Social support, psychological flexibility and coping mediate the association between COVID-19 related stress exposure and psychological distress

Emotion Regulation Under Stress: A Social Processing and Memory Perspective

Research on emotion regulation often focuses on cognitively effortful self-regulation strategies, but exposure to stress has been shown to interfere with the underlying mechanisms supporting such processes. Understanding alternative strategies that potentially bolster emotion regulation under stress is an important topic of investigation. Two potential alternatives involve everyday occurrences of social processing and memory recall. Social support and past emotional experiences may help in guiding us toward appropriate neurophysiological responses through overlapping circuitry with stress and reward systems, while also buttressing cognitive regulation strategies by expanding one's perspective and allowing multiple opportunities to regulate retrospectively. In recognition that ongoing social and emotional events are often at the beginning of a cascade of both emotion regulation and memory processes, this chapter focuses on the emerging role of social relationships and autobiographical memory recall in regulating emotions under stress, highlighting opportunities and challenges associated with this process.

Supervisor-postgraduate relationship and perceived stress: the mediating role of self-efficacy and the moderating role of psychological resilience

BACKGROUND

Postgraduate studies often entail significant stress, which can profoundly affect students' well-being and academic performance. The supervisor-postgraduate relationship plays a pivotal role in shaping stress levels among postgraduate students. This study investigates the mediating role of self-efficacy and the moderating influence of psychological resilience in the link between supervisor-postgraduate relationships and perceived stress in postgraduate students.

METHODS

This study employed a cross-sectional research design, conducting a survey among 609 postgraduate students selected through random sampling. The participants, aged between 20 and 53 years (M = 25.14, SD = 3.63), included 265 males and 344 females from various academic stages. Data were collected using validated scales to measure the supervisor-postgraduate relationship, perceived stress, self-efficacy, and psychological resilience. The moderated mediation model analysis was conducted to examine the hypothesized relationships and effects, utilizing SPSS with Hayes' PROCESS macro to validate the statistical interactions.

RESULTS

The results indicated a significant negative association between the supervisor-postgraduate relationship and perceived stress (β=-0.27, p < 0.01), with self-efficacy partially mediating this relationship (β=-0.14, p < 0.01). Additionally, psychological resilience moderated both the direct effect of the supervisor-postgraduate relationship on perceived stress and the indirect effect via self-efficacy (interaction effect β=-0.10, p < 0.01). These findings underscore the roles of self-efficacy and psychological resilience in reducing stress among postgraduate students, highlighting the importance of supportive supervisory relationships.

CONCLUSIONS

These findings underscore the critical importance of supportive supervisor-postgraduate relationships and highlight the roles of self-efficacy and resilience in alleviating stress among postgraduate students. This study offers valuable insights for cultivating positive supervisor-postgraduate relationships and enhancing well-being within postgraduate education.

Emotions, coping and psychological flexibility in earthquake survivors: a cross-sectional study

Earthquakes may play a role in the development of several psychological distresses or psychopathologies. Nevertheless, protective factors such as positive emotions, psychological flexibility, and coping mechanisms may be helpful for earthquake survivors in coping. On the other hand, the role of both positive and negative emotions of earthquake survivors in psychological flexibility and coping remains elusive. Accordingly, this study aimed to examine the relationship between emotions, coping, and psychological flexibility levels of earthquake survivors considering positive and negative emotions together. A total of 330 adult participants of the cross-sectional study completed the Participant Information Form, Perceived Ability to Cope with Trauma (PACT), Psychological Flexibility (PF), and Positive-Negative Affect Schedule (PANAS) scales. Participants were aged between 20 and 68 years (Mean ± SD = 42.42 + 12.88). It was determined that as the PACT levels increased, the PF and negative emotion levels increased yet positive emotion levels decreased. As the PF levels increased, the negative emotion levels increased yet the positive emotion levels decreased (p < 0.01). According to the established model, it was concluded that the PACT was related to positive-negative emotion levels and values, being in the moment, and dissociation sub-dimensions of PF were unrelated to contextual self and acceptance (p > 0.05). In conclusion, positive-negative emotions and PF were found to have a mediating role in the coping of earthquake survivors. Mental health professionals may contribute to increasing PACT in earthquake survivors through interventions aimed at maintaining positive emotions, recognizing negative emotions, and increasing PF.

Overcoming times of crisis: unveiling coping strategies and mental health in a transnational general population sample during and after the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has had an unparalleled impact, precipitating not only direct threats to physical health but also widespread economic and psychological challenges. This study aims to explore the dynamics of coping behaviour and psychological distress (PD) across different phases of the pandemic within an adult general population sample, spanning Austria and Italy.

METHODS

An online questionnaire-based panel study was conducted between 2020 and 2023 including three measurements. We collected data on sociodemographic variables, coping responses (Brief COPE), and PD (Brief-Symptom-Checklist). Statistical analyses were conducted within a linear-mixed-model framework. Multiple imputation and sensitivity analysis were applied to validate the results obtained by complete case analysis.

