Past Epidemics, Natural Disasters, COVID19, and Mental Health: Learning from History as we Deal with the Present and Prepare for the Future

Investigating the interpretability of ChatGPT in mental health counseling: An analysis of artificial intelligence generated content differentiation

The global impact of COVID-19 has caused a significant rise in the demand for psychological counseling services, creating pressure on existing mental health professionals. Large language models (LLM), like ChatGPT, are considered a novel solution for delivering online psychological counseling. However, performance evaluation, emotional expression, high levels of anthropomorphism, ethical issues, transparency, and privacy breaches need to be addressed before LLM can be widely adopted. This study aimed to evaluate ChatGPT's effectiveness and emotional support capabilities in providing mental health counseling services from both macro and micro perspectives to examine whether it possesses psychological support abilities comparable to those of human experts. Building on the macro-level evaluation, we conducted a deeper comparison of the linguistic differences between ChatGPT and human experts at the micro-level. In addition, to respond to current policy requirements regarding the labeling, we further explored how to identify artificial intelligence generated content (AIGC) in counseling texts and which micro-level linguistic features can effectively distinguish AIGC from user-generated content (UGC). Finally, the study addressed transparency, privacy breaches, and ethical concerns. We utilized ChatGPT for psychological interventions, applying LLM to address various mental health issues. The BERTopic algorithm evaluated the content across multiple mental health problems. Deep learning techniques were employed to differentiate between AIGC and UGC in psychological counseling responses. Furthermore, Local Interpretable Model-agnostic Explanation (LIME) and SHapley Additive exPlanations (SHAP) evaluate interpretability, providing deeper insights into the decision-making process and enhancing transparency. At the macro level, ChatGPT demonstrated performance comparable to human experts, exhibiting professionalism, diversity, empathy, and a high degree of human likeness, making it highly effective in counseling services. At the micro level, deep learning models achieved accuracy rates of 99.12 % and 96.13 % in distinguishing content generated by ChatGPT 3.5 and ChatGPT 4.0 from UGC, respectively. Interpretability analysis revealed that context, sentence structure, and emotional expression were key factors differentiating AIGC from UGC. The findings highlight ChatGPT's potential to deliver effective online psychological counseling and demonstrate a reliable framework for distinguishing between artificial intelligence-generated and human-generated content. This study underscores the importance of leveraging large-scale language models to support mental health services while addressing high-level anthropomorphic issues and ethical and practical challenges.

A global survey on the associations between the lockdown group, free memory recall and emotional responses during the COVID-19 lockdown

The unprecedented outbreak of the COVID-19 pandemic has altered the course of many lives, resulting in multiple health and social challenges. Due to the speed at which this pandemic spread, various public health 'lockdown' measures were introduced to mitigate its spread. The outcome of adherence to these measures has revealed the possible influence on individuals' varying cognitive abilities. Accordingly, this study aimed to explore the predictive relationships between lockdown responses and COVID-19 restrictions, memory recall performance, and associated emotional responses while examining the sociodemographic influences of age and sex. Participants were drawn from a secondary dataset of an international online survey study of 1634 individuals aged 18-75 years across 49 countries. Participants' demographic questionnaires, free memory recall, and hospital anxiety and depression scale scores were used to collect the data for analysis. Four-way MANOVA and hierarchical multiple regression were utilised to explore the mean differences and predict relationships between the study variables. Significant differences were found in memory recall performance and anxiety and depression scores across lockdown groups (the comply, sufferer, and defiant). Regression analysis indicated that age and gender were predictive markers of lockdown responses and anxiety (R2 = 0.14, F4,1625 = 66.15, p < .001, f2 = 0.17), while age was the only predictor of lockdown responses and depression association ([Formula: see text] = -0.78, t(1625) = -4.35, p < .001). Lockdown compliance was associated with better free recall (M = 8.51, SD = 6.38, p < .001; η2 = 0.01), lockdown suffering was associated with greater anxiety (M = 9.97, SD = 4.36, p < .001; η2 = 0.06), and lockdown deviance was associated with greater depression (M = 7.90, SD = 3.12, p < .001; η2 = 0.05). The current study provides valuable information on the mechanisms of cognitive interpretations and emotional arousal in individuals' social isolation responses to recent life stress and potential severe pandemics. This may support the need for robust interventions aimed at improving people's psychological appraisals associated with anxiety in preparation for any new potential waves or future pandemics.

Difference in Psychiatric Hospital Admissions Between Cisgender and Transgender and Gender Nonconforming Youth, Before and During the Start of the COVID-19 Pandemic

This retrospective study of 1101 children and adolescents examines differences in psychiatric admissions between cisgender and transgender/gender nonconforming (TGNC) youth between June 2018 and November 2021. Sociodemographic and clinical characteristics for each admission were extracted from medical records. We compared proportion of total admissions and clinical characteristics between cisgender and TGNC youth, during specified time frames of pre-COVID-19, during quarantine, and post-quarantine. During quarantine, 294 (89.9%) youth identified as cisgender and 33 (10.1%) youth identified as TGNC. Post-quarantine, 205 (88.4%) youth identified as cisgender and 27 (11.6%) identified as TGNC. TGNC patients had more history of mood disorders (p < 0.001), self-injurious behavior (p < 0.001), and suicide attempt (p = 0.007), whereas cisgender patients had more history of Attention-deficit/Hyperactivity Disorder (ADHD) (p = 0.011) and violence (p < 0.001) across each time frame of the study. TGNC patients were more likely to be admitted due to suicidal ideation (p = 0.003), whereas cisgender patients were more often admitted for aggression (p < 0.001). There was no change across COVID-19 time periods in terms of any psychiatric history variable among patients identifying as TGNC. The proportion of admitted youth identifying as TGNC increased by 8.1% from pre-COVID-19 to post-quarantine (p < 0.001). These findings suggest that TGNC youth might be particularly vulnerable to mental health crises when faced with pandemic-related stressors. Further research on the vulnerabilities of TGNC youth during sudden and extreme social changes and how this can impact their mental health is necessary, as global pandemics could and are anticipated to repeat.

The impact of mental health and psychological stressors on menstrual cycle modulation: exploring the influence of age and hormonal contraceptives

Stress, infections, and psychological and social well-being can affect the reproductive system. Activation of the hypothalamic-pituitary-adrenal axis can disrupt ovarian cyclicity. Estrogens can modulate stress responsiveness and mood. Thus, understanding this interaction and how it modulates the menstrual cycle is crucial for women's reproductive health.

PURPOSE

The objective of this study was to analyze the influence of a stressor, a period of the Covid-19 pandemic when there were no vaccines available yet, on the psychological state of women aged 18 to 45 years; as well as the influence of mental health on the menstrual cycle, considering the influence of age and hormonal contraceptives.

METHOD

Online questionnaire using the Google Forms platform was used.

RESULTS

There is a high prevalence of the onset of new psychosocial symptoms. Moreover, most women reported some type of change in their menstrual cycles. The women who were using hormonal contraceptives demonstrated a higher frequency of spotting and menstrual color alterations, while women without hormonal contraceptives demonstrated a higher frequency of cycle duration and menstrual odor alterations. Women without hormonal contraceptives were more susceptible to the development of psychosocial symptoms. Younger adult women were more affected by menstrual changes and psychosocial symptoms. Close to 90% of women who reported several psychosocial symptoms had changes in their menstrual cycles.

CONCLUSION

These data suggest the impact of stressors, such as a period of the pandemic, on mental health and menstrual cycles, and younger adult women can be more susceptible. This reflects the relationship between mental and reproductive health.

An exploratory investigation on internal crisis communication across private and public sector employees in Indonesia

Over the past 5 years, Indonesia has faced numerous sudden crises due to its geographical location along the Pacific Ring of Fire, making it prone to natural disasters, such as earthquakes, tsunamis, and volcanic eruptions. These events highlight the frequent occurrence of sudden crises in Indonesia and underscore the need for robust disaster preparedness and response systems. Effective crisis management requires a strategy that immediately informs organizations and the health sector of necessary actions. This study aims to investigate the effects of safety culture (SC), supportive environment (SE), management commitment (MC), and social media usage on internal crisis communication (ICC) during crises in Indonesia. It also compares the multiple regression models between employees in the private and public sectors. A cross-sectional questionnaire survey was conducted with 567 full-time employees from various organizations who have been directly affected by crises. The findings reveal that, for public sector employees, all antecedents negatively impact ICC except for SC and MC. In contrast, for private sector employees, all antecedents positively impact ICC except for MC and the perceived usefulness of social media. This study highlights the importance of MC, an SE, SC, and the perceived usefulness of social media in determining employees' ICC during crises. The significance of an SE and SC on employees' perceptions of ICC is similarly emphasized.

