An international study on psychological coping during COVID-19: Towards a meaning-centered coping style

Assessing COVID-19-Related Psychological Distress: Validation of the AMICO Scale in Spanish Nursing University Students

Background: The COVID-19 pandemic had a significant impact on nursing students by intertwining academic demands with health concerns, a situation that had effects on their emotional well-being and academic engagement. Factors such as sociodemographic characteristics and health status determined their experiences. Understanding these dynamics is crucial, especially in the context of the Spanish health and education systems. The present study aimed to adapt and assess the psychometric properties of the AMICO scale in the context of nursing students in Spain. Methods: Cross-sectional descriptive study. The study was carried out in University Nursing Centers in Spain using a non-probabilistic snowball sampling method. The total sample consisted of 1197 nursing students. Sociodemographic variables were included, as well as questions related to general health and some more specific questions about COVID-19. For the reliability study, Cronbach's alpha was calculated. An exploratory factor analysis using principal components and varimax rotation was applied, excluding items with loadings below 0.05. Results: In this study, 1197 nursing students residing in Spain participated, of whom 85% were female, with a mean age of 22.35 years. Despite 73.9% of the students being isolated due to exposure to COVID-19, they rated their general health positively (7.86). Females reported higher levels of anxiety. The AMICO scale revealed significant differences according to gender, health, and vaccination history, showing high reliability (Cronbach's alpha = 0.913). Conclusions: The two-factor structure of the AMICO scale was validated, confirming its suitability for assessing anxiety and fear among nursing students in Spain. The study revealed significant emotional distress during the COVID-19 pandemic, particularly among women, high-risk individuals, and those fully vaccinated. These findings accentuate the need for higher education institutions to implement targeted mental health interventions during public health emergencies. Future longitudinal research should examine the evolving psychological impact of such crises and the mitigating roles of quality of life, sleep, and physical activity.

Meaning-Focused Coping in University Students in Hong Kong During the COVID-19 Pandemic: A Qualitative Study

Many studies were conducted during and after the COVID-19 pandemic to examine its impact on young people's well-being. However, most studies are quantitative ones focusing on the negative impact of the pandemic on young people. In contrast, there are few studies examining the benefits of the pandemic using a qualitative methodology. Hence, we conducted focus group interviews to understand meaning-focused coping in 56 university students from late December 2022 to mid-January 2023 when Hong Kong was approaching the end of the pandemic. Thematic analysis using a deductive analytical approach based on the Revised Stress and Coping Model was applied during data analysis. The results showed that most students were able to generate positive experiences and emotions during the pandemic. Many of them reported improved mental well-being during the pandemic by infusing ordinary events with meaning. They engaged in adaptive goal processes by having a more positive attitude towards life. Students also found benefits in terms of enhanced personal strengths, better interpersonal relationships, and improved pandemic-related abilities. Furthermore, the current study compared the difference in the use of meaning-focused coping and perceived benefits by students with family or personal financial difficulties, students who coped well, and Mainland Chinese students studying in Hong Kong. This paper provides an alternative picture of the impact of the COVID-19 pandemic on university students.

Resilience and meaning-centered coping as mediators in the relationship between life satisfaction and posttraumatic outcomes among earthquake survivors in Turkey

This study aimed to examine the mediating roles of resilience and meaning-centered coping in the relationships between life satisfaction and posttraumatic growth and depreciation. The sample consisted of 255 participants (70% females, Mage = 23.35), who directly experienced the earthquakes that occurred in Turkey on February 6, 2023. Using an online survey, participants answered self-reported questions about their perceived life satisfaction, posttraumatic growth, depreciation, resilience, and meaning-centered coping. Findings showed that life satisfaction significantly predicted resilience, meaning-centered coping, and posttraumatic depreciation. Resilience and meaning-centered coping significantly predicted both posttraumatic growth and depreciation. Importantly, resilience and meaning-centered coping significantly mediated the association of life satisfaction with posttraumatic growth and depreciation. In conclusion, the findings of this study have important implications for customizing interventions designed to enhance the resilience and coping mechanisms of individuals dealing with traumas, including those with posttraumatic stress disorder.

Meaning in life during the COVID-19 pandemic in Brazil: Impact of quality of life and sociodemographic factors

Research on meaning in life typically emphasizes the psychological aspects of quality of life, neglecting broader dimensions. Additionally, its relevance to the COVID-19 context remains limited. This study investigated the relationship of meaning in life with quality of life and sociodemographic factors related to COVID-19 pandemic in Brazil. A total of 4133 Brazilian adults completed Meaning in Life Questionnaire (MLQ), WHOQOL-BREF, WHOQOL-SRPB BREF, and sociodemographic information. Our results indicated a positive correlation between the presence of meaning and quality of life dimensions, with psychological health exhibiting the strongest relationship. We found a lower presence of meaning among individuals experiencing heightened social isolation, while vaccinated individuals exhibited a greater presence of meaning. Additionally, non-working participants reported lower presence and higher search for meaning than employed individuals, with frontline workers showing the highest search for meaning. Theoretical and practical implications of these findings are discussed.

Coping Styles as Mediators Between Purpose in Life and Cognitive Function: A Longitudinal Study

This study tests associations between purpose in life and coping, and whether coping mediates the association between purpose and cognitive function. Longitudinal data from the Midlife Development in the United States (MIDUS) study were used to investigate associations between purpose at MIDUS I and coping at MIDUS II (N = 2386). Emotion-focused and problem-focused coping were tested as mediators between purpose and cognitive function (memory, executive function, global cognition) at MIDUS III. Higher purpose was associated with more problem-focused and less emotion-focused coping. Coping partially mediated the association between purpose and cognitive function. Emotion-focused coping partially mediated (14.3%) the effect of purpose on cognitive function. Problem-focused coping partially mediated (16.7%) the association of purpose on episodic memory, but not executive function or global cognition. These findings provide new evidence for links between purpose and coping and suggest coping is one mechanism linking purpose with better cognitive function.

The long-term impact of the covid-19 pandemic on patients with obsessive-compulsive disorder

We investigated how patients with obsessive-compulsive disorder (OCD) were affected by coronavirus disease of 2019 (COVID-19)-related stress over the long term compared to healthy individuals. We explored how the pandemic affected changes in obsessive-compulsive symptoms and their contributing factors. The study included 100 patients with OCD and 100 sex-matched healthy controls whose sociodemographic and clinical information were gathered. Participants in the study were recruited between December 2021 and May 2022 from individuals attending to the outpatient clinics of the University Department of Psychiatry. The Depression Anxiety Stress Scale-21, Perceptions and Attitudes Towards COVID-19 Questionnaire, COVID-19 Compliance with Prevention Measures Scale, and COVID-19 Stress Scale were used in this study. Patients were assessed using the Yale-Brown Obsession Compulsion Scale based on their conditions before and during the pandemic. Patients with OCD perceived COVID-19 disease as more dangerous and contagious (respectively P = .01, P = .01) compared to the controls. Fifty percent of the patients with OCD experienced an increase in symptoms. Disease severity was increased in mild and moderate OCD, while no significant change was found in severe OCD. Perceiving COVID-19 disease as more dangerous (P = .031), COVID-19-related traumatic stress (P = .013), compulsive control (P = .022), xenophobia (P = .005), and COVID-19-related thoughts (P = .008) were more frequent in OCD patients with clinical worsening. In regression analysis, younger age (OR: 0.95, 95% CI (0.91-0.99)) and higher levels of COVID-19-related stress (OR: 1.03 95% CI (1.01-1.05)) are associated with worsening OCD symptoms. Patients with OCD were adversely affected by the COVID-19 pandemic. Close monitoring of patients with OCD during the pandemic is recommended.

