Psychological Outcomes Associated with Stay-at-Home Orders and the Perceived Impact of COVID-19 on Daily Life

Engaging with Social Media: Implications for COVID-19 Research Participation Among Adults Living in the State of Florida

The COVID-19 pandemic led to an increased use of social media, with many people turning to it for social support. Given the varying effects of social media, this study examines how social media use influences the willingness of adults in the State of Florida to participate in COVID-19-related research. The study used data collected through the Florida Statewide Registry for Aging Studies (FSRAS), which included 587 participants who were 25 years and older. The primary outcome variables were COVID-19 treatment and COVID-19 vaccine research. Ordinal logistic regression was used to evaluate the association between social media use and willingness to participate in COVID-19 treatment and vaccination research, adjusting for sociodemographic variables. The analysis did not find a statistically significant relationship between social media use and the likelihood of participating in COVID-19 research. However, significant differences were observed across racial/ethnic groups. Participants who identified as "Hispanic/Latino" (OR-2.44, 95% CI-1.11-5.35, p = 0.03) and "Other" (OR-12.51, 95% CI-1.98-79.22, p = 0.01) were significantly associated with willingness to participate in a COVID-19 treatment research. Similarly, participants of all other races/ethnicities were significantly more willing to participate in research testing COVID-19 vaccines. Additionally, females were more likely to express willingness to participate in COVID-19 vaccine research. Social media use did not significantly affect willingness to participate in COVID-19 treatment and vaccine research; however, racial and ethnic differences significantly influenced willingness to participate. These findings suggest that implementing targeted culturally sensitive recruitment strategies and community engagement efforts can improve participation in COVID-19 research.

Effects of daily life changes due to COVID-19 on obesity in Korean adults

BACKGROUND

Owing to the changes in lifestyle caused by the COVID-19 pandemic, the risk of obesity has increased. This study analyzed the relationship between daily life changes due to COVID-19 and obesity among Korean adults.

METHODS

This study used data from the 2021 Korea Community Health Survey. A total of 225 265 Korean adults had completed the survey. The associations between general, health-related, and COVID-19-related characteristics and obesity were analyzed using Chi-square tests and multiple logistic regression analyses.

RESULTS

The obesity rate among the total participants was 30.6%. Among all participants, 18.7% responded that COVID-19 had a significant impact on their daily lives. The obesity was higher in cases where the impact of COVID-19 on daily life was significant, concerns about economic damage due to COVID-19 were present, and changes in expenditure had occurred. In addition, obesity rates were higher in participants who experienced decrease in physical activity, increase in instant food consumption, and increase in smoking after COVID-19.

CONCLUSIONS

COVID-19 has brought about significant changes in daily life, including physical activity and eating habits. Our study suggests that these changes in daily life due to COVID-19 may associate the risk of obesity.

Long-term efficacy of cognitive behavioural therapy for generalized anxiety disorder: A 2-8-year follow-up of two randomized controlled trials

Anxiety disorders are the most prevalent mental disorders globally, with generalized anxiety disorder (GAD) being one of the most common among them. While GAD can be effectively treated with bona fide cognitive behavioural therapy (CBT), research on its long-term efficacy is scarce. This study examined the long-term efficacy of CBT for GAD in terms of statistical symptom reduction and clinically significant change. A follow-up of 93 GAD patients, 2-8 years post-treatment from two randomized controlled implementation trials, was conducted. Outcome measures included two disorder-specific outcomes and three general mental health outcomes. Statistical symptom reduction was assessed using piecewise linear growth models, and clinically significant change was evaluated based on Jacobson and Truax's (1991) criteria. Results indicated that treatment gains were maintained from six-months post-treatment to long-term follow-up for all outcome measures except depressive symptoms, which increased during this period. Clinically significant change analysis showed that 57 %-77 % of participants were categorised as recovered 2-8 years post-CBT. This study provides insights into treatment durability 2-8 years post-treatment. Treatment success was largely maintained, with more than half to three-quarters of patients categorised as recovered, supporting the sustained efficacy of CBT for GAD.

Risk Predictors and Cognitive Outcomes of the Psychosocial Functioning of North American Older Adults During the COVID-19 Pandemic

Background: The COVID-19 pandemic caused a global mental health deterioration. The disruption of older adults' psychosocial functions is particularly concerning given their social support and technology use barriers. Despite a close relationship between social engagement and cognitive function in older adults, little is known about the cognitive consequences of older adults' disrupted psychosocial functions in the context of the pandemic. Aims: This study aims to identify sociodemographic and COVID-19-related predictors for psychosocial functioning in North American older adults and to examine their associated cognitive outcomes. Methods: A sample of 95 older adults aged 60 and older (M = 68.85, SD = 6.458) completed an online study from January to July 2021, including a questionnaire on sociodemographic and COVID-19-related experiences, the Kessler-10 (K10) to assess psychological distress, Satisfaction with Life Scale (SWLS) and the UCLA Loneliness Scale Revised (UCLA) to index social function, and the Go/No-go Task (GNG) and Letter Comparison Task (LCT) as cognitive measures. Results: Higher psychosocial functioning was predicted by increased approach-based coping, being aged 65-69, 70-74, and over 75 years relative to being 60-64, and being in medium to excellent relative to poor health, while lower psychosocial functioning was predicted by increased avoidance based coping strategies and having average relative to low income. Psychosocial functioning was not seen to strongly predict cognitive functioning. However, being aged 75 years and older relative to being aged 60-64 predicted decreased accuracy on no-go trials and slower cognitive speed, and lower LCT accuracy was predicted by more avoidance-based coping and being in a religion other than Christianity or Catholicism (e.g., being spiritual). Conclusions: The results identified age, income, and health status as psychosocial function predictors among North American older adults, and increased age, religion, and use of avoidance-based coping strategies as predictors for decreased cognitive performance. The results shed light on future public health strategies to promote the psychosocial and cognitive health of older adults.

The influence of face masks use, immunity boosters and visiting risky places on mental health during the COVID-19 pandemic in Serbia and Republic of Srpska (Bosnia and Herzegovina)

BACKGROUND

Because of the COVID-19 pandemic, people were recommended to implement new health behaviors into their daily routines to prevent the viral spread. The aim of this study was to investigate whether specific health behaviors, such as wearing face masks, taking immunity boosters and visiting risky places were associated with a higher level of stress due to COVID-19 in the general adult population.

METHOD

This cross-sectional study was conducted from September 1, 2020 to October 1, 2021 in eight randomly chosen cities of two Serbian speaking countries (Republic of Serbia and Republic of Srpska - Bosnia and Herzegovina). Participants filled a socio-epidemiologic questionnaire, COVID Stress Scales (CSS) and the Perceived Stress Scale (PSS).

RESULTS

The study included 2,301 participants with an average age of 36.72 ± 13.82 years of whom 54.9% were female (p = 0.001). Most participants were healthy, highly educated, employed, married, non-smokers and consumed alcohol. The mean total CSS score was 32.7 ± 23.8 out of 144, suggesting a relatively low stress due to COVID-19. The mean PSS was 19.43 ± 5.05 out of 40 indicating slightly increased level of general stress. Participants who reported higher CSS scores were more likely to wear face masks, use immunity boosters, go to cafes and clubs, have chronic illnesses, have suspicious, but not proven contact with COVID-19 positive people, and use multiple sources of information about COVID-19.

CONCLUSION

Few participants experienced high levels of stress due to COVID-19. People who used face masks, immunity boosters and visited risky places reported a higher level of stress during the pandemic.

Risk Factors for Poor Sleep Quality and Subjective Cognitive Decline in Older Adults Living in the United States During the COVID-19 Pandemic

BACKGROUND/OBJECTIVES

Poor sleep quality, depression, and anxiety are associated with subjective cognitive decline (SCD) and greater risk for developing cognitive impairment and Alzheimer's disease. The COVID-19 pandemic negatively impacted sleep habits and psychological well-being in many individuals, yet their relationship to SCD in this context remains understudied. We examined sociodemographic characteristics, depression, anxiety, and sleep changes during the pandemic (i.e., increased problems/poorer quality) and SCD in older individuals living in the US.

