Page 84 - IJPS-9-1

International Journal of
Population Studies COVID-19, economic crisis, insomnia, and stress

occurred, and our sample might not be representative of the Conflict of interest
whole population. However, education did not affect the
overall outcomes of our study. Indeed, the sample size had The authors declare no potential conflicts of interest with
adequate power to assess correlations, and the multivariate respect to the research, authorship, and/or publication of
analysis was performed with appropriate adjustment on this article.
multiple potential confounders, including education; Author contributions
all these elements are expected to decrease the effect of
the selection bias on the results. Furthermore, the cross- Conceptualization: Hala Sacre
sectional design of the study precludes causality inferences. Methodology: Pascale Salameh
In addition, although multiple potential confounders were Formal analysis: Pascale Salameh
taken into account through the multivariable analysis, Writing – original draft: Aline Hajj, Danielle A. Badro,
there is still a risk of residual confounding. However, the Carla Abou Selwan
quantitative exposure-effect relationships found after Writing – review & editing: Hala Sacre, Randa Aoun,
multivariable analyses might limit this problem (results Chadia Haddad, Pascale Salameh
shown in multiple linear regression models – in Part C in
Supplementary File; Tables S3). Ethics approval and consent to participate
Moreover, despite using validated scales with very good The Institutional Review Board of the American University
to excellent reliability, information bias cannot be ruled of Science and Technology approved this study protocol
out as the questionnaire was self-reported. Nevertheless, (AUST-IRB-20200527-01), as this work has been
this bias could be non-differential and direct the results performed in accordance with the ethical standards laid
towards the null, underestimating the magnitude of down in the 1964 Declaration of Helsinki and its later
the associations found. However, this study is relatively amendments. The topic was explained to all participants
large with acceptable methodology in the current in the introductory section of the survey and consent to
circumstances, allowing the evaluation of the combined participate was implicit. Anonymity of participants was
impact of COVID-19 and a collapsing economy on PTSS guaranteed throughout the process of data collection and
and insomnia. Additional robust studies using larger-size analysis.
and more representative samples would help confirm these Consent for publication
findings. Based on these results, decision-makers need to
acknowledge that economic hardship and the pandemic Not applicable.
can together impact mental health detrimentally. They
need to define strategies to better screen for these disorders Availability of data
while identifying triggering factors, thus implementing The datasets used and/or analyzed during the current study
individualized management plans when similar are available from the Figshare repository: https://figshare.
circumstances resurge. com/s/939d0fc0032c7af0b8c9.

5. Conclusion References
This study revealed that the fear of COVID-19 and the Abou Hassan, F.F., Bou Hamdan, M., Ali, F., & Melhem, N.M.
economic crisis are correlated with PTSS and insomnia. (2023). Response to COVID-19 in Lebanon: Update,
Moreover, the association between the fear of COVID-19 challenges and lessons learned. Epidemiology and Infection,
and insomnia showed to be related to PTSS symptoms. 151: e23.
Additional studies are needed to confirm our findings and https://doi.org/10.1017/S0950268823000067
allow a better generalization of the results. Ahorsu, D.K., Lin, C.Y., Imani, V., Saffari, M., Griffiths, M.D.,
Acknowledgments & Pakpour, A.H. (2022). The fear of COVID-19 scale:
Development and initial validation. International Journal of
The authors would like to thank all the persons who helped Mental Health and Addiction, 20(3), 1537–1545.
distribute the questionnaire, particularly Dr. Fady Farhat, https://doi.org/10.1007/s11469-020-00270-8
Dr. Zahraa Shaitly, Mrs. Joumana Sleilaty, and Mr. Jihad
Gerges. Al Karaki, G., Hallit, S., Malaeb, D., Kheir, N., Sacre, H.,
Salameh, P., & Hallit, R. (2020). Prevalence and factors
Funding associated with insomnia among a representative sample of
the lebanese population: Results of a cross-sectional study.
None. Journal of Epidemiology and Global Health, 10(2): 124-130.

Volume 9 Issue 1 (2023) 78 https://doi.org/10.36922/ijps.440