Mental Health Challenges for Spring 2021

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trader32176
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Re: Mental Health Challenges for Spring 2021

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Study addresses how to mitigate the mental health impact of Covid-19 lockdown

1/7/21

https://www.news-medical.net/news/20210 ... kdown.aspx


The Covid-19 pandemic is impacting people's mental health. But what helps and hinders people in getting through a lockdown? A new study led by researchers at the University of Basel addressed this question using data from 78 countries across the world. The results hint at the pivots and hinges on which the individual's psyche rests in the pandemic.

At the outset of the Covid-19 pandemic, little was known about the impact of population-wide governmental lockdowns. What was known was taken from restricted quarantines of small groups of people.

" On the one hand, such drastic changes to daily routines can be detrimental to mental health. On the other hand, because the entire population was more or less equally affected during the lockdown, it remained unclear whether this impact would occur."

- Andrew Gloster, Professor, University of Basel

Professor Andrew Gloster is the co-leader of the study now published in PLOS One.

To address this question, Gloster and his international colleagues conducted an online survey in 18 languages. Almost 10,000 people from 78 countries participated, giving information about their mental health and overall situation during the Covid-19 lockdown.

One in ten respondents reported low levels of mental health - including negative affect, stress, depressive behaviors and a pessimistic view of society. Another 50% had only moderate mental health, which has previously been found to be a risk factor for further complications. These figures are consistent with other studies addressing the impact of the pandemic on mental health.

Lowest levels of well-being in Hong Kong and Italy


Overall, the responses in the different surveyed countries were largely similar. However, although no country emerged as either consistently better or worse across all outcomes, there were some differences. Hong Kong and Turkey reported more stress than other countries; the USA reported more depressive symptoms; and well-being was lowest in Hong Kong and Italy. Participants in Austria, Germany and Switzerland, on the other hand, reported significantly fewer negative emotions (negative affect) than the average level across all countries.

These differences are likely due to a combination of chance, nation-specific responses to the pandemic, cultural differences and factors such as political unrest. Beyond that, they may in part be explained by factors the researchers found to be connected to outcomes. Loss of financial income compared to pre-lockdown levels and not having access to basic supplies were consistently associated with worse outcomes. Factors that consistently improved outcomes were having social support, higher education levels, and being able to respond and adapt flexibly to the situation.

"Public health initiatives should target people without social support and those whose finances worsen as a result of the lockdown. Based on these results, interventions that promote psychological flexibility like acceptance and commitment therapy hold promise when it comes to mitigating the impact of the pandemic and lockdowns," says Gloster. Given the continued fluid development of the pandemic and its economic consequences, attention to people's mental health remains important.

Source:

University of Basel

Journal reference:

Gloster, A.T., et al. (2020) Impact of COVID-19 pandemic on mental health: An international study. PLOS ONE. doi.org/10.1371/journal.pone.0244809.
trader32176
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Re: Mental Health Challenges for Spring 2021

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Six ways to ‘reboot your brain’ after a hard year of COVID-19 – according to science

December 31, 2020


https://theconversation.com/six-ways-to ... nce-151332


There’s no doubt that 2020 was difficult for everyone and tragic for many. But now vaccines against COVID-19 are finally being administered – giving a much needed hope of a return to normality and a happy 2021.

However, months of anxiety, grief and loneliness can easily create a spiral of negativity that is hard to break out of. That’s because chronic stress changes the brain. And sometimes when we’re low we have no interest in doing the things that could actually make us feel better.

To enjoy our lives in 2021, we need to snap out of destructive habits and get our energy levels back.
In some cases, that may initially mean forcing yourself to do the things that will gradually make you feel better. If you are experiencing more severe symptoms, however, you may want to speak to a professional about therapy or medication.

Here are six evidenced-based ways to change our brains for the better.

1. Be kind and helpful


Kindness, altruism and empathy can affect the brain. One study showed that making a charitable donation activated the brain’s reward system in a similar way to actually receiving money. This also applies to helping others who have been wronged.

Volunteering can also give a sense of meaning in life, promoting happiness, health and wellbeing. Older adults who volunteer regularly also exhibit greater life satisfaction and reduced depression and anxiety. In short, making others happy is a great way to make yourself happy.

2. Exercise

Exercise has been linked with both better physical and mental health, including improved cardiovascular health and reduced depression. In childhood, exercise is associated with better school performance, while it promotes better cognition and job performance in young adults. In older adults, exercise maintains cognitive performance and provides resilience against neurodegenerative disorders, such as dementia.

What’s more, studies have shown that individuals with higher levels of fitness have increased brain volume, which is associated with better cognitive performance in older adults. People who exercise also live longer. One of the very best things that you can do to reboot your brain is in fact to go out and get some fresh air during a brisk walk, run or cycling session. Do make sure to pick something you actually enjoy to ensure you keep doing it though.

3. Eat well

Nutrition can substantially influence the development and health of brain structure and function. It provides the proper building blocks for the brain to create and maintain connections, which is critical for improved cognition and academic performance. Previous evidence has shown that long-term lack of nutrients can lead to structural and functional damage to the brain, while a good quality diet is related to larger brain volume.