RESULTS

The study follows 824 participants and reveals a marginal decrease in overall PD from the first to the second follow-up, particularly in clinically relevant phobic anxiety (35.6% and 34.5% to 25.4%). Most coping behaviours exhibited stable mean-levels with intra-individual variability across the study period. Maladaptive coping strategies were consistently linked to increased PD, whereas adaptive strategies were associated with decreased PD.

CONCLUSION

Our findings underscore the complex nature of coping behaviours and PD during and after the pandemic, suggesting that while mean-levels of PD and coping responses remained relatively stable, most coping strategies were subject to intra-individual change. Maladaptive strategies were associated with increased PD, pinpointing to the need for interventions that establish the foundation for adaptive coping mechanisms and promote their application. Further research should explore the reciprocal influences of mental health on coping behaviour, incorporating interventional designs to unravel the nuances of these relationships.

Expressing Negativity Enhances Support From Romantic Partners, Even for Trivial Stressors

Receiving high-quality support confers many benefits. Yet, little is known about how support-seekers can elicit high-quality support. In two experiments and a couples' interaction study, we examined how (and why) expressing negative thoughts and feelings affects romantic partners' support and considered whether this depends on the severity of the stressor the support-seeker is facing. In Study 1, romantically involved participants who read a high (vs. low)-negative expressivity support-seeking text message wrote higher-quality support responses in both serious and trivial stressor contexts. Study 2 conceptually replicated these effects with new stressors. In Study 3, support-seekers who expressed more (vs. less) negativity during a face-to-face conversation with their romantic partner about a recent stressor received support higher in regulatory effectiveness (an index of support quality). Mediation analyses in Studies 2 and 3 suggested that negativity may enhance support, even for trivial stressors, by increasing provider perceptions that support is needed.

Childhood maltreatment and association with trajectories of depressive symptoms among older adults: a longitudinal study in China

OBJECTIVES

Childhood maltreatment has long-lasting effects on mental health. Existing evidence suggests that trajectories of depressive symptoms vary among individuals; however, little is known about how childhood maltreatment shapes these trajectory patterns. Therefore, this study investigated the impacts of childhood maltreatment on eight-year depressive trajectories among Chinese older adults.

METHOD

Five waves of longitudinal data from the China Health and Retirement Longitudinal Study were utilized. Growth Mixture Modelling was performed to identify distinct trajectories of depressive symptoms, and multinomial logistic regression was conducted to explore the associations between these trajectories and childhood maltreatment.

RESULTS

Four trajectories of depressive symptoms were identified: the 'no symptoms' class (61.83%), the 'increasing symptoms' class (14.49%), the 'decreasing symptoms' class (16.44%), and the 'chronic symptoms' class (7.24%). Older adults who experienced childhood physical abuse were more likely to be in the 'chronic symptoms' class than in the 'no symptoms' class, whereas emotional neglect did not show a significant association with three problematic trajectories.

CONCLUSION

This study provides empirical evidence that childhood physical abuse increases the likelihood of developing chronic depressive symptoms in later life. To mitigate this risk, it is crucial to institute comprehensive treatment plans that incorporate trauma-informed care principles, employ evidence-based therapies specifically designed to address the long-term effects of abuse, and prioritize regular screening and assessment of mental health among older adults.

A Structural Equation Model of the Relationship Between Symptom Burden, Psychological Resilience, Coping Styles, Social Support, and Psychological Distress in Elderly Patients With Acute Exacerbation Chronic Obstructive Pulmonary Disease in China

PURPOSE

The prevalence of psychological distress is frequently observed among old adults with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). However, current researches are insufficient to clarify the correlation among these relevant factors. This study examined the effects of symptom burden, psychological resilience, coping styles, and social support on psychological distress.

METHODS

Two hundred fifty five elderly patients with AECOPD were conveniently selected in Taian, Shandong Province. The General Information Questionnaire, Distress Thermometer, The Revised Memorial Symptom Assessment Scale, Connor-Davidson Resilience Scale, Simplified Coping Style Questionnaire, Perceived Social Support Scale were used to investigate. The relationship among factors was estimated by using a structural equation model.

RESULTS

Psychological distress score of elderly patients with AECOPD was (5.25 ± 1.01); coping styles, psychological resilience, symptom burden, and social support directly affected psychological distress (the direct effects were -.93, .17, .17, and -.09); coping styles had the largest total effect on psychological distress (the total effect was -.93); psychological resilience indirectly affected psychological distress through coping styles (the indirect effect was -.74); symptom burden indirectly affected psychological distress through psychological resilience (the indirect effect was .25); social support indirectly affected psychological distress through symptom burden, psychological resilience, and coping styles (the indirect effect was -.80).

CONCLUSION

The psychological distress of elderly patients with AECOPD is at a moderate level; coping styles, psychological resilience, and social support have positive effects on alleviating the psychological distress of elderly patients with AECOPD; symptom burden is negatively correlated with psychological distress. Healthcare professionals should pay more attention to elderly patients with AECOPD who are particularly prone to experience higher levels of psychological distress, especially in the presence of low coping style, limited psychological resilience, inadequate levels of social support, and high symptom burden.

