Why the COVID-19 pandemic is a traumatic stressor

  1. Victoria M. E. Bridgland
  2. Ella K. Moeck
  3. Deanne M. Green
  4. Taylor L. Swain
  5. Diane M. Nayda
  6. Lucy A. Matson
  7. Nadine P. Hutchison
  8. Melanie K. T. Takarangi

Reviewed by

Read the full article See related articles

Listed in

Log in to save this article

Abstract

The COVID-19 pandemic does not fit into prevailing Post-traumatic Stress Disorder (PTSD) models, or diagnostic criteria, yet emerging research shows traumatic stress symptoms as a result of this ongoing global stressor. Current pathogenic event models focus on past, and largely direct, trauma exposure to certain kinds of life-threatening events. Yet, traumatic stress reactions to future, indirect trauma exposure, and non-Criterion A events exist, suggesting COVID-19 is also a traumatic stressor which could lead to PTSD symptomology. To examine this idea, we asked a sample of online participants ( N = 1,040), in five western countries, to indicate the COVID-19 events they had been directly exposed to, events they anticipated would happen in the future, and other forms of indirect exposure such as through media coverage. We then asked participants to complete the Posttraumatic Stress Disorder Checklist-5, adapted to measure pre/peri/post-traumatic reactions in relation to COVID-19. We also measured general emotional reactions (e.g., angry, anxious, helpless), well-being, psychosocial functioning, and depression, anxiety, and stress symptoms. We found participants had PTSD-like symptoms for events that had not happened and when participants had been directly (e.g., contact with virus) or indirectly exposed to COVID-19 (e.g., via media). Moreover, 13.2% of our sample were likely PTSD-positive, despite types of COVID-19 “exposure” (e.g., lockdown) not fitting DSM-5 criteria. The emotional impact of “worst” experienced/anticipated events best predicted PTSD-like symptoms. Taken together, our findings support emerging research that COVID-19 can be understood as a traumatic stressor event capable of eliciting PTSD-like responses and exacerbating other related mental health problems (e.g., anxiety, depression, psychosocial functioning, etc.). Our findings add to existing literature supporting a pathogenic event memory model of traumatic stress.

Article activity feed

  1. Version published to 10.1371/journal.pone.0240146
  2. ScreenIT

    SciScore for 10.1101/2020.09.22.307637: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This experiment was approved by the Flinders University Social and Behavioral Research Ethics Committee.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variableParticipants ranged from 18-78 years (M = 35.7, SD = 12.3), half were male (50.70%, female = 48.8%, non-binary = 0.4%; 0.2% did not answer) and most were Caucasian 59.9%.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    Our research has limitations. First, we used the PCL-5, a self-report measure, to examine PTSD-like symptoms cross-sectionally. The Clinician Administered PTSD Scale (CAPS-5 (50)) is a more comprehensive measure that identifies the frequency and intensity of PTSD-like symptoms for an indexed event and allows a clinician to diagnose if PTSD might be present. However, we wanted to capture PTSD-like symptoms in a large sample across multiple locations that were at different points of the pandemic at the time, a goal that could not be achieved using a clinician administered scale. Second, the CAPS-5 can only be completed on clients who have experienced a Criterion A event. Here, our aim was to examine traumatic stress reactions to any type of COVID-19 event that might produce such symptoms, rather than events specifically falling within this category. Similarly, we cannot determine whether symptom levels in our sample would qualify for a PTSD diagnosis. Future research could use experience-sampling methods to capture longitudinal symptoms, or a clinician administered scale to diagnose PTSD. Second, our sample only examined five countries that were all Western, English speaking countries similar in culture and socio-economic status. As such, we can only cautiously generalize these findings to other parts of the world. Third, of course, although our data provide evidence for the potential psychological fallout of the COVID-19 pandemic, we did not investigate any personality traits,...

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • No conflict of interest statement was detected. If there are no conflicts, we encourage authors to explicit state so.
    • No funding statement was detected.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.09.22.307637v1 on bioRxiv