The mental health impact of COVID-19 and lockdown-related stressors among adults in the UK.

BACKGROUND: The COVID-19 pandemic in the UK and subsequent lockdown may have affected the mental health of the population. This study examines whether there was an increase in the prevalence and incidence of common mental disorders (CMD) in the UK adult population during the first months of lockdown and whether changes in CMD were associated with stressors related to the pandemic and lockdown. METHODS: Longitudinal data from the UK Household Longitudinal Study waves 10-11: 2019-2020 and waves 1-4 of the COVID-19 monthly surveys in April (n = 17 761) to July 2020 (n = 13 754), a representative sample of UK adult population, were analysed. CMD was measured using the 12-item General Health Questionnaire (GHQ-12) (cut-off >2). Changes in CMD were analysed in relation to COVID-19 and social stressors. RESULTS: Around 29% of adults without CMD less than a year earlier had a CMD in April 2020. However, by July 2020, monthly incidence of CMD had reduced to 9%. Most employment, financial and psychological 'shocks' were at their highest levels in April and reduced steadily in later months. Despite the lifting of some lockdown conditions by July, stressors related to loneliness, unemployment, financial problems and domestic work continued to influence CMD. CONCLUSION: Some COVID-19 policy responses such as furloughing may have been effective in mitigating the increase in CMD for some groups of employees. Despite some reduction in levels of pandemic and lockdown-related stressors by the middle of 2020, loneliness and financial stressors remained key determinants of incidence in CMD among the UK adult population.

Sexual Orientation and the Incidence of COVID-19: Evidence from Understanding Society in the UK Longitudinal Household Study.

COVID-19 infection rates and severity are worse in marginalised groups, although, for sexual and gender minorities, there are no data on infections, hospitalisations or deaths, but there may be worse rates. This study uses information from Understanding Society: The UK Household Longitudinal Study (UKHLS) to derive COVID-19 symptoms and positive tests by sexual orientation. Data came from all seven UKHLS COVID-19 survey waves in 2020 and 2021, and sexual orientation in main UKHLS waves 3 and 9. Numbers ranged from 17,800 to 12,000. Covariates in the regression models were gender, age, highest educational qualification, ethnicity, diagnosed medical condition, and key worker status. Compared to heterosexual individuals, more sexual minorities experienced symptoms, and bisexual individuals reported a greater number of symptoms. Gays and lesbians were no more or less likely to have been tested, but a larger proportion of bisexual individuals were tested. Regression models showed that differences mostly disappeared when other characteristics were considered. A small sample size means that principal questions remain, so health inequalities have been largely unnoticed and therefore not addressed. Suitable action should be taken to minimise their future risks. Why sexual and gender minorities have been omitted needs to be explored, and action needs to be taken to ensure this does not happen again.

Impacts of long-standing illness and chronic illness on working hours and household income in a longitudinal UK study.

Individuals within households encounter a variety of events including development of a disability or chronic illness. We used data from the Understanding Society, 2009-2016, to determine whether there are changes to working hours or household income as a result of an individual developing an illness. After adjusting for a variety of sociodemographic characteristics, there were few associations observed between one's own individual illness status and household income. There was a clear trend of reduction of weekly working hours with increasing severity and chronicity of the individuals' illness or disease. Individuals who were not ill, but lived in an household with an ill person worked about 30-min less per week, b = -0.69, 95% confidence interval (CI)=(-1.09, -0.30), while those with a limiting long-standing illness and a chronic disease worked 3.5 h less per week, b = -3.64, 95% CI=(-4.21, -3.08), compared to individuals with no illness in their household. Individuals with a limiting illness only had lower incomes, b = -0.04, 95% CI=(-0.07, -0.004) compared to individuals with no household illness. These associations were not greatly changed with the inclusion of reception of benefits or being cared for. Interactions were observed by gender, age being cared for and reception of benefits. Additionally, there were differences were observed by working age groups and between those who lived alone and those who did not. The findings suggest that while there is a reduction of working hours among individuals with an illness or who have an ill person in their home, household income is resilient to the experience of an illness, in the United Kingdom. However, this appeared to differ by household composition, i.e. whether individuals were of working age or whether they lived alone. Identification of households at highest risk of income reduction may serve to inform policy and appropriate distribution of services and support.

Gender differences in the associations between age trends of social media interaction and well-being among 10-15 year olds in the UK.

