Predictors of Mental Health Help-Seeking During COVID-19: Social Support, Emotion Regulation, and Mental Health Symptoms.

Little is known about factors that contribute to mental health help-seeking during disasters beyond attitudes toward counseling. The COVID-19 (SARS-CoV-2) global pandemic dramatically impacted individuals, families, and communities worldwide. The pandemic led to significant disruptions to family routines, and evidence suggests an increase in instances of mental health symptoms, like depression and anxiety, and poor utilization of mental health services. To better understand psychological factors associated with help-seeking during the COVID-19 pandemic, researchers surveyed respondents (n = 1,533 at time 1) about their mental health and help-seeking using Amazon's MTurk platform. The results indicated that individuals with higher levels of anxiety rate their likelihood of help-seeking as higher and those who do seek psychological help report higher levels of depression. Further, those who began new treatment for behavioral health difficulties during the COVID-19 pandemic reported lower social support and less clarity about how they felt (specifically, emotional clarity when upset). Implications for clinical researchers and public health are discussed.

Does perceived post-traumatic growth during the COVID-19 pandemic reflect actual positive changes?

BACKGROUND AND OBJECTIVES: People commonly report positive changes following stressful experiences (perceived posttraumatic growth; PPTG), yet whether PPTG validly reflects positive changes remains unestablished. DESIGN AND METHODS: We tested the extent to which COVID-19 pandemic-related PPTG relates to positive changes in corresponding psychosocial resources in a national US sample participating in a five wave study (T1-T5), focusing here on T2-T5: ns = 712-860. We examined correlations between resource change (both latent and observed difference scores) and PPTG at each occasion and conducted structural equation models to separate occasion-specific and stable (traitlike) PPTG variance. We related changes in resources to occasion-specific and stable PPTG components. RESULTS: Associations between change scores and occasion-specific PPTG were sparse, providing limited evidence of PPTG validity. Associations between change scores and stable PPTG tended to be positive and stronger than associations for occasion-specific PPTG. DISCUSSION: Perceptions of growth were largely unrelated to experienced positive changes and thus appear to be largely illusory. However, a personality-like tendency to believe one grows from stressful experiences relates more strongly to actual resource growth. These results suggest that people are not accurate reporters of positive changes they experience and that interventions aimed at promoting post-traumatic growth may be premature.

Social Media Use Early in the Pandemic Predicted Later Social Well-Being and Mental Health in a National Online Sample of Adults in the United States.

Social media use increased early in the Covid-19 pandemic, but little information is available about its impact. The present study examined associations of frequency of use of different social media and the motives for use with subsequent social well-being and mental health. Data were gathered on a nationwide sample of 843 Americans during the first wave of lockdowns and infections in mid-April 2020, and again five weeks later. Participants were adults ages 20 to 88 years old (M = 39.3 years old) recruited from Amazon Mechanical Turk (MTurk). Controlling for age and gender, greater frequency of Facebook and video chat app use predicted higher levels social support but also higher levels of cumulative Covid-19-related stress appraisals and posttraumatic stress symptoms. Greater use of video chat apps also predicted less loneliness. Greater use of both Instagram and Snapchat predicted more anxiety and cumulative Covid-19-related stress appraisals. Greater use of Instagram also predicted higher levels of posttraumatic stress symptoms. Motives for use (e.g., connect with others, waste time/avoid responsibility, online video gaming with others) also differentially predicted social well-being and mental health. Results indicate that greater social media use early in the pandemic was often associated with more distress and lower levels of social well-being but, effects varied depending on types, frequency, and motivations for use. Overall, the study revealed that social media use related to social well-being and mental health in complex ways.

Effects of mindful emotion regulation on parents’ loneliness and social support: A longitudinal study during the coronavirus disease 2019 (COVID-19) pandemic in the United States

