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Boehme BAE, Kinsman L, Taylor S, Asmundson GJG. Is there evidence for factorial invariance of the COVID Stress Scales? an analysis of North American and cross-cultural populations. Front Psychiatry 2024; 15:1381124. [PMID: 38596633 PMCID: PMC11002227 DOI: 10.3389/fpsyt.2024.1381124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Accepted: 03/13/2024] [Indexed: 04/11/2024] Open
Abstract
The COVID-19 pandemic impacted the mental health of more citizens globally than any previous modern viral outbreak. In response to the psychological challenges associated with COVID-19, the COVID Stress Scales (CSS) were developed to assess the presence and severity of COVID-related distress. The initial North American validation study of the CSS identified that the scale comprised five factors: danger and contamination fears, fear of socioeconomic consequences, xenophobia, checking and reassurance seeking, and traumatic stress symptoms. The CSS have since been validated across a multitude of international populations. However, findings support a five- and six-factor model. Methodological issues make interpreting most studies supporting a five-factor model challenging. The purpose of this study was to re-evaluate the factor structure of the CSS using data from North American samples, to assess for potential factorial invariance, and compare these results to cross-cultural findings. Multiple confirmatory factor analyses (mCFA) were conducted across 28 different groups (e.g., age, ethnicity/race, sex) from two large independent North American samples from 2020 (n = 6827) and 2021 (n = 5787), assessing the fit indices of the five-, six-, and alternative-factor model of the CSS. The current results provide evidence for factorial invariance of the six-factor model of the CSS across different North American demographics and highlight potential challenges in interpreting the results of studies that have supported a five-factor model of the CSS.
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Affiliation(s)
- Blake A. E. Boehme
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Laura Kinsman
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Steven Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Gordon J. G. Asmundson
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
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Rief W, Asmundson GJG, Bryant RA, Clark DM, Ehlers A, Holmes EA, McNally RJ, Neufeld CB, Wilhelm S, Jaroszewski AC, Berg M, Haberkamp A, Hofmann SG. The future of psychological treatments: The Marburg Declaration. Clin Psychol Rev 2024; 110:102417. [PMID: 38688158 DOI: 10.1016/j.cpr.2024.102417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/18/2024] [Accepted: 03/19/2024] [Indexed: 05/02/2024]
Abstract
Although psychological treatments are broadly recognized as evidence-based interventions for various mental disorders, challenges remain. For example, a substantial proportion of patients receiving such treatments do not fully recover, and many obstacles hinder the dissemination, implementation, and training of psychological treatments. These problems require those in our field to rethink some of our basic models of mental disorders and their treatments, and question how research and practice in clinical psychology should progress. To answer these questions, a group of experts of clinical psychology convened at a Think-Tank in Marburg, Germany, in August 2022 to review the evidence and analyze barriers for current and future developments. After this event, an overview of the current state-of-the-art was drafted and suggestions for improvements and specific recommendations for research and practice were integrated. Recommendations arising from our meeting cover further improving psychological interventions through translational approaches, improving clinical research methodology, bridging the gap between more nomothetic (group-oriented) studies and idiographic (person-centered) decisions, using network approaches in addition to selecting single mechanisms to embrace the complexity of clinical reality, making use of scalable digital options for assessments and interventions, improving the training and education of future psychotherapists, and accepting the societal responsibilities that clinical psychology has in improving national and global health care. The objective of the Marburg Declaration is to stimulate a significant change regarding our understanding of mental disorders and their treatments, with the aim to trigger a new era of evidence-based psychological interventions.
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Affiliation(s)
- Winfried Rief
- Philipps-University of Marburg, Department of Psychology, Clinical Psychology and Psychotherapy Group, Marburg, Germany.
| | | | - Richard A Bryant
- University of New South Wales, School of Psychology, Sydney, New South Wales, Australia
| | - David M Clark
- University of Oxford, Department of Experimental Psychology, Oxford, UK
| | - Anke Ehlers
- University of Oxford, Department of Experimental Psychology, Oxford, UK
| | - Emily A Holmes
- Uppsala University, Department of Women's and Children's Health, Uppsala, Sweden; Karolinska Institutet, Department of Clinical Neuroscience, Solna, Sweden
| | | | - Carmem B Neufeld
- University of São Paulo, Department of Psychology, Ribeirão Preto, SP, Brazil
| | - Sabine Wilhelm
- Massachusetts General Hospital and Harvard School of Medicine, Boston, USA
| | - Adam C Jaroszewski
- Massachusetts General Hospital and Harvard School of Medicine, Boston, USA
| | - Max Berg
- Philipps-University of Marburg, Department of Psychology, Clinical Psychology and Psychotherapy Group, Marburg, Germany
| | - Anke Haberkamp
- Philipps-University of Marburg, Department of Psychology, Clinical Psychology and Psychotherapy Group, Marburg, Germany
| | - Stefan G Hofmann
- Philipps-University of Marburg, Department of Psychology, Translational Clinical Psychology Group, Marburg, Germany
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Boehme BAE, Shields RE, Carleton RN, Asmundson GJG. Factor structure and factorial invariance of the PTSD checklist for DSM-5 in public safety personnel: Results from a large and diverse sample. Psychol Trauma 2023:2024-21356-001. [PMID: 37917448 DOI: 10.1037/tra0001601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Public safety personnel (PSP; e.g., correctional workers, firefighters, paramedics, and police officers) are frequently exposed to potentially psychologically traumatic events (PPTEs) and report posttraumatic stress disorder (PTSD) difficulties more frequently than the general population. The PTSD checklist for DSM-5 (PCL-5) is a commonly used measure to screen PSP for PTSD. A single previous study assessed PCL-5 factorial invariance among PSP but used a small homogenous sample. The current study evaluated factorial invariance with a large (n = 5,855) and diverse PSP sample. METHOD Multigroup confirmatory factor analyses (mCFAs; n = 98) were conducted using six competing factor models of the PCL-5 across seven PSP sectors, five age groups, and two gender groups. RESULTS The seven-factor hybrid model of PTSD (i.e., reexperiencing, avoidance, negative alterations in cognitions and mood, hyperarousal, intrusion, emotional numbing, dysphoria, dysphoric arousal, anxious arousal, anhedonia, negative affect) produced consistently superior fit across all sectors assessed and produced marginally better absolute values than the six-factor anhedonia model, supporting PCL-5 factorial invariance among PSP. CONCLUSIONS The current study is the first to use a large and diverse PSP sample to assess PCL-5 factorial invariance. The results support the PCL-5 as invariant across PSP sectors, age groups, and men and women. Consistent with other studies, the seven-factor hybrid model of PTSD produced the best fit, followed closely by the six-factor anhedonia model. Future research could use structured clinical interviews to further investigate the factorial structure and invariance of PTSD symptoms among PSPs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Blake A E Boehme
- Department of Psychology, Anxiety and Illness Behaviours Laboratory, University of Regina
| | - Robyn E Shields
- Department of Psychology, Anxiety and Illness Behaviours Laboratory, University of Regina
| | - R Nicholas Carleton
- Department of Psychology, Anxiety and Illness Behaviours Laboratory, University of Regina
| | - Gordon J G Asmundson
- Department of Psychology, Anxiety and Illness Behaviours Laboratory, University of Regina
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Abdollahi A, Gardanova ZR, Ramaiah P, Zainal AG, Abdelbasset WK, Asmundson GJG, Chupradit S, Sultonov SK, Pashanova OV, Iswanto AH. Moderating Role of Self-Compassion in the Relationships Between the Three Forms of Perfectionism with Anger, Aggression, and Hostility. Psychol Rep 2023; 126:2383-2402. [PMID: 35410529 DOI: 10.1177/00332941221087911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The prevalence of aggression in adolescents is on the rise, and it could be a serious public health concern. Studies have found positive relationships between perfectionism with anger, aggression, and hostility. However, the moderating role of self-compassion in the links between perfectionism with anger, aggression, and hostility has not been studied. To better understand the relationships between the three forms of perfectionism with anger, aggression, and hostility, this study aimed to explore the moderating role of self-compassion. Participants were 380 undergraduates selected using a multi-stage cluster sampling technique from three universities in Iran. Participants completed the Self-Compassion Scale, the Multidimensional Perfectionism Scale, and the Aggression Questionnaire Scale. The results from structural equation modelling analysis showed that other-oriented perfectionism and socially prescribed perfectionism positively predicted anger, aggression, and hostility. The results showed that self-oriented perfectionism significantly and positively predicted anger and hostility; but there were no observed statistically significant relationships of self-oriented perfectionism with verbal aggression and physical aggression. The findings showed that self-compassion played a moderating role in the relationships between other-oriented perfectionism and socially prescribed perfectionism with anger, aggression, and hostility; however, it did not play a moderating effect on self-oriented perfectionism with anger, aggression, and hostility. The findings provide a deeper understanding of the moderating role of self-compassion in the links between other-oriented perfectionism and socially prescribed perfectionism with anger, aggression, and hostility among undergraduates. The findings of this study could be applicable for psychologists and counselors who deal with aggressive behavior, anger, and hostility in undergraduate students to assess the three forms of perfectionism and self-compassion.
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Affiliation(s)
- Abbas Abdollahi
- Department of Counseling, Faculty of Education and Psychology, Alzahra University, Iran
| | - Zhanna R Gardanova
- Department of Psychotherapy, Pirogov Russian National Research Medical University, Russia
| | | | | | - Walid Kamal Abdelbasset
- Department of Health and Rehabilitation Sciences, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, Saudi Arabia
| | | | - Supat Chupradit
- Department of Occupational Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Thailand
| | - Shokhrukh Kh Sultonov
- Department of Therapeutic Disciplines No. 3, Tashkent State Dental Institute, Uzbekistan
| | - Olga V Pashanova
- Department of Organization and Economics of Pharmacy, I. M. Sechenov First Moscow State Medical University (Sechenov University), Russia
| | - A Heri Iswanto
- Public Health Department, Faculty of Health Science, University of Pembangunan Nasional Veteran Jakarta, Indonesia
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Teckchandani TA, Neary JP, Andrews KL, Maguire KQ, Jamshidi L, Nisbet J, Shields RE, Afifi TO, Sauer-Zavala S, Lix LM, Krakauer RL, Asmundson GJG, Krätzig GP, Carleton RN. Cardioautonomic lability assessed by heart rate variability changes in Royal Canadian Mounted Police cadets during the cadet training program. Front Psychol 2023; 14:1144783. [PMID: 37829079 PMCID: PMC10565660 DOI: 10.3389/fpsyg.2023.1144783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 09/14/2023] [Indexed: 10/14/2023] Open
Abstract
Objective The current study examined variations in cardioautonomic lability during the Royal Canadian Mounted Police (RCMP) Cadet Training Program (CTP) between cadets starting their training who did or did not screen positive for one or more mental health disorders (i.e., posttraumatic stress disorder [PTSD], major depressive disorder [MDD], social anxiety disorder [SAD], generalized anxiety disorder [GAD], panic disorder [PD], alcohol use disorder [AUD]). Methods Electrocardiogram (ECG) signals integrated into Hexoskin garments were used to record ECG and heart rate Over the 26-week CTP. There were 31 heart rate variability (HRV) parameters calculated using Kubios Premium HRV analysis software. Mann-Whitney U-tests were used to perform groupwise comparisons of participant raw values and HRV during the CTP. Results A total of 157 cadets (79% male) were screened for any mental disorder using self-report surveys and then grouped by positive and negative screening. Analyses indicated a statistically significant (p < 0.05) decrease in low frequency (LF): High Frequency (HF) variability during CTP, but only for cadets who endorsed clinically significant anxiety symptoms on the GAD-7 at the start of their training. There were no other statistically significant groupwise differences. Conclusion The results indicate the participants have excellent cardiac health overall and suggest potentially important differences between groups, such that cadets who endorsed clinically significant anxiety symptoms on the GAD-7 showed less variability in the LF:HF ratio over the course of the CTP. The relatively lower variability suggests decreased parasympathetic tone in those without clinically significant anxiety symptoms. The results also have important implications for future investigations of cardioautonomic dysfunction and chronic hypothalamic pituitary adrenal (HPA) axis deviations in policing populations with anxiety disorders; specifically, cardioautonomic inflexibility related to cardiovascular morbidity and mortality. In any case, the current results provide an important baseline for future cardiac research with cadets and serving officers.
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Affiliation(s)
- Taylor A. Teckchandani
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
| | - J. Patrick Neary
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, SK, Canada
| | - Katie L. Andrews
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
| | - Kirby Q. Maguire
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
| | - Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
| | - Robyn E. Shields
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Tracie O. Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Lisa M. Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Rachel L. Krakauer
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Gordon J. G. Asmundson
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | | | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
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Del Casale A, Modesti MN, Lai C, Carola V, Mimun S, Bruzzese A, Speranza AM, Drakes DH, Asmundson GJG, Nicolais G. Anxiety Symptoms, COVID-19-Related Stress Reactions in the Italian General Population, and Validation of the Italian COVID Stress Scales (CSS-I). J Clin Med 2023; 12:5680. [PMID: 37685747 PMCID: PMC10488780 DOI: 10.3390/jcm12175680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/22/2023] [Accepted: 08/28/2023] [Indexed: 09/10/2023] Open
Abstract
Background. The COVID Stress Scales (CSS) assess COVID-related stress experienced in the past week related to danger and contamination fears, socioeconomic consequences, xenophobia, compulsive checking, and reassurance seeking, and traumatic stress symptoms. Our objective was to provide a translation into Italian, replication, and psychometric validation of the CSS in the general population. Moreover, we aimed to test the convergent and discriminant validity of the Italian CSS (CSS-I) with respect to anxiety, stress, and depressive symptoms in the general Italian population. Method. Adult participants (n = 935) over the age of 18 years were recruited from the general population in Italy. Psychological status was assessed using multiple validated measures, including the CSS, Depression, Anxiety and Stress Scales-21 (DASS-21), and the Prejudice Against Immigrants Scale (PAIS). Results. Our confirmatory factor analysis supported a 6-factor model, including danger fears (DAN), socioeconomic consequences (SEC), xenophobia (XEN), compulsive checking and reassurance seeking (CHE), contamination fears (CON), and traumatic stress symptoms (TSS). Strong reliability of the CSS-I (Cronbach's α = 0.863-0.936) and convergent validity with the DASS-21 and PAI were established with positive correlations between total and scale scores across measures. Conclusions. The CSS-I is a valid and reliable instrument to measure COVID-19-related distress in the Italian population.
