The Mental Health Consequences of COVID-19 and Physical Distancing: The Need for Prevention and Early Intervention

Exploring the impact of smartphone addiction on mental health among college students during the COVID-19 pandemic: The role of resilience and parental attachment

Smartphone addiction is an increasingly severe issue in modern society, particularly impacting the mental health of college students during the COVID-19 pandemic. This study aims to explore the relationship between smartphone addiction and mental health issues among college students, and the mediating and moderating roles of psychological resilience and parental attachment. We employed a cross-sectional study design with 100,097 college Chinese students to examine the relationships between smartphone addiction, mental health (anxiety and depression), and the mediating role of psychological resilience. Parental attachment was assessed as a moderator within these relationships. Data were analyzed using multiple regression and mediation/moderation models, controlling for relevant covariates. Our findings revealed a significant positive correlation between smartphone addiction and both anxiety and depression. Psychological resilience mediated these relationships, suggesting that higher resilience levels can mitigate the negative psychological impacts of smartphone addiction. Additionally, parental attachment moderated the effects of smartphone addiction on psychological outcomes; stronger attachment was associated with less pronounced effects of addiction on anxiety and depression. Specifically, for students with low parental attachment, the predictive effect of smartphone addiction on anxiety and depression was more pronounced, whereas higher attachment levels were protective.

The longitudinal patterns of depression subtypes and stressors in depression severity in the Canadian longitudinal study on aging (CLSA)

AIM

The current study aims to characterize the longitudinal patterns of depression subtypes and investigate the associations among the stability of depression subtypes, COVID-19-related stressors, and depression severity.

METHODS

The study utilized data from the Canadian Longitudinal Study on Aging, which is a national, long-term study of Canadian adults aged 45 and older (n = 12,957). Latent profile analysis was used to identify latent depression subtypes. Latent transition analysis was then applied to assess the stability of these subtypes over time. Hierarchical multivariate linear regression was used to explore the relationships among these identified depression subtypes, COVID-19-related stressors, and depression severity among males and females, respectively.

RESULTS

Distinct depression subtypes were identified. Except for atypical depression, other depression subtypes showed greater stability over time. We also found that melancholic depression (B = 9.432) and typical depression (B = 6.677) were strongly associated with depression severity during the pandemic. Health-related stressors (B = 0.840), conflict (B = 3.639), difficulties accessing resources (B = 0.927), separation from family (B = 0.840), and caregiving experience (B = 0.764), were significantly associated with increased depression severity. Sex-specific analyses also revealed differences in the associations between stressors and depression severity between males and females.

CONCLUSIONS

This study contributes valuable insights into the latent clustering of depression subtypes and their stability. Stressors were associated with increased depression severity, with distinct associations observed among males and females. These findings have implications for targeted early interventions and integrated clinical management strategies by providing the evidence base for tailored mental health care during and after the pandemic.

Comparative Analysis of Characteristics of Patients Who Visited the Emergency Department due to Suicide Attempts During Coronavirus Disease-2019 Pandemic

The coronavirus infection 2019 (COVID-19) pandemic has affected on mental health and contributed to increased depression and anxiety. We assessed the impact of the COVID-19 pandemic on suicide-related the emergency department (ED) visits. We compared the characteristics of suicide-related patients who visited the ED between the "COVID-19 period" and the "pre-COVID-19 period". The mean age of patients was younger after COVID-19 pandemic. In comparison by age group, the proportion of patients during the COVID-19 period increased in their teens and 20s, and the rest of the age groups decreased. The proportion of patients who requested help was higher during the COVID-19. The authenticity of suicide attempts showed a higher proportion of patients during the pre-COVID-19. Therefore, during the pandemic, attention should be paid to worsening mental health problems, such as anxiety or depression, rather than the lethality of suicide attempts.

COVID-19 Personal Experiences and Posttraumatic Stress in National Guard Service Members

INTRODUCTION

The National Guard (NG) was an important component of the U.S. emergency response for the coronavirus (COVID-19) pandemic. Understanding how the personal COVID-19 experiences of NG members may be associated with posttraumatic stress symptoms (PTSS) and disorder (PTSD) can inform approaches to identifying and sustaining service members' mental health.

MATERIALS AND METHODS

We surveyed 3,993 NG service members (75% Army; 79% enlisted; 33% 30-39 years old; 81% male) during the pandemic. Forty-six percent of participants were activated in response to COVID-19. Surveys were administered between August and December 2020. We defined personal COVID-19 experiences as having COVID-19, a family member(s) having COVID-19, and/or having a close relationship with someone who died from COVID-19. In addition, using a 4-item form of the PTSD Checklist for DSM-5 (PCL-5), current posttraumatic stress symptoms (PTSS) and probable PTSD were assessed. Linear and logistic regression analyses were conducted to examine the relationship of COVID-19 experiences to PTSS and probable PTSD, respectively.

RESULTS

Approximately 32% of participants reported at least one personal COVID-19 experience. Univariable linear regression analyses indicated that NG service members who had a personal COVID-19 experience reported more PTSS than those with no personal experience (B = 0.53, SE = 0.12, P < .001). After adjusting for demographics and service-related characteristics, having a personal COVID-19 experience continued to be associated with higher PTSS (B = 0.48, SE = 0.12, P < .001). When examining the relationships of distinct types of personal COVID-19 experiences to PTSS and PTSD together in multivariable models, those who had a close relationship with someone who died from COVID-19 had higher levels of PTSS (B = 1.31, SE = 0.22, P < .001) and were almost 3 times more likely to have PTSD (OR = 2.94[95%CI = 1.93-4.47], P < .001).

CONCLUSIONS

Personal COVID-19 experiences are associated with increased PTSS and PTSD risk in NG service members. Such knowledge may aid in selection of service members for activation and identifying those in need of care.

Psychological well-being, food insecurity, academic performance and other risk factors in a sample of university students in Jordan during COVID-19

This research validated an Arabic version of the Psychological General Well-being Index-Short version (PGWB-S) and examined the relationship between perceived psychological well-being, and food insecurity, academic achievement, and other risk factors in a sample of university students in Amman, Jordan, during COVID-19. A cross-sectional study was conducted in two phases. Phase 1 translated and validated the Arabic copy of the PGWB-S in 122 students from the University of Jordan. In Phase 2, 414 students completed the demographic questionnaire, Arabic versions of the PGWB-S, the Ryff Psychological Well-being Scale, and the Individual Food Insecurity Experience Scale. The participants had a mean PGWB-S score of 15.82 ± 0.34, and 41.3% had a mean score below 15. Psychological well-being was better in students younger than 21 and/or who had a GPA ≥3.0, were of normal weight or overweight, physically inactive, and food secure, did not drink coffee or smoke, as well as in those whose neighbourhood contained grocery stores and/or public transportation (P < 0.05). In conclusion, during the pandemic, perceived mental well-being was moderate in a Jordanian sample of university students. Perceived psychological well-being was also positively associated with food security and academic performance. These findings suggest that improving food security and academic achievement may contribute to enhanced psychological well-being among university students. Therefore, higher education institutions with the help of the government are encouraged to facilitate the provision of mental health care services to students, mainly post the coronavirus, which according to our knowledge is limited.

Predicting public mental health needs in a crisis using social media indicators: a Singapore big data study

Mental health issues have increased substantially since the onset of the COVID-19 pandemic. However, health policymakers do not have adequate data and tools to predict mental health demand, especially amid a crisis. Using time-series data collected in Singapore, this study examines if and how algorithmically measured emotion indicators from Twitter posts can help forecast emergency mental health needs. We measured the mental health needs during 549 days from 1 July 2020 to 31 December 2021 using the public's daily visits to the emergency room of the country's largest psychiatric hospital and the number of users with "crisis" state assessed through a government-initiated online mental health self-help portal. Pairwise Granger-causality tests covering lag length from 1 day to 5 days indicated that forecast models using Twitter joy, anger and sadness emotions as predictors perform significantly better than baseline models using past mental health needs data alone (e.g., Joy Intensity on IMH Visits, χ2 = 14·9, P < ·001***; Sadness Count on Mindline Crisis, χ2 = 4·6, P = ·031*, with a one-day lag length). The findings highlight the potential of new early indicators for tracking emerging public mental health needs.

Tight control in patients with rheumatoid arthritis treated with targeted therapies across the COVID-19 pandemic era

OBJECTIVES

To analyze the impact of different patterns of healthcare delivery on remission of rheumatoid arthritis (RA) patients treated with targeted therapies during the first wave (2020) and second/third waves (2021) of the pandemic compared to the pre-pandemic period (2019).

METHODS

In this observational real-life study, data from RA patients treated with biologic or targeted synthetic drugs were extracted from a longitudinal registry. Clinical Disease Activity Index (CDAI) was analyzed in the same period from the 22nd of February to the 18th of May for three consecutive years. These three periods were characterized by different patterns of healthcare delivery: (1) before the pandemic (2019) only in-person visits, (2) during the first wave (2020) both in-person visits and telehealth, and (3) during the second/third waves (2021) only in-person visits. A generalized linear model with the binomial error was fitted to evaluate the difference in the proportion of patients in CDAI remission. Quantile regression was used to compare the median of CDAI in difficult-to-treat (D2T) patients.

