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Psycho-social factors associated with mental resilience in the Corona lockdown

Ilya M. Veer, Antje Riepenhausen, Matthias Zerban and 70 more

Translational Psychiatry · 2021

Abstract

The SARS-CoV-2 pandemic is not only a threat to physical health but is also having severe impacts on mental health. Although increases in stress-related symptomatology and other adverse psycho-social outcomes, as well as their most important risk factors have been described, hardly anything is known about potential protective factors. Resilience refers to the maintenance of mental health despite adversity. To gain mechanistic insights about the relationship between described psycho-social resilience factors and resilience specifically in the current crisis, we assessed resilience factors, exposure to Corona crisis-specific and general stressors, as well as internalizing symptoms in a cross-sectional online survey conducted in 24 languages during the most intense phase of the lockdown in Europe (22 March to 19 April) in a convenience sample of N = 15,970 adults. Resilience, as an outcome, was conceptualized as good mental health despite stressor exposure and measured as the inverse residual between actual and predicted symptom total score. Preregistered hypotheses (osf.io/r6btn) were tested with multiple regression models and mediation analyses. Results confirmed our primary hypothesis that positive appraisal style (PAS) is positively associated with resilience ( p < 0.0001). The resilience factor PAS also partly mediated the positive association between perceived social support and resilience, and its association with resilience was in turn partly mediated by the ability to easily recover from stress (both p < 0.0001). In comparison with other resilience factors, good stress response recovery and positive appraisal specifically of the consequences of the Corona crisis were the strongest factors. Preregistered exploratory subgroup analyses (osf.io/thka9) showed that all tested resilience factors generalize across major socio-demographic categories. This research identifies modifiable protective factors that can be targeted by public mental health efforts in this and in future pandemics.

