Risk perception of COVID-19, depressive symptoms and Internet addiction among undergraduates: a longitudinal study.

During the Covid-19 pandemic, individual and collective public health measures were undertaken to control the spread of the virus. Their effectiveness relies on people’s abilities to understand and adopt the correct behaviors. This study aims to evaluate the role of Health Literacy (HL) in influencing the adherence to Covid-19 preventive measures and risk perception of a sample of workers employed in various activities involving close contact with the population in the province of Prato (Tuscany, Italy) in the second pandemic wave (November-December 2020). A cross-sectional survey was conducted on a sample of public workers (e.g., teachers, educators, assistants/aides, other health personnel). Data on knowledge, attitudes and practices towards (KAP) Covid-19 preventive measures and risk perception were collected. HL was measured with the HLS-EU-Q6 tool. Spearman correlation analysis was used to assess the correlation between HL and KAP and Covid-19 risk perception. Multivariate linear regression analyses were performed to evaluate the role of HL in predicting KAP and Covid-19 risk perception, adjusted for sex, age, comorbidity, educational level, country of birth. A total of 402 people participated in this study; 47.8% had a problematic HL level. The HL level was correlated with KAP and practices towards Covid-19 prevention measures; no significant associations were found with Covid-19 risk perception. In multivariate models, HL significantly and positively predicted a higher level of knowledge of Covid-19 preventive measures (B = 0.413 for problematic HL; B = 0.542 for sufficient HL). Confirming a previous study conducted in Prato in the first pandemic wave, HL did not predict adherence to Covid-19 infection control measures, probably due to fear of the disease and attention towards prevention behaviors being still higher in the second pandemic wave. Key messages • HL skills are linked to understanding of public health measures. • HL skills should be improved to favor the adherence to correct behaviors.

Problematic internet use (PIU) and problematic social-media use have been associated with depressive symptoms and suicidal behaviors among university students, with limited Mediterranean evidence. This study examined their associations with stressful life events, depressive symptoms, and suicidal behaviors. A cross-sectional anonymous online survey conducted among undergraduates at the Cyprus University of Technology. Participants completed Internet Addiction Test-20 (IAT-20) to assess PIU risk, Bergen Social Media Addiction Scale (BSMAS) to assess problematic social-media use, Center for Epidemiologic Studies Depression Scale (CES-D) to assess depressive symptoms, Life Events Scale for Students (LESS-36) to assess stressful life events, and Suicidal Behaviors Questionnaire-Revised (SBQ-R) to assess suicidal behaviors. Correlation and multivariable linear regression analyses examined associations with depressive symptoms and suicidal behaviors. 1002 students completed the survey (45% response rate); 67.7% were female. PIU risk was minimal (51.1%), mild (38.6%), and moderate (10.3%). BSMAS and LESS-36 scores correlated with depressive symptoms (ρ = 0.47; ρ = 0.30) and suicidal behaviors (ρ = 0.24; ρ = 0.31; all p < 0.001). Adjusted analyses showed depressive symptoms were associated with female gender, mild-moderate PIU, problematic social-media use, and stressful life events. Suicidal behaviors were associated with male gender, non-Cypriot nationality, family history of mental illness, screen time, mild-moderate PIU, stressful life events, and depressive symptoms. Problematic internet and social-media use and stressful life events were associated with depressive symptoms and suicidal behaviors; longitudinal research is needed to clarify temporal relationships.

Background: Problematic internet use (PIU) is a serious global mental health issue that especially manifested during the Coronavirus disease (COVID-19) pandemic. Engagement in PIU as an impulsive coping with mental distress may pose a long-lasting threat to develop anxiety and depressive disorders. The first aim of our study was to investigate the prevalence of PIU and mental distress symptoms during the COVID-19 pandemic among university students in Lithuania. The second aim was to test the hypothesis that PIU affects anxiety and depressive symptoms through the mediating role of impulsivity.Methods: The cross-sectional study was comprised of 619 university students (92.9% females and 7.1% males) with a mean age of 22 ± 3 years who participated in an online survey from May to November, 2020. Participants completed the following scales: the Problematic Internet Use Questionnaire-9, the Generalized Anxiety Disorder Questionnaire-7, the Patient Health Questionnaire-9, and the Barratt Impulsiveness Scale-11. K-means cluster analysis and one-way multivariate analysis of variance were used for group comparison in terms of internet use time and habit change during COVID-19 pandemic. Structural equation modeling was applied to examine the mediating effect of impulsivity in association between PIU and mental distress, while controlling for age.Results: In sum, 45.1% of the participants reported PIU and 38.1% had markedly expressed symptoms of anxiety while 43.6% of the students reported moderate to severe depressive symptoms. During the COVID-19 pandemic 76% of the students reported at least moderate increase in their internet use time. Anxiety and depressive symptoms were significantly higher in the group of frequent internet users. The results of the structural equational modeling analysis showed a statistically significant effect of PIU on subjective anxiety symptoms and the statistically significant effect of PIU on subjective depression symptoms, both mediated via impulsivity.Conclusions: During COVID-19 pandemic, PIU, anxiety and depression symptoms are highly prevalent among students. Findings also suggest that relationships between PIU, anxiety and depressive symptoms are mediated via impulsivity. These results underscore the importance of the inclusion of impulsivity factor in the studies analyzing longitudinal effects of PIU on mental distress during COVID-19 pandemic.

