Anxiety during the Pandemic: Racial and ethnic differences in the trajectory of fear

Coping With Uncertainty: Use of Contemplative Practices Amid the COVID-19 Pandemic in the United States

Scant research has attempted to understand the use and frequency of contemplative practices across social groups of older adults in the context of uniquely uncertain and stressful circumstances, such as the COVID-19 pandemic. Using data from a nationwide web-based survey (n = 1861), we examined the change in the frequency of contemplative practices and variation across sociodemographic, health, and psychological status and we documented a significant increase in the use of prayer and meditation since the beginning of the pandemic. Minority groups and those with lower income reported praying longer than their counterparts. Respondents who were unmarried, women, and more educated were more likely to meditate, whereas lower-educated respondents were more likely to pray during the pandemic. Greater use of these practices was found among participants with higher anxiety. Our study offers much-needed guidance for future intervention studies to improve psychological well-being among diverse groups of older adults facing stressful circumstances.

Feeling Connected to Nature Attenuates the Association between Complicated Grief and Mental Health

Complicated grief (CG) predicts decreased mental health over time. Furthermore, feeling connected to nature (CN) is positively associated with beneficial mental health outcomes, such as psychological wellbeing and perceived psychological resilience. Thus, we hypothesized that CN moderates the association between general grief or CG and negative mental health for bereaved people. Further, we hypothesized that one's physical exposure to nature-that is, estimated time spent in nature and greenness (i.e., vegetation) surrounding one's residential area-might moderate the association between general grief or CG and negative mental health for bereaved people. To test these hypotheses, we conducted a cross-sectional study. We sampled 153 participants who experienced the death of a close other by COVID-19 infection. Participants reported CG, general grief, anxiety symptoms, depression symptoms, CN, estimated time spent in nature, and residential area postal code via a single online survey. We estimated greenness surrounding participants' residential areas using their self-reported five-digit U.S. postal code. Cross-sectional analyses indicated that, as predicted, CN attenuated the association between CG and depression, trended toward moderating the association between CG and anxiety, and did not moderate the associations between general grief and depression or anxiety. Other variables related to the experience of nature-the estimated time an individual spends in nature and the greenness surrounding one's residential area-did not moderate the association between general grief or CG and depression or anxiety. We thus conclude that a sense of feeling connected to nature-not simply spending more time in nature or being surrounded by nature-may serve an important role in the mental health status of people experiencing complicated grief, perhaps because CN replenishes general belonging when someone significant has passed away.

Demographic and COVID-19-Related Factors Associated with Depressive and Anxiety Symptoms Among African American and Latina Women in a Midwestern State

PURPOSE

The COVID-19 pandemic exacerbated racial and ethnic disparities among Latina and African American (AA) women, including risk factors for depression and anxiety. This study sought to identify demographic- and pandemic-related factors associated with depressive and anxiety symptoms in adult AA and Latina women living in a Midwestern state.

METHODS

Data for this secondary analysis of 1037 AA and Latina women were collected in May 2020 and June/July 2020. Participants completed an online survey about their demographic characteristics, job changes due to COVID-19, general concern about COVID-19, concern about the effects COVID-19 on their mental health, and whether they prayed to cope with COVID-19. Linear regressions with bootstrapping were conducted to determine associations.

RESULTS

Latinas had significantly higher depressive and anxiety symptoms than AA women. Older age was a buffer against depressive and anxiety symptoms. Women who anticipated a reduction in work hours or job loss had significantly higher depressive and anxiety symptoms than those with no job changes. A reduction in work hours was also a risk for higher depressive symptoms. General and specific concerns about the impact of COVID-19 were positively associated with higher depressive and anxiety symptoms. Race/ethnicity moderated the effect of praying to cope with COVID-19 on depressive symptoms.

CONCLUSIONS

As the pandemic continues, mental health resources should be allocated to help AA and Latina women who experienced or anticipate reductions in paid hours and those concerned about its effects. Research is needed to identify how praying increased depressive symptoms in adult Latina women early in the pandemic.

