Anxiety and depressive symptoms among migrants during the COVID-19 pandemic in Norway: A two-wave longitudinal study

This study was designed to examine the impact of the COVID-19 pandemic on the mental health of migrants living in Norway. We conducted a longitudinal two-waves survey among a sample of 574 migrants and multilevel modelling was used to analyse anxiety, health anxiety and depressive symptoms. Demographic and psychological predictors were investigated. The levels of anxiety, health anxiety and depressive symptoms among migrants decreased from the lockdown (strict social distancing protocols) to phaseout. Reductions in maladaptive coping strategies were related to parallel reductions in anxiety, health anxiety, and depression, and a reduction in loneliness was related to a reduction in depression. The results indicate that the elevated levels of anxiety, health anxiety and depressive symptoms among migrants in the first phase of the pandemic may be temporary.

Viral mitigation and the COVID-19 pandemic: factors associated with adherence to social distancing protocols and hygienic behaviour.

OBJECTIVE: To investigate the factors associated with adherence to viral mitigation protocols during the COVID-19 pandemic. DESIGN: This epidemiological cross-sectional study examines adherence to behaviour in 4158 adults and its relationship with sources of information. MAIN OUTCOME MEASURES: Adherence to social distancing protocols (SDPs) and adherence to hygienic behaviour (HB) recommendations. RESULTS: Individuals aged 18-30 reported lowest adherence to SDPs and HB. Alcohol consumption was associated with lower adherence. Increased risk perception, fear of infection and altruistic attitude were associated with greater adherence. Males, single and childless individuals reported lower adherence. Extroverts and urban residents reported lower adherence to SDPs, but not HB. In contrast to earlier stages of the pandemic, voluntary social distancing was associated with greater adherence to SDPs as opposed to rule-enforced social distancing. Regarding information obtainment, increased time spent acquiring information from recognised newspapers had the strongest favourable association with adherence. Relying on information from friends and family was associated with decreased adherence to SDPs. Sensitivity analyses replicated the findings, supporting the stability and robustness of the proposed models. CONCLUSION: This study identifies factors associated with favourable and detrimental adherence behaviour along with substantial dissemination routes, presenting strategies that may be of utility towards fostering adherence to contemporaneously implemented mitigation protocols.

Anxiety and depressive symptoms among migrants during the COVID-19 pandemic in Norway: A two-wave longitudinal study.

This study was designed to examine the impact of the COVID-19 pandemic on the mental health of migrants living in Norway. We conducted a longitudinal two-waves survey among a sample of 574 migrants and multilevel modelling was used to analyse anxiety, health anxiety and depressive symptoms. Demographic and psychological predictors were investigated. The levels of anxiety, health anxiety and depressive symptoms among migrants decreased from the lockdown (strict social distancing protocols) to phaseout. Reductions in maladaptive coping strategies were related to parallel reductions in anxiety, health anxiety, and depression, and a reduction in loneliness was related to a reduction in depression. The results indicate that the elevated levels of anxiety, health anxiety and depressive symptoms among migrants in the first phase of the pandemic may be temporary.

Daily dynamics and mechanisms of anxious symptomatology in the general population: A network study during the COVID-19 pandemic.

To understand the interplay between anxiety symptoms and their maintaining psychological processes in the population, an analysis of longitudinal within-person relationships is required. A sample of 1706 individuals completed daily measures during a 40-day period with strict mitigation protocols. Data of 1368 individuals who completed at least 30 assessments were analyzed with the multilevel vector autoregressive (mlVAR) model. This model estimates a temporal, a contemporaneous, and a between-person network. Uncontrollability of worry, generalized worry, fear of being infected, fear of significant others being infected, and threat monitoring had the highest outstrength within the temporal network, indicating that daily fluctuations in these components were the most predictive of next-day fluctuations in other components. Of specific connections, both fear of self and fear of close others being infected predicted generalized worry and threat monitoring. In turn, generalized worry and threat monitoring engaged in several positive feedback loops with other anxiety symptoms and processes. Also, intolerance of uncertainty was predictive of other components. The findings align with the mechanisms both in the metacognitive therapy (MCT) model and in the intolerance of uncertainty model of generalized anxiety disorder (GAD).

