The psychological distress and coping styles in the early stages of the 2019 coronavirus disease (COVID-19) epidemic in the general mainland Chinese population: A web-based survey

Longitudinal Impact of the COVID-19 Pandemic on Stress and Occupational Well-Being of Mental Health Professionals: An International Study

BACKGROUND

Increased levels of occupational stress among health professionals during the COVID-19 pandemic have been documented. Few studies have examined the effects of the pandemic on mental health professionals despite the heightened demand for their services.

METHOD

A multilingual, longitudinal, global survey was conducted at 3 time points during the pandemic among members of the World Health Organization's Global Clinical Practice Network. A total of 786 Global Clinical Practice Network members from 86 countries responded to surveys assessing occupational distress, well-being, and posttraumatic stress symptoms.

RESULTS

On average, respondents' well-being deteriorated across time while their posttraumatic stress symptoms showed a modest improvement. Linear growth models indicated that being female, being younger, providing face-to-face health services to patients with COVID-19, having been a target of COVID-related violence, and living in a low- or middle-income country or a country with a higher COVID-19 death rate conveyed greater risk for poor well-being and higher level of stress symptoms over time. Growth mixed modeling identified trajectories of occupational well-being and stress symptoms. Most mental health professions demonstrated no impact to well-being; maintained moderate, nonclinical levels of stress symptoms; or showed improvements after an initial period of difficulty. However, some participant groups exhibited deteriorating well-being approaching the clinical threshold (25.8%) and persistently high and clinically significant levels of posttraumatic stress symptoms (19.6%) over time.

CONCLUSIONS

This study indicates that although most mental health professionals exhibited stable, positive well-being and low stress symptoms during the pandemic, a substantial minority of an already burdened global mental health workforce experienced persistently poor or deteriorating psychological status over the course of the pandemic.

Demographic factors, partial social belonging and psychological resources associated with coping

Introduction

The present study investigates the role of perceived partial social belonging (PPSB) in determining societal and individual resilience and positive and negative coping indicators. It is assumed that most people aspire to belong and be integrated into their society. A sense of only partial belonging is therefore distressing for them.

Methods

Two hypotheses are examined in the current study: (a) A higher level of PPSB will predict a lower level of resilience and a higher level of psychological symptoms. (b) PPSB will mediate the associations between three stress-evoking demographic characteristics (younger age, low income, and gender) and the lower psychological resilience and higher distress associated with these demographic characteristics. These hypotheses were examined using a sample of the Israeli Jewish public (N = 1,502) who responded to an anonymous questionnaire about the investigated issues. The data were collected by an internet panel company possessing a database of more than 65,000 residents, representing the varied components of the Israeli society.

Results

The findings supported our hypotheses: (a) PPSB negatively predicted societal and individual resilience and hope and positively predicted distress symptoms and sense of danger. (b) PPSB mediated the effects of the investigated demographic variables on these psychological variables.

Conclusion

These results are discussed in association with the concept of belonging competencies. Our findings display that being unsure about one's belonging to a desired social group, has a major role in increasing psychological distress and sense of danger and in reducing hope and both individual and societal resilience.

Symptoms and risk factors of depression and PTSD in the prolonged COVID-19 pandemic: a longitudinal survey conducted from 2020 to 2022 in Japan

BACKGROUND

The present study aimed to explore changes in depression and posttraumatic stress disorder (PTSD) among the general population during the prolonged COVID-19 pandemic and to investigate risk factors and adaptive/nonadaptive strategies.

METHODS

A web-based longitudinal survey was conducted across five timepoints from 2020 to 2022 in Japan. Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9), PTSD was measured using Impact of Event Scale-Revised (IESR), and coping strategies were measured using Brief Coping Orientation to Problems Experienced (Brief COPE). Higher scores of PHQ-9 and IESR indicate more symptoms and Higher score of Brief COPE indicate that these means of coping are used very frequently.

RESULTS

A total of 1,366 participants (mean age = 52.76, SD = 15.57) were analyzed. Regarding levels of depression, PHQ-9 scores in 2022 were lower than in 2020 and 2021 (all p < 0.01). Regarding levels of PTSD, IESR scores in 2022 were lower than in 2021 among females (p < 0.001). Being younger (β = -0.08 and - 0.13, both p < 0.01) and engaging in self-blame (β = 0.12 and 0.18, both p < 0.01) increased PHQ-9 scores regardless of sex. For males, not working (β = 0.09, p = 0.004) and having suffered an economic impact (β = 0.07, p = 0.003) were risk factors for depressive symptoms, and active coping (β = -0.10, p = 0.005) was associated with decreased depressive symptoms. For females, substance use (β = 0.07, p = 0.032) and behavioral disengagement (β = 0.10, p = 0.006) increased depressive symptoms, and females did not show strategies that decreased the symptoms.

CONCLUSIONS

Levels of depression might have increased in the early stages of the pandemic and decreased in January 2022. Although males need to improve their economic situation to decrease depressive symptoms, adaptive strategies might be difficult to identify due to the prolonged pandemic among both sexes. In addition, the pandemic might be a depressive event but not a traumatic event among the general population, at least in Japan.

Stigma, Sociodemographic Factors, and Clinical Factors Associated with Psychological Distress among COVID-19 Survivors during the Convalescence Period: A Multi-Centre Study in Malaysia

High rates of psychological distress among COVID-19 survivors and stigmatisation have been reported in both early and late convalescence. This study aimed to compare the severity of psychological distress and to determine the associations among sociodemographic and clinical characteristics, stigma, and psychological distress among COVID-19 survivors across two different cohorts at two different time points. Data were collected cross-sectionally in two groups at one month and six months post-hospitalisation among COVID-19 patient from three hospitals in Malaysia. This study assessed psychological distress and the level of stigma using the Kessler Screening Scale for Psychological Distress (K6) and the Explanatory Model Interview Catalogue (EMIC) stigma scale, respectively. At one month after discharge, significantly lower psychological distress was found among retirees (B = -2.207, 95% confidence interval [95% CI] = -4.139 to -0.068, p = 0.034), those who received up to primary education (B = -2.474, 95% CI = -4.500 to -0.521, p = 0.014), and those who had an income of more than RM 10,000 per month (B = -1.576, 95% CI = -2.714 to -0.505, p = 0.006). Moreover, those with a history of psychiatric illness [one month: (B = 6.363, 95% CI = 2.599 to 9.676, p = 0.002), six months: (B = 2.887, CI = 0.469-6.437, p = 0.038)] and sought counselling services [one month: (B = 1.737, 95% CI = 0.385 to 3.117, p = 0.016), six months: (B = 1.480, CI = 0.173-2.618, p = 0.032)] had a significantly higher severity of psychological distress at one month and six months after discharge from the hospital. The perceived stigma of being infected with COVID-19 contributed to greater severity of psychological distress. (B = 0.197, CI = 0.089-0.300, p = 0.002). Different factors may affect psychological distress at different periods of convalescence after a COVID-19 infection. A persistent stigma contributed to psychological distress later in the convalescence period.

Coping as a Mediator and Moderator between Psychological Distress and Disordered Eating Behaviors and Weight Changes during the COVID-19 Pandemic

Previous research has already shown the negative impact of the COVID-19 pandemic on college students' well-being and mental health. Eating problems and weight gain due to changes in eating habits and physical activity experienced during this period have also been noticed. However, few studies have explored the role of students' resources as used during the COVID-19 pandemic, such as coping strategies. This study aimed to (1) explore the associations among psychological distress, disordered eating, coping strategies, and weight changes; (2) examine the moderating role of coping strategies in the process of weight gain and weight loss; and (3) study the mediating role of coping strategies in the process of weight gain and weight loss. The participants in this study were 772 students at a Portuguese university. The data collected included sociodemographic data and three self-reported questionnaires (Depression, Anxiety, and Stress Scale; Eating Disorder Examination Questionnaire; Brief COPE) during the first few months of the pandemic, which included a 72-day full national lockdown. The results showed that depression, anxiety, stress, and disordered eating were related to increased weight. Guilt, denial, self-distraction, use of substances, and behavior disinvestment were also related to increased weight. Behavioral disinvestment had a strong mediating effect on weight gain. Additionally, planning, positive reframing, and acceptance all showed a moderating effect between psychological distress and weight changes. In conclusion, coping strategies allow for a better understanding of the mechanisms by which psychological distress and disordered eating were related to weight changes during the pandemic.

