Journal of Mental Health

ISSN: (Print) (Online) Journal homepage: https://www.tandfonline.com/loi/ijmh20

Coping strategies and mental health during

COVID-19 lockdown

Sanja Budimir, Thomas Probst & Christoph Pieh

To cite this article: Sanja Budimir, Thomas Probst & Christoph Pieh (2021): Coping
strategies and mental health during COVID-19 lockdown, Journal of Mental Health, DOI:
10.1080/09638237.2021.1875412

To link to this article: https://doi.org/10.1080/09638237.2021.1875412

Published online: 27 Jan 2021.

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JOURNAL OF MENTAL HEALTH
https://doi.org/10.1080/09638237.2021.1875412

ORIGINAL ARTICLE

Coping strategies and mental health during COVID-19 lockdown

Sanja Budimira,b , Thomas Probsta and Christoph Pieha
a
Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an der Donau, Austria; bDepartment of Work,
Organization and Society, Ghent University, Ghent, Belgium

ABSTRACT ARTICLE HISTORY

Background: COVID-19 pandemic lockdown measures changed the everyday lives of people around Received 17 June 2020
the world. Revised 18 November 2020
Aims: To evaluate the effects of different coping strategies on mental health during COVID- Accepted 3 December 2020
19 lockdown. Published online 15 January
2021
Methods: A representative sample for Austria was recruited through QualtricsV in a period of 4 weeks
R

after the lockdown started. Measurements were coping inventory (SCI), psychological quality of life KEYWORDS
(WHO-QOL BREF, psychological domain), well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), COVID-19; coping strategies;
stress (PSS-10), and insomnia (ISI). Regression analyses were performed with coping strategies as pre- mental health
dictors and mental health measures as dependent variables.
Results: The representative sample included N ¼ 1,005 respondents (52.7% women). Positive thinking, SUBJECT CLASSIFICATION CODES
active stress coping and social support were found to be positive predictors for psychological life qual- Mental Health; COVID-19;
ity, well-being, and negative predictors for perceived stress, depression, anxiety, and insomnia. Alcohol coping strategies
and cigarette consumption was a negative predictor for psychological life quality, and well-being, and
a positive predictor for perceived stress, depression, anxiety, and insomnia. Support in faith was a posi-
tive predictor for perceived stress, depression, anxiety, and insomnia.
Conclusions: Coping strategies are significant predictors for mental health measures. Education about
positive thinking, active coping, and social support could be beneficial for dealing with a decrease in
mental health due to COVID-19 pandemic.

Within 3 months of the first occurrence of COVID-19 in fear of disease and death, suffering because of social isola-
China, at the end of December of 2019, the spread of the tion, and having fears of losing jobs (IFRC, 2020).
disease caused a global health pandemic (WHO Int, 2020). The pandemic situation required increased medical care
As there was no available effective treatment, the WHO rec- and significant reorganization of the living styles and rou-
ommendation was to introduce quarantine to prevent a tines, caused mostly by enforcement of a lockdown with a
potential spread of the virus, isolation for people with limited movement. These changes raised concerns for men-
COVID-19 symptoms, and social distancing for people with- tal health, due to the fear of coronavirus transmission and
out symptoms (Nussbaumer-Streit et al., 2020). Like many unknown definite treatments (Ho et al., 2020), especially for
other governments around the world, the Austrian govern- people who contracted the disease, those with compromised
ment also accepted those recommendation, which officially immune systems, prior mental health problems, different
took place on 16th of March 2020, and lasted almost
disabilities, insecure living conditions and living in congre-
7 weeks, until 1st of May. Despite easing the measures of
gate settings, lower income, etc. (Douglas et al., 2020;
lockdown in Austria, to this day, a number of COVID-19
Pfefferbaum & North, 2020). A negative effect of stress,
victims is continuing to increase in Austria as well as in
worries, and fears due to the COVID-19 restrictions on
other world countries, leading to new lockdown measures.
On 15th of November, the number of COVID-19 infections mental health was shown to be associated with increased
counted 53,766,728 in the world, and 1,308,975 deaths in anxiety, post-traumatic stress symptoms, depression, insom-
the world (COVID-19, WHO, 2020). Although the first nia, high stress, adjustment disorder, and severe obsessive-
lockdown measures were beneficial for physical health by compulsive symptoms (Ahmad et al., 2020; Brooks et al.,
stopping the spread of coronavirus, they had a damaging 2020; Huang & Zhao, 2020; Kazmi et al., 2020;
effect on mental health (Brooks et al., 2020; Huang & Zhao, Moghanibashi-Mansourieh, 2020; Moreira et al., 2020;
2020; Kazmi et al., 2020; Pieh et al., 2020b; Rossi et al., Pancani et al., 2020; Pieh et al., 2020a, 2020b; Rossi et al.,
2020; Wang et al., 2020a). Common reactions in time of 2020; Ueda et al., 2020; Wang et al., 2020a; Zhang
pandemics could include feeling stressed, worried, having et al., 2020).

