Maladaptive emotion regulation strategies in a vulnerable population predict increased anxiety during the Covid-19 pandemic: A pseudo-prospective study

Abstract

• state anxiety increases during the Covid-19 pandemic in a subclinical population of healthy individuals with elevated anxiety traits. • no increase in depression during the pandemic in a subclinical population of healthy individuals with elevated anxiety traits. • maladaptive emotion regulation strategies such as giving up and self-evaluation predict increase in state anxiety during the Covid-19 pandemic. • pre-pandemic tendency for social withdrawal protects anxious individuals from further increase in anxiety during the Covid-19 pandemic. • controlling for pre-pandemic state anxiety, no correlation between state anxiety and pandemic-related threats is found. The Covid-19 pandemic has led to drastic public health measures with a substantial impact on the individual. Previous studies reported elevated levels of stress, anxiety, and depression in the general population as a consequence of pandemic-related public health measures. In vulnerable individuals, exposure to an uncontrolled global stressor like the Covid-19 pandemic might be felt as particularly threatening. A population of 127 healthy individuals that expressed increased trait anxiety (HADS ≥ 8) already before the outbreak of the pandemic were tested on state and trait anxiety, stress and depression before and four weeks after the outbreak of the pandemic in the Netherlands. Online questionnaires were administered between April 16 and April 23, 2020. We observed an increase in state anxiety (STAI) during the pandemic but no change in depression. Yet, trait anxiety (STAI) before the pandemic did not predict the increase in state anxiety during the pandemic. Further, state anxiety during the pandemic was not associated with being in contact with an infected person, having symptoms of Covid-19, protective behavior, or degree of social isolation when controlling for state anxiety before the outbreak of the pandemic. However, maladaptive emotion regulation strategies measured before the pandemic predicted state anxiety and perceived stress during the pandemic, while adaptive strategies had no association with anxiety during the pandemic. Reducing learned helplessness and self-blaming to prevent maladaptive emotion regulation strategies like giving up and self-devaluation might be more beneficial than training adaptive strategies. Time variation in baseline measurements.