Emerging Adults and COVID-19: The Role of Individualism-Collectivism on Perceived Risks and Psychological Maladjustment

Interdependency or submission to authority? The impacts of horizontal and vertical collectivist orientation on vaccine attitudes in mainland China

Culture has a profound impact on preventive measures during the COVID-19 pandemic. Previous research has revealed that collectivism is associated with more effective responses to COVID-19 on the national or regional level. However, the impact of different components of collectivist orientation on vaccine attitudes remains insufficiently explored on the individual level. Two survey studies conducted in August 2021 in mainland China consistently found that individual-level horizontal collectivist orientation, rather than vertical collectivist orientation, was linked with more favourable vaccine attitudes. Specifically, Study 1 (N = 731) indicated that horizontal collectivist orientation was positive associated with vaccination intention indirectly via risk perception, and horizontal collectivist orientation was also positively associated with vaccination persuasion both directly and indirectly via risk perception. Study 2 (N = 1481), employing multilevel modelling, demonstrated that the link between horizontal collectivist orientation and confidence in vaccines remained robust regardless of provincial-level variations in socioeconomic development and cultural tightness. These findings convergently suggest that the positive vaccine attitudes among mainland Chinese are primarily driven by an amplified risk perception due to concern for others, rather than submission to authority.

Ethnic-Racial Identity and Attitude Change: Assessments of Outgroup and Diversity Attitudes among Adolescents in Sweden

Outgroup and diversity attitudes are important components of intercultural understanding and well-being. Despite the potential of ethnic-racial identity development as a means to foster positive outgroup and diversity attitudes, little is known about its effectiveness in rapidly diversifying contexts such as Sweden. This pre-registered study filled this gap by examining if adolescents taking part in an intervention focused on ethnic-racial identity exploration, the Identity Project, also reported change in outgroup and diversity attitudes, and whether migration background, education type, and ethnic-racial identity development predicted such change. Twenty-three tenth-grade classes in Sweden (N = 509; Mage = 16.28; SDage = 0.80; 66% female; 51% migration background) participated in the intervention and were assessed in four waves over a period of 26 weeks. Whereas ethnic-racial identity exploration and resolution increased for the intervention group, the adolescents reported no change in outgroup and diversity attitudes when compared to a control group. Increases in ethnic-racial identity exploration and resolution co-varied with increases in attitudes, but only at Time 3. The results do not provide support for the link between ethnic-racial identity development and positive outgroup and diversity attitudes, and challenge the notion of attitude change as a cascading effect of the Identity Project intervention in non-US sociocultural contexts. All aspects of the study were pre-registered on the Open Science Framework platform ( https://osf.io/f5896 ).

Development and validation of the Japanese version of the Auckland individualism and collectivism scale: relationship between individualism/collectivism and mental health

Background

This study developed the Japanese version of the Auckland Individualism and Collectivism Scale (J-AICS), examined its reliability and validity, and explored the associations between its factors (compete, unique, responsibility, advice, and harmony) along with variables related to mental health in the Japanese population.

Methods

We recruited 476 Japanese participants from the general population. Participants completed the J-AICS along with questionnaires pertaining to culture and mental health.

Results

Confirmatory factor analysis indicated the correlated five-factor model showed a good fit to the data. The Cronbach's α and McDonald's ω coefficients were high for the individualism, collectivism, compete, unique, and advice factors, but low for the responsibility and harmony factors. Convergent validity was supported by significant relationships between culture-related variables. A one-way analysis of variance revealed the low individualism/collectivism cluster had higher loneliness and lower satisfaction with life than the high individualism and collectivism clusters. The multiple regression analyses showed that the responsibility factor was significantly and negatively associated with mental health concerning anxiety and depressive symptoms, loneliness, and satisfaction with life. In addition, the harmony factor was significantly and positively associated with the mental health.

Conclusion

These findings demonstrate sufficient validity of the J-AICS; however, reliability was insufficient for responsibility and harmony. Further, responsibility was positively associated with mental health and harmony was negatively associated with mental health.

Parental financial support and family emotional support to young adults during COVID-19: A help or a hindrance?

The present study focuses on the role of family support to young adult children during COVID-19 in ameliorating the negative financial impact of the pandemic. Guided by the Conservation of Resources (COR) Theory of stress and coping, we conceptualize the negative financial impact due to COVID-19 as a source of financial stress that would be associated with lower levels of both financial wellbeing and positive outlook of young adults. We rely on data collected from a multinational sample of young adults (ages 18-30) from six countries (China, Italy, Lithuania, Portugal, Slovenia, US; N = 2102) over a 3-month period (July 2020-September 2020). We tested the potential effects of two types of support (i.e., parental financial support and family emotional support) using path analysis. While we find a consistent positive association between family emotional support and both financial wellbeing and positive outlook, we also find a consistent negative association between parental financial support and financial wellbeing, and a nonsignificant or negative association (Lithuania only) with a positive outlook. The significant interaction between COVID-19 financial impact and family emotional support on young adults' positive outlook reveals that the benefit of family emotional support is more evident when the negative financial impact is low or moderate. We discuss the implications of these findings in assisting young adults to cope with financial disruptions.

Students for others: Correlates of adherence to COVID-19 guidelines

Objective: The present study aimed to determine correlates of adherence to COVID-19 health precautions among college students. Drawing from the literature, the following constructs were considered: self-efficacy, conscientiousness, social support, collectivism, empathy, and fear of COVID. Participants: Undergraduate students (N = 92) recruited from psychology classes and social media, living on and off-campus, served as participants during fall 2020. Methods: Participants completed a short self-report survey, delivered online, measuring adherence to COVID-19 health precautions and its possible correlates. Results: After preliminary comparisons showing no differences in adherence between students living on and off-campus, linear regression analyses of the complete sample revealed that the significant predictors of adherence were conscientiousness, collectivism, empathy, and fear of COVID. Conclusions: College student adherence was largely driven by interpersonal motivators coupled with a modest level of fear, rather than more general constructs. These findings offer implications for considering targets in public health campaigns delivered to college students.

Association Between Risk Perceptions of COVID-19, Political Ideology, and Mask-Wearing Behavior After the Outbreak: A Cross-Sectional Survey in South Korea

Purpose

After the declaration by the World Health Organization signaling the conclusion of the COVID-19 pandemic, most countries lifted mandatory mask-wearing regulations. This study aimed to investigate factors such as risk perception and political ideology associated with continued adherence to mask-wearing among specific populations, particularly when it is no longer deemed necessary.

Methods

We conducted a cross-sectional study including a sample of 1001 respondents stratified by sex, age (≥ 18 years), and region from January 31 to February 2, 2023, after the mandatory mask regulation was lifted in South Korea. Multivariate logistic regression models were applied to estimate the relationships between risk perceptions, political ideology, and mask-wearing maintenance, adjusting for factors such as sex, age, occupation, and trust in the government.

Results

Our results indicated significant associations between age, self-reported household economic status, political ideology, affective risk perception, and perceived effectiveness of the government's COVID-related measures with indoor mask-wearing. Specifically, liberals were more likely to keep mask-wearing indoors than conservatives (adjusted odds ratio [aOR]: 2.19; 95% confidence interval [CI]: 1.33-3.59); and those who perceived a greater affective risk of COVID-19 (aOR: 2.47; 95% CI: 1.96-3.10), along with those who perceived the government's countermeasures as inadequate, were more inclined to maintain the habit of wearing masks indoors (aOR: 1.90; 95% CI: 1.19-3.03).

