Coping during the COVID-19 pandemic: A mixed methods approach to understand how social factors influence coping ability

Adaptive versus maladaptive coping strategies: insight from Lebanese young adults navigating multiple crises

BACKGROUND

Coping strategies are composites of cognitive and behavioral efforts to manage the internal and external demands of stressful situations. They have been documented to relate to general well-being and mental health. However, not all types of coping are created equal, and adaptive versus maladaptive strategies seem to have understudied differential impacts, notably with accumulated adversities.

METHODS

We examined coping strategies in a sample of 489 Lebanese university students during accumulating crises, including socio-political unrest and the COVID- 19 pandemic. They were asked to fill out an online survey including standardized questionnaires of well-being (WEMWBS), depression (PHQ- 9), anxiety (HAM-A), intolerance of uncertainty (IUS), and coping (Brief COPE), in addition to demographics and questions about their attitudes and future perspectives.

RESULTS

The results highlight that adaptive coping strategies positively correlate with psychological well-being, whereas maladaptive ones are associated with higher levels of psychopathology. Specifically, it was shown that a positive association exists between anxiety, depression, intolerance of uncertainty, and maladaptive coping strategies while evidencing a negative association between the latter and well-being. Our multinominal regression showed that anxiety, intolerance of uncertainty and well-being were associated with low levels of adaptive coping when taking adaptive coping as a dependent variable.

CONCLUSION

Our study mainly highlights the relation between coping, uncertainty, and mental health. Although intended to help relieve tension, maladaptive strategies might worsen it instead. We emphasize previous findings to promote healthy adaptive coping strategies in times of unprecedented crises.

Comparative analysis of stress level and coping strategies due to COVID-19 pandemics among dental students in Indonesia and Vietnam

Objective

This study investigated and compared the perceived stress levels and coping strategies of dental students in Indonesia and Vietnam during the COVID-19 pandemic.

Materials and methods

A cross-sectional survey was conducted online in 2022 for dental students from the University of Indonesia and Can Tho University, Vietnam (n = 304). Perceived stress levels and coping strategies were assessed using a self-administered questionnaire about student sociodemographic factors, learning experiences, coping strategies, stress-related factors, and stress levels. Data were analyzed using Mann-Whitney, Kruskal Wallis, and Spearman correlation tests.

Results

This study showed the overall mean stress level was 23.9 (SD = 5.63), with a significant difference observed between Indonesian (24.44, SD = 5.14) and Vietnamese students (23.32, SD = 6.13) (p = 0.016), indicating potential variations in stress experiences. Key findings include a correlation between living arrangements and stress, as students living independently report higher stress (23.96, SD = 6.24) compared to those living with family (23.95, SD = 5.29) (p = 0.018). Fifth-year students exhibit lower stress levels (21.17, SD = 6.12) than other grades (p = 0.026). Multiple training sessions about COVID-19 are associated with better coping strategies (9.95, SD = 0.91, p < 0.001). The study also revealed different perceptions of COVID-19 learning experiences among dental students in Indonesian and Vietnamese dental students, with significant correlations observed between stress levels, coping strategies, and specific concerns such as graduation time and COVID-19-induced changes (p < 0.05).

Conclusion

This study shows students experience moderate stress levels, but the significant differences in stress experiences and coping strategies between the two countries highlighted the need for tailored approaches. Providing social support from faculty, family, friends, and peer dental students was one of the students' strategies to cope and minimize stress levels.

Mental Health Outcomes of Endometriosis Patients during the COVID-19 Pandemic: Impact of Pre-pandemic Central Nervous System Sensitization

