Latent Patterns of Posttraumatic Stress Symptoms, Depression, and Posttraumatic Growth Among Adolescents During the COVID-19 Pandemic

Post-traumatic Reactions and Social-Emotional Competence Among Chinese High School Students Experiencing COVID-19 Lockdown: A Network Analysis

In the post-pandemic era, psychological traumas have emerged as major mental health issues. However, the post-traumatic reactions and their connections with social-emotional competence among high school students experiencing COVID-19 lockdown have not been adequately explored. This study aimed to reveal the characteristics of their positive and negative post-traumatic reactions, and their connections with social-emotional competence. Network analysis was used on data from 1096 Chinese high school students who experienced COVID-19 lockdown. Measures included the DSECS-S, the PTGI and the PC-PTSD-5. The results revealed that "Valuing life" and "Recalling unwillingly" were identified as core factors of post-traumatic reactions, while "Having close friendships", "Getting along well with others" and "Respecting others' emotions" played a bridging role in connecting the communities of social-emotional competence and post-traumatic reactions. This study enriches research on post-traumatic reactions, emphasizing the importance of implementing social-emotional competence programs to tackle mental health crises.

Assessing Post-traumatic Stress Disorder and Social Determinants Among COVID-19 Case-Contact Dyads in Household Settings

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a contagious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The COVID-19 outbreak raised several public and mental health concerns including tremendous psychological distress.

AIM

To assess post-traumatic stress disorder (PTSD) among COVID-19-positive patients and household contacts and to determine the socio-demographic factors associated with PTSD in the study population.

METHODS

A cross-sectional study was conducted among COVID-19-positive patients and their family members in Ernakulam district. A daily list of COVID-19-positive patients was obtained from the district officials. Confirmed cases and their close contacts in households were contacted over telephone and were interviewed after obtaining consent. Post-traumatic stress was assessed by the PTSD Symptom Scale - Interview Version (PSS-I-5) questionnaire.

RESULTS

There were 279 study participants, of whom 93 were COVID-19 positive and the remaining 186 were their contacts. More than a third (34, 36.6%) of cases suffered from PTSD while about a fifth (40, 21.5%) of contacts suffered from PTSD. Among cases, persons belonging to the below poverty line (BPL) had 2.9l (1.19, 7.24) times higher risk compared to those above poverty line (APL). Women also had a 2.8 (1.14, 7.01) higher odds compared to males. Among contacts, graduates had a 9.54 (95% CI: 1.84, 49.36) increased odds whereas homemakers were found to be protected (0.195 (0.06, 0.66)) against PTSD compared to the employed group.

CONCLUSIONS

Psychological counselling and support are essential for addressing PTSD among women and those living with BPL, as these groups are disproportionately affected.

Latent transition analysis on post-traumatic stress and post-traumatic growth among firefighters

Background: Firefighters, in the course of their professional responsibilities, confront an array of stressors contingent upon the distinctive characteristics of their duties.Objective: This study investigated the longitudinal impact of trauma incidents during duty on firefighters using latent transition analysis.Method: Data from 346 firefighters in South Korea who had experienced trauma events while on duty were utilized. Initially, latent groups were identified based on the relationship between post-traumatic stress disorder (PTSD) and post-traumatic growth (PTG). Groups were labelled based on the analysis of differences in PTSD, mental health, and growth-related factors among classified groups. Subsequently, transition probabilities and patterns from Time 1 to Time 2 were examined, followed by an investigation into variances based on demographic factors (gender, age) and occupational factors (work experience, shift pattern) using variance analysis and multinomial logistic regression analysis.Results: First, at Time 2, a five-group model was classified into 'Growth,' 'Resilience or Numbness,' 'Struggle,' 'Partial Struggle,' and 'PTSD' groups. Second, upon examining the transition patterns between latent groups, four patterns emerged: 'continued distress,' 'growth,' 'adaptation,' and 'escalated distress.' Third, the 'Struggle' group showed a 0% probability of transitioning to the 'Growth' group, whereas it displayed the highest probability among the groups transitioning to the 'PTSD' group. Fourth, latent transition analysis results showed a strong tendency for the 'Growth' group and 'Resilience or Numbness' group to remain in the same category. Fifth, age was found to be a significant factor affecting the transition of latent groups.Conclusion: This research represents the inaugural attempt to longitudinally investigate the interplay between PTSD and PTG among firefighters.

Italian university students' future time perspective and well-being during the COVID-19 pandemic

Introduction

During the COVID-19 pandemic, young adults worldwide showed signs of distress as they were affected in their specific developmental tasks, including the construction of personal and professional futures.

Methods

The present study aimed to assess the situational future time perspective of Italian university students during the second pandemic wave, as measured by an ad hoc constructed instrument, to explore its interaction with some dispositional traits relevant in future construction, such as optimism, sense of life, aggression, and dispositional future time perspective, and to test their effect on psychological well-being. The total sample consisted of 389 subjects (18-35 years, M = 23.5, SD = 4.4).

