Psychological Resilience Factors and Their Association With Weekly Stressor Reactivity During the COVID-19 Outbreak in Europe: Prospective Longitudinal Study

Sophie A Bögemann^#¹, Lara M C Puhlmann^#^{2

3}, Carolin Wackerhagen^#⁴, Matthias Zerban^#⁵, Antje Riepenhausen^{4

6}, Göran Köber^{7

8}, Kenneth S L Yuen^{2

5}, Shakoor Pooseh⁸, Marta A Marciniak^{9

10}, Zala Reppmann⁴, Aleksandra Uściƚko¹¹, Jeroen Weermeijer¹², Dionne B Lenferink¹, Julian Mituniewicz¹¹, Natalia Robak¹³, Nina C Donner¹⁴, Merijn Mestdagh¹⁵, Stijn Verdonck¹⁵, Rolf van Dick¹⁶, Birgit Kleim^{9

10}, Klaus Lieb^{2

17}, Judith M C van Leeuwen¹, Dorota Kobylińska^#¹¹, Inez Myin-Germeys^#¹², Henrik Walter^#^{4

6}, Oliver Tüscher^#^{2

17

18}, Erno J Hermans^#¹, Ilya M Veer^#^{4

19}, Raffael Kalisch^#^{2

5}

Affiliations

¹ Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands.
² Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
³ Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
⁴ Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
⁵ Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany.
⁶ Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany.
⁷ Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
⁸ Freiburg Center for Data Analysis and Modelling, Institute of Physics, University of Freiburg, Freiburg, Germany.
⁹ Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland.
¹⁰ Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland.
¹¹ Faculty of Psychology, University of Warsaw, Warsaw, Poland.
¹² Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium.
¹³ College of Inter-Faculty Individual Studies in Mathematics and Natural Sciences, University of Warsaw, Warsaw, Poland.
¹⁴ Concentris Research Management GmbH, Fürstenfeldbruck, Germany.
¹⁵ Research Group of Quantitative Psychology and Individual Differences, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.
¹⁶ Institute of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany.
¹⁷ Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany.
¹⁸ Institute of Molecular Biology (IMB), Mainz, Germany.
¹⁹ Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands.

^# Contributed equally.

PMID: 37847551
PMCID: PMC10618882
DOI: 10.2196/46518

Psychological Resilience Factors and Their Association With Weekly Stressor Reactivity During the COVID-19 Outbreak in Europe: Prospective Longitudinal Study

Sophie A Bögemann et al. JMIR Ment Health. 2023.

. 2023 Oct 17:10:e46518.

doi: 10.2196/46518.

Authors

Affiliations

¹ Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands.
² Leibniz Institute for Resilience Research (LIR), Mainz, Germany.
³ Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany.
⁴ Research Division of Mind and Brain, Department of Psychiatry and Psychotherapy, Charité Campus Mitte, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
⁵ Neuroimaging Center (NIC), Focus Program Translational Neuroscience (FTN), Johannes Gutenberg University Medical Center, Mainz, Germany.
⁶ Berlin School of Mind and Brain, Faculty of Philosophy, Humboldt-Universität zu Berlin, Berlin, Germany.
⁷ Institute of Medical Biometry and Statistics, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany.
⁸ Freiburg Center for Data Analysis and Modelling, Institute of Physics, University of Freiburg, Freiburg, Germany.
⁹ Division of Experimental Psychopathology and Psychotherapy, Department of Psychology, University of Zurich, Zurich, Switzerland.
¹⁰ Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital (PUK), University of Zurich, Zurich, Switzerland.
¹¹ Faculty of Psychology, University of Warsaw, Warsaw, Poland.
¹² Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium.
¹³ College of Inter-Faculty Individual Studies in Mathematics and Natural Sciences, University of Warsaw, Warsaw, Poland.
¹⁴ Concentris Research Management GmbH, Fürstenfeldbruck, Germany.
¹⁵ Research Group of Quantitative Psychology and Individual Differences, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.
¹⁶ Institute of Psychology, Goethe University Frankfurt, Frankfurt am Main, Germany.
¹⁷ Department of Psychiatry and Psychotherapy, Johannes Gutenberg University Medical Center, Mainz, Germany.
¹⁸ Institute of Molecular Biology (IMB), Mainz, Germany.
¹⁹ Department of Developmental Psychology, University of Amsterdam, Amsterdam, Netherlands.

^# Contributed equally.

PMID: 37847551
PMCID: PMC10618882
DOI: 10.2196/46518

Abstract

Background: Cross-sectional relationships between psychosocial resilience factors (RFs) and resilience, operationalized as the outcome of low mental health reactivity to stressor exposure (low "stressor reactivity" [SR]), were reported during the first wave of the COVID-19 pandemic in 2020.

Objective: Extending these findings, we here examined prospective relationships and weekly dynamics between the same RFs and SR in a longitudinal sample during the aftermath of the first wave in several European countries.

Methods: Over 5 weeks of app-based assessments, participants reported weekly stressor exposure, mental health problems, RFs, and demographic data in 1 of 6 different languages. As (partly) preregistered, hypotheses were tested cross-sectionally at baseline (N=558), and longitudinally (n=200), using mixed effects models and mediation analyses.

