Trajectories of resilience and mental distress to global major disruptions

Trajectories of depressive and anxiety symptoms and associated risk factors during the COVID-19 pandemic in Germany: A longitudinal cohort study

BACKGROUND

Most COVID-19-related mental health research focused on average levels of mental health parameters in the general population. However, considering heterogeneous groups and their long-term responses could deepen our understanding of mental health during community crises. This four-wave study aimed to (1) identify subgroups with different trajectories of depressive and anxiety symptoms in the German general population, and (2) investigate associated risk factors.

METHODS

We analyzed self-report data from N = 1257 German adults participating in a European cohort study, assessed in summer 2020 (T1), and at 6 (T2), 12 (T3), and 30 months (T4). Depressive and anxiety symptoms were measured using the PHQ-4. Sociodemographic, health-related, and pandemic-related variables were assessed at baseline. We applied growth mixture modeling to identify subgroups of symptom trajectories and conducted multinomial logistic regression to examine factors associated with class membership.

RESULTS

We identified six symptom trajectories: Low-stable (n = 971, 77.2 %), Continuous deterioration (n = 30, 2.4 %), Transient deterioration (n = 75, 6.0 %), Continuous improvement (n = 97, 7.7 %), Transient improvement (n = 38, 3.0 %) and Chronicity (n = 46, 3.7 %). Age, education, work status, mental health diagnoses, self-reported health, and pandemic-related news consumption were significantly associated with subgroup membership.

LIMITATIONS

The generalizability of the study is constrained by an unrepresentative sampling method, a notable dropout rate, and limited consideration of risk factors.

CONCLUSION

Most people experienced low symptoms or improvement during the pandemic, while others experienced chronic or transient symptoms. Specific risk factors were associated with these trajectories, revealing nuanced mental health dynamics.

Sense of coherence, mental health, and hair cortisol concentrations among older people during the COVID -19 pandemic: a cross-sectional study

BACKGROUND

A person's sense of coherence (SoC) is likely to affect coping when exposed to a life changing event like the COVID -19 pandemic, which impacted the older population especially hard, an age group that already suffers from a lot of mental illness. Thus, the aim of this study was to investigate the associations between SoC and mental health in older adults using both screening scales and hair cortisol concentrations (HCC).

METHOD

A cross-sectional design studying a cohort of 70-80 years old, N = 260, set in Swedish primary care during the pandemic years 2021-2022. Instruments used are sense of coherence 13 (SoC-13), EQ-5D-3L, Geriatric depression scale 20 (GDS-20), Hospital anxiety and depression scale (HADS), and Perceived stress scale 10 (PSS-10). Sociodemography and factors concerning SoC, and mental health are explored. HCC are measured using radioimmunoassay. Outcome measures are factors independently associated with SoC. Linear regression models were performed with SoC as dependent variable, and priory path analyses explored whether associations with SoC were direct, or indirect via anxiety.

RESULTS

SoC was significantly associated with anxiety (p < 0.001), perceived economic status (p = 0.003), belief in the future (p = 0.001), and perceived negative mental effect from the COVID -19 pandemic (p = 0.002). The latter was 96% indirectly associated with SoC (p < 0.001), whereas perceived economic status together with belief in the future was 82% directly associated with SoC (p = 0.17). HCC and sex were not significantly associated with SoC, but, noticeably, high HCC was equally distributed between women and men. Women reported significantly lower quality of life (p = 0.03), and more symptoms of anxiety (p = 0.001) and depression (p < 0.001).

CONCLUSION

Anxiety, belief in the future, perceived negative effect on mental health due to the pandemic, and perceived economic status were significantly associated with SoC. Anxiety is suggested to be important in explaining the association between perceived negative mental effect from the COVID-19 pandemic and SoC. Women reported significantly poorer mental health and life quality than men.

The three axioms of resilience

This article summarizes the growing literature on resilience in the face of aversive and potentially traumatic events (PTEs) in three basic axioms: (a) resilience is a common outcome, 2) there are no "key" traits to resilience (resilience is not a type), and (c) resilient outcomes occur through flexible self-regulation. The first axiom highlights the limitation of a traditional, binary view of trauma in terms of the presence-absence of posttraumatic stress disorder, emphasizing instead the heterogeneity of trauma outcomes. Four prototypical trajectories are reviewed: chronic symptoms; delayed symptoms; recovery; and the most common trajectory, resilience. The second axiom reviews the paradoxical inability of known correlates of resilience to adequately predict resilient outcomes. Resilience is instead described as a multifaceted phenomenon with no singular set of key traits, as various factors contribute to resilient outcomes in complex ways. The third axiom provides an explanation of how resilience can emerge from this complex array by introducing the concept of flexible self-regulation. The flexibility mindset is described as providing the motivation for flexible responding. The flexibility sequence is described as explaining the mechanisms underlying flexibility in terms of three serial stages: context sensitivity, strategy repertoire, and feedback adjustment. The final section briefly considers clinical implications.

Heterogeneous trajectories of depression and resilience following limb amputation

OBJECTIVE

To identify longitudinal trajectories of depression in the first 6 months following limb loss and to explore baseline predictors of trajectories, including pain and demographic factors. A secondary aim was to evaluate whether trajectories of depression were associated with elevated symptoms of posttraumatic stress (PTS) at 6 months.

DESIGN

Secondary longitudinal data analysis of an inception cohort study of persons with new-onset limb loss. Participants completed assessments at three intervals (initial, 3 months, and 6 months).

SETTING

Hospitalized care, acute rehabilitation, ambulatory care, and community.

PARTICIPANTS

Participants were recruited from consecutive cases of amputation surgery in a metropolitan hospital system over a period of 4 years (2002-2007). The final sample (n = 203) was predominantly White (79.3%) and male (78.8%) with an average age of 49.4 years (standard deviation [SD] = 14.6).

MAIN OUTCOME MEASURE(S)

Depression was assessed via the Patient Health Questionnaire-9 (PHQ-9); posttraumatic stress symptoms were measured via the PTSD checklist- Civilian Version (PCL-C).

RESULTS

Four trajectories of depression were identified via Latent Growth Mixture Modeling: Resilience (73.2%), Chronic Depression (11.2%), Emerging Depression (8.9%), and Recovery (6.7%). Average pain intensity significantly predicted trajectory membership. Membership in the Chronic Depression class predicted elevated 6-month PTS compared to all other classes; membership in the Resilience class predicted lower PTS than in the Chronic and Emerging Depression classes but did not differentiate from the Recovery trajectory.

CONCLUSIONS

Findings reveal that the course of depression post-amputation is heterogenous, with varying profiles of symptom development, maintenance, and remission. A majority of individuals were classified as Resilient, whereas a substantial minority of individuals developed clinically significant depression between 3 and 6 months (Emerging Depression), suggesting that early screening during acute care may be insufficient. We detected a significant prospective relation between depression trajectories and distal PTS, advancing the potential clinical utility of trajectory modeling as a risk surveillance tool.