Results and discussion

The results indicated that the pandemic experience, assessed by surveying specific indicators, negatively affected the future time perspective of students, particularly those dispositionally optimistic and convinced that life has meaning. However, awareness of the negative impact that the pandemic brought to the vision of the future seems to have dampened the levels of depression and stress, while anxiety was found to be related only to dispositional traits. The results also suggested the need for educational and economic policies that help young adults develop confidence in the future and in their ability to build it.

'Life became harder with COVID-19': exploring the experiences of the COVID-19 pandemic among youth living in eThekwini district, South Africa

BACKGROUND

In South Africa, pervasive age and gender inequities have been exacerbated by the COVID-19 pandemic and public health response. We aimed to explore experiences of the COVID-19 pandemic among youth in eThekwini district, South Africa.

METHODS

Between December 2021-May 2022 we explored experiences of the COVID-19 pandemic on youth aged 16-24 residing in eThekwini, South Africa. We collated responses to the open-ended question "Has the COVID-19 pandemic affected you in any other way you want to tell us about?" in an online survey focused on understanding the pandemic's multi-levelled health and social effects. We used a thematic analysis to summarise the responses.

RESULTS

Of 2,068 respondents, 256 (12.4%, median age = 22, 60.9% women) completed the open-ended survey question (11% in isiZulu). Results were organized into three main themes encompassing (1) COVID-19-related loss, fear, grief, and exacerbated mental and physical health concerns; (2) COVID-19-related intensified hardships, which contributed to financial, employment, food, education, and relationship insecurities for individuals and households; and (3) positive effects of the pandemic response, including the benefits of government policies and silver linings to government restrictions.

CONCLUSIONS

We found that South African youth experienced significant grief and multiple losses (e.g., death, income, job, and educational) during the COVID-19 pandemic. Trauma-aware interventions that provide economic and educational opportunities must be included in post-COVID recovery efforts.

Serial Mediation Models of Future Anxiety and Italian Young Adults Psychological Distress: The Role of Intolerance of Uncertainty and Non-Pathological Worry

Previous research has already examined the relationship between Future Anxiety, a construct recently introduced in Italy, and mental health in young adults, although possible mediating variables in this relationship have so far never been investigated. The present study attempts to fill this gap by exploring the incidence of Future Anxiety on psychological distress (i.e., Stress, Anxiety and Depression) in a group of 302 young Italian adults (18-30 years; M = 21.9; SD = 2.6; 49.0% males; 51.0% females), presenting and evaluating the simultaneous mediating effect of Intolerance of Uncertainty and Non-Pathological Worry. Findings highlighted how Future Anxiety had a positive and significant direct effect on Stress and Depression, but not on Anxiety. In the three serial mediation models proposed, Intolerance of Uncertainty and Non-Pathological Worry mediated the relationship between Future Anxiety and mental health outcomes. The results also confirmed the hypothesized serial mediation effect by highlighting how young adults with greater Future Anxiety experienced more Intolerance of Uncertainty, which positively affected Non-Pathological Worry levels and, in turn, exacerbated psychological distress. Finally, results indicated that female participants experienced more Stress, Anxiety, and Depression in relation to Future Anxiety compared to males. Starting from the review of main references on this subject, the results discussed provide new insights for understanding youth psychological distress. Finally, practical implications for the design of supportive interventions for this study's target group are proposed.

Identifying patterns of multidimensional self-compassion in Chinese young adults: implications for longitudinal mental health outcomes during the pandemic

BACKGROUND

Self-compassion (SC), reflecting self-attitude and self-connectedness, has proven to be a modifiable factor in promoting mental health outcomes. Increasingly, SC is recognized as a multidimensional construct consisting of six dimensions, rather than a single dimension.

OBJECTIVES

First, this study adopted a person-centered approach to explore profiles of SC dimensions in Chinese young adults. Second, the study examined the predictive effects of SC profiles on mental health outcomes.

METHODS

In February 2020, young adults (N = 1164) were invited to complete the 26-item Neff's Self-Compassion Scale online. Three months later, the same subjects (N = 1099) reported their levels of depressive symptoms, posttraumatic stress disorder (PTSD) symptoms, and posttraumatic growth (PTG).

RESULTS

After controlling for retrospective ACEs, four classes best characterized the profiles: self-compassionate (26.7%, N = 294), self-uncompassionate (12.3%, N = 135), average (55.9%, N = 614), and detached groups (5.1%, N = 56). Young adults in the self-compassionate group adjusted the best (with the highest level of PTG and the lowest levels of depressive and PTSD symptoms). Adults in the self-uncompassionate group demonstrated the poorest mental health outcomes (with the lowest level of PTG and the highest levels of depressive and PTSD symptoms). Young adults in the average group obtained more PTG than adults in the detached group (p < .01), but did not differ significantly in depressive and PTSD symptoms (p > .05).

