Sense of coherence and social support as predictors of mental health during COVID-19 pandemic.

OBJECTIVES: to verify the role of sense of coherence, sense of national coherence, social support and trust in institutions to predict mental health in Brazilians during the COVID-19 pandemic. METHODS: a cross-sectional study, carried out from November, 2020 to January, 2021 via an online survey. Standardized instruments were used. The sample consisted of 1,630 Brazilians. Pearson's correlation and linear regression were performed in data analysis. RESULTS: sense of coherence was the only predictor of anxiety [ß= -0.61; p<0.001], explaining 38% of the variance in its scores, while sense of coherence [ß= 0.52; p<0.001], sense of national coherence [ß= 0.16; p<0.001], and social support [ß= 0.15; p<0.001] predicted positive mental health and together explained 51% of its variance. CONCLUSIONS: the findings suggest that sense of coherence, sense of national coherence and social support represent important predictors for mental health and that strengthening these resources, could potentially promote Brazilians' mental health.

Sense of coherence and social support as predictors of mental health during COVID-19 pandemic / Senso de coerência e apoio social como preditores de saúde mental durante a pandemia de COVID-19 / Sentido de coherencia y apoyo social como predictores de salud mental durante la pandemia de COVID-19

ABSTRACT Objectives: to verify the role of sense of coherence, sense of national coherence, social support and trust in institutions to predict mental health in Brazilians during the COVID-19 pandemic. Methods: a cross-sectional study, carried out from November, 2020 to January, 2021 via an online survey. Standardized instruments were used. The sample consisted of 1,630 Brazilians. Pearson's correlation and linear regression were performed in data analysis. Results: sense of coherence was the only predictor of anxiety [β= -0.61; p<0.001], explaining 38% of the variance in its scores, while sense of coherence [β= 0.52; p<0.001], sense of national coherence [β= 0.16; p<0.001], and social support [β= 0.15; p<0.001] predicted positive mental health and together explained 51% of its variance. Conclusions: the findings suggest that sense of coherence, sense of national coherence and social support represent important predictors for mental health and that strengthening these resources, could potentially promote Brazilians' mental health.

RESUMO Objetivos: verificar o papel do senso de coerência, senso de coerência nacional, apoio social e confiança em instituições como preditores da saúde mental dos brasileiros durante a pandemia de COVID-19. Métodos: estudo transversal, realizado de novembro de 2020 a janeiro de 2021 por meio de questionário online. Foram utilizados instrumentos padronizados. A amostra foi composta por 1.630 brasileiros. Foram realizadas correlação de Pearson e regressão linear na análise dos dados. Resultados: o senso de coerência foi o único preditor de ansiedade [β=-0,61; p<0,001], explicando 38% da variação em seus escores, enquanto senso de coerência [β=0,52;p<0,001], senso de coerência nacional [β=0,16;p<0,001] e apoio social [β=0,15;p<0,001] foram preditores da saúde mental positiva e juntos explicaram 51% da sua variação. Conclusões: os achados sugerem que senso de coerência, senso de coerência nacional e apoio social representam importantes preditores da saúde mental e que o fortalecimento desses recursos, poderia potencialmente promover a saúde mental dos brasileiros.

RESUMEN Objetivos: verificar el papel del sentido de coherencia, sentido de coherencia nacional, apoyo social y confianza en las instituciones como predictores de salud mental en brasileños durante la pandemia de COVID-19. Métodos: estudio transversal, realizado de noviembre de 2020 a enero de 2021 mediante cuestionario online. Se utilizaron instrumentos estandarizados. La muestra estuvo compuesta por 1.630 brasileños. En el análisis de datos se realizaron correlación de Pearson y regresión lineal. Resultados: el sentido de coherencia fue el único predictor de ansiedad [β= -0,61;p<0,001], explicando el 38% de la variación de sus puntuaciones, mientras que el sentido de coherencia [β=0,52;p<0,001], sentido de coherencia nacional [β= 0,16;p<0,001] y apoyo social [β=0,15;p<0,001] fueron predictores de salud mental positiva y en conjunto explicaron el 51% de su variación. Conclusiones: los hallazgos sugieren que sentido de coherencia, sentido de coherencia nacional y el apoyo social representan importantes predictores de salud mental y que el fortalecimiento de estos recursos, podría potencialmente promover la salud mental de los brasileños.

