. 2021 Jan 21;11(1):67.

doi: 10.1038/s41398-020-01150-4.

Psycho-social factors associated with mental resilience in the Corona lockdown

Ilya M Veer^#¹, Antje Riepenhausen^#^{1

2}, Matthias Zerban^#³, Carolin Wackerhagen^#¹, Lara M C Puhlmann^#^{4

5}, Haakon Engen^{3

6}, Göran Köber^{7

8}, Sophie A Bögemann⁹, Jeroen Weermeijer¹⁰, Aleksandra Uściłko¹¹, Netali Mor^{12

13}, Marta A Marciniak^{14

15}, Adrian Dahl Askelund⁶, Abbas Al-Kamel¹⁶, Sarah Ayash⁴, Giulia Barsuola¹⁷, Vaida Bartkute-Norkuniene¹⁸, Simone Battaglia¹⁹, Yaryna Bobko²⁰, Sven Bölte^{21

22

23}, Paolo Cardone⁴, Edita Chvojková²⁴, Kaja Damnjanović²⁵, Joana De Calheiros Velozo¹⁰, Lena de Thurah¹⁰, Yacila I Deza-Araujo^{26

27}, Annika Dimitrov¹, Kinga Farkas^{28

29}, Clémence Feller³⁰, Mary Gazea³¹, Donya Gilan^{4

32}, Vedrana Gnjidić³³, Michal Hajduk^{34

35

36}, Anu P Hiekkaranta¹⁰, Live S Hofgaard³⁷, Laura Ilen³⁰, Zuzana Kasanova³⁸, Mohsen Khanpour³⁹, Bobo Hi Po Lau⁴⁰, Dionne B Lenferink⁹, Thomas B Lindhardt⁴¹, Dávid Á Magas²⁹, Julian Mituniewicz¹¹, Laura Moreno-López⁴², Sofiia Muzychka²⁰, Maria Ntafouli⁴³, Aet O'Leary^{44

45}, Ilenia Paparella⁴⁶, Nele Põldver⁴⁵, Aki Rintala^{10

47}, Natalia Robak⁴⁸, Anna M Rosická⁴⁹, Espen Røysamb³⁷, Siavash Sadeghi⁵⁰, Maude Schneider³⁰, Roma Siugzdaite^{17

51}, Mirta Stantić⁵², Ana Teixeira¹⁰, Ana Todorovic⁵², Wendy W N Wan⁵³, Rolf van Dick⁵⁴, Klaus Lieb^{4

32}, Birgit Kleim^{14

15}, Erno J Hermans⁹, Dorota Kobylińska¹¹, Talma Hendler^{12

13

55

56}, Harald Binder^{7

8}, Inez Myin-Germeys¹⁰, Judith M C van Leeuwen^#⁹, Oliver Tüscher^#^{4

32}, Kenneth S L Yuen^#^{3

4}, Henrik Walter^#^{1

2}, Raffael Kalisch^#^{57

58}

Affiliations

¹ Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
² Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
³ Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany.
⁴ Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
⁵ Research Group Social Stress and Family Health, Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany.
⁶ Department of Psychology, University of Oslo, Oslo, Norway.
⁷ Faculty of Medicine and Medical Center, Institute of Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany.
⁸ Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany.
⁹ Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
¹⁰ Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium.
¹¹ Faculty of Psychology, University of Warsaw, Warsaw, Poland.
¹² Tel Aviv Sourasky Medical Center, Sagol Brain Institute Tel Aviv, Tel Aviv, Israel.
¹³ Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹⁴ Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland.
¹⁵ Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland.
¹⁶ University of Bergamo, Bergamo, Italy.
¹⁷ MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.
¹⁸ Faculty of Business and Technologies at Utena University of Applied Sciences, Utena, Lithuania.
¹⁹ Center for Studies and Research in Cognitive Neuroscience, Department of Psychology, University of Bologna, Bologna, Italy.
²⁰ Faculty of Psychology, University of Economics and Human Sciences, Warsaw, Warsaw, Poland.
²¹ Center for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
²² Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
²³ Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.
²⁴ Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands.
²⁵ Laboratory for Experimental Psychology, Department of Psychology, University of Belgrade, Belgrade, Serbia.
²⁶ Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland.
²⁷ Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, Medical School, University of Geneva, Geneva, Switzerland.
²⁸ Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
²⁹ Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary.
³⁰ Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
³¹ Concentris Research Management GmbH, Fürstenfeldbruck, Germany.
³² Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany.
³³ Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia.
³⁴ Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Bratislava, Slovak Republic.
³⁵ Center for Psychiatric Disorders Research, University in Bratislava, Science Park Comenius, Bratislava, Slovak Republic.
³⁶ Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovak Republic.
³⁷ PROMENTA Research Centre, Department of Psychology, University of Oslo, Oslo, Norway.
³⁸ Leuven Research and Development, Spin-off and Innovation Unit, KU Leuven, Leuven, Belgium.
³⁹ University of Tehran, Tehran, Iran.
⁴⁰ Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong.
⁴¹ Center of Functionally Integrative Neuroscience (CFIN) and MINDLab, Department of Clinical Medicine, Århus University, Århus, Denmark.
⁴² Department of Psychiatry, University of Cambridge, Cambridge, UK.
⁴³ Sleep Research Unit, First Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece.
⁴⁴ Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany.
⁴⁵ Institute of Psychology, University of Tartu, Tartu, Estonia.
⁴⁶ Institut des Sciences Cognitives Marc Jeannerod, Lyon, France.
⁴⁷ Faculty of Social Services and Health Care, LAB University of Applied Sciences, Lahti, Finland.
⁴⁸ College of Inter-faculty Individual Studies in Mathematics and Natural Sciences, University of Warsaw, Warsaw, Poland.
⁴⁹ Faculty of Social Studies, Department of Psychology, Masaryk University, Brno, Czech Republic.
⁵⁰ Johannes Gutenberg University Mainz, Mainz, Germany.
⁵¹ Department of Experimental Clinical and Health Psychology, Ghent University, Gent, Belgium.
⁵² Department of Experimental Psychology, University of Oxford, Oxford, UK.
⁵³ Department of International Business, Tunghai University, Taichung City, Taiwan.
⁵⁴ Institute of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany.
⁵⁵ School of Psychological Science, Tel Aviv University, Tel Aviv, Israel.
⁵⁶ Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
⁵⁷ Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany. rkalisch@uni-mainz.de.
⁵⁸ Leibniz Institute for Resilience Research (LIR), Mainz, Germany. rkalisch@uni-mainz.de.

