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Background: The COVID-19 outbreak in early 2020 was associated with an immediate increase in mental health problems in a significant percentage of the general population. Therefore, it is crucial to investigate how the COVID-19 pandemic – as a psychosocial stressor – affected the aetiological processes of mental disorders. Previous research has shown that stress potentiates associative (fear) learning and analogue symptoms of posttraumatic stress disorder (PTSD) and that analogue PTSD symptoms can emerge in response to associative learning. Objective: We investigated whether distress in response to the COVID-19 outbreak support the development of intrusions and rumination after exposure to a non-COVID-19-related analogue trauma. Moreover, we examined if these effects are mediated by the strength of associative learning during analogue trauma. Method: 122 undergraduate university students participated in an online experiment between March and July 2020. They completed questionnaires measuring distress and rumination related to the COVID-19 outbreak. On a subsequent day, they went through an associative learning task, in which neutral stimuli were paired with the appearance of a highly aversive film clip. Subjective ratings were assessed as indicators of associative learning. On the next day, participants documented film-related intrusions and rumination. Results: COVID-19-related distress but not rumination was associated with post-film intrusion and rumination load. These effects were mediated by associative learning. Conclusions: The current findings are in line with the assumptions that stress enhanced both associative learning and PTSD symptoms. Specifically, they indicate that prolonged psychosocial stress – like during the COVID-19 outbreak – is linked to individual differences in memory processing of aversive events. Further confirmatory research is needed to replicate these results. High distress related to the COVID-19 outbreak was associated with analogue PTSD symptom development.This effect was mediated by the strength of associative learning.Prolonged psychosocial stress like the COVID-19 outbreak might impact memory processing of aversive events. High distress related to the COVID-19 outbreak was associated with analogue PTSD symptom development. This effect was mediated by the strength of associative learning. Prolonged psychosocial stress like the COVID-19 outbreak might impact memory processing of aversive events.

Background Several studies have investigated the relationship between emotional attachment to pets and mental health with the majority of studies finding a negative relationship between emotional attachment to pets and mental health. Interestingly, attachment to pets differs from attachment to humans with studies showing that humans with an insecure attachment style form a particularly strong emotional attachment to their companion animals. Human attachment style is also related to mental health with secure attachment being associated with superior mental health. Building on those findings, the current study aimed at exploring the role of attachment to humans in the relationship between emotional attachment to pets and mental health. Methods In this cross-sectional online survey (N = 610) we assessed the strength of emotional attachment to pets and attachment to humans. We further collected pet specific data as well as mental health burden in a sample of German dog owners (Mage=33.12; 92.79% women). We used a mediation model estimating the indirect link between emotional attachment to pets and mental health burden via human attachment and the direct link between emotional attachment to pets and mental health burden simultaneously. Results We found that attachment to humans fully mediated the positive association between emotional attachment to pets and mental health burden. A stronger emotional attachment to one’s dog was associated with lower comfort with depending on or trusting in others, whereby lower comfort with depending on or trusting in others was related to higher mental health burden. Moreover, a stronger attachment to one’s dog was also related to a greater fear of being rejected and unloved (Anxiety), which was, in turn, associated with a higher mental health burden. Conclusion Our findings suggest that the positive link between emotional attachment to pets and mental health burden is fully accounted for by its shared variance with insecure attachment to humans in a sample mostly comprising self-identified women. Future studies need to examine whether strong emotional bonds with pets may evolve as a compensatory strategy to buffer difficult childhood bonding experiences.

Introduction Stroke is the leading neurological cause of adult long-term disability in Europe. Even though functional consequences directly related to neurological impairment are well studied, post-stroke trajectories of functional health according to the International Classification of Functioning, Disability and Health are poorly understood. Particularly, no study investigated the relationship between post-stroke trajectories of activities of daily living (ADL) and self-rated health (SRH). However, such knowledge is of major importance to identify patients at risk of unfavourable courses. This prospective observational study aims to investigate trajectories of ADL and SRH, and their modifying factors in the course of the first year after stroke. Methods and analysis The study will consecutively enrol 300 patients admitted to a tertiary care hospital with acute ischaemic stroke or transient ischaemic attack (TIA; Age, Blood Pressure, Clinical Features, Duration of symptoms, Diabetes score ≥3). Patient inclusion is planned from May 2021 to September 2022. All participants will complete an interview assessing ADL, SRH, mental health, views on ageing and resilience-related concepts. Participants will be interviewed face-to-face 1–5 days post-stroke/TIA in the hospital; and will be followed up after 6 weeks, 3 months, 6 months and 12 months via telephone. The 12-month follow-up will also include a neurological assessment. Primary endpoints are ADL operationalised by modified Rankin Scale scores and SRH. Secondary outcomes are further measures of ADL, functional health, physical activity, falls and fatigue. Views on ageing, social support, resilience-related concepts, affect, frailty, illness perceptions and loneliness will be examined as modifying factors. Analyses will investigate the bidirectional relationship between SRH and ADL using bivariate latent change score models. Ethics and dissemination The study has been approved by the institutional review board of the University Medicine Greifswald (Ref. BB 237/20). The results will be disseminated through scientific publications, conferences and media. Moreover, study results and potential implications will be discussed with patient representatives. Trial registration number NCT04704635.