StayWell at Home: A Text Messaging Intervention to Counteract Depression and Anxiety during COVID-19 Social Distancing (Preprint)

2021 ◽  
Author(s):  
Adrian Aguilera ◽  
Rosa Hernandez-Ramos ◽  
Alein Yaritza Haro ◽  
Claire Elizabeth Boone ◽  
Tiffany Luo ◽  
...  
Keyword(s):  
Mental Health ◽  
Text Messaging ◽  
The United States ◽  
Text Messages ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Negative Consequences ◽  
Social Distancing ◽  
At Home

BACKGROUND Social distancing and stay-at-home orders are critical interventions to slow down person-to-person transmission of COVID-19. While these societal changes help to contain the pandemic, they also have unintended negative consequences, including anxiety and depression. We developed StayWell, a daily skills-based SMS text messaging program, to mitigate COVID-19 related depression and anxiety symptoms among people who speak English and Spanish in the United States. OBJECTIVE This paper describes the changes in the anxiety and depression levels of participants in the StayWell program after 60 days of exposure to skills-based SMS text messages. METHODS We used self-administered, empirically supported web-based questionnaires to assess the demographic and clinical characteristics of StayWell participants. Anxiety and depression were measured using the 2-item Generalized Anxiety Disorder (GAD-2) scale and the 8-item Patient Health Quesstionanire-8 (PHQ-8) scale at baseline and 60-day timepoints. We used paired t-tests to detect the change in PHQ-8 and GAD-2 scores from baseline to follow-up measured 60 days later. RESULTS The analytic sample includes 193 participants who completed both the baseline and 60-day exit questionnaires. At the 60-day time point, there were statistically significant reductions in both PHQ-8 and GAD-2 scores from baseline. We found an average reduction of -1.72 (95% CI: -2.35, -1.09) in PHQ-8 scores and -0.48 (95% CI: -0.71, -0.25) in GAD-2 scores. This translated to an 18.5% and 17.2% reduction in mean PHQ-8 scores and GAD-2, respectively. CONCLUSIONS StayWell is a low-intensity, cost-effective, and accessible population-level mental health intervention. Participation in StayWell focused on COVID-19 mental health coping skills and was related to improved depression and anxiety symptoms. In addition to improvements in outcomes, we found high levels of engagement during the 60-day intervention period. Text messaging interventions could serve as an important public health tool for disseminating strategies to manage mental health. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT04473599 INTERNATIONAL REGISTERED REPORT RR2-10.2196/23592

scholarly journals Depression and Anxiety Symptoms of British Adoptive Parents: A Prospective Four-Wave Longitudinal Study

2019 ◽  
Vol 16 (24) ◽  
pp. 5153 ◽  
Author(s):  
Rebecca E. Anthony ◽  
Amy L. Paine ◽  
Katherine H. Shelton
Keyword(s):  
Mental Health ◽  
Depressive Symptoms ◽  
Adoptive Parents ◽  
Anxiety Symptoms ◽  
Depression Symptoms ◽  
Parental Anxiety ◽  
Depression And Anxiety ◽  
Negative Consequences ◽  
Adoptive Families ◽  
Prospective Longitudinal

The mental health of birth parents has gained attention due to the serious negative consequences for personal, family, and child outcomes, but depression and anxiety in adoptive parents remains under-recognized. Using a prospective, longitudinal design, we investigated anxiety and depression symptoms in 96 British adoptive parents over four time points in the first four years of an adoptive placement. Depression and anxiety symptom scores were relatively stable across time. Growth curve analysis showed that higher child internalizing scores and lower parental sense of competency at five months post-placement were associated with higher initial levels of parental depressive symptoms. Lower parental sense of competency was also associated with higher initial levels of parental anxiety symptoms. Parents of older children and those with higher levels of parental anxiety and sense of competency at five months post-placement had a steeper decrease in depressive symptoms over time. Support for adoptive families primarily focuses on child adjustment. Our findings suggest that professional awareness of parental mental health post-placement may be necessary, and interventions aimed at improving parents’ sense of competency may be beneficial.

scholarly journals Determinants of increased frequency of depressive and anxiety symptoms in exercise professionals during the COVID-19 pandemic

Work ◽  
2021 ◽  
pp. 1-11
Author(s):  
Natan Feter ◽  
Eduardo L. Caputo ◽  
Igor R. Doring ◽  
Marcelo C. da Silva ◽  
Felipe F. Reichert ◽  
...  
Keyword(s):  
Physical Activity ◽  
Depressive Symptoms ◽  
Depression Scale ◽  
Exercise Program ◽  
Anxiety Symptoms ◽  
Anxiety And Depression ◽  
Depression Symptoms ◽  
Depression And Anxiety ◽  
Cross Sectional ◽  
Social Distancing