"Sleep Quality and Depression Level in Nurses in COVID-19 Pandemic"

The COVID-19 spread rapidly all over the world and pandemic process has negatively affected nurses. Sleep disorders and depression are among these negative effects. Managers' awareness of problems experienced by nurses and taking precautions will increase employee and patient satisfaction and provide quality patient care. The study was conducted in descriptive, cross-sectional and correlational design to explain nurses' sleep quality and depression levels and relationship between them during the COVID-19 pandemic with 142 nurses who completed Personel Information Form, Pittsburgh Sleep Quality Index (PSQI) and Beck Depression Index (BDI). Sleep quality of nurses (64.8%) was poor, 33.1% had depression, and high school education, having a chronic illness and PSQI score increased the risk of depression level of nurses. Results highlight COVID-19 pandemic affected nurses' sleep quality and depression levels. All managers should be pioneers in providing psychological support to nurses and preparing and implementing a program for prevention of insomnia and depression.

Management of High Acuity Patients in Pediatric Medical Settings: The Role of Consultation/Liaison Psychologists During the Growing Mental Health Crisis

Since the onset of the COVID-19 pandemic, consultation/liaison (C/L) psychologists had to drastically shift their practices to care for psychiatrically acute pediatric patients admitted to medical settings. The aim of the current study was to provide an updated state of the field surrounding these changes and their implications for clinical practice. Psychologists and psychology post-doctoral fellows completed an anonymous, 51-item survey distributed via a national professional organization listserv. The results review responses, by percentages, about C/L team composition and practice patterns, as they relate to suicide risk assessments, transfers to inpatient psychiatric and other levels of care, intervention for boarding patients, and disposition and safety planning. Thematically coded qualitative responses regarding impact and management of high acuity patients are also summarized. The state of the field outlined by this survey suggests an increase in C/L assessments and interventions delivered to pediatric patients with acute psychiatric needs, as well as a reverberating effects on provider wellness. Ensuring providers establish competency for this subset of patients is vital to the continued provision of optimal patient care and to sustained provider wellness. Considerations for the field are explored.

Adherence to outpatient care among individuals with pre-existing psychiatric disorders following the 2024 Noto Peninsula Earthquake: A retrospective study

Aim

The study aim was to investigate the effect of the 2024 Noto Peninsula earthquake on regular psychiatric outpatient check-ups at Kanazawa Medical University Hospital, Japan.

Methods

We retrospectively collected electronic medical records from January 4 to January 17, 2024, and analyzed data from 656 patients. χ 2 was used to analyze the association between adherence to scheduled visits and related factors, and the association between inability to attend scheduled visits and self-reported earthquake-related reasons among 84 nonadherent patients. A geographical information system was used to analyze geographic characteristics, such as municipality of residence and seismic intensity distribution.

Results

Of the 656 patients, 572 (87.2%) adhered to their scheduled visits. The failure to keep appointments was significantly associated with residence in areas with a seismic intensity of ≥6 (n = 21, 35.6%; p < 0.001). Among the 84 patients who failed to keep appointments, the inability to keep appointments owing to earthquake-related reasons was significantly associated with residence in areas with a seismic intensity of ≥6 (n = 16, 76.2%; p < 0.001) and presence of an F3 main disease code: Mood (affective) according to the International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (n = 12, 60.0%; p = 0.034).

Conclusion

Patients in areas with higher seismic intensity were more likely to miss appointments, probably because of factors such as infrastructure damage and personal losses. Among patients who missed appointments, those with F3 diagnoses were more likely to cite earthquake-related reasons. However, the high overall appointment adherence rate despite the effects of a major earthquake warrants further study.

Depressive symptomatology in Brazil: perspectives of statistical and psychometrics analyses of the PHQ-9 at four time-points (2020-2023) in the COVID-19 pandemic

The present research assessed the psychometric properties of the Patient Health Questionnaire-9 (PHQ-9) through an examination of its internal structure, invariance analysis, and standardization. Social distribution analyses of the measure were conducted using linear and binomial logistic regression. The sample consisted of 10,069 adults from all 27 states in Brazil. The data were obtained through four collections across different years of the COVID-19 pandemic (2020, 2021, 2022, and 2023), using independent samples. Confirmatory Factor Analysis (CFA) indicated that the measure is unidimensional with satisfactory fit indices. The model was invariant in relation to the variables investigated at four different levels (configural, metric, scalar, and strict). The standardization supported hypothetical cut scores indicating the severity of depressive symptoms, categorized as very low (0 to 6), low (7 to 13), moderate (14 to 19), high (20 to 23), and very high (≥ 24). We found that sex/gender, skin color/ethnicity, age, education level, and year of the pandemic were predictors of depressive symptoms in the adjusted linear regression analysis. The logistic regression showed variables with higher chances for a positive screening diagnosis of depression, with adjusted Odds Ratio as follows: years 2021 (ORadj = 1.275) and 2023 (ORadj = 1.409), women (ORadj = 1.900), Pardos individuals (ORadj = 1.252), education up to high school (ORadj = 1.272), being a northeast region resident (ORadj = 2.127), and younger people (ORadj = 1.716). The findings of this study indicate the suitability of the PHQ-9 for assessing depression in the population and recommend its use for monitoring depressive symptoms in the coming years in Brazil. Clinical implications include developing interventions to address the psychological impact of this and any future health crises.

Hate crimes and psychiatric emergency department visits among Asian Americans

INTRODUCTION

Hate crimes against Asian American surged in the United States between 2019 and 2020. Those facing COVID-19 discrimination showed heightened psychological distress. We examined whether increased hate crimes against Asian Americans corresponds positively with psychiatric Emergency Department (ED) visits among Asian Americans in California.

METHODS

We obtained our outcome variable, psychiatric ED visits, from the University of California Health Data Warehouse (UCHDW) for the period from May 2012 to August 2022. We specified our exposure as a binary indicator for months in which hate crimes against Asian Americans were positive outliers, and we obtained this data from the State of California Department of Justice Criminal Justice Statistics Center. We employed Box-Jenkins time-series methods to control for monthly temporal patterns in ED visits.

RESULTS

Increased hate crimes against Asian Americans corresponds with a rise in psychiatric ED visits among this population. After accounting for autocorrelation and controlling for psychiatric ED visits among non-Hispanic whites, our outlier-adjusted analysis shows an increase of 14.13 more psychiatric ED visits per month than expected during high hate crime months (standard error [SE] = 2.81, p < 0.001).

CONCLUSIONS

Increased racial discrimination and hate crimes at times of conflict may provoke severe mental health crises that require emergency care. Enhancing mental health support systems and providing culturally competent care tailored to the unique experiences of racial minorities remain crucial during such conflicts.

Translation and validation of the Chinese version of the Attitudes Related to Trauma-Informed Care (ARTIC-C) scale in nursing inters: a psychometric analysis

BACKGROUND

Nursing interns, the future nurses, often find it challenging to interact with trauma survivors due to their lack of experience and training. Assessing their attitudes and knowledge in trauma-informed care can improve their clinical performance.

OBJECTIVE

To culturally adapt and assess the reliability and validity of the Attitudes Related to Trauma-Informed Care Scale in Chinese nursing interns.

DESIGN

Quantitative cross-sectional design.

METHODS

The translation of Attitudes Related to the Trauma-Informed Care (ARTIC) Scale followed guidelines for the cross-cultural adaptation process. A survey was conducted with 490 nursing interns from two colleges in China in February and May 2024, and seven experts evaluated the content equivalence of each item. Reliability and validity were assessed using item analysis, exploratory factor analysis, confirmatory factor analysis, internal consistency reliability, and test-retest reliability.

RESULTS

The Chinese version of the ARTIC-C retained 35 items and demonstrated high content validity. Exploratory factor analysis revealed a 6-factor structure, explaining 61.887% of the total variance. Confirmatory factor analysis indicated that the 6-factor model adequately represented the scale structure: chi-square/degree of freedom (CMIN/DF) = 1.544, root mean square error of approximation (RMSEA) = 0.045, comparative fit index (CFI) = 0.969, incremental fit index (IFI) = 0.969, Tucker Lewis index (TLI) = 0.966, and standardized root mean square residual (SRMR) = 0.046. The scale had a Cronbach's alpha of 0.916 and test-retest reliability of 0.876.

CONCLUSIONS

The Chinese version of the ARTIC-C scale has demonstrated strong reliability and validity, making it an effective tool for measuring Chinese nursing interns' attitudes and knowledge regarding trauma-informed care.

Impact of nurse education prior to and during COVID-19 on nursing students' preparedness for clinical placement: A qualitative study

INTRODUCTION

Nursing students internationally entered challenging clinical placements during COVID-19. Lessons learnt could inform nurse education planning, particularly in preparation to implement future workforce plans.

AIM

This study aimed to explore the impact of COVID-19 on nursing students undertaking clinical placements across the UK, particularly the extent to which nursing education prior to and during COVID-19 had prepared them for placements, and to distil key messages for future nursing education.