One study of 20,000 participants from the UK-Biobank showed that a higher intake of cereal was associated with the long-term beneficial effects of increased volume of grey matter (a key component of the central nervous system), which is linked to improved cognition. However, diets rich in sugar, saturated fats or calories can damage neural function. They can also reduce the brain’s ability to make new neural connections, which negatively affects cognition.

Therefore, whatever your age, remember to eat a well-balanced diet, including fruits, vegetables and cereal.

4. Keep socially connected

Loneliness and social isolation is prevalent across all ages, genders and cultures – further elevated by the COVID-19 pandemic. Robust scientific evidence has indicated that social isolation is detrimental to physical, cognitive and mental health.

One recent study showed that there were negative effects of COVID-19 isolation on emotional cognition, but that this effect was smaller in those that stayed connected with others during lockdown. Developing social connections and alleviating loneliness is also associated with decreased risk of mortality as well as a range of illnesses.

Therefore, loneliness and social isolation are increasingly recognised as critical public health issues, which require effective interventions. And social interaction is associated with positive feelings and increased activation in the brain’s reward system.

In 2021, be sure to keep up with family and friends, but also expand your horizons and make some new connections.

5. Learn something new

The brain changes during critical periods of development, but is also a lifelong process. Novel experiences, such as learning new skills, can modify both brain function and the underlying brain structure. For example juggling has been shown to increase white matter (tissue composed of nerve fibers) structures in the brain associated with visuo-motor performance.

Similarly, musicians have been shown to have increased grey matter in the parts of the brain that process auditory information. Learning a new language can also change the structure of the human brain.

A large review of the literature suggested that mentally stimulating leisure activities increase brain-reserve, which can instil resilience and be protective of cognitive decline in older adults – be it chess or cognitive games.

6. Sleep properly

Sleep is an essential component of human life, yet many people do not understand the relationship between good brain health and the process of sleeping. During sleep, the brain reorganises and recharges itself and removes toxic waste byproducts, which helps to maintain normal brain functioning.

Sleep is very important for transforming experiences into our long-term memory, maintaining cognitive and emotional function and reducing mental fatigue. Studies of sleep deprivation have demonstrated deficits in memory and attention as well as changes in the reward system, which often disrupts emotional functioning. Sleep also exerts a strong regulatory influence on the immune system. If you have the optimal quantity and quality of sleep, you will find that you have more energy, better wellbeing and are able to develop your creativity and thinking.

So have a Happy New Year! And let’s make the most of ourselves in 2021 and help others to do the same.
trader32176
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Re: Mental Health Challenges for Spring 2021

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Study shows a 25% increase in food insufficiency during COVID-19 pandemic

1/12/21


https://www.news-medical.net/news/20210 ... demic.aspx


A new study published in the American Journal of Preventive Medicine found a 25% increase in food insufficiency during the COVID-19 pandemic. Food insufficiency, the most extreme form of food insecurity, occurs when families do not have enough food to eat. Among the nationally representative sample of 63,674 adults in the US, Black and Latino Americans had over twice the risk of food insufficiency compared to White Americans.

" People of color are disproportionately affected by both food insufficiency and COVID-19. Many of these individuals have experienced job loss and higher rates of poverty during the pandemic."

- Jason Nagata, MD, MSc, Study Lead Author, Assistant Professor, Pediatrics, University of California, San Francisco

Overall, 65% of Americans reported anxiety symptoms and 52% reported depressive symptoms in the week prior to completing the survey. Those who did not have enough to eat during that week reported worse mental health, with 89% of food-insufficient Americans reporting anxiety symptoms compared to 63% of food-sufficient Americans. Similarly, 83% of food-insufficient Americans, compared to 49% of food-sufficient, Americans reported depressive symptoms.

"Hunger, exhaustion, and worrying about not getting enough food to eat may worsen depression and anxiety symptoms," said Nagata.

Researchers found that receipt of free groceries or meals alleviated some of the mental health burden of food insufficiency.

"Policymakers should expand benefits and eligibility for the Supplemental Nutrition Assistance Program (SNAP) and other programs to address both food insecurity and mental health," said Kyle Ganson, PhD, MSW, assistant professor at the University of Toronto, a co-author of the study.

Source:


University of Toronto

Journal reference:


Nagata, J.M., et al. (2021) Food Insufficiency and Mental Health in the U.S. During the COVID-19 Pandemic. American Journal of Preventative Medicine. doi.org/10.1016/j.amepre.2020.12.004.
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Re: Mental Health Challenges for Spring 2021

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Kids already coping with mental disorders spiral as pandemic topples vital support systems

1/29/21


https://www.news-medical.net/news/20210 ... stems.aspx


A bag of Doritos, that’s all Princess wanted.

Her mom calls her Princess, but her real name is Lindsey. She’s 17 and lives with her mom, Sandra, a nurse, outside Atlanta. On May 17, 2020, a Sunday, Lindsey decided she didn’t want breakfast; she wanted Doritos. So she left home and walked to Family Dollar, taking her pants off on the way, while her mom followed on foot, talking to the police on her phone as they went.

Lindsey has autism. It can be hard for her to communicate and navigate social situations. She thrives on routine and gets special help at school. Or got help, before the coronavirus pandemic closed schools and forced tens of millions of children to stay home. Sandra said that’s when their living hell started.

“It’s like her brain was wired,” she said. “She’d just put on her jacket, and she’s out the door. And I’m chasing her.”

