Exploring the Frequency of Anxiety and Depression Symptoms in a Brazilian Sample during the COVID-19 Outbreak

Association of Emotional Self-Regulation with Psychological Distress and Positive Functioning Dimensions in Brazilian University Students during the COVID-19 Pandemic

Emotional self-regulation is a relevant factor for human development capable of minimizing emotional difficulties in the face of adverse events, as was particularly useful during the COVID-19 pandemic. The present study aimed to evaluate emotional self-regulation in Brazilian health science university students and its relationship with positive psychology constructs (subjective well-being, hope, optimism, spirituality, self-compassion, and self-efficacy) and psychological distress (depression, anxiety, and stress). This was a prospective, cross-sectional, observational, analytic study of 1062 Brazilian undergraduate students with data collected using self-administered online questionnaires. Students in the first years of their undergraduate degree programs had significantly higher dysregulation scores than those in the final years. Multiple linear regression yielded a model that explained 71.8% of the variation in emotion dysregulation. The correlations of emotion dysregulation were significant and strong, scoring negatively with self-compassion, optimism, and subjective well-being and positively with psychological distress.

Prevalence of anxiety during the COVID-19 pandemic: A systematic review and meta-analysis of over 2 million people

INTRODUCTION

Uncertainty, disruptions in daily routines, and concerns for the health and well-being during the COVID-19 pandemic are likely associated with increases in generalized anxiety. The present study aimed to systematically review the literature in order to identify the update prevalence of anxiety in the general population during the COVID-19 pandemic.

METHODS

A systematic review and meta-analysis. It included studies that assessed the prevalence of anxiety among the general population during the COVID-19 pandemic.

RESULTS

In total, we included 194 studies. The general prevalence of anxiety was 35.1 %, affecting approximately 851,000 participants. The prevalence in low and middle-income countries (35.1 %; 95%CI: 29.5 % to 41.0 %) was similar compared to high-income countries (34.7 %; 95%CI: 29.6 % to 40.1 %). In studies that provided the proportion of cases in each level of anxiety disorder, mild-to-moderate anxiety affected one quarter of the participants. One in ten cases with anxiety during the COVID-19 may be living with severe or extremely anxiety disorder. Most instruments estimated similar prevalence of anxiety disorders with notable difference in the prevalence estimated by the Generalized Anxiety Disorder 2-item (GAD-2), Zung Self-Rating Anxiety Scale (SAS), and State-Trait Anxiety Inventory (STAI).

CONCLUSION

One in three adults were living with anxiety disorder during the COVID-19 pandemic worldwide.

Disentangling crucial factors of the pandemic in Brazil: Effect of lockdown restrictions on mental health

Quarantine and social distance restrictions have been enforced worldwide to reduce the spread of coronavirus disease 2019 (COVID-19). The effects of these measures on mental health are recognised, but remaining unclear, is whether these effects are a consequence of the virus itself or policies that are enforced to prevent it. The present study investigated the impact of lockdown restrictions on anxiety and depression at two different times in 2020. Data were collected from 118 participants from all regions of Brazil. After easing quarantine restrictions in the second half of 2020, two natural groups were formed. One group included participants who voluntarily remained at home (n = 73). The other group consisted of those who decided to leave home (n = 45). A linear mixed model was used to determine the effects of group and time and their interaction. The McNemar test was used to determine intragroup differences in perceptions and concerns about COVID-19. Logistic regression identified predictors of high and stable depression and anxiety. None of the factors or their interactions was significant. Indicators of depression and anxiety remained stable over time, regardless of whether the participants left home or remained at home. Significantly, a strong and stable agreement with quarantine was found. The participants agreed that COVID-19 was a threat to public health. Political orientation was a predictor of high and stable levels of depression but not anxiety. Participants who self-identified as liberal politically were at a greater risk of developing depression. The results suggest that the lockdown policy did not contribute to disruptions of mental health, which instead was a consequence of the pandemic and virus itself. We also found wide and strong support amongst the participants for lockdown and mandatory stay-at-home policies.

