Psychometric properties of the Knowledge and Attitudes to Mental Health Scales in a Dutch sample (KAMHS-NL): A comprehensive mental health literacy measure in adolescents.

BACKGROUND: Mental health literacy (MHL) is crucial for early recognition of and coping with mental health problems, and for the use and acceptance of mental health services, leading to better health outcomes, especially in adolescence. The prevalence of mental health problems among adolescents is seen as a major public health concern and MHL is an important factor in facilitating positive mental health outcomes. However, the availability of valid measurement instruments for assessing the multifaceted nature of MHL is limited, hindering the ability to make meaningful comparisons across studies. The Knowledge and Attitudes to Mental Health Scales (KAMHS) is a promising comprehensive instrument for measuring adolescents' mental health literacy but its psychometric properties have not been explored in any other contexts than the Welsh. The aim of this study was to translate the KAMHS into Dutch, adapt it in this context, and evaluate its psychometric properties. METHODS: We performed a cross-sectional study with Dutch adolescents between the ages 11-16. We translated the KAHMS and assessed its content validity using cognitive interviewing with n = 16 adolescents. Next, n = 406 adolescents were asked to fill in the translated KAMHS-NL and reference scales, on mental health (SDQ and WHO-5), resilience (BRS), and mental health help-seeking behaviors. We assessed construct validity based on a priori hypotheses regarding convergent and divergent correlations between subscales of KAMHS-NL and the reference scales. Finally, we assessed structural validity via confirmatory factor analysis and exploratory structural equation modeling. RESULTS: The KAMHS-NL showed good content validity and satisfactory construct validity. In total, 28 of the 48 hypotheses regarding convergent and divergent correlations between the KAMHS and reference scales were confirmed. Contrary to our expectations, weak, but significant associations were found between MHL and resilience. The KAMHS showed an acceptable to good internal consistency (McDonald's omega ranging from 0.62 to 0.84). Finally, we could generally confirm the postulated structure of the KAMHS-NL in the Dutch sample with a 5-factor solution (RMSEA = 0.033; CFI = 0.96). CONCLUSIONS: The Dutch version of the KAMHS is a valid measure for detecting differences in MHL levels in adolescents. The KAMHS is a promising instrument for assessing MHL in adolescents in a multifaceted manner in other countries which may facilitate rigorous global MHL research. The instrument therefore deserves further validation research in other settings and comparisons across various cultural contexts.

The Influence of Anxiety and Avoidant Coping on Probable Cannabis Use Disorder.

Objective: Individuals with anxiety frequently use cannabis to cope and are at greater risk for developing probable cannabis use disorder (CUD). Previous literature suggests avoidant coping styles are associated with higher anxiety levels and risk for problematic cannabis use, while action-oriented coping is associated with lower anxiety and problematic cannabis use. No studies have examined whether anxiety and action-oriented coping or avoidant coping interact to influence risk for CUD, which was the aim of the present study. Method: College students were recruited as part of a cross-sectional study on cannabis use. Participants (N = 371; 72.2% female) completed the Depression Anxiety and Stress Subscale (DASS-21), Cannabis Use Disorder Identification Test-Revised (CUDIT-R), and the Brief-COPE (B-COPE). Results: The data were analyzed using logistic moderation analysis. After controlling for gender, anxiety was a positive significant predictor of probable CUD, but action-oriented coping and avoidant coping were not. The interaction between anxiety and avoidant coping on probable CUD was significant, indicating that participants with high avoidant coping (regardless of high or low anxiety) and those with high anxiety (even with low avoidant coping) were more likely to have probable CUD than those with both low anxiety and low avoidant coping. No significant interaction was observed with action-oriented coping. Conclusions: Results suggest that avoidant coping, but not action-oriented coping, influences the relationship between anxiety and risk for probable CUD. Findings emphasize the importance of targeting both anxiety and avoidant coping when considering risk for probable CUD.

