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Jing JQ, Yang CJ, Wang Y, Su XY, Du YJ. Impact of COVID-19 on emotional and behavioral problems among preschool children: a meta-analysis. BMC Pediatr 2024; 24:455. [PMID: 39014321 PMCID: PMC11251369 DOI: 10.1186/s12887-024-04931-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 07/03/2024] [Indexed: 07/18/2024] Open
Abstract
The impact of the Coronavirus Disease 2019 (COVID-19) on society is continuous, resulting in negative psychological consequences. Given the vulnerability and sensitivity to the environment among preschool children, their emotional and behavioral problems deserve more attention. The current study aimed to explore the impact of the epidemic on preschool children's mental health by determining the pooled prevalence of emotional and behavioral problems amidst the Coronavirus Disease 2019 pandemic and to reveal potential reasons for variations between studies. Published studies were searched in Embase, PubMed, ProQuest, PsycINFO, Web of Science, CNKI, and Wanfang. Based on the inclusion criteria outlined in this study, a total of 10 studies encompassing 38,059 participants were incorporated. Employing a random-effect model for estimating the prevalence of emotional and behavioral problems, the results revealed a pooled prevalence rate of 24.3% (95% CI, 0.15-0.38; I²=99.9%) among preschool children. This rate surpasses the pre-outbreak prevalence observed in different countries, signifying a detrimental influence of the epidemic on the mental well-being of preschoolers. Therefore, mental health care and recovery are essential for the vulnerable group during and after the public health crisis. Specific emotional and behavioral problems among preschool children are expected to be researched in the future to provide more targeted guidance for intervention.
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Affiliation(s)
- Jia-Qi Jing
- East China Normal University, 3663 N. Zhongshan Road, Shanghai, 200062, China
| | - Chang-Jiang Yang
- East China Normal University, 3663 N. Zhongshan Road, Shanghai, 200062, China.
| | - Yue Wang
- East China Normal University, 3663 N. Zhongshan Road, Shanghai, 200062, China
| | - Xue-Yun Su
- East China Normal University, 3663 N. Zhongshan Road, Shanghai, 200062, China
| | - Yi-Jie Du
- Qingpu Traditional Chinese Medicine Hospital, 95 Qingan Road, Shanghai, 201799, China.
- Academy of Integrative Medicine of Fudan University, 130 Dong'an Road, Shanghai, 200040, China.
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Koppner J, Lindelöf A, Iredahl F, Nilsson S, Thorsell A, Larsen HI, Faresjö Å. Sense of coherence, mental health, and hair cortisol concentrations among older people during the COVID -19 pandemic: a cross-sectional study. BMC Public Health 2024; 24:1502. [PMID: 38840150 PMCID: PMC11151583 DOI: 10.1186/s12889-024-19034-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Accepted: 06/03/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND A person's sense of coherence (SoC) is likely to affect coping when exposed to a life changing event like the COVID -19 pandemic, which impacted the older population especially hard, an age group that already suffers from a lot of mental illness. Thus, the aim of this study was to investigate the associations between SoC and mental health in older adults using both screening scales and hair cortisol concentrations (HCC). METHOD A cross-sectional design studying a cohort of 70-80 years old, N = 260, set in Swedish primary care during the pandemic years 2021-2022. Instruments used are sense of coherence 13 (SoC-13), EQ-5D-3L, Geriatric depression scale 20 (GDS-20), Hospital anxiety and depression scale (HADS), and Perceived stress scale 10 (PSS-10). Sociodemography and factors concerning SoC, and mental health are explored. HCC are measured using radioimmunoassay. Outcome measures are factors independently associated with SoC. Linear regression models were performed with SoC as dependent variable, and priory path analyses explored whether associations with SoC were direct, or indirect via anxiety. RESULTS SoC was significantly associated with anxiety (p < 0.001), perceived economic status (p = 0.003), belief in the future (p = 0.001), and perceived negative mental effect from the COVID -19 pandemic (p = 0.002). The latter was 96% indirectly associated with SoC (p < 0.001), whereas perceived economic status together with belief in the future was 82% directly associated with SoC (p = 0.17). HCC and sex were not significantly associated with SoC, but, noticeably, high HCC was equally distributed between women and men. Women reported significantly lower quality of life (p = 0.03), and more symptoms of anxiety (p = 0.001) and depression (p < 0.001). CONCLUSION Anxiety, belief in the future, perceived negative effect on mental health due to the pandemic, and perceived economic status were significantly associated with SoC. Anxiety is suggested to be important in explaining the association between perceived negative mental effect from the COVID-19 pandemic and SoC. Women reported significantly poorer mental health and life quality than men.
