How anxious did you feel during lockdown? The roles resilience, living environment, and gender play on the level of anxiety state during pandemic isolation

Abstract

In the unique context of the coronavirus disease 2019 (COVID-19) pandemic, researchers and clinicians alike drew attention to the risks involved by physical and social isolation for mental health. Factors like resilience, gender, urban/rural environment, or preexisting anxiety can impact anxious states produced by home forced isolation. Based on these, we assumed that: i) there are significant differences in the level of anxiety (state) during the pandemic, depending on the living area of the subjects; ii) gender plays a moderating role in the relationship between resilience and anxiety; and iii) anxiety (trait), experiential avoidance, resilience, and family connectedness, determine the level of anxiety (state). The MemoryLab team conducted the present study on 495 subjects (n=411 women, age between 18 and 65). Of these, 350 live in large and medium urban areas, 63 in small urban areas, and 82 in rural areas. As instruments, we used The State-Trait Anxiety Inventory (STAI 2.0), The Acceptance and Action Questionnaire 2 (AAQ-2), The Aggression Questionnaire (AQ), The Family Connectedness Questionnaire, and Connor-Davidson Resilience Scale 10 (CD-RISC-10), as well as the standard division of living areas according to community size. Data collection took place online during the spring peak of the pandemic. According to ANOVA analysis, people living in small urban areas have a higher level of anxiety. The difference is significant compared to those living in large and medium cities and villages. Gender has no moderating role in the relationship between resilience and the anxiety state. Also, experiential avoidance, anxiety (trait), and resilience play a significant role on the level of anxiety (state), measured during social isolation. The results could be an important indicator for understanding psychological mechanisms guiding interventions to support the communities effectively.

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References

Ajilore, O. (2020). Rural America is starting to feel the impact of the coronavirus. Center for American Progress. Available from: https://www.americanprogress.org/issues/economy/reports/2020/04/28/484016/rural-america-starting-feel-impactcoronavirus/

American Psychological Association (APA). (2020). Psychological impact of COVID-19. Available from: https://www.apa.org/topics/COVID-19/psychological-impact

Bartik, A. W., Bertrand, M., Cullen, Z., Glaeser, E.L., Luca, M., & Stanton, C. (2020). The impact of COVID-19 on small business outcomes and expectations. Proceedings of the National Academy of Sciences of the United States of America, 117 (30), 17656-17666. doi: 10.1073/pnas.2006991117. DOI: https://doi.org/10.1073/pnas.2006991117

Bekker, M. H. J., & van Mens-Verhulst, J. (2007). Anxiety disorders: sex differences in prevalence, degree, and background, but gender-neutral treatment. Gender Medicine, 4(2), 178-193. doi: https://doi.org/10.1016/S1550-8579(07)80057-X. DOI: https://doi.org/10.1016/S1550-8579(07)80057-X

Bennett, S. A. (1983). Patient perspective - psychological effects of barrier nursing isolation. Australian Nursing Journal, 12(10), 36-37.

Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behaviour Therapy, 42, 676-688. doi: https://doi.org/10.1016/j.beth.2011.03.007 DOI: https://doi.org/10.1016/j.beth.2011.03.007

Boulanger, J. L., Hayes, S. C., & Pistorello, J. (2010). Experiential avoidance as a functional contextual concept. In Kring, A.M., & Sloan, D.M. (Eds.), Emotion regulation, and psychopathology: A transdiagnostic approach to aetiology and treatment (pp. 107-136). New York, NY: The Guilford Press.

