Modeling pandemic depression and anxiety: The mediational role of core beliefs and meaning making

BACKGROUND: The aim of this research was to examine core belief violation and disrupted meaning making as primary cognitive processes regulating mental health during the pandemic. The study tested the hypothesis that both these cognitive processes function as mediating mechanisms, accounting for the adverse mental health effects of multiple pandemic stressors. METHODS: A survey design (N = 2380) assessed demographic variables associated with poor pandemic mental health (gender, age, ethnicity, education), direct COVID stressors (diagnosis, death), indirect COVID stressors (unemployment, increased living costs, childcare loss), core belief violation, meaning made of the pandemic, coronavirus anxiety (CA), depression, and general anxiety. RESULTS: Core belief violation and disrupted meaning making explained the severity of depression, general anxiety, and CA to a significantly greater degree than did demographics, direct COVID stressors, and indirect COVID stressors combined. In addition, core belief violation and disrupted meaning making significantly mediated the impact of direct and indirect COVID stressors on all mental health outcomes. Specifically, each stressor was associated with increased core belief violation and decreased meaning making of the pandemic, in turn, those whose core beliefs were violated and those who made less meaning of the pandemic experienced greater depression, general anxiety, and CA. LIMITATIONS: The use of a cross-sectional design prohibited assessment of alternative causal orders. CONCLUSIONS: This study describes the first unifying model of pandemic mental health, establishing violation of core beliefs and the inability to make meaning of the pandemic as targets for clinical intervention in the context diverse pandemic stressors.