Craig A. Marquardt, Carol Chu, Jessica E. Hill, Noah C. Venables, Laci Kuzenski, Nicholas D. Davenport, Seth G. Disner, Jacob A. Finn, Casey S. Gilmore, Christopher R. Erbes, and Snezana Uroševic
Journal of Psychopathology and Clinical Science, 2023, Vol. 132, No. 1, 26–37; https://dx.doi.org/10.1037/abn0000789.
Abstract
There is a public health need to understand mental health vulnerabilities to COVID-19 pandemic-relatedstressors and promote resilience among high-risk populations with preexisting psychiatric conditions. Recentcross-sectional studies suggest increases in mental health distress (e.g., depression and anxiety) during thepandemic. The present study expands upon these emergingfindings using longitudinal latent modeling andhierarchical linear regressions. Consistent with the developmental psychopathology literature on resilience,we distinguished between promotive or risk (i.e., main effect), and protective or vulnerability (i.e., modera-tion) effects on mental health during the pandemic. At a large medical center, 398 veterans receiving outpa-tient mental health care provided prepandemic (Time 1) and during pandemic (Time 2) assessments ofmental and physical health-related distress. Additional Time 2 questionnaires assessed pandemic-related stres-sors and positive behavioral adaptations in the summer of 2020. As expected, total stressor scores predictedlongitudinal worsening of self-reported mental (b=.205) and physical health (b=.217). Positive behav-ioral adaptations enacted during the pandemic moderated and protected against stressor effects on mentalhealth (b= .160). In addition, the presence of substance use disorders moderated and conferred vulnerabilityto stressor effects on physical health (b=.158). Thus, higher COVID-19 pandemic stressor exposure mayhave exacerbated mental and physical health distressamong veterans with common forms of psychopathol-ogy. Nevertheless, behavioral activation, purposeful maintenance of social connections, and focused treatmentfor substance misuse may be important intervention targets for reducing the longitudinal impact of pandemicstressors and enhancing resilience among people with mental illness.
Casey Gilmore, PhD 