Excessive Worrying as a Central Feature of Anxiety during the First COVID-19 Lockdown-Phase in Belgium: Insights from a Network Approach

Since the WHO declared the COVID-19 pandemic on March 11, 2020, the novel coronavirus, SARS-CoV-2, has profoundly impacted public health and the economy worldwide. But there are not the only ones to be hit. The COVID-19 pandemic has also substantially altered mental health, with anxiety symptoms being one of the most frequently reported problems. Especially, the number of people reporting anxiety symptoms increased significantly during the first lockdown-phase compared to similar data collected before the pandemic. Yet, most of these studies relied on a unitary approach to anxiety, wherein its different constitutive features (i.e., symptoms) were tallied into one sum-score, thus ignoring any possibility of interactions between them. Therefore, in this study, we seek to map the associations between the core features of anxiety during the first weeks of the first Belgian COVID-19 lockdown-phase (n = 2,829). To do so, we implemented, in a preregistered fashion, two distinct computational network approaches: a Gaussian graphical model and a Bayesian network modelling approach to estimate a directed acyclic graph. Despite their varying assumptions, constraints, and computational methods to determine nodes (i.e., the variables) and edges (i.e., the relations between them), both approaches pointed to excessive worrying as a node playing an especially influential role in the network system of the anxiety features. Altogether, our findings offer novel data-driven clues for the ongoing field’s larger quest to examine, and eventually alleviate, the mental health consequences of the COVID-19 pandemic.     

With crisis comes opportunity: Building ethical competencies in light of COVID-19

ABSTRACT

The emergence of the coronavirus disease 2019 (COVID-19) pandemic has wide-ranging implications for the field of professional psychology. As clinical practice has rapidly adapted to ensure continuity of care, doctoral students have encountered unique opportunities for ethics-related competency development across practicum training settings. This article discusses the relevant American Psychological Association (APA) Ethics Code standards and additional ethical considerations facing trainees as they navigate their foundational clinical experiences and develop as professional psychologists in light of a pandemic.     

Family Science in the Context of the COVID-19 Pandemic: Solutions and New Directions

The coronavirus disease 2019 (COVID-19) pandemic has precipitated substantial global disruption and will continue to pose major challenges. In recognition of the challenges currently faced by family scientists, we share our perspectives about conducting family research in the context of the COVID-19 pandemic. There are two primary issues we address in this article. First, we present a range of potential solutions to challenges in research, resulting from the pandemic, and discuss strategies for preserving ongoing research efforts. We discuss approaches to scaling back existing protocols, share ideas for adapting laboratory-based measures for online administration (e.g., using video chat platforms), and suggest strategies for addressing missing data and reduced sample size due to lower participation rates and funding restrictions. We also discuss the importance of measuring COVID-19 relevant factors to use as controls or explore as moderators of primary hypotheses. Second, we discuss how the COVID-19 pandemic represents a scientifically important context for understanding how families adjust and adapt to change and adversity. Increased stress precipitated by the pandemic, varying from acute stress associated with job loss to more chronic and enduring stress, will undoubtedly take a toll. We discuss ways that family scientists can contribute to pandemic-related research to promote optimal family functioning and protect the health of family members.     

“Love is calling”: Academic friendship and international research collaboration amid a global pandemic

In this intervention we desire to document and celebrate our own international research collaboration as an intimate long-distance relationship that sustains us amid a global pandemic of the coronavirus that causes COVID-19. We share “love letter” poems that we wrote to each other, in response to a poem by Yayoi Kusama titled “Residing in a Castle of Shed Tears,” incorporated into her mirror room installation “Love is Calling.” In our discussion we reflect upon the emotional connections that sustain academic researchers, particularly those relationships that extend beyond national boundaries and conventional heteronormative expectations.     

Health-Related Quality of Life during COVID-19 Pandemic: Assessing Impacts of Job Loss and Financial Support Programs in Japan

This cross-sectional study examined the association between job loss during the coronavirus disease 2019 (COVID-19) pandemic and health-related quality of life (HRQOL) in the Japanese working population and whether universal financial support program has a protective influence on the HRQOL. Two self-reported internet surveys were used to determine job loss during the pandemic: one was conducted between February and March 2020, just before the COVID-19 emergency declaration by the Japanese government (April 2020), and the other was conducted between August and September 2020. For the dependent variable, we used the EQ-5D-5L utility score (QOL utility score), which was assessed between August and September 2020. The independent variables were job loss after the state of emergency was declared and two types of government financial support (either universal support or support targeting child-raising households). The Tobit regression model was applied, adjusting for covariates. Job loss during the pandemic was negatively associated with the QOL utility score in the fully adjusted model; the coefficient (95% confidence interval [CI]) for job loss during the pandemic was −0.07 (−0.11 to −0.03). For the government financial support variables, the universal financial support program was associated with a better QOL utility score of the coefficient (95% CI), 0.05 (0.03 to 0.08). Job loss during the COVID-19 pandemic is negatively associated with HRQOL, while universal financial support is positively associated with HRQOL. Our study results imply that universal financial support during the COVID-19 era has a protective influence on an individual’s HRQOL.