CONTACT Sanja Budimir [email protected] Department for Psychotherapy and Biopsychosocial Health, Danube University Krems, Krems an
der Donau, Austria
ß 2021 Informa UK Limited, trading as Taylor & Francis Group
2 S. BUDIMIR ET AL.

Despite the social interaction limitations during the lock- 2008). Protective coping strategies in stressful situations can
down, online interactions enabled social connections, con- also include active coping strategy, looking for positive,
tinuation of education, many forms of businesses, and debriefing, positive thinking, optimism, acceptance, purpose
communication of relevant information for physical and in life, humor, planning, positive reframing, and social sup-
psychological health. An accurate and updated information port (G. Colville et al., 2015; Luo et al., 2015; McPherson,
about available treatments, local outbreak situations, import- 2003; Rodr
ıguez-Rey et al., 2019; Smith et al., 2008).
ance of adopting precautionary measures was found to be As the negative psychological impact of the COVID-19
associated with a lower levels of stress, anxiety, and depres- outbreak is evident, there is a need to address ways of
sion (Wang et al., 2020a). increasing protective coping mechanisms that can improve
However, a lack of editorial control in social media can mental health, and possibly be used as a prevention meas-
also bring incorrect information, fake news, misconception, ure in the future. We measured effects of coping strategies
and rumors (Allgaier & Svalastog, 2015), which are shaping (positive thinking, alcohol and cigarette consumption,
people’s perception of risks, decisions, and behaviors (Tang active stress coping, support in faith, social support) on
et al., 2018), and possibly intensifying psychological fear and mental health (psychological life quality, wellbeing, per-
rumination about contracting disease with an effect on ceived stress, depression, anxiety and insomnia), 4 weeks
behavior and social interactions (Ho et al., 2020). following the COVID-19 lockdown in Austria. It is
Identification of mental health protective factors is an expected that engagement of adaptive coping strategies
important step in understanding people who are faced with (positive thinking, active stress coping, support in faith
health problems (Smith et al., 2008). The thoughts and and social support) will have a protective role for mental
behaviors that people use to manage stressful internal and health during COVID-19 lockdown (higher psychological
external demands of situations are defined as coping life quality and wellbeing, and lower perceived stress,
(Lazarus & Folkman, 1984). Most commonly, coping is depression, anxiety and insomnia), while it is expected that
described from two main perspectives, by changing the rela- maladaptive coping strategy (alcohol and cigarette con-
tionship with the environment with coping actions (problem sumption) will be negatively correlated with negative pre-
focused coping), or by changing the interpretation of the dictive value for psychological life quality and wellbeing,
environment (emotion focused coping) (Lazarus, 1993). and positive for perceived stress, depression, anxiety,
Additionally, a third coping dimension is avoidance which and insomnia.
can be person oriented by seeking other people as social
diversion, or task oriented by seeking distraction (Endler &
Parker, 1990, 1994). Coping strategies are also often Materials and methods
described as adaptive or maladaptive, however, such cat- Study design
egorization of any of the coping strategies depends on three
factors; long-term developmental consequences, subjective Measurement of coping strategies and several mental health
experience, and their current qualities (Skinner et al., 2003). indicators during COVID-19 lockdown was performed with
QualtricsV survey platform on an Austrian representative
R