METHODS

In total, 288 older adults (Mage = 67.4 [7.4]) completed an online survey including a sociodemographic questionnaire, the Center for Epidemiologic Studies Depression Scale (Revised) (CES-D-10; depression), General Anxiety Disorder-7 (GAD-7; anxiety), the Everyday Cognition scale (ECog; SCD), and a question about increased sleep problems/worsened sleep quality during the pandemic. Hierarchical and logistic regression analyses were used to assess relations among sociodemographic factors, depression, anxiety, changes in sleep quality, and SCD.

RESULTS

Self-reported pandemic-related impairments in sleep were associated with greater SCD (β = 0.16, p = 0.01). Depression (β = 0.46, p < 0.001) and anxiety (β = 0.29, p < 0.001) were also associated with greater SCD. Depression (OR = 1.17, p < 0.001) and anxiety (OR = 1.15, p = 0.017) predicted reported poorer sleep during the pandemic.

CONCLUSIONS

Depression, anxiety, and poorer sleep quality during the COVID-19 pandemic were associated with greater SCD concerns. Greater depression and anxiety were also associated with the reported sleep problems/worsened sleep quality. Prevention and management of anxiety and depressive symptoms may help maintain sleep quality and reduce risk of cognitive decline.

Experience of the COVID-19 Pandemic in the Care of Patients with Predominantly Antibody Deficiencies (PADs)-A Qualitative Study with Perspectives from Both Patients and Nurses

Background/Objectives: One of the risk groups during the COVID-19 pandemic was people with predominantly antibody deficiencies (PADs) that have a compromised immune system. In the absence of evidence and clinical experience, there were challenges for patients in their daily life and for staff in counseling during this time. Therefore, the aim of this study was to explore the experiences of PAD patients and nurses during the COVID-19 pandemic. Methods: Focus group interviews with patients (n = 12) and nurses (n = 12) were performed separately, which were then analyzed using content analysis. Results: The daily life of PAD patients was affected during the pandemic, with concerns about becoming seriously ill. Social isolation and adherence to recommendations by the majority of the Swedish population resulted in patients feeling infectiously healthier during this period. The rapid transition of specialist care to telemedicine care encounters was an important measure taken to address patients' concerns and questions according to both patients and nurses. In addition, patients expressed a need for a coordinated care plan to facilitate access to integrated care. Conclusions: The high level of trust for authorities in Sweden was related to the high compliance with the recommendations, which reduced the spread of the infection. The role of specialized care is an important support for PAD patients, which was particularly evident during the pandemic. Information transfer to a specific risk group, such as people with PADs, is important and can usefully be coordinated by their specialist clinic. Telemedicine meetings are an important complement for people with PADs and need to be further elaborated. Also, there is a need to clarify how to better coordinate primary and specialized care.

Beyond the hype: longitudinal trends in virtual reality perceptions beyond the COVID-19 pandemic

Introduction

The metaverse is shaped significantly by spatial computing technologies, such as virtual reality (VR). However, the promise of a VR-facilitated metaverse remains unfulfilled, and public perceptions of these technologies are fluid. Therefore, this study investigates perceptions and intentions to use VR over three years, both during and after the COVID-19 pandemic.

Method

We conducted three waves of cross-sectional surveys from 2020 to 2022 (N = 928), via Amazon Mechanical Turk.

Analysis

Data were analysed using OLS regression and mediation-moderation analysis using Hayes' PROCESS Model 85.

Results

Respondents' perceptions of VR as both easy to use and useful predict their intentions to use the technology, with usefulness being the stronger predictor. When examining changes over time, in 2021, VR ownership was not a predictor of perceived usefulness, and it was associated with a decrease in intentions to use VR, potentially reflecting the dynamics of the hype cycle. The direct and indirect effects of COVID-19 on VR acceptance persisted throughout all three years of the study but appear to be diminishing with time.

Conclusion

This study contributes to the theoretical and practical discourse on the metaverse's development, advocating for a nuanced understanding of VR's role as a critical component of this digital frontier.

Psychopathological Symptoms of Individuals Recently Bereaved During COVID-19 Pandemic: Symptom Profiles, Predictive Factors and Correlations With Insomnia

AIMS

This study aimed to identify subgroups of individuals bereaved within the past 1 year during the COVID-19 pandemic based on symptoms of prolonged grief disorder (PGD), depression and post-traumatic stress (PTSD). Additionally, we examined class differences in socio-demographic and loss-related variables and explored the associations between class membership and insomnia.

METHODS

A total of 324 individuals (72.2% female) who experienced bereavement within 12 months (M = 4.01 months, SD = 2.45) completed Inventory of Complicated Grief (ICG), Patient Health Questionnaire (PHQ-9), PTSD Checklist for DSM-5 (PCL-5) and Insomnia Severity Index (ISI). Latent class analysis (LCA) with three-step and BCH procedure was employed.

RESULTS

Three distinct subgroups were identified: a high symptoms class (33.4%), a high PGD, moderate depression and PTSD class (35.2%) and a moderate PGD, low depression and PTSD class (31.4%), especially yearning, preoccupation, emotional pain and loneliness, were predominant. Class membership was influenced by relationship to the deceased and expectancy of death but not by time since loss. Death due to COVID-19 did not significantly differentiate class membership compared to other causes. Additionally, significant differences in insomnia severity were observed across classes (p < 0.001).

CONCLUSION

Distinct psychopathological patterns emerged among recently bereaved individuals during the pandemic, with PGD symptoms being particularly prominent. Tailored strategies may help address distinct symptom profiles and co-morbid symptoms within bereavement care.

What Is in a Name? Depression and Anxiety Symptoms in Collegiate Athletes With and Without a History of Concussion

CONTEXT

Athletes with a history of concussion (CON) have been demonstrated to have heightened levels of anxiety and depression that may continue well beyond the resolution of concussion symptoms. The global events of 2020 resulted in elevated levels of anxiety and depression in the general population, which may have unequally presented in collegiate athletes with (CON) than those without a history of concussion (NoCON). Using a deception design, our survey-based study compared levels of anxiety and depression in CON and NoCON collegiate athletes in response to the pandemic and social injustices. We hypothesized that the CON group would have significantly elevated anxiety and depression as compared to the NoCON group in response to events of 2020.

DESIGN AND METHODS

Collegiate athletes (N = 106) during the academic 2020-2021 academic year were divided into CON and NoCON groups based on their preinjury (baseline) concussion assessment. Participants completed the Social Readjustment Rating Scale (SSRS), Center for Epidemiologic Studies Depression Scale (CES-D), and Generalized Anxiety Disorder Scale-7 (GAD-7) via an electronic survey pertaining to the events of 2020. The term "concussion" was not used in any study materials which was the basis for our deception-based design. An analysis of covariance was used to compare group CES-D and GAD-7 outcome scores while controlling for the SSRS outcome score.

RESULTS

Our survey response rate was 14.2% (48/337 [77.1% female]) and 10.1% (58/580 [67.2% female]), for the NoCON and CON groups, respectively. The NoCON group had significantly (F1 = 5.82, P = .018, ηp2=.06) higher anxiety (8.3 [5.89]) as compared to the CON group (5.5 [2.85]). The NoCON group also had significantly (F1 = 13.7, P < .001, ηp2=.12) higher levels of depression (21.0 [12.52]) as compared to the CON group (16.07 [9.10]).

DISCUSSION

Our deception-based study revealed NoCON participants had elevated and clinically relevant mood states as compared to CON participants in response to the events of 2020.

The spatial heterogeneity effects of street environmental factors on the preference for sports and leisure cycling paths across different street types

Current research has not fully explored how streetscape elements in different street spaces affect long-distance, high-speed recreational cycling. As a result, the applicability of existing findings across different street environments is limited, hindering their practical value in urban street design. To address this issue, this study focuses on the core urban area of Hangzhou, China. Streets are functionally categorized based on Point of Interest (POI) data, and Strava crowdsourced data are used to obtain cycling activity trajectories. Streetscape indicators that may influence recreational cycling paths are calculated using streetscape imagery and machine learning techniques. Ordinary Least Squares (OLS) and Geographically Weighted Regression (GWR) models are employed to identify significant streetscape indicators that impact cycling, and spatial heterogeneity in cycling route preferences is analyzed at different scales across street types. The results indicate that: (1) Recreational cyclists prefer mixed-use and scenic streets, particularly those along river corridors or within and around large green spaces. (2) Among the streetscape indicators, safety isolation degree has the most positive impact, followed by facility diversity, motorization level, and green view index, all of which positively influence cycling traffic to varying extents. Interface transparency and disorder negatively affect cycling, with transparency having the strongest influence. (3) In mixed-use, commercial, and life service streets, the effect of streetscape indicators on cycling route preferences varies by spatial location, exhibiting both promoting and inhibiting effects. In scenic streets, streetscape indicators show stronger positive or negative impacts, while in industrial streets, their influence is weaker. Based on these findings, the study proposes strategies for creating cycling-friendly environments tailored to different street types. The results validate and extend existing theories on the interaction between street environments and cycling behavior, offering valuable insights for diagnosing problems and implementing effective interventions to promote cycling-friendly environments, thus contributing to urban health, equity, and sustainable development.

