Associations of COVID-19 Related Work Stressors with Psychological Distress: Racial and Ethnic Disparities in Californian Workers.

The COVID-19 pandemic continues to exert immense societal impacts, with recent data showing inequitable distribution of consequences among racial and ethnic groups. The objective of this study was to assess associations between COVID-related work stressors and psychological distress, with special emphasis on differences by race and ethnicity. Data were from the population-based California Health Interview Survey (CHIS) 2020. Associations of individual and cumulative work stressors, including job loss, reduced work hours, and working from home, with psychological distress in 12,113 workers were examined via multivariable linear regression, and stratified analyses were conducted for racial and ethnic subgroups. After adjustment for covariates, compared to workers with no work stressors, those who experienced either one or two/more work stressors had higher psychological distress (ßs and 95% CIs were 0.80 [0.51, 1.09] and 1.98 [1.41, 2.56], respectively). Notably, experiencing cumulative (two/more) work stressors had much stronger effects on psychological distress among participants who were Black (ß and 95% CI were 3.51 [1.09, 5.93]) or racial minorities (ß and 95% CI were 3.57 [1.10, 6.05]). Occupational consequences of the COVID-19 pandemic were associated with increased psychological distress in Californian workers and inequitably distributed, with racial and ethnic minorities suffering the greatest burden.

A Schema of Toxic Stress Informed by Racism, Transgenerational Stress, and Disadvantage.

INTRODUCTION: The Toxic Stress Schema (TSS) is an ecological framework with a social justice lens for identifying and alleviating stress and strengthening social determinants of health for children and families of color impacted by the COVID-19 pandemic and the cumulative effects of racism and generational, systemic inequities. METHOD: Relevant literature is reviewed, and examples were provided to illustrate the differential impacts of the "stress superstorm" of 2020 had on children of color based on their family's position on the advantage-disadvantage continuum. RESULTS: The utility of the TSS framework as a model for advanced nursing practice is demonstrated, and recommendations are formulated for the pediatric nurse practitioner's role in health policy. DISCUSSION: The COVID-19 pandemic elucidated the historical inequities experienced by children and families of color. The TSS framework provides a model for recognizing, organizing, and implementing.

COVID-19 anti-Asian racism: A tripartite model of collective psychosocial resilience.

Anti-Asian racism has spiked since the outbreak of the coronavirus 2019 (COVID-19) pandemic, creating compounded threats to Asian Americans' psychological wellbeing on top of other pandemic stressors (e.g., fears of infection, financial insecurity, or quarantine isolation). COVID-19 anti-Asian racism signifies the relevance of race and racism during public health crises and highlights the importance of examining the psychological impacts of racialized stress and avenues for resilience during a pandemic. This article describes a conceptual model that emphasizes the importance of rechanneling the experience of COVID-19 anti-Asian racism toward resilience. Specifically, the proposed model identifies a tripartite process of collective psychosocial resilience, comprised of (a) critical consciousness of discrimination as a common fate, (b) critical consciousness-informed racial/ethnic identity, and (c) advocacy, for empowering Asian Americans and protecting them against the harmful effects of COVID-19 anti-Asian racism during and beyond the pandemic. Theoretical and empirical underpinnings of the proposed tripartite process for cultivating resilience against COVID-19 anti-Asian racism are delineated. Practice implications and future research directions, as informed and revealed by the conceptual model, are discussed. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Outcomes of COVID-19 on Latinx youth: Considering the role of adverse childhood events and resilience.

Early research on the COVID-19 pandemic has demonstrated differential impact on the Latinx community. There has been limited research exploring the mental health outcomes of the pandemic on Latinx youth. This study explores the severity of pandemic-related stress on Latinx youth considering their resilience factors and previous adverse childhood events (ACEs). Adolescents (n = 142) ages 13-18 completed measures related to exposure to the pandemic, pandemic stress, number of ACEs, resilience factors, and general demographic information. Results of multiple regression analysis found that exposure to the pandemic, ACEs, gender, and resilience factors predicted the levels of stress that youth experienced. No differences in pandemic-related stress were found between Latinx youth and their non-Latinx counterparts. Implications are discussed related to how school psychologists can support all students with culturally sensitive practices as we continue through the pandemic and beyond. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Stress and coping among pregnant black women during the COVID-19 pandemic.