Basically, the determination of a specific coping strategy as

beneficial or harmful for the individual depends on whether sample (age, gender, education, and region). Qualtrics pro-
the individual is able to handle the demand or is over- ject team performed recruitment and data collection on ini-
whelmed by it (Skinner et al., 2003). tially specified sample of N ¼ 1000. COVID-19 lockdown
Coping strategies can contribute to the nature and was officially implemented in Austria on 16th of March
impact of psychological responses in stressful circumstances 2020, and the survey started on 10th of April 2020.
(McPherson, 2003) and can have protective or damaging
effects on mental health. Emotion focused coping strategies Governmental restriction during the survey
like rumination, thinking avoidance, denial, self-isolation,
emotion expression, and self-blame were shown to increase During the obligatory COVID-19 lockdown in Austria in
the severity of posttraumatic stress disorder (PTSD), while March 2020, permitted activities outside home included:
problem faced coping, like positive thinking had beneficial averting an immediate danger to life, limb, or property; pro-
an effect on PTSD (Rodr
ıguez-Rey et al., 2019; Sim et al., fessional activity (if home-office is not possible); errands to
2010). Additionally, a negative impact on psychological cover necessary basic needs; care and assistance for people
response can be associated with passive coping strategies, in need of support; exercise outdoors (e.g. running, walking)
rumination, thinking avoidance, self-isolation, self-blame, alone and with pets/people living in the same household.
pessimism, negative social interactions, lack of social sup-
port and communication, behavioral disengagement, denial
Study sample
and using alcohol (Colville et al., 2017, 2017; Luo et al.,
2015; McPherson, 2003; Naushad et al., 2019; Rodr
ıguez- A representative sample according to age, gender, education
Rey et al., 2019; Smith et al., 2008). Positive impact on men- and region, total of N ¼ 1005 (Table 1) participants were
tal health was found to be associated with social support recruited by Qualtrics project team, and data were collected
and optimism which were found to be have protective role during the lockdown, in the period from 10th of April until
for perceived stress, anxiety, and depression (Smith et al., 30th of April. The majority of the sample was recruited
 JOURNAL OF MENTAL HEALTH 3

Table 1. Study sample characteristics (n ¼ 1005). values. Pearson coefficients of correlation were used to spe-
Variable f % cify relationships between coping strategies and mental
Gender health scales. Several simple linear regressions (enter
Women 530 52.7
Men 475 47.3
method) were carried out to predict mental health by cop-
Age ing strategies. Linear regression analyses were performed
18–24 118 11.7 with coping strategies as predictors (1. Positive thinking, 2.
25–34 166 16.5
35–44 185 18.4
Alcohol and cigarette consumption, 3. Active stress coping,
45–54 222 22.1 4. Support in faith, 5. Social support) and measures of men-
55–64 181 18.0 tal health as criteria variable (6. psychological life quality
65þ 133 13.2
Region
(WHOQOL BREF), 7. well-being (WHO-5), 8. perceived
Burgenland 35 3.5 stress (PSS-10), 9. depression (PHQ-9), 10. anxiety (GAD-
Lower Austria 187 18.6 7), 11. insomnia (ISI)). The tests were performed two-tailed
Vienna 218 21.7
Carinthia 66 6.6 and the p-value was set to p<.05.
Styria 149 14.8
Upper Austria 172 17.1
Salzburg 63 6.3 Ethical consideration
Tyrol 77 7.7
Vorarlberg 38 3.8 This study was conducted in accordance with the
Education
No school education 1 0.1
Declaration of Helsinki and approved by the Ethics
Secondary School 26 2.6 Committee of the Danube University Krems, Austria
Apprenticeship 321 31.9 (Ethical number: EK GZ 26/2018-2021). All participants
High School 288 28.7
University 369 36.7
gave electronic informed consent for participation before
Note: f: frequencies; %: percentage.
completing the questionnaires. Data were collected anonym-
ously without IP addresses or GPS tracking and this proced-
ure was approved by the data protection officer of the
within the first few days, followed by reaching niche seg- Danube-University Krems, Austria.
ments of the sample (e.g. older participants) in the following
days.
Results

