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. 2023 Nov-Dec;21(6):508-516.
doi: 10.1370/afm.3046.

Veterans and Nonveterans Coping With Stress During 4 Months of COVID-19

Jorie M Butler  1   2   3 , Xuechen Wang  4 , Marian Riddoch  4 , Alistair Thorpe  4 , Vanessa Stevens  2   4 , Laura D Scherer  5   6 , Frank A Drews  2   7 , Holly Shoemaker  2   4 , Angela Fagerlin  2   4
Affiliations

Veterans and Nonveterans Coping With Stress During 4 Months of COVID-19

Jorie M Butler et al. Ann Fam Med. 2023 Nov-Dec.

Abstract

Purpose: Identifying how people have been coping with stress during the COVID-19 pandemic allows us to anticipate how the population may react to similar stressors over time. In this study, we assessed patterns of coping styles among veterans and nonveterans, and stability and change in these strategies at 3 time points during the pandemic.

Methods: Using an online survey platform, we circulated a questionnaire at 3 time points during the period when COVID-19 vaccines became widely available (December 2-27, 2020; January 21-February 6, 2021; and March 8-23, 2021). The questionnaire asked participants about their extent of use of 11 coping strategies, and symptoms of anxiety and depression.

Results: A total of 2,085 participants (50.8% veterans) completed the questionnaire at 1 or more time points and 930 participants (62.8% veterans) completed it at all 3 time points. Cluster analysis identified 3 distinct coping styles: adaptive, distressed, and disengaged. Compared with nonveterans, veterans more commonly had adaptive and disengaged coping styles, and less commonly had a distressed coping style. The majority of the cohort (71.3%) changed coping style at least once during the study period. Participants who used the same coping style across all 3 time points reported lower levels of anxiety and depression.

Conclusions: Our data demonstrate a need to better understand the dynamic nature of coping with pandemic-level stressors across time. We did not find patterns of change in coping styles, but our findings point to potential advantages of stability in coping style. It is possible that less adaptive styles that are more stable may be advantageous for mental health. This research has implications for supporting patients dealing with stress in family medicine.

Keywords: COVID-19; anxiety; coping styles; depression; mental health; pandemic; psychological distress; resilience, psychological; stress and coping; veteran.

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Figures

Figure 1.
Figure 1.
Coping style clusters and their component strategies at 3 time points. Notes: The adaptive, distressed, and disengaged clusters (coping styles) were based on the extent of use of the 11 coping strategies (see Methods for details).
Figure 1.
Figure 1.
Coping style clusters and their component strategies at 3 time points. Notes: The adaptive, distressed, and disengaged clusters (coping styles) were based on the extent of use of the 11 coping strategies (see Methods for details).
Figure 1.
Figure 1.
Coping style clusters and their component strategies at 3 time points. Notes: The adaptive, distressed, and disengaged clusters (coping styles) were based on the extent of use of the 11 coping strategies (see Methods for details).
Figure 2.
Figure 2.
Coping style clusters at 3 points in time. Note: Time 1 spanned December 2-27, 2020; Time 2 spanned January 21-February 6, 2021; and Time 3 spanned March 8-23, 2021.
See this image and copyright information in PMC

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