Psychometric Evaluation of the Fear of COVID-19 Scale Among Chinese Population

Gender Differences in the Longitudinal Linkages between Fear of COVID-19 and Internet Game Addiction: A Moderated Multiple Mediation Model

BACKGROUND

The COVID-19 outbreak has profoundly affected the psychological well-being of university students globally. Previous studies have found a positive longitudinal link between fear of COVID-19 (FoC-19) and internet addiction. However, there is a notable gap in the literature regarding COVID-19-specific predictors and underlying mechanisms of internet gaming addiction (IGA).

METHODS

Integrating the compensatory internet use theory and social role theory as frameworks, a three-wave longitudinal approach was used in this study to test the hypothesized model. Data spanning a duration of one year were gathered from undergraduate students in China. From 2021 to 2022, we conducted online self-report surveys in the midst of the COVID-19 pandemic to obtain participants' levels of FoC-19, loneliness, depressive symptoms, and IGA.

RESULTS

FoC-19 showed a longitudinal positive relationship with IGA. The longitudinal link between FoC-19 and IGA was mediated by loneliness and depression. Gender moderated the direct effect of FoC-19 on IGA, with this effect being significant only among male students and not among their female counterparts.

CONCLUSION

These findings advance our comprehension of the mechanisms and gender differences underlying the link between FoC-19 and IGA, and provide a novel perspective for interventions to reduce IGA.

Applying the Unified Theory of Acceptance and Use of Technology to Identify Factors Associated With Intention to Use Teledelivered Supportive Care Among Recently Diagnosed Breast Cancer Survivors During COVID-19 in Hong Kong: Cross-Sectional Survey

BACKGROUND

Many supportive cancer care (SCC) services were teledelivered during COVID-19, but what facilitates patients' intentions to use teledelivered SCC is unknown.

OBJECTIVE

The study aimed to use the unified theory of acceptance and use of technology to investigate the factors associated with the intentions of breast cancer survivors (BCS) in Hong Kong to use various types of teledelivered SCC (including psychosocial care, medical consultation, complementary care, peer support groups). Favorable telehealth-related perceptions (higher performance expectancy, lower effort expectancy, more facilitating conditions, positive social influences), less technological anxiety, and greater fear of COVID-19 were hypothesized to be associated with higher intentions to use teledelivered SCC. Moreover, the associations between telehealth-related perceptions and intentions to use teledelivered SCC were hypothesized to be moderated by education level, such that associations between telehealth-related perceptions and intentions to use teledelivered SCC would be stronger among those with a higher education level.

METHODS

A sample of 209 (209/287, 72.8% completion rate) women diagnosed with breast cancer since the start of the COVID-19 outbreak in Hong Kong (ie, January 2020) were recruited from the Hong Kong Breast Cancer Registry to complete a cross-sectional survey between June 2022 and December 2022. Participants' intentions to use various types of teledelivered SCC (dependent variables), telehealth-related perceptions (independent variables), and sociodemographic variables (eg, education, as a moderator variable) were measured using self-reported, validated measures.

RESULTS

Hierarchical regression analysis results showed that greater confidence using telehealth, performance expectancy (believing telehealth helps with daily tasks), social influence (important others encouraging telehealth use), and facilitating conditions (having resources for telehealth use) were associated with higher intentions to use teledelivered SCC (range: β=0.16, P=.03 to β=0.34, P<.001). Moreover, 2-way interactions emerged between education level and 2 of the telehealth perception variables. Education level moderated the associations between (1) performance expectancy and intention to use teledelivered complementary care (β=0.34, P=.04) and (2) facilitating conditions and intention to use teledelivered peer support groups (β=0.36, P=.03). The positive associations between those telehealth perceptions and intentions were only significant among those with a higher education level.

CONCLUSIONS

The findings of this study implied that enhancing BCS' skills at using telehealth, BCS' and their important others' perceived benefits of telehealth, and providing assistance for telehealth use could increase BCS' intentions to use teledelivered SCC. For intentions to use specific types of SCC, addressing relevant factors (performance expectancy, facilitating conditions) might be particularly beneficial for those with a higher education level.

The Fear of COVID-19 Scale: Psychometric properties and measurement invariance across 10 months

The coronavirus disease 2019 (COVID-19) has led to various negative consequences including fear. The Fear of COVID-19 Scale (FCV-19S) has been widely used in diverse cultures, but no study has ever investigated its longitudinal measurement invariance and predictive validity. Therefore, we examined its longitudinal measurement invariance and predictive validity over 10 months. A sample of Chinese undergraduates (N = 682; first wave 842; 682 second wave) completed the FCV-19S as well as measures assessing depression, anxiety, and stress. Exploratory and confirmatory factor analyses were conducted along with measurement invariance testing. The results showed that the bifactor model fitted well, and significantly predicted stress and anxiety, but not depression. The FCV-19S demonstrated partial measurement invariance (i.e. configural and metric invariances) across time. These findings suggest that the Chinese version of FCV-19S is a reliable tool and could be used in evaluating the severity of fear of COVID-19 among Chinese young adults.

Relationship between fear of COVID-19 and mental health of Chinese nurses: The mediating effects of psychological capital and burnout

AIM

The aim of the study was to investigate the correlation between fear of COVID-19 and mental health of nurses and the effects of psychological capital and burnout in this relation.

DESIGN

A cross-sectional study.

METHODS

The online surveys were conducted among mainland Chinese nurses. Participants (n = 445; average age 32.89 ± 6.76 years) completed an online-questionnaire based on the Fear of COVID-19 Scale, the Psychological Capital Scale, Maslach Burnout Inventory Human Services Survey for Medical Professionals Scale and the 12-Item Short Form Health Survey. Data analysis was conducted by Pearson's correlation analysis, Harman single-factor test and the bootstrap method for mediating effect testing.

RESULTS

(1) The study demonstrated a significant direct effect of fear of COVID-19 on nurses' mental health, as well as on mediating factors such as burnout and psychological capital. (2) Regression analyses confirmed that while psychological capital bolstered mental health, burnout undermined it, with fear of COVID-19 further imposing a negative influence. (3) Fear of COVID-19 exerted an effect on the mental health of nurses by the independent and chain intermediary functions of psychological capital and burnout, resulting in a total mediating effect of -0.233.

Psychometric evaluation of the Chinese version of new fear of the coronavirus questionnaire

The fear of COVID-19 significantly impacting the health of people globally. This study translated newly developed measurement tool New Fear of the Coronavirus Questionnaire (New_FCQ) into Chinese language and evaluated the psychometric properties of the Chinese version of New_FCQ among Chinese population. A total of 522 participants were included in the study. Internal consistency, construct validity, criterion validity, and concurrent validity of the Chinese version of New_FCQ were assessed in this study. The Chinese version of New_FCQ had excellent internal consistency (α = 0.97) and exploratory factor analysis demonstrated one-dimensional structure of the Chinese version of New_FCQ. The preliminary criterion validity revealed statistically significant differences in the fear of COVID-19 scores based on age and education level (P = .002 and P = .03, respectively). The good concurrent validity also established with the Chinese version Fear of COVID-19 Scale(P < .001). Psychometric proportions of the Chinese version of New_FCQ were established, which exhibited sufficient validity and reliability among Chinese population.

Effects of the COVID-19 Pandemic on Dairy Consumption Trends: An Empirical Investigation of Accounting Data in China

The COVID-19 pandemic may have had a negative impact on dairy consumption trends. Many dairy products are perishable and have relatively high income elasticity, causing their susceptibility to market fluctuations in general, including those specifically caused by the pandemic. However, the pandemic has also brought some other prospective possibilities. For example, during the pandemic, people paid more attention to nutrition and health issues and increased the number of meals prepared and eaten at home. In consideration of the particular circumstances during the pandemic, the Chinese government issued several policies to promote the population's dairy consumption, and the Chinese dairy cattle sector actively implemented the policy of "guarantee price, quality, and supply". These factors may have caused the Chinese population to increase their consumption of dairy products during the pandemic. Before the pandemic, the consumption of dairy products in the Chinese population showed an overall upward trend. The question addressed in this study is how has COVID-19 affected dairy consumption trends during the pandemic? This study uses accounting data from the Chinese dairy cattle sector to empirically analyze the impact of the COVID-19 pandemic on dairy consumption trends through economic theories and translog revenue function. Our study found that COVID-19 increased consumers' consumption of dairy products in China, but those people experiencing poverty may still have experienced inadequate dairy intake. This study has contributed to the body of work in this area in the literature and provides response strategies for the dairy cattle sector and the authorities.

The moderated-mediation role of risk perception and intolerance of uncertainty in the association between residual symptoms and psychological distress: a cross-sectional study after COVID-19 policy lifted in China

BACKGROUND

A considerable number of individuals infected with COVID-19 experience residual symptoms after the acute phase. However, the correlation between residual symptoms and psychological distress and underlying mechanisms are scarcely studied. We aim to explore the association between residual symptoms of COVID-19 and psychological distress, specifically depression, anxiety, and fear of COVID-19, and examine the role of risk perception and intolerance of uncertainty in the association.

