Psychological distress associated with COVID-19 quarantine: Latent profile analysis, outcome prediction and mediation analysis

Trajectories and determinants of acute stress disorder during the COVID-19 centralized quarantine: A latent class growth analysis

COVID-19 centralized quarantine may cause acute stress disorder (ASD). However, it is unknown how individuals present heterogeneous ASD trajectories during the COVID-19 centralized quarantine and what factors contribute to these patterns. This study aimed to identify the ASD trajectories and their determinants during the centralized quarantine period, and the mediating effects of resilience on these associations. A longitudinal survey with three waves was conducted in a randomly selected quarantine hotel in Shenzhen, China from October to November 2020. A total of 273 participants completed online measures assessing ASD symptoms, Eysenck's personality constructs of extraversion (E), neuroticism (N), psychoticism (P), and resilience on Day 1, and reported ASD symptoms on Days 7 and 14 during their 14-day centralized quarantine periods. Latent class growth analysis identified three trajectories: constantly high symptoms (CHS, 4.76%), decreasing symptoms (DS, 11.72%), and constantly low symptoms (CLS, 83.52%). The CHS and DS subgroups both reported lower E and higher N scores, but not P, compared with the CLS subgroup. Resilience mediated the effects of three personality constructs on ASD trajectories, except for the association between N and DS membership. Our study highlights the heterogeneity in stress responses to the COVID-19 centralized quarantine. The high-risk subgroup with persistent ASD symptoms was characterized by lower E and higher N. The resilience process accounted for the effects of personality in shaping distinct ASD trajectories. Our findings have implications to detect the populations vulnerable to ASD and provide insights for developing timely resilience enhancement intervention programs.

Large environmental changes reduce valence-dependent belief updating

When updating beliefs, humans tend to integrate more desirable information than undesirable information. In stable environments (low uncertainty and high predictability), this asymmetry favors motivation towards action and perceived self-efficacy. However, in changing environments (high uncertainty and low predictability), this process can lead to risk underestimation and increase unwanted costs. Here, we examine how people (n = 388) integrate threatening information during an abrupt environmental change (mandatory quarantine during the COVID-19 pandemic). Given that anxiety levels are associated with the magnitude of the updating belief asymmetry; we explore its relationship during this particular context. We report a significant reduction in asymmetrical belief updating during a large environmental change as individuals integrated desirable and undesirable information to the same extent. Moreover, this result was supported by computational modeling of the belief update task. However, we found that the reduction in asymmetrical belief updating was not homogeneous among people with different levels of Trait-anxiety. Individuals with higher levels of Trait-anxiety maintained a valence-dependent updating, as it occurs in stable environments. On the other hand, updating behavior was not associated with acute anxiety (State-Anxiety), health concerns (Health-Anxiety), or having positive expectations (Trait-Optimism). These results suggest that highly uncertain environments can generate adaptive changes in information integration. At the same time, it reveals the vulnerabilities of individuals with higher levels of anxiety to adapt the way they learn.

Compliance with COVID-19 preventative health measures in the United Kingdom: a latent profile analysis

Governments have adopted unprecedented measures to assist in slowing the spread of the COVID-19 pandemic, but compliance varies among individuals. This UK study uses latent profile analysis to identify four classes of individuals on factors believed to influence compliance. Those who sought health information from authoritative sources and actively sought information from multiple sources were most compliant. Profile differences in compliance and vaccination status were also primarily driven by trust in healthcare institutions over trust in government. These findings contribute to understanding compliance profiles and emphasise the importance of authoritative information and trust in healthcare systems.

Evaluation of the relationship between the fear of COVID-19 and mental status of female employees during the COVID-19 pandemic

BACKGROUND

The stress due to the COVID-19 pandemic has influenced the physical, mental, and social well-being of humans worldwide.

OBJECTIVE

To evaluate the relationship between the fear of COVID-19 and mental state of female employees during the COVID-19 pandemic.

METHODS

A cross-sectional study was conducted involving 726 participants. Data was collected using the Personal Information Form, fear of COVID-19 scale, and brief symptom inventory.

RESULTS

The fear experienced by women during the social isolation and quarantine period was associated with depression, anxiety, somatization, obsessive-compulsive disorder, interpersonal sensitivity, hostility, phobic anxiety and paranoid experiences.

CONCLUSION

Women, young people, the elderly and single individuals were most likely affected psychologically during the pandemic. Thus, interventions and psychological evaluations are recommended at an early stage to minimize this effect. Such interventions must be implemented considering the strategic planning and coordination of risk groups.

Increased experiences of loneliness during the COVID-19 pandemic, emotional distress and changes in perceived physical and mental health: A structural equation model

AIM

To explore how experiences of increased loneliness during the COVID-19 pandemic affected emotional distress and changes in perceptions of physical and mental health.

DESIGN

Cross-sectional study.

METHODS

Data from the Socio-Economic Impacts of Covid-19 Survey, a national survey administered to 5033 adults in August and September 2020 in the United States, was utilized in this study. Structural equation modelling was used to analyse the associations between increased experiences of loneliness during the pandemic, emotional distress and changes in perceptions of physical and mental health.

RESULTS

Among the 47% of participants who reported increased experiences of loneliness during the pandemic, 31% reported a poorer perceived change in mental health and 12% reported a poorer perceived change in physical health. Increased experiences of loneliness during the pandemic were significantly associated with emotional distress and poorer perceived mental and physical health changes. Emotional distress significantly mediated the effect between increased experiences of loneliness during the pandemic and poorer perceived mental and physical health changes. These findings highlight the importance of producing preventative actions to combat increased loneliness and emotional distress during and after future pandemics in order to improve health perceptions, which can result in negative health outcomes over time.

[Interaction of somatic findings and psychiatric symptoms in COVID-19. A scoping review]

An infection with SARS-CoV‑2 can affect the central nervous system, leading to neurological as well as psychiatric symptoms. In this respect, mechanisms of inflammation seem to be of much greater importance than the virus itself. This paper deals with the possible contributions of organic changes to psychiatric symptomatology and deals especially with delirium, cognitive symptoms, depression, anxiety, posttraumatic stress disorder and psychosis. Processes of neuroinflammation with infection of capillary endothelial cells and activation of microglia and astrocytes releasing high amounts of cytokines seem to be of key importance in all kinds of disturbances. They can lead to damage in grey and white matter, impairment of cerebral metabolism and loss of connectivity. Such neuroimmunological processes have been described as a organic basis for many psychiatric disorders, as affective disorders, psychoses and dementia. As the activation of the glia cells can persist for a long time after the offending agent has been cleared, this can contribute to long term sequalae of the infection.

Unveiling the relationships between eco-anxiety, psychological symptoms and anthropocentric narcissism: The psychometric properties of the Turkish version of the Hogg eco-anxiety scale

The increasing number of losses and damages caused by the climate crisis has rendered the psychometric assessment of the climate crisis more important than ever, specifically in developing countries, such as Turkey. The aim of this study was to examine the psychometric properties of the Turkish version of the Hogg Eco-Anxiety Scale (HEAS-13), using exploratory structural equation modeling (ESEM) on the cross-sectional data collected from 445 adults (286 females and 159 males; Mage = 29.76, range 18-65). The results supported the four-factor solution of the original version in the Turkish sample. Further analysis confirmed the invariance of the HEAS-13 across genders. The results demonstrated significant correlations of the HEAS-13 subscales with the Brief Symptom Inventory (BSI) and the Anthropocentric Narcissism Scale (ANS), except for that between the behavioral symptoms subscale of the HEAS-13 and the ANS. Both the total and the subscale scores of the HEAS-13 were also found to be reliable, given the internal consistency and test-retest reliability values. The Turkish version of the HEAS-13 can expand the scientific understanding of eco-anxiety, which can help develop mental health services to mitigate the negative mental health impacts of the environmental crisis.

A systematic review of studies on stress during the COVID-19 pandemic by visualizing their structure through COOC, VOS viewer, and Cite Space software

Background

The COVID-19 epidemic generated different forms of stress. From this period, there has been a remarkable increase in the quantity of studies on stress conducted by scholars. However, few used bibliometric analyses to focus on overall trends in the field.

Purpose

This study sought to understand the current status and trends in stress development during COVID-19, as well as the main research drives and themes in this field.

Methods

2719 publications from the Web of Science(WOS) core repository on stress during COVID-19 were analyzed by utilizing Co-Occurrence (COOC), VOS viewer, and Cite Space bibliometric software. The overall features of research on stress during COVID-19 were concluded by analyzing the quantity of publications, keywords, countries, and institutions.

Results

The results indicated that the United States had the largest number of publications and collaborated closely with other countries with each other. University of Toronto was the most prolific institution worldwide. Visualization and analysis demonstrated that the influence of stress during COVID-19 on the work, life, mental and spiritual dimensions is a hot research topic. Among other things, the frequency of each keyword in research on stress during COVID-19 increased from 2021 to 2022, and the researchers expanded their scope and study population; the range of subjects included children, nurses, and college students, as well as studies focusing on different types of stress, and emphasizing the handling of stress.

