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CME / ABIM MOC / CE

Why Was Time Perception Distorted During the Pandemic?

  • Authors: News Author: Batya Swift Yasgur, MA, LSW; CME Author: Laurie Barclay, MD
  • CME / ABIM MOC / CE Released: 10/28/2022
  • Valid for credit through: 10/28/2023
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  • Credits Available

    Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™

    ABIM Diplomates - maximum of 0.25 ABIM MOC points

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Target Audience and Goal Statement

This activity is intended for psychiatrists, internists, medicine/primary care physicians, pharmacists, nurses, physician assistants, and other members of the healthcare team for patients whose time perception may have been distorted during the pandemic.

The goal of this activity is for learners to be better able to describe perceptions of time passing (time perspective) and their associations with lifetime stress and trauma and pandemic-related secondary stress as COVID-19 spread across the United States.

Upon completion of this activity, participants will:

  • Describe perceptions of time passing and their associations with lifetime stress and trauma and pandemic-related secondary stress during the COVID-19 pandemic, according to a longitudinal survey study
  • Identify clinical and public health implications of perceptions of time passing and their associations with lifetime stress and trauma and pandemic-related secondary stress during the COVID-19 pandemic, according to a longitudinal survey study
  • Outline implications for the healthcare team


Disclosures

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All relevant financial relationships for anyone with the ability to control the content of this educational activity are listed below and have been mitigated. Others involved in the planning of this activity have no relevant financial relationships.


News Author

  • Batya Swift Yasgur, MA, LSW

    Freelance writer, Medscape

    Disclosures

    Batya Swift Yasgur, MA, LSW, has no relevant financial relationships.

CME Author

  • Laurie Barclay, MD

    Freelance writer and reviewer
    Medscape, LLC

    Disclosures

    Laurie Barclay, MD, has the following relevant financial relationships:
    Formerly owned stocks in: AbbVie Inc.

Editor/Nurse Planner

  • Leigh Schmidt, MSN, RN, CNE, CHCP

    Associate Director, Accreditation and Compliance, Medscape, LLC

    Disclosures

    Leigh Schmidt, MSN, RN, CNE, CHCP, has no relevant financial relationships.

Compliance Reviewer

  • Amanda Jett, PharmD, BCACP

    Associate Director, Accreditation and Compliance, Medscape, LLC

    Disclosures

    Amanda Jett, PharmD, BCACP, has no relevant financial relationships.


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In support of improving patient care, Medscape, LLC is jointly accredited with commendation by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

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CME / ABIM MOC / CE

Why Was Time Perception Distorted During the Pandemic?

Authors: News Author: Batya Swift Yasgur, MA, LSW; CME Author: Laurie Barclay, MDFaculty and Disclosures

CME / ABIM MOC / CE Released: 10/28/2022

Valid for credit through: 10/28/2023

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Note: The information on the coronavirus outbreak is continually evolving. The content within this activity serves as a historical reference to the information that was available at the time of this publication. We continue to add to the collection of activities on this subject as new information becomes available. It is the policy of Medscape Education to avoid the mention of brand names or specific manufacturers in accredited educational activities. However, manufacturer names related to the approved COVID-19 vaccines are provided in this activity in an effort to promote clarity. The use of manufacturer names should not be viewed as an endorsement by Medscape of any specific product or manufacturer. 

Clinical Context

The COVID-19 pandemic triggered a cascade of protracted secondary stress and trauma, including economic downturn, social discord, and widespread grief and loss. Accompanying lockdowns, deaths, and business closures created future uncertainty.

In this setting, time perspective (TP) changed for many, with perceptions of time slowing down, stopping, and/or speeding up. Such temporal disintegration (TD) can impair sequential thinking, appear to disconnect the present from the continuity of time, and shift away from future orientation, increasing risk for trauma-related and depressive symptoms.

Study Synopsis and Perspective

The passage of time felt altered for many people during the COVID-19 pandemic, ranging from difficulty keeping track of the days of the week to feeling that the hours either crawled by or sped up, new research suggests.

