles, we used the 14-scale Brief-Coping with Problems Experienced (Brief-COPE) questionnaire. To identify clusters, we used the algorithm fuzzy k-means. To further describe the clusters, we examined differences in age, gender, number of chronic diseases and medications prescribed, some diagnoses of chronic diseases, the number of life events, body mass index, renal function, expressed as the glomerular filtration rate, and coping styles.

Results

The most appropriate cluster solution was the one with three clusters, that were termed as: functional (FUN; N = 139), with predominant frailty or dysfunctional (DFUN; N = 81), and with predominant cognitive impairments or cognitively impaired (COG-IMP; N = 43). Participants in two pathologic clusters, DFUN and COG-IMP, were in average older and had more somatic diseases, compared to participants in cluster FUN. Significant differences between the clusters were found in diagnoses of osteoporosis, osteoarthritis, anxiety/depression, cerebrovascular disease, and periphery artery disease. Participants in cluster FUN expressed mostly positive reframing coping style. Participants in two pathological clusters were represented with negative coping strategies. Religion and self-blame were coping mechanisms specific only for cluster DFUN; self-distraction only for cluster COG-IMP; and these two latter clusters shared the mechanisms of behavioral disengagement and denial.

Conclusion

The research approach presented in this study may help PC providers in risk stratification of older individuals and in getting insights into behavioral and coping strategies of patients with similar comorbidity patterns and functional disorders, which may guide them in preparing prevention and care plans. By providing some insights into the common mechanisms and pathways of clustering frailty, cognitive impairments and mental disorders, this research approach is useful for creating new hypotheses and in accelerating geriatric research.

Influences of rurality on small business owner mental well-being in regional NSW

OBJECTIVE

To explore the influences of rurality on small business owner mental well-being and approaches to managing stress and mental well-being.

DESIGN

Semistructured interviews with small businesspeople. Concepts of salutogenesis and pathogenesis were used to interpret rurality influences on business and mental well-being. A stress-coping framework was used to categorise approaches to managing mental well-being.

SETTING

Central Western New South Wales.

PARTICIPANTS

Eleven female and male rural small businesspeople across sectors, including farming, allied health, beauty care and retail businesses.

MAIN OUTCOME MEASURES

Interviewee descriptions of experiences of small business and rurality and approaches to managing mental well-being.

FINDINGS

Rurality influenced mental well-being in four main ways: Business integration with community and owner identity; Visibility and being known; Different financial pressures; and Options for specialised support and casual relief. Rurality can be salutogenic and pathogenic, depending on circumstances, and pressures arising from rurality may differ for 'locals' and recent arrivals. High visibility in a small community can lead to a satisfying sense of belonging and connection. It can also create unwanted feelings of obligation and being watched. Most commonly the interviewees used emotional supports or distraction to adapt to stressors. This may be due to limited options to change or disengage from stressors in rural contexts.

CONCLUSION

Rurality brings its own benefits and challenges to small businesspeople's mental well-being. Given the immense contributions of small business to rural society and economies, investments in understanding and supporting the mental well-being of rural small businesspeople should be a high priority for communities and all levels of government.

Shift-&-Persist and discrimination predicting depression across the life course: An accelerated longitudinal design using MIDUSI-III

Life course theorists posit that sensitive periods exist during life span development where risk and protective factors may be particularly predictive of psychological outcomes relative to other periods in life. While there have been between-cohort studies trying to examine differences in discrimination and depressive symptoms, these studies have not been designed to identify these sensitive periods, which are best modeled by examining intra-individual change across time. To identify sensitive periods where discrimination and shift-&-persist (S&P) - a coping strategy that may protect against the negative impact of discrimination - are most strongly predictive of depressive symptoms, we employed latent growth curve modeling using an accelerated longitudinal design to track intra-individual change in depressive symptoms from ages 20-69. Participants were 3,685 adults measured at three time points ~10 years apart from the Midlife in the United States study (Mage = 37.93, SD = 6.948 at Wave I). Results identified two sensitive periods in development where high levels of S&P interacted with discrimination to protect against depressive symptoms; during the 30s and a lagged effect where 40's S&P protected against depressive symptoms when participants were in their 50s. Implications for the life course study of discrimination, coping, and depression are discussed.

Affective and coping responses to quarantine hotel stays

During the outbreak of COVID-19, many travellers had to quarantine upon arrival to their destination, often at designated hotels and usually for two weeks. Quarantine, as any type of isolation, is often emotionally challenging. This study applies the transactional theory of stress to explore guests' experiences during the hotel quarantine, the cognitive appraisals of their experiences and affective responses, and the coping strategies they deploy to address adverse mental effects of the quarantine. Data from in-depth interviews with quarantine hotel guests demonstrates that guests experience a rollercoaster of moods and emotions during their stay, moving from uncertainty and anxiety to isolation and boredom to despair and depression, and finally to relief and optimism. These hotel guests used a range of coping styles to alter the perceived space and time in quarantine, address social isolation as well as negative emotions and moods. These findings have important implications for tourism, hospitality, and health professionals in managing travel, accommodation, and quarantine arrangements during a crisis.

Psychosocial Predictors of Chronic Musculoskeletal Pain Outcomes and their Contextual Determinants Among Black Individuals: A Narrative Review

Black communities are disproportionally affected by Chronic Musculoskeletal Pain (CMP), but little is known about the psychological predictors of CMP outcomes and their contextual determinants among Black individuals. To address this gap, we conducted a narrative review of extant literature to (1) report the major conceptual models mentioned in prior work explaining the link between contextual determinants and psychological responses to pain among Black individuals with CMP; and (2) describe psychological factors related to CMP outcomes in this population that are highlighted in the literature. We searched 4 databases (APA PsycNet, PubMed/MEDLINE, Scopus, and Google Scholar) using the following search terms: musculoskeletal pain, chronic pain, mental health, psychological, coping, health disparities, contextual factors, conceptual models, psychosocial, Black, African American, pain, disability, and outcomes. We illustrate 3 relevant conceptual models - socioecological, cumulative stress, and biopsychosocial - related to contextual determinants and several psychological factors that influence CMP outcomes among Black individuals: (1) disproportionate burden of mental health and psychiatric diagnoses, (2) distinct coping strategies, (3) pain-related perceived injustice and perceived racial/ethnic discrimination, and (4) preferences and expectations related to seeking and receiving pain care. The detailed clinical and research implications could serve as a blueprint for the providers and clinical researchers to address health disparities and improve care for Black individuals with CMP. PERSPECTIVE: This narrative review illustrates conceptual models explaining the link between contextual determinants and psychological responses to pain among Black individuals with chronic musculoskeletal pain. We discuss 3 relevant conceptual models - socioecological, cumulative stress, biopsychosocial -, and 4 psychological factors: disproportionate burden of mental health, distinct coping strategies, perceived injustice/discrimination, preferences/expectations.

Coping in Anger Episodes: Developmental Differences and Self-Efficacy Beliefs

Anger has been recognized as a natural emotion; however, its poor management in adolescence is associated with some adverse developmental outcomes. The aims of this study were to compare the antecedents and coping strategies of anger episodes between adolescents and adults and the role of perceived self-efficacy on the coping strategies. A total of 88 adolescents (44 female, M_age = 16.81 years, SD = 1.21) and 94 adults (49 female, M_age = 28.11 years, SD = 5.82) reported an anger episode and the coping strategy adopted. Participants also filled in the Regulatory Emotional Self-Efficacy Scale (RESE). The results show that there are no specific antecedents among only adolescents or adults, although there are differences between the two age groups. Furthermore, the results indicate a different use of coping strategies between adolescents and adults. Specifically, a greater propensity of adolescents to use more often maladaptive strategies such as avoidance and denial emerged, but in addiction inaction, considered an adaptive strategy, can also be found. However, although adults use less maladaptive coping strategies they report a high frequency of feeling of powerlessness. The adaptive differences in coping also are explained by the different levels of self-efficacy beliefs of the participants. These findings are discussed in the light of the adaptive role of the coping strategies.

