Posttraumatic growth as a moderator between pandemic-related distress and mental health symptoms in U.S. young adults.

OBJECTIVE: Compared to other age groups, young adults are at risk of suffering COVID-19 pandemic-related psychological problems. Prior research suggests that such adverse events (like the pandemic) can initiate adaptive psychological changes, referred to as posttraumatic growth (PTG); however, limited studies have examined the moderating role of PTG among young adults in the United States with regard to COVID-19-related distress. Thus, this study examines whether pandemic-related distress has a differential effect on young adults' mental health symptoms based on varying levels of PTG. METHOD: Using the data from 661 participants who completed all three waves of the CARES study (T1: April-August 2020; T2: September 2020-March 2021; T3: April-May 2021), a moderator analysis was performed using the PROCESS Macro to determine the moderating effect of PTG. RESULTS: In our data, higher levels of PTG buffered the effects of pandemic-related distress from 2020 on depressive symptoms in 2021; PTG did not show a moderating effect with anxiety as an outcome. CONCLUSIONS: Understanding the moderating role of PTG would help to further understand the mental health trajectories of young adults in the United States who are particularly distressed by the pandemic. Our findings suggest the importance of further exploring contributors to PTG for young adults, particularly among those who have experienced high levels of pandemic-related distress to date. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Provider perspectives on the provision of safe, equitable, trauma-informed care for intimate partner violence survivors during the COVID-19 pandemic: a qualitative study.

BACKGROUND: Early research suggests the COVID-19 pandemic worsened intimate partner violence (IPV) in the US. In particular, stay-at-home orders and social distancing kept survivors in close proximity to their abusers and restricted access to resources and care. We aimed to understand and characterize the impact of the pandemic on delivery of IPV care in Boston. METHODS: We conducted individual interviews with providers of IPV care and support in the Greater Boston area, including healthcare workers, social workers, lawyers, advocates, and housing specialists, who continued to work during the COVID-19 pandemic. Using thematic analysis, we identified themes describing the challenges and opportunites providers faced in caring for survivors during the pandemic. RESULTS: Analysis of 18 interviews yielded four thematic domains, encompassing 18 themes and nine sub-themes. Thematic analysis revealed that the pandemic posed an increased threat to survivors of IPV by exacerbating external stressors and leading to heightened violence. On a system level, the pandemic led to widespread uncertainty, strained resources, amplified inequities, and loss of community. On an individual level, COVID-19 restrictions limited survivors' abilities to access resources and to be safe, and amplified pre-existing inequities, such as limited technology access. Those who did not speak English or were immigrants experienced even more difficulty accessing resources due to language and/or cultural barriers. To address these challenges, providers utilized video and telephone interactions, and stressed the importance of creativity and cooperation across different sectors of care. CONCLUSIONS: While virtual care was essential in allowing providers to care for survivors, and also allowed for increased flexibility, it was not a panacea. Many survivors faced additional obstacles to care, such as language barriers, unequal access to technology, lack of childcare, and economic insecurity. Providers addressed these barriers by tailoring services and care modalities to an individual's needs and circumstances. Going forward, some innovations of the pandemic period, such as virtual interactions and cooperation across care sectors, may be utilized in ways that attend to shifting survivor needs and access, thereby improving safe, equitable, and trauma-informed IPV care.

Impact of the COVID-19 Pandemic on Long-term Recovery From Traumatic Injury.

OBJECTIVE: Determine the proportion and characteristics of traumatic injury survivors who perceive a negative impact of the COVID-19 pandemic on their recovery and to define post-injury outcomes for this cohort. BACKGROUND: The COVID-19 pandemic has precipitated physical, psychological, and social stressors that may create a uniquely difficult recovery and reintegration environment for injured patients. METHODS: Adult (≥18 years) survivors of moderate-to-severe injury completed a survey 6 to 14 months post-injury during the COVID-19 pandemic. This survey queried individuals about the perceived impact of the COVID-19 pandemic on injury recovery and assessed post-injury functional and mental health outcomes. Regression models were built to identify factors associated with a perceived negative impact of the pandemic on injury recovery, and to define the relationship between these perceptions and long-term outcomes. RESULTS: Of 597 eligible trauma survivors who were contacted, 403 (67.5%) completed the survey. Twenty-nine percent reported that the COVID-19 pandemic negatively impacted their recovery and 24% reported difficulty accessing needed healthcare. Younger age, lower perceived-socioeconomic status, extremity injury, and prior psychiatric illness were independently associated with negative perceived impact of the COVID-19 pandemic on injury recovery. In adjusted analyses, patients who reported a negative impact of the pandemic on their recovery were more likely to have new functional limitations, daily pain, lower physical and mental component scores of the Short-Form-12 and to screen positive for PTSD and depression. CONCLUSIONS: The COVID-19 pandemic is negatively impacting the recovery of trauma survivors. It is essential that we recognize the impact of the pandemic on injured patients while focusing on directed efforts to improve the long-term outcomes of this already at-risk population.

Psychosocial correlates of posttraumatic growth among U.S. young adults during the COVID-19 pandemic.

Given the prolonged nature of the COVID-19 pandemic, the purpose of this study was to examine the association between posttraumatic growth (PTG) among young adults during the COVID-19 pandemic and their psychosocial characteristics, specifically: distress tolerance; resilience; family connectedness; depression, anxiety, and PTSD symptoms; and COVID-19-related worry. The study utilized data from 805 U.S. young adults (18-30 years) who completed online surveys during the COVID-19 pandemic across two waves (April-August 2020 and September 2020-March 2021). Overall, young adults reported low PTG scores. PTSD symptoms and COVID-19-related worry significantly predicted higher levels of PTG, while their depression symptoms predicted lower levels of PTG. Resilience and family connectedness significantly predicted higher levels of PTG, and distress tolerance significantly predicted lower levels of PTG after accounting for sociodemographic characteristics and negative influential factors. Compared to Whites, Asians were less likely to report PTG. In general, young adults have not perceived personal growth from the pandemic; however, young adults with certain psychosocial factors appear to be predisposed to such PTG. This study highlights the importance of exploring and elucidating the potential positive trajectories following the adversity of the COVID-19 pandemic.

Duties toward Patients with Psychiatric Illness.

Patients with psychiatric illness feel the brunt of the intersection of many of our society's and our health care system's disparities, and the vulnerability of this population during the Covid-19 pandemic cannot be overstated. Patients with psychiatric illness often suffer from the stigma of mental illness and receive poor medical care. Many patients with severe and persistent mental illness face additional barriers, including poverty, marginal housing, and food insecurity. Patients who require psychiatric hospitalization now face the risk of transmission of Covid-19 due to the inherent difficulties of social distancing within a psychiatric hospital. Patients whose freedom and self-determination have been temporarily overruled as they receive involuntary psychiatric treatment deserve a setting that maintains their health and safety. While tele-mental health has been rapidly expanded to provide new ways to access psychiatric treatment, some patients may have limitations in technological literacy or access to devices. The social isolation, economic fallout, and potential traumatization related to the current pandemic will disproportionately affect this vulnerable population, and society's duties to them must be considered.