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

Applying Restorative Environments in the Home Office While Sheltering-in-Place

OBJECTIVE

The objective of this review was to spotlight specific methods for people working from home to apply restorative environment research to improve productivity and mental health during shelter-in-place.

BACKGROUND

The COVID-19 pandemic has led to sheltering-in-place and telework. While necessary, these strategies may lead to negative consequences such as social isolation and worse performance. However, nature environments have been shown to have a variety of positive effects in several different settings, including improved attention, positive affect, and increased job satisfaction, and these may be translated to the home workspace setting.

METHOD

This provides a narrative review of the environmental psychology literature, describing articles involving nature in a task performance or stress context and how it has been applied. It then moves on to discuss how these findings could possibly be applied in the context of workers during the COVID-19 pandemic.

RESULTS

Although beneficial results are mixed, the review found a variety of relatively simple and cost-effective methods that could assist workers during the COVID-19 pandemic, including taking a break in nature and implementing nature in the workspace.

APPLICATION

The application of restorative environment research could be an efficient way of mitigating the negative psychological effects due to at-home sheltering and telework in order to combat COVID-19.

Increasing psychological distress among Californians from 2013 to 2020: Race/ethnic differences

The influence of the COVID-19 pandemic on mental health is of mounting concern to population-health researchers. While early reports indicated increases in mental health problems, noticeably absent from these studies is how mental health has changed in 2020 compared to previous years (2013-2019) and whether such trends vary by race/ethnicity. The present study used repeated cross-sectional data from the California Health Interview Survey (n ​= ​168,216) to systematically document trends in psychological distress scores (Kessler-6 scale; K6) and severe psychological distress scores (K6; 13+) from 2013 to 2020 and by race/ethnicity over the same period. Among all Californians we find that the reported average psychological distress scores increased by 22% between 2013 and 2020. Reported severe psychological distress scores increased 61% from 2013 to 2020. These increases were largely concentrated in the years 2017-2020. Increases in psychological distress were also especially pronounced among non-Latino/a White Californians (29% increase in K6 from 2013 to 2020), Latino/a Californians (14% increase in K6 from 2013 to 2020), and Asian Californians (35% increase in K6 from 2013 to 2020). Multiple and logistic regression models that accounted for sociodemographic and behavioral health covariates echoed these findings. Future research should continue to investigate secular trends in mental health that coincided with the COVID-19 pandemic and carefully situate the shifts into broader temporal perspective.

Social Distancing to Avoid SARS-CoV-2 Infection in Cancer and Noncancer Patients

BACKGROUND

Social distancing has been recommended by the Centers for Disease Control and Prevention to avoid exposure to SARS-CoV-2 ( Epidemiol Prev 2020;44:353-362).Cancer patients on or after active therapy seem to be more prone to COVID being symptomatic and life-threatening. When evaluating cancer patients' risk of acquiring COVID, it is essential to know the behavior of cancer patients that will affect their risk of exposure. However, it is not known to what degree social distancing is practiced by cancer patients compared with noncancer patients and what factors lead to the decision to distance oneself.

METHOD

After a pilot phase using patients' MyChart messaging, links to the electronic questionnaires were texted to patients using Twillio. Responses were stored on REDCap (Vanderbilt University, Nashville, TN). Six questions about their social distancing behavior and mask wearing were posed and responses were compared between cancer and noncancer patients. Demographics, comorbidities, and a questionnaire about anxiety (Generalized Anxiety Disorder 7-item scale) were recorded. To assess differences between cancer and noncancer groups, Bonferroni-corrected χ 2 tests and proportions confidence intervals were used.

RESULTS

The pilot survey was sent in mid-2020 and the full survey followed in January 2021 during a high community COVID incidence. Three hundred eighty-seven cancer patients (32.4% responded) and 503 noncancer patients (22.9% responded) completed the survey. Questions about leaving their houses, driving, shopping, friends, and family indicated that patients with cancer are more cautious ( P < 0.001). Cancer patients were up to 20% more likely to distance themselves. No difference was seen in wearing a mask-both groups wore approximately 90% of the time. Most respondents were female (63% versus 71%). Cancer patients were older (>60 y, 69% versus 45%) and less likely to work (52% versus 31%) or less likely to be White collar workers (21% versus 38%). In both groups, 54% marked "not at all anxious."

CONCLUSIONS

Cancer patients' responses revealed a distancing behavior that would likely lower the risk exposure to SARS-CoV-2. It is unclear which of the demographic differences would account for this behavior, although remarkably anxiety was not a clear motivating factor. The high acceptance of masks is encouraging. Early publications during the pandemic and patient education suggesting a higher COVID risk for cancer patients may have reduced risk prone behavior. Considering COVID's impact on the vulnerable cancer population and uncertainty in immunosuppressed patients about clearing the virus or adequately responding to a vaccine, further studies about health behavior and health promotion during the pandemic are needed.

Determinants of loneliness during the COVID-19 pandemic in the United States: A one-year follow-up study

An initial study on loneliness during the first month of the COVID-19 pandemic in the United States found that those who were living alone or who were single experienced greater loneliness than those who lived with others or were in a romantic relationship. This study presents follow-up analyses using data collected from the same sample (N = 428) at a total of five points in time throughout the first year of the COVID-19 pandemic in the United States. Unlike most studies using a longitudinal design to track loneliness throughout the COVID-19 pandemic, the results of this study showed that loneliness scores generally decreased over this time period. However, additional analyses showed that when participants experienced a de-escalation in their romantic relationship status (e.g., transitioning from being in a dating relationship to being single or from being married to separated), loneliness scores increased. Because prior research shows a connection between living alone and loneliness, the researchers also tested whether decreases in the number of people one lives with predicted increases in loneliness. The data was inconsistent with this prediction. Overall, these findings join a minority of other longitudinal studies investigating loneliness during the COVID-19 pandemic that found either a decrease or no change in loneliness, while also illustrating that increases in loneliness during the COVID-19 pandemic occurred after people experienced a de-escalation in their romantic relationship status. These findings underscore the importance of life events during the COVID-19 pandemic that may increase loneliness-specifically transitioning out of romantic relationships. Thus, future research on predictors of loneliness should continue to use longitudinal designs to determine how changes in one's life predict changes in loneliness.

Mental health outcomes following COVID-19 infection: impacts of post-COVID impairments and fatigue on depression, anxiety, and insomnia - a web survey in Sweden

BACKGROUND

The negative impact of the COVID-19 pandemic on the mental health is now clearly established. However, information on the levels of mental ill health of people infected with COVID-19 and potential correlates of poor mental health is still limited. Therefore, the current study aimed to study indicative of potential mental health problems in individuals with a history of probable or confirmed SARS CoV-2 infection/infections and address the impacts of post-COVID impairments and fatigue following COVID-19 infection/infections on depression, anxiety, and insomnia.

METHODS

A web-survey including demographics, questions related to COVID-19 status and post-COVID impairments, and standardized measures of depression, anxiety, insomnia, and fatigue was completed by 507 individuals with a history of probable or confirmed SARS CoV-2 infection/infections.

RESULTS

We found significant rates of significant depression, anxiety, and insomnia in our sample, with more than 70% experiencing levels above the clinical cut offs for at least one psychological health problems. Higher levels of depression, anxiety, and insomnia were associated with the severity of COVID-19 infection in the acute phase, hospitalization because of COVID-19, and higher levels of post-COVID impairments and fatigue. Reduced motivation emerged as the strongest predictor for mental ill health.

CONCLUSIONS

These findings highlight that individuals infected with COVID-19, especially those who still have experienced post-COVID impairments, are more likely to suffer from mental ill-health and may be more vulnerable for poor mental health outcomes. Therefore, more effective actions are needed to take in order to promote and protect mental health of individuals with a history of COVID-19 infection.