OBJECTIVE: This study explored stress and coping among pregnant Black women prior to and during the COVID-19 pandemic. DESIGN: Prospective, longitudinal, cohort study. SAMPLE: Thirty-three women enrolled in the Biosocial Impact on Black Births study prior to the COVID-19 pandemic and who were still pregnant during the pandemic. MEASUREMENTS: Questionnaires included the Perceived Stress Scale, Prenatal Coping Inventory, and questions related to sociodemographic characteristics, worry about COVID-19, and coping strategies used during the pandemic. RESULTS: Women reported very much being worried about my child getting COVID-19 (46%) and my family member getting COVID-19 (46%). Women reported specific active coping strategies very much reduced their feelings of discomfort during COVID-19: God, religion, or spirituality (24%), social media (24%), and following government advice (24%). Higher use of avoidance coping prior to the pandemic was associated with higher levels of stress both prior to (r = 0.60, p < .001) and during (r = 0.47, p < .01) the pandemic. CONCLUSION: Women reported worries about COVID-19 and used various strategies to cope with feelings of discomfort due to the pandemic. Nurses should assess the stress level of pregnant Black women and recommend active coping strategies during the pandemic.

Racial and Ethnic Disparities in the Prevalence of Stress and Worry, Mental Health Conditions, and Increased Substance Use Among Adults During the COVID-19 Pandemic - United States, April and May 2020.

In 2019, approximately 51 million U.S. adults aged ≥18 years reported any mental illness,* and 7.7% reported a past-year substance use disorder† (1). Although reported prevalence estimates of certain mental disorders, substance use, or substance use disorders are not generally higher among racial and ethnic minority groups, persons in these groups are often less likely to receive treatment services (1). Persistent systemic social inequities and discrimination related to living conditions and work environments, which contribute to disparities in underlying medical conditions, can further compound health problems faced by members of racial and ethnic minority groups during the coronavirus disease 2019 (COVID-19) pandemic and worsen stress and associated mental health concerns (2,3). In April and May 2020, opt-in Internet panel surveys of English-speaking U.S. adults aged ≥18 years were conducted to assess the prevalence of self-reported mental health conditions and initiation of or increases in substance use to cope with stress, psychosocial stressors, and social determinants of health. Combined prevalence estimates of current depression, initiating or increasing substance use, and suicidal thoughts/ideation were 28.6%, 18.2%, and 8.4%, respectively. Hispanic/Latino (Hispanic) adults reported a higher prevalence of psychosocial stress related to not having enough food or stable housing than did adults in other racial and ethnic groups. These estimates highlight the importance of population-level and tailored interventions for mental health promotion and mental illness prevention, substance use prevention, screening and treatment services, and increased provision of resources to address social determinants of health. How Right Now (Qué Hacer Ahora) is an evidence-based and culturally appropriate communications campaign designed to promote and strengthen the emotional well-being and resiliency of populations adversely affected by COVID-19-related stress, grief, and loss (4).

Depression, Anxiety, and Coping During the COVID-19 Pandemic Among Indian Expats in the Middle East: A Survey Study.

OBJECTIVE: There are multiple studies indicating that the Indian expat population working in the Middle East is at a significantly high risk for developing anxiety, depression, and suicidal thoughts. The coronavirus disease 2019 (COVID-19) pandemic can precipitate or exacerbate psychological distress among the expat population. The objective of this study was to evaluate psychological distress and coping mechanisms among Indian expats working in the Middle East during the COVID-19 pandemic. METHODS: An online survey was conducted with a semistructured questionnaire using a nonprobability snowball sampling technique. In addition to demographic data, a list of COVID-19 pandemic-related questions, the Brief COPE, the 9-item Patient Health Questionnaire (PHQ-9), and the 7-item Generalized Anxiety Disorder Questionnaire (GAD-7) were also utilized. RESULTS: A total of 94 responses were received. Of the respondents, 52% reported clinically significant anxiety levels, and 41% reported clinically significant depression levels. Both the PHQ-9 and GAD-7 scores were significantly associated with the level of concern with air traffic restriction (P < .05). CONCLUSIONS: Our findings show that governments of both Indian and Middle Eastern countries should pay more attention to the mental health of the expat population while combating COVID-19.

Racial and ethnic variations in caregiving-related physical, emotional, and financial strain during COVID-19 among those caring for adult cancer patients.