The Style of Coping with Stress, the Health-Related Locus of Control, and the Level of Mindfulness of Patients with Chronic Somatic Diseases in Comparison to Healthy People

Background: Psychological factors may be involved in both the development and treatment of somatic diseases. Our study aimed to evaluate the style of coping with stress, health-related locus of control, and level of mindfulness of adult patients with the most common chronic somatic diseases compared with healthy subjects. Methods: 502 chronically ill people were examined (M = 49.27; SD = 14.25), including 288 women and 214 men. The control group consisted of 117 healthy people (M = 45.66; SD = 17.86). The diagnostic survey involved using the Coping Inventory for Stressful Situations (CISS), Multidimensional Health Locus of Control Scale (MHLC), and Mindful Attention Awareness Scale (MAAS). Results: Differences between the clinical and control groups were demonstrated for MHLC: Internal (p < 0.001), Powerful Others (p < 0.05), and Chance (p < 0.001); CISS: Task (p < 0.001) and Avoidance (p < 0.05); and MAAS (p < 0.01). Conclusion: People with chronic somatic diseases, compared to healthy people, have a stronger external and weaker internal health-related locus of control, lower level of task and avoidance style for coping with stress, and lower level of mindfulness.

Impact of societal resilience on vaccine hesitancy and uptake: Lessons learned from the Israeli experience

BACKGROUND

Vaccine hesitancy threatens COVID-19 pandemic management. Increasing vaccine uptake is important to containment of the virus, and achievement of herd immunity.

OBJECTIVE

To identify factors of resilience, distress, and well-being that impact vaccine hesitancy and uptake.

METHOD

A cross-sectional study was conducted during the pandemic's fourth wave. The data were collected by an internet panel company. A representative sample of Israeli residents (N = 2002) answered an online questionnaire. A stratified sampling method was employed regarding geographic distribution, gender, and age. As vaccine hesitancy poses a threat to the effective management of the pandemic, the outcome measures included vaccine hesitancy and uptake (dependent variables), and resilience, distress, and well-being (independent variables).

RESULTS

24% of respondents reported a high level of vaccine hesitancy; 68% received 3 vaccines; 5% did not receive any vaccine. Six predictors together explained 22% of vaccine hesitancy and 15% of vaccine uptake.Path analysis indicated that: (a) Societal resilience was the best predictor of vaccine hesitancy and uptake: the higher the societal resilience, the lower vaccine hesitancy, and the higher vaccine uptake. (b) The higher sense of danger, the higher vaccine hesitancy, and the lower vaccine uptake. (c) The higher level of religiosity, the lower vaccine uptake. (d) The higher the family income, the lower level of vaccine hesitancy.

CONCLUSIONS

Findings suggest that public attitudes are primarily influenced by the degree of trust in the leadership and other components of societal resilience. Further research should investigate the impact of transparency concerning COVID-19 decision-making on vaccine hesitancy and uptake.

Antidepressants combined with psychodrama improve the coping style and cognitive control network in patients with childhood trauma-associated major depressive disorder

BACKGROUND

The use of antidepressant therapy alone has a limited efficacy in patients with childhood trauma-associated major depressive disorder (MDD). However, the effectiveness of antidepressant treatment combined with psychodrama in these patients is unclear.

AIM

To evaluate the effectiveness of antidepressant treatment combined with psychodrama.

METHODS

Patients with childhood trauma-associated MDD treated with antidepressants were randomly assigned to either the psychodrama intervention (observation group) or the general health education intervention (control group) and received combination treatment for 6 mo. The observation group received general health education given by the investigator together with the “semi-structured group intervention model” of Yi Shu psychodrama. A total of 46 patients were recruited, including 29 cases in the observation group and 17 cases in the control group. Symptoms of depression and anxiety as well as coping style and resting-state functional magnetic resonance imaging were assessed before and after the intervention.

RESULTS

Symptoms of depression and anxiety, measured by the Hamilton Depression Scale, Beck Depression Inventory, and Beck Anxiety Inventory, were reduced after the intervention in both groups of patients. The coping style of the observation group improved significantly in contrast to the control group, which did not. In addition, an interaction between treatment and time in the right superior parietal gyrus node was found. Furthermore, functional connectivity between the right superior parietal gyrus and left inferior frontal gyrus in the observation group increased after the intervention, while in the control group the connectivity decreased.

CONCLUSION

This study supports the use of combined treatment with antidepressants and psychodrama to improve the coping style of patients with childhood trauma-associated MDD. Functional connectivity between the superior parietal gyrus and inferior frontal gyrus was increased after this combined treatment. We speculate that psychodrama enhances the internal connectivity of the cognitive control network and corrects the negative attention bias of patients with childhood trauma-associated MDD. Elucidating the neurobiological features of patients with childhood trauma-associated MDD is important for the development of methods that can assist in early diagnosis and intervention.

Self-compassion, coping strategies and gender differences in psychology, counselling and psychotherapy practitioners during COVID-19: Lessons learnt

Effective coping strategies can protect against the adverse effects of stress. This study investigated self-compassion's ability to predict approach and avoidance coping in psychology, counselling and psychotherapy practitioners (PCPPs) during COVID-19, and whether this differed between genders. To date, no research has investigated this relationship, despite positive associations being drawn in other populations. Three hundred and nineteen PCPPs completed an online survey including the Brief COPE and Self-Compassion Short Form. Self-compassion significantly predicted greater use of approach coping and reduced use of avoidance coping. The predictive ability of self-compassion was slightly better in female practitioners. Self-judgement arose as a prominent subscale of self-compassion across genders, increasing both approach and avoidance coping. Implications for future research and practice are discussed, concerning barriers to self-compassion and the requirement of therapeutic programmes and psychoeducation as a prerequisite for effective coping strategies in the PCPP population.

Strategies of adults for dealing with feelings of guilt – findings from a large web-based survey

Background

Feelings of guilt are common in adulthood. Depending on the situation, individuals need different strategies for dealing with these usually unpleasant experiences. The aim of this study was to provide comprehensive empirical information about such different guilt-related strategies used in adulthood.

Participants and procedure

A cross-sectional web-based survey was conducted (05/2019-04/2020) collecting autobiographical information on guilt expe-riences. Stated strategies for dealing with feelings of guilt were classified into inductively defined categories, and the fre-quency of the categorized strategies was calculated (total, gender-, age-specific). Associations between applied strategies and gender and age were analyzed using Cramér’s φ and V as appropriate.

Results

Analyzing statements of 579 participants (18-84 years), we differentiated 34 different categories of guilt-related strategies. The most frequently used strategies were “Self-reflection; contemplation; analyzing/reviewing things one feels guilty about” and “Repressing/ignoring/(actively) forgetting/not thinking about/bottling up the feelings of guilt”. Female and male partic-ipants showed a significantly different use only in the strategy of utilizing “Professional support/therapy/counseling” (10.57% vs. 3.67%; Cramér’s φ = .13, p = .001). Additionally, only a few differences were found with regard to age.