Pandemic Palliatives and COVID-19 Coping: Toward the Development of a "Coping with Crisis Communications" (COCCO) Scale

The COVID-19 pandemic underscored the critical role of coping strategies during global crises and demonstrated how official communications shape public responses. This study evaluates the psychometric validity of a novel pentadic "Coping with Crisis Communication" (COCCO) Scale, which categorizes coping behaviors into five behavioral responses: moving-with, moving-against, moving-outward, moving-away, and moving-inward. A national representative survey of 742 Swiss residents, conducted in February 2022, measured these coping responses to official COVID-19 communications from the Swiss Federal Office of Public Health (FOPH) and traditional Swiss news media (TNM). Items were developed to assess how participants engaged with, opposed, reached outward for support, distanced from, or internalized the messages. Confirmatory factor analyses tested multiple models (5-, 6-, 7-, and 8-factor structures) based on both the initial pentadic theory and data-driven refinements. While the original 5-factor model showed insufficient fit, a 7-factor model (moving-with, moving-toward, moving-against, moving-outward, moving-away, negative-moving-inward, positive-moving-inward) provided a satisfactory factor solution. This model exhibited measurement invariance across the three language versions of the scale (French, Italian, German) and across the two communication contexts (FOPH, TNM). The COCCO scale offers an effective, movement-based assessment of coping strategies in response to crisis communications, serving as a valuable tool for understanding public behavior during global crises.

Meaning-Centred Coping Predicted Lower Depressive Symptoms among Caregivers with Complicated Grief

Background

Complicated grief is characterised by persistent low mood, intense distress and cognitive impairment. This study aimed to explore coping strategies (i.e. emotion-, problem- and meaning-centred) used by bereaved individuals facing complicated grief and how these strategies may predict psychological and cognitive outcomes.

Methods

In a cross-sectional study, 20 bereaved individuals (5 males, 15 females) that aged 27 years old-65 years old (mean = 42.25, standard deviation [SD] = 9.30) were recruited following the loss of a loved one due to physical illness. Participants were screened for complicated grief and subsequently completed self-report assessments of coping strategies and depressive symptoms using Brief Grief Questionnaire (BGQ), Brief Coping Orientation to Problems Experienced (COPE) Questionnaire, Meaning-Centered Coping Scale (MCCS) and Patient Health Questionnaire-9 Items (PHQ-9). Following that, participants underwent a neurocognitive assessment of working memory using the 2-Back task.

Results

Caregivers with complicated grief suffered from moderate severity of depressive symptoms (mean = 17.45, SD = 4.43) as they were coping with the losses. Furthermore, the findings showed that MCC significantly predicted lower levels of depressive symptoms (b = -0.50, t (16) = -2.25, P = 0.04). However, coping strategies did not significantly predict working memory performance.

Conclusion

These findings highlight the potential benefits of MCC in alleviating depressive symptoms in bereaved individuals and underscore its contribution to the development of grief interventions. Grief therapists can emphasise this coping strategy to promote healing and resilience in patients in the grief work.

Evaluation and Future Challenges in a Self-Guided Web-Based Intervention With and Without Chat Support for Depression and Anxiety Symptoms During the COVID-19 Pandemic: Randomized Controlled Trial

BACKGROUND

The COVID-19 pandemic has had an impact on mental health worldwide. Low- and middle-income countries were largely affected by it. Mexico was one of the most affected countries. Extended periods of lockdowns, isolation, and social distancing, among other factors, highlighted the need to introduce web-based psychological interventions to the Mexican population. In this context, Mental Health COVID-19 emerged as a self-guided web-based intervention (SGWI) aimed at adults to improve mental health during the COVID-19 pandemic.

OBJECTIVE

This study aims to assess the efficacy of 2 modalities of a self-guided intervention (with and without chat support) in reducing depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation. In addition, it aimed to compare the moderating role of coping strategies, acceptance, and satisfaction in participants' symptom reduction. We hypothesize that the self-guided, chat-supported modality will show higher efficacy than the modality without chat support in achieving clinical change and better performance as a moderator of depression symptoms, generalized anxiety, community posttraumatic stress, widespread fear, anxiety, sleep quality, physiological and affective coping, and suicide ideation, as well as an increase in participants' satisfaction and acceptability.

METHODS

A randomized controlled trial was conducted. Data were collected from May 2020 to June 2022. We performed intrasubject measures at 4 evaluation periods: pretest, posttest, and follow-up measurements at 3 and 6 months. Differences between intervention groups were assessed through the Mann-Whitney U test for continuous variables and the chi-square test for categorical variables. Changes due to intervention were analyzed using Wilcoxon W test. Moderated regression analysis was performed to test the hypothesized moderating role of coping strategies, usability, and opinion about treatment on clinical change.

RESULTS

A total of 36 participants completed the intervention; of these, 5 (14%) were part of the SGWI group, and 31 (86%) were on the SGWI plus chat support (SGWI+C) group, which included a chat service with therapists. The perceived high complexity of the system for the SGWI group had a moderating effect associated with a lack of efficacy of the intervention regarding depression, but not when controlled for sociodemographic variables. A perception of lower helpfulness of the intervention was associated with poorer outcomes. Coping strategies did not show moderating effects.

CONCLUSIONS

Enhancing the utility of web-based interventions for reducing clinical symptoms by incorporating a support chat to boost treatment adherence seemed to improve the perception of the intervention's usefulness. Web-based interventions face several challenges, such as eliminating complexities in platform use and increasing the users' perceived utility of the intervention, among other issues identified in the study.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04468893; https://clinicaltrials.gov/study/NCT04468893?tab=results.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/23117.

Caring for the carers: an evaluation of the recovery, readjustment and reintegration programme (R3P)

INTRODUCTION

The challenges faced by healthcare workers, not least during the response to the COVID-19 pandemic, have been extensively studied, and concerns continue to be highlighted in relation to their long-term mental health. Identifying the need to support their personnel, a leader-led structured programme of reflection: the recovery, readjustment and reintegration programme (R3P) was designed by the UK Defence Medical Services to mitigate the potential stressors associated with this outbreak and enhance the resilience of the workforce.

METHODS

128 military personnel completed an evaluation of R3P. A survey included measures of anxiety before and after the intervention, perceptions of the discussion themes and whether these brought a sense of closure to areas of distress, and attitudes to help-seeking.

RESULTS

Most respondents (86%-92%) rated the five discussion themes either 'helpful' or 'very helpful', 51% of respondents reported a sense of closure about an issue that had been causing distress and 72% of respondents felt better able to seek help should it be necessary. Evaluating the effect R3P had on anxiety, a Wilcoxon signed rank test elicited a statistically significant difference in anxiety pre-R3P and post-R3P; Z=-3.54, p<0.001. The median anxiety rating was 3.5 (IQR 4.75, 95% CI 1.25 to 6.00) before undertaking R3P, which decreased to 3 (IQR 4.75, 95% CI 1.00 to 5.75) after undertaking R3P. 39.1% of participants reported decreased anxiety, 18.8% reported increased anxiety and 42.2% reported no change.

CONCLUSION

This evaluation has identified several positive aspects to R3P with many personnel reporting a reduction in anxiety, a sense of closure and increased likelihood of help-seeking. Several participants did report an increase in anxiety and the long-term impact of R3P on mental health and well-being is unclear. Further mixed-methods evaluation incorporating a longer follow-up is required.

Longitudinal Associations of Experiential and Reflective Dimensions of Meaning in Life With Psychopathological Symptoms

Background

Rather than being rooted in deliberate reflection, the experience of meaning has been shown to evolve from intuitive processes (Heintzelman & King, 2013b, https://doi.org/10.1007/978-94-007-6527-6_7). Accordingly, experiential and reflective dimensions of meaning in life can be distinguished (Hill et al., 2019, https://doi.org/10.1080/09515070.2018.1434483). In this preregistered study, we explored how these dimensions are longitudinally associated with psychopathological symptoms. We expected that experiencing more meaning would predict fewer depressive symptoms and fewer personality functioning impairments six months later, whereas reflecting about meaning would predict more psychopathological symptoms.

Method

A German-speaking sample of N = 388 completed self-report measures assessing meaning in life, depression, and personality functioning at baseline and six months later.

Results

Controlling for depression at baseline, elevated levels of experiencing meaning in life predicted a decrease in depressive symptoms. Experiencing meaning did not predict personality functioning impairments six months later. However, exploratory analyses with a larger sample tentatively showed that experiencing meaning in life predicted less impairments in personality functioning. Evidence supporting the hypothesized association between reflection and future depression as well as future personality functioning impairments was discerned through exploratory analyses. Generalizability of results to clinical care settings is limited due to the studied non-clinical sample. No causal conclusions can be drawn from the data because the study employed an observational design with two assessment points.