An Investigation into the Prevention of Turnover of Medical Interpreters

Objective

Since there have been no studies for the prevention of job turnover among medical interpreters, this study examined the effects of social support, professional career maturity and stress coping on their attitudes toward job continuity intentions.

Design

A cross-sectional study was conducted to examine the relationships between social support, professional career maturity, stress coping and job continuity intentions.

Methods

Stress coping was measured by using a simplified stress coping scale (with 9 items and 1 factor structure). Social support was measured by defining the interpreters who answered "Yes" for "I have someone to talk to when I feel emotional stress". Professional carrier maturity was assessed by using, 12 career-related items. We defined those interpreters who responded "No" to "Have you ever wanted to quit medical interpreting due to emotional stress?" were to have job continuity intentions.

Results

The present study indicated that 14 (25.5%) of the interpreters did not intend to continue their occupation because of their psychological stresses. Compared to interpreters without social support, the odds ratio of job continuity intentions was 4.39 (95% confidence interval [CI] : 1.13-18.3) for those with social support. Moreover, in comparison with the interpreters with low professional career maturity, the odds ratio of job continuity intentions was significantly higher for those with high professional career maturity (odds ratio [OR] = 4.35; 95%CI: 1.12-21.8). However, there was an association found for stress coping.

Conclusions

Strengthening social support and helping professional career development were the important factors for medical interpreters to be able to continue their careers.

Cannabis use, social support and social engagement among working-age adults in rural America

Objective

Cannabis use has been linked to physical, psychological, and behavioral changes. Although research indicates separately that informal social support and formal social engagement - which are correlated measures - serve as protective factors in cannabis use, much of this research focuses on youth and more urban samples, limiting our understanding of if these findings are true for rural populations where social support and social engagement are particularly important for health and health behaviors. To fill the research gap, this study examines the effects of informal social support (tangible support and emotional support) and formal social engagement on cannabis use among rural working-age adults.

Methods

This research analyzed 1,122 observations from a cross-sectional online survey conducted in 2022 of working-age adults (18-64) from rural America. Multilevel logistic regression models were used to predict cannabis use in the past 12 months using informal social support (tangible support and emotional support) and formal social engagement and other sociodemographic covariates and state legalization status.

Results

Multilevel logistic modeling indicates that low emotional support and low formal social engagement are associated with a higher odds of reporting cannabis use in the past 12 months among rural working-age adults, net of other sociodemographic variables and state legalization status.

Conclusions

The study suggests that emotional support and social engagement may contribute to cannabis use prevention among rural working-age adults. These findings should inform future research as well as the development of tailored health interventions targeting rural working-age adults.

Psychological maltreatment, meaning-centered coping, psychological flexibility, and suicide cognitions: A moderated mediation model

BACKGROUND

Mental health problems are currently diversifying, increasing the possibility of suicide. Exposure to psychological maltreatment is one of the factors that increases suicidal cognitions. In addition, psychological flexibility and meaning-centered approaches may be effective in coping with suicidal cognitions.

OBJECTIVE

A hypothesized model was tested to examine the relationships among psychological maltreatment, suicidal cognitions, psychological flexibility, and meaning-centered coping.

METHOD

Data were collected from a sample of 652 participants. Mediation and moderation analyses were conducted to examine the mediating and moderating role of psychological flexibility and meaning-centered coping in the relationship between childhood psychological maltreatment and suicide cognitions among Turkish adults.

RESULTS

The results of the study indicated significant negative and positive relationships between psychological maltreatment, suicide cognitions, psychological flexibility, and meaning-centered coping. The findings suggest that psychological flexibility and meaning-centered coping have a serial mediating effect on the relationship between psychological maltreatment and suicide cognitions. Furthermore, according to the study results, psychological flexibility plays a moderating role both between psychological maltreatment and suicidal cognitions and between meaning-centered coping and suicidal cognitions.

CONCLUSIONS

The study suggests that psychological maltreatment can be considered as a risk factor and meaning-centered coping and psychological flexibility as protective factors in suicide prevention studies.

Validation of the Chinese version of the Oslo-3 Social Support Scale among nursing students: a study based on Classical Test Theory and Item Response Theory models

BACKGROUND

Nursing students are encountering a range of health issues. Assessing social support is a key component in most questionnaire surveys related to health status, aiming to investigate the relationships and mechanisms between health status and social support to enhance overall health. Therefore, it is essential to seek out appropriate instruments to evaluate social support for nursing students. The Oslo-3 Social Support Scale (OSSS-3) is a reliable and concise instrument for evaluating social support. To date, there have been no studies validating the OSSS-3 based on Item Response Theory (IRT) models. Also, an officially validated Chinese version has not been found. The current research intended to verify the Chinese version of the OSSS-3.

METHODS

The OSSS-3 was translated into Chinese and culturally adapted. Subsequently, the OSSS-3 was validated by employing the Classical Test Theory (CTT) and IRT models.

