Mental Health During the First Weeks of the COVID-19 Pandemic in the United States

Psychological Resilience and Hardiness as Protective Factors in the Relationship Between Depression/Anxiety and Well-Being: Exploratory and Confirmatory Evidence

Previous research shows depression and anxiety are negatively correlated with subjective well-being. Additionally, there is evidence psychological resilience positively influences well-being. The present study explored whether the relationship between depression/anxiety and subjective well-being might also be moderated by aspects of psychological resilience - such that depression and anxiety do not reduce well-being to the same extent in individuals high in psychological resilience traits. Participants from an exploratory sample (N = 236, Mage = 23.49) and confirmatory sample (N = 196, Mage = 24.99) completed self-report measures of depression, anxiety, well-being, resilience, and hardiness (i.e., CDRISC and DRS-15). As expected, results showed strong negative correlations between anxiety/depression and both well-being and resilience/hardiness, as well as positive correlations between well-being and resilience/hardiness. A significant interaction was also present between both resilience/hardiness and depression/anxiety in predicting well-being in the first sample. Results partially replicated in the confirmatory sample (i.e., for hardiness but not resilience). These findings add to prior work by highlighting hardiness (as measured by the DRS-15), one aspect of psychological resilience, as an important protective factor in mental health. Namely, results suggest individuals with symptoms of affective disorders may remain capable of living subjectively fulfilling lives if they possess traits of psychological resilience such as hardiness.

Risk factors and health behaviors associated with loneliness among cancer survivors during the COVID-19 pandemic

Loneliness may exacerbate poor health outcomes particularly among cancer survivors during the COVID-19 pandemic. Little is known about the risk factors of loneliness among cancer survivors. We evaluated the risk factors of loneliness in the context of COVID-19 pandemic-related prevention behaviors and lifestyle/psychosocial factors among cancer survivors. Cancer survivors (n = 1471) seen at Huntsman Cancer Institute completed a survey between August-September 2020 evaluating health behaviors, medical care, and psychosocial factors including loneliness during COVID-19 pandemic. Participants were classified into two groups: 'lonely' (sometimes, usually, or always felt lonely in past month) and 'non-lonely' (never or rarely felt lonely in past month). 33% of cancer survivors reported feeling lonely in the past month. Multivariable logistic regression showed female sex, not living with a spouse/partner, poor health status, COVID-19 pandemic-associated lifestyle factors including increased alcohol consumption and marijuana/CBD oil use, and psychosocial stressors such as disruptions in daily life, less social interaction, and higher perceived stress and financial stress were associated with feeling lonely as compared to being non-lonely (all p < 0.05). A significant proportion of participants reported loneliness, which is a serious health risk among vulnerable populations, particularly cancer survivors. Modifiable risk factors such as unhealthy lifestyle behaviors and psychosocial stress were associated with loneliness. These results highlight the need to screen for unhealthy lifestyle factors and psychosocial stressors to identify cancer survivors at increased risk of loneliness and to develop effective management strategies.

A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain

BACKGROUND

Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders.

METHODS

Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health.

RESULTS

Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst.

CONCLUSIONS

This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.

Community Members' Perceptions of a Resource-Rich Well-Being Website in California During the COVID-19 Pandemic: Qualitative Thematic Analysis

BACKGROUND

To address needs for emotional well-being resources for Californians during the COVID-19 pandemic, the Together for Wellness/Juntos por Nuestro Bienestar (T4W/Juntos) website was developed in collaboration with multiple community partners across California, funded by the California Department of Health Care Services Behavioral Health Division federal emergency response.

OBJECTIVE

This qualitative study was designed to explore and describe the perspectives of participants affiliated with California organizations on the T4W/Juntos website, understand their needs for web-based emotional health resources, and inform iterative website development.

METHODS

After providing informed consent and reviewing the website, telephone interviews were conducted with 29 participants (n=21, 72% in English and n=8, 28% in Spanish) recruited by partnering community agencies (October 2021-February 2022). A 6-phase thematic analysis was conducted, enhanced using grounded theory techniques. The investigators wrote reflexive memos and performed line-by-line coding of 12 transcripts. Comparative analyses led to the identification of 15 overarching codes. The ATLAS.ti Web software (ATLAS.ti Scientific Software Development GmbH) was used to mark all 29 transcripts using these codes. After examining the data grouped by codes, comparative analyses led to the identification of main themes, each with a central organizing concept.

RESULTS

Four main themes were identified: (1) having to change my coping due to the pandemic, (2) confronting a context of shifting perceptions of mental health stigma among diverse groups, (3) "Feels like home"-experiencing a sense of inclusivity and belonging in T4W/Juntos, and (4) "It's a one-stop-shop"-judging T4W/Juntos to be a desirable and useful website. Overall, the T4W/Juntos website communicated support and community to this sample during the pandemic. Participants shared suggestions for website improvement, including adding a back button and a drop-down menu to improve functionality as well as resources tailored to the needs of groups such as older adults; adolescents; the lesbian, gay, bisexual, transgender, and queer community; police officers; and veterans.

CONCLUSIONS

The qualitative findings from telephone interviews with this sample of community members and service providers in California suggest that, during the COVID-19 pandemic, the T4W/Juntos website was well received as a useful, accessible tool, with some concerns noted such as language sometimes being too "professional" or "clinical." The look, feel, and content of the website were described as welcoming due to pictures, animations, and videos that showcased resources in a personal, colorful, and inviting way. Furthermore, the content was perceived as lacking the stigma typically attached to mental health, reflecting the commitment of the T4W/Juntos team. Unique features and diverse resources, including multiple languages, made the T4W/Juntos website a valuable resource, potentially informing dissemination. Future efforts to develop mental health websites should consider engaging a diverse sample of potential users to understand how to tailor messages to specific communities and help reduce stigma.

Coping style and mental health amid the first wave of the COVID-19 pandemic: a culture-moderated meta-analysis of 44 nations

In the first wave of the COVID-19 pandemic, the rapid transmission of a novel virus and the unprecedented disease-mitigation measures have elicited considerable stress in many countries worldwide. Coping with pandemic stress may be differentially related to psychological symptoms across countries characterised by distinct cultural values. This study aimed to: (a) synthesise the literature by investigating the associations between some major types of coping style and psychological symptoms, and (b) investigate the moderating effects of culture on these associations. We performed a three-level random-effects meta-analysis, which included 151 independent samples from 44 countries across eight world regions (n = 137,088, 66% women, Mage = 36.08). For both problem-focused and avoidant coping styles, their hypothesised associations with psychological symptoms were robust across the countries (anxiety: rs = -.11 and .31; depression: rs = -.19 and .33; ps < .0001). For both emotion-focused and social support seeking styles, their associations with psychological symptoms were moderated by two Hofstede's cultural dimensions: uncertainty avoidance (intolerance of ambiguity) and masculinity (concern for achievement and success). The hypothesised negative coping style-symptom associations were found only in the countries with lower levels of uncertainty avoidance or masculinity, but opposite patterns of findings were found in those with higher levels of either of these two cultural dimensions.

