Coping in the Covid-19 pandemia: how different resources and strategies can be risk or protective factors to mental health in the Brazilian population

Figures & data

Table 1. Sample Descriptions and Prevalence of Depression, Anxiety and Stress symptoms.

Variables		n	(%)	X^2
Gender	Male	250	22.1
	Female	880	77.9	p < 0.01*
Income	<$580.00	303	27.0
	$580.00 – $1,940.00	512	45.6
	>$1,940.00	309	27.4	p < 0.01*
Schoolling	Elementary school	16	1.4
	High School	98	8.7
	University education	759	67.2
	Master ou PhD degrees	257	22.7	p < 0.01*
Marital Status	Singles	427	39.4
	Married or Stable Union	531	49.0
	Divorced	111	10.2
	Widowers	15	1.4	p < 0.01*
Practicing Social Distancing	Yes	778	70.5
	No	326	29.5	p < 0.01*
Stable Bond	Yes	302	26.7
	No	828	73.3	p < 0.01*
Family Support (My family cares about me and helps me when necessary)	Yes	783	69.3
	No	347	30.7	p < 0.01*
Mental Health Diagnostic Reported	Yes	456	34.7
	No	858	65.3	p < 0.01*
Depression Prevalence	Mild Symptoms	125	12,5
	Moderate Symptoms	194	19.3
	Severe or very severe Symptoms	173	17.2	p < 0.01*
Anxiety Prevalence	Mild Symptoms	84	8.3
	Moderate Symptoms	143	14.1
	Severe or very severe Symptoms
		214	21.1	p < 0.01*
Stress Prevalence	Mild Symptoms	126	12.9
	Moderate Symptoms	174	17.8
	Severe or very severe Symptoms
		187	19.2	p < 0.01*

* Chi-Square Test.

Table 2. Description of the coping results (mean and standard deviation) separately by stress, depression and anxiety levels presented (DASS-21).

