The role of extraversion and neuroticism for experiencing stress during the third wave of the COVID-19 pandemic

A systematic review and meta-analysis of neuroticism and anxiety during the COVID-19 pandemic

Introduction

In response to the global impact of the COVID-19 pandemic, concerns about mental health, particularly anxiety levels, have become prominent. This study aims to explore the relationship between neuroticism, a personality trait associated with emotional instability, and anxiety during the COVID-19 outbreak.

Methods

A comprehensive literature search was conducted using the Cochrane Library, HINARI, Google Scholar, and PUBMED, resulting in the identification of 26 relevant papers. The study protocol has been registered with PROSPERO under the number CRD42023452418. Thorough meta-analysis was performed using Comprehensive Meta-Analysis V4 software.

Results

Meta-analysis revealed a significant positive relationship between anxiety and neuroticism, with 26 studies supporting this association (OR = 3.213, 95% CI 2.352 to 4.391). The findings underscore the importance of considering personality traits, particularly neuroticism, in understanding psychological responses to major global crises such as the COVID-19 epidemic.

Discussion

The observed connection between neuroticism and heightened anxiety levels emphasizes the need for targeted interventions, especially for individuals with high levels of neuroticism. Further research into potential therapeutic approaches for mitigating anxiety consequences in the context of a significant global catastrophe is warranted.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/#CRD42023452418.

The chain mediating role of psychological resilience and neuroticism between intolerance of uncertainty and perceived stress among medical university students in Southwest China

BACKGROUND

Medical university students are confronted with unprecedented uncertainty and stress compared with their peers. Research has explored the effect of intolerance of uncertainty on perceived stress, but little attention was paid to investigate the mediating mechanisms behind this relationship, especially among medical university students. The aim of this study was to examine whether psychological resilience and neuroticism played a mediating role between medical university students' intolerance of uncertainty and perceived stress.

METHODS

A total of 717 medical university students from Chongqing in Southwest China were recruited to participate in our study and completed demographic information, Intolerance of Uncertainty Scale Short Version (IUS-12), Chinese Version of Perceived Stress Scale (CPSS), Connor-Davidson Resilience Scale-10 (CD-RISC-10) and Eysenck Personality Questionnaire (EPQ).

RESULTS

(1) Significant correlations between intolerance of uncertainty, perceived stress, psychological resilience and neuroticism were found. (2) Intolerance of uncertainty affected medical university students' perceived stress via three paths: the mediating effect of psychological resilience, the mediating effect of neuroticism, and the chain mediating effect of both psychological resilience and neuroticism.

CONCLUSIONS

Intolerance of uncertainty could directly affect the perceived stress of medical university students, and also affected perceived stress through the mediating roles of psychological resilience and neuroticism, as well as through the chain mediating role of these two variables.

Second Victims among Austrian Pediatricians (SeViD-A1 Study)

(1) Background: The second victim phenomenon (SVP) plays a critical role in workplace and patient safety. So far, there are limited epidemiological data on the SVP in German-speaking countries. Some studies have been carried out in Germany, but so far, no quantitative studies have been carried out in Austria examining the prevalence, symptom load and preferred support measures for second victims (SVs). This study therefore examines the SVP among Austrian pediatricians. (2) Methods: A nationwide, cross-sectional and anonymous online study was conducted using the SeViD questionnaire (Second Victims in Deutschland) including the Big Five Inventory-10 (BFI-10). Statistical analysis included binary-logistic and multiple linear regression with the bootstrapping, bias-corrected and accelerated (BCa) method based on 1000 bootstrap samples. (3) Results: Of 414 Austrian pediatricians, 89% self-identified as SVs. The main cause of becoming an SV was the unexpected death or suicide of a patient. High neuroticism and extraversion values as well as working in outpatient care positively correlated with having experienced the SVP. A preferred support strategy was access to legal counseling. (4) Conclusions: Austrian pediatricians have the highest SVP prevalence measured with the SeViD questionnaire. Further research should focus on prevention strategies and intervention programs.

