Mental Health and Its Predictors during the Early Months of the COVID-19 Pandemic Experience in the United States

Temporal dynamics of socioeconomic inequalities in depressive and anxiety symptoms during the COVID-19 pandemic: a scoping review

Background

The existence of socioeconomic inequalities in the prevalence of symptoms of depression and anxiety is widely acknowledged, and individuals from lower socioeconomic backgrounds tend to exhibit higher rates of symptoms. However, the direction in which the COVID-19 pandemic has influenced these disparities remains uncertain. We therefore aimed to systematically outline the available evidence on the temporal dynamics of socioeconomic inequalities in symptoms related to depression and anxiety during the COVID-19 pandemic across high-income countries.

Methods

A scoping review was conducted by searching the databases Embase, Scopus and PsycINFO. According to pre-defined eligibility criteria, two reviewers independently screened titles and abstracts as well as full texts of the compiled records. Data from the included studies were extracted using a standardised data-extraction form and analysed numerically and narratively. The scoping review followed the PRISMA-ScR guidelines.

Results

A total of 49 studies comprising 149 analyses of socioeconomic indicators in relation to symptoms of depression and anxiety were included. Despite heterogeneous study designs and results, there was a tendency of increasing (40.9%; n = 61) or persistent (38.2%; n = 57) inequality trends to the detriment of those in socially more disadvantaged positions. Increasing inequalities were most pronounced when income was used as a socioeconomic indicator. Groups with lower socioeconomic status appeared most vulnerable in the initial phase of the COVID-19 pandemic. Throughout the pandemic, dynamics were diverse, with persistent trends most frequently reported.

Conclusion

Overall, to the detriment of those with lower socioeconomic status, mental-health inequalities persisted or increased in most analyses. Continually monitoring socioeconomic inequalities over time is crucial, since this makes it possible to adapt prevention and intervention strategies to specific pandemic phases. Interventions targeting job security, income security and educational attainment could reduce mental-health inequalities. The results can contribute to preparedness plans for future pandemics and crises.

The relationship between the psychological resilience and post-traumatic growth of college students during the COVID-19 pandemic: a model of conditioned processes mediated by negative emotions and moderated by deliberate rumination

BACKGROUND

The mental health of university students during the COVID-19 pandemic has attracted the attention of researchers. For the present study researchers constructed a mediation model to explore the relationship between psychological resilience and post-traumatic growth, the mediating role of negative emotions and the moderating role of deliberate rumination in students.

METHODS

The Psychological Resilience Scale, Posttraumatic Growth Inventory, Depression-Anxiety-Stress Scale (DASS-21) and Event Related Rumination Inventory were used in a survey of 881 college students. The data were analyzed using SPSS 26.0 and the PROCESS plugin (version 3.3).

RESULTS

(1) Psychological resilience is positively related with post-traumatic growth. Deliberate rumination is positively related to psychological resilience, posttraumatic growth, and negative emotions. Psychological resilience, post-traumatic growth and negative emotions are negatively related. (2) Negative emotions mediated the relationship between psychological resilience and post-traumatic growth. (3) Deliberate rumination plays a moderating role in psychological resilience affecting negative emotions. Deliberate rumination plays a moderating role in the extent to which psychological resilience influences PTG through negative emotions.

CONCLUSIONS

Psychological resilience affects post-traumatic growth directly and also indirectly through negative emotions. With the increase of mental resilience, the level of negative emotion tended to decrease. When individuals are experiencing negative emotions, high levels of active rumination are more likely to promote post-traumatic growth. This study helps to explore the factors affecting the mental health of college students during the epidemic, thus providing guidance for appropriate mental health interventions.

Trajectories of financial distress during the COVID-19 pandemic and their associations with mental health and substance use outcomes in a cohort of young adults

The COVID-19 pandemic has led to unprecedented life disruptions among young adults, including increased job insecurity and financial strain. Mental health problems and substance use have also increased during the pandemic, with young adults particularly vulnerable to experiencing these challenges. This study examines trajectories of financial distress among young adults during the pandemic and their associations with depression, anxiety, and hazardous alcohol and cannabis use. Data from 473 young adults (ages 22-29) recruited in the Northwest United States were collected from April/May 2020 to July/August 2021. Financial distress trajectories were identified using growth mixture modeling. Negative binomial models were used to examine associations between financial distress trajectories and distal outcomes of depression, anxiety, alcohol, and cannabis use. Three distinct trajectories were identified, revealing Low, Moderate, and High financial distress experiences. Individuals with "Moderate" and "High" trajectories showed significantly greater depressive and anxiety symptom scores compared with those in the "Low" financial distress trajectory group. Trajectories were not associated with subsequent levels of alcohol or cannabis use. Young adult mental health remains a priority during periods of economic downturn. Providers must be aware of the psychological challenges imposed by financial distress among young adults to address worsening mental health symptoms.

Assets and depression in U.S. adults during the COVID-19 pandemic: a systematic review

PURPOSE

Mental health is shaped by social and economic contexts, which were altered during the COVID-19 pandemic. No study has systematically reviewed the literature on the relation between different assets and depression during the COVID-19 pandemic.

METHODS

We conducted a systematic review of the literature on financial (e.g. income/savings), physical (e.g., home ownership), and social (e.g., marital status, educational attainment) assets and depression in U.S. adults. For each asset type, we created binary comparisons to report on the direction of the relationship and described if each study reported insignificant, positive, negative, or mixed associations.

RESULTS

Among the 41 articles identified, we found that income was the most studied asset (n=34), followed by education (n=25), marital status (n=18), home ownership (n=5), and savings (n=4). 88%, 100%, and 100% of articles reported a significant association of higher income, home ownership, and higher savings, respectively, with less depression. The association between marital status and education with depression was more nuanced: 72% (13 of 18) studies showed that unmarried persons had greater risk of depression than married or cohabitating persons and 52% (13 of 25) of studies reported no significant difference in depression across educational groups.

CONCLUSION

This work adds to the literature a deeper understanding of how different assets relate to depression. In the context of largescale traumatic events, policies that maintain and protect access to social, physical, and financial assets may help to protect mental health.

Social support in older adults: Validation and norm values of a brief form of the Perceived Social Support Questionnaire (F-SozU K-6)

BACKGROUND

Social relations are crucial for maintaining physical and mental health across the life span. As social roles, networks and needs change with age a valid assessment of social support in older adults and age-specific norms are necessary. The present work aims to [1) assess the level of social support in individuals > 60 years of the general German population, [2) evaluate the brief six-item form of the Perceived Social Support Questionnaire (F-SozU K-6) in this age group and to [3) provide age-specific norm values.

METHODS

We analyze data of N = 706 people representative for the German population collected in 2021. To assess social support, we used the F-SozU K-6. We tested for selectivity, item difficulty, internal consistency, construct and factor validity, as well as factorial invariance. Additionally, we assessed correlations and associations with depression, loneliness, and sociodemographic factors. Furthermore, we reported norm values for respondents > 60 years.

RESULTS

Participants > 60 years reported a mean level of 23.97 (SD = 4.82) of social support. Results of the CFA confirmed a very good model fit. Measurement invariance across sex and age was shown. Associations with ADS and LS-S supported construct validity. Multiple regression analysis showed that female sex, increasing age, having a partner, and a higher equivalized household income were associated with higher levels of social support.

CONCLUSION

The F-SozU K-6 is a reliable and economical tool to assess perceived social support in older adults. Norm values for individual > 60 years are provided.

Stress, anxiety, and depression trajectories during the "first wave" of the COVID-19 pandemic: what drives resilient, adaptive and maladaptive responses in the Portuguese population?

Introduction

The COVID-19 outbreak and the community mitigation strategies implemented to reduce new SARS-CoV-2 infections can be regarded as powerful stressors with negative consequences on people's mental health. Although it has been shown that negative emotional symptoms subside during lockdown, it is likely the existence of inter-individual differences in stress, anxiety and depression trajectories throughout lockdown.

Objectives

We aimed to cluster participants' according to their trajectories of stress, anxiety and depression scores throughout lockdown, and identify the sociodemographic, clinical, and lifestyle factors that may distinguish the subjects included in the different clusters.