RESULTS

The split-half reliability was 0.622. The Cronbach's α coefficient was 0.687. The correlations between each item and total scores varied from 0.723 to 0.835. The retest coefficient was 0.907. The content validity index was 0.933. A single common factor was extracted and accounted for 61.559% of the variance. The item loading values on the single factor were between 0.743 and 0.814. The communalities were between 0.552 and 0.663. There was no variance between males and females (P = 0.055). The difference in scores between the top (30%) and bottom (30%) groups attained significance. IRT models results revealed that the discrimination parameters ranged from 1.39 to 2.33 and difficulty parameters increased monotonically.

CONCLUSION

The OSSS-3 demonstrates satisfying psychometric properties and is a proper instrument for measuring social support in Chinese nursing students.

Role of self-esteem and personal mastery on the association between social support and resilience among COVID-19 long haulers

Although the COVID-19 mortality rate is declining, the number of individuals dealing with persistent COVID-19 symptoms is increasing worldwide, making long COVID a global public health concern. People with long COVID (long haulers) often deal with physical and mental stressors. Long haulers' psychological resilience could play a key role in coping with these stressors in intercorrelation with psychosocial resources. The current study aims to test a hypothesized relationship between social support and its functions (i.e., instrumental and emotional) and the resilience of long haulers through serial mediation by personal mastery and self-esteem. A cross-sectional and self-administered online survey was conducted among 460 individuals with long COVID recruited from COVID-19 Facebook support groups in the United States. Analyzing data indicated a positive correlation between social support and the resilience of long haulers. Structural equation modeling suggested that self-esteem and personal mastery fully mediated the association between social (instrumental) support and resilience. Personal mastery also mediated the association between self-esteem and resilience in social (instrumental) support models. However, in the emotional support model, the indirect effect was non-significant for the mediation by personal mastery and self-esteem. Findings suggest that social support, mainly instrumental support, may protect long haulers by promoting their resilience through self-esteem and personal mastery. This study emphasizes the importance of including social support services in designing programs for COVID-19 long haulers.

Perceived social support, perceived stress, and quality of sleep among COVID-19 patients in Iran: assessing measurement invariance of the multidimensional scale of perceived social support across gender and age

Background

Perceived social support (PSS) plays a considerable role in mental health. The Multidimensional Scale of Perceived Social Support (MSPSS) is one of the most widely used scales, leading to much research evidence. The present study investigated its measurement model, equivalence across gender (male and female) and age groups (older patients= above 60 and non-older patients= below 60), and concurrent validity.

Methods

A cross-sectional survey was conducted between March and October 2020, on patients hospitalized due to COVID-19 in Tehran, Iran. The scales were administered to 328 COVID-19 patients (54.6% male, aged 21 to 92) from two general hospitals; participants completed MSPSS (including friends, family, and significant others subscales), Pittsburgh Sleep Quality Index (PSQI, include sleep latency, subjective sleep quality, habitual sleep efficiency, sleep duration, use of sleep medication, daytime dysfunction, and sleep disturbances subscales), and the Perceived Stress Scale-10 (PSS-10, to assess patients' appraisal of stressful conditions).

Results

The MSPSS three-factor structure was confirmed among COVID-19 patients by Confirmatory Factor Analysis (CFA). The results support the MSPSS internal consistency and configural, metric, and scalar invariance across gender and age groups. Nevertheless, small but significant differences were found across ages based on the latent factor mean of the MSPSS from friends, with a lower mean level in older patients. The coefficients of Cronbach's alpha (ranging from.92 to.96), the ordinal theta (ranging from.95 to.98), and Omega (ranging from.93 to.97) suggested high internal consistency of MSPSS. The concurrent validity of MSPSS was evidenced by its significant negative correlation with PSS-10 (τb = -.13, p <.01) and also subjective sleep quality (τb = -.22, p <.01), sleep disturbances (τb = -.26, p <.001), and daytime dysfunction (τb = -.26, p <.001).

Conclusions

The MSPSS was valid and reliable for measuring individuals' perception of social support between males and females and older and non-older COVID-19 patients.

Self-Differentiation, Psychological Flexibility, and Difficulties in Practice in Social Workers and Social Work Students

Practicing social work involves unique difficulties, which may vary with seniority. This study aimed to identify these difficulties among social workers and social work students and to examine the associations between psychological flexibility (PF), self-differentiation (SF), and difficulties in practice in both groups. Ninety-one social work students and seventy-five social workers completed the following questionnaires: Difficulties in Practice, the Acceptance and Action Questionnaire-II, and Differentiation of Self Inventory. Results showed higher difficulties among social work students regarding their professional competence. Social workers demonstrated higher levels of PF, while no significant difference was found in SF. SF and PF were positively correlated, and both were negatively correlated with difficulties in practice in both groups. Among social work students, a moderating effect of PF was found for the association between SF and difficulties in practice. The current study emphasizes the importance of developing SF and cultivating PF during social work education to enhance professional competence and reduce difficulties in practice.