	Level	Age	Confrontation	Problem Solving	Escape	Positive Reappraisal	Distancing	Self-Control	Social Support	Accepting responsibility
Participants without a mental health diagnostic
Depression	Mild/No symptoms	39.27 (11.38)	2.86 (2.66)	5.05 (3.00)	2.67 (1.86)	11.04 (5.66)	5.43 (3.44)	5.75 (2.71)	5.97 (3.29)	5.98 (4.08)
	Moderate	34.10 (11.07)	4.97 (2.70)	4.11 (2.34)	4.10 (1.90)	9.94 (5.41)	7.03 (3.24)	6.6.1 (2.72)	6.73 (2.87)	7.65 (3.84)
	Severe	29.78 (10.24)	6.96 (5.72)	3.59 (2.42)	4.61 (1.89)	8.58 (5.38)	8.41 (3.94)	6.54 (2.71)	6.27 (3.69)	8.22 (3.99)
	Kruskal-Wallis (p)	<0.001**	<0.001**	<0.001**	<0.001**	<0.001**	<0.001**	<0.001**	0.105	<0.001**
Anxiety	Mild/No symptoms	38.45 (11.69)	2.92 (2.57)	4.79 (3.00)	2.76 (1.95)	10.36 (5.67)	5.52 (3.47)	5.77 (2.83)	5.83 (3.23)	5.94 (3.97)
	Moderate	36.08 (13.02)	4.91 (3.23)	4.52 (2.58)	4.08 (1.76)	10.93 (5.53)	7.35 (3.60)	6.46 (2.58)	6.60 (3.00)	8.32 (3.90)
	Severe	32.04 (10.14)	7.26 (5.94)	4.39 (2.55)	4.44 (1.85)	10.84 (5.76)	7.82 (3.60)	6.90 (2.58)	7.28 (3.59)	8.22 (4.16)
	Kruskal-Wallis (p)	<0.001**	<0.001**	0.491	<0.001**	0.898	<0.001**	<0.001**	0.004**	<0.001**
Stress	Mild/No symptoms	39.21 (11.79)	2.84 (2.80)	5.00 (2.95)	2.67 (1.81)	10.82 (5.63)	5.60 (3.37)	5.85 (2.79)	5.82 (3.14)	5.98 (3.96)
	Moderate	33.72 (9.96)	5.08 (2.97)	4.31 (2.64)	3.91 (1.78)	11.40 (5.40)	7.25 (3.57)	6.40 (2.70)	7.01 (3.30)	7.82 (3.95)
	Severe	31.20 (10.59)	6.60 (3.35)	4.30 (2.50)	4.48 (1.55)	9.70 (5.48)	8.14 (3.90)	6.81 (2.62)	7.04 (3.60)	6.60 (3.35)
	Kruskal-Wallis (p)	<0.001**	<0.001**	0.03*	<0.001**	0.059	<0.001**	0.002**	0.001**	<0.001**
Participants with a mental health diagnostic
