Department of Psychiatry and Behavioral Neuroscience, The University of Chicago, 5841 S. Maryland Ave, Chicago, IL, MC307760637, USA.
Department of Obstetrics and Gynecology/Section of Gynecologic Oncology, The University of Chicago, Chicago, IL, USA.
Arch Womens Ment Health. 2022 Feb;25(1):137-146. doi: 10.1007/s00737-021-01184-7. Epub 2021 Oct 14.
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.
韧性在介导 COVID-19 大流行对美国女性心理健康的负面影响方面的作用尚未得到充分理解。我们研究了与女性韧性低相关的社会经济因素、韧性与精神疾病发病率的关系，以及韧性在大流行相关压力与其他同时存在的精神疾病发病率之间的关系中的中介作用。我们使用来自全国性小组的配额样本，于 2020 年 4 月对 3200 名美国女性进行了一项基于网络的调查。采用加权多变量逻辑回归模型来分析大流行相关压力、以及同时存在的抑郁和焦虑症状在具有和不具有低韧性的人群中的发病几率。结构方程模型用于评估韧性作为大流行相关压力与其他同时存在的精神疾病发病率之间关系的中介。低韧性的风险因素包括年龄较小、家庭收入较低、教育程度较低、失业、东亚/东南亚种族、未婚/无伴侣状态，以及更多的医疗合并症。低韧性与更大的抑郁症状（OR=3.78，95%CI [3.10-4.60]）、焦虑症状（OR=4.17，95%CI [3.40-5.11]）和大流行相关压力（OR=2.86，95%CI [2.26-3.26]）的发病几率显著相关。韧性在大流行相关压力与焦虑症状（部分中介比例=0.23）和抑郁症状（部分中介比例=0.28）之间的关系中起部分中介作用。在 COVID-19 大流行的早期，低韧性介导了大流行相关压力与精神疾病发病率之间的关系。已经证明，增强韧性的策略，如认知行为疗法、正念减压和解决社会经济因素，可以帮助减轻心理健康结果。