Gender Differences in Coping and Psychological Adaptation during the COVID-19 Pandemic

This population-based study investigated gender differences in the use of coping strategies and their relationship to anxiety symptoms during the initial COVID-19 lockdown period in the United States. A national online survey was administered between 13 April 2020 and 8 June 2020. The study sample comprised 1673 respondents (66% women). Overall, 46% reported high levels of anxiety, and women experienced significantly (p < 0.001) higher levels of anxiety than men. Women were significantly (p < 0.05) more likely to use acceptance, self-distraction, positive reframing, and emotional support than men. Significant interactions between gender and coping strategies were also identified. Women engaging in high (+1SD) vs. low (−1SD) levels of active coping were not found to have significantly different anxiety levels. In contrast, men reported higher levels of anxiety when they engaged in high levels of active coping and lower levels of anxiety when they engaged in low levels of active coping (b2 = 0.88, t = 3.33, p = 0.001). Additionally, women engaging in high levels of acceptance and positive reframing reported significantly lower anxiety levels than when engag-ing in low levels of acceptance (b1 = −1.03, t = −4.58, p < 0.001) and positive reframing (b1 = −0.72, t = −3.95, p < 0.001). No significant associations between acceptance and positive reframing levels and anxiety levels were found with men. Overall, these findings extend our understanding of the nature of gender differences in stress responsivity during periods of high psychological distress and can inform the development of mental health interventions to respond to the COVID-19 pandemic and future infectious disease outbreaks.

Domestic violence calls for police service in five US cities during the COVID-19 pandemic of 2020

BACKGROUND

When COVID-19 stay-at-home orders were instituted, there were concerns that isolation may lead to increases in domestic violence (DV). Reports of increased rates of DV during the stay-at-home period have been suggestive of this but inconsistent across different locations. We sought to complement the existing studies by characterizing changes in DV trends in US cities of Chicago, Los Angeles (LA), New York City (NYC), Philadelphia, and Phoenix using police call volume data from January 1st, 2018, through Dec 31st, 2020.

METHODS

The stay-at-home orders were generally instituted for most US states in the second half of March 2020. We used the call volume for the pre-COVID-19 period (Jan. 2018 to Feb. 2020) to model a forecast against the stay-at-home order period (Mar. - May 2020) and the period after lifting the order (June - Dec. 2020) using the interrupted autoregressive integrated moving average (ARIMA) time series model.

RESULTS

During the stay-at-home order, increases in mean DV calls relative to pre-COVID-19 were observed in Chicago (47.8%), Phoenix (18.4%), NYC (3.5%), and LA (3.4%), but a decrease in Philadelphia (-4.9%). After lifting the stay-at-home order, changes in mean calls relative to pre-COVID-19 remained elevated in Chicago, slightly elevated in Phoenix, and returned to baseline in NYC and LA.

CONCLUSION

Results suggest that the stay-at-home orders may have contributed to an increase in DV calls in some cities (Phoenix, and to a smaller extent LA, NYC), but the increase seen in Chicago (and to some extent Phoenix) persisted beyond the stay-at-home order and therefore may not be attributable to the stay-at-home orders. Additional studies are needed to help explain why the association between stay-at-home orders and DV police call volume seems to only appear in some locations.

Perceived stress and affective experience in Italian teachers during the COVID-19 pandemic: correlation with coping and emotion regulation strategies

The COVID-19 pandemic has represented a source of stress for teachers by adding new challenges. The objective of this study was to assess the association between emotion regulation and coping strategies, on the one hand, and perceived stress and affective experience on the other among teachers during the COVID-19 pandemic. A sample of 1178 of Italian pre-primary, primary, and secondary school teachers completed an online survey. Three hierarchical linear regression analyses were run to evaluate teachers’ emotion regulation, coping strategies, years of teaching experience, perceived workload, and perceptions about online teaching in predicting their perceived stress and positive and negative affect. The findings showed that cognitive reappraisal and positive attitude were associated with a lower level of perceived stress and negative affect and a higher level of positive affect. Problem orientation strategies were also associated with a higher level of positive affect. By contrast, expressive suppression was correlated with a higher level of perceived stress. Avoidance coping strategies were associated with higher perceived stress and negative affect and a lower level of positive affect. The perceived burden of online teaching was positively related with perceived stress and negative affect. Confidence in using educational technologies predicted lower levels of perceived stress, and previous online teaching experience was positively correlated with positive affect. The findings of this study could be useful for implementing teacher training programmes on emotion regulation and coping strategies to reduce stress and promote positive affect.

Facing the pandemic and lockdown: an insight on mental health from a longitudinal study using diaries

We conducted a longitudinal online study to examine attenuated psychotic symptoms (APS) over time in a sample of locked-down individuals. We used (i) questionnaires and (ii) the automatic analysis of the emotional content of narratives. Participants (N = 162) were recruited to complete an online survey 4 times between March and June 2020 (T1, T2, T3, T4). T1 completion coincided with the beginning of the lockdown, and T4 with the pandemic trough. Depression, anxiety, and stress were assessed with the DASS-42 and APS with the PQ-16. Psychosocial data such as the feeling of loneliness and social network size were also collected. The participants wrote daily narratives during the lockdown period. Anxiety and APS were the highest at T1 and decreased over time. APS and APS-associated distress were correlated with the DASS-42 at all times. APS arose acutely at the beginning of the pandemic, despite participants being socio-economically advantaged, and were related with negative emotions.

An exploratory study on emotion regulation strategy use in individuals with Williams syndrome, autism spectrum disorder and intellectual disability

Background

Individuals with neurodevelopmental disorders often have atypical emotion profiles, but little is known about how they regulate their emotions. While several studies have examined emotion regulation strategy use in autism spectrum disorder (ASD), only a few have included individuals with intellectual disability (ID) or focused on specific syndromes such as Williams syndrome (WS).

Methods

A parent-reported survey launched during the first months of the COVID-19 pandemic allowed to exploratorily study emotion regulation strategy use and its link to anxiety in individuals with ASD with (N=785) and without ID (N=596), WS (N=261), and Intellectual Disability not otherwise specified (N=649).

Results

Using multilevel analyses, besides revealing specific group differences in emotion regulation strategy use, a variety of strategies (e.g., rumination, avoiding information, repetitive behaviors) were found to be linked to elevated levels of anxiety, while focusing on the positive was linked to lower anxiety levels in all groups. Moreover, only autistic people without ID used humor more frequently while experiencing lower anxiety levels.

Conclusion

This study sheds light on an underexplored area of emotion regulation strategy use in different neurodevelopmental disorders. It also paves the way to further examine emotion regulation in more rigorous ways to better understand emotion regulation in different neurodevelopmental disorders as well as the impact on outcome measures such as anxiety. This exploratory study may help to develop and validate adequate measures to study a broad array of ER strategies used by individuals with neurodevelopmental disorders.

Early-childhood temperament moderates the prospective associations of coping with adolescent internalizing and externalizing symptoms

While appraisal and coping are known to impact adolescent psychopathology, more vulnerable or resilient responses to stress may depend on individual temperament. This study examined early life temperament as a moderator of the prospective relations of pre-adolescent appraisal and coping with adolescent psychopathology. The sample included 226 (62% female, 14–15 years) adolescents with assessments starting at 3 years of age. Adolescents were predominately White (12% Black 9% Asian, 11% Latinx, 4% Multiracial, and 65% White). Observed early-childhood temperament (fear, frustration, executive control, and delay ability) were tested as moderators of pre-adolescent coping (active and avoidant) and appraisal (threat, positive) on internalizing and externalizing symptoms during the pandemic. Interaction effects were tested using regression in R. Sex and family context of stress were covariates. Early-childhood temperament was correlated with pre-adolescent symptoms, however, pre-adolescent appraisal and coping but not temperament predicted adolescent psychopathology. Frustration moderated the relations of active and avoidant coping and positive appraisal to symptoms such that coping and appraisal related to lower symptoms only for those low in frustration. Executive control moderated the associations of avoidant coping with symptoms such that avoidance reduced the likelihood of symptoms for youth low in executive control. Findings underscore the role of emotionality and self-regulation in youth adjustment, with the impact of coping differing with temperament. These findings suggest that equipping youth with a flexible assortment of coping skills may serve to reduce negative mental health outcomes.

