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Gniewosz G. Clarifying the Links between Perceived Stress and Depressiveness: a Longitudinal Study of COVID-19's Effects on Adolescents in Germany. J Youth Adolesc 2024:10.1007/s10964-024-02012-8. [PMID: 38789874 DOI: 10.1007/s10964-024-02012-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 05/07/2024] [Indexed: 05/26/2024]
Abstract
Young people are navigating an increasingly uncertain and unstable social and economic environment, further complicated by COVID-19. Individual resources and vulnerabilities, such as mental health and sensitivity to stress, play a significant role in how well youth adapt to the career paths and living conditions altered by the pandemic, a dynamic that is not yet well understood. This study examined the role of COVID-19 on the intertwined relation between perceived stress and depressiveness (negative and positive affect) in adolescents, focusing on gender differences. Longitudinal data from 673 German adolescents (Mage = 16.8 years, SDage = 0.91; female = 59%) were collected in three waves, before (T1) and during the pandemic (T2, T3). Using Latent Change Score models, the bidirectional relation between perceived stress and depressiveness was analyzed, considering gender as a moderator. The results showed that adolescents who found their situation stressful were at risk of developing depressiveness at the outbreak of the pandemic and throughout its progression. As the pandemic progressed, an increase in positive affect was linked to heightened perceived stress. Gender-specific differences were particularly evident in the levels of perceived stress and depressiveness, with women being more vulnerable. This study highlights how vulnerabilities in stress perception affect adolescents' mental health, with gender-specific differences underscoring the need for tailored mental health measures.
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Melicherova U, Schott T, Köllner V, Hoyer J. Behavioral activation for depression in groups embedded in psychosomatic rehabilitation inpatient treatment: a quasi-randomized controlled study. Front Psychiatry 2024; 15:1229380. [PMID: 38726384 PMCID: PMC11079813 DOI: 10.3389/fpsyt.2024.1229380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
Background Behavioral activation (BA) and cognitive-behavioral therapy (CBT) have shown to be efficacious treatment methods for depression. Previous studies focused mostly on the outpatient treatment either in group or individual setting. The present study aimed at comparing the efficacy of group treatment BA vs. CBT, when embedded in inpatient psychosomatic rehabilitation treatment. Methods 375 inpatients were randomly assigned to either BA (N = 174) or CBT (N = 201). We used established scales for depression such as the Beck Depression Inventory II (BDI-II, self-rating), the Quick Inventory of Depressive Symptomatology (QIDS; expert rating) and the Behavioral Activation for Depression Scale (BADS) to assess changes over the course of the treatment and at follow-up (4 to 6 months). In addition, we measured disability-related functioning with the Mini-ICF-APP, a rating scale built in reference to the International Classification of Functioning, Disability and Health (ICF). Multilevel models with repeated measures were conducted to examine the differences between groups in relation to change over time with patients' random effects. Results Both group formats showed substantial reduction in depressive symptoms at the end of treatment (d= 0.83 BA vs. d= 1.08 CBT; BDI-II) and at follow-up after 4 to 6 months (d = 0.97 BA vs. d = 1.33 CBT, BDI-II; and d = 1.17 BA vs. d = 1.09 CBT, QIDS). There were no significant differences between treatment approaches. At least 50% symptom reduction was achieved by 53.7% and 54.2% in BA vs. CBT respectively. Reported activation levels increased from pre- to posttreatment (d = 0.76 BA vs. d = 0.70CBT), while showing loss of increment between the end of the treatment until follow up in both formats (d = 0.28 BA vs. d = 0.29 CBT). Discussion Both modalities led to significant improvement of symptomatology and functioning at the end of the treatment and at follow-up, thus for the first time demonstrating the practicability of BA in rehabilitation clinics. Considering its lower requirements regarding cognitive abilities and its easier implementation, BA proved to be a good alternative to other psychotherapeutic treatments.
