Prospective predictors of risk and resilience trajectories during the early stages of the COVID-19 pandemic: a longitudinal study

Abstract

Background. The COVID-19 pandemic is a rapidly evolving stressor with significant mental health consequences. We aimed to delineate distinct anxiety-response trajectories during the early stages of the pandemic and to identify baseline risk and resilience factors as predictors of anxiety responses. Methods. Using a crowdsourcing website, we enrolled 1,362 participants, primarily from the United States (n = 1064) and Israel (n = 222) over three time-points from April-September 2020. We used latent growth mixture modeling to identify anxiety trajectories over time. Group comparison and multivariate regression models were used to examine demographic and risk and resilience factors associated with class membership. Results. A four-class model provided the best fit. The resilient trajectory (stable low anxiety) was the most common (n = 961, 75.08%), followed by chronic anxiety (n = 149, 11.64%), recovery (n = 96, 7.50%) and delayed anxiety (n = 74, 5.78%). While COVID-19 stressors did not differ between trajectories, resilient participants were more likely to be older, living with another person and to report higher income, more education, fewer COVID-19 worries, better sleep quality, and more dispositional resilience factors at baseline. Multivariate analyses suggested that baseline emotion regulation capabilities and low conflictual relationships uniquely distinguished participants in distinct trajectories. Conclusions. Consistent with prior resilience research following major adversities, a majority of individuals showed stable low levels of low anxiety in response to the COVID-19 pandemic. Knowledge about dispositional resilience factors may prospectively inform mental health trajectories early in the course of ongoing adversity.

Trajectories of resilience and mental distress to global major disruptions

“…Optimism was also associated with more favorable mental responses for some outcomes [ 75 , 81 , 82 ]. While overall adaptive emotion regulation was related to lower mental distress [ 51 , 88 ], findings on specific emotion regulation strategies were again heterogeneous [ 75 ], with a positive effect of reappraisal only found for one outcome. For social support, findings were more mixed than for mean-level studies, only partly showing associations with favorable trajectories [ 52 , 83.…”

COVID-19 after two years: trajectories of different components of mental health in the Spanish population

“…In both cases, older age was a risk factor compared to the 'resilient' class. This differed from what was found in the literature in studies on emotional distress variables during the pandemic, where younger subjects were more vulnerable (Ellwardt and Präg, 2021;Pierce et al, 2021;Saunders et al, 2021;Shilton et al, 2021). Nevertheless, a review concerning the impact of age on mental health changes during the pandemic found heterogeneous findings in the literature, suggesting that the effect of age may depend on contextual variables but also on the mental health outcome studied (Lebrasseur et al, 2021).…”

“…Of these, we differentiated two major trends, a large proportion of people who were in 'resilient' trajectories (i.e., better previous functioning with stable trajectories during the follow-up period), and a smaller proportion of participants who were part of 'chronic-worsening' trajectories (i.e., low functioning and/or with changes during follow-up). For the 'resilient' trajectories, we also observed a lower susceptibility to the changes that occurred in Shilton et al, 2021). In the case of the so-called 'chronicworsening' trajectories, we observed greater heterogeneity and susceptibility to different periods of the pandemic.…”

“…In agreement with the assumption that psychological adjustment in front of an adverse event is heterogeneous and may vary over time, different studies have been carried out on mental health trajectories (Ahrens et al, 2021;Batterham et al, 2021;Ellwardt and Präg, 2021;Joshi et al, 2021;Pellerin et al, 2021;Pierce et al, 2021;Saunders et al, 2021;Shilton et al, 2021). Most of these studies identified trajectories based on depression and anxiety symptoms measures, using individual-centred statistical techniques, as growth mixture models (GMM) or latent class growth analysis.…”

“…These techniques rely on the assumption that individuals can be assigned to homogeneous subgroups (i.e., distinct trajectories) based on similarities on given outcomes (Nguena Nguefack et al, 2020). The abovementioned investigations identified from two (Joshi et al, 2021) to five trajectories of depression or/and anxiety symptoms (Ahrens et al, 2021;Batterham et al, 2021;Ellwardt and Präg, 2021;Pellerin et al, 2021;Pierce et al, 2021;Saunders et al, 2021;Shilton et al, 2021). In general terms, the results showed that a large proportion of the sample was classified in a stable trajectory over time (called 'resilient trajectory'), while a smaller proportion showed worse scores or worsening over the follow-up period ('chronic' and 'deteriorating trajectories') (Ahrens et al, 2021;Batterham et al, 2021;Ellwardt and Präg, 2021;Joshi et al, 2021;Pellerin et al, 2021;Pierce et al, 2021;Saunders et al, 2021;Shilton et al, 2021).…”