What set some young adults apart during the COVID-19 pandemic? Mental health trajectories, risk and protective factors in an Australian longitudinal study

OBJECTIVE

Evidence suggests that young adults (aged 18-34) were disproportionately impacted by the COVID-19 pandemic, but little is known about their longer-term mental health changes beyond the early pandemic period. This article investigates heterogeneous trajectories of mental health among Australian young adults across 2 years of the pandemic and identifies a broad range of associated risk and protective factors.

METHOD

Young adults (N = 653, Mage = 27.8 years) from the longitudinal Alone Together Study were surveyed biannually between July 2020 and June 2022. Measures assessed anxiety (7-item Generalised Anxiety Disorder scale) and depression (9-item Patient Health Questionnaire) symptoms at Waves 1-4, as well as demographic, psychological, adversity and COVID-19 factors at baseline.

RESULTS

Four and three distinct trajectories of anxiety and depressive symptoms, respectively, were identified through growth mixture modelling. The proportion of participants in each anxiety trajectory were Asymptomatic (45.9%), Mild Stable (17.9%), Moderate-Severe Stable (31.1%) and Initially Severe/Recovering (5.1%). For depression, Mild Stable (58.3%), Moderate-Severe Stable (30.5%) and Reactive/Recovering (11.2%). Baseline factors associated with severe symptom trajectories included a lifetime mental health disorder, pre-pandemic stressful events, identifying as LGBTQIA+ and/or female, and experiencing one or more infection-control measures. Higher household income was protective.

CONCLUSION

Most young adults demonstrated stable trajectories of low or high symptoms during the pandemic, with smaller groups showing initially severe or reactive symptoms followed by marked improvements over time. Vulnerable subgroups (gender- or sexuality-diverse, those with prior adversity or pre-existing mental ill-health) may face ongoing impacts and require targeted psychosocial supports to assist their mental health recovery post-COVID-19 and in the event of future crises.

Predictors of stress resilience in Parkinson's disease and associations with symptom progression

People with Parkinson's disease (PD) are sensitive to effects of long-term stress, but might differ in stress resilience, i.e. the ability to maintain mental health despite adversity. It is unclear whether stress resilience in PD is predominantly determined by dopamine deficiency, psychosocial factors, or both. In PD animal models, chronic stressors accelerate disease progression, but evidence in humans is lacking. Our objectives were to (1) distinguish stressor-reactive from resilient PD patients, (2) identify resilience factors, and (3) compare symptom progression between stressor-reactive and resilient patients. We conducted a longitudinal survey in Personalized Parkinson Project participants (N = 350 PD). We used the COVID-19 pandemic as a model of a stressor, aligned in time for the entire cohort. COVID-19-related stressors, perceived stress, and PD symptoms were assessed at 11 timepoints (April-October 2020). Both pre-COVID and in-COVID clinical assessments were available. We quantified stressor-reactivity as the residual between actual and predicted perceived stress relative to COVID-19-related stressors, and modeled trajectories of stressor-reactivity across timepoints. We explored pre-COVID predictors of 6-month average stressor-reactivity, and tested whether stressor-reactivity was prospectively associated with one-year clinical progression rates. Latent class trajectory models distinguished patients with high (N = 123) or low (N = 227) stressor-reactivity. Pre-existing anxiety, rumination and non-motor symptom severity predicted high stressor-reactivity (risk factors), whereas quality of life, social support, positive appraisal style and cognitive abilities predicted low stressor-reactivity (resilience factors). PD-specific factors, e.g. disease duration, motor severity, and levodopa use, did not predict stressor-reactivity. The COVID-19 pandemic did not accelerate disease progression, but worsened depressive symptoms in stressor-reactive PD patients.

Exploring the discourses around microdosing psychedelics within the r/microdosing online community

In the present contribution, we examine the practice of microdosing psychedelics (microdosing) through textual analysis of the content produced by a dedicated online community, the r/microdosing subreddit. We collected a comprehensive dataset of publicly available submissions from this community and used structural topic modelling to identify and analyse the prevalent topics within the discussions. Through our analysis, we identified 16 distinct topics that mapped into clinical, human enhancement, as well as self-medication narratives. Notably, we found that the majority of discussions revolved around "how to" topics, supporting our argument that such online communities serve as essential information hubs, facilitating the dissemination of practical knowledge related to microdosing practices among the general population. The identified impact of the Covid-19 pandemic on the prevalence of discussion topics suggests that individuals within the online community may perceive microdosing primarily as a means of self-medication during times of heightened stress and uncertainty. Our findings contribute to the field of health sociology and psychedelic research by shedding light on the sociocultural factors influencing healthcare practices, including the role of online communities in facilitating processes of self-medicalization and self-medication.

Spirituality and anxiety in pastoral care workers and physicians in the first wave of the COVID-19 pandemic

Background

The COVID-19 pandemic had serious impact on the well-being of health care workers and highlighted the need for resources to help hospital staff to cope with psychologically negative consequences. The purpose of this study was to investigate the potentially protective effect of spirituality, as measured by the construct of transpersonal trust, against anxiety in physicians and in hospital pastoral care workers. In addition, transpersonal trust was compared to the effects of other potential resources, namely sense of coherence, optimism, and resilience. We also explored the relationship between transpersonal trust and anxiety and how it was moderated by sense of coherence and expected a significant effect.

Method

The sample included N = 405 participants (n = 151 pastoral care workers and n = 254 physicians) who completed an online survey during the first wave of the COVID-19 pandemic between 20th April and 05th July, 2020, that comprised established questionnaires assessing anxiety, transpersonal trust, sense of coherence, and resilience.

Results

There was no statistically significant negative relationship between transpersonal trust and anxiety in either profession or broken down by occupational group. Multiple regression analysis revealed that sense of coherence inversely predicted generalized anxiety, while transpersonal trust, resilience, and optimism did not. As hypothesized, the association between transpersonal trust and anxiety was moderated by sense of coherence. However, we could not confirm our hypothesis of a protective effect of transpersonal trust against anxiety.

Conclusion

Our results point to the significant role of sense of coherence as a protective factor against anxiety and highlight the complexity of the relationship among spirituality, transpersonal trust, and anxiety.

Validation of the Distress Thermometer as a Screening Tool for Psychosocial Distress and Resilience in Parkinson's Disease

BACKGROUND

Parkinson's disease (PD) is associated with psychosocial distress that affects patients' quality of life. The distress thermometer (DT) is an 11-point visual analogue scale that is used as a screening tool for the assessment of psychosocial distress, originally developed for oncological diseases.

