STUDY: Trajectories of change in internalizing symptoms during the COVID-19 pandemic: A longitudinal population-based study

Background: Longitudinal data indicates that the mental health of the general population may not have been as badly affected by the COVID-19 pandemic as some had feared. Most studies examining change in mental health during the pandemic have assumed population homogeneity which may conceal evidence of worsening mental health for some. In this study, we applied a heterogeneous perspective to determine if there were distinct groups in the population characterised by different patterns of change in internalizing symptoms during the pandemic. Methods: Self-report data were collected from a nationally representative sample of Irish adults (N = 1,041) at four time-points between April and December 2020. Results: In the entire sample, mean levels of internalizing symptoms significantly declined from March to December 2020. However, we identified four distinct groups with different patterns of change. The most common response was ‘Resilience’ (66.7%), followed by ‘Improving’ (17.9%), ‘Worsening’ (11.3%), and ‘Sustained’ (4.1%). Belonging to the ‘Worsening’ class was associated with younger age, city dwelling, current and past treatment for a mental health problem, higher levels of empathy, and higher levels of loneliness. Limitations: Sample attrition was relatively high and although this was managed using robust statistical methods, bias associated with non-responses cannot be entirely ruled out. Conclusion: The majority of adults experienced no change, or an improvement in internalizing symptoms during the pandemic, and a relatively small proportion of adults experienced a worsening of internalizing symptoms. Limited public mental health resources should be targeted toward helping these at-risk individuals.

背景：纵向数据分析表明，与部分人原先所担忧的相比，普通民众的心理健康状况可能并未受到COVID-19疫情的严重冲击。大多数研究在考察疫情期间心理健康状况的变化时，均假设人群的同质性，这或许掩盖了部分人群心理健康状况恶化的证据。在本研究中，我们采取异质性视角，旨在探究人群中是否存在因疫情期间内部化症状变化模式不同而形成的特定群体。方法：通过自评数据收集了来自爱尔兰全国代表性样本（N = 1,041）的成年人（2020年4月至12月间四个时间点的数据）。结果：在整个样本中，内部化症状的平均水平从2020年3月到12月显著下降。然而，我们识别出四个具有不同变化模式的特定群体。最常见的反应为‘韧性’（占比66.7%），其次是‘改善’（占比17.9%）、‘恶化’（占比11.3%）和‘持续’（占比4.1%）。属于‘恶化’类别的个体通常年龄较轻，居住在城市，目前或曾接受心理健康问题的治疗，具有较高的同理心水平和孤独感水平。局限性：样本流失率相对较高，尽管我们运用了稳健的统计方法进行处理，但仍无法完全排除因未响应而产生的偏差。结论：疫情期间，大多数成年人并未经历内部化症状的变化，或症状有所改善，而只有相对较少的成年人经历了内部化症状的恶化。有限的公共心理健康资源应针对这些高风险个体进行分配。