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Psychological Adjustment in Spain during the COVID-19 Pandemic: Positive and Negative Mental Health Outcomes in the General Population

Published online by Cambridge University Press:  08 February 2021

Carmen Valiente*
Affiliation:
Universidad Complutense de Madrid (Spain)
Alba Contreras
Affiliation:
Universidad Complutense de Madrid (Spain)
Vanesa Peinado
Affiliation:
Universidad Complutense de Madrid (Spain)
Almudena Trucharte
Affiliation:
Universidad Complutense de Madrid (Spain)
Antón P. Martínez
Affiliation:
The University of Sheffield (UK)
Carmelo Vázquez
Affiliation:
Universidad Complutense de Madrid (Spain)
*
Correspondence concerning this article should be addressed to Carmen Valiente. Universidad Complutense. Facultad de Psicología. Departamento de Psicología Clínica. Campus de Somosaguas. 28223Madrid (Spain). E-mail: mcvalien@ucm.es Phone: 34–913943136. Fax: 34–913943189.

Abstract

In the midst of the COVID–19 epidemic, Spain was one of the countries with the highest number of infections and a high mortality rate. The threat of the virus and consequences of the pandemic have a discernible impact on the mental health of citizens. This study aims to (a) evaluate the levels of anxiety, depression and well-being in a large Spanish sample during the confinement, (b) identify potential predictor variables associated to experiencing both clinical levels of distress and well-being in a sample of 2,122 Spanish people. By using descriptive analyses and logistic regression results revealed high rates of depression, anxiety and well-being. Specifically, our findings revealed that high levels of anxiety about COVID–19, increased substance use and loneliness as the strongest predictors of distress, while gross annual incomes and loneliness were strongest predictors of well-being. Finding of the present study provide a better insight about psychological adjustment to a pandemic and allows us to identify which population groups are at risk of experiencing higher levels of distress and which factors contribute to greater well-being, which could help in the treatments and prevention in similar stressful and traumatic situations.

Type
Research Article
Copyright
© Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2021

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Footnotes

Conflicts of Interest: None.

Funding Statement: This work was supported, in part, by grants from the Spanish Ministerio de Ciencia e Innovación (PSI2016-74987-P and PID2019-108711GB-I00), the Instituto de Salud Carlos III (COV20/00737-CM) and the UCM Consolidated research groups (GR29/20). Two of the authors have doctoral fellowship; Almudena Trucharte had one from the UCM (CT42/18) and Vanesa Peinado from the Spanish Ministerio de Economía y Competitividad (BES-2017082015).