OBJECTIVES

To validate the DT for PD and to explore contributing factors.

METHODS

The DT scale was administered to 105 people with Parkinson's Disease (PwPD). Along with it, we assessed motor symptoms (Unified Parkinson's Disease Rating Scale part III [UPDRS III], Hoehn and Yahr-stage [H&Y]), non-motor symptoms (Non-motor Symptom Questionnaire [NMSQ]), anxiety and depression (Hospital Anxiety and Depression Scale [HADS], Fear of Progression-Questionnaire Short Form [FOP-Q-SF], Generalized Anxiety Disorder Scale-7 [GAD-7], 9-question Patient Health Questionnaire [PHQ-9]), the feeling of hope (Herth Hope Index [HHI]) and quality of life (Schedule for the Evaluation of Individual Quality of Life [SEIQoL]).

RESULTS

With a cut-off of 4, the DT identified PwPD with distress with a sensitivity of 97% and a specificity of 38%. With this cut-off, the DT will yield false negative results in 1 out of 100 cases. Factor analyses and a random forest regression of the dataset revealed that distress can be predicted by two factors, which we termed "anxiety" and "depression/resilience/motor symptoms".

CONCLUSION

The DT is an ultra-short and reliable screening tool for distress in PwPD. DT values below 4 rule out distress with a high degree of certainty. Anxiety and depression are important factors in distress but are counterbalanced by the individuals' psychological resilience.

Digital interventions to promote psychological resilience: a systematic review and meta-analysis

Societies are exposed to major challenges at an increasing pace. This underscores the need for preventive measures such as resilience promotion that should be available in time and without access barriers. Our systematic review summarizes evidence on digital resilience interventions, which have the potential to meet these demands. We searched five databases for randomized-controlled trials in non-clinical adult populations. Primary outcomes were mental distress, positive mental health, and resilience factors. Multilevel meta-analyses were performed to compare intervention and control groups at post-intervention and follow-up assessments. We identified 101 studies comprising 20,010 participants. Meta-analyses showed small favorable effects on mental distress, SMD = -0.24, 95% CI [-0.31, -0.18], positive mental health, SMD = 0.27, 95% CI [0.13, 0.40], and resilience factors, SMD = 0.31, 95% CI [0.21, 0.41]. Among middle-aged samples, older age was associated with more beneficial effects at follow-up, and effects were smaller for active control groups. Effects were comparable to those of face-to-face interventions and underline the potential of digital resilience interventions to prepare for future challenges.

Examining resilience among child protection professionals during COVID-19: A global comparison across 57 countries

BACKGROUND

The COVID-19 pandemic led to numerous challenges for child protection professionals (CPPs). However, limited research has investigated the interwoven concepts of coping, resilience, and mental distress among CPPs during COVID-19 on a global scale.

OBJECTIVES

This study aimed to explore CPPs' practice, resilience, and mental distress during COVID-19, the relationship between their resilience and mental distress, the global stability of the Multi-System Model of Resilience (MSMR), and how CPPs' resilience varied according to the Human Development Index (HDI).

METHODS

Data were collected from 420 CPPs in 57 countries across five continents between July and September 2021. Participants completed an online questionnaire on demographics, resilience, mental distress, coping, and perceptions of child protection during the pandemic in their native languages. The analyses compared the countries grouped according to HDI using means comparisons, correlations, and multiple linear regressions. A two-path analysis was also performed to identify variables associated with behavioral resilience engagement and mental distress.

RESULTS

The findings indicated that CPPs' perceptions of COVID-19's impact on child maltreatment varied in correlation with their country's HDI. There were also significant HDI-based differences regarding the perceived opportunity to engage in resilient behavior and its helpfulness. Years of professional experience, internal resilience, and external resilience were shown to be significant predictors of mental distress among CPPs during the pandemic, and resilience mediated how years of experience predicted mental distress.

CONCLUSIONS

This study emphasized the importance of experience and internal resilience for CPPs' psychological well-being. It also provides empirical evidence to support the MSMR theory on a global scale. Additionally, it demonstrates how the perceived changes in child maltreatment during COVID-19 may be associated with regional HDI. Lastly, the opportunities CPPs had to engage in resilient behavior and how much this helped them was associated with regional HDI, but not in the way originally predicted. Study results also hold implications for how practice and policy may be altered to help CPPs cope better during times of crisis and generally.

Savoring mediates the mental health benefits of positive coping processes: A prospective population-based analysis

Positive coping (e.g., self-efficacy and positive reappraisal) and savoring could bear mental health implications under large-scale disasters such as COVID-19. The integrative affect-regulation framework of psychological resilience proposes that evaluative efforts regulate affect, which then predicts positive short-term consequences and better mental health. This two-wave study was done during the prolonged, intensive COVID-19 control rules in Hong Kong and examined (1) the prospective associations of positive coping processes (i.e., self-efficacy and positive reappraisal) (T1, March-August 2021) with subsequent psychiatric symptoms (T2, September 2021-February 2022) and (2) the mediating effect of T2 savoring in the associations. Path analyses revealed that T1 self-efficacy and positive reappraisal were inversely related to T2 psychiatric symptoms. T2 savoring partially mediated the effect of T1 self-efficacy but fully mediated the effect of T1 positive reappraisal. Self-efficacy could have more sustainable direct positive associations with mental health, whereas the benefit of positive reappraisal might need to be catalyzed by savoring over time. Our study offered concrete illustrations of the conceptual tenets of the affect-regulation framework.

Resilience and Disaster: Flexible Adaptation in the Face of Uncertain Threat

Disasters cause sweeping damage, hardship, and loss of life. In this article, we first consider the dominant psychological approach to disasters and its narrow focus on psychopathology (e.g., posttraumatic stress disorder). We then review research on a broader approach that has identified heterogeneous, highly replicable trajectories of outcome, the most common being stable mental health or resilience. We review trajectory research for different types of disasters, including the COVID-19 pandemic. Next, we consider correlates of the resilience trajectory and note their paradoxically limited ability to predict future resilient outcomes. Research using machine learning algorithms improved prediction but has not yet illuminated the mechanism behind resilient adaptation. To that end, we propose a more direct psychological explanation for resilience based on research on the motivational and mechanistic components of regulatory flexibility. Finally, we consider how future research might leverage new computational approaches to better capture regulatory flexibility in real time.

What helps the helpers? Resilience and risk factors for general and profession-specific mental health problems in psychotherapists during the COVID-19 pandemic

Introduction

Although the COVID-19 pandemic has severely affected wellbeing of at-risk groups, most research on resilience employed convenience samples. We investigated psychosocial resilience and risk factors (RFs) for the wellbeing of psychotherapists and other mental health practitioners, an under-researched population that provides essential support for other at-risk groups and was uniquely burdened by the pandemic.

