Networks of pandemic-specific stressors, risk factors, and clinical symptoms: A comparison between women and men during the early phase of the COVID-19 pandemic.

BACKGROUND: During the COVID-19 pandemic, female gender was a robust factor associated with mental health problems. This study aimed to investigate associations between pandemic-related risk factors, stressors, and clinical symptoms, with special reference to gender and possible differential gender effects. METHODS: Participants were recruited from June to September 2020 through an online survey (ESTSS ADJUST study). Women (N = 796) and men (N = 796) were matched on age, education, income, and living community. Symptoms of depression (PHQ-9), anxiety (PHQ-4), adjustment disorder (ADNM-8), and PTSD (PC-PTSD-5) and different risk factors including pandemic-specific stressors (PaSS) were assessed. Separate network analyses for men and women were conducted and compared followed by a joint network analysis including gender. RESULTS: The networks of women and men did not differ in their structure (M = 0.14, p = .174) or strength of associations (S = 1.22, p = .126). Few relationships differed significantly between genders e.g., the connection between burden through work-related problems and anxiety was stronger in women. In the joint network, single factors were related to gender e.g., men felt more burdened through work-related problems and women through conflicts at home. LIMITATIONS: We cannot imply causal relationships due to the cross-sectional data of our study. The findings cannot be generalized as the sample is not representative. CONCLUSION: Men and women seem to show comparable networks of risk factors, stressors, and clinical symptoms, although differences in individual connections and in levels of clinical symptoms and burdens were found.

Risk and protective factors for posttraumatic stress disorder in trauma-exposed individuals during the COVID-19 pandemic-Findings from a pan-European study

Background: The COVID-19 pandemic is a health emergency resulting in multiple stressors that may be related to posttraumatic stress disorder (PTSD). Objective: This study examined relationships between risk and protective factors, pandemic-related stressors, and PTSD during the COVID-19 pandemic. Methods: Data from the European Society of Traumatic Stress Studies (ESTSS) ADJUST Study were used. N = 4,607 trauma-exposed participants aged 18 years and above were recruited from the general populations of eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. We assessed sociodemographic (e.g. gender), pandemic-related (e.g. news consumption), and health-related (e.g. general health condition) risk and protective factors, pandemic-related stressors (e.g. fear of infection), and probable PTSD (PC-PTSD-5). The relationships between these variables were examined using logistic regression on multiple imputed data sets. Results: The prevalence of probable PTSD was 17.7%. Factors associated with an increased risk for PTSD were younger age, female gender, more than 3 h of daily pandemic-related news consumption (vs. no consumption), a satisfactory, poor, or very poor health condition (vs. a very good condition), a current or previous diagnosis of a mental disorder, and trauma exposure during the COVID-19 pandemic. Factors associated with a reduced risk for PTSD included a medium and high income (vs. very low income), face-to-face contact less than once a week or 3-7 times a week (vs. no contact), and digital social contact less than once a week or 1-7 days a week (vs. no contact). Pandemic-related stressors associated with an increased risk for PTSD included governmental crisis management and communication, restricted resources, restricted social contact, and difficult housing conditions. Conclusion: We identified risk and protective factors as well as stressors that may help identify trauma-exposed individuals at risk for PTSD, enabling more efficient and rapid access to care. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Spanish) Antecedentes: La pandemia COVID-19 es una emergencia sanitaria que genera multiples estresores que pueden estar relacionados con el trastorno de estres postraumatico (TEPT). Objetivo: Este estudio examino las relaciones entre los factores de riesgo y protectores, estresores relacionados con la pandemia y TEPT durante la pandemia de COVID-19. Metodos: Se utilizaron los datos del estudio ADJUST de la Sociedad Europea de Estudios de Estres Traumatico (ESTSS por sus siglas en ingles). N = 4.607 participantes mayores de 18 anos expuestos a trauma fueron reclutados de la poblacion general de once paises (Austria, Croacia, Georgia, Alemania, Grecia, Italia, Lituania, Paises Bajos, Polonia, Portugal y Suecia) desde junio a noviembre 2020. Evaluamos factores de riesgo y protectores sociodemograficos (p.ej. genero), relacionados con la pandemia (p.ej. consumo de noticias) y relacionados con la salud (p.ej. estado de salud general), estresores relacionados con la pandemia (p.ej. temor a la infeccion) y TEPT probable (PC-PTSD-5 por sus siglas en ingles). Las relaciones entre estas variables se examinaron mediante regresion logistica en multiples conjuntos de datos imputados. Resultados: La prevalencia de TEPT probable fue del 17.7%. Los factores asociados con un mayor riesgo de TEPT fueron edad mas joven, sexo femenino, mas de 3 horas de consumo diario de noticias relacionadas con la pandemia (frente a ningun consumo), un estado de salud satisfactorio, malo o muy malo (frente a un estado muy bueno), un diagnostico de trastorno mental actual o previo y exposicion a un trauma durante la pandemia de COVID-19. Los factores asociados con un riesgo reducido de TEPT incluyeron ingresos medios y altos (frente a ingresos muy bajos), contacto cara a cara menos de una vez a la semana o de 3 a 7 veces por semana (frente a ningun contacto) y contacto social digital menos de una vez a la semana o de 1 a 7 dias a la semana (frente a ningun contacto). Los estresores relacionados con la pandemia asociados con un mayor riesgo de TEPT incluyeron la gestion y comunicacion de crisis gubernamental, recursos restringidos, contacto social restringido y condiciones de vivienda dificiles. Conclusiones: Identificamos factores de riesgo y protectores, asi como estresores que pueden ayudar a identificar a las personas expuestas a traumas en riesgo de TEPT, lo que permite un acceso mas eficiente y rapido a la atencion. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Profiles of risk factors for depressive and anxiety symptoms during the COVID-19 pandemic: A latent class analysis