Conclusion

Our findings reveal that the heat of stress research during COVID-19 has declined, and the main research forces come from the United States and China. Additionally, subsequent research should concern more on coping methods with stress, while using more quantitative and qualitative studies in the future.

Differential Impact of Emotional and Contextual Factors Associated with COVID-19 on Adolescent Mental Health

Background

During the confinement, there was an increase in the incidence of mental disorders such as depression and anxiety. In this regard, affectivity is of particular interest, as emotions play a fundamental role in overall mental health. The literature on COVID-19 in this population has often focused on the analysis of risk factors for mental health, while less attention has been paid to protective factors. In this paper, we propose an inclusive model of risk and protective factors for adolescent mental health through the indirect effect of negative and positive affect.

Methods

This was a cross-sectional study with a Spanish community sample of 477 adolescents (Mage = 16.23, range:14 to 20 years old; 43.4% were boys; response rate: 100%). We measured the perceived hardness of confinement, worrying about contagion, quality of relationships at home, pleasant activities, affect (positive and negative), and mental health.

Results

The results revealed a positive relationship between the perceived hardness of confinement and worrying about contagion with mental health, through the indirect effect of negative affect, and a positive relationship between home relationships and pleasant activities with mental health through an indirect effect of positive affect.

Conclusion

Our results suggest that different types of emotions generated by the various contextual variables associated with COVID-19 may have a differential impact on mental health. These findings support the inclusive model of risk and protective factors for adolescent mental health. Practical implications, future studies, and limitations are discussed.

Perceived social support attenuates increased hostile reactions to traumatic threat

OBJECTIVE

Extant literature has seldom examined the naturalistic role of reaction to threat on downstream emotional distress while also considering buffers, such as perceived social support, to acute negative mental health outcomes. The present study examined how trauma symptoms, in reaction to a global stressor, predicted increased psychological distress via elevated emotional hostility and whether perceived social support modified such effects. We predicted a priori that increased exposure to trauma would be associated with increased hostility and global psychological distress, but that this path would be attenuated by greater levels of perceived social support, as individuals who report greater support exhibit greater emotional coping.

METHODS

We recruited 408 adults from a large university in the Midwestern United States to participate in a survey assessing past-week trauma, hostility, distress, and perceived social support following the initial COVID-19 lockdown. The survey was conducted in March 2020, directly after strict shelter-in-place orders were locally mandated. To test our hypotheses, we employed a moderated mediation analysis approach.

RESULTS

Results demonstrate that higher trauma predicted increased hostility, which in turn predicted increased distress, and trauma predicted distress via hostility (an indirect effect). As hypothesized, higher perceived social support attenuated the association between trauma and hostility.

CONCLUSION

Results support a hostile emotional pathway that may increase distress in the context of increased traumatic impact; however, social support likely buffers these effects, particularly in the face of new or novel threats and stressors. Findings suggest broad application for understanding the relation between the introduction of stressors, psychological distress, and social support.

Longitudinal patterns of alcohol use and psychological symptoms during COVID-19 pandemic and role of alexithymia: A latent transition analysis in the FinnBrain Birth Cohort Study

BACKGROUND

The COVID-19 pandemic has been posing widespread influence on mental well-being. However, research on the dynamic relations between alcohol use and psychological symptoms in the context of the pandemic and the role of alexithymic traits in predicting the development of mental health problems longitudinally remains scarce.

METHODS

Latent profile and transition analyses were conducted to model the longitudinal patterns of transitions in the profiles of alcohol use and psychological symptoms across 10 months during the pandemic (from May 2020 to March 2021) and to investigate the role of alexithymia and its dimensions Difficulty Identifying and Describing Feelings (DIF and DDF), and Externally Oriented Thinking (EOT) in 720 parents from the FinnBrain Birth Cohort Study.

RESULTS

Three profiles, Risky Drinking, Distressed Non-Risky Drinking, and Non-Distressed, Non-Risky Drinking, and their transitions were identified. The role of alexithymia appeared to be stronger in Risky Drinking than Non-Distressed, Non-Risky Drinking. DIF predicted the development of symptoms in Risky Drinking, whereas DDF predicted Risky Drinking remaining stable over time and showed a trend towards psychological distress in Risky Drinking and Non-Distressed, Non-Risky Drinking. EOT was more likely to be a risk factor for Risky Drinking remaining constant and Non-Distressed, Non-Risky Drinking becoming Risky Drinking.

LIMITATIONS

This study was mainly limited by the generalizability of the findings.

CONCLUSIONS

Our findings add deeper insights into the longitudinal development of alcohol use and psychological symptoms as well as evidence on the role of alexithymia in shaping mental health, providing implications for tailoring clinical preventive and therapeutic measures.

Incidence rates of treated mental disorders before and during the COVID-19 pandemic-a nationwide study comparing trends in the period 2015 to 2021

BACKGROUND

There is a concern that exposure to psychosocial stressors during the COVID-19 pandemic may have led to a higher incidence of mental disorders. Thus, this study aimed to compare trends in incidence rates of depressive disorder, anxiety disorders, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), and eating disorders in primary- and specialist health care before (2015-2019) and during the COVID-19 pandemic (2020-2021).

METHODS

We used aggregated population registry data to calculate incidence rates of mental disorders from primary- (The Norwegian Control and Payment of Health Reimbursements Registry (KUHR)) and specialist (The Norwegian Patient Registry (NPR)) health care. The analyses included all Norwegian residents aged 18-65 during the study period. Incident cases were defined as having no previous registration with the same mental disorder in KUHR (from 2006) or NPR (from 2008). We used linear prediction models and mean models to compare incidence rates and test trends before and during the pandemic.

RESULTS

During the pandemic, the incidence rates among women were higher or as predicted for OCD in specialist health care and for eating disorders in both primary- and specialist health care. These findings were strongest among women aged 18-24 years. Incidence rates for depression and phobia/OCD among both genders in primary health care and phobic anxiety disorders among both genders in specialist health care were lower or as predicted.

CONCLUSION

The COVID-19 pandemic may have led to more women needing treatment for OCD and eating disorders in the Norwegian population. The decreased incidence rates for some disorders might indicate that some individuals either avoided seeking help or had improved mental health during the pandemic.

Examining the stability of emotional regulation and psychological distress for low-income individuals: A latent transition analysis

Previous relationship education research has focused on investigating healthy relationships at the couple level, with limited research conducted on individual-oriented relationship education programs for economically disadvantaged individuals. More specifically, there is a lack of research on how individual-oriented relationship education programs contribute to changes in unique attributes of individuals who enroll in these programs and who would benefit most from relationship education programs. The primary aim of this study is to understand the stability of economically disadvantaged individuals' psychological distress and emotion regulation over two time points, comparing individuals randomly assigned to the relationship intervention using Prevention and Relationship Education's (PREP) Within My Reach (WMR) versus those assigned to a wait-list control. Using a sample of 1129 economically disadvantaged individuals enrolled in the study, results indicated that the three-class model for psychological distress and emotion regulation was the most appropriate for the latent transition analysis. Treatment group participants were more likely to transition to more adaptive models than their wait-list control counterparts, although a small percentage of participants did transition to a less adaptive model. Implications, future directions, and limitations are discussed.

Predictors of mental well-being over the first lockdown period due to the COVID-19 pandemic in France. A repeated cross-sectional study

Introduction

Numerous studies have investigated the positive and negative effects of potential predictors of well-being during lockdowns due to COVID-19. Yet, little is known on whether these effects significantly changed with time spent in lockdown. In the current study, we described the association of mental well-being with a large number of background characteristics (e.g., socio-demographic or health-related factors), COVID-related factors, and coping strategies, over the duration of the first lockdown due to COVID-19 in France.

Methods

A nationwide online survey was conducted over 7 of the 8 weeks of the 1st lockdown in France, i.e., from 25 March 2020 to 10 May 2020. The level of mental well-being was reported using the Warwick-Edinburgh Mental Well-Being Scale (WEMWBS). We also measured various background characteristics (e.g., age, sex, education, health issues), COVID-related factors (e.g., health and economic risks, agreement with lockdown), and coping strategies. Our analytical strategy enabled us to disentangle effects aggregated over the study period from those that linearly vary with time spent in lockdown.