Method

We examined 18 psychosocial factors for their association with resilience, of which four were chosen due to their likely relevance specifically for therapists, in a cross-sectional multi-national sample (N = 569) surveyed between June and September 2020. Resilience was operationalized dimensionally and outcome-based as lower stressor reactivity (SR), meaning fewer mental health problems than predicted given a participant's levels of stressor exposure. General SR (SRG) scores expressed reactivity in terms of general internalizing problems, while profession-specific SR (SRS) scores expressed reactivity in terms of burnout and secondary trauma, typical problems of mental health practitioners.

Results

Factors previously identified as RFs in other populations, including perceived social support, optimism and self-compassion, were almost all significant in the study population (SRG: 18/18 RFs, absolute βs = 0.16-0.40; SRS: 15/18 RFs, absolute βs = 0.19-0.39 all Ps < 0.001). Compassion satisfaction emerged as uniquely relevant for mental health practitioners in regularized regression.

Discussion

Our work identifies psychosocial RFs for mental health practitioners' wellbeing during crisis. Most identified factors are general, in that they are associated with resilience to a wider range of mental health problems, and global, in that they have also been observed in other populations and stressor constellations.

Deployment-related quarantining-a risk or resilience factor for German military service members? A prospective analysis during the third-fifth waves of COVID-19

Background

Mandatory deployment-related quarantining added further constraints on soldiers during the pandemic. Contrary to overwhelming research documenting an adverse impact of quarantining on mental health, no adverse short-term mental health effects of pre-deployment quarantining for German soldiers were identified. Therefore, we are interested in a potentially delayed onset, the impact of an additional post-deployment quarantine, and quarantine-associated risk and resilience factors predicting mental health post-deployment.

Methods

In a prospective research design, 928 German soldiers enrolled in the study at the in-processing of pre-deployment quarantine between February 2021 and March 2022. Every German military service member undergoing pre-deployment quarantine could participate. The soldiers were between 18 and 64 years old; 87.5% identified as male and 12.5% as female. Self-reported mental health (Mini-SCL), perceived social support (FSozU-K22), and perceived unit cohesion were assessed three to five times: at the beginning and the end of pre-deployment quarantine (Nt1 = 928, Nt2 = 907), if still mandatory-at the beginning and the end of post-deployment quarantine (Nt3 = 143 and Nt4 = 132), and 3 months post-deployment, on average 7 to 8 months later than pre-deployment quarantine (Nt5 = 308). The analyzed quarantine-associated risk and resilience factors were informedness about COVID-19, infection risk, quarantine benefit, clarity of quarantine protocol, need for intimacy/bonding, norms, stigma, practicality, financial disadvantages, boredom, and health-promoting leadership.

Results

Despite four different mental health trajectories identified, repeated measures ANOVAs revealed a significant improvement in mental health post-deployment (F[2,265] = 21.54, p < 0.001), a small decrease in social support (F[2,266] = 16.85, p < 0.001), and no significant changes in unit cohesion (F[2,264] = 0.482, p = 0.618) 3 months post-deployment. Using stepwise regression, 24% of variance in mental health symptomatology post-deployment is predicted pre-deployment by a clear quarantine protocol, unit cohesion, intimacy/bonding, and social support (F[4,263] = 22.23, p < 0.001). In total, 30% of mental health at the end of post-deployment quarantine is predicted by stigma and a clear quarantine protocol (F[2,99] = 22.22, p < 0.001).

Conclusion

Although no overall adverse impact of quarantining on mental health was found, it is recommended to address perceived stigma and clearly communicate the quarantine protocol, and to further follow up on the perceived decrease in social support.

Finding a path in a methodological jungle: a qualitative research of resilience

Qualitative research provides an in-depth understanding of lived experiences. However, these experiences can be hard to apprehend by using just one method of data analysis. A good example is the experience of resilience. In this paper, the authors describe the chain of the decision-making process in the research of the construct of "resilience". s The authors justify the implications of a multi-method, pluralistic approach, and show how the triangulation of two or more qualitative methods and integration of several qualitative data analysis methods can improve a deeper understanding of the resilience among people with chronic pain. By combining the thematic analysis, narrative analysis, and critical incident technique, lived experiences can be seen from different perspectives.Therefore, the thematic analysis describes the content and answers to "what" regarding resilience, the narrative analysis describes the dynamics of resilience, and answers to "how", while the critical incident technique clarifies the most significant experience and the answers to "why" changes happen. This integrative approach could be used in the analysis of other psychological constructs and can serve as an example of how the rigour of qualitative research could be provided.

Multisystemic supports and adolescent resilience to depression over time: A South African mixed methods study

In sub-Saharan countries, like South Africa, there is scant understanding of adolescent resilience to depression over time; the multisystemic resource combinations that support such resilience; and whether more diverse resource combinations yield better mental health dividends. In response, we conducted a longitudinal concurrent nested mixed methods study with 223 South African adolescents (mean age: 17.16 years, SD = 1.73; 64.60% girls; 81.60% Black). Using longitudinal mixture modeling, the quantitative study identified trajectories of depression and associations between trajectory membership and resource diversity. Using a draw-and-write methodology and reflexive thematic analyses, the qualitative study explored the resource diversity associated with each trajectory. Taken together, these studies identified four depression trajectories (Stable Low; Declining; Worsening; Chronic High) with varying resource diversity at baseline and over time. Resource diversity was inclusive of personal, relational, contextual, and culturally valued resources in both the Stable Low and Declining trajectories, with emphasis on relational supports. Personal resources were emphasized in the Worsening and Chronic High trajectories, and culturally valued and contextual resources de-emphasized. In summary, resource constellations characterized by within and across system diversity and cultural responsiveness are more protective and will be key to advancing sub-Saharan adolescent mental health.

The relationship between uncertainty and acute procedure anxiety among surgical patients in Chinese mainland: the mediating role of resilience

BACKGROUND

Surgery, as one of the main diagnostic and treatment methods, is a routine work in medical settings. Patients undergoing surgery often experience acute procedure anxiety due to uncertainty. There is ample evidence showing that uncertainty is a risk factor for the acute procedure anxiety in surgical patients. However, little is known about the psychological processes mediating this relationship. Therefore, this study aims to evaluate resilience as a mediator of the association between uncertainty and anxiety.

METHODS

A population-based cross-sectional survey with a convenience sampling method was conducted, involving 243 surgical patients in Jiaxing, Zhejiang province of China was carried out. Relevant data were collected by self-reporting questionnaires, including demographic characteristics questionnaire, Amsterdam Preoperative Anxiety and Information Scale (APAIS-C), Mishel's Illness Uncertainty Scale (MUIS), Connor-Davidson Resilience Scale (CD-RISC). Pearson correlation analysis was employed to examine correlations between various variables. A path model was used to assess the mediation effect of resilience with respect to uncertainty and acute procedure anxiety.