Potential risk factors for acute grief during the COVID-19 pandemic: The mediating role of avoidance processes

Bereavement during the COVID-19 pandemic may have some unique characteristics that become potential risk factors (e.g., absence of grief rituals, no opportunity to say goodbye to the deceased and loneliness caused by social distancing) for acute grief. Avoidance processes could be significant mediators in the context of the pandemic. The current study aimed to investigate whether and how these COVID-19-related risk factors were related to acute grief severity. Bereaved adults (n = 319) who lost significant others during the COVID-19 pandemic completed a self-report questionnaire package measuring COVID-19-related factors, grief severity and depressive and anxious avoidance. Regression analyses suggested that among the three potential risk factors (loneliness, grief rituals and opportunity to say goodbye), loneliness was significantly associated with acute grief after controlling for basic demographic and loss-related information. Structural equation models suggested that depressive avoidance and anxious avoidance partially mediated the associations of loneliness with acute grief severity. The findings indicate that dealing with loss during the COVID-19 pandemic warrants further exploration concerning how potential environmental risk factors may impede adaptation to loss. Depressive and anxious avoidance processes may play important roles in grief interventions for isolated and lonely bereaved people.

Prospective Association between Smartphone Addiction and Perceived Stress and Moderation of Boredom during COVID-19 in China

Smartphone addiction (SPA) is prevalent in college students and harms their healthy development, and perceived stress (PS) has been a well-documented risk factor of SPA. People often experienced boredom during COVID-19; however, its effect on behavioral/mental health during the pandemic has been rarely tested. We investigated the prospective association between SPA and PS before and during COVID-19, as well as the moderation of boredom. A total of 197 college students participated in four-wave surveys from December 2018 to June 2020 in China. The cross-lagged model was developed to investigate the prospective association between SPA and PS from T1 to T4. Boredom was added to the model at T4 as a moderator to explore the moderating role of boredom during COVID-19. The results showed that the pandemic changed PS's prediction on SPA. During COVID-19, boredom significantly affected SPA and PS and moderated the link from PS at T3 to PS at T4. The results suggest that the prospective associations between SPA and PS varied before and during COVID-19. Prevention of SPA should be conducted for new students and should be used to enhance their stress coping capacity. Intervention programs for eliminating boredom may be effective for reducing stress and SPA during COVID-19.

Effectiveness of an Internet-Based Self-Help Intervention versus Public Mental Health Advice to Reduce Worry during the COVID-19 Pandemic: A Pragmatic, Parallel-Group, Randomized Controlled Trial

INTRODUCTION

The mental health burden for the general population due to the COVID-19 pandemic has been highlighted. Evidence on effective, easily accessible public health interventions to reduce worry, a major transdiagnostic risk-factor for, e.g., anxiety and depression, is scarce.

OBJECTIVE

In a pragmatic randomized controlled trial, we aimed to assess whether an internet cognitive-behavioral self-help intervention could reduce worry more than public mental health advice in the general population.

METHODS

Eligible internet users above the age of 18 were recruited from the German general population and randomly assigned, to either get.calm-move.on (GCMO), a 10-day unguided, internet-based self-help intervention, or mental health advice waiting group (MHA-W, receiving officially endorsed mental health recommendations). The primary outcome was level of worry, using the Penn State Worry Questionnaire (PSWQ), 2 weeks after randomization. Baseline assessment and 2-month and 6-month follow-ups were conducted. The trial was registered at the German Clinical Trials Registry (DRKS00021153).

RESULTS

Between April 7, 2020 and December 11, 2020, we randomly assigned 351 individuals to receive either GCMO (n = 175) or MHA-W (n = 176). Participants receiving GCMO (PSWQ = 46.6; change -10.3) reported significantly less worrying at post-intervention (F1,219 = 12.9; p < 0.001; d = 0.38) than MHA-W controls (PSWQ = 51.6; change -5.1). Improvements were also seen on most secondary outcomes, including symptoms of anxiety and depression, general well-being, resiliency, and emotion regulation skills. Improvements made from baseline were stable until the 6-month follow-up.

CONCLUSIONS

This internet-based self-help intervention providing cognitive-behavioral techniques to cope with the threatening pandemic situation is effective in reducing worry in the general population and should complement existing and potentially effective mental health recommendations.

Social Connectedness, Physical Distancing, and Anxiety in Complying with Shelter-In-Place Orders and Advisories during the Once-In-A-Century COVID-19 Pandemic in the US: A Study of Social Media and Internet Users

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease (COVID-19), was first identified in Wuhan, China, in December 2019. As of 20 October 2020, the virus had infected 8,202,552 people, with 220,061 deaths in US, and in countries around the world, over 38 million people have become infected and over one million have died. The virus usually spreads via respiratory droplets from an infected person. At the time of compiling this paper, while countries around the world are still striving to find a "pharmaceutical intervention (PI)", including treatments and vaccines, they are left with only "non-pharmaceutical interventions (NPIs)", such as physical distancing, wearing masks, and maintaining personal hygiene. In the US, all 50 states, the District of Columbia, and five US territories issued mandatory stay-at-home orders between March 1 and 31 May 2020 to lower the risk of virus transmission. This study empirically examined how social connectedness and anxiety interact with shelter-in-place compliance and advisories during the pandemic. The study collected information from 494 adults using an online survey during April and July 2020.

Symptoms of complicated grief and depression following job loss: Can engagement in non-work activities bring relief?

The present study aimed to examine whether day-level engagement in non-work activities can mitigate the adverse outcomes of job loss. Based on Jahoda's latent deprivation model, we hypothesized that engaging in such activities (e.g., meeting others) can fulfil five basic needs (e.g., need for time structure) and that fulfilment of these needs mitigates the negative consequences of job loss. A diary study was conducted on five consecutive days among 236 participants who had involuntarily lost their job, yielding 1046 daily measures of the time spent on activities, the evaluation of these activities, and emotional distress. Multilevel regression analyses showed that time spent on daily activities was associated with the degree of fulfilment of the basic needs and emotional distress, yet the effect sizes were small. Perceived utility of these daily activities showed more solid effect sizes with the basic needs and emotional distress. However, the mediation effect of the basic needs regarding the association between activities and emotional distress could not be confirmed. The present results suggest that, in addition to stimulating individuals who experience job loss-related emotional distress to undertake certain activities, the evaluation of these activities should also be taken into account in tailor-made interventions and preventive measures.

Exercise Participation during the COVID-19 Pandemic: Anxiety, Stress, and Precautionary Behavior

Understanding emotion is critical, as it influences behavioral responses. In particular, anxiety is one of the most significant factors affecting individuals' behavior during a pandemic situation. However, the effect of coronavirus anxiety on exercise behaviors has not been extensively explored in the extant literature. Therefore, this study examined the relationships among coronavirus anxiety, stress, precautionary behavior, and exercise participation. A total of 307 responses were collected from individuals who experienced the full length of the circuit breaker in Singapore. Data were analyzed using partial least squares structural equation modeling (PLS-SEM). Results showed that coronavirus anxiety had positive effects on stress and precautionary behavior. In addition, precautionary behavior played a mediating role in the relationships among coronavirus anxiety, stress, and exercise participation. The findings of this study identify how COVID-19 affected exercise participation during that period and suggest strategies to promote exercise participation, which would benefit individuals and governments.

Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature

The outbreak of coronavirus disease 2019 (COVID-19) represented a new worldwide challenge, strongly impacting on the global economy, overall health and lifestyle. Since then, several strategies have been adopted to contain the widespread of infection. Among these, vaccination is currently the most important measure to fight against the pandemic. However, several concerns such as slower-than-hoped-for rollout, the hurried approval with limited data, the mechanism of action (in particular mRNA-based), and the uncertain duration of protection they afforded were initially raised. Moreover, even if cutaneous reactions have been rarely reported in clinical trials, global mass vaccination showed several dermatologic reactions not initially recognized, leaving dermatologists to decide how to diagnose and treat them. In this scenario, dermatologists should be ready to promptly recognize these clinical manifestations. Thus, the aim of this manuscript is to review current literature on cutaneous reactions following COVID-19 vaccination, particularly inflammatory dermatological diseases, in order to help clinicians to better understand these dermatological conditions and to provide an extensive overview of all the vaccine-related skin manifestations.