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Affiliation(s)
- Antonio Del Casale
- Department of Dynamic and Clinical Psychology and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy (V.C.)
| | - Martina Nicole Modesti
- Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Carlo Lai
- Department of Dynamic and Clinical Psychology and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy (V.C.)
| | - Valeria Carola
- Department of Dynamic and Clinical Psychology and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy (V.C.)
| | - Simone Mimun
- Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Alba Bruzzese
- Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy
| | - Anna Maria Speranza
- Department of Dynamic and Clinical Psychology and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy (V.C.)
| | - Dalainey H. Drakes
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON K1N 6N5, Canada
| | - Gordon J. G. Asmundson
- Department of Psychology, Faculty of Arts, University of Regina, Regina, SK S4S 0A2, Canada
| | - Giampaolo Nicolais
- Department of Dynamic and Clinical Psychology and Health Studies, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy (V.C.)
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Shields RE, Teckchandani TA, Asmundson GJG, Nisbet J, Krakauer RL, Andrews KL, Maguire KQ, Jamshidi L, Afifi TO, Lix LM, Brunet A, Sauer-Zavala S, Krätzig GP, Neary JP, Sareen J, Carleton RN. Daily survey participation and positive changes in mental health symptom scores among Royal Canadian Mounted Police Cadets. Front Psychol 2023; 14:1145194. [PMID: 37599763 PMCID: PMC10437217 DOI: 10.3389/fpsyg.2023.1145194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 02/24/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Royal Canadian Mounted Police (RCMP) officers self-report high levels of mental health disorder symptoms, such as alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder. Participation in regular mental health monitoring has been associated with improved mental health disorder symptom reporting and may provide an accessible tool to support RCMP mental health. The current study assessed relationships between self-reported mental health disorder symptoms and the completion of daily surveys (i.e., daily mental health disorder symptom monitoring) by RCMP cadets during the Cadet Training Program (CTP). Methods Participants were RCMP cadets (n = 394; 76.1% men) in the Standard Training Program who completed the 26-week CTP and daily self-monitoring surveys, as well as full mental health assessments at pre-training (i.e., starting the CTP) and pre-deployment (i.e., ~2 weeks prior to deployment to the field). Symptoms of alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder were assessed. Changes in mental health disorder symptom reporting from pre-training to pre-deployment were calculated. Spearman's rank correlations were estimated for number of daily surveys completed and change in mental health disorder symptom scores between pre-training and pre-deployment. Results There were statistically significant inverse relationships between number of daily surveys completed and number of mental health disorder symptoms reported; specifically, cadets who completed more daily surveys during CTP reported fewer symptoms of alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder. Conclusion An inverse correlation between number of daily surveys completed and mental health disorder symptom scores indicated that participation in daily mental health monitoring was associated with improvements in self-reported mental health disorder symptoms between pre-training and pre-deployment. Regular self-monitoring of mental health disorder symptoms may help to mitigate mental health challenges among RCMP cadets and officers.
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Affiliation(s)
- Robyn E. Shields
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Taylor A. Teckchandani
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Gordon J. G. Asmundson
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Rachel L. Krakauer
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Katie L. Andrews
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Kirby Q. Maguire
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Tracie O. Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa M. Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alain Brunet
- McGill’s Psychiatry Department and Douglas Institute Research Center, Montréal, QC, Canada
| | | | | | - J. Patrick Neary
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Jitender Sareen
- Department of Psychiatry, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
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8
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Olthuis JV, Kaltenbach E, Giberson E, Saryeddine T, Asmundson GJG, Carleton RN, Cramm H, Crombach A, Devlin J, Mack J, Lingley-Pottie P, Rao S, Sullivan M, Wozney L, McGrath PJ. Paraprofessional delivery of online narrative exposure therapy for firefighters. J Trauma Stress 2023; 36:772-784. [PMID: 37291963 DOI: 10.1002/jts.22941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/21/2023] [Accepted: 04/08/2023] [Indexed: 06/10/2023]
Abstract
Firefighters are at increased risk for developing posttraumatic stress disorder (PTSD) and face numerous barriers to accessing mental health care. Innovative ways to increase access to evidence-based interventions are needed. This study was a case series testing the acceptability, feasibility, and preliminary effectiveness of a paraprofessional-delivered, virtual narrative exposure therapy (eNET) intervention for PTSD. Participants were 21 firefighters who met the criteria for clinical or subclinical probable PTSD and completed 10-12 sessions of eNET via videoconference. Participants completed self-report measures pre- and postintervention and at 2- and 6-month follow-ups as well as a postintervention qualitative interview. Paired samples t tests evidenced statistically significant decreases in PTSD, anxiety, and depressive symptom severity and functional impairment from pre- to postintervention, ds = 1.08-1.33, and in PTSD and anxiety symptom severity and functional impairment from preintervention to 6-month follow-up, ds = 0.69-1.10. The average PTSD symptom severity score fell from above to below the clinical cutoff for probable PTSD at postintervention and follow-ups. Qualitative interviews indicated that paraprofessionals were considered central to participants' success and experience with the intervention. No adverse events or safety concerns were raised. This study is an important step in demonstrating that appropriately trained and supervised paraprofessionals can effectively deliver eNET to firefighters with PTSD.
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Affiliation(s)
- Janine V Olthuis
- Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | | | - Emma Giberson
- Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Tina Saryeddine
- Canadian Association of Fire Chiefs, Ottawa, Ontario, Canada
- Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | | | - R Nicholas Carleton
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Anselm Crombach
- Department of Psychology, Universität des Saarlandes, Saarbrücken, Germany
| | - Julie Devlin
- Conservation and Protection, Fisheries and Oceans Canada, Ottawa, Ontario, Canada
| | - Jeff Mack
- Fredericton Fire Department, Fredericton, New Brunswick, Canada
| | - Patricia Lingley-Pottie
- IWK Health Centre, Halifax, Nova Scotia, Canada
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sanjay Rao
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michael Sullivan
- Department of Psychology, McGill University, Montreal, Québec, Canada
| | - Lori Wozney
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Patrick J McGrath
- IWK Health Centre, Halifax, Nova Scotia, Canada
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
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9
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Teckchandani T, Krakauer RL, Andrews KL, Neary JP, Nisbet J, Shields RE, Maguire KQ, Jamshidi L, Afifi TO, Lix LM, Sauer-Zavala S, Asmundson GJG, Krätzig GP, Carleton RN. Prophylactic relationship between mental health disorder symptoms and physical activity of Royal Canadian Mounted Police Cadets during the cadet training program. Front Psychol 2023; 14:1145184. [PMID: 37260953 PMCID: PMC10229095 DOI: 10.3389/fpsyg.2023.1145184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/24/2023] [Indexed: 06/02/2023] Open
Abstract
Objective Royal Canadian Mounted Police report experiencing extremely frequent potentially psychologically traumatic events (PPTE). In a recent study, approximately half of participating RCMP screened positive for one or more mental disorders, which is approximately five times the diagnostic proportion for the general Canadian population. Increased reporting of mental health symptoms been linked to PPTE exposures. Programs promoting physical activity may be useful interventions to supplement or pair with mental health interventions, providing anxiolytic, antidepressant, and stress-buffering effects. The current study was designed to assess the relationship between physical activity behaviors and reported mental health disorder symptoms of cadets during the Royal Mounted Canadian Police (RCMP) Cadet Training Program (CTP). The current study also examined the relationship between exercise and mental health disorder symptoms of cadets during the CTP. Methods The study included data from 394 cadets (76.1% male). An analysis of variance (ANOVA) and a series of t-tests were used to assess several differences across sociodemographic groups. Bivariate Spearman's Rank correlations were performed between the average number of active calories burned per day, as recorded by Apple Watches, and changes in self-reported mental health disorder symptoms (i.e., Generalized Anxiety Disorder [GAD], Major Depressive Disorder [MDD], Posttraumatic Stress Disorder [PTSD], Social Anxiety Disorder [SAD]. Alcohol Use Disorders [AUD], Panic Disorder [PD]) from pre-training (starting the CTP) to pre-deployment (completing the CTP) 26 weeks later. Results There were statistically significant correlations between physical activity and self-reported mental health disorder symptom scores during CTP. Cadets who performed more physical activity from pre-training to pre-deployment had statistically significantly greater decreases in symptoms of GAD (ρ = -0.472, p < 0.001), MDD (ρ = -0.307, p < 0.001), PTSD (ρ = -0.343, p < 0.001), and AUD (ρ = -0.085, p < 0.05). There was no statistically significant relationship between physical activity and changes in PD symptoms (ρ = -0.037, p > 0.05). There were also no statistically significant relationships between pre-CTP mental health disorder symptom scores and the volume of physical activity performed during CTP. Conclusion There was evidence of a significant relationship between reductions in mental health disorder symptom scores and physical activity during the 26-week CTP. The results highlight the role that exercise can play as an important tool for reducing mental health disorder symptoms, considering there was no relationship between pre-CTP baseline mental health scores and physical activity performed during CTP. Further research is needed to understand differences in physical activity behaviours among cadets and serving RCMP.
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Affiliation(s)
- Taylor Teckchandani
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Rachel L. Krakauer
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Katie L. Andrews
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - J. Patrick Neary
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Robyn E. Shields
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Kirby Q. Maguire
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Tracie O. Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa M. Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Gordon J. G. Asmundson
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | | | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
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Forbes D, Adler AB, Pedlar D, Asmundson GJG. Problematic anger in military and veteran populations with and without PTSD: The elephant in the room. J Anxiety Disord 2023; 96:102716. [PMID: 37163842 DOI: 10.1016/j.janxdis.2023.102716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Affiliation(s)
- David Forbes
- Phoenix, Australia: Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Australia.
| | - Amy B Adler
- Walter Reed Army Institute of Research, Silver Spring, MD, USA
| | - David Pedlar
- Canadian Institute for Military and Veteran Health Research, Queen's University, Kingston, ON, Canada
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Khoury JMB, Jamshidi L, Shields RE, Nisbet J, Afifi TO, Fletcher AJ, Stewart SH, Asmundson GJG, Sauer-Zavala S, Krätzig GP, Carleton RN. Putative risk and resiliency factors among Royal Canadian Mounted Police cadets. Front Psychol 2023; 14:1048573. [PMID: 37008880 PMCID: PMC10053504 DOI: 10.3389/fpsyg.2023.1048573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/20/2023] [Indexed: 03/17/2023] Open
Abstract
ObjectiveMental health disorders are prevalent among active-duty Royal Canadian Mounted Police (RCMP) officers. The current study was designed to assess whether RCMP cadets commencing the Cadet Training Program are inherently at greater risk of developing mental health challenges by statistically comparing cadet putative risk and resiliency scores to scores from young adult populations. The study was also designed to assess for sociodemographic differences in putative risk and resiliency variables among RCMP cadets in order to facilitate future comparisons.MethodsCadets (n = 772; 72.2% men) completed self-report measures of several putative risk variables (i.e., anxiety sensitivity, fear of negative evaluation, pain anxiety, illness and injury sensitivity, intolerance of uncertainty, and state anger) and resiliency. Scores were statistically compared to samples from Canadian, American, Australian, and European young adult populations.ResultsCadets had statistically significantly lower scores on all putative risk variables and statistically significantly higher resiliency scores compared to the young adult populations. In the cadet sample, there were statistically significant differences in putative risk and resiliency variables across gender and sex.ConclusionCadets’ significantly lower scores on putative risk variables and higher scores on resiliency suggest that they may be psychologically strong; as such, it may be that the nature of police work, as opposed to inherent individual differences in risk and resiliency, accounts for active-duty RCMP officers’ comparatively higher prevalence of mental health disorders over time.Clinical Trial Registration: ClinicalTrials.gov, Identifier NCT05527509.
