Predicting the Severity of Symptoms of the COVID Stress Syndrome From Personality Traits: A Prospective Network Analysis

Intolerance of Uncertainty and Worry Prospectively Predict COVID-19 Anxiety and Distress: A 4-Year Longitudinal Study

The COVID-19 pandemic precipitated an uptick in poor mental health outcomes, including coronavirus-related anxiety and distress. Preliminary research has shown that intolerance of uncertainty (IU) and worry proneness, two transdiagnostic risk factors for anxiety and related disorders, are associated cross-sectionally with pandemic-related fear and distress. However, the extent to which IU and worry proneness prospectively predict coronavirus-related anxiety and distress is unclear. Whether IU and worry may also interact in prospectively predicting coronavirus-related anxiety and distress is also unknown. To address this knowledge gap, the present study examined IU and trait worry as prospective predictors of the level and trajectory of coronavirus anxiety and COVID stress syndrome over time, as well as the extent to which worry moderated the relation between IU and pandemic-related outcomes. Participants (n = 310) who completed self-report measures of IU and trait worry in 2016 were contacted following the onset of COVID-19 in 2020 and completed biweekly measures of coronavirus anxiety and COVID stress syndrome for 30 weeks. Multilevel models revealed that IU assessed in 2016 significantly predicted the severity of both coronavirus anxiety and COVID stress syndrome throughout the study period in 2020. Worry also moderated the link between IU and coronavirus anxiety, such that individuals with high levels of trait worry and high IU in 2016 experienced the most coronavirus anxiety in 2020. Results suggest that IU and worry functioned as independent and interactive vulnerability factors for subsequent adverse psychological reactions to COVID-19. Clinical implications and future directions are discussed.

Characterising subgroups of people with severe COVID anxiety by latent profile analysis

BACKGROUND

People with severe COVID anxiety have had experiences of the COVID-19 pandemic which are overwhelming, and have led to patterns of behaviours that add little protective benefit but are at the expense of other priorities in life. It appears to be a complex social and psychological phenomenon, influenced by demographic and social factors. Identifying subgroups of people with severe COVID anxiety would better place clinicians to assess and support this distress where indicated.

METHODS

Measurement tools assessing depression, generalised and health anxiety, obsessive-compulsive symptoms, personality difficulty and alcohol use from 284 people living in United Kingdom with severe COVID anxiety were explored with latent profile analysis. Further analyses examined the associations of identified clusters with demographic and social factors and daily functioning, quality of life and protective behaviours.

RESULTS

A model with 4 classes provided the best fit. Distinct patterns of psychopathology emerged which were variably associated with demographic factors and COVID behaviours.

LIMITATIONS

Given the complex aetiology of COVID anxiety a number of factors which might better cluster subgroups are likely to have gone uncollected. Moreover, using data collected at a single time-point limits these results' ability to conclude whether observed relationships were the product of the pandemic or longstanding.

CONCLUSIONS

People living with severe COVID anxiety are a heterogenous group. This analysis adds to evidence that certain health behaviours and demographic factors are inextricably linked to poor mental health in people with COVID anxiety, and that targeting health behaviours with specific intervention might be beneficial.

Social connectedness and resilience post COVID-19 pandemic: Buffering against trauma, stress, and psychosis

The present study investigated psychosocial predictors of psychosis-risk, depression, anxiety, and stress in Croatia two years after the onset of the COVID-19 pandemic. Given the existing transgenerational war trauma and associated psychiatric consequences in Croatian population, a significant pandemic-related deterioration of mental health was expected. Recent studies suggest that after an initial increase in psychiatric disorders during the pandemic in Croatia, depression, stress, and anxiety rapidly declined. These findings highlight the role of social connectedness and resilience in the face of the global pandemic. We examined resilience and psychiatric disorder risk in 377 Croatian adults using an anonymous online mental health survey. Results indicate that there was an exacerbation of all mental ill health variables, including depression, anxiety, stress, and a doubled risk for psychosis outcome post-COVID pandemic. Stress decreased levels of resilience, however, those exposed to previous traumatic experience and greater social connectedness had higher resilience levels. These findings suggest that individual differences in underlying stress sensitization of Croatian population due to past trauma may continue to influence mental health consequences two years after COVID-19 pandemic. It is essential to promote the importance of social connectedness and resilience in preventing the development of variety of mental health disorders.

COVID-19 stress syndrome in the German general population: Validation of a German version of the COVID Stress Scales

The COVID Stress Scales (CSS) are a new self-report instrument for multidimensional assessment of psychological stress in the context of the pandemic. The CSS have now been translated and validated in over 20 languages, but a validated German version has not yet been available. Therefore, the aim was to develop a German version of the CSS, to test its factor structure, reliability, and validity, and to compare it with international studies. In an online survey (08/2020-06/2021), N = 1774 individuals from the German general population (71.5% female; Mage = 41.2 years, SD = 14.2) completed the CSS as well as questionnaires on related constructs and psychopathology. After eight weeks, participants were asked to participate again for the purpose of calculating retest reliability (N = 806). For the German version, the 6-factor structure with good model fit (Root Mean Square Error of Approximation, RMSEA = 0.06) was confirmed, with the six subscales: Danger, Socio-Economic Consequences, Xenophobia, Contamination, Traumatic Stress, and Compulsive Checking. Internal consistencies ranged from ω = .82-.94 (except Compulsive Checking ω = .70), and retest reliability from rtt = .62-.82. Convergent and discriminant validity were confirmed for the German version. Related constructs such as health anxiety, general xenophobia, obsessive-compulsive behavior, and posttraumatic stress disorder symptoms correlated moderately with the respective subscale and lower with the other scales. With anxiety and depression, Traumatic Stress showed the strongest correlation. Overall, there was a high degree of agreement in an international comparison. The CSS can help to identify pandemic-related psychological stress and to derive appropriate interventions.

