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Special Issue "COVID-19 Outbreak and Beyond: Psychological and Behavioral Responses and Future Perspectives"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (31 October 2021) | Viewed by 53659

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Special Issue Editors

Prof. Dr. Paolo Roma
E-Mail Website
Guest Editor
Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy
Interests: personality and individual differences; testing and assessment; clinical psychology; malingering
Special Issues, Collections and Topics in MDPI journals
Dr. Merylin Monaro
E-Mail Website1 Website2
Assistant Guest Editor
Department of General Psychology, University of Padova, 35131 Padova, Italy
Interests: forensic psychology; human computer interaction; mouse tracking; machine learning
Dr. Cristina Mazza
E-Mail Website
Assistant Guest Editor
Department of Neuroscience, Imaging and Clinical Sciences, University “G.d’Annunzio”, 61100 Chieti-Pescara, Italy
Interests: clinical psychology; forensic psychology; psychotherapy; personality and individual differences; testing and assessment
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The COVID-19 pandemic drastically changed our lifestyle when, on 30 January 2020, the World Health Organization declared the coronavirus disease outbreak a public health emergency of international concern. Since then, many governments have introduced unprecedented containment measures, hoping to slow the spread of the virus. International researches suggest that both the pandemic and the related protective measures, such as lockdown, curfews, and social distancing, are having a profound impact on the mental health of the population. Among the most commonly observed psychological effects, there are high levels of stress, anxiety, depression, and post-traumatic symptoms, along with boredom and frustration. At the same time, the behavioral response of the population is of paramount importance to successfully contain the outbreak, creating a vicious circle in which the psychological distress impacts the willingness to comply with the protective measures, which in turn, if prolonged, could exacerbate the population’s distress. For this Special Issue, we welcome original studies on the worldwide psychological and behavioral impact of COVID-19 on targeted individuals (e.g., parents, social workers, patients affected by physical and mental disorders). Moreover, studies exploring the effect of COVID-19 using advanced statistical and methodological techniques (e.g., machine learning technologies) will be prioritized. Finally, researches with a focus on practical applications that could help identify persons at risk, mitigate the negative effects of this situation, and offer insights to policymakers to manage the pandemic are also highly welcomed.

Prof. Dr. Paolo Roma
Dr. Merylin Monaro
Dr. Cristina Mazza
Guest Editors

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Keywords

  • COVID-19
  • psychological distress
  • compliance
  • behavioral response
  • advanced techniques
  • health impairments

Published Papers (35 papers)

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Research

Article
How Does Social Class Affect Need for Structure during the COVID-19 Pandemic? A Moderated Mediating Model Analysis
Int. J. Environ. Res. Public Health 2022, 19(2), 932; https://doi.org/10.3390/ijerph19020932 - 14 Jan 2022
Cited by 3 | Viewed by 582
Abstract
The COVID-19 pandemic is profoundly affecting the minds and behaviors of people worldwide. This study investigated the differences in the need for structure among people from different social classes and the psychological mechanisms underlying this need, as well as the moderating effect of [...] Read more.
The COVID-19 pandemic is profoundly affecting the minds and behaviors of people worldwide. This study investigated the differences in the need for structure among people from different social classes and the psychological mechanisms underlying this need, as well as the moderating effect of the threat posed by the pandemic. Using data collected from non-student adults in China, we found that the lower an individual’s social class, the lower their need for structure, and this effect was based on the mediating role of perceived control. However, the mediating effect was moderated by pandemic threat, and the above relationship existed only when this threat was low. When the level of pandemic threat was higher, neither the effect of social class nor of perceived control on the need for structure were significant. Specifically, in higher-threat situations, the need for structure among individuals from higher social classes and who had a higher sense of control increased significantly, meaning the mediating effect was no longer significant. This finding showed that under the threat of a pandemic, individuals who have a lower need for structure will still pursue and prefer structure and order. The theoretical and practical implications of the research are also discussed. Full article
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Article
Psychological Impact of the COVID-19 Pandemic on Students, Assistants, and Faculty of a Dental Institute of Saudi Arabia
Int. J. Environ. Res. Public Health 2021, 18(24), 13366; https://doi.org/10.3390/ijerph182413366 - 19 Dec 2021
Cited by 5 | Viewed by 1155
Abstract
This study aimed to assess the perceived stress levels in students, assistants, and faculty members of the College of Dentistry, Imam Abdulrahman Bin Faisal, University (IAU), Kingdom of Saudi Arabia (KSA) during the novel coronavirus disease 2019 (COVID-19) pandemic. Using the Cohen’s perceived [...] Read more.
This study aimed to assess the perceived stress levels in students, assistants, and faculty members of the College of Dentistry, Imam Abdulrahman Bin Faisal, University (IAU), Kingdom of Saudi Arabia (KSA) during the novel coronavirus disease 2019 (COVID-19) pandemic. Using the Cohen’s perceived stress scale (PSS) questionnaire (consisting of 14 items, hence called PSS-14), an online observational survey was conducted. The PSS 14 was rated on a 5-point Likert scale ranging from 0 (never) to 4 (very often). The scores ranging from 0–18 represented low stress, 19–37 represented moderate stress, and 38–56 represented high stress. The second-and third-year students were designated as junior year students, while fourth-year onwards were considered senior year students. Out of total 265 participants, 65% (173) were female, and the majority of the participants were dental students 70% (185) with a mean age of 26.71 ± 9.26 years. In the present study, the average PSS score for the participants was computed as 29.89 (range score: 0–56) which shows moderate stress levels among the respondents. The PSS score for the students was 31.03; for the faculty, it was 28, while for the assistants, it was 27.05. Among the three participant groups, the students were found more on the severe stress side (19%) (p-value = 0.002), and among them, the senior year students (6th year) showed significantly higher stress levels compared to the junior year students (p-value = 0.005). Age-wise, the participants below 20 years were most stressed (21%), followed by those 20–30 years old (18%). Female participants were more severely stressed than males (17% vs. 10%, respectively). It was concluded that the students experienced more stress, followed by the faculty members and dental assistants. In addition, younger participants, females, and senior year students were more stressed than their counterparts. Future studies directed at evaluating stress levels of these groups from different dental institutes could provide an opportunity for policymakers to offer various resources to improve their mental health. Full article
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Article
Undergraduate Students’ Online Health Information-Seeking Behavior during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(24), 13250; https://doi.org/10.3390/ijerph182413250 - 16 Dec 2021
Cited by 5 | Viewed by 1181
Abstract
As the COVID-19 pandemic has swept across the world, the amount of health-related information available has skyrocketed. Individuals can easily access health information through the internet, which may influence their thoughts or behavior, causing potential technological risks that may affect their lives. This [...] Read more.
As the COVID-19 pandemic has swept across the world, the amount of health-related information available has skyrocketed. Individuals can easily access health information through the internet, which may influence their thoughts or behavior, causing potential technological risks that may affect their lives. This study examined the online health information-seeking behavior of undergraduate students. Taking health issues as a guiding framework, content analysis was adopted to assess participants’ online health information-seeking behavior using a computer screen recording software, and coding analysis was conducted. The study was conducted during the COVID-19 pandemic with a formal sample of 101 participants. In terms of online health information-seeking behavior, 59% of the study participants used nouns as keywords, only 27% used Boolean logic retrieval techniques, 81% paid attention to the date of the data, and 85% did not consider the author’s professionalism. The results indicate that health information-seeking behavior and outcome judgments may be a missing piece of the puzzle in higher education. Consequently, the development of online health information-seeking skills through programs for undergraduate students is suggested to ensure that online readers have access to appropriate health information. Full article
Article
The Relationship among COVID-19 Information Seeking, News Media Use, and Emotional Distress at the Onset of the Pandemic
Int. J. Environ. Res. Public Health 2021, 18(24), 13198; https://doi.org/10.3390/ijerph182413198 - 14 Dec 2021
Cited by 1 | Viewed by 1189
Abstract
Although several theories posit that information seeking is related to better psychological health, this logic may not apply to a pandemic like COVID-19. Given uncertainty inherent to the novel virus, we expect that information seeking about COVID-19 will be positively associated with emotional [...] Read more.