BACKGROUND: The coronavirus disease (COVID-19) pandemic has affected workers in different health services including exercise professionals (EP). The urgent need to adapt in-person to online activities might have led to increased frequency of anxiety and depressive symptoms. OBJECTIVE: We aimed to identify the determinants of aggravated depressive and anxiety symptoms in EP in southern Brazil during social distancing from the COVID-19. METHODS: A cross-sectional study was conducted with EP who worked at fitness centers, sports clubs, private schools, or at a public exercise program offered by the municipal council. We used an online-based, self-administered, adapted version of the Hospital Anxiety and Depression scale to compare symptoms of depression and anxiety pre- and during social distancing. RESULTS: Participants (n = 201) had a mean age of 32.7±8.0 years, with more than half being male, white, and having an university degree. We observed that 81%and 71%of respondents reported higher frequency in anxiety and depression symptoms, respectively, during social distancing than in the period before it. Physical education teachers, women, non-white professionals, and those with chronic disease were more likely to worsen anxiety symptoms. Women had higher odds to increased frequency in depressive symptoms. Physical activity and previous experience with internet-based tools for working activities reduced the risk of increased depressive symptoms. CONCLUSIONS: Sex, ethnicity, chronic diseases, educational level, physical activity, and experience with online tools were determinants for increased frequency of depression and anxiety symptoms in EP.

scholarly journals A text-messaging study to help cope with social distancing: clinical trial protocol for the Stay Well at Home study (Preprint)

2020 ◽  
Author(s):  
Caroline Astrid Figueroa ◽  
Rosa Hernandez-Ramos ◽  
Claire Elizabeth Boone ◽  
Laura Gómez-Pathak ◽  
Vivian Yip ◽  
...  
Keyword(s):  
Machine Learning ◽  
Text Messaging ◽  
Behavioral Activation ◽  
Controlled Trial ◽  
Time Windows ◽  
Depression Scale ◽  
Depressive Mood ◽  
Text Messages ◽  
Negative Consequences ◽  
Social Distancing

BACKGROUND Social distancing is a crucial intervention to slow down person-to-person transmission of COVID-19. However, social distancing has negative consequences including increases in depression and anxiety. Digital interventions, like text-messaging, can provide accessible support on a population wide scale. We developed text messages in English and Spanish to help individuals manage their depressive mood and anxiety during the COVID-19 pandemic. OBJECTIVE In a two-arm randomized controlled trial we aim to examine the effect of our 60 days text-messaging intervention. Additionally, we aim to assess if the use of machine learning to adapt the messaging frequency and content improves the effectiveness of the intervention. Finally, we will examine the differences in daily mood ratings between the message categories and time windows. METHODS The messages are designed within two different categories: behavioral activation and coping skills. Participants will be randomized into 1) a random messaging arm, where message category and timing will be chosen with equal probabilities, and 2) a reinforcement-learning arm, with a learned decision mechanism for choosing the messages. Participants in both arms will receive one message per day within three different time windows and will be asked to provide their mood rating 3 hours later. We will compare self-reported daily mood ratings, self-reported Patient Health Questionnaire depression scale 8-item (PHQ-8) and Generalized Anxiety Disorder 7-item (GAD-7) at baseline and at intervention completion. RESULTS The Institutional Review Board at the University of California Berkeley approved this study (CPHS: 2020-04-13162) in April 2020. Data collection runs from April 2020 to April 2021. As of August 24th 2020, we have enrolled 229 participants. We plan to submit manuscripts describing the main results of the trial and results from the micro-randomized trial for publication in peer-reviewed journals and presentations at (inter)-national scientific meetings. CONCLUSIONS Results will contribute to our knowledge of effective psychological tools to alleviate the negative effects of social distancing, and the benefit of using machine learning to personalize digital mental health interventions. CLINICALTRIAL Clinicaltrials.gov: NCT04473599; pre-results.

scholarly journals Age Differences in COVID-19 Risk Perceptions and Mental Health: Evidence From a National U.S. Survey Conducted in March 2020

2020 ◽  
Author(s):  
Wändi Bruine de Bruin
Keyword(s):  
Mental Health ◽  
Older Adult ◽  
Age Differences ◽  
Risk Perceptions ◽  
The United States ◽  
Demographic Variables ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Depression Diagnosis ◽  
Adult Age