References

Ausín, B., González-Sanguino, C., Castellanos, M. A., & Muñoz, M. (2020). Gender-related differences in the psychological impact of confinement as a consequence of COVID–19 in Spain. Journal of Gender Studies.CrossRefGoogle Scholar
American Psychiatric Association (1994). Diagnostic and statistical manual of mental disorders: DSM-IV. (4th ed.) America Psychiatric Association.Google Scholar
Bajo, M., Blanco, A., Stavraki, M., Gandarillas, B., Cancela, A., Requero, B., & Díaz, D. (2018). Post-traumatic cognitions and quality of life in terrorism victims: The role of well-being in indirect versus direct exposure. Health and Quality of Life Outcomes, 16(1), Article 96. https://doi.org/10.1186/s12955-018-0923-xCrossRefGoogle ScholarPubMed
Betancourt, T. S., Brennan, R. T., Vinck, P., VanderWeele, T. J., Spencer-Walters, D., Jeong, J., Akinsulure-Smith, A. M., & Pham, P. (2016). Associations between mental health and Ebola-related health behaviors: A regionally representative cross-sectional survey in post-conflict Sierra Leone. PLOS Medicine, 13(8), Article e1002073. https://doi.org/10.1371/journal.pmed.1002073CrossRefGoogle ScholarPubMed
Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59(1), 2028. https://doi.org/10.1037/0003-066X.59.1.20CrossRefGoogle ScholarPubMed
Brewin, C., DePierro, J., Pirard, P., Vazquez, C., & Williams, R. (2020). Why we need to integrate mental health into pandemic planning. Perspectives in Public Health, 140, 309310. https://doi.org/10.1177/1757913920957365CrossRefGoogle ScholarPubMed
Carstensen, L. L., & DeLiema, M. (2018). The positivity effect: A negativity bias in youth fades with age. Current Opinion in Behavioral Sciences, 19, 712. https://doi.org/10.1016/j.cobeha.2017.07.009CrossRefGoogle ScholarPubMed
Charles, S. T., Reynolds, C. A., & Gatz, M. (2001). Age-related differences and change in positive and negative affect over 23 years. Journal of Personality and Social Psychology, 80(1), 136151. https://doi.org/10.1037/0022-3514.80.1.136CrossRefGoogle ScholarPubMed
Chaves, C., Castellanos, T., Abrams, M., & Vazquez, C. (2018). The impact of economic recessions on depression and individual and social well-being: The case of Spain (2006–2013). Social Psychiatry and Psychiatric Epidemiology, 53(9), 977986. https://doi.org/10.1007/s00127-018-1558-2CrossRefGoogle Scholar
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 behavioral responses through the first wave of the 2009 influenza A (H1N1) pandemic in Hong Kong. The Journal of Infectious Diseases, 202(6), 867876. https://doi.org/10.1086/655811CrossRefGoogle ScholarPubMed
Díaz, D., Stavraki, M., Blanco, A., & Bajo, M. (2018). 11– M victims 3 years after Madrid terrorist attacks: Looking for health beyond trauma. Journal of Happiness Studies, 19(3), 663675. https://doi.org/10.1007/s10902-016-9842-xCrossRefGoogle Scholar
Diener, E., Kahneman, D., Tov, W., & Arorad, R. (2010). Income’s association with judgments of life versus feelings. In Diener, E., Helliwell, J. F., & Kahneman, D. (Eds.), International differences in well-being (p. 315). Oxford UniversityPress. https://doi.org/10.1093/acprof:oso/9780199732739.003.0001CrossRefGoogle Scholar
Diener, E., Tay, L., & Oishi, S. (2013). Rising income and the subjective well-being of nations. Journal of Personality and Social Psychology, 104(2), 267276. https://doi.org/10.1037/a0030487CrossRefGoogle ScholarPubMed
Diez-Quevedo, C., Rangil, T., Sanchez-Planell, L., Kroenke, K., & Spitzer, R. L. (2001). Validation and utility of the patient health questionnaire in diagnosing mental disorders in 1003 general hospital Spanish inpatients. Psychosomatic Medicine, 63(4), 679686. https://doi.org/10.1097/00006842-200107000-00021CrossRefGoogle ScholarPubMed
Eid, R. S., Gobinath, A. R., & Galea, L. A. M. (2019). Sex differences in depression: Insights from clinical and preclinical studies. In Barreto, G. (Ed.), Progress in neurobiology (Vol. 176, pp. 86102). Elsevier Ltd. https://doi.org/10.1016/j.pneurobio.2019.01.006Google Scholar
