Improvements in Compassion and Fears of Compassion throughout the COVID-19 Pandemic: A Multinational Study.

During large-scale disasters, social support, caring behaviours, and compassion are shown to protect against poor mental health outcomes. This multi-national study aimed to assess the fluctuations in compassion over time during the COVID-19 pandemic. Respondents (Time 1 n = 4156, Time 2 n = 980, Time 3 n = 825) from 23 countries completed online self-report questionnaires measuring the flows of compassion (i.e., Compassionate Engagement and Action Scales) and fears of compassion toward self and others and from others (i.e., Fears of Compassion Scales) and mental health at three time-points during a 10-month period. The results for the flows of compassion showed that self-compassion increased at Time 3. Compassion for others increased at Time 2 and 3 for the general population, but in contrast, it decreased in health professionals, possibly linked to burnout. Compassion from others did not change in Time 2, but it did increase significantly in Time 3. For fears of compassion, fears of self-compassion reduced over time, fears of compassion for others showed more variation, reducing for the general public but increasing for health professionals, whilst fears of compassion from others did not change over time. Health professionals, those with compassion training, older adults, and women showed greater flows of compassion and lower fears of compassion compared with the general population, those without compassion training, younger adults, and men. These findings highlight that, in a period of shared suffering, people from multiple countries and nationalities show a cumulative improvement in compassion and reduction in fears of compassion, suggesting that, when there is intense suffering, people become more compassionate to self and others and less afraid of, and resistant to, compassion.

Well-Being of High-Level Managers during the Pandemic: The Role of Fear of Negative Appearance, Anxiety, and Eating Behaviors.

(1) Background: The COVID-19 pandemic has caused unprecedented changes in the contemporary world, significantly affecting the work of companies, especially management staff. This study investigated whether fear about one's health (caused by the pandemic, disordered eating attitudes, or concerns about one's body image) has a negative relationship with the well-being of managers. (2) Methods: N = 354 managers (222 women, 126 men, and 6 people with no gender identity) participated in the study. The following psychometric instruments were used: the psychological well-being scale, the coronavirus anxiety scale, the fear of negative appearance evaluation scale, and the eating attitude test-26. Results: the fear of negative appearance influenced the well-being of the studied managers. However, this relation was mediated by dieting as well as bulimia and food preoccupation. (4) Conclusions: the well-being level depended on the managers' positive body images, but only when mediated by healthy dieting and eating attitudes. While the well-being level of managers was high, it is worth further exploring how they can flourish and develop in life and work, which can also transfer to the quality of life of their co-workers and companies. However, the subject of the well-being of managers warrants more research; for example, by considering different moderators, such as job experience, gender, and age. Moreover, experimental studies examining the effectiveness of different interventions for the physical and mental health of managers could be worth investigating.

Development and Validation of the COVID-19 Worries and Fears Scale.

Objectives: How individuals perceive the risk of COVID-19 influences their mental health and protective behaviors. Therefore, the development of an instrument to capture COVID-19-related worries and fears is relevant. This study aims to develop and validate the CoV-WoFe to measure COVID-19-related worries and fears. Methods: An online questionnaire was completed by 593 participants during Christmas 2020 and by 328 participants during Summer 2021, from which 88 participants formed a longitudinal sample. Results: Analyses confirmed a robust adjustment for consistency over time and a gender-invariant bifactorial structure. Factor 1 represented worry about the health consequences of COVID-19 and Factor 2 represented the perceived physiological symptoms associated with fear of COVID-19. Construct validity was evidenced by: the expected relations between the CoV-WoFe and other theoretically related constructs; the serial mediating role of both dimensions in the relationship that security values establish with protective behaviors against COVID-19 and with anxiety; and the expected gender differences in the Cov-WoFe. Conclusion: The CoV-WoFe represents a short, valid, reliable, gender-invariant tool that is easy to apply in both the health professional and research context to assessCOVID-19-related worries and fears, which are variables of relevance for spread of the virus and for mental health.

Parenting under pressure: Parental transmission and buffering of child fear during the COVID-19 pandemic.

