Post-traumatic Growth in the First COVID Outbreak in Hong Kong

Posttraumatic growth modulates the response to negative emotions related to COVID-19: An event-related potentials study

There is increasing interest in identifying how posttraumatic growth (PTG) impacts emotional processing following traumatic events (e.g., the COVID-19 pandemic). Previous research suggests that high PTG levels may lead to enduring changes in positive emotional processing. Despite this fact, little is known regarding brain activation and responses to stressful emotional stimuli. The present study utilised event-related potentials (ERPs) to investigate whether individual differences in emotional responses toward neutral and negative emotional stimuli related to COVID-19 are related to self-reported PTG levels. A total of 77 participants were analysed: 21 in the high PTG group and 56 in the control group. The amplitude of the N2 was smaller in the high PTG group compared to the control group under both negative and neutral conditions. When viewing the negative emotion pictures (vs. neutral pictures), the N2 amplitude significantly decreased for the high PTG group in the right occipital and frontal-parietal areas, whereas no significant change was observed among the control group. In the time window Late Positive Potential (LPP) 600-1000 ms, emotional stimuli and the group interaction were significant. Viewing negative pictures (vs. neutral pictures) decreased the LPP 600-1000 ms amplitudes for the control group, mainly originating from the brain's frontal regions. However, there were no such significant differences for the PTG group. Due to the limited sample size and cultural differences, the applicability of these results to other regions or countries needs to be verified. The presented findings suggest that the impact of PTG during emotional response is reflected in both bottom-up (evidenced by the early ERP components) and top-down (evidenced by the later ERP components) processes. Individuals with high PTG may use a meditation-related emotional regulation strategy of acceptance at the basic stage and non-judgement at a later stage.

Factors Associated with Post-Traumatic Growth during the COVID-19 Pandemic: A Systematic Review

The COVID-19 pandemic was an unprecedented event that further stimulated the debate on the concept of trauma. To increase knowledge about the traumatic potential of the pandemic, the main objective of this study was to identify, through a systematic literature review, the main factors associated with the adaptive outcome of post-traumatic growth caused by COVID-19. Studies were selected from the PsychInfo, Embase, and PubMed databases, and 29 articles were included at the end of the screening process. The identified factors are of different natures, including personal variables such as personality traits, coping, and cognitive strategies used to face adversity, and interpersonal variables, one of the most important of which is the level of social support. In addition, several results confirmed a relationship between post-traumatic growth and post-traumatic stress symptoms, as well as indices related to psychological well-being. Finally, the results are discussed by comparing them with those already present in the literature, as well as with some of the main explanatory models of post-traumatic growth. In this regard, some of the factors identified, such as maladaptive coping, avoidance symptoms, optimism, and low-stress tolerance, suggest the possibility that the process of post-traumatic growth may also be characterized by an illusory dimension.

Hope, optimism, and pessimism as predictors of positive and negative psychological changes related to the COVID-19 pandemic in Slovak adults

Background and objectives

Positive and negative changes in outlook represent psychological changes that are the results of the cognitive processing of stressful and traumatic events by an individual. The objectives of the study were (1) to determine the level of occurrence and types of positive and negative changes in connection with the COVID-19 pandemic among adults in Slovakia and (2) to study the role of personality factors such as hope (dispositional and perceived) and life orientation (optimism and pessimism) in the prediction of positive and negative changes in adults during the fourth pandemic wave.

Methods

A Short Form of the Changes in Outlook Questionnaire (CiOQ-S), the Dispositional Hope Scale (DHS), the Perceived Hope Scale (PHS), and the Life Orientation Test (LOT-R) were administered. The research sample consisted of 102 participants, whose ages ranged from 20 to 65 years (Mage = 38.90, SD = 14.28). The research design was quantitative, exploratory, and confirmatory.

Results

In total, 95% of participants reported positive changes related to COVID-19. Concurrently, up to 70% of these participants also reported negative changes from the impact of the pandemic. Only 25% of participants reported positive changes without noticing any negative perception of the consequences of the pandemic. Overall, 68% of participants reported negative changes related to COVID-19. Only 29% of participants reported negative changes without noticing any positive perception of the consequences of the pandemic. In total, up to 86% of participants agreed with experienced psychological changes (positive or negative) as a result of the COVID-19 pandemic. The high prevalence of positive changes along with the relatively high prevalence of negative changes related to the COVID-19 pandemic outline the question of whether reported positive changes represent real or illusory growth. Optimism and pessimism were found to be significant independent predictors of positive changes related to the COVID-19 pandemic. Hope was identified as a significant independent predictor of negative changes related to the COVID-19 pandemic.

