ABSTRACT
Recently, cross-sectional relationships between psycho-social resilience factors (RFs) and resilience, operationalized as an outcome of low reactivity of mental health to stressor exposure (low ‘stressor reactivity’) during the first wave of the COVID-19 pandemic, were reported. Extending these findings, we here examine prospective relationships and weekly dynamics between the same RFs and stressor reactivity in a longitudinal sample during the aftermath of the first wave in several European countries. Over five weeks of app-based assessments, participants weekly reported stressor exposure, mental health problems, RFs, and demographic data, in one of six different languages. As (partly) preregistered, hypotheses were tested cross-sectionally at baseline (N=558) and longitudinally (N=200), using mixed effects models and mediation analyses. RFs at baseline, including positive appraisal style, optimism, self-efficacy, perceived good stress recovery, and perceived social support, were negatively associated with stressor reactivity (SR) scores, not only cross-sectionally (baseline SR scores) but also prospectively (average SR scores across subsequent weeks). In both analyses, positive appraisal style mediated the effects of perceived social support on SR. In the analyses of weekly RF-SR dynamics, RFs positive appraisal (of stressors generally and specifically of the Corona crisis) and general self-efficacy were negatively associated with SR in a contemporaneous, but not lagged fashion. We identify psychological RFs which prospectively predict resilience and co-fluctuate with weekly stressor reactivity within individuals. The prospective results endorse that the previously reported RF-SR associations do not exclusively reflect mood-congruency or other temporal bias effects. We further confirm an important role for positive appraisal in resilience.
Subject(s)
COVID-19ABSTRACT
Recently, cross-sectional relationships between psycho-social resilience factors (RFs) and resilience, operationalized as an outcome of low reactivity of mental health to stressor exposure (low ‘stressor reactivity’) during the first wave of the COVID-19 pandemic, were reported. Extending these findings, we here examine prospective relationships and weekly dynamics between the same RFs and stressor reactivity in a longitudinal sample during the aftermath of the first wave in several European countries. Over five weeks of app-based assessments, participants weekly reported stressor exposure, mental health problems, RFs, and demographic data, in one of six different languages. As (partly) preregistered, hypotheses were tested cross-sectionally at baseline (N=558) and longitudinally (N=200), using mixed effects models and mediation analyses. RFs at baseline, including positive appraisal style, optimism, self-efficacy, perceived good stress recovery, and perceived social support, were negatively associated with stressor reactivity (SR) scores, not only cross-sectionally (baseline SR scores) but also prospectively (average SR scores across subsequent weeks). In both analyses, positive appraisal style mediated the effects of perceived social support on SR. In the analyses of weekly RF-SR dynamics, RFs positive appraisal (of stressors generally and specifically of the Corona crisis) and general self-efficacy were negatively associated with SR in a contemporaneous, but not lagged fashion. We identify psychological RFs which prospectively predict resilience and co-fluctuate with weekly stressor reactivity within individuals. The prospective results endorse that the previously reported RF-SR associations do not exclusively reflect mood-congruency or other temporal bias effects. We further confirm an important role for positive appraisal in resilience.
Subject(s)
COVID-19ABSTRACT
Background: The COVID-19 pandemic might affect mental health. Data from population-representative panel surveys with multiple waves including pre-COVID data investigating risk and protective factors are still rare. Methods: In a stratified random sample of the German household population (n=6,684), we conducted survey-weighted multiple linear regressions to determine the association of various psychological risk and protective factors with changes in psychological distress (PD; measured via PHQ-4) from pre-pandemic (average of 2016 and 2019) to peri-pandemic (both 2020 and 2021) time points. Control analyses on PD change between two pre-pandemic time points (2016 and 2019) were conducted. Regularized regressions were computed to inform on which factors were statistically most influential in the multicollinear setting. Results: PHQ-4 in 2020 (M=2.45) and 2021 (M=2.21) was elevated compared to 2019 (M=1.79). Several risk factors (catastrophizing, neuroticism, asking for instrumental support) and protective factors (perceived stress recovery, positive reappraisal, optimism) were identified for the peri-pandemic outcomes. Control analyses revealed that in pre-pandemic times, neuroticism and optimism were predominantly related to PD changes. Regularized regression mostly confirmed the results and highlighted perceived stress recovery as most consistent influential protective factor across peri-pandemic outcomes. Conclusions: We identified several psychological risk and protective factors related to PD outcomes during the COVID-19 pandemic. Comparison to pre-pandemic data stress the relevance of longitudinal assessments to potentially reconcile contradictory findings. Implications and suggestions for targeted prevention and intervention programs during highly stressful times such as pandemics are discussed.