CONCLUSION

The compassionate profile is the most adaptable for young adults among all groups. This study highlights the limitations of representing the relative balance of SC with a composite score.

Relationship impacts of the COVID-19 pandemic and lockdown restrictions on young women and men in Durban and Soweto, South Africa

To deepen our understanding of the impact of the COVID-19 pandemic on intimate and/or sexual relationships, we conducted a qualitative study among 26 South African women and men aged 21-30 years in Durban and Soweto between September 2020 and March 2021. Overall, 13 women and 12 men who had been in an intimate and/or sexual relationship since the start of the COVID-19 pandemic were asked about the impact of COVID-19 on their relationships with their current or most recent primary partners. Data were analysed using reflexive thematic analysis. The three most common impacts of the COVID-19 pandemic on relationships were on (i) communication and connection; (ii) strained relationships; and (iii) job and economic loss. Both women and men discussed how COVID-19-related lockdowns provided opportunities to foster better communication, connection and support to one another. However, too little or too much time together strained relationships. Finally, income loss among young men meant that some young women became the primary income earner, changing relationship power dynamics. Findings highlight the importance of young people's relationships and the need for action to support young people in building positive relationships in challenging times.

Types of co-occurring patterns of mental health among the disaster victims in South Korea

This study examined co-occurring patterns of mental health among disaster victims using latent profile analysis and assessed the difference between sociodemographic factors and protective factors that affect group classification. The data of 2300 disaster victims from 2019 (4th wave) NDMI (National Disaster Management Research Institute) for Long-term Survey on the Change of Life of Disaster Victims were analyzed. The latent profile analysis revealed that three profiles; High comorbid symptom (HCS) (6.2%), Medium comorbid symptom (MCS) (22.6%), and Low symptom (LS) (71.2%). The factors that explain the difference in this divided profile group were the type of disaster, hurt, income, age, elapsed years, resilience, and community resilience in the multinomial logistic regression. When individual resilience and community resilience are high, more effective in making people belong to the low comorbid symptom group. Therefore, there is a need for a strategy that promotes synergy between the two relationships while maintaining a dual focus point of view that fosters resilience at the individual and community level together.

Savoring mediates the mental health benefits of positive coping processes: A prospective population-based analysis

Positive coping (e.g., self-efficacy and positive reappraisal) and savoring could bear mental health implications under large-scale disasters such as COVID-19. The integrative affect-regulation framework of psychological resilience proposes that evaluative efforts regulate affect, which then predicts positive short-term consequences and better mental health. This two-wave study was done during the prolonged, intensive COVID-19 control rules in Hong Kong and examined (1) the prospective associations of positive coping processes (i.e., self-efficacy and positive reappraisal) (T1, March-August 2021) with subsequent psychiatric symptoms (T2, September 2021-February 2022) and (2) the mediating effect of T2 savoring in the associations. Path analyses revealed that T1 self-efficacy and positive reappraisal were inversely related to T2 psychiatric symptoms. T2 savoring partially mediated the effect of T1 self-efficacy but fully mediated the effect of T1 positive reappraisal. Self-efficacy could have more sustainable direct positive associations with mental health, whereas the benefit of positive reappraisal might need to be catalyzed by savoring over time. Our study offered concrete illustrations of the conceptual tenets of the affect-regulation framework.

Longitudinal Association Between Posttraumatic Stress Symptoms and Depression Symptoms Among Chinese Adolescents During COVID-19: Evidence from Network Perspective

Although there are an increasing number of studies that have explored the mental health consequences of COVID-19 focusing on revealing risk factors, the longitudinal research examining the potential mechanism of the co-occurrence of posttraumatic stress symptoms (PTSS) and depression symptoms among adolescents were scarce. The present study identified the important comorbidity symptoms and explored longitudinal relationship of PTSS and depression symptoms from the network perspective. A two-wave investigation (4 months interval; T1 and T2) was conducted with a sample of 1225 Chinese adolescents. Cross-sectional network and cross-lagged panel network (CLPN) analyses were adopted. Results showed that comorbidity symptoms consisted of both overlapping and non-overlapping symptoms, including "Future foreshortening" at T1 and T2 from PTSS, and "Hard to get started" at T1 and "Not sleep well" at T2 from depression symptoms. Strong longitudinal pathways appeared from all PTSS to depression symptoms, among which the pathway from "Difficulty concentrating" to "Hard to get started" was the strongest. These findings suggest that the possible comorbidity between PTSS and depression symptoms is caused by their independent and related structures, and their longitudinal association. Clinical intervention for these symptoms may alleviate adolescents' psychological problems in the aftermath of traumatic events.

The roles of parenting, resilience, and interpersonal relationships on adolescents' mental health and stress-related growth during COVID-19

BACKGROUND

The present longitudinal study investigated parenting style as a precursor for Chinese adolescents' stress-related growth and mental health difficulties during the COVID-19 pandemic, as well as the mediating roles of intrapersonal resilience and interpersonal relationships (i.e., peer and parent-adolescent).

