Fear, xenophobia and collectivism as predictors of well-being during Coronavirus disease 2019: An empirical study from India

COVID-19-related fear and anxiety in a sample of patients with type 2 diabetes: a cross-sectional study in Iran after several peaks of the pandemic

Purpose

The aim of this study was to assess COVID-19-related anxiety, and fear burden in diabetic patients, as a risk group for severe COVID-19.

Methods

A cross-sectional online survey conducted on 111 type 2 diabetes mellitus (T2DM) patients referred to a Diabetes clinics of Royan institute, and 155 healthy controls recruited from normal population using a snowball sampling technique. Fear of COVID-19 Scale (FCV-19 S) and Coronavirus anxiety scale (CAS) were used.

Results

The total score of coronavirus fear in T2DM patients was 15.79 (6.39) and in healthy controls 15.48 (5.97) (p = 0.696). The total score of coronavirus fear in T2DM patients was 15.79 (6.39) and in healthy controls 15.48 (5.97) (p = 0.696). Correlation matrix between coronavirus anxiety and fear scores in these samples confirmed that in T2DM participants CAS was significantly positively associated with FCV-19 (r = 0.407, p = 0.000). There was also statistically and positively significant correlation between CAS and FCV-19 in healthy subjects (r = 0.495, p = 0.000).

Conclusion

The present study revealed that the level of fear and anxiety from COVID-19 was almost the same in a sample of Iranian T2DM patients and healthy controls. The pandemic with several peaks in the country cannot cause an increased anxiety and fear from COVID-19, especially in patients with diabetes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s40200-023-01353-8.

A systematic review of risk factors associated with depression and anxiety in cancer patients

Depression and anxiety are common comorbid conditions associated with cancer, however the risk factors responsible for the onset of depression and anxiety in cancer patients are not fully understood. Also, there is little clarity on how these factors may vary across the cancer phases: diagnosis, treatment and depression. We aimed to systematically understand and synthesise the risk factors associated with depression and anxiety during cancer diagnosis, treatment and survivorship. We focused our review on primary and community settings as these are likely settings where longer term cancer care is provided. We conducted a systematic search on PubMed, PsychInfo, Scopus, and EThOS following the PRISMA guidelines. We included cross-sectional and longitudinal studies which assessed the risk factors for depression and anxiety in adult cancer patients. Quality assessment was undertaken using the Newcastle-Ottawa assessment checklists. The quality of each study was further rated using the Agency for Healthcare Research and Quality Standards. Our search yielded 2645 papers, 21 of these were eligible for inclusion. Studies were heterogenous in terms of their characteristics, risk factors and outcomes measured. A total of 32 risk factors were associated with depression and anxiety. We clustered these risk factors into four domains using an expanded biopsychosocial model of health: cancer-specific, biological, psychological and social risk factors. The cancer-specific risk factors domain was associated with the diagnosis, treatment and survivorship phases. Multifactorial risk factors are associated with the onset of depression and anxiety in cancer patients. These risk factors vary across cancer journey and depend on factors such as type of cancer and individual profile of the patients. Our findings have potential applications for risk stratification in primary care and highlight the need for a personalised approach to psychological care provision, as part of cancer care.

Oxytocin as a transdiagnostic biomarker of well-being in severe mental illness during the Covid-19 pandemic

Individuals with severe mental illness (SMI) have been found to suffer a greater decline in psychological well-being compared to the general population in times of stress. The present study aimed to examine clinical and endocrine resilience factors of psychological well-being in SMI patients during the Covid-19 pandemic.

METHODS

After Covid-19 crisis outburst in Israel 112 participants, 69 outpatients, and 43 inpatients and day treatment patients were recruited. Outpatients signed an online informed consent and filled in questionnaires regarding their level of mental health symptoms (OQ-45), fear of Covid-19 (FCV), and psychological well-being (PWB). Inpatients answered the same questionnaires and in addition, went through a positive social interaction paradigm while providing three saliva samples to measure their s-IgA and oxytocin (OT) levels.

RESULTS

A strong negative correlation was found in the whole sample between reported mental health symptoms, fear of Covid-19, and well-being. Hierarchical regression did not find additional contribution of the fear of the pandemic in predicting well-being beyond the impact of symptomatology. For inpatients (N = 39) only, hierarchical regression found that oxytocin, but not s-IgA could explain 5% of the variance of well-being (R2 = 0.05) in individuals with SMI regardless of their mental health symptoms (R2 = 0.46) and their marital status (R2 = 0.21).

CONCLUSIONS

OT is suggested as a possible independent biological resilience factor of well-being in times of major stress among SMI patients. It is still unknown whether OT is a mediator that contributes to well-being or a biological marker that indicates the degree of beneficial social interactions.

Development and Validation of Korean 'COVID-blues' Social Syndrome Scale

This study focuses on measuring the effects of COVID-19 on mental health both at cultural and individual levels. Although many COVID-19 studies used previous COVID-19 measurements such as FCV-19S, GAD-7, PHQ-9, DASS-21, CSS, CAS, or CSI, these clinical psychology measurements did not include cultural aspects as suggested by pathogen prevalence hypothesis : Pathogen prevalence argues that psychological responses of collectivists involve clinical response as well as cultural group response, driven by strong collectivism. This study developed new "COVID-blues" scale that measure individual and cultural aspects of COVID-stress in collectivistic society context. Specifically, this study developed and validated 25-items that measure individual loneliness, fear, social anger, and socioeconomic consequences. Results of this study indicated that: (1) COVID-related stress can occur at both the individual and cultural levels, and (2) COVID-blues not only increase fear but also anger; that is, the higher the score on the COVID-blues scale, the higher the fear and anger of each individual. The findings presented robust 25-item multidimensional COVID-blues scale which can be used for conducting future health communication studies using theories such as health belief model, theory of planned behavior, or social cognitive theory in collective countries such as South Korea.