The current study investigated the impacts of parental behaviors (threat communication and comforting) on children's COVID-19 fears and whether effects differed by age. Caregivers of 283 children (5.5-17 years, M = 10.17, SD = 3.25) from 186 families completed online measures assessing children's and parents' COVID-19-related fears, children's sources of COVID-19 threat information, and parents' engagement in behaviors to reduce child distress (i.e., comfort behaviors). Higher COVID-19 fear in parents was associated with greater communication of COVID-19 threat information, which was associated with higher COVID-19 fear in younger, but not older, children. Over and above parental fear and threat communication, greater exposure to COVID-19 threat information from community sources (e.g., media, school, friends) was associated with greater COVID-19 fear in children, regardless of age. Greater engagement of parental comfort behaviors buffered the association between community sources of COVID-19 threat information and COVID-19 fears in older, but not younger, children. These findings suggest that younger children might be more vulnerable to developing heightened COVID-19 fears as a result of increasing sources of COVID-19 threat information in their lives. This study highlights the importance of supporting the socioemotional well-being of children and families through the COVID-19 pandemic and beyond.

Fear of contagion, emotional stress and coping strategies used by adults during the first wave of the COVID-19 pandemic in Nigeria.

BACKGROUND: The COVID-19 pandemic has induced high levels of stress. The aim of the study was to assess the relationship between emotional stress (COVID-19 related fear, anger, frustration, and loneliness) and the use of coping strategies among adults in Nigeria during the COVID-19 pandemic. METHODS: Data from adults aged 18 years and above were collected through an online survey from July to December 2020. The dependent variables were COVID-19 related fear (fear of infection and infecting others with COVID-19), anger, frustration, and loneliness. The independent variables were coping strategies (use of phones to communicate with family and others, video conferencing, indoor exercises, outdoor exercises, meditation/mindfulness practices, engaging in creative activities, learning a new skill, following media coverage related to COVID-19) and alcohol consumption. Five logistic regression models were developed to identify the factors associated with each dependent variables. All models were adjusted for sociodemographic variables (age, sex at birth, and the highest level of education). RESULTS: Respondents who consumed alcohol, followed media coverage for COVID-19 related information, and who spoke with friends or family on the phone had higher odds of having fear of contracting COVID-19 or transmitting infection to others, and of feeling angry, frustrated, or lonely (p < 0.05). Respondents who exercised outdoors (AOR: 0.69) or learned a new skill (AOR: 0.79) had significantly lower odds of having fear of contracting COVID-19. Respondents who practiced meditation or mindfulness (AOR: 1.47) had significantly higher odds of feeling angry. Those who spoke with friends and family on the phone (AOR: 1.32) and exercised indoors (AOR: 1.23) had significantly higher odds of feeling frustrated. Those who did video conferencing (AOR: 1.41), exercised outdoors (AOR: 1.32) and engaged with creative activities (AOR: 1.25) had higher odds of feeling lonely. CONCLUSION: Despite the significant association between emotional stress and use of coping strategies among adults in Nigeria during the COVID-19 pandemic, it appears that coping strategies were used to ameliorate rather than prevent emotional stress. Learning new skills and exercising outdoors were used to ameliorate the fear of contracting COVID-19 in older respondents.

Managing Children's Fears during the COVID-19 Pandemic: Strategies Adopted by Italian Caregivers.

BACKGROUND: Life-threatening events, such as the COVID-19 pandemic, may generate feelings of insecurity and fear in the affected population, particularly children. Parents' ability to help children cope with negative emotions is essential during challenging periods. The current study aims to analyse the coping strategies adopted by Italian caregivers concerning their children's fears about COVID-19. METHOD: An online survey was administered during the Italian lockdown to 649 parents of at least one child aged 5 to 17 years old. Respondents completed the survey for themselves and their children. In addition, a qualitative content analysis of the data from the open-ended question was conducted (N = 569; 87.9% women; MAge = 45 years). RESULTS: Several themes were identified. Firstly, families' primary approach was 'communication and meaning-making'. Secondly, another essential strategy was 'the importance of safe space', enabled by keeping routine in place and creating a loving and caring environment. Thirdly, other factors relevant to managing children's fears were 'adaptation', 'religion', 'a positive attitude', and 'humour and hope'. Finally, the last two strategies significant and valuable for Italian families were 'flexibility' and 'maintaining virtual contacts. CONCLUSION: During the pandemic COVID-19, parents may have used various strategies to protect their children from stress. Future research could investigate single parents' coping strategies explicitly developed during the COVID-19 lockdown.

