Anxiety associated with COVID-19 and concerns about death: Impacts on psychological well-being

Generalized anxiety disorder in Brazilian undergraduate dental students during the COVID-19 pandemic: A cross-sectional study

OBJECTIVE

Explore the prevalence of generalized anxiety disorder (GAD) and associated factors in undergraduate dental students during the first wave of the COVID-19 pandemic in Brazil.

MATERIALS AND METHODS

Cross-sectional study. A semi-structured questionnaire addressing the variables of interest was shared with dental students between July 8 and 27 2020. The outcome was determined using the seven-item generalized anxiety disorder (GAD-7) scale. A 'positive' diagnosis was defined as a total of ≥10 points on the scale. Statistical analysis involved descriptive, bivariate and multivariate analyses, with the significance level set at 5%.

RESULTS

Among the 1050 students evaluated, 53.8% had a positive diagnosis for GAD. The multivariate analysis revealed that the prevalence of symptoms was higher among individuals who resided with more than three people, those enrolled at teaching institutions that suspended all clinical and laboratory activities, those who did not have an adequate home situation to maintain distance learning, those who had been diagnosed with COVID-19, those who felt anxious about having to see patients with a suspicion or diagnosis of COVID-19 and those who preferred to interrupt in-person academic activities until the population is vaccinated for the COVID-19 virus.

CONCLUSION

The prevalence of GAD was high. Aspects related to the composition and organization of the home, the suspension of academic activities, a history of COVID-19 contamination, feelings of anxiety in providing dental care to patients with symptoms/suspected of COVID-19 infection and the preference to interrupt in-person academic activities until the population is vaccinated for COVID-19 were factors predisposing the students to anxiety during the first wave of the pandemic.

The Relationship of Death Anxiety With Loneliness and Psychological Well-Being in the Elderly Living in a Nursing Home

This descriptive correlational study aimed relationship of death anxiety with loneliness and psychological well-being in the elderly living in a nursing home. The study was conducted on the elderly living in a nursing home in Istanbul, Turkey, between November 2021-February 2022. The study sample included 165 nursing home residents. The Sociodemographic Characteristics Form, Death Anxiety Scale (DAS), Loneliness Scale for the Elderly (LSE) and Psychological Well-Being Scale were used as data collection tools. The elderly participants obtained a mean score of 6.10 ± 3.50 from DAS, a mean score of 9.01 ± 4.08 from LSE, and a mean score of 38.97 ± 10.05 from Psychological Well-Being Scale. When death anxiety scale mean score of the elderly was compared with their mean scores of loneliness scale and psychological well-being scale, a weak and negative correlation was determined between psychological well-being and loneliness (p < 0.001). As the mean score of psychological well-being scale increases, loneliness scale mean score decreases.

The Relationship between Perceived Infectability and Psychological Well-being: The Mediating Role of Covid-19 Anxiety

Background

COVID-19 has adversely affected economies and individuals globally. To this day, countries are facing the economic effects of the pandemic directly, and individuals' mental health is in danger as they are still indirectly dealing with the pandemic. It is imperative to understand how pandemic-related anxiety affected individuals' mental health so that all stakeholders can take essential remedial steps.

Objective

The current research aimed to investigate the relationship between Perceived Infectability, Coronavirus Anxiety, and Psychological Well-being. It also sought to explore the role of coronavirus anxiety in mediating between perceived infectability and psychological well-being.

Design

A cross-sectional correlational study design and non-probability convenience sampling technique were used to collect the data. The data were collected from 321 Pakistani adults, who filled out Google forms on the Perceived Infectability subscale of the Perceived Vulnerability to Disease Scale; the Coronavirus Anxiety Scale; and the Psychological Well-being Scale.

Results

Correlation analysis indicated that both perceived infectability and coronavirus anxiety were negatively related to psychological well-being. However, a significant positive relationship was observed between perceived infectability and coronavirus anxiety. Our findings further proved the mediating role of coronavirus anxiety between perceived infectability and the psychological well-being of adults.

Conclusion

Understanding perceived infectability and its association with COVID-19 anxiety and psychological well-being is pertinent in this post-pandemic period in both developing and developed nations. The post-pandemic world is still being jolted with the aftereffects of the pandemic. An in-depth understanding of how individuals Coped with the pandemic, might help in designing better intervention and community health programs after the pandemic, and it could also help in preparing for the crises attending future pandemics (if any).