On May 17, Sandra chased her all the way to Family Dollar. Hours later, Lindsey was in jail, charged with assaulting her mom. (KHN and NPR are not using the family’s last name.)

Lindsey is one of almost 3 million children in the U.S. who have a serious emotional or behavioral health condition. When the pandemic forced schools and doctors’ offices to close last spring, it also cut children off from the trained teachers and therapists who understand their needs.

As a result, many, like Lindsey, spiraled into emergency rooms and even police custody. Federal data shows a nationwide surge of kids in mental health crisis during the pandemic — a surge that’s further taxing an already overstretched safety net.

‘Take her’

Even after schools closed, Lindsey continued to wake up early, get dressed and wait for the bus. When she realized it had stopped coming, Sandra said, her daughter just started walking out of the house, wandering, a few times a week.

In those situations, Sandra did what many families in crisis report they’ve had to do since the pandemic began: race through the short list of places she could call for help.

First, her state’s mental health crisis hotline. But they often put Sandra on hold.

“This is ridiculous,” she said of the wait. “It’s supposed to be a crisis team. But I’m on hold for 40, 50 minutes. And by the time you get on the phone, [the crisis] is done!”

Then there’s the local hospital’s emergency room, but Sandra said she had taken Lindsey there for previous crises and been told there isn’t much they can do.

That’s why, on May 17, when Lindsey walked to Family Dollar in just a red T-shirt and underwear to get that bag of Doritos, Sandra called the last option on her list: the police.

Sandra arrived at the store before the police and paid for the chips. According to Sandra and police records, when an officer approached, Lindsey grew agitated and hit her mom on the back, hard.

Sandra said she explained to the officer: “‘She’s autistic. You know, I’m OK. I’m a nurse. I just need to take her home and give her her medication.'”

Lindsey takes a mood stabilizer, but because she left home before breakfast, she hadn’t taken it that morning. The officer asked if Sandra wanted to take her to the nearest hospital.

The hospital wouldn’t be able to help Lindsey, Sandra said. It hadn’t before. “They already told me, ‘Ma’am, there’s nothing we can do.’ They just check her labs, it’s fine, and they ship her back home. There’s nothing [the hospital] can do,” she recalled telling the officer.

Sandra asked if the police could drive her daughter home so the teen could take her medication, but the officer said no, they couldn’t. The only other thing they could do, the officer said, was take Lindsey to jail for hitting her mom.

“I’ve tried everything,” Sandra said, exasperated. She paced the parking lot, feeling hopeless, sad and out of options. Finally, in tears, she told the officers, “Take her.”

Lindsey does not like to be touched and fought back when authorities tried to handcuff her. Several officers wrestled her to the ground. At that point, Sandra protested and said an officer threatened to arrest her, too, if she didn’t back away. Lindsey was taken to jail, where she spent much of the night until Sandra was able to post bail.

Clayton County Solicitor-General Charles Brooks denied that Sandra was threatened with arrest and said that while Lindsey’s case is still pending, his office “is working to ensure that the resolution in this matter involves a plan for medication compliance and not punitive action.”

Sandra isn’t alone in her experience. Multiple families interviewed for this story reported similar experiences of calling in the police when a child was in crisis because caretakers didn’t feel they had any other option.

‘The whole system is really grinding to a halt’


Roughly 6% of U.S. children ages 6 through 17 are living with serious emotional or behavioral difficulties, including children with autism, severe anxiety, depression and trauma-related mental health conditions.

Many of these children depend on schools for access to vital therapies. When schools and doctors’ offices stopped providing in-person services last spring, kids were untethered from the people and supports they rely on.

“The lack of in-person services is really detrimental,” said Dr. Susan Duffy, a pediatrician and professor of emergency medicine at Brown University.

Marjorie, a mother in Florida, said her 15-year-old son has suffered during these disruptions. He has attention deficit hyperactivity disorder and oppositional defiant disorder, a condition marked by frequent and persistent hostility. Little things — like being asked to do schoolwork — can send him into a rage, leading to holes punched in walls, broken doors and violent threats. (Marjorie asked that we not use the family’s last name or her son’s first name to protect her son’s privacy and future prospects.)

The pandemic has shifted both school and her son’s therapy sessions online. But Marjorie said virtual therapy isn’t working because her son doesn’t focus well during sessions and tries to watch TV instead. Lately, she has simply been canceling them.

“I was paying for appointments and there was no therapeutic value,” Marjorie said.

The issues cut across socioeconomic lines — affecting families with private insurance, like Marjorie, as well as those who receive coverage through Medicaid, a federal-state program that provides health insurance to low-income people and those with disabilities.

In the first few months of the pandemic, between March and May 2020, children on Medicaid received 44% fewer outpatient mental health services — including therapy and in-home support — compared to the same time period in 2019, according to the Centers for Medicare & Medicaid Services. That’s even after accounting for increased telehealth appointments.

And while the nation’s ERs have seen a decline in overall visits, there was a relative increase in mental health visits for kids in 2020 compared with 2019.

The Centers for Disease Control and Prevention found that, from April to October 2020, hospitals across the U.S. saw a 24% increase in the proportion of mental health emergency visits for children ages 5 to 11, and a 31% increase for children ages 12 to 17.

“Proportionally, the number of mental health visits is far more significant than it has been in the past,” said Duffy. “Not only are we seeing more children, more children are being admitted” to inpatient care.