Methods

From March 23, 2020, to May 31, 2020, participants completed weekly online questionnaires on sociodemographic information (age, sex, education level, and employment status), psychological functioning (DASS-21, NEO-FFI-20), and clinical data (psychiatric disorders, psychiatric medication, physical disorders). Data regarding smoking status, alcohol consumption, physical activity, and time spent daily looking for COVID-19-related information were also collected. Stress, anxiety and depression trajectories were determined using latent class mixed models.

Results

A total of 2040 participants answered the survey at baseline and 603 participants answered all surveys. Three groups ("Resilient," "Recovered," and "Maladaptive") with distinct mental health trajectories were identified. Younger participants, women, participants with lower education level, not working, studying, diagnosed with a mental disorder, taking psychiatric medication, smokers, those who spent more time consuming COVID-19-related information and those with higher neuroticism tended to cluster in the "Maladaptive" group, placing them at higher risk of persistent negative emotional symptoms during compulsory confinement.

Conclusion

Accordingly, a tailored approach to emotional suffering for vulnerable subjects during the COVID-19 and future pandemics must be devised.

Assessing the Reasons and Adverse Effects of Self-Medication in the Context of the COVID-19 Pandemic in Sierra Leone. A Case Study of Moriba Town Section

Background

The impact of COVID-19 pandemic on healthcare resources has led to an increase in self-medication as a coping mechanism. The purpose of the study is to investigate the prevalence of self-medication, the reasons behind it, and its potential consequences during the pandemic.

Methods

A community-based cross-sectional study was conducted in Moriba Town, Bo City, Southern Sierra Leone. Using a multistage systematic sampling technique, 246 adult participants were selected. Data were collected using Kobo collect electronic platform and analyzed using SPSS version 26.0.

Results

Out of the 246 adult residents who were sampled, 63 (26%) practiced self-medication. Among them, females (33 or 52%) were more prevalent than males (30 or 48%). The most dominant age groups for self-medication were 38-47 (22 or 35%) and 28-37 (18 or 29%). The major reasons for self-medication were fear of infection (189 or 77%), fear of quarantine (199 or 81%), and stigma (189 or 77%). Delays in treatment (113 or 46%) and unavailability of Covid-19 medications (92 or 37%) were also cited. However, a majority of respondents (162 or 66%) denied the influence of friends or media (168 or 68%) on their decision to self-medicate. Reasons like "delay in receiving treatment" and "influence of friends" showed significant association with self-medication (pValue <0.05). More than half of the respondents 177 (72%) did not practice self-medication before the pandemic. Adverse reactions due to self-medication included skin rashes and blisters 29 (45%) and drowsiness 24 (38%).

Conclusion

The prevalence of unsupervised medication before and after the pandemic was minimal suggesting little impact of the pandemic. Fear and social stigma were the main drivers for self-medication. To promote safety and informed health decisions, regulatory measures, and awareness campaigns are essential to control unsupervised medication sales, improve drug labeling, and educate the public about the dangers of self-medication.

Heterogeneity in the trajectories of psychological distress among late adolescents during the COVID-19 pandemic

Background

The coronavirus disease 2019 (COVID-19) pandemic has constrained opportunities in social, educational and professional domains, leading to developmental challenges for adolescents initiating their transition to adulthood. Meta-analysis indicated that there was a small increase in psychological distress during the first year of the COVID-19 pandemic. However, significant heterogeneity in the psychological response to the COVID-19 pandemic was noted. Developmental antecedents as well as social processes may account for such heterogeneity. The goal of this study was to characterize trajectories of psychological distress in late adolescence during the COVID-19 pandemic.

Methods

5014 late adolescents born between 2000 and 2002 from the UK Millennium Cohort Study completed online self-reported assessments at three occasions during the first year of the COVID-19 pandemic (May 2020, September/October 2020 and February/March 2021). These surveys assessed psychological distress, loneliness, social support, family conflict, as well as other pandemic stressors. Information on developmental antecedents were obtained when cohort members were 17 years of age.

Results

Four distinct trajectories class were identified. Normative class (52.13%) experienced low and decreasing levels of psychological distress, while moderately increasing class (31.84%) experienced a small, but significant increase in distress over time and increasing class (8.75%) exhibited a larger increase in distress after the first wave of the pandemic. Inverted U-shaped class (7.29%) experienced elevated psychological distress during the first wave of the pandemic, followed by a decrease in distress in subsequent waves of the pandemic. Larger longitudinal increases in loneliness were noted among individuals in the elevated distress trajectory, compared to other trajectories. Pre-pandemic psychopathology was associated with elevated distress early in the pandemic.

Conclusions

The largest trajectory showed low and declining psychological distress, highlighting the resilience of the majority of late adolescents. However, a subgroup of adolescents experienced large increases in psychological distress, identifying a group of individuals more vulnerable to pandemic-related stress.

Association Between Social Support, and Depressive Symptoms Among Firefighters: The Mediating Role of Negative Coping

Background

Depressive symptoms (DS) can erode physical and mental health; social support (SS) is considered a buffer for DS and a promoter for improving coping and recovery abilities. However, there is almost no research on the mediating role of negative coping (NC) in SS and DS, especially among firefighters.

Methods

A cross-sectional survey was conducted among firefighters in Chongqing, China, and the valid data of 407 firefighters were collected through questionnaires distributed on the WeChat platform in 2020. Statistical Product and Service Solutions (SPSS) 26.0 is used for descriptive statistics and correlation analysis. Structural equation modeling was adopted to analyze the association among SS, NC, and DS. The mediation effect is also evaluated.

Results

Firefighters' detection rate of DS is 23.3%, and when they receive more SS were less likely to develop DS. NC was positively correlated with DS (β = 0.54, p < 0.001) after controlling for SS. Besides, the results of structural equation modeling showed that NC partially mediates the relationship between SS and DS (standard error = 0.039, indirect effects = 0.109, 95% confidence interval: 0.047-0.200 p < 0.001).

Conclusion

NC has a partial indirect effect between SS and DS among firefighters. SS could not only affect DS directly but also indirect work on it by affecting NC. This discovery will be a novel and meaningful part of the research on the firefighter population.

The psychological impact of the COVID-19 pandemic and the role of resilience: cross cultural differences between Brazil, Italy, and the United States

OBJECTIVE

Restrictive measures consequent to the COVID-19 pandemic have had a significant psychological impact on everyday life in the general population, even though differences between countries remain poorly investigated. The present study sought to examine the different psychological impacts and resilience of the pandemic among three of the most heavily hit countries: Brazil, Italy, and the United States.

METHODS

This cross-sectional study separately involved three national community populations, namely the Brazilian, the Italian, and the American population. Participants aged 18 years or older were recruited through a shared online survey. Participants self-completed the Connor-Davidson Resilience Scale (CD-RISC-10) and the Center for Epidemiological Studies-Depression Scale (CES-D); post-traumatic stress was additionally assessed using the Impact of Event Scale-Revised (IES-R). Three separate Analyses of Covariance (ANCOVA) were performed in order to investigate differences in the levels of resilience, post-traumatic stress, and depression among the three populations.

RESULTS

The study included in total 734 participants (mean age = 27.60 ± 11.69 years; 77% of females). Results of ANCOVA comparisons showed significant differences between the three groups in the variable measuring resilience, post-traumatic stress symptoms, and depression. As for resilience, results of post-hoc tests showed significant differences between the groups from Brazil and Italy and between the groups from Brazil and USA. As for the post-traumatic stress symptoms, results showed significant differences between the USA and Brazil groups and between the USA and Italy groups. As for the depression symptoms, results showed significant differences between the USA and Brazil groups.

CONCLUSIONS

Overall, these findings may help to increase understanding of the psychological impact of COVID-19 in Brazil, Italy, and the USA. Interventions to prevent mental disorders among general populations should take into account these findings.

Implicit and explicit COVID-19 associations and mental health in the United States: a large-scale examination and replication

BACKGROUND

Given the sensitive nature of COVID-19 beliefs, evaluating them explicitly and implicitly may provide a fuller picture of how these beliefs vary based on identities and how they relate to mental health.

OBJECTIVE

Three novel brief implicit association tests (BIATs) were created and evaluated: two that measured COVID-19-as-dangerous (vs. safe) and one that measured COVID-19 precautions-as-necessary (vs. unnecessary). Implicit and explicit COVID-19 associations were examined based on individuals' demographic characteristics. Implicit associations were hypothesized to uniquely contribute to individuals' self-reports of mental health.

