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Vo TKN, Skokauskas N, Cheslack-Postava K, Hoven CW. The relationship between safety measures, preparedness, and mental health outcomes in New York City during the COVID-19 pandemic. Front Psychiatry 2025; 16:1547178. [PMID: 40270571 PMCID: PMC12014668 DOI: 10.3389/fpsyt.2025.1547178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Accepted: 03/21/2025] [Indexed: 04/25/2025] Open
Abstract
Background The COVID-19 pandemic necessitated strict safety measures and preparedness, potentially influencing mental well-being worldwide. This study investigated the impact of safety measures and preparedness levels on mental health outcomes during the COVID-19 pandemic in New York City, USA examining how sociodemographic characteristics modified these associations. Method A longitudinal study of 1,227 participants from three ongoing cohorts, provided data through telephone interviews across three waves from March 2020 to August 2021. Depression and anxiety were measured using Patient Health Questionnaire 8 (PHQ-8) and Generalized Anxiety Disorder 7 (GAD-7). Logistic regression models were used to investigate associations between safety measures, preparedness, and mental health outcomes over time, adjusting for potential confounders and assessing the modification effect of demographic factors. Results At Wave 1, 18% of participants reported moderate to severe depression, while 20% had moderate to severe anxiety. Over time, these rates declined significantly, with depression dropping to 9% and anxiety to 10% by Wave 3. Safety measures practiced at Wave 1 showed a protective effect on depression at Wave 3 (OR=0.45, 95% CI: 0.22, 0.91). Higher preparedness levels were significantly associated with reduced odds of anxiety (aOR=0.72, 95% CI: 0.55, 0.93) in the concurrent wave. Age specific analysis revealed that individuals aged 26-35 experienced stronger protective effects from higher preparedness levels (OR=0.43, 95% CI: 0.2, 0.92) compared to younger age groups. Conclusion This study highlights the importance of safety measures and preparedness in mitigating mental health challenges during crises. Addressing age specific factors and preparedness levels can guide the public health strategies to better support diverse populations.
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Affiliation(s)
- Thi Kim Ngan Vo
- Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare, Department of Mental Health (IPH), NTNU, Trondheim, Norway
| | - Keely Cheslack-Postava
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, New York, NY, United States
| | - Christina W. Hoven
- Global Psychiatric Epidemiology Group, Division of Child and Adolescent Psychiatry, Department of Psychiatry, Columbia University-New York State Psychiatric Institute, New York, NY, United States
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, United States
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2
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Türk F. Traumatic stress and post-traumatic growth in individuals who have had Covid-19: The mediating effect of resilience and moderating effect of psychological flexibility. PLoS One 2024; 19:e0310495. [PMID: 39774492 PMCID: PMC11684618 DOI: 10.1371/journal.pone.0310495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 09/02/2024] [Indexed: 01/11/2025] Open
Abstract
The Covid-19 pandemic has had a global impact and has negatively affected the mental health of individuals. It is known that depression, anxiety and traumatic stress levels are high in individuals who have experienced Covid-19. In light of this, an increase in Post-Traumatic Growth (PTB) levels is expected. This study examines the role of resilience and psychological flexibility in the relationship between traumatic stress levels experienced in Covid-19 and PTG levels. A total of 845 (64.18% males, ages ranged from 19 and 73, with an average of 36.80 ± 8.43) adults from Türkiye participated in the online survey. Impact of Event Scale-Revised, The Posttraumatic Growth Inventory, The Psychological Resilience Scale, and Psychological Flexibility Scale were used as measurement tools. According to the research findings, a partial mediator role of resilience has emerged in the relationship between individuals' traumatic stress levels and PTG levels. Additionally, the regulatory function of psychological flexibility was determined in the relationship between traumatic stress levels and PTG levels. Accordingly, the link between Covid-19-related stress and PTG becomes stronger as the individual's psychological flexibility increases. Traumatic stress has a more positive effect on PTG in individuals who exhibit high psychological flexibility. Based on these results, it can be confirmed that resilience and psychological flexibility are crucial factors to maintain the spiritual well-being of individuals during the Covid-19 pandemic, a worldwide crisis. Therefore, they need to be considered in the field of preventive mental health.
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Affiliation(s)
- Fulya Türk
- Faculty of Education, Department of Guidance and Psychological Counseling, Yildiz Technical University, Istanbul, Türkiye
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3
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Portch E, Moseley RL, Wignall L, Turner-Cobb JM, Taylor Z, Gondelle M. 'Welcome to my world': a thematic analysis of the lived experiences of people with Myalgic Encephalomyelitis during the UK COVID-19 lockdown. Psychol Health 2024; 39:1727-1744. [PMID: 37259524 DOI: 10.1080/08870446.2023.2220009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/19/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023]
Abstract
OBJECTIVES We explore the experiences of people with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (pwME/CFS) during the first UK COVID-19 lockdown period. We specifically probe perceived commonalities and departures in experience between government- and health-imposed lockdowns, application of coping strategies for social isolation, and predictions for inclusion of the chronically ill in post-pandemic society. METHODS AND MEASURES Thirty semi-structured interviews were conducted in pwME/CFS between June - July, 2020. Responses were qualitatively analysed using an experiential, thematic framework. RESULTS While participants reported enhancements in digital accessibility during lockdown, they perceived this as an unintentional benefit from changes designed to cater universally. Similarly, their expectation was that the general population's limited experience of restriction would not engender greater understanding for those who would continue to experience health-imposed lockdowns, post-pandemic. Participants described numerous strategies for coping with restriction and isolation, developed during prior health-imposed lockdowns and applied to this novel circumstance, highlighting the presence of acceptance and resilience in the sample. CONCLUSIONS Our findings suggest that future work may fruitfully examine whether our participant's predictions for post-pandemic societal inclusion have been met, and how resilience and acceptance might be developed and nurtured in chronically ill populations through times of adversity.
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Affiliation(s)
- Emma Portch
- Department of Psychology, Bournemouth University, Poole, Dorset, UK
| | - Rachel L Moseley
- Department of Psychology, Bournemouth University, Poole, Dorset, UK
| | - Liam Wignall
- Department of Psychology, University of Brighton, Brighton, East Sussex, UK
| | | | - Zoe Taylor
- Department of Psychology, Bournemouth University, Poole, Dorset, UK
| | - Mike Gondelle
- Department of Psychology, Bournemouth University, Poole, Dorset, UK
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4
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Park CL, Kim D, Russell BS, Fendrich M. Emotional regulation and coping strategies predicted trajectories of anxiety across the first year of the COVID-19 pandemic. J Ment Health 2024:1-10. [PMID: 39584811 PMCID: PMC12103631 DOI: 10.1080/09638237.2024.2426978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 06/30/2024] [Accepted: 10/29/2024] [Indexed: 11/26/2024]
Abstract
BACKGROUND Adverse impacts of the COVID-19 pandemic on mental health have been well-documented, but only a few studies have characterized distinct trajectories of anxiety over time. Further, whether specific emotion regulation and coping efforts to manage pandemic distress predict these distinct trajectories remains unexamined. AIMS The study characterized anxiety trajectories across the first year of the pandemic and identified emotion regulation and coping strategies that predict these classes of anxiety trajectories. A national sample of 1108 U.S. adults completed online surveys six times in the first year of the pandemic. Five emotion regulation and coping strategies were assessed (substance use, active, behavioral disengagement, positive reappraisal, and catastrophizing). Latent Growth Mixture Modeling (LGGM) analyses were performed to identify anxiety trajectory classes. RESULTS LGMM revealed five latent classes: Resilience (consistently very low anxiety; 79.9%), Moderate Anxiety (8.8%), Chronic High Anxiety (4.6%), Improving-Worsening Anxiety (3.2%), and Worsening-Improving Anxiety (3.5%). Using substances, disengagement, and catastrophizing to deal with COVID-19 stress consistently predicted trajectories higher in anxiety as did active coping, while positive reappraisal was unrelated to trajectory class membership. CONCLUSIONS These results identify emotion regulation and coping strategies that appeared to exacerbate anxiety during the course of the pandemic.
