Stress-related emotional and behavioural impact following the first COVID-19 outbreak peak

Mindfulness Effects on Anxiety: Disentangling the Role of Decentering and Treatment Expectations

Mindfulness interventions have been found to lower anxiety. However, the current literature has not adequately considered the role of its individual components and of placebo effects. In an online experiment using a balanced placebo design, we aimed to disentangle effects of decentering, a key component of mindfulness, and expectations, a key component of placebo effects, on anxiety related to the COVID-19 pandemic. One hundred twenty-eight adults were randomly assigned to one of four groups: placebo/mindful decentering, placebo/sham decentering, sham/mindful decentering, and sham/sham decentering. Instructions were provided using standardized audio instructions. Current anxiety was assessed pre- and postintervention with the Short State version of the State-Trait Anxiety Inventory. Mindful decentering was found to reduce anxiety postintervention, as compared to sham decentering, regardless of induced expectations regarding its effectiveness. Participants in the mindful decentering group also mentioned more decentering-related words than those in the sham decentering group. These findings indicate that a short, standardized, and online mindful decentering intervention can effectively decrease pandemic-related anxiety independently of one's expectations. These findings provide insights into the efficacy of the individual elements of mindfulness, highlighting decentering as an effective active component for anxiety relief. Moreover, these findings suggest that, in a nonclinical sample, individuals can apply mindful decentering with minimal training.

Investigating seasonal changes in factors associated with COVID-19 concerns: Results from a serial cross-sectional survey study in Germany between 2020 and 2023

Objective

COVID-19 risk perceptions are discussed to be volatile and have been shown to be connected to the adoption of preventive public health behaviors. This study aimed to investigate changes in COVID-19 concerns and influencing factors as a function of season among the German public.

Methods

Sixty-three waves of cross-sectional telephone surveys with German participants aged 14 years and older conducted at least monthly between June 2020 and April 2023 provided the data basis (N = 63,471). After pooling participants of different waves by season (spring, summer, fall, winter), data were analyzed with regard to changes in physical health, mental health, economic, and social COVID-19 concerns. Individual characteristics (e.g., age), COVID-19 behavior (e.g., hygiene practices), and related perceptions (e.g., controllability of risk) were considered as predictors of composite concerns in different seasons.

Results

Results showed a higher between-seasons than within-seasons variability in concerns, with rises in physical and mental health and social concerns during fall. Multivariate regressions revealed being female, lower education, adopting protective measures, and higher perceived probability of infection in both public and private settings to be consistent predictors of higher COVID-19 concerns. Coefficients of these predictors remained comparatively stable over seasons and years.

Conclusion

Results indicate re-occurring changes in concerns during a prolonged crisis, with distinct characteristics being consistently associated with higher reported concerns. To ensure the application of protective measures, communicators should consider that risk perceptions are subject to fluctuations, but that certain groups of individuals tend to develop them and therefore deserve particular focus.

Stress symptoms and positive coping during coronavirus disease 2019: The need to look at health from a gender perspective

BACKGROUND

The emergency derived from coronavirus disease 2019 (COVID-19) has taught us important lessons in public and environmental health, particularly in the alarming numbers of existing noncommunicable diseases. However, one aspect to which little attention has been paid during the pandemic is mental health and its relationship with the gender perspective, in spite of gender being a determinant associated with health. In contrast, regarding health, few schemes and theories consider health from a positive and comprehensive perspective.

METHODS

This study was designed to examine the symptoms of stress and positive coping from a gender perspective. For this, the Stress Symptomatology Inventory, the Positive Coping to Life Scale and a general data questionnaire were applied to 665 individuals underwent the severe acute respiratory syndrome coronavirus 2 test at the Center for Health Studies and Services of the Universidad Veracruzana from July 2020 to November 2021.

FINDINGS

We found that women presented more stress symptoms and less positive coping in the factor of positive self-regulation of adverse situations and the factors of self-determination and positive self-regulation of important situations. Moreover, significant differences in the associations of these variables were observed between men and women.

CONCLUSIONS

Therefore, the needs of women must be considered in the approach to the emergency department due to COVID-19 and in general in the health-disease process; therefore, not considering a gender approach will continue to deepen inequalities between sexes.

