1
|
Pratt BA, Krause-Parello CA, Nguyen-Feng VN, Giordano NA, Basin SB, Peterson AL, Walsh P, Siebert AQ, Ruiz R, Kirkland DM, Nolan JP. Mission Alliance Community Engagement Project: Exploring the Impact of COVID-19 on Social Isolation, Loneliness, Mental Health and Wellbeing in Veterans. J Community Health 2024; 49:394-401. [PMID: 38066217 PMCID: PMC10981591 DOI: 10.1007/s10900-023-01314-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/08/2023] [Indexed: 04/02/2024]
Abstract
During the Coronavirus disease pandemic, many U.S. veterans with posttraumatic stress disorder (PTSD) experienced increased symptomology and worsened mental health and well-being due in part to social isolation and loneliness. The Mission Alliance project explored these ramifications and prioritized critical issues expressed by U.S. veterans and stakeholders (N = 182) during virtual regional meetings (N = 32). Field notes created specifically for this project were recorded and thematically analyzed. Emerging themes included: (1) social isolation: missed opportunities, collapsed social circles, work-life balance, fostering relationships, and evolving health care delivery; (2) loneliness: deteriorated mental health, suffered with PTSD together but alone, looked out for each other, ambivalence toward technology, and strained and broken systems; (3) mental health: sense of chaos, increased demand and decreased access, aggravation, implementation of tools, innovative solutions, fear and loss, and availability of resources; (4) wellbeing: sense of purpose, holistic perspective on well-being, recognition of balance, persisting stigma, redefined pressures, freedom to direct treatment, and reconnection and disconnection. A PTSD-related patient centered outcomes research (PCOR)/comparative effectiveness research (CER) agenda was developed from these themes. Establishment of a veteran and stakeholder network is suggested to support, facilitate, and promote the PTSD-related PCOR/CER agenda. Furthermore, enhancement of opportunities for veterans with PTSD and stakeholders to partner in PCOR/CER is required to develop and conduct projects that lead to PTSD-related comprehensive care of veterans affected by traumatic events with the potential to translate findings to other populations.
Collapse
Affiliation(s)
- Beth A Pratt
- College of Nursing, Florida Atlantic University, 3200 College Drive, LA49 228B, Davie, Boca Raton, FL, 33314, USA.
| | - Cheryl A Krause-Parello
- College of Nursing, Florida Atlantic University, 3200 College Drive, LA49 228B, Davie, Boca Raton, FL, 33314, USA
| | | | | | | | - Alan L Peterson
- University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Patrick Walsh
- University of Rochester Medical Center, Rochester, NY, USA
| | | | | | | | | |
Collapse
|
2
|
Bühler AH, Willmund GD. Deployment-related quarantining-a risk or resilience factor for German military service members? A prospective analysis during the third-fifth waves of COVID-19. Front Public Health 2023; 11:1267581. [PMID: 38152661 PMCID: PMC10751356 DOI: 10.3389/fpubh.2023.1267581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/26/2023] [Indexed: 12/29/2023] Open
Abstract
Background Mandatory deployment-related quarantining added further constraints on soldiers during the pandemic. Contrary to overwhelming research documenting an adverse impact of quarantining on mental health, no adverse short-term mental health effects of pre-deployment quarantining for German soldiers were identified. Therefore, we are interested in a potentially delayed onset, the impact of an additional post-deployment quarantine, and quarantine-associated risk and resilience factors predicting mental health post-deployment. Methods In a prospective research design, 928 German soldiers enrolled in the study at the in-processing of pre-deployment quarantine between February 2021 and March 2022. Every German military service member undergoing pre-deployment quarantine could participate. The soldiers were between 18 and 64 years old; 87.5% identified as male and 12.5% as female. Self-reported mental health (Mini-SCL), perceived social support (FSozU-K22), and perceived unit cohesion were assessed three to five times: at the beginning and the end of pre-deployment quarantine (Nt1 = 928, Nt2 = 907), if still mandatory-at the beginning and the end of post-deployment quarantine (Nt3 = 143 and Nt4 = 132), and 3 months post-deployment, on average 7 to 8 months later than pre-deployment quarantine (Nt5 = 308). The analyzed quarantine-associated risk and resilience factors were informedness about COVID-19, infection risk, quarantine benefit, clarity of quarantine protocol, need for intimacy/bonding, norms, stigma, practicality, financial disadvantages, boredom, and health-promoting leadership. Results Despite four different mental health trajectories identified, repeated measures ANOVAs revealed a significant improvement in mental health post-deployment (F[2,265] = 21.54, p < 0.001), a small decrease in social support (F[2,266] = 16.85, p < 0.001), and no significant changes in unit cohesion (F[2,264] = 0.482, p = 0.618) 3 months post-deployment. Using stepwise regression, 24% of variance in mental health symptomatology post-deployment is predicted pre-deployment by a clear quarantine protocol, unit cohesion, intimacy/bonding, and social support (F[4,263] = 22.23, p < 0.001). In total, 30% of mental health at the end of post-deployment quarantine is predicted by stigma and a clear quarantine protocol (F[2,99] = 22.22, p < 0.001). Conclusion Although no overall adverse impact of quarantining on mental health was found, it is recommended to address perceived stigma and clearly communicate the quarantine protocol, and to further follow up on the perceived decrease in social support.
Collapse
Affiliation(s)
- Antje H. Bühler
- Bundeswehr Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany
| | | |
Collapse
|
3
|
Williamson C, Jones M, Palmer L, Dighton G, Burdett H, Sharp ML, Fear NT. Anger Among UK Ex-Service Military Personnel During the COVID-19 Pandemic. J Nerv Ment Dis 2023; 211:940-947. [PMID: 37428877 DOI: 10.1097/nmd.0000000000001681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
ABSTRACT Military service and ex-service personnel commonly experience difficulties with anger. The COVID-19 pandemic had several negative consequences upon social, economic, and health factors that influence anger. This study aimed to explore 1) levels of anger in an ex-serving military cohort during the COVID-19 pandemic; 2) self-reported changes in anger compared with prepandemic levels; and 3) identify sociodemographic characteristics, military characteristics, COVID-19 experiences, and COVID-19 stressors associated with anger. UK ex-service personnel ( n = 1499) completed the Dimensions of Anger Reactions 5-item measure within an existing cohort study. Overall, 14.4% reported significant difficulties with anger, and 24.8% reported their anger worsened during the pandemic. Anger was associated with factors such as financial difficulties, extra/new caring responsibilities, and COVID-19 bereavement. Endorsing more COVID-19 stressors was associated with higher odds of anger difficulties. This study highlights the impact of the pandemic on ex-service personnel, including a strain on family/social relationships and financial hardship, which affected anger.
Collapse
|
4
|
Knowles SR, Möller SP, Stengel A, Mikocka-Walus A, Ferreira N, Trindade IA, Mokrowiecka A, Burisch J, Barreiro-de Acosta M, Bernstein CN, Lo B, Skvarc D. Exploring the Impact of Covid-19-Related Perceptions on Psychological Distress and Quality of Life in an International Gastrointestinal Cohort Over Time Guided by the Common Sense Model. J Clin Psychol Med Settings 2023; 30:804-820. [PMID: 36692701 PMCID: PMC9872753 DOI: 10.1007/s10880-023-09937-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 01/25/2023]
Abstract
The aim of this longitudinal study was to examine changes in COVID-19 and illness-related perceptions, gastrointestinal symptoms, coping, catastrophising, psychological distress, and QoL during the COVID-19 pandemic. A total of 831 adults with a gastrointestinal condition completed an online questionnaire at baseline (May-October 2020). Of those, 270 (32.5%) participants (85.2% female, mean age = 47.3 years) provided follow-up data (March-May 2021). Repeated-measures multiple analysis of variance and a cross-lagged panel model were used to test the study hypotheses. Gastrointestinal symptoms and COVID-19 perceptions at follow-up were strongly predicted by their baseline values, while illness perceptions were predicted by baseline gastrointestinal symptoms. Cross-lagged relationships indicated a reciprocal relationship between gastrointestinal symptoms and psychological distress. Moreover, gastrointestinal symptoms had substantial predictive utility, strongly predicting future gastrointestinal symptoms, and to a lesser extent, more negative illness perceptions, greater psychological distress, and greater use of adaptive coping strategies across time.
Collapse
Affiliation(s)
- Simon R Knowles
- Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia.
| | - Stephan P Möller
- Department of Psychological Sciences, Faculty of Health, Arts and Design, Swinburne University of Technology, Melbourne, Australia
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité-Universit¨Atsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | | | - Nuno Ferreira
- School of Humanities and Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Inês A Trindade
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Center for Research in Neuropsychology and Cognitive and Behavioural Intervention (CINEICC), Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
| | - Anna Mokrowiecka
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Johan Burisch
- Gastrounit, Medical Division, Copenhagen University Hospital - Amager and Hvidovre, University of Copenhagen, Hvidovre, Denmark
- Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre Hospital, Hvidovre, Denmark
| | | | - Charles N Bernstein
- University of Manitoba IBD Clinical and Research Centre and Department of Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Bobby Lo
- Gastrounit, Medical Division, Copenhagen University Hospital - Amager and Hvidovre, University of Copenhagen, Hvidovre, Denmark
- Copenhagen Center for Inflammatory Bowel Disease in Children, Adolescents and Adults, Copenhagen University Hospital - Amager and Hvidovre, Hvidovre Hospital, Hvidovre, Denmark
| | - David Skvarc
- School of Psychology, Deakin University Geelong, Geelong, Victoria, Australia
| |
Collapse
|
5
|
Murphy D, Hendrikx LJ, Williamson C, Baumann J. Longitudinal survey of UK veterans with pre-existing mental health difficulties: mental health during the COVID-19 pandemic. BMJ Mil Health 2023; 169:529-534. [PMID: 35078940 PMCID: PMC8804302 DOI: 10.1136/bmjmilitary-2021-002046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Accepted: 01/08/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION At the start of the COVID-19 pandemic, individuals with pre-existing mental health difficulties were thought to be vulnerable to mental health deterioration due to the emerging threat and the actions taken to control infection rates. Yet, there remained a paucity of research investigating changes in veteran well-being, a population facing higher rates of mental health difficulties compared with the general public. This longitudinal study aimed to investigate the mental health and well-being of UK veterans with pre-existing mental health difficulties at two time points during the COVID-19 pandemic. METHODS UK treatment-seeking veterans (N=121) completed an online survey administered towards the end of the first UK lockdown in June 2020 and 1 year later. Data were gathered on sociodemographic characteristics as well as psychometric measures of post-traumatic stress disorder (PTSD), common mental disorders (CMDs), anger difficulties and alcohol misuse. RESULTS The proportion of veterans meeting criteria of PTSD, anger and alcohol misuse remained similar across the two time points, while significantly fewer veterans met criteria for CMDs 1 year later. A notable proportion of the sample reported challenges in attending mental and physical health appointments, which was positively associated with not working and negatively associated with more COVID-19-related stressors. CONCLUSIONS These findings suggest that, to date, veterans with pre-existing mental health difficulties appear to demonstrate resilience as the COVID-19 pandemic progressed. However, as the pandemic continued, veterans faced significantly more COVID-19-related stressors, less social support, as well as difficulties attending health appointments.
