Too many lemons to make lemonade? Disentangling mental health during the third wave of COVID-19 infections in Spain.

The study aimed to analyze the longitudinal change in mental health during the third wave of COVID-19 infections in Spain. Negative (e.g., emotional distress) and positive (e.g., positive functioning variables) outcomes were analyzed. Protective factors (e.g., resilience) as predictors of psychological adjustment (i.e., positive mental health, openness to the future, and low burden due to COVID-19) after ten months of the pandemic were also examined. The sample consisted of 164 participants, and self-reported questionnaires were administered at the beginning of the lockdown (March 2020), at the end of the lockdown (June 2020), and during the third wave (January 2021). Linear mixed models showed that individuals' emotional distress increased, and positive functioning variables (i.e., meaning in life, gratitude, resilience, and life satisfaction) decreased over time, but an increase was observed in some dimensions of posttraumatic growth. Regression analyses showed that resilience scores at all three data collection time points were significant predictors of positive mental health, openness to the future, and burden during the third wave. Mediation analyses showed that positive mental health and openness to the future were mediators of the effect of resilience on burden. The prolonged situation of the COVID-19 crisis had an important impact on positive and negative mental health. However, resilience may help to build up resources that can act as a buffer against adverse psychological effects.

How the COVID-19 Pandemic and its Consequences Affect the Presence of and Search for Meaning of Life: A Longitudinal Study.

The presence of meaning in life (PML) and the search for meaning in life (SML) are crucial when facing difficult times. Although several theoretical frameworks have tried to explain the dynamics of meaning in life during adversity, empirical evidence about interactions among both constructs using longitudinal designs is scarce. This study examined the trajectories of both PML and SML during the COVID-19 lockdown period in Spain. In total, 220 adults fulfilled an online survey during two periods: a strict and a relaxed lockdown period. Latent growth models showed that both PML and SML declined slightly during the strict lockdown, but they reached a plateau during the relaxed lockdown. Results also showed that age and having a partner predicted higher PML and lower SML at baseline, whereas being male predicted higher scores on PML. PML and SML were negatively associated at baseline, higher SML at baseline was related to a steeper decreasing PML slope during the strict lockdown, and the PML and SML slopes in the relaxed lockdown period were negatively related. This study contributes to better understanding longitudinal fluctuations of meaning in life in situations of adversity.

mHealth intervention to improve quality of life in patients with chronic diseases during the COVID-19 crisis in Paraguay: A study protocol for a randomized controlled trial.

BACKGROUND: Patients with chronic disease represent an at-risk group in the face of the COVID-19 crisis as they need to regularly monitor their lifestyle and emotional management. Coping with the illness becomes a challenge due to supply problems and lack of access to health care facilities. It is expected these limitations, along with lockdown and social distancing measures, have affected the routine disease management of these patients, being more pronounced in low- and middle-income countries with a flawed health care system. OBJECTIVES: The purpose of this study is to describe a protocol for a randomized controlled trial to test the efficacy of the Adhera® MejoraCare Digital Program, an mHealth intervention aimed at improving the quality of life of patients with chronic diseases during the COVID-19 outbreak in Paraguay. METHOD: A two-arm randomized controlled trial will be carried out, with repeated measures (baseline, 1-month, 3-month, 6-month, and 12-month) under two conditions: Adhera® MejoraCare Digital Program or waiting list. The primary outcome is a change in the quality of life on the EuroQol 5-Dimensions 3-Levels Questionnaire (EQ-5D-3L). Other secondary outcomes, as the effect on anxiety and health empowerment, will be considered. All participants must be 18 years of age or older and meet the criteria for chronic disease. A total of 96 participants will be recruited (48 per arm). CONCLUSIONS: It is expected that the Adhera® MejoraCare Digital Program will show significant improvements in quality of life and emotional distress compared to the waiting list condition. Additionally, it is hypothesized that this intervention will be positively evaluated by the participants in terms of usability and satisfaction. The findings will provide new insights into the viability and efficacy of mHealth solutions for chronic disease management in developing countries and in times of pandemic. TRIAL REGISTRATION: ClinicalTrials.gov NCT04659746.

Connecting to Nature through 360° Videos during COVID-19 Confinement: A Pilot Study of a Brief Psychological Intervention.

