Developing a Measure of the Impact of COVID-19 Social Distancing on Household Conflict and Cohesion

Prevalence and risk factors for post-COVID conditions of COVID-19 among persons with HIV in Washington, DC

Post-COVID conditions (long COVID) are defined as COVID symptoms persisting 28 days post-initial infection. The limited research available on the prevalence and experiences of post-COVID conditions among persons with HIV (PWH) indicates potential increased risk for post-COVID conditions. The purpose of this study was to characterize prevalence, symptom clustering, impact, and potential risk factors of post-COVID conditions among PWH. Data come from the COVID-19 survey, conducted as a sub-study of the DC Cohort Longitudinal HIV Study, an ongoing study of over 12,000 PWH living in Washington, DC. Survey data were matched to electronic medical record data. Prevalence estimates and multivariable logistic regression analyses were calculated comparing those with and without post-COVID conditions. The prevalence of post-COVID conditions among PWH was 46% with no significant differences among demographic or HIV measures. Those with history of asthma were more likely to report post-COVID conditions symptoms. Among those with post-COVID conditions, 81% reported three or more initial COVID symptoms. Retired/disabled PWH were more likely to report post-COVID conditions compared to employed (aOR = 2.37, 95% CI = 1.06, 5.33). Post-COVID conditions significantly limited activities of daily living. Programs are needed to address the long-term impact of post-COVID conditions on activities of daily living among PWH.

The association between uncertainty intolerance, perceived environmental uncertainty, and ego depletion in early adulthood: the mediating role of negative coping styles

Introduction

Uncertainty intolerance and perceived environmental uncertainty can influence an individual's emotions and behavioral responses. Previous research showed that high uncertainty intolerance and high perceived environmental uncertainty were both negatively associated with an individual's life satisfaction. We explored the interaction effects of uncertainty intolerance and perceived environmental uncertainty on ego depletion of early adulthood and its mechanisms.

Methods

Investigating 292 college students using an uncertainty intolerance scale, a perceived environmental uncertainty scale, a negative coping style questionnaire, and an ego depletion scale. The correlations among all variables were calculated using Pearson's product-moment correlation coefficient, and then we used the PROCESS macro (model 8) in SPSS to test the conditional process model in the relationship between uncertainty intolerance and ego depletion.

Results

The results showed that the interaction terms of uncertainty intolerance and perceived environmental uncertainty were significantly associated with negative coping styles. Only in the high perceived environmental uncertainty situations, uncertainty intolerance was positively associated with negative coping styles, and negative coping styles were positively associated with ego depletion.

Discussion

In general, compared with perceived environmental uncertainty, participants' cognition towards environmental uncertainty was much more associated with individual's coping styles and psychological state, individuals with high uncertainty intolerance would face great stress and experience more emotional problems. Our results suggest that it is important for individuals' mental health to gain a sense of control in an uncertain environment and improve the tolerance of uncertainty. Future research needs to pay attention to the intervention strategy of decreasing uncertainty intolerance.

A home environment-moderated model of the influence of ergonomics on individual work performance among Filipino nurse educators working from home during the COVID-19 pandemic: An interaction moderation analysis using structural equation model

AIM

To determine the influence of ergonomics on individual work performance of nurse educators working at home during the COVID-19 pandemic and to develop a model of the moderating effect of home environment.

DESIGN

Cross-sectional, predictive-correlational design.

METHODS

Utilizing interaction moderation and structural equation modeling, 214 consecutively-selected educators from nursing schools in the Greater Manila Area, Philippines completed a four-part online survey.

RESULTS

Physical, cognitive, and organizational ergonomics positively influenced individual work performance. Home environment had a linear, positive moderation on the effects of physical and cognitive ergonomics on individual work performance but had a negative moderating effect with organizational ergonomics.

CONCLUSION

The moderated model underscored the positive effects of ergonomics and the moderating effect of home environment on the individual work performance of nurse educators working at home during the COVID-19 pandemic, and this knowledge can be used in developing appropriate programs, strategies, and policies.

IMPACT

The moderated model highlights the need for policies and programs, training and education, and organizational evaluation geared towards promoting healthy workplace and work-life balance among nurse educators transitioning to remote work and online teaching.

PATIENT OR PUBLIC CONTRIBUTION

Eligible participants contributed in the data collection with the survey responses.

Mixed Methods Analysis of Telehealth Experience, Satisfaction, and Quality of Care During the COVID Pandemic Among Persons with HIV in Washington, DC

The purpose of this study is to describe telehealth experiences and quality of HIV care provided to an urban population of people with HIV (PWH) in Washington, DC. We used self-reported survey data from a cohort of PWH in the DC Cohort longitudinal study linked to medical records (October 26, 2020-December 31, 2021). Analyses followed a mixed-methods approach, including prevalence estimates and multivariable logistic regression of telehealth use by demographic and HIV characteristics. We measured primary motivation, modes of engagement, and telehealth satisfaction. Qualitative responses to open-ended questions were coded using collaborative coding. A framework developed by the National Quality Forum (NQF) was applied to the results. Among 978 participants, 69% reported using telehealth for HIV care during the pandemic. High school graduates were less likely to use telehealth compared to those with college education (aOR 0.69, 95% CI 0.48, 0.98). PWH with > 1 co-morbid condition were more likely to use telehealth compared to those without (aOR 1.42, 95% CI 1.02, 1.95). The majority reported satisfaction with telehealth (81%). Qualitative analysis of telehealth satisfaction found that most responses were related to access to care and technology, effectiveness, and patient experience. PWH using telehealth during the pandemic were satisfied with their experience though use differed demographically. Telehealth was used effectively to overcome barriers to care engagement, including transportation, costs, and time. As we transition away from the emergency pandemic responses, it will be important to determine how this technology can be used in the future in an equitable manner to further strengthen HIV care engagement.

Development and initial psychometric evaluation of a COVID-related psychosocial experiences questionnaire for cancer survivors

BACKGROUND

Cancer survivors are at elevated risk of psychological problems related to COVID-19, yet no published measure adequately assesses their psychosocial experiences during the pandemic.

PURPOSE

Describe the development and factor structure of a comprehensive, self-report measure (COVID-19 Practical and Psychosocial Experiences questionnaire [COVID-PPE]) assessing the pandemic's impact on US cancer survivors.

METHODS

The sample (n = 10,584) was divided into three groups to assess COVID-PPE factor structure by conducting: (1) initial calibration/exploratory analysis of the factor structure of 37 items (n = 5070), (2) confirmatory factor analysis of the best-fitting model (36 items after item removal; n = 5140), and (3) post-hoc confirmatory analysis with an additional six items not collected in the first two groups (42 items; n = 374).

RESULTS

The final COVID-PPE was divided into two sets of subscales, conceptualized as Risk Factors and Protective Factors. The five Risk Factors subscales were labeled Anxiety Symptoms, Depression Symptoms, Health Care Disruptions, Disruptions to Daily Activities and Social Interactions, and Financial Hardship. The four Protective Factors subscales were labeled Perceived Benefits, Provider Satisfaction, Perceived Stress Management Skills, and Social Support. Internal consistency was acceptable for seven subscales (αs = 0.726-0.895; ωs = 0.802-0.895) but poor or questionable for the remaining two subscales (αs = 0.599-0.681; ωs = 0.586-0.692).