Psychological impact on healthcare workers, general population and affected individuals of SARS and COVID-19: A systematic review and meta-analysis

Background

Any infectious disease outbreak may lead to a negative detrimental psychological impact on individuals and the community at large, however; there was no systematic review nor meta-analysis that examined the relationship between the psychological/mental health impact of SARS and COVID-19 outbreak in Asia.

Methods and design

A systematic search was conducted using PubMed, EMBASE, Medline, PsycINFO, and CINAHL databases from 1/1/2000 to 1/6/2020. In this systematic review and meta-analysis, we analyzed the psychological impact on confirmed/suspected cases, healthcare workers and the general public during the Severe Acute Respiratory Syndrome (SARS) outbreak and Coronavirus disease (COVID-19) epidemics. Primary outcomes included prevalence of depression, anxiety, stress, post-traumatic stress disorder, aggression, sleeping problems and psychological symptoms.

Result

Twenty-three eligible studies (N = 27,325) were included. Random effect model was used to analyze the data using STATA. Of these studies, 11 were related to the SARS outbreak and 12 related to COVID-19 outbreaks. The overall prevalence rate of anxiety during SARS and COVID-19 was 37.8% (95% CI: 21.1-54.5, P < 0.001, I2 = 96.9%) and 34.8% (95% CI: 29.1-40.4), respectively. For depression, the overall prevalence rate during SARS and COVID-19 was 30.9% (95% CI: 18.6-43.1, P < 0.001, I2 = 97.3%) and 32.4% (95% CI: 19.8-45.0, P < 0.001, I2 = 99.8%), respectively. The overall prevalence rate of stress was 9.4% (95% CI: -0.4 -19.2, P = 0.015, I2 = 83.3%) and 54.1% (95% CI: 35.7-72.6, P < 0.001, I2 = 98.8%) during SARS and COVID-19, respectively. The overall prevalence of PTSD was 15.1% (95% CI: 8.2-22.0, P < 0.001) during SARS epidemic, calculated by random-effects model (P < 0.05), with significant between-study heterogeneity (I2 = 93.5%).

Conclusion

The SARS and COVID-19 epidemics have brought about high levels of psychological distress to individuals. Psychological interventions and contingent digital mental health platform should be promptly established nationwide for continuous surveillance of the increasing prevalence of negative psychological symptoms. Health policymakers and mental health experts should jointly collaborate to provide timely, contingent mental health treatment and psychological support to those in need to reduce the global disease burden.

Systematic review registration

CRD42020182787, identifier PROSPER.

An observatory on changes in dreaming during a pandemic: a living systematic review (part 1)

A 'new' way of dreaming has emerged during the pandemic, enhancing the interest of psychological literature. Indeed, during the years of the spread of coronavirus disease 2019 (COVID-19), many studies have investigated dream-related phenomena and dreaming functions. Considering the constant and rapid emergence of new results on this topic, the main aim of this study was to create an 'observatory' on the short- and long-term consequences of the COVID-19 pandemic on dreaming, by means of a living systematic review. The baseline results are presented, in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement guidelines, to identify and discuss existing studies about dreams and dreaming during the COVID-19 pandemic published until February 2022. Web of Science, Embase, EBSCO, and PubMed were used for the search strategy, yielding 71 eligible papers included in the review. Our results show: (a) a more intense oneiric activity during lockdown; (b) changes in dreaming components (especially dream-recall and nightmare frequency); (c) a particular dreaming scenario ('pandemic dreams'); (d) an alteration of the dreaming-waking-life continuum and a specific function of dreaming as emotional regulator. Findings suggest that monitoring changes in dreaming provides important information about psychological health and could also contribute to the debate on the difficulties of dreaming, as well as sleeping, in particular during and after a period of 'collective trauma'.

Musculoskeletal Components of Post-Acute Sequelae of SARS-CoV-2 Infections

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Musculoskeletal (MSK) sequelae of severe acute respiratory syndrome coronavirus 2 infections seem to be common.

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Mechanisms of such effects are becoming clear.

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There is a complex interplay of biopsychosocial effects associated with MSK symptoms after acute coronavirus disease 2019.

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Additional research should focus on completely describing the breadth of these MSK sequelae and related psychosocial symptoms.

Mental Health, Support System, and Perceived Usefulness of Support in University Students in Hong Kong Amidst COVID-19 Pandemic: A Mixed-Method Survey

BACKGROUND

This study explored the association of students' mental health with their support system, identified the preferred ways and sources of support, investigated the perceived usefulness of available university support, and recommended actionable strategies to enhance students' mental health.

METHOD

An online questionnaire survey and semi-structured focus group interviews were conducted in 2021.

RESULTS

Among 1121 university students, 39.4% reported anxiety symptoms, which were less common in Chinese students and those pursuing medical and health programmes. Overall, 32.6% reported depression symptoms, which were more common in undergraduates. Both anxiety and depression symptoms were less common in students with higher resilience and support system and more common in students with family distress. Students with higher resilience had a better support system and less family distress. Perceived support from universities was lower than from peers and families. Peer support and phone contacts were the most preferred sources and ways of support. The most useful available university support was updated university guidelines, and the least useful was the emotional hotline service from universities The qualitative findings corroborated the quantitative results.

CONCLUSION

We suggested that a holistic care approach and more proactive student-oriented university support would help students face adversity and enhance mental health.

Examining the Correlation Between Academic Achievement and Basic Psychological Needs: A Study on University Students

Aim: The purpose of this study was to examine the correlation between basic psychological needs and academic achievement in Healthcare Services Vocational High School students. Methods: The researchers conducted the descriptive correlational study with Healthcare Services Vocational High School students in a university. The target population of the study included the Healthcare Services Vocational High School students (n=174) and the sample included 139 students. The researchers collected the data via the Personal Information Form and the Basic Psychological Needs Scale. The researchers calculated the grade-point averages of the students via the end-of-term grade-point averages. Results: Mean age of the students was 19.91±2.20 years. Of the students, 65.5% were female, 51.1% were freshman students and 75.5% received education in the Elderly Care Program. The mean Basic Psychological Needs Scale Autonomy subscale score was 26.06±4.33, the mean Competence subscale score was 19.06±3.59 and the mean Relatedness subscale score was 28.51±4.90. The researchers found statistically significant correlations between the relatedness subscale scores and grade-point averages of the students in a positive direction. Conclusion: Findings of the present study demonstrated that the basic psychological needs of the students were met. As the relatedness scores of the students increased, their grade-point averages increased. Keywords: students, psychologic tests, academic achievement

Older adults' prevention and communication to beat anxiety: the diminishing utility of proactive coping actions

This study aims to investigate older adults' psychological reactions when facing changes in daily life caused by the COVID-19 pandemic and anti-epidemic measures. Specifically, this study investigated the impacts of communication types (i.e., electronic and face-to-face communication) and frequency during the pandemic and the kinds of proactive coping actions taken by older adults on their anxiety. A total of 43,019 respondents were included in this study by merging two longitudinal databases. One is the seventh wave of the Survey of Health, Ageing and Retirement in Europe (SHARE) conducted in 2017, and the other is the COVID-19 Survey of SHARE, which was conducted between June and August 2020. This study found that one third of older adults reported anxiety symptoms during the COVID-19 pandemic and one fifth reported increased anxiety than before the pandemic. Anxiety symptoms seem somewhat prevalent among older adults during the COVID-19 pandemic. During the pandemic, the more kinds of proactive coping actions taken by older adults, the more likely they felt anxious. As the pandemic continues and develops, taking proactive coping actions might no longer alleviate anxiety in older adults, showing a diminishing utility. In addition, face to face communication was found to decrease the likelihood of anxiety symptoms in older adults, whereas the opposite impact of electronic communication was found. For older adults, contacting others by electronic means may increase their anxiety feeling during the COVID-19 pandemic.

Impact of societal resilience on vaccine hesitancy and uptake: Lessons learned from the Israeli experience

BACKGROUND

Vaccine hesitancy threatens COVID-19 pandemic management. Increasing vaccine uptake is important to containment of the virus, and achievement of herd immunity.

OBJECTIVE

To identify factors of resilience, distress, and well-being that impact vaccine hesitancy and uptake.

