Suppression May Improve Adaptation to Worry When Facing Uncertainty: Studying COVID-19 Pandemic

The mediating role of positive feelings in the association between adaptation to disability and positive emotional well-being in a sample of students with congenital physical disabilities

BACKGROUND

Adaptation to disability (AD) is linked to positive feelings (PF) and positive emotional well-being (PEWB), while emotional suppression can improve adaptation and provide temporary PEWB but will not lead to sustainable positive mental health. This study examined whether and to what extent PF might mediate the link between AD and PEWB in a sample of students with congenital physical disabilities (CPD) in Rwanda.

METHODS

A sample of 46 students with CPD (21 females, i.e., 45.65% and 25 males i.e., 54.34%; mean age: M = 20 years; SD = 2.05) were administered questionnaires to assess their AD, PF, and PEWB.

RESULTS

Results showed that PF (r = - 0.37, p < 0.05) and PEWB (r = - 0.37, p < 0.05) were significantly and negatively correlated with AD, while PF was significantly and positively correlated with PEWB (r = 0.70, p < 0.01). Results further suggested that there was a strong indirect negative relationship between AD and PEWB mediated by PF (a*b = - 0.68, Bootstrap CI95 = - 1.30 and - 0.26), with the Sobel test statistics of - 2.4131 against a significant one-tailed p-value (p < 0.01) and two-tailed p-value (p < 0.05).

CONCLUSIONS

Results emphasize that understanding AD and PF for students with CPD at risk of decreased PEWB could lead to suitable interventions. Also, results can be used by future researchers, policymakers, and other related institutions to understand the inner feelings of students with CPD for further support.

Evaluation of the death anxiety beliefs and behaviors scale in Iranian adolescents

Numerous tools assess death anxiety, but many have questionable psychometric properties. The Death Anxiety Beliefs and Behaviors Scale (DABBS) addresses these shortcomings, assessing death-related maladaptive affect, beliefs, and behaviors that could be foundational to fears associated with death. We translated the DABBS into Persian and examined its psychometric properties among Iranian adolescents (n = 598, Mage = 14.80, range = 12-18 years old). Confirmatory factor analyses supported the intended three-factor structure that comprises death-related affect, beliefs, and behaviors. Furthermore, the DABBS demonstrated good internal consistency, as well as expected associations with other measures of death anxiety and psychopathology measures, except that the Behaviors subscale unexpectedly did not relate to theoretically relevant constructs. Our findings indicate that the DABBS affect and belief subscales have strong psychometric properties among Iranian adolescents. However, further research is needed to elucidate whether the overall DABBS score demonstrates improved validity when used with other populations.

Intolerance of Uncertainty as a Situational Vulnerability Factor in the Context of the Pandemic: A Systematic Review and Meta-Analysis of COVID-19-Related Psychological Impacts

BACKGROUND

Intolerance of uncertainty (IU) is widely accepted as a transdiagnostic vulnerability factor for a range of mental health problems. It is considered a transsituational vulnerability factor associated with a range of responses to different stressful life situations. The aim of this systematic review and meta-analysis is to examine the association between IU and specific psychological responses to the COVID-19 pandemic and the moderators of this relationship drawn from IU research and other studies on COVID-19.

METHOD

The studies included were as follows: (i) English-language articles published in peer-reviewed journals or thesis/dissertations; (ii) reporting specific psychological impacts of COVID-19; (c) reporting IU; (iii) case-control studies, prospective cohort studies, experimental studies and cross-sectional studies of large populations and (iv) reporting correlation coefficients between the variables of interest. Studies on participants with a diagnosis of neurological and/or organic impairment were excluded. The databases searched were Google Scholar, PubMed, ScienceDirect, and ProQuest, up until 31 December 2022. The risk of bias was assessed using the Risk of Bias Utilized for Surveys Tool (ROBUST, Nudelman et al., 2020). Sensitivity analysis was conducted using the one-study remove method, and studentized residuals and Cook's distance were examined. A random effects model was used.

RESULTS

We examined the association between IU and COVID-19-related psychological impacts across 85 studies from 22 countries (N = 69,997; 64.95% female; mean sample age, 32.90 ± 9.70). There was no evidence of publication bias. We found a medium and positive association between IU and COVID-19-related psychological impacts (N = 69,562, r = 0.35, k = 89, 95% CI [0.32, 0.37]), which was independent of the IU measure used or whether the psychological impact was measured in relation to the virus alone or broader aspects of the pandemic. It was also independent of severity, publication year, sample type and size, study quality, age and sample levels of anxiety, depressive symptoms, stress, mental well-being and social support. However, the observed association varied significantly between countries and country income levels (stronger among low-incomes) and across genders (stronger among males) and was stronger for measures with greater reliability and more items, but lower among samples with more people who had been exposed to COVID-19.

CONCLUSIONS

The findings support that IU is a higher order transsituational vulnerability factor related to cognitive, behavioural and distress responses during the pandemic. Limitations include English-language-only sources, reliance on a wide range of measures that were coded using a novel system and variable risk of bias across studies. The implications are considered in relation to the management of psychological consequences of major situational stressors experienced at a global scale, but the variations at a national and socioeconomic level also have implications for different or localized stressors at a regional or community level.