Psychological interventions have been shown to be beneficial in mitigating stress related to COVID-19 confinement. According to theories of restorative environments, exposure to natural surroundings has positive effects on well-being and stress through its restorative qualities. With 360° video-based Virtual Reality (VR), people can be exposed to nature and so better manage the consequences associated with mobility restrictions during confinement. The main aim of this pilot study was to examine whether a 360° video-based VR intervention composed of five 13-minute sessions (once a day) has positive effects on affect, well-being, and stress. The sample was made up of 10 participants (4 men and 6 women; age : M = 46.5, SD = 11.7) who were confined at home (voluntarily or not) during the COVID-19 pandemic. Participants were instructed to watch a 360° video each day (of a "beach" or "lake" environment) using their smartphone and VR glasses sent to them by mail. Participants responded with several self-reports before and/or after each session (emotions and sense of presence) and before and/or after the intervention (affect, well-being, perceived stress, perceived restorativeness of nature, and the usefulness and acceptability of the intervention). Results showed a tendency to improve positive (e.g., happiness) and negative (e.g., anxiousness) emotions and experience a high sense of presence after each session. Moreover, perceived restorative qualities of the environment and their cognitive and behavioral effects were high. A significant decrease in negative affect was found after the intervention. Usefulness and acceptability were also high. This is the first study to show that an affordable and accessible technology can be used to overcome the negative consequences of confinement and counteract its harmful psychological effects.

How the COVID-19 Pandemic and its Consequences Affect the Presence of and Search for Meaning of Life: A Longitudinal Study

The presence of meaning in life (PML) and the search for meaning in life (SML) are crucial when facing difficult times. Although several theoretical frameworks have tried to explain the dynamics of meaning in life during adversity, empirical evidence about interactions among both constructs using longitudinal designs is scarce. This study examined the trajectories of both PML and SML during the COVID-19 lockdown period in Spain. In total, 220 adults fulfilled an online survey during two periods: a strict and a relaxed lockdown period. Latent growth models showed that both PML and SML declined slightly during the strict lockdown, but they reached a plateau during the relaxed lockdown. Results also showed that age and having a partner predicted higher PML and lower SML at baseline, whereas being male predicted higher scores on PML. PML and SML were negatively associated at baseline, higher SML at baseline was related to a steeper decreasing PML slope during the strict lockdown, and the PML and SML slopes in the relaxed lockdown period were negatively related. This study contributes to better understanding longitudinal fluctuations of meaning in life in situations of adversity.

Too many lemons to make lemonade? Disentangling mental health during the third wave of COVID-19 infections in Spain

The study aimed to analyze the longitudinal change in mental health during the third wave of COVID-19 infections in Spain. Negative (e.g., emotional distress) and positive (e.g., positive functioning variables) outcomes were analyzed. Protective factors (e.g., resilience) as predictors of psychological adjustment (i.e., positive mental health, openness to the future, and low burden due to COVID-19) after ten months of the pandemic were also examined. The sample consisted of 164 participants, and self-reported questionnaires were administered at the beginning of the lockdown (March 2020), at the end of the lockdown (June 2020), and during the third wave (January 2021). Linear mixed models showed that individuals’ emotional distress increased, and positive functioning variables (i.e., meaning in life, gratitude, resilience, and life satisfaction) decreased over time, but an increase was observed in some dimensions of posttraumatic growth. Regression analyses showed that resilience scores at all three data collection time points were significant predictors of positive mental health, openness to the future, and burden during the third wave. Mediation analyses showed that positive mental health and openness to the future were mediators of the effect of resilience on burden. The prolonged situation of the COVID-19 crisis had an important impact on positive and negative mental health. However, resilience may help to build up resources that can act as a buffer against adverse psychological effects.

The relationship between social media use, anxiety and burden caused by coronavirus (COVID-19) in Spain.

The outbreak of COVID-19 and national restrictions to slow down its spread have significantly changed people's everyday lives. Many people engage in intensive social media use (SMU) to stay up-to-date about the pandemic. The present study investigated the extent of SMU as source of COVID-19 information, and its relationship with anxiety and the experienced burden caused by the pandemic in Spain. Of the 221 participants, 52.5% reported to frequently use SM as information source. The use of other information sources such as print and online newspaper reports, television reports, and official governmental online sites was not associated with anxiety and burden caused by the current COVID-19 situation. However, SMU was significantly positively linked to both variables. Moreover, anxiety significantly mediated the relationship between SMU and the experienced burden. The findings show the potential negative effect of SMU on individual emotional state and behavior during the pandemic. They emphasize the significance of an accurate and conscious use of SM specifically during extraordinary circumstances such as the COVID-19 outbreak.