More than 65% of the 5661 survey respondents reported the sense of present focus, blurring weekdays and weekends together, and uncertainly about the future, and more than half reported the experience of feeling "time speeding up or slowing down," reported the investigators, led by E. Alison Holman, PhD, professor at the Gross School of Nursing, University of California, Irvine.

Significant predictors of these time distortions included being exposed to daily pandemic-related media and having a mental health diagnosis before the pandemic; secondary stress, such as school closures and lockdown; financial stress; lifetime stress; and lifetime trauma exposure.

"Continuity between past experiences, present life, and future hopes is critical to one's well-being, and disruption of that synergy presents mental health challenges," said Holman in a news release.[1]

"We were able to measure this in a nationally representative sample of Americans as they were experiencing a protracted collective trauma, which has never been done before, and this study is the first to document the prevalence and early predictors of these time distortions," added Holman.

The findings were published online August 4 in Psychological Trauma: Theory, Research, Practice, and Policy.[2]

Unique Opportunity

During the pandemic, many persons' TP, defined as "our view of time as it spans from our past into the future," shifted as they "focused on the immediate, present danger of the COVID-19 pandemic and future plans became uncertain," the investigators wrote.

Studies of convenience samples "suggested that many people experienced time slowing down, stopping, and/or speeding up as they coped with the challenges of the pandemic": a phenomenon known as TD in psychiatric literature.

"We found that people who experienced that early sense of TD, the sense of 'time falling apart,' were more prone to getting stuck in the past and staying focused on the past event," which led to feeling "more distress over time," she said.

Research examining the prevalence of and psychosocial factors predicting TD are "quite rare," and studies examining TD "during an unfolding, protracted collective trauma are even rarer," the researchers noted.

The COVID-19 pandemic "presented a unique opportunity to conduct such a study," they added.

For their study, the investigators surveyed participants in a "probability-based panel" of 35,000 US households selected at random from across the country.

The researchers conducted the study in 2 waves: They administered the first survey in March to April 2020 and the second in September to October of that same year.

Speeding Up, Slowing Down

At Wave 2, participants completed a 7-item index of TD symptoms experienced over the previous 6 months. To adjust for psychological processes that may have predisposed individuals to experience TD during the pandemic, the researchers included a Wave 1 measure of future uncertainty as a covariate.

They had collected prepandemic health data before the current study.

Wave 1 participants completed a checklist reporting personal, work, and community-wide exposure to the COVID-19 outbreak, including contracting the virus, sheltering in place, and experiencing secondary stressors. The investigators also assessed the extent and type of pandemic-related media exposure.

At Wave 2, participants reported the extent of exposure to COVID-19, financial exposures, and secondary stressors. They also completed a non--COVID-19--related stress/trauma exposure checklist and were asked to indicate whether the trauma, disaster, or bereavement took place before or during the pandemic.

The final sample consisted of 5661 adults (52% female) who completed the Wave 2 survey. Investigators divided participants into 4 age groups: 18 to 34 years, 35 to 49 years, 50 to 64 years, and 65 years and older.

The most common experiences (reported by > 65% of respondents) included being focused on the present moment, feeling that weekdays and weekends were the same, and feeling uncertain about the future.

More than half (50.4%) of respondents reported feeling as though time was speeding up, and 55.2% reported feeling as though time was slowing down. Some also reported feeling uncertain about the time of day (46.4%) and forgetting events they had just experienced (35.2%).

When the researchers controlled for feeling uncertain about the future, they found that women reported more TD than men (b = 0.11 [95% CI: 0.07, 0.14]; P < .001).

At Wave 1, researchers found associations between TD and COVID-19--related media exposure, prepandemic mental health diagnoses, and prepandemic non--COVID-19--related stress and trauma. At Wave 2, they discovered associations between TD and COVID-19--related secondary and financial stressors (P < .001 for all).

Variable

(95% CI)

Prepandemic mental health diagnosis

0.08 (0.04, 0.11)

Prepandemic lifetime stress/trauma

0.06 (0.03, 0.09)

Media exposure

0.08 (0.04, 0.12)

Financial stressors

0.11 (0.08, 0.15)

Personal secondary stressors

0.21 (0.17, 0.24)

In contrast, COVID-19--related work exposure at Wave 1, being aged 45 to 59 years old, and living in the Midwest region were negatively associated with TD.

