Coping and health behaviours in times of global health crises: Lessons from SARS and West Nile

Evaluating the relationship of empathic concern to college students' responses to the COVID-19 pandemic

Objective: Empathic concern (EC) for others may be related to COVID-19 pandemic responses. Participants and methods: The purpose of this survey study was to examine differences in pandemic responses in 1,778 college students rated as low (LE) versus high (HE) on the EC subscale of the Interpersonal Reactivity Index. Results: HE participants reported greater concerns in numerous pandemic-related domains, including acquiring COVID-19; access to COVID-19 treatment; number of COVID-19 cases, hospitalizations, and deaths reported; staying employed; and being isolated for long periods of time. Generalized anxiety symptoms, depressive symptoms, and perceived stress scores were significantly higher for individuals in the HE group compared to the LE group. The HE group reported being significantly more adherent to health and safety recommendations than the LE group. Conclusions: Empathic concern for others is important for promoting college student prosocial behavior but is associated with anxiety and depression symptomatology during times of traumatic stress.

Cognitive and emotional factors related to COVID-19 among high-risk ethnically diverse adults at the onset of the New York City outbreak: A cross-sectional survey

A cross-sectional survey was conducted among high-risk, racially/ethnically diverse adults at the point in time when New York City (NYC) became the COVID-19 pandemic's global epicenter. The study objective was to assess the threat and coping appraisals (cognitive factors known to correspond with people's willingness to adopt behaviorally focused interventions) and levels of distress, anxiety, and intolerance for uncertainty (emotional factors). Survey respondents were recruited in April 2020 using an online survey with unpaid recruitment on the GetHealthyHeights.org community-oriented website. We also recruited participants that engaged in previous research studies to gain survey responses from community members at higher risk for COVID-19 complications due to comorbidities compared to the general population. Analysis was performed to test for differences in survey responses by comorbidities, age, race, ethnicity, and employment status. Results show that the devastating effects of the pandemic appear to have uniquely impacted minority respondents, who reported significantly higher levels of anxiety and were significantly more likely to report having little control over whether they will get COVID-19 compared with White/non-Hispanic respondents. Minority respondents also had significantly higher mean scores on the behaviorally focused dimension of the intolerance of uncertainty (IU) scale, which measures avoidance and paralysis in the face of uncertainty. In multivariate analysis, IU predicted anxiety levels, and this association was not mediated by cognitive factors (threat and coping appraisals). By conducting this survey early in the pandemic, our study uniquely evaluated cognitive and emotional factors among a racially/ethnically diverse group of NYC residents during the height of the COVID-19 pandemic. Our findings suggest the need to acknowledge the disparities that appear to exist in pandemic response and for culturally tailored messaging and interventions. Few studies have reported differences by race and ethnicity during pandemic exposure. Therefore, further research on factors that may influence pandemic response among minority populations is needed.

Factors Affecting Preventive Behaviors for Safety and Health at Work during the COVID-19 Pandemic among Thai Construction Workers

Occupational health and safety risks are of major concerns in construction industry. The COVID-19 outbreak provides an additional risk that could drastically affect the safety risks and health of construction workers. Understanding the factors that affect the health and safety of construction workers is significant in reducing risky behaviors and enhancing worker preventive behaviors. Via integrating the Protection Motivation Theory (PMT) and the extended Theory of Planned Behavior (TPB), this study investigates the factors that affect preventive behaviors among construction workers during the COVID-19 pandemic in Bangkok, Thailand. A total of 610 Thai construction workers participated in an online questionnaire survey, which consisted of nine factors with 43 questions. Structure equation modeling (SEM) was adopted to analyze the causal relationships among the latent variable. The SEM results indicated that organizational support and knowledge about COVID-19 had significant (p < 0.0001) direct influences on perceived vulnerability and perceived severity. In addition, perceived vulnerability and perceived severity had significant direct influences on perceived behavioral control. Perceived severity had significant (p < 0.0001) direct influence on attitude towards behavior. Moreover, perceived behavioral control and attitude towards behavior had significant (p < 0.0001) direct influence on intention to follow the preventive measure. Furthermore, the intention to follow the preventive measure had significant (p < 0.0001) direct influences on the COVID-19 preventive behavior. Of note, organizational support and knowledge about COVID-19 had significant (p < 0.0001) indirect influence on COVID-19 preventive behavior. The findings of this study may assist project managers/supervisors and authorities in the construction industry in understanding the challenge during COVID-19 and possible similar epidemics in the future. In addition, conducting effective strategies would improve construction industry safety and promote preventive behaviors among construction workers.

Perceived threat and coping responses during the COVID-19 pandemic: Prospective associations with vaccine hesitancy

BACKGROUND

The COVID-19 pandemic has brought to light the importance of identifying factors associated with vaccine hesitancy. Disease threat and coping responses are central to health behavior engagement and present potential alterable targets for intervention.

PURPOSE

To examine the roles of perceived threat of COVID-19 and coping in vaccine hesitancy, we examined how coping strategies involving approach and avoidance interact with perceived threat of COVID-19 to predict vaccine hesitancy.

METHODS

We used data from 1570 North American participants who reported their vaccine hesitancy as part of a longitudinal study assessing psychosocial responses to the pandemic. We used logistic regression models and mean scores of perceived threat of COVID-19, approach coping, and avoidance coping from prior timepoints to predict vaccine hesitancy in December 2020, when COVID-19 vaccines were first being approved for use in North America.

RESULTS

Low perceived threat of COVID-19 was associated with greater likelihood of being vaccine hesitant. However, approach coping moderated this association, such that people who engaged in more approach coping were less likely to be vaccine hesitant even when they did not feel personally threatened by COVID-19. In contrast, avoidance coping was associated with greater likelihood of vaccine hesitancy regardless of perceived threat of COVID-19.

CONCLUSIONS

Our results illustrate the contributions of approach and avoidance coping to vaccine hesitancy and in doing so, provide preliminary evidence for coping behavior to serve as a target for intervention to reduce vaccine hesitancy.