A critical period for pandemic adaptation: The evolution of depressive symptomatology in a representative sample of adults across a 17-month period during COVID-19.

This 17-month longitudinal study on a representative sample of 4,361 Norwegian adults employs an observational ABAB design across 6 repeated assessments and 3 pandemic waves to systematically investigate the evolution of depressive symptomatology across all modifications of social distancing protocols (SDPs) from their onset to termination. Using Latent Change Score Models to analyze 26,166 observations, the study empirically corroborates that critical fluctuations in depressive symptomatology within and across individuals occur during the first 3 months of the pandemic, after which symptom profiles are predominantly consolidated throughout the pandemic period. Contrary to established belief, female sex, young age, lower education and preexisting psychiatric diagnosis only served as adequate predictors of the initial shocks to symptomatology observed during the onset of the pandemic and did not adequately predict subsequent change observed in symptoms within and across individuals. Population-level analyses demonstrated that symptom levels strongly covaried with the presence and strictness of SDPs and were unrelated to COVID-19 incidence rates. Upon predominant termination of SDPs, population-level symptoms began declining, while large heterogeneity was present across the adult population. Detrimental long-term adversities were revealed by 10% of the adults. These individuals displayed chaotic adaptation to the pandemic and its SDPs, exhibiting substantial increases in clinical levels of symptomatology ensuing partial reopening of society and through the remainder of the pandemic, with these deleterious symptoms projected to remain heightened ahead. Frequency of quarantine exposure was incrementally tied with increases in contemporaneously experienced and long-term depressive adversities, with information obtainment through unmonitored sources further associated with contemporaneous and long-term states of heightened symptomatology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Anxiety in the adult population from the onset to termination of social distancing protocols during the COVID-19: a 20-month longitudinal study.

The social distancing protocols (SDPs) implemented as a response to the COVID-19 pandemic may seriously influence peoples' mental health. We used a sample of 4361 Norwegian adults recruited online and stratified to be nationally representative to investigate the evolution of anxiety following each modification in national SDPs across a 20-month period from the onset of the pandemic to the reopening of society and discontinuation of SDPs. The mean anxiety level fluctuated throughout the observation period and these fluctuations were related to the stringency of the modified SDPs. Those with a high initial level almost in unison showed a substantial and lasting decrease of anxiety after the first lifting of SDPs. A sub-group of 9% had developed a persistent anxiety state during the first 3 months. Younger age, pre-existing psychiatric diagnosis, and use of unverified information platforms proved to predict marked higher anxiety in the long run. In conclusion, individuals with a high level of anxiety at the outbreak of the pandemic improved when the social distancing protocols were lifted. By contrast, a sizeable subgroup developed lasting clinical levels of anxiety during the first 3 months of the pandemic and is vulnerable to prolonged anxiety beyond the pandemic period.

Psychological well-being in times of COVID-19: Associated factors and levels in the general population.

The COVID-19 pandemic and living under social distancing restrictions have been hypothesized to impact well-being and mental health in the general population. This study investigated the general Norwegian adult population's well-being after implementing and lifting strict social distancing restrictions. The study was conducted through digital surveys; during the implementation of strict social distancing restrictions in March 2020 (T1) and 3 months later, when the preponderance of strict distancing restrictions was discontinued (T2). Well-being was measured at T2. Four thousand nine hundred twenty-one individuals participated, and a sensitivity analysis was conducted to ensure that the sample reflects the true Norwegian adult population. Hierarchical regression analyses show that contemporaneous employment status and positive metacognitions at T2 were associated with higher well-being. Negative metacognitions and the use of unhelpful coping strategies at T2 had a contemporaneous association with lower mental well-being. Negative metacognitions at T1 were associated with lower well-being scores, while positive metacognitions at T1 were positively associated with higher well-being. An indirect association between social distancing and lower well-being was found through heightened depressive symptoms. These results contribute to understanding how social distancing restrictions relate to general well-being, which may further contribute to designing proper strategies to strengthen mental health and well-being during challenging and unavoidable societal conditions.

Psychiatric symptoms in COVID-19-positive individuals in the general population: Trajectories of depression, anxiety, and insomnia.