BACKGROUND: Adolescents are among the highest consumers of social media while research has shown that their well-being decreases with age. The temporal relationship between social media interaction and well-being is not well established. The aim of this study was to examine whether the changes in social media interaction and two well-being measures are related across ages using parallel growth models. METHODS: Data come from five waves of the youth questionnaire, 10-15 years, of the Understanding Society, the UK Household Longitudinal Study (pooled n = 9859). Social media interaction was assessed through daily frequency of chatting on social websites. Well-being was measured by happiness with six domains of life and the Strengths and Difficulties Questionnaire. RESULTS: Findings suggest gender differences in the relationship between interacting on social media and well-being. There were significant correlations between interacting on social media and well-being intercepts and between social media interaction and well-being slopes among females. Additionally higher social media interaction at age 10 was associated with declines in well-being thereafter for females, but not for males. Results were similar for both measures of well-being. CONCLUSIONS: High levels of social media interaction in early adolescence have implications for well-being in later adolescence, particularly for females. The lack of an association among males suggests other factors might be associated with their reduction in well-being with age. These findings contribute to the debate on causality and may inform future policy and interventions.

Sexual orientation health inequality: Evidence from Understanding Society, the UK Longitudinal Household Study.

Few studies from the United Kingdom have fully investigated inequalities between members of different sexual minority groups and heterosexuals over range of health outcomes. Using data from over 40,000 individuals, this study explores the health inequalities of sexual minority UK adults. We include respondents who identify as other and those who prefer not to say (PNS). Data come from wave three (2011-2012) of the nationally-representative Understanding Society, the UK Household Longitudinal Study. Sexual orientation was asked in the self-completion portion of the study. Markers of health include physical and mental functioning, minor psychological distress, self-rated health, substance use and disability. Multiple linear and logistic regression analyses tested for differences in markers of health between sexual orientation groups. Overall, heterosexual respondents had the best health while bisexual respondents had the worst. Gay and lesbian respondents reported poorer health than heterosexuals, specifically with regards to mental functioning, distress and illness status. The other and PNS respondents were most similar to each other and generally experienced fewer health inequalities than gay and lesbian respondents; they were less likely to use tobacco or alcohol. In sum, sexual minorities experience health inequality. The inclusion of other and PNS respondents has not been done in other studies and shows that while they may be healthier than gay/lesbian and bisexual respondents they still experiences poorer health than heterosexuals. Health promotion interventions are needed for these other and PNS individuals, who might not participate in interventions targeted toward known sexual minority groups.

Media Use, Sports Participation, and Well-Being in Adolescence: Cross-Sectional Findings From the UK Household Longitudinal Study.

Objectives. We investigated the relationship between selected types of screen-based media (SBM) use, total SBM use, sports participation, and markers of well-being. Methods. Data came from the youth panel (n = 4899) of Understanding Society, the UK Household Longitudinal Study, conducted in 2009. Well-being was measured by the Strengths and Difficulties Questionnaire and markers of happiness in different life domains. Results. The majority of young people used multiple types of SBM for at least 1 hour per day; only 30% participated in sports every day. Overall, young people with heavy SBM use were less happy than moderate users and more likely to have socioemotional difficulties. Chatting on social networking Web sites and game console use were associated with higher odds of socioemotional problems. Higher total SBM use was associated with lower odds of happiness and higher odds of socioemotional difficulties. Greater participation in sports was associated with higher odds of happiness and lower odds of socioemotional difficulties. Conclusions. Further longitudinal research could inform future interventions to reduce sedentary behavior and encourage healthy lifestyles among young people.

Psychological well-being and reactions to multiple unemployment events: adaptation or sensitisation?

BACKGROUND: Unemployment has been negatively associated with psychological well-being. This study examines the effect of multiple unemployment spells, specifically whether people become sensitised or adapt to unemployment if they are previously employed or economically inactive. METHODS: Data come from waves 1-17 of the British Household Panel Survey. Psychological well-being was measured using the 12-item General Health Questionnaire (GHQ-12), and employment status was self-reported. Multilevel modelling was used to examine the effects of unemployment, overall and by previous employment status, on well-being. RESULTS: Without consideration of prior employment status, psychological well-being was poorer at each unemployment spell. Previously employed persons had significantly higher GHQ-12 scores at the first and second unemployment spells but not at the third spell (p(trend)<0.0001). Previously economically inactive persons had poorer psychological well-being at all unemployment spells, with significantly higher scores at the third spell than those at the first two spells (p(trend)=0.0004). Thus, those employed prior to all unemployment spells adapted, while those previously economically inactive became more sensitised with additional unemployment spells. Pre-study unemployment and average annual household income moderated the effects of unemployment; effects varied by previous employment status and unemployment spell number. CONCLUSIONS: The findings suggest that initially employed people who experience repeated unemployment cope better psychologically if they are able to regain employment in between unemployment spells. Those who make several attempts to re-enter the labour market following economic inactivity have a more difficult time, becoming more distressed with each try. This has implications for people affected by welfare to work policies.

A systematic review of the effect of retention methods in population-based cohort studies.