Home office is associated with weight gain during the COVID-19 pandemic: Brazilian population-based studies

The COVID-19 pandemic caused changes in life, affecting habits and behaviors, and one of its consequences is an increase in weight. We aimed to evaluate the association between remote work and weight gain during the COVID-19 pandemic in two cities in southern Brazil. A population-based cross-sectional study carried out in the southern region of Brazil. Data were collected face-to-face, in households selected by census sampling. The outcome was weight gain, and the exposure was remote working. To verify this association, Poisson Regression was used to calculate the crude and adjusted prevalence ratio and its 95% confidence intervals, using 5% significance level. In total, 2,152 individuals were interviewed. The prevalence of weight gain during the pandemic was 38.4% (95%CI 36.1-40.7), being significantly higher in those who worked remotely (47.0% vs 37.7, p=0.02). Those individuals who worked remotely were 23% more likely to gain weight during the pandemic compared to those who did not work remotely (PR: 1.23; 95%CI 1.02-1.49). Health and education services may be encouraged to implement educational actions at the collective level, aimed at enlightening the population and preventing weight gain in periods of confinement.

Are thoughts and behaviours of individuals with schizophrenia more susceptible to being influenced during pandemic situations? A glimpse provided by the COVID-19 pandemic

Individuals with psychotic disorders such as schizophrenia may be more vulnerable during pandemics, but research on this topic is limited. This study examined COVID-19 impact on a population affected by schizophrenia during the COVID-19 pandemic. Levels of psychological distress and COVID-19-related behaviours, from the COVID-related Thoughts and Behavioral Symptoms (Cov-Tabs) Scale, were compared between 107 patients with schizophrenia and 70 control participants. Participants with schizophrenia had significantly higher Cov-Tabs scores than non-clinical participants. These results suggest a higher vulnerability in this population, emphasising the need for targeted support and further assessment.

How Did COVID-19 Change the Delivery of Embedded Mental Health Services for U.S. Air Force Airmen? A Qualitative Look

INTRODUCTION

The coronavirus disease 2019 (COVID-19) pandemic, in addition to increased mental health difficulties for society as a whole, brought unique challenges and opportunities to mental health professionals attempting to address the issues under public health limitations. Occupationally embedded mental health professionals were uniquely challenged in quickly and creatively adjusting to physical quarantining and working from home. The purpose of this study was to inquire about and categorize the experiences of embedded mental health professionals and their clients in U.S. Air Force (USAF) operational units.

METHODS

We conducted a qualitative analysis of semi-structured interviews with 26 embedded mental health professionals across 24 USAF installations and 15 Airmen clients from 5 of those installations. Their experiences within the pandemic context were systemically categorized into actionable themes through thematic content analysis.

RESULTS

U.S. Air Force embedded mental health professionals and Airmen primarily identified the challenges of staying engaged when not face-to-face, higher incidence of mental health problems, decreased availability of clinical care and other support resources, technology as a face-to-face substitute, managing safety measures, delayed initiatives, and clinical boundary setting. Alternatively, embedded mental health professionals and Airmen identified strategies to alleviate pandemic limitations, such as using technology to interact, COVID-19 mitigating actions, developing initiatives to target their population needs, and using opportunities to help reduce stigma associated with seeking help for mental health.

Impact of COVID-19 lockdown on dietary habits and weight among Tunisian adults

BACKGROUND

COVID-19 lockdown measures have profoundly altered lifestyle habits, exposing individuals to significant health risks Aim: This study aims to assess the impact of quarantine measures in Tunisia, with a focus on examining changes in dietary habits, levels of physical activity, psychological patterns, and factors contributing to weight gain.

METHODS

This is a cross-sectional study involving 1,016 participants and employed a mixed-methods approach to gather data on dietary habits, physical activity levels, and psychological indicators. Statistical analyses, including binary logistic regression, were conducted to identify independent risk factors associated with weight gain during the quarantine period.

RESULTS

Approximately 36.4% of participants reported experiencing weight gain, with a notable prevalence among younger age groups. Increased consumption of sweets, pasta, and fried foods, coupled with reduced intake of water, vegetables, and fruits, were associated with weight gain. Furthermore, a decline in physical activity levels and elevated scores of anxiety and depression were observed among individuals who reported weight gain. Binary logistic regression highlighted snack frequency, fried food consumption, and pasta intake as significant independent risk factors for weight gain.

CONCLUSION

The results underscore the importance of understanding the complex impacts of lockdowns on lifestyle habits and mental health to guide future interventions, which are necessary to mitigate adverse health consequences and promote healthy lifestyles in the post-pandemic period.

Relationship between social support and perinatal depression during the COVID-19 pandemic

AIMS/BACKGROUND

This research aimed to identify the sources of social support and its relationship with perinatal depression (PPD) during the coronavirus (COVID-19) pandemic.

DESIGN/METHODS

We carried out a cross-sectional study with a sample of 3,356 women during perinatal period living in Spain. We used five items from the Spanish version of the Coronavirus Perinatal Experiences - Impact Survey to assess the impact of COVID-19 on social support and, the Edinburgh Postnatal Depression Scale was used to assess depressive symptomatology.

RESULTS

The results obtained identified a possible relationship between seeking in-person support (OR = 0.51; 0.67, during pregnancy and after delivery respectively) and degree of feeling social support (OR = 0.77; 0.77) during the COVID-19 pandemic with a lower prevalence of depression. Otherwise, requiring the help of a mental health professional (OR = 2.92; 2.41) and weeks of confinement (OR = 1.03; 1.01) appeared to be associated with a higher prevalence of depression. During pregnancy, a possible association was found between the degree of concern about future changes in support and involvement of family and friends (OR = 1.75) with a higher prevalence of depression. On the other hand, in the postpartum period, there seems to be a relationship between seeking social support through social media (OR = 1.32) with a higher prevalence of depression and receiving support from friends (OR = 0.70) and health professionals (OR = 0.53) with a lower prevalence of depression.

CONCLUSION

These results highlighted the importance of protecting perinatal mental health during the COVID-19 pandemic by protecting and developing social support networks.

Students supporting students: evaluating the impact of the COVID-19 pandemic on resident assistant mental health

OBJECTIVE

To examine the impact of the novel coronavirus SARS-CoV2 (COVID-19) pandemic on Residents Assistants (RA) at a public university in the Midwest.

PARTICIPANTS

Sixty-seven RAs that had been offered an RA position for the '20-'21 academic year.

METHODS

An online cross-sectional survey measuring socio-demographics, stress, and well-being was fielded. MANCOVA models evaluated the impact of COVID-19 on well-being of Current RAs and compared to the non-current RA groups.

RESULTS

Sixty-seven RAs provided valid data. Overall, 47% of RAs had moderate-severe anxiety and 86.3% had moderate-high level of stress. Current RAs perceiving a great impact of COVID on life had significantly more stress, anxiety, burnout, and secondary traumatic stress than those who did not. RAs who started then quit experienced significantly higher secondary trauma compared to Current RAs.

CONCLUSIONS

Further research is needed to better understand the experiences and of RAs and to develop policies and programs to support RAs.

Temporal and Racial/Ethnic Patterns of Social Engagement among Older Adults: Evidence from American Time Use Survey 2019 to 2022

This study examines temporal and racial/ethnic patterns in social engagement among older adults from 2019 to 2022, using data from the American Time Use Survey (ATUS) for adults aged 60 and older (n = 13,605). Social engagement was operationalized as time spent on five activities in in-home and out-of-home settings. Descriptive analysis was used to characterize temporal trends of social engagement, and zero-inflated negative binomial regression was utilized to estimate year-specific racial/ethnic differences. Results indicate an initial decline in out-of-home social engagement, followed by a gradual recovery. Racial differences in social engagement became salient during the pandemic period. The evolving racial and ethnic patterns in social engagement underscore the challenges that Black and Hispanic older adults faced during the public health crisis. Understanding activity patterns specific to racial/ethnic groups has implications for targeted interventions, informing strategies to support Black, Hispanic, and other minoritized older adults in public health emergencies.