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Affiliation(s)
- Juliana M. B. Khoury
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Robyn E. Shields
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Tracie O. Afifi
- Department of Sociology and Social Studies, University of Regina, Regina, SK, Canada
| | - Amber J. Fletcher
- Mood, Anxiety, and Addiction Comorbidity (MAAC) Lab, Departments of Psychiatry and Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Sherry H. Stewart
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
| | | | - Shannon Sauer-Zavala
- Treatment Innovation for Psychological Services Research Program, Department of Psychology, University of Kentucky, Lexington, KY, United States
| | | | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- *Correspondence: R. Nicholas Carleton,
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Mason JE, Asmundson GJG. Cognitive behavioural techniques reduce exercise anxiety and improve adherence to a resistance training program for people with anxiety-related disorders: A randomized controlled trial. J Anxiety Disord 2023; 95:102693. [PMID: 36905851 DOI: 10.1016/j.janxdis.2023.102693] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 12/06/2022] [Accepted: 01/25/2023] [Indexed: 03/13/2023]
Abstract
Exercise is a cost-efficient alternative to other interventions for anxiety-related disorders (ARDs; e.g., psychotherapy, pharmaceutical) that is also associated with health benefits. Several exercise modalities, including resistance training (RT), have demonstrated efficacy at reducing symptoms of ARDs; however, there are challenges associated with effectively implementing such protocols, most notably, exercise avoidance or early discontinuation. Researchers have identified exercise anxiety as a contributor to exercise avoidance for people with ARDs. Exercise-based interventions for people with ARDs may need to include strategies for helping these individuals cope with exercise anxiety to facilitate long-term exercise engagement; however, research in this area is lacking. The primary purpose of this randomized controlled trial (RCT) was to examine the effects of combining cognitive behavioural techniques (CBT) with a RT program on changes in exercise anxiety, exercise frequency, disorder-specific anxiety symptoms, and physical activity for people with ARDs. A secondary purpose was to explore group differences in exercise motivation and exercise self-efficacy across time. A total of 59 physically inactive individuals with ARDs were randomized into either RT + CBT, RT, or waitlist (WL). Primary measures were assessed at baseline, weekly during the 4-week active phase, and at 1-week, 1-month, and 3-month follow-ups. Findings indicate both RT and RT + CBT can reduce exercise anxiety; however, the addition of CBT techniques may help facilitate improvements in exercise self-efficacy, reductions in disorder-specific anxiety, and increases in long-term exercise behaviour and vigorous physical activity. These techniques may be useful for researchers and clinicians alike in supporting individuals with ARDs interested in using exercise to cope with elevated anxiety.
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Affiliation(s)
- Julia E Mason
- Department of Psychology, University of Regina, Canada
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De Los Reyes A, Epkins CC, Asmundson GJG, Augenstein TM, Becker KD, Becker SP, Bonadio FT, Borelli JL, Boyd RC, Bradshaw CP, Burns GL, Casale G, Causadias JM, Cha CB, Chorpita BF, Cohen JR, Comer JS, Crowell SE, Dirks MA, Drabick DAG, DuPaul GJ, Ehrlich KB, Evans SC, Evans SW, Felton JW, Fite PJ, Gadow KD, Galán CA, Garbacz SA, Gaylord-Harden N, Humphreys KL, Gerber AH, Hogue A, Ivanova MY, Jarrett MA, Jensen-Doss A, Kang E, Kendall PC, Laird RD, Langberg JM, Langer DA, Lee SS, Lerner MD, Lippold MA, Luebbe AM, Makol BA, McLeod BD, McMahon RJ, Miller M, Ohannessian CM, Ollendick TH, Piña A, Prinstein MJ, Rabinowitz J, Reynolds EK, Salekin RT, Schleider JL, Scott JC, Tackett JL, Talbott E, Silverman WK, Spears AP, von der Embse N, Wakschlag LS, Wang M, Watts AL, Weisz JR, White BA, White SW, Youngstrom EA. Editorial Statement About JCCAP's 2023 Special Issue on Informant Discrepancies in Youth Mental Health Assessments: Observations, Guidelines, and Future Directions Grounded in 60 Years of Research. J Clin Child Adolesc Psychol 2023; 52:147-158. [PMID: 36652590 DOI: 10.1080/15374416.2022.2158842] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, University of Maryland
| | | | | | | | | | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, and Department of Pediatrics, University of Cincinnati
| | | | | | - Rhonda C Boyd
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia
| | | | | | - Gino Casale
- Institute for Educational Research, University of Wuppertal
| | | | - Christine B Cha
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | | | | | - Jonathan S Comer
- Center for Children and Families, Department of Psychology, Florida International University
| | | | | | | | | | | | | | | | | | - Paula J Fite
- Clinical Child Psychology Program, University of Kansas
| | | | | | | | | | | | | | | | | | | | | | - Erin Kang
- Department of Psychology, Montclair State University
| | | | - Robert D Laird
- Department of Human Development and Family Studies, University of Alabama
| | - Joshua M Langberg
- Graduate School of Applied and Professional Psychology, Rutgers University
| | | | - Steve S Lee
- Department of Psychology, University of California
| | | | | | | | | | - Bryce D McLeod
- Department of Psychology, Virginia Commonwealth University
| | - Robert J McMahon
- Department of Psychology, Simon Fraser University.,B.C. Children's Hospital
| | - Meghan Miller
- Department of Psychiatry and Behavioral Sciences and MIND Institute, University of California
| | | | - Thomas H Ollendick
- Department of Psychology, Virginia Polytechnic Institute and State University
| | - Armando Piña
- Department of Psychology, Arizona State University
| | | | | | | | | | | | - Judith C Scott
- Clinical Department, School of Social Work, Boston University
| | | | | | | | - Angela Page Spears
- Department of Counseling and Clinical Psychology, Teachers College, Columbia University
| | | | - Lauren S Wakschlag
- Department of Medical Social Sciences, Feinberg School of Medicine & Institute for Innovations in Developmental Sciences, Northwestern University
| | - Mo Wang
- Department of Management, University of Florida
| | - Ashley L Watts
- Department of Psychological Sciences, University of Missouri
| | | | | | | | - Eric A Youngstrom
- Department of Psychology and Neuroscience, University of North Carolina.,Helping Give Away Psychological Science
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14
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Nin VMEL, Willmund GD, Jungmann SM, Asmundson GJG, Piefke M. Mental health during the COVID-19 pandemic: Stress and strain profiles in the German population. Front Public Health 2023; 11:990407. [PMID: 37113182 PMCID: PMC10128881 DOI: 10.3389/fpubh.2023.990407] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 03/17/2023] [Indexed: 04/29/2023] Open
Abstract
Clinical observations indicate that people frequently display stress-related behavior during the COVID-19 pandemic. Although numerous studies have been published concerning pandemic-related psychological distress, systematic data on the interrelationships between stress sensitivity, personality, and behavioral characteristics of people are still lacking. In the present cross-sectional online survey study, we applied a German version of the COVID Stress Scales (CSS) and standard psychological questionnaires to systematically identify the complex interplay between stress sensitivity, gender, and personality in the modulation of quality of life and mental health in the German population (N = 1774; age ≥ 16 years). A CSS-based cluster analysis revealed two clusters characterized by higher and lower stress levels. Study participants in each cluster differed significantly with respect to neuroticism, extraversion, agreeableness, quality of life, depression, and anxiety. Females were significantly overrepresented in the higher stress cluster, while there was an overrepresentation of males in the lower stress cluster. Neuroticism was identified as a risk factor and extraversion as a protective factor for enhanced pandemic-related stress responses. For the first time our data show a taxonomy of factors, which modulate pandemic-related stress sensitivity and warrant consideration as key indicators of quality of life and psychological distress during the COVID-19 pandemic. We suggest that our data may advise governmental regulation of pandemic-related public health measures, to optimize quality of life and psychological health in different groups of the population.
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Affiliation(s)
- Vincent M. E. L. Nin
- Neurobiology and Genetics of Behavior, Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
- *Correspondence: Vincent M. E. L. Nin,
| | - Gerd-Dieter Willmund
- German Center for Military Mental Health, Military Hospital Berlin, Berlin, Germany
| | - Stefanie M. Jungmann
- Department of Clinical Psychology, Psychotherapy, and Experimental Psychopathology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | | | - Martina Piefke
- Neurobiology and Genetics of Behavior, Department of Psychology and Psychotherapy, Witten/Herdecke University, Witten, Germany
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15
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Heeren A, Asmundson GJG. Understanding climate anxiety: What decision-makers, health care providers, and the mental health community need to know to promote adaptative coping. J Anxiety Disord 2023; 93:102654. [PMID: 36414530 DOI: 10.1016/j.janxdis.2022.102654] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Alexandre Heeren
- Psychological Science Research Institute, UCLouvain, Louvain-la-Neuve, Belgium; Institute of Neuroscience, UCLouvain, Brussels, Belgium; National Fund for Scientific Research (FRS-FNRS), Brussels, Belgium.
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Carleton RN, McCarron M, Krätzig GP, Sauer-Zavala S, Neary JP, Lix LM, Fletcher AJ, Camp RD, Shields RE, Jamshidi L, Nisbet J, Maguire KQ, MacPhee RS, Afifi TO, Jones NA, Martin RR, Sareen J, Brunet A, Beshai S, Anderson GS, Cramm H, MacDermid JC, Ricciardelli R, Rabbani R, Teckchandani TA, Asmundson GJG. Assessing the impact of the Royal Canadian Mounted Police (RCMP) protocol and Emotional Resilience Skills Training (ERST) among diverse public safety personnel. BMC Psychol 2022; 10:295. [PMID: 36494748 PMCID: PMC9733219 DOI: 10.1186/s40359-022-00989-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/13/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Public safety personnel (PSP; e.g., border services personnel, correctional workers, firefighters, paramedics, police, public safety communicators) are frequently exposed to potentially psychologically traumatic events. Such events contribute to substantial and growing challenges from posttraumatic stress injuries (PTSIs), including but not limited to posttraumatic stress disorder. METHODS The current protocol paper describes the PSP PTSI Study (i.e., design, measures, materials, hypotheses, planned analyses, expected implications, and limitations), which was originally designed to evaluate an evidence-informed, proactive system of mental health assessment and training among Royal Canadian Mounted Police for delivery among diverse PSP (i.e., firefighters, municipal police, paramedics, public safety communicators). Specifically, the PSP PTSI Study will: (1) adapt, implement, and assess the impact of a system for ongoing (i.e., annual, monthly, daily) evidence-based assessments; (2) evaluate associations between demographic variables and PTSI; (3) longitudinally assess individual differences associated with PTSI; and, (4) assess the impact of providing diverse PSP with a tailored version of the Emotional Resilience Skills Training originally developed for the Royal Canadian Mounted Police in mitigating PTSIs based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders. Participants are assessed pre- and post-training, and then at a follow-up 1-year after training. The assessments include clinical interviews, self-report surveys including brief daily and monthly assessments, and daily biometric data. The current protocol paper also describes participant recruitment and developments to date. DISCUSSION The PSP PTSI Study is an opportunity to implement, test, and improve a set of evidence-based tools and training as part of an evidence-informed solution to protect PSP mental health. The current protocol paper provides details to inform and support translation of the PSP PTSI Study results as well as informing and supporting replication efforts by other researchers. TRIAL REGISTRATION Hypotheses Registration: aspredicted.org, #90136. Registered 7 March 2022-Prospectively registered. TRIAL REGISTRATION ClinicalTrials.gov, NCT05530642. Registered 1 September 2022-Retrospectively registered. The subsequent PSP PTSI Study results are expected to benefit the mental health of all participants and, ultimately, all PSP.
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Affiliation(s)
- R. Nicholas Carleton
- grid.57926.3f0000 0004 1936 9131Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | - Michelle McCarron
- grid.412733.00000 0004 0480 4970Research Department, Saskatchewan Health Authority, Regina, SK S4S 0A5 Canada
| | - Gregory P. Krätzig
- grid.57926.3f0000 0004 1936 9131Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | - Shannon Sauer-Zavala
- grid.266539.d0000 0004 1936 8438Treatment Innovation for Psychological Services Research Program, Department of Psychology, University of Kentucky, Lexington, KY 40506 USA
| | - J. Patrick Neary
- grid.57926.3f0000 0004 1936 9131Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S 0A2 Canada
| | - Lisa M. Lix
- grid.21613.370000 0004 1936 9609Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3 Canada
| | - Amber J. Fletcher
- grid.57926.3f0000 0004 1936 9131Department of Sociology and Social Studies, University of Regina, Regina, SK S4S 0A2 Canada
| | - Ronald D. Camp
- grid.266876.b0000 0001 2156 9982Faculty of Business and Economics, University of Northern British Columbia, Prince George, BC V2N 4Z9 Canada
| | - Robyn E. Shields
- grid.57926.3f0000 0004 1936 9131University of Regina, Regina, SK S4S 0A2 Canada
| | - Laleh Jamshidi
- grid.57926.3f0000 0004 1936 9131Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Jolan Nisbet
- grid.57926.3f0000 0004 1936 9131Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Kirby Q. Maguire
- grid.57926.3f0000 0004 1936 9131Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Renée S. MacPhee
- grid.268252.90000 0001 1958 9263Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON N2L 3C5 Canada
| | - Tracie O. Afifi
- grid.21613.370000 0004 1936 9609Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W5 Canada
| | - Nicholas A. Jones
- grid.57926.3f0000 0004 1936 9131Department of Justice Studies, University of Regina, Regina, SK S4S 0A2 Canada
| | - Ronald R. Martin
- grid.57926.3f0000 0004 1936 9131Faculty of Education, University of Regina, Regina, SK S4S 0A2 Canada
| | - Jitender Sareen
- grid.21613.370000 0004 1936 9609Department of Psychiatry, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W5 Canada
| | - Alain Brunet
- grid.459278.50000 0004 4910 4652McGill’s Psychiatry Department and Douglas Institute Research Center, 6875 Lasalle Boulevard, Verdun, QC H4H 1R3 Canada
| | - Shadi Beshai
- grid.57926.3f0000 0004 1936 9131Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | - Gregory S. Anderson
- grid.265014.40000 0000 9945 2031Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8 Canada
| | - Heidi Cramm
- grid.410356.50000 0004 1936 8331School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - Joy C. MacDermid
- grid.39381.300000 0004 1936 8884School of Physiotherapy, Western University, London, ON N6A 3K7 Canada
| | - Rosemary Ricciardelli
- grid.25055.370000 0000 9130 6822School of Maritime Studies, Fisheries and Marine Institute, Memorial University of Newfoundland, St. John’s, NL A1C 5R3 Canada
| | - Rasheda Rabbani
- grid.21613.370000 0004 1936 9609George & Fay Yee Centre for Healthcare Innovation, Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Taylor A. Teckchandani
- grid.57926.3f0000 0004 1936 9131Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Gordon J. G. Asmundson
- grid.57926.3f0000 0004 1936 9131Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
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Boehme BAE, Shields RE, Asmundson GJG, Szeto ACH, Dobson KS, Carleton RN. A short version of the Opening Minds Scale–Workplace Attitudes: Factor structure and factorial validity in a sample of Canadian public safety personnel. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement 2022. [DOI: 10.1037/cbs0000350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Gross DP, Rachor GS, Krebs BK, Yamamoto SS, Dick BD, Brown CA, Asmundson GJG, Straube S, Els C, Jackson TD, Brémault-Phillips S, Voaklander D, Stastny J, Berry T. Risk Factors for Developing Concurrent Posttraumatic Stress Injury After Work-Related Musculoskeletal Injury: A Case-Control Study. J Occup Environ Med 2022; 64:e579-e584. [PMID: 35901517 PMCID: PMC9426736 DOI: 10.1097/jom.0000000000002621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study aimed to study risk factors for developing concurrent posttraumatic stress injury (PTSI) among workers experiencing work-related musculoskeletal injury (MSI). METHODS A case-control study was conducted using workers' compensation data on injured workers undergoing rehabilitation programs for concurrent MSI and PTSI (cases) and MSI only (controls). A variety of measures known at the time of the compensable injury were entered into logistic regression models. RESULTS Of the 1948 workers included, 215 had concurrent MSI and PTSI. Concurrent MSI and PTSI were predicted by type of accident (adjusted odds ratio [OR], 25.8), experiencing fracture or dislocation fracture or dislocation (adjusted OR, 3.7), being public safety personnel (adjusted OR, 3.1), and lower level of education (adjusted OR, 1.9). CONCLUSIONS Experiencing a concurrent PTSI diagnosis with MSI after work-related accident and injury appears related to occupation, type of accident, and educational background.
