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Survey finds large increase in psychological distress reported among US adults during the COVID-19 pandemic

June 3, 2020

Science Daily/Johns Hopkins University Bloomberg School of Public Health

A new survey conducted by researchers at the Johns Hopkins Bloomberg School of Public Health during the COVID-19 pandemic found a more-than-threefold increase in the percentage of U.S. adults who reported symptoms of psychological distress -- from 3.9 percent in 2018 to 13.6 percent in April 2020. The percentage of adults ages 18-29 in the U.S. who reported psychological distress increased from 3.7 percent in 2018 to 24 percent in 2020.

The survey, fielded online April 7 to April 13, found that 19.3 percent of adults with annual household incomes less than $35,000 reported psychological distress in 2020 compared to 7.9 percent in 2018, an increase of 11.4 percentage points. Nearly one-fifth, or 18.3 percent, of Hispanic adults reported psychological distress in 2020 compared to 4.4 percent in 2018, a more than four-fold increase of 13.9 percentage points. The researchers also found that psychological distress in adults age 55 and older almost doubled from 3.8 percent in 2018 to 7.3 percent in 2020.

The survey found only a slight increase in feelings of loneliness, from 11 percent in 2018 to 13.8 percent in 2020, suggesting that loneliness is not driving increased psychological distress.

The findings were published online June 3 in a research letter in JAMA.

The disruptions of the COVID-19 pandemic -- social distancing, fear of contracting the disease, economic uncertainty, including high unemployment -- have negatively affected mental health. The pandemic has also disrupted access to mental health services.

"We need to prepare for higher rates of mental illness among U.S .adults post-COVID," says McGinty. "It is especially important to identify mental illness treatment needs and connect people to services, with a focus on groups with high psychological distress including young adults, adults in low-income households, and Hispanics."

The survey used a scale to assess feelings of emotional suffering and symptoms of anxiety and depression in the past 30 days. The survey questions included in this analysis did not ask specifically about COVID-19. The scale, a validated measure of psychological distress, has been shown to accurately predict clinical diagnoses of serious mental illness.

Using NORC AmeriSpeak, a nationally representative online survey panel, the researchers analyzed survey responses of 1,468 adults ages 18 and older. They compared the measure of psychological distress in this survey sample from April 2020 to an identical measure from the 2018 National Health Interview Survey.

"The study suggests that the distress experienced during COVID-19 may transfer to longer-term psychiatric disorders requiring clinical care," says McGinty. "Health care providers, educators, social workers, and other front-line providers can help promote mental wellness and support."

https://www.sciencedaily.com/releases/2020/06/200603132550.htm

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How Americans are coping with COVID-19 stress

June 1, 2020

Science Daily/University of Connecticut

Almost overnight, the rapid emergence of the COVID-19 pandemic in the United States and subsequent state and federal prevention measures dramatically altered daily behavior. A new study provides the first snapshot of the immediate impact of COVID-19 on Americans' stress levels, coping strategies, and adherence to public health guidelin

Several months into the pandemic, most Americans are familiar with the physical toll COVID-19 takes on those who contract it. But what about the mental and emotional implications of stress caused by the pandemic itself?

A new study by researchers from the University of Connecticut provides the first snapshot of the immediate impact of COVID-19 on Americans' stress levels, coping strategies, and adherence to public health guidelines.

For the study, which was published in the Journal of General Internal Medicine, the team surveyed over 1,000 English-speaking individuals, 18 years of age or older, living in the United States. Responses were collected in early April 2020, giving the researchers a unique view of how Americans are handling their new reality.

"Almost overnight, the rapid emergence of the COVID-19 pandemic in the United States and subsequent state and federal prevention measures dramatically altered daily behavior," says Crystal Park, professor of in the Department of Psychological Sciences. "This unique, early study and our planned future work will let us see how Americans navigate all of these changes, and how their response to this stress evolves over time."

