Longitudinal measurement invariance of the Patient Health Questionnaire-9 across racial/ethnic groups: Results from the traumatic brain injury model system study.

PURPOSE/OBJECTIVE: The aim of this article is to evaluate the measurement invariance (MI) of the Patient Health Questionnaire-9 (PHQ-9) in a sample of individuals during the first 2 years after traumatic brain injury (TBI). MI was examined among racial/ethnic groups and over time to determine the utility of the PHQ-9 across these dimensions. RESEARCH METHOD/DESIGN: In total, N = 3,227 (20% of the total sample) at 1 year and N = 3,153 (19% of the total sample) at 2 years were included for cross-sectional analyses. For the longitudinal analyses, participants with the PHQ-9 at both time points (N = 2,234; 14% of the total study sample) were included. RESULTS: Results were that the PHQ-9 is fully invariant and maintains its unidimensional factorial structure across racial/ethnic groups during the first 2 years after TBI, suggesting the scale measures the same construct equally well for participants from each group. CONCLUSION/IMPLICATIONS: Based on these results, clinicians should feel confident using the PHQ-9 with diverse TBI patient populations, and researchers can reliably and validly employ it in TBI studies across racial/ethnic groups in the United States. Given the high rates of depression among individuals after TBI and its negative impact on their lives, this instrument will continue to be a key tool to measure the prognosis and success of rehabilitation programs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Cognitive and brain connectivity trajectories in critically ill COVID-19 patients.

BACKGROUND: Multiple Organ failure (MOF) is one of the main causes of admission to the Intensive Care Unit (ICU) of patients infected with COVID-19 and can cause short- and long-term neurological deficits. OBJECTIVE: To compare the cognitive functioning and functional brain connectivity at 6-12 months after discharge in two groups of individuals with MOF, one due to COVID-19 and the other due to another cause (MOF-group), with a group of Healthy Controls (HC). METHODS: Thirty-six participants, 12 from each group, underwent a neuropsychological and neuroimaging assessment at both time-points. Functional connectivity of the resting state networks was compared between COVID-19 and HC while controlling for the effect of MOF. The association between functional connectivity and neuropsychological performance was also investigated. RESULTS: Compared to the HC, COVID-19 group demonstrated hypoconnectivity between the Default Mode Network and Salience Network. This pattern was associated with worse performance on tests of attention and information processing speed, at both time-points. CONCLUSION: The study of the association between cognitive function and brain functional connectivity in COVID-19 allows the understanding of the short- and long-term neurological alterations of this disease and promotes the development of intervention programs to improve the quality of life for this understudied population.

Patterns of Alcohol Use in Hispanic Individuals with TBI over the Ten Years Post-Injury: A Model Systems Study.

The study's aim was to examine alcohol consumption patterns and predictors of consumption across time among Hispanics with traumatic brain injury (TBI) in the U.S. within ten years post-injury. This longitudinal cohort study included 1342 Hispanic individuals (77.6% males) from the multi-site, longitudinal TBI Model Systems (TBIMS) database. The main outcome measures were consumption information, demographic, and injury characteristics. Across the full sample, alcohol consumption variables generally demonstrated quadratic movement characterized by an initial increase followed by a plateau or slight decrease over the ten years post-injury. The predictors of higher consumption were being men, single, with a history of excessive alcohol use, with a nonviolent mechanism of injury, shorter duration of PTA, and higher levels of education. Participants had a greater number of 5+ drinks/episode occurrences in the past month if they were men and had had a greater number of 5+ drinks/episode occurrences in the month before injury. There was no differential change in alcohol consumption over time as a function of these predictors. This study identified a profile of at-risk Hispanics with TBI for increased alcohol consumption. These individuals should be identified and targeted for early evidence-based alcohol intervention after TBI when results might be most favorable.

Forced social isolation and lockdown during the COVID-19 pandemic: depression, anxiety, trauma-distress and coping mechanisms of a Greek sample.

