A relational savoring intervention predicts higher levels of adherence to COVID-19 health recommendations

Understanding factors that are related to engagement in health behaviors during a health emergency is critical. Positive psychology interventions have been shown to increase positive emotion toward others and the self;enhancing feelings of self-worth might, in turn, increase adherence to health behaviors. This may be particularly important for parents of young children who are reported as having significant levels of stress and anxiety during the pandemic. Herein, we investigated the long-term effects of a personal savoring control versus a relational savoring intervention on mothers' adherence to health recommendations during the COVID-19 pandemic. Mothers (N = 61) who participated in the intervention and had agreed to continue to be contacted for further participation reported their adherence to COVID-19-related health recommendations through an online survey after the onset of the pandemic. We also assessed basic demographics, perceived threat of the pandemic, and general anxiety. As expected, independent of a host of demographic variables, perceived threat, and anxiety, mothers who had participated in the relational savoring intervention also demonstrated higher levels of adherence to COVID-19-related health recommendations. Even years after the initial intervention, relational savoring practices seem to enhance the use of appropriate health behaviors during the pandemic. There are various explanations for this, and further investigation is needed to pinpoint how relational savoring affects mechanisms that underlie positive engagement with health recommendations. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement Public Significance Statement Positive psychology interventions can influence adherence to recommendations. Promoting connection and community with close ones may be a strategy to promote engagement with health behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

COVID-19 and the Latinx Community: "Promotoras Represent a Community in Pain".

COVID-19 has disproportionately affected the Latinx community, leading to heightened economic instability and increased mortality/morbidity. Frontline community health workers (promotoras) have played an integral role in serving low-income Latinx immigrant communities, disseminating health information to this vulnerable community while also facing heightened risks to their own health and wellbeing. This study explores the impact of the pandemic on Latinx communities and the promotoras that serve them, examining how the stresses and inequities the pandemic wrought might be mitigated. Promotoras (N = 15, all female) were recruited from a local health agency in Santa Ana, CA and completed a semi-structured interview about their experiences during COVID-19. Qualitative analyses demonstrated that the pandemic substantially affected the daily lives both of community members, via economic challenges, limited access to reliable pandemic-related information, and psychological and social stress, and of promotoras, via changes to the nature of their work and psychological and social stress. Promotoras perceived that these harms might be mitigated by providing for economic and material needs in the community, and that promotoras can be fortified to continue serving the community through self-care and psychosocial healing practices. According to promotoras, the Latinx community needs economic and material resources to overcome COVID-19 related stressors. Additionally, promotoras may benefit from programming to preserve mental and physical health in the wake of new stressors. Lending greater support to promotoras within the agencies in which they are nested may enable them to be more successful in fulfilling their mission and sustaining their own health.

COVID Symptoms, Symptom Clusters, and Predictors for Becoming a Long-Hauler Looking for Clarity in the Haze of the Pandemic.

Post-acute sequelae of SARS-CoV-2 (PASC) is defined as persistent symptoms after apparent recovery from acute COVID-19 infection, also known as COVID-19 long-haul. We performed a retrospective review of electronic health records (EHR) from the University of California COvid Research Data Set (UC CORDS), a de-identified EHR of PCR-confirmed SARS-CoV-2-positive patients in California. The purposes were to (1) describe the prevalence of PASC, (2) describe COVID-19 symptoms and symptom clusters, and (3) identify risk factors for PASC. Data were subjected to non-negative matrix factorization to identify symptom clusters, and a predictive model of PASC was developed. PASC prevalence was 11% (277/2,153), and of these patients, 66% (183/277) were considered asymptomatic at days 0-30. Five PASC symptom clusters emerged and specific symptoms at days 0-30 were associated with PASC. Women were more likely than men to develop PASC, with all age groups and ethnicities represented. PASC is a public health priority.

The other COVID-19 survivors: Timing, duration, and health impact of post-acute sequelae of SARS-CoV-2 infection.