COVID-19 pandemic effects on emotional health and substance use among urban American Indian and Alaska Native people

Background: After the onset of the COVID-19 pandemic, it spread to 213 countries in 2020. In Indonesia there were 6,812,127 cases, which ranked 20th worldwide in the year 2024. In response, Indonesia issued a policy mandating mask use. This study aims to investigate the association between risk perception, sociodemographic factors, and knowledge of COVID-19 with consistent mask-wearing outside the home. Methods This was an online study conducted from November 2020 to February 2021, during the first wave of COVID-19. Participants were provided written informed consent prior to agreeing or declining to voluntarily participate in the questionnaire-based study. A total of 1,153 respondents were selected. The dependent variable was consistent mask-wearing outside the home, while the independent variables were risk perception regarding COVID-19, sociodemographic factors (location, age, gender, education, occupation, family income, family members, social health scheme), and knowledge of COVID-19. Data were analyzed using logistic regression analysis. Results The risk perception of COVID-19 as a viral disease that can cause death (aOR: 2.502; 95% CI: 1.601-3.912) was positively associated with consistent mask-wearing outside the home. Regarding sociodemographic factor, individuals aged between 25 to 44 years (aOR: 0.486; 95% CI: 0.254-0.932) were 49% less likely to consistently use masks. Knowledge of the need to change cloth masks every 4-6 hours (aOR: 1.697; 95% CI: 1.118-2.576); the transmission (aOR: 1.974; 95%CI: 1.040-3.746), knowledge of severe symptoms of COVID-19 (aOR: 1.981; 95%CI: 1.175-3.342); and awareness of the confirmed diagnosis by PCR (aOR: 2.238; 95%CI: 1.215-4.120) were positively associated with consistent mask-wearing outside the home. Conclusions The risk perception of COVID-19 as potentially fatal and knowledge regarding proper mask-changing intervals, the transmission, severe symptoms, and PCR-based diagnosis were positively associated with mask-wearing outside the home. However, individuals aged between 25 to 44 years were less likely to wear mask consistently. These findings underscore the importance of targeted public health interventions that address risk perception and enhance knowledge to promote mask use as effective COVID-19 prevention measures.

BackgroundWhether COVID-19 is associated with a change in risk perception about other health conditions is unknown. Because COVID-19 occurred during a breast cancer study, we evaluated the effect of COVID-19 risk perception on women’s breast cancer risk perception.ObjectiveThis study aims to evaluate the relationship between perceived risk of COVID-19 and change in perceived breast cancer risk. We hypothesized that women who perceived greater COVID-19 risk would evidence increased perceived breast cancer risk and this risk would relate to increased anxiety and missed cancer screening.MethodsWomen aged 40-74 years with no breast cancer history were enrolled in a US breast cancer prevention trial in outpatient settings. They had provided breast cancer risk perception and general anxiety before COVID-19. We performed a prospective observational study of the relationship between the perceived risk of COVID-19 and the change in perceived breast cancer risk compared to before the pandemic. Each woman was surveyed up to 4 times about COVID-19 and breast cancer risk perception, general anxiety, and missed medical care early in COVID-19 (May to December 2020).ResultsAmong 13,002 women who completed a survey, compared to before COVID-19, anxiety was higher during COVID-19 (mean T score 53.5 vs 49.7 before COVID-19; difference 3.8, 95% CI 3.6-4.0; P<.001) and directly related to perceived COVID-19 risk. In survey wave 1, anxiety increased by 2.3 T score points for women with very low perceived COVID-19 risk and 5.2 points for those with moderately or very high perceived COVID-19 risk. Despite no overall difference in breast cancer risk perception (mean 32.5% vs 32.5% before COVID-19; difference 0.24, 95% CI –0.47 to 0.52; P=.93), there was a direct relationship between change in perceived breast cancer risk with COVID-19 risk perception, ranging in survey wave 4 from a 2.4% decrease in breast cancer risk perception for those with very low COVID-19 risk perception to a 3.4% increase for women with moderately to very high COVID-19 risk perception. This was not explained by the change in anxiety or missed cancer screening. After adjustment for age, race, education, and survey wave, compared to women with very low perceived COVID-19 risk, perceived breast cancer risk increased by 1.54% (95% CI 0.75%-2.33%; P<.001), 4.28% (95% CI 3.30%-5.25%; P<.001), and 3.67% (95% CI 1.94%-5.40%; P<.001) for women with moderately low, neither high nor low, and moderately or very high perceived COVID-19 risk, respectively.ConclusionsLow perceived COVID-19 risk was associated with reduced perceived breast cancer risk, and higher levels of perceived COVID-19 risk were associated with increased perceived breast cancer risk. This natural experiment suggests that a threat such as COVID-19 may have implications beyond the pandemic. Preventive health behaviors related to perceived risk may need attention as COVID-19 becomes endemic.

