Traumatic Distress of COVID-19 and Depression in the General Population: Exploring the Role of Resilience, Anxiety, and Hope

A Comparison of Physical Therapist Educational Outcomes Before and During the COVID-19 Pandemic: A Multicenter Study

INTRODUCTION

The purpose of this study was to analyze and compare educational outcomes of Doctor of Physical Therapy (DPT) graduates before and during the COVID-19 pandemic.

REVIEW OF LITERATURE

Reports show increased stress, anxiety, and burnout during the COVID-19 pandemic, which may have negatively affected academic performance. Historically, academic performance is predictive of National Physical Therapy Examination (NPTE) scores. Yet, there is little evidence analyzing student outcomes during the pandemic.

SUBJECTS

Doctor of Physical Therapy graduate records (N = 1,897) were retrospectively collected from a multicenter convenience sample consisting of 5 blended programs. Records were sampled from existing "prepandemic" graduates of Fall 2018-2019 (n = 988) and "pandemic" graduates of Fall 2021-2022 (n = 909).

METHODS

A causal comparative and correlational study design was used. Grade point average (GPA) and NPTE scores were collected. A general linear model examined differences between groups, and a multiple linear regression examined predictors of NPTE performance.

RESULTS

Grade point average was a significant predictor of NPTE score (r2 = 0.56; P < .01) for the overall sample and for the prepandemic and pandemic cohorts (r2 = 0.38, P < .01; r2 = 0.45, P < .01, respectively). Grade point average was not significantly different between the groups (P = .09), nor did it significantly influence differences in NPTE scores (P = .13). Pandemic graduates displayed a significantly lower NPTE pass rate (85.1%) compared with prepandemic graduates (89.7%; P < .01). Pandemic graduates experienced higher rates of academic difficulty (20%; P < .01) and had a approximately 5 times higher likelihood of not passing the NPTE.

DISCUSSION AND CONCLUSION

This is the first study to report on DPT graduate outcomes spanning the COVID-19 pandemic. Similar to previous studies, GPA remained the most significant predictor of NPTE scores. Pandemic graduates demonstrated significantly lower NPTE scores and higher rates of academic difficulty (GPA < 3.0). Continued monitoring of NPTE performance is warranted between prepandemic, pandemic, and postpandemic cohorts across modes of program delivery.

Hope's relationship with resilience and mental health during the COVID-19 pandemic

The COVID-19 pandemic has affected individuals financially, physically, and mentally during the past couple of years. Recent research has indicated that mental health concerns such as stress, anxiety, and depression have been on the rise due to the pandemic and its consequences. Fortunately, resilience factors such as hope have also been examined in the midst of the pandemic. Hope has been found to be a buffer against stress, anxiety, and depression over time during the COVID-19 pandemic. Hope has also been associated with positive outcomes such as posttraumatic growth and well-being. These results have been investigated in populations particularly affected by the pandemic such as healthcare professionals and patients with chronic illness and cross-culturally.

Hope and depression and personality disorders

Hope is a positive psychology construct that comprises goals, agency thinking, and pathways thinking and has been associated with psychological and physical well-being. This paper summarizes recent findings regarding the relationship between hope and depressive symptoms as well as hope and personality disorders and traits. Studies have shown that hope is inversely associated with negative affect when examined cross-sectionally, although the relationship between hope and depression is more complex longitudinally. Little is known about hope as it pertains to personality disorders, though more recent studies have examined the relationship between hope and personality traits such as neuroticism and extraversion; results from those studies are mixed, leaving a wide gap in the literature for future exploration.

Psychological Distress Related to the COVID-19 Pandemic: The Protective Role of Hope

The COVID-19 outbreak and the worldwide lockdown measures had an impact on the global mental health and psychological well-being of the general population. Several studies attempted to investigate the protective and risk factors for psychological distress related to the pandemic. However, to date, little is known about the role of hope in this context. The aim of this study was to determine the relationship between hope and psychological distress related to the COVID-19 outbreak in the general population. The sample consisted of 504 Pakistani people who completed cross-sectionally the COVID-19 Peritraumatic Distress Index (CPDI) and the Adult Hope Scale (AHS). Bivariate Pearson correlation analysis was run to measure the relationship between hope and psychological distress; hierarchical regression analysis was run to investigate the association between demographics and hope with psychological distress. Higher levels of hope predicted lower levels of psychological distress. Being female, being older, lower level of education, urban residence, being married and living in nuclear family systems were associated with higher levels of psychological distress. The study highlights the protective role of hope on psychological distress related to COVID-19, contributing to knowledge on factors promoting positive mental health during emergency times and providing useful information for implementing effective public health policies and programmes.

