Mapping post-traumatic stress disorder symptoms and quality of life among residents of Wuhan, China after the COVID-19 outbreak: A network perspective.

OBJECTIVES: The Coronavirus Disease 2019 (COVID-19) outbreak may have a long-term impact on mental health in the general population. This study examined inter-relationships between post-traumatic stress disorder symptoms (PTSS) and quality of life (QOL) in Wuhan residents after the COVID-19 outbreak using network approach. METHODS: A cross-sectional survey was conducted between May 25 and June 18, 2020. PTSS and QOL were measured using Chinese versions of the Post -Traumatic Stress Disorder Checklist - Civilian Version and the World Health Organization Quality of Life Questionnaire - brief version, respectively. RESULTS: A total of 2598 participants were included. A network analysis revealed "Avoiding reminders", "Feeling emotionally numb", "Avoiding thoughts", "Hypervigilance", and "Reliving experiences" as the most central (influential) nodes in PTSS network models both before and after controlling for covariates. The connection between "Avoiding thoughts" and "Avoiding reminders" had the strongest edge. Three symptom communities were detected and can be summarized as "re-experiencing and avoidance", "negative changes in thinking and mood", and "hyperarousal". The bridge symptoms connecting PTSS and QOL were "Sleep disturbances", "Irritability", and "Loss of interest". LIMITATIONS: Limitations included the cross-sectional study design, self-report measures in data collection, and lack of follow-ups beyond the initial phase of the pandemic. CONCLUSIONS: PTSS were common among Wuhan residents even after the initial COVID-19 outbreak had passed. Attention should be paid to lingering symptoms of avoiding reminders, emotional numbness, avoiding thoughts, hypervigilance, and reliving experiences in treating PTSS related to the COVID-19 outbreak.

The longitudinal association between Perceived Stress, PTSD Symptoms, and Post-Traumatic Growth during the COVID-19 Pandemic: the role of coping strategies and psychological inflexibility.

The present study investigates the mediating roles of psychological inflexibility and differential coping strategies on perceived stress and post-traumatic symptoms and growth in the context of COVID-19. Study one recruited 662 participants (54.8% women; Mage = 40.64 years, SD = 13.04) who completed a cross-sectional questionnaire. It was proposed that orientation to the problem, avoidance strategies, psychological inflexibility, and positive attitude were mediators for the positive association between perceived stress and PTSD symptoms. The fit indices for the path model were excellent: CFI = 0.977, TLI = 0.950, RMSEA = 0.057 [90%CI = 0.043-0.081], and SRMS = 0.042. Gender and stressful events encountered had indirect effects on the endogenous variables. In study two, 128 participants (57.8% women; Mage = 42.30, SD = 12.08) were assessed for post-traumatic growth one year later. Psychological inflexibility and orientation acted as mediators between perceived stress and PTSD symptoms. Furthermore, a novel path model was constructed in which psychological inflexibility and orientation to the problem as mediators for perceived stress and PTSD symptoms. The indices for the path model were excellent: CFI = 0.99, TLI = 0.97, RMSEA = 0.055 [90%CI = 0.001-0.144], and SRMS = 0.49. Furthermore, PTSD symptoms, psychological inflexibility, and orientation to the problem predicted post-traumatic growth. Specifically, both orientation to the problem (ß = .06 [90%CI: .01;.13]) and psychological inflexibility (ß = .14 [90%CI: .08;.26]) had an indirect effect on post-traumatic growth. Overall, these results significantly contribute to the literature as orientation to the problem positively predicted PTSD symptoms and post-traumatic growth one year later while psychological inflexibility predicted PTSD symptoms and less post-traumatic growth one year later. These results underline the importance of assessing both symptomology and psychological growth to determine adaptive coping strategies in specific contexts.

Impact of coronavirus 2019 pandemic on post-traumatic stress disorder symptoms among pregnant women in Jordan.

OBJECTIVE: To examine the prevalence of psychological symptoms of the coronavirus disease 2019 outbreak among pregnant women and its association with gestational age and post-traumatic stress disorder symptoms. METHODS: A cross-sectional study was conducted between June and November 2020 to assess the impact of the COVID-19 pandemic on mental health in pregnancy using the Impact of Event Scale-Revised. Pregnant women 18 years and older were recruited from antenatal and obstetrics clinics in Jordan. A total of 481 pregnant women participated in an online survey developed on Google Forms. A self-administered structured questionnaire was used to collect sociodemographic data, mental health information, and lifestyle changes. The Impact of Event Scale-Revised, the Perceived Support Scale, and the Mental Health Lifestyle Scale were administered. Variables related to sociodemographic information and dietary behavior and perception during the COVID-19 pandemic were also assessed. RESULTS: The results showed that 58.6% of pregnant women reported the presence of post-traumatic stress disorder symptoms and women in the second trimester were more likely to show post-traumatic stress disorder symptoms compared with the first and third trimesters (p = 0.001). Moreover, a higher level of education, employment, poor dietary habits, and changes due to the pandemic were significantly associated with the Impact of Event Scale-Revised score and the presence of post-traumatic stress disorder symptoms. CONCLUSION: The COVID-19 pandemic was associated with high rates of psychological distress among pregnant women. Identifying mothers at risk of post-traumatic stress disorder symptoms may help improve maternity services and prevent adverse child outcomes.