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.

Investigating the mediating effect of anxiety and fear of a third wave of COVID-19 among students in South India

The COVID-19 pandemic, which is a global health emergency, has potentiality had a serious impact on students' mental health. An online cross-sectional survey design that included 534 senior year college students from South India revealed a significant and direct positive effect of the fear of a third wave of COVID-19 on academic anxiety which in turn showed a significant and direct positive effect on COVID-19 burnout. Academic anxiety was also found to mediate the relationship between the fear of a third wave of COVID-19 and subsequent cases of burnout. The study suggested measures to be taken by policy makers for the broader interest and wellbeing of student communities. Managerial implications, limitations and future studies were also examined in the paper.

Death Anxiety and COVID-19 Anxiety. The Mediating Role of Religious Relational Identification and the Impact of Emotional Regulation Strategies

Management theory of terror (TMT) explains the way disease and death anxiety (DA) are managed through religion during crisis (i.e., COVID-19 pandemic). 344 women students completed self-reported questionnaires regarding death and COVID-19 anxiety, religious relational identification, and emotional regulation. Results show positive relation between religious relational identification and death anxiety, and COVID-19 anxiety. The interaction between death anxiety and emotional regulation shows that both cognitive reappraisal and expressive suppression are dysfunctional for COVID-19 anxiety. A moderated mediation effect is significant, showing that COVID-19 anxiety is not decreasing due to usual and natural ways of coping (i.e., religious relational identification and cognitive reappraisal).

Personality and Family Risk Factors for Poor Mental Well-Being

There is evidence that differentiation of self (DoS) contributes to the regulation of emotions at a young age, resulting in reduced anxiety and improved mental well-being. However, there is little evidence of the relationships between these four dimensions (DoS, self-regulation, anxiety, and mental well-being), or of the potential mediating role of self-regulation and anxiety. Our primary goal was therefore to consider the links between DoS, self-regulation, anxiety, and mental well-being. It was hypothesized that DoS (emotional reactivity, I-position, emotional cutoff, fusion with others) will be positively associated with mental well-being through the mediation of self-regulation (promotion-focused, prevention-focused) and anxiety. The study included 460 participants with a mean age of 41.18 (SD = 14.97, range = 19-60). Of them, 224 (48.7%) were women. Participants filled out four questionnaires: the Differentiation of Self Inventory-Revised, General Regulatory Focus Measure, the anxiety scale from DASS-21, and the Warwick-Edinburgh Mental Well-being Scale. The findings showed that emotional cutoff positively predicted prevention and anxiety, but did not predict promotion. In addition, promotion positively predicted mental well-being. Finally, promotion mediated the relationship between I-position and mental well-being. The results indicate that well-differentiated individuals function optimally and enjoy good quality of life.

Anxiety and well-being amidst the COVID-19 outbreak and the moderating role of locus-of-hope: Evidence from a large sample in the Philippines

The COVID-19 pandemic has placed a heavy psychological burden on the lives of many individuals and created a rise in the prevalence of anxiety, which could be detrimental to people's well-being. Nevertheless, there have also been reports about having hope in overcoming the challenges brought about by the pandemic. The study intended to find out whether the different locus-of-hope dimensions (internal, family, peers, and spiritual locus-of-hope) would moderate the impact of anxiety symptoms on well-being (psychological, social, and emotional well-being). A nationwide survey was conducted among Filipino adults ( N = 10,529). Results showed that anxiety symptoms were negatively associated with psychological, social, and emotional well-being. Moderation analyses show that internal, family, and spiritual locus-of-hope buffered the negative effect of anxiety symptoms on specific well-being outcomes, whereas peer locus-of hope did not. The study demonstrates the importance of hope as a viable resource in facilitating an individual's well-being amid adverse and uncertain circumstances, such as the COVID-19 pandemic.

The Relationship Between Perceived Vulnerability to Disease and Anxiety During the COVID-19 Pandemic: Serial Mediation by Fear of COVID-19 and Trust in the Government

Purpose

The continuing global spread of COVID-19 has seriously jeopardized human mental health. How to reduce the damage of COVID-19 pandemic to people's mental health is a current research hotspot. The purpose of this study was to explore the influence mechanism of perceived vulnerability to disease on anxiety level during the COVID-19 pandemic.

