Stress of COVID-19, Anxiety, Economic Insecurity, and Mental Health Literacy: A Structural Equation Modeling Approach

Modifiable predictors of mental health literacy in the educational context: a systematic review and meta-analysis

Mental health literacy is vital for well-being in educational settings, extending beyond academics to include social and emotional development. It empowers individuals, allowing them to recognize and address their mental health needs and provide essential support to their peers. Despite the acknowledged importance of modifiable factors, there is a noticeable research gap in those amenable to change through educational interventions. Thus, this systematic review aims to identify potentially modifiable predictors of mental health literacy in the educational context. A systematic search was conducted for quantitative studies published between 2019 and October 2023 using several databases following PRISMA guidelines. Studies needed to focus on potentially modifiable predictors of mental health literacy in the educational context. Study quality was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS tool). In total, 3747 titles and abstracts were screened, 60 articles were assessed in full-text screening, and 21 were included in the review. Significant correlations between mental health literacy and modifiable predictors, including stigma toward professional help, self-efficacy, attitudes toward help-seeking, social support, positive psychological states, receiving mental health training, and psychological distress, were identified. By addressing these factors, educational institutions can cultivate community's adept in mental health, fostering an environment marked by empathy, understanding, and proactive engagement in addressing mental health issues. The implications serve as a foundation for future research, policy development, and implementing of practical strategies to enhance mental health literacy in diverse educational settings.

Role of self-esteem and personal mastery on the association between social support and resilience among COVID-19 long haulers

Although the COVID-19 mortality rate is declining, the number of individuals dealing with persistent COVID-19 symptoms is increasing worldwide, making long COVID a global public health concern. People with long COVID (long haulers) often deal with physical and mental stressors. Long haulers' psychological resilience could play a key role in coping with these stressors in intercorrelation with psychosocial resources. The current study aims to test a hypothesized relationship between social support and its functions (i.e., instrumental and emotional) and the resilience of long haulers through serial mediation by personal mastery and self-esteem. A cross-sectional and self-administered online survey was conducted among 460 individuals with long COVID recruited from COVID-19 Facebook support groups in the United States. Analyzing data indicated a positive correlation between social support and the resilience of long haulers. Structural equation modeling suggested that self-esteem and personal mastery fully mediated the association between social (instrumental) support and resilience. Personal mastery also mediated the association between self-esteem and resilience in social (instrumental) support models. However, in the emotional support model, the indirect effect was non-significant for the mediation by personal mastery and self-esteem. Findings suggest that social support, mainly instrumental support, may protect long haulers by promoting their resilience through self-esteem and personal mastery. This study emphasizes the importance of including social support services in designing programs for COVID-19 long haulers.

The relationship between COVID-19 stress and test anxiety in art students: the chain mediating roles of intolerance of uncertainty and sleep quality

BACKGROUND

The global spread of COVID-19 has brought immense physiological and psychological distress to students, such as test anxiety and poor sleep quality. This study aims to explore the relationship between COVID-19 stress and test anxiety and the mediating roles of intolerance of uncertainty and sleep quality between them.

METHODS

A study was conducted in China during the late stage of the pandemic. A total of 936 Chinese art students (age M = 18.51, SD = 2.11, 46.6% female) completed the Coronavirus Stress Measure (CSM), the 12-item Intolerance of Uncertainty (IUS-12), the Brief Version of the Pittsburgh Sleep Quality Index (B-PSQI), and the Test Anxiety Inventory (TAI). A chain mediation model analysis was conducted to examine the mediating effects of intolerance of uncertainty and sleep quality on the association with COVID-19 stress and test anxiety.

RESULTS

COVID-19 stress was positively associated with test anxiety (β = 0.50, p < 0.001). The intolerance of uncertainty and sleep quality partially and serially mediated the relationship between COVID-19 stress and test anxiety (β = 0.01, 95% CI = 0.01 to 0.02).

