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Yan Y, Zhang J, Lu N. Adverse childhood experiences and self-esteem among adolescents: The role of social capital and gender. J Adolesc 2024. [PMID: 38867608 DOI: 10.1002/jad.12361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 05/24/2024] [Accepted: 06/03/2024] [Indexed: 06/14/2024]
Abstract
INTRODUCTION Adverse childhood experiences have long-lasting effects on the self-esteem of adolescents. However, the extrinsic mechanism linking them to self-esteem, which is more modifiable, has rarely been examined. Therefore, this study examined the mediating roles of family, school, and peer social capital and the moderating role of gender in the association between adverse childhood experiences and adolescent self-esteem. METHODS This study involved a cross-sectional survey of first- and second-grade students in the only high school in Wusu, Xinjiang Uygur Autonomous Region, China. Data were collected in May 2023. A sample of 2539 students (M = 16.84 years old; 55.65% female) was included. The measurement models of family, school, and peer social capital were constructed using confirmatory factor analysis. The mediating roles of the three types of social capital and the moderating role of gender were examined using mediation analysis and multiple-group analysis, respectively. RESULTS Family, school, and peer social capital significantly mediated the relationship between adverse childhood experiences and adolescent self-esteem, and family social capital played the strongest role. Gender significantly moderated the direct effect of adverse childhood experiences on self-esteem. The direct effect was significant only among girls. CONCLUSIONS This study underscores the protective role of social capital for self-esteem among adolescents in Northwestern China and similar areas with relatively limited social services. Comprehensive interventions promoting social capital, especially family social capital, should be conducted to enhance self-esteem among adolescents.
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Affiliation(s)
- Yuqi Yan
- Center for Studies of Sociological Theory & Method, Renmin University of China, Beijing, China
- Department of Social Work, School of Social Research, Renmin University of China, Beijing, China
| | - Jingyue Zhang
- Department of Sociology, School of Philosophy and Sociology, Jilin University, Changchun, China
| | - Nan Lu
- Center for Studies of Sociological Theory & Method, Renmin University of China, Beijing, China
- Department of Social Work, School of Social Research, Renmin University of China, Beijing, China
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Sasaki N, Watanabe K, Kanamori Y, Tabuchi T, Fujiwara T, Nishi D. Effects of expanded adverse childhood experiences including school bullying, childhood poverty, and natural disasters on mental health in adulthood. Sci Rep 2024; 14:12015. [PMID: 38797740 PMCID: PMC11128446 DOI: 10.1038/s41598-024-62634-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 05/20/2024] [Indexed: 05/29/2024] Open
Abstract
The study aimed to examine the association of expanded adverse childhood experiences (ACEs) with psychological distress in adulthood. The data from nation-wide online cohort was used for analysis. Community dwelling adults in Japan were included. The ACEs was assessed by 15 items of ACE-J, including childhood poverty and school bullying. Severe psychological distress was determined as the score of Kessler 6 over 13. Multivariable logistic regression analysis was conducted, by using sample weighting. A total of 28,617 participants were analyzed. About 75% of Japanese people had one or more ACEs. The prevalence of those with ACEs over 4 was 14.7%. Those with ACEs over 4 showed adjusted odds ratio = 8.18 [95% CI 7.14-9.38] for severe psychological distress. The prevalence of childhood poverty was 29% for 50-64 year old participants and 40% of 65 or older participants. The impact of childhood poverty on psychological distress was less than other ACEs in these age cohorts. Bullying was experienced 21-27% in young generations, but 10% in 65 or older participants. However, the impact on psychological distress in adulthood was relatively high in all age groups. ACEs have impacted mental health for a long time. Future research and practice to reduce ACEs are encouraged.
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Affiliation(s)
- Natsu Sasaki
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1130033, Japan
| | - Kazuhiro Watanabe
- Department of Public Health, Kitasato University School of Medicine, Sagamihara, Japan
| | - Yoshiaki Kanamori
- Department of Psychiatric Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Takahiro Tabuchi
- Cancer Control Center, Osaka International Cancer Institute, Osaka, Japan
- The Tokyo Foundation for Policy Research, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Public Health, Tokyo Medical and Dental University, Tokyo, Japan
| | - Daisuke Nishi
- Department of Mental Health, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 1130033, Japan.
