University students' life stressors and mental health in Georgia and German-speaking Switzerland: Exploring the role of fatalism, sense of coherence, cross-cultural coping, and help-seeking

Background: The university years are associated with a variety of stressors, and recently, COVID-19 has presented an additional burden on students' mental well-being. As mental health manifestations of stressors may differ between countries, this study compared students from Switzerland and the Republic of Georgia regarding the burden of stressors and the role of potentially culture-dependent risk and protective factors of mental health (i.e., help-seeking, cross-cultural coping, fatalism, sense of coherence). Method: We assessed two samples of university students in Georgia (N = 425) and German-speaking Switzerland (N = 298), using a cross-sectional design. Quantitative data were collected with online questionnaires during the third wave of the pandemic. Mental health screenings included measures of depression, anxiety, and adjustment disorder. Results: General life- and COVID-19-related stress levels were higher in Georgia than in Switzerland. Georgian students experienced more adjustment disorder symptoms but lower levels of depression and anxiety. While Swiss students reported more protective factors (formal and informal help-seeking, sense of coherence), Georgian students experienced more risk factors (fatalism and avoidance coping). Despite significant correlations between potentially culture-dependent risk and protective factors and mental health, few associations remained significant above and beyond the impact of general life stress. Conclusions: The high prevalence of stressors and adjustment disorder symptoms and risk factors for mental health among Georgian students illustrates a potential need for psychosocial support with stress management. The cross-cultural applicability of Western models of student mental health services should be evaluated. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement The agenda of global mental health calls for addressing prevention and quality gaps, although achieving this aim is not possible if the divergent needs of specific populations, among them young people, are not studied and considered. This study explores the mental health stressors and needs of university students and compares Swiss and Georgian students' potentially culture-dependent risk and protective factors. Needs-based tailored interventions could be developed based on the findings. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Relationship between adjustment disorder symptoms and probable diagnosis before and after second lockdown in Israel: longitudinal symptom network analysis.

BACKGROUND: There is cumulative evidence of the importance of exploring the change of dynamics between symptoms over time as reflective of consolidation of psychopathology. AIMS: To explore the interactions between symptoms of ICD-11 adjustment disorder before and after the second lockdown of the COVID-19 pandemic in Israel and identify the most central symptoms and their concurrent and prospective associations with probable adjustment disorder. METHOD: This is a population-based study drawn from a probability-based internet panel. A representative sample of the adult Israeli population was assessed at two time points (T1, pre-second lockdown, n = 1029, response rate 76.17%; T2, post-second lockdown, n = 764, response rate 74.24%). Symptoms of adjustment disorder were assessed by the International Adjustment Disorder Questionnaire (IADQ). RESULTS: Although the overall strength of associations at the two measurement points was similar and two same communities were found, there was a significant change in their structure, with a more consolidated network at T2. The most central item was 'difficult to relax' in both networks. Cross-sectionally, all symptoms of failure to adapt significantly predicted adjustment disorder. 'Worry a lot more' (preoccupation) and 'difficult to adapt to life' (failure to adapt) at T1 significantly predicted this diagnosis at T2. CONCLUSIONS: Adjustment disorder symptoms consolidated during the second lockdown of the pandemic. In line with the ICD-11 conceptualisation of adjustment disorder, both preoccupation and failure-to-adapt symptoms have prognostic validity. This highlights the importance of identifying and targeting adjustment disorder symptoms during a period of stress such as the COVID-19 pandemic.

The network structure of ICD-11 adjustment disorder: A comparison of clinical and nonclinical samples.

BACKGROUND: International Classification of Diseases, 11th revision (ICD-11) adjustment disorder (AjD) is characterized by two main symptom clusters: preoccupation with the stressor and failure to adapt to the stressor. The network analytic approach provides important information on the structural validity of a disorder and reveals which symptoms are most prominent. To date, no study compared the network structure of AjD symptoms in clinical and nonclinical samples, which could potentially inform our understanding of psychopathological mechanisms that underlie AjD and identify core targets for therapy. METHODS: A network analysis was conducted on AjD symptoms as assessed by the Adjustment Disorder-New Module (ADNM-8) using data from 330 clinical participants from the UK and a nonclinical sample of 699 participants from Switzerland. RESULTS: Comparisons of network structure invariance revealed differences between the network structure of the clinical and the nonclinical samples. Results highlight that in terms of both edges strength and centrality, failure to adapt symptoms was more prominent in the clinical sample, while the preoccupation symptoms were more prominent in the nonclinical sample. Importantly, global strength was similar across networks. CONCLUSIONS: Results provide evidence of the coherence of AjD in the ICD-11 as assessed by the ADNM questionnaire. They tentatively suggest that subclinical AjD may be characterized by emerging preoccupation symptoms that may result in failure to adapt and functional impairment in clinical manifestation of AjD. However, there is a need for replication and longitudinal research to further validate this hypothesis.