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Affiliation(s)
- Ursula Melicherova
- Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Schott
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Volker Köllner
- Psychosomatic Rehabilitation Research Group, Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité – Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychosomatic Medicine, Rehabilitation Center Seehof, Federal German Pension Agency Teltow, Teltow, Germany
| | - Jürgen Hoyer
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
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Kleine R, Galimov A, Hanewinkel R, Unger J, Sussman S, Hansen J. Impact of the COVID-19 pandemic on young people with and without pre-existing mental health problems. Sci Rep 2023; 13:6111. [PMID: 37059814 PMCID: PMC10103038 DOI: 10.1038/s41598-023-32918-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/04/2023] [Indexed: 04/16/2023] Open
Abstract
The objective was to examine pandemic-related changes in depression and anxiety symptoms in adolescents and young adults in Germany considering pre-existing depression and anxiety problems. In this cross-sectional study, 11,523 adolescents and young adults aged 14-21 years who perceived an impact of the Coronavirus disease (COVID-19) pandemic on their mental health reported the frequencies of depression and anxiety symptoms retrospectively for different pre-pandemic and pandemic phases. Data were collected using web-based questionnaires between January 5th and February 20th, 2022. Depression and anxiety were assessed with a modified version of the Patient Health Questionnaire (PHQ-4). Scale-fit cut-offs were used to identify pre-existing elevated depression and anxiety scores. Multilevel mixed linear models were conducted to assess changes in depression and anxiety symptoms from 2019 to 2021 and compare for age, gender and pre-pandemic mental health problems. Among young people who were experiencing mental health changes as a result of the pandemic, the frequency of depression and anxiety symptoms increased during the COVID-19 pandemic. This association was moderated by age, gender, and pre-existing elevated depression/anxiety scores. For young people without elevated pre-pandemic depression/anxiety, the scores increased strongly over time, with 61% reporting elevated depression symptoms and 44% reporting elevated anxiety symptoms in 2021. In contrast, self-perceived change was minimal for adolescents and young adults with elevated pre-pandemic depression and anxiety. Among young people whose mental health has been affected by the COVID-19 pandemic, the group without pre-pandemic mental health conditions reported greater deterioration than those with elevated pre-pandemic depression and anxiety scores. Thus, adolescents and young adults without pre-existing depression and anxiety problems who perceived a change in general mental health due to the pandemic reported an alarming increase in symptoms of depression and anxiety during the COVID-19 pandemic period.
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Affiliation(s)
- Ronja Kleine
- Institute for Therapy and Health Research, IFT-Nord, Harmsstraße 2, 24114, Kiel, Germany.
| | - Artur Galimov
- Keck School of Medicine, University of Southern California, 1845 N. Soto Street, Los Angeles, CA, 90033, USA
| | - Reiner Hanewinkel
- Institute for Therapy and Health Research, IFT-Nord, Harmsstraße 2, 24114, Kiel, Germany
| | - Jennifer Unger
- Keck School of Medicine, University of Southern California, 1845 N. Soto Street, Los Angeles, CA, 90033, USA
| | - Steve Sussman
- Keck School of Medicine, University of Southern California, 1845 N. Soto Street, Los Angeles, CA, 90033, USA
| | - Julia Hansen
- Institute for Therapy and Health Research, IFT-Nord, Harmsstraße 2, 24114, Kiel, Germany
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Paltrinieri S, Bressi B, Mazzini E, Fugazzaro S, Rondini E, Giorgi Rossi P, Costi S. Activities Carried Out during the First COVID-19 Lockdown by Italian Citizens. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3906. [PMID: 36900917 PMCID: PMC10001561 DOI: 10.3390/ijerph20053906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 06/18/2023]
Abstract
The SARS-CoV-2 pandemic has altered how citizens engage in activities. This study describes the new activities citizens engaged in during the first lockdown, factors that helped them cope with the confinement, the supports they used the most, and which supports they would have liked to receive. This cross-sectional study consists of an online survey made of 49 questions that was completed by the citizens of the province of Reggio Emilia (Italy) from 4 May until 15 June 2020. The outcomes of this study were explored by focusing on four of the survey questions. Of the 1826 citizens who responded, 84.2% had started new leisure activities. Males, participants who lived in the plain or foothills, and those who experienced nervousness engaged less in new activities, while those whose employment status changed, whose lifestyle worsened, or whose use of alcohol increased engaged in more activities. The support of family and friends, leisure activities, continuing to work, and an optimistic attitude were perceived to be of help. Grocery delivery and hotlines providing any type of information and mental health support were used frequently; a lack of health and social care services and of support in reconciling work with childcare was perceived. Findings may help institutions and policy makers to better support citizens in any future circumstances requiring prolonged confinement.