METHODS

Participants (N = 13,413 US residents; April-November 2020) were volunteers for a COVID-19 study. Participants completed one BIAT and self-report measures. This was a preregistered study with a planned internal replication.

RESULTS

Results revealed older age was weakly associated with stronger implicit and explicit associations of COVID-as-dangerous and precautions-as-necessary. Black and Asian individuals reported greater necessity of taking precautions than White individuals (with small-to-medium effects); greater education was associated with greater explicit reports of COVID-19-as-dangerous and precautions-as-necessary with small effects. Replicated relationships between COVID-as-dangerous explicit associations and mental health had very small effects.

CONCLUSIONS

Implicit associations did not predict mental health but there was evidence that stronger COVID-19-as-dangerous explicit associations are weakly associated with worse mental health.

Change in mental health during the COVID-19 pandemic: a longitudinal study of residents of Indian metropolitan cities

BACKGROUND

Initial studies have reported an increase in the incidence of mental health problems during the early months of COVID-19. Longitudinal studies of changes in mental health undertaken in Low and Middle Income countries during the pandemic remains an under-researched area.

AIMS

The current study examines changes in mental health among adult residents of metropolitan cities of India, a middle-income country reporting the second-highest COVID cases and third-highest fatalities, during the pandemic.

METHOD

Data was collected, based on a telephonic survey using the internationally accepted abridged Depression Anxiety Stress schedule (DASS-21), in August and September 2020 and July-August 2021. The sample size is 994. The data was analysed using an ordered logit model.

RESULTS

At the onset of the pandemic, high levels of anxiety, stress and depression prevailed; their levels reduced after one year. Respondents who have experienced a decline in economic fortunes, have family members with pre-existing co-morbidity or had COVID in the family are significantly less likely to report improvement in mental health; less-educated respondents are also vulnerable.

CONCLUSIONS

Specific sub-groups, identified as at risk, need monitoring and continued provisioning of tailor-made mental health services addressing their specific needs. Relief measures targeting economically affected households are also required.

Perceived risk, emotions, and stress in response to COVID-19: The interplay of media use and partisanship

Relationships between risk perceptions, emotions, and stress are well-documented, as are interconnections between stress, emotion, and media use. During the early COVID-19 pandemic, the public responded psychologically to the threat posed by the pandemic, and frequently utilized media for information and entertainment. However, we lack a comprehensive picture of how perceived risk, emotion, stress, and media affected each other longitudinally during this time. Further, although response to the pandemic was highly politicized, research has yet to address how partisan affiliation moderated relationships between risk, emotion, stress, and media use over time. This three-wave (N = 1021) panel study assessed the interplay of risk, emotion, stress, and media use for Americans with different political affiliations between March and May of 2020. Findings indicate that perceived risk, emotion, and stress at Time 1 predicted media use at Time 2, with predictors varying by type of media. Use of entertainment media and social/mobile media predicted later stress (Time 3), but news consumption did not. Later risk perceptions (Time 3) were not influenced by media use at Time 2. The predictors and consequences of different types of media use were notably different for Republicans and Democrats. In particular, risk perceptions predicted greater news use among Democrats but greater entertainment media use among Republicans. Moreover, social/mobile media use resulted in perceiving the risks of COVID-19 as less serious for Republicans while increasing stress over time for Democrats.

Hope, optimism, and pessimism as predictors of positive and negative psychological changes related to the COVID-19 pandemic in Slovak adults

Background and objectives

Positive and negative changes in outlook represent psychological changes that are the results of the cognitive processing of stressful and traumatic events by an individual. The objectives of the study were (1) to determine the level of occurrence and types of positive and negative changes in connection with the COVID-19 pandemic among adults in Slovakia and (2) to study the role of personality factors such as hope (dispositional and perceived) and life orientation (optimism and pessimism) in the prediction of positive and negative changes in adults during the fourth pandemic wave.

Methods

A Short Form of the Changes in Outlook Questionnaire (CiOQ-S), the Dispositional Hope Scale (DHS), the Perceived Hope Scale (PHS), and the Life Orientation Test (LOT-R) were administered. The research sample consisted of 102 participants, whose ages ranged from 20 to 65 years (Mage = 38.90, SD = 14.28). The research design was quantitative, exploratory, and confirmatory.

Results

In total, 95% of participants reported positive changes related to COVID-19. Concurrently, up to 70% of these participants also reported negative changes from the impact of the pandemic. Only 25% of participants reported positive changes without noticing any negative perception of the consequences of the pandemic. Overall, 68% of participants reported negative changes related to COVID-19. Only 29% of participants reported negative changes without noticing any positive perception of the consequences of the pandemic. In total, up to 86% of participants agreed with experienced psychological changes (positive or negative) as a result of the COVID-19 pandemic. The high prevalence of positive changes along with the relatively high prevalence of negative changes related to the COVID-19 pandemic outline the question of whether reported positive changes represent real or illusory growth. Optimism and pessimism were found to be significant independent predictors of positive changes related to the COVID-19 pandemic. Hope was identified as a significant independent predictor of negative changes related to the COVID-19 pandemic.

The impact of COVID-19 on mental health and posttraumatic growth of Korean college students: a mixed method study examining the moderating role of coping flexibility and sense of community

Introduction

In the context of the COVID-19 pandemic, which has led to complex psychological problems, it is important to examine the effect of coping flexibility and sense of community, because relying solely on specific coping strategies is ineffective, and the pandemic necessitates social cooperation.

Methods

This study was divided into two parts. The first study used a quantitative research method(i.e., structural equation modeling) to test if coping flexibility and sense of community moderated the impact of COVID-19-related concerns on mental health (i.e., depression and anxiety) and posttraumatic growth among Korean college students. The second study used a qualitative research method for an in-depth examination of how Korean college students coped with the COVID-19 pandemic and if they achieved any positive change or growth. Given that the COVID-19 pandemic represents a situation distinct from what people have previously encountered, Study II was designed to examine the experiences of individuals during this exceptional period.

Results

In the first study (Study I), coping flexibility was found to increase the impact of COVID-19-related concerns and difficulties on depression and anxiety. Conversely, a sense of community reduced the consequences of these overwhelming worries on depression and anxiety, while also expanding the impact of COVID-19-related disorders on posttraumatic growth. In the second study (Study II), the findings showed that the participants experienced various psychological consequences, including depression and anxiety, and distress in other aspects of their life, including disruptions in interpersonal relationships and college life. Nonetheless, the participants made efforts to cope with such difficulties and overcome the challenges together with the community. In fact, the pandemic improved their coping skills and expanded their value system and worldview.

Conclusion

The study findings suggest that given the unique situation presented by the COVID-19 pandemic, a sense of community protected the mental well-being of Korean college students and facilitated their growth. This study emphasizes the necessity of promoting SOC to effectively cope with disaster situations.

Associations between sleep disturbance, physical activity, and anxiety sensitivity among college students during the COVID-19 pandemic

The present study sought to examine associations between anxiety sensitivity and both sleep and physical activity among college students, who are particularly vulnerable to sleep disturbance, decreased physical activity, and the development of psychopathology, especially in the wake of the COVID-19 pandemic. Participants were 683 college students (Mage = 20.33, SD = 3.58; 72% female; 70.3% White) who completed self-report measures online for course credit. Results indicated that after controlling for the effects of age, gender identity, and race, greater sleep disturbance was significantly associated with higher overall anxiety sensitivity (7% unique variance; β = 0.27, t = 6.67, p < .001) as well as its three subdomains (physical concerns: 4% variance; β = 0.21, t = 4.97, p < .001; cognitive concerns: 6% variance; β = 0.25, t = 6.17, p < .001; social concerns: 6% variance; β = 0.26, t = 6.22, p < .001). Additionally, more time spent walking was associated with greater anxiety sensitivity physical concerns (1% variance; β = 0.11, t = 2.52, p = .012) and greater vigorous intensity physical activity was associated with lower anxiety sensitivity social concerns (1% variance; β = -0.13, t = -2.76, p = .006). These findings suggest that sleep problems may be more universally relevant to anxiety sensitivity than physical activity and interventions to promote healthier sleep may be useful for decreasing anxiety sensitivity in college students.