Conclusion

Experiencing meaning in life emerged as a potential protective factor against future psychopathological symptoms, whereas exploratory analyses pointed to an opposite relationship for reflection about meaning in life. Results are discussed with regard to clinical implications and directions for future research.

End-Of-Life Cancer Patients' Dignity Perception Before and During COVID-19 Pandemic

Background: The safety and restriction regulations implemented to contain the COVID-19 pandemic significantly impacted people's quality of life compromising the perception of dignity. Preserving dignity for end-of-life patients remains a paramount objective in palliative care. This study aimed to compare dignity levels in terminal cancer patients between pre- and during-pandemic periods. Methods: Dignity was assessed by the Italian version of the Patient Dignity Inventory (PDI-IT) in both pre- and during-pandemic groups of terminal cancer inpatients (hospitalized or admitted in hospice). The 2 groups were compared using non-parametric tests and a multivariate logistic regression analysis to estimate the association of the different dimensions of dignity with COVID-19 period, adjusting for other confounders. The study involved 2 groups of end-of-life cancer patients with a Karnofsky Performance Status (KPS) index less than 50. The first group included 506 patients before COVID-19, and the second group consisted of 156 patients enrolled during pandemic. Results: Existential Distress, Loss of Purpose and Meaning, Physical Symptoms and Dependency, Social Support PDI subscales and PDI Total score were higher in the during-pandemic group. The multivariate regression model partially supported the previous results as Loss of Purpose and Meaning, Social Support, and Existential Distress PDI subscales were associated with during-pandemic period, whereas PDI Physical Symptoms and Dependency and PDI Psychological Distress were not. Conclusion: Social isolation and other restrictions put in place to contain the COVID-19 pandemic may have had a negative impact on the perception of dignity in cancer patients at the end of life.

Structural links from trait emotional intelligence to life satisfaction and depressive symptoms in women with breast cancer: post-traumatic responses as mediators

PURPOSE

The diagnosis of a disease such as breast cancer (BC) can be experienced as a sudden, unexpected, and life-threatening event accompanied by considerable uncertainty. This experience can precipitate the development of post-traumatic symptoms and depression. Conversely, certain individuals exhibit the capacity to reframe this traumatic event and transform it into an opportunity for personal growth. Existing research shows that individuals with high trait emotional intelligence (trait EI) tend to experience fewer post-traumatic stress symptoms (PTS), and greater post-traumatic growth (PTG). The aim of this study was to investigate the interrelationship among these variables and specifically examine whether PTS and PTG play a mediating role between trait EI, depression, and life satisfaction.

METHODS

Questionnaires were administered to 338 women with BC to assess trait EI, PTS, PTG, depression, and life satisfaction.

RESULTS

Results highlighted that trait EI was negatively related to PTS and depression and positively related to PTG and life satisfaction. In addition, both PTS and PTG showed a mediating role in the relationship between trait EI, depression, and life satisfaction. This study highlights the close link between depressive symptoms and post-traumatic cognitions in women with BC.

CONCLUSION

Current findings highlight links between trait EI, PTS, PTG, depressive symptoms, and life satisfaction. Clinicians could use these findings when developing interventions aimed at alleviating PTS, such as low mood and worry, and facilitating PTG. This study demonstrated that trait EI can reduce PTS and increase PTG, therefore it is important to include programs aimed at fostering trait EI.

Psychological maltreatment, meaning-centered coping, psychological flexibility, and suicide cognitions: A moderated mediation model

BACKGROUND

Mental health problems are currently diversifying, increasing the possibility of suicide. Exposure to psychological maltreatment is one of the factors that increases suicidal cognitions. In addition, psychological flexibility and meaning-centered approaches may be effective in coping with suicidal cognitions.

OBJECTIVE

A hypothesized model was tested to examine the relationships among psychological maltreatment, suicidal cognitions, psychological flexibility, and meaning-centered coping.

METHOD

Data were collected from a sample of 652 participants. Mediation and moderation analyses were conducted to examine the mediating and moderating role of psychological flexibility and meaning-centered coping in the relationship between childhood psychological maltreatment and suicide cognitions among Turkish adults.

RESULTS

The results of the study indicated significant negative and positive relationships between psychological maltreatment, suicide cognitions, psychological flexibility, and meaning-centered coping. The findings suggest that psychological flexibility and meaning-centered coping have a serial mediating effect on the relationship between psychological maltreatment and suicide cognitions. Furthermore, according to the study results, psychological flexibility plays a moderating role both between psychological maltreatment and suicidal cognitions and between meaning-centered coping and suicidal cognitions.

CONCLUSIONS

The study suggests that psychological maltreatment can be considered as a risk factor and meaning-centered coping and psychological flexibility as protective factors in suicide prevention studies.

Mediating roles of meaning in life and psychological flexibility in the relationships between occupational stress and job satisfaction, job performance, and psychological distress in teachers

Employees may experience stress in the workplace for various reasons. Psychological strengths may help them to cope with emerging challenges and foster mental health and work productivity. This study examined the mediating roles of meaning in life and psychological flexibility in the relationships between perceived occupational stress and job satisfaction, job performance and psychological distress. This cross-section study included 554 teachers (56.0% males; Mage = 36.99 ± 7.88 years) at all school levels in Türkiye. The research data was collected through a convenience sampling method using an online survey. Participants completed self-report measures of meaning in life, psychological flexibility, perceived occupational stress, job satisfaction, job performance, and psychological distress. Pearson product-moment correlation and parallel mediation model using PROCESS macro (Model 4) were utilized to analyze the data. The results showed that perceived occupational stress had a significant effect on meaning in life, psychological flexibility, job satisfaction, job performance, and psychological distress. Also, meaning in life and psychological flexibility had significant effects on job satisfaction, job performance, and psychological distress. Furthermore, meaning in life and psychological flexibility partially mediated the relationships between occupational stress and job satisfaction, job performance, and psychological distress. These findings highlight the significance of considering meaning in life and psychological flexibility as crucial factors in mitigating the impact of occupational stress on employee mental health and work productivity. By focusing on enhancing employees' sense of meaning and their ability to adapt flexibly to workplace challenges, organizations can potentially create a better environment that fosters positive outcomes for both employees and the organization. However, the impact of occupational stress on job performance, job satisfaction and psychological distress may change over time. To address this concern, future research should test the model through a longitudinal study design.

Psychological well-being of healthcare workers during COVID-19 in a mental health institution

INTRODUCTION

This study examined the psychological wellbeing of Healthcare Workers (HCWs) during COVID-19 in a mental health setting, associations of psychosocial wellbeing with coping style, and ways that organisations can mitigate the psychosocial burden on HCWs.

METHODS

Thirty-seven Mental HCWs (MHCWs) from infected and non-infected wards (control group), were recruited and assessed at three timepoints. Psychological wellbeing, perceived cohesion, and coping style (Brief-COPE) were assessed. Reports on individual coping and feedback on the organisation were collected through in-depth interview. Comparison between infected and non-infected wards, as well as comparison of psychosocial measures and perceived cohesion, across the three timepoints were made. As there were no significant changes in coping styles across the timepoints, Timepoint 1 (T1) coping style was used to correlate with the psychosocial measures across all timepoints. Thematic analysis was used for qualitative data.

RESULTS

MHCWs from infected wards reported significantly higher levels of stress, χ2(1) = 6.74, p = 0.009, effect size: medium (ε2 = 0.198), and more severe sleep disturbance (PSQI), χ2(1) = 6.20, p = 0.013, effect size: medium (ε2 = 0.182), as compared to the control group at T2. They also engaged in more problem-focused coping (T2 and T3) and emotion-focused coping (T2). As expected, negative coping style was correlated with negative outcomes except problem-focused coping that was correlated with both negative (sleep disturbance and anxiety symptoms) and positive outcomes (wellbeing). Emotion-focused coping was moderately correlated (Tb = 0.348, p<0.017) with higher levels of wellbeing at T2. Thematic analyses revealed MHCWs felt supported by the responsiveness of the institution, emotional and informational support, and the availability from direct leaders, presence of team and hospital leaders on the ground, helped build trust and confidence in the leadership.