CONCLUSION

These findings suggest that art students' intolerance of uncertainty and sleep quality partially and serially mediate the relation between COVID-19 stress and test anxiety. The results have significant implications for the intervention and prevention of test anxiety, providing additional evidence for the relationship between COVID-19 stress and test anxiety.

The relationship between autistic traits and the stress of social isolation: Development of an explanatory model

Background

Social isolation can be particularly challenging for individuals with high autistic traits who struggle with social interactions. The COVID-19 pandemic led to increased isolation, exacerbating stress for those who may have difficulty in connecting with others. This study aimed to explore the relationship between autistic traits and stress associated with social isolation.

Methods

A sample of 1597 Chinese adults completed measures of autistic traits, the stress of social isolation, psychological inflexibility and core self-evaluation, during an epidemic prevention and control period of COVID-19 in Chongqing, China. Measures included the Autism-Spectrum Quotient, Coronavirus Stress Measure, Acceptance and Action Questionnaire-II, and Core Self-Evaluation Scale.

Results

Autistic traits were positively correlated with the stress of social isolation, which was mediated by the chain effect of core self-evaluation and psychological inflexibility. individuals with high autistic traits reported significantly higher stress than individuals with low autistic traits.

Limitations

This was a cross-sectional study, which limits causal inference. In addition, data were self-reported, which may cause methodological effects. Finally, this study was conducted during China's quarantine policy and external validation of the findings is required.

Conclusions

Autistic traits are positively associated with the stress of social isolation. Autistic traits affected core self-evaluation first, and psychological inflexibility subsequently, leading to the stress of social isolation. individuals with high autistic traits tended to experience higher levels of stress during pandemic quarantines. The findings provide useful evidence for developing interventions and implementing preventive measures to reduce stress in individuals with high autistic traits and autism spectrum disorder.

Individual and context-evoked antecedents of exploration-exploitation performance

A central issue within the Carnegie approach is the exploration-exploitation tension that lies behind organizational adaptation. After decades of research, there is still little understanding of how the combination of individual and context-evoked differences affects exploration-exploitation performance. To address that issue, we build on recent psychological and neuroscientific studies to develop and test an integrative model. The model considers two individual antecedents (personality and cognitive flexibility) and three context-evoked antecedents that take place along different time horizons (recent stress, present emotional states, and present task motivation). We rely on a lab-in-the-field study of 282 leaders within the Swiss Armed Forces-an organization that exhibits the exploration-exploitation tension in an accentuated form. Using structural equation modeling, we conduct a multiple-mediation path analysis aimed at testing complex interactions between multiple variables. Our findings highlight the need to take an integrative approach; cognitive flexibility mediates the positive effect of the personality trait of emotional stability on exploration-exploitation performance, however, both cognitive flexibility and emotional stability play unique, underlying roles in explaining how organizational leaders interpret the context. Emotional stability decreases the negative effect of recent stress on a leader's cognitive flexibility. Cognitive flexibility, in turn, mediates the effect of the present positive affective signals of task motivation on exploration-exploitation performance. These findings shed new light on our understanding of how adaptive leaders leverage positive and negative context-evoked antecedents that, in turn, affect cognitive flexibility and exploration-exploitation.

Perceived Roles and Barriers in Delivering Community-Based Care: A Qualitative Study of Health and Social Care Professionals

Introduction

As healthcare systems increasingly embrace population health management, the integration of health and social care to improve the health and well-being of individuals is crucial. Thus, we conducted a qualitative study in Singapore to understand health and social care professionals' (HCPs and SCPs) perception of the roles they played in delivering community-based care.

Methods

A descriptive phenomenological research design was adopted. HCPs and SCPs (n = 53) providing services in community settings were recruited purposefully and interviewed through eleven focus group discussions. Each session was recorded and transcribed. Thematic analysis was applied.

