Anxiety in context of the COVID-19 pandemic: associations with protective and risk factors, mental disorders and vaccination acceptance

The COVID-19 pandemic is associated with numerous direct as well as indirect stressors in various areas of human life, which can cause psychological strain that often manifests in anxiety and depressive symptoms. Consequently, it is important to analyze these stress-reactive symptoms in the course of the pandemic and to identify related factors. In addition, an essential focus lies in the examination of vaccine acceptance and associated variables, as vaccination constitutes an integral instrument in the long-term management of the pandemic. In order to gain insight into these core issues, three publications are presented, which are based on data from an extensive longitudinal online-survey of adults in Germany. Using a longitudinal analysis over four measurement points, time-related courses of anxiety and depressive symptoms and associated potential protective and risk factors are examined during the first three months of the pandemic (N = 2,376). The same period is observed with a different sampling filter criterion with regard to associations with pre-existing mental disorders in a second longitudinal analysis (N = 6,551). Vaccine acceptance was recorded shortly after the start of SARS-CoV-2 vaccination in Germany in January 2021 and is investigated by a cross-sectional analysis (N = 1,779). Overall, after initially elevated symptoms, a decreasing trend in mental strain can be identified on average over the course of the first months of the pandemic. Furthermore, the data largely confirms the anticipated protective factors (self-efficacy, normalization, social contacts, medical support opportunities) as well as risk factors (unhealthy behavior, suppression of or excessive mental preoccupation with the pandemic). Individuals with pre-existing anxiety, depressive or other mental disorders exhibit on average more pronounced mental strain and also tend to display an attenuation of these symptoms over the course of the pandemic, though disorder-specific differences are evident. The overall high vaccine acceptance is positively associated with COVID-19-specific anxiety, infection- and health-related fears, but negatively associated with social and economic fears. In summary, these findings foster the understanding of psychological strain in the context of the COVID-19 pandemic. They provide a basis for theoretical considerations, further research, and the development of appropriate preventive and therapeutic measures for an adaptive coping with the pandemic on individual as well as on a societal level.Die COVID-19 Pandemie geht mit zahlreichen unmittelbaren sowie indirekten Stressoren in verschiedenen Bereichen des menschlichen Lebens einher, wodurch psychische Belastungen entstehen können, die sich insbesondere häufig in Ängsten und depressiven Symptomen äußern. Entsprechend ist es wichtig, diese stressreaktiven psychischen Symptome im Verlauf der Pandemie zu analysieren und Faktoren zu identifizieren, die damit in Zusammenhang stehen. Zudem bildet die Betrachtung der Impfbereitschaft und damit assoziierter Variablen einen wichtigen Fokus, da Impfungen ein elementares Instrument in der langfristigen Pandemie-Bewältigung darstellen. Um Aufschluss über diese Kernthemen zu erhalten, werden drei Publikationen herangezogen, die den Daten einer umfangreichen online-gestützten Längsschnittbefragung von Erwachsenen aus Deutschland entstammen. Mittels einer Längsschnittanalyse über vier Messzeitpunkte werden Verläufe der Belastungssymptome und damit assoziierte potenzielle Schutz- und Risikofaktoren in den ersten drei Monaten der Pandemie untersucht (N = 2,376). Der gleiche Zeitraum wird mit einem anderen Stichprobenfilterkriterium in Hinblick auf die Zusammenhänge mit vorbestehenden psychischen Erkrankungen in einer zweiten Längsschnittanalyse betrachtet (N = 6,551). Die Impfbereitschaft wurde kurz nach Beginn der SARS-CoV-2-Impfungen Anfang Januar 2021 in Deutschland erfasst und wird mittels einer Querschnittanalyse eruiert (N = 1,779). Insgesamt lässt sich im frühen Pandemieverlauf nach anfänglich erhöhten Werten durchschnittlich ein abnehmender Trend in den Belastungsparametern erkennen und die Daten bestätigen größtenteils die antizipierten protektiv wirkenden Faktoren (Selbstwirksamkeitserwartung, Normalisierung, soziale Kontakte, medizinische Unterstützungsmöglichkeiten) sowie Risikofaktoren (ungesundes Verhalten, Unterdrückung oder übermäßige gedankliche Beschäftigung mit der Pandemie). Individuen mit vorbestehenden Angst-, depressiven oder anderen psychischen Erkrankungen weisen im Mittel ausgeprägtere Symptombelastungen auf und zeigen tendenziell ebenfalls eine Abschwächung dieser im Verlauf, wobei erkrankungsspezifische Unterschiede ersichtlich sind. Die insgesamt hoch ausfallende Impfbereitschaft ist positiv mit COVID-19-, infektions- und gesundheitsbezogenen Ängsten, aber negativ mit sozialen und wirtschaftlichen Befürchtungen assoziiert. Zusammenfassend fördern diese Untersuchungen das Verständnis psychischer Belastung im Kontext der COVID-19 Pandemie. Sie bieten eine Grundlage für theoretische Überlegungen, weitere Forschungsvorhaben und die Ableitung geeigneter präventiver und therapeutischer Maßnahmen für eine möglichst adaptive individuelle sowie gesellschaftliche Bewältigung der Pandemie

