Psychological Distress, Loneliness, and Boredom Among the General Population of Tyrol, Austria During the COVID-19 Pandemic

Overcoming times of crisis: unveiling coping strategies and mental health in a transnational general population sample during and after the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has had an unparalleled impact, precipitating not only direct threats to physical health but also widespread economic and psychological challenges. This study aims to explore the dynamics of coping behaviour and psychological distress (PD) across different phases of the pandemic within an adult general population sample, spanning Austria and Italy.

METHODS

An online questionnaire-based panel study was conducted between 2020 and 2023 including three measurements. We collected data on sociodemographic variables, coping responses (Brief COPE), and PD (Brief-Symptom-Checklist). Statistical analyses were conducted within a linear-mixed-model framework. Multiple imputation and sensitivity analysis were applied to validate the results obtained by complete case analysis.

RESULTS

The study follows 824 participants and reveals a marginal decrease in overall PD from the first to the second follow-up, particularly in clinically relevant phobic anxiety (35.6% and 34.5% to 25.4%). Most coping behaviours exhibited stable mean-levels with intra-individual variability across the study period. Maladaptive coping strategies were consistently linked to increased PD, whereas adaptive strategies were associated with decreased PD.

CONCLUSION

Our findings underscore the complex nature of coping behaviours and PD during and after the pandemic, suggesting that while mean-levels of PD and coping responses remained relatively stable, most coping strategies were subject to intra-individual change. Maladaptive strategies were associated with increased PD, pinpointing to the need for interventions that establish the foundation for adaptive coping mechanisms and promote their application. Further research should explore the reciprocal influences of mental health on coping behaviour, incorporating interventional designs to unravel the nuances of these relationships.

Comprehensive examination of support needs and mental well-being: a mixed-method study of the Austrian general population in times of crisis

Introduction

In the recent years, the Austrian general population has faced a confluence of multiple crises. This study investigates the support wishes and mental health parameters of the Austrian general population aiming to comprehending the unmet needs and providing guidance for future psychosocial interventions and research endeavors.

Methods

1,031 participants attended the online survey and one third (n = 332) wished for further support to improve mental well-being in April 2022. A total of 280 participants accompanied their support wish with written accounts. Participants' mental health status was evaluated using the PHQ-9 (depression), GAD-7 (anxiety), ISI (insomnia), PSS-10 (perceived stress), CAGE (alcohol abuse), WHO-5 (well-being), and the SCOFF (eating disorder) questionnaires. Data analysis employed a mixed-methods approach.

Results

The preeminent support wish identified was the need for professional mental support (29.3%), followed by communication (21.6%), other professional support except mental and medical support (13.9%). In line with these findings, participants expressing a support wish experienced increased mental health distress across all assessed parameters.

Conclusion

The findings indicate the presence of a vulnerable population within the Austrian general population, which may benefit from targeted support interventions. Consequently, this study contributes to the identification of unmet support needs among the Austrian populace during times of crisis, facilitating the development and enhancement of precisely tailored intervention strategies.

Social and temporal disorientation during the Covid-19 pandemic: An analysis of 3306 responses to a quantitative questionnaire

The societal hallmark of the Covid-19 pandemic was a set of mitigation measures such as lockdowns and curfews. The cognitive impact on the public of the resulting spatial, social and temporal constraints is still being investigated. While pandemic time has been extensively studied and mostly described as slowed down and elongated, opposite experimental patterns across national and social contexts leave open an important explanatory gap in order to understand which factor has been causally fundamental in determining the phenomenology of the crisis. In this paper, we use a quantitative questionnaire developed for measuring temporal and social disorientation on a sample of 3306 respondents during an acute phase of restrictions in France. We show that social disorientation greatly contributed to the temporal disruptions experienced during the pandemic. This result reinforces the importance for public authorities to address the compounding effect of feeling isolated during crises.

Long-term impact of resilience and extraversion on psychological distress during the COVID-19 pandemic: a longitudinal investigation among individuals with and without mental health disorders

Background

Over the past years, the COVID-19 pandemic has caused significant disruptions in daily routines. Although the pandemic has affected almost everyone, it has been particularly challenging for people with pre-existing mental health conditions. Therefore, this study investigated the long-term impact of resilience and extraversion on psychological distress in individuals diagnosed with mental health disorders (MHD) compared to the general population. In addition, possible gender-specific differences were investigated.