The present study investigates differences in the trajectories of anxiety, depression, and sleep problems among infected versus non-infected case-controlled individuals. Patients who tested positive for COVID-19 were selected from a representative sample in Norway (N > 10,000). In total, 126 of these individuals were infected during the project period, and this group was analyzed at T5 (May 2021). Of these positive cases, those who had completed both PHQ-9 and GAD-7 at all three measurement points were selected for longitudinal analysis using multilevel modeling. There was a significant difference at T5 between those who had tested positive for COVID-19 and matched controls. Anxiety and depression were reduced among those who tested positive, but there were no differences in trajectory when compared to matched controls. Limitations include the use of self-report measures and the assessment of symptoms at a time when strict virus mitigation protocols were in place. The present findings indicate that individuals who test positive for COVID-19 exhibit higher levels of depressive symptoms after restrictions are lifted. However, comparison of anxiety and depression symptom trajectories with matched controls reveals that both groups exhibited stable or slightly decreased symptoms.

Trait Versus State Predictors of Emotional Distress Symptoms: The Role of the Big-5 Personality Traits, Metacognitive Beliefs, and Strategies.

ABSTRACT: To enhance formulation and interventions for emotional distress symptoms, research should aim to identify factors that contribute to distress and disorder. One way to formulate emotional distress symptoms is to view them as state manifestations of underlying personality traits. However, the metacognitive model suggests that emotional distress is maintained by metacognitive strategies directed by underlying metacognitive beliefs. The aim of the present study was therefore to evaluate the role of these factors as predictors of anxiety and depression symptoms in a cross-sectional sample of 4936 participants collected during the COVID-19 pandemic. Personality traits (especially neuroticism) were linked to anxiety and depression, but metacognitive beliefs and strategies accounted for additional variance. Among the predictors, metacognitive strategies accounted for the most variance in symptoms. Furthermore, we evaluated two statistical models based on personality traits versus metacognitions and found that the latter provided the best fit. Thus, these findings indicate that emotional distress symptoms are maintained by metacognitive strategies that are better accounted for by metacognitions compared with personality traits. Theoretical and clinical implications of these findings are discussed.

Metacognitive beliefs, maladaptive coping strategies, and depressive symptoms: A two-wave network study of the COVID-19 lockdown and reopening.

To address the increased levels of depressive symptoms during the COVID-19 and other pandemics, it is useful to identify the psychological processes that may explain the relationship between pandemic-related stressors and symptoms. In this study, both the combined network of metacognitions and maladaptive coping strategies-derived from the metacognitive therapy model-and the depressive symptoms were studied during the COVID-19 related lockdown and the partial reopening of the Norwegian society about 3 months later. In an online survey, 4936 participants responded at both these time points. They completed the Cognitive Attentional Syndrome-1 and the Patient Health Questionnaire-9. The combined process and symptom networks were estimated. The maladaptive coping strategies worry/rumination, avoidance, and thought suppression and the symptoms depressed mood and worthlessness showed both high strength centrality at the lockdown and, at least, moderate correlations between their change and overall symptom change from the lockdown to the reopening. None of the metacognitive beliefs attained these criteria. From the lockdown to the reopening, no change in strength centrality was observed. The network structure, however, was significantly different across the periods and several different connections (edge weights) between variables were revealed. For instance, low energy showed a stronger connection to anhedonia and a weaker connection to sleep problems during the reopening than during the lockdown. In conclusion, worry/rumination, avoidance, and thought suppression may maintain central depressive symptoms such as depressed mood and worthlessness during the COVID-19 pandemic. These propositions are actionable as they give access to well-established interventions.

Acute COVID-19 severity and mental health morbidity trajectories in patient populations of six nations: an observational study.

