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

Understanding the Relationships Between Fear of COVID-19, Depression, Loneliness, and Life Satisfaction in Türkiye: Testing Mediation and Moderation Effects

AIM

This study examined the mediating roles of depression and various dimensions of loneliness (family, social, and romantic) in the associations between COVID-19 fear and satisfaction with life. Additionally, the research investigated how the economic impact of COVID-19, family income, gender, and marital status may moderate these associations.

DESIGN

A cross-sectional descriptive design.

METHODS

An online survey was conducted in Türkiye. 1702 participants completed self-report measures assessing COVID-19 fear, depression, social, emotional, and romantic loneliness, and satisfaction with life.

RESULTS

The findings revealed positive associations between COVID-19 fear and depression, along with negative relationships between COVID-19 fear and family, social, and romantic loneliness. Depression was identified as a mediator in the relationship between COVID-19 fear and the different components of loneliness. These loneliness components, in turn, influenced life satisfaction. Furthermore, the study found significant moderation effects related to the economic impact of COVID-19 restrictions, family income, marital status, and gender.

CONCLUSIONS

This study provides evidence about the psychological mechanisms linking COVID-19 fear to life satisfaction. It highlights the mediating role of depression and the moderating effects of demographic and economic factors. The findings emphasise the need for targeted mental health interventions, particularly addressing the varied impact of COVID-19 fear across different social and economic groups. This evidence can inform strategies aimed at improving life satisfaction during periods of social and economic disruption.

PATIENT OR PUBLIC CONTRIBUTION

This study has no direct patient involvement in its design, conduct, or reporting. However, it contributes to public health by providing evidence about the psychological impacts of COVID-19, which may inform future interventions and mental health support strategies.

Mental health during the Covid-19 pandemic: An international comparison of gender-related home and work-related responsibilities, and social support

PURPOSE  : To assess gender differences in COVID-19 related changes in home and work responsibilities longitudinally, and determine whether these differences, together with other potential risk and protective factors, are associated with depression, anxiety, and post-traumatic stress disorder (PTSD) symptomatology.

METHOD

Symptoms of depression, anxiety, and PTSD were measured using an online survey instrument, between May 2020 and April 2021, in four waves completed at 3-monthly intervals. Analyses were based on data from the COvid MEntal healTh (COMET) survey which investigated the mental health effects of the COVID-19 outbreak spanning 13 countries on five continents in N = 7,909 participants.

RESULTS

From the first to the last wave, women reported a greater increase in home and work responsibilities, and had higher depression, anxiety and PTSD scores compared to men. Women who reported a reduction in income due to the pandemic had higher depression scores. Working harder and experiencing a reduction in income were also associated with higher anxiety scores in women but not in men. Women were more likely to score above the cut-off for depression (32.5% vs 23.6%, p < .001), anxiety (21.2% vs 14.4%, p < .001) and PTSD (21.2% vs 14.4%, p < .001) than men during the first wave. Stronger reliance on socially supported coping mechanisms was a risk factor for depression, anxiety and PTSD in men and women.

CONCLUSION

Women were more likely to report mental health problems which may be related to the gender disproportionate increase in home and work responsibilities but not necessarily due to COVID-19 stressors.

Unmasking the psychological impact of the early COVID-19 pandemic in young adults: results from a cross-sectional online survey

Background

The COVID-19 pandemic emerged as an international public health emergency and threat to individual psychological resilience.

Objective

To examine the prevalence of psychological issues and identify key associations with mental health indicators in young adults (ages 18-28) worldwide during the initial phase of the pandemic.

Methods

Through a cross-sectional online survey utilizing convenience sampling, we collected data on demographics, COVID-19-related questions, depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder-7), stress/trauma (Impact of Event Scale-Revised), and fear of COVID-19 (Fear of COVID-19 scale) between September 2020-January 2021. A total of 183 were eligible analysis. All statistical analyses were set at alpha = 0.05.

Results

Over 70% of participants reported mild anxiety (n=129), 80% mild depression (n=136), 40% pandemic-related trauma (n=61), and 50% high fear (n=88). Female respondents reported higher anxiety (t(173)=-3.352, <.001), depression (t(166)=-3.310, P=.001), and trauma from COVID-19 ((t(151)=-2.004, P=.047). Hispanic/Latino/a/x participants reported higher depression (F(2,156)=7.761, P<.001) and trauma scores (F(2,143)=3.999, P=.020). Age in 2020 was associated with trauma total scores (F(1,154)=4.230, P=0.041, R2 = 0.027). Individuals who were mandated a quarantine were linked to lower levels of anxiety (F(2,175)=3.442, P=.034) and depression (F(2,170)=3.092, P =.048) than those not mandated. Those quarantined with close contacts were linked to lower anxiety (t(162.184)=2.705, P =.008) and trauma (t(149)=2.169; P=.032). Close contacts' hospitalization from COVID-19 infections were linked to lower anxiety (t(127)=2.855, P=.005), depression(t(123)=3.111, P=.002), and trauma (t(152)=-1.975, P=.050).

Conclusion

The findings highlight the significant effect COVID-19 had on mental health in young adults worldwide.

The role of meaning in life in the association between loneliness and depression: a mediation study among older adults from 26 European countries

Loneliness and depression are serious public mental health problems. Meaning in life (MIL) is associated with reduced loneliness and depression. This study aimed to: (1) investigate associations between loneliness, MIL, and depression, differentiated by sex in individuals aged ≥ 50 years, residing in 26 European countries and Israel, and (2) to examine in men and women separately whether MIL mediated the relationship between loneliness and depression. We included 41,372 individuals (23,789 women) who responded to wave 8 of the SHARE project. The variables analyzed were loneliness (UCLA), depression (EURO-D scale), and MIL (CASP-19). The analytical procedures included regression analysis and exploratory mediation analysis. Among men and women, the odds of loneliness increasing depression were 3.6 and 3.3 times higher, respectively. Among men, feeling MIL sometimes or often had odds for reducing depression by 0.53 and 0.21, respectively. In women, feeling MIL sometimes or frequently reduced the odds of depression by 0.37 and 0.19, respectively. Regardless of sex, mediation analyses showed a positive association between loneliness and depression, while MIL was negatively associated with loneliness and depression. MIL partially mediated the association between LON and depression in male and female models by approximately 83.2% and 80.7%, respectively. No differences were found between men's and women's mediation models. Regardless of sex, high levels of MIL seem to be effective in benefiting the mental health of Europeans aged 50 and over. MIL proved to be a significant mediator of the relationship between loneliness and depression, while loneliness and depression strengthened each other.

Exploring the Physiological and Psychological Effects of Group Chanting in Australia: Reduced Stress, Cortisol and Enhanced Social Connection

Chanting, an ancient ritual practiced in diverse cultures and traditions worldwide, has typically been employed for meditation, healing, self-awareness, and psychological growth. However, there is little understanding of the physiological and psychological benefits of chanting, and how vocalization might contribute to such effects. This study aimed to determine whether 12-minutes of group chanting, through vocal or silent repetition of the sound "om," would reduce stress and anxiety, while increasing feelings of social connection, and whether vocal chanting would yield stronger effects. Thirty-four participants were randomly assigned to vocal or silent group chanting conditions. Saliva samples were collected before and after chanting to assess cortisol levels, while self-report measures included the State Trait Anxiety Inventory and the Adapted Self-Report Altruism Scale (including additional items on cross-cultural altruism). Following chanting, participants also provided a written description of their experiences. Both vocal and silent chanting resulted in significant decreases in cortisol levels and self-reported anxiety. The reduction in cortisol was similar for vocal and silent chanting, but self-reported anxiety decreased more following vocal chanting. Altruism scores increased following both vocal and silent chanting. However, there was no evidence of altruistic tendencies extending toward people from a culture other than one's own. Results are discussed in relation to the phenomenology of chanting, and to current theory and evidence on the physiological and psychological effects of chanting and singing.