Although several theories posit that information seeking is related to better psychological health, this logic may not apply to a pandemic like COVID-19. Given uncertainty inherent to the novel virus, we expect that information seeking about COVID-19 will be positively associated with emotional distress. Additionally, we consider the type of news media from which individuals receive information—television, newspapers, and social media—when examining relationships with emotional distress. Using a U.S. national survey, we examine: (1) the link between information seeking about COVID-19 and emotional distress, (2) the relationship between reliance on television, newspapers, and social media as sources for news and emotional distress, and (3) the interaction between information seeking and use of these news media sources on emotional distress. Our findings show that seeking information about COVID-19 was significantly related to emotional distress. Moreover, even after accounting for COVID-19 information seeking, consuming news via television and social media was tied to increased distress, whereas consuming newspapers was not significantly related to greater distress. Emotional distress was most pronounced among individuals high in information seeking and television news use, whereas the association between information seeking and emotional distress was not moderated by newspapers or social media news use. Full article
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Article
The Relationships among Anxiety, Subjective Well-Being, Media Consumption, and Safety-Seeking Behaviors during the COVID-19 Epidemic
Int. J. Environ. Res. Public Health 2021, 18(24), 13189; https://doi.org/10.3390/ijerph182413189 - 14 Dec 2021
Cited by 2 | Viewed by 1169
Abstract
The COVID-19 epidemic has been confirmed as the largest scale outbreak of atypical pneumonia since the outbreak of severe acute respiratory syndrome (SARS) in 2003 and it has become a public health emergency of international concern. It exacerbated public confusion and anxiety, and [...] Read more.
The COVID-19 epidemic has been confirmed as the largest scale outbreak of atypical pneumonia since the outbreak of severe acute respiratory syndrome (SARS) in 2003 and it has become a public health emergency of international concern. It exacerbated public confusion and anxiety, and the impact of COVID-19 on people needs to be better understood. Indeed, prior studies that conducted meta-analysis of longitudinal cohort research compared mental health before versus during the COVID-19 pandemic and proved that public health polices (e.g., city lockdowns, quarantines, avoiding gatherings, etc.) and COVID-19-related information that circulates on new media platforms directly affected citizen’s mental health and well-being. Hence, this research aims to explore Taiwanese people’s health status, anxiety, media sources for obtaining COVID-19 information, subjective well-being, and safety-seeking behavior during the COVID-19 epidemic and how they are associated. Online surveys were conducted through new media platforms, and 342 responses were included in the analysis. The research results indicate that the participants experienced different aspects of COVID-19 anxiety, including COVID-19 worry and perceived COVID-19 risk. Among the given media sources, the more participants searched for COVID-19 information on new media, the greater they worried about COVID-19. Furthermore, COVID-19 worry was positively related to safety-seeking behavior, while perceived COVID-19 risk was negatively related to subjective well-being. This paper concludes by offering some suggestions for future studies and pointing out limitations of the present study. Full article
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Article
Accept Anxiety to Improve Sleep: The Impact of the COVID-19 Lockdown on the Relationships between Mindfulness, Distress, and Sleep Quality
Int. J. Environ. Res. Public Health 2021, 18(24), 13149; https://doi.org/10.3390/ijerph182413149 - 13 Dec 2021
Cited by 2 | Viewed by 998
Abstract
It has been recently proposed that mindfulness can improve sleep quality through the mediating role on psychological distress and that acceptance may play a pivotal role in mindfulness beneficial effects. The aim of the present work was to understand the effects of the [...] Read more.
It has been recently proposed that mindfulness can improve sleep quality through the mediating role on psychological distress and that acceptance may play a pivotal role in mindfulness beneficial effects. The aim of the present work was to understand the effects of the COVID-19 lockdown on dispositional mindfulness, sleep, and distress, and on their relationships. In particular, we wanted to test the hypothesis that the detrimental effects of lockdown on sleep depended on mindfulness and distress (including anxiety and depression) and that the acceptance facet of mindfulness played the leading role. A longitudinal study based on self-report questionnaires was conducted on 39 Italian adults (M age = 35.03, SD = 14.02; 21 men) assessing mindfulness, distress, and sleep quality before (23 December 2019–8 March 2020) and during (27 April 2020–10 May 2020) the first Italian COVID-19 lockdown. Lockdown decreased mindfulness while increasing distress and sleep problems. Path analysis showed that the effects of lockdown on sleep were fully mediated by mindfulness and distress. Furthermore, a more detailed analysis showed that these effects were mainly dependent on the acceptance component of mindfulness working through anxiety. The present study confirms, in the context of the COVID-19 lockdown, a model according to which mindfulness, and specifically acceptance, influences sleep through the mediating role of distress. Full article
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Article
Public Perception of SARS-CoV-2 Vaccinations on Social Media: Questionnaire and Sentiment Analysis
Int. J. Environ. Res. Public Health 2021, 18(24), 13028; https://doi.org/10.3390/ijerph182413028 - 10 Dec 2021
Cited by 4 | Viewed by 1433
Abstract
Vaccine hesitancy is an ongoing concern, presenting a major threat to global health. SARS-CoV-2 COVID-19 vaccinations are no exception as misinformation began to circulate on social media early in their development. Twitter’s Application Programming Interface (API) for Python was used to collect 137,781 [...] Read more.
Vaccine hesitancy is an ongoing concern, presenting a major threat to global health. SARS-CoV-2 COVID-19 vaccinations are no exception as misinformation began to circulate on social media early in their development. Twitter’s Application Programming Interface (API) for Python was used to collect 137,781 tweets between 1 July 2021 and 21 July 2021 using 43 search terms relating to COVID-19 vaccines. Tweets were analysed for sentiment using Microsoft Azure (a machine learning approach) and the VADER sentiment analysis model (a lexicon-based approach), where the Natural Language Processing Toolkit (NLTK) assessed whether tweets represented positive, negative or neutral opinions. The majority of tweets were found to be negative in sentiment (53,899), followed by positive (53,071) and neutral (30,811). The negative tweets displayed a higher intensity of sentiment than positive tweets. A questionnaire was distributed and analysis found that individuals with full vaccination histories were less concerned about receiving and were more likely to accept the vaccine. Overall, we determined that this sentiment-based approach is useful to establish levels of vaccine hesitancy in the general public and, alongside the questionnaire, suggests strategies to combat specific concerns and misinformation. Full article
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Article
What about the Consequences of the Use of Distance Learning during the COVID-19 Pandemic? A Survey on the Psychological Effects in Both Children and Parents
Int. J. Environ. Res. Public Health 2021, 18(23), 12641; https://doi.org/10.3390/ijerph182312641 - 30 Nov 2021
Cited by 2 | Viewed by 1135
Abstract
Background: The COVID-19 pandemic implicated many social restrictions, including the use of distance learning (DL). Indeed, parents were obligated to support their children in online lessons and schoolwork. The aim of this study was to investigate the psycho-emotional impact of the COVID-19 pandemic [...] Read more.
