Resilience, COVID-19-related stress, anxiety and depression during the pandemic in a large population enriched for healthcare providers

Healthcare professionals' perceptions of system preparedness during public health emergencies: a path analysis of mental health impacts

Background

The easing of COVID-19 policies in China appears to have been inadequately prepared, leading to a profound shift in the mental wellbeing of healthcare professionals following the lifting of these measures. Our study aims to investigate the pathways underlying negative emotions experienced by healthcare professionals due to perceived inadequate system preparedness, aiming to enhance their mental health protection and facilitate more effective responses during future large-scale public health crises.

Methods

A total of 826 healthcare professionals were enrolled. Depression symptoms, anxiety symptoms, perceived stress, resilience, perceived inadequate system preparedness were measured in our research.

Results

The prevalence of depression and anxiety symptoms among healthcare professionals were 32.1 and 16.2%, respectively, during the concentrated outbreak of COVID-19 in China after easing policy. The chain mediation analysis reveals that perceived inadequate system preparedness significantly directly predicts depression or anxiety symptoms among healthcare professionals, indirectly through the mediating role of stress, as well as via the chain mediation of stress and resilience. However, it does not predict these symptoms through the mediator of resilience alone. Furthermore, contracting COVID-19 directly predicts depression symptoms.

Conclusions

Perceived inadequate system preparedness can have a detrimental impact on negative emotions through various channels. When facing the potential outbreak of a large-scale public health event in the future, it is crucial to implement measures such as providing psychological counseling, increasing risk allowances, and ensuring an adequate supply of personal protective equipment to be better prepared. Additionally, psychosocial interventions should be implemented to enhance the resilience of healthcare professionals and safeguard the mental wellbeing of those infected with COVID-19, etc.

Preparing Australia for future pandemics: strengthening trust, social capital and resilience

15 April 2025: This article published in Early View in error. The article is under embargo and will republish on 12 May 2025.

Socioecological factors linked to co-occurring early childhood sleep health disparities and developmental outcomes: protocol for the sleep in preschoolers cross-sectional study

INTRODUCTION

Sleep deficiencies, such as sleep disordered breathing (SDB) and insufficient sleep, are linked to adverse health outcomes. These sleep deficiencies are more common in racial and ethnic minoritised children and have significant negative impacts on neurobehavioural and social-emotional development. Non-Latine Black/African American children are 4-6 times more likely than non-Latine White children to experience both SDB and short sleep duration. Although SDB and insufficient sleep often co-occur in young children, there is a paucity of research considering the potential unique and additive impacts of SDB and insufficient sleep on child outcomes, as well as racial disparities in these outcomes, thus hindering comprehensive interventions. Our study objectives are to (1) examine racial disparities in the neurobehavioural and social-emotional impacts of early childhood SDB and/or insufficient sleep and (2) identify proximal and distal socioecological factors linked to these sleep disparities and outcomes.

METHODS AND ANALYSIS

A cross-sectional observational study comparing neurobehavioural (executive functioning, attention, vigilance) and social-emotional functioning (social skills, emotion regulation) in 400 dyads consisting of caregivers and their otherwise healthy Black and White 3-5 year-old children and divided into four groups: (A) preschoolers with SDB; (B) preschoolers with insufficient sleep; (C) preschoolers with both SDB and insufficient sleep and (D) matched controls. Child SDB, insufficient sleep, neurobehavioural skills and social-emotional functioning are measured using validated objective and subjective assessment tools, with a subset of caregivers completing qualitative interviews. Primary outcomes include individual differences in neurobehavioural and social-emotional functioning in these groups of Black and White preschoolers, and multilevel socioecological factors associated with variation in outcomes. Quantitative data will be analysed using descriptive analyses, linear regression and comparison of model coefficients. Qualitative data will be coded using thematic analysis and a joint display to stratify qualitative themes by child race and sleep deficiencies.

ETHICS AND DISSEMINATION

The study protocol has been approved by the institutional review board of the Children's Hospital of Philadelphia and the University of Oregon. Results will be disseminated through peer-reviewed publications and conferences.

The underlying mechanisms of family function on anxiety among nurses during the public health emergency

The occurrence of public health emergency in China often makes nurses more susceptible to anxiety. The present study aimed to investigate the prevalence of anxiety among Chinese nurses during the public health emergency and explore the association between family function and anxiety and its underlying mechanisms. Family care index questionnaire, Connor-Davidson Resilience scale, physical activity rating scale and 7-item Generalized Anxiety Disorder Scale were employed to measure family function, resilience, physical activity and anxiety among 779 Chinese nurses during public health emergency. The prevalence of anxiety among nurses during public health emergency was 29.9%. Resilience partially mediated the association of anxiety with family function. Physical activity moderated the direct and indirect effects of family function on anxiety. The direct effect became insignificant when the standard scores of physical activity were 0.629 and over. In contrast, the indirect effect of family function on anxiety through resilience was stronger when the levels of physical activity increased. The present study suggested for nurses with low levels of physical activity, intervention enhancing family function should be designed to prevent anxiety. For those with higher levels of physical activity, programs aimed at strengthening family function and supporting resilience should be developed to manage anxiety.

Predictors of stress among nucleic acid sampling support nurses (NASSNs) during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has forced nucleic acid detection to be essential for prevention and control. The psychological and physical health of healthcare staff who conducted nucleic acid sampling (NAS) should be paid attention to. This study aims to investigate the status and explore the predictors of stress among nucleic acid sampling support nurses (NASSNs) by an online survey.

MATERIAL AND METHODS

Totally 388 NASSNs were recruited through cluster random sampling for the research. An online cross-sectional survey with structured questionnaires was used, including socio-demographic information, the stressor scale of nucleic acid sampling nurses (SSNASN), and the challenge-hindrance stress scale (CHSS). T-tests, ANOVA, and multivariable linear regression model were used to analyze data.

RESULTS

A total of 324 NASSNs filled out questionnaires online with a response rate of 83.51%. NASSNs had an overall mean score of (2.199 ± 0.917) for challenge stress and (2.014 ± 0.805) for hindrance stress. The item "the amount of responsibility I have" scored highest in the challenge stress dimension, while "the lack of job security I have" scored highest in the hindrance stress dimension. The predictors of challenge and hindrance stress include concern about the preparedness of NASSNs and their families, working environment, and competence of emergency disposal. An additional socio-demographic predictor of challenge stress was motivation, while that of hindrance stress was longer nursing experiences.

CONCLUSIONS

During the COVID-19 pandemic, stress among NASSNs was moderately low. The factors detected to be predictors of stress include motivation, nursing experiences, concern about the preparedness of NASSNs and their families, working environment, and competence in emergency disposal. Therefore, in advance of responding to a public health event, we recommend that subsequent short-term psychological counseling be given to healthcare workers and accompanying psychological counseling be provided to prevent the emergence of mental health problems thereafter.

Factors associated with long Covid in nursing professionals

OBJECTIVE

To analyze the association between sociodemographic variables, lifestyle and mental health habits, and long Covid in nursing professionals.

METHOD

Quantitative, observational, cross-sectional and analytical study, with 109 nursing professionals who had Covid-19 between 2020 and 2022. Data collection was carried out using an online form, with the following variables of interest: resilience, subjective well-being, age, sex, professional category, vaccination, physical activity, presence of symptoms resulting from Covid-19 infection after the acute phase of the disease and long Covid. Data were analyzed descriptively and inferentially using Poisson regression with robust variance and a significance level of 5%.

RESULTS

Male sex, high resilience, and high positive affect decrease the prevalence of long Covid by 71% (RP = 0.29), 40% (RP = 0.60) and 43% (RP = 0.57), respectively, while being in the nursing technician category increases its prevalence by 74% (RP = 1.74).

CONCLUSION

The results emphasize the importance and support the development of promotion, prevention, treatment, and rehabilitation actions for individuals with long Covid. To achieve this, multidisciplinary care, centered on the person and directed at the context and work environment is required.

Spatiotemporal dynamic and regional differences of public attention to vaccination: An empirical study in China

BACKGROUND

Internet searches offer an indicator of public attention and possible demand for certain things. Studying the spatiotemporal characteristics of the public's concern for vaccination can determine the spatiotemporal distribution of demand for vaccines in China, and capture the changes in the health awareness of the Chinese population, thus informing future vaccination strategies.

METHODS

Based on the collection of Baidu search indices for vaccination-related keywords in 363 cities in China, This paper seeks to explore the spatiotemporal changes and regional differences in public attention toward vaccination in China by using the seasonal index, seasonal concentration index, Herfindahl index, Moran index, and Dagum Gini coefficient.