Results

Our final dataset included 18,957 participants. The level of mental well-being dropped gradually from the third to the eighth week of lockdown [49.7 (sd 7.9) to 45.5 (sd 10.6)]. Time in lockdown was associated with a decrease in well-being (for each additional 10 days of lockdown: B = -0.30, 95%CI: -0.62, -0.15). Factors that showed significantly negative and positive effects on well-being as time in lockdown progressed were (for each additional 10 days of lockdown): having current psychiatric problems (B = -0.37; 95%CI: -0.63, -0.04), worries about having access to personal protective equipment (B = -0.09; 95%CI: -0.18, -0.01), coping by having positive beliefs about the future of the pandemics (B = 0.29; 95%CI: 0.04, 0.62), being supported by neighbors (B = 0.24; 95%CI: 0.04, 0.44), and being involved in collective actions (B = 0.23; 95%CI: 0.04, 0.46).

Discussion

Participants from our sample saw a drop in their mental well-being throughout the first period of COVID-19 lockdown. Policymakers should be mindful of factors contributing to greater deterioration of mental well-being over time, such as having current psychiatric issues. Promoting collective actions and local support from neighbors may alleviate the deterioration of mental well-being over time.

Differences in mental health and alcohol use across profiles of COVID-19 disruptions

This study aimed to examine differences in mental health and alcohol use outcomes across distinct patterns of work, home, and social life disruptions associated with the COVID-19 pandemic. Data from 2093 adult participants were collected from September 2020 to April 2021 as a part of a larger study examining the impacts of the COVID-19 pandemic on substance use. Participants provided data on COVID-19 pandemic experiences, mental health outcomes, media consumption, and alcohol use at baseline. Alcohol use difficulties, including problems related to the use, desire to use alcohol, failure to cut down on alcohol use, and family/friend concern with alcohol use, were measured at 60-day follow-up. Factor mixture modeling followed by group comparisons, multiple linear regressions, and multiple logistic regressions was conducted. A four-profile model was selected. Results indicated that profile membership predicted differences in mental health and alcohol use outcomes above and beyond demographics. Individuals experiencing the most disruption reported the strongest daily impact of COVID-19 and significantly high levels of depression, anxiety, loneliness, overwhelm, alcohol use at baseline, and alcohol use difficulties measured at 60-day follow-up. The findings highlight the need for integrated mental health and/or alcohol services and social services targeting work, home, and social life during public health emergencies in order to respond effectively and comprehensively to the needs of those requiring different types of support.

Coping with COVID: risk and resilience factors for mental health in a German representative panel study

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic might affect mental health. Data from population-representative panel surveys with multiple waves including pre-COVID data investigating risk and protective factors are still rare.

METHODS

In a stratified random sample of the German household population (n = 6684), we conducted survey-weighted multiple linear regressions to determine the association of various psychological risk and protective factors assessed between 2015 and 2020 with changes in psychological distress [(PD; measured via Patient Health Questionnaire for Depression and Anxiety (PHQ-4)] from pre-pandemic (average of 2016 and 2019) to peri-pandemic (both 2020 and 2021) time points. Control analyses on PD change between two pre-pandemic time points (2016 and 2019) were conducted. Regularized regressions were computed to inform on which factors were statistically most influential in the multicollinear setting.

RESULTS

PHQ-4 scores in 2020 (M = 2.45) and 2021 (M = 2.21) were elevated compared to 2019 (M = 1.79). Several risk factors (catastrophizing, neuroticism, and asking for instrumental support) and protective factors (perceived stress recovery, positive reappraisal, and optimism) were identified for the peri-pandemic outcomes. Control analyses revealed that in pre-pandemic times, neuroticism and optimism were predominantly related to PD changes. Regularized regression mostly confirmed the results and highlighted perceived stress recovery as most consistent influential protective factor across peri-pandemic outcomes.

CONCLUSIONS

We identified several psychological risk and protective factors related to PD outcomes during the COVID-19 pandemic. A comparison of pre-pandemic data stresses the relevance of longitudinal assessments to potentially reconcile contradictory findings. Implications and suggestions for targeted prevention and intervention programs during highly stressful times such as pandemics are discussed.

Psychiatric and non-psychiatric population vulnerabilities in time of a crisis: the unsuspected aggression factor

OBJECTIVES

In March 2020, France faced a health crisis due to the COVID-19 outbreak that, like previous infectious disease crises, involved high psychological and emotional stress, a series of factors that influenced the ongoing mental health crisis.

METHODS

We recruited 384 respondents to complete an online questionnaire during the second month of isolation: 176 psychotherapy recipients (68 were currently attending psychiatric care) and 208 healthy controls. We measured demographic characteristics, impulsivity, aggression, hopelessness, suicidal risk, and the global level of anxiety and depression in order to estimate potential discrepancies in clinical measures across these populations.

RESULTS

Our results indicate that the group currently undergoing psychiatric care was prone to loneliness and social isolation. Regarding clinical and nonclinical population, there were differences in suicidal risk, depression, anxiety, and hopelessness but mainly in aggression. Regression analysis also demonstrated that aggression surprisingly influenced anxiety levels. Patients undergoing therapy compared with patients who were not displayed differences only in suicidal risk, anxiety, and hopelessness, with those undergoing therapy having higher scores. The outpatient group undergoing therapy had a significantly lower level of impulsivity. Moreover, the regression to predict anxiety and depression levels from correlated factors highlighted the potentially heightened role of aggression in predicting anxiety in the clinical group.

CONCLUSION

New research into stress reactions should assess other clinical signals, such as aggression, and examine preventive mental health interventions in times of crisis.

Generalised anxiety disorder, depressive symptoms and their subjective change after the first wave of COVID-19 among gamers in Poland

Previous studies have indicated that levels of emotional distress were considerably elevated during the COVID-19 pandemic; however, some longitudinal studies did not confirm these findings. There is a very limited number of studies on specific subpopulations, such as video gamers in this particular period. Playing video games may have either a beneficial influence on mental health by diminishing stress or a detrimental impact in terms of increasing depression and anxiety. It is, therefore, important to establish whether regular gamers differ from the general population in terms of symptoms of depression and anxiety during COVID-19. A total of 1023 participants (aged 18-50) participated in the study. The sample was composed of gamers and was representative of the Polish population. Participants completed a modified version of GAD-7, PHQ-9 online, addressing subjective change in anxiety and depressive symptoms. 25% of the sample reported clinically significant anxiety levels, and 35% mentioned depression. There were no differences in anxiety and depression levels between the investigated sample of gamers and the general population. However, up to 30% of individuals reported an increase in subjective change in anxiety or depressive symptoms during COVID-19. A further 30% reported a downward subjective change in anxiety or depressive symptoms during COVID-19. The remaining 40% declared a lack of change in the subjective change in anxiety or depressive symptoms during COVID-19. Those who reported an increase scored substantially higher in anxiety and depression than other groups. This indicates that the COVID-19 pandemic may have impacted people's mental health along a syndemic-syndaimonic continuum. COVID-19 might have been harmful to those with already poorer mental health and beneficial to those with good mental health. It is also important to plan interventions targeting vulnerable individuals who report clinically significant levels of anxiety and depression - women and younger adults and those who subjectively perceive their emotional condition to deteriorate during the COVID-19 lockdown.

Investigating the psychological effects of home quarantine during the early peaks of the COVID-19 pandemic: a survey from Iran

We assessed psychological symptoms among individuals who were quarantined during early coronavirus disease 2019 (COVID-19) peaks. This cross-sectional study was performed during April-October 2020 in Iran. We surveyed 100 individuals with COVID-19 patients in their families and 100 others with health conditions associated with a higher risk of developing critical forms of COVID-19 infection, who have completed at least 14 days of home quarantine. Validated Persian versions of the 21-item Depression, Anxiety, and Stress and 22-item Impact of Event Scale-Revised were used to measure the symptoms of depression, anxiety, stress and distress. The rates of stress, anxiety, depression and quarantine-related distress were 46.5, 48.5, 57.0 and 80.5%, respectively; however, they were not significantly different between the contact and no-contact groups. Female sex and being unemployed were significantly associated with quarantine-related distress, P  = 0.007 and P  = 0.018, respectively. Independent risk factors for anxiety were a history of medical comorbidity ( P  = 0.025) and contact with COVID-19 patients ( P  = 0.007). Findings show high prevalence rates of psychological symptoms among quarantined individuals, regardless of whether they had contact with COVID-19 patients or not. Female sex and unemployment were risk factors for quarantine-related distress.

