Shaped by the COVID-19 pandemic: Psychological responses from a subjective perspective–A longitudinal mixed-methods study across five European countries

Abstract

Background Contextual factors are essential for understanding long-term adjustment to the COVID-19 pandemic. Therefore, the present study investigated changes in mental health outcomes and subjective pandemic-related experiences over time and across countries. The main objective was to explore how psychological responses vary in relation to individual and environmental factors. Methods The sample consisted of N = 1070 participants from the general population of Austria, Croatia, Georgia, Greece, and Portugal. We applied a longitudinal mixed-methods approach, with baseline assessment in summer and autumn 2020 (T1) and follow-up assessment 12 months later (T2). Qualitative content analysis by Mayring was used to analyse open-ended questions about stressful events, positive and negative aspects of the pandemic, and recommendations on how to cope. Mental health outcomes were assessed with the Adjustment Disorder–New Module 8 (ADNM-8), the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5), the Patient Health Questionnaire-2 (PHQ-2), and the 5-item World Health Organization Well-Being Index (WHO-5). The analyses were performed with SPSS Statistics Version 26 and MAXQDA 2022. Results The mental health outcomes significantly differed over time and across countries, with e.g. Greek participants showing decrease in adjustment disorder symptoms (p = .007) between T1 and T2. Compared with other countries, we found better mental health outcomes in the Austrian and the Croatian sample at both timepoints (p < .05). Regarding qualitative data, some themes were equally represented at both timepoints (e.g. Restrictions and changes in daily life), while others were more prominent at T1 (e.g. Work and finances) or T2 (e.g. Vaccination issues). Conclusions Our findings indicate that people’s reactions to the pandemic are largely shaped by the shifting context of the pandemic, country-specific factors, and individual characteristics and circumstances. Resource-oriented interventions focusing on psychological flexibility might promote resilience and mental health amidst the COVID-19 pandemic and other global crises.

Trajectories of Adjustment Disorder and Well-Being in Austria and Croatia during 20 Months of the COVID-19 Pandemic

“…The fluctuations in AD symptoms also differed significantly across individuals. This is in line with a recent study which identified four distinct trajectories of AD [54], highlighting the high variability in people's reactions to the pandemic, as demonstrated earlier [76,77].…”

Factors Associated with Parenting Adaptability in Facing the First COVID-19 Lockdown: A Study on Portuguese Parents

“…Regarding post-pandemic interventions, these remain important as a societal and intergovernmental approach to face the consequences of the pandemic, strengthening the intersectorial delivery and developing their progressive universal delivery without compromising the implementation of specific measures for at-risk populations [28]. Looking at public health policymaking through the lens of social justice would promote social and public health policies that might overcome and prevent the occurrence of some difficulties and iniquities that were lived by some parents during the pandemic [22].…”