The Psychological Ability to Cope Reduced Infections During the Pandemic: A Two-Year Population-Based Study of The Determinants of 123 Million COVID-19 Test Results in Denmark (preprint)

During the COVID-19 pandemic, a key concern for authorities was to identify and activate the psychological states most likely to motivate the public to engage in protective behavior such as physical distancing and hygienic protection. While feelings of fear and threat were rampant during the pandemic, theories of health psychology have highlighted appraisals related to the ability to cope (e.g., the feeling of being able to cost-effectively adhere to government advice) and argued that coping appraisals are superior predictors of motivations to protect the self against risks. In this study, we provide a massive population-based comparison of the association between, on the one hand, threat appraisals, and coping appraisals and, on the other hand, protection against actual infection during the COVID-19 pandemic. To this end, we utilize a unique data infrastructure from Denmark that couple surveys of 8 % of the adult Danish population (N= 386.633) with the individual results of all 123 million COVID-19 tests performed in Denmark during 23 months of the COVID-19 pandemic. Overall, controlling for a comprehensive range of sociodemographic measures and employing panel data to bolster internal validity, we observe that stronger coping appraisals are consistently associated with lower individual probability of COVID-19 infection risk. We find no con-sistent evidence for a similar association for threat appraisals. Threat appraisals rather seem to index – to some extent, accurately – individual feelings of infection exposure. As appeals to fear also have unintended negative consequences (includ-ing anxiety, fatigue, and stigmatization), the findings provide strong empirical support for relying on coping-oriented public health communication in future societal crises in the domain of health and beyond.

Physical activity, low-grade inflammation, and psychological responses to the COVID-19 pandemic among older adults in England (preprint)

Mental health responses to the COVID-19 pandemic have been widely studied, but less is known about the potentially protective role of physical activity (PA) and the impact of low-grade inflammation. Using a sample of older adults from England, this study tested (1) if pre-pandemic PA and its changes during the pandemic were associated with mental health responses; (2) if older adults with low-grade inflammation experienced greater increases in depression and anxiety, compared to pre-pandemic levels; (3) if PA attenuated the association between inflammation and depression/anxiety. The study used data from the English Longitudinal Study of Ageing, a cohort study following a national sample aged 50+. Information on mental health and PA were collected before the pandemic (2016/17 and 2018/19) and during November and December 2020. Inflammation was ascertained using pre-pandemic C-reactive protein (CRP). Analyses were adjusted for sociodemographic and health-related factors and pre-pandemic mental health. Increasing PA from before to during the pandemic was linked to reduced odds of depression (OR = 0.955, 95%CI [0.937, 0.974]) and anxiety (OR = 0.954, 95%CI [0.927; 0.982]). Higher pre-pandemic PA was associated with reduced odds of depression (OR = 0.964, 95%CI [0.948, 0.981]) and anxiety (OR = 0.976, 95%CI [0.953, 1.000]), whereas elevated CRP was associated with 1.343 times higher odds of depression (95%CI [1.100, 1.641]). PA did not attenuate the inflammation-depression association. The findings suggest that PA may contribute to psychological resilience among older adults, independently of inflammation. Further research is needed to explore the psychobiological pathways underlying this protective mechanism.

Psychosocial Predictors of Sleep Disturbances during COVID-19: differential contributions of demographic, psychological, pandemic-related factors to sleep health. (preprint)

Aim: Since the declaration of COVID-19 as a Public Health Emergency of International Concern on January 30, 2020, the disease escalated into a global pandemic forcing governments around the world to impose measures that affected all aspects of life. Among other countries, Greece adopted social restriction, lockdowns, and quarantines to reduce transmission from person to person.  Subjects and Methods: This cross-sectional study aimed to investigate the impact of those measures on sleep health in a Greek adult sample. An online questionnaire collected data during from 650 participant.  Results: 60% of responders scored below the clinical cut-off on the RU-SATED, indicating they experienced poor sleep health. Better sleep health was reported with increased age and years of education. On the other hand, higher trauma-related distress, depression, anxiety and stress symptomatology were related to poorer sleep health. No gender differences were observed, and degree of compliance to pandemic restrictions did not influence sleep health. Hierarchical regression analysis indicated difficulty in securing enough/healthy food, testing positive for COVID-19, experiencing an increase in verbal arguments/conflicts at home and an increase in responsibilities were the strongest predictors of poor sleep heath.  Conclusions: Results highlight the importance of maintaining good sleep health as a pillar of general physical and mental health.

