Suffering, Mental Health, and Psychological Well-being During the COVID-19 Pandemic: A Longitudinal Study of U.S. Adults With Chronic Health Conditions

Abstract

Suffering has been a topic of considerable discussion in the fields of medicine and palliative care, yet few studies have reported causal evidence linking the experience of suffering to health and well-being. In this three-wave prospective cohort study, we explore the potential psychological implications of suffering during the COVID-19 pandemic by examining relations among suffering, mental health, and psychological well-being in a sample of U.S. adults living with chronic health conditions. We analyzed data from n = 184 participants who completed assessments one month before the SARS-CoV-2 outbreak was declared a pandemic by the World Health Organization (February 2020) and then two months (April 2020) and four months later (May/June 2020). Analyses controlled for a range of factors, including sociodemographic characteristics, physical health, religious/spiritual factors, psychological characteristics, and prior values of the predictor and each of the outcomes assessed one month before the COVID-19 pandemic. Results of the primary analysis indicated that greater overall suffering assessed one month into the COVID-19 pandemic was associated with lower psychological well-being (β = -.17, 95% CI: -.29, -.05) and higher levels of anxiety (β = .27, 95% CI: .13, .41) and depression (β = .16, 95% CI: .03, .29) two months later. In a secondary analysis that explored anxiety, depression, and psychological well-being as candidate antecedents of suffering, depression assessed one month into the COVID-19 pandemic was most strongly associated with worse overall suffering two months later. We highlight the implications of the findings for high-risk populations who are suffering amidst the challenges of the COVID-19 pandemic. Potential benefits of both integrating assessments of suffering into screening procedures and addressing experiences of suffering in mental health service settings are discussed.

Are depression and suffering distinct? An empirical analysis

“…However, the findings of previous studies provide little evidence in alignment with this notion. Effect sizes reported in a number of prior cross-sectional studies suggest a small-to-moderate positive association between depression and suffering (e.g., Büchi et al, 2002;Brady et al, 2019;Davis et al, 2021), with slightly smaller effect sizes found in a few longitudinal studies that have been conducted (e.g., Cowden et al, 2021b;Ho et al, 2022).…”

“…For example, many theoretical accounts suggest that a central characteristic of suffering is the threat to, or loss of, one's sense of personhood (e.g., Cassell, 1999;Tate and Pearlman, 2019). The physical dimension of depression (i.e., somatic symptoms, such as fatigue) resonates particularly closely with accounts of suffering that are prevalent in the empirical literature, given that research on suffering has typically addressed clinical populations dealing with physical health concerns or illness (Cowden et al, 2021b). However, even if physical symptoms or issues are the primary cause of a person's suffering, the object of their suffering may be entirely different (VanderWeele, 2019).…”

Handbook of Positive Psychology, Religion, and Spirituality

“…Few studies went beyond the role of R/S in facing distress or remaining psychologically buoyant while navigating adversity. Further research is needed to understand how R/S might facilitate personal growth or otherwise enable people to thrive in response to negative life events, particularly studies focused on forms of distress (e.g., suffering) that many R/S traditions emphasize as having the capacity to bring about personal or R/S transformation (Cowden, Davis et al, 2021). For example, culturally responsive research that crosspollinates PP and the PRS in these three regions could expand the corpus of empirical literature on suffering by providing additional insight into how non-Western worldviews shape perspectives of suffering, responses to suffering, and adaptive processes that enable people to transcend suffering.…”

Pandemic Times for Fitness Professionals and Health and Well-Being Coaches

“…As might be expected, suffering early in the pandemic predicted greater anxiety, depression, and lower psychological well-being (12). However, it was less predictable that the relationship between psychological well-being and PsychCap would change during the pandemic (13).…”