RESULTS

In the three periods, we included 407, 450, and 540 RA patients respectively. The percentages of patients in CDAI remission were similar in the three periods (prevalence ratio 1.07, p value 0.423 between 2020 and 2019, and 1.01, p-value 0.934 between 2021 and 2019). The CDAI remission rate was 40.55% (N = 163), 43.18% (N = 155) and 40.82% (N = 220) in 2019, 2020 and 2021, respectively. Among our cohort of D2T patients, CDAI remission was similar across the three periods (N = 30, 22.22%; N = 27, 23.68%; and N = 34, 21.52% respectively).

CONCLUSION

Although the pandemic has imposed changes in our healthcare delivery, these different strategies seem to be effective in ensuring satisfactory management of RA treated with targeted therapies. The approaches modulated in the context of the different periods have been a feasible compensation for ensuring disease control even in D2T patients.

Spiritual Needs of Iranian Patients with COVID-19: A Qualitative Study

Facing crises, life problems, and illnesses, many people turn to religion, spirituality, and faith as a psychosocial adjustment approach. This qualitative study assessed the spiritual needs of fourteen Iranian patients who recovered from COVID-19. Qualitative content analysis resulted in three themes, including "composure" with three categories of "prayer", "hope", and "connection"; "meaning in the life" comprising two categories of "a new prospect of life" and "the power of nature"; and "global responsibility" involving one category of "the relationships between individuals, communities, and the world". This study highlighted that patients relied on spirituality to cope with COVID-19 disease.

Sexual Orientation Concealment, Hope, and Depressive Symptoms Among Sexual Minority Women: The Moderating Role of Sexual Orientation

Sexual minority women (SMW) experience higher levels of depression compared to heterosexual women, and bisexual women show higher levels than lesbian women. Sexual orientation concealment is a risk factor for depressive symptoms among SMW. Hope is protective against depressive symptoms in diverse samples, but limited research in this area has centered on SMW. This study examined the role of hope and its components, agency and pathways, as moderators of the relation between sexual orientation concealment and depressive symptoms, and whether the moderating effects were conditional on sexual orientation. An international sample of 218 lesbian women aged 18 to 69 (M = 32.93 years, SD = 12.75) and 230 bisexual women aged 18 to 67 (M = 27.83 years, SD = 7.52) completed an online survey. Hope, agency, and pathways did not moderate the relation between sexual orientation concealment and depressive symptoms. The significant negative relations between hope and depressive symptoms, and between agency and depressive symptoms, were moderated by sexual orientation: the relations were stronger among lesbian women than bisexual women. Results suggest that increasing levels of hope and agency through clinical intervention may reduce depressive symptoms for both groups of women, with more pronounced effects among lesbian women.

A cross-sectional survey on the effects of the COVID-19 pandemic on psychological well-being and quality of life in people with spinal cord injury

BACKGROUND

SARS-CoV-2 (COVID-19) has disrupted lives worldwide, affecting individuals from all walks of life. Individuals who have a spinal cord injury (SCI) are also affected by this phenomenon. This survey compares the quality of life (QOL), depression, and anxiety of SCI patients before and during COVID-19 in Wuhan City, China.

METHODS

A cross-sectional survey utilized an online questionnaire to assess the QOL, levels of anxiety, and depression among 189 SCI patients admitted to Wuhan Tongji Hospital during pandemic from November 2020 to April 2021. Data before COVID-19 outbreak from November to December 2019 was retrieved from hospital records with the same assessment previously performed in-person or during a follow up visit. However, some participants were excluded for various reasons, such as declining to participate, not being admitted to a rehabilitation program due to the pandemic, or being under 18 years old. The World Health Organization's (WHO) QOL-Brief Version (BREF) and disability (DIS) modules, which focus on disability-related QOL, were used to assess the participants' QOL.

RESULTS

SCI patients had lower QOL scores during the pandemic compared to pre-pandemic times. Mean scores on the 12-item DIS module significantly differed before and during the COVID-19 period. Participants showed higher adherence to self-isolation and quarantine measures for high-risk encounters (64.94%), but lower compliance with home disinfection and proper rest practices (23.38%).

CONCLUSIONS

The COVID-19 pandemic has had a detrimental effect on the QOL of SCI patients in China, highlighting the urgent requirement for telehealth-based rehabilitation to mitigate its impact. It is crucial to provide essential.

On social health: history, conceptualization, and population patterning

We propose a psychologically-informed concept of social health to join physical and mental components in a more comprehensive assessment of human health. Although there is an extensive literature on the importance of social relationships to health, a theoretical framework is needed to coalesce this work into a codified conceptualisation of social health, defined here as adequate quantity and quality of relationships in a particular context to meet an individual's need for meaningful human connection. Informing this novel conceptualisation, we outline eight key propositions to guide future research and theory on social health, including five propositions focused on the conceptualisation of social health and three focused on its population patterning. The former five propositions include that social health is an outcome in its own right, that health interventions can have divergent effects on social versus physical and mental aspects of health, that social health has independent effects on quality of life, that it is a dynamic and contextual construct, and that it is embedded and encoded in the human body (and mind). The utility of the social health concept is further revealed in its significance for understanding and addressing population health concerns, such as health inequalities experienced by marginalised groups.

Effect of Motor Interference Therapy on Distress Related to Traumatic Memories: A Randomized, Double-Blind, Controlled Feasibility Trial

INTRODUCTION

Traumatic memories (TM) are a core feature of stress-related disorders, including posttraumatic stress disorder (PTSD). Treatment is often difficult, and specific pharmacological interventions are lacking. We present a novel non-pharmacological intervention called motor interference therapy (MIT) as a promising alternative for these symptoms.

AIMS

To determine the feasibility of MIT, a brief, audio-delivered, and non-pharmacological intervention that uses cognitive and motor tasks to treat TM.

METHODS

We designed a randomized, double-blind trial. Twenty-eight participants from an outpatient clinic with at least one TM were included to receive either MIT or progressive muscle relaxation (PMR). Spanish versions of the PTSD symptom severity scale (EGS), visual analog scale for TM (TM-VAS), and quality of life (EQ-VAS) were applied prior to intervention, 1 week, and 1 month following intervention.

RESULTS

Mean scores on all measures improved from baseline to posttest for both groups. MIT participants showed significantly more positive scores at 1 week and 1 month (TM-VAS baseline: 9.8 ± 0.4; immediate: 6.0 ± 2.0; 1 week: 3.8 ± 3.1 [d = 1.57]; 1 month 2.9 ± 2.8 [d = 1.93]) than PMR participants on measures of distress due to TM, trauma re-experiencing, anxiety, and a composite measure of PTSD.

CONCLUSION

MIT is a simple, effective, and easy-to-use tool for treating TM and other stress-related symptoms. It requires relatively few resources and could be adapted to many contexts. The results provide proof-of-principle support for conducting future research with larger cohorts and controls to improve clinical effectiveness and research on brief interventions.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT03627078.

Young adults with a history of substance use disorder experienced more negative mental health, social and economic outcomes during the COVID-19 pandemic period

BACKGROUND AND AIMS

For young adults, the disruptions brought by the COVID-19 pandemic to work, social relationships and health-care probably impacted normative life stage transitions. Disaster research shows that negative effects of these events can persist for years after the acute crisis ends. Pandemic-related disruptions may have been especially consequential for young adults with a history of substance use disorder (SUD). The current work aimed to measure the broad impact of the COVID-19 pandemic on young adults with and without a history of SUD.

DESIGN, SETTING AND PARTICIPANTS

Data were from a longitudinal panel of n = 4407 young adults across the United States surveyed repeatedly from 2014 to 2019 (aged 19-26 years, pre-pandemic) and again in 2021 (aged 28 years, mid-pandemic).

MEASUREMENTS

We fitted multi-level models to understand the association between SUD history and pandemic outcomes, controlling for potential confounders (socio-demographic and health measures). Outcomes included overall life disruption; mental health, social and economic impacts; substance use; and physical health.

FINDINGS

Young adults with a history of SUD reported greater life disruption (standardized β = 0.13-0.15, Ps < 0.015) and negative mental health impacts (standardized β = 0.12-0.14, Ps < 0.012), experienced approximately 20% more work-related stressors (relative risks = 1.18-1.22, Ps < 0.002) and 50% more home-related stressors (relative risks = 1.40-1.51, Ps < 0.001), and had two to three times the odds of increased substance use during the pandemic (odds ratios = 2.07-3.23, Ps < 0.001). Findings generally did not differ between those with a recent SUD diagnosis and those in recovery from SUD before the pandemic began.

CONCLUSIONS

United States young adults with a history of substance use disorder (SUD) reported more life disruption and greater negative physical and mental health, social and economic impacts during the COVID mid-pandemic period than young adults with no history of SUD.

Emotional Impact of COVID-19 and Emotional Eating and the Risk of Alcohol Use Disorder in Peruvian Healthcare Students

BACKGROUND

This study aimed to explore the association between the emotional impact of COVID-19 and emotional eating and the risk of alcohol use disorder among Peruvian health science students.