METHOD

A cross-sectional study was conducted during the pandemic's fourth wave. The data were collected by an internet panel company. A representative sample of Israeli residents (N = 2002) answered an online questionnaire. A stratified sampling method was employed regarding geographic distribution, gender, and age. As vaccine hesitancy poses a threat to the effective management of the pandemic, the outcome measures included vaccine hesitancy and uptake (dependent variables), and resilience, distress, and well-being (independent variables).

RESULTS

24% of respondents reported a high level of vaccine hesitancy; 68% received 3 vaccines; 5% did not receive any vaccine. Six predictors together explained 22% of vaccine hesitancy and 15% of vaccine uptake.Path analysis indicated that: (a) Societal resilience was the best predictor of vaccine hesitancy and uptake: the higher the societal resilience, the lower vaccine hesitancy, and the higher vaccine uptake. (b) The higher sense of danger, the higher vaccine hesitancy, and the lower vaccine uptake. (c) The higher level of religiosity, the lower vaccine uptake. (d) The higher the family income, the lower level of vaccine hesitancy.

CONCLUSIONS

Findings suggest that public attitudes are primarily influenced by the degree of trust in the leadership and other components of societal resilience. Further research should investigate the impact of transparency concerning COVID-19 decision-making on vaccine hesitancy and uptake.

A Multi-Center Study on the Negative Psychological Impact and Associated Factors in Chinese Healthcare Workers 1 Year After the COVID-19 Initial Outbreak

Objectives: The study aimed at analyzing the prevalence of five psychological outcomes (depression, anxiety, stress, post-traumatic stress disorder (PTSD), and suicidal ideation) among Chinese healthcare workers (HCWs), and measured the total possible negative psychological impact 1 year after the COVID-19 initial outbreak. Methods: A cross-sectional nationwide multi-center study was performed between November 2020 and March 2021 in China. A self-report questionnaire was applied, and three psychological scales were used. Binary logistic regression was performed to analyze the risk factors associated with each psychological outcome. Results: The findings demonstrated that the COVID-19 pandemic had a negative psychological impact on HCWs, which was still evident 1 year after the initial outbreak. Nurses showed higher depression and anxiety than other HCWs. Female gender, passive coping, long working hours, having a chronic disease, and experiencing violence, among other factors, were all risk factors for psychological impairment. Conclusion: Developing and promoting programs to improve mental health among HCWs, and identifying those who might need psychological support is still relevant 1 year after the initial outbreak.

A Cross-Sectional Study to Examine the Psychological Impact of the COVID-19 Pandemic on Healthcare Workers in Kuwait

In this study, we aimed to evaluate the psychological impact of the COVID-19 pandemic on healthcare workers to determine the prevalence of symptoms of depression, anxiety, and well-being, and to identify the factors associated with adverse psychological effects. This study was conducted 5 months into the COVID-19 pandemic. We used an online questionnaire to collect data from 378 healthcare workers. To examine the psychological impact, three standardized questionnaires were utilized. This includes the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder Scale (GAD-7), and the WHO Well-Being Scale (WHO-5) to measure depression, anxiety, and quality of life, respectively. More than half of the participants (52.9%) exhibited moderate or high levels of depression, and 40.5% reported moderate or high levels of anxiety. Unmarried HCWs reported more severe levels of depression; moderately severe depression (24.0% vs. 16.1%) and severe depression (12.4% vs. 6.8%). Unmarried HCWs also reported more severity of anxiety as well as lower overall wellbeing. Understanding how personal factors such as marital status can influence the degree of psychological distress can allow us to make better investments in supporting the mental health needs of HCWs in Kuwait. Governments and organizations must establish protective measures, such as continually assessing the mental health status of HCWs throughout the pandemic and providing support services for HCWs in need to minimize adverse consequences and ensure optimal health system operation.

Personal network protects, social media harms: Evidence from two surveys during the COVID-19 pandemic

Background

The classic debate regarding the complex relationships between personal network, social media use, and mental well-being requires renewed examination in the novel context of pandemic-related social isolation.

Data and method

We present two surveys conducted at (i) the earlier months of the pandemic and (ii) the end of large scale social-lockdown measures in the U.S. to explore the social and behavioral antecedents of mental health states relating to social media use. Study 1 tracked the longitudinal changes of personal network, social media use, and anxiety level of a group of individuals (N = 147) over a three-month period during the pandemic. Study 2 replicated and extended the theoretical model to a race-representative U.S. adult sample (N = 258).

Results

Both studies consistently show that (1) more time on social media worsens anxiety. It also mediates the relationship between personal network size and anxiety. That is, a small personal network predicts more social media use, which is in turn related to increased anxiety. (2) Moreover, the effect of social media use on anxiety is mainly explained by news consumption on social media, rather than non-news related usage. (3) This link’s strength is moderated by one’s perception of COVID-19 impact, such that news consumption on social media increases anxiety more when the perceived impact is higher.

Conclusion

These results demonstrate communication technologies’ increasingly critical and multifaceted role in affecting mental health conditions.

Challenges and Implications of the COVID-19 Pandemic on Mental Health: A Systematic Review

The measures put in place to contain the rapid spread of COVID-19 infection, such as quarantine, self-isolation, and lockdown, were supportive but have significantly affected the mental wellbeing of individuals. The primary goal of this study was to review the impact of COVID-19 on mental health. An intensive literature search was conducted using PsycINFO, PsyciatryOnline, PubMed, and the China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and June 2022 were retrieved and appraised. Reviews and retrospective studies were excluded. One hundred and twenty-two (122) relevant articles that fulfilled the inclusion criteria were finally selected. A high prevalence of anxiety, depression, insomnia, and post-traumatic stress disorders was reported. Alcohol and substance abuse, domestic violence, stigmatization, and suicidal tendencies have all been identified as direct consequences of lockdown. The eminent risk factors for mental health disorders identified during COVID-19 include fear of infection, history of mental illness, poor financial status, female gender, and alcohol drinking. The protective factors for mental health include higher income levels, public awareness, psychological counseling, social and government support. Overall, the COVID-19 pandemic has caused a number of mental disorders in addition to economic hardship. This strongly suggests the need to monitor the long-term impact of the COVID-19 pandemic on mental health.

Partial Social Integration as a Predictor of COVID-19 Vaccine Rejection and Distress Indicators

Partial social integration refers to the perceived exclusion of individuals or groups, from full participation in their society. The current study claims that perceived partial social integration (PPSI) constitutes a substantial predictor of the rejection of the COVID-19 vaccine, a significant mediator of the impact of demographic variables (such as age and level of income) on this vaccine rejection, and an important predictor of indices of psychological distress during pandemic times. Previous publications show that although vaccines constitute a very efficient means for countering pandemics, vaccine hesitancy is a prevalent public response to the COVID-19 pandemic. The present study is one of a few studies examining the impact of psychological variables on the actual behavior of vaccine rejection rather than on the cognitive element of vaccine hesitancy. A sample of 600 Israeli Jewish adults responded in February 2022 to an anonymous questionnaire exploring, among other issues, the (PPSI), the individual level of vaccine uptake, and the level of distress of these individuals. Path analyses of the variables predicted by PPSI indicated the following results: (a) PPSI score negatively predicted vaccine uptake level and significantly mediated the effects of age and family income on the level of vaccination. (b) PPSI levels significantly predicted higher levels of anxiety, depression, and a sense of danger and negatively predicted societal resilience. The discussion elaborates the contention that the PPSI is a substantial cause of psychological distress and in compliance with the pandemic vaccination guidelines, despite the potential health risk involved.

Prevalence and risk factors associated with self-reported psychological distress among college students during the omicron outbreak in Shanghai

Background

More and more attention has been paid to the mental health of students in higher education. The Omicron outbreak has brought renewed attention to this vulnerable group.

Objective

To understand the prevalence and influencing factors of anxiety symptoms and depression symptoms of college students in a closed state.

Methods

This large cross-sectional study using data from a survey on the mental health of college students in Shanghai (China), conducted by using a stratified cluster random sampling method between March 15th and April 15th, 2022. To estimate results related to regional location, only data from students with Internet protocol addresses and current addresses in Shanghai were included. The main outcome was self-reported psychological distress (including depressive symptoms, anxiety symptoms, and self-assessment of health), measured using the epidemiologic studies depression scale (CES-D), the Spielberger state-trait anxiety inventory (STAI) and self-rated mental health (SRMH), respectively. Moreover, the Simplified Coping Style Scale (SCSS) was also used to assess how participants coped with negative emotions.