Prosocial behavior in emergencies: Evidence from blood donors recruitment and retention during the COVID-19 pandemic

The impact of COVID-19 represents a specific challenge for voluntary transfusional systems sustained by the intrinsic motivations of blood donors. In general, health emergencies can stimulate altruistic behaviors. However, in this context, the same prosocial motivations, besides the personal health risks, could foster the adherence to social distancing rules to preserve collective health and, therefore, discourage blood donation activities. In this work, we investigate the consequences of the pandemic shock on the dynamics of new donors exploiting the individual-level longitudinal information contained in administrative data on the Italian region of Tuscany. We compare the change in new donors' recruitment and retention during 2020 with respect to the 2017-2019 period (we observe 9511 individuals), considering donors' and their municipalities of residence characteristics. Our results show an increment of new donors, with higher proportional growth for older donors. Moreover, we demonstrate that the quality of new donors, as proxied by the frequency of subsequent donations, increased with respect to previous years. Finally, we show that changes in extrinsic motivations, such as the possibility of obtaining a free antibody test or overcoming movement restrictions, cannot explain the documented increase in the number of new donors and in their performance. Therefore, our analyses indicate that the Tuscan voluntary blood donation system was effective in dealing with the challenges posed by the COVID-19 pandemic.

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

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

COVID-19 related stigma, empathy and intention for testing in Jordan

Stigmatization of COVID-19 disease has been speculated due to misinformation about the disease, fearing of contracting the infection, absence of available cure, and holding responsibility for infecting others. We aimed to establish the prevalence of COVID-19 related stigma and its association with empathic responding, in addition to exploring predictors of stigma and testing intention among Jordanian people. A quantitative, descriptive and predictive design was used and data were collected using a web-based survey from 1074 adults. Findings showed that participants had high stigmatization against COVID-19 infection. Higher empathic responding (both cognitive and affective), being a female participant, and older age resulted in higher stigmatization. Only stigmatization of COVID-19 negatively predicted individuals’ intention for testing. These findings warrant intensive efforts from the Jordanian government on a local and national level to provide ongoing public education related to several aspects of COVID-19 disease, in order to reduce or prevent the associated stigma and increase people’s intention for testing.

Political ideology and pandemic lifestyles: the indirect effects of empathy, authoritarianism, and threat

Background

In this paper, we integrate theory and research from sociology, psychology, and political science to develop and test a mediation model that helps to explain why political conservatism is often associated with pandemic behaviors and lifestyles that are inconsistent with public health recommendations for COVID-19.

Methods

Using national data from the 2021 Crime, Health, and Politics Survey (n = 1743), we formally test the indirect effects of political conservatism (an index of Republican party identification, conservative political orientation, right-wing news media consumption, and 2020 Trump vote) on pandemic lifestyles (an index of social distancing, hand sanitizing, mask usage, and vaccination) through the mechanisms of empathy (concern about the welfare of others), authoritarian beliefs (authoritarian aggressiveness and acquiescence to authority), and pandemic threat perceptions (threats to self and to the broader society).

Result

Our results confirm that political conservatism is associated with riskier pandemic lifestyles. We also find that this association is partially mediated by lower levels of empathy, higher levels of authoritarian beliefs, and lower levels of perceived pandemic threat.

Conclusions

Understanding why political conservatism is associated with riskier pandemic lifestyles may eventually lead us to ways of identifying and overcoming widespread cultural barriers to critical pandemic responses.

Cross-Sectional Study of Factors Influencing Perceived Threat and Stress among the Arab Minority in Israel during the COVID-19 Pandemic

This study aimed to examine the impact of the locus of control, coping strategies and loneliness on perceived threat and stress among the Arab minority in Israel during the first COVID-19 closure. This was a cross-sectional online study, with 486 participants who completed a questionnaire measuring the study variables during the period of 28-31 March 2020. Statistical analyses included t-tests and analyses of variance. Means, standard deviations and intercorrelations for the study variables were calculated. The results revealed a moderate-low level of stress and a moderate-high level of perceived threat. Higher stress was related to higher perceived threat, a greater external locus of control, lower problem-focused coping, higher emotion-focused coping and social support-seeking and higher loneliness. Perceived threat was positively related to both problem-focused coping and emotion-focused coping. The results show that the Arab population in Israel coped as a strong minority group. This study contributes to our understanding of how minority groups cope in the current epidemic and to the identification of effective strategies for reducing stress during this challenging period. The study's results may help devise intervention programs that foster more effective coping capabilities among this and other minority populations.

Psychotherapists' Reports regarding the Impact of the COVID-19 Pandemic on Their Patients: A Cross-National Descriptive Study Based on the Social-Ecological Model (SEM)

The COVID-19 outbreak has raised questions about how vulnerable groups experience the pandemic. Research that focuses on the view of individuals with pre-existing mental health conditions is still limited, and so are cross-country comparative surveys. We gathered our sample of qualitative data during the first lockdown after governmental measures against the spread of the SARS-CoV-2 virus came into force in Austria, Czechia, Germany, and Slovakia. A total of n = 1690 psychotherapists from four middle European countries answered the question of how the COVID-19 pandemic was addressed in sessions by their patients during the early stage of unprecedented public health conditions. We employed a descriptive qualitative methodology to determine themes following levels of the social-ecological model (SEM) regarding how the COVID-19 pandemic affected patients. At the public policy level, stressful environmental conditions concerned the governmental mitigation efforts. At the level of community/society, reported key themes were employment, restricted access to educational and health facilities, socioeconomic consequences, and the pandemic itself. Key themes at the interpersonal level regarded forced proximity, the possibility of infection of loved ones, childcare, and homeschooling. Key themes at the individual level were the possibility of contracting COVID-19, having to stay at home/isolation, and a changing environment. Within the SEM framework, adaptive and maladaptive responses to these stressors were reported, with more similarities than differences between the countries. A quantification of word stems showed that the maladaptive reactions predominated.

