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BackgroundThe COVID-19 pandemic has created a public mental health crisis. Brief, valid electronic tools are required to evaluate mental health status, identify specific risk factors, and offer treatment when needed.ObjectiveTo determine the construct validity, reliability, and measurement invariance of a brief screening tool for mental health symptoms by sex, loss of loved ones, personal COVID-19 status, and psychological care-seeking during the COVID-19 pandemic. Furthermore, the aim involved establishing a predictive pattern between the mental health variables.MethodA total sample of 27,320 Mexican participants, with a mean age of 32 years (SD = 12.24, range = 18–80), 67% women (n = 18,308), 23.10% with a loss of loved ones (n = 6,308), 18.3% with COVID-19 status (n = 5,005), and 18.40% seeking psychological care (n = 5,026), completed a questionnaire through a WebApp, containing socio-demographic data (sex, loss of loved ones, COVID-19 status, and psychological care-seeking) and the dimensions from the Posttraumatic Checklist, Depression-Generalized Anxiety Questionnaires, and Health Anxiety-Somatization scales. We used the confirmatory factor analysis (CFA: through maximum likelihood to continuous variable data, as an estimation method), the invariance measurement, and the structural equational modeling (SEM) to provide evidence of the construct validity of the scale and the valid path between variables. We analyzed the measurement invariance for each dimension by comparison groups to examine the extent to which the items showed comparable psychometric properties.FindingsThe tool included eight dimensions: four posttraumatic stress symptoms -intrusion, avoidance, hyperactivation, and numbing, as well as depression, generalized anxiety, health anxiety, and somatization The tool’s multidimensionality, was confirmed through the CFA and SEM. The participants’ characteristics made it possible to describe the measurement invariance of scales because of the participants’ attributes. Additionally, our findings indicated that women reported high generalized anxiety, hyperactivation, and depression. Those who lost loved ones reported elevated levels of intrusion and health anxiety symptoms. Participants who reported having COVID-19 presented with high levels of generalized anxiety symptoms. Those who sought psychological care reported high levels of generalized anxiety, intrusion, hyperactivation, and health anxiety symptoms. Our findings also show that intrusion was predicted by the avoidance dimension, while health anxiety was predicted by the intrusion dimension. Generalized anxiety was predicted by the health anxiety and hyperactivation dimensions, and hyperactivation was predicted by the depression one. Depression and somatization were predicted by the health anxiety dimension. Last, numbing was predicted by the depression and avoidance dimensions.Discussion and OutlookOur findings indicate that it was possible to validate the factor structure of posttraumatic stress symptoms and their relationship with depression, anxiety, and somatization, describing the specific bias as a function of sociodemographic COVID-19-related variables. We also describe the predictive pattern between the mental health variables. These mental health problems were identified in the community and primary health care scenarios through the CFA and the SEM, considering the PCL, depression, generalized anxiety, health anxiety, and somatization scales adapted during the COVID-19 pandemic. Therefore, future studies should describe the diagnosis of mental health disorders, assessing the cut-off points in the tool to discriminate between the presence and absence of conditions and mental health cut-off points. Community and primary care screening will lead to effective early interventions to reduce the mental health risks associated with the current pandemic.LimitationsFuture studies should follow up on the results of this study and assess consistency with diagnoses of mental health disorders and evaluate the effect of remote psychological help. Moreover, in the future, researchers should monitor the process and the time that has elapsed between the occurrence of traumatic events and the development of posttraumatic stress and other mental health risks through brief electronic measurement tools such as those used in this study.