CONCLUSIONS

To our knowledge, this is the first published self-report measure comprehensively capturing psychosocial impact-both positive and negative-of the pandemic on cancer survivors. Future work should evaluate predictive utility of COVID-PPE subscales, particularly as the pandemic evolves, which may inform recommendations for cancer survivors and facilitate identification of survivors most in need of intervention.

Cohesion and conflict for mothers during the pandemic: Results of the Portuguese version of the COVID-19 Household Environment Scale

The coronavirus disease 2019 (COVID-19) pandemic is a worldwide event that has caused significant changes in the daily lives of individuals and families. The combined effect of the pandemic and the stress associated with major life cycle changes, such as the transition to parenthood, is yet to be understood. The aim of the current study was to validate the Portuguese version of the recently developed COVID-19 Household Environment Scale (CHES) and examine its psychometric properties in a sample of mothers who had given birth during the pandemic. The CHES is a self-report measure assessing the consequences of the COVID-19 pandemic in household cohesion and conflict and includes two sections. Section 1 contains 25 descriptive items pertaining to sociodemographic and household characteristics and COVID-19 stressors. Section 2 encompasses household cohesion and conflict, assessing any change in household experiences and activities following the onset of social distancing. The participants consisted of 342 mothers, aged between 19 and 50 years (M = 31.43; SD = 4.38). A confirmatory factor analysis supported the original CHES bifactor structure of household cohesion and conflict, which obtained an acceptable fit (CFI = 0.900, RMSEA = 0.065). Correlations between household cohesion and conflict and family cohesion and dyadic coping contributed to developing the construct validity of this scale. Furthermore, both CHES subscales demonstrated very good internal consistency. Further research is warranted to assess the CHES in other cultural contexts. This is a useful tool to assess change in family households due to the unprecedented adverse pandemic experience.

Family Functioning and Community Resilience During the COVID-19 Lockdown Period in Turkey

The COVID-19 outbreak has left families with many adverse effects that can disrupt functioning. The aim of this study was to evaluate the associations between family functioning and community resilience during the COVID-19 lockdown. An online survey was conducted with community-dwelling adult people (n= 411) based on quantitative descriptive-correlational research. According to the results, families show dysfunctional trends during the COVID-19 outbreak (%56), especially in affective involvement, problem-solving, and behavior control categories. Community resilience was positively associated with family functioning. Also, income dissatisfaction, use of social services, and social trust were determined as predictors of family functioning in the COVID-19 lockdown. Further research and social work practices in public health to address the family system as a whole should be evaluated and interventions aiming at community resilience should be designed to increase families' functioning during the pandemics.

Psychological impact of six weeks of strict home confinement in Spanish families having school-aged children with attention-deficit/hyperactivity disorder

After the COVID-19 outbreak, early publications reported worsening symptoms and increased caregiver burden in families having children with Attention-Deficit/Hyperactivity Disorder (ADHD). In the present study, we launched an online survey to examine the psychological impact of the 41 days of strict home confinement implemented in Spain in families having children with ADHD compared to families having children with typical development (TD). We achieved a representative sample of 190 school-aged children (NADHD =100 and NTD=90) from 181 families. Respondents were mainly mothers (≈96%). We found that mother reports of hyperactive-impulsive symptoms significantly increased during home confinement regardless of ADHD diagnosis. During the lockdown, we also found that perceived stress significantly increased in mothers of ADHD and TD children, but, unexpectedly, this increase was much more noticeable for the latter group. Moreover, our study suggests that children having parents working in frontline jobs or living in families with higher household conflicts might display increased ADHD symptoms during the lockdown, irrespective of ADHD diagnosis. Our results highlight the need to provide psychological support to families most exposed to the pandemic and target household problems and mothers' well-being at intervention processes, in both ADHD and TD families.

Were we happy and we didn't know it? A subjective dynamic and financial assessment pre-, during and post-COVID-19

The COVID-19 pandemic has brought many changes into people's lives. Fear, job insecurity, changes in their financial stability, concerns about their future lives have changed the entire lives of people and have affected the cognitive well-being of individuals. The purpose of the present analysis is to measure how the COVID-19 pandemic, along with financial factors, has affected the perceived level of well-being of individuals. We are also interested whether there are differences between life before COVID-19, life now with COVID-19, and life after the COVID-19 pandemic, in terms of future expectations. To address this objective, we performed an ANOVA approach and a GLM estimate on repeated measures for a large sample (1572 respondents) from 43 worldwide countries, during the period May 2020 and July 2021. Our results show that financial factors reflected by both the size of income and changes in personal or family income affect the levels of happiness. Robustness checks using stress as an alternative estimator for happiness have consolidated our results. Additionally, we find that well-being during COVID-19 compared to the previous period decreased, while in future, people expect to be happier, but not more than in the past when they did not know about the existence of this virus. This is one of the first studies to investigate the relationship between happiness and income before, during, and after COVID-19. These findings are important for policymakers to improve the conditions of living in the areas of health and financial stability.

COVID-19 and Family Distancing Efforts: Contextual Demographic and Family Conflict Correlates

Since the COVID-19 outbreak, family members have spent more time together at home. This study introduces the concept of "family distancing"-the efforts to prevent the spread of the coronavirus to family members. We explore which demographic characteristics are associated with family distancing efforts and how the family distancing efforts are associated with family conflicts. Survey data were collected from adults (N = 324, M = 37 years; SD = 10.5 years; 65.1% female) in Korea. We found that gender, education, marital status, physical health status, and number of family members who live together were significantly associated with family distancing efforts. In addition, lower compliance with the request for family distancing was significantly associated with a higher degree of negative emotions (i.e., anger), which in turn was associated with more family conflict. The findings highlight the potential importance of family distancing efforts to maintain health but also their potential to increase family conflict.

Home quarantine during COVID-19 blunted childhood trauma-related psychiatric symptoms in Chinese college students

Background

Childhood trauma confers risks to mental health. However, little is known about whether home quarantine (HQ) during the coronavirus disease 2019 (COVID-19) pandemic exaggerated or mitigated the effect of childhood trauma on mental health.

Objective

To examine the modulating effects of prior childhood traumas on the longitudinal changes of psychiatric symptoms in college students before and after HQ during the pandemic.

Methods

This was a two-wave longitudinal study on the mental health of 2,887 college students before and after HQ during the COVID-19 pandemic. The relationships between the changes in the Patient Health Questionnaire-9 (PHQ-9), Symptom Checklist-90 (SCL-90), 16-item Prodromal Questionnaire (PQ-16), Childhood Trauma Questionnaire (CTQ), and Social Support Rating Scale (SSRS) scores were analyzed.