BACKGROUND: Long-term mental and physical health consequences of COVID-19 (long COVID) are a persistent public health concern. Little is still known about the long-term mental health of non-hospitalised patients with COVID-19 with varying illness severities. Our aim was to assess the prevalence of adverse mental health symptoms among individuals diagnosed with COVID-19 in the general population by acute infection severity up to 16 months after diagnosis. METHODS: This observational follow-up study included seven prospectively planned cohorts across six countries (Denmark, Estonia, Iceland, Norway, Sweden, and the UK). Participants were recruited from March 27, 2020, to Aug 13, 2021. Individuals aged 18 years or older were eligible to participate. In a cross-sectional analysis, we contrasted symptom prevalence of depression, anxiety, COVID-19-related distress, and poor sleep quality (screened with validated mental health instruments) among individuals with and without a diagnosis of COVID-19 at entry, 0-16 months from diagnosis. In a cohort analysis, we further used repeated measures to estimate the change in mental health symptoms before and after COVID-19 diagnosis. FINDINGS: The analytical cohort consisted of 247 249 individuals, 9979 (4·0%) of whom were diagnosed with COVID-19 during the study period. Mean follow-up was 5·65 months (SD 4·26). Participants diagnosed with COVID-19 presented overall with a higher prevalence of symptoms of depression (prevalence ratio [PR] 1·18 [95% CI 1·03-1·36]) and poorer sleep quality (1·13 [1·03-1·24]) but not symptoms of anxiety (0·97 [0·91-1·03]) or COVID-19-related distress (1·05 [0·93-1·20]) compared with individuals without a COVID-19 diagnosis. Although the prevalence of depression and COVID-19-related distress attenuated with time, individuals diagnosed with COVID-19 but never bedridden due to their illness were consistently at lower risk of depression (PR 0·83 [95% CI 0·75-0·91]) and anxiety (0·77 [0·63-0·94]) than those not diagnosed with COVID-19, whereas patients who were bedridden for more than 7 days were persistently at higher risk of symptoms of depression (PR 1·61 [95% CI 1·27-2·05]) and anxiety (1·43 [1·26-1·63]) than those not diagnosed throughout the study period. INTERPRETATION: Severe acute COVID-19 illness-indicated by extended time bedridden-is associated with long-term mental morbidity among recovering individuals in the general population. These findings call for increased vigilance of adverse mental health development among patients with a severe acute disease phase of COVID-19. FUNDING: Nordforsk, Horizon2020, Wellcome Trust, and Estonian Research Council.

Mechanisms associated with the trajectory of depressive and anxiety symptoms: A linear mixed-effects model during the COVID-19 Pandemic.

With the fluctuations in anxious and depressive symptomatology accompanied by the pandemic crises, studies on the trajectories of these symptom domains are warranted to monitor the development of mental health problems in the population. This pre-registered longitudinal study examines stable factors and mechanistic processes covarying with the trajectory of anxiety and depressive symptoms using linear-mixed effects models in 4936 adults from the pandemic's onset to four months into the COVID-19 pandemic in Norway. Prevalence estimates of moderate to severe levels of clinically impairing symptoms of anxiety and depression revealed high but reduced occurrence four months into the pandemic where social distancing protocols were substantially lightened in severity, revealing associations between symptoms and viral mitigation protocols after stringent control of plausible confounders. Subgroups at risk at the onset of the pandemic sustained their relative position compared to their counterparts four months into the pandemic, indicating prolonged suffering of these subgroups. Among mechanistic processes, key differences were identified regarding the trajectory of anxiety and depressive symptoms. Physical exercise was associated with long-term but not momentaneous alleviations in anxiety. In contrast, reductions in depressive symptoms were associated with both the simultaneous exertion as well as dose-increases in exercise over time. Increased knowledge about how to best cope with pandemic challenges was associated with greater improvement in depressive but not anxiety symptoms. Reductions in maladaptive coping strategies and negative metacognitive beliefs was substantially associated with greater improvement of both anxious and depressive symptomatology. Mechanistic processes divergently relate to the trajectory of depressive and anxious symptomatology, yielding domain-specific information of utility for preventive and interventive efforts aimed at impeding deleterious symptom levels. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12144-022-02732-9.

Parental burnout during the COVID-19 pandemic.