METHODS

Chinese adolescents in a middle school (7th grade) and their parents in Beijing, China, were invited to complete a survey at two time points (T1: September 2020, T2: June 2021). A total of 206 adolescents (52.9% boys; Mage  = 12.90 years, SDage  = 0.33) and parents (17.5% fathers, 82.4% mothers; Mage  = 43.50 years, SDage  = 4.76 years) were included in this study.

RESULTS

Results showed that Chinese parents' authoritarian, not authoritative parenting, predicted adolescents' mental health difficulties nine months later. In addition, parent-adolescent relationships, but not peer relationships nor resilience, mediated the relations between parenting style and stress-related growth. Adolescents' resilience predicted fewer mental health difficulties.

CONCLUSION

It is important to target multiple ecologies (e.g., family) of adolescents for promoting positive adjustment.

Longitudinal profile of post-traumatic symptoms in HealthCare Workers during COVID-19 pandemic: A latent transition model

INTRODUCTION

Pandemics have the potential to be considered traumatic event, increasing the risk of developing post-traumatic stress symptoms (PTSS) in HealthCare Workers (HCW). However, few longitudinal studies have evaluated the impact of prolonged exposure to the risk imposed by COVID-19. Our aim was to identify subgroups of HCW with profiles of PTSS, how this profile changed during the pandemic and which variables were related to these changes.

METHODS

We evaluated the levels of PTSS and psychological distress in a Brazilian HealthCare Workers' sample (n = 1398) in three waves of assessment: from May to June 2020 (Wave 1), December 2020 to February 2021 (Wave 2) and May to August 2021 (Wave 3), using Latent Profile Analysis (LPA) to identify subgroups with different profiles of symptms, and then, Latent Transition Analysis (LTA) was applied to examine changes in symptom profiles over time, including gender, psychiatric diagnosis history, and pandemic-related fears as covariates.

RESULTS

two profiles were identified: high-PTSS profile (Wave 1-23%; Wave 2-64% and Wave 3-73%) and a low-PTSS (Wave 1-77%; Wave 2-36% and Wave 3-27%). Being female, fear of contamination, and fearing financial problems were strong predictors of changes in the profile. In addition, the participants had a high probability of being in the high-PTSS in the long run.

CONCLUSION

These results suggests that targeted interventions can mitigate the impact of pandemic. Providing financial support, and psychological support can be beneficial for those with psychiatric diagnoses and experiencing bereavement.

Predictors of pretraumatic stress during the COVID-19 pandemic in Poland

BACKGROUND

Pretraumatic stress has the same symptoms as post-traumatic stress but instead pertains to anticipated threats. There is evidence that pretraumatic stress occurs among soldiers and pregnant people.

OBJECTIVE

We analyzed correlates of pretraumatic stress concerning the threat of COVID-19 infection.

METHOD

Our pilot study was cross-sectional (N = 74); our main study was longitudinal and consisted of three waves (N = 1067, N = 894, and N = 752 for Waves 1, 2, and 3, respectively). Our pilot study used correlation and multiple linear regression. Our main study used quadratic regression and a random intercept cross-lagged panel model.

RESULTS

The pilot study found that pretraumatic stress was positively correlated with agreeableness (r = .24, p < .01) and negatively correlated with emotional stability (r = -.30, p < .01) and intellect/imagination (r = -.37, p < .01). The main study demonstrated that pretraumatic stress was positively correlated with other measures of mental health problems during the COVID-19 pandemic and with perceived positive aspects of the pandemic (r = .11, p < .01). There is evidence of a U-shaped relationship between pretraumatic stress and perceived positive aspects of the pandemic. A random intercept cross-lagged panel model analysis demonstrated that pretraumatic stress in Wave 2 was negatively predicted by levels of prosocial behavior in Wave 1 (B = -1.130, p < .01).

CONCLUSION

Mental health professionals should take into account pretraumatic stress, not only as a possible consequence of the COVID-19 pandemic outbreak but more generally as a risk in situations that are new, difficult, and challenging for people.

Post-traumatic stress disorders, anxiety, and depression in college students during the COVID-19 pandemic: a cross-sectional study

OBJECTIVES

The COVID-19 pandemic has caused an increase in psychiatric disorders in college students, particularly posttraumatic stress disorders (PTSD), depression, and anxiety. While existing studies assess the prevalence of these disorders and their predictors, they overlook potential complications caused by comorbidity between these disorders. To fill this gap, this study examined the prevalence of PTSD, depression, anxiety, and their comorbidity to inform targeted intervention for college students during the COVID-19 pandemic.

DESIGN

Self-report questionnaires were used to assess 6,898 college students about six months after the COVID-19 outbreak.