Depression	Mild/No symptoms	40.99 (12.74)	3.66 (2.66)	4.61 (2.37)	2.91 (2.09)	10.51 (5.29)	5.70 (3.48)	5.26 (2.60)	6.96 (3.66)	5.97 (4.21)
	Moderate	33.57 (9.97)	5.69 (3.27)	4.16 (2.48)	4.32 (1.84)	9.98 (5.84)	7.30 (2.97)	6.12 (2.39)	7.21 (3.48)	7.29 (3.55)
	Severe	33.04 (10.75)	6.82 (3.60)	3.85 (2.61)	4.72 (2.08)	9.63 (5.27)	8.08 (3.61)	6.95 (2.65)	7.17 (3.27)	9.60 (4.25)
	Kruskal-Wallis (p)	<0.001**	<0.001**	0.093	<0.001**	0.229	<0.001**	<0.001**	0.729	<0.001**
Anxiety	Mild/No symptoms	40.87 (12.70)	3.40 (2.98)	4.35 (2.66)	2.92 (2.11)	9.70 (5.33)	5.84 (3.40)	5.32 (2.55)	6.09 (3.28)	5.71 (4.05)
	Moderate	35.51 (12.28)	5.40 (3.11)	4.19 (2.48)	3.35 (1.99)	10.76 (5.44)	6.89 (3.27)	5.73 (2.38)	8.00 (3.92)	7.70 (3.83)
	Severe	33.59 (10.43)	6.61 (3.24)	4.25 (2.34)	4.89 (1.86)	10.19 (5.52)	7.76 (3.62)	6.86 (2.60)	7.67 (3.18)	8.95 (4.28)
	Kruskal-Wallis (p)	<0.001**	<0.001**	0.899	<0.001**	0.769	0.006**	<0.001**	0.001**	<0.001**
Stress	Mild/No symptoms	41.15 (13.12)	3.37 (2.38)	4.39 (2.43)	2.94 (1.96)	10.02 (5.59)	5.75 (3.29)	5.22 (2.66)	6.38 (3.79)	5.93 (3.98)
	Moderate	34.31 (9.74)	5.05 (3.31)	4.16 (2.45)	3.43 (1.76)	10.56 (4.83)	7.24 (2.72)	6.49 (2.32)	7.43 (2.85)	7.76 (4.14)
	Severe	34.08 (10.53)	6.99 (3.01)	4.19 (2.60)	4.60 (1.75)	10.25 (5.31)	7.90 (3.74)	6.46 (2.52)	7.76 (3.35)	8.87 (4.40)
	Kruskal-Wallis (p)	<0.001**	<0.001**	0.941	<0.001**	0.972	0.001**	0.003**	0.012**	<0.001**

Table 3. Multinomial Logistic Regression Model, Stepwise Method adjusted for income, for Dependent Variable Depression (Severe and Moderate Depression in comparison to mild or no Depression symptoms)

