Psychological and social determinants of adaptation: the impact of finances, loneliness, information access and chronic stress on resilience activation.

Background: Many people who face adversity, such as disasters, demonstrate resilience. However, less is known about reactions to large scale disasters with longer recovery periods. The concern is that protracted disasters may result in more chronic or accumulated stressors with an uncertain or unknown end point and can exhaust the natural coping methods and ability to rebound. Thus, understanding patterns of longer-term disaster recovery, inclusive of resilience, is needed. Further resilience is not individual specific rather social determinants, such as support networks and available resources, are contributing factors. Methods: The purpose of this study is to improve understanding of mental health and resilience during increased stress, we aim to identify profiles of adaptation and psychological and social determinants that predict membership within predominant symptom groupings. We conducted an exploratory cross-section study (N = 334) with two phases of multivariate analysis. Latent profile models were estimated to identify groups based on depression, anxiety, and resilience scores. The second phase included a step-wise multinomial logistic regression to predict class membership. Results: We identified four distinct groups: 33% of participants were categorized as anxious, 18% depressed, 9% comorbid, and 40% with above average levels of resilience. Psychosocial factors such as demographics, trauma history, information access, loneliness, and lack of financial resources predicted poorer mental health outcomes and lower resilience. Conclusion: This study identified factors that contribute to overall wellbeing despite chronic stressors. Social determinants of adaptation, found in this study population, include loneliness, finances, and information access. The findings from this study support the need for both psychological and social adaption supports, inclusive of mental health treatment, to strengthen resilience activation.

Psychological predictors of the time perspective: The role of posttraumatic stress disorder, posttraumatic growth, and temporal triggers in a sample of bereaved adults.

INTRODUCTION: The process of coping with loss and trauma is inextricably linked with subjective experiences and perceptions of time. The Time Perspective Framework, suggests that temporal frames influence an individual's actions, judgements, and the decisions that they make. Similarly, time perspective has been linked with psychosocial outcomes of trauma and loss (e.g. posttraumatic stress disorder). The aim of this study is to identify factors that may influence survivor's time perspective in order to determine if posttraumatic stress disorder (PTSD), posttraumatic growth (PTG), and temporal triggers (MIT) influenced different time perspective orientations. METHODS: Data was collected via Qualtrics survey between July 2019 and July 2020. Measures included basic demographic characteristics, posttraumatic stress disorder checklist, posttraumatic growth inventory, an assessment of temporal triggers, and the Zimbardo time perspective inventory. A series of OLS regression analyses were estimated. RESULTS: PTG was positively associated with future time perspective scores, whereas PTSD was associated with an increase in past negative orientation. The endorsement of temporal triggers like markers in time was negatively associated with present hedonistic scores and positively associated with future time perspective scores. Interestingly, PTSD, PTG and the endorsement of MIT were not associated with present time perspective scores. DISCUSSION AND IMPLICATIONS: Identifying the relationship between PTSD, PTG, marker in time, and time perspective may offer important insights into treatment modalities that can improve outcomes for bereaved individuals. We discuss limitations of the current analysis and make recommendations for future research.

Work Environment and Health Care Workforce Well-Being: Mental Health and Burnout in Medically Underserved Communities Prone to Disaster.

Health care workers (n = 71) completed an online survey or participated in one of five focus groups. Clinical cutoff scores revealed concerning levels of depression (16%), anxiety, and burnout (49%). Qualitative responses (n = 172) yielded two themes: work environment and well-being. Addressing burnout requires an ecological systems mindset, which accounts for complex stressors present in individual providers' lives (large-scale disasters and personal stressors), agency-level factors (scheduling and workload), and larger social and contextual administrative factors (allocating time for self-care through scheduling and billing codes). (Am J Public Health. 2024;114(S2):S156-S161. https://doi.org/10.2105/AJPH.2023.307478).

The Weaving Healthy Families program: Promoting parenting practices, family resilience, and communal mastery.

Parenting quality, family resilience, and community resilience and support have been found to be primary protective factors for the disproportionate burden of anxiety, posttraumatic stress disorder (PTSD), substance use disorder (SUD), depression, and suicide that US Indigenous youth and adults tend to experience. The purpose of this research study was to examine pilot results for outcomes related to relational factors for Indigenous family members who participated in the Weaving Healthy Families (WHF) program (translated to Chukka Auchaffi' Natana, in the Choctaw tribal language), a culturally grounded and empirically informed program geared toward promoting wellness, family resilience, parenting practices, and community resilience while also preventing SUD and violence. This nonrandomized pre-experimental pilot intervention followed a longitudinal design, which included pre-test, a post-test, and a 6-, 9-, and 12-month post-intervention follow-up surveys. Repeated-measures regressions were utilized with generalized estimating equations (GEE) to examine changes in parenting, family resilience, and communal mastery before and after the intervention for 24 adults and adolescents (12-17) across eight tribal families. Results indicate that the overall quality of parenting improved, as measured by improved parental monitoring and reductions in inconsistent discipline and corporal punishment. We identified sex differences in positive parenting, poor monitoring, and corporal punishment, with greater decreases in these measures among males over time. Family resilience and communal mastery improved for adolescent and adult participants after the WHF program. Our results indicate promising improvements across relational, familial, and community ecological, which provide clear clinical implications.

