Resilience level and its association with maladaptive coping behaviours in the COVID-19 pandemic: a global survey of the general populations

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Abstract

Background

The coronavirus disease 2019 (COVID-19) pandemic has induced a significant global concern on mental health. However few studies have measured the ability of individuals to “withstand setbacks, adapt positively, and bounce back from adversity” on a global scale. We aimed to examine the level of resilience, its determinants, and its association with maladaptive coping behaviours during the pandemic.

Methods

The Association of Pacific Rim Universities (APRU) conducted a global survey involving 26 countries by online, self-administered questionnaire (October 2020-December 2021). It was piloted-tested and validated by an expert panel of epidemiologists and primary care professionals. We collected data on socio-demographics, socioeconomic status, clinical information, lifestyle habits, and resilience levels measured by the Brief Resilience Scale (BRS) among adults aged ≥ 18 years. We examined factors associated with low resilience level, and evaluated whether low resilience was correlated with engagement of maladaptive coping behaviours.

Results

From 1,762 surveys, the prevalence of low resilience level (BRS score 1.00–2.99) was 36.4% (America/Europe) and 24.1% (Asia Pacific). Young age (18–29 years; adjusted odds ratio [aOR] = 0.31–0.58 in older age groups), female gender (aOR = 1.72, 95% C.I. = 1.34–2.20), poorer financial situation in the past 6 months (aOR = 2.32, 95% C.I. = 1.62–3.34), the presence of one (aOR = 1.56, 95% C.I. = 1.19–2.04) and more than two (aOR = 2.32, 95% C.I. = 1.59–3.39) medical conditions were associated with low resilience level. Individuals with low resilience were significantly more likely to consume substantially more alcohol than usual (aOR = 3.84, 95% C.I. = 1.62–9.08), take considerably more drugs (aOR = 12.1, 95% C.I. = 2.72–54.3), buy supplements believed to be good for treating COVID-19 (aOR = 3.34, 95% C.I. = 1.56–7.16), exercise less than before the pandemic (aOR = 1.76, 95% C.I. = 1.09–2.85), consume more unhealthy food than before the pandemic (aOR = 2.84, 95% C.I. = 1.72–4.67), self-isolate to stay away from others to avoid infection (aOR = 1.83, 95% C.I. = 1.09–3.08), have an excessive urge to disinfect hands for avoidance of disease (aOR = 3.08, 95% C.I. = 1.90–4.99) and transmission (aOR = 2.54, 95% C.I. = 1.57–4.10).

Conclusions

We found an association between low resilience and maladaptive coping behaviours in the COVID-19 pandemic. The risk factors identified for low resilience in this study were also conditions known to be related to globalization-related economic and social inequalities. Our findings could inform design of population-based, resilience-enhancing intervention programmes.

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Most cited references 47

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Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention

Zunyou Wu, Jennifer M. McGoogan (2020)

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Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC).

Kathryn M Connor, Jonathan Davidson (2003)

Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.

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Prevalence of stress, anxiety, depression among the general population during the COVID-19 pandemic: a systematic review and meta-analysis

Nader Salari, Amin Hosseinian-Far, Rostam Jalali … (2020)

Background The COVID-19 pandemic has had a significant impact on public mental health. Therefore, monitoring and oversight of the population mental health during crises such as a panedmic is an immediate priority. The aim of this study is to analyze the existing research works and findings in relation to the prevalence of stress, anxiety and depression in the general population during the COVID-19 pandemic. Method In this systematic review and meta-analysis, articles that have focused on stress and anxiety prevalence among the general population during the COVID-19 pandemic were searched in the Science Direct, Embase, Scopus, PubMed, Web of Science (ISI) and Google Scholar databases, without a lower time limit and until May 2020. In order to perform a meta-analysis of the collected studies, the random effects model was used, and the heterogeneity of studies was investigated using the I2 index. Moreover. data analysis was conducted using the Comprehensive Meta-Analysis (CMA) software. Results The prevalence of stress in 5 studies with a total sample size of 9074 is obtained as 29.6% (95% confidence limit: 24.3–35.4), the prevalence of anxiety in 17 studies with a sample size of 63,439 as 31.9% (95% confidence interval: 27.5–36.7), and the prevalence of depression in 14 studies with a sample size of 44,531 people as 33.7% (95% confidence interval: 27.5–40.6). Conclusion COVID-19 not only causes physical health concerns but also results in a number of psychological disorders. The spread of the new coronavirus can impact the mental health of people in different communities. Thus, it is essential to preserve the mental health of individuals and to develop psychological interventions that can improve the mental health of vulnerable groups during the COVID-19 pandemic.