Predictors of mental health among U.S. adults during COVID-19 early pandemic, mid- pandemic, and post-vaccine eras

BACKGROUND

A collective trauma like COVID-19 impacts individuals differently due to socio-contextual and individual characteristics. Younger adults, minorities, affiliates of certain political parties, and residents of some regions of the United States reported experiencing poorer mental health during the pandemic. Being diagnosed with COVID-19, or losing a friend/family to it, was related to more adverse mental health symptoms. While the negative impact of COVID-19 on health outcomes has been studied, mental health changes during this pandemic need further exploration.

METHODS

In a study of 8,612 U.S. households, using three surveys collected from a nationally representative panel between May 2020 and October 2021, using a repeated cross-sectional design, a linear mixed effect regression model was performed to investigate factors associated with the mental health status, based on the Mental Health Inventory-5, of individuals throughout different phases of the COVID-19 pandemic, and whether an improvement over time, especially after vaccines became available, was observed.

RESULTS

An overall improvement in mental health was observed after vaccines became available. Individuals with no COVID-related death in their household, those not wearing masks, those identifying as members of the Republican Party, race/ethnicities other than Asian, men, older adults, and residents of the South were less likely than others to report mental health challenges.

CONCLUSIONS

Our results highlight the need for widespread mental health interventions and health promotion to address challenges during the COVID-19 pandemic and beyond. Due to the worse mental health observed among Asians, younger adults, women, low-income families, those with a higher level of concern for COVID-19, people who lost someone to COVID-19, and/or individuals with histories of opioid use disorder and criminal legal involvement, over the period of this study, targeted attention needs to be given to the mental health of these groups.

Factors related to increased alcohol misuse by students compared to non-students during the first Covid-19 lockdown in France: the Confins study

BACKGROUND

The closure of bars and lockdowns related to the Covid-19 pandemic changed alcohol use levels in France during the spring of 2020. We wondered whether this sudden cessation of social interactions impacted students more than non-students and what factors specific to students would explain the increase in alcohol misuse. The aims of this study were to compare self-reported changes in alcohol misuse (alcohol intake and binge-drinking frequency) during the first Covid-19 lockdown from March 17 to May 10, 2020, between French students and non-students and describe factors associated with this alcohol misuse in each subgroup.

METHODS

Data collected in the Confins study from April 8 to May 10, 2020, were used in cross-sectional analyses stratified by student status. Multiple logistic regression was performed to estimate the association between self-reported increase in alcohol intake or binge-drinking frequency (at least six drinks of alcohol on one occasion) and demographic, socioeconomic, and clinical factors, as well as conditions associated with the Covid-19 pandemic. The population-attributable fraction was then used to estimate the contribution of identified risk factors to increased alcohol misuse in students and non-students.

RESULTS

Among both students and non-students, a self-reported decrease or no change in alcohol intake or binge-drinking was more common than an increase. However, the risk factors explaining an increase in alcohol intake differed among students (≥ 25 years old, not working or studying in the health field, and having suicidal ideation during the last 7 days) and non-students (having a medical diagnosis of mental disorders). The risk factors explaining an increase in binge-drinking frequency were similar in the two subgroups (being a tobacco smoker before lockdown and not practicing any physical activity during the last 7 days), except suicidal thoughts, which was a risk factor for alcohol misuse specific to students.

CONCLUSIONS

These results highlight the vulnerability of certain French students to alcohol misuse and the necessity of combining both mental health and substance use-related screening in the student population.

The impact of COVID-19 on nurse alcohol consumption: A qualitative exploration

AIMS AND OBJECTIVES

To explore the long-term impact of the COVID-19 pandemic on nurse alcohol consumption.

BACKGROUND

The COVID-19 pandemic has caused immense disruption to healthcare services worldwide, and nurses have not been immune, experiencing burnout, declining mental health and ultimately, attrition from the profession. Increases in alcohol consumption have been reported across subsections of society, including those with pre-existing mental ill health and experiencing high stress, and exploring this phenomenon in nurses is essential for workforce well-being and sustainability.

DESIGN

Qualitative descriptive study design.

METHODS

Secondary analysis of individual, semi-structured interviews with nurses (N = 42) from diverse settings across Australia, including community, primary and hospital settings, conducted in July and August 2021. Data were analysed using structural coding and reported in accordance with the CORE-Q guidelines.

FINDINGS

Two key themes were found after analysis of the data: (1) factors influencing alcohol consumption (subthemes: workplace factors and external factors), and (2) the pandemic's influence on alcohol consumption (subthemes: increased consumption, moderation of consumption and alcohol as a reward).

CONCLUSIONS

Several participants described increased alcohol consumption because of the COVID-19 pandemic, particularly due to the stress of working in an environment where resources were scarce. Workplace factors such as overtime, missed breaks and heightened workload were all described as driving stress, and in turn increased alcohol consumption.

RELEVANCE TO CLINICAL PRACTICE

Increased alcohol consumption has been associated with burnout, absenteeism and intention to leave. The nursing profession is currently undergoing significant continuing stress providing care and management to patients with the SARS-CoV-2 virus, and increased alcohol consumption is a significant threat to personal and workforce well-being, workforce sustainability and quality nursing care.

Comparative Study of the Long-Term Impact of the COVID-19 Pandemic on Mental Health and Nutritional Practices Among International Elite and Sub-Elite Athletes: A Sample of 1420 Participants from 14 Countries

BACKGROUND

Although several studies have shown that the Coronavirus Disease 2019 (COVID-19) lockdown has had negative impacts on mental health and eating behaviors among the general population and athletes, few studies have examined the long-term effects on elite and sub-elite athletes. The present study aimed to investigate the long-term impact of COVID-19 lockdown on mental health and eating behaviors in elite versus sub-elite athletes two years into the pandemic. A cross-sectional comparative study was conducted between March and April 2022, involving athletes from 14 countries, using a convenient non-probabilistic and snowball sampling method. A total of 1420 athletes (24.5 ± 7.9 years old, 569 elites, 35% women, and 851 sub-elites, 45% women) completed an online survey-based questionnaire. The questionnaire included a sociodemographic survey, information about the COVID-19 pandemic, the Depression, Anxiety and Stress Scale-21 Items (DASS-21) for mental health assessment, and the Rapid Eating Assessment for Participants (REAP-S) for assessing eating behavior.

RESULTS

The results showed that compared to sub-elite athletes, elite athletes had lower scores on the DASS-21 (p = .001) and its subscales of depression (p = .003), anxiety (p = .007), and stress (p < .001), as well as a lower REAP-S score indicating lower diet quality (p = .013).

CONCLUSION

In conclusion, two years into the pandemic, elite athletes were likelier to have better mental health profiles than sub-elite athletes but surprisingly had lower diet quality.

