Impact of the COVID-19 Pandemic on U.S. Women's Mental Health.

Background: Women are more likely than men to be diagnosed with depression and anxiety with rates increasing since the COVID-19 pandemic. This study sought to understand how women's intersecting identities, personal strengths, and COVID-19-related stressors were associated with their anxiety, depression, and post-traumatic stress disorder (PTSD) symptoms early in the pandemic. Methods: During May-June 2020, American women (N = 398) recruited via MTurk completed an online questionnaire assessing mental health (PTSD, anxiety, and depression), demographic characteristics, personal strengths (coping, hope, social support), and experiences with COVID-19-specific stressors. Results: Women who had a child younger than 18 years of age, lived in rural or urban areas (compared with suburban), and identified as sexual minority reported increased levels of PTSD, depression, and anxiety symptoms. Social support and hope (Agency) were associated with fewer mental health symptoms. Engagement in maladaptive coping and greater perception of COVID-19 threat and perceived stress was associated with more PTSD, depression, and anxiety symptoms. COVID-19-related illness events and difficulty accessing living essentials were associated with increased anxiety symptoms. COVID-19-related disruption to living and income were associated with increased PTSD symptoms. Loneliness was associated with increased anxiety and depression symptoms. Conclusions: Results of this study can inform prevention and intervention efforts to address depression and anxiety among women with intersecting identities during times of stress. Specifically, supporting the development of women's resilience and adaptive coping and intervening to address maladaptive coping strategies, such as drinking, provide paths to supporting women's mental health.

American Women's Experiences With Intimate Partner Violence during the Start of the COVID-19 Pandemic: Risk Factors and Mental Health Implications.

In an online survey, women self-reported high prevalence of intimate partner violence during the early days of the pandemic. Risk factors for experiencing intimate partner violence (IPV) included having a child under the age of 18, being a sexual minority, living in a rural community, and stressors related to healthcare access, income/employment stress, and COVID-19 exposure or illness. Women who worked during the pandemic and were older were less likely to experience IPV. Women who reported IPV also reported increased anxiety and depression. The results are discussed in terms of clinical and policy implications for supporting women who are victims of IPV.

Health sciences students' career commitment, mental health, and physical activity during the COVID-19 pandemic.

Objective: To understand the biopsychosocial dimensions of university health sciences students' experiences during the COVID-19 pandemic. Participants: Health sciences students (n = 297) from two universities in July and August 2020. Methods: Participants completed a Web-based survey asking about depression, anxiety, physical activity, coronavirus threat, and career commitment. Results: Moderate or severe depression and anxiety were reported by 28.6% and 31.3% of respondents, respectively. Depression and anxiety were positively correlated with perceived coronavirus threat and negatively correlated with career commitment and strenuous physical activity. A change in career commitment interests during the COVID-19 pandemic was reported by 11% of respondents. Conclusions: Identified factors that could be targeted by universities to support their students and secure career commitment include online learning challenges, ability to secure clinical placements, mental health (anxiety and depression), financial challenges, family pressure, and promotion of physical activity.

Habit and diabetes self-management in adolescents with type 1 diabetes.

OBJECTIVE: The development of habit (i.e., behavioral automaticity, the extent to which a behavior is performed with decreased thresholds for time, attention [effort], conscious awareness, and goal dependence), for goal-directed health behaviors facilitates health behavior engagement in daily life. However, there is a paucity of research examining automaticity for Type 1 diabetes self-management in adolescence. This study examined if greater perceived automaticity for diabetes self-management was associated with increased daily self-management, decreased daily self-regulation failures in glucose checking, and more optimal daily glycemic levels in adolescents with Type 1 diabetes. METHOD: Adolescents aged 13-17 and diagnosed with Type 1 diabetes (n = 79) completed the Self-Report Behavioral Automaticity Index, a measure of automaticity of diabetes self-management (i.e., automaticity of glucose checking, carbohydrate counting, and insulin dosing), and a measure of perceived self-management at baseline. One to 3 months later, a subsample of teens (n = 42) also completed a daily diary for a 7-day period including perceptions of daily self-management, daily self-regulation failures in glucose checking, and daily glucose levels. RESULTS: Greater overall automaticity of diabetes self-management was associated with greater baseline and daily self-management, fewer daily self-regulation failures in glucose checking, and lower average daily mean blood glucose levels but not more optimal daily variations in blood glucose levels. CONCLUSIONS: Greater automaticity for diabetes self-management may support more optimal daily diabetes self-management in adolescence. Further research is needed to clarify the benefits and mechanisms of automaticity and explore possible interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Exploring American Parents' Lived Experiences During the COVID-19 Pandemic: Ramifications for Well-Being.

OBJECTIVE: The objective of this study was to document the direct impact of the COVID-19 pandemic on parents and families in the United States. METHODS: Parents' experiences during the pandemic were examined using an online survey (N = 564) collected during May and June 2020. RESULTS: Parents reported experiencing a high frequency of COVID-19-related events (e.g., job loss and health concerns) and impact on their lives. Parents' experiences with COVID-19, as well as self-reported perceived increase in home labor, experiences with assisting children with remote schooling, and work-life conflict were all significantly associated with higher levels of parental role overload. COVID-19-related events and impact, as well as parental role overload, significantly predicted parents' anxiety and depression, even after controlling for demographic factors. CONCLUSIONS: The findings suggest the importance of providing support for parents and families through direct services and public policy changes.