RESULTS

The following findings are presented. First, there are significant seasonal fluctuations and unbalanced monthly distributions of vaccination-related public attention in China. Second, the public attention in Chinese cities shows the spatial characteristics of "leading in the east, followed by the central, western and northeastern regions". The spatial correlation of attention has been strengthened, and the high-high clusters are mainly distributed in the Beijing-Tianjin-Hebei (BTH), Yangtze River Delta (YRD), and Greater Bay Area (GBA) urban agglomerations. Third, regional differences in overall public attention narrowed in China, with intra-regional differences narrowing in seven regions (Northwest China, Central China, and so on), and intra-regional differences increasing in East China. The dominant role in the Gini coefficient changes from transvariation intensity to inter-regional differences.

CONCLUSION

Major public health emergencies stimulate the public's attention to health topics. Although the short-term increase in vaccination-related public attention was not observed to translate into a long-term increase in public vaccine literacy, the seasonal and regional differences in vaccination-related public attention in China have significantly narrowed before and after COVID-19, suggesting that the imbalance between public health literacy levels has improved.

Measurement of Psychological Resilience to Support Therapy Interventions for Clients in the Clinical Mental Healthcare Setting: A Scoping Review

Waves of psychological research over 50 years have resulted in the development of scales to measure psychological resilience. Multiple psychological resilience definitions and factors have emerged during this time, making its measurement complex. The overall aim of the review was to identify and describe developments in the measurement of psychological resilience in the clinical mental healthcare setting. Specific objectives included (1) consideration of the validity and reliability of psychological resilience scales, (2) the effectiveness of the scales in clinical mental healthcare settings and (3) to identify the scope that resilience factors are addressed in the included scales. It provides a timely update regarding psychological resilience measurement tools and considers further developments that may be required. Between 2011 and 2024, databases were searched, and English-language, peer-reviewed papers with full text were extracted. Eligible studies were those reporting validated existing resilience measures or the outcomes of new measures for use in clinical mental healthcare settings. Seventeen studies met the inclusion criteria. The review demonstrated that psychological resilience measures require further development, particularly focusing on the utility of measurement tools in clinical mental healthcare settings. In this review, we highlight an existing gap in resilience measurement and underscore the need for a new measure of psychological resilience that can effectively assess individuals' subjective experience of their psychological resilience in clinical mental healthcare settings. The currently available psychological resilience measures included in this review do not directly reflect all the factors that might impact a client's depression or anxiety and warrant further research.

Addressing psychological resilience and its determinants among university students during the COVID-19 pandemic: a three-wave longitudinal study in Shandong Province, China

BACKGROUND

The relationship between public health emergencies and psychological distress had been well known, yet none research had been conducted on the trend in psychological resilience and its longitudinal determinants during the pandemic. This study aimed to explore the changes of psychological resilience of university students during COVID-19 pandemic, and further clarify the longitudinal relationship between family factors, mental health, social mentality and psychological resilience.

METHODS

Questionnaires were distributed to students from five universities in Shandong Province, China during the COVID-19. A total of 1635 students were finally included in this three-wave follow-up study using stratified random sampling method. Mental health was assessed by Depression Anxiety Stress Scale, social mentality was measured by the Bi-Dimensional Structure Questionnaire of Social Mentality, psychological resilience was evaluated by the Chinese version of the Psychological Resilience Scale. Repeated-measures analysis of variance was used to analyze the longitudinal changes of psychological resilience, generalized estimating equation (GEE) was conducted to estimate the determinants of psychological resilience.

RESULTS

Psychological resilience changed from 28.37 in Wave 1, 29.10 in Wave 2, and 29.15 in Wave 3 among the university students. The students who majored in Art (β = 0.872, P = 0.032), parents (mother β = 0.546, P = 0.035; father β = 0.718, P = 0.012) had a greater influence on children's personality, and positive social mentality (β = 5.725, P < 0.001) were more likely to report a higher psychological resilience. Being female (β=-0.932, P < 0.001), not being a student leader (β=-0.911, P < 0.001), being anxious (β=-1.845, P < 0.001) and depressed (β=-1.846, P < 0.001), and negative social mentality (β=-0.803, P < 0.001) were less likely to report a higher psychological resilience.

CONCLUSIONS

The psychological resilience of the university students in Shandong Province, China increased significantly from Wave 1 to Wave 3 during the COVID-19 pandemic. Majoring in Art, parents having a greater influence on children's personality, better mental health, positive social mentality were more likely to report a higher psychological resilience, while female, not student leader, worse mental health, and negative social mentality were less likely to report a higher the psychological resilience.

Examining interrelations among trajectories of mindful awareness, acceptance, and values-consistent actions in acceptance-based behavioral therapy for generalized anxiety disorder

The goal of this study was to understand how mindful awareness, acceptance, and values-consistent action change across acceptance-based behavioral therapy (ABBT) for generalized anxiety disorder (GAD) and determine their effect on symptoms. We examined weekly data from 31 individuals who received ABBT as part of a randomized control trial for individuals with GAD (Hayes-Skelton, Roemer, & Orsillo, 2013). Participants answered questions weekly about three components of ABBT, including the percentages of time they spent over their past week: 1) aware of the present moment, 2) accepting of their internal experiences, and 3) engaging in values. GAD symptoms were examined using two self-report measures (DASS-21 Stress subscale and PSWQ) and two clinician-rated interview measures (CSR and SIGH-A) at pre- and post-treatment.1 Mindful awareness, acceptance, and values-consistent action increased linearly across ABBT. All three change trajectories were positively correlated (Z's 2.99 to 8.74, p's < .001). Mindful awareness, acceptance, and values-consistent action across treatment predicted decreases in GAD symptoms above and beyond baseline for most outcome measures (Z's -1.95 to -3.03, p's < .05), with the exception that mindfulness did not predict DASS-stress (Z = -1.39, p = .17). These findings are consistent with the structure and model of ABBT.

Evaluating Emotional Intelligence in Medical Students: A Comparative Analysis of Their Trait Emotional Intelligence (TEI) Scores Before and During the COVID-19 Pandemic

INTRODUCTION

Medical education, which generally relied heavily on intelligence quotients, has found a new value in emotional intelligence (EI), specifically after the challenges faced during the COVID-19 pandemic. The COVID-19 pandemic has had some apparent and some intangible effects, as this required an emergency switch to online teaching and learning.  Aim: This study was conducted to compare the trait emotional intelligence (TEI) score of medical undergraduates with the increasing number of years of medical curriculum. The COVID-19 pandemic serendipitously provided an opportunity to compare the TEI scores in pre-pandemic and during pandemic times.  Materials and methods: Trait emotional intelligence was computed using a pre-validated Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF). The study was conducted in two time frames and in two study groups, the Class of 2019 (pre-pandemic cohort) and the Class of 2020 (pandemic cohort). Further, the pre-pandemic cohort's EI score was assessed twice, initially in August 2019 (Timeframe 1 (T1) which was before the pandemic) and secondly in October 2020 (Timeframe 2 (T2) which was during the pandemic) in Phase II and the COVID-19 first wave was peaking in India. The TEI scores of the pre-pandemic cohort and pandemic cohort were compared using an unpaired T-test. The pre-pandemic cohort scores assessed in two time frames were compared using a paired T-test.  Results: The pandemic cohort showed significantly less total TEI (p < 0.05) and well-being score (p < 0.05) in the pre-pandemic cohort from August 2019 (T1) to October 2020 (T2) (p = 0.036).  Conclusions: The low TEI scores in the pandemic cohort may be attributed to the sudden psychological and social effects of the pandemic. Moreover, with advancing age and years of medical curriculum, the TEI scores increased.

Social isolation, psychological distress and resilience of Chinese college students during COVID-19 pandemic

It has been 3 years since the first appearance of COVID-19 in China. During this time, social isolation was widely used as an important method to fight it. However, this measure had many negative effects on the mental health of college students. To better understand this issue, this study aims to explore the impact of social isolation and COVID-19-related stress on psychological distress among Chinese college students. Additionally, resilience has been evaluated as a key component of stress resistance in this situation. Coronavirus Stress Measure (CSM), the Connor-Davidson Resilience Scale (CD-RISC) and the Brief Symptom Inventory (BSI) were used in this study. A total of 388 Chinese college students participated in the survey via the Internet. Two groups (isolated group vs. non-isolated group) were divided according to whether they have been isolated from their classmates and families. Data analysis adopts t-test, F test and mediate effect analysis by SPSS21.0. (1) All factors, except resilience, were found to have lower scores in the isolated group; (2) significant correlations were found between all factors; (3) resilience partially mitigated the impact of COVID-19 stress on psychological symptoms. Social isolation has been found to be a significant factor contributing to negative psychological distress in Chinese college students. The COVID-19-related stress may increase the likelihood of psychological suffering among isolated group. Resilience can help reduce the negative effects of COVID-19 stress on college students. Therefore, providing appropriate psychological support tailored to different isolation situations is crucial.