Adolescent Total and Mental Health-Related Emergency Department Visits During the COVID-19 Pandemic

Importance

Previous research has assessed changes in pediatric and adolescent health care utilization during the COVID-19 pandemic; however, less is known regarding how the pandemic affected adolescents' use of emergency care, specifically for mental health (MH).

Objective

To determine how adolescents (ages 12-17 years), compared with other age groups, sought help in emergency departments (EDs) in general and for MH conditions during the COVID-19 pandemic.

Design and Setting

In this cross-sectional study, National Syndromic Surveillance Program data and the Centers for Disease Control and Prevention Mental Health, version 1, query were used to track patterns in weekly adolescent ED visits by region across the 10 US Department of Health and Human Services regions from January 2019 through December 2021. Data analysis was performed in April and May 2023.

Main Outcomes and Measures

Total ED visits, MH-related ED visits, and the proportion of total ED visits that were MH related by week-region.

Results

Both weekly regional ED visits and MH-related ED visits dropped after the onset of the pandemic. Because total ED visits dropped more than MH-related ED visits, the proportion of MH-related ED visits increased for the adolescent group. Total ED visits only returned to prepandemic weekly levels (2019: mean [range], 7358 [715-25 908] visits) in the middle of 2021 (overall in 2021: mean [range], 6210 [623-25 777] visits). Mental health-related visits also dropped in 2020 but rebounded to prepandemic weekly levels (2019: mean [range], 634 [56-1703] visits) by the end of 2020 (mean [range], 533 [39-1800] visits).

Conclusions and Relevance

This cross-sectional study suggests that families' perceptions of the need for emergent MH care were reduced during the pandemic by less than their perception of the need for emergency care overall. Emergency departments should be equipped to provide critical care specifically for adolescents facing MH emergencies.

Prevalence of suicidal ideation and correlated risk factors during the COVID-19 pandemic: A meta-analysis of 113 studies from 31 countries

The purpose of this study was to estimate the prevalence of suicidal ideation and correlated risk factors during the COVID-19 pandemic. Web of Science (WOS) and PubMed were searched according to a pre-set strategy. A total of 132 studies were identified, 104 of which were included in the meta-analysis. The prevalence of suicidal ideation was approximately 14.7% (95%CI: 12.5%, 16.8%, P < 0.01) in the general population, approximately 22.4% (95%CI: 17.1%, 27.8%, P < 0.01）in adolescents, approximately 21.0% (95%CI: 12.8%, 29.2%, P < 0.01) in psychiatric patients, approximately 20.6% (95%CI: 18.7%, 22.5%, P < 0.01）in university students, approximately 18.9% (95%CI: 8.3%, 29.5%, P < 0.01) in younger adults, approximately 10.6% (95%CI: 1.0%, 20.2%, P = 0.031) in COVID-19 patients and approximately 7.4% (95%CI: 4.3%, 10.5%, P < 0.01) in healthcare workers. The prevalence in North America was approximately 16.0% (95%CI: 13.6%-18.4%, P < 0.001), approximately 14.5% in Asia (95%CI: 9.5%-19.4%, P < 0.001), approximately 10.5% in Europe (95%CI: 8.5%-12.4%, P < 0.001), and approximately 20.5% in South America (95%CI: 19.5%-21.5%, P < 0.001). The following were risk factors which might be correlated with suicidal ideation: severe anxiety symptoms, mild to moderate depression, a strong feeling of loneliness/social isolation, poor sleep quality, having COVID-19-related experience, having quarantine or lockdown experience, being female, being single or divorced, having financial problems and having a history of suicidal ideation/attempt. This article reports the prevalence of suicidal ideation and discussing potential risk factors during the pandemic among general population and vulnerable groups. Early detection and follow-up were necessary for the noteworthy population.

Positive Emotions Training (PoET) as an online intervention to improve mental health: a feasibility study

BACKGROUND

Positive psychology interventions are known to have an impact on mental health as well as on a number of beneficial characteristics like optimism, gratitude and self-efficacy. The Positive Emotions Training (PoET) is one of the first holistic training programs covering eleven positive psychology constructs. The goal of this study was to test PoET's feasibility in the general population and to assess possible effects on positive and negative mental health factors. Additionally, possible effects on optimism, gratitude, happiness, resilience, and self-efficacy were examined.

METHODS

The sample (n = 101) was not randomized. Participants were allocated to PoET (n = 55) or control group (n = 46) that did not receive treatment initially. The PoET group completed two training sessions (3.5 h each) that were conducted in an online format with groups of about 30 people. All participants completed positive and negative mental health measures at the beginning of the first training session and at the beginning of the second one as well as 30 days after the second session. Two-factorial repeated measures ANOVAs were conducted to test for possible effects of PoET on mental health.

RESULTS

The results showed that the contents were comprehensible and that the conduction of the training was feasible overall. In addition, a significant decrease of depression and anxiety symptoms as well as a significant increase of optimism were found in the PoET group. No significant changes were found in the control group.

CONCLUSIONS

Results indicate that PoET is an applicable intervention for improving mental health in the general population.

TRIAL REGISTRATION

Retrospectively registered at ClinicalTrials.gov on 21/02/2023 (Identifier/Trial registration number: NCT05737251).

Analysis of Changes in Time Use and Activity Participation in Response to the COVID-19 Pandemic in the United States: Implications for Well-Being

This research aims to investigate the well-being implications of changes in activity-travel and time-use patterns brought about by the COVID-19 pandemic. The study uses American Time Use Survey (ATUS) data from 2019 and 2020 to assess changes in activity-travel and time-use patterns. It applies two methods—a well-being scoring method and a time-poverty analysis method—to evaluate the impacts of these changes on society. The results show that individuals experienced diminished well-being during the pandemic even when their time-poverty statistics showed an improvement; this is because the pandemic did not allow individuals to pursue activities in a way that would enhance well-being. In general, well-being is positively associated with the pursuit of discretionary activities in the company of others in favored out-of-home locations. This explains why people have rapidly embraced traveling again in a post-pandemic era. At the same time, people desire more discretionary time (less time poverty); because the elimination of the commute contributes to this, workers are reluctant to return fully to the workplace. Planning processes need to account for a new normal in which activity-travel patterns will be increasingly shaped by the human desire to accumulate positive life experiences.

COVID-19 stigma and depression across race, ethnicity and residence

Our cross-sectional study seeks to understand how COVID-19 stigma, race/ethnicity [Asian, Black, Hispanic/Latinx, white] and residency [New York City (NYC) resident vs. non-NYC resident] associated with depression. Our sample includes 568 participants: 260 (45.77%) were NYC residents and 308 (54.3%) were non-NYC residents. A series of multiple linear regression were run to examine the relationship between race/ethnicity, COVID-19 stigma, and depressive symptoms. Irrespective of residency, older age and ever being diagnosed with COVID-19 were negatively associated with depressive symptoms. Stigma and thinking less of oneself significantly associates with depressive symptoms across residency. Our study expects to benefit mental health care providers and public health professionals in designing best practices to mitigate stigma in ongoing or future pandemics.