METHODS

A cross-sectional survey was conducted by online questionnaire-based approach in mid-January 2023. Self-reported demographic characteristics, COVID-19-related information, and residual symptoms were collected. Depression, anxiety, fear, risk perception and intolerance of uncertainty were evaluated using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Fear of COVID-19 Scale (FCV-19S), COVID-19 Risk Perception Scale and Intolerance of Uncertainty Scale-12 (IUS-12), respectively. Linear regression analyses were conducted to explore the associations. A moderated mediation model was then constructed to examine the role of risk perception of COVID-19 and intolerance of uncertainty in the association between residual symptoms and psychological distress.

RESULTS

1735 participants effectively completed the survey. 34.9% of the patients experienced residual symptoms after acute phase of COVID-19. Psychological distress was markedly increased by COVID-19 infection, while residual symptoms had a significant impact on psychological distress (Ps < 0.001), including depression (β = 0.23), anxiety (β = 0.21), and fear of COVID-19 (β = 0.14). Risk perception served as a mediator between residual symptoms and all forms of psychological distress, while intolerance of uncertainty moderated the effect of risk perception on depression and anxiety.

CONCLUSION

A considerable proportion of patients experience residual symptoms after acute phase of COVID-19, which have a significant impact on psychological distress. Risk perception and intolerance of uncertainty play a moderated-mediation role in the association between residual symptoms and depression/anxiety. It highly suggests that effective treatment for residual symptoms, maintaining appropriate risk perception and improving intolerance of uncertainty are critical strategies to alleviate COVID-19 infection-associated psychological distress.

Perceived risk of COVID-19 hurts mental health: the mediating role of fear of COVID-19 and the moderating role of resilience

BACKGROUND

Depression and anxiety have been found prevalent during all phases of the COVID-19 pandemic. In late December 2022, almost all COVID-19 control measures were lifted in China, leading to a surge in COVID-19 infections. The public's perceived risk and fear of COVID-19 would be increased. This study aims to examine the prevalence of depression and anxiety in the Chinese general population and explores the mediating role of fear of COVID-19 between COVID-19 perceived risk and depression/anxiety and the moderating role of resilience between fear of COVID-19 and depression/anxiety.

METHODS

A cross-sectional online survey was conducted in Wenzhou, China, immediately following almost all COVID-19 control measures lifted. The 9-item Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), the COVID-19 Risk Perception Scale, the Fear of COVID-19 Scale, and the Connor-Davidson Resilience Scale (CD-RISC) were used to evaluate depression, anxiety, COVID-19 perceived risk, fear of COVID-19, and resilience, respectively. Structural Equation Modeling (SEM) with Maximum Likelihood (ML) estimator and adjusted for significant background factors was performed to test the moderated mediation. Data obtained from 935 participants were analyzed.

RESULTS

The prevalence of moderate to severe depression and anxiety was 23.7% and 9.5%, respectively. The present study revealed positive associations among COVID-19 perceived risk, fear of COVID-19 and depression/anxiety, and negative associations between resilience and fear of COVID-19/depression/anxiety. Fear of COVID-19 partially mediated the association between COVID-19 perceived risk and depression/anxiety. Furthermore, resilience significantly moderated the association between fear of COVID-19 and depression/anxiety. Two moderated mediation models were constructed.

CONCLUSION

Depression and anxiety were prevalent among Chinese adults during the final phase of the pandemic in China. The significant mediation role of fear of COVID-19 implies that reducing fear of COVID-19 may effectively alleviate depression and anxiety symptoms. Moreover, enhancing public resilience during an epidemic crisis is crucial for promoting mental health.

Prevalence of COVID-19 fear and its association with quality of life and network structure among Chinese mental health professionals after ending China's dynamic zero-COVID policy: a national survey

Background

China recorded a massive COVID-19 pandemic wave after ending its Dynamic Zero-COVID Policy on January 8, 2023. As a result, mental health professionals (MHPs) experienced negative mental health consequences, including an increased level of fear related to COVID-19. This study aimed to explore the prevalence and correlates of COVID-19 fear among MHPs following the end of the Policy, and its association with quality of life (QoL) from a network analysis perspective.

Methods

A cross-sectional national study was conducted across China. The correlates of COVID-19 fear were examined using both univariate and multivariate analyses. An analysis of covariance (ANCOVA) was conducted to determine the relationship between fear of COVID-19 and QoL. Central symptoms were identified using network analysis through the "Expected Influence" of the network model while specific symptoms directly correlated with QoL were identified through the "flow function."

Results

A total of 10,647 Chinese MHPs were included. The overall prevalence of COVID-19 fear (FCV-19S total score ≥ 16) was 60.8% (95% CI = 59.9-61.8%). The binary logistic regression analysis found that MHPs with fear of COVID-19 were more likely to be married (OR = 1.198; p < 0.001) and having COVID-19 infection (OR = 1.235; p = 0.005) and quarantine experience (OR = 1.189; p < 0.001). Having better economic status (good vs. poor: OR = 0.479; p < 0.001; fair vs. poor: OR = 0.646; p < 0.001) and health status (good vs. poor: OR = 0.410; p < 0.001; fair vs. poor: OR = 0.617; p < 0.001) were significantly associated with a lower risk of COVID-19 fear. The ANCOVA showed that MHPs with fear of COVID-19 had lower QoL [F = 228.0, p < 0.001]. "Palpitation when thinking about COVID-19" was the most central symptom in the COVID-19 fear network model, while "Uncomfortable thinking about COVID-19" had the strongest negative association with QoL (average edge weight = -0.048).

Conclusion

This study found a high prevalence of COVID-19 fear among Chinese MHPs following the end of China's Dynamic Zero-COVID Policy. Developing effective prevention and intervention measures that target the central symptoms as well as symptoms correlated with QoL in our network structure would be important to address COVID-19 fear and improve QoL.

Translation and psychometric properties of the Mandarin Chinese version of the COVID-19 Impact Scale in college students

The COVID-19 pandemic has caused significant long psychological impacts that require a novel measurement tool to capture the changes in such impacts. To this end, the COVID-19 Impact Scale (CIS) was developed as an instrument to evaluate psychological responses associated with the pandemic, and has shown evidence of a one-factor structure. The CIS was initially created using an Korea University students sample, and has since been translated and validated in Turkish. A total of 504 College students, aged 17-25, took part in the study from two universities in Jinan, located in Shandong Province, Eastern China, via an online survey platform. They were administered the Chinese versions of the following self-report instruments: Mandarin Chinese CIS, Fear of COVID-19 Scale, Depression Anxiety Stress Scale-21 and Satisfaction With Life Scale. Moreover, a sample of 86 participants who provided their contact information and agreed to participate in the second-round survey were asked to reassess using the Mandarin Chinese CIS after a period of 3 weeks following the initial testing. Results showed that Mandarin Chinese CIS had good internal consistency and test-retest reliability. Additionally, the Mandarin Chinese CIS presented good criterion validity and estimates of convergent validity and incremental validity. In confirmatory factor analysis, the one-factor model showed an acceptable fit after incorporating correlations between error terms. Our findings suggest that the Mandarin Chinese CIS is a reliable and valid self-report tool that demonstrates robust psychometric properties and acceptable construct validity when used with a Chinese university students.

Moderating Effect of eHealth Literacy on the Associations of Coronaphobia With Loneliness, Irritability, Depression, and Stigma in Chinese Young Adults: Bayesian Structural Equation Model Study

BACKGROUND

The COVID-19 pandemic has led to an increase in known risk factors for mental health problems. Although medical information available through the internet and smartphones has greatly expanded, people's ability to seek, eschew, and use reliable web-based medical information and services to promote their mental health remains unknown.

OBJECTIVE

This study aims to explore the associations between coronaphobia and 4 frequently reported mental health problems, loneliness, irritability, depression, and stigma, during the COVID-19 pandemic and to assess the moderating effects of eHealth literacy (eHL) on the adjustment of these relationships in Chinese young adults.

METHODS

The data used in this study were collected from a web-based survey of the general Chinese population, aged between 18 and 30 years, conducted in China between December 2022 and January 2023. A nonprobability snowball sampling method was used for data collection. A Bayesian structural equation model (BSEM) using parameter expansion was used to estimate the moderating effect of eHL on the relationship between coronaphobia and psychological problems. The posterior mean and 95% highest density intervals (HDIs) were estimated.