The COVID-19 pandemic has caused a high burden in the general population. The exposure to an accumulation of risk factors, as opposed to a single risk, may have been associated with higher levels of depressive and anxiety symptoms during the pandemic. This study aimed to (1) identify subgroups of individuals with distinct constellations of risk factors during the COVID-19 pandemic and (2) investigate differences in levels of depressive and anxiety symptoms. German participants (N = 2,245) were recruited between June-September 2020 through an online survey (ADJUST study). Latent class analysis (LCA) and multiple group analyses (Wald-tests) were conducted to identify profiles of risk factors and examine differences in symptoms of depression (PHQ-9) and anxiety (GAD-2). The LCA included 14 robust risk factors of different domains, e.g., sociodemographic (e.g., age), health-related (e.g., trauma), and pandemic-related (e.g., reduced income) factors. The LCA identified three risk profiles: High sociodemographic risk (11.7%), high social and moderate health-related risk (18.0%), and low general risk (70.3%). Individuals with high sociodemographic risk reported significantly higher symptom levels of depression and anxiety than the remaining groups. A better understanding of risk factor profiles could help to develop targeted prevention and intervention programs during pandemics.

Profiles of risk factors for depressive and anxiety symptoms during the COVID-19 pandemic: A latent class analysis.

The COVID-19 pandemic has caused a high burden in the general population. The exposure to an accumulation of risk factors, as opposed to a single risk, may have been associated with higher levels of depressive and anxiety symptoms during the pandemic. This study aimed to (1) identify subgroups of individuals with distinct constellations of risk factors during the COVID-19 pandemic and (2) investigate differences in levels of depressive and anxiety symptoms. German participants (N = 2245) were recruited between June-September 2020 through an online survey (ADJUST study). Latent class analysis (LCA) and multiple group analyses (Wald-tests) were conducted to identify profiles of risk factors and examine differences in symptoms of depression (PHQ-9) and anxiety (GAD-2). The LCA included 14 robust risk factors of different domains, for example, sociodemographic (e.g., age), health-related (e.g., trauma), and pandemic-related (e.g., reduced income) factors. The LCA identified three risk profiles: High sociodemographic risk (11.7%), high social and moderate health-related risk (18.0%), and low general risk (70.3%). Individuals with high sociodemographic risk reported significantly higher symptom levels of depression and anxiety than the remaining groups. A better understanding of risk factor profiles could help to develop targeted prevention and intervention programs during pandemics.

Coping profiles and differences in well-being during the COVID-19 pandemic: A latent profile analysis.

During the current COVID-19 pandemic, people need to cope with multiple stressors which may affect their well-being. This study aimed (1) to identify latent coping profiles in the German general population, and (2) to investigate differences between these profiles in well-being. In total, N = 2326 German participants were recruited as part of the European Society of Traumatic Stress Studies (ESTSS) ADJUST study from June to September 2020 using an online survey. Coping strategies were assessed using the Brief-COPE and the Pandemic Coping Scale; well-being was assessed using the WHO-5 Well-Being Index. Coping profiles were identified using latent profile analysis; differences between profiles were examined using the automatic BCH method and multiple group analyses. Five coping profiles were identified that included different types and numbers of coping strategies: (1) High functional coping (17.84%), (2) Moderate functional coping (40.63%), (3) High functional and religious coping (9.07%), (4) Low functional coping (22.06%), (5) Moderate functional and dysfunctional coping (10.40%). The identified profiles significantly differed in well-being (χ2  = 503.68, p <0.001). Coping profiles indicating high functional coping were associated with greater well-being compared to coping profiles indicating low (χ2  = 82.21, p <0.001) or primarily dysfunctional (χ2  = 354.33, p <0.001) coping. These results provide insight into how people differ in their coping strategies when dealing with stressors in an early phase of the COVID-19 pandemic. The study indicates higher levels of well-being in coping profiles with more frequent use of functional strategies. To promote well-being in the general population, it might be beneficial to train functional coping strategies in appropriate interventions that are associated with increased well-being.