Online peer support for mental health in individuals with post-acute sequelae of COVID-19: A pre-post pilot study with mixed methods (preprint)

Objective This pilot examined the effect of online peer support on mental health problems among individuals with post-acute sequelae of COVID-2019 (PASC).Methods A single-arm pre-post design of online peer support design consisting of eight sessions of 1 h per week with three to six participants and two facilitators per group was performed. Participants were recruited from online communities, social media, and medical clinics for the PASC between May and August 2023. The degrees of depression, anxiety, loneliness, social withdrawal, and self-esteem were measured pre- and post-intervention. Participants’ statements during the sessions were analyzed using thematic analyses.Results Of the 18 participants, 3 dropped out of the interventions, and 17 (including 2 participants who dropped out) completed the pre- and post-intervention questionnaires. Depression severity significantly decreased in the paired t-test and linear mixed model. The following interactions were extracted: conveying the same feelings, dealing with difficulties, showing empathy, enhancing the atmosphere, and adapting to suit health conditions. Impressions extracted from participating in the interventions included feelings of emotional support, a sense of bonding, changes in perspective, changes in behaviors or new actions through participation, inadequacy during sessions, and adverse effects associated with participation.Conclusion Online peer support may be helpful in treating depression in individuals with PASC.

Pre-pandemic Predictivity of Anxious-Depressive Symptoms in Post-surgical Traumatic Distress in Hysterectomy for Benign Disease and COVID-19 Outbreak: A Case-Control Study (preprint)

The Sars-Cov-2 pandemic led to several needed containing measures that conditioned the onset of depressive, anxiety and post-traumatic stress symptoms in population. These symptoms, espe-cially if not diagnosed and treated, can also occur in patients undergoing surgery with high im-pact on people’s lives, like hysterectomy. To evaluate the post-surgical distress and anx-ious-depressive symptoms following hysterectomy for benign disease focusing on the impact of COVID-19 pandemic. The prospective observational cohort study included patients undergoing hysterectomy for benign disease. Psychologic evaluation through social-demographic question-naires was obtained before surgery (T1), postoperatively (T2), and 3 months after surgery (T3). The HADS (Hospital Anxiety and Depression Scale) was used to evaluate anxious-depressive symptoms and the PCL-5 (Post-traumatic Stress Disorder Checklist for DSM-5) compared the on-set of post-surgical distress and anxiety and depressive symptoms. The pre-COVID-19 pan-demic period was compared to the post-COVID-19 pandemic phase. Patients treated after COVID-19 pandemic showed higher depressive symptoms rate compared to those treated before (p-value=0.02); conversely, pre-COVID-19 patients were more prone to develop a PTSD (p-value=0.04). A significative association between the occurrence PTSD and anxiety-depressive symptoms registered at T2 a (p-value=0.007) and T3 (p-value

Life changes and mental health among Chinese children and adolescents during the pandemic: a combination of cross-sectional, longitudinal and clustering studies (preprint)

The measures to prevent COVID-19 pandemic had caused significant life changes, which could be distressing for mental health among children and adolescents. We aimed to evaluate the short- and long-term effects of life changes on children’s mental health in a large Chinese cohort. Survey-based life changes during COVID-19 lockdown were measured among 7,829 Chinese students at Grade 1–9, including social contacts, lifestyles and family financial status. Clustering analysis was applied to identify potential patterns of these changes. Depressive and anxiety symptoms were measured using the Center for Epidemiologic Studies Depression Scale and Screen for Child Anxiety Related Emotional Disorders. Logistic regression models were used to investigate the associations between these changes, their patterns and the presence of depression/anxiety symptoms using both cross-sectional and longitudinal designs. We found that the prevalence of depression and anxiety symptoms decreased during pandemic (34.6–32.6%). However, during and shortly after lockdown, students who reported negative impacts on their study, social and outside activities and diet, and decreased electronic time and sugar-sweetened consumption, as well as family income decline and unemployment had increased risks of depressive/anxiety symptoms, and students with changed sleep time had increased depressive symptoms. These associations attenuated or disappeared one year later. Similar patterns were observed in clustering analysis, while only the group with severe impact on family financial status showed a sustained increase in depression symptoms. In summary, restrictive measures that changed children and adolescents’ daily life during COVID-19 lockdown showed negative effects on their mental health, with some commonalities and distinctions patterns in the manifestation of depression and anxiety symptoms.