Campbell-Sills, L., Forde, D. R., & Stein, M. B. (2009). Demographic and childhood environmental predictors of resilience in a community sample. Journal of Psychiatric Research, 43(12), 1007-1012. doi: https://doi.org/10.1016/j.jpsychires.2009.01.013 DOI: https://doi.org/10.1016/j.jpsychires.2009.01.013

Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (2020). The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research, 112934. doi: https://doi.org/10.1016/j.psychres.2020.112934 DOI: https://doi.org/10.1016/j.psychres.2020.112934

Chawla, N., & Ostafin, B. (2007). Experiential avoidance as a functional dimensional approach to psychopathology: An empirical review. Journal of clinical psychology, 63(9), 871-890. doi: https://doi.org/10.1002/jclp.20400 DOI: https://doi.org/10.1002/jclp.20400

Chew, Q. H., Wei, K. C., Vasoo, S., Chua, H. C., & Sim, K. (2020). Narrative synthesis of psychological and coping responses towards emerging infectious disease outbreaks in the general population: practical considerations for the COVID-19 pandemic. Singapore medical journal, 61(7), 350-356. doi: https://doi.org/10.11622/smedj.2020046 DOI: https://doi.org/10.11622/smedj.2020046

Cohen-Cline, H., Turkheimer, E., & Duncan, G. E. (2015). Access to green space, physical activity, and mental health: a twin study. Journal of Epidemiology and Community Health, 69(6), 523-529. doi: http://dx.doi.org/10.1136/jech-2014-204667 DOI: https://doi.org/10.1136/jech-2014-204667

Comisia Națională pentru Statistică și Prognoză (CNSP) [National Board of Strategy and Prognosis]. (2019). Proiecţia principalilor indicatori economico-sociali în PROFIL TERITORIAL până în 2023. Available from: http://www.cnp.ro/user/repository/prognoze/Prognoza_profil_teritorial_toamna_2019.pdf

Connor, K. M., & Zhang, W. (2006). Resilience: Determinants, measurement, and treatment responsiveness. CNS spectrums, 11(S12), 5-12. doi: https://doi.org/10.1017/S1092852900025797 DOI: https://doi.org/10.1017/S1092852900025797

Cowling, B. J., Ng, D. M. W., Ip, D. K. M., Liao, Q., Lam, W. W. T., Wu, J. T., Lau, J. T. F., Griffiths, S. M., & Fielding, R. (2010). Community psychological and behavioural responses through the first wave of the 2009 influenza A(H1N1) pandemic in Hong Kong. The Journal of Infectious Diseases, 202(6), 867-876. doi: https://doi.org/10.1086/655811 DOI: https://doi.org/10.1086/655811

de Vries, S., Verheij, R. A., Groenewegen, P. P., & Spreeuwenberg, P. (2003). Natural Environments-Healthy Environments? An Exploratory Analysis of the Relationship between Greenspace and Health. Environment and Planning A: Economy and Space, 35(10), 1717-1731. doi: https://doi.org/10.1068/a35111 DOI: https://doi.org/10.1068/a35111

Douglas, M., Katikireddi, S. V., Taulbut, M., McKee, M., & Mc-Cartney, G. (2020). Mitigating the wider health effects of COVID-19 pandemic response. British Medical Journal, 369, 1-6. doi: https://doi.org/10.1136/bmj.m1557 DOI: https://doi.org/10.1136/bmj.m1557

Eisenberg, M. E., & Resnick, M. D. (2006). Suicidality among Gay, Lesbian, and Bisexual Youth: The Role of Protective Factors. Journal of Adolescent Health, 39(5), 662-668. doi: https://doi.org/10.1016/j.jadohealth.2006.04.024 DOI: https://doi.org/10.1016/j.jadohealth.2006.04.024

Fledderus, M., Bohlmeijer, E. T., & Pieterse, M. E. (2010). Does experiential avoidance mediate the effects of maladaptive coping styles on psychopathology and mental health? Behaviour Modification, 34(6), 503-519. doi: https://doi.org/10.1177/0145445510378379 DOI: https://doi.org/10.1177/0145445510378379

Haddadi, P., & Besharat, M. A. (2010). Resilience, vulnerability, and mental health. Procedia - Social and Behavioral Sciences, 5, 639-642. doi: https://doi.org/10.1016/j.sbspro.2010.07.157 DOI: https://doi.org/10.1016/j.sbspro.2010.07.157