Disparities in insecurity, social support, and family relationships in association with poor mental health among US adults during the COVID-19 pandemic

The COVID-19 pandemic has had a significant impact on mental health. Identifying risk factors and susceptible subgroups will guide efforts to address mental health concerns during the pandemic and long-term management and monitoring after the pandemic. We aimed to examine associations of insecurity (concerns about food, health insurance, and/or money), social support, and change in family relationships with poor mental health and to explore disparities in these associations. An online survey was collected from 3952 US adults between May and August 2020. Symptoms of anxiety, depression, stress, and trauma-related disorders were assessed by the Generalized Anxiety Disorder 7-item scale, the Patient Health Questionnaire-9, the Perceived Stress Scale-4, and the Primary Care Post-Traumatic Stress Disorder Screen, respectively. Social support was measured by the Oslo Social Support Scale. Logistic regression was used and stratified analyses by age, race/ethnicity, and sex were performed. We found a higher prevalence of poor mental health among those who were younger, female, with lower socioeconomic status, and racial/ethnic minorities. Participants who were worried about money, health insurance, or food had higher odds of symptoms of anxiety (OR = 3.74, 95% CI: 3.06-4.56), depression (OR = 3.20, 95% CI: 2.67-3.84), stress (OR = 3.08, 95% CI: 2.67-3.57), and trauma-related disorders (OR = 2.93, 95% CI: 2.42-3.55) compared to those who were not. Compared to poor social support, moderate and strong social support was associated with lower odds of all four symptoms. Participants who had changes in relationships with parents, children, or significant others had worse mental health. Our findings identified groups at higher risk for poor mental health, which offers insights for implementing targeted interventions.

A confirmatory factor analysis of a cognitive model of COVID-19 related anxiety and depression

The mental health impact of the COVID-19 pandemic has been significant, with many regions across the globe reporting significant increases in anxiety, depression, trauma, and insomnia. This study aims to validate a potential cognitive model of maintenance factors of COVID-19 related distress by examining psychological predictors of distress, and their goodness-of-fit as a coherent model. Participants from the general population (n = 555) were recruited using a cross-sectional on-line survey design, assessing Demographic factors, Anxiety, Depression, Loneliness, COVID-19 related distress, Trauma Cognitions related to COVID-19, Rumination, Safety Behaviours, Personality Factors, and Mental Effort related to COVID-19. A series of stepwise linear regressions found that components of the model were significant and accounted for a large percentage of variance when examining Covid-19 related distress (R² = 0.447 Covid Stress Scale), Anxiety (R² = 0.536 DASS-Anxiety Subscale) and Depression (R² = 0.596 Depression DASS-subscale). In a confirmatory factor analysis, Loneliness, Post-Traumatic Cognitions about Self, Post-Traumatic Cognitions about the World, Emotional Stability, and Mental Effort related to COVID-19 loaded onto a single factor. The final model showed adequate fit (CFI = 0.990, TLI = 0.983, RMSEA = 0.053 (0.027-0.080), GFI = 0.986, SRMR = 0.0216, χ2 = 23.087, p = .006). The results highlight the importance of cognitive factors, such as post-traumatic cognitions, rumination, and mental effort in maintaining COVID-19 related distress.

Related factors to the coping style of patients with sudden sensorineural hearing loss

BACKGROUND

Coping style can affect the patient's physical and mental health management. Therefore this study aimed to identify factors related to the coping style of young and middle-aged sudden sensorineural hearing loss (SSNHL) patients to provide reference for clinical nursing practice.

METHODS

A cross-sectional study was conducted on young and middle-aged SSNHL patients hospitalized in the otolaryngology departments of four hospitals in Suzhou City, China. A paper-based self-administered questionnaire investigated the patient's coping style and related factors. Multiple linear stepwise regression analysed the effective related factors in patients' coping styles.

RESULTS

Among 872 patients, 866 completed the survey, with an average age of 37.27 y. Factors related to the coping style of these patients included gender, chronic diseases, history of trauma, social support and type D personality (p<0.05). Female patients adopt more negative coping styles than male patients. Patients with chronic diseases or a history of trauma had more positive coping styles. Higher social support scores were related to improvements in coping style. Patients with type D personality were more likely to adopt negative coping styles.

CONCLUSIONS

This study suggests that psychological assessment of patients, chronic diseases, history of trauma, social support and type D personality may benefit the understanding of these patients' coping styles and, as a consequence, may improve their stress management.

The Association of Social Support and Loneliness with Symptoms of Depression, Anxiety, and Posttraumatic Stress during the COVID-19 Pandemic: A Meta-Analysis

BACKGROUND

Research suggests that changes in social support and loneliness have affected mental disorder symptoms during the COVID-19 pandemic. However, there are a lack of studies comparing the robustness of these associations.

AIMS

The aims were to estimate the strength of the associations of loneliness and social support with symptoms of depression, anxiety, and posttraumatic stress during the COVID-19 pandemic (2020-2022) in the general population.

METHOD

The method entailed a systematic review and random-effects meta-analysis of quantitative studies.

RESULTS

Seventy-three studies were included in the meta-analysis. The pooled correlations of the effect size of the association of loneliness with symptoms of depression, anxiety, and posttraumatic stress were 0.49, 0.40, and 0.38, respectively. The corresponding figures for social support were 0.29, 0.19, and 0.18, respectively. Subgroup analyses revealed that the strength of some associations could be influenced by the sociodemographic characteristics of the study samples, such as age, gender, region, and COVID-19 stringency index, and by methodological moderators, such as sample size, collection date, methodological quality, and the measurement scales.

CONCLUSIONS

Social support had a weak association with mental disorder symptoms during the COVID-19 pandemic while the association with loneliness was moderate. Strategies to address loneliness could be highly effective in reducing the impact of the pandemic on social relationships and mental health.

A descriptive literature review of early research on COVID-19 and close relationships

This in-depth critical review investigates the impact of COVID-19 on personal relationships from the start of the pandemic in early 2020 to September 2021. Research examining six themes are identified and described in detail: the impact of COVID-19 on (1) family and intimate relationships; (2) LGBTQ+ relationships; (3) how COVID-19 is linked to technologically mediated communication and personal relationships; (4) potential shifts in sexual behaviors and desire; (5) potential shifts in relational conflict and intimate partner violence; and (6) constructive aspects of personal relationships, which is a broad theme that includes outcomes such as resilience, relational quality, coping, and social support. Findings for overarching patterns are offered to highlight implications for current research and identify future directions to consider when continuing to study personal relationships during the COVID-19 pandemic and similar future crises.

Caregiver Worry of Infection and Family Co-existence Difficulty and Association With Change in Children's Internalizing and Externalizing Symptoms During the Initial COVID-19 Lockdown in the UK and Turkey

The study examined whether caregiver worry of COVID-19 infection and co-existence difficulty differentially predicted child mental health and wellbeing during the lockdown in two culturally different countries that were severely affected by the pandemic: the UK and Turkey. Co-existence difficulty is the hardship experienced by family members living all together in the same house at the same time during the lockdown period. Participants were 1849 caregivers of children between 5- and 12-years old living in the UK (n = 995) and Turkey (n = 854), who completed an electronic survey distributed via social networks during the initial phase of the COVID-19 lockdown (July and August 2020). Caregivers completed a set of questionnaires on child and family wellbeing and on whether the child's internalizing and externalizing symptoms changed during the lockdown as compared to before. Worry of COVID-19 infection was higher amongst caregivers in the Turkish sample and was associated with higher levels of child internalizing symptoms during the lockdown in the Turkish sample, however there were no statistically significant differences in the size of the impact of worry of infection on the children's internalizing symptoms between the two countries. Co-existence difficulty independently predicted increase in children's internalizing and externalizing symptoms during the lockdown in both samples. Families in the UK experienced a higher level of difficulty with co-existence compared to the families living in Turkey but the magnitude of the impact of co-existence difficulty on children's outcomes between the two samples was not significantly different.The findings suggest that public health strategies should aim to reduce social anxiety and invest in the development of programs aimed at supporting families to overcome the challenges of co-existence during times of public health crisis.

Trajectories of psychological distress during the COVID-19 pandemic among community-dwelling older adults in Quebec: A longitudinal study

OBJECTIVE

The COVID-19 pandemic and its associated public health measures may increase the risk for psychological distress among vulnerable older adults. This longitudinal study aimed to identify predictors of psychological distress trajectories among community-dwelling older adults in Quebec, Canada.