^# Contributed equally.

PMID: 33479211
PMCID: PMC7817958
DOI: 10.1038/s41398-020-01150-4

Psycho-social factors associated with mental resilience in the Corona lockdown

Ilya M Veer et al. Transl Psychiatry. 2021.

. 2021 Jan 21;11(1):67.

doi: 10.1038/s41398-020-01150-4.

Authors

Affiliations

¹ Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy CCM, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
² Faculty of Philosophy, Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany.
³ Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany.
⁴ Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
⁵ Research Group Social Stress and Family Health, Max Planck Institute for Cognitive and Brain Sciences, Leipzig, Germany.
⁶ Department of Psychology, University of Oslo, Oslo, Norway.
⁷ Faculty of Medicine and Medical Center, Institute of Medical Biometry and Statistics, University of Freiburg, Freiburg, Germany.
⁸ Freiburg Center for Data Analysis and Modelling, University of Freiburg, Freiburg, Germany.
⁹ Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
¹⁰ Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium.
¹¹ Faculty of Psychology, University of Warsaw, Warsaw, Poland.
¹² Tel Aviv Sourasky Medical Center, Sagol Brain Institute Tel Aviv, Tel Aviv, Israel.
¹³ Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
¹⁴ Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland.
¹⁵ Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland.
¹⁶ University of Bergamo, Bergamo, Italy.
¹⁷ MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.
¹⁸ Faculty of Business and Technologies at Utena University of Applied Sciences, Utena, Lithuania.
¹⁹ Center for Studies and Research in Cognitive Neuroscience, Department of Psychology, University of Bologna, Bologna, Italy.
²⁰ Faculty of Psychology, University of Economics and Human Sciences, Warsaw, Warsaw, Poland.
²¹ Center for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet Center of Neurodevelopmental Disorders (KIND), Karolinska Institutet and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
²² Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
²³ Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, WA, Australia.
²⁴ Department of Psychological Methods, University of Amsterdam, Amsterdam, The Netherlands.
²⁵ Laboratory for Experimental Psychology, Department of Psychology, University of Belgrade, Belgrade, Serbia.
²⁶ Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland.
²⁷ Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, Medical School, University of Geneva, Geneva, Switzerland.
²⁸ Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary.
²⁹ Department of Cognitive Science, Budapest University of Technology and Economics, Budapest, Hungary.
³⁰ Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland.
³¹ Concentris Research Management GmbH, Fürstenfeldbruck, Germany.
³² Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany.
³³ Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia.
³⁴ Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Bratislava, Slovak Republic.
³⁵ Center for Psychiatric Disorders Research, University in Bratislava, Science Park Comenius, Bratislava, Slovak Republic.
³⁶ Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovak Republic.
³⁷ PROMENTA Research Centre, Department of Psychology, University of Oslo, Oslo, Norway.
³⁸ Leuven Research and Development, Spin-off and Innovation Unit, KU Leuven, Leuven, Belgium.
³⁹ University of Tehran, Tehran, Iran.
⁴⁰ Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong.
⁴¹ Center of Functionally Integrative Neuroscience (CFIN) and MINDLab, Department of Clinical Medicine, Århus University, Århus, Denmark.
⁴² Department of Psychiatry, University of Cambridge, Cambridge, UK.
⁴³ Sleep Research Unit, First Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece.
⁴⁴ Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany.
⁴⁵ Institute of Psychology, University of Tartu, Tartu, Estonia.
⁴⁶ Institut des Sciences Cognitives Marc Jeannerod, Lyon, France.
⁴⁷ Faculty of Social Services and Health Care, LAB University of Applied Sciences, Lahti, Finland.
⁴⁸ College of Inter-faculty Individual Studies in Mathematics and Natural Sciences, University of Warsaw, Warsaw, Poland.
⁴⁹ Faculty of Social Studies, Department of Psychology, Masaryk University, Brno, Czech Republic.
⁵⁰ Johannes Gutenberg University Mainz, Mainz, Germany.
⁵¹ Department of Experimental Clinical and Health Psychology, Ghent University, Gent, Belgium.
⁵² Department of Experimental Psychology, University of Oxford, Oxford, UK.
⁵³ Department of International Business, Tunghai University, Taichung City, Taiwan.
⁵⁴ Institute of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany.
⁵⁵ School of Psychological Science, Tel Aviv University, Tel Aviv, Israel.
⁵⁶ Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel.
⁵⁷ Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany. rkalisch@uni-mainz.de.
⁵⁸ Leibniz Institute for Resilience Research (LIR), Mainz, Germany. rkalisch@uni-mainz.de.