Anxiety levels among Palestinian university students during the COVID-19 pandemic: A cross-sectional study

Background:

The widespread of COVID-19 causes serious distress on the mental health of the students during the lockdown period. The present study aimed to identify anxiety levels among students during the COVID-19 crisis.

Design and methods:

A cross-sectional web-based survey was carried out among university students aged 18–47 years. The 7-item Generalized Anxiety Disorder Scale (GAD-7) was used to assess anxiety symptoms.

Results:

Among the 1252 participants, the mean age was 28.82 (±7.28) years and 72.6% were female. Based on the results, 22.0% of the participants had no symptoms of anxiety, 25.2% had mild anxiety, 29.6% moderate anxiety, and 23.2% severe anxiety. Moreover, being a female (OR = 0.480, 95% CI = 0.257–0.704), younger age (OR = 0.359, 95% CI = 0.132–0.586), undergraduate level (OR = 0.493, 95% CI = 0.288–0.698), and stability of monthly income (OR = 0.516, 95% CI = 0.308–0.723) were found to be a protective factor against anxiety suffered by the participants. However, having a COVID-19-infected relative or acquaintance was a risk factor for anxiety (OR = 21.870, 95% CI = 21.870–21.870). The results revealed that the level of anxiety symptoms was positively associated with COVID-19 related stressors such as effects on daily living (r = 0.163, p < 0.001), economic stressors (r = 0.153, p < 0.001), and educational consequences (r = 0.150, p < 0.001), however, social support (r = 0.472, p < 0.001) was negatively associated with the anxiety.

Conclusion:

The psychological status of university students should be followed during times of health emergencies. It is essential to design a health program for influenced students to assist them to stay resilient throughout perilous situations.

Mental Health Impact of the COVID-19 Pandemic on Mexican Population: A Systematic Review

The COVID-19 pandemic has had an impact on mental health in the general population, but no systematic synthesis of evidence of this effect has been undertaken for the Mexican population. Relevant studies were identified through the systematic search in five databases until December, 2021. The selection of studies and the evaluation of their methodological quality were performed in pairs. The Newcastle-Ottawa Scale (NOS) was used for study quality appraisal. The protocol of this systematic review was registered with PROSPERO (protocol ID: CRD42021278868). This review included 15 studies, which ranged from 252 to 9361 participants, with a total of 26,799 participants. The findings show that COVID-19 has an impact on the Mexican population’s mental health and is particularly associated with anxiety, depression, stress and distress. Females and younger age are risk factors for development mental health symptoms. Mitigating the negative effects of COVID-19 on mental health should be a public health priority in Mexico.

Translation and validation of the evidence-based practice attitude scale (EBPAS-15) to Brazilian Portuguese: Examining providers' perspective about evidence-based parent intervention

BACKGROUND

Few existing evidence-based parent interventions (EBPIs) for prevention and treatment of child and youth mental health disorders are implemented in low-middle-income countries. This study aimed to translate and confirm the factor structure of the Evidence-Based Practice Attitude Scale (EBPAS-15) survey in Brazilian Portuguese with the goal of examining providers' perspective about EBPIs.

METHODS

We translated and back translated the EBPAS-15 from English to Brazilian Portuguese. Participants were recruited via snowball sampling and data were collected using an online survey from July of 2018 through January of 2020. A confirmatory factor analysis was conducted to determine if the scale retained its original structure. Open-ended questions about providers' perspectives of their own clinical practice were coded using the Theoretical Domains Framework (TDF). Analyses included data from 362 clinicians (318 women, 41 men) from 20 of the 27 states of Brazil. Participants on average were 26.7 years old, held specialist degrees in the field of psychology, actively worked as therapists, and practiced in private clinics.