CONCLUSIONS

MHCWs experienced significantly higher levels of stress and sleep disturbance during COVID-19. The ways that organizations can offset the psychological burden of pandemics on MHCWs are discussed.

The role of planfulness for well-being, stress, and goal disruption during COVID-19

Planfulness refers to an individual's tendency to be future oriented, mentally flexible, and cognitively strategic when engaging with goals, and has been shown to predict goal completion. We investigated the relationships among planfulness, goal disruption, stress, and psychological well-being during the COVID-19 pandemic, which served as a unique setback context. We measured these constructs using the planfulness scale, an ad-hoc survey item probing goal disruption in the pandemic, the perceived stress scale, and the Warwick-Edinburgh Mental Wellbeing Scale, respectively. Participants were university students (N = 174; mean age 23.03, SD: 4.37; 77% female). Higher planfulness predicted lower goal-disruption, lower stress, and higher well-being during the pandemic, extending its benefits beyond the goal domain. High levels of planfulness did not protect against goal disruption among those participants in which the self-reported personal impact of the pandemic was highest. Differences in goal disruption across levels of planfulness were constrained to lower reported pandemic impact. However, the differences in psychological well-being and stress by levels of planfulness were retained even when self-reported perceptions of personal pandemic impact were high. More planful students maintained lower stress and higher psychological well-being than their less planful peers across levels of adversity. These findings suggest that even in extremely difficult contexts in which planfulness does not protect against goal disruption, it still confers personal benefits in terms of psychological health.

Navigating the crisis: A review of COVID-19 research and the importance of academic publications - The case of a private university in Lebanon

Objectives

The threat of the Corona virus has had a profound global impact, prompting extensive discussions among academicians and medical researchers seeking to understand its implications across various fields. Consequently this review aims to explore the COVID-19 research approaches adopted at the Lebanese American University (LAU) between 2019 and 2022 and, to eventually shed light on the importance of the academic publications during this crisis period in the context of Lebanon.

Design Data sources Eligibility criteria

Studies related to "Coronavirus", "SARS-CoV-2," or "COVID-19″ were extracted from the SciVal database spanning the period 2019 to 2022. The identified studies, totaling 97 publications, were indexed in Scopus and Web of Science and underwent narrative analysis along with an evaluation using a predefined scale to determine their eligibility. The majority of the studies were literature reviews, followed by observational studies, modeling studies, systematic reviews, and meta-analyses.

Results

The majority of the identified studies (31 %) were focused on the medical field, primarily the impact of SARS-CoV-2 infection. Additionally, 22 % of studies discussed updates related to global finance and economic markets, while 18 % addressed the psychological burden of the pandemic. Other areas covered in the literature included the impact on performance, nutrition, tourism, politics, and telecommunication.

Conclusion

This study marks a pioneering endeavor that sparks a crucial dialogue regarding peer-reviewed scientific literature during a period of immense need for accurate information. The prevalence of literature reviews can be attributed to the demand for swift dissemination of preliminary findings and the increased call for COVID-19-related research. However, despite the abundance of publications in this specific domain, it is imperative for future research to shift its focus towards the development of novel therapies, preventive measures, psychological insights, and strategies to address the socioeconomic and financial burdens stemming from the pandemic. This study has the potential to establish a standardized framework for addressing similar crises across diverse fields and at various levels.

Limitations

The review readily acknowledges certain limitations. By solely relying on specific databases like Scopus and WoS, there is a possibility of inadvertently overlooking relevant studies. Although the study provides insights into the impact of COVID-19 across different fields and their respective publications, it is important to recognize that the continuous updates to databases and potential exclusions of related studies may have imposed constraints on the findings. Moreover, the urgency for expeditious peer-review during the pandemic may have heightened the chances of errors and diminished transparency. This urgency has unfortunately increased the risk of fraudulent activities and misconduct.

Reappraising personal values in cancer: Meaning-in-life adaptation, meaningfulness, and quality of life

OBJECTIVE

This study explores the reappraisal of personal values among people with cancer post-diagnosis and its connections to meaningfulness, encompassing personal meaning and sense of meaning, and various dimensions of quality of life.

METHODS

A total of 144 patients with diverse cancer types and a control group comprising 158 healthy adults with similar demographic characteristics completed the Valued Living Questionnaire-Perceived Change, the Personal Meaning Profile-Brief, the Portrait Values Questionnaire, and the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being.

RESULTS

Cancer patients displayed a substantial values reappraisal compared to healthy adults. They reported an increased significance of social areas and self-transcendental values, including close relationships (family, partner, and friends), spirituality, citizenship, and universalism, as well as an increased importance of self-care and self in general. Conversely, cancer patients assigned less importance to work and self-enhancement values such as stimulation, power, and achievement. Cluster analysis revealed that patients who reappraised their values exhibited higher meaningfulness and better indicators of quality of life, including spiritual and physical well-being, compared to patients who did not modify their value system.

CONCLUSIONS

These findings underscore the importance of assessing and promoting meaning-in-life adaptability among people with cancer, with potential applications in meaning-centered therapies and interventions aimed at enhancing psychological flexibility.

Positivity and coping as key to well-being and psychological adjustment during the pandemic of COVID-19: A follow-up study in Portugal

This follow-up study aimed to analyze the protective role of positivity and coping strategies on the well-being and psychological distress levels reported during Portugal's first and third waves of COVID-19. The total sample consisted of 135 participants (82.0% women) with ages ranging from 20 to 72 years (M = 39.29, SD = 11.46). Results suggested a significant decrease in well-being levels but no changes in psychological distress were observed. Positivity was a strong and significant predictor of well-being and psychological distress during the pandemic crisis. Among the set of strategies used by individuals at the first wave, denial, self-blame, and self-distraction predicted a poorer adaptation with more significant mental health impairment, with self-blame standing out as the most harmful. This study highlighted the key role of positivity in adjusting to the current pandemic crisis and the lasting detrimental impact of specific coping strategies.

The Trajectory of Depression through Disenfranchised Grief in Young Widows in Times of COVID-19: A Case Report from Rural India

The COVID-19 pandemic was one of this century's deadliest and most widespread viral outbreaks, with higher mortality rates in men than women. Disruptions in funeral rituals and customs, no social recognition of the losses, and limited social support have complicated the grieving process and are linked to disenfranchised (not openly acknowledged, socially recognized, or publicly mourned) grief. Depression is also highly comorbid with complicated grief. Losing a spouse can be devastating, and this is more severe for women with limited or no resources, who are vulnerable because of the patriarchal society. In the current COVID-19 era, increased uncertainty and disenfranchised grief can worsen the clinical scenario and hamper interventions, as highlighted by the present case report on disenfranchised grief with depressive symptoms in a 30-year-old woman from rural India who, after a year of marriage, lost her husband due to COVID-19. This case study emphasizes the impact of multiple types of disadvantages due to sociodemographic and cultural determinants that can complicate the grieving process in the current context. The bioecological model of grief recovery considers individual features and societal/environmental factors to postulate the appropriate intervention. Finding meaning and purpose in life and restoration-oriented coping were successful for the clinical management of the patient.

Transcending the self to transcend suffering

Suffering is inevitable in human life. Our perspective paper theorizes on precise mechanisms for how self-transcendence-the state in which an individual looks beyond the self and adopts a larger perspective including concern for others and the world-may help people endure the experience of suffering. From an examination of empirical literature ranging from social psychology to clinical research, we propose that self-transcendence may aid the endurance of suffering along three psychological levels: (1) On the level of affect, the unique profundity and positivity of self-transcendent experiences (e.g., awe, flow, compassion) may supersede and reduce the salience of negative affect arising from suffering (e.g., fear, despair, depressive mood). (2) On the level of cognition, the larger frame of reference provided by self-transcendent thinking may contextualize one's suffering as something comprehendible, thereby helping to resolve the challenges of making meaning from suffering (e.g., that one's existing meaning systems are unable to explain the suffering event). (3) On the level of motivation, the drive to fulfill one's need for self-transcendence may counterbalance the more hedonically-oriented motivations that can promote negative coping strategies in response to suffering (e.g., avoidance, substance abuse). All three mechanisms may also provoke downstream prosocial behaviors that help embed the individual into networks of social support. Altogether, by synthesizing specific mechanisms from affective, cognitive, and motivational self-transcendent processes, our paper establishes a theoretical framework for how self-transcendence may help people endure and transcend suffering, thereby elevating the conditions and experiences of our existence.