^# Contributed equally.

PMID: 33479211
PMCID: PMC7817958
DOI: 10.1038/s41398-020-01150-4

Abstract

The SARS-CoV-2 pandemic is not only a threat to physical health but is also having severe impacts on mental health. Although increases in stress-related symptomatology and other adverse psycho-social outcomes, as well as their most important risk factors have been described, hardly anything is known about potential protective factors. Resilience refers to the maintenance of mental health despite adversity. To gain mechanistic insights about the relationship between described psycho-social resilience factors and resilience specifically in the current crisis, we assessed resilience factors, exposure to Corona crisis-specific and general stressors, as well as internalizing symptoms in a cross-sectional online survey conducted in 24 languages during the most intense phase of the lockdown in Europe (22 March to 19 April) in a convenience sample of N = 15,970 adults. Resilience, as an outcome, was conceptualized as good mental health despite stressor exposure and measured as the inverse residual between actual and predicted symptom total score. Preregistered hypotheses (osf.io/r6btn) were tested with multiple regression models and mediation analyses. Results confirmed our primary hypothesis that positive appraisal style (PAS) is positively associated with resilience (p < 0.0001). The resilience factor PAS also partly mediated the positive association between perceived social support and resilience, and its association with resilience was in turn partly mediated by the ability to easily recover from stress (both p < 0.0001). In comparison with other resilience factors, good stress response recovery and positive appraisal specifically of the consequences of the Corona crisis were the strongest factors. Preregistered exploratory subgroup analyses (osf.io/thka9) showed that all tested resilience factors generalize across major socio-demographic categories. This research identifies modifiable protective factors that can be targeted by public mental health efforts in this and in future pandemics.

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Conflict of interest statement

The authors declare to have no direct conflicts of interest related to this article. S.B. has in the last 3 years acted as an author, consultant, or lecturer for Medice and Roche. He receives royalties for text books and diagnostic tools from Hogrefe, Kohlhammer and UTB. T.H. is a chief medical scientist for GrayMatters Health Co., Haifa, Israel. R.K. receives advisory honoraria from JoyVentures, Herzlia, Israel.

Figures

**Fig. 1. Associations of hypothesized resilience factors with outcome-based resilience (RES) and mediation effects.**
A Multiple regressions with covariates of resilience factors on resilience, calculated separately for each factor. Shown are the regression coefficients (β) and 99% confidence intervals (CI). Effects are similar for resilience to all stressors combined (RES_C), resilience to general (RES_G), and resilience to Corona-specific stressors (RES_S). Resilience factors: PAS, positive appraisal style; PSS, perceived social support; CSS, perceived increase in social support during the Corona crisis; OPT, optimism; GSE, perceived general self-efficacy; REC, perceived good stress recovery; NEU, neuroticism; BCS, behavioral coping style; PAC, positive appraisal specifically of the Corona crisis. B Mediation analyses testing if the positive association of PSS with RES_C is mediated by PAS (top) and if the positive association of PAS on RES_C is mediated by REC (bottom). Shown are β of all paths. Indirect path a × b: β with 99% CI. ***p < 0.0001.

**Fig. 2. Combined multi-variable analysis (LASSO) of the relative associations of resilience factors and covariates with resilience (RES_C).**
To identify the strongest of the partly correlated resilience factors, sparse regression was performed with an optimal penalty term λ (vertical broken line), as determined by cross-validation. Resilience factors are indicated in color, covariates in gray. The initial position of a curve on the y-axis signifies the association of the corresponding resilience factor or covariate with RES_C in the case of very low penalization. By increasing λ (x-axis), regression coefficients (β) get increasingly drawn to zero, to leave only the strongest associations. The order of resilience factors in the color legend corresponds to their determined relative strengths (absolute values) at optimal λ (broken line). Except for BCS (behavioral coping style), all resilience factors were selected in all 800 repeated LASSO runs, indicating strong replication stability.

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Psycho-social factors associated with mental resilience in the Corona lockdown

Affiliations

Psycho-social factors associated with mental resilience in the Corona lockdown

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Conflict of interest statement

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