Conclusion

Our study highlighted the multifaceted factors influencing mask-wearing behavior in the post-COVID-19 era. Even after adjusting for various confounding factors, such as age, sex, and trust in the government, an association remained between affective risk perception, political ideology, and mask-wearing behavior. However, further research for psychological mechanisms is needed to foster a culture of preventive behaviors proportional to the risk of infection.

Deontological Guilt Mediates the Effects of Personality on the Symptoms of Romantic Relationship Obsessive Compulsive Disorder (ROCD)

Objective

Relationship obsessive-compulsive disorder (ROCD), a clinical variant of OCD, is associated with personality traits and guilt sensitivity. Previous studies have not investigated whether the guilt associated with ROCD stems from deontological or altruistic morality. The main aim of the present study was to explore the differentiated impact of deontological and altruistic guilt on ROCD symptoms in romantic relationships. The study also aimed to test the mediating role of guilt in the relationships between personality traits and ROCD symptoms.

Method

Through linear regressions and path analysis, we examined the results of an online survey administered to 659 emerging adults, assessing the Big-5 personality traits, ROCD symptoms, and the moral orientation of guilt feelings (deontological/altruistic).

Results

Results revealed the negative influence of agreeableness and emotionality on ROCD symptoms. Moral dirtiness, as a facet of deontological moral orientation, was found to mediate the effects of personality predictors on relationship-centred but not on partner-focused ROCD symptoms, providing support for differential diagnosis.

Conclusions

These findings provide a clearer understanding of the cognitive determinants that sustain ROCD symptoms and offer evidence on associated personality traits. These results may represent a valuable source of knowledge for researchers as well as clinical therapists dealing with ROCD symptoms, couple disorders, and sexual dysfunction.

Elevated depression and anxiety predict future patterns of individualistic and collectivistic cultural values: A cross-lagged longitudinal network analysis

BACKGROUND

Specific components of independent and interdependent self-construal have been associated with psychopathology. However, most studies on this topic have been cross-sectional, precluding causal inferences. We used contemporaneous and temporal cross-lagged network analysis to establish weak causal effects in understanding the association between self-construal and psychopathology components.

METHODS

Middle-aged and older community-dwelling adults (n = 3294) participated in the Midlife Development in the United States study across two time-points, spaced nine years apart. Six self-construal (interdependence: connection to others, commitment to others, receptiveness to influence; independence: behavioral consistency, sense of difference from others, self-reliance) and three psychopathology nodes (major depressive disorder (MDD), generalized anxiety disorder (GAD), and panic disorder (PD) symptom severity) were examined. All network analyses controlled for age, sex, race, and number of chronic illnesses as covariates.

RESULTS

Contemporaneous and temporal networks yielded relations between elevated MDD and PD and increased receptiveness to influence. Heightened GAD symptom severity was associated with future increased difference from others and decreased connection to others, commitment to others, and receptiveness to influence. Higher MDD, GAD, and PD severity were associated with future lower self-reliance. Network comparison tests revealed no consistent network differences across sex and race.

LIMITATIONS

DSM-III-R measures of MDD, GAD, and PD were used. Results may not generalize to culturally diverse racial groups.

CONCLUSIONS

Changes in self-construal may result from increased MDD, GAD, and PD severity. Findings suggest the importance of targeting common mental health symptoms to positively influence how individuals view the self and others in various social contexts.

Thematic analysis of COVID-19's impacts on transitions among emerging adults

Objectives

This study explored how the COVID-19 pandemic impacted emerging adults. Previous COVID-19 research with this age demographic has focused on specific facets of life transitions (e.g., academic or economic stress) but does not consider the interrelatedness of these life domains. This project fills this gap by allowing participants to report on any aspects of their life to better understand frequent challenges with and experiences that may have helped with managing "the new normal" of the COVID-19 pandemic amidst typical transitions of emerging adulthood.

Methods

Qualitative and quantitative data gathered in July 2020 (n = 145) and January 2021 (n = 143) as part of a longitudinal study of emerging adults (18-24 years) who were enrolled at a Midwestern United States University at baseline were analyzed to explore impacts of COVID-19, particularly in relation to stress.

Results

Qualitative results demonstrate a range of negative COVID-19 effects, including health challenges and relationship strain. Interestingly, positive effects were also reported, including allocating more time for hobbies and spending quality time with loved ones. Quantitative findings indicate that COVID-19 distress did not increase over time, but perceived exposure to pandemic effects significantly increased. A general perceived distress measure demonstrated a slight decrease in distress over time, suggesting a potential adjustment to 'the new normal.'

Discussion

COVID-19 impacted multiple domains of typical developmental transitions for many emerging adults in our sample. Individual qualitative reports demonstrate uniquely personal impacts of COVID-19, while thematic trends appear across responses (e.g., relationship strain). Health care providers must consider how these impacts influence the wellbeing of emerging adults with whom they work as the pandemic continues to evolve.

Trust in government moderates the association between fear of COVID-19 as well as empathic concern and preventive behaviour

With the COVID-19 pandemic, behavioural scientists aimed to illuminate reasons why people comply with (or not) large-scale cooperative activities. Here we investigated the motives that underlie support for COVID-19 preventive behaviours in a sample of 12,758 individuals from 34 countries. We hypothesized that the associations of empathic prosocial concern and fear of disease with support towards preventive COVID-19 behaviours would be moderated by trust in the government. Results suggest that the association between fear of disease and support for COVID-19 preventive behaviours was strongest when trust in the government was weak (both at individual- and country-level). Conversely, the association with empathic prosocial concern was strongest when trust in the government was high, but this moderation was only found at individual-level scores of governmental trust. We discuss how motivations may be shaped by socio-cultural context, and outline how findings may contribute to a better understanding of collective action during global crises.

Third- and First-Person Effects of COVID News in HBCU Students' Risk Perception and Behavioral Intention: Social Desirability, Social Distance, and Social Identity

With COVID-19's unprecedented impact and ongoing debates on prosocial social distancing and antisocial beach crowd gathering, this study examined the roles of social desirability, social distance marked by race, and social identity in the third-person effect (TPE) of COVID-related news concerning risk perception among Historically Black College and University (HBCU) students. The findings confirmed third- and first-person effects with the perceived influence of antisocial (beach partying) news greater for others than themselves, whereas the self was perceived to be more responsive to the influence of prosocial (social distancing) news. A symmetric interaction between social desirability and social identity indicated that the racial out-group, non-HBCU students in Florida were perceived as more affected by antisocial beach party news, whereas the in-group HBCU peers were perceived as more influenced by desirable social distancing warning news and COVID news in general. The first-person perception and shrunk self-other gap in COVID news influence on HBCU students" concerns may be associated with perceived personal vulnerability and responsibility as well as a political reflection on the government's handling of COVID. While they presumed favorable media influence on self and the in-group to preserve collective self-esteem, they made realistic threat judgments from perceiving undesirable media influence on their in-group peers' risky behavior tendency and intended to take preventive actions (staying home) to avoid the health risk. Further, it was the first-person perceptual gap between themselves and the out-group, non-HBCU students that influenced them to heed social distancing warnings.