Background: The COVID-19 pandemic implicated many social restrictions, including the use of distance learning (DL). Indeed, parents were obligated to support their children in online lessons and schoolwork. The aim of this study was to investigate the psycho-emotional impact of the COVID-19 pandemic on parents and children submitted to DL. Methods: One hundred and ninety-two participants (96 parents and 96 children) were enrolled in this study. Parents and children completed an online questionnaire, structured in four sections. Results: The results showed that parents had higher levels of stress and anxiety. In particular, the stress for DL was positively correlated with depression and anxiety. Parents’ jobs were negatively correlated with their levels of anxiety and stress. On the other hand, children reported higher levels of depressive symptoms and event-related anxiety, which increased as children got older. The stress and the anxiety in parents were positively correlated with the mood depression and anxiety of their children. Conclusions: The COVID-19 pandemic had a negative impact on the psychological well-being of children and parents who used DL. Although DL could be an alternative teaching method during pandemics, face-to-face teaching is fundamental and irreplaceable as it encourages dialogue, involvement, and human contact. Full article
Article
Quality of Life, Insomnia and Coping Strategies during COVID-19 Pandemic in Hospital Workers. A Cross-Sectional Study
Int. J. Environ. Res. Public Health 2021, 18(23), 12466; https://doi.org/10.3390/ijerph182312466 - 26 Nov 2021
Cited by 3 | Viewed by 961
Abstract
COVID-19 became a pandemic in a few months, leading to adverse health outcomes, reducing the quality of life, affecting the sleep/wake cycle, and altering coping strategies, especially among hospital personnel. Life quality, insomnia, and coping strategies were thus assessed among hospital personnel during [...] Read more.
COVID-19 became a pandemic in a few months, leading to adverse health outcomes, reducing the quality of life, affecting the sleep/wake cycle, and altering coping strategies, especially among hospital personnel. Life quality, insomnia, and coping strategies were thus assessed among hospital personnel during the first wave of the COVID-19 pandemic in Italy. This cross-sectional study was conducted from May to November 2020 through an online survey. There were 558 participants (28.5% males and 71.5% females) enrolled in two different metropolitan areas (in North and South of Italy, respectively). Three standardized questionnaires were administered: European Quality of life–5 Dimensions (EQ-5D), Athens Insomnia Scale (AIS), and Brief COPE. Differences in sociodemographic characteristics and work-related factors were also investigated in order to identify possible predictors through a generalized linear model and logistic regression analysis. Results showed good perceived life quality and high insomnia prevalence. After sample stratification, the statistical analysis highlighted that personal (gender, age, educational level) and work-related factors (employment in COVID wards, remote working) played different roles in predicting quality of life, insomnia, and coping attitude. Active, Planning, and Acceptance were the most frequently adopted coping strategies. Despite women confirming their attitude in reacting to the difficulties, adopting emotion-focused coping strategies, they showed a higher probability to develop insomnia, so a gender perspective should be considered in the health protection of this working category. An integrated approach should be implemented at individual, interpersonal and organizational levels aiming to monitor psychological distress, favor regular sharing and communication between peers, and also allow conciliation of work with family life. At the organizational level, preventive and protective measures adequate to work-related risk to COVID-19 should be adopted. Full article
Article
Sustained Effects of Government Response on the COVID-19 Infection Rate in China: A Multiple Mediation Analysis
Int. J. Environ. Res. Public Health 2021, 18(23), 12422; https://doi.org/10.3390/ijerph182312422 - 25 Nov 2021
Cited by 2 | Viewed by 722
Abstract
Many scholars have considered the relationship between the government response to COVID-19, an important social intervention strategy, and the COVID-19 infection rate. However, few have examined the sustained impact of an early government response on the COVID-19 infection rate. The current paper fills [...] Read more.
Many scholars have considered the relationship between the government response to COVID-19, an important social intervention strategy, and the COVID-19 infection rate. However, few have examined the sustained impact of an early government response on the COVID-19 infection rate. The current paper fills this gap by investigating a national survey performed in February 2020 and infection data from Chinese cities surveyed 1.5 years after the outbreak of COVID-19. The results suggest that the Chinese government’s early response to COVID-19 significantly and sustainedly reduced China’s COVID-19 infection rate, and that this impact worked through risk perception, the adoption of protective action recommendations (PARs), and the chain-mediating effects of risk perception and the adoption of PARs, respectively. These findings have important practical value. In demonstrating how government response and infection rate at the macro level are connected to the behaviour of individuals at the micro level, they suggest feasible directions for curbing the spread of diseases such as COVID-19. When facing such public health emergencies, the focus should be on increasing the public’s risk perception and adoption of PARs. Full article
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Article
Behavioral Factors Associated with COVID-19 Risk: A Cross-Sectional Survey in Japan
Int. J. Environ. Res. Public Health 2021, 18(22), 12184; https://doi.org/10.3390/ijerph182212184 - 20 Nov 2021
Cited by 1 | Viewed by 1215
Abstract
Background: Behaviors to avoid infection are key to minimizing casualties of the COVID-19 pandemic, as well as to avoid excessive interventions that are less effective. This study aims to identify behavioral patterns associated with SARS-CoV-2 infection in the real world. Methods: A questionnaire-based [...] Read more.
Background: Behaviors to avoid infection are key to minimizing casualties of the COVID-19 pandemic, as well as to avoid excessive interventions that are less effective. This study aims to identify behavioral patterns associated with SARS-CoV-2 infection in the real world. Methods: A questionnaire-based cross-sectional study was conducted targeting a research panel of NTTCom Online Marketing Solutions Corporation or its affiliates. Data were extracted so that their demographic composition ratios matched the population estimates. Individuals who answered with consistency to have been diagnosed with SARS-CoV-2 at a medical facility were categorized into a SARS-CoV-2 group. Differences in lifestyles were compared using multiple regression and inverse probability weighing. Results: In total 13,277 participants were included, of whom 44 (0.33%) were categorized as the SARS-CoV-2 group. Diagnosis of SARS-CoV-2 was negatively correlated with crowd avoidance, mask wearing, and hand-washing behavior. On the contrary, the diagnosis was positively correlated with some behaviors that appear to be preventive actions against the infection, such as changing clothes frequently, sanitizing belongings, and remote working. Conclusions: It is important to conduct evidence-based intervention on people’s behaviors and to avoid excessive interventions that are less effective, so that people can minimize the indirect harm, such as exhaustion and economic loss. Full article
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Article
Predictors of Positive and Negative Emotions Experienced by Poles during the Second Wave of the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(22), 11993; https://doi.org/10.3390/ijerph182211993 - 15 Nov 2021
Cited by 2 | Viewed by 746
Abstract
The objective of the research was to specify the predictors of positive and negative emotions experienced by Poles during the second wave of the COVID-19 pandemic. The researchers used the following standardized measurement tools: emotions (PANAS), mood (UMACL), satisfaction with life (SWLS), optimism [...] Read more.
The objective of the research was to specify the predictors of positive and negative emotions experienced by Poles during the second wave of the COVID-19 pandemic. The researchers used the following standardized measurement tools: emotions (PANAS), mood (UMACL), satisfaction with life (SWLS), optimism (LOT-R), and coping with stress (CISS). They also used a questionnaire to collect sociodemographic information and data concerning COVID-19 infections. In total, 595 participants (80.50% women) aged 18–75 participated in the research. It was concluded that the predictors of positive emotions included a task-oriented coping style, level of satisfaction with life, being a man, hedonic tone in the description of mood, and being an employed student. The negative predictors of positive emotions included emotion-oriented coping and the level of energetic arousal in the description of mood. The predictors of negative emotions were tense arousal in the description of mood, emotion-oriented coping, being over 60 years of age, and changes in respondents’ standard of living. The negative predictors of negative emotions included living in a medium-sized town or in a village. The research conclusions encourage us to pay special attention to possible at-risk groups threatened with mental health disorders and to factors that protect people against negative psychological consequences of the COVID-19 pandemic. Full article
Article
Fear of Infection and the Common Good: COVID-19 and the First Italian Lockdown
Int. J. Environ. Res. Public Health 2021, 18(21), 11341; https://doi.org/10.3390/ijerph182111341 - 28 Oct 2021
Cited by 1 | Viewed by 751
Abstract
In the first quarter of 2020, Italy became one of the earliest hotspots of COVID-19 infection, and the government imposed a lockdown. During the lockdown, an online survey of 2053 adults was conducted that asked about health behaviors and about the psychological and [...] Read more.
