RESUMO
Previous research has demonstrated the efficacy of psychological interventions to foster resilience. However, little is known about whether the cultural context in which resilience interventions are implemented affects their efficacy on mental health. Studies performed in Western (k = 175) and Eastern countries (k = 46) regarding different aspects of interventions (setting, mode of delivery, target population, underlying theoretical approach, duration, control group design) and their efficacy on resilience, anxiety, depressive symptoms, quality of life, perceived stress, and social support were compared. Interventions in Eastern countries were longer in duration and tended to be more often conducted in group settings with a focus on family caregivers. We found evidence for larger effect sizes of resilience interventions in Eastern countries for improving resilience (standardized mean difference [SMD] = 0.48, 95% confidence interval [CI] 0.28 to 0.67; p < 0.0001; 43 studies; 6248 participants; I2 = 97.4%). Intercultural differences should receive more attention in resilience intervention research. Future studies could directly compare interventions in different cultural contexts to explain possible underlying causes for differences in their efficacy on mental health outcomes.
Assuntos
Qualidade de Vida , Estresse Psicológico , Ansiedade/diagnóstico , Cuidadores/psicologia , Depressão/diagnóstico , Humanos , Saúde Mental , Estresse Psicológico/psicologiaRESUMO
Although resilience is a multi-level process, research largely focuses on the individual and little is known about how resilience may distinctly present at the group level. Even less is known about subjective conceptualizations of resilience at either level. Therefore, two studies sought to better understand how individuals conceptualize resilience both as an individual and as a group. Study 1 (N = 123) experimentally manipulated whether participants reported on either individual or group-based responses to real stressors and analysed their qualitative responses. For individual responses, subjective resilience featured active coping most prominently, whereas social support was the focus for group-based responses. As these differences might be attributable to the different stressors people remembered in either condition, Study 2 (N = 171) held a hypothetical stressor (i.e., natural disaster) constant. As expected, resilience at the group level emphasized maintaining group cohesion. Surprisingly, the group condition also reported increased likelihood to engage in blame, denial, and behavioural disengagement. Contrary to expectations, participants in the individual condition reported stronger desire to seek out new groups. The combined findings are discussed within the framework of resilience and social identity and highlight the necessity of accounting for multiple levels and subjective conceptualizations of resilience.
Assuntos
Resiliência Psicológica , Coesão Social , Adaptação Psicológica , Humanos , Apoio SocialRESUMO
BACKGROUND: Acute disease outbreaks such as the COVID-19 pandemic cause a high burden of psychological distress in people worldwide. Interventions to enable people to better cope with such distress should be based on the best available evidence. We therefore performed a scoping review to systematically identify and summarize the available literature of interventions that target the distress of people in the face of highly contagious disease outbreaks. METHODS: MEDLINE, Cochrane CENTRAL, Web of Science (January 2000 to May 7, 2020), and reference lists were systematically searched and screened by two independent reviewers. Quantitative and qualitative studies investigating the effects of psychological interventions before, during, and after outbreaks of highly contagious emerging infectious diseases, such as SARS, MERS, Ebola, or COVID-19 were included. Study effects were grouped (e.g. for healthcare professionals, community members, people at risk) and intervention contents at the individual and organizational level summarized. We assessed the level of evidence using a modified scheme from the Oxford Centre for Evidence-based Medicine and the Australian National Health and Medical Research Council. RESULTS: Of 4030 records found, 19 studies were included (two RCTs). Most interventions were delivered during-exposure and face-to-face, focused on healthcare workers and crisis personnel, and combined psychoeducation with training of coping strategies. Based on two high-quality studies, beneficial effects were reported for resilience factors (e.g. positive cognitive appraisal) and professional attitudes of healthcare workers, with mixed findings for mental health (e.g. depression). Across all studies, there was positive qualitative feedback from participants and facilitators. We identified seven ongoing studies mostly using online- and mobile-based deliveries. CONCLUSIONS: There is preliminary evidence for beneficial effects of interventions to enable people to better cope with the distress of highly contagious emerging disease outbreaks. Besides the need for more high-quality studies, the summarized evidence may inform decision makers to plan interventions during the current pandemic and to develop pandemic preparedness plans.
Assuntos
COVID-19/patologia , Saúde Mental , Sistemas de Apoio Psicossocial , Adaptação Psicológica , COVID-19/epidemiologia , COVID-19/virologia , Surtos de Doenças , Pessoal de Saúde/psicologia , Humanos , Resiliência Psicológica , SARS-CoV-2/isolamento & purificaçãoRESUMO
BACKGROUND: The SARS-CoV-2 pandemic has caused mental stress in a number of ways: overstrain of the health care system, lockdown of the economy, restricted opportunities for interpersonal contact and excursions outside the home and workplace, and quarantine measures where necessary. In this article, we provide an overview of psychological distress in the current pandemic, identifying protective factors and risk factors. METHODS: The PubMed, PsycINFO, and Web of Science databases were systematically searched for relevant publications (1 January 2019 - 16 April 2020). This study was registered in OSF Registries (osf.io/34j8g). Data on mental stress and resilience in Germany were obtained from three surveys carried out on more than 1000 participants each in the framework of the COSMO study (24 March, 31 March, and 21 April 2020). RESULTS: 18 studies from China and India, with a total of 79 664 participants, revealed increased stress in the general population, with manifestations of depression and anxiety, post-traumatic stress, and sleep disturbances. Stress was more marked among persons working in the health care sector. Risk factors for stress included patient contact, female sex, impaired health status, worry about family members and significant others, and poor sleep quality. Protective factors included being informed about the increasing number of persons who have recovered from COVID, social support, and a lower perceived infectious risk. The COSMO study, though based on an insufficiently representative population sample because of a low questionnaire return rate (<20%), revealed increased rates of despondency, loneliness, and hopelessness in the German population as compared to norm data, with no change in estimated resilience. CONCLUSION: Stress factors associated with the current pandemic probably increase stress by causing anxiety and depression. Once the protective factors and risk factors have been identified, these can be used to develop psychosocial interventions. The informativeness of the results reported here is limited by the wide variety of instruments used to acquire data and by the insufficiently representative nature of the population samples.