The COVID-19 pandemic has introduced unprecedented challenges and demands for parents or caregivers of children who experienced disruptions in social support and feelings of isolation. Mindful emotion regulation may be a resilient factor for parents? psychosocial outcomes. Mindful emotion regulation refers to individuals? inherent capacities to regulate emotions mindfully, i.e., through paying attention to one?s experiences in the present moment nonjudgmentally. Based on the theoretical and empirical literature associating mindful emotion regulation with loneliness and perceived social support, the current study tested the effects of mindful emotion regulation on later changes in perceived social support and loneliness in U.S. parents during the pandemic. Participants were 147 parents/caregivers who were living with at least one child or adolescent in their household during the pandemic in the USA. Data were collected from a national online sample at four time points: baseline (April 7?21, 2020), 30-, 60-, and 90-days later. Results of longitudinal mediational structural equation modeling showed that mindful emotion regulation was directly associated with increased perceived social support and decreased loneliness. Moreover, mindful emotion regulation was also associated with perceived social support indirectly through its effects on loneliness. Focusing on the needs of parents is important for promoting family and child wellbeing to ameliorate negative health consequences. More research is needed to elucidate whether and how mindful emotion regulation may be beneficial for parents in the social relationship domain.

Does perceived post-traumatic growth predict better psychological adjustment during the COVID-19 pandemic? Results from a national longitudinal survey in the USA

Perceiving that one has grown in positive ways following highly stressful experiences (perceived posttraumatic growth;PPTG) is common and sometimes--but not always--related to psychological wellbeing. However, PPTG is typically studied cross-sectionally and well after the stressful experience has passed;how PPTG might relate to wellbeing over time in an unprecedented, ongoing worldwide disaster such as the COVID-19 pandemic remains unknown. Thus, the current study sought to answer whether, in the midst of the pandemic, PPTG relates to subsequent wellbeing, broadly defined. Participants were N = 1544 MTurk workers who completed a five-wave (T1-T5) six-month longitudinal study. Current analyses focused on T2-T5 (ns = 860–712). At each time point, participants completed self-report measures of PPTG and wellbeing (depression, anxiety, stress, positive states of mind, alcohol use, posttraumatic stress). In cross-lagged panel models, PPTG was largely unrelated to subsequent wellbeing. Somewhat more evidence was found that increasing distress led to increases in PPTG, suggesting perceptions of growth may serve as a coping mechanism. PPTG does not appear to benefit adjustment to the COVID-19 pandemic and may simply reflect efforts to manage distress.

Emotion Regulation Resources Explain Middle-Aged and Older Adults' COVID-19-Related Distress

As the pandemic caused widespread disruption across the world, studies suggested younger adults were faring more poorly than other adults. We hypothesized that younger adults might possess fewer emotion regulation resources and skills, accounting for their greater distress. In a national sample of 1528 adults, we examined how baseline resources (in mid-April, during initial peak infections) predicted distress (depression, anxiety, PTSD symptoms) five weeks later, when states began initial reopenings. Younger adults reported greater distress and less social support, mindfulness, and emotion regulation skills than did middle aged and older adults.. Controlling for stress exposure, younger adults’ distress was predicted by impulsivity and lack of perceived strategies while middle-aged and older adults’ distress was predicted by acceptance of negative emotions;perceived social support was related to lower distress for both groups but mindfulness was unrelated. Results suggest that emotion regulation skills are a promising prevention and intervention focus.

A latent profile analysis of the COVID-19 Stressors Scale.

OBJECTIVE: Research from the early months of the SARS-Cov-2 (COVID-19) pandemic identifies many COVID-related stressors, including fears of infection, disruptions to work/learning and daily self-care routines, and lack of access to reliable information and resources. Measuring the complex, ongoing nature of the stressors related to COVID-19 is of great practical utility, as is investigating how people may differently respond to stressors. The objective of the present study was to identify the possible profiles of COVID-19-related stressors using a recently developed measure, the COVID-19 Stressors Scale. METHOD: The present study sampled individuals from Amazon Mechanical Turk (MTurk; n = 1,530) and examined the COVID-19 Stressors Scale with a latent profile analysis. RESULTS: Using a latent profile analysis, three profiles of COVID-19-related stressors were identified, Moderate Disruption Distress, High Disruption Distress, and Identity and Role Strain. CONCLUSIONS: Based on the results of the study, the authors encourage researchers to differentiate types of stressors profiles of individual experiences COVID-19 or future pandemics. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Short-term impacts of COVID-19 on family caregivers: Emotion regulation, coping, and mental health.

