The Nature and Treatment of Pandemic-Related Psychological Distress

The Angry Echo Chamber: A Study of Extremist and Emotional Language Changes in Incel Communities Over Time

Involuntary celibates, or incels, are part of a growing online subculture. Incels are men who are unable to engage in a sexual relationship with a woman and who experience significant distress and anger as a result. In recent years, high-profile incidents of violence perpetrated by incels or those who share incel ideology have increased research attention. Incels communicate online and share several characteristics with other online extremist groups. While only a fraction of incels engage in such violence, a broader spectrum of violence should be considered, including online harassment or general violence against women. This study sought to examine how ongoing engagement on an online incel forum affects changes in incel comments in terms of expressed anger and sadness and use of incel violent extremist language. We collected comments made on an incel forum over a 3-month period. We then identified prolific users and included their comments in our analysis. To assess how their language changed, we used a text-processing program (LIWC: Linguistic Inquiry and Word Count) to assess the extent to which anger, sadness, and incel violent extremist language were expressed in the comments. Our findings indicated that incels express more anger in their comments than users on other platforms such as Reddit, Facebook, and Twitter. However, they did not express greater sadness. Further, we found that incels are already quite angry and sad when they join the forum, and they already use a fair amount of incel vocabulary. Initially, these aspects of their language increase, but they flatten over time. This pattern suggests that introduction to and embracing of incel ideology occurs elsewhere on the Internet, and prior to people joining an incel forum. Implications in terms of prevention of online radicalization and future directions are discussed.

Assessing the need for pre-mental health competencies in undergraduate education: insights from graduate faculty surveys

Introduction

Despite the value of clinical competencies for masters- and doctoral-level practitioners as well as the tremendous variability in preparedness for graduate school and at graduation from graduate school, there are no competency standards for students pursuing mental healthcare careers prior to graduate study. This study aimed to identify potential pre-mental health competency standards for undergraduates pursuing mental healthcare careers.

Methods

Faculty at masters and doctoral programs in a range of mental healthcare fields were asked to rate their expectations of entry-level competence and the perceived entry-level competence of their first-year, bachelor-level graduate students on 42 sub-competencies derived from the APA's Competency Benchmarks in Professional Psychology.

Results

Faculty of both masters (N = 320) and doctoral (N = 220) programs reported high expectations of first-year graduate students for 11 competency categories (professional values/attitudes; relationships; management-administration; interdisciplinary systems; individual/cultural diversity; advocacy; scientific knowledge and methods; reflective practice, self-assessment, and self-care; ethical standards and policy; supervision, and research/evaluation) and 25 sub-competencies. Faculty in masters programs rated students as not meeting their expectations in 28 sub-competencies, while faculty in doctoral programs rated students as not meeting their expectations in 17 sub-competencies. Faculty recommended internships as well as improvement in writing, counseling skills, professional behavior, diversity, equity, and inclusion, cultural competence and humility, research methods, reading research, connecting research to practice, and education about the different mental healthcare professions.

Discussion

Our findings suggest that students would benefit from intentional training in multiple pre-mental health competency areas at the undergraduate level to facilitate graduate-level training in mental healthcare and to better prepare our future clinicians.

Fear, Stress, Susceptibility, and Problematic Social Media Use Explain Motivation for COVID-19 Preventive Behaviors Among Patients With Stroke and Their Caregivers

The COVID-19 pandemic presented significant challenges for individuals who experienced stroke and their caregivers. It is essential to understand the factors affecting preventive behavior in these populations. Therefore, the present study examined the factors that influenced COVID-19 preventive behavior and motivation for COVID-19 vaccine uptake among patients with stroke and their caregivers. A cross-sectional study comprising 191 participants (81 patients with stroke and 110 caregivers) was carried out. Participants completed a survey assessing fear of COVID-19, stress, perceived susceptibility, problematic social media use, preventive behaviors, and motivation for vaccine uptake. Statistical analyses included descriptive statistics, Pearson correlations, and multiple linear regressions. Motivation for COVID-19 vaccine uptake was significantly positively correlated with problematic social media use (r = 0.225, P = .002), perceived susceptibility (r = 0.197, P = .008), and fear of COVID-19 (r = 0.179, P = .015), but negatively correlated with stress (r = -0.189, P = .010). Caregivers, compared to patients, showed a lower level of preventive behavior (standardized coefficient = -0.23, P = .017). Furthermore, higher levels of fear were associated with increased preventive behavior (standardized coefficient = 0.22, P = .006), while greater stress correlated with lower preventive behavior (standardized coefficient = -0.38, P < .001). Among patients with stroke and their caregivers, motivation of COVID-19 vaccine uptake and preventive behaviors were influenced by factors such as fear, perceived susceptibility, social media use, and stress. By using strategies such as targeted education, support, and communication campaigns, healthcare providers and policymakers may be able to enhance the well-being of patients with stroke and their caregivers during future pandemics.

