"Stay at Home" in Italy during the COVID-19 Outbreak: A Longitudinal Study on Individual Well-Being among Different Age Groups

Do Social Support and Loneliness Influence Emerging Adults' Mental Health during the First Year of the COVID-19 Pandemic?

Youths' mental health is at a crisis level, with mental health problems doubling in the US since the pandemic began. To compound the mental health crisis, there is a global loneliness epidemic, with emerging adults worldwide experiencing some of the highest rates. One study with two phases examined the influence of social support and loneliness on mental health in US emerging adults during the pandemic, including changes in these relationships over one year. Emerging adults (N = 449) completed online questionnaires via Prolific in May 2020 (Phase 1) and again from January to May 2021 (N = 253; Phase 2). More perceived support was related to reduced loneliness, with family support having the most significant influence. Loneliness mediated the link between perceived support and adverse health outcomes. Higher loneliness predicted more perceived stress and sleep difficulties concurrently and over time. There was a bidirectional relationship between loneliness and depression, such that higher levels of either variable at Time 1 predicted increases in the other over time. Results highlight the detrimental impact of loneliness on emerging adults' mental health.

Exploring Social Bonds and Well-Being in Young Adults during and beyond the COVID-19 Pandemic

BACKGROUND

Young adults, aged between 17 and 25 years, experienced a strong impact on both their mental health and well-being due to COVID-19. Indeed, they were simultaneously faced with the normative tasks of their age and stressors associated with the long-lasting COVID-19 pandemic. This study offers further insights into the perceptions of the well-being (stress, anxiety, and depression) and social bonds in young Italian adults during and after the COVID-19 pandemic.

METHODS

The first survey was conducted between December and February 2021 (i.e., during the second wave in Italy) and included a total sample of 347 participants. The second survey took place between April and May 2022 (i.e., at the end of the health emergency in Italy) and consisted of a total sample of 313 participants.

RESULTS

T-tests, correlations, and linear regressions were performed. Overall, our findings showed an increased mood disturbance was positively correlated with having contracted COVID-19 and negatively associated with social connectedness. Furthermore, social assurance was found to negatively predict mood disorders during COVID-19.

CONCLUSION

While numerous studies have focused on mental health, there has been limited exploration of protective factors, which could represent a different perspective that emphasizes individuals' resources rather than their vulnerabilities.

The COVID-19 pandemic as an existential threat: Evidence on young people's psychological vulnerability using a Multifaceted Threat Scale

Research offers evidence that younger generations suffered the most psychologically from the COVID-19 crisis. In this article, we look at the onset of the pandemic to understand the reasons for this increased vulnerability. We use the COVID-19 Multifaceted Threat Scale to explore potential mechanisms underlying generational differences in psychological well-being. In a sample of 994 individuals (+18) obtained in the USA and India, we first assess levels of perceived psychological well-being across the generations. Thus, we measure cross-generational differences in the perceived levels of financial, relational, existential, health and lifestyle threats experienced by respondents seven months after the pandemic broke out. In accordance with earlier findings, the results confirm that people from Generation Z and Generation Y reported worse levels of psychological well-being than older adults. Our results suggest that the heightened existential threat, as reflected in a loss of meaning and feelings of being "trapped", mediate the association between younger generations and worse psychological well-being. No substantial intergenerational differences were found for other threat dimensions. The observed effects were consistent across both national contexts, hence stressing the importance of existential concerns as a mechanism underlying the psychological vulnerability of younger people in the historical contingencies of the COVID-19 pandemic.

