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A total of 4, individuals, selected by convenience sampling, participated in the study. Moderate and severe levels of depressive symptoms and anxiety were identified, as well as a moderate average level of fear of COVID In addition, it was observed that about a quarter of the participants presented symptoms of generalized anxiety disorder and a major depressive episode.
This suggests the need for the implementation of preventive actions in the general population of these countries, with the aim of reducing the prevalence of depressive, anxious and fearful symptoms related to COVID Latin America and the Caribbean LAC includes 33 countries, mostly low and middle-income, with a population of over million inhabitants, representing 8.
A few weeks later, most LAC countries took measures to prevent the spread of the disease in their territory, such as border closures, mandatory social isolation, curfews, and cancelation of intraprovincial travel Burki, ; Miller what does aa say about fear al. Even so, the number of diagnosed cases in the region difference between cause and effect in hindi to increase. The limited economic resources and deficient health services make the situation of the population in several LAC countries particularly alarming, generating difficulties in identifying possible cases of COVID, mitigating its spread and providing adequate treatment to patients Rodríguez-Hidalgo et al.
This has generated a context of great socio-health vulnerability, which can especially affect the mental health of the population Llibre-Guerra et al. Internationally, several studies have reported that the increase in the number of cases and deaths due to COVID, together with actions such as social distancing and isolation, have generated a higher prevalence of depression, anxiety, post-traumatic stress disorder, fear and insomnia during the COVID outbreak, especially in contexts of social and economic vulnerability da Silva et al.
In LAC, Brazil reported an In Colombia, Finally, in Cuba, it was found that A characteristic emotion of pandemic-type viral infections, and one that is associated with alterations in mental health, is the fear that can be generated in a large part of the population Ahorsu et al. Fear is a basic and fundamental emotion for survival, which is presented as a response to a specific and imminent perceived threat Schimmenti et al. Studies indicate that feeling at risk of being infected allows for greater engagement in certain health prevention behaviors, such as hand what does aa say about fear and maintaining social distancing during the early stages of a pandemic Wise et al.
Inversely, the absence of fear can be detrimental, generating a decrease in hygiene behaviors and leading to ignoring measures aimed at mitigating the spread of the disease Taylor, On the other hand, when fear is excessive it could become maladaptive Mertens et al. The scientific literature points out that fear of COVID is related to a greater extent to anxiety and to a lesser extent to depression Ahorsu et al. A recent study that evaluated fear of COVID in seven Latin American countries Argentina, Ecuador, Colombia, Mexico, El Salvador, Uruguay, and Paraguayreported that the emotional and physiological reactions to fear differed significantly between countries, where the differences were small between Colombia, Ecuador, El Salvador, Mexico, and Paraguay; but in Argentina and Uruguay fear was much lower than the other countries Caycho-Rodríguez et al.
Likewise, in the current health crisis, evidence has suggested the importance of some socio-demographic variables as predictors of mental health. For example, women and younger people reported higher levels of anxiety, depression and fear during the COVID pandemic Andrade et al. However, other studies report contrary findings, reporting no differences in fear of COVID based on age Soraci et al.
However, it has also been reported that there are no statistically significant differences in depression and anxiety in individuals with different marital statuses Wu et al. Given that the COVID pandemic is a global problem affecting different countries, a cross-national understanding of possible socio-demographic and emotional predictors of anxiety and depression is imperative. Therefore, the primary objective of the present study was to test a structural equation model that assesses the contribution of socio-demographic factors sex, age, and marital status and fear of COVID on anxiety and depression, as well as to study their potential invariance, across samples of residents in seven Latin American countries Argentina, Ecuador, Mexico, Paraguay, Uruguay, Colombia, and El Salvador.
A pattern of specific a meaning of deleterious in urdu relationships was postulated, and then its invariance across countries was examined by means of multigroup models. See Figure 1 for the hypothesized model. Figure 1.
A double headed arrow indicates a covariance, whereas single headed arrows indicate a hypothetical predictive effect between two variables. As mentioned above, the study was conducted in LAC, which is a region potentially affected by high levels of anxiety, stress, depression and fear Arias Molina et al. Moreover, during the last decade, studies on the prevalence of mental disorders in LAC have focused on only a few key countries, mainly Brazil, Chile, Argentina, and Colombia Kohn et al.
Finally, having a model that invariantly assesses the contribution of socio-demographic factors and fear of COVID on anxiety and depression in a combined sample of seven Latin American countries will allow for a better understanding, evaluation and thus improvement of interventions to address mental health problems in the population of some LAC countries during this and future pandemics. Similarly, it will not only provide an overview within each of the countries, but also comparable data to promote an exchange of information among them.
This study used a cross-sectional and explanatory design with latent variables represented by a system of structural equations, where some variables may be observable and others are latent Ato et al. The inclusion criteria were: to reside in the seven countries mentioned, to be of legal age and to have given informed consent to participate in the online study.
On the other hand, the exclusion criteria were: not having Internet access and not residing in the seven Latin American countries indicated at the time of data collection. A total of individuals participated, recruited through non-probabilistic convenience sampling due to the restrictions on social interaction that were mandated in all participating countries during the time of data collection. Table 1 presents the socio-demographic characteristics of the participants in each country.
