Trajectories of Mental Distress and Resilience During the COVID-19 Pandemic Among Healthcare Workers

<b>Background/Objectives</b>: The recent COVID-19 pandemic posed a significant psychological challenge for healthcare workers. Resilience and the extent of psychological stress varied across professional groups and individual circumstances. This study aims to longitudinally capture the trajectories of psychological stress and resilience among medical personnel during the pandemic and identify various contributing factors. <b>Methods</b>: Over a period of three years, healthcare workers from five locations (Bonn, Cologne, Ulm, Erlangen, and Dresden) were surveyed regarding their psychological stress (PHQ-4) and other aspects of mental health. Data were collected at five different points during the pandemic. Using Growth Mixture Modeling (GMM), various stress trajectories during the crisis were modeled without initial adjustment for covariates to allow for an unbiased identification of latent classes. Differences in demographic and occupational factors (e.g., age, gender, profession) were analyzed across the identified trajectory groups in subsequent steps. <b>Results</b>: The application of GMM revealed three distinct profiles of psychological stress and resilience among the respondents, largely consistent with the literature. The largest group was the 'resilience' group (81%), followed by the 'recovery' (10%) and 'delayed' groups (9%). Group membership was consistent with self-reported trajectories over the course of the pandemic. It was not possible to predict individual trajectories based on the results of a short resilience questionnaire (RS-5). <b>Conclusions</b>: The COVID-19 pandemic had multiple psychological impacts on healthcare workers, manifesting in clearly differentiated group trajectories of distress over time. While a majority of respondents in this sample exhibited a stable trajectory with low distress, other groups showed varying stress responses over time. These findings highlight the necessity of longitudinal approaches to understand the complex interplay of stressors and coping mechanisms during prolonged crises.