How Do People Cope During the COVID-19 Pandemic and Stay Well? A Salutogenic Longitudinal Study in Israel.

Employing the salutogenic approach, this longitudinal study explored the effects of coping with the COVID-19 pandemic in Israel, as it evolved from an acute to a chronic stress situation, during the first year. We examined the role of individual [sense of coherence (SOC)], social (perceived social support), and national [sense of national coherence (SONC)] coping resources, as well as situational and demographic factors, in predicting mental health and anxiety. Data was collected in five phases between March 2020 and February 2021 via a repeated panel sample and included 198 Jewish Israelis (52% males) age 18-64 (M = 43.5). The results confirmed the expected pattern of moving from acute to chronic stressful situation: levels of general anxiety were higher in the first phase of the pandemic outbreak as compared to the other phases. Levels of social and national coping resources significantly decreased over time. However, as expected, the salutogenic resource of the individual sense of coherence remained stable and was also found as the main predictor of both anxiety and mental health in the 5 phases of the study. Beyond the explanatory factor of SOC, mental health was better explained by the social and national coping resources, while anxiety was explained by situational factors (level of financial risk and gender). The discussion delineates the longitudinal effects of individual, social, and national coping resources on mental health and anxiety during the dynamic process of the long period of 1 year of the pandemic, evolving from acute to chronic phases of the complicated health, economic, social, and political crisis.

Living in opposition: How women in the United States cope in spite of mistrust of federal leadership during the pandemic of Covid-19.

International research collaborators conducted research investigating sociocultural responses to the Covid-19 pandemic. Our mixed methods research design includes surveys and interviews conducted between March and September of 2020 including 249 of 506 survey responses and 18 of 50 in-depth, exploratory, semi-structured interviews with self-defined politically left-leaning women in the United States. We employ a sequential design to analyze statistical and qualitative data. Despite international data suggesting that trust in federal governments reduces anxiety, women who did not trust and actively opposed the Trump administration reported lower levels of anxiety than expected. Results indicate reliance on and development of new forms of connection that seem to mitigate symptomatic anxieties when living in opposition. Women living in opposition to the leadership of the federal government use and develop resources to help them cope. Research on coping strategies and mental health and anxiety during crisis can inform recommendations for ways to support and strengthen sense of coherence during tumultuous times.

Individual, social and national coping resources and their relationships with mental health and anxiety: A comparative study in Israel, Italy, Spain, and the Netherlands during the Coronavirus pandemic.

Employing the salutogenic model, we asked how individuals in different countries cope with the COVID-19 crisis and stay healthy. We were interested in exploring the individual (i.e. sense of coherence) as well as the social and national resources (i.e. social support, sense of national coherence, and trust in governmental institutions) that could explain levels of mental health and anxiety during the outbreak of the pandemic. Data collection was conducted via convenience sampling on online platforms, during the end of March and the beginning of April 2020. The data included four samples: 640 Israeli participants (319 males), 622 Dutch participants (177 males), 924 Italian participants (338 males) and 489 Spanish participants (117 males); age range of 18-88 years. The questionnaires included standard tools (MHC-SF, GAD-7, SOC, SONC). Several questions were adapted to the context of coronavirus and measured levels of exposure to COVID-19, trust in governmental institutions, and social support. The results significantly confirmed the suggested salutogenic model regarding the contribution to individual and national coping resources to anxiety levels and mental health. The patterns of the coping resources in explaining anxiety and mental health were similar in the four samples, and SOC was the main predictor these outcomes. Despite these similarities, a different pattern and also different magnitudes of the predictive value of the coping resources were found for the two different reactions: anxiety vs. mental health. While SOC and situational factors (like financial threat) were significant in explaining anxiety levels, the SOC and national resources were found as significant in explaining mental health levels. The findings support the salutogenic approach in studying reactions during pandemic time. They also shed some light on the difference between pathogenic and salutogenic measures in studying psychological reactions to stressful situations.

