Culture Related Factors May Shape Coping During Pandemics

Coping Strategies Among Adolescents During the COVID-19 Pandemic: A Cross-Cultural Exploration

PURPOSE

To identify the patterns of stressors associated with the COVID-19 pandemic among adolescents living in different cultural settings and to explore how adolescents cope with such stressors, particularly by type of stressor, site, and gender.

METHODS

The study was based on focus group discussion data from 9 urban poor communities in Kinshasa (Democratic Republic of Congo), Blantyre (Malawi), Shanghai (China), Semarang and Denpasar (Indonesia), New Orleans (USA), Ghent (Belgium), São Paulo (Brazil), and Santiago (Chile). Translated transcripts from the focus group discussions were uploaded into ATLAS.ti (Version 9.1) and analyzed using an inductive thematic analytical approach to code and identify themes related to the primary objectives.

RESULTS

Adolescents in Blantyre and Kinshasa reported stressors primarily related to economic constraints and hardships, whereas adolescents in other sites were more likely to report stressors related to school lockdowns. Patterns of coping strategies also loosely aligned with these differences, as adolescents in Blantyre and Kinshasa were also more likely to report using religious coping strategies compared to any other site. Still, the most common coping mechanism mentioned across sites was obtaining social support, with support from friends and family being the most dominant.

DISCUSSION

A comprehensive understanding of adolescent stressors and coping mechanisms is valuable for promoting internal resources and positive outcomes for adolescents. Given that adolescents' stressors and types of coping strategies varied primarily by socioeconomic factors, interventions that aim to bolster positive coping among adolescents need to consider the local context and available resources.

Personality factors and pandemic-related behaviors

Purpose

The purpose of the current study was to determine whether there are personality differences (the HEXACO model, narcissism, sadism, compassion for others) in mask-wearing, social distancing, and hoarding.

Findings

Those who always wore masks were significantly higher in compassion for others and significantly lower in sadism compared to those who did not always wear masks. Those who always socially distanced (compared to those who did not) were significantly higher in openness, compassion for others, and conscientiousness. Those who hoarded were significantly lower in agreeableness than those who did not hoard.

Conclusion

Perhaps physicians may use information to boost states of altruistic-type traits (agreeableness, compassion for others) while educating patients during visits in order to increase the likelihood of receiving vaccinations or booster shots.

Sociocultural predictors of immigrant adjustment and well-being

Introduction

Research shows that culture change may pose risks to immigrant wellbeing. Our study examined adult Georgians (N = 431) residing in Greece, Italy, and Germany, and explored associations between their demographic characteristics, sociocultural adjustment, and psychological well-being outcomes.

Methods

Conducted via electronic self-report survey, the cross-sectional study measured participants' levels of sociocultural adjustment, psychological adjustment, and depression along with the willingness to interact with host nationals, perceived sense of discrimination, history of being undocumented, age and length of relocation, and fluency in host language. The study also examined differences in three subsamples from the standpoint of intercultural distance. Sociocultural Adjustment Scale, Brief Psychological Adaptation Scale, Center for Epidemiologic Studies Depression Scale and Host Interaction Scale were used to measure the corresponding variables. Perceived history of discrimination was measured by a Likert-scale question about discrimination in a host country. Intercultural distance was established by Hofstede cultural compass and was estimated to be the smallest with Greece and the largest with Germany.

Results

Depression was positively predicted by histories of discrimination and illegal immigration, host language fluency upon relocation, and was negatively predicted by sociocultural adjustment. Psychological adjustment was positively predicted by sociocultural adjustment, willingness to interact with host nationals, and ongoing language fluency, while perceived sense of discrimination, age, and poor financial state acted as negative predictors. Finally, sociocultural adjustment acted as the strongest determinant of wellbeing predicting both lower depression and higher psychological adjustment.

Discussion

Our findings suggested that adjustment in diverse sociocultural domains was the most critical for the immigrants' psychological well-being along with the lack of perceived discrimination. Additional factors associated with the better adaptation outcomes included younger age, willingness to interact with host nationals, language fluency, better financial standing and no history of being undocumented. The results also indicated that host language proficiency upon relocation may contribute to migrant susceptibility, whereas intercultural distance may be overshadowed in importance by acculturation conditions. The findings illustrate the complexity of migration and culture change and point to the superiority of wholistic policies and practices in promoting smooth transition of immigrant populations.

