Hesitancy about the COVID-19 vaccine in high-income countries can be caused by diverse psychological and social factors. Few studies on vaccine concerns have examined the interplay of the effects of mental disorders, social and economic factors, gender and refugee status. To investigate these issues, this article reports findings from the 2023 wave of a longitudinal study involving 709 women who are mothers of young children in Australia, both refugees and Australian-born.

Respondents were asked if they had any worries or fears about receiving the COVID-19 vaccine. In previous waves they completed standardized assessments of mental health and sociodemographic factors. An open-ended question provided insights into the reasons for self-reported vaccine concerns. Descriptive statistics and binary logistic regression analyses were conducted, and demographic adjusted logistic regression undertaken separately for Australian-born and refugee women. Formal comparisons of effect sizes between Australian-born and refugee women were performed, with Cohen's d quantifying the magnitude of these differences. Qualitative responses were coded by topic and ranked by frequency.

More than half of the respondents reported worries about receiving a COVID-19 vaccine. Concerns were significantly higher for younger age women, those with a lower educational level and those with a history of mood disorder, panic disorder or separation anxiety disorder. Vaccine hesitancy was associated with poorer quality of life, living difficulties and disability among refugee women only. Separation anxiety disorder and a younger age were associated with an increased odds among Australian-born women only. The newness of the vaccine and concern about side effects were the greatest concerns among respondents who reported hesitancy.

Young mothers with mental health problems and lower education need to be sensitively targeted to improve COVID-19 vaccine uptake. Mental health and public health professionals need to be aware of differences reported for women from refugee background. Improved quality of life and economic status will increase vaccine uptake among socioeconomically challenged communities.

Rural men face a greater risk of ill-health than their urban counterparts but often lack access to appealing health programs. Aussie Fans in Training (Aussie-FIT) is an engaging men's health program delivered in urban professional sports contexts. This study examines the feasibility of implementing an adapted version of Aussie-FIT in rural Western Australia, focussing on the recruitment and retention of program coaches and participants. Men (aged 35-65) with overweight or obesity were recruited via Facebook, word of mouth, and local media for the 12-session Aussie-FIT program in 3 rural towns. Coaches were recruited via local stakeholder networks. A mixed-methods approach included process data relating to the number of coaches expressing interest and delivering programs, program reach, attendance registers, and five post-program participant focus groups (total n = 25). Qualitative data exploring barriers and facilitators to engaging men were analysed using reflexive thematic analysis. Eighty-three of 124 men (67%) expressing interest enrolled, with most residing in low-to-middle socioeconomic areas (n = 77; 96%) and not university educated (n = 60; 74%). Half (n = 40) were recruited via Facebook and a third by word of mouth. Average attendance was 8.2 of 12 sessions, with 57 (69%) completers. Retention varied by site (59-79%), partly due to Covid-19. An inclusive and supportive environment, the football theme and setting, and intragroup connectedness supported engagement. Findings suggest that it is feasible to implement Aussie-FIT in rural Western Australia without a professional club affiliation or setting, and that popular local sporting codes and community sports settings can be utilized to engage rural men in behavioural health programs.

Objective: This study explored the relations between campus safety and loneliness among Asian and Asian American college students. We investigated the mediation effect of psychological distress and the moderation effect of COVID-19-related discrimination in these relations. Participants: 1,685 Asian and Asian American college students who participated in the Fall 2020, American College Health Association - National College Health Assessment III survey. Method: The moderated mediation analysis was conducted. Results: The findings revealed a negative correlation between campus safety and both psychological distress (b = -0.05, p < 0.001) and loneliness (b = -0.12, p < 0.001), but this weakened for those experiencing COVID-19 discrimination. Psychological distress consistently mediated the safety-loneliness link regardless of discrimination. Conclusions: The current findings highlight the support from the university for Asian and Asian American college students. The specific implications for practice and policy are discussed.

The study objective was to determine factors associated with obtaining COVID-19 vaccination in people with co-occurring alcohol use disorder (AUD) and serious mental illness (SMI).

Survey responses were obtained from 135 adults with SMI seeking community-based AUD treatment about their primary series vaccination status, COVID-19 preventative practices, vaccination motivators, reasons for vaccine hesitancy, and strategies to increase vaccination uptake. Vaccinated and unvaccinated groups were compared. Responses to survey items with nominal or Likert scales were analyzed with chi-square tests of association. Logistic regression was employed to determine predictors of vaccine status.

Seventy-nine percent (n=107) of participants reported they were vaccinated. A higher proportion of vaccinated participants believed COVID-19 was a serious disease. While both groups adopted preventative hygiene practices at similar rates (e.g., washing hands), vaccinated participants engaged in more interpersonal practices directly involving others (e.g., wearing masks and avoiding crowds). The strongest vaccine motivator was protecting personal health, while the primary reason for hesitancy was potential side effects. Most unvaccinated participants endorsed increased safety information availability (61.1 %) and living with a high-risk-for-severe-infection individual (55.6 %) as reasons to overcome hesitancy.

Vaccination rates, motivators, and hesitancy reasons were similar to the general United States population. Strategies to increase vaccination in this high-risk population should include education on vaccine safety and side effects and the impacts of COVID-19 and other respiratory illnesses on others.

Early in the COVID-19 pandemic, adherence to non-pharmaceutical interventions is especially critical to controlling disease spread. Understanding the factors that influence the initial demotivation to comply with public health guidance can enable the design of more effective interventions for future epidemics.

We collected participant-reported data on psychological distress and the number of weekly contacts with non-household members across six surveys administered between April and September 2020 among two cohorts: (1) families with children and (2) adults aged 50 years and older. We then used marginal structural models to examine the time-varying effect of distress on future interactions with non-household members as a measure of pandemic fatigue.

Among families with children, each unit increase in distress at the beginning of the study resulted in a 9% increase in non-household contacts (RR: 1.09; 95% CI: 1.03 to 1.16), but the effect declined with each additional week by 1.8% (ratio of RR: 0.982; 95% CI: 0.971 to 0.993). For adults over age 50, the relationship was reversed. Increasing distress led to a 7.2% decline in contacts (RR: 0.928; 95% CI: 0.863, 0.998) at the beginning of the study, but this effect increased by 1.0% with each additional week (ratio of RR: 1.01; 95% CI: 1.00 to 1.02).