Abstract Objectives Theories of aging posit that older adult age is associated with less negative emotions, but few studies have examined age differences at times of novel challenges. As COVID-19 spread in the United States, this study therefore aimed to examine age differences in risk perceptions, anxiety, and depression. Method In March 2020, a nationally representative address-based sample of 6,666 U.S. adults assessed their perceived risk of getting COVID-19, dying if getting it, getting quarantined, losing their job (if currently working), and running out of money. They completed a mental health assessment for anxiety and depression. Demographic variables and precrisis depression diagnosis had previously been reported. Results In regression analyses controlling for demographic variables and survey date, older adult age was associated with perceiving larger risks of dying if getting COVID-19, but with perceiving less risk of getting COVID-19, getting quarantined, or running out of money, as well as less depression and anxiety. Findings held after additionally controlling for precrisis reports of depression diagnosis. Discussion With the exception of perceived infection-fatality risk, U.S. adults who were relatively older appeared to have a more optimistic outlook and better mental health during the early stages of the pandemic. Interventions may be needed to help people of all ages maintain realistic perceptions of the risks, while also managing depression and anxiety during the COVID-19 crisis. Implications for risk communication and mental health interventions are discussed.

scholarly journals Emotion regulation difficulties and interpersonal problems during the COVID-19 Pandemic: Predicting anxiety and depression

2021 ◽  
Author(s):  
Ole Andre Solbakken ◽  
Omid V. Ebrahimi ◽  
Asle Hoffart ◽  
Jon T. Monsen ◽  
Sverre Urnes Johnson
Keyword(s):  
Mental Health ◽  
Emotion Regulation ◽  
Mental Health Problems ◽  
Interpersonal Problems ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Social Distancing ◽  
Symptoms Of Depression ◽  
Interpersonal Difficulties ◽  
The Impact

Background: Central components of psychological functioning, such as difficulties in emotion regulation and interpersonal problems are likely to have been substantially impacted by COVID-19 and the amelioration measures of societal lock-down and social distancing. In turn, these factors are likely to predict mental health outcomes, such as symptoms of depression and anxiety throughout the pandemic and beyond. Methods: To investigate this issue, we conducted an internet-based survey with 10,061 responders at the height of lock-down (T1). After social distancing measures had been eased (T2), 4,936 responders (49.1%) completed the survey again. Results: Emotion regulation difficulties, interpersonal problems, and symptoms of depression and anxiety decreased from T1 to T2, but changes were minor. After controlling for age and gender, emotion regulation- and interpersonal difficulties were associated with anxiety and depression throughout the study period, and changes in all domains occurred in concert. More extensive problems with emotion regulation at T1 predicted greater reductions in both symptom domains as amelioration measures were eased, while the converse was true for interpersonal problems. Furthermore, the impact of initial emotion regulation difficulties on subsequent changes in both anxiety- and depressive symptoms was dependent on the level of interpersonal difficulties, so that high interpersonal problem load at T1 reversed the effect of emotion regulation difficulties on symptom development. Conclusions: The results suggest that emotion regulation- and interpersonal difficulties are highly central to mental health during the pandemic, and may be important targets for remediation to reduce mental health problems throughout the course of the pandemic and beyond.

scholarly journals Digital phenotyping of complex psychological responses to the COVID-19 pandemic

2020 ◽  
Author(s):  
Thomas Hull ◽  
Jacob Levine ◽  
Niels Bantilan ◽  
Angel Desai ◽  
Maimuna S. Majumder
Keyword(s):  
Mental Health ◽  
Large Scale ◽  
Anxiety Symptom ◽  
The United States ◽  
Anxiety Symptoms ◽  
Response To Treatment ◽  
Depression Symptom ◽  
Depression And Anxiety ◽  
Psychological Reactions ◽  
Symptom Scores