Measures Sociodemographic characteristics of N ¼ 1,005 participants

are presented in Table 1. The sample is representative for
 Stress and Coping Inventory (SCI): measures coping Austrian population according to gender, age, education
strategies in the period of past two weeks: positive think- and region.
ing, active stress management, social support, support in Correlations between coping strategies and mental health
faith, and alcohol and cigarette consumption are shown in Table 2.
(Satow, 2012). Higher mental health was correlated with coping strat-
 WHOQOL-BREF: measures life quality (physical, psy- egies: positive thinking (rWHOQOL ¼ .60, p < 0.001; rWHO-5
chological, social relationships, and environment) during ¼ .55, p < 0.001; rPSS-10 ¼ .54, p < 0.001; rPHQ-9 ¼ .51,
the past 2 weeks (WHO, 1996). In this study, only a p < 0.001; rGAD-7 ¼ .52, p < 0.001; rISI ¼ .34, p < 0.001) ,
measure of psychological life quality was used. active stress coping (rWHOQOL ¼.37, p < 0.001; rWHO-5 ¼
 The World Health Organization - Five Well-Being Index .34, p < 0.001; rPSS-10 ¼ .41, p < 0.001; rPHQ-9 ¼ .35,
(WHO-5): measures a well-being within the last two p < 0.001; rGAD-7 ¼ .35, p < 0.001; rISI ¼ .21, p < 0.001)
weeks (WHO, 1998). and social support (rWHOQOL ¼ .52, p < 0.001; rWHO-5 ¼
 Perceived stress (PSS-10): measures perceived stress over .46, p < 0.001; rPSS-10 ¼ .42, p < 0.001; rPHQ-9 ¼ .46,
the last month (Cohen et al., 1983). p < 0.001; rGAD-7 ¼ .41, p < 0.001; rISI ¼ .28, p < 0.001).
 Patient Health Questionnaire (PHQ-9): measures depres- Lower mental health was correlated with the coping strategy
sive symptoms over the period of previous two weeks alcohol and cigarette consumption (rWHOQOL ¼ .19, p <
(Spitzer, 1999). .001; rWHO-5 ¼ .15, p < 0.001; rPSS-10 ¼ .15, p < 0.001;
 Generalized Anxiety Disorder – 7 scale (GAD-7): meas- rPHQ-9 ¼ .23, p < 0.001; rGAD-7 ¼ .20, p < 0.001; rISI ¼ .13,
ures anxiety symptoms in the past two weeks (Spitzer p < 0.001), and coping strategy support in faith (rWHOQO
et al., 2006). ¼.12, p < 0.001; rWHO-5 ¼ .11, p < 0.001).
 Insomnia Severity Index (ISI): measures insomnia and Linear regression analyses were performed with coping
sleep quality in the last two weeks (Morin et al., 2011). strategies as predictors (Table 3).
All measured coping strategies were significant predic-
tors for all measured mental health scales, with the high-
Statistical analysis
est percentage of explained variance for psychological life
All data were analyzed using SPSS version 24 (IBM Corp, quality (WHOQOL BREF), 43% (F (5, 1008) ¼ 148.53;
Armonk, NY). Descriptive statistics were conducted to p < 0.001; DR2 ¼ 0.43), followed with perceived stress
describe the demographic characteristics and scales mean (PSS-10), 37% (F (5, 1008) ¼ 115.75; p < 0.001; DR2 ¼
4 S. BUDIMIR ET AL.

Table 2. Descriptive statistics and Pearson coefficients of correlations for coping strategies and mental health scales.
n M SD 1 2 3 4 5 6 7 8 9 10 11
1. Positive thinking 1005 11.25 2.49 –
2. Alcohol and cigarette consumption 1005 6.56 2.74 .13 –
3. Active stress coping 1005 11.77 2.30 .35 .11 –
4. Support in faith 1005 8.24 3.05 .18  .05 .12 –
5. Social support 1005 11.43 2.72 .61 .12 .25 .16 –
6. WHOQOL BREF 1005 69.83 18.70 .60 .19 .37 .12 .52 –
7. Wellbeing (WHO-5) 1005 15.05 5.40 .55 .15 .34 .11 .46 .77 –
8. Perceived stress (PSS-10) 1005 15.97 7.47 .54  .15 .41  .04 .42  .74 .73 –
9. Depression (PHQ-9) 1005 6.19 5.40 .51 .23 .35 .07 .46 .77 .72 .74 –
10. Anxiety (GAD-7) 1005 5.84 4.70 .52 .20 .35 .02 .41 .71 .69 .79 .81 –
11. Insomnia (ISI) 1005 8.31 5.70 .34 .13 .21 .01 .28 .54 .59 .56 .66 .59 –
p < 0.001, n: sample size, M: mean value, SD: standard deviation, WHO-QOL BREF psychological domain: Quality of Life questionnaire of the World Health
Organization (WHO); WHO-5: Well-being questionnaire of the World Health Organization (WHO); PSS-10: Perceived Stress Scale 10; PHQ-9: Patient Health
Questionnaire 9 scale; GAD-7 (Generalized Anxiety Disorder 7 scale); ISI: Insomnia Severity Index.