Fuller-Thomson, E., Lung, Y., West, K. J., Keyes, C. L. M., & Baiden, P. (2020). Suboptimal baseline mental health associated with 4-month premature all-cause mortality: Findings from 18 years of follow-up of the Canadian National Population Health Survey. Journal of Psychosomatic Research, 136, Article 110176. https://doi.org/10.1016/j.jpsychores.2020.110176CrossRefGoogle ScholarPubMed
Galea, S., Vlahov, D., Resnick, H., Ahern, J., Susser, E., Gold, J., Bucuvalas, M., & Kilpatrick, D. (2003). Trends of probable post-traumatic stress disorder in New York City after the September 11 terrorist attacks. American Journal of Epidemiology, 158(6), 514524. https://doi.org/10.1093/aje/kwg187CrossRefGoogle ScholarPubMed
García, F. E., Cova, F., Rincón, P., & Vázquez, C. (2015). Trauma or growth after a natural disaster? The mediating role of rumination processes. European Journal of Psychotraumatology, 6(1), Article 26557. https://doi.org/10.3402/ejpt.v6.26557CrossRefGoogle ScholarPubMed
García-Campayo, J., Zamorano, E., Ruiz, M. A., Pardo, A., Pérez-Páramo, M., López- Gómez, V., Freire, O., & Rejas, J. (2010). Cultural adaptation into Spanish of the generalized anxiety disorder–7 (GAD–7) scale as a screening tool. Health and Quality of Life Outcomes, 8, Article 8. https://doi.org/10.1186/1477-7525-8-8CrossRefGoogle ScholarPubMed
Henares Montiel, J., Ruiz-Pérez, I., & Sordo, L. (2020). Salud mental en España y diferencias por sexo y por comunidades autónomas [Mental health in Spain and differences by sex, and by autonomous communities]. Gaceta Sanitaria, 34(2), 114119. https://doi.org/10.1016/j.gaceta.2019.03.002CrossRefGoogle Scholar
Hervás, G., & Vázquez, C. (2013). Construction and validation of a measure of integrative well-being in seven languages: The Pemberton Happiness Index. Health and Quality of Life Outcomes, 11(1), Article 66. https://doi.org/10.1186/1477-7525-11-66CrossRefGoogle ScholarPubMed
Hughes, M. E., Waite, L. J., Hawkley, L. C., & Cacioppo, J. T. (2004). A short scale for measuring loneliness in large surveys. Research on Aging, 26(6), 655672. https://doi.org/10.1177/0164027504268574CrossRefGoogle Scholar
Iasiello, M., van Agteren, J., Keyes, C. L. M., & Cochrane, E. M. (2019). Positive mental health as a predictor of recovery from mental illness. Journal of Affective Disorders, 251, 227230. https://doi.org/10.1016/j.jad.2019.03.065CrossRefGoogle ScholarPubMed
Kalin, N. H. (2020). The critical relationship between anxiety and depression. The American Journal of Psychiatry, 177(5), 365367. https://doi.org/10.1176/appi.ajp.2020.20030305CrossRefGoogle ScholarPubMed
Keiding, N., & Louis, T. A. (2018). Web-based enrollment and other types of self-selection in surveys and studies: Consequences for generalizability. Annual Review of Statistics and its Application, 5, 2547. https://doi.org/10.1146/annurev-statistics-031017-100127CrossRefGoogle Scholar
Keyes, C. L. M. (2005). Mental illness and/or mental health? Investigating axioms of the complete state model of health. Journal of Consulting and Clinical Psychology, 73(3), 539548. https://doi.org/10.1037/0022-006X.73.3.539CrossRefGoogle ScholarPubMed
Keyes, C. L. M. (2007). Promoting and protecting mental health as flourishing: A complementary strategy for improving national mental health. American Psychologist, 62(2), 95108. https://doi.org/10.1037/0003-066X.62.2.95CrossRefGoogle ScholarPubMed
Kroenke, K., & Spitzer, R. L. (2002). The PHQ–9: A new depression diagnostic and severity measure. Psychiatric Annals, 32(9), 509515. https://doi.org/10.3928/0048-5713-20020901-06CrossRefGoogle Scholar
Lee, S. A., Jobe, M. C., & Mathis, A. A. (2020). Mental health characteristics associated with dysfunctional coronavirus anxiety. Psychological Medicine, 12. https://doi.org/10.1017/S003329172000121XCrossRefGoogle Scholar
Levis, B., Benedetti, A., Ioannidis, J. P. A., Sun, Y., Negeri, Z., He, C., Wu, Y., Krishnan, A., Bhandari, P. M., Neupane, D., Imran, M., Rice, D. B., Riehm, K. E., Saadat, N., Azar, M., Boruff, J., Cuijpers, P., Gilbody, S., Kloda, L. A., … Thombs, B. D. (2020). Patient Health Questionnaire–9 scores do not accurately estimate depression prevalence: Individual participant data meta-analysis. Journal of Clinical Epidemiology, 122, 115128. https://doi.org/10.1016/j.jclinepi.2020.02.002CrossRefGoogle Scholar