Increased and long-term parental stress related to one's parental role can lead to parental burnout. In the early phase of the COVID-19 pandemic, families experienced intensified pressure due to the government-initiated contact restrictions applied to prevent the spread of the virus in the population. This study investigates the risk factors and predictors of parental burnout in a large sample of parents (N = 1488) during the COVID-19 pandemic in Norway. Demographic and psychosocial factors were assessed at two timepoints: at the beginning of the pandemic outbreak in March 2020 (T1) and at 3 months follow-up (T2). A hierarchical regression analysis was applied to identify the factors that contribute to parental burnout at T2. Parental burnout was additionally explored across subgroups. Findings revealed that younger age was associated with more parental burnout. Concurrent (T2) use of unhelpful coping strategies, insomnia symptoms, parental stress, and less parental satisfaction was significantly associated with the presence of greater parental burnout (T2). Additionally, parental stress and satisfaction measured in the earliest phase of the pandemic (T1) were associated with parental burnout 3 months later (T2) over and above concurrent parental stress/satisfaction. Unemployed parents and individuals with a mental health condition were identified as subgroups with substantially heightened levels of parental burnout.

El estrés cada vez mayor y a largo plazo relacionado con el papel que desempeñan los padres puede conducir al agotamiento parental. En la primera fase de la pandemia de la COVID-19, las familias sufrieron cada vez más presión debido a las restricciones en el contacto iniciadas por el gobierno que se aplicaron para prevenir la propagación del virus en la población. En este estudio se investigan los factores de riesgo y los factores pronósticos del agotamiento parental en una muestra grande de padres (N = 1488) durante la pandemia de la COVID-19 en Noruega. Se evaluaron factores demográficos y psicosociales en dos intervalos de tiempo: al comienzo de la pandemia en marzo de 2020 (primera fase) y tres meses después (segunda fase). Se aplicó un análisis de regresión jerárquica para identificar los factores que contribuyen al agotamiento de los padres en la segunda fase. Además, se analizó el agotamiento de los padres entre subgrupos. Los resultados revelaron que las edades más jóvenes estuvieron asociadas con un mayor agotamiento parental. El uso simultáneo (en la segunda fase) de estrategias de afrontamiento poco útiles, los síntomas de insomnio, el estrés de los padres y una menor satisfacción de los padres estuvieron asociados significativamente con la presencia de un mayor agotamiento de los padres (segunda fase). Además, el estrés y la satisfacción de los padres medidos en la fase inicial de la pandemia (primera fase) estuvieron asociados con el agotamiento de los padres tres meses después (segunda fase) por encima del estrés y la satisfacción simultáneos de los padres. Los padres y las personas desempleadas con una enfermedad de salud mental se identificaron como subgrupos con niveles considerablemente elevados de agotamiento parental.

Parenting in a Pandemic: Parental stress, anxiety and depression among parents during the government-initiated physical distancing measures following the first wave of COVID-19.

Drawing on the tenets of family stress theory, the aim of this study is to examine parents' perceived stress, symptoms of anxiety, depression, and associated risk- and protective factors across demographic subgroups during in the first wave of the COVID-19 pandemic. Norwegian parents (N = 2868; 79.5% mothers) with >1 child under 18 years of age completed an online survey two weeks after the implementation of government-initiated distancing measures. The survey includes measures of COVID-related risk factors (parental stress, burnout, depression, anxiety, anger of parents towards children, difficulty working from home, and positive beliefs about worry) and protective factors (self-efficacy and social support). Mothers, parents living with more than one child, and parents with a psychiatric diagnosis reported greater levels of parental stress, more burnout, and more anger towards their children, as well as less social support. Almost 25% of the parents reported anxiety and depression that are clinically significant. Parents who followed distancing measures reported significantly higher distress. Anger of parents towards children explains 41% of the variation in parental stress. These findings indicate that parents have experienced symptoms of deteriorated mental health due to the COVID- 19 pandemic, including parental stress, anxiety, and depression. The study presents practical implications for meso- and macro-level policymaking and offers support to further the potential aims of public health and clinical interventions. Future studies to monitor long-term aversive mental health outcomes among parents are warranted.

Within- and across-day patterns of interplay between depressive symptoms and related psychopathological processes: a dynamic network approach during the COVID-19 pandemic.