The silver lining behind the dark cloud: Exploring the psycho-social factors impacting successful adaptation during the COVID-19 pandemic

While most studies have been reporting the psychological issues being faced by the public due to the global spread of coronavirus and sudden restrictions and changes accompanying it, the present study attempted to explore dynamic human experiences during the COVID-19 pandemic and resultant lockdown, so as to understand the psycho-social factors that acted as adaptive resources or as buffers to maintain a stable mental state amidst this crisis. In-depth telephonic interviews with 30 participants were conducted to explore their experiences in dealing with the COVID-19 pandemic and the lockdown. Thematic analysis performed to identify the positive and protective factors that helped people adapt in a healthy way revealed that although the initial response of the participants to the pandemic was “optimistic bias” followed by downplaying the seriousness of the issue, later they demonstrated increased realization and acceptance to the seriousness of the situation. Upon realizing the situation, their positive psychological resources acted as a buffer against the ill effects of the pandemic, and they used both cognitive and behavioral coping. The study clearly demonstrates that crisis in life is not just a source of stress, anxiety, and uncertainty but also an opportunity to test one’s psychological resources to learn and grow.

Compliance with Standard Precaution and Its Relationship with Views on Infection Control and Prevention Policy among Chinese University Students during the COVID-19 Pandemic

Background: COVID-19 has placed tremendous pressure on the global public health system and has changed daily life. Aim: To examine the relationships between the perceived threat, perceived stress, coping responses and infection control practices towards the COVID-19 pandemic among university students in China. Methods: Using a cross-sectional survey, 4392 students were recruited from six universities in two regions of China. Methods: Data were collected via an online platform using self-reported questionnaires. Hierarchical multiple regression analyses were performed to predict the variables on COVID-19 infection control practices. Results: Pearson correlation coefficients showed a significant negative relationship between perceived stress and COVID-19 infection control practices. A significant positive relationship was observed between wishful thinking and empathetic responding, and infection control practices. Hierarchical multiple regression analyses revealed that gender, geographical location, perceived stress and emotion-focused and relationship-focused coping responses were predictors of COVID-19 infection control practices. Conclusions: The findings suggest that university students displayed moderate levels of stress, using wishful thinking and empathetic responses as coping strategies. Counselling services should therefore emphasise reassurance and empathy. Male university students tended to be less compliant with social distancing. Both counselling and public health measures should recognise the importance of gender differences. Nurses should integrate these findings into future health programme planning and interventions.

Associations between adolescents' prosocial experiences and mental health during the COVID-19 pandemic

Natural disasters and times of crisis, such as the COVID-19 pandemic, are extremely stressful events, with severe mental health consequences. However, such events also provide opportunities for prosocial support between citizens, which may be related to mental health symptoms and interpersonal needs. We examined adolescents' prosocial experiences as both actors and recipients during the early stages of the COVID-19 pandemic and assessed whether these experiences were associated with indicators of mental health. Adolescents (N = 426; 78% female) aged 13 to 20 years (M age  = 16.43, SD = 1.10; 63.6% White, 12.9% Hispanic/Latinx, 8.5% Asian, 4.2% Black, 2.8% Native American) were recruited across the US in early April of 2020. Participants reported on their COVID-19 prosocial experiences (helping others, receiving help) and mental health (depressive symptoms, anxiety symptoms, burdensomeness, belongingness). Multiple regression models indicated greater engagement in COVID-19 prosocial behavior was associated with greater anxiety symptoms and greater burdensomeness. Receiving more COVID-19 help was associated with lower depressive symptoms and higher belongingness. Findings highlight the importance of furthering our understanding of the nuanced connections between prosocial experiences and adolescents' mental health to help inform post-pandemic recovery and relief efforts.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12144-021-02670-y.

The Effect of Perceived Threat Avoidability of COVID-19 on Coping Strategies and Psychic Anxiety Among Chinese College Students in the Early Stage of COVID-19 Pandemic

BACKGROUND

The novel coronavirus disease 2019 (COVID-19) outbreak has seriously threatened the mental health of college students. This study intended to invest whether perceived threat avoidability of COVID-19 relates to psychic anxiety among college students during the early stage of the COVID-19 pandemic, as well as the mediating roles of COVID-19-specific wishful thinking and COVID-19-specific protective behaviors in this relationship.

METHODS

A cross-sectional study was conducted in China, using a random sampling method (February 6-25, 2020). Self-reported questionnaires were conducted online included the Perceived Threat Avoidability of COVID-19 Scale, COVID-19-specific Wishful Thinking Scale, COVID-19-specific Protective Behaviors Scale, and the Hamilton Psychogenic Anxiety Scale. The data were analyzed using Structural equation modeling and Bootstrapping procedure.

RESULTS

A total of 2922 samples were collected in this study. Perceived threat avoidability of COVID-19 is negatively related to psychic anxiety (β = -0.158, p< 0.001), and both COVID-19-specific wishful thinking (β = -0.006, p = 0.029, 95% CI: [-0.012, -0.001]) and protective behaviors (β = -0.029, p< 0.001, 95% CI: [-0.043, -0.018]) mediate this relationship. Also, COVID-19-specific wishful thinking is found to correlate with COVID-19-specific protective behaviors negatively (β = -0.112, p < 0.001).

CONCLUSION

Perceived threat avoidability of COVID-19 contributes to psychic anxiety among college students. COVID-19-specific wishful thinking strategy plays a negative mediating role and increases the level of anxiety; COVID-19-specific protective behaviors strategy plays a positive mediating role and reduces the level of anxiety; meanwhile, wishful thinking also suppresses college students from adopting protective behaviors.

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

BACKGROUND/OBJECTIVE

This study examined the role of different psychological coping mechanisms in mental and physical health during the initial phases of the COVID-19 crisis with an emphasis on meaning-centered coping.

METHOD

A total of 11,227 people from 30 countries across all continents participated in the study and completed measures of psychological distress (depression, stress, and anxiety), loneliness, well-being, and physical health, together with measures of problem-focused and emotion-focused coping, and a measure called the Meaning-centered Coping Scale (MCCS) that was developed in the present study. Validation analyses of the MCCS were performed in all countries, and data were assessed by multilevel modeling (MLM).

RESULTS

The MCCS showed a robust one-factor structure in 30 countries with good test-retest, concurrent and divergent validity results. MLM analyses showed mixed results regarding emotion and problem-focused coping strategies. However, the MCCS was the strongest positive predictor of physical and mental health among all coping strategies, independently of demographic characteristics and country-level variables.

