Stressors, coping and symptoms of adjustment disorder in the course of COVID-19 pandemic – Study protocol of the European Society for Traumatic Stress Studies (ESTSS) pan-European study

The study explores the impact of the COVID-19 pandemic on maladaptive psychological adjustment across eleven European countries. Objective: This longitudinal online cohort study aims (1) to explore psychosocial reactions to the COVID-19 pandemic across eleven European countries; (2) to examine the relationships between risk and resilience factors, stressors, and maladaptive adjustment during the pandemic; and (3) to investigate whether these relationships are moderated by coping behaviors. Method: In eleven countries (Austria, Croatia, Germany, Georgia, Greece, Italy, Lithuania, Netherlands, Poland, Portugal, and Sweden) at least 1,000 participants will be recruited. Participants will be assessed at two time points (T1, T2 6-month follow-up). Following a conceptual framework based on the WHO’s social framework of health, an assessment of risk and resilience factors, COVID-19 related stressors, and pandemic-specific coping behavior will be measured to estimate their contribution to maladaptive adjustment. As indicators of maladaptive adjustment, symptoms of adjustment disorder and symptoms of posttraumatic stress disorder will be measured at T1 and T2. Data analysis: Applying multilevel analyses, the relative contribution of risk factors, resilience factors, and stressors on symptoms of adjustment disorder or symptoms of posttraumatic stress disorder will be estimated. To determine the moderating effects of different types of coping behavior on these relationships, a multilevel mediation analyses will be carried out.