Psychometric properties of a brief version of the COVID‐19 Stress Scales (CSS‐B) in young adult undergraduates

We extracted items to create a brief version of the COVID-19 Stress Scale (i.e., CSS-B) and examined its psychometric properties in young adults. A sample of 1318 first- and second-year undergraduates from five Canadian universities (mean [SD] age = 19.27 [1.35] years; 77.6% women) completed an online cross-sectional survey that included the CSS-B as well as validated measures of anxiety and depression. The 18-item CSS-B fit well on both a 5-factor and a hierarchical model indicating that the five CSS-B dimensions may be factors of the same over-arching construct. The CSS-B factor structure displayed lower-order and higher-order configural and metric invariance across sites but not scalar invariance indicating that the intercepts/means were not consistent across sites. The CSS dimensions were positively related to measures of general anxiety and depression but not so strongly as to indicate that they are measuring the same construct. The CSS-B scale is a valid measure of COVID-19 stress among young adults. It is recommended that this shorter version of the scale be considered for use in longer surveys to avoid participant fatigue.

The Contributions of Pandemic Severity, Government Stringency, Cultural Values and Internet Usage to Post-traumatic Stress Disorder During the COVID-19 Pandemic: An Analysis of Data From 35 Countries

Emergent symptoms of post-traumatic stress disorder (PTSD) have been frequently reported in the context of the COVID-19 pandemic, and may affect up to 17-18% of individuals. There is preliminary evidence that pandemic severity, cultural values, restrictions imposed by governments, and Internet usage may all influence the emergence of PTSD symptomatology. In this study, possible linear- and non-linear associations between these factors and the prevalence of PTSD symptoms across 35 countries were examined based on data from existing research. Evidence was found for a positive logarithmic relationship between the COVID-19 case-fatality ratio and PTSD (p = 0.046), a positive logarithmic relationship between power distance and PTSD (p = 0.047), and a trend toward a negative quadratic association with Internet usage (p = 0.051). No significant cross-national effect was observed for government restrictiveness. These findings suggest that strategies aimed at minimizing COVID-19 deaths, and at ensuring equitable access to essential resources, may be of use in reducing the emergence of PTSD symptoms at a population level during this pandemic.

Pandemics and Clinical Psychology

Pandemics are complex events involving a range of stressors affecting mental health. The recent COVID-19 pandemic served as a catalyst, accelerating preexisting trends in clinical care such as the rise of e-health for rapidly and broadly disseminating psychological services. The process of adapting face-to-face clinical services to online formats occurred rapidly during COVID-19, underscoring the adaptability of clinicians to meet new challenges. However, COVID-19 also highlighted important shortcomings in clinical care, including planning deficiencies and shortages of clinicians with specialized training for treating various psychological problems (e.g., prolonged grief disorder). These problems and potential solutions are discussed.

The Psychology of Pandemics

This article reviews the current state of knowledge and promising new directions concerning the psychology of pandemics. Pandemics are disease outbreaks that spread globally. Historically, psychological factors have been neglected by researchers and health authorities despite evidence that pandemics are, to a large extent, psychological phenomena whereby beliefs and behaviors influence the spreading versus containment of infection. Psychological factors are important in determining (a) adherence to pandemic mitigation methods (e.g., adherence to social distancing), (b) pandemic-related social disruption (e.g., panic buying, racism, antilockdown protests), and (c) pandemic-related distress and related problems (e.g., anxiety, depression, posttraumatic stress disorder, prolonged grief disorder). The psychology of pandemics has emerged as an important field of research and practice during the coronavirus 2019 (COVID-19) pandemic. As a scholarly discipline, the psychology of pandemics is fragmented and diverse, encompassing various psychological subspecialties and allied disciplines, but is vital for shaping clinical practice and public health guidelines for COVID-19 and future pandemics. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

Associations between Personality Traits, Intolerance of Uncertainty, Coping Strategies, and Stress in Italian Frontline and Non-Frontline HCWs during the COVID-19 Pandemic-A Multi-Group Path-Analysis

The COVID-19 pandemic represented a very difficult physical and psychological challenge for the general population and even more for healthcare workers (HCWs). The main aim of the present study is to test whether there were significant differences between frontline and non-frontline Italian HCWs concerning (a) personality traits, intolerance of uncertainty, coping strategies and perceived stress, and (b) the models of their associations. A total of 682 Italian HCWs completed a self-report questionnaire: 280 employed in COVID-19 wards and 402 in other wards. The analysis of variance omnibus test revealed significant differences between the two groups only for perceived stress, which was higher among the frontline. The multi-group path analysis revealed significant differences in the structure of the associations between the two groups of HCWs, specifically concerning the relations between: personality traits and intolerance of uncertainty; intolerance of uncertainty and coping strategies. Regarding the relation between coping strategies and stress no difference was identified between the two groups. In both of them, emotionally focused coping was negatively related with perceived stress, whereas dysfunctional coping was positively related with stress. These results could be useful in planning actions aiming to reduce stress and improve the effectiveness of HCWs' interventions. Training programs aimed to provide HCWs with a skillset to tackle uncertain and stressful circumstances could represent an appropriate support to develop a preventive approach during outbreaks.