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Affiliation(s)
- Jenny Koppner
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden.
| | - Ann Lindelöf
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Fredrik Iredahl
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Staffan Nilsson
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Annika Thorsell
- Department of Biomedical and Clinical Sciences/Center for Social and Affective Neuroscience, Medicine, Linköping University, Linköping, Sweden
| | - Hanna Israelsson Larsen
- Department of Health, Medicine and Caring Sciences, Division of General practice, Linköping University, Linköping, Sweden
| | - Åshild Faresjö
- Department of Health, Medicine and Caring Sciences, Division of Society and Health/Public Health, Linköping University, Linköping, Sweden
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Briand C, Giguère CÉ, Macario de Medeiros J, Vallée C, Luconi F, Vachon B, Drolet MJ, Monthuy-Blanc J, Mahroug A, Hakin R. The effectiveness of an online short-format Recovery College model: a co-learning model to support mental health. Int J Ment Health Syst 2024; 18:17. [PMID: 38698411 PMCID: PMC11065681 DOI: 10.1186/s13033-024-00637-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Accepted: 04/25/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Our societies are facing mental health challenges, which have been compounded by the Covid-19. This event led people to isolate themselves and to stop seeking the help they needed. In response to this situation, the Health and Recovery Learning Center, applying the Recovery College (RC) model, modified its training program to a shorter online format. This study examines the effectiveness of a single RC training course delivered in a shortened online format to a diverse population at risk of mental health deterioration in the context of Covid-19. METHODS This quasi-experimental study used a one-group pretest-posttest design with repeated measures. Three hundred and fifteen (n = 315) learners agreed to take part in the study and completed questionnaires on wellbeing, anxiety, resilience, self-management, empowerment and stigmatizing attitudes and behaviors. RESULTS Analyses of variance using a linear mixed models revealed that attending a RC training course had, over time, a statistically significant effect on wellbeing (p = 0.004), anxiety (p < 0.001), self-esteem/self-efficacy (p = 0.005), disclosure/help-seeking (p < 0.001) and a slight effect on resilience (p = 0.019) and optimism/control over the future (p = 0.01). CONCLUSIONS This study is the first to measure participation in a single online short-format RC training course, with a diversity of learners and a large sample. These results support the hypothesis that an online short-format training course can reduce psychological distress and increase self-efficacy and help-seeking. TRIAL REGISTRATION This study was previously approved by two certified ethics committees: Comité d'éthique de la recherche du CIUSSS EMTL, which acted as the committee responsible for the multicenter study, reference number MP-12-2021-2421, and Comité d'éthique avec les êtres humains de l'UQTR, reference number CER-20-270-07.01.
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Affiliation(s)
- Catherine Briand
- Department of Occupational Therapy, University of Quebec at Trois-Rivières, Trois-Rivières, Québec, Canada.
- Research Center of Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada.
| | - Charles-Édouard Giguère
- Research Center of Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | | | - Catherine Vallée
- School of Rehabilitation Sciences, Université Laval, Québec City, Québec, Canada
| | - Francesca Luconi
- Office for Continuing Professional Development, Faculty of Medicine and Health Sciences, McGill University, Montréal, Québec, Canada
| | - Brigitte Vachon
- Research Center of Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Montréal, Québec, Canada
| | - Marie-Josée Drolet
- Department of Occupational Therapy, University of Quebec at Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Johana Monthuy-Blanc
- Research Center of Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
- Department of Education, University of Quebec at Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Amani Mahroug
- Research Center of Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
| | - Régis Hakin
- Research Center of Institut universitaire en santé mentale de Montréal, Montréal, Québec, Canada
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4
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Danioni F, Sorgente A, Lanz M, Iafrate R, Regalia C, Rosnati R, Barni D. Sense of coherence and Covid-19 related stress: A three-wave longitudinal study. J Health Psychol 2024:13591053241242545. [PMID: 38641874 DOI: 10.1177/13591053241242545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024] Open
Abstract
Sense of coherence (SOC) is the fundamental concept of the salutogenic approach to health promotion. The main aim of the current longitudinal study is to consider whether SOC has had a positive effect in reducing people's levels of stress during the prolonged time of the pandemic or rather stress has posed a threat to SOC. A large sample of Italian adults completed an online questionnaire at three different moments of the Covid-19 pandemic (from March 2020 to May 2021). To test the reciprocal associations between SOC and stress we estimated a cross-lagged panel model. Results questioned the stability of SOC, which changed across the different moments of the pandemic, and its causal role with respect to stress since, after controlling for gender and age, it emerged a significant effect only from stress to SOC. The implications of these results and the further expansions of the study are discussed.