In the study, the UConn researchers present baseline data on COVID-19-related stressors in three categories: stress related to the virus itself, stress related to changes in daily routines caused by the pandemic, and financial or resource-related stress. These measures allowed them to examine the circumstance-specific stressors of COVID-19 rather than global stress that could have other causes.

Based on previous work during SARS outbreaks and the early months of the COVID-19 pandemic, the researchers created an assessment of 23 COVID-19 stressors and their degree of stressfulness. The survey showed that Americans have high stress exposure from COVID-19, and that some demographic groups appear particularly vulnerable to stress effects. Reading or hearing about the severity and contagiousness of COVID-19 was the most common stressor, with almost 97% of survey respondents experiencing it. Uncertainty about the duration of social distancing requirements and changes to social and daily personal care routines also ranked high on the list of stressors with between 80% and 88% of those surveyed experiencing them.

While fears related to the virus itself were the most common, the survey showed that respondents were more acutely concerned about the financial consequences caused by the pandemic. Of the stressors experienced, respondents ranked loss of job security or income as the most stressful, followed by risk of a loved one's illness.

The researchers also looked at the methods Americans reported using to cope with these stressors. Distraction, seeking emotional social support, and active coping were the most commonly reported strategies. Younger participants, sexual minorities, and those with greater financial instability generally reported greater use of less helpful strategies, including substance use, behavioral disengagement, and humor.

Because of the unprecedented nature of the COVID-19 pandemic, the researchers say it's hard to determine which strategies will be healthy for managing stress over the weeks and months ahead.

"Distraction or avoidance is usually considered to be an unproductive coping strategy for most challenging situations and can lead to negative outcomes," says Beth Russell, associate professor of Human Development and Family Sciences and director of the Center for Applied Research in Human Development (CARHD). "But in this instance where people don't have much control over making the disease itself better, we can do small things to help ourselves and others -- seek connections through telemediated emotional support, for example -- and find ways to let the time pass. We'll see in the long run how those strategies help people's mental health."

The survey also showed very high rates of compliance with social distancing and federal Centers for Disease Control and Prevention (CDC) guidelines. Approximately 95% of respondents avoided eating out at bars or restaurants and visiting nursing homes, although these behaviors are likely impacted by policies enacted at the state and municipal levels. Almost 90% of respondents had stopped discretionary travel and were keeping the recommended six-feet distance from others. Approximately 75% of respondents reported adhering to CDC guidelines related to hygiene, like avoiding touching their faces and regularly cleaning and disinfecting surfaces. Some of the reported behaviors showed a potentially worrisome lack of adherence to critical CDC guidelines though, particularly for men and younger adults.

The role demographics play in stress, coping, and adherence to guidelines will be the focus of future studies by the team. Those results will be important for clinicians and policymakers as they develop the most effective health interventions to stem the anticipated long-term mental health impacts, they say.

"As we focus on developing treatments and vaccines, it is critical that we also understand the social aspects of this virus," says Michael Fendrich, associate dean for research in UConn's School of Social Work and co-author of the paper. "Understanding how Americans experience and respond to COVID-19 stressors and how this varies by socio-demographic characteristics can help to more effectively target prevention measures across various groups."

The team is continuing to monitor Americans' response to stress from the COVID-19 pandemic in future longitudinal waves of this study, which they hope will inform effective health behavior interventions to stop its spread.

https://www.sciencedaily.com/releases/2020/06/200601134607.htm

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Anxious about COVID-19? Stress can have lasting impacts on sperm and future offspring

Study identifies biological mechanism by which stress alters sperm and impacts brain development in next generation

March 23, 2020

Science Daily/University of Maryland School of Medicine

Prolonged fear and anxiety brought on by major stressors, like the coronavirus pandemic, can not only take a toll on a person's mental health, but may also have a lasting impact on a man's sperm composition that could affect his future offspring. That is the finding of a provocative new study published in the journal Nature Communications by researchers at the University of Maryland School of Medicine.

