Coronavirus Anxiety Scale: A brief mental health screener for COVID-19 related anxiety

Anxiety and Depression in the Initial Stage of the COVID-19 Outbreak in a Portuguese Sample: Exploratory Study

BACKGROUND

In previous studies, it was found that the confinement to which the population was subjected during the quarantine of the COVID-19 pandemic increased the risk of anxiety and depression.

OBJECTIVE

to analyze the levels of anxiety and depression symptoms in Portugal residents during the quarantine of the COVID-19 pandemic.

METHODS

This is a descriptive, transversal, and exploratory study of non-probabilistic sampling. Data collection was carried out between 6th and 31st of May 2020. Sociodemographic and health questionnaires PHQ-9 and GAD-7 were used.

RESULTS

The sample consisted of 920 individuals. The prevalence for depressive symptoms (PHQ-9 ≥ 5) was 68.2% and (PHQ-9 ≥ 10) was 34.8%, and for anxiety symptoms (GAD-7 ≥ 5) was 60.4% and (GAD-7 ≥ 10) was 20%. Depressive symptoms were moderately severe for 8.9% of the individuals, and 4.8% presented severe depression. Regarding the generalized anxiety disorder, we found that 11.6% of individuals present moderate symptoms, and 8.4% severe anxiety symptoms.

CONCLUSIONS

The prevalence of depressive and anxiety symptoms were substantially higher than those previously found for the Portuguese population and when compared with other countries during the pandemic. Younger individuals, female, with chronic illness and medicated, were more vulnerable to depressive and anxious symptoms. In contrast, participants who maintained frequent levels of physical activity during confinement had their mental health protected.

COVID-19 anxiety and associated factors among university students in Bangladesh

Cross-sectional data were collected from 787 Bangladeshi students ages 18 to 27 years, to assess dysfunctional COVID-19 anxiety using the Coronavirus anxiety Scale or CAS and to identify factors influencing their anxiety. Results indicated that 53% of the respondents attained CAS scores in the clinical range. Women reported a significantly higher anxiety than men. Additionally, not having a steady family income, having poor physical health, having relatives or acquaintances infected with COVID-19, and being highly worried about becoming infected were associated with COVID-19 anxiety. Psychosocial interventions should be adopted to mitigate the anxiety of these high-risk groups and to deter harmful behavior during this emergency.

The association of severe COVID anxiety with poor social functioning, quality of life, and protective behaviours among adults in United Kingdom: a cross-sectional study

BACKGROUND

Anxiety about COVID-19 is common. For most people this is an appropriate response to the loss of livelihoods and loved-ones, disruptions to social networks, and uncertainty about the future. However, for others these anxieties relate to contracting the virus itself, a phenomenon termed COVID anxiety. Little is known about the characteristics of people with severe COVID anxiety or the impact it has on their daily lives.

METHODS

We conducted a two-phase cross-sectional survey of people aged 18 or over who were living in United Kingdom, self-identified as anxious about COVID-19, and had a score of ≥9 on the Coronavirus Anxiety Scale. We recruited participants nationally through online adverts and locally via primary care services in London. Data on demographic and clinical factors were used in multiple regression modelling to examine the greatest contributors to functional impairment, poor health-related quality of life and protective behaviours in this sample of individuals with severe COVID anxiety.

RESULTS

We recruited 306 people with severe COVID anxiety between January and September 2021. Most were female (n = 246, 81.2%); they had a median age of 41 (range = 18-83). The majority of participants also had generalised anxiety (n = 270, 91.5%), depression (n = 247, 85.5%), and a quarter (n = 79, 26.3%) reported a physical health condition which put them at increased risk of hospitalisation with COVID-19. Half had severe social dysfunction (n = 151, 52.4%). One in ten reported never leaving their home, one in three washed all items brought into their house, one in five washed their hands constantly, and one in five of those with children reported not sending them to school because of fears of COVID-19. Increasing co-morbid depressive symptoms best explained functional impairment and poor quality of life after controlling for other factors.

CONCLUSIONS

This study highlights the high degree of co-occuring mental health problems, and the extent of functional impairment and poor health-related quality of life among people with severe COVID anxiety. Further research is needed to establish the course of severe COVID anxiety as the pandemic progresses, and steps that can be taken to support people who experience this distress.

Generalized anxiety disorder among rural primary and middle school students during the outbreak of COVID-19: a multicenter study in three southern Chinese cities

BACKGROUND

The major public health crisis caused by the rapid spread of the coronavirus disease 2019 (COVID-19) and the large-scale public health measures such as social isolation and school closures enforced by some countries have severely affected on the physical and mental wellbeing of children and adolescents globally. This study aimed to estimate the prevalence of the psychological impact and investigate the similarities and differences in the influential factors for generalized anxiety disorder among rural adolescents as a relatively lesser noticed population the outbreak of COVID-19.

METHODS

From May 11 to 22, 2020, a total of 1,179 adolescents, including Grade 5-6 in primary school and Grade 7-8 in middle school, were selected by multistage sampling in three Southern Chinese cities (Shantou, Guangdong Province; Hezhou, Guangxi Province; Nanchong, Sichuan Province), and completed the questionnaires including sociodemographic, generalized anxiety disorder, academic stress, coronaphobia, knowledge of COVID-19, and precautionary measures. ANOVA, Chi-square test, Kruskalwallis H test and multivariate linear regression were performed in the statistical analysis.

RESULTS

The average scores of generalized anxiety disorder during the past two weeks were 3.43 (SD 4.46), 4.47 (SD 5.15), and 4.10 (SD 4.94) in Shantou, Hezhou and Nanchong, respectively. For the pooled data, academic stress (P < 0.001), coronaphobia (P < 0.001), and precautionary measures (P = 0.002) contributed to the prediction of anxiety scores. Academic stress was significantly associated to anxiety symptoms in all cities (P all < 0.001). Coronaphobia was also significantly associated to anxiety symptoms in all cities (P all < 0.001).

CONCLUSION

This study highlights the urgent need for researchers and policymakers to focus on the mental health of rural children and adolescents during the COVID-19 epidemic. The adolescents with academic stress and coronaphobia, the greater the risk that adolescents will suffer from anxiety, suggesting mental health counseling and professional family support are needed.

Psychological Factors Explaining the COVID-19 Pandemic Impact on Mental Health: The Role of Meaning, Beliefs, and Perceptions of Vulnerability and Mortality

This study tested an expanded version of the explanatory model of the negative impact of the COVID-19 pandemic on mental health proposed by Milman and colleagues. Participants (N = 680) completed an online survey on demographic variables associated with poor pandemic mental health, COVID-19 stressors, mental health symptoms, and pandemic-related psychological processes we hypothesized as mediating mechanisms explaining the negative mental health effects of the COVID-19 stressors. Results indicated that these psychological processes (core belief violation, meaning made of the pandemic, vulnerability, and mortality perception) explained the severity of mental health symptoms to a far greater extent than COVID-19 stressors and demographics combined. In addition, these psychological processes mediated the impact of COVID-19 stressors on all mental health outcomes. Specifically, COVID-19 stressors were associated with increased core belief violation, decreased meaning making, and more intense perceived vulnerability and mortality. In turn, those whose core beliefs were more violated by the pandemic, who made less meaning of the pandemic, and who perceived a more pronounced vulnerability and mortality experienced a worse mental health condition. This study's results suggest some possible ways of intervention in pandemic-like events useful for limiting such impact at the individual, group, social and political levels.