A systematic review of longitudinal risk and protective factors for loneliness in youth

To effectively tackle loneliness in youth, prevention and intervention strategies should be based on solid evidence regarding risk and protective factors in this age group. This systematic literature review identifies and narratively synthesizes longitudinal studies of risk and protective factors for loneliness in children and adolescents aged below 25 years. A systematic literature search was conducted in October 2023 using PsycINFO and MEDLINE, resulting in n = 398 articles, with n = 105 articles meeting the inclusion criteria. The examined factors included demographic (e.g., gender), socioeconomic (e.g., income sufficiency), social (e.g., peer acceptance), mental health (e.g., depression), physical health (e.g., disabilities), health behavior (e.g., sport participation), and psychological factors (e.g., shyness). Additionally, adverse childhood experiences (e.g., child maltreatment) and environmental factors (e.g., neighborhood characteristics) were investigated. Despite the wide range of potential risk and protective factors examined, relatively few studies provided strong evidence for a prospective association with loneliness. Risk factors that were consistently identified across multiple longitudinal studies included low peer acceptance and peer victimization, depression, social anxiety, internalizing symptoms, low self-esteem, shyness, and neuroticism. Additional replication is required to evaluate factors that have shown significant associations with loneliness in only a limited number of longitudinal studies (e.g., aggression).

In-person and computer-mediated social support for international students at U.S. universities: Associations with acculturative stress and mental health

Objectives: The current study explored whether social support received from either mediated or in-person contact varied among international students depending on the level of social ties (stronger/weaker) with existing support groups. This study also examined whether in-person or computer mediated social support (CMSS) is a better predictor of acculturative stress which might influence mental health of international students. Methods: An online survey was conducted among 179 international students across three U.S. universities. Results: Results showed that international students perceive stronger online social ties compared to in-person social ties, t(125)=- 3.57, p < .001. Stronger ties with CMSS significantly negatively influence acculturative stress compared to in-person social support for international students, (b = -0.24, 95% CI [-0.45, -0.03]). This indicates that as CMSS increases, acculturative stress decreases among international students. Conclusions: This study concludes that online social support groups can positively influence mental health of college student populations, particularly those who feel stressed out.

Combinatorial therapy with sub-effective Ro25-6981 and ZL006 ameliorates depressive-like behavior in single or combined stressed male mice

Major depression is a severe neuropsychiatric disorder that poses a significant challenge to health. However, development of an effective therapy for the disease has long been difficult. Here, we investigate the efficacy of a novel combinatorial treatment employing sub-effective doses of Ro25-6981, an antagonist targeting GluN2B-containing NMDA receptors, in conjunction with ZL006, an inhibitor of the PSD95/nNOS, on mouse models of depression. We employed social isolation, chronic restraint stress, or a combination of both to establish a depressed mouse model. Treatment with the drug combination reduced depressive-like behaviors without affecting locomotor activity in mice subjected to social isolation or chronic restraint stress. Furthermore, the combination therapy ameliorated depressive-like behaviors induced by combined stress of chronic restraint followed by social isolation. Mechanistic studies revealed that the combined treatment downregulated the hippocampal nitric oxide level. However, the therapeutic benefits of this combination were negated by the activation of NMDA receptors with a low dose of NMDA or by increasing nitric oxide levels with l-arginine. Moreover, the combinatorial treatment had negligible effects on object memory and contextual fear memory. Our data establish a combined therapy paradigm, providing a potential strategy targeting major depression.

Social isolation, loneliness, and subjective wellbeing among Chinese older adults during the COVID-19 pandemic

The COVID-19 pandemic has brought unprecedented challenges to the wellbeing of the older adults worldwide. Both social isolation and loneliness are associated with decreased subjective wellbeing, but it is uncertain whether their effects are independent or if loneliness represents the affective pathway through which social isolation impairs subjective wellbeing. We therefore assessed the extent to which the association between social isolation and subjective wellbeing is mediated by loneliness. We utilized data from the 2020 China Family Panel Studies (CFPS) and focused on a sample of 3,821 individuals aged 60 and above as the participants for our study. The results revealed a significant negative association between social isolation and subjective wellbeing among the older adults during the COVID-19 pandemic. Furthermore, loneliness was found to mediate this relationship, indicating that social isolation led to increased feelings of loneliness, which in turn negatively impacted subjective wellbeing. These findings highlight the detrimental effects of social isolation and loneliness on the wellbeing of the older adults in China during the pandemic. The implications of these results emphasize the need for interventions and support systems that address social isolation and loneliness among the older adults, promoting their wellbeing and overall mental health during challenging times such as the COVID-19 pandemic.

Mobile phone dependence among Chinese university students: the contribution of irrational beliefs and solitude

This research aimed to explore the impact of selected psychological variables on mobile phone dependence among Chinese university students. Specifically, the study focused on the relationship between solitude and irrational beliefs on mobile phone dependence. The study included 2,888 university students from Guangdong, Southern China, and found that both irrational beliefs and solitude had significant direct effects on mobile phone dependence. The study also revealed that solitude mediated the relationship between irrational beliefs and mobile phone dependence. The results of this study indicate that psychosocial environments, including feelings of solitude and irrational beliefs, can influence mobile phone dependence among undergraduate students. Therefore, it is important to pay attention to these factors and their potential impact on student behavior, particularly when it comes to academic growth and development. Further research in this area may help identify effective strategies to address mobile phone dependence among university students and promote healthier psychosocial environments.

The association between COVID-19 related income loss and diet quality: The mediating role of distress

The COVID-19 lockdowns saw many individuals lose income, experience distress and increase intake of foods that would typically be considered less 'healthy' (more processed and less fresh produce). Establishing whether there are direct and indirect links between these variables would be of benefit in preparing for similar future events but also has implications for the current global financial climate, where many are experiencing relative decreases in income. Adults in two locations (UK and Australia) (N = 917) completed online questionnaires to explore the impact of the first COVID-19 lockdown on their change in income, emotional wellbeing (depression, anxiety, stress, loneliness), resilience and diet quality. A structural equation model revealed that income loss was indirectly associated with diet quality via distress. As such, the greater the loss of income experienced, the more distress reported; distress was then directly associated with a less nutritious diet. This pattern of results existed when data from both countries were combined but also when they were modelled individually. Our findings indicate that where individuals experience a sudden reduction of income there are likely to be negative consequences for both mental and physical health. It is plausible that these findings would extend to other circumstances in which sudden loss of income may be experienced such as reductions in state social care, rising inflation and interest rates and sudden increases to the general cost of living.

Prevalence of Anxiety and Depression Symptoms among University Teachers in Ethiopia during the COVID-19 Pandemic

A growing body of evidence suggests an increased prevalence of anxiety and depression among teachers during the COVID-19 pandemic. However, there is little evidence in research documenting the extent of anxiety and depression in the university teacher population and how these relate to feelings of loneliness. This study aims to explore the prevalence of anxiety and depression symptoms among university teachers, identify differences, and further examine the relationships between loneliness and symptoms of anxiety and depression. The study participants included university teachers in the College of Health and Medical Sciences from four purposefully selected public universities who completed a survey questionnaire consisting of items that measured anxiety and depressive symptoms as well as loneliness. The final sample included 148 participants (45 participants [30.4%] located in the center or capital; 125 (83.1%) men; and 90 [62.5%] taught both online and face-to-face). The university teachers' sample mean age = 39.07 had an SD = 7.67. As per the findings of this study, the prevalence of anxiety and depression symptoms was significant (11% and 12.3%) among university teachers in Ethiopia during the COVID-19 pandemic. Also, this study found a significant association between these symptoms and loneliness. Therefore, incorporating relevant strategies to promote mental well-being and targeting individuals who felt lonely were essential for overcoming health-related burdens. Universities should equip teachers with resources to prevent mental health issues and offer need-based counseling services to alleviate them.

Quality of Life and Loneliness Among American Military Veterans

ABSTRACT

Quality of life and loneliness are closely associated with mental and physical health outcomes. This relationship is particularly important in Veterans who experience elevated rates of disabilities, comorbidities, and chronic health conditions as compared with non-Veterans. In the present project, we use data from the Military Health and Well-Being Project ( n = 1469, 67.2% men, 32.3% women, 0.5% transgender, nonbinary, prefer not to say) to investigate the link between five domains of quality of life ( i.e. , general quality of life, physical health, psychological health, social relationships, and environment) with loneliness in American Military Veterans. Findings indicated that every domain of quality of life was negatively and significantly associated with loneliness ( r 's < -0.45, p 's < 0.001), such that quality of life decreased as loneliness increased. We further found, using linear regression, that quality social relationships (β = -0.385, t = -13.23), psychological functioning (β = -0.196, t = -5.28), and physical health (β = -0.133, t = -4.174) were related to low levels of loneliness. Taken together, these findings indicate that in this sample of Veterans 1) general quality of life, physical health, psychological health, social relationships, and environment are all strongly connected with loneliness, and 2) of these, social relationships, psychological health, and physical health seem to protect most against loneliness, with large robust effect sizes. We recommend that intervention and policy researchers continue to investigate and develop feasible, acceptable, and cost-effective ways to promote social relationships, psychological health, and physical health among Veterans. Data were collected during the COVID-19 pandemic, which may limit generalizability of these findings.