METHODS

We conducted a cross-sectional analytical study in which an online questionnaire was administered to 456 health science interns from four cities in Peru. We used the COVID-19 Emotional Impact Profile questionnaire, Mindful Eating Questionnaire, and Alcohol Use Disorders Identification Test. Spearman's correlations were calculated and two multiple linear regression models were developed.

RESULTS

68.4% of the participants were emotional eaters and 8.6% reported low-risk levels of alcohol use disorder. Based on the results of the first model, the overall emotional impact of COVID-19, being overweight or obese, depression and anxiety levels, and living with only one parent were factors associated with emotional eating. The results of the second model showed that the level of depression, living with just one parent, living alone, sex, and number of months as an intern were factors associated with the risk of alcohol use disorder.

CONCLUSIONS

To reduce emotional eating and the risk of alcohol use disorder among interns, universities should implement interventions aimed at reducing the emotional impact of COVID-19 and provide nutritional counseling.

The Relations Between Self-Warmth, Self-Coldness, Internalized Heterosexism, and Depressive Symptoms Among Sexual Minority Men: A Moderated-Mediation Model

Depression is a prevalent mental health issue for sexual minority men (SMM), with the internalization of sexual identity-based stigma a key risk factor. Self-warmth is a protective factor and self-coldness is a risk factor for depressive symptoms, yet limited research in this area has focused on SMM. In the present study, an international sample of 1,285 gay and 487 bisexual men completed measures of depression, internalized heterosexism, and self-warmth/self-coldness. A multiple linear regression showed that internalized heterosexism explained 0.4% unique variance, self-warmth explained 0.5% unique variance, and self-coldness explained 18.8% unique variance in depressive symptoms. Self-warmth was directly and indirectly related to lower levels of depressive symptoms among SMM. In contrast, self-coldness was directly related to higher levels of depressive symptoms among SMM, and indirectly related to higher levels of depressive symptoms only for gay men. Findings should inform work aiming primarily to reduce self-coldness among SMM, thereby reducing depressive symptoms.

Comparison of death anxiety symptoms between generalized anxiety disorder and somatization disorder in geriatric patients attending a psychiatric outpatient clinic for the first time

Somatic complaints are among the important complaints frequently seen in Generalized Anxiety Disorder (GAD) and Somatic Symptom Disorder (SSD). Death anxiety has also increased significantly with the Covid-19 pandemic, especially in the elderly population. In this study, we compared the difference of the death anxiety level among patients with GAD, SSD and healthy controls. This cross-sectional study which was carried out in Artvin State Hospital's Psychiatric Outpatient Clinic included 59 participants (GAD = 21, SSD = 18, HC = 20). Three groups were subjected to detailed psychiatric examination by the same psychiatrist. Subsequently, anxiety, somatic symptoms and death anxiety were assessed using standardized tools (GAD-7, Templer Death Anxiety Scale, Somatic Symptom Scale). The GAD-7 Scale mean of the GAD group was significantly higher than SSD (p = 0.001) and Healthy Control (HC) (p = 0.001) groups. Death anxiety and Somatic Symptom levels in GAD and SSD groups were significantly higher than in healthy controls. (GAD, p = 0.001; SSD, p = 0.001) with no significant difference between GAD and SSD groups (p = 1). Healthy controls exhibited significantly lower scores in the three scales mean scores compared to the SSD and GAD groups (p = 0.001). Irrespective of specific psychiatric diagnoses, these findings highlight elevated death anxiety in the elderly, underscoring the need for tailored mental health interventions.

Longitudinal changes in depression and anxiety during the COVID-19 pandemic and the impact of COVID-related factors

OBJECTIVE

This study is an investigation of five specific COVID-related stressors and their longitudinal impact on adult depression and anxiety.

METHOD

A total of 592 adults comprised the initial sample at Time 1 in April/May 2020. Follow-ups were conducted about a month later, again in March 2021 and then in March 2022.

RESULTS

Applied linear mixed effect models showed a significant decrease in mean depression scores and anxiety scores from Time 1 to both Times 3 and 4. Neither change over time in anxiety or depression were found to be related to COVID diagnosis, COVID hospitalization, or COVID death. Self-quarantine was related to changes over time in both depression and anxiety, and household quarantine was related to changes over time in depression.

CONCLUSION

While the fallout of the pandemic continues, it is important to understand how these factors may be affecting mental health to better understand where intervention is necessary.

Impacts of COVID-19 shelter in place across key life domains among immigrant farmworker Latina mothers and young adults

OBJECTIVE

Individuals and families from racial and ethnic groups experience social and economic disadvantage making them vulnerable to the disproportionate impact of the COVID-19 pandemic. This study sought to capture the impacts of Shelter in Place (SIP) across key life domains including family life, education, work, mental health, and coping strategies among a sample of Mexican-origin mothers who were currently engaged in agricultural work, or whose spouses were engaged in agricultural work, and young adults who had a parent working in agriculture.

METHOD

During the summer of 2020, while California was under SIP orders, we conducted three virtual focus groups using Zoom(r). We recruited focus group participants from the Center for the Health Assessment of Mothers and Children of Salinas (CHAMACOS), an ongoing, 20-year, longitudinal cohort study of Mexican-origin families in a predominantly agricultural area of California. Three focus groups were conducted with mothers (n = 9), mean age = 48 years, young adult women (n = 8) and young adult men (n = 5), mean age = 18 years, respectively.

RESULTS

Mothers reported high levels of stress stemming from fear of Covid-19 infection, work instability and financial concerns, children's schooling, anxiety about an uncertain future, and the demands of caretaking for dependents. Adverse mental health impacts were particularly pronounced among participants experiencing multiple adversities pre-dating the pandemic, including unemployment, single motherhood, and having undocumented family members. For young adults, work instability and varying work hours were also a source of stress because they made it difficult to make decisions about the future, such as whether to attend college or how many classes to take. Families used coping strategies including expressing gratitude, focusing on what's under one's control, familismo, and community engagement to manage mental health challenges during SIP.

CONCLUSION

In the event of future pandemics or disasters, particular attention is needed to those who experience unemployment, are undocumented and/or have undocumented family members, and/or are single parents facing economic adversity. During public health emergencies, action at the local, state, and national level is needed to support farmworkers and other vulnerable groups' secondary major stressors stemming from inequities in access to affordable housing, childcare, living wages, healthcare, and other benefits.

The Depression, Anxiety, and Stress of Student-Athletes from a Pre- to Post-COVID-19 World

This study explored differences in student-athletes' symptoms of depression, anxiety, and stress pre- to post-COVID-19-pandemic. The WHO reported a 25% increase in depression and anxiety rates worldwide, with young people disproportionately affected. Student-athletes face many stressors related to their sporting and academic feats, but what is not known is how the COVID-19 pandemic affected their experiences of symptoms of mental illness. A multiple-cohort cross-sectional study design was employed, and data collected using physical and online surveys. Participants (cohort 1 M age = 20.18 years, SD = 1.52; cohort 2 M age = 19.75 years, SD = 1.45) were recruited from UK universities (N = 807; 427 pre-pandemic cohort, 380 post-pandemic cohort). Results revealed statistically significant differences in mean depression (F (1, 805) = 23.92, p < 0.001), anxiety (F (1, 806) = 20.15, p < 0.001), and stress symptoms (F (1, 805) = 5.24, p = 0.022) scores between cohorts. Scores for the post-pandemic cohort were significantly higher than pre-pandemic, suggesting a worsening of symptom severity. Distributions of student-athletes across categories of symptom severity also worsened for depressive and anxiety symptoms post-pandemic and were skewed towards more severe categories. Symptoms of depression, anxiety, and stress were a concern pre-pandemic. Rates are higher in the post-pandemic cohort, suggesting a worsening of symptoms. These data add to evidence on student-athletes' symptoms of mental illness by exploring a UK sample and comparing scores pre- and post-pandemic.

A multimodal group-based immersive virtual reality intervention for improving cognition and mental health in patients with post-covid-19 condition. A quasi-experimental design study

Introduction

Adults with Post-COVID-19 Condition (PCC) may show cognitive impairments in attention, processing speed, memory, and executive function. Multimodal programs that combine cognitive training, physical activity and emotional tasks, such as mindfulness-based interventions (MBIs), may offer a suitable alternative for improving PCC treatments. Immersive Virtual Reality (IVR) is a promising technology that can enhance traditional cognitive training, physical activity, and MBIs. The use of IVR technology may increase engagement with these interventions and potentially enhance the individual benefits of cognitive training, exercise and MBIs. The current study evaluated the impact of a multimodal IVR intervention, comparing this with a usual care intervention (control group), in order to assess changes in cognition and mental health in adults with PCC. We also aimed to assess user experience factors such as enjoyment, perceived improvement, and fatigue following each multimodal IVR session within the experimental group.

Method

Thirty-one participants with PCC symptoms were assigned to either the experimental group (IVR, n = 15) or the control group (usual care intervention, n = 16) in a quasi-experimental design study. The multimodal IVR intervention consisted of MBI, cognitive training and physical exercise and was delivered in a 60-min group session with 5 participants, twice a week, for 8 weeks (16 sessions in total). Measures of global cognition, attention, processing speed, verbal episodic memory and subjective memory complaints (primary measures), and depressive and anxiety symptoms and fatigue (secondary measures) were assessed at baseline and also after 8 weeks (post-intervention).