PURPOSE: Cancer caregiving is shown to be a burdensome experience in typical times. The purpose of this study was to describe cancer caregivers' emotional, physical, and financial strain during the COVID-19 pandemic and compared to preCOVID-19, and explore racial and ethnic variations in caregiver strain. METHODS: We conducted a cross-sectional online survey using Lucid, LLC, incorporating quotas for race, ethnicity, gender and age. Caregivers had to be adults living in the USA and currently providing unpaid care to an adult cancer patient (i.e., during COVID-19) and prior to the pandemic. We assessed the caregivers' emotional, physical, and financial strain and asked them to compare to preCOVID-19 caregiving. Analyses included descriptive and linear regression adjusting for sociodemographic and caregiving-related variables. RESULTS: A total of 285 caregivers met eligibility, and most were nonHispanic white (72.3%) and female (59.6%). Based on a scale of "1: Much lower" to "5: Much higher", the financial, physical and emotional strain/stress experienced by caregivers compared to preCOVID-19 was, on average, 3.52 (SD: 0.82; range: 1-5) for financial strain, 3.61 (SD: 0.86; range: 1-5) for physical strain, and 3.88 (SD: 0.89; range: 1-5) for emotional stress. NonHispanic black caregivers were significantly more likely than nonHispanic white caregivers to indicate that caregiving-related financial strain was higher than preCOVID-19. Moreover, Hispanic caregivers compared to nonHispanic white caregivers reported caregiving-related emotional stress was higher than preCOVID-19. CONCLUSION: These findings suggest a need to be attentive to racial and ethnic variations in emotional and financial strain and provide targeted support in clinical care and via public policy during a public health crisis.

Historical trauma and social support as predictors of psychological stress responses in American Indian adults during the COVID-19 pandemic.

BACKGROUND: American Indians (AIs) live with historical trauma, or the cumulative emotional and psychological wounding that is passed from one generation to the next in response to the loss of lives and culture. Psychological consequences of historical trauma may contribute to health disparities. PURPOSE: Here, we investigate whether historical trauma predicts changes in psychological stress associated with the onset of the COVID-19 pandemic in AI adults. Based on the stress-sensitization theory, we hypothesize that greater historical trauma will predict greater increases in levels of psychological stress from before the onset of the pandemic to after. METHOD: Our analytic sample consisted of 205 AI adults. We measured historical trauma and levels of psychological stress before and after the onset of the pandemic. RESULTS: Using hierarchical regression models controlling for age, biological sex, income, symptoms of depression and anxiety, psychological stress at Time 1, COVID-19 specific stress, and childhood trauma, we found that greater historical trauma preceding the pandemic predicted greater increases in psychological stress (ß = 0.38, t = 5.17 p < .01, ΔR2 = 0.12), and levels of social support interacted with historical trauma to predict changes in psychological stress (ß = -0.19, t = -3.34, p = .001, ΔR2 = 0.04). The relationship between historical trauma and changes in stress was significant for individuals with low levels of social support. CONCLUSIONS: Historical trauma may contribute to AI mental health disparities, through heightened psychological stress responses to life stressors and social support appears to moderate this relationship.

Evaluation of Factors Associated with Anxiety and Depression in Chinese Visiting Scholars in the United States During the COVID-19 Pandemic Assessed by Online Questionnaires.

BACKGROUND This study aimed to use online questionnaires to evaluate the factors associated with anxiety and depression in Chinese visiting scholars in the United States during the COVID-19 pandemic. MATERIAL AND METHODS Using a cross-sectional design, 311 Chinese scholars visiting 41 states in the United States were interviewed on 20 and 21 April 2020 through WeChat using the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) questionnaire. RESULTS Of these 311 visiting scholars, 69 (22.2%) reported no symptoms of anxiety or depression, whereas 63 (20.3%) reported severe anxiety and 67 (21.5%) reported severe depression. Risk of anxiety was 93% higher in visiting scholars with than without accompanying parents in the US (odds ratio [OR], 1.93; 95% confidence interval [CI], 1.01-3.68) and was 1.72-fold (95% CI, 1.04-2.84) higher in those experiencing stress about family members with COVID-19. Stresses about personal security and return to China on schedule were associated with 1.73-fold (95% CI, 1.03-2.92) and 3.00-fold (95% CI, 1.51-5.95) higher risks of anxiety, respectively. Risks of depression were 1.86-fold (95% CI, 1.14-3.05), 1.84-fold (95% CI, 1.10-3.07), and 3.45-fold (95% CI, 1.72-6.92) higher in visiting Chinese scholars who were than were not experiencing stresses about financial support, personal security and return to China on schedule, respectively. CONCLUSIONS Chinese scholars visiting the United States during the COVID-19 pandemic experienced severe psychological distress. Surveys that include larger numbers of visiting scholars are warranted.

Perceived Stress, Stigma, Traumatic Stress Levels and Coping Responses amongst Residents in Training across Multiple Specialties during COVID-19 Pandemic-A Longitudinal Study.