Hankin, B.L., Mermelstein, R., & Roesch, L. (2007). Sex differences in adolescent depression: stress exposure and reactivity models. Child Development, 78(1). doi: https://doi.org/10.1111/j.1467-8624 .2007.00997.x

Hardway, C., & Fuligni, A. J. (2006). Dimensions of family connectedness among adolescents with Mexican, Chinese, and European backgrounds. Developmental Psychology, 42(6), 1246-1258. doi: https://doi.org/10.1037/0012-1649.42.6.1246 DOI: https://doi.org/10.1037/0012-1649.42.6.1246

Hegberg, N. J., & Tone, E. B. (2015). Physical activity and stress resilience: Considering those at-risk for developing mental health problems. Mental Health and Physical Activity, 8, 1-7. doi: https://doi.org/10.1016/j.mhpa.2014.10.001 DOI: https://doi.org/10.1016/j.mhpa.2014.10.001

Hesketh, T., & Ding, Q. J. (2005). Anxiety and depression in adolescents in urban and rural China. Psychological Reports, 96(2), 435-444. doi: https://doi.org/10.2466/pr0.96.2.435-444 DOI: https://doi.org/10.2466/pr0.96.2.435-444

Hettema, J. M., Neale, M. C., & Kenneth S., & Kendler, K. S. (2001). A review and meta-analysis of the genetic epidemiology of anxiety disorders. The American Journal of Psychiatry, 158(10), 1568-1578. doi: https://doi.org/10.1176/appi.ajp.158.10.1568 DOI: https://doi.org/10.1176/appi.ajp.158.10.1568

Huang, Y., & Zhao, N. (2020). Generalized anxiety disorder, depressive symptoms, and sleep quality during the COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Research, 112954. doi: https://doi.org/10.1016/j.psychres.2020.112954 DOI: https://doi.org/10.1016/j.psychres.2020.112954

Iglesias, M. E. L., de Bengoa Vallejo, R. B., Salvadores Fuentes, P. (2010). The relationship between experiential avoidance and burnout syndrome in critical care nurses: A cross-sectional questionnaire survey. International Journal of Nursing Studies, 47(1), 30-37. doi: https://doi.org/10.1016/j.ijnurstu.2009.06.014. DOI: https://doi.org/10.1016/j.ijnurstu.2009.06.014

INS (National Institute of Statistics). (2020). Starea economică şi socială a României 2017 şi 2018 - Date statistice. Available from: https://insse.ro/cms/sites/default/files/field/publicatii/starea_economica_si_sociala_a_romaniei_2020.pdf

Jacobson, K. C., & Rowe, D. C. (1999). Genetic and environmental influences on the relationships between family connectedness, school connectedness, and adolescent depressed mood: Sex differences. Developmental Psychology, 35(4), 926-939. doi: https://doi.org/10.1037/0012-1649.35.4.926 DOI: https://doi.org/10.1037/0012-1649.35.4.926

James, P., Hart, J. E., Banay, R. F., & Laden, F. (2016). Exposure to greenness and mortality in a nationwide prospective cohort study of women. Environmental health perspectives, 124(9), 1344-1352. doi: https://doi.org/10.1289/ehp.1510363 DOI: https://doi.org/10.1289/ehp.1510363

Lamond, A. J., Depp, C. A., Allison, M., Langer, R., Reichstadt, J., Moore, D. J. (2008). Measurement and predictors of resilience among community-dwelling older women. Journal of Psychiatric Research, 43(2), 148-154. doi: 10.1016/j.jpsychires.2008.03.007 DOI: https://doi.org/10.1016/j.jpsychires.2008.03.007

Law 351/ 6.07.2001. Available from: http://legislatie.just.ro/Public/DetaliiDocument/29780

