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Individual differences in the long-term impact of the pandemic: moderators of COVID-related hardship, worry, and social support

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Abstract

Purpose

Understanding people’s response to the pandemic needs to consider individual differences in priorities and concerns. The present study sought to understand how individual differences in cognitive-appraisal processes might moderate the impact of three COVID-specific factors—hardship, worry, and social support—on reported depression.

Methods

This longitudinal study of the psychosocial impact of the COVID-19 pandemic included 771 people with data at three timepoints over 15.5 months. Participants were recruited from panels of chronically ill or general population samples. Depression was measured by an item response theory validated depression index created using items from existing measures that reflected similar content to the Patient Health Questionnaire-8. COVID-specific factors of hardship, worry, and social support were assessed with items compiled by the National Institutes of Health. The Quality of Life Appraisal Profilev2 Short-Form assessed cognitive appraisal processes. A series of random effects models examined whether appraisal moderated the effects of hardship, worry, and social support on depression over time.

Results

Over time the association between low social support and depression was greater (p = 0.0181). Emphasizing the negative was associated with exacerbated depression, in particular for those with low social support (p = 0.0007). Focusing on demands and habituation was associated with exacerbated depression unless one experienced greater hardship (p = 0.0074). There was a stronger positive connection between recent changes and depression for those people with higher worry scores early in the pandemic as compared to later, but a stronger positive correlation for those with lower worry scores later in the pandemic (p = 0.0015). Increased endorsement of standards of comparison, emphasizing the negative, problem goals, and health goals was associated with worse depression scores (all p < 0.0001). People who were younger, disabled, or had greater difficulty paying bills also reported worse depression (p < 0.0001, 0.0001, and 0.002, respectively).

Conclusion

At the aggregate level, COVID-specific stressors changed over the course of the pandemic, whereas depression and social-support resources seemed stable. However, deeper analysis revealed substantial individual differences. Cognitive-appraisal processes showed considerable variability across individuals and moderated the impact of COVID-specific stressors and resources over time. Future work is needed to investigate whether coaching individuals away from maladaptive cognitive-appraisal processes can reduce depression and lead to better overall well-being.

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Data availability

The study data are confidential and thus not able to be shared.

Notes

  1. To take into account that we are modeling the intersection of multiple individual-level predictors, i.e., the interaction between levels of appraisal scores, COVID-specific stressors, and time.

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Acknowledgements

We are grateful to Wesley Michael, M.B.A., of Rare Patient Voice, LLC, and IPSOS-Insight, LLC, for facilitating access to participants; and to the participants themselves who provided data for this project.

Funding

This work was not funded by an external organization or grant.

Author information

Authors and Affiliations

  1. DeltaQuest Foundation, Inc., 31 Mitchell Road, Concord, MA, USA

    Carolyn E. Schwartz & Katrina Borowiec

  2. Departments of Medicine and Orthopaedic Surgery, Tufts University Medical School, Boston, MA, USA

    Carolyn E. Schwartz

  3. Department of Measurement, Evaluation, Statistics, & Assessment, Boston College Lynch School of Education and Human Development, Chestnut Hill, MA, USA

    Katrina Borowiec

  4. Department of Psychiatry & Behavioral Sciences and the Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Yuelin Li

  5. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA

    Bruce D. Rapkin

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Contributions

CES and BDR designed the research study. CES and KB analyzed the data. CES wrote the paper, and KB and BDS edited the manuscript. All authors read and approved the final manuscript.

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Correspondence to Carolyn E. Schwartz.

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The protocol was reviewed and approved by the New England Independent Review Board (NEIRB #2021164).

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All participants agreed to their data being published in a journal article.

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Schwartz, C.E., Borowiec, K., Li, Y. et al. Individual differences in the long-term impact of the pandemic: moderators of COVID-related hardship, worry, and social support. Qual Life Res 33, 927–939 (2024). https://doi.org/10.1007/s11136-023-03573-0

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