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

The role of uncertainty tolerance and meaning in life on depression and anxiety throughout Covid-19 pandemic

The aim of the current study was to investigate the predictive role of intolerance to uncertainty, meaning in life, gender, marital status, having a child, chronic illness, living with a relative over the age of 65, having health care worker relative, the presence of someone infected with Covid-19 around, and frequency of hand washing on depression and anxiety throughout Covid-19 pandemic. 426 adults (263 women, 163 men) participated to the study. The range of age was between 18 and 74, with the mean of 37.40. Intolerance to Uncertainty Scale, Meaning in Life Scale, Beck Anxiety Scale, Beck Depression Scale were used to collect data. The results indicated that 13.8% (59) of participants had depression, 7% had moderate, 7.5% severe anxiety. Findings yielded that meaning in life and intolerance of uncertainty were significant predictors of depression and anxiety. Chronic illness significantly predicted anxiety, the frequency of washing hand significantly predicted depression. It was concluded that the most important variables predicting both depression and anxiety was intolerance to uncertainty and meaning in life.

Is COVID-19 a threat or an opportunity for healthy eating? An exploration of the factors that moderate the impact of the pandemic on eating habits in Uruguay

In May 2020, Uruguay was one of the few Latin American countries that had managed to control the outbreak of COVID-19 without mandatory curfews or quarantines. However, several social distancing measures created a major disruption in different aspects of the daily life of Uruguayan citizens. In this context, the objectives of the present work were i) to identify changes in eating habits perceived by Uruguayan citizens as a consequence of the COVID-19 pandemic, and ii) to explore factors associated with different perceived changes on eating habits. A cross-sectional online study was conducted with 891 participants, recruited using an advertisement on Facebook and Instagram. Fifty-one percent of the participants indicated that their eating habits had changed since the detection of the first cases of COVID-19 in Uruguay. Large heterogeneity in the categorization of the changes existed: 45% of the participants regarded the changes as positive, 32% as negative and 23% as neither positive nor negative. A multinomial logistic regression analysis was used to study the influence of explanatory variables in the likelihood of belonging to groups who reported different changes in eating habits (no changes, positive, negative, or neither positive nor negative changes). Household income and reliance on instrumental and emotional support increased the likelihood of reporting positive changes in eating habits, whereas negative changes were associated with a reduction in household income due to COVID-19 and the coping strategies self-distraction and self-blaming. Insights for policy making to reinforce positive effects and minimize threats to healthy eating are discussed.

Effects of social position and household affordances on COVID-19 lockdown resilience and coping

In France, the COVID-19 pandemic and ensuing lockdown measures have created unprecedented circumstances that increase stress and anxiety, thus leading individuals experiencing home confinement to adopt various coping strategies that contribute to building resilience. Given the novelty and recency of the COVID-19 lockdown, factors of coping and resilience in this specific context of home confinement remain undefined. Based on some recent observations, we conducted a study on a convenience sample in France (N = 809) in order to investigate two potential factors of lockdown resilience and coping: social position and household affordances, while also exploring some complementary hypotheses based on the literature. Social position and household affordances were identified as significant predictors of lockdown coping and resilience, and low social position was found to coincide with less social support coping strategies. Results are discussed in relation to the theory and the limits identified in this study. Recommendations are made for potential second waves of COVID-19 spread or similar pandemics in the future.

Symptoms of depression, anxiety, and perceived mastery in older adults before and during the COVID-19 pandemic: Results from the Longitudinal Aging Study Amsterdam

OBJECTIVE

Governmental measures to protect older adults from COVID-19 are hypothesized to cause anxiety and depression. Previous studies are heterogeneous and showed small effects. This study aims to assess depressive and anxiety symptoms and perceived mastery just after the first wave of the COVID-19 pandemic compared to previous years in community-dwelling older adults and to identify potential risk groups according to the comprehensive geriatric assessment framework.

METHODS

Data were used from 1068 Dutch older adults (aged 55-93 at baseline in 2011-2013) participating in the Longitudinal Aging Study Amsterdam, including 4 follow-ups spanning 9 years. Depressive symptoms, anxiety symptoms and feelings of mastery were assessed with the short Center for Epidemiologic Studies Depression scale (CES-D-10), the Hospital Anxiety Depression Scale - Anxiety subscale (HADS-A) and the Pearlin Mastery Scale. Linear mixed regression was used to compare outcomes in June-August 2020 to previous years and to examine predictors to identify risk groups.

RESULTS

Slight increases in CES-D-10 (1.37, 95% Confidence interval [CI] 1.12;1.62), HADS-A (0.74, 95% CI 0.56;0.94) and mastery (1.10, 95% CI 0.88;1.31) occurred during the COVID year compared to previous years. Older adults with functional limitations or with frailty showed a smaller increase in feelings of mastery in the COVID-year.

CONCLUSION

Our results suggest limited mental health effects on older adults from the first COVID-19 wave. Older adults have perhaps better coping strategies than younger adults, or preventive measures did not have extensive consequences for the daily life of older adults. Further monitoring of depression, anxiety and perceived mastery is recommended.

A systematic review of loneliness and social isolation scales used in epidemics and pandemics

The COVID-19 pandemic has heightened social isolation and loneliness. There is a lack of consensus on rating scales to measure these constructs. Our objectives were to identify commonly used loneliness and social isolation scales over the last two decades and test their user characteristics. 7928 articles were searched in PubMed/MEDLINE, CINAHL, Web of Science, and APA PsychINFO databases. 41 articles were included based on study criteria. Among fourteen scales reported, UCLA 3-item loneliness scale was found to be most commonly used. The scale is specifically developed for telephone use and is the fastest taking less than a minute for self-administration.

Virtual reality adoption during the COVID-19 pandemic: A uses and gratifications perspective

The coronavirus disease 2019 (COVID-19) pandemic has impacted all aspects of people's lives, including how we work, play, learn, exercise, and socialize. Virtual reality (VR) technology has the potential to mitigate many of the challenges brought about by the pandemic, which has spurred increased adoption. However, relatively low adoption overall and limited software still restrict the power of VR to address COVID-19 difficulties effectively. This study examines how the perceived impacts of COVID-19 might lead to different VR uses and gratifications and device ownership / variability. Furthermore, we investigate the importance of social interactivity within VR for increasing adoption intentions. We surveyed 298 Amazon Mechanical Turk users during the Fall of 2020. Results indicate that the pandemic's perceived impacts influenced the likelihood of acquiring VR for education, tourism, and work. For VR ownership and variability, those who purchased VR during the pandemic were more likely to report buying it for work. Those with access to high-end VR hardware were more likely to report a broader range of uses, including socializing, health, and telemedicine. Validating the importance of various applications during the pandemic, we found that the desire for social interactivity mediates the impacts of COVID-19 on future adoption intentions. Theoretically, we propose several gratifications sought via the use of VR during the pandemic. Practically, we discuss recommendations for future VR research, marketing, and software design.

Associations of loneliness, belongingness and health behaviors with psychological distress and wellbeing during COVID-19

BACKGROUND

The aim of this study was to assess the effects of loneliness, belongingness and other modifiable factors on psychological distress and wellbeing and whether the effects of COVID-19 modulated these relationships.

METHODS

The current study reported on 1217 participants aged 18 years or older who completed an online survey from 28 to 31 March 2020. Survey measures included demographic characteristics; exposure to COVID-19; impact of COVID-19 on employment, finance, and work and social adjustment; loneliness, thwarted belongingness, and health behavior changes as modifiable factors. Outcome measures were psychological distress and wellbeing.

RESULTS

Linear regression models revealed that COVID-19 related work and social adjustment difficulties, financial distress, loneliness, thwarted belongingness, eating a less healthy diet poorer sleep and being female were all associated with increased psychological distress and reduced wellbeing (p < 0.05). Psychological distress was more elevated for those with high difficulties adjusting to COVID-19 and high levels of thwarted belongingness (p < 0.005). Similarly, as COVID-19 related work and social adjustment difficulties increased, wellbeing reduced. This was more pronounced in those who felt lower levels of loneliness (p < 0.0001). Other interactions between COVID-19 impacts were observed with gender and poorer diet for psychological distress and cigarette use, age and gender for wellbeing (p < 0.05).

LIMITATIONS

The study was cross-sectional, preventing causal interpretation of the relationships.