Inspired in Adversity: How Inspiration Mediates the Effects of Emotions on Coping Strategies

Purpose

Inspiration is a psychological construct that has been relatively understudied in times of difficulty. This study aims to investigate the mediating effect of inspiration on the relationship between emotions and coping strategies in the context of adversity and to testify the effect in Chinese as well as the International societies.

Participants and Methods

Using the snowball sampling method, two survey studies were conducted among 523 Chinese and 503 international participants during and soon after the local Covid-19 outbreak to testify how positive and negative emotions contributed to various coping strategies and whether the experience of inspiration mediated these relations. Structural equation modeling (SEM) was used to analyze the data.

Results

Positive emotions had a higher impact on problem-solving and seeking social support coping strategies, whereas negative emotions had a higher impact on avoidance coping strategy. Both positive and negative emotions had positive relationships with inspiration, but positive emotions had a higher impact than negative ones. The indirect effects of emotions on problem-solving and social support coping strategies through inspiration were significantly positive, while the avoidance coping strategy was not influenced by the experience of inspiration.

Conclusion

The results suggest that being inspired in both positive and negative emotions is positively related to approach coping strategies in adverse situations such as COVID-19, with the effect patterns slightly differing between Chinese participants and their Western counterparts. This study highlights the importance of inspiration experience as a motivational state that can help individuals bring newly acquired ideas into fruition, especially during times of difficulty. By understanding the role of inspiration in the context of adversity, public health systems can better assist individuals in different societies to cope with the challenges they face.

The mediating role of anxiety and depression in the relationship between coping styles and life satisfaction among frontline medical workers during the COVID-19 pandemic: A cross-sectional study

This study aimed to examine the mediating role of anxiety and depression in the relationship between coping styles and life satisfaction among frontline medical workers during the COVID-19 pandemic. Five hundred and fourteen frontline medical workers from Zunyi were recruited to complete questionnaires, including the Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), Satisfaction with Life Scale (SWLS), and Simplified Coping Style Questionnaire (SCSQ). SPSS 24.0 was used to measure the characteristics of anxiety, depression, life satisfaction, and coping styles. We found that the prevalence rates of anxiety and depression among study participants were 22.57% and 18.29%, respectively. Besides, anxiety was positively correlated with depression; anxiety and depression were positively correlated with passive coping style but negatively correlated with life satisfaction and active coping style; life satisfaction was positively correlated with active coping style and negatively correlated with passive coping style (all p < 0.001). Moreover, anxiety and depression mediated the relationship between coping styles and life satisfaction. Anxiety accounted for 18.6% of the effect of active coping style and 35.48% of the effect of passive coping style on life satisfaction. Depression accounted for 48.84% of the effect of active coping style and 67.74% of the effect of passive coping style on life satisfaction. The present study provides novel insights into the effect of subclinical anxiety and depression on frontline medical workers in the pandemic area. Anxiety and depression yielded a mediating effect on the relationship between coping styles and life satisfaction.

The impact of COVID-19 pandemic on depression and anxiety symptoms: Findings from the United Arab Emirates Healthy Future (UAEHFS) cohort study

BACKGROUND

Significant concerns about mental health were raised during the COVID-19 pandemic. We investigated the prevalence of depression and anxiety symptoms among the participants of the United Arab Emirates Healthy Future Study (UAEHFS); a national cohort study. We further explored the change in the prevalence of depression symptoms among those with comparable pre-pandemic data.

METHODS

A sample of UAEHFS participants were invited to complete a COVID-19 online questionnaire during the first wave of the pandemic. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire Depression Scale (PHQ-8) and the Generalized Anxiety Disorder-7 Scale (GAD-7) respectively. Unpaired analyses were done to examine the effect of COVID-19 on depression and anxiety symptoms during the pandemic. Paired analysis was conducted to examine the change in depression symptoms.

RESULTS

During the pandemic, we reported a prevalence of 32.8% (95% CI: 27.0, 39.1) for depression and 26.4% (95% CI: 21.0, 32.6) for anxiety symptoms. Younger people reported higher levels of depression (40.4%) and anxiety (34.5%) symptoms. Females reported higher levels of depression (36.5%) and anxiety (32.7%) symptoms. In paired analysis, the prevalence of depression symptoms during the pandemic was 34% (95% CI: 26.5, 42.4) compared to 29.9% (95% CI: 22.7, 38.1) before the pandemic. No statistically significant difference was observed, p-value = 0.440. Adjusted multivariate logistic regression models for PHQ-8 and GAD-7 during the pandemic showed that participants, who were experiencing flu-like symptoms, had higher odds of reporting depression symptoms compared to those without symptoms. Additionally, age was significantly negatively associated with anxiety symptoms.