CONCLUSIONS

The findings suggest that the MCCS is a valid measure to assess meaning-centered coping. The results also call for policies promoting effective coping to mitigate collective suffering during the pandemic.

Risk Perception, Self-efficacy, Lay Theories of Health, and Engagement in Health-Protective Behaviors Among Hospital Pharmacists During the COVID-19 Pandemic

BACKGROUND

Risk perception is an important predictor of health-protective behaviors during pandemics. However, the underlying mechanism connecting risk perception and health-protective behaviors is not well understood. The current study investigates how risk perception predicts hospital pharmacists' engagement in health-protective behaviors during the peak period of COVID-19 pandemic in China and the mediating effects of lay theories of health and self-efficacy.

METHOD

A cross-sectional study on risk perception and engagement in health-protective behaviors was conducted among hospital pharmacists during the COVID-19 pandemic in China. A total of 4121 hospital pharmacists completed the study.

RESULTS

Risk perception, self-efficacy, and lay theories of health were significant predictors of health-protective behaviors among pharmacists. Lay (entity) theories of health and self-efficacy mediated the relationship between risk perception and engagement in health-protective behaviors among hospital pharmacists.

CONCLUSION

Risk perception, self-efficacy, and lay theories (entity versus incremental) of health significantly predicted hospital pharmacists' engagement in health-protective behaviors during the COVID-19 pandemic in China.

Adherence to Recommended Preventive Behaviors During the COVID-19 Pandemic: The Role of Empathy and Perceived Health Threat

Background

Coping via empathic responding may play a role in preventive behavior engagement during the COVID-19 pandemic, and unlike trait empathy, is a potentially alterable target for changing health behavior.

Purpose

Our goal was to examine the role of empathic responding in preventive behavior engagement during the COVID-19 pandemic, independent of trait empathy and perceived threat of COVID-19.

Methods

Participants (N = 2,841) completed a baseline survey early in the pandemic, and a follow-up survey approximately 2 weeks later (M = 13.50 days, SD = 5.61). Preventive health behaviors, including physical distancing and hygiene practices, were assessed at both timepoints. Hierarchical linear regression examined the contributions of trait empathy, perceived threat of COVID-19, and empathic responding at baseline to preventive behaviors at follow-up.

Results

Controlling for baseline levels of preventive behaviors and demographic covariates, trait empathy and threat of COVID-19 at baseline were each independently associated with preventive behaviors at follow-up. An interaction between perceived threat and empathic responding indicated that those perceiving high threat of COVID-19 at baseline tended to report engaging in preventive behaviors at follow-up regardless of their levels of empathic responding, whereas for those reporting low levels of perceived threat, higher levels of empathic responding were associated with higher engagement in preventive behavior.

Conclusions

When perceived threat of COVID-19 was low, higher empathic responding was associated with increased engagement in preventive behaviors regardless of trait empathy, suggesting that empathic responding can serve as an actionable target for intervention to promote preventive behavior during the pandemic.

Are we behaviorally immune to COVID-19 through robots?

In the context of the health risks of the COVID-19 pandemic, tourists' choices have shifted to reflect a subconscious psychological mechanism - the behavioral immune system - that facilitates human organisms to better identify plausible threats to ones' health through environment cues. This research draws upon this theoretical lens to assess tourists' pre-trip hotel evaluation in two 2 × 2 between-subject experiments. Experiment 1 (robot vs. human) tested the service provider's effect on hotel selection evaluation through the mediation of sense of control and the moderation of pandemic risk. Experiment 2 examined this chain of relationship through the moderation of hotel type. This research contributes to the literature by underscoring the pathogen-avoidance mechanism in tourist evaluation and the peril of robotization.

Would Older Adults Perform Preventive Practices in the Post-COVID-19 Era? A Community-Based Cross-Sectional Survey in China

During the post-COVID-19 era, preventive practices, such as washing hands and wearing a mask, remain key measures for controlling the spread of infection for older adults. This study investigated the status of preventive practices among older adults and identified the related influencing factors. Participants who were ≥60 years old were recruited nationwide. Data were collected through self-designed questionnaires, including demographic variables, knowledge, perceived vulnerability, response efficacy, anxiety and preventive practices. Descriptive statistics and chi-square tests were performed. Hierarchical logistic regression was conducted to determine the predictors. A total of 2996 participants completed this study. Of them, 2358 (78.7%) participants reported washing hands regularly in the last two weeks, and 1699 (56.7%) always wore masks outside this year. Knowledge (hand washing: OR = 1.09, p < 0.01; mask wearing: OR = 1.17, p < 0.01) and response efficacy (hand washing: OR = 1.61, p < 0.01; mask wearing: OR = 1.70, p < 0.01) were positively associated with preventive practices, whereas perceived vulnerability had a negative effect (hand washing: OR = 0.54, p < 0.01; mask wearing: OR = 0.72, p < 0.01). Knowledge, response efficacy and perceived vulnerability were found to be significant predictors of the preventive practice among older adults in the post-COVID-19 era. This study provides new insights into preventive suggestions after the peak of the pandemic and also has significant implications in improving the life quality of older adults.

Associations between demographic characteristics, perceived threat, perceived stress, coping responses and adherence to COVID-19 prevention measures among Chinese healthcare students

Aim

To investigate the associations between demographic characteristics, perceived threat, perceived stress, coping responses and adherence to COVID‐19 prevention measures in Chinese Healthcare students.

Design

A cross‐sectional survey collecting data in Hong Kong and Fujian Province of China in April 2020.

Methods

A convenience and snowball sample of 2706 students aged 18 years or older and studying a healthcare programme were recruited in tertiary education institutions/universities in Hong Kong and Putian. The participants completed the questionnaire with six scales: Social Distancing Scale; Personal Hygiene Scale; Empathic Responding Scale; Wishful Thinking Scale; Perceived Stress Scale and Perceived Threat Scale. Path analysis was performed to identify factors associated with the preventive measures outcomes. p value < .05 was considered as statistical significance.