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De Los Reyes A, Tyrell FA, Watts AL, Asmundson GJG. Conceptual, methodological, and measurement factors that disqualify use of measurement invariance techniques to detect informant discrepancies in youth mental health assessments. Front Psychol 2022; 13:931296. [PMID: 35983202 PMCID: PMC9378825 DOI: 10.3389/fpsyg.2022.931296] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/24/2022] [Indexed: 12/13/2022] Open
Abstract
On page 1 of his classic text, Millsap (2011) states, “Measurement invariance is built on the notion that a measuring device should function the same way across varied conditions, so long as those varied conditions are irrelevant [emphasis added] to the attribute being measured.” By construction, measurement invariance techniques require not only detecting varied conditions but also ruling out that these conditions inform our understanding of measured domains (i.e., conditions that do not contain domain-relevant information). In fact, measurement invariance techniques possess great utility when theory and research inform their application to specific, varied conditions (e.g., cultural, ethnic, or racial background of test respondents) that, if not detected, introduce measurement biases, and, thus, depress measurement validity (e.g., academic achievement and intelligence). Yet, we see emerging bodies of work where scholars have “put the cart before the horse” when it comes to measurement invariance, and they apply these techniques to varied conditions that, in fact, may reflect domain-relevant information. These bodies of work highlight a larger problem in measurement that likely cuts across many areas of scholarship. In one such area, youth mental health, researchers commonly encounter a set of conditions that nullify the use of measurement invariance, namely discrepancies between survey reports completed by multiple informants, such as parents, teachers, and youth themselves (i.e., informant discrepancies). In this paper, we provide an overview of conceptual, methodological, and measurement factors that should prevent researchers from applying measurement invariance techniques to detect informant discrepancies. Along the way, we cite evidence from the last 15 years indicating that informant discrepancies reflect domain-relevant information. We also apply this evidence to recent uses of measurement invariance techniques in youth mental health. Based on prior evidence, we highlight the implications of applying these techniques to multi-informant data, when the informant discrepancies observed within these data might reflect domain-relevant information. We close by calling for a moratorium on applying measurement invariance techniques to detect informant discrepancies in youth mental health assessments. In doing so, we describe how the state of the science would need to fundamentally “flip” to justify applying these techniques to detect informant discrepancies in this area of work.
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Affiliation(s)
- Andres De Los Reyes
- Comprehensive Assessment and Intervention Program, Department of Psychology, The University of Maryland at College Park, College Park, MD, United States
- *Correspondence: Andres De Los Reyes,
| | - Fanita A. Tyrell
- Resilient Adaptation Across Culture and Context Lab, Department of Psychology, The University of Maryland at College Park, College Park, MD, United States
| | - Ashley L. Watts
- Department of Psychological Sciences, University of Missouri, Columbia, MO, United States
| | - Gordon J. G. Asmundson
- Anxiety and Illness Behaviour Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
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20
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Carleton RN, Krätzig GP, Sauer-Zavala S, Neary JP, Lix LM, Fletcher AJ, Afifi TO, Brunet A, Martin R, Hamelin KS, Teckchandani TA, Jamshidi L, Maguire KQ, Gerhard D, McCarron M, Hoeber O, Jones NA, Stewart SH, Keane TM, Sareen J, Dobson K, Asmundson GJG. The Royal Canadian Mounted Police (RCMP) Study: protocol for a prospective investigation of mental health risk and resilience factors. Health Promot Chronic Dis Prev Can 2022; 42:319-333. [PMID: 35993603 PMCID: PMC9514212 DOI: 10.24095/hpcdp.42.8.02] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The Royal Canadian Mounted Police (RCMP), like all public safety personnel (PSP), are frequently exposed to potentially psychologically traumatic events that contribute to posttraumatic stress injuries (PTSI). Addressing PTSI is impeded by the limited available research. In this protocol paper, we describe the RCMP Study, part of the concerted efforts by the RCMP to reduce PTSI by improving access to evidence-based assessments, treatments and training as well as participant recruitment and RCMP Study developments to date. The RCMP Study has been designed to (1) develop, deploy and assess the impact of a system for ongoing annual, monthly and daily evidence-based assessments; (2) evaluate associations between demographic variables and PTSI; (3) longitudinally assess individual differences associated with PTSI; (4) augment the RCMP Cadet Training Program with skills to proactively mitigate PTSI; and (5) assess the impact of the augmented training condition (ATC) versus the standard training condition (STC). Participants in the STC (n = 480) and ATC (n = 480) are assessed before and after training and annually for 5 years on their deployment date; they also complete brief monthly and daily surveys. The RCMP Study results are expected to benefit the mental health of all participants, RCMP and PSP by reducing PTSI among all who serve.
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Affiliation(s)
- R Nicholas Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Gregory P Krätzig
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Shannon Sauer-Zavala
- Department of Psychology, University of Kentucky, Lexington, Kentucky, United States of America
| | - J Patrick Neary
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amber J Fletcher
- Department of Sociology and Social Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Tracie O Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alain Brunet
- Department of Psychiatry and Douglas Institute Research Centre, McGill University, Verdun, Quebec, Canada
| | - Ron Martin
- Faculty of Education, University of Regina, Regina, Saskatchewan, Canada
| | | | - Taylor A Teckchandani
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, Saskatchewan, Canada
| | - Kirby Q Maguire
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, Saskatchewan, Canada
| | - David Gerhard
- Department of Computer Science, University of Regina, Regina, Saskatchewan, Canada
| | | | - Orland Hoeber
- Department of Computer Science, University of Regina, Regina, Saskatchewan, Canada
| | - Nicholas A Jones
- Department of Justice Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Sherry H Stewart
- Mood, Anxiety, and Addiction Comorbidity (MAAC) Lab, Departments of Psychiatry and Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Terence M Keane
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System & Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Jitender Sareen
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Keith Dobson
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Gordon J G Asmundson
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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21
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De Los Reyes A, Asmundson GJG. Reimaging context within exposure-based treatments for adolescent social anxiety disorder: It all begins with optimizing the context-sensitivity of our clinical assessments. J Anxiety Disord 2022; 87:102545. [PMID: 35217501 DOI: 10.1016/j.janxdis.2022.102545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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22
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Carlander A, Lekander M, Asmundson GJG, Taylor S, Olofsson Bagge R, Lindqvist Bagge AS. COVID-19 related distress in the Swedish population: Validation of the Swedish version of the COVID Stress Scales (CSS). PLoS One 2022; 17:e0263888. [PMID: 35157739 PMCID: PMC8843112 DOI: 10.1371/journal.pone.0263888] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 01/28/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The COVID Stress Scales (CSS) assess health- and contamination-related distress in the face of a medical outbreak like the ongoing COVID-19 pandemic. Though the CSS is translated into 21 languages, it has not been validated in a Swedish national sample. AIM Our general objective is to provide a translation, replication, and validation of the CSS and test its convergent- and discriminant validity in relation to anxiety, health anxiety, depression, and stress in the general Swedish population. We also present latent psychometric properties by modelling based on item response theory. METHODS Participants consisted of 3044 Swedish adults (> 18 years) from a pre-stratified (gender, age, and education) sample from The Swedish Citizen Panel. Mental health status was assessed by validated instruments, including the CSS, PHQ-4, SHAI-14, and PSS-10. RESULTS Results indicate that our Swedish translation of CSS has good psychometric properties and consists of 5 correlated factors. DISCUSSION The CSS is useful either as a unidimensional or multidimensional construct using the CSS scales to measure key facets of pandemic-related stress. CONCLUSIONS The findings support the cross-cultural validity of the CSS and its potential utility in understanding many of the emotional challenges posed by the current and future pandemics.
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Affiliation(s)
- Anders Carlander
- SOM Institute, University of Gothenburg, Gothenburg, Sweden
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- * E-mail:
| | - Mats Lekander
- Department of Psychology, Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | | | - Steven Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
| | - Roger Olofsson Bagge
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Surgery, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
| | - Ann-Sophie Lindqvist Bagge
- Wallenberg Centre for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden
- Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
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23
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Affiliation(s)
- Steven Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, BC V6E 2A1, Canada.
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Sareen J, Bolton SL, Mota N, Afifi TO, Enns MW, Taillieu T, Stewart-Tufescu A, El-Gabalawy R, Marrie RA, Richardson JD, Stein MB, Bernstein CN, Bolton JM, Wang J, Asmundson GJG, Thompson JM, VanTil L, MacLean MB, Logsetty S. Lifetime Prevalence and Comorbidity of Mental Disorders in the Two-wave 2002-2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS): Prévalence et Comorbidité de Durée de vie Des Troubles Mentaux Dans l'Enquête de Suivi Sur la Santé Mentale Auprès des Membres des Forces Armées Canadiennes et Des ex-Militaires (ESSMFACM) en Deux Cycles de 2002 à 2018. Can J Psychiatry 2021; 66:951-960. [PMID: 33715467 PMCID: PMC8649821 DOI: 10.1177/07067437211000636] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVE The current study used the Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS) to (1) examine the incidence and prevalence of mental disorders and (2) estimate the comorbidity of mental disorders over the follow-up period. METHOD The CAFVMHS (2018) is a longitudinal study with two time points of assessment. The sample is comprised of 2,941 Canadian Forces members and veterans who participated in the 2002 Canadian Community Health Survey: Canadian Forces Supplement. The World Health Organization Composite International Diagnostic Interview (WHO-CIDI) was utilized to diagnose Diagnostic and Statistical Manual-IV post-traumatic stress disorder (PTSD), major depressive episode (MDE), generalized anxiety disorder, social anxiety disorder (SAD), and alcohol abuse and dependence. Self-report health professional diagnoses were assessed for attention deficit hyperactivity disorder (ADHD), mania, obsessive compulsive disorder (OCD), and personality disorder. We established weighted prevalence of mental disorders and examined the association between mental disorders using logistic regression. RESULTS In 2018, lifetime prevalence of any WHO-CIDI-based or self-reported mental disorder was 58.1%. Lifetime prevalence of any mood or anxiety disorder or PTSD was 54.0% in 2018. MDE (39.9%), SAD (25.7%), and PTSD (21.4%) were the most common mental disorders. There was a substantial increase in new onset or recurrence/persistence of mental disorders between the two measurement points (16-year assessment gap); 2002-2018 period prevalences were 43.5% for mood and anxiety disorder and 16.8% for alcohol abuse or dependence. The prevalence of self-reported ADHD, OCD, any personality disorder, and mania were 3.3%, 3.0%, 0.8%, and 0.8%, respectively. Comorbidity between mental disorders increased over the follow-up. CONCLUSIONS This study demonstrates a high burden of mental disorders among a large Canadian military and veteran cohort. These findings underscore the importance of prevention and intervention strategies to reduce the burden of mental disorders and alcohol use disorders in these populations.