Country's value priorities in health crisis: How dominant societal motivations shape COVID-19 severity

This paper presents two comprehensive studies examining how Schwartz's human values dimensions at the country level predict COVID-19 pandemic severity. Study 1 aggregated survey data across 89 countries from the European Social Survey and World Values Survey to assess societal-level conservation versus openness to change (CON-OTC) and self-enhancement versus self-transcendence (SE-ST) value-continuums. Study 2 developed an innovative archival measurement approach using 10 indicators to estimate these value dimensions for over 180 countries. Both studies employed multilevel modeling to test the relationships between country-level values and COVID-19 severity, measured through epidemiological indicators of transmission speed, case fatality rate, infection prevalence and mortality burden. Results revealed that the CON-OTC and SE-ST value-continuums showed consistent, significant negative associations with transmission speed and infection prevalence before adjusting for modernization, latitude, historical pathogen prevalence and government stringency across both studies. However, after accounting for these socioecological and policy covariates, the CON-OTC value-continuum positively predicted case fatality rate in both studies, implying conservation values could increase COVID-19 lethality. In contrast, across both studies, the SE-ST value-continuum negatively predicted case fatality rate after adjusting for the covariates, suggesting countries prioritizing self-enhancement values exhibited relatively lower pandemic severity and lethality when accounting for developmental, ecological, and policy factors. Accordingly, the studies advance theoretical understanding of how country's value priorities shape COVID-19 impact. Methodologically, these studies contribute through multilevel techniques that account for spatial dependencies, as well as an innovative ecological measurement. Overall, this research demonstrates the value of applying Schwartz's framework at a societal level to predict global health crises and pandemics.

A "transatlantic" follow-up study of the impact of the COVID-19 pandemic on patients with obsessive-compulsive disorder

BACKGROUND

Obsessive-compulsive symptom fluctuations may be contingent on the number of stressful pandemic-related events and the resilience characterizing different cultures. We investigated the influence of the pandemic on symptom changes in a sample of obsessive-compulsive disorder (OCD) patients from Brazil and Italy, two countries that were highly affected by the outbreak.

METHODS

Ninety-one OCD outpatients were evaluated at baseline and about one year later. Thirty of them were assessed in Brazil and 61 in Italy. Socio-demographic variables, symptoms' severity and the number of stressful pandemic-related events were collected. Comparisons between countries' samples were performed, and a linear regression examined whether the country of origin, demographic features and the number of stressful events were able to predict the symptoms' severity at the follow-up.

RESULTS

Brazilian patients experienced more stressful pandemic-related events than Italian patients (p = 0.018). However, along with higher age (p < 0.01) and increased severity of symptoms at baseline (p < 0.01), lower number of events predicted increased symptoms' severity after one year (p < 0.01). Country of origin was not a significant predictor of severity.

LIMITATIONS

Small number of subjects; lack of information regarding duration of illness; and potential sample differences between countries.

CONCLUSIONS

During the pandemic, the occurrence of more stressful pandemic-related events was associated with decreased severity of patients' OCD symptoms. Nevertheless, older patients and those with more severe symptoms seemed prone to exhibit increased OCD severity at follow-up.

Psychological distress and everyday discrimination among Chinese international students one year into COVID-19: a preregistered comparative study

BACKGROUND AND OBJECTIVES

During the COVID-19 pandemic, Chinese international students (CISs) experienced distress associated with both unique and universal stressors, among which everyday discrimination may be especially harmful.

DESIGN

Cross-sectional design.

METHODS

We compared distress between CISs (N = 381) and Chinese students in Chinese colleges (CSCCs; N = 305) and examined correlates of distress including the association between everyday discrimination and distress as well as moderators on this link.

RESULTS

Compared to CSCCs, CISs reported greater depression and anxiety. Sensitivity analyses - multiple regressions controlling for covariates and coarsened exact matched (CEM) comparisons - replicated the results. 28.6% CISs reported suicidal ideation (PHQ-9 item 9) at least several days during the past two weeks. Within CISs, depression was associated with being older, female, non-heterosexual, increased everyday discrimination, decreased self-esteem, coping flexibility, perceived social support, and satisfaction with online learning. Anxiety was associated with being in undergraduate years, female, increased discrimination, decreased self-esteem, coping flexibility, and satisfaction with online learning. High perceived social support and being heterosexual weakened the association between discrimination and anxiety and depression, while high self-esteem strengthened the association between discrimination and anxiety.

CONCLUSIONS

Our study underscored the distress experienced by CISs and highlighted risk/protective factors that may warrant attention.

A review of mental health disparities during COVID-19: Evidence, mechanisms, and policy recommendations for promoting societal resilience

Social and economic inequality are chronic stressors that continually erode the mental and physical health of marginalized groups, undermining overall societal resilience. In this comprehensive review, we synthesize evidence of greater increases in mental health symptoms during the COVID-19 pandemic among socially or economically marginalized groups in the United States, including (a) people who are low income or experiencing homelessness, (b) racial and ethnic minorities, (c) women and lesbian, gay, bisexual, transgender, queer, and questioning (LGBTQ+) communities, (d) immigrants and migrants, (e) children and people with a history of childhood adversity, and (f) the socially isolated and lonely. Based on this evidence, we propose that reducing social and economic inequality would promote population mental health and societal resilience to future crises. Specifically, we propose concrete, actionable recommendations for policy, intervention, and practice that would bolster five "pillars" of societal resilience: (1) economic safety and equity, (2) accessible healthcare, including mental health services, (3) combating racial injustice and promoting respect for diversity, equity, and inclusion, (4) child and family protection services, and (5) social cohesion. Although the recent pandemic exposed and accentuated steep inequalities within our society, efforts to rebuild offer the opportunity to re-envision societal resilience and policy to reduce multiple forms of inequality for our collective benefit.

Emerging Adult Resilience to the Early Stages of the COVID-Pandemic: A Systematic Scoping Review

Human resilience to COVID-19 related stressors remains a pressing concern following the aftereffects of the pandemic and in the face of probable future pandemics. In response, we systematically scoped the available literature (n = 2030 records) to determine the nature and extent of research on emerging adults' adaptive responses to COVID-19 stressors in the early stages of the pandemic. Using a multisystem resilience framework, our narrative review of 48 eligible studies unpacks the personal, relational, institutional and/or physical ecological resources that enabled positive emerging adult outcomes to COVID-18 stressors. We found that there is a geographical bias in studies on this topic, with majority world contexts poorly represented. Resources leading to positive outcomes foregrounded psychological and social support, while institutional and ecological supports were seldom mentioned. Multisystemic combinations of resources were rarely considered. This knowledge has valuable implications for understanding resilience in the context of other large-scale adverse conditions.

Individualism-Collectivism and COVID-19 Prevention Behaviors in Young Adults: The Indirect Effects of Psychological Distress and Pandemic Fears

Stemming on the theoretical framework of individualism-collectivism, this study aims to interpret COVID-19 prevention behaviors in young adults in the light of cultural orientations, hypothesizing the mediating role of two pandemic affects (i.e., fear for COVID-19 consequences and psychological distress during pandemic). Participants were 296 young adults living in Italy (Mage = 23.96, SDage = 3.04; 79.7% women), who completed an online anonymous survey. Data were gathered from December 2020 to May 2021. A path analysis model explored direct and indirect relationships among study variables. Psychological distress significantly reduced the compliance with prevention measures, whereas pandemic fears increased it. The collectivistic orientations (Vertical Collectivism and Horizontal Collectivism) positively predicted prevention behaviors via increasing pandemic fears. The egalitarian dimensions (Horizontal Individualism and Horizontal Collectivism) were positive predictors of compliance via reducing psychological distress during pandemic. Finally, Vertical Individualism was a risk factor that negatively predicted prevention behaviors both directly and indirectly, via increasing psychological distress. The results provide new insights into the emotional mechanisms that link individualism and collectivism orientations to COVID-19 prevention behaviors, with interesting implications for public health policies, prevention, and future research.