Attitudes and perceptions towards public health safety measures during a global health crisis: Social and personal consequences.

The COVID-19 pandemic that spread throughout the globe has significantly altered our social and personal relationships. During the early phase of the pandemic, pharmaceutical interventions such as vaccine research and production were still in development, with international health agencies and governments promoting public health safety measures such as limiting mobility, school and work closures, lockdowns, economic incentives, mask-wearing, social distancing, quarantine, and hygiene to reduce the spread and flatten the curve regarding transmission and hospitalization. During the early wave (May 2020 through July 2020), we utilized a qualitative longitudinal research design coupled with weekly Zoom diary entries to investigate participant (n = 14) experiences. In doing so, we captured participant attitudes towards public health safety measures, as well as perceptions of social and interpersonal relationships during the pandemic. The main themes that emerged in our findings include feelings of safety and preparedness, personal accountability and collective responsibility, and changes to social life and relationships. While individuals have learned how to live with the pandemic, and have a new sense of normalcy, lessons learned from the impact of public health measures and social relationships have applicability moving forward post-pandemic. In particular, how to best protect against the deleterious effects of isolation during a future public health crisis.

Predicting profiles of post-trauma adaptation in first responders and civilians after the 2013 Boston Marathon bombings: The role of distress, growth, and emotion regulation.

INTRODUCTION: Responses to trauma are often characterized either by the presence or absence of psychological distress; however, the process of adapting after trauma also includes potential positive change. While some studies document that the majority of individuals exposed to single event terrorism report low levels of psychological distress, more research is needed to understand different adaptation profiles following this type of trauma, and the factors that might predict responses. METHODS: We examined post-trauma responses in 257 first responders/medical professionals (66.8 percent) and civilians (33.2 percent) exposed to the 2013 Boston Marathon Bombings. Data for post-trauma profiles-post-traumatic growth (PTG), post-traumatic stress, and emotion regulation-and profile predictors-trauma proximity, trauma history, and coping flexibility-were collected approximately 2.5 years after the bombings. Latent profile analysis identified response profiles, and multinomial logistic regression identified demographic, event-specific, and psychological predictors of profile membership. RESULTS: Four profiles emerged: (1) symptomatic, (2) resistant, (3) resilient, and (4) struggling growth. First responder role decreased the odds of belonging to the struggling growth profile, as compared to the symptomatic profile. Greater coping flexibility and adaptive emotion regulation increased the odds of membership in the struggling growth, rather than symptomatic profile. CONCLUSION: A subset of individuals experiencing post-traumatic stress symptoms years after trauma exposure may also be utilizing flexible, adaptive coping strategies and experiencing PTG. First responders may have difficulty experiencing simultaneous -distress and growth, and interventions designed to promote healthy post-trauma adaptation for this population could be tailored accordingly.

Health-care Worker Engagement in Federally Qualified Health Centers and Associations with Confidence in Making Health-care Recommendations: Evidence from the Louisiana Community Engagement Alliance.

Throughout the coronavirus disease 2019 (COVID-19) pandemic, there have been numerous demands on primary care practices and providers affecting work engagement and burnout, which can affect health-care delivery and patient outcomes. We determined potentially modifiable factors associated with work engagement among employees of federally qualified health centers (FQHCs) throughout Louisiana. Resilient coping, spirituality, and social support were associated with being engaged at work. FQHC employees perceiving a more chaotic work environment and those with depressive or anxiety symptoms were less likely to be engaged at work. Being engaged was associated with confidence in COVID-19 vaccine recommendation for adults.

Centering Historical Oppression in Prevention Research with Indigenous Peoples: Differentiating Substance Use, Mental Health, Family, and Community Outcomes.