COVID-19 Stressors and Resilience Among Nurse Leaders

The COVID-19 pandemic introduced many new stressors to nurses in general, yet little is known about COVID-19-related stressors and resilience among nursing leaders. The aims of this study were to explore (1) the COVID-19-related stressor and resilience by personal and work demographics, (2) the relationship between COVID-19 stressors and resilience, and (3) resilience strategies used by leaders and their recommendations to other nurse leaders. This descriptive, cross-sectional study employed an electronic survey to measure COVID-19-related stressors and resilience and included qualitative open-ended questions. A total of 57 nurse leaders responded to the survey. Nurse leaders who were female, African American, chief nurse executive or nursing director, and had more than 10 years of experience reported highest COVID-19 stress in most of subscales. Nurse leaders who were male, African American, chief nurse executive or nursing director, and had more than 10 years of experience reported highest resilience scores. Nurse leaders with higher resilience levels had lower levels of COVID-19 stress in all subscales. Nurse leaders reported the top 3 resilience strategies as (1) prayer and faith, (2) social support, and (3) self-care and the top 3 recommendations to other nurse leaders as (1) disconnect, (2) positive and creative thinking, and (3) self-care.

Challenges Experienced by Health Care Workers During Service Delivery in the Geographically Challenging Terrains of North-East India: Study Involving a Thematic Analysis

BACKGROUND

The public health landscape in North-East India is marked by the foundational principle of equitable health care provision, a critical endeavor considering the region's intricate geography and proximity to international borders. Health care workers grapple with challenges, such as treacherous routes, limited infrastructure, and diverse cultural nuances, when delivering essential medical services. Despite improvements since the National Rural Health Mission in 2005, challenges persist, prompting a study to identify health care workers' challenges and alternative strategies in Manipur and Nagaland.

OBJECTIVE

This study aims to document the challenges experienced by health care workers during service delivery in the geographically challenging terrains of North-East India.

METHODS

This study is part of the i-DRONE (Indian Council of Medical Research's Drone Response and Outreach for North East) project, which aims to assess the feasibility of drone-mediated vaccine and medical delivery. This study addresses the secondary objective of the i-DRONE project. In-depth interviews of 29 health care workers were conducted using semistructured questionnaires in 5 districts (Mokokchung and Tuensang in Nagaland, and Imphal West, Bishnupur, and Churachandpur in Manipur). Nineteen health facilities, including primary health care centers, community health centers, and district hospitals, were selected. The study considered all levels of health care professionals who were in active employment for the past 6 months without a significant vacation and those who were engaged in ground-level implementation, policy, and maintenance activities. Data were recorded, transcribed, and translated, and subsequently, codes, themes, and subthemes were developed using NVivo 14 (QSR International) for thematic analysis.

RESULTS

Five themes were generated from the data: (1) general challenges (challenges due to being an international borderline district, human resource constraints, logistical challenges for medical supply, infrastructural issues, and transportation challenges); (2) challenges during the COVID-19 pandemic (increased workload, lack of diagnostic centers, mental health challenges and family issues, routine health care facilities affected, stigma and fear of infection, and vaccine hesitancy and misinformation); (3) perception and awareness regarding COVID-19 vaccination; (4) alternative actions or strategies adopted by health care workers to address the challenges; and (5) suggestions provided by health care workers. Health care workers demonstrated adaptability by overcoming these challenges and provided suggestions for addressing these challenges in the future.

CONCLUSIONS

Health care workers in Manipur and Nagaland have shown remarkable resilience in the face of numerous challenges exacerbated by the pandemic. Despite infrastructural limitations, communication barriers, and inadequate medical supply distribution in remote areas, they have demonstrated adaptability through innovative solutions like efficient data management, vaccination awareness campaigns, and leveraging technology for improved care delivery. The findings are pertinent for not only health care practitioners and policymakers but also the broader scientific and public health communities. However, the findings may have limited generalizability beyond Manipur and Nagaland.

Symptoms of Post-Traumatic Stress and Mental Health in a Sample of University Students: The Mediating Role of Resilience and Psychological Well-Being

The COVID-19 pandemic has been one of the most stressful events in recent times across the world. The long-term effect of these experiences raises several concerns, including the development of post-traumatic stress symptomatology. However, little is known about the psychological processes that mediate this association. The aim of this study was to explore the association of emotional exhaustion and anxiety in post-traumatic stress symptomatology, and the mediating role of resilience and psychological well-being in university students. A total of 526 university students of both sexes participated in this study, and they were aged between 17 and 62 years old. Symptoms of anxiety and emotional exhaustion were significantly higher in females, in contrast, males showed on average more resilience and psychological well-being. Additionally, participants with COVID-19 infection had higher levels of emotional exhaustion, anxiety, and PTSD. The results indicated that the variables were correlated with each other (p < 0.001). A conceptual model was confirmed that describes anxiety and emotional exhaustion as predictors, post-traumatic stress symptomatology as an outcome variable, and resilience and psychological well-being as mediators. Resilience and psychological well-being can be important protective factors for adaptive responses in stressful situations. The findings obtained in this study will provide a theoretical basis for designing targeted interventions to improve psychological health, whether for crisis intervention, the process of adapting to higher education, or for recovery plans from psychological trauma.

Exploring the association between social support and anxiety during major public emergencies: a meta-analysis of the COVID-19 pandemic

Objective

The COVID-19 pandemic has prompted a surge in research focusing on mental health issues faced by society, with particular emphasis on the interplay between social support and anxiety. However, the results of these studies have often been controversial.

Methods

To address this, we conducted a meta-analysis of 104 studies (N = 107,660) to investigate the relationship between anxiety and social support and the potential moderate variables.

Results

Our meta-analysis revealed a negative correlation between social support and anxiety (r = -0.233). The study also demonstrated the variation in the relationship between social support and anxiety was moderated by cultural area (Q = 14.120, p < 0.05) and phrase of the pandemic (Q = 13.678, p < 0.05).

Conclusion

The relationship between social support and anxiety can differ across different cultural areas and throughout the phrase of the pandemic. Consequently, we advocate for a nuanced assessment of the role of social support in mitigating public anxiety, taking into account the mediating effects of these factors in the context of major public emergencies.

Real-world predictors of changes in fear of COVID-19 in the Japanese general population: a large-scale internet-based cohort study with 20,712 participants

BACKGROUND

Coronavirus disease 2019 (COVID-19) is a respiratory infection that considerably impacts both physical and mental health. In particular, the prolonged nature of psychological issues associated with COVID-19 has become a concern. However, evidence based on longitudinal studies investigating the changes in fear of COVID-19 has been limited, posing a public health challenge.

METHODS

We investigated the predictors of changes in the Fear of COVID-19 Scale (FCV-19S) scores in the general Japanese population using data from a large-scale internet-based cohort study.

RESULTS

We included 20,712 study participants (mean age = 51.1 years, percentage of males = 49.9%). The baseline FCV-19S score for the research participants was 17.0, and one year later, the FCV-19S score decreased to 15.8. The predictors of increase in FCV-19S scores were older age, male sex, COVID-19 requiring oxygen therapy, higher baseline FCV-19S total score, severe psychological distress, never married, worsening subjective health status, a greater number of COVID-19 vaccinations, a history of alcohol dependency, and living with family members. Conversely, the predictors of decrease in FCV-19S scores included habitual alcohol intake, COVID-19 not requiring oxygen therapy and a higher household income. Our study was an internet-based survey focused on residents of Japan, which raises the possibility of selection bias and makes it unclear whether the findings can be extrapolated to other countries and cultures.

CONCLUSION

During the observation period, the FCV-19S scores significantly decreased. Severe COVID-19 requiring oxygen therapy within one year of baseline was the most impactful predictor of an increase in FCV-19S score. On the other hand, mild COVID-19 not requiring oxygen therapy was a predictor of a decrease in FCV-19S scores. Therefore, we believe that it is necessary to adopt individualized approaches stratified by the severity of the infection when addressing the fear of COVID-19.

Risk factors for COVID-19-related stress among college-going students

OBJECTIVE

To explore the degree of COVID-19-related stress among college students enrolled in higher level institutions and identify socio-demographic and psychosocial factors that may predict, or be associated with, higher levels of pandemic-related distress.

METHOD

Data were obtained from a cross-sectional survey completed by 321 college students primarily recruited from Universities in Ireland. Ages ranged between 18-21 years (n = 176) and 22-25 years (n = 145). Participants answered some demographic questions before completing scales assessing their experience of childhood adversity, their present resilience and levels of psychological distress, as well as their COVID-19-specific stress.

RESULTS

Multiple regression analysis revealed that students who were female, who had chronic illness, who experienced monetary concerns and who expressed psychological distress experienced greater stress related to COVID-19.