Teachers’ demographic and occupational attributes predict feelings of hopelessness during the COVID-19 pandemic

The outbreak of the COVID-19 pandemic has resulted in many emotional consequences for teachers, including feelings of isolation, loneliness, and hopelessness. However, evidence on the prevalence of hopelessness and the associated factors in teachers during the pandemic is limited. The purpose of this research was to examine the prevalence of hopelessness in public school teachers and identify risk factors associated with it. A sample of 168 teachers aged 25–49 years participated in the study by completing the Socio-Demographic Questionnaire, the Beck Hopelessness Scale (BHS), and the Multi-Dimensional Scale of Perceived Social Support (MSPSS). The results revealed a moderate level of experienced hopelessness in teachers. Hopelessness prevalence was also significantly different across teacher gender (males = 79%), age groups (&gt;40 = 77%), socioeconomic status (poor socioeconomic status = 70%), educational level (high school teachers = 79%), professional experience (experienced teachers = 82%), and perceived social support (low perceived social support = 79%). The results of a logistic regression analysis confirmed the effects of these demographic and occupational attributes on hopelessness by explaining ~71% of the variance in hopelessness feelings. Higher odds ratios were associated with age, socioeconomic status, and perceived social support, signifying the prominence of these factors in predicting hopelessness. The study contributes to identifying and screening teachers at risk of hopelessness in public schools and recommends promoting collegial/superior support as well as a positive school climate as the protective factors against hopelessness.

Stress, anxiety, and depression in times of COVID-19: Gender, individual quarantine, pandemic duration and employment

Objectives

This study explores the inter-relationship between emotional distress in adults and gender, quarantine experiences, pandemic duration, and employment.

Methods

An online cross-sectional online survey comprised 943 Israelis. The link to the survey was distributed via different personal and academic social networking sites (e.g., Facebook, WhatsApp, and Twitter). The survey was administered using the online survey portal Google Forms. Participants addressed questions about their socio-demographic characteristics (e.g., gender, age, family status, employment, and quarantine experiences) and ranked their levels of stress, anxiety, and depression using the Hebrew version of the Depression, Anxiety and Stress Scale-DASS-21.

Results

The majority of the respondents (72%) were women, 39% experienced quarantine, and 55% were unemployed. About 42% experienced a short-term pandemic (one lockdown), and the rest experienced a continuous pandemic (two lockdowns). The MANCOVA results, controlling for family status, indicated that women and unemployed participants reported higher stress, anxiety, and depression levels than men and employed participants. Participants who experienced individual quarantine reported higher anxiety and depression. Furthermore, there was a significant interaction between gender, employment, and pandemic duration. The experience of individual quarantine intensified the stress, anxiety, and depression for both employed and unemployed women. Conversely, the quarantine intensified stress, anxiety, and depression only for unemployed men, whereas the quarantine did not affect stress, anxiety, and depression among employed men.

Conclusions

Employment is a critical factor regarding men's emotional state during such stressful situations as the COVID-19 pandemic. Furthermore, individual quarantine and long-term pandemics are associated with opposite outcomes regarding individual mental health. The individual quarantine is associated with increased anxiety and depression, while a long-term, continuous pandemic is associated with decreased stress.

Self-perceived loneliness and depression during the Covid-19 pandemic: a two-wave replication study

The global Covid-19 pandemic has forced countries to impose strict lockdown restrictions and mandatory stay-at-home orders with varying impacts on individual's health. Combining a data-driven machine learning paradigm and a statistical approach, our previous paper documented a U-shaped pattern in levels of self-perceived loneliness in both the UK and Greek populations during the first lockdown (17 April to 17 July 2020). The current paper aimed to test the robustness of these results by focusing on data from the first and second lockdown waves in the UK. We tested a) the impact of the chosen model on the identification of the most time-sensitive variable in the period spent in lockdown. Two new machine learning models - namely, support vector regressor (SVR) and multiple linear regressor (MLR) were adopted to identify the most time-sensitive variable in the UK dataset from Wave 1 (n = 435). In the second part of the study, we tested b) whether the pattern of self-perceived loneliness found in the first UK national lockdown was generalisable to the second wave of the UK lockdown (17 October 2020 to 31 January 2021). To do so, data from Wave 2 of the UK lockdown (n = 263) was used to conduct a graphical inspection of the week-by-week distribution of self-perceived loneliness scores. In both SVR and MLR models, depressive symptoms resulted to be the most time-sensitive variable during the lockdown period. Statistical analysis of depressive symptoms by week of lockdown resulted in a U-shaped pattern between weeks 3 and 7 of Wave 1 of the UK national lockdown. Furthermore, although the sample size by week in Wave 2 was too small to have a meaningful statistical insight, a graphical U-shaped distribution between weeks 3 and 9 of lockdown was observed. Consistent with past studies, these preliminary results suggest that self-perceived loneliness and depressive symptoms may be two of the most relevant symptoms to address when imposing lockdown restrictions.

Longitudinal Aging Study Amsterdam COVID-19 exposure index: a cross-sectional analysis of the impact of the pandemic on daily functioning of older adults

OBJECTIVES

The aim of this study was to develop an index to measure older adults' exposure to the COVID-19 pandemic and to study its association with various domains of functioning.

DESIGN

Cross-sectional study.

SETTING

The Longitudinal Aging Study Amsterdam (LASA), a cohort study in the Netherlands.

PARTICIPANTS

Community-dwelling older adults aged 62-102 years (n=1089) who participated in the LASA COVID-19 study (June-September 2020), just after the first wave of the pandemic.

PRIMARY OUTCOME MEASURES

A 35-item COVID-19 exposure index with a score ranging between 0 and 1 was developed, including items that assess the extent to which the COVID-19 situation affected daily lives of older adults. Descriptive characteristics of the index were studied, stratified by several sociodemographic factors. Logistic regression analyses were performed to study associations between the exposure index and several indicators of functioning (functional limitations, anxiety, depression and loneliness).

RESULTS

The mean COVID-19 exposure index score was 0.20 (SD 0.10). Scores were relatively high among women and in the southern region of the Netherlands. In models adjusted for sociodemographic factors and prepandemic functioning (2018-2019), those with scores in the highest tertile of the exposure index were more likely to report functional limitations (OR: 2.24; 95% CI: 1.48 to 3.38), anxiety symptoms (OR: 3.14; 95% CI: 1.82 to 5.44), depressive symptoms (OR: 2.49; 95% CI: 1.55 to 4.00) and loneliness (OR: 2.97; 95% CI: 2.08 to 4.26) than those in the lowest tertile.

CONCLUSIONS

Among older adults in the Netherlands, higher exposure to the COVID-19 pandemic was associated with worse functioning in the physical, mental and social domain. The newly developed exposure index may be used to identify persons for whom targeted interventions are needed to maintain or improve functioning during the pandemic or postpandemic.

Longitudinal Aging Study Amsterdam COVID-19 exposure index: a cross-sectional analysis of the impact of the pandemic on daily functioning of older adults

OBJECTIVES

The aim of this study was to develop an index to measure older adults' exposure to the COVID-19 pandemic and to study its association with various domains of functioning.

DESIGN

Cross-sectional study.

SETTING

The Longitudinal Aging Study Amsterdam (LASA), a cohort study in the Netherlands.

PARTICIPANTS

Community-dwelling older adults aged 62-102 years (n=1089) who participated in the LASA COVID-19 study (June-September 2020), just after the first wave of the pandemic.

PRIMARY OUTCOME MEASURES

A 35-item COVID-19 exposure index with a score ranging between 0 and 1 was developed, including items that assess the extent to which the COVID-19 situation affected daily lives of older adults. Descriptive characteristics of the index were studied, stratified by several sociodemographic factors. Logistic regression analyses were performed to study associations between the exposure index and several indicators of functioning (functional limitations, anxiety, depression and loneliness).

RESULTS

The mean COVID-19 exposure index score was 0.20 (SD 0.10). Scores were relatively high among women and in the southern region of the Netherlands. In models adjusted for sociodemographic factors and prepandemic functioning (2018-2019), those with scores in the highest tertile of the exposure index were more likely to report functional limitations (OR: 2.24; 95% CI: 1.48 to 3.38), anxiety symptoms (OR: 3.14; 95% CI: 1.82 to 5.44), depressive symptoms (OR: 2.49; 95% CI: 1.55 to 4.00) and loneliness (OR: 2.97; 95% CI: 2.08 to 4.26) than those in the lowest tertile.