COVID-19 Worries and Insomnia: A Follow-Up Study

The COVID-19 pandemic was associated with significant increases in sleep disorder symptoms and chronic worry. We previously demonstrated that worry about the pandemic was more strongly associated with subsequent insomnia than the converse during the acute (first 6 months) phase of the pandemic. In this report, we evaluated whether that association held over one year of the pandemic. Participants (n = 3560) completed self-reported surveys of worries about the pandemic, exposure to virus risk factors, and the Insomnia Severity Index on five occasions throughout the course of one year. In cross-sectional analyses, insomnia was more consistently associated with worries about the pandemic than exposure to COVID-19 risk factors. In mixed-effects models, changes in worries predicted changes in insomnia and vice versa. This bidirectional relationship was further confirmed in cross-lagged panel models. Clinically, these findings suggest that during a global disaster, patients who report elevations in either worry or insomnia should be considered for evidence-based treatments for these symptoms to prevent secondary symptoms in the future. Future research should evaluate the extent to which dissemination of evidence-based practices for chronic worry (a core feature of generalized anxiety disorder or illness anxiety disorder) or insomnia reduces the development of co-occurring symptoms during a global disaster.

The association between facets of mindfulness and COVID-19 related distress: A cross-sectional study

OBJECTIVES

Trait mindfulness could function as a protective factor against distress. The current study investigated the relationship of the five distinct facets of mindfulness and COVID-19 related distress.

METHODS

An online self-report study was conducted in a Dutch sample (N = 811; M_age = 49 ± 17; 54.5 % female) in February 2021. Dispositional mindfulness was assessed with the Five Facet Mindfulness Questionnaire, and the COVID Stress Scale was used to assess COVID-19 related distress.

RESULTS

Multivariate regression analyses showed that describing and non-judging were inversely related to COVID-19 related distress. Specifically, describing was related to fewer socioeconomic worries, while describing and non-judging were negatively associated with traumatic stress symptoms. Non-judging was negatively associated with COVID-19-related compulsive checking.

CONCLUSIONS

The results indicate that individuals high in mindfulness traits describing and non-judging, experience less distress during the pandemic. Teaching mindfulness skills and practice could be helpful in global situations like pandemics.

Impact of COVID-19 on public social life and mental health: a statistical study of google trends data from the USA

The COVID-19 pandemic has caused a significant disruption in the social lives and mental health of people across the world. This study aims to asses the effect of using internet search volume data. We categorize the widely searched keywords on the internet in several categories, which are relevant in analyzing the public mental health status. Corresponding to each category of keywords, we conduct an appropriate statistical analysis to identify significant changes in the search pattern during the course of the pandemic. Binary segmentation method of changepoint detection, along with the combination of ARMA-GARCH models are utilized in this analysis. It helps us detect how people's behavior changed in phases and whether the severity of the pandemic brought forth those shifts in behaviors. Interestingly, we find that rather than the severity of the outbreak, the long duration of the pandemic has affected the public health status more. The phases, however, align well with the so-called COVID-19 waves and are consistent for different aspects of social and mental health. We further observe that the results are typically similar for different states as well.

A meta-analytic review of the associations between dimensions of religious coping and psychological symptoms during the first wave of the COVID-19 pandemic

INTRODUCTION

In the first wave of the COVID-19 pandemic, the unknown etiology and treatment of the highly transmissible coronavirus posed considerable threats to public mental health. Many people around the globe turned to religion as an attempt to mitigate their heightened psychological distress, but mixed findings have been obtained regarding the association between the use of religious coping and two psychological symptoms-anxiety and depressive symptoms-widely reported in the initial wave.

OBJECTIVE

The present meta-analysis was conducted to resolve the empirical inconsistency by synthesizing this body of studies and identifying both individual and national-level factors that accounted for the inconsistent findings.

METHODS

Following PRISMA guidelines, the literature search and data screening procedures yielded 42 eligible studies, with 25,438 participants (58% females, average age = 36.50 years) from 24 countries spanning seven world regions.

RESULTS

Overall, the results showed that only negative religious coping was positively associated with psychological symptoms (r = 0.2886, p < 0.0001). Although the associations of both general and positive religious coping with psychological symptoms were non-significant (rs = 0.0425 and -0.0240, ps > 0.39), the moderation analysis revealed significant positive associations between positive religious coping and psychological symptoms in two demographic groups who experienced greater pandemic distress than their counterparts: younger participants and female participants.

DISCUSSION

This meta-analysis provides a nuanced understanding of the complex nature of religious coping in the initial wave of the COVID-19 pandemic when the levels of public anxiety and stress were heightened. The exclusive use of religious coping may not be associated with low levels of psychological symptoms, implying the importance of supplementing the deployment of this strategy with an array of other strategies. Therapists of mental health interventions should show their clients how to make good use of positive religious coping together with other strategies, and how to avoid the use of negative religious coping, to handle their psychological problems.

SYSTEMATIC REVIEW REGISTRATION

https://osf.io/shb32/.

Factors associated with psychological distress during the COVID-19 pandemic: Data from two early waves in Russia

There is limited information about how the mental health of people has changed over time during the COVID-19 pandemic in low- and middle-income countries. In a cross-sectional study, we identified factors associated with psychological distress at two periods immediately after two peaks of the COVID-19 pandemic in Russia. Data were collected via online surveys. In May-June 2020, we surveyed 373 respondents across Russia. In January-February 2021, we surveyed 743 people, using the same approach for survey distribution. With Kessler-10 as a measure of psychological distress, we used regression analysis to determine factors associated with higher psychological distress among Russians. Levels of psychological distress were high in both time periods and did not significantly change between the surveys. Having had COVID-19, losing one's job, experiencing problems accessing healthcare, and changing drinking behaviour during the pandemic were associated with higher psychological distress. Apart from getting sick or worrying about the virus, psychological distress is affected by restrictions and the consequences of the pandemic situation. As the COVID-19 pandemic continues, actions are needed to address the mental well-being of the population in Russia.

Maternal Anxiety and Its Associated Factors During the First and Second Wave of COVID-19 Pandemic in Serbia: A Cross-Sectional Study

Aim

The COVID 19-pandemic affects people differently, while pregnant women are among the most sensitive populations. The data about maternal mental health during the COVID-19 outbreak are in some ways consistent but also country-specific.

Purpose

The study aims to explore the impact of the COVID-19 pandemic on pregnant women's anxiety and identify its associated factors.

Patients and Methods

This cross-sectional study included a sample of 358 pregnant women during the first and second waves of the pandemic in Serbia. An anonymous survey included basic demographic questions, pregnancy-related background questions, the question of self-reported COVID-19-related fear, State-Trait Anxiety Inventory (STAI), and Multidimensional Scale of Perceived Social Support (MSPSS).