AIMS AND OBJECTIVES: To determine the frequency, timing, and duration of post-acute sequelae of SARS-CoV-2 infection (PASC) and their impact on health and function. BACKGROUND: Post-acute sequelae of SARS-CoV-2 infection is an emerging major public health problem that is poorly understood and has no current treatment or cure. PASC is a new syndrome that has yet to be fully clinically characterised. DESIGN: Descriptive cross-sectional survey (n = 5163) was conducted from online COVID-19 survivor support groups who reported symptoms for more than 21 days following SARS-CoV-2 infection. METHODS: Participants reported background demographics and the date and method of their covid diagnosis, as well as all symptoms experienced since onset of covid in terms of the symptom start date, duration, and Likert scales measuring three symptom-specific health impacts: pain and discomfort, work impairment, and social impairment. Descriptive statistics and measures of central tendencies were computed for participant demographics and symptom data. RESULTS: Participants reported experiencing a mean of 21 symptoms (range 1-93); fatigue (79.0%), headache (55.3%), shortness of breath (55.3%) and difficulty concentrating (53.6%) were the most common. Symptoms often remitted and relapsed for extended periods of time (duration M = 112 days), longest lasting symptoms included the inability to exercise (M = 106.5 days), fatigue (M = 101.7 days) and difficulty concentrating, associated with memory impairment (M = 101.1 days). Participants reported extreme pressure at the base of the head, syncope, sharp or sudden chest pain, and "brain pressure" among the most distressing and impacting daily life. CONCLUSIONS: Post-acute sequelae of SARS-CoV-2 infection can be characterised by a wide range of symptoms, many of which cause moderate-to-severe distress and can hinder survivors' overall well-being. RELEVANCE TO CLINICAL PRACTICE: This study advances our understanding of the symptoms of PASC and their health impacts.

Sleep Patterns and Affect Dynamics Among College Students During the COVID-19 Pandemic: Intensive Longitudinal Study.

BACKGROUND: Sleep disturbance is a transdiagnostic risk factor that is so prevalent among young adults that it is considered a public health epidemic, which has been exacerbated by the COVID-19 pandemic. Sleep may contribute to mental health via affect dynamics. Prior literature on the contribution of sleep to affect is largely based on correlational studies or experiments that do not generalize to the daily lives of young adults. Furthermore, the literature examining the associations between sleep variability and affect dynamics remains scant. OBJECTIVE: In an ecologically valid context, using an intensive longitudinal design, we aimed to assess the daily and long-term associations between sleep patterns and affect dynamics among young adults during the COVID-19 pandemic. METHODS: College student participants (N=20; female: 13/20, 65%) wore an Oura ring (Oura Health Ltd) continuously for 3 months to measure sleep patterns, such as average and variability in total sleep time (TST), wake after sleep onset (WASO), sleep efficiency, and sleep onset latency (SOL), resulting in 1173 unique observations. We administered a daily ecological momentary assessment by using a mobile health app to evaluate positive affect (PA), negative affect (NA), and COVID-19 worry once per day. RESULTS: Participants with a higher sleep onset latency (b=-1.09, SE 0.36; P=.006) and TST (b=-0.15, SE 0.05; P=.008) on the prior day had lower PA on the next day. Further, higher average TST across the 3-month period predicted lower average PA (b=-0.36, SE 0.12; P=.009). TST variability predicted higher affect variability across all affect domains. Specifically, higher variability in TST was associated higher PA variability (b=0.09, SE 0.03; P=.007), higher negative affect variability (b=0.12, SE 0.05; P=.03), and higher COVID-19 worry variability (b=0.16, SE 0.07; P=.04). CONCLUSIONS: Fluctuating sleep patterns are associated with affect dynamics at the daily and long-term scales. Low PA and affect variability may be potential pathways through which sleep has implications for mental health.

A Pediatrician's Guide to Working with Children on the Autism Spectrum in Coronavirus Disease 2019 and Beyond: Retrospect and Prospect.