RESULTS

A total of 4119 participants completed the questionnaire and provided valid responses. Among them, 64.4% (n=2653) were female and 58.7% (n=2417) were rural residents. All measures showed statistically significant but minor-to-moderate associations (correlation coefficients ranged from -0.04 to 0.65). Significant heterogeneity was observed between rural and urban residents at the eHL level, and coronaphobia was observed. The BSEM results demonstrated that eHL was a significant moderator in reducing the negative effects of coronaphobia on loneliness (posterior mean -0.0016, 95% HDI -0.0022 to -0.0011), depression (posterior mean -0.006, 95% HDI -0.0079 to -0.004), stigma (posterior mean -0.0052, 95% HDI -0.0068 to -0.0036), and irritability (posterior mean -0.0037, 95% HDI -0.0052 to -0.0022). The moderating effects of eHL varied across the rural and urban subsamples.

CONCLUSIONS

Using BSEM, this study demonstrated that improving eHL can significantly mitigate the negative effects of coronaphobia on 4 COVID-19-related mental health problems in Chinese young adults. Future eHL initiatives should target rural communities to ensure equal access to information and resources that can help protect their mental health during the pandemic.

Relationships between childhood trauma and mental health during the COVID-19 pandemic: a network analysis

Background

Childhood trauma has been found to have an important impact on mental health. However, little is known regarding the intercorrelations between childhood trauma and mental health during the COVID-19 pandemic. This study aimed to investigate such complex interplay between childhood trauma, depression, anxiety, post-traumatic stress level during the COVID-19 pandemic, and fear of COVID-19 using network analysis.

Methods

A total of 1,247 college students were recruited and were asked to complete a series of questionnaires, including the Childhood Trauma Questionnaire, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, Post-traumatic Stress Checklist-Civilian version, and Fear of COVID-19 Scale. The Gaussian graphical model with the scores of the questionnaires as nodes was estimated. The partial correlations between nodes were calculated as edges. Moreover, network comparison tests were conducted to compare the network patterns between participants with high levels of childhood trauma and low levels of childhood trauma.

Results

Childhood trauma was found to be connected to depression, anxiety, and post-traumatic stress level. The node of childhood trauma exhibited the strongest strength and the highest expected influence in the network. Participants with high levels of childhood trauma and participants with low levels of childhood trauma showed comparable network structure and global strength.

Conclusion

Our findings revealed a complex network pattern between childhood trauma and different mental health problems, indicating that childhood trauma might be a risk factor for mental health during the COVID-19 pandemic.

The role of biofield energy treatment on psychological symptoms, mental health disorders, and stress-related quality of life in adult subjects: A randomized controlled clinical trial

Background

Western and Eastern cultures have practiced biofield energy therapy for thousands of years, but empirical research on effectiveness of this therapy is relatively nascent. Study was aimed to assess the safety and efficacy of biofield therapy on psychological symptoms and mental health disorders in adult subjects.

Methods

Seventy-seven participants (39 male and 38 female) underwent clinical trial. This trial was simple randomized, placebo-controlled, parallel-group, open-label, and single-center with subjects, who have one or more psychological symptoms. Two sessions of biofield energy attunement were given in-person at day 0 and 90 for 3 min (treatment group, n = 35) and others allocated to naive attunement (placebo group, n = 42). Subjects were assessed psychological questionnaire scoring using standard scale of assessment and levels of physiological biomarkers in serum were determined by parameter-specific ELISA.

Results

Perceived psychological symptoms/scores (asthenia, sleep disturbances, anxiety, depression, stress, confusion, future fearness, sexual desireness, motivation, confidence, emotional trauma, etc.) were significantly (p ≤ 0.0001) improved in the treatment group than placebo control group. Furthermore, physiological biomarkers: vitamins (B12, C, and D3 metabolites), immune biomarker (CD8+CD28-), neurotransmitters (acetylcholine, noradrenaline, and dopamine), hormones (oxytocin, 17-β-estradiol, and insulin), and antiaging protein (klotho) levels were significantly (p ≤ 0.001) increased in treatment group than placebo. Proinflammatory cytokines (TNF-α, IL-1β, IL-6, and IL-8) and oxidative stress biomarkers (isoprostane and oxidized LDL) were reduced in treatment group compared with placebo.

Conclusions

Results suggest that experimenter's biofield energy plays a significant role in information transfer processes that contribute to individual's state of physical, mental, emotional, and spiritual well-being as well as improved overall health and quality of life.

Impact of the COVID-19 pandemic on the quality of life and accessing rehabilitation services among patients with spinal cord injury and their fear of COVID-19

BACKGROUND

The unanticipated coronavirus disease (COVID-19) had a negative effect on the quality of life (QoL) of patients with spinal cord injury (SCI) and made significant changes in their daily routine. Patients with SCI face additional health risks, especially mental, behavioral, and physical. Without regular physiotherapy sessions, patients' psychological and functional abilities can deteriorate, and complications can occur. There is little information available about the impact of COVID-19 on the quality of life of patients with SCI, and their access to rehabilitation services during the pandemic.

OBJECTIVE

This study was designed to examine the effects of the COVID-19 pandemic on the quality of life of patients with SCI and also their fear of COVID-19. The pandemic's impact on the accessibility of rehabilitation services and attendance at physiotherapy sessions in one Chinese hospital were also documented.

DESIGN

An observational study based on an online survey.

SETTING

Outpatients clinic at the rehabilitation department of Wuhan's Tongji Hospital.

PARTICIPANTS

People who had been diagnosed with a spinal cord injury (SCI) and who were receiving regular medical monitoring as outpatients at the rehabilitation department were invited to participate in our study (n = 127).

INTERVENTION

Not applicable.

OUTCOME MEASURES

A 12-Item Short-Form Health Survey (SF-12) designed to measure participants' quality of life before and during the pandemic. Their fear of COVID-19 was quantified using the Fear of COVID-19 Scale (FCV-19S). Demographic and medical status information was extracted from their medical records. Their use of rehabilitation services and attendance at physical therapy sessions was also documented.

RESULTS

Seventy-nine patients with SCI completed the SF-12 and FCV-19 scale. The mental and physical aspects of the participants' quality of life declined significantly, during the epidemic compared to the pre-epidemic period. More than half of the participants have experienced fear of COVID-19 based on FCV-19S. Most received only irregular physical therapy during routine checkups. Worry about virus transmission was the most common cause cited for not attending regular physical therapy sessions.

CONCLUSIONS

The quality of life of these Chinese patients with SCI declined during the pandemic. Most of the participants were shown a high level of fear of COVID-19 and were classified as having an intense fear of COVID-19, in addition to the impact of the pandemic on their access to rehabilitation services and attendance at physical therapy sessions.

Development of the Scale for Measuring Perceived Daily Life Disruption

The measures that were taken in many countries as a response to the COVID-19 pandemic not only brought about new stimuli in the lives of individuals, but also gave rise to various restrictions that led to discontinuities in many aspects of daily life. Therefore, the development of a sound measure for monitoring the level of perceived daily life disruption is important. The Perceived Daily Life Disruption (PDLD) scale is proposed and its initial validation based on the assessment of key psychometric properties is targeted in this study. A confirmatory factor analysis (CFA) on the PDLD scale was conducted on a representative sample (n = 1372). In addition, univariate statistics were calculated, internal consistency was tested, and unidimensionality based on principal component analysis was performed. The CFA yielded satisfactory results concerning the standard indices and achieved a high internal consistency. It was observed that the scale adequately differentiates the level of perceived daily life disruption among diverse subpopulations. Usage of the PDLD scale can be recommended; it is easy to administer and it yields acceptable results.

Is indoor and outdoor greenery associated with fewer depressive symptoms during COVID-19 lockdowns? A mechanistic study in Shanghai, China

Increasing numbers of studies have observed that indoor and outdoor greenery are associated with fewer depressive symptoms during COVID-19 lockdowns. However, most of these studies examined direct associations without sufficient attention to underlying pathways. Furthermore, few studies have combined different types of indoor and outdoor greenery to examine their effects on the alleviation of depressive symptoms. The present study hypothesized that indoor and outdoor exposure to greenery increased the perceived restorativeness of home environments, which, in turn, reduced loneliness, COVID-related fears, and, ultimately, depressive symptoms. To test our hypotheses, we conducted an online survey with 386 respondents in Shanghai, China, from April to May 2022, which corresponded to strict citywide lockdowns that resulted from the outbreak of the Omicron variant. Indoor greenery measures included the number of house plants, gardening activities, and digital nature exposure as well as semantic image segmentation applied to photographs from the most viewed windows to quantify indoor exposure to outdoor trees and grass. Outdoor greenery measures included total vegetative cover (normalized difference vegetation index [NDVI]) within a 300 m radius from the home and perceived quality of the community's greenery. Associations between greenery and depressive symptoms/clinical levels of depression, as measured by the Patient Health Questionnaire-9 (PHQ-9), were examined using generalized linear and logistic regression models. Structural equation modeling (SEM) was used to test pathways between greenery exposure, restorativeness, loneliness, fear of COVID-19, and depressive symptoms. The results showed that: 1) indoor and outdoor greenery were associated with fewer depressive symptoms; 2) greenery could increase the restorativeness of the home environment, which, in turn, was associated with fewer COVID-related mental stressors (i.e., loneliness and fear of COVID-19), and ultimately depressive symptoms; and 3) gender, education, and income did not modify associations between greenery and depressive symptoms. These findings are among the first to combine objective and subjective measures of greenery within and outside of the home and document their effects on mental health during lockdowns. Comprehensive enhancements of greenery in living environments could be nature-based solutions for mitigating COVID-19 related mental stressors.