CONCLUSION

Modifiable factors, age and gender had significant impacts on psychological distress and wellbeing. Public health and policy approaches to improving social, economic and lifestyle factors may mitigate the negative mental health effects of the pandemic and its restrictions.

Face mask use and physical distancing before and after mandatory masking: No evidence on risk compensation in public waiting lines

During the COVID-19 pandemic, the introduction of mandatory face mask usage triggered a heated debate. A major point of controversy is whether community use of masks creates a false sense of security that would diminish physical distancing, counteracting any potential direct benefit from masking. We conducted a randomized field experiment in Berlin, Germany, to investigate how masks affect distancing and whether the mask effect interacts with the introduction of an indoor mask mandate. Joining waiting lines in front of stores, we measured distances kept from the experimenter in two treatment conditions - the experimenter wore a mask in one and no face covering in the other - in two time spans - before and after mask use becoming mandatory in stores. We find no evidence that mandatory masking has a negative effect on distance kept toward a masked person. To the contrary, masks significantly increase distancing and the effect does not differ between the two periods. However, we show that after the mandate distances are shorter in locations where more non-essential stores, which were closed before the mandate, had reopened. We argue that the relaxations in general restrictions that coincided with the mask mandate led individuals to reduce other precautions, like keeping a safe distance.

Impact of the COVID-19 Pandemic and Psychosocial Coping Strategies in Health Sciences Students at the University of Seville: A Pilot Study

The new infection by coronavirus has supposed a challenge to all health systems worldwide, affecting our psychosocial health. Education as we knew it has changed, which is why university students, attending Health Sciences courses in this case, have been affected by the pandemic. This study aimed to analyze the impact of the preventative measures and restrictions associated with COVID-19 on multiple mental health and psychological well-being indicators in Health Sciences students at the University of Seville. A descriptive and cross-sectional pilot study in the University of Seville by means of an online questionnaire elaborated was conducted. Of the final sample (n = 68), more than 60% of the students acknowledged having received specific training by their university and/or health institution where they perform practices on COVID-19 measures; however, they negatively emphasized not having received psychosocial aid or support in most of the cases (94.12%). As the health situation imposed by COVID-19 is considered long-lasting, the proposal is to plan short- and long-term strategies for promotion and intervention in the mental health of students and future health care workers.

Assessing Mental Health of Women Living in Karachi During the Covid-19 Pandemic

Introduction: Women are more susceptible to mental health disorders and have been reported to experience higher levels of depression and anxiety during previous large-scale disease outbreaks. Stressful events like the COVID-19 pandemic can add extra burdens to women's already multifaceted lives. Keeping the gender implications of COVID-19 in mind can assist health care workers to offer more effective management. In our study, we aimed to assess the impact of COVID-19 on the mental health of women in Karachi, Pakistan and investigate the possible risk factors.

Methods: An online questionnaire was distributed to women on social media platforms in the month of June 2020. The questionnaire had two self-assessment scales, Patient Health Questionnaire (PHQ-9) scale which measures the symptoms of depression and General Anxiety Disorder (GAD-7) scale which measures anxiety.

Results: Three hundred and ninety three individuals completed the questionnaire with the mean age calculated to be 27.6 ± 11.7 years. Age, education, marital status, number of children, financial issues, employment status, smoking, comorbidities and mental illnesses were significantly associated with participants' mean anxiety and depression scores. The depression scores were generally higher compared to anxiety scores in each category. As the age increased, their scores decreased, with women aged 18–30 having a significantly higher mean depression and anxiety scores compared to women who were above 50. Severe anxiety was identified in 21.9% women and severe depression was noted in 17.8% women. A frightening number of 148 (37.7%) was found of women who had self-destructive thoughts at one time or another. Out of these women, surprisingly 97 (65.5%) individuals were not previously diagnosed with any mental illnesses.

Discussion: This study supports the existing literature regarding the disturbed psychological state of women close to the peak of the covid-19 pandemic. We noted increased percentage of depressive women as compared to studies conducted before the covid-19 era. This raises concern especially with our thought provoking finding of self-harm or suicidal thoughts among women. Most of our female population is also seen to be anxious. This study highlights the importance for help and support groups of mental health to effectively reach women during this period of social isolation.

Unveiling Associations of COVID-19 Vaccine Acceptance, Hesitancy, and Resistance: A Cross-Sectional Community-Based Adult Survey

COVID-19 vaccines are essential to limit and eliminate the infectious disease. This research aims to identify strong vaccination resistance profiles and/or hesitation considering health, psychosocial, and COVID-related variables. A cross-sectional online survey (N = 300) was conducted in the context of strict COVID-related gathering and mobility restrictions (January–March 2021). Data collected were vaccine acceptance, hesitancy and resistance rates, general psychosocial status, and preventive practices and beliefs regarding COVID-19 and its vaccination, among other factors. Logistic regression was applied to a real-world data set and a significant model (χ² (7, N = 278) = 124.548, p < 0.001) explaining 51.3% (R² Nagelkerke) of attitudes towards vaccination was obtained, including the following predictors for acceptance: to have greater confidence in the COVID vaccine security (OR = 0.599) and effectiveness (OR = 0.683), older age (OR = 0.952), to be a healthcare professional (OR = 0.363), to have vulnerable individuals in charge (OR = 0.330), and sustain the belief that the vaccine will end the pandemic situation (OR = 0.346) or not being sure but give some credence to that belief (OR = 0.414). Findings could help understand the rate and determinants of COVID-19 vaccine resistance/hesitancy among a Spanish population sample and facilitate multifaceted interventions to enhance vaccine acceptance.

Sleep Quality and Mental Health of Medical Students in Greece During the COVID-19 Pandemic

Background-Aim: Medical students have been greatly affected by the COVID-19 pandemic due to their educational program, which comprises theoretical knowledge and also clinical duties, making them vulnerable to viral exposures and possibly affecting their everyday life. The aim of this study was to explore changes in sleep and mental health parameters among medical students in Greece during the second year of the pandemic. Methods: This cross-sectional study comprised students of all medical schools in Greece (n = 7), using an anonymous online survey. Participants completed the following questionnaires: Pittsburgh Sleep Quality Index (PSQI), Athens Insomnia Scale (AIS), Fatigue Severity Scale (FSS), General Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9). Statistical analysis was conducted with the use of SPSS v.26 (IBM SPSS, Armonk NY, USA). Results: Out of the 562 received responses, 559 met the inclusion criteria. The largest proportion of the respondents came from 4th-year (27.8%) and the majority of the sample were females (69.8%). Only 5.9% of the participants reported having been infected by SARS-COV-2. Most of the respondents experienced insomnia (65.9%, mean AIS score: 7.59 ± 4.24), poor sleep quality (52.4%, mean PSQI score: 6.6 ± 3.25) and increased fatigue (48.5%, mean 35.82 ± 11.74). Moderate to severe symptoms of anxiety (mean 9.04 ± 5.66) and depression (mean 9.36 ± 6.15) were noted. Suicidal ideation was found in 16.7% of the sample, while use of sleeping pills in the previous month was reported by 8.8% (n = 47). Further analysis revealed independent associations between sleep and mental health parameters. Higher AIS score was associated with greater FSS score; higher PSQI scores with higher GAD-7 and PHQ-9 scores. Additionally, female students were found to be significantly more affected than males by the COVID-19 pandemic, displaying higher levels of insomnia, sleep disturbances, anxiety and depression. In addition, those with a history of COVID-19 infection or in close proximity with a positive case reported significantly more significant post-traumatic symptoms in IES-COVID-19 questionnaire. Conclusions: In the aftermath of the COVID-19 pandemic, prevalence of sleep and mental health disorders among Greek medical students is significant, highlighting the need for better surveillance of students' wellbeing and subsequent counseling, with special focus on female students and other affected groups.

Rhythms of the day: How electronic media and daily routines influence mood during COVID-19 pandemic

This study aims to investigate how daily activities affect mood in the context of social distancing guidelines enforced during the COVID‐19 pandemic. Using Ecological Momentary Assessment (EMA) administered four times a day during a 2‐week period, we asked participants (N = 91) about their mood and the activities they engaged in. Seven individuals were selected for a follow‐up, open‐ended questionnaire. Results show that a stable routine, including physical exercise, hobbies, regular sleep hours, and minimal time spent in front of the computer, helps maintain a good mood. Coping strategies such as planning and scheduling help keep routines and circadian rhythms stable. Face‐to‐face contact is associated with a more positive mood, while similar interaction through electronic communication has a less positive effect. We observe an effect related to the infodemic phenomenon: Daily reports on COVID‐19 cases and deaths affect mood fluctuations. This is an important consideration in shaping public information policies.