METHODS

The study spanned four time points across 13 months and three waves of the COVID-19 pandemic. The sample included 645 community-dwelling older adults ages 60 years and older in Quebec. Participants completed telephone-based interviews that included the Kessler 6-item Psychological Distress Scale (K6) to assess psychological distress at each time point as well as information on socioeconomic, medical, psychological and COVID-19 related factors. Group-based trajectory modelling was used to identify distinct trajectories of psychological distress across time.

RESULTS

Three group-based trajectories of psychological distress were identified: the resilient (50.5%), reactive (34.9%), and elevated distress groups (14.6%). Individuals with mobility issues, insomnia symptoms, COVID-19 related acute stress, general health anxiety, increased loneliness symptoms, and those unable to use technology to see others were more likely to be in the reactive and elevated groups than the resilient group. Those with past mental health problems had uniquely increased odds of being in the reactive group compared to the resilient group. Individuals living in poverty and those who reported taking psychotropic medication had increased odds of being in the elevated distress group compared to the resilient group.

CONCLUSION

These findings characterized distinct trajectories of psychological distress in older adults and identified risk factors for elevated distress levels.

The dynamics of Appraisal II: a meta-analysis of the relationship between fortitude and the indices of psychological well-being

Identifying the factors that contribute to differential vulnerability in the face of adversity is key to psychology fulfilling its mandate as a helping profession. One such factor, fortitude, which is described as the psychological strength to manage adversity and to stay well, has consistently been linked to psychological well-being. The objective of the research was to statistically integrate studies examining the relationship between fortitude and the indices of psychological well-being by using a meta-analysis. We used a random-effects model for the meta-analysis. In addition to the overall effect size, we examined publication bias and the moderating role of age and methodological quality. We also performed a subgroup analysis to compare between studies with positive and negative indicators of psychological well-being. In addition, we used robust variance estimation to account for effect-size dependencies, as some studies have reported more than one correlation coefficient. A total of 13 studies reporting 35 correlation coefficients pertaining to the relationship between fortitude and the indices of psychological well-being were extracted. The meta-analysis revealed a significant overall effect ( r = .44, p < .001). The results also indicated that age and methodological quality did not influence the effect size. Subgroup analysis indicated that the overall effect size for studies that used positive indicators ( r = .49, p < .001) was higher than that for studies that used negative indicators ( r = .36, p < .001). In addition, no visual or statistical evidence of publication bias was observed. The robust variance estimation results also confirmed that the effect-size dependencies did not influence the overall effect size. The study results provide strong evidence regarding the association between fortitude and psychological well-being. This finding has several implications for promoting mental health and suggests that interventions aimed at building fortitude can be leveraged to mitigate psychological distress.

Reliving a traumatic experience through emotional creativity: the bright side of cancer during the COVID-19 pandemic

Purpose

The COVID-19 outbreak has undoubtedly affected overall mental health. Thus, researching resilience is important, as it has been previously discussed as a means to protect people from mental health problems. This study aims to clarify whether survivors of a traumatic event (i.e. cancer survivors) are more resilient to living through another traumatic experience, such as COVID-19, compared to those who have never had such an experience. The study also examines the role of emotional creativity in this process.

Design/methodology/approach

A quantitative research design was adopted. The data collection was performed through a survey (N = 338), which was conducted among two separate groups of participants. The first group (N = 152) included the survivors of a traumatic event (i.e. cancer survivors), and the second group (N = 186) included those who did not have such an experience.

Findings

The results demonstrate that living through a traumatic experience results in a higher level of resilience during another traumatic experience (i.e. COVID-19), which is the result of higher post-traumatic growth. Moreover, emotional creativity is discussed as an explanatory variable that explains a significantly higher level of post-traumatic growth among survivors of a traumatic event.

Originality/value

This research offers a better understanding of the effect of living through a traumatic event on post-traumatic growth and resilience in living through another traumatic experience. Moreover, post-traumatic growth is explained through emotional creativity improvement, which happens after experiencing a traumatic life event.

Psychological factors in adherence to COVID-19 public health restrictions in Italy: A path model testing depressed mood, anxiety, and co-rumination via cellphone

During the COVID-19 pandemic, the success of major non-pharmaceutical interventions, such as quarantine orders, has depended upon robust rates of citizens' adherence to protocols. Thus, it is critical to public health for research to illuminate factors that affect compliance with contagion-mitigating practices. Previous research has examined sociodemographic factors and aspects of psychological distress as correlates of adherence to public health guidelines. The current study expanded this research to investigate the psychosocial process of co-rumination, which has been identified in previous research as a maladaptive type of social interaction that is associated with elevated levels of anxiety and depression. Data were collected from 932 Italian adults during the initial stages of the highly stressful COVID-19 pandemic and lockdown. A path model was tested to examine multivariate relationships among sociodemographic characteristics, symptoms of psychological distress (i.e., depression and anxiety), co-rumination via cellphone, and self-reported adherence to COVID-19-related public health restrictions. Results revealed that higher rates of co-rumination via cellphone were associated with lower levels of adherence to public health restrictions. Symptoms of depression and anxiety were differentially related to co-rumination processes and adherence to public health restrictions. Higher levels of depression symptoms were directly associated with poorer adherence to public health restrictions, and this path was mediated through higher levels of co-rumination via cellphone. On the contrary, higher levels of state anxiety were directly associated with greater adherence to public health guidelines. This path was also mediated through co-rumination via cellphone. Higher levels of anxiety were correlated with lower levels of co-rumination, which in turn were correlated with lower levels of adherence. These results suggest fruitful directions for future research examining co-rumination as a maladaptive coping behavior that may be addressed within public health interventions.

Coping and post-traumatic stress disorder symptoms among Chinese youth in the peak and remission periods of COVID-19

The COVID-19 pandemic has exposed emergent vulnerability to adolescents' mental health. This longitudinal study investigated the association between coping at the peak of the COVID outbreak (T1) and Post-Traumatic Stress Disorder (PTSD) symptoms concurrently, and at the remission periods of COVID in China three months (T2) and six months (T3) later in a sample of 6th to 12th-grade students (N = 782). The results showed that forward-focus coping was negatively associated with PTSD symptoms across all three timepoints and predicted reduced risk for more PTSD symptoms at T2, and trauma-focus coping was positively associated with PTSD symptoms across all three timepoints and predicted higher risk of PTSD symptoms both at T2 and T3. There was an interaction effect of trauma-focus coping and T1 symptoms on later symptoms (T3) - trauma-focus coping was more detrimental for those who had more initial symptoms. The results showed the beneficial effects of future-oriented coping and harmful effects of trauma-focus coping for Chinese youth during the epidemic. Clinical implications of the results were discussed.

Using patient-reported outcome measures to assess psychological well-being in a non-representative US general population during the COVID-19 pandemic

PURPOSE

The impact of the COVID-19 pandemic on psychological well-being will likely be long-lasting. Efforts directed towards monitoring the onset and progression of distress and mental health disorders are needed to identify and prioritize at-risk populations. This study assesses the psychological well-being of the United States (US) general population during the early phase of the COVID-19 COVID-19 pandemic using validated patient-reported outcome measures (PROMs).

METHODS

A cross-sectional study design was used. Adults (18 years or older) who could read and write in English were recruited through Prolific in May 2020. Participants completed a REDCap survey including demographic and health-related questions and three PROMs measuring global health (PROMIS-10 Global Health), anxiety [Generalized Anxiety Disorder Scale-7 (GAD-7)], and depression [Patient Health Questionnaire-9 (PHQ-9)]. A multivariable linear regression was used to identify key factors associated with worse psychological well-being.

RESULTS

Mean age of the 2023 participants was 31.92 ± 11.57 years (range, 18-82). Participants were mainly White (64.7%, n = 1309), female (52.2%, n = 1057), working full-time before the pandemic (43.5%, n = 879), and completed a college, trade, or university degree (40.7%, n = 823). Most participants reported mild to severe anxiety (57.3%, n = 1158) and depression (60%, n = 1276) on the GAD-7 and PHQ-9, respectively. Patient characteristics associated with worse psychological well-being included: age ≤ 39 years, non-White, female or gender diverse, BMI ≥ 30, uninsured, annual income ≤ $49,999 (USD), lower educational attainment, and belief that COVID-19 is deadlier than flu.

