Sense of coherence (SOC) was found to be an important predictor and modulator of psychopathological symptoms associated with the COVID-19 pandemic. These findings were published in the Journal of Psychiatric Research.

This cross-sectional online study was conducted in February 2020. After the outbreak of the COVID-19 pandemic, the study authors decided to expand the study and allow for pre- and postpandemic comparisons. German speakers (N=1479) who lived in Germany and neighboring countries were invited to respond to surveys about SOC, psychopathological symptoms, sleep quality, and COVID-19-related rumination.

At baseline, participants were aged mean 55.3 (range, 20-95) years, 52.8% were women, and most lived in Germany (96.3%).

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A well-fit model of effects coupled SOC with psychopathological symptoms with a unidirectional coupling relationship (χ2, 78.70; P <.001).

Constant increases to SOC (α, 15.05; P <.001) and psychopathological symptoms (α, 36.01; P <.001) were observed, in which increased SOC or psychopathological symptoms associated with greater changes in SOC or psychopathological symptoms but were not interrelated. However, previous SOC predicted changes in psychopathological symptoms (z, -1.99; P =.048).

These relationships indicated that individuals with low SOC and average psychopathological symptoms at baseline would be expected to have a 3.04-point increase in psychopathological symptom scores during the pandemic compared with a 2.93-point decrease in symptoms among those with strong SOC.

The trajectories of SOC and psychopathological symptoms had 6 patterns. The group with high COVID-19 rumination had increased psychopathological symptoms (F[1,647], 275.43; P <.001), poorer sleep quality (F[1,654], 17.91; P <.001), and weaker SOC (F[1,656], 66.48; P <.001).

A model using COVID-19-related rumination as a moderator improved the model fit (χ2, 194.54; P <.001).

SOC changed among both the low- (α, 16.75; P <.001) and high- (α, -21.28; P <.001) rumination groups. In both groups, changes in SOC did not relate with psychopathological symptoms.

These relationships indicated that in the high-rumination group, individuals with lower SOC and average psychopathological symptoms at baseline would be expected to have a 10.51-point increase in psychopathological symptom scores during the pandemic compared with a 9.78-point decrease in symptoms for those with strong SOC.

The limitations of this study included the reliance on self-reported data and the fact that the study population did not represent the general population of Germany with regard to age and education.

The study authors concluded, “The current study improves our understanding of the interaction between the resilience factor SOC and mental health during the COVID-19 pandemic. We found a small, yet significant increase of psychopathological symptoms in the total sample and identified a subgroup of respondents (17.2%) characterized by high COVID-19-related rumination, high levels of psychopathological symptoms and weaker SOC that was particularly burdened by the pandemic. In this subgroup, and in the total sample, previous levels of SOC were predictive of later changes in psychopathological symptoms. A stronger SOC was associated with smaller changes and a greater chance to experience symptom decreases over time.”


Schäfer SK, Sopp MR, Koch M, Göritz AS, Michael T. The long-term buffering effect of sense of coherence on psychopathological symptoms during the first year of the COVID-19 pandemic: a prospective observational study. J Psychiatr Res. 2022;153:236-244. doi:10.1016/j.jpsychires.2022.07.004