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Rask CU, Duholm CS, Poulsen CM, Rimvall MK, Wright KD. Annual Research Review: Health anxiety in children and adolescents-developmental aspects and cross-generational influences. J Child Psychol Psychiatry 2024; 65:413-430. [PMID: 37909255 DOI: 10.1111/jcpp.13912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 11/03/2023]
Abstract
Health anxiety involves excessive worries about one's health along with beliefs one has an illness or may contract a serious disease. Concerning evidence suggests that health anxiety is on the rise in society, possibly further fueled by the COVID-19 pandemic. Recent classification systems acknowledge that impairing health-related worries and beliefs can emerge in early childhood with significant levels of symptoms persisting throughout childhood, and possibly continuous with diagnostic considerations in adulthood. This narrative review summarizes recent research advances in health anxiety in children and adolescents, focusing on various developmental aspects of health anxiety and related concepts in youths. Findings suggest that health anxiety symptoms in young age groups are associated with impairment, distress, and increased healthcare use, as well as substantial comorbidity with mainly other emotional problems and disorders. Furthermore, longitudinal studies suggest that childhood health anxiety can persist across adolescence, perhaps with links to chronic courses in adulthood. The growing literature was further reviewed, thus extending our understanding of early risk factors, including the potential role of exposure to serious illness and transgenerational transmission of health anxiety. Learning more about developmental trajectories will be highly relevant to inform strategies for early detection and prevention. While modified cognitive behavioral therapies in adults are successful in treating health anxiety, specific interventions have not yet been tested in youths. Given substantial overlaps with other psychopathology, it could be important to develop and explore more transdiagnostic and scalable approaches that take advantage of common factors in psychotherapy, while also including a wider perspective on potential familiar maladaptive illness cognitions and behaviors.
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Affiliation(s)
- Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Charlotte Steen Duholm
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Martin Køster Rimvall
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Kristi D Wright
- Department of Psychology, University of Regina, Regina, SK, Canada
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Dalgaard IK, Rask CU, Bilenberg N, Hulgaard DR. Pandemic life in families with health anxiety symptoms, parental perspectives. Scand J Child Adolesc Psychiatr Psychol 2024; 12:23-32. [PMID: 38855577 PMCID: PMC11156484 DOI: 10.2478/sjcapp-2024-0003] [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: 06/11/2024] Open
Abstract
Background The covid-19 pandemic has influenced children and parents worldwide. The pandemic has also been suggested to especially affect and exacerbate health anxiety (HA) symptoms in children and adolescents. However, there is limited understanding of the potential mechanisms challenges of families where parents themselves experience mental health issues such as high degree of HA symptoms. Objective The aim of this study was to explore parental experiences of pandemic life in families with continuously high levels of HA symptoms during the covid-19 pandemic. Method Six parents, identified with high levels of HA symptoms, participated in qualitative individual semi-structured interviews. Interviews were analysed according to Interpretative Phenomenological Analysis principles. Results Three main themes emerged. Theme 1) "Anxious children in a pandemic world" explores how pandemic - independent child factors including anxious temperament may have influenced the child pandemic experience. Theme 2) "Parental influences on child anxiety" describes parental reflections on their possible influence on child anxious thoughts. Theme 3) "Living with pandemic guidelines and restrictions" demonstrates the varying parental experiences of interventions and how these may affect HA thoughts. Conclusion Parents who themselves experience HA symptoms see their children, who also experience HA symptoms, to be particularly susceptible and vulnerable to both content and rhetoric of pandemic information. These children may however, experience school lockdown to be anxiety relieving. Parents who themselves have illness-related fears may not see themselves as perpetuating for their child's anxious thoughts.