Results

Among 13,000 college students who completed the survey, 12,124 students were included in the final analysis, and the total effective rate was 93.3%. The prevalence of depressive symptoms and anxiety symptoms were 14.1 and 9.8%, respectively. By using Multivariate logistics regression analysis, we found that being male and negative coping were risk factors for depressive symptoms and anxiety symptoms, while positive coping, such as study or learning, were protective factors. Moreover, linear regression analysis showed that learning or study improved the overall mental health index by improving anxiety or depressive symptoms, and played a partial mediating role.

Conclusions

These findings suggest that a significant number of college students, especially boys, will experience emotional problems during the course of closed schools. Therefore, we need to give them proper attention and advise them to adopt positive coping strategies, such as learning or study, to resist bad emotions.

A Cross-Sectional Study of Depression, Anxiety, and Insomnia Symptoms in People in Quarantine During the COVID-19 Epidemic

Objective: To investigate the status and influential factors of depression, anxiety, and insomnia among people in quarantine during COVID-19. Methods: Data was collected from August 2020 to November 2021 through an online survey of 1,360 people in a quarantined hotel. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Insomnia Severity Index (ISI) were used to assess different mental symptoms. Results: 19.9% (n = 270), 17.6% (n = 239) and 7.1% (n = 97) of participants had depression, anxiety and insomnia. Married (OR = 0.641, 95% CI = 0.450-0.915) was a protective factor for depression. Chronic disease (OR = 2.579, 95% CI = 1.416-4.698) was a risk factor for insomnia. No psychiatric medication history was a protective factor for depression (OR = 0.227, 95% CI = 0.068-0.757) and insomnia (OR = 0.240, 95%CI = 0.078-0.736). Female, history of mental illness, low moods at check-in, and partial/cannot understand the quarantine policies were risk factors for anxiety, depression, and insomnia. Conclusion: People in quarantine had problems with depression, anxiety, and insomnia. Female, low moods at check-in, and partial/cannot understand the quarantine policies had significant impacts. It is necessary to help quarantined people understand quarantine policies, reduce negative emotions and improve sleep quality.

Depressive symptoms among adults in 2018-2019 and during the 2020 COVID-19 pandemic in Italy

BACKGROUND

Restrictions due to Coronavirus disease 2019 (COVID-19) has produced a large number of effects on mental health, which are expected to endure over time. In this study, we assessed depressive symptom levels before the COVID-19 pandemic, from January 2018 to December 2019, and during the pandemic in Italy in 2020.

METHODS

We used the Patient Health Questionnaire-2 (PHQ-2), which is a screening instrument devised to detect probable depression and which has been annually administered in the framework of the Italian Behavioural Risk Factor Surveillance System since 2008. Depressive symptoms were assessed in a sample of 41,362 18-64-year-old adults surveyed in 2018-2019 and in a sample of 14,612 adults surveyed in 2020.

RESULTS

The prevalence of depressive symptoms increased from 6.1% (95% CI 5.8%-6.4%) in 2018-2019 to 7.1% (95% CI 5.6%-8.6%) in March-April 2020. It then declined in May-June to 4.4% (95% CI 3.2%-5.5%) but in July-August it once again increased to 8.2% (95% CI 6.0%-10.4%) and, finally, gradually returned above the pre-lockdown level by November-December 2020 (5.9%; 95% CI 4.7%-7.1%). Compared to before the health crisis, during the pandemic, women and individuals with financial difficulties were found to have a significantly higher risk of depressive symptoms while younger, individuals with a higher education and those living in South Italy became increasingly vulnerable.

CONCLUSIONS

While the average response to the pandemic was one of resilience over time, women and younger individuals were found to be particularly prone to the risk of depressive symptoms, as a result of the pandemic. In future investigations, the risk of individuals living in the South of Italy should also be taken into consideration.

The impact of virtual learning on students' educational behavior and pervasiveness of depression among university students due to the COVID-19 pandemic

Background

One of the worst pandemics of recent memory, COVID-19, severely impacted the public. In particular, students were physically and mentally affected by the lockdown and the shift from physical person-to-person classrooms to virtual learning (online classes). This increased the prevalence of psychological stress, anxiety, and depression among university students. In this study, we investigated the depression levels in Saudi Arabian university students who were learning virtually because of the COVID-19 pandemic and examined its impact on their educational proficiency.

Methods

The study focused on two points: first, examining the depression levels among undergraduate students in Saudi Arabia, by adapting the Zung (Self-Rating Depression Scale) questionnaire. Second, whether there is an association between the levels of depression and various distress factors associated with virtual (online) learning resulting from the COVID-19 pandemic and its impact on students’ educational behaviors. The questionnaire was prepared using a monkey survey and shared online, via email, and on WhatsApp groups, with participants in two universities, a public and private university in the largest city of Saudi Arabia. A total of 157 complete responses were received. Data were analyzed using SPSS-24, the chi-square test, descriptive statistics, and multilinear regression.

Results

The results indicated that three-fourths of the university students suffered from different depressive symptoms, half of which had moderate to extreme levels of depression. Our study confirmed that a boring virtual (online) learning method, stress, fear of examinations, and decreased productivity were significantly associated with increased depression. In addition, 75% and 79% of the students suffered from stress and fear of examinations, respectively. About half of the students were associated with increased depression. The outcome also indicated that female students experienced extreme depression, stress, and fear of examinations more than males.

Conclusion

These findings can inform government agencies and representatives of the importance of making swift, effective decisions to address students’ depression levels. It is essential to provide training for students to change their educational experience mindset, which might help decrease "depression and stress-related growth." There is also a need to search for a better virtual teaching delivery method to lessen students' stress and fear of examinations.

The potential of psychological connectedness: Mitigating the impacts of COVID-19 through sense of community and community resilience

The purpose of this study was to identify patterns of relationships connecting sense of community (SOC) and community resilience with psychological wellbeing, via the mediation of coronavirus disease 2019 (COVID-19) impacts on life domains. Survey data were collected from an international sample of adults (n = 824) during the COVID-19 outbreak (June-September 2020). Using a structural equation model, we tested a mediation model to identify the associations between SOC and community resilience with the perceived impacts of the emergency situation and with psychological wellbeing. Results revealed that SOC mitigated the impacts of COVID-19 on multiple life domains, and it was also positively associated with wellbeing. Community resilience was correlated with SOC and wellbeing but showed no significant relationship with COVID-19 impacts. The findings support that SOC has a protective function and can contribute to mitigating the impacts of difficult life situations. SOC can also be leveraged as an intervention aimed at protecting the wellbeing of people and communities, particularly in times of crisiss.

Association between psychological distress and coping strategies among students engaged in online learning

Distant or online learning on digital platforms has become the norm in education worldwide, putting students under immense mental strain. The present study examined the association between psychological distress and coping strategies among students engaged in online learning. This study used a cross-sectional design. A structured questionnaire was sent to each of the 210 university students at two prestigious public and private universities in Bangladesh through email. Data was collected from March 26 to April 27, 2021. Severe psychological distress was found in 55.2 percent of the population. Younger age groups, public university students, students with no self-income, moderate aid from the university in providing resources from home, and students with existing mental health illnesses were significantly associated with psychological distress (p-value<0.05). Among all 14 items of Brief COPE, active coping, using emotional support, and self-blame significantly influenced the psychological distress instrument Kessler-10 (p-value<0.01). Given the perspective of this study, coping strategies alleviate stress and facilitate positive psychological outcomes. Students’ mental health is a prioritized issue that needs more attention. Because of its higher prevalence and adverse consequences, institution authorities should support each student by providing study materials, student loans, and scholarships. Routine screening will allow identifying students going through a difficult time who can get help from experts through counseling.

