Related Experiment Video
Updated: Feb 24, 2026

Polar Histogram Visualization of Acute Stress Disorder Scale Scores for Comprehensive Clinical Assessment
Published on: December 6, 2024
Psychological Distress Severity and Behaviors Among Missouri Residents Who Experienced COVID-19-related Death of a
Shafeel Umam1, Germysha Little2, Sydney Grellner2
1Behavioral Science and Health Equity, https://ror.org/01p7jjy08Saint Louis University College for Public Health and Social Justice, United States.
Objective:
Explore the relationship between the severity of psychological distress symptoms and COVID-19-related bereavement, along with various sociodemographic factors and smoking/substance use behaviors during the COVID-19 pandemic.
Methods:
This study used 962 Missouri residents' (age: mean 44.8, SD 16.7, range 18-86 years; 67% [641] female) responses in the context of COVID-19 during 2022. Severity of psychological distress was measured using combined responses from PHQ-8 and GAD-7 scales and classified as moderate to severe using a cutoff score of ≥15 in PHQ-8 or ≥10 in GAD-7 scale. Predictors were bereavement (yes/no), current smoking (yes/no), and any substance use and polysubstance use (≥2). Logistic regressions adjusted for age, highest educational level, and employment status.
Results:
Approximately 19% experienced loss due to COVID-19; 28% exhibited moderate to severe symptoms of psychological distress. Individuals who experienced COVID-19-related deaths were more likely to suffer from moderate to severe psychological distress symptoms (Adjusted Odds Ratios (AOR): 1.46; 95% CI:1.00, 2.12). Smoking (AOR:1.68; 95% CI: 1.20, 2.36) and polysubstance use (AOR: 2.44; 95% CI: 1.64, 3.65) also exhibited higher odds.
Conclusions:
COVID-19 bereavement and smoking/substance use were linked to higher distress. Future research and strategies should integrate bereavement supports with substance-use screening/brief intervention in disaster mental-health services.
Related Concept Videos
Kubler Ross's Stages of Dying
In denial, individuals reject the reality of their condition, often thinking, "This isn't true; I feel fine," as a way to protect themselves from...
Psychological Responses to Stress
Stress and Mental Health
Individuals with depression often experience challenges in both their personal and professional...
Bonanno's Theory of Grieving
Resilience
Stress Prevention and Stress Management Techniques V
Introduction to Stress and Lifestyle