Leal, P. C., Goes, T. C., da Silva, L. C. F., & Teixeira-Silva, F. (2017). Trait vs state anxiety in different threatening situations. Trends in Psychiatry and Psychotherapy, 39(3), 147-157. doi: https://doi.org/10.1590/2237-6089-2016-0044 DOI: https://doi.org/10.1590/2237-6089-2016-0044

Lister, R. G. (1990). Ethologically-based animal models of anxiety disorders. Pharmacology & Therapeutics, 46(3), 321-340. doi: https://doi.org/10.1016/0163-7258(90)90021-S DOI: https://doi.org/10.1016/0163-7258(90)90021-S

Luo, M., Guo, L., Yu, M., Jiang, W., & Wang, H. (2020). The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public - A systematic review and meta-analysis. Psychiatry Research, 291, 113190. doi: https://doi.org/10.1016/j.psychres.2020.113190 DOI: https://doi.org/10.1016/j.psychres.2020.113190

Madhav, N., Oppenheim, B., Gallivan, M., Mulembakani, P., Rubin, E., & Wolfe, N. (2017). Chapter 17. Pandemics: risks, impacts, and mitigation. In: Jamison, D. T., Gelband, H., Horton S, Jha, P., Laxminarayan, R., Mock, G. N. & Nugent, R. (Eds). Disease control priorities: improving health and reducing poverty. 3rd edition. The International Bank for Reconstruction and Development/The World Bank. doi: https://doi.org/10.1596/978-1-4648-0527-1_ch17 DOI: https://doi.org/10.1596/978-1-4648-0527-1_ch17

Mahoney, C. T., Segal, D. L., & Coolidge, F. L. (2015). Anxiety sensitivity, experiential avoidance, and mindfulness among younger and older adults: age differences in risk factors for anxiety symptoms. The International Journal of Aging and Human Development, 81(4), 217-240. doi: https://doi.org/10.1177/0091415015621309. DOI: https://doi.org/10.1177/0091415015621309

Malaquias, S., Crespo, C., & Francisco, R. (2015). How do adolescents benefit from family rituals? Links to social connectedness, depression, and anxiety. Journal of Child and Family Studies, 24(10), 3009-3017. doi: https://doi.org/10.1007/s10826-014-0104-4. DOI: https://doi.org/10.1007/s10826-014-0104-4

McKee-Ryan, F., Song, Z., Wanberg, C. R., & Kinicki, A. J. (2005). Psychological and physical well-being during unemployment: a meta-analytic study. Journal of Applied Psychology, 90(1), 53. doi: https://doi.org/10.1037/0021-9010.90.1.53 DOI: https://doi.org/10.1037/0021-9010.90.1.53

McKenzie, K., Murray, A., & Booth, T. (2013). Do urban environments increase the risk of anxiety, depression, and psychosis? An epidemiological study. Journal of affective disorders, 150(3), 1019-1024. https://doi.org/10.1016/j.jad.2013.05.032 DOI: https://doi.org/10.1016/j.jad.2013.05.032

Min, J. A., Lee, N. B., Lee, C. U., Lee, C., & Chae, J. H. (2012). Low trait anxiety, high resilience, and their interaction as possible predictors for treatment response in patients with depression. Journal of affective disorders, 137(1-3), 61-69. doi: https://doi.org/10.1016/j.jad.2011.12.026 DOI: https://doi.org/10.1016/j.jad.2011.12.026

Minnesota Student Survey (2004). Available from: https://www.health.state.mn.us/data/mchs/surveys/mss/docs/countytables/countycover04.pdf

Moghanibashi-Mansourieh, A. (2020). Assessing the anxiety level of Iranian general population during the COVID-19 outbreak. Asian Journal of Psychiatry, 51, 1-5. doi: https://doi.org/10.1016/j.ajp.2020.102076 DOI: https://doi.org/10.1016/j.ajp.2020.102076

Pagel, J. I., & Choukèr, A. (2016). Effects of isolation and confinement on humans-implications for manned space explorations. Journal of Applied Physiology, 120 (12), 1449-1457. doi: https://doi.org/10.1152/japplphysiol.00928.2015 DOI: https://doi.org/10.1152/japplphysiol.00928.2015

Roya, A. (2017). Mediating role of interpersonal problems in the relationship between experiential avoidance with depression and anxiety. Journal of Applied Psychology, 4(40), 523-542.