Eating behaviors, eating styles and body mass index during COVID-19 confinement in a college sample: a predictive model.

BACKGROUND: COVID-19 confinement affected lifestyles. There is inconclusive evidence about changes in eating patterns, and there are few studies on the impact on body mass index (BMI), the occurrence of dysfunctional behaviors (binge eating, fat intake), and the predictive role of maladaptive eating styles (emotional, external, and restrained eating). OBJECTIVES: (1) To analyze the differences in binge eating, fat intake, BMI, and maladaptive eating styles before and during COVID-19 confinement, and (2) to analyze whether maladaptive eating styles (before confinement) predicted binge eating, fat intake, and BMI during confinement. METHODS: The sample consisted of 146 Spanish college students, divided into 104 females (71.2%; age: M = 22.20, SD = 2.97) and 42 males (28.8%; age: M = 24.74; SD = 3.53). All completed several dietary measures and BMI twice: before COVID-19 confinement (T1, November 2019) and during COVID-19 confinement (T2, April 2020). RESULTS: BMI and maladaptive eating styles did not change in T2 (vs. T1). However, binge eating and fat intake decreased in T2. Emotional eating at T1 positively predicted BMI and binge eating at T2. External eating at T1 positively (and marginally) predicted fat intake at T2. Restrained eating at T1 positively predicted binge eating at T2, and negatively (and marginally) predicted BMI and fat intake at T2. The model explained 80.5% of the variance in BMI, 41.5% of the variance in binge eating, and 25.8% of the variance in fat intake during COVID-19 confinement. CONCLUSIONS: The COVID-19 confinement had a positive impact on some eating behaviors. Future policies should focus part of their prevention on maladaptive eating styles to curb dysfunctional eating behaviors and BMI problems in times of stress.

The COVID-19 confinement affected the lifestyles of the young population, especially eating behaviors. It is not yet known whether eating problems, such as binge eating and high fat intake, changed during this period in the young people. It is also not known whether the young population perceived changes in their BMI during COVID-19 confinement. In addition, eating styles (emotional eating, restrictive eating, and external eating) may be predictors of this change. The present study found that binge eating and fat intake decreased in COVID-19 confinement, and BMI and eating styles remained stable. Eating styles predicted change in these eating problems (binge eating and fat intake) and change in BMI during this period of elevated stress. Therefore, eating styles may help to understand dietary changes during times of high stress.

The Impact of a Web-Based Lifestyle Educational Program ('Living Better') Reintervention on Hypertensive Overweight or Obese Patients.

'Living Better', a self-administered web-based intervention, designed to facilitate lifestyle changes, has already shown positive short- and medium-term health benefits in patients with an obesity-hypertension phenotype. The objectives of this study were: (1) to examine the long-term (3-year) evolution of a group of hypertensive overweight or obese patients who had already followed the 'Living Better' program; (2) to analyze the effects of completing this program a second time (reintervention) during the COVID-19 pandemic. A quasi-experimental design was used. We recruited 29 individuals from the 105 who had participated in our first study. We assessed and compared their systolic and diastolic blood pressure (SBP and DBP), body mass index (BMI), eating behavior, and physical activity (PA) level (reported as METs-min/week), at Time 0 (first intervention follow-up), Time 1 (before the reintervention), and Time 2 (post-reintervention). Our results showed significant improvements between Time 1 and Time 2 in SBP (-4.7 (-8.7 to -0.7); p = 0.017), DBP (-3.5 (-6.2 to -0.8); p = 0.009), BMI (-0.7 (-1.0 to -0.4); p < 0.001), emotional eating (-2.8 (-5.1 to -0.5); p = 0.012), external eating (-1.1 (-2.1 to -0.1); p = 0.039), and PA (Time 1: 2308 ± 2266; Time 2: 3203 ± 3314; p = 0.030, Z = -2.17). Statistical analysis showed no significant differences in SPB, DBP, BMI, and eating behavior between Time 0 and Time 1 (p > 0.24). Implementation of the 'Living Better' program maintained positive long-term (3-year) health benefits in patients with an obesity-hypertension phenotype. Moreover, a reintervention with this program during the COVID-19 pandemic produced significant improvements in blood pressure, BMI, eating behavior, and PA.

