Differences in post-traumatic growth: Individual quarantine, COVID-19 duration and gender

The Effects of General Mental Health Symptomatology, COVID Anxiety, and Sociodemographic Factors on Pandemic-Induced Negative and Positive Trauma Effects: A Polish Survey from the Late Stages of the Pandemic

Background/Objectives: COVID-19, caused by the SARS-CoV-2 virus, emerged in late 2019 and rapidly became a global pandemic, affecting over 200 countries. The pandemic has had profound impacts on global health, the economy, and mental health, leading to increased anxiety and more cases of posttraumatic stress disorder in the general population. This study aimed to evaluate the factors influencing the long-term psychological effects, both positive and negative, seen in the late stages of the COVID-19 pandemic in Poland (starting in the second half of 2021). It combined specific COVID-19 anxiety factors with a broader general mental health assessment to identify significant associations. Methods: Data were collected from 416 participants through paper-based and online questionnaires, with 235 valid responses gathered in total. This study utilized the Coronavirus Anxiety Scale; General Health Questionnaire (GHQ-28); and, to study Positive Trauma Effects (PTEs) and Negative Trauma Effects (NTEs), the Changes in Outlook Questionnaire. Data analysis was performed using the R language and a Generalized Additive Model analysis was also performed. Results: The study found generally low levels of COVID-19 anxiety and mental distress among participants. Significant predictors of NTEs included COVID-19 anxiety and general mental health status, which explained 47% of the variance. PTEs were significantly associated with gender, with women experiencing higher PTE levels relative to men. Conclusions: The findings indicate that combining specific ailment anxiety measurements with general mental health assessments enhances our ability to predict Negative Trauma Effects. Addressing mental health symptomatology and well-being during mass health crises is crucial to mitigate long-lasting psychological damage.

The Role of Sex Differences in the Link Between Emotion Regulation and Psychological Well-Being During a Major Mental Health Crisis

Emotion regulation (ER) strategies, such as reappraisal and suppression, have been linked to psychological well-being. The available evidence points to the differential impact of ER strategies on resilience and post-traumatic growth (PTG), as factors related to well-being, as well as to sex differences in the link between ER preference and well-being. However, previous studies are mixed regarding these links. To address this issue, college students (N = 1254) recruited between 2020 and 2023 reported their habitual use of ER strategies, resilience and PTG during the COVID-19 pandemic, which, as a global health crisis, has raised not only severe physical health concerns but also mental distress. First, reappraisal was positively associated with both resilience and PTG, whereas suppression was negatively correlated with these measures. Second, female participants had lower suppression scores and higher PTG scores than male participants. Third, a moderation analysis showed that the positive relationship between reappraisal and PTG was stronger in female participants, whereas the negative relationship between suppression and PTG was stronger in male participants. Overall, these findings shed light on the links among ER strategies, resilience, and PTG and have relevance for customized training in the use of reappraisal to increase well-being in women and men.

Fear of COVID-19, traumatic growth, and traumatic stress symptoms: the mediating role of basic psychological needs

Although COVID-19 brought many negative psychological consequences, many people also experienced psychological growth. The present study investigated why this happened and hypothesized that self-determination theory's (SDT's) basic psychological needs (BPNs) may play a role in this explanation. Based on SDT, this cross-sectional study hypothesized that both the satisfaction and frustration of BPNs mediated the associations between fear of COVID-19, post-traumatic growth (PTG), and post-traumatic stress (PTS) symptoms. A sample of 391 Peruvian adults (70.6% women; Mage  = 35.04, age range between 18 and 84) responded to several valid and reliable questionnaires: Fear of COVID-19 Scale (FCV.19S); Basic Psychological Needs Satisfaction and Frustration Scale (BPNSFS); Impact Event Scale-Revised (IES-R); Post-Traumatic Growth Inventory (PTGI). The results showed that need satisfaction mediated the negative association between fear of COVID-19 and PTG, and need frustration mediated the positive association between fear of COVID-19 and PTG. In addition, a direct effect was found from fear of COVID-19 toward PTS symptoms. The results showed the importance of considering SDT's BPNs in explaining PTG and PTS after experiencing fear of COVID-19.