Fear of COVID-19 and Anxiety: Serial Mediation by Trust in the Government and Hope

Purpose

How to reduce the damage of COVID-19 pandemic to people's mental health is a current research hotspot. The present study examined the mediating role of trust in the government and hope in the relationship between fear of COVID-19 and anxiety.

Participants and Methods

In this cross-sectional study, a total of 1053 Chinese subjects (20.24±3.97 years old, 85.3% female) were investigated by using the Fear of COVID-19 Scale, Anxiety Scale, Trust in the Government Measure Scale and Herth Hope Scale, which was conducted by an online survey using snowball sampling technique. Hayes PROCESS macro for SPSS was used to test the hypothesized mediating effects of trust in the government and hope in the relationship between fear of COVID-19 and anxiety.

Results

The fear of COVID-19 could positively predict anxiety level (β=0.36, p<0.001). Results of the mediation analyses demonstrated that trust in the government (β=-0.16, p<0.001) and hope (β=-0.28, p<0.001) mediated the relationship between fear of COVID-19 and anxiety level respectively. Moreover, fear of COVID-19 could also indirectly predict anxiety level through the chain-mediated role of the trust in the government and the hope (β=0.28, p<0.001).

Conclusion

Our findings shed light on a correlation between fear of COVID-19 and anxiety. This study emphasizes the value of trust in the government and hope in maintaining mental health when individuals face public stress events from both external and internal perspectives.

The Relationship Between Perceived Vulnerability to Disease and Anxiety During the COVID-19 Pandemic: Serial Mediation by Fear of COVID-19 and Trust in the Government

Purpose

The continuing global spread of COVID-19 has seriously jeopardized human mental health. How to reduce the damage of COVID-19 pandemic to people's mental health is a current research hotspot. The purpose of this study was to explore the influence mechanism of perceived vulnerability to disease on anxiety level during the COVID-19 pandemic.

Methods

A total of 1085 Chinese subjects were investigated by using the Fear of COVID-19 Scale, Perceived Vulnerability to Disease Scale, Trust in the Government Measure Scale and Anxiety Scale, which was conducted by an online survey using snowball sampling technique. Hayes PROCESS macro for SPSS was used to test the hypothesized mediating effects of fear of COVID-19 and rust in the government measure in the relationship between perceived vulnerability to disease (PVD) and anxiety.

Results

(1) the PVD significantly positively predicts anxiety level (0.001); (2) Fear of COVID-19 (p<0.001) and trust in the government (p<0.001) mediated the relationship between PVD and anxiety level respectively; (3) PVD could also indirectly predict anxiety level through the chain-mediated role of the fear of COVID-19 and the trust in the government measure (p<0.001).

Conclusion

Our findings shed light on a correlation between perceived vulnerability to disease and anxiety. This study emphasizes the value of trust in the government in facing public stress events. Moreover, this study provides some implications for how to prevent or reduce public anxiety in an epidemic setting.

Psychometric properties of the traditional Chinese version of the COVID Stress Scales in Hong Kong

Introduction

The COVID Stress Scales (CSS) assess six domains of COVID-19-related stress, including (a) COVID danger, (b) COVID socioeconomic consequences, (c) COVID xenophobia, (d) COVID contamination, (e) COVID traumatic stress symptoms, and (f) COVID compulsive checking. Although the CSS have been validated in various cultural contexts, their psychometric properties in Hong Kong have not been examined. This study endeavors to validate the traditional Chinese version of the 36-item CSS (CSS-36) and the 18-item CSS (CSS-18) in Hong Kong.

Method

Participants were 521 Hong Kong undergraduate students (61% female) aged from 18 to 26 years (M = 20.65, SD = 1.56). An online questionnaire was used for data collection.

Results

The results of confirmatory factor analyses supported a six-factor structure for both the CSS-36 and the CSS-18. Multiple-group confirmatory factor analyses established the gender invariance of the six-factor model for both the CSS-36 and the CSS-18. The CSS-36 and the CSS-18 exhibited good internal consistency reliability and concurrent validity with fear of COVID-19 and negative emotional states.

Discussion

The findings offer evidence for the psychometric properties of the traditional Chinese version of the CSS-36 and the CSS-18 in the Hong Kong context.

Associations between sedentary behavior and negative emotions in adolescents during home confinement: Mediating role of social support and sleep quality

Background

Prolonged periods of sedentary behaviour, for instance, engendered by home confinement in Shenzhen city, has led to negative mental health consequences, especially in adolescents. Previous research suggests, in general, that sedentary behavior can increase negative emotions. However, the specific mechanism driving the relationship between sedentary behavior and negative emotions is still relatively unclear. Social support and sleep quality might partly explain the effect of sedentary behavior on negative emotions. Thus, the current study aimed to examine the associations between sedentary behavior and negative emotions, and to investigate if social support and sleep quality mediate such a relationship.

Method

During home confinement due to the COVID-19 Omicron variant outbreak, 1179 middle and high school students in Shenzhen were invited to voluntarily complete an e-questionnaire, including the 21-item Depression Anxiety Stress Scale (DASS-21), the short form of the International Physical Activity Questionnaire (IPAQ-SF), the Social Support Rating Scale (SSRS) and the Pittsburgh Sleep Quality Index (PSQI). Data from 1065 participants were included in the analysis.

Results

We observed significant sex-related and demografic-related differences in emotional (e.g., anxiety, stress and social support) and other outcome variables (e.g., sitting duration and PSQI score). Furthermore, sedentary behavior, social support, and sleep quality were associated with negative emotions (p < .01), even after controlling for sex, age, only-child case, body mass index, and metabolic equivalent level. In addition, social support and sleep quality partially mediated the association between sedentary behavior and negative emotions.

Conclusion

The findings of the current study suggest that social support and sleep quality partially mediate the relationship between sedentary behavior and negative emotions in middle and high school students during home confinement in Shenzhen city.

Proposed Cut-Off Score for the Japanese Version of the Fear of Coronavirus Disease 2019 Scale (FCV-19S): Evidence from a Large-Scale National Survey in Japan

The Fear of coronavirus disease 2019 (COVID-19) Scale (FCV-19S) is a seven-item self-administered psychological scale for measuring the fear of this disease. The scale has been widely adapted and validated worldwide. This study aimed to propose a cut-off score for the validated Japanese version of the FCV-19S. We conducted a nationwide online survey and included 26,286 respondents in the analysis. Respondents answered questions on their sociodemographic characteristics, and using the FCV-19S and six-item Kessler Psychological Distress Scale, we measured psychological distress and assessed whether the fear of COVID-19 interfered with their daily lives. A total score of ≥21 points was considered adequate to identify those with psychological distress or difficulties in daily living because of the fear of COVID-19. This cut-off score will contribute to mental health assessment during the COVID-19 pandemic.

Participation in community seniors' organizations and mental health among retired adults in urban China: The mediating role of interpersonal needs

Purpose

This study aimed to investigate the association between participation in community seniors' organizations (CSOs) and mental health among retired adults in urban China, and illustrate the causal mechanism.

Methods

We collected data on participation from a community seniors' organization and mental health survey in Shenzhen City, China, in July 2022. The survey used a two-stage cluster sample design, based on administrative divisions as the primary sampling unit and communities as the second sampling unit, where retired adults were randomly sampled. The inclusion criteria were individuals >60 years old (the mandatory age for retirement in China) or women who retired early at the age of 45 years. We used three multivariable regression models to estimate the effects of participation in CSOs on mental health. Furthermore, we used structural equation models to examine the mediator of acquired interpersonal needs in the association between CSOs participation and mental health.

Results

The study examined the values of CSOs, generated explicitly for older adults and explained how participation in such organizations benefits retired adults' mental health. Mental health is defined in three dimensions: aggregate mental health, positive emotions, and negative emotions. The results show that constituting social networks with like-minded individuals and perceiving interpersonal needs are the two main benefits of CSOs on mental health. The retired individual who participated in CSOs with a higher level of diversity and frequency, joined specific types such as health- and study-related CSOs, could receive more interpersonal needs and were probably mentally healthier. The mediating mechanism of interpersonal needs associated with participation in mental health was significant. Besides, mental health is generally affected by physical health, sleep quality, and socioeconomic status.

Conclusion

This study suggested that CSOs have expanded the social interaction channels of retired adults and affected their mental health by providing basic interpersonal needs such as inclusion, dominance, and affection. Among the types of CSOs, health and study organizations might enhance mental health most effectively, while semi-official organizations have no effect.