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Affiliation(s)
| | | | | | | | | | - Rosa Rosnati
- Università Cattolica del Sacro Cuore of Milan, Italy
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5
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Culmann AC, Baranowski AM, Matthias JK, Tüttenberg SC, Belschner W, Erim Y, Morawa E, Beschoner P, Jerg-Bretzke L, Albus C, Steudte-Schmiedgen S, Reuter M, Geiser F. Spirituality and anxiety in pastoral care workers and physicians in the first wave of the COVID-19 pandemic. Front Psychiatry 2024; 15:1354044. [PMID: 38528972 PMCID: PMC10961463 DOI: 10.3389/fpsyt.2024.1354044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/26/2024] [Indexed: 03/27/2024] Open
Abstract
Background The COVID-19 pandemic had serious impact on the well-being of health care workers and highlighted the need for resources to help hospital staff to cope with psychologically negative consequences. The purpose of this study was to investigate the potentially protective effect of spirituality, as measured by the construct of transpersonal trust, against anxiety in physicians and in hospital pastoral care workers. In addition, transpersonal trust was compared to the effects of other potential resources, namely sense of coherence, optimism, and resilience. We also explored the relationship between transpersonal trust and anxiety and how it was moderated by sense of coherence and expected a significant effect. Method The sample included N = 405 participants (n = 151 pastoral care workers and n = 254 physicians) who completed an online survey during the first wave of the COVID-19 pandemic between 20th April and 05th July, 2020, that comprised established questionnaires assessing anxiety, transpersonal trust, sense of coherence, and resilience. Results There was no statistically significant negative relationship between transpersonal trust and anxiety in either profession or broken down by occupational group. Multiple regression analysis revealed that sense of coherence inversely predicted generalized anxiety, while transpersonal trust, resilience, and optimism did not. As hypothesized, the association between transpersonal trust and anxiety was moderated by sense of coherence. However, we could not confirm our hypothesis of a protective effect of transpersonal trust against anxiety. Conclusion Our results point to the significant role of sense of coherence as a protective factor against anxiety and highlight the complexity of the relationship among spirituality, transpersonal trust, and anxiety.
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Affiliation(s)
- Anna C. Culmann
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Medical Faculty and University Hospital, Bonn, Germany
- Department of Psychology, University of Bonn, Bonn, Germany
| | - Andreas M. Baranowski
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Medical Faculty and University Hospital, Bonn, Germany
| | - Julia-K. Matthias
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Medical Faculty and University Hospital, Bonn, Germany
| | - Simone C. Tüttenberg
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Medical Faculty and University Hospital, Bonn, Germany
| | - Wilfried Belschner
- Department of Psychology, Carl von Ossietzky University of Oldenburg, Oldenburg, Germany
| | - Yesim Erim
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Eva Morawa
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Petra Beschoner
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, University Ulm, Ulm, Germany
- Department of Psychosomatic Medicine and Psychotherapy, Hospital Christophsbad, Göppingen, Germany
| | - Lucia Jerg-Bretzke
- Department of Psychosomatic Medicine and Psychotherapy, Ulm University Medical Center, University Ulm, Ulm, Germany
| | - Christian Albus
- Department of Psychosomatics and Psychotherapy, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Faculty of Medicine, Dresden University of Technology, Dresden, Germany
| | - Martin Reuter
- Department of Psychology, University of Bonn, Bonn, Germany
| | - Franziska Geiser
- Department of Psychosomatic Medicine and Psychotherapy, University of Bonn, Medical Faculty and University Hospital, Bonn, Germany
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6
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Schäfer SK, Fritz J, Sopp MR, Kunzler AM, von Boros L, Tüscher O, Göritz AS, Lieb K, Michael T. Interrelations of resilience factors and their incremental impact for mental health: insights from network modeling using a prospective study across seven timepoints. Transl Psychiatry 2023; 13:328. [PMID: 37872216 PMCID: PMC10593776 DOI: 10.1038/s41398-023-02603-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/25/2023] Open
Abstract