That’s because there are fewer outpatient services now available to children, she said, and because the conditions of the children showing up at ERs “are more serious.”

This crisis is not only making life harder for these kids and their families, but it’s also stressing the entire health care system.

Child and adolescent psychiatrists working in hospitals around the country said children are increasingly “boarding” in emergency departments for days, waiting for inpatient admission to a regular hospital or psychiatric hospital.

Before the pandemic, there was already a shortage of inpatient psychiatric beds for children, said Dr. Christopher Bellonci, a child psychiatrist at Judge Baker Children’s Center in Boston. That shortage has only gotten worse as hospitals cut capacity to allow for more physical distancing within psychiatric units.

“The whole system is really grinding to a halt at a time when we have unprecedented need,” Bellonci said.

‘A signal that the rest of your system doesn’t work’

Psychiatrists on the front lines share the frustrations of parents struggling to find help for their children.

Part of the problem is there have never been enough psychiatrists and therapists trained to work with children, intervening in the early stages of their illness, said Dr. Jennifer Havens, a child psychiatrist at New York University.

“Tons of people showing up in emergency rooms in bad shape is a signal that the rest of your system doesn’t work,” she said.

Too often, Havens said, services aren’t available until children are older — and in crisis. “Often for people who don’t have access to services, we wait until they’re too big to be managed.”

While the pandemic has made life harder for Marjorie and her son in Florida, she said it has always been difficult to find the support and care he needs. Last fall, he needed a psychiatric evaluation, but the nearest specialist who would accept her commercial insurance was 100 miles away, in Alabama.

“Even when you have the money or you have the insurance, it is still a travesty,” Marjorie said. “You cannot get help for these kids.”

Parents are frustrated, and so are psychiatrists on the front lines. Dr. C.J. Glawe, who leads the psychiatric crisis department at Nationwide Children’s Hospital in Columbus, Ohio, said that once a child is stabilized after a crisis it can be hard to explain to parents that they may not be able to find follow-up care anywhere near their home.

“Especially when I can clearly tell you I know exactly what you need, I just can’t give it to you,” Glawe said. “It’s demoralizing.”

When states and communities fail to provide children the services they need to live at home, kids can deteriorate and even wind up in jail, like Lindsey. At that point, Glawe said, the cost and level of care required will be even higher, whether that’s hospitalization or long stays in residential treatment facilities.

That’s exactly the scenario Sandra, Lindsey’s mom, is hoping to avoid for her Princess.

“For me, as a nurse and as a provider, that will be the last thing for my daughter,” she said. “It’s like [state and local leaders] leave it to the school and the parent to deal with, and they don’t care. And that’s the problem. It’s sad because, if I’m not here …”

Her voice trailed off as tears welled.

“She didn’t ask to have autism.”

To help families like Sandra’s and Marjorie’s, advocates said, all levels of government need to invest in creating a mental health system that’s accessible to anyone who needs it.

But given that many states have seen their revenues drop due to the pandemic, there’s a concern services will instead be cut — at a time when the need has never been greater.
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Re: Mental Health Challenges for Spring 2021

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Study finds increased substance use, mental health issues in people with obesity during the pandemic

2/8/21


https://www.news-medical.net/news/20210 ... demic.aspx


The COVID-19 pandemic is having a detrimental impact on substance use, mental health, and weight-related health behaviors among people with obesity, according to a new study by researchers at UT Southwestern and the UTHealth School of Public Health.

The study, published in the journal Clinical Obesity, surveyed 589 patients with obesity who are enrolled in the UT Southwestern Weight Wellness Program, a multidisciplinary weight management and post-bariatric care clinic. Nearly half of the group reported using recreational drugs and alcohol, and 10 percent reported increased use since the start of the pandemic. Seventeen of the patients have tested positive for COVID-19.

Almost a quarter (24.3 percent) of the patients reported using opioids in the 30 days preceding the survey, 9.5 percent sedatives or tranquilizers, 3.6 percent marijuana, and 1 percent stimulants. Patients were surveyed from June 1, 2020, to Sept. 30, 2020, after COVID-19 stay-at-home orders had been lifted in North Texas.

" Many patients with obesity are also challenged by mental health conditions. Those who reported anxiety, depression, and trouble sleeping were two to four times more likely to increase their use of substances. For those who reported stress eating, there was a sixfold increase in substance use."

- Jaime Almandoz, M.D., MBA, Study Author, Medical Director, Weight Wellness Program and Assistant Professor of Internal Medicine, UT Southwestern Medical Center

According to the Centers for Disease Control and Prevention, more than 42 percent of American adults are obese. Obesity-related health conditions include heart disease, stroke, Type 2 diabetes, and certain types of cancer that are some of the leading causes of preventable, premature death.

Nearly 70 percent of the patients reported that it was more difficult to achieve their weight loss goals during the pandemic, with about half spending less time on exercise. These findings were similar to another paper authored by Almandoz last spring, which was one of the first studies to show the impact of shelter-in-place orders on health behaviors in people with obesity.

"This study demonstrates that adults with obesity continued to engage in the same behaviors and struggled with mental health challenges, even after lockdown orders were lifted. We need to develop interventions targeting these vulnerable groups, such as telehealth options and outreach efforts," says senior author Sarah Messiah, Ph.D., M.P.H., an adjunct professor in the UTSW department of population and data sciences and a professor in the department of epidemiology, human genetics, and environmental sciences at the UTHealth School of Public Health.