Neuroticism and fear of COVID-19 during the COVID-19 pandemic: Testing the mediating role of intolerance of uncertainty and sense of control among Chinese high school students

Since the COVID-19 pandemic broke out in 2019, neuroticism has been proven a predictor of fear of COVID-19 infection. However, only few studies have been conducted on the factors affecting the relationship between neuroticism and this kind of fear. The present study is aimed at analyzing the role intolerance of uncertainty (IU) and sense of control (SOC) play in relation to neuroticism and the fear of COVID-19. We conducted a cross-sectional study in Guangdong and Guangxi provinces, China, and we collected complete datasets from 792 high school students. The main results can be described as follows: (a) individuals with high neuroticism tended to have higher intolerance of uncertainty (IU) and a lower sense of control (SOC); (b) IU and SOC played a mediating role between neuroticism and fear of COVID-19, and a serial mediation effect was found between these factors; (c) after controlling for both IU and SOC, the effect of neuroticism on fear was no longer significant. The results suggested a critical role of IU and sense of control in the causal relationship between neuroticism and fear.

Intolerance of uncertainty and future career anxiety among Chinese undergraduate students during COVID-19 period: Fear of COVID-19 and depression as mediators

Uncertainty is mushrooming throughout COVID-19, and intolerance of uncertainty (IoU) nudges people into mental health difficulties involving fear, depression, and anxiety. The objective of this study was to investigate the role of depression and fear of COVID-19 (FoC) in the association between IoU and future career anxiety (FCA) among Chinese university students during the COVID-19 pandemic. This study involved 1,919 Chinese undergraduate students from 11 universities in eight Chinese cities with an online self-administered survey that included demographic information, IoU, FoC, depression, and FCA completed by all participants. Our study demonstrated a positive relationship between IoU and FCA and the chain mediation effect of FoC and depression. Thus, understanding how FoC affects FCA not only informs university career professionals and assists students in preparing for employment, but also motivates schools to offer career opportunities workshops and, most importantly, provides mental health support to help students effectively cope with uncertainty and overcome COVID-19-related stress.

The Impacts of the COVID-19 Pandemic on Hong Kong Nursing Students' Mental Health and Quality of Life

Evidence shows that university students, especially healthcare students, experienced considerable health impacts during COVID-19. This study examined Hong Kong general nursing students' mental health and quality of life during the COVID-19 pandemic. An online questionnaire composed of personal demographics, the Fear of COVID-19 scale (FCV-19S), the Depression Anxiety Stress Scale short version (DASS21), and the World Health Organization Quality of Life-BREF (WHOQOL-BREF) was used for data collection in early 2021. Among 380 respondents, 170 (45%) did not attend clinical practicum during the pandemic. Students who did not participate in clinical training scored lower in FCV-19S but higher in WHOQOL-BREF than those who participated (p = 0.001 or p < 0.001). FCV-19S and WHOQOL-BREF were negatively correlated (r = -0.623 to -0.446, p < 0.001). Slight negative correlations were found between the FCV-19S and DASS-21 scores. Although there were no significant differences in DASS21 (p = 0.294-0.931) between these two student groups, there was a considerably high prevalence rate of depression (57.1%), anxiety (47.6%), and stress (39.5%). Hong Kong nursing students, especially those who attended clinical practicum during the pandemic, experienced substantial emotional and quality of life implications. Local universities are recommended to organize appropriate interventions to prepare and support nursing students' wellbeing and health in coping with future disasters.

The effects of forest therapy on public mental health and circular economy: A policy support model in Japan

Background

Forest therapy has gained popularity in Japan and even other nations/regions due to its health benefits. In addition, forest therapy has contributed to the development of circular economy and industrial upgrading. Japanese successful practice can serve as a model for other countries in the Asia-Pacific region. To this end, the aim of this study was to determine whether forest therapy can improve the whole well-being of the participants and has a positive effect on the development of circular economy in the region.

Methods

Both empirical and inductive research methods were used; empirical approach was conducted to perform comparative analysis of regional data that was retrieved from the research project of Japanese Forestry Agency in 2015. Specifically, the efficacy of forest therapy on physical (blood glucose, blood pressure, body weight) and mental (sleep quality e.g.,) health outcomes among 815 participants was investigated. Regional data are from the statistics of Iiyama City from 1990 to 2005. After the concept of forest therapy became popular in the late 1990s, this element had a great positive impact on the economic benefits of Ishiyama City and other major forest scenic areas. We summarize and analyze a series of policies made by relevant departments of the Japanese government in the years from 2019 to 2021 to promote forest therapy and related circular industry development.

Results

Significant (pre-to-post participation) changes in physical measure was observed. Firstly, mean weight of those overweight participants decreased across three different time points (pre-test/enrollment = 79.7 kg, 3-month participation = 77.2, and 6-month participation = 76.8 kg), while overall mean weight of the participants decreased to 61, 60.5, and 60.4 kg, respectively. Secondly, Participant with normal weight showed a decrease on mean HbA1C (from 6.09 to 6.06) at Week 24, while overweight participants demonstrated a slight change 6.03-6.01 after 6 months the average HOMA-IR for overweight participants decreased from 3.5 to 2.5 at Week 24, while participants with normal weight demonstrated a decrease from 2.2 to 1.7 at Week 24. Forest Therapy has emerged in Japan since Mid-1990s and has attracted a large number of tourists all over the world due to its unique health benefits.

Conclusion

Forest therapy in Japan has positive effects on whole well-being of Japanese residents and it has helped public mental health promotion and economic growth. Under the guidance and support of government policies, it can promote the development of circular economy and industrial transformation and set a model of Japanese forest therapy development for other countries in the Asia-Pacific region.

Physical activity and mental health in sports university students during the COVID-19 school confinement in Shanghai

Background

In 2022, Shanghai was seriously affected by the coronavirus disease 2019 (COVID-19) pandemic. The government implemented citywide static management for 2 months, as well as all universities in Shanghai, which changed the normal learning and living style of sports students and led to a decline in physical activity level. As the physical activity has a strong correlation with mental health, this study aimed to investigate the current state of physical activity (PA) and mental health of the students in Shanghai University of Sport. It will try to reveal the correlation between PA and depressive symptoms, anxiety symptoms, fear of COVID-19 and smartphone addiction.

Methods

A cross-sectional survey was conducted on a random sample of 400 students who came from six different majors in May 2022 at the Shanghai University of Sport. Respondents completed the International Physical Activity Questionnaire Short Form (IPAQ-SF), the Chinese version of the 9-item Patient Health Questionnaire (PHQ-9), the Chinese version of the Generalized Anxiety Disorder Scale (GAD-7), the Chinese version of the COVID-19 Fear Scale (FCV- 19S), and the Smartphone Addiction Scale (SAS-SV). Demographics, PA, depressive symptoms, anxiety symptoms, fear of COVID-19, and smartphone addiction were compared. A binary logistic regression model was used for the further analysis.

Results

A total of 376 college students were included in the final analysis. Binary logistics analysis showed that moderate physical activity (MPA) was negatively correlated with depression (OR = 0.95, 95%CI = 0.93-0.98), anxiety (OR = 0.97, 95%CI = 0.95-0.99), fear of COVID 19(OR = 0.99, 95%CI = 0.98-0.99)and smartphone addiction (OR = 0.94, 95%CI = 0.9-0.98) (all P < 0.05). Sedentary behavior was positively correlated with smartphone addiction (OR = 1.01, P < 0.01, 95%CI = 1.001-1.004).

Conclusion

There was an association between the presence of MPA and depressive symptoms, anxiety symptoms, fear of COVID-19, smartphone addiction, and sedentary behavior associated with smartphone addiction levels. Clarifying the causal relationship between PA and mental health will require further research.

Concerns of High-Risk Pregnancies During Pandemic: COVID-19 and Fear of Birth

AIM

This study was conducted to determine the fear of birth and coronavirus disease 2019 in pregnant women who applied to the high-risk pregnancy outpatient clinic during the pandemic and investigate whether there is a relationship between these fears.

METHOD

This study is a descriptive cross-sectional study using questionnaires. The Fear of COVID-19 Scale and Fear of Birth Scale for Pregnant Women were validated in Turkish in outpatient women with high-risk pregnancies. The study was carried out with 238 pregnant women between February 15 - April 15, 2021.

RESULTS

The mean age of the pregnant women participating in the study was 30.22 ± 6.01, the mean week of gestation was 30.87 ± 5.56, the total mean of Fear of COVID-19 Scale score was found to be 18.23 ± 6.41, and Fear of Birth Scale for Pregnant Women total mean score was 62.30 ± 25.66. An increased prevalence of anxiety has been found in high-risk pregnant women during the coronavirus disease-2019 pandemic. It was observed that there was a significant, positive, and low-level relationship between Fear of COVID-19 Scale-19 and Fear of Birth Scale for Pregnant Women of high-risk pregnant women (r = .268; p = .000).