METHODS

A UK-wide qualitative study was conducted using audio or written placement diaries and post-placement telephone or online interviews with nursing students from all years of study and from adult, children, mental health and learning disability disciplines. Transcripts were analysed thematically using the Framework Approach. A pre-survey collected participants' demographic information, details and expectations of their upcoming clinical placements, and how well prepared they felt. Ethical approval was gained.

RESULTS

Two hundred and sixteen nursing students from across the UK participated in the study. Five key themes were identified: 'stepping up to the challenge and feeling the fear', 'new ways of learning', 'theory versus clinical practice', 'impact on clinical and academic partnerships', and 'concerns around demonstrating proficiency'.

DISCUSSION

Differing levels of preparedness of nursing students for clinical placement were reported. While many felt honoured to be a part of the nursing workforce during COVID-19, the rapidly changing clinical landscape led to unplanned changes to placements, lack of skills practice, uncertain practice supervision and distance learning which impacted on their confidence and perceived levels of competence leading to anxiety around demonstrating proficiency and achieving practice hours. Greater collaboration between universities, clinical placement teams, policy makers and regulators are key lessons post COVID19 to improve the support and preparedness of nursing students.

The Self-Reported Human Health Impacts of Disaster on People in India: A Cross-Sectional Analysis of the Longitudinal Aging Study India

INTRODUCTION

The human health impacts of disaster are predicted to increase in frequency and severity due to the effects of climate change. This has impacts on all nations, but understanding disaster-related health impacts in highly populous nations, such as India, will help to inform risk preparedness and reduction measures for large proportions of the global population.

PROBLEM

Disaster-related human health impacts in India were examined via the use of survey data to inform risk reduction.

METHODS

A cross-sectional analysis of Wave 1 (2017-2018) data from the Longitudinal Aging Study India (LASI) was conducted to explore the impact of both natural and human-induced disasters on the self-reported health of people 45 years and above, as well as their partners (irrespective of age). Descriptive statistics, chi square tests of association, odds ratio, and logistic regression were used to analyze the data by socio-demographics, geographic location, and health concern type.

RESULTS

Out of a total 72,250 respondents, 2,301 (3.5%) reported disaster-related health impacts, of which 90.1% were significant. Rural residents and those with no education were more likely to be affected. Droughts were most commonly responsible for affecting human health (41.7%), followed by floods (24.0%). Two-thirds of the sample reported psychological trauma and one-in-five experienced chronic illness.

DISCUSSION

The LASI study presents an important first understanding of the self-reported human health impacts of disasters, both natural and human-induced in India. Findings indicate social determinants such as education level and rurality impact risk of disaster-related health impacts, while mental health concerns represent the biggest disaster-related health concern.

CONCLUSION

Future waves of LASI should be examined to determine if human health impacts are increasing due to the effects of climate change, as well as the vulnerability of an aging cohort.

Examining Predictors of Post-Traumatic Changes Among Mothers in Turkey Following Earthquakes

OBJECTIVES

This study aims to assess the prevalence of Post-Traumatic Stress Disorder (PTSD) in mothers affected by the February 2023 earthquakes in Turkey and to explore the influence of spiritual well-being and other factors on their Post-Traumatic Growth (PTG) levels.

METHODS

The study's sample consisted of mothers invited to participate voluntarily through online social media platforms between October-December 2023. The Mother Information Form, Post-Traumatic Stress Disorder Control List, Post-Traumatic Growth Scale, and Spiritual Well-Being Scale (SWBS) were used as data collection instruments.

RESULTS

A total of 303 mothers participated in this study. The mean total PTSD score was 49.35 (SD: 19.76), and 83.5% of mothers were categorized under severe anxiety levels. There was a statistically significant weak and positive relationship between PTSD and PTG levels (r: 0.282, P:0.000). When the predictors of PTG are considered, the spiritual well-being of mothers significantly predicts PTG (F: 43.944, P: 0.000). It accounts for 12.7% (R Square = 0.127) of the variance in mothers' PTG.

CONCLUSIONS

Mothers showed high PTSD levels 9 months after the earthquakes, but alongside these high levels, it has a positive relation with their PTG, which may show mothers becoming stronger after their traumatic experience. Study results showed the mothers' spiritual levels were a significant predictor for PTG.

The impact of pandemic threats on intertemporal choices in Chinese and Americans

Intertemporal decisions are crucial to survival, especially when humans are exposed to ecological threats. However, it remains unclear whether and how pandemic threats impact intertemporal choices across cultures. We conducted two studies in two cultural contexts (N = 1180). Study 1a found that Chinese who perceived more pandemic threats showed higher temporal discounting rates (i.e., preferred immediate smaller over delayed larger rewards), and this relationship was mediated by negative emotions. Study 1b, using threat priming, revealed that Chinese participants primed with a high-threat condition (depicting a pandemic threat) showed higher temporal discounting rates compared to those primed with a low-threat condition (describing the flu). Differently, Study 2a revealed that perceived pandemic threat levels of Americans did not directly predict temporal discounting rates. Using similar threat priming, Study 2b further confirmed that Americans in the high-threat priming condition showed no significant differences in temporal discounting rates compared to those in the low-threat priming condition. The current research deepens the understanding of the cultural difference in the impact of pandemic threats on intertemporal decision-making and further informs the development of interventions that promote individual future-oriented thinking in the face of pandemics.

Descriptive study of mental health care users 12 months pre- and post-COVID-19 lockdown

Background

Coronavirus disease 2019 (COVID-19) has impacted on a range of physical, mental and societal health indices. Increased levels of psychological stress are often reported following pandemics.

Aim

To describe and compare the presentations of mental health care users pre- and post-initiation of the lockdown, with an emphasis on demographic profiles and final diagnoses.

Setting

The study was conducted as a retrospective record review over the predetermined period at a large public hospital in Johannesburg and included all mental health care users requiring psychiatry consultation during the study period.

Methods

Clinical records were traced via the emergency department registration desk, and information pertaining to demographics, presenting complaints, date of presentation and diagnosis was extracted.

Results

A significant increase was seen in patients with psychotic disorders from pre-COVID-19 to post-COVID-19. There was a reduction in presentations of mood disorders and substance-related disorders. Patients presenting in the post-COVID-19 time period were significantly younger than in the pre-COVID-19 time period.

Conclusion

Pandemics result in notable negative mental health sequelae. Policies aimed at mitigating the spread of infective agents should be implemented with consideration of the burden of psychological distress following the pandemic.

Contribution

This study provides insights into clinical and demographic variables in a mental health care population serviced at a government hospital pre- and post-COVID-19 lockdown regulations.

Fear of COVID-19 and illicit drug use during COVID-19 pandemic in Japan: a case-control study

Background

Some people use illicit drugs to relieve stress. However, these drugs cause serious damage not only to individuals but also to society as a whole. Stress caused by the COVID-19 pandemic is considerable, as the number of illicit drug users continues to increase, despite a decrease in the availability of drugs and opportunities to leave the house during the pandemic. Fear of COVID-19 causes stress; however, its association with illicit drug use is not yet understood. In this study, we examined whether the fear of COVID-19 affects the subsequent use of illicit drugs.

Methods

We conducted a retrospective longitudinal case-control study using data from an Internet survey performed annually between 2020-2022, with the 2020 survey as the baseline survey and the 2021 and 2022 surveys as follow-up surveys. Those who were illicit drug use-free at the baseline survey but had a history of drug use upon follow-up were defined as the outcome group, whereas those who remained illicit drug use-free at follow-up were defined as the no-outcome group. Logistic regression analysis was conducted between the two groups, using "the fear of COVID-19" as the explanatory variable and adjusting for the effects of confounding factors. The same analysis was conducted by dividing illicit drugs into cannabis and non-cannabis groups, then setting their use as a secondary outcome.

Results

The study included 17,800 subjects, 837 of whom used illicit drugs at follow-up and 16,963 who did not use illicit drugs at follow-up. Logistic regression analysis revealed that higher levels of fear over COVID-19 correlated with higher illicit drug use among the participants. However, our analysis of cannabis-only outcomes showed no significant differences.

Conclusions

We found that fear of COVID-19 was a contributing factor to illicit drug use. Although the exact mechanism through which fear influences illicit drug use remains unknown, previous studies have shown that fear of certain targets increases illicit drug use, and our study adds to this evidence. However, in this study, we were unable to show a statistically significant causal relationship between fear of COVID-19 and the use of cannabis alone. Further research on the relationship between fear and the use of cannabis or other drugs, for varying focuses of fear, may broaden our knowledge of the different reasons individuals have for using different drugs.