A Counseling Application as an Alternative Tool in Increasing Coping Self-Efficacy Among University Students With Academic Distress During Coronavirus Disease 2019 Pandemic in Indonesia: A Study Protocol for a Randomized Controlled Non-Inferiority Trial

The coronavirus disease 2019 (COVID-19) pandemic increased education-related distress among University students globally, including in Indonesia. Psychological factors, such as academic demands, limited opportunity to meet their peers, problematic use of technology, and domestic problems, influenced the well-being of the students, leading to poor academic performance. A mobile-based counseling application was developed to address the distress among University students. The application was meant to reach students living remotely to enable them to access psychological assistance. Therefore, the purpose of this study was to describe a protocol aimed to evaluate the equivalence of the application when compared to the Treatment-As-Usual (TAU) in increasing the coping self-efficacy (CSE) and resilience of students as well as in decreasing their level of depression. A two-armed parallel randomized control non-inferiority trial will be conducted among approximately 430 students with selected academic problems. The participants will be randomly allocated into the TAU and the intervention groups. The primary and secondary outcomes will be measured by the Indonesian versions of the Coping Self-Efficacy (CSE) Scale, the Resilience Scale (RS-14), and the Patient Health Questionnaire (PHQ-9). The data will be collected at baseline, at the end of each session, and after 3 months. The outcomes will be analyzed using repeated-measures ANOVAs, intention-to-treat, and per-protocol analysis. If proven, the application will be used as an alternative media in helping the students.

Clinical Trial Registration: Thailand Clinical Trials Registry (TCTR20200530001); Date of registration: May 28, 2020.

Home Garden With Eco-Healing Functions Benefiting Mental Health and Biodiversity During and After the COVID-19 Pandemic: A Scoping Review

The COVID-19 pandemic has led to tremendous impacts on human lives and society, which are not only because of negative effects on people's mental health due to isolation policies and physical distance for mitigating the spread of SARS-CoV-2, but also because the incident post-acute sequelae of the coronavirus will cause mental disorders. A green environment is a health resource, which cannot only benefit human physical and mental health, but also increases biodiversity, contributes to flood mitigation, and cools urban areas. A home garden, as a kind of small green space, can provide ecosystem services with eco-healing functions in reducing mental stress during the isolation period of the COVID-19 pandemic through the garden itself and physical activities in it. Such an eco-healing approach within a mini-therapeutic landscape can also benefit biodiversity by enhancing plant diversity in residence and increasing biodiversity at a large scale. In this article, we propose a conceptual framework describing a home garden as "ecological medicine" with healing functions to improve mental health, as well as indirectly enhancing urban biodiversity. A home garden, as a mini-type of green landscape with biodiversity content, allows people to get close with nature so that it can promote comfortable and natural feelings during the pandemic. Furthermore, such an eco-healing home garden approach benefiting urban biodiversity can meet the challenges in maintaining environmental and mental health in post COVID-19 pandemic recovery, as well as preparing unknown next-surge risks with potential isolation regulations.

Psychological Adjustment, Quality of Life and Well-Being in a German and Portuguese Adult Population During COVID-19 Pandemics Crisis

Introduction: The pandemics crisis had consequences in psychological adjustment of persons all over the world. The current study analyzes comparatively the topics of quality of life, and well-being, considering as predictors trait anxiety, feeling of threat, difficulty to relax, empathy and pro-social attitude, health care, sleep quality and optimism, in a population of German and Portuguese adults during the pandemics, in order to obtain a deeper understanding of the psychological reactions to crisis across countries and cultures.

Methods: A sample of 470 adults divided in three age groups – —young adults (18—34 years), middle-age adults (34–54 years) and old adults (55 years and older)— completed a self-report questionnaire assessing socio-demographic data, quality of life, well-being, quality of sleep, trait anxiety, Coronavirus threat, optimism regarding the pandemics, difficulty to relax, empathy, and pro-social attitude during the pandemics period.

Results: Portuguese participants expresses higher empathy and pro-social attitude and health care but in Germany people have higher quality of sleep. Young adults (a) rated their quality of life lower than middle-age adults and old adults, (b) showed also lower optimism than middle-age and old adults, and (c) showed lower well-being than middle-age,.

Conclusions: Young adults rated their quality of life, optimism and well-being during pandemics lower than middle-age and old adults, and experienced higher levels of trait anxiety and difficulty to relax. It seems that young adults show a lower psychological adjustment than other age groups during COVID-19 crisis. It is concluded that quality of life, optimism, and well-being during the pandemics are affected differently according to country and group of age, suggesting individual differences across cultures and ages, and consequently the need of specific interventions to cope with the psychological reactions to pandemics crisis.

Mental health and factors related to life satisfaction in nursing home and community-dwelling older adults during COVID-19 pandemic in Turkey

BACKGROUND

The geriatric population is supposed to be at high risk for psychological distress as well as adverse outcomes and mortality during the COVID-19 pandemic. This study aimed to investigate the levels of depression, anxiety, death anxiety and life satisfaction levels and factors related to life satisfaction in individuals aged 65 years and older during the pandemic and to compare these variables between nursing home (NH) and community-dwelling older adults.

METHOD

This study has a cross-sectional and descriptive design, and a total of 133 nursing NH and community-dwelling older adults were enrolled in the study. Turkish death anxiety scale (TDAS), life satisfaction scale (SLS) and depression anxiety stress scale-21 (DASS-21) were used for the assessment.

RESULTS

The majority of the older adults had no or mild depression, anxiety and stress symptoms in spite of the prolonged confinements, and were slightly satisfied with their lives. However, depression, anxiety, stress and TDAS levels were higher in participants aged 80 years and older. Residents of NHs had higher TDAS, depression and anxiety levels and lower SLS levels than community-dwelling older adults. Participants who were meeting their children and/or grandchildren less than 2 h a week, were found to have significantly lower SLS and higher depression scores. The increase in depression and TDAS scores predicted a decrease in SLS scores in older adults.

CONCLUSIONS

As NH resident older adults have higher psychological distress and decreased life satisfaction due to the social isolation caused by the prolonged confinements, NH staff should be regularly informed on both preventive measures and mental health consequences of the pandemic, and should be trained for basic therapeutic interventions. Older adults should be supported to use telecommunication technologies to contact their families and friends, and participate in safe and accessible person-centred activity programs.

Social Isolation and Anxiety Disorder During the COVID-19 Pandemic and Lockdown in China

The COVID-19 pandemic and lockdown measures have had a profound impact on the emotions, anxiety, and mental health of affected communities. Despite this, there is a lack of knowledge about the possible generational and geographical differences in the effects on the mental health of individuals. This study examines the impact of COVID-19 related quarantine on symptoms of generalized anxiety disorders (GAD) among parents and children (N = 4503). It also compares the outcomes of residents from the initial COVID-19 epicenter of Wuhan to those in surrounding areas. Subgroup analyses were conducted by child and parent samples, and by Wuhan city and other cities in the Hubei province. Propensity score radius matching and ordinary least squares regressions were used to examine the relationship between quarantine and GAD symptoms. Results showed that quarantine had more psychological impact on parents than children, regardless of geographic location. Parents that experienced quarantine in Wuhan city, reported a significantly higher level of symptoms of GAD than those that did not. Parents from other cities showed no such difference. For both children and parents, interpersonal communication about COVID-19 and social media exposure to pandemic-related information were linked to GAD symptoms. Targeted policies and interventions are needed to address the psychological impacts of COVID-19 lockdown.