Adaptation and Preliminary Validation of the Fear of Coronavirus Vaccination Scale in the Prospective Study among a Representative Sample of Polish, Israeli, Slovenian, and German Adults during the COVID-19 Pandemic.

Although concerns about harm and side effects are among the most important factors determining vaccine hesitancy, research on the fear of vaccination is sparse. The purpose of this study is a validation the Fear of Coronavirus Vaccination Scale (FoCVVS), adapted from the Fear of COVID-19 Scale. A representative sample of 1723 young adults aged 20-40 from Poland, Israel, Slovenia, and Germany participated during two time-points of the third COVID-19 pandemic wave. The online survey included demographic variables and several well-being dimensions, including gender, vaccination status, fear of coronavirus (FoCV-19S), physical health (GSRH), life satisfaction (SWLS), and perceived stress (PSS-10), anxiety (GAD-7), and depression (PHQ-9). Exploratory factor analysis (EFA) was performed at T1, and confirmatory analysis (CFA) at T2. The second-order two-factor structure demonstrated the best fit and very good discriminant and convergent validation. The general factor of the FoCVVS included two subscales assessing the emotional and physiological symptoms of fear of vaccination. Unvaccinated people showed higher levels of fear of vaccination than those vaccinated. A vaccination status, fear of vaccination T1, and fear of COVID-19 T1 were significant predictors of fear of vaccination T2. Vaccination-promoting programs should be focused on decreasing fear and enhancing the beneficial effects of vaccination.

Validation of the fear of COVID-19 scale in a central Balkan country - Serbia.

Validation of the fear of introduction: High levels of fear of COVID-19 may be associated with increased levels of stress, anxiety, and depression, as well as decreased resilience and life expectancy. Objective: This study aimed to translate and confirm the Serbian version of the Fear of COVID-19 scale as well as to investigate its psychometric properties. Methods: The translation and intercultural adaptation of the Fear of COVID-19 scale was performed by the leading standard of the International Society for Pharmacoeconomics and Outcome Research. When the distribution was normal, the Kolmogorov-Smirnov test was used. The reliability of the Serbian version of FCV-19S was tested by measuring the internal consistency through the value of Cronbach's alpha. Results: The original version of the Fear of COVID-19 scale was tested on a sample of 256 subjects with a mean age of 25.38 ± 12.47. The Cronbach's alpha value was 0.864. We divided the scale by the split-half method (Spearman-Brown), and the value of the coefficient for the questionnaire as a whole was 0.882. Divergent criterion validity was tested through the non-parametric correlation between the scores of the Fear of COVID-19 scale and the Fear of Hospitalization scale. A score of the Fear of COVID-19 scale was calculated as the sum of each question for each of the respondents. Convergent criterion validity was tested through the non-parametric correlation between the scores of the Fear of COVID-19 scale and the Emotional Regulation Questionnaire. Conclusion: The validated version of the scale in Serbia complements versions available in other cultures and other languages and facilitates global studies related to mental health during the COVID-19 pandemic.

Anxiety towards COVID-19, Fear of Negative Appearance, Healthy Lifestyle, and Their Relationship with Well-Being during the Pandemic: A Cross-Cultural Study between Indonesia and Poland.

The COVID-19 pandemic has led to massive changes in almost all aspects of human life, including emotional states such as anxiety and fear, perspectives about healthy lifestyles, and psychological outcomes. This study aimed to disentangle the mechanisms that underlie the relationships of anxiety towards COVID-19 and fear of negative appearance with well-being, we also investigated the effects of cultural variations on levels of anxiety, fear of negative appearance, healthy lifestyles, and well-being. A total of 881 Indonesians (n = 172) and Poles (n = 709) participated in this study. Participants completed self-report measures of psychological well-being, anxiety, fear of negative appearance, compulsive exercise, and eating disorders. Multigroup structural equation modelling (SEM) was used. The results showed no statistically meaningful relationship between anxiety towards COVID-19 and well-being. However, it was found that, in the Polish sample, compulsive exercise and eating disorders mediated the relationship between fear of negative appearance and well-being. Cultural differences were also found in the mean scores of all examined constructs, with eating disorders being an exception. Therefore, this study highlights cultural aspects that determine emotional states, healthy lifestyles, and well-being.