Identifying health research in the era of COVID-19: A scoping review

Background

Health improvements are considered one of the most important fields of research. Since the coronavirus disease 2019 was declared a pandemic, it might have impacted clinical and public health research in various forms.

Objectives

The goal of this study is to explore health research approaches in the era of coronavirus disease 2019.

Methods

In this scoping review, we reviewed published medical full-text studies and identified potential areas of interest of health research in the era the coronavirus disease 2019 pandemic during the last 3 years within a higher educational setting. A bibliometric analysis was used to compare among published works.

Results

Among the 93 studies that met the inclusion criteria, most focused on mental health (n = 23; 24.7%). Twenty-one publications targeted coronavirus disease 2019 and its consequences on general health. Other studies have described hemato-oncological, cardiovascular, respiratory, and endocrinological diseases. 42 studies were cross-sectional or cohort studies and most of them published in Q1 journals. Almost half of them belonged to the Faculty of Medicine (49.5%) followed by the School of Arts, Sciences, and Psychology (26.9%).

Conclusions

Health research has been demonstrated to be important, at all times, especially during crises. Therefore, researchers need to invest more efforts into seeking new medical updates in various health-related fields, regardless of their correlation with coronavirus disease 2019.

Meaning in challenging times: Sense of meaning supports wellbeing despite pandemic stresses

The COVID-19 pandemic created stress and trauma for many individuals. Traumatic experiences often trigger reflection on meaning in life, with subsequent growth or despair. This study evaluates the role of meaning in life in buffering stressors in the early stages of the COVID-19 pandemic. The purpose of this study was to determine the extent to which the negative effects of COVID-19 stressors (self-perceived stress, emotional state, and cognitive adaptation to stress in the pandemic) are influenced by meaning in life in the context of the early stages of the pandemic. Further, this study described differences in meaning in life observed across demographic groups. Web-based surveys were completed by 831 Slovenian participants in April of 2020. Demographic data; perceptions of stressors related to lacking necessities, movement restrictions, and concerns at home; meaning in life; perceived overall health status; anxiety; emotional state; and perceived stress were measured. A moderately strong sense of meaning in life (M = 5.0, SD = 0.74, range 1-7) was reported by participants, and meaning in life was associated with enhanced wellbeing (B = 0.06-.28, p < .01). Both direct and indirect relationships were observed between stressors and wellbeing outcomes. The indirect effects of meaning in life were especially prominent in the relationship between stressors related to lacking necessities and concerns at home and outcomes of anxiety, perceived stress, and negative emotions, contributing 13-27% of the total observed effects. Increased meaning in life was observed across older age groups (F(5, 825) = 4.8, p < .001) and for those in partnered relationships (t(829) = -3.397, p <.001). A strong sense of meaning in life was associated with improved well-being, even for individuals who experienced pandemic-related stressors. Public health initiatives and media may help improve resilience to pandemic trauma by emphasizing the collective meaning in challenging situations.

Varieties of suffering in the clinical setting: re-envisioning mental health beyond the medical model

In this paper, we argue for the need to rethink mental health beyond the medical model because much of human suffering cannot be diagnosed by the DSM-5. During the pandemic and post-pandemic, people have learned to accept the fact that no one is immune from suffering. Given the universality and complexity of human suffering, it is natural for people to wrestle with existential questions such as "Why struggle when all life end in death?" and "How can one flourish when life is so hard?" Existential positive psychology (EPP or PP2.0) was developed to address these existential concerns. After explaining the inherent limitations of the medical model and the need for EPP as an alternative vision for mental health, we provide illustrative clinical cases to demonstrate the advantages of this broader existential framework for both case conceptualization and interventions. According to EPP, mental illness is reconceptualized as both deficiency in knowledge and skills in coping with the demands of life and deficiency in meeting the basic needs for livelihood and mental health, the Soul's yearnings for faith, hope, and love. Finally, we introduce integrative meaning therapy as a therapeutic framework which can equip people with the needed skills to achieve healing, wholeness, and total wellbeing.

Marketing in the metaverse era: toward an integrative channel approach

The development pace of digital socialization has accelerated drastically in the past decade, especially with the COVID-19 pandemic. Through that continuing digital shift, the idea of the metaverse, a virtual parallel world that can digitally replicate people's lives, is developing fast through Meta's (previously known as Facebook) announcement in October 2021 that it will dedicate sizeable investments in it. While the metaverse provides immense opportunities to brands, the primary concern will be on how integrate it with current media and retail channels, whether they are offline or online. Accordingly, using an exploratory qualitative approach, this study examined the potential strategic channel-based marketing routes that companies would face in the presence of the metaverse. The findings show that the route to market will become much more complex given the metaverse's own platform setup. Strategic multichannel and omnichannel routes are examined through a proposed framework that takes into consideration the expected evolution of the metaverse platform.

Threat Appraisal, Resilience, and Health Behaviors in Recovered COVID-19 Patients: The Serial Mediation of Coping and Meaning-Making

Research indicates that both cognitive appraisal and personal resources can noticeably influence health behaviors, as individuals modify their health convictions and practices on the basis of threat appraisal, personality, and meaning. The aim of the current study was to investigate whether coping strategies and meaning-making can serially mediate the relationship of threat appraisal and resilience with health behaviors in recovered COVID-19 patients. Self-report measures of threat appraisal, resilience, coping, meaning-making, and health behaviors were completed by 266 participants (aged 17 to 78, 51.5% female) who had recovered from COVID-19. The serial mediation analysis showed that the relationship of threat appraisal and resilience with health behaviors was mediated by problem-focused coping, meaning-focused coping, and meaning-making, but not by emotion-focused coping. These results suggest that associations among threat perception, resilience, and health behavior depend to some extent on the interplay of coping and meaning-making, which reveals their unique role in the process of recovery from COVID-19, with potential implications for health interventions.

Cross-Cultural Psychometric Analysis of the Mature Happiness Scale-Revised: Mature Happiness, Psychological Inflexibility, and the PERMA Model

The present study aimed to evaluate the psychometric properties of the Mature Happiness Scale, a measure focused on inner harmony. Mature happiness is achieved when a person can live in balance between both positive and negative aspects of their life. A total sample of 2,130 participants from five countries (Canada: n = 390, United States: n = 223, United Kingdom: n = 512, Spain: n = 724, and Hungary: n = 281) responded to an online survey including the original Mature Happiness Scale, the PERMA-Profiler, and the Acceptance and Action Questionnaire-II. Exploratory and confirmatory factor analyses yielded a one-factor solution with seven positive items (non-reversed). We called this new version of the questionnaire the Mature Happiness Scale-Revised (MHS-R). Measurement invariance was found across countries, age groups, gender, and mental disorder diagnosis. Internal consistency and test-retest reliability were high. Older people, males, and people without a mental disorder diagnosis scored higher in mature happiness than younger ones, females, and those with a mental health disorder diagnosis, respectively. Mature happiness showed strong positive associations with various subscales of the PERMA-Profiler, specifically with positive emotions and meaning in life. In addition, mature happiness was strongly correlated with less negative affect and inner conflict and lower psychological inflexibility, whereas it was moderately correlated with lower loneliness. This validity evidence supports the cross-cultural use of the MHS-R in the aforementioned countries to reliably measure happiness among adults. With its holistic approach, the MHS-R may be a unique complement to other well-being measures, particularly to better predict mental health problems.