Collapse
Affiliation(s)
- Dominic Murphy
- Department of Research, Combat Stress, Leatherhead, UK
- King's Centre for Military Health Research, King's College London, London, UK
| | - L J Hendrikx
- Department of Research, Combat Stress, Leatherhead, UK
| | - C Williamson
- Department of Research, Combat Stress, Leatherhead, UK
- King's Centre for Military Health Research, King's College London, London, UK
| | - J Baumann
- Department of Research, Combat Stress, Leatherhead, UK
| |
Collapse
|
6
|
Kay CWP, Sutton RJ, Margerison GL, McKenna J. Providing recovery support to wounded, injured, and sick UK military personnel throughout the COVID-19 pandemic. MILITARY PSYCHOLOGY 2023; 35:408-419. [PMID: 37615553 PMCID: PMC10453965 DOI: 10.1080/08995605.2022.2126655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 09/02/2022] [Indexed: 10/10/2022]
Abstract
Health precautions implemented by the United Kingdom (UK) government to limit the spread of the Coronavirus Disease 2019 (COVID-19) led to the closure of many well-being support services in 2020. This created a need to re-think how impactful recovery support courses can be provided. One such service was that of the five-day Multi Activity Course (MAC) which was redesigned in accordance with national health guidelines to allow continued access for Wounded, Injured and Sick (WIS) military personnel to the service; the positive impacts of which are well established. This study investigated the influence of the newly developed Reduced numbers MAC (R-MAC) on the WIS participants lives during and for 12 months after attending. The R-MAC led to comparable impacts for participants well-being, at a time in which people's mental well-being was often being adversely affected. The positive mental well-being of the 261 participants improved by 33% throughout the course and remained 14% higher for the 37 participants who provided data six months after attending. Key facets of the experience that were most impactful for the participants were (i) shared experience with other veterans, (ii) discussing issues in a safe environment while receiving support from the staff and (iii) developing knowledge around self-help/personal development. Adapting to the challenging circumstances and developing the R-MAC mitigated against the already adverse impact of the COVID-19 pandemic for the WIS participants.
Collapse
Affiliation(s)
| | | | | | - Jim McKenna
- Carnegie School of Sport, Leeds Beckett University, Leeds, UK
| |
Collapse
|
7
|
Patil T, Raguindin JJ, Radtke M, Smigiel J, Savona N, Kavuru B, Sekhri A. Evaluating the Association of Montelukast Use on Neuropsychiatry-Related Healthcare Utilization and Depression in COVID-19-Hospitalized Veterans: A Nationwide VA Observational Cohort Study. Clin Drug Investig 2023; 43:605-619. [PMID: 37498493 DOI: 10.1007/s40261-023-01292-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2023] [Indexed: 07/28/2023]
Abstract
BACKGROUND Montelukast's new boxed warning for neuropsychiatric events questions its use in the setting of coronavirus disease 2019 (COVID-19) due to increased risk for new-onset psychiatric diagnoses. OBJECTIVE We aim to evaluate the impact of using montelukast in patients hospitalized with COVID-19 on neuropsychiatry-related healthcare utilization and depression. METHODS This retrospective nationwide observational cohort study using the Veterans Health Administration database included patients from January 1, 2020, through July 1, 2021. The treatment cohorts consisted of patients with and without montelukast use prior to COVID-19 hospitalization and matched using propensity score (PS) to two control cohorts: patients with COVID-19-related hospitalization without prior montelukast use and patients with prior montelukast use who were hospitalized for reasons other than COVID-19. The primary outcome of psychiatric hospitalizations at 90 days and 180 days and mental health visits at 180 days were compared using Poisson or negative binomial regression. Secondary outcomes of new-onset depression and new use of antidepressants were analyzed using multivariable logistic regression. RESULTS After PS matching, a total of 415 patients were included in COVID-19 with and without montelukast matched cohort and 409 patients in montelukast with and without COVID-19-related hospitalization matched cohorts. For the primary outcomes, inpatient psychiatric hospitalization at 90 days [incidence rate ratio (IRR) 95% CI 1.79 (1.36-2.36)] and 180 days [IRR 95% CI 1.79 (1.32-2.25)] and mental health visits at 180 days [IRR 95% CI 1.72 (1.45-2.03)] were significantly higher in the montelukast with COVID-19 hospitalization group compared with those hospitalized without COVID-19. No difference in primary outcomes were noted in patients hospitalized with COVID-19 with and without use of montelukast. No significant difference was found in the secondary outcomes between either comparator group. CONCLUSIONS Patients with prior montelukast use who were hospitalized with COVID-19 appeared to have increased rate of neuropsychiatry-related healthcare utilization.
Collapse
Affiliation(s)
- Tanvi Patil
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA.
| | - Jasper Jade Raguindin
- Central Western Massachusetts Veterans Affair Health Care System, 421 N Main St, Leeds, MA, 01053, USA
| | - Michelle Radtke
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
| | - Joseph Smigiel
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
| | - Natalie Savona
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
| | - Bush Kavuru
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
| | - Anuradha Sekhri
- Salem Veterans Affairs HealthCare System, 1970 Roanoke Blvd, Salem, VA, 24153, USA
| |
Collapse
|
8
|
Walker DL, Nouri MS, Plouffe RA, Liu JJW, Le T, Forchuk CA, Gargala D, St Cyr K, Nazarov A, Richardson JD. Telehealth experiences in Canadian veterans: associations, strengths and barriers to care during the COVID-19 pandemic. BMJ Mil Health 2023:military-2022-002249. [PMID: 37172981 DOI: 10.1136/military-2022-002249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 05/02/2023] [Indexed: 05/15/2023]
Abstract
INTRODUCTION Identifying barriers to care in veteran populations is critical, as veterans face increased social isolation, relationship strains and financial insecurities. For Canadian veterans experiencing barriers to accessing healthcare, telehealth may be a promising alternative with comparable effectiveness to in-person services; however, the potential benefits and limitations of telehealth require further examination to determine its long-term utility, and to inform health policy and planning. The goal of the present research was to identify predictors and barriers to telehealth usage in Canadian veterans in the context of the COVID-19 pandemic. METHODS Data were drawn from baseline data of a longitudinal survey examining the psychological functioning of Canadian veterans during the COVID-19 pandemic. Participants were 1144 Canadian veterans aged 18-93 years (Mage=56.24, SD=12.92; 77.4% men). We assessed reported telehealth use (ie, for mental healthcare, physical healthcare), healthcare access (ie, difficulty accessing care, avoidance of care) and mental health and stress since the beginning of the COVID-19 pandemic, sociodemographic variables and open-ended responses about telehealth experiences. RESULTS Findings suggest that sociodemographic factors and previous telehealth use were significantly associated with telehealth use during the COVID-19 pandemic. Qualitative evidence highlighted both the benefits (eg, reducing barriers of access) and drawbacks (eg, not all services can be delivered) of telehealth services. CONCLUSIONS This paper provided a deeper understanding of Canadian veterans' experiences with accessing telehealth care during the COVID-19 pandemic. While for some, the use of telehealth mitigated perceived barriers (eg, safety concerns of leaving home), others felt that not all health services could be appropriately carried out through telehealth. Altogether, findings support the use of telehealth services in increasing care accessibility for Canadian veterans. Continued use of quality telehealth services may be a valuable form of care that extends the reach of healthcare professionals.
Collapse
Affiliation(s)
- Deanna L Walker
- MacDonald Franklin Operational Stress Injury Research Centre, London, Ontario, Canada
- Psychology, Western University, London, Ontario, Canada
| | - M S Nouri
- MacDonald Franklin Operational Stress Injury Research Centre, London, Ontario, Canada
| | - R A Plouffe
- MacDonald Franklin Operational Stress Injury Research Centre, London, Ontario, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - J J W Liu
- MacDonald Franklin Operational Stress Injury Research Centre, London, Ontario, Canada
| | - T Le
- MacDonald Franklin Operational Stress Injury Research Centre, London, Ontario, Canada
| | - C A Forchuk
- MacDonald Franklin Operational Stress Injury Research Centre, London, Ontario, Canada
| | - D Gargala
- MacDonald Franklin Operational Stress Injury Research Centre, London, Ontario, Canada
| | - K St Cyr
- MacDonald Franklin Operational Stress Injury Research Centre, London, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - A Nazarov
- MacDonald Franklin Operational Stress Injury Research Centre, London, Ontario, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - J D Richardson
- MacDonald Franklin Operational Stress Injury Research Centre, London, Ontario, Canada
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- St. Joseph Operational Stress Injury Clinic, St. Joseph's Healthcare London, London, Ontario, Canada
| |
Collapse
|
9
|
Li S, Huang S, Hu S, Lai J. Psychological consequences among veterans during the COVID-19 pandemic: A scoping review. Psychiatry Res 2023; 324:115229. [PMID: 37121218 PMCID: PMC10131745 DOI: 10.1016/j.psychres.2023.115229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 04/09/2023] [Accepted: 04/25/2023] [Indexed: 05/02/2023]
Abstract
Although there is an increasing number of studies reporting the psychological impact of COVID-19 on the general population and healthcare workers, relatively less attention has been paid to the veterans. This study aimed to review the existing literature regarding the psychological consequences of COVID-19 on veterans. A systematic search was conducted on PubMed, Embase, and the Cochrane Library from inception to December 3, 2022. A total of twenty-three studies were included with moderate-quality of evidence. Veterans experienced more mental health problems than civilians. The prevalence rates of alcohol use, anxiety, depression, post-traumatic stress disorder, stress, loneliness, and suicide ideation significantly increased during the pandemic, ranging from 9.6% to 47.4%, 9.4% to 53.5%, 8.6% to 55.1%, 4.1% to 58.0%, 4.3% to 39.4%, 15.9% to 28.4%, and 7.8% to 22.0%, respectively. The main risk factors of negative consequences included pandemic-related stress, poor family relationships, lack of social support, financial problems, and preexisting mental disorders. In contrast, higher household income and greater community interaction and support appeared to be resilience factors. In conclusion, the COVID-19 pandemic has increased adverse mental health consequences among veterans. Tackling mental health issues due to the COVID-19 pandemic among veterans should be a priority.
Collapse
Affiliation(s)
- Shaoli Li
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; Department of Medical Oncology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310009, China
| | - Shu Huang
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorders' Management in Zhejiang Province, Hangzhou 310003, China; Brain Research Institute of Zhejiang University, Hangzhou 310058, China; Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou 310003, China; Department of Neurobiology, NHC and CAMS Key Laboratory of Medical Neurobiology, School of Brain Science and Brian Medicine, and MOE Frontier Science Center for Brain Science and Brain-Machine Integration, Zhejiang University School of Medicine, Hangzhou 310003, China.
| | - Jianbo Lai
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China; The Key Laboratory of Mental Disorders' Management in Zhejiang Province, Hangzhou 310003, China; Brain Research Institute of Zhejiang University, Hangzhou 310058, China; Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou 310003, China; Department of Neurobiology, NHC and CAMS Key Laboratory of Medical Neurobiology, School of Brain Science and Brian Medicine, and MOE Frontier Science Center for Brain Science and Brain-Machine Integration, Zhejiang University School of Medicine, Hangzhou 310003, China.
| |
Collapse
|
10
|
Xue S, Gu Q, Zhu K, Jiang J. Self-compassion buffers the impact of learned helplessness on adverse mental health during COVID-19 lockdown. J Affect Disord 2023; 327:285-291. [PMID: 36758873 PMCID: PMC9907794 DOI: 10.1016/j.jad.2023.01.099] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 01/10/2023] [Accepted: 01/27/2023] [Indexed: 02/11/2023]
Abstract
BACKGROUND Learned helplessness may be the underlying cause of poor mental health status among college students during the COVID-19 lockdown, and self-compassion as a positive psychological quality may influence the link between learned helplessness and mental health. METHODS A sample of 869 Chinese college students (443 male and 426 female), with a mean age of 20.03 (SD = 1.68), completed the Learned Helplessness Scale (LHS), Self-Compassion Scale (SCS), and DASS-21. The moderating effect of self-compassion on the relationship between learned helplessness and anxiety, depression, and stress were calculated. RESULTS The interaction term between learned helplessness and self-compassion has a significant coefficient on anxiety, depression, and stress, pointing out self-compassion as a moderator of the association between learned helplessness and adverse mental health. LIMITATIONS In the absence of longitudinal data or experimental manipulations, cross-sectional methods cannot verify causal conclusions among the study variables. The analysing results are based only on self-reported data. DISCUSSION The present study contributes to a deeper understanding of how learned helplessness and self-compassion during COVID-19 contribute to adverse mental health. The findings suggest that adverse mental health during lockdown is significantly associated with learned helplessness and that self-compassion can buffer this effect, contributing to future psychotherapy and clinical research. Future studies should examine the relationship through a longitudinal design to sort out whether self-compassion is a protective factor against learned helplessness or a moderator of the effects of learned helplessness on mental health.