A network analysis on biopsychosocial factors and pain-related outcomes assessed during a COVID-19 lockdown

Psychological stress, social isolation, physical inactivity, and reduced access to care during lockdowns throughout a pandemic negatively impact pain and function. In the context of the first COVID-19 lockdown in Spain, we aimed to investigate how different biopsychosocial factors influence chiropractic patients' pain-related outcomes and vice-versa. A total of 648 chiropractic patients completed online questionnaires including variables from the following categories: demographics, pain outcomes, pain beliefs, impact of the COVID-19 pandemic, stress/anxiety and self-efficacy. Twenty-eight variables were considered in a cross-sectional network analysis to examine bidirectional associations between biopsychosocial factors and pain outcomes. Subgroup analyses were conducted to estimate differences according to gender and symptom duration. The greatest associations were observed between pain duration and pain evolution during lockdown. Participants' age, pain symptoms' evolution during lockdown, and generalized anxiety were the variables with the strongest influence over the whole network. Negative emotions evoked by the pandemic were indirectly associated with pain outcomes, possibly via pain catastrophizing. The network structure of patients reporting acute pain showed important differences when compared to patients with chronic pain. These findings will contribute to identify which factors explain the deleterious effects of both the pandemic and the restrictions on patients living with pain.

Medication adherence among community-dwelling schizophrenia patients during the COVID-19 pandemic: A cross-sectional study

OBJECTIVES

This study aims to investigate medication adherence during the COVID-19 pandemic among community-dwelling schizophrenia patients, and to explore the role of social support in improving medication adherence in a rural community sample in China.

METHODS

A cross-sectional sample of 800 patients was recruited using a cluster random sampling method in Yingshan County, Sichuan Province. Information on participant demographic characteristics, social support and medication adherence was collected through face-to-face interviews. The data analysis was performed using SAS9.4. Two binary logistic regression models were employed to identify the association between regular medication use and social support.

RESULTS

The rate of regular medication adherence among community-dwelling patients with schizophrenia was 41.5%,which was lower than that indicated by recent research(Li et al., 2020) before COVID-19 in western rural China. The mean scores and standard deviation of the patient's objective support, subjective support, and support utilization were 4.94 ± 1.57, 17.03 ± 5.24, and 5.25 ± 2.75, respectively. The social support standard deviation was 27.22 ± 6.32. The crude odds ratio of objective support, subjective support, and support utilization were 0.790 (95%CI:0.713-0.876), 0.999 (95%CI:0.971-1.027), and 1.049 (95%CI:0.995-1.105) respectively. After adjusting for potential factors, the adjusted odds ratio of objective support, subjective support, and support utilization were 0.758 (95%CI:0.673-0.853), 1.030 (95%CI:0.994-1.068), and 1.043 (95%CI:0.985-1.105), respectively.

CONCLUSIONS

During the COVID-19 pandemic, community-dwelling schizophrenia patients had a low rate of regular medication adherence. This was particularly true of those who were older adults, less educated and living in rural areas. The results of this study suggest that strengthening social support may effectively improve medication adherence for those patients.

Cultural Perspectives, Feelings and Coping Behaviors during the COVID-19 Pandemic: A Case Study of Romanian Students

Socio-cultural patterns and communication styles differ from culture to culture. As such, the way in which people deal with a crisis situation is also culture-dependent. The COVID-19 pandemic has pointed, once more, to the cultural diversity of the world through a variety of reactions to the measures imposed by the global spread of the deadly virus. The present research aims at identifying the feelings, coping behaviors and communication patterns of the younger Romanian generation during the COVID-19 pandemic and at explaining them from a cultural standpoint, in an effort to raise awareness of the cultural (un)predictability of human reactions to certain external stimuli. The survey conducted online on 409 students at Politehnica University of Timișoara (Romania) revealed that most of students' socio-cultural behavior could have been anticipated by the Romanian authorities when they decided a certain pandemic action plan, and that the few unexpected results indicate the versatility of a culture that is still changing under the Western European influence caused by the fact that Romania has adhered to European Union principles for more than fifteen years.

Negative interpretation of ambiguous bodily symptoms among illness-anxious individuals: Exploring the role of developmental and maintenance constructs

BACKGROUND

Cognitive factors play an essential role in the development and maintenance of anxiety problems. Among individuals with illness anxiety problems, their interpretation of bodily symptoms is a crucial factor in the determination of their ability to regulate their emotions. The catastrophic interpretation of ambiguous bodily symptoms and changes, known as interpretation bias, in line with the failure to reappraise the symptoms in safer ways, is supposed to increase the levels of anxiety in illness-anxious individuals.

METHODS

This study aimed to address the statistical limitations of the direct (self-report) measure of interpretation bias, using an indirect (online interpretation bias task) measure for assessing biased interpretations of bodily symptoms. In addition, we examined the contribution of self-report anxiety sensitivity (AS), intolerance of uncertainty (IU), interpretation bias, and reappraisal to illness anxiety problems in a subclinical population and compared it with controls with low levels of illness anxiety.

FINDINGS

Illness-anxious individuals made more negative interpretations of ambiguous, potentially health-threatening information. They used less reappraisal to regulate their emotion. Among the measures, the physical subscale of AS and the reaction time to the safe resolution of ambiguous information were the best factors that could contribute to the differentiation between the illness-anxious individuals and non-anxious individuals.

CONCLUSION

Our findings provided further support for the biased processing of information related to physical symptoms among individuals with illness anxiety. AS-physical and safe resolutions for ambiguous situations could differentiate the illness-anxious and the control groups better than other factors. These findings suggest that a change of interpretation of ambiguous bodily symptoms among individuals suffering from chronic conditions can be a possible intervention to target anxiety and improve patients' lives.