Aim: The COVID-19 outbreak escalated into a global pandemic, pushing many governments around the world to impose measures affecting all aspects of life. Similar to other countries, Greece adopted social restriction, lockdowns, and quarantines to reduce transmission from person-to-person. This cross-sectional study investigated the association between social restriction measures, an mental health and coping strategies employed by a Greek adult sample. Subject and methods: An online questionnaire was used to collect data during the second national lockdown (February to May 2021). A total of 650 participants (M age 33.13, 71.5% female) comprised the final sample. Results: The results show 21.3% of respondents reported moderate-to-extremely severe anxiety, 33% moderate-to-extremely severe depression, 31.8% moderate-to-severe stress, and 38% clinically significant trauma-related distress. Hierarchical linear regression analyses revealed that the strongest contributors to adverse mental health outcomes were being female, of younger age, experiencing increases in verbal arguments at home, being separated from family and close friends, and being unable to afford enough or healthy food. Lastly, participants reported moving away from social support and into more individual strength and resilience-based coping strategies to cope with challenges. Conclusion: These findings suggest that in addition to the detrimental effects on physical health, social restriction measures related to COVID-19 also imposed a heavy psychological burden on the population via forced social isolation, which, by design, increased not only physical distancing but also psychological distancing between people. Supplementary Information: The online version contains supplementary material available at 10.1007/s10389-023-01907-3.

Sexual Health and Sexual Quality of Life Among Individuals With Spinal Cord Injury in Latin America.

Background: Sexual changes are an area of primary concern for individuals with spinal cord injury (SCI) and their partners, but the topic has gone largely unexplored in the research literature. Objectives: This study examined how individuals with SCI in Latin America experience their sexuality and what issues they and their partners face in this area. Methods: A total of 248 individuals with SCI from Latin America completed an online 60-item survey regarding sexuality. Results: The majority of participants (87.7%) reported that they had noticed changes in sexuality after the injury, mainly physical problems (50.7%), emotional problems (38.7%), and changes in relationships with partners (27.5%). Regarding sexual desire, 47.2% indicated that desire remained the same after SCI. The majority of participants (81.9%) indicated not having received any information about sexuality after SCI during their hospital stay but reported that they would have liked to have received information (98.1%). Of all participants, 66.1% reported never having been asked about problems or difficulties in their sexual life after SCI by any health professional. Conclusion: Interventions designed to educate individuals with SCI regarding the effect of injury on their sexual functioning, responsiveness, and expression, as well as to support them in maintaining and enhancing their sexual well-being, may be extremely beneficial, particularly in Latin America. Findings highlight the distinct need for professionals to introduce the topic of sexuality by discussing it in a straightforward, nonjudgmental manner and to integrate discussions about sex and related issues into assessment, planning, and ongoing treatment.

School professionals' knowledge about pediatric traumatic brain injury: an international study.

OBJECTIVE: To determine Spanish-speaking school professionals' level of knowledge and attitudes regarding pediatric TBI. METHODS: School professionals(n = 2,238) from 19 countries completed an online-survey regarding their training, knowledge and misconceptions, attitudes and perceptions about TBI. RESULTS: Of the full sample 75% (n = 1689) knew what TBI was, though only 18% (n = 350) reported having experience with a student with TBI. Only 7.7% (n = 143) and 3% (n = 55) of participants could identify all of the common short- and long-term TBI sequelae, respectively. Special education professionals, those with experience with a student with TBI, and those who had received training regarding TBI showed greater knowledge in these areas. Although participants showed high levels of knowledge in 6/24 misconceptions of TBI, they endorsed others. Group, sex, experience with students with TBI, training in TBI, and number of years working were significantly linked to some misconceptions about TBI; however, the effect sizes were small. CONCLUSION: The knowledge and experience that Spanish-speaking school professionals have regarding childhood TBI are minimal. It is therefore critical that these professionals receive a more comprehensive education during their academic training and the practice of their profession about TBI.

The profession of neuropsychologist in Canada: Findings of a national survey.

The purpose of this study was to investigate the demographic characteristics, academic training and types of professional activities of clinical neuropsychologists in Canada.282 participants completed an online-based survey.Respondents were women for the most part and had a mean age of 43 years. They typically had doctoral-level training (85%) and about one-quarter had postdoctoral training (23%). Nearly half (47%) had a lifespan practice, over one-third (37%) had an adults-only practice, and about one-sixth (16%) had an exclusively pediatric practice. Most worked full-time (79%). Respondents were almost evenly split three ways between those who worked in the public sector, those who worked in the private sector, and those who worked in both. The most common professional activities related to assessment (95%), although clinical supervision (43%) and rehabilitation (42%) were also quite frequent, whereas research (27%) and teaching (18%) were less so. The most common reason for referral was to determine a diagnosis (79%). Pediatric neuropsychologists worked primarily with individuals with neurodevelopmental disorders and neuropsychologists working with adult populations worked primarily with individuals with emotional disorders, acquired neuropsychological disorders (traumatic brain injury, stroke/vascular), and neurocognitive disorders (dementia).At time of study, Canadian neuropsychologists seemed to enjoy a fairly balanced situation: Their level of training and the ratio of neuropsychologists per population were both high. However, these varied widely across Canada. This suggests that the profession and public interest would stand to gain from seeing training standardized to some extent nationwide.