Sanad, H. M. (2019). Stress and anxiety among junior nursing students during the initial clinical Training: a descriptive study at college of health sciences. American Journal of Nursing Research, 7(6), 995-999. doi: 10.12691/ajnr-7-6-13

Saviola, F., Pappaianni, E., Monti, A., Gregucci, A., Jovicich, J., & De Pisapia, N. (2020). Trait and state anxiety are mapped differently in the human brain. Scientific Reports, 10(1). doi: https://doi.org/10.1038/s41598-020-68008-z DOI: https://doi.org/10.1038/s41598-020-68008-z

Savitsky, B., Findling, Y., Ereli, A., & Hendel, T. (2020). Anxiety and coping strategies among nursing students during the COVID-19 pandemic. Nurse Education in Practice, 102809. doi: https://doi.org/10.1016/j.nepr.2020.102809 DOI: https://doi.org/10.1016/j.nepr.2020.102809

Schiele, M. A., & Domschke, K. (2018). Epigenetics at the crossroads between genes, environment and resilience in anxiety disorders. Genes, Brain and Behavior, 17, 1-15. doi: https://doi.org/10.1111/gbb.12423 DOI: https://doi.org/10.1111/gbb.12423

Shi, R., Zhang, S., Zhang, Q., Fu, S., Wang, Z. (2016). Experienial avoidance mediates the association between emotion regulation abilities and loneliness. PLoS One, 11(12):e0168536. doi: https://doi.org/10.1371/journal.pone.0168536 DOI: https://doi.org/10.1371/journal.pone.0168536

Southwick, S. M., Vythilingam, M., & Charney, D. S. (2005). The psychobiology of depression and resilience to stress: implications for prevention and treatment. Annual Review of Clinical Psychology, 1, 255-291. doi: https://doi.org/10.1146/annurev.clinpsy.1.102803.143948 DOI: https://doi.org/10.1146/annurev.clinpsy.1.102803.143948

Spielberger, C. D. (1983). State-Trait Anxiety Inventory for Adults (STAI-AD). doi: https://doi.org/10.1037/t06496-000 DOI: https://doi.org/10.1037/t06496-000

Sylvester, C. M., Corbetta, M., Raichle, M. E., Rodebaugh, T., Schlaggar, B. L., Sheline, Y. I., Zorumski, C. F., & Lenze, E. J. (2012). Functional network dysfunction in anxiety and anxiety disorders. Trends in Neuroscience, 35(9), 527-535. doi: https://doi.org/10.1016/j.tins.2012.04.012 DOI: https://doi.org/10.1016/j.tins.2012.04.012

Taquet., M., Luciano, S., Geddes, J. R., & Harrison, P. J. (2020). Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA. The Lancet - Psychiatry. doi: https://doi.org/10.1016/ S2215-0366(20)30462-4 DOI: https://doi.org/10.1016/S2215-0366(20)30462-4

Thompson, C. W., Roe, J., Aspinall, P., Mitchell, R., Clow, A., & Miller, D. (2012). More green space is linked to less stress in deprived communities: Evidence from salivary cortisol patterns. Landscape and urban planning, 105(3), 221-229. doi: https://doi.org/10.1016/j.landurbplan.2011.12.015 DOI: https://doi.org/10.1016/j.landurbplan.2011.12.015