CONCLUSION

PROMs can be used to assess and monitor psychological well-being during the COVID-19 pandemic and to inform the planning and delivery of targeted public health interventions to support at-risk populations.

Coping methods and college adjustment in a sample of U.S. Undergraduate students during the COVID-19 pandemic

Objective: To examine the associations between coping methods and college adjustment among a sample of U.S. undergraduate students during the COVID-19 pandemic. Participants: We used a sample of 117 undergraduate students between the age of 18-25 years old. Approximately 76% of the sample identified as women and 58% identified as White. Methods: Participants completed online questionnaires that assessed the use of forward-focused coping, trauma-focused coping, and several domains of college adjustment (i.e., academic adjustment, social adjustment, personal-emotional adjustment, and attachment). We used multiple regression to identify the association between coping methods and college adjustment, using race and gender as control variables. Results: Forward-focused coping methods were significantly and positively related to academic adjustment, social adjustment, and attachment, while and trauma-focused coping methods were significantly and negatively related to personal-emotional adjustment. Conclusions: The use of forward-focused coping methods may be beneficial for undergraduate students during the COVID-19 pandemic.

Post-traumatic growth in people experiencing high post-traumatic stress during the COVID-19 pandemic: The protective role of psychological flexibility

The COVID-19 pandemic evokes high levels of post-traumatic stress (PTS) in some people as well as positive personal changes, a phenomenon known as post-traumatic growth (PTG). Experiencing an adverse event as traumatic is crucial for triggering PTG, therefore higher PTS is often associated with higher PTG. This longitudinal study examined the protective role of psychological flexibility in fostering PTG in a group of people reporting high PTS related to COVID-19 as compared to those with low PTS. We hypothesized that higher psychological flexibility will be associated with higher PTG in those with high PTS and that psychological flexibility would be unrelated to PTG in those with low PTS. Secondary data analysis was conducted on data from a larger project investigating the psychological impacts of COVID-19. Adult Italians (N = 382) completed online surveys at Time 1 (three months after the first national lockdown, July 2020) and Time 2 (three months later when the number of COVID-19 cases increased, October 2020). Based on the Impact of Event Scale–Revised cut-off score, two PTS groups were identified at Time 2: low PTS (below cut-off) and high PTS (above cut-off). As predicted, moderation analyses showed that after controlling for Time 1 PTS and PTG and confounding variables, Time 1 psychological flexibility was associated with higher Time 2 PTG in the high PTS group, whereas psychological flexibility was unrelated to PTG in the low PTS group. Four psychological flexibility sub-processes (present moment awareness, defusion, values, committed action) at Time 1 were related to higher Time 2 PTG in only the high PTS group. Findings advance understanding of the role of psychological flexibility in trauma reactions and pandemic mental health adjustment. Evidence-based approaches that target psychological flexibility, like Acceptance and Commitment Therapy, are likely to foster PTG and ultimately adjustment in people with high PTS during and after the pandemic.

Sub-groups (profiles) of individuals experiencing post-traumatic growth during the COVID-19 pandemic

Objective

Some people experience post-traumatic growth (PTG), entailing positive changes such as a greater appreciation of life following traumatic events. We examined PTG in the context of the negative consequences of the COVID-19 pandemic, notably working from home and social distancing. We aimed to assess whether distinct sub-groups (profiles) of individuals experiencing PTG could be identified by how they appraised and coped with the COVID-19 pandemic.

Method

For this cross-sectional study, we used convenience sampling. In total, 951 participants from the general population completed an online questionnaire with items focusing on primary and secondary appraisal, positive reappraisal, rumination, and coping flexibility. For the latent profile analysis, we selected a sample of 392 individuals who had experienced moderate degrees of pandemic-related PTG, reporting at least two of the 10 positive changes in the PTG Inventory-Short Form.

Results

We identified two distinct profiles among people experiencing PTG. The first was characterised by low levels of primary appraisal and stressfulness and higher levels of secondary appraisal (e.g., resilient group), increased coping flexibility and greater use of positive reappraisal. The second was characterised by higher levels of stressfulness and primary appraisal (e.g., stressed group) and greater use of rumination.

Conclusion

The two sub-groups evidently appraised and coped with the COVID-19 pandemic differently. Therefore, future research should account for these different profiles of people experiencing PTG.

The Impact of Working from Home on Mental Health: A Cross-Sectional Study of Canadian Worker's Mental Health during the Third Wave of the COVID-19 Pandemic

The COVID-19 pandemic has seen a considerable expansion in the way work settings are structured, with a continuum emerging between working fully in-person and from home. The pandemic has also exacerbated many risk factors for poor mental health in the workplace, especially in public-facing jobs. Therefore, we sought to test the potential relationship between work setting and self-rated mental health. To do so, we modeled the association of work setting (only working from home, only in-person, hybrid) on self-rated mental health (Excellent/Very Good/Good vs. Fair/Poor) in an online survey of Canadian workers during the third wave of COVID-19. The mediating effects of vaccination, masking, and distancing were explored due to the potential effect of COVID-19-related stress on mental health among those working in-person. Among 1576 workers, most reported hybrid work (77.2%). Most also reported good self-rated mental health (80.7%). Exclusive work from home (aOR: 2.79, 95%CI: 1.90, 4.07) and exclusive in-person work (aOR: 2.79, 95%CI: 1.83, 4.26) were associated with poorer self-rated mental health than hybrid work. Vaccine status mediated only a small proportion of this relationship (7%), while masking and physical distancing were not mediators. We conclude that hybrid work arrangements were associated with positive self-rated mental health. Compliance with vaccination, masking, and distancing recommendations did not meaningfully mediate this relationship.

Prediction of post-traumatic growth in the face of the COVID-19 crisis based on resilience, post-traumatic stress and social participation: A longitudinal study

The COVID-19 crisis has generated a severe and negative psychological impact worldwide. Despite this, it is also possible to experience post-traumatic growth (PTG). This study aimed to longitudinally explore the prevalence of PTG in the Spanish population and test a predictive model for PTG from resilience, post-traumatic stress symptoms (PTSS), and participation in social activities. Data were collected longitudinally in March, July, and November 2020 via an online survey. About 20% of the sample showed moderate-high levels of PTG, with no significant differences over time. The predictive model explained 19% of the variance in PTG, showing that the inverse relation between resilience and PTG was mediated by PTSS. Additionally, participation in social activities acted as a predictor of PTG. Women, young people, those who had lost their job and people who had experienced COVID-19 symptoms or the loss of a loved one presented higher PTG. Thus, people have experienced positive changes (PTG), but these did not protect them from adverse symptomatology (PTSS).

Associations between early-life stress exposure and internalizing symptomatology during the COVID-19 pandemic: Assessing the role of neurobehavioral mediators

Background

The ongoing COVID-19 pandemic is a major stressor that has been associated with increased risk for psychiatric illness in the general population. Recent work has highlighted that experiences of early-life stress (ELS) may impact individuals' psychological functioning and vulnerability for developing internalizing psychopathology in response to pandemic-related stress. However, little is known about the neurobehavioral factors that may mediate the association between ELS exposure and COVID-related internalizing symptomatology. The current study sought to examine the mediating roles of pre-pandemic resting-state frontoamygdala connectivity and concurrent emotion regulation (ER) in the association between ELS and pandemic-related internalizing symptomatology.

Methods

Retrospective life-stress histories, concurrent self-reported ER strategies (i.e., reappraisal and suppression), concurrent self-reported internalizing symptomatology (i.e., depression- and anxiety-related symptomatology), and resting-state functional connectivity data from a sample of adults (N = 64, M age = 22.12, female = 68.75%) were utilized.

Results

There were no significant direct associations between ELS and COVID-related internalizing symptomatology. Neither frontoamygdala functional connectivity nor ER strategy use mediated an association between ELS and COVID-related internalizing symptomatology (ps > 0.05). Exploratory analyses identified a significant moderating effect of reappraisal use on the association between ELS and internalizing symptomatology (β = -0.818, p = 0.047), such that increased reappraisal use buffered the impact of ELS on psychopathology.

Conclusions

While frontoamygdala connectivity and ER do not appear to mediate the association between ELS and COVID-related internalizing symptomatology, our findings suggest that the use of reappraisal may buffer against the effect of ELS on mental health during the pandemic.