A narrative systematic review of changes in mental health symptoms from before to during the COVID-19 pandemic

The onset of the COVID-19 pandemic raised concerns regarding population-wide impacts on mental health. Existing work on the psychological impacts of disaster has identified the potential for multiple response trajectories, with resilience as likely as the development of chronic psychopathology. Early reviews of mental health during the pandemic suggested elevated prevalence rates of multiple forms of psychopathology, but were limited by largely cross-sectional approaches. We conducted a systematic review of studies that prospectively assessed pre- to peri-pandemic changes in symptoms of psychopathology to investigate potential mental health changes associated with the onset of the pandemic (PROSPERO #CRD42021255042). A total of 97 studies were included, covering symptom clusters including obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), fear, anxiety, depression, and general distress. Changes in psychopathology symptoms varied by symptom dimension and sample characteristics. OCD, anxiety, depression, and general distress symptoms tended to increase from pre- to peri-pandemic. An increase in fear was limited to medically vulnerable participants, and findings for PTSD were mixed. Pre-existing mental health diagnoses unexpectedly were not associated with symptom exacerbation, except in the case of OCD. Young people generally showed the most marked symptom increases, although this pattern was reversed in some samples. Women in middle adulthood in particular demonstrated a considerable increase in anxiety and depression. We conclude that mental health responding during the pandemic varied as a function of both symptom cluster and sample characteristics. Variability in responding should therefore be a key consideration guiding future research and intervention.

A Digital Music-Based Mindfulness Intervention for Black Americans With Elevated Race-Based Anxiety: A Multiple-Baseline Pilot Study

BACKGROUND

Race-based anxiety is a substantial health issue for the Black community. Although mindfulness interventions have demonstrated efficacy for alleviating anxiety, three central barriers prevent Black Americans from accessing existing mindfulness treatments: high costs, excessive time commitments, and limited cultural relevance. There is a need for novel mindfulness interventions for the Black community that can overcome these barriers.

OBJECTIVE

The goal of this web-based study was to examine the preliminary efficacy, feasibility, and acceptability of a novel digital music-based mindfulness intervention for middle-to-low-income Black Americans with elevated race-based anxiety.

METHODS

This study used a nonconcurrent multiple-baseline design (n=5). The intervention featured contributions from Lama Rod Owens (a world-renowned meditation teacher and LA Times best-selling author) and Terry Edmonds (the former chief speechwriter for President Bill Clinton). We examined the effect of the intervention on state anxiety and assessed its feasibility and acceptability using quantitative and qualitative measures.

RESULTS

Results revealed that administration of the intervention led to significant decreases in state anxiety (Tau-U range -0.75 to -0.38; P values<.001). Virtually all feasibility and acceptability metrics were high (ie, the average likelihood of recommending the intervention was 98 out of 100).

CONCLUSIONS

This study offers preliminary evidence that a digital music-based mindfulness intervention can decrease race-based anxiety in Black Americans. Future research is needed to replicate these results, test whether the intervention can elicit lasting changes in anxiety, assess mechanisms of change, and explore the efficacy of the intervention in real-world contexts.

Effects of Locomotion Regulatory Mode on COVID-19 Anxiety: The Mediating Role of Resilience

The COVID-19 pandemic has exerted a significant impact on mental health globally. The uncertainty, fear, and stress associated with this crisis have contributed to a heightened prevalence of anxiety, depression, and various other mental health disorders. In this scenario, the present study aimed at investigating the relationship between locomotion regulatory mode, resilience, and COVID-19 anxiety. It is worth noting that previous extensive research has established a significant correlation between high levels of locomotion and diverse positive psychological conditions, such as optimism, reduced hopelessness, and a positive effect. A total of 243 participants completed measures of locomotion regulatory mode, resilience, and COVID-19 anxiety. In line with our hypotheses, individuals' locomotion regulatory mode was negatively, although non-significatively, associated with COVID-19 anxiety. Furthermore, resilience was found to mediate the relationship between the locomotion regulatory mode and COVID-19 anxiety, indicating that individuals displaying high locomotion may be better equipped to cope with the stress and uncertainty of the COVID-19 pandemic due to their greater levels of resilience. Taken together, these findings highlight the importance of considering both locomotion and resilience in managing anxiety related to COVID-19, and suggest that interventions aimed at enhancing resilience may be particularly beneficial for individuals with a low locomotion regulatory mode.