Development of a decentralized cohort for studying post-acute sequelae of COVID-19 in India in the Data4life Study

BACKGROUND

Decentralized, digital health studies can provide real-world evidence of the lasting effects of COVID-19 on physical, socioeconomic, psychological, and social determinant factors of health in India. Existing research cohorts, however, are small and were not designed for longitudinal collection of comprehensive data from India's diverse population. Data4Life is a nationwide, digitally enabled, health research initiative to examine the post-acute sequelae of COVID-19 across individuals, communities, and regions. Data4Life seeks to build an ethnically and geographically diverse population of at least 100,000 participants in India.

METHODS

Here we discuss the feasibility of developing a completely decentralized COVID-19 cohort in India through qualitative analysis of data collection procedures, participant characteristics, participant perspectives on recruitment and reported study motivation.

RESULTS

As of June 13th, 2022, more than 6,000 participants from 17 Indian states completed baseline surveys. Friend and family referral were identified as the most common recruitment method (64.8%) across all demographic groups. Helping family and friends was the primary reason reported for joining the study (61.5%).

CONCLUSIONS

Preliminary findings support the use of digital technology for rapid enrollment and data collection to develop large health research cohorts in India. This demonstrates the potential for expansion of digitally enabled health research in India. These findings also outline the value of person-to-person recruitment strategies when conducting digital health research in modern-day India. Qualitative analysis reveals opportunities to increase diversity and retention in real time. It also informs strategies for improving participant experiences in the current Data4Life initiative and future studies.

COVID-19 fear and its associated correlates among type-2 diabetes patients in Bangladesh: A hospital-based study

The outbreak of COVID-19 has caused widespread fear among people around the world, particularly those with underlying health conditions such as type-2 diabetes. This study aimed to investigate COVID-19 fear and its associated potential factors among type-2 diabetes patients in Bangladesh. A total of 1,036 type-2 diabetes patients residing in the Jashore district of Bangladesh were interviewed using the COVID-19 Fear Scale in Bengali language. A pre-validated questionnaire was used to collect data on sociodemographic, lifestyle-related characteristics, and COVID-19-related information. Logistic regression was performed to identify factors associated with perceived fear of COVID-19. The mean score of the COVID-19 fear was 18.1 ± 5.6. Approximately 45 and 39% were most afraid and uncomfortable thinking about COVID-19, respectively. Regression analysis revealed that gender, age, occupation, residence, physical activity, smoking, and dietary diversity score were associated with fear. Additionally, respondents who had limited self-care practice, unaffordable medicine, medicine shortages, a close friend or family member diagnosed with COVID-19, and financial problems during COVID-19 were significant predictors of COVID-19 fear. Healthcare providers should implement interventions, including appropriate education and counseling, to address the psychological impact of the COVID-19 pandemic on type-2 diabetes patients in Bangladesh.

The Relationship between Perceived Infectability and Psychological Well-being: The Mediating Role of Covid-19 Anxiety

Background

COVID-19 has adversely affected economies and individuals globally. To this day, countries are facing the economic effects of the pandemic directly, and individuals' mental health is in danger as they are still indirectly dealing with the pandemic. It is imperative to understand how pandemic-related anxiety affected individuals' mental health so that all stakeholders can take essential remedial steps.

Objective

The current research aimed to investigate the relationship between Perceived Infectability, Coronavirus Anxiety, and Psychological Well-being. It also sought to explore the role of coronavirus anxiety in mediating between perceived infectability and psychological well-being.

Design

A cross-sectional correlational study design and non-probability convenience sampling technique were used to collect the data. The data were collected from 321 Pakistani adults, who filled out Google forms on the Perceived Infectability subscale of the Perceived Vulnerability to Disease Scale; the Coronavirus Anxiety Scale; and the Psychological Well-being Scale.

Results

Correlation analysis indicated that both perceived infectability and coronavirus anxiety were negatively related to psychological well-being. However, a significant positive relationship was observed between perceived infectability and coronavirus anxiety. Our findings further proved the mediating role of coronavirus anxiety between perceived infectability and the psychological well-being of adults.

Conclusion

Understanding perceived infectability and its association with COVID-19 anxiety and psychological well-being is pertinent in this post-pandemic period in both developing and developed nations. The post-pandemic world is still being jolted with the aftereffects of the pandemic. An in-depth understanding of how individuals Coped with the pandemic, might help in designing better intervention and community health programs after the pandemic, and it could also help in preparing for the crises attending future pandemics (if any).

The impact of pandemic mental cognition on cultural values: an empirical study based on social media

BACKGROUND

COVID-19 has triggered a global public health crisis, and had an impact on economies, societies, and politics around the world. Based on the pathogen prevalence hypothesis suggested that residents of areas with higher infection rates are more likely to be collectivists as compared with those of areas with lower infection rates. Many researchers had studied the direct link between infectious diseases and individualism/collectivism (infectious diseases→ cultural values), but no one has focused on the specific psychological factors between them: (infectious diseases→ cognition of the pandemic→ cultural values). To test and develop the pathogen prevalence hypothesis, we introduced pandemic mental cognition and conducted an empirical study on social media (Chinese Sina Weibo), hoping to explore the psychological reasons behind in cultural value changes in the context of a pandemic.

METHODS

We downloaded all posts from active Sina Weibo users in Dalian during the pandemic period (January 2020 to May 2022) and used dictionary-based approaches to calculate frequency of words from two domains (pandemic mental cognition and collectivism/individualism), respectively. Then we used the multiple log-linear regression analysis method to establish the relationship between pandemic mental cognition and collectivism/individualism.