Short-term psychological consequences of the COVID-19 pandemic: Results of the first wave of an ecological daily study in the Italian population

COVID-19 pandemic involved several psychosocial consequences. We aimed at monitoring the mental health of Italian adults during the lockdown imposed by the government. We present here results from the baseline assessment of the "EmotionalThermometer [TermometroEmotivo] project on a sample of 1548 Italian adults. We assessed the socio-demographic conditions of participants, individuals' perception of the COVID-19-situation, psychological distress, emotion regulation strategies, and perceived social support. Having a worse representation of COVID-19 and consulting news more frequently, with higher anxiety and less credibility of different sources of information, were positively associated with psychological distress and post-traumatic responses. Being female, younger age, living in high-risk regions, having symptoms of COVID-19, and having relatives/friends with such symptoms represented risk factors for a worse perception of COVID-19 and distress. Social support and cognitive reappraisal represented protective factors for mental health.

Longitudinal associations between internalizing symptoms, social behavior, and social perceptions in the initial months of the COVID-19 pandemic: Findings from a transdiagnostic community sample

BACKGROUND

Burgeoning evidence suggests that loneliness during the COVID-19 pandemic is tied to high levels of depression and anxiety. The current study is unique, though, in examining which facets of social behavior and perceived social quality are most tied to internalizing symptoms using longitudinal data, including a pre-pandemic baseline, collected from a community sample of adults with pre-existing mental health concerns (analyzed n = 144).

METHODS

Participants completed measures of depressive and anxious symptoms pre-pandemic, followed by three weekly surveys during the pandemic. We distinguished four social variables: in-person social engagement, remote social engagement, social disruption, and social distress. OLS and mixed-effects regression models examined 1) pre-pandemic baseline symptoms as predictors of social functioning during the pandemic and 2) time-lagged associations between symptoms and social functioning during the pandemic.

RESULTS

Social behavior and social perceptions were dissociable. Baseline depressive, but not anxious, symptoms predicted greater social distress during the pandemic. Both anxious and depressive symptoms were predicted by social variables, but the specific associations differed: depressive symptoms were related to perceived social quality, whereas anxious symptoms were more tied to reported social behavior.

LIMITATIONS

We relied on self-report indices, and causality should not be inferred directly from these correlational data.

CONCLUSIONS

Overall, our results indicate that it is possible to follow social guidelines and even to spend relatively few hours socializing with close others, while still feeling connected and rewarded; however, people who struggle with depression and anhedonia were particularly vulnerable to distressing feelings of social disconnection amid the pandemic.

Gender, employment, and continuous pandemic as predictors of alcohol and drug consumption during the COVID-19

AIMS

This study aims to assess the impacts of the continuous pandemic state, gender and employment status on changes in substance use during the COVID-19 outbreak.

METHODS

A sample of 828 Israelis participated in an online survey and answered questions on demographic characteristics, ranking their substance consumption, and perceived increase in alcohol/drug consumption. The age range was 18-65 (Mean = 30.10, S.D. = 11.99), and the majority (72.9 %) were female. We gathered the data in two waves: 1) during and following the early first lockdown; 2) following the second lockdown.

RESULTS

Men reported higher beer, hard liquor, and illegal drug consumption than women. Continuous COVID-19 was associated with higher consumption of all alcohol, and cannabis, and higher perceived increases in substance consumption than short-term COVID-19. Significant interactions were found between gender and employment regarding all-drug consumption measurements and interactions between gender, employment, and pandemic duration (short/continuous) were found regarding cannabis consumption.

CONCLUSIONS

The discussion addresses the results in the context of continuous COVID-19 and traditional gender roles. Policymakers should develop prevention and harm reduction interventions for substance use and abuse, focusing on unemployed men as an at-risk group.

No Sex Differences in Psychological Burden and Health Behaviors of Healthcare Workers During the COVID-19 Stay-at-Home Orders

Background: Females with novel coronavirus disease 2019 (COVID-19) state-ordered home isolation were associated with higher anxiety and reduced sleep quality than males. Sex differences in psychobehavioral changes during the COVID-19 stay-at home orders among healthcare workers remained unclear. The purpose of this study was to explore the sex differences in psychological burden and health behaviors among these persons.

Methods: This was a cross-sectional study using online data available in the open Interuniversity Consortium for Political and Social Research (OPENICPSR). Healthcare workers including females and males who transitioned to working from home during the COVID-19 stay-at-home orders were included. Sex differences were compared using the chi-square test and Student's t-test. We performed logistic and linear regression analyses to determine the association of females with psychological burden and health behaviors.

Results: A total of 537 respondents (425 females and 112 males) were enrolled in our study. Sex differences in age (42.1 ± 12.3 years vs. 46.6 ± 15.7 years, t = −2.821, p = 0.005), occupation (χ² = 41.037, p < 0.001), mood change (n = 297, 69.9% vs. n = 61, 54.5%, χ² = 9.482, p = 0.002), bedtime schedule (χ² = 6.254, p = 0.044) and news consumption (n = 344, 80.9% vs. n = 76, 67.9%, χ² = 8.905, p = 0.003) were statistically significant. Logistic regression showed that females was negatively associated with better mood status (OR = 0.586, 95% CI 0.153–2.247, p = 0.436). In addition, linear regression showed that females were not correlated with total sleep time after adjusting for sio-demographics, mental health outcomes and health behaviors (B = 0.038, 95% CI −0.313–0.388, p = 0.833).

Conclusion: No sex differences in psychological burden and health behaviors of healthcare workers were found during the COVID-19 stay-at-home orders. The COVID-19 state-ordered home isolation may be a potential way to reduce disproportionate effects of COVID-19 pandemic on females and help to minimize sex differences in psychological burden and health behaviors among healthcare workers.

Impact of Covid-19 on health-related quality of life of patients: A structured review

Introduction

Coronavirus disease (Covid-19) has led to a global pandemic since its emergence in December 2019. The majority of research into Covid-19 has focused on transmission, and mortality and morbidity associated with the virus. However, less attention has been given to its impact on health-related quality of life (HRQoL) of patients with Covid-19.

Methods

We searched for original studies published between December 2019 and Jan 2021 in PubMed, Scopus and Medline databases using a specific search strategy. We also explored literature on websites of distinguished public health organisations and hand-searched reference lists of eligible studies. The studies were screened by two reviewers according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) flowchart using pre-determined eligibility criteria. Data were synthesised, analysed descriptively and reported in line with PRISMA guidelines.

Results

In total, 1276 studies were identified through the search strategy. Of these, 77 studies were selected for full-text reading after screening the studies. After reading full-text, 12 eligible studies were included in this review. The majority of the studies used a generic HRQoL assessment tool; five studies used SF-36, five studies used EQ-5D-5L, and three used pulmonary disease-specific HRQoL tools (two studies used two tools each). The impact of Covid-19 on HRQoL was found to be considerable in both Acute Covid and Long Covid patients. Higher impact on HRQoL was reported in Acute Covid, females, older ages, patients with more severe disease and patients from low-income countries.

Conclusion

The impact of Covid-19 on HRQoL of Acute and Long Covid patients is substantial. There was disproportional impact on patients by gender, age, severity of illness and study country. The long-term impact of Covid-19 is still in its initial stage. The findings of the review may be useful to researchers, policymakers, and clinicians caring for people following Covid-19 infection.

Fear of COVID-19 and general self-efficacy among Turkish teachers: Mediating role of perceived social support

Coronavirus-19 (COVID-19), which has influenced the world since the last months of 2019, has not only affected people physiologically, but also had serious adverse effects on mental health. Unavoidable increases in positive case numbers and loss of life have caused fear and anxiety, which is a psychological aspect of the COVID-19 outbreak. In this study, it was aimed to examine the mediating role of perceived social support in the relationship between teachers' general self-efficacy perceptions and their fear of COVID-19. The sample of the study consists of 322 Turkish teachers (198 women and 124 men; aged between 23 and 66 years). Data collection tools are the Fear of COVID-19 Scale, the General Self-Efficacy Scale, and the Perceived Multidimensional Social Support Scale. To test the model structural equation modeling and bootstrapping were used. In the study it was found that fear of COVID-19 has a negative impact on general self-efficacy and the perceived social support. Besides, it was found that perceived social support partially mediates the relationship between fear of COVID-19 and general self-efficacy. Thus, higher fear of COVID-19 was related to lower self-efficacy and perceived social support. In turn, higher perceived social support was associated with higher self-efficacy. The results were discussed within the framework of the literature, and implications presented.

