Risk and protective factors for posttraumatic stress disorder in trauma-exposed individuals during the COVID-19 pandemic – findings from a pan-European study

Figures & data

Table 1. Sociodemographic characteristics (N = 4607).

Characteristic
Age^a	M (SD)
Mean	43.77 (14.38)
Range	18–89
Gender	n (%)
Male	1218 (26.4%)
Female	3364 (73.0%)
Other	25 (0.5%)
Education
<10 years of schooling	93 (2.0%)
≥10 years of schooling	915 (19.9%)
Vocational studies	724 (15.7%)
Completed studies	2875 (62.4%)
Income^b
Very low	312 (7.0%)
Low	778 (17.4%)
Medium	1699 (38.0%)
High	1686 (37.7%)
Reduced income^c
No	3082 (67.2%)
Yes	1507 (32.8%)
Financial support
No	2813 (61.1%)
Yes	313 (6.8%)
Question not answered	1481 (32.1%)
Work/training status^d
Training/study	655 (14.3%)
Employed part-time	770 (16.9%)
Employed full-time	2359 (51.6%)
Self-employed	304 (6.7%)
Freelancer	160 (3.5%)
Retired	470 (10.3%)
Seeking work	277 (6.1%)
Other	273 (6.0%)
(Almost) daily face-to-face contact at work^e
No	1389 (31.8%)
Yes	2981 (68.2%)
Work area^f
Health care	639 (15.6%)
Public security	293 (7.1%)
Retail, Services	210 (5.1%)
Maintenance/repair/construction	103 (2.5%)
Education	600 (14.6%)
Not working	777 (19.0%)
Other work area	1478 (36.0%)

Notes. Reduced income = Reduced monthly household income due to the COVID-19 pandemic. Financial support = Receiving financial support from government due to financial loss related to the pandemic.

^a n = 4603.

^b n = 4475.

^c n = 4589.

^d n = 4568.

^e n = 4370.

^f n = 4100.

Multiple answers were possible.

Table 2. Pandemic-related characteristics (N = 4607).

Characteristic	n (%)
Spent more time at home^a
No	609 (13.2%)
Yes, social distancing	3685 (80.0%)
Yes, self-isolation	110 (2.4%)
Yes, quarantine	106 (2.3%)
Not applicable	94 (2.0%)
Hours per day outside^b	M (SD)
Mean	4.34 (4.03)
Range	0–24
Face-to-face contact	n (%)
No contact	371 (8.1%)
<once a week	1092 (23.7%)
once a week	665 (14.4%)
1–2 times a week	946 (20.5%)
3–7 times a week	1533 (33.3%)
Digital contact
No contact	129 (2.8%)
<once a week	444 (9.6%)
once a week	362 (7.9%)
1–2 times a week	803 (17.4%)
3–7 times a week	2869 (62.3%)
Pandemic-related news consumption
I do not watch, read or listen to news	264 (5.7%)
< 30 min a day	2239 (48.6%)
30–60 min a day	1315 (28.5%)
1–2 h a day	447 (9.7%)
2–3 h a day	178 (3.9%)
>3 h a day	164 (3.6%)

Notes. More time at home = Spent more time at home due to the pandemic. Social distancing = spent more time at home as a precautionary measure (social distancing). Self-isolation = stayed at home in self-isolation because of self-infection. Quarantine = stayed at home due to contact with infected people or being in risk areas. Face-to-face contact = Face-to-face contact with loved ones or friends. Digital social contact = Digital contact with loved ones or friends, e.g. by phone, Skype, or Zoom. News consumption = Hours a day watching, reading, or listening to the news or other information about the COVID-19 pandemic.

^a n = 4604.

^b n = 4066.

Table 3. Health-related characteristics (N = 4607)

Characteristic	n (%)
Current health status
Very good	1076 (23.4%)
Good	2075 (45.0%)
Satisfactory	1137 (24.7%)
Poor	273 (5.9%)
Very poor	46 (1.0%)
COVID-19 infection
No	4515 (98.0%)
Yes, recovered	88 (1.9%)
Yes, currently affected	4 (0.1%)
At risk for severe COVID-19
No	3329 (72.3%)
Yes	1278 (27.7%)
Diagnosis of mental disorder
No	3182 (69.1%)
Yes, recovered	837 (18.2%)
Yes, currently affected	588 (12.8%)
Trauma during pandemic^a
No	3523 (76.8%)
Yes	1065 (23.2%)
Trauma before pandemic^b
No	572 (12.4%)
Yes	4033 (87.6%)
Probable PTSD (PC-PTSD-5 > 3)^c	798 (17.7%)
PC-PTSD-5 total score^c	M (SD)
	1.63 (1.68)

Notes: COVID-19 infection = Infected (i.e. tested positive) with COVID-19. PTSD = post-traumatic stress disorder. PC-PTSD-5 = Primary Care PTSD Screen for DSM-5.