Self-harm in Young People: Investigating the Role of Resilience and Posttraumatic Stress Related to the COVID-19 Pandemic

Evidence shows that young people may have experienced increased levels of posttraumatic stress and depression during the COVID-19 pandemic. However, the landscape on self-harm is still unclear. This study aimed to examine the role of COVID-19 related posttraumatic stress, depression and resilience as predictors of self-harm with and without suicidal intent. Participants were 625 young people aged 17-25 years old (M = 20.2 years, SD = 2.47). Resilience was measured using the self-reported Child & Youth Resilience Scale Measure - Revised (CYRM-R). Posttraumatic stress related to COVID-19 were measured using the Impact of Event Scale- Revised. Depression was measured using the depression subscale of the Depression, Anxiety and Stress Scale-21. Self-harm was evaluated with two dichotomous items. Participants reported high levels of depression and COVID-19 posttraumatic stress, and a significant percentage reported engaging in self-harm. Hierarchical logistic regressions showed that caregiver resilience decreased approximately 20% the odds of engaging in self harm with and without suicidal intent remaining a consistent predictor even after accounting posttraumatic stress and depression in the models. Posttraumatic stress and depression predicted a one-fold increase in the odds of engaging in self-harm with and without suicidal intent. However, posttraumatic stress was no longer a significant predictor when depression was entered in the model in self-harm without suicidal intent. The COVID-19 pandemic may have increased the likelihood of engaging in self-harm in young people. However, caregiver resilience seems to operate as a protective factor. This important finding carries implications beyond the context of the COVID-19 pandemic.

The association of mindfulness and psychological well-being among individuals who have recovered from COVID-19 in Jianghan District, Wuhan, China: A cross-sectional study

BACKGROUND

In the global pandemic of the coronavirus disease 2019 (COVID-19), depression and post-traumatic stress disorder (PTSD) have commonly occurred among COVID-19 patients, whose experiences of infection and subsequent treatment might develop negative consequences on their mental well-being even after recovery. Despite the general recognition of efficacy of mindfulness-based interventions in reducing psychological distress among various populations, there were insufficient studies on the relationship between mindfulness and mental health among individuals who have recovered from COVID-19.

OBJECTIVE

The current study aims to identify the prevalence of common mental health challenges among recovered COVID-19 patients in Jianghan District, Wuhan, China and to explore the potential mechanism through which mindfulness alleviate depression and PTSD.

METHODS

A cross-sectional survey on mental health was conducted among a convenience sample of adults recovered from COVID-19 in Jianghan District, Wuhan, China. The study participants completed questionnaires under the assistance of trained investigators. The questionnaire included Chinese version of Five Facets of Mindfulness Questionnaire-Short Form (FFMQ-SF), Generalized Anxiety Disorder Questionnaire (GAD-7), Resilience Style Questionnaire (RSQ), Impact of Events Scale-Revised (IES-R), and Patient Health Questionnaire (PHQ-9) to measure mindfulness, anxiety, resilience, PTSD, and depression respectively. Structural equation modeling was used to explore the relationship between mindfulness and mental health outcomes of this population.

RESULTS

1541 respondents (654 [42.4 %] men and 887 [57.6 %] women) completed the questionnaire between June 10 and July 25, 2021, of whom 36.2 % and 27.1 % had mild and severe levels of depressive and anxiety symptoms respectively, and 15.2 % was indicated with PTSD. The average score of mindfulness of the study participants was (3.100 ± 0.387), and that of resilience was (3.560 ± 0.877). The structural equation model fit the data well, demonstrating that mindfulness was negatively associated with depressive symptoms directly (β = -0.031, P = 0.021) or indirectly through the mediation effect of resilience (β = -0.019, P = 0.009) and anxiety symptoms (β = -0.208, P < 0.001), and was negatively associated with PTSD through the mediation effect of anxiety symptoms (β = -0.142, P < 0.001).