References 53

1.
Pfefferbaum B, et al. The H1N1 crisis: a case study of the integration of mental and behavioral health in public health crises. Disaster Med. Public Health Prep. 2012;6:67-71.
Not in our library10.1001/dmp.2012.2
2.
Lee AM, et al. Stress and psychological distress among SARS survivors 1 year after the outbreak. Can. J. Psychiatry. 2007;52:233-240.
Not in our library10.1177/070674370705200405
3.
Reissman, D. B., Watson, P. J., Klomp, R. W., Tanielian, T. L., Prior, S. D. Pandemic influenza preparedness: adaptive responses to an evolving challenge. J. Homel. Sec. Emerg. Manag. 3, https://www.degruyter.com/view/journals/jhsem/3/2/article-jhsem.2006.3.2.1233.xml (2006).
Not in our library
4.
Yang H, Ma J. How an epidemic outbreak impacts happiness: factors that worsen (vs. protect) emotional well-being during the coronavirus pandemic. Psychiatry Res. 2020;289:113045.
Not in our library10.1016/j.psychres.2020.113045
5.
A Nationwide Survey of Psychological Distress among Italian People during the COVID-19 Pandemic: Immediate Psychological Responses and Associated Factors · 2020
No notice
6.
Liu, C. H., Zhang, E., Wong, G. T. F., Hyun, S. & Hahm, H. C. Factors Associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: clinical implications for U.S. young adult mental health. Psychiatry Res. 290, 113172 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7263263/ (2020).
Not in our library10.1016/j.psychres.2020.113172
7.
Brooks SK, et al. The psychological impact of quarantine and how to reduce it: rapid review of the evidence. Lancet. 2020;395:912-920.
Not in our library10.1016/s0140-6736(20)30460-8
8.
Lei, L. et al. Comparison of prevalence and associated factors of anxiety and depression among people affected by versus people unaffected by quarantine during the COVID-19 epidemic in Southwestern China. Med. Sci. Monit. 26, https://www.medscimonit.com/abstract/index/idArt/924609 (2020).
Not in our library10.12659/msm.924609
9.
Tull MT, et al. Psychological outcomes associated with stay-at-home orders and the perceived impact of COVID-19 on daily life. Psychiatry Res. 2020;289:113098.
Not in our library10.1016/j.psychres.2020.113098
10.
Odriozola-González P, Planchuelo-Gómez Á, Irurtia MJ, de Luis-García R. Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university. Psychiatry Res. 2020;290:113108.
Not in our library10.1016/j.psychres.2020.113108
11.
Boserup, B., McKenney, M., Elkbuli, A. Alarming trends in US domestic violence during the COVID-19 pandemic. Am. J. Emerg. Med. 0, https://www.ajemjournal.com/article/S0735-6757(20)30307-7/abstract (2020).
Not in our library10.1016/j.ajem.2020.04.077
12.
Cerami, C. et al. Covid-19 outbreak in Italy: are we ready for the psychosocial and the economic crisis? Baseline findings from the PsyCovid study. Front. Psychiatry. 11, https://www.frontiersin.org/articles/10.3389/fpsyt.2020.00556/full (2020).
Not in our library10.3389/fpsyt.2020.00556
13.
Holmes, E. A. et al. Multidisciplinary research priorities for the COVID-19 pandemic: a call for action for mental health science. Lancet Psychiatry. 7, e43 (2020).
Not in our library10.1016/s2215-0366(20)30168-1
14.
Monteiro J. Keep mental health in mind. Nat Med26, 631 (2020). 10.1038/s41591-020-0914-4.
Not in our library10.1038/s41591-020-0914-4
15.
Kopelovich, S. L. et al. Community mental health care delivery during the COVID-19 pandemic: practical strategies for improving care for people with serious mental illness. Commun. Ment. Health J. 10.1007/s10597-020-00662-z (2020).
Not in our library10.1007/s10597-020-00662-z
16.
Xiang Y-T, et al. Timely mental health care for the 2019 novel coronavirus outbreak is urgently needed. Lancet Psychiatry. 2020;7:228-229.
Not in our library10.1016/s2215-0366(20)30046-8
17.
Kisely, S. et al. Occurrence, prevention, and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis. BMJ. 369, https://www.bmj.com/content/369/bmj.m1642 (2020).
Not in our library10.1136/bmj.m1642
18.
Zhang W, et al. Mental health and psychosocial problems of medical health workers during the COVID-19 epidemic in China. PPS. 2020;89:242-250.
Not in our library10.1159/000507639
19.
Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019 · 2020
No notice
20.
Qiu J, et al. A nationwide survey of psychological distress among Chinese people in the COVID-19 epidemic: implications and policy recommendations. Gen. Psychiatr. 2020;33:e100213.
Not in our library10.1136/gpsych-2020-100213
21.
Fear of the coronavirus (COVID-19): Predictors in an online study conducted in March 2020 · 2020
No notice
22.
Mental health problems and social media exposure during COVID-19 outbreak · 2020
No notice
23.
Impact of the COVID-19 Pandemic on Mental Health and Quality of Life among Local Residents in Liaoning Province, China: A Cross-Sectional Study · 2020
No notice
24.
Xiao, H., Zhang, Y., Kong, D., Li, S., Yang, N. The effects of social support on sleep quality of medical staff treating patients with coronavirus disease 2019 (COVID-19) in January and February 2020 in China. Med. Sci. Monit. 26, e923549-1–e923549-8 (2020).
Not in our library10.12659/msm.923549
25.
Cao W, et al. The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Res. 2020;287:112934.
Not in our library10.1016/j.psychres.2020.112934
26.
Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China · 2020
No notice
27.
Kalisch R, et al. The resilience framework as a strategy to combat stress-related disorders. Nat. Hum. Behav. 2017;1:784.