CONCLUSION

Findings suggest that certain categories of college students may be at higher risk for experiencing poor mental health during a global pandemic. Higher level institutions should consider this when designing and delivering support services aiming to promote student mental health and alleviate mental distress.

Reduced stress among COVID-symptomatic undergraduates: act with awareness, nonjudgment, and nonreactivity as key facets of mindfulness

Objective

Associations between mindfulness and improved physical and psychological health have been established, but COVID-19 presents a novel context. This study examined the relation between individual mindfulness facets and general stress among college students experiencing at least one symptom of acute COVID-19 infection in the context of the pandemic.

Methods

Five hundred sixteen university students experiencing at least one CDC-identified COVID-19 symptom completed measures of general stress, mindfulness, and somatic symptoms in 2020-2021 during the COVID-19 pandemic following IRB approval and informed consent.

Results

The act with awareness, nonjudgment, and nonreactivity facets of mindfulness were associated with general stress. In total, the model accounted for over half of the variance in general stress (R2 = 0.51, p < 0.001).

Conclusion

Mindfulness may be particularly important in explaining general stress among college students reporting a symptom of COVID-19. Mindfulness may benefit college students as the pandemic continues to unfold and monitoring of one's physical health remains a primary mitigation strategy. These results may also inform understanding and responses to future public health emergencies in which monitoring somatic symptoms is encouraged by public health officials to contain spread.

Evaluating the mental health status, help-seeking behaviors, and coping strategies of Canadian essential workers versus non-essential workers during COVID-19: a longitudinal study

OBJECTIVE

This study examined mental health symptoms, help-seeking, and coping differences between Canadian essential workers (EWs) versus non-EWs, as well as common COVID-related concerns and longitudinal predictors of mental health symptoms among EWs only.

DESIGN

An online, longitudinal survey (N = 1260; response rate (RR) =  78.5%) assessing mental health and psychosocial domains amongst Canadian adults was administered during the first wave of COVID-19 with a six-month follow-up (N = 821; RR = 53.7%).

METHODS

Cross tabulations and chi-square analyses examined sociodemographic, mental health, and coping differences between EWs and non-EWs. Frequencies evaluated common COVID-related concerns. Linear regression analyses examined associations between baseline measures with mental health symptoms six months later amongst EWs.

RESULTS

EWs reported fewer mental health symptoms and avoidance coping than non-EWs, and were most concerned with transmitting COVID-19. Both groups reported similar patterns of help-seeking. Longitudinal correlates of anxiety and perceived stress symptoms among EWs included age, marital status, household income, accessing a psychologist, avoidant coping, and higher COVID-19-related distress.

CONCLUSIONS

COVID-19 has had a substantial impact on the mental health of Canadian EWs. This research identifies which EWs are at greater risk of developing mental disorders, and may further guide the development of pandemic-related interventions for these workers.

Psychosocial resources and psychopathology among persons with neuromuscular disorders during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic substantially affected the lives of persons with inherited neuromuscular disorders (INMD), causing disruption in clinical and support services. While several studies have investigated mental health, distress and psychosocial resources in the general population during the pandemic, little is known about the experience of persons with INMD.

METHODS

This study was aimed to fill this gap by jointly investigating both psychopathological symptoms and psychosocial resources - specifically, resilience and perceived social support - among persons with INMD during the pandemic, taking into account demographic and clinical factors. Between April and December 2020, 59 participants with INMD (aged 15-59, 71.2% M) completed a questionnaire collecting demographic and clinical data, the Multidimensional Scale of Perceived Social Support, the Resilience Scale for Adults, and the Achenbach System of Empirically Based Assessment.

RESULTS

Overall, participants showed good levels of resilience and perceived social support. A minority of participants reported clinically relevant psychopathological symptoms, 28.81% for anxiety and depression. Most psychopathological symptoms were negatively correlated with resilience (-0.347 < r < - .420), but not significantly associated with social support. Consistent with previous studies, regression analyses highlighted that participants with Duchenne muscular dystrophy were more prone to report anxious and depressive symptoms (B = 1.748, p = .028, OR = 5.744), and participants with myotonic dystrophy, attention problems (B = 2.339, p = .006, OR = 10.376). Resilience emerged as a potential predictor of lower anxious-depressive symptoms (B=-1.264, p = .012, OR = 0.283).

CONCLUSIONS

The findings suggest the importance to investigate psychosocial resources in addition to psychopathology among persons with INMD, and to design interventions supporting resilience as a protective factor for mental health promotion.

International students' perceived discrimination and psychological distress during the COVID-19 pandemic

OBJECTIVE

This study examined the relationship between perceived discrimination and psychological distress among international students during the COVID-19 pandemic.

METHODS

A total of 188 international students from two large U.S. universities participated in the study. Perceived discrimination, psychological distress, and demographic information were assessed using self-reported questionnaires.

RESULTS

COVID-related variables and perceived discrimination were significantly associated with international students' psychological distress. Their COVID-related anxiety mediated the relationship between perceived discrimination and psychological distress.

CONCLUSION

Initiatives to mitigate the perceived discrimination experienced by international students may improve their mental health.

Pain mechanisms in the transgender individual: a review

Specific Aim

Provide an overview of the literature addressing major areas pertinent to pain in transgender persons and to identify areas of primary relevance for future research.

Methods

A team of scholars that have previously published on different areas of related research met periodically though zoom conferencing between April 2021 and February 2023 to discuss relevant literature with the goal of providing an overview on the incidence, phenotype, and mechanisms of pain in transgender patients. Review sections were written after gathering information from systematic literature searches of published or publicly available electronic literature to be compiled for publication as part of a topical series on gender and pain in the Frontiers in Pain Research.

Results

While transgender individuals represent a significant and increasingly visible component of the population, many researchers and clinicians are not well informed about the diversity in gender identity, physiology, hormonal status, and gender-affirming medical procedures utilized by transgender and other gender diverse patients. Transgender and cisgender people present with many of the same medical concerns, but research and treatment of these medical needs must reflect an appreciation of how differences in sex, gender, gender-affirming medical procedures, and minoritized status impact pain.

Conclusions

While significant advances have occurred in our appreciation of pain, the review indicates the need to support more targeted research on treatment and prevention of pain in transgender individuals. This is particularly relevant both for gender-affirming medical interventions and related medical care. Of particular importance is the need for large long-term follow-up studies to ascertain best practices for such procedures. A multi-disciplinary approach with personalized interventions is of particular importance to move forward.

Factors associated with psychological distress of workers in the Finnish Evangelical Lutheran Church

BACKGROUND

The work of church employees contains many elements causing symptoms of stress and anxiety. They can lead into psychological distress and possibly indicate the beginning of a more serious psychological state. Women seem to be more disposed to psychological stress than men. We investigated factors contributing to psychological distress among women and men in four professions of the Evangelical Lutheran Church of Finland (ELCF).

METHODS

A link to an electronic survey was sent to the members of respective trade unions of four professions of the ELCF, and we got responses from pastors (n = 241), church musicians (n = 92), diaconal workers (n = 85) and youth workers (n = 56). Psychological distress was assessed using the Mental Health Inventory-5 (MHI-5; cut-off value ≤ 52 indicating severe distress). We used logistic regression to examine sociodemographic, health-related, and work-related factors that could potentially be associated with psychological distress.

RESULTS

We found severe psychological distress in all profession groups. Gender differences were scarce. Loneliness was the most important factor associated with psychological distress in both men and women (OR 14.01; 95% CI 2.68-73.25 and OR 7.84; 3.44-17.88, respectively), and among pastors and church musicians (OR 8.10; 2.83-23.16 and OR 24.36; 2.78-213.72, respectively). High mental strain of work was associated with distress in women (OR 2.45; 1.01-5.97). Good work satisfaction was a protective factor for men and women (OR 0.06; 95% CI 0.01-0.40 and OR 0.61; 0.18-0.40, respectively) and for pastors and church musicians (OR 0.22; 0.08-0.73 and OR 0.06; 0.01-0.43, respectively). For women, additional protective factors were being a pastor (OR 0.26; 0.07-0.95), or youth worker (OR 0.08; 0.01-0.48), and good self-reported health (OR 0.38; 0.18-0.82).

CONCLUSION

Even though we found some protective factors, the share of workers with severe distress was higher in all profession groups of the ELCF than in the general population. Loneliness was the strongest stressor among both genders and high mental strain among women. The result may reflect unconscious mental strain or subordination to the prevailing working conditions. More attention should be paid to the mental wellbeing and work conditions of church employees.

