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.
Highlights
As the general stressor list contained items that might be exacerbated by the Corona crisis, answers to this list might be influenced by the crisis
As the combined stressor exposure score EC explained most variance in mental health problems P, we focus on resilience to all stressors combined (RESC)
We identify a positive association between resilience—
Summary
Pandemics can induce high levels of stress and result in mental health problems, including depression, anxiety, and posttraumatic stress disorder symptomatology[1,2,3].Marked effects have been reported during the current severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) pandemic in Asia, Europe, and North America[4,5,6].Veer et al Translational Psychiatry (2021)11:67Measures of social distancing and quarantine aimed to curtail the spread of the pathogen can have additional detrimental psychological effects[7], as has been seen during the current pandemic[8,9,10]. First evidence from Italy and the United States indicates other psycho-social consequences, in particular increased loneliness and domestic violence[11,12] On this basis, urgent calls for mental health science in the SARS-CoV-2 pandemic have been issued and it has been pointed out that such research is important to better prepare individuals and health systems for future pandemics or potential other waves of the current one We here present data collected through a globally available online survey between 22 March and 19 April (23:59 h) This timeframe corresponds to a phase of the pandemic when severe lockdown measures were in place in many of the most affected European countries and where the stresses related to the physical threat posed by the virus and the uncertainty about the further course of the pandemic mixed with the specific challenges posed by the curfews and the other movement and contact restrictions
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