Factors Associated With Psychological Distress of Individuals With COVID-19 Isolating at Home: A Cross-Sectional Correlational Study

The purpose of the current study was to clarify the effects of illness perceptions, coping styles, and social support on psychological distress of individuals with coronavirus disease 2019 (COVID-19) isolating at home. A cross-sectional study was performed in a state hospital in Turkey with 112 individuals with confirmed cases of COVID-19. Data were collected online using self-report scales between June 8, 2020, and December 25, 2020. Regression models were used to determine predictors of psychological distress. Significant predictors were cognitive and emotional illness representations, self-blame, and positive reinterpretation coping methods. Health care providers should consider individuals' illness perceptions and coping methods and their effect on psychological distress when providing in-home and follow-up care. [Journal of Psychosocial Nursing and Mental Health Services, 61(12), 27-36.].

Influence of the COVID-19 pandemic on prenatal and postpartum patient experiences and well-being

BACKGROUND

It has yet to be fully elucidated how differing populations of obstetric patients adapted to the disruptions in perinatal care and postpartum support from the COVID-19 pandemic. We surveyed an enriched sample of socioeconomically advantaged patients to understand the influence of COVID-19 on their perinatal care experience, well-being, and coping.

METHODS

We surveyed pregnant and postpartum patients (n = 6140) at a large academic medical center in the Midwest of the United States using the Coronavirus and Perinatal Experiences instrument in Spring 2021.

RESULTS

The survey was sent to 6141 pregnant and postpartum patients; 1180 (17.8%) respondents completed the survey, including 256 who were pregnant and 834 postpartum. Most pregnant patients experienced no changes in their prenatal care with 16.5% indicating somewhat worsened care. In the postpartum cohort, 37.5% stated their care had somewhat worsened. In describing influences on stress and mental health, 58.1% of postpartum respondents stated it was moderately, and 17.4% significantly, worse. The pandemic had a somewhat or moderately negative influence for 72.7% of respondents, with 11.0% stating these effects were extremely negative. Both cohorts characterized a range of coping strategies, most commonly, talking with friends and family (76.3%).

CONCLUSION(S)

Even among this sample of socioeconomically advantaged patients, respondents indicated that the pandemic disrupted many facets of their medical care and daily life, especially social activities and postpartum support. Our findings suggest that counseling on coping and adaptation strategies for stressors and increased health systems support be part of perinatal care during public health emergencies for all demographic groups.

Coping strategies in postpartum women: exploring the influence of demographic and maternity factors

BACKGROUND

Postpartum depression is a frequent mental health issue that affects many women due to this stressful phase. The aim of the study is to gain insight into the coping strategies employed by postpartum women and to explore how these strategies are influenced by various demographic and maternity factors.

METHODS

The study adopted a quantitative, cross-sectional design. Data were collected from 239 postpartum women receiving care at a Gynecology and Obstetrics Clinic using self-reported tools, which include the Brief COPE survey and the socio-demographics and obstetric/maternal history form from October 2022 to April 2023.

RESULTS

The study findings indicate that individuals aged over 40 tend to use more emotional-focused coping compared to those aged 21-30 (p = 0.002) and 31-40. Additionally, both genders of children were associated with more emotional-focused coping (p = 0.007) compared to only having boys. Cesarean section delivery (p = 0.001) was associated with more avoidant-focused coping than normal vaginal delivery. Avoidant-focused coping was significantly predicted by problem-focused coping (p < 0.001), emotional-focused coping (p = 0.034), age (p = 0.003), and gender of children (only boys, p < 0.001; both boys and girls, p = 0.019). Furthermore, problem-focused coping was significantly predicted by age (p = 0.004), gender of children (male child, p = 0.002; both boy and girl: p = 0.014), and avoidant-focused coping (p < 0.001).

CONCLUSIONS

The study examined how postpartum women cope with the challenges of motherhood and how this relates to their demographic and maternity factors. The results suggest that healthcare professionals should promote effective coping strategies and discourage avoidance-oriented approaches in postpartum interventions.

The relationship between social support and depression among HIV-positive men who have sex with men in China: the chain mediating role of psychological flexibility and hope

Introduction

HIV and mental health problems are a global syndemic. One key issue is that the significant mental health problems among people vulnerable to acquiring or living with HIV have not been fully addressed. Access to social support has been one of the biggest challenges for HIV-positive men who have sex with men (HIV+ MSM). Lower social support has been linked to more severe depression symptoms. However, the mechanisms underlying the association between social support and depression in HIV+ MSM are unclear. Two possible mediators include hope and psychological flexibility. This study aimed to examine the relationship between social support and depression in HIV+ MSM and to explore the single mediating effects of hope and psychological flexibility and the chain mediating effect of these two variables on this relationship.

Methods

A convenience sample was used to recruit participants from the designated HIV/AIDS hospital in Changsha city, Hunan Province of China. A total of 290 HIV+ MSM completed questionnaires.

Results

Our findings showed that hope mediated the relationship between social support and depression in HIV+ MSM. Furthermore, the chain mediation model confirmed a direct negative association between social support and depression, but this relationship was largely mediated by the chain effects of hope and psychological flexibility.