Table 3. Linear regressions analyses with mental health scales as dependent variables and coping strategies as predictors.
Variable B SE b t p 95% CI F R R2 DR2
Psychological quality of life (WHOQOL BREF)
(Constant) 7.67 3.24 2.39 .018 [1.31, 14.02] 148.53 .65 .43 .43
Positive thinking 2.90 0.24 0.38 12.23 .000 [2.43, 3.36]
Alcohol and cigarette consumption 0.62 0.17 0.09 3.71 .000 [.94, .30]
Active stress coping 1.33 0.21 0.16 6.36 .000 [.92, 1.74]
Support in faith 0.04 0.15 0.01 .274 .784 [.34, .25]
Social support 1.60 0.21 0.23 7.64 .000 [1.19, 2.02]
Wellbeing (WHO-5)
(Constant) 1.76 1.00 1.77 .077 [3.71, .19] 108.82 .59 .35 .35
Positive thinking 0.82 0.07 0.38 11.22 .000 [.67, .96]
Alcohol and cigarette consumption 0.12 0.05 0.06 2.44 .015 [.22, .02]
Active stress coping 0.38 0.06 0.16 5.87 .000 [.25, .50]
Support in faith 0.01 0.05 0.01 0.20 .845 [.10, .08]
Social support 0.36 0.06 0.18 5.56 .000 [.23, .49]
Perceived stress (PSS-10)
(Constant) 39.48 1.36 29.05 .000 [36.82, 42.16] 115.75 .61 .37 .37
Positive thinking 1.16 0.10 0.39 11.68 .000 [1.36, .97]
Alcohol and cigarette consumption 0.17 0.07 0.06 2.48 .013 [.04, .31]
Active stress coping 0.79 0.09 0.24 8.99 .000 [.96, .62]
Support in faith 0.20 0.06 0.08 3.11 .002 [.07, .32]
Social support 0.35 0.09 0.13 3.92 .000 [.52, .17]
Depression (PHQ-9)
(Constant) 20.97 1.00 21.06 .000 [19.02, 22.93] 107.8 .59 .35 .35
Positive thinking 0.67 0.07 0.31 9.16 .000 [.81, .52]
Alcohol and cigarette consumption 0.29 0.05 0.15 5.66 .000 [.19, .39]
Active stress coping 0.43 0.06 0.18 6.72 .000 [.56, .31]
Support in faith 0.09 0.05 0.05 2.03 .043 [.003, .18]
Social support 0.43 0.07 0.21 6.61 .000 [.55, .30]
Anxiety (GAD-7)
(Constant) 18.23 0.88 20.76 .000 [16.50, 19.95] 99.25 .58 .33 .33
Positive thinking 0.70 0.06 0.37 10.88 .000 [.82, .57]
Alcohol and cigarette consumption 0.20 0.05 0.12 4.45 .000 [.11, .29]
Active stress coping 0.38 0.06 0.19 6.69 .000 [.49, .27]
Support in faith 0.16 0.04 0.10 3.87 .000 [.08, .24]
Social support 0.24 0.06 0.14 4.13 .000 [.35, .12]
Insomnia (ISI)
(Constant) 17.97 1.21 14.91 .000 [15.61, 20.34] 34.32 .38 .15 .15
Positive thinking 0.55 0.09 0.24 6.20 .000 [.72, .37]
Alcohol and cigarette consumption 0.15 0.06 0.07 2.48 .013 [.03, .27]
Active stress coping 0.26 0.08 0.11 3.34 .001 [.41, .11]
Support in faith 0.16 0.06 0.09 2.88 .004 [.05, .27]
Social support 0.25 0.08 0.12 3.13 .002 [.40, .09]
Model 1; B: unstandardized coefficients, SE: standardized error, b – beta standardized coefficient,: t: t test, p: p-values (2-tailed); Cl: confidence interval, F: F
ratio, DR2: R square change; WHO-QOL BREF: Quality of Life questionnaire of the World Health Organization (WHO); WHO-5: Well-being questionnaire of the
World Health Organization (WHO); PSS-10: Perceived Stress Scale 10; PHQ-9: Patient Health Questionnaire 9 scale; GAD-7 (Generalized Anxiety Disorder 7 scale);
ISI: Insomnia Severity Index.

