Do coping responses predict better/poorer mental health in Portuguese adults during Portugal's national lockdown associated with the COVID-19?

Psychometric Validation of the Portuguese Obsession with COVID-19 Scale (PT-OCS)

The psychological effects of the COVID-19 pandemic on the Portuguese population are quite relevant and partially related to their repetitive and disruptive thinking about the disease. The successive periods of lockdown contributed to an additional burden on the family-work-life balance for parents. This study aims to validate the Portuguese version of the Obsession with COVID-19 Scale (PT-OCS), which was developed using a general sample from several regions of the country (n = 531) together with a specific sample of Portuguese parents (n = 109). The confirmatory factor analysis results indicate that the PT-OCS includes a set of excellent psychometric properties concerning both the general sample (χ2(1) = 0.446, p = 0.504; CFI = 1.0; GFI = 1.0; RMSEA = 0.0; standardised RMR = 0.003) and the parent group (χ2(2) = 1.816, p = 0.403; CFI = 1.0; GFI = 0.99; RMSEA = 0.0; standardised RMR = 0.016; Bollen-Stine bootstrap p = 0.65). The scale shows very good reliability (0.84 < α/ω < 0.88). As expected, obsession with COVID-19 was highly correlated with COVID-19 anxiety, and women had higher PT-OCS scores. The findings suggest that the PT-OCS is a reliable and valid measure for both persistent and disruptive thinking about COVID-19 in different groups of the Portuguese population, with potential for studying future epidemic events.

Loneliness and associated factors among older adults during COVID-19 lockdown in Spain

Considering the health outcomes of loneliness, it is important to understand the effects of the COVID-19 pandemic for older adults to facilitate detection and intervention. The aim of this study was to examine loneliness among Spanish older adults during the first wave lockdown and associated factors, in comparison to younger adults. An online survey was completed by 3508 adults (401 aged 60 or above). Older adults felt higher social loneliness than younger adults, but lower emotional loneliness. Living alone, poor mental health, and poor healthy habits were related to higher loneliness for both age groups. The results suggest that loneliness should be an important factor in primary care, and prevention efforts should be taken, e.g., by generating open and safe community spaces and contexts for social interaction and promoting the access and ability to use technologies that maintain social connections.

Managing the unexpected: Bicultural identity integration during the COVID-19 emergency

Unexpected and sudden emergency situations such as COVID-19 may render ethnic minorities particularly vulnerable to experiencing negative outcomes. Yet, we put forward that Bicultural Identity Integration (BII) - the degree to which bicultural individuals perceive their cultural identities as compatible and overlapping - may represent a resource in times of emergencies, since it may positively influence, through enhancement of psychological well-being, how bicultural individuals respond in terms of distress and coping strategies. Based on this assumption, the present study aimed at examining the relationship between BII and responses to COVID-19. N = 370 bicultural individuals (mean age = 26.83, SD = 8.74) from different cultural backgrounds were recruited online and completed measures of BII, psychological well-being, COVID-19 distress and coping strategies (positive attitudes, avoidance, social support seeking) during the second wave of the COVID-19 pandemic in Italy. We tested a model in which BII was the predictor, psychological well-being was the mediator and reactions to the COVID-19 emergency (distress, use of coping) were the outcomes. This model was tested against two alternative models. The proposed model showed a better fit to the data compared to the alternative models. In this model, psychological well-being mediated the relationship between BII (harmony) and coping strategies, except social support seeking. These findings highlight the important role played by BII in emergency situations, as it may indirectly, through enhancement of psychological well-being, contribute to enhance biculturals' adaptive reactions in terms of distress as well as affect coping strategies during highly stressful events.

Turning to Religion During COVID-19 (Part II): A Systematic Review, Meta-analysis and Meta-regression of Studies on the Relationship between Religious Coping and Mental Health throughout COVID-19

The COVID-19 pandemic and the many associated socio-economic changes constitute a stressful event that required adaptation to new, dynamic, and often threatening conditions. According to the literature, coping strategies are one of the factors that determine a person's degree of adaptation to stressful situations. A systematic review and meta-analysis was performed on the relationship between religious coping and selected indicators of mental health. Due to the large amount of data, this work has been divided into two parts: Part I discussed the positive mental health indicators (Pankowski & Wytrychiewicz-Pankowska, 2023), while this Part II discusses negative mental health indicators. A systematic review of the databases of Science Direct, EBSCO, Cochrane, PubMed, and Google Scholar identified 33 articles related to the severity of depressive symptoms: 30 to anxiety, 23 to stress, 1 related to PTSD symptoms and peritraumatic stress, and 5 related to general negative mental health. The limitations of the research as well as further directions for exploration are discussed.Clinical trial registration This Review was pre-registered at OSF: osf.io/54ygr ( https://doi.org/10.17605/OSF.IO/GMNFV ).