BACKGROUND: The negative mental health impact of coronavirus disease 2019-related stressors may be heightened for those caring for children, who bear responsibity for their welfare during disasters. AIM: Based on the Transactional Model of Stress and Coping, we inquired whether caregivers' emotion regulation and coping behavior were associated with posttraumatic stress symptoms (PTSS). MATERIALS & METHODS: Data were collected through a national online survey in April 2020, and again 60 days later. RESULTS: Of the 801 longitudinal cases, 176 (63.6% female; mean age = 33.5) reported caring for minors in their homes during the pandemic. Over 20% of caregivers experienced clinically concerning PTSS, rates higher than their noncaregiving counterparts. Regression analysis indicates caregivers' baseline mental health symptoms and emotion regulation predicted PTSS 60 days later. DISCUSSION: Implications for needed parenting supports among families experiencing traumatic stress are provided. CONCLUSION: Anxiety symptoms at baseline were the most significant and consistent contributor to all models and were significantly higher among those with clinically concerning levels of PTSS suggesting a clear intervention target.

Psychological resilience early in the COVID-19 pandemic: Stressors, resources, and coping strategies in a national sample of Americans.

Spreading rapidly across the United States beginning in the spring of 2020, the coronavirus disease 2019 (COVID-19) pandemic radically disrupted Americans' lives. Previous studies of community-wide disasters suggested people are fairly resilient and identified resources and strategies that promote that resilience. Yet, the COVID-19 pandemic is in some ways unique, with high levels of uncertainty, evolving implications and restrictions, and varied and uneven impacts. How resilient were Americans as the pandemic progressed? What psychosocial resources and coping strategies facilitated adjustment as the country moved into a summer of uneven reopenings and reclosures? Data from a national sample of 674 Americans were gathered at the height of early lockdowns and peaking infections in mid-April, 2020, and again, 5 and 10 weeks later. The study aimed to determine levels and sources of distress and to identify the resources and coping efforts that promoted or impeded resilience. Early levels of distress diminished to some extent over subsequent months while levels of wellbeing were comparable with usual norms, suggesting a largely resilient response. COVID-19-related stress exposure also decreased gradually over time. Older age, higher levels of mindfulness and social support, and meaning focused coping predicted better adjustment, reflecting resilience, while avoidance coping was particularly unhelpful. In models predicting change over time, approach-oriented coping (i.e., active coping, meaning-focused coping, and seeking social support) was minimally predictive of subsequent adjustment. Given the unique and ongoing circumstances presented by COVID-19, specific interventions targeting psychosocial resources and coping identified here may help to promote resilience as the pandemic continues to unfold. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Associations of alcohol, marijuana, and polysubstance use with non-adherence to COVID-19 public health guidelines in a US sample.

Background: We sought to understand the association between heavy alcohol and frequent drug use and non-adherence to recommended social distancing and personal hygiene guidelines for preventing the spread of COVID-19 early in the US pandemic. Methods: A survey was offered on the crowdsourcing platform, Amazon Mechanical Turk (MTurk) during April 2020 (the early days of strict, social distancing restrictions). The study included 1,521 adults ages 18 years and older who resided in the US and were enrolled as MTurk workers, i.e., workers who are qualified by Amazon to complete a range of human interaction tasks, including surveys through the MTurk worker platform. Main predictors included measures of heavy drinking, marijuana, and polysubstance use. The dependent measures were measures of social distancing and personal hygiene, based on guidelines recommended at the time of the survey by the US Centers for Disease Control to prevent the spread of COVID-19. Results: We found consistent negative associations between heavy drinking and drug use and adherence to social distancing and personal hygiene. Additionally, three control variables, age, gender, and race/ethnicity, were significant correlates of adherence to these measures. Conclusions: The findings here are consistent with previous research exploring links between substance use and other adverse health behaviors. Further, the negative association between heavy drinking (five or more drinks in one sitting) and adherence underscore the public health risks entailed with the unrestricted reopening of public drinking establishments.

Americans' distress early in the COVID-19 pandemic: Protective resources and coping strategies.