Effectiveness of groups for adolescents with type 1 diabetes mellitus and their parents.

Peer- and family-based group therapies have been used as separate interventions to improve adjustment and self-management among youth with Type 1 diabetes mellitus. This study replicates a treatment protocol that combined these two types of diabetes management groups, while also using a wait-list control design methodology within an outpatient mental health clinic setting. General psychosocial and diabetes-related variables were assessed at baseline, immediately posttreatment, and 4 months posttreatment. Youths' medical information, including metabolic control values, was extracted from medical charts for the 6 months prior to baseline and 6 months after treatment ended. At 4 months posttreatment, parents and youth reported increased parent responsibility, and parents reported improved youth diabetes-specific quality of life. Although there were no statistically significant changes in hemoglobin A1c values and health care utilization frequency from 6 months prior to and 6 months posttreatment, other psychosocial changes (i.e., increases in parent responsibility and diabetes-specific quality of life) were documented. Therefore, this treatment was found to be a promising intervention for use in an outpatient clinical setting to aid in improving the psychosocial functioning of youth with Type 1 diabetes mellitus.

Exploratory analysis of the relationships among different methods of assessing adherence and glycemic control in youth with type 1 diabetes mellitus.

OBJECTIVES: The present study examined four methods of assessing diabetes adherence (self-report, diary measure, electronic monitoring, and provider rating) within a population of youth with Type I Diabetes Mellitus (T1DM). METHODS: Comparisons were conducted among the four methods of assessing diabetes adherence. Associations among the seven different measures of blood glucose monitoring (BGM) and HbA1c were examined. An exploratory stepwise regression analysis was conducted to determine the best predictors of glycemic control (i.e., Hemoglobin A1c; HbA1c) while controlling for relevant demographic variables. RESULTS: The adherence measures appeared to be interrelated. The relationships between many of the BGM measures and HbA1c demonstrated a medium effect size. The Self Care Inventory (SCI) adjusted global score was the strongest predictor of HbA1c, even after taking the demographic variables into account. CONCLUSIONS: The SCI is a robust, easy-to-use, and cost-efficient measure of adherence that has a strong relationship to HbA1c. Demographic variables are important to examine within the context of different methods of assessing adherence. The research methodology utilized to assess both general diabetes adherence and more specific behavioral measurements of BGM should be clearly documented in future studies to ensure accurate interpretation of results.

Exploring self-management characteristics in youths with type 1 diabetes mellitus: does membership in a glycemic control category matter?

BACKGROUND: Hemoglobin A1c (HbA1c) levels have been shown to worsen in adolescence and be related to long-term diabetes complications. Although categories of diabetes control (e.g., ideal, satisfactory, and poor) are routinely used in clinical practice, research has not fully explored whether these categories meaningfully distinguish between different self-management characteristics. OBJECTIVES: This study examines potential differences in self-management characteristics for youths and their caregivers for three different categories of diabetes control (e.g., ideal, satisfactory, and poor control). METHODS: A total of 69 adolescents (35 M/34 F) with type 1 diabetes mellitus (T1DM) (aged 12-17 yr) and their caregivers completed questionnaires of readiness to change the balance of responsibility for diabetes tasks, family responsibility in diabetes management, and self-efficacy for diabetes. A medical record review yielded demographic information, most recent HbA1c level, and health care utilization over the past year. RESULTS: Youths in the three different categories of diabetes control demonstrated no significant differences on measures of self-management characteristics. Maternal caregivers from the satisfactory control category and youths in the poor control category demonstrated the most consistent responses across various self-management characteristics. CONCLUSIONS: Youths classified in different categories of glycemic control may not be as different in their self-management characteristics as was presumed. Moreover, associations among self-management characteristics were not universal across responders. Therefore, individual assessments of youths' and caregivers' self-management characteristics need to occur independent of the youths' membership in a certain category of diabetes control.

Family psychological factors in relation to children's asthma status and behavioral adjustment at age 4.

The objectives of this study were to determine whether family psychosocial factors influenced asthma development by age 4, and whether family factors and early wheezing illness were associated with behavioral adjustment at age 4. Participants were 98 children enrolled in an intervention study at 9-24 months and followed to age 4. Baseline evaluations assessed infants' respiratory illness severity, family psychosocial characteristics, and parental risk factors for asthma development. Active asthma categorization at age 4 utilized both parent report and objective data. Parents completed the Child Behavior Checklist (CBCL). Caregiver single-parent status, a composite of baseline family stresses, and early wheezing illness severity were associated with active asthma at age 4. The contribution of prenatal smoke exposure and early hospitalization to active asthma varied with racial/ethnic group membership. Maternal mental health and family stresses predicted CBCL scores at age 4, whereas early illness severity and hospitalization were unrelated to CBCL scores. CBCL scores were not elevated for children with active asthma at age 4. Family factors consistent with a negative emotional environment were associated with both active asthma and adjustment problems at age 4, suggesting that both outcomes may be influenced by a common factor.