Turning to Religion During COVID-19 (Part I): A Systematic Review, Meta-analysis and Meta-regression of Studies on the Relationship Between Religious Coping and Mental Health Throughout COVID-19

The COVID-19 pandemic and the many associated socio-economic changes constitute a stressful event that required adaptation to new, dynamic, and often threatening conditions. According to the literature, coping strategies are one of the factors that determine a person's degree of adaptation to stressful situations. A systematic review and meta-analysis was performed on the relationship between religious coping and selected indicators of mental health. Due to the large amount of data, this work has been divided into two parts: this first part discusses positive mental health indicators, while the second discusses negative mental health indicators (Pankowski & Wytrychiewicz-Pankowska, 2023). A systematic review of PubMed, Science Direct, the Cochrane Library, Google Scholar, the Database of Abstracts of Reviews of Effects, and Google Scholar databases was carried out. In addition to the synthesis of information obtained from the research, a meta-analysis of correlation was also performed to determine the strengths of the relationships between the analysed variables, and selected moderators were assessed using meta-regression. Quality of life, well-being, satisfaction with life, happiness, and post-traumatic growth were the positive mental health indicators considered. Meta-analyses indicated a statistically significant relationship between positive religious coping and flourishing (well-being) with overall correlation values of 0.35 [0.30; 0.40]. Further calculations also indicated a relationship between negative religious coping and flourishing - 0.25 [- 0.34; - 0.15]. Data synthesis shows associations between religious coping and such indicators as satisfaction with life and post-traumatic growth, but these issues require further investigation.

Mental health among the Moroccan population during SARS-CoV-2 outbreak: MAROCOVID study

BACKGROUND

The SARS-CoV-2 pandemic's unpredictability and ambiguity, combined with the lockdown, social distancing, containment measures, and economic impact could increase the risk of mental health issues.

OBJECTIVE

To assess the magnitude of mental health outcomes and risk factors among Moroccans, using an online survey, during the SARS-CoV-2 outbreak.

METHODS

This cross-sectional, survey-based study collected demographic data and mental health measurements from 11,123 participants. The degree of depression, anxiety, and insomnia symptoms were assessed by the 9-item Patient Health Questionnaire, the 7-items Generalized Anxiety disorder, and the 7-items Insomnia Severity Index.

RESULTS

The survey was completed by 11,123 individuals out of a total of 15,008 contacts. 7315 (65.8%) were women, and 7182 (64.6%) were aged 18 to 34. A significant proportion of respondents experienced depression (5894 [53%]), anxiety (5544 [49.8%]), and insomnia (4410 [39.6%]). Multivariable logistic regression analysis showed that being a woman, being married, and being a parent of children aged less than five years were associated with severe symptoms of depression and anxiety (e.g. severe depression among women vs. men (OR, 1.19; 95%CI, 1.06-1.33; P = .003), severe depression among married compared to unmarried respondents (OR, 1.92; 95%CI, 1.71-2.16; P < .000), e.g. severe anxiety among women vs. men (OR, 1.40; 95%CI, 1.24-1.58; <0.000), severe anxiety among married people compared to unmarried (OR, 1.14; 95%CI, 1.00-1.28; P < .003).

CONCLUSION

Our findings reported a significant mental health burden on the general public during the COVID-19 lockdown. In addition to efforts deployed to prevent the spread of the disease, timely and culturally-specific mental health care needs to be developed urgently.

Coping and Anxiety During Lockdown in Spain: The Role of Perceived Impact and Information Sources

Background/Purpose

In the context of COVID-19 lockdowns, extant research suggests that secondary coping (a strategy aimed at adjusting oneself self to the stressor) is more robustly associated with better mental health than primary coping (a strategy aimed at adjusting the stressor to oneself). We investigated whether these findings are generalizable to Spain-one of the most severely affected countries at that time. We also tested whether the link between secondary coping and mental health (as measured by anxiety) can be accounted for by how individuals perceive the COVID-19 impact (ie, perceived life changes and personal global impact) and how frequently they use traditional and social media to check COVID-19-related information.