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Affiliation(s)
- Jitender Sareen
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shay-Lee Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Natalie Mota
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tracie O Afifi
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Murray W Enns
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tamara Taillieu
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | | | - Renée El-Gabalawy
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Anesthesia and Perioperative Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ruth Ann Marrie
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - J Don Richardson
- Department of Psychiatry, Western University, London, Ontario, Canada.,St. Joseph's OSI Clinic, London, Ontario, Canada
| | - Murray B Stein
- Department of Psychiatry, UCSD School of Medicine, La Jolla, CA, USA
| | - Charles N Bernstein
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - James M Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jianli Wang
- Institute of Mental Health Research, University of Ottawa, School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ontario, Canada
| | | | - James M Thompson
- Department of Public Health Sciences, Queens University, Kingston, Ontario, Canada.,Department of Family Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Linda VanTil
- Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
| | - Mary Beth MacLean
- Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
| | - Sarvesh Logsetty
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Surgery, University of Manitoba, Winnipeg, Manitoba, Canada
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25
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Afifi TO, Bolton SL, Mota N, Marrie RA, Stein MB, Enns MW, El-Gabalawy R, Bernstein CN, Mackenzie C, VanTil L, MacLean MB, Wang JL, Patten S, Asmundson GJG, Sareen J. Rationale and Methodology of the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (CAFVMHS): A 16-year Follow-up Survey: Raison D'être Et Méthodologie De L'enquête De Suivi Sur La Santé Mentale Des Membres Des Forces Armées Canadiennes Et Des Anciens Combattants, 2018 (ESSMFACM). Can J Psychiatry 2021; 66:942-950. [PMID: 33624524 PMCID: PMC8649811 DOI: 10.1177/0706743720974837] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Knowledge is limited regarding the longitudinal course and predictors of mental health problems, suicide, and physical health outcomes among military and veterans. Statistics Canada, in collaboration with researchers at the University of Manitoba and an international team, conducted the Canadian Armed Forces Members and Veterans Mental Health Follow-Up Survey (CAFVMHS). Herein, we describe the rationale and methods of this important survey. METHOD The CAFVMHS is a longitudinal survey design with 2 time points (2002 and 2018). Regular Force military personnel who participated in the first Canadian Community Health Survey Cycle 1.2-Mental Health and Well-Being, Canadian Forces Supplement (CCHS-CFS) in 2002 (N = 5,155) were reinterviewed in 2018 (n = 2,941). The World Mental Health Survey-Composite International Diagnostic Interview was used with the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria. RESULTS The CAFVMHS includes 2,941 respondents (66% veterans; 34% active duty) and includes data on mental disorder diagnoses, physical health conditions, substance use, medication use, general health, mental health services, perceived need for care, social support, moral injury, deployment experiences, stress, physical activity, military-related sexual assault, childhood experiences, and military and sociodemographic information. CONCLUSIONS The CAFVMHS provides a unique opportunity to further understand the health and well-being of military personnel in Canada over time to inform intervention and prevention strategies and improve outcomes. The data are available through the Statistics Canada Research Data Centres across Canada and can be used cross-sectionally or be longitudinally linked to the 2002 CCHS-CFS data.
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Affiliation(s)
- Tracie O Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shay-Lee Bolton
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Natalie Mota
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ruth Ann Marrie
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Faculty of Medicine, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Murray B Stein
- Department of Psychiatry, UCSD School of Medicine, California, USA.,The Harold Wertheim School of Public Health and Human Longevity Science, UCSD, California, USA.,Altman Clinical and Translational Research Institute, UCSD School of Medicine, California, USA
| | - Murray W Enns
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Renée El-Gabalawy
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Clinical Health Psychology, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Anesthesia, Perioperative and Pain Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Charles N Bernstein
- Department of Internal Medicine, Max Rady College of Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Corey Mackenzie
- Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Linda VanTil
- Research Directorate, Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
| | - Mary Beth MacLean
- Research Directorate, Veterans Affairs Canada, Charlottetown, Prince Edward Island, Canada
| | - Jian Li Wang
- School of Epidemiology and Public Health, University of Ottawa, Ontario, Canada
| | - Scott Patten
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
| | | | - Jitender Sareen
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.,Department of Psychology, University of Manitoba, Winnipeg, Manitoba, Canada
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Afifi TO, Sareen J, Taillieu T, Stewart-Tufescu A, Mota N, Bolton SL, Asmundson GJG, Enns MW, Ports KA, Jetly R. Association of Child Maltreatment and Deployment-related Traumatic Experiences with Mental Disorders in Active Duty Service Members and Veterans of the Canadian Armed Forces: Association de la Maltraitance des Enfants et des Expériences Traumatisantes Liées au Déploiement Avec les Troubles Mentaux Chez les Membres du Service Actif et Les Anciens Combattants des Forces Armées Canadiennes. Can J Psychiatry 2021; 66:961-970. [PMID: 33472392 PMCID: PMC8649822 DOI: 10.1177/0706743720987086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Mental health among military personnel is an important public health priority. It is known that military personnel experience a high prevalence of child maltreatment and deployment-related traumatic events (DRTEs) and both are related to mental health outcomes. However, few, if any, studies have examined the cumulative and interactive effects of child maltreatment and DRTEs on mental health disorders in a sample of active duty service members and military veterans. METHODS Data were from the Canadian Armed Forces (CAF) Members and Veterans Mental Health Follow-up Survey collected in 2018 (N = 2,941, response rate = 68.7%), a 16-year follow-up survey of CAF Regular Force members interviewed in 2002. Five types of child maltreatment and 10 types of DTREs were assessed for impact on mental health. Mental disorders included past 12-month generalized anxiety disorder (GAD), panic disorder, social phobia, and major depressive episode (MDE). Past 12-month symptoms of posttraumatic stress disorder (PTSD) were also examined. RESULTS The prevalence of any exposure to child maltreatment and DRTEs was 62.5% and 68.6%, respectively. All types of child maltreatment were associated with increased odds of past 12-month PTSD symptoms and mental disorders with the exception of physical abuse and GAD as well as childhood exposure to intimate partner violence and panic disorder. Cumulative effects of having experienced both child maltreatment and DRTEs increased the odds of past 12-month PTSD symptoms, GAD, social phobia, and MDE. No interaction effects were significant. CONCLUSIONS The prevalence of a child maltreatment history is high among active Canadian military and veterans. As well, child maltreatment may increase the likelihood of mental disorders across the life span. This may be especially true for individuals who also experience DRTEs. Understanding these relationships may provide insight into developing effective interventions for military personnel and veteran mental health outcomes.
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Affiliation(s)
- Tracie O Afifi
- Departments of Community Health Sciences and Psychiatry, 8664University of Manitoba, Winnipeg, Canada
| | - Jitender Sareen
- Department of Psychiatry, 8664University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tamara Taillieu
- Department of Community Health Sciences, 8664University of Manitoba, Winnipeg, Manitoba, Canada
| | - Ashley Stewart-Tufescu
- Departments of Community Health Sciences and Psychiatry, 8664University of Manitoba, Winnipeg, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, 8664University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shay-Lee Bolton
- Department of Psychiatry, 8664University of Manitoba, Winnipeg, Manitoba, Canada
| | - Gordon J G Asmundson
- Department of Psychology and Anxiety and Illness Behaviours Lab, University of Regina, Regina, Saskatchewan, Canada
| | - Murray W Enns
- Department of Psychiatry, 8664University of Manitoba, Winnipeg, Manitoba, Canada
| | - Katie A Ports
- Department of Defense, Sexual Assault Prevention and Response Office, Alexandria, USA
| | - Rakesh Jetly
- Canadian Forces Health Services, Department of National Defence, Ottawa, Ontario, Canada
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Mota N, Bolton SL, Enns MW, Afifi TO, El-Gabalawy R, Sommer JL, Pietrzak RH, Stein MB, Asmundson GJG, Sareen J. Course and Predictors of Posttraumatic Stress Disorder in the Canadian Armed Forces: A Nationally Representative, 16-Year Follow-up Study: Cours et prédicteurs du trouble de stress post-traumatique dans les Forces armées canadiennes: une étude de suivi de 16 ans nationalement représentative. Can J Psychiatry 2021; 66:982-995. [PMID: 33522288 PMCID: PMC8649830 DOI: 10.1177/0706743721989167] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVE This study examined baseline risk and protective predictors and interim correlates of the persistence/recurrence, remission, and onset of posttraumatic stress disorder (PTSD) in a 16-year prospective, nationally representative sample of Canadian Forces members and veterans. METHODS The 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey is a prospective study of 2,941 regular force service members and veterans who participated in the 2002 Canadian Community Health Survey on Mental Health and Wellbeing: Canadian Forces Supplement (n = 5,155; ages 15 to 64 years; response rate 68%). PTSD diagnoses in 2002 and 2018 were used to create 4 groups: (1) no lifetime, (2) remitted, (3) new onset, and (4) persistent/recurrent PTSD. Multinomial regressions were conducted to identify predictors of PTSD courses. RESULTS Female sex, being a junior noncommissioned member (vs. officer), and land (vs. air) operations in 2002 were associated with all PTSD courses relative to no lifetime PTSD (relative risk ratio [RRR] range: 1.28 to 3.65). After adjusting for sociodemographic variables, baseline predictors of all PTSD courses included lifetime mental disorder, history of mental health care utilization, all trauma type categories (deployment-associated, sexual, "other"), and the number of lifetime traumatic events (RRR range: 1.14 to 8.95). New ("since 2002") traumas, transitioning to veteran status, and alcohol dependence were mostly associated with the new onset and persistent/recurrent PTSD courses (RRR range: 1.79 to 4.31), while mental health care utilization and greater avoidance coping were associated with all PTSD courses (RRR range: 1.10 to 17.87). Protective factors for several PTSD courses at one or both time points included social support, social network size, and problem-focused coping (RRR range: 0.71 to 0.98). CONCLUSIONS This is the first population-based survey to examine the longitudinal course of PTSD in Canadian Forces members. Prevention and intervention programs focused on bolstering social support and active coping strategies as possible protective factors/correlates may help mitigate the development and persistence of PTSD.
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Affiliation(s)
- Natalie Mota
- Departments of Clinical Health Psychology and Psychiatry, 8664University of Manitoba, Winnipeg, Manitoba, Canada
| | - Shay-Lee Bolton
- Department of Psychiatry, 8664University of Manitoba, Winnipeg, Manitoba, Canada
| | - Murray W Enns
- Department of Psychiatry, 8664University of Manitoba, Winnipeg, Manitoba, Canada
| | - Tracie O Afifi
- Departments of Community Health Sciences and Psychiatry, 8664University of Manitoba, Winnipeg, Manitoba, Canada
| | - Renée El-Gabalawy
- Departments of Anesthesiology, Perioperative and Pain Medicine, and Clinical Health Psychology, 8664University of Manitoba, Winnipeg, Manitoba, Canada
| | - Jordana L Sommer
- Departments of Psychology and Anesthesiology, Perioperative and Pain Medicine, 8664University of Manitoba, Winnipeg, Manitoba, Canada
| | - Robert H Pietrzak
- Department of Psychiatry, 5755Yale University School of Medicine, New Haven, CT, USA.,National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Murray B Stein
- Departments of Psychiatry and of Family Medicine and Public Health, University of California San Diego, La Jolla, and VA San Diego Healthcare System, San Diego, CA, USA
| | - Gordon J G Asmundson
- Department of Psychology and Anxiety and Illness Behaviours Lab, 8664University of Regina, Regina, Canada
| | - Jitender Sareen
- Department of Psychiatry, 8664University of Manitoba, Winnipeg, Manitoba, Canada
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Milic M, Dotlic J, Rachor GS, Asmundson GJG, Joksimovic B, Stevanovic J, Lazic D, Stanojevic Ristic Z, Subaric Filimonovic J, Radenkovic N, Cakic M, Gazibara T. Validity and reliability of the Serbian COVID Stress Scales. PLoS One 2021; 16:e0259062. [PMID: 34705857 PMCID: PMC8550439 DOI: 10.1371/journal.pone.0259062] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 10/11/2021] [Indexed: 11/18/2022] Open
Abstract
This study aimed to generate a linguistic equivalent of the COVID Stress Scales (CSS) in the Serbian language and examine its psychometric characteristics. Data were collected from September to December 2020 among the general population of three cities in Republic of Serbia and Republic of Srpska, countries where the Serbian language is spoken. Participants completed a socio-demographic questionnaire, followed by the CSS and Perceived Stress Scale (PSS). The CSS was validated using the standard methodology (i.e., forward and backward translations, pilot testing). The reliability of the Serbian CSS was assessed using Cronbach’s alpha and McDonald’s omega coefficients and convergent validity was evaluated by correlating the CSS with PSS. Confirmatory factor analysis was performed to examine the construct validity of the Serbian CSS. This study included 961 persons (52.8% males and 47.2% females). The Cronbach’s alpha coefficient of the Serbian CSS was 0.964 and McDonald’s omega was 0.964. The Serbian CSS with 36 items and a six-factorial structure showed a measurement model with a satisfactory fit for our population (CMIN/DF = 4.391; GFI = 0.991; RMSEA = 0.025). The CSS total and all domain scores significantly positively correlated with PSS total score. The Serbian version of the CSS is a valid and reliable questionnaire that can be used in assessing COVID-19-related distress experienced by Serbian speaking people during the COVID-19 pandemic as well as future epidemics and pandemics.