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Affiliation(s)
- Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Dahee Kim
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Beth S Russell
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
| | - Michael Fendrich
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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5
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Li X, Han J, Lin H. The effects of psychological flexibility and night shifts on mental health and well-being in nurses. PLoS One 2024; 19:e0313634. [PMID: 39541325 PMCID: PMC11563484 DOI: 10.1371/journal.pone.0313634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2024] [Accepted: 10/28/2024] [Indexed: 11/16/2024] Open
Abstract
BACKGROUND Examining mental health among nurses in the later stages of the COVID-19 pandemic could offer valuable information for addressing these symptoms in the long term. Therefore, the current study aimed to assess the mental health and well-being of Chinese nurses, as well as investigate the impact of psychological flexibility and night shifts on this relationship. METHOD In cross-sectional, hospital-based, multicenter study, 422 Chinese nurses were selected by multistage stratified cluster random sampling. The mental health status, psychological flexibility, and wellbeing were assessed via 12-item General Health Questionnaire (GHQ-12), Chinese version of Personalized Psychological Flexibility Index, and Chinese version of the 5-item WHO Well-Being Index, respectively. To examine the proposed theoretical model, we conducted structural equation modeling using SPSS Amos 26 version. The age, gender, night shift, psychological flexibility, mental health, and well-being data were entered into the model. Pearson correlation and chi-square were used to explore the correlation between variables. RESULTS The high night shifts, being young and low psychological flexibility significantly had a direct effect on worse mental health (night shifts: ES, 95% CI: 0.619, 0.328-0.725; age: ES, 95% CI: 0.542, 0.226-0.993; psychological flexibility: ES, 95% CI: 0.675, 0.369-1.466). The low psychological flexibility and worse mental health were able to directly effect on worse wellbeing (psychological flexibility: ES, 95% CI: 0.419, 0.757-1.519; mental health: ES, 95% CI: 0.719, 1.109-2.607). In addition, psychological flexibility through the mediation of mental health also had an indirect effect on wellbeing (ES, 95% CI: 0.269, 0.957-2.165). CONCLUSIONS Being young, having more night shifts and having less psychological flexibility can be related to the deterioration of mental health and well-being in nurses. Therefore, it is recommended that nurses use the shift routine program with the least focus on the night shifts. Also, interventions to teach younger nurses how to face work stress and interventions to improve the psychological flexibility of all nurses are needed.
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Affiliation(s)
- Xinhong Li
- Department of Outpatient Surgery, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
| | - Juan Han
- Hyperbaric Oxygen, Jinan Central Hospital, Jinan, Shandong Province, China
| | - Hongmei Lin
- Department of Gynecology, Central Hospital Affiliated to Shandong First Medical University, Jinan, Shandong Province, China
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Ebrahimi OV, Freichel R, Johnson SU, Hoffart A, Solbakken OA, Bauer DJ. Depressive Symptom Change Patterns during the COVID-19 Pandemic and Their Impact on Psychiatric Treatment Seeking: A 24-Month Observational Study of the Adult Population. Depress Anxiety 2024; 2024:1272738. [PMID: 40226660 PMCID: PMC11918502 DOI: 10.1155/2024/1272738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 06/17/2024] [Accepted: 06/29/2024] [Indexed: 04/15/2025] Open
Abstract
Despite the presence of individual differences in the depressive symptom change in adults during the COVID-19 pandemic, most studies have investigated population-level changes in depression during the first year of the pandemic. This longitudinal repeated-measurement study obtained 39,259 observations from 4,361 adults assessed nine times over a 24-month period in Norway (March 2020 to March 2022). Using a Latent Change Score Mixture Model to investigate differential change patterns in depressive symptoms, five profiles were identified. Most adults revealed a consistently resilient (42.52%) or predominantly resilient pattern differentiated by an initial shock in symptomatology (13.17%). Another group exhibited consistently high depressive adversities (8.5%). One group showed mild deterioration with small increases in depressive symptomatology compared to onset levels (29.04%), and a second strong deterioration group exhibited clinically severe levels of gained symptoms over time (6.77%). Both deteriorating depressive symptom change patterns predicted the presence of a psychiatric diagnosis and treatment seeking at the end of the study period. Together, the absence of a preexisting psychiatric diagnosis at the onset of the pandemic and severe symptom increases during, combined with reports of psychiatric treatment seeking and diagnosis at the end of the study period, indicated that the strongly deteriorating subgroup represents an additional and newly emerged group of adults struggling with depressive problems. Factors related to general adverse change (lower education levels, lone residence), initial shocks prior to recovery (frequent information seeking, financial and occupational concerns), and resilience and recovery (older age, being in a relationship, physical activity) were identified. Binge drinking and belonging to an ethnic minority were influential predictors of the strongly deteriorating group. All major change patterns in depressive symptoms occurred during the first 3 months of the pandemic, suggesting this period represents a window of sensitivity for the development of long-lasting depressive states versus patterns of recovery and resilience. These findings call for increased vigilance of psychiatric symptoms during the initial phases of infectious disease outbreaks and highlight a specific target period for the implementation of preventive measures.
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Affiliation(s)
- Omid V. Ebrahimi
- Department of Experimental Psychology, University of Oxford, Oxford, UK
- Department of Psychology, University of Oslo, Oslo, Norway
| | - René Freichel
- Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Sverre Urnes Johnson
- Department of Psychology, University of Oslo, Oslo, Norway
- Modum Bad Psychiatric Hospital and Research Center, Vikersund, Norway
| | - Asle Hoffart
- Modum Bad Psychiatric Hospital and Research Center, Vikersund, Norway
| | | | - Daniel J. Bauer
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, USA
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Vacchi OGB, Menis D, Scarpis E, Tullio A, Piciocchi B, Gazzetta S, Del Pin M, Ruscio E, Brusaferro S, Brunelli L. Stress management: how does the academic staff cope with it? a cross-sectional study at the university of Udine. BMC Public Health 2024; 24:1509. [PMID: 38840259 PMCID: PMC11155012 DOI: 10.1186/s12889-024-18935-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/23/2024] [Indexed: 06/07/2024] Open
Abstract
BACKGROUND Increasing work-related stress in academia can have an impact on physical and mental health. The aim of this study was to analyse the coping strategies of staff employed at the University of Udine and to verify whether sociodemographic data, professional position, and the presence of anxiety or depression symptoms are related to the use of different coping strategies. METHODS We conducted a cross-sectional study between June and December 2020 using the Brief COPE questionnaire. We correlated coping strategies with professional position, sociodemographic data, and the presence of anxiety or depressive symptoms measured with the Patient Health Questionnaire-9 and the General Anxiety Disorder-7. RESULTS A total of 366 people participated in the study, including 109 junior academics, 146 senior academics, and 111 administrative staff (response rate 23.6%). The three most frequently used coping strategies in terms of approach coping style were planning (6.77 ± 1.41), active coping (6.58 ± 1.45) and acceptance (6.23 ± 1.44). Women were more likely than men to report using approach and avoidant coping strategies (p < 0.001). Positive reframing and religion were most commonly used by administrative staff (p < 0.05), in contrast to junior academics, who were more likely to use substances and self-blame (p < 0.05). Anxiety was found to correlate with self-blame (OR 1.94) as a coping strategy, while depression was associated with venting (OR 2.83), self-blame (OR 3.27), and humor (OR 3.02). CONCLUSION Identifying profiles of coping strategies can help higher education institutions to implement support strategies for the academic community, ultimately promoting healthier lives and more effective teaching and research. Our study has shown that women and junior academics among staff at the Udine University would benefit from a tailored health promotion intervention that encourages the use of approach coping styles to reduce their risk of developing anxiety and depressive symptoms.
