Sex differences and psychological stress: responses to the COVID-19 pandemic in China

Abstract

Background About 83,000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contain its spread - have altered individuals’ “normal” daily functioning. These impacts on social, psychological, and emotional well-being remain relatively unexplored – in particular, the ways in which Chinese men and women experience and respond to potential behavioral stressors. Our study investigated sex differences in psychological stress, emotional reactions, and behavioral responses to COVID-19 and related threats among Chinese residents. Methods In late February (2020), an anonymous online questionnaire was disseminated via WeChat, a popular social media platform in China. The cross-sectional study utilized a non-probabilistic “snowball” or convenience sampling of residents from various provinces and regions of China. Basic demographic characteristics (e.g., age and gender) – along with residential living arrangements and conditions – were measured along with psychological stress and emotional responses to the COVID-19 pandemic. Results Three thousand eighty-eight questionnaires were returned: 1749 females (56.6%) and 1339 males (43.4%). The mean stress level,as measured by a visual analog scale, was 3.4 (SD = 2.4) - but differed significantly by sex. Besides sex, factors positively associated with stress included: age (< 45 years), employment (unsteady income, unemployed), risk of infection (exposureto COVID-19, completed medical observation), difficulties encountered (diseases, work/study, financial, mental), and related behaviors (higher desire for COVID-19 knowledge, more time concerning on the COVID-19 outbreak). “Protective” factors included frequent contact with colleagues, calmness of mood comparing with the pre-pandemic, and psychological resilience. Males and females also differed significantly in adapting to current living/working, conditions, responding to run a fever, and needing psychological support services. Conclusions The self-reported stress of Chinese residents related to the COVID-19 pandemic was significantly related to sex, age, employment, resilience and coping styles. Future responses to such public health threats may wish to provide sex- and/or age-appropriate supports for psychological health and emotional well-being to those at greatest risk of experiencing stress.

Depressive and anxiety symptoms and COVID-19-related factors among men and women in Nigeria

“…While the rates of testing and presence of COVID-19 symptoms were comparable in male and female participants, women reported more worry about personal and family risk for COVID-19 infection and the impact of the lockdown on their incomes. This is consistent with previous findings [43] and may reflect the higher pre-pandemic risk for stress-related conditions in women [25,44]. In contrast, men reported greater disruption in their lives due to the pandemic and this may be understood in the context of the male participants in the present study being older and more likely to be married.…”

“…Consistent with findings from previous research [24,25,44], depressive and anxiety symptoms were significantly higher among female participants. These may reflect the impacts of higher levels of psychosocial stressors among women such as intimate partner violence or higher COVID-19-related concerns among them such as worry about infection [43].…”

Life With Corona: Increased Gender Differences in Aggression and Depression Symptoms Due to the COVID-19 Pandemic Burden in Germany

“…Losada-Baltar et al (2020) showed that feelings of loneliness and psychological distress were higher in women in Spain. Higher stress levels in women during the early stage of the pandemic were also found in China (Yan et al, 2021). However, these studies are not able to identify the effect of the pandemic on GD in anxiety.…”

Perceived Stress of Quarantine and Isolation During COVID-19 Pandemic: A Global Survey

“…In contrast, the need for information about the pandemic, worsening of the outbreak locally, and health problems during the quarantine were the key risk factors among females. Interestingly, the authors noted that males were less adaptive and had a lower tendency to recognize the need for psychological support when compared with females; however, they were more likely to seek medical care in response to infective symptoms (24). The observed gender differences are postulated to be due to the variation in psychological, physiological, and cognitive processes between the two sexes and their consequent response to stressful situations (25)(26)(27).…”

“…On the other hand, Hawryluck et al reported that the level of education did not affect both the understanding of quarantine requirements or the psychological impact of quarantining (19). In contrast, Song et al noted that a higher educational status correlated positively with stress levels during the COVID-19 pandemic (24). Regardless, the need for information about the illness from public health officials and its clarity have been reported to influence the mental health of individuals in quarantine/isolation (32).…”