Sense of coherence among Bedouin women in polygamous marriages compared to women in monogamous marriages.

We compared sense of coherence (SOC) among Bedouin women in polygamous with those in monogamous marriages. SOC is a global orientation toward life as comprehensible, manageable, and meaningful, and is derived from generalized resistance resources that promote effective coping in stressful life situations. Strong SOC may be a resource for strengthening resilience and promoting health. We administered questionnaires to 464 Indigenous Arab Bedouin women (ages 18-49 years) in 2008-2009 using the 13-item SOC questionnaire. Contrary to our hypothesis, SOC was higher among women in polygamous compared to monogamous marriages. Husband's education, husband's abandonment of the household, living in unrecognized villages, and low mastery (perception of one's ability to control life situations) were associated with higher SOC. These results might suggest that polygamy may provoke new coping mechanisms among women as they reappraise life amidst low mastery, accept cultural norms, and marshal new resources, thereby increasing key elements of SOC, including comprehensibility, manageability, and meaningfulness. Interventions and services seeking to empower women in polygamous marriages should build on their resilience.

Sense of coherence, hope, and home demolition are differentially associated with anger and anxiety among Bedouin Arab adolescents in recognized and unrecognized villages.

BACKGROUND AND OBJECTIVES: This research investigated how coping resources explain emotional reactions of anger and anxiety, in the context of threat of house demolition, among adolescents in three groups: Adolescents living in a recognized village with no demolition, adolescents living in an unrecognized village (by the Israeli government as legal) with no demolition, and adolescents living in an unrecognized village with demolition. The framework of this research is based on Antonovsky's salutogenic theory, which suggests examining ability to cope with stressful situations. DESIGN: Multi-group cross-sectional study. METHODS: The study was carried out during 2010-2011 and included 910 participants, of whom 411 adolescents lived in unrecognized villages where 193 of them experienced home demolition. Participants filled out a questionnaire including demographics, coping resources and emotional reactions. RESULTS: Findings showed that stress reactions were the highest among adolescents from unrecognized villages with demolition. Personal sense of coherence (SOC) was related to fewer emotional reactions among the adolescents from recognized villages; among adolescents from unrecognized villages, especially adolescents living in an unrecognized village with demolition, a stronger SOC was linked to stronger emotional reactions. CONCLUSIONS: These findings have important implications for understanding the role of coping among youth from different cultural groups.

Sense of community coherence and inter-religious relations.

The current article attempts to broaden the individual-based concept of sense of coherence to the community level. We examine sense of community coherence and its connection with perceptions of collective narratives and acculturation tendencies in the social context of Palestinian Muslims and Christians living in Israel. Questionnaires that were developed and adapted for the unique population in this study were distributed to a representative sample of 1034 Muslims (455 males) and 720 Christians (354 males), all Israeli citizens aged 18 and up. As expected, sense of community coherence was negatively related to the level of acceptance of the out-group collective narratives and positively related to the level of acceptance of the in-group collective narratives. In the same vein, it was also positively related to the tendency for separation and negatively related to the tendency for integration and assimilation. The discussion focuses on the contribution of the research findings to the deepening of our understanding of the concepts of sense of coherence and sense of community coherence.

Sense of coherence and depressive symptoms among low-income Bedouin women in the Negev Israel.