     

Expanding Possibilities: Flexibility and Solidarity with Under-resourced Immigrant Families During the COVID-19 Pandemic

The novel coronavirus has added new anxieties and forms of grieving to the myriad practical and emotional burdens already present in the lives of underserved and uninsured immigrant families and communities. In this article, we relate our experiences since the COVID-19 crisis to the lessons we have learned over time as mental health professionals working with families in no-cost, student-managed community comprehensive health clinics in academic-community partnerships. We compare and contrast the learnings of flexibility of time, space, procedures, or attendance we acquired in this clinical community setting during regular times, with the new challenges families and therapists face, and the adaptations needed to continue to work with our clients in culturally responsive and empowering ways during the COVID-19 pandemic. We describe families, students, professionals, promotoras (community links), and IT support staff joining together in solidarity as the creative problem solvers of new possibilities when families do not have access to Wi-Fi, smartphones, or computers, or suffer overcrowding and lack of privacy. We describe many anxieties related to economic insecurity or fear of facing death alone, but also how to visualize expanding possibilities in styles of parenting or types of emotional support among family members as elements of hope that may endure beyond these unprecedented tragic times of loss and uncertainty.     

Development of a Brief Group CBT Intervention to Reduce COVID-19 Related Distress Among School-Age Youth

School-aged youth have been significantly impacted by the COVID-19 pandemic. The effects of the pandemic will likely have long-standing effects on the well-being of youth, and access to mental health care is even more critical during this time. For the past 5 years, TRAILS (Transforming Research into Action to Improve the Lives of Students) has been working throughout the state to increase utilization of evidence-based mental health practices among K-12 school mental health professionals (SMHPs). By leveraging SMHPs who are widely accessible to students, TRAILS seeks to improve youth access to effective mental health care and reduce current mental health inequities. In March 2020, TRAILS responded to the COVID-19 pandemic by developing a group manual designed to be delivered virtually by SMHPs to help students develop effective coping skills to mitigate the impact of COVID-19. TRAILS focuses on promoting use of CBT and mindfulness, as these skills are ideally suited for school-based delivery, and thus the new manual, Coping with COVID-19 (CC-19), was grounded in these modalities. This article will describe the design, development, and deployment of the CC-19 program to address the mental health needs of students in the context of the pandemic. Early acceptability and penetration data will also be discussed.     

Perceived risk of using shared mobility services during the COVID-19 pandemic

The COVID-19 pandemic has caused our daily routines to change quickly. The pandemic provokes public fear, resulting in changes in what modes of transport people use to perform their daily activities. It is imperative for transportation authorities to properly identify the different degrees of behavioral change among various social groups. A major factor that can substantially explain individuals’ behavioral changes is the personal risk perceptions toward using shared mobility solutions. Thus, this study explores the risk that individuals perceive while using public transit and ridesharing services (as the most widespread forms of shared mobility) during the COVID-19 pandemic. To do so, we designed and implemented a multidimensional travel-behavior survey in the Chicago metropolitan area that comprises socio-demographic information and retrospective questions related to attitudes and travel behavior before and during the pandemic. Utilizing a bivariate ordered probit modeling approach to better account for the potential correlation between unobserved factors, we simultaneously modeled the perceived risk of exposure to the novel coronavirus in case of riding transit and using ridesharing services. A wide range of factors is found to be influential on the perceived risk of using shared mobility services, including the socio-demographic attributes, built environment settings, and the virus spread. Further, our results indicate that the mitigation strategies to increase the ridership of shared mobility services should be adaptive considering the spatial variations.     

Does disseminating (mis)information restore social connection during a global pandemic?