Risk and protective factors for posttraumatic stress disorder in trauma-exposed individuals during the COVID-19 pandemic – findings from a pan-European study Factores de riesgo y protectores para el trastorno de éstres postráumatico en individuos expuestos a trauma durante la pandemia COVID-19 – hallazgos de un estudio paneuropeo COVID-19 疫情期间创伤暴露个体的创伤后应激障碍风险和保护因素——一项泛欧研究的结果

Background: The COVID-19 pandemic is a health emergency resulting in multiple stressors that may be related to posttraumatic stress disorder (PTSD). Objective: This study examined relationships between risk and protective factors, pandemic-related stressors, and PTSD during the COVID-19 pandemic. Methods: Data from the European Society of Traumatic Stress Studies (ESTSS) ADJUST Study were used. N = 4,607 trauma-exposed participants aged 18 years and above were recruited from the general populations of eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. We assessed sociodemographic (e.g. gender), pandemic-related (e.g. news consumption), and health-related (e.g. general health condition) risk and protective factors, pandemic-related stressors (e.g. fear of infection), and probable PTSD (PC-PTSD-5). The relationships between these variables were examined using logistic regression on multiple imputed data sets. Results: The prevalence of probable PTSD was 17.7%. Factors associated with an increased risk for PTSD were younger age, female gender, more than 3 h of daily pandemic-related news consumption (vs. no consumption), a satisfactory, poor, or very poor health condition (vs. a very good condition), a current or previous diagnosis of a mental disorder, and trauma exposure during the COVID-19 pandemic. Factors associated with a reduced risk for PTSD included a medium and high income (vs. very low income), face-to-face contact less than once a week or 3–7 times a week (vs. no contact), and digital social contact less than once a week or 1–7 days a week (vs. no contact). Pandemic-related stressors associated with an increased risk for PTSD included governmental crisis management and communication, restricted resources, restricted social contact, and difficult housing conditions. Conclusion: We identified risk and protective factors as well as stressors that may help identify trauma-exposed individuals at risk for PTSD, enabling more efficient and rapid access to care. HIGHLIGHTS N =  4,607 trauma-exposed adult participants were recruited from the general population during the first year of the COVID-19 pandemic. The prevalence for probable posttraumatic stress disorder was 17.7%. We identified risk factors (e.g. poor health condition) and protective factors (e.g. social contact) associated with posttraumatic stress disorder.

High genetic diversity of Babesia canis (Piana & Galli-Valerio, 1895) in a recent local outbreak in Berlin/ Brandenburg, Germany.

Canine babesiosis caused by Babesia canis (Piana & Galli-Valerio, 1895) is emerging in new regions in Europe since its vector Dermacentor reticulatus (Fabricius, 1794) is expanding its geographic range. In the Berlin/Brandenburg area in northeast Germany, D. reticulatus is highly abundant but in the past only one autochthonous B. canis infection was reported. Since 2015, autochthonous cases were occasionally diagnosed but numbers increased since autumn 2019. The aim of the study was to genotype autochthonous canine Babesia spp. infections from Berlin/Brandenburg. Between 04/2015 and 01/2022, 46 dogs with acute babesiosis were presented to the small animal clinic (one dog was infected twice resulting in 47 samples). There were 32 dogs that had never left Berlin/Brandenburg and 14 others that had not left the region in the 6 weeks prior to disease onset. PCRs targeting the 18S rRNA and the Bc28.1 merozoite surface antigen were positive in 47 and 42 samples, respectively. Sequencing of cloned PCR products identified all samples as B. canis with 17 18S rRNA and 12 Bc28.1 haplotypes. Based on network analysis for 18S rRNA sequences and a previously described polymorphic dinucleotide, samples were assigned to two distinct clusters. One contained 31 and the other 16 samples. Using network analysis, the Bc28.1 haplotypes could also be separated into two clusters differing by at least five polymorphisms. Analyses of sequences from multiple clones indicated the presence of up to five 18S rRNA and eight Bc28.1 haplotypes and thus high parasite variability in an individual host. The genetic diversity could suggest that the parasites in the region have multiple origins, but diversity in individual dogs and dog populations from endemic regions is unknown. The suitability of both markers for genotyping is questionable due to potential intragenomic diversity for the rRNA and high intergenomic variability for the Bc28.1 marker.

The pandemic coping scale - validity and reliability of a brief measure of coping during a pandemic.