Beyond the surface: accounting for confounders in understanding the link between collectivism and COVID-19 pandemic in the United States

According to the parasite-stress theory, collectivism serves as a trait of ingroup assortative sociality, providing defense against infectious diseases. This study investigated the association between cultural collectivism and COVID-19 severity at the state (Study 1: N = 51), county (Study 2: N = 3,133), and daily (Study 3: N = 52,806) levels from the beginning of 2020 to the end of 2022. State-level collectivism was assessed using two distinct measures: the U.S. collectivism index, focusing on social interconnectedness and interdependence, and the subjective-culture individualism-collectivism index (reversed), capturing attitudes and beliefs related to religion, abortion, and same-sex marriage. By employing random-intercept multilevel models, the results demonstrated significant and negative effects of state-level collectivism, as measured by the U.S collectivism index, on COVID-19 cases per million, COVID-19 deaths per million, and composite COVID-19 severity index, after controlling for confounding factors, such as socioeconomic development, ecological threats, disease protective behaviors, cultural norms, and political influences. A mini meta-analysis (Study 4: N = 9) confirmed the significance of these effects across studies. These findings supported the proactive role of collectivism in defending against the novel coronavirus in the United States, aligning with the parasite-stress theory of sociality. However, the subjective-culture individualism-collectivism index (reversed) did not exhibit a significant relationship with COVID-19 severity when confounding factors were considered. The high correlation between the subjective-culture individualism-collectivism index (reversed) and the controlled variables suggested shared variance that could diminish its impact on COVID-19 outcomes. Accordingly, the present findings underscore the significance of accounting for confounding factors when examining the association between collectivism and COVID-19 severity at population level. By considering relevant confounding factors, researchers could gain a comprehensive understanding of the complex interplay between cultural collectivism and its influence on COVID-19 severity. Overall, this research contributes to our understanding of how cultural collectivism shapes the COVID-19 pandemic in the United States, emphasizing the importance of adjusting for confounding effects in population level studies.

The Relationship between Sense of Belonging and Well-Being Outcomes in Emerging Adults with Care Experience

Robust social resources that lead to a healthy sense of belonging are imperative during emerging adulthood. However, young adults with alternative care experience, such as residential or foster care, often lack the social resources necessary to transition to adulthood successfully. Though some research has examined the importance of social resources in this population, less is known about a sense of belonging, which is associated with these social resources. The current study examined the association between care experience, belonging, and well-being outcomes among emerging adults (n = 703) who were separated from their biological parents during care and received alternative care in 16 nations. The presence of belonging was associated with type of alternative care, age at separation, and reason for separation. There was also an association between belonging and well-being outcomes, including homelessness and suicidal ideation. Adults lacking a sense of belonging reported higher rates of homelessness and suicidal ideation, lower life satisfaction, and lower resilience. The study has global implications for enhancing social support for emerging adults with care experience in order to facilitate a sense of belonging as a social resource.

Identification and comparison of pandemic-to-symptom networks of South Korea and the United States

Background

The Coronavirus (COVID-19) pandemic resulted in a dramatic increase in the prevalence of anxiety and depression globally. Although the impact on the mental health of young adults was especially strong, its underlying mechanisms remain elusive.

Materials and methods

Using a network approach, the present study investigated the putative pathways between pandemic-related factors and anxiety and depressive symptoms among young adults in South Korea and the U.S. Network analyses were conducted on cross-country data collected during the COVID-19 lockdown period (n = 1,036). Our model included depression symptoms (PHQ-9), generalized anxiety symptoms (GAD-7), and COVID-19-related factors (e.g., COVID-19-related traumatic stress, pandemic concerns, access to medical/mental health services).

Results

The overall structure of pandemic-to-symptom networks of South Korea and the U.S. were found to be similar. In both countries, COVID-related stress and negative future anticipation (an anxiety symptom) were identified as bridging nodes between pandemic-related factors and psychological distress. In addition, worry-related symptoms (e.g., excessive worry, uncontrollable worry) were identified as key contributors in maintaining the overall pandemic-to-symptom network in both countries.

Conclusion

The similar network structures and patterns observed in both countries imply that there may exist a stable relationship between the pandemic and internalizing symptoms above and beyond the sociocultural differences. The current findings provide new insights into the common potential pathway between the pandemic and internalizing symptoms in South Korea and in the U.S. and inform policymakers and mental health professionals of potential intervention targets to alleviate internalizing symptoms.

Measuring information overload and message fatigue toward COVID-19 prevention messages in USA and China

COVID-19 prevention messages are a crucial component of disease mitigation strategies and the primary driver of health decision-making during the global pandemic. However, the constant and repetitive nature of COVID-19 messaging may cause unintended consequences. Among the commonly observed phenomena are information overload and message fatigue, which might be experienced differently depending on cultural background. Using measurement invariance testing, this study compared how individuals from two countries-USA (n = 493) and China (n = 571)-experienced information overload and message fatigue toward COVID-19 prevention messages. Findings revealed that people in China showed significantly lower level of information overload and message fatigue than those in the USA. This study explores the extent of the unintended persuasive effects that people have experienced during the COVID-19 pandemic in different societies, a comparison which has never been studied before, even outside of the context of COVID-19. The study also provides much-needed practical insights to develop public health initiatives that improve COVID-19 prevention communication, which can further reduce these unintended effects in both countries, and has implications for other countries as well.

COVID-19 and Public Masking Compliance in Korea: We-ness and Individualism-Collectivism at the Individual Level

In Korea, mask-wearing behavior (MWB) has become the "new normal" to prevent the spread of COVID-19. This study aimed to explore the cultural factors affecting MWB in Korea and identify the health value of culture hidden behind the collective preventive actions of Koreans through etic (external, general) and emic (internal, indigenous) cultural approaches. We conducted a survey (N = 720) to measure MWB perception based on its necessity and actual MWB, with an individual-level analysis of vertical and horizontal collectivism-individualism and we-ness. The results indicated that horizontal individualism, vertical collectivism, cognitive we-ness, and affective we-ness positively influenced MWB perception, whereas vertical individualism negatively influenced the dependent variable. Our results contradict previous understandings of collective action as rooted in collectivism, and suggest that horizontal individualism with civic consciousness and we-ness are needed to develop culturally appropriate communication strategies that encourage collective cooperation and response.

The Contribution of Meaning Making and Religiosity to Individuals' Psychological Wellbeing During the COVID-19 Pandemic: Prosocial Orientation Matters

The COVID-19 pandemic has dramatically affected individuals' psychological well-being worldwide, thus representing a challenge for flourishing among emerging adults. To understand psychological processes involved in the positive adaptation to this challenge, the present study examined the role of meaning in life and religious identity as crucial resources for flourishing in a sample of 255 Italian emerging adults. Specifically, as in the midst of a stressful event individuals may experience the potential for flourishing through the process of search for meaning, the study examined the mediated role of existential, spiritual/religious and prosocial orientations as the three primary trajectories for building meaning. Results from path analytic mediation models revealed a positive influence of presence of meaning and in-depth exploration on flourishing. Findings also suggested the contribution of prosocial orientation in building meaning and, ultimately, in increasing flourishing. Implications are discussed.