Subject(s)
COVID-19ABSTRACT
Background. Higher levels of stress and negative emotions such as anxiety and depression have been reported since the beginning of the COVID-19 pandemic, but it remains less clear how positive emotions, such as hedonic capacity, may be affected. Further, during lockdowns, the ability to learn new pleasurable activities (hedonic learning) may be particularly relevant. Here, we investigated if state hedonia and/or hedonic learning mediated the relationship between COVID-19 stress and mental health. Moreover, we explored whether positive appraisal style (PAS), a major resilience factor, influenced these relationships.Methods. Using a cross-sectional design, 5000 German-speaking participants filled out online questionnaires targeting stressors, mental health, state hedonia, hedonic learning, and PAS between April 9 and May 15, 2020. After confirming the factor structure of our constructs, we applied latent structural equation modeling to test mediation as well as moderated mediation models.Results. Stress showed a positive association with mental health symptoms, which was buffered by both state hedonia and hedonic learning. While higher stress was related to lower state hedonia, participants reported more hedonic learning with greater stressor load. The latter effect was greater for individuals with high PAS.Limitations. The present results should be replicated in longitudinal designs with representative samples to confirm the directionality and generalizability of effects.Conclusions. Both state hedonia and hedonic learning buffered the effect of stress on mental health in an early phase of the COVID-19 pandemic. Learning new rewarding activities in combination with a PAS may be especially relevant for maintaining mental health during lockdowns.
Subject(s)
COVID-19 , Anxiety Disorders , Intellectual DisabilityABSTRACT
Healthy reward processing is a complex interplay of several components. Recent self-report measures of anhedonia, the decrease or loss of hedonic capacity, take this complexity into account. The Dimensional Anhedonia Rating Scale (DARS) measures interest, motivation, effort and consummatory pleasure across four domains: hobbies, food/drink, social activities and sensory experiences. In the present cross-sectional survey study, we validated the German version of the DARS in a sample of 557 young healthy adults. Factor structure as well as convergent and divergent validity were assessed. As a secondary aim, we examined the effects of the COVID-19 pandemic on state anhedonia and depression severity. Our results suggest good convergent and divergent validity and high internal consistency of the German DARS. The original differentiation of four factors mapping onto the four domains was confirmed. We conclude that the DARS is a valid instrument to comprehensively assess state anhedonia in German samples. Future studies should further assess the utility of the German DARS in clinical contexts. In line with many previous reports, there were significantly higher levels of depressive symptoms during the pandemic. We found no indication that the COVID-19 pandemic affected state hedonic capacity.
Subject(s)
COVID-19 , AnhedoniaABSTRACT
Introduction: A growing number of psychological interventions are delivered via smartphone with the aim to increase the efficacy and effectiveness of these treatments and provide scalable access to interventions for improving mental health. Most of the scientifically tested apps are based on cognitive behavioural therapy principles which are considered as a gold standard for the treatment of many mental health problems. Objective: This review aimed to investigate standalone smartphone-based ‘ecological momentary interventions’ (EMIs) to improve mental health, that were built based on principles derived from cognitive behavioural therapy (CBT). Methods: We searched MEDLINE, PsycINFO, Embase and PubMed databases for peer-reviewed studies published between 1st January 2007 and 15th January 2020. We included studies with a focus on standalone app-based approaches to improve mental health and their feasibility, and/or efficacy and/or effectiveness. Both within- and between-group designs and studies with both healthy and clinical samples were included. Blended interventions, e.g., app-based treatments in combination with psychotherapy, were not included. Selected studies were evaluated in terms of their design, i.e., choice of the control condition, sample characteristics, EMI content, EMI delivery characteristics, feasibility, efficacy and effectiveness. The latter was defined in terms of improvement in primary outcomes used in the studies. Results: A total of 26 studies were selected. The results show that EMIs based on CBT principles can be successfully delivered, significantly increase well-being among users, and reduce mental health symptoms. Standalone EMIs were rated as helpful (m=70.8%), and outcomes were satisfying by users (m=72.6%). Conclusions: Study quality was heterogeneous, and feasibility was often not reported in the reviewed studies, hence limiting the conclusions that can be drawn from the existing data. Together, the studies show that EMIs may help increase mental health and thus support individuals in their daily life. Such EMIs provide readily available, scalable and evidence-based mental health support. These characteristics appear crucial in the context of a global crisis, such as the COVID-19 pandemic, but may also help reduce personal and economic costs of mental health impairment beyond this situation or in the context of potential future pandemics.
Subject(s)
COVID-19ABSTRACT
The SARS-CoV-2 pandemic is not only a threat to physical health but is also having severe impacts on mental health. While 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. In order 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 (March 22nd to April 19th) 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.