McCleery Amanda, Wynn Jonathan K, Novacek Derek M, Reavis Eric A, Senturk Damla, Sugar Catherine A, Tsai Jack, Green Michael F
Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242, USA.
Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
Soc Psychiatry Psychiatr Epidemiol. 2024 Jan;59(1):111-120. doi: 10.1007/s00127-023-02518-9. Epub 2023 Jun 14.
Mental health trajectories during the COVID-19 pandemic have been examined in Veterans with tenuous social connections, i.e., those with recent homelessness (RHV) or a psychotic disorder (PSY), and in control Veterans (CTL). We test potential moderating effects on these trajectories by psychological factors that may help individuals weather the socio-emotional challenges associated with the pandemic (i.e., 'psychological strengths').
We assessed 81 PSY, 76 RHV, and 74 CTL over 5 periods between 05/2020 and 07/2021. Mental health outcomes (i.e., symptoms of depression, anxiety, contamination concerns, loneliness) were assessed at each period, and psychological strengths (i.e., a composite score based on tolerance of uncertainty, performance beliefs, coping style, resilience, perceived stress) were assessed at the initial assessment. Generalized models tested fixed and time-varying effects of a composite psychological strengths score on clinical trajectories across samples and within each group.
Psychological strengths had a significant effect on trajectories for each outcome (ps < 0.05), serving to ameliorate changes in mental health symptoms. The timing of this effect varied across outcomes, with early effects for depression and anxiety, later effects for loneliness, and sustained effects for contamination concerns. A significant time-varying effect of psychological strengths on depressive symptoms was evident in RHV and CTL, anxious symptoms in RHV, contamination concerns in PSY and CTL, and loneliness in CTL (ps < 0.05).
Across vulnerable and non-vulnerable Veterans, presence of psychological strengths buffered against exacerbations in clinical symptoms. The timing of the effect varied across outcomes and by group.
在新冠疫情期间,对社会关系脆弱的退伍军人(即近期无家可归者或患有精神疾病者)以及对照退伍军人的心理健康轨迹进行了研究。我们通过可能帮助个体应对与疫情相关的社会情感挑战的心理因素(即“心理优势”)来测试对这些轨迹的潜在调节作用。
在2020年5月至2021年7月期间的5个时间段,我们评估了81名患有精神疾病的退伍军人、76名近期无家可归的退伍军人和74名对照退伍军人。在每个时间段评估心理健康结果(即抑郁、焦虑、对污染的担忧、孤独症状),并在初次评估时评估心理优势(即基于对不确定性的容忍度、表现信念、应对方式、恢复力、感知压力的综合得分)。广义模型测试了综合心理优势得分对各样本及每组临床轨迹的固定效应和随时间变化的效应。
心理优势对每个结果的轨迹都有显著影响(p值<0.05),有助于缓解心理健康症状的变化。这种影响的时间因结果而异,对抑郁和焦虑的影响较早,对孤独的影响较晚,对污染担忧的影响持续存在。心理优势对抑郁症状的显著随时间变化的效应在近期无家可归的退伍军人和对照退伍军人中明显,对焦虑症状在近期无家可归的退伍军人中明显,对污染担忧在患有精神疾病的退伍军人和对照退伍军人中明显,对孤独在对照退伍军人中明显(p值<0.05)。
在脆弱和非脆弱的退伍军人中,心理优势的存在缓冲了临床症状的加重。这种影响的时间因结果和组别而异。