COVID-19 Vaccine Hesitancy: A Global Public Health and Risk Modelling Framework Using an Environmental Deep Neural Network, Sentiment Classification with Text Mining and Emotional Reactions from COVID-19 Vaccination Tweets

Popular social media platforms, such as Twitter, have become an excellent source of information with their swift information dissemination. Individuals with different backgrounds convey their opinions through social media platforms. Consequently, these platforms have become a profound instrument for collecting enormous datasets. We believe that compiling, organizing, exploring, and analyzing data from social media platforms, such as Twitter, can offer various perspectives to public health organizations and decision makers in identifying factors that contribute to vaccine hesitancy. In this study, public tweets were downloaded daily from Tweeter using the Tweeter API. Before performing computation, the tweets were preprocessed and labeled. Vocabulary normalization was based on stemming and lemmatization. The NRCLexicon technique was deployed to convert the tweets into ten classes: positive sentiment, negative sentiment, and eight basic emotions (joy, trust, fear, surprise, anticipation, anger, disgust, and sadness). t-test was used to check the statistical significance of the relationships among the basic emotions. Our analysis shows that the p-values of joy-sadness, trust-disgust, fear-anger, surprise-anticipation, and negative-positive relations are close to zero. Finally, neural network architectures, including 1DCNN, LSTM, Multiple-Layer Perceptron, and BERT, were trained and tested in a COVID-19 multi-classification of sentiments and emotions (positive, negative, joy, sadness, trust, disgust, fear, anger, surprise, and anticipation). Our experiment attained an accuracy of 88.6% for 1DCNN at 1744 s, 89.93% accuracy for LSTM at 27,597 s, while MLP achieved an accuracy of 84.78% at 203 s. The study results show that the BERT model performed the best, with an accuracy of 96.71% at 8429 s.

Trajectories of the socioeconomic gradient of mental health: Results from the CLSA COVID-19 Questionnaire Study

As the coronavirus disease (COVID-19) pandemic prolongs, documenting trajectories of the socioeconomic gradient of mental health is important. We describe changes in the prevalence and absolute and relative income-related inequalities of mental health between April and December 2020 in Canada. We used data from the Canadian Longitudinal Study on Aging (CLSA) COVID-19 Questionnaire Study and the pre-pandemic CLSA Follow-up 1. We estimated the prevalence proportion, the concentration index (relative inequality), and the generalized concentration index (absolute inequality) for anxiety and self-reported feeling generally unwell at multiple points in April-December 2020, overall, by sex and age group, by region, and among those who reported poor or fair overall health and mental health pre-pandemic. Overall, the prevalence of anxiety remained unchanged (22.45 to 22.10%, p = 0.231), but self-reported feeling generally unwell decreased (9.83 to 5.94%, p = 0.004). Relative and absolute income-related inequalities were unchanged for both anxiety and self-reported feeling generally unwell, with exceptions of an increased concentration of self-reported feeling generally unwell among the poor, measured by the concentration index, overall (-0.054 to -0.115, p = 0.004) and in Ontario (-0.035 to -0.123, p = 0.047) and British Columbia (-0.055 to -0.141, p = 0.044). The COVID-19 pandemic appeared to neither exacerbate nor ameliorate existing income-related inequalities in mental health among older adults in Canada between April and December 2020. Continued monitoring of inequalities is necessary.

Alexithymia in adolescents in Poland: an important issue in the holistic approach to patients' care

Introduction

Alexithymia is defined as a disturbed ability to identify and verbally express emotions with a limited imaginative capacity as well as externally oriented thinking. The literature on alexithymia is limited and scarce research concentrated on alexithymia in different gender groups.

Aim

As alexithymia may influence the therapeutic outcome, the objective of the study was to assess the prevalence of alexithymia in adolescents in Poland, paying special attention to gender differences.

Material and methods

This cross-sectional study was run on a group of 730 high school students in Poland. The mean age of this group was 17.05 ±1.18 years (age range: 15-19 years). Alexithymia was assessed with Toronto Alexithymia Scale (TAS-20).

Results

Alexithymia was found in 31.0% of adolescents. 56.0% of subjects presented with signs of at least intermediate (borderline) alexithymia. Significantly more females than males suffered from alexithymia (37.0% and 20.8%, respectively; p < 0.001). TAS-20 scores were also significantly higher in females than males (55.59 ±12.32 points and 49.40 ±12.00, respectively; p < 0.001). The same phenomenon was observed for the following domains of alexithymia: difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF). However, there was no difference in gender distribution in the externally oriented thinking (EOT) domain.

Conclusions

Alexithymia was shown to be common among adolescents in our country. More females than males suffer from this condition. This seems to be of importance in the holistic approach to patients' care.

