Associations between psychological inflexibility and mental health problems during the COVID-19 pandemic: A three-level meta-analytic review

One-year predictors of PTSD symptoms, anxiety, and depression in SARS-CoV-2 survivors: psychological flexibility and major life events as main predictive factors

Introduction

The COVID-19 pandemic held considerable health-related outcomes worldwide, including mental health challenges, with elevated risk of psychiatric sequelae.

Methods

This study aimed to test the longitudinal (1 year) predictive role of psychosocial factors on post-traumatic stress disorder (PTSD), anxiety, and depressive symptoms in SARS-CoV-2 survivors (N = 209 at T1; N = 61; attrition rate 70.83%), through Pearson's correlation analyses and longitudinal multiple regression analyses. Participants (age M = 35.4, SD = 10.1) completed online self-report questionnaires of psychosocial variables, PTSD, anxiety, and depression.

Results

Depression and anxiety symptoms were increased, and 42% of survivors presented clinically meaningful PTSD symptoms. PTSD symptoms were longitudinally predicted by having children (β = 0.32, p < 0.01), number of recent major life events (β = 0.34, p < 0.01), and psychological flexibility (β = -0.36, p < 0.01). Number of major life events (β = 0.29, p < 0.05) and psychological flexibility (β = -0.29, p < 0.05) predicted anxiety. Number of recent major life events (β = 0.32, p < 0.01) was the sole predictor of depressive symptoms.

Discussion

Psychosocial variables contribute to the long-term harmful effects of the COVID-19 pandemic on psychopathological symptoms. These results suggest that, during the pandemic, mental health was impacted by both socio-contextual factors and individual self-regulatory skills, namely the ability to respond flexibily to contextual cues and guide behavior according to the direct experience. Specifically, results point out the importance of societal incentives to reduce parental burden and socioeconomic losses, as well as to promote adaptive psychological skills such as psychological flexibility.

Loneliness and Relationship Well-Being: Investigating the Mediating Roles of Relationship Awareness and Distraction among Romantic Partners

Loneliness arises when there is a discrepancy between one's desired and actual social connection with others. Studies examining the effects of loneliness in romantic relationships show that people who are lonely are less satisfied and committed to their romantic relationships. The present study explored the association between loneliness and romantic relationship well-being. Using a cross-sectional design, loneliness was correlated with relationship commitment, trust, and conflict. Relationship awareness, but not relationship distraction, statistically mediated the association between loneliness, relationship conflict, and relationship trust. The indirect effect of loneliness on relationship well-being was only present in people reporting low and medium levels of psychological inflexibility. Implications are discussed for acceptance- and mindfulness-based interventions for persons in romantic relationships.

The relationship between autistic traits and the stress of social isolation: Development of an explanatory model

Background

Social isolation can be particularly challenging for individuals with high autistic traits who struggle with social interactions. The COVID-19 pandemic led to increased isolation, exacerbating stress for those who may have difficulty in connecting with others. This study aimed to explore the relationship between autistic traits and stress associated with social isolation.

Methods

A sample of 1597 Chinese adults completed measures of autistic traits, the stress of social isolation, psychological inflexibility and core self-evaluation, during an epidemic prevention and control period of COVID-19 in Chongqing, China. Measures included the Autism-Spectrum Quotient, Coronavirus Stress Measure, Acceptance and Action Questionnaire-II, and Core Self-Evaluation Scale.

Results

Autistic traits were positively correlated with the stress of social isolation, which was mediated by the chain effect of core self-evaluation and psychological inflexibility. individuals with high autistic traits reported significantly higher stress than individuals with low autistic traits.

Limitations

This was a cross-sectional study, which limits causal inference. In addition, data were self-reported, which may cause methodological effects. Finally, this study was conducted during China's quarantine policy and external validation of the findings is required.

Conclusions

Autistic traits are positively associated with the stress of social isolation. Autistic traits affected core self-evaluation first, and psychological inflexibility subsequently, leading to the stress of social isolation. individuals with high autistic traits tended to experience higher levels of stress during pandemic quarantines. The findings provide useful evidence for developing interventions and implementing preventive measures to reduce stress in individuals with high autistic traits and autism spectrum disorder.