Conclusions

Integrating hope and psychological flexibility into interventions may provide better mental health support for HIV+ MSM and improve their wellbeing and quality of life.

Post-covid-19 syndrome: Self-compassion and psychological flexibility moderate the relationship between physical symptom load and psychosocial impact

Living with persistent physical symptoms of an acute COVID-19 infection has a substantial impact on individuals' everyday lives. The identification of potential therapeutic targets for Post-COVID-19 Syndrome (PCS) or "Long-COVID" that can be utilised to reduce the impact of symptoms, is necessary to support effective rehabilitation. Self-compassion and psychological flexibility are thought to be important constructs to consider when understanding how individuals approach the management of long-term health challenges. The present study investigated the extent to which self-compassion and psychological flexibility moderate the relationship between physical symptoms and their impact on daily life. One-hundred and five participants (91 females) who were living with PCS after an acute COVID-19 infection, completed measures to assess PCS physical symptom prevalence as well as measures to assess impact on daily life, self-compassion and psychological flexibility. Two parallel moderation analyses showed that self-compassion and psychological flexibility significantly moderated the relationships between physical symptom presentation and their psychosocial impact. This research highlights the buffering effects of self-compassion and psychological flexibility and the need to consider these psychological therapeutic targets, as part of PCS multidisciplinary rehabilitation.

Impact of the COVID-19 Pandemic on U.S. Women's Mental Health

Background: Women are more likely than men to be diagnosed with depression and anxiety with rates increasing since the COVID-19 pandemic. This study sought to understand how women's intersecting identities, personal strengths, and COVID-19-related stressors were associated with their anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms early in the pandemic. Methods: During May-June 2020, American women (N = 398) recruited via MTurk completed an online questionnaire assessing mental health (PTSD, anxiety, and depression), demographic characteristics, personal strengths (coping, hope, social support), and experiences with COVID-19-specific stressors. Results: Women who had a child younger than 18 years of age, lived in rural or urban areas (compared with suburban), and identified as sexual minority reported increased levels of PTSD, depression, and anxiety symptoms. Social support and hope (Agency) were associated with fewer mental health symptoms. Engagement in maladaptive coping and greater perception of COVID-19 threat and perceived stress was associated with more PTSD, depression, and anxiety symptoms. COVID-19-related illness events and difficulty accessing living essentials were associated with increased anxiety symptoms. COVID-19-related disruption to living and income were associated with increased PTSD symptoms. Loneliness was associated with increased anxiety and depression symptoms. Conclusions: Results of this study can inform prevention and intervention efforts to address depression and anxiety among women with intersecting identities during times of stress. Specifically, supporting the development of women's resilience and adaptive coping and intervening to address maladaptive coping strategies, such as drinking, provide paths to supporting women's mental health.

Predicting anxiety and depression over 12 months of the COVID-19 pandemic: A machine learning study

OBJECTIVES

The coronavirus disease 2019 (COVID-19) pandemic was associated with substantial increases in anxiety and depressive symptoms. To understand individual risk, we examined a large set of potential risk factors for anxiety and depression in the pandemic context.

METHODS

Adults in the United States (N = 1200) completed eight online self-report assessments over 12 months of the COVID-19 pandemic. Area under the curve scores summarized cumulative experiences of anxiety and depression over the assessment period. A machine learning approach to elastic net regularized regression was used to select predictors of cumulative anxiety and depression severity from a set of 68 sociodemographic, psychological, and pandemic-related baseline variables.

RESULTS

Cumulative anxiety severity was most strongly explained by stress and depression-related variables (such as perceived stress) and select sociodemographic characteristics. Cumulative depression severity was predicted by psychological variables, including generalized anxiety and depressive symptom reactivity. Being immunocompromised or having a medical condition were also important.

CONCLUSIONS

By considering many predictors, findings provide a more complete view than previous studies focused on specific predictors. Important predictors included psychological variables suggested by prior research and variables more specific to the pandemic context. We discuss how such findings can be used in understanding risk and planning interventions.

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.

COVID-19 Pandemic-Related Job Loss Impacts on Mental Health in South Korea

OBJECTIVE

The economic hardship brought by the coronavirus disease-2019 (COVID-2019) pandemic has caused mental health problems among people of different socioeconomic status (SES). As social support helps to buffer these problems, we investigated the association between job loss related to COVID-19 and depression, anxiety, and suicidal thoughts; the differences in the effects according to SES; and the mediating effects of social support.

METHODS

The effects of COVID-19-related job loss on depression, anxiety, and suicidal thoughts among 1,364 people were investigated through semi-structured and self-administered questionnaires: Patient Health Questionnaire-9, General Anxiety Disorder-7, and the Functional Social Support Questionnaire. Logistic regression and subgroup analyses were performed to assess the association between job loss and mental health status, and the moderating effects of income and educational levels. Moreover, the mediating effects of perceived social support on the association between job loss and depression, anxiety, and suicidal thoughts were analyzed.