The Association Between Perceived Risk of COVID-19, Psychological Distress, and Internet Addiction in College Students: An Application of Stress Process Model

The closed-off management of the university during coronavirus disease 2019 (COVID-19) may be associated with an elevated odds of psychological and behavioral issues among college students. We aimed to use the stress-process model to explore the potential mechanisms for this phenomenon. A total of 924 college students were recruited via posters, peer referrals, and class attendance. Among them, 82 (9%) were probable depression, 190 (20.8%) were probable anxiety, and 69 (7.5%) were internet addiction. Parallel mediation was used to test this theoretical model. For personal resources, the perceived risk of COVID-19 was positively associated with psychological distress via negative coping style (β = 0.051) and internet addiction via negative coping style or self-esteem (β = 0.023 for negative coping style, β = 0.015 for self-esteem). For social resources, the perceived risk of COVID-19 was positively associated with psychological distress and internet addiction via roommate relationships (β = 0.19 for psychological distress, β = 0.046 for internet addiction). Negative coping styles and roommate relationships are possible psychological mechanisms linking the perceived risk of COVID-19, psychological distress, and internet addiction.

Seroprevalence of COVID-19 and Psychological Distress among Front Liners at the Universiti Malaysia Sabah Campus during the Third Wave of COVID-19

In 2020, the COVID-19 pandemic struck the globe and disrupted various aspects of psychological wellbeing, more so in frontline workers. Research on assessing the seroprevalence of COVID-19 has been scarce; in addition, there are limited studies assessing the association between the seroprevalence of COVID-19 and psychological distress. Therefore, this study aimed to determine the seroprevalence of COVID-19 and the prevalence of psychological distress and to determine whether sociodemographic variables, occupational information variables, coping styles, and psychological processes might contribute to the development of psychological distress. A cross-sectional study involving 168 Universiti Malaysia Sabah (UMS) front liners was carried out to assess these issues. The Depression, Anxiety and Stress Scale (DASS-21) was employed to assess psychological distress, together with the COVID-19 Rapid Test Kit Antibody (RTK Ab) and a series of questionnaires, including a sociodemographic and occupational information questionnaire, the Balanced Index of Psychological Mindedness (BIPM) questionnaire, the Mindfulness Attention and Awareness Scale (MAAS), the Acceptance and Action Questionnaire (AAQ-II), and the Brief COPE questionnaire. The results demonstrated a seroprevalence of COVID-19 at 8.3% (95% CI = 5.0–14.0). Non-healthcare workers (HCWs) had a higher COVID-19 prevalence. Meanwhile, the prevalence of depression, anxiety, and stress among front liners was low (3.0%, 3.6%, and 1.2%, respectively). Younger people (aged 30 years old or less) and HCWs had a higher prevalence of psychological distress; being a HCW was significantly associated with a higher level of anxiety. Dysfunctional coping and psychological inflexibility were consistently found to be predictors for higher levels of the three psychological distress variables. This study suggested some alternatives that could be explored by mental health providers to address mental health issues among front liners at universities.

COVID-19 Pandemic and Teachers' Classroom Safety Perception, Anxiety and Coping Strategies during Instructional Delivery

Several professionals, including teachers, have been engrossed in fear of the worst happening due to COVID-19 and the rapidly evolving nature of the virus affecting the perception of safety in any working environment. This study examined teachers' perception of classroom safety, anxiety, and coping strategies during instructional delivery in senior high schools in Ghana. Adopting the cross-sectional survey design with a quantitative approach, a convenient sample of 174 senior high school teachers in the Cape Coast Metropolis completed a questionnaire. Data were analyzed using descriptive analysis, analysis of variance, and multiple linear regression. The findings showed that teachers perceived their classroom environment as unsafe during instructional delivery amidst COVID-19 and reported modest to extreme levels of anxiety. Further, teachers with a high level of COVID-19 anxiety were found to utilize active coping strategies to manage stressful situations. The reported unsafe working environment in schools during pandemic times highlights the critical role of supportive working environments for teachers' mental and psychological wellness. School counseling psychologists, school welfare officers, and school health coordinators should collaborate to implement interventions (e.g., social emotional learning; resilience strategies) that promote the wellbeing of teachers and a safe working environment.

Self-Reported Mental Health and Lifestyle Behaviour During the COVID-19 Pandemic in the Czech Population: Evidence From Two Cross-Sectional Surveys

Objectives: Evidence of the impact of COVID-19 pandemic on mental and physical health behaviours is limited. This study presents results of two cross-sectional surveys on mental health changes and its consequences on healthy and unhealthy lifestyle behaviours.

Methods: An online survey was distributed during Spring 2020 (N = 9,168) and Autumn 2020 (N = 1,042) in the Czech Republic. Differences in mental health observed in both surveys were evaluated using Mann-Whitney test and logistic regressions were used to examine demographic and socio-economic determinants of COVID-19-related mental health issues and resulting healthy and unhealthy lifestyle behaviours.

Results: In multivariable models, the youngest individuals, females, people with increased work demands and participants with a reduced personal income due to the COVID-19 pandemic were all negatively associated with self-reported mental health issues (p < 0.05). A worsened quality of sleep, dietary habits, physical activity and unhealthy behaviours were highly associated with affected mental health in the models adjusted for potential covariates (p < 0.05).

Conclusion: Taken together, these findings suggest that health promotion strategies directed to individuals who are at risk should be encouraged to adopt and/or maintain positive health-related behaviours.

Stigma, Uncertainty, and Coping at the Time of COVID-19 Pandemic Amid Health Care Professionals: How Far Have We Gone?

Stigma and uncertainty are noticed in global pandemics. Their impacts on health care providers tend to persist notably during and after the outbreaks. Our objective was to assess stigma, uncertainty, and coping among health care providers through an online survey using the Discrimination and Stigma Scale Version 12 (DISC-12) modified version to assess stigma related to treating COVID-19, the Intolerance of Uncertainty Scale, and the Brief Resilient Coping Scale (BRCS). Of the respondents (n = 65), 63.1% treated patients with COVID-19, and 21.5% worked in isolation hospitals. Physicians who treated patients with COVID-19 had significantly higher scores in all DISC subscales: unfair treatment (8.73 ± 6.39, p = 0.001), stopping self from doing things (2.05 ± 1.41, p = 0.019), overcoming stigma (1.17 ± 0.80, p = 0.035), and positive treatment (1.90 ± 1.65, p = 0.005). Unfair treatment was negatively correlated with BRCS (r = -0.279, p = 0.024). On the other hand, physicians who did not treat patients with COVID-19 had significantly higher BRCS scores. We concluded that frontline physicians experienced greater stigma associated with lower resilient coping strategies.

Trauma-Related Distress During the COVID-19 Pandemic In 59 Countries

The COVID-19 pandemic has upended life like few other events in modern history, with differential impacts on varying population groups. This study examined trauma-related distress among 6,882 adults ages 18 to 94 years old in 59 countries during April to May 2020. More than two-thirds of participants reported clinically significant trauma-related distress. Increased distress was associated with unemployment; identifying as transgender, nonbinary, or a cisgender woman; being from a higher income country; current symptoms and positive diagnosis of COVID-19; death of a loved one; restrictive government-imposed isolation; financial difficulties; and food insecurity. Other factors associated with distress included working with potentially infected individuals, care needs at home, a difficult transition to working from home, conflict in the home, separation from loved ones, and event restrictions. Latin American and Caribbean participants reported more trauma-related distress than participants from Europe and Central Asia. Findings inform treatment efforts and highlight the need to address trauma-related distress to avoid long-term mental health consequences.

Exploring Factors and Associate Responses for Anxiety in the Coronavirus Disease 2019 Pandemic: A Web-Based Survey in Japan

Background and Objectives

Anxiety plays an important role in psychology. An exploration of anxiety and its associated reactions may provide insight into measures for addressing mental health problems caused by the coronavirus disease 2019 (COVID-19) pandemic. Data from this study provide potential correlational responses to anxiety.

Methods

A cross-sectional study using data collected via an online self-reported questionnaire was conducted in Japan during the COVID-19 pandemic. Using the State-Trait Anxiety Inventory (STAI-6), we assessed anxiety levels and explored the relationship between anxiety STAI-6 score, sources of COVID-19 information, the influences of COVID-19, social anxiety symptoms, discrimination, and evaluation of the government.