Results

The study revealed no pregnant women with low anxiety levels measured by STAI-T and STAI-S, while the STAI-S and STAI-T scores indicated high anxiety in 32.4% and 42.7% of pregnant women, respectively. The obtained results pointed out the nonlinear dependence of state anxiety on observed associated factors and their complex interactions, including the data collecting period.

Conclusion

Our findings reveal that COVID-19 affects pregnant women's mental health and makes it necessary for psychological monitoring and support for pregnant women, which may be reflected in their mental health but also the development of their offspring.

Aggression and violence during the lockdown caused by the COVID-19 pandemic in Kuwait

Background

The lives of the global population have been drastically altered since the emergence of the 2019 coronavirus disease (COVID-19) pandemic. These changes comprise their daily lifestyle practices and the professional, and educational systems. In addition to these changes, many psychological illnesses issues have been detected globally.

Methods

This study aimed to investigate whether there are significant sociodemographic differences in reported cases of physical and verbal aggression, anger, hostility, and violence among 815 Kuwaiti residents during the lockdown caused by the COVID-19 pandemic. A non-random sample was recruited through the WhatsApp platform. The online survey contained sociodemographic information and 29 self-reported items rated on a Likert scale. In addition to demographic questions, online questionnaires included the Aggression Questionnaire (AQ). Questions regarding violence and COVID-19 infection were included in the online survey.

Results

Men, younger people, those who were single or divorced, students, and those with a lower level of education were more likely to report more instances of physical and verbal aggression, as well as hostility.

Conclusions

To assist psychologically vulnerable individuals in overcoming the negative effects of the COVID-19 pandemic, it is crucial to develop community-based strategies that are tailored to the specific conditions and cultural traditions of each country. Diverse strategies for mental health support programs administered by social workers and mental health professionals are required to reduce aggression and violence levels. Since this study is a cross-sectional survey conducted during the total lockdown, it is difficult to conclude that the lockdown provoked the escalation of the aggression.

Coping strategies and household stress/violence in remote Alaska: a longitudinal view across the COVID-19 pandemic

The COVID-19 pandemic has introduced novel stressors. Remote/rural communities have experienced additional difficulties, while also potentially benefitting from unique sources of resilience against such stressors. However, very little research has been conducted in remote/rural communities regarding coping and stress/violence. This study examines coping strategies and household stress/violence in remote Alaska communities across the pandemic through three online survey waves (November 2020-September 2021) (total n = 1,020). Across all waves, personal care was reported most frequently followed by social activities, religious activities, and traditional/subsistence activities. Substance use combined (alcohol, nicotine, marijuana) and seeking counselling were less frequently reported, with significant differences across gender and age categories. Less than 10% of individuals reported physical violence towards children and/or other adults within the household. Overall, these findings indicate that individuals are primarily relying on positive coping strategies to contend with additional stress brought into their lives by the COVID-19 pandemic.

Factors affecting tobacco, nicotine, and cannabis product use among California young adults during the COVID-19 pandemic: A qualitative study

The effects of COVID-19 on tobacco use and cannabis has been variable, and it is unclear the extent to which factors affecting changes in tobacco and cannabis use differ. The purpose of this study was to identify the COVID-19-related factors that affect changes in tobacco and cannabis use during the pandemic. Focus groups with 114 young adults in California in April 2021 were held to discuss tobacco and cannabis use patterns, adverse events, and the effect of COVID-19 on tobacco and cannabis product use. Factors affecting changes in use were largely similar between tobacco products and cannabis products. Drivers of increased cannabis use distinct from tobacco or nicotine product use included feeling greater freedom to disengage and perceptions of less harm. Increases in product use were a result of changing social environment, coping with emotional and psychological distress, and product related factors. Decreases in product use were a result of social isolation, COVID-19-related health concerns, disruptions in daily patterns of living, and reduced access. Improved understanding of how the pandemic has affected tobacco and cannabis use can inform tailored interventions to both support those who have decreases or quit and assist those who have increased use during the pandemic to reduce or cease their consumption.

The effect of different degrees of lockdown and self-identified gender on anxiety, depression and suicidality during the COVID-19 pandemic: Data from the international COMET-G study

INTRODUCTION

During the COVID-19 pandemic various degrees of lockdown were applied by countries around the world. It is considered that such measures have an adverse effect on mental health but the relationship of measure intensity with the mental health effect has not been thoroughly studied. Here we report data from the larger COMET-G study pertaining to this question.

MATERIAL AND METHODS

During the COVID-19 pandemic, data were gathered with an online questionnaire from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Anxiety was measured with the STAI, depression with the CES-D and suicidality with the RASS. Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively.

STATISTICAL ANALYSIS

It included the calculation of Relative Risk (RR), Factorial ANOVA and Multiple backwards stepwise linear regression analysis RESULTS: Approximately two-thirds were currently living under significant restrictions due to lockdown. For both males and females the risk to develop clinical depression correlated significantly with each and every level of increasing lockdown degree (RR 1.72 and 1.90 respectively). The combined lockdown and psychiatric history increased RR to 6.88 The overall relationship of lockdown with severity of depression, though significant was small.

CONCLUSIONS

The current study is the first which reports an almost linear relationship between lockdown degree and effect in mental health. Our findings, support previous suggestions concerning the need for a proactive targeted intervention to protect mental health more specifically in vulnerable groups.

Changes in Life Circumstances and Mental Health Symptoms during the COVID-19 Pandemic among Midlife Women with Elevated Risk for Cardiovascular Disease

Cardiovascular disease (CVD) remains the leading cause of death among women. During midlife (ages 40-60), universal aging processes, sex-specific factors such as menopause, psychological distress, and conditions such as hypertension substantially increase women's risk for CVD. The onset of the COVID-19 pandemic has impacted employment, social interactions, caregiving responsibilities, and overall well-being worldwide; however, little research has investigated how COVID-19 has affected women in midlife. The present study was designed to determine how COVID-19 has affected women in midlife with elevated risk for CVD, by examining changes in their mental health symptoms and life domains across three time points: prior to COVID-19 (2019), during stay-at-home orders (April-June 2020), and during initial reopening (August 2020). Women in midlife with one or more CVD risk conditions (e.g., hypertension; n = 35) responded to questions related to COVID-19, changes in life circumstances, and mental health symptoms at each time point. Findings showed meaningful changes in caregiving, medical visits, and employment status, as well as significant changes in depression and sleep quality scores across time. However, the findings also showed that women were distressed prior to COVID-19 and did not exhibit changes in perceived stress, body dissatisfaction, or anxiety symptoms over time. Findings from this study highlight the impact of the COVID-19 pandemic on an at-risk group of women, which may be used to help guide future health promotion efforts specifically tailored to this population.

Snapshot of health-related behaviours in adults living with disabilities 1 year into the COVID-19 pandemic: a cross-sectional survey study

OBJECTIVES

This survey aimed to assess the status of a range of health-related behaviours 1 year after the coronavirus outbreak was declared a pandemic in adults living with disabilities comparative with those with no disabilities.

