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1. Mental Distress in the United States at the Beginning of the COVID-19 Pandemic

   https://doi.org/10.2105/AJPH.2020.305857  

   Holingue, Calliope; Kalb, Luther G.; Riehm, Kira E.; Bennett, Daniel; Kapteyn, Arie; Veldhuis, Cindy B.; Johnson, Renee M.; Fallin, M. Daniele; Kreuter, Frauke; Stuart, Elizabeth A.; et al (November 2020, American Journal of Public Health)

   null (Ed.)

   Objectives. To assess the impact of the COVID-19 pandemic on mental distress in US adults. Methods. Participants were 5065 adults from the Understanding America Study, a probability-based Internet panel representative of the US adult population. The main exposure was survey completion date (March 10–16, 2020). The outcome was mental distress measured via the 4-item version of the Patient Health Questionnaire. Results. Among states with 50 or more COVID-19 cases as of March 10, each additional day was significantly associated with an 11% increase in the odds of moving up a category of distress (odds ratio = 1.11; 95% confidence interval = 1.01, 1.21; P = .02). Perceptions about the likelihood of getting infected, death from the virus, and steps taken to avoid infecting others were associated with increased mental distress in the model that included all states. Individuals with higher consumption of alcohol or cannabis or with history of depressive symptoms were at significantly higher risk for mental distress. Conclusions. These data suggest that as the COVID-19 pandemic continues, mental distress may continue to increase and should be regularly monitored. Specific populations are at high risk for mental distress, particularly those with preexisting depressive symptoms. 

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2. Psychosocial Effects of the COVID-19 Pandemic: Large-scale Quasi-Experimental Study on Social Media

   https://doi.org/10.2196/22600  

   Saha, Koustuv; Torous, John; Caine, Eric D; De Choudhury, Munmun (January 2020, Journal of Medical Internet Research)

   null (Ed.)

   Background The COVID-19 pandemic has caused several disruptions in personal and collective lives worldwide. The uncertainties surrounding the pandemic have also led to multifaceted mental health concerns, which can be exacerbated with precautionary measures such as social distancing and self-quarantining, as well as societal impacts such as economic downturn and job loss. Despite noting this as a “mental health tsunami”, the psychological effects of the COVID-19 crisis remain unexplored at scale. Consequently, public health stakeholders are currently limited in identifying ways to provide timely and tailored support during these circumstances. Objective Our study aims to provide insights regarding people’s psychosocial concerns during the COVID-19 pandemic by leveraging social media data. We aim to study the temporal and linguistic changes in symptomatic mental health and support expressions in the pandemic context. Methods We obtained about 60 million Twitter streaming posts originating from the United States from March 24 to May 24, 2020, and compared these with about 40 million posts from a comparable period in 2019 to attribute the effect of COVID-19 on people’s social media self-disclosure. Using these data sets, we studied people’s self-disclosure on social media in terms of symptomatic mental health concerns and expressions of support. We employed transfer learning classifiers that identified the social media language indicative of mental health outcomes (anxiety, depression, stress, and suicidal ideation) and support (emotional and informational support). We then examined the changes in psychosocial expressions over time and language, comparing the 2020 and 2019 data sets. Results We found that all of the examined psychosocial expressions have significantly increased during the COVID-19 crisis—mental health symptomatic expressions have increased by about 14%, and support expressions have increased by about 5%, both thematically related to COVID-19. We also observed a steady decline and eventual plateauing in these expressions during the COVID-19 pandemic, which may have been due to habituation or due to supportive policy measures enacted during this period. Our language analyses highlighted that people express concerns that are specific to and contextually related to the COVID-19 crisis. Conclusions We studied the psychosocial effects of the COVID-19 crisis by using social media data from 2020, finding that people’s mental health symptomatic and support expressions significantly increased during the COVID-19 period as compared to similar data from 2019. However, this effect gradually lessened over time, suggesting that people adapted to the circumstances and their “new normal.” Our linguistic analyses revealed that people expressed mental health concerns regarding personal and professional challenges, health care and precautionary measures, and pandemic-related awareness. This study shows the potential to provide insights to mental health care and stakeholders and policy makers in planning and implementing measures to mitigate mental health risks amid the health crisis. 