Results

Our results revealed eight themes in three main categories describing the roles played by HCPs and SCPs, including: (1) delivering needs-based care in community settings; (2) activating and empowering clients in health care, and (3) fostering community-based sustainable support networks. Six barriers encountered while performing these roles were also identified.

Discussion and Conclusion

Our results highlight that the roles of HCPs and SCPs go beyond the provision of direct medical and social care. They were involved in activating and empowering clients to take care of their health, and importantly, fostering community-based sustainable support networks to better empower individuals in coping with health challenges. The identified barriers shed light on areas for potential improvements for integrated community care.

Psychosocial impact of the COVID-19 pandemic for adolescents with type-1-diabetes: a qualitative interview study involving adolescents and parents

This study aims to investigate the psychosocial impact of the COVID-19 pandemic on adolescents with type-1-diabetes (T1D). We conducted 18 semi-structured interviews including adolescents with T1D (n = 10, 50% female, 15-18 years) and their parents (n = 8, 88% mothers). The main topics addressed were experiences during confinement regarding everyday life, lifestyle behaviors, diabetes management and treatment. We applied thematic analysis to identify common patterns of meanings. Being aware of belonging to a potential COVID-19 risk group caused worries especially in parents which resulted in strict adherence to preventive measures. Information from trustworthy sources regarding the actual risk mitigated the concerns. Digital diabetes treatment was well accepted and experienced as highly usable. The pandemic situation either facilitated or hindered the transition from parental control to diabetes self-management. While some patients managed to improve healthy lifestyle behaviors as their everyday lives seemed more predictable, others had difficulties in adapting to changed daily routines resulting in increased sedentary behavior and snacking. The perceived level of stress was directly associated with blood glucose levels. In conclusion, the implementation of psychological interventions (both for adolescents with T1D and their parents) addressing mental health literacy and media literacy seems to be important to promote positive coping skills for dealing with the pandemic situation.

Depression and academic engagement among college students: the role of sense of security and psychological impact of COVID-19

Background

The negative consequences of depression in college students have garnered global attention, especially in relation to academic achievement during the COVID-19 pandemic, which need critical assessment.

Aim

This study investigated whether a sense of security mediated the relationship between depression and academic engagement among college students during the pandemic and whether the moderating psychological impact of COVID-19 has a moderating effect on this relationship.

Methods

In this cross-sectional study, we recruited 466 college students from 30 provincial-level administrative regions in China via the Internet and used established scales to measure depression, academic engagement, a sense of security, and the psychological impact of COVID-19. The mediating and moderating effects were tested using the bootstrap method.

Results

Depression was found to negatively influence academic engagement, with a sense of security partially mediating this relationship. Moreover, the psychological impact of COVID-19 was shown to have a moderating effect on this mediating process.

Conclusion

This study could aid in crafting pertinent strategies to mitigate the adverse effects of depression on learning amid unexpected public health crises and foster better mental health among college students.

Anxiety and Stress Related to COVID-19 Among the Community Dwelling Older Adults Residing in the Largest Refugee Camp of the World

The current cross-sectional study was conducted among 864 older adults aged ≥ 60 years residing in Rohingya refugee camp through face-to-face interviews during November-December 2021. COVID-19-related anxiety was measured using the five-point Coronavirus Anxiety Scale (CAS) and perceived stress using the 10-point Perceived Stress Scale (PSS). The linear regression model identified the factors associated with COVID-19-related anxiety and perceived stress. The prevalence of COVID-19-related anxiety and perceived stress was 68% and 93%, respectively. The average COVID-19-related anxiety score expected to be significantly higher among those who were physically inactive, concerned about COVID-19, had a close friend/family member diagnosed with COVID-19, and had some difficulty in getting food and routine medical care during the COVID-19 pandemic. Meanwhile, the average perceived stress score was expected to be significantly higher among those without partners, who were feeling overwhelmed by COVID-19, and who experienced COVID-19-related anxiety during the pandemic. The findings suggest providing immediate psychosocial support to older Rohingya adults.