		Participants without mental health diagnostic						Participants with mental health diagnostic
		Univariate			Multivariate Model			Univariate Analyzes			Multivariate Model
		OR	95% CI	p	OR adj	95% CI	p	OR	95% CI	p	OR adj	95% CI	p
Moderate Depression
Age		0.96	0.94-0.97	<0.001	1.01	0.98-1.04	0.44	0.95	0.92-0.98	<0.001	0.95	0.90-1.00	0.072
Social Distancing	Yes	1.20	0.78–1.83	0.40	1.85	1.05-3.26	0.03	2.62	1.18–5.8	0.018	4.26	1.47-12.36	0.008
Marital Status (Reference: married)	Singles	2.36	1.17–4.77	0.01	1.63	0.62-4.31	0.32	2.27	0.67–7.72	0.19	0.57	0.09–3.42	0.537
	Divorced or Widower	1.17	0.58–2.35	0.66	0.97	0.41-2.30	0.94	1.59	0.47–5.33	0.45	1.61	0.34–7.74	0.550
Stable Bond		0.56	0.37–0.88	0.01	0.69	0.38-1.27	0.24	0.83	0.42–1.64	0.58	2.12	0.73–6.16	0.169
Family Support	Do not have	1.44	0.88–2.34	0.14	1.00	0.48-2.11	0.99	1.13	0.53–2.40	0.76	1.72	0.53–5.61	0.368
Confrontation		1.80	1.19–1.37	<0.001	1.24	1.12-1.37	<0.001	1.26	1.23–1.56	<0.001	1.26	1.04–1.53	0.017
Problem solving		0.88	0.75–0.89	0.001	0.81	0.72-0.92	0.001	0.91	0.79–1.04	0.176	0.96	0.77–1.19	0.705
Escape		1.48	1.32–1.65	<0.001	1.44	1.22-1.69	<0.001	1.41	1.18–1.69	<0.001	1.44	1.09–1.88	0.008
Positive Reappraisal		0.96	0.93–0.99	0.02	0.87	0.82-0.94	<0.001	0.98	0.92–1.04	0.44	0.98	0.87–1.11	0.749
Distancing		1.14	1.08–1.2	<0.002	1.09	1.00-1.20	0.042	1.15	1.03–1.28	0.009	1.03	0.86–1.24	0.722
Self-Control		1.12	1.04–1.20	0.002	1.04	0.93-1.17	0.498	1.15	0.99–1.32	0.052	1.03	0.83–1.28	0.790
Social Support		1.06	0.99–1.13	0.06	1.02	0.91-1.13	0.775	1.03	0.93–1.13	0.61	0.97	0.82–1.13	0.663
Accepting responsibility		1.10	1.05–1.16	<0.001	1.05	0.96-1.16	0.284	1.07	0.98–1.17	0.10	0.96	0.82–1.13	0.650
Severe Depression
Age		0.92	0.89-0.94	<0.001	0.99	0.95-1.03	0.71	0.94	0.92-0.97	<0.001	0.95	0.89–1.02	0.132
Social Distancing	Yes	1.67	0.98–2.84	0.056	2.37	1.10-5.08	0.027	2.00	1.03–3.87	0.04	3.19	1.11–9.18	0.032
Marital Status (Reference: married)	Singles	3.15	1.43–6.95	0.004	2.32	0.60-8.95	0.221	1.25	0.49–3.18	0.64	0.48	0.07–3.30	0.452
	Divorced or Widower	0.49	0.20–1.18	0.11	0.38	0.10-1.41	0.15	0.84	0.33–2.1	0.71	1.59	0.30–8.35	0.583
Stable Bond		0.49	0.29–0.83	0.008	0.78	0.32–1.93	0.60	0.61	0.32–1.16	0.13	1.53	0.48–4.91	0.472
Family Support	Do not have	2.70	1.64–4.43	<0.001	2.57	1.08–6.13	0.033	1.53	0.78–2.97	0.21	1.95	0.57–6.63	0.286
Confrontation		1.47	1.33–1.55	<0.001	1.39	1.23–1.58	<0.001	1.39	1.23–1.56	<0.001	1.33	1.10–1.60	0.004
Problem solving		0.82	0.75–0.89	<0.001	0.75	0.63–0.88	0.001	0.88	0.77–0.99	0.046	0.93	0.73–1.18	0.541
Escape		1.67	1.47–1.93	<0.001	1.48	1.19–1.84	<0.001	1.52	1.28–1.81	<0.001	1.49	1.12–1.98	0.007
Positive Reappraisal		0.91	0.87–0.95	<0.001	0.85	0.78–0.93	0.001	0.96	0.91–1.02	0.22	0.92	0.80–`0.05	0.196
Distancing		1.24	1.16–1.32	<0.001	1.20	1.07–1.35	0.002	1.22	1.10–1.35	<0.001	0.96	0.79–1.16	0.653
Self – Control		1.13	1.04–1.23	0.005	0.99	0.86–1.17	0.960	1.35	1.17–1.54	<0.001	1.11	0.89–1.39	0.349
Social Support		1.01	0.95–1.09	0.68	0.95	0.83–1.09	0.450	1.03	0.94–1.13	0.55	0.92	0.78–1.09	0.350
Accepting responsibility		1.12	1.06–1.19	<0.001	1.08	0.96–1.23	0.200	1.22	1.12–1.33	<0.001	1.17	0.99–1.38	0.052

