Evaluating Resilience in Response to COVID-19 Pandemic Stressors Among Veteran Mental Health Outpatients

• Published in: Journal of psychopathology and clinical science 2023-01, Vol.132 (1), p.26-37
• Main Authors: Marquardt, Craig A., Chu, Carol, Hill, Jessica E., Venables, Noah C., Kuzenski, Laci, Davenport, Nicholas D., Disner, Seth G., Finn, Jacob A., Gilmore, Casey S., Erbes, Christopher R., Urošević, Snežana
• Format: Article
• Language: English
• Subjects: Activation; Cognitive behavioral therapy; Connectedness; Coronaviruses; COVID-19; Cross-sectional studies; Distress; Female; Health behavior; Health status; High risk; Human; Humans; Male; Mental disorders; Mental Health; Mental health care; Mental health services; Military Veterans; Moderation; Outpatient; Outpatients; Pandemics; Physical Health; Physical symptoms; Psychological distress; Psychological Stress; Psychopathology; Public health; Resilience; Resilience (Psychological); Stress; Substance use disorder; Veterans; Vulnerability
• ISSN: 2769-7541; 2769-755X
• DOI: 10.1037/abn0000789

There is a public health need to understand mental health vulnerabilities to COVID-19 pandemic-related stressors and promote resilience among high-risk populations with preexisting psychiatric conditions. Recent cross-sectional studies suggest increases in mental health distress (e.g., depression and anxiety) during the pandemic. The present study expands upon these emerging findings using longitudinal latent modeling and hierarchical linear regressions. Consistent with the developmental psychopathology literature on resilience, we distinguished between promotive or risk (i.e., main effect), and protective or vulnerability (i.e., moderation) effects on mental health during the pandemic. At a large medical center, 398 veterans receiving outpatient mental health care provided prepandemic (Time 1) and during pandemic (Time 2) assessments of mental and physical health-related distress. Additional Time 2 questionnaires assessed pandemic-related stressors and positive behavioral adaptations in the summer of 2020. As expected, total stressor scores predicted longitudinal worsening of self-reported mental (β = −.205) and physical health (β = −.217). Positive behavioral adaptations enacted during the pandemic moderated and protected against stressor effects on mental health (β = .160). In addition, the presence of substance use disorders moderated and conferred vulnerability to stressor effects on physical health (β = −.158). Thus, higher COVID-19 pandemic stressor exposure may have exacerbated mental and physical health distress among veterans with common forms of psychopathology. Nevertheless, behavioral activation, purposeful maintenance of social connections, and focused treatment for substance misuse may be important intervention targets for reducing the longitudinal impact of pandemic stressors and enhancing resilience among people with mental illness. General Scientific Summary Veterans from psychiatric outpatient clinics were assessed before and during the COVID-19 pandemic on measures of mental and physical health. Pandemic stressor exposures were associated with increased mental and physical health distress, but positive behavioral adaptations and a lack of preexisting substance use disorders conferred a protective buffering against stressor effects. Behavior activation and meaningful social connections may be important targets for enhancing resilience among veterans with preexisting psychopathology.