0.37), well-being (WHO-5), 35% (F (5, 1008) ¼ 108.82; Positive thinking was the strongest predictor for all meas-
p < 0.001; DR2 ¼ 0.35), depression (PHQ-9), 35% (F (5, ured mental health scales, followed by active stress coping
1008) ¼ 107.84; p < 0.001; DR2 ¼ 0.35), anxiety (GAD-7), and social support. All three coping strategies, positive
33% (F (5, 1008) ¼ 99.25; p < 0.001; DR2 ¼ 0.33), and thinking (PT), active stress coping (ASC), and social support
insomnia (ISI), 15% (F (5, 1008) ¼ 34.32; p < 0.001; DR2 (SS) were found to be positive predictors for psychological
¼ 0.15). life quality (WHOQOL BREF), (bPT ¼ 0.38; t ¼ 12.23;
 JOURNAL OF MENTAL HEALTH 5

p < 0.001; bASC ¼ 0.16; t ¼ 6.36; p < 0.001; bSS ¼ 0.23; three coping strategies, the strongest predictor was positive
t ¼ 7.64; p < 0.001), well-being (WHO-5) (bPT ¼ 0.38; thinking for all mental health scales followed with social
t ¼ 11.22; p < 0.001; bASC ¼ 0.16; t ¼ 5.87; p < 0.001; bSS ¼ support, indicating that these coping strategies were found
0.18; t ¼ 5.56; p < 0.001). In other words, positive thinking, to be the most beneficial for mental health. Rodr
ıguez-Rey
social support and active stress coping contribute to higher et al. (2019) demonstrated relevance of positive thinking as
psychological life quality and higher wellbeing. The same a coping strategy for mental health, more specifically they
coping mechanisms were found to be negative predictors for found an association of positive thinking with lower score
perceived stress (PSS-10) (bPT ¼ 0.39; t ¼ 11.68; on PTSD screening instrument. The use of positive coping
p < 0.001; bASC ¼ 0.24; t ¼ 8.99; p < 0.001; bSS ¼ 0.13; strategies was found to be associated with lower depressive
t ¼ 3.92; p < 0.001), depression (PHQ-9) (bPT ¼ 0.31; t symptoms and with less distress during the COVID-19 pan-
¼ 9.16; p < 0.001; bASC ¼ 0.18; t ¼ 6.72; p < 0.001; bSS demic as well (Babore et al., 2020; Skapinakis et al., 2020).
¼ 0.21; t ¼ 6.61; p < 0.001), anxiety (GAD-7) (bPT ¼ Although, the coping strategy active coping was also
0.37; t ¼ 10.88; p < 0.001; bASC ¼ 0.19; t ¼ 6.69; found to be a significant predictor for all measured scales
p < 0.001; bSS ¼ 0.14; t ¼ 4.13; p < 0.001), and insomnia during COVID-19 pandemic, the effect is much smaller
(ISI) (bPT ¼ 0.24; t ¼ 6.20; p < 0.001; bASC ¼ 0.11; compared to positive thinking as a coping strategy. Active
t ¼ 3.34; p ¼ 0.001; bSS ¼ 0.12; t ¼ 3.13; p ¼ 0.002). coping is the second highest predictor for perceived stress
That indicates that employment of the coping mechanisms and anxiety, while social support is the second highest pre-
such as positive thinking, social support, and active stress dictor for psychological quality of life, depression, well-
coping contributes to lower depression, anxiety, being, depression, and insomnia. Protective role of active
and insomnia. coping on mental health has been shown in previous
Alcohol and cigarette consumption was a small but a sig- research (Luo et al., 2015; Main et al., 2011; Smith et al.,
nificant predictor for all measured scales. It was a negative 2008), and approach coping during COVID-19 pandemic
predictor for psychological life quality (b WHOQOL BREF ¼ was found to be associated to a higher wellbeing and lower
0.09; t ¼ 3.71; p < 0.001) and well-being (bWHO-5 ¼ depression (Dawson & Golijani-Moghaddam, 2020). The
0.06; t ¼ 2.44; p ¼ 0.015), which indicates lower psycho- smaller effect of active coping strategy compared to positive
logical life quality and wellbeing for those who employ this thinking during the lockdown situation can be explained by
coping strategy. Alcohol and cigarette consumption was also limited options for active coping in the situation where the
a positive predictor for perceived stress (bPSS-10 ¼ 0.06; removal of the stress source is not under the control of the