RESULTS

COVID-19-related job loss increased the risk of depression and suicidal thoughts. Adults with lower income and education level were at higher risk of depression, anxiety, and suicidal thoughts; perceived social support level had significant mediating effects on the association between job loss and depression/anxiety; and income level had significant moderating effects on this mediating pathway.

CONCLUSION

COVID-19-related job loss were likely to be significantly associated with negative mental health outcomes, especially among individuals with low income and education levels. As social support had buffering effects on such outcomes, related government policies in cooperation with the governance of communities and stakeholders must be prepared.

Impact of COVID-19 Pandemic on Well-Being, Social Relationships and Academic Performance in a Sample of University Freshmen: A Propensity Score Match Evaluation Pre- and Post-Pandemic

The COVID-19 pandemic has impacted freshmen, compromising their mental health, lifestyles, and academic performance. There are few studies that have investigated changes in the health status and lifestyles of freshmen before and after the pandemic. The aims of this study were: (1) to carry out a pre-post-COVID-19 pandemic comparison between two freshmen samples, in order to detect differences in their socio-demographic characteristics and in some clinical variables; (2) to assess the effect of the COVID-19 pandemic on the social and academic lives of the second sample of freshmen. The samples recruited in 2019 and 2022, matched by propensity score procedure (N = 553), were mostly female (57.3% vs. 55.3%); the mean age was 22.9 and 20.9 years, respectively. The freshmen recruited after the pandemic had less psychological distress and substance use than freshmen recruited before the pandemic. Seventy-eight percent of the freshmen stated that the pandemic had an impact on their social relationships. This effect was greater for females and Italian students. Forty-seven percent reported that the pandemic has worsened their academic performance, while 60% stated that pandemic has improved their grades. The results of this study can provide valuable insights into the impact of the pandemic on freshmen, in order to implement interventions to mitigate the consequences of the pandemic in some subgroups of this target population.

Mental health and psychosocial support in response to onset of the COVID-19 pandemic: Emotional and Stress Management Intervention in Liberia, Sierra Leone, and Ivory Coast

Background

In response to the psychological distress experienced by people affected by the onset of the COVID-19 pandemic, Action Against Hunger (Action contre la Faim, ACF) developed and implemented the Emotional and Stress Management Intervention (ESMI) in Liberia, Sierra Leone, and Ivory Coast. ESMI is a person-to-person two-session, non-specialized, mental health and psychosocial support intervention for adults and adolescents in the general population based in problem solving therapy and principles of emotional regulation.

Methods

Using de-identified programmatic data for each country, we conducted paired t-tests to assess whether adults and adolescents who received ESMI experienced changes in reported psychological distress and perceived social support following the intervention. We also performed pairwise correlations to test whether there were associations between changes in distress and social support over the course of participation in ESMI. Descriptive analyses were performed for presenting problems and coping strategies reported during the sessions.

Results

Mean scores for psychological distress at baseline and follow-up were significantly different in all countries: Sierra Leone (mean (m) = -6.11; 95% confidence interval (CI) = -6.25 to -5.96); Ivory Coast (m = -3.21; 95% CI = -3.33 to -3.10); and Liberia (m = -2.86; 95% CI = -3.15 to -2.56). Changes in perceived social support were also statistically significant for Sierra Leone (m = 6.87; 95% CI = 6.72-7.02); Ivory Coast (m = 3.12; 95% CI = 2.97-3.27); and Liberia (m = 1.13; 95% CI = 1.00-1.27). Correlations (r) between changes in distress and changes in social support varied by country, and ranged from negative in Liberia, (r = -0.88, P = 0.001), to positive in Ivory Coast (r = 55, P = 0.001), and null in Sierra Leone (r = -0.07, P = 0.11).

Conclusions

Our findings show changes in psychological distress and perceived social support for participants who completed two sessions of ESMI, suggesting a potential benefit of ESMI as a person-to-person mental health and psychosocial support for individuals in distress affected by a pandemic. A future randomized controlled trial with a focus on key implementation factors (i.e., pre-testing visual analogue scales, treatment fidelity, and comparison of in-person vs remote) is recommended as next steps in research.

The role of cognitive flexibility in moderating the effect of school-related stress exposure

Educators are exposed to various stressful events as part of their ongoing work, including violence, sexual assaults, suicidal behavior, and loss or illness of students or their family members. Previous studies revealed an increased risk of developing PTSD symptoms in healthcare and supportive professionals exposed to repeated stress as part of their work. Cognitive flexibility might be a protective factor against the negative effect of such stress. The current study aimed to examine the interactive effects of school-related stress exposure and cognitive flexibility on the tendency to develop Post Traumatic Stress Disorder (PTSD) symptoms and the coping abilities of educators. One hundred and fifty educators (86.5% female; Mage = 43.08, Mteaching_experience = 12.90) volunteered to participate in this study. They completed questionnaires measuring levels of stress exposure, cognitive flexibility, coping ability, and PTSD symptoms. Analyses revealed that cognitive flexibility moderated the relationship between school-related stress exposure and both PTSD symptoms severity and maladaptive coping. Specifically, whereas educators with low cognitive flexibility exhibited positive associations between continuous stress exposure and both levels of PTSD symptoms and maladaptive coping, no such association was found among educators with high cognitive flexibility. The results highlight the importance of cognitive flexibility as a protective factor against the harmful effects of possible stress exposure in school environments. Awareness of the crucial role of cognitive flexibility as a protective factor for educators can be a breakthrough in improving educators' well-being and adaptive functioning.