Protecting healthcare workers' mental health against COVID-19-related stress: The effects of stress mindset and psychological resilience

Healthcare workers have been on the frontline of the battle against COVID-19 disease. However, this has taken a toll on them, resulting in elevated stress and poor mental health. We argue that healthcare workers' stress mindset and resilience could mitigate negative outcomes of COVID-19-related stress by helping them view this stressful situation in a more positive light and appraise it as a challenge rather than a threat. Accordingly, we hypothesized that both a stress-is-enhancing mindset about COVID-19-related stress and resilience would improve healthcare workers' appraisal of their personal resources and increase their challenge appraisals, positively contributing to their mental health. We collected data from 160 healthcare workers and performed structural equation modeling for hypothesis testing. The results indicate that both a stress-is-enhancing mindset about COVID-19-related stress and psychological resilience are indirectly related to better mental well-being and lower health-related anxiety through challenge appraisals. This study contributes to research in mental health by suggesting that protecting and promoting healthcare workers' mental health is possible by empowering them through increasing personal resources such as a positive mindset about stressful situations and resilience.

Stigma and posttraumatic growth among COVID-19 survivors during the first wave of the COVID-19 pandemic in Malaysia: a multicenter cross-sectional study

Background

Contracting COVID-19 can cause negative and distressing psychological sequelae, but traumatic stressors may also facilitate the development of positive psychological change beyond an individual's previous level of adaptation, known as posttraumatic growth (PTG). As a result, studies have investigated the negative effects of COVID-19 on mental health, but data on PTG among patients who have recovered from COVID-19 remains limited. This study aims to evaluate the level of PTG and its associations with stigma, psychological complications, and sociodemographic factors among COVID-19 patients 6 months post-hospitalization.

Method

A cross-sectional online survey of 152 COVID-19 patients was conducted after 6 months of being discharged from Hospital Canselor Tuanku Muhriz, MAEPS Quarantine Center, or Hospital Sungai Buloh, Malaysia. Patients completed a set of questionnaires on sociodemographic and clinical data. The Posttraumatic Growth Inventory (PTGI-SF) was used to assess the level of PTG, the Kessler Psychological Distress (K6) was used to measure the degree of psychological distress, the General Anxiety Disorder-7 (GAD-7) was used to evaluate the severity of anxiety symptoms, the Patient Health Questionnaire (PHQ-9) was used to assess the severity of depression symptoms, and the Explanatory Model Interview Catalog Stigma Scale (EMIC-SS) was used to record the degree of perceived stigma toward COVID-19.

Results

The median PTGI SF score of the respondents was 40.0 (Interquartile range 16.0). Multivariable general linear model with bootstrapping (2,000 replications) revealed factors that significantly predicted PTG, which were at the higher level of the perceived stigma score, at 37 (B = 0.367, 95% CI = 0.041 to 0.691, p = 0.026), among the Malay ethnicity (B = 12.767, 95% CI 38 = 7.541 to 17.993, p < 0.001), retirees (B = -12.060, 95% CI = -21.310 to -2.811, p = 0.011), and those with a history of medical illness (B = 4.971, 95% CI = 0.096 to 9.845, p = 0.046).

Conclusion

Experiencing stigma contributed to patients' PTG in addition to psychosocial factors such as ethnicity, history of medical illness, and retirement.

Post Traumatic Growth (PTG) in the Frame of Traumatic Experiences

The psychopathological consequences of traumatic experiences have been object of study from the beginning of medical science. During the last centuries, the scientific literature in the field of mental health mainly focused on the negative consequences of traumatic events. More recently, increasing interest was paid to the features of resilience and to the possible positive consequences of trauma, leading to the concept of Post Traumatic Growth (PTG). However, the eventual co-existence of both the conditions should also be considered. The role of vulnerability and environmental factors in the balance between positive and negative outcomes after life events is discussed, particularly in light of a neurodevelopmental approach to psychopathology.

Prediction of post-traumatic growth in the face of the COVID-19 crisis based on resilience, post-traumatic stress and social participation: A longitudinal study

The COVID-19 crisis has generated a severe and negative psychological impact worldwide. Despite this, it is also possible to experience post-traumatic growth (PTG). This study aimed to longitudinally explore the prevalence of PTG in the Spanish population and test a predictive model for PTG from resilience, post-traumatic stress symptoms (PTSS), and participation in social activities. Data were collected longitudinally in March, July, and November 2020 via an online survey. About 20% of the sample showed moderate-high levels of PTG, with no significant differences over time. The predictive model explained 19% of the variance in PTG, showing that the inverse relation between resilience and PTG was mediated by PTSS. Additionally, participation in social activities acted as a predictor of PTG. Women, young people, those who had lost their job and people who had experienced COVID-19 symptoms or the loss of a loved one presented higher PTG. Thus, people have experienced positive changes (PTG), but these did not protect them from adverse symptomatology (PTSS).