t ¼ 2.48; p ¼ 0.013), depression (bPHQ-9 ¼ 0.15; t ¼ 5.66; individual. Active coping would allow smaller modulations
p < 0.001), anxiety (bGAD-7 ¼ 0.12; t ¼ 4.45; p < 0.001), and of behavior which could include practicing measures of pre-
insomnia (bISI ¼ 0.07; t ¼ 2.48; p ¼ 0.013). This indicates caution in the case of exposure to the risk of contamination.
that people employing this coping strategy are more likely Social support as a coping strategy was also found to be
to have higher scores on perceived stress, depression, anx- predictive of mental health during the lockdown. Importance
iety, and insomnia scales. of social support in reducing distress and mental health diffi-
Support in faith was a small positive, but significant pre- culties in stressful circumstances is known from previous
dictor only for the scales: perceived stress (bPSS-10 ¼ 0.08; research (Fasihi Harandi et al., 2017; Naushad et al., 2019;
t ¼ 3.11; p ¼ 0.002), depression (bPHQ-9 ¼ 0.05; t ¼ 2.03; Ozbay et al., 2007). Although, one of the main goals of the
p ¼ 0.043), anxiety (bGAD-7 ¼ 0.10; t ¼ 3.87; p < 0.001), and lockdown was to reduce number of infections through reduc-
insomnia (bISI ¼ 0.09; t ¼ 2.88; p ¼ 0.004). These predictors tion of social contacts, a social support played a significant
indicate that employing the coping strategy support in faith protective role for mental health. Social support might have
is predictive for higher scores on a stress, depression, anx- been received through online media, which could have been
iety, and insomnia scales. used for establishing and/or maintaining support system with
friends, families, and community members. For example, rea-
sonable amount of social media usage for providing informa-
Discussion
tional, emotional and peer support during the COVID-19
This study examined predictive value of coping strategies outbreak in Wuhan was found to be beneficial for mental
for mental health indicators on a representative Austrian health (Zhong et al., 2021).
sample during the 4 weeks of COVID-19 lockdown. The Additionally, we found a coping strategy of alcohol and
major finding of this study is that scores for coping strat- cigarette consumption to be a small, but significant pre-
egies were found to be predictors for scores on all or the dictor of lower psychological life quality, wellbeing, and
majority of mental health indicators. higher perceived stress, depression, anxiety, and insomnia.
More specifically, a group of coping strategies; positive Other studies also found a negative impact of substance use
thinking, active stress coping and social support contribute on a psychological response, either in a form of association
to higher psychological life quality, well-being, perceived of alcohol intake with higher risk on reporting the burnout
stress, depression, anxiety, and insomnia. These results indi- (Colville et al., 2017), or substance use with lower resilience
cate that an individual who has higher scores on these cop- that is highly correlated with anxiety, depression and per-
ing strategies in their coping with COVID-19 pandemic, ceived stress (Smith et al., 2008), and with increased anxiety
had better mental health during the lockdown. Among these (McPherson, 2003). Several studies showed negative effect of
6 S. BUDIMIR ET AL.

maladaptive coping styles on mental health during COVID- ORCID

19 pandemic, associating it with higher anxiety and depres-
Sanja Budimir http://orcid.org/0000-0002-4110-9112
sion, higher level of psychological distress and lower well- Thomas Probst http://orcid.org/0000-0002-6113-2133
being (Dawson & Golijani-Moghaddam, 2020; Rahman Christoph Pieh http://orcid.org/0000-0003-2708-303X
et al., 2020; Rettie & Daniels, 2020; Wang et al., 2020b; Yan
et al., 2020).
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