Results

The participants reported high compliances to both social distancing (SoD) and personal hygiene measures (PHM). Confidence to manage the current situation, wishful thinking and empathetic responding directly predicted compliance with SoD and PHM. The final model constructed demonstrated a very good fit to the data.

Conclusion

The findings suggest that students who are male, habituate in Hong Kong, have more clinical experience and weak confidence to manage the threat tend to have lower compliance with the COVID‐19 preventive measures.

Impact

The predictive model constructed is the first one to explore factors associating with the compliance with infection control measures in healthcare students amid the COVID‐19 outbreak. As the infection control behaviours of healthcare students, whom are still under training and are the high‐risk group of being infected and infecting others in the community, are rarely reported in literature, this study has provided empirical evidence to nurses and other healthcare professionals to identify students susceptible to poor compliance and provide early monitoring and education to suppress the COVID‐19 transmission.

Implicit theories of health, consideration of future consequences, and engagement in health protective behaviors during the COVID-19 pandemic in China

This research investigated how implicit theories of health and consideration of future consequences influence people's engagement in health-protective behaviors during the COVID-19 pandemic in China. Three hundred and ninety Chinese completed the study during the peak period of COVID-19 pandemic in China. Gender, education level, implicit theories of health, and consideration of future consequences were significant predictors of people's engagement in health-protective behaviors. Consideration of future consequences mediated the effect of implicit (incremental) theories of health on people's engagement in health-protective behaviors. Implications of the current research for promoting engagement in health-protective behaviors during pandemics of infectious diseases and directions for future research are discussed.

How the Affective Quality of Social Connections May Contribute to Public Health: Prosocial Tendencies Account for the Links Between Positivity Resonance and Behaviors that Reduce the Spread of COVID-19

Although behaviors such as handwashing, mask wearing, and social distancing are known to limit viral spread, early in the COVID-19 pandemic, many individuals in the United States did not adopt them. The positivity resonance theory of co-experienced positive affect (Fredrickson, 2016) holds that shared pleasant states that include the key features of mutual care and a sense of oneness through behavioral synchrony function to build prosocial tendencies (e.g., self-transcendent and other-oriented dispositions of felt unity, empathy, altruism, and general positivity toward humanity). We tested the theory-driven hypothesis that prosocial tendencies are associated with high-quality social connections characterized by the affective state of positivity resonance and, in turn, account for behaviors to slow the spread of COVID-19. We measured perceived positivity resonance at the level of social episodes either during the COVID-19 pandemic (study 1, N = 1059, April-May 2020) or before it (study 2, N = 227, March-November 2019). In both studies, cross-sectionally and prospectively, results suggest that perceived positivity resonance had a positive indirect effect on self-reported hygienic behaviors (e.g., handwashing and mask wearing), which was mediated by a latent measure of prosocial tendencies. Sensitivity analyses confirmed these mediation effects to be independent of competing predictors of prosocial tendencies (e.g., overall positive and negative affect, frequency of social interaction) and competing predictors of health behaviors (e.g., political orientation, high-risk status, illness symptoms). Effects for social distancing were mixed. Overall, findings are consistent with the view that positivity resonance builds self-transcendent prosocial tendencies that motivate behaviors to protect community health.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-021-00035-z.

The Role of Social Cognition Abilities in Parkinson's Disease in the Era of COVID-19 Emergency

Introduction: Parkinson's Disease (PD) is characterized by motor and non-motor symptoms, among which deficits in social cognition might affect ~20% of patients. This study aims to evaluate the role of social cognitive abilities in the perceived impact of COVID-19 emergency, and the effects of lockdown measures on patients' social network and caregivers' burden. Methods: Fourteen PD patients performed a neuropsychological battery including sociocognitive tasks before the introduction of COVID-19 restrictive measures (i.e., social distancing and isolation). A structured interview through an online platform was performed in the last 2 weeks of the first lockdown phase to assess patients' health status, perception of COVID-19 emergency, changes in caregivers' burden, and patients' social isolation. Non-parametric analyses were performed to evaluate the association between social skills and patients' COVID-19 perception, as well as the effects of restrictive measures. Results: At baseline evaluation, half of the PD patients showed sociocognitive dysfunctions, mainly on mentalizing abilities. Patients with impaired social cognition skills showed a significantly lower concern on the possible effects of COVID-19 on their health. Caregiver burden and patients' social network remained stable during the lockdown. Conclusion: These preliminary results underline that PD sociocognitive dysfunctions might affect patients' abilities to estimate the effects of COVID-19 infection. However, the lack of a significant increase in caregivers' burden and social isolation suggests, in our sample, a good coping to COVID-19 emergency. Since COVID-19 pandemic can have direct and indirect severe consequences in patients with PD, the development of educational and preventive programs is recommended.

Coping Styles, Mental Health, and the COVID-19 Quarantine: A Nationwide Survey in Poland

Background: The outbreak of the novel coronavirus COVID-19 that began from March 2020 is yet to be contained. Consequences of the ongoing pandemic may have a negative impact on the mental health of affected individuals. This particularly refers to those quarantined. Since the COVID-19 pandemic is currently one of the biggest health issues worldwide, a higher demand emerges for research concentrating on the worsening of psychological well-being among the general and the quarantined population, as well as on individual coping strategies that may moderate the occurrence of psychopathologies. Method: Data were collected within the first weeks of the COVID-19 pandemic in Poland. Participants represented quarantine (+) and quarantine (-) groups. Quarantine (+) group, different from quarantine (-), consisted of people who experienced it themselves or someone close to them did after contacting an infected individual. To measure psychopathological symptoms a General Health Questionnaire (GHQ-28) was used. For measuring PTSD symptoms, the Impact of Event Scale-Revised (IES-R) was used. This study followed the coping strategies manifested among the participants using the MiniCope questionnaire. Results: A total of 2,036 individuals participated in this study. Quarantine (+) individuals had significantly higher total and subscales GHQ-28 scores (anxiety, insomnia, and somatic symptoms) as well as a higher IES-R arousal score. The quarantine (+) individuals were more likely to use self-distraction as a coping strategy. This research identified positive and negative correlations between presented coping styles and manifested psychopathology. Conclusion: This nationwide study suggests occurrence of negative effects on mental health due to the COVID-19 pandemic and quarantine. It is observed on most of the measured psychopathological symptoms. The present research provides a line of action that should be followed in the future in case of another epidemic and in the event restrictions like quarantine have to be introduced again.