Results

Mixed between-group (group) and within-group (pre-post assessments) ANOVAs revealed significant group*time interactions in global cognition, simple attention, processing speed, memory and depressive symptoms, with large effect sizes (p < 0.05; partial η2 > 0.14). There was also a marginally significant group*time interaction for executive function (p = 0.05). Follow-up analyses comparing pre-and post-intervention outcomes for each group separately showed that the experimental group significantly improved in global cognition, processing speed, memory and depressive symptoms, while the control group showed no significant pre-post changes. Friedman tests showed a significant main effect of time (χ2(2) = 6.609, p = 0.04), with a gradual increase in enjoyment from the first, to the mid, and then to the final session. In addition, perceived improvement scores remained high throughout the intervention, and patient-reported fatigue levels did not fluctuate significantly throughout the intervention.

Conclusion

To our knowledge, no previous research has combined cognitive training, physical exercise and MBI using an IVR paradigm in adults with PCC. Despite their inherent limitations, our findings mark a pioneering step toward improving cognition and mental health outcomes in PCC through the innovative use of new technology and multimodal approaches. This first study should be accompanied by more extensive, randomized clinical trials aimed at further exploring and refining these interventions.

Operational status of mental health, substance use, and problem gambling services: A system-level snapshot two years into the COVID-19 pandemic

BACKGROUND

The aim of this paper is to provide a system-level snapshot of the operational status of mental health, substance use, and problem gambling services 2 years into the pandemic in Ontario, Canada, with a specific focus on services that target individuals experiencing vulnerable circumstances (e.g., homelessness and legal issues).

METHODS

We examined data from 6038 publicly funded community services that provide mental health, substance use, and problem gambling services in Ontario. We used descriptive statistics to describe counts and percentages by service type and specialisation of service delivery. We generated cross-tabulations to analyse the relationship between the service status and service type for each target population group.

RESULTS

As of March 2022, 38.4% (n = 2321) of services were fully operational, including 36.0% (n = 1492) of mental health, 44.1% (n = 1037) of substance use, and 23.4% (n = 78) of problem gambling services. These service disruptions were also apparent among services tailored to sexual/gender identity (women/girls, men/boys, 2SLGBTQQIA + individuals), individuals with legal issues, with acquired brain injury, and those experiencing homelessness.

CONCLUSION

Accessible community-based mental health, substance use and problem gambling services are critical supports, particularly for communities that have historically contended with higher needs and greater barriers to care relative to the general population. We discuss the public health implications of the findings for the ongoing pandemic response and future emergency preparedness planning for community-based mental health, substance use and problem gambling services.

COVID again? Health workers' burnout and turnover intentions: possible impacts of coronavirus-induced anxiety and first-level servant leaders

PURPOSE

Building on social exchange and leader-member exchange theories, this paper aims to propose a model of the impact of coronavirus-induced anxiety on health-care professionals' burnout and turnover intention through the mediation role of servant leadership.

DESIGN/METHODOLOGY/APPROACH

This model was examined by adopting partial least square-based structural equation modeling using data collected from 271 health professionals (doctors, nurses, midwives and analysts) from Turkey.

FINDINGS

The findings of the research illustrate that coronavirus-induced anxiety is positively associated with burnout and turnover intention. Furthermore, servant leadership mediates the relationship between coronavirus-induced anxiety, burnout and turnover intention. Yet, according to factor loadings, the mediating role of servant leadership is not strong (β : 0.035 and 0.053, respectively).

RESEARCH LIMITATIONS/IMPLICATIONS

First, this study targeted the health-care professionals from Turkey. Therefore, this population may not be able to provide general information on the topic. Thus, this study suggests that the subject be addressed in other populations as well. Second, the data were self-reported by the participants. Although common method bias and social desirability bias were not an issue in this study, it should be known that the results are based on the subjective judgments of the participants. Third, this study was limited to investigating the mediating role of servant leadership only.

PRACTICAL IMPLICATIONS

This study gives much beneficial information to both administrators and organizations by mirroring highly stressed workers' inside throughout statistically results. Hence, it is assumed that the findings will help leaders to cope with several difficult situations, especially in crisis moments. As the chaotic circumstances occurred, achieving organizational goals became more and more difficult. To do this, some leaders play critical roles for members like servant leaders by contributing uniquely spiritual dimensions.

SOCIAL IMPLICATIONS

Struggling with the COVID-19 pandemic has aggravated the health-care professionals' existing mental health and has loaded more agitation on them. According to Mozes (2021), suicide cases among nurses have doubled the number of women in the general population. Thus, leaders should do something to lower those ratios. This study points out that servant leaders could break down those unwanted issues by decreasing burnout and turnover intention rates of health workers. Barbuto and Wheeler (2006) highlighted this situation by creating a dimension called "The Natural Desire to Serve Others."

ORIGINALITY/VALUE

To the best of the authors' knowledge, to date, this study is the first to examine the mediating role of servant leadership in the effect of coronavirus-induced anxiety on burnout and turnover intention. Furthermore, this research reveals that servant leadership may play a role in avoiding burnout and turnover intention in the health sector.

Subjective Stress Appraisals Over Time: the Evolving Structure of the COVID-19 Stressor Scale

The COVID-19 Stressors Scale measures individuals' appraisals of stressors related to the pandemic. Measurement of perceptions of stressors is necessary to understand the socioemotional impacts of not only the COVID-19 pandemic, but other disasters. The study examined the factor structure of the scale among adults in the U.S. over six time points. A shortened version was used, and the fit was examined over time. The results of the study show contextual appraisals change over time and offer important implications for the measurement of stressfulness of disasters, a critical step in designing and assessing impacts of social programs aimed to reduce the deleterious effects of disasters.

Teachers' competence: How to protect teachers' mental health from the burden caused by students' private in-class use of technical devices?

The current study investigated how students' private in-class use of technical devices is associated with teachers' mental health. Data of 361 teachers from primary and secondary schools in Germany were assessed via online surveys. The present cross-sectional results show a positive association between burden caused by the students' private in-class use of technical devices and teachers' depression symptoms. Both were negatively linked to teachers' positive mental health (PMH) and teachers' competence in handling students' private in-class use of technical devices. In a moderated mediation analysis, the association between burden and depression symptoms was mediated by PMH. Teachers' competence moderated the link between PMH and depression symptoms. Specifically, the higher the competence, the weaker the relationship between both variables. Thus, the protective effect of teachers' competence could be especially important in persons with low PMH. Competence training in handling students' use of technical devices is discussed as a potential step that could protect teachers' mental health.

Prevalence, Determinants, and Trends in the Experience and Perpetration of Intimate Partner Violence Among a Cohort of Gay, Bisexual, and Other Men Who Have Sex with Men in Montréal, Toronto, and Vancouver, Canada (2017-2022)

Purpose: Longitudinal data on the experience and perpetration of intimate partner violence (IPV) among gay, bisexual, and other men who have sex with men (GBM) are limited. We estimated the prevalence of past 6-month (P6M) physical and/or sexual IPV (hereafter IPV) experience and perpetration, identified their determinants, and assessed temporal trends, including the impact of the coronavirus disease (COVID)-19 pandemic. Methods: We used data from the Engage Cohort Study (2017-2022) of GBM recruited using respondent-driven sampling in Montréal, Toronto, and Vancouver. Adjusted prevalence ratios (aPRs) for determinants and self-reported P6M IPV were estimated using generalized estimating equations, accounting for attrition (inverse probability of censoring weights) and relevant covariates. Longitudinal trends of IPV were also assessed. Results: Between 2017 and 2022, 1455 partnered GBM (median age 32 years, 82% gay, and 71% White) had at least one follow-up visit. At baseline, 31% of participants experienced IPV in their lifetime and 17% reported ever perpetrating IPV. During follow-up, IPV experience was more common (6%, 95% confidence interval [CI]: 5%-7%) than perpetration (4%, 95% CI: 3%-5%). Factors associated with P6M IPV experience included prior IPV experience (aPR: 2.68, 95% CI: 1.76-4.08), lower education (aPR: 2.31, 95% CI: 1.32-4.04), and substance use (injection aPR: 5.05, 95% CI: 2.54-10.05, non-injection aPR: 1.68, 95% CI: 1.00-2.82). Similar factors were associated with IPV perpetration. IPV was stable over time; periods of COVID-19 restrictions were not associated with IPV changes in this cohort. Conclusion: Prevalence of IPV was high among GBM. Determinants related to marginalization were associated with an increased risk of IPV. Interventions should address these determinants to reduce IPV and improve health.

Attention-Deficit/Hyperactivity Disorder Diagnoses in Finland During the COVID-19 Pandemic

Importance

Several reports suggest an increase in attention-deficit/hyperactivity disorder (ADHD) symptoms during the COVID-19 pandemic. This nationwide study assessed new ADHD diagnoses and ADHD prevalence before and during the pandemic.