BACKGROUND: In order to understand the intricate patterns of interplay connected to the formation and maintenance of depressive symptomatology, repeated measures investigations focusing on within-person relationships between psychopathological mechanisms and depressive components are required. METHODS: This large-scale preregistered intensive longitudinal study conducted 68,240 observations of 1706 individuals in the general adult population across a 40-day period during the COVID-19 pandemic to identify the detrimental processes involved in depressive states. Daily responses were modeled using multi-level dynamic network analysis to investigate the temporal associations across days, in addition to contemporaneous relationships between depressive components within a daily window. RESULTS: Among the investigated psychopathological mechanisms, helplessness predicted the strongest across-day influence on depressive symptoms, while emotion regulation difficulties displayed more proximal interactions with symptomatology. Helplessness was further involved in the amplification of other theorized psychopathological mechanisms including rumination, the latter of which to a greater extent was susceptible toward being influenced rather than temporally influencing other components of depressive states. Distinctive symptoms of depression behaved differently, with depressed mood and anhedonia most prone to being impacted, while lethargy and worthlessness were more strongly associated with outgoing activity in the network. CONCLUSIONS: The main mechanism predicting the amplifications of detrimental symptomatology was helplessness. Lethargy and worthlessness revealed greater within-person carry-over effects across days, providing preliminary indications that these symptoms may be more strongly associated with pushing individuals toward prolonged depressive state experiences. The psychopathological processes of rumination, helplessness, and emotion regulation only exhibited interactions with the depressed mood and worthlessness component of depression, being unrelated to lethargy and anhedonia. The findings have implications for the impediment of depressive symptomatology during and beyond the pandemic period. They further outline the gaps in the literature concerning the identification of psychopathological processes intertwined with lethargy and anhedonia on the within-person level.

Insomnia Symptoms in the General Population During the COVID-19 Pandemic.

This empirical study aims to investigate factors associated with insomnia symptoms during the COVID-19 pandemic in 4,921 Norwegian adults. Participants were queried across two time-points, between March 31st and April the 7th 2020, and between June 22nd and July 13th, 2020. Relevant risk factors and psychological correlates at the first time-point and insomnia symptoms were measured 3 months later, allowing for the investigation of concurrent associations as well as associations across time. Insomnia symptoms were measured with the Bergen Insomnia Scale. The results revealed that individuals reported higher mean levels of insomnia symptoms during the COVID-19 lockdown, compared to pre-pandemic surveys from 2008 (p < 0.0001, Cohen's d = 0.29). Individuals who predominantly socially distanced reported higher mean levels of insomnia symptoms than those who did not predominantly distance. Females, individuals with lower education levels, individuals who had lost their job, and individuals who declared having been diagnosed with an unspecified pre-existing psychiatric disorder reported the most symptoms. The regression model (R2 = 0.44) showed that physical exercise, was associated with less symptoms of insomnia. Symptoms of health Anxiety, symptoms of depression, unhelpful coping strategies, worry about job and economy, and older age were all associated with higher levels of insomnia symptoms. These findings highlight particularly vulnerable subgroups, as well as providing clinicians with key areas of intervention to help individuals suffering from insomnia symptoms.

Pandemic Information Dissemination and Its Associations With the Symptoms of Mental Distress During the COVID-19 Pandemic: Cross-sectional Study.

