

Ci a ion: Mole o Ju ado, M.d.M.;
Pé ez-Fuen es, M.d.C.; He e a-Peco,
I.; O opesa Ruiz, N.F.; Ba agán
Ma ín, A.B.; Ma os Ma ínez, Á.;
Simón Má quez, M.d.M.; Gázquez
Lina es, J.J. Men al Heal h in Se ings
wi h COVID-19 Posi i e Cases in he
Spanish Popula ion: The P o ec i e
Role o he Capaci y o Adap o
Change. J. Clin. Med. 2022,11, 1497.
h ps://doi.o g/10.3390/jcm11061497
Academic Edi o : Michele Roccella
Recei ed: 9 Feb ua y 2022
Accep ed: 7 Ma ch 2022
Published: 9 Ma ch 2022
Publishe ’s No e: MDPI s ays neu al
wi h ega d o ju isdic ional claims in
published maps and ins i u ional a il-
ia ions.
Copy igh : © 2022 by he au ho s.
Licensee MDPI, Basel, Swi ze land.
This a icle is an open access a icle
dis ibu ed unde he e ms and
condi ions o he C ea i e Commons
A ibu ion (CC BY) license (h ps://
c ea i ecommons.o g/licenses/by/
4.0/).
Jou nal o
Clinical Medicine
A icle
Men al Heal h in Se ings wi h COVID-19 Posi i e Cases in he
Spanish Popula ion: The P o ec i e Role o he Capaci y o
Adap o Change
Ma ía del Ma Mole o Ju ado 1, Ma ía del Ca men Pé ez-Fuen es 1, I án He e a-Peco 2,
Nie es Fá ima O opesa Ruiz 1, Ana Belén Ba agán Ma ín1,Á ica Ma os Ma ínez 1,* ,
Ma ía del Ma Simón Má quez 1and JoséJesús Gázquez Lina es 1,3
1Depa men o Psychology, Facul y o Psychology, Uni e si y o Alme ía, 04120 Alme ia, Spain;
[email p o ec ed] (M.d.M.M.J.); [email p o ec ed] (M.d.C.P.-F.); [email p o ec ed] (N.F.O.R.);
[email p o ec ed] (A.B.B.M.); [email p o ec ed] (M.d.M.S.M.); [email p o ec ed] (J.J.G.L.)
2Nu sing Depa men , Heal h Sciences Collegue, Al onso X El Sabio Uni e si y, 28691 Mad id, Spain;
[email p o ec ed]
3Depa men o Psychology, Uni e sidad Au ónoma de Chile, P o idencia 7500000, Chile
*Co espondence: [email p o ec ed]; Tel.: +34-950015598
Abs ac :
Backg ound: The capaci y o adap o change in complex, highly demanding si ua ions,
such as hose de i ed om he COVID-19 pandemic, is essen ial in main aining one’s men al heal h.
This s udy analyzed he men al heal h o he Spanish popula ion in se ings wi h COVID-19 posi i e
cases and he p o ec i e ole o adap a ion o change. Me hods: The sample consis ed o 1160 adul
Spania ds aged 18 o 82 wi h a mean age o 38.29 (SD = 13.71). Da a we e collec ed by a CAWI
(Compu e Aided Web In e iewing) su ey which included he Gene al Heal h Ques ionnai e
(GHQ-28), Adap a ion o Change Ques ionnai e (ADAPTA-10), and an ad hoc ques ionnai e ela ed
o COVID-19 (pe cei ed economic impac , COVID-19 posi i e diagnosis o no , and whe he he e
was a posi i e case close o hem). Resul s: The da a e ealed ha he pe cei ed economic impac
showed a nega i e associa ion be ween he emo ional ac o and he o al sco e in adap a ion o
change. Las ly, he emo ional ac o in adap a ion o change ope a ed as a p o ec o om he e ec
ha a se ing wi h COVID-19 posi i e cases exe s on men al heal h. Conclusions: Coping wi h
COVID-19 equi es s eng hening he capaci y o adap a ion o changes gene a ed in he se ing,
especially emo ional, as i could con ibu e o imp o ing he men al heal h o indi iduals, especially
in hose se ings whe e hey ind and know a COVID-19 posi i e case.
Keywo ds: adap a ion o change; COVID-19; emo ion; pandemic; heal h
1. In oduc ion
In iew o he wo ldwide si ua ion gene a ed by he COVID-19 pandemic [
1
], i is
essen ial o know how indi iduals adap o he many changes caused by he i us in hei
e e yday a ai s and he e ec s o his capaci y o adap a ion on public men al heal h.
Capaci y o adap ing e e s o unc ional modi ica ion o he indi idual’s psycho-
logical and beha io al esponses o change. These changes mus ha e bene icial esul s
enabling hem o success ully cope wi h e en s and daily demands [
2
]. Fu he mo e,
he mos con empo a y app oaches o heal h esponse ocus on main aining indi idual
physical and men al wellbeing, and i s co esponding epe cussions on socie y [
3
]. The
implica ion o he concep o heal h in he social se ing is essen ial o e e ing o adequa e
in eg a ion o indi iduals in he socie y hey pe ain o [4].