Moral foundations are better predictors of belief in COVID-19 conspiracy theories than the Big Five personality traits

Upon the sudden outbreak of COVID-19 pandemic, various conspiracy theories regarding the virus proliferated in the social media. This study focused on the sociodemographic, personality, and moral predictors of these beliefs. More specifically, we asked whether moral values predict belief in COVID-19 conspiracy theories over and above sociodemographic variables and the Big Five personality traits. According to Moral Foundations Theory, five cross-cultural moral foundations are more broadly categorized under individualizing (Care & Fairness) and binding (Loyalty, Authority, & Sanctity) foundations. A sixth moral foundation was Liberty which we included along with binding and individualizing foundations. Participants were 227 Iranians (mean age = 31.43, SD = 12.61, 75.3% female) who responded to Moral Foundations Questionnaire and Liberty items, a range of COVID-19 conspiracy beliefs, and the 10-Item Personality Measure of the Big Five. Among demographic variables, religiosity and socioeconomic status were the strongest determinants of conspiracy beliefs regarding the origin of Coronavirus. Among the Big Five, only extraversion predicted these beliefs in a positive direction. Moral foundations, most notably Authority and Sanctity, showed incremental predictive power over both demographic variables and the Big Five personality traits. Findings are discussed in light of the role of social media in dissemination of conspiracy beliefs regarding the pandemic. They point to the more relevance of moral foundations, particularly binding foundations, than the Big Five in the context of pandemic-related conspiracy beliefs, and add to the literature on the unique contribution of moral foundations to socio-political attitudes across cultures.

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.

Awake and Sleep Bruxism Prevalence and Their Associated Psychological Factors in First-Year University Students: A Pre-Mid-Post COVID-19 Pandemic Comparison

There is a broad consensus accepting that psychological variables such as stress, anxiety, or depression play an important role in bruxism. The COVID-19 pandemic has led to an increase in stress, anxiety, and depression levels. The purpose of this study was to evaluate the impact of the COVID-19 pandemic on possible awake and sleep bruxism prevalence and on the psychological factors associated with bruxism, comparing pre-pandemic, pandemic/lockdown, and post-pandemic samples of first-year students. A total of 274 dentistry students from the Complutense University of Madrid participated in the study: 92 from 2018/2019 (pre-pandemic), 90 from 2020/2021 (pandemic), and 92 students from 2021/2022 (post-pandemic) academic years. The participants filled out a thorough battery of validated questionnaires evaluating bruxism and different psychological characteristics, such as anxiety, depression, somatization, personality, and stress coping styles. While sleep bruxism prevalence was significantly higher for the pandemic group, awake bruxism was smaller in comparison to pre-pandemic and post-pandemic groups. The post-pandemic group also presented higher levels of neuroticism and agreeableness personality traits, and positive reappraisal than the pre-pandemic group, with the pandemic group somewhere in between. Additionally, both the pandemic and post-pandemic group showed higher levels of depression and acceptance/resignation coping styles than the pre-pandemic group. Thus, among the three groups of students, the post-pandemic group was the one that showed a larger effect of the pandemic situation in their psychological variables, presenting higher levels of anxiety (state and trait), depression, acceptation/resignation coping style, higher neuroticism (emotional instability trait), and lower agreeableness trait. Nonetheless, the increase of positive reappraisal in the post-pandemic group (an adaptive coping stress style) might be also a sign of recovery. The higher sleep bruxism for the pandemic group might be related to the pandemic situation and lockdown, passively suffered, possibly promoting feelings of impotency, increased levels of depression and acceptance/resignation (normally considered a passive/maladaptive coping style), while acute stressful situations derived from daily personal social interactions might have increased anxiety levels and induced higher levels of awake bruxism observed in both the pre-pandemic and post-pandemic groups. However, further research, including larger and more representative samples, is needed to confirm this possible relationship.