The Critical Issues for Patients and Caregivers in Neuro-Oncology During Covid-19 Pandemic: What We Have Learnt by an Observational Study. (preprint)

Objective: The COVID-19 pandemic inferred on neuro-oncological patients (PTS) and the caregivers regarding tumor care and emotional functioning. This study aimed to understand how COVID-19 affects their psychological state and relations between PTS and health personnel in neuro-oncology. Methods: A cross-sectional study on neuro-oncological PTS and their caregivers. Results: A total of 162 PTS and 66 caregivers completed the questionnaire. The 37.5% of PTS perceived greater risk of contracting the COVID-19 compared to the general population. On the 0-10 scale, PTS tumor-related anxiety score was 5.8 and COVID-related 4.6. The caregivers reported 7.7 and 5.5 respectively. The QoL was described at least as good in 75% of both PTS and caregivers; the caregivers’ care burden increased in 22.7% during the pandemic, with no correlation with QoL. Future perception often changed both in PTS and in the caregivers. Cancer treatment schedule was changed in 18.5%, including for PTS decision. However, the 93.5% of PTS was satisfied with the overall care. Conclusion: A considerable proportion of PTS and caregivers still perceived the tumor disease as more burdensome than the pandemic, and perceived their future as more uncertain. Such data rinforce the need to build a proficient alliance between PTS and health personnel.

Social isolation emanated psychological exhaustion and disconnectedness among physicians during the COVID-19 pandemic: Results of a qualitative study in Pakistan (preprint)

Background: During the COVID-19 pandemic, many healthcare providers remained on call in COVID-19 wards, isolation centres, and emergency departments, caring for both infected and non-infected patients. Physicians have faced various challenges during the pandemic, including the stress of working with limited resources, the physical burden of long work hours and fear of public abuse in terms of stigmatization. Therefore, this study focusses on social-psychological aspects of isolation period of physicians during the COVID-19 pandemic. Methods: It is a qualitative study based on responses from 14 physicians working in two hospitals located in Islamabad, which is the capital city of Pakistan (Pakistan Institute of Medical Sciences [PIMS] and PolyclinicHospital). In-depth interviews were conducted with selected physicians by using an interview guide as a tool of data collection to explore the experiences of those physicians who suffered from COVID-19 and lived in isolation as their quarantine period. The data was analyzed by using thematic analysis technique. Results: The study explored isolation experiences of physicians during the selected period of COVID-19 and significantly found that two major themes emerged, i.e. psychological exhaustion (depression, anxiety and loneliness were subthemes) and disconnectedness (relational detachment and lack of interaction were subthemes). Conclusions: This pandemic crisis has significantly resulted in having adverse impact on the ability of physicians to approach both potential and existing patients. Particularly in times of such a crisis, adequate measures have to be taken to address mental health issues of the health workforce.

Decisional procrastination and problematic mobile phone use: the mediation of anxiety and the moderation of 2019-nCoV traumatic experience (preprint)

Background Decisional procrastination (DP) has an important effect on problematic mobile phone use (PMPU); however, the potential mechanisism and boundary conditions between DP and PMPU remianed to be further explored. This essay studied the mediation of anxiety between DP and PMPU and whether 2019-nCoV traumatic experience moderated the mediation process.Methods A questionnaire was used in this study. A valid sample of 798 college students reported levels of decisional procrastination, problematic mobile phone use, anxiety, and 2019-nCoV traumatic experience.Results The results indicated that decisional procrastination is positively associated with problematic mobile phone use among college students. Anxiety served as a partial mediator in the association between decisional procrastination and problematic mobile phone use. 2019-nCoV traumatic experience would positively moderated the mediating effects of anxiety between DP and PMPU. A higher degree of 2019-nCoV traumatic experience would strengthen the mediation effects of DP to PMPU through anxiety.Conclusions This study deepens our understanding of how DP affects college students' PMPU. It was found in the study that 2019-nCoV traumatic experience positively moderated the mediation effects of anxiety between DP and PMPU. These findings provide universities with a theoretical foundation for preventing PMPU among college students.