CONCLUSIONS

Overall, we found that depression and anxiety symptoms were more prevalent among young people and females. However, we did not find a significant change in the prevalence of depression symptoms among those with comparable pre-pandemic data. Identifying vulnerable groups and understanding trajectories through longitudinal studies would help with planning for effective mental health interventions for the current and future pandemics.

How culture orientation influences the COVID-19 pandemic: An empirical analysis

Purpose

This study aims to investigate the mediational path of the influence of cultural orientation on the COVID-19 pandemic outcome at the national level and find out whether some culture-related factors can have a moderating effect on the influence of culture.

Methodology

Cultural dimension theory of Hofstede is used to quantify the degree of each dimension of culture orientation. The cross-section regression model is adopted to test if culture orientations affect the pandemic outcome, controlling for democracy, economy, education, population, age, and time. Then, a mediational analysis is conducted to examine if policy response is the mediator that culture makes an impact on the pandemic outcome. Finally, a moderation analysis is carried out to determine how each control variable has moderated the influence.

Findings

The cross-section regression results showed that culture orientation influences the outcome of the COVID-19 pandemic at the 99% confidence level and that among the six cultural dimensions, collectivism-individualism has the most significant impact. It has also been found that policy response is the mediator of cultural influence, and culture-related factors can moderate the influence.

Contribution

The contribution of this research lies in developing the assertion that culture influences pandemic outcomes. Our findings indicate that collectivism-individualism culture orientation affects the effectiveness of epidemic controls the most among the six culture dimensions. Additionally, our research is the first to study the mediating effect of policy responses and the moderating effect of culture-related factors on the influence of cultural orientation on the pandemic outcome.

Validity and Reliability of Cultural Mix Coping Inventory for Stressful Situations among Healthcare Professionals in Ghana Amidst COVID-19

The Cultural Mix Coping Inventory for Stressful Situations is one of the recent coping measures developed to overcome the weaknesses of existing coping scales. Since its development and validation, the inventory has been used by previous studies to measure coping among teachers and students in stressful situations. Health professionals are workers who typically encounter stressful situations due to their work demands. In this study, we assessed the validity and reliability of cultural mix inventory for stressful situations among healthcare professionals in Ghana. The research was guided by three major objectives: (1) to assess the factor structure of the cultural mix coping inventory, (2) to evaluate the construct validity and reliability of the cultural mix coping inventory based on internal structure and (3) to test for evidence of criterion validity based on the external structure of the measure. Approximately 312 health workers were purposefully sampled to participate in the study. The study confirmed the original four-factor solution of the coping inventory with evidence of the construct validity based on the internal structure. Validity evidence based on the external structure of the measure was found to be sufficient. Given the COVID-19 pandemic and coupled with the stressful nature in the line of duty of healthcare professionals, this inventory provides a useful and sound measure of coping options among this cohort.

Anxiety, Worry, Life Satisfaction and Coping During the Acute VS Prolonged Pandemic Stress: Evidence From a Repeated Cross-Sectional Study

Objectives: The COVID-19 pandemic remains a continuous stressor worldwide. Our study aimed at comparing the data of waves from two lockdowns in Georgia, one in the acute stress phase (May 2020) and the other in the prolonged stress phase (December 2020).

Methods: In total, 750 and 716 individuals participated in the study with a repeated cross-sectional design. Sample equivalence was reached via controlling demographic variables. Anxiety, COVID-19 worry, and life satisfaction were measured along with coping behaviors and four coping styles—information-accessing/processing and action-planning (two problem-focused coping styles), and passive-submissive and avoidant (two emotion-focused coping styles).

Results: As pandemic prolonged, mental health indicators worsened, the action-planning style and behavioral coping decreased, while the information-accessing/processing style increased. The link between the COVID-19 worry and the action-planning coping style was strong in the acute stage and dissapeared in the prolonged stage. The individual context, namely, a history of coronavirus in the household, accounted for lower protective behaviors and higher information seeking in the prolonged phase.

Conclusion: The findings highlighted the importance of timing and general and individual contexts in coping with the pandemic.

