COVID-19: Psychological flexibility, coping, mental health, and wellbeing in the UK during the pandemic

Effects of subjective successful aging on emotional and coping responses to the COVID-19 pandemic

BACKGROUND

Middle-aged and older adults are more vulnerable to hospitalization and mortality if they are infected with the COVID-19 virus. The present study investigates the longitudinal effects of subjective successful aging on middle-aged and older adults' emotional and coping responses to the COVID-19 pandemic, and explores an underlying mechanism through perceived time limitation during the pandemic.

METHODS

A sample of 311 Hong Kong Chinese middle-aged and older adults (M_age = 64.58, SD = 10.14, Range = 45-90 years) were recruited from an Adult Development and Aging Project and participated in a questionnaire study via an online platform or phone interview. Their levels of subjective successful aging, perceived time limitation, and emotional and coping responses to the pandemic were measured.

RESULTS

The respondents who perceived themselves as more successful in aging process reported more positive and fewer negative emotions compared with their counterparts with lower levels of subjective successful aging. The mediation analysis showed that perceived time limitation could partially account for the effects of subjective successful aging on emotional and coping responses.

CONCLUSIONS

Findings of this study unveil the beneficial effects of subjective views of successful aging on emotional and coping responses to the pandemic through alleviating their perception of time limitation.

Dealing with the impact of the COVID-19 outbreak: Are some athletes' coping profiles more adaptive than others?

The public health policies and sanitary measures taken by governments in various countries to stem the spread of the COVID-19 pandemic (e.g. lockdown, social distancing) have major implications for athletes. The radical changes are challenging and risk causing significant career disruption to athletes, with subsequent negative psychological effects. Thus, the ways athletes cope with such adversity is of critical importance. The present study aimed to identify athletes' coping profiles using a person-centred approach, based on their reported use of multiple coping strategies in response to the impact of the COVID-19 outbreak, and to compare levels of anxiety, stress appraisals, interpersonal coping strategies, and availability and appreciation of the major sources of support across profiles. A total of 526 French athletes competing at national to elite levels answered an online questionnaire during the lockdown. Latent profile analysis results yielded four distinct coping profiles (i.e. self-reliant, engaged, avoidant, active and social). The MANOVA showed that athletes belonging to the four profiles differed on anxiety, stress appraisals, social support, and interpersonal coping. In particular, avoidant copers reported high levels of anxiety, threat, and uncontrollability, and appeared less able to regulate responses to the impact of the COVID-19 outbreak. Using a person-centred approach, the findings could inform the development of more adequate care, support, and intervention for athletes, especially avoidant copers, who were characterized by the least effective coping skills and resources. Accordingly, stress reappraisal and stress mindset interventions could be promising approaches to effectively manage pandemic-related impact during and after the COVID-19 crisis.Highlights The COVID-19 outbreak has major implications for athletes and is causing significant disruption to their careers. Using a person-centred approach, four coping profiles emerge showing athletes' preferred use of several coping strategies in response.The four coping profiles (i.e. self-reliant, engaged, avoidant, active and social) differentiate distinct groups of athletes in relation to anxiety, stress appraisals, social support, and interpersonal coping.Avoidant copers were characterized by the least effective coping skills and social context of coping. Management of the COVID-19 situation may be more problematic for them than other in mitigating its negative psychological effects.Using a person-centred approach, the findings could inform the development of more adequate care, support, and intervention for athletes, especially avoidant copers, who were characterized by the least effective coping skills and resources.

Keeping well in a COVID-19 crisis: a qualitative study formulating the perspectives of mental health service users and carers

BACKGROUND

People with existing mental health conditions may be particularly vulnerable to the psychological effect of the COVID-19 pandemic. But their positive and negative appraisals, and coping behaviour could prevent or ameliorate future problems.

OBJECTIVE

To explore the emotional experiences, thought processes and coping behaviours of people with existing mental health problems and carers living through the pandemic.