Resilience can be viewed as trajectory of stable good mental health or the quick recovery of mental health during or after stressor exposure. Resilience factors (RFs) are psychological resources that buffer the potentially negative effects of stress on mental health. A problem of resilience research is the large number of conceptually overlapping RFs complicating their understanding. The current study sheds light on the interrelations of RFs in the face of the COVID-19 pandemic as a use case for major disruptions. The non-preregistered prospective study assessed a sample of 1275 German-speaking people from February 2020 to March 2021 at seven timepoints. We measured coping, hardiness, control beliefs, optimism, self-efficacy, sense of coherence (SOC), sense of mastery, social support and dispositional resilience as RFs in February 2020, and mental health (i.e., psychopathological symptoms, COVID-19-related rumination, stress-related growth) at all timepoints. Analyses used partial correlation network models and latent growth mixture modeling (LGMM). Pre-pandemic RFs were strongly interrelated, with SOC being the most central node. The strongest associations emerged between coping using emotional support and social support, SOC and sense of mastery, and dispositional resilience and self-efficacy. SOC and active coping were negatively linked. When we examined RFs as predictors of mental health trajectories, SOC was the strongest predictor of psychopathological symptoms and rumination, while trajectories of stress-related growth were predicted by optimism. Subsequent network analyses, including individual intercepts and slopes from LGMM, showed that RFs had small to moderate associations with intercepts but were unrelated to slopes. Our findings provide evidence for SOC playing an important role in mental distress and suggest further examining SOC's incremental validity. However, our results also propose that RFs might be more important for stable levels of mental health than for adaptation processes over time. The differential associations for negative and positive outcomes support the use of multidimensional outcomes in resilience research.
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Affiliation(s)
- Sarah K Schäfer
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany
- Department of Clinical Psychology, Psychotherapy and Psychodiagnostics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Jessica Fritz
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
- Department of Clinical Psychology, Philipps-University Marburg, Marburg, Germany
| | - M Roxanne Sopp
- Department of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Angela M Kunzler
- Leibniz Institute for Resilience Research, Mainz, Germany
- Institute for Evidence in Medicine, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Lisa von Boros
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University, Mainz, Germany
- Institute for Molecular Biology, Mainz, Germany
| | - Anja S Göritz
- Behavioral Health Technology, Augsburg University, Augsburg, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University, Mainz, Germany
| | - Tanja Michael
- Department of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany.
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Issler TC, Ferreira de Sá D, Michael T, Schäfer SK. The relationship between childhood gender nonconformity, aversive childhood experiences, and mental health in heterosexual and non-heterosexual cisgender men: The buffering effect of sense of coherence. Stress Health 2023; 39:782-797. [PMID: 36680490 DOI: 10.1002/smi.3227] [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] [Received: 08/22/2022] [Revised: 12/08/2022] [Accepted: 01/17/2023] [Indexed: 01/22/2023]
Abstract
Childhood gender nonconformity (CGNC) seems to be associated with more mental health problems in adulthood. Previous research has suggested that this link might be mediated via the increased risk for aversive childhood experiences (ACEs) as a negative social reaction to CGNC. However, no study yet examined the role of resilience factors in this relationship. The present study aims to address this gap by examining the potential buffering effect of sense of coherence (SOC). In a German sample of 371 cisgender men, we used mediation models to investigate the relationship between CGNC, ACEs, and mental health problems in adulthood, that is, depressive symptoms, loneliness, and suicidal behavior. We then employed moderated mediation models to examine the buffering effect of SOC on the association ACEs and mental health problems. The results showed that higher levels of CGNC were associated with more severe adult mental health problems, with this link being partially mediated by higher levels of ACEs. For depressive symptoms and suicidal behavior in the last 12 months, we found evidence of a buffering effect of SOC. Higher levels of SOC were associated with a weaker association between ACEs and mental health problems. In contrast, this effect was absent for loneliness and lifetime suicidal behavior. Our study provides evidence that ACEs partly account for the relationship between CGNC and mental health in adulthood. Moreover, we found support for SOC having a buffering effect on this link. Future studies need to examine whether SOC might be an important target for resilience training in those experiencing CGNC. However, sustainable interventions may rather address the negative social reactions to CGNC.