Results

The students with childhood trauma showed a significantly greater decrement in psychiatric symptoms after HQ (F = 17.21, 14.11, 18.87, and 17.42 for PHQ-9, PQ-16 objective and distress, and SCL-90, respectively). The correlation coefficients between the CTQ and these symptoms scales were significant at baseline (r = 0.42, 0.34, 0.37, and 0.39), and decreased after HQ (r = 0.17, 0.20, 0.18, and 0.19). The decrement of depressive, psychotic, and overall symptoms was positively correlated with the scores of the CTQ (r = 0.08-0.27) but negatively correlated with SSRS (r = -0.08--0.14). Multilinear regression analysis confirmed the results of the CTQ and SSRS regarding the modulation of the dynamic changes in psychiatric symptoms. A constructed structural equation model indicated that the total effects of childhood trauma on decreased psychiatric symptoms were partly mediated by lower baseline social support.

Conclusion

Home quarantine during the COVID-19 pandemic could blunt the adverse effects of childhood trauma on mental health, especially for prodromal psychotic symptoms in college students. Changes in relative deprivation and social support may be mediating factors.

COVID-19 Pandemic and Lockdown: Associations With Personality and Stress Components

The present study examines the role of personality traits, interpersonal relationships, and sociodemographic factors on perceived stress, related to COVID-19, and compliance with measures to mitigate its spread. Data were collected in the midst of the 'first wave' lockdown, with the survey completed in full by 963 participants. We measured stress, directly related to the pandemic, rather than general stress, and were able to distinguish between symptoms of emotional, behavioural, cognitive, physical stress, and alienation with high concordance. We included personality scoring with standardized T-scores, allowing for cross-study comparison, and a broader questionnaire on the participants' support for COVID-19 mitigation measures. Results of the multiple regression models indicated that low emotional stability and introversion, and high conscientiousness, common conflicts with loved ones, and some demographics (female gender, middle age, chronic health problems) correspond to elevated stress. Conscientiousness was positively associated with total stress and some of its components, whereas opposite results were found for emotional stability. Extraversion was negatively correlated to total stress, its emotional and physical components, and alienation. Surprisingly, increased stress was not related to greater measure adherence. The present results shed light on how personality, interpersonal relationships, and sociodemographic factors influence people's stress response during a pandemic.

The Impact of COVID-19 Household Isolation on Conflict and Cohesion in One-, Two-, and Three-Generation Households With Older Adults

The current cross-sectional study examined the effect of coronavirus disease 2019 (COVID-19) household isolation on household conflict and cohesion in one-, two-, and three-generation households with older adults (aged ≥65 years). Participants were 757 adults (aged ≥18 years) with at least one older adult in their household. Respondents were from 51 countries. Study variables were measured with the COVID-19 Household Environmental Scale. Non-parametric tests were used to assess differences between groups. Most participants (n = 437, 57.7%) lived in three-generation homes. Three-generation homes reported greater increases in conflict (p < 0.001) and cohesion (p < 0.001) during household isolation compared to oneand two-generation homes. Findings suggest that older adults living in multigenerational households experienced more cohesive and conflictive household environments as a function of the COVID-19 pandemic. Further research should explore how family or health care interventions could better support older adults and families as a unit of care to avoid adverse outcomes and boost resilience. [Journal of Gerontological Nursing, 49(4), 47-56.].

Comparing the impact of high versus low lockdown severity on the mental health of young people in Australia during the COVID-19 pandemic

Young Australians have been differentially affected by lockdowns and social restrictions during the COVID-19 pandemic. This study compared the mental health impacts of the COVID-19 pandemic and associated restrictions for young people in two Australian states, Victoria and Queensland, with Victoria experiencing more days in lockdown and greater infection rates. An online survey was completed between 01/04/2021 and 31/07/2021 by 687 young people, aged 16 to 24 years; 337 from Victoria and 350 from Queensland. Levels of negative emotion feelings (as measured by the Depression Anxiety Stress Scale), and COVID-19 risk factors for negative emotions (such as financial hardship, education disruption, loneliness and household conflict), as well as protective factors (resilience and self-esteem) were compared between the Victorian and Queensland samples, also considering some early pandemic data and pre-pandemic norms. No significant differences in negative emotions were found between young people living in the two states, despite substantial differences in pandemic restrictions. The results indicated that young people in Queensland and Victoria had experienced similarly high levels of negative emotions, at levels also seen at the start of the pandemic in Victoria. This is of grave concern, requiring urgent attention as the pandemic continues.

Examining the Relationships Between Fear of Coronavirus, State Anxiety, and Relationship Happiness Among Married Turkish Individuals During COVID-19

The present study aimed to investigate the mediating role of state anxiety in the relationship between the fear of COVID-19 and relationship happiness among married individuals. An additional aim of the study also tested the moderating role of joint family activities between state anxiety and relationship happiness. The study sample consisted of 1713 married individuals (1031 women and 682 men). The study findings showed both the significant direct associations among the studied variables and the mediating role of state anxiety in the relationship between fear of COVID-19 and relationship happiness. It also found that the path of state anxiety to relationship happiness among married individuals having family activities was significantly lower than those who did not. Directions for future research and application were discussed.

Examining Adolescents' Mental Health Before and During the COVID-19 Pandemic

The current study characterized the impact of the COVID-19 pandemic and stay-at-home orders on adolescents' internalizing symptoms and assessed predictors of adolescents' internalizing symptoms during the pandemic. Seventy-nine adolescents (18 autistic, 61 nonautistic) and their parents who participated in a previous study and were at least 10 years old (M = 13.8, SD = 1.7) were invited to participate in three online follow-up surveys post-stay-at-home order (May through November 2020). Measures of children's anxiety and depressive symptoms, parenting practices, family togetherness, conflict, financial problems, and parental mental health during the pandemic were collected. Nonautistic adolescents experienced a significant decrease in anxiety symptoms across the beginning of the pandemic and a significant increase in depressive symptoms from pre- to post-stay-at-home order. Permissive parenting and financial problems predicted adolescents' depressive symptoms. Parental mental health difficulties and permissive parenting predicted adolescents' anxiety symptoms. Results underscore the need to support parents and youth.

AIM2ACT: Randomized controlled trial protocol for a mobile health intervention for early adolescents with asthma

Early adolescents diagnosed with asthma have difficulties consistently performing disease self-management behaviors, placing them at-risk for poor asthma control, morbidity, and reduced quality of life. Helpful caregiver support is pivotal in determining whether early adolescents develop and master asthma self-management behaviors. We developed Applying Interactive Mobile health to Asthma Care in Teens (AIM2ACT), a mobile health intervention to facilitate helpful caregiver support in early adolescents (12-15 year-olds) with poorly controlled asthma. AIM2ACT is a dyadic smartphone intervention that contains three components: 1) ecological momentary assessment to identify personalized strengths and weaknesses in asthma self-management behaviors; 2) collaborative identification and tracking of goals that help early adolescents to become increasingly independent in managing their asthma; and 3) a suite of skills training videos. This paper describes our plans to test the efficacy of AIM2ACT and evaluate long-term maintenance of treatment effects in a fully powered randomized controlled trial with 160 early adolescents with poorly controlled persistent asthma, ages 12-15 years, and a caregiver. Families will be randomly assigned to receive AIM2ACT (n = 80) or a mHealth attention control condition (n = 80) that accounts for attention and novelty of a technology-based intervention for 6 months. Assessments will occur at baseline, post-intervention, and 3-, 6-, and 12-month follow-up time points. We will collect patient-reported and objectively monitored (e.g., spirometry, adherence) outcomes. Given the timing of the trial, a secondary exploratory goal is to evaluate the perceived impact of COVID-19 on family functioning and parental control of their adolescent's asthma in the context of our intervention.