RESULTS

In the path model, uncertainty have an indirect effect on acute procedure anxiety through resilience. The results suggest that resilience has a mediating role in uncertainty and acute procedure anxiety among surgical patients.

CONCLUSIONS

These findings call for the development of interventions targeting the role of resilience in effectively predicting and preventing acute procedure anxiety and uncertainty among surgical patients.

Depressive and anxiety symptom trajectories in Polish adolescents during the COVID-19 pandemic and the outbreak of war in Ukraine: uncovering the role of family relations

INTRODUCTION

The aim of the study was to investigate longitudinal trajectories of change in anxiety and depression symptoms in Polish adolescents during the second year of the COVID-19 pandemic and after the outbreak of the war in Ukraine. Additionally, we aimed to identify risk/protective factors and outcomes associated with these trajectories.

METHOD

We collected data in three waves between November 2021 and May 2022. Adolescents (N = 281 in the first wave) completed the Patient Health Questionnaire-9, the Generalized Anxiety Disorder-7, the Filial Responsibility Scale for Youth, and questions related to the COVID-19 pandemic and war in Ukraine.

RESULTS

We identified three trajectories of depressive symptoms: resilient with low, stable symptoms (71% of participants), chronically elevated symptoms (11%), and acute symptoms followed by recovery (18%). We distinguished two trajectories of anxiety symptoms: resilient (75%) and chronic (25%). Non-resilient trajectories were predicted by higher levels of familial unfairness (perceived lack of equality and reciprocity in the family), relationship difficulties at school and at home, older age, and poor socioeconomic status. Chronic depressive and anxiety symptoms were associated with higher war-related concerns.

DISCUSSION

These findings can inform preventive and therapeutic interventions for at-risk adolescents to reduce negative long-term outcomes of social crises.

Interrelations of resilience factors and their incremental impact for mental health: insights from network modeling using a prospective study across seven timepoints

Resilience can be viewed as trajectory of stable good mental health or the quick recovery of mental health during or after stressor exposure. Resilience factors (RFs) are psychological resources that buffer the potentially negative effects of stress on mental health. A problem of resilience research is the large number of conceptually overlapping RFs complicating their understanding. The current study sheds light on the interrelations of RFs in the face of the COVID-19 pandemic as a use case for major disruptions. The non-preregistered prospective study assessed a sample of 1275 German-speaking people from February 2020 to March 2021 at seven timepoints. We measured coping, hardiness, control beliefs, optimism, self-efficacy, sense of coherence (SOC), sense of mastery, social support and dispositional resilience as RFs in February 2020, and mental health (i.e., psychopathological symptoms, COVID-19-related rumination, stress-related growth) at all timepoints. Analyses used partial correlation network models and latent growth mixture modeling (LGMM). Pre-pandemic RFs were strongly interrelated, with SOC being the most central node. The strongest associations emerged between coping using emotional support and social support, SOC and sense of mastery, and dispositional resilience and self-efficacy. SOC and active coping were negatively linked. When we examined RFs as predictors of mental health trajectories, SOC was the strongest predictor of psychopathological symptoms and rumination, while trajectories of stress-related growth were predicted by optimism. Subsequent network analyses, including individual intercepts and slopes from LGMM, showed that RFs had small to moderate associations with intercepts but were unrelated to slopes. Our findings provide evidence for SOC playing an important role in mental distress and suggest further examining SOC's incremental validity. However, our results also propose that RFs might be more important for stable levels of mental health than for adaptation processes over time. The differential associations for negative and positive outcomes support the use of multidimensional outcomes in resilience research.

Psychological Resilience Factors and Their Association With Weekly Stressor Reactivity During the COVID-19 Outbreak in Europe: Prospective Longitudinal Study

BACKGROUND

Cross-sectional relationships between psychosocial resilience factors (RFs) and resilience, operationalized as the outcome of low mental health reactivity to stressor exposure (low "stressor reactivity" [SR]), were reported during the first wave of the COVID-19 pandemic in 2020.

OBJECTIVE

Extending these findings, we here examined prospective relationships and weekly dynamics between the same RFs and SR in a longitudinal sample during the aftermath of the first wave in several European countries.

METHODS

Over 5 weeks of app-based assessments, participants reported weekly stressor exposure, mental health problems, RFs, and demographic data in 1 of 6 different languages. As (partly) preregistered, hypotheses were tested cross-sectionally at baseline (N=558), and longitudinally (n=200), using mixed effects models and mediation analyses.

RESULTS

RFs at baseline, including positive appraisal style (PAS), optimism (OPT), general self-efficacy (GSE), perceived good stress recovery (REC), and perceived social support (PSS), were negatively associated with SR scores, not only cross-sectionally (baseline SR scores; all P<.001) but also prospectively (average SR scores across subsequent weeks; positive appraisal (PA), P=.008; OPT, P<.001; GSE, P=.01; REC, P<.001; and PSS, P=.002). In both associations, PAS mediated the effects of PSS on SR (cross-sectionally: 95% CI -0.064 to -0.013; prospectively: 95% CI -0.074 to -0.0008). In the analyses of weekly RF-SR dynamics, the RFs PA of stressors generally and specifically related to the COVID-19 pandemic, and GSE were negatively associated with SR in a contemporaneous fashion (PA, P<.001; PAC,P=.03; and GSE, P<.001), but not in a lagged fashion (PA, P=.36; PAC, P=.52; and GSE, P=.06).

CONCLUSIONS

We identified psychological RFs that prospectively predict resilience and cofluctuate with weekly SR within individuals. These prospective results endorse that the previously reported RF-SR associations do not exclusively reflect mood congruency or other temporal bias effects. We further confirm the important role of PA in resilience.

Time-course changes in mental distress and their predictors in response to the coronavirus disease 2019 (COVID-19) pandemic: A longitudinal multi-site study of hospital staff

The coronavirus disease 2019 (COVID-19) pandemic provides a unique opportunity studying individual differences in the trajectory of mental distress to relatively homogeneous stressors by longitudinally examining time-course changes between pandemic waves. For 21 months, we tested the effects of COVID-19 waves on mental health among 545 staffs at 18 hospitals treating COVID-19 patients in Shizuoka Prefecture, Japan. Contrary to increasing new infected cases as waves progressed, initially elevated psychological distress (K6) and fear of COVID-19 (FCV-19S) were decreased among waves (K6: B = -.02, 95% confidence interval [CI] = -.03 to -.01; FCV-19S: B = -.10, 95% CI = -.16 to -.04). This initial increase and subsequent decrease in K6 and FCV-19S were more prominent in individuals with high trait anxiety (K6: B = 1.55, 95% CI = 1.18 to 1.91; FCV-19S: B = 4.27, 95% CI = 2.50 to 6.04) and in occupations other than physicians or nurses. The current study revealed time-course changes in psychological distress and fear regarding COVID-19 in each pandemic wave and across waves, and indicated the usefulness of trait anxiety and occupation as predictors of mental health outcomes.