Turning to Religion During COVID-19 (Part II): A Systematic Review, Meta-analysis and Meta-regression of Studies on the Relationship between Religious Coping and Mental Health throughout COVID-19

The COVID-19 pandemic and the many associated socio-economic changes constitute a stressful event that required adaptation to new, dynamic, and often threatening conditions. According to the literature, coping strategies are one of the factors that determine a person's degree of adaptation to stressful situations. A systematic review and meta-analysis was performed on the relationship between religious coping and selected indicators of mental health. Due to the large amount of data, this work has been divided into two parts: Part I discussed the positive mental health indicators (Pankowski & Wytrychiewicz-Pankowska, 2023), while this Part II discusses negative mental health indicators. A systematic review of the databases of Science Direct, EBSCO, Cochrane, PubMed, and Google Scholar identified 33 articles related to the severity of depressive symptoms: 30 to anxiety, 23 to stress, 1 related to PTSD symptoms and peritraumatic stress, and 5 related to general negative mental health. The limitations of the research as well as further directions for exploration are discussed.Clinical trial registration This Review was pre-registered at OSF: osf.io/54ygr ( https://doi.org/10.17605/OSF.IO/GMNFV ).

Turning to Religion During COVID-19 (Part I): A Systematic Review, Meta-analysis and Meta-regression of Studies on the Relationship Between Religious Coping and Mental Health Throughout COVID-19

The COVID-19 pandemic and the many associated socio-economic changes constitute a stressful event that required adaptation to new, dynamic, and often threatening conditions. According to the literature, coping strategies are one of the factors that determine a person's degree of adaptation to stressful situations. A systematic review and meta-analysis was performed on the relationship between religious coping and selected indicators of mental health. Due to the large amount of data, this work has been divided into two parts: this first part discusses positive mental health indicators, while the second discusses negative mental health indicators (Pankowski & Wytrychiewicz-Pankowska, 2023). A systematic review of PubMed, Science Direct, the Cochrane Library, Google Scholar, the Database of Abstracts of Reviews of Effects, and Google Scholar databases was carried out. In addition to the synthesis of information obtained from the research, a meta-analysis of correlation was also performed to determine the strengths of the relationships between the analysed variables, and selected moderators were assessed using meta-regression. Quality of life, well-being, satisfaction with life, happiness, and post-traumatic growth were the positive mental health indicators considered. Meta-analyses indicated a statistically significant relationship between positive religious coping and flourishing (well-being) with overall correlation values of 0.35 [0.30; 0.40]. Further calculations also indicated a relationship between negative religious coping and flourishing - 0.25 [- 0.34; - 0.15]. Data synthesis shows associations between religious coping and such indicators as satisfaction with life and post-traumatic growth, but these issues require further investigation.

The influence of resilience on stress reaction of college students during COVID-19: the mediating role of coping style and positive adaptive response

The COVID-19 pandemic was a stressful event for all. It threatened people's physical and mental health. Previous studies have found that resilience can help people deal with stress and difficulties more effectively and prevent them from mental health problems. Coping style mediates the relationship between resilience and psychological well-being. Given the novelty and recency of the COVID-19, it is unknown whether resilience can also protect individuals in new difficulties, and whether the previous effective coping styles can be applied to new situations. The current study aimed to explore the influence mechanism of college students' resilience on negative stress response during the pandemic, and the chain mediation of coping style and positive adaptive response. A questionnaire survey was conducted among 910 college students (Mage = 20.58 years; 41.1% men, 58.9% women) studying in Shanghai by stratified random cluster sampling. At that time, they were in 27 different provinces and cities because of the COVID-19 pandemic lockdown. The research tools included Connor-Davidson Resilience Scale (CD-RISC), Simplified Coping Style Questionnaire (SCSQ), Positive Adaptive Response Questionnaire (PARQ), and Negative Stress Reaction Questionnaire (NSRQ). The results showed that: (1) College students' resilience, coping style, positive adaptive response and negative stress reaction were significantly correlated with each other; (2) Resilience could not directly affect negative stress reaction, but it could affect negative stress reaction through the chain mediation of coping style and positive adaptive response. These findings suggest that resilience enhancement intervention programs need to focus on the cultivation of individual positive coping style; In response to major emergencies such as the COVID-19 pandemic, officials can help people reduce negative stress reaction by disseminating positive coping strategies through the media.

The COVID-19 Pandemic Between Bio-Ethics, Bio-Law and Bio-Politics: A Case Study on The Italian Experience of The DuPre Commission

The aim of this qualitative study was to consider the question of whether the Italian political management of the pandemic respected the European bio-ethical and bio-juridical approaches in light of the principles of autonomy, dignity, integrity and vulnerability. As no specific consolidated literature exists on the subject, the Italian situation was taken into consideration, specifically the work of a spontaneous commission (DuPre) that collected the reflections of academics and researchers interested in discussing political decisions for the management of the emergency, which was the coronavirus disease (COVID-19) pandemic. The analysis took into account the contributions of scholars during two conferences (without proceedings), which were transcribed and examined. From the texts processed with a thematic analysis, three main themes emerged: ‘pandemic as a state of exception, sovereignty and crisis of democracy’, ‘the value of doubt and refutation’ and ‘elimination of informed consent between persuasion and blackmail’. In this paper, the final bio-political considerations on the European approach and the management of the COVID-19 pandemic in Italy are presented.

Use of preventive measures, beliefs and information received about COVID-19 and their effects on mental health, in two stages of the pandemic in Colombia

BACKGROUND

Several studies have highlighted the effects of the COVID-19 pandemic on both physical and mental health. The aim of this study is to analyse the effects on mental health in two phases of the COVID-19 pandemic (April 2020 and February 2021) in the population of Colombia.

METHODS

Observational, prospective, cross-sectional study along two periods, April 2020 and February 2021. The sample (N = 1309) was extracted from the Colombian population, only including individuals over the age of 18 and residing in Colombia during the pandemic. The IMPACTCOVID-19 questionnaire was used, previously validated in Spain and cross-culturally adapted to the Colombian population, which included sociodemographic data, use of preventive measures, information received and the Goldberg General Health Questionnaire (GHQ-12) for psychological distress (PD). Participants had to sign an informed consent before taking part in the investigation.

RESULTS

A higher level of PD was observed among women (M = 3.99, SD = 3.39) (p < .001), in those who lived without a partner (M = 3.83, SD = 3.47) (p = .036), and in those with a worse perception of health (M = 6.27, SD = 3.51) (p < .001). PD decreased in the second period from M = 3.99 (SD = 3.36) to M = 2.98 (SD = 3.30) (p < .001), coinciding with a higher use of preventive measures, less distress caused by COVID-19 and greater confidence in healthcare professionals and clinical structures. In the second period, the time spent in getting informed decreased, but the sources of information were the same, principally social media and official sources.

CONCLUSIONS

Better information on the effects and preventive measures to prevent the pandemic improves confidence in the health system and its professionals, reducing the level of PD. There is a need for quality information on social networks and an adaptation of telemedicine to address the pandemic effects on mental health.Key messagesPsychological distress (PD) decreased in February 2021, as compared to April 2020, due to a greater use of preventive measures against COVID-19, and the confidence on the recommendations made by health officials and professionals.Higher PD has been found in women and people who lived without a partner, in line with studies performed in other countries.The accessibility to quality information on the pandemic should be promoted by the Official Health Authorities, thus counteracting data that could be classified as "fake news".

Psychosocial Influences on Coping and Wellbeing during the Covid-19 Lockdown in the Early Days of the Pandemic: A Mixed Methods Research

This study focuses on the psychosocial impacts of COVID-19 restrictions on wellbeing and uses a mixed methods design to develop a more profound understanding about adaptive coping during stressful situations. The quantitative phase of this study examined the association between psychological capital, perceived stress, coping and wellbeing. The online survey was conducted in May 2020 and had 257 participants. The Structural Equation Modelling (SEM) results showed that the hypothesized model had an adequate fit [χ2(306, N = 257) = 547.185, p = 0.00]; and that both psychological capital and perceived stress were significant predictors of wellbeing. Significantly, young people reported a more negative impact on their wellbeing during the lockdowns. In the subsequent qualitative phase, in-depth interviews with 21 voluntary participants (14 females and 7 males) suggested that individuals could reappraise stressful situations and use coping strategies for psychosocial adaptation. From this research, it was identified that especially the younger age group is at risk, and that that psychosocial resources, such as psychological capital, could be developed to enhance coping and wellbeing with the ongoing impacts of the pandemic.