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Song W, McLean KJ, Gifford J, Kissner H, Sipe R. Adverse Childhood Experiences and Health Outcomes Among Transition-Age Autistic Youth. J Autism Dev Disord 2024:10.1007/s10803-024-06401-7. [PMID: 38771506 DOI: 10.1007/s10803-024-06401-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/08/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) have been associated with poor health outcomes in the general population. However, their impact on autistic youth remains unclear. OBJECTIVE The primary objective was to understand how childhood adversity is related to the general health, mental health, and physical health of transition-age autistic youth. PARTICIPANTS AND SETTING Using data from the 2018-2021 National Survey of Children's Health, this cross-sectional study involved 2056 autistic youth aged 12-17. METHODS Logistic regression was employed to test the association between three measures of ACEs - individual ACEs, cumulative ACEs, and grouped ACEs based on contexts, and health outcomes of autistic youth. RESULTS Our study observed a high prevalence of ACEs among autistic youth, with a substantially higher proportion experiencing multiple ACEs than their neurotypical peers. Individual ACEs were significantly associated with specific health issues. Cumulative ACEs demonstrated a clear dose-response relationship with health outcomes, with higher ACE counts increasing the likelihood of experiencing poor general health, mental health conditions, and physical health issues. Moreover, grouped ACEs associated with health differently, with community-based ACEs being particularly linked to general health status, mental health conditions, and physical health conditions, while family-based ACEs correlated more with more severe mental health conditions and being overweight. CONCLUSION These findings collectively emphasize the importance of addressing ACEs as a public health concern among transition-age autistic youth, highlighting the need for targeted interventions, prevention strategies, and support services to mitigate the negative impact of ACEs on the overall well-being of this growing community.
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Affiliation(s)
- Wei Song
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA.
| | - Kiley J McLean
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
| | - Jordan Gifford
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
| | - Hailey Kissner
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
| | - Rosalind Sipe
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
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Zhang Z, Wang W, Yuan X, Wang X, Luo Y, Dou L, Zhang L, Wu M. Adverse childhood experiences and subsequent physical and mental health among young adults: Results from six universities in China. Psychiatry Res 2024; 335:115832. [PMID: 38471243 DOI: 10.1016/j.psychres.2024.115832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 02/28/2024] [Accepted: 02/29/2024] [Indexed: 03/14/2024]
Abstract
Research has shown that individuals with adverse childhood experiences (ACEs) are more likely to encounter heightened risks of physical and psychological challenges later in life. However, limited research has explored the comprehensive impact on the physical and mental health of young adults. Thus, we conducted a study to investigate the associations of ACEs with the physical and mental health of 18,723 college students in China. Their physical and mental health status was assessed using self-perceived health assessments, self-reported disease diagnoses, and the Generalized Anxiety Disorder-7-item scale. Results showed that 82.6 % of participants had experienced at least one ACE, with 10.7 % reporting exposure to four or more ACEs. Compared to participants with low ACEs exposure (≤ 1), participants with high ACEs exposure (≥ 4) had a nearly twofold increase in the odds of cardiometabolic diseases (OR [95 % CI] = 2.06 [1.55-2.74]) and fractures (2.32 [1.88-2.87]). Additionally, individuals with high ACE exposure exhibited a threefold increased odds of severe anxiety symptoms (3.78 [2.59-5.51]) and bipolar disorder/schizophrenia (3.38 [2.18-5.23]). These findings highlight ACEs as a significant risk factor for poor physical and mental health among young adults. Targeted support and interventions for individuals with multiple ACEs may help mitigate their long-term disease burden.