This study assessed the validity and reliability of the Pandemic Coping Scale (PCS), a new brief measure of coping with pandemic-related stressors. Methods: The PCS was administered to N = 2316 German participants during the COVID-19 pandemic. Exploratory and confirmatory factor analysis was applied among random splits of the sample. Global goodness of fit (χ 2, RMSEA, SRMR, CFI, TLI), local goodness of fit (factor loadings, communalities, factor reliability, discriminant validity) and additional test quality criteria (internal consistency, item discrimination and difficulty) were evaluated for a four-factor model vs. a four-factor model combined with a second-order general factor. Convergent and divergent validity were examined by Pearson correlations of the PCS subscales with the Brief-COPE subscales; criterion validity was evaluated by correlations with wellbeing (WHO-5), depressive (PHQ-9) and anxiety symptoms (GAD-2). Results: Exploratory factor analysis suggested a four-factor solution ('Healthy Lifestyle', 'Joyful Activities', 'Daily Structure', 'Prevention Adherence'). Confirmatory factor analysis showed a sufficient global fit for both specified models which did not differ in their fit to the data. Local goodness of fit indices showed moderate to large factor loadings and good factor reliabilities except for the subscale 'Prevention Adherence'. Internal consistencies were good for the PCS total scale (α = .83), the 'Healthy Lifestyle' (α = .79) and the 'Daily Structure' (α = .86) subscales, acceptable for 'Joyful Activities' (α = .60), and low for 'Prevention Adherence' (α = .52). The four subscales evidenced convergent and divergent validity with the Brief-COPE subscales. The subscales 'Healthy lifestyle', 'Joyful activities' and 'Daily structure' showed criterion validity with wellbeing, depressive and anxiety symptoms. Conclusions: The PCS is a reliable and valid measure to assess pandemic-specific coping behavior in the domains of 'Healthy Lifestyle', 'Joyful Activities', and 'Daily Structure'. The PCS subscale 'Prevention Adherence' might be improved by adding items with varying item difficulties.

Childhood maltreatment and social functioning in psychotic disorders: a systematic review protocol.

Background: Childhood maltreatment (CM) is thought to play a key role in the etiology and course of psychotic disorders (PD). In addition, CM is related to neurobiological and clinical characteristics that can lead to poor social functioning. However, the extent to which CM and social functioning are directly associated in individuals with PD, is unclear. Therefore, we aim to systematically review the literature to provide an estimate on the strength of the association between CM and different domains of social functioning in PD and to summarize potential moderators and mediators of this association.Methods and analysis: To identify relevant studies, we will systematically search the following databases: Pubmed (Medline), PsycInfo, Embase, Web of Science (Core Collection), and Pilots (trauma), manually search reference lists and contact experts in the field. Studies will be included if they investigate and report on the association between CM (exposure) and social functioning (outcome) in adults with PD. Two independent reviewers will screen titles, abstracts and full texts according to eligibility criteria, perform data extraction and assess study quality according to a modified version of the Newcastle-Ottawa Scale.Analysis: Effect estimates will be pooled in a meta-analysis. Heterogeneity and publication bias will be assessed and the effects of potential moderators (genetic factors, type of diagnosis, duration of illness, type of CM and age at the time of CM exposure) will be analyzed using meta-regressions. Candidate moderators and mediators (neurocognition, cognitive schemas, comorbidities, stress sensitivity, attachment) will be also examined qualitatively.Ethics and dissemination: Because this review will make use of already published data, ethical approval will not be sought. This work has the potential to inform upcoming investigations on the association between the exposure to CM in PD and social functioning. PROSPERO registration number CRD42020175244.

The first systematic review (and meta-analysis) of the association between CM and different domains of social functioning in individuals with PD.Evidence on both moderators and mediators of the association is summarized.

The Pandemic Stressor Scale: factorial validity and reliability of a measure of stressors during a pandemic.