The effects of the COVID-19 pandemic on perceived stress among Romanian young adults: negative affect and avoidant coping as mediators / El impacto de la pandemia COVID-19 en el estrés percibido por jóvenes rumanos: los afectos negativos y las estrategias evasivas como mediadores

Antecedentes y objetivos: Aunque se consideraba que los jóvenes estaban menos expuestos a contraer una forma severa de la infección, los efectos que ellos más resintieron fueron los psicosociales. El presente artículo se propone comprobar el papel mediador de los afectos negativos y de las estrategias evasivas, primero en la relación entre el impacto de la pandemia COVID-19 y el estrés percibido, y luego entre la amenaza percibida y el estrés. Diseño: Se utilizó un diseño transversal. Métodos: Se empleó una muestra de 669 estudiantes de grado (18 - 28 años) durante la cuarta oleada de coronavirus, cuando la variante delta era la dominante. Resultados: Se observaron asociaciones positivas entre el impacto de la pandemia COVID-19 y el estrés percibido (r = .485; p<.001), por un lado, y entre la amenaza percibida y el estrés (r = .283; p< .001), por otro lado. Los datos estadísticos demuestran que los afectos negativos y las estrategias evasivas actúan como mediadores seriales (efecto indirecto = .3349, 95% CI, [.2858; .3852] / (efecto indirecto = .2072, 95% CI, [.1515; .2624]). Consecuentemente, el impacto de la pandemia COVID-19 (β = .137; 95% CI [.0019; .0045]) y la amenaza percibida (β = .069; 95% CI [.0007; .0046]) aumentan el estrés no sólo de manera directa, sino también indirecta, intensificando los afectos negativos. Esto genera una propensión hacia el uso específico de estrategias evasivas de afrontamiento. Conclusiones: El estudio subraya algunos mecanismos explicativos en cuanto a las relaciones entre variables que afectan la salud mental durante la pandemia COVID-19.(AU)

Background and objectives:Although young adults were considered to face a lower risk of severe coronavirus infection, they were at higher risk for adverse psychosocial effects. The aim of this study was to test the me-diating roles of negative affect and avoidant coping, firstly in the relation-ship between COVID-19 impact and perceived stress, and then in the rela-tionship between perceived coronavirus threat and perceived stress. Design:Cross-sectional design. Methods: We conducted the study on a sample of 669 university students (aged between 18-28), during the critical fourth wave, when the delta variant was the dominant strain. Results: The results indicate significant positive associations between the impact of COVID-19 and perceived stress (r = .485; p<.001), and between perceived corona-virus threat and perceived stress (r= .283; p<.001). Our findings demon-strate that negative affect and avoidant coping serially mediate these rela-tionships (total indirect effect = .3349, 95% CI, [.2858; .3852] / (total indi-rect effect = .2072, 95% CI, [.1515; .2624]). Thus, the impact of COVID-19 (β= .137; 95% CI [.0019; .0045]) and perceived coronavirus threat (β= .069; 95% CI [.0007; .0046]) induce an increase in stress not only directly, but also indirectly, through amplified negative affect, which in turn in-creases the specific-oriented use of avoidant coping strategies. Conclusions:Our results highlighted some new explanatory relationships between varia-bles that affect mental health during the COVID-19 pandemic.(AU)

Emotional regulation and suicidal ideation-Mediating roles of perceived social support and avoidant coping.

Introduction: Recent research has uncovered a wide prevalence variation of suicidal ideation in university students ranging from 9.7% to 58.3%. India has witnessed a 4.5% increase in suicide rates in the year 2021. The interplay between cognitive reappraisal of a stressful situation, suppression of emotional expression, and coping strategies for suicidal ideation of Indian University students is yet to be explored. We aim to determine whether suicidal ideation would differ across different types of family units, and to predict the extent to which perceived social support and avoidant coping could mediate the relation between emotion regulation processes and suicidal ideation. Methods: Two hundred randomly selected University students (Mean age = 19.9, SD = 1.43) participated. Kruskal-Wallis, Pearson's product-moment correlation, and GLM mediation model were computed. Results and discussion: Lifetime suicidal ideation significantly differed between those who stay alone and those who live in a nuclear family (p < 0.01), and also those who stay in a joint family (p < 0.05). Cognitive reappraisal predicted a reduction in suicidal ideation mediated by perceived social support (B = -0.06, p < 0.05) and avoidant coping (B = -0.07, p < 0.05). Whereas, expressive suppression predicted induced levels of suicidal ideation through perceived social support (B = 0.05, p < 0.05), and avoidant coping (B = 0.06, p < 0.05) as mediators. Conclusion: Though our sample size restricts the generalization, our findings implied the importance of regular psychological consultation regarding the efficacy of the said coping processes in dealing with suicidal ideation.