Background: The novel coronavirus disease 2019 (COVID-19) has negatively impacted mortality, economic conditions, and mental health. A large scale study on psychological reactions to the pandemic to inform ongoing population-level symptom tracking and response to treatment is currently lacking.Methods: Average intake scores for standard depression and anxiety symptom scales were tracked from January 1, 2017 to June 9, 2020 for patients seeking treatment from a digital mental health service to gauge the relationship between COVID-19 and self-reported symptoms. We applied natural language processing (NLP) to unstructured therapy transcript data from patients seeking treatment during the height of the pandemic in the United States between March 1, 2020 and June 9, 2020 to identify words associated with COVID-19 mentions. This analysis was used to identify symptoms that were present beyond those assessed by standard depression and anxiety measures.Results: Depression and anxiety symptoms reported by 169,889 patients between January 1, 2017 and June 9, 2020 were identified. There was no detectable change in intake depression symptom scores. Intake anxiety symptom scores increased 1.42 scale points [95% CI: 1.18, 1.65] between March 15, 2020 and April 1, 2020, when scores peaked. In the transcript data of these 169,889 patients, plus an expanded sample of 49,267 patients without symptom reports, term frequency-inverse document frequency (tf-idf) identified 2,377 positively correlated and 661negatively correlated terms that were significantly (FDR<.01) associated with mentions of the virus. These terms were classifiable into 24 symptoms beyond those included in the diagnostic criteria for anxiety or depression.Conclusions: The COVID-19 pandemic may have increased intake anxiety symptoms for individuals seeking digital mental health treatment. NLP analyses suggest that standard symptom scales for depression and anxiety alone are inadequate to fully assess and track psychological reactions to the pandemic. Symptoms of grief, trauma, obsession-compulsion, agoraphobia, hypochondriasis, panic, and non- suicidal self-injury should be monitored as part of a new COVID-19 Syndrome category.

scholarly journals Association between SARS-CoV-2 infection, exposure risk and mental health among a cohort of essential retail workers in the United States

2020 ◽  
Author(s):  
Fan-Yun Lan ◽  
Christian Suharlim ◽  
Stefanos N. Kales ◽  
Justin Yang
Keyword(s):  
Mental Health ◽  
The United States ◽  
Cross Sectional Study ◽  
Anxiety And Depression ◽  
Health State ◽  
Cross Sectional ◽  
Social Distancing ◽  
General Anxiety Disorder ◽  
General Anxiety ◽  
Retail Workers

ABSTRACTObjectivesTo investigate SARS-CoV-2 (the virus causing COVID-19) infection and exposure risks among grocery retail workers, and to investigate their mental health state during the pandemic.MethodsThis cross-sectional study was conducted in May 2020 in a single grocery retail store in Massachusetts, USA. We assessed workers’ personal/occupational history and perception of COVID-19 by questionnaire. The health outcomes were measured by nasopharyngeal SARS-CoV-2 reverse transcriptase polymerase chain reaction (RT-PCR) results, GAD-7 (General Anxiety Disorder-7) and PHQ-9 (Patient Health Questionnaire-9).ResultsAmong 104 workers tested, twenty-one (20%) had positive viral assays. Seventy-six percent positive cases were asymptomatic. After multi-variate adjustments, employees with direct customer exposure had an odds of 4.7 (95% CI 1.2 to 32.0) being tested positive for SARS-CoV-2, while smokers had an odds of 0.1 (95% CI 0.01 to 0.8) having positive assay. As to mental health, the prevalence of anxiety and depression (i.e. GAD-7 score > 4 or PHQ-9 score >4) was 24% and 8%, respectively. After adjusting for potential confounders, those able to practice social distancing consistently at work had odds of 0.2 (95% CI 0.1 to 0.7) and 0.1 (95% CI 0.01 to 0.6) screening positive for anxiety and depression, respectively.ConclusionsWe found a considerable asymptomatic SARS-CoV-2 infection rate among grocery workers. Employees with direct costumer exposure were 5 times more likely to test positive for SARS-CoV-2, while cigarette smokers were 90% less likely to have positive assays. Those able to practice social distancing consistently at work had significantly lower risk of anxiety or depression.

scholarly journals Immigration Policy Vulnerability Linked to Adverse Mental Health Among Latino Day Laborers

2021 ◽  
Author(s):  
Alein Y. Haro-Ramos ◽  
Hector P. Rodriguez
Keyword(s):  
Mental Health ◽  
Health Outcomes ◽  
Immigration Policy ◽  
The United States ◽  
Anxiety Symptoms ◽  
Mental Health Outcomes ◽  
Depression Symptoms ◽  
Day Laborers ◽  
Depression And Anxiety ◽  
Latino Day Laborers

AbstractLatino day laborers in the United States are socially and economically vulnerable due to exclusionary immigration policies. Using data from a multi-mode survey, we examine the relationship between immigration policy legal vulnerability and mental health outcomes among 138 Latino, male day laborers (mean age = 45.65, SD = 12.05). Multivariable linear and logistic regression models separately estimated the effect of legal vulnerability, as measured by the Perceived Immigration Policy Effects Scale, on anxiety and depression symptoms and a positive depression and anxiety screening, respectively. Approximately 26.1% and 27.9% of day laborers reported depression and anxiety symptoms, respectively. In each adjusted model, we find a positive relationship between legal vulnerability and adverse mental health. Immigration policy legal vulnerability is associated with more depression and anxiety symptoms among Latino day laborers. Policies to reduce legal vulnerability, such as pathways to citizenship and employment authorization, may support Latino day laborers' mental health outcomes.