RESULTS

Among three dimensions of pandemic mental cognition, only the sense of uncertainty had a significant positive relationship with collectivism, and also had a marginal significant positive relationship with individualism. There was a significant positive correlation between the first-order lag term AR(1) and individualism, which means the individualism tendency was mainly affected by its previous level.

CONCLUSIONS

The study found that more collectivist regions are associated with a higher pathogen burden, and recognized the sense of uncertainty as its underlying cause. Results of this study validated and further developed the pathogen stress hypothesis in the context of the COVID-19 pandemic.

A systematic review on the cultural factors associated with stigma during pandemics

Both public stigma and perceived self-stigma are prevalent during pandemics threatening a divide among the global community. This systematic review examined the cultural factors associated with viral respiratory-related pandemic stigma. Following PRISMA guidelines, the keywords, "culture, stigma, and pandemic" were searched across relevant databases for empirical papers between January 2000 to March 2022. Quality assessment and coding were adopted in the screening process. Thirty-one articles were included in the final analysis. Themes revealed that collectivistic values, cultural identities, and non-western regions were associated with public (others) stigma; mismatch of cultural values, minority groups, and North America, Asia, Oceania, and African regions were associated with higher perceived and self-stigma. We further mapped the themes into a proposed systemic cultural stigma model to integrate the dynamic intersection of cultural values, identity, and ecology. The cultural factors and their influence on stigma were then explained by drawing on two evolutionary theories: Cultural rationality theory and scapegoating theory. Lastly, we proposed culturally sensitive and responsive practices for stigma management at the community level, especially in non-Western regions during the pandemic recovery phase.

Covid-19 Effects on Psychological Outcomes: How Do Gender Responses Differ?

The study aims at understanding the relationships between the fear of COVID-19 and perceived stress, wellbeing, and life satisfaction. The study also analyses the role of gender on the relationship of fear of COVID-19 with these study variables. For this, a cross-sectional study was conducted among 1125 participants in India, comprising 638 men and 487 women. Structural equation model was used to analyse the data. It was found that the fear of COVID-19 is positively related to perceived stress and negatively related to wellbeing and life satisfaction. It was also found that, these relationships are stronger among women than among men. The study shows the importance of psychiatric assessment during pandemic times and alerts policy makers and society in general, to take measures for ensuring mental health among people during times of crisis. Future studies can include longitudinal research for a comprehensive understanding of the psychological impacts of the pandemic.

Impact of COVID-19 pandemic on the psychological well-being of migrants and refugees settled in Spain

OBJECTIVES

The COVID-19 pandemic has exacerbated health inequalities worldwide, having a disproportionately harsh impact on unprivileged populations such as migrants and refugees. These populations are often more exposed to the virus, but less protected, while at the same time being at higher risk of suffering from poor living and working conditions, limited access to healthcare, and discrimination by the host society, all of which is challenging to their mental health. Empirical evidence on how the COVID-19 pandemic is affecting migrants and refugees is required to design effective actions aimed at ensuring health equity. Therefore, this paper aims to analyse how the pandemic has impacted the psychological well-being of migrants and refugees living in Spain.

DESIGN

This study was carried out within the framework of the ApartTogether study sponsored by the World Health Organization. Data collection was carried out during March-November 2020, through an online survey completed by 241 participants (age: M = 37 years; 129 women).

RESULTS

The results indicate that 78.7% of participants had suffered a decrease in their psychological well-being since the onset of the COVID-19 pandemic, with number of difficulties and worries experienced being the best individual predictors of this outcome. Enjoying social connections and perceiving positive treatment from the host society were positively associated with psychological well-being at a relational and community level, respectively.

CONCLUSION

Based on these findings, we outline priority areas of psychosocial interventions aimed at guaranteeing the mental health of migrants and refugees in the face of the pandemic in Spain.

Typologies of people's preexisting political ideology and values would determine their post-pandemic mental health and political behaviors: Evidence from China

The pandemic of COVID-19 has caused economic and social crisis across the world. Existing studies have shown that the uncertain social context has profoundly affected people's life, triggering a variety of social psychological phenomena including the deterioration of mental health and the change of political behavioral patterns. However, little has been known about the differences in people's pre-pandemic political ideology and their influences on people's mental health and political behaviors after the pandemic. Using the secondary data from the 2018 and 2020 China Family Panel Studies, we measured nationalism tendencies, state performance ratings, social justice evaluation and life satisfaction of 29,629 adults before the pandemic. Using latent profile analysis (LPA), we examined the typologies of respondents' political ideology and values. Five types emerged to identify respondents with different political ideology and values: (Class-1) High nationalism tendency, country evaluation, social justice perception, and life satisfaction; (Class-2) Low life satisfaction; (Class-3) Moderate ratings; (Class-4) Low nationalism tendency; and (Class-5) Low country evaluation, low social justice perception. We further explored the predicting roles of those typologies on people's depressive symptoms and political engagement behaviors after the pandemic. We found that, after the pandemic, although the depressive symptoms of people with low life satisfaction (Class-2) and low country and society ratings (Class-5) eased, they still tended to have more severe depressive symptoms than the Moderate ratings group (Class-3). People with low life satisfaction (Class-2) were also less likely to follow political information than the moderate group (Class-3). Our research revealed how the psychology and behaviors of Chinese people with different political views changed when faced with uncertainty in social context. Further research needs to be carried out to depict how these changes occur.

