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

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.

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Predictors of mental health during the Covid-19 pandemic in the US: Role of economic concerns, health worries and social distancing

PLoS ONE ◽

10.1371/journal.pone.0241895 ◽

2020 ◽

Vol 15 (11) ◽

pp. e0241895

Author(s):

Fabrice Kämpfen ◽

Iliana V. Kohler ◽

Alberto Ciancio ◽

Wändi Bruine de Bruin ◽

Jürgen Maurer ◽

...

Keyword(s):

Mental Health ◽

Depression And Anxiety ◽

Public Health Response ◽

Health Crisis ◽

Economic Implications ◽

Social Distancing ◽

Symptoms Of Depression ◽

The Us ◽

The Impact

Despite the profound health and economic implications of Covid-19, there is only limited knowledge to date about the role of economic concerns, health worries and social distancing for mental health outcomes during the pandemic. We analyze online survey data from the nationally representative “Understanding America Study” (UAS) covering the period of March 10-31st 2020 (sample size: 6,585). Mental health is assessed by the validated PHQ-4 instrument for measuring symptoms of depression and anxiety. About 29% (CI:27.4-.30.4%) of the US adult population reported some depression/anxiety symptoms over the study period, with symptoms deteriorating over the month of March. Worsening mental health was most strongly associated with concerns about the economic consequences of the pandemic, while concerns about the potential implications of the virus for respondents’ own health and social distancing also predicted increases in symptoms of depression and anxiety during the early stages of the pandemic in the US, albeit less strongly. Our findings point towards the possibility of a major mental health crisis unfolding simultaneously with the pandemic, with economic concerns being a key driving force of this crisis. These results highlight the likely importance of economic countermeasures and social policy for mitigating the impact of Covid-19 on adult mental health in the US over and above an effective public health response.

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THE EARLY BIRD GETS THE WORM, NOT ANXIETY OR DEPRESSION: HOW INSOMNIA SYMPTOMS PREDICT ANXIETY AND DEPRESSION

Innovation in Aging ◽

10.1093/geroni/igz038.174 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

pp. S45-S45

Author(s):

Courtney J Bolstad ◽

Anisha L Thomas ◽

Michael R Nadorff

Keyword(s):

Older Adults ◽

Depressive Symptoms ◽

Anxiety Symptoms ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Regression Analyses ◽

Symptoms Of Depression ◽

Early Bird ◽

The Impact ◽

Insomnia Symptoms

Abstract Symptoms of insomnia are associated with symptoms of depression and anxiety in older adults, yet less is known about the impact of specific forms of insomnia (i.e. onset, maintenance, and terminal insomnia). We explored how insomnia type predicted symptoms of anxiety and depression in older adults (n = 133; mean age 69, range 65-89). We hypothesized that onset and maintenance insomnia would have stronger relations to depression and anxiety than terminal insomnia. Regression analyses indicated that onset insomnia was the only significant predictor of anxiety symptoms, and maintenance was the only significant predictor of depressive symptoms. Thus, our findings suggest that despite overlap between depression and anxiety, insomnia may have different mechanisms of affecting each disorder. Implications for the treatment of anxiety and depressive symptoms by addressing insomnia problems will be discussed.

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The Impact of a Digital Intervention (Happify) on Loneliness During COVID-19: Qualitative Focus Group

JMIR Mental Health ◽

10.2196/26617 ◽

2021 ◽

Vol 8 (2) ◽

pp. e26617

Author(s):

Eliane M Boucher ◽

Emily C McNaughton ◽

Nicole Harake ◽

Julia L Stafford ◽

Acacia C Parks

Keyword(s):