Resilience, Positivity and Social Support as Perceived Stress Predictors among University Students

Since the COVID-19 pandemic, researchers have been trying to identify which personal resources can contribute to minimizing the mental health costs in students incurred due to the restrictions that disrupted safety and predictability in their academic lives. The aim of the study was to verify if and how individual factors (resilience and positivity) and socio-environmental factors (social support and nationality) allow prediction of the level of perceived stress. University students (n = 559) from Poland, Serbia, and Italy were surveyed using the Perceived Stress Scale (PSS-10), the Brief Resilience Scale (BRS), the Positivity Scale (PS), and the Interpersonal Support Evaluation List (ISEL-12). Personal resources-positivity, resilience, and support-were found to be positively interrelated and significantly associated with stress levels. Additionally, gender and nationality differentiated stress levels. A general linear model (GLM) showed that levels of perceived stress are best explained by resilience, positivity, tangible support, and gender. The results obtained can strengthen students' awareness of personal resources and their protective role in maintaining mental health, as well as contribute to the creation of prevention-oriented educational activities. Nationality was not a significant predictor of the level of perceived stress, which highlights the universality of examined predictors among university students from different countries and suggests that interventions aimed at enhancing these resources could benefit students across different cultural contexts.

Intervening on Global Emergencies: The Value of Human Interactions for People's Health

Literature about global emergencies and their impact on people's health underlines the need to improve the social cohesion of human community and the availability of tools to support people and foster community interactions. This paper illustrates research aimed at describing and measuring human interactions in the Veneto community and its changing during the COVID-19 pandemic. 50,000 text occurrences from social media and newspapers about these topics were analyzed between December 2021 and January 2022. People present themselves as members of different teams, pursuing conflicting aims, and attributing the decision-making responsibility of emergencies management exclusively to governments, without considering themselves as active parts of the community. This delegation process on citizens' behalf can affect their health: by taking minor responsibility in handling the repercussions of these events on the community and by arguing over the most effective way to deal with them, they risk freezing and waiting for action by third parties, thus leaving mutual interactions and the promotion of their own health at a standstill. Local institutions can use these data to shape prevention policies to manage the community's emergencies and use them as opportunities to promote public health.

Impact of COVID-19 Pandemic on Well-Being, Social Relationships and Academic Performance in a Sample of University Freshmen: A Propensity Score Match Evaluation Pre- and Post-Pandemic

The COVID-19 pandemic has impacted freshmen, compromising their mental health, lifestyles, and academic performance. There are few studies that have investigated changes in the health status and lifestyles of freshmen before and after the pandemic. The aims of this study were: (1) to carry out a pre-post-COVID-19 pandemic comparison between two freshmen samples, in order to detect differences in their socio-demographic characteristics and in some clinical variables; (2) to assess the effect of the COVID-19 pandemic on the social and academic lives of the second sample of freshmen. The samples recruited in 2019 and 2022, matched by propensity score procedure (N = 553), were mostly female (57.3% vs. 55.3%); the mean age was 22.9 and 20.9 years, respectively. The freshmen recruited after the pandemic had less psychological distress and substance use than freshmen recruited before the pandemic. Seventy-eight percent of the freshmen stated that the pandemic had an impact on their social relationships. This effect was greater for females and Italian students. Forty-seven percent reported that the pandemic has worsened their academic performance, while 60% stated that pandemic has improved their grades. The results of this study can provide valuable insights into the impact of the pandemic on freshmen, in order to implement interventions to mitigate the consequences of the pandemic in some subgroups of this target population.

Decision-Making and Risk-Propensity Changes during and after the COVID-19 Pandemic Lockdown

The imposition of lockdowns during the COVID-19 pandemic placed individuals under conditions of environmental stress, threatening individual and collective wellbeing. This study aimed to investigate the temporal effects of isolation and confinement during and after the Italian lockdown on decision-making, risk propensity, and cognitive control processes. The present study covered almost the entire Italian lockdown period (each week from the end of March to mid-May 2020), plus a follow-up measure (September 2020). At each time-point, respondents completed online behavioral tasks, which involved measuring risk-propensity (Balloon Analogue Risk Task), decision-making (Iowa Gambling Task), and cognitive flexibility (Category Switch Task). They also filled in questionnaires regarding subjective stress and anxiety. The main findings showed that the decision-making abilities of the respondents were affected as the confinement progressed. Furthermore, individuals who were more subjectively impacted by the lockdown/isolation experience exhibited impaired decision-making, especially during the lockdown. The results of the study highlight that prolonged confinement may affect human decision making, and help understand individuals' misbehaviors during emergencies and develop effective countermeasures aimed at reducing the burden of the healthcare system.