The co-occurrence of attention-deficit/hyperactivity disorder (ADHD) and problematic Internet use (PIU) is associated with increased severity of PIU and poorer treatment outcomes. The main objective of this study was to examine the association between PIU and adult ADHD symptoms and determine whether adult ADHD symptoms were a predictor of PIU in the general adult population. We also examined the potential mediating role of the dimensional psychopathological factors, including anxiety, depression, impulsivity, and emotion regulation, in this relationship. To achieve these aims, we recruited 532 regular Internet users online from the general adult population. The participants completed an online questionnaire assessing PIU (Internet Addiction Test), anxiety and depression symptoms (Hospital Anxiety and Depression Scale), adult ADHD symptoms (Adult ADHD Self-Report Scale-V1.1), emotion regulation (Emotion Regulation Questionnaire), and impulsivity (UPPS-P Impulsive Behavior Scale). We conducted a multiple regression analysis to determine the predictors of PIU and mediation analyses to identify the psychopathological mediators of the association between adult ADHD symptoms and PIU. PIU was observed in 17.9% of our sample. A significantly higher proportion of respondents with PIU screened positive for adult ADHD symptoms compared to respondents without PIU (50.5 vs. 21.7%; p < 0.001). Individuals with PIU reported significantly higher scores than those without PIU for anxiety and depressive symptoms, impulsivity, and the emotion regulation strategy of expressive suppression. Additionally, they had significantly lower scores than those without PIU on cognitive reappraisal than non-problematic Internet users. In addition to adult ADHD symptoms, the multiple regression analysis revealed that PIU was also positively predicted by depressive symptoms, positive urgency, lack of perseverance, and expressive suppression, and is negatively predicted by cognitive reappraisal and negative urgency. The mediation analysis showed that lack of perseverance, positive urgency, and depressive and anxiety symptoms were partial mediators of the relationship between adult ADHD symptoms and PIU. Our results highlight the significant co-occurrence of PIU and adult ADHD symptoms. This study also provides support for a theoretical model in which impulsivity dimensions, emotion regulation strategies, as well as the tendency to anxiety and depressive symptoms, may play a mediating role in this co-occurrence. In summary, the findings emphasize the need to assess these psychological characteristics in problematic Internet users, as they can be a factor of clinical complexity, as well as the importance of targeting them as part of integrated interventions for both adult ADHD symptoms and PIU.

The interesting scenario involving COVID-19's breakout in multiple nations is still serious in many areas of the world. This perceived risk can significantly increase compliance with COVID-19 prevention behaviors during the next pandemic. The purpose of this study was to explore how people perceive COVID-19 risk, disease severity, and COVID-19 prevention in Samut Songkhram province, Thailand. A study examined the relationship between people's perceptions of risk, COVID-19 severity, and COVID-19 prevention activity. The COVID-19 issue was the subject of this cross-sectional investigation, using a Geographic Information System. A cross-sectional study on perception of COVID-19 risk, disease severity, and COVID-19 prevention. Explore the relationship between the people's perception of COVID-19 risk, disease severity, and COVID-19 prevention behaviors. Descriptive statistics, such as frequency distribution methods, mean, standard deviation. Analytical statistics, such as correlation and multiple regression, were used to analyze the data. This study found that the female to male ratio is around 1:2. The age group with the most representation was 15-26 years old. The results showed that people's perception of COVID-19 risk had no relationship to COVID-19 preventive behaviors. People's perception of COVID-19 severity was shown to be significantly associated with COVID-19 prevention behaviors at 0.001. The multiple regression equation to estimate COVID-19 prevention behaviors in a new epidemic; P (the COVID-19 prevention) = 4.344 – 0.115 Female(X1) + 0.141 Farmer(X2) +0.356 Trading(X3) + 0.733 Traveled to an endemic area(X4) + 0.253 Age, 28-36 years(X5) – 0.546 Age, 37-46 years(X6) + 0.317 Age, 47-56 years(X7) + 0.151 Age, &gt;56 years(X8) + 0.318 The perception of COVID-19 severity(X9) – 0.092 The perceptions of COVID-19 risk(X10). The results of this study will be used to establish an intervention model for encouraging and establishing effective COVID-19 preventive practices, as well as maintaining and continuing them.