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Affiliation(s)
- Tobias C Issler
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Diana Ferreira de Sá
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany
| | - Tanja Michael
- Department of Psychology, Division of Clinical Psychology and Psychotherapy, Saarland University, Saarbrücken, Germany
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8
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Schäfer SK, von Boros L, Göritz AS, Baumann S, Wessa M, Tüscher O, Lieb K, Möhring A. The Perceived Stress Scale 2&2: a two-factorial German short version of the Perceived Stress Scale. Front Psychiatry 2023; 14:1195986. [PMID: 37484682 PMCID: PMC10358735 DOI: 10.3389/fpsyt.2023.1195986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 06/16/2023] [Indexed: 07/25/2023] Open
Abstract
Background Stress is among the leading causes for diseases. The assessment of subjectively perceived stress is essential for resilience research. While the Perceived Stress Scale (PSS) is a widely used questionnaire, a German short version of the scale is not yet available. In the current study, we developed such a short version using a machine learning approach for item reduction to facilitate the simultaneous optimization of multiple psychometric criteria. Method We recruited 1,437 participants from an online panel, who completed the German long version of the PSS along with measures of mental health and resilience. An ant-colony-optimization algorithm was used to select items, taking reliability, and construct validity into account. Findings on validity were visualized by psychological network models. Results We replicated a bifactor structure for the long version of the PSS and derived a two-factor German short version of the PSS with four items, the PSS-2&2. Its factors helplessness and self-efficacy showed differential associations with mental health indicators and resilience-related factors, with helplessness being mainly linked to mental distress. Conclusion The valid and economic short version of the PSS lends itself to be used in future resilience research. Our findings highlight the importance of the two-factor structure of the PSS short versions and challenge the validity of commonly used one-factor models. In cases where the general stress factor is of interest, researchers should use the longer versions of the PSS that allow for the interpretation of total scores, while the PSS-2&2 allows of an economic assessment of the PSS factors helplessness and self-efficacy.
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Affiliation(s)
- Sarah K. Schäfer
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department for Clinical Psychology, Psychotherapy and Psychodiagnostics, Technische Universität Braunschweig, Braunschweig, Germany
| | - Lisa von Boros
- Leibniz Institute for Resilience Research, Mainz, Germany
| | - Anja S. Göritz
- Behavioral Health Technology, Augsburg University, Augsburg, Germany
| | - Sophie Baumann
- Department Methods in Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Michèle Wessa
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg University Mainz, Mainz, Germany
| | - Oliver Tüscher
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University, Mainz, Germany
- Institute for Molecular Biology, Mainz, Germany
| | - Klaus Lieb
- Leibniz Institute for Resilience Research, Mainz, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center of Johannes Gutenberg University, Mainz, Germany
| | - Anne Möhring
- Department Methods in Community Medicine, University Medicine Greifswald, Greifswald, Germany
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9
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Mennig EF, Schäfer SK, Eschweiler GW, Rapp MA, Thomas C, Wurm S. The relationship between pre-surgery self-rated health and changes in functional and mental health in older adults: insights from a prospective observational study. BMC Geriatr 2023; 23:203. [PMID: 37003994 PMCID: PMC10064967 DOI: 10.1186/s12877-023-03861-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 02/27/2023] [Indexed: 04/03/2023] Open
Abstract
BACKGROUND Elective surgeries are among the most common health stressors in later life and put a significant risk at functional and mental health, making them an important target of research into healthy aging and physical resilience. Large-scale longitudinal research mostly conducted in non-clinical samples provided support of the predictive value of self-rated health (SRH) for both functional and mental health. Thus, SRH may have the potential to predict favorable adaptation processes after significant health stressors, that is, physical resilience. So far, a study examining the interplay between SRH, functional and mental health and their relative importance for health changes in the context of health stressors was missing. The present study aimed at addressing this gap. METHODS We used prospective data of 1,580 inpatients (794 complete cases) aged 70 years or older of the PAWEL study, collected between October 2017 and May 2019 in Germany. Our analyses were based on SRH, functional health (Barthel Index) and self-reported mental health problems (PHQ-4) before and 12 months after major elective surgery. To examine changes and interrelationships in these health indicators, bivariate latent change score (BLCS) models were applied. RESULTS Our analyses provided evidence for improvements of SRH, functional and mental health from pre-to-post surgery. BLCS models based on complete cases and the total sample pointed to a complex interplay of SRH, functional health and mental health with bidirectional coupling effects. Better pre-surgery SRH was associated with improvements in functional and mental health, and better pre-surgery functional health and mental health were associated with improvements in SRH from pre-to-post surgery. Effects of pre-surgery SRH on changes in functional health were smaller than those of functional health on changes in SRH. CONCLUSIONS Meaningful changes of SRH, functional and mental health and their interplay could be depicted for the first time in a clinical setting. Our findings provide preliminary support for SRH as a physical resilience factor being associated with improvements in other health indicators after health stressors. Longitudinal studies with more timepoints are needed to fully understand the predictive value of SRH for multidimensional health. TRIAL REGISTRATION PAWEL study, German Clinical Trials Register, number DRKS00013311. Registered 10 November 2017 - Retrospectively registered, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00013311 .