Viral simulations in dreams: The effect of the COVID-19 pandemic on threatening dream content in a Finnish sample of diary dreams

Previous research indicates that the COVID-19 pandemic has affected dreaming negatively. We compared 1132 dreams collected with prospective two-week dream diary during the pandemic to 166 dreams collected before the pandemic. We hypothesized that the pandemic would increase the number of threatening events, threats related to diseases, and the severity of threats. We also hypothesized that dreams that include direct references to the pandemic will include more threatening events, more disease-related threats, and more severe threats. In contradiction with our hypotheses, results showed no differences between pandemic and pre-pandemic samples in the number of threats, threats related to diseases, or severe threats. However, dreams with direct references to the pandemic had more threats, disease-related threats, and severe threats. Our results thus do not suggest a significant overall increase in nightmarish or threatening dream content during the pandemic but show a more profound effect on a minority of dreams.

Stemming the "ageism pandemic": A qualitative inquiry with older adults in residential care facilities during the Covid-19 outbreak

The Covid-19 pandemic added to collective concerns, making health risks salient especially for the older population. The health emergency exacerbated an already widespread negative representation of aging, and phenomena such as ageism. With the present qualitative inquiry, 21 episodic interviews were collected with the aim of understanding the experience of older adults in residential care facilities, exploring their ideas of aging and the viewpoints that helped them to respond to the pandemic successfully. A thematic analysis was conducted using NudIst software. The results show that participants described multiple personal and relational resources they used to cope with the pandemic, and they were able to express counter-narratives to the ideas of aging as coinciding with decline, and of lockdown as a source of distress alone. The paper concludes with reflections on the relevance of research capable of challenging unhelpful dominant discourses and averting the risk of them turning into negative prophecies.

Psychological and social determinants of adaptation: the impact of finances, loneliness, information access and chronic stress on resilience activation

Background

Many people who face adversity, such as disasters, demonstrate resilience. However, less is known about reactions to large scale disasters with longer recovery periods. The concern is that protracted disasters may result in more chronic or accumulated stressors with an uncertain or unknown end point and can exhaust the natural coping methods and ability to rebound. Thus, understanding patterns of longer-term disaster recovery, inclusive of resilience, is needed. Further resilience is not individual specific rather social determinants, such as support networks and available resources, are contributing factors.

Methods

The purpose of this study is to improve understanding of mental health and resilience during increased stress, we aim to identify profiles of adaptation and psychological and social determinants that predict membership within predominant symptom groupings. We conducted an exploratory cross-section study (N = 334) with two phases of multivariate analysis. Latent profile models were estimated to identify groups based on depression, anxiety, and resilience scores. The second phase included a step-wise multinomial logistic regression to predict class membership.

Results

We identified four distinct groups: 33% of participants were categorized as anxious, 18% depressed, 9% comorbid, and 40% with above average levels of resilience. Psychosocial factors such as demographics, trauma history, information access, loneliness, and lack of financial resources predicted poorer mental health outcomes and lower resilience.

Conclusion

This study identified factors that contribute to overall wellbeing despite chronic stressors. Social determinants of adaptation, found in this study population, include loneliness, finances, and information access. The findings from this study support the need for both psychological and social adaption supports, inclusive of mental health treatment, to strengthen resilience activation.

Long-term psychological impact of the pandemic COVID-19: Identification of high-risk groups and assessment of precautionary measures five months after the first wave of restrictions was lifted

Critical facets of our lives have been disrupted by the COVID-19 outbreak for almost three years. During this time, there has been a lot of clinical and research interest in issues related to mental health. However, few have examined the pandemic's long-term psychological effects. The aims of the present study were to assess the long-term psychological impact of the pandemic COVID -19, five months after the first wave restriction measures were lifted, to identify high-risk groups and to address the use of precautionary measures (PM). Information about sociodemographic characteristics, mental health, coping mechanisms, and compliance with precautionary measures (PM) were all gathered in Cyprus through an anonymous online survey. The poll was completed by 1128 people (73% of whom were female). For the purposes of the present study, descriptive statistics and structural equation modeling were used. 32.3% of participants experienced moderate-to-severe anxiety symptoms, where 16.4% and 23% reported moderate-to-severe depression and post-traumatic stress symptoms respectively. Lower levels of anxiety, depression, and post-traumatic stress symptoms as well as greater compliance to PM were linked to higher levels of resilience. Additionally, subgroups of participants, at a higher risk for negative psychological effects were identified, such as women and young adults. Our findings demonstrate the long-lasting effects of the COVID-19 pandemic on mental health and provide guidance on how to deal with similar situations. It also raises questions about the concurrent effects on people with the long COVID syndrome.

The mediating effect of resilience and COVID-19 anxiety on the relationship between social support and insomnia among healthcare workers: a cross-sectional study

Background

Insomnia in healthcare workers has become a topic of concern in the health system. The high infectivity and longevity of the COVID-19 pandemic have resulted in great pressure and a high incidence of insomnia among healthcare workers. Insomnia among healthcare workers has a negative impact on high-quality healthcare services in addition to their health. Thus, it's necessary to explore insomnia's underlying mechanisms.

Object

The present research's aims were threefold: explored the association between social support, resilience, COVID-19 anxiety, and insomnia among healthcare workers during the pandemic, elucidated the underlying mechanism of insomnia, and offered recommendations for improving the health of these workers.

Materials and methods

A cross-sectional design was adopted. From May 20 to 30, 2022, 1038 healthcare workers were selected to fill out the Oslo 3-item Social Support Scale, the eight-item Athens Insomnia Scale, the Coronavirus Anxiety Scale, and the Brief Resilience Scale. Descriptive statistics and correlations were analyzed by SPSS 25.0. Mediation analysis was conducted by Mplus 8.3 using 5000 bootstrap samples.

Results

Of the participating 1038 healthcare workers, the prevalence of insomnia was 41.62% (432/1038). Significant associations were found involving insomnia, resilience, COVID-19 anxiety, and social support. Insomnia was directly affected by social support. Moreover, three indirect pathways explain how social support affected insomnia: resilience's mediating role, COVID-19 anxiety's mediating role, and the chain-mediation role of resilience and COVID-19 anxiety.

Conclusion

The results validated our hypotheses and supported the opinion of Spielman et al. 's three-factor model of insomnia. Social support of healthcare workers has an indirect impact on insomnia in addition to its direct one via independent and chain-mediation effects of resilience and COVID-19 anxiety.

The impact of the pandemic on mothers and children, with a focus on syndemic effects on black families: the "Prenatal to Preschool" study protocol

Introduction

Racism, a known social determinant of health, affects the mental health and well-being of pregnant and postpartum women and their children. Convincing evidence highlights the urgent need to better identify the mechanisms and the ways in which young children's development and mental health are adversely impacted by their mothers' experiences of racism. With the additional stressor of the COVID-19 pandemic, the criticality of improving knowledge of these domains has never been starker. The proposed project will address these questions and move the field forward to create targeted, culturally informed preventative interventions, thus achieving mental health equity for all children and families.

Methods

This prospective research is a cohort study that will longitudinally observe the outcomes of a cohort of mothers and their children recruited during the initial phase of the COVID-19 pandemic. Data will be parent/caregiver questionnaires assessing mental health, racism, support, and resilience at multiple time points with the first beginning at 24 months, clinical interviews with mothers, electronic medical records of mothers, and videotaped dyadic interactions at child age 24 and 48 months. A subset of Black participants will be asked to participate in qualitative interviews at child age 36 months.

Results

Analyze will be performed within and across Black and Non-Latino/a/e/x white (NLW) groups, and comparing mothers and fathers/secondary caregivers. Descriptive and multivariate analyzes will be run to better characterize how young children's development and mental health may be adversely impacted by their caregiver's experiences of racism.

Discussion

This prospective longitudinal mixed-methods study evaluates the simultaneous effects of the COVID-19 pandemic and racism on mothers and their developing children to characterize cross-racial differences, providing insight into risk and resilience factors in early development and the peripartum period.

Assessment of psychological distress as a function of positive psychological variables during the COVID-19 pandemic: A university longitudinal study

Objective: To examine changes in psychological distress of college students as a function of demographic and psychological variables over time during the COVID-19 pandemic. Participants: Subjects were recruited from a large public university in Northeast Ohio using electronic surveys administered at three time points in 2020. Methods: Demographics, positive psychological metrics (flourishing, perceived social support, and resilience) and psychological distress were collected and a mixed linear model was run to estimate their effect on change in distress. Results: Psychological distress did not change significantly across time. Females experienced more psychological distress than males. Higher levels of flourishing, perceived social support, and resilience were associated with less distress overall. Conclusions: Although psychological distress did not change across observed time, previous data suggests heightened psychological distress that remained elevated across observed time during the COVID-19 pandemic. Positive psychological variables were shown to mitigate psychological distress, and the relationship was stable over time.

