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Contextual factors are essential for understanding long-term adjustment to the COVID-19 pandemic. Therefore, the present study investigated changes in mental health outcomes and subjective pandemic-related experiences over time and across countries. The main objective was to explore how psychological responses vary in relation to individual and environmental factors. The sample consisted of N = 1070 participants from the general population of Austria, Croatia, Georgia, Greece, and Portugal. We applied a longitudinal mixed-methods approach, with baseline assessment in summer and autumn 2020 (T1) and follow-up assessment 12 months later (T2). Qualitative content analysis by Mayring was used to analyse open-ended questions about stressful events, positive and negative aspects of the pandemic, and recommendations on how to cope. Mental health outcomes were assessed with the Adjustment Disorder-New Module 8 (ADNM-8), the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), the Patient Health Questionnaire-2 (PHQ-2), and the 5-item World Health Organization Well-Being Index (WHO-5). The analyses were performed with SPSS Statistics Version 26 and MAXQDA 2022. The mental health outcomes significantly differed over time and across countries, with e.g. Greek participants showing decrease in adjustment disorder symptoms (p = .007) between T1 and T2. Compared with other countries, we found better mental health outcomes in the Austrian and the Croatian sample at both timepoints (p < .05). Regarding qualitative data, some themes were equally represented at both timepoints (e.g. Restrictions and changes in daily life), while others were more prominent at T1 (e.g. Work and finances) or T2 (e.g. Vaccination issues). Our findings indicate that people's reactions to the pandemic are largely shaped by the shifting context of the pandemic, country-specific factors, and individual characteristics and circumstances. Resource-oriented interventions focusing on psychological flexibility might promote resilience and mental health amidst the COVID-19 pandemic and other global crises.

Background: The COVID-19 pandemic exposes individuals to multiple stressors, such as quarantine, physical distancing, job loss, risk of infection, and loss of loved ones. Such a complex array of stressors potentially lead to symptoms of adjustment disorder. Objective: This cross-sectional exploratory study examined relationships between risk and protective factors, stressors, and symptoms of adjustment disorder during the first year of the COVID-19 pandemic. Methods: Data from the first wave of the European Society of Traumatic Stress Studies (ESTSS) longitudinal ADJUST Study were used. N = 15,563 participants aged 18 years and above were recruited in eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. Associations between risk and protective factors (e.g. gender, diagnosis of a mental health disorder), stressors (e.g. fear of infection, restricted face-to-face contact), and symptoms of adjustment disorder (ADNM-8) were examined using multivariate linear regression. Results: The prevalence of self-reported probable adjustment disorder was 18.2%. Risk factors associated with higher levels of symptoms of adjustment disorder were female gender, older age, being at risk for severe COVID-19 illness, poorer general health status, current or previous trauma exposure, a current or previous mental health disorder, and longer exposure to COVID-19 news. Protective factors related to lower levels of symptoms of adjustment disorder were higher income, being retired, and having more face-to-face contact with loved ones or friends. Pandemic-related stressors associated with higher levels of symptoms of adjustment disorder included fear of infection, governmental crisis management, restricted social contact, work-related problems, restricted activity, and difficult housing conditions. Conclusions: We identified stressors, risk, and protective factors that may help identify individuals at higher risk for adjustment disorder. We examined symptoms of adjustment disorder in 15,563 adults during the COVID-19 pandemic. The prevalence of probable adjustment disorder was 18.2%. We identified stressors, risk, and protective factors that may help identify individuals at higher risk for adjustment disorder.

Background: The COVID-19 pandemic is a health emergency resulting in multiple stressors that may be related to posttraumatic stress disorder (PTSD). Objective: This study examined relationships between risk and protective factors, pandemic-related stressors, and PTSD during the COVID-19 pandemic. Methods: Data from the European Society of Traumatic Stress Studies (ESTSS) ADJUST Study were used. N = 4,607 trauma-exposed participants aged 18 years and above were recruited from the general populations of eleven countries (Austria, Croatia, Georgia, Germany, Greece, Italy, Lithuania, the Netherlands, Poland, Portugal, and Sweden) from June to November 2020. We assessed sociodemographic (e.g. gender), pandemic-related (e.g. news consumption), and health-related (e.g. general health condition) risk and protective factors, pandemic-related stressors (e.g. fear of infection), and probable PTSD (PC-PTSD-5). The relationships between these variables were examined using logistic regression on multiple imputed data sets. Results: The prevalence of probable PTSD was 17.7%. Factors associated with an increased risk for PTSD were younger age, female gender, more than 3 h of daily pandemic-related news consumption (vs. no consumption), a satisfactory, poor, or very poor health condition (vs. a very good condition), a current or previous diagnosis of a mental disorder, and trauma exposure during the COVID-19 pandemic. Factors associated with a reduced risk for PTSD included a medium and high income (vs. very low income), face-to-face contact less than once a week or 3-7 times a week (vs. no contact), and digital social contact less than once a week or 1-7 days a week (vs. no contact). Pandemic-related stressors associated with an increased risk for PTSD included governmental crisis management and communication, restricted resources, restricted social contact, and difficult housing conditions. Conclusion: We identified risk and protective factors as well as stressors that may help identify trauma-exposed individuals at risk for PTSD, enabling more efficient and rapid access to care. N =  4,607 trauma-exposed adult participants were recruited from the general population during the first year of the COVID-19 pandemic. The prevalence for probable posttraumatic stress disorder was 17.7%. We identified risk factors (e.g. poor health condition) and protective factors (e.g. social contact) associated with posttraumatic stress disorder.

