ACTing towards better living during COVID-19: The effects of Acceptance and Commitment therapy for individuals affected by COVID-19

Factors associated with loneliness, depression, and anxiety during the early stages of the COVID-19 pandemic

The COVID-19 pandemic was an unparalleled stressor that enhanced isolation. Loneliness has been identified as an epidemic by the US Surgeon General. This study aimed to: (1) characterize longitudinal trajectories of loneliness during the acute phase of the COVID-19 pandemic; (2) identify longitudinal mediators of the relationship of loneliness with anxiety and depression; and (3) examine how loneliness naturally clusters and identify factors associated with high loneliness. Two hundred and twenty-nine adults (78% female; mean age = 39.5 ± 13.8) completed an abbreviated version of the UCLA Loneliness Scale, Perceived Stress Scale, Emotion Regulation Questionnaire, State Anxiety Inventory, and Patient Health Questionnaire-8 longitudinally between April 2020 and 2021. Trajectory analyses demonstrated relatively stable loneliness over time, while anxiety and depression symptoms declined. Longitudinal analyses indicated that loneliness effects on anxiety and depression were both partially mediated by perceived stress, while emotion regulation capacity only mediated effects on anxiety. Three stable clusters of loneliness trajectories emerged (high, moderate, and low). The odds of moderate or high loneliness cluster membership were positively associated with higher perceived stress and negatively associated with greater cognitive reappraisal use. Our results demonstrate the important interconnections between loneliness and facets of mental health throughout the early phases of the pandemic and may inform targeted future interventions for loneliness work.

Behavioral, cognitive and emotional determinants of getting vaccinated for COVID-19 and the mediating role of institutional trust among young adults in Cyprus

BACKGROUND

Vaccination uptake is a complex behavior, influenced by numerous factors. Behavioral science theories are commonly used to explain the psychosocial determinants of an individual's health behavior. This study examined the behavioural, cognitive, and emotional determinants of COVID-19 vaccination intention based on well-established theoretical models: Acceptance and Commitment Therapy (ACT), Capability, Opportunity, Motivation, and Behaviour (COM-B) and the Health Belief Model (HBM). Additionally, it examined the mediating role of institutional trust in the relationship between determinants of these models and vaccination intentions.

METHODS

A cross-sectional study was conducted from January to May 2022, where university students in Cyprus completed an online survey.

RESULTS

A total of 484 university students completed the online survey, with 23.8% reporting being vaccinated with fewer than three vaccination doses and/or no intention to vaccinate further. Hierarchical logistic regression analysis showed that higher scores in institutional trust, perceived severity, motivation, physical and psychological capability were significantly associated with higher odds of intending to vaccinate. Higher psychological flexibility and not being infected with COVID-19 were also associated with higher odds of vaccination intention, but not in the final model when all determinants were included. Additionally, significant indirect effects of psychological and physical capability, motivation and perceived severity on vaccination intention were found to be mediated by institutional trust.

CONCLUSIONS

When tackling COVID-19 vaccination hesitancy, behavioural, cognitive, and emotional aspects should be considered. Stakeholders and policymakers are advised to implement targeted vaccination programs in young people while at the same time building trust and improving their capabilities and motivation towards getting vaccinated.

Serially mediated effects of psychological inflexibility on quality of life of refugees in Uganda during coronavirus pandemic