DESIGN

This cross-sectional study reports findings from an online survey conducted in March 2021. Mann-Whitney U and Χ2 tests were used to compare a range of health behaviours including time spent self-isolating, smoking, alcohol consumption, exercise frequency and diet in adults with and without disabilities.

SETTING

A convenience sample of UK adults was recruited through the researchers' personal and professional networks including UK-based sight loss sector charities, social media platforms and professional forums.

PARTICIPANTS

A total of 123 UK participants completed the survey.

OUTCOME MEASURES

COVID-19 diagnosis, time spent self-isolating, alcohol consumption frequency, exercise frequency, change in smoking habit and eating habits.

RESULTS

No significant differences were found in alcohol consumption, smoking, water intake, breakfast, or fruit and vegetable intake. There were statistically significant differences in the time spent self-isolating (U=2061, p=0.001), exercise frequency (U=1171.5, p=0.005) and the amount of food eaten (χ2 (2)=9.60, p=0.008, Cramer's V=0.281). Although the majority in both groups reported exercising three to four times per week and eating what they should, those with disabilities were more likely to eat less than they should, not exercise at all and to have been self-isolating for over 6 months than participants with no disabilities.

CONCLUSIONS

The data in this study present some key differences between the two groups, with those living with disabilities being more likely to report that they had been self-isolating for prolonged periods of time, not exercising at all, and not eating as much as they should . This raises concerns for the health and well-being of individuals with disabilities.

The ‘Fauci Effect’: Reducing COVID-19 Misconceptions and Vaccine Hesitancy Using an Authentic Multimodal Intervention

Social media environments enable users to proliferate misinformation surrounding COVID-19. Expert sources, such as Dr. Anthony Fauci have leveraged social media to present corrective multimedia messages. However, little is known about the efficacy of these messages in revising common misconceptions about COVID-19 and influencing behavior. In this study, we examined the efficacy of a multimodal intervention using authentic social media messages that directly addressed common COVID-19 misconceptions. Going further, we identified individual differences that influenced the effectiveness of the intervention, as well as whether those factors predicted individuals’ willingness to receive a COVID-19 vaccine. The results showed that the intervention was successful in increasing knowledge when compared to a baseline control. Those who were older and reported less vaccine hesitancy showed greater learning from the intervention. Factors that significantly predicted intention to vaccinate included receiving the intervention, vaccine confidence, vaccine hesitancy, prior flu vaccination history, age, and fear of COVID-19. These findings indicate that multimodal messages can be effectively leveraged in social media to both fight misinformation and increase intention to be vaccinated - however, these interventions may not be as effective for all individuals.

COVID-19 Worry and Mental Health Among the Economically Active Population in Guangdong, China

Background

The rapid spread of the coronavirus disease 2019 (COVID-19) pandemic has caused people to worry, which has affected their mental health. This study aimed to access the impact of COVID-19 worry on the mental health of the economically active population (EAP) in a province of China.

Methods

An online cross-sectional survey study was conducted during an outbreak of COVID-19 in Guangdong, China. The survey used the 12-item General Health Questionnaire (GHQ-12) to evaluate participants' mental health status and was completed by 1,584 of the 1,708 participants (a response rate of 92.74%). Ordinary least squares (OLS) regression models were used to identify the correlation between COVID-19 worry and mental health.

Results

Approximately 42.05% of participants reported that they were very worried or extremely worried about the COVID-19 pandemic. COVID-19 worry was negatively correlated with mental health (p < 0.01) and exhibited a stronger influence on the mental health of participants who were male, younger (aged 16–45), or unemployed than on the mental health of participants who were women, older (aged over 45), or employed.

Conclusion

The findings suggest that COVID-19 worry has generated new inequalities in mental health among the EAP of China. The government should provide more public reassurance and psychological support to the EAP to mitigate the effects of COVID-19 worry and prevent mental health disorders.

Social Media Addiction during COVID-19-Mandated Physical Distancing: Relatedness Needs as Motives

In the early stages of the coronavirus disease 2019 (COVID-19) pandemic, national lockdowns and stay-at-home orders were implemented by many countries to curb the rate of infection. An extended stay-at-home period can frustrate people’s need for relatedness, with many turning to social media to interact with others in the outside world. However, social media use may be maladaptive due to its associations with social media addiction and psychosocial problems. Our study was set at this special context to examine the associations among social media addiction, two aspects of relatedness needs (i.e., satisfaction and frustration), and two prominent psychosocial problems (i.e., depressive symptoms and loneliness). The participants were 1048 residents of the U.K. or U.S. (46% men, mean age = 44.10 years, SD = 12.59, age range: 18–65). The results indicated significant positive associations between relatedness need frustration and social media addiction as well as significant positive associations between social media addiction and the two types of psychosocial problems. More importantly, both of these significant associations were strong enough to partially explain the significant positive associations between relatedness need frustration and the two types of psychosocial problems. These findings provided some support for relatedness need frustration as a motivation of social media addiction.

COVID-19, Violent Crime, and Domestic Violence: An Exploratory Analysis

As the world continues to struggle with the effects of the COVID-19 pandemic, there has been much speculation on the impact of the virus on crime rates, especially violent crime and domestic violence. Disruptions in the patterns of daily, routine activities of life caused by lockdowns have been linked to changes in opportunities for criminal events, and these opportunities may vary based on the type of crime. The purpose of this paper is to examine the rates of violent interpersonal crime and domestic violence in the State of Florida, USA from 1/1/2020 to 12/31/2020. Using counties as the unit of analysis, the rates for selected violent crimes was predicted based on the differential impact of the COVID-19 virus, controlling for various county-level social vulnerability and health-related factors. Comparisons between violent crime levels in 2019 and 2020 were also made. Under opportunity theory, it was predicted that the level of domestic violence would increase in counties that experienced higher infection rates and deaths from COVID-19. Conversely, it was predicted that interpersonal violence would decrease in counties with greater impacts and restrictions due to the COVID-19 virus. The results suggest that as the COVID-19 death rate increased, incidents of domestic violence decreased. Altruism was proposed as an alternative explanation for this atypical finding.

The Impact of COVID-19 on Sleep Quality in People Living With Disabilities

Background: Research exploring the impact of the COVID-19 pandemic on sleep in people with disabilities has been scarce. This study provides a preliminary assessment of sleep in people with disabilities, across two timepoints during the pandemic, with a focus on those with visual impairment (VI).

Methods: Two online surveys were conducted between April 2020 and March 2021 to explore sleep quality using the Pittsburgh Sleep Quality Index (PSQI). A convenience sample of 602 participants completed the first survey and 160 completed the follow-up survey.