RESULTS

The translation of the EBPAS to Brazilian Portuguese retained the same four-factor structure as the English version except for dropping one item from the Divergence domain. When asked about the challenges in their practices, providers generally referred to parents as clients with little skills to discipline their children and lacking knowledge about child development.

DISCUSSION

The Brazilian version of the EBPAS-15 is promising, but future research should consider using quantitative data alongside qualitative information to better understand providers' attitudes about evidence-based interventions to inform implementation efforts.

TRIAL REGISTRATION

N/A.

Prevalence and Factors of Anxiety During the Coronavirus-2019 Pandemic Among Teachers in Saudi Arabia

Background

Teachers play a central role in successful education. Due to the COVID-19 pandemic, regular in-person attendance in classes at all levels of education has been disrupted for more than 1 year in many countries. These lockdowns, which include the discontinuation of in person learning at schools and universities has presented a significant challenge for teachers to adapt to online teaching. Given this rapid format change, occupational anxiety levels among educators has increased.

Objective

The primary objective of this study was to assess the prevalence of anxiety among teachers in Saudi Arabia. A secondary objective was to explore characteristics of teachers associated with the level of anxiety level during the period of lockdown.

Methods

An anonymous, online cross-sectional study was carried for 3 months (February 2021 through April 2021). The questionnaire consisted of four sections and included the Generalized Anxiety Disorder instrument (GAD-7). Chi-square tests were completed for categorical comparisons while binary logistic regressions were used for associative relationship exploration. The IRB at King Saudi University Medical City, Saudi Arabia approved this study.

Results

A total of 742 respondents completed the survey yielding an anxiety prevalence of 58.2 % among teachers. Medium degree of statistically significant differences identified as marital status (p = 0.046). women had higher anxiety (65.3%) than men (34.7%) but gender with anxiety was low degree of statistical significance compared with non-anxiety status (p = 0.697). The odds of anxiety among middle teachers was twice (OR = 2.01) as high as the odds of anxiety among other levels of teacher (p = 0.01, 95% CI 0.94–4.26).

Conclusions

This study identified that many teachers experienced anxiety during the lockdown, especially women and middle school teachers. Future studies should identify contributing factors to estimate the magnitude of the exposure to anxiety between different types of teachers to help establish better preventive measures based on the workplace environment.

Social Support and Dietary Habits as Anxiety Level Predictors of Students during the COVID-19 Pandemic

The COVID-19 pandemic is a public health emergency concern and a challenge to students' mental health due to changes in education and social isolation. The aim of this research was to expand knowledge about the relations that shape the level of anxiety amongst men and women who are studying during the pandemic in terms of the relations towards their sense of social support and their nutritional behaviors. A State-Trait Anxiety Inventory was used to measure anxiety level, alongside supplementary questions such as the feeling of support from close ones, concentration of attention on nutrition during the pandemic and externally derived factors (university, specialization). Analysis of the regression was applied to the examination of the dependency between the anxiety level (in both forms of its occurrence-as state-anxiety and as trait-anxiety). We observed that the pandemic situation affected a level of state-anxiety above average (mean value of 46-48 points) even when students felt social support. Nutrition habits and chosen education type are associated with trait-anxiety level, which was also elevated (mean values of 49-50 points). Chosen factors had a partial influence on the anxiety level of students, therefore their mental health should concern shaping positive nutrition habits and social support.

Analyzing Predictors of Control Measures and Psychosocial Problems Associated with COVID-19 Pandemic: Evidence from Eight Countries