Methods

A total of 1085 Chinese subjects were investigated by using the Fear of COVID-19 Scale, Perceived Vulnerability to Disease Scale, Trust in the Government Measure Scale and Anxiety Scale, which was conducted by an online survey using snowball sampling technique. Hayes PROCESS macro for SPSS was used to test the hypothesized mediating effects of fear of COVID-19 and rust in the government measure in the relationship between perceived vulnerability to disease (PVD) and anxiety.

Results

(1) the PVD significantly positively predicts anxiety level (0.001); (2) Fear of COVID-19 (p<0.001) and trust in the government (p<0.001) mediated the relationship between PVD and anxiety level respectively; (3) PVD could also indirectly predict anxiety level through the chain-mediated role of the fear of COVID-19 and the trust in the government measure (p<0.001).

Conclusion

Our findings shed light on a correlation between perceived vulnerability to disease and anxiety. This study emphasizes the value of trust in the government in facing public stress events. Moreover, this study provides some implications for how to prevent or reduce public anxiety in an epidemic setting.

Influence of mental health on the well-being status among Malaysian adults before and during COVID-19 pandemic

The coronavirus disease (COVID-19) pandemic has affected the well-being of individuals worldwide. Due to the scarcity of information in the Malaysian context, this study aimed at investigating the changes in well-being before and during the Movement Control Order (MCO) in Malaysia and its association with mental health status. This cross-sectional study was part of a Malaysian non-probabilistic online survey on psychosocial well-being in Malaysia, under the Personal and Family Coping with COVID-19 Global South Research Consortium. A total of 543 respondents (≥18 years old) were recruited using snowball sampling. A validated self-administered questionnaire for assessing sociodemographic characteristics, well-being, anxiety, boredom, and loneliness was circulated on social media platforms (such as Facebook, Twitter, and WhatsApp) and emails. Paired samples t-test, chi-square test, and multinomial logistic regression analyses were applied during data analysis. Results revealed significant changes in the mean scores of well-being, anxiety, boredom, and loneliness before and during MCO (p < 0.05). When comparing with no change in the well-being group, changes in boredom were less likely to be observed in the decreased well-being group (Adj OR = 0.874; p = 0.003) but were more likely to be observed in the group with increased well-being (Adj OR = 1.110; p = 0.002). The findings indicated that the pandemic did not necessarily create adverse effects. Instead, a different perspective is offered, which can be used as a public health strategy to help individuals cope with their mental health needs more positively.

Gratitude, relatedness needs satisfaction, and negative psychological outcomes during the COVID-19 pandemic: A short-term longitudinal study

OBJECTIVES

Although gratitude relates to coronavirus disease 2019 (COVID-19) well-being outcomes in the United States, more evidence is needed to understand how this psychological strength reciprocally relates to mental health during this pandemic. This study examines the association of gratitude with stress, anxiety, and depression among undergraduate students in the United States via a longitudinal design.

METHODS

An online survey was administered to 643 undergraduate students in a public university located in the southeastern region of the United States. There was a 1-month interval between the first and second waves of data collection.

RESULTS

Cross-lagged panel structural equation modeling showed that whereas gratitude positively predicted subsequent relatedness needs satisfaction, it negatively predicted later stress, anxiety, and depression. Relatedness needs satisfaction was reciprocally linked to subsequent gratitude.

CONCLUSION

Results suggest that gratitude might serve as a protective psychological resource against the detrimental mental health impacts of the COVID-19 pandemic.

The Effect of Group Identification on Death Anxiety: The Chain Mediation Role of Close Relationships and Self-Esteem

Based on the terror management theory (TMT), this study integrated self-esteem and close relationships to explore the effects of group identification on death anxiety. Five hundred and four participants completed the Death Anxiety, Rosenberg Self-Esteem, Social Identity, and Inclusion of Other in the Self scales via online platforms. There were significant correlations among group identification, close relationship, self-esteem, and death anxiety. Group identification had a significant negative predictive effect on death anxiety. Specifically, group identification affects death anxiety through two pathways: the separate mediating role of self-esteem and the serial mediation pathway of close relationships → self-esteem. Our study provides direct evidence that group identification relieves death anxiety. The results showed that the alleviating function of group identification was mediated by self-esteem and close relationships. This study provides a new perspective concerning TMT as a defense mechanism against death anxiety.