Measuring various aspects of coronavirus anxiety: a psychometric evaluation of Pandemic anxiety and Coronophobia scales from the latent and network perspective

Since the outbreak of COVID-19, understanding and describing the changes in experiences related to the pandemic and its correlates have become crucial. The current study aims to provide a psychometric evaluation and examination of the relationship of two COVID-related anxiety scales through the latent and network approach. The data was collected from the same participants at two time points (Nwave 1 = 1283; Nwave 2 = 1326). The study examined the psychometric properties of the Pandemic Anxiety Scale and Coronaphobia scale. It also examined the factor structure, invariance and relationship with selected variables through both the latent and network approach. The results revealed that both scales provided good fit and psychometric properties-PAS (wave1: CFI = 0.97, TLI = 0.95, RMSEA = 0.05 [0.04, 0.07], SRMR = 0.048; wave2: CFI = 0.97, TLI = 0.95, RMSEA = 0.05 [0.04, 0.07], SRMR = 0.049), and Coronaphobia scale (wave1: CFI = 0.99, TLI = 0.98, RMSEA = 0.05 [0.03, 0.07], SRMR = 0.027; wave2: CFI ~ 1, TLI = 0.99, RMSEA = 0.03 [0.002, 0.06], SRMR = 0.015). The results also indicated that distinguishing between them is crucial as they were related differently to various variables. The global network models provided a more complex insight in their connections with the set of selected variables. The PAS and Coronaphobia scales are brief and valid measures that can be used in research looking at mental health issues related to the pandemic. The present study shows a unique pattern of relationships of these scales with other variables, extending previous studies into the topic of COVID-related anxiety.

How anxiety attributed to COVID-19, disease knowledge, and intention to vaccinate against SARS-CoV-2 viral infection prevail in general public of Saudi Arabia?

Aim

The study aimed to document the anxiety attributed to COVID-19, disease knowledge, and intention to vaccinate against the disease in general public. Moreover, the interplay among these three outcomes was also investigated.

Methods

A cross-sectional study was conducted for 2 months in three cities of Dammam Region of Saudi Arabia. The target segment was the adult population of Saudi Arabia. Convenience sampling was used and all adults aged ≥18 were invited to participate. The questionnaire used in the study was available in both Arabic and English languages. It included a demographic section, a section dedicated to vaccination intention and, a section containing coronavirus anxiety scale (CAS). The data analysis was carried out using IBM SPSS version 23. The study was approved by an ethics committee (IRB-2021-05-297).

Results

A total of 542 responses were analyzed. Most respondents had no anxiety attributed to COVID-19 (92.1%), self-reported good knowledge of COVID-19 (79.7%) and intended to administer a vaccine (57.4%). Age groups 18-29 years and 30-45 years, and having a chronic medical condition, were found to be determinants of having COVID-19 anxiety (p < 0.05). The variables of self-rated good knowledge of disease, never contracted COVID-19, and incomes of SAR 5,000 (i.e., USD 1333), and SAR 7,500-10,000 (i.e., USD 1999.5-2666), were found to be determinants of having positive intention toward vaccination (p < 0.05).

Conclusion

The anxiety due to COVID-19 was present in a few participants. Besides, self-reported knowledge about COVID-19 and intention to administer a vaccine, were positively linked to each other. However, both variables had no effect on COVID-19 anxiety. It is important to review and address the determinants of positive intention to further increase vaccine acceptance rate.

Continuous Exposure to Terrorism during the COVID-19 Pandemic: A Moderated Mediation Model in the Israeli Context

This study tested the role of perceived social support as a moderating factor in the mediation of COVID-19-related concerns in the association between continuous traumatic stress (CTS) and depression. The study participants were 499 college students who responded to an anonymous online questionnaire. Measures included the assessment of prior continuous exposure to threats of terrorism, COVID-19-related distress, perceived social support and depressive symptoms. The results demonstrated that COVID-19-related concerns mediated the relationship between continuous exposure to threats of terrorism and depression symptoms, and that perceived social support moderated the association between COVID-19-related concerns and depression. The implications of the study highlight the role of prior exposure to traumatic stress as a risk factor for depression and the role of social support as a protective factor. These results point to the need to develop accessible and non-stigmatic mental health services for populations exposed to other types of continuous traumatic stress.

Increased alcohol use to cope with COVID-19-related anxiety one year into the coronavirus pandemic

Background: An increase in drinking to cope with anxiety provoked by the coronavirus was observed during the first few months of the COVID-19 pandemic. Objective: In the present study, we examined the role of drinking motives in the anxiety–alcohol link one year into the pandemic. Methods: Using a cross-sectional design, we collected data between April and May 2021: 678 participants located in Romania or the Netherlands completed an online survey on alcohol consumption in the past month (assessed using a simple quantity-frequency measure), change in drinking during the past year (assessed using a single item asking whether there had been an increase, decrease or no change), drinking motives (assessed using the Revised Drinking Motives Questionnaire), drinking-related problems (assessed using the Alcohol Use Disorder Identification Test), and COVID-19-related anxiety (assessed using the Coronavirus Anxiety Scale). Results: Compared to before the pandemic, while 42% of participants had decreased their alcohol consumption, 15% reported an increase. Participants with clinically relevant COVID-19-related anxiety (11%) were more likely to drink to cope with negative affect, enhance positive affect, and conform to others. The association between COVID-19-related anxiety and drinking-related problems was specifically moderated by drinking to cope, such that the anxiety–alcohol link was stronger in participants who endorsed this drinking motive more. Conclusion: Drinking is a maladaptive coping strategy for individuals with high levels of COVID-19-related anxiety. These individuals might benefit from interventions involving the learning of healthier skills to deal with the ongoing pandemic.

The Effects of the COVID-19 Pandemic on Women's Mental Helath in Turkey and What these Effects Suggest

Objective: The COVID-19 pandemic has deeply affected societies and individuals in all aspects, including mental and physical health. In this study, we aimed to determine the effects of COVID 19 pandemic on anxiety and depression levels and related factors in women. Methods: As a descriptive cross-sectional study, it was conducted with a total of 728 women between December 2020 and March 2021. Data were collected by Google survey using the descriptive information form, the Coronavirus Anxiety Scale (CAS), and the Hospital Anxiety and Depression Scale (HADS). Results: Having concerns about own health had a strong effect on coronavirus-related anxiety (p&lt;0.001, η2 = 0.037) and the anxiety dimension of Hospital Anxiety and Depression Scale (HADS) (p&lt;0.001, η2 = 0.098). Marital relationships had a strong effect on HADS depression dimension scores (p&lt;0.001, η2 = 0.067). Conclusion: The younger women, those who had problematic marital relationship and those who were exposed to domestic violence had higher anxiety and depression scores. Relevant measures should be taken to reduce the concerns of more risky groups, especially women, in the health system and should be considered in future planning on this subject.

Application of Stress and Anxiety to Viral Epidemics-6 to Measure the Anxiety Response of Cold Chain Practitioners During the COVID-19 Post-Pandemic Era in China

OBJECTIVE

This study explored the psychometric properties of the Chinese version of the Stress and Anxiety to Viral Epidemics-6 Items (SAVE-6) scale for cold chain practitioners exposed to moderate-to-high risk of infection.

METHODS

A total of 233 cold chain practitioners participated in an anonymous online survey, conducted from October to November 2021. The questionnaire comprised participant demographic characteristics, the Chinese version of SAVE-6, the Generalized Anxiety Disorders-7 (GAD-7), and the Patient Health Questionnaire-9 (PHQ-9) scales.

RESULTS

Based on the results of the parallel analysis, the single-structure model of the Chinese version of SAVE-6 was adopted. The scale showed satisfactory internal consistency (Cronbach's alpha=0.930) and good convergent validity based on Spearman's correlation coefficient with the GAD-7 (rho=0.616, p<0.001) and PHQ-9 (rho=0.540, p<0.001) scale scores. The optimal cutoff score for Chinese Stress and Anxiety to Viral Epidemics-9 Items was identified as ≥12 (area under the curve=0.797, Sensitivity=0.76, Specificity=0.66) for cold chain practitioners.

CONCLUSION

The Chinese version of the SAVE-6 scale has good psychometric properties and can be applied as a reliable and valid rating scale to assess the anxiety response of cold chain practitioners in the post-pandemic era.

