Level and factors of support for the Living with the Virus policy in a Chinese adult general population: a mediation analysis via positive and negative attitudes toward the policy.

Background: This study investigated the public's support for the Living with the Virus (LWV) policy, its associated factors, and related mediations at a time when more countries were considering adopting the LWV policy amid the COVID-19 pandemic. Methods: A random, population-based telephone survey was conducted among 500 Chinese adults in Hong Kong during March/April 2022. Results: 39.6% of the participants were supportive/strongly supportive of the LWV policy. Perceived efficacy of the control measures was negatively associated with the support and was partially mediated via the perception that the policy would greatly improve the economy/daily life of the policy. Perceived physical harms of the Omicron variant was negatively associated with the support and was fully mediated via perceived negative impacts of the policy. 26.2%/54.6% believed that the policy would improve the economy/daily life greatly; about 40% perceived negative impacts on deaths and the medical system due to the policy. COVID-19 ever infection did not significantly moderate the studied associations. Conclusion: The public was split regarding the support for the LWV policy and whether it would cause better economy/daily life, unnecessary deaths, and the collapse of the medical system. Health communication is needed in shifting toward the LWV policy.

The long-term effects of war exposure on psychological health: An experimental study with Turkish conscript veterans.

The study of the effects of war exposure on the psychological health of combatants has so far been constrained by possible selection biases which limits the establishment of causality, the clear identification of dynamics, and the generalizability of findings. In this study, we make use of a population-level natural experiment enabled by the strict military conscription system in Turkey which uses a draft lottery to randomly allocate conscripts to bases across the country, including those south-eastern areas experiencing a long running civil conflict. We build on this setting with a representative field survey of 5024 adult males. Our results indicate that those exposed to high intensity armed conflict environments during their service are more likely to experience depressive symptoms even long after their discharge. Further detailing conflict exposure, we find war traumas to be the primary drivers of the effects we observe.

The Ukraine-Russia war: A symptoms network of complex posttraumatic stress disorder during continuous traumatic stress.

OBJECTIVE: This study is aimed to test the symptoms network of International Classification of Diseases, 11th Revision (ICD-11) complex posttraumatic stress disorder (CPTSD) symptoms, using data collected from Ukrainian civilians during the 2022 Russia-Ukraine war. Findings can inform our understanding of the stress response in individuals exposed to continuous trauma and give insight into the nature of CPTSD during the war. METHOD: A network analysis was conducted on CPTSD symptoms as assessed by the International Trauma Questionnaire using data from a nationally representative sample of 2,000 Ukrainians. RESULTS: While PTSD and disturbances in self-organization clusters did not enmesh, several communities within these clusters were merged. Results highlight that in terms of strength centrality, emotional dysregulation (emotional numbing) and a heightened sense of threat (SoT) were most prominent. CONCLUSION: The results confirm the ICD-11 structure of CPTSD but suggest that continuous traumatic stress manifests in more condensed associations between CPTSD symptoms and that emotional regulation may play a vital role in activating the CPTSD network. War-exposed populations could be provided with scalable, brief self-help materials focused on fostering emotion regulation and an SoT. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A cross-disasters comparison of psychological distress: Symptoms network analysis.

Large-scale traumatic events have the potential to trigger psychological distress, particularly among those in the affected areas. However, the manifestation of psychological distress may vary across different types of disasters. This study thus aimed to compare the symptoms network structure of psychological distress as assessed by the Kessler Psychological Distress Scale across three types of disasters: Terror (n = 5842), COVID-19 (n = 2428), and a nature-related disaster (n = 1001). Across disasters, two communities representing depression and anxiety symptoms were revealed. However, while after a nature-related disaster and the COVID-19 pandemic depression and anxiety items were interconnected via hopelessness, a terror attack resulted in more separated manifestations of anxiety and depression. Examination of symptom centrality showed that while in the Terror and the COVID-19 networks "depressed/no cheering up" was most connected to other symptoms, for the nature-related disaster network, two items were most central: "depressed/no cheering up" and "restless or fidgety". The results may point to different mechanisms of psychological distress structures after different disasters. Depending on the type of disaster, trauma-focused interventions may require targeted support and treatment.

