Abstract
Continuous exposure to stressors can lead to vulnerability and, in some cases, resilience. This study examined the variation in its psychological impact across the first four waves of COVID-19 in Hong Kong. Transcripts from Open Up, an online text-based counseling service, between January 2019 and January 2021 were analyzed (N = 60 775). We identified COVID-19 mentioned sessions using keywords and further categorized them into those that also mentioned symptoms of common mental disorders (CMDs) and those that did not. Autoregressive integrated moving average models were used to analyze the associations between the severity of the outbreak and the mention of COVID-19 and CMDs. Results revealed that the pandemic led to increased psychological distress. Compared to prior to its advent, more people sought help in the initial months of the outbreak. Furthermore, associations were found between the severity of the outbreak and the number of help-seeker mentioning the pandemic, as well as between the outbreak severity and the number of help-seekers disclosing psychological distress. However, these relationships were not uniform across the four waves of outbreaks; a dissociation between outbreak severity and help-seekers' concern was found in the fourth wave. As the pandemic waxes and wanes, people may become habituated to its psychological toll. This may be interpreted as a form of resilience. Instead of worsening with time, the psychological impact of COVID-19 may reduce with repeated exposure.
Highlights
MethodHelp-seekers in Open Up communicate anonymously with professional counselors and trained volunteers via the service’s web portal, SMS, WhatsApp, Facebook messenger, or WeChat
Continuous exposure to stressors can lead to vulnerability and, in some cases, resilience
The results suggest that the significance of COVID-19 impact was mainly contributed by the impulse function from the second wave, ImpF-2: coefficient = 34.87, p = 0.042
Summary
Help-seekers in Open Up communicate anonymously with professional counselors and trained volunteers via the service’s web portal, SMS, WhatsApp, Facebook messenger, or WeChat. A strong ordinal association between the COVID-mention and number of reported cases was observed (Kendall’s τ-b = 0.642, p = 0.026), suggesting that the severity of the outbreak triggered more discussion among help-seekers. A similar but milder pattern was observed in the CMD-mention subgroup For those who did not mention CMDs, the chosen ARIMA model included a positive autoregressive component AR (1), and the significance of COVID-19 impact mainly came from the magnitude effect of the third wave. The chosen model suggests that COVID-mention was associated with number of reported cases lagged by one day, and the pattern of change was mainly contributed by the CMD-mention subgroup. A simple autoregressive pattern AR (1) was observed from the CMD-mention subgroup; the influence of the number of reported cases was negligible. These results suggest a notable decrease in COVID-mention in the fourth wave
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