Not in our library10.1038/s41562-017-0200-8
28.
Mancini AD, Bonanno GA. Predictors and parameters of resilience to loss: toward an individual differences model. J. Pers. 2009;77:1805-1832.
Not in our library10.1111/j.1467-6494.2009.00601.x
29.
Bonanno GA, Romero SA, Klein SI. The temporal elements of psychological resilience: an integrative framework for the study of individuals, families, and communities. Psychol. Inq. 2015;26:139-169.
Not in our library10.1080/1047840x.2015.992677
30.
A Systematic Review of Amenable Resilience Factors That Moderate and/or Mediate the Relationship Between Childhood Adversity and Mental Health in Young People · 2018
No notice
31.
Kalisch R, Müller MB, Tüscher O. A conceptual framework for the neurobiological study of resilience. Behav. Brain Sci. 2015;38:e92.
Not in our library10.1017/s0140525x1400082x
32.
Veer, I. M. et al. Mental resilience in the Corona lockdown: first empirical insights from Europe. Preprint at 10.31234/osf.io/4z62t (2020).
Not in our library
33.
Goldberg DP, et al. The validity of two versions of the GHQ in the WHO study of mental illness in general health care. Psychol. Med. 1997;27:191-197.
Not in our library10.1017/s0033291796004242
34.
Amstadter AB, Myers JM, Kendler KS. Psychiatric resilience: longitudinal twin study. Br. J. Psychiatry. 2014;205:275-280.
Not in our library10.1192/bjp.bp.113.130906
35.
Adolescent friendships predict later resilient functioning across psychosocial domains in a healthy community cohort · 2017
No notice
36.
Kalisch, R. et al. A generic solution for the operationalization and measurement of resilience and resilience processes in longitudinal observations: rationale and basic design of the MARP and LORA studies. Preprint at 10.31234/osf.io/jg238 (2020).
Not in our library
37.
Tofighi D, MacKinnon DP. RMediation: an R package for mediation analysis confidence intervals. Behav. Res. Methods. 2011;43:692-700.
Not in our library10.3758/s13428-011-0076-x
38.
Hastie, T., Tibshirani, R., Wainwright, M. Statistical learning with sparsity: the Lasso and generalizations, https://www.crcpress.com/Statistical-Learning-with-Sparsity-The-Lasso-and-Generalizations/Hastie-Tibshirani-Wainwright/p/book/9781498712163 (Chapman & Hall/CRC Press, 2015).
Not in our library
39.
Friedman J, Hastie T, Tibshirani R. Regularization paths for generalized linear models via coordinate descent. J. Stat. Softw. 2010;33:1-22.
Not in our library10.18637/jss.v033.i01
40.
Cross-validation pitfalls when selecting and assessing regression and classification models · 2014
No notice
41.
Romppel, M. et al. Cross‐cultural measurement invariance of the General Health Questionnaire‐12 in a German and a Colombian population sample. Int. J. Methods Psychiatr. Res. 26, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6877231/ (2017).
Not in our library10.1002/mpr.1532
42.
Rodrigo, M. F., Molina, J. G., Losilla, J.-M., Vives, J., Tomás J. M. Method effects associated with negatively and positively worded items on the 12-item General Health Questionnaire (GHQ-12): results from a cross-sectional survey with a representative sample of Catalonian workers. BMJ Open. 9, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6924827/ (2019).
Not in our library10.1136/bmjopen-2019-031859
43.
Jeronimus BF, Kotov R, Riese H, Ormel J. Neuroticism’s prospective association with mental disorders halves after adjustment for baseline symptoms and psychiatric history, but the adjusted association hardly decays with time: a meta-analysis on 59 longitudinal/prospective studies with 443 313 participants. Psychol. Med. 2016;46:2883-2906.
Not in our library10.1017/s0033291716001653
44.
Ungar M. What Works - a Manual for Designing Programs that Build Resilience (Resilience Research Center, 2019).
Not in our library
45.
Joyce, et al. Road to resilience: a systematic review and meta-analysis of resilience training programmes and interventions. BMJ Open. 2018;8:e017858.
Not in our library10.1136/bmjopen-2017-017858
46.
Smith BW, et al. The brief resilience scale: assessing the ability to bounce back. Int. J. Behav. Med. 2008;15:194-200.
Not in our library10.1080/10705500802222972
47.
Alford B. A., Beck A. T. The Integrative Power of Cognitive Therapy p. 197 (Guilford, 1997).
Not in our library
48.
The Benefit of Web- and Computer-Based Interventions for Stress: A Systematic Review and Meta-Analysis · 2017
No notice
49.
Joyce, et al. Resilience@work mindfulness program: results from a cluster randomized controlled trial with first responders. J. Med. Internet Res. 2019;21:e12894.
Not in our library10.2196/12894
50.
Kazlauskas E, Eimontas J, Olff M, Zelviene P, Andersson G. Adherence predictors in internet-delivered self-help intervention for life stressors-related adjustment disorder. Front. Psychiatry. 2020;11:137.
Not in our library10.3389/fpsyt.2020.00137
51.
van Buschbach S, van der Meer CAI, Dijkman L, Olff M, Bakker A. Web-based peer support education program for health care professionals. Jt Comm. J. Qual. Patient Saf. 2020;46:227-231.
Not in our library10.1016/j.jcjq.2019.12.005
52.
Progression of Mental Health Services during the COVID-19 Outbreak in China · 2020
No notice
53.
Allison, P. D. In Quantitative Applications in the Social Sciences Vol. 160, https://methods.sagepub.com/book/fixed-effects-regression-models (SAGE, Thousand Oaks, CA, USA, 2009).
Not in our library

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