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Affiliation(s)
| | - Diana Menis
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italia
| | - Enrico Scarpis
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italia.
| | - Annarita Tullio
- Istituto di Igiene ed Epidemiologia Clinica, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italia
| | | | - Silvia Gazzetta
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italia
| | - Massimo Del Pin
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italia
| | - Edoardo Ruscio
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italia
| | - Silvio Brusaferro
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italia
| | - Laura Brunelli
- Dipartimento di Area Medica, Università degli Studi di Udine, Udine, Italia
- SOC Accreditamento, Qualità e Rischio Clinico, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italia
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8
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Cojocaru CM, Popa CO, Schenk A, Marian Ș, Marchean H, Suciu BA, Szasz S, Popoviciu H, Mureșan S. Personality and Pain Outcomes in Rheumatic Disease: The Mediating Role of Psychological Flexibility. Healthcare (Basel) 2024; 12:1087. [PMID: 38891162 PMCID: PMC11171698 DOI: 10.3390/healthcare12111087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Chronic pain is associated with increased disability and vulnerability to emotional disorders. Personality and psychological flexibility (PF) describe interindividual differences that shape the adjustment to chronic pain. Specifically, PF was found to be associated with pain, fatigue, anxiety, and depression intensity. Although previous studies established strong correlations between personality and pain outcomes, evidence on the nature of this relationship is scarce. Therefore, the objective of this study is to explore the mediating effect of PF on the relationship between personality and distress. METHODS This transversal study included 108 participants (age M = 56.7, SD = 11.3) diagnosed with musculoskeletal chronic pain. Self-reported measures were administered by the medical care team. Multiple mediation models were performed for estimating the indirect effects on each outcome variable. RESULTS After controlling for age and gender covariates, we found that PF completely mediated the relationship between personality traits and all pain outcomes and partially mediated the impact of extraversion on anxiety. In addition, emotional stability also had an indirect effect on anxiety through PF. CONCLUSIONS Personality traits and PF are significant predictors of pain outcomes. PF represents a core process mediating the impact of personality traits on the perceived intensity of pain, fatigue, anxiety, and depression in patients with rheumatic disease. These results could facilitate the application of individualized psychological interventions in clinical contexts targeting the reduction of emotional avoidance and in chronic pain patients.
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Affiliation(s)
- Cristiana-Manuela Cojocaru
- The Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (C.-M.C.); (A.S.); (H.M.)
| | - Cosmin Octavian Popa
- Department of Ethics and Social Sciences, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania
| | - Alina Schenk
- The Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (C.-M.C.); (A.S.); (H.M.)
| | - Ștefan Marian
- Department of Psychology, West University of Timişoara, 300223 Timişoara, Romania;
| | - Horia Marchean
- The Doctoral School, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (C.-M.C.); (A.S.); (H.M.)
| | - Bogdan Andrei Suciu
- Department of Anatomy and Morphological Science, George Emil Palade University of Medicine, Pharmacy, Science, and Technology, 540142 Targu-Mures, Romania;
| | - Simona Szasz
- Department of Rheumatology, Physical and Rehabilitation Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (S.S.); (H.P.)
| | - Horațiu Popoviciu
- Department of Rheumatology, Physical and Rehabilitation Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania; (S.S.); (H.P.)
| | - Simona Mureșan
- Department of Internal Medicine IV, George Emil Palade University of Medicine, Pharmacy, Science and Technology, 540142 Targu-Mures, Romania;
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9
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Probst-Hensch N, Imboden M, Jeong A, Keidel D, Vermes T, Witzig M, Cullati S, Tancredi S, Noor N, Rodondi PY, Harju E, Michel G, Frank I, Kahlert C, Cusini A, Rodondi N, Chocano-Bedoya PO, Bardoczi JB, Stuber MJ, Vollrath F, Fehr J, Frei A, Kaufmann M, Geigges M, von Wyl V, Puhan MA, Albanese E, Crivelli L, Lovison GF. Long-term trajectories of densely reported depressive symptoms during an extended period of the COVID-19 pandemic in Switzerland: Social worries matter. Compr Psychiatry 2024; 130:152457. [PMID: 38325041 DOI: 10.1016/j.comppsych.2024.152457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 01/04/2024] [Accepted: 01/29/2024] [Indexed: 02/09/2024] Open
Abstract
Previous mental health trajectory studies were mostly limited to the months before access to vaccination. They are not informing on whether public mental health has adapted to the pandemic. The aim of this analysis was to 1) investigate trajectories of monthly reported depressive symptoms from July 2020 to December 2021 in Switzerland, 2) compare average growth trajectories across regions with different stringency phases, and 3) explore the relative impact of self-reported worries related to health, economic and social domains as well as socio-economic indicators on growth trajectories. As part of the population-based Corona Immunitas program of regional, but harmonized, adult cohorts studying the pandemic course and impact, participants repeatedly reported online to the DASS-21 instrument on depressive symptomatology. Trajectories of depressive symptoms were estimated using a latent growth model, specified as a generalised linear mixed model. The time effect was modelled parametrically through a polynomial allowing to estimate trajectories for participants' missing time points. In all regions level and shape of the trajectories mirrored those of the KOF Stringency-Plus Index, which quantifies regional Covid-19 policy stringency. The higher level of average depression in trajectories of those expressing specific worries was most noticeable for the social domain. Younger age, female gender, and low household income went along with higher mean depression score trajectories throughout follow-up. Interventions to promote long-term resilience are an important part of pandemic preparedness, given the observed lack of an adaptation in mental health response to the pandemic even after the availability of vaccines in this high-income context.
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Affiliation(s)
- N Probst-Hensch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland.
| | - M Imboden
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland
| | - A Jeong
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland
| | - D Keidel
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland
| | - T Vermes
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland
| | - M Witzig
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland
| | - S Cullati
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland; Department of Readaptation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - S Tancredi
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - N Noor
- Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - P-Y Rodondi
- Institute of Family Medicine (IMF), University of Fribourg, Fribourg, Switzerland
| | - E Harju
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Luzern, Switzerland.; ZHAW Zurich University of Applied Sciences, School of Health Sciences, Winterthur, Switzerland
| | - G Michel
- Faculty of Health Sciences and Medicine, University of Lucerne, Alpenquai 4, 6005 Luzern, Switzerland
| | - I Frank
- Clinical Trial Unit, Cantonal Hospital Luzern, Luzern, Switzerland
| | - C Kahlert
- Department of Infectious Diseases and Hospital Epidemiology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland; Infectious Diseases and Hospital Epidemiology, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - A Cusini
- Division of Infectious Diseases, Cantonal Hospital of Grisons, Chur, Switzerland
| | - N Rodondi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - P O Chocano-Bedoya
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland
| | - J B Bardoczi
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - M J Stuber
- Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland; Department of General Internal Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - F Vollrath
- Corona Immunitas Program Management Group, Swiss School of Public Health, Zurich, Switzerland
| | - J Fehr
- Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - A Frei
- Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - M Kaufmann
- Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - M Geigges
- Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - V von Wyl
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
| | - M A Puhan
- Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - E Albanese
- Institute of Public Health, Faculty of BioMedicine, Università Della Svizzera Italiana, Lugano, Switzerland
| | - L Crivelli
- Institute of Public Health, Faculty of BioMedicine, Università Della Svizzera Italiana, Lugano, Switzerland; Department of Business Economics, Health and Social Care, University of Applied Sciences and Arts of Southern Switzerland, Lugano, Switzerland
| | - G F Lovison
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland; Department of Public Health, University of Basel, Switzerland
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10
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Somere K, Munkevics M, Krams R, Rača G, Luoto S, Krams I. The effect of yin yoga intervention on state and trait anxiety during the COVID-19 pandemic. Front Psychiatry 2024; 15:1345455. [PMID: 38550540 PMCID: PMC10973109 DOI: 10.3389/fpsyt.2024.1345455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/13/2024] [Indexed: 11/12/2024] Open
Abstract
Introduction Although some findings indicate that yoga can reduce stress and anxiety, many studies present mixed results. The potential of yoga interventions to alleviate anxiety, including the mechanisms and boundary conditions by which it does so, is an under-researched topic. Anxiety is often divided into "state anxiety" and "trait anxiety," the former being a temporary reaction to stressful events, while the latter is a more stable personality feature that responds to adverse situations or perceived threats. Materials and methods This study investigates whether a yin yoga intervention delivered online reduces state anxiety immediately after each yoga session and whether the anxiety levels are significantly lower at the end of the 10-week yoga intervention than at the beginning of the study. We also predicted no effect of yin yoga intervention on trait anxiety. The study was conducted during the COVID-19 pandemic when participants (N = 48 Latvian women) experienced heightened anxiety levels. Results This study shows that a ten-week online yin yoga intervention significantly reduced state anxiety in the intervention group compared with the control group. State anxiety levels also significantly decreased after each yin yoga session, providing more support for the anxiety-reducing effect of yin yoga. In contrast, yoga participation did not cause differences in trait anxiety between the control and intervention groups, even though trait anxiety decreased in the intervention group and increased in the control group over the study period. Conclusion The positive effects of yin yoga on state anxiety indicate the potential of yin yoga intervention as a first-line treatment to control and reduce state anxiety, with possible additional effects on trait anxiety.