CONCLUSIONS

Among older adults in the Netherlands, higher exposure to the COVID-19 pandemic was associated with worse functioning in the physical, mental and social domain. The newly developed exposure index may be used to identify persons for whom targeted interventions are needed to maintain or improve functioning during the pandemic or postpandemic.

Dynamic associations between stress and relationship functioning in the wake of COVID-19: Longitudinal data from the German family panel (pairfam)

Individuals all across the world experienced significant disruptions in their personal and family life with the outbreak of the new coronavirus disease 2019 (COVID-19). The current study investigated dynamic associations between stress and relationship functioning over time in the face of the COVID-19 pandemic. Perceived stress, relationship satisfaction, and relationship quality (appreciation, intimacy, conflict) were reported by 1483 young to middle-aged participants who were in a romantic relationship and lived with their partner in 2018/2019 and in May-July 2020 (a few months after the onset of COVID-19). Data were analyzed using bivariate latent change score models. Relationship functioning (satisfaction, appreciation, intimacy) showed small decreases from before to during the pandemic. Contrary to expectations, levels of perceived stress also decreased on average from before to during the pandemic. Changes in relationship functioning were correlated with changes in stress over time, so that participants with greater decreases in relationship satisfaction, appreciation, and intimacy and greater increases in conflict from before to during the pandemic showed lesser decreases/greater increases in stress. Higher pre-pandemic relationship satisfaction was associated with greater decreases/lesser increases in stress from before to during the pandemic. Pre-pandemic levels of other measures of relationship functioning or stress were not associated with changes in outcomes over time. Results add to the literature demonstrating that stress is closely intertwined with the functioning of intimate relationships. Furthermore, they suggest that greater relationship satisfaction may serve as a protective factor for stressful life events.

Impacts of COVID-19 Pandemic on Dermatology Outpatient Department at a Tertiary Hospital in Eastern China: A Pre-Post Study

Background

The COVID-19 pandemic has considerable impact on health care system in the world directly. Although the pandemic has been effectively controlled, people’s lifestyle, stress of job, economic status and health conditions have all changed. Therefore, it is unclear whether the COVID-19 pandemic has affected the distribution of diseases in dermatology outpatient department, especially in the post-pandemic era and how we should respond to these changes.

Objective

We aimed to assess the impact of the COVID-19 pandemic on diagnosis of dermatology outpatient department in eastern China.

Methods

A pre-post study design was a retrospective study to assess the changes of diseases diagnoses from the outpatient department of Dermatology, Taicang first people’s hospital, Suzhou University, Suzhou, China in the 2021 (Post-COVID-19 pandemic) compared to the 2019 (Pre-COVID-19 pandemic). Statistical analysis was performed using the SPSS 23.0 and Excel 2010. The data were analysed by methods independent t-test and Pearson’s chi-square test. A two-sided p-value of <0.05 was considered statistically significant.

Results

A total of 67,994 patients in 2019 and 67,288 patients in 2021 were included in the study. During the pre-pandemic year, the most common diagnoses in the outpatient department were urticaria, fungal dermatitis, acne, herpes zoster, seborrheic dermatitis. Urticaria, acne, allergic dermatitis, fungal dermatitis, herpes zoster, were statistically more common in the post-pandemic period. Acne, animal-related diseases, allergic dermatitis, insect dermatitis, alopecia, and verruca vulgaris diagnoses were found to increase statistically during the post-pandemic period when compared with the pre-pandemic period.

Conclusion

The COVID-19 pandemic had a minimal effect on the average yearly dermatology outpatients department visits, but the distribution of dermatology diagnoses was affected. As a result, governments and health departments may introduce innovative ways and training of medical teams according to the impact of the pandemic to ensure normal medical care.

Depression and Related Factors in Korean Adults During the Coronavirus Disease 2019 Outbreak

OBJECTIVE

We aimed to determine the status of depression and its related factors among adult Koreans during the coronavirus disease 2019 (COVID-19) outbreak.

METHODS

We used data from the 2020 Korea Community Health Survey (KCHS). We assessed depressive feelings and symptoms using the Patient Health Questionnaire-9 (PHQ-9 ≥10). In addition, we assessed general and COVID-19-related characteristics, including isolation due to and concerns about COVID-19. We analyzed the data using chi-square tests and multiple logistic regression analyses.

RESULTS

The rates of depressive feelings and symptoms were 5.9% and 2.9%, respectively. Of the adult respondents, 68.5% were concerned about COVID-19, while 75.9% were concerned about economic harm due to COVID-19. The adjusted odds ratios for depressive symptoms assessed using the PHQ-9 were significantly high among women responders, adults aged 19-44 years, low-income households, those who experienced COVID-19-related symptoms, and those concerned about death due to COVID-19 and economic harm due to COVID-19. Similar results were obtained for depressive feeling.

CONCLUSION

Concerns related to COVID-19 infection are related to depression. This suggests that COVID-19 significantly affects mental health. Therefore, during public health crises, such as new communicable diseases, mental health and the incidence of the infectious disease require assessment and monitoring.

Cognitive-Attentional Syndrome Moderates the Relationship Between Fear of Coronavirus and Symptoms of Coronavirus-Specific Health Anxiety

This study was aimed at exploring the possible roles of the cognitive attentional syndrome (CAS) and metacognitive beliefs in moderating the relationships between fear of coronavirus during the pandemic and health anxiety. Because some symptoms of health anxiety may overlap with symptoms of other anxiety disorders, we also tried to ascertain whether our hypothesized relations would be maintained when taking other anxiety disorder symptoms into account. We hypothesized that CAS strategies and meta-beliefs would play a role in the progression from fears of the coronavirus to coronavirus health anxiety. The method done was a cross-sectional study with n = 783 participants who completed questionnaires on fear of coronavirus, coronavirus-specific health anxiety, CAS, and symptoms of anxiety disorders. Fear of coronavirus and coronavirus health anxiety are correlated with medium effect size. CAS and metacognitive beliefs moderate the relationship between fear of coronavirus and symptoms of coronavirus-specific health anxiety. CAS predicts a unique part of health anxiety symptoms variance above symptoms of other anxiety disorders. The results of this cross-sectional study preclude causal inferences but tentatively suggest that CAS strategies may play a role in moderating the relationship between fear of coronavirus and coronavirus-related health anxiety. These relationships were obtained after controlling for variance shared with agoraphobia, social phobia, and general physical symptoms of anxiety.

Versorgung pflegender Angehöriger von Menschen mit Demenz in der Kommune während der Pandemie

Zusammenfassung. Hintergrund: Die Verfügbarkeit von Unterstützungsangeboten für pflegende Angehörige von Menschen mit Demenz in der Kommune weist durch die Corona-Pandemie Defizite auf und birgt somit eine veränderte Versorgung der Pflegenden. Fragestellung: Es stellen sich die Fragen, welche Veränderungen der Versorgung pflegender Angehöriger von Menschen mit Demenz Pflegende wahrnehmen, wie Akteur_innen aus der Kommune diese Versorgungssituation während der Pandemie erleben und inwiefern die Wahrnehmung der Gruppen übereinstimmt bzw. sich unterscheidet. Methode: Die Datengrundlage bilden Rathausgespräche und Fokusgruppen aus 13 Kommunen Deutschlands. Hieran nahmen pflegende Angehörige von Menschen mit Demenz sowie Akteur_innen aus der Kommune teil. Die Datenanalyse erfolgte mittels qualitativer Inhaltsanalyse. Ergebnis: Nachteilige Veränderungen der Versorgung Pflegender zeigen sich z.B. durch den Wegfall von Betreuungsangeboten oder Angehörigengruppen. V.a. Akteur_innen nehmen vorteilhafte Veränderungen wahr, wie eine voranschreitende Digitalisierung oder verstärkte Nachbarschaftshilfe. Die Wahrnehmung der Veränderungen der Versorgungssituation unterscheidet sich in mehreren Subkategorien zwischen Pflegenden und Akteur_innen. Schlussfolgerung: Obwohl durch die Pandemie große Versorgungslücken entstanden sind, ergeben sich durch aufkommende Herausforderungen neue Möglichkeiten der Unterstützung wie digitale Angehörigengruppen. Zukünftig müssen Möglichkeiten geschaffen werden, um bereits entwickelte Interventionen so zu implementieren, dass die Zielgruppe diese in Anspruch nehmen kann.