Methods

123 patients with pre-existing MHD and 343 control subjects from Austria and Italy participated in three online surveys that had been conducted after the initial wave of the COVID-19 pandemic (t0), during the second lockdown in both countries (t1), and one year thereafter (t2). Participants completed standardized questionnaires on psychological distress (Brief-Symptom-Checklist), resilience (Resilience Scale), and extraversion (Big Five Inventory). A mediation model was employed to test the primary hypothesis. Possible gender-specific differences were analyzed using a moderated mediation model.

Results

The prevalence of psychological distress was consistently higher in patients compared to controls (t0: 37.3% vs. 13.2%, t1: 38.2% vs 11.7%, t2: 37.4% vs. 13.1%). This between-group difference in psychological distress at the first follow-up was fully mediated by baseline resilience scores (65.4% of the total effect). During the second-follow up, extraversion accounted for 18% of the total effect, whereas resilience slightly decreased to 56% of the total effect. Gender was not a significant moderator in the model.

Conclusion

Next to showing that people with MHD were particularly affected by the pandemic, these findings indicate that higher degrees of resilience and extraversion are related to less long-term psychological distress. Our findings stress the relevance of strengthening resilience and extraversion and to provide mental health support in times of crises, both to patients with MHD and the general population.

Creative minds at rest: Creative individuals are more associative and engaged with their idle thoughts

Despite an established body of research characterizing how creative individuals explore their external world, relatively little is known about how such individuals navigate their inner mental life, especially in unstructured contexts such as periods of awake rest. Across two studies, the present manuscript tested the hypothesis that creative individuals are more engaged with their idle thoughts and more associative in the dynamic transitions between them. Study 1 captured the real-time conscious experiences of 81 adults as they voiced aloud the content of their mind moment-by-moment across a 10-minute unconstrained baseline period. Higher originality scores on a divergent thinking task were associated with less perceived boredom, more words spoken overall, more freely moving thoughts, and more loosely-associative (as opposed to sharp) transitions during the baseline rest period. In Study 2, across 2,612 participants, those who reported higher self-rated creativity also reported less perceived boredom during the COVID-19 pandemic, a time during which many people experienced unusually extended periods of unstructured free time. Overall, these results suggest a tendency for creative individuals to be more engaged and explorative with their thoughts when task demands are relaxed, raising implications for resting state functional MRI and societal trends to devalue idle time.

Persistent somatic symptoms are key to individual illness perception at one year after COVID-19 in a cross-sectional analysis of a prospective cohort study

OBJECTIVE

Subjective illness perception (IP) can differ from physician's clinical assessment results. Herein, we explored patient's IP during coronavirus disease 2019 (COVID-19) recovery.

METHODS

Participants of the prospective observation CovILD study (ClinicalTrials.gov: NCT04416100) with persistent somatic symptoms or cardiopulmonary findings one year after COVID-19 were analyzed (n = 74). Explanatory variables included demographic and comorbidity, COVID-19 course and one-year follow-up data of persistent somatic symptoms, physical performance, lung function testing, chest computed tomography and trans-thoracic echocardiography. Factors affecting IP (Brief Illness Perception Questionnaire) one year after COVID-19 were identified by regularized modeling and unsupervised clustering.

RESULTS

In modeling, 33% of overall IP variance (R2) was attributed to fatigue intensity, reduced physical performance and persistent somatic symptom count. Overall IP was largely independent of lung and heart findings revealed by imaging and function testing. In clustering, persistent somatic symptom count (Kruskal-Wallis test: η2 = 0.31, p < .001), fatigue (η2 = 0.34, p < .001), diminished physical performance (χ2 test, Cramer V effect size statistic: V = 0.51, p < .001), dyspnea (V = 0.37, p = .006), hair loss (V = 0.57, p < .001) and sleep problems (V = 0.36, p = .008) were strongly associated with the concern, emotional representation, complaints, disease timeline and consequences IP dimensions.