Impact of COVID19 pandemic on the incidence of health-care associated Clostridioides difficile infection.

OBJECTIVE: To investigate the impact of COVID19 pandemic on the incidence of health-care associated Clostridioides difficile infection (HA-CDI). METHODS: Retrospective study conducted in the Hospital Universitario de Valme (HUV) and the Hospital General Universitario de Alicante (HGUA) in Spain between January 2019 and February 2021. The study period was divided into non-COVID19 period (2019 and months from 2020 to 2021 with ≤30 hospitalized COVID19 patients) and COVID19 period (months from 2020 to 2021 with >30 COVID19 patients). HA-CDI incidence rates (IR) were calculated as the number of new CDI cases per 10.000 occupied bed-days (OBD) and antimicrobial consumption by means of the defined daily dose (DDD) per 1000 OBD. RESULTS: During the COVID19 period, HA-CDI IR in the HUV was 2.6 per 10.000 OBD, which was lower than what was observed during the non-COVID19 period (4.1 per 10.000 OBD; p = 0.1). In the HGUA, HA-CDI IR during COVID19 period was 3.9 per 10.000 OBD, which was not significantly different to the IR observed during the non-COVID19 period (3.7 per 10.000 OBD; p = 0.8). There was a slight increase in the total antibiotic consumption during COVID19 period in both hospitals, with significant increases of certain high-risk antibiotics as cephalosporins. CONCLSUSIONS: HA-CDI incidence has not increased during the COVID19 pandemic in two tertiary centers in Spain, in spite of a slightly higher antibiotic consumption during the COVID19 period in both hospitals. These findings suggest that, in the presence of strict infection control measures, hospital antibiotic consumption might have a lower impact than expected on HA-CDI.

Exploring the Heterogeneity and Trajectories of Positive Functioning Variables, Emotional Distress, and Post-traumatic Growth During Strict Confinement Due to COVID-19.

COVID-19 pandemic-related confinement may be a fruitful opportunity to use individual resources to deal with it or experience psychological functioning changes. This study aimed to analyze the evolution of different psychological variables during the first coronavirus wave to identify the different psychological response clusters, as well as to keep a follow-up on the changes among these clusters. The sample included 459 Spanish residents (77.8% female, Mage = 35.21 years, SDage = 13.00). Participants completed several online self-reported questionnaires to assess positive functioning variables (MLQ, Steger et al. in J Loss Trauma 13(6):511-527, 2006. 10.1080/15325020802173660; GQ-6, McCullough et al. in J Person Soc Psychol 82:112-127, 2002. 10.1037/0022-3514.82.1.112; CD-RISC, Campbell-Sills and Stein in J Traum Stress 20(6):1019-1028, 2007. 10.1002/jts.20271; CLS-H, Chiesi et al. in BMC Psychol 8(1):1-9, 2020. 10.1186/s40359-020-0386-9; SWLS; Diener et al. in J Person Assess, 49(1), 71-75, 1985), emotional distress (PHQ-2, Kroenke et al. in Med Care 41(11):1284-1292, 2003. 10.1097/01.MLR.0000093487.78664.3C; GAD-2, Kroenke et al. in Ann Internal Med 146(5):317-325, 2007. 10.7326/0003-4819-146-5-200703060-00004; PANAS, Watson et al. in J Person Soc Psychol 47:1063-1070, 1988; Perceived Stress, ad hoc), and post-traumatic growth (PTGI-SF; Cann et al. in Anxiety Stress Coping 23(2):127-137, 2010. 10.1080/10615800903094273), four times throughout the 3 months of the confinement. Linear mixed models showed that the scores on positive functioning variables worsened from the beginning of the confinement, while emotional distress and personal strength improved by the end of the state of alarm. Clustering analyses revealed four different patterns of psychological response: "Survival", "Resurgent", "Resilient", and "Thriving" individuals. Four different profiles were identified during mandatory confinement and most participants remained in the same cluster. The "Resilient" cluster gathered the largest number of individuals (30-37%). We conclude that both the heterogeneity of psychological profiles and analysis of positive functioning variables, emotional distress, and post-traumatic growth must be considered to better understand the response to prolonged adverse situations. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s10902-021-00469-z.