Stress symptoms and positive coping during coronavirus disease 2019: The need to look at health from a gender perspective

BACKGROUND

The emergency derived from coronavirus disease 2019 (COVID-19) has taught us important lessons in public and environmental health, particularly in the alarming numbers of existing noncommunicable diseases. However, one aspect to which little attention has been paid during the pandemic is mental health and its relationship with the gender perspective, in spite of gender being a determinant associated with health. In contrast, regarding health, few schemes and theories consider health from a positive and comprehensive perspective.

METHODS

This study was designed to examine the symptoms of stress and positive coping from a gender perspective. For this, the Stress Symptomatology Inventory, the Positive Coping to Life Scale and a general data questionnaire were applied to 665 individuals underwent the severe acute respiratory syndrome coronavirus 2 test at the Center for Health Studies and Services of the Universidad Veracruzana from July 2020 to November 2021.

FINDINGS

We found that women presented more stress symptoms and less positive coping in the factor of positive self-regulation of adverse situations and the factors of self-determination and positive self-regulation of important situations. Moreover, significant differences in the associations of these variables were observed between men and women.

CONCLUSIONS

Therefore, the needs of women must be considered in the approach to the emergency department due to COVID-19 and in general in the health-disease process; therefore, not considering a gender approach will continue to deepen inequalities between sexes.

Mental health literacy and COVID-19 related stress: The mediating role of healthy lifestyle in Tabriz

Introduction

Data concerning the relationship between Mental Health Literacy (MHL) and COVID-19 stress are limited. The study explored the relationship between COVID-19-related stress, MHL, and healthy lifestyle and their components. The current study aimed to investigate the moderating role of a healthy lifestyle in the relationship between MHL and COVID-19-related stress among people referring to health complexes in Tabriz.

Methods

In this descriptive-correlational study, 1011 people who referred to health complexes in Tabriz were selected using cluster sampling and responded to the COVID-19 Stress Scale (CSS), Mental Health Knowledge Questionnaire (MHKQ), and Lifestyle Questionnaire (LSQ). Data analysis was performed using structural equation modeling. SPSS ver.19 and LISREL ver. 8.5 statistical software is used to classify, process, and analyze data and test research hypotheses.

Results

The results indicated that stress caused by COVID-19 has a negative relationship with lifestyle and MHL. The relationship between lifestyle and MHL was positive, and it has the positive effect on a healthy lifestyle (with a standardized coefficient of 0.23). In addition, MHL had a negative effect on the stress related to the coronavirus (with a standard coefficient of -0.22), and the relationship between a healthy lifestyle was also negative on the stress related to the coronavirus (with a standard coefficient of -0.20). The evaluation of the hypothetical research model using fit indices showed that the hypothetical model fits the measurement model (Comparative Fit Index (CFI) = 0.97, Goodness of Fit Index (GFI) = 0.95, Root Mean Square Error of Approximation (RMSEA) = 0.055). All the comparative indices as well as the comparative fit index were found to be close to one and greater than 0.90.

Conclusion

This study highlights that healthcare providers must develop effective preventive and therapeutic interventions to deal with COVID-19-related stress and pay attention to the issue of increasing the level of MHL during international crises taking into consideration the moderating role of a healthy lifestyle, and develop educational and treatment programs.

Exploring the relationship between unemployment perception and health during COVID-19: a comparative study of rural and urban adults in China

Introduction

The COVID-19 pandemic has significantly impacted global economies and individual health. This study uses data from the China Family Panel Data (CFPS) in 2018 (before the pandemic) and 2020 (during the pandemic) to a) estimate the relationships between the perceived risk of unemployment and individuals' mental health, physical health, and health behaviors; and b) explore the variations of these relationships between rural and urban adults in China.