The influence of emotional reactions and compliance with Ministry of Health guidelines during the COVID-19 pandemic in Israel: a longitudinal study of gender differences

This study sought to examine gender differences in emotional reactions and compliance with Ministry of Health (MOH) guidelines during the COVID-19 pandemic in Israel, with the goal of gaining a deeper understanding of these gender-related variations throughout the lockdown periods. A longitudinal study comprising 2509 participants was conducted during two of Israel's lockdowns: 1424 participants completed a questionnaire during the first lockdown (23 April-5 May 2020); of these, 1085 completed a follow-up questionnaire during the second lockdown (September 30-October 10, 2020). Participants exhibited higher levels of compliance with MOH guidelines (e.g., wearing face masks, maintaining social distancing) and knowledge about COVID-19 during the second lockdown, whereas they exhibited more negative emotional reactions during the first lockdown. Female participants scored higher than male participants on all measures. Multiple regression results showed that about 21% of the variance in compliance with MOH guidelines was explained by lockdown type (i.e., first or second), gender, and age, while knowledge and negative emotional reactions added another 19% to the explained variance. The results suggest that the impact of the pandemic on emotional reactions decreased over time, with people exhibiting greater compliance with MOH guidelines and more knowledge about COVID-19. Moreover, the behavioral and psychological impact of the pandemic was greater on women than on men. The results suggest that healthcare professionals should pay more attention to mental health issues during a pandemic. Moreover, policymakers should focus on women as a vulnerable group and suggest appropriate solutions to reduce their emotional distress. Furthermore, governments and employers should provide greater flexibility and support for single mothers during the pandemic. In addition, gender inequality during lockdowns may place women at greater risk of psychological distress.

Posttraumatic growth in eating disorder recovery

OBJECTIVE

To investigate posttraumatic growth in individuals recovering from an eating disorder.

DESIGN

A convergent parallel mixed methods design was used.

PARTICIPANTS

The sample consisted of 28 participants who completed the entire study and an additional 10 who completed only the quantitative portion of this mixed methods study.

METHODS

The National Eating Disorders Association (NEDA) provided a link to the electronic survey via their website. Participants were asked to complete the Posttraumatic Growth Inventory (PTGI) and the Core Beliefs Inventory (CBI) in the quantitative strand. For the qualitative strand, participants were asked to describe any positive changes in their beliefs or life as the result of their eating disorder (ED).

RESULTS

Participants reported a high amount of posttraumatic growth as indicated by their mean score on the CBI (30.39, SD 7.89) and (71.26, SD 16.58) on the PTGI. Qualitative categories included relating to others, personal strength, new possibilities, appreciation of life, and spiritual change.

CONCLUSION

Participants described the transformation they experienced in the recovery process, with recovery from an eating disorder facilitating an opportunity for growth. Providing posttraumatic growth interventions may have the potential to help individuals with eating disorders find meaning in their pathway through recovery.

Psychological experience of university students during prolonged quarantine in China: a qualitative study

OBJECTIVE

To explore the psychological experiences of university students in prolonged quarantine during the COVID-19 pandemic.

DESIGN

A qualitative descriptive study based on semistructured interviews; data were analysed using a thematic topic analysis approach.

SETTING

Interviews were conducted via WeChat video.

PARTICIPANTS

20 full-time undergraduate students from seven districts in Shanghai Province who experienced prolonged quarantine were interviewed from June to August 2022.

RESULTS

The data analysis revealed three themes with corresponding subthemes related to the psychological experiences of university students during prolonged quarantine: (1) dynamic and complex psychological experiences, encompassing the feelings of relief, confusion, anxiety, insecurity, loneliness, craving for catharsis and emotional numbness; (2) desire for diverse support; and (3) self-reflection and growth, mainly including learning to be grateful, self-efficacy enhancement, reconsideration of the meaning of life and restructuring of future planning.