Psychological Distress Related to the COVID-19 Pandemic: The Protective Role of Hope

The COVID-19 outbreak and the worldwide lockdown measures had an impact on the global mental health and psychological well-being of the general population. Several studies attempted to investigate the protective and risk factors for psychological distress related to the pandemic. However, to date, little is known about the role of hope in this context. The aim of this study was to determine the relationship between hope and psychological distress related to the COVID-19 outbreak in the general population. The sample consisted of 504 Pakistani people who completed cross-sectionally the COVID-19 Peritraumatic Distress Index (CPDI) and the Adult Hope Scale (AHS). Bivariate Pearson correlation analysis was run to measure the relationship between hope and psychological distress; hierarchical regression analysis was run to investigate the association between demographics and hope with psychological distress. Higher levels of hope predicted lower levels of psychological distress. Being female, being older, lower level of education, urban residence, being married and living in nuclear family systems were associated with higher levels of psychological distress. The study highlights the protective role of hope on psychological distress related to COVID-19, contributing to knowledge on factors promoting positive mental health during emergency times and providing useful information for implementing effective public health policies and programmes.

Depression, Anxiety, Stress, and Coping Mechanism During Covid-19 Pandemic

"The current pandemic due to the COVID-19 virus has caught the entire world by surprise, on all aspects of life, from economic and work-related ones to education and online communication. Psychological health issues are not an exception to this rule, as people have been forced to either stay indoors during lockdown periods, or completely change their habits for longer periods of time. In this study, we investigated the effects of the pandemic on a sample of 241 adults, on several concepts. The study is relevant for understanding the factors that can contribute to maintaining a balance in life, especially in times of hardship. Keywords: anxiety, coping, Covid-19, depression, stress. "

The impact of the COVID-19 pandemic on individuals with generalized anxiety disorder: assessing COVID-19 media source exposure and behaviour changes

Background

The COVID-19 pandemic that has resulted in social distancing, lockdowns, and increase in media posts has taken a toll on the mental health of many people especially those living with Generalized Anxiety Disorder (GAD). The main objective of this study is to understand whether the source of information people use to receive information about COVID-19 and increase or decrease in personal weekly habits during the pandemic were associated with severity of GAD. 

Methods

This study was a cross sectional design and was based on data from Canada. The Canadian Perspective Survey Series (CPSS) 4, 2020: Information Sourced Consulted During the Pandemic was used for the study. The outcome variable was severity of GAD. Multivariate logistic regression was carried out using STATA IC 13.

Results

Severity of GAD was significantly associated with being a female, the type of information source used to find out about COVID-19 and change in weekly habits (consuming alcohol, consuming cannabis spending time on the internet and eating junk foods or sweets).

Conclusion

The results indicate that getting information from credible sources about the pandemic, staying connected with family and friends, seeking virtual mental health services, and learning positive coping strategies can help reduce the severity of GAD.

Intolerance of Uncertainty and Health-Related Anxiety in Youth amid the COVID-19 Pandemic: Understanding and Weathering the Continuing Storm

The COVID-19 pandemic is a public health crisis that continues to impact individuals worldwide. While children may be less susceptible to severe medical complications, they are nonetheless vulnerable to stress and anxiety associated with the pandemic. However, current understanding of psychological functioning and potential strategies to mitigate distress amid a pandemic is naturally limited. Consequently, this article is an attempt to fill that gap. Existing literature on pandemics, health-related anxieties, intolerance of uncertainty, and psychopathological sequelae is summarized within the context of the COVID-19 outbreak. Conclusions from the empirical data and emerging theoretical models are reviewed and synthesized. Finally, several potentially engaging and effective examples of developmentally appropriate interventions targeting intolerance of uncertainty and health-related anxieties in pediatric patients during the peri- and post-pandemic periods are described.

Cognitive training using a mobile app as a coping tool against COVID-19 distress: A crossover randomized controlled trial

BACKGROUND

The COVID-19 pandemic has been suggested to constitute a broad base stressor with severe mental health consequences. mHealth applications are accessible self-help tools that can be used to reduce psychological distress during the pandemic. This randomized controlled trial evaluated the effects of mobile-based cognitive training exercises on COVID-19 related distress and maladaptive cognitions.

METHODS

Following initial screening (n = 924), participants scoring 1 standard deviations above the mean of the COVID-19 Distress Scale were randomized into two groups. Participants in the immediate-app group (iApp; n = 25) started using the application at baseline (T0) for 12 days (from T0 to T1). Participants in the delayed-app group (dApp; n = 22) started using the mobile application at T1 (crossover) and used it for the following 12 days (T1 to T2).