We observed that the initial effect of psychological distress on adherence to recommendations to reduce non-household contacts and the change in the effect of distress over time (pandemic fatigue) differed between our two cohorts. Response strategies among younger/lower risk populations may be more effective when focused on broader implications of community transmission, while response strategies among older/higher risk populations may be more effective if they focus on increasing resilience and fostering safe coping strategies.

Studies have shown that the coronavirus (COVID-19) pandemic negatively impacted the mental health of young Australians. However, there is limited longitudinal research exploring how individual factors and COVID-19 related public-health restrictions influenced mental health in young people over the acute phase of the COVID-19 pandemic. This study aimed to identify risk and protective factors associated with changes in individual symptoms of anxiety and depression among young Australians during the COVID-19 pandemic.

This prospective cohort study collected data on anxiety and depression symptoms of young Australians aged 15-29 years old using the Depression, Anxiety and Stress Scale short form (DASS-21). We delivered four online questionnaires from April 2020 to August 2021 at intervals of 3, 6, and 12 months after the initial survey. We implemented linear mixed-effects regression models to determine the association among demographic, socioeconomic, lifestyle and COVID-19 public health restrictions related factors and the severity of anxiety and depression symptoms over time.

Analyses included 1936 young Australians eligible at baseline. There was a slight increase in DASS-21 anxiety mean scores from timepoint 3 to timepoint 4. DASS-21 depression scores showed slight fluctuations across timepoints with the highest mean score observed in timepoint 2. Factors associated with increases in anxiety and depression severity symptoms included LGBTQIA + identity, financial insecurity both before and during the pandemic, higher levels of loneliness, withdrawal or deferral of studies, spending more time on social media, and difficulties to sleep. Risk factors for only depression symptoms include unemployment during COVID-19 pandemic and being in lockdown. Living with someone was a protective factor for both anxiety and depression symptoms, pre-COVID-19 unemployment for depression symptoms, and older age and unemployment during the pandemic for anxiety symptoms.

These findings indicate that during the first year of the pandemic in Australia, there were significant changes in young people's mental health which were associated with multiple demographic, socioeconomic, lifestyle, and lockdown factors. Hence, in future public health crises, we suggest more inclusive guidelines that involve young people in their development and implementation ensuring that their unique perspectives and needs are adequately considered.

Research has documented that domestic violence increased worldwide during the COVID-19 pandemic. Studies have also suggested that alcohol use, which also increased during COVID-19, is a risk factor for domestic violence victimization. However, research has yet to examine whether alcohol consumption mediated the relationship between pandemic-related stressful events and domestic violence. Using structural equation modeling, the current study examines the impact of three types of pandemic-related strains (financial problems, familial problems, and work problems) on individual assessments about whether their drinking became problematic during the pandemic and then whether problematic alcohol use increases the risk of psychological and physical domestic violence. This model was analyzed across six countries: Ukraine, The Netherlands, Pakistan, Denmark, Guatemala, and the United States. Results indicate that the associations between pandemic-related strains and self-assessed problematic drinking varied by country. However, across all countries, problematic alcohol consumption was associated with increased physical and psychological domestic violence victimization. Overall, the findings of the current study support the use of programs that aim to reduce problematic consumption of alcohol with the hopes that they may, in turn, reduce psychological and physical domestic violence victimization.

Impulsivity and substance-related outcomes share a complex relationship, as various facets of impulsivity exhibit distinct associations with different drug-related outcomes. This study examines the associations between frequency and quantity of alcohol and marijuana use with impulsivity traits, psychological distress, and the utilization of emotion regulation strategies. A survey asked Argentinian citizens (n = 1507, 356 men) about frequency and quantity of alcohol or marijuana use on each day of a typical week, as well as anxiety, stress, and depression symptoms (DASS-21), impulsivity-like traits (UPPS-P), and emotion regulation strategies (ERQ). The 2-month prevalence of alcohol or marijuana use was 80.1%, and 27.2%, respectively. Premeditation was significantly (p < 0.05) and negatively associated with both frequency and quantity of alcohol consumed, whereas negative and positive urgency were positively and significantly (p < 0.05) associated with quantity of alcohol or marijuana use, respectively. Greater depression symptoms predicted greater quantity of alcohol use, whereas lower emotional suppression or lower cognitive reappraisal were significantly (p < 0.05) associated with a greater frequency of alcohol or marijuana use. Sensation seeking was significantly (p < 0.05) and positively associated with frequency of marijuana use. Individuals with higher levels of impulsivity-like traits, higher levels of depression, or lower use of emotional regulation abilities appeared to be at a higher risk of alcohol or marijuana use. In this sample, the use of alcohol (though not marijuana) seems to fit a negative reinforcement pathway. The study suggests that individuals with risk factors for drug misuse could benefit from interventions aimed at enhancing emotion regulation.

With the creation of a social distancing policy due to coronavirus disease 2019 (COVID-19), home visit workers are under mental stress as they are treated as the source of infection for COVID-19. Since door-to-door rental equipment examiners and gas inspectors must perform their duties even in the COVID-19 situation, they are being discriminated against so severely. The purpose of study was to examine the mediating role of perceived stress on the relationship between risk perception and fear. Data was collected data through labor unions among 275 home visiting workers who examine rental home appliance equipment or inspecting gas. On-line survey was conducted to assess COVID-19 risk perception, fear, perceived stress, and demographic characteristics. The data was analyzed using PROCESS Macro (Model 4). The results of the study showed that stress plays an important role in increasing COVID-19 fears when COVID-19 risk perception increases. Meanwhile, it was found that COVID-19 fear decreased when the level of perceived stress decreased. To reduce the impact of COVID-19 risk perception on COVID-19 fears, appropriate educational programs to reduce stress should be developed for home visit workers. Policymakers need to develop online or mobile Infectious disease education programs for COVID-19 risk at work and establish policies to apply legal education.