Pandemic Loneliness in Healthcare Workers. Does It Predict Later Psychological Distress?

Increased loneliness associated with the COVID-19 pandemic has been widely reported, with healthcare workers at increased risk compared to the general population. Pre-pandemic research indicates that loneliness has long-term detrimental effects on mental well-being, but the effect of loneliness in the context of COVID-19 is not clear. We conducted an online survey of healthcare workers (HCWs) at a large teaching hospital in Sydney, Australia after the peak of the first wave of the pandemic in 2020. Over one-third experienced loneliness at the peak of the first wave. An observed association with high psychological distress in subsequent months was attenuated after adjusting for status of mental well-being during the peak and before the pandemic. Mental well-being during the peak of the pandemic and, to a lesser extent, mental well-being before the pandemic were the strongest predictors of later distress. Increased conflict at home was also predictive of later distress. The mental health of HCWs is an important consideration at any time and is especially so in the face of crises such as the current global pandemic. Strategies to enhance baseline mental well-being and bolster well-being during crisis situations should assist HCWs cope with unexpected stressors and reduce the associated detrimental psychological consequences.

Psychological distress, employment, and family functioning during the COVID-19 outbreak among recent immigrant families in Israel: Moderating roles of COVID-19 prevalence

Grounded in an ecodevelopment perspective, in the current study we examined unique and moderating effects of daily COVID-19 prevalence (social contexts) on effects of COVID-19 related risk and protective factors such as emotional distress (individual contexts) and employment (working from home and unemployment status; family contexts) on family functioning among 160 recent immigrant families in Israel. In general, results indicate several unique effects of COVID-19 related factors (such as COVID-19 emotional distress, unemployment, and remote work arrangements) on both parents' and adolescents' reports of family functioning. However, results indicated that there were more significant associations between COVID-19 factors (e.g., emotional distress and COVID-19 prevalence) and family functioning indicators with adolescents, than with parents. The effects of COVID-19 factors (e.g., emotional distress and remote work arrangements) were moderated by daily COVID-19 prevalence (new cases and deaths). We discuss ways in which interventionists can contribute to pandemic-related research to promote optimal family functioning among immigrant families.

Antecedents and Outcomes of Work-Life Balance While Working from Home: A Review of the Research Conducted During the COVID-19 Pandemic

We present a systematic review of 48 studies conducted between March 2020 and March 2022 that examined work-life balance (WLB) among those who worked from home. We propose a conceptual framework that organizes the antecedents and outcomes of WLB based on resource loss and gain. Resource loss occurred when employees faced stressors such as perceived work intensity, workspace limitations, technostress, professional isolation, work interdependence, housework intensity, care work intensity, and emotional demands. Resource gain was likely when employees were supported by resources such as work supervisors and family members, received job autonomy, and were personally adaptable. Our findings have resonance for remote work contexts beyond the pandemic by seeking patterns across the literature that examined WLB while working from home. We contextualize antecedents and outcomes of WLB and suggest stressors and resources that impact WLB are dynamically related. Our review informs HRD practitioners as they manage the post-pandemic remote work.

Stress-related to COVID-19, anxiety, and protective factors among middle-aged and older adults in the largest outbreak areas in South Korea

OBJECTIVES

The present study examined the impact of psychological stress related to COVID-19 on anxiety as well as protective factors against these negative psychological consequences among middle-aged and older adults in the largest outbreak areas in South Korea.

METHOD

Participants included 667 middle-aged and older adults (ages 40 to 76) living in the largest outbreak areas at the time of the survey based on the number of confirmed COVID-19 cases in South Korea. Path analysis was conducted.

RESULTS

Stress related to COVID-19 and loneliness were positively associated with anxiety. However, family cohesion, resilience, health, and being married were negatively associated with anxiety. Also, family cohesion, resilience, income, and being married were negatively associated with loneliness among middle-aged and older adults in the largest outbreak areas in South Korea.

CONCLUSION

As postulated by the Stress Process Model, stress related to COVID-19 may have increased loneliness and anxiety among middle-aged and older adults in the largest outbreak areas in South Korea; however, resilience and family cohesion reduced these negative consequences both directly and indirectly. Findings are discussed and implications are addressed.

The impact of COVID-19 on individuals with ASD in the US: Parent perspectives on social and support concerns

The COVID-19 pandemic’s disruptions to daily routines and services have proven especially challenging for children with autism spectrum disorder (ASD) and their families. The current retrospective study aimed to determine the impact of the COVID-19 pandemic’s social environmental changes on parental ratings of personal and child concerns about family conflict, opportunities for social interaction, and loss of institutional support (school and therapy services). Analyses of responses from families with ASD in the US determined differences in concerns across three time points which were measured simultaneously: prior to COVID-19, at the start of COVID-19, and at the time of survey completion. From our sample of 246 school-aged children, parents retrospectively reported significantly increasing levels of concern for both themselves and their children over time, with parents’ personal concern levels rated consistently higher than their ratings of their child’s level of concern. Concerns about loss of institutional support were higher for parents of children reported as having co-occurring intellectual disability. Further, parents of younger children also reported more concerns about loss of services, as well as more social concerns. For parent ratings of child concerns, children who were reportedly aware of COVID-19 were determined to have higher levels of social concerns and concerns about loss of institutional support. Meanwhile, the child’s age and gender did not impact their parent ratings of child concerns. The increased level of parental and child-perceived concerns over the course of the pandemic suggests a need for improved service delivery and support for these families. The high levels of concerns observed in the current study provide support for the need to assess families’ priorities and tailor services to best meet families’ needs. This will potentially increase the quality of life of family members, and improve ASD services across the lifespan, and improve outcomes.

Assessing the influence of COVID-19 protocol on online health information seeking intention of athletes in India

Purpose

The Internet is used as a tool to seek health information by individuals. Mental health concerns are the high prevalence of the novel coronavirus disease 2019 (COVID-19) and preventive steps are required to curb the illness. Therefore, to gain more insight into health concerns, it is now a common practice to seek health information on the Internet. This study propose an integrated theoretical model to explore the relationship between COVID-19 protocols and perceived online trust with online health information seeking intention (OHISI) and a moderating effect of perceived severity and perceived urgency.

Design/methodology/approach

Data are collected from 325 athletes in the category of individual and team sports through an online survey in a Likert-scale questionnaire. The analysis is performed with a quantitative methodology.