RESULTS

Intention to treat analyses indicated that the iApp group exhibited lower COVID-19 distress, lower depression, fewer intolerance of uncertainty and obsessive beliefs than the dApp group at T1. In addition, using the app for 12 consecutive days was associated with large effect-size reductions (Cohen's d ranging from 0.81 to 2.35) in COVID-19 distress and related maladaptive cognitions in the iApp group (from T0 to T1) and the dApp group (from T1 to T2). Moreover, these reductions were maintained at the follow-up.

LIMITATIONS

This study was a crossover trial with a relatively limited sample size and mainly female participants.

CONCLUSION

Our findings underscore the usefulness of brief, low-intensity, portable interventions in alleviating the negative effects of the pandemic on mental health.

Latent class analysis of health, social, and behavioral profiles associated with psychological distress among pregnant and postpartum women during the COVID-19 pandemic in the United States

BACKGROUND

There is a growing body of literature documenting negative mental health impacts from the COVID-19 pandemic. The purpose of this study was to identify risk and protective factors associated with mental health and well-being among pregnant and postpartum women during the pandemic.

METHODS

This was a cross-sectional, anonymous online survey study distributed to pregnant and postpartum (within 6 months) women identified through electronic health records from two large healthcare systems in the Northeastern and Midwestern United States. Survey questions explored perinatal and postpartum experiences related to the pandemic, including social support, coping, and health care needs and access. Latent class analysis was performed to identify classes among 13 distinct health, social, and behavioral variables. Outcomes of depression, anxiety, and stress were examined using propensity-weighted regression modeling.

RESULTS

Fit indices demonstrated a three-class solution as the best fitting model. Respondents (N = 616) from both regions comprised three classes, which significantly differed on sleep- and exercise-related health, social behaviors, and mental health: Higher Psychological Distress (31.8%), Moderate Psychological Distress (49.8%), and Lower Psychological Distress (18.4%). The largest discriminatory issue was support from one's social network. Significant differences in depression, anxiety, and stress severity scores were observed across these three classes. Reported need for mental health services was greater than reported access.

CONCLUSIONS

Mental health outcomes were largely predicted by the lack or presence of social support, which can inform public health decisions and measures to buffer the psychological impact of ongoing waves of the COVID-19 pandemic on pregnant and postpartum women. Targeted early intervention among those in higher distress categories may help improve maternal and child health.

Household Mealtimes During the 2020 COVID-19 Lockdown in Aotearoa New Zealand: The Influence of Household Type and Psychological Distress

COVID-19 lockdown meant disruptions to daily routines for households in Aotearoa New Zealand. The research presented here investigates how mealtimes changed for people living in New Zealand during the first COVID-19 lockdown in mid-2020 and sought to determine if household composition type and psychological distress impacted the frequency of engaging in several mealtime behaviors. The COVID Kai Survey collected data using an anonymous, online survey and asked questions on sociodemographic characteristics including household composition, frequency of engaging in different mealtime behaviors before and during lockdown, and psychological distress, which was measured using the Kessler 6 screening tool. The findings of this study shows an increase in the perceived importance of mealtimes (n = 807, 26.9% before lockdown, n = 1,154, 38.5% during lockdown) and an increase in the proportion of the survey respondents who stated that they frequently ate meals at the dinner table (n = 1,343, 44.8% before lockdown, n = 1,481, 49.4% during lockdown). There was a decrease, across all household composition types, in the proportion of respondents who ate out frequently at a restaurant or café (n = 878, 29.3% before lockdown, n = 5, 0.2% during lockdown, P < 0.001). The use of meal kits, e-dining, and eating meals in front of screens is also presented and discussed. All results are discussed with reference to Aotearoa New Zealand’s stringent lockdown restrictions. Respondents who experienced psychological distress during lockdown were 1.47 times more likely to consider mealtimes an important part of their day and respondents living in households with one adult and at least one child who also experienced psychological distress were 5.95 times more likely to eat dinner at the dinner table than those who did not report psychological distress. Findings of this study further the understanding of the wider societal impact of COVID-19 lockdown on everyday life.

Mental health provider perspectives of the COVID-19 pandemic impact on service delivery: a focus on challenges in remote engagement, suicide risk assessment, and treatment of psychosis

Background

The COVID-19 pandemic has been impacting the need, utilization, and delivery of mental health services with greater challenges being faced by clients and providers. With many clients facing reduced access to services and social isolation, a focus on suicide risk assessment and prevention is critical. Concern is particularly increased for clients with schizophrenia spectrum disorders given data show suicide rates are disproportionately high for those with psychosis in comparison to the general population. Provider perspectives of challenges in service delivery are needed to inform efforts to improve access, feasibility, and quality of mental health care throughout the evolving pandemic. This study explored mental health provider perspectives of client challenges in service utilization and provider challenges in service delivery, including remote engagement, suicide risk assessment, and treatment of psychosis.