CONCLUSION

Prenatal anxiety was prevalent among high-risk pregnant women who required routine anxiety screening and psychosocial support during the coronavirus disease-2019 pandemic.

Assessing anxiety during the COVID-19 delta epidemic: Validation of the Chinese coronavirus anxiety scale

The study aimed to examine the psychometric properties of the coronavirus anxiety scale (CAS) during the coronavirus disease 2019 (COVID-19) delta epidemic. A total of 2,116 participants on the Chinese mainland completed the online survey. We employed exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to investigate the factor structure. The findings showed that the one-factor model of the CAS Chinese version fitted perfectly with the data. The multigroup CFAs showed the measurement invariance across gender and age groups (18–29 and 30–68). We also examined the CAS’s internal consistency and convergent and concurrent validity. The results demonstrated that the one-factor model had good reliability and convergent and concurrent validity. Overall, according to our findings, the CAS Chinese version was reliable for measuring coronavirus anxiety during the COVID-19 delta outbreak.

Fear of COVID-19 and the career maturity of Chinese international high school students: The mediating effect of the intolerance of uncertainty

This study examined the influencing mechanism underlying the relationship between the fear of COVID-19 and Chinese international high school students' career maturity by investigating the mediating role of the intolerance of uncertainty. The results indicated that the fear of COVID-19 and the intolerance of uncertainty are negatively associated with international high school students' career maturity. Moreover, intolerance of uncertainty plays a mediating role in the relationship between the fear of COVID-19 and career maturity. The findings contribute to the literature on mental health and have important practical implications for international high school students' mental health and career development.

Validation of the 4-Item and 10-Item Uncertainty Stress Scale in a Community-Based Sample of Chinese Adults

Purpose

The objectives of this study were to examine the psychometric properties of the Uncertainty Stress Scale (USS) and to compare the usefulness of two versions of the scale (USS-4 and USS-10) among a large community-based sample of Chinese adults.

Participants and Methods

The Uncertainty Stress Scale was validated in 904 community residents (mean age: 32.71 ± 10.99; male: 41.7%) through an online survey conducted in February 2020. Psychometric properties of reliability (Cronbach’s alpha), construct validity (confirmatory factor analysis), and criterion validity (correlation and ROC curve analyses) were evaluated using established benchmarks. To validate the USS, we used the Chinese version of the Perceived Stress Scale (CPSS). In addition, sensitivity, specificity, and suitable cutoff values of the two versions of USS were determined.

Results

Both versions of the USS had high internal consistency (USS-10: 0.941; USS-4: 0.851). Confirmatory factor analyses supported a one-factor structure for both measures. Both USS-4 and USS-10 scores were significantly positively correlated with CPSS scores, indicating acceptable criterion validity.

Conclusion

The findings of the current study confirmed that the psychometric properties of two Chinese versions of USS are acceptable. Furthermore, the 4-item USS was as effective as the 10-item USS for the measurement of uncertainty stress in our community-based sample of Chinese adults suggesting that the USS-4 is a time-efficient alternative to the USS-10 which can be used when the circumstances require a time-efficient instrument (eg, in epidemiological studies with a large test battery).

Validation of the fear of COVID-19 scale in a central Balkan country - Serbia

Validation of the fear of introduction

High levels of fear of COVID-19 may be associated with increased levels of stress, anxiety, and depression, as well as decreased resilience and life expectancy.

Objective

This study aimed to translate and confirm the Serbian version of the Fear of COVID-19 scale as well as to investigate its psychometric properties.

Methods

The translation and intercultural adaptation of the Fear of COVID-19 scale was performed by the leading standard of the International Society for Pharmacoeconomics and Outcome Research. When the distribution was normal, the Kolmogorov-Smirnov test was used. The reliability of the Serbian version of FCV-19S was tested by measuring the internal consistency through the value of Cronbach's alpha.

Results

The original version of the Fear of COVID-19 scale was tested on a sample of 256 subjects with a mean age of 25.38 ± 12.47. The Cronbach's alpha value was 0.864. We divided the scale by the split-half method (Spearman-Brown), and the value of the coefficient for the questionnaire as a whole was 0.882. Divergent criterion validity was tested through the non-parametric correlation between the scores of the Fear of COVID-19 scale and the Fear of Hospitalization scale. A score of the Fear of COVID-19 scale was calculated as the sum of each question for each of the respondents. Convergent criterion validity was tested through the non-parametric correlation between the scores of the Fear of COVID-19 scale and the Emotional Regulation Questionnaire.

Conclusion

The validated version of the scale in Serbia complements versions available in other cultures and other languages and facilitates global studies related to mental health during the COVID-19 pandemic.

The adaption of the Chinese version of the COVID Stress Scales as a screening instrument of stress: Psychometric properties during the COVID-19 pandemic

The COVID Stress Scales (CSS) was used to access related distress concerning Corona Virus Disease 2019 (COVID-19). Based on China's epidemic prevention and control policies during the COVID-19 pandemic, the adaption of the Chinese version of the CSS was developed. Our study evaluated the reliability and validity of the Chinese adapted version of the CSS during the COVID-19 pandemic. An online survey was employed to construct a national sample of 2,116 participants in Chinese mainland. We examined the factor structure, internal consistency, convergent validity, discriminant validity, and concurrent validity. The results demonstrated that the six-factor solution for the Chinese adaptation of the CSS proved a good fit with the data after comparing the factor structure with the five-factor model. The six-factor model had good reliability and supported good convergent, discriminant, and concurrent validity of the CSS Chinese adaption. Overall, our findings supported the Chinese adapted version of the CSS as a psychometrically sound measure of stress during the COVID-19 pandemic in China.

Institutional Trust as a Protective Factor during the COVID-19 Pandemic in China

Previous research has demonstrated that institutional trust protects subjective well-being during pandemics. However, the potential mediation mechanisms underlying this linkage remain unclear. This study constructs a mediating model to investigate the effect of institutional trust on subjective well-being and the mediating roles of belief in a just world and fear of COVID-19 in the Chinese context. To this end, we survey a sample of 881 participants. The results show that institutional trust, belief in a just world, fear of COVID-19, and subjective well-being (i.e., life satisfaction, positive affect, and negative affect) are significantly interrelated. The results also indicate a significant impact of institutional trust on life satisfaction, positive affect, and negative affect. Belief in a just world and fear of COVID-19, independently and in sequence, mediate the relationship between institutional trust and subjective well-being.

Cross-Cultural Adaptation and Validation of the Fear of COVID-19 Scale for Chinese University Students: A Cross-Sectional Study

BACKGROUND

fear of COVID-19 is widespread among the population, especially among college students because of their increased exposure to the media information overload of the COVID-19 outbreak. The Fear of COVID-19 scale (FCV-19 S) is a relatively short instrument used to evaluate fears surrounding the COVID-19 pandemic. However, the validity and reliability of the Fear of COVID-19 Scale have not been fully investigated in Chinese university student groups.

OBJECTIVES

this study assessed the cross-cultural adaptability and reliability of the FCV-19S for Chinese university students.

METHODS

a Chinese version of Fear of COVID-19 Scale (C-FCV-19S) was generated using the translation-backward translation method. Psychometric properties of the C-FCV-19S, including internal consistency, split-half reliability, construct reliability, convergent validity, and diagnostic accuracy, were evaluated. The Patient Health Questionnaire (PHQ) and Generalized Anxiety Disorder Questionnaire (GAD-7) scales were also used to evaluate participants for depression and anxiety.

RESULTS

the C-FCV-19S has acceptable internal consistency (Cronbach's alpha: 0.872) and satisfactory split-half reliability (correlation coefficient: 0.799). Using the exploratory factor analysis (EFA), we examined the construct reliability (KMO = 0.920). The confirmatory factor analysis (CFA) confirmed that the bifactor model of scale (including general factor, factor1: the awareness of COVID-19 and physiological arousal, factor 2: fear-related thinking) had a good fit index (χ2/df =6.18, RMSEA= 0.067, SRMR = 0.028, GFI = 0.986, TLI = 0.970 and CFI= 0.988). Using depression-positive and anxiety-positive scores as reference criteria, we found that the areas under the curve were 0.70 and 0.68, respectively, and that the optimal cutoff scores of the C-FCV-19S was 17.5 (sensitivity: 66.3% and 58.7%, respectively).

CONCLUSIONS

the validity and reliability of C-FCV-19S are satisfactory, and the optimal cutoff point was 17.5. The C-FCV-19S can be applied adopted in Chinese university students.

Psychometric validity and reliability of the 10- and 2-item Connor-Davidson resilience scales among a national sample of Americans responding to the Covid-19 pandemic: an item response theory analysis

Purpose

Psychometric validity/reliability of 10-item and 2-item abbreviations of the Connor–Davidson Resilience Scale (CD-RISC-10; CD-RISC-2) was investigated via item response theory and classic approaches.