Objective

To investigate trends in new ADHD diagnoses, prevalence, and ADHD medication use from 2015 to 2022 in Finland.

Design, Setting, and Participants

This longitudinal cohort study comprised the entire Finnish population. ADHD diagnoses and medication use were obtained from nationwide registers and assessed at 3 time points: in 2015 and before (2020) and after (2022) the pandemic. Data were analyzed from January 2015 to June 2022.

Main outcomes and Measures

New ADHD diagnoses, ADHD lifetime prevalence, and ADHD medication use.

Results

The cohort comprised 5 572 420 individuals (2 819 645 women [50.6%]). Lifetime prevalence of ADHD increased by 2.7-fold during 2015 to 2022; prevalence was 1.02% in 2015 (95% CI, 1.01%-1.03%), 1.80% in 2020 (95% CI, 1.79%-1.81%), and 2.76% in 2022 (95% CI, 2.75%-2.77%). Young men aged 13 to 20 years had the highest lifetime prevalence of 11.68% (95% CI, 11.56%-11.81%) in 2022. New ADHD diagnoses doubled during the pandemic, from 238 per 100 000 in 2020 to 477 per 100 000 in 2022. The pandemic-associated incremental increase in new diagnoses was 18.60% (95% CI, 16.47%-20.49%; 9482 per 50 897 cases). Young women aged 13 to 20 years had a 2.6-fold increase in new diagnoses during the pandemic, from 577 per 100 000 in 2020 to 1488 per 100 000 in 2022, and women aged 21 to 30 years had a 3.0-fold increase, from 361 per 100 000 to 1100 per 100 000. New diagnoses increased by 2.9-fold among those older than 55 years (from 5 per 100 000 to 13 per 100 000 in women and from 5 per 100 000 to 14 per 100 000 in men). Boys younger than 13 years had the highest absolute rate of new ADHD diagnoses in 2022 (1745 per 100 000), but boys and young men younger than 21 years did not show a significant incremental increase in new diagnoses. Lifetime prevalence of ADHD medication purchases was 0.57% (95% CI, 0.56%-0.58%) in 2015 (31 771 [55.62%] of those with ADHD diagnosis), 1.15% (95% CI, 1.14%-1.16%) in 2020 (64 034 [63.83%]), and 1.69% (95% CI 1.68%-1.70%) in 2022 (92 557 [61.43%]), respectively.

Conclusions and Relevance

In this nationwide cohort study, new ADHD diagnoses and ADHD prevalence showed significant increase in Finland during the pandemic. ADHD medication use did not increase in relation to ADHD diagnoses. These results highlight potential adverse outcomes of pandemic-associated changes in living conditions.

Death and Other Losses in the COVID-19 Pandemic in Long-Term Care Facilities for Older Adults in the Perception of Occupational Therapists: A Qualitative Study

Long-term care facilities for older adults (LTCFs) were directly affected by the COVID-19 pandemic. This study aimed to discuss the perceptions of occupational therapists about deaths and other losses in LTCFs during the pandemic. This qualitative study is anchored in social phenomenology, and conducted in-depth interviews with eight occupational therapists who worked in LTCFs. Thus, two themes were generated after the Thematic Analyses: "The proximity of death" and "Losses associated with living and dying in a LTCF." In the first theme, the interviewees addressed the feeling of imminent death in the daily life of the LTCF, and feelings related to their own death, that of their family members and other older adults. In the second, the professionals highlighted three groups of losses: social, functional, and psychological/cognitive. These results highlighted the challenges faced by occupational therapists and can contribute to improve behavior and care for institutionalized older adults during the pandemic.

Risk factors and health behaviors associated with loneliness among cancer survivors during the COVID-19 pandemic

Loneliness may exacerbate poor health outcomes particularly among cancer survivors during the COVID-19 pandemic. Little is known about the risk factors of loneliness among cancer survivors. We evaluated the risk factors of loneliness in the context of COVID-19 pandemic-related prevention behaviors and lifestyle/psychosocial factors among cancer survivors. Cancer survivors (n = 1471) seen at Huntsman Cancer Institute completed a survey between August-September 2020 evaluating health behaviors, medical care, and psychosocial factors including loneliness during COVID-19 pandemic. Participants were classified into two groups: 'lonely' (sometimes, usually, or always felt lonely in past month) and 'non-lonely' (never or rarely felt lonely in past month). 33% of cancer survivors reported feeling lonely in the past month. Multivariable logistic regression showed female sex, not living with a spouse/partner, poor health status, COVID-19 pandemic-associated lifestyle factors including increased alcohol consumption and marijuana/CBD oil use, and psychosocial stressors such as disruptions in daily life, less social interaction, and higher perceived stress and financial stress were associated with feeling lonely as compared to being non-lonely (all p < 0.05). A significant proportion of participants reported loneliness, which is a serious health risk among vulnerable populations, particularly cancer survivors. Modifiable risk factors such as unhealthy lifestyle behaviors and psychosocial stress were associated with loneliness. These results highlight the need to screen for unhealthy lifestyle factors and psychosocial stressors to identify cancer survivors at increased risk of loneliness and to develop effective management strategies.

Covid-19 pandemic, social normative compliance, and sustainable consumption: Evidence from experiments

This research aims to investigate the causal effects of consumers' Covid-19 pandemic experiences on their preferences for sustainable consumption. Drawing on social identity theory, we argue that pandemic experiences heighten consumers' awareness of the importance of adhering to collective social norms, subsequently motivating them to adopt sustainable consumption practices that promote collective interests. Through three preregistered experiments, we demonstrate that: (i) Covid-19 pandemic experiences increase consumers' preferences for sustainable consumption; (ii) this effect is more pronounced for individuals with severer pandemic experiences and females; (iii) pandemic experiences influence sustainable consumption preferences by enhancing consumers' social normative compliance. This study contributes to the understanding of Covid-19's consequences from a micro-level perspective of consumer behavior and offers insights into the factors driving consumers' sustainable consumption preferences.

Long-term cardiovascular disease outcomes in non-hospitalized medicare beneficiaries diagnosed with COVID-19: Population-based matched cohort study

BACKGROUND

SARS-CoV2, the virus that causes coronavirus disease 2019 (COVID-19), can affect multiple human organs structurally and functionally, including the cardiovascular system and brain. Many studies focused on the acute effects of COVID-19 on risk of cardiovascular disease (CVD) and stroke especially among hospitalized patients with limited follow-up time. This study examined long-term mortality, hospitalization, CVD and stroke outcomes after non-hospitalized COVID-19 among Medicare fee-for-service (FFS) beneficiaries in the United States.

METHODS

This retrospective matched cohort study included 944,371 FFS beneficiaries aged ≥66 years diagnosed with non-hospitalized COVID-19 from April 1, 2020, to April 30, 2021, and followed-up to May 31, 2022, and 944,371 propensity score matched FFS beneficiaries without COVID-19. Primary outcomes were all-cause mortality, hospitalization, and incidence of 15 CVD and stroke. Because most outcomes violated the proportional hazards assumption, we used restricted cubic splines to model non-proportional hazards in Cox models and presented time-varying hazard ratios (HRs) and Bonferroni corrected 95% confidence intervals (CI).

RESULTS

The mean age was 75.3 years; 58.0% women and 82.6% non-Hispanic White. The median follow-up was 18.5 months (interquartile range 16.5 to 20.5). COVID-19 showed initial stronger effects on all-cause mortality, hospitalization and 12 incident CVD outcomes with adjusted HRs in 0-3 months ranging from 1.05 (95% CI 1.01-1.09) for mortality to 2.55 (2.26-2.87) for pulmonary embolism. The effects of COVID-19 on outcomes reduced significantly after 3-month follow-up. Risk of mortality, acute myocardial infarction, cardiomyopathy, deep vein thrombosis, and pulmonary embolism returned to baseline after 6-month follow-up. Patterns of initial stronger effects of COVID-19 were largely consistent across age groups, sex, and race/ethnicity.

CONCLUSIONS

Our results showed a consistent time-varying effects of COVID-19 on mortality, hospitalization, and incident CVD among non-hospitalized COVID-19 survivors.

Effectiveness of an eHealth intervention for reducing psychological distress and increasing COVID-19 knowledge and protective behaviors among racialized sexual and gender minority adults: A quasi-experimental study (#SafeHandsSafeHearts)

PURPOSE

Sexual and gender minority and racialized populations experienced heightened vulnerability during the Covid-19 pandemic. Marginalization due to structural homophobia, transphobia and racism, and resulting adverse social determinants of health that contribute to health disparities among these populations, were exacerbated by the Covid-19 pandemic and public health measures to control it. We developed and tested a tailored online intervention (#SafeHandsSafeHearts) to support racialized lesbian, gay, bisexual, transgender, queer, and other persons outside of heteronormative and cisgender identities (LGBTQ+) in Toronto, Canada during the pandemic.

METHODS

We used a quasi-experimental pre-test post-test design to evaluate the effectiveness of a 3-session, peer-delivered eHealth intervention in reducing psychological distress and increasing Covid-19 knowledge and protective behaviors. Individuals ≥18-years-old, resident in Toronto, and self-identified as sexual or gender minority were recruited online. Depressive and anxiety symptoms, and Covid-19 knowledge and protective behaviors were assessed at baseline, 2-weeks postintervention, and 2-months follow-up. We used generalized estimating equations and zero-truncated Poisson models to evaluate the effectiveness of the intervention on the four primary outcomes.