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Affiliation(s)
- Ida Kathrine Dalgaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Child and Adolescent Psychiatric Research Unit, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Niels Bilenberg
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Child and Adolescent Psychiatric Research Unit, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
| | - Ditte Roth Hulgaard
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Child and Adolescent Psychiatric Research Unit, Mental Health Services in the Region of Southern Denmark, University of Southern Denmark, Odense, Denmark
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Ushimoto T, Murasaka K, Sakurai M, Ishizaki M, Wato Y, Kanda T, Kasamaki Y. Physicians' Resilience as a Positive Effect of COVID-19. JMA J 2023; 6:365-370. [PMID: 37941699 PMCID: PMC10628123 DOI: 10.31662/jmaj.2022-0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 08/02/2023] [Indexed: 11/10/2023] Open
Abstract
People devoid of COVID-19 may exhibit mental health problems, such as anxiety disorders, depression, panic attack, insomnia, emotional disorder, and suicidal actions. Healthcare workers (HCWs) may also exhibit these problems. Physicians should be careful an "at-risk" population. Physicians revealed higher levels of resilience than the popular workers. Humans with stronger resilience have lower feeling of anxiety and depression. We investigated the risk to physicians from an infected environment to infected patients during the pandemic. The social and psychological support of all HCWs, particularly physicians, is significant in the fight against this pandemic. Physicians working with patients with COVID-19 should set enough time to relax, sleep, and spend time with family. Resilience in physicians facing COVID-19 can induce post-traumatic growth in the future.
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Affiliation(s)
- Tomoyuki Ushimoto
- Department of Emergency Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Kenshi Murasaka
- Department of Emergency Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Masaru Sakurai
- Department of Emergency Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Masao Ishizaki
- Department of Emergency Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Yukihiro Wato
- Department of Emergency Medicine, Kanazawa Medical University, Uchinada, Japan
| | - Tsugiyasu Kanda
- Department of Community Medicine, Kanazawa Medical University, Uchinada, Japan
- Department of General Medicine, Kanazawa Medical University Himi Municipal Hospital, Himi, Japan
| | - Yuji Kasamaki
- Department of Community Medicine, Kanazawa Medical University, Uchinada, Japan
- Department of General Medicine, Kanazawa Medical University Himi Municipal Hospital, Himi, Japan
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Agurto-Ramírez A, Pino-Rosón C, Ayala A, Falcón M, Rodríguez-Blázquez C, Forjaz MJ, Romay-Barja M. Association Between Pandemic Fatigue and Disease Knowledge, Attitudes, Concerns, and Vaccination Intention at Two Key Moments of the COVID-19 Pandemic. Int J Public Health 2023; 68:1606049. [PMID: 37822565 PMCID: PMC10563199 DOI: 10.3389/ijph.2023.1606049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 09/03/2023] [Indexed: 10/13/2023] Open
Abstract
Objective: This study aimed to describe the change in knowledge, attitudes, concerns, perceptions, preventive practices, and vaccination intention at two key time points of the COVID-19 pandemic and to assess whether these changes varied by level of pandemic fatigue. Methods: Data included in this study came from the third and the ninth round of the COSMO-Spain cross-sectional study. A general linear model was used to investigate the interaction terms between rounds and levels of pandemic fatigue. Results: Changes between rounds were observed in knowledge, attitudes, concerns, perceptions, behaviours, and vaccination intention. Significant interactions between rounds indicated that those with low levels of pandemic fatigue had a greater increase in knowledge, lower decrease in concerns, greater decrease in agreement with the decisions made, and lower increase in vaccination intention compared with those with high pandemic fatigue. Conclusion: As a pandemic evolves, it becomes necessary to consider the level of pandemic fatigue of the population and how this affects knowledge, concerns, and agreement with the measures adopted, as they influence the population's adherence to public health recommendations aimed at controlling infections and protecting the most vulnerable.