Collapse
Affiliation(s)
- Shengping Xue
- School of Humanities and Social Sciences, Binzhou Medical University, 346 Guanhai Road, Yantai 264003, China
| | - Qian Gu
- Liaocheng Fourth People's Hospital, 49 North Huayuan Road, Liaocheng 252002, China
| | - Kaixu Zhu
- School of Humanities and Social Sciences, Binzhou Medical University, 346 Guanhai Road, Yantai 264003, China
| | - Jinghua Jiang
- Liaocheng Fourth People's Hospital, 49 North Huayuan Road, Liaocheng 252002, China.
| |
Collapse
|
11
|
Hansen KT, Plouffe RA, Walker DL, Wanklyn SG, Lamrock L, Maher P, Nazarov A, Richardson JD. Impact of the COVID-19 pandemic on the mental health and well-being of Veterans' spouses: a cross sectional analysis. BMC Psychiatry 2023; 23:188. [PMID: 36949446 PMCID: PMC10032243 DOI: 10.1186/s12888-023-04687-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 03/15/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND COVID-19 has negatively impacted the mental health and well-being of both Canadians and the world as a whole, with Veterans, in particular, showing increased rates of depression, anxiety, and PTSD. Spouses and common-law partners often serve as primary caregivers and sources of support for Veterans, which may have a deleterious effect on mental health and increase risk of burnout. Pandemic related stressors may increase burden and further exacerbate distress; yet the effect of the pandemic on the mental health and well-being of Veterans' spouses is currently unknown. This study explores the self-reported mental health and well-being of a group of spouses of Canadian Armed Forces Veterans and their adoption of new ways to access healthcare remotely (telehealth), using baseline data from an ongoing longitudinal survey. METHODS Between July 2020 and February 2021, 365 spouses of Veterans completed an online survey regarding their general mental health, lifestyle changes, and experiences relating to the COVID-19 pandemic. Also completed were questions relating to their use of and satisfaction with health-care treatment services during the pandemic. RESULTS Reported rates of probable major depressive disorder (MDD), generalized anxiety disorder (GAD), alcohol use disorder (AUD), and PTSD were higher than the general public, with 50-61% believing their symptoms either directly related to or were made worse by the pandemic. Those reporting being exposed to COVID-19 were found to have significantly higher absolute scores on mental health measures than those reporting no exposure. Over 56% reported using telehealth during the pandemic, with over 70% stating they would continue its use post-pandemic. CONCLUSIONS This is the first Canadian study to examine the impact of the COVID-19 pandemic specifically on the mental health and well-being of Veterans' spouses. Subjectively, the pandemic negatively affected the mental health of this group, however, the pre-pandemic rate for mental health issues in this population is unknown. These results have important implications pertaining to future avenues of research and clinical/programme development post-pandemic, particularly relating to the potential need for increased support for spouses of Veterans, both as individuals and in their role as supports for Veterans.
Collapse
Affiliation(s)
- Kevin T Hansen
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada.
- Department of Psychiatry, Western University, London, ON, Canada.
| | - Rachel A Plouffe
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
| | - Deanna L Walker
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
| | - Sonya G Wanklyn
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
- St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care London, London, ON, Canada
| | - Laryssa Lamrock
- The Atlas Institute for Veterans and Families, Ottawa, ON, Canada
| | - Polliann Maher
- The Atlas Institute for Veterans and Families, Ottawa, ON, Canada
| | - Anthony Nazarov
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - J Don Richardson
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, ON, Canada
- Department of Psychiatry, Western University, London, ON, Canada
- St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care London, London, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| |
Collapse
|
12
|
Hill ML, Nichter B, Na PJ, Norman SB, Morland LA, Krystal JH, Pietrzak RH. Mental health impact of the COVID-19 pandemic in U.S. military veterans: a population-based, prospective cohort study. Psychol Med 2023; 53:945-956. [PMID: 34120667 PMCID: PMC8245339 DOI: 10.1017/s0033291721002361] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 12/24/2022]
Abstract
BACKGROUND The coronavirus disease-2019 (COVID-19) pandemic has caused myriad health, social, and economic stressors. To date, however, no known study has examined changes in mental health during the pandemic in the U.S. military veteran population. METHODS Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study, a nationally representative, prospective cohort survey of 3078 veterans. Pre-to-peri-pandemic changes in psychiatric symptoms were evaluated, as well as pre-pandemic risk and protective factors and pandemic-related correlates of increased psychiatric distress. RESULTS The prevalence of generalized anxiety disorder (GAD) positive screens increased from pre- to peri-pandemic (7.1% to 9.4%; p < 0.001) and was driven by an increase among veterans aged 45-64 years (8.2% to 13.5%; p < 0.001), but the prevalence of major depressive disorder and posttraumatic stress disorder positive screens remained stable. Using a continuous measure of psychiatric distress, an estimated 13.2% of veterans reported a clinically meaningful pre-to-peri-pandemic increase in distress (mean = 1.1 standard deviation). Veterans with a larger pre-pandemic social network size and secure attachment style were less likely to experience increased distress, whereas veterans reporting more pre-pandemic loneliness were more likely to experience increased distress. Concerns about pandemic-related social losses, mental health COVID-19 effects, and housing stability during the pandemic were associated with increased distress, over-and-above pre-pandemic factors. CONCLUSIONS Although most U.S. veterans showed resilience to mental health problems nearly 1 year into the pandemic, the prevalence of GAD positive screens increased, particularly among middle-aged veterans, and one of seven veterans experienced increased distress. Clinical implications of these findings are discussed.
Collapse
Affiliation(s)
- Melanie L. Hill
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
| | - Brandon Nichter
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Peter J. Na
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Sonya B. Norman
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
- National Center for PTSD, White River Junction, VT, USA
- VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA
| | - Leslie A. Morland
- Department of Psychiatry, University of California, San Diego, CA, USA
- VA San Diego Healthcare System, San Diego, CA, USA
- VA Center of Excellence for Stress and Mental Health, San Diego, CA, USA
- National Center for PTSD, Pacific Islands Division, Honolulu, HI, USA
| | - John H. Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Robert H. Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| |
Collapse
|
13
|
Matos M, McEwan K, Kanovský M, Halamová J, Steindl SR, Ferreira N, Linharelhos M, Rijo D, Asano K, Vilas SP, Márquez MG, Gregório S, Brito-Pons G, Lucena-Santos P, da Silva Oliveira M, de Souza EL, Llobenes L, Gumiy N, Costa MI, Habib N, Hakem R, Khrad H, Alzahrani A, Cheli S, Petrocchi N, Tholouli E, Issari P, Simos G, Lunding-Gregersen V, Elklit A, Kolts R, Kelly AC, Bortolon C, Delamillieure P, Paucsik M, Wahl JE, Zieba M, Zatorski M, Komendziński T, Zhang S, Basran J, Kagialis A, Kirby J, Gilbert P. Improvements in Compassion and Fears of Compassion throughout the COVID-19 Pandemic: A Multinational Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1845. [PMID: 36767212 PMCID: PMC9915071 DOI: 10.3390/ijerph20031845] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 06/18/2023]
Abstract
During large-scale disasters, social support, caring behaviours, and compassion are shown to protect against poor mental health outcomes. This multi-national study aimed to assess the fluctuations in compassion over time during the COVID-19 pandemic. Respondents (Time 1 n = 4156, Time 2 n = 980, Time 3 n = 825) from 23 countries completed online self-report questionnaires measuring the flows of compassion (i.e., Compassionate Engagement and Action Scales) and fears of compassion toward self and others and from others (i.e., Fears of Compassion Scales) and mental health at three time-points during a 10-month period. The results for the flows of compassion showed that self-compassion increased at Time 3. Compassion for others increased at Time 2 and 3 for the general population, but in contrast, it decreased in health professionals, possibly linked to burnout. Compassion from others did not change in Time 2, but it did increase significantly in Time 3. For fears of compassion, fears of self-compassion reduced over time, fears of compassion for others showed more variation, reducing for the general public but increasing for health professionals, whilst fears of compassion from others did not change over time. Health professionals, those with compassion training, older adults, and women showed greater flows of compassion and lower fears of compassion compared with the general population, those without compassion training, younger adults, and men. These findings highlight that, in a period of shared suffering, people from multiple countries and nationalities show a cumulative improvement in compassion and reduction in fears of compassion, suggesting that, when there is intense suffering, people become more compassionate to self and others and less afraid of, and resistant to, compassion.