Impact of the COVID-19 Pandemic on Swedish Adolescents’ Mental Health, Psychosocial Functioning, Risk Behaviours, and Victimisation: Gender Differences and Implications (preprint)

The COVID-19 pandemic has shown varying effects on adolescents’ mental health, psychosocial functioning, risk behaviours, and victimisation. This study aims to examine the changes reported by a sample of Swedish adolescents (N=1607) at the end of the first year of the pandemic in relation to these factors. Data was collected with an electronic survey between September 2020 and February 2021, targeting upper-secondary high school students (aged 15-19 years). The results indicate a relatively low overall impact of the pandemic on Swedish upper-secondary school students, with notable gender differences. Compared to females, a higher percentage of male adolescents reported experiencing elevated levels of anxiety, depression, sleep disturbances, anger, and increased illicit drug use as consequences of the pandemic. In contrast, females demonstrated an increase in several salutogenic behaviours. Victimisation rates generally decreased during this period. These findings underscore the importance of heightened awareness among professionals within schools, social services, and healthcare settings regarding the distinct challenges encountered by a larger portion of male adolescents during the COVID-19 pandemic in Sweden.

Educator Perspectives on Stressors and Health: A qualitative study of U.S. K-12 educators in February 2022 (preprint)

Background The teaching profession, already characterized by high stress and burnout, experienced exacerbated challenges during the height of the COVID-19 pandemic. While educators faced changing job demands over the course of the pandemic with switches in remote and in-person teaching along with COVID-19 transmission prevention strategies, the demands and resulting impact in the years that follow are still being explored. We sought to understand the stressors and health impacts of U.S. educators in the 2021–2022 school year, 2 years following the acute phase of the pandemic.Methods Thirty-four certified educators based in Connecticut, USA participated in 4 virtual focus groups in February 2022. A semi-structured focus group script, designed by the research team and guided by the job demands-resources model, was administered to understand stress impacts and stressors. Data were transcribed and analyzed using the constant comparative method to identify themes and sub-themes. Themes were summarized by frequency as well as by individuals.Results The majority of respondents reported educator well-being impacts of stress fell into three categories: physical health impacts and behaviors (76%; e.g. poor sleep, physical exhaustion, lack of exercise, unhealthy eating), psychological health impacts (62%; e.g. emotional exhaustion, anxiety, negative self-evaluation); and social well-being impacts and behaviors (68%; e.g. connections with family or friends, connections with others, relationships with coworkers). Sources of reported stressors included the school or district (94%), personal (65%), situational (35%), and to a lesser extent parents (24%), other work factors (15%), community (12%), students (12%), and state or national level (9%) factors. At the school/district level, stressors were related to protocols/expectations (91%, e.g. excessive or increased demands, insufficient or decreased resources) or administrators (38%). Personal level stressors included personal life (41%); other personal factors (20%); and income (17%); situational factors included the pandemic (26%) and safety concerns (9%).Conclusion Focus groups allowed us to assess the health and working conditions of Connecticut’s public education workforce 2 years following the acute phase of the pandemic. Lasting effects are relevant in the post-pandemic era and continue to pose challenges as teacher shortages increase. Targeted interventions are needed to reduce school and district-related demands and to address stress-related educator well-being.

A qualitative exploration of active ingredients and mechanisms of action of an online singing programme with mothers experiencing postnatal depression during the COVID-19 pandemic: SHAPER-PNDO study. (preprint)

Background Social distancing restrictions and the suspension of in-person treatment and support contributed to an increase in postnatal depression during the coronavirus disease 2019 (COVID-19) pandemic. Creative health interventions can help to alleviate anxiety and depression, with studies showing that singing is particularly effective for supporting the mental health of new mothers. We adapted an in-person group singing programme (Breathe Melodies for Mums (M4M)) to online delivery during the COVID-19 pandemic to support the mental health of new mothers, and, in a feasibility study, found improvements in postnatal depression (PND) symptoms at 6-month follow up. The current qualitative study aimed to explore how and why M4M-online impacted the mental health of those taking part.Methods We took a theory-based approach using the Ingredients in Arts in Health (INNATE) Framework of ‘active ingredients’ and the Multi-level Leisure Mechanisms Framework of ‘mechanisms of action’ to identify and categorise intervention components and change mechanisms. Iterative consensus building between three researchers were complemented by qualitative semi-structured online interviews with 24 women experiencing PND symptoms who took part in M4M-online. Data were analysed inductively using reflexive thematic analysis.Results Consistency was found between the online and in-person interventions in active ingredients relating to project design, content, programme management and the composition of the group. Key differences were in the social and contextual ingredients. Psychological, social and behavioural mechanisms for improved mental health and wellbeing included: 1) Increased self-confidence as a mother, 2) Increased positive emotional responses, 3) A supported change in identity, 4) Reduced loneliness and isolation, 5) Increased social bonding and connections with family and 6) Enhanced sense of time through new routines.Conclusions Participating in online group singing can support new mothers experiencing PND by triggering psychological, social and behavioural responses that lead to improved mental health. Key programme features are identified which can be used to design future online creative health interventions or tailor in-person activities for remote delivery to support populations who may face practical and social barriers to attending in-person.