RESULTS

The results found that the prevalence of PTSD, depression, and anxiety were 15.5%, 32.2%, and 32.1% respectively, and the prevalence of comorbid PTSD and depression, comorbid PTSD and anxiety, comorbid depression and anxiety, and comorbid PTSD, depression, and anxiety symptoms were 11.5%, 11.6%, 20.4%, and 9.4% respectively. Moreover, left-behind status, lower economic status, previous trauma experiences, exposure to the pandemic, and rumination were risk factors of psychological distress, but self-disclosure was a protective factor for these disorders.

CONCLUSION

These results indicate that distinct psychiatric disorders may be comorbid in individuals, and are further influenced by pre-, within-, and post-disaster factors. Furthermore, psychological service targeted at college students should pay attention to comorbid symptoms rather than only symptoms of single disorders.

True grit and brain: Trait grit mediates the connection of DLPFC functional connectivity density to posttraumatic growth following COVID-19

BACKGROUND

There is increasing interest in identifying factors to predict posttraumatic growth (PTG), a positive psychological response following traumatic events (e.g., the COVID-19 pandemic). Grit, a psychological trait of perseverance and passion to pursue long-term goals, has emerged as a promising predictor for PTG. This study aimed to examine the functional connectivity markers of grit and the potential brain-grit mechanism in predicting PTG.

METHODS

Baseline brain imaging scans and grit scale and other controlling measures were administered in 100 normal young adults before the COVID-19 pandemic, and follow-up PTG measurement was obtained during the period of community-level outbreak. Whole-brain correlation analysis and prediction analysis were used to identify the brain regions whose functional connectivity density (FCD) related to individuals' grit scores. Mediation analyses were performed to explore the mediation relation between FCD, grit and PTG.

RESULTS

Grit was positively related to FCD in the right dorsolateral prefrontal cortex (DLPFC), a core hub implicated in self-regulation and reward-motivation processes. Furthermore, grit mediated the effect of right DLPFC FCD on COVID-related PTG. These results survived controlling for self-control and family socioeconomic status.

LIMITATIONS

Our study is limited by only one-session neuroimaging data and self-reported behavioral measures in a sample of normal adults.

CONCLUSIONS

This study indicates grit and right DLPFC FCD as neuropsychological contributors for the development of PTG. It deepens our understanding of the neural bases of grit, and may have clinical potential to develop targeted brain interventions aimed at improving grit to raise PTG and mental health during the pandemic.

Anxiety Levels and Coping Strategies to Deal with COVID-19: A Cross-Cultural Study among the Spanish and Latin American Healthcare Populations

Given its impact, COVID-19 has engendered great challenges in terms of health, highlighting the key role of health personnel. This study aims to analyze the level of anxiety, as well as coping strategies, among the health personnel in Latin American countries and Spain. An exploratory, descriptive, quantitative, cross-sectional study was conducted with 584 participants from the healthcare population. No significant differences were observed in anxiety levels due to COVID-19 between Latin American countries and Spain. In Spain, an active and passive coping style is used, while in Latin American countries, an avoidance coping style is employed; there is a direct correlation between anxiety levels and the avoidance coping style. There exists an inverse correlation between anxiety levels and the use of an active coping style; moreover, there are no significant differences in the anxiety level of health personnel depending on whether they have cared for patients with COVID-19. Low cognitive activity, use of the avoidance method and Spanish geography were the main predictive coping styles of anxiety. Effective measures are required for preserving the mental health of health professionals during pandemics.

Prevalence of mental health symptoms in children and adolescents during the COVID-19 pandemic: A meta-analysis

The COVID-19 pandemic and its accompanying infection control measures introduced sudden and significant disruptions to the lives of children and adolescents around the world. Given the potential for negative impacts on the mental health of youths as a result of these changes, we conducted a systematic review and meta-analysis to examine the prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances in children and adolescents during the pandemic. We searched major literature databases for relevant cross-sectional or longitudinal studies that included primary and secondary school students or children and adolescents ≤18 years of age. Prevalence values were extracted, logit-transformed, and pooled. Based on 191 included studies with 1,389,447 children and adolescents, we found the pooled prevalence of depressive symptoms, anxiety symptoms, and sleep disturbances to be 31%, 31%, and 42%, respectively. Age, grade levels, education levels, gender, geographical regions, and electronics use were correlated with the prevalence of mental health symptoms. The prevalence of mental health symptoms also increased with time, although signs of recovery and stabilization were also observed. Overall, the results from this review demonstrate the need for increased mental health research, monitoring, and intervention for children and adolescents during the current and future pandemics.