The 50th anniversary of May 4, 1970 is associated with elevations of distress but no increase in mental health symptoms

Anniversaries of traumatic events are associated with increased symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety, especially in individuals with prior mental health symptoms. However, research has largely focussed on 1-year anniversaries, and it is unclear whether symptom exacerbation persists for more distal, or milestone, anniversaries. Symptoms typically decrease over time after traumatic events, but major anniversaries may be associated with increases in mental health symptoms. During and 3 months after the 50th anniversary of the political protest violence at Kent State University on May 4, 1970, 115 individuals completed measures of PTSD, depression, anxiety, and anniversary-related stress. Participants reported greater stress (t(97) = 4.04 p ≤ .001) during the 50th anniversary compared to 3 months later, but there were no differences in total PTSD (t(114) = .65, p = .52) or depression/anxiety symptoms (all p's > .05). Even in higher-risk individuals (those who previously received mental health services), symptoms did not differ during versus after the anniversary. In general, long-term anniversaries may contribute to transient increases in distress but do not induce major changes in mental health symptoms.

Changes in Internalizing Symptoms and Anxiety Sensitivity Among College Students During the COVID-19 Pandemic

The early months of the COVID-19 pandemic saw significant increases in symptoms of anxiety and depression, particularly among college students. However, research has not examined how internalizing symptoms in this population have changed as the pandemic has continued into its second year. Further, there has yet to be an examination of potential changes in transdiagnostic vulnerability factors. Therefore, the purpose of the current repeated cross-sectional study was to examine differences by term in undergraduates’ symptoms of depression, anxiety, worry, social anxiety, and anxiety sensitivity in the Spring 2020 (n = 251), Fall 2020 (n = 427), and Spring 2021 (n = 256) semesters. Results indicated that there were significant increases in depression, anxiety, worry, and anxiety sensitivity from Spring 2020 to Fall 2020 that were maintained through the Spring 2021 semester, and levels of social anxiety were significantly higher in Spring 2021 compared to Spring 2020. These findings suggest that the mental health impacts of the COVID-19 pandemic on college students have continued beyond the initial months, and colleges and universities will need to develop comprehensive plans to adequately address college students’ mental health needs.

The consequences of a year of the COVID-19 pandemic for the mental health of young adult twins in England and Wales

BACKGROUND

The COVID-19 pandemic has affected all our lives, not only through the infection itself but also through the measures taken to control the spread of the virus (e.g. lockdown).

AIMS

Here, we investigated how the COVID-19 pandemic and unprecedented lockdown affected the mental health of young adults in England and Wales.

METHOD

We compared the mental health symptoms of up to 4773 twins in their mid-20s in 2018 prior to the COVID-19 pandemic (T1) and during four-wave longitudinal data collection during the pandemic in April, July and October 2020, and in March 2021 (T2-T5) using phenotypic and genetic longitudinal designs.

RESULTS

The average changes in mental health were small to medium and mainly occurred from T1 to T2 (average Cohen d = 0.14). Despite the expectation of catastrophic effects of the pandemic on mental health, we did not observe trends in worsening mental health during the pandemic (T3-T5). Young people with pre-existing mental health problems were disproportionately affected at the beginning of the pandemic, but their increased problems largely subsided as the pandemic persisted. Twin analyses indicated that the aetiology of individual differences in mental health symptoms did not change during the lockdown (average heritability 33%); the average genetic correlation between T1 and T2-T5 was 0.95, indicating that genetic effects before the pandemic were substantially correlated with genetic effects up to a year later.

CONCLUSIONS

We conclude that on average the mental health of young adults in England and Wales has been remarkably resilient to the effects of the pandemic and associated lockdown.

Stress-related psychopathology during the COVID-19 pandemic

The COVID-19 pandemic has introduced widespread societal changes that have required ongoing adaptation. Unsurprisingly, stress-related psychopathology has increased during the pandemic, in both children and adults. We review these patterns through the lens of several leading conceptual models of the link between stress and psychopathology. Some of these models focus on characteristics of environmental stressors-including cumulative risk, specific stressor types, and stress sensitization approaches. Understanding the specific aspects of environmental stressors that are most likely to lead to psychopathology can shed light on who may be in most need of clinical intervention. Other models center on factors that can buffer against the onset of psychopathology following stress and the mechanisms through which stressors contribute to emergent psychopathology. These models highlight specific psychosocial processes that may be most usefully targeted by interventions to reduce stress-related psychopathology. We review evidence for each of these stress models in the context of other widescale community-level disruptions, like natural disasters and terrorist attacks, alongside emerging evidence for these stress pathways from the COVID-19 pandemic. We discuss clinical implications for developing interventions to reduce stress-related psychopathology during the pandemic, with a focus on brief, digital interventions that may be more accessible than traditional clinical services.

Exploring posttraumatic growth after the COVID-19 pandemic

Although it is undeniable that the COVID-19 pandemic presented new threats and traumas for human beings, posttraumatic growth that took place after the struggle with this highly challenging crisis cannot be ignored. Therefore, based on the posttraumatic growth theory, the present research focuses on aspects of tourists' positive changes after the COVID-19 outbreak. A total of 1165 potential tourists from 197 cities in 31 provinces of China were analyzed using symmetrical and asymmetrical approaches. The results of the partial least squares test revealed the net effects of social support, psychological distress, and infection risk perception on the three dimensions of tourists' posttraumatic growth, namely, travel risk aversion, social identity, and altruistic behavior. Fuzzy-set qualitative comparative analysis provided causal recipes for realizing posttraumatic growth, and necessary condition analysis supplemented the necessary antecedents. The implications of the findings and the paths for future research are also presented.

Exploring posttraumatic growth after the COVID-19 pandemic

Although it is undeniable that the COVID-19 pandemic presented new threats and traumas for human beings, posttraumatic growth that took place after the struggle with this highly challenging crisis cannot be ignored. Therefore, based on the posttraumatic growth theory, the present research focuses on aspects of tourists' positive changes after the COVID-19 outbreak. A total of 1165 potential tourists from 197 cities in 31 provinces of China were analyzed using symmetrical and asymmetrical approaches. The results of the partial least squares test revealed the net effects of social support, psychological distress, and infection risk perception on the three dimensions of tourists' posttraumatic growth, namely, travel risk aversion, social identity, and altruistic behavior. Fuzzy-set qualitative comparative analysis provided causal recipes for realizing posttraumatic growth, and necessary condition analysis supplemented the necessary antecedents. The implications of the findings and the paths for future research are also presented.

Age differences in mental health from May through August 2020 among U.S. adults: trajectories and the role of pandemic, lifestyle, and social factors

Objectives: Using nationally representative data among U.S. adults, we assess age differences in changes in mental health both from 2018 to May 2020 and during the pandemic. We also examine factors explaining age differences in mental health.Methods: We analyzed 2018 General Social Survey data (N = 2,348; age 18-89) and three waves of COVID Response Tracking Study data (N = 2,279; age 20-94) spanning May-August 2020. Outcomes included happiness, loneliness, stress, positive affect, and negative affect.Results: U.S. adults reported greater loneliness and less happiness in May 2020 versus 2018. Only loneliness and negative affect changed significantly from May to August 2020, showing declines. Mental health trajectories did not differ significantly by age. Overall, older adults reported lower loneliness, stress, and negative affect than younger adults during 2020. Older age was associated with two factors linked with better mental health: less likelihood of COVID-19 exposure and greater satisfaction with social activities and relationships. However, none of the factors examined herein explained age differences in mental health.Conclusion: Although mental health trajectories during the pandemic were similar across ages, older adults tended to report better mental health than younger adults. Future research should identify factors that explain age differences in mental health that persisted into 2020.

Longitudinal links between behavioral activation coping strategies and depressive symptoms of U.S. adults living alone during the COVID-19 pandemic

The COVID-19 pandemic and related physical distancing measures have posed a significant threat to the mental health of adults, particularly those living alone. Accordingly, the World Health Organization implemented the #HealthyAtHome program, encouraging people to keep in regular contact with loved ones, stay physically active, and keep a regular routine. The current study aims to examine a micro-longitudinal link between behavioral activation coping strategies (exercise, meditation, relaxation, and social connection) and depressive symptoms among adults who lived alone during the COVID-19 pandemic. We used 21 biweekly waves of longitudinal data from the Understanding America Study (UAS) collected between April 2020 and February 2021 (N = 1,280). The multilevel models with correlated random effects were estimated to examine lagged effects of coping strategies (t-1) on depressive symptoms (t). The results showed that exercise was predictive of lower depressive symptoms even after controlling for time-invariant and time-varying covariates. The results showed that modifiable lifestyle factors, such as taking time to exercise, may be beneficial for the mental health of Americans living in single-person households.