Background: Prior studies suggest that lower levels of mindfulness contribute to the motivation of using alcohol to cope with distress. Research examining this possibility is scarce or limited to alcohol, but not marijuana, related outcomes. Objectives: We examined separate models (for alcohol and for marijuana) to determine the associations between trait mindfulness (describing, acting with awareness, non-judging, non-reactivity) and alcohol and marijuana outcomes (use indicators and negative consequences) via emotional psychopathology (i.e., a latent variable assessing symptoms of depression and anxiety) and alcohol/marijuana coping motives. Results: The final analytic sample consisted of 456 participants (Mean age = 22.96 ± 3.12 years; 66.2% women) for the alcohol model; and 232 participants (Mean age = 22.96 ± 3.01 years; 66.2% women) for the marijuana model. Two path models were conducted, such that indirect paths were examined for each trait mindfulness facet on alcohol/marijuana outcomes (e.g., describing → emotional psychopathology → alcohol coping motives → binge drinking frequency). Within the comprehensive alcohol model, describing, acting with awareness, non-judging and non-reactivity were associated with less binge drinking frequency and lower number of alcohol-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of drinking to cope motives. For the marijuana model, describing, acting with awareness, and non-judging of inner experience were associated with less marijuana quantity (grams) consumed and lower number of marijuana-related negative consequences via lower severity of emotional psychopathology symptoms and lower endorsement of marijuana coping motives. Conclusions: Prevention and intervention programs of alcohol and marijuana in Argentina may benefit from improving mindfulness skills and targeting emotional psychopathology and motives to use drugs, to prevent or reduce negative drug-related consequences.

To examine the association of health and hospital workers' fears of coronavirus disease 2019 (COVID-19) with anxiety, anxiety sensitivity, depression, and sociodemographic variables during the COVID-19 pandemic. A total of 527 participants (237 men/289 women) were included, 222 of the participants were doctors, 99 nurses, 22 assistant health personnel, and 182 hospital personnel without health education. Participants filled in the sociodemographic data form, Beck Depression Inventory, Beck Anxiety Inventory, Anxiety Sensitivity Index-3, and Fear of COVID-19 Inventory. In linear regression analysis, independent predictors of the fear of COVID-19 were determined as Beck Anxiety Inventory (p < 0.001), Beck Depression Inventory (p = 0.001), and Anxiety Sensitivity Index-3 Physical subscale (p = 0.001). The fear of COVID-19 is associated with the physical subscale of anxiety, depression, and anxiety sensitivity.

We review recent evidence on Illness Anxiety Disorder (IAD), including risk factors and precipitants, diagnostic classification, clinical characteristics of the disorder, and assessment and treatment in both children and adults.

IAD places a substantial burden on both individuals and society. Despite its impact, understanding of the disorder is lacking and debates remain about whether IAD should be classified as an anxiety disorder and whether it is distinct from Somatic Symptom Disorder. Cognitive behavioural therapy (CBT) is an effective treatment for IAD and there are multiple validated measures of health anxiety available. However, research on health anxiety in children and youth is limited. IAD is chronic, and debilitating, but when identified, it can be effectively treated with CBT. Research using DSM-5 IAD criteria is lacking, and more research is needed to better understand the disorder, particularly in children and youth.

Objective: Optimism is an important factor impacting health and human functioning. Originally conceptualized as a trait, increasing evidence indicates that optimism can change over time and could be an intervention target. Measures are needed that can capture changes in optimism.

Design: In this secondary analysis, we compared the performance of a newly developed state measure, the State Optimism Measure (SOM), to the widely used trait measure, the Life Orientation Test-Revised (LOT-R), in detecting changes over time during a disruptive life event: the onset of the COVID-19 pandemic in the United States.

Main Outcome Measures: Participants (n = 81) were nondaily smokers participating in a smoking cessation intervention, who completed the SOM and LOT-R before and after the initial COVID-19 outbreak.

Results: Optimism declined from pre- to post-COVID-19 outbreak, as assessed by both scales (LOT-R: p=.0147,gav=0.23; SOM: p<.0001,gav=0.56). The change detected was greater when measured by the SOM (p<.0001). Changes in optimism were correlated with concurrent changes in perceived stress, positive affect, and negative affect.

Conclusion: Our results suggest that the SOM has a greater sensitivity to detect within-person changes in optimism than the LOT-R and highlight the SOM's utility for longitudinal studies assessing changes in optimism.

The long-term consequences of the COVID-19 pandemic on college students' mental health remains unknown. The current study explored self-reported Obsessive-Compulsive symptomatology among college student cohorts from pre-, peak-, and later-pandemic time points.

Undergraduate college students (N = 524) who volunteered for course credit.

Self-report responses on the Dimensional Obsessive-Compulsive Scale (DOCS), which includes subscales for contamination, unacceptable thoughts, harm responsibility, and symmetry, were collected from November 29, 2016 through April 27, 2021 and assessed for differences between the pre-, peak-, and later-pandemic cohorts.

Peak-pandemic responders reported higher symptomatology for contamination and unacceptable thoughts compared to pre-pandemic responders (and for pre- vs. later-pandemic for contamination), with no significant effects for symmetry or harm responsibility.

Although the longer-term consequences of the COVID-19 pandemic on students remains unknown, a greater shift in college mental health services from prevention to assessing and addressing more immediate challenges may be necessary.

Stressful life events, such as the coronavirus disease-2019 (COVID-19) pandemic, can cause acute insomnia. Cognitive behavioral therapy for acute insomnia is effective but is both time and resource-intensive. This study investigated if an online behavioral self-help intervention, which has been successfully used alongside sleep restriction for acute insomnia, reduced insomnia severity and improved mood in acute insomnia. This study also assessed good sleepers to explore if a "sleep vaccination" approach was feasible.

In this online stratified randomized controlled trial, 344 participants (103 good sleepers and 241 participants with DSM-5 acute insomnia) were randomized to receive the intervention/no intervention (good sleepers) or intervention/intervention after 28 days (poor sleepers). Insomnia severity was assessed using the ISI (primary outcome), and anxiety and depression using the GAD-7/PHQ-9 (secondary outcomes) at baseline, 1 week, 1 month, and 3-month follow-up.

In people with acute insomnia, relative to baseline, there were significant reductions in ISI (dz = 1.17), GAD-7 (dz = 0.70), and PHQ-9 (dz = 0.60) scores at 1-week follow-up. ISI, GAD-7, and PHQ-9 scores were significantly lower at all follow-up time points, relative to baseline. Subjective diary-derived sleep continuity was unaffected. No beneficial effects on sleep or mood were observed in good sleepers.

An online behavioral self-help intervention rapidly reduces acute insomnia severity (within 1 week), and benefits mood in people with acute insomnia. These beneficial effects are maintained up to 3 months later. Although the use of the intervention is feasible in good sleepers, their subjective sleep was unaffected.

Testing an early online intervention for the treatment of disturbed sleep during the COVID-19 pandemic; prospectively registered at ISRCTN on 8 April 2020 (identifier: ISRCTN43900695).

Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders.

Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health.

Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst.

This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.

We investigated changes over time in mental and social wellbeing indicators for vulnerable population subgroups during the pandemic. These groups were younger people, people with disabilities, low-income groups, unemployed, culturally, and linguistically diverse communities (CaLD), and Aboriginal and Torres Strait Islander peoples.

A series of four repeated population representative surveys were conducted in June 2020, September 2020, January 2022, and June 2022. Questions included items on psychological distress, financial hardship, social connection, and life satisfaction.

For most groups, social connection and life satisfaction improved in 2022 relative to 2020. Psychological distress and financial hardship showed the opposite pattern, with some groups having worse results in 2022 relative to 2020. People without any vulnerability had better mental health and social wellbeing outcomes at each time point relative to the vulnerable population subgroups.

Pandemic-related policies had differential effects over time and for different population groups. Future policies and research need to closely monitor how they impact population subgroups, and the overall results clearly demonstrate the inequity in mental health and social wellbeing outcomes for vulnerable population cohorts.

The outset of the COVID-19 pandemic was characterized by prolonged periods of chronic stress and social isolation. While studies have investigated the changes to well-being (WB) during this period, the impact of the social environment on long-term physical and mental health requires further study. This study aimed to assess the factors influencing WB and health outcomes, with the hypothesis that a positive social environment would play a significant immediate and long-term role in improving WB and preventing the effects of anxiety associated with the pandemic. At time point 1 (April 2020), an Israeli sample of 206 participants (84% female, mean age 31.5) responded to traditional questionnaires assessing mental health and social support. Factors affecting WB were assessed within subjects during the first COVID-19 lockdown for 6 weeks using a daily survey (Beiwe phone application). A year later, in May 2021, at time point 2, the initial questionnaires were readministered to a subset of the same participants (N = 94). We found that anxiety during the first lockdown adversely affected WB and predicted health and WB deterioration a year later. In contrast, a high quality of social relationships was associated with better short- and long-term WB, and mitigated the adverse effects of anxiety. Daily activities, including physical activity, meditation, and romantic relations, were also positively associated with WB during the first lockdown but did not have long-term effects. In summary, our study underscores the enduring health advantages of a positive social environment, particularly during stressful periods. These results have implications for health policymakers: programs which support individuals with high anxiety and low support, by integrating them into community-based interventions, promise to enhance well-being (WB) and health, as well as to fortify the community as a whole.

Increased hygiene behavior may be a factor in the development of contamination-related obsessive-compulsive symptoms (C-OCS). We aimed at investigating (1) the course of C-OCS over 1 year after the start of the COVID-19 pandemic and (2) the effects of changes in hand hygiene (i.e., duration and frequency of handwashing) and related distress regulation on the long-term course of C-OCS. In a longitudinal study, we assessed 1,220 individuals from the German general population at the start of the COVID-19 pandemic (t1), 3 months later (t2), and 12 months later (t3). Pre-pandemic data were available in a subsample from 2014 (n = 430). A decrease in C-OCS over the first year of the pandemic emerged with a small effect size. Thirty-six percent of the participants scored above the clinical cut-off score at t1, 31% at t2, and 27% at t3. In 2014, only 11% scored above the clinical cut-off score. Hierarchical regression showed that C-OCS at t1 was the strongest predictor of a long-term increase in C-OCS. With small effect sizes, change in the duration (not frequency) of handwashing from t1 to t2, as well as the distress-reducing effect of handwashing served as additional predictors. Implications for information on hand hygiene guidelines are discussed.

The COVID-19 pandemic and related restrictions may have led to increased stress, particularly in people with mental health problems. Since stress factors play important role in the emergence of suicide attempts (SA) and suicidal ideation (SI), they may have been exacerbated by the pandemic, which could have led to an increased number of suicide attempts. Thus, we first investigated whether the pandemic affected personal stress experiences and appraisal of coping potential in individuals with and without SA and SI. In a second step, we analyzed the frequency and dynamics of SAs by patients admitted to a psychiatric university clinic over a period of four years.

We examined stress experiences and appraisal of coping resources of inpatients recruited between March 2021 and February 2022 with SA (n=38), SI (n=27), and with mood disorder without SA or SI (n=45). In the second study, we investigated the time course of prospectively recorded patients with a suicide attempt (n=399) between January 1st 2018 and December 31st 2021 using interrupted time-series Poisson regression models.

There was a significant main effect of group (F[2,107]=6.58, p=0.002) regarding psychological stress levels, which was significantly higher in the SA and SI groups than in the psychiatric control group. No significant differences were found in the appraisal of coping resources or in the frequency of SAs before and during pandemic. However, the pandemic had a significant impact on the seasonal pattern of SAs.

The pandemic increased psychological stress levels in individuals with SA and SI, which may be related to SI and do not necessarily result in SA. The pandemic did not affect the overall frequency of SA between March 2020 and December 2021, but interfered with the seasonal pattern of SA occurrence. Effective intervention strategies during a pandemic should include programs to strengthen the psychological resilience of people who are susceptible to mental health problems.

The aim of this study was to identify heterogeneity in trajectories of body mass index (BMI) during the Covid-19 pandemic in the Netherlands. Moreover, we aimed to investigate whether work- and mental health-related disruptive events experienced during the pandemic, such as job insecurity or depression, were associated with such BMI trajectories.

Longitudinal data from the Lifelines Covid Questionnaire was used (21 waves between April 2020 and July 2021; n = 64,630). Different trajectories were identified using group-based trajectory models. Multinomial regression models were fitted to analyse the main determinants of experiencing changes in BMI during the pandemic.

Trajectories of increased BMI, and, to a lesser extent also trajectories of decreased BMI, were more common among those who experienced disruptive work-related events (e.g., being laid-off or having a temporary contract) and mental health-related events (e.g., anxiety or depression) during the pandemic. Those experiencing multiple events were particularly likely to show trajectories of increased or decreased BMI.

During the Covid-19 pandemic, strong heterogeneity was observed in BMI trajectories. This was partially related to work- and mental health-related events.