BACKGROUND: Higher sense of coherence (SOC) has been associated with lower depression in Western societies; however, it is not clear whether this association manifests similarly in non-Western cultural contexts. AIMS: To examine the associations between different levels of SOC and depressive symptoms (DS) among indigenous-minority Arab Bedouin women in Israel and explore possible explanatory variables for this association. METHODS: We conducted face-to-face interviews with 464 women (aged 18-49 years). DS was measured based on the Center for Epidemiologic Studies Depression Scale. We used the SOC-13 questionnaire and conducted path analysis using Structural Equation Modeling to examine the contribution of two levels of SOC (low/high) to predict DS beyond psychological resources and socioeconomic position. RESULTS: The mean score of SOC was 3.42, standard deviation (SD) = 1.15. While high SOC (mean = 4.38, SD = 0.66, range = 3.5-6.38) was positively and significantly associated with DS (r = 0.46), SOC was not associated (r = 0.02) with DS in the low SOC group (mean = 2.4, SD = 0.56, range = 1-3.42). CONCLUSIONS: Relationships between high versus low SOC and DS among Bedouin women differ from those found in Western societies. This raises questions about the use of SOC as a universal tool in different cultural contexts.

Community resilience and sense of coherence as protective factors in explaining stress reactions: comparing cities and rural communities during missiles attacks.

Based on the salutogenic theory, the aim of this study was to examine sense of coherence and communal resiliency as related to stress reactions during missile attacks. Data were gathered in August 2011 while missiles were being shot from Gaza to the Negev communities in Israel from approximately 150 participants, aged 15-85. Participants lived in cities and different types of small rural villages. Self reported questionnaires were administered via the internet and included demographic data, coping resource of sense of coherence and community resiliency as coping resources, as well as state anxiety, state anger and psychological distress as stress reaction outcomes. Overall, the participants in our study reported strong personal and communal resources and relatively low levels of stress reactions. Personal and communal resources were linked negatively to the different stress reactions. However, some differences emerged when we compared participants from different types of communities. The most resilient group was composed of people who lived in the rural and communal communities. Differences also emerged on patterns of relationships between the community resource and state anxiety. While among the rural citizens, community resilience was strongly linked to anxiety, no relationships were revealed in the urban citizens group.

Stress reactions and coping strategies among Bedouin Arab adolescents exposed to demolition of houses.

The aim of this study was to examine emotional reactions and coping strategies of Bedouin adolescents against the backdrop of house demolitions in the unrecognized Bedouin villages in the Negev, Israel. We compared two groups of adolescents living in unrecognized Bedouin villages, teenagers whose houses had been destroyed (acute + chronic group) and their counterparts whose houses had not been destroyed (chronic group). Data were gathered during October to December 2010 from 465 Bedouin adolescents aged 13-18 years. Adolescents filled out self-report questionnaires, which included demographics, objective and subjective exposure to house demolition, state anxiety, state anger, psychological distress and Adolescent Coping Scale. Results show differences between the two groups in stress reactions as well as in objective exposure to house demolition with the acute + chronic group reporting more stress and more exposure. In addition, different variables explained stress reactions in the different groups. Whereas in the acute + chronic group, objective and subjective exposure were the most significant variables, in the chronic group, the coping strategies explained stress with more variance. Results are discussed in terms of differentiating between types of stress, chronic versus acute + chronic and in relation to the interactionist model of coping with stress.

Brief report: adolescents under missile attacks: sense of coherence as a mediator between exposure and stress-related reactions.

Employing the salutogenic approach (Antonovsky, 1987), this pilot study aimed at exploring the mediation effect of Sense of Coherence (SOC) on the relationships between exposure to missile attacks and stress-related reactions among adolescents. A strong SOC means a tendency to see the world as more comprehensible, manageable and meaningful. Data were gathered during August 2006 (Second Lebanon War) from 230 Israeli adolescents, 12-18 years old. Adolescents filled out self-reported questionnaires, including demographics, level of physical exposure, SOC, Scale of Psychological Distress (SPD), State Anxiety and State Anger. Exposure to missile attacks was found to be significantly positively linked to stress reactions; exposure was negatively linked to SOC which was also negatively linked to stress reactions. The mediation hypothesis was supported, with SOC mediating the effect of exposure to missile attacks on stress reactions. It seems that SOC may have a protective effect against stress reactions among adolescents exposed to political violence. This should be further studied in a longitudinal research.