Growing amidst the COVID-19 pandemic: The interplay among transformational leadership in government, public trust, and posttraumatic growth

Individuals may experience positive changes or gain growths after struggling with traumas or challenging circumstances such as the COVID-19 pandemic. This study aimed to assess potential levels of posttraumatic growth (PTG) of the general public during the COVID-19 pandemic and PTG's associations with perceptions of transformational leadership in local government and public trust. The data of a probability sample of 1011 community-dwelling adults (61.2% females; Mean age = 41.2 years, SD = 15.8) in Macao, China, were collected via a telephone poll survey. Multiple regression analyses were conducted and a bootstrapping approach was utilized to test the hypothesized moderating effects and mediating effects of trust in local government on the association between perceived transformational leadership and PTG, respectively. Results showed that about half of the respondents reported at least a medium level of PTG. Whereas perceived transformational leadership in the Macao local government was positively associated with four individual aspects of PTG (i.e., appreciation of life, new possibilities, personal strength, and relating to others) as well as the overall PTG, while controlling for the demographic variables, trust in the local government showed no moderating or mediating effects in these associations. Our findings suggest the value of governments’ transformational leadership in promoting people's PTG in the face of public crises such as COVID-19. More transformational leadership behaviors, such as attending to citizens’ personal needs and conveying an inspirational vision, in government are called for to bring about greater positive responses from individuals and ensure social vitality and resilience during this long-term public health battle.

The impact of family function on post-traumatic reactions of Chinese adolescents infected with COVID-19: a latent profile study

Background

Since the end of 2019, Corona Virus Disease 2019, also known as COVID-19, has broken out in various countries. However, the change of China's COVID-19 prevention and control policy and the sharp increase in the number of infected people are making the teenagers have post-traumatic reactions. Negative post-traumatic reactions include: post-traumatic stress disorder (PTSD), depression, anxiety. Positive post-traumatic reaction mainly refers to post-traumatic growth (PTG). The purpose of this study is to explore the post-traumatic reaction, which refers to PTSD, depression, anxiety and the co-occurrence pattern of growth after trauma and to further explore the influence of family function on different categories of Post-traumatic Reactions.

Methods

Latent profile analysis (LPA) was used to explore the co-occurrence of PTSD, depression, anxiety, and PTG. Multiple logistics regression was used to analyze the influence of family function on different categories of post-traumatic response.

Results

There were three categories of post-traumatic reactions in adolescents infected with COVID-19 adolescents infected with COVID-19, namely: growth class, struggling class, and pain class. Multivariate Logistic regression showed that the growth class and struggling class were affected by problem solving and behavior control in family function, while the growth class and pain class were affected by problem solving, roles, behavior control, and general functioning. Multiple logistic regression showed that the growth class and struggling class were affected by problem solving and roles.

Conclusions

The findings of this study provide evidence for the identification of high-risk individuals and the provision of effective interventions in clinical practice, as well as the influence of family functioning on the different categories of PTSD among adolescents infected with COVID-19.

Self-harm in Young People: Investigating the Role of Resilience and Posttraumatic Stress Related to the COVID-19 Pandemic

Evidence shows that young people may have experienced increased levels of posttraumatic stress and depression during the COVID-19 pandemic. However, the landscape on self-harm is still unclear. This study aimed to examine the role of COVID-19 related posttraumatic stress, depression and resilience as predictors of self-harm with and without suicidal intent. Participants were 625 young people aged 17-25 years old (M = 20.2 years, SD = 2.47). Resilience was measured using the self-reported Child & Youth Resilience Scale Measure - Revised (CYRM-R). Posttraumatic stress related to COVID-19 were measured using the Impact of Event Scale- Revised. Depression was measured using the depression subscale of the Depression, Anxiety and Stress Scale-21. Self-harm was evaluated with two dichotomous items. Participants reported high levels of depression and COVID-19 posttraumatic stress, and a significant percentage reported engaging in self-harm. Hierarchical logistic regressions showed that caregiver resilience decreased approximately 20% the odds of engaging in self harm with and without suicidal intent remaining a consistent predictor even after accounting posttraumatic stress and depression in the models. Posttraumatic stress and depression predicted a one-fold increase in the odds of engaging in self-harm with and without suicidal intent. However, posttraumatic stress was no longer a significant predictor when depression was entered in the model in self-harm without suicidal intent. The COVID-19 pandemic may have increased the likelihood of engaging in self-harm in young people. However, caregiver resilience seems to operate as a protective factor. This important finding carries implications beyond the context of the COVID-19 pandemic.

Examining the protective influence of posttraumatic growth on interpersonal suicide risk factors in a 6-week longitudinal study

Research has found an inverse relationship between posttraumatic growth (PTG) and suicidal ideation in military and community samples that holds when controlling for other suicide risk factors. However, further research is needed into the underlying mechanisms to clarify how PTG protects against the formation of suicidal ideation. The current two-wave longitudinal study examined whether perceiving PTG from recent adverse circumstances while in a national lockdown during the COVID-19 pandemic attenuated the positive relationship of two interpersonal suicide risk factors – perceived burdensomeness (PB) and thwarted belonginess (TB)–over 6 weeks. Participants (n = 170) were recruited online from Prolific from income-deprived areas in the United Kingdom (mean age = 37.65; SD = 12.50; 53.5% female). Post-hoc power analyses indicated we had insufficient power to examine the hypothesised mediation for TB. We examined whether PTG mediated the relationship between PB at wave 1 and wave 2 while controlling for depression and anxiety in a sample of individuals at-risk for suicidal ideation. PTG did significantly and partially mediate the positive relationship between PB at wave 1 and 2. We discuss the theoretical and clinical implications that could result if future research successfully replicates these initial exploratory findings.