CONCLUSION

Persistent somatic symptoms rather than abnormalities in cardiopulmonary testing influence IP one year after COVID-19. Modifying IP represents a promising innovative approach to treatment of post-COVID-19 condition. Besides COVID-19 severity, individual IP should guide rehabilitation and psychological therapy decisions.

Alcohol Use, Anxiety and Depression among French Grandes Écoles Engineering Students during the COVID-19 Pandemic

In French Grandes Écoles, heavy alcohol consumption seems to be generalized and largely tolerated, leading to particular concerns about Alcohol Use Disorder and harmful alcohol practices among students. The COVID-19 pandemic led to increased psychological difficulties, and two coexisting scenarios seemed to emerge regarding alcohol consumption: A decrease in alcohol consumption linked to the absence of festive events, and an increase in solitary alcohol consumption to cope with lockdowns. The aim of this exploratory study is to investigate the evolution of alcohol consumption, consumption motives and the relationship of these factors to the anxiety and the depression of French Grandes Écoles students during the COVID-19 pandemic, depending on their residential status. After the last lockdown, 353 students completed a questionnaire measuring alcohol consumption, motivation to drink, anxiety and depression during and after the COVID-19 period. Although students confined to campus were more likely to increase their alcohol use, they also presented higher well-being scores than those who lived off campus. A significant proportion of students were aware of their increased alcohol use due to the COVID-19 pandemic, and the motives attributed to their increased consumption highlight the need for vigilance and specialized support facilities.

Living with a Pandemic from Psycho-Social Perspectives: A Narrative Review

This narrative review aims to identify psycho-social issues related to the COVID-19 pandemic, especially among vulnerable populations. Through understanding the psychosocial meanings underneath, the suffering from the pandemic and the transformative experiences toward better society could be substantiated. Searching relevant studies and literature on psycho-social impacts in relation to COVID-19 was conducted from psycho-social points of view. Vulnerable populations such as the mentally ill, the poor, refugees, immigrants, the elderly, and other stigmatized groups were focused on. Reflections and plans on the worsened health disparities and increased stresses among vulnerable groups will help our society to be healthier and safer.

Examining Differences, Relationships, and Predictors for Loneliness in an Adult Population: The Roles of Personal Characteristics, Place of Residence, Leisure Activities, Mental Health, and Social Outcomes

Loneliness is associated with poor mental and social outcomes globally. The literature suggests an association between loneliness and personal characteristics, place of residence, and leisure activities. However, the current literature has produced inconsistent findings and has focused largely on older adults. This study is one of the first to examine the differences, relationships, and predictors of loneliness in an adult population, and the roles of personal characteristics, place of residence, leisure activities, mental health, and social outcomes. A cross-sectional online survey was undertaken. A sample of 155 adults responded, with a mean age of 34.5 years (SD = 13.2), and with 54.1% identifying as female. An analysis revealed experiences of loneliness across the sample. In addition, age was moderately associated with loneliness, while psychological distress, depressive symptoms, and social networks were significantly associated with loneliness. Depressive symptoms were a positive predictor for loneliness, and social networks were a negative predictor for loneliness. This study has confirmed findings from previous research and provided new information on loneliness, which can guide future research and interventions to prevent or support people who suffer from loneliness.

Double jeopardy: How lower levels of support during COVID-19 exacerbated the relationship between loneliness and distress

While the relationship between loneliness and psychological distress is well documented, the mechanisms underlying this relationship are less clear. One factor known to be related to loneliness as well as psychological distress, is social support, with some studies suggesting that support-both received and provided-can serve as a mechanism to reduce the distress associated with loneliness. In this paper we examine the mediating role of both aspects of support in the relationship between loneliness and psychological distress in the COVID-19 context. We used a multi-country dataset collected at two timepoints during the pandemic; the first during the early stages (N = 6,842, 11 countries) and the second collected for a subset of countries (N = 1,299, 3 countries) 3 months later. Across all eleven countries, results revealed significant positive associations between loneliness and distress. Furthermore, using longitudinal data, we investigated the directionality of this relationship and found that increased loneliness over time was associated with increased psychological distress. The data also showed that both feeling unsupported and feeling unable to provide support to others mediated this relationship. These findings point to the need to facilitate people's ability to draw effective social support and help others-particularly at times when social connectedness is threatened-as a way of alleviating the psychological distress that commonly presents with loneliness.