The purpose of this pilot study was to understand how historical oppression relates to changes in outcomes for people who participate in the culturally grounded Weaving Healthy Families (WHF) program (i.e., alcohol and drug use, symptoms of anxiety, parenting practices, and communal mastery [CM]). This nonexperimental and longitudinal design used repeated measures regression analysis and generalized estimating equations (GEE) to examine postintervention changes according to reported levels of historical oppression among 24 participants in eight families. How do postintervention changes differ for WHF participants reporting lower and higher levels of historical oppression? Results indicated that participants reporting lower historic oppression reported greater postintervention improvements as indicated by declines in alcohol use, anxiety, and poor parental monitoring. All participants reported increases in CM, regardless of the level of historical oppression. Given historical oppression drives psychosocial conditions, such as substance abuse, mental health, and family challenges, settler colonial oppression must be addressed within social service interventions. Social service providers must work redress historical oppression rather than replicate them. The WHF program holds promise to center structural determinants in social service programs. Future inquiries assessing longitudinal changes in perceptions of historical oppression change and how they are associated with psychosocial outcomes are needed.

Long-COVID stress symptoms: Mental health, anxiety, depression, or posttraumatic stress.

OBJECTIVE: Currently, there is no single profile of mental health sequela in long-coronavirus disease (COVID) patients, impacting identification, treatment, and exacerbating stigma among this population. This article highlights the rationale for mental health professionals to consider a summary of mental health symptoms in long-COVID patients. METHOD: This article provides an overview of the existing literature regarding the health and mental health impact of long COVID on patients and proposes an approach to conceptualizing mental health symptoms in individuals living with long COVID. This article summarizes the health and mental health impacts of long COVID and underscores the limitations of the current approach to measuring and screening mental health symptoms in long-COVID patients. RESULTS: Long-COVID patients have reported new and worsening mental health symptoms; most frequently reported are depression, anxiety, posttraumatic stress disorder (PTSD), and insomnia. The article concludes by proposing the notion of long-COVID stress symptoms and calls for mental health researchers to identify the unique and complex mental health profiles emerging among this patient population. CONCLUSIONS: Though some long-COVID patients survived life-threatening illnesses and may, therefore, meet the formal criteria for PTSD, many will present with posttraumatic symptomology that mimics PTSD but may not arise from life-threatening medical trauma. A better understanding of the mental health burden of long-COVID stress symptoms is essential to providing efficient and effective mental health treatment, supporting physicians treating long-COVID patients, and enhancing access to and utilization of medical services. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Intersectionality of Sex and Race in the Relationship Between Posttraumatic Stress Disorder and Cardiovascular Disease: A Scoping Review.

Objectives: Posttraumatic stress disorder (PTSD) has been linked with cardiovascular disease (CVD), suggesting a risk for negative health outcomes among individuals with PTSD. This review synthesizes the temporal relationship between PTSD and CVD and highlights the intersection of sex and race. Methods: Covidence was used to systematically review the literature published between 1980 and 2020. Results: 176 studies were extracted. 68 (38.64%) of the studies were a predominantly male sample. 31 studies (17.61%) were a predominantly female sample. Most reported participants of both sexes (n = 72; 40.91%) and only 5 (2.84%) did not report respondent sex. No studies reported transgender participants. 110 (62.5%) studies reported racial and ethnic diversity in their study population, 18 (10.22%) described a completely or predominantly white sample, and 48 (27.27%) did not report race or ethnicity of their study population. Conclusion: A compelling number of studies did not identify sex differences in the link between PTSD and CVD or failed to report race and ethnicity. Investigating sex, race, ethnicity, and the temporal relationship between PTSD and CVD are promising avenues for future research.

Markers in Time: Expanding Our Concept of Trauma Triggers to Include Subjective Experiences of Time Among Adults Surviving Traumatic Loss.

We outline two studies that collected exploratory data on the meaningful time approach and explore the notion of temporal triggers that emerge in the process of coping with traumatic loss. Qualitative data analysis was completed on data gathered from face-to-face interviews as well as open ended responses to an online survey. 35 themes and sub-codes were identified. 30 of these were replicated in both studies. Our data supported the notion of "markers in time" and identified three clear phases to these markers. Participants also noted the consequences of loss on their lives, and the influence of societal and religious approaches to bereavement on their process of coping. Results of this study support a cyclical approach to understanding coping with loss and provides clinicians working with bereaved individuals yet another tool to address the dynamic experience of bereavement.

Mechanisms of recovery: Community perceptions of change and growth following multiple disasters.