CONCLUSION

Individuals who have recovered from COVID-19 commonly experienced psychological distress. Mindfulness is associated with alleviation of depressive and PTSD symptoms directly or indirectly. Interventions based on mindfulness are suggested to improve the mental well-being of this population.

Hope and PTSD

This paper reviews the present literature examining how hope relates to PTSD and broader functioning after a trauma, including potential underlying mechanisms and significant factors impacting these relationships and the role of hope as a mechanism of change within interventions for PTSD. First, the ways in which trauma impacts hope are discussed. Afterwards, an overview is provided of cross-sectional and prospective research indicating that greater hope reduces the risk of PTSD and promotes positive outcomes of adversity. Next, potential underlying mechanisms and determinants of the relationship between hope and adjustment are explored, including adaptive appraisals, productive coping, and social support. Finally, evidence supporting the role of hope as a mechanism of change in treatments for PTSD is reviewed.

Prevalence and Predictors of Somatization in Peruvian Undergraduate Students during the COVID-19 Pandemic

The COVID-19 pandemic had a strong impact on mental health. Multiple studies report the alarming prevalence of depression, anxiety, and stress-related conditions due to the lockdown measures. Nevertheless, somatization has been an overlooked topic in current literature despite its strong relationship with most mental health conditions. The aim of this study was to describe the prevalence of somatic symptoms and their associated factors in a sample of 3218 undergraduate students from Lima, Peru. A cross-sectional design was carried out. The prevalence of somatic symptoms was measured with the PHQ-15. As predictors of somatic symptom severity, we included psychopathological (depression, anxiety, and stress), psychological (perceived social support, resilience, satisfaction with life, and academic self-efficacy), and sociodemographic (e.g., age, sex, employment status, relationship status, daily hours of sleep) variables. A generalized linear model from a binomial family and a logit link function were applied based on a Factor Score Regression approach, with half of the sample presenting moderate-to-severe somatic symptoms. Anxiety was the strongest predictor of somatic symptom severity, followed by academic self-efficacy. Significant differences were found regarding sex, relationship status, daily hours of sleep and COVID-19 risk-related variables. In conclusion, interventions on reducing anxiety and promoting academic self-efficacy may have a stronger impact on somatic symptom severity and should focus on more vulnerable specific demographic groups such as females.

Psychological distress and post-traumatic growth in France during the COVID-19 pandemic: A mediation model of psychosocial safety climate as a determinant of work performance

The psychosocial safety climate (PSC) reflects workers’ perceptions of senior management’s concern for mental health. Because the COVID-19 pandemic has exacerbated organizational issues, PSC could be a target for interventions attempting to preserve both the psychological health of employees and the economic health of companies. This study examines the direct and indirect relationships between PSC and work performance through two indicators of psychological health, psychological distress and post-traumatic growth, during a health crisis, i.e., prior to the second confinement in France. To this end, 2,004 participants from the French workforce completed a survey in October 2020. The results of mediation analyses indicate that PSC has a direct and positive influence on post-traumatic growth (PTG) and performance, as well as a direct negative influence on psychological distress. PSC also has an indirect positive influence on performance via psychological distress. Organizations that wish to jointly address mental health and performance at work would benefit from optimizing PSC.

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.

Exploring the Factors of Rural Tourism Recovery in the Post-COVID-19 Era Based on the Grounded Theory: A Case Study of Tianxi Village in Hunan Province, China

Effective recovery of rural tourism in the post-COVID-19 era could consolidate achievements in poverty alleviation and promote rural revitalization in China. In order to explore the factors influencing the rural tourism recovery from the COVID-19 crisis, this explorative–qualitative study chose Tianxi village in Hunan province of China as a typical case, as it has been officially selected as one of the key national villages for developing rural tourism. It was found that the process of rural tourism recovery in the post-COVID-19 era consists substantially of the development and evolutionary resilience in rural tourism. In the proposed theoretical model, the governance capability of local governments, robustness of rural social networks, activeness of rural talent, innovativeness of development mechanisms, and persistence of resilience cultivation are all essential factors throughout this process. Evolutionary resilience of rural tourism could enable destinations to manage unpredictable crises and even to seize novel development opportunities.

