Pre-Pandemic Emotion Regulation and Supportive Relationships as Protective Factors Across Development: Prospective Prediction of Mental Health During the COVID-19 Pandemic

Individuals vary widely in their mental health responses to major stressors, but prospective evidence identifying which resilience factors confer protection is limited. By prospectively assessing resilience factors prior to the COVID-19 pandemic, the current study was uniquely positioned to test how pre-pandemic resilience predicted mental health outcomes during a global crisis. We followed a cohort from a pre-pandemic assessment of resilience-related processes and psychopathology into the early COVID-19 pandemic. Participants represented a psychiatrically enriched cohort that included both individuals with elevated psychiatric risk and non-clinical controls. The study examined whether baseline emotion regulation and supportive close relationships were associated with mental health functioning during a significant stressor, after controlling for baseline symptoms. At baseline (Time 1; 05/2017-8/2019), 96 participants (mean age=19.34, SD=5.08, range=8-29; 51% female; 59% People of Color) completed in-person assessments. Approximately 21 months later, during the pandemic (Time 2; 05/2020-08/2020), participants completed remote self-report assessments of mental health and sleep. Multivariate regression analyses revealed that higher pre-pandemic emotion regulation was associated with lower levels of anxiety (p=.007), psychosis-spectrum symptoms (p=.034), and sleep problems (p=.002) during the pandemic. Higher pre-pandemic levels of supportive close relationships were associated with fewer subsequent sleep problems (p=.022). Findings demonstrate that resilience-related processes assessed before a major stressor predicted mental health functioning nearly two years later. Emotion regulation was protective across multiple mental health outcomes, whereas supportive relationships were associated with fewer sleep problems. These results underscore the value of targeting resilience pathways to reduce vulnerability during future large-scale stressors.