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Affiliation(s)
- Marija Milic
- Department of Epidemiology, Faculty of Medicine, University of Pristina Temporarily Seated in Kosovska Mitrovica, Kosovska Mitrovica, Kosovo, Serbia
| | - Jelena Dotlic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | | | - Bojan Joksimovic
- Faculty of Medicine, University of East Sarajevo, Foca, Republic of Srpska Bosnia and Herzegovina
| | - Jasmina Stevanovic
- Department of Epidemiology, Faculty of Medicine, University of Pristina Temporarily Seated in Kosovska Mitrovica, Kosovska Mitrovica, Kosovo, Serbia
| | - Dragoslav Lazic
- Department of Dentistry, Faculty of Medicine, University of Pristina Temporarily Seated in Kosovska Mitrovica, Kosovska Mitrovica, Kosovo, Serbia
| | - Zorica Stanojevic Ristic
- Department of Pharmacology, Faculty of Medicine, University of Pristina Temporarily Seated in Kosovska Mitrovica, Kosovska Mitrovica, Kosovo, Serbia
| | - Jelena Subaric Filimonovic
- Department of Epidemiology, Faculty of Medicine, University of Pristina Temporarily Seated in Kosovska Mitrovica, Kosovska Mitrovica, Kosovo, Serbia
| | - Nikoleta Radenkovic
- Department of Epidemiology, Faculty of Medicine, University of Pristina Temporarily Seated in Kosovska Mitrovica, Kosovska Mitrovica, Kosovo, Serbia
| | - Milica Cakic
- Clinic for Obstetrics and Gynecology, Clinical Center of Serbia, University of Belgrade, Belgrade, Serbia
| | - Tatjana Gazibara
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- * E-mail:
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29
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Brady RE, Hegel MT, Curran GM, Asmundson GJG, Xie H, Bruce ML. Evaluation of a brief psychosocial intervention for health anxiety delivered by medical assistants in primary care: Study protocol for a pilot hybrid trial. Contemp Clin Trials 2021; 111:106574. [PMID: 34628077 DOI: 10.1016/j.cct.2021.106574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/16/2021] [Accepted: 09/18/2021] [Indexed: 12/01/2022]
Abstract
Health anxiety is a chronic mental health condition that exerts substantial personal and economic burdens on patients, providers, and the larger healthcare system. Patients with health anxiety experience persistent worry and dread over the possibility that they are presently ill with an undetected or poorly defined physical illness or may soon become ill despite an absence of evidence and physician reassurance of wellness. A complication of health anxiety is that the sufferer frequently denies the presence of excessive anxiety, typically attributing their distress to an inability of the medical team to correctly identify the feared illness. As a result, these patients are challenging to engage in evidence-based psychosocial interventions. The present study protocol describes a psychosocial intervention based on cognitive-behavioral therapy that is adapted for delivery by Medical Assistants in the primary care setting. The rationale for this approach is that delivery by Medical Assistants has the potential to overcome barriers to engagement that prevent effective care. Moreover, deploying a task-shifted intervention relieves strain on the care team by sharing the responsibility for helping the patient manage health anxiety. The aim of this study is to demonstrate the effectiveness of this intervention and approach on health anxiety, while simultaneously collecting data on the barriers and facilitators of implementation, consistent with a hybrid type 1 study design. We will compare patient-level outcomes for participants randomized to the study intervention versus routine referral to mental health services and characterize the potential for implementation using qualitative data drawn from patient and clinical stakeholders.
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Affiliation(s)
- Robert E Brady
- Geisel School of Medicine at Dartmouth, 1 Rope Ferry Rd, Hanover, NH 03755, USA; Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA.
| | - Mark T Hegel
- Geisel School of Medicine at Dartmouth, 1 Rope Ferry Rd, Hanover, NH 03755, USA
| | - Geoffrey M Curran
- University of Arkansas for Medical Sciences, 4301 W. Markham St, Little Rock, AR 72205, USA
| | | | - Haiyi Xie
- Geisel School of Medicine at Dartmouth, 1 Rope Ferry Rd, Hanover, NH 03755, USA; Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA
| | - Martha L Bruce
- Geisel School of Medicine at Dartmouth, 1 Rope Ferry Rd, Hanover, NH 03755, USA; Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, USA
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30
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Abstract
BACKGROUND Social support may be a protective factor for the mental health of public safety personnel (PSP), who are frequently exposed to potentially psychologically traumatic events and report substantial post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) symptoms. Research examining perceived social support and its association with PTSD and MDD in different PSP categories (e.g. firefighters, paramedics) is limited. AIMS To examine differences in perceived social support across PSP and determine whether perceived social support is associated with differences in rates of MDD and PTSD. METHODS We asked Canadian PSP, including correctional workers and officers, public safety communications officials, firefighters, paramedics, municipal and provincial police officers, and Royal Canadian Mounted Police (RCMP) officers, to complete an online anonymous survey that assessed socio-demographic information (e.g. occupation, sex, marital status, service years), social supports and symptoms of mental disorders, including PTSD and MDD. Analyses included ANOVA and logistic regression models. RESULTS Perceived social support differed by PSP occupation. RCMP officers reported lower social support than all other PSP except paramedics. For most PSP categories, PSP who reported greater social support were less likely to screen positive for PTSD (adjusted odds ratios [AORs]: 0.90-0.93). Across all PSP categories, greater perceived social support was associated with a decreased likelihood of screening positive for MDD (AORs: 0.85-0.91). CONCLUSIONS Perceived social support differs across some PSP categories and predicts PTSD and MDD diagnostic status. Studies involving diagnostic clinical interviews, longitudinal designs and social support interventions are needed to replicate and extend our results.
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Affiliation(s)
- K D Vig
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - J E Mason
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - R N Carleton
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - G J G Asmundson
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - G S Anderson
- Office of Applied Research and Graduate Studies, Justice Institute of British Columbia, New Westminster, British Columbia, Canada
| | - D Groll
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
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31
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Taylor S, Fong A, Asmundson GJG. Predicting the Severity of Symptoms of the COVID Stress Syndrome From Personality Traits: A Prospective Network Analysis. Front Psychol 2021; 12:632227. [PMID: 33995185 PMCID: PMC8116691 DOI: 10.3389/fpsyg.2021.632227] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 04/12/2021] [Indexed: 12/17/2022] Open
Abstract
Psychological stress reactions to the COVID-19 pandemic are complex and multifaceted. Research provides evidence of a COVID Stress Syndrome (CSS), consisting of (1) worry about the dangerousness of getting infected with SARSCoV2 and coming into contact with infected surfaces, (2) worry concerning the personal socioeconomic consequences of COVID-19, (3) xenophobic fears that SARSCOV2 is being spread by foreigners, (4) COVID-19-related traumatic stress symptoms (e.g., nightmares), and (5) compulsive checking and reassurance-seeking about COVID-19. Little is known about how these symptoms are related to vulnerability and protective personality factors. Based on data from 1,976 US and Canadian adults, we conducted a prospective network analysis in which personality factors were initially assessed at Time 1 and then symptoms of the CSS were assessed at Time 2, 2.5 months later. Results indicated that trait optimism and trait resilience were negatively associated with negative emotionality, suggesting a modulatory (inhibitory) influence. Negative emotionality was positively linked to the narrower traits of intolerance of uncertainty and health anxiety proneness. These narrower traits, in turn, were prospectively linked to symptoms of the CSS. Results suggest that the effects of broad personality traits (e.g., negative emotionality, trait resilience) on symptoms of the CSS were mediated by narrower traits such as the intolerance of uncertainty. Treatment implications are discussed.
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Affiliation(s)
- Steven Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Allan Fong
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Gordon J. G. Asmundson
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
- Department of Psychology, University of Regina, Regina, SK, Canada
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32
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Khosravani V, Samimi Ardestani SM, Sharifi Bastan F, McKay D, Asmundson GJG. The associations of obsessive-compulsive symptom dimensions and general severity with suicidal ideation in patients with obsessive-compulsive disorder: The role of specific stress responses to COVID-19. Clin Psychol Psychother 2021; 28:1391-1402. [PMID: 33881790 PMCID: PMC8250844 DOI: 10.1002/cpp.2602] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/18/2021] [Accepted: 04/19/2021] [Indexed: 12/15/2022]
Abstract
Suicidal ideation is prevalent in patients with obsessive–compulsive disorder (OCD); but, during COVID‐19, it may be increased. The present study aimed to examine the effects of obsessive–compulsive (OC) symptom dimensions and OCD severity on suicidal ideation by considering the role of stress responses in reaction to COVID‐19 in a clinical sample of patients with OCD. In a cross‐sectional study, 304 patients with OCD completed measures of OC symptom dimensions, OCD severity, general mental health (depression and anxiety), and COVID‐19‐related stress. Results showed that after controlling for depression, anxiety, comorbidity, and lifetime suicide attempts, the OC symptom dimensions of responsibility for harm and unacceptable obsessional thoughts as well as general severity had indirect effects on suicidal ideation through the specific stress responses to COVID‐19, including traumatic stress and compulsive checking. The study shows that OCD patients with specific OC symptom dimensions and severe OCD are more likely to have suicidal ideation during the pandemic. Further, the specific stress responses to COVID‐19 may be an underlying mechanism. Clinicians should carefully assess suicidal ideation in patients with OCD who experience responsibility for harm and unacceptable thoughts, particularly during the pandemic.
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Affiliation(s)
- Vahid Khosravani
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mehdi Samimi Ardestani
- Department of Psychiatry, Behavioral Sciences Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Dean McKay
- Department of Psychology, Fordham University, New York, USA
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33
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Affiliation(s)
| | - Steven Taylor
- Department of Psychology, University of British Columbia, British Columbia, Canada.
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34
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Rogers AH, Zvolensky MJ, Ditre JW, Buckner JD, Asmundson GJG. Association of opioid misuse with anxiety and depression: A systematic review of the literature. Clin Psychol Rev 2021; 84:101978. [PMID: 33515811 DOI: 10.1016/j.cpr.2021.101978] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 11/19/2020] [Accepted: 11/29/2020] [Indexed: 12/14/2022]
Abstract
The opioid epidemic is a public health problem associated with a host of negative outcomes. Although clinicians recognize covariation between opioid misuse with anxiety and depressive symptoms and disorders, research on this topic has only recently accumulated. Progress in this domain is impeded by the lack of systematic and integrative research to better understand and treat these co-occurring problems. This paper represents the first attempt to systematically review the empirical literature examining relations between opioid use and misuse, and anxiety and depression. In the first section, we define key terms and describe the article selection strategy. In the second section, we review the prevalence of anxiety and depressive symptoms among individuals who use and misuse prescription and illicit opioids. In the third section, we review the magnitude of associations between anxiety and depressive symptoms and disorders with opioid misuse, as well as highlight studies examining the longitudinal and temporal sequence of the relations between these variables. In the fourth section, we focus on experimental therapeutics, reviewing what is known about individual difference and transdiagnostic vulnerability factors for anxiety and depression that might contribute to opioid misuse and its symptoms. Finally, we discuss current knowledge gaps and present a heuristic model to guide future research.
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Affiliation(s)
- Andrew H Rogers
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, TX, United States; Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, United States; HEALTH Institute, University of Houston, Houston, TX, United States.
| | - Joseph W Ditre
- Department of Psychology, Syracuse University, Syracuse, NY, United States
| | - Julia D Buckner
- Department of Psychology, Louisiana State University, Baton Rouge, LA, United States
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35
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Taylor S, Asmundson GJG. Negative attitudes about facemasks during the COVID-19 pandemic: The dual importance of perceived ineffectiveness and psychological reactance. PLoS One 2021; 16:e0246317. [PMID: 33596207 PMCID: PMC7888611 DOI: 10.1371/journal.pone.0246317] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/18/2021] [Indexed: 12/28/2022] Open
Abstract
This study reports a comprehensive empirical investigation of the nature and correlates of anti-mask attitudes during the COVID-19 pandemic. Accumulating evidence underscores the importance of facemasks, as worn by the general public, in limiting the spread of infection. Accordingly, mask wearing has become increasingly mandatory in public places such as stores and on public transit. Although the public has been generally adherent to mask wearing, a small but vocal group of individuals refuse to wear masks. Anti-mask protest rallies have occurred in many places throughout the world, sometimes erupting violently. Few empirical studies have examined the relationship between anti-mask attitudes and mask non-adherence and little is known about how such attitudes relate to one another or other factors (e.g., non-adherence to social distancing, anti-vaccination attitudes). To investigate these issues, the present study surveyed 2,078 adults from the US and Canada. Consistent with other surveys, we found that most (84%) people wore masks because of COVID-19. The 16% who did not wear masks scored higher on most measures of negative attitudes towards masks. Network analyses indicated that negative attitudes about masks formed an intercorrelated network, with the central nodes in the network being (a) beliefs that masks are ineffective in preventing COVID-19, and (b) psychological reactance (PR; i.e., an aversion to being forced to wear masks). These central nodes served as links, connecting the network of anti-masks attitudes to negative attitudes toward SARSCoV2 vaccination, beliefs that the threat of COVID-19 has been exaggerated, disregard for social distancing, and political conservatism. Findings regarding PR are important because, theoretically, PR is likely to strengthen other anti-masks attitudes (e.g., beliefs that masks are ineffective) because people with strong PR react with anger and counter-arguments when their beliefs are challenged, thereby leading to a strengthening of their anti-mask beliefs. Implications for improving mask adherence are discussed.
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Affiliation(s)
- Steven Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
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36
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Paluszek MM, Asmundson AJN, Landry CA, McKay D, Taylor S, Asmundson GJG. Effects of anxiety sensitivity, disgust, and intolerance of uncertainty on the COVID stress syndrome: a longitudinal assessment of transdiagnostic constructs and the behavioural immune system. Cogn Behav Ther 2021; 50:191-203. [PMID: 33576712 DOI: 10.1080/16506073.2021.1877339] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Excessive fear and worry in response to the COVID-19 pandemic (e.g., COVID stress syndrome) is prevalent and associated with various adverse outcomes. Research from the current and past pandemics supports the association between transdiagnostic constructs-anxiety sensitivity (AS), disgust, and intolerance of uncertainty (IU)-and pandemic-related distress. Recent research suggests a moderating effect of disgust on the relationship of AS-physical concerns and COVID-19-related distress, suggesting that transdiagnostic constructs underlie individual differences in activation of the behavioral immune system (BIS). No previous study has examined the independent and conjoint effects of pre-COVID-19 AS-physical concerns, disgust propensity (DP), disgust sensitivity (DS), and IU in this context; thus, we did so using longitudinal survey data (N = 3,062 Canadian and American adults) with simple and moderated moderations controlling for gender, mental health diagnosis, and COVID-19 diagnosis. Greater AS-physical concerns, DP, and DS predicted more severe COVID stress syndrome assessed one month later. Either DP or DS further amplified the effect of AS-physical concerns on COVID stress syndrome, except danger and contamination fears. IU did not interact with AS-physical concerns and DS or DP. Theoretical and clinical implications pertaining to delivery of cognitive behavioural therapy for pandemic-related distress are discussed.
