COVID-19 worry, mental health indicators, and preparedness for future care needs across the adult lifespan

OBJECTIVE

The COVID-19 pandemic has been a source of worry for many, but older adults have been identified as more vulnerable to serious cases and may therefore feel more concerned about the virus. We assessed whether COVID-19 worry was related to indicators of mental health and preparedness for future care, in an adult lifespan sample.

METHOD

An online study (n = 485; age 18-82, M = 49.31, SD = 15.39) included measures of COVID-19 worry, depression, general anxiety, health anxiety, hostile and benevolent ageism, preparedness for future care, and demographic information.

RESULTS

Age and living alone were positively associated with greater COVID-19 worry, as were health anxiety, general anxiety, benevolent ageism, and preparedness for future care needs via gathering information. A significant interaction indicated that among individuals reporting lower health anxiety, greater preference for gathering information was positively associated with greater COVID-19 worry; however, for individuals having high health anxiety, gathering information about future care was not related to COVID-19 worry, as their COVID-19 worry levels were moderately high.

CONCLUSION

Older age was associated with greater COVID-19 worry, perhaps in response to the much publicized greater risk for negative outcomes in this population. In spite of this specific concern, indicators of older adults' continued mental health emerged. Preparedness for future care is also highlighted, as well as clinical implications.

A trouble shared is a trouble halved: The role of family identification and identification with humankind in well-being during the COVID-19 pandemic

The COVID‐19 pandemic has triggered health‐related anxiety in ways that undermine peoples’ mental and physical health. Contextual factors such as living in a high‐risk area might further increase the risk of health deterioration. Based on the Social Identity Approach, we argue that social identities can not only be local that are characterized by social interactions, but also be global that are characterized by a symbolic sense of togetherness and that both of these can be a basis for health. In line with these ideas, we tested how identification with one’s family and with humankind relates to stress and physical symptoms while experiencing health‐related anxiety and being exposed to contextual risk factors. We tested our assumptions in a representative sample (N = 974) two‐wave survey study with a 4‐week time lag. The results show that anxiety at Time 1 was positively related to stress and physical symptoms at Time 2. Feeling exposed to risk factors related to lower physical health, but was unrelated to stress. Family identification and identification with humankind were both negatively associated with subsequent stress and family identification was negatively associated with subsequent physical symptoms. These findings suggest that for social identities to be beneficial for mental health, they can be embodied as well as symbolic.

An Examination of Factors Contributing to the Acceptance of Online Health Misinformation

This study examined factors including health-related anxiety, preexisting misinformation beliefs, and repeated exposure contributing to individuals’ acceptance of health misinformation. Through a large-scale online survey, this study found that health-related anxiety was positively associated with health misinformation acceptance. Preexisting misinformation beliefs, as well as repeated exposure to health misinformation, were both positively associated with health misinformation acceptance. The results also showed that demographic variables were significantly associated with health misinformation acceptance. In general, females accepted more health misinformation compared to males. Participants’ age was negatively associated with health misinformation acceptance. Participants’ education level and income were both negatively associated with their acceptance of health misinformation.

Health anxiety among medical students: A comparison between preclinical and clinical years of training

OBJECTIVE

It is common among medical students to falsely attribute bodily sensations/symptoms and holds a belief of having a medical illness with varying level of conviction. We studied and compared this condition known as "medical student syndrome", a type of hypochondriasis, between preclinical and clinical years students.

METHODOLOGY

This research was a descriptive study where a total of 100 students were approached and were asked to complete a short form of health anxiety inventory (SHAI) which has Cronbach's alpha 0.855. No personal identifiers were included in the study questionnaires. All statistical analyses were performed using the SPSS statistical software package (IBM SPSS Statistics Version 23, SPSS Inc., Chicago, IL, USA).

RESULTS

The response rate among participants was 88% (42 from preclinical and 48 from clinical years of training). Health-related anxiety (SHAI main section score ≥ 18) was found in 14.77% of students with a higher proportion in preclinical than clinical, 16.66% and 13.04%, respectively. The difference was not significant between the two groups (χ ² = 0.429 [1], P = 0.766). Students having medical professional in family had lower rate of health-related anxiety, χ ² (1, n = 88) = 0.228, P = 0.633. The association between family or personal history of psychiatry or medical illness was not significant with SHAI scores. No relation was noted between current health anxiety (SHAI score) and the number of visits to the doctor per year before entering the medical course (χ = 0.174, P = 0.112).

CONCLUSION

Every seventh medical student was found to have health-related anxiety. It was not affected by personal and family history of either psychiatric or medical illness.