Disability and post-traumatic stress symptoms in the Ukrainian General Population during the 2022 Russian Invasion.

AIMS: Previous research has shown that people with disabilities are disproportionately vulnerable to symptoms of psychological distress after exposure to armed conflict. Past work has also shown that individuals displaced by conflict are at heightened risk of post-traumatic stress. Using a national online sample of Ukrainians in the early weeks of the 2022 Russian invasion, we aim to examine associations between functional disability and symptoms of post-traumatic stress. METHODS: We examined the association between levels of functional disability in the Ukrainian population and symptoms of post-traumatic stress during the 2022 Russian invasion of Ukraine. We analysed data from a national sample of 2000 participants from across this country, assessing disability using the 12-item World Health Organization Disability Assessment Schedule (WHODAS-12)(six domains of disability) and the International Trauma Questionnaire assessment of post-traumatic stress disorder (PTSD) symptomatology according to the Eleventh Edition of The International Classification of Diseases (ICD-11). Moderated regression examined the impact of displacement status on the disability-post-traumatic stress relationship. RESULTS: Different domains of disability predicted post-traumatic stress symptoms (PTSSs) to varying extents, with overall disability score significantly associated with PTSSs. This relationship was not moderated by displacement status. Consistent with previous research, females reported higher levels of post-traumatic stress. CONCLUSIONS: In a study of a general population during a time of armed conflict, individuals with more severe disabilities were at greater risk of PTSSs. Psychiatrists and related professionals should consider pre-existing disability as a risk factor for conflict-related post-traumatic stress.

PTSD symptoms among civilians being displaced inside and outside the Ukraine during the 2022 Russian invasion.

The 2022 Russian invasion of the Ukraine created a large-scale humanitarian crisis. PTSD symptoms are common amongst refugees but there is less information on the mental health of internally displaced peoples. We examined a national sample of 2,000 Ukrainians during the Russian invasion, assessing PTSD symptoms using the recent ICD-11 Results showed that displacement was associated with PTSD symptoms (non-displaced M = 11.02 [SD = 4.88], displaced within the Ukraine M = 12.55 [SD = 4.94]; displaced outside the Ukraine M = 12.90 [SD = 4.61]; F (2,1999) = 21.93; p <0.001). Findings underline the risk to those displaced inside their own country in addition to those displaced overseas.

Vaccine hesitancy prospectively predicts nocebo side-effects following COVID-19 vaccination.

The directionality between vaccine hesitancy and COVID-19 vaccine side-effects has not been hitherto examined. We hypothesized a nocebo effect, whereby vaccine hesitancy towards the second Pfizer vaccination dose predicts subsequent side-effects for a booster dose, beyond other effects. We expected these nocebo effects to be driven by (mis)information in males and prior experience in females. A representative sample of older adults (n = 756, mean age = 68.9 ± 3.43) were questioned in a typical cross-lagged design (wave 1 following a second Pfizer dose, wave 2 after their booster). As hypothesized, earlier vaccine hesitancy predicted subsequent booster side-effects for females (ß = 0.10 p = 0.025, f 2 = 0.02) and males (ß = 0.34, p < 0.001, f 2 = 0.16); effects were stronger in males (χ2Δ (1) = 4.34, p = 0.03). The (W1-to-W2) side-effect autoregression was stronger in females (ß = .34, p < 0.001; males ß = 0.18, p < 0.001), χ2Δ (1) = 26.86, p < 0.001. Results show that a quantifiable and meaningful portion of COVID-19 vaccine side-effects is predicted by vaccine hesitancy, demonstrating that side-effects comprise a psychosomatic nocebo component in vaccinated individuals. The data reveal distinct risk levels for future side-effects, suggesting the need to tailor public health messaging.

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.