Methods

Data were collected from social work mental health providers (n = 12) in United States community mental health setting. Providers consented to participate and responded to questions about service delivery experiences in late 2020 and in relation to COVID-19. Demographic and practice-related provider data were explored descriptively using SPSS and qualitative data using open coding and grounded theory methods in Dedoose.

Results

Among the 9 providers who engaged in remote service delivery, 7 (77.8%) experienced challenges in remote engagement with clients and 8 (88.9%) experienced challenges in treatment of psychosis. Among the 7 providers who engaged in remote suicide assessment, 4(57%) experienced challenges. Qualitative themes emerged including logistic (e.g., technology access and use), engagement (e.g., virtual rapport-building and limited remote services), and clinical (e.g., difficulty assessing suicide risk, internal stimuli, abnormal involuntary movement, and affect) challenges in service delivery.

Conclusions

Provider perspectives are essential to inform efforts to build resources and problem-solve challenges and barriers that both providers and clients face throughout various shifts in mental health service delivery. Findings emphasize the need to troubleshoot client access to technology, bolster support for providers to prevent burnout, and greater provider training to improve skills in remote engagement, assessment, and treatment, particularly in relation to psychosis and suicide prevention. Study implications are not only critical for the evolving COVID-19 pandemic, but also in preparation for ongoing shifts in service delivery as technology evolves.

The Upside of Negative Emotions: How Do Older Adults From Different Cultures Challenge Their Self-Growth During the COVID-19 Pandemic?

Background and Objective

The outbreak of Coronavirus Disease 2019 (COVID-19) has raised increased challenges for older adults' personal growth in diverse cultural settings. The aim of this study was to analyze negative emotions and their role on older adults' self-growth in Mexico, Italy, Portugal, and Spain, during the COVID-19 pandemic. For this purpose, a cross-national qualitative research was carried out.

Methods

Data were collected from 338 community-dwelling participants aged 65 years and older, using a semi-structured interview protocol. Older adults were asked about negative emotions that significantly contribute to their self-growth during the COVID-19 pandemic. Content analysis was used to identify key themes.

Results

Seven main negative emotions (fear, sadness, anger, grief, boredom, loneliness, and shame) significantly contributed to seven themes of self-growth, across the samples: sharing difficult experiences with others, supportive partner, spiritual practices, engagement with life, generativity, volunteering activities, and intimacy and sexual satisfaction. Sharing difficult experiences with others was most pertinent to Mexican (13.9%) and to Italian (3.0%) participants, and a supportive partner to Portuguese (12.1%), and to Spanish participants (6.5%).

Conclusion

The findings of this study indicate that negative emotions during the COVID-19 pandemic contributed to their older adults' self-growth. This study highlighted the cultural diversity of experiences during the pandemics and underlined the upside of negative emotions and its relation to older adults' self-growth during this period.

How the home features in young adults' representations of loneliness: The impact of COVID-19

Loneliness is a rapidly growing problem globally and has attracted a great deal of attention in light of the COVID-19 pandemic. Young adults, and in particular, those residing in deprived areas are currently the loneliest group in the United Kingdom. Utilizing a novel-free association technique, young adults' experiences of loneliness were explored both prior to (n = 48) and during (n = 35) the COVID-19 pandemic. Drawing on social representations theory, a thematic analysis revealed that many young adults associated the experience of loneliness with their homes. Therefore, this comparative study aims to investigate how the home features in young adults' representations of loneliness, prior to and during the COVID-19 pandemic using a systematic qualitative methodology. Three salient themes emerged from the data in both periods: 'The Lonely Home,' 'The Socially Connected Home' and 'The Safe, Peaceful, Authentic Home'. 'The Lonely Home' and 'The Socially Connected Home' emerged as a dialogical antimony. Representations of home were similar across the two periods; however, there were some notable differences. In particular, the themes 'The Socially Connected Home' and 'The Safe, Peaceful, Authentic Home' were less frequently mentioned by the during-COVID-19 sample where the 'The Lonely Home' was more frequently mentioned by the during-COVID-19 sample. Overall, discussion of the home was more negatively valenced in the during-COVID-19 sample compared to the pre-COVID-19 sample. This comparative, exploratory study alerts us to the nature of the role that home plays in exacerbating or ameliorating loneliness both prior to and during the COVID-19 pandemic.