BACKGROUND: The 2020-2021 COVID-19 pandemic has added to the mental health strain on individuals and groups across the world in a variety of ways. Viral mitigation protocols and viral spread affect people on all continents every day, but at widely different degrees. To understand more about the mental health consequences of the pandemic, it is important to investigate whether or how people gather pandemic-related information and how obtaining this information differentially affects individuals. OBJECTIVE: This study aimed to investigate whether and to what extent higher levels of COVID-19-related media consumption across information sources are associated with the symptoms of anxiety, health anxiety, and depression, and whether and to what extent using social media and online interactive platforms versus traditional media platforms is associated with the symptoms of anxiety, health anxiety, and depression. Additionally, we aimed to investigate whether and to what extent avoidance of COVID-19-related information is associated with the aforementioned symptoms. METHODS: In a cross-sectional preregistered survey, 4936 participants responded between June 22 and July 13, 2020. Eligible participants were adults currently residing in Norway and were thus subjected to identical viral mitigation protocols. This sample was representative of the Norwegian population after utilizing an iterative raking algorithm to conduct poststratification. As 2 subgroups (transgender and intersex individuals) were too small to be analyzed, the final sample for descriptive statistics and regressions included 4921 participants. Multiple regressions were used to investigate associations between the symptoms of psychopathology and COVID-19-related information dissemination. Part correlations were calculated as measures of the effect size for each predictor variable. Due to the large anticipated sample size, the preregistered criterion for significance was set at P<.01. RESULTS: The symptoms of anxiety and health anxiety were significantly associated with obtaining information from newspapers (P<.001), social media (P<.001), and the broader categories of online interactive (P<.001) and traditional media (P<.001). The symptoms of depression were significantly associated with obtaining information from newspapers (P=.003), social media (P=.009), and the broader category of online interactive media (P<.001). Additionally, avoidance of COVID-19-related information showed a significant association in all 3 domains of psychopathological symptoms (anxiety and depression, P<.001; health anxiety, P=.007). CONCLUSIONS: This study found significant associations between the symptoms of psychopathology and the use of media for obtaining information related to the COVID-19 pandemic. Significant findings for obtaining information through newspapers, social media, and online interactive media were seen across all 3 measures of psychopathology. Avoidance of COVID-19-related information and associations with the symptoms of psychopathology emerged as core findings, with generally higher effect sizes compared with information attainment. TRIAL REGISTRATION: ClinicalTrials.gov NCT04442360; https://clinicaltrials.gov/ct2/show/NCT04442360.

Feelings of worthlessness links depressive symptoms and parental stress: A network analysis during the COVID-19 pandemic.

BACKGROUND: The prevalent co-occurrence between parental stress and depression has been established prior to and during the COVID-19 pandemic outbreak. However, no studies to date have identified the connections through which these symptom domains interact with each other to emerge into a complex and detrimental mental health state, along with the plausible mechanistic variables that may play key roles in maintaining parental stress and depression. The aim of this research is to uncover these interactions in a period where parents experience heightened demands and stress because of the strict social distancing protocols. METHODS: Network analysis is utilized to examine parental stress and depressive symptoms during the COVID-19 pandemic in a large cross-sectional study (N = 2,868) of parents. Two graphical Gaussian graphical network models were estimated, one in which only parental stress and depression symptoms were included, and another in which several mechanistic variables were added. RESULTS: Expected influence and bridge expected influence revealed that feeling worthless was the most influential node in the symptoms network and bridged the two psychological states. Among the mechanistic variables, worry and rumination was specifically relevant in the depressive cluster of symptoms, and self-criticism was connected to both constructs. CONCLUSION: The study displays that the co-occurrence of parental stress and depression has specific pathways, was manifested through feelings of worthlessness, and has specific patterns of connection to important mechanisms of psychopathology. The results are of utility when aiming to avoid the constellation of co-occurring parental stress and depressive symptoms during the pandemic.

Loneliness during the COVID-19 pandemic: change and predictors of change from strict to discontinued social distancing protocols.

BACKGROUND AND OBJECTIVES: The COVID-19 pandemic and the social distancing protocols designed to impede transmission of the corona virus have severe mental health consequences. This study examine changes in loneliness in the general adult population when the corona-related social distancing protocols were largely discontinued (T2) following a period of strict protocols (T1), predictors and correlates of these changes, and the associations between loneliness and depression and anxiety symptoms. DESIGN: In an online survey, 10,061 responded at T1. At T2, these respondents were asked to complete the survey again, and 4936 (49.1%) of them responded. RESULTS: Loneliness decreased from T1 to T2, but only to a minor extent. Using a multilevel approach, younger age was found to be related to more reduction of loneliness from T1 to T2. Higher health anxiety was found to predict less reduction of loneliness across time. Reduction of maladaptive coping strategies and negative metacognitive beliefs from T1 to T2 were both associated with reduction in loneliness. In turn, reductions in loneliness were associated with reductions of depression and anxiety symptoms. CONCLUSIONS: The results suggest that health anxiety, maladaptive coping strategies and negative meta-beliefs are potential targets of intervention to alleviate loneliness. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT04444115.