Changes in guilt cognitions mediate the effect of trauma-informed guilt reduction therapy on PTSD and depression outcomes.

OBJECTIVE: Trauma-informed guilt reduction therapy (TrIGR), a six-session cognitive behavioral therapy targeting trauma-related guilt and distress, reduces guilt and symptoms of posttraumatic stress disorder (PTSD) and depression, yet little is known regarding how and why TrIGR may be effective. METHOD: This study examined treatment-related changes in avoidant coping and trauma-related guilt cognitions as possible mediators of treatment effects on PTSD and depression outcomes at 3- and 6-month follow-up. Data were from a randomized controlled trial for treatment of trauma-related guilt comparing TrIGR and supportive care therapy among 145 post-9/11 US veterans (Mage = 39.2 [8.1], 93.8% male). RESULTS: At pretreatment, most (86%) met PTSD criteria. Intent to treat analyses using parallel mediation models indicated changes in guilt cognitions, but not avoidant coping, mediated the effect of TrIGR on reducing PTSD severity at 3-month (a × b = -0.15, p < 0.01, 95% CI: [-0.24 to -0.06], p = 0.001) and 6-month (a × b = -0.17, 95% CI: [-0.26 to -0.07], p = 0.001) follow-up. Similarly, changes in guilt cognitions, but not avoidant coping, mediated the effect of TrIGR on reducing depression severity at 3-month (a × b = -0.10, 95% CI: [-0.18 to -0.02], p = 0.02) and 6-month (a × b = -0.11, 95% CI: [-0.20 to -0.03], p = 0.01) follow-up. CONCLUSIONS: Compared to guilt cognitions, changes in avoidant coping were less integral to downstream PTSD and depression symptom reduction. Guilt cognition change may be a salient active ingredient of PTSD and depression treatment for those with trauma-related guilt and a key therapy element to which providers should be attuned.

Variables implicadas en la abstinencia de alcohol a largo plazo: cuáles son y cuándo juegan un papel más importante / Variables involved in the long-term alcohol abstinence: Which variables are involved and at what point of time?

Diversas variables psicológicas están implicadas en el pronóstico de los pacientes con dependencia de alcohol, durante el tratamiento y después del alta. Sin embargo, aún no conocemos el papel que juegan estas variables en la consecución y mantenimiento de la abstinencia y, si éstas, se modifican a lo largo del tiempo. Metodología: Se recogieron datos longitudinalmente relacionados con ansiedad, depresión, impulsividad, estrategias de afrontamiento, sentido de la vida (SV) y asistencia a las asociaciones de ayuda-mutua (AM) de pacientes ambulatorios con dependencia de alcohol (N=159, 66% varones, edad media=42.54 años). Se realizaron evaluaciones basalmente, al alta (después de 2 años de tratamiento), a los 2 y a los 4 años después del alta. Las variables relacionadas con el consumo de alcohol fueron evaluadas con el método Timeline Followback. Resultados: En la evaluación basal, el estilo de afrontamiento evitativo y la impulsividad se asociaron con los meses de abstinencia acumulada a los 4 años. Al alta, y a los 2 años de seguimiento, las puntuaciones altas en el SV se asociaron con los meses de abstinencia acumulada a los 4 años. Los modelos de mediación encontraron que el SV incrementaba los meses de abstinencia acumulada a los 4 años a través del estilo de afrontamiento evitativo y una reducción de los niveles de depresión. Conclusiones: El SV es un componente determinante en la abstinencia a largo plazo. Dado que las asociaciones de AM promueven el SV, éstas deberían ser recomendadas como una parte esencial de un tratamiento integrado de la dependencia de alcohol. (AU)