Fear of COVID-19 and Subjective Well-Being: Sequential Mediating Role of Cognitive Flexibility and Psychological Resilience

The negative relationship between fear of COVID-19 and well-being has been revealed over the last years. However, the potential variables that affect this relationship need to be studied. This study examines the sequential mediating role of cognitive flexibility and psychological resilience in the relationship between fear of COVID-19 and subjective well-being. Six hundred and eight participants (339 females and 269 males, aged between 18-79 years) completed the Fear of COVID-19 Scale, the Brief Resilience Scale, the Cognitive Flexibility Inventory, the Positive and Negative Affect Schedule, and the Satisfaction with Life Scale online. The path analysis was conducted using PROCESS macro in the study. The sequential mediation analyses show that the control dimension of cognitive flexibility and psychological resilience fully mediate the relationship between fear of COVID-19 and subjective well-being. In other words, fear of COVID-19 indirectly affects subjective well-being via the control dimension of cognitive flexibility and psychological resilience. In order to restrain the adverse effects of COVID-19, individuals’ cognitive flexibility and psychological resilience levels should be increased to enhance their well-being.

Emotion regulation and subjective wellbeing among Turkish population: the mediating role of COVID-19 fear

We examined fear of COVID-19 as a mediator of the relationship between emotion regulation (suppression, reappraisal) and subjective wellbeing. In this cross-sectional study, 1,014 Turkish individuals completed assessments of positive affect, negative affect, satisfaction with life, emotion regulation (suppression, reappraisal), and fear of COVID-19. Network analysis revealed that all variables were associated with each other. Structural equation modelling indicated that greater suppression was associated with greater fear of COVID-19 and less subjective wellbeing. Greater reappraisal was associated with less fear of COVID-19 and greater subjective wellbeing. In addition greater suppression was associated with less subjective well-being and greater reappraisal was associated with greater subjective well-being. Mediation analyses demonstrated that fear of COVID-19 partially mediated the relationship between suppression, reappraisal and subjective wellbeing. Findings expand our understanding of the link between emotion regulation and subjective wellbeing during the COVID-19 pandemic.

Bireylerin Aşılara Yönelik Tutumları Üzerine COVID-19 Korkusunun Etkisi

Giriş: Covid-19 hastalığının psikolojik etkileri devam etmektedir. Hastalığa ilişkin yaşanılan korku bireylerin Covid-19 aşılarına yönelik tutumlarını etkilemektedir. Amaç: Bireylerin Covid-19 aşısına yönelik tutumları üzerine Covid-19 korkusunun etkisini belirlemektir. Yöntem: Niceliksel araştırma yöntemlerinden tanımlayıcı tipte bir araştırmadır. Çalışmanın verileri 1 Temmuz- 31 Ağustos 2021 tarihleri arasında kartopu örnekleme tekniği kullanılarak online olarak toplanmıştır. Belirtilen süre içerisinde araştırmaya gönüllü olarak katılmayı kabul eden ve formu eksiksiz dolduran 221 kişi araştırmanın örneklemini oluşturmuştur. Veri toplama araçları “Katılımcı Bilgi Formu”, “Covid-19 Korku Ölçeği” ve “Covid-19 Aşısına Yönelik Tutumlar Ölçeği” dir. Bulgular: Araştırmaya katılan bireylerin Covid-19 korku ölçeği puan ortalaması 17.84 ± 6.65; Covid-19 aşısına yönelik olumlu tutum alt boyut puan ortalaması 3.79 ± 1.12; Covid-19 aşısına yönelik olumsuz tutum alt boyut puan ortalaması 3.57 ± 1.23 olarak tespit edilmiştir. Covid-19 korku ve Covid-19 aşısına yönelik olumlu tutum değişkenleri arasında pozitif yönde, anlamlı (r = .28; p = .000) bir ilişki saptanmıştır. Ayrıca, Covid-19 korkusunun bireylerin Covid-19 aşına yönelik olumlu tutum düzeyi üzerinde anlamlı bir etkiye sahip olduğu görülmüştür (t = 4.396; p = .000). Sonuç: Covid-19 korkusu bireylerin Covid-19 aşısına yönelik tutumunu olumlu şekilde etkilemiştir

Uneven Implications of Lockdown Amid COVID-19 in India: From Harassment, Stigma, Crime, and Internally Displaced People to Stress and Coping Strategies in the Middle/Upper Class

A content analysis of an English Newspaper, The Times of India (the world's largest newspaper by circulation) during the first national lockdown amid the COVID-19 pandemic identified nine different categories culled out from a total of 129 news categories reporting unprecedented COVID-19 stories. Half of them portrayed two sides of a coin: from daily wagers and migrant workers, including internally displaced people (23/129), harassment and stigma (4/129), and crime (3/129) to stressors and coping strategies for middle/upper class individuals (39/129). Reports evidenced increased vulnerability in the lower layers of Indian stratified society. Yet, two years later, the uneven implications on physical and mental health are scarcely studied by scientific researchers.

COVID-19 health certification reduces outgroup bias: evidence from a conjoint experiment in Japan

The psychological theory argues that serious threats cause negative attitudes from ingroups to outgroups. However, the factors that can reduce such outgroup bias caused by the health threats of a pandemic are unknown. Here, we provide evidence that health certifications to prove immunity or negative test result for COVID-19 reduce outgroup bias. Using a discrete choice experiment with a randomized conjoint design in Japan, we investigated public attitudes towards inbound travelers entering the country, including foreigners, immigrants, and tourists. We found that travelers carrying a vaccination certificate or a negative test result for COVID-19 have a higher probability or rating of being admitted to the country. These effects are the same size as those for travelers undergoing self-isolation. Thus, our results demonstrate that health certification can mitigate outgroup bias among ingroup members experiencing threats to health due to the COVID-19 pandemic. We anticipate that the findings would support the combined usage of vaccine passports and negative certificates to reopen the international borders.