Public Support for COVID-19 Responses: Cultural Cognition, Risk Perception, and Emotions

As one of the biggest challenges facing mankind in recent history, the COVID-19 pandemic has had profound impact on the United States. However, government responses ranging from stay-at-home orders to temporary closing of nonessential businesses are not palatable for everyone. This study examines how cultural cognition, risk perception, and discrete emotions influence Americans' support for COVID-19 responses. We found that compared to communitarians and egalitarians, individualists and hierarchists were less likely to support COVID-19 responses. In addition, fear and anger mediated the relationship between risk perception and public support in the opposite direction. The highlight of this study is the moderating role of cultural cognition. Specifically, individualistic worldviews significantly moderated anger's mediation effect on the relationship between risk perception and support for COVID-19 responses.

Covid-Related Stress in the Financial, Relational and Health Domains. Which Longitudinal Effects on Present and Future Perception?

While pre-covid literature about stress has indicated the importance of studying domain-specific stress, studies conducted during the pandemic have investigated covid-related stress as a monodimensional construct. The current study aimed to assess the impact that covid-related stress in three domains (financial, relational, health) had on individuals' psychological well-being and future anxiety. Furthermore, we aimed to assess whether the relationship among variables changed during the different phases of the pandemic as well as whether age moderated those relationships. Data were collected from 4185 Italian participants (55.4% female) aged 18-90 years (M = 46.10; SD = 13.47) at three waves: April 2020 (time 1), July 2020 (time 2), May 2021 (time 3). A cross-lagged panel model was run in Mplus. Results indicated that the financial domain is the life domain within which people are most worried during the pandemic, as it had the strongest impact on both psychological well-being and future anxiety. Having high levels of psychological well-being at time t served as a protective factor, as it was negatively related to any kinds of stress as well as to future anxiety at time t+1. These relationships among variables were stable over the course of the pandemic. Finally, we found significant age differences in the mean level for all variables under investigation, where young adults were the group with the highest level of stress and future anxiety as well as the lowest level of psychological well-being. Despite these differences in the variables' level, the relationships between variables were invariant across age groups. Implications for researchers and practitioners are discussed.

Grief and mourning in Covid-19 pandemic and delayed business as a new concept

The measures, restrictions, and death-related rituals in the COVID-19 pandemic have affected the mourning-related routines of individuals. Moreover, mourning processes have been affected by the restriction of death-related cultural rituals, funeral ceremonies performed only by the officials, and the prohibition of visiting graves. This study aims to investigate the experiences of individuals who lost their loved ones in Turkey during the COVID-19 pandemic. For that purpose, the phenomenological method is employed in the design of the study. Individual interviews were conducted with nine participants who lost their relatives during the COVID-19 pandemic. Data were collected through semi-structured interview forms prepared by the researchers. The study participants described the various factors contributing to the grief and mourning process in the COVID-19 pandemic. These factors were categorized into three following main categories: grief and mourning responses of the individuals lost loved ones, including cognitive, emotional, and behavioral responses; risk factors including the expectation of harm, unfinished business, and restriction of death-related religious-cultural rituals; and protective factors including relative support (i.e., family, spouse, friend, partner), tele-support (i.e., mobile phone, internet, social media), positive coping strategies (cognitive, behavioral, and religious-spiritual), and delayed business. The "delayed business" concept was also addressed within protective factors and explained in general terms. Finally, the findings were discussed considering the literature and presented some theoretical and practical implications.

Examination of the COVID-19 Pandemic's Impact on Mental Health From Three Perspectives: Global, Social, and Individual

The extent of the deleterious effects of the COVID-19 pandemic on mental health is recognized ubiquitously. However, these effects are subject to many modulatory factors from a plethora of domains of examination. It is important to understand the intersection of societal and individual levels for global stressors compared with local phenomena and physical-health outcomes. Here, we consider three perspectives: international/cultural, social, and individual. Both the enduring threat of COVID-19 infection and the protective measures to contain contagion have important consequences on individual mental health. These consequences, together with possible remedial interventions, are the focus of this article. We hope this work will stimulate more research and will suggest factors that need to be considered in the coordination of responses to a global threat, allowing for better preparation in the future.

The Psychological Impact of the COVID-19 Pandemic on Alcohol Abuse and Drunkorexia Behaviors in Young Adults

The COVID-19 outbreak negatively affected young adults' psychological well-being, increasing their stress levels and symptoms of anxiety and depression, and potentially triggering health-risk behaviors. The present study was aimed at investigating the psychological impact of the COVID-19 pandemic on alcohol abuse and drunkorexia behaviors among young adults living in Italy. Participants were 370 emerging adults (63% women, 37% men; Mage = 21.00, SDage = 2.96, range: 18-30) who were recruited through an online survey between November 2021 and March 2022. Participants completed measures of alcohol abuse, drunkorexia behaviors, negative life experiences, and post-traumatic symptoms related to the COVID-19 outbreak. The results showed that the emotional impact and negative life experiences associated with the pandemic predicted both alcohol abuse and drunkorexia behaviors, albeit in different ways. Specifically, the number of negative life experiences during the pandemic and the tendency to avoid COVID-19-related negative thoughts positively predicted alcohol abuse; and the presence of intrusive thoughts associated with the pandemic significantly predicted the frequency of drunkorexia behaviors. Implications for research and clinical practice are discussed.

Using Metaphors to Understand Suffering in COVID-19 Survivors: A Two Time-Point Observational Follow-Up Study

Accumulating evidence indicates that the COVID-19 pandemic carries risks to psychological health and represents a collective traumatic experience with consequences at the social, economic, and health levels. The primary aim of this study was to collect ongoing COVID-19 survivors’ pandemic-related experiences as expressed through the use of metaphors; the secondary aim was to explore socio-demographic variables associated with the metaphor orientation as negative, positive or neutral. An observational follow-up survey was conducted and reported according to the STROBE guidelines. Patients ≥ 18 years, who were treated for COVID-19 during the first wave (March/April 2020) and who were willing to participate in a telephone interview were involved and asked to summarize their COVID-19 experience as lived up to 6 and 12 months in a metaphor. A total of 339 patients participated in the first (6 months) and second (12 months) data collection. Patients were mainly female (51.9%), with an average age of 52.9 years (confidence interval, CI 95% 51.2−54.6). At 6 months, most participants (214; 63.1%) used a negative-oriented metaphor, further increasing at 12 months (266; 78.5%), when they used fewer neutral-/positive-oriented metaphors (p < 0.001). At the 6-month follow-up, only three individual variables (female gender, education, and experiencing symptoms at the COVID-19 onset) were significantly different across the possible metaphor orientation; at 12 months, no individual variables were significantly associated. This study suggests increasingly negative lived experiences over time and the need for personalized healthcare pathways to face the long-term traumatic consequences of COVID-19.

Adoption of measures to mitigate the impact of COVID-19: In search of a Hofstedian explanation for patterns among individual countries and country clusters

We consider multiple safety measures in relation to the COVID-19 virus and look at their adoption levels for a variety of 15 individual countries, based on data from Yougov.co.uk. Subsequently, we establish correlation coefficients between measure-specific uptake levels and Hofstede dimension scores for all countries considered. We notably find that Power Distance Index (PDI) and Individualism (IDV) have a considerable explanatory power. In addition, we carried out a Principal Components Analysis (PCA) and a cluster analysis to see whether the behavioural patterns across countries can be grouped, and which Hofstede dimensions correlate strongest with the two main components that follow from the PCA. The PCA provides further confirmation of PDI and IDV being the most important explanatory factors for the uptake of measures across countries. The cluster analysis, in turn, reveals four broad groups, which only partly coincide with the way that the mental image clustering scheme by Wursten (2019) allots countries into its respective clusters. Hence, this provides a basis to suggest that data-driven exercises like the ones from our paper can serve to adjust Wursten's intuitive scheme.