Health anxiety, which is defined as fear of having or contracting serious physical illness, is particularly salient in light of the COVID-19 pandemic. We conducted a mixed methods study in which 578 narrative samples were analyzed using Linguistic Inquiry and Word Count (LIWC) software to determine linguistic markers from six LIWC categories relevant to cognitive-behavioral features of health anxiety. Broad linguistic predictors were analyzed through three backward elimination regression models in order to inform subcategory predictors of each area of health anxiety. Thus, both broad and specific linguistic predictors of general health anxiety, virus-relevant body vigilance, and fears of viral contamination were examined. Greater use of affective category words in written narratives predicted general health anxiety, as well as body vigilance and viral contamination fears. These findings represent the first direct demonstration of linguistic analysis of health anxiety and provide nuanced information about the nature and etiology of health anxiety.

Since the coronavirus disease 2019 (COVID-19) epidemic, insomnia has become one of the longer COVID-19 symptoms. This study aimed to investigate insomnia among COVID-19 survivors and explore the occurrence and influencing factors of insomnia. A cross-sectional study was performed from December 2022 to February 2023 through an online questionnaire star survey with 8 questions. The insomnia severity index scale (ISI) was used to assess the severity of insomnia. Univariate analysis was used to analyze the factors related to COVID-19 infection. A total of 564 participants (183 males and 381 females) were surveyed in the present study. The prevalence of insomnia was 63.12%. Among these insomnia patients, there were 202 (35.82%) with sub-threshold symptoms, 116 (20.57%) with moderate symptoms, and 38 (6.74%) with severe symptoms. Univariate analysis indicated that there were statistically significant differences in the prevalence of insomnia among COVID-19 survivors of different ages, occupations, and educational levels (P < .05). Of the 356 insomnia patients, 185 (51.97%) did not take any measures against insomnia, while those who took drugs only, physical exercise only, drugs and physical exercise, and other measures were 90 (25.28%), 42 (11.80%), 17 (4.78%), and 22 (6.18%), respectively. Additionally, of the 107 insomnia patients with drug therapy, 17 (15.89%) took estazolam, 16 (14.95%) took alprazolam, 39 (36.45%) took zopiclone, and 35 (32.71%) took other drugs to improve insomnia symptoms. The prevalence of insomnia symptoms remains high among COVID-19 survivors in China. Education level and occupation may be the influencing factors. Unfortunately, most patients with insomnia do not take corresponding treatment measures.

During the COVID 19 pandemic, there were social restrictions with severe mental stress for a long time. Most studies on mental health consequences of the pandemic focused primarily on the beginning of the pandemic. The present study on families of patients or study participants of a child and adolescent psychiatry aimed to examine long-term profiles of emotions and worries in adults with and without mental health condition (mhc) during the first 1.5 years of the COVID-19 pandemic.

We surveyed emotions and worries of 128 adults with (n = 32) and without (n = 96) pre-pandemic mhc over a 1.5-year study period from spring 2020 until summer/autumn 2021. Emotions and worries were captured at four time points: [i] pre-pandemic, [ii] spring 2020 (first lockdown was implemented), [iii] December 2020 (hard lockdown at Christmas time) and [iv] summer/autumn 2021 (considerable ease of regulations); [i] pre-pandemic and [iii] December 2020 were measured retrospectively). First, we run non-parametric tests to compare emotions and worries between adults with and without pre-pandemic mhc at the four time points. Next, we conducted latent profile analysis to identify subgroups from the total sample who share similar trajectories of emotions and worries. Finally, a logistic regression analysis was run to examine whether socio-demographic and psycho-social factors were related to identified trajectories of emotions and worries.

Adults without pre-pandemic mhc reported a strong worsening of emotions and worries at the beginning of the pandemic and a lower worsening during the course, while adults with pre-pandemic mhc reported a constant worsening of emotions and worries. The latent profile analysis revealed three profiles of adults who show either i) an adaption, ii) no adaption or iii) a continuous high condition. With increasing age, higher perceived stress and pre-pandemic mhc, the likelihood of an adaption was increased.

The results of the present study suggested that adults (both with and without pre-pandemic mhc) coped the crisis with different strategies and that most of them returned to their initial, pre-pandemic levels of emotions and worries when social restrictions were considerably eased or stopped.

Background: The psychological well-being of students may be especially affected by the COVID-19 pandemic; international students can lack local support systems and represent a higher risk subgroup. Methods: Self-reported depressive symptoms, suicidal ideation, anxiety, post-traumatic stress disorder (PTSD), insomnia, alcohol use, academic stress, and loneliness were examined in two cohorts of university students (March 2020 n = 207, March 2021 n = 142). We investigated differences i) between 2020 and 2021, ii) between domestic and international students, and ii) whether differences between the two cohorts were moderated by student status. Results: More depressive symptoms, academic stress, and loneliness were reported in 2021. International students reported more depressive symptoms, suicidal ideation, anxiety, PTSD, academic stress, and loneliness. The main effect of cohort was not moderated by student status. Conclusions: International students had worse mental health outcomes overall, but were not affected more by the COVID-19 pandemic than domestic students.

Telehealth services ensure the delivery of healthcare services to a wider range of consumers through online platforms. Nonetheless, the acceptance and uptake of telehealth remain elusive. This study aims to understand the (a) uptake and (b) acceptability of telemedicine, (c) if therapeutic alliance mediates the relationship between the frequency of consultations with clinicians and the uptake of telemedicine in patients with early psychosis, and (d) role of education in moderating the relationship between therapeutic alliance and the uptake of telemedicine for their mental healthcare.

A convenience sample of outpatients (n = 109) seeking treatment for early psychosis and their care providers (n = 106) were recruited from a tertiary psychiatric care centre. Sociodemographic and clinical characteristics, therapeutic alliance (Working Alliance Inventory), and telemedicine use were captured through self-administered surveys. The moderated mediation analysis was performed using PROCESS macro 3.4.1 with therapeutic alliance and level of education as the mediating and moderating factors, respectively.

The acceptance of telemedicine was high (possibly will use: 47.7%; definitely will use: 26.6%) whilst the uptake was low (11%). Therapeutic alliance mediated the relationship between the frequency of consultation and the uptake of telemedicine (β: 0.326; CI: 0.042, 0.637). This effect was moderated by the level of education (β: -0.058; p < 0.05).

Therapeutic alliance mediates the relationship between the frequency of consultations and the uptake of telemedicine services with the level of education moderating this mediation. Focusing on the patients with lower education to improve their telemedicine knowledge and therapeutic alliance might increase the uptake.

Although several studies have documented the impact of the COVID-19 pandemic on mental health, the long-term effects remain unclear.

To examine longitudinal changes in mental health before and during the consecutive COVID-19 waves in a well-established probability sample.