METHODS

UK participants who identified as a mental health service user (N18), a carer (N5) or both (N8) participated in 30-minute semi-structured remote interviews (31 March 2020 to 9 April 2020). The interviews investigated the effects of social distancing and self-isolation on mental health and the ways in which people were coping. Data were analysed using a framework analysis. Three service user researchers charted data into a framework matrix (consisting of three broad categories: "emotional responses", "thoughts" and "behaviours") and then used an inductive process to capture other contextual themes.

RESULTS

Common emotional responses were fear, sadness and anger but despite negative emotions and uncertainty appraisals, participants described efforts to cope and maintain their mental wellbeing. This emphasised an increased reliance on technology, which enabled social contact and occupational or leisure activities. Participants also spoke about the importance of continued and adapted mental health service provision, and the advantages and disadvantages associated with changes in their living environment, life schedule and social interactions.

CONCLUSION

This study builds on a growing number of qualitative accounts of how mental health service users and carers experienced and coped with extreme social distancing measures early in the COVID-19 pandemic. Rather than a state of helplessness this study contains a clear message of resourcefulness and resilience in the context of fear and uncertainty.

Coping strategies and mental health during COVID-19 lockdown

BACKGROUND

COVID-19 pandemic lockdown measures changed the everyday lives of people around the world.

AIMS

To evaluate the effects of different coping strategies on mental health during COVID-19 lockdown.

METHODS

A representative sample for Austria was recruited through Qualtrics^® in a period of 4 weeks after the lockdown started. Measurements were coping inventory (SCI), psychological quality of life (WHO-QOL BREF, psychological domain), well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), stress (PSS-10), and insomnia (ISI). Regression analyses were performed with coping strategies as predictors and mental health measures as dependent variables.

RESULTS

The representative sample included N = 1,005 respondents (52.7% women). Positive thinking, active stress coping and social support were found to be positive predictors for psychological life quality, well-being, and negative predictors for perceived stress, depression, anxiety, and insomnia. Alcohol and cigarette consumption was a negative predictor for psychological life quality, and well-being, and a positive predictor for perceived stress, depression, anxiety, and insomnia. Support in faith was a positive predictor for perceived stress, depression, anxiety, and insomnia.

CONCLUSIONS

Coping strategies are significant predictors for mental health measures. Education about positive thinking, active coping, and social support could be beneficial for dealing with a decrease in mental health due to COVID-19 pandemic.

Predictors of emotional distress during the COVID-19 pandemic; a Croatian study

The study aimed to assess relations between coronavirus-related psychological distress and its potentially predictive factors. An online sample of 2860 Croatian adults filled in questionnaires on socio-demographic characteristics, distress (the Depression, Anxiety and Stress Scale 21), coping (the Brief COPE), personality (the International Personality Item Pool), and social support (the Duke-UNC Functional Social Support Questionnaire) during the COVID-19 lockdown and after the capital was hit by an earthquake. Results indicated that 15.9% of the respondents experienced severe to extreme depression, 10.7% severe to extreme anxiety, and 26.2% severe to extreme stress. The hierarchical regressions analysis indicated that the considered variables explained a substantial percentage of the variance in depression (51.4%), anxiety (35.2%), and stress (45.5%). Main predictors of emotional distress were lower scores of Emotional Stability, higher scores of Agreeableness, avoidant coping, lack of active coping and perceived social support. The negative effect of the earthquake was weak. Results provide information on a broad range of potentially protective or vulnerability factors that could help identify those at risk for developing coronavirus-related psychological distress. Findings suggest that promoting active coping styles and social interactions could be preventive and potentially therapeutic in general populations.

Psychological Predictors of COVID-19 Prevention Behavior in Hungarian Women Across Different Generations

BACKGROUND

Age related differences were found in prevention behavior, showing that older individuals tend to be the most proactive. The aim of the study was the identification of psychological predictors on COVID-19 prevention behavior in women, across four generations. In addition, the predictive role of the psychological variables was explored through the lens of negative and positive information processing perspective on total and domain-specific COVID-19 prevention behavior.