What is the Current and Future Status of Digital Mental Health Interventions?

The prevalence of mental disorders continues to increase, especially with the advent of the COVID-19 pandemic. Although we have evidence-based psychological treatments to address these conditions, most people encounter some barriers to receiving this help (e.g., stigma, geographical or time limitations). Digital mental health interventions (e.g., Internet-based interventions, smartphone apps, mixed realities -virtual and augmented reality) provide an opportunity to improve accessibility to these treatments. This article summarizes the main contributions of the different types of digital mental health solutions. It analyzes their limitations (e.g., drop-out rates, lack of engagement, lack of personalization, lack of cultural adaptations) and showcases the latest sophisticated and innovative technological advances under the umbrella of precision medicine (e.g., digital phenotyping, chatbots, or conversational agents). Finally, future challenges related to the need for real world implementation of these interventions, the use of predictive methodology, and hybrid models of care in clinical practice, among others, are discussed.

Corrigendum: Elena+ Care for COVID-19, a Pandemic Lifestyle Care Intervention: Intervention Design and Study Protocol.

[This corrects the article DOI: 10.3389/fpubh.2021.625640.].

Elena+ Care for COVID-19, a Pandemic Lifestyle Care Intervention: Intervention Design and Study Protocol.

Background: The current COVID-19 coronavirus pandemic is an emergency on a global scale, with huge swathes of the population required to remain indoors for prolonged periods to tackle the virus. In this new context, individuals' health-promoting routines are under greater strain, contributing to poorer mental and physical health. Additionally, individuals are required to keep up to date with latest health guidelines about the virus, which may be confusing in an age of social-media disinformation and shifting guidelines. To tackle these factors, we developed Elena+, a smartphone-based and conversational agent (CA) delivered pandemic lifestyle care intervention. Methods: Elena+ utilizes varied intervention components to deliver a psychoeducation-focused coaching program on the topics of: COVID-19 information, physical activity, mental health (anxiety, loneliness, mental resources), sleep and diet and nutrition. Over 43 subtopics, a CA guides individuals through content and tracks progress over time, such as changes in health outcome assessments per topic, alongside user-set behavioral intentions and user-reported actual behaviors. Ratings of the usage experience, social demographics and the user profile are also captured. Elena+ is available for public download on iOS and Android devices in English, European Spanish and Latin American Spanish with future languages and launch countries planned, and no limits on planned recruitment. Panel data methods will be used to track user progress over time in subsequent analyses. The Elena+ intervention is open-source under the Apache 2 license (MobileCoach software) and the Creative Commons 4.0 license CC BY-NC-SA (intervention logic and content), allowing future collaborations; such as cultural adaptions, integration of new sensor-related features or the development of new topics. Discussion: Digital health applications offer a low-cost and scalable route to meet challenges to public health. As Elena+ was developed by an international and interdisciplinary team in a short time frame to meet the COVID-19 pandemic, empirical data are required to discern how effective such solutions can be in meeting real world, emergent health crises. Additionally, clustering Elena+ users based on characteristics and usage behaviors could help public health practitioners understand how population-level digital health interventions can reach at-risk and sub-populations.

Exploring the Heterogeneity and Trajectories of Positive Functioning Variables, Emotional Distress, and Post-traumatic Growth During Strict Confinement Due to COVID-19