The Outcome of the Psychological and Therapeutical Care of Hospitalized COVID-19 Patients: National African Pilot Study (preprint)

Introduction: Hospitalization in a COVID-19 unit represents a significant source of stress and psychological distress for patients. Our study aims to determine the factors of psychological distress in the therapeutic and psychosocial management of patients hospitalized with a COVID-19 infection. Methods: This cross-sectional study was carried out over 8 months at the COVID-19 zone of the CHU HASSAN II of FES. 99 patients were evaluated within days of diagnosis by psychometric scales of anxiety, depression, and post-traumatic stress. In the course of this follow-up, we found the presence of psychological impacts in these patients, and we tried to find correlating factors between the occurrence of psychiatric disorders and the set of factors related to sociodemographic data, hospitalization course and treatments taken, as well as family support. Results: 35% of patients had scores in favor of post-traumatic stress disorder, 37% of the patients had definite depression and 50% had anxiety. Post-traumatic stress, depression, and anxiety were correlated with sociodemographic factors, hospitalization, treatments received, and length of stay. Conclusion: The prevalence of anxiety-depressive disorders and post-traumatic stress disorder was high in patients with COVID-19, hence the interest in providing psychological and psychosocial care in the emergency department.

The Development of Indoor Natural Elements Had Relaxing Psychophysiological Effects on Older Adults in Taiwan During the COVID-19 Pandemic (preprint)

While the COVID-19 pandemic has affected all types of people, older adults have been disproportionately affected. Therefore, during this period we developed an indoor program inspired by art and natural elements (plant essential oils [EOs]) intended to create a relaxing effect akin to a forest atmosphere to enhance their psychophysiological health. There are for 30 Taiwanese older adults (range, 59-79 years) participated in the study. We combined art activity (still-life painting of vegetables) with breathing Pseudotsuga menziesii and Lavandula angustifolia EOs during a 100-minute experiment involving still-life painting and the inhalation of 2.5% diffused EOs. The research shows physiological measures (heart rate, normalized low-frequency heart oscillations, ratio of low- to high-frequency heart oscillations, high-beta waves, and gamma waves) decreased;correspondingly, an increased standard deviation of normal-to-normal intervals, normalized high-frequency heart oscillations, and high-alpha waves were observed, indicating relaxation physiological state. Subjective psychological assessments using the State-Trait Anxiety Inventory–Stateyielded lower post-test scores, further supporting relaxation effects. The psychophysiological data from this study provide important scientific evidence for the physical and mental health benefits of indoor nature-based activity programs for older adults, thereby improving their quality of life.

Long COVID in Children and Adolescents: A Retrospective Controlled Cohort Study from Iran (preprint)

Background: After recovering from the acute phase of COVID-19, some of the infected children manifest long COVID symptoms. The present study aims to identify long COVID symptoms in children and adolescents admitted to hospitals in Bushehr, Iran, during 2021 to 2023, and compare them with the non-affected group. Methods: This retrospective cohort study was conducted on 141 children and adolescents with COVID-19 and 141 non-affected peers. The data were collected using the data recorded in the patients’ records, conducting telephone interviews and completing the prevalent long COVID symptom form. Results: The mean age of the hospitalized children with COVID-19 was 79±5.24 months old, 57.4% of whom were boys. Also, 46 individuals of the infected group (32.6%) manifested long COVID symptoms. The most prevalent symptoms included fatigue (54.3%), impaired attention or concentration (41.3%) and depression or anxiety symptoms (34.7%). Significant correlation was found between disease severity and muscle and joint pain (P=0.025) as well as between length of hospital stay and cough (P=0.022), weight loss (P=0.047) and depression or anxiety symptoms (P=0.008). Older age [(6-11 y; OR=3.18, CI=1.03-9.88); (12≥ y; OR= 4.57, CI=1.40-14.96)] and having history of smoking or being exposed to secondhand smoke (OR= 12.45, CI= 3.14-49.36) were considered as risk factors for long COVID. Conclusions: Informing the public about smoking or being exposed to smoke as risk factors for long COVID, in addition to its other hazards, is of particular importance. Informing the healthcare staff and general public about the most prevalent symptoms of long COVID could be effective in timely diagnosis and treatment as well as reducing families’ stress burden.