Results

A total of 4,127 participants were included in the analysis. The level of anxiety was not equally distributed across the general population with respect to age, gender, educational level, occupation, income, presence of underlying disease, and location (p < 0.05). The number of sources of information on COVID-19 had a positive correlation with the STAI-6 score (Spearman’s rho = 0.176, p < 0.001). The influence of the pandemic was correlated with moderate–severe anxiety. A high level of anxiety added to social anxiety (Spearman’s rho = 0.04, p < 0.05) and discriminatory behavior (Spearman’s rho = 0.11, p < 0.01). Being female (Estimate = 0.926) and from a non-emergency area (Estimate = −0.308) was related to higher STAI scores, and higher education (Estimate = −0.305), and income (Estimate = −0.168) decreased the STAI score. The respondents who had a lower evaluative score of the preventive activities undertaken by the national and local governments had higher STAI-6 scores.

Conclusion

Our findings provide statistical evidence for the associated reaction of anxiety and that anxiety reactions may vary in predictable ways. Further studies should focus on the strategic interventions that may decrease the associated responses to anxiety, to address mental health issues due to the pandemic.

Analysis of the Predictive Role of Self-Compassion on Emotional Distress during COVID-19 Lockdown

Research has shown that the COVID-19 pandemic has caused a mental health burden worldwide. Most studies have focused on the factors associated with a higher risk of mental health problems, and only a few studies have looked at the potential protective factors. The general objective of this study was to determine whether self-compassion has a protective effect against the risk of mental health problems and especially on perceived infectability. If so, we intended to determine which of the three specific facets of self-compassion (i.e., mindfulness vs. over-identification; self-kindness vs. self-judgment; common humanity vs. isolation;) has the greatest weight in predicting emotional distress. We conducted a cross-sectional study through an online survey completed by 855 participants in Spain. Results confirmed that the three facets of self-compassion reduce the negative correlation between perceived infectability and emotional distress, diminishing its role in predicting emotional distress. These results are discussed in relation to the protective role of self-compassion and the need to further explore the variables associated with a lower risk of mental problems derived from the SARS-CoV-2 pandemic.

The Oneiric Activity during and after the COVID-19 Total Lockdown in Italy: A Longitudinal Study

A growing body of evidence highlights that the COVID-19 pandemic affected oneiric activity. However, only a few studies have assessed the longitudinal changes in dream phenomenology during different phases of the pandemic, often focused on a limited number of dream variables. The aim of the present study was to provide an exhaustive assessment of dream features during total lockdown (TL) and a post-lockdown (PL) period characterized by eased restrictive measures in Italy. We performed a longitudinal study using a web-based survey to collect demographic, COVID-19 related, clinical, sleep, and dream data at TL and PL. Our final sample included 108 participants. The high frequency of poor sleep quality, anxiety, and depressive symptoms observed during TL remained stable at PL, while sleep latency (t = −4.09; p < 0.001) and PTSD-related disruptive nocturnal behaviors (t = −5.68; p < 0.001) exhibited a reduction at PL. A PL decrease in time spent with digital media was observed (t = −2.77; p = 0.007). We found a strong PL reduction in dream frequency (t = −5.49; p < 0.001), emotional load (t = −2.71; p = 0.008), vividness (t = −4.90; p < 0.001), bizarreness (t = −4.05; p < 0.001), length (t = −4.67; p < 0.001), and lucid dream frequency (t = −2.40; p = 0.018). Fear was the most frequently reported emotion in dreams at TL (26.9%) and PL (22.2%). Only the frequency of specific lockdown-related dream contents exhibited a reduction at PL. These findings highlight that the end of the home confinement had a strong impact on the oneiric activity, in the direction of reduced dream frequency, intensity, and lockdown-related contents. The co-occurrence of such changes with a decline in nocturnal PTSD-related symptoms, sleep latency, and time with digital media suggests an influence of post-traumatic stress levels, lifestyle modifications, and sleep pattern on dream changes during different phases of the pandemic. The stable prevalence of fear in dreams and the large frequency of poor sleep quality, depressive symptoms, and anxiety are probably related to the persistence of many negative consequences of the pandemic. Overall, these results are consistent with the continuity hypothesis of dreams.

An Investigation into the Relation of Coping Skills with Mental Health and Quality of Life in Family Members of Nurses During the COVID-19 Pandemic

OBJECTIVES

During the coronavirus disease (COVID-19) pandemic, health care workers, including nurses and their family members, experienced various psychological problems. Coping skills may help them deal with the current challenge and maintain their mental health and improve their quality of life. Therefore, this study investigated the relation of coping skills with mental health and quality of life of the nurses' family members during the COVID-19 pandemic.

METHODS

This cross-sectional study was conducted on the family members of the nurses working at Hajar Hospital of Shahrekord dedicated to admission and hospitalization of COVID-19 infected patients using a census sampling method in 2020. Participation in this study was voluntary and finally 220 persons were included in this study. To prevent the spread of COVID-19 through respiratory droplets or contact, a weblog was created using blogging software that contained questionnaires for collecting data on demographic information, mental health (PHQ-9), coping skills (coping responses inventory [CRI], Billings & Moos), and quality of life (SF-36). The collected data were analyzed using descriptive and inferential statistical tests in SPSS software version 22 (IBM Corp, Armonk, NY).

RESULTS

Of the 220 participants in this study, 101 participants were male and 119 were female. The mean age of the subjects was 35.78 years, and 56.4% of them had an academic education level. The Pearson correlation analysis showed a significant relationship between coping skills and mental health, quality-of-life items, total quality-of-life score, and demographic variables of participants (except education) (P < 0.05). This was a direct relationship in such a way that as the score of coping skills increases, so does the score of mental health and quality of life. Based on the results of regression analysis, the predictive power of mental health, coping skills, and education level was obtained to be 0.634. The coping skill variable was the strongest predictor (ß = 0.467), and after that, the mental health variable (ß = 0.421) had the highest predictive power.

CONCLUSION

The obtained results showed that coping skill is the association between psychological health and quality of life such that the coping skill has a significant direct effect on psychological health and quality of life. The results also showed that, at the time of crisis, further attention should be paid to coping skills to develop and improve the quality of life and psychological health.

Effects of COVID-19-related stress and fear on depression in schizophrenia patients and the general population

This study compared the coronavirus disease 2019 (COVID-19)-related stress, fear of infection, loneliness, and depression between patients with schizophrenia and the general population. A face-to-face survey was administered to 1340 patients with a schizophrenia spectrum disorder and online survey of the general population (n = 2000) was conducted. The information gathered included the level of COVID-19-related stress, fear of infection, the Patient Health Questionnaire-9 score, and the three-item UCLA Loneliness Scale score. Structural equation modeling revealed a significant effect of fear of COVID-19 infection on depression among the general population and on loneliness among patients with schizophrenia. Loneliness experienced during COVID-19 exacerbated depression in both groups. In the COVID-19-related stress-loneliness-depression pathway, the partial mediating effect of loneliness was significant in both groups. Conversely, in the COVID-19-related fear-loneliness-depression pathway, the full mediating effect of loneliness was only significant in patients with schizophrenia. In conclusion, the loneliness associated with COVID-19-related stress and fear of infection was an important factor influencing depression, and the impact was greater in patients with schizophrenia compared with the general population. Thus, different mental health intervention plans are needed for patients with schizophrenia during the COVID-19 pandemic. During the long-lasting COVID-19 pandemic, social support and provision of mental health services to prevent loneliness and consequent depression are required in patients with schizophrenia.

Coping Strategies for Stress Used by People Working in Managerial Positions in Schools and Educational Establishments during the COVID-19 Pandemic

Although the ability to deal with stress is one of the key competences of people working in managerial positions in schools and educational establishments, principals in this area are very poorly diagnosed. The aim of this study was to consider the coping strategies used by headmasters and deputy headmasters of schools and educational establishments during the COVID-19 pandemic. For this purpose, Mini-COPE was used. The respondents (N = 159) obtained a higher mean for “active coping”, “planning”, “positive reframing”, “acceptance”, “use of instrumental support”, “venting”, and “problem-focused strategies” than the normative value. Compared to deputy headmasters, headmasters obtained higher mean results for “planning” and “religion”, and lower results for “behavioral disengagement”. Respondents with longer job seniority in a managerial position, obtained a higher mean for “use of instrumental support” and lower for “religion”. Compared to respondents employed in private schools, people in the public education sector are more likely to use “behavioral disengagement” and less their “sense of humor”. The respondents working in primary schools scored higher on average for “use of instrumental support” and “problem-focused strategies”. It would be advisable to compare the results with the teachers and the persons holding managerial positions in institutions and organizations not related to education.