Collapse
Affiliation(s)
- Marcela Matos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), 3004-531 Coimbra, Portugal
| | - Kirsten McEwan
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby DE22 1G, UK
| | - Martin Kanovský
- Institute of Social Anthropology, Faculty of Social and Economic Sciences, Comenius University, 814 99 Bratislava, Slovakia
| | - Júlia Halamová
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University, 814 99 Bratislava, Slovakia
| | - Stanley R. Steindl
- Compassionate Mind Research Group, School of Psychology, University of Queensland, Brisbane 4072, Australia
| | - Nuno Ferreira
- Department of Social Sciences, University of Nicosia, Nicosia 2417, Cyprus
| | - Mariana Linharelhos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), 3004-531 Coimbra, Portugal
| | - Daniel Rijo
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), 3004-531 Coimbra, Portugal
| | - Kenichi Asano
- Department of Psychological Counseling, Faculty of Psychology, Mejiro University, Tokyo 161-0032, Japan
| | - Sara P. Vilas
- Behavior, Emotions, and Health Research Group, Department of Psychology, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Margarita G. Márquez
- Behavior, Emotions, and Health Research Group, Department of Psychology, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Sónia Gregório
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), 3004-531 Coimbra, Portugal
- Behavior, Emotions, and Health Research Group, Department of Psychology, Faculty of Biomedical and Health Sciences, Universidad Europea de Madrid, 28670 Madrid, Spain
| | - Gonzalo Brito-Pons
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago 8331150, Chile
| | - Paola Lucena-Santos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), 3004-531 Coimbra, Portugal
| | - Margareth da Silva Oliveira
- Evaluation and Treatment in Cognitive and Behavioral Psychotherapies—Research Group (GAAPCC), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre 90619-900, Brazil
| | | | | | - Natali Gumiy
- Motivación Compasiva, Buenos Aires C1001, Argentina
| | | | - Noor Habib
- Neuroscience Department, Section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah 11564, Saudi Arabia
| | - Reham Hakem
- Neuroscience Department, Section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah 11564, Saudi Arabia
| | - Hussain Khrad
- Neuroscience Department, Section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah 11564, Saudi Arabia
| | - Ahmad Alzahrani
- Neuroscience Department, Section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah 11564, Saudi Arabia
| | - Simone Cheli
- School of Human Health Sciences, University of Florence, 50121 Florence, Italy
| | - Nicola Petrocchi
- Department of Economics and Social Sciences, John Cabot University, 00165 Rome, Italy
| | - Elli Tholouli
- Center for Qualitative Research in Psychology and Psychosocial Well-Being, National and Kapodistrian University of Athens, 157 72 Athens, Greece
| | - Philia Issari
- Center for Qualitative Research in Psychology and Psychosocial Well-Being, National and Kapodistrian University of Athens, 157 72 Athens, Greece
| | - Gregoris Simos
- Department of Educational and Social Policy, University of Macedonia, 546 36 Thessaloniki, Greece
| | | | - Ask Elklit
- Department of Psychology, University of Southern Denmark, 5230 Odense, Denmark
| | - Russell Kolts
- Department of Psychology, Eastern Washington University, Cheney, WA 99004, USA
| | - Allison C. Kelly
- Department of Psychology, University of Waterloo, Waterloo, ON N2L 3G1, Canada
| | - Catherine Bortolon
- Laboratoire Inter-Universitaire de Psychologie: Personnalité, Cognition et Changement Social, Grenoble Alpes University, 38400 Grenoble, France
- Centre Hospitalier Alpes Isère, C3R—Réhabilitation Psychosociale et Remédiation Cognitive, 38100 Grenoble, France
| | - Pascal Delamillieure
- CHU de Caen, Service de Psychiatrie Adulte, 14000 Caen, France
- UNICAEN, ISTS, GIP Cyceron, University of Normandy, 76000 Caen, France
| | - Marine Paucsik
- Laboratoire Inter-Universitaire de Psychologie: Personnalité, Cognition et Changement Social, Grenoble Alpes University, 38400 Grenoble, France
| | - Julia E. Wahl
- The Mind Institute Poland, 33-332 Warsaw, Poland
- Institute of Psychology, Department of General Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland
| | - Mariusz Zieba
- Institute of Psychology, Department of General Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland
| | - Mateusz Zatorski
- Institute of Psychology, Department of General Psychology, SWPS University of Social Sciences and Humanities, 03-815 Warsaw, Poland
| | - Tomasz Komendziński
- Department of Cognitive Science, Nicolaus Copernicus University, 87-100 Torún, Poland
- Neurocognitive Laboratory, Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, 87-100 Torún, Poland
| | - Shuge Zhang
- School of Human Sciences, University of Derby, Derby DE22 1G, UK
| | - Jaskaran Basran
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby DE22 1G, UK
| | - Antonios Kagialis
- Department of Social Sciences, University of Nicosia, Nicosia 2417, Cyprus
| | - James Kirby
- Compassionate Mind Research Group, School of Psychology, University of Queensland, Brisbane 4072, Australia
| | - Paul Gilbert
- Centre for Compassion Research and Training, College of Health, Psychology and Social Care, University of Derby, Derby DE22 1G, UK
| |
Collapse
|
14
|
Zerach G. Posttraumatic Stress Symptoms and Parenting Competence among Israeli Male Veterans: The Mediating Roles of Experiential Avoidance and Parental Reflective Functioning. JOURNAL OF CHILD AND FAMILY STUDIES 2023; 32:301-313. [PMID: 35350596 PMCID: PMC8945870 DOI: 10.1007/s10826-022-02288-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/27/2022] [Indexed: 05/17/2023]
Abstract
Although empirical studies have documented associations between posttraumatic stress symptoms (PTSS) and parenting among various high-risk populations, there is a relatively limited amount of research on paternal parenting among veterans. Moreover, the understanding of possible mechanisms which may account for this effect is severely lacking. This study examined associations between military related PTSS and parenting sense of competence (PSOC) among veteran fathers. Furthermore, we examined the mediating role of experiential avoidance (EA) and parental reflective functioning (PRF) in the association between PTSS and PSOC. Participants were 189 Israel Defense Forces (IDF) male combat veterans (mean age = 30.03) who completed a set of validated self-report questionnaires in a cross-sectional design study. Results showed negative associations between PTSS and PSOC-parental satisfaction but not parental efficacy. Furthermore, EA mediated the association between PTSS and parental satisfaction and efficacy; PRF- Pre mentalizing modes mediated the association between PTSS and parental satisfaction. Our findings imply that EA and PRF may serve as mechanisms of the association between PTSS and PSOC among veteran fathers. These findings are discussed in light of a psychological trauma perspective, and clinical implications to increase fathers' mentalization and psychological flexibility are suggested.
Collapse
Affiliation(s)
- Gadi Zerach
- Department of Psychology, Ariel University, Ariel, Israel
| |
Collapse
|
15
|
Kim SH, Han MA. Depression and Related Factors in Korean Adults During the Coronavirus Disease 2019 Outbreak. Psychiatry Investig 2022; 19:965-972. [PMID: 36444160 PMCID: PMC9708867 DOI: 10.30773/pi.2022.0131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 09/24/2022] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE We aimed to determine the status of depression and its related factors among adult Koreans during the coronavirus disease 2019 (COVID-19) outbreak. METHODS We used data from the 2020 Korea Community Health Survey (KCHS). We assessed depressive feelings and symptoms using the Patient Health Questionnaire-9 (PHQ-9 ≥10). In addition, we assessed general and COVID-19-related characteristics, including isolation due to and concerns about COVID-19. We analyzed the data using chi-square tests and multiple logistic regression analyses. RESULTS The rates of depressive feelings and symptoms were 5.9% and 2.9%, respectively. Of the adult respondents, 68.5% were concerned about COVID-19, while 75.9% were concerned about economic harm due to COVID-19. The adjusted odds ratios for depressive symptoms assessed using the PHQ-9 were significantly high among women responders, adults aged 19-44 years, low-income households, those who experienced COVID-19-related symptoms, and those concerned about death due to COVID-19 and economic harm due to COVID-19. Similar results were obtained for depressive feeling. CONCLUSION Concerns related to COVID-19 infection are related to depression. This suggests that COVID-19 significantly affects mental health. Therefore, during public health crises, such as new communicable diseases, mental health and the incidence of the infectious disease require assessment and monitoring.
Collapse
Affiliation(s)
- Seo-Hee Kim
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea.,Department of Public Health, Graduate School, Chosun University, Gwangju, Republic of Korea
| | - Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| |
Collapse
|
16
|
Mikocka-Walus A, Skvarc D, de Acosta MB, Evertsz FB, Bernstein CN, Burisch J, Ferreira N, Gearry RB, Graff LA, Jedel S, Mokrowiecka A, Stengel A, Trindade IA, van Tilburg MAL, Knowles SR. Exploring the Relationship Between Self-Isolation and Distress Among People with Gastrointestinal Disorders During the COVID-19 Pandemic. J Clin Psychol Med Settings 2022; 29:654-665. [PMID: 34494184 PMCID: PMC8423336 DOI: 10.1007/s10880-021-09818-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/23/2021] [Indexed: 12/17/2022]
Abstract
This study aimed to explore the association between perceived isolation and symptoms of distress in people with GI disorders at the time of the pandemic; and to examine factors which moderate this relationship. This online cross-sectional survey was advertised in May-September 2020 via patient organisations and associated social media. Overall, 831 people (82% female, mean age 49 years) from 27 countries participated. A significant relationship between social isolation and psychological distress was noted (r = .525, p < .001). GI symptoms moderated the association between isolation and distress (B = .047, t = 2.47, p = .015). Interventions targeting these factors may help to reduce distress in people with GI disorders at the time of major stressors such as the COVID-19 pandemic.
Collapse
Affiliation(s)
| | - David Skvarc
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Manuel Barreiro de Acosta
- Department of Gastroenterology, IBD Unit, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Floor Bennebroek Evertsz
- Department of Medical Psychology, Amsterdam University Medical Centres, Amsterdam, the Netherlands
| | | | - Johan Burisch
- Medical Division, Hvidovre Hospital, University of Copenhagen, GastrounitHvidovre, Denmark
| | - Nuno Ferreira
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Richard B Gearry
- Department of Medicine, University of Otago Christchurch, Christchurch, New Zealand
| | - Lesley A Graff
- Max Rady College of Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Sharon Jedel
- Division of Digestive Diseases, Rush University Medical Center, Chicago, IL, USA
| | - Anna Mokrowiecka
- Department of Digestive Tract Diseases, Medical University of Lodz, Lodz, Poland
| | - Andreas Stengel
- Department of Psychosomatic Medicine and Psychotherapy, University Hospital Tübingen, Tübingen, Germany
- Charité Center for Internal Medicine and Dermatology, Department for Psychosomatic Medicine, Charité Universitätsmedizin Berlin and Berlin Institute of Health, Berlin, Germany
| | - Inês A Trindade
- Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
| | - Miranda A L van Tilburg
- College of Pharmacy & Health Sciences, Campbell University, Buies Creek, NC, USA
- Division of Gastroenterology, University of North Carolina, Chapel Hill, NC, USA
- School of Social Work, University of Washington, Seattle, WA, USA
| | - Simon R Knowles
- Department of Psychological Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia
| |
Collapse
|
17
|
Iverson KM, Dardis CM, Cowlishaw S, Webermann AR, Shayani DR, Dichter ME, Mitchell KS, Mattocks KM, Gerber MR, Portnoy GR. Effects of Intimate Partner Violence During COVID-19 and Pandemic-Related Stress on the Mental and Physical Health of Women Veterans. J Gen Intern Med 2022; 37:724-733. [PMID: 36042090 PMCID: PMC9427167 DOI: 10.1007/s11606-022-07589-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 04/01/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Little is known about women veterans' intimate partner violence (IPV) experiences during the COVID-19 pandemic or the impacts of pandemic-related stress on their mental and physical health. OBJECTIVES To identify IPV experiences among women veterans prior to and during the pandemic, pandemic-related stressors, and examine their respective contributions to mental and physical health. DESIGN National sample of women veterans drawn from a larger web-based longitudinal study. Relationships between recent IPV and pandemic-related stressors were tested with linear regressions, controlling for pre-pandemic IPV and mental and physical health symptoms, demographic, and military-related covariates. PARTICIPANTS One hundred forty-two women veterans (Mage=58.8 years). MAIN MEASURES We assessed IPV (CTS-2), PTSD (PCL-5), depression (CESD), anxiety (DASS-A), physical health (PHQ-15), and physical health-related quality of life (SF-12) prior to the pandemic (June 2016-December 2016/January 2017) and during the pandemic study period (March 2020-December 2020/January 2021). We assessed pandemic-related stressors (EPII) during the pandemic study period. KEY RESULTS Over a third (38.7%) of participants experienced IPV during the pandemic study period (psychological: 35.9%, physical: 9.9%, sexual: 4.2%). Overall rates, frequency, and severity of IPV experience did not significantly differ between the pre-pandemic and pandemic study periods. Few participants tested positive for COVID-19 (4.2%); however, most participants reported experiencing pandemic-related stressors across life domains (e.g., social activities: 88%, physical health: 80.3%, emotional health: 68.3%). IPV during the pandemic and pandemic-related stressors were both associated with greater PTSD and depressive symptoms. Pandemic-related stressors were associated with worse anxiety and physical health symptoms. Neither IPV during the pandemic nor pandemic-related stressors were associated with physical health-related quality of life. CONCLUSIONS IPV experiences during the pandemic were common among women veterans, as were pandemic-related stressors. Although IPV did not increase in the context of COVID-19, IPV experiences during the pandemic and pandemic-related stressors were linked with poorer mental and physical health.