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Affiliation(s)
- Kristīne Somere
- Department of Human and Animal Physiology, University of Latvia, Riga, Latvia
| | - Maris Munkevics
- Department of Zoology and Animal Ecology, University of Latvia, Riga, Latvia
- Statistics Unit, Riga Stradins University, Riga, Latvia
| | - Ronalds Krams
- Sport Center, University of Latvia, Riga, Latvia
- Institute of Life Sciences and Technologies, Daugavpils University, Daugavpils, Latvia
| | - Gunta Rača
- Institute of Life Sciences and Technologies, Daugavpils University, Daugavpils, Latvia
| | - Severi Luoto
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Indrikis Krams
- Department of Zoology and Animal Ecology, University of Latvia, Riga, Latvia
- Latvian Biomedicine Research and Study Centre, Riga, Latvia
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Yao Y, Tang J, Meng H, Li Y, Du H, Li Z. The mediating effect of psychological flexibility on fatigue and depressive symptoms among nursing staff. Int J Occup Med Environ Health 2023; 36:563-574. [PMID: 37964727 PMCID: PMC10691421 DOI: 10.13075/ijomeh.1896.02073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 10/19/2023] [Indexed: 11/16/2023] Open
Abstract
Objectives To explore the relationship between depressive symptoms, fatigue and psychological flexibility, as well as their interactions on depression in Chinese nurses. Material and Methods Using convenience sampling, a cross-sectional survey of 796 nurses in municipal hospitals of Zhengzhou, Henan Province, China, was conducted. The questionnaires of Work-related Acceptance and Action Questionnaire, Center for Epidemiological Studies Depression Scale and Fatigue Assessment Instrument were used. Hierarchical regression and bootstrap methods were used to examine the mediating effect of psychological flexibility between fatigue and depression. Results More than 51.8% of the nurses were at risk of depression and 62.3% were at risk of fatigue. There was a significantly positive and moderate correlation between depression and fatigue severity, situation specificity, and consequences (r = 0.43, r = 0.24 and r = 0.31, respectively, p < 0.01). Depression was negatively correlated with psychological flexibility (r = -0.28, p < 0.01). Psychological flexibility had a negative impact on depression with the explained variance increased by 4.2% (β = -0.211, p < 0.001). The bootstrap method showed that the mediating effect of psychological flexibility accounting for 8.5% and 12.3% on fatigue and depressive symptoms, respectively. Conclusions Psychological flexibility plays a partial mediating role between the fatigue severity, consequences of fatigue and depressive symptoms of nurses. Hospital managers should improve medical staff work acceptance to alleviate their depressive symptoms. Int J Occup Med Environ Health. 2023;36(4):563-74.
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Affiliation(s)
- Yongcheng Yao
- Zhengzhou Normal University, School of Mathematics and Statistics, Zhengzhou, China
| | - Jie Tang
- Zhengzhou Normal University, School of Mathematics and Statistics, Zhengzhou, China
| | - Hongling Meng
- Zhengzhou Normal University, School of Mathematics and Statistics, Zhengzhou, China
| | - Yuping Li
- Zhengzhou Normal University, School of Mathematics and Statistics, Zhengzhou, China
| | - Haixia Du
- Zhengzhou Normal University, School of Mathematics and Statistics, Zhengzhou, China
| | - Zhenzhen Li
- Zhengzhou Normal University, School of Mathematics and Statistics, Zhengzhou, China
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12
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Strizzi JM, Pavan S, Frederiksen EL, Andersson M, Graugaard C, Frisch M, Hald GM. Symptoms of anxiety and depression in Denmark during the first year of the COVID-19 pandemic: A two-wave matched-control study. Scand J Psychol 2023; 64:563-573. [PMID: 37137485 DOI: 10.1111/sjop.12924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/02/2023] [Accepted: 04/11/2023] [Indexed: 05/05/2023]
Abstract
Subsequent to the restriction measures taken to curb the COVID-19 infection rate, researchers theorized these would have detrimental mental health consequences. This two-wave matched-control study investigates depression and anxiety symptoms during the first 12 months of the pandemic (March 2020-March 2021) in Denmark with data from the I-SHARE and Project SEXUS studies. The I-SHARE study includes 1,302 (Time period 1 only n = 914, Time period 2 only n = 304, both time periods 1 and2 n = 84) Danish participants, and the sex and birth year-matched control participants from the Project SEXUS study comprise 9,980 Danes. During the first year of the pandemic, the study populations' anxiety and depression symptom mean levels did not significantly differ from pre-pandemic matched controls. Younger age, female gender, fewer children in the same household (depression only), lower education level, and not being in a relationship (depression only) were associated with increased anxiety and depression symptom scores. The key COVID-19-related variable linked with significantly higher anxiety and depression symptom scores was COVID-19-related loss of income. Contrary to initial concerns, we did not find a significant effect of the pandemic on anxiety and depression symptom scores. However, the results underscore the importance of structural resources to prevent income loss to safeguard mental health during crises such as a pandemic.
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Affiliation(s)
| | - Silvia Pavan
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Mikael Andersson
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
| | - Christian Graugaard
- Department of Clinical Medicine, Center for Sexology Research, Aalborg University, Aalborg, Denmark
| | - Morten Frisch
- Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark
- Department of Clinical Medicine, Center for Sexology Research, Aalborg University, Aalborg, Denmark
| | - Gert Martin Hald
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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13
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Pakenham KI, Landi G, Cattivelli R, Grandi S, Tossani E. Identification of psychological flexibility and inflexibility profiles during the COVID-19 pandemic. J Clin Psychol 2023; 79:2225-2250. [PMID: 37192495 DOI: 10.1002/jclp.23536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 03/31/2023] [Accepted: 05/03/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND The first coronavirus disease 2019 (COVID-19) wave and lockdown adversely affected the lives of people in diverse ways. AIMS This study used a person-centered approach to identify patterns of engagement in the 12 psychological flexibility (PF) and inflexibility (PI) processes to manage the first COVID-19 wave and lockdown hardships. MATERIALS & METHODS A total of 1035 Italian adults completed an online survey. RESULTS Latent profile analyses conducted on the 12 PI/PF processes measured by the Multidimensional Psychological Flexibility Inventory identified five profiles; three reflected gradations of high to low PF with corresponding inverse levels of PI, while two represented more complex relationships between PI and PF. After controlling for relevant socio-demographic and COVID-19/lockdown factors, the five profiles differed in mental health (depression, anxiety, and COVID-19 distress). Essentially a gradient of progressive decreases in all PI processes (except experiential avoidance) corresponded with increments in mental health across all profiles. Two profiles, which evidenced the highest levels of mental health (highly flexible and moderately flexible profiles), also had the greatest proportion of the sample 56.42% (n = 584), and the highest levels of PF and experiential avoidance. DISCUSSION Findings from this and similar studies suggest intersecting complex relationships among the PI/PF processes that are likely to shift in response to changing contexts. We suggest this network of relationships is better represented by a three-dimensional PF/PI hexaflex than a simplistic two-dimensional depiction of the model. CONCLUSION Distinguishing different PF/PI profiles identified groups most at risk for the adverse mental health impacts of the pandemic and exposed variations in the mental health protective and risk roles of PF and PI processes, respectively, that can inform ACT-based mental health promotion interventions.
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Affiliation(s)
- Kenneth I Pakenham
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Giulia Landi
- Department of Psychology, University of Bologna, Bologna, Italy
- Department of Psychology, Laboratory of Psychosomatics and Clinimetrics (head Prof. Silvana Grandi), University of Bologna, Cesena, Italy
| | - Roberto Cattivelli
- Department of Psychology, University of Bologna, Bologna, Italy
- Department of Psychology, Laboratory of Psychosomatics and Clinimetrics (head Prof. Silvana Grandi), University of Bologna, Cesena, Italy
| | - Silvana Grandi
- Department of Psychology, University of Bologna, Bologna, Italy
- Department of Psychology, Laboratory of Psychosomatics and Clinimetrics (head Prof. Silvana Grandi), University of Bologna, Cesena, Italy
| | - Eliana Tossani
- Department of Psychology, University of Bologna, Bologna, Italy
- Department of Psychology, Laboratory of Psychosomatics and Clinimetrics (head Prof. Silvana Grandi), University of Bologna, Cesena, Italy
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14
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Branje S. The impact of the COVID-19 pandemic on adolescent mental health across the world. Curr Opin Psychol 2023; 53:101665. [PMID: 37562339 DOI: 10.1016/j.copsyc.2023.101665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 08/12/2023]
Abstract
The global impact of the COVID-19 pandemic on adolescents has been substantial. The current review aimed to summarize the existing literature on the impact of the pandemic on mental health during adolescence, with a specific focus on longitudinal studies. The findings from these studies indicated that many adolescents experienced increased mental health problems, especially those who were already vulnerable prior to the pandemic. Several preexisting factors, such as socioeconomic background and gender, and pandemic-related factors, such as perceived stress and restrictive measures, were identified that contribute to interindividual differences in how adolescents were affected by the pandemic. However, it is crucial to interpret these changes in the context of the ongoing trend of increasing mental health problems among youth over the past decades.