METHODS

A cross-sectional research was conducted. The sample included 834 Hungarian speaking women. The assessed variables were: COVID-19 knowledge, risk perception, COVID-19 health anxiety, negative automatic thoughts, psychological flexibility, and four domains of COVID-19 prevention behavior (social distancing, general hygiene, information seeking, health behavior). A three-level hierarchical linear regression analysis was conducted to investigate the predictors of preventive behavior in each generation.

RESULTS

A diversity across generations was found. In case of baby boomer generation, the final model explained 32.4% of the variance for total prevention behavior [F(14,215) = 8.847, p < 0.001], and only perceived risk made a significant contribution. For Gen X the final model accounted for 21.1% of variance of total prevention behavior [F(14,341) = 7.788, p < 0.001], marital status, perceived risk, COVID-19 health anxiety, and negative automatic thoughts made significant contributions. In case of Gen Y the final model accounted for 6.2% of variance on total prevention behavior [F(14,147) = 1.761, p = 0.05], only perceived risk had a contribution to the final model. For Gen Z the final model accounted for 23.4% of variance on total preventive behavior [F(13,71) = 2.979, p = 0.002], and only psychological flexibility made a contribution to the model. The results on the distinct domains of COVID-19 prevention behavior emphasized details in the dissimilarity among generations.

CONCLUSION

The role of generational identity on COVID-19 prevention behavior is relevant. The coexistence of negative and positive information processing may have its beneficial role in certain areas of prevention.

Approach Coping Mitigates Distress of COVID-19 Isolation for Young Men With Low Well-Being in a Sample of 1,749 Youth From Australia and the USA

The unprecedented COVID-19 pandemic has led to lockdowns across the world with people being separated from their loved ones including partners, family, and friends. Here, using a large sample of 1,749 Australians and Americans, we investigated the impact of COVID-19 isolation on younger populations (13-25 years), and the influence of coping strategies and mental well-being on this impact. Overall, COVID-19 isolation had a more negative impact on adolescence (13-17 years) than young adulthood (18-25 years), but with no difference apparent between men and women, or between Australian and American residents. However, a deeper analysis revealed a gender-specific effect: the type of coping strategies differentially influenced the negative impact of COVID-19 isolation on men with various levels of well-being, an interaction effect not apparent in women. For men with lower levels of mental well-being, COVID-19 isolation appeared to have a less negative impact on them if they used more approach-oriented coping strategies (e.g., actively focusing on the problem). Our results provide cross-sectional evidence for a differential impact on young men at low levels of wellbeing by pandemic isolation. In sum, young men and adolescent boys with lower well-being coped better with COVID-19 isolation when they used more approach coping strategies.

Peri-Traumatic Distress and Its Relationship to Resilience and Coping Among Medical Students in Malaysia During COVID-19 Lockdown

Background: Medical students are not spared from the challenges related to the Covid-19 lockdown. The fear and uncertainties may lead to traumatic symptoms and test their resilience and sense of coping. Thus, this study aims to determine the prevalence of peri-traumatic distress symptoms and its association with the level of resilience and the coping strategies used during the lockdown among medical students. Materials and Methods: This was a cross-sectional online questionnaire survey involving medical students from a public university in Malaysia. It was conducted during the COVID-19 lockdown or Movement Control Order (MCO) where the students were asked to fill in the COVID-19 Peri-traumatic Distress Index (CPDI), Brief COPE Inventory, and Connor Davidson Resilience Scale (CDRS-25). Results: A total of 282 clinical and 172 pre-clinical medical students were involved. Peri-traumatic distress symptoms were reported by 27% out of the total students. This study found that those who were having peritraumatic distress symptoms were from the pre-clinical years, had poor internet access, as well as lower resilience levels, and used more dysfunctional coping strategies. Pre-clinical medical students with difficult internet access were eight times more likely to have peritraumatic distress symptoms. Conclusions: Given the high level of peri-traumatic distress symptoms reported by medical students during the lockdown, it is vital to identify the vulnerable students, assess their needs and risks to mental health problems during this challenging time as the pandemic is still ongoing with countries going in and out of lockdown depending on the cases at the time. The university administration for each University in Malaysia will need to have a clear academic guideline and policy as well as providing improved infrastructure to minimize the distress faced by medical students.