Association between food addiction with ultra-processed food consumption and eating patterns in a Brazilian sample

The study objectives were to determine whether consumption of ultra-processed foods (UPF) and eating patterns are associated with food addiction (FA) in a Brazilian sample. This is a cross-sectional study. The Brazilian Food and Nutrition Surveillance System tool assessed food consumption markers and dietary patterns. The modified Yale Food Addiction Scale 2.0 was used to determine FA. 5946 participants were included with a mean age of 24 ± 6 years, and 4371 (73.5%) were female. After statistical adjustments for confounders, individuals with FA had lower consumption of fresh fruits (PR: 0.88; 95%CI: [0.79; 0.97]), vegetables (PR: 0.87; 95%CI: [0.79; 0.97]), and beans (PR: 0.85; 95%CI: [0.77; 0.95]). They also had higher consumption of UPF: hamburgers/sausages (PR: 1.15; 95%CI: [1.04; 1.27]), instant noodles, packaged snacks, and/or salty cookies (PR: 1.27; 95%CI: [1.13; 1.42]), and sandwich cookies, sweets, and/or treats (PR: 1.26; 95%CI: [1.14; 1.40]). Positive associations between FA and having meals in front of the screen (PR: 1.48; 95%CI: [1.28; 1.71]) and having a late-night snack (PR: 1.24; 95%CI: [1.11; 1.39]) remained. The negative association between FA and skipping breakfast (PR: 0.76; 95%CI: [0.68; 0.85]) also remained. These eating patterns may contribute to FA, which could be potential targets for clinical intervention.

Emotional disturbance and risk factors among COVID-19 confirmed cases in isolation hotels

Patients with coronavirus disease 2019 (COVID-19) has been isolated in hospital-managed isolation hotels under a policy of the Taiwan government. Centrally isolation patients are more likely to experience psychological symptoms. The purpose of the study was to investigate emotional disturbance during their isolation period and then pinpoint the factors during their isolation period associated with the emotional disturbance. We retrospectively analysed the medical charts of the patients confined to a Banqiao isolation hotel between May 28 and July 3, 2021. The 5-item brief symptom rating scale (BSRS-5) was used to evaluate emotional disturbance levels. Descriptive and logistic regression was used for the data analysis. In total, 197 complete medical records were reviewed, and of these 84 (42.6%) showed emotional disturbance. The majority of them reported only minor disturbance (n = 49, 58.3%). After controlling for confounding factors, being satisfied about medical information was the only protective factor associated with emotional disturbance (OR = 0.2, P = 0.018). Being a male patient (OR = 3.0, P = 0.005), worrying about stigmatization (OR = 2.2, P = 0.041) and being unable to contact family members (OR = 2.9, P = 0.018) increased the risk of experiencing emotional disturbance. Patients with clinical symptoms, namely sore throat (OR = 3.4, P = 0.013) and muscle aches (OR = 6.3, P = 0.005), were also found to be more likely to report emotional disturbance. Mental disturbance commonly occurs among patient with COVID-19 who are isolated in a hospital-managed hotel. Being a male patient, having symptoms, namely a sore throat and muscle pain, being unable to contact family and/or a failure to receive sufficient medical information were found to be associated with emotional disturbance. In order to help isolated patients, government officials should provide a clear rationale for isolation and recognize the patients' efforts to follow the government's policy, which will help to minimize social stigma.

Fear of Covid-19 and perceived academic safety: the buffering role of personal resources

Purpose

The study investigates the moderating effect of personal resources, including optimism and resilience, on the link between fear of Covid-19 and perceptions of academic safety among university students in Ghana.

Design/methodology/approach

A total of 618 students took part in the research by completing an online self-reported questionnaire. The respondents were chosen using a simple random sample method. The data was processed and analysed using IBM SPSS version 24 and SEM-PLS, respectively.

Findings

Results reveal fear of Covid-19 positively influence students' perception of academic safety. Furthermore, both resilience and optimism mitigate the impact of fear of Covid-19 on students' perceptions of academic safety.

Originality/value

This is the first study to examine personal resources as a moderator between fear of Covid-19 and students' perceptions of academic safety. Practical and theoretical implications are added to the text.

The Emotional and Personal Experiences of the COVID-19 Illness During the Early Pandemic: A Qualitative Study

BACKGROUND

Several studies report the incidence of psychiatric symptoms and disorders among patients who recovered from coronavirus disease 2019 (COVID-19); however, little is known about the emotional impact of acute COVID-19 illness and recovery on these survivors. Qualitative methods are ideal for understanding the psychological impact of a novel illness.

OBJECTIVE

To describe the emotional experience of the acute COVID-19 illness and recovery in patients who contracted the virus during the early months of the pandemic.

METHODS

Semi-structured interviews conducted by consultation-liaison (C-L) psychiatrists were used to elicit participant responses about the emotional impact of the acute and recovery phases of the COVID-19 illness. Participants recruited from the Maryland, District of Columbia, and Virginia area were interviewed which was audio recorded between June 2020 and December 2020. The research team extracted qualitative themes from the recordings using the principles of thematic analysis.

RESULTS

One hundred and one COVID-19 survivors (54 women; mean [SD] age, 50 [14.7] years) were interviewed at a mean of 5.16 months after their acute illness, and their responses were audio-recorded. Most participants were White (77%), non-Hispanic/Latino (86.1%), and not hospitalized for COVID-19 (87.1%). Coders identified 26 themes from participant responses. The most frequently coded themes included anxiety/worry (49), uncertainty (37), supportfrom others (35), alone/isolation (32), and positive reframe/positive emotions (32).

CONCLUSIONS

Survivors who contracted severe acute respiratory syndrome coronavirus 2 during the early months of the pandemic described both negative and positive valence emotions. They experienced emotional distress and psychosocial stressors associated with the acute illness and recovery but also drew upon personal resiliency to cope. This report highlights the utility of qualitative research methods in identifying emotional responses to a novel illness that may otherwise go unnoted. Consultation-liaison psychiatrists may be uniquely positioned to work in collaboration with medical colleagues in developing a multidimensional approach to evaluating an emerging illness.

Initial risk factors, self-compassion trajectories, and well-being outcomes during the COVID-19 pandemic: A person-centered approach

Introduction

We investigated whether initial risk classes and heterogeneous trajectories of self-compassion over the course of the pandemic may impact well-being outcomes 1 year into the pandemic.

Methods

A large, representative sample of Canadians (N = 3,613; 50.6% women) was sampled longitudinally over 11 waves (April 2020-April 2021), using a rolling cross-sectional survey design. Analyses were conducted in three steps: (1) latent class analysis to identify heterogeneity in risk factors (sociodemographic, cognitive-personality, health-related) early in the pandemic, (2) latent class growth analysis (LCGA) to identify longitudinal self-compassion trajectories, and (3) GLM to examine effects of risk factor classes and self-compassion trajectories, as well as their interaction, on later well-being (mental health, perceived control, life satisfaction).

Results and Discussion

Four risk factor classes emerged, with 50.9% of participants experiencing low risk, 14.3% experiencing multiple risks, 20.8% experiencing Cognitive-Personality and Health risks, and 14.0% experiencing sociodemographic and Cognitive-Personality risks. Four self-compassion trajectories also emerged, with 47.7% of participants experiencing moderate-high self-compassion that decreased then stabilized, 32.0% experiencing moderate self-compassion that decreased then stabilized, 17.3% experiencing high and stable self-compassion across time, and 3.0% experiencing low and decreasing self-compassion. Comparisons of well-being outcomes 1 year post-pandemic indicated that higher levels of self-compassion over time may protect against the impact of initial risk on well-being outcomes. Further work is still needed on heterogeneity in experiences of risk and protective factors during stressful life events.

Continuous Exposure to Terrorism during the COVID-19 Pandemic: A Moderated Mediation Model in the Israeli Context

This study tested the role of perceived social support as a moderating factor in the mediation of COVID-19-related concerns in the association between continuous traumatic stress (CTS) and depression. The study participants were 499 college students who responded to an anonymous online questionnaire. Measures included the assessment of prior continuous exposure to threats of terrorism, COVID-19-related distress, perceived social support and depressive symptoms. The results demonstrated that COVID-19-related concerns mediated the relationship between continuous exposure to threats of terrorism and depression symptoms, and that perceived social support moderated the association between COVID-19-related concerns and depression. The implications of the study highlight the role of prior exposure to traumatic stress as a risk factor for depression and the role of social support as a protective factor. These results point to the need to develop accessible and non-stigmatic mental health services for populations exposed to other types of continuous traumatic stress.

Latent profiles of psychological status among populations cumulatively exposed to a flood and the recurrence of the COVID-19 pandemic in China

Henan Province in Central China was hit by unprecedented, rain-triggered floods in July 2021 and experienced a recurrence of the COVID-19 pandemic. The current study aims to identify the latent profiles of psychological status and acceptance of change among Henan residents who have been cumulatively exposed to these floods and the COVID-19 pandemic. A total of 977 participants were recruited. Latent profile analysis (LPA) was used to explore underlying patterns of psychological status (i.e., perceived risk of the COVID-19 pandemic, post-traumatic stress symptoms, anxiety and rumination) and acceptance of change. The predictors were evaluated with multinomial logistic regression. LPA identified four patterns of psychological status and acceptance of change: high distress/high acceptance (5.1%), moderate distress/moderate acceptance (20.1%), mild distress/mild acceptance (45.5%), and resilience (29.3%). The additive impact of the floods and COVID-19 pandemic and negative emotion during the floods were the risk factors, while flood coping efficacy, trust, and a closer psychological distance change were the protective factors. The present study therefore provides novel evidence on psychological status after both a natural disaster and a major public health event. The cumulative effects of the floods and the COVID-19 pandemic may have heightened the risk of post-disaster maladaptation. A complex relationship between psychological outcomes and acceptance of change was also found. The findings of this study thus provide a foundation for both disaster management and psychological assistance for particular groups.