CONCLUSION

This study explored the psychological experiences of university students in prolonged quarantine through qualitative interviews, which contributed to our understanding of their emotions, needs and conceptual changes during quarantine. Combined with the experiences of university students in quarantine, they reported complex emotional changes and diverse needs, as well as the impact of prolonged quarantine on their outlook on life. These findings can serve as a reference and basis for the development of future psychological intervention measures in line with national conditions.

Posttraumatic growth of medical staff during COVID-19 pandemic: A scoping review

BACKGROUND

The COVID-19 pandemic has imposed unprecedented stress and challenges upon medical staff, potentially resulting in posttraumatic growth (PTG). This scoping review aims to synthesize the existing knowledge on PTG among medical staff during the pandemic by identifying its current status and potential influencing factors. The findings may provide a foundation for future research and interventions to enhance the medical staff's psychological resilience and well-being.

METHODS

Literature was systematically searched on PTG among medical staff during the COVID-19 pandemic from 01 January 2020 to 31 December 2022. The following databases were searched: PubMed, Web of Science, Embase, CINAHL, PsycINFO, Cochrane Library, China National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Service System (SinoMed), and Wanfang Data. Eligibility criteria included: (1) medical staff as research subjects; (2) a focus on "posttraumatic growth" or "alternative posttraumatic growth" related to the COVID-19 outbreak and pandemic; (3) discussion of the situation and influencing factors of PTG; and (4) study types, such as qualitative, quantitative, and mixed methods. Two researchers independently selected and extracted study characteristics (study design, study population, region, measurement instruments, and primary outcomes) from the included literature. The data were synthesized qualitatively and descriptively.

RESULTS

Thirty-six papers from 12 countries met the inclusion criteria. Moderate PTG levels were observed among healthcare workers during the COVID-19 pandemic, with emphasis on "interpersonal relationships," "changes in life philosophy," and "growth in personal competence." Influencing factors included trauma exposure, sociodemographics, psychological characteristics (resilience and positive qualities), coping, and social support.

CONCLUSIONS

This review discovered moderate PTG levels among medical staff during the COVID-19 pandemic, with critical areas in interpersonal relationships, life philosophy, and personal competence. The identified influencing factors can inform future research and interventions to enhance healthcare workers' psychological resilience and well-being.

Positive and negative aspects of the COVID-19 pandemic among a diverse sample of US adults: an exploratory mixed-methods analysis of online survey data

BACKGROUND

The COVID-19 pandemic had a profound social and economic impact across the United States due to the lockdowns and consequent changes to everyday activities in social spaces.

METHODS

The COVID-19's Unequal Racial Burden (CURB) survey was a nationally representative, online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Latino (English- and Spanish-speaking), Native Hawaiian/Pacific Islander, White, and multiracial adults living in the U.S. For this analysis, we used data from the 1,931 participants who responded to the 6-month follow-up survey conducted between 8/16/2021-9/9/2021. As part of the follow-up survey, participants were asked "What was the worst thing about the pandemic that you experienced?" and "Was there anything positive in your life that resulted from the pandemic?" Verbatim responses were coded independently by two coders using open and axial coding techniques to identify salient themes, definitions of themes, and illustrative quotes, with reconciliation across coders. Chi-square tests were used to estimate the association between sociodemographics and salient themes.

RESULTS

Commonly reported negative themes among participants reflected disrupted lifestyle/routine (27.4%), not seeing family and friends (9.8%), and negative economic impacts (10.0%). Positive themes included improved relationships (16.9%), improved financial situation (10.1%), and positive employment changes (9.8%). Differences in themes were seen across race-ethnicity, gender, and age; for example, adults ≥ 65 years old, compared to adults 18-64, were more likely to report disrupted routine/lifestyle (37.6% vs. 24.2%, p < 0.001) as a negative aspect of the pandemic, and Spanish-speaking Latino adults were much more likely to report improved relationships compared to other racial-ethnic groups (31.1% vs. 14.8-18.6%, p = 0.03).

DISCUSSION

Positive and negative experiences during the COVID-19 pandemic varied widely and differed across race-ethnicity, gender, and age. Future public health interventions should work to mitigate negative social and economic impacts and facilitate posttraumatic growth associated with pandemics.