Protected areas as a space for pandemic disease adaptation: A case of COVID-19 in Hong Kong

As COVID-19 has swept across the world, governments have been prompted to order social distancing measures, from the closure of schools, restaurants and public facilities to quarantines and lockdowns. Access to and contact with nature have been suggested to help combat impacts associated with isolation measures, and a coincidental surge in the number of visitors to country parks in Hong Kong has recently been observed. The current study sought to explore the visitation of country parks as an adaptation to COVID-19 by employing the socio-psychological model of precautionary adaptation (SPMPA). Questionnaire surveys were administered in 12 country parks in Hong Kong, and a total of 600 samples were collected. A conceptual model based on the SPMPA was proposed and tested through multiple regression analysis. Significant associations between perceived severity, threat experience and adaptative behaviour were found, suggesting the possible risks of visiting country parks. However, the relationships among perceived adaptation efficacy, adaptation cost and reliance on public adaptation implied that the adaptative benefits of visiting country parks may outweigh the risks when proper visitor management measures are implemented. The findings highlighted the importance of providing accessible protected areas or other types of nature-based spaces to facilitate the adaptation of people to disease outbreaks in both the short and long run.

COVID-19 Worries and Behavior Changes in Older and Younger Men and Women

OBJECTIVES

The case fatality rate of coronavirus disease 2019 (COVID-19) is higher among older adults than younger adults and is also higher among men than women. However, worry, which is a key motivator of behavioral health changes, occurs less frequently for older than younger adults, and less frequently for men than women. Building on this, we tested whether older adults-and particularly older men-would report the least amount of COVID-19 worry and also fewer COVID-19 behavior changes.

METHOD

From March 23-31, 2020, we administered an online questionnaire assessing COVID-19 perceptions, worries, and behavior changes. Participants were a convenience sample of U.S. residents, who were community-dwelling younger adults (18-35) or older adults (65-81). Analyses included 146 younger adults (68 men, 78 women) and 156 older adults (82 men, 74 women). Participants were predominately white, living in suburban/urban areas, and had completed some college.

RESULTS

During the early phase of the outbreak in the United States, older adults perceived the risks of COVID-19 to be higher than did younger adults. Despite this, older men were comparatively less worried about COVID-19 than their younger counterparts. Compared with the other participants, older men had also implemented the fewest behavior changes.

DISCUSSION

Interventions are needed to increase COVID-19 behavior changes in older men. These results also highlight the importance of understanding emotional responses to COVID-19, as these are predictive of their behavioral responses.

Vulnerable learners in the age of COVID-19: A scoping review

This scoping review provides an overview of COVID-19 approaches to managing unanticipated school closures and available literature related to young people learning outside-of-school. A range of material has been drawn upon to highlight educational issues of this learning context, including psychosocial and emotional repercussions. Globally, while some countries opted for a mass school shut-down, many schools remained open for students from disadvantaged backgrounds. This partial closure not only enabled learning in smaller targeted groups but also offered a safe sanctuary for those who needed a regulated and secure environment. In Australia, if full school closures were to be enforced over a long period, a significant proportion of students from more vulnerable backgrounds would likely experience persistent disadvantage through a range of barriers: long-term educational disengagement, digital exclusion, poor technology management, and increased psychosocial challenges. This scoping review combines research on technology availability and learning, with analysis of the long-term educational impacts of navigating the COVID-19 disruption.

Safe but Lonely? Loneliness, Anxiety, and Depression Symptoms and COVID-19

Background

The COVID-19 pandemic has led governments worldwide to implement unprecedented response strategies. While crucial to limiting the spread of the virus, “social distancing” may lead to severe psychological consequences, especially in lonely individuals.

Methods

We used cross-sectional (n = 380) and longitudinal (n = 74) designs to investigate the links between loneliness, anxiety, and depression symptoms (ADS) and COVID-19 risk perception and affective response in young adults who implemented social distancing during the first 2 weeks of the state of epidemic threat in Poland.

Results

Loneliness was correlated with ADS and with affective response to COVID-19’s threat to health. However, increased worry about the social isolation and heightened risk perception for financial problems was observed in lonelier individuals. The cross-lagged influence of the initial affective response to COVID-19 on subsequent levels of loneliness was also found.

Conclusion

The reciprocal connections between loneliness and COVID-19 response may be of crucial importance for ADS during the COVID-19 crisis.

Coping of Chinese Citizens Living in Spain during the COVID-19 Pandemic: Lessons for Personal Well-Being and Social Cohesion

Chinese citizens in China were the first affected by the COVID-19 outbreak. Nevertheless, the disease rapidly spread around the world, leading to the worst pandemic experienced in modern societies. Spain has become one of the countries more severely affected by it, while having a large Chinese community. This study aims to explore the perception of Chinese citizens living in Spain regarding the outbreak in their host country. Communicative interviews were conducted with ten Chinese men and women who had been living in Spain for at least five years. Results show cultural differences in the coping strategies of the Chinese as a response to the pandemic, which differ from those observed by the participants in their fellow Spanish citizens. These findings unveil the potential of integrating the cultural knowledge and coping strategies of migrant groups in the host communities in managing a pandemic, as well as the negative outcomes for social cohesion and well-being from new racism emerging in the context of COVID-19.