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Affiliation(s)
- Susan Branje
- Faculty of Social and Behavioural Sciences, Utrecht University, the Netherlands.
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15
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Li L, Zhu M, Yao A, Yang J, Yang L. Daily stress, and mental health of professional degree graduate students in Chinese traditional medicine universities: the mediating role of learning career adaptation. BMC MEDICAL EDUCATION 2023; 23:627. [PMID: 37661266 PMCID: PMC10476438 DOI: 10.1186/s12909-023-04614-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 08/25/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND With the expansion of professional degree graduate students' enrollment in China education, the mental health of these professional degree graduate students in medical-related majors who are under pressure of study, scientific research, clinical practice, and employment should not be ignored. What is the mental health level of these graduate students under the effect of learning career adaptation (internal resources) in the face of daily stress (external factors)? The purpose of this study is to discuss the relationship between these variables, and the mediating role of learning career adaptation of professional degree graduate students in traditional Chinese medicine colleges, and universities, to provide a theoretical basis for improving the learning career adaptation of students, and improving the level of mental health. METHODS A cross-sectional survey was conducted among 1593 professional degree graduate students majoring in clinical medicine, traditional Chinese medicine, and nursing in five traditional Chinese medicine universities. Finally, 660 questionnaires were returned, with a recovery rate of 41.43%. The scores of daily stress, learning career adaptation, and mental health were measured by Daily Stressors Scale for graduate students, graduate-students learning career adaptation scale, and General Mental Health Questionnaire (GHQ-20). Descriptive statistics were used to analyze the status quo of daily stress, learning career adaptation, and mental health. Pearson correlation analysis were used to analyze the relationship between them. we undertake analyses using structural equation modeling to construct the latent variable path model of daily stress, learning career adaptation on mental health. The significance level of the mediating effect was tested by the non-parametric percentile bootstrap method. RESULTS The scores of mental health, daily stress, and learning career adaptation were 50.56 ± 10.80, 35.12 ± 19.55, and 67.13 ± 7.48 respectively. Daily stress was negatively correlated with the three dimensions of learning career adaptation: career confidence, focus on his career, and career control (P < 0.01). Daily stress was positively correlated with depression and anxiety (P < 0.01). Self-affirmation, depression, and anxiety were negatively correlated with career confidence, focus on his career, and career control (P < 0.05). Learning career adaptation plays a partial mediating role between daily stress, and mental health (p < 0.001), with an intermediate effect value of 0.127, representing 28.54% of the total effect. CONCLUSIONS Mental health, learning career adaption of medical-related professional degree graduate students in traditional Chinese medical universities were at a moderate degree, and an upper-middle level respectively, while daily stress is to a lesser extent. Learning career adaptation mediates the relationship between daily stress, and mental health partially. To some extent, it can buffer the impact of daily stress on mental health, especially anxiety. The educational administrator could take various measures to improve the mental health of professional degree graduate students. It can also enhance their learning career adaptation from the perspective of individuals, and organizations to improve their mental health.
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Affiliation(s)
- Ling Li
- School of Nursing, Zhejiang Shuren University, 8 Shuren Road, Hangzhou, Zhejiang Province, 310053, China
| | - Mingling Zhu
- School of Nursing, Zhejiang Chinese Medical University, 548 Bin-wen Road, Hangzhou, Zhejiang Province, 310053, China
| | - Anling Yao
- School of Nursing, Zhejiang Chinese Medical University, 548 Bin-wen Road, Hangzhou, Zhejiang Province, 310053, China
| | - Jialu Yang
- School of Nursing, Zhejiang Shuren University, 8 Shuren Road, Hangzhou, Zhejiang Province, 310053, China
| | - Lili Yang
- School of Nursing, Zhejiang Chinese Medical University, 548 Bin-wen Road, Hangzhou, Zhejiang Province, 310053, China.
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16
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Ayuso-Mateos JL, Morillo D, Haro JM, Olaya B, Lara E, Miret M. Changes on depression and suicidal ideation under severe lockdown restrictions during the first wave of the COVID-19 pandemic in Spain: a longitudinal study in the general population. Epidemiol Psychiatr Sci 2023; 32:e55. [PMID: 37655398 PMCID: PMC10539734 DOI: 10.1017/s2045796023000677] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/26/2023] [Indexed: 09/02/2023] Open
Abstract
AIMS To assess whether there is a change in the prevalence of depression and suicidal ideation after the strict lockdown measures due to the first wave of the COVID-19 pandemic in Spain, and to assess which are the factors associated with the incidence of a depressive episode or suicidal ideation during the lockdown. METHODS Data from a longitudinal adult population-based cohort from Madrid and Barcelona were analysed (n = 1103). Face-to-face home-based (pre-pandemic) and telephone interviews were performed. Depression and suicidal ideation were assessed through an adaptation of the Composite International Diagnostic Interview (CIDI 3.0). Population prevalence estimates and multivariable logistic regressions were computed. RESULTS Prevalence rates of depression changed significantly from before to after the COVID-19 outbreak (from 3.06% to 12.00%; p = 0.01) and per sex and age groups. Individuals reporting COVID-19 concerns (odds ratio [OR] = 3.11; 95% confidence interval [CI] = 1.45-6.69) and those feeling loneliness (OR = 1.99; 95% CI = 1.52-2.61) during the lockdown were at increased risk of developing depression during the confinement. Resilience showed a protective effect against the risk of depression (OR = 0.57; 95% CI = 0.39-0.83), while individuals perceiving social support during the confinement were at lower risk of developing suicidal thoughts (OR = 0.21; 95% CI = 0.09-0.46). Greater disability during the lockdown was also associated with the risk of suicidal ideation (OR = 2.77; 95% CI = 1.53-5.03). CONCLUSIONS Continuous reinforcement of mental health preventive and intervening measures is of global importance, particularly among vulnerable groups who are experiencing the most distress. Future research should strive to evaluate the long-term effects of the COVID-19 crisis on mental health.
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Affiliation(s)
- J. L. Ayuso-Mateos
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - D. Morillo
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - J. M. Haro
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - B. Olaya
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
- Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Sant Boi de Llobregat, Barcelona, Spain
| | - E. Lara
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
- Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
- Department of Personality, Evaluation and Clinical Psychology, Universidad Complutense de Madrid, Madrid, Spain
| | - M. Miret
- Department of Psychiatry, Universidad Autónoma de Madrid, Madrid, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain
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McCracken LM, Buhrman M, Brocki K. COVID-19 and processes of adjustment in people with persistent pain: the role of psychological flexibility. Scand J Pain 2023; 23:539-545. [PMID: 36779299 DOI: 10.1515/sjpain-2022-0138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/14/2023] [Indexed: 02/14/2023]
Abstract
OBJECTIVES The purpose of the current study was to investigate facets of Psychological Flexibility (PF) and Psychological Inflexibility (PI) and their relations with depression, anxiety, and insomnia in people with chronic pain during the COVID-19 pandemic. It was predicted that the full set of facets would significantly predict all three outcomes. The relative contributions of differing facets and dimensions was explored. METHODS Participants with pain were selected from a sample of 1,657 Swedish adults responding to an online survey of health and COVID-19. Persistent pain was defined as pain on most days, present for three months or more. A total of 560, 33.8% of the total sample, were included in the analyses. Standardized and validated measures were used to measure depression, anxiety, and insomnia, and the Multidimensional Psychological Flexibility Inventory (MPFI) was used to measure both PF and PI. RESULTS Significant rates of depression, anxiety, and insomnia, at 43.1, 26.4, and 64.2%, respectively, were found in this sample. These rates appear higher than those found in a general sample in Sweden. PF was negatively associated with these problems while PI was positively associated with them. Better prediction of outcome was obtained by PI compared to PF. CONCLUSIONS PF and especially PI appear to have played a role in relation to health outcomes in people with persistent pain during the COVID-19 pandemic. This group of people appears to have been especially vulnerable to the impacts of the pandemic. This study motivates further investigation and development of treatment approaches, possibly focusing on training PF, for people with persistent pain in the current pandemic context and in the future.