Psychological impacts of the COVID-19 pandemic in a Hispanic sample: Testing the buffering role of resilience and perceived social support

The current study examined the effects of specific COVID-19 stressors (i.e., family member's death due to COVID-19, COVID-19 infection, and school/financial stressors) on stress, anxiety, and depression and the potential buffering roles of resilience and perceived social support in the association between COVID-19 stressors and psychological symptoms in a Hispanic university student sample (n = 664). Participants were classified in three stressor groups: those reporting a family member's death due to COVID-19 (15.7%), those reporting their own or a family member's COVID-19 infection but no COVID-19 death (35.5%), and those reporting only school and/or financial stressors due to the pandemic (48.8%). Participants completed self-report measures online. Over 50% of participants with a COVID-19 death or infection in the family reported clinical levels of depression symptoms and over 40% endorsed clinically elevated anxiety symptoms. A series of moderation analyses with multi-categorical predictors found that among relatively highly resilient people, the magnitudes of the impact of COVID-19 infection or death on stress, anxiety, and depression were similar to the effect of a financial/school stressor alone, suggesting the buffering role of resilience. Perceived social support did not play a buffering role in the associations. Family member death due to COVID-19 and COVID-19 infection had significant negative psychological impacts on Hispanic young adults. Internal personal resources such as resilience, rather than external personal resources such as perceived social support, appear to be a critical factor that may help protect Hispanic individuals' mental health from the worst stressors of the COVID-19 pandemic.

Impact of COVID-19 pandemic on older cancer patients: Proposed solution by the International Geriatric Radiotherapy Group

Older cancer patients are disproportionally affected by the Coronavirus 19 (COVID-19) pandemic. A higher rate of death among the elderly and the potential for long-term disability have led to fear of contracting the virus in these patients. This fear can, paradoxically, cause delay in diagnosis and treatment that may lead to a poor outcome that could have been prevented. Thus, physicians should devise a policy that both supports the needs of older patients during cancer treatment, and serves to help them overcome their fear so they seek out to cancer diagnosis and treatment early. A combination of telemedicine and a holistic approach, involving prayers for older cancer patients with a high level of spirituality, may improve vaccination rates as well as quality of life during treatment. Collaboration between health care workers, social workers, faith-based leaders, and cancer survivors may be crucial to achieve this goal. Social media may be an important component, providing a means of sending the positive message to older cancer patients that chronological age is not an impediment to treatment.

A cross-sectional study of the psychological impact of the COVID-19 pandemic on camped refugees in Ghana

Vulnerable populations such as camped refugees are often exposed to spread of infectious diseases because of their living conditions, limited resources available to them and exclusion from social services. This study examined the psychological state of camped refugees in Ghana during the COVID-19 pandemic and how their background characteristics predict the severity of the pandemic's psychological impact. It covered 763 refugees aged 15 years and above resident in two (Krisan = 316 and Ampain = 447) camps. Nine COVID-19 Anxiety Scale indicators were used to examine the psychological state of camped refugees. A composite indicator was derived to examine the overall psychological impact. Logistic regression was used to examine the factors that were associated with severe psychological impact. The multivariate analysis revealed that sex of the respondent, marital status and age of head of household were the only socio-demographic factors associated with having a severe psychological impact of the pandemic. There was very strong evidence that respondents who had moderate (OR = 1.74, 95% CI = 1.12, 2.7) and high (OR = 1.66, 95% CI = 1.05, 2.63) knowledge of the disease had increased odds of severe psychological impact. Also, those with moderate (OR = 2.97, 95% CI = 1.78, 4.97) and high (OR = 12.98, 95% CI = 7.86, 21.42) adherence had increased odds of severe psychological impact. None of the pre-existing health conditions and challenges were not significantly associated with severe psychological impact. The limited number of significant socio-demographic covariates suggests that severe psychological impact of the pandemic was a problem in the general population, and thus interventions should target the general population of camped refugees. Also, health education should not only focus on enhancing knowledge and promoting preventive measures but also on managing psychological distress.

COVID-19-Related Stressors and Mental Health Disorders Among US Adults

Objectives:

The COVID-19 pandemic has led to severe mental health repercussions. We examined rates of anxiety and depression in the United States during the pandemic by demographic characteristics, individual stressors, and COVID-19 infection rates and policy contexts.

Methods:

We merged data from the April 2020–March 2021 US Household Pulse Survey with state-level data on COVID-19 rates and mitigation policies, including stay-at-home orders, face mask mandates, and restaurant closures. We estimated weighted logistic regression models to assess correlates of anxiety and depression.

Results:

Rates of anxiety and depression peaked in late 2020 at 39% and 32%, respectively. Food insecurity and disrupted medical care were associated with more than twice the odds of anxiety and depression (food insecurity: odds ratio [OR] = 2.58 for anxiety and 2.61 for depression; disrupted medical care: OR = 2.40 and 2.27). Being not employed (OR = 1.32 for anxiety and 1.45 for depression), uninsured (OR = 1.30 and 1.38), housing insecure (OR = 1.41 and 1.34), and experiencing disruptions in education (OR = 1.28 and 1.25) were linked to 25% to 45% increased odds of anxiety and depression. Increases in state COVID-19 infection rates were associated with significantly heightened odds of anxiety and depression (OR = 1.01 for anxiety and depression), but state mitigation policies were not.