Negative Social Exchanges During the Pandemic, Loneliness, and the Mediating Role of Stress and Feeling Misunderstood Among People at High-Risk for COVID-19 Related Complications

The goal of this study was to investigate the links between social interactions and mental health for people who are high-risk for COVID-19 complications. Specifically, we tested the relationships between negative social exchanges during the pandemic and loneliness through two mediators: stress and feeling misunderstood about one's health status. Data were collected via Amazon's MTurk from participants (N = 271) who self-identified as being high-risk for COVID-19. The results from our model showed both a direct association between negative social interactions and loneliness, and an indirect link between these variables through stress. Overall, these results highlight the importance of understanding social interactions for people who are at high-risk for COVID-19 and their mental well-being. The results and implications are discussed.

Loneliness-associated factors among older adults: Focus on friendship type and number of friends

AIM

Loneliness among older people is prevalent. Few studies have examined the association of loneliness with the type of friendship and number of friends. This study aimed to clarify the loneliness-related factors among older adults by gender focusing on the type of friendship and number of friends.

METHODS

An anonymous, self-administered questionnaire survey was conducted on 1610 older adults in Japan. The questionnaire included basic characteristics, health status used by the self-administered dementia checklist, type of friendship and number of friends evaluated by the Lubben Social Network Scale, and loneliness evaluated using the University of California, Los Angeles Loneliness Scale. Univariate analysis was performed with loneliness as the dependent variable, and multiple logistic regression analysis was also performed.

RESULTS

A total of 1082 older adults were included for analysis. The loneliness rate was 16.8%. Regarding the type of friendship and number of friends, having <3 close friends to call on for help (tangible aid) was most associated with loneliness (men odds ratio [OR]: 2.88, women OR: 3.10). Higher awareness of the participants of subjective symptoms of dementia was proportionally related to loneliness (men, OR: 3.06; women, OR: 2.40). Among women, economic insecurity (OR: 1.68), subjective health (OR: 2.12), having <3 friends with whom they feel easy to talk about private matters (emotional support) were related to loneliness (OR: 2.38).

CONCLUSION

The results suggested that the type of friendship and number of friends, economic insecurity, and health status might be associated with loneliness among older adults. Several factors related to loneliness might differ by gender.

Australians' Well-Being and Resilience During COVID-19: The Role of Trust, Misinformation, Intolerance of Uncertainty, and Locus of Control

Background/Objectives: In response to the COVID-19 pandemic, Australian state and federal governments enacted boarder closures, social distancing measures, and lockdowns. By the end of October 2020, the 112-day lockdown in the Australian state of Victoria was the longest continuous lockdown period internationally. Previous studies have examined how the COVID-19 pandemic and government restrictions have affected Australians' mental health and well-being; however, less is known about the relationship between psychological variables and well-being. Methods: We administered a national survey of Australians aged 16 years and over (N = 1380) in November 2020 to examine the psychological factors that promoted and hindered Australians' well-being and resilience during the first year of the pandemic. Results: Our study found that Australians reported normal to moderate levels of anxiety, moderate stress, mild depression, and moderate to high loneliness. Interpersonal trust was consistently a protective factor for well-being and resilience and was associated with less depression, anxiety, stress, and loneliness, and greater resilience. Participants with greater inhibitory anxiety (intolerance of uncertainty) and an external locus of control were more likely to be depressed, anxious, stressed, and lonely, and less resilient, compared with those with less inhibitory anxiety and those who believed that these outcomes were determined by their own actions. COVID-19 beliefs were associated with more depression, anxiety, stress, and resilience. Conclusions: This study seeks to inform the development of mental-health, well-being, and resilience strategies by government agencies, non-government organisations, and healthcare providers in times of crisis and in "ordinary" times.

Validation of the French COVID-Related Thoughts and Behavioral Symptoms Questionnaire (Cov-Tabs): A self-report assessment

OBJECTIVES

The COVID-Related Thoughts and Behavioral Symptoms (Cov-Tabs) is a self-reported questionnaire developed to identify the presence of psychological distress and anxiety-related behavior associated with COVID-19. This scale has been used since the first episodes of mass contamination of COVID-19 disease in the USA without psychometric validation analysis. The objective of this paper is to validate the French version of the Cov-TaBS.

METHOD

In this study, we assessed a French translation of Cov-Tabs in 300 subjects from the general population. Moreover, we assessed convergent and discriminant validities using an anxiety and depression scale and a paranoid ideation scale. Statistical analyses consisted of evaluating internal consistency, test-retest reliability, and construct validity as well.

RESULTS

The French translation of the Cov-Tabs demonstrated high internal consistency and reliability, as well as good temporal stability over a period of less than 2 weeks. It also showed strong convergent validity with anxiety and depression traits and divergent validity with paranoid ideation.

CONCLUSION

Our study indicates that the French version of the Cov-Tabs has robust psychometric properties and is a valid tool for evaluating behavioral symptomatology and thoughts related to COVID-19 disease. Therefore, the French version of the Cov-Tabs is a valid tool that can be used in French-speaking individuals.

Do measures of social support and social distress share general factors associated with suicidal ideation and attempts?

INTRODUCTION

Aspects of social relationships have variably been associated with suicidal ideation (SI) and suicide attempts (SAs). This study assessed whether social support and social distress measures have general factors versus measure-specific factors that are associated with suicide risk.

METHODS

Adults (N = 455, 60.0% female), admitted to psychiatric inpatient units following a recent suicide attempt or active SI, completed assessments of social support (emotional support, instrumental support, friendship, perceived support from significant others, friends, family) and social distress (loneliness, perceived rejection, perceived burdensomeness, thwarted belongingness). Bifactor modeling examined general and specific factors of social support and distress in relation to SI (week prior to hospitalization, via the Beck Scale for SI) and SAs (past 30 days, via the Columbia Suicide Severity Rating Scale).

RESULTS

SI was significantly associated with the general social support (B = -1.51), the general social distress (B = 1.67), and the specific perceived burdensomeness (B = 1.57) factors. SAs were significantly associated with the specific Perceived Rejection (OR = 1.05) and Thwarted Belongingness (OR = 0.91) factors.

CONCLUSION

General social support and social distress were associated with SI but not recent SAs. Specific social distress factors were also related to SI and SAs controlling for general social distress, suggesting areas for future interventions.

How did previously obese children and adolescents behave during the SARS-CoV-2 pandemic in relation to weight gain?

OBJECTIVE

The objective of this study was to analyze the implications of social contingency measures and interruption of outpatient follow-up on weight gain in children and adolescents with a previous diagnosis of obesity.

METHODS

This is an observational study with data from electronic medical records of children and adolescents followed up at a specialized outpatient clinic from 2019 to 2023. Weight gain, height, BMI variation, BMI z-score, laboratory tests, and associated comorbidities were analyzed. The data were computed and analyzed using the Statistical Package for the Social Sciences (SPSS), and the results were considered statistically significant when p<0.05.

RESULTS

There was a weight gain of approximately 17.66% in the total set of participants, corresponding to a median increase of 14 kg. When analyzing between genders, we observed an approximate increase of 21.38% in body weight for men, while for women, it was 21.45%.

CONCLUSIONS

The COVID-19 pandemic has led to significant weight gain among previously obese children and adolescents in follow-up at a specialized outpatient clinic.

The psychosocial effects of the COVID-19 pandemic on Turkish older adults: is there a difference between males and females?

BACKGROUND

The COVID-19 pandemic has seriously affected older adults' social lives, physical activity, and cognitive functions. Additionally, the lockdowns have disrupted regular healthcare for patients with chronic illnesses or needing acute care. Furthermore, the pandemic has negatively affected different psychosocial influences in each country due to the various cultural characteristics, technology, health system, and financial opportunities. This study aimed to investigate the effects of COVID-19 on mood, social participation, and healthcare use in older adults living in Turkey.

METHODS

A cross-sectional study was conducted during the third wave of the COVID-19 pandemic (March-December 2021) in three medical centers in Turkey. Patients aged 60 + years without significant cognitive impairment were recruited by mail or at hospital admissions. Information on demographics, pandemic-related distancing measures, healthcare use, lifestyle, symptoms of anxiety, depression, and social participation were assessed.