Moderate, Little, or No Improvements in Neurobehavioral Symptoms among Individuals with Long COVID: A 34-Country Retrospective Study.

(1) Background: Some people with COVID-19 develop a series of symptoms that last for several months after infection, known as Long COVID. Although these symptoms interfere with people's daily functioning and quality of life, few studies have focused on neurobehavioral symptoms and the risk factors associated with their development; (2) Methods: 1001 adults from 34 countries who had previously tested positive for COVID-19 completed the Neurobehavioral Symptom Inventory reporting the symptoms before their COVID-19 diagnosis, during the COVID-19 infection, and currently; (3) Results: Participants reported large-sized increases before vs. during COVID-19 in all domains. Participants reported a medium-sized improvement (during COVID-19 vs. now) in somatic symptoms, a small-sized improvement in affective symptoms, and very minor/no improvement in cognitive symptoms. The risk factors for increased neurobehavioral symptoms were: being female/trans, unemployed, younger age, low education, having another chronic health condition, greater COVID-19 severity, greater number of days since the COVID-19 diagnosis, not having received oxygen therapy, and having been hospitalized. Additionally, participants from North America, Europe, and Central Asia reported higher levels of symptoms across all domains relative to Latin America and Sub-Saharan Africa; (4) Conclusions: The results highlight the importance of evaluating and treating neurobehavioral symptoms after COVID-19, especially targeting the higher-risk groups identified. General rehabilitation strategies and evidence-based cognitive rehabilitation are needed in both the acute and Long COVID phases.

Employment probability trajectories in hispanics over the 10 years after traumatic brain injury: A model systems study.

BACKGROUND: Research has found that Hispanics with traumatic brain injury (TBI) have reduced functional outcomes compared to non-Hispanic Whites, including lower probabilities of post-injury employment. However, previous studies were cross-sectional, combined racial/ethnic minority groups, and did not examine the factors that predict return to work of Hispanics longitudinally. OBJECTIVE: To determine the demographic and injury-related predictors of employment probability trajectories during the first 10 years after TBI. METHODS: 1,346 Hispanics in the TBI Model Systems Database were included. Hierarchical linear modeling was used to examine baseline predictors of employment probability trajectories across this time period. RESULTS: Employment probability demonstrated a quadratic movement over time, with an initial increase followed by a plateau or slight decrease. Hispanics with TBI had higher employment probability trajectories if they had been younger at the time of injury, spent less time in posttraumatic amnesia, had greater years of education, had been employed at the time of injury, had higher annual earnings at the time of injury, and had experienced a non-violent mechanism of injury. CONCLUSION: Culturally adapted treatment programs with a focus on early intervention incorporating vocational rehabilitation and employment programs for Hispanics with TBI who present with these risk factors are needed.

An international study of post-COVID sleep health.

OBJECTIVES: COVID-19 has infected millions of people worldwide, with growing evidence that individuals with a history of infection may continue to show persistent post-COVID symptoms (long COVID). The aim of this study was to investigate sleep health in an international sample of individuals who reported previously testing positive for COVID-19. DESIGN: Cross-sectional. SETTING: Online survey distributed online between March and June 2021. PARTICIPANTS: A total of 1001 individuals who reported a positive diagnosis of COVID-19 across different geographical regions, including North and South America, Sub-Saharan Africa, and Europe. MEASUREMENTS: Self-reported sleep health, using the Regulatory Satisfaction Alertness Timing Efficiency Duration scale, as recalled before a COVID-19 diagnosis and also reported currently. RESULTS: Individuals reported worse overall current sleep health, with lower ratings across the 6 dimensions of sleep health (sleep regularity, satisfaction, alertness, timing, efficiency, and duration) compared to their ratings as recalled before COVID-19 infection. Greater severity of COVID-19 symptoms was the strongest predictor of poor current sleep health (P < .001), independent of demographics, presence of a pre-existing chronic health condition, and time since infection. Poor current sleep health was associated with poorer current quality of life (P < .001). CONCLUSIONS: Poor current sleep health is evident in individuals with a history of COVID-19, particularly those with more severe symptoms at the time of their COVID-19 infection and is associated with a poorer quality of life. Clinicians and researchers should assess sleep health in COVID-19 patients and investigate long-term associations with their mental and physical health, as well as potential benefits of improving sleep in this population.