Mental health during the COVID-19 pandemic: Stress and strain profiles in the German population

Clinical observations indicate that people frequently display stress-related behavior during the COVID-19 pandemic. Although numerous studies have been published concerning pandemic-related psychological distress, systematic data on the interrelationships between stress sensitivity, personality, and behavioral characteristics of people are still lacking. In the present cross-sectional online survey study, we applied a German version of the COVID Stress Scales (CSS) and standard psychological questionnaires to systematically identify the complex interplay between stress sensitivity, gender, and personality in the modulation of quality of life and mental health in the German population (N = 1774; age ≥ 16 years). A CSS-based cluster analysis revealed two clusters characterized by higher and lower stress levels. Study participants in each cluster differed significantly with respect to neuroticism, extraversion, agreeableness, quality of life, depression, and anxiety. Females were significantly overrepresented in the higher stress cluster, while there was an overrepresentation of males in the lower stress cluster. Neuroticism was identified as a risk factor and extraversion as a protective factor for enhanced pandemic-related stress responses. For the first time our data show a taxonomy of factors, which modulate pandemic-related stress sensitivity and warrant consideration as key indicators of quality of life and psychological distress during the COVID-19 pandemic. We suggest that our data may advise governmental regulation of pandemic-related public health measures, to optimize quality of life and psychological health in different groups of the population.

Learning burnout and its association with perceived stress, social support, and the Big Five personality traits in Chinese medical students during the COVID-19 pandemic: a cross-sectional study

BACKGROUND

Owing to the coronavirus disease 2019, medical learning burnout has attracted increasing attention in educational research. It has a serious negative impact on medical students and their service quality. This could impair the professional development of medical students; weaken their personal and professional quality; and lead to problems such as increased medical errors and reduced patient care quality and satisfaction. This study aimed to examine the effects of perceived stress, social support, and the Big Five personality traits on learning burnout among medical students.

METHODS

In November 2021, a cross-sectional survey was conducted at three medical universities in China. A self-administered questionnaire was distributed to 616 third- year students. Learning burnout, perceived stress, social support, and the Big Five personality traits (neuroticism, extroversion, openness, agreeableness, and conscientiousness) were anonymously measured. A total of 583 students were included in the final sample. Hierarchical linear regression was performed to explore the effects of perceived stress, social support, and Big Five personality traits on medical students' learning burnout.

RESULTS

Perceived stress was positively associated with learning burnout (emotional exhaustion: ß = 0.577, p < 0.001; cynicism: ß = 0.543, p < 0.001; low professional efficacy: ß = 0.455, p < 0.001) whereas social support was negatively related with it (low professional efficacy: ß = -0.319, p < 0.001). Neuroticism had a positive effect on emotional burnout (ß = 0.152, p = 0.009). Extraversion (ß = -0.116, p = 0.006) and conscientiousness (ß = -0.363, p < 0.001) had a negative effect on low professional efficacy. Agreeableness negatively affected emotional exhaustion (ß = -0.181, p < 0.001) and cynicism (ß = -0.245, p < 0.001) and positively affected low professional efficacy (ß = 0.098, p = 0.008). The associated factors together accounted for an additional variance of learning burnout (emotional exhaustion: 39.0%; cynicism: 36.8%; low professional efficacy: 48.7%).

CONCLUSIONS

Social support is a positive resource for fighting medical students' burnout. Perceived stress was the strongest indicator of learning burnout. In addition to reducing perceived stress, developing extraversion, agreeableness, and conscientiousness should be included in burnout prevention and treatment strategies, particularly for medical students.

Personality, Defenses, Mentalization, and Epistemic Trust Related to Pandemic Containment Strategies and the COVID-19 Vaccine: A Sequential Mediation Model

BACKGROUND

The COVID-19 pandemic has considerably influenced all domains of people's lives worldwide, determining a high increase in overall psychological distress and several clinical conditions. The study attempted to shed light on the relationship between the strategies adopted to manage the pandemic, vaccine hesitancy, and distinct features of personality and mental functioning.

METHODS

The sample consisted of 367 Italian individuals (68.1% women, 31.9% men; M age = 37, SD = 12.79) who completed an online survey, including an instrument assessing four response styles to the pandemic and lockdown(s), the Personality Inventory for DSM-5-Brief Form, the Defense Mechanisms Rating Scales-Self-Report-30, the Reflective Functioning Questionnaire, and the Epistemic Trust, Mistrust, Credulity Questionnaire.

RESULTS

Maladaptive response patterns to pandemic restrictions were related to dysfunctional personality traits, immature defense mechanisms, poor mentalization, and epistemic mistrust or credulity. Moreover, more severe levels of personality pathology were predictive of an extraverted-maladaptive response style to health emergency through the full mediation of low overall defensive functioning, poor certainty of others' mental states, and high epistemic credulity.