RESULTS

A total of 343 participants were included in the study. Women had a higher rate of hypertension, symptoms of anxiety, depression, and fatigue compared to men (p < 0.05). Since the start of the pandemic, only 22.4% of non-acute healthcare appointments were conducted face-to-face. Time spent with family and friends, hope for the future, and physical activity decreased. At the same time, the experience of loneliness, the number of meals and unhealthy snacks, and the use of digital services increased. Women were also more concerned about getting coronavirus infection, transmitting the virus to others, and being discriminated against because of the infection (p < 0.05).

CONCLUSIONS

These pandemic days have had a significant psychosocial impact on Turkish older adults, especially women. As a strategy of the health care policy, easy access and follow-up to the health system should be provided, and the necessary support should be procured to minimize the detrimental effects of the pandemic on older people.

Bouncing back from COVID-19: The role of resilience in depression, substance use, and loneliness in college students amidst the pandemic

Objective: To assess the influence of specific COVID-19 impacts on college student depression, loneliness, and alcohol and cannabis use, and to investigate if resilience moderates these relationships. Participants: Data were collected from students (N = 1849, 80.9% white, 66.6% female) at a midwestern university during the 2021 winter/spring semester. Methods: Data were gathered cross-sectionally through an online survey platform. COVID-19 impacts and resilience's relationships with mental health variables were analyzed with multiple regression analysis. Moderation analyses were conducted using PROCESS. Results: The COVID-19 impacts measured in this study were significantly related to student depression and cannabis use. Resilience moderated the association between COVID-19 impacts and (a) depression and (b) cannabis use. Conclusion: Resilience may mitigate the effect of pandemic-related impacts on depression and cannabis use in college students, but not loneliness and alcohol use. These findings hold important implications for further research and practice.

Sleep Disturbances in Health Professional Students During the COVID-19 Pandemic: A Concept Analysis

AIM

The aim is to delineate the concept of sleep disturbances in health professional students during the COVID-19 pandemic.

DESIGN

A concept analysis was conducted.

METHODS

A systematic search was conducted for relevant articles published and performed from inception to July 5, 2024. Electronic databases searched included PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase and Web of Science. Rodgers' method of evolutionary concept analysis was used.

RESULTS

A total of 50 pertinent articles were included in our analysis. Utilising inductive thematic analysis, this study identified attributes, antecedents and consequences of sleep disturbances. Important attributes included insomnia, disrupted sleep patterns, altered sleep duration/nocturnal sleep duration and poor sleep quality. Antecedents encompassed factors such as gender, age/grade levels, physical activity, screen time of digital production, mental health issues, COVID-19-related stressors, financial strain and academic stress. Consequences included both mental and physical health implications. By addressing sleep disturbances and promoting better sleep health among students, we can enhance their learning and performance, which could translate to improved patient care outcomes. Additionally, understanding and mitigating sleep disturbances can contribute to the development of a more resilient and effective health care workforce, capable of providing high-quality care even during crises like the COVID-19 pandemic.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution.

Environmental Factors for Sustained Telehealth Use in Mental Health Services: A Mixed Methods Analysis

Background: The mental health service delivery gap remains high globally. Appropriate telehealth use may increase capacity through flexible remote care provision. Despite the historical lack of telehealth integration into publicly funded mental health services, during COVID-19 lockdowns, services rapidly switched to telephone and audiovisual care provision. In Aotearoa New Zealand (NZ), this was abandoned when no longer required by COVID-19 restrictions. This study explores environmental factors associated with telehealth implementation and ongoing use or discontinuation across a multiregional outpatient mental health service. This work contributes to understanding system-level factors influencing telehealth use and thus informs policy and practice in postpandemic environments. Methods: This mixed methods study applied an interpretive description methodology. Semistructured interviews with 33 mental health clinicians were thematically analysed. Qualitative findings were reframed and evaluated using time series analyses of population-level quantitative data (prior to and throughout the pandemic). Findings were synthesised with qualitative themes to develop an understanding of environmental factors contributing to telehealth use. Results: Findings highlighted an increase in clients assessed by mental health services and declining clinician numbers, contributing to pressure placed on clinicians. There was a lack of culture supporting telehealth, including limited awareness, leadership, and champions to facilitate implementation. Some teams provided services suited to telehealth; other subspeciality teams had limited applications for telehealth. There was a general lack of policy and guidelines to support telehealth use and limited technical support for clinicians unfamiliar with audiovisual software. Conclusion: Disorganised telehealth adoption in the study regions provides insight into wider environmental drivers affecting telehealth uptake. For telehealth to become a workable service delivery mode following COVID-19, stewardship and culture shifts are required, including policy development, technical support, and resources to support clinical teams. Telehealth may address growing service demand by improving interfaces with primary care and providing timely access to specialist input.

Loneliness and mental health during the COVID-19 pandemic in the Dutch general population: The moderating role of psychological flexibility

Previous studies conducted during the COVID-19 pandemic found an increased risk of loneliness due to measurements taken by governments to limit social interaction. The current study addresses the relationship between loneliness and both positive and negative mental health in times of the COVID-19 pandemic and the role of psychological flexibility. Data was collected in the Dutch general population (18+) with two online questionnaires (T1-T2), with an interval of four weeks. A sample of 340 participants varying in age from 18 to 83 years (Mage (SD): 52.83 (13) and 61.8 % female), filled in both questionnaires. Loneliness and (the six core processes of) psychological flexibility were measured at T1 and negative mental health (depression, anxiety and stress) and positive mental health (emotional, psychological and social well-being) at T2. Regression analyses indicated a positive (prospective) relation between loneliness and depression, anxiety and stress and a negative (prospective) relation between loneliness and emotional, psychological and social well-being. Psychological flexibility had a moderating effect on the relation between loneliness and depression but not on the relation between loneliness and respectively anxiety, stress or well-being. Looking at the six core processes of psychological flexibility, being present and committed action were significant moderators of the relation between loneliness and depression. We conclude that while it has yet to be determined whether the moderating relationships found in this study hold beyond COVID-19 conditions, the findings do provide support for the benefits of psychological flexibility to intervene in situations where external circumstances or psychological challenges are beyond one's control.

Stability and Volatility in the Contextual Predictors of Working-Age Mortality in the United States

The contextual predictors of mortality in the United States are well documented, but the COVID-19 pandemic may have upended those associations. Informed by the social history of disease framework (SHDF), this study examined how the importance of county contexts on adult deaths from all causes, drug poisonings, and COVID-19-related causes fluctuated during the pandemic. Using 2018 to 2021 vital statistics data, for each quarter, we estimated associations between county-level deaths among adults ages 25 to 64 and prepandemic county-level contexts (economic conditions, racial-ethnic composition, population health profile, and physician supply). The pandemic significantly elevated the importance of county contexts-particularly median household income and counties' preexisting health profile-on all-cause and drug poisoning deaths. The elevated importance of household income may be long-lasting. Contextual inequalities in COVID-19-related deaths rose and then fell, as the SHDF predicts, but rose again along with socio-political disruptions. The findings support and extend the SHDF.

The self-reported impacts of the COVID-19 pandemic on psychological health of U.S. Air Force cyber personnel

U.S. Air Force cyber personnel were faced with changes in their workplace, fitness routines, and personal lives during the COVID19 pandemic. Adjusting to COVID-19-related requirements likely increased the stress of already stressful jobs for military members and their families, which could have resounding impacts on emotional, social, and physical well-being. Therefore, it is important to evaluate psychological health outcomes and self-perceived impacts of the changes presented to cyber personnel because of the COVID-19 pandemic. An online occupational health assessment that included demographics, standardized measures of burnout, psychological distress, and work role strain; health behaviors; and perceived impacts of the COVID-19 pandemic was administered to 1488 cyber personnel. Thirty-two negative themes and 13 positive themes were created from qualitative coding for "How has the COVID-19 pandemic impacted you as an individual?" Of the themes created, 966 (68.5%) reported at least one negative impact and 440 (31.2%) reported at least one positive impact. Top-reported negative impacts were limited face-to-face interactions and loss of personal activities. Negative impacts were associated with negative psychological health outcomes (e.g., psychological distress, exhaustion, cynicism) and work role strain. Action-oriented recommendations are given in the event of another pandemic.