Results: RFs at baseline, including positive appraisal style (PAS), optimism (OPT), general self-efficacy (GSE), perceived good stress recovery (REC), and perceived social support (PSS), were negatively associated with SR scores, not only cross-sectionally (baseline SR scores; all P<.001) but also prospectively (average SR scores across subsequent weeks; positive appraisal (PA), P=.008; OPT, P<.001; GSE, P=.01; REC, P<.001; and PSS, P=.002). In both associations, PAS mediated the effects of PSS on SR (cross-sectionally: 95% CI -0.064 to -0.013; prospectively: 95% CI -0.074 to -0.0008). In the analyses of weekly RF-SR dynamics, the RFs PA of stressors generally and specifically related to the COVID-19 pandemic, and GSE were negatively associated with SR in a contemporaneous fashion (PA, P<.001; PAC,P=.03; and GSE, P<.001), but not in a lagged fashion (PA, P=.36; PAC, P=.52; and GSE, P=.06).

Conclusions: We identified psychological RFs that prospectively predict resilience and cofluctuate with weekly SR within individuals. These prospective results endorse that the previously reported RF-SR associations do not exclusively reflect mood congruency or other temporal bias effects. We further confirm the important role of PA in resilience.

Keywords: COVID-19; mental health; pandemic; positive appraisal; resilience; stressor reactivity.

©Sophie A Bögemann, Lara M C Puhlmann, Carolin Wackerhagen, Matthias Zerban, Antje Riepenhausen, Göran Köber, Kenneth S L Yuen, Shakoor Pooseh, Marta A Marciniak, Zala Reppmann, Aleksandra Uściƚko, Jeroen Weermeijer, Dionne B Lenferink, Julian Mituniewicz, Natalia Robak, Nina C Donner, Merijn Mestdagh, Stijn Verdonck, Rolf van Dick, Birgit Kleim, Klaus Lieb, Judith M C van Leeuwen, Dorota Kobylińska, Inez Myin-Germeys, Henrik Walter, Oliver Tüscher, Erno J Hermans, Ilya M Veer, Raffael Kalisch. Originally published in JMIR Mental Health (https://mental.jmir.org), 17.10.2023.

PubMed Disclaimer

Conflict of interest statement

Conflicts of Interest: RK has received advisory honoraria from JoyVentures, Herzlia, and Israel.

Figures

**Figure 1**
Study design and hypotheses. To test the described hypotheses, the variables of interest were assessed at baseline (BL) and at 5 weekly follow-ups. The arrows indicate the hypothesized directions of statistical effects between the variables. At BL, resilience factors (RFs) were mostly assessed as general styles (subscript S) or traits (subscript T), while at the follow-ups, RFs were assessed as weekly modes (subscript M), that is, how frequent or extensively a certain RF was expressed during the preceding week. For each RF assessed as mode, an average weekly mode was also calculated, as the mean value across time points. Abbreviations: PA_S: positive appraisal style; OPT_T: optimism (trait); REC_S: perceived good stress recovery (style); PSS_S: perceived social support (style); CSS_M: perceived change in social support during the COVID-19 pandemic (mode); BC_S: behavioral coping style; NEU_T: neuroticism (trait); PAC_M: positive appraisal specifically of the COVID-19 pandemic (mode); GSE_M: general self-efficacy (mode); PSS_M: perceived social support (mode); PA_M: positive appraisal (mode); BC_M: behavioral coping (mode); SR: stressor reactivity.

**Figure 2**
Association of baseline resilience factors (RFs) with stressor reactivity (SR). The β coefficients show associations from separate multiple regression analyses for each baseline RF with baseline SR (testing hypothesis H1: cross-sectional association) and average SR across the weekly longitudinal follow-ups (testing H2: prospective prediction). Negative associations suggest that factors contribute to dampening mental health reactivity to stressor exposure, that is, they promote resilience. Error bars depict 95% CIs. Abbreviations: PA_S: positive appraisal style; PAC_M: positive appraisal specifically of the COVID-19 pandemic (mode); OPT_T: optimism (trait); GSE_M: general self-efficacy (mode); REC_S: perceived good stress recovery (style); PSS_S: perceived social support (style); CSS_M: perceived change in social support during the COVID-19 pandemic (mode); BC_S: behavioral coping style; NEU_T: neuroticism (trait).

**Figure 3**
Association of weekly measured resilience factors (RFs) with weekly stressor reactivity (SR). The β coefficients show associations from separate mixed effects analyses for each weekly measured RF mode with SR measured at the same time points (testing hypothesis H3: contemporaneous association) and SR measured 1 week later (t+1) in the longitudinal follow-ups (testing H4: lagged RF-SR association). Error bars depict 95% CIs. Abbreviations: PA_M: positive appraisal (mode); PAC_M: positive appraisal specifically of the COVID-19 pandemic (mode); GSE_M: general self-efficacy (mode); PSS_M: perceived social support (mode); BC_M: behavioral coping (mode).

**Figure 4**
Association of weekly measured stressor exposure (E) with weekly lagged resilience factors (RFs). The β coefficients show associations from separate mixed effects analyses for each weekly measured E with RFs measured 1 week later (t+1) in the longitudinal follow-ups (testing H5: Lagged E-RF associations). Error bars depict 95% CIs. Abbreviations: PA_M: positive appraisal (mode); PAC_M: positive appraisal specifically of the COVID-19 pandemic (mode); GSE_M: general self-efficacy (mode); PSS_M: perceived social support (mode); BC_M: behavioral coping (mode).

See this image and copyright information in PMC

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Psychological Resilience Factors and Their Association With Weekly Stressor Reactivity During the COVID-19 Outbreak in Europe: Prospective Longitudinal Study

Affiliations

Psychological Resilience Factors and Their Association With Weekly Stressor Reactivity During the COVID-19 Outbreak in Europe: Prospective Longitudinal Study

Authors

Affiliations

Abstract

Conflict of interest statement

Figures

References

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Full Text Sources

Research Materials