^a n = 4588.

^b n = 4605.

^c n = 4516.

Table 4. Pandemic-related stressors (N = 4607).

PaSS domain	M (SD)
Restricted social contact	1.58 (0.90)
Problems with childcare	0.36 (0.81)
Work-related problems^a	0.62 (0.82)
Fear of infection	1.71 (0.76)
Restricted activity	1.55 (0.84)
Crisis management/communication	1.20 (0.86)
Restricted access to resources	0.85 (0.78)
Difficult housing condition	0.64 (0.80)
Burden of infection	0.61 (0.84)

Notes. PaSS = Pandemic Stressor Scale. 0 = ‘Not at all burdened’; 1 = ‘Somewhat burdened’; 2 = ‘Moderately burdened’; 3 = ‘Strongly burdened.

^a n = 4391.

Figure 1. Effect estimates of regression analysis.

Notes. Effect estimates are unstandardised regression coefficients. Reference categories: ^a Male. ^b Less than 10 years of schooling. ^c Very low. ^d No. ^e No. ^f Other. ^g No. ^h No personal contact with other people. ⁱ No contact by phone, skype, etc. ^j I do not watch, read or listen to news about the coronavirus pandemic. ^k Very good. ^l No. ^m No. ⁿ No. ^o No. ≥ 10 years = 10 or more years of schooling. Reduced income = Reduced monthly household income due to the coronavirus. Financial support = Receiving financial support from the government. Maintenance/repair/etc.= Maintenance, repair, construction. More at home = Spent more time at home due to the coronavirus pandemic. social dist. = Spent more time at home as a precautionary measure (social distancing). Self-isolation = Stayed at home in self-isolation because of self-infection. quarantine = Stayed at home due to contact with infected people or being in risk areas. Face contact = Face-to-face contact to loved ones or friends. Face contact at work = Work involve (almost) daily face-to-face contact with other people. Digital contact = Digital contact with loved ones or friends, e.g. by phone, Skype or Zoom. News = Hours a day watching, reading or listening to news or other information about the coronavirus pandemic. COVID-19 inf. = Infected (i.e. tested positive) with the coronavirus.

Table 5. Effect estimates of regression analysis (N = 4607).