Boredom in a Time of Uncertainty: State and Trait Boredom's Associations with Psychological Health during COVID-19

Throughout the COVID-19 pandemic, studies have demonstrated increases in boredom and its negative impact on mental health. This cross-sectional study examines state and trait boredom at four different points of the pandemic using an online sample of participants from the United States (n = 783). The results showed significant increases in boredom proneness, state boredom, substance use, loneliness, and distress. Boredom was associated with increases in each of these variables and a greater likelihood of testing positive for COVID-19. Moreover, the increases in distress, loneliness, and substance use became non-significant when controlling for boredom. Boredom proneness remained associated with all adverse outcomes when accounting for state boredom. In contrast, the relationships between state boredom and most adverse outcomes lost significance when controlling for boredom proneness, and state boredom was positively associated with increased hope for the future. Overall, the results suggest that high boredom proneness is an important vulnerability factor for poor psychological health and risky behaviors during the pandemic. However, high levels of recent state boredom, independent of boredom proneness, do not predict similarly negative outcomes. State boredom may indicate the extent to which one remains hopeful that circumstances will improve without resorting to risky, potentially maladaptive coping strategies.

Are healthcare workers particularly vulnerable to loneliness? The role of social relationships and mental well-being during the COVID-19 pandemic

Loneliness is a major public health issue with renewed prominence due to the COVID-19 pandemic and associated social restrictions. Healthcare workers (HCWs) may be at heightened risk, but research is lacking. We measured the prevalence of loneliness among HCWs during the pandemic in 2020 and examined pre-pandemic predictors and pandemic experiences associated with loneliness. HCWs at a designated COVID-19 hospital in Sydney, Australia completed an online survey examining health and well-being before and during the pandemic and changes to work, family and social experiences. Loneliness had negatively affected the well-being of 129 (39%) respondents (n ​= ​330). Pre-pandemic factors predicting loneliness were younger age (<30years compared to ≥50years), having ever been told you had a mental health problem and living alone. These became non-significant when pandemic-related factors were added to the regression. Less contact with family and friends, increased conflict at home, and living alone or with family but not a partner, increased the odds of loneliness, while a sense of camaraderie with colleagues had the opposite effect. Psychological distress and poor mental health during the pandemic were also positively associated with loneliness. Efforts to promote congenial social contacts may be effective in averting loneliness among HCWs.

Who Is at Risk of Poor Mental Health Following Coronavirus Disease-19 Outpatient Management?

Background

Coronavirus Disease-19 (COVID-19) convalescents are at risk of developing a de novo mental health disorder or worsening of a pre-existing one. COVID-19 outpatients have been less well characterized than their hospitalized counterparts. The objectives of our study were to identify indicators for poor mental health following COVID-19 outpatient management and to identify high-risk individuals.

Methods

We conducted a binational online survey study with adult non-hospitalized COVID-19 convalescents (Austria/AT: n = 1,157, Italy/IT: n = 893). Primary endpoints were positive screening for depression and anxiety (Patient Health Questionnaire; PHQ-4) and self-perceived overall mental health (OMH) and quality of life (QoL) rated with 4 point Likert scales. Psychosocial stress was surveyed with a modified PHQ stress module. Associations of the mental health and QoL with socio-demographic, COVID-19 course, and recovery variables were assessed by multi-parameter Random Forest and Poisson modeling. Mental health risk subsets were defined by self-organizing maps (SOMs) and hierarchical clustering algorithms. The survey analyses are publicly available (https://im2-ibk.shinyapps.io/mental_health_dashboard/).