Fear of COVID-19 and secondary trauma: Moderating role of self-efficacy

COVID-19 has affected millions of people around the globe. People's mental health, especially those of nurses, has been primarily affected by the fear of this virus. More focus has been paid to vaccination and treatment of the virus, but less attestation has been given to addressing the mental health of people affected by the virus. Empirical studies show that different external factors are not easily manageable and controllable by the individual. This study preliminarily explores the connection between fear of COVID-19 and secondary traumatic stress in nurses. Further, it examines the moderating effects of occupational self-efficacy on the relationship between fear of COVID-19 and secondary traumatic stress. Data for the study was collected from the nurses of six large hospitals in Karachi, Pakistan. The final analysis was performed on 243 samples. Studies on COVID-19 suggest that increased occupational self-efficacy decreases fear and its impact. This study offers insights for managers to develop stress management programs and provide proper training and counseling sessions to the nurses to motivate them emotionally. Theoretically, this study broadens the understanding of the theory of emotions by using the pandemic as a stressor. Future studies may explore different roles of occupational self-efficacy and study its influential role in managing different kinds of emotions explained by the theory of emotions. Managers at the workplace could design different self-efficacy training for nurses to increase their self-motivation to fight different types of stress they face at the workplace.

Fear, Stigma and Othering: The Impact of COVID-19 Rumours on Returnee Migrants and Muslim Populations of Nepal

The paper explores how COVID-19-related moral panics have led to fear and othering practices among returnee Nepalese migrants from India and Muslims living in Nepal. This qualitative study included in-depth interviews with 15 returnee migrants, 15 Muslims from Kapilvastu and Banke districts of Nepal, and eight interviews with media and health professionals, and representatives from migration organisations. Four themes emerged from our data analysis: (1) rumours and mis/disinformation; (2) impact of rumours on marginalised groups (with three sub-themes: (i) perceived fear; (ii) othering practices; (iii) health and social impact); (3) resistance; and (4) institutional response against rumours. Findings suggest that rumours and misinformation were fuelled by various media platforms, especially social media (e.g., Facebook, YouTube) during the initial months of the lockdown. This created a moral panic which led to returnee migrants and Muslim populations experiencing fear and social isolation. Resistance and effective institutional responses to dispel rumours were limited. A key contribution of the paper is to highlight the lived experiences of COVID-19 related rumours on marginalised groups. The paper argues that there is a need for clear government action using health promotion messages to tackle rumours (health-related or otherwise), mis/disinformation and mitigating the consequences (hatred and tensions) at the community level.

Collectivism, individualism and COVID-19 prevention: a cross sectional study of personality, culture and behavior among Canadians

Background

Collectivism has been identified as a protective factor against COVID-19 – perhaps due to increased conformity with social norms regarding prevention behaviors. Other studies have also found that individualism can inspire uptake of preventative behaviors as a means of personal protection. It is possible that these cultural orientations may promote different patterns of prevention (e.g. mask wearing vs. social distancing). Furthermore, existing studies examining the role of individualism and collectivism during the COVID-19 pandemic have frequently failed to account for other psychological processes, including differences in personality, which could help provide a better understanding of the psychological process underlying prevention behavior.

Methods

Participants were recruited using social media advertisements. The Cultural Orientations Scale measured individualism–collectivism and hierarchism-egalitarianism. The Ten Item Personality Inventory measured the five factor model of personality. Multivariable models, dominance analyses and structural equation mediation tests were used to identify the most important predictors of COVID-19 prevention behavior (i.e. mask-wearing, hand-washing, reducing social interactions, physical distancing, staying at home and social bubbling), controlling for demographic and situational factors.

Results

Among 774 participants, most (i.e. 60–80%) reported uptake of COVID-19 prevention behaviors. Higher vertical (hierarchical) collectivism was associated with staying at home and higher horizontal (egalitarian) individualism was associated with mask-wearing and reducing social interactions. Neither Vertical Collectivism nor Horizontal Collectivism were significantly associated with any of the prevention behaviors when controlling for personality traits and confounding variables. Agreeableness was identified as a key mediator of the correlation between these cultural orientations on general uptake of COVID-19 prevention behaviors.

Conclusions

Cultural orientations (e.g. collectivism-individualism, hierarchism-egalitarianism) and personality traits (e.g. Agreeableness) are salient correlates of COVID-19 prevention behaviors and therefore should be accounted for in the development, design and delivery of health promotion messages aiming to increase uptake of these behaviors.

Fear of COVID-19 and its association with mental health-related factors: systematic review and meta-analysis

BACKGROUND

The severity of COVID-19 remains high worldwide. Therefore, millions of individuals are likely to suffer from fear of COVID-19 and related mental health factors.

AIMS

The present systematic review and meta-analysis aimed to synthesize empirical evidence to understand fear of COVID-19 and its associations with mental health-related problems during this pandemic period.

METHOD

Relevant studies were searched for on five databases (Scopus, ProQuest, EMBASE, PubMed Central, and ISI Web of Knowledge), using relevant terms (COVID-19-related fear, anxiety, depression, mental health-related factors, mental well-being and sleep problems). All studies were included for analyses irrespective of their methodological quality, and the impact of quality on pooled effect size was examined by subgroup analysis.

RESULTS

The meta-analysis pooled data from 91 studies comprising 88 320 participants (mean age 38.88 years; 60.66% females) from 36 countries. The pooled estimated mean of fear of COVID-19 was 13.11 (out of 35), using the Fear of COVID-19 Scale. The associations between fear of COVID-19 and mental health-related factors were mostly moderate (Fisher's z = 0.56 for mental health-related factors; 0.54 for anxiety; 0.42 for stress; 0.40 for depression; 0.29 for sleep problems and -0.24 for mental well-being). Methodological quality did not affect these associations.