Sexual and gender identities and alcohol use during the COVID-19 pandemic

This study examined differences in alcohol use by sexual and gender identities during the COVID-19 pandemic, and assessed whether variation between groups was explained by pandemic-related stressors and minority stress. Data from 2,429 partnered adults in the National Couples' Health and Time Use Study (n = 3,593) collected from September 2020 to April 2021 were used to model drinking patterns (frequency, amount, and drinking to cope) by sexual and gender identities, COVID-19 stress and disruption, microaggressions, and supportive climate. Regression models indicated differences in drinking by gender and sexual identities, even controlling for demographic and socioeconomic factors. Gay, lesbian, and bisexual people had higher odds of drinking to cope with the pandemic than did heterosexual people, and cisgender men had higher odds than did cisgender women. Gay and lesbian people drank more regularly than did heterosexual people, as did cisgender men in relation to cisgender women. Exclusively bisexual people drank significantly more drinks than exclusively heterosexual people, and cisgender men drank significantly more drinks than did cisgender women and those who identified as trans/another gender identity. COVID-19 stress and minority stress were associated with greater alcohol consumption, but they did not account for these differentials. Moving forward, researchers will need to continuously assess these associations, as sources of discrimination and stress will persist beyond the pandemic. Although LGBTQ+ people have disproportionate sources of stress, they varied in how they used alcohol to cope. Potential sources of resilience among sexual and gender diverse individuals should be explored.

The Impact of COVID-19 on Neuropsychological and Emotional-Behavioural Development in a Group of 8- and 9-Year-Old Children

Introduction: The rapid spread of the COVID-19 pandemic has had a significant impact on the psychological well-being of millions of people around the world, and even more so among children. Contracting SARS-CoV-2, resulting in home confinement and restrictions on daily and school activities, led to negative effects on the mental health of the paediatric population. Although children suffering from COVID-19 had milder general symptoms compared to adults, impairments in cognitive, neuropsychological, and emotional-behavioural development were noted. Objective: The main aim of the present study was to detect possible changes in the neuropsychological and emotional-behavioural development of children after infection with the SARS-CoV-2 virus. The second aim was to investigate possible relationships between cognitive abilities and psychosocial characteristics. Methods: A total of 40 patients aged 8-9 years were recruited and divided into two groups: children who contracted (CG) and did not contract (NCG) SARS-CoV-2. The BVN 5-11 (Neuropsychological evaluation battery for developmental age from 5 to 11 years) instrument was administered to assess attention, memory, verbal recall, planning, phonemics, and categorical fluency domains in the paediatric population. Data on changes in emotional-behavioural profile and daily activities were collected through a questionnaire to parents. Results: The Wilcoxon signed-rank test revealed a significant change in mood after the COVID-19 period only in the CG participants (p = 0.019). However, the neuropsychological performance of the two identified groups on BVN 5-11 sub-items was below the cutoff of clinical significance. Correlations were found between sub-items of the BVN 5-11 battery, extracurricular activities, and children's psycho-motor development. Significant positive correlations were observed between Naming on visual presentation and Reading time (p = 0.006), backward digit span and time of motor activity (p = 0.009), Visual attention and Reading time (p = 0.048), and Phonemic fluency and time observed using devices (p = 0.030). Positive statistically significant correlations were also found between Mood and Free behaviour (p = 0.000), between Mood and Structured behaviour (p = 0.005), and between Mood and peer Interaction (p = 0.013). Conclusions: SARS-CoV-2 infection negatively affected the emotional development of children contracting the virus. The neuropsychological functioning of the paediatric population was influenced by psychosocial variables and time spent on daily activities, which played a protective role in children's cognitive development.

Intrinsic Motivation and Institutional Limitations: Key Implementation Determinants of Psychological First Aid Training

Psychological first aid (PFA) trainings are conducted to train frontline care workers in practical and emotional support to people who have been recently affected by stressful events. The aim of this study was to describe the determinants of the implementation behavior of a PFA training strategy in Chile and to provide theoretical information on the factors that influence trainers' self-efficacy. For this purpose, the Determinants of Implementation Behavior Questionnaire, administered online to a sample of 117 PFA trainers throughout Chile, was used. The results indicate that the main facilitators for implementation originate in the intrinsic motivation of the trainers, while the barriers are mainly found in the limited institutional opportunities offered by the context. Evidence was also found on the effect of motivation and context on trainer self-efficacy. PFA trainers may need to invest a lot of psychological resources to overcome the barriers encountered during implementation.

The moderating effects of intolerance of uncertainty and social connectedness on college students' addictive behaviors and mental health symptoms during the COVID-19 pandemic

Objective: This study aimed to understand COVID-19 pandemic impacts on anxiety, depression, and addictive/excessive behaviors, with exploration of intolerance of uncertainty (IU) and social connectedness as potential moderators. Participants: Adult college students participated. Method: Our online survey assessed symptoms and behaviors prior to COVID-19, during the initial outbreak (Wave 1), and during early 2021 (Wave 2). Results: Significant increases were found in anxiety, depression, binge eating, sexual behaviors, video game playing, internet/social media usage, and compulsive exercise in both waves. IU moderated the relationship between both depression/anxiety and certain excessive behaviors; social connectedness moderated the relationship between anxiety and smoking. Conclusions: This study replicated prior work and highlights new impacts on addictive/excessive behaviors, as well as moderating effects from social connectedness and IU. Future research is warranted to evaluate the efficacy of treatments targeting IU and social connectedness as the pandemic continues to unfold.

Predicting the Persistence of Insomnia Symptoms during the COVID-19 Pandemic

OBJECTIVE

The goal of this study is to evaluate the factors associated with vulnerability and course of insomnia longitudinally in the COVID-19 pandemic and examine differences between: (a) those who never demonstrated clinical insomnia symptoms, (b) those who demonstrated clinically elevated insomnia symptoms at 1 or 2 time points, and (c) those who demonstrated clinically elevated insomnia symptoms at all 3 time points.

METHODS

Participants (≥18 years old) completed measures of insomnia (ISI), depression (PHQ-8), anxiety (GAD-7), and pre-sleep arousal (PSAS) at 3 time points (baseline, 1 month, and 3 months). Data were analyzed using univariable odds ratios and multivariable multicategory logistic regression to determine demographic, psychological, and behavioral predictors of insomnia persistence.

RESULTS

A total of 129 participants completed all 3 assessments (70 female, age M = 44 years, SD = 16). We found that 40% (N = 51) never had insomnia symptoms, 33% (N = 42) reported transient insomnia symptoms (1 or 2 time points), and 28% (N = 36) reported persistent insomnia symptoms (all 3 time points). From the multivariable multicategory logistic analyses, pre-sleep arousal, gender, and income were significant predictors of insomnia persistence.

CONCLUSIONS

Findings indicate elevated insomnia symptoms were persistent in a substantial number of individuals throughout the pandemic. Results suggest additional insomnia and psychological interventions are needed to improve sleep and mental health.

Walk-in mental health: Bridging barriers in a pandemic

'Single Session Therapy' (SST) is a service delivery model that seeks to provide an evidence-based, solution-focused, brief intervention within a single therapy session. The stand-alone session affords the opportunity to provide brief psychological interventions while clients await access to longer-term services. The COVID-19 pandemic has adversely impacted individuals' mental health. However, the majority of research has investigated patient mental health within hospital settings and community organizations that offer long-term services, whereas minimal research has focused on mental health concerns during COVID-19 within an SST model. The primary aim of the study was to measure client experiences of a brief mental health service. The nature of client mental health concerns who access such services at various points during a pandemic was also investigated. The current study utilized client feedback forms and the Computerized Adaptive Testing-Mental Health (CAT-MH) to measure client experiences and mental health concerns. Qualitative analysis of client feedback forms revealed themes of emotional (e.g., safe space) and informational support (e.g., referrals). Clients also reported reduced barriers to accessing services (e.g., no appointment necessary, no cost), as well as limitations (e.g., not enough sessions) of the Walk-in clinic. Profile analysis of the CAT-MH data indicated that clients had higher rates of depression before COVID-19 (M = 64.2, SD = 13.07) as compared to during the pandemic (M = 59.78, SD = 16.87). In contrast, higher rates of positive suicidality flags were reported during the pandemic (n = 54) as compared to before (n = 29). The lower reported rates of depression but higher rate of suicidality during the pandemic was an unanticipated finding that contradicted prior research, to which possible explanations are explored. Taken together, the results demonstrate the positive experiences of clients who access a single session therapy.

Preferences for woodland activities and forest features as predictors of well-being after forest visits: Evidence from a nationally representative survey in Slovakia

The link between subjective well-being (SWB) and forest visits is increasingly driving the development and preservation of restorative forest environments in numerous countries. However, there is limited knowledge regarding the effect of people's preferences for forest patterns and activities on this connection. Here we investigated whether associations exist between the preferences for certain forest features and activities, and the SWB increase and stress reduction in response to forest visits. A nationwide digital survey was administered to a representative sample of the Slovak population. The recollection-based data obtained from one thousand respondents were analysed through agglomerative clustering and ordinal regression. The analyses revealed that improved SWB and stress reduction were associated with preferences for uneven-aged forests, forest smell, as well as recreational, but not provisioning forest activities. The respective interrelationships explained up to 20% of SWB increase and stress reduction after forest visits. The results suggest that recollection-based study findings can be generalized for real-world forests and that forest management can contribute to the well-being of forest visitors by shaping the diversity of woodlands and their sensory experiences.

