Mental Health Risks after Repeated Exposure to Multiple Stressful Events during Ongoing Social Unrest and Pandemic in Hong Kong: The Role of Rumination: Risques pour la santé mentale après une exposition répétée à de multiples événements stressants d'agitation sociale durable et de pandémie à Hong Kong: le rôle de la rumination.

OBJECTIVES: The co-occurrence of different classes of population-level stressors, such as social unrest and public health crises, is common in contemporary societies. Yet, few studies explored their combined mental health impact. The aim of this study was to examine the impact of repeated exposure to social unrest-related traumatic events (TEs), coronavirus disease 2019 (COVID-19) pandemic-related events (PEs), and stressful life events (SLEs) on post-traumatic stress disorder (PTSD) and depressive symptoms, and the potential mediating role of event-based rumination (rumination of TEs-related anger, injustice, guilt, and insecurity) between TEs and PTSD symptoms. METHODS: Community members in Hong Kong who had utilized a screening tool for PTSD and depressive symptoms were invited to complete a survey on exposure to stressful events and event-based rumination. RESULTS: A total of 10,110 individuals completed the survey. Hierarchical regression analysis showed that rumination, TEs, and SLEs were among the significant predictors for PTSD symptoms (all P < 0.001), accounting for 32% of the variance. For depression, rumination, SLEs, and PEs were among the significant predictors (all P < 0.001), explaining 24.9% of the variance. Two-way analysis of variance of different recent and prior TEs showed significant dose-effect relationships. The effect of recent TEs on PTSD symptoms was potentiated by prior TEs (P = 0.005). COVID-19 PEs and prior TEs additively contributed to PTSD symptoms, with no significant interaction (P = 0.94). Meanwhile, recent TEs were also potentiated by SLEs (P = 0.002). The effects of TEs on PTSD symptoms were mediated by rumination (ß = 0.38, standard error = 0.01, 95% confidence interval: 0.36 to 0.41), with 40.4% of the total effect explained. All 4 rumination subtypes were significant mediators. CONCLUSIONS: Prior and ongoing TEs, PEs, and SLEs cumulatively exacerbated PTSD and depressive symptoms. The role of event-based rumination and their interventions should be prioritized for future research.

Psychological well-being of ruminative adolescents during the transition to COVID-19 school closures: An EMA study.

INTRODUCTION: Adolescents with moderate-to-severe levels of trait rumination are at heightened risk for psychopathology and may be particularly vulnerable to disruptions caused by the onset of the COVID-19 pandemic. As most past research documenting the impact of COVID-19 on adolescent well-being has been cross-sectional, it is unclear exactly how ruminative adolescents responded to the onset of the pandemic as it unfolded. METHODS: We used ecological momentary assessment (EMA) to explore changes in rumination among adolescents during the initial transition to distance learning in the United States. A subsample of 22 ruminative youth (Mage = 13.58; SD = 0.96; 54.5% male; 86.4% White) from a larger study provided EMA data throughout January-April 2020 (M responses per participant = 105.09, SD = 65.59). Following school closures, we hypothesized that adolescents would report greater rumination (i.e., focusing on emotions and problems) and depressive symptom level would moderate this effect. RESULTS: Surprisingly, rumination decreased, and this effect was moderated by depressive symptom level for emotion-focused rumination, i.e., those with average and below-average depressive symptoms experienced decreases in rumination. CONCLUSIONS: These results suggest that the first wave of stay-at-home orders and the transition to distance learning were not immediately distressing to vulnerable adolescents. However, more research is needed to determine whether the results from recent research are generalizable to other adolescents and to examine the long-term impact of the pandemic on adolescent well-being.

The influence of COVID-induced job search anxiety and conspiracy beliefs on job search effort: A within-person investigation.

New labor market entrants face significant hurdles when searching for a job, with these stressors likely amplified during the COVID-19 pandemic. Here, we consider how COVID-induced job search anxiety-feeling anxious about one's job search due to issues imposed by the pandemic-has the potential to affect adaptive, goal-directed efforts, and maladaptive, goal-avoidant reactions. We theorize that this anxiety can prompt job seekers to engage in problem-solving pondering and affect-focused rumination, with these experiences relating to whether job seekers engage in various forms of search-related efforts the following week. In particular, we consider whether job seekers are engaging in dream job search effort (i.e., effort toward pursuing one's dream job), as well as focused (i.e., effort toward a selection of carefully screened jobs), exploratory (i.e., effort toward a wide swath of jobs in a broad manner), and haphazard (i.e., effort toward applying for any job without a clear plan) job search effort. Further, we consider how stable beliefs relevant to the pandemic (i.e., belief in conspiracy theories; belief in COVID-19 being a public health crisis) affect the aforementioned relationships. Using a weekly study of 162 new labor market entrants, results indicated that COVID-induced job search anxiety positively related to problem-solving pondering and affect-focused rumination; problem-solving pondering promoted dream, focused, and exploratory job search effort the following week, whereas affect-focused rumination hindered dream job search effort. Finally, the detrimental effects of COVID-induced job search anxiety via affect-focused rumination were amplified for those who held higher levels of conspiracy theory beliefs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

COVID-19 Rumination Scale (C-19RS): Initial psychometric evidence in a sample of Dutch employees.