Risk-stratified analysis of sex risk behaviors and correlates among school-going adolescents in Argentina: insights from a national survey

OBJECTIVES

This study was conducted to address a critical gap in understanding adolescent sexual health risks in Argentina, a country that has undergone substantial socio-economic changes that made significant strides in education and healthcare.

METHODS

A secondary data analysis of the 2018 Argentina Global School-based Student Health Survey was performed. In this study, 23,262 sexually active adolescents were categorized into four risk groups based on the predicted granular risk: number of sexual partners and condom use in their last sexual encounter.

RESULTS

Males and older adolescents were more prone to high-risk sexual behaviors. Additionally, key psychosocial factors such as loneliness, anxiety, experiences of violence, and school absenteeism were significantly associated with high-risk sexual behaviors. Early alcohol use and recent experiences of hunger were also identified as strong predictors of heightened sexual risk behaviors. Conversely, positive parental engagement and awareness exhibited protective factors.

CONCLUSIONS

These findings highlight the necessity for policy interventions that focus on mental health support, parental involvement, and awareness of adolescent issues and activities.

Longitudinal Problematic Social Media Use in Students and Its Association with Negative Mental Health Outcomes

Purpose

Social media has become increasingly part of our everyday lives and is influential in shaping the habits, sociability, and mental health of individuals, particularly among students. This study aimed to examine the relationship between changes over time in problematic social media use and mental health outcomes in students. We also investigated whether resilience and loneliness moderated the relationship between social media use and mental health.

Patients and Methods

A total of 103 participants completed a baseline virtual study visit, and 78 participants completed a follow-up visit, 4-weeks later. Participants completed a comprehensive set of questionnaires measuring symptoms of depression and anxiety, perceived stress, loneliness, and resilience.

Results

Our results showed that problematic social media use at baseline was significantly negatively correlated with resilience and positively correlated with all other mental health outcomes. Furthermore, increases in problematic social media use were significantly associated with increased depressive symptoms and loneliness between visits. Resilience significantly moderated the relationship between increased problematic social media use and heightened perceived stress. Poor mental health at baseline did not predict increased problematic social media use over time. Contrarily to problematic use, frequency of social media use was not significantly correlated with any mental health measures at baseline.

Conclusion

This study offers a longitudinal perspective, providing valuable insights into the potential protective role of resilience against the detrimental mental health effects seen with increases in problematic social media use.

COVID-19 Pandemic-Related Stress and Subjective Well-Being Across Age: The Mediating Role of Social Resources

Stress associated with the COVID-19 pandemic and the measures implemented to prevent its spread dramatically shifted our social networks, interactions, and contexts, all of which influence the assessment of one's subjective well-being (SWB). Drawing on data collected from 1,318 adults between April and May 2020, we used structural equation modeling to analyze the relationship between pandemic-related stress and SWB (life satisfaction, positive affect, negative affect), and examined how these relationships vary across age. Pandemic-related stress was associated with lower life satisfaction and higher negative affect. However, no evidence of age moderation emerged. Subsequent analysis examined different aspects of social resources as potential mediating variables. Loneliness fully mediated the relationship between stress and life satisfaction, while social support demonstrated evidence of partial mediation. Further, loneliness and social support partially mediated the relationship between stress and negative affect. Findings suggest that pandemic-related stress impacts SWB, and social resources help explain these impacts.

Reliability and validity of the Patient Health Questionnaire-4 scale and its subscales of depression and anxiety among US adults based on nativity

BACKGROUND

The burdens of anxiety and depression symptoms have significantly increased in the general US population, especially during this COVID-19 epidemiological crisis. The first step in an effective treatment for anxiety and depression disorders is screening. The Patient Health Questionnaire-4 (PHQ-4, a 4-item measure of anxiety/depression) and its subscales (PHQ-2 [a 2-item measure of depression] and Generalized Anxiety Disorder [GAD-2, a 2-item measure of anxiety]) are brief but effective mass screening instruments for anxiety and depression symptoms in general populations. However, little to no study examined the psychometric properties (i.e., reliability and validity) of the PHQ-4 and its subscales (PHQ-2 and GAD-2) in the general US adult population or based on US nativity (i.e., foreign-born vs. the US-born). We evaluated the psychometric properties of the PHQ-4 and its subscales in US adults, as well as the psychometric equivalence of the PHQ-4 scale based on nativity.

METHODS

We conducted a cross-sectional survey of 5,140 adults aged ≥ 18 years. We examined the factorial validity and dimensionality of the PHQ-4 with confirmatory factor analysis (CFA). A multiple-group confirmatory factor analysis (MCFA) was used to evaluate the comparability of the PHQ-4 across nativity groups. Reliability indices were assessed. Also, the scales' construct validities were assessed by examining the associations of both the PHQ-4 and its subscales' scores with the sociodemographic characteristics and the 3-item UCLA Loneliness scale.

RESULTS

The internal consistencies were high for the PHQ-4 scale (α = 0.92) and its subscales of PHQ-2 (α = 0.86) and GAD-2 (α = 0.90). The CFA fit indices showed evidence for the two-factor structure of the PHQ-4. The two factors (i.e., anxiety and depression) were significantly correlated (r = 0.92). The MCFA demonstrated measurement invariance of the PHQ-4 across the nativity groups, but the model fits the data better in the foreign-born group. There were significant associations of the PHQ-4 scale and its subscales' scores with the sociodemographic characteristics and the UCLA Loneliness scale (all p < 0.001).

CONCLUSIONS

The PHQ-4 and its subscales are reliable and valid measures to screen anxiety and depression symptoms in the general US adult population, especially in foreign-born individuals during the COVID-19 pandemic.

Away from the herd: loneliness as a dysfunction of social alignment

The tendency of all humans to experience loneliness at some point in their lives implies that it serves an adaptive function. Building on biological theories of herding in animals, according to which collective movement emerges from local interactions that are based on principles of attraction, repulsion and alignment, we propose an approach that synthesizes these principles with theories of loneliness in humans. We present here the 'herding model of loneliness' that extends these principles into the psychological domain. We hold that these principles serve as basic building blocks of human interactions and propose that distorted attraction and repulsion tendencies may lead to inability to align properly with others, which may be a core component in loneliness emergence and perpetuation. We describe a neural model of herding in humans and suggest that loneliness may be associated with altered interactions between the gap/error detection, reward signaling, threat and observation-execution systems. The proposed model offers a framework to predict the behavior of lonely individuals and thus may inform intervention designs for reducing loneliness intensity.

Bedtime procrastination related to loneliness among Chinese university students during post-pandemic period: a moderated chain mediation model

BACKGROUND

This study examined the relationship between loneliness and bedtime procrastination among Chinese university students, the mediating effects of COVID-19 risk perception and self-regulatory fatigue, and connectedness to nature's protective role, post pandemic.

METHODS

We recruited 855 students to complete the Loneliness, Perceived Risk of COVID-19 Pandemic, Self-Regulatory Fatigue, Bedtime Procrastination, and Connectedness to Nature Scales. Data for descriptive statistics, correlation analysis, and moderated chain mediation effects were analyzed using SPSS 24.0 and process 3.5 macros.

RESULTS

Loneliness positively correlated with bedtime procrastination, COVID-19 risk perception mediated the impact of loneliness on bedtime procrastination, self-regulatory fatigue mediated the effect of loneliness on bedtime procrastination, and COVID-19 risk perception and self-regulatory fatigue mediated the effect between loneliness and bedtime procrastination. Furthermore, connectedness to nature mediated the impact of COVID-19 risk perception on self-regulatory fatigue.

CONCLUSIONS

The results indicate the effects and potential mechanisms of loneliness on bedtime procrastination after the relaxation of the pandemic prevention and control policy in China from the perspective of self-regulatory resources and provide insights into improving university students' sleep routine and mental health post pandemic.