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Affiliation(s)
| | | | | | - Dean McKay
- Department of Psychology, Fordham University, New York, United States
| | - Steven Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
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37
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Angehrn A, Vig KD, Mason JE, Stelnicki AM, Shields RE, Asmundson GJG, Carleton RN. Sex differences in mental disorder symptoms among Canadian police officers: the mediating role of social support, stress, and sleep quality. Cogn Behav Ther 2021; 51:3-20. [PMID: 33554743 DOI: 10.1080/16506073.2021.1877338] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Police officers, and specifically women officers, report elevated mental disorder rates relative to the general population, which may be impacted by sleep quality, policing-related stress, and social support. In a sample of Canadian police officers, sex was indirectly related to post traumatic stress, depression, generalized anxiety, panic, and social anxiety symptoms through its relationships with social support and sleep quality, but not through policing-related stress. Sex was indirectly related to problematic alcohol use symptoms through sleep quality only. Differences in clinical symptom severity between both sexes may be partially accounted for by the worsened sleep quality reported by women officers relative to their men counterparts. Conversely, general social support appears to be a protective, albeit insufficient, factor influencing the mental health of women police officers. Male and women police officers did not differ in their reports of policing-related stress. The current results underscore the importance of incorporating strategies to improve sleep practices into police workplace environments. Additionally, findings that general social support and policing-related stress do not help explain the trend of increased clinical severity reported by women police suggest that more research is still needed to identify and delineate other contributing factors.
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Affiliation(s)
- Andréanne Angehrn
- Anxiety and Illness Behaviour Laboratory, University of Regina, Regina, Canada
| | - Kelsey D Vig
- Anxiety and Illness Behaviour Laboratory, University of Regina, Regina, Canada
| | - Julia E Mason
- Anxiety and Illness Behaviour Laboratory, University of Regina, Regina, Canada
| | - Andrea M Stelnicki
- Canadian Institute for Public Safety Research and Treatment, Regina, Canada
| | - Robyn E Shields
- Anxiety and Illness Behaviour Laboratory, University of Regina, Regina, Canada
| | | | - R Nicholas Carleton
- Anxiety and Illness Behaviour Laboratory, University of Regina, Regina, Canada.,Canadian Institute for Public Safety Research and Treatment, Regina, Canada
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38
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Elhai JD, Yang H, McKay D, Asmundson GJG, Montag C. Modeling anxiety and fear of COVID-19 using machine learning in a sample of Chinese adults: associations with psychopathology, sociodemographic, and exposure variables. Anxiety Stress Coping 2021; 34:130-144. [PMID: 33496211 DOI: 10.1080/10615806.2021.1878158] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES Research during prior virus outbreaks has examined vulnerability factors associated with increased anxiety and fear. DESIGN We explored numerous psychopathology, sociodemographic, and virus exposure-related variables associated with anxiety and perceived threat of death regarding COVID-19. METHOD We recruited 908 adults from Eastern China for a cross-sectional web survey, from 24 February to 15 March 2020, when social distancing was heavily enforced in China. We used several machine learning algorithms to train our statistical model of predictor variables in modeling COVID-19-related anxiety, and perceived threat of death, separately. We trained the model using many simulated replications on a random subset of participants, and subsequently externally tested on the remaining subset of participants. RESULTS Shrinkage machine learning algorithms performed best, indicating that stress and rumination were the most important variables in modeling COVID-19-related anxiety severity. Health anxiety was the most potent predictor of perceived threat of death from COVID-19. CONCLUSIONS Results are discussed in the context of research on anxiety and fear from prior virus outbreaks, and from theory on outbreak-related emotional vulnerability. Implications regarding COVID-19-related anxiety are also discussed.
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Affiliation(s)
- Jon D Elhai
- Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, People's Republic of China.,Department of Psychology, University of Toledo, Toledo, OH, USA.,Department of Psychiatry, University of Toledo, Toledo, OH, USA
| | - Haibo Yang
- Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, People's Republic of China
| | - Dean McKay
- Department of Psychology, Fordham University, Bronx, NY, USA
| | - Gordon J G Asmundson
- Anxiety and illness Behaviors Laboratory, Department of Psychology, University of Regina, Regina, Canada
| | - Christian Montag
- Department of Molecular Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany.,neuSCAN Laboratory, Clinical Hospital of the Chengdu Brain Science Institute and Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, People's Republic of China
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39
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Khosravani V, Asmundson GJG, Taylor S, Sharifi Bastan F, Samimi Ardestani SM. The Persian COVID stress scales (Persian-CSS) and COVID-19-related stress reactions in patients with obsessive-compulsive and anxiety disorders. J Obsessive Compuls Relat Disord 2021; 28:100615. [PMID: 33354499 PMCID: PMC7746142 DOI: 10.1016/j.jocrd.2020.100615] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 12/14/2022]
Abstract
The COVID Stress Scales (CSS) were designed to assess stress related to the COVID-19 pandemic. Emerging evidence indicates that people with anxiety disorders (ADs) and obsessive-compulsive disorder (OCD) may be more negatively impacted by COVID-19 than those with mood disorders or healthy individuals. Accordingly, this study sought to validate the Persian CSS (Persian-CSS) and to compare COVID-19-related stress reactions among patients with specific ADs and OCD. Patients with OCD (n = 300) and ADs (n = 310) completed the Persian-CSS and other scales developed to assess anxiety-related traits and COVID-19-related distress. The Persian-CSS replicated a five-factor structure similar to the original CSS in OCD and ADs. The total CSS and its scales had good reliability and validity. Patients with generalized anxiety disorder, panic disorder, and OCD had higher COVID-19 stress reactions than patients with social anxiety disorder and specific phobia. Patients with panic disorder had higher danger and contamination fears and xenophobia than patients with OCD. The study suggests that the Persian-CSS is a valid scale to be used in patients with OCD and ADs, each of whom differs in their specific patterns of COVID-19-related stress reactions.
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Affiliation(s)
- Vahid Khosravani
- Behavioral Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Steven Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | | | - Seyed Mehdi Samimi Ardestani
- Departments of Psychiatry, Behavioral Sciences Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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40
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Elhai JD, McKay D, Yang H, Minaya C, Montag C, Asmundson GJG. Health anxiety related to problematic smartphone use and gaming disorder severity during COVID-19: Fear of missing out as a mediator. Hum Behav Emerg Technol 2020; 3:137-146. [PMID: 33363275 PMCID: PMC7753448 DOI: 10.1002/hbe2.227] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 02/06/2023]
Abstract
Health anxiety has been linked with fear and anxiety regarding COVID-19. Higher levels of health anxiety likely increased social distancing and self-isolating during the pandemic. We investigated relations among health anxiety, fear of missing out (FOMO) on rewarding social experiences from social distancing, and consequential levels of problematic smartphone use (PSU) and gaming disorder (GD). We surveyed a broad sample of 812 U.S. and Canadian participants during the pandemic, in late-May 2020, using the Short Health Anxiety Inventory, FOMO Scale, Smartphone Addiction Scale-Short Version, and GD test. Significant bivariate relationships were found among health anxiety, FOMO, PSU, and GD severity. Using structural equation modeling, FOMO mediated relations between health anxiety and both PSU and GD severity. We discuss FOMO as an important variable explaining problematic digital technology use to compensate for unmet social needs from social distancing. We discuss these findings within the context of the Interaction of Person-Affect-Cognition-Execution theoretical model of problematic internet use. Results offer novel insight into the role of health anxiety on FOMO from unmet social needs during the COVID-19 pandemic, and consequential problematic internet use.
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Affiliation(s)
- Jon D Elhai
- Academy of Psychology and Behavior Tianjin Normal University Tianjin China.,Department of Psychology University of Toledo Toledo Ohio USA.,Department of Psychiatry University of Toledo Toledo Ohio USA
| | - Dean McKay
- Department of Psychology Fordham University New York New York USA
| | - Haibo Yang
- Academy of Psychology and Behavior Tianjin Normal University Tianjin China
| | - Charlene Minaya
- Department of Psychology Fordham University New York New York USA
| | - Christian Montag
- Department of Molecular Psychology Institute of Psychology and Education, Ulm University Ulm Germany.,neuSCAN Laboratory, Clinical Hospital of the Chengdu Brain Science Institute and Key Laboratory for Neuroinformation University of Electronic Science and Technology of China Chengdu China
| | - Gordon J G Asmundson
- Anxiety and illness Behaviors Laboratory, Department of Psychology University of Regina Regina Saskatchewan Canada
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41
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Paulus DJ, Rogers AH, Asmundson GJG, Zvolensky MJ. Pain severity and anxiety sensitivity interact to predict drinking severity among hazardous drinking college students. Am J Drug Alcohol Abuse 2020; 46:795-804. [PMID: 32931714 DOI: 10.1080/00952990.2020.1804921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Hazardous alcohol use among college students is a growing problem. Alcohol is commonly used in the context of pain due to acute analgesic effects, although the role of pain among hazardous drinkers has not been examined. Little is known regarding factors that may moderate pain-alcohol relations. One factor is anxiety sensitivity, which reflects the fear of physiological sensations. Pain severity and anxiety sensitivity may interact such that those with high anxiety sensitivity may have stronger pain-alcohol relations.Objectives: The current study examined interactive associations of pain severity and anxiety sensitivity in relation to hazardous drinking severity, alcohol consumption, and alcohol problems among hazardous drinking college students (n = 370; 78.1% female).Methods: Self report measures of alcohol use, pain severity, and anxiety sensitivity were collected and moderation analyses were conducted.Results: There was a significant interaction of pain severity and anxiety sensitivity in relation to hazardous drinking severity (β = 0.25, p = .037); pain severity was significantly related to hazardous drinking for high (β = 0.28, p < .001) but not low (β = 0.09, p = .202) anxiety sensitivity. There was a similar interaction for alcohol consumption (β = 0.35, p = .008). For alcohol problems, there was no significant interaction, but there were unique main effects of both pain severity (β = 0.23, p < .001) and anxiety sensitivity (β = 0.34, p < .001).Conclusions: These findings suggest that drinkers with high anxiety sensitivity may use alcohol hazardously (and in greater quantities) in the context of pain. If replicated with longitudinal samples, the findings may inform clinical practice in terms of screening for and treatment of anxiety sensitivity.
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Affiliation(s)
- Daniel J Paulus
- Department of Neuroscience, Medical University of South Carolina , Charlestion, SC, USA.,Department of Psychology, University of Houston , Houston, TX, USA
| | - Andrew H Rogers
- Department of Psychology, University of Houston , Houston, TX, USA
| | | | - Michael J Zvolensky
- Department of Psychology, University of Houston , Houston, TX, USA.,Department of Behavioral Science, The University of Texas MD Anderson Cancer Center , Houston, TX, USA.,Health Institute, University of Houston , Houston, TX, USA
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McKay D, Asmundson GJG. Substance use and abuse associated with the behavioral immune system during COVID-19: The special case of healthcare workers and essential workers. Addict Behav 2020; 110:106522. [PMID: 32622026 PMCID: PMC7319914 DOI: 10.1016/j.addbeh.2020.106522] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 06/22/2020] [Indexed: 12/14/2022]
Affiliation(s)
- Dean McKay
- Department of Psychology, Fordham University, United States; Department of Psychology, University of Regina, Canada.
| | - Gordon J G Asmundson
- Department of Psychology, Fordham University, United States; Department of Psychology, University of Regina, Canada
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Taylor S, Landry CA, Paluszek MM, Groenewoud R, Rachor GS, Asmundson GJG. A Proactive Approach for Managing COVID-19: The Importance of Understanding the Motivational Roots of Vaccination Hesitancy for SARS-CoV2. Front Psychol 2020; 11:575950. [PMID: 33192883 PMCID: PMC7604422 DOI: 10.3389/fpsyg.2020.575950] [Citation(s) in RCA: 181] [Impact Index Per Article: 45.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Accepted: 10/01/2020] [Indexed: 01/24/2023] Open
Abstract
Importance Vaccination hesitancy—the reluctance or refusal to be vaccinated—is a leading global health threat (World Health Organization, 2019). It is imperative to identify the prevalence of vaccination hesitancy for SARS-CoV2 in order to understand the scope of the problem and to identify its motivational roots in order to proactively prepare to address the problem when a vaccine eventually becomes available. Objective To identify (1) the prevalence of vaccination hesitancy for a SARS-CoV2 vaccine, (2) the motivational roots of this hesitancy, and (3) the most promising incentives for improving the likelihood of vaccination uptake when a vaccine does become available. Design, Setting, and Participants A cross-sectional sample of 3,674 American and Canadian adults assessed during the COVID-19 pandemic in May 2020. Main Outcomes Measures of vaccination intention (i.e., “If a vaccine for COVID-19 was available, would you get vaccinated?”), attitudes toward vaccines in general and specific to SARS-CoV2 using the Vaccination Attitudes Examination Scale, and incentives for getting vaccinated for those who reported they would not get vaccinated. Results Many American (25%) and Canadian (20%) respondents said that they would not get vaccinated against SARS-CoV2 if a vaccine was available. Non-adherence rates of this magnitude would make it difficult or impossible to achieve herd immunity. Vaccine rejection was most strongly correlated with mistrust of vaccine benefit, and also correlated with worry about unforeseen future effects, concerns about commercial profiteering from pharmaceutical companies, and preferences for natural immunity. When asked about incentives for getting vaccinated, respondents were most likely to report that evidence for rigorous testing and safety of the vaccine were of greatest importance. Conclusions and Relevance Vaccination hesitancy is a major looming problem for COVID-19. To improve vaccine uptake, it is imperative that the vaccine is demonstrated to the public to be rigorously tested and not perceived as rushed or premature in its dissemination.