The researchers noted that the patients surveyed were predominantly white, college-educated individuals with middle- to high-income levels. Thus, the survey results may not be generalizable to other populations, and may not accurately assess the burden of the pandemic on obesity-related health behaviors in lower socioeconomic status and/or ethnic minority populations disproportionately affected more by obesity and COVID-19. The survey participants were established weight management patients with health insurance - not representative of the average American challenged with obesity, in which less than 2 percent receive anti-obesity medications and fewer than 1 percent undergo bariatric surgery.

Source:

UT Southwestern Medical Center

Journal reference:

Almandoz, J.P., et al. (2021) Substance use, mental health and weight‐related behaviours during the COVID‐19 pandemic in people with obesity. Clinical Obesity. doi.org/10.1111/cob.12440.
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Re: Mental Health Challenges for Spring 2021

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College students forced to relocate during COVID-19 pandemic are more likely to have depression

2/24/21


https://www.news-medical.net/news/20210 ... ssion.aspx


Numerous psychiatric studies have documented increased rates of depression and anxiety among those forced to relocate, with sudden moves often affecting individuals' social support and sense of identity and control.

As the COVID-19 pandemic spread through the U.S. in March of 2020, universities evacuated students from their campuses, and thousands quickly relocated. Few studies have examined the mental health impact of the sudden disruption.

In a new study of 791 undergraduate and graduate students, surveyed between April 9 and August 4, 2020, researchers from Brigham and Women's Hospital, Boston University's School of Social Work, and McLean Hospital revealed that students forced to relocate during the spring were more likely to report COVID-19-related grief, loneliness and generalized anxiety symptoms than students who did not relocate. The findings are published in the Journal of Psychiatric Research.

" Students have high rates of mental health concerns, and moving is a major life stressor for anyone, so we wondered what the consequences of relocating from campus would be. We saw that moving, itself, predicted mental health concerns, even when accounting for other factors that might be involved in mental health."

- Cindy Liu, PhD, Study Corresponding Author, Departments of Pediatric Newborn Medicine and Psychiatry, Brigham and Women's Hospital

These other factors included sociodemographic determinants like age and race, pre-existing mental health diagnoses, measurements of psychological resilience and distress tolerance, the COVID-19 transmission rate in the state where the school was located, and when students took the survey between April and August.

"Even before the pandemic, college students suffered from mental health crises, but COVID-19 has amplified depression, anxiety, and virus-related worry. One of the important findings of the study shows that those who have higher levels of psychological resilience and distress tolerance are much less likely to have symptoms of depression, anxiety, and PTSD. In other words, those with a higher ability to bounce back from adversity and/or to manage and cope with emotional distress were less likely to have mental health problems during the pandemic," said Hyeouk "Chris" Hahm, chair and associate professor of the Social Research Department at BU's School of Social Work, one of the paper's authors.

Approximately one-third of the respondents were required to leave campus, and roughly 80 percent needed to complete the move within one week. Of the 264 students who relocated, roughly 40 percent stated that they left valuable personal belongings behind.

These students were more likely to report COVID-19-related worries, grief, and symptoms of depression, generalized anxiety and post-traumatic stress disorder (PTSD) symptoms, even when accounting for the same predictors of mental health described above.

The association between mental health concerns and leaving behind personal belongings -- which could include medication or other essential items -- was particularly striking to the researchers.

"The logistics surrounding the move, the sense of loss associated with it, how colleges communicate the relocation, and whether or not they provide resources to help students -- those are all very critical considerations that need to take place," Liu said. "When we make the decision to move students off campus, it's important to acknowledge that there may be downstream effects from that action."

Hahm added, "Many students became frustrated with the unclear guidelines coming from their colleges regarding their return dates. Some were led to believe that they could return to campus within a month; thus, some students left their belongings in their dorms. Not all students were able to return to pick up their belongings because of the long distance or limited time."

Certain vulnerable subpopulations were more likely to relocate, including those who indicated nonbinary gender identities and those who received financial aid. Compared to men, those with nonbinary gender identities were more likely to report depressive, generalized anxiety and PTSD symptoms.

The findings come from a larger survey of young adults between the ages of 18 and 30 called the CARES 2020 Project (COVID-19 Adult Resilience Experiences Study), spearheaded by Liu and Hyeouk Chris Hahm, MSSW, PhD, of the School of Social Work at Boston University. The study assesses symptoms of loneliness, depression, anxiety, and post-traumatic stress disorder, as well as two new metrics -- COVID-19-related grief and worry -- that the researchers developed to examine losses and insecurities specifically associated with the pandemic. These range from difficulties in accessing resources to fears about contracting the virus or transmitting it to loved ones. The researchers recruited participants through email lists, social media pages, and by word-of-mouth.

Achieving accurate demographic representation was difficult, which the researchers note can limit the ability to generalize their findings. For example, 80 percent of respondents were women, and Black and Latinx individuals accounted for 4.8 and 5.8 of respondents, respectively.