Longitudinal changes in anxiety and psychological distress, and associated risk and protective factors during the first three months of the COVID‐19 pandemic in Germany

Background: The COVID-19 pandemic is related to multiple stressors and therefore may be associated with psychological distress. The aim of this study was to longitudinally assess symptoms of (un-)specific anxiety and depression along different stages of the pandemic to generate knowledge about the progress of psychological consequences of the pandemic and to test the role of potential risk and resilience factors that were derived from cross-sectional studies and official recommendations. Methods: The present study uses a longitudinal observational design with four waves of online data collection (from March 27 to June 15, 2020) in a convenience sample of the general population in Germany. A total of N = 2376 participants that completed at least two waves of the survey were included in the analyses. Findings: Specific COVID-19-related anxiety and the average daily amount of preoccupation with the pandemic decreased continuously over the four waves. Unspecific worrying and depressive symptoms decreased on average but not on median level. Self-efficacy, normalization, maintaining social contacts, and knowledge, where to get medical support, were associated with fewer symptoms relative to baseline. Suppression, unhealthy habits, and a longer average daily time of thinking about the pandemic were correlated with a relative increase of symptoms. Interpretation: Our findings provide insight into the longitudinal changes of symptoms of psychological distress along the first three months of the COVID-19 pandemic in Germany. Furthermore, we were able to reaffirm the anticipated protective and risk factors that were extracted from previous studies and recommendations

Mental Health in German Paralympic Athletes During the 1st Year of the COVID-19 Pandemic Compared to a General Population Sample

Introduction: The COVID-19 pandemic has huge influences on daily life and is not only associated with physical but also with major psychological impacts. Mental health problems and disorders are frequently present in elite paralympic athletes. Due to the pandemic situation, new stressors (e.g., loss of routine, financial insecurity) might act upon the athletes. Therefore, the assessment of mental health in athletes during the COVID-19 pandemic is important to identify prevalence of psychological problems and propose countermeasures. Methods: The mental health of German paralympic athletes was longitudinally monitored (starting in May 2019). The athletes completed the Patient Health Questionnaire 4 (PHQ-4) on a weekly basis and reported a stress level, training hours, and training load. During the pandemic, 8 measurement time points (March 2020 to April 2021) were used to reflect the psychological health course of the athletes. In parallel, a convenience sample of the general population was questioned about their psychological distress, including the PHQ-4. To be included in the analysis, participants of both groups had to complete at least 4 measurement time points. Matching of the para-athletes and the general population sample was prioritized upon completion of the same measurement time points, gender, and age. Results: Seventy-eight paralympic athletes (40 women, 38 men, age: 29.8 ± 11.4 years) met the inclusion criteria. Seventy-eight matched pairs of the general population (40 women; 38 men; age: 30.5 ± 10.9 years) were identified. The para-athletes had a significantly (p < 0.0001; 0.39 < r < 0.48) lower PHQ-4 value at each measurement time point compared to the matched control group. No significant age or sex differences were evident regarding the symptom burden. In para-athletes, no significant and a weak positive correlation was found between decreased training load and PHQ-4 values and Mental Health in Para-Athletes During COVID-19 a stress level, respectively. Reduced physical activity was significantly (p < 0.0001) associated with higher PHQ-4 values in the general population sample. Discussion: Lower PHQ-4 values were reported by the para-athletes compared to the general population sample. However, small sample sizes must be considered while interpreting the data. Nevertheless, adequate support for individuals suffering from severe psychopathological symptoms should be provided for para-athletes as well as for the general population

Raman Optical Activity Using Twisted Photons

Raman optical activity underpins a powerful vibrational spectroscopic technique for obtaining detailed structural information about chiral molecular species. The effect centers on the discriminatory interplay between the handedness of material chirality with that of circularly polarized light. Twisted light possessing an optical orbital angular momentum carries helical phase fronts that screw either clockwise or anticlockwise and, thus, possess a handedness that is completely distinct from the polarization. Here a novel form of Raman optical activity that is sensitive to the handedness of the incident twisted photons through a spin-orbit interaction of light is identified, representing a new chiroptical spectroscopic technique