Relationship Between Severity and Length of Exposure to COVID-19 Parameters and Resulting Government Responses and the Suicide Crisis Syndrome (SCS)

OBJECTIVE

The COVID-19 pandemic has had a globally devastating psychosocial impact. A detailed understanding of the mental health implications of this worldwide crisis is critical for successful mitigation of and preparation for future pandemics. Using a large international sample, we investigated in the present study the relationship between multiple COVID-19 parameters (both disease characteristics and government responses) and the incidence of the suicide crisis syndrome (SCS), an acute negative affect state associated with near-term suicidal behavior.

METHODS

Data were collected from 5528 adults across 10 different countries in an anonymous web-based survey between June 2020 and January 2021.

RESULTS

Individuals scoring above the SCS cut-off lived in countries with higher peak daily cases and deaths during the first wave of the pandemic. Additionally, the longer participants had been exposed to markers of pandemic severity (eg, lockdowns), the more likely they were to screen positive for the SCS. Findings reflected both country-to-country comparisons and individual variation within the pooled sample.

CONCLUSION

Both the pandemic itself and the government interventions utilized to contain the spread appear to be associated with suicide risk. Public policy should include efforts to mitigate the mental health impact of current and future global disasters.

Joint developmental trajectories of depression and post-traumatic stress disorder symptoms among Chinese children during COVID-19

BACKGROUND

In early 2020, Chinese children started to demonstrate severe depression and post-traumatic stress disorder symptoms (PTSS) caused by lockdown and self-isolation (measures taken at the beginning of the COVID-19 pandemic).

OBJECTIVES

Concerning the significant impact of the pandemic on children's physical and mental development, the study aimed to explore children's depression and PTSS during the COVID-19 pandemic and the protective effects of family resilience on the trajectories.

METHODS

883 children participated and completed three waves of online follow-up questionnaires. The latent growth mixture modeling (LGMM) analysis was used to explore the trajectories of children's depression and PTSS based on the individual approach.

RESULTS

Two types of depression trajectories were identified and defined as the resilient group (83.01 %) and the recovery group (16.99 %); Two types of PTSS trajectories were identified and defined as the resilient group (71.12 %) and the recovery group (28.88 %); Two types of the joint trajectories of depression and PTSS were identified and defined as the resilient group (83.47 %) and the chronic group (16.53 %). The results indicated that maintaining a positive outlook (a dimension of family resilience) was the potential predictor of PTSS trajectories.

CONCLUSION

The trajectories of depression and PTSS among Chinese children during the COVID-19 pandemic were heterogeneous, and there were similar evolving subtypes. Family resilience could be a critical protective factor for children and families.

Aging and Emotional Well-Being After Disasters: Vulnerability and Resilience

BACKGROUND AND OBJECTIVES

Climate change threatens well-being and has increased the prevalence of weather-related disasters. We investigated age differences in emotional well-being among adults who had experienced hurricane-related, unavoidable stressors. Socioemotional selectivity theory (SST) posits that age-related motivational shifts buffer older adults against psychological distress, whereas the strength and vulnerability integration model (SAVI) posits that unavoidable stressors are more detrimental to older adults' well-being compared to younger adults.

RESEARCH DESIGN AND METHODS

We used existing self-report data from a life-span sample of adults (N = 618, M age = 58.44 years, standard deviation = 16.03, 18-96 years) who resided in the U.S. Gulf Coast region. The sample was recruited in 2016 to examine the sequelae of the Deepwater Horizon oil spill and contacted again after the 2017 and 2018 hurricane seasons. In 2016, participants reported their depression, anxiety, and trauma history. After the 2017-2018 hurricane seasons, participants reported their depression, post-traumatic stress, exposure to hurricane-related adversities, injuries and casualties, self-efficacy, and perceived health.

RESULTS

In line with SST, older age was associated with reporting significantly fewer depression and post-traumatic stress disorder symptoms, even after controlling for exposure to hurricane-related adversities, injuries and casualties, health, self-efficacy, pre-hurricane depression, anxiety, and trauma. The association between older age and fewer depression symptoms was stronger among those who experienced hurricane-related adversities compared to those who had not, in contrast to predictions based on SAVI.

DISCUSSION AND IMPLICATIONS

We discuss the implications of age-related strengths in emotional well-being for policy and practice in the context of the ongoing climate crisis.

The Unspoken Wounds: Understanding the Psychological Impact on Healthcare Professionals Fighting COVID-19 in Pakistan

During the COVID-19 pandemic, hospital staff faced numerous mental health challenges. However, limited research focused on anxiety and stress specifically among hospital workers during this time. Therefore, this study aimed to investigate the anxiety levels of healthcare workers during the COVID-19 pandemic. A multidimensional, cross-sectional survey was distributed to healthcare workers and staff at hospitals, COVID-19 laboratories, and healthcare settings. The survey included a total of 625 frontline healthcare workers, with 445 (71.2%) being male and 180 (28.8%) female. There were 405 (64.8%) lab professionals, 90 (14.0%) doctors, and 130 (20.8%) others, including nursing staff, administrative personnel, and supporting staff crucial to the functioning of healthcare settings. Among the lab professionals, 37.0% reported moderate depression levels and 16.0% reported severe depression levels during the pandemic. For doctors, 22.2% experienced mild depression and 33.33% experienced severe depression. Several factors were significantly associated with depression and anxiety among frontline healthcare workers, including physiological and social factors, fear of infection, risk of infecting family members and colleagues, lack of personal protective equipment (PPE), long working hours, untrained staff, social issues, and cooperation problems. These factors collectively contributed to reduced work efficacy during the pandemic. Frontline health workers played a critical role in the fight against COVID-19. The findings from this study have important implications for developing strategies to improve the mental health of healthcare workers during the pandemic and implementing policies that enhance work efficacy, ultimately leading to the improved outcomes.

Prevalence of depression, stress and suicide tendency among individuals with long COVID and determinants: a protocol of a systematic review and meta-analysis

BACKGROUND

It is well known that the COVID-19 pandemic has had a devastating impact on mental health, especially among individuals with long COVID. This systematic review and meta-analysis aims to investigate the prevalence of depression, stress and suicide tendencies among individuals with long COVID, as well as to explore the factors that contribute to these conditions.

METHODS AND ANALYSIS

A comprehensive review of literature will be conducted in various databases of including PubMed, including Medline, Embase, PsycINFO, CINAHL and Cochrane Library. The studies to be included in this review will be published in the English language, and the time frame of included studies will be from the date of inception of COVID-19 until 30 December 2023. Two independent reviewers will identify studies for inclusion based on a screening questionnaire, and the JBI standardised critical appraisal checklist for studies reporting prevalence data will be used to assess the methodological quality. The strength of the body of evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation approach. To analyse the data, a robust Bayesian approach will be applied using the STATA software package (V.14; STATA) and JASP software. The findings of this systematic review and meta-analysis will provide valuable insights into the prevalence of depression, stress and suicide tendencies among individuals with long COVID, as well as the factors that contribute to these conditions.

ETHICS AND DISSEMINATION

There is no research ethics board approval required. The dissemination plan is to publish results in a peer-reviewed academic journal.

PROSPERO REGISTRATION NUMBER

CRD42022346858.

The crisis is over, long live the crisis: mental health in emerging adulthood during the course of the COVID-19 pandemic

Introduction

As a multidimensional stressor, the COVID-19 pandemic posed a significant threat to mental health, with studies showing younger age groups to be particularly vulnerable. Thus, this study aimed to monitor mental health, potential risk/protective factors, and pandemic-related variables among young university students during the pandemic.

Methods

Students of the University of Greifswald (M age = 23.0 years, 73.9% female) participated in five cross-sectional online surveys in December 2020 (N = 1,127), March 2021 (N = 760), June/July 2021 (N = 531), December 2021 (N = 1,226), and December 2022 (N = 814). Sociodemographic data, depression and anxiety severity, loneliness, quality of life, coping strategies, resilience, self-esteem, and emotion regulation were measured. First, results from December 2020 were compared to pre-pandemic normative data. Second, the time course during the pandemic was analyzed. Third, linear models were calculated to examine the influence of risk and protective factures on depression and anxiety severity.

Results

Higher levels of depression, anxiety, and loneliness, as well as lower levels of self-esteem, physical and mental health, social relationships and well-being were found in December 2020 compared to pre-pandemic. Levels of depression and anxiety severity peaked in December 2022. Female sex, loneliness, and previous mental treatment showed associations with higher depression and anxiety severity, while higher self-esteem, resilience and use of reappraisal strategies appeared to act as protective factors.