How social support predicts anxiety among university students during COVID-19 control phase: Mediating roles of self-esteem and resilience

Public health emergency, such as COVID-19 pandemic, generally has severe impacts on mental health in public. One of the often-neglected negative consequences is that the control and prevention measures of COVID-19 in the post-epidemic can pose psychological threats to public mental health. This study aimed to seek the factors and mechanisms to alleviate this mental health threat based on a sample of university students in China. Accordingly, this study proposed an environmental-individual interaction model examining the multiple mediating effects of self-esteem and resilience in the association between social support and anxiety among university students during COVID-19 control phase. A questionnaire containing multiple scales were administered on the sample of 2734 Chinese university students. Results indicated that social support negatively predicted anxiety through the serial mediating effects of self-esteem and resilience sequentially. Our results highlight the impact of social support and the internal factors on relieving anxiety among university students in COVID-19 control phase. Findings suggest that effective psychological intervention tools should be designed and offered to college students to reduce anxiety distress and improve mental health in the post-epidemic era or the similar situations in the future.

Validation of the Malay Version of the COVID-19 Anxiety Scale in Malaysia

Background

Malaysians are disillusioned with the increased number of COVID-19 infection cases and the prolonged lockdown period. As a result of COVID-19 mitigation measurements, Malaysians are experiencing emotional and psychological consequences such as anxiety. Thus, there is an urgent need to have an instrument that could serve as a tool to assess the psychological impact of COVID-19 among Malaysians rapidly.

Methods

This study aimed to adapt and validate the Malay version of the COVID-19 Anxiety Scale (M-CAS) among Malaysian adults. The back-to-back translation was done to produce a M-CAS. Following face validation, M-CAS was self-administered to 225 participants from Malaysia via an online survey. The participants also completed the Generalised Anxiety Disorder 7-item Scale (GAD-7), World Health Organization Quality of Life Scale, Abbreviated Version (WHOQOL-BREF) and the Fear of COVID-19 Scale (FCV-19S). Data analysis was conducted using Statistical Package for the Social Sciences and Analysis of a Moment Structures. The psychometric properties of the M-CAS were examined via Cronbach alpha and confirmatory factor analysis. M-CAS scores were compared with the other tools to provide external validity.

Results

The statistical analysis revealed that the M-CAS demonstrated adequate internal consistency (Cronbach's alpha = 0.890) and presented with a unidimensional factor structure. M-CAS scores were strongly correlated with GAD-7 (r = 0.511, P < 0.001) and FCV-19S (r = 0.652, P < 0.001). Lack of correlation between M-CAS and WHOQOL-BREF showed that M-CAS scores did not reflect perceived quality of life.

Conclusion

The M-CAS is a valid and reliable tool in the Malay language that can be self-administered among Malaysians to assess anxiety levels induced by COVID-19. The M-CAS has only 7 items and utilised little time in real-life clinical practice.

The Fear of COVID-19: Gender Differences among Italian Health Volunteers

Background: During the COVID-19 pandemic, the fear of being infected was a major concern, resulting in both physical and psychological effects. Despite several studies on fear of COVID-19 in the general population, the effects on healthy volunteers who face COVID-19 on the frontlines have not yet been investigated. Methods: An online survey on specific psychological variables related to COVID-19 was administered to 720 healthy volunteers, and gender differences were investigated. Results: The primary finding was that females showed higher scores in all dimensions assessed. A multiple linear regression conducted on both genders exhibited a similar pattern of predictors, highlighting the pivotal role of negative affect in the male group. Conclusions: The findings suggest that COVID-19 had significant effects on healthy volunteers, especially in the female group. Although the previous literature did not report the crucial role played by the negative affect in the male sample, these results highlight the need to deepen how both genders use different emotional strategies to cope with stressful situations. This study may be useful in the development of specific psychological support and ad hoc training for healthy volunteers.