Can patriotism be a protective factor for symptoms of post-traumatic stress disorder? The case of the Russia - Ukraine 2022 war.

The 2022 Russian invasion of the Ukraine created a large-scale humanitarian crisis that has intensified as the conflict persists. The impact of armed conflict, such as forced migration, exposure to violence, supply shortages, destruction of infrastructure, and interruption of essential services, can have serious negative consequences for the mental health and wellbeing of Ukrainians living through the invasion and its aftermath. At the same time threat to a nation can trigger a wave of patriotism. Such feelings of patriotic belonging, love, pride and caring for a country can help maintain national group cohesion and respect for civic authorities. We studied demographic and war related factors associated with patriotic attitudes and posttraumatic stress disorder (PTSD) symptoms in a national Ukraine sample of 2000 respondents six weeks into this crisis. Respondents completed an online inventory assessing patriotic attitudes, PTSD symptoms, having relatives wounded or killed, having relatives who left Ukraine due to the war, alongside key demographics. Hierarchical regressions found that having relatives that were wounded or that left Ukraine because of the war and those coming from a Ukrainian speaking region were associated with patriotic attitudes. Patriotic attitudes were positively associated with elevated risk for PTSD symptoms. Mental health professionals should consider the potential mental health burden of existential national conflicts amongst civilian populations with strongly patriotic attitudes.

Legal restrictions and mitigation strategies amongst a disabled population during COVID-19.

The impact of physical disability on protective behaviors during COVID-19 has been little studied. This retrospective study compared the 699 the self-declared behaviors of 699 people with disabilities before and after the relaxation of COVID-19 restrictions in England. We found that people with disabilities in England showed high compliance with protective behaviors and mitigation strategies during a period of legal restrictions. Following the lifting of restrictions, respondents engaged in less social mixing, fewer distancing and hygiene behaviors and were less likely to use face coverings. Hierarchical regressions revealed that socio-economic status, age, and gender moderated protective behaviors: while those with higher socio-economic status were more relaxed with regard to hygiene and distancing behaviors, they were more cautious about mixing with others after the end of restrictions. Age, (male) gender, and being unvaccinated were positively associated with relaxation in the use of facemasks in public places, not needing a carer with fewer out-of-home visits. Taken together these findings suggest that the removal of restrictions had an unequal impact on the population of England, placing a disproportionate burden on some people with disabilities.

Two-Tailed Dogs, Social Unrest and COVID-19 Vaccination: Politics, Hesitancy and Vaccine Choice in Hungary and Thailand.

BACKGROUND: A long tradition of research has shown an association between political orientation and vaccine uptake. However, we know little about political preferences and the choice of specific vaccines. METHODS: We conducted two national surveys, in Hungary (Study 1, online, n = 1130) and Thailand (Study 2, on the street survey: n = 1052), testing associations between political allegiance, trust in government, vaccine willingness, and vaccine choice. RESULTS: In Hungary, those supporting the government or on the political right were more willing to be vaccinated, with this association strongest for government approved vaccines. These respondents were also more likely to accept Chinese and Russian vaccines and reject the Moderna vaccine. In Thailand, vaccinated respondents reported greater trust in the government, with preference for AstraZeneca associated with support for pro-government political parties and preference for Pfizer with anti-government attitudes. CONCLUSIONS: Vaccine campaigns need to recognise the role of political loyalties not only in vaccine willingness, but in vaccine choice, especially given the mixing of vaccines across doses.

For better or worse: Relationship change in Thailand during COVID-19.