A Mixed-Methods and Prospective Approach to Understanding Coping Behaviors, Depression, Hopelessness, and Acute Stress in a U.S. Convenience Sample During the COVID-19 Pandemic

The COVID-19 pandemic has led to increases in U.S. residents' stressors while limiting many of the resources previously available to cope with stress. Coping behaviors may contribute to the prevention or proliferation of psychological distress during and after the pandemic. Understanding these coping behaviors and associated psychological outcomes can help health educators develop programs that encourage effective coping and promote mental health. This study used a sequential mixed-methods approach informed by Roth and Cohen's conceptualization of coping to understand the use of approach coping behaviors- which are active and directed toward the perceived threat-and avoidance coping behaviors-which include activity directed away from perceived threat during the COVID-19 pandemic. U.S. residents (N = 2,987) were surveyed online in April 2020 and again in September 2021. Open-ended responses at baseline were thematically analyzed to illustrate coping behaviors in participants' own words. At baseline, more than half (56%) of the sample met criteria for probable depression, 51% for acute stress symptoms, and 42% for moderate to severe hopelessness. At follow-up, 45% meet criteria for probable depression and 23% for acute stress. However, the proportion of the sample who reported moderate to severe hopelessness increased to 48%. We used mixed-effects general linear models to examine changes over time and found that increases in approach coping behaviors were associated with decreases in depressive symptoms and hopelessness; increases in avoidance coping were associated with higher levels of depressive symptoms and higher levels of hopelessness. Increases in both types of coping were associated with increases in acute stress symptoms related to COVID-19. Although there was some attenuation in distress in our sample between April 2020 and September 2021, our findings suggest a need for interventions that encourage the use of approach coping behaviors and that both increase access to and decrease stigma for mental health support.

Post Traumatic Growth in Radiation Medicine following the COVID-19 Outbreak

Purpose

It has been reported that adversarial growth during traumatic events potentially enhances coping with sequelae. The purpose of this work was to assess posttraumatic growth (PTG) among radiation medicine staff members at the individual level as well as changes in perceptions of departmental culture after the COVID-19 pandemic.

Methods and Materials

An anonymous PTG inventory (PTGI) survey comprising 21 indicators was disseminated to all 213 members of our multicenter radiation department to measure perceptions of change in personal, interpersonal-relationship, and philosophy of life factors using principal-factor analysis. Additionally, 8 department safety-culture indicators from the National Hospital Patient Safety Culture Survey developed by the Agency for Healthcare Research and Quality were included to assess changes in department safety-culture perceptions verses a prepandemic survey. The survey was repeated 15 months later to assess longitudinal trends.

Results

With a 56.3% survey-response rate, PTGI factor analysis yielded Cronbach's alpha values exceeding 0.90 for the 3 aforementioned PTG factors. The average growth per indicator was 2.3 (out of 5.0), which fell between small and moderate. The values were 2.4 (personal), 2.1 (interpersonal), and 1.6 (philosophy) for the 3 factors. The total PTGI score (47.7 ± 28.3 out of 105 points) was lower for masked, patient-facing, frontline workers members (41.8 ± 28.4) compared with others (53.1 ± 27.3, P value .001). For the Agency for Healthcare Research and Quality survey there was an improvement of 15% in perceptions of department safety culture, and 7 of the 8 indicators showed improvements compared with baseline. The follow-up survey demonstrated overall sustained findings, albeit with a trend toward declining PTG scores for nonfrontline workers, notably in interpersonal relationships (47.4 ± 27.0, P value .05).

Conclusions

A fair-to-moderate degree of PTG was observed in personal and interpersonal relationship factors whereas least growth was noted in spiritual and religious beliefs. Perceptions of department patient-safety culture improved substantially. Sustained improvements were thus perceived at the individual and department levels.

Redefining "masstige" luxury consumption in the post-COVID era

The concept of "new luxury" has challenged the conventional marketing of luxury goods as prestigious, leading to greater expansion of mass luxury meaning. This has become more evident since the outbreak of COVID-19, which has been a catalyst for consumption in the luxury market. This paper investigates the mass marketing of luxury goods and explores the essence of masstige luxury consumption since the outbreak of COVID-19. An interpretive approach was conducted based on semi-structured, in-depth interviews with 31 participants. It analyzes four themes of mass luxury: self as content, self as process, self as context, and self-other. We further argue that the mass consumption of luxury reduces cognitive dissonance, with the pandemic resolving the dark side of conventional luxury consumption. Our findings provide important insights for both scholars and practitioners in the development of a more holistic understanding of masstige in the post-COVID era.

A Year Through the COVID-19 Pandemic: Deleterious Impact of Hormonal Contraception on Psychological Distress in Women

BACKGROUND

Women are more at risk than men of suffering from psychological distress during disease outbreaks. Interestingly, no biological factors have been studied to explain this disparity in such contexts. Sex hormone variations induced by hormonal contraceptives (HC) have been associated with mental health vulnerabilities. However, most studies have examined current effects of HC without considering whether a chronic modulation of sex hormone levels could induce long-lasting effects that persist after HC cessation.

OBJECTIVES

To date, the role of HC on psychological health in women during a disease outbreak is still unknown. We aimed to investigate both current and long-term effects of HC on psychological distress throughout the COVID-19 pandemic.