An online survey was completed by the participants of the COVID-19 add-on study at four time points: pre-COVID-19 period (2014-2015, n = 1823), first COVID-19 wave (April to May 2020, n = 788), second COVID-19 wave (August to October 2020, n = 532) and third COVID-19 wave (March to April 2021, n = 383). Data were collected via a set of validated instruments, and analysed with latent growth models.

During the pandemic, we observed a significant increase in stress levels (standardised β = 0.473, P < 0.001) and depressive symptoms (standardised β = 1.284, P < 0.001). The rate of increase in depressive symptoms (std. covariance = 0.784, P = 0.014), but not in stress levels (std. covariance = 0.057, P = 0.743), was associated with the pre-pandemic mental health status of the participants. Further analysis showed that secondary stressors played a predominant role in the increase in mental health difficulties. The main secondary stressors were loneliness, negative emotionality associated with the perception of COVID-19 disease, lack of resilience, female gender and younger age.

The surge in stress levels and depressive symptoms persisted across all three consecutive COVID-19 waves. This persistence is attributable to the effects of secondary stressors, and particularly to the status of mental health before the COVID-19 pandemic. Our findings reveal mechanisms underlying the surge in mental health difficulties during the COVID-19 waves, with direct implications for strategies promoting mental health during pandemics.

The first objective was to track temporal changes in participants' mental health during the 2020 lockdown in Spain. Second, we tested whether age moderated the association between the use of psychological withdrawal and mental health over time. Design: Participants (N = 396, 74% women) completed three waves of a web-based survey during the lockdown. Age mean was 40.11 (sd = 12.66).

Participants answered a set of sociodemographic data, the General Health Questionnaire (GHQ-12), and the Measures of Affect Regulation Scale (MARS).

Disruptions and withdrawal were associated with more mental health symptoms (between 39% and 41% mental distress). Growth models showed that social dysfunction increased over time while dysphoric symptoms decreased. The use of withdrawal aggravated social dysfunction symptoms. Young people who use more withdrawal experienced more social dysfunction and dysphoria over time than those who used less withdrawal strategies.

The differential trends in social dysfunction versus dysphoria symptoms suggest an adaptation process after the initial stress of the lockdown. Older age was correlated with less mental health problems and reflects age related improvements in emotional regulation.

This study examines the feasibility of SilverCloud therapy for anxiety and/or depression. Findings may help determine SilverCloud effectiveness based on patients' profiles.

Participants were randomly assigned to the immediate or later therapy groups. GAD-7, PHQ-9, and WHO-5 scores were measured at baseline and pre/post therapy. A mixed-methods approach was used.

GAD-7, PHQ-9, and WHO-5 scores improved significantly from pre- to post-therapy (p<0.05) for social, behavioral, and economic reasons for anxiety and/or depression.

This SilverCloud study shows feasibility for participants who had moderate to severe anxiety and/or depression due to social, behavioral, or economic reasons.

The significant disruption of COVID-19 on schooling has heightened concerns about its impact on educators' wellbeing. The current study examined how educators' worry regarding the COVID-19 pandemic compared to their worry about other extreme events, such as natural disasters and critical incidents (a death or suicide of a child, young person, or colleague). Educators report that they were most worried about COVID-19. Educators working in preschools were more worried about COVID-19 and natural disasters than those in primary and secondary schools. However, worry regarding critical incidents increased with the age of students taught. Worry was influenced by socio-economic advantage (SEIFA), whereby educators working in higher SEIFA communities were less worried about natural disasters and critical incidents but shared similar levels of worry about COVID-19 as educators in lower SEIFA communities. With a better understanding about how different types of worry and levels of worry vary across different educator groups and different contexts, more effective supports can be developed and offered.

The COVID-19 pandemic affected well-being and health behaviors, especially among healthcare workers and employees in other fields. This is of public health concern because health behaviors and well-being influence long-term negative health outcomes. The purpose of this study was to explore health behaviors and well-being among university and medical center staff during COVID-19.

EMPOWER (Employee Well-being during Epidemic Response) was a three-wave observational study (wave 1: 1,994; wave 2: 1,426; wave 3: 1,363) measuring health behaviors and well-being of university and medical center staff. Surveys were disseminated online to all employees between April and September 2020. Descriptive statistics explored trends across waves for health behaviors (physical activity [PA], diet), and well-being (mental well-being [MWB], depression, anxiety, and stress). Logistic regressions explored associations between health behaviors and well-being factors adjusting for demographics and clinical role. Interactions explored moderation by clinical role.

Most participants reported same/healthier changes in PA (54-65%) and diet (57-73%) and decreased MWB across waves (62%-69%). Nonclinical workers were less likely than clinical workers to experience worse MWB and moderate/severe anxiety and stress (odds ratios [ORs] ranged from 0.38 to 0.58 across waves and well-being outcomes). Participants who maintained/increased PA and diet were less likely to experience worse well-being (ORs ranged from 0.44 to 0.69 across waves and well-being outcomes). Interactions by clinical role were not significant.

Maintaining/increasing health behaviors during COVID-19 may be protective of mental health/well-being in some healthcare workers. These findings support health promotion efforts focused on maintaining or improving diet and PA.

This study explored the impacts of COVID-19 on the mental health (MH)-related visits to general practices (GPs) among children and young people (CYP) up to 18 years of age in Australia. This study analysed national-level data captured by the NPS MedicineWise program on monthly CYP MH-related visits per 10,000 visits to GPs from January 2014 to September 2021. We considered the pre-COVID-19 period (January 2014-February 2020) and the COVID-19 period (March 2020-September 2021). We used a Bayesian structural time series (BSTS) model to estimate the impact of COVID-19 on MH-related GP visits per 10,000 visits. A total of 103,813 out of 7,690,874 visits to GP (i.e., about 135 per 10,000 visits) were related to MH during study period. The BSTS model showed a significant increase in the overall MH-related visits during COVID-19 period (33%, 95% Credible Interval (Crl) 8.5%-56%), particularly, visits related to depressive disorders (61%, 95% Crl 29%-91%). The greatest increase was observed among females (39%, 95% Crl 12%-64%) and those living in socioeconomically least disadvantaged areas (36%, 95% Crl 1.2-71%). Our findings highlight the need for resources to be directed towards at-risk CYP to improve MH outcomes and reduce health system burden.