Methods

Ordinary linear regression models or Logit models are employed, depending on the nature (continuous vs. discrete) of the dependent variables.

Results

We find that the perceived risk of unemployment was statistically and positively associated with the risk of depression, and the association was greater for rural adults than for urban adults. Rural-urban variations were observed in various dimensions. For rural adults, the perceived risk of unemployment was statistically and negatively associated with life satisfaction, the probability of gaining weight and becoming obese, the probability of having adequate sleep, and computer-based screen time. These associations were statistically insignificant for urban adults. On the other hand, the perceived risk of unemployment was statistically and negatively associated with self-rated very-good-to-excellent health condition and health-compromising behaviors (e.g., smoking and drinking) for urban adults; but such associations were statistically insignificant for rural adults.

Discussion

These findings suggest that rural and urban adults exhibited different psychological and behavioral responses to the unemployment risk during the COVID-19 pandemic. Public policies aiming to improve health and employment should be strategically designed to address the unique needs of urban and rural populations.

Mental Health Needs and Services Utilization among Undergraduate and Graduate Students in Texas during the COVID-19 Pandemic

COVID-19 created a global crisis, exacerbating disparities in social determinants of health (SDOH) and mental health (MH). Research on pandemic-related MH and help-seeking is scarce, especially among high-risk populations such as college/university students. We examined self-rated MH and psychological distress, the perceived need for MH services/support, and the use of MH services across the SDOH among college/university students during the start of the pandemic. Data from the COVID-19 Texas College Student Experiences Survey (n = 746) include full- and part-time undergraduate/graduate students. Regressions examined self-rated MH, psychological distress, perceived need, and service use across SDOH, controlling for pre-pandemic MH, age, gender, and race/ethnicity. Economic stability was associated with higher risk of poor MH and need for MH services/support. Aspects of the social/community context protected student MH, especially among foreign-born students. Racial discrimination was associated with both greater psychological distress and use of services. Finally, beliefs related to the sufficiency of available institutional MH resources shaped perceived need for and use of services. Although the worst of the pandemic is behind us, the inequitable distribution of the SDOH among students is unwavering. Demand for MH support is high, requiring higher education institutions to better mobilize MH services to meet the needs of students from diverse social contexts.

The Effect of Stress of COVID-19 on Chinese Adults' Work-Family Conflict: Testing a Moderated Mediation Model

Purpose

The current study examined the effect of stress of COVID-19 on work-family conflict, how perceived work ability may mediate this effect, and lastly how perceived social support may moderate the various indirect pathway during COVID-19 pandemic.

Methods

A total of 2558 Chinese adults were recruited from the first author's university completed the questionnaire including stress of COVID-19 scale, work-family conflict, perceived social support and perceived work ability scale.

Results

The present study showed that stress of COVID-19 was positively associated with work-family conflict while negatively associated with perceived work ability, which in turn, was negatively associated with work-family conflict. Perceived social support magnified the effects of perceived work ability on work-family conflict.

Conclusion

Findings of this study shed light on a correlation between stress of COVID-19 and work-family conflict. Moreover, this study emphasizes the value of intervening individuals' perceived work ability and increasing the ability of perceived social support in the context of COVID-19.

[Changes in sleep patterns and the doom-scrolling (doom-surfing) phenomenon as modifiable risk factors for anxiety due to continuous stress of the COVID-19 pandemic]

OBJECTIVE

To evaluate the modifiable daily behavior patterns associated with increased anxiety indicators in the general population in response to the COVID-19 pandemic.

MATERIAL AND METHODS

The study examined the characteristics of the Russian population (n=7777) of the international multicenter project COMET-G. In particular, variables were targeted to describe deviations in the behavior of adults during the period of application of measures of social isolation in connection with the pandemic, and revealing a relationship with the total score on the Spielberger State Anxiety Scale (STAI-S). Among these variables, experts selected those that could potentially be subject to change in the short term, that is, act as manageable or modifiable risk factors for the development of anxiety. The selected variables were analyzed in a statistical PLS-model to identify indicators that make the most significant contribution to the increase in the total anxiety score.