Findings

The study reveals the bright side of online health information (OHI), which brings athletes together and has played out with virtual happy hours, meetings and events. The bright side of OHI reflects social, cultural, technological and economic benefits. An OHI chatbot offers bright personalised side information to the individual seeker, which is more convenient and efficient than human capabilities.

Originality/value

The pivotal contribution is the integrated theoretical framework that is derived from multidisciplinary literature to capture the complexity of OHI. Also, it conceptualises the constructs in the context of OHI and COVID-19.

Gamification and family leisure to alleviate the psychological impact of confinement due to COVID-19

This study presents a quasi-experimental longitudinal mixed-methods research about the participation in leisure activities, physical activity, and games, as part of the family leisure programme ("Lunae Magic School") for Spanish families with children under 12 years old during COVID-19 lockdown. The impact on parents and their perception of the psychological well-being of their children is evaluated. The results show that leisure activities reduce the parent's anxiety levels measured with STAI scale (p = .0001) and their perception of the physical and emotional discomfort of their children, measured with PSC scale (p < .0001). It is qualitatively argued that despite the confinement situation, the gamification, the variety of activities and the fact of being able to enjoy quality time with the family have allowed the creation of spaces of fun and flow. Therefore, although the findings on the importance of family leisure were encouraging, more research is needed on the implementation of similar programmes.

The Predictive Effects of Family and Individual Wellbeing on University Students' Online Learning During the COVID-19 Pandemic

The COVID-19 pandemic has significantly changed university students' life routines, such as prolonged stay at home and learning online without prior preparation. Identifying factors influencing student online learning has become a great concern of educators and researchers. The present study aimed to investigate whether family wellbeing (i.e., family support and conflict) would significantly predict university students' online learning effectiveness indicated by engagement and gains. The mediational role of individual wellbeing such as life satisfaction and sleep difficulties was also tested. This study collected data from 511 undergraduate students (Mean age = 20.04 ± 1.79 years, 64.8% female students) via an online survey. Structural equation modeling analysis revealed positive effects of family support on students' learning engagement and gains through the mediational effects of life satisfaction and sleep difficulties. In contrast to our expectation, family conflict during the pandemic also positively predicted students' learning gains, which, however, was not mediated by individual wellbeing. The findings add value to the existing literature by delineating the inter-relationships between family wellbeing, individual wellbeing, and online learning effectiveness. The study also sheds light on the unique meaning of family conflict, which needs further clarification in future studies.

Family Systems Cultural and Resilience Dimensions to Consider in Nutrition Interventions: Exploring Preschoolers' Eating and Physical Activity Routines During COVID-19

OBJECTIVE

To describe the weight-related family functioning of racial minority families with low income using family systems theory as an interpretive framework.

DESIGN

Primarily a qualitative study with interviews plus; descriptive demographics, anthropometrics, a family functioning measure, and food insecurity screening.

SETTING

Telephone interviews with families of preschool-aged children in an urban setting.

PARTICIPANTS

Primary caregivers of preschool-aged children.

PHENOMENON OF INTEREST

Cultural impacts on family systems.

ANALYSIS

Interviews were audio-recorded, transcribed verbatim, and loaded into NVivo 12 for thematic analysis. Descriptive statistics.

RESULTS

The 23 participants were mothers and 2 maternal grandmothers. Seventy-four percent were African American, most children were normal weight (n = 15, 65%), mean family function scores were high, and more than half the families were at risk for food insecurity (n = 13, 56%). Acculturation and intergenerational eating-related cultural dimensions were discerned as the overarching themes influencing family cohesion. Family cohesion appeared to have helped the families adapt to the impact of coronavirus disease 2019.

CONCLUSIONS AND IMPLICATIONS

Cultural dimensions such as acculturation and intergenerational influences appeared to be associated with social cohesion and family functioning around weight-related behaviors for these families. These findings add cultural and family resilience dimensions to family systems theory in nutrition interventions.

Are healthcare workers particularly vulnerable to loneliness? The role of social relationships and mental well-being during the COVID-19 pandemic

Loneliness is a major public health issue with renewed prominence due to the COVID-19 pandemic and associated social restrictions. Healthcare workers (HCWs) may be at heightened risk, but research is lacking. We measured the prevalence of loneliness among HCWs during the pandemic in 2020 and examined pre-pandemic predictors and pandemic experiences associated with loneliness. HCWs at a designated COVID-19 hospital in Sydney, Australia completed an online survey examining health and well-being before and during the pandemic and changes to work, family and social experiences. Loneliness had negatively affected the well-being of 129 (39%) respondents (n ​= ​330). Pre-pandemic factors predicting loneliness were younger age (<30years compared to ≥50years), having ever been told you had a mental health problem and living alone. These became non-significant when pandemic-related factors were added to the regression. Less contact with family and friends, increased conflict at home, and living alone or with family but not a partner, increased the odds of loneliness, while a sense of camaraderie with colleagues had the opposite effect. Psychological distress and poor mental health during the pandemic were also positively associated with loneliness. Efforts to promote congenial social contacts may be effective in averting loneliness among HCWs.

The Effects of COVID-19 on Family Climate: A Fuzzy Clustering Approach to Examine Spanish Households

Spain was one of the countries in which more severe lockdown policies were imposed during the second term of 2020 to mitigate the unprecedented health crisis. The measures restricted citizens’ mobility, obliging families to stay confined at homes for 99 days since 15 March 2020. The measures created a number of challenges that affect the family climate. This paper aims to empirically analyse how the family climate in Spain has been affected by COVID-19. The family climate assessment was based on an online questionnaire answered by 2034 citizens. A multi-criteria decision-making method rooted in fuzzy logic and TOPSIS, and a fuzzy clustering method, are applied to analyse the effects of the COVID-19 on the family climate. The fuzzy clustering method reveals that there are three different family climate profiles, namely (1) extreme positive, (2) extreme negative, and (3) intermediate. Our results show that some traits affect having a more or less positive family climate. The authors discuss the main contributions and the policy implications that could provide insights into future measures.

Clinician Perspectives on the Impact of COVID-19 on the Treatment of Adults and Youth with Anxiety

We describe the perceptions of mental health clinicians practicing in the United States about the effects of the COVID-19 pandemic on the presentation and treatment course of active clients with anxiety. Clinician participants reported on client symptomology at the beginning of treatment, just before (prior to March 2020), and at a mid-pandemic timepoint (December 2020/January 2021). An initial sample of 70 clinicians responded to a survey assessing their clients' overall anxiety severity, anxiety sensitivity, pathological uncertainty, family accommodation, and avoidance levels. Of these, 54 clinician responses were included in study analyses, providing detailed clinical information on 81 clients. Findings suggest that the COVID-19 pandemic was associated with increases in anxiety severity in the majority of clients; overall, clinicians reported that 53% of clients had symptoms worsen due to COVID-19 and that only 16% experienced improvement of symptoms during treatment. Those who had lower levels of avoidance pre-pandemic and those who increased their frequency of treatment were more likely to experience increases in anxiety severity by the mid-pandemic timepoint. Further research is needed to understand the extended effects of the COVID-19 pandemic on anxiety symptomology and treatment.