The COVID-19 pandemic impeded social interaction, negatively affecting well-being worldwide. To slow virus spread, practices were enacted to minimize face-to-face contact, leading to increased social disconnection. As people turned increasingly to online environments (e.g., social media) to fulfill needs for inclusion and belonging, misinformation regarding COVID-19 simultaneously ran rampant. The purpose of the current study was to examine whether impeded social inclusion may have contributed to the spread of misinformation. We recruited a sample of adult social media users in the United States (N = 431) and randomly assigned them to be either included, ostracized (i.e., ignored), or rejected (i.e., to receive explicitly negative attention). Participants subsequently rated their willingness to share COVID-19 claims via social media (in fact, all claims were false). Participants learned that sharing some claims would likely lead to high expected engagement from others on social media (e.g., “likes”), whereas some claims would likely lead to little expected engagement. While information sharing was low in our sample, participants were more willing to share claims that they believed would lead to higher levels of engagement—consistent with the idea that sharing information is motivated not only by the desire to educate others but also to elicit social connection. However, this behavioral intention was no more common among participants who had been momentarily ostracized or rejected online than among participants who had been included. Future research should continue to explore the link between social exclusion and the motivation to disseminate (mis)information beyond a pandemic-related context.     

Sleep disturbances and depression are bidirectionally associated among college student athletes across COVID-19 pandemic exposure classes

College athletes may be vulnerable to sleep disturbances and depression during the COVID-19 pandemic as a result of large shifts in social and athletic obligations. In a national sample of college athletes, we examined the associations between sleep disturbances and depression across two timepoints, using COVID-19 exposure as a moderator. Data were collected from 2098 NCAA Division I, II, and III college athletes during two timepoints, from April 10 to May 23, and from August 4 to September 15, 2020. First, a latent class analysis was conducted with five indicators of levels of COVID-19 exposure to determine different exposure profiles. Second, to examine the directionality of associations between sleep disturbance and depression, a cross-lagged panel model was added to the latent class membership structural equation model; this allowed for testing of moderation by COVID exposure class membership. Four highly homogeneous, well-separated classes of COVID-19 exposure were enumerated: Low Exposure (57%); Quarantine Only (21%); High Other, Low Self Exposure (14%); and High Exposure (8%). COVID-19 exposure class membership did not significantly moderate associations between sleep disturbances and depression. However, student athletes significantly differed in T2 depression by their COVID-19 exposure class membership. Depression and sleep disturbances were positively correlated at both timepoints (r_T1 = 0.39; r_T2 = 0.30). Additionally, cross-lagged associations were found such that T2 depression was associated with T1 sleep disturbances (β = 0.14) and vice versa (β = 0.11). These cross-lagged associations were not significantly affected by athletes’ level of COVID-19 exposure during the beginning of the pandemic.     

Physical activity is positively associated with college students' positive affect regardless of stressful life events during the COVID-19 pandemic

The study was designed to determine associations between physical activity (PA) and affect before and during COVID-19 stay-at-home orders and how change in PA predicted change in affect during this time. Before and during COVID-19 stay-at-home orders, college students (n = 107) completed assessments of PA, positive and negative affect, sleep quality, food insecurity, and stressful life events (during stay-at-home order only). Total minutes of PA was positively associated with positive affect before (B = 0.01, p < 0.01) and during (B = 0.01, p = 0.01) COVID-19 stay-at-home orders. Change in minutes of PA was positively associated with change in positive affect (B = 0.01, p = 0.01). Associations between PA and positive affect were not moderated by stressful life events. PA only predicted negative affect before COVID-19 stay-at-home orders (B = −0.003, p = 0.04). PA appears to enhance positive affect during a global pandemic. Findings have implications for PA as a tool for maintaining or enhancing mental health during a time of trauma and uncertainty.     

Employee psychological well-being during the COVID-19 pandemic in Germany: A longitudinal study of demands,resources, and exhaustion

Many governments react to the current coronavirus/COVID-19 pandemic by restricting daily (work) life. On the basis of theories from occupational health, we propose that the duration of the pandemic, its demands (e.g., having to work from home, closing of childcare facilities, job insecurity, work-privacy conflicts, privacy-work conflicts) and personal- and job-related resources (co-worker social support, job autonomy, partner support and corona self-efficacy) interact in their effect on employee exhaustion. We test the hypotheses with a three-wave sample of German employees during the pandemic from April to June 2020 (N_w1 = 2900, N_w12 = 1237, N_w123 = 789). Our findings show a curvilinear effect of pandemic duration on working women's exhaustion. The data also show that the introduction and the easing of lockdown measures affect exhaustion, and that women with children who work from home while childcare is unavailable are especially exhausted. Job autonomy and partner support mitigated some of these effects. In sum, women's psychological health was more strongly affected by the pandemic than men's. We discuss implications for occupational health theories and that interventions targeted at mitigating the psychological consequences of the COVID-19 pandemic should target women specifically.     