RESULTS

Our statistical model explained 48.4% of the variability in the STAI-S anxiety total scores related to changes in daily life habits. In particular, doom-scrolling/doom-surfing about the spread of the virus and the COVID-19 pandemic, changes in sleep patterns and usual daily life activities due to social isolation measures presented as factors significantly contributing to the increase of state anxiety.

CONCLUSION

Given the manageable or modifiable risk factors that we have identified, public awareness and therapeutic recommendations, pointing to the need to (I) control the amount of time spent in the internet and monitor their internet-based content consumption, (II) regulate sleep-wake patterns, (III) maintain daily habits and household activities, may reduce the likelihood of developing anxiety disorders in the context of the impact of a global chronic stress due to the COVID-19 pandemic and associated social isolation measures.

Existential Well-being, Mental Health, and COVID-19: Reconsidering the Impact of Lockdown Stressors in Moscow

Background

Initial psychological papers on COVID-19, mental health and wellbeing mostly focus on the aftermath lockdown-related stress and stress related to the disease itself. Still, we presume that personal well-being can be resistant to stressors depending on the way the person is settled in their life.

Objective

We seek to reconsider the contribution of lockdown-related stressors to existential well-being, to assess existential well-being during the outbreak and to compare the contribution of living conditions and COVID-19-related factors on well-being.

Design

An online survey was conducted during the peak of the outbreak in Moscow (April-May 2020) (N=880). The data was obtained using the "Test of Existential Motivations" questionnaire and a series of questions addressing (1) living conditions - mental and physical health, employment, and social distancing; (2) COVID-19-related stressors - non-chronic illness, financial losses, and unavailability of goods or services; (3) sociodemographic indicators - age, gender, and income. Data analysis included hierarchical multiple regression, one-sample t-test, and analysis of variance.

Results

Surprisingly, the existential well-being of Moscow citizens during the research period was moderate. Each of the three groups of factors predicted a similar proportion of the variance of well-being (3-3,9%). The strongest predictors of well-being were long-term mental health status and financial stability. The effect of COVID-19-related stressors was most pronounced when they co-occur.

Conclusion

The negative association between lockdown-related stressors and poor well-being is not universal. It is necessary to study the effect of COVID-19-related stressors in combination with individual living conditions and region-specific factors and to focus on the prevention of the occurrence of stressors.

Effects of Stressors of COVID-19 on Chinese College Students' Problematic Social Media Use: A Mediated Moderation Model

PURPOSE

Isolation policies are long-term and strictly enforced in China during the COVID-19 outbreak. Social media might be widely used for communication, work, understanding the development of the epidemic, etc. However, these behaviors might lead to problematic social media use. The present study investigated the effect of stressors of COVID-19 on problematic social media use, as well as the internal mechanisms involved.

METHODS

One thousand three hundred seventy-three Chinese college students (M _age = 19.53, SD _age = 1.09) were recruited randomly from four grades who completed Coronavirus Stress Scale, Fear of Missing Out Scale, Problematic Mobile Social Media Usage Assessment Questionnaire, and Regulatory Emotional Self-Efficacy Scale.

RESULTS

Stressors of COVID-19 were positively related to problematic social media use. The link between stressors of COVID-19 and problematic social media use was mediated by fear of missing out. Additionally, the association between fear of missing out and problematic social media use, as well as the association between stressors of COVID-19 and problematic social media use were moderated by regulatory emotional self-efficacy.

CONCLUSION

The current findings reveal the mechanism that may be used to reduce the likelihood of problematic social media use in the context of the COVID-19 outbreak. To prevent and intervene in problematic social media use during the COVID-19 pandemic, this study stressed the importance of decreasing the fear of missing out and enhancing regulatory emotional self-efficacy.