The Association Between Physical Distancing Behaviors to Avoid COVID-19 and Health-Related Quality of Life in Immunocompromised and Nonimmunocompromised Individuals: Patient-Informed Protocol for the Observational, Cross-Sectional EAGLE Study

BACKGROUND

Immunocompromised individuals are known to respond inadequately to SARS-CoV-2 vaccines, placing them at high risk of severe or fatal COVID-19. Thus, immunocompromised individuals and their caregivers may still practice varying degrees of social or physical distancing to avoid COVID-19. However, the association between physical distancing to avoid COVID-19 and quality of life has not been comprehensively evaluated in any study.

OBJECTIVE

We aim to measure physical distancing behaviors among immunocompromised individuals and the association between those behaviors and person-centric outcomes, including health-related quality of life (HRQoL) measures, health state utilities, anxiety and depression, and work and school productivity impairment.

METHODS

A patient-informed protocol was developed to conduct the EAGLE Study, a large cross-sectional, observational study, and this paper describes that protocol. EAGLE is designed to measure distancing behaviors and outcomes in immunocompromised individuals, including children (aged ≥6 mo) and their caregivers, and nonimmunocompromised adults in the United States and United Kingdom who report no receipt of passive immunization against COVID-19. We previously developed a novel self- and observer-reported instrument, the Physical Distancing Scale for COVID-19 Avoidance (PDS-C19), to measure physical distancing behavior levels cross-sectionally and retrospectively. Using an interim or a randomly selected subset of the study population, the PDS-C19 psychometric properties will be assessed, including structural validity, internal consistency, known-group validity, and convergent validity. Associations (correlations) will be assessed between the PDS-C19 and validated HRQoL-related measures and utilities. Structural equation modeling and regression will be used to assess these associations, adjusting for potential confounders. Participant recruitment and data collection took place from December 2022 to June 2023 using direct-to-patient channels, including panels, clinician referral, patient advocacy groups, and social media, with immunocompromising diagnosis confirmation collected and assessed for a randomly selected 25% of immunocompromised participants. The planned total sample size is 3718 participants and participant-caregiver pairs. Results will be reported by immunocompromised status, immunocompromising condition category, country, age group, and other subgroups.

RESULTS

All data analyses and reporting were planned to be completed by December 2023. Results are planned to be submitted for publication in peer-reviewed journals in 2024-2025.

CONCLUSIONS

This study will quantify immunocompromised individuals' physical distancing behaviors to avoid COVID-19 and their association with HRQoL as well as health state utilities.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR1-10.2196/52643.

Eating disorders and COVID-19 - different or just more?

BACKGROUND

COVID-19 saw an increase in child mental health presentations internationally. Clinicians analogised the exponential increase in anorexia nervosa to a 'tsunami' or 'outbreak', raising parallel concerns regarding medical and psychological risks (Marsh in The Guardian, 2021; Leask in NZ Herald, 2021; Monteleone et al. in Eat Weight Disord 26(8):2443-2452, 2021) . It is unclear whether Ireland emulated this picture of increased referrals with increased medical compromise.

AIMS

This paper examines both rates and clinical profiles of child eating disorder presentations in the Republic of Ireland (ROI), across different clinical settings.

METHODS

Following ethical approval, retrospective chart reviews were conducted in a community eating disorder service and in two paediatric hospital settings. The time frame of the different studies ranged from January 2016 to December 2022.

RESULTS

Community eating disorder services saw significantly higher referral rates post COVID-19 (3.78/month vs. 2.31/month, p = 0.02), with a shorter duration of illness (4.8 months vs. 7.4 months, p = 0.001), but no significant difference in ideal body weight % (IBW%) at referral (85.32% vs. 83.7%, p = 0.1). Both paediatric hospitals witnessed significantly increased referrals post-COVID-19 (hospital 1; 4.38/month vs. 1.93/month, p = 0.0001; hospital 2; 2.8/month vs. 0.92/month, p < 0.0001), but no significant difference in IBW% at assessment (hospital 1; 82.7% vs. 81.39%, p = 0.673; hospital 2; 81.5% vs. 83%, p = 0.563). There was no significant difference in clinical profile, management, or duration of hospital stay.

CONCLUSIONS

This study supports the growing consensus of a pandemic specific increase in eating disorder referrals to both medical and psychiatry services. However, there was little to indicate a change in clinical profile or severity. Ongoing monitoring of referrals is necessary to ensure adequate service availability and expertise.

Mourning in the time of coronavirus: Examining how grief differs in those who lost loved ones to COVID-19 vs. natural causes in Iran

OBJECTIVES

Our study aimed to analyze and compare the grief experiences of individuals in Iran who lost family members to COVID-19 and those who lost loved ones to other natural causes.

METHODS

In this study, telephone interviews were conducted with 640 first-degree relatives, and finally, a total of 395 people remained in the research. Participants answered the Prolonged Grief Questionnaire (PG-13-R) and Grief Experience Questionnaire.

RESULTS

The results showed that the most common symptoms and features of grief were feeling guilt, searching for an explanation, somatic reactions, and rejection, with no significant difference observed between the 2 death groups. However, the average scores for these symptoms were higher in the COVID-19 death group. Moreover, the majority of bereaved reported signs and symptoms of prolonged grief, with a higher percentage in the COVID-19 death group, although there was no significant difference between the 2 death groups in terms of the distribution of symptoms and signs of prolonged grief. These findings suggest that the bereavement process can be challenging, and losing a loved one to COVID-19 may lead to more intense experiences of grief.

SIGNIFICANCE OF RESULTS

The study reveals high levels of guilt, searching for meaning, somatic reactions, and rejection among COVID-19 grievers. Losing loved ones to the pandemic appears linked to more intense, prolonged grief symptoms.

Effect of COVID-19 lockdowns on quality-of-life and health services access by socio-economic status in Australia

This study examined changes in physical and mental health quality-of-life and health services access before and after the onset of the COVID-19 pandemic among individuals of lower and higher socio-economic status (SES) in Australia. Difference-in-differences and logistic regression models were undertaken using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey and government data on COVID-19 lockdowns between January 2020 and February 2021. Individuals from higher SES reported larger decreases in mental health quality-of-life scores than those from lower SES after the onset of the pandemic. Those from lower SES reported less disruption with any health services (24.2% vs 30.4%; OR = 0.68; p < 0.001), specifically dental services (8.2% vs 15.4%; OR = 0.51; p < 0.001) and allied health services (5.9% vs 8.5%; OR = 0.60; p < 0.001), compared with those from higher SES. Additional days under lockdown were associated with reduced access to all health services (OR = 1.19). Furthermore, long-term health conditions (higher SES: OR = 1.54) and scores indicative of poorer physical (lower SES: OR = 1.17; higher SES: OR = 1.07) and mental health (lower SES: OR = 1.16; higher SES: OR = 1.12) were associated with increased health services disruption. While individuals from higher SES were more likely than those from lower SES to experience greater relative declines in mental health and increased disruption with health services access, individuals with a greater apparent need for health services, regardless of SES, may have faced inequalities in accessing these services during the COVID-19 pandemic.

Determinants of social health trajectories during the COVID-19 pandemic in older adults: the Rotterdam Study

OBJECTIVES

The coronavirus disease-2019 (COVID-19) pandemic and accompanying lockdown restrictions impacted social life significantly. We studied associations of sociodemographic factors, mental and social health markers, and brain structure with social health trajectories during the COVID-19 pandemic.

DESIGN

Prospective longitudinal population-based cohort study.

SETTING

Community-dwelling inhabitants of Rotterdam, the Netherlands.

PARTICIPANTS

Repeated questionnaires including questions on social health were sent to Rotterdam Study participants from April 2020 onwards. Social health data at study baseline were available for 5017 participants (mean age: 68.7 ± 11.3; 56.9% women).

MEASUREMENTS

Determinants were assessed in routine Rotterdam Study follow-up (1990-2020), including global brain volumes in a subset of participants (N = 1720). We applied linear mixed models and generalized estimating equations to quantify associations between determinants and trajectories of loneliness, perceived social isolation and social connectedness over three time points from April 22nd to July 31st 2020.