Psychometric properties of a brief version of the COVID‐19 Stress Scales (CSS‐B) in young adult undergraduates

We extracted items to create a brief version of the COVID-19 Stress Scale (i.e., CSS-B) and examined its psychometric properties in young adults. A sample of 1318 first- and second-year undergraduates from five Canadian universities (mean [SD] age = 19.27 [1.35] years; 77.6% women) completed an online cross-sectional survey that included the CSS-B as well as validated measures of anxiety and depression. The 18-item CSS-B fit well on both a 5-factor and a hierarchical model indicating that the five CSS-B dimensions may be factors of the same over-arching construct. The CSS-B factor structure displayed lower-order and higher-order configural and metric invariance across sites but not scalar invariance indicating that the intercepts/means were not consistent across sites. The CSS dimensions were positively related to measures of general anxiety and depression but not so strongly as to indicate that they are measuring the same construct. The CSS-B scale is a valid measure of COVID-19 stress among young adults. It is recommended that this shorter version of the scale be considered for use in longer surveys to avoid participant fatigue.

An evaluation of the impact of COVID-19 safety measures in public transit spaces on riders' Worry of virus contraction

The coronavirus pandemic has brought about global change in travel behavior. Transit ridership volumes have dropped to record lows. Concerning environmental, health, and social consequences lie in store if transit networks are not able to regain a substantial portion of pre-pandemic users. Transit providers have implemented several interventions aimed at both slowing the spread of the virus and retaining riders as travel restrictions lift. While the effectiveness of these measures has been evaluated with respect to spread rate reduction, little consideration has been given to their impact on riders' feelings of worry regarding virus contraction. By deploying a photo-simulation approach in a randomized control trial, this study finds that level of compliance with safety measures and the conditions of transit spaces themselves significantly impact riders' levels of worry. Given these findings, a series of recommendations are made regarding compliance practices that are expected to lessen rider worry regarding the risks of COVID-19 infection.

The Relationship Between Social Support, Fear, and Psychological Distress Among Frontline Nurses During the COVID-19 Pandemic in Indonesia

The current cross-sectional study aimed to examine the relationship between social support, fear, and psychological distress among frontline nurses during the coronavirus disease 2019 (COVID-19) pandemic. Participants from 20 wards for adult patients from public and private hospitals in Indonesia were recruited. The Fear of COVID-19 Scale, Job Stress Scale, and Perceived Social Support Questionnaire were used to measure outcomes of interest. Questionnaires were completed by a total of 211 nurses. High risk working unit, higher fear score, younger age, less working experience, and less social support were significant influences on nurses' psychological distress. Social support as a modifiable factor is a potential target for intervention strategies to manage psychological issues among nurses. Findings can help policymakers and managers better understand how to support frontline nurses' psychological health and maintain well-engaged nursing staff. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

The mental health impact of COVID-19 on pre-registration nursing students in Australia: Findings from a national cross-sectional study

AIM

The study aimed to measure and describe the mental health impact of COVID-19 on Australian pre-registration nursing students.

BACKGROUND

The COVID -19 pandemic has had a swift and significant impact on nursing students across the globe. The pandemic was the catalyst for the closure of schools and universities across many countries. This necessary measure caused additional stressors for many students, including nursing students, leading to uncertainty and anxiety. There is limited evidence available to identify the mental health impact of COVID-19 on Australian pre-registration nursing students currently.

DESIGN

A cross-sectional study was conducted across 12 Australian universities.

METHODS

Using an anonymous, online survey students provided demographic data and self-reported their stress, anxiety, resilience, coping strategies, mental health and exposure to COVID-19. Students' stress, anxiety, resilience, coping strategies and mental health were assessed using the Impact of Event Scale-Revised, the Coronavirus Anxiety Scale, the Brief Resilience Scale, the Brief Cope and the DASS-21. Descriptive and regression analyses were conducted to investigate whether stress, anxiety, resilience and coping strategies explained variance in mental health impact. Ethical Approval was obtained from the University of New England Human Research Ethics Committee (No: HE20-188). All participating universities obtained reciprocal approval.

RESULTS

Of the 516 students who completed the survey over half (n = 300, 58.1%) reported mental health concerns and most students (n = 469, 90.9%) reported being impacted by COVID-19. Close to half of students (n = 255, 49.4%) reported signs of post-traumatic stress disorder. Mental health impact was influenced by students' year level and history of mental health issues, where a history of mental health and a higher year level were both associated with greater mental health impacts. Students experienced considerable disruption to their learning due to COVID-19 restrictions which exacerbated students' distress and anxiety. Students coped with COVID-19 through focusing on their problems and using strategies to regulate their emotions and adapt to stressors.

CONCLUSION

The COVID-19 pandemic has considerably impacted pre-registration nursing students' mental health. Strategies to support nursing students manage their mental health are vital to assist them through the ongoing pandemic and safeguard the recruitment and retention of the future nursing workforce.

IMPACT STATEMENT

This study adds an Australian understanding to the international evidence that indicates student nurses experienced a range of negative psychosocial outcomes during COVID-19. In this study, we found that students with a pre-existing mental health issue and final-year students were most affected. The changes to education in Australian universities related to COVID-19 has caused distress for many nursing students. Australian nursing academics/educators and health service staff need to take heed of these results as these students prepare for entry into the nursing workforce.

PATIENT OR PUBLIC INVOLVEMENT

The study was designed to explore the impact of COVID-19 on the mental health of undergraduate nursing students in Australia. Educators from several universities were involved in the design and conduct of the study. However, the study did not include input from the public or the intended participants.

Brazilian Adaptation of the Coronavirus Anxiety Scale: A Psychometric Investigation of a Measure of Coronaphobia

This study examined the psychometric properties of a Brazilian adapted version of the Coronavirus Anxiety Scale (CAS-BR) in a sample of adults in Brazil. Confirmatory factor analyses demonstrated that the CAS-BR produces a reliable (α = .84), unidimensional construct whose structure was shown to be invariant across gender, race, and age. However, some items of the CAS-BR were stronger indicators of the coronavirus anxiety construct for women and younger adults. Although the CAS-BR demonstrated evidence of discrimination ability for functional impairment (AUC = .77), Youden indexes were low to identify a clinical cut-score. Construct validity was demonstrated with correlations between CAS-BR scores and measures of functional impairment, generalized anxiety, and depression. Exploratory analyses revealed that CAS-BR total scores were higher among women and participants with a history of anxiety disorder. These findings are consistent with previous investigations and support the validity of CAS-BR for measuring coronavirus anxiety with Brazilian adults.

Fear of COVID-19, Coronavirus Anxiety, COVID-19 Burnout, and Resilience: Examining Psychometric Properties of COVID-19 Burnout Scale in Urdu

This research examined the associations between resilience, fear of COVID-19, coronavirus anxiety and COVID-19 burnout. The study also aimed to validate the COVID-19 Burnout Scale (COVID-19-BS) in Urdu. Participants included 812 Pakistani young adults (55.7% males; mean _age 26.4 ± 8.7 years). Results supported a one-factor solution for the COVID-19-BS with high reliability. Mediation analysis showed that resilience mediated the relationships between fear of COVID-19 and coronavirus anxiety with COVID-19 burnout. The study provided preliminary evidence that fear of COVID-19 and coronavirus anxiety might be significant risk factors for burnout among the Pakistani general population, and resilience might mitigate the impacts of these factors.

Anxiety and functional impairment affects undergraduate psychology students' learning in remote emergency teaching during the COVID-19 pandemic

This study aimed to explore the impact of anxiety and functional impairment measures on a sample of undergraduate psychology students. Learning performance was evaluated during the emergency remote teaching during the first wave and in the post-vaccination period of the COVID-19 pandemic in Brazil. Data modeling revealed that psychometric indicators of severe anxiety and severe functional impairment predicted students with lower learning performance in pairs of pre- and post-test multiple-choice questions. This is the first study to highlight the association between measures of generalized anxiety and functional impairment having a deleterious impact on students' learning performance. This manuscript highlights that educational policies should be designed to deal with students' mental health under stressful situations.

Perpetration of Intimate Partner Violence and COVID-19-Related Anxiety During the Second Lockdown in Portugal: The Mediating Role of Anxiety, Depression, and Stress

Purpose

The restrictions imposed during lockdown by COVID-19 pandemic entailed increased risks for the perpetration of intimate partner violence (IPV). Widespread fear and uncertainty related to the virus and the policies adopted to contain it have been linked to a set of social, emotional, and economic stressors that can increase the risk of IPV. The present study aims to assess the association between COVID-19-related anxiety, psychological distress (depression, anxiety, and stress), and IPV perpetration in the community, as well as to assess the mediating role of psychological distress and depression, anxiety, and stress in the relationship between COVID-19-related anxiety and the perpetration of IPV.