Conclusions

Adults use a broad variety of different strategies for dealing with feelings of guilt. Strategies regulating emotional responses to the problem causing feelings of guilt seem to be at least as important as strategies targeting the problem itself. Many strategies do not serve pro-social functions. Feelings of guilt are an issue relevant for mental health care since several of the adults with feelings of guilt utilize professional help, and an even higher number may need such help.

Association between psychological distress and coping strategies among students engaged in online learning

Distant or online learning on digital platforms has become the norm in education worldwide, putting students under immense mental strain. The present study examined the association between psychological distress and coping strategies among students engaged in online learning. This study used a cross-sectional design. A structured questionnaire was sent to each of the 210 university students at two prestigious public and private universities in Bangladesh through email. Data was collected from March 26 to April 27, 2021. Severe psychological distress was found in 55.2 percent of the population. Younger age groups, public university students, students with no self-income, moderate aid from the university in providing resources from home, and students with existing mental health illnesses were significantly associated with psychological distress (p-value<0.05). Among all 14 items of Brief COPE, active coping, using emotional support, and self-blame significantly influenced the psychological distress instrument Kessler-10 (p-value<0.01). Given the perspective of this study, coping strategies alleviate stress and facilitate positive psychological outcomes. Students’ mental health is a prioritized issue that needs more attention. Because of its higher prevalence and adverse consequences, institution authorities should support each student by providing study materials, student loans, and scholarships. Routine screening will allow identifying students going through a difficult time who can get help from experts through counseling.

Understanding the Quality of Life Impacts of Providing Informal Care to People with Dementia: A Systematic Review of Qualitative Studies

BACKGROUND

There is currently a lack of a comprehensive review identifying the broad scope of factors that impact quality of life (QoL) of informal carers of people with dementia to validate existing measures and inform the provision of support services for carers of people with dementia that impact QoL domains important to them.

OBJECTIVE

To explore and identify QoL impacts on informal carers from providing care to people with dementia.

METHODS

A systematic review was conducted across four databases: EMBASE, CINAHL, PsychINFO, and Medline. Eligible studies consisted of published, peer-reviewed, qualitative studies focusing on lived experiences of informal carers of people with dementia. Non-English studies and quantitative studies were excluded. Screening of included studies was conducted independently by three reviewers. A "best-fit" framework synthesis was used to combine the qualitative data, applying deductive and inductive analysis techniques. Quality assessment was conducted using the Critical Appraisal Skills Programme.

RESULTS

Of the 4,251 articles identified, 59 articles were included. Five main themes pertaining to QoL aspects were identified that included coping (emotion-coping and problem-coping), relationship with the person with dementia (sense of loss and change in relationship), support (formal support and informal support), interference with life (control over caring situation and freedom and independence), and health (physical health, emotional and mental health, and social health).

CONCLUSION

This study identified domains of QoL that are impacted by providing informal care to people living with dementia, offering a conceptual framework for instrument validation and development as well as guidance for service provision.

Workload and job satisfaction among Austrian pediatricians: gender and generational aspects

BACKGROUND

The aim of this study was to evaluate different factors that may contribute to workload and job satisfaction among Austrian pediatricians.

METHODS

We conducted an online survey with 16 questions and performed statistical analyses.

RESULTS

Of 375 participating pediatricians, 61% were female, 39% male, 61% clinicians, 21% panel doctors and 12% private doctors. Overall, job satisfaction was moderate (6 ± 2.4 on a positive scale of 0-10). Higher working hours (p = 0.014) and higher patient numbers (p = 0.000) were significantly associated with lower job satisfaction. Lowest satisfaction was described for administrative or other nonmedical work. Lack of time for patient consultation was also correlated with poor satisfaction. Pediatricians older than 65 years reported the highest job satisfaction whereas pediatricians between 55 and 65 years and younger than 36 years showed the lowest scores. Although male pediatricians worked significantly more often more than 40 h per week than females (75% vs. 53%, p = 0.000), female pediatricians were less satisfied about the proportion of administrative (p = 0.015) and other nonmedical work (p = 0.014).

CONCLUSION

New working models considering less workload, particularly less nonmedical work and intensified collaboration between pediatric clinicians and practitioners are needed to allow more available time per patient, to increase job satisfaction and thus to raise attractivity for pediatric primary care.

Social support, psychological flexibility and coping mediate the association between COVID-19 related stress exposure and psychological distress

The COVID-19 pandemic has contributed to an increase in psychological distress. However, protective factors such as social support, psychological flexibility, and coping mechanisms can help individuals cope with the effects of psychological distress. This study aimed to test a recent hypothesis suggesting that psychological flexibility is not necessarily a coping strategy but a mechanism that can influence the coping strategies an individual employs during stressful events. We tested a mediation model that COVID-19 concerns would contribute to higher levels of perceived social support, which would directly increase psychological flexibility, and finally test if the effect of psychological flexibility on distress was mediated by approach and avoidant coping strategies. The results show that social support facilitates higher levels of psychological flexibility. Further, that psychological flexibility indirectly reduces psychological distress by reducing avoidant coping and increasing approach coping strategies. Within the context of COVID-19, we have shown the importance of social support and psychological flexibility for reducing distress. We have provided further evidence that psychological flexibility might not be a coping mechanism but a strategy that leads individuals to engage in more approach coping strategies and fewer avoidant coping strategies.

Characterizing User Experiences With an SMS Text Messaging-Based mHealth Intervention: Mixed Methods Study

BACKGROUND

Limited access to mental health care services due to provider shortages, geographic limitations, and cost has driven the area of mobile health (mHealth) care to address these access gaps. Reports from the Cohen Veterans Network and National Council for Behavioral Health show that in states where mental health care is more accessible, 38% of people still do not receive the care they need. mHealth strategies help to provide care to individuals experiencing these barriers at lower cost and greater convenience, making mHealth a great resource to bridge the gaps.

OBJECTIVE

We present a mixed methods study to evaluate user experiences with the mental mHealth service, Cope Notes. Specifically, we aimed to investigate the following research questions: How do users perceive the service in relation to stigma, impact of the intervention, and perceived usefulness? How do users rate the Cope Notes service and SMS text messaging along various dimensions of acceptability? What is the relationship between Cope Notes SMS text message ratings, user personality, and coping strategies? What are user perspectives of leveraging ubiquitous sensing technologies to improve delivery and provide tailored content?

METHODS

We performed qualitative interviews with Cope Notes users (N=14) who have used the service for at least 30 days to evaluate their experiences and usefulness of the service. These interviews were coded by 2 raters (SLK and JL), and the interrater reliability was calculated with SPSS (IBM Corp) at 61.8%. In addition, participants completed quantitative measures, including a user experiences survey, personality inventory (Big Five Inventory-10), and coping assessment (Brief Coping Orientation to Problems Experienced).

RESULTS

We derived 7 themes from our qualitative interviews: Likes or Perceived Benefits, Dislikes or Limitations, Suggested Changes, Stigma or Help Seeking, Perceptions of Ubiquitous Sensing, Cultural Sensitivity, and Alternative mHealth Resources. Exploratory analyses between acceptability ratings of Cope Notes and personality factors showed statistically significant positive relationships between seeing oneself as someone who is generally trusting and acceptability items, the most significant being item 7 (I fully understood the sentiment behind Cope Notes Messages) with (r_s(10)=0.82, P=.001). We also found statistically significant relationships between acceptability and Brief Coping Orientation to Problems Experienced items, with the strongest positive correlation between participants strongly endorsing coping by accepting the reality that an event has happened and acceptability item 7 (r_s(8)=0.86, P=.001).