BACKGROUND: Longitudinal studies are of aetiological and public health relevance but can be undermined by attrition. The aim of this paper was to identify effective retention strategies to increase participation in population-based cohort studies. METHODS: Systematic review of the literature to identify prospective population-based cohort studies with health outcomes in which retention strategies had been evaluated. RESULTS: Twenty-eight studies published up to January 2011 were included. Eleven of which were randomized controlled trials of retention strategies (RCT). Fifty-seven percent of the studies were postal, 21% in-person, 14% telephone and 7% had mixed data collection methods. A total of 45 different retention strategies were used, categorised as 1) incentives, 2) reminder methods, repeat visits or repeat questionnaires, alternative modes of data collection or 3) other methods. Incentives were associated with an increase in retention rates, which improved with greater incentive value. Whether cash was the most effective incentive was not clear from studies that compared cash and gifts of similar value. The average increase in retention rate was 12% for reminder letters, 5% for reminder calls and 12% for repeat questionnaires. Ten studies used alternative data collection methods, mainly as a last resort. All postal studies offered telephone interviews to non-responders, which increased retention rates by 3%. Studies that used face-to-face interviews increased their retention rates by 24% by offering alternative locations and modes of data collection. CONCLUSIONS: Incentives boosted retention rates in prospective cohort studies. Other methods appeared to have a beneficial effect but there was a general lack of a systematic approach to their evaluation.

A longitudinal analysis of stressful life events, smoking behaviors, and gender differences in a multicultural sample of adolescents.

Many studies have addressed the associations between stressful life events and adolescent smoking. Few studies, however, have examined gender differences, specifically with multicultural samples. This longitudinal study examines the relationship between 6 stress subscales and smoking behaviors 716 multicultural U.S. adolescents living in the greater Los Angeles area in 2000-2001. At baseline the ethnic break-down of the sample was 63% Latino and 26% Asian/PI and 70% were 11 years of age. Negative personal events were associated with lifetime smoking and negative school events were associated with intentions to smoke. Stratification of the sample by gender indicated that gender confounded the relationship between negative personal stress and lifetime smoking and negative school stress, positive personal stress and intentions to smoke. Two significant interactions were found. Findings indicate there are differential effects of stressful events between genders which may lead to smoking experimentation or intentions to smoke. Implications and limitations are discussed.

Stressful life events and smoking behaviors in Chinese adolescents: a longitudinal analysis.

The associations between stressful life events and smoking have been established among adolescents in the United States. However, whether these relationships are similar in adolescents from other non-Western cultures is unknown. Understanding these relationships in adolescents may help to provide opportunities to reduce the smoking rates in those cultures by providing positive coping methods that do not include smoking. In this longitudinal study, the associations between nine stressful life events scales and smoking behaviors were examined in a sample of Chinese adolescents. Six of these scales, positive school-related, negative school-related, positive family-related, positive peer-related, negative peer-related, and negative health-related had significantly different means among females and males. Among males, positive school-related stress was a protective factor for smoking susceptibility. Among females, positive school-related stress was a protective factor and negative school-related stress was a risk factor for lifetime smoking, and negative family-related stress was a risk factor for smoking susceptibility. Findings indicate that smoking among male adolescents in China may not be the result of stress; however, in females stress may contribute to the decision to smoke. Future directions are discussed.

Stressful life events, smoking behavior, and intentions to smoke among and multiethnic sample of sixth graders.

OBJECTIVES: Adolescent smoking has been associated with stressful life events. However, few studies have examined the associations between stress, smoking intentions, and smoking behavior among a multiethnic sample of adolescents. METHODS: We compiled a checklist of stressful life events relevant to multiethnic youth and administered it to 1,074 sixth-grade students in urban Los Angeles. RESULTS: The most frequently reported stressful events were similar across ethnic groups and generations in the USA: test taking, chores, and arguments with friends. The events reported as the most severe were disturbances in family life, such as: death, arguments between parents, and illness or injury. Whites and Latinos had reported higher levels of ever smoking and intentions to smoke than Asian/Pacific Islanders (PIs). On the positive family-related events scale Latinos scored higher than did whites or Asian/PIs. Whites scored higher than Latinos or Asian/PIs on both negative peer-related and negative personal-related events. Associations were observed between total stress, stressful life events, and smoking behavior and intentions to smoke. Total stress was associated ith ever smokers, smoking intentions within the next year and in high school over the entire sample. Negative peer-related events were associated with intention to smoke within the next year, among Latinos. Among Asian/PIs negative peer-related events were associated with intention to smoke within the next year and in high school. Negative school-related events were significantly associated with ever smoking and intentions to smoke in the next year and marginally associated with intentions to smoke in high school among children born in the USA whose parents were also born in the USA. Negative peer-related events and positive personal-related events were significantly associated with intentions to smoke in the next year among children born in the USA whose parents were immigrants. CONCLUSIONS: Results suggest that negative peer- and school-related events may lead to increased risk of smoking behavior and intentions to smoke among multicultural adolescents.