Differential Susceptibility to the Impact of the COVID-19 Pandemic on Working Memory, Empathy, and Perceived Stress: The Role of Cortisol and Resilience

Abstract

There are important individual differences in adaptation and reactivity to stressful challenges. Being subjected to strict social confinement is a distressful psychological experience leading to reduced emotional well-being, but it is not known how it can affect the cognitive and empathic tendencies of different individuals. Cortisol, a key glucocorticoid in humans, is a strong modulator of brain function, behavior, and cognition, and the diurnal cortisol rhythm has been postulated to interact with environmental stressors to predict stress adaptation. The present study investigates in 45 young adults (21.09 years old, SD = 6.42) whether pre-pandemic diurnal cortisol indices, overall diurnal cortisol secretion (AUCg) and cortisol awakening response (CAR) can predict individuals' differential susceptibility to the impact of strict social confinement during the Coronavirus Disease 2019 (COVID-19) pandemic on working memory, empathy, and perceived stress. We observed that, following long-term home confinement, there was an increase in subjects' perceived stress and cognitive empathy scores, as well as an improvement in visuospatial working memory. Moreover, during confinement, resilient coping moderated the relationship between perceived stress scores and pre-pandemic AUCg and CAR. In addition, in mediation models, we observed a direct effect of AUCg and an indirect effect of both CAR and AUCg, on change in perceived self-efficacy. These effects were parallelly mediated by the increase in working memory span and cognitive empathy. In summary, our findings reveal the role of the diurnal pattern of cortisol in predicting the emotional impact of the COVID-19 pandemic, highlighting a potential biomarker for the identification of at-risk groups following public health crises.

Keywords: COVID-19; anxiety; cortisol; depression; empathic concern; empathy; individual differences; perceived stress; perspective-taking; social confinement; stress; working memory.

Figure 1

Conceptual models for the theoretical framework of the hypotheses: (a) Coping abilities of subjects will moderate the influence of pre-pandemic cortisol indices on self-reported depressive-like symptoms, anxiety, and perceived stress during pandemic + confinement; (b) Change in cognitive capacities during pandemic + confinement will mediate the change in perceived stress as caused by pre-pandemic cortisol indices.

Figure 2

Study-related procedures in a timeline.

Figure 3

Pre-confinement and during-confinement scores: (a) Violin graphs (with median) showing an increase in perceived helplessness (PSS-H) and total perceived stress (T. PSS) (b) An increase in the perspective-taking (PT) aspect of dispositional empathy (c) Scores on the change-location task and (d) An increase in the number of block-sequences correctly recalled during Corsi-Forward and Corsi-Total. Note: Conf. = Confinement; PSS = Perceived Stress Scale; PSS-SE = Perceived (lack-of) Self-Efficacy; PSS-H = Perceived Helplessness; IRI = Interpersonal Reactivity Index; PT = Perspective-Taking; EC: Empathic Concern; Corsi-T = Total Corsi Score; Corsi-F = Corsi-Forward Score; Corsi-B = Corsi-Backward Score. * p < 0.05; ** p < 0.01.

Figure 4

(a) Simple moderation analysis statistical model with standardized regression coefficients. (b) Simple slopes (conditional effects) representing the association between Resilient Coping and pre-pandemic daytime cortisol total diurnal cortisol release (AUCg), predicting confinement total perceived stress. BRCS = Brief Resilient Coping Score; AUCg = Total diurnal cortisol release; PSS = Perceived Stress Score.

Figure 4

(a) Simple moderation analysis statistical model with standardized regression coefficients. (b) Simple slopes (conditional effects) representing the association between Resilient Coping and pre-pandemic daytime cortisol total diurnal cortisol release (AUCg), predicting confinement total perceived stress. BRCS = Brief Resilient Coping Score; AUCg = Total diurnal cortisol release; PSS = Perceived Stress Score.

Figure 5

Simple moderation analysis statistical model with standardized regression coefficients. BRCS = Brief Resilient Coping Score, CAR = Cortisol Awakening Response.

Figure 6

Mediation models (a) AUCg cortisol predicting change in perceived self-efficacy; (b) Cortisol awakening response (CAR) predicting change in perceived self-efficacy. PT = Perspective-Taking; PSS-SE = Perceived stress scale Self-Efficacy; AUCg = Total diurnal cortisol release; CAR = Cortisol Awakening Response; ns = non-significant. Standardized effect sizes in red.