Stressors, coping and symptoms of adjustment disorder in the course of COVID-19 pandemic – Study protocol of the European Society for Traumatic Stress Studies (ESTSS) pan-European study

European Journal of Psychotraumatology

Annett Lotzin, Elena Acquarini, Dean Ajdukovic, Vittoria Ardino, Maria Böttche, Kristina Bondjers, Maria Bragesjö, Małgorzata Dragan, Piotr Grajewski, Margarida Figueiredo-Braga, Odeta Gelezelyte, Jana Darejan Javakhishvili, Evaldas Kazlauskas, Matthias Knefel, Brigitte Lueger-Schuster, Nino Makhashvili, Trudy Mooren, Luisa Sales, Aleksandra Stevanovic & Ingo Schäfer

https://doi.org/10.1080/20008198.2020.1780832

Abstract

Background: During the current COVID 19 pandemic, people in Europe are exposed to self-isolation, quarantine, job loss, risk of contracting COVID-19, or grief of loved ones. Such a complex array of stressors may lead to symptoms of adjustment disorder or posttraumatic stress disorder. This research protocol describes a study launched by the European Society of Traumatic Stress Studies (ESTSS) to investigate the impact of the COVID-19 pandemic on symptoms of adjustment disorder across eleven European countries.

Objective: The longitudinal online cohort study aims to (1) explore psychosocial reactions to the COVID-19 pandemic across eleven European countries; (2) examine the relationships between risk and resilience factors, stressors and symptoms of adjustment disorder during the pandemic; and (3) investigate whether these relationships are moderated by coping behaviors.

Method: In eleven countries (Austria, Croatia, Georgia, Germany, Italy, Lithuania, Netherlands, Norway, Poland, Portugal, and Sweden) between 1,000 and 2,000 participants will be recruited, depending on the size of the country. Participants will be assessed at two timepoints with a six-month interval. Following a conceptual framework based on the WHO’s social framework of health, an assessment of risk and resilience factors, COVID-19 related stressors and pandemic-specific coping behavior will be measured to estimate their contribution to symptoms of adjustment disorder. The Adjustment Disorder New Module 8 (ADNM-8) will be used to measure symptoms of adjustment disorder. As a secondary measure, symptoms of posttraumatic stress disorder will be assessed using the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5).

Data analysis: The relative contribution of risk factors, resilience factors, and stressors on symptoms of adjustment disorder or symptoms of posttraumatic stress disorder will be estimated using multilevel analyses. To determine the moderating effects of different types
of coping behavior on these relationships, a multilevel mediation analysis will be carried out.

Keywords: COVID-19; pandemic; disaster; coronavirus; mental health; stressors; stress-related disorders; coping style; adjustment disorder; posttraumatic stress

Received 19 May 2020, Accepted 27 May 2020, Published online: 27 Aug 2020