Entity theory of emotion was associated with more daily negative affect during quarantine: Evidence from a 14-day diary study among healthy young adults

During the COVID-19 pandemic, quarantine has been implemented as a physical distancing measure to reduce the risk of transmission. However, no studies have examined the relationship between quarantine and daily affective experiences. Few studies have examined the individual-level factors that may alleviate or strengthen the negative impact of quarantine on daily affective experiences. To this end, we conducted a diary study by comparing the affective experiences of people in quarantine with those of people not subject to quarantine. There were 201 participants in the study. After the pretest collecting responses on demographic information and entity theory of emotion, the participants completed a daily questionnaire measuring their daily positive and negative affect for 14 consecutive days. The results of hierarchical linear modeling showed that the participants in the quarantine condition reported less daily positive affect than those in the social interaction condition. We found that when the participants under quarantine believed more strongly that their emotions could not be changed, they reported a higher level of daily negative affect. These findings demonstrate the role of entity theory of emotion in understanding daily negative affect during quarantine.

Psychological treatment of traumatic memories in COVID-19 survivors

The COVID-19 pandemic, which has affected a significant number of individuals worldwide, is generating serious mental health issues. Recovered COVID-19 patients have experienced traumatic events related to their symptoms, isolation, possible hospitalization, bereavement, fear of infecting loved ones and the physical consequences of COVID-19. One effective psychological treatment for these patients is Eye Movement Desensitization and Reprocessing (EMDR). The aim of this paper is to describe the therapeutic intervention and effects of EMDR in a pool of COVID-19 survivors referred to an integrated psychological/psychiatric outpatient service. Twelve patients, comprising of nine males and three females, underwent EMDR psychotherapy from October 2020 to February 2022. Each patient received 8-16 weekly treatment sessions. The standard EMDR protocol of eight stages was administered to enable desensitization and reprocessing of four main targets: first positive swab, hospitalization, isolation and fear for relatives' health. Efficacy of EMDR was demonstrated by the significant improvement at clinical scale for subjective distress caused by traumatic events. For the therapists, carrying out these treatments was an intense and challenging experience. In fact, the perceived distance between therapist and patient was less defined than in other hospital settings because the pandemic affects everyone equally. However, with the widespread availability of vaccines and although the pandemic is still ongoing with the emergence of new variants, a window of improvement in the mental health landscape is starting to open up.

Development of Social Distancing Phobia Scale and Its Association with Anxiety and Perceived Stress

The aim of the present study is to develop the social distancing phobia scale and is to determine the role of generalized anxiety disorder of the individual in predicting social distancing phobia and perceived stress. The sample of the study consists of 1260 people selected according to the convenience sampling method. Social distancing phobia scale, generalized anxiety disorder, perceived stress scale, and positive negative emotion scale were used in the study. As a result of the analysis, this scale consists of 17 items with three factors including "physiological, emotional, and behavioral response." With its psychometric properties in assessing the three-sub-dimensional construct of the social distancing phobia scale, this scale will help to provide a better understanding of the emotions and psychological or psychiatric disorders during the COVID-19 pandemic. In addition, generalized anxiety disorder was found to significantly predict perceived stress and social distancing phobia.

Relationship between attitudes toward COVID-19 infection, depression and anxiety: a cross-sectional survey in Japan

BACKGROUND

Although negative attitudes are known to develop with experiences of COVID-19 infection, it remains unclear whether such attitudes contribute to depression and anxiety as sequelae of COVID-19. We aimed to investigate the relationships between attitude towards COVID-19 infection and post-COVID-19 depression and anxiety.

METHODS

A cross-sectional survey of COVID-19 recovered patients was conducted from July to September 2021 in Japan. Outcome variables, depression and anxiety were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7); scores of 10 and above were identified as having symptoms of depression and anxiety, respectively. Exposure variables were whether participants were experiencing the following attitude strongly: threat to life due to COVID-19 infection, helplessness regarding COVID-19 infection, blaming a third party who did not restrain from going outside, blaming themselves for their COVID-19 infection, worry about spreading the infection to others, and self-stigma (Self-Stigma Scale-Short). Modified Poisson regression analyses were performed to analyze the findings.

RESULTS

A total of 6016 responses were included in the analyses. The proportion of depression was 19.88%, and anxiety was 11.47%. The threat of life due to COVID-19 infection, helplessness regarding COVID-19 infection, blaming oneself for their COVID-19 infection, and self-stigma were significantly associated with depression and anxiety after adjusting covariates. Blaming the third party who did not restrain from going outside was associated with anxiety. There was no association between the worry about spreading infection to others and depression or anxiety.

CONCLUSION

Negative attitudes, including self-stigma with the experience of COVID-19 infection, were related to depression and anxiety. Further studies confirming whether countermeasures for preventing or decreasing the negative attitude towards COVID-19 infection mitigate these symptoms are needed.

Mediator role of presence of meaning and self-esteem in the relationship of social support and death anxiety

Introduction

Death anxiety has increased following the COVID-19 pandemic. Although terror management theory has suggested social support, presence of meaning and self-esteem functioned as death anxiety buffers, few existing works have explored the mechanism of how social support, presence of meaning, and self-esteem buffer death anxiety. To identify these mechanisms is the aim of this study.

Methods

Our cross-sectional study was conducted with 1167 people in China from 19 May 2020 to 1 June 2020 during the COVID-19 outbreak. The average age of participants was 26 years. Data were by questionnaire, including demographic information, the Templer's Death anxiety scale, the multidimensional scale of perceived social support, the presence of meaning scale, and the Rosenberg self-esteem scale.

Results

Results using structural equation modeling showed presence of meaning and self-esteem fully mediated the relationship between social support and death anxiety, respectively and sequentially. The proposed model showed good fit of indices: χ² = 243.384, df = 58, p < 0.001; CFI = 0.968, TLI = 0.954, RMSEA = 0.052, SRMR = 0.044.

Discussion

This study demonstrates significant mediator roles of presence of meaning and self-esteem in the relationship of social support and death anxiety. Multi-component interventions are needed to manage death anxiety by targeting increasing social support, presence of meaning and self-esteem and increasing presence of meaning and self-esteem when social support is diminished in the pandemic.

Young children's traumatic stress reactions to the COVID-19 pandemic: The long reach of mothers' adverse childhood experiences

BACKGROUND

The COVID-19 pandemic has negatively impacted parental and child mental health; however, it is critical to examine this impact in the context of parental histories of adversity. We hypothesized that maternal adverse childhood experiences (ACEs) and pandemic-related negative life events would predict child traumatic stress symptoms (TSS) and tested potential mediating pathways through maternal pandemic-related TSS and/or poorer maternal sensitivity during the pandemic.

METHODS

Data were collected from a longitudinal sample of low-income, racially/ethnically diverse mothers and their children. Between May and November 2020, mothers (n = 111) of young children (M age = 7.42 years, SD = 0.45) completed questionnaires to assess their own and their child's pandemic-related TSS, exposure to pandemic-related negative events, and parent-child relationship quality. Maternal ACEs, maternal depression, parent-child relationship quality, and child internalizing symptoms had been assessed approximately 1-3 years prior.

RESULTS

Structural equation analyses revealed that pandemic negative life events were indirectly associated with child TSS via greater maternal TSS. For mothers, recent pandemic-related negative events were associated with their own TSS, whereas maternal ACEs were not. Maternal ACEs directly predicted greater child TSS, with no evidence of mediation by either maternal TSS or maternal sensitivity.

LIMITATIONS

All measures were parent report, and pandemic-related measures were collected at the same time point.

CONCLUSIONS

Findings underscore the long reach of mothers' own adverse childhood experiences, highlighting the negative consequences of these prior traumatic exposures alongside current pandemic-related maternal trauma symptoms for children's adjustment during the pandemic.

The Effects of the COVID-19 Pandemic on the Psychology of the Pharmacy School Stakeholders in Türkiye

Objectives

The state of anxiety seen during the coronavirus disease-2019 (COVID-19) pandemic needs to be evaluated and controlled. Studies indicate that high anxiety reduces students' academic performance. The productivity and scientific studies of academicians have also been negatively affected during the pandemic. Psychological conditions of students and academicians need to be improved as high anxiety levels can affect academic achievement. In this study, the effects on psychological well-being (PWB) of COVID-19 anxiety levels of students and academicians in pharmacy schools in Türkiye have been determined.