Exploring the Mental Health Needs of Persons With Autoimmune Diseases During the Coronavirus Disease 2019 Pandemic: A Proposed Framework for Future Research and Clinical Care

Although the coronavirus disease 2019 (COVID-19) pandemic has been associated with increased psychological distress globally, it poses unique challenges to persons who are potentially more vulnerable to its effects, including patients with autoimmune disease. In this article, we review the published literature and media reports to determine factors that may contribute to mental health challenges in persons with autoimmune disease. We then explore existing mental health interventions that have been developed for use in COVID-19 and in patients with autoimmune disorders in general. We identified several potential contributors to psychological distress in patients with autoimmune disease during the pandemic, as follows: feelings of discrimination related to societal response to COVID-19, fear of infection and uncertainty related to immunosuppressive medication, diminished access to usual care and resources, previous health-related trauma, and the exacerbating effect of social isolation. Drawing from existing literature, we synthesize the identified evidence to develop a proposed framework for researching and managing mental health challenges in autoimmune disease during the pandemic and its aftermath.

The Psychological Impact and Associated Factors of COVID-19 on the General Public in Hunan, China

PURPOSE

This study aimed to assess the psychological impact of the COVID-19 pandemic among the general public in Hunan Province, China, which could help develop psychological interventions and mental health programs.

PARTICIPANTS AND METHODS

This online cross-sectional study recruited 571 participants through snowball sampling between February 2 and February 5, 2020. Data were collected through a general information questionnaire, the Public Emergency Psychological State Questionnaire, the Simple Coping Style Questionnaire, and the Public Disease Awareness on COVID-19 Scale.

RESULTS

The total mean score of the public emergency psychological state of the sample was 0.27 (0.31) points, with only 5.78% of participants (n = 33) developing psychological distress. Avoidant coping style and disease awareness were weakly positively correlated (rs = 0.257, p < 0.01) and weakly negatively correlated (rs = -0.124, p <0.01) with psychological responses, respectively. There were significant psychological differences among the following variables: occupation, symptoms of fever or fatigue, discernment of the authenticity of COVID-19 information, and level of concern regarding COVID-19 (p < 0.05).

CONCLUSION

The COVID-19 pandemic appears to have had a minor psychological impact on the general population in Hunan Province. However, psychological health promotion in the general public is still required, especially for employees (such as company employees, migrant workers, and businessmen), individuals with COVID-19-like symptoms, limited discernment competence and unconcerned attitudes.

IMPLICATIONS

The initiatives for improving psychological health among the general public could focus on delivering COVID-19 knowledge and alleviating avoidant coping styles. Our findings could provide important insight for the development of psychological support strategies in China, as well as in other places affected by the epidemic.

Association Between Preventive Behaviour and Anxiety at the Start of the COVID-19 Pandemic in Slovenia

Introduction

The first large outbreak of SARS-CoV-2 in Europe occurred in Northern Italy in February 2020. The relatively fast spread of the infection to Slovenia was expected, and preventive measures for its suppression were widely discussed.

Methods

An online questionnaire was designed to evaluate adherence to preventive measures and the extent to which the taking of preventive measures was associated with people's anxiety level, psychological burden, their perceived vulnerability to disease, germ aversion and a number of demographic characteristics in the early stage of Covid-19 spread. The survey was active for 24 hours (13-14 March 2020). There were 12,307 responses and 7,764 questionnaires were completed in full.

Results

Higher preventive behaviour was found in individuals who experienced greater psychological distress, were more anxious, and expressed greater perceived infectability and germ aversion. Greater compliance with preventive behaviour was found among women, those sharing a household with people aged over 65, the elderly and those who knew somebody who had been infected. These groups also showed higher anxiety levels, which appeared to be significantly increased in general as a result of the specific situation. Quarantine was evaluated as the most efficient preventive measure, and was respected relatively strictly even before it became an officially announced protective measure.

Conclusion

This research reveals a strong association between preventive behaviour and anxiety. Anxiety, together with social distancing, may affect physical and psychological health in the population in the long term. Other aspects of public health might therefore be influenced by the measures currently being enforced to prevent the spread of SARS-CoV-2.