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Affiliation(s)
- Steven Taylor
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | | | | | - Rosalind Groenewoud
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
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Taylor S, Landry CA, Rachor GS, Paluszek MM, Asmundson GJG. Fear and avoidance of healthcare workers: An important, under-recognized form of stigmatization during the COVID-19 pandemic. J Anxiety Disord 2020; 75:102289. [PMID: 32853884 PMCID: PMC7434636 DOI: 10.1016/j.janxdis.2020.102289] [Citation(s) in RCA: 167] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND During past disease outbreaks, healthcare workers (HCWs) have been stigmatized (e.g., shunned, ostracized) by members in their community, for fear that HCWs are sources of infection. There has been no systematic evaluation of HCW stigmatization during the COVID-19 pandemic. METHODS Non-HCW adults from the United States and Canada (N = 3551) completed an online survey, including measures of HCW stigmatization, COVID Stress Syndrome, and avoidance. RESULTS Over a quarter of respondents believed that HCWs should have severe restrictions placed on their freedoms, such as being kept in isolation from their communities and their families. Over a third of respondents avoided HCWs for fear of infection. Participation in altruistic support of HCWs (i.e., evening clapping and cheering) was unrelated to stigmatizing attitudes. Demographic variables had small or trivial correlations with HCW stigmatization. People who stigmatized HCWs also tended to avoid other people, avoid drug stores and supermarkets, and avoid leaving their homes. Factor analysis suggested that HCW stigmatization is linked to the COVID Stress Syndrome. CONCLUSION Fear and avoidance of HCWs is a widespread, under-recognized problem during the COVID-19 pandemic. It is associated with the COVID Stress Syndrome and might be reduced by interventions targeting this syndrome.
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Affiliation(s)
- Steven Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
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45
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Elhai JD, Yang H, McKay D, Asmundson GJG. COVID-19 anxiety symptoms associated with problematic smartphone use severity in Chinese adults. J Affect Disord 2020; 274:576-582. [PMID: 32663990 PMCID: PMC7251360 DOI: 10.1016/j.jad.2020.05.080] [Citation(s) in RCA: 163] [Impact Index Per Article: 40.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/13/2020] [Accepted: 05/15/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND COVID-19 is fast-spreading and potentially fatal, introducing home quarantine, social distancing, and increased internet usage globally. We investigated COVID-19 anxiety, general anxiety and depression symptoms, and their impact on problematic smartphone use (PSU) severity METHODS: Participants were 908 residents of a large Eastern Chinese city, surveyed from late-February to mid-March, 2020. We administered online measures including the Depression Anxiety Stress Scale-21, Smartphone Addiction Scale-Short Version, and items querying COVID-19-related news exposure and threat of death. Additionally, participants rated anxiety using the Generalized Anxiety Disorder Scale-7 with reference to COVID-19. RESULTS COVID-19 anxiety correlated with severity of PSU, depression and anxiety. Using established cut-off scores, 12% of participants were identified with at least moderate depression, and 24% with moderate anxiety. Using structural equation modeling, COVID-19 anxiety related to PSU severity, mediating relations between general anxiety and PSU severity. However, controlling PSU for general anxiety and depression severity, COVID-19 anxiety no longer predicted PSU severity. LIMITATIONS Limitations include the cross-sectional research design and reliance on data from only one country. CONCLUSIONS Results are discussed in context of the I-PACE model of excessive internet use. While COVID-19 anxiety is likely a global anxiety-provoking event, other everyday worries and anxiety are additionally clinically important in driving excessive internet use.
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Affiliation(s)
- Jon D Elhai
- Academy of Psychology and Behavior, Tianjin Normal University, No. 57-1 Wujiayao Street, Hexi District, Tianjin 300074, China; Department of Psychology, University of Toledo, 2801 West Bancroft Street, Toledo, OH 43606, USA; Department of Psychiatry, University of Toledo, 3000 Arlington Avenue, Toledo, OH 43614, USA
| | - Haibo Yang
- Academy of Psychology and Behavior, Tianjin Normal University, No. 57-1 Wujiayao Street, Hexi District, Tianjin 300074, China.
| | - Dean McKay
- Department of Psychology, Fordham University, 441 East Fordham Road, Bronx, NY 10458, USA
| | - Gordon J G Asmundson
- Anxiety and Illness Behaviors Laboratory, Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK S4S0A2, Canada
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46
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Parkerson HA, Sareen J, Asmundson GJG. Breaking the cycle of smoking and pain: do pain-related anxiety and pain reduction expectancies sabotage attempts to quit smoking and can smoking cessation improve pain and pain-related disability outcomes? Cogn Behav Ther 2020; 50:154-171. [PMID: 32852241 DOI: 10.1080/16506073.2020.1798498] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Contemporary models of smoking and pain suggest a reciprocal and self-perpetuating cycle, wherein smoking reduces pain in the short term but indirectly exacerbates pain in the long term. In a sample of participants engaged in an active smoking-cessation attempt, this investigation assessed a) whether specific smoking risk factors (i.e., smoking expectancies for pain reduction, pain-related anxiety) acted as barriers to cessation, and b) whether breaking the smoking-pain cycle through successful smoking abstinence impacted pain and pain-related disability outcomes for participants with pain. Participants comprised 168 smokers (44.4% with pain) who engaged in an online smoking-cessation program. Pain-related anxiety, but not smoking expectancies, accounted for a significant proportion of variance of smoking dependence from pre- to post-intervention. Results suggest that pain-related anxiety is a risk factor for maintained smoking dependence for all smokers regardless of pain status. Participants with pain who successfully quit smoking experienced statistically and clinically meaningful decreases in pain and pain-related disability from pre- to post-intervention. Exploratory post hoc analyses indicated that individuals who signed-up for the smoking cessation program but failed to begin a quit-attempt had significantly higher pain disability, depression, and anxiety scores than participants who commenced a quit-attempt. Theoretical and practical implications are discussed.
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Affiliation(s)
| | - Jitender Sareen
- Department of Psychiatry, University of Manitoba , Winnipeg, Canada
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47
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Asmundson GJG, Paluszek MM, Landry CA, Rachor GS, McKay D, Taylor S. Do pre-existing anxiety-related and mood disorders differentially impact COVID-19 stress responses and coping? J Anxiety Disord 2020; 74:102271. [PMID: 32673930 PMCID: PMC7342169 DOI: 10.1016/j.janxdis.2020.102271] [Citation(s) in RCA: 268] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 06/29/2020] [Accepted: 06/30/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND People with pre-existing mental health conditions may be more susceptible to stressors associated with COVID-19 relative to the general population; however, no studies have assessed whether susceptibility differs between classes of mental health disorders. We assessed COVID-19-related stress, self-isolation stressors, and coping in those with a primary anxiety-related disorder diagnosis, a primary mood disorder diagnosis, and no mental health disorder. METHODS Adults from a population-representative sample from the United States and Canada who reported current (past year) anxiety-related (n = 700) or mood (n = 368) disorders were compared to a random sample of respondents who did not report a current mental health diagnosis (n = 500) on COVID-19-related stress, self-isolation stress, and coping. RESULTS The anxiety-related disorders group exhibited higher COVID Stress Scales total scores and higher scores on its fears about danger and contamination, socioeconomic consequences, xenophobia, and traumatic stress symptoms scales than the other groups. The mood disorders group had higher scores on the traumatic stress symptoms and socioeconomic consequences scales than those with no current mental disorder. Those with current anxiety-related or mood disorders were more likely to voluntarily self-isolate and were more likely to report greater self-isolation stressors and distress than those without a mental health disorder. Yet, there were no major differences in perceived effectiveness of coping strategies across groups. CONCLUSION People with anxiety-related or mood disorders were more negatively affected by COVID-19 compared to those with no mental health disorder; however, adding to psychological burden, those with anxiety-related disorders reported greater fears about danger and contamination, socioeconomic consequences, xenophobia, and traumatic stress symptoms than the other groups. These findings suggest the need for tailoring COVID-19-related mental health interventions to meet the specific needs of people with pre-existing mental health conditions.
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Affiliation(s)
| | | | | | | | - Dean McKay
- Department of Psychology, Fordham University, New York, USA
| | - Steven Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
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48
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Afifi TO, Taillieu T, Salmon S, Davila IG, Stewart-Tufescu A, Fortier J, Struck S, Asmundson GJG, Sareen J, MacMillan HL. Adverse childhood experiences (ACEs), peer victimization, and substance use among adolescents. Child Abuse Negl 2020; 106:104504. [PMID: 32402816 DOI: 10.1016/j.chiabu.2020.104504] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 02/12/2020] [Accepted: 04/09/2020] [Indexed: 05/15/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are common and related to substance use problems in adulthood. Less is known about these relationships in adolescence and if experiencing ACEs in addition to peer victimization (or bullying) would have an interaction or cumulative effect on the odds of adolescent substance use. METHOD Data were used from the Well-Being and Experiences Study (The WE Study), a cross-sectional survey of adolescents aged 14-17 years (n = 1002) in Manitoba, Canada collected between July 2017 and October 2018. Statistical methods included descriptive statistics and logistic regression models. RESULTS The prevalence of experiencing any of the 12 ACEs was 75.1 %. The prevalence of any peer victimization (monthly or more often) was 24.1 %. All individual ACEs were associated with increased odds of substance use. No significant interaction effects between ACEs and peer victimization on substance use were found. Significant cumulative effects were found, indicating that experiencing both ACEs and peer victimization, compared with experiencing ACEs only, significantly increased the odds of substance use among adolescents. CONCLUSION The odds of substance use becomes significantly greater if the adolescent with a history of ACEs also experiences peer victimization. Further research aimed at effective prevention of ACEs, peer victimization, and substance use is needed.
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Affiliation(s)
- Tracie O Afifi
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, Canada.
| | - Tamara Taillieu
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Samantha Salmon
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Isabel Garcés Davila
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Ashley Stewart-Tufescu
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, Canada.
| | - Janique Fortier
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Shannon Struck
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Canada.
| | - Gordon J G Asmundson
- Department of Psychology and Anxiety and Illness Behaviours Lab, University of Regina, Regina, Canada.
| | - Jitender Sareen
- Department of Psychiatry, University of Manitoba, Winnipeg, Manitoba, Canada.
| | - Harriet L MacMillan
- Department of Psychiatry and Behavioural Neurosciences, and of Pediatrics, Offord Centre for Child Studies, McMaster University, Hamilton, Ontario, Canada.
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Taylor S, Landry CA, Paluszek MM, Fergus TA, McKay D, Asmundson GJG. COVID stress syndrome: Concept, structure, and correlates. Depress Anxiety 2020; 37:706-714. [PMID: 32627255 PMCID: PMC7362150 DOI: 10.1002/da.23071] [Citation(s) in RCA: 362] [Impact Index Per Article: 90.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/11/2020] [Accepted: 06/13/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Research shows that the COVID Stress Scales have a robust multifactorial structure, representing five correlated facets of COVID-19-related distress: (a) Fear of the dangerousness of COVID-19, which includes fear of coming into contact with fomites potentially contaminated with SARSCoV2, (b) worry about socioeconomic costs of COVID-19 (e.g., worry about personal finances and disruption in the supply chain), (c) xenophobic fears that foreigners are spreading SARSCoV2, (d) traumatic stress symptoms associated with direct or vicarious traumatic exposure to COVID-19 (nightmares, intrusive thoughts, or images related to COVID-19), and (e) COVID-19-related compulsive checking and reassurance seeking. These factors cohere to form a COVID stress syndrome, which we sought to further delineate in the present study. METHODS A population-representative sample of 6,854 American and Canadian adults completed a self-report survey comprising questions about current mental health and COVID-19-related experiences, distress, and coping. RESULTS Network analysis revealed that worry about the dangerousness of COVID-19 is the central feature of the syndrome. Latent class analysis indicated that the syndrome is quasi-dimensional, comprising five classes differing in syndrome severity. Sixteen percent of participants were in the most severe class and possibly needing mental health services. Syndrome severity was correlated with preexisting psychopathology and with excessive COVID-19-related avoidance, panic buying, and coping difficulties during self-isolation. CONCLUSION The findings provide new information about the structure and correlates of COVID stress syndrome. Further research is needed to determine whether the syndrome will abate once the pandemic has passed or whether, for some individuals, it becomes a chronic condition.
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Affiliation(s)
- Steven Taylor
- Department of PsychiatryUniversity of British ColumbiaVancouverBritish ColumbiaCanada
| | | | | | - Thomas A. Fergus
- Department of Psychology and NeuroscienceBaylor UniversityWacoTexas
| | - Dean McKay
- Department of PsychologyFordham UniversityNew YorkNew York
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50
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Affiliation(s)
- Dean McKay
- Department of Psychology, Fordham University, United States.
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