To, K. K. W., Hung, I. F. N., Ip, J. D., Chu, A. W. H., Chan, W. M., Tam, A. R., Fong, C. H. Y., Yuan, S., Tsoi, H. W., Ng, A. C. K., Lee, L. L. Y., Wan, P., Tso, E., Wing-Kin To, W. K., Tsang, D., Chan, K. Y., Huang, J. D., Kok, K. H., Cheng, V. C. C., Yuen, K. Y. (2020). COVID-19 reinfection by a phylogenetically distinct SARS-coronavirus-2 strain confirmed by whole-genome sequencing. Clinical Infectious Diseases [published online ahead of print, 2020 Aug 25], ciaa1275. doi: https://doi.org/10.1093/cid/ciaa1275 DOI: https://doi.org/10.1093/cid/ciaa1275

Verheij, R. A. (1996). Explaining urban-rural variations in health: A review of interactions between individual and environment. Social Science & Medicine, 42(60), 923-935. doi: https://doi.org/10.1016/0277-9536(95)00190-5 DOI: https://doi.org/10.1016/0277-9536(95)00190-5

Wainer, J., & Chesters, J. (2000). Rural mental health: neither romanticism nor despair. The Australian Journal of Rural Health, 8, 141-147. doi: https://doi.org/10.1046/j.1440-1584.2000.00304.x DOI: https://doi.org/10.1046/j.1440-1584.2000.00304.x

Walters, K., Breeze, E., Wilkinson, P., Price, G. M., Bulpitt, C. J., & Fletcher, A. (2004). Local area deprivation and urbanrural differences in anxiety and depression among people older than 75 years in Britain. American Journal of Public Health, 94(10), 1768-1774. doi: https://doi.org/10.2105/AJPH.94.10.1768 DOI: https://doi.org/10.2105/AJPH.94.10.1768

Ward, D. (2000). Infection control: reducing the psychologicalveffects of isolation. British Journal of Nursing, 9(3), 162-170. doi: https://doi.org/10.12968/bjon.2000.9.3.162 DOI: https://doi.org/10.12968/bjon.2000.9.3.162

Wheaton, M. G., Deacon, B. J., McGrath, P. B., Berman, N. C., & Abramowitz, J. S. (2012). Dimensions of anxiety sensitivity in the anxiety disorders: Evaluation of the ASI-3. Journal of Anxiety Disorders, 26(3), 401-408. doi: https://doi.org/10.1016/j.janxdis.2012.01.002 DOI: https://doi.org/10.1016/j.janxdis.2012.01.002

White, M. P., Alcock, I., Wheeler, B. W., & Depledge, M. H. (2013). Would you be happier living in a greener urban area? A fixed-effects analysis of panel data. Psychological Science, 24(6), 920-928. doi: https://doi.org/10.1177/0956797612464659 DOI: https://doi.org/10.1177/0956797612464659

Zerbe M. B., Parkerson, S. G., & Spitzer, T. (1994). Laminar airflow versus reverse isolation: nurses’ assessments of moods, behavior, and activity levels in patients receiving bone marrow transplants. Oncology Nursing Forum, 21(3), 565-568. doi: https://europepmc.org/article/med/8052552

Zhang, M., Zhang, J., Zhang, F., Zhang, L., & Feng, D. (2018). Prevalence of psychological distress and the effects of resilience and perceived social support among Chinese college students: Does gender make a difference? Psychiatry Research, 267, 409-413. doi: https://doi.org/10.1016/j.psychres.2018.06.038 DOI: https://doi.org/10.1016/j.psychres.2018.06.038

Published
2021-01-14
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Special section COVID-19
Keywords:
Anxiety state and trait, resilience, living environment, gender, family connectedness.
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Rotărescu, V. S., Matei, D. B., Mircea, I. A., Mirescu, A. M., Nedelescu, B. G., Nedelea, D. G., Raluca Neagu, A. N., Necșulescu, A. G., Oteșanu, G. A., & Tudor, L. C. (2021). How anxious did you feel during lockdown? The roles resilience, living environment, and gender play on the level of anxiety state during pandemic isolation. Research in Psychotherapy: Psychopathology, Process and Outcome, 23(3). https://doi.org/10.4081/ripppo.2020.496