Ongoing shielding behavior one year post COVID-19: results from a longitudinal study of patients with inflammatory arthritis

Many patients with inflammatory arthritis (IA) were instructed to shield during the COVID-19 pandemic. Despite the ending of lockdowns and vaccination, large proportions of IA patients were continuing to shield when it is no longer needed. Given the detrimental effects of shielding on mental and physical health, understanding the rates and reasons for shielding is needed to help clinicians advise patients accordingly. This study was a 12-month prospective study following participants with IA during the COVID-19 pandemic. The proportions of IA patients shielding at each time point were calculated. Additionally, regressions and odds ratios for shielding were determined to assess medication type, mental health, and risk perception. While the extent of shielding fluctuated over the year of lockdowns, nearly all IA patients (93.5%) were still engaging in some shielding in 2021, with nearly half (43%) still shielding most or all of the time. Medications that were previously considered higher risk were not significantly associated with higher rates of shielding (OR = 1.60, p = 0.29), but greater symptoms of depression in June 2020 (OR = 1.07, p = 0.03) was both associated with increased the odds of shielding in June 2021. The high rates of IA patients continuing to shield in 2021 put more strain on patients and professionals as social isolation is linked with worsening mental and physical health, as well as greater difficulty with self-management. It is important for clinicians to be aware of this trend to ease the stress on patients.

Neurogenetics and Epigenetics of Loneliness

Loneliness, an established risk factor for both, mental and physical morbidity, is a mounting public health concern. However, the neurobiological mechanisms underlying loneliness-related morbidity are not yet well defined. Here we examined the role of genes and associated DNA risk polymorphic variants that are implicated in loneliness via genetic and epigenetic mechanisms and may thus point to specific therapeutic targets. Searches were conducted on PubMed, Medline, and EMBASE databases using specific Medical Subject Headings terms such as loneliness and genes, neuro- and epigenetics, addiction, affective disorders, alcohol, anti-reward, anxiety, depression, dopamine, cancer, cardiovascular, cognitive, hypodopaminergia, medical, motivation, (neuro)psychopathology, social isolation, and reward deficiency. The narrative literature review yielded recursive collections of scientific and clinical evidence, which were subsequently condensed and summarized in the following key areas: (1) Genetic Antecedents: Exploration of multiple genes mediating reward, stress, immunity and other important vital functions; (2) Genes and Mental Health: Examination of genes linked to personality traits and mental illnesses providing insights into the intricate network of interaction converging on the experience of loneliness; (3) Epigenetic Effects: Inquiry into instances of loneliness and social isolation that are driven by epigenetic methylations associated with negative childhood experiences; and (4) Neural Correlates: Analysis of loneliness-related affective states and cognitions with a focus on hypodopaminergic reward deficiency arising in the context of early life stress, eg, maternal separation, underscoring the importance of parental support early in life. Identification of the individual contributions by various (epi)genetic factors presents opportunities for the creation of innovative preventive, diagnostic, and therapeutic approaches for individuals who cope with persistent feelings of loneliness. The clinical facets and therapeutic prospects associated with the current understanding of loneliness, are discussed emphasizing the relevance of genes and DNA risk polymorphic variants in the context of loneliness-related morbidity.

The importance of trust and altruistic social orientation for COVID-19 distress

BACKGROUND

The COVID-19 pandemic, the biggest global health crisis in decades, has been a difficult experience for nations all over the world. In the present study we wanted to assess to what extent a positive attitude towards others, expressed in altruistic social orientation and a high level of trust, would be linked to lower levels of COVID-19 distress in infected and non-infected individuals.

PARTICIPANTS AND PROCEDURE

A total 405 individuals (180 women, 44%), aged 18-60 (M = 38.91, SD = 11.02) participated in the study. Respondents were recruited by a research platform. The following questionnaires were completed: the Subjective Happiness Scale, Generalized Trust Scale, survey about COVID-19, social value orientations.

RESULTS

The analysis showed that in non-infected high trustors the relationship between altruistic social orientation and COVID-19 distress was significant - the more they were willing to benefit others, the less distress they felt. The reverse effect was observed for infected high trustors - the more altruistic social orientation they expressed, the higher the level of COVID-19 distress they declared.

CONCLUSIONS

Our findings shed some light on the importance of a positive attitude towards others in assessing the emotional outcomes of the COVID-19 pandemic. They also imply that people who have experienced the COVID-19 disease can suffer from distress differently than people who have not been affected.

Effects of Online Fan Community Interactions on Well-Being and Sense of Virtual Community

Activities in the digital economy driven by information technology have rapidly increased in scope and speed in the aftermath of COVID-19. Meanwhile, social isolation accelerated by quarantine measures has increased concerns about individuals' mental health. However, little is known about the specific consequences of online interactions, especially when applied in online fan community-based relationships. Therefore, we examined the impact of loneliness in the context of COVID-19 on online interaction with other fans and parasocial relationships with celebrities on the Weverse platform. We also examined how these interactions influence mental well-being and the sense of virtual community. With 202 valid data samples acquired from global BTS fandom, this study conducted a partial least squares-structural equation modeling analysis. The empirical results demonstrate a significant positive relationship between loneliness and the extent of online interaction, while no significant impact on parasocial relationships was observed. Both online interaction and parasocial relationships were found to enhance both well-being and SOVC. However, these results were observed to differ between Weverse paid subscribers and free users.

Trend in loneliness among Swiss university students during the first year of the COVID-19 pandemic

BACKGROUND

The need to maintain physical and social distance between people and the stay-at-home recommendation/order to contain the spread of COVID-19 have raised concerns about the possible increase in loneliness. However, few studies have analyzed trends or changes in loneliness in samples of young adults. The present study aimed to explore the prevalence of loneliness and its change during the COVID-19 pandemic.

PARTICIPANTS AND PROCEDURE

This is a repeated cross-sectional study analyzing data collected through six online surveys between April 2020 and March 2021 from 5,669 university students in Switzerland. Logistic regression models were used to examine trends in loneliness and associations between loneliness, well-being, life at home, COVID-19 symptoms and tests.

RESULTS

Loneliness decreased between April 2020 and May-June 2020. In contrast, loneliness was higher in December 2020, January and March 2021 compared to April 2020. Loneliness was associated with younger age, studying architecture, design and civil engineering or engineering, enjoying time spent with family/partner, experiencing tensions and conflicts at home, boredom, feeling locked up and subjective well-being and current health.

CONCLUSIONS

Our findings highlight an increase in loneliness during the second wave of the COVID-19 pandemic, although a seasonality effect cannot be excluded. Public health systems and educational institutions need to monitor the effects of social distancing measures and reduced social contact on students' loneliness and well-being.

Unravelling the link between sleep and mental health during the COVID-19 pandemic

The emergence of COVID-19 brought unparalleled changes in people's lifestyle, including sleep. We aimed to assess the bidirectional association between sleep quality and mental health and describe how sleep and mental health were affected in Sweden during the COVID-19 pandemic (between June 2020 and September 2021). Data were obtained from the Omtanke2020 study. Participants who completed the baseline survey and each of the 8 monthly follow-up surveys were included (N = 9035). We described the distribution of sleep and mental health in the different Swedish regions using maps and over the study period with longitudinal graphs adjusting for sex, age, recruitment type (self-recruitment or invitation), and COVID-19 status. The inner relationships between mental health, sleep and Covid infection were described through relative importance networks. Finally, we modelled how mental health affects sleep and vice versa using generalized estimating equations with different adjustments. Seasonal and north-south regional variations were found in sleep and mental health outcomes at baseline and attenuated over time. The seasonal variation of sleep and mental health correlated moderately with the incidence rate of COVID-19 in the sample. Networks indicate that the relationship between COVID-19 incidence and mental health varies over time. We observed a bidirectional relationship between sleep quality and quantity at baseline and mental health at follow-up and vice versa. Sleep quality and quantity at baseline was associated with adverse symptom trajectories of mental health at follow-up, and vice versa, during the COVID-19 pandemic. There was also a weak relationship between COVID-19 incidence, sleep, and mental health.

Why elderly in rural China didn't wear masks during the COVID-19 pandemic? A qualitative narrative interview study

BACKGROUND

During the COVID-19 pandemic, ageism and stigmatization towards the elderly have been prominent issues. In addition, there have been debates on Chinese social media as to why elderly people in rural areas are not wearing masks. While some factors that affect the mask-wearing behaviour of the elderly have been analyzed, little attention has been given to the lived experiences and behavioral intentions of rural elderly people who choose not to wear masks, despite government mandates to do so.

METHOD

In this research, 50 semi-structured interviews with 30 elderly individuals in three Chinese villages were carried out using the qualitative method of semi-structured interviews. Following verbatim recording and transcription of the conversations, the subject was analyzed using the Theory of Reasoned Action.