RESULTS

From March to November 2021, 202 participants (median age, 27 years [Interquartile range: 23-32]) were enrolled in #SafeHandsSafeHearts. Over half (54.5%, n = 110) identified as cisgender lesbian or bisexual women or women who have sex with women, 26.2% (n = 53) cisgender gay or bisexual men or men who have sex with men, and 19.3% (n = 39) transgender or nonbinary individuals. The majority (75.7%, n = 143) were Black and other racialized individuals. The intervention led to statistically significant reductions in the prevalence of clinically significant depressive (25.4% reduction, p < .01) and anxiety symptoms (16.6% reduction, p < .05), and increases in Covid-19 protective behaviors (4.9% increase, p < .05), from baseline to postintervention.

CONCLUSION

We demonstrated the effectiveness of a brief, peer-delivered eHealth intervention for racialized LGBTQ+ communities in reducing psychological distress and increasing protective behaviors amid the Covid-19 pandemic. Implementation through community-based organizations by trained peer counselors supports feasibility, acceptability, and the importance of engaging racialized LGBTQ+ communities in pandemic response preparedness. This trial is registered with ClinicalTrials.gov, number NCT04870723.

Disparities in COVID-19-Related Psychological Distress Among Recipients of a State's Public Mental Health Services

OBJECTIVE

The authors examined changes in perceived anxiety, stress, and mental health symptoms (i.e., psychological distress) reported by recipients of New York State public mental health services during the early months of the COVID-19 pandemic, as well as whether these changes varied by demographic characteristics or pandemic-related socioeconomic challenges.

METHODS

A statewide survey of service recipients (N=3,483) was conducted (May 8-June 22, 2020). Descriptive analyses were summarized, and logistic regression was used to evaluate associations between increases in reported psychological distress and age, gender, region of residence, race and ethnicity, socioeconomic challenges, and alcohol or drug use.

RESULTS

Fifty-five percent of respondents (N=1,933) reported a slight or moderate increase in COVID-19-related psychological distress, and 15% (N=520) reported a substantial increase. In adjusted models, substantial elevations in psychological distress were associated with identifying as female (AOR=1.83, 95% CI=1.50-2.25), experiencing three or more pandemic-related socioeconomic challenges (AOR=2.41, 95% CI=1.91-3.03), and reporting increased use of alcohol or drugs (AOR=1.81, 95% CI=1.34-2.44). Compared with non-Hispanic/Latinx White service recipients, non-Hispanic/Latinx Black individuals had lower odds of reporting substantially increased psychological distress (AOR=0.59, 95% CI=0.45-0.76), as did non-Hispanic/Latinx Asian-descent individuals (AOR=0.28, 95% CI=0.12-0.64).

CONCLUSIONS

In this large sample of recipients of New York State public mental health services, the COVID-19 pandemic's impact on psychological well-being was widespread and varied by gender, race and ethnicity, and socioeconomic vulnerability. These relationships must be considered in ongoing efforts to provide optimal care for this population.

Mentally healthy living after pandemic social distancing: a study of older Canadians reveals helpful anxiety reduction strategies

BACKGROUND

Throughout the COVID-19 pandemic, older Canadians were the most at risk of severe physical harm, including death, and their return to post-COVID life was expected to be especially anxiety-provoking. A study was conducted to obtain nationally representative evidence of older Canadians' self-perceived anxiety levels and their strategies to manage or mitigate it as public health restrictions were lifting.

MATERIALS AND METHODS

This study had a cross-sectional descriptive design. An e-survey was used to collect data from 1327 Canadians aged 60+ stratified by age, sex, and education to resemble the larger general population. Participants completed the Geriatric Anxiety Scale (GAS-10) and indicated which of the 16 Centre for Addictions and Mental Health's (2022) Coping with Stress and Anxiety strategies they were using to manage or mitigate their anxiety when social distancing was lifting. Descriptive statistics, Pearson correlation, and multiple regression analysis were used to explore the data.

RESULTS

While, on average, older Canadians were mildly anxious, nearly one-quarter of responders rated their anxiety as severe. Age, sex, perceived health, were statistically significant correlates of anxiety. Six coping strategies were associated with significantly lower anxiety scores. Moreover, accepting some fear and anxiety as normal, challenging worries and anxious thoughts, and practising relaxation/meditation appeared to increase anxiety.

CONCLUSION

Older Canadians used multiple strategies to manage or mitigate their anxiety, and seemingly, with more successful than detrimental tries. Practitioners have much to learn and understand about older people's mental health promotion efforts after social distancing, now and for future pandemics.

Can a web application foster emotional competence in children and adolescents? The case of PandHEMOT®

The COVID-19 pandemic has had many traumatic consequences for the physical and psychological functioning of children and adolescents. Internet-based interventions can reach a large audience and be a potentially powerful resource for promoting well-being among young people. We tested the efficacy of the web application PandHEMOT®, developed ad hoc for increasing knowledge about pandemics, emotions, and emotion regulation. We involved a sample of 147 Italian third and seventh graders. The sample was assigned to an experimental (participating in the training) and a waitlist condition (who participated following a waitlist design). All the participants completed pretest and posttest measures. The intervention was structured into three units. The training took place between November and December 2021. Generalized linear mixed models and linear mixed models revealed that knowledge about pandemics, emotions, emotion regulation, and metacognitive awareness increased for the experimental condition. Moreover, adolescents performed better than children. The findings supported the efficacy of an Internet-based training for increasing children and adolescents' resilience, according to the standards of evidence-based research.

'We all have a stake in this': a phenomenological inquiry into integrating suicide intervention in home-delivered meal service contexts

OBJECTIVES

Late-life suicide is a public health concern, yet many older adults do not have access to traditional mental health services. The present study sought to explore how suicide intervention is integrated into home-delivered meal (HDM) contexts following volunteer training in an evidence-based suicide first responder program.

METHODS

Using phenomenological inquiry, we examined the experiences of 20 HDM volunteers trained in ASIST.

RESULTS

Three primary themes emerged: (a) Logistics influencing integration of Suicide Intervention into HDM Systems, describing HDM program logistics; (b) Intrapersonal Context, describing HDM volunteer characteristics influencing intervention utilization and HDM client concerns; and (c) Interpersonal Context, describing HDM relationship characteristics that influenced intervention utilization.

CONCLUSION

HDM and other nutrition services have potential for addressing late life suicide, particularly when volunteers best equipped to address risk receive training and HDM policies reflect the needs of their clients. Implications for HDM services, as well as the Aging Services Network, are discussed.

Association of Individual Behaviors With Infection Prevention Measures and COVID-19 Development: A Japanese Cross-Sectional Study

During the COVID-19 pandemic, people often modified their behaviors and performed individual infection control practices despite the uncertain effectiveness of these in preventing COVID-19. A cross-sectional study using a nationwide internet survey (Japan COVID-19 Society Internet Survey) was conducted from September 2022 through October 2022. The questionnaire consisted of individual-level social distancing behaviors and infection prevention measures, and COVID-19 vaccination status. A multivariate logistic regression was performed to determine factors associated with the diagnosis of COVID-19 in the last two months of the survey date. In total, 19,296 respondents were selected for the primary analysis. Of 19,296 respondents, those with COVID-19 diagnosed in the last two months were 1,909 (9.9%). Factors independently associated with a recent history of COVID-19 were meeting colleagues in person ≧ 1 per week (adjusted odds ratio [aOR] 1.72). The response of "never or rarely" to the question of taking out (i.e., dining in) foods was marginally associated with a recent history of COVID-19 (aOR 1.27). Most individual, infection prevention practices and behavioral modifications during the omicron variant phase of the pandemic did not substantially impact COVID-19 prevention in the community.

The relationship between fear of old age, loneliness and death anxiety in adults

BACKGROUND

The increase in the number of elderly people in the world, individuals' perspectives on older adults, and false beliefs and ideas about old age negatively affect adults in terms of ageing. This study was conducted to determine the relationship between fear of old age, loneliness and death anxiety in adults.

METHOD

This study, which was designed in a correlational cross-sectional descriptive model, was conducted with 1074 adult individuals living in one province in eastern Turkey. Data were collected using Personal Information Form, Fear of Old Age Scale, UCLA Loneliness Scale and Turkish Death Anxiety Scale. Data were analyzed using SPSS 25.0, AMOS 24.0, G*Power 3.1 statistical package programs.

RESULTS

In our study, it was determined that the model created in line with the hypotheses was compatible and the model fit indices were within the desired limits as χ2/df = 4.737, root mean square error of approximation = 0.05, comparative fit index = 0.93, goodness-of-fit index = 0.92, adjusted goodness-of-fit index = 0.90, IFI = 0.93. There is a significant relationship between loneliness and death anxiety (P < 0.05). There is a significant relationship between loneliness and fear of old age (P < 0.05). There is a significant relationship between death anxiety and fear of old age (P < 0.05). It was determined that death anxiety has a mediating role in the effect of loneliness on fear of old age (95% confidence interval: 0.112-0.226; P < 0.05).