Hispanic neuropsychologists in the United States: What do we know about them and how can the field address their needs?

BACKGROUND: Despite numerous calls throughout the years for an increase in ethnic, cultural, and racial diversity within the field of psychology, it remains an elusive reality for Hispanic neuropsychology practitioners in the United States (U.S.). OBJECTIVE: 1. Determine the background and current work situation of Hispanic clinical neuropsychologists in the U.S. (e.g., professional training, assessment and diagnostic procedures used, rehabilitation techniques employed, populations targeted, teaching responsibilities, and research activities), and 2. Examine issues related to perceived discrimination in the field of neuropsychology and what this means for our profession. METHODS: The sample consisted of 107 Hispanic neuropsychologists residing among the 50 United States, District of Columbia, and Puerto Rico who took a survey of professional practices and experiences in clinical neuropsychology. RESULTS: Our findings confirm that Hispanic neuropsychologists in the U.S. are culturally diverse, present with varied levels of bilingualism, have been faced with discrimination during training and in their workplace, and compare favorably with non-Hispanic neuropsychologists in terms of education and clinical training. CONCLUSIONS: Transforming neuropsychology into a diverse and inclusive field requires intentional, strategic, and systematic interventions in education, academia, training, professional organizations and in research.

Validation of the Norma Latina neuropsychological assessment battery in individuals with multiple sclerosis in Mexico.

BACKGROUND: Between 50-60% of Multiple Sclerosis (MS) patients have cognitive alterations. There are several batteries to assess cognitive impairments in MS, however, few exist for Latin Americans. The objective of this study is to evaluate the neuropsychological profile of Mexican people with MS (PwMS) and assess the utility of Norma Latina, a new battery for cognitive assessment in Latin America, in differentiating cognitive test performance between PwMS and healthy controls (HCs). METHODS: 100 PwMS and 100 HCs from Mexico were evaluated with the Norma Latina battery. The following analyses were conducted: 1) low-percentiles of each participant were calculated, 2) Area Under the Curve was used to determine whether the battery discriminated between PwMS and HCs, 3) four composite scores were calculated, and student's t-test was used to compare groups according to these domains. RESULTS: PwMS obtained a greater number of impaired scores compared to HCs, principally in executive function. The battery successfully discriminated between PwMS and HCs, with the strongest capacity to discriminate in the executive functions, and the weakest in memory. CONCLUSION: Establishing validation of a neuropsychological battery for Mexican PwMS will help to more accurately detect cognitive alterations, which will guide the decisions of professionals in terms of cognitive rehabilitation.

Trauma-Related Distress During the COVID-19 Pandemic In 59 Countries.

The COVID-19 pandemic has upended life like few other events in modern history, with differential impacts on varying population groups. This study examined trauma-related distress among 6,882 adults ages 18 to 94 years old in 59 countries during April to May 2020. More than two-thirds of participants reported clinically significant trauma-related distress. Increased distress was associated with unemployment; identifying as transgender, nonbinary, or a cisgender woman; being from a higher income country; current symptoms and positive diagnosis of COVID-19; death of a loved one; restrictive government-imposed isolation; financial difficulties; and food insecurity. Other factors associated with distress included working with potentially infected individuals, care needs at home, a difficult transition to working from home, conflict in the home, separation from loved ones, and event restrictions. Latin American and Caribbean participants reported more trauma-related distress than participants from Europe and Central Asia. Findings inform treatment efforts and highlight the need to address trauma-related distress to avoid long-term mental health consequences.

A Survey of Latin American Rehabilitation Professionals on Addressing Sexuality-Related Concerns After Spinal Cord Injury.