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Affiliation(s)
- Adriana Agurto-Ramírez
- Hospital General Universitario de Valencia, Valencia, Spain
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain
| | - Candela Pino-Rosón
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain
- Departamento de Medicina Preventiva e Saúde Pública, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Alba Ayala
- Unidad de Investigación en Cuidados y Servicios de Salud (Investén), Instituto de Salud Carlos III, Madrid, Spain
- Research Network on Chronic Diseases, Primary Care and Health Promotion (RICAPPS), Madrid, Spain
| | - María Falcón
- Departamento de Ciencias Sociosanitarias, Medicina Legal y Forense, Instituto Murciano de Investigación Biosanitaria (IMIB), Universidad de Murcia, Murcia, Spain
| | - Carmen Rodríguez-Blázquez
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Maria João Forjaz
- Research Network on Chronic Diseases, Primary Care and Health Promotion (RICAPPS), Madrid, Spain
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - María Romay-Barja
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spain
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Mertens G, Engelhard IM, Novacek DM, McNally RJ. Managing Fear During Pandemics: Risks and Opportunities. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2023:17456916231178720. [PMID: 37358917 PMCID: PMC10293863 DOI: 10.1177/17456916231178720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Fear is an emotion triggered by the perception of danger and motivates safety behaviors. Within the context of the COVID-19 pandemic, there were ample danger cues (e.g., images of patients on ventilators) and a high need for people to use appropriate safety behaviors (e.g., social distancing). Given this central role of fear within the context of a pandemic, it is important to review some of the emerging findings and lessons learned during the COVID-19 pandemic and their implications for managing fear. We highlight factors that determine fear (i.e., proximity, predictability, and controllability) and review several adaptive and maladaptive consequences of fear of COVID-19 (e.g., following governmental health policies and panic buying). Finally, we provide directions for future research and make policy recommendations that can promote adequate health behaviors and limit the negative consequences of fear during pandemics.
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Affiliation(s)
- Gaëtan Mertens
- Department of Medical and Clinical Psychology, Tilburg University
| | | | - Derek M. Novacek
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles
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Kupcova I, Danisovic L, Klein M, Harsanyi S. Effects of the COVID-19 pandemic on mental health, anxiety, and depression. BMC Psychol 2023; 11:108. [PMID: 37041568 PMCID: PMC10088605 DOI: 10.1186/s40359-023-01130-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/20/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic affected everyone around the globe. Depending on the country, there have been different restrictive epidemiologic measures and also different long-term repercussions. Morbidity and mortality of COVID-19 affected the mental state of every human being. However, social separation and isolation due to the restrictive measures considerably increased this impact. According to the World Health Organization (WHO), anxiety and depression prevalence increased by 25% globally. In this study, we aimed to examine the lasting effects of the COVID-19 pandemic on the general population. METHODS A cross-sectional study using an anonymous online-based 45-question online survey was conducted at Comenius University in Bratislava. The questionnaire comprised five general questions and two assessment tools the Zung Self-Rating Anxiety Scale (SAS) and the Zung Self-Rating Depression Scale (SDS). The results of the Self-Rating Scales were statistically examined in association with sex, age, and level of education. RESULTS A total of 205 anonymous subjects participated in this study, and no responses were excluded. In the study group, 78 (38.05%) participants were male, and 127 (61.69%) were female. A higher tendency to anxiety was exhibited by female participants (p = 0.012) and the age group under 30 years of age (p = 0.042). The level of education has been identified as a significant factor for changes in mental state, as participants with higher levels of education tended to be in a worse mental state (p = 0.006). CONCLUSIONS Summarizing two years of the COVID-19 pandemic, the mental state of people with higher levels of education tended to feel worse, while females and younger adults felt more anxiety.
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Affiliation(s)
- Ida Kupcova
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, Bratislava, 811 08, Slovakia
| | - Lubos Danisovic
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, Bratislava, 811 08, Slovakia
| | - Martin Klein
- Institute of Histology and Embryology, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, Bratislava, 811 08, Slovakia
| | - Stefan Harsanyi
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, Bratislava, 811 08, Slovakia.
