Flexibility Predicts Chronic Anxiety and Depression During the First Year of the COVID-19 Pandemic—A Longitudinal Investigation of Mental Health Trajectories

Objective: The COVID-19 pandemic is a significant stressor, potentially putting the well-being of the general population at risk. However, a significant proportion of the population exhibits resilience, raising questions regarding psychological constructs that could contribute to resilient coping. Studies indicate that flexibility, defined as the ability to adapt to changing contextual demands by employing various emotional, cognitive, and behavioral strategies, may significantly contribute to coping with long-term stressors such as COVID-19. Method: Cognitive and coping flexibility domains and longitudinal trajectories of anxiety and depression were assessed at three-time points across 13 months in 571 Israelis. Results: Analyses revealed four different trajectories for anxiety: resilient (66%), chronic (22%), emerging (7%), and improving (6%), and two trajectories for depression: resilient (87%) and chronic (13%). Individuals in the chronic trajectory group (for both anxiety and depression) exhibited lower cognitive flexibility and coping flexibility levels than individuals in the resilient trajectory group. Across time, anxiety and depression were linked to clinically significant posttraumatic stress disorder-like symptoms. Conclusions: Low cognitive and coping flexibility are linked to the probability of experiencing chronic mental health problems, making them a potential target for prevention and treatment.