The unexpected outbreak and rapid spread of COVID-19 necessitated radical and stringent control measures, consequently changing how people live globally. To vulnerable populations like refugees, who were already living a disrupted life, the outbreak of COVID-19 and accompanying control measures complicated their living conditions and drastically affected their mental health and, consequently, their quality of life. The current study aimed to test whether psychological inflexibility was a factor in lowering the quality of life of refugees in Uganda during the COVID-19 pandemic. The study further examines whether the effects of psychological inflexibility on quality of life were serially mediated by avoidance coping, perceived threat, adherence to COVID-19 control measures, and general mental health states. The study was conducted among refugees living in Kampala city suburbs and Bidibidi refugee settlement in Uganda. Data was collected using a survey questionnaire during the partial reopening of the economy in mid-2020, after the first lockdown. The analysis assesses a serial mediation model of the effects of psychological inflexibility on the quality of life of refugees through avoidance coping, perceived threat, adherence to COVID-19 control measures, and mental health using PROCESS Macro. The study involved 353 participants. Our analyses revealed that psychological inflexibility was negatively associated with the perceived threat, adherence, and quality of life. Psychological inflexibility was positively associated with avoidance coping and poor mental health. The data supported all hypothesized mediation paths. These findings support literature suggesting that psychological inflexibility is a maladaptive attribute that thwarts positive coping and behavior adjustment in times of crisis. Consequently, psychological inflexibility can worsen mental health problems and quality of life, especially in populations such as refugees in low-income countries who live in precarious conditions. Incorporating interventions that reduce psychological inflexibility in crisis management efforts can help refugees maintain good psychological functioning and quality of life.

Resilience, Coping, and the Covid-19 Pandemic Across the Globe - an Update: What Have we Learned?

The SARS-CoV-2 (COVID-19) pandemic is a mass traumatic event that has universally and indiscriminately negatively affected the world. The adverse consequences of the pandemic have globally impacted psychological health and well-being via increased stressors, such as uncertainty, health anxieties, and financial instability. During the initial months of the pandemic, we (Polizzi et al., 2020) identified coping strategies that may be well-suited to address the sequelae of the pandemic. These strategies included behavioral activation, acceptance-based coping, mindfulness practice, and loving-kindness meditation. We argued that these coping skills may foster resilience and recovery during the pandemic by generating a sense of social connection, encouraging meaning-making, and enhancing feelings of control amid uncertainty. Three years later, we update our initial suggestions by providing a narrative review that considers empirical evidence collected during the pandemic to support the utility of the previously identified coping strategies as well as additional strategies. We also discuss cross-cultural similarities and differences among these strategies and how research supports their application across diverse countries and groups. Finally, we conclude by synthesizing the literature within a regulatory flexibility framework that emphasizes flexible skill implementation with respect to sensitivity to context, coping repertoires, and feedback from the environment.

Associations of psychological inflexibility with posttraumatic stress disorder and adherence to COVID-19 control measures among refugees in Uganda: The moderating role of coping strategies

Refugees are vulnerable to developing mental health problems. The unprecedented appearance and rapid spread of COVID-19 exacerbated this vulnerability, especially in low-income countries where refugees survive on humanitarian aid and live in congested settlements. These appalling living conditions are a stressor, making adherence to COVID-19 control measures impractical and an additional psychological strain for refugees. The present study examined how psychological inflexibility is associated with adherence to COVID-19 control measures. A sample of 352 refugees from Kampala City and Bidibidi settlements were recruited. Refugees with high levels of psychological inflexibility reported higher PTSD symptom severity and low adherence to COVID-19 control measures. Moreover, PTSD severity mediated the association between psychological inflexibility and adherence, while avoidance coping moderated both direct and indirect effects. Interventions for reducing psychological inflexibility and avoidance coping may be essential in boosting adherence to measures relevant to the current and future status of the pandemic, along with other crises that refugees face.

Psychological Capital and Quality of life of Refugees in Uganda During COVID-19 Pandemic: A Serial Mediation Model

Background: The COVID-19 pandemic has in the past two years caused and continues to cause enormous effects on lifestyle, mental health, and quality of life. With no known treatment and vaccination, behavioral control measures became central in controlling the pandemic. However, the intensity of the pandemic and the stringent control measures were immensely stressful. The control measures became an added psychological burden to people living in precarious situations such as refugees in low-income countries. Purpose: Given the benefits of psychological capital, the present study aimed at investigating the role of psychological capital in enhancing the quality of life among refugees in Uganda during the COVID-19 pandemic. It was hypothesized that the effects of psychological capital on quality of life are serially mediated through coping strategies, adherence to COVID-19 control measures, and mental health. Methods: Data was collected using a self-administered questionnaire in July and August 2020 after the first lockdown. Participants were 353 South Sudanese and Somali refugees living in Kampala city suburbs and Bidibidi refugee settlement. Findings: Psychological capital was positively associated with approach coping, mental health, and quality of life. However, psychological capital was negatively associated with adherence to COVID-19 control measures. Significant indirect effects of psychological capital on quality of life through approach coping, mental health, and adherence were found. However, serial mediation effects were only substantial via approach coping and mental health. Conclusion: Psychological capital is an important resource in coping with the challenges posed by COVID-19 and maintaining a good level of psychological functioning and quality of life. Preserving and boosting psychological capital is essential in responding to COVID-19 and other related disasters and crises, which are common in vulnerable populations such as refugee communities in low-income countries.