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Affiliation(s)
- Eva F Mennig
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Strasse 48, 17475, Greifswald, Germany
- Department of Geriatric Psychiatry and Psychotherapy, Klinikum Stuttgart, Priessnitzweg 24, 70374, Stuttgart, Germany
| | - Sarah K Schäfer
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Strasse 48, 17475, Greifswald, Germany
- Leibniz Institute for Resilience Research, Wallstrasse 7, 55122, Mainz, Germany
| | - Gerhard W Eschweiler
- Geriatric Center at the University Hospital Tübingen, University Hospital of Psychiatry and Psychotherapy Tübingen, Calwerstrasse 14, 72076, Tübingen, Germany
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Calwerstrasse 14, 72076, Tübingen, Germany
| | - Michael A Rapp
- Department of Social and Preventive Medicine, University of Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany
| | - Christine Thomas
- Department of Geriatric Psychiatry and Psychotherapy, Klinikum Stuttgart, Priessnitzweg 24, 70374, Stuttgart, Germany
- Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Calwerstrasse 14, 72076, Tübingen, Germany
| | - Susanne Wurm
- Department of Prevention Research and Social Medicine, Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Strasse 48, 17475, Greifswald, Germany.
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Schäfer SK, Sopp MR, Fuchs A, Kotzur M, Maahs L, Michael T. The relationship between sense of coherence and mental health problems from childhood to young adulthood: A meta-analysis. J Affect Disord 2023; 325:804-816. [PMID: 36638967 DOI: 10.1016/j.jad.2022.12.106] [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] [Received: 12/21/2021] [Revised: 10/07/2022] [Accepted: 12/23/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Sense of coherence (SOC) as the key component of the salutogenesis framework is negatively correlated with mental health problems in adults but also in children and adolescents. Since SOC is conceptualized to develop and stabilize from childhood to young adulthood, these life phases are of critical importance for the salutogenesis concept. Individual studies examining SOC's link with mental health at younger ages yielded heterogeneous effect size estimates. Thus, the present meta-analysis is the first to quantify the current state of evidence on the association between SOC and mental health problems. METHODS The random-effects multi-level meta-analysis followed PRISMA guidelines and was based on 57 studies (70 samples) comprising 41,013 participants. Weighted mean age of participants was 15.46 years and 50.4 % were female. RESULTS The mean correlation (r) between SOC and overall mental health problems was M(r) = -0.46, 95 % CI [-0.53, -0.39]. However, there was substantial heterogeneity between studies, while differences between symptom types were smaller. Subsequent moderator analyses showed that higher sample age was associated with more negative relationships and higher internal consistencies of SOC measures. Moreover, internalizing symptoms, depressive symptoms, and feelings of loneliness showed a stronger negative association with SOC than psychosomatic symptoms. LIMITATIONS Our findings on age-related differences were based on (repeated) cross-sectional data and require replication in longitudinal studies. CONCLUSIONS Results yielded a negative association between SOC and mental health problems with increasing magnitude from childhood to young adulthood. Thus, SOC-fostering interventions may help to buffer negative effects of stress and improve resilience starting from early ages.