The research outlines a biological mechanism for how a father's experience with stress can influence fetal brain development in the womb. The effects of paternal stress can be transferred to offspring through changes in the extracellular vesicles that then interact with maturing sperm. Extracellular vesicles are small membrane-bound particles that transport proteins, lipids, and nucleic acids between cells. They are produced in large amounts in the reproductive tract and play an integral role in sperm maturation.

"There are so many reasons that reducing stress is beneficial especially now when our stress levels are chronically elevated and will remain so for the next few months," said study corresponding author Tracy Bale, PhD, Professor of Pharmacology and Director of the Center for Epigenetic Research in Child Health & Brain Development at the University of Maryland School of Medicine. "Properly managing stress can not only improve mental health and other stress-related ailments, but it can also help reduce the potential lasting impact on the reproductive system that could impact future generations."

She and her colleagues did not specifically study those who were under stress due to the coronavirus pandemic.

To examine a novel biological role for extracellular vesicles in transferring dad's stress to sperm, the researchers examined extracellular vesicles from mice following treatment with the stress hormone corticosterone. After treatment, the extracellular vesicles showed dramatic changes in their overall size as well as their protein and small RNA content.

When sperm were incubated with these previously "stressed" extracellular vesicles prior to fertilizing an egg, the resulting mouse pups showed significant changes in patterns of early brain development, and as adults these mice were also significantly different than controls for how they responded to stress themselves.

To see if similar differences occurred in human sperm, the researchers recruited students from the University of Pennsylvania to donate sperm each month for six months, and complete questionnaires about their perceived stress state in the preceding month. They found that students who had experienced elevated stress in months prior showed significant changes in the small RNA content of their sperm, while those who had no change in stress levels experienced little or no change. These data confirm a very similar pattern found in the mouse study.

"Our study shows that the baby's brain develops differently if the father experienced a chronic period of stress before conception, but we still do not know the implications of these differences," said Dr. Bale. "Could this prolonged higher level of stress raise the risk for mental health issues in future offspring, or could experiencing stress and managing it well help to promote stress resilience? We don't really know at this point, but our data highlight why further studies are necessary."

The research team did find that stress-induced changes in the male reproductive system take place at least a month after the stress is attenuated and life has resumed its normal patterns. "It appears the body's adaptation to stress is to return to a new baseline," Dr. Bale said, "a post-stress physiological state -- termed allostasis."

This research was funded by the National Institute of Mental Health and included co-authors from the Institute for Genome Sciences at the University of Maryland School of Medicine and the Department of Pharmaceutical Science at the University of Maryland School of Pharmacy, as well as the University of Pennsylvania.

"This research represents a critical step in understanding important mechanisms that underlie the field of intergenerational epigenetics," said UMSOM Dean E. Albert Reece, MD, PhD, MBA, who is also the Executive Vice President for Medical Affairs, University of Maryland, and the John Z. and Akiko K. Bowers Distinguished Professor. "Such knowledge is crucial to identify early interventions to improve reproduction and early childhood development down the road."

While the study did not test stress management interventions to determine what effects they might have on attenuating the changes in sperm composition, Dr. Bale, who goes for regular runs to reduce the stress of the current COVID-19 pandemic, contends that any lifestyle habits that are good for the brain are likely good for the reproductive system.

"It is important to realize that social distancing does not have to mean social isolation, especially with modern technologies available to many of us," said Joshua Gordon, Director of the National Institute of Mental Health in his web message about coping with coronavirus. "Connecting with our friends and loved ones, whether by high tech means or through simple phone calls, can help us maintain ties during stressful days ahead and will give us strength to weather this difficult passage."

The Centers for Disease Control and Prevention has tips on "stress and coping" page on their COVID-19 site that recommends the following to "support yourself":

  • Take breaks from watching, reading, or listening to news stories, including social media. Hearing about the pandemic repeatedly can be upsetting.

  • Take care of your body. Take deep breaths, stretch, or meditate. Try to eat healthy, well-balanced meals, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.

  • Make time to unwind. Try to do some other activities you enjoy.

  • Connect with others. Talk with people you trust about your concerns and how you are feeling.

https://www.sciencedaily.com/releases/2020/03/200323132410.htm

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