A systematic review of fear, stigma, and mental health outcomes of pandemics

The relationship between strong-ties weak-ties rationality and COVID-19 public stigma: A cross-cultural study of Malaysia and Australia

We investigated the relationship between strong-ties versus weak-ties rationality and public stigma (PS) during the COVID-19 pandemic. We also explored the cultural group differences (Malaysians vs. Australians) in this relationship. An online survey was conducted in 2021 with a final sample of 830 eligible Malaysians and 394 eligible Australians. Participants completed the multidimensional strong-ties weak-ties rationality Scale (STWTRS) and an adapted public stigma (PS) scale towards COVID-19 patients. Through multiple regression analysis, we found that the strong-ties rationality, ST-Authoritarian rationality, was positively associated with PS-Blame in both countries. However, the variable Country moderated the relationship between ST-Communal and PS-Rejection, with a negative association found in Malaysia and a positive association in Australia. The findings confirmed the strong-ties weak-ties rationality framework, where ST rationality, especially ST-Authoritarian, could explain the cognitive mechanism behind negative attitudes towards those who pose threat towards the in-group survival. However, ST-Communal could buffer the rejection towards the COVID-19 patients in Malaysia due to its emphasis on social harmony. This study can inform future interventions aimed at mitigating stigma and promoting a more inclusive and supportive society in times of crisis.

Revealing the Obscurity of Attitudes Towards Mental Health Conditions: A Cross-Sectional Study of Attitudes Among the General Population of Iraq

BACKGROUND

Mental health conditions cause a huge burden on individuals and healthcare systems. According to the World Health Organization, around 970 million individuals worldwide had a mental disorder in 2019.

AIM/QUESTION

To explore the attitudes towards mental health conditions among the Iraqi community and determine factors influencing such attitudes.

METHODS

A cross-sectional survey was conducted on 1394 individuals of the Iraqi general population between December 2022 and February 2023 using a self-administered online questionnaire in Arabic, utilising convenience and snowball sampling. The data were analysed using R Statistical Software.

RESULTS

In total, 763 (54.73%) individuals had positive attitudes towards mental health conditions. The multivariate regression analysis revealed the males and age group of 46 years, and more were significantly associated with negative attitudes (p = 0.001, p = 0.045 respectively).

DISCUSSION

Individuals with mental health conditions experience stigmatising attitudes as in the Middle East jeopardising their treatment and recovery. This is the first study to address the Iraqi population's attitudes towards mental health conditions indicating overall positive attitudes.

IMPLICATIONS FOR PRACTICE

Health promotions must be conducted by educators, healthcare workers and universities to dispel the myths. Future studies with extensive sampling will help clarify the obscurity of mental health conditions in Iraq.

Exploring the Impact of Positive Psychology-Based Virtual Music Therapy on Mental Health in Stressed College Students during COVID-19: A Pilot Investigation

This study explored the effectiveness of a virtual music therapy program, based on positive psychotherapy principles, in college students during the COVID-19 pandemic. Twenty-four undergraduate students with partial PTSD were initially assigned to either an experimental group or a control group, with 11 participants in each group by the study's end. The experimental group underwent 15 video sessions of the therapy program, completing one session per weekday over 3 weeks. The program involved worksheets targeting goals aligned with positive psychology, such as positive affect, life meaning, personal strengths, gratitude, hope, and happiness. The activities included writing music autobiographies, creating and analyzing song lyrics, and exploring various music pieces. The effectiveness of the intervention was measured using the 21-item Depression Anxiety Stress Scale and the Korean Version of Positive Psychological Capital (K-PPC) before, immediately after, and 3 weeks post-program. The experimental group showed significant improvements in stress (F = 5.759, p < 0.05), anxiety (F = 4.790, p < 0.01), depression (F = 5.740, p < 0.01), self-efficacy (F = 3.723, p < 0.05), resilience (F = 4.739, p < 0.05), and the K-PPC total score (F = 3.740, p < 0.05) compared with the control group. These improvements were maintained at the 3-week follow-up. The findings suggest that positive psychology-based virtual music therapy can significantly enhance the mental health of highly stressed college students, especially during challenging times such as the COVID-19 pandemic.

A Preference-Based Value Assessment of the Fear of COVID-19 Contagion

Purpose

To assess the preference-based value of the fear of COVID-19 contagion.