CONCLUSION

As the level of loneliness increases, the level of death anxiety and fear of old age increases. Fear of old age also increases in the mediating role of death anxiety. It is recommended to conduct intervention studies to reduce fear of old age. Longitudinal study on fear of old age is recommended.

Patterns of peripartum depression and anxiety during the pre-vaccine COVID-19 pandemic

BACKGROUND

Pregnant people are vulnerable to new or worsening mental health conditions. This study aims to describe prevalence and course of depression and anxiety symptoms in pregnancy during the pre-vaccine COVID-19 pandemic.

METHODS

This is a prospective cohort study of pregnant individuals with known or suspected COVID-19. Participants completed Edinburgh Postnatal Depression Scale (EPDS) and Generalized-Anxiety Disorder-7 (GAD-7) questionnaires, screening tools for depression and anxiety, at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum. Prevalence of elevated depressive and anxiety symptoms at each visit was described. Univariable logistic regression analysis was used to determine the association between demographic and clinical factors and those with elevated depression or anxiety symptoms.

RESULTS

317 participants were included. The prevalence of elevated antepartum depression symptoms was 14.6%, 10.3%, and 20.6% at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum, respectively. The rate of elevated anxiety symptoms was 15.1%, 10.0%, and 17.3% at 34weeks gestational age, 6-8weeks postpartum, and 6months postpartum, respectively. A prior history of depression and/or anxiety (p's < 0.03), as well as higher EPDS and GAD-7 scores at enrollment (p's < 0.04) associated with elevated depression and anxiety symptoms throughout pregnancy and the postpartum period. Quarantining during pregnancy was associated with elevated anxiety symptoms at 34weeks gestational age in univariate (P = 0.027) analyses. COVID-19 diagnosis and hospitalization were not associated with elevated depression or anxiety symptoms.

CONCLUSIONS

Elevated depression and anxiety symptoms were prevalent throughout pregnancy and the postpartum period, particularly in those with prior depression and/or anxiety and who quarantined. Strategies that target social isolation may mitigate potential adverse consequences for pregnant people, and continued vigilance in recognition of depression and anxiety in pregnancy should be considered.

Social isolation and mental well-being among Korean older adults: a focus on living arrangements

Introduction

The aging population in South Korea, characterized by an increasing number of older adults living alone, has raised concerns about its implications on mental health, specifically social isolation and loneliness that accompanies solitary living arrangements. This study explores the impact of living arrangements on the mental well-being of Korean older adults by focusing on the prevalence of depression and the role of social isolation in the context of evolving family structures and the COVID-19 pandemic.

Methods

This cross-sectional study analyzed the responses of older adults aged 65 years and above (mean: 73.1, SD: 5.1) by using data from the Korea National Health and Nutrition Examination Survey conducted in 2018 and 2020. In total, responses from 3,365 older adults (1,653 in 2018 and 1,712 in 2020) were employed in this research. The participants' mental health status was assessed using the Patient Health Questionnaire-9, with living arrangements categorized by household size. A zero-inflated Poisson regression analysis was employed to investigate the relationship between living arrangements and depression severity, controlling for demographic, socioeconomic, and psychological factors.

Results

The study found that older adults living with others exhibited a lower depression severity than those living alone. Notably, the severity of depression decreased as the number of household members increased up to a certain threshold. Socio-economic factors, such as income level, marital status, and psychological stress were also identified as significant predictors of depression severity. However, the COVID-19 pandemic did not have a statistically significant impact on depression rates among older adults during the study period.

Conclusion

Living arrangements play a critical role in the mental health of Korean older adults, with solitary living being associated with higher levels of depression. These findings underscore the importance of social support systems and suggest the need for policies and interventions that promote social connectivity and address the challenges of loneliness faced by them. Future research should explore longitudinal and qualitative studies to further understand causal relationships and develop targeted interventions to improve the mental well-being of the aging population.

A population health approach to workplace mental health: rationale, implementation and engagement

Objectives

To describe a population health-based program to support employee and dependent mental health and learn from engagement trends.

Methods

Retrospective analysis of a program utilizing an assessment of mental health risk. For scoring "at risk," a Care Concierge is offered to connect users with resources.

Results

Participation was offered to 56,442 employees and dependents. Eight thousand seven hundred thirty-one completed the assessment (15%). Of those, 4,644 (53%) scored moderate or higher. A total of 418 (9%) engaged the Care Concierge. Factors that negatively influenced the decision to engage care included bodily pain, financial concerns. Positive influences were younger age, high stress, anxiety, PTSD and low social support.

Conclusion

Proactive assessment plus access to a Care Concierge facilitates mental healthcare utilization. Several factors influence likelihood to engage in care. A better understanding of these factors may allow for more targeted outreach and improved engagement.

Effect of COVID-19 pandemic on lifestyle and bone mineral density in young adults

OBJECTIVES

This study investigates the relationships between the COVID-19 pandemic, lifestyle factors, and their impact on bone mineral density in the radius forearm bone and the total bone mineral content in young adults from Slovakia.

METHODS

We assessed 773 Slovak young adults aged 18 to 30 years, divided into subgroups on their pandemic status. Bone mineral density (BMD) was analyzed by the QUS device (Sunlight MiniOmni™), and bone mineral content (BMC) and fat mass (FM) were measured by InBody 770 bioimpedance analyzer. Finally, linear regression analysis tested the associations.

RESULTS

Statistically significant lower speed of sound (SOS) along the length of the forearm radius bone and Z-score values was determined in participants during the COVID-19 pandemic than before it, and statistically significant lower BMC values were observed in the male group during COVID-19 than beforehand. Regression analysis confirmed the negative pandemic effect in the following indices: SOS (p < .001 for women and p = .035 for men), Z-score (p < .001 for women and p = .003 for men), and BMC (p = .024 for men). Vitamin D was a further significant SOS predictor in women at p = .029, but this association was not detected in men. In contrast, the significant male BMC predictors were pandemic presence (p = .028), physical activity (p = .028), and fat mass percentage (p = .001).

CONCLUSIONS

Significant COVID-19 pandemic effects on bone tissue were determined on bone mass density in the radius forearm bone and the total bone mineral content. These effects establish that the pandemic had a negative impact on both their bone quality and health.

Association of licensure and relationship requirement waivers with out-of-state tele-mental health care, 2019-2021

During the COVID-19 public health emergency, states waived in-state licensure and pre-existing patient-physician relationship requirements to increase access to care. We exploit this state telehealth policy variation to estimate the association of in-state licensure requirement waivers and pre-existing patient-physician relationship requirement waivers with out-of-state tele-mental health care utilization of patients diagnosed with COVID-19. Using claims from January 2019 until December 2021 of 2 037 977 commercially insured individuals in 3 metropolitan statistical areas (MSAs) straddling Midwestern state borders, we found increased out-of-state telehealth utilization as a share of out-of-state mental health care by 0.1411 and 0.0575 visits per month or 1679.76% and 467.48% after licensure and relationship waivers, respectively. Within-MSA analyses illustrate an urban-rural digital divide in out-of-state utilization as a share of total or telehealth mental health care. Our findings indicate waivers primarily enhance access to care of established patients by enabling the transition of in-person out-of-state health care online. Interstate medical licensure compact participation may provide broader access to out-of-state tele-mental health care than emergency waivers.

Anticipatory worry and returning to campus during the COVID-19 pandemic

BACKGROUND

Assessing the psychological needs of students and employees as they return to campus is crucial to resuming University life in a safe and secure way. The current research aimed to explore how safety concerns, anticipatory worry, and mitigation efforts affected the well-being of individuals within a campus community.

METHODS

A five-part survey was distributed via student & employee listservs in the Fall 2020 at a midsize private university in the Mid-Atlantic Mid-Atlantic United States. Participants were surveyed about sources of worry regarding Covid-19, levels of anticipatory worry, amenability to various mitigation strategies and whether intended implementation of safety mitigation measures impacted worry levels.

RESULTS

Data collected from 559 students and employees indicated a relationship between source of worry and level of distress, with the greatest source of worry being fear of getting sick. Anticipatory worry after thinking about safety mechanisms was significantly lower than anticipated worry before thinking about safety mechanisms. No differences were found between students and employee experiences of worry, and there was no moderating effect of role on the difference between anticipated worry after, as compared to before, thinking about the mechanisms.

CONCLUSION

Findings highlight how different sources of concern related to Covid-19 are associated with varying levels of distress, the significant impact that the presence of mitigation strategies can have on reducing overall levels of anticipatory worry, and the universality of distress associated with Covid-19.

Understanding and mitigating negative affect in preventive health behaviors: Evidence from the COVID-19 vaccination process

The study investigated the willingness for vaccine uptake during the COVID-19 pandemic (April-June 2021), and explored the effect of both mindfulness and health education in managing negative affect post-vaccination. In study 1, a sample of 468 Chinese college students completed a one-time survey, assessing loneliness, stress, medical fear, and vaccination likelihood. Results showed that medical fear mediated the relationship between loneliness, stress and vaccination likelihood. In study 2, 70 college students were randomly assigned to one of three intervention conditions (mindfulness, health education, and control) during vaccination. Participants in mindfulness group showed lower negative affect scores than the control group post-intervention (p = 0.019). However, no significant difference was reported between health education with the other two conditions. As such, medical fear would be an important factor to target for improving the likelihood of vaccine uptake. Furthermore, a short mindfulness intervention was effective to improve experience of vaccination through mitigating negative affect.