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Author and article information

Contributors

Martin C. S. Wong: wong_martin@cuhk.edu.hk

Mellissa Withers: mwithers@usc.edu

Journal

Journal ID (nlm-ta): Global Health

Journal ID (iso-abbrev): Global Health

Title: Globalization and Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1744-8603

Publication date (Electronic): 3 January 2023

Publication date PMC-release: 3 January 2023

Publication date Collection: 2023

Volume: 19

Electronic Location Identifier: 1

Affiliations

[1 ]GRID grid.10784.3a, ISNI 0000 0004 1937 0482, JC School of Public Health and Primary Care, Faculty of Medicine, , The Chinese University of Hong Kong, ; Hong Kong, China

[2 ]GRID grid.10784.3a, ISNI 0000 0004 1937 0482, Centre for Health Education and Health Promotion, Faculty of Medicine, , The Chinese University of Hong Kong, ; Hong Kong, China

[3 ]GRID grid.10784.3a, ISNI 0000 0004 1937 0482, Department of Sports Science and Physical Education, , The Chinese University of Hong Kong, ; Hong Kong, China

[4 ]GRID grid.12981.33, ISNI 0000 0001 2360 039X, School of Public Health, , Sun Yat-Sen University, ; Guangzhou, China

[5 ]GRID grid.511083.e, ISNI 0000 0004 7671 2506, The Seventh Affiliated Hospital, Sun Yat-Sen University, ; Shenzhen, China

[6 ]GRID grid.8547.e, ISNI 0000 0001 0125 2443, Department of Epidemiology, School of Public Health, , Fudan University, ; Shanghai, China

[7 ]GRID grid.11135.37, ISNI 0000 0001 2256 9319, Department of Global Health, School of Public Health, , Peking University, ; Beijing, China

[8 ]GRID grid.412498.2, ISNI 0000 0004 1759 8395, Center for Experimental Economics in Education, , Shaanxi Normal University, ; Xi’an, China

[9 ]GRID grid.506261.6, ISNI 0000 0001 0706 7839, School of Population Medicine and Public Health, , Chinese Academy of Medical Sciences & Peking Union Medical College, ; Beijing, China

[10 ]GRID grid.16821.3c, ISNI 0000 0004 0368 8293, North Ruijin Hospital, Shanghai Jiaotong University, ; Shanghai, China

[11 ]GRID grid.449728.4, Institute of Management, , University of the Philippines Baguio, ; Baguio, Philippines

[12 ]GRID grid.7922.e, ISNI 0000 0001 0244 7875, College of Public Health Sciences, , Chulalongkorn University, ; Bangkok, Thailand

[13 ]GRID grid.412251.1, ISNI 0000 0000 9008 4711, Instituto de Investigaciones en Biomedicina iBioMed, , Universidad San Francisco de Quito, ; Quito, Ecuador

[14 ]GRID grid.412251.1, ISNI 0000 0000 9008 4711, Colegio de Ciencias de La Salud, Escuela de Medicina, Universidad San Francisco de Quito, ; Quito, Ecuador

[15 ]GRID grid.412251.1, ISNI 0000 0000 9008 4711, Sistemas Médicos SIME, Universidad San Francisco de Quito, ; Quito, Ecuador

[16 ]GRID grid.9486.3, ISNI 0000 0001 2159 0001, Institute of Legal Research, , National Autonomous University of Mexico (UNAM), ; Mexico, Mexico

[17 ]GRID grid.17091.3e, ISNI 0000 0001 2288 9830, Department of Psychiatry, Faculty of Medicine, , The University of British Columbia, ; Vancouver, Canada

[18 ]GRID grid.5808.5, ISNI 0000 0001 1503 7226, i3S-Instituto de Investigação E Inovação Em Saúde, , Universidade Do Porto, ; Porto, Portugal

[19 ]GRID grid.42505.36, ISNI 0000 0001 2156 6853, Department of Population and Public Health Sciences, APRU Global Health Program, Keck School of Medicine, , University of Southern California, ; Soto Street Building, MC 9239, Los Angeles, CA 90089-9239 USA

Article

Publisher ID: 903

DOI: 10.1186/s12992-022-00903-8

PMC ID: 9808687

PubMed ID: 36597129

SO-VID: 172f024d-0abf-4657-8d11-717b3c8e7603

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 24 August 2022

Date accepted : 21 December 2022

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: covid-19,pandemic,resilience,maladaptive coping behaviours

Data availability:

ScienceOpen disciplines: Health & Social care

Keywords: covid-19, pandemic, resilience, maladaptive coping behaviours

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