Table 4. Multinomial Logistic Regression Model, Stepwise Method adjusted for income, for Dependent Variable Anxiety (Severe and Moderate Anxiety in comparison to mild or no Anxiety symptoms)

		Participants without mental health diagnostic						Participants with mental health diagnostic
		Univariate			Multivariate Model			Univariate Analyzes			Multivariate Model
		OR	95% CI	p	OR adj	95% CI	p	OR	95% CI	p	ORadj	95% CI	P
Moderate Anxiety
Age		0.98	0.96–1.00	0.07	1.04	1.00–1.07	0.02	0.96	0.93–0.99	0.91	0.12	0.90–1.01	0.12
Social Distancing	Yes	0.96	0.601–1.55	0.88	0.86	0.48–1.65	0.62	0.75	0.35–1.61	0.46	1.77	0.62–5.03	0.28
Marital Status (Reference: married)	Singles	1.89	0.81–4.43	0.141	2.27	0.74–6.90	0.14	1.43	0.43–4.67	0.55	0.68	0.11–4.31	0.68
	Divorced or Widower	1.71	0.74–3.94	0.21	2.41	0.99–6.51	0.08	1.03	0.32–3.29	0.96	1.68	0.29–8.57	0.58
Stable Bond		0.62	0.38–1.03	0.06	0.74	0.38–1.42	0.36	0.55	0.25–1.21	0.14	0.12	0.35–3.56	0.85
Family Support	Do not have	1.54	0.90–2.64	0.11	2.12	1.05–4.31	0.04	0.47	0.18–1.25	0.13	0.16	0.03–1.00	0.05
Confrontation		1.28	1.18–1.39	<0.001	1.12	1.00–1.26	0.05	1.30	1.14–1.49	<0.001	1.29	1.10–1.56	0.01
Problem solving		0.96	0.89–1.04	0.30	0.86	0.75–0.98	0.02	0.98	0.84–1.13	0.76	0.84	0.66–1.07	0.16
Escape		1.43	1.26–1.62	<0.001	1.27	1.06–1.51	0.009	1.18	0.97–1.43	0.10	0.82	0.61–1.10	0.18
Positive Reappraisal		1.00	0.96–1.04	0.87	0.98	0.91–1.05	0.58	1.03	0.96–1.10	0.44	1.05	0.93 −1.19	0.43
Distancing		1.14	1.07–1.21	<0.001	0.86	0.48–1.65	0.62	1.10	0.98–1.23	0.10	0.92	0.83–1.21	0.92
Self-Control		1.08	0.99–1.17	0.09	0.93	0.82 −1.06	0.28	1.06	0.91–1.24	0.45	0.93	0.72–1.19	0.56
Social Support		1.06	0.99–1.13	0.119	1.01	0.90–1.14	0.81	1.18	1.05–1.32	0.006	1.28	1.08–1.51	0.005
Accepting responsibility		1.14	1.08–1.20	<0.001	1.12	1.02 −1.26	0.02	1.14	1.03–1.26	0.008	1.00	0.85–1.19	0.96
Severe Anxiety
Age		0.94	0.93–0.96	<0.001	0.98	0.95–1.01	0.28	0.95	0.92–0.97	<0.001	0.96	0.90–1.04	0.10
Social Distancing	Yes	1.21	0.77–1.90	0.41	1.79	0.96–3.35	0.06	1.67	0.85–3.23	0.14	3.34	1.27–9.58	0.02
Marital Status (Reference: married)	Singles	2.00	0.97–4.14	0.06	1.95	0.58–6.53	0.28	1.71	0.64–4.55	0.28	0.81	0.14–4.56	0.81
	Divorced or Widower	1.20	0.57–2.49	0.63	1.97	0.64–6.00	0.23	1.16	0.43–2.91	0.82	2.04	0.44–9.41	0.36
Stable Bond		0.65	0.42–1.03	0.06	0.96	0.48–1.91	0.90	0.78	0.43–1.42	0.41	1.90	0.65–5.58	0.24
Family Support	Do not have	1.73	1.07–2.81	0.02	1.68	0.80–3.55	0.17	1.43	0.752–2.71	0.27	1.97	0.66–5.91	0.22
Confrontation		1.47	1.35–1.58	<0.001	1.38	1.24–1.54	0.000	1.43	1.26–1.61	<0.001	1.28	1.08–1.53	0.005
Problem solving		0.95	0.88–1.02	0.18	0.82	0.72–0.93	0.03	1.00	0.89–1.12	0.99	0.96	0.78–1.18	0.70
Escape		1.59	1.40–1.79	<0.001	1.34	1.12 −1.60	0.01	1.73	1.43–1.08	<0.001	1.52	1.16–1.99	0.003
Positive Reappraisal		1.09	0.97–1.05	0.63	0.81	0.94–1.08	0.92	1.02	0.97–1.08	0.48	0.96	0.86–1.07	0.48
Distancing		1.19	1.12–1.26	<0.001	1.01	0.91–1.11	0.81	1.18	1.07–1.29	0.001	0.95	0.30–1.13	0.53
Self – Control		1.16	1.07–1.26	<0.001	1.01	0.89–1.15	0.84	1.30	1.14–1.48	<0.001	1.06	0.86–1.29	0.59
Social Support		1.11	1.04–1.18	0.001	1.07	0.95–1.20	0.24	1.16	1.06–1.28	0.002	1.12	0.96–1.31	0.14
Accepting responsibility		1.35	1.08–1.19	<0.001	0.96	0.86–1.05	0.38	1.22	1.12–1.32	<0.001	1.07	0.93–1.23	0.35