Parallel exploratory and confirmatory factor analysis of the Hungarian Fear of COVID-19 Scale in a large general population sample: a psychometric and dimensionality evaluation.

BACKGROUND: This study aims to confirm validity and reliability of the Hungarian version of Fear of COVID-19 Scale (FCV-19S) and evaluate its dimensional structure. METHODS: Cross-sectional survey was carried out in 2021 among Hungarian general population. In addition to classical test theory methods, construct dimensionality of FCV-19S was assessed using EFA with principal axis factoring method and CFA with diagonally-weighted least squares estimation. Fear score was compared in age, gender, educational level, vaccination and infection subgroups. RESULTS: Significant differences in FCV-19S mean scores were observed between three subgroups (age, gender, vaccination). Items showed good internal consistency (Cronbach α = 0.88). EFA identified two latent factors (eig = 4.2 and 1.02), though parallel analysis supports the one-factor model. The two-dimensional structure was confirmed by CFA, items 3,4,6,7 correlated with Factor 1 (physiological fear), items 1,2,5 with Factor 2 (emotional fear). CONCLUSION: The Hungarian version of FCV-19S seems valid and reliable. The EFA identified two-latent factors (emotional and physiological fear), that was confirmed by CFA. The two-factor structure had better model fit, though its' acceptance is limited.

The role of healthy emotionality in the relationship between fear of COVID-19 and mental health problems: a cross-sectional study.

Understanding pandemic-related psychopathology development is limited due to numerous individual and contextual factors. It is widely accepted that individual differences to endure or cope with distress predict psychopathology development. The present study investigated the influence of individual differences in neuroticism and healthy emotionality concerning the association between fear of COVID-19 and mental health problems. It was hypothesized that healthy emotionality would moderate the mediated link between fear of COVID-19 and mental health problems. A sample of 752 participants (351 males and 401 females) completed an online survey including the Emotional Style Questionnaire, Fear of COVID-19 Scale, the Neuroticism subscale of the Big Five Inventory, and General Health Questionnaire. The results showed that the fear of COVID-19 positively predicted mental health problems (ß = .43, SE = .05, p < .001, Cohen's f 2 = .24). Neuroticism also showed a significant mediation effect on the relationship between fear of COVID-19 and mental health problems. Fear of COVID-19 indirectly predicted psychopathology through neuroticism (ß = - .16, SE = .04, p < .001, t = 4.53, 95% CI [0.11, 0.23]). Moreover, healthy emotionality had a moderating effect on the relationship between fear of COVID-19 and mental health problems, ß = - .21, SE = .03, p < .001, t = 5.91, 95% CI [- 0.26, - 0.14]. The study's findings are expected to contribute to a better understanding of the roles of both individual differences in personality traits and healthy emotionality in psychopathology development during the current pandemic.

Fear of COVID-19, stress and depression: A meta-analytic test of the mediating role of anxiety.

OBJECTIVES: The COVID-19 pandemic has negatively affected the lives of millions of individuals physiologically, behaviorally, socially, and/or psychologically. Moreover, there is now much empirical evidence that mental health problems have increased during the pandemic period and these problems have various consequences. The changes in the mood states of individuals due to the pandemic underpins the rationale of the present study. The aim of the study was to identify the cross-sectional associations between fear of COVID-19, stress, anxiety, and depression by using two stage-meta-analytic structural equation modeling (TS-MASEM). DESIGN: This is a meta-analytic structural equation modelling study. METHOD: A systematic literature review initially identified 4840 studies. As a result of applying inclusion and exclusion criteria, 25 studies comprising 28 samples (reporting 120 effect sizes) were eligible for inclusion in the current TS-MASEM (N = 16,452). RESULTS: The results showed significant associations between fear of COVID-19, stress, anxiety, and depression. Additionally, the mediation role of anxiety in the association between depression and fear of COVID-19 and stress was explored. CONCLUSIONS: Although the results did not allow for causal inferences regarding depression, they provide insight into the possible consequences of fear of COVID-19 and comorbid problems for clinicians and researchers.