Short-term effect of a negative colonoscopy in patients with functional constipation

The yield of colonoscopy for neoplasia among patients with chronic constipation is very low. However, a negative colonoscopy may benefit these patients by decreasing anxiety and thereby alleviating constipation symptoms. We performed a prospective study to characterize the effect of a negative colonoscopy in patients with functional constipation. Seventy-five patients with chronic constipation were enrolled, and 69 patients were diagnosed with functional constipation through the Rome III criteria. After excluding patients whose constipation symptoms were affected by medications (e.g., laxatives, prokinetics), 45 patients were included in the study. Among the 45 patients, the average health-related anxiety score decreased from 21.0 to 15.6 at 1 week after colonoscopy (P < 0.01). Sustained improvement was observed in anxiety scores at 1 month (14.0), 2 months (12.4), and 6 months (11.2). Mean constipation symptom score was also decreased at 1 week (8.7), 1 month (8.0), 2 months (7.6), and 6 months (6.8) compared with the precolonoscopy period (11.5; P < 0.01). These results suggest that a negative colonoscopy in patients with functional constipation is associated with a decline in health-related anxiety and constipation symptom scores. (Registration number: ChiCTR-OOh-16008488).

Testing a biopsychosocial model of the basic birth beliefs

BACKGROUND

Women perceive what birth is even before they are pregnant for the first time. Part of this conceptualization is the basic belief about birth as a medical and natural process. These two separate beliefs are pivotal in the decision-making process about labor and birth. Adapting Engel's biopsychosocial framework, we explored the importance of a wide range of factors which may contribute to these beliefs among first-time mothers.

METHOD

This observational study included 413 primiparae ≥24 weeks' gestation, recruited in medical centers and in natural birth communities in Israel. The women completed a questionnaire which included the Birth Beliefs Scale and a variety of biopsychosocial characteristics such as obstetric history, birth environment, optimism, health-related anxiety, and maternal expectations.

RESULTS

Psychological dispositions were more related to the birth beliefs than the social or biomedical factors. Sociodemographic characteristics and birth environment were only marginally related to the birth beliefs. The basic belief that birth is a natural process was positively related to optimism and to conceiving spontaneously. Beliefs that birth is a medical process were related to pessimism, health-related anxiety, and to expectations that an infant's behavior reflects mothering. Expectations about motherhood as being naturally fulfilling were positively related to both beliefs.

CONCLUSION

Psychological factors seem to be most influential in the conceptualization of the beliefs. It is important to recognize how women interpret the messages they receive about birth which, together with their obstetric experience, shape their beliefs. Future studies are recommended to understand the evolution of these beliefs, especially within diverse cultures.

Health-Related Anxiety and Hypochondriacal Concerns in Medical Students: A Cross-Sectional Study From Pakistan

Phenomenon: Transient health-related anxiety/hypochondriacal concerns in medical students are well documented. The literature suggests that after studying a particular disease, medical students are likely to consider any symptoms earlier regarded as normal to be signs of the disease they are studying. The aim of this study was to investigate the prevalence of these phenomena and their cognitive and distress aspects among medicals students in Karachi, Pakistan.

APPROACH

This was an analytical, cross-sectional study. Self-administered questionnaires comprising demographic details, the Short Health Anxiety Inventory, Medical Students' Disease (MSD) Perception Scale, and MSD Distress Scale were distributed to 1st- through 5th-year medical students.

FINDINGS

In total, 513 medical students (66% female) participated. Their mean age was 21 ± 1.6 years. Three hundred seventy-five students (73%) reported having visited a doctor at least once in the past 6 months. Fifty students (9.9%) admitted to having addictions. The overall prevalence of significant hypochondriacal concerns was 11.9% (61 students). The presence of addiction was associated with a greater likelihood of developing significant health-related anxiety (odds ratio = 3.82, p = .003), 95% confidence interval [1.51, 7.11]. Age, gender, medical school, year of medical school, and visits to the doctor in the previous 6 months were not associated with greater likelihood of developing significant health-related anxiety. Second-year medical students experienced a significantly greater degree of worry (MSD-Distress scale) than 5th-year students (M score = 12.6 ± 4.6 vs. 10.7 ± 4.4, p = .04). Insights: The prevalence of substantial hypochondriacal concerns in medical students in Pakistan was low in comparison to similar studies published in literature. Student health physicians should be aware of the true prevalence of hypochondriacal concerns and behavior and not dismiss legitimate complaints. Educational sessions to counteract this phenomenon can be incorporated into the curriculum of undergraduate medicine. By defining heightened awareness of symptoms as a normal process, different coping techniques can be discussed to help medical students reduce their level of stress.

Cyberchondria: emerging themes for children's nurses in the internet age

In many countries, anxious adults and young people are increasingly searching the web for information about their health or ill health and that of their family. This activity often increases their anxiety and confusion. Cyberchondria refers to the resulting match with real or imagined symptoms, and may lead to unnecessary medical consultation. Advantages of online searching include knowledge, empowerment, autonomy and self-responsibility. Disadvantages are increased fears and possible misinformation and misdiagnosis and inappropriate self-treatment. There is also loss of placebo-style trust in, and concordance with, professionals, who may experience reduced confidence, authority and effectiveness. However, a new and more collaborative style of consultation has developed, with the practitioner confirming or refuting information rather than protecting it.