The COVID-19 pandemic is an unprecedented event with devastating effects on children and families, highlighting and broadening disparities in the care of children with developmental disabilities, while simultaneously catalyzing innovation. Children are vulnerable to the impacts of COVID-19, resulting in increased stress, anxiety, isolation, and health challenges, further amplified in autistic children and children with other neurodevelopmental disabilities. These children are uniquely vulnerable due to communication impairments, comorbid medical disorders, reduced adaptability, and reliance on therapeutic interventions. Abrupt reduction in services and access to care during the pandemic compromised physical and mental health and led to missed intervention opportunities at critical times. It is important to examine the effects that the pandemic triggered, address deficiencies, and recognize new opportunities to improve systems of care to prepare for unforeseen futures.

Being a Parent during COVID-19: Risk for Psychological Distress in the United States and Italy

The COVID-19 pandemic has had significant effects on people worldwide, yet the psychological impact of collective traumas may differ at the individual and societal level. Parents may be exposed to greater pandemic-related stressors, yet also are more likely than non-parents to have social interactions during social distancing mandates. Furthermore, varying degrees of pandemic severity in countries may alter the adverse outcomes of pandemic stressors on psychopathology across nations. The purpose of this investigation was to cross-nationally explore how COVID-19 stress exposure relates to psychological distress and whether the association differed by parental status and nationality. Individuals from the United States (n = 2449) and Italy (n = 579) completed assessments measuring traumatic stress, depressive symptoms, and COVID-19-related stressors. COVID-19-related stressors were positively associated with traumatic stress and depressive symptoms. The association between COVID-19-related stressors and psychological distress did not differ by parental status or nationality. We also found that being a young adult, having a lower educational status, not being a parent, and being Italian were related to exposure to COVID-19-related stressors. We discuss these findings and their implications for our understanding of unique contexts that may pose as risk or resiliency factors during a global collective trauma, particularly on parental psychological distress as a way of promoting whole-family wellness.

Be My Safe Haven: Parent-Child Relationships and Emotional Health During COVID-19.

OBJECTIVE: Since March 2020, millions of children have been confined to their homes and restricted from in-person activities, radically changing the dynamics of parent-child relationships. This study examines the association between coronavirus disease 2019 (COVID-19) impact and the mental health of parents and school-aged children; specifically, whether qualities of the parent-child relationship moderated the relationship between parents' emotional health (EH) and children's emotional and behavioral health (EBH). METHODS: Data from this Internet-based study of a community sample were collected in March-May 2020. Parents (N = 158, 92.4% White, 96.2% female) reported on COVID-19 impacts, their own EH, perceptions of their relationship with their eldest child between 6 and 12 years-old, and the EBH of that child. RESULTS: Responses to questions about COVID-19 impact were assigned weighted values and used to create a COVID-19 impact scale. Hierarchical linear regressions revealed that greater COVID-19 impact was associated with greater parents' EH issues only, and parents' EH was a significant positive predictor of children's EBH. Positive qualities and conflict in the parent-child relationship moderated the link between parents' and children's EH. At higher levels of relationship conflict and lower levels of positivity, there were stronger positive associations between parents' and children's EH. Parent-child relationship quality did not moderate the association between parents' EH and children's behavioral health (BH). CONCLUSIONS: These cross-sectional study results suggest that beyond focusing on symptom management, families may benefit from supports targeting the parent-child relationship. Insights and implications for practitioners are discussed.

Using Multimodal Assessments to Capture Personalized Contexts of College Student Well-being in 2020: Case Study.