Methods

A sample of 336 participants (282 females, Mage = 34.91, SD = 11.72) was recruited from the Portuguese population through an online self-report questionnaire, completed after the second lockdown (from April and July 2021).

Results

High rates of IPV perpetration during the confinement, in particular psychological and physical IPV, were found. COVID-19-related anxiety and psychological distress (depression, anxiety, and stress) were related to higher levels of IPV perpetration. Psychological distress and stress mediated the relationship between COVID-19-related anxiety and total IPV perpetration and psychological distress and depression mediated the relationship between COVID-19-related anxiety and psychological IPV perpetration.

Conclusions

This study highlights the mediating role of psychological distress on IPV perpetration. Practical implications for intervention policies in IPV perpetration will be discussed.

A meta-analytic review of the associations between dimensions of religious coping and psychological symptoms during the first wave of the COVID-19 pandemic

Introduction

In the first wave of the COVID-19 pandemic, the unknown etiology and treatment of the highly transmissible coronavirus posed considerable threats to public mental health. Many people around the globe turned to religion as an attempt to mitigate their heightened psychological distress, but mixed findings have been obtained regarding the association between the use of religious coping and two psychological symptoms-anxiety and depressive symptoms-widely reported in the initial wave.

Objective

The present meta-analysis was conducted to resolve the empirical inconsistency by synthesizing this body of studies and identifying both individual and national-level factors that accounted for the inconsistent findings.

Methods

Following PRISMA guidelines, the literature search and data screening procedures yielded 42 eligible studies, with 25,438 participants (58% females, average age = 36.50 years) from 24 countries spanning seven world regions.

Results

Overall, the results showed that only negative religious coping was positively associated with psychological symptoms (r = 0.2886, p < 0.0001). Although the associations of both general and positive religious coping with psychological symptoms were non-significant (rs = 0.0425 and -0.0240, ps > 0.39), the moderation analysis revealed significant positive associations between positive religious coping and psychological symptoms in two demographic groups who experienced greater pandemic distress than their counterparts: younger participants and female participants.

Discussion

This meta-analysis provides a nuanced understanding of the complex nature of religious coping in the initial wave of the COVID-19 pandemic when the levels of public anxiety and stress were heightened. The exclusive use of religious coping may not be associated with low levels of psychological symptoms, implying the importance of supplementing the deployment of this strategy with an array of other strategies. Therapists of mental health interventions should show their clients how to make good use of positive religious coping together with other strategies, and how to avoid the use of negative religious coping, to handle their psychological problems.

Systematic review registration

https://osf.io/shb32/.

Catastrophizing and Risk-Taking

Background

Catastrophizing, when an individual overestimates the probability of a severe negative outcome, is related to various aspects of mental ill-health. Here, we further characterize catastrophizing by investigating the extent to which self-reported catastrophizing is associated with risk-taking, using an online behavioural task and computational modelling.

Methods

We performed two online studies: a pilot study (n = 69) and a main study (n = 263). In the pilot study, participants performed the Balloon Analogue Risk Task (BART), alongside two other tasks (reported in the Supplement), and completed mental health questionnaires. Based on the findings from the pilot, we explored risk-taking in more detail in the main study using two versions of the Balloon Analogue Risk task (BART), with either a high or low cost for bursting the balloon.

Results

In the main study, there was a significant negative relationship between self-report catastrophizing scores and risk-taking in the low (but not high) cost version of the BART. Computational modelling of the BART task revealed no relationship between any parameter and Catastrophizing scores in either version of the task.

Conclusions

We show that increased self-reported catastrophizing may be associated with reduced behavioural measures of risk-taking, but were unable to identify a computational correlate of this effect.

Multiple Sclerosis Patients’ COVID-19 Catching Ratios and Disease Profiles

Objective: For a long time ımmunomodulatory / immunosuppressive drugs are used to slow the progression of multiple sclerosis (MS). These treatments are known to suppress the immune system and create susceptibility to infections. In our study, it was aimed to evaluate whether MS patients who received immunomodulatory / immunosuppressive treatments in the current coronavirus disease 2019 (COVID-19) pandemic, negatively affect them in terms of disease severity, frequency and psychological outcomes. Methods: Participants consist of MS patients who acquired COVID-19 (group 1) aged 18-65, using disease modifying treatments (DMT) with follow-up in neurology outpatient clinic, and the other two groups consist of similar age and gender. One of the other two groups is MS patients who have not had COVID-19 (group 2), the other group consisted of patients who had COVID-19 and did not have MS (group 3). MS profile, coronavirus anxiety scale (CAS) and Beck depression inventory (BDI) scales between groups 1 and 2; COVID-19 profile between groups 1 and 3 compared. Results: As a result of comparing the MS disease profile of the 1st and 2nd groups and in terms of the COVID-19 disease profile of the 1st and 3rd groups, there was no statistically significant difference in these paired comparison groups (p> 0.05). Conclusion: İt was concluded that DMT use does not increase the severity of COVID-19 and acquiring COVID-19 did not affect the psychiatric outcomes in MS patients, since no statistically significant difference was observed in 2 MS group and 2 COVID-19 group comparison

Risk and resilience factors associated with college students' psychological distress and PTSD symptoms during the COVID-19 pandemic

Objective: College students are experiencing pronounced mental health difficulties as a result of the COVID-19 pandemic. Little is known, however, about underlying risk and resilience factors contributing to students' psychological health during this time. The current study examined mindfulness, resilience, coping, emotion regulation, and daily hassles as possible predictors of COVID-19 concern, psychological distress, and PTSD symptoms in a sample of college students. Participants: One hundred and thirty-five undergraduate college students participated in this study during the COVID-19 pandemic. Methods: Participants completed a series of self-report questionnaires. Results: Risk and resilience factor hierarchical regression models were run separately to predict the three outcomes. Daily hassles, ethnicity, and first-generation college student status predicted greater COVID-19 concern; daily hassles and difficulties with emotion regulation predicted greater psychological distress; daily hassles, difficulties with emotion regulation, avoidant coping, and problem-focused coping positively predicted PTSD symptoms. Acting with awareness mindfulness and continuing-generation college student status predicted lower COVID-19 concern; acting with awareness mindfulness, nonjudging mindfulness, and resilience predicted lower psychological distress; acting with awareness mindfulness, nonjudging mindfulness, and resilience also predicted lower PTSD symptomatology. Conclusions: Identifying underlying factors associated with college students' mental health during the COVID-19 pandemic may facilitate the development and implementation of targeted preventative interventions aimed at promoting well-being in this uniquely vulnerable population.

Use of substances to cope during the COVID-19 pandemic among transgender and gender diverse adults

Background: Studies have found changes in substance use during the COVID-19 pandemic in specific populations. Transgender and gender diverse (TGD) individuals have experienced greater distress compared to cisgender individuals during the pandemic; however, there is little research on substance use among TGD individuals during this sensitive time period.Objectives: The objective of this study is to examine distress from COVID-19 and coping via substance use including alcohol, cannabis, tobacco, and non-medical use of prescription drugs (NMUPD) among TGD adults.Method: An online survey assessing substance use, general psychiatric symptoms, and COVID-19 anxiety was completed by 342 TGD individuals (16.4% transfeminine, 19.6% transmasculine, 64.0% Gender Diverse) in June/July 2020. Chi-square and structural equation modeling (SEM) analyses examined the connections between distress, coping, and substance use.Results: Seventy-one percent of participants reported no changes in substance use since the start of the pandemic and 22% reported an increase in substance use. Increased substance use was associated with alcohol (p < .001), cannabis (p < .001), and combustible tobacco (p < .001) use in the prior three months. SEM showed significant direct effects between distress and substance use coping, substance use coping and recent drug use, and an indirect effect of distress on recent drug use through substance use coping (β = .31, p = .001).Conclusion: Results highlight the risk of substance use to cope with COVID-19-related stress in a large sample of a minoritized population with mental health disparities. Transmasculine and gender diverse participants were especially likely to report using substances to cope.