What Should I do and Who's to blame? A cross-national study on youth's attitudes and beliefs in times of COVID-19

The COVID-19 crisis has had a major impact on youth. This study examined factors associated with youth's attitudes towards their government's response to the pandemic and their blaming of individuals from certain risk groups, ethnic backgrounds, and countries or regions. In a sample of 5,682 young adults (Mage = 22) from 14 countries, lower perceived burden due to COVID-19, more collectivistic and less individualistic values, and more empathy were associated with more positive attitudes towards the government and less blaming of individuals of certain groups. Youth's social identification with others in the pandemic mediated these associations in the same direction, apart from the COVID-19 burden on attitudes, which had a positive indirect effect. No evidence of country-level moderation was found.

The Relationship between COVID-19 Protection Behaviors and Pandemic-Related Knowledge, Perceptions, Worry Content, and Public Trust in a Turkish Sample

Background: This study aimed to explore the effect of knowledge, COVID-19-related perceptions, and public trust on protective behaviors in Turkish people. Methods: Data were collected from an online survey (Turkish COVID-19 Snapshot Monitoring) conducted between July 2020 and January 2021. The recommended protective behaviors (hand cleaning, wearing a face mask, and physical distancing) to prevent COVID-19 were examined. The impacts of the following variables on protective behaviors were investigated using logistic regression analysis: knowledge, cognitive and affective risk perception, pandemic-related worry content, public trust, conspiracy thinking, and COVID-19 vaccine willingness. Results: Out of a total of 4210 adult respondents, 13.8% reported nonadherence to protection behavior, and 86.2% reported full adherence. Males and young (aged 18−30 years) people tend to show less adherence. Perceived self-efficacy, susceptibility, and correct knowledge were positively related to more adherence to protective behavior. Perceptual and emotional factors explaining protective behavior were perceived proximity, stress level, and worrying about the relatives who depended on them. Trust in health professionals and vaccine willingness were positive predictors, while conspiracy thinking and acquiring less information (<2, daily) were negative predictors. Unexpectedly, trust in the Ministry of Health showed a weak but negative association with protection behavior. Conclusions: Perceived stress, altruistic worries, and public trust seem to shape protection behaviors in addition to individuals’ knowledge and cognitive risk perception in respondents. Males and young people may have a greater risk for nonadherence. Reliable, transparent, and culture-specific health communication that considers these issues is required.

College Student Resilience During COVID-19: Examining the Roles of Mindfulness, Compassion, and Prosocial Behavior

The present study examined factors associated with resilience in college students during the COVID-19 pandemic. Participants were undergraduates at a large Midwestern university in the USA (N = 848). Hierarchical linear regression analyses examined self-reported pandemic-related adversity, community COVID-19 case rates, mindfulness, compassion, and prosocialness to determine the strongest associates of resilience. Findings demonstrated that mindfulness was the only psychological process of interest significantly associated with resilience, so specific facets were further explored in a regression analysis. Specifically, higher levels of the following mindfulness skills were associated with greater resilience: ability to describe internal experiences, to remain aware while engaging in action, and to take a nonreactive stance toward internal experiences. Mindfulness-based interventions may be appropriate for promoting resilience in college students during the COVID-19 pandemic.

#COVID19 and #Breastcancer: A Qualitative Analysis of Tweets

Rapid and efficient communication regarding quickly evolving medical information was paramount for healthcare providers and patients throughout the COVID-19 pandemic. Over the last several years, social media platforms such as Twitter have emerged as important tools for health promotion, virtual learning among healthcare providers, and patient support. We conducted a qualitative thematic content analysis on tweets using the hashtags #BreastSurgery, #BreastCancer, #BreastOncology, #Pandemic, and #COVID19. Advocacy organizations were the most frequent authors of tweets captured in this dataset, and most tweets came from the United States of America (64%). Seventy-three codes were generated from the data, and, through iterative, inductive analysis, three major themes were developed: patient hesitancy and vulnerability, increased efforts in knowledge sharing, and evolving best practices. We found that Twitter was an effective way to share evolving best practices, education, and collective experiences among key stakeholders. As Twitter is increasingly used as a tool for health promotion and knowledge translation, a better understanding of how key stakeholders engage with healthcare-related topics on the platform can help optimize the use of this powerful tool.

Mask-wearing behavior during the COVID-19 pandemic in Korea: The role of individualism in a collectivistic country

The behavior of the general public is crucial for an effective COVID-19 response. The Republic of Korea has shown better performance in this regard than many other countries worldwide. Based on the theories of individualism and collectivism, this study analyzes how Korean culture and political preferences influence the mask-wearing behavior of people in Korea. We conducted two online surveys after the first wave and in the middle of the third wave of the pandemic in Korea. The results showed only small partisan differences in the level of mask-wearing behavior in Korea. Additionally, regression analysis results demonstrate that, when demographic variables are controlled, concerns of spreading infection and horizontal individualistic tendencies of younger respondents have a significant positive relation to mask-wearing behavior. Meanwhile, horizontal collectivism had a significant positive relationship with older respondents' mask-wearing behavior, as expected in the collectivistic culture of the Korean people. As a result, horizontal individualism has similar characteristics with horizontal collectivism in Koreans and both have a positive relation to their mask-wearing behavior.

A Cross-Sectional Study on the Prevalence of Depressive Symptoms and Its Associated Sociodemographic Factors in Peru during the COVID-19 Pandemic

The present study aims to analyze the prevalence of depressive symptoms and its sociodemographic-associated factors in Peruvian adults. Data was extracted from a nation-wide representative survey in which depression symptoms were measured with the PHQ-9 and sociodemographic information was extracted from household data. Depression severity rates were estimated for each symptom, and responses were modeled through the Rating Scale Model to obtain a depression measure used as dependent variable on a Generalized Mixed Linear Model. The most frequent depression symptoms were emotional, such as discouragement, sad mood, hopelessness, and lack of pleasure when doing activities. Our model showed that, after controlling the effects of all the variables considered, the most relevant predictors were gender, education level, physiographic region, age, marital status, and number of coresidents. Higher depression levels were found in women, people who did not complete higher education, participants living in the Highlands, older adults, single participants, and people living alone. Thus, interventions to promote or prevent depression severity during similar situations as the pandemic should focus on specific sociodemographic groups and their particular needs.

How to enhance psychological security of enterprise employees during the COVID-19 pandemic: Based on MRA and fsQCA

The economic impact caused by the outbreak and dynamic evolution of COVID-19 has reduced employees' psychological security (PS), which not only threatens the physical and mental health of employees but also seriously affects the stable operation and sustainable development of enterprises. PS has been determined to be closely related to daily life experiences. Therefore, the purpose of this article is to examine the types and combinations of life events that improve employees' PS during the pandemic. Cross-sectional data came from 764 enterprise employees in 8 provinces and cities in China during the pandemic period. The participants completed the PS scale to evaluate their PS, and the PS events scale to evaluate the different types of daily life events they experienced. Multiple regression analysis (MRA) and fuzzy-set qualitative comparative analysis (fsQCA) methods were used to test the research hypothesis. The results of MRA suggest that rich leisure activities (RLA), harmonious family relationship (HFR), stable economic order (SEO) and recognition and support from others (RSO) are important life events that enhance employees' PS. The results of fsQCA suggest that the independent role of SEO, the combined role of sound social security system (SSSS), peace and health events (PHE) and HFR, the combined role of PHE, fulfilling work/life status (FWLS), SEO and RSO can substitute for each other to promote employees' high PS. This article reveals the contribution of daily life events to the PS of enterprise employees, and provides an empirical basis for formulating corresponding intervention measures to promote the physical and mental health of enterprise employees and effective enterprise management.