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Affiliation(s)
| | - Monica Buhrman
- Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Karin Brocki
- Department of Psychology, Uppsala University, Uppsala, Sweden
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18
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Kupcova I, Danisovic L, Klein M, Harsanyi S. Effects of the COVID-19 pandemic on mental health, anxiety, and depression. BMC Psychol 2023; 11:108. [PMID: 37041568 PMCID: PMC10088605 DOI: 10.1186/s40359-023-01130-5] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 03/20/2023] [Indexed: 04/13/2023] Open
Abstract
BACKGROUND The COVID-19 pandemic affected everyone around the globe. Depending on the country, there have been different restrictive epidemiologic measures and also different long-term repercussions. Morbidity and mortality of COVID-19 affected the mental state of every human being. However, social separation and isolation due to the restrictive measures considerably increased this impact. According to the World Health Organization (WHO), anxiety and depression prevalence increased by 25% globally. In this study, we aimed to examine the lasting effects of the COVID-19 pandemic on the general population. METHODS A cross-sectional study using an anonymous online-based 45-question online survey was conducted at Comenius University in Bratislava. The questionnaire comprised five general questions and two assessment tools the Zung Self-Rating Anxiety Scale (SAS) and the Zung Self-Rating Depression Scale (SDS). The results of the Self-Rating Scales were statistically examined in association with sex, age, and level of education. RESULTS A total of 205 anonymous subjects participated in this study, and no responses were excluded. In the study group, 78 (38.05%) participants were male, and 127 (61.69%) were female. A higher tendency to anxiety was exhibited by female participants (p = 0.012) and the age group under 30 years of age (p = 0.042). The level of education has been identified as a significant factor for changes in mental state, as participants with higher levels of education tended to be in a worse mental state (p = 0.006). CONCLUSIONS Summarizing two years of the COVID-19 pandemic, the mental state of people with higher levels of education tended to feel worse, while females and younger adults felt more anxiety.
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Affiliation(s)
- Ida Kupcova
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, Bratislava, 811 08, Slovakia
| | - Lubos Danisovic
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, Bratislava, 811 08, Slovakia
| | - Martin Klein
- Institute of Histology and Embryology, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, Bratislava, 811 08, Slovakia
| | - Stefan Harsanyi
- Institute of Medical Biology, Genetics and Clinical Genetics, Faculty of Medicine, Comenius University in Bratislava, Sasinkova 4, Bratislava, 811 08, Slovakia.
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19
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Probst-Hensch N, Jeong A, Keidel D, Imboden M, Lovison G. Depression trajectories during the COVID-19 pandemic in the high-quality health care setting of Switzerland: the COVCO-Basel cohort. Public Health 2023; 217:65-73. [PMID: 36854252 PMCID: PMC9841075 DOI: 10.1016/j.puhe.2023.01.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/13/2022] [Accepted: 01/09/2023] [Indexed: 01/18/2023]
Abstract
OBJECTIVES During the pandemic, Switzerland avoided stringent lockdowns and provided funds to stabilize the economy. To assess whether and in what subgroups the pandemic impacted on depressive symptoms in this specific Swiss context, we derived depression trajectories over an extended pandemic period in a Swiss cohort and related them to individuals' sociodemographic characteristics. STUDY DESIGN This was a population-based cohort study. METHODS The population-based COVCO-Basel cohort in North-Western Switzerland invited 112,848 adult residents of whom 12,724 participated at baseline. Between July 2020 and December 2021, 6396 participants answered to additional 18 monthly online questionnaires. Depression symptoms were repeatedly measured by the DASS-21 scale. Group-based Trajectory Models methods were applied to identify clusters of similar depression trajectories. Trajectory clusters were characterized descriptively and with a Multinomial response model. RESULTS Three distinct trajectories were identified. The 'Highly affected' trajectory (13%) had a larger presence of younger and female participants with lower average income, higher levels of past depression, and living alone. A majority of individuals in the 'Unaffected' trajectory (52%) were of medium or high average income, older average age, without previous depression symptoms, and not living alone. The 'Moderately affected' trajectory (35%) had a composition intermediate between the two opposite 'extreme' trajectories. CONCLUSIONS This study is among few studies investigating depression trajectories up to the time when COVID-19 vaccination was readily available to the entire population. During these 18 months of the pandemic, depressive symptoms increased in a substantial percentage of participants. Economic support, high-quality health care system, and moderate containment measures did not sufficiently protect all population subgroups from adverse, potentially long-term psychological pandemic impacts.
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Affiliation(s)
- N. Probst-Hensch
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland,Department of Public Health, University of Basel, Switzerland,Corresponding author. Head Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Kreuzstrasse 2, 4123 Allschwil, Switzerland
| | - A. Jeong
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland,Department of Public Health, University of Basel, Switzerland
| | - D. Keidel
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland,Department of Public Health, University of Basel, Switzerland
| | - M. Imboden
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland,Department of Public Health, University of Basel, Switzerland
| | - G. Lovison
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland,Department of Public Health, University of Basel, Switzerland,Department of Economics, Business and Statistics, University of Palermo, Italy
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Ditton E, Knott B, Hodyl N, Horton G, Oldmeadow C, Walker FR, Nilsson M. Evaluation of an App-Delivered Psychological Flexibility Skill Training Intervention for Medical Student Burnout and Well-being: Randomized Controlled Trial. JMIR Ment Health 2023; 10:e42566. [PMID: 36745486 PMCID: PMC9941904 DOI: 10.2196/42566] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/06/2022] [Accepted: 12/24/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Physician burnout is a common problem, with onset frequently occurring during undergraduate education. Early intervention strategies that train medical students in psychological flexibility skills could support well-being and mitigate burnout risks associated with unmodifiable career stressors. There is a need for randomized controlled trials to assess effectiveness. As psychological flexibility varies contextually and among individuals, tailoring interventions may improve outcomes. Smartphone apps can facilitate individualization and accessibility, and the evaluation of this approach is an identified research priority. OBJECTIVE This study aimed to evaluate the effectiveness of a stand-alone app-delivered Acceptance and Commitment Training intervention for improving medical students' self-reported burnout, well-being, psychological flexibility, and psychological distress outcomes. We aimed to explore whether an individualized app would demonstrate benefits over a nonindividualized version. METHODS This parallel randomized controlled trial was conducted with a sample of medical students from 2 Australian universities (N=143). Participants were randomly allocated to 1 of 3 intervention arms (individualized, nonindividualized, and waitlist) using a 1:1:1 allocation ratio. Individualized and nonindividualized participants were blinded to group allocation. The 5-week intervention included an introductory module (stage 1) and on-demand access to short skill training activities (stage 2), which students accessed at their own pace. Stage 2 was either nonindividualized or individualized to meet students' identified psychological flexibility training needs. RESULTS The mean differences in change from baseline between the intervention groups and the waitlist group were not statistically significant for burnout outcomes: exhaustion (primary; individualized: -0.52, 95% CI -3.70 to 2.65, P=.75; nonindividualized: 1.60, 95% CI -1.84 to 5.03, P=.37), cynicism (individualized: -1.26, 95% CI -4.46 to 1.94, P=.44; nonindividualized: 1.00, 95% CI -2.45 to 4.46, P=.57), and academic efficacy (individualized: 0.94, 95% CI -0.90 to 2.79, P=.32; nonindividualized: 2.02, 95% CI 0.02-4.03, P=.05). Following the intervention, the individualized group demonstrated improved psychological flexibility (0.50, 95% CI 0.12-0.89; P=.01), reduced inflexibility (0.48, 95% CI -0.92 to -0.04; P=.04), and reduced stress (-6.89, 95% CI -12.01 to 5.99; P=.01), and the nonindividualized group demonstrated improved well-being (6.46, 95% CI 0.49-12.42; P=.04) and stress (-6.36, 95% CI -11.90 to -0.83; P=.03) compared with waitlist participants. Between-group differences for the individualized and nonindividualized arms were not statistically significant. High attrition (75/143, 52.4%) was observed. CONCLUSIONS This trial provides early support for the potential benefits of Acceptance and Commitment Training for medical student well-being and psychological outcomes and demonstrates that psychological flexibility and inflexibility can be trained using a smartphone app. Although postintervention burnout outcomes were not statistically significant, improvements in secondary outcomes could indicate early risk mitigation. Replication studies with larger samples and longer-term follow-up are required, and future research should focus on improving implementation frameworks to increase engagement and optimize individualization methods. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry 12621000911897; https://tinyurl.com/2p92cwrw. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/32992.