Cultivating a Healthy Living Environment for Adolescents in the Post-COVID Era in Hong Kong: Exploring Youth Health Needs

Studies have shown that adolescents now have a higher exposure to health risks than those in the past, and Hong Kong adolescents are no exception, particularly with the social crisis in 2019 and then the COVID-19 pandemic in 2020. Data from health care services for children and adolescents only represent the tip of the clinical iceberg, and health profiles, including living habits, lifestyles, data on health status, and health service utilization, are not always readily available for effective planning to cultivate a healthy living environment. In this paper, an exploratory study on secondary school students was conducted in one district of Hong Kong that has the potential and resources to become a healthy city. Students were found to have a high prevalence of poor sleep quality and quantity; excess screen time; physical inactivity; an insufficient intake of healthy food; emotional disturbance, including symptoms of post-traumatic stress disorders (PTSDs); and irregular attendance to student health services. A multivariate analysis showed that excessive time on social media websites, short sleeping hours, symptoms of PTSD, and a lack of regular exercise were independently associated with emotional distress. Youth service providers should re-orientate student health services, moving away from routine services to be more outreaching in order to cultivate a supportive living and learning environment, promoting better health for adolescents.

COVID-19 pandemic-related posttraumatic growth in a small cohort of university students: A 1-year longitudinal study

The COVID-19 pandemic has affected all areas of life, with severe potential consequences for people's mental health. Posttraumatic growth (PTG), a positive psychological change that may develop following a traumatic event, in light of the COVID-19 pandemic has only received little attention. The current study aimed to investigate (1) the prevalence of PTG within the context of the COVID-19 pandemic and (2) which psychological aspects predict COVID-19 pandemic-related PTG using a 1-year longitudinal design. A sample of 70 participants completed a survey on COVID-19, posttraumatic stress, emotional well-being, coping styles, determinates of resilience, and PTG at both T1, May 2020, and T2, May 2021. Results reveal moderate levels of PTG for about one in five participants at both T1 and T2 (21% and 23%, respectively). Moreover, PTG at T1 and T2 were moderate to strongly, positively correlated, r = 0.62. Posttraumatic stress and social support were found to positively predict PTG at T1, while positive affect and social skills were found to positively predict PTG at both T1 and T2, βs = 0.22-.52. Implications of the current findings and suggestions for future research are discussed.

Entrepreneurial Resilience: A Case Study on University Students

Entrepreneurial resilience refers to the capacity to face, overcome and project oneself after suffering life events with a negative impact. Emerging adulthood and the characteristics of university life facilitate the occurrence of stressful situations that can affect well-being. The aim of this phenomenological research is to explore the strategic components of entrepreneurial resilience and how young university students have shaped their entrepreneurial resilience after experiencing negative life events. The present research is a multiple case study that was developed through a mixed methodology. The methodological sequence was quantitative and qualitative, with priority given to the qualitative phase of the research. Ten university students with high levels of resilience were interviewed. The data were analysed using thematic analysis. The results indicate that resilience is built through intrapersonal and exopersonal processes. These processes make up a set of strategic dimensions related to entrepreneurial behaviour that are used for the construction of personal projects.

Mental Health Screening of Healthcare Professionals Who Are Candidates for Psychological Assistance during the COVID-19 Pandemic

Healthcare professionals (HCPs) are among those most affected by the COVID-19 health emergency, with many presenting symptoms of anxiety and depression. Research shows that one of the factors involved in mitigating the impact of stressful situations is the use of cognitive emotional regulation mechanisms. The aims of this study were (a) to describe the functional and dysfunctional cognitive emotional regulation mechanisms (FRMs and DRMs) by gender, (b) to screen the main group of healthcare professionals who are candidates to receive psychological assistance based on FRMs and DRMs, and (c) to determine the HCP profile of candidates for psychological assistance. A cross-sectional descriptive study was conducted. Data were obtained from an adhoc questionnaire-the Cognitive Emotional Regulation Questionnaire (CERQ-18), the Generalized Anxiety Disorder scale (GAD-7), and the nine-item Patient Health Questionnaire (PHQ-9). The representative sample comprised 1452 HCPs. The results revealed significant differences between men and women in the use of DRMs. Women showed a higher use of catastrophizing (≤0.001) and rumination (0.008). The screening procedure detected that 7.5% (109 cases) of the HCPs were candidates to receive psychological support. According to the results of this study, age group (30-39 years old), professional activity (being a nurse or nursing assistant), and having psychological symptoms of anxiety and depression are variables that independently increase the probability of requiring psychological assistance. The gender variable was not found to be an independent factor when it comes to receiving psychological support. In conclusion, it is necessary to consider the influence of cognitive emotional regulation strategies employed by HCPs in the screening of candidates for psychological assistance and design effective interventions to reverse the emotional distress caused by COVID-19.