Predictors of changing patterns of adherence to containment measures during the early stage of COVID-19 pandemic: an international longitudinal study.

BACKGROUND: Identifying common factors that affect public adherence to COVID-19 containment measures can directly inform the development of official public health communication strategies. The present international longitudinal study aimed to examine whether prosociality, together with other theoretically derived motivating factors (self-efficacy, perceived susceptibility and severity of COVID-19, perceived social support) predict the change in adherence to COVID-19 containment strategies. METHOD: In wave 1 of data collection, adults from eight geographical regions completed online surveys beginning in April 2020, and wave 2 began in June and ended in September 2020. Hypothesized predictors included prosociality, self-efficacy in following COVID-19 containment measures, perceived susceptibility to COVID-19, perceived severity of COVID-19 and perceived social support. Baseline covariates included age, sex, history of COVID-19 infection and geographical regions. Participants who reported adhering to specific containment measures, including physical distancing, avoidance of non-essential travel and hand hygiene, were classified as adherence. The dependent variable was the category of adherence, which was constructed based on changes in adherence across the survey period and included four categories: non-adherence, less adherence, greater adherence and sustained adherence (which was designated as the reference category). RESULTS: In total, 2189 adult participants (82% female, 57.2% aged 31-59 years) from East Asia (217 [9.7%]), West Asia (246 [11.2%]), North and South America (131 [6.0%]), Northern Europe (600 [27.4%]), Western Europe (322 [14.7%]), Southern Europe (433 [19.8%]), Eastern Europe (148 [6.8%]) and other regions (96 [4.4%]) were analyzed. Adjusted multinomial logistic regression analyses showed that prosociality, self-efficacy, perceived susceptibility and severity of COVID-19 were significant factors affecting adherence. Participants with greater self-efficacy at wave 1 were less likely to become non-adherence at wave 2 by 26% (adjusted odds ratio [aOR], 0.74; 95% CI, 0.71 to 0.77; P < .001), while those with greater prosociality at wave 1 were less likely to become less adherence at wave 2 by 23% (aOR, 0.77; 95% CI, 0.75 to 0.79; P = .04). CONCLUSIONS: This study provides evidence that in addition to emphasizing the potential severity of COVID-19 and the potential susceptibility to contact with the virus, fostering self-efficacy in following containment strategies and prosociality appears to be a viable public health education or communication strategy to combat COVID-19.

Mental Health and Adherence to COVID-19 Protective Behaviors among Cancer Patients during the COVID-19 Pandemic: An International, Multinational Cross-Sectional Study.

A population-based cross-sectional study was conducted during the first COVID-19 wave, to examine the impact of COVID-19 on mental health using an anonymous online survey, enrolling 9565 individuals in 78 countries. The current sub-study examined the impact of the pandemic and the associated lockdown measures on the mental health, and protective behaviors of cancer patients in comparison to non-cancer participants. Furthermore, 264 participants from 30 different countries reported being cancer patients. The median age was 51.5 years, 79.9% were female, and 28% had breast cancer. Cancer participants reported higher self-efficacy to follow recommended national guidelines regarding COVID-19 protective behaviors compared to non-cancer participants (p < 0.01). They were less stressed (p < 0.01), more psychologically flexible (p < 0.01), and had higher levels of positive affect compared to non-cancer participants. Amongst cancer participants, the majority (80.3%) reported COVID-19, not their cancer, as their priority during the first wave of the pandemic and females reported higher levels of stress compared to males. In conclusion, cancer participants appeared to have handled the unpredictable nature of the first wave of the pandemic efficiently, with a positive attitude towards an unknown and otherwise frightening situation. Larger, cancer population specific and longitudinal studies are warranted to ensure adequate medical and psychological care for cancer patients.

Patterns of Psychological Responses among the Public during the Early Phase of COVID-19: A Cross-Regional Analysis.

This study aimed to compare the mediation of psychological flexibility, prosociality and coping in the impacts of illness perceptions toward COVID-19 on mental health among seven regions. Convenience sampled online survey was conducted between April and June 2020 from 9130 citizens in 21 countries. Illness perceptions toward COVID-19, psychological flexibility, prosociality, coping and mental health, socio-demographics, lockdown-related variables and COVID-19 status were assessed. Results showed that psychological flexibility was the only significant mediator in the relationship between illness perceptions toward COVID-19 and mental health across all regions (all ps = 0.001-0.021). Seeking social support was the significant mediator across subgroups (all ps range = <0.001-0.005) except from the Hong Kong sample (p = 0.06) and the North and South American sample (p = 0.53). No mediation was found for problem-solving (except from the Northern European sample, p = 0.009). Prosociality was the significant mediator in the Hong Kong sample (p = 0.016) and the Eastern European sample (p = 0.008). These findings indicate that fostering psychological flexibility may help to mitigate the adverse mental impacts of COVID-19 across regions. Roles of seeking social support, problem-solving and prosociality vary across regions.