Tracking collective emotions in 16 countries during COVID-19: a novel methodology for identifying major emotional events using Twitter

Using messages posted on Twitter, this study develops a new approach to estimating collective emotions (CEs) within countries. It applies time series methodology to develop and demonstrate a novel application of CEs to identify emotional events that are significant at the societal level. The study analyzes over 200 million words from over 10 million Twitter messages posted in 16 countries during the first 120 days of the COVID-19 pandemic. Daily levels of collective anxiety and positive emotions were estimated using Linguistic Inquiry and Word Count's (LIWC) psychologically validated lexicon. The time series estimates of the two collective emotions were analyzed for structural breaks, which mark a significant change in a series due to an external shock. External shocks to collective emotions come from events that are of shared emotional relevance, and this study develops a new approach to identifying them. In the COVID-19 Twitter posts used in the study, analysis of structural breaks showed that in all 16 countries, a reduction in collective anxiety and an increase in positive emotions followed the WHO's declaration of COVID-19 as a global pandemic. Announcements of economic support packages and social restrictions also had similar impacts in some countries. This indicates that the reduction of uncertainty around the evolving COVID-19 situation had a positive emotional impact on people in all the countries in the study. The study contributes to the field of CEs and applied research in collective psychological phenomena.

Community Members' Perceptions of a Resource-Rich Well-Being Website in California During the COVID-19 Pandemic: Qualitative Thematic Analysis

BACKGROUND

To address needs for emotional well-being resources for Californians during the COVID-19 pandemic, the Together for Wellness/Juntos por Nuestro Bienestar (T4W/Juntos) website was developed in collaboration with multiple community partners across California, funded by the California Department of Health Care Services Behavioral Health Division federal emergency response.

OBJECTIVE

This qualitative study was designed to explore and describe the perspectives of participants affiliated with California organizations on the T4W/Juntos website, understand their needs for web-based emotional health resources, and inform iterative website development.

METHODS

After providing informed consent and reviewing the website, telephone interviews were conducted with 29 participants (n=21, 72% in English and n=8, 28% in Spanish) recruited by partnering community agencies (October 2021-February 2022). A 6-phase thematic analysis was conducted, enhanced using grounded theory techniques. The investigators wrote reflexive memos and performed line-by-line coding of 12 transcripts. Comparative analyses led to the identification of 15 overarching codes. The ATLAS.ti Web software (ATLAS.ti Scientific Software Development GmbH) was used to mark all 29 transcripts using these codes. After examining the data grouped by codes, comparative analyses led to the identification of main themes, each with a central organizing concept.

RESULTS

Four main themes were identified: (1) having to change my coping due to the pandemic, (2) confronting a context of shifting perceptions of mental health stigma among diverse groups, (3) "Feels like home"-experiencing a sense of inclusivity and belonging in T4W/Juntos, and (4) "It's a one-stop-shop"-judging T4W/Juntos to be a desirable and useful website. Overall, the T4W/Juntos website communicated support and community to this sample during the pandemic. Participants shared suggestions for website improvement, including adding a back button and a drop-down menu to improve functionality as well as resources tailored to the needs of groups such as older adults; adolescents; the lesbian, gay, bisexual, transgender, and queer community; police officers; and veterans.

CONCLUSIONS

The qualitative findings from telephone interviews with this sample of community members and service providers in California suggest that, during the COVID-19 pandemic, the T4W/Juntos website was well received as a useful, accessible tool, with some concerns noted such as language sometimes being too "professional" or "clinical." The look, feel, and content of the website were described as welcoming due to pictures, animations, and videos that showcased resources in a personal, colorful, and inviting way. Furthermore, the content was perceived as lacking the stigma typically attached to mental health, reflecting the commitment of the T4W/Juntos team. Unique features and diverse resources, including multiple languages, made the T4W/Juntos website a valuable resource, potentially informing dissemination. Future efforts to develop mental health websites should consider engaging a diverse sample of potential users to understand how to tailor messages to specific communities and help reduce stigma.

The growing interdisciplinarity of developmental psychopathology: Implications for science and training

The field of developmental psychopathology has grown exponentially over the past decades, and has become increasingly multifaceted. The initial focus on understanding abnormal child psychology has broadened to the study of the origins of psychopathology, with the goals of preventing and alleviating disorder and promoting healthy development. In this paper, we discuss how technological advances and global events have expanded the questions that researchers in developmental psychopathology can address. We do so by describing a longitudinal study that we have been conducting for the past dozen years. We originally planned to examine the effects of early adversity on trajectories of brain development, endocrine function, and depressive symptoms across puberty; it has since become an interdisciplinary study encompassing diverse domains like inflammation, sleep, biological aging, the environment, and child functioning post-pandemic, that we believe will advance our understanding of neurobehavioral development. This increase in the breadth in our study emerged from an expansion of the field; we encourage researchers to embrace these dynamic changes. In this context, we discuss challenges, opportunities, and institutional changes related to the growing interdisciplinarity of the field with respect to training the next generation of investigators to mitigate the burden of mental illness in youth.

Online peer-led intervention to improve adolescent wellbeing during the COVID-19 pandemic: a randomised controlled trial

BACKGROUND

The COVID-19 pandemic and associated lockdown measures have posed a major risk to young people's wellbeing, which might be ameliorated by peer-led programmes. Using a randomised controlled trial (ISRCTN registry, number ISRCTN77941736 https://doi.org/10.1186/ISRCTN77941736 ), we tested the short-term efficacy of an online peer-led intervention designed to equip young people with skills to support their mental health and wellbeing during the COVID-19 pandemic.

METHODS

Through schools and social media ads, we recruited one hundred young people (aged 16-18) in the UK, focusing on areas with the highest incidence of COVID cases. In December 2020, participants were randomly allocated (1:1) to immediate 5 day Coping during COVID course (n = 49) or a wait-list (n = 51) through a survey software automated randomisation tool. Our primary outcome was self-reported mental wellbeing, and secondary outcomes included self-reported social connectedness, coping skills, sense of purpose, self-esteem, and self-compassion. We also collected qualitative reports of participants' perceived impact of the course and intentions to use what they have learnt from the course in their life moving forward. Assessments were completed at baseline, 1 week post randomisation (primary endpoint), and 2-weeks post-randomisation.

RESULTS

Young people allocated to the peer-led intervention reported significantly greater wellbeing, social connectedness, coping skills, sense of purpose, self-esteem, and self-compassion 1 week and 2 weeks post-randomisation (medium-large effect sizes). Specific benefits to mental health, sense of purpose and connectedness were also emphasised in qualitative reports.

CONCLUSIONS

An online, peer-led intervention targeting youth wellbeing during the context of the COVID-19 pandemic brought benefits across a range of outcomes, suggesting that structured programmes that incorporate peer-to-peer support can be a valuable approach to promote young people's wellbeing and foster psychological resources during a health crisis.

Caregiving experiences of primary family caregivers caring for family members affected by COVID-19 during home isolation: A phenomenology study

During home isolation due to the coronavirus disease, family caregivers assumed the responsibility of caring for infected family members; however, the full extent of the difficulties and challenges they encountered remains unclear. This study applied a descriptive phenomenology approach, using semi-structured, one-on-one, in-depth interviews to explore the experiences of 16 primary family caregivers during home isolation amid the coronavirus disease. The key themes identified were as follows: (1) protecting family, comprising anxiety over preventing infection and bearing the responsibility of caregiving and a concern about the diagnosis; (2) seeking stability, encompassing the impact of epidemic control policies on daily routines, strategies to overcome obstacles caused by quarantine measures, and gathering resources and receiving support; and (3) reflections on life, including favoring love over discrimination, rediscovering oneself, cherishing family, and acknowledging personal growth and dedication. This study highlights that family members who took on caregiving roles due to obstacles or health risks faced significant pressure to protect their family members during isolation and actively sought professional consultation and acquired caregiving skills to enhance their confidence and adaptability.

Stemming the "ageism pandemic": A qualitative inquiry with older adults in residential care facilities during the Covid-19 outbreak

The Covid-19 pandemic added to collective concerns, making health risks salient especially for the older population. The health emergency exacerbated an already widespread negative representation of aging, and phenomena such as ageism. With the present qualitative inquiry, 21 episodic interviews were collected with the aim of understanding the experience of older adults in residential care facilities, exploring their ideas of aging and the viewpoints that helped them to respond to the pandemic successfully. A thematic analysis was conducted using NudIst software. The results show that participants described multiple personal and relational resources they used to cope with the pandemic, and they were able to express counter-narratives to the ideas of aging as coinciding with decline, and of lockdown as a source of distress alone. The paper concludes with reflections on the relevance of research capable of challenging unhelpful dominant discourses and averting the risk of them turning into negative prophecies.