Methods

We sampled 5023 adult American participants in a June/July 2020 survey on the COVID-19 pandemic’s psychological effects. Our questionnaire incorporated the CD-RISC-10 with other validated measures. CD-RISC-10 items were ranked on item-to-scale correlations, loadings on a one-factor confirmatory factor analysis model, and item slope/threshold parameters plus information curves from a unidimensional graded response model. Concurrent validity of the highest ranked item pair was evaluated vis-à-vis the CD-RISC-10 and CD-RISC−2. Internal consistency, based on average variance extracted (AVE) and multiple reliability coefficients, was also compared. Convergent/divergent validity was tested by correlating anxiety, depression, fear of COVID-19, anxiety sensitivity, coping, and personality measures with both scales and the highest ranked item pair. Binary agreement/classification indexes assessed inter-rater reliability.

Results

Items 2 and 9 from CD-RISC-10 ranked the highest. Reliability coefficients were > 0.93, > 0.72, and > 0.82 for the CD-RISC-10, CD-RISC-2, vs summation of items 2 and 9. AVEs were 0.66, 0.67, and 0.77. CD-RISC abbreviations and the summation of items 2 and 9 correlated negatively with anxiety (> − 0.43), depression (> − 0.42), and fear of COVID-19 (> − 0.34); positively with emotional stability (> 0.53) and conscientiousness (> 0.40). Compared to the CD-RISC-2, summative scores of items 2 and 9 more efficiently classified/discriminated high resilience on the CD-RISC-10.

Conclusion

We confirmed construct validity/reliability of copyrighted CD-RISC abbreviations. The CD-RISC-10’s items 2 and 9 were psychometrically more salient than the CD-RISC−2.

Supplementary Information

The online version contains supplementary material available at 10.1007/s11136-022-03125-y.

Fear of COVID-19 Among College Students: A Systematic Review and Meta-Analysis

Background

Mental health issue among college students is routinely a major public health concern, and coronavirus disease 2019 (COVID-19) pandemic may have exacerbated the students' mental health issues which include psychological distress, panic disorder, insomnia, and posttraumatic stress symptoms. However, few studies reached a consensus on the impact of COVID-19 fear on mental health among college students. Therefore, we aimed to conduct a systematic review and meta-analysis that quantitatively synthesized the fear among college students during the COVID-19 pandemic.

Methods

PubMed, EMBASE, CINAHL, and PsycINFO electronic databases were systematically searched to identify cross-sectional study reporting the state of COVID-19 fear examined by the Fear of COVID-19 Scale (FCV-19S) published up until November 20, 2021. Methodological quality was complied with the evaluation criteria of the Agency for Healthcare Research and Quality. The random effects model was employed to estimate the pooled mean of FCV-19S score. Subgroup analysis and meta-regression analysis were also conducted. Publication bias was assessed by Begg's test and funnel plot.

Results

A total of 16 studies with a sample size of 11,872 were included. A pooled mean of FCV-19S score was 17.60 [95% confidence interval (CI): 16.41–18.78]. The mean of COVID-19 fear in women (17.11, 95% CI: 16.59–17.64) was higher than that in men (15.21, 95% CI: 14.33–16.08). The highest and lowest pooled means of FCV-19S score were observed in the studies conducted in multiple countries that include Israel, Russian, and Belarus (21.55, 95% CI: 20.77–22.33) and in Europe (16.52, 95% CI: 15.26–17.77), respectively. No significant publication bias was detected by Begg's test.

Conclusions

College students experienced a moderate level of fear caused by COVID-19 pandemic. It is necessary to design and implement prevention programs that target the mental health of college students.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021287017, identifier: CRD42021287017.

Cross-cultural measurement invariance of the fear of COVID-19 scale in three Portuguese-speaking countries

This study evaluated the measurement invariance of the Portuguese version of the Fear of COVID-19 Scale (FCV-19S) across three countries: Brazil (South America), Mozambique (East Africa), and Portugal (Southwest Europe). A total of 8694 participants were recruited through convenience sampling (7430 Brazilians, 387 Mozambicans, and 877 Portuguese adults). The unidimensional structure of the FCV-19S fitted well with each country’s data. Multigroup confirmatory factor analysis showed that the FCV-19S was partially invariant across countries and fully invariant across gender and age groups, thus providing a solid basis for cross-group comparisons. Structural invariance tests revealed different levels of fear across countries and genders but not across age groups.

Development of the "COVID-19 psychological impact Scale": A validity and reliability study

This scale development study aimed to identify the level of COVID-19 impact on the psychology of adults during or after the pandemic. The study group consisted of 1604 individuals for the first stage and 597 individuals for the second stage, who were reached online through convenience sampling method. After the exploratory factor analysis performed on the 50-item pilot survey, a three-factor structure was obtained explaining 60.96% of the total variance. The load values of the items in the "Dejection" sub-dimension were between 0.65 and 0.82, in the "Anxiety" sub-dimension between 0.59 and 0.77 and in the "Frustration" sub-dimension between 0.70 and 0.76. In the reliability analysis, the Cronbach Alpha value for the whole scale was found to be 0.93, and the Cronbach Alpha values for the subscales were found to be Dejection = 0.94, Anxiety = 0.81 and Frustration = 0.83. For similar criterion validity, the survey was applied to 597 new participants and the Pearson Moment Correlation Coefficient between the "COVID-19 Psychological Impact Scale" and the "Depression Anxiety Stress Scale" was found to be 0.71. A confirmatory factor analysis was carried out with the new data set from 597 participants and the goodness of fit index values obtained showed that the model was acceptable and/or perfect compatible. As a result of the research, it has been revealed that the "COVID-19 Psychological Impact Scale" is a valid and reliable scale applicable to adults aged 18 and over.

Psychometric Properties of an Instrument to Assess the Fear of COVID-19 in a Sample in Argentina: a Mixed Approach

The FCV-19S was the first instrument designed to assess the severity of fear related to COVID-19 and has already been validated in many languages. The objective of this study was to evaluate the homogeneity and construct validity of the 5-item version of the FCV19S, using an online questionnaire in 599 people. The participants' age ranged from 18 to 65 years. Age, gender, marital status, educational level, employment status, and socioeconomic status were analyzed. In the evaluation process we assessed interitem correlation, item rest-correlation, confirmatory factor analysis: Root Mean Square Error of Approximation, Comparative Fix Index, Tucker-Lewis Index; internal consistency (Cronbach's alpha, McDonald's omega), and the Rasch model was assessed for learning more about the psychometric properties of the scale, which allows a detailed knowledge of the strengths and weaknesses of a scale. The FCV-5S has adequate psychometric indicators from the perspective of the Classical Theory of Items. The major limitations were using a self-reported measure and having a convenience sample not necessarily representative of the general population of Argentina.

Psychometric evaluation of fear of COVID-19 Scale (FCV-19S) among Chinese primary and middle schoolteachers, and their students

Utilizing a large-scale cross-sectional survey, the present study tested the advanced psychometric properties of Fear of COVID-19 Scale (FCV-19S) in specific populations (i.e., primary and middle schoolteachers, and their students). The present study also examined the association between perceived fear of COVID-19 and psychological distress among home-room teachers (i.e., teachers who teach all their students in one classroom all day) and their students. The results among participants (11,134 teachers and 4,335 students) indicated good internal reliability of FCV-19S and excellent factorial validity with a two-factor structure utilizing these specific populations. Furthermore, the multilevel analysis showed that home-room teachers' psychological distress, but not fear of COVID-19, was positively associated with their students. In sum, the FCV-19S is a useful tool to assess the fear of COVID-19 on potentially vulnerable populations (i.e., primary/middle schoolteachers and their students). Future studies are encouraged to use the present study's findings to investigate possible underlying mechanisms for developing effective coping strategies and interventions.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12144-021-02471-3.

Impact of the COVID-19 pandemic on the mental health of nursing students in Japan: a cross-sectional study

BACKGROUND

The effect of the prolonged coronavirus disease (COVID-19) pandemic on the mental health of nursing students is unclear. This study assesses the prevalence of anxiety, depression, and insomnia among nursing students in Japan during the pandemic and determines the risk factors associated with such symptoms.

METHODS

An online survey-based cross-sectional study was conducted from August 16 to October 16, 2021. Participants were first- to fourth-year nursing students enrolled in undergraduate programs at the eight universities in Japan. Anxiety, depression, and insomnia were assessed using the Generalized Anxiety Disorder-7, Patient Health Questionnaire-9, and Insomnia Severity Index-7, respectively. We calculated descriptive statistics for each measurement item and performed univariate and logistic regression analyses to evaluate the potential risk factors.