Results: Across both timepoints, participants with disabilities reported significantly poorer global sleep quality and higher levels of sleep disturbance, use of sleep medication and daytime dysfunction than those with no disabilities. Participants with VI reported significantly higher levels of sleep disturbance and use of sleep medication at both timepoints, poorer global sleep quality, sleep duration and latency at time 1, and daytime dysfunction at time 2, than those with no disabilities. Global sleep quality, sleep duration, sleep efficiency, and self-rated sleep quality deteriorated significantly in participants with no disabilities, but daytime dysfunction increased in all three groups. Disability and state anxiety were significant predictors of sleep quality across both surveys.

Conclusion: While sleep was consistently poorer in people with disabilities such as VI, it appears that the COVID-19 pandemic has had a greater impact on sleep in people with no disabilities. State anxiety and, to a lesser extent, disability, were significant predictors of sleep across both surveys, suggesting the need to address anxiety in interventions targeted toward improving sleep.

Evaluation of COVID-19 pandemic on components of social and mental health using machine learning, analysing United States data in 2020

BACKGROUND

COVID-19 was named a global pandemic by the World Health Organization in March 2020. Governments across the world issued various restrictions such as staying at home. These restrictions significantly influenced mental health worldwide. This study aims to document the prevalence of mental health problems and their relationship with the quality and quantity of social relationships affected by the pandemic during the United States national lockdown.

METHODS

Sample data was employed from the COVID-19 Impact Survey on April 20-26, 2020, May 4-10, 2020, and May 30-June 8, 2020 from United States Dataset. A total number of 8790, 8975, and 7506 adults participated in this study for April, May and June, respectively. Participants' mental health evaluations were compared clinically by looking at the quantity and quality of their social ties before and during the pandemic using machine learning techniques. To predict relationships between COVID-19 mental health and demographic and social factors, we employed random forest, support vector machine, Naive Bayes, and logistic regression.

RESULTS

The result for each contributing feature has been analyzed separately in detail. On the other hand, the influence of each feature was studied to evaluate the impact of COVID-19 on mental health. The overall result of our research indicates that people who had previously been diagnosed with any type of mental illness were most affected by the new constraints during the pandemic. These people were among the most vulnerable due to the imposed changes in lifestyle.

CONCLUSION

This study estimates the occurrence of mental illness among adults with and without a history of mental disease during the COVID-19 preventative limitations. With the persistence of quarantine limitations, the prevalence of psychiatric issues grew. In the third survey, which was done under quarantine or house restrictions, mental health problems and acute stress reactions were substantially greater than in the prior two surveys. The findings of the study reveal that more focused messaging and support are needed for those with a history of mental illness throughout the implementation of restrictions.

The Impact of Maternal Anxiety on Early Child Development During the COVID-19 Pandemic

Background: Maternal prenatal anxiety is among important public health issues as it may affect child development. However, there are not enough studies to examine the impact of a mother's anxiety on the child's early development, especially up to 1 year. Objective: The present prospective cohort study aimed to examine whether maternal trait anxiety, perceived social support, and COVID-19 related fear impacted speech-language, sensory-motor, and socio-emotional development in 12 months old Serbian infants during the COVID-19 pandemic. Methods: This follow-up study included 142 pregnant women (Time 1) and their children at 12 months (Time 2). Antenatal maternal anxiety and children's development were examined. Maternal anxiety was assessed using the State-Trait Anxiety Inventory (STAI). Child speech-language, sensory-motor, and socio-emotional development were assessed using the developmental scale in the form of an online questionnaire that examined the early psychophysiological child development. Information on socioeconomic factors, child and maternal demographics, clinical factors, and perceived fear of COVID-19 viral infection were collected. Multivariable General Linear Model analysis was conducted, adjusted for demographic, clinical, and coronavirus prenatal experiences, maternal prenatal anxiety levels, perceived social support, speech-language, motor skills, and cognitive and socio-emotional development at the infants' age of 12 months. Results: The study revealed the influence of the COVID-19 pandemic on maternal trait anxiety. The association between selected independent factors and infants' development was found in a demographically unified sample except for employment and the number of children. There was a correlation between all observed developmental functions. Univariate General Linear model statistical analysis indicated that linear models with selected independent factors and covariates could account for 30.9% (Cognition) up to 40.6% (Speech-language) of variability in developmental functions. It turned out that two-way and three-way interactions had a dominant role on models, and STAI-T Level and COVID-19 related fear were present in all interaction terms. Conclusion: Our findings reveal important determinants of child developmental outcomes and underline the impact of maternal anxiety on early child development. These findings lay the groundwork for the following interdisciplinary research on pregnancy and child development to facilitate and achieve positive developmental outcomes and maternal mental health.

Protective and Non-Protective Factors of Mental Health Distress in the United States during the COVID-19 Pandemic: A Systematic Review

Background and objectives: Health care organizations continue to respond to the COVID-19 global pandemic and an ongoing array of related mental health concerns. These pandemic-related challenges continue to be experienced by both the U.S. population and those abroad. Materials and methods: This systematic review queried three research databases to identify applicable studies related to protective and non-protective factors of mental health distress experienced during the pandemic within the United States. Results: Three primary factors were identified as protective factors, potentially helping to moderate the incidence of mental distress during the pandemic: demographics, personal support/self-care resources, and income/financial concerns. Researchers also identified these same three constructs of non-protective factors of mental health distress, as well as two additional variables: health/social status and general knowledge/government mistrust. Conclusions: This systematic review has identified protective and non-protective factors of mental health distress experienced in the United States during the COVID-19 pandemic (to date) that can further assist medical providers in the U.S. and beyond as the pandemic and related mental health concerns continue at a global level.

Does COVID-19 Clinical Status Associate with Outcome Severity? An Unsupervised Machine Learning Approach for Knowledge Extraction

Since the beginning of the COVID-19 pandemic, 195 million people have been infected and 4.2 million have died from the disease or its side effects. Physicians, healthcare scientists and medical staff continuously try to deal with overloaded hospital admissions, while in parallel, they try to identify meaningful correlations between the severity of infected patients with their symptoms, comorbidities and biomarkers. Artificial intelligence (AI) and machine learning (ML) have been used recently in many areas related to COVID-19 healthcare. The main goal is to manage effectively the wide variety of issues related to COVID-19 and its consequences. The existing applications of ML to COVID-19 healthcare are based on supervised classifications which require a labeled training dataset, serving as reference point for learning, as well as predefined classes. However, the existing knowledge about COVID-19 and its consequences is still not solid and the points of common agreement among different scientific communities are still unclear. Therefore, this study aimed to follow an unsupervised clustering approach, where prior knowledge is not required (tabula rasa). More specifically, 268 hospitalized patients at the First Propaedeutic Department of Internal Medicine of AHEPA University Hospital of Thessaloniki were assessed in terms of 40 clinical variables (numerical and categorical), leading to a high-dimensionality dataset. Dimensionality reduction was performed by applying a principal component analysis (PCA) on the numerical part of the dataset and a multiple correspondence analysis (MCA) on the categorical part of the dataset. Then, the Bayesian information criterion (BIC) was applied to Gaussian mixture models (GMM) in order to identify the optimal number of clusters under which the best grouping of patients occurs. The proposed methodology identified four clusters of patients with similar clinical characteristics. The analysis revealed a cluster of asymptomatic patients that resulted in death at a rate of 23.8%. This striking result forces us to reconsider the relationship between the severity of COVID-19 clinical symptoms and the patient's mortality.