COVID-19 has harshly impacted communities globally. This study provides relevant information for creating equitable policy interventions to combat the spread of COVID-19. This study aims to predict the knowledge, attitude, and practice (KAP) of the COVID-19 pandemic at a global level to determine control measures and psychosocial problems. A cross-sectional survey was conducted from July to October 2020 using an online questionnaire. Questionnaires were initially distributed to academicians worldwide. These participants distributed the survey among their social, professional, and personal groups. Responses were collected and analyzed from 67 countries, with a sample size of 3031. Finally, based on the number of respondents, eight countries, including Bangladesh, China, Japan, Malaysia, Mexico, Pakistan, the United States, and Zambia were rigorously analyzed. Specifically, questionnaire responses related to COVID-19 accessibility, behavior, knowledge, opinion, psychological health, and susceptibility were collected and analyzed. As per our analysis, age groups were found to be a primary determinant of behavior, knowledge, opinion, psychological health, and susceptibility scores. Gender was the second most influential determinant for all metrics except information about COVID-19 accessibility, for which education was the second most important determinant. Respondent profession was the third most important metric for all scores. Our findings suggest that health authorities must promote health educations, implement related policies to disseminate COVID-19-awareness that can prevent and control the spread of COVID-19 infection.

How Has the COVID-19 Crisis Affected the Academic Stress of University Students? The Role of Teachers and Students

The effects of the COVID-19 pandemic have required substantial adjustments in terms of university teaching-learning processes. The aim of this study was to verify whether there were significant differences between the academic year of 2020 and the two preceding years in factors and symptoms and stress. A total of 642 university students (ages 18-25 years) participated by filling out validated self-reports during the months from March to August 2020. Using an ex post facto design, SEM analyses and simple and multiple ANOVAs were performed. Structural results showed that stress factors from the teaching process had a predictive value for the learning process, emotions, and academic burnout, and being a man was a factor predicting negative emotion. In a similar way, inferential results revealed no significant effect of academic year but did show an effect of gender on stress experiences during the pandemic. Aside from certain specific aspects, there was no significant global effect of the year 2020 on factors and symptoms of stress. The results showed that studying in the year of the COVID-19 outbreak did not have a significant effect on stress triggered by the teaching process. From these results, we draw implications for specific guidance interventions with university teachers and students.

Music Listening in Times of COVID-19 Outbreak: A Brazilian Study

The COVID-19 outbreak required diverse strategies, such as social distancing and self-isolation, to avoid a healthcare system crisis. However, these measures have been associated with the onset or increase of anxiety and depression symptoms in the population. Music listening was previously shown to regulate emotion, consequently reducing depression symptoms. Since previous studies with Brazilian samples have already shown a high prevalence of depressive symptoms during the first confinement period, the aim of this study was threefold: (i) to compare groups with severe depression symptoms and no depression in what concerns to demographic and socio-economic factors as well as symptoms of anxiety and resilience levels, (ii) to explore changes in music listening daily routine during the confinement measures by both groups (no depression and severe depression), and (iii) to investigate which were the main factors influencing both two groups to music listening during the COVID-19 pandemic. This cross-sectional study included 494 Brazilian respondents aged 18 years and above. Our online survey comprised demographics, socio-economic, and COVID-19 related questionnaires, with questions regarding music listening used during social distancing measures on which the participants rated how much each of the 41 potential reasons for listening to music changed in importance compared to the situation before the pandemic and also the evaluation of anxiety, depression, and resilience levels. The respondents with severe depression were younger and showed higher levels of anxiety symptoms and lower resilience level. Furthermore, they were increasingly likely to listen to music to feel emotionally better with the situation, to feel comfort, to forget problems, to be energetic, to decrease sad feelings, to relax, to cheer up, to forget concerns, to express feelings, to reduce anxiety, to remember better times, to relieve boredom, to mentally stimulate themselves, and to ward off stressful thoughts compared to the participants with no depression. The exploratory factor analysis (FA) identified four types of music listening functions during social distancing measures: negative mood management, cognitive functioning, positive mood management, and physical involvement, in which the participants with severe depression revealed significant differences compared to non-depressed participants for the negative mood management factor, which shows the importance of music listening to regulate their negative emotions. As a conclusion, we can argue that most of our respondents used music listening to cope with and regulate their moods during confinement, especially those who presented with severe depression symptoms.