Discussion

The study indicates the pandemic's detrimental impact on students' mental health and quality of life. Identified risk and protective factors provide guidance for tailored prevention and treatment, as well as the design of measures for future pandemics and other crisis.

Global Trends in the Incidence of Anxiety Disorders From 1990 to 2019: Joinpoint and Age-Period-Cohort Analysis Study

BACKGROUND

Anxiety disorders (ADs) are the most common mental illness with high prevalence, chronicity, and comorbidity. Despite rapid economic and cultural development, the global incidence of ADs continues to increase, with predominance in male individuals.

OBJECTIVE

To address the above issues, we analyzed the dynamic trends of the global incidence and disease burden of ADs from 1990 to 2019 and their different effects on age, period, and birth cohort and predicted the future trend of AD incidence.

METHODS

The data were obtained from the Global Burden of Disease study in 2019. A joinpoint regression model was used to calculate the annual percent change in AD incidence, and age-period-cohort analysis was used to estimate the independent effects of age, period, and cohort. Nordpred age-period-cohort analysis was used to predict the incidence of ADs from 2020 to 2044.

RESULTS

The age-standardized incidence rate of ADs increased by 1.06% for both sexes, and the age-standardized disability-adjusted life-year (DALY) rate (ASDR) decreased by 0.12%. Joinpoint regression indicated that increments in average annual percent changes in the age-standardized incidence rate (0.068 vs 0.012) and ASDR (0.035 vs -0.015) for ADs globally were higher among male individuals than female individuals. The age-period-cohort analyses revealed that the relative risk (RR) of the incidence and DALYs of ADs among people of different sexes increased with age in adolescence and middle age and then decreased. For the period effect, the RR of incidence decreased, whereas the RR of DALYs increased in both sexes. Moreover, the RR of the incidence gradually increased and DALYs slowly decreased with birth year for both male and female individuals. New cases of ADs in male individuals are predicted to increase in the coming 25 years.

CONCLUSIONS

This study provided the changing trend of the global incidence and disease burden of ADs in the past 3 decades, indicating that early prevention and effective control cannot be ignored. We analyzed the age-period-cohort effect of potential trends in ADs and predicted future incidence trends. The results suggest that we should take active intervention measures, focusing on high-risk groups and developing effective management and control policies to reduce the global burden of disease.

Public Health and Health System's Responsiveness During the 2022 Floods in Pakistan: What Needs to Be Done?

OBJECTIVE

In 2022, Pakistan witnessed unprecedented flooding, submerging one-third of the country under-water, ruining millions of houses, taking lives, afflicted injuries, and displacing scores of people. Our study documents not only the public health problems that have arisen due to this natural calamity but also the state of health systems' response.

METHODS

We conducted a qualitative study asking key questions around prevalent health problems, health-care seeking, government's response, resource mobilization, and roadmap for the future. We purposively selected 16 key frontline health workers for in-depth interviews.

RESULTS

Waterborne and infectious diseases were rampant posing huge public health challenges. Disaster mitigation efforts and relief operations were delayed and not at scale to cover the entire affected population. Moreover, a weak economy, poverty, and insufficient livelihoods compounded the tribulations of floods. Issues of leadership and governance at state level resulted in disorganized efforts and response.

CONCLUSIONS

Pakistan is famous for its philanthropy; however, lack of transparency and accountability, the actual benefits seldom reach the beneficiaries. Such climatic disasters necessitate a more holistic approach and a greater responsiveness of the health system. In addition to health services, the state must respond to financial, social, and infrastructural needs of the people suffering from the calamity.

Understanding the Impact of the COVID-19 Pandemic on the Mental Health of Latinx Children, Youth, and Families: Clinical Challenges and Opportunities

Latinx children, youth, and families in the United States have been disproportionally affected by the COVID-19 pandemic compared to non-Latinxs, experiencing a higher burden of deaths, economic adversity, parental stress, and mental health problems. At the same time, Latinx children, youth, and families in the United States have rich cultural and community resources that serve as a source of protection and promotion. To our knowledge, no special issue has been devoted to the impact of the pandemic on Latinx children, youth, and families, which limits opportunities to examine its implications for clinical theory, research, assessment, policy, and practice. To address this gap, we present this special issue entitled "Understanding the impact of the COVID-19 pandemic on the mental health of Latinx children, youth, and families: Clinical challenges and opportunities," a collection of nine articles written by Latinx scholars. In this introduction, we explain why it is important to center Latinx children, youth, and families and why we need to use a structural-intersectional approach. We summarize the articles in this collection by grouping them by themes: immigration and family separation; the impact of family economic adversity; school and family contexts of mental health; the pandemic experience of Latinx LGBTQ and AfroLatinx youth; and a model to imagine the future of Latinx children, youth, and families. We conclude with a brief summary and suggestions for future research.

A Review of the Effects of the COVID-19 Pandemic on Children and Adolescents' Mental Health

Disaster poses a huge threat to physical health as much as mental health, and COVID-19 is not any different. Understanding that physical and social factors can all contribute to mental health disruptions explains the rising concern of the global community about the impacts of COVID-19 on mental health, especially among the vulnerable, including children and adolescents. It is imperative to explore the diverse impacts of COVID-19 on the paediatric age group, especially to better address its effect and adequately strategize for its resulting conditions. This narrative review, therefore, explores literature reports on the effect of the pandemic on the mental health of children and adolescents. As observed in the literature, COVID-19 did not only threaten the physical health of children and adolescents but also their mental health, especially in terms of anxiety, depression, sleep alteration, etc. In this paper, we have discussed interventions, such as adequate sleep, healthy lifestyles, and nutritious foods, to improve paediatric mental health even after the pandemic.

'EMERALD' online early intervention programme for psychological well-being: A detailed description using the TIDieR checklist

Objective

The rising prevalence of mental health symptoms brought on by the COVID19 pandemic led to the inception and development of EMERging Anxiety, Loneliness, Depression (EMERALD) well-being programme. EMERALD was designed to improve psychological well-being of the general population who had not previously sought mental health support. The programme incorporated a focus on lifestyle medicine and was underpinned by solution focused health coaching. The aim of the paper is to describe the programme according to the Template for Intervention Description and Replication (TIDieR) checklist to provide detailed reporting of the intervention's elements.

Methods

The TIDieR checklist was utilised to comprehensively describe the programme, including theoretical underpinnings, materials, procedures, providers, mode of delivery and tailoring of the programme. The Behaviour Change Technique Taxonomy v2 was used to identify the specific behaviour change techniques used within the solution focused health coaching framework.

Results

The programme was developed to align with the latest evidence-based literature in lifestyle medicine and solution focused coaching. The programme also offered allied health expertise, online educational modules and was tailored to the participants. The programme was delivered online through a telehealth platform.

Conclusion

The TIDieR checklist has enabled the provision of a detailed structure of the EMERALD program intervention. The behaviour change taxonomy has facilitated the outlining of specific techniques used in health coaching sessions. Both structures have operationalised the detail of the intervention for the purposes of replication and informing the literature.

Investigating the experiences of medical students quarantined due to COVID-19 exposure

Background

The COVID-19 pandemic profoundly impacted medical education systems worldwide. Between March 2020 and December 2021, 111 MD students at the University of Toronto completed two-week quarantines due to hospital or community exposures and experienced disrupted clinical instruction. We explored the experiences, barriers, and supports of these quarantined medical students to identify program development opportunities and improve student supports.

Methods

We used a qualitative descriptive approach to explore experiences of clerkship students quarantined due to COVID-19 exposure. Methods included an online survey with open-ended questions and an audio-recorded interview. We analysed the demographic survey responses using descriptive statistics. Subsequently, we conducted descriptive thematic analysis of the narrative survey responses and transcribed interview recordings.

Results

Concerns reported in surveys (n = 23, response rate 20.7%) and interviews (n = 5) included themes of illness uncertainty, racial tensions, confidentiality of COVID-19 status, unclear academic expectations, and financial burden. Supports included friends, family, and MD program administration. Recommendations related to communication, administration, equity considerations, supports, confidentiality/privacy, and academics.

Conclusion

Supporting student wellbeing and learning is at the core of medical training. Enhanced understanding of health profession trainee needs during COVID can improve institutional supportive responses to students routinely and during times of crisis.

Mental health during the COVID-19 pandemic in a longitudinal study of Hurricane Katrina survivors

While the COVID-19 pandemic is known to have caused widespread mental health challenges, it remains unknown how the prevalence, presentation, and predictors of mental health adversity during the pandemic compare to other mass crises. We shed light on this question using longitudinal survey data (2003-2021) from 424 low-income mothers who were affected by both the pandemic and Hurricane Katrina, which struck the U.S. Gulf Coast in 2005. The prevalence of elevated posttraumatic stress symptoms was similar 1-year into the pandemic (41.6%) as 1-year post-Katrina (41.9%), while elevated psychological distress was more prevalent 1-year into the pandemic (48.3%) than 1-year post-Katrina (37.2%). Adjusted logistic regression models showed that pandemic-related bereavement, fear or worry, lapsed medical care, and economic stressors predicted mental health adversity during the pandemic. Similar exposures were associated with mental health adversity post-Katrina. Findings underscore the continued need for pandemic-related mental health services and suggest that preventing traumatic or stressful exposures may reduce the mental health impacts of future mass crises.