BACKGROUND: This study aimed to assess the factorial validity and reliability of the Pandemic Stressor Scale (PaSS), a new measure to assess the severity of distress for different stressors relevant during a pandemic or epidemic. METHODS: The PaSS was administered in N = 2760 German participants. Exploratory factor analysis was used to extract factors. The factor structure obtained in the German sample was examined in N = 1021 Austrian participants using confirmatory factor analysis. χ2, RMSEA, SRMR, CFI, TLI were assessed as global goodness of fit indices for two models (Model 1: nine-factor model; Model 2: nine-factor model combined with a second-order general factor). We additionally assessed factor loadings, communalities, factor reliability, discriminant validity as local fit indices. Internal consistency, item discrimination, and item difficulty were assessed as additional test quality criteria. RESULTS: The results of the exploratory factor analysis suggested a nine-factor solution with factor loadings accounting for 50.4% of the total variance (Factor 1 'Problems with Childcare', Factor 2 'Work-related Problems', Factor 3 'Restricted Face-to-Face Contact', Factor 4 'Burden of Infection ', Factor 5 'Crisis Management and Communication', Factor 6 'Difficult Housing Condition', Factor 7 'Fear of Infection', Factor 8 'Restricted Access to Resources', Factor 9 'Restricted Activity'). The confirmatory factor analysis showed a sufficient global fit for both tested models (Model 1: χ2 (369, N = 1021) = 1443.28, p < .001, RMSEA = .053, SRMR = .055, CFI = .919, TLI = .904; Model 2: χ2 (396, N = 1021) = 1948.51, p < .001, RMSEA = .062, SRMR = .074, CFI = .883, TLI = .871). The results of the chi-square difference test indicated a significantly better model-fit of Model 1 compared to Model 2 (∆χ2 (27, N = 1021) = 505.23, p < .001). Local goodness of fit indices were comparable for both tested models. We found good factor reliabilities for all factors and moderate to large factor loadings of the items as indicators. In Model 2, four first-order factors showed small factor loadings on the second-order general factor. CONCLUSION: The Pandemic Stressor Scale showed sufficient factorial validity for the nine measured domains of stressors during the current COVID-19 pandemic.

Associations of Depressive Symptoms, COVID-19-Related Stressors, and Coping Strategies. A Comparison Between Cities and Towns in Germany.

BACKGROUND: The COVID-19 pandemic has led to a wide range of stressors related to depressive symptoms. Prevention measures like physical distancing have burdened the general population, especially in highly urbanized areas. However, little is known about the associations between pandemic-related stressors, coping strategies, and depressive symptoms in highly urbanized vs. less urbanized environments. METHODS: Participants were recruited in a cross-sectional online survey in Germany. Propensity score matching yielded a matched sample of city (n = 453) and town (n = 453) inhabitants. Depressive symptoms, COVID-19-related stressors, and coping strategies were compared between cities and towns. Multiple regression analysis was performed to determine associations between pandemic-related stressors and depressive symptoms for the two groups separately. RESULTS: City inhabitants showed significantly higher depression scores than town inhabitants (t = 2.11, df = 897.95, p = 0.035). Seven coping strategies were more often used by the city sample. Depressive symptoms were associated with "restricted physical social contact" and "difficult housing conditions" (adjusted R 2= 0.19, F [9,443] = 12.52, p < 0.001) in city inhabitants, and with "fear of infection" and "difficult housing conditions" (adjusted R 2= 0.20, F [9,443] = 13.50, p < 0.001) in town inhabitants. LIMITATIONS: The data were collected at the end of the first wave and represent a snapshot without causal inferences. Pandemic-related stressors were measured with a newly developed scale. CONCLUSION: Depressive symptoms, perceived stressors, and approach/avoidance coping strategies differed between city vs. town inhabitants. These differences should be considered in policy-making and mental health care.

Risk and protective factors, stressors, and symptoms of adjustment disorder during the COVID-19 pandemic – First results of the ESTSS COVID-19 pan-European ADJUST study COVID-19 疫情期间适应障碍的风险与保护因素, 应激源和症状——ESTSS COVID-19 全欧洲 ADJUST 研究的初步结果 Factores de riesgo y de protección, factores estresantes, y síntomas del trastorno de adaptación durante la pandemia de COVID-19: Primeros resultados del estudio paneuropeo de COVID-19 ADJUST de la ESTSS

Background The COVID-19 pandemic exposes individuals to multiple stressors, such as quarantine, physical distancing, job loss, risk of infection, and loss of loved ones. Such a complex array of stressors potentially lead to symptoms of adjustment disorder. Objective This cross-sectional exploratory study examined relationships between risk and protective factors, stressors, and symptoms of adjustment disorder during the first year of the COVID-19 pandemic. Methods Data from the first wave of the European Society of Traumatic Stress Studies (ESTSS) longitudinal ADJUST Study were used. N = 15,563 participants aged 18 years and above were recruited in eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. Associations between risk and protective factors (e.g. gender, diagnosis of a mental health disorder), stressors (e.g. fear of infection, restricted face-to-face contact), and symptoms of adjustment disorder (ADNM-8) were examined using multivariate linear regression. Results The prevalence of self-reported probable adjustment disorder was 18.2%. Risk factors associated with higher levels of symptoms of adjustment disorder were female gender, older age, being at risk for severe COVID-19 illness, poorer general health status, current or previous trauma exposure, a current or previous mental health disorder, and longer exposure to COVID-19 news. Protective factors related to lower levels of symptoms of adjustment disorder were higher income, being retired, and having more face-to-face contact with loved ones or friends. Pandemic-related stressors associated with higher levels of symptoms of adjustment disorder included fear of infection, governmental crisis management, restricted social contact, work-related problems, restricted activity, and difficult housing conditions. Conclusions We identified stressors, risk, and protective factors that may help identify individuals at higher risk for adjustment disorder. HIGHLIGHTS We examined symptoms of adjustment disorder in 15,563 adults during the COVID-19 pandemic. The prevalence of probable adjustment disorder was 18.2%. We identified stressors, risk, and protective factors that may help identify individuals at higher risk for adjustment disorder.