Materials and Methods

This research was quantitative. As a data collection tool in the research, a questionnaire consisting of three parts was applied to the academic staff and students of pharmacy schools. After the first part of the questionnaire that aimed to determine general information, there were questions about the pandemic anxiety (PA) and the PWB scales. The universe of the study consists of 1.563 academic staff working in pharmacy schools and 17.101 students in these faculties. The level of significance (α) was determined as 0.05 in the analysis made in the study.

Results

Two hundred fortyseven academicians and 1.698 students participated in the research. Data was analyzed by SPSS ver. 25.0 program. 79% of the academic staff participating in the study were women, while 21% were men; for students, it was 77% and 23%, respectively. Female academicians found to have significantly higher (p=0.001) PA level than males. Female students had significantly higher levels of PA (p=0.000) and PWB (p=0.027) compared to male students.

Conclusion

In the study, PA of academicians was generally lower than students, while PWB was higher. When the relationship between PA and PWB was examined, the relationship between PA and PWB of the academicians was very low and positive; for the students, it was found to be very low and negative.

Development of a novel patient-reported outcome measure to assess signs and symptoms of COVID-19

Background

Given the urgent need for vaccines and treatments for coronavirus disease 2019 (COVID-19), the Symptoms of Infection with Coronavirus-19 (SIC), a comprehensive, patient-reported outcome (PRO) measure of signs and symptoms associated with COVID-19, was developed in full alignment with current US regulatory guidance to support evaluations of vaccines and treatments in development.

Methods

An initial version of the SIC was developed to address concepts identified through a targeted literature review and consultation with experts in infectious diseases and clinicians routinely managing COVID-19 in a hospital setting. A qualitative study was conducted in sites in the United States among 31 participants aged ≥ 18 years who were English-speaking and willing and able to provide informed consent and a self-reported history by telephone or online method. The measure was refined based on additional feedback from the clinicians and three iterative rounds of combined concept elicitation and cognitive debriefing interviews conducted with patients, caregivers, and healthy volunteers.

Results

Among 39 scientific articles identified in the literature review, 35 COVID-19 signs and symptoms were reported and confirmed during interviews with clinicians, patients, and caregivers. Patients and healthy participants suggested changes for refining the draft SIC to ensure consistent interpretation and endorsed both the 24-h recall period and use of an 11-point numeric rating scale (NRS) for capturing change in symptom severity. The final version of the SIC captures the daily presence or absence of 30 symptoms and a rating of severity for 25 of the 30 symptoms using an NRS for those symptoms reported as present.

Conclusions

The SIC comprehensively addresses observations described in the literature, by clinicians, and by patients, and captures patients’ experiences with COVID-19 in a manner that minimizes complexity and facilitates completion for both patients and healthy volunteers. This measure is thus appropriate for use in clinical trials of both therapeutics and vaccines for COVID-19.

Supplementary Information

The online version contains supplementary material available at 10.1186/s41687-022-00471-w.

The relationship between fear of COVID-19 infection, fear of COVID-19 vaccination and Big Five personality traits: a mediation model

BACKGROUND

The primary objective of our correlational, cross-sectional study was to determine the relationship between fear of COVID-19 infection and fear of COVID-19 vaccination and the role of the Big Five personality traits in this relationship.

PARTICIPANTS AND PROCEDURE

The study sample consisted of 462 participants, including 286 women and 176 men, aged 18 to 75, recruited from the general population. The Big Five personality traits were diagnosed using the Polish version of the Ten-Item Personality Inventory. We used an 11-point numerical rating scale to measure the intensity of fear of COVID-19 infection as well as fear of COVID-19 vaccination.

RESULTS

The results indicate that fear of infection has a weak positive correlation with fear of vaccination. Both types of fear have a weak negative correlation with emotional stability and openness to experience. People diagnosed with COVID-19 have significantly higher levels of fear of vaccination and lower levels of emotional stability compared to those without a COVID-19 diagnosis. Fear of infection proves a good predictor of fear of vaccination and a likely mediator between emotional stability and fear of vaccination against COVID-19.

CONCLUSIONS

The results may increase our understanding of the role of personality traits, such as emotional stability, in the fear of infection and COVID-19 vaccination hesitancy.

Indirect contact with nature, lifestyle, and mental health outcomes during mandatory hotel quarantine in Hong Kong

BACKGROUND

During the pandemic of COVID-19 Hong Kong lead one of the world's longest and most stringent quarantine measures.

AIMS

To examine cross-sectionally (i) the relationship between the duration of mandatory hotel quarantine and mental health outcomes; (ii) whether indirect contact with nature and lifestyle factors (i.e. diet, sleep, exercises, social support, and sense of meaning), mitigated this relationship.

METHODS

A group of 248 participants under 14 or 21-d mandatory hotel quarantine in Hong Kong completed an online questionnaire that included quarantine and lifestyle-related questions, as well as mental health outcome measures.

RESULTS

For those under a 21-d quarantine, there was a significant effect of the week of quarantine on the level of depressive symptoms (Patient Health Questionnaire-4), which peaked in Week 2. Worse quality of sleep, a lower sense of meaning, and a longer set (but not completed) duration of quarantine were predictors of worse mental health outcomes. The positive relationship between the day of quarantine and the level of perceived stress was moderated by the indirect contact with nature.

CONCLUSION

The results shed light on the potential negative impact of prolonged periods of quarantine on mental health outcomes and the possible protective factors.

#COVID19 and #Breastcancer: A Qualitative Analysis of Tweets

Rapid and efficient communication regarding quickly evolving medical information was paramount for healthcare providers and patients throughout the COVID-19 pandemic. Over the last several years, social media platforms such as Twitter have emerged as important tools for health promotion, virtual learning among healthcare providers, and patient support. We conducted a qualitative thematic content analysis on tweets using the hashtags #BreastSurgery, #BreastCancer, #BreastOncology, #Pandemic, and #COVID19. Advocacy organizations were the most frequent authors of tweets captured in this dataset, and most tweets came from the United States of America (64%). Seventy-three codes were generated from the data, and, through iterative, inductive analysis, three major themes were developed: patient hesitancy and vulnerability, increased efforts in knowledge sharing, and evolving best practices. We found that Twitter was an effective way to share evolving best practices, education, and collective experiences among key stakeholders. As Twitter is increasingly used as a tool for health promotion and knowledge translation, a better understanding of how key stakeholders engage with healthcare-related topics on the platform can help optimize the use of this powerful tool.

Risk perception of COVID-19 among college students in China: Latent profile analysis

Background

The outbreak of the new coronavirus-2019 (COVID-19) has had a significant impact on people's mental and physical health. Meanwhile, people's perceptions of risk may influence their emotional states and preventative behavior during an epidemic. Previous research have revealed the diversity and uniqueness of risk perception, and college students may have a different perspective on risk perception. The objective of this study was to describe the subtypes of risk perception for COVID-19 among college students in China, identify the subtypes' traits, and investigate their affecting variables.

Methods

College students from 10 Chinese provinces participated in a cross-sectional study (n = 2,000) that from January 16 to 30, 2022. The latent profiles and influencing factors for risk perception were investigated using latent profile analysis, one-way analysis of variance, and multinomial logistical regression.

Results

The sample group of this survey was 1,946 students, and the response rate was 97.3%. The best model was suggested to consist of three profiles: "neutral risk perception" (20.3%), "perception seriously without susceptible" (52.8%), and "low risk perception" (26.9%). Risk perception of COVID-19 was positively associated with attention to negation information (r = 0.372, p < 0.01), anxiety (r = 0.232, p < 0.01), and depression (r = 0.241, p < 0.01), and negatively associated with perceived social support (r = -0.151, p < 0.01). Logistic-regressions analyses mainly revealed that the risk perception of three profiles related to having chronic diseases (OR = 2.704, p < 0.01), medical major (OR = 0.595, p < 0.01; OR = 0.614, p < 0.05), without having COVID-19 confirmed cases around (OR = 0.539, p < 0.01), attention to negative information (OR = 1.073, p < 0.001; OR = 1.092, p < 0.001), and perceived social support (OR = 0.0.975, p < 0.01).

Conclusions

The level of risk perception for COVID-19 among Chinese college students was unsatisfactory, and the risk perception of COVID-19 had significant group characteristics and heterogeneity. Colleges and public health practitioners could have a theoretical and empirical basis to implement risk perception intervention efforts by identifying latent subgroups during the COVID-19 epidemic.

Stress, anxiety, and depression in times of COVID-19: Gender, individual quarantine, pandemic duration and employment

Objectives

This study explores the inter-relationship between emotional distress in adults and gender, quarantine experiences, pandemic duration, and employment.