In the first quarter of 2020, Italy became one of the earliest hotspots of COVID-19 infection, and the government imposed a lockdown. During the lockdown, an online survey of 2053 adults was conducted that asked about health behaviors and about the psychological and overall impact of COVID-19. The present study is a secondary analysis of that data. We hypothesized that self-control, higher socio-economic status, existing health conditions, and fear of infection were all inversely related to actions (or intentions) that violated the lockdown (i.e., infractions). Using partial least squares structural equation modeling (PLS-SEM), we found that only the fear of infection significantly dissuaded people from violating lockdown rules. Since it is not practical or ethical to sow a fear of infection, our study indicates that enacting rules and enforcing them firmly and fairly are important tools for containing the infection. This may become more important as vaccines become more widely available and people lose their fear of infection. Full article
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Article
Generalized Anxiety as a Risk Factor for Dysfunctional Eating Behavior after Obesity Surgery during the COVID-19 Pandemic
Int. J. Environ. Res. Public Health 2021, 18(20), 10890; https://doi.org/10.3390/ijerph182010890 - 16 Oct 2021
Viewed by 945
Abstract
Purpose: The present study investigates the impact of obesity surgery on mental health (i.e., eating behavior and distress) during the COVID-19 pandemic. Methods: Two hundred fifty-four participants were recruited via social media. One hundred fourteen (44.53%) of them were surgery candidates (waiting for [...] Read more.
Purpose: The present study investigates the impact of obesity surgery on mental health (i.e., eating behavior and distress) during the COVID-19 pandemic. Methods: Two hundred fifty-four participants were recruited via social media. One hundred fourteen (44.53%) of them were surgery candidates (waiting for obesity surgery), while 142 (55.46%) had already undergone surgery. Participants who underwent surgery were compared to participants that did not yet undergo surgery in terms of mental burden (depression and anxiety), as well as safety and eating behavior. Further moderation analyses attempted to identify risk factors for increased COVID-19-related dysfunctional eating behavior after surgery. Results: Participants who underwent surgery showed generally lower levels of depression and general anxiety on a trend level. Moderation analyses suggested that people with high levels of generalized anxiety actually show more dysfunctional COVID-19-specific eating behavior after obesity surgery. Conclusion: On a trend level, obesity surgery appears to attenuate symptoms of generalized anxiety and depression. Yet, surgery patients with high levels of generalized anxiety exhibit even higher levels of dysfunctional eating during the COVID-19 pandemic. It is therefore particularly important to support people at risk. Full article
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Article
Consequences of the COVID-19 Lockdown in Germany: Effects of Changes in Daily Life on Musical Engagement and Functions of Music
Int. J. Environ. Res. Public Health 2021, 18(19), 10463; https://doi.org/10.3390/ijerph181910463 - 05 Oct 2021
Viewed by 1026
Abstract
The current study investigated how music has been used during the COVID-19 pandemic and how personal factors have affected music-listening behavior. During the shutdown in Spring 2020 in Germany, 539 participants took part in an online survey reporting on functions of music listening, [...] Read more.
The current study investigated how music has been used during the COVID-19 pandemic and how personal factors have affected music-listening behavior. During the shutdown in Spring 2020 in Germany, 539 participants took part in an online survey reporting on functions of music listening, attributes of listened music, and active engagement with music, retrospectively before and during the pandemic. Next to these implicit questions, participants were asked to describe the changes they explicitly noticed in handling music during COVID-19, their current worries, and their new everyday life during the pandemic as well as personality traits and stress reactivity. A logistic regression model was fitted, showing that people reduced their active engagement with music during the lockdown, and the function of killing time and overcoming loneliness became more important, reflecting the need for distraction and filling the silence. Before the lockdown, music was listened to for the function of motor synchronization and enhanced well-being, which reflects how people have lost both their musical and activity routines during the lockdown. The importance of in-person engagement with music in people’s lives became particularly evident in the connection between worries about further restrictions and the need for live music. Full article
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Article
The Impact of COVID-19 Pandemic on Italian University Students’ Mental Health: Changes across the Waves
Int. J. Environ. Res. Public Health 2021, 18(18), 9897; https://doi.org/10.3390/ijerph18189897 - 20 Sep 2021
Cited by 7 | Viewed by 1374
Abstract
To reduce the spread of COVID-19, the Italian government imposed a rigid lockdown and, for a whole year, continued to declare stringent rules to curb the community spread. This study provides an overview of university students’ symptomatology and help-seeking behaviour before and during [...] Read more.
To reduce the spread of COVID-19, the Italian government imposed a rigid lockdown and, for a whole year, continued to declare stringent rules to curb the community spread. This study provides an overview of university students’ symptomatology and help-seeking behaviour before and during the pandemic. It aims to evaluate the impact of the different phases of the pandemic on students’ mental health. We collected data in four-time points between March 2019 and March 2021. A total of 454 students (F = 85; M = 15) were included in the study. Students answered a socio-demographic and a standardized questionnaire (i.e., SCL-90-R) to evaluate a broad range of symptomatology. The results suggest that students experienced moderate to severe levels of depressive, obsessive-compulsive and anxiety symptomatology. About 14% of the sample met the criteria for at least one mental health disorder, but most were not receiving mental health care. During the lockdown, compared with other phases, female students reported worse symptoms in the obsessive-compulsive, interpersonal sensitivity, depression, paranoid ideation, and psychoticism dimensions. The increasing symptomatology disappeared after the lifting of the lockdown. The results showed no difference in the male groups. Preventive and support strategies should be improved in the university context. Full article
Article
Fear of COVID-19 in Patients with Acute Myocardial Infarction
Int. J. Environ. Res. Public Health 2021, 18(18), 9847; https://doi.org/10.3390/ijerph18189847 - 18 Sep 2021
Cited by 1 | Viewed by 874
Abstract
A marked decline in myocardial infarction (AMI) hospitalizations was observed worldwide during the COVID-19 outbreak. The pandemic may have generated fear and adverse psychological consequences in these patients, delaying hospital access. The main objective of the study was to assess COVID fear through [...] Read more.
A marked decline in myocardial infarction (AMI) hospitalizations was observed worldwide during the COVID-19 outbreak. The pandemic may have generated fear and adverse psychological consequences in these patients, delaying hospital access. The main objective of the study was to assess COVID fear through the FCV-19S questionnaire (a self-report measure of seven items) in 69 AMI patients (65 ± 11 years, mean ± SD; 59 males). Females presented higher values of each FCV-19S item than males. Older subjects (>57 years, 25th percentile) showed a higher total score with respect to those in the first quartile. The percentage of patients who responded “agree” and “strongly agree” in item 4 (“I am afraid of losing my life because of the coronavirus”) and 3 (“My hands become clammy when I think about the coronavirus”) was significantly greater in the elderly than in younger patients. When cardiovascular (CV) patients were compared to a previously published general Italian population, patients with CV disease exhibited higher values for items 3 and 4. Measures should be put in place to assist vulnerable and high CV risk patients, possibly adding psychologists to the cardiology team. Full article
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Article
Longitudinal Distress among Brazilian University Workers during Pandemics
Int. J. Environ. Res. Public Health 2021, 18(17), 9072; https://doi.org/10.3390/ijerph18179072 - 27 Aug 2021
Cited by 2 | Viewed by 1023
Abstract
The present study aimed to examine changes in mental distress in Brazilian university workers during the pandemic. All workers (n ≃ 1850) of an institution were invited to respond to a survey that took place in three stages, with collections in May [...] Read more.