COVID-19 Adaptive Interventions: Implications for Wellbeing and Quality-of-Life

Social bonds may assist in cultivating a more positive attitude to life through commonly shared meanings about the COVID-19 pandemic. The key challenge, however, is how to foster social bonds meeting the changing demands in a post pandemic world. Yet, it is in the middle of a crisis that the conversation needs to start about how to strategically plan for the recovery. This is important not only in the current pandemic, but also in a post pandemic world. Reinforcing or fostering new social bonds is likely to bring positive experiences. The latter is central to human health and wellbeing, and has potential to contribute greatly in enhancing people's quality of life. In an attempt to foster place social bonding in the COVID-19 pandemic and beyond to subsequently contribute to wellbeing, this paper develops and proposes a new conceptual framework suggesting the need for adaptive social bonding interventions in the SARS-CoV-2 pandemic. This is an essential measure to manage the significant impacts on our global health services due to a decline in people's mental health in addition to COVID-19 physical impacts. The paper discusses how promoting adaptive social bonding interventions (psycho-socio, digital and nature social bonding) can make people more resilient. It further discusses how they can be empowered psychologically, socially, and emotionally in the current challenging times. The conceptual framework posits that social bonding interventions can assist in maintaining better mental, physical, emotional, and spiritual wellbeing and discusses how these wellbeing outcomes may also be experienced post the pandemic. This has important benefits and is of relevance to governments, policy makers and healthcare professionals in delivering better health care and equipping people with coping mechanisms both throughout the pandemic and in the long run.

Incremental theory of personality attenuates the effect of environmental uncertainty on intertemporal choices

To examine the impact of environmental uncertainty on individuals’ intertemporal choices and the moderating effect of implicit personality theory, two studies were conducted. Study 1 investigated the moderating role of implicit personality theory in the influence of environmental uncertainty on intertemporal choice using questionnaires. Study 2 examined whether priming incremental personality theory could change entity theorists’ intertemporal preference in an uncertain environment. The results showed that implicit personality theory plays a moderating role in the influence of environmental uncertainty on intertemporal choice. For entity theorists, the delay discounting rate was positively correlated with environmental uncertainty. In contrast, for incremental theorists, the delay discounting rate was not significantly correlated with environmental uncertainty. After priming incremental personality theory, entity theorists’ delay discounting decreased significantly. Thus, we conclude that incremental personality theory buffers the effect of environmental uncertainty on intertemporal choice.

Interpersonal cognitive distortions and family role performances in spouses during COVID-19 pandemic process in Turkey

PURPOSE

This study aimed to examine the relationship between interpersonal cognitive distortions and family role performances in spouses during the pandemic process.

DESIGN AND METHODS

This cross-sectional study was conducted on 402 married individuals.

FINDINGS

The total score of interpersonal cognitive distortions and task performance scores were higher in males. The individuals who go to the workplace during the Coronavirus disease 2019 (COVID-19) process have higher unrealistic relationship expectancy score and total score of interpersonal cognitive distortion. Interpersonal cognitive distortions were determined to explain 5% of task and relationship performance in family role performance.

PRACTICE IMPLICATIONS

It was determined that the relationships in the spouses were associated with cognitive distortions and family role performance. Interpersonal cognitive distortions in spouses were found to affect role performance in the family.

COVID-19 Daily Realities for Families: A South African Sample

The COVID-19 pandemic affected families globally. Empirical research has been explored to understand the impact of COVID-19 on families across countries, however, there are limited findings of how COVID-19 has affected the daily realities of families in South Africa. This study used an exploratory qualitative research approach to explore the experiences of COVID-19 for South African families. Findings suggest that the negative outcomes of COVID-19 experienced by South African families included a shift in the daily routines, restrictions on family events, lack of socialization and loss of connections, family conflicts, financial constraints as well as psychological impacts. On the contrary, the positive outcomes included increased family time and communication, cleanliness, and good health status, and improved financial management. Implications for future research should include research focused on the health impacts of COVID-19 on diverse family structures, family compositions, and family dynamics. In-depth research and findings can assist in developing policies and interventions for families.

Assessing the Impact of COVID-19 Social Distancing and Social Vulnerability on Family Functioning in an International Sample of Households with and without Children

The COVID-19 pandemic is a worldwide event that has exacerbated stress and caused significant disruptions in the day-to-day living of families. Of particular concern are socially vulnerable families, which have felt the impacts of the pandemic most acutely. Because stress can alter family dynamics, it is important to understand which stressors impact families the most, and what resources can be leveraged to strengthen family functioning. The current study examined the impacts of COVID-19 on the conflict and cohesion of households with children compared to households without children. Additionally, we sought to assess how conflict and cohesion are related to social vulnerabilities in the context of the pandemic. Using an international sample, we analyzed responses to the COVID-19 Household Environment Scale (N = 4122) using descriptive and bivariate analyses. Latent class analysis was used to identify patterns of family functioning in households with and without children. We found that social vulnerability was associated with more disrupted family functioning, and that households with children (n = 2666) reported less disrupted family functioning when compared to households without children (n = 1456), despite having higher social vulnerability scores. Our exploratory latent class analysis identified a 5-class model among both subgroups. Conflict, cohesion, family functioning and social vulnerability varied significantly by subgroup and class membership. Our findings add to a body of evidence that argues that despite facing greater vulnerability, households with children have many strengths to draw from. Family interventions that help to promote family cohesion and conflict resolution can foster resilience in stressful circumstances.

Internet Addiction Increases in the General Population During COVID-19: Evidence From China

BACKGROUND AND OBJECTIVES

COVID-19-related quarantine and stress have likely escalated the crisis of Internet addiction. This study aimed to determine the impact of the COVID-19 pandemic on Internet use and related risk factors among the general public in China.

METHODS

A large-sample cross-sectional online survey was conducted from March 24 to April 30, 2020, in China, and 20,472 participants completed the survey. We investigated the prevalence and severity of Internet addiction based on the Internet Addiction Test (IAT), and explored the risk factors related to increases in time spent on Internet use and severity of Internet addiction, as well as severe Internet addiction.

RESULTS

The overall prevalence of Internet addiction was 36.7% among the general population during the pandemic, and that of severe Internet addiction was 2.8%, according to IAT scores. Time spent on recreational Internet use had significantly increased during the pandemic, and almost half of participants reported increases in the severity of Internet addiction. Risk factors for increases in time spent on Internet use and severity of Internet addiction and severe Internet addiction included having fewer social supporters, perceiving pressure and impact on mental health status due to COVID-19, and being over-engaged in playing videogames.

DISCUSSION AND CONCLUSIONS

The COVID-19 pandemic adversely impacted Internet use and increased the prevalence and severity of Internet addiction among the general population in China, especially in vulnerable populations.