Psychological distress and fear of Covid-19 in student nurses before clinical placement: a cross-sectional study.

OBJECTIVE: To determine the degree of psychological distress and fear of COVID-19 experienced by undergraduate student nurses who were about to begin their clinical placements. METHOD: A cross-sectional study was carried out with 100 second- and third-year undergraduate student nurses of the University of Zaragoza (Spain). Measures included the Fear of COVID-19 Scale and the Depression Anxiety Stress Scales. RESULTS: Regularly, student nurses did not think of themselves as vulnerable to COVID-19. However, a significant association was observed between the student nurses' level of psychological distress and cohabiting with relatives or people who were considered vulnerable to the infection (p = 0.035). The Depression Anxiety Stress Scale results revealed a low level of psychological distress in general; the Fear of COVID-19 Scale indicated moderate fear (2.94). CONCLUSION: Student nurses who lived with their relatives experienced higher levels of stress due to the perceived risk of transmission, but were less fearful of loss of work and income. Anxiety in our sample was associated principally with not knowing their upcoming placement location.

Health literacy and fear among Iranian medical students due to COVID-19: An observational study.

INTRODUCTION: The coronavirus disease of the 2019 (COVID-19) pandemic has created a sense of fear due to uncertainties in medical students' personal and professional lives. Medical education is challenging and poses a more significant academic and emotional rigor when compared with other professional programs. With the COVID-19 having limited treatment options, health literacy (HL) is crucial for managing and responding to the pandemic. This research aims to examine the impact of HL on COVID-19-associated fear among Iranian medical students. METHODS: A cross-sectional study was conducted measuring the HL and fear of COVID-19 using validated scales. Two hundred and seventy-eight survey responses were received and analyzed descriptively by using SPSS software inferential statistics. RESULTS: Mean age of participants was 22.93 ± 5.427 years. The correlation between students' total health literacy (HELIA) scores and their fear of COVID-19 (FCV-19S) scores was -0.279 (p value = .019). The FCV-19S has a negative correlation with total HELIA in the group of females and males, single and married people, bachelor and MD students, and students living in rural areas and urban areas. The negative correlation of FCV-19S with total HELIA in males and students who reside in rural areas was the only one that was not significant. In associate degree students, the correlation between FCV-19S and total HELIA was positive but not significant. Education grades had a significant impact on FCV-19S. Furthermore, the place of residence also had a significant impact on FCV-19S. However, the gender and marital status did not significantly impact FCV-19S. CONCLUSIONS: The present study showed that students with higher HL scores had lesser fear of COVID-19. The key stakeholders require several positive strategies to reduce fear and improve health, and such vital policies will assist in improving the students' health and achieving the sustainable developmental goals.

Relationships between the Fear of COVID-19 Scale and regional brain atrophy in mild cognitive impairment.

BACKGROUND: Several studies have reported that the pandemic of coronavirus disease 2019 (COVID-19) influenced cognitive function in the elderly. However, the effect of COVID-19-related fear on brain atrophy has not been evaluated. In this study, we evaluated the relation between brain atrophy and the effect of COVID-19-related fear by analysing changes in brain volume over time using magnetic resonance imaging (MRI). METHODS: Participants were 25 Japanese patients with mild cognitive impairment (MCI) or subjective cognitive decline (SCD), who underwent 1.5-tesla MRI scan twice, once before and once after the pandemic outbreak of COVID-19, and the Fear of Coronavirus Disease 2019 Scale (FCV-19S) assessment during that period. We computed regional brain atrophy per day between the 1st and 2nd scan, and evaluated the relation between the FCV-19S scores and regional shrinkage. RESULTS: There was significant positive correlation between the total FCV-19S score and volume reduction per day in the right posterior cingulate cortex. Regarding the subscales of FCV-19S, we found significant positive correlation between factor 2 of the FCV-19S and shrinkage of the right posterior cingulate cortex. CONCLUSIONS: There was positive correlation between the FCV-19S score and regional brain atrophy per day. Although it is already known that the psychological effects surrounding the COVID-19 pandemic cause cognitive function decline, our results further suggest that anxiety and fear related to COVID-19 cause regional brain atrophy.