Emotional fear of COVID-19, but not physiological expressions of fear, explains variability in COVID-19's impact on individuals' lives

The COVID-19 pandemic has had a profound and robust impact on individuals' lives and has particularly negatively affected individuals' experiences with fear of catching COVID-19. To measure this fear, researchers created the unidimensional Fear of COVID-19 Scale (FCV-19S). However, some exploratory factor analysis studies suggested the presence of two factors, which are 1) emotional fear and 2) physiological expressions of fear. In the current exploratory study, we aimed to confirm this factor structure using confirmatory factor analysis and to examine how these two new factors of the FCV-19S explain variability in the impacts of COVID-19 on nine life domains (i.e., finances, loved ones, job, safety, school, mental health, physical health, social activities, and quality of life). Participants were undergraduate students (n = 224) from a Midwestern University (White: 60.7%; Male: 48.0%) who participated in the study for course credit. The results revealed that the two-factor model had an excellent fit for the FCV-19S, both subscales had excellent psychometric properties, and the emotional fear subscale significantly explained variability in all nine life domains (7% to 54%). However, the physiological fear subscale only significantly explained variability in the physical health domain along with emotional fear (28%). The findings suggested that emotional fear of COVID-19 may explain more variability in the impact of COVID-19 across life domains, while physiological fear may only explain the effects of COVID-19 on physical health. We further discussed implications, limitations, and future directions.

COVID-19-related risk perception, anxiety and protective behaviours among Nigerian adults: a cross-sectional study

Background

Pandemics such as the current COVID-19 pandemic are often associated with heightened fear and significant adjustments in health behaviours.

Aim

This study aimed to assess perceived risk, anxiety and protective behaviours of the general public during the early phase of the coronavirus disease (COVID-19) pandemic in Nigeria.

Methods

An online cross-sectional study among 1197 respondents aged 18 years and above between 27 April to 16 May 2020.

Result

More than half (61.9%) of the respondents had high risk perception towards COVID-19, and high anxiety level was found in 37.2%. Male gender, being a Christian, having more than 12 years of formal education and high risk perception were positively associated with observance of more than one protective measure against COVID-19. The predictors of COVID-19-related anxiety were high risk perception and being a Muslim.

Conclusions

This study showed that risk perception has an influence on both anxiety and observance of protective behaviours. Being a novel experience, this research has implications to support current and future responses to a pandemic experience.

Nursing Students' Computer Anxiety and Attitudes Before and During the COVID-19 Pandemic

Purpose of this research was to investigate how the COVID-19 pandemic affected the level of computer anxiety of nursing students and also their attitude related to computer use. A cross-sectional study was conducted in two periods, one before the COVID-19 pandemic (1st period) and the second during the COVID-19 pandemic (2nd period). The research instrument consisted of three parts, a questionnaire with questions about demographic and educational characteristics such as gender and semester of study, the Computer Anxiety Rating Scale (CARS), that used to assess the nursing students' levels of computer anxiety and the Computer Attitude Scale (CAS) that used to measure nursing students' positive and negative attitudes towards computers. Data from 957 undergraduate nursing students were obtained. Specifically, in the 1st period, 370 nursing students participated (38.66%), while in the 2nd period 587 (61.34%) undergraduates participated. The anxiety of participants during COVID-19 pandemic period was reduced compared to that of participants before the COVID-19 period. Respondents during the COVID-19 pandemic have fewer negative feelings towards computers, based on their answers in contrast to the participants in the study before the COVID-19 pandemic. Computer anxiety and attitudes have change among nursing students among COVID-19 pandemic. Nursing students after the implementation of online training are reporting positive feeling towards computer use and are more confident for their ICT skills.

Linear Regression Analysis of Sleep Quality in People with Insomnia in Wuhan City during the COVID-19 Pandemic

Objective

COVID-19 has evolved into a major global public health event. The number of people reporting insomnia is growing exponentially during the pandemic. This study aimed to explore the relationship between aggravated insomnia and COVID-19-induced psychological impact on the public, lifestyle changes, and anxiety about the future.

Methods

In this cross-sectional study, we used the questionnaires from 400 subjects who were obtained from the Department of Encephalopathy of the Wuhan Hospital of Traditional Chinese Medicine between July 2020 and July 2021. The data collected for the study included demographic characteristics of the participants and psychological scales consisting of the Spiegel Sleep Questionnaire, the Fear of COVID-19 Scale (FCV-19S), the Zung Self-Rating Anxiety Scale (SAS), and the Zung Self-Rating Depression Scale (SDS). The independent sample t-test and one-way ANOVA were used to compare the results. Correlation analysis of variables affecting insomnia was performed using Pearson correlation analysis. The degree of influence of the variables on insomnia was determined using linear regression, and a regression equation was derived.

Results

A total of 400 insomnia patients participated in the survey. The median age was 45.75 ± 15.04 years. The average score of the Spiegel Sleep Questionnaire was 17.29 ± 6.36, that of SAS was 52.47 ± 10.39, that of SDS was 65.89 ± 8.72, and that of FCV-19S was 16.09 ± 6.81. The scores of FCV-19S, SAS, and SDS were closely related to insomnia, and the influencing degree was in the following order: fear, depression, and anxiety (OR = 1.30, 0.709, and 0.63, respectively).

Conclusion

Fear of COVID-19 can be one of the primary contributors to worsening insomnia.

The Use of Dietary Supplements and Their Association with COVID-19-Related Anxiety among Non-Institutionalized Elderly in Northern Greece

The elderly constitute a vulnerable group for increased anxiety and poor diet during the COVID-19 pandemic. There is limited research on the levels of COVID-19-related anxiety and dietary habits including dietary supplementation practices among the elderly and very elderly in Greece. A cross-sectional survey was conducted in 364 non-institutionalized elderly (65-74 y) and very elderly (≥75 y) living in northern Greece, with the aim to investigate the use of dietary supplements and their association with other factors, particularly the COVID-19-related anxiety. Levels of anxiety were assessed with the use of the Coronavirus Anxiety Scale (CAS-5). The percentage of dietary supplement users was 62.6%. The most popular dietary supplements used were vitamin D followed by vitamin C and multivitamin and mineral supplements. Multivariate analysis showed that the very elderly and overweight individuals were less likely to consume vitamin D supplements. Approximately a third of the participants (33.8%) exhibited signs of COVID-19-related anxiety but only 8% showed dysfunctional levels of anxiety. Regression analysis indicated that women, former smokers, and people exhibiting any sign of COVID-19 anxiety were approximately two times more likely to consume dietary supplements of any kind (Gender: OR 2.34, 95% CI 1.30-4.19; Smoking: OR 2.15, 95% CI: 1.08-4.26; COVID-19 anxiety: OR 2.16, 95 % CI: 1.20-3.91). Our results provide useful insights into the current practices of dietary supplement use in this population group and could be used by dietetic and medical associations as well as public authorities in the formulation of targeted, safe, and effective interventions for the protection of public health.

Health-related social media use and COVID-19 anxiety in adolescence: health anxiety as covariate and moderator

Background

Adolescents can benefit from engagement with health-related content on social media (e.g., viewing, commenting, or sharing content related to diseases, prevention, or healthy lifestyle). Nevertheless, such content may be distressing or exaggerated and present a challenge to mental well-being, especially during the COVID-19 pandemic. Rumination about such content may lead to COVID-19 anxiety. Yet, the individual factors that would explain the association between health-related social media use (SMU) and COVID-19 anxiety are understudied.

Objective

In the current study, we aimed to fill the gap by investigating the association between health-related social media use (SMU) and COVID-19 anxiety in light of several individual factors: health anxiety, eHealth literacy, and mild and severe experience with COVID-19 infection. We (1) studied the relationship between individual factors and health-related SMU, (2) tested health anxiety as a moderator in the association between health-related SMU and COVID-19 anxiety, and (3) explored a direct effect of experience with COVID-19 on COVID-19 anxiety.