CONCLUSIONS

Our study found that Cope Notes subscribers appreciate the service for reframing their mental wellness with statistically significant correlations between personality and acceptability of the service. We found that some users prefer a more personalized experience with neutral to positive reactions to a potential companion app that continuously monitors user behavior via smartphone sensors to provide just-in-time interventions when users need it most.

Temporomandibular Disorders, Bruxism, Perceived Stress, and Coping Strategies among Medical University Students in Times of Social Isolation during Outbreak of COVID-19 Pandemic

The COVID-19 pandemic caught universities along with their students off-guard, enforcing online education. Fear of the unknown, disinformation, and isolation resulted in an increased stress level in the entire population. Medical university students are particularly endangered with high stress levels and developing TMD. Temporomandibular disorders (TMD) are of multifactorial etiology, and manifest with jaw dysfunction, masticatory muscle tension or pain, as well as headache. Though bruxism can act as an exacerbating factor for TMD, stress can also play crucial role in the onset. The study aimed to measure occurrence of TMD and bruxism symptoms in the medical student population, asses the stress level, and evaluate adopted stress-coping strategies during the COVID-19 pandemic outbreak. A survey study was performed among 1018 students at Medical University of Lodz during April 2020. A self-designed questionnaire for screening TMD and bruxism symptoms, Perceived Stress Scale (PSS-10), and Brief-COPE questionnaires were applied. TMD and bruxism symptoms were observed in the majority of subjects during social isolation. The perceived stress levels were significantly higher in those experiencing TMD and bruxism symptoms. Mostly maladaptive, emotion-focused coping strategies were chosen by study subjects experiencing high levels of stress. Choosing Self-Blaming as a coping strategy is the strongest predictor of perceived stress.

Modulating Elements of Nurse Resilience in Population Care during the COVID-19 Pandemic

COVID-19 has significantly affected the work environment of nurses. In the face of the challenges posed by stressors in clinical practice, some nurses adapt and prove to be resilient. In the face of the COVID-19 pandemic, the nature of care itself and the new ways of working are potentially very stressful. We aim to analyze the resilience of care nurses to the psychological impact of the COVID-19 pandemic. This study is a systematic review of nurse caregiver resilience to the COVID-19 pandemic in 2021. Our search was conducted in the WOS, Medline/PubMed, Cochrane, BVS/LILACS, and Cuiden databases. The inclusion criteria were: studies published in Spanish or English; carried out from March 2020 to May 2021 on nurses caring for patients with COVID-19; and investigating the factors influencing the psychological impact, resilience, strategies to develop it, and interventions to promote it during this pandemic and others, such as SARS, MERS, or ebola. The quality of the studies and the risk of bias were evaluated following ICROMS, STROBE and AMSTAR-2 criteria. Twenty-two studies were selected. Most of the studies highlighted the presence of stressors in nurses, emphasizing those of the environment, which converged in dysfunctional responses that hurt their resilience. The most persuasive factors were social and organizational support. Coping strategies developed by nurses and especially interventions by organizations were detected as instruments to foster resilience, but have not been well researched. Resilience has a key moderating role in mitigating the psychological impact of nurses in the face of the COVID-19 pandemic.

Analysis of the Coping Strategies of Primary Health Care Professionals: Cross-Sectional Study in a Large Brazilian Municipality

Objective: To analyze the coping strategies used by primary healthcare (PHC) professionals. Methods: A cross-sectional, descriptive-analytical study realized with professionals working in primary healthcare units in São José do Rio Preto, a large city in the interior of São Paulo, Brazil. For data collection, we used an instrument developed by the researchers containing sociodemographic and professional variables, as well as the Problem Coping Modes Scale (EMEP). Results: We evaluated 333 PHC professionals. A difference was observed between the scores of the four coping strategies (p < 0.001), with the highest score for the problem-focused strategy (3.8) and the lowest score for the emotion-focused strategy (2.4). Physicians had the lowest scores in coping strategies focused on religious practices/fantastical thinking (p < 0.001) and pursuit of social support (p = 0.045), while community health agents had the highest scores in these coping strategies. Conclusions: Professionals working in PHC have different coping strategies for the problems and stressful situations experienced in the work environment. These strategies can involve more positive attitudes focused on confrontation and problem solving, and on emotional responses that involve attitudes of avoidance and denial of the problem.

The fear of COVID-19 and job insecurity impact on depression and anxiety: An empirical study in China in the COVID-19 pandemic aftermath

The employees' psychological health and resilience in times of emergency and general uncertainty was chosen due to the immense implications for economics, entrepreneurs, psychologists and psychiatrists, and policymakers. This study aims to provide an insight into uncertainty-induced anxiety and depression among Chinese employees in the aftermath of the COVID-19 outbreak. Analysis performed in the context of China in the COVID-19 pandemic aftermath is significant due to the universal nature of external shock impact on psychological welfare, applicable across nations and business sectors and in similar contexts. The statistical analysis was performed with SEM software AMOS version 23. The research model consisting of fear of COVID-19, job insecurity, anxiety, depression, was empirically tested. A purposive sampling technique was applied with the online questionnaire shared with employees in companies located in China. Respondents were working in educational services, information technology, engineering, electronics, and other sectors on white-collar jobs. The data collection was conducted from May to August 2020, in the aftermath of the COVID-19 pandemic in China. The research sample consisting of 283 respondents was used for analysis. Path analysis was performed, and standardized parameter estimates, standard errors, and p-values were calculated. The results indicate a positive and significant impact of job insecurity on depression and anxiety. Furthermore, results indicate that the fear of COVID-19 significantly impacts anxiety and depression but does not impact job insecurity. The findings can be used in a multidisciplinary effort to mitigate the psychological damage. Furthermore, they complement the ongoing epidemiological and scientific discourse on people's personal health and choice of coping.

Psychological impact of COVID-19 pandemic in Brazil: Adaptation and validation of mental impact and distress screening instrument and the sociodemographic profile of impact

The Mental Impact and Distress Scale: COVID-19 (MIDc) was constructed and validated by one of the first pandemic-impact research teams in February 2020 and aims to assess psychosocial impacts of the COVID-19 pandemic. The purpose of the present research was to determine the psychometric properties of the MIDc's Brazilian form and outline a sociodemographic profile of the pandemic's psychosocial impact in a Brazilian sample. Altogether, 1004 Brazilians living in different regions of Brazil completed an online survey. The adapted Brazilian version presented significant validity and reliability as assessed by exploratory and confirmatory factor analysis, Cronbach alpha and Spearman-Brown coefficients, and associations with related psychological measures. Even though the Brazilian version differs from a previous (Macau) version, it contains both anticipation (i.e., the mental engagement processes of managing the unknowns) and modulation (i.e., the mental processes of insulation being activated to maintain a sense of normalcy) factors. Findings indicate greater vulnerability to modulation among younger and female participants. Black participants and those with lower family income were more prone to be economically impacted. Participants living in isolation were more vulnerable to anticipation. Thus, the COVID-19 pandemic was found to differentially affect gender, ethnic, and social groups in Brazil.