Mental Health ◽

Focus Group ◽

Mental Health Problems ◽

Health Problems ◽

Health Intervention ◽

Health Concern ◽

Mental Health Intervention ◽

Social Distancing ◽

Self Perceptions ◽

The Impact

Background Loneliness is a growing area of concern, attracting attention as a public health concern due to its association with a variety of psychological and physical health problems. However, interventions targeting loneliness are less common than interventions for other mental health problems, such as depression and anxiety, and existing interventions focus primarily on building social skills and increasing opportunities for social interaction despite research suggesting these techniques are not the most effective. Furthermore, although there is an increasing need for scalable and convenient interventions, digital interventions for loneliness are even less common. Objective Using a qualitative approach, we explore how adults (18-64 years of age) who express wanting to be more connected to others experience loneliness and react to a digital mental health intervention targeting loneliness. Methods A total of 11 participants were recruited from a pilot randomized controlled trial exploring the impact of a digital mental health intervention, Happify Health, on loneliness among adults aged 18-64 years who indicated wanting to feel more connected to others when signing up for the platform. Participants were invited to participate in a 3-day asynchronous focus group about their experiences with loneliness, with Happify Health, and with social distancing during the COVID-19 pandemic. All 11 participants completed the focus group in May 2020. Results Participants’ responses were coded using thematic analysis, which led to identifying five themes, each with separate subthemes, that could be applied across the 3-day focus group: loneliness, relationships, social distancing, skill acquisition, and coping. Overall, we observed variability across participants in terms of the source of their loneliness, their perceptions of their social connections, and their motivation to reduce feelings of loneliness; however, participants commonly referred to negative self-perceptions as a cause or consequence of loneliness. Participants also varied in the extent to which they felt social distancing increased or decreased feelings of loneliness. In regard to the intervention, participants showed evidence of adopting skills they used to address their loneliness, particularly mindfulness and gratitude, and then using these skills to shift toward more active coping strategies following the intervention, including during the COVID-19 pandemic. Conclusions The heterogeneity in participants’ experiences with loneliness described during this focus group emphasizes the subjective and complex nature of loneliness. This highlights the importance of developing loneliness interventions that use a variety of strategies, including both direct and indirect strategies for reducing loneliness. However, based on our data, a key component to loneliness interventions is incorporating strategies for addressing underlying negative self-perceptions that stem from, but also contribute to, loneliness. This data also provides preliminary evidence that digital platforms may be an effective tool for disseminating loneliness interventions while providing the added benefit of offering a productive distraction when feeling lonely.

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Psychiatric Manifestations and Associated Risk Factors among Hospitalized Patients with COVID-19 in Edo State, Nigeria.

10.1101/2021.10.12.21264913 ◽

2021 ◽

Author(s):

Esther O Okogbenin ◽

Omonefe J Seb-Akahomen ◽

Osahogie I. Edeawe ◽

Mary Ehimigbai ◽

Helen Eboreime ◽

...

Keyword(s):

Mental Health ◽

Risk Factors ◽

Mental Health Problems ◽

Health Workers ◽

Depression And Anxiety ◽

Cross Sectional Survey ◽

Prevalence Of Depression ◽

Edo State ◽

Associated Risk Factors ◽

The Impact

Objective The Coronavirus Disease 2019 (COVID-19) has had devastating effects globally. These effects are likely to result in mental health problems at different levels. Although studies have reported the mental health burden of the pandemic on the general population and frontline health workers, the impact of the disease on the mental health of patients in COVID-19 treatment and isolation centres have been understudied in Africa. We estimated the prevalence of depression and anxiety and associated risk factors in hospitalized persons with COVID-19. Methods A cross-sectional survey was conducted among 489 patients with COVID-19 at the three government-designated treatment and isolation centres in Edo State, Nigeria. The 9-item Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) tool were used to assess depression and anxiety respectively. Binary logistic regression was applied to determine risk factors of depression and anxiety. Results Of the 489 participants, 49.1% and 38.0% had depressive and anxiety symptoms respectively. The prevalence of depression, anxiety, and combination of both were 16.2%, 12.9% and 9.0% respectively. Moderate-severe symptoms of COVID-19, ≥14 days in isolation, worrying about the outcome of infection and stigma increased the risk of having depression and anxiety. Additionally, being separated/divorced increased the risk of having depression and having comorbidity increased the risk of having anxiety. Conclusion A substantial proportion of our participants experienced depression, anxiety and a combination of both especially in those who had the risk factors we identified. The findings underscore the need to address these risk factors early in the course of the disease and integrate mental health interventions into COVID-19 management guidelines.

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Protocol for an App-Based Affective Control Training for Adolescents

10.21203/rs.2.126/v1 ◽

2018 ◽

Author(s):

Susanne Schweizer ◽

Jovita T. Leung ◽

Rogier Kievit ◽

Maarten Speekenbrink ◽

William R. Tender ◽

...

Keyword(s):