CONCLUSIONS

Fear of COVID-19 has associations with various mental health-related factors. Therefore, programmes for reducing fear of COVID-19 and improving mental health are needed.

Evolution of intersectional perceived discrimination and internalized stigma during COVID-19 lockdown among the general population in Spain

BACKGROUND

Stigma and discrimination have been associated with different diseases and pandemics, with negative consequences for the people who suffered them and for their communities. Currently, COVID-19 has become a new source of stigmatization.

AIMS

The aim of the present study is to analyze longitudinally the evolution of intersectional perceived discrimination and internalized stigma among the general population of Spain, at three points in time throughout the confinement.

METHOD

Participants completed an online survey.

RESULTS

Results show an increase in both variables from the first to the second evaluation, and a slight decrease from the second to the third evaluation. Moreover, these changes are explained by depression, anxiety and family support.

CONCLUSIONS

These findings indicate the factors that need to be considered to reduce the perception of discrimination and the internalization of stigma, and their detrimental consequences, during an especially stressful event such as the current pandemic outbreak.

Developmental Trend of Subjective Well-Being of Weibo Users During COVID-19: Online Text Analysis Based on Machine Learning Method

Currently, the coronavirus disease 2019 (COVID-19) pandemic experienced by the international community has increased the usage frequency of borderless, highly personalized social media platforms of all age groups. Analyzing and modeling texts sent through social media online can reveal the characteristics of the psychological dynamic state and living conditions of social media users during the pandemic more extensively and comprehensively. This study selects the Sina Weibo platform, which is highly popular in China and analyzes the subjective well-being (SWB) of Weibo users during the COVID-19 pandemic in combination with the machine learning classification algorithm. The study first invokes the SWB classification model to classify the SWB level of original texts released by 1,322 Weibo active users during the COVID-19 pandemic and then combines the latent growth curve model (LGCM) and the latent growth mixture model (LGMM) to investigate the developmental trend and heterogeneity characteristics of the SWB of Weibo users after the COVID-19 outbreak. The results present a downward trend and then an upward trend of the SWB of Weibo users during the pandemic as a whole. There was a significant correlation between the initial state and the development rate of the SWB after the COVID-19 outbreak (r = 0.36, p < 0.001). LGMM results show that there were two heterogeneous classes of the SWB after the COVID-19 outbreak, and the development rate of the SWB of the two classes was significantly different. The larger class (normal growth group; n = 1,229, 93.7%) showed a slow growth, while the smaller class (high growth group; n = 93, 6.3%) showed a rapid growth. Furthermore, the slope means across the two classes were significantly different (p < 0.001). Therefore, the individuals with a higher growth rate of SWB exhibited stronger adaptability to the changes in their living environments. These results could help to formulate effective interventions on the mental health level of the public after the public health emergency outbreak.

Lessons learnt from emergency medicine services during the COVID-19 pandemic: A case study of India and the United States

India and the United States have both witnessed a high burden of COVID-19 infections since the pandemic was declared in early 2020. However, the COVID-19 restrictions have met with mixed responses in India and the US. Despite recommendations to continue social isolation and personal hygiene measures, India has not been able to curb the rise in daily cases. Our findings demonstrate the difference in the manner by which India and the US differ in their emergency handling of patients. We conducted a thorough review of the existing protocols and data concerning emergency responses in India and the US. The triage and care of suspected COVID-19 positive patients is different across India and the US. We find that there is a shortage of oxygenation, vaccination and other essential supplies in India. Further, the US is able to triage patients through telemedicine and EMS before suspected COVID-19 patients arrive, which is less prevalent in India. Our study identifies the importance of the emergency department (ED) as a critical contributor to the prevention and care of suspected and confirmed COVID-19 patients. Hospitals in India have been struggling to accommodate a huge influx of patients during its second wave with the ED playing a key link in their COVID-19 response.

The Relationship Between Pre-pandemic Measures of Religiosity and Psychological Responses to the COVID-19 Pandemic: A Secondary Analysis of Data From a Multi-Country Study

Background

The uncertainty and socioeconomic disruption caused by the COVID-19 pandemic have been frequently associated with negative affective responses, particularly depression and anxiety. People from countries across the globe have frequently resorted to religious coping to deal with these emotions. However, there are conflicting results in the literature about the impact of prior patterns of religious belief and practice on emotional responses to COVID-19.

Methods

In this cross-sectional, country-level study, the association between pre-pandemic measures of religious affiliation and practice, obtained from prior survey data and self-reported symptoms of depression, anxiety, and stress across 29 countries from a recent multi-country study, were examined while correcting for potential confounders.

Results

There was a trend towards a positive association between pre-pandemic religious belief and practice and anxiety in response to the pandemic (r = .36, p = .057), but this was not significant on multivariate analysis (β = .08, p = .691). Cultural individualism and urbanization were negatively associated with anxiety during the pandemic. There was also preliminary evidence of a non-linear relationship between religiosity and pandemic-related anxiety.

Conclusions

The relationship between religiosity and mental health during the COVID-19 pandemic is unlikely to be a direct one and can be influenced by demographic and cultural factors.