Inhibitory Control in Individuals with Clinical Levels of Depression and Anxiety Symptoms.

Previous research has shown that individuals suffering from depression and generalized anxiety disorder (GAD) seem to have inhibitory control deficits compared with healthy controls. However, few studies have been conducted in Spanish-speaking countries. Thus, this study aims to analyze the performance on the Stroop Color and Word Test (SCWT) between groups of Colombian participants with clinical levels of depression and GAD symptoms and a nonclinical control group. According to previous research, we expected to find significant differences in inhibitory control among groups. An ex post facto design was implemented. The SCWT was administered to a total sample of 105 individuals (64.8% women, M = 22.94 years, SD = 4.62), including 27 depressed and 15 anxious participants according to their scores on the Personal Health Questionnaire-9 and the Generalized Anxiety Disorder-7, respectively. Bayesian t-tests showed that depressed participants showed the same processing speed but lower scores on inhibitory control than healthy controls, BF = 13.70, δ = 0.50, 95% CI [0.08, 0.94]. Conversely, anxious participants showed deficits in processing speed, SCWT-Word: BF = 16.19, δ = 0.68, 95% CI [0.15, 1.24]; SCWT-Color: BF = 5.98, δ = 0.50, 95% CI [-0.01, 1.04], but not in inhibitory control compared with the nonanxious counterparts. This study provides preliminary evidence concerning the inhibitory control deficits in Colombian depressed individuals and processing speed deficits in those experiencing clinical levels of GAD symptoms.

To Help or Not to Help? Prosocial Behavior, Its Association With Well-Being, and Predictors of Prosocial Behavior During the Coronavirus Disease Pandemic.

The coronavirus disease (COVID-19) pandemic fundamentally disrupted humans' social life and behavior. Public health measures may have inadvertently impacted how people care for each other. This study investigated prosocial behavior, its association well-being, and predictors of prosocial behavior during the first COVID-19 pandemic lockdown and sought to understand whether region-specific differences exist. Participants (N = 9,496) from eight regions clustering multiple countries around the world responded to a cross-sectional online-survey investigating the psychological consequences of the first upsurge of lockdowns in spring 2020. Prosocial behavior was reported to occur frequently. Multiple regression analyses showed that prosocial behavior was associated with better well-being consistently across regions. With regard to predictors of prosocial behavior, high levels of perceived social support were most strongly associated with prosocial behavior, followed by high levels of perceived stress, positive affect and psychological flexibility. Sociodemographic and psychosocial predictors of prosocial behavior were similar across regions.

Impact of COVID-19 pandemic on mental health: An international study.

BACKGROUND: The COVID-19 pandemic triggered vast governmental lockdowns. The impact of these lockdowns on mental health is inadequately understood. On the one hand such drastic changes in daily routines could be detrimental to mental health. On the other hand, it might not be experienced negatively, especially because the entire population was affected. METHODS: The aim of this study was to determine mental health outcomes during pandemic induced lockdowns and to examine known predictors of mental health outcomes. We therefore surveyed n = 9,565 people from 78 countries and 18 languages. Outcomes assessed were stress, depression, affect, and wellbeing. Predictors included country, sociodemographic factors, lockdown characteristics, social factors, and psychological factors. RESULTS: Results indicated that on average about 10% of the sample was languishing from low levels of mental health and about 50% had only moderate mental health. Importantly, three consistent predictors of mental health emerged: social support, education level, and psychologically flexible (vs. rigid) responding. Poorer outcomes were most strongly predicted by a worsening of finances and not having access to basic supplies. CONCLUSIONS: These results suggest that on whole, respondents were moderately mentally healthy at the time of a population-wide lockdown. The highest level of mental health difficulties were found in approximately 10% of the population. Findings suggest that public health initiatives should target people without social support and those whose finances worsen as a result of the lockdown. Interventions that promote psychological flexibility may mitigate the impact of the pandemic.

Development and initial validation of the Generalized Tracking Questionnaire.