Collapse
Affiliation(s)
- Katherine M Iverson
- Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA.
| | | | - Sean Cowlishaw
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, Australia
| | | | - Danielle R Shayani
- Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
| | - Melissa E Dichter
- VA Center for Health Equity Research and Promotion, Corporal Michael J. Crescenz VA Medical Center, Philadelphia, PA, USA
- School of Social Work, Temple University, Philadelphia, PA, USA
| | - Karen S Mitchell
- Women's Health Sciences Division of the National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Kristin M Mattocks
- VA Central Western Massachusetts Healthcare System, Leeds, MA, USA
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Megan R Gerber
- Division of General Medicine, Albany Medical College, Albany, NY, USA
- Albany Stratton VA Medical Center, Albany, NY, USA
| | - Galina R Portnoy
- VA Connecticut Healthcare System, West Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| |
Collapse
|
18
|
Del Casale A, Ferracuti S, Barbetti AS, Bargagna P, Zega P, Iannuccelli A, Caggese F, Zoppi T, De Luca GP, Parmigiani G, Berardelli I, Pompili M. Grey Matter Volume Reductions of the Left Hippocampus and Amygdala in PTSD: A Coordinate-Based Meta-Analysis of Magnetic Resonance Imaging Studies. Neuropsychobiology 2022; 81:257-264. [PMID: 35158360 DOI: 10.1159/000522003] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 01/15/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION In recent years, research on posttraumatic stress disorder (PTSD) focused on the description of different biological correlates of illness. Morphological changes of different brain regions were involved in PTSD neurophysiopathology, being related to trauma or considered a resilience biomarker. In this meta-analysis, we aimed to investigate the grey matter changes reported in magnetic resonance imaging (MRI) studies on patients who have developed PTSD compared to exposed subjects who did not show a clinical PTSD onset. METHODS We meta-analysed eight peer-reviewed MRI studies conducted on trauma-exposed patients and reported results corrected for false positives. We then conducted global and intergroup comparisons from neuroimaging data of two cohorts of included subjects. The included studies were conducted on 250 subjects, including 122 patients with PTSD and 128 non-PTSD subjects exposed to trauma. RESULTS Applying a family-wise error correction, PTSD subjects compared to trauma-exposed non-PTSD individuals showed a significant volume reduction of a large left-sided grey matter cluster extended from the parahippocampal gyrus to the uncus, including the amygdala. CONCLUSIONS These volumetric reductions are a major structural correlate of PTSD and can be related to the expression of symptoms. Future studies might consider these and other neural PTSD correlates, which may lead to the development of clinical applications for affected patients.
Collapse
Affiliation(s)
- Antonio Del Casale
- Department of Dynamic and Clinical Psychology, and Health Studies, Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
| | - Stefano Ferracuti
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University, Rome, Unit of Risk Management, "Sant'Andrea" University Hospital, Rome, Italy
| | - Andrea Steven Barbetti
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
| | - Paride Bargagna
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
| | - Paolo Zega
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
| | - Alessia Iannuccelli
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
| | - Federico Caggese
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
| | - Teodolinda Zoppi
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
| | - Gabriele Pasquale De Luca
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
| | - Giovanna Parmigiani
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Isabella Berardelli
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University, Unit of Psychiatry, "Sant'Andrea" University Hospital, Rome, Italy
| |
Collapse
|
19
|
PTSD Symptoms and Coping with COVID-19 Pandemic among Treatment-Seeking Veterans: Prospective Cohort Study. J Clin Med 2022; 11:jcm11102715. [PMID: 35628844 PMCID: PMC9147870 DOI: 10.3390/jcm11102715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 05/08/2022] [Accepted: 05/09/2022] [Indexed: 02/04/2023] Open
Abstract
Background: The aim of this study was to examine post-traumatic stress disorder (PTSD) symptom levels and coping strategies during the COVID-19 pandemic among treatment-seeking veterans with pre-existing PTSD. Method: A cohort of 176 male treatment-seeking veterans with pre-existing PTSD during the first COVID-19 pandemic lockdown (T1) and 132 participants from the same cohort one year after the onset of the pandemic (T2) participated in a longitudinal study. All participants responded to a COVID-19-related questionnaire and the following measures: the Life Events Checklist for DSM-5 (LEC-5), PTSD Checklist for DSM-5 (PCL-5) and the Brief COPE. Results: The intensity of overall PTSD symptoms, avoidance symptoms and negative alterations in cognitions and mood was lower at T2. PTSD symptoms were not significantly correlated with SARS-CoV-2 potentially traumatic events (PTE) at T2. Veterans scored higher on emotion-focused and problem-focused coping than on dysfunctional coping. Conclusions: Veterans with pre-existing PTSD who were receiving long-term treatment coped with COVID-19 stressors without the effects of retraumatization and a consequent worsening of PTSD symptoms.
Collapse
|
20
|
Jaworski BK, Taylor K, Ramsey KM, Heinz AJ, Steinmetz S, Owen JE, Tsai J, Pietrzak RH. Predicting Uptake of the COVID Coach App Among US Military Veterans: Funnel Analysis Using a Probability-Based Panel. JMIR Ment Health 2022; 9:e36217. [PMID: 35245204 PMCID: PMC8985691 DOI: 10.2196/36217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 02/15/2022] [Accepted: 03/01/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although the COVID-19 pandemic has not led to a uniform increase of mental health concerns among older adults, there is evidence to suggest that some older veterans did experience an exacerbation of preexisting mental health conditions, and that mental health difficulties were associated with a lack of social support and increasing numbers of pandemic-related stressors. Mobile mental health apps are scalable, may be a helpful resource for managing stress during the pandemic and beyond, and could potentially provide services that are not accessible due to the pandemic. However, overall comfort with mobile devices and factors influencing the uptake and usage of mobile apps during the pandemic among older veterans are not well known. COVID Coach is a free, evidence-informed mobile app designed for pandemic-related stress. Public usage data have been evaluated; however, the uptake and usage of the app among older veterans have not been explored. OBJECTIVE The purpose of this study was to characterize smartphone ownership rates among US veterans, identify veteran characteristics associated with downloading and use of COVID Coach, and characterize key content usage within the app. METHODS Data were analyzed from the 2019-2020 National Health and Resilience in Veterans Study (NHRVS), which surveyed a nationally representative, prospective cohort of 3078 US military veterans before and 1 year into the pandemic. The NHRVS sample was drawn from KnowledgePanel, a research panel of more than 50,000 households maintained by Ipsos, Inc. The median time to complete the survey was nearly 32 minutes. The research version of COVID Coach was offered to all veterans who completed the peripandemic follow-up assessment on a mobile device (n=814; weighted 34.2% of total sample). App usage data from all respondents who downloaded the app (n=34; weighted 3.3% of the mobile completers sample) were collected between November 14, 2020, and November 7, 2021. RESULTS We found that most US veterans (81.5%) own smartphones, and that veterans with higher education, greater number of adverse childhood experiences, higher extraversion, and greater severity of pandemic-related posttraumatic stress disorder symptoms were more likely to download COVID Coach. Although uptake and usage of COVID Coach were relatively low (3.3% of eligible participants, n=34), 50% of the participants returned to the app for more than 1 day of use. The interactive tools for managing stress were used most frequently. CONCLUSIONS The COVID-19 pandemic has increased the need for and creation of digital mental health tools. However, these resources may require tailoring for older veteran populations. Future research is needed to better understand how to optimize digital mental health tools such as apps to ensure uptake and usage among older adults, particularly those who have experienced traumas across the lifespan.
Collapse
Affiliation(s)
- Beth K Jaworski
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Katherine Taylor
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Kelly M Ramsey
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Adrienne J Heinz
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Sarah Steinmetz
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Jason E Owen
- National Center for Posttraumatic Stress Disorder, Dissemination & Training Division, US Department of Veterans Affairs, Menlo Park, CA, United States
| | - Jack Tsai
- National Center on Homelessness Among Veterans, US Department of Veterans Affairs, Tampa, FL, United States.,School of Public Health, San Antonio Campus, University of Texas Health Science Center at Houston, San Antonio, TX, United States
| | - Robert H Pietrzak
- National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, US Department of Veterans Affairs, New Haven, CT, United States.,Department of Psychiatry, Yale School of Medicine, New Haven, CT, United States
| |
Collapse
|
21
|
Chuang YC, Tsai HW, Liu SA, Wu MJ, Liu PY. COVID-19 in Veterans: A Narrative Review. Risk Manag Healthc Policy 2022; 15:805-815. [PMID: 35502442 PMCID: PMC9056054 DOI: 10.2147/rmhp.s354814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 04/09/2022] [Indexed: 01/08/2023] Open
Affiliation(s)
- Yu-Chuan Chuang
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Hung-Wen Tsai
- Medical Administration Department, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shih-An Liu
- Center of Quality Management, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Ming-Ju Wu
- Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Po-Yu Liu
- Division of Infection, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
- Correspondence: Po-Yu Liu, Division of Infection, Department of Internal Medicine, Taichung Veterans General Hospital, No. 1650, Sec. 4, Taiwan Blvd., Xitun Dist., Taichung City, 407219, Taiwan, Tel +886 4 2359 2525, Email
| |
Collapse
|
22
|
Fein‐Schaffer D, Hawn SE, Annunziata AJ, Ryabchenko K, Miller MW, Wolf EJ. Premorbid traumatic stress and veteran responses to the COVID-19 pandemic. J Trauma Stress 2022; 35:559-569. [PMID: 34861065 PMCID: PMC9015518 DOI: 10.1002/jts.22770] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 08/16/2021] [Accepted: 09/15/2021] [Indexed: 12/20/2022]
Abstract
The COVID-19 pandemic has had unprecedented effects on lifestyle stability and physical and mental health. We examined the impact of preexisting posttraumatic stress disorder (PTSD), alcohol use disorder (AUD), and depression on biopsychosocial responses to the pandemic, including psychiatric symptoms, COVID-19 exposure, and housing/financial stability, among 101 U.S. military veterans enrolled in a longitudinal study of PTSD, a population of particular interest given veterans' trauma histories and defense-readiness training. Participants (83.2% male, 79.2% White, Mage = 59.28 years) completed prepandemic, clinician-administered psychiatric diagnostic interviews and a phone-based assessment between May and September 2020 using a new measure, the Rapid Assessment of COVID-19-Related Experiences (RACE), which was used to assess pandemic responses and its effects on mental and physical health; COVID-19 diagnosis and testing were also extracted from electronic medical records. Multivariate regressions showed that, controlling for demographic characteristics, prepandemic PTSD, β = .332; p = .003, and AUD symptoms, β = .228; p = .028, were associated with increased pandemic-related PTSD symptoms. Prepandemic AUD was associated with increased substance use during the pandemic, β = .391; p < .001, and higher rates of self-reported or medical record-based COVID-19 diagnosis, β = .264; p = .019. Minority race was associated with pandemic-related housing/financial instability, β = -.372; p < .001, raising concerns of population inequities. The results suggest that preexisting PTSD and AUD are markers for adverse pandemic-related psychiatric outcomes and COVID-19 illness. These findings carry implications for the importance of targeting prevention and treatment efforts for the highest-risk individuals.
