(PS6-D88) Modeling Trends in Mental Health over Time in the Context of a Global Pandemic: Effects of Trait Affirmation, Trait Defensiveness, and Drinking Patterns on PHQ-4

Rationale: The COVID-19 pandemic has presented a powerful threat to people’s sense of physical wellbeing. This threat was especially salient in the first year of the pandemic when rates of death following infection were high and no vaccine was available. According to theory from social psychology, people often react defensively when their feelings of self-integrity are threatened, seeking to avoid the threat physically and/or mentally. Moreover, drinking alcohol is one way that people cope with feeling threatened, as low doses of alcohol can reduce rumination. This study explores the hypotheses that, in the context of the early stages of the COVID-19 pandemic, elevated trait defensiveness and alcohol use were risk factors for worsening mental health over time, and elevated trait affirmation was protective against this trend.

Methods: This study uses longitudinal data from a randomized controlled trial (RCT) of an alcohol use intervention in a sample of undergraduate students (aged 18-24) in the Northeast of the United States of America. All the students in the broader RCT were mandated to complete an alcohol education program following a first-time violation of campus alcohol policy. The students in the sample used for these analyses (N=51, 37% female, 63% first year students) were recruited during the fall of 2020 and enrolled in the minimal control condition, a brief evidence-based online behavior intervention designed to help people recognize and reduce high-risk alcohol use. Measurements of trait affirmation and defensiveness were taken at baseline, and measurements of drinking patterns and mental health were taken at baseline and 1, 3, and 6 months post-intervention.

Results: Generalized estimating equation modeling was used to evaluate the differential effects of trait affirmation, trait defensiveness, and drinking behavior on mental health, as measured by the PHQ-4 scale. Analyses indicated a significant positive relationship (β=.860, p=.025) between the measure of trait defensiveness and PHQ-4, indicating that participants with higher levels of trait defensiveness tended to have greater levels of anxiety and/or depression. The measures of trait affirmation (β=-.153, p=.556) and drinking patterns (β=.104, p=.301) had non-significant relationships with PHQ-4.

Conclusions: These findings suggest that elevated trait defensiveness may be a risk factor for increased symptoms of anxiety and depression, at least among college students and in the context of a pandemic. Further research is needed to elucidate potential causal mechanisms of this association, which may facilitate the development of interventions capable of ameliorating this risk.