The present study aimed to examine changes in mental distress in Brazilian university workers during the pandemic. All workers (n ≃ 1850) of an institution were invited to respond to a survey that took place in three stages, with collections in May (n = 407), June/July (n = 258), and August (n = 207) 2020, and included questions on demographic, health, general and psychological support, and psychometric assessment of mental distress (Clinical Outcome Routine Evaluation- CORE-OM) combined with an open question about major concerns. The results of the Multilevel Modeling analysis pointed to the absence of significant differences across the repeated measures of distress. The only variable associated with increased psychological distress over time was a lower level of support for household chores. Qualitative analysis of the reported major concerns was carried out with a sub-sample who showed reliable deterioration in CORE-OM across time (n = 17). The diversity of concerns reported by this group reinforced that work–life imbalance contributes to mental distress of university workers during the pandemic. Low response rate, although not unexpected due to the circumstances, limits the generalization of findings. The present data suggest that in addition to issues related to contagion and specific restricted measures to contain the spread of the disease, the personal reorganization of life required to maintain activities at home and work can be an important contributor to pandemic-related psychological distress. Full article
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Article
Factors Affecting COVID-19 Preventive Behaviors among University Students in Beijing, China: An Empirical Study Based on the Extended Theory of Planned Behavior
Int. J. Environ. Res. Public Health 2021, 18(13), 7009; https://doi.org/10.3390/ijerph18137009 - 30 Jun 2021
Cited by 5 | Viewed by 1886
Abstract
Higher education institutions (HEIs), among other social systems, have an irreplaceable role in combating COVID-19. However, we know little about institutional and individual factors that might facilitate university students’ beliefs and behaviors toward preventive behaviors for COVID-19 within the higher education context. Our [...] Read more.
Higher education institutions (HEIs), among other social systems, have an irreplaceable role in combating COVID-19. However, we know little about institutional and individual factors that might facilitate university students’ beliefs and behaviors toward preventive behaviors for COVID-19 within the higher education context. Our study applies an extended theory of planned behavior (TPB) model to investigate the structural relationships among the institutional climate, attitudes, subjective norms, perceived behavioral control and preventive behaviors of university students and to detect the moderating impacts of perceived risk on the structural model. Data were collected from 3693 university students at 18 universities in Beijing, China through an online survey. Structural equation modeling (SEM) and multigroup analysis were performed to examine the empirical model. The results reveal that (1) the institutional climate has a significant, direct effect on preventive behaviors for COVID-19 among university students, (2) the TPB components, namely attitudes, subjective norms and perceived behavioral control, partially mediate the relationship between the institutional climate and preventive behaviors for COVID-19, and (3) perceived risk moderates several paths in the model. Theoretical and practical implications are offered, and recommendations for future research are outlined. Full article
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Article
COVID-19 Pandemic Causing Depression in Different Sociodemographic Groups in Saudi Arabia
Int. J. Environ. Res. Public Health 2021, 18(13), 6955; https://doi.org/10.3390/ijerph18136955 - 29 Jun 2021
Cited by 2 | Viewed by 1065
Abstract
COVID-19 disease was announced as a global pandemic in March 2020 by the World health organization (WHO). Saudi Arabia was among the first countries to enforce restriction measures such as closing schools, remote working, and a travel ban. We aim to evaluate the [...] Read more.
COVID-19 disease was announced as a global pandemic in March 2020 by the World health organization (WHO). Saudi Arabia was among the first countries to enforce restriction measures such as closing schools, remote working, and a travel ban. We aim to evaluate the impact of the COVID-19 pandemic on people’s depression in Saudi Arabia. A cross-sectional online survey of 1109 participants was conducted during the curfew between 18th of May and 11th of June 2020. An online questionnaire included questions about the commitment to follow the precautionary measures, knowledge on COVID-19, and depression. Depression was assessed with the Impact of Event Scale-Revised method. Females, unmarried individuals, elderly persons, parents of young children, unemployed, and small families were more likely to be depressed. Education level did not explain the differences in depression. However, the more knowledge the participants had about COVID-19 the better they followed the restrictions. A regression analysis revealed that the commitment of a person to follow the restrictions increased his/her depression symptoms. Attention should be paid to different groups of people in future psychiatric planning. Full article
Article
Emotional Intelligence and Social Support: Two Key Factors in Preventing Occupational Stress during COVID-19
Int. J. Environ. Res. Public Health 2021, 18(13), 6918; https://doi.org/10.3390/ijerph18136918 - 28 Jun 2021
Cited by 3 | Viewed by 1553
Abstract
Emotional intelligence (EI) and social support are among the most investigated hypothesized variables that affect stress at work. The current study aims to evaluate the direct association between EI and occupational stress and its indirect relationship mediated by three sources of social support [...] Read more.
Emotional intelligence (EI) and social support are among the most investigated hypothesized variables that affect stress at work. The current study aims to evaluate the direct association between EI and occupational stress and its indirect relationship mediated by three sources of social support during the spread of the COVID-19. The total sample was composed of 367 individuals (53.7% males), aged from 20 to 68 (M = 37.84, SD = 10.39), who filled out an online questionnaire. A mediation analysis was performed to test the hypothesized relationships. Our findings showed that EI has a direct effect on psychological effects and an indirect effect on almost all the facets of occupational stress. The significant mediators were social support from both family and friends. Theoretical and practical implications are discussed and directions for future studies are suggested. Full article
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Article
Perceived Benefits Matter the Most in COVID-19 Preventive Behaviors: Empirical Evidence from Okara District, Pakistan
Int. J. Environ. Res. Public Health 2021, 18(13), 6772; https://doi.org/10.3390/ijerph18136772 - 24 Jun 2021
Cited by 3 | Viewed by 1236
Abstract
The 2019 coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus has affected the social determinants of health, worsening health inequities and deteriorating healthcare capacities around the globe. The objective of this study is to investigate the COVID-19 prevention behaviors within the framework of [...] Read more.
The 2019 coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus has affected the social determinants of health, worsening health inequities and deteriorating healthcare capacities around the globe. The objective of this study is to investigate the COVID-19 prevention behaviors within the framework of the Health Belief Model in the city of Depalpur in the Okara District of Pakistan in May 2020. Using an observational, cross-sectional, and quantitative study design, a face-to-face field survey was conducted during the epidemic of COVID-19 in district Okara, Pakistan. A sample of 500 adults was selected from the city of Depalpur the in Okara district of Pakistan, using a two-stage sampling design with cluster sampling in stage one and systematic random sampling at stage two. A COVID-19 prevention behavior scale was computed based on twelve dichotomous items. Descriptive statistics, analysis of variance (ANOVA), and negative binomial regression analyses were performed. The most common prevention behavior among study participants was avoiding going for walks in the parks (81.0%), followed by not leaving home during the lockdown (72.6%), and washing hands every day with soap and water for 20 s after going out of their home (64.0%). Fewer people exhibited prevention behaviors such as social distancing (e.g., staying at least six feet away from other people) which in the EU was recommended to be a minimum of 1.5–2 m (44.4%) and following all of the basic protective measures (e.g., hand washing, use of a face covering in public, social distancing) in order to protect against COVID-19 (33.0%). The results from the negative binomial regression analysis showed that after controlling for the other HBM constructs and sociodemographic factors, only the perceived benefits of preventative actions showed significant association with the prevention behavior scale (IRR, 1.16; CI, 1.061–1.276; p < 0.001). The study findings show that public health interventions attempting to control the spread of COVID-19 in Pakistan may want to affect a change in people’s perceived benefits of preventative actions through mass awareness-raising campaigns. Full article
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Article
Get Close to the Robot: The Effect of Risk Perception of COVID-19 Pandemic on Customer–Robot Engagement
Int. J. Environ. Res. Public Health 2021, 18(12), 6314; https://doi.org/10.3390/ijerph18126314 - 10 Jun 2021
Cited by 2 | Viewed by 1711
Abstract
The purpose of this study was to examine the effect of the COVID-19 pandemic on customer–robot engagement in the Chinese hospitality industry. Analysis of a sample of 589 customers using service robots demonstrated that the perceived risk of COVID-19 has a positive influence [...] Read more.