Coping resources as explanatory factors of stress reactions during missile attacks: comparing Jewish and Arab adolescents in Israel.

The aim of this study was to explore coping resources as explanatory factors in reducing emotional distress of adolescents in an acute stress situation. We compared two ethnic groups-Jewish and Arab-Bedouin Israelis-during intensive missile attacks in January 2009. Data were gathered from 138 Israeli-Jews and 84 Israeli-Arab Bedouins, 12-18 years old, who filled out self reported questionnaires among which state anxiety, state anger, and psychological distress (SPD) were measures of emotional distress, and sense of coherence (SOC) and hope index served as measures of coping resources. Findings indicated no differences between the two groups on state anxiety, SPD and hope levels. Arab Bedouins reported higher levels of state anger and lower levels of sense of coherence. The coping resources, however, explained the stress reactions differently among the two groups. While SOC made a major contribution in explaining stress reactions among Jewish adolescents, hope index explained stress reactions only for the Arab group. The findings are discussed against the background of the salutogenic theory and the cultural differences between the two ethnic groups.

Coping strategies as mediators of the relationship between sense of coherence and stress reactions: Israeli adolescents under missile attacks.

This study aimed to explore the relationships between sense of coherence (SOC) and stress reactions as mediated by cognitive appraisal and coping strategies among adolescents facing the acute stressful situation of missile attacks. Employing the Salutogenic Model and the interactionist approach to coping, we asked what the roles of situational factors such as coping strategies and cognitive appraisal were in mediating the relationship between SOC and stress reactions. Data were gathered during January 2009 when hundreds of missiles fell in southern Israel. One hundred and thirty eight adolescents filled out questionnaires dealing with SOC, cognitive appraisal (endangerment feelings), Adolescent Coping Scale, state anxiety, state anger, and psychological distress. Overall, our model explained 55% of the variance in stress reactions. SOC had the strongest total direct and indirect effects. Previous findings have indicated SOC as playing only a limited role in explaining stress reactions in acute stress situations. The results of this study highlight the potential of SOC as a powerful resilience factor even in an acute situation, through mediation of situational factors.

Salutogenesis and culture: personal and community sense of coherence among adolescents belonging to three different cultural groups.

The salutogenic theory considers sense of coherence (SOC) as a cross-cultural concept ( Antonovsky, 1987 ), meaning that in all cultures and at all stages of coping with a stressor, a person with a strong SOC is at an advantage in preventing tension from being transformed into stress. However, in seeking to understand how the SOC works, it is culture which seems to define which resources are appropriate. The aim of our paper is to examine this theoretical assumption of Antonovsky. Data on personal and community SOC as well as on stress reactions were gathered after the last fire in northern Israel (December 2010) among adolescents aged 12-18 belonging to three cultural groups (Jews, Druze, Muslims). We compared the pattern of personal versus community SOC in explaining stress reactions in the three cultures. Results indicate that personal SOC was the strongest predictor of stress reactions in all cultures. Community SOC, however, played a significant role mainly for Druze. Results are discussed relating to Antonovsky's theory and to adolescence as a 'universal' period, as well as considering the uniqueness of each culture separately.

Coping strategies among adolescents: Israeli Jews and Arabs facing missile attacks.

The study examined the use of coping strategies among Israeli Jewish and Arab adolescents who faced missile attacks during the Second Lebanon War. We further explored the role of ethnicity, gender and age in explaining psychological distress and the ways in which different coping strategies relate to health outcomes in the two ethnic groups. Data were gathered from 303 Israeli adolescents (231 Jews and 72 Arabs), 12-19 years old, who filled out self-reported questionnaires among which were demographics; Adolescent Coping Scale, Scale of Psychological Distress (SPD), state anxiety and state anger. Both Jewish and Arab adolescents mostly used "problem solving" coping strategies and reported relatively low levels of psychological distress. Similarities among Jews and Arabs were indicated in the use of "problem solving" coping strategies but not in the use of "reference to others"--and "non-productive" coping strategies. Significant but small effects were indicated for gender and interaction of ethnicity and age on "psychological distress." The coping strategies explained only 35% of the variance of stress reactions for the Jewish group but 51% for the Arab group. The results are discussed against the background of an interactionist approach, considering coping as a function of interaction between the stressful war event and the individual-cultural background.