McBride, O., Murphy, J., Shevlin, M., Gibson Miller, J., Hartman, T. K., Hyland, P., Levita, L., Mason, L., Martinez, A., McKay, R., Stocks, T., Bennett, K., Vallières, F., Karatzias, T., Valiente, C., Vázquez, C., & Bentall, R. (2020). An overview of the context, design and conduct of the first two waves of the COVID-19 Psychological Research Consortium (C19PRC) Study. International Journal of Methods in Psychiatric Research, Article e1861. https://doi.org/10.1002/mpr.1861CrossRefGoogle Scholar
Mushtaq, R., Shoib, S., Shah, T., & Mushtaq, S. (2014). Relationship between loneliness, psychiatric disorders and physical health? A review on the psychological aspects of loneliness. Journal of Clinical and Diagnostic Research, 8(9), WE01– WE04. http://doi.org/10.7860/JCDR/2014/10077.4828Google Scholar
Neria, Y., Nandi, A., & Galea, S. (2008). Post-traumatic stress disorder following disasters: A systematic review. Psychological Medicine, 38(4), 467480. https://doi.org/10.1017/S0033291707001353CrossRefGoogle ScholarPubMed
Nieto, I., Navas, J. F., & Vázquez, C. (2020). The quality of research on mental health related to the COVID–19 pandemic: A note of caution after a systematic review. Brain, Behavior, & Immunity–Health, 7, Article 100123. https://doi.org/10.1016/j.bbih.2020.100123CrossRefGoogle Scholar
Odriozola-González, P., Planchuelo-Gómez, A., Irurtia-Muñiz, M. J., & de Luis-García, R. (2020). Psychological symptoms of the outbreak of the COVID–19 crisis and confinement in the population of Spain. PsyArXiv. https://doi.org/10.31234/osf.io/mq4fgCrossRefGoogle Scholar
Páez, D., Rimé, B., Basabe, N., Wlodarczyk, A., & Zumeta, L. (2015). Psychosocial effects of perceived emotional synchrony in collective gatherings. Journal of Personality and Social Psychology, 108(5), 711729. https://doi.org/10.1037/pspi0000014CrossRefGoogle ScholarPubMed
Pfefferbaum, B., & North, C. S. (2020). Mental health and the Covid–19 pandemic. New England Journal of Medicine, 383, 510512. https://doi.org/10.1056/NEJMp2008017CrossRefGoogle ScholarPubMed
Pfefferbaum, B., Vinekar, S. S., Trautman, R. P., Lensgraf, S. J., Reddy, C., Patel, N., & Ford, A. L. (2002). The effect of loss and trauma on substance use behavior in individuals seeking support services after the 1995 Oklahoma City bombing. Annals of Clinical Psychiatry, 14(2), 8995. https://doi.org/10.1023/A:1016802920870CrossRefGoogle ScholarPubMed
Qian, M., Wu, Q., Wu, P., Hou, Z., Liang, Y., Cowling, B. J., & Yu, H. (2020). Psychological responses, behavioral changes and public perceptions during the early phase of the COVID–19 outbreak in China: A population based cross-sectional survey. MedRxiv, 21(1), Article 20024448. https://doi.org/10.1101/2020.02.18.20024448Google Scholar
Qiu, J., Shen, B., Zhao, M., Wang, Z., Xie, B., & Xu, Y. (2020). A nationwide survey of psychological distress among Chinese people in the COVID–19 epidemic: Implications and policy recommendations. General Psychiatry, 33(2), Article e100213. https://doi.org/10.1136/gpsych-2020-100213CrossRefGoogle ScholarPubMed
Rodríguez-Rey, R., Garrido-Hernansaiz, H., & Collado, S. (2020). Psychological impact and associated factors during the initial stage of the coronavirus (COVID– 19) pandemic among the general population in Spain. Frontiers in Psychology, 11, Article 1540. https://doi.org/10.3389/fpsyg.2020.01540CrossRefGoogle Scholar
Sancho, P., Pinazo-Hernandis, S., Donio-Bellegarde, M., & Tomás, J. M. (2020). Validation of the University of California, Los Angeles Loneliness Scale in Spanish older population: An application of exploratory structural equation modelling. Australian Psychologist, 55(3), 283292. https://doi.org/10.1111/ap.12428CrossRefGoogle Scholar
Schotanus-Dijkstra, M., ten Have, M., Lamers, S. M. A., de Graaf, R., & Bohlmeijer, E. T. (2017). The longitudinal relationship between flourishing mental health and incident mood, anxiety and substance use disorders. The European Journal of Public Health, 27(3), 563568. https://doi.org/10.1093/eurpub/ckw202Google ScholarPubMed