Collapse
Affiliation(s)
- Dana Fein‐Schaffer
- National Center for PTSD at VA Boston Healthcare SystemBostonMassachusettsUSA
| | - Sage E. Hawn
- National Center for PTSD at VA Boston Healthcare SystemBostonMassachusettsUSA,Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
| | | | - Karen Ryabchenko
- National Center for PTSD at VA Boston Healthcare SystemBostonMassachusettsUSA,Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
| | - Mark W. Miller
- National Center for PTSD at VA Boston Healthcare SystemBostonMassachusettsUSA,Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
| | - Erika J. Wolf
- National Center for PTSD at VA Boston Healthcare SystemBostonMassachusettsUSA,Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
| |
Collapse
|
23
|
Hendrikx LJ, Williamson C, Baumann J, Murphy D. The impact of the COVID-19 pandemic on treatment-seeking veterans in the United Kingdom with preexisting mental health difficulties: A longitudinal study. J Trauma Stress 2022; 35:330-337. [PMID: 34655485 PMCID: PMC8662124 DOI: 10.1002/jts.22742] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 06/22/2021] [Accepted: 07/19/2021] [Indexed: 11/07/2022]
Abstract
Individuals with preexisting psychological difficulties are at risk of further deterioration of their mental well-being during the COVID-19 pandemic. This longitudinal study, conducted during the period between two national lockdowns, aimed to investigate the impact of the COVID-19 pandemic on veterans in the United Kingdom with preexisting mental health difficulties. Treatment-seeking veterans with preexisting mental health difficulties (N = 95) were surveyed in two waves. Wave 1 was conducted at the end of the first lockdown (June 2020-July 2020), and Wave 2 took place during the second lockdown (November 2020). Participants completed measures to assess symptoms of posttraumatic stress disorder (PTSD); common mental health difficulties (CMDs), including anxiety and depression; anger; and alcohol use. Initial analyses revealed no significant changes in symptoms of PTSD, CMDs, anger, or alcohol use between the lockdowns, ps = .247-.986. However, veterans who experienced more COVID-19-related stressors were more likely to experience increases in PTSD, odds ratio (OR) = 6.30, p = .002, and CMD symptoms, OR = 4.32, p = .025. Participants with lower levels of social support during the second lockdown were more likely to experience increased anger difficulties, OR = 0.91, p = .025. The findings suggest that although mental health among veterans in the United Kingdom may have remained relatively stable between the two lockdowns, those who reported more COVID-related stressors and lower levels of social support may have been particularly vulnerable to symptom exacerbation. Such findings hold important implications for tailoring support for veterans during the COVID-19 pandemic.
Collapse
Affiliation(s)
| | - Charlotte Williamson
- Combat Stress, Research DepartmentTyrwhitt HouseLeatherheadSurreyUK,King's Centre for Military Health ResearchKing's College LondonLondonUK
| | - Julia Baumann
- Combat Stress, Research DepartmentTyrwhitt HouseLeatherheadSurreyUK
| | - Dominic Murphy
- Combat Stress, Research DepartmentTyrwhitt HouseLeatherheadSurreyUK,King's Centre for Military Health ResearchKing's College LondonLondonUK
| |
Collapse
|
24
|
Stellman JM, Stellman SD, Spiro A, Pless Kaiser A, Smith BN. Impact of Military Service in Vietnam on Coping and Health Behaviors of Aging Veterans During the COVID-19 Pandemic. Front Public Health 2022; 9:809357. [PMID: 35111722 PMCID: PMC8802994 DOI: 10.3389/fpubh.2021.809357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/16/2021] [Indexed: 11/13/2022] Open
Abstract
Many Vietnam War veterans who experienced military trauma still exhibit PTSD symptomatology. Little is known about how new stressful situations, like the COVID-19 pandemic, affect previously traumatized people or whether they will react differently to them. We explore whether military combat experiences in Vietnam affect veterans' perceived abilities to cope with COVID-19 and whether current PTSD symptoms and later-adulthood reengagement with trauma memories are related to coping. We examine the extent that current PTSD symptoms and trauma reengagement relate to preventive practices. Participants were part of a randomly sampled cohort of American Legionnaires who responded to two previous surveys (1984, 1998), were born 1945-1953 and deployed to Vietnam 1963-1973, thus representing an aging veteran population. A survey supplement assessed coping with the pandemic and adherence to public health guidelines. The response rate was 74% (N = 507); 422 (61.6%) completed the COVID-19 supplement. Military experiences were found to affect coping with 41.4% reporting they affected ability to cope with COVID-19. Medium- and high-combat veterans were more likely to report that military experience affected coping than low-combat (OR 2.4, 95% CI 1.51–3.96; 2.6, 95% CI 1.41–4.61, respectively). Those with high PTSD scores had 7.7-fold (95% CI 4.3–13.17) increased likelihood of reporting that their coping was affected, compared to low-PTSD scorers. Few adopted social distancing (4%), staying at home (17%), or ceasing usual activities (32%); high-combat veterans were least likely to stay home. Veterans who practiced handwashing, sanitizer use, mask-wearing, and surface disinfection had significantly higher PTSD scores than those who did not. Veterans with higher scores on the LOSS-SF scale associated more reengagement with trauma memories and were more likely to engage in personal preventive strategies. Analysis of open-ended responses supported these findings. We conclude that fifty years after returning from Vietnam, PTSD scores were high for high-combat veterans, suggestive of PTSD diagnosis. Military experiences affected coping with COVID both positively and negatively, and may have helped instill useful personal health behaviors. Veterans, especially those with PTSD symptomatology, may have special needs during stressful times, like the COVID-19 pandemic, affecting compliance with recommended practices, as well as their overall health and well-being.
Collapse
Affiliation(s)
- Jeanne M. Stellman
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY, United States
- *Correspondence: Jeanne M. Stellman
| | - Steven D. Stellman
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Avron Spiro
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System and Departments of Epidemiology and Psychiatry, Boston University Schools of Public Health and Medicine, Boston, MA, United States
| | - Anica Pless Kaiser
- National Center for PTSD Behavioral Science Division at VA Boston Healthcare System and Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| | - Brian N. Smith
- National Center for PTSD Women's Health Sciences Division, VA Boston Healthcare System and Department of Psychiatry, Boston University School of Medicine, Boston, MA, United States
| |
Collapse
|
25
|
Compassion Protects Mental Health and Social Safeness During the COVID-19 Pandemic Across 21 Countries. Mindfulness (N Y) 2022; 13:863-880. [PMID: 35003380 PMCID: PMC8724602 DOI: 10.1007/s12671-021-01822-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 12/12/2022]
Abstract
Objectives The COVID-19 pandemic is having an unprecedented detrimental impact on mental health in people around the world. It is important therefore to explore factors that may buffer or accentuate the risk of mental health problems in this context. Given that compassion has numerous benefits for mental health, emotion regulation, and social relationships, this study examines the buffering effects of different flows of compassion (for self, for others, from others) against the impact of perceived threat of COVID-19 on depression, anxiety, and stress, and social safeness. Methods The study was conducted in a sample of 4057 adult participants from the general community population, collected across 21 countries from Europe, Middle East, North America, South America, Asia, and Oceania. Participants completed self-report measures of perceived threat of COVID-19, compassion (for self, for others, from others), depression, anxiety, stress, and social safeness. Results Perceived threat of COVID-19 was associated with higher scores in depression, anxiety, and stress, and lower scores in social safeness. Self-compassion and compassion from others were associated with lower psychological distress and higher social safeness. Compassion for others was associated with lower depressive symptoms. Self-compassion moderated the relationship between perceived threat of COVID-19 on depression, anxiety, and stress, whereas compassion from others moderated the effects of fears of contracting COVID-19 on social safeness. These effects were consistent across all countries. Conclusions Our findings highlight the universal protective role of compassion, in particular self-compassion and compassion from others, in promoting resilience by buffering against the harmful effects of the COVID-19 pandemic on mental health and social safeness. Supplementary Information The online version contains supplementary material available at 10.1007/s12671-021-01822-2.
Collapse
|
26
|
Richardson JD, St Cyr K, Forchuk C, Liu JJW, Plouffe RA, Le T, Gargala D, Deda E, Soares V, Hosseiny F, Smith P, Dupuis G, Roth M, Bridgen A, Marlborough M, Jetly R, Heber A, Lanius R, Nazarov A. Well-being of Canadian Veterans during the COVID-19 pandemic: cross-sectional results from the COVID-19 Veteran well-being study. Eur J Psychotraumatol 2022; 13:2012374. [PMID: 35087643 PMCID: PMC8788339 DOI: 10.1080/20008198.2021.2012374] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The impacts of the COVID-19 pandemic have disproportionally affected different population groups. Veterans are more likely to have pre-existing mental health conditions compared to the general Canadian population, experience compounded stressors resulting from disruptions to familial, social, and occupational domains, and were faced with changes in health-care delivery (e.g. telehealth). The objectives of this study are to assess (a) the mental health impact of COVID-19 and related life changes on the well-being of Veterans and (b) perceptions of and satisfaction with changes in health-care treatments and delivery during the pandemic. METHODS A total of 1136 Canadian Veterans participated in an online survey. Participants completed questions pertaining to their mental health and well-being, lifestyle changes, and concerns relating to the COVID-19 pandemic, as well as experiences and satisfaction with health-care treatments during the pandemic. RESULTS Results showed that 55.9% of respondents reported worse mental health functioning compared to before the pandemic. The frequency of probable posttraumatic stress disorder, major depressive disorder, generalized anxiety disorder, alcohol use disorder, and suicidal ideation were 34.2%, 35.3%, 26.8%, 13.0%, and 22.0%, respectively. Between 38.6% and 53.1% of respondents attributed their symptoms as either directly related to or exacerbated by the pandemic. Approximately 18% of respondents reported using telehealth for mental health services during the pandemic, and among those, 72.8% indicated a choice to use telehealth even after the pandemic. CONCLUSIONS This study found that Veterans experienced worsening mental health as a result of the COVID-19 pandemic. The use of telehealth services was widely endorsed by mental health treatment-seeking Veterans who transitioned to virtual care during the pandemic. Our findings have important clinical and programmeadministrator implications, emphasizing the need to reach out to support veterans, especially those with pre-existing mental health conditions and to enhance and maintain virtual care even post-pandemic.