Moderation effects of loneliness between fatalism and wellbeing during the COVID-19 pandemic

The COVID-19 pandemic has put more than just our physical health at risk. Due to containment measures, people have become increasingly isolated and have drastically reduced their daily social interactions. Many studies have already shown the negative effects of these measures, including fatalism. However, research linking fatalism during COVID-19 to well-being indicators is still limited. The goal of this study is to examine the relationship between COVID-19-related fatalism and well-being indicators, as well as the role of loneliness in moderating this relationship. Data was collected from 1,036 adults in Peru through an online survey that included the Quality-of-Life Index, the Fatalism Facing COVID-19 Scale, the Loneliness Scale, and the Mood Assessment Scale. Three models were tested using linear regression and ordinary least squares with bias-corrected bootstrapping. The results indicate that fatalism has a negative impact on quality of life and a positive effect on negative affect, and loneliness moderates both relationships, supporting the conclusion that fatalism exacerbates the effect of well-being indicators and negative affect.

COVID-19-related social isolation and symptoms of depression and anxiety in young men in Poland: Does insomnia mediate the relationship?

The need for physical distancing due to COVID-19 mitigation efforts forced prolonged social isolation, which may affect sleep and lead to mental health problems. Previous research has shown that young adults are particularly vulnerable to psychological stress caused by social isolation, the negative psychological impact of the pandemic, and greater frequency and severity of sleep problems. Therefore, the main goal of the present study was to examine whether insomnia could constitute a mediation mechanism that explains the relationship between social isolation experienced during the COVID-19 pandemic and mental health outcomes (depression and anxiety) reported up to 1.5 years later. The study was conducted among young (M±SD; 24.08±3.75) men (N = 1025) in Poland. Data were collected by means of self-report questionnaires, including The Social Isolation Index, The Athens Insomnia Scale, The State-Trait Anxiety Inventory (STAI-S) and Beck's Depression Inventory (BDI-II). The results show that insomnia mediates the relationships between social isolation and both anxiety and depression. The current findings emphasize the role of insomnia in the relationships between social isolation experienced during COVID-19 and negative emotional states. From a clinical perspective, the results suggest that implementing therapeutic components that address social isolation in insomnia treatment programs may prevent the development of depression and anxiety symptoms among young men.

Age-Based Differences in Sleep Quality, Pre-Sleep Arousal, and Psychosocial Factors during the Second Wave Lockdown of the COVID-19 Pandemic in Georgia-A Higher Vulnerability of Younger People

The COVID-19 pandemic has deeply disrupted sleep and mental health of people around the world. We aimed to investigate age-based differences in the prevalence of and relationship between sleep quality, pre-sleep arousal, and psychosocial factors during the second wave lockdown of the COVID-19 pandemic in Georgia. Data were collected through an online survey (n = 1117). Participants were categorized into four age groups: 18-29, 30-41, 42-53, and 54-70 years. The youngest participants reported the most prevalent disruption of sleep behavior. Overall, 58.3% of respondents were poor sleepers. The Pittsburgh Sleep Quality Index (PSQI) global score was highest in the youngest age group but the difference was not significant. There was a significant difference in the PSQI component scores for subjective sleep quality, sleep latency, and daytime dysfunction, all being worse in young respondents. We also observed a significantly higher prevalence rate of worse sleep quality in the youngest age group, relative to the pre-pandemic period. On the other hand, the oldest respondents showed significantly greater use of sleeping medications. Significantly higher levels of somatic and cognitive pre-sleep arousal, perceived stress, feeling depressed, anxious, and socially isolated were reported by the youngest age group. Study findings indicate a higher vulnerability of younger people to the impact of the COVID-19 pandemic. Assessment of pre-sleep arousal and implementation of specific, age-based interventions may prove beneficial to improve possible consequences of the pandemic on sleep and mental health.