The Effectiveness of Socially Assistive Robots in Improving Children’s Pain and Negative Affectivity during Needle-based Invasive Treatment: A Systematic Review and Meta-analysis (preprint)

Background The ability of socially assistive robots (SARs) to treat dementia and Alzheimer’s disease has been verified. Currently, to increase the range of their application, there is an increasing amount of interest in using SARs to relieve pain and negative emotions among children in routine medical settings. However, there is little consensus regarding the use of these robots. Objective This study aimed to evaluate the effect of SARs on pain and negative affectivity among children undergoing invasive needle-based procedures. Design This study was a systematic review and meta-analysis of randomized controlled trials that was conducted in accordance with the Cochrane Handbook guidelines. Methods The PubMed, Embase, EBSCO, Web of Science, Cochrane Library, Embase, CNKI, and WanFang databases were searched from inception to January 2024 to identify relevant randomized controlled trials (RCTs). We used the Cochrane Risk of Bias tool 2.0 (RoB2.0) to assess the risk of bias among the included studies, and we used RevMan 6.3 software to conduct the meta-analysis. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework was used to assess the quality of the evidence. Results Ten RCTs involving 815 pediatric subjects were selected for this review and reported outcomes related to pain and emotions during IV placement, port needle insertion, flu vaccination, blood sampling, and dental treatment. Children undergoing needle-related procedures with SARs reported less anxiety (SMD= -0.36; 95% CI= -0.64, -0.09; P = 0.01) and fewer distressed avoidance behaviors (SMD= -0.67; 95% CI= -1.04, -0.30; P = 0.0004) than did those receiving typical care. There were nonsignificant differences between these groups in terms of in pain (SMD = -0.02; 95% CI = − 0.81, 0.78; P = 0.97) and fear (SMD = 0.38; 95% CI= -0.06, 0.82; P = 0.09). The results of exploratory subgroup analyses revealed no statistically significant differences based on the intervention type of robots or anesthetic use. Conclusions The use of SARs is a promising intervention method for alleviating anxiety and distress among children undergoing needle-related procedures. However, additional high-quality randomized controlled trials are needed to further validate these conclusions. Registrations The protocol of this study has been registered in the database PROSPERO (registration ID: CRD42023413279).

Prevalence and influencing factors of sleep disorders in medical students after the COVID-19 pandemic (preprint)

Background The prevalence of sleep disorders among medical students was high during the COVID-19 pandemic. However, there are fewer studies of sleep disorders in medical students after the COVID-19 pandemic. This study aimed to investigate the prevalence and factors influencing sleep disorders among Chinese medical students after COVID-19.Methods We enrolled 1194 medical students. The Self-administered scale was used to collect the demographic characteristics. The Self-rating Depression Scale (SDS), the Self-rating Anxiety Scale (SAS), and the Pittsburgh Sleep Quality Index (PSQI) were used to assess subjects' depression, anxiety, and sleep disorders, respectively. The chi-square test and binary logistic regression were used to identify factors that influence sleep disorders. The receiver operating characteristic (ROC) curve was used to assess the predictive value of relevant variables for sleep disorders.Results We found that the prevalence of sleep disorders among medical students after COVID-19 was 82.3%. According to logistic regression results, medical students with depression were 1.151 times more likely to have sleep disorders than those without depression (OR = 1.151, 95% CI 1.114 to 1.188). Doctoral students were 1.908 times more likely to have sleep disorders than graduate and undergraduate students (OR = 1.908, 95% CI 1.264 to 2.880). In addition, the area under the ROC curve for depression is 0.689.Conclusion The prevalence of sleep disorders among medical students is high after COVID-19. In addition, high academic level and depression are risk factors for sleep disorders. Therefore, medical colleges and administrators should pay more attention to sleep disorders in medical students after the COVID-19 pandemic. Regular assessment of sleep disorders and depression is extremely necessary.