Characteristics of suicidal poisoned patients admitted to tertiary care center during COVID-19 pandemic

Background

Suicidal poisoning is a major concern during the COVID-19 pandemic that has several physical and mental hazards. This study aimed to evaluate the characteristics of suicidal poisoned patients admitted to a tertiary poison control center during the pandemic lockdown and assess COVID-related knowledge and attitude among those patients to identify the high-risk group for suicide. This cross-sectional study was conducted on acutely poisoned patients admitted to Tanta University Poison Control Center from June to December 2020. Upon admission, socio-demographic data, causative poisoning agents, COVID-related knowledge and attitude, Hamilton Anxiety Rating Scale (HAM-A), and Hamilton Depression Rating Scale (HAM-D) were collected from all participants.

Results

A total of 254 poisoned patients were categorized into suicidal (85.04%) and accidental (14.96%) poisoning groups. The former was caused mainly by phosphides and was significantly associated with a history of using psychotropic medications and high HAM-A and HAM-D results. Logistic regression analysis showed that a history of psychiatric illness, low attitude scores, and high HAM-D scores were significant risk factors for suicidal poisoning.

Conclusions

Considerable number of suicidal poisoned patients had moderate-to-severe depressive symptoms, highlighting the importance of providing specialized psychiatric services in poisoning centers, particularly among vulnerable populations, to prevent the overwhelming repeated suicidal attempts.

Stress and coping strategies in the general population of Greece and Cyprus in response to the COVID-19 pandemic: a cross-sectional study

The COVID-19 pandemic and the lockdown policy had a profound psychological impact on the general population worldwide. The aim of this study was to assess the level of stress and coping strategies used during the initial stage of the COVID-19 outbreak and their association. Secondary aims were to a) identify the most important coping strategies and b) investigate predictors of stress. A cross-sectional study was conducted by using an anonymous online questionnaire. The study was carried out from April 23 to May 4 2020. A snowball sampling method was conducted to recruit potential participants from the general population of Greece and Cyprus. Participants over 18 years old who were familiar with the Greek language were included. The psychological impact was assessed by the Impact of Event Scale-Revised (IES-R). Coping strategies were assessed using 15 statements detected from a review of the literature. Participants were asked to rate each one of the coping strategies according to how important it was to them, on a four-point likert scale. The sample consisted of 3941 participants (74.2% women, N=2926), with a mean age of 36.9 years old. The most important coping strategies adopted were 1) "Dealing the situation with a positive attitude" (96.5%), 2) "Follow strict personal protective measures" (95,9%), 3) "Acquiring knowledge about coronavirus" (94.6%), 4) "Engaging in health-promoting behaviors" (89.6%), 5) "Limiting the time spent on media" (75.5%). The highest and positive coefficients were recorded for the association of IES-R scales with 1) "Talking with family and friends to reduce stress", 2) "Seeking help from a mental health professional", 3) "Limiting the time spent on media", 4) "Relieving and managing emotions", 5) "Practicing relaxation techniques". 26.5% showed severe psychological impact. Conclusion: Addressing stress levels with the use of functional coping strategies can be beneficial to protect the general population from adverse psychological outcomes.

Coping profiles and differences in well‐being during the COVID‐19 pandemic: A latent profile analysis

During the current COVID-19 pandemic, people need to cope with multiple stressors which may affect their well-being. This study aimed (1) to identify latent coping profiles in the German general population, and (2) to investigate differences between these profiles in well-being. In total, N = 2326 German participants were recruited as part of the European Society of Traumatic Stress Studies (ESTSS) ADJUST study from June to September 2020 using an online survey. Coping strategies were assessed using the Brief-COPE and the Pandemic Coping Scale; well-being was assessed using the WHO-5 Well-Being Index. Coping profiles were identified using latent profile analysis; differences between profiles were examined using the automatic BCH method and multiple group analyses. Five coping profiles were identified that included different types and numbers of coping strategies: (1) High functional coping (17.84%), (2) Moderate functional coping (40.63%), (3) High functional and religious coping (9.07%), (4) Low functional coping (22.06%), (5) Moderate functional and dysfunctional coping (10.40%). The identified profiles significantly differed in well-being (χ²  = 503.68, p <0.001). Coping profiles indicating high functional coping were associated with greater well-being compared to coping profiles indicating low (χ²  = 82.21, p <0.001) or primarily dysfunctional (χ²  = 354.33, p <0.001) coping. These results provide insight into how people differ in their coping strategies when dealing with stressors in an early phase of the COVID-19 pandemic. The study indicates higher levels of well-being in coping profiles with more frequent use of functional strategies. To promote well-being in the general population, it might be beneficial to train functional coping strategies in appropriate interventions that are associated with increased well-being.

Two Years of COVID-19 in Austria-Exploratory Longitudinal Study of Mental Health Outcomes and Coping Behaviors in the General Population

Since the long-term mental health impact of COVID-19 is not yet fully understood, the present study explored changes in mental health outcomes and pandemic-related coping behaviors across four pandemic stages. The main objective was to gain insights into the dynamics of mental health and coping, considering different pandemic features at different assessment waves. The final sample consisted of N = 243 adults from the Austrian general population. Data were collected at four timepoints (between June 2020 and December 2021) via LimeSurvey, an open-source online survey tool. Symptoms of posttraumatic stress disorder (PTSD), adjustment disorder (AD), anxiety, and depression were assessed using validated instruments: Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), AD-New Module 8 (ADNM-8), and Patient Health Questionnaire (PHQ4). We also administered the Pandemic Coping Scale (PCS) to address pandemic-related coping behaviors. Cochran’s Q test and repeated measures ANOVAs were applied to assess changes over time. The results indicated that prevalence rates of AD (χ2(2) = 16.88, p = 0.001), depression (χ2(3) = 18.69, p < 0.001), and anxiety (χ2(3) = 19.10, p < 0.001) significantly changed across four assessment waves. Changes in mean scores of the assessed mental health outcomes were also observed. For pandemic-related coping, we found differences in the subscales: healthy lifestyle: F(3, 651) = 5.11, prevention adherence: F(2.73, 592.35) = 21.88, and joyful activities: F(3, 651) = 5.03. Taken together, our study showed a higher mental health burden in wintertime than in summertime, indicating an increased need for psychosocial support in times of stricter measures, higher incidences, and higher death rates. Furthermore, the observed decrease in adaptive coping behaviors suggests that easy-to-implement coping strategies should be actively promoted in order to maintain mental health during and in the aftermath of pandemics.

Determinants of Quality of Life in the COVID-19 Pandemic Situation among Persons Using Psychological Help at Various Stages of the Pandemic

This article presents the results of three surveys conducted during the initial stage of the COVID-19 pandemic, in March 2020 and in late June/early July 2020, when pandemic restrictions were in force. The surveys covered patients who had used psychological assistance before the pandemic. two were cross-sectional and one was longitudinal. The first survey involved 270 people (age: M = 29.59, SD = 10.74, women 79.3%), and the second one covered 117 subjects (age: M = 29.40, SD = 11.49, women 85.5%). The third, longitudinal, survey covered 83 subjects (age: M = 26.61, SD = 7.17, women 89.2%). In our research we used the Conservation of Resources Evaluation questionnaire, the abbreviated version of the Coping Orientation to Problems Experienced, the WHO Quality of Life Scale, and a questionnaire for collecting sociodemographic information. Our analysis of the quality-of-life correlates in the two cross-sectional studies leads to an observation that for people using psychological help, the constant determinants of quality of life during a pandemic are high gain in resources and little loss of resources. In the first phase of the pandemic, active strategies were not linked to the sense of quality of life. This sense, however, was diminished by a number of negative strategies, such as denial, venting, substance use, restraint, and self-blame. After 3 months of the ongoing pandemic, perceived quality of life was positively correlated with strategies related to seeking instrumental support and active coping. this most likely points to a process of adapting to a difficult situation. The results of our longitudinal surveys demonstrate increasing escapism. Our attempt at explaining which factors determined the quality of life after 3 months of the ongoing pandemic showed that the crucial factors are: a sense of quality of life before the occurrence of the pandemic, changes in the distribution of resilience-oriented resources, changed frequency of using passive strategies, and active ways of coping-but only after 3 months into the pandemic. The results thus obtained can be used both in prevention and in work with persons affected by the negative consequences of the COVID-19 pandemic.