RESULTS

We identified four factors that influence the non-masking behaviour of rural elderly, including past experiences, cultural concepts, cognitive attitudes, and health and safety anxiety, and identified nine sub-themes based on the four overarching themes. Past knowledge, experience, and history have led rural elderly people to distrust the government's mandatory "mask mandate," believing that they do not need to wear masks. Rural cultural concepts and habits make the elderly feel that masks not only fail to provide protection but also become obstacles, resulting in poor daily experiences. Cognitive attitudes and emotions determine the elderly's evaluation of masks, which in turn affects their use of masks. Finally, elderly individuals'chronic diseases directly affect the physical pain and life safety caused by their use of masks, which is a major objective factor for their non-masking.

CONCLUSIONS

Although numerous studies have concluded that Chinese people wore masks out of collectivism and conformity during the pandemic, marginalized groups' opposition to wearing masks also contains distinctive, individualized elements and underlying causes. By exposing these elements and reasons, we can better comprehend the peculiar behavior of particular groups while fighting the pandemic. The needs of marginalized populations should be prioritized by public health policy makers to provide more equitable services.

Psychological resilience matters in the relationship between the decline in economic status and adults' depression half a year after the outbreak of the COVID-19 pandemic

Background/objective

The outbreak of COVID-19 in China since 2019 has had a significant impact on the mental health of people in Hubei Province during the three-year pandemic period. Therefore, studying the prevalence of depression among the population of Hubei Province since the pandemic is of great significance.

Methods

Based on opportunity and stress theory, we collected provincial-level data from Hubei (N = 3,285) to examine the impact of declining economic status on depressive symptoms and to investigate the moderating effect of psychological resilience during the period of economic adjustment.

Results

We used propensity score matching to estimate the treatment effect of economic status decline on depression severity and confirmed the moderating effect of psychological resilience. We found that the more that an individual's economic status declines, the more severe that his or her depressive symptoms become. Specifically, each unit decrease in economic status is associated with an increase of approximately 0.117 units in depression level. In addition, our results indicated that psychological resilience significantly moderated the relationship between economic decline and depression (-0.184*).

Conclusions and implications

Our study confirms the role of economic status in depressive symptoms. Compared with traditional research on the relationship between economic status and mental illness, this paper expands the research regarding the two in the context of a major public health emergency. Furthermore, we suggest ways to improve people's mental health following the pandemic.

University students' psychological distress during the COVID-19 pandemic: A structural equation model of the role of resource loss and gain

Using the Conservation of Resources (COR) theory, we aimed to determine whether university students' loss and gain in resources during the pandemic mediated the relationships between COVID-19 exposure/concern and depression and anxiety. In 2021, 7013 Israeli university students completed online questionnaires. We assessed the data using structural equation modeling. We found that resource loss was directly related to concern (β = 0.32, p < 0.001). Depression and anxiety were both directly related to loss of resources (depression: β = 0.75, p < 0.001; anxiety: β = 0.69, p < 0.001) and concern (depression: β = 0.06, p < 0.001; anxiety: β = 0.12, p < 0.001). Resource loss had an indirect effect on the relationships between concern and depression (β = 0.24, p < 0.001) and concern and anxiety (β = 0.22, p < 0.001). COR theory may help explain the mechanisms behind university students' mental health during the pandemic and provides a framework to better understand preparedness for future pandemics, epidemics, and major disasters. Governments and universities should help prevent the loss of resources during future emergencies.

Psychosocial Perspective on Problem Gambling: The role of Social Relationships, Resilience, and COVID-19 Worry

The COVID-19 pandemic has amplified several psychosocial risks and problem behaviors among vulnerable individuals. Given that gambling has high addictive potential, it is important to consider the underlying mechanisms of problem gambling. This study examined psychosocial factors associated with pandemic-time problem gambling.Cross-sectional data were gathered via an online survey of 18-75-year-old Finnish, Swedish, and British respondents (n = 2,022) who reported having gambled at least occasionally during the pandemic. Measures included problem gambling, loneliness, COVID-19 worry, social support, and psychological resilience. Control variables included gender, age, and education. Structural equation modeling was used as an analytical technique.Loneliness was found to be associated with problem gambling. While COVID-19 worry was not directly associated with problem gambling, it predicted higher loneliness, which in turn was associated with problem gambling. Evidence was not found regarding the protective role of resilience or social support in problem gambling. However, social support was found to be associated with higher problem gambling severity. Male gender and younger age were associated with problem gambling.The results bring insight into underlying vulnerabilities regarding problem gambling during the pandemic. More focus should be placed on the quality and sources of social support, as well as on how psychosocial risk and protective factors might work differently among different populations of gamblers.

Impact of the COVID-19 pandemic on adults with Fetal Alcohol Spectrum Disorder: linking immune function to mental health status

Prenatal alcohol exposure (PAE) is known to cause a variety of cognitive, behavioral, and neurological changes. Importantly, mental health problems are also overrepresented in individuals with Fetal Alcohol Spectrum Disorder (FASD), the group of neurodevelopmental conditions that can occur following PAE. Approximately 90% of individuals with FASD report experiencing mental health problems over their lifespan, compared to approximately 30% in the overall population. Individuals with FASD also display impairments in coping skills and increased vulnerability to stress. Here, we investigated whether the COVID-19 pandemic would have a differential impact on mental health and inflammation-to-mood associations in adults with FASD, compared to unexposed controls (no PAE). We capitalized on our pre-pandemic study examining health and immune function and invited past-participants to enroll in the current study. Participants completed mental health assessments and COVID-related questionnaires by phone. In addition, blood samples collected at baseline (pre-pandemic) were used to probe for inflammation-to-mood associations. Overall, our results indicate that lower SES was predictive of higher coronavirus anxiety scores, with no differences between adults with FASD and controls. In addition, while there were no differences in depression or anxiety measures at baseline (pre-pandemic) or during the pandemic, examination of inflammation-to-mood associations identified differential relationships in adults with FASD compared to unexposed controls. Specifically, there was a positive association between baseline neutrophil counts and both baseline and pandemic mental health scores in unexposed controls only. In addition, for unexposed controls there was also a negative association between baseline interferon-ɣ (IFN-ɣ) and pandemic mental health scores. By contrast, only adults with FASD showed positive associations between baseline interleukin-12p70 (IL-12p70), IL-8, soluble intercellular adhesion molecule-1 (sICAM-1), and soluble vascular cell adhesion molecule-1 (sVCAM-1) and pandemic mental health scores. Taken together, to our knowledge, this study is the first to examine the impact of the pandemic in adults with FASD. And while it may be too soon to predict the long-term effects of the pandemic on mental health, our data suggest that it will be important that future work also takes into account how immune function may be modulating mental health outcomes in this population.

Fear, Loneliness, Happiness and Mental Health in the Post-COVID-19 Period: A Cross-Cultural Study in a Sample of Japanese and Polish University Students

Background

During the COVID-19 pandemic, interpersonal relations were highly constrained due to the social distancing rules and sanitary restrictions imposed to prevent the transmission of the virus. These social changes gave rise to ever-deepening experiences of loneliness, deterioration of mental well-being, and fear of COVID-19, which affected the citizens of all the countries struggling with the pandemic.

Methods

The present paper reports the results of a study on mental health, interdependent happiness, loneliness and fear of COVID-19 in Polish and Japanese university students. A total of 180 people (83 Poles and 97 Japanese) aged 19-41 participated in the study. The participants were surveyed using the Mental Health Continuum-Short Form to assess three dimensions of mental health; the UCLA Three-Item Loneliness Scale to measure loneliness; the Interdependent Happiness Scale based on the concept of a relational sense of community with others as associated with well-being, and the Fear of COVID-19 Scale (FCV-19S). The respondents were also asked one question about their subjectively perceived economic status.

Results

The largest cross-cultural difference in the investigated variables concerned fear of COVID-19. The Japanese university students showed higher levels of this fear. The level of fear of COVID-19 in the group of women, regardless of the culture they came from, was not associated with any other variables we analyzed. In the Japanese sample, it was negatively correlated with interdependent happiness, and in the Polish sample, fear od COVID-19 was only correlated with the Social dimension of Mental Health. Other variables that differentiated the two nationalities, though to a lesser extent, were the Social dimension of Mental Health, which was higher in the Japanese sample, and the Psychological dimension of Social Health, with higher scores in the Polish sample.