OBJECTIVES: Starting with the spring of 2020, COVID-19 pandemic has impacted nearly every aspect of our lives. Due to its threatening nature, along with the rapid rise in contamination and mortality figures, the spread of the virus has caused a considerable rise in individuals' anxieties. To enable the assessment of the COVID-19-triggered individual rumination, we developed and tested a COVID-19 Rumination Scale (C-19RS). DESIGN AND METHODS: Demographics (i.e., gender, age and education) and several items assessing the proximity of one's exposure to the virus (i.e., whether one's family and close friends are affected) were evaluated as antecedents of C-19RS that provided evidence for the criterion validity of the scale. A sample of 523 Dutch employees working in different companies and sectors completed the online survey in March 2020. RESULTS: Results showed that women, older individuals and workers with lower educational level ruminated considerably more about COVID-19. In keeping with prior theoretical and empirical work on stress and coping, we established that COVID-19 ruminative thoughts can unlock withdrawal coping reactions (i.e., self-handicapping) and drain individual's energy (i.e., causing emotional exhaustion), whereby providing evidence for the predictive validity of the new instrument. In addition, we examined how the COVID-19 rumination evolved during the nearly 3-week period of the data collection, a time-frame that coincided with the introduction of the national restrictive measures in the Netherlands. Results showed a drop in the level of rumination, which might be indicative of potential habituation with the stressor. CONCLUSIONS: The results supported the sound psychometric qualities of the scale.

The role of leisure crafting for emotional exhaustion in telework during the COVID-19 pandemic.

BACKGROUND: After the worldwide outbreak of COVID-19 in 2020, many employees transitioned from in-office work to telework to slow down the spread of the virus. Building on the Job Demands-Resources model, we examined day-level relationships between job demands, home demands and emotional exhaustion during telework. Moreover, we tested if leisure crafting (i.e., the proactive pursuit and enactment of leisure activities targeted at goal setting, socializing, growth and development) is negatively related to emotional exhaustion. We expected that proactive personality would be positively related to leisure crafting. Finally, emotional exhaustion was predicted to relate negatively to job performance. METHODS: We tested our assumptions using a daily diary study on seven consecutive days with 178 employees (964 observations in total). RESULTS: Multilevel path analysis supports the assumptions that daily job demands as well as daily home demands during telework are positively related to emotional exhaustion. As predicted, we found leisure crafting to be negatively related to emotional exhaustion, and proactive personality to be positively related to leisure crafting. Finally, emotional exhaustion was negatively related to job performance. CONCLUSIONS: Overall, our study supports a health-promoting role of leisure crafting above the unfavorable relationships between job demands and home demands with emotional exhaustion.

Concerns, Perceived Impact, Preparedness in Coronavirus Disease (COVID-19) Pandemic and Health Outcomes among Italian Physicians: A Cross-Sectional Study.

BACKGROUND: Health care workers (HCWs) are among the professionals at serious risk for the impact of the COVID-19 pandemic on their mental health. In this sense, the next public health challenge globally will be to preserving healthy HCWs during this pandemic. AIM: The present study has the aim of investigating the relationship among concerns, perceived impact, preparedness for the COVID-19 pandemic and the mental health of Italian physicians. METHODS: From March 29th to April 15th 2020, we conducted an online survey using snowball sampling techniques through Limesurvey platform. Data were analyzed using descriptive statistics and multiple binary logistic regressions. RESULTS: Multivariate analysis showed that the risk factors for perceived job stress were concerns about catching COVID-19 (OR = 3.18 [95% CI = 2.00-5.05] P < .001), perceived impact on job demands (OR = 1.63 [95% CI = 1.05-2.52] P < .05), perceived impact on job role (OR = 2.50 [95% CI = 1.60-3.90] P < .001), and non-working concerns (OR = 1.86 [95% CI = 1.15-3.03] P < .05). With respect to the risk factors for rumination about the pandemic emerged concerns about catching COVID-19 (OR 1.74, [95% CI = 1.12-2.71] P < .05), perceived impact on job role (OR = 1.68 [95% CI = 1.12-2.52] P < .05), and impact on personal life (OR = 2.04 [95% CI = 1.08-3.86] P < .05). Finally, the risk factors for crying at work were perceived impact on job role (OR = 2.47, [95% CI = 1.20-5.09] P < .05), rumination about the pandemic (OR = 3.027 [95% CI = 1.27-7.19] P < .01), watching colleagues crying at work (OR = 3.82 [95% CI = 1.88-7.77] P < .01), and perceived job stress (OR = 3.53 [95% CI = 1.24-10.07] P < .05). CONCLUSION: In general, our results highlighted that being concerned about being infected/infecting other people, carrying out new and unusual tasks, and witnessing colleagues crying at work were important risk factors for physicians' well-being. Additional data are necessary to advance understanding of these risk factors in a long-term perspective.

Social Media Exposure and College Students' Mental Health During the Outbreak of COVID-19: The Mediating Role of Rumination and the Moderating Role of Mindfulness.

In response to reports of people experiencing varying levels of anxiety and depression during the outbreak of COVID-19, researchers have argued that exposure to related information on social media is a salient contributing factor. Based on the integrated model of ruminative response style and the diathesis-stress model, it has been suggested that incorporating rumination and mindfulness may elucidate the potential mechanism underlying the aforementioned association. This study aimed to examine the mediating role of rumination and the moderating role of mindfulness in the association between social media exposure (SME) to COVID-19 information and psychological distress. The results from online questionnaire responses of 439 college students from two universities in Wuhan, Hubei Province, showed that rumination mediated the association between SME and psychological distress. Furthermore, mindfulness was revealed as a protective factor that buffered the adverse effect of SME on psychological distress through rumination. These findings advance a better understanding of the formation process of psychological symptoms during the COVID-19 pandemic and provide insights regarding effective interventions for adverse mental health consequences in college students.