Parent and Child Anxiety Evaluated During an Early Period of the COVID-19 Pandemic: A Mixed-Methods Study

Purpose

The objective of this study was to explore parent and child anxiety during the pandemic. Unlike previous pandemics, measures implemented to prevent the transmission of the SARS-CoV-2 virus have been much more limiting.

Methods

An explanatory convergent mixed-methods design was used to describe anxiety of children 9-17 years of age and their parents during August-October 2020. Adult and child versions of State-Trait Anxiety Inventory (STAI) were used to examine levels as measured on STAI's state-anxiety subscale. Web-based interviews with a subset of patients were conducted qualitatively to analyze anxiety-related themes.

Results

A total of 188 parents and 140 children responded to the questionnaires. Mean overall anxiety scores for parents (49.17 [standard deviation: 12.247]) and children (35.43 [standard deviation: 7.894]) were higher than published norms. Parent and child anxiety were positively correlated (r=0.36; P=0.01). From interviews with 11 parents and 11 children; 4 major themes and 10 subthemes describing physical and emotional outcomes resulting from limited social contact, work and family role strain, and uncertainty about COVID-19 were identified.

Conclusions

Parents and children reported elevated anxiety levels during the COVID-19 pandemic. Findings of this study can guide the development of strategies that mitigate the negative impact of isolation, role strain, and uncertainty related to future public health crises.

Core belief challenge moderated the relationship between posttraumatic growth and adolescent academic burnout in Wenchuan area during the COVID-19 pandemic

This study investigates the characteristics of posttraumatic growth (PTG) and academic burnout among adolescents in an ethnic minority area in China during the COVID-19 pandemic, and examines the moderating role of core belief challenge on the association between PTG and academic burnout. This study surveyed 941 secondary school students in Wenchuan using the posttraumatic growth inventory, adolescent academic burnout inventory, core beliefs inventory, and a self-designed demographic questionnaire. The results showed that: (1) Five months after the COVID-19 outbreak in China, the level of PTG among adolescents in the Wenchuan area was high and its prevalence was 32.3%. Among them, the dimension of perceived changes in self was the highest, and the PTG level of junior high school students was higher than that of high school students. The academic burnout level of adolescents, particularly emotional exhaustion, was also high. The academic burnout level of the high school students was higher than that of junior high school students. (2) There was a significant negative correlation between PTG and academic burnout among adolescents. (3) Core belief challenge moderated the relationship between PTG and academic burnout. PTG had a significant negative predictive effect on adolescents’ academic burnout only when the core belief challenge was above a moderate level. These results showed the uniqueness of PTG and psychological behavioral problems of adolescents in ethnic minority areas during the COVID-19 pandemic. They also emphasized the key role of core belief challenge in the process of PTG in reducing adolescents’ academic burnout. Based on these results, recommendations are provided to alleviate academic burnout among adolescents in Wenchuan against the background of the COVID-19 pandemic. While providing full play to ethnic minority cultural characteristics to promote posttraumatic growth, guiding adolescents’ value reflection and cognitive reconstruction should be focused on.

Posttraumatic Stress Disorder in Children in the Context of the COVID-19 Pandemic

With its global spread and protracted threat, mounting morbidity and mortality, pervasive social and economic ramifications, vital public health measures, and often compromised risk communication, the COVID-19 pandemic has increased the risk to children's emotional health relative to more common biological, natural, and man-made events. Posttraumatic stress disorder (PTSD) and PTSD symptoms have been the primary focus of child disaster mental health research. The adult literature has questioned the appropriateness of focusing on PTSD in the context of the COVID-19 pandemic, because most of the extensive adult research on PTSD has not appropriately assessed all diagnostic criteria for the disorder.¹ The pandemic experiences of participants in most studies examined in a recent review did not meet the PTSD exposure criterion,¹ which requires that exposure be "directly" experienced, witnessed in person, secondary to the involvement of a close family member or friend, or "repeated or extreme" contact with "aversive details" of the event.² Instead, participants' experiences were primarily indirect (eg, media contact) and constituted fear related to contracting the disease.¹ This concern extends to the relatively few empirical COVID-19 studies of PTSD in children and exemplifies a problem in many child disaster mental health studies, especially those assessing general population samples that primarily comprise children who do not meet the PTSD exposure criterion.

Prospective examination of adolescent emotional intelligence and post-traumatic growth during and after COVID-19 lockdown

OBJECTIVES

While there have been some studies examining the post-traumatic growth (PTG) responses to the COVID-19 pandemic, few have been longitudinal studies exploring the changes over time or examining the underlying psychological PTG mechanisms. This study examined whether baseline perceived emotional intelligence (EI) predicted PTG through self-esteem and emotional regulation (ER) in a five-month follow-up study conducted on Chinese adolescents during the COVID-19 pandemic.

