Individual Risk Factors Drive PTSD and Wellbeing After Pandemic-Related Trauma Exposure

Abstract The COVID-19 pandemic heightened exposure to potentially traumatic events, such as severe illness or the loss of a loved one. The prolonged nature of the pandemic may influence how mental health symptoms evolve. This study examined changes in PTSD symptoms and mental wellbeing over time, and investigated which factors contributed to differences in these outcomes. Panel survey data were collected from Dutch youth and adults between March 2022 and June 2024. Participants were presented with a list of potentially traumatic events they could have experienced during the pandemic and the question whether they still felt affected by any of them. The PTSD Checklist for DSM-5 (PCL-5) was anchored to their self-reported most distressing event. Mental wellbeing was measured using the MHI-5. Only respondents who still felt affected by the event and completed the PCL-5 were included in the analysis. Stepwise mixed-effects regression models assessed the predictive value of event-related factors (e.g. time since exposure and type of event) and individual-level risk (e.g. loneliness, stress, somatic symptoms, gender, and education) factors on PTSD symptoms and wellbeing over time. In total, 5,782 observations over time were included. 13.5% scored above the PTSD cut-off. PTSD symptoms declined slightly over time, but individual-level factors were stronger predictors than event-related factors. 36.5% reported low mental wellbeing. Only individual-level factors were important risk factors for mental wellbeing, event-related factors were not significant. While previous studies have highlighted the relevance of event characteristics, this study suggests that in the aftermath of pandemic-related trauma, individual-level factors are more important in predicting PTSD symptoms and wellbeing. These findings underscore the need to target individual-level risk factors, such as loneliness and stress, in mental health interventions to strengthen resilience to large-scale public health crises. Key messages • Individual-level risk factors predicted PTSD and wellbeing better than event-related factors during the pandemic. • Mental health support should focus on individual risk factors like loneliness and stress to build resilience after large-scale crises.