SCIENTIFIC SIGNIFICANCE

This study provides evidence for policymakers to refine public health policies to control the pandemic and make efforts to provide population-specific prevention and interventions for people at risk of developing Internet addiction. (Am J Addict 2021;00:00-00).

Climate Change, Migration, Urbanization, and the Mental Health of Children at Risk in the European Union

Abstract. Psychologists face a growing mental health challenge, calling for innovative large-scale interventions. World population growth and industrialization are causing climate change, forcing families to migrate into rapidly expanding cities, and suffer in refugee camps. European in-country migration from rural villages adds to urban growth. This rapid shift in adaptation between uprooted families and their new environments tends to increase the risk of family system disorganization, poor child attachment, and child abandonment. The paper presents demographic data and projections concerning the effects of urban life on childbirth frequency, marital constancy, how early in life children are cared for outside the home, and the placement of children in Alternative Care. European Federation of Psychologist’s Association initiatives addresses new questions. How can research recommendations be applied in cross-professional interventions? Can e-learning open new channels for dissemination? The author presents how a European Union Lifelong Learning grant project in 10 member countries later developed into the Fairstart Foundation’s partnerships with world NGOs and government agencies. Five hundred twelve partner staff in 26 countries have been educated in 6-month online classrooms and trained the foster parents and group home staff of some 40,000 children in attachment-based care. Lessons learned for interventions are discussed, to inspire further developments.

Psychological Distress and Physical Health Symptoms in the Latinx Population During the COVID-19 Pandemic: Exploring the Role of Anxiety Sensitivity

Objective

The outbreak of the novel 2019 SARS2-Coronavirus disease (COVID-19) has led to substantial physical and mental health consequences. Rates of mortality and hospitalization are highest among those of racial and ethnic minority persons, including Latinx persons. Further, Latinx persons have been experiencing elevated mental health problems in response to the pandemic compared to non-Latinx Whites. The current study examined whether individual differences in anxiety sensitivity (AS) related to more severe emotional distress associated with social distancing, financial strain, fear of COVID-19, and physical health symptoms stemming from the COVID-19 pandemic among Latinx adults.

Methods

Participants included 188 Latinx persons (31.4% female, M_age = 34.1 years, SD = 8.16) recruited via an online survey panel program.

Results

Results indicated that AS significantly contributed to increased severity of the emotional stress response associated with social distancing (ΔR² = 0.15, p < 0.001), financial strain (ΔR² = 0.15, p < 0.001), physical health symptoms (ΔR² = 0.03, p = 0.006), and fear of COVID-19 (ΔR² = 0.15, p < 0.001). These effects were evident over and above the variance accounted for by gender, years living in the United States, education, and work and home life COVID-19-related stress.

Conclusions

These cross-sectional findings suggest AS may be an important individual difference factor for better understanding mental health among Latinx persons in the context of the COVID-19 pandemic.

Health, work, and contributing factors on life satisfaction: A study in Norway before and during the COVID-19 pandemic

Background

The COVID-19 outbreak has posed considerable challenges for people's health, work situations and life satisfaction. This article reports on a study of the relationship between self-reported health and life satisfaction before and during the COVID-19 pandemic in Norway, and examines the role of work in explaining the health-life satisfaction relationship.

Method

The study was based on survey data collected from 3185 Norwegian employees in 2019 and 3002 employees in 2020. Propensity score matching techniques were used to assess the mediating effects of work situations and income loss on the health-life satisfaction relationship. Skew-t regression models were further applied to estimate changes in life satisfaction before and during the pandemic, as well as to explore different underlying mechanisms for the health-life satisfaction association.

Results

The study found a negative association between ill health and life satisfaction. Compared to the healthy population, people with poor health were more likely to experience worsened work situations. A negative work situation is further associated with lower life satisfaction, and the pandemic aggravated life satisfaction for those who had worsened work situations. When exploring central contributing factors for life satisfaction, we found that health-related risks and work-life balance played predominant roles in predicting life satisfaction before the pandemic, while different types of household structure were among the most important predictors of life satisfaction during the pandemic.

Conclusion

A reduction in life satisfaction is explained by ill health, but different underlying mechanisms facilitated people's life satisfaction before and during the pandemic. While work situation and health risks were important predictors for life satisfaction in 2019, worries about more unstable work situations and less access to family support accentuated worsened life satisfaction in 2020. The findings suggest the necessity of labour market interventions that address the security and maintenance of proper and predictable work situations, especially in these more uncertain times.

Top problems of adolescents and young adults with ADHD during the COVID-19 pandemic

OBJECTIVE

ADHD symptom severity appears to be exacerbated during the COVID-19 pandemic. The present study surveyed top problems experienced by adolescents and young adults (A/YAs) with ADHD during the COVID-19 pandemic to identify possible reasons for symptom escalation and potential targets for intervention. We also explored perceived benefits of the pandemic for A/YAs with ADHD.

METHOD

At the outbreak of the COVID-19 pandemic (April-June 2020), we administered self and parent ratings about current and pre-pandemic top problem severity and benefits of the pandemic to a sample of convenience (N = 134 A/YAs with ADHD participating in a prospective longitudinal study).

RESULTS

The most common top problems reported in the sample were social isolation (parent-report: 26.7%; self-report: 41.5%), difficulties engaging in online learning (parent-report: 23.3%, self-report: 20.3%), motivation problems (parent-report: 27.9%), and boredom (self-report: 21.3%). According to parent (d = 0.98) and self-report (d = 1.33), these top problems were more severe during the pandemic than in prior months. Contrary to previous speculation, there was no evidence that pandemic-related changes mitigated ADHD severity. Multi-level models indicated that A/YAs with higher IQs experienced severer top problems exacerbations at the transition to the COVID-19 pandemic.

CONCLUSIONS

For A/YAs with ADHD, several risk factors for depression and school dropout were incurred during the early months of the COVID-19 pandemic. A/YAs with ADHD should be monitored for school disengagement and depressive symptoms during the COVID-19 pandemic. Recommended interventions attend to reducing risk factors such as increasing social interaction, academic motivation, and behavioral activation among A/YAs with ADHD.

Save for Safe: Effect of COVID-19 Pandemic on Consumers' Saving and Spending Behavior in China

In public health emergencies, people are more willing to save money rather than spending it, which is not conductive to economic development and recovery. Due to the absence of relevant research, the internal logic of this phenomenon is not clear. In the context of the COVID-19 pandemic, this study systematically explored whether and why public health emergencies stimulate consumers' preference for saving (vs. spending). We conducted two online surveys and used methods including stepwise regression analysis and bootstrapping to test the hypotheses. The first survey, with 1,511 participants from China in February 2020, indicates that the severity of emergencies has a significant positive impact on the populations' willingness to save (vs. spend). Risk perception plays a mediating role between the severity of emergencies and consumers' saving (vs. spending) willingness. Materialism plays a moderating role between risk perception and an individual's saving (vs. spending) willingness, individuals who are more materialistic have a lower saving (vs. spending) willingness when they perceive the risks of the pandemic. To verify the duration of the above effects, we conducted a follow-up survey consisted of 466 instances in August 2020. It is noteworthy that the above effects are not significant during the post-pandemic period. Thus, spending behavior in public health emergencies can be motived by reducing risk perception and increasing materialism. These findings can provide a valuable inspiration for public health, crisis management, and economic recovery during public health emergencies.