Women from refugee background residing in high income countries are at greater mental health risk during the COVID-19 pandemic given their higher baseline prevalence of mental disorders, trauma exposures and social adversities. During the COVID-19 pandemic we drew on data from wave-4 of the WATCH cohort study, collected between October 2019 and June 2021. We conducted a cross-sectional analysis to compare the prevalence of common mental disorders (CMDs) from the sample of 650 consecutively recruited women, 339 (52.2%) from the refugee-background who were resettled in Australia and 311 (48.8%) randomly and contemporaneously selected Australian born women. We assessed COVID-19 psychosocial stressors: 1. COVID-related material hardship and 2. COVID-related fear and stress. We examined for associations between scores on these two items and CMDs in each group respectively. Compared to Australian-born woman, women from refugee background recorded a significantly higher prevalence of Major Depressive Disorder (MDD) (19.8% vs 13.5%), PTSD (9.7% vs 5.1%), Separation Anxiety Disorder (SEPAD) (19.8% vs 13.5%) and Persistent Complicated Bereavement Disorder (PCBD) (6.5% vs 2.9%). In refugee women, associations were found between COVID-related material hardship and CMDs [MDD, Relative Risk (RR) = 1.39, 95%CI: 1.02-1.89, p = 0.02] as well as between COVID-related fear and stress and CMDs (MDD, RR = 1.74, 95%CI: 1.04-2.90, p = 0.02 p = 0.02). For Australian-born women, associations were more commonly found between CMDs and material hardship. Our study demonstrates that both women from refugee background and those born in Australia are experiencing significant rates of CMD during the pandemic and that material hardship is an associated factor. We found that women from refugee background are at greater risk for mental health problems and are more likely to report an association of those problems with fear and stress related to COVID_19. All women, and particularly those from refugee background, require urgent and specialised attention to their mental health and psychosocial problems during this pandemic.

Study examined predictors and mental health consequences of appraisal (threat, support satisfaction) and coping (active, avoidant) in a sample of low-income women during coronavirus disease 2019 (COVID-19). Pre-COVID-19 contextual risk and individual resources and COVID-19-specific risk factors were examined as predictors of COVID-19 appraisal and coping, which, in turn, were tested as predictors of changes in depression and anxiety across the pandemic. Pre-COVID-19 resilience predicted more active coping, whereas pre-COVID-19 anxiety and depression predicted more avoidant coping and lower support satisfaction, respectively. Increases in anxiety were predicted by lower pre-COVID-19 self-compassion and higher concurrent threat appraisal and avoidant coping. Increases in depression were related to lower pre-COVID-19 self-compassion, active coping and support satisfaction, and higher COVID-19 hardships and health risk. Findings highlight contextual and individual factors and processes that contribute to mental health problems in a vulnerable population during community-level stressors, with implications for prevention and intervention.

Social concepts such as loneliness and social isolation are fairly new factors that have been recently gaining attention as to their involvement in changes in cognitive function and association with dementia. The primary aim of this narrative review was to describe the current understanding of how loneliness and social isolation influence cognitive aging and how they are linked to dementia. Studies have shown that there is an association between loneliness, social isolation, and reduced cognitive function, in older adults, across multiple cognitive domains, as well as a heightened risk of dementia. Numerous changes to underlying neural biomechanisms including cortisol secretion and brain volume alterations (e.g., white/grey matter, hippocampus) may contribute to these relationships. However, due to poor quality research, mixed and inconclusive findings, and issues accurately defining and measuring loneliness and social isolation, more consistent high-quality interventions are needed to determine whether studies addressing loneliness and social isolation can impact longer term risk of dementia. This is especially important given the long-term impact of the COVID-19 pandemic on social isolation in older people is yet to be fully understood.

Given the vulnerability of children during the COVID-19 pandemic, paying close attention to their wellbeing at the time is warranted. The present protocol-based systematic mixed-studies review examines papers published during 2020-2022, focusing on the impact of the COVID-19 pandemic on children's internalizing/externalizing symptoms and the determinants thereof.

PROSPERO: CRD42022385284. Five databases were searched and the PRISMA diagram was applied. The inclusion criteria were: papers published in English in peer-reviewed journals; papers published between January 2020 and October 2022 involving children aged 5-13 years; qualitative, quantitative, and mixed studies. The standardized Mixed Method Appraisal Tool protocol was used to appraise the quality of the studies.

Thirty-four studies involving 40,976 participants in total were analyzed. Their principal characteristics were tabulated. The results showed that children's internalizing/externalizing symptoms increased during the pandemic, largely as a result of disengagement from play activities and excessive use of the internet. Girls showed more internalizing symptoms and boys more externalizing symptoms. Distress was the strongest parental factor mediating children's internalizing/externalizing symptoms. The quality of the studies was appraised as low (n = 12), medium (n = 12), and high (n = 10).

Gender-based interventions should be designed for children and parents. The studies reviewed were cross-sectional, so long-term patterns and outcomes could not be predicted. Future researchers might consider a longitudinal approach to determine the long-term effects of the pandemic on children's internalizing and externalizing symptoms.

https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022385284, identifier: CRD42022385284.

The COVID-19 pandemic is a global public health problem affecting mental health, and basic data are required for evidence-based mental health interventions. This study aimed to identify the prevalence of psychological impacts, anxiety, depression, stress, and any associated risk factors in individuals living in Turkey during the COVID-19 pandemic.

The population of this descriptive study consisted of individuals over the age of 18 living in Turkey. The data were collected between July-September 2020 using the snowball sampling method. The study was completed with 1733 participants. The data were collected using the Impact of Events Scale-Revised and the Depression Anxiety Stress Scale. Statistical analyses included percentage, mean, standard deviation, a Chi-square test, a Mann Whitney U test, Kruskal Wallis and Tamhane's T2 post hoc, and Spearman's correlation. P < 0.05 was considered statistically significant.

45.1% had moderate or severe psychological effects; 42.7% had a moderate or severe depression, 31.7% had moderate or severe anxiety, and 28.5% had moderate or severe stress levels. Being a woman, being single, unemployment, smoking, the presence of chronic diseases, being young (<35), being a university graduate, having a household size of 5 or more, a low income, having poor health, and being underweight were significantly correlated with some psychological impact, depression, anxiety, and stress levels of people.

During the pandemic period, almost half of the respondents were found to experience some psychological impact of the pandemic and have negative moderate to severe mental health levels. Risk groups for mental health were identified.