A cross-disasters comparison of psychological distress: Symptoms network analysis

Large-scale traumatic events have the potential to trigger psychological distress, particularly among those in the affected areas. However, the manifestation of psychological distress may vary across different types of disasters. This study thus aimed to compare the symptoms network structure of psychological distress as assessed by the Kessler Psychological Distress Scale across three types of disasters: Terror (n = 5842), COVID-19 (n = 2428), and a nature-related disaster (n = 1001). Across disasters, two communities representing depression and anxiety symptoms were revealed. However, while after a nature-related disaster and the COVID-19 pandemic depression and anxiety items were interconnected via hopelessness, a terror attack resulted in more separated manifestations of anxiety and depression. Examination of symptom centrality showed that while in the Terror and the COVID-19 networks "depressed/no cheering up" was most connected to other symptoms, for the nature-related disaster network, two items were most central: "depressed/no cheering up" and "restless or fidgety". The results may point to different mechanisms of psychological distress structures after different disasters. Depending on the type of disaster, trauma-focused interventions may require targeted support and treatment.

Counselors' Perceptions of Their Preparedness for Telemental Health Services: A Phenomenological Examination

Background

To examine counselors' perceptions of their formal preparation for engaging in telemental health (TMH) counseling with the intent of gaining an understanding of their lived experiences.

Materials and Methods

Semistructured interviews were conducted with seven seasoned counselors who regularly engage in technology-mediated distance counseling.

Results

The results highlighted themes within two emerging categories: the counselor and training/education. Themes related to motivation and specific counselor attributes emerged from the first category and themes of availability, inadequacy, and modality emerged from the second category.

Discussion

The implications from this study suggest a lack of availability and standardization of effective training on TMH delivery.

Conclusion

This study identifies areas of potential future research related to counselors' preparation experiences as well specific areas of need for TMH training in counseling graduate programs and other natural opportunities.

Prevalence of suicidal ideation and correlated risk factors during the COVID-19 pandemic: A meta-analysis of 113 studies from 31 countries

The purpose of this study was to estimate the prevalence of suicidal ideation and correlated risk factors during the COVID-19 pandemic. Web of Science (WOS) and PubMed were searched according to a pre-set strategy. A total of 132 studies were identified, 104 of which were included in the meta-analysis. The prevalence of suicidal ideation was approximately 14.7% (95%CI: 12.5%, 16.8%, P < 0.01) in the general population, approximately 22.4% (95%CI: 17.1%, 27.8%, P < 0.01）in adolescents, approximately 21.0% (95%CI: 12.8%, 29.2%, P < 0.01) in psychiatric patients, approximately 20.6% (95%CI: 18.7%, 22.5%, P < 0.01）in university students, approximately 18.9% (95%CI: 8.3%, 29.5%, P < 0.01) in younger adults, approximately 10.6% (95%CI: 1.0%, 20.2%, P = 0.031) in COVID-19 patients and approximately 7.4% (95%CI: 4.3%, 10.5%, P < 0.01) in healthcare workers. The prevalence in North America was approximately 16.0% (95%CI: 13.6%-18.4%, P < 0.001), approximately 14.5% in Asia (95%CI: 9.5%-19.4%, P < 0.001), approximately 10.5% in Europe (95%CI: 8.5%-12.4%, P < 0.001), and approximately 20.5% in South America (95%CI: 19.5%-21.5%, P < 0.001). The following were risk factors which might be correlated with suicidal ideation: severe anxiety symptoms, mild to moderate depression, a strong feeling of loneliness/social isolation, poor sleep quality, having COVID-19-related experience, having quarantine or lockdown experience, being female, being single or divorced, having financial problems and having a history of suicidal ideation/attempt. This article reports the prevalence of suicidal ideation and discussing potential risk factors during the pandemic among general population and vulnerable groups. Early detection and follow-up were necessary for the noteworthy population.

Youth Mental Health Outcomes up to Two Years After SARS-CoV-2 Infection Long-COVID or Long-Pandemic Syndrome: A Retrospective Cohort Study

PURPOSE

Youth mental distress has substantially increased during the COVID-19 pandemic. However, it is unclear if mental symptoms are directly related to SARS-CoV-2 infection or to social restrictions. We aimed to investigate mental health outcomes in infected versus uninfected adolescents, for up to two years after an index polymerase chain reaction (PCR) test.

METHODS

A retrospective cohort study, based on electronic health records from a large nationally representative Israeli health fund, among adolescents aged 12-17 years with a PCR test for SARS-CoV-2 between March 1, 2020 and March 1, 2021. Infected and uninfected individuals were matched by age, sex, test date, sector, and socioeconomic status. Cox regression was used to derive hazard ratios (HRs) for mental health outcomes within two years from PCR test for infected versus uninfected individuals, while accounting for pre-existing psychiatric history. External validation was performed on UK primary care data.

RESULTS

Among 146,067 PCR-tested adolescents, 24,009 were positive and 22,354 were matched with negative adolescents. SARS-CoV-2 infection was significantly associated with reduced risks for dispensation of antidepressants (HR 0.74, 95% confidence interval [CI] 0.66-0.83), diagnoses of anxiety (HR 0.82, 95% CI 0.71-0.95), depression (HR 0.65, 95% CI 0.53-0.80), and stress (HR 0.80, 95% CI 0.69-0.92). Similar results were obtained in the validation dataset.

DISCUSSION

This large, population-based study suggests that SARS-CoV-2 infection is not associated with elevated risk for mental distress in adolescents. Our findings highlight the importance of taking a holistic view on adolescents' mental health during the pandemic, with consideration of both SARS-CoV-2 infection and response measures.

Trajectories of Adjustment Disorder and Well-Being in Austria and Croatia during 20 Months of the COVID-19 Pandemic

The present study aimed to investigate the trajectories of adjustment disorder (AD) symptoms and well-being over 20 months of the COVID-19 pandemic in Austria and Croatia. Further objectives of this study were to examine whether sociodemographic characteristics and the symptoms of anxiety and depression could predict these trajectories. As part of the pan-European ESTSS ADJUST study, N = 1144 individuals were recruited using convenience sampling and assessed four times between June 2020 and January 2022 through an online survey. Latent growth curve modelling was applied to estimate the trajectories of AD symptoms and well-being. Over time, the prevalence of probable AD varied between 9.8% and 15.1%. The symptoms of AD tended to increase, whereas well-being tended to decrease. According to the majority of the models tested, women, participants from Austria and those with lower income had higher initial AD symptoms, whereas older participants and those from Croatia had higher initial well-being. In all models and at all timepoints, anxiety and depression significantly predicted AD and well-being scores. Overall, our study points to several predictors of AD and well-being and indicates high variability in people's reactions to the pandemic. Psychosocial support for the general population is needed during pandemics and similar crises, with a special focus on vulnerable groups.

Emotions, COVID-19 related thoughts and satisfaction with life during the critical period from control to relaxation

Introduction

In the context of declining mortality rates and increasing infectivity, it has become unavoidable for the majority of individuals to experience a COVID-19 infection at some point. This study aimed to investigate the psychological well-being of the general population during China's transition period from strict control measures to relaxed policies in COVID-19 prevention and control, as well as the impact of COVID-19 related thoughts on emotion and life satisfaction during widespread infections.

Methods

A cross-sectional study was conducted involving a sample size of 1578 participants. Participants completed self-report questionnaires assessing positive and negative emotions, thoughts about COVID-19, and satisfaction with life. Demographic characteristics such as sex, age, and education level were controlled for in the analysis.

Results

The findings revealed that individuals who had been infected with COVID-19 (specifically the Omicron variant BA.5.2 or BF.7) reported lower levels of positive emotions compared to those who were uninfected or had recovered from the infection. There was a significant relationship between COVID-19-related thoughts, emotions, and life satisfaction. Positive COVID-19 related thoughts were found to mediate the relationship between negative emotions and satisfaction with life.

Discussion

This study represents a comprehensive examination conducted in China, focusing on assessing the impact of the COVID-19 pandemic on the general population during the critical transition period from control to relaxation. Throughout this period, the number of infections experienced fluctuations, initially rising but eventually declining over a one-month span. In such a momentous historical period, maintaining a positive perspective on COVID-19 and its management becomes paramount in enhancing the emotional well-being, life satisfaction and overall well-being of individuals.