Abstract  COVID-19 pandemic-related confinement may be a fruitful opportunity to use individual resources to deal with it or experience psychological functioning changes. This study aimed to analyze the evolution of different psychological variables during the first coronavirus wave to identify the different psychological response clusters, as well as to keep a follow-up on the changes among these clusters. The sample included 459 Spanish residents (77.8% female, Mage = 35.21 years, SDage = 13.00). Participants completed several online self-reported questionnaires to assess positive functioning variables (MLQ, Steger et al. in J Loss Trauma 13(6):511–527, 2006. 10.1080/15325020802173660;GQ-6, McCullough et al. in J Person Soc Psychol 82:112–127, 2002. 10.1037/0022-3514.82.1.112;CD-RISC, Campbell-Sills and Stein in J Traum Stress 20(6):1019–1028, 2007. 10.1002/jts.20271;CLS-H, Chiesi et al. in BMC Psychol 8(1):1–9, 2020. 10.1186/s40359-020-0386-9;SWLS;Diener et al. in J Person Assess, 49(1), 71–75, 1985), emotional distress (PHQ-2, Kroenke et al. in Med Care 41(11):1284–1292, 2003. 10.1097/01.MLR.0000093487.78664.3C;GAD-2, Kroenke et al. in Ann Internal Med 146(5):317–325, 2007. 10.7326/0003-4819-146-5-200703060-00004;PANAS, Watson et al. in J Person Soc Psychol 47:1063–1070, 1988;Perceived Stress, ad hoc), and post-traumatic growth (PTGI-SF;Cann et al. in Anxiety Stress Coping 23(2):127–137, 2010. 10.1080/10615800903094273), four times throughout the 3 months of the confinement. Linear mixed models showed that the scores on positive functioning variables worsened from the beginning of the confinement, while emotional distress and personal strength improved by the end of the state of alarm. Clustering analyses revealed four different patterns of psychological response: “Survival”, “Resurgent”, “Resilient”, and “Thriving” individuals. Four different profiles were identified during mandatory confinement and most participants remained in the same cluster. The “Resilient” cluster gathered the largest number of individuals (30–37%). We conclude that both the heterogeneity of psychological profiles and analysis of positive functioning variables, emotional distress, and post-traumatic growth must be considered to better understand the response to prolonged adverse situations. Supplementary Information The online version contains supplementary material available at 10.1007/s10902-021-00469-z.

Internet-delivered Cognitive-Behavioral Therapy (iCBT) for Adults with Prolonged Grief Disorder (PGD): A Study Protocol for a Randomized Feasibility Trial.

INTRODUCTION: Grief is an emotional reaction to the loss of a loved one with a natural recovery. Approximately 10% of people who lose a loved one develop prolonged grief disorder (PGD). Internet-based and computer-based interventions (ie, internet-delivered cognitive-behavioural therapy, iCBT) are a cost-effective alternative that makes it possible to reach more people with PGD. The main aim of this study is to assess the feasibility of a new iCBT-called GROw-for PGD. As a secondary objective, the potential effectiveness of GROw will be explored. METHODS AND ANALYSIS: This study is a two-arm feasibility randomised trial. A total of 48 adults with PGD who meet the eligibility criteria will be randomised to the experimental group (iCBT: GROw) or the active control group (face-to-face CBT treatment). The treatment is organised sequentially in eight modules in the iCBT format and 8-10 sessions in the face-to-face format, and both formats have the same therapeutic components. There will be five assessment points with qualitative and quantitative evaluations: screening, baseline, after the intervention, 3-month follow-up and 12-month follow-up. Consistent with the objectives, the measures are related to the feasibility outcomes for the main aim of the study (participant adherence, expectations and satisfaction with the treatment, preferences, alliance and utility) and psychological and mental health outcomes for secondary analyses (symptoms of grief, symptoms of depression, symptoms of anxiety, affectivity, quality of life, work and social adaptation, post-traumatic growth, purpose in life, mindfulness and compassion). ETHICS AND DISSEMINATION: The Ethics Committee of the Universitat Jaume I (Castellón, Spain) granted approval for the study (CD/002/2019). Dissemination will include publications and presentations at national and international conferences. TRIAL REGISTRATION NUMBER: NCT04462146.

The impact of strict and forced confinement due to the COVID-19 pandemic on positive functioning variables, emotional distress, and posttraumatic growth in a Spanish sample.