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Affiliation(s)
- Sarah K Schäfer
- Department of Clinical Psychology and Psychotherapy, Saarland University, Building A1 3, D-66123 Saarbruecken, Germany; Leibniz Institute for Resilience Research, Wallstrasse 7, D-55122 Mainz, Germany..
| | - M Roxanne Sopp
- Department of Clinical Psychology and Psychotherapy, Saarland University, Building A1 3, D-66123 Saarbruecken, Germany
| | - Alicia Fuchs
- Department of Clinical Psychology and Psychotherapy, Saarland University, Building A1 3, D-66123 Saarbruecken, Germany
| | - Maren Kotzur
- Department of Clinical Psychology and Psychotherapy, Saarland University, Building A1 3, D-66123 Saarbruecken, Germany
| | - Lisann Maahs
- Department of Clinical Psychology and Psychotherapy, Saarland University, Building A1 3, D-66123 Saarbruecken, Germany
| | - Tanja Michael
- Department of Clinical Psychology and Psychotherapy, Saarland University, Building A1 3, D-66123 Saarbruecken, Germany
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Gómez-Salgado J, Arias-Ulloa CA, Ortega-Moreno M, García-Iglesias JJ, Escobar-Segovia K, Ruiz-Frutos C. Sense of Coherence in Healthcare Workers During the COVID-19 Pandemic in Ecuador: Association With Work Engagement, Work Environment and Psychological Distress Factors. Int J Public Health 2022; 67:1605428. [PMID: 36545403 PMCID: PMC9760665 DOI: 10.3389/ijph.2022.1605428] [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: 09/23/2022] [Accepted: 11/18/2022] [Indexed: 12/12/2022] Open
Abstract
Objectives: The aim of this study was to test the association between the sense of coherence, work engagement, and psychological distress in healthcare workers in Ecuador during the first phase of the COVID-19 pandemic. Methods: A cross-sectional observational study in a sample of 803 healthcare professionals from all regions of Ecuador between 2 April and 17 May 2020. A self-administered questionnaire was used, which contained sociodemographic and work environment variables, the Utrecht Work Engagement Scale (UWES-9), the General Health Questionnaire (GHQ-12), and Sense of Coherence Scale (SOC-13). Results: The mean value of sense of coherence was M = 65.04; SD = 12.74; for work engagement, it was M = 39.36; SD = 10.53; and for psychological distress, M = 4.58; SD = 3.44. There is a positive correlation (p < 0.01) between the sense of coherence and work engagement, and a negative correlation with psychological distress. Conclusion: During the pandemic in Ecuador, healthcare professionals have suffered a major deterioration of their mental health. Sense of coherence has been associated with work engagement and psychological distress. They have perceived a worsening of the quality of care and working conditions compared to those existing before COVID-19.
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Affiliation(s)
- Juan Gómez-Salgado
- Department of Sociology Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Cristian Arturo Arias-Ulloa
- Faculty of Engineering in Mechanics and Production Sciences, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador,*Correspondence: Cristian Arturo Arias-Ulloa, ; Juan Jesús García-Iglesias,
| | | | - Juan Jesús García-Iglesias
- Department of Sociology Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain,*Correspondence: Cristian Arturo Arias-Ulloa, ; Juan Jesús García-Iglesias,
| | - Kenny Escobar-Segovia
- Faculty of Engineering in Earth Sciences, Escuela Superior Politécnica del Litoral, Guayaquil, Ecuador
| | - Carlos Ruiz-Frutos
- Department of Sociology Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
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Trajectories of resilience and mental distress to global major disruptions. Trends Cogn Sci 2022; 26:1171-1189. [PMID: 36302711 PMCID: PMC9595401 DOI: 10.1016/j.tics.2022.09.017] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 09/20/2022] [Accepted: 09/24/2022] [Indexed: 11/06/2022]
Abstract
The COVID-19 pandemic has resulted in a major societal disruption, raising the question of how people can maintain or quickly regain their mental health (i.e., be resilient) during such times. Researchers have used the pandemic as a use case for studying resilience in response to a global, synchronously starting, and chronic set of stressors on the individual and societal level. Our review of this recent literature reveals that mental distress trajectories during the pandemic largely resemble mental distress responses to individual-level macro-stressors, except for a lower prevalence of recovery trajectories. Results suggest more resilient responses in older adults, but trajectories are less consistent for younger and older ages compared with middle-aged adults. We call for more research integrating state-of-the-art operationalizations of resilience and using these to study resilience over the lifespan.