Effect of COVID-19 Pandemic-Induced Dietary and Lifestyle Changes and Their Associations with Perceived Health Status and Self-Reported Body Weight Changes in India: A Cross-Sectional Survey

Home confinement during the COVID-19 pandemic is accompanied by dramatic changes in lifestyle and dietary behaviors that can significantly influence health. We conducted an online cross-sectional survey to assess COVID-19 pandemic-induced dietary and lifestyle changes and their association with perceived health status and self-reported body weight changes among 1000 Indian adults in early 2021. Positive improvements in dietary habits, e.g., eating more nutritious (85% of participants) and home-cooked food (89%) and an increase in overall nutrition intake (79%), were observed. Sixty-five percent of participants self-reported increased oat consumption to support immunity. There were some negative changes, e.g., more binge eating (69%), eating more in between meals (67%), and increasing meal portion size (72%). Two-thirds of participants reported no change in lifestyles, whereas 21 and 23% reported an increase, and 13 and 10% reported a decrease in physical activity and sleep, respectively. Overall, 64 and 65% of participants reported an improvement in perceived health and an increase in body weight during the COVID-19 period compared to pre-COVID-19, respectively. The top motivations for improving dietary habits included improving physical and mental health and building immunity. In conclusion, the overall perceived health was improved and there was an increase in self-reported body weight in most participants during COVID-19. Diet emerged as the most crucial determinant for these changes.

The Interplay between Housing Environmental Attributes and Design Exposures and Psychoneuroimmunology Profile-An Exploratory Review and Analysis Paper in the Cancer Survivors' Mental Health Morbidity Context

Adult cancer survivors have an increased prevalence of mental health comorbidities and other adverse late-effects interdependent with mental illness outcomes compared with the general population. Coronavirus Disease 2019 (COVID-19) heralds an era of renewed call for actions to identify sustainable modalities to facilitate the constructs of cancer survivorship care and health care delivery through physiological supportive domestic spaces. Building on the concept of therapeutic architecture, psychoneuroimmunology (PNI) indicators-with the central role in low-grade systemic inflammation-are associated with major psychiatric disorders and late effects of post-cancer treatment. Immune disturbances might mediate the effects of environmental determinants on behaviour and mental disorders. Whilst attention is paid to the non-objective measurements for examining the home environmental domains and mental health outcomes, little is gathered about the multidimensional effects on physiological responses. This exploratory review presents a first analysis of how addressing the PNI outcomes serves as a catalyst for therapeutic housing research. We argue the crucial component of housing in supporting the sustainable primary care and public health-based cancer survivorship care model, particularly in the psychopathology context. Ultimately, we illustrate a series of interventions aiming at how housing environmental attributes can trigger PNI profile changes and discuss the potential implications in the non-pharmacological treatment of cancer survivors and patients with mental morbidities.

Prevalence and health correlates of Onine Fatigue: A cross-sectional study on the Italian academic community during the COVID-19 pandemic

Background

During the COVID-19 pandemic, many people had to shift their social and work life online. A few researchers and journalists described a new form of fatigue associated with a massive use of technology, including videoconferencing platforms. In this study, this type of fatigue was referred to as Online Fatigue. A new tool (the Online Fatigue Scale) was developed, and its psychometric properties were evaluated. This tool was used to assess Online Fatigue among Italian academics and to examine its associations with psychological and physical health.

Methods

An online survey was conducted in December 2020 on a sample of Italian academics. Besides the Online Fatigue Scale (11 items) used to assess Online Fatigue, the survey was composed of questionnaires (including validated measures) focused on sociodemographic and job-related information, technostress creators, health status, psychological well-being, and COVID-related perceived distress. The psychometric properties of the Online Fatigue Scale were evaluated, and statistical analyses were conducted to examine the associations between Online Fatigue and all the other variables.

Results

Participants were 307 academics aged 24–70 years old (mean age = 40.7; SD = 10.1). The Online Fatigue Scale showed good psychometric properties. Two subscales were identified: Off-Balance Fatigue and Virtual Relations Fatigue. High levels of Off-Balance Fatigue were associated with a greater use of technology, female gender, and presence of minor children. Participants with high scores on both subscales reported a greater frequency of psychosomatic symptoms, unhealthy habits, poorer psychological well-being, and greater Covid-related perceived distress.

Conclusions

The Online Fatigue Scale can be considered a reliable tool to assess Online Fatigue, which was significantly detected in our sample of Italian academics, along with its negative effects on physical and psychological health. Being a woman and having young children represent important risk factors. Universities should promote the separation between work and private life by encouraging self-care activities.

Exploring People's Reaction and Perceived Issues of the COVID-19 Pandemic at Its Onset

The experience of the COVID-19 Pandemic has varied considerably from individual-to-individual. Little is known about the changes in the level of experience general people went through during the first few months after the coronavirus (COVID-19) was declared as a Pandemic. This longitudinal qualitative study explores the general public’s reports of their experience with the COVID-19 Pandemic during its early stage. An online survey was conducted using a convenience/snowball sampling technique in March and again in May 2020, where North American adults with at least a college-degree, and female majority, shared their experiences with the COVID-19 Pandemic in response to an open-ended question, apart from completing questionnaires assessing transitional impact and psychological well-being. Open responses were first content analyzed to identify themes most commonly reported, and then, the quantitative analysis examined the reliability of the changes of themes between the two-time points. Text-analysis of the open-responses from the two waves identified seven themes, namely emotional response, social contact, virus-infected, financial impact, impact on plans, disease, and non-disease related concern, as well as social-distance. These themes indicated that, (a) people were distressed and having negative affective thoughts; (b) they spoke more about their plans-and-goals that were affected by the Pandemic than their financial condition; (c) people mostly used digital platforms to maintain contact with their social network, although they preferred face-to-face interactions; (d) they spoke more about the infection experienced by people in general than infection experienced by themselves and individuals they know. Surprisingly, (e) people mentioned more about the way the Pandemic had disrupted their day-to-day activities than the disease-related health concern. Finally, (f) most of the respondents approved of the practice of social distancing while some expressed its negative or neutral effect on their social lives. The quantitative measure determined that as time passed, people’s experience with the Pandemic became quite different as people talked more about getting infected, and their affected goals-and-plans. We concluded with a remark that this Pandemic would most likely leave an impression on people’s lives and that these online comment-style responses might provide us with insights into people’s perspectives as the Pandemic unfolds, helping us in understanding the uniqueness of the Pandemic experience of individuals for an effective tailored intervention to protect their well-being during a health-crisis.

Loneliness and Depression among Women in Poland during the COVID-19 Pandemic

Background: The COVID-19 pandemic has forced many changes in the functioning of people all over the world in a short period of time. According to a WHO report (2020), it is women who are at a particular risk of the negative effects of the pandemic, especially in terms of mental health. Aim of study: The aim of the study was to assess the prevalence of anxiety, depression, irritability, and loneliness among adult women during the COVID-19 pandemic. Materials and methods: The study was conducted on a representative sample of women in Poland (n = 452). The data were collected using the HADS-M scale and the R-UCLA scale. Results: A low level of loneliness was found in 37.3% of the women, moderate in 38.9%, moderately high in 22.3% and very high in 1.3% of women. Self-rating of physical and mental health was significantly positively correlated with anxiety, depression, and irritability in HADS-M, and loneliness in R-UCLA. As the severity of loneliness increased, so did Hospital Anxiety and Depression Scale scores on all subscales (p < 0.001). Conclusions: The study group presented with mental well-being disorders in the form of anxiety and depression. Two in three women experienced loneliness.

The Influence of Family Function on State Anxiety of Chinese College Students During the Epidemic of COVID-19

The Coronavirus Disease 2019 (COVID-19) may affect mental health. There is little research about the influence of family function on the state anxiety of college students in the context of the global pandemic. The study aimed to clarify that generalized anxiety disorder (GAD) and trait anxiety had mediating effects in family function on the state anxiety of Chinese college students following the "stay-at-home" order during the outbreak of COVID-19. This cross-sectional study was conducted online with 1,039 respondents. We analyzed demographics, The State-Trait Anxiety Inventory (ST-AI) and Chinese Family Function Scale (FAD-18), Generalized Anxiety Disorder-7 (GAD-7), and used path analysis to discuss the influence of family function on state and trait anxiety. The results showed that female students' state and trait anxiety was higher than that of male students (P < 0.05). Medical students' state and trait anxiety was lower than that of literature students (P < 0.05). The GAD of the male was lower compared with the female. The score of family function has significant differences in gender, age, education, and region (P < 0.05). Gender, family function, state anxiety, trait anxiety, and GAD relate to others (r = 0.07∼0.85, p < 0.05). The results of fit indices for measurement invariance models showed that the impact of family function among GAD, state and trait anxiety across gender is significantly different (each step p < 0.05). GAD and trait anxiety had a complete meditating effect between family function and state anxiety (the proportion of standard indirect mediating effect was 24.94% in females and 36.79% in males). A healthy family function may alleviate GAD and anxiety of college students during the COVID-19 pandemic.