Greater knowledge about COVID-19, more negative emotions. Research in adult Poles after 2nd and 5th waves of the pandemic

Introduction: The study investigated the dynamics of cognitive and emotional representation of COVID-19 in adult Poles, following the second (2021) and the fifth (2022) wave of the pandemic. Material and methods: The study involved a total of 303 subjects (N = 198 in Survey 1 in 2021, and N = 105 in Survey 2 in 2022). The following measures were used: a questionnaire covering demographic data and general opinions about COVID-19 as well as the Revised Illness Perception Questionnaire (IPQ-R). Results: After the fifth wave, significantly more respondents were convinced that COVID-19 was a real and dangerous disease. Cognitive deficits were more commonly recognised among symptoms of the viremia. Vaccination against COVID-19 was recognised as an essential preventive measure. Both surveys showed that COVID-19 representation was characterised by negative emotions and low sense of illness coherence. However, there was increased belief that the disease can be controlled through medical interventions. The age of the respondents in Survey 1 and Survey 2 was differently related to beliefs about COVID-19. Conclusions: 1. After 2.5 years of the pandemic, the awareness of Poles about the causes, symptoms and methods of preventing the disease has increased. 2. Failure to vaccinate against COVID-19 has been identified as a significant cause of viremia. 3. Negative emotions and a sense of serious consequences were predominant in both Surveys, but after the fifth wave of the pandemic the scores reflect increased perception of the chronic nature of the disease and belief that the illness can be treated with medication, whereas the sense of personal control was found to decrease. 4. After the fifth wave of the pandemic, older age corresponded to increased belief in the relevance of some preventive measures, and to greater awareness of the viral origin, increased belief in the feasibility of controlling the disease through one's behaviours and a greater sense of illness coherence. 5. The intensification of negative emotions related to the pandemic can be treated as a predictor of the increase in adjustment disorders and risk of mental health deterioration among adult Poles in the following years. Keywords: cognitive and emotional representation of illness, COVID-19 pandemic, Polish adults

Dissecting Causal Associations of Diet-Derived Circulating Antioxidants with Six Major Mental Disorders: A Mendelian Randomization Study

Although observational studies have suggested associations between circulating antioxidants and many mental disorders, causal inferences have not been confirmed. Mendelian randomization (MR) analyses were conducted using summary-level statistics from genome-wide association studies (GWASs) to explore whether genetically determined absolute circulating antioxidants (i.e., ascorbate, retinol, β-carotene, and lycopene) and metabolites (i.e., α- and γ-tocopherol, ascorbate, and retinol) were causally associated with the risk of six major mental disorders, including anxiety disorders (AD), major depressive disorder (MDD), bipolar disorder (BIP), schizophrenia (SCZ), post-traumatic stress disorder (PTSD), and obsessive-compulsive disorder (OCD). MR analyses were performed per specific-outcome databases, including the largest GWAS published to date (from 9725 for OCD to 413,466 for BIP participants), UK Biobank (over 370,000 participants), and FinnGen (over 270,000 participants), followed by meta-analyses. We found no significant evidence that genetically determined diet-derived circulating antioxidants were significantly causally associated with the risk of the six above-mentioned major mental disorders. For absolute antioxidant levels, the odds ratios (ORs) ranged from 0.91 (95% CI, 0.67-1.23) for the effect of β-carotene on OCD to 1.18 (95% CI, 0.90-1.54) for the effect of ascorbate on OCD. Similarly, for antioxidant metabolites, ORs ranged from 0.87 (95% CI, 0.55-1.38) for the effect of ascorbate on MDD to 1.08 (95% CI, 0.88-1.33) for the effect of ascorbate on OCD. Our study does not support significant causal associations of genetically determined diet-derived circulating antioxidants with the risk of major mental disorders.

Contrasting Hygiene-Related Gastrointestinal Infections and Stress-Related Diseases at a Primary Health Care Facility within a Sub-Saharan African City: Before and during the COVID-19 Pandemic

BACKGROUND

With the advent of the COVID-19 pandemic caused by SARS-CoV-2, protocols such as social distancing and upscaling of hygiene practices were implemented to limit the spread of the disease. Meanwhile, along with COVID-19 came stress due to restrictions on movement, trade and transport, and closure of schools, among others.

AIM

This study compared the prevalence of hygiene-related gastrointestinal infections and stress-related diseases before (March 2019-February 2020) and during (March 2020-February 2021) the COVID-19 pandemic.