Shaped by the COVID-19 pandemic: Psychological responses from a subjective perspective-A longitudinal mixed-methods study across five European countries

BACKGROUND

Contextual factors are essential for understanding long-term adjustment to the COVID-19 pandemic. Therefore, the present study investigated changes in mental health outcomes and subjective pandemic-related experiences over time and across countries. The main objective was to explore how psychological responses vary in relation to individual and environmental factors.

METHODS

The sample consisted of N = 1070 participants from the general population of Austria, Croatia, Georgia, Greece, and Portugal. We applied a longitudinal mixed-methods approach, with baseline assessment in summer and autumn 2020 (T1) and follow-up assessment 12 months later (T2). Qualitative content analysis by Mayring was used to analyse open-ended questions about stressful events, positive and negative aspects of the pandemic, and recommendations on how to cope. Mental health outcomes were assessed with the Adjustment Disorder-New Module 8 (ADNM-8), the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), the Patient Health Questionnaire-2 (PHQ-2), and the 5-item World Health Organization Well-Being Index (WHO-5). The analyses were performed with SPSS Statistics Version 26 and MAXQDA 2022.

RESULTS

The mental health outcomes significantly differed over time and across countries, with e.g. Greek participants showing decrease in adjustment disorder symptoms (p = .007) between T1 and T2. Compared with other countries, we found better mental health outcomes in the Austrian and the Croatian sample at both timepoints (p < .05). Regarding qualitative data, some themes were equally represented at both timepoints (e.g. Restrictions and changes in daily life), while others were more prominent at T1 (e.g. Work and finances) or T2 (e.g. Vaccination issues).

CONCLUSIONS

Our findings indicate that people's reactions to the pandemic are largely shaped by the shifting context of the pandemic, country-specific factors, and individual characteristics and circumstances. Resource-oriented interventions focusing on psychological flexibility might promote resilience and mental health amidst the COVID-19 pandemic and other global crises.

Mental health and psychological resilience during the COVID-19 pandemic: A cross-cultural comparison of Japan, Malaysia, China, and the U.S

BACKGROUND

The current study examined how psychological resilience acted as a buffer against mental health deterioration during the coronavirus disease 2019 (COVID-19) pandemic. We conducted an online survey in four countries (Japan, Malaysia, China, and the U.S.) to examine how psychological resilience functions toward the maintenance of mental health during the COVID-19 pandemic.

METHODS

We collected data from 1583 citizens from four countries via an online survey between October 14 and November 2, 2020. We gathered demographic data and measured mental distress (depression, anxiety, and stress) and fear of COVID-19. Data on sense of control, ego-resilience, grit, self-compassion, and resilience indicators were also collected.

RESULTS

Sense of control was negatively associated with mental distress in all four countries. Self-compassion was negatively associated with mental distress in the samples from Japan, China, and the U.S. We also found an interaction effect for sense of control: the lower the sense of control, the stronger the deterioration of mental distress when the fear of COVID-19 was high.

LIMITATIONS

This study's cross-sectional design precludes causal inferences. Further, lack of data from people who were actually infected with the virus limits comparisons of people who were and were not infected. Finally, as this study only compared data from four countries, comparisons with more countries are needed.

CONCLUSIONS

A sense of control and self-compassion may help buffer against mental health deterioration during the COVID-19 pandemic. Sense of control was consistently associated with mental health across cultures.