The global evolution of mental health problems during the COVID-19 pandemic: A systematic review and meta-analysis of longitudinal studies

BACKGROUND

The COVID-19 pandemic impacted mental health, but the global evolution of mental health problems during the pandemic is unknown. We conducted a systematic review and meta-analysis of longitudinal studies to evaluate the global evolution of mental health problems during the pandemic.

METHODS

To conduct this systematic review, we searched for published articles from APA PsycInfo (Ovid), CINAHL (EBSCOhost), Embase (Ovid), MEDLINE (Ovid), and Web of Science. Longitudinal (at least 2 waves during the COVID-19 pandemic) and peer-reviewed articles on mental health problems conducted as from 2020 and after were included in the current study. Of 394 eligible full texts, 64 articles were included in the analysis. We computed random effects, standardized mean differences, and log odds ratio (LOR) with 95 % CIs. The meta-analysis protocol was registered with PROSPERO (CRD42021273624).

RESULTS

Results showed that anxiety (LOR = -0.33; 95 % CI, -0.54, -0.12) and depression symptoms (LOR = -0.12; 95 % CI, -0.21, -0.04) decreased from baseline to follow up. However, other mental health problems showed no change. Higher prevalence rates (40.9 %; 95 % CI, 16.1 %-65.8 %) of psychological distress were found in months after July 2020, respectively, while there were no significant month differences for the prevalence of other mental health problems. Higher means of anxiety (d = 3.63, 95 % CI, 1.66, 5.61), depression (d = 3.93; 95 % CI, 1.68, 6.17), and loneliness (d = 5.96; 95 % CI, 3.22, 8.70) were observed in May 2020. Higher prevalence of anxiety, depression, and PTSD and higher means of anxiety, depression and loneliness were observed in North America. The prevalence of psychological distress and insomnia was higher in Latin America and Europe, respectively.

LIMITATIONS

There is a lack of longitudinal studies in some parts of the world, such as Africa, the Caribbean, India, the Middle East, in Latin America, and Asia.

CONCLUSIONS

Results indicated that anxiety and depression symptoms decreased during the COVID-19 pandemic while other mental health problems showed no statistical change. The findings reveal that mental health problems peaked in April and May 2020. Prevalence of mental health problems remains high during the pandemic and mental health prevention, promotion and intervention programs should be implemented to mitigate the consequences of the COVID-19 pandemic on the global population.

Climate Changes, Natural Resources Depletion, COVID-19 Pandemic, and Russian-Ukrainian War: What Is the Impact on Habits Change and Mental Health?

Climate Change, Natural Resources Depletion, COVID-19, and Wars are some of the great challenges of our time. The consequences will affect psychological well-being and could have a harmful impact on mental health. This study aimed to assess the level of preoccupation and fears surrounding issues of the 21st-century and the implication for psychological well-being of the general population from Central/Southern Italy among different age groups. A questionnaire that included sociodemographic characteristics, topics formulated ad-hoc about preoccupation, fears, habits, and willingness to change habits in the future related to the 21st-century challenges, and the Depression Anxiety Stress Scales 21 (DASS-21) was administered online. A sample of 1831 participants (61% F; mean age 47.71 ± 17.30) was obtained. Results showed that young adults and older adults, respectively, reported greater and less psychological well-being. Young adults reported higher scores for preoccupation, changing habits, and willingness to change habits in the future, while older adults reported the lowest scores except for changing habits, also controlling for gender. Results for this variable, as well as correlations between the many variables described, rely on the specificity of age, and 21st-century challenges. Moreover, the main fears related to the 21st-century concerns were different based on both age and gender. In conclusion, the various stresses of the 21st-century discussed in this study have a relationship with personal well-being, and it is important to consider potential global mental health issues resulting from these stressors.