Impact of COVID-19 Pandemic on the Psychological Status of Palestinian Adults in the West Bank, Palestine; A Cross-Sectional Study

Background:

Coronavirus Disease 2019 (COVID-19) rapid manifestation and spread have disrupted world norms and affected people's daily activities and life. Many ministries chose mass lockdown protocol as a way to control the virus spread. Though this protocol has shown to be effective in limiting the Virus transmission, it might have a negative impact on the population's psychological status, such as boredom, confusion, psychological stress, anxiety, depression, and physical effects.

Objective:

This study aimed to find the impact of the COVID-19 pandemic on the Palestinian adults' psychological status by assessing the participant's practices, reports of anxiety and depression during the pandemics

Methods:

An observational descriptive cross-sectional study was conducted among Palestinian adults in the West Bank, at the occupied Palestinian territories, between July and September 2020. The questionnaire was structured into two domains: the first domain includes nine questions about sociodemographic data. The second consisted of 33 (yes and no) questions evaluating the participant's psychological status.

Results:

739 participants with a mean age of 31.76, filled the online questionnaire. Around one-third of respondents revealed having many signs of anxiety, and around 42% of respondents expressed having many signs of depression. Females were significantly more likely to have signs of depression, whereas front-line COVID-19 health care workers were significantly the least likely to have signs of depression and no signs of depression were found among participants with high incomes.

Conclusion:

COVID-19 pandemic has a negative effect on mental status; most participants have signs of anxiety and depression.

Anxiety, depressive, and trauma symptoms during the COVID-19 pandemic: Evaluating the role of disappointment with God

BACKGROUND

The COVID-19 pandemic has led to pervasive social and economic disruptions. This cross-sectional investigation aimed to evaluate associations between religious/spiritual factors and mental health symptoms among community residents in a southern US state. In particular, we focused on perceptions of God's distance, a salient aspect of religious/spiritual struggle that has received little scrutiny in health research.

METHODS

Participants included 551 respondents assessed during a period of gradual reopening but rising infection rates. Mental health outcomes were assessed using standardized measures of generalized anxiety, depression, and trauma symptoms. Perceptions of an affirming relationship with God, anger at God, and disappointment at God's distance were evaluated using an adapted version of the Attitudes-Toward-God Scale-9.

RESULTS

In multivariate analyses that accounted for pandemic-related and demographic factors, positive relationships with God were related to diminished symptoms on all three mental heatlh indices (all p's ≤.003), whereas disappointment with God's distance was associated with more pronounced difficulties (all p's ≤.014).

LIMTATIONS

The cross-sectional design precludes causal conclusions.

CONCLUSIONS

Findings suggest that perceived relationships with God are tied to clinically relevant mental health outcomes during periods of major upheaval. Disappointment with God's distance may be an important, understudied dimension of religious/spiritual struggle meriting further investigation.

Lockdown fatigue among college students during the COVID-19 pandemic: Predictive role of personal resilience, coping behaviors, and health

OBJECTIVES

This study was conducted to examine the levels of lockdown-induced fatigue and its association with personal resilience, coping skills, and health in college students.

DESIGN AND METHODS

This is an online cross-sectional study involving 243 college students in the Central Philippines during the 6th month of the lockdown measure implementation.

FINDINGS

College students experience moderate levels of fatigue during the mandatory lockdown period. Increased personal resilience and coping skills were associated with lower levels of lockdown fatigue.

PRACTICE IMPLICATIONS

Lockdown fatigue may be addressed by formulating and implementing interventions to enhance personal resilience and coping skills among college students.

Social and emotional loneliness among college students during the COVID-19 pandemic: The predictive role of coping behaviors, social support, and personal resilience

OBJECTIVE

To determine the influence of coping behaviors, resilience, and social support on students' emotional and social loneliness during the COVID-19 pandemic.

DESIGN AND METHODS

A cross-sectional research design was used to gather data from 303 college students from the Central Philippines using four standardized scales through an online survey.

FINDINGS

Loneliness among students was high during the coronavirus pandemic. Resilience, coping behaviors, and social support were identified as protective factors against loneliness.

PRACTICE IMPLICATIONS

Interventions directed toward increasing resilience, social support, and coping behaviors may help decrease emotional and social loneliness caused by the mandatory lockdown during the COVID-19 pandemic.

A prospective examination of COVID-19-related social distancing practices on suicidal ideation

BACKGROUND

The COVID-19 pandemic has spurred the implementation of several public safety measures to contain virus spread, most notably socially distancing policies. Prior research has linked similar public safety measures (i.e., quarantine) with suicide risk, in addition to supporting the role of social connection in suicidal thoughts and behaviors; consequently, there is a need to better understand the relationship between widespread social distancing policies and suicide risk. The current study aimed to examine the prospective association between COVID-19-related social distancing practices and suicidal ideation.

METHODS

Participants (N = 472) completed measures of suicidal ideation and impacts of social distancing practices at baseline and two weeks later.

RESULTS

After controlling for general psychosocial distress (i.e., depression, social connectedness), cross-lagged regression models identified prospective, bidirectional relationships between perceived impacts of social distancing on one's mental health and both passive and active suicidal ideation. The impact of social distancing on work/social routine was not associated with suicidal ideation.

CONCLUSIONS

Overall, findings suggest the importance of an individual's perception regarding the effect of social distancing on their mental health, rather than the disruption to work or social routine, in suicide risk. Findings highlight potential targets for suicide risk prevention and intervention.

Child Maltreatment During the COVID-19 Pandemic: A Systematic Rapid Review

The present study is systematic rapid review on the nature of the relationship between the COVID-19 pandemic and child maltreatment. Database searches on December 28, 2020, identified 234 unique citations; 12 were ultimately included in our analysis. Included articles measured child maltreatment inclusive of physical, psychological, and sexual abuse, and child neglect during the COVID-19 pandemic. Compared with the prepandemic period, 5 articles found an increase in child maltreatment, 6 articles found a decrease, and 1 study found no difference. There existed variation in geography of study location, age of child maltreatment victims, and types of child maltreatment assessed.

Impact of Stress on Menstrual Cyclicity During the Covid-19 Pandemic: A Survey Study

Background: The Covid-19 pandemic has introduced acute and persistent psychosocial stressors for many individuals, with emerging gender differences that suggest women may be at greater risk for poorer mental health outcomes. This may have unintended consequences for women's overall health and well-being, including disruptions to reproductive function as elevated stress is often associated with menstrual cycle irregularities. The objective of this study was to determine if and how the Covid-19 pandemic and its related stressors have impacted women's menstrual cyclicity. Materials and Methods: An online survey instrument designed to capture self-reported information on menstrual cycle changes and perceived stress levels was distributed between July and August 2020. A total of 210 women between the ages of 18-45 years met stringent inclusion and exclusion criteria and completed the survey. Results: Of the 210 respondents, more than half (54%) reported changes in their menstrual cycles. These included changes in menstrual cycle length (50%), the duration of menses (34%), and changes in premenstrual symptoms (50%). Respondents with high perceived stress scale (PSS) scores during Covid were more likely to experience a longer duration of menses (p < 0.001) and heavier bleeding during menses (p = 0.028) compared with those with moderate Covid PSS scores. Conclusions: By uncovering a trend in increased menstrual cycle irregularities during the early months of the Covid-19 pandemic, this study contributes to our understanding of the implications that the pandemic may have on women's reproductive health.

Associations of physical activity and sedentary behaviors with child mental well-being during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic resulted in public health and policy measures to reduce in-person contact and the transmission of the virus. These measures impacted daily life and mental well-being (MWB). The aims of this study were to explore the MWB impacts of COVID-19 on children and assess the associations among perceived changes in physical activity (PA) and sedentary behaviors (SB), with perceived MWB changes, using a mixed-methods approach.