Patients and Methods

We conducted a web-based, cross-sectional discrete choice experiment among 544 US adults. We used a Bayesian efficient design to generate choice sets. Each choice set comprised two hypothetical COVID-19 vaccine options characterized by seven attributes: chance of COVID-19 infection, chance of having severe symptoms from COVID-19 infection, vaccine protection duration, chance of mild to moderate adverse events from vaccination, chance of serious adverse events from vaccination, chance of future exposure to COVID-19 after vaccination, and out-of-pocket cost. We used mixed logit (ML) and latent class (LC) models to analyze data. Furthermore, we calculated the willingness-to-pay for eliminating the chance of future exposure to COVID-19, shedding light on the value attributed to the fear of contagion.

Results

The ML model demonstrated all attributes, including the chance of future exposure to COVID-19, were statistically significant. The participants were willing to pay approximately $13,046 to eliminate the chance of future exposure to COVID-19 or their fear of contagion when COVID-19 was still pandemic. The LC model unveiled two participant classes with distinct preference weights for the chance of future exposure to COVID-19 and out-of-pocket cost attributes. Nevertheless, the chance of future exposure to COVID-19 exposure held a significant degree of importance in both classes.

Conclusion

The chance of future exposure to COVID-19 exposure or fear of contagion was a significant element in the value assessment of COVID-19 vaccines. Further studies should be conducted to verify the value of fear of contagion and include it in the value assessment of healthcare technologies for infectious diseases.

Development and validation of the Post-Pandemic Fear of Viral Disease scale and its relationship with general anxiety disorder: a cross-sectional survey from Pakistan

BACKGROUND

Given the worldwide reach of COVID-19, media coverage has amplified the psychological and social effects of this pandemic causing a widespread fear. Despite substantial research on the short-term psychological impact of COVID-19, its long-term consequences on mental health remain relatively unexplored. This research aims to develop and validate a Post-Pandemic Fear of Viral Disease (PPFVD) scale and to see its relationship with general anxiety disorder among the Pakistani population.

METHODS

A cross-sectional online-based survey was conducted with 457 respondents in August and September 2022. We adopted the modified fear of coronavirus scale (FCV-19 S) consisting of seven items and the Generalized Anxiety Disorder (GAD) questionnaire to measure anxiety disorder. Confirmatory factor analysis was applied using the maximum likelihood estimation method. Scale dimensions and item reliability were tested for their validity and goodness of fit. SPSS and AMOS were used for data management and analyses.

RESULTS

All inter-item correlations were found to be significant and ranged between 0.30 and 0.70. The value of Cronbach's alpha was 0.887, indicating good reliability. Corrected item-total correlations ranged between 0.632 and 0.754. Factor loadings ranged from 0.664 to 0.810, indicating a good internal consistency. Overall, these results clearly demonstrate that the one-factor solution model for PPFVD presents a good fit to the data. The composite reliability (CR = 0.747) was also good.

CONCLUSIONS

The COVID-19 pandemic has negatively affected the mental health of people globally. This measurement scale can be trusted and used to test the PPFVD in the post-pandemic situation. Prospective research might validate this instrument in newly emerging scenarios and test it with diverse ethnic groups.

Screening for postpartum depression and risk of suicidality with obstetrical patients: a cross-sectional survey

BACKGROUND

Pregnancy is a vulnerable time where the physical and social stress of the COVID-19 pandemic affects psychological health, including postpartum depression (PPD). This study is designed to estimate the prevalence and correlates of PPD and risk of suicidality among individuals who gave birth during the COVID-19 pandemic.

METHODS

We surveyed individuals who gave birth at The Ottawa Hospital and were ≥ 20 days postpartum, between March 17 and June 16, 2020. A PPD screen consisted of a score ≥ 13 using the Edinburgh Postnatal Depression Scale. A score of 1, 2, or 3 on item 10 ("The thought of harming myself has occurred to me") indicates risk of suicidality. If a participant scores greater than ≥ 13 or ≥ 1 on item 10 they were flagged for PPD, the Principal Investigator (DEC) was notified within 24 h of survey completion for a chart review and to assure follow-up. Modified Poisson multivariable regression models were used to identify factors associated with PPD and risk of suicidality using adjusted risk ratios (aRR) and 95% confidence intervals (CI).