Two Years of COVID-19 in Austria-Exploratory Longitudinal Study of Mental Health Outcomes and Coping Behaviors in the General Population

Since the long-term mental health impact of COVID-19 is not yet fully understood, the present study explored changes in mental health outcomes and pandemic-related coping behaviors across four pandemic stages. The main objective was to gain insights into the dynamics of mental health and coping, considering different pandemic features at different assessment waves. The final sample consisted of N = 243 adults from the Austrian general population. Data were collected at four timepoints (between June 2020 and December 2021) via LimeSurvey, an open-source online survey tool. Symptoms of posttraumatic stress disorder (PTSD), adjustment disorder (AD), anxiety, and depression were assessed using validated instruments: Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), AD-New Module 8 (ADNM-8), and Patient Health Questionnaire (PHQ4). We also administered the Pandemic Coping Scale (PCS) to address pandemic-related coping behaviors. Cochran’s Q test and repeated measures ANOVAs were applied to assess changes over time. The results indicated that prevalence rates of AD (χ2(2) = 16.88, p = 0.001), depression (χ2(3) = 18.69, p < 0.001), and anxiety (χ2(3) = 19.10, p < 0.001) significantly changed across four assessment waves. Changes in mean scores of the assessed mental health outcomes were also observed. For pandemic-related coping, we found differences in the subscales: healthy lifestyle: F(3, 651) = 5.11, prevention adherence: F(2.73, 592.35) = 21.88, and joyful activities: F(3, 651) = 5.03. Taken together, our study showed a higher mental health burden in wintertime than in summertime, indicating an increased need for psychosocial support in times of stricter measures, higher incidences, and higher death rates. Furthermore, the observed decrease in adaptive coping behaviors suggests that easy-to-implement coping strategies should be actively promoted in order to maintain mental health during and in the aftermath of pandemics.

The Fear of COVID-19: Gender Differences among Italian Health Volunteers

Background: During the COVID-19 pandemic, the fear of being infected was a major concern, resulting in both physical and psychological effects. Despite several studies on fear of COVID-19 in the general population, the effects on healthy volunteers who face COVID-19 on the frontlines have not yet been investigated. Methods: An online survey on specific psychological variables related to COVID-19 was administered to 720 healthy volunteers, and gender differences were investigated. Results: The primary finding was that females showed higher scores in all dimensions assessed. A multiple linear regression conducted on both genders exhibited a similar pattern of predictors, highlighting the pivotal role of negative affect in the male group. Conclusions: The findings suggest that COVID-19 had significant effects on healthy volunteers, especially in the female group. Although the previous literature did not report the crucial role played by the negative affect in the male sample, these results highlight the need to deepen how both genders use different emotional strategies to cope with stressful situations. This study may be useful in the development of specific psychological support and ad hoc training for healthy volunteers.

Adapting to a major crisis: Sleep and mental health during two lockdowns

The present study aimed at investigating the impact of the pandemic on sleep and mental health in healthy individuals (n = 78) as well as in psychiatric outpatients (n = 30) during the first and the second lockdown in Germany, in March and November 2020, respectively. Sleep quality and anxiety were worse in patients compared with controls during both lockdowns. Further, patients but not controls exhibited higher levels of depression and overall psychiatric symptomatology during the second lockdown. No differences were found in the perceived threat evoked by the pandemic. The data suggest that healthy individuals adapt flexibly to the difficult situation over the time course of the pandemic, whereas psychiatric patients seem to get worse, indicating difficulties in adapting to stressful circumstances.