Psychological inflexibility and mental health symptoms during the COVID-19 lockdown in Spain: A longitudinal study

Spain, one of the European countries most affected by the COVID-19 pandemic, underwent a strict lockdown between March and May 2020. This study examines longitudinally the evolution of both psychological inflexibility and mental health symptoms in a sample of college students from the beginning and throughout the end of the mandated lockdown period. We present the results from 197 participants who responded to an online survey at least at two of three data-collection waves scheduled at the beginning (N = 226), halfway (N = 172), and end (N = 188) of the lockdown. The analyses revealed that psychological inflexibility and symptomatology increased over time, and that inflexibility at the beginning of the lockdown indirectly predicted self-reported symptoms at the end of the lockdown via autoregressive parallel paths that also connected cross-sectionally to reveal that changes in inflexibility were predictive of changes in mental health. These results present a dynamic and robust relationship between psychological inflexibility and mental health symptoms throughout a relatively long and presumably stressful period of time.

Examining the Associations between Psychological Flexibility, Mindfulness, Psychosomatic Functioning, and Anxiety during the COVID-19 Pandemic: A Path Analysis

Social distancing plays a leading role in controlling the spread of coronavirus. However, prolonged lockdown can lead to negative consequences in terms of mental health. The goal of the research is to examine the relationship between anxiety and general psychosomatic functioning during the COVID-19 pandemic; the impact of psychological flexibility and mindfulness is also considered. Variables were measured with self-report questionnaires and symptom checklists. The sample included 170 people (M = 27.79, SD = 8.16). Pearson’s correlation, stepwise regression, and path analysis were conducted. The results showed a significant positive relationship between state anxiety and somatic and psychological responses to the pandemic. Path analysis revealed that mindfulness had a direct negative impact on and decreased the level of state anxiety (b = −0.22, p = 0.002), whereas psychological flexibility influenced the variable indirectly (b = 0.23, p = 0.002) by enhancing psychosomatic functioning (b = −0.64, p < 0.001). Psychological flexibility and mindfulness may mediate the development of mental disorders and facilitate achieving overall wellbeing. The study points to the usefulness of mindfulness practice as a form of self-help with anxiety symptoms; this is crucial during the pandemic because contact with clients is restricted.

Leadership in a crisis: doing things differently, doing different things

This article summarises the findings from a review of publications related to healthcare leadership that were published during the first wave of the COVID-19 crisis in 2020. The review discusses a range of strategies for leaders to adopt in challenging situations and identifies three aspects of leadership which are considered essential when leading teams during a crisis: 1) communication, 2) decision making and 3) mental health and wellbeing. This article identifies key principles for each of these three aspects and provides practical tips for how leaders can use the lessons learned from the pandemic in their own contexts.

Impact on Mental Health Due to COVID-19 Pandemic: Cross-Sectional Study in Portugal and Brazil

Mental health effects secondary to the COVID-19 pandemic were till recently considered less important or were neglected. Portugal and Brazil are facing the pandemic in quite different ways. This study aimed to describe the mental health status of the general adult population in Portugal and Brazil during the COVID-19 pandemic and analyze the differences between the two countries. A cross-sectional quantitative study was based on an online questionnaire. Socio-demographic data were collected in addition to four validated scales: CAGE (acronym cut-annoyed-guilty-eye) Questionnaire, Satisfaction with Life Scale, Generalized Anxiety Disorder-7 and Patient Health Questionnaire-2. For each outcome, a multiple linear regression was performed. Five hundred and fifty people answered the questionnaire (435 women). The median age was 38 (Q1, Q3: 30, 47) years, 52.5% resided in Brazil and 47.5% in Portugal. The prevalence of anxiety was 71.3% (mild anxiety was present in 43.1%), the prevalence of depression was 24.7% and 23.8% of the sample had both depression and anxiety. Isolation was a significant factor for depression but not for anxiety. Well-being was below average. Mental illness was considerably higher than pre-COVID-19 levels. Portugal and Brazil will have to be prepared for future consequences of poor mental health and contribute immediate psychological support to their adult populations.