Conclusions:

Levels of anxiety and depression rose during the pandemic, particularly among economically vulnerable individuals and those experiencing economic and service disruptions. Future research should assess the effectiveness of policies targeting COVID-19 economic and service disruptions.

Racial and ethnic differences in perseverative cognition at the onset of the COVID-19 pandemic

Rationale

Coronavirus (COVID-19) disproportionately affects people of color (e.g., Black and Latinx individuals) in the U.S., increasing their morbidity and mortality relative to White people. Despite this greater threat to their well-being, the mental health impact of COVID-19 on people of color remains poorly understood. Perseverative cognition (PC; i.e., excessive worry and/or rumination), is a common psychological response to such threats that independently associates with poor mental and physical health.

Objective

To examine patterns of PC across race/ethnicity when the COVID-19 pandemic began.

Methods

This study surveyed 6,514 respondents from the NORC AmeriSpeak panel, a probability-based representative national sample of U.S. adults between 3/18/20-4/18/20. We employed traditional statistical analyses and natural language processing of open-ended data to examine pandemic-related worries.

Results

Weighted regression analyses with relevant covariates revealed group differences across specific domains of COVID-related worry. Relative to White respondents, Hispanic/Latino respondents reported more worries about social disarray, meeting basic needs, experiencing economic impacts, obtaining healthcare, and contracting COVID-19. Black respondents reported more worry about economic impacts relative to Whites. Additional group differences in worry emerged in open-ended data: Black respondents perseverated about death from COVID-19, whereas Hispanic/Latino respondents reported concerns about COVID-19 spread, and people refusing to uphold mitigation mandates. In contrast, White respondents expressed worry over compromised immune systems and economic collapse.

Conclusions

Results identify significant group differences in COVID-19 related PC, suggesting that people of color faced greater threat to mental well-being at the onset of the pandemic, and may be at greater risk for downstream PC-related physical health consequences.

Factors Associated With Experiences of Fear, Anxiety, Depression, and Changes in Sleep Pattern During the COVID-19 Pandemic Among Adults in Nigeria: A Cross-Sectional Study

Background

Multiple facets of the pandemic can be a source of fear, depression, anxiety and can cause changes in sleep patterns. The aim of this study was to identify health profiles and the COVID-19 pandemic related factors associated with fear, depression, anxiety and changes in sleep pattern in adults in Nigeria.

Methods

The data for this analysis was extracted from a cross-sectional online survey that collected information about mental health and well-ness from a convenience sample of adults 18 years and above resident in Nigeria from July to December 2020. Study participants were asked to complete an anonymous, closed-ended online questionnaire that solicited information on sociodemographic profile, health profiles (high, moderate and low COVID-19 infection risk profile) including HIV status, COVID-19 status, and self-reported experiences of fear, anxiety, depression and changes in sleep patterns.

Results

In total, 4,439 participants with mean age of 38.3 (±11.6) years responded to the survey. Factors associated with higher odds of having COVID-19 related fear were health risk (p < 0.05); living with HIV (AOR: 3.88; 95% CI: 3.22-4.69); having COVID-19 symptoms but not tested (AOR: 1.61; 95% CI: 1.30-1.99); having a friend who tested positive to COVID-19 (AOR: 1.28; 95% CI: 1.07-1.53) and knowing someone who died from COVID-19 (AOR: 1.43; 95% CI: 1.24-1.65). The odds of feeling anxious was significantly higher for those with moderate or low health risk profile (p < 0.05); living with HIV (AOR: 1.64; 95% CI: 1.32-2.04); had a friend who tested positive for COVID-19 (AOR: 1.35; 95% CI: 1.08-1.68) or knew someone who died from COVID-19 (AOR: 1.53; 95% CI: 1.28-1.84). The odds of feeling depressed was significantly higher for those with health risk profile (p < 0.05); living with HIV (AOR: 2.49; 95% CI: 1.89-3.28); and respondents who had COVID-19 symptoms but had not taken a test (AOR: 1.41; 95% CI: 1.02-1.94). Factors associated with higher odds of having sleep pattern changes were having moderate and low health risk profiles (p < 0.05).

Conclusion

The study findings suggest that the pandemic may cause fear, anxiety, depression and changes in sleep patterns differently for people with different health profile, HIV status and COVID-19 status.