The cognitive basis of psychosocial impact in COVID-19 pandemic. Does it encircle the default mode network of the brain? A pragmatic proposal

Epigenetics, hypothalamic-pituitary axes, environmental and metabolic influences, and transgenerational plasticity govern social behavior. Cognitive research considers the brain's default mode network (DMN) as a central hub that integrates various cognitive and social processing domains responsible for emotion perception, empathy, theory of mind, and morality. Hence, DMN is regarded as the "social brain." Upsurge in social turmoil, social anxiety, panic, depression, post-traumatic stress, hoarding, herd behavior, substance and behavioral addictions, sexual abuse, and violence in the time of the COVID-19 pandemic are intricately related to personality traits resulting in disruptive social cognition and social behavior, conceptualized as the result of unsettling and disruption of the functional nexus of the DMN. Considering overt and conspicuous display of neuroticism during the current pandemic, its impact upon modulation of the DMN functional nexus and the DMN itself, and the potential to presage cognitive impairment in the future, the authors caution that an increase in the global burden of dementia may be one of the long-term ramifications of COVID-19. Social behavior, a functional derivative of the DMN, can strikingly affect the functional nexus of DMN and the DMN itself, in a centripetal way via the phenomenon called "Experience-Dependent Plasticity," with long-term consequences. In this review, we intend to 1) decipher the association between social cognition and social behavior with the DMN, in time of COVID-19; and to 2) discuss the prospective aftermath of disrupted social behavior during the pandemic on modulation/alteration of functional connectomes of DMN or the DMN itself in the time ahead.

Mental contamination, PTSD symptoms, and coping following sexual trauma: Results from a daily monitoring study

Mental contamination (MC) - dirtiness experienced in the absence of contact with a physical contaminant - has been linked to PTSD symptoms following sexual trauma. However, there is limited understanding regarding the temporal nature of this association. The present study utilized experience sampling to examine associations between baseline and daily experiences of MC and PTSD symptoms and the mediating role of avoidance and approach coping among a sample of 41 adult women with a history of sexual trauma and current MC. Participants completed baseline measures and 14 days of twice-daily assessments. Results indicated that daily MC and PTSD symptoms were bidirectionally related. The tendency to engage in avoidance coping positively mediated relations between 1) baseline MC and daily PTSD symptoms and 2) baseline PTSD symptoms and daily MC. Further, daily avoidance coping (T-1) positively mediated associations between daily MC (T-2) and subsequent daily PTSD symptoms (T). Approach coping was not a mediator (between- or within-) in any models. Findings lend support to a mutual maintenance model of PTSD symptoms and trauma-related MC mediated by avoidance coping. Future research over a more extended period is warranted to clarify whether PTSD symptoms and MC indeed mutually maintain or exacerbate one another over time.

Coping Strategies of Healthcare Professionals with Burnout Syndrome: A Systematic Review

Background and Objectives: To evaluate the efficacy of coping strategies used to reduce burnout syndrome in healthcare workers teams. Materials and Methods: We used PubMed and Web of Science, including scientific articles and other studies for additional citations. Only 7 of 906 publications have the appropriate inclusion criteria and were selected. A PRISMA 2020 flow diagram was used. Results: The most common coping strategies that the literature studies showed were efficient, in particular social and emotional support, physical activity, physical self-care, emotional and physical distancing from work. Coping mechanisms associated with less burnout were also physical well-being, clinical variety, setting boundaries, transcendental, passion for one’s work, realistic expectations, remembering patients and organizational activities. Furthermore, it was helpful to listen to the team’s needs and preferences about some types of training. Conclusion: We suppose that the appropriate coping strategies employed in the team could be useful also in the prevention of psychological suffering, especially in contexts where working conditions are stressful. Studies about coping strategies to face burnout syndrome in healthcare workers should be increased.

Effects of COVID-19 on Mental Health and Its Relationship With Death Attitudes and Coping Styles Among Hungarian, Norwegian, and Turkish Psychology Students

The purpose of this study was to investigate mental effects of coronavirus disease 2019 (COVID-19) and its relationship with death attitudes and coping styles among Hungarian, Norwegian, and Turkish psychology students. A total of 388 participants from Hungary (N = 122, 31.4%), Norway (N = 96, 24.7%), and Turkey (N = 170, 43.8%) were recruited during the pandemic. The Depression, Anxiety and Stress Scale, the Impact of Event Scale-Revised, the Carver Brief COPE Inventory, and the Death Attitude Profile-Revised were used. The results indicated that escape acceptance might be the most maladaptive death attitude during COVID-19, as it was related to poorer mental health among the Hungarian, Norwegian, and Turkish psychology students. Self-blame, behavioral disengagement, self-distraction, and substance use coping styles were also related to poorer mental health, whereas positive-reframing (only among the Hungarian and Turkish participants) and humor (only among the Norwegian participants) were related to better mental health among our sample in the context of COVID-19. The findings implied that death attitudes and coping styles may differ in their efficacy among the Hungarian, Norwegian, and Turkish participants. These differences were discussed in detail in the discussion part. During the pandemic, practitioners might pay closer attention to patients with higher escape acceptance death attitude and patients who use dysfunctional coping styles. Additionally, patients can be encouraged to use techniques involving positive reframing and humor coping styles.

Coping with Stress During the Second Wave of the COVID-19 Pandemic by Polish University Students: Strategies, Structure, and Relation to Psychological Well-Being

Purpose

The aim of the study was to establish a hierarchy of strategies and the structure of copIng with the stress of the COVID-19 pandemic by university students and the relationship between coping strategies and psychological well-being.

Participants and Methods

An exploratory study was conducted using a cross-sectional research design. The study involved 1330 university students, aged 18 to 30 years. The Brief COPE Scale, being the Polish adaptation by Juczyński and Ogińska-Bulik, and the short version of the Psychological General Well-Being Index (authors’ adaptation) were used.

Results

Acceptance, doing something else, active coping, and physical activity were the most commonly used strategies for coping with stress during the second wave of the pandemic. Substance use, denial, and behavioral disengagement were lowest in the hierarchy of coping strategies. Female and master’s students used a variety of strategies more than male and bachelor’s students. Coping strategies correlated significantly with psychological well-being. Four second-degree factors were distinguished, explaining 55.1% of the total variation: maladaptive coping, coping by support, by positive reappraisal, and by action. Stepwise regression analysis confirmed the importance of the second-degree factors as predictors of psychological well-being.

Conclusion

Our findings show that young adults studying at the university of physical Education in Poland used adaptive strategies to cope with stress during the second wave of the COVID-19 pandemic. Gender differences in coping with pandemic stress are similar to those found in previous studies. The structure of coping with pandemic stress is to some extent similar, but also partially dependent on various cultural factors.

The Impact of COVID-19 and Associated Interventions on Mental Health: A Cross-Sectional Study in a Sample of University Students

BACKGROUND

Mental health issues have continued to rise globally, including among university students. The COVID-19 pandemic has exacerbated the previously existing and concerning problem. Given that coping mechanisms have been proposed to mediate the relationship between stressors and mental health, the aim of our cross-sectional study was to investigate the mediation of coping mechanisms on the relationship between the impact of the COVID-19 pandemic and mental health.

METHODS

University students (≥18 years old; N = 676; 31% male, 69% female) were administered an anonymous survey addressing current demographics, COVID-19 pandemic-related demographics, personal experiences, sources of stress and perceived effect on mental health, politics, sources of news/information, and various pre-validated scales addressing mental health (DASS-21), the impact of the COVID-19 pandemic (IES-R) and coping strategies utilized (Brief COPE).