Association between perceived stress, fear and anxiety of COVID 19 with self-care in pregnant women: a cross-sectional study.

Pandemic COVID-19 has negative effects on the mental health of all people, especially pregnant women. This study aimed to determine the psychological effects of COVID-19 on self-care in pregnant women. The Cross-sectional study using the Multistage sampling technique was conducted among 215 pregnant women selected randomly from the Iranian Integrated Health System in 2020. Data were collected using demographic and obstetrics questionnaires, Pregnancy Self-Care Scale, Fear of COVID-19, COVID-19 Anxiety Scale(CDAS), and Perceived Stress Scale (PSS) by the self-report method. Data analysis was performed using SPSS software version 21 with Pearson correlation test and multivariable linear regression.The Mean (Standard Deviation (SD)) of Fear, anxiety, perceived stress, and self-care was 20.85(6.45), 18.20(10.45), 31.16 (7.65) and 40.84(4.11), respectively. The correlational analyses showed small positive significant associations between Fear (r=0.20; P=0.004) and anxiety of COVID-19 (r=0.14; P=0.03)with self-car but the association between perceived stress and self-care was small negative significant (r= -0.14; P=0.04). Based on regression analysis, 11% of the self-care changes could be explained by three independent variables (ß= 0.130, SE= 0.043, P=0.002). Based on the findings, pregnant women may benefit from psychoeducation that focuses on the effect of mental health problems on pregnant women.

The Only Thing I Have to Fear Is Fear Itself.

This autobiographical essay provides a discussion of how understanding being counterphobic limited the physician's ability to be realistically afraid during the intial phase of the COVID-19 pandemic.

Mental health of individuals who are deaf during COVID-19: Depression, anxiety, aggression, and fear.

This study aims to assess depression and anxiety levels among individuals, who are deaf during the lockdown throughout the first wave of the pandemic United Arab Emirates. The sample of the study consisted of 36 (n = 36) individuals aged 20.3 ± 1.2 years, who were deaf from birth. The respondents were divided into two groups; (1) those who were living with their parents (n = 20), (2) those who were independently living on their own (n = 16). Results of the study indicated that from May to October, there was decrease in the number of normal mental health cases among those living with parents (p ≤ 0.05). The results of the study show that in the time of the pandemic, deaf people constitute a vulnerable portion of the population. The correlation between living alone and stress levels was 0.78. The correlation between living with parents and stress levels was -0.85.

The fear of the COVID-19 Scale: validation in the Portuguese general population.

The coronavirus disease (COVID-19) pandemic is having a profound effect on mental health and it is therefore fundamental to evaluate individual psychological responses to COVID-19. The 7-item Fear of COVID-19 Scale (FCV-19S) assesses different aspects of the fear of coronavirus and has been applied worldwide. This study aimed to translate and validate the FCV-19S in the Portuguese population. The scale was administered to a convenience sample of 1203 Portuguese adults. Exploratory factor analysis was carried out on the initial model proposed by the authors of the FCV-19S. Further analysis revealed that the Portuguese version has good psychometric properties.

Lessons on COVID-19 from Home and Community: Perspectives of Nursing Leaders at All Levels.

The initial focus of the COVID-19 pandemic was on the surge capacity of hospitals. Moving forward, however, the attention needs to shift toward keeping people healthy at home. In this paper, we discuss critical insights from the home and community care sector, which shed light on pre-pandemic fault lines that have widened. The paper, however, takes a positive look at how a better future can be built, particularly for those most vulnerable in society. We offer three key insights and analyses as well as examples of how one national homecare organization in Canada, SE Health, is facing the pandemic. We discuss the following key insights: (1) pre-pandemic systemic biases and barriers were exasperated during the pandemic, which impacted the most vulnerable; (2) nurse leaders were faced with unprecedented fear and anxiety from both patients and their staff colleagues; and (3) the pandemic provided an opportunity for significant learning, innovation and capacity development. The pandemic is far from over - we are in a marathon, not a sprint. The paper concludes with how nurse leaders can lead the way in navigating through the pandemic and build a better "new normal."