Optical orbital angular momentum: twisted light and chirality

The question of how the orbital angular momentum of structured light might engage with chiral matter is a topic of resurgent interest. By taking account of electric quadrupole transition moments, it is shown that the handedness of the beam can indeed be exhibited in local chiral effects, being dependent on the sign of the topological charge. In the specific case of absorption, a significant interplay of wavefront structure and polarization is resolved, and clear differences in behavior are identified for systems possessing a degree of orientational order and for those that are randomly oriented

Spin-orbit interactions and chiroptical effects engaging orbital angular momentum of twisted light in chiral and achiral media

There is recurrent interest in the orbital angular momentum (OAM) conveyed by optical vortices, which are structured beams with a helically twisted wave front. Particular significance is attached to the issue of how material interactions with light conveying OAM might prove sensitive to the handedness and degree of twist in the optical wave front. As a result of recent experimental and theoretical studies, the supposition that beams with OAM might enable spectroscopic discrimination between oppositely handed forms of matter has become a renewed focus of attention. Some of the tantalizing conclusions that are beginning to emerge from this research have, however, not yet established a definitive basis for a supporting mechanism. To resolve this problem requires the development of theory to support a faithful representation, and a thorough understanding, of the fundamental molecule-photon physics at play in such optical processes - even for processes as basic as absorption. The present analysis establishes mechanisms at play that entail an unconventional manifestation of optical spin-orbit interactions, engaging transition electric-quadrupole moments. Powerful symmetry principles prove to render distinctively different criteria governing the exhibition of two-dimensional (2D) and 3D chirality. These results elucidate the operation of such effects, identifying their responsibility for discriminatory optical interactions of various forms in both chiral and achiral media

Associations between COVID-19 related media consumption and symptoms of anxiety, depression and COVID-19 related fear in the general population in Germany

In context of the current COVID-19 pandemic the consumption of pandemic-related media coverage may be an important factor that is associated with anxiety and psychological distress. Aim of the study was to examine those associations in the general population in Germany. 6233 participants took part in an online-survey (March 27th-April 6th, 2020), which included demographic information and media exploitation in terms of duration, frequency and types of media. Symptoms of depression, unspecific anxiety and COVID-19 related anxiety were ascertained with standardized questionnaires. Frequency, duration and diversity of media exposure were positively associated with more symptoms of depression and unspecific and COVID-19 specific anxiety. We obtained the critical threshold of seven times per day and 2.5 h of media exposure to mark the difference between mild and moderate symptoms of (un)specific anxiety and depression. Particularly the usage of social media was associated with more pronounced psychological strain. Participants with pre-existing fears seem to be particularly vulnerable for mental distress related to more immoderate media consumption. Our findings provide some evidence for problematical associations of COVID-19 related media exposure with psychological strain and could serve as an orientation for recommendations-especially with regard to the thresholds of critical media usage

Distinguishing metastatic triple‐negative breast cancer from nonmetastatic breast cancer using second harmonic generation imaging and resonance Raman spectroscopy

Triple-negative breast cancer (TNBC) is an aggressive subset of breast cancer that is more common in African-American and Hispanic women. Early detection followed by intensive treatment is critical to improving poor survival rates. The current standard to diagnose TNBC from histopathology of biopsy samples is invasive and time-consuming. Imaging methods such as mammography and magnetic resonance (MR) imaging, while covering the entire breast, lack the spatial resolution and specificity to capture the molecular features that identify TNBC. Two nonlinear optical modalities of second harmonic generation (SHG) imaging of collagen, and resonance Raman spectroscopy (RRS) potentially offer novel rapid, label-free detection of molecular and morphological features that characterize cancerous breast tissue at subcellular resolution. In this study, we first applied MR methods to measure the whole-tumor characteristics of metastatic TNBC (4T1) and nonmetastatic estrogen receptor positive breast cancer (67NR) models, including tumor lactate concentration and vascularity. Subsequently, we employed for the first time in vivo SHG imaging of collagen and ex vivo RRS of biomolecules to detect different microenvironmental features of these two tumor models. We achieved high sensitivity and accuracy for discrimination between these two cancer types by quantitative morphometric analysis and nonnegative matrix factorization along with support vector machine. Our study proposes a new method to combine SHG and RRS together as a promising novel photonic and optical method for early detection of TNBC