A Survey of Fear for Others, Fear for Self, and Pandemic Anxiety Predicting Intention to Take the First Booster Vaccine to Combat COVID-19

This study examined the impact of fear and anxiety on the intent to take the first COVID-19 booster vaccine. The objective of this study is to provide guidance for messaging campaigns of public health practitioners. A survey approach provided insights about individuals' emotions of fear and anxiety related to adopting the first booster vaccine for the Coronavirus disease 2019 (COVID-19).

METHODS

Three independent variables were considered in their ability to predict the intent to take the first COVID-19 booster vaccine (BINT): Fear for Others (FOTH), Fear for SELF (FSELF), and COVID-19 Anxiety (CANX).

RESULTS

The confirmatory factor analysis supported an underlying three-factor solution for three central emotions in this study. A path analysis indicated significant direct effects for FOTH and FSELF in the prediction of BINT. The interdependent nature of these variables on the intent to get the first booster vaccine also was indicated by significant indirect effects.

DISCUSSION

Fear should be more precisely refined to include the fear for others (FOTH) beyond consideration of the fear for self (FSELF) from the impact of COVID-19.

CONCLUSIONS

FOTH and FSELF were demonstrated to be direct predictors of BINT. CANX was only found to be significant as part of indirect effects impacting BINT. Future investigation should be given to the mediating role of anxiety with FOTH and FSELF as the context changes.

Stress, resilience, and moral distress among health care providers in oncology during the COVID-19 pandemic

Background

The coronavirus pandemic has potential implications for stress levels and resilience among oncology healthcare professionals (HCPs). This study aims to assess perceived stress, resilience, and moral distress levels among oncology HCPs in Jordan during the pandemic and identify associated risk factors.

Methods

An online cross-sectional survey was conducted among oncology HCPs in Jordan using three validated tools: Perceived Stress Scale (PSS), Connor-Davidson Resilience Scale (CD-RSIC), and Moral Distress Thermometer (MDT). Seven items were used to assess sources of stress.

Results

A total of 965 participants enrolled with a 74% response rate. The participants' ages ranged from 20 to 74 (mean = 32.74, SD = 5.197), with 79.1% males, 45.1% were physicians, 32.6% were public hospital workers, 57.1% were married, and 56.6% had children below 18 years. Findings indicated moderate perceived stress (Mean = 15.87, SD = 5.861), low resilience (Mean = 29.18, SD = 5.197), and high moral distress (Mean = 4.72, SD = 2.564). Females, unmarried individuals, and younger age groups exhibited higher PSS (p = 0.009, p < 0.001, and P<0.001) and lower resilience (p = 0.024, p = 0.034, and p = 0.001). Not having children below 18 years correlated with higher perceived stress (P < 0.001). In linear regression analysis, age and gender emerged as significant predictors of both perceived stress and resilience. Female participants reported stress related to the risk of contracting COVID-19 (p = 0.001), transmitting it to others (p = 0.017), social isolation (P < 0.001), and having children at home due to school closures (p = 0.000). A cohort of 239 participants repeated the survey within a two-month interval, revealed a statistically significant decrease in the CD-RISC scores (p < 0.001).

Conclusion

Oncology HCPs in Jordan experienced moderate stress, high moral distress, and poor resilience during the COVID-19 pandemic. These factors may negatively affect the quality of oncology care. Urgent measures are necessary to support HCPs in coping with unforeseen circumstances in the future.

Nightmare distress, insomnia and resilience of nursing staff in the post-pandemic era

Introduction

The pandemic has led to notable psychological challenges among healthcare professionals, including nurses.

Objective

Our aims of this study were to assess insomnia and nightmare distress levels in nurses and investigate their association with mental resilience.

Methods

Nurses participated in an online survey, which included the Nightmare Distress Questionnaire (NDQ), Brief Resilience Scale (BRS) and Athens Insomnia Scale (AIS). Demographic information, such as age, professional experience and gender, was also collected.

Results

The study included 355 female and 78 male nurses. Findings revealed that 61.4% had abnormal AIS scores, 7% had abnormal NDQ scores and 25.4% had low BRS scores. Female nurses had higher AIS and NDQ scores but lower BRS scores compared to males. BRS demonstrated negative correlations with both AIS and NDQ. Multiple regression analysis indicated that NDQ accounted for 24% of the AIS variance, with an additional 6.5% explained by the BRS. BRS acted as a mediator, attenuating the impact of nightmares on insomnia, with gender moderating this relationship.

Conclusions

Nursing staff experienced heightened sleep disturbances during the pandemic, with nightmares and insomnia being prevalent. Nightmares significantly contributed to insomnia, but mental resilience played a vital role in mitigating this effect. Strategies are warranted to address the pandemic's psychological impact on nursing professionals.

Exploring the lived experiences of participants and facilitators of an online mindfulness program during COVID-19: a phenomenological study

The coronavirus pandemic (COVID-19) has placed incredible demands on healthcare workers (HCWs) and adversely impacted their well-being. Throughout the pandemic, organizations have sought to implement brief and flexible mental health interventions to better support employees. Few studies have explored HCWs' lived experiences of participating in brief, online mindfulness programming during the pandemic using qualitative methodologies. To address this gap, we conducted semi-structured interviews with HCWs and program facilitators (n = 13) who participated in an online, four-week, mindfulness-based intervention program. The goals of this study were to: (1) understand how participants experienced work during the pandemic; (2) understand how the rapid switch to online life impacted program delivery and how participants experienced the mindfulness program; and (3) describe the role of the mindfulness program in supporting participants' mental health and well-being. We utilized interpretive phenomenological analysis (IPA) to elucidate participants' and facilitators' rich and meaningful lived experiences and identified patterns of experiences through a cross-case analysis. This resulted in four main themes: (1) changing environments; (2) snowball of emotions; (3) connection and disconnection; and (4) striving for resilience. Findings from this study highlight strategies for organizations to create and support wellness programs for HCWs in times of public health crises. These include improving social connection in virtual care settings, providing professional development and technology training for HCWs to adapt to rapid environmental changes, and recognizing the difference between emotions and emotional states in HCWs involved in mindfulness-based programs.

Can Resilience Buffer the Effects of Loneliness on Mental Distress Among Working-Age Adults in the United States During the COVID-19 Pandemic? A Latent Moderated Structural Modeling Analysis

BACKGROUND

The profound health consequences of loneliness are well-established. However, less is known about the protective factors which may alleviate the effects of loneliness on mental health especially among working-age adults amidst the COVID-19 pandemic. We draw on the social ecology of resilience and examine whether resilience factors can buffer the effects of loneliness on mental distress.

METHODS

Data came from the National Well-being Survey-a national study of a demographically representative sample of U.S. working-age adults (N = 4014). We used (a) structural equation models with latent variables to examine the main effects of loneliness, psychological resilience, and perceived social support on mental distress, and (b) latent moderated structural equations to estimate the latent interaction effects.

RESULTS

Results revealed that (a) loneliness was positively associated with mental distress and psychological resilience was negatively related to mental distress, and (b) psychological resilience and perceived social support moderated the strength of the relationship between loneliness and mental distress.

CONCLUSIONS

Our study highlights the importance of psychological resilience and perceived social support as two protective factors in the relationship between loneliness and mental distress. Given that loneliness significantly predicts worse mental and physical health and higher mortality, identifying protective factors that might disrupt these connections is vital. As such, public health efforts to strengthen and expand familial and community social support networks and foster psychological resilience are urgently needed to support mental health among working-age adults during additional waves of the pandemic or future similar stressors.

Social and Psychological Effects of COVID-19 Pandemic on Adolescents' and Young Adults' Mental Health: A Cross-Cultural Mediation Study

The ongoing pandemic has dramatically disrupted daily life, increasing the risk of developing psychiatric disorders and poor mental wellbeing. The compound effects of social, political and psychological stressors have increased psychological symptoms among adolescents and young people, with worries about COVID-19 playing a central role in the clinical course of their mental health problems caused by the pandemic. The aim of this cross-cultural study was to examine the social psychological effects of COVID-19 on adolescents' and young people's mental health and wellbeing in Ibero-American population. Participants involved 6,283 adolescents and young adults from five different Spanish-Speaking countries (83.7% female) aged between 12 and 30 years (M = 18.79; SD = 3.48). Participants completed the Worries about COVID-19 and its Consequences Scale (W-COV), the Satisfaction with Life Scale (SWLS), and the Depression, Anxiety and Stress Scale (DASS-21). Descriptive analyses, multivariate ANOVAs and Pearson correlations were performed, as well as Structural Equation Modelling (SEM) testing a mediational model. The results indicate cross-cultural difference in COVID-19 related worries, emotional symptoms and life satisfaction. Results from SEM confirmed the overall indirect effects of COVID-19 cases, political response and participants' conditions during lockdown on depression, anxiety, stress and life satisfaction mediated by COVID-19 related worries. These findings suggest that the social psychological factors underlying psychological symptoms could be partly explained by increased worries about COVID-19 and its personal, social, economic and political consequences, which may offer guidance to policy makers and health services for safeguarding youth mental well-being.