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Affiliation(s)
- Elizabeth Ditton
- Centre for Rehab Innovations, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia.,College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | | | - Nicolette Hodyl
- Centre for Rehab Innovations, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia.,New South Wales Regional Health Partners, Newcastle, Australia
| | - Graeme Horton
- College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Christopher Oldmeadow
- Hunter Medical Research Institute, New Lambton Heights, Australia.,College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Frederick Rohan Walker
- Centre for Rehab Innovations, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia.,College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia
| | - Michael Nilsson
- Centre for Rehab Innovations, University of Newcastle, Callaghan, Australia.,Hunter Medical Research Institute, New Lambton Heights, Australia.,College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, Australia.,Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
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21
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Salituro N, Landi G, Garelli S, Balsamo F, Rottoli M, Cattivelli R, Tossani E, Grandi S, Pagotto U, Bernante P, Agostini A. The impact of psychological distress on weight regain in post-bariatric patients during the COVID-19 pandemic: A latent profile analysis. J Psychosom Res 2023; 165:111144. [PMID: 36608506 PMCID: PMC9805045 DOI: 10.1016/j.jpsychores.2022.111144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/29/2022] [Accepted: 12/29/2022] [Indexed: 01/02/2023]
Abstract
OBJECTIVE The COVID-19 pandemic has caused a global health crisis disrupting healthcare delivery for people with severe obesity who have undergone bariatric surgery. This study examined the role of psychological distress during the first Italian COVID-19 lockdown in predicting post-operative outcomes in post-bariatric patients reaching the end of the 12-18 months follow-up during the lockdown. By using a person-centered approach, groups of patients with different psychological distress profiles were identified. We hypothesized that compared to post-bariatric patients with low psychological distress, post-bariatric patients with high psychological distress will be more at risk of weight regain. METHODS A total of 67 patients (71.6% female, Mage = 45.9) participated in this observational retrospective cohort study. Patients' anthropometric data were gathered from medical records while the weight at the end of the lockdown through phone interviews. Psychological distress, operationalized with anxiety symptoms, depressive symptoms, and sleep disturbances, was assessed by an online self-report questionnaire. RESULTS Significant differences were highlighted in the high and low psychological distressed group in weight changes, F(1,58) = 5.2, p < 0.001, η2 = 0.3. Specifically, compared to post-bariatric patients in the low psychological distress group, those in the high psychological distressed group reported weight regained (95% CI = 1.0, 2.6). CONCLUSION Results highlight the need to target post-bariatric patients with high psychological distress who are at risk for weight regain during the COVID-19 pandemic. Interventions mitigating psychological distress and obesogenic behaviors during future pandemics or in post-COVID times are needed in vulnerable post-bariatric patients reporting high psychological distress.
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Affiliation(s)
- N. Salituro
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - G. Landi
- Department of Psychology “Renzo Canestrari”, University of Bologna, Italy,Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy,Corresponding author at: Department of Psychology, University of Bologna, viale Berti Pichat 5, Bologna 40127, Italy
| | - S. Garelli
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - F. Balsamo
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), S. Orsola-Malpighi Hospital, Alma Mater University of Bologna, Bologna 40138, Italy
| | - M. Rottoli
- Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - R. Cattivelli
- Department of Psychology “Renzo Canestrari”, University of Bologna, Italy,Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy
| | - E. Tossani
- Department of Psychology “Renzo Canestrari”, University of Bologna, Italy,Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy
| | - S. Grandi
- Department of Psychology “Renzo Canestrari”, University of Bologna, Italy,Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy
| | - U. Pagotto
- Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - P. Bernante
- Surgery of the Alimentary Tract, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - A. Agostini
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), S. Orsola-Malpighi Hospital, Alma Mater University of Bologna, Bologna 40138, Italy
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22
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Feldman G, Martin S, Donovan E. Psychological flexibility as a predictor of mental health outcomes in parents of pre-school children during the COVID-19 pandemic: A two-year longitudinal study. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023; 27:116-119. [PMID: 36711009 PMCID: PMC9859767 DOI: 10.1016/j.jcbs.2023.01.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/01/2022] [Accepted: 01/13/2023] [Indexed: 01/22/2023]
Abstract
In light of the adverse mental health impacts of the COVID-19 pandemic for parents of preschool-aged children, it is important to identify modifiable protective factors that can inform interventions for parents who continue to struggle. The present study examined prospective and concurrent associations of parental psychological flexibility (acceptance, defusion, and committed action) with measures of parental stress and depression symptoms in an international sample of parents of preschoolers assessed at three time points over the first two years of the COVID-19 pandemic: The start of the pandemic (T1) as well as the end of the first (T2) and second (T3) year of the pandemic. Consistent with hypotheses, the three measures of parent psychological flexibility (assessed at T2) prospectively predicted parenting stress levels one year later (T3) (p < .05). Defusion and Committed Action also prospectively predicted lower levels of depression symptoms one year later [p < .05]. Comparable concurrent analyses of data of parents who provided data at T1 and T2 (N = 79) are also presented with acceptance and defusion negatively associated with parental stress (p < .001) and defusion negatively associated with depression (p < .05). This study contributes longitudinal evidence for the value of psychological flexibility for parents and suggests that Acceptance and Commitment Therapy interventions may help to support parental mental health during sustained periods of stress such as the COVID-19 pandemic.
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23
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Zrnić Novaković I, Ajduković D, Bakić H, Borges C, Figueiredo-Braga M, Lotzin A, Anastassiou-Hadjicharalambous X, Lioupi C, Javakhishvili JD, Tsiskarishvili L, Lueger-Schuster B. Shaped by the COVID-19 pandemic: Psychological responses from a subjective perspective-A longitudinal mixed-methods study across five European countries. PLoS One 2023; 18:e0285078. [PMID: 37098092 PMCID: PMC10128933 DOI: 10.1371/journal.pone.0285078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/16/2023] [Indexed: 04/26/2023] Open
Abstract
BACKGROUND Contextual factors are essential for understanding long-term adjustment to the COVID-19 pandemic. Therefore, the present study investigated changes in mental health outcomes and subjective pandemic-related experiences over time and across countries. The main objective was to explore how psychological responses vary in relation to individual and environmental factors. METHODS The sample consisted of N = 1070 participants from the general population of Austria, Croatia, Georgia, Greece, and Portugal. We applied a longitudinal mixed-methods approach, with baseline assessment in summer and autumn 2020 (T1) and follow-up assessment 12 months later (T2). Qualitative content analysis by Mayring was used to analyse open-ended questions about stressful events, positive and negative aspects of the pandemic, and recommendations on how to cope. Mental health outcomes were assessed with the Adjustment Disorder-New Module 8 (ADNM-8), the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), the Patient Health Questionnaire-2 (PHQ-2), and the 5-item World Health Organization Well-Being Index (WHO-5). The analyses were performed with SPSS Statistics Version 26 and MAXQDA 2022. RESULTS The mental health outcomes significantly differed over time and across countries, with e.g. Greek participants showing decrease in adjustment disorder symptoms (p = .007) between T1 and T2. Compared with other countries, we found better mental health outcomes in the Austrian and the Croatian sample at both timepoints (p < .05). Regarding qualitative data, some themes were equally represented at both timepoints (e.g. Restrictions and changes in daily life), while others were more prominent at T1 (e.g. Work and finances) or T2 (e.g. Vaccination issues). CONCLUSIONS Our findings indicate that people's reactions to the pandemic are largely shaped by the shifting context of the pandemic, country-specific factors, and individual characteristics and circumstances. Resource-oriented interventions focusing on psychological flexibility might promote resilience and mental health amidst the COVID-19 pandemic and other global crises.