An Infectious Silver Lining: Is There a Positive Relationship Between Recovering From a COVID Infection and Psychological Richness of Life?

This paper draws from the recent literature on psychological richness of life (PRL), conceptualized as a third dimension of a good life which would be particularly desirable when happiness or meaning in life cannot be satisfactory attained, to investigate whether recovering from a COVID infection could be associated with PRL. We hypothesize that people who have recovered from being infected by the virus rate their PRL higher than those who have not been infected. Two cross-sectional studies (n = 937, and n = 1,012) support the hypothesis, and also found that people who recovered from a COVID infection were less prone to want to delete the pandemic time period from their life line and reported lower levels of death anxiety. The findings have implications for coping both on a societal and individual level, by changing perspectives and valuing the richness of positive as well as negative experiences, as well as counteracting repetitiveness and tedium and stimulating new experiences and reflection. The findings also have implications for future research on well-being, which could be informed by expanding the perspective from living well to a life well-lived, and future research on PRL and coping in terms of investigating causalities and interaction effects.

Existential Insights in Cancer: Meaning in Life Adaptability

Previous research demonstrated that the cancer diagnosis and treatment evoke existential concerns, especially ones related to meaning in life and meaning-making processes. The cancer experience is a vital challenge that often entails changes in what is personally important in life. Firstly, this paper collects evidence supporting that meaning adaptability, the way people adapt their meaning in life to the cancer experience, is a central element in the mental health of cancer patients. Various theories that could account for this meaning adaptability are introduced. Secondly, the paper provides a compilation of studies showing how people change what is significant in their lives within the course of cancer. Finally, the paper presents the available psychological therapies directed to facilitate meaning adaptability in this population. Meaning-centered interventions have been demonstrated to be effective in alleviating the suffering related to the cancer experience and promoting personal growth.

Symptoms of Post-Traumatic Stress Disorder and the Sense of Gains and Losses during the COVID-19 Pandemic: An International Study

This study was primarily designed to investigate the perception of changes in selected areas of life experienced by adults of various nationalities in connection to the long-lasting COVID-19 pandemic. The second objective was to identify the factors increasing the risk of perception of negative changes in life during the pandemic. The tools applied in the study include a self-report questionnaire designed to measure sociodemographic data and health status of the subjects, COVID-19 Sense of Life Changes Questionnaire, as well as the Impact of Event Scale: Revised. The study involved over 600 adult subjects. With increased intensity of intrusions, the likelihood of negative perception of the changes emerging as a result of the pandemic was reduced by approximately 7%, whereas a higher intensity of hyperarousal increased that risk. Individuals reporting a sense of negative changes presented a greater degree of hyperarousal compared to those reporting positive changes. In the group of subjects perceiving the changes in a positive way, increasing the intensity of intrusion and/or hyperarousal corresponded to a growing conviction about a negative nature of life changes concerning the relationship with their partner and affecting their work as well as regarding a positive meaning of the changes in relations with their parents and in daily life. Generally, there was a prevailing sense of negative changes; however, there was also a group of subjects that perceived these as positive. Intrusions and hyperarousal in certain individuals may play a role in motivating them to take action in protecting against effects of the pandemic and, in others, may lead to frustration and anxiety.

A "Viral Epistolary" and Psychosocial Spirituality: Restoring Transcendental Meaning During COVID-19 Through a Digital Community Letter-Writing Project

This article outlines the results of a three-month-long community letter-writing and letter-sharing project called "Viral Epistolary" (VE), which we completed online in Italy during the first wave of COVID-19 lockdowns. In it, we collected 340 digital letters from all over the country and connected thousands of people through epistolary exchanges. We used the genre of letters as a mediating, meaning-making, and (auto)biographical tool whereby people could share their experiences of domestic isolation and physical distancing, thus creating a community of support. Based on a well-documented understanding of meaning-making as a core human endeavor, especially in times of social disruption and personal crisis, this article frames sense-making as a transcendental and even spiritual process that yields broad principles for organizing life. Thus, the research adopts a psychosocial perspective on spirituality and applies thematic analysis to qualitatively analyze written narratives. The results reveal that many respondents underwent a three-part, not-necessarily-sequential process of collapsing, self-distancing, and transcending during lockdown, which allowed them to rearrange themselves according to the new total social fact of the pandemic. Through this process, respondents negotiated themes of semiotic crisis, striving for meaning, and beyond meaning (the essential). Finally, the article discusses the role of meaning as a transcendental component of psychosocial meaning-making coping processes and tries to highlight how shared writing experiences can stimulate personal and communal healing processes in the wake of social crises.

You can't do anything about it, but you can make the best of it: a qualitative analysis of pandemic-related experiences in six European countries

BACKGROUND

The complex system of stressors related to the coronavirus disease 2019 (COVID-19) pandemic has affected the global population, provoking a broad range of psychological reactions. Although numerous studies have investigated the mental health impact of COVID-19, qualitative research and cross-country comparisons are still rare.

OBJECTIVE

This qualitative study aimed to explore self-perceived challenges and opportunities related to COVID-19 across six European countries. The overall objective was to provide a differentiated picture of individual subjective experiences in the early stages of the pandemic.

METHOD

The present study included 7309 participants from Austria, Croatia, Georgia, Greece, Poland, and Portugal. We performed qualitative content analysis according to Mayring analyse open-ended questions regarding stressful events, positive and negative aspects of the pandemic, and recommendations to cope with the pandemic situation. MAXQDA software was used for data management and analysis.

RESULTS

Participants' accounts were moderately consistent across the countries. The most prominent themes regarding stressful and negative pandemic aspects included: Restrictions and changes in daily life, Emotional distress, and Work and finances. Answers about positive pandemic consequences were mainly centred around the themes Reflection and growth, Opportunity for meaningful/enjoyable activities, and Benefits on interpersonal level. Key themes identified from participants' recommendations to cope with the pandemic included Beneficial behavioural adjustment, Beneficial cognitive-emotional strategies, and Social support.

CONCLUSIONS

Participants experienced various challenges, but also shared several positive pandemic consequences and recommendations to cope with the pandemic. These first-hand data could inform mental health practices to promote well-being during COVID-19 and similar global challenges in the participating countries and possibly beyond.

HIGHLIGHTS

We examined COVID-19-related experiences in 7309 adults from six European countries.Besides challenges, participants identified many positive pandemic consequences.Participants' recommendations to cope with COVID-19 included behavioural and cognitive-emotional strategies.

Health co-inquiry in migraine: Online participation and stakeholder experiences before and during the COVID-19 pandemic

A migraine is more than head pain, and chronic migraine can dramatically impact a person and those around her/him/them. To better understand those effects it is important to study the experiences of persons with migraine and their caregivers, family, friends, and health and mental health providers. When they collaborate, stakeholders may improve outcomes for persons with chronic migraine. One type of stakeholder cooperation is Health Co-Inquiry, involving a person-centered approach, activation of persons toward collaboration and improved health, evidence-based practice, and integrated care. The current study investigated Health Co-Inquiry at online forums, blogs, and bulletin boards where people came together to discuss migraine. A "Bifurcated Method" was used to conduct inductive, thematic analyses, quantitize themes, and cross-check themes using a robot program, which crawled the Internet to gather data about stakeholder sites and posts related to migraine. Key themes in the online narratives of migraine stakeholders included seeking and providing advice, help, and information. In addition, giving personal stories and testimonials, selling computer applications and products, and providing misinformation were frequent. Differences in the types of posts by various stakeholder groups were identified and may inform researchers about their varied perspectives and goals. Remarkably, migraine is still migraine-before a pandemic and during it. As such, migraineur concerns remained stable across thematic analyses of blog and forum posts before and during the worldwide COVID-19 pandemic.