Engaging marginalized groups in the study was both important and challenging amidst the broader upheaval of the pandemic. To this end, the authors speculate that their respondents were, on average, supported by families with more stable socioeconomic statuses: 44 percent received no financial aid and, of those who relocated, 86 percent were able to return to a parent or guardian and 91 percent were not obligated to pay for their living arrangement.

The researchers are currently examining the experiences of self-identified sexual and gender minorities in more depth. They have also obtained data from a second wave of the study to track young people's experiences during the pandemic beyond the timeframe covered by the initial responses.

"Hopefully there won't be a need for students to relocate again," Liu said. "But going forward, I think we need to continue following the psychological consequences of that move."

Source:

Brigham and Women's Hospital

Journal reference:

Conrad, R. C., et al. (2021) College student mental health risks during the COVID-19 pandemic: Implications of campus relocation. Journal of Psychiatric Research. doi.org/10.1016/j.jpsychires.2021.01.054.
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Re: Mental Health Challenges for Spring 2021

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Large declines in physical activity during COVID-19 associated with higher rates of depression

3/5/21


https://www.news-medical.net/news/20210 ... ssion.aspx


Exercise has long-been recommended as a cognitive-behavioral therapy for patients of depression, yet new evidence from the University of California of San Diego suggests that the COVID-19 pandemic changed the nature of the relationship between physical activity and mental health.

In a study of college students conducted before and during the pandemic, findings revealed the average steps of subjects declined from 10,000 to 4,600 steps per day and rates of depression increased from 32% to 61%.

The research, recently published in the Proceedings of the National Academy of Sciences, also revealed short-term restoration of exercise does not meaningfully improve mental well-being.


" This raises many possible explanations, including that the impact of physical activity may require a longer-term intervention. At the same time, our results clearly show that those who maintained physical exercise throughout the pandemic were the most resilient and least likely to suffer from depression."

- Sally Sadoff, Co-Author, Associate Professor of Economics and Strategy, UC San Diego's Rady School of Management

Sadoff added there is a 15 to 18 percentage point difference in depression rates between participants who experienced large disruptions to their mobility, compared those who maintained their habits.

Sadoff and coauthors from the University of Pittsburg and Carnegie Mellon University point to the alarming trend of increased depression among young adults (ages 18-24) during the pandemic, which is two-times higher than the general population.

The students in the study answered repeated surveys about their well-being and time use over the course of a semester. From March to July 2020, depression rates skyrocketed by 90%, compared to pre-pandemic levels.

Fitbit data helps fill in the gaps in understanding mobility's role in mental health


The study enrolled multiple cohorts of hundreds of U.S. college students from February 2019 through July 2020. In addition to filling out surveys, participants received wearable devices (Fitbits) that track their activity levels. Participants in the 2020 cohort began the study in February and continued participating after their university moved all classes online in March and encouraged students not to return to campus.

Among the subjects, sleep increased by 25 to 30 minutes per night, time spent socializing declined by more than half (less than 30 minutes per day), and screen time more than doubled to five or more hours per day.

The researchers found large declines in physical activity during COVID-19 was most strongly associated with higher rates of depression. Physical activity minutes translate to about 10 minutes in which the heart rate is raised enough to burn at least 1.5 times as many calories as it does at rest.

Those who experienced declines of one to two hours of physical activity per day were most at risk for depression during the pandemic. While participants who were able to maintain their daily habits were at the lowest risk for depression.

"This relationship is one that only emerges during the pandemic," the authors note. "Before the pandemic, there was not a very strong connection between changes in physical activity and mental health, but our analyses suggest that disruption to physical activity is a leading risk factor for depression during this period."

Short-term restoration of exercise habits does not provide mental health relief


In order to examine whether a policy intervention could help counteract some of the pandemic's adverse impacts to mental health, the researchers implemented a randomized experiment.

Half of the participants were incentivized to walk at least 10,000 steps per day for two weeks. The strategy significantly increased their average steps by about 2,300 steps per day and physical activity by almost 40 min per day, compared to the other half of subjects. However, the impact of exercise did not translate into an improvement in mental health, nor did it encourage the students to keep up the physical activity after the two-week period ended.

"Physical activity may have important interactions with other lifestyle behaviors such as social interactions," the authors write. "It could also be the case that the relationship between physical activity and depression is driven more by mental health than it is by lifestyle habits."

They conclude more research is needed to understand how to improve both physical and mental health during such periods of large disruption.

Adding, "The pandemic tightened the relationship between the maintenance of lifestyle habits and mental health."

Source:

University of California - San Diego

Journal reference:

Giuntella, O., et al. (2021) Lifestyle and mental health disruptions during COVID-19. PNAS. doi.org/10.1073/pnas.2016632118.
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Re: Mental Health Challenges for Spring 2021

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Outdoor activities help improve mental health and well-being of teenagers during the pandemic

3/8/21


https://www.news-medical.net/news/20210 ... demic.aspx


A study from North Carolina State University found outdoor play and nature-based activities helped buffer some of the negative mental health impacts of the COVID-19 pandemic for adolescents.

Researchers said the findings, published in the International Journal of Environmental Research and Public Health, point to outdoor play and nature-based activities as a tool to help teenagers cope with major stressors like the COVID-19 pandemic, as well as future natural disasters and other global stressors. Researchers also underscore the mental health implications of restricting outdoor recreation opportunities for adolescents, and the need to increase access to the outdoors.