Seligman, M. E. P., & Csikszentmihalyi, M. (2014). Positive psychology: An introduction. In Csikszentmihalyi, M. (Ed.), In flow and the foundations of positive psychology (Vol. 9789401790, pp. 279298). Springer. https://doi.org/10.1007/978-94-017-9088-8_18Google Scholar
Shevlin, M., McBride, O., Murphy, J., Miller, J. G., Hartman, T. K., Levita, L., Mason, L., Martinez, A. P., McKay, R., Stocks, T. V. A., Bennett, K. M., Hyland, P., Karatzias, T., & Bentall, R. P. (2020). Anxiety, depression, traumatic stress, and COVID–19 related anxiety in the UK general population during the COVID–19 pandemic. PsyArXiv. https://doi.org/10.31234/OSF.IO/HB6NQCrossRefGoogle Scholar
Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder. Archives of Internal Medicine, 166(10), 10921097. https://doi.org/10.1001/archinte.166.10.1092CrossRefGoogle ScholarPubMed
Steptoe, A., Deaton, A., & Stone, A. A. (2015). Subjective wellbeing, health, and ageing. The Lancet, 385(9968), 640648. https://doi.org/10.1016/S0140-6736(13)61489-0CrossRefGoogle ScholarPubMed
Tugade, M. M., & Fredrickson, B. L. (2004). Resilient individuals use positive emotions to bounce back from negative emotional experiences. Journal of Personality and Social Psychology, 86(2), 320333. https://doi.org/10.1037/0022-3514.86.2.320CrossRefGoogle ScholarPubMed
Valiente, C., Espinosa, R., Trucharte, A., Nieto, J., & Martínez-Prado, L. (2019). The challenge of well-being and quality of life: A meta-analysis of psychological interventions in schizophrenia. Schizophrenia Research, 208, 1624. https://doi.org/10.1016/j.schres.2019.01.040CrossRefGoogle Scholar
Valiente, C., Vázquez, C., Contreras, A., Peinado, V., & Trucharte, A. (2021) A symptom-based definition of resilience in times of pandemics: patterns of psychological responses over time and their predictors. European Journal of Psychotraumatology https://doi.org/10.1080/20008198.2020.1871555CrossRefGoogle Scholar
Vázquez, C. (2017). What does positivity add to psychopathology? An introduction to the special issue on ‘positive emotions and cognitions in clinical psychology.’ Cognitive Therapy and Research, 41(3), 325334. https://doi.org/10.1007/s10608-017-9847-8CrossRefGoogle Scholar
Vázquez, C., & Hervás, G. (2008). Salud positiva: Del síntoma al bienestar. [Positive Health: From Symptoms to Well-being]. Psicología positiva aplicada, 1739.Google Scholar
Vázquez, C., & Hervás, G. (2010). Perceived benefits after terrorist attacks: The role of positive and negative emotions. The Journal of Positive Psychology, 5(2), 154163. https://doi.org/10.1080/17439761003630060CrossRefGoogle Scholar
Vázquez, C., Valiente, C., García, F., Contreras, A., Peinado, V., Trucharte, A., & Bentall, R. P. (2021) Post-Traumatic growth and stress-related responses during the COVID-19 pandemic in a national representative sample: The role of positive core beliefs about the world and others. Journal of Happiness Studies. https://doi.org/10.1007/s10902-020-00352-3CrossRefGoogle Scholar
Wang, W., Tang, J., & Wei, F. (2020). Updated understanding of the outbreak of 2019 novel coronavirus (2019-nCoV) in Wuhan, China. Journal of Medical Virology, 92(4), 441447. https://doi.org/10.1002/jmv.25689CrossRefGoogle Scholar
Whiteford, H. A., Degenhardt, L., Rehm, J., Baxter, A. J., Ferrari, A. J., Erskine, H. E., Charlson, F. J., Norman, R. E., Flaxman, A. D., Johns, N., Burstein, R., Murray, C. J. L., & Vos, T. (2013). Global burden of disease attributable to mental and substance use disorders: Findings from the Global Burden of Disease Study 2010. The Lancet, 382(9904), 15751586. https://doi.org/10.1016/S0140-6736(13)61611-6CrossRefGoogle ScholarPubMed
World Health Organization Regional Office for Europe. (2020, May). Coronavirus disease (COVID–19) outbreak. http://www.euro.who.int/en/health-topics/health-emergencies/coronavirus-covid-19/Google Scholar
Zhu, X., Wu, S., Miao, D., & Li, Y. (2008). Changes in emotion of the Chinese public in regard to the SARS period. Social Behavior and Personality, 36(4), 447453. https://doi.org/10.2224/sbp.2008.36.4.447CrossRefGoogle Scholar
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