To examine rehabilitation professionals' training and education, attitudes, beliefs or misconceptions, and assessment of issues related to sexuality in individuals with Spinal Cord Injury (SCI) and their romantic partners. 318 healthcare professionals from Latin America (LA) who worked with individuals with SCI completed an online survey. 99.0% affirmed that sexuality is an issue that should be addressed during the rehabilitation of people with SCI. 86.0% reported being asked questions about sexuality after SCI by their patients and/or their partners, but only 33.2% of the professionals affirmed that it was very likely for them to initiate a conversation about the topic. Only 35.4% reported discussing sexuality issues with patients and their partners as a regular practice; further, 61.5% of the sample reported not being prepared at a scientific, therapeutic, and/or educational level to be able to advise people with SCI in the area of sexuality. 95.9% indicated they would be interested in attending courses, seminars, or conferences tailored to the topic of sexuality after SCI. Participants agreed nearly unanimously (96.8%) that it would be easier to discuss sexuality with people with SCI and their partners if they had more training on this topic, which they believed should have been received during their undergraduate (63.5%) and advanced (34.9%) studies. Findings provide insight into the way sexuality is addressed and attended to in the field of rehabilitation in LA and inform initiatives to improve the provision of care in the realm of sexuality for individuals after SCI.

Prevalence of low scores on language tests as a potential factor in misdiagnosis of cognitive impairment in a Spanish-speaking adult population.

OBJECTIVE: In this study, the prevalence of low scores for two neuropsychological tests of language has been determined. METHODS: In total, N = 5218 healthy adults from 11 countries in Latin America (LA) were administered the Boston Naming Test (BNT) and the Verbal Fluency Test (VFT) as part of a comprehensive neuropsychological evaluation. Z-scores were calculated for BNT Total score, and phonological (letters F, A, S, M) and semantic (Animals, Fruits). Scores were adjusted for age, age2, sex, education, and interaction variables if significant for the given country. Each Z-score was converted to a percentile for each of the seven test-scores. Each participant was categorized based on his/her number of low scoring tests in specific percentile cutoff groups (25th, 16th, 10th, 5th, and 2nd). RESULTS: Between 53% (Paraguay) and 71% (Mexico) of the sample had at least 1-score below the 25th percentile, and between 41% (Paraguay) and 55% (Cuba) scored below the 16th percentile. Between 27% (Paraguay) and 39% (Peru) scored below the 10th percentile on at least 1-score, and between 17% (Chile) and 23% (Argentina) scored below the 5th percentile. CONCLUSIONS: Clinicians should use these data to reduce false-positive diagnoses and to improve the neuropsychological assessments in Spanish-speaking individuals from LA countries.

Network Analysis of Neurobehavioral Symptom Patterns in an International Sample of Spanish-Speakers with a History of COVID-19 and Controls.

(1) Background: Psychometric network analysis provides a novel statistical approach allowing researchers to model clusters of related symptoms as a dynamic system. This study applied network analysis to investigate the patterns of somatic, cognitive, and affective neurobehavioral symptoms in an international sample of Spanish-speaking individuals with a history of COVID-19 positivity and non-COVID controls; (2) methods: the sample (n = 1093) included 650 adults from 26 countries who reported having previously tested positive for COVID-19 (COVID+) through a viral and/or antigen test (average of 147 days since diagnosis). The control group (COVID-) was comprised of 443 adults from 20 countries who had completed the survey prior to the COVID-19 pandemic; (3) results: relative to the COVID- network, the COVID+ network was very well-connected, such that each neurobehavioral symptom was positively connected to the network. The organize-to-headache and dizzy-to-balance connections in the COVID+ network were stronger than in the COVID- network. The hearing, numbness, and tense symptoms were more central to the COVID+ network with the latter connected to the sleep, fatigue, and frustrated symptoms. The COVID- network was largely disjointed, with most of the somatosensory symptoms forming their own cluster with no connections to other symptom groups and fatigue not being connected to any other symptom. The cognitive and affective symptoms in the COVID- network were also largely connected to symptoms from within their own groups; (4) conclusions: These findings suggest that many of the long-term neurobehavioral symptoms of COVID-19 form a discernable network and that headaches, frustration, hearing problems, forgetfulness, and tension are the most central symptoms. Cognitive and behavioral rehabilitation strategies targeting these central symptom network features may hold promise to help fracture the lingering symptom network of COVID-19.

Psychosocial Impacts of the COVID-19 Quarantine: A Study of Gender Differences in 59 Countries.