RESULTS

Our results indicate a substantial proportion of our sample reporting scores in the severe and extremely severe DASS-21 categories, in addition to ~50% reporting a perceived deterioration in mental health relative to pre-COVID-19 pandemic. Moreover, a substantial proportion of students reported IES-R scores at levels where PTSD is of clinical concern. Alarmingly, a significant proportion of females (~15%) reported scores reflecting potential long-term PTSD-related implications. Females tended to be more severely impacted in all mental health measures. Mediation analysis indicated that while dysfunctional coping mediated the relationship between the impact of the event (COVID-19 pandemic) and all three mental health outcomes, overall, this was not the case with the positive coping strategies.

CONCLUSION

Our study appears to indicate a reduced buffering influence on negative mental health outcomes by the positive coping mechanisms investigated in relation to the COVID-19 pandemic and secondary interventions implemented. While the findings of this study pertain specifically to university students, they corroborate the existing extensive body of research (from physiological to behavioral, preclinical to clinical) pertaining to the response associated with major stressful events at every level of society. In this regard, the findings imply the necessity for health and other authorities, tasked with safeguarding public well-being, to avoid reactive interventions that do not appropriately balance the risks and benefits, potentially exacerbating pre-existing psychopathologies and compromising social order.

Prevalence and influencing factors of psychological distress among nurses in sichuan, china during the COVID-19 outbreak: A cross-sectional study

BACKGROUND

The COVID-19 pandemic has spread across the world. Nurses have inevitably been influenced by it.

PURPOSE

To investigate the prevalence and influencing factors of psychological distress among nurses in Sichuan, China over the COVID-19 outbreak.

METHODS

This study used a cross-sectional survey design. Thousand eight hundred and seventy nurses who worked in COVID-19-designated hospitals participated in the study during the pandemic. Data was collected online between February 8 and February 13, 2020. The self-designed General Information Questionnaire, the General Health Questionnaire-12, the Perception of Hospital Safety Climate Scale, and the Simplified Coping Style Questionnaire were used. The binomial logistic regression model was applied to assess the association between psychological distress and potential explanatory variables.

FINDINGS

At the beginning of the epidemy of the COVID-19 outbreak, 12% of nurses were found to experience psychological distress. The main influencing factors were personal precautionary measures at work, discomfort caused by protective equipment, perception of the hospital safety climate, coping style, and professional title.

CONCLUSIONS

In the pandemic, wearing protective equipment correctly, a safe hospital climate, and positive coping style for nurses could be beneficial for nurses' mental health. Nurse managers should take measures to build a safe hospital climate.

The Construct Structures of Psychological and Behavioral Responses to COVID-19 Pandemic in Pregnant Women

AIM

The present study aimed to investigate the construct structure behind the psychosocial response, behavioral response, prenatal depression, and post-traumatic stress disorder (PTSD) in pregnant women during the COVID-19 pandemic in China.

METHOD

The validated Chinese version of the Edinburgh Postnatal Depression Scale (EPDS), PTSD CheckList (PCL)-6, and two newly established scales for COVID-19-related psychological and behavioral responses were used. Structural equation modeling (SEM) analysis was applied to evaluate the structural relationships of psychological and behavioral responses during the COVID-19 pandemic.

RESULTS

Of the 1,908 mothers who completed the questionnaires, 1,099 met the criteria for perinatal depression, and 287 were positively screened for PTSD, where 264 women exceed the cut-off points for both. Pregnant women with full-time or part-time jobs tended to have the lowest scores of EPDS (10.07 ± 5.11, P < 0.001) and stress levels (23.85 ± 7.96, P = 0.004), yet they were more likely to change their behavior in accordance with the COVID-19 outbreak (13.35 ± 3.42, P = 0.025). The structural model fit the data (χ² = 43.260, p < 0.001) and resulted in satisfactory fit indices (CFI = 0.984, TLI = 0.959, RMSEA = 0.072, and χ²/df = 10.815), all path loadings were significant (p < 0.05). The SEM indicates that the level of QoL was attributable to the occurrence of PND, leading to PTSD, and COVID-19 related behavioral and psychological responses.

CONCLUSION

The inter-relationships between the COVID-19-related psychosocial and behavioral responses have been assessed, indicating that the pandemic increased the burden of perinatal depression. Psychoeducation, as well as other psychological interventions, may be needed to alleviate the COVID-19-based anxiety and increase their engagement in protective behaviors.

AN ANXIETY AS A RESPONSE TO DISTRESS AND AS A SYMPTOM OF STRESS DISORDERS IN WARTIME

OBJECTIVE

The aim: A comprehensive analysis of anxiety as an emotional state and pathopsychological symptom in the situation of a massive humanitarian catastrophe in wartime.

PATIENTS AND METHODS

Materials and methods: A systematic search was conducted up to April 2022 in the following databases: Google Scholar, PubMed, DOAJ, and CORE. Three reviewers independently assessed full-text articles according to a predefined aim. We used a quantitative and qualitative approach to infer. The range of mental reactions to the intensive stress with a pooled prevalence of anxiety was estimated. Anxiety as an independent structural psychological phenomenon or incorporated into more complicated mental states, including mental disorders, was assessed.

CONCLUSION

Conclusions: The anxiety features as an expected mental reaction to the threatening environment are established, the analysis of anxiety development trajectories was shown, and the basic principles of psychological care in anxiety states are considered. The criteria of pathological anxiety, the characteristic of the anxiety symptom as a structural element of psychiatric diseases, and the modern methods of treatment of anxiety disorders are presented. Many specialists in the different areas work with anxious people and patients with anxiety disorders in the Ukrainian current situation, so it was concluded that understanding and being aware of the differentiation of anxiety states will improve psychological care and, if necessary, will lead to providing of a full spectrum of specialized medical care.

Coping with COVID-19: Exploring coping strategies, distress, and post-traumatic growth during the COVID-19 pandemic in Australia

OBJECTIVE

This study aimed to explore coping strategies, distress, and post-traumatic growth among Australians with and without a history of a mental health diagnosis during the COVID-19 pandemic.

MATERIALS AND METHODS

Australians (N = 381) completed an online survey between 4-August 2020 and 25-October-2020. Coping strategies, distress, and post-traumatic growth were ascertained via the Brief COPE, Depression Anxiety and Stress Scale (DASS-21), and Post-Traumatic Growth Inventory (PTGI), respectively. Linear regression was conducted to examine the relationship between the Brief COPE, DASS-21, and PTGI, adjusting for sociodemographic factors. Models were conducted separately for those with/without a history of a mental health diagnosis.

RESULTS

Higher distress was found among those with a history of a mental health diagnosis. Significant differences in the types of coping strategies associated with distress and post-traumatic growth were identified between the groups, however, behavioral disengagement and self-blame consistently predicted depression, anxiety, and stress. For those with a history of a mental health diagnosis, positive reframing decreased anxiety. Self-distraction was associated with post-traumatic growth across both groups.

CONCLUSION

There are important differences in the way people with and without a history of a mental health diagnosis cope with the COVID-19 pandemic.