RESULTS

We received responses from 1,222 of 3,056 nursing students (response rate: 40.0%). After 25 participants were excluded due to missing outcome values, 1,197 students (valid response rate: 98.0%) were included in the analysis. The prevalence of anxiety, depression, and insomnia was 4.8%, 12.4%, and 18.0%, respectively. The risk of anxiety was lower among participants who did not have any relatives or friends who had been infected with SARS-CoV-2 than among those who did (aOR 0.36, 95% CI 0.14-0.94). The risk of depression was higher among participants whose financial status had worsened during the pandemic than among those whose financial status had not changed (aOR 3.44; 95% CI 1.98-5.96). Common factors that increased the risk of anxiety, depression, and insomnia were life satisfaction and fear of COVID-19.

CONCLUSION

Mental health-related symptoms among nursing students in Japan have not necessarily worsened with the spread of COVID-19 but were exacerbated by the intensity of changes in daily living and fear, which are psychosocial effects associated with the pandemic.

Adaptation and psychometric evaluation of Hungarian version of the Fear of COVID-19 Scale

Background

COVID-19 pandemic has had a global major healthcare, social and economic impact. In present study we aim to adapt the Fear of COVID-19 Scale to Hungarian.

Materials and methods

Forward-backward translation method was used to translate the English version of the scale to Hungarian. Participants were a convenience sample of 2175 university students and employees. The study was conducted between January 18^th and February 12^th 2021. The test battery included Hungarian versions of Fear of COVID-19 scale, short Beck Depression Inventory (BDI-H) and State-Trait Anxiety Inventory (STAI).

Results

The scale showed one-factor structure, the loadings on the factor were significant and strong (from .47 to .84). Internal consistency was very good (α = .84). Construct validity for the Fear of COVID-19 Scale was supported by significant and positive correlations with STAI (r = 0.402; p < 0.001) and BDI-H (r = 0.270; p < 0.001).

Conclusion

The Hungarian version of Fear of COVID-19 Scale is a reliable and valid tool in assessing fear of coronavirus.

Personality Traits That Affect Travel Intentions during Pandemic COVID-19: The Case Study of Serbia

The pandemic caused by COVID-19 has enormous effects on peoples’ lives and on the global economy. The outbreak and effects of COVID-19 have resulted in fears, concerns, and anxiety among people all around the world. The aim of this study is to investigate the relationship between the fear of COVID-19, travel anxiety, and travel intention among residents in Serbia. In addition to the above, the aim of the study was to examine the impact of personality traits on the fear of COVID-19, travel anxiety, and travel intentions. To enhance the understanding of the relationship between the mentioned variables, this study proposes a research model based on the use of measurement scales from the existing studies to develop the questionnaire. The standard paper-and-pen survey was used for data collection from the respondents from Serbia. The total sample include 987 respondents. It was determined that Travel intention was negatively influenced by Neuroticism and Conscientiousness, but positively by Extroversion and Openness. The supposed Agreeableness did not have a significant effect on Travel intention. This study contributes to understanding the respondents’ behavior during pandemic of COVID-19, and their responses to the crisis according to their personality traits might have practical implications in the travel sector.

The Effect of Fear of the COVID-19 on Depression Among Chinese Outbound Students Studying Online in China Amid the COVID-19 Pandemic Period: The Role of Resilience and Social Support

Objective: The present study focused on examining fear of the coronavirus disease 2019 (COVID-19) is correlated with depression and explored the potential role of resilience and social support on the association between fear of the COVID-19 (FoC) and depression among Chinese outbound students studying online in China amid the COVID-19 pandemic period. Methods: A total of 476 Chinese outbound students from different universities worldwide, currently studying via online mode in China, completed an online survey including measures on FoC, resilience, social support, and depression. Results: (1) Fear of the COVID-19 was positively correlated with depression and negatively correlated with resilience and social support. Both resilience and social support were negatively correlated with depression. Social support showed a positive correlation with resilience. (2) The effect of FoC on depression mainly occurred through two paths: the mediating effect of resilience and the moderating effect of resilience. However, the moderating effect of social support on the association between FoC and depression was not sustained in this study. Conclusion: This study indicated the mediating and moderating effects of resilience on the association between FoC and depression among Chinese outbound students studying online in China during the COVID-19 pandemic period. The current findings confirmed that resilience has significant implications in preventing negative mental states under the COVID-19 context among this particular group.

Does Fear of the New Coronavirus Lead to Low-Carbon Behaviors: The Moderating Effect of Outcome Framing

PURPOSE

Air pollution has been found to aggravate the infection and mortality of COVID-19, leading to increasing attention on pro-environmental behaviors. Considering individuals' psychological distance from COVID-19, this research aims to examine the relationship between fear of COVID-19, air pollution concern, and low-carbon behaviors.

METHODS

Two survey-based studies were conducted in this research. Study 1 consisted of 323 participants and examined the relationships between psychological distance (PD) from COVID-19, fear of COVID-19, air pollution concern, and low-carbon behaviors. Study 2 identified the moderating effect of outcome framing using an intergroup experiment in which 304 participants were randomly assigned to two groups (gain framing vs loss framing).

RESULTS

The results of Study 1 showed that the closer the PD was, the higher the fear was. Fear of COVID-19 and low-carbon behaviors were positively associated. Additionally, air pollution concern acted as a mediator in their relationship. The results of the moderating effect test in Study 2 showed that fear and air pollution concern led to higher low-carbon behavioral intention within gain framing than within loss framing.

CONCLUSION

This research revealed that personal fear of public health emergencies will lead to environmental pollution concern and pro-environmental behaviors, and information from the outside plays a moderating role. The results provide implications for policy advocacy of the health and environmental sectors and for guiding people's low-carbon behaviors.

The Factor Structure and Rasch Analysis of the Fear of COVID-19 Scale (FCV-19S) Among Chinese Students

The Fear of COVID-19 Scale (FCV-19S) is a new one-dimensional scale used to measure fear of an individual about the COVID-19. Given the seriousness of the COVID-19 situation in China when our study was taking place, our aim was to translate and examine the applicability of the FCV-19S in Chinese students. The sample used for validation comprised 2,445 Chinese students. The psychometrical characteristics of the Chinese FCV-19S (FCV-19S-C) were tested using Rasch analysis. Principal component analysis (PCA) proved the unidimensional structure of the model. Both infit and outfit mean square (MNSQ) values (0.69-1.31) and point-measure correlations (0.82-0.86) indicated a good model fit. Person-item separation and reliability values indicated good reliability of the scale. The person-item map revealed an acceptable level of match between the persons and the items. Differential item functioning of the FCV-19S-C showed no differences with respect to age or gender. FCV-19S-C scores were significantly associated with anxiety, stress, depression, ego-resilience, and general health. The FCV-19S-C was proven to be effective in measuring fear of Chinese students about the COVID-19.

Fear of COVID-19 in Patients with Acute Myocardial Infarction

A marked decline in myocardial infarction (AMI) hospitalizations was observed worldwide during the COVID-19 outbreak. The pandemic may have generated fear and adverse psychological consequences in these patients, delaying hospital access. The main objective of the study was to assess COVID fear through the FCV-19S questionnaire (a self-report measure of seven items) in 69 AMI patients (65 ± 11 years, mean ± SD; 59 males). Females presented higher values of each FCV-19S item than males. Older subjects (>57 years, 25th percentile) showed a higher total score with respect to those in the first quartile. The percentage of patients who responded "agree" and "strongly agree" in item 4 ("I am afraid of losing my life because of the coronavirus") and 3 ("My hands become clammy when I think about the coronavirus") was significantly greater in the elderly than in younger patients. When cardiovascular (CV) patients were compared to a previously published general Italian population, patients with CV disease exhibited higher values for items 3 and 4. Measures should be put in place to assist vulnerable and high CV risk patients, possibly adding psychologists to the cardiology team.

Mental health problems among Chinese adolescents during the COVID-19: The importance of nutrition and physical activity

Mental health problems are common among adolescents and greatly influenced by stressful events. This study sought to assess the prevalence and correlates of insomnia, depressive and anxiety symptoms among Chinese adolescents during the COVID-19.

METHOD

Cross-sectional study (N = 1,794 adolescents, mean age = 15.26) was conducted in May 2020. An online survey was used to collect socio-demographic data, COVID-related fear (COVID-fear), nutrition, physical activity (PA) level and the symptoms of insomnia, depression and anxiety.

RESULTS

The prevalence of insomnia, depressive and anxiety symptoms was 37.80%, 48.20% and 36.70%, respectively, among Chinese adolescents during the pandemic. Generalized linear models revealed that female, left behind children, and students with greater COVID-fear tended to report symptoms of insomnia, depression and anxiety concurrently. After adjusting for socio-demographic factors and COVID-fear, better nutritional status and moderately active PA were both associated with lower levels of depressive and anxiety symptoms, while highly active PA was associated with lower levels of insomnia, depressive and anxiety symptoms.

CONCLUSIONS

These findings suggest that more attention should be paid to psychological health among adolescents while combating COVID-19. To promote adolescents' mental health, educators should help adolescents develop a healthy lifestyle with balanced diet and regular exercise.