Risk and protective factors, stressors, and symptoms of adjustment disorder during the COVID-19 pandemic - First results of the ESTSS COVID-19 pan-European ADJUST study.

Background: The COVID-19 pandemic exposes individuals to multiple stressors, such as quarantine, physical distancing, job loss, risk of infection, and loss of loved ones. Such a complex array of stressors potentially lead to symptoms of adjustment disorder. Objective: This cross-sectional exploratory study examined relationships between risk and protective factors, stressors, and symptoms of adjustment disorder during the first year of the COVID-19 pandemic. Methods: Data from the first wave of the European Society of Traumatic Stress Studies (ESTSS) longitudinal ADJUST Study were used. N = 15,563 participants aged 18 years and above were recruited in eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. Associations between risk and protective factors (e.g. gender, diagnosis of a mental health disorder), stressors (e.g. fear of infection, restricted face-to-face contact), and symptoms of adjustment disorder (ADNM-8) were examined using multivariate linear regression. Results: The prevalence of self-reported probable adjustment disorder was 18.2%. Risk factors associated with higher levels of symptoms of adjustment disorder were female gender, older age, being at risk for severe COVID-19 illness, poorer general health status, current or previous trauma exposure, a current or previous mental health disorder, and longer exposure to COVID-19 news. Protective factors related to lower levels of symptoms of adjustment disorder were higher income, being retired, and having more face-to-face contact with loved ones or friends. Pandemic-related stressors associated with higher levels of symptoms of adjustment disorder included fear of infection, governmental crisis management, restricted social contact, work-related problems, restricted activity, and difficult housing conditions. Conclusions: We identified stressors, risk, and protective factors that may help identify individuals at higher risk for adjustment disorder.

Antecedentes: La pandemia de COVID-19 expone a las personas a múltiples factores estresantes, como la cuarentena, el distanciamiento físico, la pérdida del trabajo, el riesgo de infección, y la pérdida de seres queridos. Esta compleja serie de factores estresantes puede potencialmente conducir a síntomas del trastorno de adaptación.Objetivo: Este estudio exploratorio transversal examinó las relaciones entre los factores de riesgo y de protección, los factores estresantes, y los síntomas del trastorno de adaptación durante el primer año de la pandemia de COVID-19.Métodos: Se utilizaron datos de la primera ola del estudio longitudinal ADJUST de la Sociedad Europea de Estudios de Estrés Traumático (ESTSS en su sigla en inglés). N = 15.563 participantes de 18 años o más fueron reclutados en once países (Austria, Croacia, Georgia, Alemania, Grecia, Italia, Lituania, Países Bajos, Polonia, Portugal, y Suecia) de junio a noviembre de 2020. Se examinaron mediante regresión lineal multivariante las asociaciones entre los factores de riesgo y de protección (p. ej., género, diagnóstico de un trastorno de salud mental), factores estresantes (p. ej., miedo a la infección, contacto restringido cara a cara), y síntomas del trastorno de adaptación (ADNM-8 en su sigla en inglés).Resultados: La prevalencia del trastorno de adaptación probable autoinformado fue del 18,2%. Los factores de riesgo asociados con niveles más altos de síntomas del trastorno de adaptación fueron género femenino, edad avanzada, riesgo de enfermedad grave por COVID-19, peor estado de salud general, exposición a un trauma actual o anterior, un trastorno de salud mental actual o anterior, y una exposición más prolongada a las noticias de COVID-19. Los factores de protección relacionados con niveles más bajos de síntomas del trastorno de adaptación fueron mayores ingresos, estar jubilado, y tener más contacto cara a cara con sus seres queridos o amigos. Los factores estresantes relacionados con la pandemia que se asociaron con niveles más altos de síntomas del trastorno de adaptación incluyeron miedo a la infección, manejo gubernamental de crisis, contacto social restringido, problemas relacionados con el trabajo, actividad restringida, y condiciones de vivienda difíciles.Conclusiones: Identificamos factores estresantes, de riesgo, y protectores que pueden ayudar a identificar a las personas con mayor riesgo de trastorno de adaptación.