Methods

A diverse community sample (N = 408), collected during the first lockdown in Spain (early April 2020), completed a multi-measure online survey including the targeted variables.

Results

Secondary coping outperformed primary coping in predicting reduced anxiety during the lockdown in Spain. Moreover, lower perceived life changes from COVID-19 and reduced personal global impact from COVID-19 both mediated the negative secondary coping-anxiety relationship. No indirect effects emerged for either conventional or social media exposure.

Conclusion

These results (a) strengthen the cross-cultural validity of the link between secondary coping and anxiety and (b) advance our understanding of the psychological mechanisms underlying this association.

The Future Looks Good: Examining the Associations Between Coping, Psychological Distress, and Optimism

The recent pandemic and consequent lockdown had a substantial impact on mental health and optimism regarding the future. Previous research showed that levels of depression, anxiety, and stress had increased throughout the pandemic. Nonetheless, how individuals cope when faced with adversity may be associated with positive expectations regarding the future. A sample of 274 Portuguese workers (female = 54) with a mean age of 40.86 (SD = 0.70) and work experience of 19.68 years (SD = 12.07) met inclusion criteria and agreed to participate in the proposed study. They represented a variety of working classes (i.e., arts, engineering, marketers, transportation and logistic, clerks, personal trainers, managers, lawyers, accountants, directors, journalism, health care). We investigated the associations between depression, stress, anxiety, adaptive and maladaptive coping, and optimism while controlling for working experience, gender, and work type. We found that depression was related to lower levels of optimism. However, for participants scoring high on adaptive coping and anxiety, higher scores of optimism were reported. Gender, work type, and experience did not significantly influence the results. These results provide evidence through which positive mental health can be promoted after the pandemic.

Post-traumatic stress symptoms during the first and second COVID-19 lockdown in Greece: Rates, risk, and protective factors

The aim was to (i) compare the rates of perceived stress, post-traumatic stress symptoms (PTSS) and other potential correlates (i.e., resilience, social support, coping strategies, and loneliness) in the general population between the two COVID-19 lockdowns in Greece and (ii) explore risk and protective factors of PTSS. Online data were collected amid the first (timepoint 1-T1) and second lockdown (timepoint 2-T2) by 1009 and 352 participants, respectively. The PTSD Checklist for DSM-5 and the Perceived Stress Scale measured levels of PTSS and perceived stress. The Brief Resilience Scale, the COPE, the revised UCLA Loneliness Scale, and the ENRICHD Social Support Instrument measured resilience, coping strategies, loneliness, and social support, respectively. Higher levels of PTSS and perceived stress were reported during T2, compared to T1. Clinically significant levels of PTSS were presented by 26.1% and 35.5% of the participants during T1 and T2, respectively. Higher levels of loneliness and use of maladaptive coping strategies and lower levels of social support, resilience and use of adaptive coping strategies were also found. During both lockdowns, PTSS were predicted by perceived stress, loneliness, reduced resilience and the coping strategies of denial and self-blame. PTSS were associated with younger age, female gender, being single, not having children, and the evaluation of the pandemic as a crisis. The findings highlight the significant public mental health concerns during the COVID-19 lockdowns. Understanding the risk and protective factors against PTSS and focusing on vulnerable populations should be prioritized by the governments worldwide in the development of evidence-based interventions.

Mental Health and Psychological Impact during COVID-19 Pandemic: An Online Survey of Portuguese Higher Education Students

The COVID-19 pandemic has had significant psychological impact on vulnerable groups, particularly students. The present study aims to investigate the mental and psychological impact of the COVID-19 pandemic and associated factors in a sample of Portuguese higher education students. An online cross-sectional study was conducted among 1522 higher education students selected by convenience sampling. The survey assessed mental health symptoms as well as sociodemographic variables, health-related perceptions, and psychological factors. Results were fitted to binary and multivariable logistic regression models. The overall prevalences of stress, anxiety, and depression were 35.7%, 36.2%, and 28.5%, respectively. Poor mental health outcomes were related with being female, having no children, living with someone with chronic disease, facing hopelessness, and lacking resilient coping. Future studies focusing on better ways to promote mental health and wellbeing among students are warranted. It is necessary to gather more evidence on the post-pandemic mental health using robust study designs and standardized assessment tools.