Methods

An online cross-sectional online survey comprised 943 Israelis. The link to the survey was distributed via different personal and academic social networking sites (e.g., Facebook, WhatsApp, and Twitter). The survey was administered using the online survey portal Google Forms. Participants addressed questions about their socio-demographic characteristics (e.g., gender, age, family status, employment, and quarantine experiences) and ranked their levels of stress, anxiety, and depression using the Hebrew version of the Depression, Anxiety and Stress Scale-DASS-21.

Results

The majority of the respondents (72%) were women, 39% experienced quarantine, and 55% were unemployed. About 42% experienced a short-term pandemic (one lockdown), and the rest experienced a continuous pandemic (two lockdowns). The MANCOVA results, controlling for family status, indicated that women and unemployed participants reported higher stress, anxiety, and depression levels than men and employed participants. Participants who experienced individual quarantine reported higher anxiety and depression. Furthermore, there was a significant interaction between gender, employment, and pandemic duration. The experience of individual quarantine intensified the stress, anxiety, and depression for both employed and unemployed women. Conversely, the quarantine intensified stress, anxiety, and depression only for unemployed men, whereas the quarantine did not affect stress, anxiety, and depression among employed men.

Conclusions

Employment is a critical factor regarding men's emotional state during such stressful situations as the COVID-19 pandemic. Furthermore, individual quarantine and long-term pandemics are associated with opposite outcomes regarding individual mental health. The individual quarantine is associated with increased anxiety and depression, while a long-term, continuous pandemic is associated with decreased stress.

Adaptive responding to prolonged stress exposure: A binational study on the impact of flexibility on latent profiles of cognitive, emotional and behavioural responses to the COVID-19 pandemic

The high level of uncertainty brought about by the COVID-19 pandemic has affected the general population's well-being and capacity for adaptive responding. Studies indicate that flexibility, defined as the ability to choose and employ a variety of emotional, cognitive and behavioural strategies in accordance with changing contextual demands, may significantly contribute to adaptive responding to long-term stressors such as COVID-19. In the current study, we aimed to investigate which facets of flexibility predict different latent profiles of adaptive responding to the COVID-19 pandemic in Israel and Germany. A total of 2330 Israelis and 743 Germans completed online questionnaires measuring cognitive and coping regulatory flexibility and cognitive, emotional and behavioural responding to the COVID-19 pandemic. Analyses revealed three distinct response profiles in each country (high, medium and low). These profiles differed in both anxiety and depression symptoms with the non-adaptive response group experiencing clinically relevant symptoms both in Israel and Germany. Additionally, cognitive flexibility and coping flexibility emerged as significant predictors of response profiles in both countries. Training cognitive and coping flexibility may thus help individuals respond more adaptively to psychosocial stressors such as COVID-19. Such training could be selectively administered to less flexible subpopulations as well as adapted to the specific population characteristics.

Quarantining: a mentally distressful but physically comfortable experience in South Korea

Objective

Quarantine is the first response to the COVID-19 pandemic. Restricting daily life can cause several problems. This study aimed to measure the impact of the COVID-19 quarantine on health-related quality of life (HRQoL) by comparing to the pre-pandemic.

Methods

HRQoL during COVID-19 quarantine was surveyed online using EQ-5D index and matched to that of the pre-pandemic-extracted from nationwide representative data of the Korea Community Health Survey- with propensity scores. A beta regression for the EQ-5D scores and a logistic analysis for individual dimensions of the EQ-5D index were performed to measure the impact of the COVID-19 quarantine on health utility.

Results

The overall scores of the EQ-5D index were significantly higher in the group under quarantine during the COVID-19 pandemic (0.971 SD 0.064) than those before the pandemic (0.964 SD 0.079, Diff. 0.007 SD 0.101, p = 0.043). The beta regression for the overall scores of EQ-5D revealed that quarantining during the COVID-19 pandemic increased by 52.7% compared to normal life before the outbreak(p = 0.045). Specifically, “Depression/Anxiety” deteriorated significantly during quarantining (OR = 0.62, 95% CI:0.48–0.80). However, “Pain/Discomfort” and “Mobility” significantly improved (OR = 5.37, 95% CI:3.71–7.78 and OR = 2.05, 95% CI:1.11–3.80, respectively).

Conclusion

Although the world is facing a challenging moment that it has never been through before, mandatory quarantine has served as an experience that provided mental distress but physical comfort in the Korean context.

Older adults' prevention and communication to beat anxiety: the diminishing utility of proactive coping actions

This study aims to investigate older adults' psychological reactions when facing changes in daily life caused by the COVID-19 pandemic and anti-epidemic measures. Specifically, this study investigated the impacts of communication types (i.e., electronic and face-to-face communication) and frequency during the pandemic and the kinds of proactive coping actions taken by older adults on their anxiety. A total of 43,019 respondents were included in this study by merging two longitudinal databases. One is the seventh wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) conducted in 2017, and the other is the COVID-19 Survey of SHARE, which was conducted between June and August 2020. This study found that one third of older adults reported anxiety symptoms during the COVID-19 pandemic and one fifth reported increased anxiety than before the pandemic. Anxiety symptoms seem somewhat prevalent among older adults during the COVID-19 pandemic. During the pandemic, the more kinds of proactive coping actions taken by older adults, the more likely they felt anxious. As the pandemic continues and develops, taking proactive coping actions might no longer alleviate anxiety in older adults, showing a diminishing utility. In addition, face to face communication was found to decrease the likelihood of anxiety symptoms in older adults, whereas the opposite impact of electronic communication was found. For older adults, contacting others by electronic means may increase their anxiety feeling during the COVID-19 pandemic.

The COLIBAS Study—COVID-19 Lockdown Effects on Mood, Academic Functioning, Alcohol Consumption, and Perceived Immune Fitness: Data from Buenos Aires University Students

A recent study was conducted in the Netherlands to evaluate the impact of the 2019 coronavirus (COVID-19) pandemic and its associated lockdown periods on academic functioning, mood, and health correlates such as alcohol consumption. The study revealed that lockdowns were associated with a significantly poorer mood and a reduced perceived immune fitness. Overall, a reduction was seen in alcohol consumption during the lockdown periods. Academic functioning in terms of performance was unaffected; however, a significant reduction in interactions with other students and teachers was reported. There was, however, great variability between students as follows: both an increase and a reduction in alcohol consumption were reported, as well as improvements and poorer academic functioning. The aim of the current online study was to replicate these findings in Argentina. To this extent, a modified version of the survey was conducted among students at the University of Buenos Aires, which was adapted to the local lockdown measures. The survey assessed possible changes in self-reported academic functioning, mood, and health correlates, such as alcohol consumption, perceived immune functioning, and sleep quality compared to before the COVID-19 pandemic. Retrospective assessments were made for four periods, including (1) the period before COVID-19, (2) the first lockdown period (March–December 2020), (3) summer 2021 (January-March 2021, no lockdown), and (4) the second lockdown (from April 2021 to July 2021). This article describes the content of the survey and the corresponding dataset. The survey was completed by 508 participants.

Meta-analysis of prevalence: the psychological sequelae among COVID-19 survivors

OBJECTIVE

This meta-analysis aims to estimate the pooled prevalence of mental disorders among COVID-19 survivors.

METHODS

The databases Pubmed, Google Scholar, ScienceDirect, and medRxiv have been searched up to 1 August 2021 using COVID-19, survivors, mental disorders, and their related MeSH terms. The included studies were either cross-sectional, cohort, or case-control in design. Those studies included COVID-19 survivors after 14 or more days from their COVID-19 recovery and used validated questionnaires to assess their mental health outcomes. The random-effects model was used to pool the data from the incorporated studies. The heterogeneity was assessed using Cochran's Q heterogeneity test and I² statistic.

RESULTS

Twenty-seven studies were included in the data synthesis with a total sample size of 9605 COVID-19 survivors. The prevalence rates for Post-Traumatic Stress Disorder (PTSD), anxiety, psychological distress, depression, and sleeping disorders were 20% (95% CI = 16-24%), 22% (95% CI = 18-27%), 36% (95% CI = 22-51%), 21% (95% CI = 16-28%), and 35% (95% CI = 29-41%), respectively.

CONCLUSIONS

Although we found high heterogeneity across the included studies, our meta-analysis provides evidence that there are psychological sequelae in COVID-19 survivors that require medical assiduity as well as further research on the matter.KEY POINTSIncreased prevalence of psychological sequelae among COVID-19 survivors.The prevalence of PTSD was 20% (95% CI = 16-24%) and of anxiety was 22% (95% CI = 18-27%) among COVID-19 survivors.The prevalence of psychological distress was 36% (95% CI = 22-51%), of depression was 21% (95% CI = 16-28%), and of sleep disorders was 35% (95% CI = 29-41%) among COVID-19 survivors.Future researches are recommended to search for effective and safe methods to mitigate the psychological sequelae in COVID-19 patients.