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Affiliation(s)
- Zheng Zhang
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, PR China; Xiangya School of Medicine, Central South University, Changsha, Hunan, PR China
| | - Wenhua Wang
- Shaanxi Medical Association, Xi'an, PR China; Shaanxi Provincial Health Industry Association Service Center, Xi'an, PR China.
| | - Xiaoxiao Yuan
- Shaanxi Medical Association, Xi'an, PR China; Shaanxi Provincial Health Industry Association Service Center, Xi'an, PR China
| | - Xue Wang
- Shaanxi Medical Association, Xi'an, PR China; Shaanxi Provincial Health Industry Association Service Center, Xi'an, PR China
| | - Yi Luo
- Shaanxi Medical Association, Xi'an, PR China; Shaanxi Provincial Health Industry Association Service Center, Xi'an, PR China
| | - Linfei Dou
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, PR China
| | - Lei Zhang
- Shaanxi Medical Association, Xi'an, PR China; Shaanxi Provincial Health Industry Association Service Center, Xi'an, PR China.
| | - Mingyang Wu
- Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, PR China.
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Smith BD, Spencer BH, Nur-Singletary Z, Adane N, Moser N, Powell TW. Assessing the association between safety perceptions and communication about sex and drugs among Black adolescents exposed to adversity. J Trauma Stress 2024. [PMID: 38602222 DOI: 10.1002/jts.23044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 03/07/2024] [Accepted: 03/07/2024] [Indexed: 04/12/2024]
Abstract
The present study examined the association between safety perceptions and communication with a trusted adult about sex and drugs among Black adolescents exposed to adverse childhood experiences (ACEs) and the role of gender as a potential moderator in this association. Data were drawn from a small, randomized control pilot test of an adapted evidence-based intervention conducted from 2022 to 2023 in Baltimore, Maryland. The sample included 57 Black adolescents who had been exposed to ACEs (Mage = 15.14 years, SD = 0.81l; 47.4% female, 52.6% male). Information about safety perceptions, health communication, health behaviors, and demographic characteristics was measured using an electronic survey at baseline. Group differences by gender emerged among ACEs and substance use behaviors. Safety perceptions were significantly associated with communication with a trusted adult, B = 0.31, SE = 0.24, p = .039. As youth felt more unsafe, their communication with a trusted adult about sex and drugs increased; this association did not differ by gender. Health communication was also associated with ACEs. Black adolescents living with a parent with mental health challenges reported increased communication, B = 0.60, SE = 0.20, p = .005, whereas youth experiencing homelessness had reduced health communication, B = -0.63, SE = 0.24, p = .012. A lack of perceived safety significantly impacts health communication; however, having trusted adults outside of the home, school, and neighborhood can serve as a protective factor in reducing substance use and sexual risk-taking among this population.
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Affiliation(s)
- Bianca D Smith
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Bailey Holmes Spencer
- Department of Health, Behavior, and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | | | - Nancy Adane
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Naya Moser
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Terrinieka W Powell
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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Landa-Blanco M, Vásquez G, Portillo G, Sproviero F, Echenique Y. The impact of adverse childhood experiences on mental health, sexual risk behaviors, and alcohol consumption in adulthood. Front Psychiatry 2024; 15:1352824. [PMID: 38659462 PMCID: PMC11039929 DOI: 10.3389/fpsyt.2024.1352824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
The purpose of the study was to determine how Adverse Childhood Experiences (ACE) relate to adulthood flourishing, symptoms of depression, anxiety, somatization, self-reported health, sexual risk behaviors, and alcohol consumption. A quantitative cross-sectional methodology was used. A total of 452 adults completed the survey. The most prevalent ACE include physical abuse (44.69%), separation/divorce of parents (41.81%), living with someone with alcohol problems (39.38%), and being sworn, insulted, or humiliated by adults at home (35.62%). Almost one out of every four respondents (24.34%) reported being touched by an adult, 17.92% reported that an adult tried to manipulate the respondent into touching them, and 8.19% were forced to have sexual intercourse. Results indicate that women reported a higher number of ACE than men. The number of ACE is inversely related to flourishing and self-reported health; while being positively associated with participant's scores in depression, anxiety, somatization, sexual risk behaviors, and alcohol use. The regression model, including the eleven ACE and respondents' sex and age, achieved medium effect sizes for somatization, depression, and anxiety symptoms and small effect sizes for flourishing, self-reported health, sexual risk behaviors, and alcohol consumption. Specific ACE have a particularly significant negative impact on mental health outcomes: forced intercourse, witnessing familial violence, verbal humiliation, and living with individuals struggling with mental health issues and drug consumption or who were incarcerated. In conclusion, the study highlights the alarming prevalence of ACE among the Honduran population and their significant negative impact on mental health outcomes during adulthood.
