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The impact of psychological strengths on Veteran populations’ mental health trajectories during the COVID-19 pandemic

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Abstract

Purpose

Mental health trajectories during the COVID-19 pandemic have been examined in Veterans with tenuous social connections, i.e., those with recent homelessness (RHV) or a psychotic disorder (PSY), and in control Veterans (CTL). We test potential moderating effects on these trajectories by psychological factors that may help individuals weather the socio-emotional challenges associated with the pandemic (i.e., ‘psychological strengths’).

Methods

We assessed 81 PSY, 76 RHV, and 74 CTL over 5 periods between 05/2020 and 07/2021. Mental health outcomes (i.e., symptoms of depression, anxiety, contamination concerns, loneliness) were assessed at each period, and psychological strengths (i.e., a composite score based on tolerance of uncertainty, performance beliefs, coping style, resilience, perceived stress) were assessed at the initial assessment. Generalized models tested fixed and time-varying effects of a composite psychological strengths score on clinical trajectories across samples and within each group.

Results

Psychological strengths had a significant effect on trajectories for each outcome (ps < 0.05), serving to ameliorate changes in mental health symptoms. The timing of this effect varied across outcomes, with early effects for depression and anxiety, later effects for loneliness, and sustained effects for contamination concerns. A significant time-varying effect of psychological strengths on depressive symptoms was evident in RHV and CTL, anxious symptoms in RHV, contamination concerns in PSY and CTL, and loneliness in CTL (ps < 0.05).

Conclusion

Across vulnerable and non-vulnerable Veterans, presence of psychological strengths buffered against exacerbations in clinical symptoms. The timing of the effect varied across outcomes and by group.

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Data availability

Deidentified data are available upon request.

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Acknowledgements

We extend our gratitude to our recruiters and interviewers without whom this work would not have been possible: Lauren Catalano, PhD, Gerard De Vera, Arpi Hasratian, Julio Iglesias, Brian Ilagan, Mark McGee, Jessica McGovern, PhD, Ana Ceci Myers, Megan Olsen, and Michelle Torreliza. Finally, we thank our Veteran volunteers for taking the time to participate in this research. This study was funded by the Research Enhancement Award Program to Enhance Community Integration in Homeless Veterans (MFG) Rehabilitation Research and Development grant D1875-F from the Department of Veteran Affairs, https://www.research.va.gov/, and by the VA National Center on Homelessness among Veterans (MFG), https://www.va.gov/homeless/nchav/index.asp. Amanda McCleery, PhD, is supported by a career development award from National Institute of Mental Health (K23MH108829). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The contents of this article do not represent the views of the United States Department of Veterans Affairs or the United States Government.

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Authors and Affiliations

  1. Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242, USA

    Amanda McCleery

  2. Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA

    Amanda McCleery, Jonathan K. Wynn, Derek M. Novacek, Eric A. Reavis, Damla Senturk, Catherine A. Sugar & Michael F. Green

  3. VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA

    Jonathan K. Wynn, Derek M. Novacek, Eric A. Reavis & Michael F. Green

  4. Department of Biostatistics, University of California, Los Angeles, CA, USA

    Damla Senturk & Catherine A. Sugar

  5. VA National Center on Homelessness Among Veterans, Washington, DC, USA

    Jack Tsai

  6. School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA

    Jack Tsai

  7. Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA

    Jack Tsai

Authors
  1. Amanda McCleery
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  2. Jonathan K. Wynn
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  3. Derek M. Novacek
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  4. Eric A. Reavis
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  5. Damla Senturk
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  6. Catherine A. Sugar
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  7. Jack Tsai
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  8. Michael F. Green
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Contributions

AM, JKW, CS, JT, EAR, and MFG: contributed to the conception of the study and the research design. AM, JKW, and DMN: contributed to data acquisition and project management. AM, JKW, EAR, DS, CS, and MFG: contributed to analysis and interpretation of the data. AM: wrote the main manuscript text, and JKW: prepared the figures. All authors contributed to reviewing and editing the manuscript.

Corresponding author

Correspondence to Amanda McCleery.

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The authors declare that they have no conflict of interest.

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McCleery, A., Wynn, J.K., Novacek, D.M. et al. The impact of psychological strengths on Veteran populations’ mental health trajectories during the COVID-19 pandemic. Soc Psychiatry Psychiatr Epidemiol 59, 111–120 (2024). https://doi.org/10.1007/s00127-023-02518-9

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