Mental Health ◽

Emotion Regulation ◽

Mental Health Problems ◽

Controlled Trial ◽

Self Regulation ◽

Health Problems ◽

Matching Task ◽

Double Blind ◽

Wide Range ◽

The Impact

Abstract Background: 75% of all mental health problems have their onset before the end of adolescence. Adolescence, thus may be a particularly sensitive time period for preventing mental health problems. Affective control, the capacity to engage with goal relevant and inhibit distracting information in affective contexts, has been proposed as a potential target for prevention. In this study, we will explore the impact of improving adolescents’ affective control capacity on their mental health. Methods: The proof-of-principle double-blind randomized controlled trial will compare the effectiveness of an app-based affective control training (AC-Training) to a placebo training (P- Training) app. 200 (~50% females) adolescents (11-19 years) will train for 14 days on their training app. The AC-Training will include three different n-back tasks: visuospatial, auditory and dual (i.e., including both modalities). These tasks require participants to flexibly engage and disengage with affective and neutral stimuli (i.e., faces and words). The P-Training will present participants with a perceptual matching task. The three versions of the P-Training tasks vary in the stimuli included (i.e., shapes, words and faces). The two training groups will be compared on gains in affective control, mental health, emotion regulation and self-regulation, immediately after training, 1 month and 1 year after training. Discussion: If, as predicted, the proposed study finds that AC-Training successfully improves affective control in adolescents, there would be significant potential benefits to adolescent mental health. As a free app, the training would also be scalable and easy to disseminate across a wide range of settings. Trial registration: The trial was registered on December 10 2018 with the International Standard Randomised Controlled Trial Number (Registration number: ISRCTN17213032, http://www.isrctn.com/ISRCTN17213032). Keywords: Mental health; Adolescence; Emotion regulation; Affective control; App-based training

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Promotion of Perinatal Mental Health

NUTA Journal ◽

10.3126/nutaj.v5i1-2.23454 ◽

2018 ◽

Vol 5 (1-2) ◽

pp. 33-39

Author(s):

Bhabani Adhikari

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Perinatal Period ◽

Perinatal Mental Health ◽

Anxiety And Depression ◽

Symptoms Of Depression ◽

Quality Health ◽

Healthy Housing ◽

Positive Support ◽

Quality Health Services

The aim of this paper is to discuss different aspects of perinatal mental health like; risk factor, impact, issues and to suggest the guidelines for promotion of perinatal mental health. Perinatal mental health is an emerging concept, generally refers to the period 22 completed weeks (i.e. 154 days) of gestation and ending seven completed days after birth. During the pregnancy women may suffer from different mental health problems such as anxiety and depression. Lack of nutritious food, proper healthy housing, and adequate time for rest, quality health services and positive support by the intimacy partner are major responsible factors for getting mental disorder during perinatal period. Problem with in-laws and domestic violence are also responsible for this. Individual, family, community and national agencies should aware the problem and difficulties of the perinatal period and ways to eliminating the associated problems by their action and efforts. Without waiting the sign and symptoms of depression all well pregnant women need to be screened as part of their perinatal health check.

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Are dietary patterns differently associated with differentiated levels of mental health problems? Results from a large cross-sectional study among Iranian manufacturing employees

BMJ Open ◽

10.1136/bmjopen-2017-020083 ◽

2019 ◽

Vol 9 (1) ◽

pp. e020083 ◽

Cited By ~ 3

Author(s):

Zahra Heidari ◽

Awat Feizi ◽

Hamidreza Roohafza ◽

Katayoun Rabiei ◽

Nizal Sarrafzadegan

Keyword(s):

Mental Health ◽

Dietary Patterns ◽

Mental Health Problems ◽

Workplace Health Promotion ◽

Depression Scale ◽

Health Problems ◽

Anxiety And Depression ◽

Manufacturing Companies ◽

Cross Sectional ◽

The Impact

ObjectivesThe present study aimed to classify participants based on mental health problems profile and to evaluate its relationship with dietary patterns among Iranian manufacturing employees.DesignObservational study with a cross-sectional design.SettingThis study was conducted in Esfahan Steel Company, one of the biggest Iranian industrial manufacturing companies.ParticipantsComplete data on 2942 manufacturing employees, with a mean (SD) age of 36.68 (7.31) years, were analysed.Outcome measuresHospital Anxiety and Depression Scale(HADA) and General Health Questionnaire (GHQ-12) were used to evaluate anxiety and depression and psychological distress, respectively.ResultsThree major dietary patterns, namely ‘western’, ‘healthy’ and ‘traditional’, were extracted using factor analysis. A two-class, one-factor structure was identified from study participants in terms of mental health problems profile based on the factor mixture model. Two identified classes were labelled as ‘low mental health problems’ (2683 manufacturing employees, 91.2%) and ‘high mental health problems’ (259 individuals, 8.8%). After adjusting for the impact of potential confounders, manufacturing employees in the highest tertile of healthy dietary pattern had lower odds of being in the high mental health problems profile class (OR=0.67, 95% CI 0.49 to 0.92). In contrast, greater adherence to Western and traditional dietary patterns was associated with increased odds of being in the high mental health problems class (OR=1.66, 95% CI: 1.18 to 2.35 and OR=1.52, 95% CI :1.10 to 2.11, respectively).ConclusionsOur study provided informative pathways on the association of dietary patterns and mental health among manufacturing employees. The findings can be used by workplace health promotion policymakers in improving mental health in such study population. Interventional and prospective studies that investigate the effects of change in dietary patterns on the mental health of manufacturing employees are suggested.