Identification of psychological flexibility and inflexibility profiles during the COVID-19 pandemic

BACKGROUND

The first coronavirus disease 2019 (COVID-19) wave and lockdown adversely affected the lives of people in diverse ways.

AIMS

This study used a person-centered approach to identify patterns of engagement in the 12 psychological flexibility (PF) and inflexibility (PI) processes to manage the first COVID-19 wave and lockdown hardships.

MATERIALS & METHODS

A total of 1035 Italian adults completed an online survey.

RESULTS

Latent profile analyses conducted on the 12 PI/PF processes measured by the Multidimensional Psychological Flexibility Inventory identified five profiles; three reflected gradations of high to low PF with corresponding inverse levels of PI, while two represented more complex relationships between PI and PF. After controlling for relevant socio-demographic and COVID-19/lockdown factors, the five profiles differed in mental health (depression, anxiety, and COVID-19 distress). Essentially a gradient of progressive decreases in all PI processes (except experiential avoidance) corresponded with increments in mental health across all profiles. Two profiles, which evidenced the highest levels of mental health (highly flexible and moderately flexible profiles), also had the greatest proportion of the sample 56.42% (n = 584), and the highest levels of PF and experiential avoidance.

DISCUSSION

Findings from this and similar studies suggest intersecting complex relationships among the PI/PF processes that are likely to shift in response to changing contexts. We suggest this network of relationships is better represented by a three-dimensional PF/PI hexaflex than a simplistic two-dimensional depiction of the model.

CONCLUSION

Distinguishing different PF/PI profiles identified groups most at risk for the adverse mental health impacts of the pandemic and exposed variations in the mental health protective and risk roles of PF and PI processes, respectively, that can inform ACT-based mental health promotion interventions.

Eudaimonic Well-Being of Italian Young Adults during the COVID-19 Pandemic: Predictive and Mediating Roles of Fear of Death and Psychological Inflexibility

The literature has widely acknowledged the impact of the COVID-19 pandemic on the mental health of young adults. Despite extensive research, eudaimonic well-being, which focuses on self-knowledge and self-realization, has been scarcely investigated. This cross-sectional study aimed to add knowledge on the eudaimonic well-being of young adults one year after the outbreak of the COVID-19 pandemic, verifying its potential linkages with fear of death and psychological inflexibility. A total of 317 young Italian adults (18-34 years), recruited through a chain sampling method, completed measures of psychological inflexibility, fear of death, and eudaimonic well-being included in an online survey. The study's hypotheses were tested with multivariate multiple regression and mediational analyses. Results showed that psychological inflexibility was negatively associated with all the dimensions of well-being, while fear of the death of others was associated with autonomy, environmental mastery, and self-acceptance. Furthermore, in the association between fear of death and well-being, the mediation role of psychological inflexibility was verified. These results contribute to the extant literature on the factors associated with eudaimonic well-being, providing clinical insights into the work with young adults within challenging times.

Posttraumatic stress disorder symptoms among healthcare workers during the Omicron era

Background

The COVID-19 pandemic has caused significant psychological stress among healthcare workers. This study aimed to clarify the factors that influenced health workers' posttraumatic stress disorder (PTSD) symptoms.

Method

A total of 443 healthcare workers from eight Mental Health Centers in Shandong were recruited to attend an online survey. Participants completed self-evaluation measures of exposure to the COVID-19 environment and PTSD symptoms, as well as measures of potential protective factors such as euthymia and perceived social support.

Results

About 45.37% of healthcare workers had severe symptoms of PTSD symptoms. Healthcare workers with more serious PTSD symptoms were significantly related to higher exposure to COVID-19 (r = 0.177, p < 0.001), as well as lower levels of euthymia (r = -0.287, p < 0.001) and perceived social support (r = -0.236, p < 0.001). The structural equation model (SEM) further revealed that the impact of exposure to COVID-19 on PTSD symptoms was partially mediated by euthymia, and moderated by perceived social support, especially from others (e.g., friends, leaders, relatives and colleagues).

Conclusion

These findings suggested that improving the state of euthymia, getting social support from others could alleviate PTSD symptoms among healthcare workers during the COVID-19.