Resilience and Meaning-and-Purpose 5-6 Months into the COVID-19 Disaster: The Moderating Role of Having a Pre-existing Mental Health Condition in a Cross-sectional Survey Study (Preprint)

Abstract

BACKGROUND As with other natural disasters, including epidemics in recent history, rates of anxiety and depression increased significantly at the beginning of the COVID-19 pandemic. Studies of resilience and meaning and purpose during the early months of COVID-19 found that these positive psychology constructs are generally negatively associated with anxiety and depression. However, there are risk factors for resilience that may alter this association, such as having a pre-existing mental health condition. OBJECTIVE Our goals were to examine the relationship between strengths-based psychological factors (resilience and meaning-and-purpose) and anxiety and depression symptoms, 5-6 months following the US COVID-19 emergency declaration (August-September, 2020) in a sample of adults in the Midwest. METHODS Adults (≥18 years of age) were recruited via flyers, emails, and word of mouth to participate in daily polls assessing attitudes about the pandemic and monthly surveys measuring anxiety, depression, resilience, and meaning-and-purpose. A study community advisory board identified local resources and recommended new poll questions to coincide with changes in pandemic trends. The current study examines mental health survey data from participants who enrolled between August 1–September 30, 2020. RESULTS Participants (N=106; Asian (0.9%), Black (45.3%), Latine/Hispanic (6.6%), White (42.5%), Mixed/Multiple (2.8%), and Other (2.8%)) reported anxiety and depression in the mild ranges. In a regression analysis, meaning-and-purpose (P=.002) was significantly, negatively associated with anxiety, and both resilience (BRS; P=.02) and meaning-and-purpose (P<.001) were significantly, negatively associated with depression over and above relevant demographic covariates. Additionally, the moderation between having a self-reported, pre-existing mental health condition and resilience (P=.01) was significantly associated with anxiety, such that those who reported a mental health condition tended towards greater anxiety as resilience increased, while those who did not report a mental health condition tended towards lower anxiety as resilience increased. CONCLUSIONS Consistent with previous literature from the initial pandemic period, our data found that resilience and meaning-and-purpose were significantly, negatively associated with mental health outcomes. Furthermore, the association between resilience and anxiety was moderated by having a self-reported, pre-existing mental health condition. Therefore, in studying resilience in a disaster context, having a pre-existing mental health condition is a salient risk factor to consider. Findings specifically contribute to our understanding of resilience during a longer-term disaster (e.g., pandemic). Further research is warranted to better understand how the protective benefits of resilience may be differentially experienced by those with and without a pre-existing mental health condition.