ORCID

https://orcid.org/0000-0003-1144-7126

Date of Award

2024

Document Type

Dissertation

Degree Name

Philosophy (Ph.D)

Department

Psychology

First Advisor

Elizabeth Brondolo

Second Advisor

Robin Wellington

Third Advisor

William Chaplin

Abstract

During 2020, the COVID-19 pandemic emerged as a threatening, unpredictable, and uncontrollable stressor. Meaning-making, or one’s ability to make sense of a stressful life event, integrate the event into one’s narrative of the world and meaning in life, and accordingly revise life goals, is a salient intrapsychic process contributing to psychological adjustment in the face of very stressful or traumatic experiences such as chronic health issues, interpersonal grief, and natural and man-made disasters. Early findings provide evidence for the critical role of meaning-making in coping with stressors associated with the COVID-19 pandemic. Though meaning-making is a universal process, one’s capacity to do so may be fundamentally shaped by contextual factors related to social determinants of health (SDoH; i.e., the social, cultural, and economic factors that affect health status). However, relations of these factors to meaning-making during the pandemic are not yet fully understood. Further, it is not yet known how meaning-making may mediate the link between SDoH and mental health in the content of COVID-19. The aim of this study is to evaluate pathways by which a broad range of individual and community level SDoH influence meaning-making and mental health outcomes during the pandemic. In a nationally representative sample of 572 American adults, stressors associated with individual SDoH and COVID-19 burden were linked with disrupted meaning made of the pandemic and poorer mental health outcomes marked by greater anxiety and depressive symptoms. However, community stressors reflective of neighborhood burden were not linked with psychological processes. A serial mediation model in which the pathway between individual SDoH burden and psychological distress operates indirectly through individual COVID-19 burden and meaning made of the pandemic was supported. These findings suggest that individual stressors associated with SDoH may be a key force in shaping mental health outcomes during the pandemic, potentially through their relations with increased personal COVID-19 disease burden and lower capacity to make meaning of the pandemic. Findings may be used to guide psychotherapeutic assessment and interventions and to inform public health messaging and policy change around social determinants of health and COVID-19 health disparities.

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