The complex system of stressors related to the coronavirus disease 2019 (COVID-19) pandemic has affected the global population, provoking a broad range of psychological reactions. Although numerous studies have investigated the mental health impact of COVID-19, qualitative research and cross-country comparisons are still rare. This qualitative study aimed to explore self-perceived challenges and opportunities related to COVID-19 across six European countries. The overall objective was to provide a differentiated picture of individual subjective experiences in the early stages of the pandemic. The present study included 7309 participants from Austria, Croatia, Georgia, Greece, Poland, and Portugal. We performed qualitative content analysis according to Mayring analyse open-ended questions regarding stressful events, positive and negative aspects of the pandemic, and recommendations to cope with the pandemic situation. MAXQDA software was used for data management and analysis. Participants' accounts were moderately consistent across the countries. The most prominent themes regarding stressful and negative pandemic aspects included: Restrictions and changes in daily life, Emotional distress, and Work and finances. Answers about positive pandemic consequences were mainly centred around the themes Reflection and growth, Opportunity for meaningful/enjoyable activities, and Benefits on interpersonal level. Key themes identified from participants' recommendations to cope with the pandemic included Beneficial behavioural adjustment, Beneficial cognitive-emotional strategies, and Social support. Participants experienced various challenges, but also shared several positive pandemic consequences and recommendations to cope with the pandemic. These first-hand data could inform mental health practices to promote well-being during COVID-19 and similar global challenges in the participating countries and possibly beyond. We examined COVID-19-related experiences in 7309 adults from six European countries. Besides challenges, participants identified many positive pandemic consequences. Participants' recommendations to cope with COVID-19 included behavioural and cognitive-emotional strategies.

The COVID-19 pandemic is a manifestation of trauma exposure that could eventuate in psychological distress, anxiety, depression, and various mental health disturbances, especially in people who have experienced an additional stressor such as a traumatic event. This cross-sectional study assessed the relationship between pandemic-related stressors, post-traumatic stress disorder (PTSD), the risk for severe or life-threatening symptoms, and resilience among individuals with a traumatic history amidst the coronavirus disease. This study is part of a longitudinal pan-European research, the ADJUST study. The present study consisted of 14.106 participants. The questionnaires utilized included: sociodemographics, health aspects, the Criterion A section of the PTSD Checklist for DSM-5 (PCL-5), the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), the Pandemic Stressor Scale (PaSS), and the Resilience Evaluation Scale (RES). For the analysis, descriptive statistics and logistic regression analysis were applied. 29% of the respondents reported a traumatic history. Fear of infection, burden of infection, crisis management and communication, restricted activity, risk for severe or life-threatening symptoms of the coronavirus disease, PTSD, and resilience were the predictive factors in the trauma-exposed population. This research provides insights into the stressors that individuals with a traumatic background might experience through the COVID-19 pandemic. Future interventions and worldwide health policies should target trauma-exposed populations to enhance psychological health amidst COVID-19 and other stressful events.

The COVID-19 pandemic caused multiple stressors that may lead to symptoms of adjustment disorder. We longitudinally examined relationships between risk and protective factors, pandemic-related stressors and symptoms of adjustment disorder during the COVID-19 pandemic, as well as whether these relationships differed by the time of assessment. The European Society for Traumatic Stress Studies (ESTSS) ADJUST Study included = 15,169 participants aged 18 years and above. Participants from 11 European countries were recruited and screened three times at 6-month intervals from June 2020 to January 2022. Associations between risk and protective factors (e.g. gender), stressors (e.g. fear of infection), and symptoms of adjustment disorder (AjD, ADNM-8) and their interaction with time of assessment were examined using mixed linear regression. The following predictors were significantly associated with higher AjD symptom levels: female or diverse gender; older age; pandemic-related news consumption >30 min a day; a current or previous mental health disorder; trauma exposure before or during the pandemic; a good, satisfactory or poor health status (vs. very good); burden related to governmental crisis management and communication; fear of infection; restricted social contact; work-related problems; restricted activity; and difficult housing conditions. The following predictors were associated with lower AjD levels: self-employment or retirement; working in healthcare; and face-to-face contact ≥ once a week with loved ones or friends. The effects of the following predictors on AjD symptoms differed by the time of assessment in the course of the pandemic: a current or previous mental disorder; burden related to governmental crisis management; income reduction; and a current trauma exposure. We identified risk factors and stressors predicting AjD symptom levels at different stages of the pandemic. For some predictors, the effects on mental health may change at different stages of a pandemic.