Adolescents under rocket fire: when are coping resources significant in reducing emotional distress?

Stress reactions and coping resources of adolescents in chronic and acute situations evoked by missile fire were examined. Data were gathered during August 2006 (Second Lebanon War) on a sample of 303 Israeli adolescents living in Northern Israel (acute state) and 114 youths from Sderot and the Negev, an area which has been exposed to frequent rocket attacks in the last seven years (chronic state). State anxiety and psychological distress were measured as stress reactions. Sense of coherence, family sense of coherence, sense of community and level of exposure were investigated as potential explanatory factors in reducing emotional distress. The overall magnitude of variance explanation was found to be different at each state: a relatively high amount explained variance of stress reactions was found in the chronic stress situation, but not in the acute state. These data support the value of developing a model that differentiates stress situations with the aim of understanding patterns of significant resources in moderating stress reactions in each state.

Hope in times of threat: the case of Israeli and Palestinian youth.

This study was developed by a group of Israeli and Palestinian researchers for the purpose of examining levels and contents of hope among young people in the conflicted region of the Middle East. Hope was defined as the interaction between wishes and positive future expectations. The differentiation between personal and collective hopes, as well as stability and/or change of levels of hope in the context of a changing reality, were examined. Data were collected at two points of time: during the period of the Oslo Accords talks (1999-2000) and in the time of events of the Al-Aksa Intifada (2002). The representative samples in the first stage were comprised of 1,183 Palestinian high-school students from the Palestinian National Territories, and 1,188 Israeli Jewish students. The adolescents' hopes, wishes and expectations for the future are compared and discussed from individual, social, and cultural perspectives.

Moderating factors explaining stress reactions: comparing chronic-without-acute-stress and chronic-with-acute-stress situations.

The author compared patterns of moderating factors explaining stress reactions during 2 states: chronic-without-acute-stress and chronic-with-acute-stress. She hypothesized that personal dispositions would contribute more to understanding stress reactions during a prolonged stress state than during an acute state. The participants were Israeli Jewish adolescents living in West Bank settlements during the prolonged (chronic-without-acute-stress) state of the intifada (the Palestinian uprising against Israeli occupation) and during the chronic-with-acute-stress state, immediately after the assassination of Prime Minister Rabin. The author examined 5 variables as moderating factors--trait anxiety, sense of coherence, cognitive appraisal of the political situation, family sense of coherence, and sense of community--and measured 2 stress reactions--state anxiety and psychological distress. Data were collected from 266 8th-grade students during the chronic-without-acute-stress state and 448 students at the same grade level at the chronic-with-acute-stress state. The overall magnitude of variance explanation was different at each state: The author found a relatively high explained variance of state anxiety and psychological distress in the chronic-without-acute-stress situation but not in the chronic-with-acute stress state. These data support the value of developing a model that would recognize the different types of stress situations for moderating the effects of stress.

Interpretations of the past and expectations for the future among Israeli and Palestinian youth.

This study was developed by a group of Israeli and Palestinian researchers for the purpose of examining social knowledge of young people in the conflicted region of the Middle East. The article examines the relations between measures of interpretations of the past (perceptions of legitimacy and emotional reactions toward the historical "narratives" of Israelis and Palestinians) and measures of expectations of the collective future, as reflected in conflict resolution beliefs. Data were collected from December 1999 to February 2000 (before the present crisis [2000-2002] in Jewish-Palestinian relations) among representative samples of high school students (Grades 10 and 12): 1,183 Palestinians in the Palestinian National Territories and 1,188 Israeli Jewish students. The results are discussed from developmental, social, and cultural perspectives.