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Hemi A, Sopp MR, Schäfer SK, Michael T, Levy‐Gigi E. Adaptive responding to prolonged stress exposure: A binational study on the impact of flexibility on latent profiles of cognitive, emotional and behavioural responses to the COVID-19 pandemic. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6163-e6174. [PMID: 36184793 PMCID: PMC10092359 DOI: 10.1111/hsc.14053] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 07/05/2022] [Accepted: 09/12/2022] [Indexed: 06/16/2023]
Abstract
The high level of uncertainty brought about by the COVID-19 pandemic has affected the general population's well-being and capacity for adaptive responding. Studies indicate that flexibility, defined as the ability to choose and employ a variety of emotional, cognitive and behavioural strategies in accordance with changing contextual demands, may significantly contribute to adaptive responding to long-term stressors such as COVID-19. In the current study, we aimed to investigate which facets of flexibility predict different latent profiles of adaptive responding to the COVID-19 pandemic in Israel and Germany. A total of 2330 Israelis and 743 Germans completed online questionnaires measuring cognitive and coping regulatory flexibility and cognitive, emotional and behavioural responding to the COVID-19 pandemic. Analyses revealed three distinct response profiles in each country (high, medium and low). These profiles differed in both anxiety and depression symptoms with the non-adaptive response group experiencing clinically relevant symptoms both in Israel and Germany. Additionally, cognitive flexibility and coping flexibility emerged as significant predictors of response profiles in both countries. Training cognitive and coping flexibility may thus help individuals respond more adaptively to psychosocial stressors such as COVID-19. Such training could be selectively administered to less flexible subpopulations as well as adapted to the specific population characteristics.
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Affiliation(s)
- Alla Hemi
- Faculty of EducationBar Ilan UniversityIsrael
| | - M. Roxanne Sopp
- Faculty of EducationBar Ilan UniversityIsrael
- Division of Clinical Psychology and Psychotherapy, Department of PsychologySaarland UniversitySaarbrückenGermany
| | | | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Department of PsychologySaarland UniversitySaarbrückenGermany
| | - Einat Levy‐Gigi
- Faculty of EducationBar Ilan UniversityIsrael
- The Gonda Multidisciplinary Brain Research CenterBar Ilan UniversityIsrael
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Schäfer SK, Sopp MR, Koch M, Göritz AS, Michael T. The long-term buffering effect of sense of coherence on psychopathological symptoms during the first year of the COVID-19 pandemic: A prospective observational study. J Psychiatr Res 2022; 153:236-244. [PMID: 35841820 PMCID: PMC9257329 DOI: 10.1016/j.jpsychires.2022.07.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/27/2022] [Accepted: 07/01/2022] [Indexed: 01/21/2023]
Abstract
The COVID-19 pandemic is a major chronic stressor affecting all societies and almost all individuals. Consequently, research demonstrated a negative impact of COVID-19 on mental health in parts of the general population. However, not all people are affected equally thus making the identification of resilience factors modulating the pandemic's impact on mental health an important research agenda. One of these factors is sense of coherence (SOC), the key component of the salutogenesis framework. The current study aimed at investigating the long-term relationship between SOC and psychopathological symptoms, and the impact of COVID-19-related rumination as its moderator. The prospective observational study assessed psychopathological symptoms and SOC before the COVID-19 outbreak in Germany (February 2020) and at six critical time points during the pandemic in an online panel (n = 1,479). Bivariate latent change score models and latent growth mixture modeling were used to analyze changes in psychopathological symptoms and SOC along with their interaction and to differentiate trajectories of COVID-19-related rumination. A model allowing for unidirectional coupling from SOC to psychopathological symptoms demonstrated best fit. In the total sample, psychopathological symptoms increased significantly over time. Previous SOC predicted later changes in psychopathological symptoms, whereby a stronger SOC was associated with a decrease in symptoms over time. The same pattern of results was evident in the high-rumination (17.2%) but not in the low-rumination group (82.8%). Our findings demonstrate that SOC is an important predictor and modulator of psychopathological symptoms during the COVID-19 pandemic, particularly in those respondents that ruminate about the pandemic.
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Affiliation(s)
- Sarah K Schäfer
- Department of Clinical Psychology and Psychotherapy, Saarland University, Germany; Leibniz Institute for Resilience Research, Germany.
| | - M Roxanne Sopp
- Department of Clinical Psychology and Psychotherapy, Saarland University, Germany
| | - Marco Koch
- Department of Differential Psychology and Psychodiagnostics, Saarland University, Germany
| | - Anja S Göritz
- Occupational and Consumer Psychology, University of Freiburg, Germany
| | - Tanja Michael
- Department of Clinical Psychology and Psychotherapy, Saarland University, Germany
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