Term	b	SE	df	p	95% CI low	95% CI up
Intercept	0.14	0.56	4403.1	<.001	0.05	0.42
Age (per 10 years increase)	0.77	0.07	4337.0	<.001	0.67	0.88
Gender: (ref. male)
Female	2.07	0.13	4343.0	<.001	1.62	2.65
Other	2.06	0.53	4432.5	.174	0.73	5.82
Education (ref. <10 years)
≥10 years	0.83	0.28	4423.4	.506	0.48	1.44
Vocational studies	0.85	0.30	4418.1	.581	0.47	1.53
Completed studies	0.74	0.29	4416.2	.285	0.42	1.29
Income (ref. very low)
Low	0.73	0.18	3725.8	.088	0.51	1.05
Medium	0.68	0.18	4110.5	.032	0.47	0.97
High	0.62	0.19	3959.0	.012	0.42	0.90
Reduced income (ref. no)
Yes	1.02	0.16	4339.8	.925	0.74	1.39
Financial support (ref. no)
Yes	1.04	0.18	4421.1	.839	0.73	1.48
Not answered	0.82	0.19	4428.1	.302	0.56	1.20
Work status (ref. no)
Training/study: Yes	0.93	0.16	4363.2	.671	0.68	1.28
Employed part-time: Yes	1.37	0.16	4293.5	.051	1.00	1.89
Employed full-time: Yes	1.35	0.17	4051.0	.082	0.96	1.89
Self-employed: Yes	1.16	0.21	4269.9	.474	0.77	1.74
Freelancer: Yes	1.17	0.25	4157.7	.539	0.72	1.90
Retired: Yes	1.28	0.32	1732.0	.438	0.69	2.38
Seeking work: Yes	1.26	0.30	1333.1	.438	0.70	2.26
Other: Yes	0.98	0.21	3801.8	.913	0.65	1.47
Face-to-face contact at work (ref. no)
Yes	1.08	0.13	1815.8	.531	0.84	1.39
Work area^e (ref. other area)
Health care	1.03	0.15	1145.9	.851	0.77	1.38
Public security	1.31	0.23	3172.6	.243	0.83	2.07
Retail. Services	0.99	0.23	496.2	.969	0.63	1.55
Maintenance/repair/etc.	1.14	0.34	1098.7	.695	0.58	2.24
Education	1.27	0.15	1319.3	.115	0.94	1.71
Not working	1.19	0.29	630.9	.552	0.67	2.10
Spent more time at home (ref. no)
Yes, social dist.	0.98	0.15	4358.0	.909	0.74	1.31
Yes, self-isolation	1.45	0.34	4421.6	.267	0.75	2.80
Yes, quarantine	1.54	0.30	4423.7	.146	0.86	2.74
Not applicable	0.80	0.35	4430.8	.531	0.41	1.59
Hours per day outside home	1.01	0.05	1256.2	.875	0.91	1.12
Face-to-face contact (ref. no contact^a)
<once a week	0.65	0.17	4426.9	.011	0.47	0.90
once a week	0.83	0.19	4429.8	.305	0.57	1.19
1–2 times a week	0.73	0.18	4427.5	.080	0.51	1.04
3–7 times a week	0.70	0.17	4415.3	.034	0.50	0.97
Digital social contact (ref. no contact^b)
<once a week	0.52	0.27	4430.9	.014	0.31	0.88
once a week	0.48	0.28	4431.9	.008	0.28	0.82
1–2 times a week	0.44	0.25	4433.1	.001	0.27	0.72
3–7 times a week	0.48	0.24	4431.0	.002	0.30	0.76
News consumption (ref. no ^c)
<30 min. a day	0.97	0.20	4421.5	.864	0.66	1.42
30–60 min a day	1.07	0.21	4427.2	.735	0.72	1.61
1–2 h a day	0.90	0.24	4424.5	.670	0.56	1.45
2–3 h a day	0.69	0.30	4428.7	.209	0.39	1.23
>3 h a day	1.82	0.28	4429.3	.032	1.05	3.15
Current health status (ref. very good)
Good	1.28	0.14	4432.4	.068	0.98	1.67
Satisfactory	1.55	0.15	4429.5	.004	1.15	2.08
Poor	2.23	0.20	4425.0	<.001	1.51	3.32
Very poor	4.05	0.39	4432.7	<.001	1.87	8.77
At risk for severe COVID-19: Yes	1.20	0.11	4431.2	.086	0.97	1.49
Diagnosis of mental disorder (ref. no)
Yes, recovered	1.74	0.12	4429.5	<.001	1.39	2.18
Yes, currently affected	4.60	0.12	4427.1	<.001	3.62	5.85
COVID-19 inf. (ref. no)
Yes, recovered	0.58	0.35	4429.2	.127	0.29	1.17
Yes, currently affected	2.88	1.16	4425.3	.361	0.30	27.81
Trauma during a pandemic (ref. no)
Yes	1.63	0.14	4411.3	<.001	1.24	2.13
Trauma before pandemic (ref. no)
Yes	1.35	0.17	4425.1	.086	0.96	1.90
Burden of pandemic-related stressors (PaSS)
Crisis management/communication	1.19	0.05	4427.7	<.001	1.07	1.31
Restricted resources	1.17	0.05	4424.7	.002	1.06	1.30
Fear of infection	1.04	0.06	4427.0	.541	0.93	1.16
Burden of infection	1.03	0.05	4429.4	.588	0.93	1.13
Restricted social contact	1.16	0.06	4431.2	.010	1.04	1.31
Restricted activity	0.99	0.06	4430.7	.831	0.89	1.10
Work-related problems	1.07	0.06	2826.4	.280	0.95	1.19
Problems with childcare	0.99	0.05	4426.3	.746	0.90	1.08
Difficult housing condition	1.24	0.05	4422.7	<.001	1.12	1.37
Stringency	1.02	0.08	4427.8	.792	0.87	1.20

Notes. b = unstandardised regression coefficients. Ref. = reference category. <10 years = Less than 10 years of schooling.

^a I have no personal contact with other people.

^b I have no contact by phone, skype, etc.

^c I do not watch, read or listen to news about the coronavirus pandemic.

Data availability

The detailed sociodemographic and clinical information of the dataset does not fully protect the anonymity of the respondents. For this reason, the entire dataset cannot be made publicly available. However, excerpts of the data on a higher aggregation level can be provided upon justified request by the first author.