Fear and Attitude towards SARS-CoV-2 (COVID-19) Infection in Spanish Population during the Period of Confinement

In January 2020, the WHO classified SARS-CoV-2 infection as a public health emergency and it was declared a pandemic on 11 March 2020. The media warned about the danger of infection, fuelling the population’s fear of the new situation and increasing the perception of risk. This fear can cause behaviour that will determine the course of the pandemic and, therefore, the purpose of this study was to analyse the fear of infection from COVID-19 among the Spanish population during the state of emergency. A cross-sectional, descriptive observational study was conducted with 16,372 participants. Data on sociodemographic factors, health factors, risk perception and fear were collected through an online survey. Level of fear is associated with older age, a lower level of education, having a person infected with SARS-CoV-2 in the immediate surroundings and living with and belonging to the most socioeconomically vulnerable group of people. Risk perception is associated with increased preventive behaviour. This paper provides relevant information for the public health sector since it contributes first-hand knowledge of population data that is highly useful in terms of prevention. Understanding the experiences of people in this pandemic helps to create more effective future intervention strategies in terms of planning and management for crisis situations.

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 effect of COVID-19 lockdown on mental health, gut microbiota composition and serum cortisol levels

The aim of this study was to assess changes in mental health, gut microbiota composition, and stress marker serum cortisol due to COVID-19 lockdown in asymptomatic individuals. Healthy adults participated in anthropometric measurements, blood and stool sample collection pre-lockdown and post-lockdown (n = 38, 63.2% females), lifestyle and psychological questionnaires were included in pre-lockdown measurement and lockdown survey (n = 46, 67.4% females). Subjects reported significantly higher body dissatisfaction (p = 0.007) and anxiety (p = 0.002), and significantly lower positive affect (p = 0.001) during lockdown compared with pre-lockdown. According to perceived stress, 51.6% of females and 20% of males experienced moderate to high stress. This was reflected in serum cortisol levels that significantly increased only in females (p = 0.006) post-lockdown and correlated with perceived stress (p = 0.037) and anxiety (p = 0.031). In addition to psychological measures, changes in gut microbiota composition were observed. Gut microbial alpha diversity significantly decreased (p = 0.033), whereas relative abundance of Proteobacteria significantly increased (p = 0.043) post-lockdown. Depression during lockdown was moderately positively correlated with changes in Bacteroidetes abundance (p = 0.015) and negatively with changes in Firmicutes abundance (p = 0.008). Alistipes abundance post-lockdown was moderately positively correlated with anxiety (p = 0.004) and negative affect (p = 0.005) during lockdown. Despite a small sample size and not being able to perform objective measurements during lockdown, the results confirm the effect of lockdown on mental health and gut microbiota composition that could have a great impact on our health (ClinicalTrials identifier: NCT04347213).

Changes in sleep pattern and dream activity across and after the COVID-19 lockdown in Italy: A longitudinal observational study

A large body of evidence has documented the impact of the global COVID‐19 outbreak – and especially the lockdown period – on sleep quality and quantity. Here, we present the first Italian longitudinal study on sleep and COVID‐19 considering four different time points collected during lockdown (from 29 March 2020 to 3 May 2020) and a subsequent follow‐up period (October 2020). We used an online survey to collect socio‐demographic and COVID‐19 related information. Subjects were also asked to complete a sleep diary at each time point of the study. Our longitudinal sample included 147 participants. Statistical comparison across time intervals showed remarkable changes in sleep patterns during and after the lockdown. In particular, during lockdown we observed longer sleep latency, less ease of falling asleep, a higher total bedtime, and a lower dream frequency. The week‐by‐week evaluation described relatively stable patterns in the observed measures during the lockdown period, except for dream frequency, affected by a rapid increase in the early phase of lockdown. Our findings are in line with the current literature. Furthermore, the prospective longitudinal investigation comprising several time points offered the possibility of (a) observing the temporal dynamics and the different entities of such changes over time, and (b) reducing the typical memory bias for these studies.