Several psychological variables have been associated with the prognosis during alcohol dependence treatment and after discharge. However, we still do not know the role that these variables play in the achievement of abstinence and if they modify throughout time. Method: Longitudinal survey data related to anxiety, depression, impulsivity, coping, meaning in life (MiL) and attendance to mutual-help groups were collected from outpatients with alcohol dependence (N= 159, 66% male, mean age=42.54 years). Assessment points were the following: baseline, at discharge (after 2-years of treatment), and 2-years and 4-years follow-up after discharge. Drinking outcomes were evaluated with the Timeline Followback Method Assessment. Results: At baseline, levels of avoidance coping and impulsivity were associated with months of accumulated abstinence at 4-years-follow-up. However, at discharge and at two-years follow-up, higher scores in MiL were consistently associated with months of accumulated abstinence at 4-years of follow-up. Mediation models showed that MiL increased accumulated abstinence at 4 years-follow-up by increasing avoidance coping and reducing levels of depression. Conclusions: MiL is a determining component in the long-term sustained abstinence. Our results support the key role of MiL and point to a new mechanism through which it influences the maintenance of sobriety. Because mutual-help groups have consistently demonstrated to promote MiL, they should be implemented and recommended as an essential part of an integrated treatment of alcohol dependence. (AU)

Variables involved in the long-term alcohol abstinence: Which variables are involved and at what point of time? / Variables implicadas en la abstinencia de alcohol a largo plazo: cuáles son y cuándo juegan un papel más importante

Diversas variables psicológicas están implicadas en el pronóstico de los pacientes con dependencia de alcohol, durante el tratamiento y después del alta. Sin embargo, aún no conocemos el papel que juegan estas variables en la consecución y mantenimiento de la abstinencia y, si éstas, se modifican a lo largo del tiempo. Metodología: Se recogieron datos longitudinalmente relacionados con ansiedad, depresión, impulsividad, estrategias de afrontamiento, sentido de la vida (SV) y asistencia a las asociaciones de ayuda-mutua (AM) de pacientes ambulatorios con dependencia de alcohol (N=159, 66% varones, edad media=42.54 años). Se realizaron evaluaciones basalmente, al alta (después de 2 años de tratamiento), a los 2 y a los 4 años después del alta. Las variables relacionadas con el consumo de alcohol fueron evaluadas con el método Timeline Followback. Resultados: En la evaluación basal, el estilo de afrontamiento evitativo y la impulsividad se asociaron con los meses de abstinencia acumulada a los 4 años. Al alta, y a los 2 años de seguimiento, las puntuaciones altas en el SV se asociaron con los meses de abstinencia acumulada a los 4 años. Los modelos de mediación encontraron que el SV incrementaba los meses de abstinencia acumulada a los 4 años a través del estilo de afrontamiento evitativo y una reducción de los niveles de depresión. Conclusiones: El SV es un componente determinante en la abstinencia a largo plazo. Dado que las asociaciones de AM promueven el SV, éstas deberían ser recomendadas como una parte esencial de un tratamiento integrado de la dependencia de alcohol. (AU)

Several psychological variables have been associated with the prognosis during alcohol dependence treatment and after discharge. However, we still do not know the role that these variables play in the achievement of abstinence and if they modify throughout time. Method: Longitudinal survey data related to anxiety, depression, impulsivity, coping, meaning in life (MiL) and attendance to mutual-help groups were collected from outpatients with alcohol dependence (N= 159, 66% male, mean age=42.54 years). Assessment points were the following: baseline, at discharge (after 2-years of treatment), and 2-years and 4-years follow-up after discharge. Drinking outcomes were evaluated with the Timeline Followback Method Assessment. Results: At baseline, levels of avoidance coping and impulsivity were associated with months of accumulated abstinence at 4-years-follow-up. However, at discharge and at two-years follow-up, higher scores in MiL were consistently associated with months of accumulated abstinence at 4-years of follow-up. Mediation models showed that MiL increased accumulated abstinence at 4 years-follow-up by increasing avoidance coping and reducing levels of depression. Conclusions: MiL is a determining component in the long-term sustained abstinence. Our results support the key role of MiL and point to a new mechanism through which it influences the maintenance of sobriety. Because mutual-help groups have consistently demonstrated to promote MiL, they should be implemented and recommended as an essential part of an integrated treatment of alcohol dependence. (AU)

A randomised controlled trial evaluating the Guide Cymru mental health literacy intervention programme in year 9 (age 13-14) school pupils in Wales.