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Affiliation(s)
- Sara Paltrinieri
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
- Public Health Sciences PhD Program, Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
| | - Barbara Bressi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
- PhD Program in Clinical and Experimental Medicine, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41124 Reggio Emilia, Italy
| | - Elisa Mazzini
- Scientific Directorate Hospital Network, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Stefania Fugazzaro
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
| | - Ermanno Rondini
- Lega Italiana Contro i Tumori-LILT Reggio Emilia, 42123 Reggio Emilia, Italy
- Regional Center for Education in Health Promotion-Luoghi di Prevenzione, 42122 Reggio Emilia, Italy
| | - Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42122 Reggio Emilia, Italy
| | - Stefania Costi
- Physical Medicine and Rehabilitation Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, 42123 Reggio Emilia, Italy
- Department of Surgery, Medicine, Dentistry and Morphological Sciences, Università di Modena e Reggio Emilia, 41124 Modena, Italy
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Herzberg PY, Stender T, Dechmann JCG, Čolić J, Hoyer J. Do what matters, no matter what! Factorizing positive activities during COVID-19 lockdown. J Health Psychol 2022; 28:477-490. [PMID: 36124687 PMCID: PMC9490392 DOI: 10.1177/13591053221120967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Behavioral activation (BA) interventions systematically encourage positive and value-based activities. Engaging in them is an effective way to counteract negative affect, but it is unknown whether there are subtypes of activities that may have differential effects on mood. This study investigated the factorial structure of 99 potentially rewarding activities used in an online BA intervention during the COVID-19 lockdown. About 3624 German-speaking participants evaluated a list of 99 activities that were easy to apply. We analyzed the initially 99 activities by means of confirmatory factor analysis. Since activities can either be seen as reflective or formative indicators, a reflective as well as a formative model was analyzed. Although the range of chosen activities differed clearly between respondents, a one-factor model provided the best fit. It seems that a general "activity" factor is more important for explaining whether people choose a certain activity or not, than specific characteristics of the activity itself.
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Obschonka M, Gewirtz AH, Zhu L. Psychological implications of the COVID-19 pandemic around the world: Introduction to the special issue. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2021; 56:493-497. [PMID: 34286872 PMCID: PMC8427042 DOI: 10.1002/ijop.12793] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 01/30/2023]
Abstract
Although psychological researchers have long studied the implications of major crises, the outbreak and spread of the COVID‐19 pandemic have confronted the global community of psychologists and psychological researchers with new challenges. This special issue contributes to the growing empirical literature on the immediate psychological implications of the COVID‐19 pandemic. We present and discuss diverse work from authors that followed our call for papers in May 2020, shortly after the World Health Organisation declared COVID‐19 a global pandemic. The studies focus on the early phases of the pandemic by addressing (a) implications of the pandemic for psychological well‐being and mental health, (b) psychological effects of lockdown scenarios as well as (c) individual compliance with COVID‐19 prevention and intervention measures. We conclude by highlighting the need for new research efforts, with a special focus on low‐ and middle‐income regions, international research collaborations and cross‐cultural research designs.
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Affiliation(s)
| | - Abigail H Gewirtz
- University of Minnesota, St Paul, MN, USA.,Department of Psychology, Arizona State University, USA
| | - Liqi Zhu
- Chinese Academy of Science, Beijing, China
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