BACKGROUND: The year 2020 has been challenging for many, particularly for young adults who have been adversely affected by the COVID-19 pandemic. Emerging adulthood is a developmental phase with significant changes in the patterns of daily living; it is a risky phase for the onset of major mental illness. College students during the pandemic face significant risk, potentially losing several protective factors (eg, housing, routine, social support, job, and financial security) that are stabilizing for mental health and physical well-being. Individualized multiple assessments of mental health, referred to as multimodal personal chronicles, present an opportunity to examine indicators of health in an ongoing and personalized way using mobile sensing devices and wearable internet of things. OBJECTIVE: To assess the feasibility and provide an in-depth examination of the impact of the COVID-19 pandemic on college students through multimodal personal chronicles, we present a case study of an individual monitored using a longitudinal subjective and objective assessment approach over a 9-month period throughout 2020, spanning the prepandemic period of January through September. METHODS: The individual, referred to as Lee, completed psychological assessments measuring depression, anxiety, and loneliness across 4 time points in January, April, June, and September. We used the data emerging from the multimodal personal chronicles (ie, heart rate, sleep, physical activity, affect, behaviors) in relation to psychological assessments to understand patterns that help to explicate changes in the individual's psychological well-being across the pandemic. RESULTS: Over the course of the pandemic, Lee's depression severity was highest in April, shortly after shelter-in-place orders were mandated. His depression severity remained mildly severe throughout the rest of the months. Associations in positive and negative affect, physiology, sleep, and physical activity patterns varied across time periods. Lee's positive affect and negative affect were positively correlated in April (r=0.53, P=.04) whereas they were negatively correlated in September (r=-0.57, P=.03). Only in the month of January was sleep negatively associated with negative affect (r=-0.58, P=.03) and diurnal beats per minute (r=-0.54, P=.04), and then positively associated with heart rate variability (resting root mean square of successive differences between normal heartbeats) (r=0.54, P=.04). When looking at his available contextual data, Lee noted certain situations as supportive coping factors and other situations as potential stressors. CONCLUSIONS: We observed more pandemic concerns in April and noticed other contextual events relating to this individual's well-being, reflecting how college students continue to experience life events during the pandemic. The rich monitoring data alongside contextual data may be beneficial for clinicians to understand client experiences and offer personalized treatment plans. We discuss benefits as well as future directions of this system, and the conclusions we can draw regarding the links between the COVID-19 pandemic and college student mental health.

Assessing the Mental Health of Emerging Adults Through a Mental Health App: Protocol for a Prospective Pilot Study.

BACKGROUND: Individuals can experience different manifestations of the same psychological disorder. This underscores the need for a personalized model approach in the study of psychopathology. Emerging adulthood is a developmental phase wherein individuals are especially vulnerable to psychopathology. Given their exposure to repeated stressors and disruptions in routine, the emerging adult population is worthy of investigation. OBJECTIVE: In our prospective study, we aim to conduct multimodal assessments to determine the feasibility of an individualized approach for understanding the contextual factors of changes in daily affect, sleep, physiology, and activity. In other words, we aim to use event mining to predict changes in mental health. METHODS: We expect to have a final sample size of 20 participants. Recruited participants will be monitored for a period of time (ie, between 3 and 12 months). Participants will download the Personicle app on their smartphone to track their activities (eg, home events and cycling). They will also be given wearable sensor devices (ie, devices that monitor sleep, physiology, and physical activity), which are to be worn continuously. Participants will be asked to report on their daily moods and provide open-ended text responses on a weekly basis. Participants will be given a battery of questionnaires every 3 months. RESULTS: Our study has been approved by an institutional review board. The study is currently in the data collection phase. Due to the COVID-19 pandemic, the study was adjusted to allow for remote data collection and COVID-19-related stress assessments. CONCLUSIONS: Our study will help advance research on individualized approaches to understanding health and well-being through multimodal systems. Our study will also demonstrate the benefit of using individualized approaches to study interrelations among stress, social relationships, technology, and mental health. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/25775.

Mental health and clinical psychological science in the time of COVID-19: Challenges, opportunities, and a call to action.

COVID-19 presents significant social, economic, and medical challenges. Because COVID-19 has already begun to precipitate huge increases in mental health problems, clinical psychological science must assert a leadership role in guiding a national response to this secondary crisis. In this article, COVID-19 is conceptualized as a unique, compounding, multidimensional stressor that will create a vast need for intervention and necessitate new paradigms for mental health service delivery and training. Urgent challenge areas across developmental periods are discussed, followed by a review of psychological symptoms that likely will increase in prevalence and require innovative solutions in both science and practice. Implications for new research directions, clinical approaches, and policy issues are discussed to highlight the opportunities for clinical psychological science to emerge as an updated, contemporary field capable of addressing the burden of mental illness and distress in the wake of COVID-19 and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).