METHODOLOGY

This was a retrospective single-center review of deidentified patient data from the Korle Bu Polyclinic, Accra, Ghana.

RESULTS

Comparing the pre-COVID-19 era to the COVID-19 era, there was a statistically nonsignificant change in the number of cases and prevalence of gastroenteritis and enteric fever (p = 0.084 and 0.081, respectively), although for gastroenteritis, the prevalence was higher for the pre-COVID-19 era compared to during COVID-19 by 1.8 per 1000 cases, while that of enteric fever was higher during the COVID-19 era compared to the pre-COVID-19 era by 1.0 per 1000 cases. Of the stress-related diseases, statistically significant increases in the prevalence of anxiety disorders (p = 0.028), insomnia (p = 0.001), and headache (p = 0.010), were noted, with 2.3, 5.5, and 2.4 per 1000 cases, respectively. There were more female cases than male cases recorded for depression (p = 0.001), headache (p = 0.010), and hypertension (p = 0.001) during the pandemic, and these were statistically significant.

CONCLUSION

During the pandemic, a significant increase in the prevalence of stress-related diseases was observed. However, a statistically nonsignificant change was recorded for gastrointestinal infections, with females reporting more of these disorders. Consequently, it is important to strengthen the capacity for managing stress-related conditions alongside diseases that cause pandemics when they arise.

Fear of contagion, emotional stress and coping strategies used by adults during the first wave of the COVID-19 pandemic in Nigeria

BACKGROUND

The COVID-19 pandemic has induced high levels of stress. The aim of the study was to assess the relationship between emotional stress (COVID-19 related fear, anger, frustration, and loneliness) and the use of coping strategies among adults in Nigeria during the COVID-19 pandemic.

METHODS

Data from adults aged 18 years and above were collected through an online survey from July to December 2020. The dependent variables were COVID-19 related fear (fear of infection and infecting others with COVID-19), anger, frustration, and loneliness. The independent variables were coping strategies (use of phones to communicate with family and others, video conferencing, indoor exercises, outdoor exercises, meditation/mindfulness practices, engaging in creative activities, learning a new skill, following media coverage related to COVID-19) and alcohol consumption. Five logistic regression models were developed to identify the factors associated with each dependent variables. All models were adjusted for sociodemographic variables (age, sex at birth, and the highest level of education).

RESULTS

Respondents who consumed alcohol, followed media coverage for COVID-19 related information, and who spoke with friends or family on the phone had higher odds of having fear of contracting COVID-19 or transmitting infection to others, and of feeling angry, frustrated, or lonely (p < 0.05). Respondents who exercised outdoors (AOR: 0.69) or learned a new skill (AOR: 0.79) had significantly lower odds of having fear of contracting COVID-19. Respondents who practiced meditation or mindfulness (AOR: 1.47) had significantly higher odds of feeling angry. Those who spoke with friends and family on the phone (AOR: 1.32) and exercised indoors (AOR: 1.23) had significantly higher odds of feeling frustrated. Those who did video conferencing (AOR: 1.41), exercised outdoors (AOR: 1.32) and engaged with creative activities (AOR: 1.25) had higher odds of feeling lonely.

CONCLUSION

Despite the significant association between emotional stress and use of coping strategies among adults in Nigeria during the COVID-19 pandemic, it appears that coping strategies were used to ameliorate rather than prevent emotional stress. Learning new skills and exercising outdoors were used to ameliorate the fear of contracting COVID-19 in older respondents.

Individual and regional characteristics associated with changes in mental health before and during the COVID-19 pandemic in South Korea

Mental health has been a major public health concerns during the COVID-19 pandemic. This study investigated the effects of COVID-19 on mental health and whether individual and regional characteristics are associated with the changes in mental health. We estimated district-specific changes in the prevalence of moderate stress, extreme stress, and depression before and during the COVID-19 pandemic after adjusting for the time trend of mental health outcomes. Then, a meta-regression was conducted to examine the associations between district-level characteristics and changes in mental health due to the pandemic. The prevalence of moderate stress, extreme stress, and depression increased during the pandemic and the increases were more prominent in districts with high population density and in individuals aged 19–59 years, with a high education level, and with high household income. The % with reduced physical activity due to the pandemic were positively associated with increases in stress; while, the % that have mutual trust among neighbors and the number of sports facilities were negatively associated with increases in stress. Local tax per person had a positive association with increase in depression. Our study provides epidemiological evidence into the mental health consequences of the pandemic, which can inform the priority of resource allocation for managing mental health.