The relationship of Internet addiction severity with Attention Deficit Hyperactivity Disorder symptoms in Turkish University students; impact of personality traits, depression and anxiety

Objective: The aim of this study was to investigate the prevalence of internet addiction (IA), and the relationship between (IA) and cognitive functions like selective and sustained attention, inhibitory control, set shifting by using Stroop and Trail Making Tests. Methods: Two hundred and twenty-one university students participated in the re-search. At first step, the participants were filled Sociodemographic Form and Internet Addiction Scale (IAS). At the second step, 30 participants with IA whom score was above the threshold (≥81 for IAS) and 29 participants without IA whom score was under the threshold for IAS were recruited. Stroop Test (ST), Trail Making Tests (TMT) and Beck Depression Inventory (BDI) were applied to individuals with and without IA at the second step of the study. Results: Prevalence of IA was 15.3% (n=34) in all participants. Four of participants who had IA did not accept to participate the second step. IAS score was positively correlated with Stroop phonemic time, Stroop color naming time, Stroop interference time, TMT-B form time and TMT-B form false number (respectively; r=0.31, r=0.50, r=0.46, r=0.39, and r=0.66). Conclusion: Our results have shown that attention-related problems and inability of behavioral control may be related to IA.

This study investigated the impacts of risk perception of COVID-19 on anxiety and depression symptoms among hospital pharmacists in China. We conducted a cross-sectional study with hospital pharmacists during the COVID-19 pandemic in China. Some 4,219 hospital pharmacists completed an online survey including demographic questions, risk perception of COVID-19, General Anxiety Disorder-7, Patient Health Questionnaire-9, and Positive and Negative Affect Schedule. Multivariate regression and mediation analyses were conducted. The results indicated that 41.9% and 29.4% of hospital pharmacists experienced mild to severe levels of anxiety and depression symptoms, respectively. In older age, a higher level of risk perception of COVID-19, and negative affect experience were risk factors, whereas positive affect experience was a protective factor for anxiety and depression symptoms among pharmacists. Experience of positive and negative affect mediated the relationship between risk perception of COVID-19 and anxiety and depression among hospital pharmacists in China. Timely mental health services need to be provided for hospital pharmacists during the COVID-19 pandemic.

Self-compassion is a psychological construct associated with enhanced well-being, which, to a lesser extent, has been examined in relation to addictive behaviors. The present study aims to: (1) examine gender differences in self-compassion, anxiety and depressive symptoms, and problematic Internet and smartphone use; (2) analyze the relationships among these variables; and (3) determine whether self-compassion moderates the association between anxiety and depressive symptomatology and problematic Internet and smartphone use. The sample consisted of 953 Spanish secondary school students aged 13 to 18 years (M= 15.42,SD= 1.17; 55.0% females). Significant gender differences were found in all study variables except problematic Internet use, with females reporting higher levels of anxiety, depression, and problematic smartphone use, and males scoring higher in self-compassion. Moderation analyses revealed that depression and anxiety were positively associated with both problematic Internet smartphone use, while self-compassion showed negative associations with both outcomes. Significant interactions were observed, with stronger positive associations between anxiety and depression and both problematic Internet and smartphone use at higher levels of self-compassion. Our results underscore that association between depressive and anxiety symptoms and problematic Internet and smartphone use in adolescents varied across levels of self-compassion, supporting its consideration in interventions targeting behavioral addictions.