The impact of lockdown policy on depressive symptoms among pregnant women in China: mediating effects of internet use and family support

BACKGROUND

Although more and more attention has been paid to the psychological consequences of the lockdown policy amongst pregnant women, the underlying mechanism linking the lockdown policy to maternal depression has not been studied in the context of China. This study aimed to explore the association between the lockdown policy and maternal depressive symptoms, and whether such association was mediated by internet use and/or family support.

METHODS

This cross-sectional study used multi-stage sampling techniques in central and western China. Data were collected from 1266 pregnant women using a structtured questionnaire that measured internet use, family support, and depressive symptoms. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depressive symptoms. Internet use was measured by length of usage and varierity of purpose for internet use. Family support was measureed by spousal support and parental support. The structural equation modelling was employed to conduct mediation analysis to test the specificity of the hypothetical paths.

RESULTS

Overall, 527 respondents (41.63%) presented depressive symptoms. The lockdown policy was negatively associated with depressive symptoms in pregnant women (β = - 0.925, 95% CI = -1.510, - 0.360). The impact of the lockdown policy on depressive symptoms was partially mediated by internet use (β = 1.589, 95% CI = 0.730, 2.807) and family support (β = - 0.162, 95% CI = - 0.341, - 0.017), accounting for 42.67% of the total effect.

CONCLUSIONS

The lockdown policy was generally associated with fewer depressive symptoms in pregnant women. The lockdown policy increased maternal depressive symptoms through increased internet use, but decreased maternal depressive symptoms through enhanced family support. The findings suggest that the psychological consequence of the lockdown policy may vary across different populations, and warrant the need to take into consideration the features of subgroups.

Women Face to Fear and Safety Devices During the COVID-19 Pandemic in Italy: Impact of Physical Distancing on Individual Responsibility, Intimate, and Social Relationship

The COVID-19 pandemic of 2020 in Italy had its first epidemic manifestations on January 31, 2020. The socio-sanitary rules imposed by the government concerned the social distance and management of intimate relationships, the sense of individual responsibility toward public health. Physical distancing and housing isolation have produced new representations of intrafamily, generational, neighborhood, community responsibility, bringing out a new “medicalized dimension” of society. In light of this contextual framework, the research aims are to analyze how: the perception of individual responsibility for public and familial health and physical distancing has redrawn the relation between subjects-family-community; the State's technical-health intervention has reformulated the idea of social closeness, but also how the pandemic fear and social confinement has re-evaluated a desire for community, neighborhood, proximity; during the lockdown families, friends, neighbors have reconstructed feelings of closeness and forms of belonging. The methodology used is quanti-qualitative and involved 300 women through an online questionnaire. The data collected highlight how the house during the lockdown is perceived as a safe place and how women implement both the recommendations and the behaviors aimed at preventing contagion, but also ways that allow coping with the situation from a perspective of well-being. Furthermore, the data show how the dimension of distancing has loosened the relational dimension outside the family unit, with a greater distancing compared to pre-pandemic data. However, the majority of women report that they have joined solidarity initiatives, demonstrating that they want to maintain ties and participate actively in community life.

Families in the Time of the Pandemic: Breakdown or Breakthrough?

The COVID-19 pandemic has taken a toll on all individuals and their families around the world. Some suffer more adversely than others depending on their unique developmental needs, resources, and resilience. However, instead of breaking down, many families and therapists have hunkered down to cope with this 'wicked' situation as it continues to evolve. This article examines the unique challenges and opportunities of COVID-19 for families at different life developmental stages, as well as the challenges and opportunities for systemic therapists as they venture into unfamiliar territory. Through a case example and by integrating recent literature related to this pandemic, we apply three key and interconnected systemic themes (unsafe uncertainty, family life cycle, and social diversity) to discuss the challenges and opportunities for families and therapists, respectively. We are optimistic that there are many possibilities as families and therapists draw on, and often reinvent, currently available resources to navigate their course in this pandemic. We also find that while the pandemic continues to present unsafe and uncertain situations, there are new ways of being and behaving, especially when families and professionals work together collaboratively. Despite formidable challenges, there are many opportunities, both within families and communities that cut through different social contexts related to family, culture, economics, and even politics. Families and therapists could endure better when they are more cognisant of how and what these contexts may impact and offer them.

A Mixed Approach on Resilience of Spanish Dwellings and Households during COVID-19 Lockdown

The confinement by COVID-19 has meant a re-reading of housing for Spanish households, resulting in the only available and safe space to carry out daily activity. This complex phenomenon has generated a completely different way of inhabiting it, as well as of relating to domestic spaces. For this reason, the home perception and its characteristics must be evaluated, highlighting those perceived as deficiencies, or as preferences in such an unusual context as lockdown, where the experience was different depending on the dwelling characteristics, and the family in question. To deepen in this double perception home-dwelling, a mixed method was used, with two online forms. The first is a quantitative questionnaire, while the second asks the participants for photographs and narratives about such images. More than 1800 surveys and 785 qualitative responses were obtained. From both approaches, the joint discourse arose, allowing an exploratory analysis of the current situation of the Spanish residential park, and the resilience demonstrated in this period by both households and their usual dwellings. This study should facilitate the development of new proposals on housing in contexts similar to the COVID-19 pandemic.

Prevalence of Anxiety in Medical Students during the COVID-19 Pandemic: A Rapid Systematic Review with Meta-Analysis

The novel coronavirus disease (COVID-19) pandemic has brought a great deal of pressure for medical students, who typically show elevated anxiety rates. Our aim is to investigate the prevalence of anxiety in medical students during this pandemic. This systematic review and mini meta-analysis has been conducted following the PRISMA guidelines. Two researchers independently searched PubMed on 26 August 2020 for cross-sectional studies on medical students during the COVID-19 outbreak, with no language restrictions applied. We then performed a manual search to detect other potentially eligible investigations. To the 1361 records retrieved in the initial search, 4 more were added by manual search on medRxiv. Finally, eight studies were finally included for qualitative and quantitative analysis, which yielded an estimated prevalence of anxiety of 28% (95% CI: 22-34%), with significant heterogeneity between studies. The prevalence of anxiety in medical students is similar to that prior to the pandemic but correlates with several specific COVID-related stressors. While some preventive and risk factors have been previously identified in a non-pandemic context, knowledge and cognitions on COVID-19 transmission, treatment, prognosis and prevention negatively correlate with anxiety, emerging as a key preventive factor that may provide a rationale for why the levels of anxiety have remained stable in medical students during the pandemic while increasing in their non-medical peers and the general population. Other reasons for the invariability of anxiety rates in this population are discussed. A major limitation of our review is that Chinese students comprised 89% the total sample, which could compromise the external validity of our work.