Conclusion

The power of mental resources, although it may vary among individuals, is independent of culture. Regardless of the level of fear of COVID-19 in the two cultures, the examined mental resources are positively associated with well-being and the return to normal functioning after the pandemic.

'When you give kindness out, you get it back ten times more': Ontario adults' prosocial behaviour during the first 16 months of the COVID-19 pandemic

The COVID-19 pandemic has provided a collective opportunity to engage in prosocial behaviours, including kindness; however, little is known about the long-term impacts of the pandemic on such behaviours. As a part of a larger study (Health Outcomes for Adults During and Following the COVID-19 Pandemic), the purpose of this mixed methods research was two-fold: (1) to quantitatively explore adults' prosocial behaviour over time during the first 16 months of the pandemic in Ontario, Canada (April 2020-August 2021); and, (2) to more deeply explore, via focus groups, a sub-sample of Ontario adults' lived experiences of prosocial behaviour (assessed March 2022). A total of 2,188 participants were included in this study, with the majority of participants identifying as female (89.5%). At three time points, participants completed online questionnaires which included demographics, Prosocialness Scale for Adults, and three global kindness questions. A subset of participants (n = 42) also participated in one of six focus groups exploring their experiences of prosocial behaviour during the pandemic. A series of one-way repeated measures ANOVAs revealed that participants' self-reported prosocial behaviour increased significantly over time, while participants' awareness of kindness, engagement in acts of kindness, and view of kindness as crucial significantly decreased. Thematic analysis revealed three main themes: (1) shift in prosocial behaviour during the pandemic; (2) kindness from various perspectives; and, (3) prosocial burnout. This study provides insight into the longer-term effects of the pandemic on adults' prosocial behaviours and should be leveraged to help understand how individuals respond in times of crises.

Psychological factors associated with COVID-19 related anxiety and depression in young adults during the COVID-19 pandemic

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic and the corresponding lockdown have drastically changed our lives and led to high psychological distress and mental health problems. This study examined whether psychological factors such as loneliness, perfectionism, and health anxiety are associated with COVID-19 related anxiety and depression during the pandemic in young Korean adults, after controlling for various socio-demographic factors and early life stress.

METHODS

A total of 189 participants (58.2% women) completed a cross-sectional online survey including the Fear of COVID-19 Scale, Center for Epidemiologic Studies Depression Scale, 3-item Revised UCLA Loneliness Scale, Frost Multidimensional Perfectionism Scale, and Whiteley Index-6. Hierarchical linear regression analyses with three blocks were employed to identify the factors that contributed to COVID-19 related anxiety and depressive symptoms.

RESULTS

Hierarchical regression analyses showed that higher health anxiety was significantly associated with more severe COVID-19 related anxiety (standardized regression coefficient, β = 0.599, p < 0.001). Additionally, higher levels of loneliness (β = 0.482, p < 0.001), perfectionism (β = 0.124, p = 0.035), and health anxiety (β = 0.228, p < 0.001) were significantly associated with higher depression scores. The three psychological factors explained 32.8% of the total variance in depressive symptom scores, after taking all covariates into account.

CONCLUSION

The results showed that health anxiety was a risk factor for both COVID-19 related anxiety and depression in young adults. Loneliness was the strongest predictor of depressive symptoms during the COVID-19 pandemic. These findings highlight the importance of identifying vulnerable individuals and encouraging psychological counselling and social connections to reduce the burden of psychiatric disorders during the pandemic.

Mental condition and physical activity of individuals working during the COVID-19 pandemic in Poland

OBJECTIVES

The study assessed quality of life and depression in working people during COVID-19 pandemic, relative to their physical activity.

MATERIAL AND METHODS

The study involved 1194 people living in south-eastern Poland, and assessed life satisfaction (Life Satisfaction Questionnaire - 9 [LISAT-9]), quality of life (World Health Organization Quality of Life - BREF [WHOQoL-BREF]), depression (Beck Depression Inventory [BDI]) and physical activity.

RESULTS

The respondents on average scored 4.32 in LISAT-9; respectively 66.2, 68.3, 69.6 and 63.5 in physical, psychological, social and environment domains of WHOQoL-BREF and 9.2 in BDI. Regularly performed physical activity positively affected the scores in all the psychometric tests in women with higher and secondary education and in men with vocational education. Women presented lower life satisfaction, poorer quality of life and higher level of depression than men. The psychometric scores were also differentiated by type of employment and job. Depression was identified in 44% of all the respondents.

CONCLUSIONS

Individuals who are economically active during the pandemic report good quality of life and no or only mild signs of depression. Working people with higher education cope more effectively with adversities of the pandemic, compared to those with lower education. Int J Occup Med Environ Health. 2023;36(2):274-90.

Effectiveness of a Brief Online Mindfulness-Based Intervention for University Students

Objectives

The COVID-19 pandemic resulted in a dramatic increase in Web-based education, lacking face-to-face student-teacher and student-student interaction, and consequently impairing students' sense of belonging to a community, interoceptive awareness, and academic self-efficacy. This study examined how a brief mindfulness-based intervention in an online university course can be effective in enhancing attention resources, developing a stronger sense of academic self-efficacy, and improving the sense of belonging to a community, which represent critical factors affecting students' participation in online and blended courses.

Method

Four-hundred and eighty-six participants (Mage 22.88) completed a battery of measures at pre- and post-treatment. One class (experimental group) participated in a brief online mindfulness-based intervention (42%), whereas the other one (control group) did not take part in the intervention (58%). The intervention included breathing meditation at the beginning of class, sharing of experiences, mini-lectures on mindfulness, and daily practice, and lasted for 28 consecutive days.

Results

Participants in the experimental group when compared to controls showed a significant increase in the feeling of influencing the course activities (F = 9.628; p < 0.005), in the self-regulation of attention (F = 19.133; p < 0.001), in academic self-efficacy (F = 9.220; p < 0.005), and, particularly, in their self-efficacy in regulating learning (F = 12.942; p < 0.001). The students' adherence to the assigned practice could partially explain the effectiveness of the intervention.

Conclusions

This study offers useful clues about the effectiveness of mindfulness interventions in the classroom in enhancing sense of belonging to a community, attention grounded in bodily sensations, and academic self-efficacy.

Preregistration

This study is not preregistered.

'Women in the front': Psychological impact of the COVID-19 pandemic: Depression, anxiety, loneliness, and somatization in the Israel population

The COVID-19 pandemic has generated a high level of psychological distress in the general population. The aims of this study were to examine the mental health of men and women in the general population in Israel during the first lockdown. The sample comprised 587 participants (426 females and 161 males), whose age ranged between 16 and 85. They completed the Patient Health Questionnaire-4 (PHQ-4), the Psychosomatic Symptoms Scale, and the Connor-Davidson Resilience Scale (CD-RISC2). Psychological distress was expressed in our measures of depression, anxiety, loneliness, and somatization, in conjunction with high resilience. Women exhibited higher levels of these symptoms than men-but this fluctuates with age, and can match the levels of these symptoms reported by men. Specifically, no difference between the genders was found for loneliness, in age groups 24-39 and 56-85; and for depression, in age groups 40-55 and 56-85. For somatization, the difference is reversed for age group 56-85. In contrast, while women generally scored lower than the men for resilience, this was specifically for age group 16-23. Our findings suggest that young women report more mental health problems, and that men and women may be differentially vulnerable to disaster-related stressors, such as experienced during the pandemic.

Understanding the Impact of the COVID-19 Pandemic on the Perception and Use of Urban Green Spaces in Korea

Faced with the prospect that the impact of the COVID-19 pandemic and climate change will be far-reaching and long-term, the international community is showing interest in urban green space (UGS) and urban green infrastructure utilization as a solution. In this study, we investigated how citizens' perceptions and use of UGS have changed during COVID-19. We also collected their ideas on how UGS can raise its usability. As a result, more people became to realize the importance of UGS. In particular, the urban environmental purification function from UGS was recognized as giving great benefits to respondents. On the other hand, the patterns of UGS use were mixed with decreasing UGS use to maintain social distancing or increasing UGS use to maintain health or substitute other restricted facilities. More than half of respondents had their UGS visit patterns impacted by COVID-19. In particular, the increase rate of UGS use was rather high in the group that seldom used UGS before COVID-19. In addition, they increased the use of UGS to replace other limited facilities, and thus tended to demand an increase in rest facilities. Based on these results, this paper suggested securing social support and sustainability for the policy by reflecting users' demand in landscape planning related to the increase of UGS in the city. This study can contribute to improving the resilience of UGS and the sustainability of urban space planning.