Collapse
Affiliation(s)
- J Don Richardson
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada.,St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care, London, Ontario, Canada
| | - Kate St Cyr
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Callista Forchuk
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada
| | - Jenny J W Liu
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
| | - Rachel A Plouffe
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
| | - Tri Le
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada
| | - Dominic Gargala
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada
| | - Erisa Deda
- St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care, London, Ontario, Canada
| | - Vanessa Soares
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada
| | - Fardous Hosseiny
- Centre of Excellence for PTSD, Ottawa, Ontario, Canada.,The Royal's Institute for Mental Health Research, Ottawa, Ontario, Canada
| | - Patrick Smith
- Centre of Excellence for PTSD, Ottawa, Ontario, Canada.,The Royal's Institute for Mental Health Research, Ottawa, Ontario, Canada
| | - Gabrielle Dupuis
- Centre of Excellence for PTSD, Ottawa, Ontario, Canada.,The Royal's Institute for Mental Health Research, Ottawa, Ontario, Canada
| | - Maya Roth
- St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care, London, Ontario, Canada.,School of Graduate Studies, Ryerson University, Toronto, Ontario, Canada
| | - Andrew Bridgen
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada
| | - Michelle Marlborough
- Department of Psychiatry, Western University, London, Ontario, Canada.,St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care, London, Ontario, Canada
| | - Rakesh Jetly
- The Royal's Institute for Mental Health Research, Ottawa, Ontario, Canada
| | - Alexandra Heber
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada.,Veterans Affairs Canada, Ottawa, Ontario, Canada
| | - Ruth Lanius
- Department of Psychiatry, Western University, London, Ontario, Canada.,St. Joseph's OSI Clinic, Parkwood Institute, St. Joseph's Health Care, London, Ontario, Canada
| | - Anthony Nazarov
- The MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Ontario, Canada.,Department of Psychiatry, Western University, London, Ontario, Canada.,Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| |
Collapse
|
27
|
Medium-term and peri-lockdown course of psychosocial burden during the ongoing COVID-19 pandemic: a longitudinal study on patients with pre-existing mental disorders. Eur Arch Psychiatry Clin Neurosci 2022; 272:757-771. [PMID: 34825249 PMCID: PMC8614217 DOI: 10.1007/s00406-021-01351-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 11/08/2021] [Indexed: 12/16/2022]
Abstract
While the COVID-19 pandemic continues, patients with pre-existing mental disorders are increasingly recognized as a risk group for adverse outcomes. However, data are conflicting and cover only short time spans so far. Here, we investigate the medium-term and peri-lockdown-related changes of mental health outcomes in such patients in a longitudinal study. A cohort of 159 patients comprising all major mental disorders (ICD-10 F0-F9) were interviewed twice with the Goettingen psychosocial Burden and Symptom Inventory (Goe-BSI) to evaluate psychosocial burden, psychiatric symptoms and resilience at the end of the first (April/May 2020) and the second lockdown in Germany (November/December 2020). For the primary outcome "psychosocial burden" ratings also comprised retrospective pre-pandemic (early 2020) and very early states during the pandemic (March 2020). For all diagnostic groups, psychosocial burden varied significantly over time (p < 0.001) with an increase from the pre-pandemic to the initial phase (p < 0.001), followed by a steady decrease across both lockdowns, normalizing in November/December 2020. Female gender, high adjustment disorder symptom load at baseline and psychiatric comorbidities were risk factors for higher levels and an unfavorable course of psychosocial burden. Most psychiatric symptoms changed minimally, while resilience decreased over time (p = 0.044 and p = 0.037). The longitudinal course of psychosocial burden indicates an initial stress response, followed by a return to pre-pandemic levels even under recurrent lockdown conditions, mimicking symptoms of an adjustment disorder. Strategies for proactive, specific and continuous treatment have to address resilience capacities before their depletion in the pandemic aftermath, especially for patients with additional risk factors.
Collapse
|
28
|
Im H, Ahn C, Wang P, Chen C. An Early Examination: Psychological, Health, and Economic Correlates and Determinants of Social Distancing Amidst COVID-19. Front Psychol 2021; 12:589579. [PMID: 34456776 PMCID: PMC8385125 DOI: 10.3389/fpsyg.2021.589579] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/14/2021] [Indexed: 11/13/2022] Open
Abstract
Federal and local government agencies were quick to issue orders for residents to shelter-in-place in response to the COVID-19 outbreak. This study utilized data collected from Unacast Inc., spanning observations of 3,142 counties across 50 states and the District of Columbia (N = 230,846) from March 8, 2020 to April 13, 2020 (n = 104,930) and from April 14, 2020 to May 24, 2020 (n = 131,912) in a 3-level multilevel model to examine the correlates of social distancing behavior, as measured by the relative reduction in (1) distance traveled and (2) non-essential visitations since baseline pre-COVID-19 times. Results showed that educational attainment and political partisanship were the most consistent correlates of social distancing. State-level indicators of culture appeared to have differentiated effects depending on whether the model outcomes were reduction in general mobility or to non-essential venues. State-level neuroticism was generally positively related to social distancing, but states marked by high neuroticism were slower to engage in such behaviors. Counties and states characterized as already engaging in preventive health measures (e.g., vaccination rates, preparedness for at-risk populations) enjoyed quicker engagement in social distancing. Specific implications of findings and future directions are discussed.
Collapse
Affiliation(s)
- Hohjin Im
- Department of Psychological Science, University of California Irvine, Irvine, CA, United States
| | - Christopher Ahn
- Department of Psychology, New York University, New York City, NY, United States
| | - Peiyi Wang
- Department of Psychological Science, University of California Irvine, Irvine, CA, United States
| | - Chuansheng Chen
- Department of Psychological Science, University of California Irvine, Irvine, CA, United States
| |
Collapse
|
29
|
Sharp ML, Serfioti D, Jones M, Burdett H, Pernet D, Hull L, Murphy D, Wessely S, Fear NT. UK veterans' mental health and well-being before and during the COVID-19 pandemic: a longitudinal cohort study. BMJ Open 2021; 11:e049815. [PMID: 34452965 PMCID: PMC8406464 DOI: 10.1136/bmjopen-2021-049815] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 08/09/2021] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE To investigate the impact of the COVID-19 pandemic on the health and well-being of UK ex-service personnel (veterans) before and during the pandemic, and to assess associations of COVID-19 experiences and stressors with mental health, alcohol use and loneliness. DESIGN An additional wave of data was collected from a longitudinal cohort study of the UK Armed Forces. SETTING Online survey June-September 2020. PARTICIPANTS Cohort members were included if they had completed a questionnaire at phase 3 of the King's Centre for Military Health Research health and well-being study (2014-2016), had left the Armed Forces after regular service, were living in the UK, had consented to follow-up and provided a valid email address. Invitation emails were sent to N=3547 with a 44% response rate (n=1562). PRIMARY OUTCOME MEASURES Common mental health disorders (CMDs) (measured using the General Health Questionnaire, 12 items-cut-off ≥4), hazardous alcohol use (measured using the Alcohol Use Disorder Identification Test, 10 items-cut off ≥8) and loneliness (University of California, Los Angeles, Loneliness Scale- 3 items-cut-off ≥6). RESULTS Veterans reported a statistically significant decrease in hazardous drinking of 48.5% to 27.6%, while CMD remained stable (non-statistically significant increase of 24.5% to 26.1%). 27.4% of veterans reported feelings of loneliness. The COVID-19 stressors of reporting difficulties with family/social relationships, boredom and difficulties with health were statistically significantly associated with CMD, hazardous drinking and loneliness, even after adjustment for previous mental health/hazardous alcohol use. CONCLUSIONS Our study suggests a COVID-19 impact on veterans' mental health, alcohol use and loneliness, particularly for those experiencing difficulties with family relationships. Veterans experienced the pandemic in similar ways to the general population and in some cases may have responded in resilient ways. While stable levels of CMD and reduction in alcohol use are positive, there remains a group of veterans who may need mental health and alcohol treatment services.
Collapse
Affiliation(s)
- Marie-Louise Sharp
- King's Centre for Military Health Research, Psychological Medicine, King's College London, London, UK
| | - Danai Serfioti
- King's Centre for Military Health Research, Psychological Medicine, King's College London, London, UK
| | - Margaret Jones
- King's Centre for Military Health Research, Psychological Medicine, King's College London, London, UK
| | - Howard Burdett
- King's Centre for Military Health Research, Psychological Medicine, King's College London, London, UK
| | - David Pernet
- King's Centre for Military Health Research, Psychological Medicine, King's College London, London, UK
| | - Lisa Hull
- King's Centre for Military Health Research, Psychological Medicine, King's College London, London, UK
| | - Dominic Murphy
- King's Centre for Military Health Research, Psychological Medicine, King's College London, London, UK
- Research Department, Combat Stress, Leatherhead, UK
| | - Simon Wessely
- King's Centre for Military Health Research, Psychological Medicine, King's College London, London, UK
| | - Nicola T Fear
- King's Centre for Military Health Research, Psychological Medicine, King's College London, London, UK
- Academic Department of Military Mental Health, Psychological Medicine, King's College London, London, UK
| |
Collapse
|
30
|
Murphy L, Markey K, O' Donnell C, Moloney M, Doody O. The impact of the COVID-19 pandemic and its related restrictions on people with pre-existent mental health conditions: A scoping review. Arch Psychiatr Nurs 2021; 35:375-394. [PMID: 34176579 PMCID: PMC9759111 DOI: 10.1016/j.apnu.2021.05.002] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/26/2021] [Accepted: 05/01/2021] [Indexed: 12/16/2022]
Abstract
CONTEXT Globally, governments have introduced a variety of public health measures including restrictions and reducing face-to-face contact, to control the spread of COVID-19. This has implications for mental health services in terms of support and treatment for vulnerable groups such as people with pre-existent mental health conditions. However, there is limited evidence of the impact of COVID-19 and its related restrictions on people with pre-existent mental health conditions. OBJECTIVES To identify the impact of COVID-19 and its related restrictions on people with pre-existent mental health conditions. METHODS A scoping review of the literature was employed. Eight electronic databases (PsycINFO, Cochrane, Web of Science, MEDLINE, EMBASE, CINAHL, Scopus, Academic Search Complete) were searched and 2566 papers identified. 30 papers met the criteria for this review and findings were summarised under three key review questions. RESULTS COVID-19 and its related restrictions have had a notable effect on people with pre-existent mental health conditions. Public health restrictions have contributed to increased levels of social isolation, loneliness, and reduced opportunities for people to connect with others. Reduced access to health services and treatments has compounded matters for those seeking support. Exacerbation and deterioration of symptoms are commonly reported and can lead to greater susceptibility to COVID-19 infection. IMPLICATIONS The importance of proactive planning, alternative accessible healthcare services and supports for vulnerable and at-risk groups is illuminated. Increased monitoring, early intervention and individually tailored care strategies are advocated. Recommendations revolve around the need for enhanced provision of remote support strategies facilitated using technology enhanced resources. ACCESSIBLE SUMMARY.
Collapse
Affiliation(s)
- Louise Murphy
- School of Nursing and Midwifery, National University of Ireland Galway, Aras Moyola, University Road, Galway, Ireland.
| | - Kathleen Markey
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Claire O' Donnell
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Mairead Moloney
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Owen Doody
- Department of Nursing and Midwifery, Faculty of Education and Health Sciences, Health Research Institute, University of Limerick, Limerick, Ireland.
| |
Collapse
|
31
|
Amsalem D, Lazarov A, Markowitz JC, Gorman D, Dixon LB, Neria Y. Increasing treatment-seeking intentions of US veterans in the Covid-19 era: A randomized controlled trial. Depress Anxiety 2021; 38:639-647. [PMID: 33734539 PMCID: PMC8251313 DOI: 10.1002/da.23149] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 02/16/2021] [Accepted: 03/02/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Veterans have higher rates of anxiety, depression, and posttraumatic stress disorder (PTSD), and may be vulnerable to mental health consequences of the Covid-19 pandemic. More than half of veterans who meet mental illness criteria do not seek help. This study screened for clinical symptoms and evaluated the efficacy of a brief, online social-contact-based video intervention in increasing treatment-seeking intentions among veterans. We hypothesized that the video-based intervention would increase treatment-seeking intentions more than written vignette and control conditions. METHODS One hundred seventy-two veterans were randomized to either a (a) brief video-based intervention; (b) written vignette intervention, or (c) nonintervention control group. In the 3-min video, a veteran previously diagnosed with PTSD described his symptom reactivation by Covid-19, his barriers to care, and how therapy helped him to cope. Assessments were conducted at baseline, postintervention, and at 14- and 30-day follow-ups. RESULTS A total of 91 (53%) veterans reported high levels of clinical symptoms, especially those self-reporting Covid-19 exposure. The brief video-based intervention yielded greater increase in treatment-seeking intentions among veterans. Within the video group, women showed an increase in treatment-seeking intentions from baseline to postintervention only, whereas men showed a more sustained effect, from baseline to Day 14. CONCLUSIONS Surveyed veterans reported high symptoms levels. A brief video intervention increased treatment-seeking intention, likely through identification and emotional engagement with the video protagonist. This easily disseminable video-based intervention has the potential to increase likelihood of seeking care. Future research should examine longer term sustainability and changes in help-seeking behavior.