Stress and trauma prevention for employees in the health sector

Employees working in acute medical-care settings are exposed to high levels of psychological stress. These have been further exacerbated by the COVID pandemic. Different strategies for the prevention of stress in general occupational contexts have been proposed, many of them involving peer support. However, only very few of them have been empirically validated, and it remains to be seen whether they are appropriate for the health-care sector. The Hamburg Strategy for Stress and Trauma Prevention builds on the standards established by German Social Accident lnsurance (DCUV), adding to them the components "chronic stress in the work context" and "operational implementation". An evaluation of training for peer supporters (N = 26), a key aspect of the strategy, indicates a high level of acceptance. lt has also yielded positive effects with regard to the anticipated assurance of participants in supporting relevant colleagues. The COVID pandemic has put the strategy to the test and has stimulated the development of further elements. With appropriate setting-related adjustments, the strategy would also appear to be suitable for contexts other than a maximum-care hospital. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Abstract (German) Beschaftigte in medizinischen Akutbereichen sind erhohten psychischen Belastungen ausgesetzt, die durch die COVID-Pandemie weiter verstarkt wurden. Es wurden unterschiedliche Konzepte zur Pravention von Belastungsfolgen im Arbeitskontext vorgelegt, die haufig kollegiale Ersthe/ fer*innen (Peer-Beratende) beinhalten. Allerdings sind diese bislang kaum empirisch uberpruft und ihre Ubertragbarkeit auf den Gesundheitsbereich ist nicht empirisch gesichert. Das Hamburger Konzept zur Stress- undTraumapravention berucksichtigt die inzwischen vorgelegten Standards der Deutschen Gesetzlichen Unfallversicherung und erganzt diese um die Aspekte chronischer Stress im Arbeitskontext und betriebliche Implementierung. Eine Evaluation der darin enthaltenen Ausbildung von Peer- Beratenden (N = 26) zeigte eine hohe Akzeptanz des Konzeptes und positive Effekte in Bezug auf die subjektive Sicherheit bei der Durchfuhrung von entlastenden Interventionen bei betroffenen Kolleg*innen. Die COVID-Pandemie stellte im vergangenen Jahr eine Bewahrungsprobe des Konzeptes dar und fuhrte zur Entwicklung weiterer Elemente. Bei entsprechenden setting bezogenen Anpassungen scheint das Konzeptgrundsatzlich auch fur andere Kontexte als den einer Klinik der Maximalversorgung geeignet. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Stressors, coping and symptoms of adjustment disorder in the course of the COVID-19 pandemic - study protocol of the European Society for Traumatic Stress Studies (ESTSS) pan-European study.

BACKGROUND: During the current COVID-19 pandemic, the people in Europe are exposed to self-isolation, quarantine, job loss, risk of contracting COVID-19, or grief of loved ones. Such a complex array of stressors may lead to symptoms of adjustment disorder or posttraumatic stress disorder. This research protocol describes a study launched by the European Society of Traumatic Stress Studies (ESTSS) to investigate the impact of the COVID-19 pandemic on symptoms of adjustment disorder across European countries. OBJECTIVE: The longitudinal online cohort study aims (1) to explore psychosocial reactions to the COVID-19 pandemic across ten European countries; (2) to examine the relationships between risk and resilience factors, stressors and symptoms of adjustment disorder during the pandemic; and (3) to investigate whether these relationships are moderated by coping behaviours. METHOD: In ten countries (Austria, Croatia, Georgia, Germany, Italy, Lithuania, Netherlands, Poland, Portugal, and Sweden), between 1,000 and 2,000 participants will be recruited, depending on the size of the country. Participants will be assessed at two timepoints with a six-month interval. Following a conceptual framework based on the WHO's social framework of health, an assessment of risk and resilience factors, COVID-19 related stressors and pandemic-specific coping behaviours will be measured to estimate their contribution to symptoms of adjustment disorder. The Adjustment Disorder New Module 8 (ADNM-8) will be used to assess symptoms of adjustment disorder. As a secondary measure, symptoms of posttraumatic stress disorder will be measure using the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5). DATA ANALYSIS: The relative contribution of risk factors, resilience factors, and stressors on symptoms of adjustment disorder or symptoms of posttraumatic stress disorder will be estimated using multilevel analysis. To determine the moderating effects of different types of coping behaviours on these relationships, a multilevel mediation analysis will be carried out.