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Han L, Bai H, Lun B, Li Y, Wang Y, Ni Q. The Prevalence of Fear of Childbirth and Its Association With Intolerance of Uncertainty and Coping Styles Among Pregnant Chinese Women During the COVID-19 Pandemic. Front Psychiatry 2022; 13:935760. [PMID: 35832593 PMCID: PMC9273116 DOI: 10.3389/fpsyt.2022.935760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/27/2022] [Indexed: 01/11/2023] Open
Abstract
Background Fear of childbirth (FOC) is one of the most common psychological symptoms among pregnant women and significantly relates to cesarean section, anxiety, and depression. However, it is not clear the prevalence and risk factors of FOC among Chinese pregnant women since the outbreak of the COVID-19 pandemic. Aims The objective of this study was to examine the associations between coping styles, intolerance of uncertainty, and FOC. Method From December 2021 to April 2022, a cross-sectional survey was conducted in two hospitals in China through convenient sampling. The cross-sectional survey was conducted among 969 pregnant women, which included the Childbirth Attitude Questionnaire (CAQ), Intolerance of Uncertainty Scale-12 (IUS-12), and Simplified Coping Style Questionnaire (SCSQ). Results The total prevalence of FOC was 67.8%. The percentages of women with mild (a score of 28-39), moderate (40-51), and severe FOC (52-64) were 43.6, 20.2, and 4.0%, respectively. The regression results indicated that primiparas, unplanned pregnancy, few spousal support, intolerance of uncertainty, and negative coping styles were significant risk factors of FOC. Women who adopt positive coping strategies experienced a lower level of childbirth fear. Conclusion These findings suggest that cultivating positive coping styles and obtaining sufficient childbirth information may be helpful for mothers' mental health. Regular screening assessment of perinatal psychological symptoms, such as the high level of intolerance of uncertainty and negative coping styles, should be adopted to reduce the risk of fear of childbirth.
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Affiliation(s)
| | - Hua Bai
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
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Friesen E, Michael T, Schäfer SK, Sopp MR. COVID-19-related distress is associated with analogue PTSD symptoms after exposure to an analogue stressor. Eur J Psychotraumatol 2022; 13:2127185. [PMID: 36353527 PMCID: PMC9640168 DOI: 10.1080/20008066.2022.2127185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: The COVID-19 outbreak in early 2020 was associated with an immediate increase in mental health problems in a significant percentage of the general population. Therefore, it is crucial to investigate how the COVID-19 pandemic - as a psychosocial stressor - affected the aetiological processes of mental disorders. Previous research has shown that stress potentiates associative (fear) learning and analogue symptoms of posttraumatic stress disorder (PTSD) and that analogue PTSD symptoms can emerge in response to associative learning. Objective: We investigated whether distress in response to the COVID-19 outbreak support the development of intrusions and rumination after exposure to a non-COVID-19-related analogue trauma. Moreover, we examined if these effects are mediated by the strength of associative learning during analogue trauma. Method: 122 undergraduate university students participated in an online experiment between March and July 2020. They completed questionnaires measuring distress and rumination related to the COVID-19 outbreak. On a subsequent day, they went through an associative learning task, in which neutral stimuli were paired with the appearance of a highly aversive film clip. Subjective ratings were assessed as indicators of associative learning. On the next day, participants documented film-related intrusions and rumination. Results: COVID-19-related distress but not rumination was associated with post-film intrusion and rumination load. These effects were mediated by associative learning. Conclusions: The current findings are in line with the assumptions that stress enhanced both associative learning and PTSD symptoms. Specifically, they indicate that prolonged psychosocial stress - like during the COVID-19 outbreak - is linked to individual differences in memory processing of aversive events. Further confirmatory research is needed to replicate these results.
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Affiliation(s)
- Edith Friesen
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Sarah K Schäfer
- Leibniz Institute for Resilience Research, Research Group Lieb, Leibniz Association, Mainz, Germany
| | - M Roxanne Sopp
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
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