OBJECTIVE: Novel infectious diseases have the potential to both strengthen or weaken interpersonal relationships within a society. In a collectivist setting such as Thailand amplification of relationships may be particularly marked, but may be associated with individual factors, including personal values and perceived control over the virus. METHODS: A national on-street survey in Thailand (April 2020, N = 1,000), collected data from five regions across the country (response rate 82.6%). Participants reported demographics, anxiety, perceived control, and personal values of security and universalism, and indicated changes, from negative to positive, across four relationship types (relationship partners, family, friendships and neighbourhood). RESULTS: While relationship changes were small overall, there was an improvement in close relations (partners, family members) but not amongst friends and neighbours. Respondents who were married without children recorded less enhancement of partnerships, friendships and neighbourhood relations. Those with less perceived control over the infection reported relationship decline, while single people reported fewer positive changes in their partnership or family relations. Multiple regression analyses demonstrated the prioritisation of security was associated with a decline in each of the relationships, while universalism was positively associated with change in the family, in friendships and neighbourly relations. CONCLUSIONS: Personal values and marital status may impact on relationship functioning during a national health crisis. These issues should be considered by clinicians and health practitioners when trying to assist those struggling with interpersonal relations during a pandemic.

Anxiety, past trauma and changes in relationships in Japan during COVID-19.

Widely shared traumas have the potential to both improve and impair our relationships with others. During COVID-19 anxiety has been seen as a major individual vulnerability associated with relationship change, as have the wider economic, situational factors facing families and communities. In this national sample of 997 Japanese respondents we assessed perceived relationship changes in couple relations, neighbourhood relations, and wider relations with Japanese nationals, alongside anxiety, exposure to previous mass traumas, household economics, education, and vulnerability to COVID-19. Whilst most respondents reported little change in their relationships during this year there was a small overall improvement in couple relationships and a decline in relations with wider communities. Participant's economic resources were positively associated with an improvement in couple relationships, while anxiety was associated with a decline in relations with both the neighbourhood and the wider society. While neither prior experience of mass trauma, nor education or health vulnerability to COVID-19, were associated with relationship change, having time to talk, and younger age, was positively associated with improvement in couple relations. Findings suggest that anxiety can function to distance relationships during a time of stress, but perceived changes in relationships are little effected by experience of previous trauma. Relationship growth is likely to be greatest in those with better economic conditions. Practitioners need to be mindful of the impact of enhanced anxiety during the pandemic on interpersonal relations, and a potential threat to the relationships of older couples during this time of pandemic threat.

Psychological factors underpinning vaccine willingness in Israel, Japan and Hungary.

The spread of SARS-CoV-2 led to rapid vaccine development. However, there remains considerable vaccine hesitancy in some countries. We investigate vaccine willingness in three nations with very different vaccine histories: Israel, Japan and Hungary. Employing an ecological-systems approach we analyse associations between health status, individual cognitions, norms, trust in government, COVID-19 myths and willingness to be vaccinated, with data from three nationally representative samples (Israel, Jan. 2021, N = 1011; Japan, Feb. 2021, N = 997; Hungary, April 2021, N = 1130). Vaccine willingness was higher in Israel (74%) than Japan (51%) or Hungary (31%). In all three countries vaccine willingness was greatest amongst who would regret not being vaccinated and respondents who trusted their government. Multi-group latent class analysis identified three groups of COVID myths, with particular concern about alteration of DNA (Israel), allergies (Hungary) and infection from the vaccine (Japan). Intervention campaigns should address such cultural myths while emphasising both individual and social benefits of vaccination.

COVID-19 post-vaccination depression in older Israeli adults: the role of negative world assumptions.

Background: With the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, the aging population has been shown to be highly vulnerable. As a result, policy makers and the media urged older adults to restrict social interactions, placing them at greater risk of mental health problems, such as depression. However, there has been a little previous attempt to examine coronavirus disease-2019 (COVID-19) vaccine-related risk factors and depressive symptoms amongst older adults. Methods: Participants (938 older adults, Mage = 68.99, s.d. = 3.41, range 65-85) answered an online questionnaire at the start of the COVID-19 vaccination program in Israel. Participants completed measures of background characteristics, world assumptions, COVID-19 vaccine-related variables, and symptoms of depression. Results: Univariate logistic regression revealed that more negative world assumptions were linked with clinical depression levels. Conclusions: Older adults in our sample were susceptible to unique factors associated with clinical depression influenced by their world assumptions during their COVID-19 vaccination. The high level of depression following vaccination indicates that it may take time to recover from depression associated with pandemic distress. Cognitive interventions that focus on world assumptions are recommended.