Healthcare Professionals' Resilience During the COVID-19 and Organizational Factors That Improve Individual Resilience: A Mixed-Method Study

Healthcare workers are a susceptible population to be psychologically affected during health crises, such as the recent COVID-19 pandemic. Resilience has been pointed out in the literature as a possible protective factor against psychological distress in crisis situations. This can be influenced by internal and external factors, such as individual characteristics and organizational factors. Thus, this study aims to characterize the overall resilience levels among healthcare professionals in Portugal and to understand the perspectives of this healthcare workers regarding organizational factors that improve individual resilience. This is a mixed-method study: a first quantitative study using a cross-sectional design to administer the Resilience Scale for Adults (RSA) to 271 healthcare professionals (Mage 33.90, SD = 9.59 years, 90.80% female), followed by a qualitative study through 10 in-depth interviews. The mean score for the total RSA was 178.17 (SD = 22.44) out of a total of 231. Qualitative analysis showed 4 major themes on factors that enhance resilience: "Professional's Training," "Support and Wellbeing Measures," "Reorganization of Services" and "Professional Acknowledgment." The findings may contribute to the development of targeted interventions and support systems to enhance resilience and well-being among healthcare workers.

Two-year follow-up of post-traumatic stress disorder symptoms in healthcare workers after the COVID-19 pandemic in China

OBJECTIVES

This study aimed to conduct a 2-year follow-up of mental disorders in healthcare workers (HCWs) in a region of China outside the epidemic's core zone who happened to be directly or possibly exposed to persons with COVID-19.

MATERIAL AND METHODS

A cognitive analysis scale was utilized in the evaluation the mental or emotional state of HCWs at Xuzhou Medical University's affiliated hospital in the city of Xuzhou, China (a non-core epidemic area) 2 years after the first assessment during the COVID-19 pandemic. A total of 165 HCWs were selected as the study subjects. In accordance to the exposure risk of COVID-19 patients, the subjects were separated into 2 categories: a group with a high risk HCW (HHCW) (HCWs working in COVID-19-positive wards; N = 91) and a group with a minimal risk HCW (LHCW) (HCWs who worked in wards without COVID-19 patients at the same hospital; N = 75). The clinical as well as demographic information of every HCWs were collected.

RESULTS

The demographic data revealed significant differences in terms of occupation, remuneration, and selfless concerns amidst both categories (p < 0.05). There lacked a statistically notable difference in the occurrence of PTSD between the 2 groups. Data was analyzed for factors associated with PTSD, and the results showed that psychological resilience, job risk, and stress in the workplace were risk factors for PTSD. Additionally, the results of the logistic regression analysis showed that psychological resilience was a significant shared risk factor for PTSD in HCWs after the COVID-19 pandemic.

CONCLUSIONS

The 2-year follow-up showed no statistical difference in the incidence of PTSD between the HHCW group and the LHCW group. Workplace stress, occupational hazards, and psychological resilience were the major contributing risk factors for PTSD in HCWs. Int J Occup Med Environ Health. 2023;36(3):324-32.

A typology of healthcare pathways after hospital discharge for adults with COVID-19: the evolution of UK services during pandemic conditions

Introduction

Over half of post-COVID-hospitalisation adults have persistent symptoms 2 years after discharge, providing a challenge for individuals and healthcare systems. We therefore aimed to describe a typology of UK healthcare pathways post-hospital discharge as a first step towards understanding clinical effectiveness and cost-effectiveness of different healthcare pathways.

Methods

In 2021, we surveyed hospital sites taking part in the UK Post-hospital COVID-19 (PHOSP-COVID) study. The online survey explored the availability of proactive follow-up, patient selection, involvement of multidisciplinary teams, investigations, assessment and access to mental health and rehabilitation interventions. The typology was defined by a three-stage process: 1) using the survey results to develop a bespoke algorithm to inform a draft classification, 2) a stakeholder event for refinement and 3) finalisation between the Project Advisory Group and research team. The bespoke algorithm was used to map each site onto the classification with further mapping by level of mental health and rehabilitation provision.

Results

70% of hospital sites (45 out of 64) responded to the survey. 82% (37 out of 45) reported delivering a follow-up service after hospital discharge during the first few months of the pandemic. Only 13 out of 37 services (35%) were delivered by permanent staff. The final typology of five categories included no proactive follow-up, and a matrix of four groups based on patient selection (prespecified subgroup/all patients) and complexity of assessment (low/high). The complexity of assessment, rehabilitation and mental health interventions was variable within sites.

Discussion

We describe the first typology of post-hospitalisation COVID-19 healthcare pathways to enable modelling of clinical effectiveness and cost-effectiveness to inform future policy. Our results highlight the heterogeneity and vulnerability of healthcare services after COVID-19 hospitalisation.

Mental Health Issues as a Consequence of the Pandemic: Group Psycho-Educational Intervention to Support Patients Recovered from COVID-19 Infection

Common psycho-physical symptoms have emerged in patients who were previously recovered for COVID-19 infection, including traumatic experience and enduring emotional disturbances. A group psycho-educational intervention of seven weekly sessions and a follow-up after three months was proposed to all Italian-speaking patients formally discharged from a public hospital in northern Italy and physically recovered from infection. Eighteen patients were recruited and divided into four age-homogenous groups, each led by two facilitators (psychologists and psychotherapists). The group sessions followed a structured format with thematic modules, including main topics, tasks, and homework assignments. Data were collected through recordings and verbatim transcripts. The objectives of the study were twofold: (1) to analyze the emerging themes and gain insight into the significant aspects of the participants' lived experience of COVID-19, and (2) to examine changes in how participants approached these themes throughout the intervention process. Semantic-pragmatic text analyses, specifically thematic analysis of elementary context and correspondence analysis, were conducted using T-LAB software. Linguistic analysis revealed a congruence between the intervention's objectives and the participants' experiences. The study highlighted an evolution in the narratives, as participants transitioned from a passive and concrete perspective on the disease to a more comprehensive cognitive and emotional elaboration of their personal illness stories. These findings hold potential relevance for healthcare services and professionals working in this field.

Relationships between COVID-19 and disaster risk in Costa Rican municipalities

The COVID-19 pandemic has had far-reaching impacts on every aspect of human life since the first confirmed case in December 2019. Costa Rica reported its first case of COVID-19 in March 2020, coinciding with a notable correlation between the occurrence of disaster events at the municipal scale over the past five decades. In Costa Rica, over 90% of disasters are hydrometeorological in nature, while geological disasters have caused significant economic and human losses throughout the country's history. To analyze the relationship between COVID-19 cases and disaster events in Costa Rica, two Generalized Linear Models (GLMs) were used to statistically evaluate the influence of socio-environmental parameters such as population density, social development index, road density, and non-forested areas. The results showed that population and road density are the most critical factors in explaining the spread of COVID-19, while population density and social development index can provide insights into disaster events at the municipal level in Costa Rica. This study provides valuable information for understanding municipal vulnerability and exposure to disasters in Costa Rica and can serve as a model for other countries to assess disaster risk.

The Coronavirus Impact Scale: Construction, Validation, and Comparisons in Diverse Clinical Samples

Objective

This report is of the construction and initial psychometric properties of the Coronavirus Impact Scale in multiple large and diverse samples of families with children and adolescents. The scale was established to capture the impact of the coronavirus pandemic during its first wave. Differences in impact between samples and internal structure within samples were assessed.

Method

A total of 572 caregivers of children and adolescents or expecting mothers in diverse clinical and research settings completed the Coronavirus Impact Scale. Samples differed in regard to developmental stage, background, inpatient/outpatient status, and primary research or clinical setting. Model free methods were used to measure the scale's internal structure and to determine a scoring method. Differences between samples in specific item responses were measured by multivariate ordinal regression.

Results

The Coronavirus Impact Scale demonstrated good internal consistency in a variety of clinical and research populations. Across the groups studied, single, immigrant, predominantly Latinx mothers of young children reported the greatest impact of the pandemic, with noteworthy effects on food access and finances reported. Individuals receiving outpatient or inpatient care reported greater impacts on health care access. Elevated scores on the Coronavirus Impact Scale were positively associated with measures of caregiver anxiety and both caregiver- and child-reported stress at a moderate effect size.

Conclusion

The Coronavirus Impact Scale is a publicly available scale with adequate psychometric properties for use in measuring the impact of the coronavirus pandemic in diverse populations.

A bibliometric analysis of emerging adulthood in the context of higher education institutions: A psychological perspectives

In recent years, there has been a rise in studies aimed at better understanding the needs and traits of emerging adults and the role that higher education institutions play in their development and success. Despite the relevance of higher education institutions to the emerging adulthood development, there has been scant work done to synthesise the literature on this topic. A bibliometric method was utilised to retrieve 2484 journal articles from Web of Science (WoS). Utilizing co-citation analysis and co-word analysis, we determined the most influential publications, mapped the knowledge structure, and predicted future trends. The results of the co-citation analysis indicate five clusters, while the co-word analysis indicates four. The results could be used as a roadmap for the future of research on emerging adults by a variety of interested parties, including policymakers, university administrators, funders, and academics.