Des psychologues en milieu hospitalier lors de la crise sanitaire de la Covid-19 : mieux comprendre leur vécu à l’aide du concept de générativité

IntroductionDuring the COVID-19 pandemic, everyone was confronted with their finitude, risking a crisis of meaning. Considering with Erikson (1950) that generativity is a great vector of meaning in life, which allows an individual to ensure the continuity of society through transmission and care, caregivers usually have a higher generativity score than the general population (Grossman & Gruenewald, 2017). This study then looks for signs of generativity among caregivers, hypothesising that it was particularly mobilised during this health crisis.PurposeThe purpose of this study is to explore the experiences of psychologists working in hospitals on somatic wards in order to identify the impacts of the COVID-19 pandemic and signs of generativity.MethodIn this exploratory, qualitative, prospective, multicenter study, nine psychologists working in hospital wards were interviewed individually to explore their experiences during a semi-structured interview.ResultsThe markers of existential crisis linked to COVID-19, such as signs of exhaustion and anxiety, were prominent in their discourse. Strong elements of generativity are also found in the interviews. This reflects the testing of their resources.ConclusionGenerativity allowed adaptation during the crisis but does not seem to be sufficient to protect against exhaustion and existential crisis.     

Safety behaviors were associated with greater anxious symptoms during the first year of the COVID-19 pandemic

Research shows that people who use safety behaviors are at greater risk factor for anxiety than people who do not use safety behaviors. However, the perception of some safety behaviors changed during the COVID-19 pandemic; behaviors that were once considered unnecessary or excessive were now commonplace (e.g., monitoring bodily symptoms, avoiding crowds). The purpose of this study was to determine the degree to which the pandemic changed the status of health-related safety behaviors as a risk factor for symptoms of anxiety. To this end, we tested the effect of safety behavior use on anxious symptoms during the first year of the pandemic using a longitudinal design with 8 time points and participants (n = 233) from over 20 countries. Despite possible changes in their perception, those engaging in high levels of safety behaviors reported the greatest levels of anxious symptoms throughout the pandemic year. However, the outcomes for safety behavior users were not all negative. Safety behavior use at baseline was the only predictor of participants' willingness to receive the COVID-19 vaccine (measured one year later).     

An outbreak of xenophobia: Perceived discrimination and anxiety in Chinese American college students before and during the COVID-19 pandemic

Since the outbreak of the novel coronavirus (COVID-19) pandemic, reports of xenophobic and racist incidents directed at Chinese Americans have escalated. The present study adds further understanding to potential psychosocial effects of the COVID-19 pandemic by comparing self-reported questionnaire data from two groups of Chinese students attending a public university in western United States: the group who participated in the study before the outbreak of COVID-19 (Pre-COVID, N = 134), and the group who participated at the beginning (during-COVID, N = 64). The aim of the study was to: (a) compare mean differences in perceived discrimination and anxiety between the two groups, (b) test whether COVID-19 moderated the link between perceived discrimination and anxiety, and (c) examine whether media exposure portraying Chinese individuals negatively mediated relations between COVID-19 and discrimination. Results showed that the During-COVID group reported higher perceived discrimination and anxiety than the Pre-COVID group. The link between perceived discrimination and anxiety was stronger for the During-COVID group. Mediation analyses suggested that negative Chinese media exposure partly accounted for the group difference in perceived discrimination. Results suggest that future studies on the psychosocial implications of the COVID-19 pandemic should consider the role of discrimination in understanding the mental health of Chinese American college students.     

Treating Social Anxiety in an Era of Social Distancing: Adapting Exposure Therapy for Youth During COVID-19

The novel coronavirus (COVID-19) pandemic has caused widespread disruption to our traditional way of life and mental health therapy has not been spared. A combination of increased anxiety, diminished social opportunities, and the shift to telehealth service provision presents particular challenges for the treatment of social anxiety in youth, which relies heavily on exposures to social situations with peers, adults, or other feared social stimuli. The objective of this commentary is to provide guidance to clinicians working with youth with social anxiety on how to maintain ethical, evidence-informed provision of exposure therapy in light of these unusual circumstances. We first present an overview of how COVID-19 may uniquely impact youth with social anxiety and highlight the importance of continuing to provide exposure-based treatments during this time. We then discuss guiding principles for delivering exposure therapy during COVID-19. We focus on providing practical examples of how common social anxiety exposures can be adapted and delivered successfully through telehealth while abiding by COVID-19 social distancing guidelines. Finally, we discuss key recommendations to assist clinicians in moving treatment forward while considering changing safety guidelines pertaining to COVID-19.     