Implications of the Online Teaching Model Derived from the COVID-19 Lockdown Situation for Anxiety and Executive Functioning in Spanish Children and Adolescents

Given the seriousness of the existing situation regarding the mental health of children and adolescents relating to the confinement period imposed due to COVID-19, we conducted this study to describe the effects of the confinement on state anxiety and executive functioning dimensions in a period of online educational modality. A sample of 953 children and adolescents was assessed. A sociodemographic questionnaire, the State Anxiety Inventory for Children (STAIC), and the Behavioral Evaluation of Executive Function (BRIEF-2) scale were applied. The analysis of the results indicates that 68.8% of children and adolescents presented medium–high levels of anxiety. Regarding sex, females showed higher levels of anxiety and worse levels of executive functioning. Although the group aged 11 to 18 years showed methodologically higher state anxiety (p = 0.041) than the group aged 6 to 10 years, the difference was not clinically relevant (δ = −0.113). The state anxiety variable was also correlated positively and significantly to the three executive functioning dimensions explored. In conclusion, it seems evident that COVID-19 lockdowns could have psychological and emotional effects on children and adolescents.

Emotional intelligence training as a protective factor for mental health during the COVID-19 pandemic

INTRODUCTION

The COVID-19 pandemic has presented a major challenge to mental health and emotional wellbeing. The present study examined whether training in emotional intelligence (EI) skills, provided before the pandemic, would serve as a protective factor for sustaining mental health during the COVID-19 crisis.

METHODS

Data came from a longitudinal study (N = 89) that was initially designed to test the effectiveness of an EI training program versus a non-emotion-focused placebo program. The design and timing of the study were such that baseline and posttraining assessments of depression and anxiety had been completed before the pandemic, and planned 6-month follow-ups were serendipitously scheduled to occur after the onset of the COVID-19 crisis. This provided us with an unexpected real-world opportunity to investigate whether EI training would bolster emotional resilience to the challenges posed by the COVID-19 pandemic.

RESULTS

Although mental health concerns generally increased after the start of the pandemic, individuals who completed the EI training program scored lower on depression, suicidal ideation, and state anxiety relative to individuals who had been assigned to the placebo training program.

CONCLUSION

Online EI training appears to be effective at sustaining critical aspects of mental health during a subsequent real-life crisis.

The Long-Term Impact of the COVID-19 Pandemic on Loneliness in People Living With Disability and Visual Impairment

Background: There has been growing concern about the impact of restrictions put in place to contain the coronavirus pandemic on loneliness, particularly in individuals with disabilities. This study explored the longitudinal impact of the pandemic on loneliness in these individuals, with a focus on those living with visual impairment (VI). Methods: An online survey was conducted in April-2020 and repeated in March 2021 to explore current life circumstances, health-related behaviours, sleep (Pittsburgh Sleep Quality Index) and social well-being, including state anxiety (State-Trait Anxiety Index) and loneliness (UCLA Loneliness scale). A convenience sample of 602 participants completed the first survey. Participants who agreed to be re-contacted were invited to take part in the follow-up survey. Results: Data is presented for the 160 participants who completed both timepoints. At both timepoints, median loneliness was significantly higher in participants with disabilities and those with VI than in participants with no disabilities. While there was no significant change in loneliness in any of the three subgroups, participants with VI experienced the largest increase in median loneliness. Loneliness was associated with having a mental health condition and higher levels of state anxiety at both timepoints. Conclusions: Individuals with disabilities such as VI experienced consistently higher levels of loneliness than those with no disabilities throughout the pandemic. While loneliness remained relatively stable in individuals with no disabilities, it increased, albeit to a non-significant level, in those with disabilities and particularly those with VI. Interventions designed to alleviate loneliness may benefit from addressing state anxiety.

Increasing aggression during the COVID-19 lockdowns

Background

To combat the spread of COVID-19, many communities implemented restrictions on personal movement, often referred to as "lockdowns." We hypothesized that continued lockdowns might be associated with increased feelings of aggression.

Methods

Over the first six months of the COVID-19 pandemic, the Buss-Perry Aggression Questionnaire (BPAQ) was administered to a total of 5,928 adults distributed proportionally from across the United States during independent online cross-sectional surveys collected each month. Data across the 6-month period were compared between those under lockdown versus those not under such restrictions.

Results

BPAQ Total Aggression scores showed a significant main effect for both month and lockdown status as well as a significant interaction effect, with increasing scores evident for those reporting that they were under lockdown relative to those reporting no restrictions. This same pattern was evident for all four subscales of the BPAQ, including Physical Aggression, Verbal Aggression, Anger, and Hostility.

Limitations

Random sampling of the entire population was not possible, so generalization of the results should be made with caution. Additionally, data were collected cross-sectionally and cannot be considered to reflect longitudinal change within individuals. Finally, the cross-sectional survey design means that it is impossible to infer that the lockdowns caused the increase in aggression.

Conclusions

Lockdowns were associated with elevated levels of aggression that were higher in later months of the national pandemic response.

Anxiety and Depressive Disorders and Quality of Life Assessment of Poles-A Study Covering Two Waves of the COVID-19 Pandemic

Background: More than a year after the first case of SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus-2) viral pneumonia, the world is still engulfed by the pandemic, and we know that this condition has an enormous impact not only on individuals but also on the social order in virtually every aspect of daily life, deteriorating our mental health. This study aims to assess the prevalence of depressive and anxiety symptoms and the subjective assessment of the quality of life in the different stages of the COVID-19 (Coronavirus Disease 2019) pandemic based on a nationwide online survey. Materials and Methods: The study was conducted using an original questionnaire assessing the sociodemographic status and standardized psychometric tools: Beck Depression Inventory (BDI), Generalized Anxiety Disorder (GAD-7) and Manchester Short Assessment of Quality of Life (MANSA). The study was conducted in two stages corresponding to the first and second wave of the COVID-19 pandemic. Results: In total, 4,083 respondents participated in the survey. The first observation stage took place between 17 and 26 April 2020 and comprised 2,457 respondents; the repeated survey that took place between 1 and 30 December 2020 comprised 1,626 respondents. In both cases, women constituted the majority of respondents (82.5% in the first stage and 79.6% in the second stage). Statistically significantly higher levels of depression and anxiety were found in second stage, with mean scores of BDI and GAD-7. In the case of MANSA, participants in the different stages of the pandemic showed no significant differences in terms of mean scores. However, women were more susceptible to developing the depression and anxiety symptoms and it was obtained in both waves of the pandemic Conclusions: As the Covid-19 pandemic progressed, there was higher level of depressive and anxiety symptoms among Poles.