Coping with COVID-19 Stressors: Adverse and Protective Factors Responding to Emotions in a Chinese Sample (preprint)

Background: The potential roles of affective responses to environmental stressors in individuals' physical and mental health are complex and multi-faceted. This study, then, explores Chinese citizens' emotional responses to COVID-19-related stressors and influence factors which may boost or buffer such effects. Methods: From late March to early June (2020), a cross-sectional study was conducted using an anonymous online questionnaire included demographic characteristics, COVID-19-related stressors related to individuals' daily functioning, and the self-assessed impact of protective and adverse internal factors on emotions. Results: 1,662 questionnaires were received from residents in 32 Chinese provinces classified by prevalence level according to COVID-19 infections. Among the 17 positive and negative emotional responses, agglomerative hierarchical clustering revealed four subclassifications: (1) stress relations; (2) missing someone relations; (3) individual relations; and (4) social relations. Additionally, heightened regional prevalence levels positively corresponded to intensity of stress relations. Lowest intensity of social relations was found in the areas surrounding Wuhan and coastal areas. Specially, economic- and work-related stressors as well as negative self-perceptions (e.g., suppression, emotionally unstable, self-denial) implicated in negative emotions. While positive emotions were tied to demographic characteristics (e.g., high education, young age and male) and protective traits (e.g., creativity, sympathy, social responsibility), and inversely linked to relationships- and pandemic-related stressors, etc. Conclusion: Associations were clearly noted among Chinese residents' emotions to specific stressors during pandemic. Providing appropriate psychological resources/supports during future or extended public health crises may help offset the cognitive burden of individuals striving to regain an adequate level of normalcy and emotional well-being.

Sex differences and Psychological Stress: Responses to the COVID-19 epidemic in China (preprint)

Background: About 83,000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contain its spread - have altered individuals’ “normal” daily functioning. These impacts on social, psychological, and emotional well-being remain relatively unexplored – in particular, the ways in which Chinese men and women experience and respond to potential behavioral stressors. Our study investigated sex differences in psychological stress, emotional reactions, and behavioral responses to COVID-19 and related threats among Chinese residents. Methods: In late February (2020), an anonymous online questionnaire was disseminated via WeChat, a popular social media platform in China. The cross-sectional study utilized a non-probabilistic “snowball” or convenience sampling of residents from various provinces and regions of China. Basic demographic characteristics (e.g., age and gender) – along with residential living arrangements and conditions – were measured along with psychological stress and emotional responses to the COVID-19 pandemic. Results: 3,088 questionnaires were returned: 1,749 females (56.6%) and 1,339 males (43.4%). The mean stress level,as measured by a visual analog scale, was 3.4 (SD=2.4) - but differed significantly by sex. Besides sex, factors positively associated with stress included: age (<45 years), employment (unsteady income, unemployed), risk of infection (exposureto COVID-19，completed medical observation), difficulties encountered (diseases, work/study, financial, mental), and related behaviors (higher desire for COVID-19 knowledge, more time concerning on the COVID-19 outbreak). “Protective” factors included frequent contact with colleagues, calmness of mood comparing with the pre-pandemic, and psychological resilience. Males and females also differed significantly in adapting to current living/working, conditions, responding to run a fever, and needing psychological support services. Conclusions: The self-reported stress of Chinese residents related to the COVID-19 pandemic was significantly related to sex, age, employment, resilience and coping styles. Future responses to such public health threats may wish to provide sex- and/or age-appropriate supports for psychological health and emotional well-being to those at greatest risk of experiencing stress.

Psychological Stress and Gender Differences during COVID-19 Pandemic in Chinese Population (preprint)

About 83000 COVID-19 patients were confirmed in China up to May 2020. The effects of this public health crisis - and the varied efforts to contains its spread - have altered individuals "normal" daily functioning. This impact on social, psychological, and emotional well-being remain relatively unexplored, especially the ways in which Chinese men and women experience and respond to potential behavioral-related stressors. A cross-sectional study was conducted in late February 2020. Demographic characteristics and residential living conditions were measured along with psychological stress and behavior responses to the COVID-19 epidemic. 3088 questionnaires were received: 1749 females (56.6%) and 1339 males (43.4%). The mean level of stress, as measured by a visual analog scale, was 3.4 (SD=2.4) - but differed significantly by sex. Besides sex, factors positively associated with stress included: age ([≤]45 years), employment (unsteady income, unemployed), risk infection population (exposed to COVID-19, completed medical observation), difficulties encountered (diseases, work/study, financial, mental), behaviors(higher desire for COVID-19 knowledge, more time spent on the COVID-19). "Protective" factors included frequently contact with colleagues, calmness, and psychological resilience. Males and females also differed significantly in adapting to current living/working status, coping with heating, and psychological support service needs. Among Chinese, self-reported stress related to the COVID-19 epidemic were significantly related to sex, age, employment, resilience and coping styles. Future responses to such public health threats may wish to provide sex- and/or age-appropriate supports for psychological health and emotional well-being to those at greatest risk of experiencing stress.