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@article{ Wechsler2022,
 title = {Individual changes in stress, depression, anxiety, pathological worry, posttraumatic stress, and health anxiety from before to during the COVID-19 pandemic in adults from Southeastern Germany},
 author = {Wechsler, Theresa F. and Schmidmeier, Melissa and Biehl, Stefanie and Gerczuk, Jennifer and Guerrero-Cerda, Fiorella-Maria and Mühlberger, Andreas},
 journal = {BMC Psychiatry},
 number = {1},
 pages = {1-20},
 volume = {22},
 year = {2022},
 issn = {1471-244X},
 doi = {https://doi.org/10.1186/s12888-022-04148-y},
 urn = {https://nbn-resolving.org/urn:nbn:de:0168-ssoar-94417-7},
 abstract = {Background: Many studies have previously compared the prevalence or sample means of distress and mental health problems from before to during the COVID-19 pandemic, while results on changes at the individual-level, and regarding multiple outcome measures are demanded. Methods: This online study investigated individual changes in stress and mental health from before the COVID-19 pandemic to the first lockdown in adults from Southeastern Germany. This region was selected as it was where SARS-CoV-2 was first documented in Germany, and also due to the implementation of strict stay-at-home orders and social contact prohibitions. From April 10–27, 2020, we collected state measures and their clinical relevance for the subareas of perceived stress: worries, tension, joy, and demands. We also collected information regarding the following mental health problems: depression, anxiety, pathological worry, posttraumatic stress disorder (PTSD), and health anxiety; as well as retrospective measures of how participants felt they have changed in comparison to before the pandemic, ranging from worse to better. Results: The analytical sample comprised 396 adult participants. On average, participants experienced increases in worries, tension, and lack of joy, and increases in mental health problems, but a decrease in demands. Perceived increases in symptoms of depression (26.0%) and PTSD (25.5%) were significantly more frequent than in symptoms of anxiety (particularly acute fear and panic) (5.6%), pathological worry (9.8%), and health anxiety (7.3%) (ps<.001). One per 10 participants (10.4%) reported an increase in depressive symptoms, and nearly two per 10 (18.4%) an increase in PTSD symptoms and additionally showed a clinically relevant symptom strain during lockdown. Interestingly, mainly non-specific PTSD symptoms associated with a general stress reaction were experienced to be increased. Conclusion: The findings suggest a dissociation of perceived changes in subareas of stress and mental health with a particular experience of increases in depressive and general stress symptoms and a decrease in external demands. This points to a need for a more differentiated view on the impact of the COVID-19 pandemic on stress and mental health, and for targeted interventions for mental health problems arising frequently during the pandemic.},
 keywords = {Stress; psychophysical stress; Depression; depression; Angst; anxiety; Gesundheit; health; gesundheitliche Folgen; health consequences; psychische Belastung; psychological stress; psychische Gesundheit; mental health; Trauma; trauma; Bundesrepublik Deutschland; Federal Republic of Germany; Süddeutschland; Southern Germany}}