Covid-19 Outbreak In Italy: Are We Ready for the Psychosocial and the Economic Crisis? Baseline Findings From the PsyCovid Study

The Covid-19 pandemic is burning all over the world. National healthcare systems are facing the contagion with incredible strength, but concern regarding the psychosocial and economic effects is growing quickly. The PsyCovid Study assessed the influence of psychosocial variables on individual differences from the perceived impact of the Covid-19 outbreak on the issues of health and economy in the Italian population. Italian volunteers from different regions completed an online anonymous survey. The main outcomes were the perceived impact of the Covid-19 outbreak on health and the economy. A two-way MANOVA evaluated differences in the main outcomes, with geographical area (northern, central, and southern regions) and professional status (healthcare workers or not) as factors. We then tested the relationship linking psychosocial variables (i.e. perceived distress and social isolation, empathy, and coping style) to the main outcomes through two different mediation models. 1163 responders completed the survey (835 females; mean age: 42 ± 13.5 y.o.; age range: 18-81 y.o.) between March 14 and 21, 2020. Healthcare workers and people living in northern Italy reported a significantly worse outbreak impact on health, but not on the economy. In the whole sample, distress and loneliness were key variables influencing the perceived impact of the Covid-19 outbreak on health, while empathy and coping style affected the perceived impact on the economy. The Covid-19 pandemic is a worldwide emergency in terms of psychological, social, and economic consequences. Our data suggests that in the Italian population, actual differences in individual perception of the Covid-19 outbreak severity for health are dramatically modulated by psychosocial frailty (i.e., distress and loneliness). At the same time, problem-oriented coping strategies and enhanced empathic abilities increase people's awareness of the severity of the impact of the Covid-19 emergency on economics. There is an immediate need for consensus guidelines and healthcare policies to support interventions aimed to manage psychosocial distress and increase population resilience towards the imminent crisis.

Counselling and psychotherapy post-COVID-19

We consider how the prolonged, complex and uncertain aftermath of the COVID‐19 crisis will present challenges and opportunities for counselling and psychotherapy. Increased mental strain on populations, individuals and professionals is likely to be compounded by further constraints in therapeutic resources. Nevertheless, emerging needs and priorities will offer ground for systems thinking in linking the application of a range of therapeutic frameworks, theories to address global challenges, integration of counselling and psychotherapy into new sectors, service models for the most vulnerable, use of digital approaches, support mechanisms for professionals and interdisciplinary research.

News coverage of the COVID-19 pandemic: Missed opportunities to promote health sustaining behaviors

Background

Given that individuals may make health decisions based on mass media coverage, and given that such decisions have broad consequences in the case of highly contagious infectious disease, it is imperative that public health practitioners are aware of mass media coverage on emerging health threats such as COVID-19. The purpose of this study was to examine the content of news segments covering COVID-19 posted on-line.

Methods

Using the Google Videos function on a cleared browser, all videos identified from January and February, 2020 were archived by URL for analysis. After applying exclusion criteria, a total of 401 remained, comprising the sample. Content categories derived from trusted sources were applied to assess the content of broadcast news segments pertaining to COVID-19 on Google Videos.

Results

The most common topic mentioned across all videos was death and the death rate (43.6%) and many connoted anxieties surrounding the COVID-19 outbreak (37.4%). Critically important information about the prevention of COVID-19 spread received little attention. For example, only 3.0% of videos discussed coughing into or blowing one's nose into a tissue and throwing the tissue away, 6.2% talked about wearing a facemask when caring for the ill, and 8.8% covered disinfecting highly touched objects and surfaces. International videos more often presented captions and English subtitles (with and without narration) (7.8% vs. 0.9%, p = 0.018) and even more frequently discussed death and the death rate associated with COVID-19 (56.9% vs. 41.7%, p = 0.04).

Conclusion

Coupled with the resultant increase in negative emotion, the majority of videos missed an opportunity to reframe messages to encourage and promote coping strategies and health sustaining behaviors. Future videos should avoid contributing to negative emotion.

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Prevention information on reducing transmission was rarely covered in the news videos included in this sample.

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Death and death rate were the most commonly mentioned aspect of COVID-19 in these news videos.

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Forthcoming news clips should strive to demonstrate ways to enhance safety.

Narrative synthesis of psychological and coping responses towards emerging infectious disease outbreaks in the general population: practical considerations for the COVID-19 pandemic

INTRODUCTION

Emerging infectious disease outbreaks, such as the present coronavirus disease 2019 (COVID-19) pandemic, often have a psychological impact on the well-being of the general population, including survivors and caregivers. Our study aimed to synthesise extant literature regarding the combined psychological responses and coping methods used by the general population in past outbreaks.

METHODS

We conducted a narrative synthesis of the published literature over the last two decades with a quality appraisal of included articles that reported both psychological responses and coping strategies within infectious disease outbreaks.

RESULTS

A total of 144 papers were identified from the search, 24 of which were included in the review. Overall, 18 studies examined the psychosocial responses of the general population towards the severe acute respiratory syndrome epidemic, four studies focused on the Ebola epidemic and two studies covered the H1N1 outbreak. Common themes in psychological responses included anxiety/fears, depression, anger, guilt, grief and loss, post-traumatic stress and stigmatisation, but also a greater sense of empowerment and compassion towards others. Coping strategies adopted included problem-focused coping (seeking alternatives, self- and other-preservation), seeking social support, avoidance, and positive appraisal of the situation.

CONCLUSION

Amid the range of psychosocial responses seen in past infectious disease outbreaks, practical considerations for the current COVID-19 pandemic need to focus on the individual in the context of the larger social environment, with an emphasis on raising awareness of the range of possible psychosocial responses, access to psychological help, self-care, empowering self-support groups and sustained engagement with updated, reliable information about the outbreak.

Safe but Lonely? Loneliness, Anxiety, and Depression Symptoms and COVID-19

BACKGROUND

The COVID-19 pandemic has led governments worldwide to implement unprecedented response strategies. While crucial to limiting the spread of the virus, "social distancing" may lead to severe psychological consequences, especially in lonely individuals.

METHODS

We used cross-sectional (n = 380) and longitudinal (n = 74) designs to investigate the links between loneliness, anxiety, and depression symptoms (ADS) and COVID-19 risk perception and affective response in young adults who implemented social distancing during the first 2 weeks of the state of epidemic threat in Poland.

RESULTS

Loneliness was correlated with ADS and with affective response to COVID-19's threat to health. However, increased worry about the social isolation and heightened risk perception for financial problems was observed in lonelier individuals. The cross-lagged influence of the initial affective response to COVID-19 on subsequent levels of loneliness was also found.

CONCLUSION

The reciprocal connections between loneliness and COVID-19 response may be of crucial importance for ADS during the COVID-19 crisis.