METHOD

At four time points during the COVID-19 pandemic (June 2020, September 2020, December 2020, March 2021), we collected self-reported data on psychological distress, assessing symptoms of post-traumatic stress [via the Impact of Event Scale-Revised (IES-R)], symptoms of depression, anxiety, and stress [via the Depression Anxiety Stress Scales (DASS-21)]. Linear mixed models were first used to compare men (n = 49), naturally cycling women (n = 73), and women using HC (n = 32) across time. To examine long-lasting effects of HC, exploratory analyses were restricted to women, comparing current HC users (n = 32), past users (n = 56), and never users (n = 17).

RESULTS

The first model revealed that women taking HC reported stable post-traumatic stress symptoms across time, compared to naturally cycling women and men who showed a significant decrease from T1 to T2. HC users also reported greater DASS-21 total scores over time. Moreover, HC users reported higher stress and anxiety symptoms than men. In the second model, results showed that past HC users had similar anxiety levels as current HC users. These two groups reported significantly more anxiety symptoms than never users.

CONCLUSION

HC users report increased distress during the pandemic relative to naturally cycling women and men. Our results also suggest a long-lasting effect of HC intake, highlighting the importance of considering both the current use of HC and its history. This could provide some insight into potential avenues for explaining why some women are prone to higher psychological distress than men.

Distress in the time of COVID-19: Understanding the distinction between COVID-19 specific mental distress and depression among United States adults

BACKGROUND

During the COVID-19 pandemic, many Americans have experienced mental distress, which may be partially characterized by a rise in mental illnesses. However, COVID-19 specific psychological distress may also be separate from diagnosable conditions, a distinction that has not been well established in the context of the pandemic.

METHODS

Data came from an online survey of US adults collected in March 2020. We used factor analysis to assess the relationship between COVID-19 related mental distress and depressive symptoms. Using four questions on psychological distress modified for COVID-19 and eight depressive symptoms, we conducted an exploratory factor analysis (EFA) to identify the factor structure and then estimated a confirmatory factor analysis (CFA).

RESULTS

The EFA model indicated a two-factor solution, where the COVID-19 distress items loaded onto the first factor and depression items loaded onto the second. Only two items cross-loaded between factors: feeling fearful and being bothered by things that do not usually bother the participant. The CFA indicated that this factor structure fit the data adequately (RMSEA=0.106, SRMR=0.046, CFI=0.915, TLI=0.890).

LIMITATIONS

It is possible that there are additional important symptoms of COVID-19 distress that were not included. Depression symptoms were measured via the CES-D-10, which while validated is not equivalent to a clinician diagnosis.

CONCLUSIONS

As COVID-19 related mental distress appears to be distinct from, though related to, depression, public health responses must consider what aspects of depression treatment may apply to this phenomenon. For COVID-related distress, it may be more appropriate to treat symptomatically and with supportive psychotherapy.

Generalized Anxiety as a Risk Factor for Dysfunctional Eating Behavior after Obesity Surgery during the COVID-19 Pandemic

Purpose: The present study investigates the impact of obesity surgery on mental health (i.e., eating behavior and distress) during the COVID-19 pandemic. Methods: Two hundred fifty-four participants were recruited via social media. One hundred fourteen (44.53%) of them were surgery candidates (waiting for obesity surgery), while 142 (55.46%) had already undergone surgery. Participants who underwent surgery were compared to participants that did not yet undergo surgery in terms of mental burden (depression and anxiety), as well as safety and eating behavior. Further moderation analyses attempted to identify risk factors for increased COVID-19-related dysfunctional eating behavior after surgery. Results: Participants who underwent surgery showed generally lower levels of depression and general anxiety on a trend level. Moderation analyses suggested that people with high levels of generalized anxiety actually show more dysfunctional COVID-19-specific eating behavior after obesity surgery. Conclusion: On a trend level, obesity surgery appears to attenuate symptoms of generalized anxiety and depression. Yet, surgery patients with high levels of generalized anxiety exhibit even higher levels of dysfunctional eating during the COVID-19 pandemic. It is therefore particularly important to support people at risk.

Students' Wellbeing during Transition from Onsite to Online Education: Are There Risks Arising from Social Isolation?

The COVID-19 pandemic has caused disruption to activities in many fields, including education and lifestyle. Major changes have taken place in the education system, where specific activities migrated suddenly from onsite to online. As a result, this period has witnessed an increased interest in impact studies that analyse the perceptions of the actors involved in the educational process. Based on the survey data (N = 665), the perceptions of the students in Romanian universities with regard to the effects of online education during the pandemic on their wellbeing were analysed. The empirical apparatus-SEM analysis-reached the following conclusions: the students' wellbeing was increased under the traditional education system; the economic crisis has caused concern, and a decrease in their wellbeing; their contamination fear is moderate to low, and does not influence their wellbeing; they have been discouraged in terms of their personal development during the pandemic, and their wellbeing has suffered as a result; the role of institutions is extremely important, given that the students' ability to study online depends on the universities' efficiency in implementing the online system.