This research aims to highlight and understand the factors associated with excessive internet use. The population studied consisted of 904 students, aged 12 to 18 years. The study was conducted in Magnesia prefecture of central Greece, in a period after the economic recession, and participants came from a large urban area, a prefecture's capital, a municipal unit of the prefecture's capital and an island. Students were provided with the following questionnaires: Internet Addiction Test (IAT), Brief Symptom Inventory (BSI), Self-Efficacy Questionnaire for Children (SEQ-C), and Egna Minnen av Barndoms Uppfostran: \"My Memories of Upbringing\" for Children (EMBU-C). Participants were asked to fill out questionnaires about sociodemographic characteristics and the use of online activities. The findings indicated that 14.1% of students were excessive internet users, and social media was the principal reason for using the internet. Excessive internet users had increased symptoms of psychopathology, control-overprotection, rejection, anxious rearing, and decreased academic, emotional, social self-efficacy, and emotional warmth. Finally, the increased symptoms of psychopathology and parents' rejection were the predictive factors in excessive internet use. In conclusion, Greek adolescents participating in this study are susceptible to excessive internet use. Most importantly, rejection as a parental rearing practice and adolescents' psychopathology seemed to impact the development of addictive behavior and should be taken into consideration by future research.

Background: Early empirical data shows that school-aged children, adolescents and adults are experiencing elevated levels of anxiety and depression during the COVID-19 pandemic. Currently, there is very little research on mental health outcomes for young children. Objectives: To describe the formation of a global collaboration entitled, 'COVID-19 Unmasked'. The collaborating researchers aim to (1) describe and compare the COVID-19 related experiences within and across countries; (2) examine mental health outcomes for young children (1 to 5 years) and caregivers over a 12-month period during the COVID-19 pandemic; (3) explore the trajectories/time course of psychological outcomes of the children and parents over this period and (4) identify the risk and protective factors for different mental health trajectories. Data will be combined from all participating countries into one large open access cross-cultural dataset to facilitate further international collaborations and joint publications. Methods: COVID-19 Unmasked is an online prospective longitudinal cohort study. An international steering committee was formed with the aim of starting a global collaboration. Currently, partnerships have been formed with 9 countries (Australia, Cyprus, Greece, the Netherlands, Poland, Spain, Turkey, the UK, and the United States of America). Research partners have started to start data collection with caregivers of young children aged 1-5 years old at baseline, 3-months, 6-months, and 12-months. Caregivers are invited to complete an online survey about COVID-19 related exposure and experiences, child's wellbeing, their own mental health, and parenting. Data analysis: Primary study outcomes will be child mental health as assessed by scales from the Patient-Reported Outcomes Measurement Information System - Early Childhood (PROMIS-EC) and caregiver mental health as assessed by the Depression Anxiety Stress Scale (DASS-21). The trajectories/time course of mental health difficulties and the impact of risk and protective factors will be analysed using hierarchical linear models, accounting for nested effects (e.g. country) and repeated measures. This article describes the formation of a global collaboration between 9 countries that are collecting data to examine mental health outcomes for young children (1 to 5 years) and caregivers over a 12-month period during the COVID-19 pandemic.

In modern military operations, psychological resilience has become essential to mission accomplishment and service members' well-being. Combat environments subject military personnel to extreme stress and trauma, which can result in long-term psychological repercussions including posttraumatic stress disorder (PTSD). Military personnel are exposed to unique challenges that can significantly impact their mental health. While combat, dangerous missions, and severe training incidents are well-known contributors, veterans experience PTSD at a slightly higher rate than civilians, approximately 7 percent versus 6 percent in the overall population. The prevalence is higher among female veterans, with 13 percent affected versus 6 percent of their male counterparts. The likelihood of developing PTSD varies across different service eras, with the highest rates seen in veterans from Operations Iraqi Freedom and Enduring Freedom, where nearly 29 percent experienced PTSD at some point in their lives. The mental health of military veterans, especially concerning PTSD, remains a persistent issue. Not all military personnel exposed to trauma will develop PTSD.