Heterogeneity in mental health change during the COVID‐19 pandemic in Germany: The role of social factors

Abstract

The COVID‐19 pandemic constitutes a prolonged global crisis, but its effects on mental health seem inconsistent. This inconsistency highlights the importance of considering the differential impact of the pandemic on individuals. There is some evidence that mental health trajectories are heterogeneous and that both sociodemographic and personal characteristics are associated with higher risk for mental health issues. By contrast, information on the role of social factors as potential determinants of initial reactions to the pandemic and on heterogeneous trajectories over time is lacking. We analysed seven assessments of a large‐scale ( N = 2203) longitudinal study across 1.5 years, beginning in March 2020. Using self‐report data on mental health and life satisfaction, we applied latent change models to examine initial reactions and mean changes across the pandemic. In addition, we applied latent class growth analyses to investigate whether there were distinct groups with different patterns of change. Results showed that on average, levels of life satisfaction and anxiety decreased ( d = −0.31 and d = −0.11, respectively), levels of depressive symptoms increased ( d = 0.13), and stress levels remained unchanged ( d = −0.01) during the first year of the pandemic. For each outcome, we identified four distinct mental health trajectories. Between 5% (for anxiety) and 11% (for life satisfaction) of the sample reported consistently high—and even increasing—impairments in mental health and well‐being. The trajectories of a sizeable number of people covaried with the course of the pandemic, such that people experienced better mental health when the number of COVID cases was low and when fewer restrictions were placed on public life. Low emotional support, high instrumental support, and the tendency to compare oneself with others were associated with more mental health issues. Findings show that whereas a substantial portion of people were largely unaffected by the pandemic, some individuals experienced consistently high levels of psychological distress. Social factors appear to play a crucial role in the maintenance of well‐being.

Trajectories of resilience and mental distress to global major disruptions

“…Three studies found concepts associated with regulatory flexibility [ 75 , 80 , 81 ] to be positively related to resilience trajectories. Similarly, pandemic-related research showed that self-reported resilience was associated with more favorable mental responses for some but not all outcomes [ 52 , 77 , 78 , 89 ]. Optimism was also associated with more favorable mental responses for some outcomes [ 75 , 81 , 82 ].…”

Psychological distress and digital health service use during COVID-19: A national Australian cross-sectional survey

“…An identified limitation of previous studies investigating the mental health impact of the pandemic is their focus on overall “mean effects without addressing the possibility of heterogeneity in mental health” response (p.2) ( 38 ). However, in this study we sought to examine contributing factors to mental distress in order to identify sub-groups of individuals most at risk and in need of support.…”

Greater knowledge about COVID-19, more negative emotions. Research in adult Poles after 2nd and 5th waves of the pandemic

“…There was also a change in the emotional representation of the disease. Initial increase in negative emotions [23,31] was followed with a slight decrease in the negative perceptions of COVID-19 [4], and even with a sense of positive changes in life [32]. However, a meta-analysis [33] of research reports focusing on mental health during the COVID-19 pandemic showed that stress and mental burden in this case were comparable to war time experiences.…”

“…Healthcare workers and elderly people were commonly perceived as a high-risk group, as opposed to children or young people. As for the consequences of COVID-19, numerous studies clearly showed that the pandemic was perceived as a factor adversely affecting mental health, social functioning, or economic status [3][4][20][21][22][23] and leading to existential crisis [24]. Researchers have also shown links between representation of COVID-19 and individual factors.…”