Increased Risk Perception, Distress Intolerance and Health Anxiety in Stricter Lockdowns: Self-Control as a Key Protective Factor in Early Response to the COVID-19 Pandemic

Studies provide evidence that distress, (health) anxiety, and depressive symptoms were high during the first weeks of COVID-19 lockdown restrictions, decreasing over time (possibly due to individuals’ protective psychological factors). Relations between different lockdown restrictions, mental health issues, and protective factors need to be explored, since even small lockdown effects might increase the risk of future mental health issues. We merged objective lockdown stringency data with individual data (N = 1001) to examine differences in lockdown effects in strict lockdown (Romania) and mild lockdown (Hungary) conditions between March and May 2020 on stressors and mental health symptoms, taking protective factors into account. The stricter lockdown in Romania revealed higher levels of perceived risk of infection, distress intolerance, and COVID-19 health anxiety. Protective psychological factors were not affected by the lockdown measures. Surpassing psychological flexibility and resilient coping, self-control proved to be the most promising protective factor. It is recommended that future research merge objective data with study data to investigate the effects of different COVID-19 lockdown measures on mental health and protective factors. Policy decisions should consider lockdown-dependent consequences of mental health issues. Intervention programs are suggested to mitigate mental health issues and to strengthen peoples’ protective psychological factors.

Morbid Polarization: Exposure to COVID-19 and Partisan Disagreement about Pandemic Response

The COVID-19 pandemic has affected the lives of all Americans, but the severity of the pandemic has been experienced unevenly across space and time. Some states saw sharp rises in COVID-19 cases in early March, whereas case counts rose much later in the rest of the country. In this article, we examine the relationship between exposure to COVID-19 and citizens' views on what type of measures are required to deal with the crises and how experience with and exposure to COVID-19 is associated with greater partisan polarization. We find consistent evidence of partisan divergence in pandemic-response policy preferences across the first six months of the COVID-19 pandemic: Republicans support national control measures whereas Democrats support welfare policies, and interparty differences grow over time. We find only limited evidence that exposure or experience moderates these partisan differences. Our findings are consistent with the view that Americans interpret the COVID-19 pandemic in fundamentally partisan manner, and that objective pandemic conditions play at most a minor role in shaping mass preferences.

Effect of online counselling on emotional outcomes during the COVID‐19 pandemic: An innovative group intervention for university students using the Brain Wave Modulation Technique

Young people's mental health problems are a matter of concern during the COVID‐19 pandemic. Counselling services for university students by means of telemental support can help them to deal with psychological issues that they may be facing due to the pandemic. The present study investigated the effects of four once‐weekly online counselling sessions based on a mind‐body technique (the Brain Wave Modulation Technique; BWM‐T) on enhancing positive affect and on reducing negative affect and anxiety in a sample of 54 university students (96.3% females; M_age = 21.31 years, SD = 2.09). An experimental design was conducted: the participants were randomly assigned to the intervention group, which received 15 min of a guided online BWM‐T session, or to the control group, which watched a 15‐min video on how to sustain their psychological well‐being. The results of a two‐factor mixed‐design analysis of variance (ANOVA) showed that the participants in the intervention group reported a significant increase in positive affect and a decrease in negative affect over time compared to those in the control group. They also reported a slight decrease in state anxiety compared to the control group, although this was just short of statistical significance. The information provided by this study, regarding emotional outcomes among university students after four brief online counselling sessions, suggests that such interventions could be an effective and sustainable way to reinforce young people's mental health during the COVID‐19 pandemic, as well as later in their university careers and adult lives.

The Relationships among Anxiety, Subjective Well-Being, Media Consumption, and Safety-Seeking Behaviors during the COVID-19 Epidemic

The COVID-19 epidemic has been confirmed as the largest scale outbreak of atypical pneumonia since the outbreak of severe acute respiratory syndrome (SARS) in 2003 and it has become a public health emergency of international concern. It exacerbated public confusion and anxiety, and the impact of COVID-19 on people needs to be better understood. Indeed, prior studies that conducted meta-analysis of longitudinal cohort research compared mental health before versus during the COVID-19 pandemic and proved that public health polices (e.g., city lockdowns, quarantines, avoiding gatherings, etc.) and COVID-19-related information that circulates on new media platforms directly affected citizen’s mental health and well-being. Hence, this research aims to explore Taiwanese people’s health status, anxiety, media sources for obtaining COVID-19 information, subjective well-being, and safety-seeking behavior during the COVID-19 epidemic and how they are associated. Online surveys were conducted through new media platforms, and 342 responses were included in the analysis. The research results indicate that the participants experienced different aspects of COVID-19 anxiety, including COVID-19 worry and perceived COVID-19 risk. Among the given media sources, the more participants searched for COVID-19 information on new media, the greater they worried about COVID-19. Furthermore, COVID-19 worry was positively related to safety-seeking behavior, while perceived COVID-19 risk was negatively related to subjective well-being. This paper concludes by offering some suggestions for future studies and pointing out limitations of the present study.