Introduction and purpose: The geographic location of the Gulf South leaves communities in continuous threat, response, and recovery disaster cycles. Hurricane Katrina in 2005 provided an opportunity to study disaster mental health. Less than 5 years after the storm, many Hurricane Katrina survivors were impacted again by the Deepwater Horizon Gulf oil spill. Despite adversities impacting Gulf communities, over 90% of participants reported they were resilient. The purpose of this study was to improve the understanding of the mechanisms that contribute to strengths following adversity in communities affected by repeated disasters. Specifically, we focused on survivor perceptions of personal, spiritual, or community changes in efforts to describe community resilience and posttraumatic growth (PTG). Methods: Participants were recruited through a quantitative survey and community flyers. Participants represented southeastern Louisiana, in areas impacted by hurricanes and the oil spill-for a total of five focus groups and 41 participants. Focus groups began by asking each participant to provide a brief overview of their disaster survival story and three additional guiding strengths-based questions. Data were transcribed using Dragon Speech Recognition software. A total of 963 unique responses were analyzed and coded. Results: The following themes were identified: connectedness (n = 259), coping (n = 94), spirituality (n = 60), adaptability (n = 47), and self-reliance (n = 23). Participants noted a growth mindset from the disasters and also acknowledged coinciding negative experiences (n = 154) associated with community change and loss, where subthemes included change in connectedness (n = 97), crime (n = 26), and feeling like an outsider (n = 31). Discussion and implications: These findings help scholars and mental health practitioners better understand the lived experiences of PTG in a community of survivors impacted by recurring traumatic experiences. In keeping with previous literature, PTG and negative experiences associated with trauma are not mutually exclusive, but occur simultaneously. Our results offer a holistic picture of coping with cumulative or repeated traumas and suggest that connectedness, coping, and spirituality provide important buffers to negative psychosocial outcomes.

Utilizing a Matrix Approach to Analyze Qualitative Longitudinal Research: A Case Example During the COVID-19 Pandemic.

Qualitative Longitudinal Research (QLR) is an evolving methodology used in understanding the rich and in-depth experiences of individuals over time. QLR is particularly conducive to pandemic or disaster-related studies, where unique and rapidly changing environments warrant fuller descriptions of the human condition. Despite QLR's usefulness, there are a limited number of articles that detail the methodology and analysis, especially in the social sciences, and specifically social work literature. As researchers adjust their focus to incorporate the impact of the COVID-19 global pandemic, there is a growing need in understanding the progression and adaptation of the pandemic on individuals' lives. This article provides a process and strategy for implementing QLR and analyzing data in online diary entries. In the provided case example, we explore a phenomenological QLR conducted with graduate level students during the COVID-19 pandemic (Saltzman et al., 2021), and outline a matrix framework for QLR analysis. This paper provides an innovative way in which to engage in qualitative data collection and analysis for social science research.

What's Time Got to Do With It?: A Time-Informed Approach to Longitudinal Research With Trauma Affected and Bereaved Populations.

This paper outlines a new approach to using participants' self-identified temporal triggers to center data collection around meaningful time periods as it pertains to coping with loss and trauma. We describe the utility of ecological momentary assessment and wearable technology as tools for time-informed data collection; and provide a study protocol for a recent study in which we paired these approaches to gather data from adult respondents who had lost a loved one. Data collection included two phases: a baseline phase and a target date phase. The target date phase was centered around the participant's self-identified temporal trigger. Several lmitations to this mode of data collection are disucsed. The overall approach is client centered and more accurately captures the lived experiences of individuals coping with loss and trauma. Data of this kind will begin to highlight the psychological and physiological impacts of anniversary dates among survivors of trauma and loss.

COVID-19 behavioral health and quality of life.

In addition to concern about physical health consequences of COVID-19, many researchers also note the concerning impact on behavioral health and quality of life due to disruption. The purpose of this paper is to explore pathways of COVID-19 behavioral health and quality of life. We found increased anxiety, depression, and alcohol misuse and that the pandemic exacerbated prior problems. Further community indicators also lead to poorer behavioral health and overall decreased quality of life. The nature of COVID-19 and vast reach of the virus suggests that behavioral health concerns should take a primary role in pandemic recovery.

Mental health and well-being for aging adults during the COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic remains a significant mental health crisis. Although empirical research works to better understand the impact of COVID-19 on the mental health of the general population, some groups remain at greater risk for adverse mental health consequences. The purpose of this study is to better understand how COVID-19 experiences, food insecurities, and social support are associated with mental health and well-being for aging populations. METHODS: Data collection began April 1, 2020 and continued through May 22, 2020. Study participants were recruited via website and media promotion and completed an anonymous survey. A sample of adults age 50 years and older (N = 136) were selected for the current analysis. Measures included scales of anxiety, depression, resilience, quality of life, COVID-19 experiences, interdependence, and insecurities. Three stepwise linear regression models were conducted using forward selection were estimated. RESULTS: The first model found food insecurity, community closeness, and COVID-19 experiences predicted 23% of the variance in mental health. The second model found having enough money to meet needs, COVID-19 interdependence, and age predicted 20% of the variance in resilience. The final model found having enough money to meet needs, COVID-19 experiences, community closeness, and information access predicted 45% of the variance in quality of life. DISCUSSION: Our discussion highlights the role of COVID-19 experiences, tangible resource losses, and community connection in mental health outcomes for aging populations during COVID-19. We suggest areas of future research and highlight the important role of technology in both scholarship and practice.