COVID-19 Related Stress and Mental Health Outcomes 1 Year After the Peak of the Pandemic Outbreak in China: the Mediating Effect of Resilience and Social Support

BACKGROUND

COVID-19 outbreak have a long-term negative impact on mental health. Meanwhile, it may also provide opportunities for positive outcomes (e.g., post-traumatic growth). Resilience and social support could serve as psychological resources to protect individuals against the detrimental effects of the COVID-19 crisis and enable people to develop positive changes during challenging times.

OBJECTIVE

By testing the roles of resilience and social support in the relationship between COVID-19 related stress and negative mental health outcomes (depression and anxiety), as well as the relationship between COVID-19 related stress and positive mental health outcomes (post-traumatic growth, PTG), this study aimed to investigate the psychological mechanisms involved in different mental health outcomes induced by COVID-19.

METHODS

An online survey was conducted 1 year after the peak of the COVID-19 outbreak (from April to August 2021) in China. The survey includes demographic questionnaires and six scales: the Impact of Event Scale-Revised for COVID-19 (IES-RC), the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), the Perceived Social Support Scale (PSSS), the Center for Epidemiological Studies Depression Scale (CES-D), the Generalized Anxiety Disorder scale (GAD-7) and the Posttraumatic Growth Inventory (PTGI). The structural equation model (SEM) was used to evaluate the relations and mechanisms between COVID-19 related stress and resilience, social support in depression, anxiety, and PTG.

RESULTS

A total of 771 Chinese subjects completed the questionnaire, including 416 (54%) females. COVID-19 related stress was associated with anxiety (P < 0.001), PTG (P < 0.001), and depression (P < 0.001). Resilience was related to depression (P < 0.001), anxiety (P < 0.001), and PTG (P < 0.001). Social support was associated with depression (P < 0.001), anxiety (P < 0.001), and PTG (P < 0.001). Under SEM analysis, resilience mediated the effects of COVID-19 related stress on depression and post-traumatic growth. Social support mediated the impacts of COVID-19 related stress on post-traumatic growth, depression, and anxiety. The path coefficients of the mediation effects were statistically significant.

CONCLUSIONS

The current findings suggest that COVID-19 related stress has a double-edged effect on mental health. Depression, anxiety, and PTG coexist in Chinese individuals 1 year after the peak of the pandemic. Resilience and social support serve as important protective factors of mental health, safeguard people from the negative mental health outcomes of the COVID-19, and promote PTG.

The impact of the first wave of the Covid-19 pandemic on parents of children with externalising difficulties in ireland: A longitudinal cohort study

BACKGROUND

This longitudinal cohort study aimed to examine the impact of the first wave of the COVID-19 pandemic in Ireland on parents of children with externalising difficulties, in comparison to parents of children without such difficulties.

METHOD

Parents of 159 children completed online self-report measures at three time points during the first wave of the COVID-19 pandemic; (a) Delay and Mitigation Phase (March 2020 to May 2020), (b) Reopening of Society Phase (June 2020 to July 2020) and (c) Wave 2 Case Acceleration Phase (September 2020 to October 2020). Participants were allocated to the clinical group if they met the clinical cut off point on the Conduct or Hyperactivity/Inattention subscales of the Strengths and Difficulties Questionnaire at Time 1.

RESULTS

Parents of children with externalising difficulties experienced significantly higher levels of stress, lower levels of wellbeing and engaged in higher levels of avoidant-focused coping strategies longitudinally. There was a significant difference between outcomes at the different phases of the COVID-19 pandemic, for stress related to parenting, personal/family stress related to the impact of the COVID-19 and type of coping strategies employed. Children with externalising difficulties, in comparison to children without externalising difficulties, showed significantly greater adjustment over time for behavioural and emotional difficulties, as reported by their parents.

CONCLUSIONS

Results provide important information regarding the trajectory of psychological outcomes in parents of children with externalising difficulties over the first wave of the COVID-19 pandemic, highlighting the need for increased parental supports during, and after, the COVID-19 pandemic.