Results

Depression and/or anxiety before infection was reported by 4.6% (IT)/6% (AT) of participants. At a median of 79 days (AT)/96 days (IT) post-COVID-19 onset, 12.4% (AT)/19.3% (IT) of subjects were screened positive for anxiety and 17.3% (AT)/23.2% (IT) for depression. Over one-fifth of the respondents rated their OMH (AT: 21.8%, IT: 24.1%) or QoL (AT: 20.3%, IT: 25.9%) as fair or poor. Psychosocial stress, physical performance loss, high numbers of acute and sub-acute COVID-19 complaints, and the presence of acute and sub-acute neurocognitive symptoms (impaired concentration, confusion, and forgetfulness) were the strongest correlates of deteriorating mental health and poor QoL. In clustering analysis, these variables defined subsets with a particularly high propensity of post-COVID-19 mental health impairment and decreased QoL. Pre-existing depression or anxiety (DA) was associated with an increased symptom burden during acute COVID-19 and recovery.

Conclusion

Our study revealed a bidirectional relationship between COVID-19 symptoms and mental health. We put forward specific acute symptoms of the disease as "red flags" of mental health deterioration, which should prompt general practitioners to identify non-hospitalized COVID-19 patients who may benefit from early psychological and psychiatric intervention.

Clinical Trial Registration

[ClinicalTrials.gov], identifier [NCT04661462].

Mental health in individuals with severe mental disorders during the covid-19 pandemic: a longitudinal investigation

Research on the long-term mental health impact of the COVID-19 pandemic across mental disorders is limited, and information on the impact of public health policy measures with varying strictness is missing. This study therefore aimed at investigating psychological distress among residents of Tyrol (Austria) and South Tyrol (Italy) at the early stages of the pandemic and 5 months thereafter and examined how sociodemographic, protective, and risk factors relate to change over time. One hundred and fifteen people with severe mental illness (SMI; schizophrenia spectrum disorder, bipolar disorder, major depressive disorder with psychotic features) or major depressive disorder without psychotic features (MDD) and 481 community controls without mental disorders participated in an online survey. Next to the collection of sociodemographic and COVID-19 related variables, the Brief Symptom Checklist, the Resilience Scale, the Multidimensional Scale of Perceived Social Support, the Three-Item Loneliness Scale, and the Multidimensional State Boredom Scale-Short Form were used to assess psychological distress, resilience, perceived social support, loneliness, and boredom. Levels of psychological symptoms and the prevalence of psychological distress were significantly higher in individuals with MDD compared to the other two groups, and Italian participants were more prone to anxiety than those from Austria. Psychological distress was predicted by a lower degree of both resilience and perceived social support as well as loneliness and boredom. Notably, the prevalence of clinically relevant psychological symptoms remained unchanged among each group over time. These results underscore the relevance of tailored prevention and mitigation strategies to meet the specific needs of people both with and without mental disorders.

Having a Break or Being Imprisoned: Influence of Subjective Interpretations of Quarantine and Isolation on Boredom

Boredom has been identified as one of the greatest psychological challenges when staying at home during quarantine and isolation. However, this does not mean that the situation necessarily causes boredom. On the basis of 13 explorative interviews with bored and non-bored persons who have been under quarantine or in isolation, we explain why boredom is related to a subjective interpretation process rather than being a direct consequence of the objective situation. Specifically, we show that participants vary significantly in their interpretations of staying at home and, thus, also in their experience of boredom. While the non-bored participants interpret the situation as a relief or as irrelevant, the bored participants interpret it as a major restriction that only some are able to cope with.

Addiction in the time of COVID-19: Longitudinal course of substance use, psychological distress, and loneliness among a transnational Tyrolean sample with substance use disorders

INTRODUCTION

Next to an increased use of alcohol, the current pandemic has been associated with increased psychological distress among the general population. Research on its effects on individuals suffering from substance use disorders (SUD) is scarce. This study aimed at expanding the existing literature on this topic with a focus on the impact of loneliness and perceived social support.

METHODS

Sixty-eight people diagnosed with SUD according to ICD-10 from the Austrian state of Tyrol and from the Italian Province of South Tyrol who had been treated in a psychiatric hospital in 2019 and one hundred and thirty-six matched reference subjects of the same regional background participated in an online survey. Sociodemographic variables and scores on the Brief Symptom Checklist, the Three-Item Loneliness Scale, and the Multidimensional Scale of Perceived Social Support were collected at baseline and 5 months thereafter. Baseline took place after the first wave, while follow-up largely coincided with the second wave of the pandemic.