Risk factors for worsening of somatic symptom burden in a prospective cohort during the COVID-19 pandemic

Introduction

Little is known about risk factors for both Long COVID and somatic symptoms that develop in individuals without a history of COVID-19 in response to the pandemic. There is reason to assume an interplay between pathophysiological mechanisms and psychosocial factors in the etiology of symptom persistence.

Objective

Therefore, this study investigates specific risk factors for somatic symptom deterioration in a cohort of German adults with and without prior SARS-CoV-2 infection.

Methods

German healthcare professionals underwent SARS-CoV-2 IgG antibody testing and completed self-rating questionnaires at baseline and 21 months later between April 2020 and February 2022. Differences in variables between the time points were analyzed and a regression analysis was performed to predict somatic symptom deterioration at follow-up.

Results

Seven hundred fifty-one adults completed both assessments. Until follow-up, n = 58 had contracted SARS-CoV-2 confirmed by serology. Between baseline and follow-up, signs of mental and physical strain increased significantly in the sample. Symptom expectations associated with COVID-19 and a self-reported history of COVID-19, but not serologically confirmed SARS-CoV-2 infection, significantly predicted somatic symptom deterioration at follow-up. A further predictor was baseline psychological symptom burden.

Conclusions

This study supports a disease-overarching biopsychosocial model for the development of burdensome somatic symptoms during the COVID-19 pandemic and supports research findings that symptom burden may be more related to the psychosocial effects of the pandemic than to infection itself. Future studies on Long COVID should include SARS-CoV-2 negative control groups and consider symptom burden prior to infection in order to avoid an overestimation of prevalence rates.

Parent and Child Anxiety Evaluated During an Early Period of the COVID-19 Pandemic: A Mixed-Methods Study

Purpose

The objective of this study was to explore parent and child anxiety during the pandemic. Unlike previous pandemics, measures implemented to prevent the transmission of the SARS-CoV-2 virus have been much more limiting.

Methods

An explanatory convergent mixed-methods design was used to describe anxiety of children 9-17 years of age and their parents during August-October 2020. Adult and child versions of State-Trait Anxiety Inventory (STAI) were used to examine levels as measured on STAI's state-anxiety subscale. Web-based interviews with a subset of patients were conducted qualitatively to analyze anxiety-related themes.

Results

A total of 188 parents and 140 children responded to the questionnaires. Mean overall anxiety scores for parents (49.17 [standard deviation: 12.247]) and children (35.43 [standard deviation: 7.894]) were higher than published norms. Parent and child anxiety were positively correlated (r=0.36; P=0.01). From interviews with 11 parents and 11 children; 4 major themes and 10 subthemes describing physical and emotional outcomes resulting from limited social contact, work and family role strain, and uncertainty about COVID-19 were identified.

Conclusions

Parents and children reported elevated anxiety levels during the COVID-19 pandemic. Findings of this study can guide the development of strategies that mitigate the negative impact of isolation, role strain, and uncertainty related to future public health crises.

Feeling lonelier during the early COVID-19 pandemic: A cross-sectional analysis of adults living in the United States

The Coronavirus Disease 2019 (COVID-19) pandemic had many negative consequences, one of which was the increase of loneliness. We aimed to explore associations between sociodemographic, work-related, home-related, and COVID-19-related characteristics and increased feelings of loneliness among adults living in the United States (US). We analyzed cross-sectional baseline data from The Quickly Understanding Impacts of COVID-19 Study (The QUICk Study) collected from May to October 2020 using online surveys completed by a sample of adults living in the US. We used chi-square tests, Fisher exact tests, and logistic regression to identify characteristics associated with increased loneliness. The study sample included 577 adults living in the US. Approximately 37% of the sample reported feeling lonelier than usual over the past month. Younger age, sexual minority status, lower education level, depression, living alone, part-time employment status, and student employment status were significantly associated with increased feelings of loneliness. Depression, younger age, and living alone remained significantly associated with increased feelings of loneliness in the multivariable logistic regression analysis. In the US, young adults, adults with depression, and adults who live alone may have been more likely to experience increased feelings of loneliness during the early COVID-19 pandemic.

Psychosocial indicators of individual behavior during COVID 19: Delphi approach

The COVID-19 pandemic revealed the weakness of the health care system to incorporate indicators of human behavior in the rapid response to the virus. This study aims to establish consensus on the psychosocial indicators of COVID-19 preventive behaviors during the initial phase of the outbreak in Arab countries. This qualitative study used a combined scoping review of the literature to develop the 24 psychosocial indicators and the Delphi approach with a panel of 27 experts from nine Arab countries to achieve a consensus on preventive behavior indicators. The most robust agreement with an average rating of at least 4 was found for five social indicators including Belief System with an average rating (5). Income Status average rating (4.9). Family Commitment average rating (4). Faith average rating (4). Kinship System average rating (3.9). Four psychological indicators were identified namely Self-Efficacy with an average rating of (5). Perception of Hazard with an average rating of (4.5). Motivation with an average rating of (4.5). Stigma with an average rating of (4.2). The nine indicators provide a strong base for redesigning pandemic control interventions. The Delphi study demonstrates the feasibility of a participatory approach during the outbreak of COVID-19. Moreover, future interventions need to accommodate individual psychological and social determinants to increase adherence and decrease resistance to public health guidelines.

One uncertainty added on top of another: Challenges and resources of mothers of preterm infants during the COVID-19 pandemic

Aims and objectives

To qualitatively explore COVID-19-related experiences of mothers of preterm infants in the Neonatal Intensive Care Unit (NICU), the main challenges they face, and the resources available for them.

Background

The birth of a preterm infant is a stressful event under otherwise normal circumstances. The outbreak of COVID-19, the uncertainty about the virus and how it spreads, and the restrictions imposed, may have exacerbated the stress of caring for a preterm infant.

Design

Retrospective interviews.

Methods

In-depth interviews with 12 mothers of preterm infants who were hospitalized in the NICU at the time of study. The interview addressed challenges and resources related to coping with the pandemic. The interviews were transcribed and content analyzed, based on Lieblich et al’s model for narrative analysis. This research was conducted in accordance with the COREQ checklist.

Results

The overarching experience shared by all mothers was accumulative stress caused by a combination of factors related to the infant’s health and COVID-19-related stressors. A central theme was the dissonance between the mothers’ expectations from the birth and infant, and the reality they encountered. Other themes included fear of infecting the infant, loneliness, and stress caused by the restrictions that disrupted daily routines. Resources included a sense of shared fate regarding the pandemic, improvements in the infant’s condition, religious faith, emotional support from the partner, and support from professional staff.

Conclusion

Caring for a preterm infant during a pandemic is a challenging experience on many levels. The loss of significant support resources puts mothers of these infants at a higher risk for psychological distress.

Relevance to clinical practice

Awareness of mothers’ accumulative stress due to the COVID-19 pandemic may assist the staff in developing procedures that can alleviate parental stress, for example by enabling mothers to connect to each other, giving clear information to compensate for physical and social distancing and providing professional mental health support.

Work, life and COVID‐19: a rapid review and practical recommendations for the post‐pandemic workplace

Remote working because of the COVID‐19 pandemic has eroded boundaries between work and home, necessitating the need to evaluate the long‐term impacts of these changes and mitigate any negative effects on workers' work‐life experiences. To do so, we reviewed and examined work‐life research published since the start of the pandemic. The review yielded a sample of 303 work‐life scholarly articles, with three common themes: 1) work‐life boundaries have become more permeable, with behavior‐based and time‐based work‐life conflict emerging as the more salient forms of work‐life conflict; 2) technical work demands have increased, as employees grapple with techno‐invasion, techno‐overload and techno‐complexity; and 3) psychological and emotional work demands have intensified. Based on these key findings, we call for multi‐level and multi‐agency responses to deal with the complex, diverse nature of work‐life demands. Specifically, we offer recommendations at the individual‐, team/organizational‐ and societal/governmental‐levels to enhance employees' work and non‐work lives after the pandemic.