Methods

Using structural equation modeling, we analyzed cross-sectional data from a representative sample of 2,500 Czech adolescents aged 11-16, 50% girls. Sociodemographic measures, health-related SMU, COVIDCOVID-19 anxiety, health anxiety, eHealth literacy, and mild and severe experience with COVID-19 infection were assessed with an anonymous online survey. The data were collected in June 2021.

Results

We conducted a path analysis to test the main relationships and an additional simple-slopes analysis to explore the moderating effect of health anxiety. Higher health anxiety and eHealth literacy were associated with increased health-related SMU. The effect of experience with COVID-19 infection on both COVID-19 anxiety and health-related SMU was negligible. Health-related SMU and COVID-19 anxiety were positively associated, however, only for adolescents high in health anxiety. For other adolescents, the two variables were unrelated.

Conclusion

Our findings show that adolescents with higher health anxiety and eHealth literacy engage in health-related SMU more intensively. Furthermore, for adolescents high in health anxiety, the frequency of health-related SMU is associated with the risk of COVID-19 anxiety. This is likely due to differences in media use. Adolescents with high health anxiety may use social media for content that is more likely to lead to COVID-19 anxiety compared to other adolescents. We recommend focusing on the identification of such content, which may lead to more precise recommendations regarding health-related SMU compared to cut-back on the frequency of overall SMU.

The Relationship of COVID-19 Student Stress with School Burnout, Depression and Subjective Well-Being: Adaptation of the COVID-19 Student Stress Scale into Turkish

COVID-19 has caused psychological problems in all age groups since it emerged from the first day. One of the most important groups has been affected negatively during the COVID-19 pandemic process are university students. One of the negative situations caused by the pandemic process in university students is student stress caused by COVID-19. To assess stress situations in Italian culture, the COVID-19 student stress scale (CSS-S) has been developed. In this context, the aim of this study was to adapt the CSS-S into Turkish. Another aim of the study was to investigate the direct and indirect relationships of COVID-19 student stress with school burnout, depression and subjective well-being. The participants of the study were 485 Turkish university students. The values obtained with the confirmatory factor analysis revealed that the factor structure of CSS-S is satisfying (χ²/df = 2.99, AGFI = .95, TLI = .93, CFI = .96, IFI = .96, REMSEA = .06, SRMR = .04). Moreover, it was found that school burnout has a mediating role in the relationship between COVID-19 student stress and depression and subjective well-being (χstructure of CSS-S is satisfying/df = 2.41, AGFI = .87, TLI = .91, CFI = .91, IFI = .91, REMSEA = .05, SRMR = .05). These findings imply that psychosocial intervention studies to reduce COVID-19 student stress can reduce students' school burnout and depression. It also implies that these psychosocial intervention studies can have a positive impact on students' subjective well-being.

Nurses' Psychological Trauma and Cognitive Control in the COVID-19 Pandemic

Introduction

During the COVID-19 pandemic, nurses have faced various nurse-specific traumas in their workplaces, but there is limited understanding of the resulting outcomes and factors that contribute to them.

Objective

To address this gap, the study employed the middle-range theory of nurses' psychological trauma (NPT) to examine these relationships among frontline nurses working in critical care areas.

Methods

In a quantitative cross-sectional study, the study compared nurses identified as probable cases of posttraumatic stress disorder (PTSD) with those identified as not probable cases. The study investigated the nurse-specific traumas they experienced, their individual personality traits, and the buffers they possessed. The study also sought to identify specific types of nurse-specific traumas that could be associated with negative outcomes, such as alcohol and drug use.

Results

It was found that PTSD-probable nurses reported higher levels of trauma from disasters and system/medically induced trauma compared to not-probable nurses. They also experienced more nonwork-related humankind traumas and displayed lower resilience. Furthermore, PTSD-probable nurses identified with trait urgency and trait avoidance motivation. Additionally, trauma from disasters was associated with alcohol use.

Conclusion

The study highlights the elevated levels of trauma, lower resilience, and specific psychological traits associated with PTSD-probable nurses, emphasizing the need for targeted interventions and support to mitigate the negative outcomes experienced by frontline nurses.

Cyberchondria and COVID-19 anxiety and internet addiction among nursing students

This study was conducted to determine the relationship between cyberchondria and COVID-19 anxiety and internet addiction in nursing students. This cross-sectional study was conducted with 843 students studying in the nursing department of Adnan Menderes University. The mean age of the students was 20.8 ± 1.72 years and 61.2% were female. The Cyberchondria Severity Scale-Short Form, Coronavirus Anxiety Scale, and the Young Internet Addiction Test-Short Form were used to collect data. The study found a positive association between internet addiction, cyberchondria severity, and anxiety about COVID-19. It was found that the anxiety of COVID-19 had a mediating role in the association between internet addiction and cyberchondria severity. It was found that the use of the internet as a source of information on health problems and trusting the health information found had a significant effect on high cyberchondria levels (p < 0.05). Taken together, the findings of previous studies and this study on the role of the association between internet addiction and cyberchondria exacerbating anxiety due to the pandemic provide further evidence for healthcare professionals that greater focus is needed on the problems of the new era related to people-internet interaction. To reduce the negative effects of the current health crisis and future health crises, interventions for nursing students to control their internet use and cyberchondria behaviors should be prioritized.

Mental health of agricultural adolescents and adults: Preliminary results of a five-year study

Background

Work-related stressors common to agriculture have been associated with adverse mental health outcomes among adult farmers and ranchers. However, the mental health status of agricultural youth is unknown, despite farm and ranch youth being exposed to the same occupational hazards as their adult counterparts. The objective of this study was to estimate the prevalence of symptoms of depression and anxiety among farm adults and their adolescent child and examine the correlation between symptoms of mental health conditions and financial indicators described in the Family Stress Model (FSM).

Methods

Farm families were recruited to participate in online surveys by mail, email, and social media. One adolescent and at least one adult from each family were invited to complete on online survey. Where available, validated instruments were used to collect mental health, stress, family dynamics, and household financial variables. Descriptive statistics were used to describe sample demographics and prevalence of symptoms of depression and anxiety. Pearson correlations describe associations between variables within the Family Stress Model.

Results

Farm families (N = 122) completed the online survey. The mean age of farm parents was 41.4 years (SD = 4.4) and the mean age of farm adolescents was 15.4 (1.2). A majority of farm parents and farm adolescents were male, 58.2% and 70.5%, respectively. The sample was primarily white, non-Hispanic. In this sample of farm parents and adolescents alike, 60% met the criteria for at least mild depression, based on the Patient Health Questionnaire-9 (PHQ-9) and Patient Health Questionnaire-A (PHQ-A). Similarly, among adolescents, 45.1% met the criteria for Generalized Anxiety Disorder (GAD), as did 54.9% of adults. As a measure of economic hardship, per capita income by itself showed relatively low correlations, even with other economic measures (r = 0.11 with negative financial events, r = 0.20 with financial needs, r = 0.17 with financial situation, and r = 0.27 with debt). Parent depressed mood was in turn highly associated with adolescent depression (r = 0.83), social anxiety (r = 0.54), and generalized anxiety (r = 0.69).

Conclusions

The results show a strong association between parent and adolescent mental health and parental depressed mood and debt. There is not a clear association between economic stress and mental health in this sample, but further work is needed to be done at a population level. Preliminary results are promising for application of the full Family Stress Model as we continue to accrue farm families into the study cohort.

Determining the coronavirus awareness of the Turkish society and the anxiety stress levels

The aim of the study is to determine the awareness of the Turkish society in COVID-19, and determine the anxiety stress levels. Research two months after the start of the outbreak in Turkey has reached 2163 individuals completed the online platform. The Integrated Anxiety Stress Scale significantly changed according to age, gender, marital status and working status after the pandemic. According to the results of multiple binary logistic regression analysis, individuals aged 50 and over, female gender, being single and not working after the pandemic for anxiety; female gender, being married, and post-pandemic study were found to be risk factors for Covid awareness. It is recommended that epidemic awareness studies and information sharing on controlled healing measures are planned considering the anxiety levels.