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Affiliation(s)
- Miguel Landa-Blanco
- School of Psychological Sciences, National Autonomous University of Honduras, Tegucigalpa, Honduras
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Lin WH, Chiao C. Adverse childhood experience and young adult's problematic Internet use: The role of hostility and loneliness. CHILD ABUSE & NEGLECT 2024; 149:106624. [PMID: 38227984 DOI: 10.1016/j.chiabu.2023.106624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 11/01/2023] [Accepted: 12/27/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Few studies have explored the relationship between adverse childhood experiences (ACEs) and problematic Internet use (PIU) during young adulthood. Moreover, even fewer studies have explored the roles of loneliness (social and emotional) and hostility in this relationship. METHODS This study used data from the Taiwan Youth Project (2011-2017). The analytical sample included 1885 participants (mean age = 31.3 years). PIU was measured using the short form of Chen's Internet Addiction Scale (2017). ACEs were assessed at the baseline of the adolescent phase (mean age = 14.3 years); this indicator has undergone recent revision. Hostility (three items from the Symptom Checklist-90-Revised) and loneliness (six items from the De Jong Gierveld scale) were measured in 2011 and 2014, respectively. RESULTS ACEs were associated with hostility and loneliness (emotional and social). Additionally, hostility (β = 0.62, p < .01) and emotional loneliness (β = 0.44, p < .01) were significantly associated with PIU. Most mediating paths (e.g., ACE → hostility → PIU) were significant, based on the bootstrapping results. CONCLUSIONS This study suggests that ACEs have a long-term shadow effect on PIU in young adults. ACEs show an indirect association with PIU through both hostility and loneliness, as well as involving the relationship between them.
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Affiliation(s)
- Wen-Hsu Lin
- Institute of Health and Welfare, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
| | - Chi Chiao
- Institute of Health and Welfare, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Weiss NH, Goncharenko S, Forkus SR, Ferguson JJ, Yang M. Longitudinal Investigation of Bidirectional Relations Between Childhood Trauma and Emotion-Driven Impulsivity in the Adolescent Brain Cognitive Development Study. J Adolesc Health 2023; 73:731-738. [PMID: 37410001 PMCID: PMC10529354 DOI: 10.1016/j.jadohealth.2023.05.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 05/01/2023] [Accepted: 05/27/2023] [Indexed: 07/07/2023]
Abstract
OBJECTIVE Exposure to childhood trauma is associated with numerous adverse mental health consequences. Addressing important gaps in the existing research, the proposed study clarifies the longitudinal and bidirectional associations between childhood trauma and both negative and positive emotion-driven impulsivity. METHOD This study utilized a sample of 11,872 9- to 10-years-olds recruited from 21 research sites across the United States from the Adolescent Brain Cognitive Ddevelopment (ABCD) Study. Childhood trauma was assessed at one- and two-year follow-ups. Negative and positive urgency were assessed at baseline and two-year follow-up. Cross-lagged panel models evaluated the longitudinal and bidirectional associations between childhood trauma and both negative and positive emotion-driven impulsivity. RESULTS Findings showed that earlier childhood trauma was associated with higher levels of later negative (β = 0.133, p < .001) and positive (β = 0.125, p < .001) emotion-driven impulsivity. Further, higher levels of earlier positive (β = 0.033, p < .006), but not negative (β = 0.010, p = .405), emotion-driven impulsivity were associated with later childhood trauma. Finally, the strength of the relations between childhood trauma and emotion-driven impulsivity did not differ by sex (ΔX2 = 10.228, p > .05). DISCUSSION Identification of both negative and positive emotion-driven impulsivity among children exposed to trauma may serve as a point of intervention to reduce subsequent risk for deleterious health outcomes.