The Mediating Role of Resilience and Electronic Health Literacy in the Relationship Between Pandemic Fatigue and Adherence to Preventive Behaviours Against COVID-19

Introduction: There is emerging literature on the decline in adherence to preventive measures against the COVID-19 pandemic, a phenomenon of pandemic fatigue (PF). However, academics and policymakers have debated its existence and consequences. We conducted this study to explore this phenomenon, its existence, determinants, and relation to adherence to COVID-19 preventive measures, and the mediating role of resilience, fear of COVID-19, and electronic health literacy about COVID-19 in this relationship.

Methods: This cross-sectional online study was conducted from April to June 2021 using a convenience sample of 650 Saudi adults from all regions of Saudi Arabia using a reliable questionnaire. A structural equation model (SEM) was used for mediation analysis.

Results: The results revealed a moderate level of PF among Saudi adults. Younger patients experienced more PF. Fear of COVID-19 had a non-significant (p=0.127) effect on PF. SEM analysis revealed that both resilience and electronic health literacy significantly (p=0.000) mediated the relationship between PF and adherence to preventive measures, and acted as protective factors. In conclusion, there is evidence that PF exists and negatively affects adherence to preventive measures.

Conclusion: Policymakers should apply evidence-based programs to increase public resilience, particularly targeting young adults, as the results of the current study shed light on its protective mediating role against PF. Increasing electronic health literacy is an effective strategy for preventing PF through an increase in the perceived effectiveness of preventive measures.

Reentry During A Pandemic: A Pilot Study of Access to Peer Support Through Technology to Reduce Social Isolation

Returning to society after incarceration is a challenging and stressful process, and the COVID-19 pandemic exacerbated this difficult transition. Although previous research has identified social connectedness as reducing stress and improving wellbeing during stressful life events, much of this research has not addressed prison reentry, despite the relevance to the challenges faced by this unique group of individuals. Additionally, examining how such support can be provided during the COVID-19 pandemic with required social distancing, stay-at-home orders, and business shutdowns has not been studied. This study examines the Offender Alumni Association (OAA), a program operated entirely by formerly incarcerated persons, and its ability to provide social support through obstacles created by reentry and the COVID-19 pandemic. Based on focus groups and surveys of OAA members (N = 77) and non-OAA members (N = 41), we find that, when compared to the comparison group of non-OAA members, those in OAA reported significantly stronger social support and less social isolation. Such results strengthen the argument that within-group support matters in providing protection against the impacts of stressful life events. Further, OAA participants overwhelmingly supported the use of technology during times of crisis as a means to feel connected and supported. Findings indicate that technology can support vulnerable groups and protect public health simultaneously. Further, findings reveal important policy implications, as well as arguments to use technology to expand programming during reentry. (230 Words).

Supplementary Information

The online version contains supplementary material available at 10.1007/s12103-022-09690-9.

Postnatal depression and anxiety during the COVID-19 pandemic: The needs and experiences of New Zealand mothers and health care providers

Objective

The postnatal period is a vulnerable time for women's mental health, particularly within the context of the COVID-19 pandemic. This study interviewed Auckland-based mothers and healthcare providers to find out their perspectives on the needs and experiences of women with postnatal mental health concerns within the pandemic context.

Design

Semi-structured interviews were conducted via video conferencing.

Setting

Interviews were conducted between May and July 2021 during the COVID-19 pandemic.

Participants

Participants included eight mothers who gave birth during the first year of the pandemic (between January and December 2020) and self-identified as experiencing postnatal depression and/or anxiety, and three healthcare providers who support women with postnatal mental illness. All participants were based in Auckland, New Zealand.

Measurements and Findings

Interviews were analysed using thematic analysis. Five main themes were identified including (1) uncertainty and anxiety, (2) financial and work stress, (3) importance of the “village”, (4) inner resilience, and (5) “no one cared for mum”. The participants’ stories reflected a period of uncertainty, anxiety, and isolation. A lack of focus on mothers’ mental health during postnatal healthcare appointments was evident, as well as a lack of support services to refer the women to should they reach out for help.

Key Conclusions and Implications for Practice

The results of this study highlight the importance of prioritising safe, in-person access to healthcare providers and sources of social support for postnatal women during pandemic lockdowns to help reduce isolation during this vulnerable time. Improving accessibility to a range of treatment options for those with mild to moderate mental illness also needs to be a priority. A dedicated postnatal mental health support line could be beneficial to broaden the support options available to mothers, both within and outside the pandemic context. More focus on mental health training for midwives and other postnatal healthcare providers such as well child nurses is also recommended, to increase their ability to support women struggling with postnatal mental illness.

The relationship between health worry, work distress, and affective symptoms during the COVID-19 pandemic: The mediating role of hopelessness and helplessness

OBJECTIVES

The COVID-19 pandemic presented both serious health threats and economic hardships, which were reflected in increased rates of mood and anxiety symptoms. We examined two separate distress domains, health worries and work distress, as predictors of mood and anxiety symptoms. Additionally, we considered whether these two domains might be uniquely associated with the development of dysfunctional beliefs, as a proposed mechanism to account for increased symptoms during the pandemic. Two separate models were considered to examine if associations remained stable through the first year of the pandemic.

METHODS

Participants (N = 2152) were a representative sample of Florida adults. They completed online surveys at three waves: Wave 1 (April-May 2020), Wave 2 (May-June 2020), and Wave 3 (December-February 2021). Participants completed measures of COVID-19 health worry and work distress, anxiety, and depression. They also reported their level of hopelessness and helplessness (indices of dysfunctional beliefs).

RESULTS

In an early pandemic model (Wave 1-Wave 2), health worry directly and indirectly predicted anxiety and depression via dysfunctional beliefs. In contrast, work distress only indirectly predicted both outcomes. In a longer-term model (Wave 2-Wave 3), health worry had direct and indirect effects on downstream anxiety but not depression. Pandemic work distress had no effect on depression or dysfunctional beliefs; however, it was associated with less anxiety.

CONCLUSIONS

Although health worry and work distress predicted later symptoms of anxiety and depression, they appeared to operate through different pathways. These findings provide guidance for the development of more effective interventions to reduce the impact of pandemics.

Comparison between emerging adults and adults in terms of contamination fear, post-COVID-19 PTSD and psychiatric comorbidity

The present study compared Chinese emerging adults and adults regarding the association between contamination fear, posttraumatic stress disorder post-COVID-19 and psychiatric comorbidity after controlling for demographic and trauma exposure variables. 1089 Chinese civilians (M = 382; F = 707) with a mean age of 26 years (M = 26.36, SD = 8.58) were recruited from different provinces in China via an online survey posted on mainstream Chinese social networking platforms. They completed a demographic page with questions on trauma exposure, the Vancouver Obsessional Compulsive Inventory, the Posttraumatic Stress Disorder Checklist for DSM-5 and the General Health Questionnaire-28. Results showed that 12.7%, 68.7% and 18.6% met criteria for full, partial and no PTSD, respectively. Emerging adults reported significantly lower levels of symptoms of re-experiencing, avoidance, somatic problems, anxiety and fear of contamination than adults. In both emerging adults and adults, contamination fear was correlated with PTSD and psychiatric comorbidity. High educational attainment was significantly correlated with psychiatric comorbidity in emerging adults, but with PTSD in adults. Length of quarantine was correlated with psychiatric comorbidity only in adults. In conclusion, both emerging adults and adults developed varying levels of contamination fear, posttraumatic stress and general psychological symptoms following the outbreak of COVID-19. Emerging adults were more resilient than adults in coping with distress.