Understanding cultural factors in mental health during the COVID-19 pandemic: when collectivism meets a tight culture

The long-standing pathogen prevalence hypothesis suggests that collectivism can protect from epidemics and pandemics in terms of psychological well-being. However, studies exploring the protective mechanism induced when collectivism meets cultural tightness (the strength of social norms and tolerance for deviant behavior) are few. Therefore, this study aimed to investigate the protective effect of collectivism in detail considering loose and tight cultural contexts. The sample comprised 2001 Chinese participants (M age  = 18.41 ± 2.388 years; 50.2% female). Moderated regression analyses indicated that more perceived risk of COVID-19 predicted severe mental health responses (i.e., depression and anxiety), collectivism moderated this positive relationship but individualism did not. Notably, the protective effect of collectivism is especially evident in tight cultures but ineffective in loose cultures. This study emphasized that the protective effects of collectivism on mental health during a pandemic should be considered within the framework of cultural tightness. This study's findings may advance knowledge about the relationship between cultural type and mental health during epidemics.

Collectivism reduces objective mobility trends to public areas during the COVID-19 pandemic

In order to slow down the spread of the coronavirus, staying at home and avoiding going outside have been either strongly recommended or stringently enforced by governments all over the globe. Previous studies found that people with more collectivist orientation were more willing to comply with governmental guidelines and engage in preventive behaviors such as social distancing. However, these studies were based on self-report data within a short period. The current study aims to overcome these limitations by using objective mobility data generated by Google users all over the world during the past two years, thus providing a stronger test for the predictive effect of collectivism on preventive measures in response to the pandemic. We found consistent results at both the US state level (n = 50) and the country/territory level (n = 133), such that people in more collectivistic regions reduced their visits to and length of stay at certain public areas such as parks during the past two years. Our findings emphasize the importance of cultural values in face of global crises.

Risk, Obligation, and Public Noncompliance with Mobility Directives in China during the COVID-19 Pandemic

Human mobility greatly increases the risk of epidemic transmission. This study examines the psychological mechanism of individuals' noncompliance with public health directives and their choice to travel amidst threats through two rounds of surveys (N = 1473 in total) in China at different stages of the COVID-19 pandemic. This research revealed the relative strength of the motivating and impeding factors that determined behavioral intention. In subtle internal conflicts, maladaptive responses (e.g., wishful thinking, denial, fatalism) were identified as a significant factor in negotiating risk-related constraints and encouraging risky travel behavior. Interestingly, both those who traveled amidst threats and those who did not travel agreed that they had social obligations for epidemic prevention. The results demonstrated that obligation could have an indirect negative impact on behavioral intention only via attitude. By unveiling the psychological mechanism of individuals' noncompliance with health directives and travel during the pandemic, this study can aid in the development of appropriate operational strategies to manage population mobility during crises.

Unraveling the effect of ambivalence over emotional expression on subjective wellbeing in Chinese college students in romantic relationships: A multiple mediation model

The sudden and unpredictable outbreak of the COVID-19 pandemic has severely threatened young adults' physical and mental health and damaged the quality of relationships. As a critical stage of development, their well-being is more vulnerable to adverse environments which may lead to profound negative long-life mental health status. The current study aimed to investigate the mediation effects of fear of intimacy and attachment avoidance in the association between ambivalence over emotional expression and subjective wellbeing. A sample of 555 Chinese college students who are currently involved in romantic relationships (Mean age = 19.69, SD age = 1.36, 52% females) completed anonymous questionnaires regarding ambivalence over emotional expression, fear of intimacy, attachment avoidance, and subjective wellbeing. The findings revealed that ambivalence over emotional expression can predict negative subjective wellbeing of college students in romantic relationships significantly, and fear of intimacy and attachment avoidance played a sequentially mediating role in the association between ambivalence over emotional expression and subjective wellbeing. Surprisingly, when considering attachment avoidance independently, we found it had an inhibitory action on the link between ambivalence over emotional expression and subjective wellbeing. The present study contributes to a better understanding of how ambivalence over emotional expression can decrease subjective wellbeing, and also has implications for the intervention of students' subjective wellbeing and closeness during the period of COVID-19.

Sociodemographic and Digital Education Factors Are Associated to General Health, Coping Strategies, and Academic Outcomes of Undergraduate Students during the Post-Pandemic Period

The COVID-19 pandemic suddenly and forever changed the lives of many undergraduate students around the globe, forcing them to switch to online learning while undergoing social confinement within their homes. It is now well-established that this prolonged period of uncertainty impacted students’ well-being, health, and academic achievement. However, how student-related factors, such as coping strategies as well as sociodemographic, contextual, and technological variables, are linked to digital education factors is currently less understood. Using multiple regression analysis, this study investigates the results of an online questionnaire administered to students from two universities in southern Italy, differing in positioning and size, as well as policies and attitude towards digital learning. The results of this study show the positive effects of expertise with digital devices and university digital learning policies on students’ perceived general health. Conversely, isolation and lack of relational connectedness negatively impacted students’ health. Furthermore, this study highlights the role of different coping strategies, demonstrating that active forms of coping have a positive effect on students’ health, whereas avoidance strategies have the opposite effect. Taken together, this study provides crucial links between the many factors influencing students’ experience with online learning and health, and provides useful indications to promote the uptake of and adaptation to online learning.

The Association of Social Emotions, Perceived Efficiency, Transparency of the Government, Concerns about COVID-19, and Confidence in Fighting the Pandemic under the Week-Long Lockdown in Shenzhen, China

The outbreak and spread of the COVID-19 pandemic have had a far-reaching impact. The present study investigated the factors primarily affecting the execution of the control measures, including social emotions, concerns about the pandemic, perceived efficiency, transparency of the government in publishing the pandemic-related information, and confidence in fighting the pandemic. Specifically, we examined the differences in these factors across four areas (i.e., lockdown area, control area, prevention area, and safe area) according to different COVID control measures under the week-long lockdown in Shenzhen. We found that social emotions, concerns about the pandemic, perceived efficiency of the government, and confidence in fighting the pandemic were more negative in the lockdown area than that in other areas. More importantly, after controlling for areas and education level of participants, the emotion of optimism, concerns about the COVID-19 pandemic, perceived efficiency, and perceived transparency of the government in releasing COVID-19 relevant information positively predicted confidence in fighting the pandemic, while anger negatively predicted confidence in fighting the pandemic. Therefore, the government and communities could make efforts at effective communication and find innovative approaches to make individuals (especially in the lockdown area) maintain social connections, reduce negative emotions, and enhance confidence in combating the pandemic.

The association between protein levels in 24-hour urine samples and maternal and neonatal outcomes of pregnant women with preeclampsia

Objective

Hypertensive diseases of pregnancy are one of the leading causes of maternal and perinatal mortality worldwide. The aim of this study was to evaluate the association between protein levels in 24-hour urine samples and maternal and perinatal outcomes in preeclamptic patients.

