(PS2-A4) Examining the Prospective Role of Emotion Regulation Difficulties and Perceived Stress on Traumatic Stress, Anxiety, and Safety Behavior Use During a Chronic Stressor: A Four-year Longitudinal Study

The coronavirus pandemic (COVID-19) has had devastating societal impacts, including millions of lives lost, high rates of unemployment, and a multitude of negative economic consequences. The COVID-19 pandemic may be conceptualized as a chronic stressor that may shed light on robust risk factors for anxious responding to other chronic life stressors. For instance, given that emotion regulation difficulties confer risk for poor responses to stress, they may predict who is at risk for adverse psychological reactions to major chronic stressors such as the COVID-19 pandemic.

Specific adverse reactions to the pandemic may include more severe traumatic stress, anxiety, and excessive safety behavior use (i.e., excessive hand washing). While emotion regulation difficulties may be a diathesis for adverse reactions to chronic stressors, the context(s) by which they confer elevated risk remains unclear. Accordingly, the present longitudinal study examined the interaction between pre-pandemic emotion regulation difficulties and early pandemic perceived stress in predicting subsequent COVID-related traumatic stress, anxiety, and safety behavior use over 32 weeks of the pandemic.

Community adults (N = 145) who completed a measure of emotion regulation in 2016 as part of a larger study were recontacted at the start of the pandemic (March 2020) and assessed every two weeks for 32 weeks. The age of the present sample ranged from 23 to 65 years old (M = 46.53, SD = 13.26), and the sample was predominantly female (n = 126, 86.9%) and White (n = 132; 91.0%). Consistent with a diathesis-stress model, the interaction between difficulties in emotion regulation in 2016 and perceived stress early in 2020 was marginally significant in predicting COVID-19 traumatic stress (Estimate = 0.004, SE = 0.002, t(136.90) = 1.81, p = .073) and safety behavior use (Estimate = 0.025, SE = 0.014, t(139.24) = 1.83, p = .069).

Furthermore, the interaction between difficulties in emotion regulation and perceived stress was significant in predicting COVID-19 anxiety (Estimate = 0.004, SE = 0.001, t(137.27) = 3.07, p = .003) such that at high, but not low, levels of perceived stress, difficulties in emotion regulation in 2016 significantly predicts higher coronavirus anxiety in 2020. These findings highlight that current perceived stress is an important context that potentiates the effects of preexisting emotion regulation difficulties on the emergence of anxiety-related symptoms during COVID-19. These findings will be discussed in the context of diathesis-stress models of adverse reactions to chronic stressors.