In.To. COVID-19 socio-epidemiological co-causality

Social media can forecast disease dynamics, but infoveillance remains focused on infection spread, with little consideration of media content reliability and its relationship to behavior-driven epidemiological outcomes. Sentiment-encoded social media indicators have been poorly developed for expressed text to forecast healthcare pressure and infer population risk-perception patterns. Here we introduce Infodemic Tomography (InTo) as the first web-based interactive infoveillance cybertechnology that forecasts and visualizes spatio-temporal sentiments and healthcare pressure as a function of social media positivity (i.e., Twitter here), considering both epidemic information and potential misinformation. Information spread is measured on volume and retweets, and the Value of Misinformation (VoMi) is introduced as the impact on forecast accuracy where misinformation has the highest dissimilarity in information dynamics. We validated InTo for COVID-19 in New Delhi and Mumbai by inferring distinct socio-epidemiological risk-perception patterns. We forecast weekly hospitalization and cases using ARIMA models and interpolate spatial hospitalization using geostatistical kriging on inferred risk perception curves between tweet positivity and epidemiological outcomes. Geospatial tweet positivity tracks accurately [Formula: see text]60[Formula: see text] of hospitalizations and forecasts hospitalization risk hotspots along risk aversion gradients. VoMi is higher for risk-prone areas and time periods, where misinformation has the highest non-linear predictability, with high incidence and positivity manifesting popularity-seeking social dynamics. Hospitalization gradients, VoMi, effective healthcare pressure and spatial model-data gaps can be used to predict hospitalization fluxes, misinformation, healthcare capacity gaps and surveillance uncertainty. Thus, InTo is a participatory instrument to better prepare and respond to public health crises by extracting and combining salient epidemiological and social surveillance at any desired space-time scale.

Alexithymia in Adolescents with Acne: Association with Quality of Life Impairment and Stigmatization

Alexithymia seems to be more common among patients with skin diseases. However, studies on acne patients are very limited. We conducted this study to evaluate alexithymia in adolescents with acne. In our cross-sectional study, 730 high school students (mean age: 17.05 ± 1.18 years) were recruited. The Toronto Alexithymia Scale (TAS-20) was used to measure alexithymia, the Dermatology Life Quality Index (DLQI) was employed to study quality of life (QoL), and the 6-item Stigmatization Scale (6ISS) was used to evaluate the level of stigmatization in acne subjects. Alexithymia was found in 31% of adolescents, with similar prevalence among those with and without acne (31.3% and 30.1%, respectively). The mean scoring on the TAS-20 in patients with acne (53.1 ± 12.8 points) was not significantly different from that of the non-acne group (53.5 ± 11.9 points). However, significant correlations between TAS-20 scores and QoL assessments (r = 0.332, p < 0.001) as well as stigmatization level (r = 0.284, p < 0.001) were found. These correlations were also significant for the domains of alexithymia described as difficulty in identifying feelings (DIF) and difficulty in describing feelings (DDF), but not for externally oriented thinking (EOT). The findings clearly showed that acne does not predispose to alexithymia; however, alexithymia in acne subjects is related to impaired QoL and stigmatization.

The Moderation Effects of Comparative Thinking Between Gratitude and Negative Affect During the COVID-19 Outbreak

The aim of this research was to examine the moderation effects of comparative thinking (CT) across the relationship between gratitude and affect during the COVID-19 outbreak. To this purpose, multiple regression as well as moderation analyses were carried out. Age and sex were also addressed as variables of interest as described in previous literature. A sample of 306 north Americans was recruited by crowdsourcing platform ProA to obtain a representative sample based on age and gender. The participants filled in a questionnaire based on comparative thinking in relation to the emotional experience experienced before and during the COVID-19 outbreak, positive and negative affect schedule for positive and negative affect, as well as Gratitude Questionnaire - Six Items Form scores for gratitude. The main results of the current study related to the COVID-19 outbreak can be listed as follows: (i) no differences between CT groups in the gratitude trait, but differences in positive and negative affect did occur; (ii) regression models that included age, gratitude, and affect variables predicted negative and positive affects but gender did not reach the statistical level; (iii) two moderation models predicted affect from gratitude, with the CT variable moderating this effect; this moderation effect was also statistically significant in predicting negative affect but it was not statistically significant in predicting positive affect. These results might be of interest for training programs in applied levels and theoretical models of gratitude.