BACKGROUND: Adolescent mental health has become a public health concern as 10-20% of adolescents have experiences with mental health problems. Improving mental health education is critical to reducing stigma and improving access to appropriate care when needed. Here we examine the impact of a mental health literacy programme (Guide Cymru) in young adolescents in the UK. A randomised controlled trial assessed the effectiveness of the Guide Cymru intervention. METHOD: A total of 1,926 pupils (860 males and 1066 females) aged 13-14 (year 9) took part in the study. The secondary schools were randomised into the active and control arms of the study. Teachers in the active arm of the study were trained on the Guide Cymru and then delivered the intervention to their pupils. Pupils in the active groups received six modules of mental health literacy (the Guide Cymru), and control schools received teaching as usual. Mental health literacy across several domains (e.g., knowledge, stigma, help-seeking intentions) were assessed both before and after the intervention. Data collection for the randomised controlled trial ran from September 2019 to March 2020. Multi-level modelling analysis was conducted to account for the clustered nature of the design. RESULTS: All aspects of mental health literacy, including mental health knowledge (g = 0.32), good mental health behaviours (g = 0.22), mental health stigmas (g = 0.16), intentions to seek help (g = 0.15), and avoidant coping (g = 0.14) improved after completing the Guide Cymru programme (ps < .001). DISCUSSION: The current study presents evidence for the Guide Cymru's effectiveness in improving secondary school pupils' mental health literacy. We demonstrate that providing teachers with appropriate resources and training to deliver the Guide Cymru programme within their classrooms can improve the mental health literacy of pupils. These findings have important implications for the beneficial impacts the secondary school system can have on reducing the burden of mental health problems at a critical point in a young person's life. TRIAL REGISTRATION: ISRCTN15462041. Registered 03/10/2019.

Psychological Capital and Quality of life of Refugees in Uganda During COVID-19 Pandemic: A Serial Mediation Model.

Background: The COVID-19 pandemic has in the past two years caused and continues to cause enormous effects on lifestyle, mental health, and quality of life. With no known treatment and vaccination, behavioral control measures became central in controlling the pandemic. However, the intensity of the pandemic and the stringent control measures were immensely stressful. The control measures became an added psychological burden to people living in precarious situations such as refugees in low-income countries. Purpose: Given the benefits of psychological capital, the present study aimed at investigating the role of psychological capital in enhancing the quality of life among refugees in Uganda during the COVID-19 pandemic. It was hypothesized that the effects of psychological capital on quality of life are serially mediated through coping strategies, adherence to COVID-19 control measures, and mental health. Methods: Data was collected using a self-administered questionnaire in July and August 2020 after the first lockdown. Participants were 353 South Sudanese and Somali refugees living in Kampala city suburbs and Bidibidi refugee settlement. Findings: Psychological capital was positively associated with approach coping, mental health, and quality of life. However, psychological capital was negatively associated with adherence to COVID-19 control measures. Significant indirect effects of psychological capital on quality of life through approach coping, mental health, and adherence were found. However, serial mediation effects were only substantial via approach coping and mental health. Conclusion: Psychological capital is an important resource in coping with the challenges posed by COVID-19 and maintaining a good level of psychological functioning and quality of life. Preserving and boosting psychological capital is essential in responding to COVID-19 and other related disasters and crises, which are common in vulnerable populations such as refugee communities in low-income countries.

Cognitive Avoidance Is Associated with Decreased Brain Responsiveness to Threat Distractors under High Perceptual Load.

Cognitive coping strategies to deal with anxiety-provoking events have an impact on mental and physical health. Dispositional vigilance is characterized by an increased analysis of the threatening environment, whereas cognitive avoidance comprises strategies to inhibit threat processing. To date, functional neuroimaging studies on the neural underpinnings of these coping styles are scarce and have revealed discrepant findings. In the present study, we examined automatic brain responsiveness as a function of coping styles using functional magnetic resonance imaging. We administered a perceptual load paradigm with contemptuous and fearful faces as distractor stimuli in a sample of N = 43 healthy participants. The Mainz Coping Inventory was used to assess cognitive avoidance and vigilance. An association of cognitive avoidance with reduced contempt and fear processing under high perceptual load was observed in a widespread network including the amygdala, thalamus, cingulate gyrus, insula, and frontal, parietal, temporal, and occipital areas. Our findings indicate that the dispositional tendency to divert one's attention away from distressing stimuli is a valuable predictor of diminished automatic neural responses to threat in several cortical and subcortical areas. A reduced processing in brain regions involved in emotion perception and attention might indicate a potential threat resilience associated with cognitive avoidance.