A Psychosocial Exploration of Body Dissatisfaction: A Narrative Review With a Focus on India During COVID-19

COVID-19 has been an unprecedented global crisis. Besides the public health impact, the pandemic necessitated measures, such as quarantine, travel restrictions, and lockdown, that have had a huge effect on digital screen time, dietary habits, lifestyle measures, and exposure to food-related advertising. At the same time, a reduction in physical activity, an increase of social media consumption, and an increase in fitness tutorials during the lockdown have contributed to body image issues. Emerging evidence from India suggests that peer conversations about appearance as negative body talk (fat talk) is particularly salient in contributing to body dissatisfaction and body perception ideals, which are more prevalent in women. Even though there has been an increase in research on the psychosocial impact of COVID-19, its influence on body image perceptions and consequent distress have been stigmatized and classified as under-spoken areas. With this background, this article reviews research on the biopsychosocial factors that influence body dissatisfaction among women, particularly the role of media. It also highlights the development of body image concerns in India, one of the worst-hit countries in the pandemic, through liberalization, importing Western notions of body instrumentality, demographic shift, and resultant social changes. Finally, the psychosocial strategies for positive body image ideas to prevent and mitigate the adverse effects of body dissatisfaction are discussed, particularly those that focus on cognitive behavioral techniques (CBTs) from the perspectives of positive psychology, media literacy programs, and involvement of the media. Interventions and further research to address body dissatisfaction among women, especially in the post-COVID aftermath, need to be a recognized as a public health goal.

Examining the Mediating Effects of Stress on Fear of COVID-19 and Well-being Using Structural Equation Modeling

This study focuses on the effects of fear factor due to COVID-19 on stress and well-being of college students in India. The authors conducted a cross-sectional survey among 625 Indian students across various Indian universities and structural equation modeling (SEM) has been performed for analyzing the data. The findings of the study show a positive effect of fear of COVID-19 on stress with β = .27, p < 0.05, and a negative effect on well-being (β = -.13, p < 0.05). The results also depicted the mediating role of stress between fear of COVID-19 and well-being. Therefore, it is suggested that measures must be taken by individuals, society, and policy makers to include mental health maintenance in the pandemic response activities. Further longitudinal studies in different geographical regions and demographics can provide a more generalized understanding of the relationship between the pandemic and mental health. The limitations, policy implications, and suggestions are discussed.

Change in Youth Mental Health During the COVID-19 Pandemic in a Majority Hispanic/Latinx US Sample

OBJECTIVE

Children and adolescents, individuals from racial and ethnic minority groups, and those with mental health conditions may be at greater risk for worsened mental health because of the COVID-19 pandemic. This study examined change in mental health from before to during the pandemic among predominantly Hispanic/Latinx adolescents.

METHOD

A total of 322 young adolescents (mean age = 11.99 years, 55% female and 45% male), with a racial/ethnic composition of 72.7% Hispanic/Latinx, 9.3% Black or African American, 5.9% multiple races, 5.0% Asian, 1.6% White, and 1.2% American Indian, completed a mental health screening measure prior to the COVID-19 pandemic and at 3 time-points beginning 1 month after COVID-19 stay-at-home measures were implemented. A subsample also completed a survey about their experience at home during COVID-19. Repeated-measures mixed analysis of covariance was used to evaluate change in each mental health domain, and whether youths who had elevated symptoms at baseline differed in their level of change, controlling for age and gender.

RESULTS

For youths who had elevated levels of mental health problems before the pandemic, symptoms were significantly reduced across domains during the pandemic. Reductions in internalizing, externalizing, and total problems were clinically significant. For other youths, there were statistically significant reductions in internalizing and total problems, and no change in attention or externalizing problems. Post hoc analyses revealed that better family functioning was consistently related to lower mental health symptoms in youths during COVID-19 follow-ups.

CONCLUSION

COVID-19 stay-at-home regulations may offer protective effects for youth mental health. Study results may be specific to this population of predominantly Hispanic/Latinx youths from a large city in the southwestern United States.

Psychosocial Framework of Resilience: Navigating Needs and Adversities During the Pandemic, A Qualitative Exploration in the Indian Frontline Physicians

INTRODUCTION

Frontline healthcare workers (HCW) have faced significant plight during the ongoing Coronavirus disease 2019 (COVID-19) pandemic. Studies have shown their vulnerabilities to depression, anxiety disorders, post-traumatic stress, and insomnia. In a developing country like India, with a rising caseload, resource limitations, and stigma, the adversities faced by the physicians are more significant. We attempted to hear their "voices" to understand their adversities and conceptualize their resilience framework.

METHODS

A qualitative approach was used with a constructivist paradigm. After an initial pilot, a socio-demographically heterogeneous population of 172 physicians working in COVID-designated centers were purposively sampled from all over India. Following in-depth virtual interviews using a pre-formed semi-structured guide, the data was transcribed and translated verbatim. The interview was focused on their challenges, needs, and processes of coping and support. Charmaz's grounded theory was used for analysis supplemented by NVivo 10 software.

RESULTS

Fear of infection, uncertainty, stigma, guilt, and social isolation emerged as the main challenges. Simultaneously, their "unmet needs" were flexible work policies, administrative measures for better medical protection, the sensitivity of media toward the image of HCW, effective risk communication for their health, and finally, social inclusion. Their resilience "framework" emerged as a process while navigating these adversities and consisted of three facets: forming a "resilient identity," managing the resilience, and working through the socio-occupational distress. The role of mental well-being, social network, peer support, problem negotiation, and self-care emerged as the key coping strategies.

CONCLUSION

The study findings support the global call for better psychosocial health and quality of life of the frontline HCWs. Their "unheard voices" explored in the study can anchor subsequent resilience-enhancing interventions and policies. Guidelines focusing on the psychological wellbeing of frontline HCWs need to be grounded in their unmet needs and lived experiences.