Nursing students' perceptions of how the COVID-19 pandemic impacts mental well-being and educational environment

Background

Challenging work conditions put over 20 million U.S. health workers, including nurses, at risk for mental health problems. Mental health concerns among nurses and nursing students include anxiety, burnout, and stress which can lead to substance abuse and suicidal behavior. Nursing students practice in environments where they are exposed to complex challenges and high-stress situations that can lead to a higher prevalence of psychiatric disorders. As nursing students attempt to adapt to a post-pandemic educational environment, it is important to identify perceptions of nursing students' mental well-being.

Methods

A qualitative design was utilized using a descriptive method. Semi-structured interviews were conducted with a purposeful sample of BSN students (n = 11) from the southeastern U.S. Content analysis and coding were utilized in the study.

Results

Coping strategies and coping skills are imperative for nursing students to thrive in the educational environment, which includes a multitude of stressors that can negatively impact academic success. The rigorous workload of nursing schools, lack of support, financial challenges, and lack of experience are contributing factors that lead to decreased mental well-being among nursing students.

Conclusion

Interventions that aid in recognizing students at high risk for negative mental health outcomes must be implemented to ensure academic success. Implementing interventions to support healthy mental well-being among nursing students can also create an educational environment that prepares students to provide high-quality, safe, and effective patient care.

The psychological stress response of COVID-19 to medical staff and prevention: A large sample study from China

Objectives

In the face of the COVID-19 pandemic, medical staff in China were more likely to suffer from psychological problems. By investigating the actual state of psychological stress response of medical staff during the COVID-19 outbreak, the study discussed and analyzed the influencing factors of different psychological states in order to prevent the occurrence of serious adverse emotional events in medical staff.

Methods

In the Xiangyang Central Hospital, 1,466 medical staff members have adopted the Psychological Questionnaire for Emergencies Events of Public Health (PQEEPH), which includes questions about depression, neurasthenia, fear, obsessive anxiety, and hypochondriac disorders. The questionnaire also asks about gender, age, education level, health, department, position, and whether personnel exposure history correlation analysis has been confirmed.

Results

The survey revealed that 55% had depression, 26.7% had neurasthenia, 95% had fear, 47.9% had obsessive anxiety, and 69.3% had hypochondria. The effects of depression and hypochondriac emotional stress were significantly greater in female workers than in male workers (p < 0.05). Those with higher educational levels had a stronger emotional stress response. Medical professionals with or without contact histories, those who were suspected or confirmed, as well as those in various positions and departments, all demonstrated significant differences in their stress emotions (p < 0.05).

Conclusion

Emotional stress affected medical professionals, especially doctors and nurses, who were on the front lines of clinical work in the face of significant public health emergencies. Therefore, to reduce the stress burden and enhance mental health on medical staff, hospitals were suggested to improve their emergency management practices. In addition, the sensitization knowledge training and psychological counseling for front-line clinical staff should be strengthened.

Trajectories of resilience and mental distress to global major disruptions

The COVID-19 pandemic has resulted in a major societal disruption, raising the question of how people can maintain or quickly regain their mental health (i.e., be resilient) during such times. Researchers have used the pandemic as a use case for studying resilience in response to a global, synchronously starting, and chronic set of stressors on the individual and societal level. Our review of this recent literature reveals that mental distress trajectories during the pandemic largely resemble mental distress responses to individual-level macro-stressors, except for a lower prevalence of recovery trajectories. Results suggest more resilient responses in older adults, but trajectories are less consistent for younger and older ages compared with middle-aged adults. We call for more research integrating state-of-the-art operationalizations of resilience and using these to study resilience over the lifespan.

Resilience and Wellbeing Strategies for Pandemic Fatigue in Times of Covid-19

The COVID-19 pandemic is truly one of the greatest collective health crises in history which have altered our life and living. For years, people have felt fatigued from following public health directives such as social distancing, wearing masks, washing hands frequently, and working or studying remotely without in-person interactions. In this paper, we explore strategies for resilience and wellbeing which can mitigate pandemic-caused stress and behavioural fatigue. We start with individual level strategies including reworking stress appraisals, the importance of psychological flexibility, reducing loneliness through adaptive online platform use, optimizing familial relationships when living in close quarters for a prolonged period, reducing symptoms of burnout and using adaptive distractions, using specific evidence-based resilience strategies. We discuss specific considerations which tap on our shared identities and shared responsibilities which can enhance a sense of community, especially for individuals from marginalized backgrounds and how suicide risks can be minimized.