RESULTS

Among both patients and the matched reference group, substance use as a means to feel better facing the pandemic rose and predicted higher levels of psychological distress. Patients were less likely to receive specific care at follow-up than at baseline and presented with a significantly higher prevalence of clinically relevant psychological distress and loneliness than the matched reference group at both assessment times. Among both groups, psychological burden remained unchanged over time. Perceived social support was generally significantly higher in the matched reference group than in patients. Loneliness and, to a lesser degree, low perceived social support predicted psychological distress.

CONCLUSION

These findings emphasize the need of preventive and educational measures regarding substance use behavior for both individuals suffering from SUD and those without mental health disorders.

The Impact of Resilience and Extraversion on Psychological Distress, Loneliness, and Boredom During the COVID-19 Pandemic: A Follow-Up Study Among the General Population of Tyrol, Austria

Background: The Covid-19 pandemic and related measures represent an enormous burden on mental health. The aim of this study was to investigate longitudinal changes in psychological distress, loneliness, boredom, and resilience over the course of the pandemic and to examine the associations between resilience and extraversion at baseline (summer 2020) and psychological distress, loneliness, and boredom at 5-month-follow-up. Methods: Residents of Tyrol (≥18a) completed an online survey on psychological distress, loneliness, boredom, resilience, and extraversion by using the Brief-Symptom-Checklist, the Three-Item Loneliness Scale, the Multidimensional State Boredom Scale-Short Form (MSBS-SF), the Resilience Scale, and the Extraversion subscale of the Big Five Inventory. Results: Of the 961 baseline participants, 384 took part in the follow-up survey. The percentage of study participants with striking psychological distress remained the same. Similarly, resilience did not change from baseline to follow-up, whereas the number of those experiencing moderate loneliness increased significantly. In contrast, at follow-up, severe loneliness was detected in significantly less people. Boredom decreased significantly over time. A moderate negative association was detected between baseline resilience and psychological distress, loneliness, and boredom at follow-up, and a weak but still significant negative association between extraversion and these outcomes. Discussion: These findings indicate that a subset of the general population consistently suffers from high levels of psychological distress and point to the protective effects of resilience and extraversion in this context. They reemphasize the importance of prevention and mitigation strategies to address these public health problems.

The Mediating Role of Resilience and Extraversion on Psychological Distress and Loneliness Among the General Population of Tyrol, Austria Between the First and the Second Wave of the COVID-19 Pandemic

Background: During the first 3 weeks of the COVID-19 pandemic, the federal state of Tyrol, Austria had one of the strictest curfews in Austria and worldwide. The aim of the current study was to investigate the assumingly protective role of resilience and extraversion and its impact on mental health following such an uncertain and unpredictable situation. Methods: Between the first and the second wave of the pandemic, adult residents of Tyrol were invited to participate in an online survey. Next to the assessment of sociodemographic and COVID-19-related variables the Brief-Symptom-Checklist, the Three-Item Loneliness Scale, the Resilience Scaled, and the Big Five Inventory were used to assess psychological distress, loneliness, resilience, and extraversion. Mediation analysis was used to investigate the role of resilience and extraversion in the context of age-, sex-, and partnership- related differences in psychological distress and loneliness. Results: One hundred and forty-five participants took part in the survey (68.2% female). Overall, psychological distress and severe loneliness were more often detected in women and singles. They also were less resilient, while men and singles presented with a lower degree of extraversion. Study participants under the age of 30 experienced severe loneliness more frequently than older people, whereas psychological distress, resilience, and extraversion were comparable between age groups. Resilience significantly mediated the relationship between both study participants' sex and partnership situation on one hand and psychological distress and severe loneliness on the other. In addition, extraversion significantly mediated the relationship between participants' partnership situation and psychological distress. Discussion: Our findings suggest that women, singles, and young people may be particularly affected by the measures and sequelae of the COVID-19 pandemic. Interventions promoting resilience and extraversion among these groups are urgently needed to foster mental health. Ideally, they can be utilized at home in case of renewed mobility restrictions or quarantine in the future.