" Families should be encouraged that building patterns in outdoor recreation can give kids tools to weather the storms to come. Things happen in life, and getting kids outside regularly is an easy way to build some mental resilience."

- Kathryn Stevenson, Study Co-Author and Assistant Professor of Parks, Recreation and Tourism Management at NC State

In the survey, conducted from April 30 to June 15, 2020, researchers asked 624 adolescents between the ages of 10 to 18 years to report their participation in outdoor recreation both before the pandemic and after social distancing measures were in effect across the United States. They also asked adolescents about their subjective well-being, a measure of happiness, and mental health.

The findings revealed the pandemic had an impact on the well-being of many teens in the survey, with nearly 52 percent of adolescents reporting declines in subjective well-being. They also saw declines in teens' ability to get outside, with 64 percent of adolescents reporting their outdoor activity participation fell during the early months of the pandemic. Despite these declines in outdoor activity participation, nearly 77 percent of teens surveyed believed that spending time outside helped them deal with stress associated with the COVID-19 pandemic.

"We know that a lot of outdoor activities that kids engage in happen during school, in youth sports leagues or clubs, and those things got put on hold during the pandemic," said the study's lead author Brent Jackson, a graduate student in the Fisheries, Wildlife and Conservation Biology Program at NC State. "Based on our study, they were getting outside less - we think not being in school and having those activities really contributed to that."

When they broke down recreation by type, they saw participation in outdoor play activities such as sports, biking, going for walks, runs or skating declined by 41.6 percent, nature-based activities such as camping, hiking, fishing, hunting, and paddling dropped by 39.7 percent, and outdoor family activities declined by 28.6 percent. In those early months of the pandemic, about 60 percent of teens said they were able to get outside once a week or less.

"We saw declines in all three types of outdoor recreation participation," Jackson said. "Nature-based activities had the lowest participation before and during the pandemic, which may point to the need for more access to natural spaces in general."

Results showed that well-being and outdoor recreation trends were linked, and the negative trends they saw during the pandemic for well-being and participation in outdoor recreation were seen regardless of teens' race, gender, age, income community type or geographic region. Kids who did not get outside as much saw declines in well-being, but those who got outside both before and during the pandemic were able to maintain higher levels of well-being.

"This tells us that outdoor recreation can promote well-being for kids when it happens, and can potentially take away from well-being when it doesn't," Stevenson said.

Teens who had high rates of outdoor play before the pandemic were more resistant to negative changes in social well-being. Those who got outside frequently before the pandemic were more likely to experience a lesser decline in well-being, regardless of participation during the pandemic. And, for teens who were able to play outside or get involved in nature-based activities during the pandemic, their well-being was on par with pre-pandemic levels.

"Kids who were able to continue participating in outdoor play and nature-based activities had subjective well-being levels that were similar to what they were before the pandemic, but kids who weren't able to participate saw much greater declines," Jackson said.

The study's findings also point to strategies to help kids navigate future global stressor events, as well as the importance of ensuring access to outdoor recreation. They help define the risks associated with policies that reduce kids' ability get outside.

"Going outside and participating in activities that provide exposure to nature, physical activity and safe social interaction during the pandemic were really powerful in terms of improving kids' resilience," Jackson said.

Source:

North Carolina State University

Journal reference:

Brent Jackson, S., et al. (2021) Outdoor Activity Participation Improves Adolescents’ Mental Health and Well-Being during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health. doi.org/10.3390/ijerph18052506.
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Re: Mental Health Challenges for Spring 2021

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Believing in one’s own capabilities boosts personal resilience, shows study

3/11/21


https://www.news-medical.net/news/20210 ... study.aspx


The unpredictable nature of life during the coronavirus pandemic is particularly challenging for many people. Not everyone can cope equally well with the uncertainty and loss of control.

Research has shown that while a large segment of the population turns out to be resilient in times of stress and potentially traumatic events, others are less robust and develop stress-related illnesses. Events that some people experience as draining seem to be a source of motivation and creativity for others.

These differing degrees of resilience demonstrate that people recover from stressful events at different rates, with psychosocial factors such as positivity, optimism, the ability to self-regulate, social skills, problem-solving skills and social support playing a role.

A team from the Department of Psychology and the University Hospital of Psychiatry Zurich teamed up with researchers from New York to investigate how people can strengthen their psychological resilience when facing adversity.

Importance of believing in your own power

" Self-efficacy is a key element of resilience. by self-efficacy, I mean the belief that we have the ability to influence things to at least a small degree, even if some things are unchangeable."

- Birgit Kleim, Study Director and Professor of Psychology, University of Zurich

A self-efficacious person is convinced that they can draw on their own powers to overcome difficult and challenging situations. It doesn't matter whether this is actually the case, as Kleim explains: "Without believing in your own capabilities, you wouldn't take on any challenges in the first place." Self-efficacious people have stronger problem-solving abilities and a higher level of persistence. They also show changes in brain activation in regions linked to emotional regulation.

How might it be possible, then, to boost people's self-efficacy so that they can harness its positive powers in the coronavirus era? For the resilience study, a team of researchers examined 75 people who were distressed by a negative emotional memory.

Before recalling and reassessing this distressing memory, one group of subjects was instructed to vividly recall a positive event such as a beautiful experience in nature or a joyful encounter with others. The others were instructed to think of a time in which they felt they were particularly self-efficacious: situations such as having a successful conversation, passing a difficult exam or giving a presentation. In many cases, doing this exercise just once was already enough to achieve a positive effect.