Glycosylated Hemoglobin as an Independent Prognostic Marker in COVID-19 Patients With Diabetes Mellitus

Objective

The main objective of this study is to analyze the severity of coronavirus disease 2019 (COVID-19) among patients with diabetes mellitus using glycosylated hemoglobin (HbA1c) as a prognostic marker in predicting the outcome among these individuals.

Methods

This was a retrospective, observational study conducted in a tertiary care center during the first and second waves of COVID-19 in Salem, Tamil Nadu, for a period of one year (September 2020-September 2021). Numerous variables, including socio-demographic data, vitals, laboratory and radiological investigations, and end variables like mortality and morbidity due to COVID-19, were studied.

Results

Out of the 754 people admitted, 253 were diabetic, among which only 65 individuals fulfilled the criteria for participation. Among the 65 patients in the study, 21 had mild disease, 28 had moderate disease, among whom, two patients had HbA1c less than 7, 10 had between 7 and 8, 11 had between 8 and 10, and five had above 10, and 16 had severe disease, among whom one patient had HbA1c less than 7, 4 between 7 and 8, seven between 8 and 10, and four above 10. This was statistically significant (0.005).

Conclusion

The incidence of mortality was high among patients with prolonged uncontrolled diabetes mellitus with high HbA1c and among patients presenting diabetic complications like diabetic ketoacidosis (DKA), euglycemic ketoacidosis, and hyperglycemic hyperosmolar syndrome (HHS).

Cross-sectional survey following a longitudinal study on mental health and insomnia of people with sporadic COVID-19

BACKGROUND

In the post-pandemic era, the emergence of sporadic cases of coronavirus disease 2019 (COVID-19) and the scale of the pandemic are unpredictable. Therefore, the impact of sporadic cases of COVID-19 and isolation measures on mental health and sleep in different groups of people need to be analyzed.

AIM

To clarify the severity of psychological problems and insomnia of staff and community residents around a hospital with sporadic cases of COVID-19, and their relationship with quarantine location and long-term changes.

METHODS

A cross-sectional survey was conducted on community residents and medical staff. Many of these medical staff had been subjected to different places of quarantine. Community residents did not experience quarantine. Hospital anxiety and depression scale (HADS), acute stress disorder scale (ASDS) and insomnia severity index (ISI) were used to evaluate anxiety and depression, acute stress disorder symptoms, and the severity of insomnia. Additionally, we conducted a 1-year follow-up study on medical staff, with related scales measurement immediately after and one year after the 2-wk quarantine period.

RESULTS

We included 406 medical staff and 226 community residents. The total scores of ISI and subscale in HADS of community residents were significantly higher than that of medical staff. Further analysis of medical staff who experienced quarantine showed that 134 were quarantined in hotels, 70 in hospitals and 48 at home. Among all subjects, the proportions of HADS, ASDS and ISI scores above normal cutoff value were 51.94%, 19.17% and 31.11%, respectively. Multivariable logistic regression analysis found that subjects with higher total ASDS scores had a greater risk to develop anxiety and depression. The total ISI score for medical staff in hotel quarantine was significantly higher than those in home quarantine. Total 199 doctors and nurses who completed the 1-year follow-up study. Compared with baseline, HADS and ASDS scores decreased significantly one year after the end of quarantine, while ISI scores did not change significantly.

CONCLUSION

Sporadic COVID-19 cases had a greater psychological impact on residents in surrounding communities, mainly manifested as insomnia and depressive symptoms. Hotel quarantine aggravated the severity of insomnia in medical staff, whose symptoms lasted ≥ 1 year.

A profile analysis of COVID-19 stress-related reactions: The importance of early childhood abuse, psychopathology, and interpersonal relationships

BACKGROUND

There is little argument that COVID-19 is potentially highly stressful for many people, however, little research has broken down COVID-19-related distress into different aspects clustering together, and how these clusters differ in terms of the vulnerability of the individuals.

OBJECTIVE

The primary aim of the present study was to identify distinct profiles of individuals' reactions to COVID-19-related stress, and analyze potential differences and risk and protective factors associated with these profiles in relation to childhood abuse, psychopathology, and interpersonal relationships.

PARTICIPANTS AND SETTING

Data was collected online among a convenience sample of 914 men and women in Israel.

METHODS

A Latent Profile Analysis (LPA) for estimating distinct profiles in people's COVID-19-related distress was applied. Next, profiles were compared in childhood abuse, psychopathology, perceived social support and relationship satisfaction.

RESULTS

Five distinct profiles were identified: The distressed (23.75%), the worried (38.96%), the financially and socially distressed (15.20%), the caregivers (13.65%), and the untroubled (8.44Profiles in which individuals had more COVID-19 related distress are characterized by more childhood abuse, psychopathology, and less social support and relationship satisfaction.

CONCLUSION

An assessment of the psychological implications of COVID-19 (when screening the population and creating prevention/intervention programs) should take into account the different responses individuals have when facing COVID-19, and their vulnerability, including their history of abuse, psychopathology, social support and relationship satisfaction, so that these programs will be better tailored to each type of distress experienced.

Concern about COVID-19 among the Spanish population: Validation of a scale and associated symptoms

BACKGROUND

The health crisis caused by the COVID-19 pandemic has led to a considerable increase in the psychopathology of COVID-19 patients and among the general population. This study aims to conduct the psychometric analysis of the scale of concern about COVID-19 in the Spanish population and to estimate the level of concern and dysfunctional anxiety present one year after the lockdown measures in Spain aimed at resisting the spread of the viral disease among the population.

METHODS

The factorial structure of the instrument, its reliability for the general population and for COVID patients, and its construct validity have been analyzed, and measurements of dysfunctional concern have been obtained from a sample of 502 adults.

RESULTS

The scale of concern about COVID-19 showed optimal results of reliability and validity for the Spanish population, confirming that it is an ideal instrument for estimating the concern regarding coronavirus contagion.

LIMITATIONS

This study used a cross-sectional design and thus, could not compare the changes in the incidence of anxiety symptoms before and after the COVID-19 outbreak. Furthermore, the use of mental health services prior to the COVID-19 restrictions was not assessed in this study, and therefore, no comparisons between the two time points could be made.

CONCLUSIONS

After a year of the confinement measures that was instilled to avoid further spread of the disease, the Spanish population presented levels of concern and anxiety that may require clinical attention, with a significant percentage of participants meeting the requirements to be diagnosed with generalized anxiety disorders.

Prevalence of food addiction and its association with anxiety, depression, and adherence to social distancing measures in Brazilian university students during the COVID-19 pandemic: a nationwide study

The study's objective was to determine the prevalence of food addiction (FA) in Brazilian university students and to verify whether there is an association with anxiety, depression, and adherence to the social distancing measures adopted during the COVID-19 pandemic. This is a nationwide cross-sectional study carried out through the application of online questionnaires. Self-reported data on age, sex, economic class, race/skin color, anthropometric data, depression diagnosis, anxiety, modified Yale Food Addiction Scale 2.0 (mYFAS 2.0), and adherence to social distancing measures were collected. 5368 participants were included, with a mean age was 24.1 ± 6.3 years, the majority were female (n = 3990; 74.3%), and the mean BMI in our sample was 24.5 ± 5.3 kg/m². The prevalence of FA was 19.1% (95%CI: 18.0; 20.0%). An association was observed between FA with depression (PR: 1.60; 95%CI: 1.43; 1.78; p < 0.01), and anxiety (3.13; 95%CI: 2.74; 3.58; p < 0.01), but not with adherence to social distancing measures (p = 0.70). In conclusion, there was a higher prevalence of FA in Brazilian university students. Besides, university students with anxiety, depression, overweight, or obesity and females are more prone to FA.Level of evidence Level V, Opinions of authorities, based on descriptive studies, narrative reviews, clinical experience, or reports of expert committees.

Differences in post-traumatic growth: Individual quarantine, COVID-19 duration and gender

Objective

This study focuses on positive effects of the COVID-19 pandemic and aims to identify associations between gender, individual quarantine and duration of the COVID-19 (short- medium- and long-term pandemic), and posttraumatic growth (PTG).

Method

The data was collected via an online survey in Israel, and included 1,301 participants, 543 participants experienced short-term pandemics, 428 participants experienced medium-term pandemics and 330 participants experienced long-term pandemics. Most of the participants were female (73.6%), ranging from 18 to 89 years-old. The participants answered questions about their demographic background, individual quarantine experiences and ranked their PTG level.

Results

The results indicate a significant main effect of gender and pandemic duration (short-, medium- and long-term pandemic). Women reported higher PTG levels than men, and participants experiencing short-term pandemic reported significantly lower PTG levels than participants experiencing medium- or long-term pandemic. There was also a significant interaction between gender and pandemic duration regarding PTG and a significant interaction in PTG by gender, pandemic duration and individual quarantine.

Conclusion

The discussion addresses the findings in the context of traditional gender roles and gender differences in finding meaning and worth in home confinement situations.