The COVID-19 pandemic has a ec ed indi idual physical heal h due o i s se e e
symp oms [
5
,
6
]. Howe e , i has also a ec ed he men al dimension o heal h, since he
disease i sel , ac ions o i s con ol, and access o in o ma ion ha e modi ied usual indi id-
ual and social beha io [
7
–
10
]. These changes in how one ela es o he se ing may cause
J. Clin. Med. 2022,11, 1497. h ps://doi.o g/10.3390/jcm11061497 h ps://www.mdpi.com/jou nal/jcm
J. Clin. Med. 2022,11, 1497 2 o 13
indi iduals o become ulne able [
11
], con ibu ing o he appea ance o psychological
symp oms such as anxie y, i i abili y, u y, us a ion, eelings o loneliness, ea , and
in ole ance o unce ain y [9,12–19].
Re u ning o he capaci y o adap a ion, his a iable is conside ed a skill o dispo-
si ion o change in beha io in he ace o modi ica ions in one’s ac i i ies, beha io s o
social no ms, and e en changes in se ing [
20
]. The capaci y o adap a ion is demons a ed
when any change occu s, whe he o no i has nega i e conno a ions o he indi idual.
In his adap a ion, esilience may help o e come such ad e se s ess ul si ua ions [
21
].
Resilience may be de ined as “bouncing back” om di icul expe iences, so ha indi iduals
adap o s ess ul changes, aumas, agedies, o e en se ings o si ua ions, while hei
usual social beha io s emain unal e ed, ha is, s able and unc ional [
22
,
23
]. I is he e o e
a p o ec i e mechanism agains he pe nicious e ec s o s ess [
24
]. Some s ess ul si ua ions
ha could equi e an indi idual’s capaci y o esilience a e dea h, na u al disas e s, o
o he ca as ophic e en s, such as a pandemic [
25
], and ad e se economic si ua ions [
26
,
27
].
No e e yone has he same capaci y o adap a ion o change in hei se ing, since
esilience is a phenomenon a ec ed by a mul i ude o ac o s [
22
]. One ac o in luencing
i is sex, as women adap wo se o s ess ul changes in hei se ing [
28
]. Ano he is age,
as olde age has been ound o be associa ed wi h highe capaci y o esilience, which, in
u n, is associa ed wi h s onge and mo e esolu e pu pose in li e [
29
,
30
]. O he ac o s
ela ed o esilience may be ained and imp o ed, such as posi i e coping [
31
,
32
], and
anxie y and s ess educ ion echniques [
33
] can imp o e he capaci y o adap a ion [
22
,
34
].
T aining in coping s a egies o s ess ul o ca as ophic si ua ions enables ulne abili y
and exhaus ion o be educed and a mo e p ecise and e icien esponse o ins uc ions
om au ho i ies [
35
–
37
]. Managemen and coping he e o e exe a undamen al ole in
adap a ion o change.
Two main dimensions should be men ioned wi h ega d o coping wi h s ess ul
si ua ions: (i) cogni i e-beha io al and (ii) emo ional [2].
The cogni i e-beha io al dimension includes ac o s associa ed wi h con ol, manage-
men , and ac ion aken o adap o change, such as awa eness, cogni i e lexibili y, and
s ess managemen . Likewise, among he de e minan s in ol ed in he emo ional dimen-
sion ha in luence he capaci y o adap ing o change a e social suppo and ole ance o
unce ain y, no omi ing dep ession and anxie y [2,38].
In he emo ional dimension o adap a ion o change, dep ession is associa ed wi h
unc ional al e a ions, which may include limi a ions on ac i i y, educed concen a ion,
low ene gy o a igue, and o he s [39].
I should also be men ioned ha social suppo ein o ces esilience o adap abili y
o s ess ul e en s, educing hei impac on he indi idual [
20
,
40
]. Social suppo has a
s uc u al dimension in he size o he indi idual’s con ac ne wo k and he equency
o hose con ac s, bu also a unc ional dimension ha is ela ed o empa hy o suppo
ecei ed [
41
]. People wi h a nume ous and unc ional social suppo ne wo k can imp o e
hei esilience be e and cope posi i ely wi h s ess ul e en s, imp o ing hei quali y o
li e [31], and can ede ine a si ua ion so i is no longe s ess ul [42].
In addi ion, ole ance o unce ain y may be de ined as indi iduals’ cogni i e and
emo ional esponses o unknown si ua ions [
43
]. I is wo h men ioning ha he si ua ion
associa ed wi h COVID-19, ela ed o no ha ing adequa e, unde s andable in o ma ion,
gene a es unce ain y [
44
], which, in u n, is associa ed wi h he appea ance o anxie y,
s ess, and emo ional al e a ions [
45
,
46
]. In he ligh o hese indings, managing emo ions
akes on conside able impo ance o adap ing o si ua ions ha gene a e unce ain y.