Effects of COVID-19 Social Distancing Measures in Individuals with Chronic Pain Living in Spain in the Late Stages of the Lockdown

Social distancing measures during the lockdown have had a negative impact on chronic pain patients' function. Research, however, has only focused on the early stages of the first lockdowns. The aim of this study was to improve the understanding of the effects of COVID-19 social distancing measures on individuals with chronic pain living in Spain during the late stages of the lockdown. A group of 361 adults with pain participated in this study. They responded to an online survey and provided information on sociodemographic issues, pain, fatigue, perceived health, and quality of life. The data showed that most participants suffered moderate to severe pain and interferences with pain treatment and an increase in pain intensity during the lockdown. Most participants also informed us that fatigue had worsened during the lockdown (62%). Importantly, females with lower monthly family income and lower education have been found to be associated with greater levels of pain and fatigue. Despite this, participants perceived themselves as having good health and good quality of life. The findings from this study can be used to inform policy and specific responses for future COVID-19 waves and future pandemics where social distancing measures must be implemented.

Perceived Vulnerability and Severity Predict Adherence to COVID-19 Protection Measures: The Mediating Role of Instrumental Coping

The COVID-19 disease has caused thousands of deaths worldwide and required the rapid and drastic adoption of various protective measures as main resources in the fight to reduce the spread of the disease. In the present study we aimed to identify socio cognitive factors that may influence adherence to protective measures toward COVID-19 in a Spanish sample. This longitudinal study analyzes the predictive value of perceived severity and vulnerability of infection, self-efficacy, direct exposure to the virus, and instrumental focused coping style for adhering to infection protection behaviors during the first months of the COVID-19 pandemic. It also tests sex and age differences in these factors and changes over time. A two-wave longitudinal study (N = 757) was conducted in March and April 2020 starting the day after a strict national lockdown was decreed in Spain. A path analysis was used to test direct and indirect effects between vulnerability and the adherence to protective behaviors. Results suggest that individuals' perceived severity and vulnerability to COVID-19 and instrumental coping strategies are related to the use of more protective behaviors. This coping strategy mediates the effect of perceived vulnerability on engaging in protective behaviors, and this effect depends on direct exposure to COVID-19 and perceived self-efficacy moderators. Results suggest that recognizing one's own abilities to engage in instrumental actions may facilitate adherence to protective measures in people who had not been directly exposed to COVID-19. Therefore, adopting instrumental coping strategies to manage an individual's perceived vulnerability to infection may positively impact the adherence to protective behaviors, especially during the onset of an unexpected threat and when there is no prior direct experience with the situation.

Dealing With the Pandemic of COVID-19 in Portugal: On the Important Role of Positivity, Experiential Avoidance, and Coping Strategies

The global COVID-19 pandemic crisis has caused an unprecedented impact on most areas of people's lives. Thus, framed within the scope of Existential Positive Psychology (PP2.0), this study aimed at assessing the psychological distress of adults living in Portugal during the first national lockdown, how they are coping with stress, as well to contribute to a deeper understanding about the role that positivity, experiential avoidance, and coping strategies have in psychological distress and well-being. For this purpose, 586 Portuguese adults (73% females) ranging between 18 and 78 years old (M = 38.96, SD = 12.20) completed an online survey during the initial phase of the pandemic crisis in Portugal. Findings suggest that experiential avoidance was the strongest predictor of a negative response (depression, anxiety, stress, loneliness, and negative emotions), whereas positivity was a better predictor of psychological well-being and lower levels of depression. Additionally, self-blame, behavioral disengagement, and emotional venting were strong risk factors for psychological distress, whereas positive reframing, planning, and acceptance were associated with more positive outcomes. These findings highlight the critical role of experiential avoidance on individuals' psychological distress and the essential contribution of positive life orientation in promoting flourishing. By offering a better understanding of the complex navigation through the dialectics between positive and negative life features, this study provides important and useful cues for psychological interventions directed at promoting a more positive and adaptive human functioning even through such potential adverse and painful life events.