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

10.2196/preprints.25298 ◽

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

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Predictors of cosmetic surgery and its effects on psychological factors and mental health: a population-based follow-up study among Norwegian females

Psychological Medicine ◽

10.1017/s0033291711001267 ◽

2011 ◽

Vol 42 (3) ◽

pp. 617-626 ◽

Cited By ~ 25

Author(s):

T. von Soest ◽

I. L. Kvalem ◽

L. Wichstrøm

Keyword(s):

Mental Health ◽

Drug Use ◽

Risky Sexual Behavior ◽

Cosmetic Surgery ◽

Mental Health Problems ◽

Survey Study ◽

Depression And Anxiety ◽

Limited Information ◽

Symptoms Of Depression ◽

Appearance Satisfaction

BackgroundThere is limited information about psychological predictors of cosmetic surgery and how cosmetic surgery influences subsequent changes in mental health and overall appearance satisfaction. To date, there is a lack of studies examining this issue, whereby representative population samples are assessed at an age before cosmetic surgery is typically conducted and followed up after such surgery has commonly been performed.MethodWe obtained data from a survey study following 1597 adolescent females from a representative Norwegian sample over a 13-year period. Participants provided information on cosmetic surgery, appearance satisfaction, mental health, risky sexual behavior, drug use and conduct problems at two time-points (overall response rate 67%).ResultsOf all participants, 78 (4.9%) reported having undergone cosmetic surgery, of whom 71 were operated on during the course of the study and seven before the first data collection. Symptoms of depression and anxiety [odds ratio (OR) 1.66, 95% confidence interval (CI) 1.07–2.57] and a history of deliberate self-harm (OR 2.88, 95% CI 1.46–5.68), parasuicide (OR 3.29, 95% CI 1.53–7.08) and illicit drug use (OR 2.46, 95% CI 1.07–5.82) predicted prospective cosmetic surgery. Moreover, those who underwent surgery during the course of the study experienced a greater increase than other females in symptoms of depression and anxiety (t=2.07, p=0.04) and eating problems (t=2.71, p<0.01). Patients' use of alcohol also increased more than among non-patients (t=2.47, p=0.01).ConclusionsA series of mental health symptoms predict cosmetic surgery. Cosmetic surgery does not in turn seem to alleviate such mental health problems.

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Low-Intensity Cognitive Behavioural Therapy-Based Music Group (CBT-Music) for the Treatment of Symptoms of Anxiety and Depression: A Feasibility Study

Behavioural and Cognitive Psychotherapy ◽

10.1017/s1352465817000480 ◽

2017 ◽

Vol 46 (2) ◽

pp. 168-181 ◽

Cited By ~ 4

Author(s):

Chris Trimmer ◽

Richard Tyo ◽

Jennifer Pikard ◽

Claire McKenna ◽

Farooq Naeem

Keyword(s):

Mental Health ◽

Treatment Group ◽

Mental Health Services ◽

Community Mental Health ◽

Health Services ◽

Community Mental Health Services ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Symptoms Of Depression ◽

Low Intensity

Background: Music has the potential to be an effective and engaging therapeutic intervention in the treatment of mental illness. This research area remains underdeveloped. Aims: This paper reports the feasibility of an innovative low-intensity CBT-based music (CBT-Music) group targeted to symptoms of depression and anxiety. Method: A total of 28 participants with symptoms of depression and anxiety who were attending community mental health services were recruited for the study and randomized into TAU (treatment as usual) plus low-intensity CBT-Music (treatment) or to TAU alone (control). The treatment group consisted of a 9-week music group that incorporated various components of CBT material into a musical context. Feasibility was the primary outcome. The secondary outcomes were a reduction in depression, anxiety (Hospital Anxiety and Depression Scale) and disability (WHO Disability Assessment Schedule 2.0) assessed at baseline and 10 weeks. Results: Recruitment proved feasible, retention rates were high, and the participants reported a high level of acceptability. A randomized control study design was successfully implemented as there were no significant differences between treatment and control groups at baseline. Participants in the treatment group showed improvement in disability (p = 0.027). Despite a reduction in depression and anxiety scores, these differences were not statistically significant. Conclusions: A low-intensity CBT-based music group can be successfully administered to clients of community mental health services. There are indications of effectiveness in reducing disability, although there appears to be negligible effect on symptoms of anxiety and depression. This is the first report of a trial of a low-intensity CBT-based music group intervention.

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