Recalling autobiographical self-efficacy yields dramatic effects

"Recalling a specific instance of one's own self-efficacy proved to have a far greater impact than recalling a positive event," says Kleim. People who actively recalled their own self-efficacious behavior found it easier to reassess a negative situation and view it in a different light. They perceived the negative experience as less distressing than the subjects who were instructed to reflect on a positive memory unconnected to self-efficacy.

"Our study shows that recalling self-efficacious autobiographical events can be used as a tool both in everyday life and in clinical settings to boost personal resilience," explains the research team. It may be possible to strategically use memories of overcoming past challenges as a way of coping with crisis situations. This also applies to the coronavirus crisis, where these memories can be used to shield against the negative impacts of the pandemic.

Source:

University of Zurich

Journal reference:

Paersch, C., et al. (2021) Recalling autobiographical self-efficacy episodes boosts reappraisal-effects on negative emotional memories. Emotion. doi.org/10.1037/emo0000949.
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Re: Mental Health Challenges for Spring 2021

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Study reports high prevalence of depression and anxiety during COVID-19 pandemic

3/18/21


https://www.news-medical.net/news/20210 ... demic.aspx


A study conducted at Columbia University Mailman School of Public Health reports a high global prevalence of both depression and anxiety during the COVID-19 pandemic and shows how implementation of mitigation strategies including public transportation and school closures, and stay-at-home orders impacted such disorders. The results are published in Psychological Medicine.

" Our research found an elevated global prevalence of these mental health issues during COVID-19 and also revealed there was a wide variance in each at the region- and country-level."

- João Castaldelli-Maia, MD, PhD, NIDA-INVEST Postdoctoral Fellow and Study Lead Author, Department of Epidemiology,

In particular, Asia (most studies came from China) presented lower levels of both anxiety and depression, compared to the other regions of the world. Closure of public transportation increased levels of anxiety, whether it was two weeks or four weeks past the passage of closure enactment, especially in Europe."

Using an end date of July 29th, 2020, the researchers analyzed data from Pubmed, MEDLINE, Web of Science, and medRxiv, among other databases, for depression and anxiety prevalence. They also reviewed the Oxford Covid-19 Government Response Tracker for the containment and closure policies indexes; and the Global Burden of Disease Study for previous levels of depression and anxiety. The WHO database which includes COVID literature for studies published by the same date was also used.

In total, 226,638 individuals were assessed within 60 included studies. Global prevalence of both depression and anxiety during the COVID-19 pandemic were 24 percent and 21 percent, respectively. Asia with rates of 18 percent for each, and China especially, had the lowest prevalence of both disorders.

Regarding the impact of mitigation strategies on mental health -- whether it was public transportation closures, school closings, workplace closures, cancellation of public events, or restrictions on gathering -- only public transportation closures increased prevalence of anxiety, especially in Europe.

Castaldelli-Maia and colleagues found a 21 percent global prevalence of anxiety. Asia had lower levels of anxiety (18 percent) compared to other regions of the world (29 percent). In this case, Europe did not differ from Asia and other regions of the world. Again, a subgroup analysis at the country-level showed that China had a lower prevalence of anxiety at 15.5 percent compared to all other countries at 26 percent.

"Our study confirms how critical it is to investigate levels of mental health disorders and the possible impacts of social distancing measures on mental health outcomes, according to Silvia Martins, MD, PhD, associate professor of Epidemiology at Columbia Mailman School, and senior author. "Mental health concerns should not be viewed only as a delayed consequence of the COVID-19 pandemic, but also as a concurrent epidemic."

Within the subgroup of Asian countries, estimates of depression prevalence ranged from 15 percent to 20 percent. When comparing the prevalence of depression in the pre-and post-COVID-19 eras, the estimates ranging from 1.3-3.4 percent, are demonstrably larger after the initiation of COVID-19.

Depression was observed among 26 percent of the population in Europe, and among 39 percent in other non-Asia regions of the world. A further analysis showed that China had a lower prevalence of depression, 16 percent compared with 29 percent in other countries.

Similarly, the prevalence of anxiety, as reported in the subgroup of Asian countries is higher post-COVID-19. Rates of anxiety prior to COVID-19 ranged from 2.1 to 4.1 percent vs. 18 percent in the present study. Increases in anxiety can be observed in countries outside Asia and Europe (3 to 7 percent vs. 29 percent).

"The lower levels of depression and anxiety that we found in Asian countries could be culture-dependent," observes Martins.

The effect of public transportation closures on anxiety levels points to the importance of these systems to global populations, particularly the results in Europe but not in Asia. "These findings could be linked to the fact that Europe has a more effective and implemented public transport network on average, making Europeans depending more on public transportation than people in Asian countries," noted Martins.

"The COVID-19 pandemic, and the resulting physical distancing measures to mitigate viral spread, has certainly impacted population mental health worldwide, and the high prevalence of mental health disorders is a considerable concern during the COVID era," said Castaldelli-Maia. "These results have important implications for policymakers and show the urgent need for the healthcare sector to increase support now for prevention and early intervention of depression and anxiety."

Source:


​Columbia University's Mailman School of Public Health
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