Association between individual resilience and depression or anxiety among general adult population during COVID-19: a systematic review

BACKGROUND

The coronavirus disease (COVID-19) pandemic exacerbated depression and anxiety worldwide. Resilience is important to maintain mental health during uncertain times, but limited study has systematically reviewed its association with depression or anxiety with an emphasis on the general population.

METHODS

We searched PubMed and Embase for quantitative or mixed-methods studies on the general adult population published between 1 January 2020 and 31 April 2022 (PROSPERO ID: CRD 42022340935). National Institute of the Health quality assessment tools was used to assess the risk of bias. We qualitatively synthesized findings by outcome and study design.

RESULTS

A total of 2945 studies were screened and 35 studies were included in the narrative analysis (5 on depression, 9 on anxiety, and 21 on both). Overall, 21 studies identified statistically significant inverse associations between resilience and depression, while 24 studies found statistically significant inverse associations between resilience and anxiety. Eight studies reported no statistically significant relationships between resilience with depression or anxiety.

CONCLUSIONS

Resilience was found to be inversely associated with depression and anxiety during the COVID-19 pandemic. The findings highlight the importance of resilience-enhancing intervention in migrating the global mental health burden from outbreaks of infectious diseases.

The Influence of Pandemic-Related Worries During Pregnancy on Child Development at 12 Months

The COVID-19 pandemic has been linked to increased risk for perinatal anxiety and depression among parents, as well as negative consequences for child development. Less is known about how worries arising from the pandemic during pregnancy are related to later child development, nor if resilience factors buffer negative consequences. The current study addresses this question in a prospective longitudinal design. Data was collected from a sub-study (n = 184) of a longitudinal study of pregnant individuals (total n = 1173). During pregnancy (April 17-July 8, 2020) and the early postpartum period (August 11, 2020-March 2, 2021), participants completed online surveys. At 12 months postpartum (June 17, 2021-March 23, 2022), participants completed online surveys and a virtual laboratory visit, which included parent-child interaction tasks. We found more pregnancy-specific pandemic worries were prospectively related to lower levels of child socioemotional development based on parent report (B = - 1.13, SE = .43, p = .007) and observer ratings (B = - 0.13, SE = .07, p = .045), but not to parent-reported general developmental milestones. Parental emotion regulation in the early postpartum period moderated the association between pregnancy-specific pandemic worries and child socioemotional development such that pregnancy-specific pandemic worries did not relate to worse child socioemotional development among parents with high (B = - .02, SE = .10, t = - .14, p = .89) levels of emotion regulation. Findings suggest the negative consequences of parental worry and distress during pregnancy on the early socioemotional development of children in the context of the COVID-19 pandemic. Results highlight that parental emotion regulation may represent a target for intervention to promote parental resilience and support optimized child development.

Factors associated with the intensity of anxiety and depression symptoms in health workers of two centres of reference for COVID 19 patient care in Antioquia, Colombia - A latent class analysis

OBJECTIVE

To classify the staff of two reference institutions for COVID-19 care in Antioquia according to the intensity of anxiety and depression symptoms, and to determine the factors associated with these classes.

METHODS

Cross-sectional study in which the GAD-7, PHQ-9, fear of COVID-19, and the Copenhagen Burnout scale were used. Latent class analysis was performed to identify the classes, and the factors associated with these were determined using multinomial logistic regression.

RESULTS

486 people participated. The three-class model had the best fit: class I with low scores on the scales; class II with mild degrees of anxiety and depression, and intermediate levels of fear of COVID-19 and perceived stress; and class III with moderate and severe degrees of anxiety, depression, and perceived stress. The factors associated with belonging to class III were age (OR = 0.94; 95%CI, 0.91-0.96), change of residence to avoid exposing relatives (OR = 4.01; 95%CI, 1.99-8.09), and a history of depressive disorder (OR = 3.10; 95%CI, 1.27-7.56), and anxiety (OR = 5.5; 95%CI, 2.36-12.90). Factors associated with class II were age (OR = 0.97; 95%CI, 0.95-0.99), history of depressive disorder (OR = 3.41; 95%CI, 1.60-7.25), living with someone at risk of death from COVID-19 (OR = 1.86; 95%CI, 1.19-2.91), family member being healthcare staff (OR = 1.58; 95%CI, 1.01-2.47), and change of residence to avoid exposing relatives (OR = 1.99; 95%CI, 1.11-3.59).

CONCLUSIONS

Three classes of participants were obtained, two of them with anxiety and depression symptoms. Younger age and a history of mental disorder were factors associated with the two classes of symptomatic patients; other factors may be causes or consequences of the symptoms.

The Influence of Multiple Community Level Traumatic Event Types on Mental Health Outcomes

Lebanon witnessed three large-scale negative community level events in 2020; a severe economic crisis, the COVID-19 pandemic, and an explosion in the port of the capital city, Beirut, which resulted in the deaths of 218 individuals and several thousand injured. The current study examined the relationship between the number of community level events individuals identified as personally impactful and corresponding levels of anxiety, depression, and symptoms of PTSD. The study also examined the roles of specific protective factors including perceived social support, resilience, and religious coping. A total of 406 participants aged between 18 to 64 years completed validated self-report measures online in February 2021. Results indicated elevated levels of mental health difficulties within the sample with over half of the participants reporting moderate to severe anxiety and moderate to severe depression and meeting the cut-off for probable PTSD. Females had significantly higher scores on measures of depression, anxiety, and PTSD. Individuals reporting all three events as negatively impactful were 47% more likely to meet the cut-off for PTSD than individuals identifying a single event. Resilience appeared to be the strongest protective factor against elevated scores on all three mental health outcomes. Higher scores on negative religious coping were also associated with elevated PTSD scores. Low levels of resilience, higher negative religious coping, and being a female were identified as significant predictors of reaching the PTSD cut-off using binary logistic regression analysis.

Psychological Predictors of COVID-19-Related Anxiety in Vulnerable Groups

This study responds to the need to explore psychological predictors of COVID-19-related anxiety in vulnerable groups. An anonymous voluntary online survey was conducted (n = 520) with (a) working parents with young children (0-12 y.o.), (b) people with chronic physical conditions, (c) people with multiple vulnerability characteristics and (d) a control group (no self-reported vulnerability) in 2022. Findings showed that perceived stress of the parents and trait anxiety of the chronic sufferers were single weak positive predictors of COVID-19 anxiety. However, both psychological factors had a stronger effect on the pandemic-related anxiety for the group with multiple vulnerabilities. In the control group, trait resilience and optimistic expectations (combined with perceived stress) were moderate negative predictors of COVID-19 anxiety. The findings emphasize the importance of perceptions, expectations, trait anxiety as well as the need for intersectional research of vulnerability from multiple perspectives. Furthermore, they highlight the necessity of group-specific policies and interventions aimed both at handling the negative psychological tendencies of the vulnerable groups and at strengthening the positive tendencies of non-vulnerable groups, rather than tackling only emergent anxiety conditions in crisis times.

COVID-19 Impacts on Pennsylvania Coordinated Specialty Care for Early Psychosis Participants

OBJECTIVES

The coronavirus disease (COVID-19) pandemic produced swift, extensive changes in daily life, including for first-episode psychosis (FEP) clients. This study examined pandemic-related psychosocial impacts to clients while engaged in Coordinated Specialty Care (CSC). We also examined FEP client vaccination rates, as vaccinations can reduce hospitalizations/deaths, and related worries.

METHODS

Thirty-one clients (45% female; ages 13-39; 26% black, 61% white) from Pennsylvania (PA) CSC outpatient programs completed an online survey evaluating exposure to COVID-19, associated worries, coping, and safety strategies. Descriptive statistics characterized responses and demographic group differences. Additional program evaluation data informed vaccination rates for PA FEP clients.

RESULTS

Participants reported substantial pandemic-related impacts to daily life. Many clients reported improved safety measures to protect themselves/others from COVID-19. Clients largely denied substantial worries about infection for themselves, reporting greater concern for loved ones. Multiple coping strategies were endorsed, which, with few exceptions, did not differ among demographic groups. FEP clients had a low reported rate of vaccination (28.6%) as of September 2021.

CONCLUSIONS

Observed prolonged pandemic effects may alter FEP client progress in CSC. Stakeholders should be prepared to adjust FEP treatment accordingly in the event of a similar disaster. Concentrated vaccination efforts may be necessary for this population.