Major emerging vector-borne zoonotic diseases of public health importance in Canada

In Canada, the emergence of vector-borne diseases may occur via international movement and subsequent establishment of vectors and pathogens, or via northward spread from endemic areas in the USA. Re-emergence of endemic vector-borne diseases may occur due to climate-driven changes to their geographic range and ecology. Lyme disease, West Nile virus (WNV), and other vector-borne diseases were identified as priority emerging non-enteric zoonoses in Canada in a prioritization exercise conducted by public health stakeholders in 2013. We review and present the state of knowledge on the public health importance of these high priority emerging vector-borne diseases in Canada. Lyme disease is emerging in Canada due to range expansion of the tick vector, which also signals concern for the emergence of human granulocytic anaplasmosis, babesiosis, and Powassan virus. WNV has been established in Canada since 2001, with epidemics of varying intensity in following years linked to climatic drivers. Eastern equine encephalitis virus, Jamestown Canyon virus, snowshoe hare virus, and Cache Valley virus are other mosquito-borne viruses endemic to Canada with the potential for human health impact. Increased surveillance for emerging pathogens and vectors and coordinated efforts among sectors and jurisdictions will aid in early detection and timely public health response.

The mental health status and associated factors affecting underprivileged Iranian women

PURPOSE

The prevalence of mental disorders in Iran approximates to that of other countries. This study evaluates mental health status and its related factors among underprivileged women in Shiraz, Iran.

METHODS

This research was conducted between June, 2010 and November, 2012, and comprised 2108 women who participated in the Shiraz Women's Health Cohort Study. The questionnaire used in the study was completed by trained general practitioner and included demographic information and the 28-item version of the General Health. The t-test, chi-square test and multivariate logistic regression model were used for statistical analysis. A P-value <0.05 was considered significant.

RESULTS

The mean age of the participants was 49.7±10.6 years. According to the General Health Questionnaire, the most prevalent mental disorder was social dysfunction observed in 1643 (77.9%) participants followed by somatic symptoms found in 1308 (62%) subjects. Mental disorders were most prevalent among married women (63.8%, P=0.004). Participants holding high school diploma or university degree (141; 52.4%) comprised the smallest proportion of subjects with mental disorders (P=0.01). Of a total 265 participants whose husband were in prison, 171 (64.5%) exhibited mental disorders, presenting the greatest proportion of women with mental disorders. Logistic regression analysis showed an association between mental health status and participants' level of education, number of children and marital status, based on the General Health Questionnaire total score.

CONCLUSIONS

The results of this study showed a considerably higher prevalence of mental disorders among Iranian women in comparison with the general population. Therefore policymakers should pay greater attention to the mental health status of underprivileged Iranian women.

Intolerance of uncertainty, appraisals, coping, and anxiety: the case of the 2009 H1N1 pandemic

OBJECTIVES

Although ambiguous and uncertain situations, such as those dealing with the threat of widespread viral illness, may have pronounced psychological ramifications, there have been few studies that examined the factors that contributed to such outcomes. The purpose of the present investigation was to examine emotional reactions to a health threat.

DESIGN

A structural equation model examined the interplay between anxiety and intolerance of uncertainty, as sequentially mediated by appraisals and coping strategies.

METHODS

Adult participants over the age of 18 (N = 1,027) completed online self-report measures during the H1N1 pandemic in 2009.

RESULTS

Greater intolerance of uncertainty was related to lower appraisals of self- and other control, which predicted low levels of problem-focused coping and greater reports of H1N1-related anxiety. Additionally, individuals with a high intolerance of uncertainty were more likely to perceive the pandemic as threatening and also were more apt to use emotion-focused coping strategies, and both of these factors predicted elevated levels of anxiety.

CONCLUSIONS

Together, these data indicate that threats, such as those related to a potential pandemic, not only have implications for physical health, but also for psychological distress, and that such outcomes vary with a constellation of appraisal and coping factors.

STATEMENT OF CONTRIBUTION

What is already known on this subject? It has been established that the public is often confused by the threat that a potential pandemic virus poses and that they are unsure of what information related to the disease they can trust. Government health agencies often walk the line of minimizing the threat to prevent panic, but simultaneously emphasize the importance of action (vaccination) to prevent a worldwide pandemic. What does this study add? Beyond the physical threat of a pandemic, a significant psychological toll may occur for certain individuals. Anxiety regarding H1N1 is heightened amongst those who cannot tolerate uncertainty. Appraisals of threat, control, and the use of emotion-focused coping mediate the above relationship.

Association of socioeconomic status and life-style factors with coping strategies in Isfahan Healthy Heart Program, Iran

AIM

To investigate the association between life-style and socioeconomic factors and coping strategies in a community sample in Iran.

METHOD

As part of a community-based study called Isfahan Healthy Heart Program, we studied 17593 individuals older than 19 living in the central part of Iran. Demographic and socioeconomic factors (age, sex, occupation status, marital status, and educational level) and lifestyle variables (smoking status, leisure time physical activity, and psychological distress), and coping strategy were recorded. Data were analyzed by Pearson correlation and multiple linear regression.

RESULTS

Not smoking (women beta=-11.293, P<0.001; men beta=-3.418, P=0.007), having leisure time physical activity (women beta=0.017, P=0.046; men beta=0.005, P=0.043), and higher educational level (women beta=0.344, P=0.015; men beta=0.406, P=0.008) were predictors of adaptive coping strategies, while smoking (women beta=11.849, P<0.001; men beta=9.336, P<0.001), high stress level (women beta=1.588, P=0.000; men beta=1.358, P<0.001), and lower educational level (women beta=-0.443, P=0.013; men beta=-0.427, P=0.013) were predictors of maladaptive coping strategies in both sexes. Non-manual work was a positive predictor of adaptive (beta=4.983, P<0.001) and negative predictor of maladaptive (beta=-3.355, P=0.023) coping skills in men.

CONCLUSION

Coping strategies of the population in central Iran were highly influenced by socioeconomic status and life-style factors. Programs aimed at improving healthy life-styles and increasing the socioeconomic status could increase adaptive coping skills and decrease maladaptive ones and consequently lead to a more healthy society.