The current study investigated the association between psychological factors and financial behaviour during the COVID-19 pandemic in older people. Older people were chosen compared to other age groups because of the relatively greater impact in this age group of suboptimal financial decisions on future financial wellbeing. We hypothesised that the psychological factors facilitating general wellbeing during the COVID-I9 pandemic, i.e., positive mental wellbeing, hope, and positive coping, will have positive effects on financial behaviour. Based on telephone interviews, 1501 older Australians (Men = 750 and Women = 751; 55-64y = 630; > 65y = 871) completed an omnibus questionnaire examining coping, hope, mental wellbeing, and financial behaviour. Data was analysed using logistic regression and an ordinary and two-stage least square frameworks. Analyses revealed that the psychological factors identified as facilitating general wellbeing during the COVID-I9 pandemic also facilitated positive financial behaviour with hope and mental wellbeing emerging as significant determinants. Based on weightings from principal component analysis, one item each from the hope and mental wellbeing scale with eigenvalues > 1 were found to be robust predictors of positive financial behaviours. In conclusion, the findings support the assumption that the psychological factors associated with general wellbeing during the COVID-19 pandemic are also associated with positive financial behaviour. They further raise the possibility that single hope and positive mental well-being items can also be used to monitor psychological health and predict financial behaviour in older people and, in particular, at times of crisis. The latter may be useful measures for government to monitor psychological and financial wellbeing and inform policy for supporting older people at times of crisis.

The present study investigated psychosocial predictors of psychosis-risk, depression, anxiety, and stress in Croatia two years after the onset of the COVID-19 pandemic. Given the existing transgenerational war trauma and associated psychiatric consequences in Croatian population, a significant pandemic-related deterioration of mental health was expected. Recent studies suggest that after an initial increase in psychiatric disorders during the pandemic in Croatia, depression, stress, and anxiety rapidly declined. These findings highlight the role of social connectedness and resilience in the face of the global pandemic. We examined resilience and psychiatric disorder risk in 377 Croatian adults using an anonymous online mental health survey. Results indicate that there was an exacerbation of all mental ill health variables, including depression, anxiety, stress, and a doubled risk for psychosis outcome post-COVID pandemic. Stress decreased levels of resilience, however, those exposed to previous traumatic experience and greater social connectedness had higher resilience levels. These findings suggest that individual differences in underlying stress sensitization of Croatian population due to past trauma may continue to influence mental health consequences two years after COVID-19 pandemic. It is essential to promote the importance of social connectedness and resilience in preventing the development of variety of mental health disorders.

Concerns about disease and an increase in health anxiety levels are expected consequences of the COVID-19 pandemic. However, there have been few longitudinal studies of health anxiety in the general population during this time period. The aim of this study was to examine health anxiety levels before and during the COVID-19 pandemic in an adult, working population in Norway.

This study included 1012 participants aged 18-70 years with one or more measurements of health anxiety (1402 measurements total) from the pre-pandemic period (2015 to March 11, 2020) and/or during the COVID-19 pandemic (March 12, 2020 to March 31, 2022). Health anxiety was measured with the revised version of the Whiteley Index-6 scale (WI-6-R). We estimated the effect of the COVID-19 pandemic on health anxiety scores with a general estimation equation analysis, and age, gender, education, and friendship were included in subgroup analyses.

We found no significant change in health anxiety scores during the COVID-19 pandemic compared to the pre-pandemic period in our adult, working population. A sensitivity analysis restricted to participants with two or more measurements showed similar results. Moreover, the effect of the COVID-19 pandemic on health anxiety scores was not significant in any subgroup analysis.

Health anxiety remained stable, with no significant change observed between the pre-pandemic period and the first 2 years of the COVID-19 pandemic in an adult, working population in Norway.

Individuals vary in their ability to tolerate uncertainty. High intolerance of uncertainty (the tendency to react negatively to uncertain situations) is a known risk factor for mental health problems. In the current study we examined the degree to which intolerance of uncertainty predicted depression and anxiety symptoms and their interrelations across the first year of the COVID-19 pandemic. We examined these associations across three time points (May 2020 - April 2021) in an international sample of adults (N = 2087, Mean age = 41.13) from three countries (UK, USA, Australia) with varying degrees of COVID-19 risk. We found that individuals with high and moderate levels of intolerance of uncertainty reported reductions in depression and anxiety symptoms over time. However, symptom levels remained significantly elevated compared to individuals with low intolerance of uncertainty. Individuals with low intolerance of uncertainty had low and stable levels of depression and anxiety across the course of the study. Network analyses further revealed that the relationships between depression and anxiety symptoms became stronger over time among individuals with high intolerance of uncertainty and identified that feeling afraid showed the strongest association with intolerance of uncertainty. Our findings are consistent with previous work identifying intolerance of uncertainty as an important risk factor for mental health problems, especially in times marked by actual health, economic and social uncertainty. The results highlight the need to explore ways to foster resilience among individuals who struggle to tolerate uncertainty, as ongoing and future geopolitical, climate and health threats will likely lead to continued exposure to significant uncertainty.

Alexithymia has been linked to risky or problematic alcohol use, with a common interpretation invoking deficient emotion regulation and use of alcohol to cope with distress. An alternative explanation positing a general deficit of interoception in alexithymia suggested that poor awareness of internal cues of overconsumption may promote excessive drinking. The present study assessed predictions based on these hypotheses in 337 young adult alcohol users recruited online. Participants completed validated questionnaire indices of alcohol use, alexithymia, emotion regulation, interoceptive sensibility, and sensitivity to reward and punishment. Alcohol use was positively correlated with alexithymia and reward sensitivity, and negatively correlated with emotion regulation as expected, but was uncorrelated with interoceptive sensibility. Alexithymia was not significantly correlated with most dimensions of interoceptive sensibility but was highly negatively correlated with emotion regulation. Hierarchical regression controlling for demographic variables indicated that alexithymia, emotion regulation, sex, and sensitivity to reward and punishment were significant predictors of alcohol use levels. Bootstrapped mediation test controlling for all other variables indicated mediation of the association between alexithymia and alcohol use by deficient emotion regulation but not interoceptive sensibility. Results supported the emotion regulation deficit interpretation of the association of alexithymia with alcohol use. Limitations concerning interoception measurement, online samples, self-report measures, cross-sectional designs, and collection of data during the COVID-19 pandemic are discussed. Future research could follow up on these findings by testing interoceptive accuracy in addition to interoceptive sensibility in relation to alexithymia and alcohol use.