The concept of rule-governed behavior (RGB) has been used in the behavior-analytic literature as a way to analyze complex human behavior, including thinking and problem-solving. Relational frame theory suggests the existence of two main functional types of RGB termed pliance and tracking. In this paper, we describe the development of the Generalized Tracking Questionnaire (GTQ) and the preliminary evaluation of its psychometric properties and validity through three studies, with a total of 1155 participants. In Study 1, a pool of items describing the main characteristics of generalized tracking was designed and evaluated by experts on the RFT account of RGB. The resulting 11 items were administered to 460 undergraduates to examine the understandability and psychometric quality of the items. The exploratory factor analysis indicated that the GTQ can be seen as a unidimensional scale, with all items exhibiting high factor loadings and corrected item-total correlations. In Study 2, the GTQ was administered online to a sample of 464 non-clinical participants and a clinical sample of 125 participants. The one-factor model of the GTQ obtained a good fit in the conducted confirmatory factor analysis. The GTQ showed measurement invariance across gender and clinical and nonclinical participants. It also obtained excellent internal consistency and correlated in theoretically coherent ways with other constructs. In Study 3, the GTQ and a neuropsychological battery of executive functions were administered to 105 participants. The GTQ showed statistically significant, medium-size correlations with working memory tests, verbal fluency, planning, and behavioral inhibition. In conclusion, the GTQ seems to be a promising measure to advance in the empirical analysis of functional classes of RGB.

Psychometric properties and measurement invariance of the Generalized Tracking Questionnaire-children

Self-report measures of generalized patterns of rule-following are being developed in the last years including the Generalized Pliance Questionnaire (GPQ) and the Generalized Tracking Questionnaire (GTQ). Specifically, the GTQ is a 11-item self-report developed for adults that has shown excellent psychometric properties, a one-factor structure, and criterion validity in view of its positive correlations with executive functions tests. This study aims to develop the children's version of the GTQ (i.e., Generalized Tracking Questionnaire-Children, GTQ-C). In so doing, we adapted the vocabulary of some of the GTQ items and added an additional item (i.e., the GTQ-C consisted of 12 items). Afterward, the GTQ for children (i.e., GTQ-C) was administered to a sample of 730 Colombian children and adolescents from 7 to 17 years. A cross-validation study was conducted to analyze the factor structure of the questionnaire. The analysis showed that a one-factor structure showed a good fit to the data. All items of the GTQ-C showed good discrimination indexes and the whole questionnaire showed adequate internal consistency. The GTQ-C showed measurement invariance across gender and age group. In conclusion, the GTQ-C seems to be a valid and reliable measure of generalized tracking for children that might be used to analyze the developmental trajectories of tracking and its relationship with other relevant behavioral processes

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Efficacy of a two-session repetitive negative thinking-focused acceptance and commitment therapy (ACT) protocol for depression and generalized anxiety disorder: A randomized waitlist control trial.

This parallel randomized controlled trial aimed to evaluate the effect of acceptance and commitment therapy (ACT) focused on disrupting repetitive negative thinking (RNT) versus a waitlist control (WLC) in the treatment of depression and generalized anxiety disorder (GAD). Forty-eight participants with a main diagnosis of depression and/or GAD were allocated by means of simple randomization to a 2-session RNT-focused ACT intervention or to the WLC. The primary outcomes were emotional symptoms as measured by the Depression, Anxiety, and Stress Scales-21. Process outcomes included ACT- and RNT-related measures: general RNT, experiential avoidance, cognitive fusion, values, and generalized pliance. At the 1-month follow-up, linear mixed effects models showed that the intervention was efficacious in reducing emotional symptoms (d = 2.42, 95% confidence interval [1.64, 3.19]), with 94.12% of participants in the RNT-focused ACT condition showing clinically significant change in the Depression, Anxiety, and Stress Scales-21 total scores versus 9.09% in the WLC condition (70% vs. 8% in intention-to-treat analysis). The intervention effects were maintained at the 3-month follow-up. No adverse events were found. A very brief RNT-focused ACT intervention was highly effective in the treatment of depression and GAD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Psychometric properties and factor structure of the Ruminative Responses Scale-Short Form in Colombia

The Ruminative Response Scale (RRS) is the most used measure of rumination in response to depressive mood. The RRS consists of 22 items that are responded on a 4-point Likert-type scale. A 10-item version of the RRS (RRS-SF) has been developed by removing the items that overlap with items of depression measures. The RRS-SF contains two subscales (Brooding and Reflection) that showed acceptable psychometric properties in the original and Spanish version. However, the psychometric properties and factor structure of the RRS-SF have not been tested in Colombia. After warranting validity content of the Spanish version of the RRS-SF, it was administered to a total of 604 participants including a nonclinical and clinical sample. The internal consistency of both subscales was acceptable and similar to the original version. The two-factor model showed a good fit to the data and measurement invariance across samples. The clinical sample’s mean scores on the RRS-SF subscales were significantly higher than scores of the nonclinical sample. Brooding and Reflection scores were significantly related to measures of pathological worry, emotional symptoms, psychological distress, experiential avoidance, and cognitive fusion. The Spanish version of the RRS-SF showed good psychometric properties in Colombia (AU)

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