OBJECTIVE: The rapid emergence of the coronavirus disease 2019 (COVID-19) pandemic in the United States has dramatically altered daily life and taken a toll on Americans' physical, mental, social, and financial well-being. Based on previous widespread disasters, future high prevalence of short- and long-term adverse mental health consequences are anticipated. Studies of COVID-19 outside the United States indicated moderately high levels of distress, but we have little information regarding Americans' distress nor the factors associated with relative distress or adjustment during this unprecedented time. This study represents the first national view of Americans' distress during the massive disruption of COVID-19 and identifies levels of stress exposure, protective psychosocial resources, and coping strategies. METHOD: Data were collected April 7-9, 2020 from an online platform, using best practices for ensuring high-quality data; 1,015 completed respondents are included ([53.9%] women; average age = 38.9 years; mostly White [82.4%] and non-Hispanic [91.5%]). Respondents' locations ranged across the United States, from 18.5% in the Northeast to 37.8% in the South. RESULTS: Fairly high levels of stress exposure and peritraumatic and general distress (depression, anxiety, and stress) were reported. Emotion regulation skills along with active and distraction coping emerged as the strongest predictors of lower distress levels. CONCLUSIONS: These results identify potential targets for online mental health interventions-focusing on engaging in adaptive emotion regulation and coping (e.g., through telehealth mental health first aid)-during the pandemic to offset the likely rise in distress over the months ahead. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Measuring Cumulative Stressfulness: Psychometric Properties of the COVID-19 Stressors Scale.

Scales assessing stressor exposure often fail to demonstrate adequate psychometric qualities, demonstrating low interitem reliability or complex factor structures, as would be expected, given that the majority of stressors are independent events. However, in large-scale mass crisis events, the stressors may be highly interrelated, indicating shared experience. Furthermore, few stressor exposure scales also measure appraised stressfulness of those stressors. Development of a psychometrically sound measure of both stressor exposure and appraisal advances the study of highly stressful events such as community-wide crises, especially in providing a useful measure of its cumulative stressfulness. The coronavirus disease 2019 (COVID-19) pandemic is an enduring, worldwide stressor with an indefinite timeline. The COVID-19 Stressor Scale is a 23-item measure of stressor exposure and appraisal related to the pandemic developed within the first weeks of widespread shelter-in-place practices in the Unites States. We present initial psychometric results of the COVID-19 Stressor Scale. Results of a principal components analysis indicate that the measure is unidimensional and has strong internal consistency. Evidence of convergent and discriminant validity were demonstrated. The COVID-19 Stressor Scale is a useful measure for studying the ongoing stressors associated with the pandemic and presents a model for measuring other massive, ongoing crises.

Americans' COVID-19 Stress, Coping, and Adherence to CDC Guidelines.

IMPORTANCE: Documenting Americans' stress responses to an unprecedented pandemic and their degree of adherence to CDC guidelines is essential for mental health interventions and policy-making. OBJECTIVE: To provide the first snapshot of immediate impact of COVID-19 on Americans' stress, coping, and guideline adherence. DESIGN: Data were collected from an online workers' platform for survey research (Amazon's Mechanical Turk) from April 7 to 9, 2020. The current data represents the baseline of a longitudinal study. Best practices for ensuring high-quality data were employed. PARTICIPANTS: Individuals who are 18 years of age or older, living in the USA, and English-speaking were eligible for the study. Of 1086 unique responses, 1015 completed responses are included. SETTING: Population-based. MAIN OUTCOMES: Exposure to and stressfulness of COVID-19 stressors, coping strategies, and adherence to CDC guidelines. RESULTS: The sample was 53.9% women (n = 547), with an average age of 38.9 years (SD = 13.50, range = 18-88), most of whom were White (n = 836, 82.4%), non-Hispanic (n = 929, 91.5%), and straight/heterosexual (n = 895, 88.2%); 40% were currently married (n = 407), and 21.6% (n = 219) were caregivers. About half (50.5%) endorsed having at least "mostly" enough money to meet their needs. Respondents' locations across the USA ranged from 18.5% in the Northeast to 37.8% in the South. The most commonly experienced stressors were reading/hearing about the severity and contagiousness of COVID-19, uncertainty about length of quarantine and social distancing requirements, and changes to social and daily personal care routines. Financial concerns were rated most stressful. Younger age, female gender, and caregiver status increased risk for stressor exposure and greater degree of stressfulness. The most frequently reported strategies to manage stress were distraction, active coping, and seeking emotional social support. CDC guideline adherence was generally high, but several key social distancing and hygiene behaviors showed suboptimal adherence, particularly for men and younger adults. CONCLUSIONS AND RELEVANCE: Americans have high COVID-19 stress exposure and some demographic subgroups appear particularly vulnerable to stress effects. Subgroups less likely to adhere to CDC guidelines may benefit from targeted information campaigns. these findings may guide mental health interventions and inform policy-making regarding implications of specific public health measures.