RESULTS

Of the 216 respondents, 64 (30%) screened positive for PPD and 17 (8%) screened positive for risk of suicidality. The maternal median age of the total sample was 33 years (IQR: 30-36) and the infant median age at the time of the survey was 76 days (IQR: 66-90). Most participants reported some form of positive coping strategies during the pandemic (97%) (e.g. connecting with friends and family, exercising, getting professional help) and 139 (64%) reported negative coping patterns (e.g. over/under eating, sleep problems). In total, 47 (22%) had pre-pregnancy anxiety and/or depression. Negative coping (aRR:2.90, 95% CI: 1.56-5.37) and pre-existing anxiety/depression (aRR:2.03, 95% CI:1.32-3.11) were associated with PPD. Pre-existing anxiety/depression (aRR:3.16, 95% CI:1.28-7.81) was associated with risk of suicidality.

CONCLUSIONS

Almost a third of participants in this study screened positive for PPD and 8% for risk of suicidality. Mental health screening and techniques to foster positive coping skills/strategies are important areas to optimize postpartum mental health.

COVID-19 stigma and depression across race, ethnicity and residence

Our cross-sectional study seeks to understand how COVID-19 stigma, race/ethnicity [Asian, Black, Hispanic/Latinx, white] and residency [New York City (NYC) resident vs. non-NYC resident] associated with depression. Our sample includes 568 participants: 260 (45.77%) were NYC residents and 308 (54.3%) were non-NYC residents. A series of multiple linear regression were run to examine the relationship between race/ethnicity, COVID-19 stigma, and depressive symptoms. Irrespective of residency, older age and ever being diagnosed with COVID-19 were negatively associated with depressive symptoms. Stigma and thinking less of oneself significantly associates with depressive symptoms across residency. Our study expects to benefit mental health care providers and public health professionals in designing best practices to mitigate stigma in ongoing or future pandemics.

The experience of hate incidents across racial and ethnic groups during the COVID-19 pandemic

Introduction

Racism is a root cause of ill health for communities of color, and hate incidents are one manifestation of racism. Marginalized racial and ethnic groups, including but not limited to Asian Americans, have been the target of highly publicized violence, hate, and discrimination which has been amplified during the COVID-19 pandemic.

Objectives

This paper investigates (1) the prevalence of hate incidents across racial and ethnic groups, and (2) the relationship between race and ethnicity and hate incidents during the first year of the COVID-19 pandemic. We also seek to (3) situate study findings within theories of racism.

Methods

This study utilizes national data from the Understanding America Study (UAS) COVID-19 Longitudinal Survey from June 10, 2020 to March 30, 2021 (n = 8,436). Hate incidents in six categories were examined: being treated with less courtesy, receiving poorer service, others acting as if they were not smart, others acting as if they were afraid of them, being threatened or harassed, and experiencing any of the previous categories of hate incidents. Main analyses were conducted via population averaged logistic panel regression.

Results

The majority of members of all six marginalized racial and ethnic groups reported at least one hate incident during the first year of the COVID-19 pandemic. In addition, all marginalized racial or ethnic groups had statistically significant higher odds of experiencing at least two categories of hate incidents compared to white individuals. Asian, AI/AN, Black, and Multiracial groups had significantly higher odds of experiencing each category of hate incident. All marginalized racial and ethnic groups had significantly higher odds of receiving poorer service and others acting as if they were afraid of them.

Conclusion

All marginalized racial and ethnic groups experienced significant levels of hate incidents within the first year of the COVID-19 pandemic. The public health community must continue to research, monitor, treat, and prevent hate incidents as a public health issue while recognizing the social and historical contexts of structural and interpersonal racism in the US.

Confronting SARS-CoV-2 Infection: Patients' Experience in the First Pandemic Wave-Cross-Sectional Study

The aim of the study was to investigate the real-life experience of persons infected with SARS-CoV-2 in Slovenia in the first pandemic wave and how the buffering effect of social and informational support affected negative feelings. We used a self-administrated questionnaire. There were 1182 eligible notified cases with the response rate 64.9%. At least 62% of responders were able to follow the isolation rules, while 21.1% did not or could not organize their living separately from other household members. The main providers during the isolation period were close family members. The most prevalent emotion in our study was worry (70.3%) and fear (37.6%). Worry and fear during the illness were less probable for men than women, but more probable for older patients. Participants with strong emotional support had lower odds of being sad. Those who were exposed to a larger number of sources of information had higher odds of being worried. Those patients who used a higher number of more credible sources of information had higher odds of being afraid during illness. Pets did not play a special role in psychological well-being. The role of the media and public health communications should be explored further to achieve an improved response.