Widespread Distortion

Ruth Ogden, PhD, a lecturer at Liverpool John Moores University, United Kingdom, said the findings "confirm those reported in Europe, South America, and the Middle East, that widespread distortion to time was common during the pandemic and that distortions to time were greatest amongst those most negatively affected by the pandemic."

The results also support her own recent research[3] in the United Kingdom "suggesting that distortions to time during the pandemic extend to our memory for the length of the pandemic, with most people believing that lockdowns lasted far longer than they actually did," said Ogden, who was not involved with Holman and colleagues' current study.

"This type of subjective lengthening of the pandemic may reinforce trauma by making the traumatic period seem longer, further damaging health and well-being," she noted.

 "As the negative fallouts of the pandemic continue, it is important to establish the long-term effects of time distortions during the pandemic on mental health and well-being," she added.

The study was funded by US National Science Foundation and the National Institute on Minority Health and Health Disparities. The investigators report no relevant financial relationshipsOgden receives funding from the Wellcome Trust.

Study Highlights

  • A probability-based national sample panel (N = 5661) completed a mental and physical health survey prepandemic and 2 online surveys during March 18, 2020 to April 18, 2020 and September 26, 2020 and October 16, 2020.
  • 6 months into the pandemic, > 65% reported present focus, blurring weekdays and weekends together, and uncertainty about the future; 50.4% time speeding up; 55.2% time slowing down; 46.4% uncertainty about time of day; and 35.2% forgetting events just experienced.
  • After controlling for future uncertainty, women reported more TD than men (b = 0.11 [95% CI: 0.07, 0.14]; P < .001).
  • Predictors of TD were prepandemic mental health diagnoses; daily pandemic-related media exposure; secondary stress (eg, school closures, lockdown); financial stress; and lifetime stress and trauma exposure.
  • At Wave 1, TD was linked with COVID-19--related media exposure, prepandemic mental health diagnoses, and prepandemic non--COVID-19--related stress and trauma.
  • At Wave 2, TD was associated with COVID-19--related secondary and financial stressors (all P < .001).
  • COVID-19--related work exposure at Wave 1, age 45 to 59 years, and Midwest residence were negatively associated with TD.
  • The investigators concluded that during the first 6 months of the COVID-19 pandemic, which was an unprecedented collective trauma, TD was widespread and linked to prepandemic mental health, lifetime stress and trauma exposure, and pandemic-related media exposure and stressors.
  • TP involving time slowing down may make the pandemic seem longer, reinforcing trauma and further damaging mental health.
  • Altered TP may be explained by attentional resources being taxed; sudden changes in the context and complexity of our lives; and anxiety caused by the unknown of the pandemic.
  • TD during the pandemic may reflect schedule changes; loss of temporal landmarks providing external boundaries for experiencing time, and subjective, internal experiences coloring our perspective of time passing.
  • As TD is a risk factor for mental health challenges, including depression and anxiety, these findings have potential implications for public mental health.
  • Knowing who is most vulnerable to experiencing TD may inform allocation of mental health resources.
  • To help prevent mental health sequelae from collective trauma, TD may be an important risk factor to target with early interventions such as TP therapy, which helps patients with posttraumatic stress disorder build continuity across time, by understanding and learning from the past, living in the present, and moving toward the future.
  • The findings shed light on TD and suggest new avenues for longitudinal research examining risk and resilience during protracted collective traumatic events.
  • As the pandemic produced tremendous social isolation and loneliness, future research should examine the pattern of associations between TD and loneliness and connections among perceived time, social environment, and mental health over time.

Clinical Implications

  • During the first 6 months of the COVID-19 pandemic, TD was very common and linked to stress, poor mental health, and other predictors.
  • As TD is a risk factor for mental health challenges, including depression and anxiety, these findings have potential implications for public mental health.
  • Implications for the Healthcare Team: It is important for members of the healthcare team to recognize TD as a long-term effect on mental health and well-being and provide appropriate resources for ongoing management and care.

 

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