The relationship between childhood gender nonconformity, aversive childhood experiences, and mental health in heterosexual and non-heterosexual cisgender men: The buffering effect of sense of coherence

Childhood gender nonconformity (CGNC) seems to be associated with more mental health problems in adulthood. Previous research has suggested that this link might be mediated via the increased risk for aversive childhood experiences (ACEs) as a negative social reaction to CGNC. However, no study yet examined the role of resilience factors in this relationship. The present study aims to address this gap by examining the potential buffering effect of sense of coherence (SOC). In a German sample of 371 cisgender men, we used mediation models to investigate the relationship between CGNC, ACEs, and mental health problems in adulthood, that is, depressive symptoms, loneliness, and suicidal behavior. We then employed moderated mediation models to examine the buffering effect of SOC on the association ACEs and mental health problems. The results showed that higher levels of CGNC were associated with more severe adult mental health problems, with this link being partially mediated by higher levels of ACEs. For depressive symptoms and suicidal behavior in the last 12 months, we found evidence of a buffering effect of SOC. Higher levels of SOC were associated with a weaker association between ACEs and mental health problems. In contrast, this effect was absent for loneliness and lifetime suicidal behavior. Our study provides evidence that ACEs partly account for the relationship between CGNC and mental health in adulthood. Moreover, we found support for SOC having a buffering effect on this link. Future studies need to examine whether SOC might be an important target for resilience training in those experiencing CGNC. However, sustainable interventions may rather address the negative social reactions to CGNC.

Contribution of risk and resilience factors to anxiety trajectories during the early stages of the COVID-19 pandemic: A longitudinal study

The COVID-19 pandemic, and the response of governments to mitigate the pandemic's spread, resulted in exceptional circumstances that comprised a major global stressor, with broad implications for mental health. We aimed to delineate anxiety trajectories over three time-points in the first 6 months of the pandemic and identify baseline risk and resilience factors that predicted anxiety trajectories. Within weeks of the pandemic onset, we established a website (covid19resilience.org), and enrolled 1362 participants (n = 1064 from US; n = 222 from Israel) who provided longitudinal data between April-September 2020. We used latent growth mixture modelling to identify anxiety trajectories and ran multivariate regression models to compare characteristics between trajectory classes. A four-class model best fit the data, including a resilient trajectory (stable low anxiety) the most common (n = 961, 75.08%), and chronic anxiety (n = 149, 11.64%), recovery (n = 96, 7.50%) and delayed anxiety (n = 74, 5.78%) trajectories. Resilient participants were older, not living alone, with higher income, more education, and reported fewer COVID-19 worries and better sleep quality. Higher resilience factors' scores, specifically greater emotion regulation and lower conflict relationships, also uniquely distinguished the resilient trajectory. Results are consistent with the pre-pandemic resilience literature suggesting that most individuals show stable mental health in the face of stressful events. Findings can inform preventative interventions for improved mental health.

Resilience and Psychological Well-Being of Polish Women in the Perinatal Period during the COVID-19 Pandemic

PURPOSE

The COVID-19 pandemic, with its multidimensional consequences, is the most serious threat of the 21st century affecting the mental health of women in the perinatal period around the world. Resilience, which assumes the flexible use of an individual's resources in facing adversity, is an important, protective factor influencing mental well-being. The presented study aimed to determine to what extent psychological resilience, mitigates the relationship between adverse consequences of the COVID-19 pandemic and symptoms of depression and anxiety in women in the perinatal period.

METHODS

We recruited pregnant women from 17 February to 13 October 2021, using social media, the parenting portal, and the snowball method. To assess mental well-being, we used: The Edinburgh Postnatal Depression Scale (EPDS), The Beck Depression Inventory (BDI-2), Self-report Labour Anxiety Questionnaire-LAQ and the self-developed COVID-19 Pandemic Anxiety Questionnaire (CRAQ). Resilience was measured usingthe Resilience Measure Questionnaire (KOP26). Multiple Correspondence Analysis (MCA), an independent t-test, and a Pearson correlation analysis were performed.

RESULTS

Low resilience was significantly associated with depressive symptoms (r = -0.46; p < 0.05) and anxiety related to childbirth (r = -0.21; p < 0.05). No associations were found for resilience and pandemic-related stress. Very high and high perinatal anxiety along with the lowest level of resilience clustered with EPDS and BDI-2 scores indicating depression.

CONCLUSIONS

Our study provides evidence that lower levels of resilience during pregnancy may be a significant predictor of increased severity of depressive symptoms and higher levels of anxiety related to childbirth among the perinatal population.

The mental health impact of the COVID-19 pandemic on older adults: a systematic review and meta-analysis

BACKGROUND

Early in the COVID-19 pandemic, many experts pointed to potential adverse mental health effects for older adults. By contrast, many studies in young to middle-aged adults found older age to be associated with reduced mental burden. However, a systematic review on older adults is missing.

OBJECTIVES

To comprehensively assess the pandemic's mental health impact on older adults.

DATA SOURCES

We searched nine databases from December 2019 to April 2022.

STUDY SELECTION

We included longitudinal and repeated cross-sectional studies assessing pre- and/or peri-pandemic mental distress and/or positive mental health indicators (e.g. wellbeing) on at least two occasions.

DATA SYNTHESIS

We identified 108 studies comprising 102,136 participants (≥60 years). After removal of outliers, there was a small increase in mental distress from pre-to-peri-pandemic assessments, standardised mean difference (SMD) = 0.10, 95% confidence interval (CI) [0.01, 0.18]. Furthermore, a small peri-pandemic decrease in anxiety symptoms was observed, whereas other symptoms remained unchanged. For positive mental health indicators, wellbeing and quality of life showed an initial decrease, whereas overall positive mental health increased during the pandemic, SMD = 0.08, 95% CI [0.01, 0.15]. Being female was related to larger peri-pandemic increases in mental distress.

CONCLUSIONS

Based on many studies, this review demonstrated small decreases in mental health during early stages of the pandemic in older adults, with evidence for later recovery. These findings are similar to those for younger adults and correct earlier claims that older adults are at particular risk for negative mental health consequences. The results ask for further research into resilience and adaptation processes in older adults.