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Affiliation(s)
- Irina Zrnić Novaković
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
- Vienna Doctoral School in Cognition, Behaviour and Neuroscience, University of Vienna, Vienna, Austria
| | - Dean Ajduković
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Helena Bakić
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Camila Borges
- Trauma Observatory, Centre for Social Studies (CES) of the University of Coimbra, Coimbra, Portugal
| | - Margarida Figueiredo-Braga
- Trauma Observatory, Centre for Social Studies (CES) of the University of Coimbra, Coimbra, Portugal
- Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Annett Lotzin
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychology, MSH Medical School Hamburg, Hamburg, Germany
| | | | - Chrysanthi Lioupi
- Department of Social Sciences, School of Humanities, Social Sciences and Law, University of Nicosia, Nicosia, Cyprus
| | | | | | - Brigitte Lueger-Schuster
- Department of Clinical and Health Psychology, Faculty of Psychology, University of Vienna, Vienna, Austria
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24
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Yao X, Xu X, Chan KL, Chen S, Assink M, Gao S. Associations between psychological inflexibility and mental health problems during the COVID-19 pandemic: A three-level meta-analytic review. J Affect Disord 2023; 320:148-160. [PMID: 36179778 PMCID: PMC9516602 DOI: 10.1016/j.jad.2022.09.116] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/18/2022] [Accepted: 09/21/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND An increasing number of research has documented the positive associations between psychological inflexibility (PI) and mental health problems (i.e., depressive, anxiety, and stress symptoms) during the COVID-19 pandemic. However, the documented associations have been inconsistent. This review thus aimed to quantitatively summarize primary research to gain better estimates of these associations. METHODS A systematic literature review was conducted in six databases and three-level meta-analytic models were used to statistically synthesize effect sizes and to examine moderators of the associations between PI and depressive, anxiety, and stress symptoms. RESULTS A total of 22 studies yielded 63 effect sizes on associations between PI and depressive, anxiety, or stress symptoms. The results of three separate meta-analyses revealed a large and significant association between PI and depressive (r = 0.580, 95 % CI [0.549; 0.775]), anxiety (r = 0.548, 95 % CI [0.468; 0.761]), and stress symptoms (r = 0.548, 95 % CI [0.506; 0.725]). The association between PI and depressive symptoms is stronger for males than for females, and the association between PI and stress symptoms varies by type of measure that primary studies use to assess PI and stress symptoms. LIMITATIONS Temporal or causal conclusions are not allowed due to cross-sectional nature of the associations included in meta-analyses. Clinical samples with high levels of stress were underrepresented. CONCLUSIONS PI seems an important risk factor for symptoms of depression, anxiety, and stress, and should therefore be targeted in interventions addressing mental health problems during the COVID-19 pandemic and beyond.
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Affiliation(s)
- Xiaoyu Yao
- School of Sociology and Political Science, Shanghai University, Shanghai, China
| | - Xinhan Xu
- School of Sociology and Political Science, Shanghai University, Shanghai, China
| | - Ko Ling Chan
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Shimin Chen
- School of Public Administration, China University of Mining and Technology, Xuzhou, China
| | - Mark Assink
- Research Institute of Child Development and Education, University of Amsterdam, Amsterdam, the Netherlands
| | - Shuling Gao
- School of Sociology and Political Science, Shanghai University, Shanghai, China.
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25
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LoBue V, Pérez-Edgar K, Kirkham N, Herbert J. The impact of COVID-19 on infant development: A special issue of infancy. INFANCY 2023; 28:4-7. [PMID: 36629027 DOI: 10.1111/infa.12528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Affiliation(s)
| | | | | | - Jane Herbert
- University of Wollongong, Wollongong, New South Wales, Australia
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26
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Dell’Acqua C, Mura F, Messerotti Benvenuti S, Patron E, Palomba D. Reduced heart rate variability and expressive suppression interact to prospectively predict COVID-19 pandemic-related post-traumatic stress symptoms. Sci Rep 2022; 12:21311. [PMID: 36494439 PMCID: PMC9734110 DOI: 10.1038/s41598-022-25915-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
The COVID-19 pandemic is a unique period of stress that, in some cases, led to post-traumatic stress symptoms (PTSSs). Emotion regulation strategies are known to modulate the emotional response to stressful events. Expressive suppression (ES) is a maladaptive strategy related to the exacerbation of the physiological stress response. Heart rate variability (HRV), an index of cardiac autonomic balance strictly related to ES, was also shown to predict PTSSs. This was the first study to investigate whether the pre-pandemic ES use and resting-state HRV predicted pandemic-related PTSSs. Before the pandemic, 83 (58 females) university students completed the Emotion Regulation Questionnaire (ERQ), self-report measures of anxiety and depressive symptoms, and a three-minute resting-state electrocardiogram recording. After 12 months, 61 (45 females) participants completed a self-report measure of pandemic-related PTSSs and repeated the self-report psychological measures. Pre-pandemic anxiety symptoms prospectively predicted greater PTSSs. Moreover, a significant interaction between HRV and ES in predicting PTSSs emerged, whereby those who had higher levels of ES and reduced HRV showed higher PTSSs. These findings suggest that an integrated assessment of HRV and ES might be useful for identifying individuals who are more vulnerable to the development of PTSSs during crises.
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Affiliation(s)
- Carola Dell’Acqua
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Francesca Mura
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
| | - Simone Messerotti Benvenuti
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy ,grid.411474.30000 0004 1760 2630Hospital Psychology Unit, Padua University Hospital, Padua, Italy
| | - Elisabetta Patron
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy
| | - Daniela Palomba
- grid.5608.b0000 0004 1757 3470Department of General Psychology, University of Padua, Via Venezia, 8, 35131 Padua, Italy ,grid.5608.b0000 0004 1757 3470Padova Neuroscience Center (PNC), University of Padua, Padua, Italy
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27
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Landi G, Pakenham KI, Mattioli E, Crocetti E, Agostini A, Grandi S, Tossani E. Post-traumatic growth in people experiencing high post-traumatic stress during the COVID-19 pandemic: The protective role of psychological flexibility. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022; 26:44-55. [PMID: 36060527 PMCID: PMC9420208 DOI: 10.1016/j.jcbs.2022.08.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 08/17/2022] [Accepted: 08/22/2022] [Indexed: 12/22/2022]
Abstract
The COVID-19 pandemic evokes high levels of post-traumatic stress (PTS) in some people as well as positive personal changes, a phenomenon known as post-traumatic growth (PTG). Experiencing an adverse event as traumatic is crucial for triggering PTG, therefore higher PTS is often associated with higher PTG. This longitudinal study examined the protective role of psychological flexibility in fostering PTG in a group of people reporting high PTS related to COVID-19 as compared to those with low PTS. We hypothesized that higher psychological flexibility will be associated with higher PTG in those with high PTS and that psychological flexibility would be unrelated to PTG in those with low PTS. Secondary data analysis was conducted on data from a larger project investigating the psychological impacts of COVID-19. Adult Italians (N = 382) completed online surveys at Time 1 (three months after the first national lockdown, July 2020) and Time 2 (three months later when the number of COVID-19 cases increased, October 2020). Based on the Impact of Event Scale-Revised cut-off score, two PTS groups were identified at Time 2: low PTS (below cut-off) and high PTS (above cut-off). As predicted, moderation analyses showed that after controlling for Time 1 PTS and PTG and confounding variables, Time 1 psychological flexibility was associated with higher Time 2 PTG in the high PTS group, whereas psychological flexibility was unrelated to PTG in the low PTS group. Four psychological flexibility sub-processes (present moment awareness, defusion, values, committed action) at Time 1 were related to higher Time 2 PTG in only the high PTS group. Findings advance understanding of the role of psychological flexibility in trauma reactions and pandemic mental health adjustment. Evidence-based approaches that target psychological flexibility, like Acceptance and Commitment Therapy, are likely to foster PTG and ultimately adjustment in people with high PTS during and after the pandemic.
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Affiliation(s)
- Giulia Landi
- Department of Psychology, University of Bologna, Bologna, Italy
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy
| | - Kenneth I Pakenham
- School of Psychology, The University of Queensland, Brisbane QLD, Australia
| | - Elisa Mattioli
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy
| | | | - Alessandro Agostini
- Department of Experimental, Diagnostic and Specialty Medicine DIMES St.Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Silvana Grandi
- Department of Psychology, University of Bologna, Bologna, Italy
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy
| | - Eliana Tossani
- Department of Psychology, University of Bologna, Bologna, Italy
- Laboratory of Psychosomatics and Clinimetrics, Department of Psychology, University of Bologna, Cesena, Italy
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