METHODS

A convergent parallel mixed-methods design consisting of an online survey with a convenience sample and interviews was conducted from May through July 2020 with parents/caregivers of kindergarten through 5th graders in the St. Louis region. Survey domains assessed included child MWB, PA, and SB. Interviews were recorded, transcribed, and qualitatively analyzed using a code book developed to elicit themes. Survey data was analyzed with chi-squared tests and logistic regressions. The dependent variable was perceived change in child MWB due to the impact of COVID-19. Independent variables included perceived changes in PA, SB, and child concerns about COVID-19.

RESULTS

Sample size consisted of 144 surveys and 16 interviews. Most parents reported a perceived decrease in child MWB (74%), a decrease in child PA (61%), and an increase in child SB (91%). Discontentment with stay-at-home orders and concern about COVID-19 were associated with a perceived decrease in MWB. Children whose PA decreased were 53% less likely to have the same or better MWB (OR 0.47) and children whose outside PA decreased were 72% less likely to have the same or better MWB (OR 0.28). Common qualitative themes included difficulty in adjusting to COVID-19 restrictions due to school closures and lack of socializing, child concerns about family getting sick, and PA benefits for improving MWB.

CONCLUSIONS

Based on parent perceptions, MWB decreased with COVID-19. Maintained or increased child PA improved the chances MWB would remain the same or improve. Parent interviews provide context to these findings by showing how COVID-19 impacted MWB and the associations between PA and MWB. Understanding protective factors for child MWB during COVID-19 is important to offset negative long-term health outcomes from this ongoing pandemic.

Communication outside of the home through social media during COVID-19

This study explored, through quantitative and qualitative survey analysis (N = 307), the role of communication through social media during the COVID-19 pandemic. Data were collected in April 2020 to understand how individuals engaged with their network through social media and the subsequent relationship with subjective well-being, conceptualized as loneliness, life satisfaction, and positive and negative affect. Results identified that passive social media use contributed to greater loneliness and a decrease in life satisfaction. Some active use of social media contributed to an increase in positive affect. However, other active uses increased feelings of loneliness. Results also spoke to differences across platforms, with time on Twitter leading to increased feelings of loneliness. Qualitative results pointed to an increase in social media use during the pandemic while also highlighting the opportunity to digitally reconnect with old friends and family.

Maintenance of high quality of life as an indicator of resilience during COVID-19 social distancing among community-dwelling older adults in Finland

PURPOSE

Social distancing during the COVID-19 pandemic reduced possibilities for activities of choice potentially threatening quality of life (QoL). We defined QoL resilience as maintaining high quality of life and studied whether walking speed, absence of loneliness, living arrangement, and stress-coping ability predict QoL resilience among older people.

METHODS

Community-dwelling 75-, 80-, and 85-year-old persons (n = 685) were interviewed and examined in 2017-2018 and were followed up during COVID-19 social distancing in 2020. We assessed QoL using the OPQOL-brief scale and set a cut-off for 'constant high' based on staying in the highest baseline quartile over the follow-up and categorized all others as having 'low/moderate'. Perceived restrictiveness of the social distancing recommendations was examined with one item and was categorized as 'yes' or 'no' restrictiveness.

RESULTS

Better stress-coping ability (OR 1.21, 95% CI 1.14-1.28) and not being lonely (OR 2.67, 95% CI 1.48-4.63) increased the odds for constant high QoL from before to amid social distancing, and the odds did not differ according to the perceived restrictiveness of the social distancing recommendations. Higher walking speed predicted constant high QoL only among those perceiving restrictiveness (OR 1.16, 95% CI 1.07-1.27). Living arrangement did not predict constant high QoL.

CONCLUSION

During social distancing, psychosocial resources helped to maintain good QoL regardless how restrictive the social distancing recommendations were perceived to be. Better physical capacity was important for constant high QoL only among those perceiving restrictiveness presumably because it enabled replacing blocked activities with open outdoor physical activities.

New-Onset Psychosis Following COVID-19 Infection

Previous studies have suggested that some individuals experience neuropsychiatric symptoms following coronavirus disease 2019 (COVID-19) infection. We describe a case of new-onset psychosis following COVID-19 infection in a 55-year-old female with no prior psychiatric history. The patient started exhibiting symptoms of COVID-19 infection three weeks prior and was treated in the hospital with 4 L oxygen, dexamethasone 6 mg, and remdesivir therapy for seven days. Throughout her hospital stay, the patient had no neuropsychiatric symptoms. During her last week of stay, she was solely getting oxygen at home before presenting to the emergency department (ED) with severe psychosis. Her COVID-19 test in ED presentation was negative, and all potential etiologies for psychosis were ruled out. She was effectively treated for two weeks with 10 mg haloperidol and 1000 mg sodium valproate daily, followed by outpatient care. While variables such as a family history of bipolar disorder, psychosocial stressors, and steroid medication may have contributed to the patient's presentation, these circumstances alone did not result in neuropsychiatric symptoms in the past. COVID-19 infection may enhance the likelihood of developing neuropsychiatric problems on its own or amplify the effects of risk factors associated with an increased risk of psychosis. Neuropsychiatric consequences of COVID-19 infection may be under- or over-reported in individuals treated with steroids. Further research is necessary to identify individuals at risk of experiencing neuropsychiatric issues owing to COVID-19 infection and the prognosis.

Impact of the COVID-19 pandemic on exercise habits among cancer patients

Purpose There is limited information on how the COVID-19 pandemic has changed health behaviors among cancer patients. We examined the impact of the pandemic on changes in exercise behaviors and identified characteristics associated with these changes among cancer patients. Methods Cancer patients (n  =  1,361) completed a survey from August-September 2020 to assess COVID-19 pandemic-related changes in health behaviors and psychosocial factors. Patients were categorized into 3 groups: exercising less, exercising did not change, and exercising more. Patient characteristics were compared by exercise groups. Results One-third of the patients reported a decreased amount of regular exercise, while 11% reported exercising more during the pandemic. Patients who exercised less were more likely to be unemployed/retired, undergoing active treatment, and had increased pandemic-related alcohol consumption and psychosocial stressors such as loneliness and financial stress (all p  < 0.05). In contrast, patients who exercised more were younger, female, full-time employed, did not consume alcohol, and had good health status and more social interactions (all p  < 0.05). Patients who were living in rural areas and did not experience changes in daily life, were also more likely not to experience changes in exercise habits (all p  < 0.05). Conclusion Our results indicate that a significant proportion of cancer patients experienced changes in exercise habits during the first 6 months of the COVID-19 pandemic. Age, sex, employment status, health status, alcohol consumption, and psychosocial factors were associated with changes in exercise behaviors. Providers should monitor for changes in health behaviors, such as exercise, because of their importance in improving cancer survivorship.

Loneliness among Middle-Aged and Older Middle-Aged Adults in Russia (Saint Petersburg) before and during COVID-19 Pandemic

Loneliness has been considered a major challenge since long before the pandemic. Changes caused by the COVID-19 pandemic included modifications in social communications and activities. Thus, it was expected that loneliness would increase during the pandemic. The first studies of loneliness during the pandemic revealed inconsistent results. We hypothesized that physical isolation led to changes in the quality of relationships; thus, loneliness trends could be different from those predicted. For our study we used methods to measure loneliness: the Social and Emotional Loneliness Scale (SELSA-S) for Adults and Older Adults; the Multidimensional Inventory of Loneliness Experience; and demographic data. Participants were middle-aged and older middle-aged adults (n = 457) aged 35-59 (M = 45.5, SD = 6.88, 35.4% males). Participants came from two studies: Study 1 consisted of 280 participants aged 35-59 (M = 44.8; SD = 6.93; 29.6% males), the study was conducted before the pandemic in late 2019; participants in Study 2 were adults (n = 177) aged 35-59 (M = 46.5; SD = 6.68; 44.6% males), data were collected in the fall of 2020. The results did not confirm increase in loneliness; moreover, participants reported lower scores of loneliness in some domains. Regression analyses showed that general experience of loneliness was predicted by different loneliness characteristics in pre-pandemic and pandemic age groups. We found some similar mechanisms that were activated within different situations. Our results confirmed the complex nature of loneliness, they argue that pandemic effects were not limited to increase in loneliness and that the mechanism of loneliness can adjust to environmental factors.