Creativity as a Means to Well-Being in Times of COVID-19 Pandemic: Results of a Cross-Cultural Study

The coronavirus disease 2019 (COVID-19) pandemic has brought about unprecedented uncertainty and challenges to the worldwide economy and people’s everyday life. Anecdotal and scientific evidence has documented the existence of a positive relationship between the experience of crisis and creativity. Though this appears to be ubiquitous, the crisis-creativity-well-being relationship has not been sufficiently examined across countries and using a working adult sample. The current study drew on a sample consisting of 1,420 employees from China (n = 489, 40% females), Germany (n = 599, 47% females), and the United States (n = 332, 43% females) to examine whether creativity can function as an effective means to cope with crisis and to achieve both flourishing and social well-being. Multivariate analyses showed that perceived impact of COVID-19 was positively related to creative process engagement, which was positively related to employees’ self-reported creative growth. Creative growth was associated with a higher level of flourishing well-being. This sequential mediation model was significant across the three samples. Creativity also mediated the relationship between perceived impact of COVID-19 and social well-being (social connectedness), but this connection was only found for the Chinese sample. Further data analyses revealed that individualism moderated this serial mediation model in that the positive coping effect of creativity on both flourishing and social well-being was stronger for individuals who hold more collectivistic views. Results of the study have implications for crisis management, personal development, and positive functioning of individuals and society.

Scanning the VIRUS: A study of dimensions of stress and coping with COVID-19

The current research examines the psychosocial stressors that Indians are facing as a result of the COVID-19 pandemic, using a self-constructed COVID-19 Stress Scale (CSS). It also assesses the coping strategies being used currently. The sample comprised of 1009 Indians ranging between 17 and 83 years. The items of the CSS were constructed based on a review of existing scales, expert evaluations, and participant interviews. The factor structure of COVID-19 Stress Scale (CSS) was examined through the use of an exploratory factor analysis. Several psychometric tests were conducted to ascertain its reliability and validity properties. Results suggest a five-factor structure: Vexation with Others, Immediate Concerns, Routine Disruption, Uncertainty about the Future, and Systemic stressors (abbreviated as VIRUS) explaining 55.269% of the total variance in COVID-19 stress. Coefficient alphas for the entire scale (0.90) and for each of the five factors, ranging from 0.69–0.85, indicate satisfactory internal consistency. One-way analysis of variance was done to assess the differences among emotion-focused, problem-solving, and seeking social support coping strategy. Correlations were calculated between various coping strategies and COVID-19 Stress. Results suggested that seeking social support was the most used coping strategy. No significant correlation was found between the use of any coping strategy and COVID-19 stress. The proposed VIRUS model adequately captures the stressful experience of COVID-19. COVID-19 Stress Scale (CSS), a 21-item scale has robust psychometric properties.

Mental Distress and Human Rights Violations During COVID-19: A Rapid Review of the Evidence Informing Rights, Mental Health Needs, and Public Policy Around Vulnerable Populations

Background: COVID-19 prevention and mitigation efforts were abrupt and challenging for most countries with the protracted lockdown straining socioeconomic activities. Marginalized groups and individuals are particularly vulnerable to adverse effects of the pandemic such as human rights abuses and violations which can lead to psychological distress. In this review, we focus on mental distress and disturbances that have emanated due to human rights restrictions and violations amidst the pandemic. We underscore how mental health is both directly impacted by the force of pandemic and by prevention and mitigation structures put in place to combat the disease. Methods: We conducted a review of relevant studies examining human rights violations in COVID-19 response, with a focus on vulnerable populations, and its association with mental health and psychological well-being. We searched PubMed and Embase databases for studies between December 2019 to July 2020. Three reviewers evaluated the eligibility criteria and extracted data. Results: Twenty-four studies were included in the systematic inquiry reporting on distress due to human rights violations. Unanimously, the studies found vulnerable populations to be at a high risk for mental distress. Limited mobility rights disproportionately harmed psychiatric patients, low-income individuals, and minorities who were at higher risk for self-harm and worsening mental health. Healthcare workers suffered negative mental health consequences due to stigma and lack of personal protective equipment and stigma. Other vulnerable groups such as the elderly, children, and refugees also experienced negative consequences. Conclusions: This review emphasizes the need to uphold human rights and address long term mental health needs of populations that have suffered disproportionately during the pandemic. Countries can embed a proactive psychosocial response to medical management as well as in existing prevention strategies. International human rights guidelines are useful in this direction but an emphasis should be placed on strengthening rights informed psychosocial response with specific strategies to enhance mental health in the long-term. We underscore that various fundamental human rights are interdependent and therefore undermining one leads to a poor impact on the others. We strongly recommend global efforts toward focusing both on minimizing fatalities, protecting human rights, and promoting long term mental well-being.

The "Labeled" Side of COVID-19 in India: Psychosocial Perspectives on Islamophobia During the Pandemic

The Coronavirus disease 2019 (COVID-19) has emerged as a global public health threat over the last few months. Historically, infectious disease outbreaks like the plague, Influenza, cholera, HIV, etc. have generated stigma, prejudice, "othering" and xenophobia, against certain communities. One such prevalent form of xenophobia, is Islamophobia or "fear and discrimination against the Muslims." Though debated over its various facets and definitions, it is on the rise worldwide. India, being a socio-politically diverse and populous nation, has been facing unique challenges during COVID-19. Considering Hinduism and Islam are the two major religious communities, the subcontinent has witnessed complex dynamics in their relationship throughout history. The pandemic has further instigated Islamophobia, and consequent discrimination, as well as unrest. This can have significant effect of public behavior and health. In the recent past, few legislations in India were interpreted to be Islamophobic and generated nation-wide protest, which provided a fertile backdrop against the discriminative effects of the pandemic. Keeping this in background, this commentary highlights the social contexts of increase in Islamophobia in India during the pandemic, discusses the possible psychological explanations and public health impact, as well as outlines some ways to mitigate it focusing on collectivism.