The purpose of this study was to examine the effect of the COVID-19 pandemic on customer–robot engagement in the Chinese hospitality industry. Analysis of a sample of 589 customers using service robots demonstrated that the perceived risk of COVID-19 has a positive influence on customer–robot engagement. The positive effect is mediated by social distancing and moderated by attitudes towards risk. Specifically, the mediating effect of social distancing between the perceived risk of COVID-19 and customer–robot engagement is stronger for risk-avoiding (vs. risk-seeking) customers. Our results provide insights for hotels when they employ service robots to cope with the shock of COVID-19 pandemic. Full article
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Article
Intention-Based Critical Factors Affecting Willingness to Adopt Novel Coronavirus Prevention in Pakistan: Implications for Future Pandemics
Int. J. Environ. Res. Public Health 2021, 18(11), 6167; https://doi.org/10.3390/ijerph18116167 - 07 Jun 2021
Cited by 36 | Viewed by 1980
Abstract
Since human beings have a long tradition of coexistence with pandemics, which may profoundly impact them, adopting preventive measures is crucial for humankind’s survival. This study explores the intention-based critical factors affecting the willingness of individuals to adopt pandemic prevention. To this end, [...] Read more.
Since human beings have a long tradition of coexistence with pandemics, which may profoundly impact them, adopting preventive measures is crucial for humankind’s survival. This study explores the intention-based critical factors affecting the willingness of individuals to adopt pandemic prevention. To this end, a representative sample of 931 Pakistanis filled in an online questionnaire. However, only 828 questionnaires were found to be complete and valid for path modeling analysis. The core findings are as follows: Firstly, peer groups’ beliefs, self-efficacy, perceived risk, pandemic knowledge, ease of pandemic prevention adoption, and risk-averse behavior are revealed as driving forces of the individuals’ willingness to adopt pandemic prevention. Contrastingly, a lack of trust in political will and mythical attitude towards pandemics are uncovered as inhibitors. Nevertheless, moral values depict a neutral role. Secondly, the peer groups’ beliefs are highest ranked, followed by the lack of trust in political will and a mythical attitude towards pandemic prevention. Finally, moral values are determined as the lowest-ranked critical factor. Based on these results, the government should promote awareness campaigns on lethality and fatality of the pandemic at both centralized and decentralized levels to win people’s trust at the grass-roots level and overcome the mythical attitude of individuals at all societal levels. Besides, access to personal protective gears should be made feasible since an easier pandemic prevention adoption would increase the individuals’ willingness to adopt such preventative measures. Full article
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Article
Precautionary Behavior Practices and Psychological Characteristics of COVID-19 Patients and Quarantined Persons
Int. J. Environ. Res. Public Health 2021, 18(11), 6070; https://doi.org/10.3390/ijerph18116070 - 04 Jun 2021
Cited by 3 | Viewed by 1518
Abstract
Background: since the coronavirus disease (COVID-19) was first reported in 2019, South Korea has enforced isolation of patients with confirmed cases of COVID-19, as well as quarantine for close contacts of individuals diagnosed with COVID-19 and persons traveling from abroad, in order to [...] Read more.
Background: since the coronavirus disease (COVID-19) was first reported in 2019, South Korea has enforced isolation of patients with confirmed cases of COVID-19, as well as quarantine for close contacts of individuals diagnosed with COVID-19 and persons traveling from abroad, in order to contain its spread. Precautionary behavior practices and psychological characteristics of confirmed and quarantined persons were investigated for planning pandemic recovery and preparedness. Methods: this study was conducted with 1716 confirmed patients and quarantined persons in Daegu and Busan, regions where a high number of cases were confirmed during the early stage of the COVID-19 outbreak in South Korea. We collected online survey data from 23 April to 20 May 2020, in Daegu, and 28 April to 27 May 2020, in Busan, in cooperation with Daegu and Busan Infectious Disease Control Centers and public health centers in the regions. COVID-19 symptoms, pre-cautionary behavior practices, psychological states, and the need for improvement in isolation/quarantine environments were examined using an online survey. Results: compared to patients infected with coronavirus, quarantined persons engaged in more hygiene-related behaviors (e.g., hand washing, cough etiquette, and proper mask-wearing) and social distancing. COVID-19 patients had a strong fear of stigma, while quarantined persons had a strong fear of contracting COVID-19. Study participants responded that it was necessary to provide financial support and adequate information during isolation/quarantine. Conclusions: the study highlights the importance of precautionary behavior to prevent COVID-19 infection and the need to provide support (both psychological and financial) to patients and quarantined persons, to reinforce effective communication, social solidarity, and public health emergency preparedness (PHEP) in a pandemic situation. Full article
Article
The Impact of the COVID-19 Pandemic on Primary Emotional Systems and Emotional Regulation
Int. J. Environ. Res. Public Health 2021, 18(11), 5742; https://doi.org/10.3390/ijerph18115742 - 27 May 2021
Cited by 6 | Viewed by 1740
Abstract
(1) Background: The COronaVIrus Disease 2019 (COVID-19) pandemic poses a unique challenge as a severe global crisis affecting physical and psychological health. The main purpose of this work is to study the impact of a traumatic event while also observing the human ability [...] Read more.
(1) Background: The COronaVIrus Disease 2019 (COVID-19) pandemic poses a unique challenge as a severe global crisis affecting physical and psychological health. The main purpose of this work is to study the impact of a traumatic event while also observing the human ability to adapt. One of the first theories to study the adaptive importance of the evolutionary lineage of the affective systems is referred to as BrainMind (Panksepp, 2010). This study aims to explore whether primary emotional systems (PES) and emotion regulation (ER) strategies show differences between the pre- and post- lockdown period; and if positive systems and specific emotion regulation pre-pandemic act as a protective or risk factor for mental and physical wellbeing. (2) Methods: 98 participants who had participated in a previous study before the pandemic were re-contacted to refill the Affective Neuroscience Personality Scale (ANPS) and the Emotion Regulation Questionnaire (ERQ) after the outbreak of the pandemic with the addition of the Symptom Checklist-90-Revised (SCL-90R). (3) Results: The results showed that the COVID-19 lockdown rules had an impact on Emotional Regulation and on a re-balancing of PES. Moreover, pre-pandemic expressive–suppressive ERQ strategies and ANPS SADNESS scores appeared as relevant risk factors, which predicted higher Global Severity Index (GSI) scores during lockdown. (4) Conclusions: The lockdown appears to have activated PLAY and CARE as protective systems, but has detuned the ability to positively reinterpret the situation. Full article
Article
Older Adolescents Who Did or Did Not Experience COVID-19 Symptoms: Associations with Mental Health, Risk Perception and Social Connection
Int. J. Environ. Res. Public Health 2021, 18(9), 5006; https://doi.org/10.3390/ijerph18095006 - 09 May 2021
Cited by 8 | Viewed by 1863
Abstract
After a decrease in detected cases in the summer, Europe faced the emergence of a second wave of coronavirus disease 19 (COVID-19). Few studies have investigated adolescents, who may constitute a target group with possible lower compliance to public health measures, particularly the [...] Read more.