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3. Childhood adversity during the post‐apartheid transition and COVID ‐19 stress independently predict adult PTSD risk in urban S outh A frica: A biocultural analysis of the stress sensitization hypothesis

   https://doi.org/10.1002/ajpa.24791  

   Kim, Andrew Wooyoung; Said Mohamed, Rihlat; Norris, Shane A.; Naicker, Sara; Richter, Linda M.; Kuzawa, Christopher W. (June 2023, American Journal of Biological Anthropology)

   Abstract ObjectivesThe COVID‐19 pandemic in South Africa introduced new societal adversities and mental health threats in a country where one in three individuals are expected to develop a psychiatric condition sometime in their life. Scientists have suggested that psychosocial stress and trauma during childhood may increase one's vulnerability to the mental health consequences of future stressors—a process known as stress sensitization. This prospective analysis assessed whether childhood adversity experienced among South African children across the first 18 years of life, coinciding with the post‐apartheid transition, exacerbates the mental health impacts of psychosocial stress experienced during the 2019 coronavirus (COVID‐19) pandemic (ca. 2020–2021). Materials and MethodsData came from 88 adults who participated in a follow‐up study of a longitudinal birth cohort study in Soweto, South Africa. Childhood adversity and COVID‐19 psychosocial stress were assessed as primary predictors of adult PTSD risk, and an interaction term between childhood adversity and COVID‐19 stress was calculated to evaluate the potential effect of stress sensitization. ResultsFifty‐six percent of adults exhibited moderate‐to‐severe PTSD symptoms. Greater childhood adversity and higher COVID‐19 psychosocial stress independently predicted worse post‐traumatic stress disorder symptoms in adults. Adults who reported greater childhood adversity exhibited non‐significantly worse PTSD symptoms from COVID‐19 psychosocial stress. DiscussionThese results highlight the deleterious mental health effects of both childhood trauma and COVID‐19 psychosocial stress in our sample and emphasize the need for greater and more accessible mental health support as the pandemic progresses in South Africa. 

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4. The roles of life stress and preventive health behaviors on parent mental health during the COVID-19 pandemic

   https://doi.org/10.1177/13591053211026742  

   Liu, Cindy H; Smiley, Patricia A; Vicman, Jessica M; Wong, Ga Tin; Doan, Stacey N (May 2022, Journal of Health Psychology)

   The COVID-19 pandemic has disrupted millions of lives, with life stress and daily hassles having a potential impact on parent mental health. This study examined whether preventive health behaviors (e.g. social distancing, mask wearing) and social support relate to parent mental health. In a cross-sectional analysis of parents ( N = 176, May–September 2020), life events and daily hassles were positively associated with depressive and anxiety symptoms. Preventive health behaviors moderated the association between daily hassles and depressive symptoms. Preventive health behaviors may protect those with high levels of daily hassles from moderate levels of depression. 

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5. Community Mobility and Depressive Symptoms During the COVID-19 Pandemic in the United States

   https://doi.org/10.1001/jamanetworkopen.2023.34945  

   Perlis, Roy H.; Lunz Trujillo, Kristin; Safarpour, Alauna; Quintana, Alexi; Simonson, Matthew D.; Perlis, Jasper; Santillana, Mauricio; Ognyanova, Katherine; Baum, Matthew A.; Druckman, James N.; et al (September 2023, JAMA Network Open)

   ImportanceMarked elevation in levels of depressive symptoms compared with historical norms have been described during the COVID-19 pandemic, and understanding the extent to which these are associated with diminished in-person social interaction could inform public health planning for future pandemics or other disasters. ObjectiveTo describe the association between living in a US county with diminished mobility during the COVID-19 pandemic and self-reported depressive symptoms, while accounting for potential local and state-level confounding factors. Design, Setting, and ParticipantsThis survey study used 18 waves of a nonprobability internet survey conducted in the United States between May 2020 and April 2022. Participants included respondents who were 18 years and older and lived in 1 of the 50 US states or Washington DC. Main Outcome and MeasureDepressive symptoms measured by the Patient Health Questionnaire-9 (PHQ-9); county-level community mobility estimates from mobile apps; COVID-19 policies at the US state level from the Oxford stringency index. ResultsThe 192 271 survey respondents had a mean (SD) of age 43.1 (16.5) years, and 768 (0.4%) were American Indian or Alaska Native individuals, 11 448 (6.0%) were Asian individuals, 20 277 (10.5%) were Black individuals, 15 036 (7.8%) were Hispanic individuals, 1975 (1.0%) were Pacific Islander individuals, 138 702 (72.1%) were White individuals, and 4065 (2.1%) were individuals of another race. Additionally, 126 381 respondents (65.7%) identified as female and 65 890 (34.3%) as male. Mean (SD) depression severity by PHQ-9 was 7.2 (6.8). In a mixed-effects linear regression model, the mean county-level proportion of individuals not leaving home was associated with a greater level of depression symptoms (β, 2.58; 95% CI, 1.57-3.58) after adjustment for individual sociodemographic features. Results were similar after the inclusion in regression models of local COVID-19 activity, weather, and county-level economic features, and persisted after widespread availability of COVID-19 vaccination. They were attenuated by the inclusion of state-level pandemic restrictions. Two restrictions, mandatory mask-wearing in public (β, 0.23; 95% CI, 0.15-0.30) and policies cancelling public events (β, 0.37; 95% CI, 0.22-0.51), demonstrated modest independent associations with depressive symptom severity. Conclusions and RelevanceIn this study, depressive symptoms were greater in locales and times with diminished community mobility. Strategies to understand the potential public health consequences of pandemic responses are needed. 

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