CONCLUSIONS

Recognizing and understanding dysfunctional psychological pathways associated with individuals' difficulties in dealing with the pandemic are crucial for developing tailored mental-health interventions and promoting best practices in healthcare services.

Pandemic stressors and depressive symptoms: Examining within- and between-person effects of neuroticism

Experiencing stressors related to the COVID-19 pandemic such as health-related concern, social isolation, occupational disruption, financial insecurity, and resource scarcity can adversely impact mental health; however, the extent of the impact varies greatly between individuals. In this study, we examined the role of neuroticism as an individual-level risk factor that exacerbates the association between pandemic stressors and depressive symptoms. With repeated assessments of pandemic stressors and depressive symptoms collected from 3181 participants over the course of the pandemic, we used multilevel modeling to test if neuroticism moderated the association between pandemic stressors and depressive symptoms at both between- and within-person levels. At the between-person level, we found that participants who reported more pandemic stressors on average had higher levels of depressive symptoms and that this association was stronger among those high in neuroticism. At the within-person level, reporting more pandemic stressors relative to one's average on any given occasion was also associated with heightened depressive symptoms and this effect was similarly exacerbated by neuroticism. The findings point to pandemic stressor exposure and neuroticism as risk factors for depressive symptoms and, in demonstrating their synergistic impact, may help identify individuals at greatest risk for adverse psychological responses to the COVID-19 pandemic.

Parents' personality, parenting stress, and problem behaviors of children with special needs in China before and during the COVID-19 pandemic

The positive predictive effect of children's problem behaviors on parenting stress has been verified to some extent, but research on parents of children with special needs remains insufficient. Moreover, the role of parental personality traits in the relationship between children's problem behaviors and parenting stress, and whether it differs from before the COVID-19 pandemic, remains unclear. Accordingly, in this study, online questionnaires were used to survey parents of children with autism and intellectual disabilities in China - 337 parents before and 604 during the COVID-19 pandemic - to explore the relationship between problem behaviors in the children and parenting stress as well as the moderating effect of parents' personality. The results showed that problem behaviors of children with autism and intellectual disabilities had a positive predictive effect on parenting stress. However, there was no significant difference in this effect before and during the pandemic. In addition, the relationship between children's problem behaviors and parenting stress was moderated by the Agreeableness and Neuroticism of the parents, but only during COVID-19 pandemic. The research results suggest that, during the pandemic when facing problem behaviors of children with autism or intellectual disabilities, positive personality characteristics such as Agreeableness have a protective effect on parenting stress. By contrast, negative personality characteristics such as Neuroticism are risk factors. The study results provide evidence from special groups regarding the role of parents' personalities in the parent - child interaction and the parenting stress models.

Fear of COVID-19 and Perceived Stress: The Mediating Roles of Neuroticism and Perceived Social Support

Background: Fear of COVID-19 leads to stress and may result in various kinds of mental health problems. Many factors are associated with an individual’s perception of stress, including neuroticism and perceived social support. This study aimed to examine the role of neuroticism and perceived social support as mediators of fear of COVID-19 on perceived stress. Methods: Data from 3299 participants aged ≥18 years from the HOME-COVID-19 survey in 2020 were used for analysis. Measurements used included the Fear of COVID-19 and Impact on Quality of Life Scale, the Perceived Stress Scale-10, the Neuroticism inventory and the Multidimensional Scale of Perceived Social Support-12. A parallel mediation model within a structural equation modeling framework with 5000 bootstrapping sampling was used to test the mediating effect. Results: Fear of COVID-19 had a direct effect on perceived stress (B  =  0.100, 95% CI = 0.080−0.121, p < 0.001), whereas neuroticism, but not perceived social support, partially mediated the relationship between fear of COVID-19 and perceived stress (B = 0.018, 95% CI = 0.000−0.036). Among all types of social support, only perceived support from friends was a significant mediator (B = 0.016, 95% CI = 0.006−0.025). Conclusions: Neuroticism and perceived support from friends are critical factors in the relationship between fear of COVID-19 and perceived stress.