Stress, Anxiety, Depression, and Positive Mental Health During Times of COVID-19 and War in Ukraine: A Four-Wave Longitudinal Study in Lithuania and Germany.

On average, no significant changes were observed in mental health indicators across the four measurement points spanning pre-pandemic to the ongoing war in Ukraine.

• The study used latent change analysis to examine trajectories of stress, anxiety, depression, and positive mental health (PMH)
• Sample consisted of N = 432 young adults from Lithuania and Germany (76.4% female; Mage = 22.98, SDage = 6.35 at T1)
• Four measurement points covered pre-pandemic, COVID-19 pandemic periods, and the Russia-Ukraine war period

Latent class analysis revealed two distinct mental health trajectory groups among participants.

• 76.4% of participants belonged to a low-symptom group
• 23.6% of participants belonged to a high-symptom group
• These two classes showed markedly divergent patterns of change across all mental health indicators over the study period

In the low-symptom group, depression, anxiety, and stress all decreased over the study period.

• Depression decreased with effect size d = -0.61
• Anxiety decreased with effect size d = -0.19
• Stress decreased with effect size d = -0.26
• These represent small to medium improvements in the majority of the sample

In the high-symptom group, depression, anxiety, and stress increased substantially while positive mental health decreased.

• Depression increased with effect size d = 2.32, indicating a very large increase
• Anxiety increased with effect size d = 0.79
• Stress increased with effect size d = 1.09
• Positive mental health (PMH) decreased with effect size d = 0.82 in this group

Better positive mental health (PMH) before the pandemic and during the second COVID-19 outbreak predicted lower stress a year later.

• Cross-lagged panel analysis was used to examine how mental health indicators predicted one another over time
• PMH measured at pre-pandemic and during the 2nd COVID-19 outbreak were significant predictors of subsequent stress levels
• Higher PMH was associated with lower stress approximately one year later

Higher anxiety before the pandemic and during the release of COVID-19 restrictions predicted higher stress a year after.

• Anxiety measured at the pre-pandemic wave predicted stress levels approximately one year later
• Anxiety measured during the release of COVID-19 restrictions also predicted higher stress a year after
• This finding was identified using cross-lagged panel analysis