Personal space increases during the COVID-19 pandemic in response to real and virtual humans

Personal space is the distance that people tend to maintain from others during daily life in a largely unconscious manner. For humans, personal space-related behaviors represent one form of non-verbal social communication, similar to facial expressions and eye contact. Given that the changes in social behavior and experiences that occurred during the COVID-19 pandemic, including "social distancing" and widespread social isolation, may have altered personal space preferences, we investigated this possibility in two independent samples. First, we compared the size of personal space measured before the onset of the pandemic to its size during the pandemic in separate groups of subjects. Personal space size was significantly larger in those assessed during (compared to those assessed before) the onset of the pandemic (all d > 0.613, all p < 0.007). In an additional cohort, we measured personal space size, and discomfort in response to intrusions into personal space, longitudinally before and during the pandemic, using both conventional and virtual reality-based techniques. Within these subjects, we found that measurements of personal space size with respect to real versus virtual humans were significantly correlated with one another (r = 0.625-0.958) and similar in magnitude. Moreover, the size of personal space, as well as levels of discomfort during personal space intrusions, increased significantly during (compared to before) the COVID-19 pandemic in response to both real and virtual humans (all d > 0.842, all p < 0.01). Lastly, we found that the practice of social distancing and perceived (but not actual) risk of being infected with COVID-19 were linked to this personal space enlargement during the pandemic (all p < 0.038). Taken together, these findings suggest that personal space boundaries expanded during the COVID-19 pandemic independent of actual infection risk level. As the day-to-day effects of the pandemic subside, personal space preferences may provide one index of recovery from the psychological effects of this crisis.

Assessing anxiety during the COVID-19 delta epidemic: Validation of the Chinese coronavirus anxiety scale

The study aimed to examine the psychometric properties of the coronavirus anxiety scale (CAS) during the coronavirus disease 2019 (COVID-19) delta epidemic. A total of 2,116 participants on the Chinese mainland completed the online survey. We employed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to investigate the factor structure. The findings showed that the one-factor model of the CAS Chinese version fitted perfectly with the data. The multigroup CFAs showed the measurement invariance across gender and age groups (18–29 and 30–68). We also examined the CAS’s internal consistency and convergent and concurrent validity. The results demonstrated that the one-factor model had good reliability and convergent and concurrent validity. Overall, according to our findings, the CAS Chinese version was reliable for measuring coronavirus anxiety during the COVID-19 delta outbreak.

Gender Effects on Depression, Anxiety, and Stress Regarding the Fear of COVID-19

The fear of the COVID-19 pandemic is associated with negative effects on mental health. The study investigates depression, anxiety, and stress and their relationship to gender among hospitality sector employees in the USA during COVID-19. Fear has been one of the most common psychological responses in the population during the COVID-19 pandemic. The aim of this study is to examine its relationship with depression, anxiety, and stress to combat the fear of COVID-19 between the gender. The study was conducted using an online questionnaire. A sociodemographic data form, the Fear of COVID-19 scale, and the Depression, Anxiety and Stress Scale (DASS-21) were used for data collection. In total, 341 valid questionnaires were analyzed using SPSS version 24. The results showed that the fear of COVID-19 positively and significantly impacted stress (Coeff = .4992, 95% confidence interval (CI): .4409–.5575), anxiety (Coeff = .4825, 95% CI: .4245–.5405), and depression (Coeff = . 4601, 95% CI: .3992–.5210), and these effects differed according to gender. The effects of the fear of COVID-19 on stress and anxiety were higher in women compared with men. This cross-sectional study shows that the psychological effects of the fear of COVID-19 are more significant in women than in men. The study makes significant contributions to the literature in terms of showing the gender differences related to COVID-19 within the hospitality sector. Therefore, women should be prioritized in future psychiatric recovery plans.

Development and Preliminary Validation of the Pandemic Avoidance and Concern Scales (PACS)

The COVID-19 pandemic has led to radical disruptions to the routines of individuals and families, but there are few psychometrically assessed measures for indexing behavioural responses associated with a modern pandemic. Given the likelihood of future pandemics, valid tools for assessing pandemic-related behavioral responses relevant to mental health are needed. This need may be especially salient for studies involving families, as they may experience higher levels of stress and maladjustment related to school and business closures. We therefore created the Pandemic Avoidance and Concern Scales (PACS) to assess caregivers’ and youths’ adjustment to COVID-19 and future pandemics. Concern and Avoidance factors derived from exploratory factor analyses were associated with measures of internalizing symptoms, as well as other indices of pandemic-related disruption. Findings suggest that the PACS is a valid tool for assessing pandemic-related beliefs and behaviors in adults and adolescents. Preliminary findings related to differential adjustment between caregivers and youths are discussed.

Stressors and uplifts of confinement due to covid‐19: A longitudinal study on mental health in a sample of academic and administrative university staff in Spain

The rapid spread of COVID-19 caused many countries to decide to enter full lockdown, a circumstance that impacted all aspects of life, including mental health. The present longitudinal study aimed to analyse how stressors and uplifts of confinement were linked to psychological symptoms at three different time points: during the full lockdown (wave 1), after the gradual lifting of restrictions (wave 2) and after confinement (wave 3). The sample was made up by one hundred and twenty academic and administrative staff from a big University in Spain, they all completed an online survey. Results showed that psychological status did not change over time, but a significant interindividual variability was found throughout. Some stressors were only linked to symptoms at wave 1, but others maintained their associations during waves 2 and 3. Uplifts were, for the most part, inversely (and exclusively) linked to symptoms at wave 1. However, some of them, although enjoyable, were paradoxically linked to worse mental health at wave 1, and even at waves 2 and 3. These findings highlight the importance of providing preventive psychological strategies for mental distress before, during and after confinement.

The Impact of Changing Social Support on Older Persons' Onset of Loneliness During the COVID-19 Pandemic in the United Kingdom

BACKGROUND AND OBJECTIVES

Social distancing measures aimed at controlling the spread of coronavirus disease 2019 (COVID-19) are likely to have increased social isolation among those older than 70 instructed to shield at home. This study examines the incidence of loneliness by gender over the first 10 months of the COVID-19 pandemic among persons aged 70 and older in the United Kingdom, and the impact of changing social networks and perceived social support on the new occurrence of loneliness.

RESEARCH DESIGN AND METHODS

Participants (N = 1,235) aged 70 and older with no reports of loneliness before the pandemic who participated in 7 rounds of the Understanding Society: COVID-19 Study (April 2020-January 2021) and the main Understanding Society Study conducted during 2019. Cox regression analyzed the time to a new occurrence of loneliness.

RESULTS

Among older people who hardly ever/never felt lonely before the pandemic, 33.7% reported some degree of loneliness between April 2020 and January 2021. Living in a single-person household, having received more social support before the pandemic, changes in support receipt during the pandemic, and a deteriorating relationship with one's partner during the pandemic increased the risk of experiencing loneliness. Older women were more likely than older men to report loneliness, even when living with a partner.

DISCUSSION AND IMPLICATIONS

During the 3 COVID-19-related lockdowns in the United Kingdom, changes in older people's social networks and support resulted in a significant onset of loneliness. Findings highlight the risks of shielding older persons from COVID-19 in terms of their mental well-being and the importance of strengthening intergenerational support.

Impact of the COVID-19 pandemic on rural and urban cancer patients' experiences, health behaviors, and perceptions

PURPOSE

The COVID-19 pandemic has disrupted many facets of life. We evaluated pandemic-related health care experiences, COVID-19 prevention behaviors and measures, health behaviors, and psychosocial outcomes among rural and urban cancer patients.

METHODS

Among 1,472 adult cancer patients, who visited Huntsman Cancer Institute in the past 4 years and completed a COVID-19 survey (August-September 2020), we assessed the impact of the pandemic on medical appointments, prevention/health behaviors, and psychosocial factors, stratified by urbanicity.

FINDINGS

Mean age was 61 years, with 52% female, 97% non-Hispanic White, and 27% were residing in rural areas. Rural versus urban patients were more likely to be older, not employed, uninsured, former/current smokers, consume alcohol, and have pandemic-related changes/cancellations in surgery appointments (all P<.05). Changes/cancellations in other health care access (eg, doctor's visits) were also common, particularly among urban patients. Urban versus rural patients were more likely to socially distance, use masks and hand sanitizer, and experience changes in exercise habits and in their daily lives (all P<.05). Less social interaction and financial stress were common among cancer patients but did not differ by urbanicity.