Living with the Threat of Covid-19: Exploring the Psychological Impact of Covid-19 in Those who Conceived Through ART Versus Spontaneously

OBJECTIVES

To explore and compare anxiety relating to the threat of Covid-19 in pregnancy by women who conceived through assisted reproductive technology (ART) and spontaneously. We also examined the psychological coping strategies used and lived experience for both groups.

METHODS

A total of 21 women who conceived through ART at a private university based IVF and a matched sample of women who conceived spontaneously were enrolled from July 2020 to February 2021. This was a mixed methods study. Covid-19-specific anxiety was measured using the coronavirus anxiety scale (CAS) as well as a validating qualitative data model with the use of open-ended questions to expand on quantitative findings.

RESULTS

In both groups of women the level of anxiety detected by the CAS was low and mixed coping strategies (emotion-focused and problem-solving) were utilized. The ART group expressed more positive feelings towards pregnancy during the Covid-19 pandemic.

CONCLUSION

The vulnerable ART group is no more at risk for negative emotional well-being during the Covid-19 pandemic. Additionally, healthcare providers ought to be knowledgeable of various Covid-19 coping strategies that may provide emotionally protective measures for all women of reproductive age. This is of particular importance as effective coping may ultimately prevent disruptions that could compromise prenatal care during the covid-19 pandemic.

Prevalence and correlates of coronavirus anxiety in Germany: Results of a nationally representative survey

The aim was to identify the prevalence and correlates of coronavirus anxiety in the nationally representative adult population in Germany (N = 3,075) via an online survey conducted in August/September 2021. The Coronavirus Anxiety Scale was used to quantify coronavirus anxiety. In sum, 71.2% of the respondents did not report coronavirus anxiety at all (i.e., a score of zero). The average score for coronavirus anxiety was 1.3 (SD: 2.9, ranging from 0 to 20). Several correlates were identified via two-part models. Knowledge about the correlates of coronavirus anxiety may assist in providing targeted support to individuals at risk of high anxiety levels.

The effects of anxiety about their parents getting COVID-19 infection on children's mental health

Although the effects of COVID-19 on children's physical health are relatively less serious, it is known that pandemic has serious effects on children's mental health. Anxiety and related symptoms increase among children during this period. The main purpose of this study is to measure children's anxiety about their parents and themselves with structured scales. Children who applied to the pediatric outpatient clinic were included in the study. Participants were asked questions about their parents' and their own concerns about getting COVID-19. Psychiatric symptoms of the participants were evaluated with the Revised Child Anxiety and Depression Scale, the Coronavirus Anxiety Scale, and Anxiety Sensitivity Index for Children. Increased social phobia, separation anxiety, generalized anxiety, total anxiety, total internalizing disorder scores, increased anxiety sensitivity, and increased coronavirus anxiety were detected among children who have increased subjective anxiety for themselves about getting COVID-19. In addition, increased social phobia, depression, separation anxiety, generalized anxiety, total anxiety, total internalizing disorder scores, and anxiety sensitivity were also detected among children who have increased subjective anxiety for their parents about getting COVID-19. In logistic regression, panic, separation anxiety, and generalized anxiety scores significantly predicted children's anxiety for their parents, and separation anxiety and generalized anxiety were shown to predict anxiety for themselves.

CONCLUSION

Children who have increased subjective anxiety about their parents and themselves also have increased anxiety, anxiety sensitivity, and coronavirus anxiety scores. This is the first study which determines that children who are worried about their parents and themselves have higher levels of anxiety, depression symptoms, and anxiety sensitivity.

WHAT IS KNOWN

• Although COVID19 pandemic's negative effects on the mental health of children and adolescents has been investigated and consistently demonstrated, the children's anxiety about their parents getting infection were less researched.

WHAT IS NEW

• Children's anxiety about their parents getting SARS-Cov-2 infection was investigated with the questionnaires. • The scale scores of the children who expressed their anxiety with open-ended questions were statistically significantly higher.

Mental Health among Young Adults during the COVID-19 Pandemic: A Two-Wave Longitudinal Investigation

This study aimed to assess changes in COVID-19 related factors (i.e. risk perception, knowledge about the virus, preventive behaviors and perceived efficacy) and mental health (i.e. psychological distress and positive mental health), in a sample of Romanian young adults attending college, assessed immediately after the national COVID-19 lockdown ended (Time 1) and six months after the end of the lockdown (Time 2). We also evaluated the longitudinal relations between COVID-19 related factors and mental health. The sample consisted of 289 undergraduate students (89.3% female, Mage = 20.74, SD = 1.06), who completed questionnaires assessing mental health and COVID-19-related factors via two online surveys, six months apart. The results showed that perceived efficacy and preventive behaviors, as well as positive mental health, but not psychological distress, decreased significantly over the six months period. Risk perception and perceived efficacy of preventive behaviors at Time 1 were positively related with the number of preventive behaviors measured six months later. Risk perception at Time 1 and fear of COVID-19 at Time 2 predicted the mental health indicators at Time 2. Public-health strategies should find the right balance in cultivating proper levels of risk perception that would be most beneficial for prevention of COVID-19 spread and mental health problems due to pandemic.

A Systematic Review of Assessment Methods for Seafarers' Mental Health and Well-Being During the COVID-19 Pandemic

Seafarers spend more time at sea than on land, which makes them a hard-to-reach community. Since their mental health and well-being is usually addressed from a land-based perspective, dedicated and validated methods incorporating maritime specificities are lacking. During the COVID-19 pandemic, research into seafarers' mental health and well-being flourished. However, a systematic review of the literature to assess the type and appropriateness of assessment methods pertaining to the mental health and well-being of seafarers has yet to be undertaken. This study reviews 5 databases (ERIC, Scopus, PubMed, Google Scholar and EBSCO) to assess the methods used to examine seafarers' mental health and well-being during the pandemic. Peer-reviewed literature alongside grey literature that applied quantitative or qualitative instruments to measure seafarers' mental health and/or well-being, published in English between March 2020 and February 2023, was eligible for the review. Studies from all geographic regions and regardless of nationality, rank and ship type of the subjects were explored. Database searches produced 272 records. Five additional records were identified via other methods. We identified 27 studies suitable for review, including 24 published in peer-reviewed scientific journals and 3 reports and surveys produced by the industry or welfare organizations. Assessment methods used to measure seafarers' mental health and well-being vary significantly in the literature. The frequent use of ad hoc questionnaires limits the possibility to replicate and compare the studies due to various inconsistencies. Furthermore, several validation and reliability measures needed more solidity when applied to the seafaring population. Such inadequate measuring and a mix of assessment methods impacted the comparison of results and might inflate the risks of underreporting or overstating mental complaints.

Dietary Supplementation Practices Among Undergraduate Students in Greece During the COVID-19 Pandemic and Their Association with COVID-19-related Anxiety

Background

Despite the lack of evidence-based guidance on supplement use for the prevention and treatment of COVID-19, consumption of dietary supplements has been shown to increase in many countries.

Objective

This study aimed to explore the use of dietary supplements among undergraduate students.

Methods

An online cross-sectional survey was conducted between May and June 2021, involving a total of 536 participants (57.8% female) aged between 18-30 years in two university towns in central and northern Greece. Two validated questionnaires were used regarding dietary supplements and stress during COVID-19.

Results

The prevalence of dietary supplement use was 67.5%. The three most popular supplements consumed were vitamin C (65.2%), followed by vitamin D (58.3%), and multivitamin and mineral supplements (56.9%). The use of CAS-5 indicated that 13.1% of students were classified as having dysfunctional anxiety due to COVID-19 (CAS-5 score ≥5). Logistic regression analysis showed that those who exhibited CAS-5 ≥5 were over two times more likely to consume supplements compared to no-stress participants (OR 2.29, 95%CI: 1.09-4.82). Particularly vitamin D use was associated with CAS score ≥5 (OR 2.18, 95%CI 1.22-3.89) a finding that was not observed with other types of dietary supplements.