Help-Seeking as a Maladaptive Coping Style in the Pandemic Scenario: What Worked and What Did Not for Facing This New Stressor

The spread of COVID-19 and its related confinement measures were important stressors for a large part of the global population, with massive effects on both physical and mental health. Assessing how individuals coped with such a stressor and which strategies were effective is one of the main challenges for psychological research. In this study, we aimed to investigate the coping strategies implied during the COVID-19 lockdown and their effectiveness. We recruited 374 Italian participants through convenience sampling during the first pandemic wave (April 2020). We administered to our participants an online battery of questionnaires including the Brief COPE, the use of alternative coping strategies proposed by the WHO to help people facing lockdown stress, and a range of psychological symptoms. An exploratory factor analysis conducted on the subscales of the Brief COPE revealed a three-factor structure. Following the previous literature, we named these factors engagement, disengagement, and help-seeking coping styles. In the pandemic scenario, the engagement and disengagement styles revealed the typical correlation patterns with psychological symptoms (i.e., the engagement was adaptive while the disengagement was maladaptive). Instead, contrary to previous literature, help-seeking was positively related to psychological symptoms, suggesting a mismatch between searching for help and finding it during the lockdown. This result supports the importance of evaluating the effectiveness of coping strategies in the pandemic scenario, to give more compelling and precise advice to the population.

The relationship between healthcare service provision models and patient experience

Purpose

User experience is key for measuring and improving the quality of services, especially in high personal and relation-intensive sectors, such as healthcare. However, evidence on whether and how the organizational model of healthcare service delivery can affect the patient experience is at an early stage. This study investigates the relationship between healthcare service provision models and patient experience by focusing on the nursing care delivery.

Design/methodology/approach

65 nurses' coordinators were involved to map the nursing models adopted in the healthcare organizations of in an Italian region, Tuscany. This dataset was merged with patient experience measures reported by 9,393 individuals discharged by the same organizations and collected through a Patient-Reported Experience Measures Observatory. The authors run a series of logistic regression models to test the relationships among variables.

Findings

Patients appreciate those characteristics of care delivery related to a specific professional nurse. Having someone who is in charge of the patient, both the reference nurse and the supervisor, makes a real difference. Purely organizational features, for instance those referring to the team working, do not significantly predict an excellent experience with healthcare services.

Research limitations/implications

Different features referring to different nursing models make the difference in producing an excellent user experience with the service.

Practical implications

These findings can support managers and practitioners in taking decisions on the service delivery models to adopt. Instead of applying monolithic pure models, mixing features of different models into a hybrid one seems more effective in meeting users' expectations.

Originality/value

This is one of the first studies on the relationship between provision models of high-contact and relational-intensive services (the healthcare services) and users' experience. This research contributes to the literature on healthcare service management suggesting to acknowledge the importance of hybridization of features from different, purely theoretical service delivery models, in order to fit with providers' practice and users' expectations.

Highlights

This is one of the first studies on the relationship between provision models of nursing care and patient experience.

Healthcare services' users appreciate service delivery characteristics identified with “be cared by,” or in other words with having a reference nurse.

Nursing models' features that relate to the organizations and that providers tend to judge as professionalizing and evolutive, such as team working, appear not key in relation to patient experience.

Pure models of service delivery are theoretically useful, but hybrid models can better meet users' expectations.

The Role of the Results of Functional Tests and Psychological Factors on Prediction of Injuries in Adolescent Female Football Players

Football is a popular sport among adolescent females. Given the rate of injuries in female footballers, identifying factors that can predict injuries are important. These injuries are often caused by complex reasons. The aim of this study was to investigate if the combination of demographic (age, number of training and match play hours/week), psychosocial (perceived stress, adaptive coping strategies) and physiological factors (functional performance) can predict a traumatic injury in adolescent female footballers. A cohort consisting of 419 female football players aged 13-16 years was established. Baseline questionnaires covered potential risk factors for sport injuries, and measurements included football-related functional performance tests. Data were collected prospectively with a weekly online questionnaire for 52 weeks covering, e.g., injuries, training, and match play hours/week. A total of 62% of the players reported at least one traumatic injury during the 52 weeks. The coping strategy "positive reframing" had the strongest association with the risk of traumatic injuries. The combination of more frequent use of the coping strategy, positive reframing, and high levels of physical performance capacity may prevent a traumatic injury in adolescent female footballers. Coaches are encouraged to adopt both physiological and psychological factors when preventing injuries in young female footballers.

Coping strategies patterns to buffer the psychological impact of the State of Emergency in Spain during the COVID-19 pandemic's early months

Coping style represents the cognitive and behavioral patterns to manage particular demands appraised as taxing the resources of individuals. Studies report associations between certain coping styles and levels of adjustment of anxious symptomatology and emotional distress. The main objective of this study was to analyze behavioral co-occurrent patterns and relationships in the coping strategies used to deal with psychological distress displayed by the Spanish adult population during the first State of Emergency and lockdown of the COVID-19 pandemic. This is a cross-sectional study that uses selective methodology complemented with an indirect observational methodology, with a nomothetic/punctual/unidimensional design. We collected 996 surveys from 19 out of the 22 autonomous regions in Spain. We focused the analysis on sociodemographic variables, cumulative incidence of the COVID-19 disease and psychological distress variables. We performed two different inferential analyses: Lag sequential analysis to define the participant coping patterns, and polar coordinate analysis to study the interrelationship of the focal behavior with conditioned behaviors. We found behavioral co-occurrent patterns of coping strategies with problem avoidance being found as the coping strategy most frequently engaged by participants. Interestingly, the problem avoidance strategy was not associated with lower anxious symptomatology. By contrast, emotion-focused strategies such as express emotions and social support were associated with higher anxious symptomatology. Our findings underscore the importance of furthering our understanding of coping as a way to aid psychological distress during global public health emergencies.

Convergence, preliminary findings and future directions across the four human connectome projects investigating mood and anxiety disorders

In this paper we provide an overview of the rationale, methods, and preliminary results of the four Connectome Studies Related to Human Disease investigating mood and anxiety disorders. The first study, "Dimensional connectomics of anxious misery" (HCP-DAM), characterizes brain-symptom relations of a transdiagnostic sample of anxious misery disorders. The second study, "Human connectome Project for disordered emotional states" (HCP-DES), tests a hypothesis-driven model of brain circuit dysfunction in a sample of untreated young adults with symptoms of depression and anxiety. The third study, "Perturbation of the treatment resistant depression connectome by fast-acting therapies" (HCP-MDD), quantifies alterations of the structural and functional connectome as a result of three fast-acting interventions: electroconvulsive therapy, serial ketamine therapy, and total sleep deprivation. Finally, the fourth study, "Connectomes related to anxiety and depression in adolescents" (HCP-ADA), investigates developmental trajectories of subtypes of anxiety and depression in adolescence. The four projects use comparable and standardized Human Connectome Project magnetic resonance imaging (MRI) protocols, including structural MRI, diffusion-weighted MRI, and both task and resting state functional MRI. All four projects also conducted comprehensive and convergent clinical and neuropsychological assessments, including (but not limited to) demographic information, clinical diagnoses, symptoms of mood and anxiety disorders, negative and positive affect, cognitive function, and exposure to early life stress. The first round of analyses conducted in the four projects offered novel methods to investigate relations between functional connectomes and self-reports in large datasets, identified new functional correlates of symptoms of mood and anxiety disorders, characterized the trajectory of connectome-symptom profiles over time, and quantified the impact of novel treatments on aberrant connectivity. Taken together, the data obtained and reported by the four Connectome Studies Related to Human Disease investigating mood and anxiety disorders describe a rich constellation of convergent biological, clinical, and behavioral phenotypes that span the peak ages for the onset of emotional disorders. These data are being prepared for open sharing with the scientific community following screens for quality by the Connectome Coordinating Facility (CCF). The CCF also plans to release data from all projects that have been pre-processed using identical state-of-the-art pipelines. The resultant dataset will give researchers the opportunity to pool complementary data across the four projects to study circuit dysfunctions that may underlie mood and anxiety disorders, to map cohesive relations among circuits and symptoms, and to probe how these relations change as a function of age and acute interventions. This large and combined dataset may also be ideal for using data-driven analytic approaches to inform neurobiological targets for future clinical trials and interventions focused on clinical or behavioral outcomes.