Associations of psychological inflexibility with posttraumatic stress disorder and adherence to COVID-19 control measures among refugees in Uganda: The moderating role of coping strategies.

Refugees are vulnerable to developing mental health problems. The unprecedented appearance and rapid spread of COVID-19 exacerbated this vulnerability, especially in low-income countries where refugees survive on humanitarian aid and live in congested settlements. These appalling living conditions are a stressor, making adherence to COVID-19 control measures impractical and an additional psychological strain for refugees. The present study examined how psychological inflexibility is associated with adherence to COVID-19 control measures. A sample of 352 refugees from Kampala City and Bidibidi settlements were recruited. Refugees with high levels of psychological inflexibility reported higher PTSD symptom severity and low adherence to COVID-19 control measures. Moreover, PTSD severity mediated the association between psychological inflexibility and adherence, while avoidance coping moderated both direct and indirect effects. Interventions for reducing psychological inflexibility and avoidance coping may be essential in boosting adherence to measures relevant to the current and future status of the pandemic, along with other crises that refugees face.

Coping strategies and personal growth: The case of Palestinian refugees in Shatila camp, Lebanon.

This study investigated the relationship between coping strategies used by adolescent refugees in the Palestinian refugees' Shatila camp in Lebanon and posttraumatic growth. Moreover, the study explored and predicted the impact of coping strategies utilized by adolescent Palestinians in Shatila camp, Lebanon on their personal growth and psychological well-being. Data were collected using two questionnaires and a checklist: (a) LEC-5 checklist as an assessment tool to make sure that all the participants have faced or experienced stressful events, (b) questionnaires including the Ways of Coping Questionnaire (WCQ) to find out the style of coping refugees used, and (c) Posttraumatic Growth Inventory (PTGI) to identify the factors of growth refugees developed as a result of using different coping strategies. Sixty adolescent refugees at one of the centers in the camp (31 females and 29 males) who benefited from counseling services participated in the study. Adolescent refugees' performance on the checklist and questionnaires revealed the prevalence of stressors among the refugees. The coping strategies mostly utilized were problem-focused coping strategies, as there was a correlation between its factors and some coping strategies, and there were coping strategies used that predict the development of growth among. Finally, as for the counseling and training programs and services, interventions and guidance services seem to better prepare refugees to handle and cope with the stress that they encounter to develop personal growth.

Family Communication and Psychological Distress in the Era of COVID-19 Pandemic: Mediating Role of Coping.

This study aims to examine the association between family communication and psychological distress with coping as a potential mediator. The study also developed and validated the Family Communication Scale (FCS) in the context of COVID-19 pandemic. Participants (n = 658; 74.9% female) were general public ranged in age between 18 and 58 years (mean age = 26.38, SD = 10.01). The results showed that family communication directly influenced psychological distress and indirectly influenced through approach coping. However, avoidant coping was not directly associated with psychological distress, nor did it mediate the association between family communication and psychological distress. The findings suggest that people, who have better family communication, highly engage in approach coping which in turn leads to better psychological health in face of adversity. The findings have important empirical and theoretical implications.

Racial Disparities in Avoidant Coping and Hypertension Among Midlife Adults.