After a decrease in detected cases in the summer, Europe faced the emergence of a second wave of coronavirus disease 19 (COVID-19). Few studies have investigated adolescents, who may constitute a target group with possible lower compliance to public health measures, particularly the social distancing measures. A total sample of 492 participants was included in the study, and the ages of the participants ranged from 18–24 years. According to the hypothesis of our study, the sample was divided into two groups: those who experienced COVID-19 symptoms and those who did not experience COVID-19 symptoms. Demographic characteristics, knowledge, perceptions, and behaviors related to COVID-19 were investigated with ad hoc items; in addition, mood disorders, self-efficacy, and social connectedness were explored. Our results showed significant differences in the variables of risk perception, self-efficacy, and measures of belongingness among older adolescents who did or did not experience COVID-19 symptoms. In this period, adolescents experienced unprecedented disruptions in their daily lives, leading them to isolation and loneliness. Compliance with restrictive measures is considered both a proactive behavior and a social responsibility, especially if supported by prosocial reasons to prevent others from getting sick; therefore, this must be the focus of raising awareness of anti-COVID-19 compliance among adolescents. Full article
Article
Individual-Level Determinants of Lifestyle Behavioral Changes during COVID-19 Lockdown in the United States: Results of an Online Survey
Int. J. Environ. Res. Public Health 2021, 18(8), 4364; https://doi.org/10.3390/ijerph18084364 - 20 Apr 2021
Cited by 19 | Viewed by 2441
Abstract
This study examined individual-level determinants of self-reported changes in healthy (diet and physical activity) and addictive (alcohol use, smoking, and vaping) lifestyle behaviors during the initial COVID-19 lockdown period in the USA. A national online survey was administered between May and June 2020 [...] Read more.
This study examined individual-level determinants of self-reported changes in healthy (diet and physical activity) and addictive (alcohol use, smoking, and vaping) lifestyle behaviors during the initial COVID-19 lockdown period in the USA. A national online survey was administered between May and June 2020 that targeted a representative U.S. sample and yielded data from 1276 respondents, including 58% male and 50% racial/ethnic minorities. We used univariate and multivariable linear regression models to examine the associations of sociodemographic, mental health, and behavioral determinants with self-reported changes in lifestyle behaviors. Some study participants reported increases in healthy lifestyle behaviors since the pandemic (i.e., 36% increased healthy eating behaviors, and 33% increased physical activity). However, they also reported increases in addictive lifestyle behaviors including alcohol use (40%), tobacco use (41%), and vaping (46%). With regard to individual-level determinants, individuals who reported adhering to social distancing guidelines were also more likely to report increases in healthy lifestyle behaviors (β = 0.12, 95% CI 0.04 to 0.21). Conversely, women (β = −0.37, 95% CI −0.62 to −0.12), and unemployed individuals (β = −0.33, 95% CI −0.64 to −0.02) were less likely to report increases in healthy lifestyle behaviors. In addition, individuals reporting anxiety were more likely to report increases in addictive behaviors (β = 0.26, 95% CI 0.09 to 0.43). Taken together, these findings suggest that women and unemployed individuals may benefit from interventions targeting diet and physical activity, and that individuals reporting anxiety may benefit from interventions targeting smoking and alcohol cessation to address lifestyle changes during the pandemic. Full article
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Article
Avoidance of Healthcare Utilization in South Korea during the Coronavirus Disease 2019 (COVID-19) Pandemic
Int. J. Environ. Res. Public Health 2021, 18(8), 4363; https://doi.org/10.3390/ijerph18084363 - 20 Apr 2021
Cited by 13 | Viewed by 1667
Abstract
Avoidance of healthcare utilization among the general population during pandemic outbreaks has been observed and it can lead to a negative impact on population health. The object of this study is to examine the influence of socio-demographic and health-related factors on the avoidance [...] Read more.
Avoidance of healthcare utilization among the general population during pandemic outbreaks has been observed and it can lead to a negative impact on population health. The object of this study is to examine the influence of socio-demographic and health-related factors on the avoidance of healthcare utilization during the global outbreak of a novel coronavirus (COVID-19) in 2020. Data were collected through an online survey four weeks after the Korea Centers for Disease Control and Prevention (KCDC) confirmed the first case in South Korea; 1000 subjects were included in the analysis. The logit model for regression was used to analyze the associations between sociodemographic and health-related factors regarding the avoidance of healthcare utilization. Among the participants, 73.2% avoided healthcare utilization, and there was no significant difference in the prevalence of healthcare avoidance between groups with (72.0%) and without (74.9%) an underlying disease. Sociodemographic characteristics (e.g., gender, age, income level, and residential area) were related to healthcare avoidance. Among the investigated influencing factors, residential areas highly affected by COVID-19 (i.e., Daegu/Gyeoungbuk region) had the most significant effect on healthcare avoidance. This study found a high prevalence of healthcare avoidance among the general population who under-utilized healthcare resources during the COVID-19 outbreak. However, the results reveal that not all societal groups share the burden of healthcare avoidance equally, with it disproportionately affecting those with certain sociodemographic characteristics. This study can inform healthcare under-utilization patterns during emerging infectious disease outbreaks and provide information to public health emergency management for implementing strategies necessary to improve the preparedness of the healthcare system. Full article
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Article
Gender Differences in the COVID-19 Pandemic Risk Perception, Psychology, and Behaviors of Spanish University Students
Int. J. Environ. Res. Public Health 2021, 18(8), 3908; https://doi.org/10.3390/ijerph18083908 - 08 Apr 2021
Cited by 46 | Viewed by 3974
Abstract
The actual COVID-19 pandemic scenario has generated a context of uncertainty, helplessness, and inequality. Yet, the perception of COVID-19 risk has influenced nutritional, psychological, and physical activity patterns depending on gender. We conducted the present research with the aim of studying gender differences [...] Read more.
The actual COVID-19 pandemic scenario has generated a context of uncertainty, helplessness, and inequality. Yet, the perception of COVID-19 risk has influenced nutritional, psychological, and physical activity patterns depending on gender. We conducted the present research with the aim of studying gender differences of university students in the perceived risk of the COVID-19 pandemic, and in psychological, nutritional, oral health, and physical activity habits. To reach the study’s aim, 300 volunteer university students completed an online questionnaire which analyzed variables of perceived risk of the COVID-19 pandemic, psychological profiles, and nutritional, oral health, and physical activity habits. Results showed that females presented a higher perception of danger to the COVID-19 virus than males but showed no differences in how the pandemic has affected personal lives. Females showed higher values of anxiety, conscientiousness, neuroticism, and openness to experience, while males presented higher values of extraversion. Nutritionally, males presented greater consumption of soft drinks, meat, and pasta or rice, and lower buccal hygiene. Yet, no differences were found regarding physical activity patterns. Results from the present study could be used by various educational institutions to implement multidisciplinary interventions to reduce the stress and risk perception. Full article
Article
Information and Communications Technology (ICT) Usage during COVID-19: Motivating Factors and Implications
Int. J. Environ. Res. Public Health 2021, 18(7), 3571; https://doi.org/10.3390/ijerph18073571 - 30 Mar 2021
Cited by 9 | Viewed by 2434
Abstract
This study was designed to investigate the roles information and communications technology (ICT) played during the current COVID-19 pandemic. Specifically, we focused on the relationships between ICT use and perceived importance of social connectedness and future anxiety, while considering relevant personality and psychosocial [...] Read more.