RESULTS

Loneliness prevalence was 27.9% in April 2020 versus 12.6% prepandemic. Social isolation (baseline mean 4.7 ± 2.4) and loneliness scores (baseline mean 4.9 ± 1.5) decreased over time, whereas social connectedness trajectories remained stable. Depressive symptoms, female sex, prepandemic loneliness, living alone, and not owning a pet were independently associated with lower social connectedness and higher social isolation and loneliness at COVID-19 baseline, but recovery of social health was similar for all determinants. Larger intracranial volume was associated with higher social connectedness.

CONCLUSIONS

Despite baseline differences for specific determinants, older adults showed similar recovery of loneliness and social isolation alongside stable social connectedness over time during the pandemic. Social health is multidimensional, especially during a global health crisis.

The impact of social isolation on smartphone addiction among college students: the multiple mediating effects of loneliness and COVID-19 anxiety

Background

The widespread use of smartphones has significantly increased smartphone addiction among college students, especially during the COVID-19 pandemic. Since the COVID-19 outbreak, university campuses in mainland China have strictly followed the Chinese government's strict quarantine policy, including closed campus management, prohibitions against gatherings, and social distancing, increasing student loneliness and anxiety and thus increasing the risk of smartphone addiction. Extant Studies have revealed that social isolation is a prominent predictor of smartphone addiction but have failed to systematically explore the complex relationship between social isolation and smartphone addiction in the context of COVID-19; therefore, the underlying mechanisms of these factors in the post-pandemic era are unclear.

Objective

This study is the first attempt to consider loneliness, COVID-19 anxiety and social isolation as a whole and to clarify the underlying mechanisms of social isolation and smartphone addiction by constructing a multiple mediating model.

Method

This study included students enrolled at eight higher education institutions in Conghua District (Guangzhou city). Quota proportional sampling was adopted, 900 self-report questionnaires were distributed through the WeChat groups of these universities from December 10 to December 15, 2022, and 868 valid questionnaires (620 females, 248 males) were ultimately obtained.

Results

The direct effect of social isolation on smartphone addiction was significant, and loneliness and COVID-19 anxiety mediated the association between social isolation and smartphone addiction in both parallel and sequential ways. Moreover, a reverse mediation model with COVID-19 anxiety as the first mediator and loneliness as the second mediator was found.

Conclusion

College students who experience social isolation are at greater risk for smartphone addiction, and the core factor leading to their smartphone addiction is the subjective psychological state triggered by campus isolation and social distancing, such as loneliness and anxiety. These risky behaviors of people should receive extra attention, and psychological factors such as loneliness and COVID-19 anxiety should be considered in future therapies aimed at reducing addiction.

Exploring the association between social support and anxiety during major public emergencies: a meta-analysis of the COVID-19 pandemic

Objective

The COVID-19 pandemic has prompted a surge in research focusing on mental health issues faced by society, with particular emphasis on the interplay between social support and anxiety. However, the results of these studies have often been controversial.

Methods

To address this, we conducted a meta-analysis of 104 studies (N = 107,660) to investigate the relationship between anxiety and social support and the potential moderate variables.

Results

Our meta-analysis revealed a negative correlation between social support and anxiety (r = -0.233). The study also demonstrated the variation in the relationship between social support and anxiety was moderated by cultural area (Q = 14.120, p < 0.05) and phrase of the pandemic (Q = 13.678, p < 0.05).

Conclusion

The relationship between social support and anxiety can differ across different cultural areas and throughout the phrase of the pandemic. Consequently, we advocate for a nuanced assessment of the role of social support in mitigating public anxiety, taking into account the mediating effects of these factors in the context of major public emergencies.

Physical, psychological, and social experiences of women recovered from COVID-19 in Iran: A qualitative study

BACKGROUND

This paper aims to examine the impact of COVID-19 on various health aspects of women recovered from this disease in Ardabil province, Iran.

MATERIALS AND METHODS

This qualitative study using a content analysis approach was carried out through in-depth individual and focus group discussion using semi-structured interviews schedule in 26 women during June and August 2021. Interviews were recorded, transcribed, and MAXQDA six-stage analysis framework.

RESULTS

Negative consequences of COVID-19 were generally categorized into five main themes (including increased self-conscious excitement, perceived social stigma, depression, changes in behavioral patterns, and reduced level of quality of life) and 13 subthemes. The positive consequences were the following five themes (including the development of the spiritual attitude, increasing the importance of personal health, the rise of perceived support, increased sense of altruism, and increased financial management) and four subthemes.

CONCLUSION

Based on the findings, it is concluded that effective support by the government, society, and the medical staff could help to relieve people's psychological and social stress through providing financial aid, the right information, and training.

Socio-demographic factors and COVID-19 experiences predict perceived social support and social media engagement among college students in the U.S

OBJECTIVE

This study examined socio-demographic characteristics and COVID-19 experiences as concurrent predictors of perceived familial and friend social support, social media use, and socio-emotional motives for electronic communication during the COVID-19 pandemic among college students.

PARTICIPANTS

Participants were 619 emerging adults (18-29-year-olds) currently enrolled at, or recently graduated from, a U.S.-based college or university (Mean age = 21.8, SD = 2.2; 64% female; 60% Non-Hispanic White).

METHODS

Online surveys were administered between May and June 2020. A path analysis model was conducted to examine the concurrent associations between socio-demographic factors, COVID-19-related experiences, social media/electronic engagement, and perceived social support.

RESULTS

Findings indicated significant differences in perceived social support, social media use, and socio-emotional motives for electronic communication as a function of gender, race, sexual orientation, first-generation status, and relationship status.

CONCLUSIONS

Our findings highlight the role of both individual and situational differences in interpersonal functioning and demonstrate how college students differently engaged with social media for socio-emotional purposes during the COVID-19 pandemic.

Stress and the Consumption of Ultra-Processed Foods during COVID-19's Social Distancing: Are Mental Disorders Mediators in This Association? ELSA-Brasil Results

The COVID-19 pandemic exacerbated various determinants of mental disorders. Several behavioral changes were observed given this increase, including harmful health consequences, such as excessive consumption of ultra-processed foods (UPFs). To assess this relationship, we investigated the meditational role of symptoms of mental disorders (anxiety and depression) in the association between stress resulting from social distancing during the COVID-19 pandemic and the consumption of UPFs in 3884 Brazilian public employees in a supplementary study of the ELSA-Brasil study. Structural equation models (SEMs) were estimated to assess the direct and indirect effects mediated by symptoms of mental disorders. The results suggested a significant and positive mediational effect of the symptoms of mental disorders on the association between the stress resulting from social distancing and the consumption of UPFs. These findings contribute to informing the need for policies and early interventions in potentially stressful situations, with a focus on the promotion of mental health, and may thus help prevent or reduce the consumption of unhealthy foods.

The Effect of Peer Relationships on Adolescent Loneliness: The Role of Psychological Resilience and the OXTR Gene

Background

Based on the gene-environment interaction paradigm, this study explored the effect of peer relationships on adolescent loneliness and the role of psychological resilience and the oxytocin receptor gene (OXTR).

Methods

A survey was conducted in a sample of 619 adolescents, and their oral cells were collected for DNA extraction and genotyping.

Results

The results showed that (1) both peer relationships and psychological resilience significantly affected adolescent loneliness; (2) psychological resilience partially mediated the relationship between peer relationships and loneliness in adolescents; (3) OXTR gene rs53576 polymorphism moderated both the first and second half of the indirect pathway of the mediation model. Specifically, carriers of the rs53576 polymorphism A/A genotype showed a significantly enhanced effect of peer relationships on adolescent psychological resilience, while carriers of the rs53576 polymorphism G/G genotype showed a significantly enhanced effect of psychological resilience on adolescent loneliness.

Conclusion

These findings helped elucidate the developmental mechanisms of adolescent loneliness in terms of peer relationships, psychological resilience, and OXTR gene polymorphisms.

Introducing a Remote Patient Monitoring Usability Impact Model to Overcome Challenges

Telehealth and remote patient monitoring (RPM), in particular, have been through a massive surge of adoption since 2020. This initiative has proven potential for the patient and the healthcare provider in areas such as reductions in the cost of care. While home-use medical devices or wearables have been shown to be beneficial, a literature review illustrates challenges with the data generated, driven by limited device usability. This could lead to inaccurate data when an exam is completed without clinical supervision, with the consequence that incorrect data lead to improper treatment. Upon further analysis of the existing literature, the RPM Usability Impact model is introduced. The goal is to guide researchers and device manufacturers to increase the usability of wearable and home-use medical devices in the future. The importance of this model is highlighted when the user-centered design process is integrated, which is needed to develop these types of devices to provide the proper user experience.