Incidence and persistence of psychological distress during the COVID-19 pandemic among individuals with and without disability

OBJECTIVES

We investigated the incidence (becoming distressed at the follow-up) and persistence (distressed at the baseline and the follow-up) of psychological distress among individuals with and without disability in the period from early 2017 (before the COVID-19 pandemic) to late 2020 (the second wave of the pandemic).

METHODS

We analyzed the population-based FinHealth 2017 survey and its follow-up conducted in 2020 (number of individuals who participated in both surveys: n = 4881; age = 18+). Logistic regressions were applied to investigate differences in the incidence and persistence of psychological distress between people with and without disability. We also investigated whether age, quality of life at the baseline, and perceived increase in loneliness during the COVID-19 pandemic moderated the association between disability and the incidence of distress.

RESULTS

The incidence of psychological distress was higher (OR = 3.01, 95% CI:2.09-4.35) for people with disability (18.9%) than among those without (7.4%), being highest (31.5%) among the youngest participants with disability, aged 18 to 39. People with disability who had a poor quality of life at the baseline were particularly prone to become distressed during the follow-up. People who reported perceived increase in loneliness during the pandemic were prone to become distressed at the follow-up regardless of their disability status. The persistence of distress was more common (OR = 6.00, 95% CI:3.53-10.12) among people with disability (65.7%) than among those without (24.9%).

CONCLUSION

The COVID-19 pandemic had more negative mental health effects on people with disability, especially adults with disability who were young and had a low quality of life before the pandemic.

Interventions to reduce loneliness among Chinese older adults: A network meta-analysis of randomized controlled trials and quasi-experimental studies

This meta-analytic study investigates the effectiveness of different interventions in alleviating loneliness among Chinese older adults aged 50 years and above. We searched eight English databases, four Chinese databases, and grey literature. Thirty-four studies, including four randomized controlled trials (RCTs) and 30 quasi-experimental studies, were eventually included in the meta-analysis (n = 3843). Quality appraisal indicated risks of bias in the included studies. The pooled effect size was large and significant (Hedge's g = 0.84, 95% CI [0.54, 1.15]), indicating the effectiveness of interventions in reducing loneliness. However, the effect size may be overestimated due to publication bias. Moderation analyses showed significant differences in effect sizes by study designs and regions of studies. Network meta-analysis (NMA) indicated that hybrid and psychological interventions appeared to be advantageous over others. In addition, group-based delivery modes can add extra benefits to the interventions. This study adds to the knowledge of the effectiveness of current interventions in reducing Chinese older people's loneliness. However, the findings need to be interpreted with caution due to the relatively low study quality, considerable heterogeneity, and publication bias. Despite the limitations, this study offers valuable insights for future research, practice, and policy-making in reducing older people's loneliness.

Understanding and overcoming challenges in times of personal or global crisis-Editorial on the Special Issue on Loneliness and Health

The ever-present interest in loneliness has increased during the last decade. Although loneliness is generally not as prevalent as other topics and not among the top 5 most read papers in the journal Applied Psychology: Health and Well-Being, it is closely connected to topics therein, such as well-being and health. Conceptualizing loneliness as indicator of risk, it may function as a cue for action. Accordingly, understanding loneliness, its development, prevalence, effects, and how to support individuals to prevent or overcome loneliness is key and the main aim of this special issue. Therefore, theories and models are reviewed in this paper and synthesized together with other aspects relating to the field of loneliness research and intervention. Accordingly, we propose an agenda including key determinants (e.g., risk groups), how to proceed (various research methods), intervention components (e.g., behavior change techniques, SDGs), and how to perform dissemination (open science practices, co-creative approaches, etc.). The original studies in this special issue provide stimulating examples. Moreover, the commentaries give new insights and inspiring ideas. Overall, this special issue aims to give readers a lens with which to re-examine their own research, enable innovation, and empower addressing loneliness and its interconnection synergistically.

Teleworking Is Significantly Associated with Anxiety Symptoms and Sleep Disturbances among Paid Workers in the COVID-19 Era

Due to social distancing during COVID-19, teleworking has spread in Korea. Accordingly, the effects of teleworking on physical and mental health have emerged. We aim to determine the association between teleworking and mental health, including anxiety symptoms and sleep disturbance, in paid workers. The data of paid workers from the Sixth Korean Working Conditions Survey, collected between October 2020 and April 2021, were analyzed. Gender stratification analysis and propensity score matching were performed for variables relevant to sociodemographic and occupational characteristics. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) for each sex were analyzed using multivariable logistic regression, adjusting for sociodemographic and occupational characteristics. Among 28,633 participants, analyses were performed for anxiety symptoms (teleworkers vs. non-teleworkers; men: 12.1% vs. 4.9%; women: 13.5% vs. 5.3%) and sleep disturbance (men: 33.6% vs. 21.3%; women: 39.7% vs. 25.3%). In male teleworkers, the AORs for anxiety symptoms and sleep disturbance were 1.86 (95% CI: 1.14-3.04) and 1.52 (95% CI: 1.10-2.11), respectively. In female teleworkers, the AORs for anxiety symptoms and sleep disturbance were 1.66 (95% CI: 1.13-2.43) and 1.65 (95% CI: 1.28-2.14), respectively. Our results emphasize the importance of mental health and the need for continuous education and care for teleworkers, given the rapid increase in teleworking.

Depression, Perceived Risk of COVID-19, Loneliness, and Perceived Social Support from Friends Among University Students in Poland, UK, and India

Background

The study examines the prevalence of depression among university students in Poland, the UK and India in the face of the second pandemic wave of COVID-19. The paper also examines the protective role of perceived social support, the hypothesis being that social support from friends would reduce depression.

Methods

The data from university students (N=732) in Poland (N=335), UK (N= 198), and India (N=199) were collected online during of the fall/winter 2021. Participants completed measures of depression (CES-D), COVID-19 risk perception index, loneliness (DJGLS), and perceived social support (MSPSS).

Results

Almost 52% of all participants (58.5% in Poland, 62.6% in the UK, and 29.1% in India) met the criteria for major depression. The higher levels of depression symptoms were associated with a higher perceived risk of COVID-19, greater loneliness, female gender, younger students' age, and the lower levels of perceived social support. The greater family support predicted lower levels of depression symptoms in the Polish and Indian samples. Structural equation analyses (SEM) revealed the indirect effect of perceived social support from friends on the association between social loneliness and depression and between age and depression. This result shows that the support from friends significantly reduced depression, regardless of age, the level of social loneliness, and the perceived risk of COVID-19.

Conclusion

Our conclusions link to university specialists' enhancement of psychological help for students with depression. We also recommend information campaigns on depression and treatment options.

Mental Health among Young Adults during the COVID-19 Pandemic: A Two-Wave Longitudinal Investigation

This study aimed to assess changes in COVID-19 related factors (i.e. risk perception, knowledge about the virus, preventive behaviors and perceived efficacy) and mental health (i.e. psychological distress and positive mental health), in a sample of Romanian young adults attending college, assessed immediately after the national COVID-19 lockdown ended (Time 1) and six months after the end of the lockdown (Time 2). We also evaluated the longitudinal relations between COVID-19 related factors and mental health. The sample consisted of 289 undergraduate students (89.3% female, Mage = 20.74, SD = 1.06), who completed questionnaires assessing mental health and COVID-19-related factors via two online surveys, six months apart. The results showed that perceived efficacy and preventive behaviors, as well as positive mental health, but not psychological distress, decreased significantly over the six months period. Risk perception and perceived efficacy of preventive behaviors at Time 1 were positively related with the number of preventive behaviors measured six months later. Risk perception at Time 1 and fear of COVID-19 at Time 2 predicted the mental health indicators at Time 2. Public-health strategies should find the right balance in cultivating proper levels of risk perception that would be most beneficial for prevention of COVID-19 spread and mental health problems due to pandemic.

Were there losses in social support during the pandemic? Testing the impact of COVID-19 on psychological adjustment to trauma in United States adults

Introduction

Social support is a key protective factor in the psychological adjustment of individuals to traumatic events. However, since March 2020, extant research has revealed evidence of increased loneliness, social isolation, and disconnection, likely due to COVID-19 pandemic-related recommendations that restricted day-to-day contact with others.