Background: The adverse consequences of the COVID-19 pandemic on mental health have been widely studied in recent months. However, few studies have examined the protective psychological factors that may explain how individuals are coping with the COVID-19 pandemic and its forced confinements. Objective: This study analyzes the impact of confinement due to the COVID-19 pandemic on positive functioning variables (resilience, meaning of life, gratitude, compassion, life satisfaction), emotional distress (depression, anxiety, perceived stress, affect), and posttraumatic growth (PTG). The impact was measured during and after the first month of strict and obligatory confinement in Spain. Methods: The sample was composed of 438 Spanish residents (78.3% women) between the ages of 18 and 68 (M = 35.68; SD = 13.19) during the first stage (first two weeks) of confinement. The sample was reduced to 197 participants during the second stage (fifth week) of confinement. Several online self-reported questionnaires were administered to assess positive functioning variables, emotional distress, and PTG. Results: Women, youths, individuals without a partner, with lower monetary incomes, or diagnosed with a mental disorder or chronic illness experienced lower scores in positive functioning variables and greater emotional distress during the first stage of confinement. Linear mixed models showed that scores on positive functioning variables, emotional distress, and PTG worsened in the second stage of confinement. Nevertheless, a structural equations model showed that increases in positive functioning variables in the second stage were associated with increases in life satisfaction (R2 = .450) and related to decreases in emotional distress (R2 = .186), leading in turn to increases in PTG (R2 = .061). Conclusions: Individuals could experience PTG during strict and mandatory confinement. The increase in PTG during this adverse event was indirectly associated with increases in positive functioning variables (i.e. gratitude, presence of meaning, resilience), through improvements in life satisfaction and emotional distress.

Antecedentes: Las consecuencias adversas de la pandemia de COVID-19 en la salud mental han sido ampliamente estudiadas en los últimos meses. Sin embargo, pocos estudios han examinado los factores psicológicos protectores que pueden explicar cómo los individuos están haciendo frente a la pandemia de COVID-19 y sus confinamientos forzados.Objetivos: Este estudio analiza el impacto del confinamiento debido a la pandemia COVID-19 sobre las variables de funcionamiento positivo (resiliencia, sentido en la vida, gratitud, compasión, satisfacción con la vida), el malestar emocional (depresión, ansiedad, estrés percibido, afecto) y el crecimiento postraumático (CPT). El impacto se midió durante y después del primer mes de un confinamiento estricto y obligatorio en España.Métodos: La muestra estuvo compuesta por 438 residentes españoles (78.3% mujeres), con edades comprendidas entre 18 y 68 años (M= 35.68; DT= 13.19) en la primera medición (las dos primeras semanas de confinamiento). La muestra se redujo a 197 participantes en la segunda medición (la quinta semana de confinamiento). Se administraron varios cuestionarios auto-informados online dirigidos a evaluar las variables de funcionamiento positivo, el malestar emocional y el CPT.Resultados: Los participantes que eran mujeres, más jóvenes, sin pareja, con ingresos económicos más bajos, o diagnosticados con un trastorno mental o enfermedad crónica, experimentaron menores puntuaciones en variables de funcionamiento positivo y mayor malestar emocional en las primeras semanas del confinamiento. Los modelos lineales mixtos mostraron que las puntuaciones en las variables de funcionamiento positivo, el malestar emocional y el CPT empeoraron en la segunda etapa del confinamiento. Sin embargo, un modelo de ecuaciones estructural mostró que los aumentos en la segunda etapa en las variables positivas de funcionamiento se asociaban con aumentos en la satisfacción de la vida (R2 = .450), y se relacionaban con disminuciones en el malestar (R2 = .186), lo que a su vez conducía a aumentos en el CPT (R2 = .061).Conclusiones: Las personas pueden experimentar CPT durante el confinamiento estricto y obligatorio. El aumento de la CPT durante dicho evento adverso se asoció indirectamente con el aumento de las variables de funcionamiento positivo (i.e. gratitud, sentido en la vida, resiliencia), a través de las mejoras en la satisfacción de la vida y el malestar emocional.

The association between depression symptoms, psychological burden caused by Covid-19 and physical activity: An investigation in Germany, Italy, Russia, and Spain.

The outbreak of Covid-19 required the re-organization of everyday life. While some people accepted this challenge, other experienced the current situation as a heavy burden that impedes the adaptation to the new life conditions. The present study investigated factors that can impact the level of burden caused by Covid-19. Burden, depression symptoms and frequency of physical activity (e.g., jogging, cycling) were assessed via online surveys in overall 1,931 people from four countries (Germany: N = 625; Italy: N = 936; Russia: N = 230; Spain: N = 140). Similar result patterns were found in all country-specific samples. Burden by Covid-19 was significantly positively associated with depression symptoms, while it was significantly negatively linked to physical activity. Moreover, physical activity buffered the association between depression symptoms and burden. The present cross-national findings emphasize the protective effect of physical activity specifically in times of Covid-19. This issue should be addressed in governmental programs to longitudinally protect mental and physical health and to enhance the willingness to adhere to the anti-Covid-19 measures among the population.