Redefining the Narrative: How Work from Home Job Demands Elevate Workplace Anxiety but Enhance Psychological Capital (preprint)

Globally, workplace stress and anxiety are at an all-time high, with 42% of employees experiencing daily work-related stress and anxiety. Drawing from workplace anxiety (WA) theory (Cheng & McCarthy, 2018), we advance a model that considers four job demands – role ambiguity, work overload, job insecurity, and work-home conflict – as sources of daily WA, and in turn the downstream effects of WA on psychological capital (PsyCap). Our model posits gender as a moderator of the association between job demands and WA, and digital technology characteristics as moderators of the association between WA and PsyCap. We tested our predictions on a sample of 162 South African employees. Consistent with our predictions, we found positive effects of job demands on WA, with the relationship being stronger for females. Contrary to expectations, we found positive effects of WA on PsyCap, suggesting an adaptive function of WA. Perceived ease of use of digital technology moderated the association between WA and PsyCap, such that the association was strong at higher levels of perceived ease of use. This research advances our understanding of the sources of WA, the adaptive function of WA, and predictors of PsyCap. Broadly, our study adds to understanding emotions’ impact on workplace behavior.

The relationship between maternal anxiety due to the COVID-19 pandemic and children's anxiety following school reopening in the post-pandemic era: an analytical cross-sectional study (preprint)

Background Although infection rates and mortality have decreased, COVID-19-related anxiety persists in families, especially among mothers, even in the post-pandemic period. Maternal mental health issues may jeopardize various aspects of children's development. This study aims to explore the correlation between maternal COVID-related anxiety and their children's anxiety following the reopening of primary schools in the post-pandemic era.Methods This analytical cross-sectional study involved the selection of 305 pairs of mothers and children. Data collection instruments comprised demographic questionnaires as well as assessments for COVID-related anxiety and manifest anxiety. Statistical analyses encompassed independent t-tests, one-way analysis of variance (ANOVA), and multivariate regression.Results Children's manifest anxiety was predicted by maternal anxiety related to COVID-19 (B = 0.907, P < 0.001). Moreover, significant associations were observed between the mean difference in mothers' COVID anxiety scores and their educational attainment and occupation, as well as their children's education and age, residential area, and their husbands' education and occupation (P < 0.001). Conversely, no significant differences were detected in maternal COVID anxiety scores concerning maternal age, spouse's age, and child's gender (P > 0.05).Conclusions Given the study's findings, it is recommended that nurses and psychologists provide educational interventions for mothers who need psychological support.

Video Game Play and Mental Health During the COVID-19 Pandemic: A Meta-Analysis of Global Findings (preprint)

During the COVID-19 pandemic, video gaming was often suggested as a way to help maintain physical distancing by encouraging people to stay indoors and play games instead of seeking social activities. However, there was concern about whether the increased time spent on video gaming could negatively affect players' mental health. In our meta-analysis, we synthesized studies to quantify changes in gaming time during the pandemic and examine its association with positive and negative mental health metrics. We searched databases for studies published from March 2020 to December 2021 reporting gaming time and mental health positive (e.g., happiness, positive affect, relaxation) or negative (e.g., depression, anxiety, stress, loneliness, anger) indicators during the pandemic. We employed random effects meta-analyses with robust variance estimates. We accounted for potential moderators (e.g., world region). In 17 studies (26 effects, n = 18026), we found a small increase in time spent gaming during the pandemic versus pre-pandemic, d = 0.26, 95% CI [0.14, 0.37], p = .0004). In 22 studies (100 effects, n = 19752), gaming time was not associated with mental health (r = -0.03, 95% CI [-0.08, 0.02], p = .22), regardless of whether it was for well-being or ill-being measures. Moderator analyses indicated negligible differences across study characteristics (d< 0.20). These findings challenge the simplistic view that more gaming time automatically leads to worse (or better) mental health during pandemics. They provide important insights for researchers, policymakers, educators, and caregivers about the role of digital technologies in easing the impact of pandemics and lockdowns. This research is vital for developing evidence-based public health policies and recommendations regarding video gaming in the event of future pandemics and lockdowns.