CONCLUSIONS

These findings suggest that the COVID-19 pandemic had a substantial impact on cancer patients, with several challenges specific to rural patients. This comprehensive study provides unique insights into the first 6 months of COVID-19 pandemic-related experiences and continuity of care among rural and urban cancer patients predominantly from Utah. Further research is needed to better characterize the pandemic's short- and long-term effects on rural and urban cancer patients and appropriate interventions.

The benefits of career adaptability on African international students' perception of social support and quality of life in China during the COVID-19 pandemic

With economic globalization, there has been a rapid increase in the number of sojourners in the workforce and in international education. However, little is known about the impact of career adaptability (a key psychosocial resource for managing career transitions) on international students' adaptation in cross-cultural contexts, particularly their quality of life during the COVID-19 pandemic. Based on career construct theory, this study examined how career adaptability directly and indirectly enhances international students' quality of life through perceived online and offline social support, and how the COVID-19 pandemic affected their adaptation in cross-cultural context. With a sample of 328 African international students in China, we found that career adaptability and perceived online/ offline social support were positively related to the quality of life during the COVID-19 pandemic. Furthermore, perceived offline social support, but not perceived online social support, was an adapting response through which career adaptability enhances international students' quality of life in cross-cultural context. The mediating effect of perceived offline social support diminished when the self-rated COVID-19 impact on international students was severe. These findings provide a basis for future psychosocial interventions to enhance international students' adaptation to cross-cultural contexts during and after the COVID-19 pandemic.

Neuropsychological effects of COVID-19: A review

OBJECTIVE

The purpose of this review is to examine review literature on the psychological effects of the COVID-19 pandemic.

METHODS

Studies were identified by an online search of the PubMed database. We selected studies published from January to May 2020 (during the COVID-19 emergency).

RESULTS

We found that psychological effects of COVID-19 remain serious among the most of the population, in particular for people with mental disorders, adolescents, healthcare workers, and the general population that experienced high levels of stress, anxiety, and depression symptoms, with possible long-term psychological implications.

CONCLUSION

Findings revealed that living in urban areas, having economic stability, and living with parents were protective factors against anxiety for youth groups, whereas a risk factor was represented by the presence of COVID-19 infection that involved family members.

Posttraumatic stress and COVID-19-related stressors: a prospective observational study

BACKGROUND

The COVID-19 pandemic may trigger posttraumatic stress symptoms (PTSS) due to its threat to health, well-being, and survival.

OBJECTIVES

We sought to assess levels of change in PTSS at three waves during the COVID-19 pandemic. Our second objective was to examine the role of four objective and subjective predictors salient to COVID-19-loss of resources, sense of loneliness, perceived COVID-19 threat, and uncertainty stress-on the trajectory of PTSS.

METHODS

The study consisted of three waves, a month apart, between June and August 2020, with 903, 718, and 684 participants in each wave, respectively.

RESULTS

At T0, participants had a medium level of PTSS (M = 2.07, SD = 0.89), which increased at T1 (M = 2.46, SD = 0.97) and decreased at T2 (M = 2.24, SD = 0.93). Linear mixed-effects modeling showed that loss of resources, sense of loneliness, perceived COVID-19 threat, and uncertainty stress were significant predictors of PTSS over the three time-points. Significant interactions between these predictors (except sense of loneliness) and time were found: At higher levels of resource loss, uncertainty stress, and COVID-19 threat, there was a steeper increase in PTSS from baseline to 1 month.

CONCLUSIONS

The four predictors of PTSS should be addressed via strengthening resilience of individuals and communities.

The corona blues according to daily life changes by COVID-19: A partial least squares regression model

This study identifies determinants of the variation in depression resulting from COVID-19, specifies in detail the changes to daily life, and then compares the determinants' magnitude. The determinants were combined into three groups: first, the unpredictability of the disease and side effects by its response measures (specifically, restrictions on the freedom of movement and strain on social relationships); second, (mis)information through social media, public authorities, and mass media; and third, income reductions and other sociodemographic factors. Daily life changes were divided into four categories: travel/mobility, time at home (alone and with family), domestic activities (remote work, online shopping, food deliveries, reading, and online networking), and conflicts (with family and neighbors). We measured the total 29 predictors using data from the 2020 Seoul Survey, which is based on face-to-face interviews with a probability sample of adult residents. We made our estimations using partial least squares regression, which can analyze all original variables regardless of collinearity. The regression model found that major stressors include declines in out-of-home offline networking and the rise of domestic activities-and subsequent conflicts with family-restrictions on mobility (specifically, those of leisure travel), and income reductions. In contrast, changes to working and shopping (to remote work and online shopping) rather than leisure increased uses of private transportation modes. Moreover, we found influences of all forms of communications and media to be insignificant. We shall also provide a discussion on policy and academic implications of the findings.

A multiple-group analysis of social Capital and loneliness among community-dwelling older adults in urban China during the outbreak of the COVID-19 pandemic

The present study examined the moderating effects of family social capital on the relationship between community social capital and loneliness among older adults in urban Chinese communities during the COVID-19 outbreak period between January and March 2020.Method: We used quota sampling to recruit 472 community-dwelling older adults aged 60 years or older. A multiple-group analysis was applied to examine the proposed hypotheses.Results: Community-based cognitive social capital was significantly associated with both social and emotional loneliness among older adults with relatively low levels of family social capital. However, these associations were statistically nonsignificant among those with high family social capital levels. Community-based structural social capital was not associated with loneliness in either family social capital group.Conclusion: The findings highlight the role of cognitive social capital in reducing loneliness and support community social capital replacement theory in explaining the mechanism linking social capital to loneliness in later life in the context of the COVID-19 pandemic.

Personal network protects, social media harms: Evidence from two surveys during the COVID-19 pandemic

Background

The classic debate regarding the complex relationships between personal network, social media use, and mental well-being requires renewed examination in the novel context of pandemic-related social isolation.

Data and method

We present two surveys conducted at (i) the earlier months of the pandemic and (ii) the end of large scale social-lockdown measures in the U.S. to explore the social and behavioral antecedents of mental health states relating to social media use. Study 1 tracked the longitudinal changes of personal network, social media use, and anxiety level of a group of individuals (N = 147) over a three-month period during the pandemic. Study 2 replicated and extended the theoretical model to a race-representative U.S. adult sample (N = 258).

Results

Both studies consistently show that (1) more time on social media worsens anxiety. It also mediates the relationship between personal network size and anxiety. That is, a small personal network predicts more social media use, which is in turn related to increased anxiety. (2) Moreover, the effect of social media use on anxiety is mainly explained by news consumption on social media, rather than non-news related usage. (3) This link's strength is moderated by one's perception of COVID-19 impact, such that news consumption on social media increases anxiety more when the perceived impact is higher.

Conclusion

These results demonstrate communication technologies' increasingly critical and multifaceted role in affecting mental health conditions.

Suicide Risk During COVID-19: Correlates of Peri-pandemic Suicidal Ideation Controlling for Pre-pandemic Ideation

Suicide is a public health concern which warrants considerable attention, especially with the onset of the COVID-19 pandemic. The current study sought to examine the relationship between behavioral, psychological, and economic impacts of COVID-19 on suicidal ideation severity in a sample of 90 undergraduate students who completed a comprehensive survey on mental health in January 2020 and were re-assessed in April, June, and July of 2020. Multiple regression analyses showed that changes in experience of loneliness, loneliness due to social distancing, pandemic-related concerns, COVID contagion anxiety, and quarantining alone positively and significantly correlated with peri-pandemic suicidal ideation severity after accounting for pre-pandemic suicidal ideation and sexual orientation, while time spent talking to romantic partner and time spent talking to friends and family were negatively correlated. Findings provide insights into the psychological and behavioral effects of social distancing measures and the pandemic, but further research is needed to generalize findings.