How are experiences and acceptability of child maltreatment related to resilience and posttraumatic growth: a cross cultural study

Background: Post-traumatic growth (PTG) and resilience, regarded as positive psychological change following a traumatic experience, are under-researched across cultures in people exposed to child maltreatment (CM).Objective: We investigated how experiences and the perceived acceptability of CM are related to resilience and PTG in countries with different cultures, living standards, and gross national income.Method: A total of 478 adults from Cameroon (n = 111), Canada (n = 137), Japan (n = 108), and Germany (n = 122) completed an online survey with self-reported questionnaires, including the Brief Resilience Scale and the Post Traumatic Growth Inventory-Short Form.Results: Across countries, self-reported male gender and age were positively associated with resilience, while experiences of physical abuse and emotional maltreatment were negatively associated with resilience. Experiences of emotional maltreatment were positively associated with PTG. Higher levels of PTG and resilience were found amongst Cameroonian participants as compared to other countries.Conclusion: Our results suggest that positive changes following CM can vary significantly across cultures and that experiences of specific CM subtypes, but not the perceived acceptability of CM, may be important for a deeper understanding of how individuals overcome trauma and develop salutogenic outcomes. Our findings may inform CM intervention programmes for an enhanced cultural sensitivity.

The personal growth resources of the adult population following the first months of the war in Ukraine

We aimed to determine the peculiarities of personal growth resources among the adult population following the first months of the war in Ukraine. The study, which included 1257 respondents (32.3% male and 67.7% female, aged 18-61+ years), used the Posttraumatic Growth Inventory-Expanded, the Brief Resilience Scale, the Professional Hardiness Questionnaire and the General Self-Efficacy Scale. We found the following descending sequence of expression of the components of personal growth: appreciation of life, spiritual and existential changes, relations to others, new possibilities and personal strengths. Personal resources included resilience, professional commitment, professional control, professional challenge acceptance and self-efficacy, of which the last two were the most important. All indicators of personal growth were significantly higher in women but were more closely related to personal resources in men. Our findings suggest directions interventions should take to promote the Ukrainian adult population's personal growth and prevent negative mental health consequences.

The prevalence and factors associated with posttraumatic growth after 3-years outbreak of COVID-19 among resident physicians in China: a cross-sectional study

Introduction

The Coronavirus disease 2019 (COVID-19) pandemic is a global traumatic event that has profoundly struck individuals' mental health. However, this might potentially promote positive transformation such as posttraumatic growth (PTG). Studies have indicated that the COVID-19 pandemic negatively affected the well-being of resident physicians, but little is known about PTG among this vulnerable population in China. Therefore, this study investigated the prevalence and associated factors of PTG among Chinese resident physicians after 3-years outbreak of COVID-19.

Methods

An online survey was conducted from 9 March to 20 March in 2023. PTG was assessed using the 10-item Posttraumatic Growth Inventory-Short Form (PTGI-SF). Scores ≥30 implied moderate-to-high PTG. We also collected possible associated factors for PTG, including socio-demographic and psychological variables. Data was analyzed by applying descriptive statistics, univariable and multivariable logistic regression models.

Results

In total, 2267 Chinese resident physicians provided validated data. 38.7% of them reported moderate-to-high PTG. In the multivariable logistic regression models, age (odds ratio, OR = 1.039; 95% confidence interval, 95%CI = 1.008-1.070), female (OR = 1.383, 95%CI = 1.151-1.662), satisfied or neutral with annual income (OR = 2.078, 95%CI = 1.524-2.832; OR = 1.416, 95%CI = 1.157-1.732), sufficient support at work (OR = 1.432, 95%CI = 1.171-1.751) and resilience (OR = 1.171, 95%CI = 1.096-1.252) were significantly positively associated with moderate-to-high PTG. On the contrary, burnout (OR = 0.653, 95%CI = 0.525-0.812), depression symptoms (OR = 0.700, 95%CI = 0.552-0.889), and stress (OR = 0.757, 95%CI = 0.604-0.949) were significantly negatively associated with moderate-to-high PTG.