METHODS

Validated measures were completed by 2090 participants, which assessed both the perceived EI and the PTG 1 month after a nationwide lockdown in China, with 1609 of these participating in the follow-up five months later. Structural equation models (SEM) were then used to explore the paths between the variables.

RESULTS

As hypothesized, the follow-up survey found that the baseline perceived EI predicted PTG, ER, and self-esteem outcomes. The SEM analyses also revealed that self-esteem and ER significantly mediated the association between EI and PTG.

LIMITATIONS

Studies of three or more waves may be more suitable for longitudinal mediation analyses. Self-assessment reports may have subjective effects.

CONCLUSIONS

It was concluded that perceived EI might improve PTG in adolescents following the COVID-19 pandemic, and self-esteem and ER program training could be helpful in promoting PTG.

Children's Mental Health During the First Two Years of the COVID-19 Pandemic: Burden, Risk Factors and Posttraumatic Growth - A Mixed-Methods Parents' Perspective

The COVID-19 pandemic and the accompanying containment measures such as physical distancing and school closures led to major changes in children's everyday lives. By means of a mixed-methods study, the "Tyrolean COVID-19 Children's Study" investigated the effects of the pandemic and factors influencing mental health and health-related quality of life of North Tyrolean (Austria) and South Tyrolean (Italy) children aged 3-13 years. Parents filled out N = 2,691 online questionnaires (951 preschool children: 3-6 years; 1,740 schoolchildren: 7-13 years) at four measurement time points (March 2020, December 2020, June 2021, December 2021). For both age groups, children's mental health outcomes (internalising problems, posttraumatic stress symptoms) were worse in December 2021 (t4) than children's mental health outcomes in March 2020 (t1). With regard to aggressive behaviour, this difference was only found among schoolchildren. Thematic analysis of an open ended, written question revealed the following positive changes in children during the Corona crisis: (1) the importance of intra- and extra-familial relationships, (2) new competences and experiences, (3) values and virtues, (4) use of time, and (5) family strength. Using multilevel modelling, threat experience, economic disruption, and perceived posttraumatic growth were shown to be the strongest predictors of all outcomes. Additionally, male gender was shown to be a predictor of aggressive behaviour. In terms of age, schoolchildren showed more internalising problems, aggressive behaviour, and threat experience than preschool children. With regard to time, parents in December 2021 reported more threat experience in older children and less perceived posttraumatic growth in both older and younger children, than parents at the beginning of the pandemic. Targeted support for vulnerable children may prevent longer-term development of psychopathologies and contribute to society's psychosocial resilience in the current COVID-19 pandemic. Moreover, sustainable promotion of children's posttraumatic growth can also contribute to children's mental health and could even offer a chance to turn the crisis into an opportunity.

Post accidental injury: Mediating roles of emotional expressivity, rumination, and posttraumatic growth

This study explored the relationship between rumination (deliberate or intrusive), emotional expressivity (positive or negative), and posttraumatic growth among patients within 1 month after an accidental injury. Using a cross-sectional design, 313 patients were investigated in two comprehensive hospitals. The results revealed that intrusive rumination had a significant positive effect on posttraumatic growth, partly through four different pathways: (i) the mediating role of deliberate rumination; (ii) the chain mediating role of deliberate rumination and negative emotional expressivity; (iii) the chain mediating role of negative emotional expressivity and positive emotional expressivity; and (iv) the chain mediating role of negative emotional expressivity, positive emotional expressivity, and deliberate rumination. Interventions to encourage emotional expressivity and facilitate the transition from intrusive rumination to deliberate rumination may promote posttraumatic growth soon after an accidental injury.

Post-Traumatic Stress Disorder, Mobile Phone Dependence, and Academic Boredom in Adolescents During the COVID-19 Pandemic

Background: The coronavirus disease (COVID-19) pandemic has threatened adolescents’ mental health and even elicited their academic problems. Post-traumatic stress disorder (PTSD) is one of the most common negative psychological reactions, and academic boredom is a typical academic problem to the pandemic. PTSD might be related to academic boredom, but the underlying mechanism of this potential relation in the context of the COVID-19 pandemic remains unclear.

Aims: Under the framework of the job demands–resources model and the model of compensatory internet use, this study aims to examine the mediating role of mobile phone dependency in the relation between PTSD and academic boredom.

Methods: Six hundred and thirty-one middle school students in Hubei Province were investigated using self-report questionnaires. SPSS19.0 and Mplus7.0 were used for data analysis.

Results: PTSD symptoms were associated positively with academic boredom, and mobile phone dependence played a mediating role in the relation between PTSD and academic boredom. Specifically, adolescents with severe PTSD symptoms tended to report greater dependency on mobile phones, and hence show higher levels of boredom in learning.

Conclusion: PTSD symptoms of adolescents directly aggravated their academic boredom, and indirectly affected academic boredom by increasing their dependence on mobile phones.