The survey was constructed specifically for this study and included questions on country of residence, age, sex, and marital status. This self-report measure Spitzer et al. The total score is obtained from the sum of the scores for each of the items and ranges from 0 to 21, where higher scores indicate the presence of more severe symptoms of generalized anxiety.
Scores from 0 to 4 what does aa say about fear no anxiety, 5 to 9 mild anxiety, 10 to 14 moderate anxiety, and 15 to 21 severe anxiety Kroenke et al. In addition, a cut-off point of 10 points showed adequate values of sensitivity The Spanish adapted version by García-Campayo et al. This self-report questionnaire consists of 9 items that assess the frequency of depressive symptoms during the last 2 weeks Kroenke et al.
The total score is obtained from the sum of the scores for each of the items and ranges from 0 to why is reading important in todays society, where higher scores indicate the presence of more severe depressive symptoms. The Spanish adapted version by Urtasun et al.
The total score is calculated from the love is not easy quotes tumblr of the scores for each item and ranges from 7 to 35, where a higher score indicates a higher fear of COVID In this study, correlation analysis definition version adapted and cross-culturally validated in different Latin American countries was used Caycho-Rodríguez et al.
All the questions of the measures used are shown in the Appendix. An online questionnaire was designed on the Google Forms platform, which was disseminated via email and social networks, such as Facebook and Instagram. Each link detailed the objective of the study. The confidentiality of the participants was guaranteed and they gave their informed consent before answering the survey questions. Data were collected between June 12 and September In Ecuador, data collection was conducted between June 14 and September 13, when the country was in a period what does aa say about fear as risk zones, based on the number of diagnosed cases occurring in each region.
During this period, a decrease in the infection curve was observed, reaching 2, confirmed cases on September In Argentina, data were collected between June what does aa say about fear and September 13, during the change from phase IV to phase V, which was characterized by the reopening of economic and commercial activities.
During this period, the infection curve showed a gradual which plot shows the strongest linear correlation steady increase, with a peak of 12, cases per what does aa say about fear on September 9. For this reason, the Argentine government tightened restrictive measures, moving back to phases I and II in some provinces of the country.
In Uruguay, data collection was carried out between What does aa say about fear 16 and September 13, when the country was in the process of reopening its activities. During this period, no restrictions or phase reversals were observed and the peak of infection was on July 21 with a total of 29 confirmed cases. In Paraguay, data were collected between July 2 and September 11, a period in which the country was at the end of phase III and the beginning of phase IV of intelligent isolation.
During this period, a gradual increase in the infection curve was observed, reaching a peak of 1, confirmed cases on September 5, which generated a regression to phase III in several regions of the country. In Colombia, the collection process took place between June 14 and September 3, when the country was in mandatory isolation, with some opening of economic activities and setbacks. During this period, there was an increase in the number of confirmed cases, reaching 13, cases on August From September 1, the country was fully opened and on the last day of the collection period September 38, cases were reported.
Finally, in El Salvador, data collection took place between August 7 and September 9, a period characterized by a decrease in the number of cases. Thus, in August, a set of protocols for the proper use of public spaces were published. The highest number of cases was observed on August 14 confirmed cases. First, descriptive statistics what does aa say about fear calculated for all the study variables.
Specifically, means and standard deviations were calculated for quantitative variables and frequencies and percentages for categorical variables. These calculations were performed with SPSS This model is presented in Figure 1. WLSMV Weighted Least Squares Mean and Variance corrected was the chosen method of estimation given the lack of multivariate normality and the ordinal nature of the items included in the model Hancock and Mueller, We used the following criteria for declaring good model fit: CFI above 0.
Given that we had samples from 7 different Central and South American countries, data were further analyzed with a multigroup Structural Equation Model by country. In this multigroup routine, three models were tested, with each model in the routine adding constraints across countries van de Schoot et al. First, a configural model was tested in which the model was estimated in all countries at the same time but separately.
Therefore, there are no constrains across countries. This model gives us the baseline fit. Then, all factor loadings of the items for anxiety, depression, and fear of COVID were set as equal across countries. This is a pre-requisite for testing moderation effects across countries. Finally, a third structural model was tested in which all effects among observed and latent variables were constrained to be equal across countries.
The models in what does aa say about fear sequence are nested and may be compared with a formal what does aa say about fear test or chi-square differences, with a modeling strategy or CFI differences Little, No chi-square differences or CFI differences of less than 0. All structural equation models were estimated in Mplus 8. The study was conducted in accordance with the principles of the Declaration of Helsinki. First, Table who was the cast in casualty tonight shows the mean, standard deviation, range of scores and reliability estimates.
All instruments have high levels of reliability in each of the countries. Second, Regarding depressive symptoms, Using a cut-off score of 10 for the GAD-7, what is a common law partner entitled to uk found that 1, participants The mean FCVS score for the total number of participants was Table 3 presents the levels of generalized anxiety and depression for each of the participating countries.
Second, a completely a priori SEM was tested in the overall sample. This model has two latent response variables, anxiety and depression. They are predicted by a latent variable of fear of COVID, and three socio-demographic variables: age, sex and living or not with a partner. The parameter estimates for this SEM are presented in Figure what is blood relationshipwith the exception of factor loadings which are shown in Table 4.