Discussion

Overall, resident physicians in China experienced relatively high prevalence of PTG that could be associated with several psychosocial factors. Findings may provide evidence to develop interventions for resident physicians to systematically and constructively process traumatic events related to the pandemic and foster their PTG.

The rapid change in mental health among college students after introduction of on-campus quarantine during the 2022 Shanghai COVID-19 lockdown

Objectives

Among the various impacts of disasters in terms of emotions, quarantine has been proven to result in significant increases in mental health problems. Studies of psychological resilience during outbreaks of epidemics tend to focus on long-term social quarantine. In contrast, insufficient studies have been conducted examining how rapidly negative mental health outcomes occur and how these outcomes change over time. We evaluated the time course of psychological resilience (over three different phases of quarantine) among students at Shanghai Jiao Tong University to investigate the influence of unexpected changes on college students.

Methods

An online survey was conducted from 5 to 7 April 2022. A structured online questionnaire was administered using a retrospective cohort trial design. Before 9 March (Period 1), individuals engaged in their usual activities without restrictions. From 9 to 23 March (Period 2), the majority of students were asked to remain in their dormitories on campus. From 24 March to early April (Period 3), restrictions were relaxed, and students were gradually allowed to participate in essential activities on campus. We quantified dynamic changes in the severity of students' depressive symptoms over the course of these three periods. The survey consisted of five sets of self-reported questions: demographic information, lifestyle/activity restrictions, a brief mental health history, COVID-19-related background, and the Beck Depression Inventory, second edition.

Results

A total of 274 college students aged 18-42 years (mean = 22.34; SE = 0.24) participated in the study (58.39% undergraduate students, 41.61% graduate students; 40.51% male, 59.49% female). The proportion of students with depressive symptoms was 9.1% in Period 1, 36.1% in Period 2, and 34.67% in Period 3. Depressive symptoms increased notably with the introduction of the quarantine in Periods 2 and 3. Lower satisfaction with the food supplied and a longer duration of physical exercise per day were found to be positively associated with changes in depression severity in Periods 2 and 3. Quarantine-related psychological distress was more evident in students who were in a romantic relationship than in students who were single.

Conclusion

Depressive symptoms in university students rapidly increased after 2 weeks of quarantine and no perceptible reversal was observed over time. Concerning students in a relationship, ways to take physical exercise and to relax should be provided and the food supplied should be improved when young people are quarantined.

Stress, anxiety, and depression in times of COVID-19: Gender, individual quarantine, pandemic duration and employment

Objectives

This study explores the inter-relationship between emotional distress in adults and gender, quarantine experiences, pandemic duration, and employment.

Methods

An online cross-sectional online survey comprised 943 Israelis. The link to the survey was distributed via different personal and academic social networking sites (e.g., Facebook, WhatsApp, and Twitter). The survey was administered using the online survey portal Google Forms. Participants addressed questions about their socio-demographic characteristics (e.g., gender, age, family status, employment, and quarantine experiences) and ranked their levels of stress, anxiety, and depression using the Hebrew version of the Depression, Anxiety and Stress Scale-DASS-21.

Results

The majority of the respondents (72%) were women, 39% experienced quarantine, and 55% were unemployed. About 42% experienced a short-term pandemic (one lockdown), and the rest experienced a continuous pandemic (two lockdowns). The MANCOVA results, controlling for family status, indicated that women and unemployed participants reported higher stress, anxiety, and depression levels than men and employed participants. Participants who experienced individual quarantine reported higher anxiety and depression. Furthermore, there was a significant interaction between gender, employment, and pandemic duration. The experience of individual quarantine intensified the stress, anxiety, and depression for both employed and unemployed women. Conversely, the quarantine intensified stress, anxiety, and depression only for unemployed men, whereas the quarantine did not affect stress, anxiety, and depression among employed men.

Conclusions

Employment is a critical factor regarding men's emotional state during such stressful situations as the COVID-19 pandemic. Furthermore, individual quarantine and long-term pandemics are associated with opposite outcomes regarding individual mental health. The individual quarantine is associated with increased anxiety and depression, while a long-term, continuous pandemic is associated with decreased stress.