scholarly journals Depression and Anxiety Symptoms Relate to Distinct Components of Pain Experience among Patients with Breast Cancer

2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Sarah K. Galloway ◽  
Megan Baker ◽  
Pierre Giglio ◽  
Steve Chin ◽  
Alok Madan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Patients ◽  
The United States ◽  
Anxiety Symptoms ◽  
Appreciable Amount ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Newly Diagnosed ◽  
Breast Cancer Patients ◽  
Pain Experience

Breast cancer is a leading cancer diagnosis among women worldwide, with more than 210,000 new cases and 40,000 deaths per year in the United States. Pain, anxiety, and depression can be significant factors during the course of breast cancer. Pain is a complex experience with sensory, affective, and cognitive dimensions. While depression and anxiety symptoms are relatively common among breast cancer patients, little is known about the relation between these psychiatric factors and distinct components of the pain experience. In the present study 60 females presenting to an NCI-designated Cancer Center with newly diagnosed breast cancer completed the Center for Epidemiological Studies 10-item Depression Scale, the State Instrument of the Spielberger State-Trait Anxiety Inventory, and the McGill Pain Questionnaire. Findings indicate that anxiety and depression are common among newly diagnosed breast cancer patients; furthermore, patients experience an appreciable amount of pain even before oncologic treatment starts. State anxiety serves as a predictor of the sensory dimension of the pain experience, whereas depression serves as a predictor of the affective dimension of the pain experience.

scholarly journals Mental Health and Behavior of College Students in the COVID-19 Pandemic: A Longitudinal Mobile Smartphone and Ecological Momentary Assessment Study - Part II (Preprint)

2021 ◽  
Author(s):  
Dante Mack ◽  
Alex DaSilva ◽  
Courtney Rogers ◽  
Elin Hedlund ◽  
Eilis Murphy ◽  
...  
Keyword(s):  
Mental Health ◽  
Large Scale ◽  
Sedentary Time ◽  
The United States ◽  
Anxiety And Depression ◽  
Depression And Anxiety ◽  
Health Changes ◽  
And Behaviors ◽  
Ecological Momentary ◽  
Mobile Smartphone

BACKGROUND Since late 2019, the lives of people across the globe have been disrupted by COVID-19. Millions of people have become infected; billions have been continually asked or required by local and national governments to change their behavioral patterns. Previous research on the COVID-19 pandemic suggests that it is associated with large-scale behavioral and mental health changes, but few studies have been able to track these changes with frequent, near real-time sampling or compare these changes to previous years of data for the same individuals. OBJECTIVE By combining mobile phone sensing and self-reported mental health data in a cohort of college-aged students enrolled in a longitudinal study, we seek to understand the behavioral and mental health impacts associated with the pandemic, measured by search term interest in "coronavirus" and "covid fatigue" across the United States. METHODS Behaviors such as the number of locations visited, distance traveled, duration of phone usage, number of phone unlocks, sleep duration, and sedentary time were measured using the StudentLife mobile smartphone sensing app. Depression and anxiety were assessed using weekly self-reported Ecological Momentary Assessments (EMAs), including the Patient Health Questionnaire-4 (PHQ-4). Participants were 217 undergraduate students. Differences in behaviors and self-reported mental health collected during the Spring 2020 term, as compared to previous terms in the same cohort, were modeled using mixed linear models. RESULTS Linear mixed models observed differences in phone usage, sleep, sedentary time and the number of locations visited associated with the COVID-19 pandemic. In further models, these behaviors were strongly associated with increased interest in covid fatigue. When mental health metrics (e.g., depression and anxiety) were added to the previous measures (week of term, number of locations visited, phone usage, sedentary time), both anxiety and depression (_P_<.001) were significantly associated with interest in covid fatigue. Notably, these behavioral and mental health changes are consistent with those observed around the initial implementation of COVID-19 lockdowns in the spring of 2020 [@Huckins2020]. CONCLUSIONS In the initial lockdown phase of the COVID-19 pandemic, people spent more time on their phones, were more sedentary, visited fewer locations, and exhibited increased symptoms of anxiety and depression. As the pandemic persisted through the spring, people continued to exhibit very similar changes in both mental health and behaviors. Though unsurprising, understanding these large-scale shifts in mental health and behaviors is critical in disrupting the negative consequences to mental health during the ongoing pandemic. INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.31234/osf.io/8yt4x

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