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Affiliation(s)
- Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island.
| | | | - Shannon R Forkus
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island; Medical University of South Carolina, Charleston, South Carolina
| | - Jewelia J Ferguson
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island
| | - Manshu Yang
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island
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Mirhosseini T, Guastello AD, Dale LP, Sambuco N, Allen BR, Mathews CA. Effects of COVID-19 stress, proximity, and adverse childhood experiences on healthcare workers' mental health. Front Psychol 2023; 14:1228515. [PMID: 37727750 PMCID: PMC10505740 DOI: 10.3389/fpsyg.2023.1228515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 08/08/2023] [Indexed: 09/21/2023] Open
Abstract
Past research has shown that healthcare workers (HCWs) experience high levels of psychological distress during epidemics and pandemics, resulting in cascading effects that have led to chronically understaffed hospitals and healthcare centers. Due to the nature of their responsibilities and workplace stress, HCWs are among vulnerable groups especially during global health crises. During COVID-19 many healthcare workers reported greater symptoms of anxiety, depression, and COVID-19 related worries. Furthermore, adverse childhood experiences increase vulnerability for psychological conditions, especially during pandemics. This study sets out to (1) investigate the moderating effects of adverse childhood experiences on healthcare workers' COVID-19 related stressors and depression/anxiety symptoms, and (2) investigate the moderating effects of adverse childhood experiences on proximity to the COVID-19 virus and depression/anxiety symptoms. Participants included 438 employed HCWs recruited from academic medical centers and smaller healthcare agencies in northcentral Florida between October to December 2020. Mean age of participants was 38.23 (SD = 11.5) with most of the HCWs being white (72.1%), non-Hispanic (86.8%) and female (82%). Healthcare workers completed several online questionnaires, including the Adverse Childhood Experiences scale, Patient Health Questionnaire, Generalized Anxiety Disorder Scale, a COVID-19 specific worries scale, and a Social Proximity to COVID-19 scale. Healthcare workers experiencing specific COVID-19 worries reported experiencing anxiety and depressive symptoms. A significant positive interaction was seen between childhood adverse experiences globally and COVID-19 worries on anxiety symptoms. A significant positive interaction was observed between childhood maltreatment specifically and COVID-19 worries on depressive symptoms. Additionally, a positive interaction effect was seen between childhood adverse experiences and COVID-19 social proximity for both depression symptoms and anxiety symptoms. Findings from the present study indicate that adverse childhood experiences strengthen the relationship between COVID-19 worry/proximity and negative psychological symptoms. Vulnerable populations such as individuals who have experienced ACEs could benefit from targeted and specific interventions to cope with the collective trauma experienced globally due to COVID-19. As COVID-19 becomes endemic, hospital leadership and authorities should continue addressing COVID-19 worries and HCWs' psychological symptoms through mental health support and organizational interventions.
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Affiliation(s)
- Tannaz Mirhosseini
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, United States
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- UF Center for OCD, Anxiety, and Related Disorders, University of Florida, Gainesville, FL, United States
| | - Andrea D. Guastello
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, United States
- UF Center for OCD, Anxiety, and Related Disorders, University of Florida, Gainesville, FL, United States
- Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Lourdes P. Dale
- Department of Psychiatry, College of Medicine-Jacksonville, University of Florida, Jacksonville, FL, United States
| | - Nicola Sambuco
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, United States
- UF Center for OCD, Anxiety, and Related Disorders, University of Florida, Gainesville, FL, United States
- Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, United States
| | - Brandon R. Allen
- Department of Emergency Medicine, College of Medicine, University of Florida, Gainesville, FL, United States
| | - Carol A. Mathews
- Department of Psychiatry, College of Medicine, University of Florida, Gainesville, FL, United States
- UF Center for OCD, Anxiety, and Related Disorders, University of Florida, Gainesville, FL, United States
- Evelyn F. and William L. McKnight Brain Institute, University of Florida, Gainesville, FL, United States
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