Psychological Wellbeing and Associated Factors Among Ethnic Minorities During the COVID-19 Pandemic

This study assessed the psychological wellbeing and its associated factors amongst ethnic minorities during the coronavirus disease 2019 (COVID-19) pandemic. A total of 310 Hong Kong South Asians aged 41.3 (SD 13.7) years completed an anonymous online survey between July 2020 and February 2021. The results showed an overall moderate level of stress and high levels of depression, anxiety and post-traumatic stress disorder (PTSD) symptoms amongst South Asian minorities. Multivariable regression analyses suggested that being single/divorced, following Hinduism or other non-Muslim religions, having lower perceived knowledge of COVID-19 and having worried about losing job were significant predictors of higher levels of depression, anxiety and/or stress; additionally, being male, having a low monthly household income, having worried about losing job and healthcare collapse were significant predictors of a higher level of PTSD symptoms. The findings suggest an urgent need to alleviate the psychological impacts of the COVID-19 pandemic on ethnic minorities, specifically for those most vulnerable to these impacts.

Understanding Compliant Behavior During a Pandemic: Contribution From the Perspective of Schema-Based Psychotherapy

Objective

The current study examined whether compliance with anti-pandemic measures during the COVID-19 pandemic relates to (a) importance of the fulfillment of core psychological needs, namely, relationship, self-esteem, efficacy, and pleasure; (b) coping behavior styles, namely, surrender, self-soothing, divert attention, and confrontation; and (c) worries or concerns beyond COVID-19 which may impair wellbeing.

Methods

This study used a cross-sectional design and online survey data from responses to a structured questionnaire developed within the theoretical framework of schema-based psychotherapy on psychological needs and coping behavior styles from 740 participants in Central Europe and West Africa.

Results

Analysis indicated that people with the psychological needs of “pleasure” and “efficacy” and the coping style of “surrender” were more likely to comply with anti-pandemic measures. We also found that people with the coping style of “confrontation” were less likely to comply. There were no statistically significant relationships between compliance and “relationship,” “self-esteem,” “self-soothing,” “divert attention,” and “existential concerns.”

Discussion

Our findings indicate that how likely a given individual is to comply with prescribed pandemic countermeasures varies based on their specific psychological needs and behavior styles. Therefore, to control contagion during a pandemic, authorities must recognize the relevance of human need fulfillment and their behavior styles and accordingly highlight and encourage admissible and feasible actions. The findings demonstrate that some individual differences in core psychological needs and coping behavior patterns predict compliance behavior.

Benefit finding: understanding the impact and public health factors among COVID-19 patients in China

BACKGROUND

This study aimed to determine the level of benefit finding among COVID-19 patients in a hospital in mainland China, and to identify its associated impact and public health factors.

METHODS

Using a cross-sectional design, a total of 288 COVID-19 patients were recruited in Huoshenshan Hospital in Wuhan, China to complete a survey on benefit finding. The level of benefit finding evaluated by the Benefit Finding Scale (BFS), mental resilience evaluated by the Connor-Davidson Resilience Scale (CD-RISC), social support evaluated by the Multidimensional Scale of Perceived Social Support (MSPSS), medical coping modes evaluated by the Medical Coping Modes Questionnaire (MCMQ), and general information was collected by self-designed questionnaires. T-test and chi-square test were used for single-factor analyses. For multiple factor analyses, multivariate regression analyses were performed.

RESULT

The mean BFS score of 288 participants was 61.26±10.25. Multivariate regression analysis showed that the factors associated with the level of benefit finding among COVID-19 patients in China included education level, having experienced major event, social support, optimism, confrontive coping and resigned coping mode.

CONCLUSIONS

In general, the patients with COVID-19 in this study had a middle level of benefit finding. Health professionals should take measures to identify the influencing factors on the quality of the life and take targeted intervention measures.

Prevalence of COVID-19 Pandemic, Self-Esteem and Its Effect on Depression Among University Students in Saudi Arabia

Background and Aims

University students are commonly identified as susceptible, suffering from higher anxiety, stress, and depression than the overall population. During the Corona Virus Disease pandemic (COVID), education was shifted to the virtual learning environment. Students' ambiguity regarding academic accomplishment, imminent careers, changes in social life, and other concerns all these factors played a role in amplifying their stress levels, anxiety, and depression worldwide. This study investigates university students' self-esteem and depressions after they have been online learning for over 1 year due to the COVID-19 pandemic in Saudi Arabia.

Methods

For this research, an adapted questionnaire of Rosenberg (Self-Esteem Scale) and Zung (Self-Rating Depression Scale) was used to get the responses of the participants of public and private universities in Saudi Arabia during March-April 2021. We received a total of 151 valid responses from respondents. For data analysis, we used descriptive statistics, ANOVA, multiple regression and binary logistic regression.

Findings

The results showed that 75% of the students experienced different levels of depressions, with half (37.5%) having moderate to extreme levels of depression. A total of 41% of students experienced low self-esteem (38% females and 45% males). The regression results indicated depressive symptoms for low self-esteem. Furthermore, results of logistic regression showed that high self-esteem reduces the chances of getting depressive symptoms by 17%. The depressive symptoms were higher in female students than their male counterparts; furthermore, males experienced depressive symptoms less than females by 38%.

Conclusions

Based on the current research results, it is concluded that the presence of the COVID-19 pandemic has dramatically increased the depressive symptoms in students, especially in female students. The findings suggested instant consideration and support for students. It is also suggested to the quest for potential managing policies that have been known and effective during the pandemic. Moreover, training should be provided for students to shift their educational experience mindset to an adaptive mindset, which can help them adapt to the new ways of learning and education.

The Ability to Rest at Home During COVID-19 Symptom Manifestation and Depressive Symptoms: Evidence From Korea

OBJECTIVE

This study investigated the association between ability to rest at home in times of coronavirus disease 2019 (COVID-19) symptom manifestation and depressive symptoms.

METHODS

The 2020 Korea Community Health Survey data were used. The presence of depressive symptoms was determined using the Patient Health Questionnaire-9. The relationship between depressive symptoms and ability to rest at home was examined using logistic regression analysis. Additional analysis was performed on the reasons for the inability to stay at home.

RESULTS

Depressive symptoms were more common in participants who could not rest at home if symptoms manifested (4.1%) than those who could rest at home (2.7%). Participants who could not rest at home (OR 1.53, 95% CI 1.34-1.74) were more likely to have depressive symptoms, particularly when they had to report to work (OR 1.50, 95% CI 1.30-1.74) or purchase daily necessities (OR 2.40, 95% CI 1.15-5.03).

CONCLUSION

Inability to rest at home in the case of COVID-19 symptom manifestation was associated with depressive symptoms. The findings suggest the need to address the identified vulnerable groups to mitigate the mental health consequences of the pandemic.

The COVID-19 pandemic in Italy: Depressive symptoms immediately before and after the first lockdown

BACKGROUND

Italy was one of the first countries to be heavily hit by the spread of the new Coronavirus. Longitudinal studies are needed to investigate the real effect of COVID-19 on adult mental health. The Italian Twin Registry carried out a study to investigate, over time, the course of depressive symptoms in the general population.

METHODS

The study relies on data collected just before the beginning (February 2020) and the end (June 2020) of the first lockdown. Symptoms of depression were assessed using the Patient Health Questionnaire, and total scores or categorized depression scores were considered in the analyzes.

RESULTS

A total of 1690 adult twins were recruited. The study showed a mean depression score of 1.11 immediately before lockdown and 1.20 immediately after, with an overall prevalence of depressive symptoms increasing from 33.6 to 38.9%. Depressive symptoms immediately after the restriction period were associated with Covid-19 symptoms affecting households, financial problems due to the pandemic and poor social support. Independently of the baseline risk of depressive symptoms, we observed an increased risk among younger and less educated people. Compared to the pre-lockdown period, women and middle-aged people also were found to be at greater risk of developing depressive symptoms.

LIMITATIONS

Possible participation bias and residual selection bias.

CONCLUSIONS

The study shows that the COVID-19 pandemic was associated with an increased depressive symptomatology and that, in such health emergency times, the most vulnerable persons are young adults, women, and those living in a socially, culturally, or economically disadvantaged environment.