A user-centred assessment of a new bicycle sharing system in Medellin

A bicycle sharing system (BSS) offers multiple benefits to a city as well as numerous challenges for effective implementation, especially if the system is connected to other modes of transportation. User-centred assessments of BSSs have been recognised as a paramount factor in transportation research, although it has received relatively little attention. This ethnographic study implemented a user experiential approach for assessing EnCicla, which is a new BSS in the city of Medellin, Colombia. A deeper understanding of users was needed for identifying the perceived journey maps; including route stages, functional likes and dislikes, affective reactions, and motivations for using the system. Findings identified not only the functional but also the affective aspects of the user experience. The 40 participants were also classified into four user groups: Lover, Civic, Grateful, and Adapted. Managerial implications involved recommendations for improving the service design and the communication and promotion strategies of the system. Limitations have to do with the specific characteristics of the sample.     

Responding to the Psychological Needs of Health-Care Workers During the COVID-19 Pandemic: Case Study from the Medical College of Wisconsin

With the advent of the novel coronavirus (COVID-19) pandemic, health-care workers have been faced with an inordinately high level of trauma as frontline providers. The Medical College of Wisconsin (MCW) partnered with affiliate hospitals and community partners to mobilize a matrix of available support and interventions to deliver psychological services to reach all levels of health-care providers in timely, accessible formats. While virtual peer support groups were the most utilized resource among the support group options, other opportunities also provided unique benefits to learners whose education had been disrupted by the pandemic. Mental health must be prioritized for health-care workers in the event of future public health crises. Lessons learned from this pandemic indicate that it is critical to involve learners early on in the process in order to meet their educational needs and to increase access to evidence-based care.

     

Life Interrupted: Family Routines Buffer Stress during the COVID-19 Pandemic

Adoption of certain behavioral and social routines that organize and structure the home environment may help families navigate the challenges presented by the COVID-19 pandemic. The current cross-sectional study aimed to assess family routines prior to and during the COVID-19 pandemic and examine associations with individual and family well-being. Using a national sample, 300 caregivers of children ages 6-18 were surveyed using Amazon Mechanical Turk platform during the first three months of COVID-19 pandemic in the United States. Caregivers reported on family demographics, COVID-19-related stress, engagement in family routines (prior to and during the COVID-19 pandemic), stress mindset, self-efficacy, and family resiliency. Overall, families reported engaging in fewer routines during the COVID-19 pandemic compared to prior to the pandemic. COVID-19-related stress was highest in low-income families, families of healthcare workers, and among caregivers who had experienced the COVID-19 virus. Moreover, COVID-19-related stress was negatively related to self-efficacy, positively related to an enhancing stress mindset, and negatively related to family resilience. Engagement in family routines buffered relations between COVID-19-related stress and family resilience, such that COVID-19-related stress was not associated with lower family resilience among families that engaged in high levels of family routines. Results suggest that family routines were challenging to maintain in the context of the COVID-19 pandemic, but were associated with better individual and family well-being during this period of acute health, economic, and social stress.

     

The influence of personal and public health and smart applications on biking behavior in South Korea

Bicycling is an important form of active transport that contributes to sustainability mobility as a result of its role in personal and public health and emissions reduction. The significance of which has grown since the COVID-19 pandemic outbreak. However, biking studies have neglected, in theoretical terms, developing an understanding of why consumers bike. Therefore, this research designs and verifies an extended theory of planned behavior adding personal and public health and a moderator of perceived smart application usage to help explain such consumer behavior. This study is based on a digital survey of South Koreans who biked for leisure, tourism, and/or work, utilizing partial least squares-structural equation modeling with multi-group analysis and Fuzzy-set Qualitative Comparative Analysis. Results revealed that personal health is most important to cyclists, followed by public health, attitude, and subjective norm. Interestingly, people with perceived high usage of smart applications for biking show stronger relationships between public health and attitude and perceived behavioral control and behavioral intention than low users. In contrast, individuals with perceived low usage of smart applications for biking reveal a stronger relationship between attitude and behavioral intention than high users. The high and low user groups of smart applications also distinctively differ in levels of cycling behavior. Consequently, this work offers several theoretical and managerial implications for research and practice.