The Contributions of Pandemic Severity, Government Stringency, Cultural Values and Internet Usage to Post-traumatic Stress Disorder During the COVID-19 Pandemic: An Analysis of Data From 35 Countries

Emergent symptoms of post-traumatic stress disorder (PTSD) have been frequently reported in the context of the COVID-19 pandemic, and may affect up to 17-18% of individuals. There is preliminary evidence that pandemic severity, cultural values, restrictions imposed by governments, and Internet usage may all influence the emergence of PTSD symptomatology. In this study, possible linear- and non-linear associations between these factors and the prevalence of PTSD symptoms across 35 countries were examined based on data from existing research. Evidence was found for a positive logarithmic relationship between the COVID-19 case-fatality ratio and PTSD (p = 0.046), a positive logarithmic relationship between power distance and PTSD (p = 0.047), and a trend toward a negative quadratic association with Internet usage (p = 0.051). No significant cross-national effect was observed for government restrictiveness. These findings suggest that strategies aimed at minimizing COVID-19 deaths, and at ensuring equitable access to essential resources, may be of use in reducing the emergence of PTSD symptoms at a population level during this pandemic.

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.

Typologies of stress appraisal and problem-focused coping: associations with compliance with public health recommendations during the COVID-19 pandemic

BACKGROUND

Given prior research finding that young adults are less likely to engage in recommended public health behaviors (PHBs) than older adults, understanding who is and is not likely to engage in PHBs among young adults is crucial to mitigating the effects of the COVID-19 pandemic. Drawing on the Transactional Theory of Stress and Coping, this study examined how typologies of stress appraisal (SA) and problem-focused coping (PFC) among young adults were associated with compliance with public health recommendations during the pandemic.

METHODS

An online sample of young adults in the United States, ages 18-35, was recruited during the early phase of the pandemic (April-May 2020). Participants reported their appraisals of how central, threatening, and uncontrollable the pandemic was, their tendencies to engage in instrumental, problem-focused coping strategies, and how frequently they engaged in three recommended PHBs (social distancing, mask wearing, and hand washing).

RESULTS

Using latent class analysis, we identified three classes of individuals: Low-SA/Low-PFC, Low-SA/High-PFC, and High-SA/High-PFC. Demographics did not efficiently distinguish membership in the three classes. The former two classes reported less compliance with public health recommendations than did the latter class. Tests of measurement invariance for gender indicated trivial differences in the composition of class membership and relations to compliance.

CONCLUSIONS

This research uncovered three qualitatively distinct classes of people who differed in their appraisal of the pandemic and their tendency to engage in PFC. Individuals who view the pandemic as central and threatening and engage in problem-focused coping were more likely than their peers to comply with guidelines recommending social distancing, mask wearing, and hand washing. These results contribute to our understanding of why people do and do not comply with public health guidelines and highlight the importance of attending to psychological variables in public health research. Understanding what drives poor compliance with public health recommendations can contribute to efforts promoting better compliance, and ultimately better health outcomes.

The Depression Anxiety Stress Scale 8-Items Expresses Robust Psychometric Properties as an Ideal Shorter Version of the Depression Anxiety Stress Scale 21 Among Healthy Respondents From Three Continents

To examine the cultural limitations and implications in the applicability of the Depression Anxiety Stress Scale 8-items (DASS-8)-a shortened version of the DASS-21 recently introduced in an Arab sample-this study evaluated its psychometric properties, including measurement invariance, among healthy subjects from the United States, Australia, and Ghana. Confirmatory factor analysis revealed good fit of the DASS-8 relative to a 12-item version (DASS-12). Both the DASS-8 and the DASS-12 were invariant at all levels across genders, employment status, and students vs. non-students. The DASS-8/DASS-12 also expressed invariance at the configural and metric levels across all countries, albeit scalar invariance was not maintained due to misspecification of the factor loadings in the Ghanian sample. Mann-Whitney U test revealed significantly lower levels of mental symptomatology on the DASS measures among Ghanian students than in English-speaking respondents (both students and non-students). The DASS-8 expressed excellent internal consistency (coefficient alpha = 0.89), good convergent validity-noted by high values of item-total correlations (r = 0.87 to 0.88), good predictive validity-indicated by significantly strong correlation with the DASS-21 and its subscales (r = 0.95 to 0.80), and adequate discriminant validity-indicated by heterotrait-monotrait ratio of correlations <0.85. The DASS-8 correlated with the Internet Gaming Disorder-9, the Adult attention-deficit/hyperactivity disorder Self-Report Scale, and the Individualism and Collectivism Scale/Culture Orientation Scale at the same level as the DASS-21 and the DASS-12, denoting its adequate criterion validity. The DASS-8 can be used as a brief alternative to the DASS-21 to screen for mental symptomatology in English-speaking and African cultures. However, the same scores on the DASS-8 and the DASS-12 may not always indicate the same level of symptom severity in subjects from different countries. Further inter-cultural evaluations of the DASS-8 are needed.

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.