The impact of political violence on posttraumatic stress symptomology: a longitudinal analysis.

OBJECTIVE: The current paper uses the Conservation of Resources Theory to frame an examination of the impact of exposure to political violence on posttraumatic stress symptomology among three groups within Israeli society: (1) Native Born Jews; (2) Foreign Born Jews; and (3) Palestinian Citizens of Israel. METHODS: The study population was a large nationally representative sample of 1613 respondents collected during The Second Intifada. The sample consists of approximately 40% Jews born in Israel (n = 652), 30% (n = 484) were Jews who immigrated to Israel, and close to 30% (n = 477) were Palestinian Citizens of Israel. Mediation analyses explored the role of resource loss in the relationship between social status and posttraumatic stress disorder (PTSD) symptom severity. RESULTS: Compared to native born Jews, foreign born Jews and Palestinian Citizens of Israel reported greater PTSD symptom severity at wave III. These relationships were not mediated by psychosocial resource loss or economic resource loss. CONCLUSIONS: We discuss the importance of tailored interventions with minority groups in the context of ongoing political violence.

COVID-19 Mental Health Disparities.

Communities of color in the United States have been disproportionately impacted by the COVID-19 pandemic. Studies exploring the mental health implications of these disparities have only just begun to emerge. The purpose of this study is to better understand mental health concerns and test whether social determinants of health and COVID-19-related experiences influence these concerns. In April 2020, we launched a community-based survey for adults across the United States. A total of 341 respondents completed the survey, which included questions about demographics, depression, social isolation, work environment, and preexisting mental health conditions. We generated matched controls by adding county data from the Robert Wood Johnson Foundation to our survey. Chi square, Pearson product-moment correlation, point biserial correlation, and logistic regression were estimated. Our analysis revealed that respondents who identified as Latinx, Latin@, or Hispanic were 10 times more likely to meet the threshold score for depression. Similarly, individuals with prior mental health conditions and those who expressed feelings of social isolation due to COVID-19 were 3 times more likely to meet the threshold score for depression. These results confirm our hypothesis that communities of color will likely experience disproportionate mental health impacts of COVID-19-specifically, the mental health sequela that emerge from exposure, cumulative burden, and social isolation. We discuss the implications for expanding access and quality of health and mental health services to address current inequities.

Sex Differences in the Relationship Between Child Maltreatment, Recent Bereavement, and Average Heart Rate.

The study explores the sex differences in cardiovascular outcomes among bereaved individuals. In addition, the study differentiates the impact of child maltreatment and recent loss on the physical health of adult men and women. This study conducted a secondary analysis of data drawn from the Biomarker Subproject of the National Survey of Midlife Development in the United States (n = 1,255). Analysis included a series of regression models estimated in Stata version 15.1. A main effect for both sex and loss was observed. Both male and female respondents with loss had higher average heart rates as compared to male respondents without loss. Interestingly, being a female without loss was also associated with a higher average heart rate as compared to males without loss. The findings suggest that sex differences in cardiovascular functioning do occur and that these differences may be exacerbated by experiences of trauma and loss, and this relationship has implications for assessment and intervention.

Loneliness, isolation, and social support factors in post-COVID-19 mental health.

Social support plays a key role in well-being, yet one of the major preventative efforts for reducing the spread of COVID-19 involves social distancing. During times of crisis, social support is emphasized as a coping mechanism. This requires many people to change their typical ways of connectedness and assumes that people have existing healthy relationships or access to technology. The purpose of this article was to explore the potential impact of COVID-19 on loneliness and well-being. Social support is an important consideration for understanding the impact of COVID-19 Psychological First Aid and Skills for Psychological Recovery, which are tools used to inform response methods to help people connect during isolation and are interventions that could be adapted to COVID-specific needs for what may be a prolonged isolation and postisolation. Given the many unknowns of COVID-19, studies are needed to understand the larger behavioral health impact to ensure resources are available, current, and evidence informed. Future studies are also needed to understand how access to technology may help buffer loneliness and isolation and thus improve the social outcomes of the current pandemic. (PsycInfo Database Record (c) 2020 APA, all rights reserved).