Social distancing stress, anxiety/depression, COVID-19 diagnosis, gender identity, and immigration status

BACKGROUND

Strict social distancing public health measures to decrease COVID-19 spread increased social distancing stress. However, differences in social distancing stress by anxiety/depression symptoms are understudied, especially based on COVID-19 diagnosis status, gender identity, and immigration status. We examined whether the association between social distancing stress and anxiety/depression symptoms was moderated by COVID-19 diagnosis status, gender identity, and immigration status. We further examined the associations of social distancing stress with anxiety/depression symptoms, gender identity, and immigration status among individuals with and without COVID-19.

METHODS

We utilized data from a national cross-sectional survey among adults aged ≥ 18 years in the United States between May 13, 2021, and January 9, 2022 (n = 5,255). Multivariable logistic regression models were used to examine the associations.

RESULTS

The prevalence of social distancing stress was higher among individuals with COVID-19 (79.23%) than among those without COVID-19 (67.51%). We observed significant associations between social distancing stress and anxiety/depression symptoms, moderated by COVID-19 diagnosis status, immigration status, and gender identity, respectively. Anxiety/depression symptoms were associated with social distancing stress among both individuals with and without COVID-19. Gender identity and immigration status were associated with social distancing stress among only individuals without COVID-19.

CONCLUSIONS

Our findings revealed that the association between social distancing stress and anxiety/depression varied by COVID-19 diagnosis status, gender identity, and immigration status. The findings underscore the need for more targeted psychological distress strategies to reduce social distancing stress and anxiety/depression among diverse US populations, while considering the impacts of COVID-19 diagnosis status, gender identity, and immigration status.

The social, psychological, and physical impact of COVID-19 restrictions for institutionalized adults with intellectual and developmental disabilities

During the COVID-19 pandemic, drastic measures to interrupt SARS-CoV-2 infection chains were implemented. In our study we investigated the consequences of pandemic related restrictions on the social, psychological, and physical well-being of institutionalized adults with intellectual and developmental disabilities. Methods: Online survey among professional caregivers in 71 residential groups, caring for 848 residents. Findings: (i.) A lack of participation concerning infection protection measures of the residents, their relatives, and their caregivers; (ii.) A 20% increase in doctor contacts during the pandemic; (iii.) A considerable deterioration in at least one item of the subdomains mood (49%), everyday skills (51%), social interaction (29%), exercise and coordination skills (12%), behavior (11%) and cognition and communication (7%); (iv.) A deterioration of the overall condition in 41%; Summery: Intensive attempts should be made to find individual and less categorical contra-infectious measures without questioning the basic everyday needs of people with intellectual and developmental disabilities.

Risk factors and health behaviors associated with loneliness among cancer survivors during the COVID-19 pandemic

Loneliness may exacerbate poor health outcomes particularly among cancer survivors during the COVID-19 pandemic. Little is known about the risk factors of loneliness among cancer survivors. We evaluated the risk factors of loneliness in the context of COVID-19 pandemic-related prevention behaviors and lifestyle/psychosocial factors among cancer survivors. Cancer survivors (n = 1471) seen at Huntsman Cancer Institute completed a survey between August-September 2020 evaluating health behaviors, medical care, and psychosocial factors including loneliness during COVID-19 pandemic. Participants were classified into two groups: 'lonely' (sometimes, usually, or always felt lonely in past month) and 'non-lonely' (never or rarely felt lonely in past month). 33% of cancer survivors reported feeling lonely in the past month. Multivariable logistic regression showed female sex, not living with a spouse/partner, poor health status, COVID-19 pandemic-associated lifestyle factors including increased alcohol consumption and marijuana/CBD oil use, and psychosocial stressors such as disruptions in daily life, less social interaction, and higher perceived stress and financial stress were associated with feeling lonely as compared to being non-lonely (all p < 0.05). A significant proportion of participants reported loneliness, which is a serious health risk among vulnerable populations, particularly cancer survivors. Modifiable risk factors such as unhealthy lifestyle behaviors and psychosocial stress were associated with loneliness. These results highlight the need to screen for unhealthy lifestyle factors and psychosocial stressors to identify cancer survivors at increased risk of loneliness and to develop effective management strategies.

Exercise activates interferon response of the liver via Gpld1 to enhance antiviral innate immunity

Healthy behavioral patterns could modulate organ functions to enhance the body's immunity. However, how exercise regulates antiviral innate immunity remains elusive. Here, we found that exercise promotes type I interferon (IFN-I) production in the liver and enhances IFN-I immune activity of the body. Despite the possibility that many exercise-induced factors could affect IFN-I production, we identified Gpld1 as a crucial molecule, and the liver as the major organ to promote IFN-I production after exercise. Exercise largely loses the efficiency to induce IFN-I in Gpld1-/- mice. Further studies demonstrated that exercise-produced 3-hydroxybutanoic acid (3-HB) critically induces Gpld1 expression in the liver. Gpld1 blocks the PP2A-IRF3 interaction, thus enhancing IRF3 activation and IFN-I production, and eventually improving the body's antiviral ability. This study reveals that exercise improves antiviral innate immunity by linking the liver metabolism to systemic IFN-I activity and uncovers an unknown function of liver cells in innate immunity.

Changes in Sleep Duration and Sleep Timing in the General Population from before to during the First COVID-19 Lockdown: A Systematic Review and Meta-Analysis

BACKGROUND

The COVID-19 lockdown had a profound effect on everyday life, including sleep health. This systematic review and meta-analysis evaluated changes in quantitative sleep parameters during the first lockdown compared with pre-lockdown in the general population.

METHODS

A search in scientific databases was performed to identify eligible observational studies from inception to 8 February 2023. We performed a random effects meta-analysis of those studies reporting (a) means of sleep duration, time in bed (TIB), and sleep timing (bedtime and wake-up time); (b) the percentages of atypical sleep duration before and during the lockdown; (c) the percentages of change in sleep duration and sleep timing.

RESULTS

A total of 154 studies were included. A small increase in sleep duration (0.25 standardized mean difference, 95% CI 0.180-0.315) was found, with 55.0% of the individuals reporting changes, predominantly an increase (35.2%). The pooled relative risk for sleeping more than 8/9 h per night was 3.31 (95% IC 2.60-4.21). There was a moderately significant delay in sleep timing and a surge in napping.

CONCLUSION

An increase in sleep duration and napping, and delayed sleep timing were observed. High-quality studies should evaluate whether these parameters have now become chronic or have returned to pre-lockdown values.

Positive effects of the COVID-19 pandemic on depression and anxiety in Chinese adolescents

The potential impact on mental health of home schooling and social isolation due to COVID-19 lockdowns has led to widespread concern, particularly for adolescents. However, studies including pre-pandemic data from longitudinal cohorts with an assessment of the longer-term impact of the Covid-19 pandemic beyond the first months of 2020 are scarce. This longitudinal study of 1534 adolescents attending a secondary school in Hunan province investigated self-reported symptoms of anxiety and depression using two validated scales (Screen for Child Anxiety Related Disorders, Child Mood and Feelings Questionnaire) at six time points before, during, and after the 2020 national lockdown restrictions in China. Perceived COVID-related stress was assessed by an author-developed scale at two timepoints during the lockdown. We investigated trends in symptoms over time with a fixed effects model and multiple imputations of missing data. Counter to our expectations, depressive and anxiety symptoms were reduced during the 2020 lockdown relative to pre-lockdown (depression: b = - 3.37, SE = 0.345, Cohen's d = - 0.25, p < 0.0001; anxiety: b = - 4.55, SE = 0.382, Cohen's d = - 0.30, p < 0.0001). Symptoms remained significantly reduced even after lockdown restrictions eased. Higher symptom levels during lockdown were associated with greater self-reported COVID-related stress (depression: b = 0.11, SE = 0.026, p < 0.0001; anxiety: b = 0.11, SE = 0.036, p < 0.0001). Although COVID-related stresses correlated with higher levels of anxiety and depression, the lockdown period was associated with improved symptom levels in the adolescents taking part in our study. School closures may have improved the mental health of adolescents in China. We speculate this beneficial effect of lockdown can be explained by the adverse effects of attending school itself such as exposure to bullying and achievement pressures.