Validation of the International Adjustment Disorder Questionnaire in Israel and Switzerland.

The ICD-11 has introduced a new conceptualization of adjustment disorder (AjD) as a stress response syndrome with core symptoms of preoccupations and failure to adapt to the stressor. The current study aimed to assess the reliability and validity of the International Adjustment Disorder Questionnaire (IADQ) in two culturally distinct samples from Israel and Switzerland. Two samples were recruited in Israel (N = 1142) and Switzerland (N = 699) during the initial stages of the COVID-19 pandemic. Confirmatory factor analysis indicated that a correlated two-factor model provided an excellent fit to the Israeli and Swiss sample data. The IADQ scores correlated strongly with another measure of AjD symptoms and with symptoms of depression, anxiety, acute stress and negative emotions, whereas correlations with posttraumatic stress disorder, complex posttraumatic stress disorder and positive emotions were weaker. In the Swiss sample, 18.8% met diagnostic criteria for probable AjD and 10.2% in the Israeli sample. The current study provides the first evidence of the validity of the German and Hebrew versions of the IADQ and can be used for the screening of this debilitating condition.

Cross-cultural investigation of COVID-19 related acute stress: A network analysis.

The outbreak of the COVID-19 pandemic has confronted humanity with an ongoing biopsychosocial stressor, imposing multifaceted challenges to individuals and societies. Particularly, the pandemic reflects an ongoing, potentially life-threatening danger to self and others, which may instigate acute stress symptoms (ASS). This study utilized a network framework to assess cross-national ASS a short time following the initial COVID-19 outbreak. Three samples of adult participants from China, Israel, and Switzerland completed a self-report assessment of acute stress symptoms. Network analyses were utilized to uncover the phenotype and dynamics of different ASS in these three countries. The ASS network analyses revealed extensive connections in all networks and reflected the structure of ASS. The centrality indexes in all networks were from the hyperarousal cluster. "Feeling jumpy" was the node with the highest strength centrality in the Israeli sample and "physiological reactivity" was the item with the highest centrality in the Swiss sample. In the Chinese sample, the item with the highest centrality was "feeling alert to danger." The findings reveal that despite some variations, the overall clinical picture of ASS in response to the COVID-19 pandemic is universal. These findings highlight the centrality of hyperarousal symptoms, presumably reflecting its significance for clinical interventions.

Negative Affect, Fatalism, and Perceived Institutional Betrayal in Times of the Coronavirus Pandemic: A Cross-Cultural Investigation of Control Beliefs.

Background: A growing number of studies report that the COVID-19 pandemic has resulted in diverse aversive psychological reactions and created a global mental health crisis. However, the specific mechanisms underlying the negative emotional reactions as well as the differences between countries are only beginning to be explored. The present study examined the association of COVID-19-related fear and negative affect in Israel and Switzerland. The mediating roles of three control beliefs were explored, namely, fatalism, locus of control, and perceived institutional betrayal. Method: General population samples of 595 Swiss and 639 Israeli participants were recruited and completed an online self-report survey. Moderated Mediation using multigroup path analysis models for the two samples were conducted and compared using AMOS. Results: The multigroup path model had excellent fit for both samples. The different paths were moderated by country affiliation. Higher levels of COVID-19-related fear were associated with negative affect to an equal extent in both samples. COVID-19-related fear was associated with higher reports of institutional betrayal and a lower locus of control in both samples. Higher COVID-19-related fear was associated with lower fatalism in the Swiss sample only. In both samples, institutional betrayal mediated the association between COVID-19-related fear and negative affect, however, locus of control was a mediator in the Israeli sample only. Conclusion: The current results suggest that the reaction of the government was of crucial importance with regard to the emotional state of the two populations. Interestingly, while in the context of adversity fatalism is generally considered a risk factor for mental health, during the time of the pandemic it seems to have had protective qualities among the Swiss population. Interventions that strengthen the personal locus of control have the potential to mitigate the negative affect in Israel but not in Switzerland. Despite the fact that COVID-19 is a global phenomenon, prevention and intervention strategies should be adjusted to local contexts.