This study was designed to investigate the roles information and communications technology (ICT) played during the current COVID-19 pandemic. Specifically, we focused on the relationships between ICT use and perceived importance of social connectedness and future anxiety, while considering relevant personality and psychosocial factors. A U.S. sample of 394 adults answered questions about ICT use, pandemic-related reactions and actions, demographics, and psychosocial factors via an online survey. Using logistic regression, findings indicated that personality (extraversion and conscientiousness) and psychosocial (need to belong and perceived attachment to phone) factors, types of ICT as news source, and gender were associated with perceived importance of social connectedness. Neuroticism, time spent on ICT for social purposes, and perceived threat of COVID-19 were associated with future anxiety. In addition, using Mann–Whitney U test, people who rated higher on importance of social connectedness had higher ICT use, both in terms of types and time spent on ICT. Overall, results are consistent with the idea that technology is a coping tool during the pandemic and balanced use can lead to feelings of social connectedness and less future anxiety. Therefore, it is important for authorities to align their messaging and outreach with people’s psychosocial, personality, and health considerations through ICT channels while empowering ICT users to be responsible for their interactions with the technology. Full article
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Article
Psychological Health Status of Psychiatric Patients Living in Treatment Communities before and during the COVID-19 Lockdown: A Brief Report
Int. J. Environ. Res. Public Health 2021, 18(7), 3567; https://doi.org/10.3390/ijerph18073567 - 30 Mar 2021
Cited by 9 | Viewed by 1275
Abstract
Many studies investigated the psychological impact of lockdown measures on the general population, while few studies focused on the psychiatric population. This study aimed to investigate the role of therapeutic communities in the management and containment of symptoms of patients with psychosis living [...] Read more.
Many studies investigated the psychological impact of lockdown measures on the general population, while few studies focused on the psychiatric population. This study aimed to investigate the role of therapeutic communities in the management and containment of symptoms of patients with psychosis living in psychiatric residential facilities. Data were collected at two different points: November 2019 (Coronavirus disease 19 had not yet spread) and April 2020 (during the lockdown in Italy). Twenty-two study participants were recruited from three residential accredited psychiatric facilities. During lockdown, the patients showed a small increase in symptomatology in terms of emotional isolation. In addition, it was been observed significant differences in certain functional areas of the behavior, measured as lower inclination towards violent behaviors during lockdown, and higher scores in substance abuse and medical impairment. The lockdown condition could represent a form of containment; daily routines, along with adequate social support, are important aspects of the stability and the level of behavioral functioning of psychiatric patients. Social support and continuity of care offered by psychiatric communities can be an effective safeguard against the psychological impact of the COVID-19 epidemic. Full article
Article
Health Anxiety Predicts the Perceived Dangerousness of COVID-19 over and above Intrusive Illness-Related Thoughts, Contamination Symptoms, and State and Trait Negative Affect
Int. J. Environ. Res. Public Health 2021, 18(4), 1933; https://doi.org/10.3390/ijerph18041933 - 17 Feb 2021
Cited by 3 | Viewed by 1483
Abstract
This study sought to evaluate the specificity of health anxiety, relative to other forms of psychopathology, in perceptions of COVID-19 as dangerous. Measures of health anxiety, COVID-19 perceived dangerousness, negative affect, anxiety, depression, stress, contamination-related obsessions and compulsions, and intrusive illness-related thoughts were [...] Read more.
This study sought to evaluate the specificity of health anxiety, relative to other forms of psychopathology, in perceptions of COVID-19 as dangerous. Measures of health anxiety, COVID-19 perceived dangerousness, negative affect, anxiety, depression, stress, contamination-related obsessions and compulsions, and intrusive illness-related thoughts were administered online to 742 community individuals during the Italian national lockdown. Results showed that, after controlling for demographic variables and other internalizing problems, health anxiety was the single most important factor associated with the perceived dangerousness of COVID-19. Moreover, a comparison between the current sample’s scores on various symptom measures and scores from prepandemic Italian samples revealed that, whereas other internalizing symptoms increased by a large or very large magnitude during the pandemic, levels of health anxiety and negative affect increased by a medium amount. This result may indicate that health anxiety is relatively trait-like, increasing the likelihood that our correlational data support the model of health anxiety as a vulnerability rather than an outcome. Together, these results indicate that health anxiety may be a specific risk factor for COVID-related maladjustment and support the distinction of health anxiety from other psychological problems. Full article
Article
Precautionary Behavior and Depression in Older Adults during the COVID-19 Pandemic: An Online Cross-Sectional Study in Hubei, China
Int. J. Environ. Res. Public Health 2021, 18(4), 1853; https://doi.org/10.3390/ijerph18041853 - 14 Feb 2021
Cited by 17 | Viewed by 2424
Abstract
The large-scale COVID-19 pandemic has not only resulted in the risk of death but also augmented the levels of depression in community-dwelling older adults. The present study aimed to investigate the characteristics of depression in Chinese older adults during the COVID-19 pandemic, to [...] Read more.
The large-scale COVID-19 pandemic has not only resulted in the risk of death but also augmented the levels of depression in community-dwelling older adults. The present study aimed to investigate the characteristics of depression in Chinese older adults during the COVID-19 pandemic, to examine the association of individual precautionary behavior with older adults’ depression levels, and to identify the moderating role of socioeconomic indicators in the aforementioned association. Five hundred and sixteen older adults were recruited from five cities of Hubei province in China. They were asked to complete an online questionnaire survey. Results showed that 30.8% of participants indicated a significant depressive symptom during the pandemic. Older adults’ depression levels differed significantly in marital status, living situation, education level, household income, subjective health status, and infected cases of acquaintances. Precautionary behavior change showed significant inverse associations with older adults’ depression levels, where household income moderated this relationship. This is the first study to investigate the characteristics, behavioral correlates, and moderators of depression among Chinese older adults during the COVID-19 pandemic. Research findings may provide new insights into interventions and policy-making on individual precautionary behavior and mental health among older adults for future pandemics. Full article
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Article
Mediating Effects of Risk Perception on Association between Social Support and Coping with COVID-19: An Online Survey
Int. J. Environ. Res. Public Health 2021, 18(4), 1550; https://doi.org/10.3390/ijerph18041550 - 06 Feb 2021
Cited by 11 | Viewed by 1845
Abstract
Coronavirus disease 2019 (COVID-19) is a novel infectious disease which has had a great impact on the public. Further investigations are, therefore, needed to investigate how the public copes with COVID-19. This study aimed to develop a model to estimate the mediating effects [...] Read more.
Coronavirus disease 2019 (COVID-19) is a novel infectious disease which has had a great impact on the public. Further investigations are, therefore, needed to investigate how the public copes with COVID-19. This study aimed to develop a model to estimate the mediating effects of risk perception and confidence on the association between perceived social support and active coping with the COVID-19 pandemic among people in Taiwan. The data of 1970 participants recruited from a Facebook advertisement were analyzed. Perceived social support, active coping with COVID-19, risk perception and confidence were evaluated using self-administered questionnaires. Structural equation modeling was used to verify the direct and indirect effects between variables. The mediation model demonstrated that lower perceived social support was significantly associated with a higher level of active coping with COVID-19, and this was mediated by a higher level of risk perception. The present study identified the importance of risk perception on the public’s coping strategies during the COVID-19 pandemic. Full article
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