Lockdown strictness and mental health effects among older populations in Europe

This paper investigates whether lockdown policies aggravated mental health problems of older populations (50 and over) in Europe during the first COVID-19 wave. Using data from the Survey of Health, Ageing and Retirement in Europe (SHARE COVID-19 questionnaire) and from the Oxford COVID-19 Government Response Tracker for 17 countries, we estimate the causal effect of lockdown policies on mental health by combining cross-country variability in the strictness of the policies with cross-individual variability in face-to-face contacts prior to the pandemic. We find that lockdown policies worsened insomnia, anxiety, and depression by 5, 7.2 and 5.1 percentage points, respectively. This effect was stronger for women and those aged between 50 and 65. Interestingly, lockdown policies notably damaged the mental health of healthy populations. We close with a discussion of lockdown policies targeted at individuals above 65 and/or with pre-existing conditions.

Coping and Post-traumatic Growth Among COVID-19 Patients: A Qualitative Study

Pandemic diseases have caused dramatic changes in people's lives throughout history. Today, the COVID-19 virus spreads rapidly and affects human beings around the globe. This study aimed to discover the coping strategies and post-traumatic growth (PTG) experiences of persons who were infected by the COVID-19 virus using the qualitative research method. The research involved 17 individuals, nine of whom were female. All had been diagnosed with COVID-19. Face-to-face and online interviews were conducted with participants. In the analysis of the data, the thematic analysis method was performed by developing themes and sub-themes. The created themes include coping strategies, existential growth, lessons learned from disease, new opportunities, and social growth. These themes indicated positive changes in the lives of persons who were infected by the COVID-19 virus after the COVID-19 disease. Findings and implications for the practice were discussed.

Cross-Cultural Adaptation and Psychometric Evaluation of the Perceived Ability to Cope With Trauma Scale in Portuguese Patients With Breast Cancer

Background

The impact of a cancer diagnosis may be traumatic, depending on the psychological resources used by patients. Appropriate coping strategies are related to better adaptation to the disease, with coping flexibility, corresponding to the ability to replace ineffective coping strategies, demonstrated to be highly related with self-efficacy to handle trauma. The Perceived Ability to Cope with Trauma (PACT) scale is a self-rated questionnaire that assesses the perceived ability to cope with potentially traumatic events, providing a measure of coping flexibility. The current study aimed at examining the psychometric properties of the PACT Scale in Portuguese patients with breast cancer.

Methods

The study included 172 patients recently diagnosed with early breast cancer. Participants completed a Portuguese version of the PACT scale, and instruments of self-efficacy for coping with cancer (Cancer Behavior Inventory-Brief Version—CBI-B), of quality of life (European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core-30—QLQ-C30), and of psychological distress (Hospital Anxiety and Depression Scale—HADS) that were used as convergent and divergent measures, thus assessing construct validity. A confirmatory factor analysis (CFA) was performed to test the factor structure of the Portuguese version of PACT scale and reliabilities were examined.

Results

Results from the CFA confirmed the two-factor structure, consistent with the original Forward and Trauma focus subscales. The two subscales demonstrated high internal consistencies. Convergent and divergent validities were confirmed: the PACT scale was related to high self-efficacy to cope with cancer (CBI-B), to high perceived quality of life (QLQ-C30), and to low psychological distress (HADS).

Discussion

Overall, the current results support and replicate the psychometric properties of the PACT scale. The scale was found to be a valid and reliable self-reported measure to assess Portuguese breast cancer patients regarding beliefs about their capabilities in managing the potentially traumatic sequelae of cancer. The PACT is a simple and brief measure of coping flexibility to trauma, with potential relevance for application in clinical and research settings.

Mental Health, Burnout, and Resilience in Healthcare Professionals After the First Wave of COVID-19 Pandemic in Spain: A Longitudinal Study

OBJECTIVE

This study aims to examine whether there are differences in symptoms of posttraumatic stress, depression, anxiety, levels of burnout and resilience in Spanish healthcare staff between the first wave of the COVID-19 pandemic and after it, depending on several demographic and work-related variables.

METHODS

A longitudinal study was conducted in April 2020 (T0), and July 2020 (T1). Symptoms of posttraumatic stress, depression, anxiety, burnout, levels of resilience, along with demographic and work-related variables in 443 workers were assessed.

RESULTS

Symptoms and burnout were more pronounced at T0, whereas the levels of resilience were higher at T1. Being women, being young, holding a lower-level job, less years of experience, lower educational level, and/or working rotating shifts are associated with having more posttraumatic stress symptoms and burnout.

CONCLUSION

These variables would be considered in similar situations.

Slovak Adaptation of the Coronavirus Anxiety Scale

This study examined the psychometric properties of the Slovak version of the Coronavirus Anxiety Scale (CAS-SK) in a sample of adult Slovaks (N = 743). The data were collected online during the second wave of the COVID-19 pandemic in Slovakia. Along with the Coronavirus Anxiety Scale, the Perceived Stress Scale, and the Well-Being Index were administered to the respondents. The results of the Confirmatory Factor Analysis show a stable uni-dimensional structure of the CAS-SK, good reliability, and adequate convergent validity. The Item Response Theory findings suggest that all items have good discrimination parameters, all thresholds increased monotonically across the rating scale, and that the CAS-SK is more informative in individuals with a high level of coronavirus anxiety. These results suggest that the CAS-SK is a valid and reliable tool for measuring coronavirus anxiety.

Stop talking about it already! Co-ruminating and social media focused on COVID-19 was associated with heightened state anxiety, depressive symptoms, and perceived changes in health anxiety during Spring 2020

BACKGROUND

Social distancing presents a significant obstacle for relationships and threatens mental health. Identifying maladaptive, voluntary coping strategies may inform how to maintain interpersonal relationships and mental health during quarantine. Co-ruminating with peers on negative events, moods and fears has adjustment trade-offs of increasing depression and anxiety risk while also enhancing friendship quality. Similarly, social media use is associated with social benefits and risk to mental health. We extend prior research by examining whether co-ruminating on COVID-19, social media use, and social media use focused on COVID-19 during social isolation was associated with heightened depression and anxiety symptoms but also lower loneliness and higher social support during initial lockdown measures in the USA.

METHODS

Adults were recruited through social media (n = 345) to complete self-report surveys on co-rumination, social media use, social distancing, social support from March-May 2020. During this cross-sectional assessment, in addition to completing surveys on current depressive symptoms and state and health anxiety, participants also provided retrospective report of their perceived health anxiety levels six months prior.

RESULTS

Co-ruminating on COVID-19 with peers and greater time on social media focused on COVID-19 predicted perceived increases in health anxiety and were also associated with higher depressive symptoms and state anxiety, even after controlling for significant demographic predictors. Further, in the context of social distancing, both interaction strategies failed to confer social benefits.

CONCLUSIONS

Results have direct implications for maintaining psychosocial health during social distancing restrictions. Adults may modify how they engage with peers by limiting COVID-19 content on social media and COVID-19 discussion.

Perceived coping mitigates anxiety symptoms in the context of COVID-19 stress in an urban university student sample

Perceived coping and its two subprocesses, trauma-focused coping (finding meaning in the details and memory of a potential trauma or stressor) and forward-focused coping (focusing on planning for the future) have been shown to be important in the context of potentially traumatic events. The COVID-19 pandemic and its associated stressors have negatively impacted population mental health, and preliminary investigations have demonstrated the importance of perceived abilities to cope during the pandemic. The current study sought to examine the potentially moderating role of each subprocess on the relationship between stress and anxiety symptoms in a low-income student sample during COVID-19 (N = 2364). We computed two hierarchical multiple linear regressions to assess for significant interactions between stress and perceived coping subprocess scores on anxiety outcomes. Our results demonstrated that both trauma-focused coping and forward-focused coping served as effect modifiers in the relationship between COVID-19related stress and anxiety. Such findings highlight the importance of interventions that incorporate both forms of coping for low-income students during a chronic stressor.