BackgroundThe COVID-19 pandemic has created a public mental health crisis. Brief, valid electronic tools are required to evaluate mental health status, identify specific risk factors, and offer treatment when needed.ObjectiveTo determine the construct validity, reliability, and measurement invariance of a brief screening tool for mental health symptoms by sex, loss of loved ones, personal COVID-19 status, and psychological care-seeking during the COVID-19 pandemic. Furthermore, the aim involved establishing a predictive pattern between the mental health variables.MethodA total sample of 27,320 Mexican participants, with a mean age of 32 years (SD = 12.24, range = 18–80), 67% women (n = 18,308), 23.10% with a loss of loved ones (n = 6,308), 18.3% with COVID-19 status (n = 5,005), and 18.40% seeking psychological care (n = 5,026), completed a questionnaire through a WebApp, containing socio-demographic data (sex, loss of loved ones, COVID-19 status, and psychological care-seeking) and the dimensions from the Posttraumatic Checklist, Depression-Generalized Anxiety Questionnaires, and Health Anxiety-Somatization scales. We used the confirmatory factor analysis (CFA: through maximum likelihood to continuous variable data, as an estimation method), the invariance measurement, and the structural equational modeling (SEM) to provide evidence of the construct validity of the scale and the valid path between variables. We analyzed the measurement invariance for each dimension by comparison groups to examine the extent to which the items showed comparable psychometric properties.FindingsThe tool included eight dimensions: four posttraumatic stress symptoms -intrusion, avoidance, hyperactivation, and numbing, as well as depression, generalized anxiety, health anxiety, and somatization The tool’s multidimensionality, was confirmed through the CFA and SEM. The participants’ characteristics made it possible to describe the measurement invariance of scales because of the participants’ attributes. Additionally, our findings indicated that women reported high generalized anxiety, hyperactivation, and depression. Those who lost loved ones reported elevated levels of intrusion and health anxiety symptoms. Participants who reported having COVID-19 presented with high levels of generalized anxiety symptoms. Those who sought psychological care reported high levels of generalized anxiety, intrusion, hyperactivation, and health anxiety symptoms. Our findings also show that intrusion was predicted by the avoidance dimension, while health anxiety was predicted by the intrusion dimension. Generalized anxiety was predicted by the health anxiety and hyperactivation dimensions, and hyperactivation was predicted by the depression one. Depression and somatization were predicted by the health anxiety dimension. Last, numbing was predicted by the depression and avoidance dimensions.Discussion and OutlookOur findings indicate that it was possible to validate the factor structure of posttraumatic stress symptoms and their relationship with depression, anxiety, and somatization, describing the specific bias as a function of sociodemographic COVID-19-related variables. We also describe the predictive pattern between the mental health variables. These mental health problems were identified in the community and primary health care scenarios through the CFA and the SEM, considering the PCL, depression, generalized anxiety, health anxiety, and somatization scales adapted during the COVID-19 pandemic. Therefore, future studies should describe the diagnosis of mental health disorders, assessing the cut-off points in the tool to discriminate between the presence and absence of conditions and mental health cut-off points. Community and primary care screening will lead to effective early interventions to reduce the mental health risks associated with the current pandemic.LimitationsFuture studies should follow up on the results of this study and assess consistency with diagnoses of mental health disorders and evaluate the effect of remote psychological help. Moreover, in the future, researchers should monitor the process and the time that has elapsed between the occurrence of traumatic events and the development of posttraumatic stress and other mental health risks through brief electronic measurement tools such as those used in this study.
Introduction: the COVID-19 pandemic is associated with mental health symptoms. Objective: to screen mental health symptoms by validating the factor structure of the screening test related to sociodemographic variables during the COVID-19 pandemic. Method: we worked with 36,811 Mexican (M = 34 years; SD = 11.68), 61.8% (22,743) women, 15.3% (5,643) losing loved ones, 12.7% (4,683) having a COVID-19 condition, and 8.22% (3,027) sought remote psychological care. We required participants to answer the Posttraumatic Stress Checklist (PCL-C), Patient Health Questionnaire (PHQ), Goldberg’s Generalized Anxiety Questionnaire, Health Anxiety, and Somatization tests in a WebApp. Results: the Confirmatory Factor Analysis indicated good factor structures and measurement invariances of the scales because of participants´ sociodemographic characteristics and their structural equation model. Discussion: therefore, Women showed re-experimentation, numbing, anxiety, and somatization symptoms. Grieving or suffering a COVID-19 condition associated with generalized anxiety. People seeking psychological care reported somatization symptoms. Also, avoidance predicted symptoms of re-experimentation, and re-experimentation predicted health anxiety. Health anxiety predicted somatization, depression, and generalized anxiety, denoted by hyperarousal symptoms. Depression predicted numbing and hyperarousal symptoms. Conclusions: there are mental health risks in women, people with loved-one losses, those with a COVID-19 condition, or people seeking psychological care. Future research will show how early interventions interrupt mental health risks associated with the pandemic.
La Organización Mundial de la Salud (2020) se ha pronunciado sobre las consecuencias psicosociales y de salud en la población mundial, a causa del SARS-CoV-2. El presente trabajo de investigación tiene como objetivo valorar el impacto de la exposición a la pandemia de covid-19, en la salud mental y calidad de vida de la población ecuatoriana durante el año 2022. La metodología aplicada consistió en una investigación cualitativa con alcance descriptivo haciendo uso de la escala Dass y escala Whoqol con una muestra de 518 personas ecuatorianas. El 35,3% de los participantes se infectaron de covid-19, de los encuestados 51,4% son solteros, un 0,6% de encuestados no escolarizados frente a 75,5% de personas con educación superior y un 86,1% de personas con estrato económico. Este estudio establece una línea de investigación centrada en describir cómo la covid-19 ha impactado en la salud mental y calidad de vida en las personas ecuatorianas. El estrés y la ansiedad fueron presentados por trabajadores, estudiantes con nivel de estudios básicos (4.8%), medio (19.1%), superior (75.5%) y no escolarizados un 0.6%. De ellos el 47,0% mostró alteración en los niveles de estrés, siendo este factor el más notorio en cuanto a las afectaciones producidas.
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