Tragic Optimism as a Buffer Against COVID-19 Suffering and the Psychometric Properties of a Brief Version of the Life Attitudes Scale

The Life Attitudes Scale (LAS) was designed to measure tragic optimism (TO)-a distinct type of optimism that could generate hopeless hope even in dire situations according to existential positive psychology (PP 2.0). This study explains why only a faith-based TO could serve as a buffer against suffering at the Nazi death camps as well as the global coronavirus disease 2019 (COVID-19) pandemic. In study 1, the results showed that the factorial structure of a 15-item LAS-Brief (LAS-B), which is a short measure of TO, replicated the original structure of the 32-item long version. The five factors (i.e., affirmation, acceptance, courage, faith, and self-transcendence) provided a good data model fit statistics for LAS-B; the measure had adequate-to-strong internal and latent construct reliability estimates. In study 2, the buffering effect of TO on the association between suffering experiences during COVID-19 and life satisfaction in adults was examined. The results of the studies were consistent with our hypothesis that TO as measured by LAS-B serves as a buffer against the impact of COVID-19 suffering on life satisfaction.

Sleep problems during COVID-19 pandemic and its' association to psychological distress: A systematic review and meta-analysis

BACKGROUND

The emerging novel coronavirus disease 2019 (COVID-19) has become one of the leading cause of deaths worldwide in 2020. The present systematic review and meta-analysis estimated the magnitude of sleep problems during the COVID-19 pandemic and its relationship with psychological distress.

METHODS

Five academic databases (Scopus, PubMed Central, ProQuest, ISI Web of Knowledge, and Embase) were searched. Observational studies including case-control studies and cross-sectional studies were included if relevant data relationships were reported (i.e., sleep assessed utilizing the Pittsburgh Sleep Quality Index or Insomnia Severity Index). All the studies were English, peer-reviewed papers published between December 2019 and February 2021. PROSPERO registration number: CRD42020181644.

FINDINGS

168 cross-sectional, four case-control, and five longitudinal design papers comprising 345,270 participants from 39 countries were identified. The corrected pooled estimated prevalence of sleep problems were 31% among healthcare professionals, 18% among the general population, and 57% among COVID-19 patients (all p-values < 0.05). Sleep problems were associated with depression among healthcare professionals, the general population, and COVID-19 patients, with Fisher's Z scores of -0.28, -0.30, and -0.36, respectively. Sleep problems were positively (and moderately) associated with anxiety among healthcare professionals, the general population, and COVID-19 patients, with Fisher's z scores of 0.55, 0.48, and 0.49, respectively.

INTERPRETATION

Sleep problems appear to have been common during the ongoing COVID-19 pandemic. Moreover, sleep problems were found to be associated with higher levels of psychological distress. With the use of effective programs treating sleep problems, psychological distress may be reduced. Vice versa, the use of effective programs treating psychological distress, sleep problems may be reduced.

FUNDING

The present study received no funding.

An integer programming model to assign patients based on mental health impact for tele-psychotherapy intervention during the Covid-19 emergency

The Covid-19 pandemic challenges healthcare systems worldwide while severely impacting mental health. As a result, the rising demand for psychological assistance during crisis times requires early and effective intervention. This contributes to the well-being of the public and front-line workers and prevents mental health disorders. Many countries are offering diverse and accessible services of tele-psychological intervention; Ecuador is not the exception. The present study combines statistical analyses and discrete optimization techniques to solve the problem of assigning patients to therapists for crisis intervention with a single tele-psychotherapy session. The statistical analyses showed that professionals and healthcare workers in contact with Covid-19 patients or with a confirmed diagnosis had a significant relationship with suicide risk, sadness, experiential avoidance, and perception of severity. Moreover, some Covid-19-related variables were found to be predictors of sadness and suicide risk as unveiled via path analysis. This allowed categorizing patients according to their screening and grouping therapists according to their qualifications. With this stratification, a multi-periodic optimization model and a heuristic are proposed to find an adequate assignment of patients to therapists over time. The integer programming model was validated with real-world data, and its results were applied in a volunteer program in Ecuador.

Do Social Connections and Digital Technologies Act as Social Cure During COVID-19?

Although COVID-19 pandemic has re-orientated humans to be more physically healthy and hygienic, it has also persuaded humans to create affiliations and experience a sense of belongingness through social networks and digital technologies. However, amidst these changes, experiences of COVID-19 patients and their perception of the outside world's attitudes toward them appears to be less attended in literature which formed the basis for the current study's objectives. Using qualitative methodology, the present study explored the experiences, perceptions and attitudes of patients and their care-givers' toward COVID-19. The thematic analysis emerged with four major themes. Psychological Experiences of People was generated prominently with sub-themes indicating the perceived experiences like fear of spreading diseases to others, and the need for psychological counseling. Attitude of others toward patients and caregivers revealed that family members and relatives played a major positive role on the patient's mental health, however, the neighbor's stigmatized attitude led to several undesired behaviors. Social Connectedness was another major theme derived from the study. Altruistic volunteers, a sub-theme of Social connectedness have indicated that amidst these negative factors, one can spread social harmony by motivating and supporting the victims with basic needs, financial support, hope and social empathy. Opinions of participants for digital technology through technological aids and preventive measures emphasized an overall positive attitude as it helped the society, in general to maintain social connections as well to curb the rate of COVID-19 cases.