This study aimed to explore changes in psychological responses (perceived stress, traumatic stress, stigma, coping) over time in residents, as well as their predictors. The level of perceived stress, traumatic stress, stigma, and coping responses were assessed using the Perceived Stress Scale, Impact of Event-Revised, Healthcare Workers Stigma Scale, and Brief Coping Orientation to Problems Experienced (COPE) Inventory, respectively. We collected responses from 274 residents at baseline and 221 residents at 3 months follow-up (timepoint 2) from the National Healthcare Group (NHG) residency programs in Singapore. All residents reported lower perceived stress and lower perceived stigma compared to baseline. Use of avoidance coping was associated with all three psychological responses (perceived stress, traumatic stress, and stigma) across the two timepoints. Compared to baseline, specific factors associated with perceived stress and traumatic stress at timepoint 2 were living alone, less problem solving, and seeking social support. Residency programs should encourage active coping strategies (e.g., seeking social support, positive thinking, problem solving) among residents, and proactively identify residents who may be at higher risk of psychological sequelae due to circumstances that contribute to isolation.

Vulnerability and resilience to pandemic-related stress among U.S. women pregnant at the start of the COVID-19 pandemic.

RATIONALE: Women pregnant during the COVID-19 pandemic are experiencing moderate to high levels of emotional distress, which has previously been shown to be attributable to two types of pandemic-related pregnancy stress: stress associated with feeling unprepared for birth due to the pandemic (Preparedness Stress) and stress related to fears of perinatal COVID-19 infection (Perinatal Infection Stress). OBJECTIVE: Given the well-documented harms associated with elevated prenatal stress and the critical importance of developing appropriately targeted interventions, we investigated factors predictive of pandemic-related pregnancy stress. METHOD: Between April 25 and May 15, 2020, 4,451 pregnant women in the U.S. were recruited via social media to complete an online questionnaire that included sociodemographic, medical, and COVID-19 situational factors, as well as the Pandemic-Related Pregnancy Stress Scale (PREPS). Binary logistic regression was used to calculate odds ratios for high stress. RESULTS: Nearly 30% of participants reported high Preparedness Stress; a similar proportion reported high Perinatal Infection Stress. Abuse history, chronic illness, income loss due to the pandemic, perceived risk of having had COVID-19, alterations to prenatal appointments, high-risk pregnancy, and being a woman of color were associated with greater levels of one or both types of stress. Access to outdoor space, older age, and engagement in healthy behaviors were protective against stress. CONCLUSIONS: Practices that may alleviate pandemic-related stress such as minimizing disruptions to prenatal care, ensuring access to outdoor space, and motivating engagement in health behaviors are of vital importance. Particular attention is needed for more vulnerable populations including women of color, women with a history of abuse, and those with high-risk pregnancy. Research focused on the short and longer-term impact of pandemic-related pregnancy stress on maternal mental and physical health, perinatal outcomes, and child development is critical to identify these effects and marshal appropriate resources to reduce them.

Effect of Covid-19 pandemic on mental health among Albanian people residing in the country and abroad - Implications for mental care.

BACKGROUND: Coronavirus disease caused by the novel coronavirus Covid-19 is a current worldwide outbreak. The use of quarantine and isolation proved effective in containing the spread of infection. OBJECTIVES: The purpose of this cross-sectional study was to assess the mental health of Albanian people residing in the country and abroad during the quarantine period for the Covid-19 pandemic. DESIGN: This study was carried out from 25th March - 20th April 2020 through a web survey shared on social networks. The goal was to reach at least the minimum sample size for cross-sectional studies. The Patient Health Questionnaire (PHQ-9) was used to assess mental health. Chi-square (χ2) and Fisher -Exact test were used to assess the statistical significance among variables. P values ≤0.05 were considered statistically significant. RESULTS: 715 participants were included in the final analyses (78.41% females and 21.53% males). Most were residents in Albania (80.41%) and the others resided mainly in Italy (6.89%), Greece (3.51%), Germany (2.43%), Kosovo (1.62%) and the UK (1.69%). Statistical association was found between gender, country of residency and measures taken. Summary score of PHQ-9 items was 6.4662. The total score of depression classification shows that 31.82% and 12.90% of participants have respectively mild and moderate depression. Female participants showed the highest score for some items of PHQ-9, p≤0.05. CONCLUSIONS: Findings suggest that health care professionals should recognize and address mental health problems associated with Covid-19 especially in vulnerable groups. Acting in a timely and proper manner is essential in preventing these problems from becoming chronic.