Table 5. Multinomial Logistic Regression Model, Stepwise Method adjusted for income, for Dependent Variable Stress (Severe and Moderate Stress in comparison to mild or no Stress symptoms).

		Participants without mental health diagnostic						Participants with mental health diagnostic
		Univariate			Multivariate Model			Univariate Analyzes			Multivariate Model
		OR	95% CI	p	OR adj	95% CI	P	OR	95% CI	p	OR adj	95% CI	p
Moderate Stress
Age		0.95	0.94–0.97	<0.000	0.97	0.94–1.00	0.08	0.95	0.92–0.98	0.003	0.94	0.88–0.99	0.28
Social Distancing	Yes	0.71	0.47–1.06	0.09	0.75	0.44–1.29	0.29	0.84	0.39–1.82	0.67	1.56	0.55–4.43	0.41
Marital Status (Reference: married)	Singles	2.24	1.04–4.80	0.04	1.18	0.40–3.51	0.77	1.43	0.43–4.67	0.55	0.73	0.12–4.36	0.23
	Divorced or Widower	1.87	0.89–3.94	0.10	1.34	0.51–3.55	0.55	1.03	0.32–3.29	0.96	0.27	0.25–6.47	0.77
Stable Bond		0.69	0.45–1.06	0.09	0.81	0.43–1.51	0.50	0.55	0.25–1.21	0.14	2.52	0.82 – 7.74	0.11
Family Support	Do not have	1.44	0.88–2.34	0.14	1.30	0.60–2.80	0.51	0.47	0.18–1.25	0.13	2.79	0.79–9.88	0.11
Confrontation		1.36	1.26–1.47	<0.001	1.29	1.15–1.44	0.00	1.35	1.16–1.58	<0.001	1.37	1.10–1.71	0.05
Problem solving		0.91	0.84–0.99	0.02	0.81	0.72–0.92	0.001	0.98	0.86–1.13	0.84	0.85	0.67–1.08	0.17
Escape		1.46	1.29–1.65	<0.001	1.24	1.06 −1.46	0.009	1.16	0.96–1.41	0.11	0.95	0.71–1.25	0.67
Positive Reappraisal		1.02	0.98–1.05	0.28	1.00	0.93–1.07	0.96	1.00	0.93–1.07	0.94	1.00	0.88–1.13	0.98
Distancing		1.13	1.06–1.2	<0.001	0.30	0.96–1.15	0.29	1.14	1.01–1.28	0.03	1.56	0.55–4.43	0,41
Self-Control		1.07	0.99–1.15	0.08	0.95	0.84–1.07	0.35	1.19	1.03–1.39	0.01	1.11	0.89–1.40	0.36
Social Support		1.11	1.05–1.19	<0.001	1.06	0.95–1.18	0.30	1.10	0.98–1.23	0.08	1.12	0.95–1.32	0.19
Accepting responsibility		1.11	1.05–1.16	<0.001	1.01	0.92–1.11	0.86	1.12	1.02–1.22	0.02	0.98	0.83–1.14	0.76
Severe Stress
Age		0.93	0.91–0.97	<0.001	0.99	0.95–1.02	0.43	0.95	0.92–0.97	<0.001	0.97	0.91–1.02	0.23
Social Distancing	Yes	0.85	0.53–1.36	0.51	1.05	0.55–2.00	0.89	1.02	0.57–2.03	0.83	1.69	0.61–4.61	0.32
Marital Status (Reference: married)	Singles	2.91	1.32–6.41	0.008	2.10	0.58–7.47	0.26	1.88	0.70–5.00	0.21	1.23	0.19–7.88	0.82
	Divorced or Widower	0.92	0.40–2.11	0.90	1.10	0.34–3.56	0.88	1.60	0.62–4.16	0.34	4.00	0.76–20.94	0.10
Stable Bond		0.65	0.39–1.06	0.08	1.01	0.48–2.12	0.98	0.60	0.61–2.66	0.50	0.74	0.25–0.2.23	0.59
Family Support	Do not have	2.70	1,64–4.43	<0.001	2.03	0.91–4.55	0.08	1.53	0.78–2.97	0.21	2.73	0.84–8.82	0.09
Confrontation		1.53	1.34–1.67	<0.001	1.45	1.29–1.64	<0.001	1.64	1.41–1.90	<0.001	1.64	1.33–2.00	0.00
Problem solving		0.91	0.89–0.99	0.03	0.88	0.77–1.01	0.08	0.98	0.86–1.09	0.69	0.94	0.76–1.17	0.59
Escape		1.79	1.55–2.08	<0.001	1.52	1.25–1.80	<0.001	1.68	1.38–2.02	<0.001	1.26	0.99–1.65	0.10
Positive Reappraisal		0.95	0.92–1.00	0.05	0.90	0.83–0.98	0.01	1.00	0.95–1.06	0.80	0.97	0.67–1.10	0.57
Distancing		1.20	1.13–1.28	<0.001	1.07	0.97–1.19	0.17	1.20	1.10– 1.33	<0.001	1.07	0.90–1.26	0.47
Self – Control		1.16	1.06–1.26	0.001	1.03	0.90–1.18	0.58	1.25	1.10–1.43	<0.001	1.00	0.87–1.24	0.97
Social Support		1.08	1.01–1.16	0.01	1.09	0.96–1.23	0.17	1.13	1.03–1.24	0.01	1.10	0.92–1.27	0.36
Accepting responsibility		1.14	1.07–1.20	<0.001	0.97	0.86–1.08	0.58	1.19	1.10–1.29	<0.001	0.96	0.83–1.12	0.60

Data availability statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to their containing information that could compromise research participants’ privacy or ethical restrictions.