Background: We assessed the relationship between depressive symptoms and perceived COVID-19 risk in the next month. Methods: This analysis used survey data collected during a July 2020 cross-sectional study using a household-based probability sampling design. A total of 615 noninstitutionalized, English- and/or Spanish-speaking adults in Ohio were included. Depressive symptoms screening occurred using the Patient Health Questionnaire-2 (PHQ-2). We applied survey weights so that presented analyses represent the adult population in Ohio. We performed log-risk regression modeling (generalized linear model with binomial distribution and log link) to estimate unadjusted and covariate-adjusted prevalence ratios examining the association between screening positive for depressive symptoms and perceived risk of COVID-19 in the next month. Results: The study population was majority female (59.1%) and White (90.3%). The mean age was 55.9 years (standard deviation (SD)=17.3). About 1 in 20 (4.6%) screened positive for depressive symptoms. A positive depressive symptoms screen was not significantly associated with perceived risk of COVID-19 in the next month (prevalence ratio [PR]=0.75; 95% confidence interval [CI]=0.25–2.24). After confounder adjustment, the adjusted prevalence ratio (aPR) was nearly unchanged (aPR=0.78; 95% CI=0.24–2.55). Conclusion: As depression is often associated with anxiety and pessimism toward the future, the lack of association between depressive symptoms screening and perception of COVID-19 risk in the next month is surprising. Social withdrawal, which is also associated with depression, may have concealed any increased perceived COVID-19 risk, as depressed individuals who remained socially isolated may have had lower perceived COVID-19 risk.

Background In the absence of definitive treatment, vaccination against COVID-19 emerged as an effective solution to the spread of the pandemic. This study aimed to investigate the factors impacting the rates of COVID-19 vaccine acceptance in Jordan, in addition to examining the relationship between COVID-19 risk perception and vaccine acceptance among the Jordanian population. Methods This cross-sectional study was conducted among a sample of adults (aged ≥18) residing in Jordan. Data were collected using an online questionnaire disseminated using social media platforms between December 2nd and December 29th, 2020. Results A total of 2,268 (72.3%) participants demonstrated willingness to receive the COVID-19 vaccine. The mean COVID-19 risk perception score among the participants was 4.65 out of 10 (median 5; IQR 3–6). Higher risk perception scores were significantly associated with being female (p = .001), young (p < .001), or a smoker (p = .005). A significant positive correlation was identified between COVID-19 vaccine acceptance and risk perception scores (OR = 1.319, 95%, CI = 1.261–1.380, p < .001). Moreover, male participants (75%, OR = 1.220, 95% CI = 1.007–1.479, p = .043), participants aged 18–24 years (78.1%, OR = 1.635, 95% CI = 1.189–2.246, p = .002), and participants with children aged under 18 years (73.9%, OR = 1.210, 95% CI = 1.010–1.450, p = .039) were more willing than their counterparts to get vaccinated. Conclusion COVID-19 risk perception and certain sociodemographic characteristics (i.e., being male, being young, and having children aged under 18 years) were found to be significantly associated with vaccine acceptance. Policymakers are recommended to develop public educational campaigns to enhance people’s trust in and willingness to take the COVID-19 vaccine.

BackgroundThe prevalence of problematic Internet use (PIU) among adolescents and young adults (AYA) was approximately 9–11% before the COVID-19 pandemic. The purpose of this study was to determine the prevalence of PIU among AYAs (especially younger adolescents) during the COVID-19 pandemic using the Problematic and Risky Internet Use Screening Scale (PRIUSS). Additionally, we examined the relationship between PIU, depression and anxiety among AYAs during the same period.MethodsA descriptive-analysis survey study was completed over a 6-month period from January 4, 2021, to June 30, 2021. It was conducted at a tertiary care Adolescent Medicine Clinic with AYAs age 12–21. The PRIUSS screened for PIU, the PHQ-9A [Patient Health Questionnaire-9A] screened for depression, and the GAD-7 [General Anxiety Disorder-7] screened for generalized anxiety. Fisher’s exact test, the Mann–Whitney test and Spearman correlations were performed.ResultsA positive PRIUSS score was observed in 18% of the 447 participants. Of these participants, 44% had a pre-existing diagnosis of depression, 39% had a pre-existing diagnosis of anxiety and 29% had a pre-existing diagnosis of depression and anxiety. There was a positive correlation between PRIUSS, PHQ-9A and GAD-7 total scores. A higher PRIUSS score was associated with a higher PHQ-9A and GAD-7 score (p < 0.001). There was also a positive correlation between a positive PRIUSS score and a pre-existing diagnosis of depression (p < 0.001).ConclusionsThis study showed a higher prevalence of PIU during the COVID-19 pandemic using the PRIUSS. In addition, a positive correlation between PRIUSS scores and pre-existing diagnosis of depression, positive GAD-7 and PHQ-9A scores was noted. In conclusion, medical providers should consider screening for PIU in AYAs with positive mental health screens.