To correlate pain-related phenotyping for central nervous system sensitization in endometriosis-associated pain with mental health outcomes during the COVID-19 pandemic, the prospective Endometriosis and Pelvic Pain Interdisciplinary Cohort (ClinicalTrials.gov #NCT02911090) was linked to the COVID-19 Rapid Evidence Study of a Provincial Population-Based Cohort for Gender and Sex (RESPPONSE) dataset. The primary outcomes were depression (PHQ-9) and anxiety (GAD-7) scores during the pandemic. The explanatory variables of interest were the Central Sensitization Inventory (CSI) score (0-100) and endometriosis-associated chronic pain comorbidities/psychological variables before the pandemic. The explanatory and response variables were assessed for correlation, followed by multivariable regression analyses adjusting for PHQ-9 and GAD-7 scores pre-pandemic as well as age, body mass index, and parity. A higher CSI score and a greater number of chronic pain comorbidities before the pandemic were both positively correlated with PHQ-9 and GAD-7 scores during the pandemic. These associations remained significant in adjusted analyses. Increasing the CSI score by 10 was associated with an increase in pandemic PHQ-9 by .74 points (P < .0001) and GAD-7 by .73 points (P < .0001) on average. Each additional chronic pain comorbidity/psychological variable was associated with an increase in pandemic PHQ-9 by an average of .63 points (P = .0004) and GAD-7 by .53 points (P = .0002). Endometriosis patients with a history of central sensitization before the pandemic had worse mental health outcomes during the COVID-19 pandemic. As a risk factor for mental health symptoms in the face of major stressors, clinical proxies for central sensitization can be used to identify endometriosis patients who may need additional support. PERSPECTIVE: This article adds to the growing literature of the clinical importance of central sensitization in endometriosis patients, who had more symptoms of depression and anxiety during the COVID-19 pandemic. Clinical features of central sensitization may help clinicians identify endometriosis patients needing additional support when facing major stressors.

Stress during the COVID-19 Pandemic and Emotional Eating Scale Adapted for Children and Adolescents (EES-C) Results in Girls: Polish Adolescents' COVID-19 Experience (PLACE-19) Study

Stress related to the outbreak of the COVID-19 pandemic may have caused substantial changes in eating behaviors, and may have been associated with emotional eating, especially in female individuals. The aim of the present study was to analyze the association between stress perceived during the COVID-19 pandemic and emotional eating in girls, within the third phase of the Polish Adolescents' COVID-19 Experience (PLACE-19) Study. A nationwide sample of 818 Polish female adolescents, aged 15-20, was gathered. The adolescents were recruited to the study based on a random quota sampling procedure. Using a computer-assisted web interview (CAWI) survey, participants filled out the Emotional Eating Scale Adapted for Children and Adolescents (EES-C) to assess the urge to cope with negative emotions by eating, and the Adolescent Stress Questionnaire (ASQ) to assess perceived stress. Additionally, the data concerning body mass, height, as well as body mass change during the COVID-19 pandemic were verified. The groups most susceptible to emotional eating were excessive body mass female adolescents, those who gained weight during the COVID-19 pandemic and those experiencing high stress levels while facing negative emotions. In order to plan effective therapeutic interventions dealing with the issue of emotional eating, both psychological therapy and dietary strategy tailored to the individual should be considered for the indicated susceptible groups.

The impact of social support and emotion dysregulation on COVID-19 depressive symptoms

Introduction

Stress resulting from the global COVID-19 pandemic has been linked to psychological consequences, such as depressive symptoms, for individuals worldwide. Outbreaks and pandemics are known to accentuate stressors or generate new ones owing to health-related worries, reduced mobility, and social activity due to quarantine, and sudden life changes. Although post-lockdown U.S. research findings suggest a greater risk of depression among 18- to 25-year-olds, familiarity with technology and virtual socializing may offer college students some protective effect, warranting research with such groups.

Methods

The current study thus explored emotion dysregulation (ED) and perceived social support (PSS) as potential mechanisms for the relationship between COVID-19 stress and depressive symptoms among students at a southern university in the United States. Participants (N = 489) completed a cross-sectional survey assessing their current levels of COVID-19 stress, ED, PSS, and depressive symptoms.

Results

Path analysis showed that PSS buffered the effect of ED on depressive symptoms. The results support the explanatory role of ED in the relationship between COVID-19 stress and depressive symptoms.

Discussion

The perceived social connection may be an essential factor for psychological outcomes during periods of stress and isolation, particularly for those reporting high ED.