Association between mental health trajectories and somatic symptoms following a second lockdown in Israel: a longitudinal study.

OBJECTIVES: To identify mental health prospective trajectories before and after a second lockdown during the COVID-19 pandemic and their associations with somatic symptoms. DESIGN: Prospective Study. SETTING: Population-based study drawn from a probability-based internet panel of over 100 000 Israelis. PARTICIPANTS: Adults aged 18 years or more, representative of the adult Israeli population. The participants were measured at two time points (time 1 (T1) pre-second lockdown N=1029; response rate=76.17%; time 2 (T2) post-second lockdown N=764; response rate=74.24%). MAIN OUTCOME MEASURES: Trajectories of anxiety and adjustment disorder based on clinical cut-off score for probable diagnoses across T1-T2, somatic symptoms at T2. The four trajectories: stable-low, (no probable diagnosis), stable-high (stable probable diagnosis), exacerbation (no probable diagnosis at T1, probable diagnosis at T2), recovery (probable diagnosis at T1, no probable diagnosis at T2). RESULTS: Three anxiety trajectories predicted probable somatic symptoms (stable-high OR=6.451; exacerbation OR=5.379; recovery OR=2.025) compared with the stable-low trajectory. The three adjustment disorder trajectories also predicted somatic symptoms (stable-high OR=4.726; exacerbation OR=6.419; recovery OR=4.666) compared with the stable-low trajectory. CONCLUSIONS: Our data show elevated somatic symptoms among those whose mental health trajectories were poor, exacerbated and those who recovered following the second lockdown. The presentation of somatic symptoms may mask psychological vulnerabilities, even among those who appear to have recovered from the stressor. This indicates that lockdown may be a double-edged sword and should be carefully administered given these populations vulnerabilities.

Factors associated with current posttraumatic stress disorder among COVID-19 vaccinated older adults in Israel.

This is the first study to examine COVID-19 vaccine-related stressors in the context of current posttraumatic stress disorder (PTSD) symptoms amongst older adults exposed to traumatic events prior to the COVID-19 outbreak, with particular focus on the associations between ageism, vaccine-related stressors and PTSD. Five hundred and sixty-three participants aged 65 and above reported exposure to at least one traumatic event, their current PTSD level, physical and mental health, ageist attitudes, and vaccine related stressors. Univariate logistic regression revealed that depressive symptoms, ageism, vaccine hesitancy and severity of side effects were the main factors associated with clinical levels of current PTSD. These results suggest that older adults were vulnerable to intensified PTSD symptoms, not only as a result of greater depression, but also as a consequence of other factors, including ageism, vaccination hesitancy and vaccination side effects. Practitioners would benefit from awareness to these factors.

The toll of a second lockdown: A longitudinal study.

Background The mental health toll of a second lockdown during the COVID-19 pandemic has not been yet examined. The purpose of the study was to examine psychological predictors before the second lockdown and their impact on the prediction of ICD-11 probable Adjustment Disorder (AjD) after the second lockdown. Methods Using a longitudinal design we surveyed a national representative sample of the Israeli population before and after the second lockdown. In wave 1, 1029 were surveyed (Response Rate (RR) = 76.17%) and in Wave 2, 764 were surveyed (RR = 74.24%). Participants answer a questionnaire tapping COVID-19 stressful related events, uncertainty, probable depression predicting ICD-11 and probable AjD. Results The main predictors of AjD after the second lockdown were sex (OR = 1.868; p ≤0.01), having a COVID-19 occupational related stressful event (OR = 2.855; p <0.001), probable depression (OR = 2.520; p <0.001) and Uncertainty (OR = 4.485; p <0.001). Limitations We recognise the limitations of response bias. In addition, we did not measure pre COVID-19 mental health. Conclusions The study results show the mental toll of a second lockdown during the COVID-19 pandemic.