Material and Methods

This retrospective cohort study was conducted with pregnant women who were diagnosed with preeclampsia (PE) and delivered in our clinic between 2010 and 2018. Patients were divided into those with a proteinuria value below 300 mg/24 h (non-proteinuria), proteinuria value between 300-2000 mg/24 h (mild proteinuria), proteinuria value between 2000-5000 mg/24 h (severe proteinuria) and proteinuria value >5000 mg/24 h (massive proteinuria) and were compared in terms of maternal and perinatal outcomes. Demographic characteristics (age, body mass index in kg/m2, gravidity), PE-related clinical symptoms (epigastric pain, neurological and respiratory symptoms), laboratory findings (24 h protein level, lactate dehydrogenase, aspartate aminotransferase, platelet count and creatine levels) were recorded in all patients.

Results

A total of 1,379 patients meeting the study criteria were included. There were 315 (23%) patients in the non-proteinuria group, 704 (51%) in the mild proteinuria group, 234 (17%) patients in the severe group and 126 (9%) patients in the massive proteinuria group. The massive proteinuria group was found to have the highest rates of maternal and prenatal complications. The Apgar score, umbilical cord pH value, birth weight, gestational week at delivery, intrauterine growth restriction and intrauterine fetal death were significantly higher in the massive proteinuria group.

Conclusion

Our data showed that the degree of proteinuria appears to be associated with maternal, fetal and neonatal outcomes among women diagnosed with PE. Women with proteinuria of >5000 mg/24 hours had notably poorer natal outcomes.

Health inequities as measured by the EQ-5D-5L during COVID-19: Results from New York in healthy and diseased persons

INTRODUCTION

The effects of the COVID-19 pandemic caused considerable psychological and physical effects in healthy and diseased New Yorkers aside from the effects in those who were infected. We investigated the relationship between known risk-enhancing and health-promoting factors (social and medical), comorbidity indicators, and, as the primary outcome, health-related quality of life (HRQoL).

METHODS

Between April 22 and May 5, 2020, a market research agency (Dynata) administered a digital survey including the EQ-5D-5L and items related to individual characteristics, social position, occupational and insurance status, living situation, exposures (smoking and COVID-19), detailed chronic conditions, and experienced access to care to an existing internet panel representative of New Yorkers.

RESULTS

2684 persons completed the questionnaire. The median age was 48 years old, and most respondents were non-Hispanic white (74%) and reported at least higher vocational training or a university education (83%). During COVID-19, mean HRQoL scores were 0.82 for the EQ-5D-5L index and 79.3 for the EQ VAS. Scores varied for healthy and diseased respondents differently by the above determinants. Lower age, impaired occupational status, loss of health insurance, and limited access to care exerted more influence on EQ-5D-5L scores of diseased persons compared to healthy persons. Among diseased persons, the number of chronic conditions and limited access to health care had the strongest association with EQ-5D-5L scores. While EQ-5D-5L scores improved with increasing age, gender had no noticeable effect. Deprivation factors showed moderate effects, which largely disappeared in (stratified) multivariable analysis, suggesting mediation through excess chronic morbidity and poor healthcare access. Generally, modifying effects were larger in the EQ-5D-5L as compared to the EQ VAS.

CONCLUSIONS

Almost all factors relating to a disadvantaged position showed a negative association with HRQoL. In diseased respondents, pre-existing chronic comorbidity and experienced access to health care are key factors.

Adolescent Resilience during the COVID-19 Pandemic: A Review of the Impact of the Pandemic on Developmental Milestones

This review explores the literature regarding the ways in which the COVID-19 pandemic has affected the navigation of developmental milestones among adolescents, specifically those in late adolescence, across several domains of their lives. The exploration is contextualized globally, focusing on five key areas: mental health, physical health, education, peer relationships, and family relationships. Implications for practice and interventions are explored in each key area to provide recommendations for those working with adolescents, as well as future research. The changes brought about by the pandemic and the readjustment to what some have referred to as the "new normalcy" will undoubtedly have lasting effects on all areas of life for this cohort of adolescents, who have shown remarkable resilience navigating this new and unfamiliar world. These changes are synthesized, with the aim to highlight differences and similarities of the shared experiences of the pandemic globally. After exploring the current realities, this chapter goes on to outline the ways in which the experience of such a significant developmental period of one's life during the COVID-19 pandemic will have an impact on adolescents for years to come. Although it is still impossible to comprehend the long-term effects, in examining proximal effects, we can postulate distal implications and potential future effects, as well as possible ways to mitigate these implications as we transition back to more of what was experienced pre-pandemic life, from a post-pandemic experience.

Aligning personal and collective interests in emerging adults during the COVID-19 emergency in Italy

This study investigated the relations of emerging adults' personal (civic competence and interdependent self-construal) and community-based (sense of community and civic engagement) resources as predictors of appraisal of COVID-19 Public Health Emergency Management (PHEM) and attitudes toward preventing contagion in Italy. Participants were 2873 Italian emerging adults (71% females) aged 19-30 years (M = 22.67, SD = 2.82). Structural equation modeling revealed both direct and indirect positive associations among study variables. Civic competence and interdependent self-construal were related to sense of community and civic engagement behavior which, in turn, predicted appraisal of PHEM. Appraisal of PHEM in turn predicted attitudes toward preventing contagion. Overall, findings highlight the importance of examining the alignment between personal and collective interests to understand emerging adults' evaluative and attitudinal experiences during a period of crisis, such as that created by COVID-19.

Stigmatization related COVID-19 and PTSD among Chinese graduates

BACKGROUND

Since COVID-19 broke out worldwide, it had caused extensive public health concerns and psychological distress, including PTSD and stigmatization towards recovered patients and people from high-risk areas. However, the association between PTSD, stigmatization and certain related factors have not been confirmed.

METHODS

Through cluster random sampling, 946 Chinese graduates were investigated from 5 universities in Shanghai at three months after China lifted its coronavirus lockdown. PTSD symptoms were evaluated with PCL-5. Demographic and disease-related characteristics including stigmatization, educational attainment and working position were collected to assess their association with PTSD.

RESULTS

12.4% graduates were reported significant PTSD symptoms in PCL-5 screening with a cut-off of 33. Graduates with a Master's degree (P = 0.02) or working position like "looking for a job" and "planning to go abroad" (P = 0.038) showed severer stigmatization related to COVID-19. Stigmatization towards both patients recovering from COVID-19 and people from high-risk areas had significant association with PTSD symptoms. Multivariate linear regression analysis showed that stigmatization can explain 5% of variation of PCL-5 scores after controlling gender, age, educational attainments and working position.

CONCLUSION

Graduates who were looking for jobs or preparing to go abroad showed more stigmatization related to COVID-19. There was a positive correlation between stigma against COVID-19 and PTSD symptoms. More attention should be paid to the mental health status of graduates who are preparing to go abroad or looking for jobs.

Social Motivation to Comply with COVID-19 Guidelines in Daily Life in South Korea and the United States

Collectivism assessed at the national level has been suggested as a psychological factor that affects compliance with COVID-19 guidelines in daily life. The level of assessment and conceptual construct of collectivism, however, vary across studies, which calls for the need to clarify the power of collectivism in explaining individuals’ compliance behaviour. With this aim, we investigated individual-level collectivism, the unique variance and other relevant factors, such as altruism (e.g., for the family, community, and humanity) and impression management (e.g., what others would think of me) in explaining compliance with COVID-19 guidelines in US and South Korean participants. The results of hierarchical regression analysis showed that collectivism was a significant factor that explained compliance only in the US participants, whereas impression management was significant and explained the additional variance over collectivism in compliance in both the US and South Korean participants. The findings suggest the importance of elucidating the overlap between collectivism and impression management in studies exploring COVID-19 guideline adherence in daily life.