Methods

In this investigation, we applied a case-control design to test the direct impacts of the pandemic on social support in United States adults recovering from a significant injury caused by PTSD-qualifying, traumatic events (e.g., motor vehicle crashes, violence, etc.). We compared individuals who experienced trauma during the pandemic, the "cases" recruited and evaluated between December 2020 to April 2022, to trauma-exposed "controls," recruited and evaluated pre-pandemic, from August 2018 through March 9, 2020 (prior to changes in public health recommendations in the region). Cohorts were matched on key demographics (age, sex, education, race/ethnicity, income) and injury severity variables. We tested to see if there were differences in reported social support over the first 5 months of adjustment, considering variable operationalizations of social support from social network size to social constraints in disclosure. Next, we tested to see if the protective role of social support in psychological adjustment to trauma was moderated by cohort status to determine if the impacts of the pandemic extended to changes in the process of adjustment.

Results

The results of our analyses suggested that there were no significant cohort differences, meaning that whether prior to or during the pandemic, individuals reported similar levels of social support that were generally protective, and similar levels of psychological symptoms. However, there was some evidence of moderation by cohort status when examining the process of adjustment. Specifically, when examining symptoms of post-traumatic stress over time, individuals adjusting to traumatic events during COVID-19 received less benefit from social support.

Discussion

Although negative mental health implications of the pandemic are increasingly evident, it has not been clear how the pandemic impacted normative psychological adjustment processes. These results are one of the first direct tests of the impact of COVID-19 on longitudinal adjustment to trauma and suggest some minimal impacts.

The Consequences of the Pandemic for Subjective Well-Being: Data for Improving Policymaking

The pandemic has affected people's lives and emotions in profound ways, which governments ignore at their peril. Among the often disregarded consequences of the pandemic, especially in developing countries, are its toll on subjective well-being and its implications for health policymaking. This paper uses a battery of surveys with over 1800 observations collected in 2019 and 2020, which inform on many aspects of subjective well-being before and during the pandemic in Cali, Colombia. The results show a dramatic and widespread reduction in life satisfaction in several dimensions of well-being beyond health, and not just among those directly affected by COVID-19. This analysis focuses on differences in well-being by gender and health status, providing information about gender variances and differences in subjective well-being between those who experienced and those who did not experience physical illness (including the COVID-19 infection) during the pandemic. This analysis aims at contributing to the body of research that studies the consequences of the pandemic for life satisfaction and well-being, in the context of a city experiencing profound social unrest during the pandemic.

Security motives and negative affective experiences during the early months of the COVID-19 pandemic

OBJECTIVE

Self-regulation can help individuals cope during stressful events, but little is known about why and when this might occur. We examined if being more focused on prevention was linked to negative affective experiences during the COVID-19 pandemic. We also examined possible underlying mechanisms for this association, and whether social support buffered it.

DESIGN

Pre-registered longitudinal study, with surveys every 2 weeks over one month (N = 1269).

MAIN OUTCOME MEASURES

Regulatory focus and worry for health (T1), adherence to self-isolation and preventive health behaviours (T2), negative affective experiences, positive affect, frequency of online interactions, and perceived social support (T3).

RESULTS

Prevention focus was associated with health worries at baseline and linked to greater adherence to preventive health behaviours (T2). Only adherence to self-isolation was linked to more negative affective experiences (T3). Exploratory analyses showed that prevention focus was linked to more negative affective experiences (T3), but only for participants with fewer online interactions with their family and less perceived social support from family and friends.

CONCLUSIONS

Prevention motives in threatening times can be a double-edged sword, with benefits for health behaviours and consequences for negative affective experiences. Having a strong social network during these times can alleviate these consequences.

The impact of the coronavirus disease 2019 pandemic on abortion access and pre-abortion mental health in Shanghai

OBJECTIVE

To understand the barriers to abortion in Shanghai during the COVID-19 pandemic, and to compare pre-abortion mental health status before and during the crisis.

METHODS

In this case-control study, two groups of women seeking abortion (age ≥18 years, pregnancy duration <98 days) were recruited from March to September, 2021 (n = 1070) and from February to April 2022 (n = 625). The evaluation included COVID-19-related abortion stress questions, the Symptom Checklist-90 Revised questionnaire, the Pittsburgh Sleep Quality Index (PSQI), and the Family Environment Scale Chinese version. The researchers conducted interviews and collected questionnaires.

RESULTS

The median pregnancy duration at abortion among women during the pandemic was 65 days, compared with 51 days in the pre-pandemic group (P < 0.001). Anxiety and depression symptoms increased during the crisis (P < 0.001). Sleep disturbances were more common. Higher PSQI scores were related to increased anxiety and depression symptoms. A more negative family climate was described during the pandemic.

CONCLUSION

During the COVID-19 pandemic, abortion access was delayed and pre-abortion mental disorders increased. More attention should be paid to the mental health of women seeking abortions, and innovations should be promoted to ensure abortion services without delay.

Loneliness and the onset of new mental health problems in the general population

PURPOSE

Loneliness is associated with poor health including premature mortality. There are cross-sectional associations with depression, anxiety, psychosis, and other mental health outcomes. However, it is not known whether loneliness is causally linked with the new onset of mental health problems in the general population. Longitudinal studies are key to understanding this relationship. We synthesized evidence from longitudinal studies investigating the relationship between loneliness and new onset of mental health problems, in the general population.

METHOD

We systematically searched six electronic databases, unpublished sources, and hand-searched references, up to August 2021. We conducted a meta-analysis of eight independent cohorts and narrative synthesis of the remaining studies.

RESULTS

We included 32 studies, of which the majority focused on depression. Our narrative synthesis found most studies show loneliness at baseline which is associated with the subsequent new onset of depression. The few studies on anxiety and self-harm also showed a positive association. Our meta-analysis found a pooled adjusted odds ratio of 2.33 (95% CI 1.62-3.34) for risk of new onset depression in adults who were often lonely compared with people who were not often lonely. This should be interpreted with caution given evidence of heterogeneity.

CONCLUSION

Loneliness is a public mental health issue. There is growing evidence it is associated with the onset of depression and other common mental health problems. Future studies should explore its impact across the age range and in more diverse populations, look beyond depression, and explore the mechanisms involved with a view to better informing appropriate interventions.

Impact of loneliness on health-related factors in Australia during the COVID-19 pandemic: A retrospective study

COVID-19 pandemic and its associated social and physical distancing restrictions may have had a severe impact on health. In the present study, we investigate the changes in physical, social and mental health, as well as the health literacy of Australians subsequent to the onset of COVID-19 pandemic, and examine the influence of loneliness on these health-related factors. Using a retrospective cross-sectional study design, 607 Australian adults completed a self-report online survey which assessed their health-related factors before and after onset of the COVID-19 pandemic (data collected between June 2020 to November 2020). Australians reported statistically significant increase in a number of (poorer) health-related factors (e.g., weight gain, sleeping difficulties, poor somatic health, higher loneliness, more issues navigating the healthcare system) post onset of COVID-19 pandemic. Further, after adjusting for covariates, higher loneliness during pandemic predicted poorer health-related outcomes (e.g., more somatic health complaints, poorer quality of diet, poorer social support for health). The COVID-19 pandemic and its associated social and physical distancing restrictions may have contributed towards poorer health-related factors among Australian adults. Further, increased loneliness during the pandemic may have further worsened physical health and health literacy outcomes among Australians.

The hidden minority: Discrimination and mental health among international students in the US during the COVID-19 pandemic

International students in the US occupy a precarious position at the intersection of immigration policy and global education mobility, one made more challenging by the disparate impact of COVID-19 on college students' mental health. Few studies, however, have explored the pandemic's effects on mental well-being among the international student population in the US. Our study aims to provide initial empirical evidence on the mental health status of these students, with a specific focus on discrimination, loneliness, anxiety, and depression. We propose a mediation framework and estimate the mediating effects of loneliness and anxiety in the relationships between discrimination and depression in a sample of US-based international students (N = 103). We collected cross-sectional data from July to August 2020, using a 50-item online survey instrument with three open-ended questions. Mediation analyses using PROCESS Macro were used to analyse quantitative data and thematic analysis was used to analyse qualitative data. Findings showed that higher levels of discrimination were significantly associated with higher levels of loneliness. Higher levels of loneliness were significantly associated with higher levels of anxiety, which in turn led to high levels of depressive symptoms. Our study contributes to understanding the needs and capacities of international students in the wake of COVID-19 and simultaneously provides pragmatic program and policy implications for inclusive higher education environments and the overall health and well-being of this crucial US student population.