The Relationship Between Perceived Stress, State-Trait Anxiety, and Sleep Quality Among University Graduates in China During the COVID-19 Pandemic

The study aimed to investigate the relationship among perceived stress, state-trait anxiety, and sleep quality of graduates to provide a reference for improving their psychological status and attitude adjustment of job-searching during the COVID-19 pandemic. The research was conducted in a descriptive cross-sectional online survey between May 2020 and August 2020. The data were collected from 1,200 participants by using the personal information form prepared by the researchers in line with the literature, the Perceived Stress Scale, the State-Trait Anxiety Inventory, and the Pittsburgh Sleep Quality Index (PSQI). Among the surveyed participants, 47.67% were female, and 10.92% were medical students. The mean perceived stress, state anxiety, trait anxiety, and sleep quality were moderate and found as 31.4±6.69, 46.67±5.80, 49.45±5.54, and 5.94±2.47, respectively. The detection rates of state anxiety and trait anxiety were 48.63 and 49.50%, respectively. There was no significant difference in the detection rate of state anxiety and trait anxiety among different genders and majors (p >0.05). The detection rate of state anxiety and trait anxiety of rural family students was higher than that of urban family students (p <0.01). The score on the PSQI was positively associated with the scores on the perceived stress, state anxiety, and trait anxiety scales (p <0.001 for each model). Sleep quality was associated with increased perceived stress, state anxiety, and trait anxiety among graduates in China. Collectively, the study revealed the relationship between perceived stress, state-trait anxiety, and sleep quality among university graduates in China during the COVID-19 pandemic. Our results offer novel practical implications for all circles of the society to ensure students' health under the context of the COVID-19 epidemic.

Place Affect Interventions During and After the COVID-19 Pandemic

The COVID-19 health and economic crisis has also brought a rise in people being unable to cope with their existing medical conditions and other issues such as domestic violence, drugs, and alcohol among others. Suicidal tendencies have been on the rise. Feelings of isolation causing emotional distress in place-confined settings have put additional pressure on the healthcare systems demanding that we find additional and complementary means of support for those in need. This is important not only in the current pandemic but also in the post-pandemic world. The goal is to collectively contribute and address the recurring calls for actions to maintain global well-being and public health. An important discussion to bring on the table is the need to promote interventions for people to cope with the pandemic and to adjust to the post-pandemic world. Promoting affective attitudes toward place can foster well-being outcomes. This has important benefits and is of relevance to governments, policymakers, and healthcare professionals in delivering better healthcare equipping people with coping mechanisms both throughout the pandemic and in the long run. However, the key challenge is how to foster these place affect attitudes meeting the changing demands in the post-pandemic world. It is in the middle of a crisis that the conversation needs to start about how to strategically plan for the recovery.

Social Bonding and Public Trust/Distrust in COVID-19 Vaccines

COVID-19 vaccine hesitancy has been a growing concern. The pandemic has proved to be very complicated with the mutated virus. The Delta variant is contributing to a surge of cases across the globe. Vaccine hesitancy can be socially contagious, requiring more stringent efforts from policy makers and health professionals in promoting vaccine uptake. Some evidence shows that vaccine acceptance appears to have played an integral role in successfully controlling the pandemic. Vaccination acceptance, however, demands that the public has a good understanding of the vaccine’s benefits in promoting healthier societies and people’s quality of life. Unclear COVID-19 vaccine information can lead to distrust in vaccines and vaccine hesitancy. It is of paramount importance to communicate clear and unbiased vaccine information to the public to encourage vaccine uptake. Word of mouth communication remains important to further promote COVID-19 vaccine uptake in the community. This short paper discusses the role of social bonds and public trust/distrust and word of mouth communication in vaccine decision making.

Online Mindfulness May Target Psychological Distress and Mental Health during COVID-19

Background

The COVID-19 pandemic has dramatically affected mental health, creating an urgent need for convenient and safe interventions to improve well-being. Online mindfulness interventions show promise for improving depression, anxiety, and general well-being.

Objective

To assess: 1) the impact of online mindfulness on psychological distress, 2) altruistic efforts, and 3) the quantity, quality, and availability of online mindfulness resources during the COVID-19 pandemic.

Methods

233 participants (203 U.S.; 20 international; 10 unknown) participated in this prospective, single-arm, non-randomized clinical trial of a single online mindfulness meditation session with pre- and post-surveys.

Main Outcome Measures

(a) Mindfulness session helpfulness, online platform effectiveness, and immediate pre- to post-session changes in momentary stress, anxiety, and COVID-19 concern; (b) qualitative themes representing how people are helping others during the pandemic; (c) absolute changes in quantity of mindfulness-oriented web content and free online mindfulness resource availability from May to August 2020.

Results

Most participants felt the online mindfulness session was helpful and the electronic platform effective for practicing mindfulness (89%, 95% CI: [82 to 93%]), with decreased momentary anxiety (76%; 95% CI: [69 to 83%]), stress (80%; [72 to 86%]), and COVID-19 concern (55%; [46 to 63%]), (p < 0.001 for each measure). Participants reported helping others in a variety of ways during the pandemic, including following public health guidelines, conducting acts of service and connection, and helping oneself in hopes of helping others. "Mindfulness + COVID" search results increased by 52% from May to August 2020. Most (73%) Academic Consortium for Integrative Medicine and Health member websites offer free online mindfulness resources.

Conclusions

Virtual mindfulness is an increasingly accessible intervention available world-wide that may reduce psychological distress during this isolating public health crisis. Kindness and altruism are being demonstrated during the pandemic. The consolidated online mindfulness resources provided may help guide clinicians and patients.

Stay Home or Not? Modeling Individuals’ Decisions During the COVID-19 Pandemic

During the COVID-19 pandemic, staying home proved to be an effective way to mitigate the spread of the virus. Stay-at-home orders and guidelines were issued by governments across the globe and were followed by a large portion of the population in the early stages of the outbreak when there was a lack of COVID-specific medical knowledge. The decision of whether to stay home came with many trade-offs, such as risking personal exposure to the virus when leaving home or facing financial and mental health burdens when remaining home. In this research, we study how individuals make strategic decisions to balance these conflicting outcomes. We present a model to study individuals’ decision making based on decision and prospect theory, and we conduct sensitivity analysis to study the fluctuations in optimal strategies when there are changes made to the model’s parameters. A Monte Carlo simulation is implemented to further study the performance of our model, and we compare our simulation results with real data that captures individuals’ stay-at-home decisions. Overall, this research models and analyzes the behaviors of individuals during the COVID-19 pandemic and can help support decision making regarding control measures and policy development when public health emergencies appear in the future.

The challenge of COVID-19 for adult men and women in the United States: disparities of psychological distress by gender and age

Objectives

During the COVID-19 pandemic, the prevalence of psychological distress rose from 11% in 2019 to more than 40% in 2020. This study aims to examine the disparities among US adult men and women.

Study design

We used 21 waves of cross-sectional data from the Household Pulse Survey that were collected between April and December 2020 for the study. The Household Pulse Survey was developed by the U.S. Census Bureau to document the social and economic impact of COVID-19.

Methods

The study population included four groups of adults: emerging adults (18–24 years); young adults (25–44 years); middle-aged adults (45–64 years); and older adults (65–88 years). Psychological distress was measured by their Generalized Anxiety Disorder score and the Patient Health Questionnaire. The prevalence of psychological stress was calculated using logistic models adjusted for socio-demographic variables including race/ethnicity, education, household income, and household structure. All descriptive and regression analysis considered survey weights.

Results

Younger age groups experienced higher prevalence of psychological distress than older age groups. Among emerging adults, the prevalence of anxiety (42.6%) and depression (39.5%) was more than twice as high as older adults who experienced prevalence of anxiety at 20% and depression at 16.6%. Gender differences were also more apparent in emerging adults. Women between 18 and 24 years reported higher differential rates of anxiety and depression than those with men (anxiety: 43.9% vs. 28.3%; depression: 33.3% vs. 24.9%).

Conclusion

Understanding the complex dynamics between COVID-19 and psychological distress has emerged as a public health priority. Mitigating the negative mental health consequences associated with the COVID-19 pandemic, for younger generations and females in particular, will require local efforts to rebuild capacity for social integration and social connection.