Psychological distress during pandemic Covid-19 among adult general population: Result across 13 countries

The COVID-19 pandemics caused an unprecedented mortality, distress, and globally poses a challenge to mental resilience. To our knowledge, this is the first study that aimed to investigate the psychological distress among the adult general population across 13 countries. This cross-sectional study was conducted through online survey by recruiting 7091 respondents. Psychological distress was evaluated with COVID-19 Peritraumatic Distress Index (CPDI). The crude prevalence of psychological distress due to COVID-19 is highest in Vietnam, followed by Egypt, and Bangladesh. Through Multivariate Logistic Regression Analysis, the respondents from Vietnam holds the highest level of distress, while the respondents from Sri Lanka holds the lowest level of distress with reference to Nepal.Female respondents had higher odds of having reported psychological distress, and those with tertiary education were less likely to report psychological distress compared to those with lower level of education. The findings indicate that psychological distress is varies across different countries. Therefore, different countries should continue the surveillance on psychological consequences through the COVID-19 pandemic to monitor the burden and to prepare for the targeted mental health support interventions according to the need. The coping strategies and social support should be provided especially to the lower educational attainment group.

COVID-19 Suicide Survivors-A Hidden Grieving Population

Present time has been dominated by the COVID-19 pandemic. People are grieving several non-death related situations: the loss of a job, of a status, of a role, of their life. Restrictive measures and uncertainty about the future makes individuals vulnerable to feelings of hopelessness and helplessness. Mental health support has been hindered and teams are reinventing themselves to reach people in need. Nevertheless, decompensation of previous psychiatric disorders, increasing levels of depression and anxiety, economical handicaps and fear of the infection, are prompting several cases of COVID-19 related suicides worldwide. Every suicide affects between 5 and 80 individuals, which are known as suicide survivors. Suicide grief is particularly challenging, with rates of complicated grief as high as 40%. Suicide survivors are at increased risk of developing depression, anxiety disorders and of suicidal behaviors. Moreover, feelings of guilt and shame, as well as social stigma, are major obstacles for them to reach form help. This article aims to review the existing literature on COVID-19 related suicides, complicated grief in suicide survivors and highlight modifiable risk factors for both conditions, as well as propose some public health measures to reduce the impact of the pandemic context on self-inflicted harm and its consequences on families, friends and the community. Obstacles to access to mental health support need to be overcome through the use of technology. Technicians should actively approach populations more vulnerable to develop suicidal ideation. Social media have the obligation to provide accurate an non-sensationalistic information. Families and friends should maintain social proximity, despite the need for physical distancing. When a suicide death occurs, police forces and health staff should be prepared to share the news with the family using an empathic and humane approach and providing psychological support. Funerals, memorials and other services should be held as much as possible. Closer contacts should be signalized and closely followed in order to detect the need for specific interventions. Help seeking behaviors should be promoted. Additionally, people should be educated on suicide and its impacts, in order to reduce stigma.

Mental health outcomes associated with the COVID-19 pandemic: Prevalence and risk factors in a southern US state

The COVID-19 pandemic has had a dramatic effect on the functioning of individuals and institutions around the world. This cross-sectional registry-based study examined some of the burdens of the pandemic, the prevalence of mental health difficulties, and risk factors for psychosocial morbidity among community residents in Arkansas. The study focused on a period of gradual reopening but rising infection rates. The investigation included validated screening measures of depressive symptoms (PHQ-9), generalized anxiety (GAD-7), trauma-related symptoms (PCL-5), and alcohol use (AUDIT-C). A notable percentage of participants reported elevated symptoms on each of these outcomes. In separate multivariable analyses that accounted for a number of demographic and pandemic-related covariates, individuals who reported greater pandemic-related disruption in daily life, and those with a prior history of mental health concerns, were more likely to screen positive for depressive, anxiety and trauma-related symptoms. Findings illuminate burdens experienced by community residents during a period of phased reopening, and offer a foundation for future screening and intervention initiatives.

[Pandemic COVID-19 and mental disorders international experience and therapeutic approaches]

The article considers the COVID-19 pandemic impact on the population mental health, the main psychogenic and somatogenic mental disorders associated with COVID-19 are distinguished. The comorbid PTSD clinical features are described. The mental health risk factors for health workers are presented. The psychotherapeutic and psychopharmaceutical approaches are proposed.