Pursuing Pleasure Despite Pain: A Mixed-Methods Investigation of Black Women's Responses to Sexual Pain and Coping

The current mixed-methods study is the first to explore Black women's (N = 153) cognitive (e.g., worry about being perceived as sexually unresponsive) and emotional (e.g., sadness) responses to sexual pain based on age and relationship status, and coping strategies. Findings indicated significant differences in younger and single Black women's cognitive and emotional responses to sexual pain compared to older and coupled Black women. Qualitative responses revealed Black women engage in several proactive coping strategies to mitigate their sexual pain, including non-penetrative activities, foreplay, tools for increasing arousal, making physical adjustments, and intimacy and sexual communication. Implications for sexual health providers are discussed.

Components of Unrealistic Optimism of College Students: The Case of the COVID-19 Pandemic

College students are among the most strongly affected populations by the coronavirus disease-2019 (COVID-19) pandemic because of uncertainty regarding academic success, future careers, and social life during their study period. Their mental health and behavior may dramatically be impacted. The study examined an unrealistic optimism of Israeli college students in assessing the health, security, and economic risks during the pandemic, and the contributions of these perceived risks to the prediction of psychological coping responses, such as well-being, and coping suppressing response of anxiety, expressed during this pandemic. Using social networks, a questionnaire was disseminated to students during the third lockdown that was implemented in Israel because of the pandemic. Depressive and anxiety symptoms, perceived threats, resilience, well-being, hope, and morale were measured using a structured quantitative questionnaire. First, we hypothesized that the three perceived risks would be inversely rated, so perceived health risk would be rated lowest, and perceived economic risk would be rated highest. The second and third hypotheses claimed that psychological coping responses articulated along this pandemic would be predicted by all these perceived risks, as well as the observance of pandemic precaution rules. The fourth hypothesis suggested that the three investigated perceived risks will positively and significantly correlate with each other. The results generally supported the hypotheses and indicated that the unrealistic optimism process was employed quite consistently by the participating students.

Coping Strategies, Neural Structure, and Depression and Anxiety During the COVID-19 Pandemic: A Longitudinal Study in a Naturalistic Sample Spanning Clinical Diagnoses and Subclinical Symptoms

BACKGROUND

Although the COVID-19 pandemic has been shown to worsen anxiety and depression symptoms, we do not understand which behavioral and neural factors may mitigate this impact. To address this gap, we assessed whether adaptive and maladaptive coping strategies affect symptom trajectory during the pandemic. We also examined whether pre-pandemic integrity of brain regions implicated in depression and anxiety affect pandemic symptoms.

METHODS

In a naturalistic sample of 169 adults (66.9% female; age 19-74 years) spanning psychiatric diagnoses and subclinical symptoms, we assessed anhedonia, tension, and anxious arousal symptoms using validated components (21-item Depression, Anxiety, and Stress Scale), coping strategies (Brief-Coping Orientation to Problems Experienced), and gray matter volume (amygdala) and cortical thickness (hippocampus, insula, anterior cingulate cortex) from magnetic resonance imaging T1-weighted scans. We conducted general linear mixed-effects models to test preregistered hypotheses that 1) maladaptive coping pre-pandemic and 2) lower structural integrity pre-pandemic would predict more severe pandemic symptoms; and 3) coping would interact with neural structure to predict pandemic symptoms.

RESULTS

Greater use of maladaptive coping strategies was associated with more severe anxious arousal symptoms during the pandemic (p = .011, false discovery rate-corrected p [p FDR] = .035), specifically less self-distraction (p = .014, p FDR = .042) and greater self-blame (p = .002, p FDR = .012). Reduced insula thickness pre-pandemic predicted more severe anxious arousal symptoms (p = .001, p FDR = .027). Self-distraction interacted with amygdala volume to predict anhedonia symptoms (p = .005, p FDR = .020).

CONCLUSIONS

Maladaptive coping strategies and structural variation in brain regions may influence clinical symptoms during a prolonged stressful event (e.g., COVID-19 pandemic). Future studies that identify behavioral and neural factors implicated in responses to global health crises are warranted for fostering resilience.

Mental health in people with Parkinson's disease during the COVID-19 pandemic: potential for targeted interventions?

The COVID-19 pandemic has introduced a myriad of challenges to the social life and care of people with Parkinson’s disease (PD), which could potentially worsen mental health problems. We used baseline data of the PRIME-NL study (N = 844) to examine whether the association between COVID-19 stressors and mental health is disproportionately large in specific subgroups of people with PD and to explore effects of hypothetical reductions in COVID-19 stressors on mental health and quality of life. The mean (SD) age of the study population was 70.3 (7.8) years and 321 (38.0%) were women. The linear regression effect estimate of the association of COVID-19 stressors with mental health was most pronounced in women, highly educated people, people with advanced PD and people prone to distancing or seeking social support. Smaller effect estimates were found in people scoring high on confrontive coping or planful problem solving. The parametric G-formula method was used to calculate the effects of hypothetical interventions on COVID-19 stressors. An intervention reducing stressors with 50% in people with above median MDS-UPDRS-II decreased the Beck Depression Inventory in this group from 14.7 to 10.6, the State-Trait Anxiety Inventory from 81.6 to 73.1 and the Parkinson’s Disease Quality of Life Questionnaire from 35.0 to 24.3. Insights from this cross-sectional study help to inform tailored care interventions to subgroups of people with PD most vulnerable to the impact of COVID-19 on mental health and quality of life.

Exploring Coping Strategies of Different Generations of Students Starting University

Introduction: Coping strategies and adaptation skills are key features in successfully adjusting to university challenges. Coping skills are an essential part of the Psychological immune system, which leads to successful adaptation. Due to COVID-19 most universities have changed their face-to-face teaching for online education. Nevertheless, there is little concrete empirical evidence on how this generation of students with the ongoing impacts of disruptive changes can cope with it. Colleges and universities need to make changes in order to retain this new generation of students. Our aim was to explore the characteristics and changes in coping skills of university students from three different age groups.

Method: Psychological coping skills were measured by the Psychological Immune Competence Inventory (PICI). Differences were detected between generations. Group comparisons (pre-2004, pre-Covid, and post-Covid) groups were compared) using PICI subscales using independent sample analysis of variance. The sample consisted of 4,731 university students, 2,768 (58.5%) were men and 1,730 (36.56%) were women.

Results: Students from 2004 showed significantly higher scores in the Self-regulation subsystem scale compared to students in the pre-Covid and post-Covid groups. Self-regulation subsystem: F(2, 2,569.607) = 444.375, p < 0.001, η² = 0.27: small effect, ω² = 0.27; Resilience: F(2, 2,372.117) = 1171.855, p < 0.001, η² = 0.14: small effect, ω² = 0.14. Based on the results, the explained variance ratio was at least 10% based on self-regulation and resilience.

Conclusions: Psychological immune capacity of students seems to decrease through the years. Nonetheless, interventions may have a further facilitating role in the maintenance and development of psychological immunity during college years.