Social Isolation and Social Support Among Young Adult Vs. Older Adult Cancer Survivors during One Year of the COVID-19 Pandemic: A Propensity Score Matched Analysis

Background/Purpose: Social isolation is associated with worse outcomes among cancer survivors, whereas social support is protective. Social factors are particularly important to evaluate among young adult (YA) cancer survivors aged 18-39 given the rapid social development that occurs during young adulthood, and social isolation may have been exacerbated during the COVID-19 pandemic. We examined differences in social isolation and social support among YA vs. older adult cancer survivors (aged >=40) across one year of the COVID-19 pandemic. Method(s): Participants were recruited to a large cohort study from 11/2020 to 02/2021. PROMIS short forms were used to assess social isolation at enrollment, 2-months, 6-months, and 10-months, and social support (i.e., emotional, instrumental, and informational support and companionship) at 2-months, 4-months, 6-months, 8-months, and 12-months. Propensity score matching to nearest neighbor was used to match YAs with older adult cancer survivors based on demographic and clinical characteristics. Multilevel models were used to evaluate the effects of age (YA vs. older adult), time (month), and the interaction of age and time on social isolation and social support. Result(s): In total, 504 participants were included (252 matched pairs). Most were female (70%), White (81%), and non-Hispanic (83%). YAs were M = 33.6 years (SD = 4.5) and older adults were M = 58.8 years (SD = 10.4). Across age groups and time, average scores for social isolation and social support were within normal ranges. YAs reported more social isolation than older adults (Mpooled = 48.7 and 45.8, respectively;Beta = 2.50, p < 0.01), and social isolation and companionship decreased similarly for YAs and older adults (Beta = -0.12, p = 0.04 and Beta = -0.12, p = 0.02, respectively). No other associations were observed. Conclusions and Implications: YA cancer survivors reported more social isolation than older adults during the COVID-19 pandemic, though differences were small and not clinically meaningful. Future studies should identify patient characteristics associated with high social isolation and low social support to identify subgroups that may benefit from intervention.

Relationships Between Gratitude and Mental Health Difficulties During the COVID-19 Pandemic in a Southern Region of the United States

Introduction: The extensive disruptions of the COVID-19 pandemic have led to heightened concerns about mental health sequelae. There has been significant interest in identifying factors associated with psychosocial vulnerability or resilience. Aims: This study examined associations of trait grat-itude with mental health difficulties among community residents in a southern state of the US. Methods: In this cross-sectional online investigation, 543 adults were assessed during an earlier phase of the pandemic, characterized by the reopening of facilities but mounting infection rates. Participants were evaluated using a validated measure of trait gratitude and clinically relevant screening assessments of depression, anxiety, and trauma symptoms. Results: After adjusting for a range of pandemic-associated burdens and sociodemographic factors, multivariable analyses indicated that gratitude was significantly related to diminished levels of depression, anxiety, and trauma. These effects remained significant after additional adjustment for other psychosocial resources (religiousness and perceived support). Conclusions: Findings provide novel information regarding relationships between gratitude and reduced mental health difficulties among community residents during a stressful period early in the pandemic. Results set the stage for longitudinal research. A disposition to identify and appreciate beneficial experiences might contribute to more favorable adaptation to communal crises, and warrants further investigation.