Background and Objectives: There is strong evidence in the literature that women experience psychological disorders at significantly higher rates than men. The higher rates of psychological disorders in women may partly be attributable to gender differences in response to stressors and coping styles. The objective of this study was to contribute to the growing body of literature investigating gender differences in mental health outcomes and coping styles during the coronavirus disease 2019 pandemic in a large sample of individuals from 59 countries with variable demographic and socio-cultural characteristics. Materials and Methods: Survey data were collected from the general population following a snowball sampling method, and the survey was promoted through social media platforms and mailing lists. Participants included 6882 individuals from the general population from 59 countries around the world. A combination of both standardized and adapted measures was used to create a survey, originally in English and then translated to Spanish, Italian, French, German, and Turkish. Results: Compared with men, women presented with higher levels of trauma-related distress; had a harder time decompressing; were more depressed, anxious and stressed; showed decreased frustration tolerance and reported lower quality of sleep and an increased likelihood of taking sleep medication or other natural sleep remedies. Overall, women tended to be more vulnerable during the pandemic in developing symptoms consistent with various forms of mental disorders such as depression, anxiety and post-traumatic distress. However, they also were more likely than men to use a variety of adaptive coping strategies, including concentrating on doing something about the situation and getting emotional support from others. Conclusions: A high prevalence of mood symptoms was noted among women. In addition to meeting the physical health needs of the population, emphasis needs to be given to mental health and the prevention of psychiatric disorders, particularly in women.

Sleeping when the world locks down: Correlates of sleep health during the COVID-19 pandemic across 59 countries.

OBJECTIVES: COVID-19 escalated into a global pandemic affecting countries around the world. As communities shut down to reduce disease spread, all aspects of life have been altered, including sleep. This study investigated changes in sleep patterns and correlates of sleep health in a global sample and examined relationships between sleep health and psychological distress. DESIGN: Cross-sectional. SETTINGS: Online survey distributed between April 19 and May 3, 2020. PARTICIPANTS: Total 6882 participants (18-94 years) across 59 countries. MEASUREMENTS: Sleep health (RU-SATED), demographics, pandemic-related factors, mood. RESULTS: More than half the sample shifted their sleep toward later bed- and wake-times, and more than a third reported increased sleep disturbances during the pandemic. Older age, being partnered, and living in a higher income country were associated with better sleep health, while a stricter level of quarantine and pandemic-related factors (being laid off from job, financial strain, or difficulties transitioning to working from home) were associated with poorer sleep health. Domestic conflict was the strongest correlate of poorer sleep health. Poorer sleep health was strongly associated with greater depression and anxiety symptoms. Participants from Latin America reported the lowest sleep health scores. CONCLUSIONS: COVID-19-associated factors have impacted sleep health on a global level. While our data are correlational, sleep health is strongly linked with mental health and could play a protective role against developing mental distress during pandemic-related isolation. Sleep health should be incorporated into public health messages aimed at helping people cope with the effects of a pandemic to maintain optimal mental and physical health.

Normative data of neuropsychological tests of attention and executive functions in Ecuadorian adult population.

OBJECTIVE: The purpose of this study was to generate normative data for five tests of attention and executive functions (M-WCST, Stroop test, TMT, BTA, and SDMT), in a group of 322 Ecuadorian adults from Quito between the ages of 18 and 85. METHOD: Multiple regression analyzes taking into account age, education, and gender were used to generate the normative data. RESULTS: Age and education were significantly related to test performance such that scores decreased with age and improved as a function of education. An online calculator is provided to generate normative test scores. CONCLUSIONS: This is the first study that presents normative data for tests of executive functions and attention in an Ecuadorian adult population. This data will improve the clinical practice of neuropsychology and help to develop the field in the country.

How the COVID-19 pandemic has changed our lives: A study of psychological correlates across 59 countries.

OBJECTIVE: This study examined the impact of the COVID-19 pandemic and subsequent social restrictions or quarantines on the mental health of the global adult population. METHOD: A sample of 6,882 individuals (Mage = 42.30; 78.8% female) from 59 countries completed an online survey asking about several pandemic-related changes in life and psychological status. RESULTS: Of these participants, 25.4% and 19.5% reported moderate-to-severe depression (DASS-21) and anxiety symptoms (GAD-7), respectively. Demographic characteristics (e.g. higher-income country), COVID-19 exposure (e.g., having had unconfirmed COVID-19 symptoms), government-imposed quarantine level, and COVID-19-based life changes (e.g., having a hard time transitioning to working from home; increase in verbal arguments or conflict with other adult in home) explained 17.9% of the variance in depression and 21.5% in anxiety symptoms. CONCLUSIONS: In addition to posing a high risk to physical health, the COVID-19 pandemic has robustly affected global mental health, so it is essential to ensure that mental health services reach individuals showing pandemic-related depression and anxiety symptoms.