Interventions to build resilience and to ameliorate negative psychosocial effects of the COVID-19 pandemic on children and adolescents: a systematic review and meta-analysis

The psychosocial health of children and adolescents has been particularly affected by the COVID-19 pandemic. Containment measures have restricted social development, education and recreational activities, may have increased family conflicts and, in many cases, led to feelings of loneliness, sleep disturbances, symptoms of anxiety and depression. We conducted a systematic review to identify interventions that seek to ameliorate these detrimental effects of the COVID-19 pandemic and to build resilience in children and adolescents. Literature searches were conducted in the databases MEDLINE, EMBASE, PsycINFO, CENTRAL, WHO COVID-19 Global literature on coronavirus disease and Cochrane COVID-19 Study Register (up to 30 June 2022). The searches retrieved 9557 records of which we included 13 randomized-controlled trials (RCTs) for evidence synthesis. Included studies predominantly implemented online group sessions for school-aged children with either a psychological component, a physical activity component, or a combination of both. A meta-analysis of seven studies on anxiety and five on depressive symptoms provided evidence for a positive effect of interventions by reducing anxiety (Standardized Mean Difference (SMD) (95% CI): - 0.33 (- 0.59; - 0.06)) and depressive symptoms (SMD (95% CI): - 0.26 (- 0.36; - 0.16)) compared to the control interventions. Studies also showed improvements in positive mental health outcomes, such as resilience (n = 2) and mental and psychological wellbeing (n = 2). Exploratory subgroup analyses suggested a greater effectiveness of interventions that (i) are of higher frequency and duration, (ii) enable personal interaction (face-to-face or virtually), and (iii) include a physical activity component. Almost all studies were judged to be at high risk of bias and showed considerable heterogeneity. Further research may focus on the contribution of different intervention components or distinct subgroups and settings, and should examine children and adolescents over longer follow-up periods.

An investigation of what protective individual- and community-level factors are associated with life satisfaction in middle-aged and older family carers in Ireland

Background

Family care plays an essential role in providing care in society. However, caring can cause stress, and mental and physical responses to caring vary widely. Different outcomes for carers may reflect different approaches or adaptability to caring and their ability to maintain or recover their mental health and wellbeing following an adverse event (psychosocial resilience). We aim to identify factors that may promote psychosocial resilience, conceptualized as maintaining or recovering subjective wellbeing and operationalized as satisfaction with life, among carers.

Methods

Data were from 6 Waves (2009-2021) of The Irish Longitudinal Study on Aging (TILDA), a prospective biennial nationally representative longitudinal study of older adults aged ≥50 in Ireland. Family caregiving was assessed in Waves 3-6. Participants were asked if they cared for someone, their relationship to the recipient, and the number of hours per week that they provided care. We used growth mixture modeling to identify latent trajectories of satisfaction with life (SWL) before and after caring was initiated. Regression modeling was then used to identify protective factors (at the individual, family, and community levels) associated with resilient trajectories.

Results

Overall, 731 (12.2%) participants became carers during follow-up. We identified three trajectories in SWL in carers following initiation of caring, namely, Resilient-Stable (81%), Resilient-Recovery (12%), and Non-recovery (6%). Membership in Resilient-Stable and Resilient-Recovery trajectories was associated with fewer depressive symptoms (OR = 0.86, 95% CI 0.78, 0.94) and chronic conditions (OR = 0.21, 95% CI 0.06, 0.74), larger social networks (OR = 2.03, 95% CI 1.06, 3.86), more close friends and relatives (OR = 1.15, 95% CI 1.01, 1.32), and caring for someone other than a child (OR = 0.19, 95% CI 0.07, 0.51) compared to the Non-recovery group.

Conclusion

Becoming a family carer was associated with a decline in SWL over time in some carers. However, most carers either did not experience a decline in SWL or recovered their SWL over time. We found that both individual and community-level supports may be protective for carers' wellbeing. These results will inform the priorities for social and community-level services and support for older carers and contribute to the design of new projects and programs to meet these needs.

The application of metagenomic next-generation sequencing in pathogen diagnosis: a bibliometric analysis based on Web of Science

Background

Infectious disease is a large burden on public health globally. Metagenomic next-generation sequencing (mNGS) has become popular as a new tool for pathogen diagnosis with numerous advantages compared to conventional methods. Recently, research on mNGS increases yearly. However, no bibliometric analysis has systematically presented the full spectrum of this research field. Therefore, we reviewed all the publications associated with this topic and performed this study to analyze the comprehensive status and future hotspots of mNGS for infectious disease diagnosis.

Methods

The literature was searched in the Web of Science Core Collection and screened without year or language restrictions, and the characteristics of the studies were also identified. The outcomes included publication years, study types, journals, countries, authorship, institutions, frontiers, and hotspots with trends. Statistical analysis and visualization were conducted using VOSviewer (version 1.6.16) and CiteSpace (version 6.1. R3).

Results

In total, 325 studies were included in the analysis after screening. Studies were published between 2009 and 2022 with a significantly increasing number from 1 to 118. Most of the studies were original articles and case reports. Frontiers in Cellular and Infection Microbiology and Clinical Infectious Disease were the most commonly cited and co-cited journals. Institutions and researchers from China contributed the most to this field, followed by those from the USA. The hotspots and frontiers of these studies are pneumonia, tuberculosis, and central nervous system infections.

Conclusion

This study determined that mNGS is a hot topic in the diagnosis of infectious diseases with development trends and provides insights into researchers, institutions, hotspots and frontiers in mNGS, which can offer references to related researchers and future research.

The Perceived Stress Scale 2&2: a two-factorial German short version of the Perceived Stress Scale

Background

Stress is among the leading causes for diseases. The assessment of subjectively perceived stress is essential for resilience research. While the Perceived Stress Scale (PSS) is a widely used questionnaire, a German short version of the scale is not yet available. In the current study, we developed such a short version using a machine learning approach for item reduction to facilitate the simultaneous optimization of multiple psychometric criteria.

Method

We recruited 1,437 participants from an online panel, who completed the German long version of the PSS along with measures of mental health and resilience. An ant-colony-optimization algorithm was used to select items, taking reliability, and construct validity into account. Findings on validity were visualized by psychological network models.

Results

We replicated a bifactor structure for the long version of the PSS and derived a two-factor German short version of the PSS with four items, the PSS-2&2. Its factors helplessness and self-efficacy showed differential associations with mental health indicators and resilience-related factors, with helplessness being mainly linked to mental distress.

Conclusion

The valid and economic short version of the PSS lends itself to be used in future resilience research. Our findings highlight the importance of the two-factor structure of the PSS short versions and challenge the validity of commonly used one-factor models. In cases where the general stress factor is of interest, researchers should use the longer versions of the PSS that allow for the interpretation of total scores, while the PSS-2&2 allows of an economic assessment of the PSS factors helplessness and self-efficacy.

