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Resilience: a mediator of the negative effects of pandemic-related stress on women’s mental health in the USA

ABSTRACT: The role of resilience in mediating the negative effects of the COVID-19 pandemic on the mental health of US women is poorly understood. We examined socioeconomic factors associated with low resilience in women, the relationship of low resilience with psychiatric morbidity, and the mediating role of resilience in the relationship between pandemic-related stress and other coincident psychiatric morbidities. Using a quota-based sample from a national panel, we conducted a web-based survey of 3200 US women in April 2020. Weighted, multivariate logistic regression was used to model the odds of pandemic-related stress, and coincident depression and anxiety symptoms among those with and without low resilience. Structural equation modeling was used to evaluate resilience as a mediator of the relationship between pandemic-related stress and other coincident psychiatric morbidities. Risk factors for low resilience included younger age, lower household income, lower education, unemployment, East/Southeast Asian race, unmarried/unpartnered status, and higher number of medical comorbidities. Low resilience was significantly associated with greater odds of depression symptoms (OR = 3.78, 95% CI [3.10–4.60]), anxiety symptoms (OR = 4.17, 95% CI [3.40–5.11]), and pandemic-related stress (OR = 2.86, 95% CI [2.26–3.26]). Resilience acted as a partial mediator in the association between pandemic-related stress and anxiety symptoms (proportion mediated = 0.23) and depression symptoms (proportion mediated = 0.28). In the early days of the COVID-19 pandemic, low resilience mediated the association between pandemic-related stress and psychiatric morbidity. Strategies proven to enhance resilience, such as cognitive behavioral therapy, mindfulness-based stress reduction, and addressing socioeconomic factors, may help mitigate mental health outcomes.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00737-021-01184-7.

SUBMITTER: Kumar S

PROVIDER: S-EPMC8516405 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundCOVID-19 outbreak have a long-term negative impact on mental health. Meanwhile, it may also provide opportunities for positive outcomes (e.g., post-traumatic growth). Resilience and social support could serve as psychological resources to protect individuals against the detrimental effects of the COVID-19 crisis and enable people to develop positive changes during challenging times.ObjectiveBy testing the roles of resilience and social support in the relationship between COVID-19 related stress and negative mental health outcomes (depression and anxiety), as well as the relationship between COVID-19 related stress and positive mental health outcomes (post-traumatic growth, PTG), this study aimed to investigate the psychological mechanisms involved in different mental health outcomes induced by COVID-19.MethodsAn online survey was conducted 1 year after the peak of the COVID-19 outbreak (from April to August 2021) in China. The survey includes demographic questionnaires and six scales: the Impact of Event Scale-Revised for COVID-19 (IES-RC), the 10-item Connor-Davidson Resilience Scale (CD-RISC-10), the Perceived Social Support Scale (PSSS), the Center for Epidemiological Studies Depression Scale (CES-D), the Generalized Anxiety Disorder scale (GAD-7) and the Posttraumatic Growth Inventory (PTGI). The structural equation model (SEM) was used to evaluate the relations and mechanisms between COVID-19 related stress and resilience, social support in depression, anxiety, and PTG.ResultsA total of 771 Chinese subjects completed the questionnaire, including 416 (54%) females. COVID-19 related stress was associated with anxiety (P < 0.001), PTG (P < 0.001), and depression (P < 0.001). Resilience was related to depression (P < 0.001), anxiety (P < 0.001), and PTG (P < 0.001). Social support was associated with depression (P < 0.001), anxiety (P < 0.001), and PTG (P < 0.001). Under SEM analysis, resilience mediated the effects of COVID-19 related stress on depression and post-traumatic growth. Social support mediated the impacts of COVID-19 related stress on post-traumatic growth, depression, and anxiety. The path coefficients of the mediation effects were statistically significant.ConclusionsThe current findings suggest that COVID-19 related stress has a double-edged effect on mental health. Depression, anxiety, and PTG coexist in Chinese individuals 1 year after the peak of the pandemic. Resilience and social support serve as important protective factors of mental health, safeguard people from the negative mental health outcomes of the COVID-19, and promote PTG.

Project description:BackgroundLongitudinal work on the impact of COVID-19 on population mental health and resilience beyond the first year of the pandemic is lacking. We aimed to understand how mental health and resilience evolved during the pandemic (2020) and two years later (2022) in a multi-ethnic Singaporean population. In addition, we assessed what characteristics were associated with mental health and resilience scores.MethodsWe surveyed and analysed two balanced panel samples up to four times between 30th April 2020 and 11th July 2022. One panel assessed psychological distress (Kessler-10) and well-being (short Warwick Edinburgh Mental Well-being scale) n = 313, and one panel assessed resilience (10-item Connor-Davidson Resilience Scale©) n = 583. A linear panel regression model with random effects assessed the temporal patterns for psychological distress, well-being, and resilience.ResultsMean psychological distress scores (Kessler-10) were relatively stable over time and were not statistically significantly worse than baseline at any follow-up. Well-being scores improved over time and were significantly better than baseline by the third survey (22nd Jul-18th Aug 2020) (0.54 p = 0.007, Cohen's d 0.12). Scores had worsened by the last survey (27th June-11th July 2022) but were not significantly different from baseline 0.20 p = 0.30. Resilience scores declined over time. Scores at both follow-ups (14th Aug- 4th Sep 2020 and 27th June-11th July 2022) were statistically significantly lower than baseline: -1.69 p < 0.001 (Cohen's d 0.25) and -0.96 p = 0.006 (Cohen's d 0.14), respectively.ConclusionsOur study joins a body of work measuring the longitudinal effects of COVID-19 on population mental health and resilience. While, the magnitude of the effect related to resilience decline is small, our findings indicate that particular attention should be given to ongoing population surveillance, with the aim of maintaining good health and well-being.

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Resilience: a mediator of the negative effects of pandemic-related stress on women’s mental health in the USA

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