While associations between stress and hypertension have been documented, little research has examined the association between coping and hypertension, especially in the context of understanding racial disparities. Utilizing data from the CHDS-DISPAR study, we examine the association between avoidant coping and hypertension among adults age 50 while assessing for potential differences across (1) coping in response to the general stress and discrimination and (2) African American and White racial groups. Coping was measured using a 9-item scale with an avoidant coping subscale (e.g., drinking alcohol). Mean avoidance coping scores were calculated for both general stress and discrimination. No racial differences in avoidant coping were found. Within our sample (n = 414), there was a high burden of hypertension among African American respondents compared to White respondents (50.3% vs. 22.6%). Models assessed associations between avoidant coping and hypertension adjusted for sociodemographic factors, obesity, and either experience of stress or discrimination depending on the coping domain examined. Avoidant coping in response to the general stress and discrimination was associated with increased hypertension among White respondents (PR: 1.63 [95%CI 1.01, 2.24]; PR: 1.69 [95%CI 1.12, 2.26], respectively) and no associations among African American respondents (PR: 0.83 [95%CI 0.57, 1.09]; PR: 0.82 [95%CI 0.52, 1.12], respectively). This research suggests that racial disparities in hypertension may not be attributable to individual-level coping behaviors.

Mental Health Status, Coping Strategies During Covid-19 Pandemic Among Undergraduate Students of Healthcare Profession.

The present study aimed to assess the prevalence of psychological distress, associated lifestyle behaviors, and associated coping strategies among the students of healthcare profession. A total of 588 medical, dental, and nursing students studying in institutes of health sciences, KIIT University, Bhubaneswar, India participated in this cross-sectional online survey during September-October, 2020. A semi-structured questionnaire, DASS-21questionnaire, and Brief COPE were used to collect relevant information. The proportion of students experiencing symptoms of depression, anxiety, and stress was 26.2%, 27.7%, and 9.7%, respectively. Body mass index, presence of comorbidity, and soft drink consumption were significantly associated with psychological distress. Students experiencing psychological distress were applying emotion-focused coping behaviors (venting, acceptance, self-blame, substance use, religion) and avoidant coping behaviors (self-distraction, behavioral disengagement, denial). The prevalence of psychological distress among the students of health profession studying in KIIT University of Bhubaneswar during the period of Covid-19 pandemic is low and it can be further lowered by designing appropriate interventions incorporating healthy lifestyle behaviors and suitable coping strategies thereby ensuring sound mental health of these students.

Job stress and depression among Malaysian anti-drug professionals: The moderating role of job-related coping strategies.

Depression can cause negative consequences to workers' health and social functioning, such as poor work productivity, mental disorders, and suicide. Existing studies have argued that job stress is closely related to depression in many professions. Yet, information on how coping strategies play a significant role in the relationships among Malaysian anti-drug professionals is still scarce. Thus, the aim of this study was to examine to what extent coping strategies moderate the relationship between job stress and depression among Malaysian anti-drug professionals. A total of 3,356 National Antidrug Agency (NADA) officers aged between 21 and 59 years completed online self-report measures of depression, job stress, and job-related control coping and avoidant coping behaviors. The results showed that job stress was strongly correlated with depression, and both coping strategies were found to significantly moderate the correlations. The correlations between stress and depression were stronger among participants who had higher levels of avoidant coping or those who had lower levels of control coping. To conclude, this study highlights the importance of considering job stress and coping behaviors to understand anti-drug professionals' mental health during this challenging COVID-19 pandemic.

The Moderating Roles of Resilience and Coping Strategy on Well-Being of Victimized Forensic Workers.

Previous research on workplace victimization has often disregarded forensic psychiatric populations and not yet been extended to the coronavirus pandemic. The present study expected the isolation of the government-issued lockdown to increase aggressive behavior in forensic patients, ultimately decreasing the general well-being of victimized forensic workers. Possible buffering protective factors (resilience and active coping) and enhancing risk factors (avoidant coping and passive coping) were investigated with the intention of optimizing the general well-being of at-risk forensic workers. The valid sample (N = 311) consisted of Dutch and Belgian forensic workers (74.6% females) with at least 9 hours of weekly patient contact, and with a mean age of 37.99 (SD = 12.20). Participants reported the number of violent incidents in the past 2 months, as well as completed a questionnaire battery including measures of well-being, resilience, and coping strategies. A significant increase of victimization during the lockdown compared to after it was lifted was found, however, the study did not find evidence to support that this negatively influenced the worker's general well-being. Active coping was found to be a significant moderator and protective factor for the general well-being of victimized forensic workers. In contrast, resilience, avoidant and passive coping were not significant moderators in this association. The present study has valuable clinical implications that could lead to preparatory and preventative measures for forensic workers at risk of being victimized. Future research may investigate constructs such as life satisfaction and post-traumatic growth, as well as be broadened into prison populations.