Love under lockdown: How changes in time with partner impacted stress and relationship outcomes during the COVID-19 pandemic

With the onset of COVID-19, governments around much of the world implemented strict social distancing and stay-at-home orders that profoundly affected the amount of time many couples were spending together. In the present research, we examined whether perceptions of a change in time spent with a partner were associated with stress, and whether stress levels in turn predicted relationship commitment and satisfaction, both in the short term (Time 1) and longer term (Time 2; i.e., after 10 months). Results indicated partial mediation, such that less (vs. more) time spent with the partner was associated with greater stress at Time 1, which in turn partly accounted for lower commitment and relationship satisfaction both at Time 1, and satisfaction at Time 2. Less (vs. more) time spent with partner at Time 1 also predicted a greater likelihood of relationship dissolution at Time 2, again partially mediated by stress. An increase in quality time spent together at Time 2 predicted stress and relationship outcomes over and above the change in time spent together more generally. This research has important implications for understanding the ongoing effects of the pandemic on romantic relationships. In addition, this study provides new evidence regarding how changes in time spent with a partner are associated with stress and subsequent relationship outcomes.

Self-care behaviors, drinking, and smoking to cope with psychological distress during COVID-19 among Chinese college students: the role of resilience

OBJECTIVE

College students are vulnerable to psychological distress during COVID-19 due to pandemic-related stressors. In response to psychological distress, college students engage in various coping behaviors, such as self-care behaviors and substance use. The transactional model of stress and coping depicts a cognitive appraisal process in the stress-coping association. Psychological resilience is an essential factor for the cognitive appraisal. This study aimed to investigate the mediation effects of resilience on psycho-behavioral health in response to COVID-19 stressors.

DESIGN

Longitudinal data were collected from 1,225 Chinese college students via web-based anonymous surveys at wave 1 (T1, between Jan 31 and Feb 11, 2020) and wave 2 (T2, between Mar 20 and Apr 3, 2020).

MAIN OUTCOME MEASURES

Participants reported their COVID-19 stressors (T1), resilience (T1), psychological distress (depression and anxiety; T2), and coping behaviors (self-care behaviors, drinking, and smoking; T2). Path analysis was used for data analyses.

RESULTS

Resilience mediated the association between COVID-19 stressors and psychological distress. Resilience together with psychological distress mediated the association of COVID-19 stressors with self-care behaviors or drinking.

CONCLUSIONS

Resilience appears to offer protection that promotes psycho-behavioral health in college students in the face of COVID-19 stressors. Interventions for college students should attend to resilience.

Unleashing the link between the relaxation of the COVID-19 control policy and residents' mental health in China: the mediating role of family tourism consumption

Objective

COVID-19 has negatively influenced industrial development, family consumption, and residents' mental health. Unfortunately, it has not yet been studied whether this adverse situation can be alleviated after the relaxation of the COVID-19 control policy (RCC). Therefore, this study aimed to analyze the effect of the RCC on the resident's mental health and the mediating effect of family tourism consumption.

Methods

By using the PSM and mediating effetc model to research the panel data of two periods (April 2021 and April 2023) for Shaanxi province, China.

Results

The RCC negatively inhibited the mental health severity of residents, and the mental health severity decreased by 0.602. In particular, the RCC showed the most substantial negative effect on residents' stress, followed by anxiety and depression. Meanwhile, it is found that the impact of the RCC on the mental health of residents is highly heterogeneous. The RCC indicates a linear significant effect on the mental health of residents under 60 years of age, while the results were found insignificant for residents above 60 years of age. Meanwhile, the RCC's improvement effect on urban residents' mental health is greater than that of rural residents. In addition, mechanism analysis showed that tourism consumption plays a mediating role in the influence of the RCC on the mental health of residents, and the mediating effect accounted for 24.58% of the total effect.

Conclusion

Based on the findings, the study proposes that government and policymakers should strengthen mental health intervention, improve access to mental health counseling, stimulate economic development, expand the employment of residents, and track the mutation of the novel coronavirus.

The Relationship Between Fear of COVID-19 and Psychological Distress in Tour Guides: The Mediating Role of Job Insecurity and the Moderating Role of Psychological Resilience

Purpose

The COVID-19 has greatly affected the tourism industry in China, leading to an increase in psychological distress among tour guides. This study explores the mechanisms by which tour guides' fear of the COVID-19 affects psychological distress, using job insecurity as a mediating variable and psychological resilience as a moderating variable.

Patients and Methods

From August 11 to 30, 2022, 447 Chinese tour guides were invited online to fill in a questionnaire, and SPSS and Mplus tools were used for statistical analysis and hypothesis testing to conduct an empirical analysis of the relationship between COVID-19 fear and psychological distress.

Results

A total of 417 questionnaires (effective rate was 93.3%) were collected, among which female (n = 243) and male (41.7%) (n =174). The age concentration of participants was 46.5% between 26 and 35 years old, 9.1% under 25 years old, and 9.8% over 46 years old. Guides' fear of COVID-19 positively and significantly influenced psychological distress (β= 0.3051), and the relationship between fear of COVID-19 and psychological distress was mediated by job insecurity (β=0.196, 95% CI = 0.141, 0.255). In addition, psychological resilience significantly moderated the pathway from fear of COVID-19 to job insecurity and from fear of COVID-19 to guided psychological distress (β= 0.1371; β=0.116).

Conclusion

The diversion of fear of COVID-19 and job insecurity can alleviate the psychological distress of tour guides; strengthening their own psychological construction also helps to alleviate the effects of fear of COVID-19 on job insecurity and psychological distress. The findings of the study can provide theoretical support for the prevention and counseling of psychological problems of tourism employees in public health crises.

The Covid-19 pandemic had polarizing effects on trait scores depending on a person's resilience and predispositions: A longitudinal prospective study

While Covid-19 is, first and foremost, a pernicious physical illness, its highly contagious nature has led to significant disruption in social life and psychological stress, occasionally resulting in dire mental health consequences that are still not fully understood. To address this issue, a prospective longitudinal design study was conducted by administering standard self-reporting questionnaires covering the NEO-five factor inventory (NEO-FFI), shyness, alexithymia, autism quotient, anxiety, depression, and sensory processing sensitivity (SPS). A total of 114 participants (of which 71.93% were females) with an average age of 30.29 (standard deviation = 11.04) completed the survey before and a few months after the pandemic. Results revealed the distribution of population scores to become more extreme in either positive or negative trait directions despite the stability of average trait scores across the population. Higher resilience was found to be positively correlated with improved trait scores post-pandemic but corona anxiety score was not correlated with trait score changes. In addition, in the subjects with moderate negative trait scores, agreeableness and autism scores and in subjects with high negative trait scores, openness, SPS and shyness scores were significantly correlated with trait scores changes post-pandemic. These results reveal the nuanced effects of the pandemic on the people's psychological well-being and highlight vulnerabilities for certain groups despite the overall stability of population that needs to be taken into account for mental health policies going forward.

Predictors of resilience for people with spinal cord injury over two periods of COVID-19 social distancing restrictions: a 12-month longitudinal study using structural equation modelling

BACKGROUND

The novel coronavirus (COVID-19) pandemic is disproportionately impacting the health of people with disability. Resilience has remained an important health promoting characteristic during periods of social distancing restrictions. Factors promoting resilience for people with disability under the context of the pandemic remains poorly understood. Studies have yet to investigate evidence-based factors that promote resilience over multiple periods of restrictions for people with disability.

METHODS

A longitudinal study developed via a collaborative partnership between peer-support workers with lived experience of spinal cord injury (SCI) and university researchers was undertaken to fill knowledge gaps around factors promoting resilience for people with SCI during two periods of stringent social distancing restrictions within Victoria, Australia. Over 12-months, participants with SCI completed two surveys, towards the end of two lockdown periods. Evidence-based factors associated with resilience were measured. The Impact on Participation and Autonomy Questionnaire, the International SCI Quality of Life scale, and the 10-item Conor Davidson Resilience Scale, respectively measured autonomy and participation limitations, life satisfaction and psychological health, and resilience. A structural equation modelling (SEM) approach established factors directly and indirectly associated with resilience.

RESULTS

A model with excellent fit was produced. During two extended lockdowns over the 12-month period, increased family role limitations and favourable psychological health were respectively, negatively (Lockdown 1 [n = 127]: β = -.251, p < .01, Lockdown 2: β = -.400, p < .01) and positively (Lockdown 1: β = .601, p < .01, Lockdown 2 [n = 65]: β = .430, p < .01) associated with resilience. Indirect negative associations between resilience and increased outdoor autonomy limitations (Lockdown 1: β = -.195, p < .01, Lockdown 2: β = -.255, p < .01) and social life limitations (Lockdown 1: β = -.217, p < .01, Lockdown 2: β = -.142, p < .05) existed, and these relationships were moderated by psychological health.

CONCLUSIONS

Psychological health, and participation and autonomy are determinants of resilience during periods of crisis. Health and social care providers and public health departments should prioritise programs promoting these domains, to counter the negative impact of social distancing.