Differential associations of leisure music engagement with resilience: A network analysis

Background/Objective

Several factors associated with resilience as the maintenance of mental health despite stress exposure can be strengthened through participation in leisure time activities. Since many people listen to or make music in their leisure time, the aim of the present study was to provide insights into the architecture of how resilience relates to passive and active music engagement.

Method

511 participants regularly listening to and/or making music completed an online survey on resilient outcomes (i.e., mental health and stressor recovery ability), different resilience factors (e.g., optimism, social support), quantitative music engagement (i.e., time spent with music listening/making) and qualitative music engagement (i.e., use of music listening/making for mood regulation).

Results

Bivariate correlations showed that subjects spending more time with music making reported better stressor recovery ability and less mental health problems, while partial correlational network analysis revealed no unique associations for quantitative music engagement. Regarding qualitative music engagement, people using music-based mood regulation reported lower mental health, mindfulness, and optimism, but also higher social support. A more heterogeneous pattern emerged for single music-based mood regulation strategies.

Conclusions

Our findings highlight the importance of the individual (mal-)adaptive use of music, painting a more nuanced picture of music engagement and resilience.

Higher family and individual resilience and lower perceived stress alleviate psychological distress in female breast cancer survivors with fertility intention: a cross-sectional study

PURPOSE

The aim of this study was to explore how family resilience and individual resilience reduce perceived stress and psychological distress in young female breast cancer survivors with fertility intention.

METHODS

From June 2020 to June 2021, female breast cancer survivors were selected from the cancer centers of 10 tertiary Level A general hospitals in five cities of Sichuan Province. The survivors completed the Chinese versions of the Family Resilience Assessment Scale, Connor-Davidson Resilience Scale, Perceived Stress Scale, and a self-report distress thermometer. A multiple mediation effects test and structural equation modeling were used to explore the relationships among family resilience, individual resilience, perceived stress, and psychological distress.

RESULTS

The direct effect of family resilience on perceived stress was β = -0.320 (95% confidence interval -0.365, -0.271, P < 0.01). The direct effect of family resilience on psychological distress was β = -0.263 (95% confidence interval -0.363, -0.153, P < 0.001). The direct effect of family resilience on individual resilience was β = 0.593 (95% confidence interval 0.542-0.640, P < 0.001). The indirect effect of family resilience on psychological distress was β = -0.322 (95% confidence interval -0.373, -0.274, P < 0.001). Both perceived stress and individual resilience mediated the relationship between family resilience and psychological distress. Furthermore, a partial mediating effect of perceived stress and individual resilience on family resilience and psychological distress was observed.

CONCLUSION

Young female breast cancer survivors in China experience moderate levels of psychological distress.

Heterogeneous Mental Health Responses to the COVID-19 Pandemic in Germany: An Examination of Long-Term Trajectories, Risk Factors, and Vulnerable Groups

Abundant studies have examined mental health in the early periods of the COVID-19 pandemic. However, empirical work examining the mental health impact of the pandemic's subsequent phases remains limited. In the present study, we investigated how mental vulnerability and resilience evolved over the various phases of the pandemic in 2020 and 2021 in Germany. Data were collected (n = 3522) across seven measurement occasions using validated and self-generated measures of vulnerability and resilience. We found evidence for an immediate increase in vulnerability during the first lockdown in Germany, a trend towards recovery when lockdown measures were eased, and an increase in vulnerability with each passing month of the second lockdown. Four different latent trajectories of resilience-vulnerability emerged, with the majority of participants displaying a rather resilient trajectory, but nearly 30% of the sample fell into the more vulnerable groups. Females, younger individuals, those with a history of psychiatric disorders, lower income groups, and those with high trait vulnerability and low trait social belonging were more likely to exhibit trajectories associated with poorer mental well-being. Our findings indicate that resilience-vulnerability responses in Germany during the COVID-19 pandemic may have been more complex than previously thought, identifying risk groups that could benefit from greater support.

The relationship between sense of coherence and mental health problems from childhood to young adulthood: A meta-analysis

BACKGROUND

Sense of coherence (SOC) as the key component of the salutogenesis framework is negatively correlated with mental health problems in adults but also in children and adolescents. Since SOC is conceptualized to develop and stabilize from childhood to young adulthood, these life phases are of critical importance for the salutogenesis concept. Individual studies examining SOC's link with mental health at younger ages yielded heterogeneous effect size estimates. Thus, the present meta-analysis is the first to quantify the current state of evidence on the association between SOC and mental health problems.

METHODS

The random-effects multi-level meta-analysis followed PRISMA guidelines and was based on 57 studies (70 samples) comprising 41,013 participants. Weighted mean age of participants was 15.46 years and 50.4 % were female.

RESULTS

The mean correlation (r) between SOC and overall mental health problems was M(r) = -0.46, 95 % CI [-0.53, -0.39]. However, there was substantial heterogeneity between studies, while differences between symptom types were smaller. Subsequent moderator analyses showed that higher sample age was associated with more negative relationships and higher internal consistencies of SOC measures. Moreover, internalizing symptoms, depressive symptoms, and feelings of loneliness showed a stronger negative association with SOC than psychosomatic symptoms.

LIMITATIONS

Our findings on age-related differences were based on (repeated) cross-sectional data and require replication in longitudinal studies.

CONCLUSIONS

Results yielded a negative association between SOC and mental health problems with increasing magnitude from childhood to young adulthood. Thus, SOC-fostering interventions may help to buffer negative effects of stress and improve resilience starting from early ages.

Everyday life experiences for evaluating post-traumatic stress disorder symptoms

Background: Previous research has highlighted the importance of regularizing daily routines for maintaining mental health. Little is known about whether and how regularity of daily routines is associated with reduced post-traumatic stress disorder (PTSD) symptoms.Objective: We aimed to examine the associations between regularity of daily routines and PTSD symptoms in two studies (N = 796).Method: In Study 1, prospective data were analysed with the latent change score model to investigate the association between sustainment of regular daily routines and change in PTSD symptoms over time amid massive civil unrest in Hong Kong in 2019. Study 2 used vignette as a quasi-experimental method to assess the ability of maintaining regular daily routines in face of a major stressor, and tested its associations with PTSD symptoms.Results: In Study 1, increased regularity of diverse daily routines was inversely associated with increased PTSD symptoms amid the civil unrest in Hong Kong (β = -.427 to -.224, 95% confidence intervals [-.543 to -.359, -.310 to -.090], p values < .01). In Study 2, a greater ability to maintain regular daily routines during stress was associated with lower levels of PTSD symptoms (β = -.285 to -.096, 95% confidence intervals [-.379 to -.189, -.190 to -.003], p values < .05).Conclusions: Our findings suggest the benefit of considering diverse everyday activities in evaluating PTSD symptoms in both clinical and subclinical populations. Interventions with the direct focus on the role of daily living could promote psychological resilience during and after potentially traumatic events.