Male-Type Depression Mediates the Relationship between Avoidant Coping and Suicidal Ideation in Men.

Despite known links between men's avoidant coping behaviours (e.g., distraction, denial, substance use) and suicide risk, little research has explored the mechanisms underpinning this relationship. This study sought to examine whether male-type depression symptoms (e.g., anger, aggression, emotion suppression), assessed by the Male Depression Risk Scale, mediate the association between avoidant coping and suicide/self-harm ideation in men. Data were drawn from an online survey of a community sample of 606 Australian men (M age = 50.11 years; SD = 15.00), conducted during the COVID-19 pandemic. Mediation analyses were applied to examine the effect of male-type depression on the association between avoidant coping and suicidal/self-harm ideation, controlling for age, resilience and the experience of two psychosocial stressors during the COVID-19 pandemic (financial stress and government restrictions). Avoidant coping was associated with suicidal/self-harm ideation, r = 0.45, p < 0.001. Results supported a mediating role of male-type depression symptoms in this relationship, R2= 0.29, PM = 0.36, p < 0.001, underscoring the importance of screening for male-type depression symptoms to better identify men at risk of suicidal/self-harm ideation. Results also suggest a need to support men to develop effective coping strategies, particularly in the context of common psychosocial stressors experienced during the COVID-19 pandemic and beyond.

Coping With Anxiety: Brain Structural Correlates of Vigilance and Cognitive Avoidance.

Background: Individuals differ in their dispositional coping behavior when they are confronted with anxiety-provoking situations. Cognitive avoidance is characterized by a withdrawal from threatening information, whereas vigilance denotes the intensive search for threat-related information. Functional neuroimaging studies indicate alterations in brain responsivity to emotional stimuli as a function of cognitive avoidant and vigilant coping, but findings are partially discrepant. Studies on structural correlates of coping styles are scarce. Materials and Methods: By using structural magnetic resonance imaging, the present study examined the relationship between brain gray matter volume and coping strategies in 114 healthy individuals. Individual differences in vigilance and cognitive avoidance were measured by the Mainz Coping Inventory. Results: Exploratory whole-brain analyses were conducted. Cognitive avoidant coping significantly predicted reduced gray matter volume in the bilateral thalamus, whereas vigilant coping was associated with volumetric increases in the bilateral thalamus. These relationships remained significant when controlling for a potential influence of age, sex, depressive symptoms, and trait anxiety. Discussion: Our findings indicate that dispositional strategies to deal with anxiety-provoking situations are related to volumetric alterations in the thalamus, a brain structure that has been implicated in the mediation of attentional processes and alertness, and the anticipation of harm. The dispositional tendency to monitor the environment for potential threats (i.e., vigilance), appears to be associated with volumetric increases in the thalamus, whereas the dispositional inclination to divert one's attention away from distressing stimuli (i.e., cognitive avoidance) seems to go along with reductions in thalamic gray matter density.

Interaction Effects of DRD2 Genetic Polymorphism and Interpersonal Stress on Problematic Gaming in College Students.

Problematic gaming has become a public concern, influenced both by genetic factors and stressful environments. Studies have reported the effects of dopamine-related genes and interpersonal stressors on problematic gaming, but gene and environment interaction (G × E) studies have not been conducted. In this study, we investigated the interaction effects of dopamine receptor D2 (DRD2) polymorphisms and interpersonal stress on problematic gaming and the mediating effect of avoidant coping to reveal the mechanism of the G × E process. We recruited 168 college students (mean age = 22; male 63.1%) and genotyped their DRD2 C957T (rs6277) and Taq1 (rs1800497) polymorphisms. The results of the mediated moderation analysis showed that, when experiencing interpersonal stressors, individuals with both the C957T T allele and the Taq1 A1 allele showed more elevated problematic gaming scores than non-carriers. Moreover, the interaction effect of the combined DRD2 polymorphisms and interpersonal stress was significantly mediated by avoidant coping. These findings suggest that the influence of interpersonal stress on problematic gaming can be changed as a function of DRD2 genotypes, which may be because of the avoidant coping styles of C957T T allele and Taq1 A1 allele carriers in response to stress.