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Background: The current study argues that population prevalence estimates for mental health disorders, or changes in mean scores over time, may not adequately reflect the heterogeneity in mental health response to the COVID-19 pandemic within the population. Methods: The COVID-19 Psychological Research Consortium (C19PRC) Study is a longitudinal, nationally representative, online survey of UK adults. The current study analysed data from its first three waves of data collection: Wave 1 (March 2020, N = 2025), Wave 2 (April 2020, N = 1406) and Wave 3 (July 2020, N = 1166). Anxiety-depression was measured using the Patient Health Questionnaire Anxiety and Depression Scale (a composite measure of the PHQ-9 and GAD-7) and COVID-19-related posttraumatic stress disorder (PTSD) with the International Trauma Questionnaire. Changes in mental health outcomes were modelled across the three waves. Latent class growth analysis was used to identify subgroups of individuals with different trajectories of change in anxiety-depression and COVID-19 PTSD. Latent class membership was regressed on baseline characteristics. Results: Overall prevalence of anxiety-depression remained stable, while COVID-19 PTSD reduced between Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesised classes reflecting (i) stability, (ii) improvement and (iii) deterioration in mental health were identified. Psychological factors were most likely to differentiate the improving, deteriorating and high-stable classes from the low-stable mental health trajectories. Conclusions: A low-stable profile characterised by little-to-no psychological distress ('resilient' class) was the most common trajectory for both anxiety-depression and COVID-19 PTSD. Monitoring these trajectories is necessary moving forward, in particular for the ~30% of individuals with increasing anxiety-depression levels. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) emergency has led to numerous attempts to assess the impact of the pandemic on population mental health. The findings indicate an increase in depression and anxiety but have been limited by the lack of specificity about which aspects of the pandemic (e.g. viral exposure or economic threats) have led to adverse mental health outcomes. Methods: Network analyses were conducted on data from wave 1 (N = 2025, recruited 23 March–28 March 2020) and wave 2 (N = 1406, recontacts 22 April–1 May 2020) of the COVID-19 Psychological Research Consortium Study, an online longitudinal survey of a representative sample of the UK adult population. Our models included depression (PHQ-9), generalized anxiety (GAD-7) and trauma symptoms (ITQ); and measures of COVID-specific anxiety, exposure to the virus in self and close others, as well as economic loss due to the pandemic. Results: A mixed graphical model at wave 1 identified a potential pathway from economic adversity to anxiety symptoms via COVID-specific anxiety. There was no association between viral exposure and symptoms. Ising network models using clinical cut-offs for symptom scores at each wave yielded similar findings, with the exception of a modest effect of viral exposure on trauma symptoms at wave 1 only. Anxiety and depression symptoms formed separate clusters at wave 1 but not wave 2. Conclusions: The psychological impact of the pandemic evolved in the early phase of lockdown. COVID-related anxiety may represent the mechanism through which economic consequences of the pandemic are associated with psychiatric symptoms. [ABSTRACT FROM AUTHOR]

Objectives: Paranoia is known to be associated with insecure attachment, with negative self‐esteem as a mediator, but this pathway is insufficient to explain the paranoid individual's beliefs about malevolent others. Mistrust is a likely additional factor as it is a core feature of paranoid thinking also associated with insecure attachment styles. In this study, we tested whether mistrust – operationalized as judgements about the trustworthiness of unfamiliar faces – constitutes a second pathway from insecure attachment to paranoia. Design: The design of the study was cross‐sectional. Methods: A nationally representative British sample of 1,508 participants aged 18–86, 50.8% female, recruited through the survey company Qualtrics, completed measurements of attachment style, negative self‐esteem, and paranoid beliefs. Usable data were obtained from 1,121 participants. Participants were asked to make trustworthiness judgements about computer‐generated faces, and their outcomes were analysed by conducting signal detection analysis, which provided measures of bias (the tendency to assume untrustworthiness in conditions of uncertainty) and sensitivity (accuracy in distinguish between trustworthy and untrustworthy faces). Results: Results using structural equation modelling revealed a good model fit (RMSEA =.071, 95% CI: 0.067–0.075, SRMR =.045, CFI =.93, TLI =.92). We observed indirect effects through bias towards mistrust both for the relationship between attachment anxiety and avoidance (β =.003, 95% CI: 0.001–0.005,p <.001) and attachment anxiety and paranoia (β =.003, 95% CI 0.002–0.006, p <.001). We observed an indirect effect through negative self‐esteem only for the relationship between attachment anxiety and paranoia (β =.064, 95% CI: 0.053–0.077, p <.001). Trust judgements and negative self‐esteem were not associated with each other. Conclusions: We find that a bias towards mistrust is associated with greater paranoia. We also find indirect effects through bias towards mistrust between attachment styles and paranoia. Finally, we reaffirm the strong indirect effect through negative self‐esteem between attachment anxiety and paranoia. Limitations of the study are discussed. Practitioner points: When working with individuals suffering from paranoia, clinicians should consider not only explicit, deliberative cognitive processes of the kind addressed in cognitive behaviour therapy (e.g. cognitive restructuring) but also the way in which their patients make perceptual judgements (e.g., their immediate reactions on encountering new people) and consider interventions targeted at these judgements, for example, bias modification training.Assessment and clinical interventions for people should consider the role of trust judgements and the way in which they combine with low self‐esteem to provoke paranoid beliefs.Psychological interventions targeting paranoid beliefs should focus on both attachment anxiety and attachment avoidance. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the association between anxiety associated with COVID-19 and somatic symptoms, using data from a large, representative sample (N = 2,025) of the UK adult population. Results showed that moderate to high levels of anxiety associated with COVID-19 were significantly associated with general somatic symptoms and in particular with gastrointestinal and fatigue symptoms. This pattern of associations remained significant after controlling for generalized anxiety disorder (GAD), pre-existing health problems, age, gender, and income. This is the first evidence that anxiety associated with COVID-19 makes a unique contribution to somatization, above and beyond the effect of GAD. [ABSTRACT FROM AUTHOR]