Mediating Effects of Social Support and Resilience on the Association between COVID-19-Related Stress and Mental Health in Korean Young Adults

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Abstract

Young adults were vulnerable to mental health issues during the COVID-19 pandemic. However, the underlying pathway by which COVID-19-related stress influences mental health outcomes among young adults remains unclear. This study aimed to examine the mediating effects of social support and resilience between COVID-19-related stress and mental health outcomes. A sample of 1000 Korean young adults was obtained via online survey. Participants completed self-report questionnaires assessing COVID-19-related stress, social support, resilience, depression, and anxiety. Overall, 48.1% and 23.4% of participants were classified as having depression and anxiety states, respectively. Path analysis using AMOS version 26.0 (IBM Corp., Armonk, NY, USA) showed that the direct effects of stress from social distancing difficulties on depression and anxiety were much greater than those of stress from fear of infection and anger toward others. In addition, there were significant indirect effects of social support and resilience in the relationship between stress related to difficulties due to social distancing and mental health outcomes. The mediating roles of social support and resilience suggest that interventions to increase these factors can be effective strategies to reduce the risks of depression and anxiety among young adults suffering from stress related to social distancing difficulties.

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Resilience may be viewed as a measure of stress coping ability and, as such, could be an important target of treatment in anxiety, depression, and stress reactions. We describe a new rating scale to assess resilience. The Connor-Davidson Resilience scale (CD-RISC) comprises of 25 items, each rated on a 5-point scale (0-4), with higher scores reflecting greater resilience. The scale was administered to subjects in the following groups: community sample, primary care outpatients, general psychiatric outpatients, clinical trial of generalized anxiety disorder, and two clinical trials of PTSD. The reliability, validity, and factor analytic structure of the scale were evaluated, and reference scores for study samples were calculated. Sensitivity to treatment effects was examined in subjects from the PTSD clinical trials. The scale demonstrated good psychometric properties and factor analysis yielded five factors. A repeated measures ANOVA showed that an increase in CD-RISC score was associated with greater improvement during treatment. Improvement in CD-RISC score was noted in proportion to overall clinical global improvement, with greatest increase noted in subjects with the highest global improvement and deterioration in CD-RISC score in those with minimal or no global improvement. The CD-RISC has sound psychometric properties and distinguishes between those with greater and lesser resilience. The scale demonstrates that resilience is modifiable and can improve with treatment, with greater improvement corresponding to higher levels of global improvement. Copyright 2003 Wiley-Liss, Inc.