Background The COVID‐19 pandemic is related to multiple stressors and therefore may be associated with psychological distress. The aim of this study was to longitudinally assess symptoms of (un‐)specific anxiety and depression along different stages of the pandemic to generate knowledge about the progress of psychological consequences of the pandemic and to test the role of potential risk and resilience factors that were derived from cross‐sectional studies and official recommendations. Methods The present study uses a longitudinal observational design with four waves of online data collection (from March 27 to June 15, 2020) in a convenience sample of the general population in Germany. A total of N = 2376 participants that completed at least two waves of the survey were included in the analyses. Findings Specific COVID‐19‐related anxiety and the average daily amount of preoccupation with the pandemic decreased continuously over the four waves. Unspecific worrying and depressive symptoms decreased on average but not on median level. Self‐efficacy, normalization, maintaining social contacts, and knowledge, where to get medical support, were associated with fewer symptoms relative to baseline. Suppression, unhealthy habits, and a longer average daily time of thinking about the pandemic were correlated with a relative increase of symptoms. Interpretation Our findings provide insight into the longitudinal changes of symptoms of psychological distress along the first three months of the COVID‐19 pandemic in Germany. Furthermore, we were able to reaffirm the anticipated protective and risk factors that were extracted from previous studies and recommendations.

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Background The role of maternal personality and perceived social support for peripartum changes in psychopathological symptoms remains unresolved. Methods In a regional-epidemiological sample of 306 women, depressive, anxiety, and stress symptoms were assessed three times during pregnancy and three times after delivery with the 21-item version of the Depression Anxiety Stress Scale. In pregnancy, the Big Five personality traits and perceived social support were assessed with the short version of the Big Five Inventory and the Social Support Questionnaire. Results Multilevel analyses revealed that depressive (b =-0.055) and stress (b =-0.047) symptoms decreased from early to late pregnancy. After delivery, anxiety symptoms were lower (two months postpartum: b =-0.193; four/ 16 months postpartum: b =-0.274), but stress symptoms were higher (two months postpartum: b = 0.468; four/ 16 months postpartum: b = 0.320) than during pregnancy. Across the peripartum period, more conscientious and more extraverted women experienced lower depressive and stress symptoms (b =-0.147 to-0.177), and more emotionally stable women experienced lower depressive, anxiety, and stress symptoms (b =-0.294 to-0.415). More emotionally stable women more strongly increased in anxiety during pregnancy (b = 0.019), and more extraverted women less strongly increased in depression after delivery (b =-0.010). Moreover, peripartum depressive, anxiety, and stress symptoms were lower in women with higher perceived social support (b =-0.225 to-0.308).

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Unforeseen difficulties in the translation of our paradigm to a clinical setting required some deviations from the preregistered protocol. We explicitly detail these changes, discuss the accompanied additional challenges that can arise in clinical neurofeedback studies, and formulate recommendations for how these can be addressed. Taken together, this work provides new insights about the feasibility of motor imagery-based graded fMRI-NF training in MCA stroke survivors and serves as a first example for comprehensive study preregistration of an (fMRI) neurofeedback experiment.

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