Conclusion

Women, passive smokers, and those who believe that DS are necessary during the COVID-19 pandemic were also more likely to consume dietary supplements. The use of dietary supplements is widespread among Greek students. Future studies should be conducted to monitor whether these increases in DS use are maintained.

Public Health Dimensions of CVD Prevention and Control - Global Perspectives and Current Situation in the Federation of BiH

Background

CVD remains a leading cause of death in Europe and worldwide accounting for 3.9 million deaths each year in Europe alone. Even with well-known risk factors and the current standards of health care, improvement of health and quality of life of CVD patients are still remains one of the biggest public health challenges we must overcome.

Objective

The aim of this narrative review is to provide a brief overview of the recent and relevant documents of good practice in prevention, diagnostic and therapeutic approaches of Cardiovascular diseases that should be consider as milestones for the health authorities in the Federation of BiH. Cardiovascular diseases stil represent a worldwide public health problem, with some new dimensions caused by challenges caused through pandemic of COVID-19. The wellknown cardiovascular risk factors require new and more efficient public health approaches to the prevention and control.

Conclusion

Due to the recently developed cardiovascular guidelines that were made by the European Society of Cardiology and World Heart Federation, key priority for health authorities should be is to update the existing CVD guidelines in the Federation of BiH in accordance with the international good practice.

Death anxiety, death reflection and interpersonal communication as predictors of social distance towards people infected with COVID 19

Our study investigates several antecedents and consequences of negative emotional reactions to the COVID-19 pandemic in a cross-national sample of 737 participants. Our results show that COVID-19 anxiety and negative mood are positively predicted by death anxiety and the use in communication of general COVID-19 information. Death reflection reduces negative mood in relation to COVID-19 and attenuates the positive association between death anxiety on the one hand and the negative mood and anxiety in relation to COVID-19 on the other hand. The use of humoristic information about COVID-19 reduces anxiety and social distance towards people infected with COVID-19 and also attenuates the positive association between the use in communication of general COVID-19 information and negative mood in relation to COVID-19. Our results also show that the association between death anxiety and social distance towards those infected with COVID-19 is mediated by anxiety and negative mood in relation to COVID-19. Finally, the association between the use of COVID-19 information in interpersonal communication and social distance is mediated by anxiety and negative mood in relation to COVID-19. The study thus reveals specific insights for tailored interventions to reduce negativity towards people infected with COVID-19.

A self-support approach to satisfy basic psychological needs during difficult situations

We tested whether a self-support approach to satisfy basic psychological needs to increase students' basic need satisfaction, mindfulness, and subjective vitality, and decrease their need frustration, coronavirus, and test anxiety during the novel coronavirus and university final exams. Three hundred and thirty students (M _age = 21.45, SD = 2.66) participated in this 6-day long experimental study and they were randomly allocated to either experimental (self-support approach, n = 176) or control (no-intervention) condition. Students completed the targeted questionnaires at the beginning (first day of the university final exams, Time 1) middle (3 days after the beginning of the study, Time 2), and the end of study (6 days after the beginning of the study, Time 3). Compared to students in the control condition, students in the experimental condition reported higher need satisfaction, mindfulness, subjective vitality, and lower need frustration, coronavirus, and test anxiety. Through a path analysis, the experimental condition predicted positively students higher need satisfaction, which in turn, predicted their higher subjective vitality, and lower coronavirus and test anxiety at Time 3. Results highlighted the importance of a self-support approach on students' outcomes during difficult situations, that have implications for theory and practice.

When COVID-19 strikes mental health: a measurement analysis of reassurance seeking behavior scale in Peruvian population

Background

The long-lasting impact of the COVID-19 pandemic cannot be overstated. To combat its dire consequences, some screening measures have been hastily developed and require robust verification to explore their adequacy across different groups. The present research study aimed to analyze measurement invariance by sociodemographic characteristics of the Coronavirus Reassurance Seeking Behavior Scale (CRSB) in Peruvian adults.

Methods

A total of 661 participants completed The Coronavirus Reassurance Seeking Behavior Scale (CRSB), the Coronavirus Anxiety Scale (CAS), and sociodemographic information a subgroup filled in the Patient Health Questionnaire (PHQ-9). Reliability and measurement invariance across sociodemographic characteristics were analyzed. Likewise, associations with depression and dysfunctional coronavirus anxiety were examined.

Results

Results showed that the single factor structure of the CRSB with correlated errors fitted the data adequately and the instrument was invariant across gender, age, and loss of a significant relative to COVID-19. In addition, significant associations with depressive symptoms and dysfunctional anxiety were found.

Conclusion

The findings of the present study suggest that the Coronavirus Reassurance Seeking Behaviors Scale is invariant across different sociodemographic characteristics.

Public Health Dimensions of CVD Prevention and Control - Global Perspectives and Current Situation in the Federation of BiH

Background

CVD remains a leading cause of death in Europe and worldwide accounting for 3.9 million deaths each year in Europe alone. Even with well-known risk factors and the current standards of health care, improvement of health and quality of life of CVD patients are still remains one of the biggest public health challenges we must overcome.

Objective

The aim of this narrative review is to provide a brief overview of the recent and relevant documents of good practice in prevention, diagnostic and therapeutic approaches of Cardiovascular diseases that should be consider as milestones for the health authorities in the Federation of BiH. Cardiovascular diseases stil represent a worldwide public health problem, with some new dimensions caused by challenges caused through pandemic of COVID-19. The wellknown cardiovascular risk factors require new and more efficient public health approaches to the prevention and control.

Conclusion

Due to the recently developed cardiovascular guidelines that were made by the European Society of Cardiology and World Heart Federation, key priority for health authorities should be is to update the existing CVD guidelines in the Federation of BiH in accordance with the international good practice.

Well-Being of High-Level Managers during the Pandemic: The Role of Fear of Negative Appearance, Anxiety, and Eating Behaviors

(1) Background: The COVID-19 pandemic has caused unprecedented changes in the contemporary world, significantly affecting the work of companies, especially management staff. This study investigated whether fear about one's health (caused by the pandemic, disordered eating attitudes, or concerns about one's body image) has a negative relationship with the well-being of managers. (2) Methods: N = 354 managers (222 women, 126 men, and 6 people with no gender identity) participated in the study. The following psychometric instruments were used: the psychological well-being scale, the coronavirus anxiety scale, the fear of negative appearance evaluation scale, and the eating attitude test-26. Results: the fear of negative appearance influenced the well-being of the studied managers. However, this relation was mediated by dieting as well as bulimia and food preoccupation. (4) Conclusions: the well-being level depended on the managers' positive body images, but only when mediated by healthy dieting and eating attitudes. While the well-being level of managers was high, it is worth further exploring how they can flourish and develop in life and work, which can also transfer to the quality of life of their co-workers and companies. However, the subject of the well-being of managers warrants more research; for example, by considering different moderators, such as job experience, gender, and age. Moreover, experimental studies examining the effectiveness of different interventions for the physical and mental health of managers could be worth investigating.

Substance Use and Psychological Distress in Mexican Adults during COVID-19 Pandemic: A Cross-Sectional Study

OBJECTIVES

This observational cross-sectional study examined changes in substance use during the coronavirus disease 2019 (COVID-19) pandemic in the Mexican population and evaluated whether depression or anxiety was associated with these new consumption patterns.

METHODS

An online survey was distributed to the general population. Participants were questioned about their demographics, situation during the COVID-19 pandemic, and substance consumption patterns. The Patient Health Questionnaire-9 for depression and the Coronavirus Anxiety Scale were used.

RESULTS

A total of 866 individuals completed the survey. The mean scores for the Patient Health Questionnaire-9 and Coronavirus Anxiety Scale were 8.89 ± 6.20 and 3.48 ± 3.22, respectively. The preferred substances were alcohol (19%), tobacco (16.5%), and marijuana (5.6%). Consumption of alcohol (p = 0.042) significantly increased during the pandemic and it was higher in women than in men (p = 0.040).

CONCLUSIONS

Substance use patterns were affected by the pandemic, with an increase in the number of users and consumption rate, as well as the reported psychiatric symptoms.