Coping, depressive and anxiety symptoms over three and a half years of the COVID-19 pandemic: a cross-lagged panel network analysis

J Affect Disord. 2026 Mar 13:121620. doi: 10.1016/j.jad.2026.121620. Online ahead of print.

ABSTRACT

BACKGROUND: Cross-sectional studies have already investigated associations between coping (i.e., strategies for dealing with stressors) and depressive and anxiety symptoms during the COVID-19 pandemic. However, these studies often lack considerations of temporal dynamics. Understanding these dynamics is crucial for addressing mental health challenges and preparing for future crises. This five-wave cohort study aimed to explore the relationship between coping, depressive and anxiety symptoms.

METHODS: We included self-report data from n = 1289 German adults participating in a European cohort study (‘ADJUST’). Individuals were surveyed at five timepoints between June 2020 and March 2024. Depressive and anxiety symptoms (anhedonia, depressed mood, anxious arousal, worrying) were measured using the Patient Health Questionnaire-4. Coping was assessed using the Brief-COPE, which incorporates 14 subscales (e.g., positive reframing, humor, behavioral disengagement, denial, self-blame). Cross-lagged panel network analysis was conducted to evaluate the relationship between coping and symptoms. We estimated three networks (temporal, contemporaneous, between-person) to quantify associations.

RESULTS: We found several temporal associations. For example, increased worrying was linked to heightened denial and self-blame. Increased depressed mood was associated with stronger behavioral disengagement, which in turn was linked to decreased depressed mood and anhedonia. Humor was related to decreased anxious arousal, while positive reframing was linked to reduced anhedonia.

CONCLUSIONS: The findings showed cross-lagged associations in which coping strategies and symptoms influence each other over time. Future preventive, psychotherapeutic, or policy interventions could focus on addressing worrying and strengthening adaptive coping strategies such as positive reframing and humor to improve mental health.

PMID:41833618 | DOI:10.1016/j.jad.2026.121620