Antecedentes: Durante la actual pandemia de COVID-19, las personas en Europa están expuestas a autoaislamiento, cuarentena, pérdida de empleo, riesgo de contraer COVID-19 o duelo de sus seres queridos. Un conjunto tan complejo de factores estresantes puede provocar síntomas de trastorno de adaptación o trastorno de estrés postraumático. Este protocolo de investigación describe un estudio lanzado por la Sociedad Europea de Estudios de Estrés Traumático (ESTSS) para investigar el impacto de la pandemia COVID-19 en los síntomas del trastorno de adaptación en países europeos.Objetivo: El estudio longitudinal de cohorte en línea tiene como objetivo (1) explorar las reacciones psicosociales a la pandemia de COVID-19 en diez países europeos; (2) examinar las relaciones entre los factores de riesgo y resiliencia, estresores y síntomas de trastorno de adaptación durante la pandemia; e (3) investigar si estas relaciones son moderadas por comportamientos de afrontamiento.Método: En diez países (Austria, Croacia, Georgia, Alemania, Italia, Lituania, Países Bajos, Polonia, Portugal y Suecia) serán reclutados entre 1,000 y 2,000 participantes, dependiendo del tamaño del país. Los participantes serán evaluados en dos momentos con un intervalo de seis meses. Siguiendo un marco conceptual basado en el marco social de salud de la OMS, una evaluación de los factores de riesgo y resiliencia, factores estresantes relacionados con COVID-19 y el comportamiento de afrontamiento específico de la pandemia serán medidos para estimar su contribución a los síntomas de trastorno de adaptación. El nuevo módulo de trastorno de adaptación 8 (ADNM-8) se utilizará para medir los síntomas del trastorno de adaptación. Como medida secundaria, se evaluarán síntomas de trastorno de estrés postraumático usando el cribaje de TEPT en atención primaria para DSM-5 (PC-PTSD-5).Análisis de datos: La contribución relativa de los factores de riesgo, factores de resiliencia y los estresores sobre los síntomas de trastorno de adaptación o síntomas de trastorno de estrés postraumático se estimará mediante análisis multinivel. Para determinar los efectos moderadores de diferentes tipos de conductas de afrontamiento en estas relaciones, se llevará a cabo un análisis de mediación multinivel.

Trauma-informed responses in addressing public mental health consequences of the COVID-19 pandemic: position paper of the European Society for Traumatic Stress Studies (ESTSS).

The COVID-19 pandemic has changed life in Europe and globally. The pandemic affects both individuals and the broader society across many domains, including physical and psychological health, the economy and general welfare. The measures taken to counteract the pandemic have significantly altered daily life and, along with the threat of contracting the coronavirus and uncertainties surrounding future developments, created a complex system of stressors with a negative impact on public mental health. This paper aims to outline the ESTSS strategy to address mental health issues related to COVID-19 and focuses on (1) trauma-informed policies, (2) capacity building, (3) collaborative research and (4) knowledge-exchange. To facilitate implementation of a trauma-informed approach and appropriate measures, ESTSS has developed a toolkit of recommendations on mental health and psychosocial assistance to be provided during the different phases of crisis and its aftermath. To promote capacity building, ESTSS offers a certification programme based on a curriculum in psychotraumatology and corresponding on-line training to the European community of mental health professionals. To assure evidence-based approaches and methods tailored to current circumstances, ESTSS has initiated a pan-European research project with international cooperation aimed at studying the mental health consequences of the pandemic, with a focus on psychological trauma and other stress-related reactions. To foster knowledge-exchange, the European Journal of Psychotraumatology (EJPT), the official journal of ESTSS, is publishing a special issue on COVID-19.

La pandemia de COVID-19 ha cambiado la vida en Europa y en todo el mundo. La pandemia afecta tanto a los individuos como a la sociedad en general en muchos ámbitos, incluida la salud física y psicológica, la economía y el bienestar general. Las medidas tomadas para contrarrestar la pandemia han alterado significativamente la vida diaria y, junto con la amenaza de contraer el coronavirus y las incertidumbres que rodean los desarrollos futuros, crearon un complejo sistema de estresores con un impacto negativo en la salud mental pública. En este artículo se pretende esbozar la estrategia de la ESTSS para abordar los problemas de salud mental relacionados con COVID-19 y se centra en: 1. Políticas informadas en trauma, 2. capacitación, 3. investigación colaborativa, 4. e intercambio de conocimientos. Para facilitar la implementación de un enfoque basado en el trauma y las medidas apropiadas, la ESTSS ha desarrollado un conjunto de herramientas de recomendaciones sobre salud mental y asistencia psicosocial que se proporcionará durante las diferentes fases de la crisis y sus consecuencias. Para fomentar la capacitación, la ESTSS ofrece un programa de certificación basado en un plan de estudios en psicotraumatología y la formación on-line correspondiente a la comunidad europea de profesionales de la salud mental. Para asegurar enfoques y métodos basados en la evidencia adaptados a las circunstancias actuales, la ESTSS ha iniciado un proyecto de investigación paneuropeo con cooperación internacional, destinado a estudiar las consecuencias de la pandemia en la salud mental, con enfoque en el trauma psicológico y otras reacciones relacionadas con el estrés. Para fomentar intercambio de conocimiento, la European Journal of Psychotraumatology (EJPT), la revista oficial de ESTSS, publica un número especial sobre COVID-19.