Collapse
Affiliation(s)
- Doron Amsalem
- Department of Psychiatry, New York State Psychiatric InstituteColumbia University Vagelos College of Physicians & SurgeonsNew YorkNew YorkUSA
| | - Amit Lazarov
- School of Psychological Sciences, Tel Aviv UniversityTel AvivIsrael
| | - John C. Markowitz
- Department of Psychiatry, New York State Psychiatric InstituteColumbia University Vagelos College of Physicians & SurgeonsNew YorkNew YorkUSA
| | - Daniel Gorman
- Department of Psychiatry, New York State Psychiatric InstituteColumbia University Vagelos College of Physicians & SurgeonsNew YorkNew YorkUSA
| | - Lisa B. Dixon
- Department of Psychiatry, New York State Psychiatric InstituteColumbia University Vagelos College of Physicians & SurgeonsNew YorkNew YorkUSA
| | - Yuval Neria
- Department of Psychiatry, New York State Psychiatric InstituteColumbia University Vagelos College of Physicians & SurgeonsNew YorkNew YorkUSA,Department of EpidemiologyColumbia University Irving Medical CenterNew YorkNew YorkUSA
| |
Collapse
|
32
|
Matos M, McEwan K, Kanovský M, Halamová J, Steindl SR, Ferreira N, Linharelhos M, Rijo D, Asano K, Gregório S, Márquez MG, Vilas SP, Brito-Pons G, Lucena-Santos P, da Silva Oliveira M, de Souza EL, Llobenes L, Gumiy N, Costa MI, Habib N, Hakem R, Khrad H, Alzahrani A, Cheli S, Petrocchi N, Tholouli E, Issari P, Simos G, Lunding-Gregersen V, Elklit A, Kolts R, Kelly AC, Bortolon C, Delamillieure P, Paucsik M, Wahl JE, Zieba M, Zatorski M, Komendziński T, Zhang S, Basran J, Kagialis A, Kirby J, Gilbert P. Fears of compassion magnify the harmful effects of threat of COVID-19 on mental health and social safeness across 21 countries. Clin Psychol Psychother 2021; 28:1317-1333. [PMID: 33880832 PMCID: PMC8251194 DOI: 10.1002/cpp.2601] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/07/2021] [Accepted: 04/12/2021] [Indexed: 12/14/2022]
Abstract
Background The COVID‐19 pandemic is a massive global health crisis with damaging consequences to mental health and social relationships. Exploring factors that may heighten or buffer the risk of mental health problems in this context is thus critical. Whilst compassion may be a protective factor, in contrast fears of compassion increase vulnerability to psychosocial distress and may amplify the impact of the pandemic on mental health. This study explores the magnifying effects of fears of compassion on the impact of perceived threat of COVID‐19 on depression, anxiety and stress, and social safeness. Methods Adult participants from the general population (N = 4057) were recruited across 21 countries worldwide, and completed self‐report measures of perceived threat of COVID‐19, fears of compassion (for self, from others, for others), depression, anxiety, stress and social safeness. Results Perceived threat of COVID‐19 predicted increased depression, anxiety and stress. The three flows of fears of compassion predicted higher levels of depression, anxiety and stress and lower social safeness. All fears of compassion moderated (heightened) the impact of perceived threat of COVID‐19 on psychological distress. Only fears of compassion from others moderated the effects of likelihood of contracting COVID‐19 on social safeness. These effects were consistent across all countries. Conclusions Fears of compassion have a universal magnifying effect on the damaging impact of the COVID‐19 pandemic on mental health and social safeness. Compassion focused interventions and communications could be implemented to reduce resistances to compassion and promote mental wellbeing during and following the pandemic.
Collapse
Affiliation(s)
- Marcela Matos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Kirsten McEwan
- College of Health, Psychology and Social Care, Centre for Compassion Research and Training, University of Derby, Derby, UK
| | - Martin Kanovský
- Institute of Social Anthropology, Faculty of Social and Economic Sciences, Comenius University, Bratislava, Slovakia
| | - Júlia Halamová
- Institute of Applied Psychology, Faculty of Social and Economic Sciences, Comenius University, Bratislava, Slovakia
| | - Stanley R Steindl
- School of Psychology, Compassionate Mind Research Group, University of Queensland, Brisbane, Queensland, Australia
| | - Nuno Ferreira
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Mariana Linharelhos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Daniel Rijo
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Kenichi Asano
- Department of Psychological Counseling, Faculty of Psychology, Mejiro University, Tokyo, Japan
| | - Sónia Gregório
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal.,Department of Psychology, Faculty of Biomedical and Health Sciences, Behavior, Emotions, and Health Research Group, Universidad Europea de Madrid, Madrid, Spain
| | - Margarita G Márquez
- Department of Psychology, Faculty of Biomedical and Health Sciences, Behavior, Emotions, and Health Research Group, Universidad Europea de Madrid, Madrid, Spain
| | - Sara P Vilas
- Department of Psychology, Faculty of Biomedical and Health Sciences, Behavior, Emotions, and Health Research Group, Universidad Europea de Madrid, Madrid, Spain
| | - Gonzalo Brito-Pons
- Escuela de Psicología, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paola Lucena-Santos
- University of Coimbra, Center for Research in Neuropsychology and Cognitive Behavioral Intervention (CINEICC), Faculty of Psychology and Educational Sciences, Coimbra, Portugal
| | - Margareth da Silva Oliveira
- Evaluation and Treatment in Cognitive and Behavioral Psychotherapies-Research Group (GAAPCC), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | | | | | | | - Noor Habib
- Neuroscience Department, section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah, Saudi Arabia
| | - Reham Hakem
- Neuroscience Department, section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah, Saudi Arabia
| | - Hussain Khrad
- Neuroscience Department, section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah, Saudi Arabia
| | - Ahmad Alzahrani
- Neuroscience Department, section of Psychiatry and Psychology, King Faisal Specialist Hospital and Research Centre (KFSH&RC), Jeddah, Saudi Arabia
| | - Simone Cheli
- School of Human Health Sciences, University of Florence, Florence, Italy
| | - Nicola Petrocchi
- Department of Economics and Social Sciences, John Cabot University, Rome, Italy
| | - Elli Tholouli
- Center for Qualitative Research in Psychology and Psychosocial Well-being, National and Kapodistrian University of Athens, Athens, Greece
| | - Philia Issari
- Center for Qualitative Research in Psychology and Psychosocial Well-being, National and Kapodistrian University of Athens, Athens, Greece
| | - Gregoris Simos
- Department of Educational and Social Policy, University of Macedonia, Thessaloniki, Greece
| | | | - Ask Elklit
- Department of Psychology, University of Southern Denmark, Odense, Denmark
| | - Russell Kolts
- Department of Psychology, Eastern Washington University, Cheney, Washington, USA
| | - Allison C Kelly
- Department of Psychology, University of Waterloo, Waterloo, Ontario, Canada
| | - Catherine Bortolon
- Laboratoire Inter-universitaire de Psychologie : Personnalité, Cognition et Changement Social, Grenoble Alpes University, Grenoble, France.,C3R-Réhabilitation Psychosociale et Remédiation Cognitive, Centre Hospitalier Alpes Isère, Grenoble, France
| | - Pascal Delamillieure
- Service de Psychiatrie Adulte, CHU de Caen, Caen, France.,UNICAEN, ISTS, GIP Cyceron, University of Normandy, Caen, France
| | - Marine Paucsik
- Laboratoire Inter-universitaire de Psychologie : Personnalité, Cognition et Changement Social, Grenoble Alpes University, Grenoble, France
| | - Julia E Wahl
- The Mind Institute Poland, Warsaw, Poland.,SWPS University of Social Sciences and Humanities, Warsaw& Poznań, Poland
| | - Mariusz Zieba
- SWPS University of Social Sciences and Humanities, Warsaw& Poznań, Poland
| | - Mateusz Zatorski
- SWPS University of Social Sciences and Humanities, Warsaw& Poznań, Poland
| | - Tomasz Komendziński
- Department of Cognitive Science, Nicolaus Copernicus University, Torún, Poland.,Neurocognitive Laboratory, Centre for Modern Interdisciplinary Technologies, Nicolaus Copernicus University, Torún, Poland
| | - Shuge Zhang
- School of Human Sciences, University of Derby, Derby, UK
| | - Jaskaran Basran
- College of Health, Psychology and Social Care, Centre for Compassion Research and Training, University of Derby, Derby, UK
| | - Antonios Kagialis
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - James Kirby
- School of Psychology, Compassionate Mind Research Group, University of Queensland, Brisbane, Queensland, Australia
| | - Paul Gilbert
- College of Health, Psychology and Social Care, Centre for Compassion Research and Training, University of Derby, Derby, UK
| |
Collapse
|
33
|
Günaydın HD. The impact of social problem skills on academic motivation by means of Covid-19 fear: A SEM Model: Social Problem Solving, Covid-19, Academic Motivation. CURRENT PSYCHOLOGY 2021; 41:427-436. [PMID: 33821113 PMCID: PMC8012071 DOI: 10.1007/s12144-021-01665-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/19/2021] [Indexed: 11/30/2022]
Abstract
Recent studies have investigated the relationship between the social problem-solving skills and academic motivation; nevertheless, new studies should examine the relationships between the social problem solving and academic motivation taking the effect of Covid-19 fear into consideration. As a result of this, in this study, it was aimed to a construct structural equation model by which the impacts of social problem-solving skills on academic motivation by means of Covid-19 fear were studied. Therefore, 513 university students participated in the study and completed Social Problem-Solving Inventory-Short Form, the Fear of Covid-19 Scale, and Academic Motivation Scale. The SEM model analysis indicated that rational problem solving, negative orientation to problem, impulsive/careless style and avoidant style predicted %15 of the Covid-19 fear. Altogether rational problem solving, negative orientation to problem, impulsive/careless style, avoidant style, positive orientation to problem and Covid-19 fear explained %32 of the academic motivation.
Collapse
Affiliation(s)
- H Deniz Günaydın
- Department of Psychology, Faculty of Social Human Sciences, Konya Food and Agriculture University, Konya, Turkey
| |
Collapse
|
34
|
Kanaan RA, Chen G, Olver J. How has the COVID pandemic affected functional neurological disorder? A mixed-methods analysis. Gen Hosp Psychiatry 2021; 69:129-130. [PMID: 33451858 PMCID: PMC7959885 DOI: 10.1016/j.genhosppsych.2020.12.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 12/21/2020] [Accepted: 12/23/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Richard A. Kanaan
- Corresponding author at: Department of Psychiatry, LTB10, Austin Health, 145 Studley Road, Heidelberg, VIC 3084, Australia
| | | | | |
Collapse
|