The e o e, i seems likely ha hose wi h be e capaci y o emo ional managemen will
also ha e be e adap i e capaci y [47].
Pu pose and Hypo heses
Based on he discussion abo e, his s udy analyzed he capaci y o adap a ion o
s ess ul si ua ions, such as he COVID-19 pandemic, wi h a en ion o sociodemog aphic
J. Clin. Med. 2022,11, 1497 3 o 13
a iables, se ing cha ac e is ics, and men al heal h p oblems. P e ious s udies ha e
ocused on knowing how he acili y o o e coming ad e si y, which gene a es wellbeing
in indi iduals, is a ec ed by psychological dis ess caused by COVID-19 [
48
,
49
]. In ou
s udy, we wan ed o know whe he he e a e nega i e e ec s on men al heal h i he e is an
inadequa e adap i e esponse. We wan ed o ind ou he indica o s and cha ac e is ics o
indi iduals a high men al heal h isk, which in u n enables in e en ion be o e i de i es
in nega i e clinical si ua ions.
The main objec i es we e o: (1) Iden i y he epe cussion o si ua ions de i ed om
he COVID-19 pandemic, and (2) S udy he media ing ole o adap a ion o change in
se ings whe e he e a e COVID-19 posi i e cases on men al heal h (Figu e 1).
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 3 o 13
Pu pose and Hypo heses
Based on he discussion abo e, his s udy analyzed he capaci y o adap a ion o
s ess ul si ua ions, such as he COVID-19 pandemic, wi h a en ion o sociodemog aphic
a iables, se ing cha ac e is ics, and men al heal h p oblems. P e ious s udies ha e
ocused on knowing how he acili y o o e coming ad e si y, which gene a es wellbeing
in indi iduals, is a ec ed by psychological dis ess caused by COVID-19 [48,49]. In ou
s udy, we wan ed o know whe he he e a e nega i e e ec s on men al heal h i he e is
an inadequa e adap i e esponse. We wan ed o ind ou he indica o s and cha ac e is ics
o indi iduals a high men al heal h isk, which in u n enables in e en ion be o e i
de i es in nega i e clinical si ua ions.
The main objec i es we e o: (1) Iden i y he epe cussion o si ua ions de i ed om
he COVID-19 pandemic, and (2) S udy he media ing ole o adap a ion o change in
se ings whe e he e a e COVID-19 posi i e cases on men al heal h (Figu e 1).
Figu e 1. Hypo hesized model o he media ing ole o adap a ion o change on he e ec o COVID-
19 on men al heal h.
The ollowing hypo heses we e posed:
Hypo hesis 1 (H1). I was expec ed ha he e would be signi ican di e ences be ween men and
women in he capaci y o adap a ion o change.
Hypo hesis 2 (H2). The capaci y o adap ing o change would be posi i ely co ela ed wi h age.
Hypo hesis 3 (H3). The capaci y o adap ing o change would be nega i ely associa ed wi h he
pe cei ed economic impac o COVID-19.
Hypo hesis 4 (H4). Adap a ion o change would be nega i ely co ela ed o men al heal h
p oblems.
Hypo hesis 5 (H5). The emo ional ac o o adap a ion o change would unc ion as a media o o
he e ec ha a se ing whe e he e a e COVID-19 posi i e cases has on one’s men al heal h.
2. Ma e ials and Me hods
2.1. Pa icipan s
Fo he selec ion o he sample in his c oss-sec ional s udy, he inclusion c i e ia we e
being o legal age and ha ing access o he in e ne . Those indi iduals who did no answe
all he ques ions o did so andomly we e disca ded. The e o e, pa icipa ion was 1688
adul s, o whom 528 we e disca ded due o incomple e o andom answe s. The inal
sample was comp ised o 1160 adul Spania ds aged 18 o 82 and a mean age o 38.29 (SD
= 13.71).
O he o al sample, 30.1% (n = 349) we e men and 69.9% (n = 811) we e women, wi h
a mean o age o 41.16 (SD = 14.13) and 37.05 (SD = 13.34), espec i ely. O hese, 47% (n =
545) did no ha e a s able pa ne and 53% (n = 615) did. Conce ning educa ion, 77% o
Figu e 1.
Hypo hesized model o he media ing ole o adap a ion o change on he e ec o COVID-19
on men al heal h.
The ollowing hypo heses we e posed:
Hypo hesis 1 (H1).
I was expec ed ha he e would be signi ican di e ences be ween men and
women in he capaci y o adap a ion o change.
Hypo hesis 2 (H2). The capaci y o adap ing o change would be posi i ely co ela ed wi h age.
Hypo hesis 3 (H3).
The capaci y o adap ing o change would be nega i ely associa ed wi h he
pe cei ed economic impac o COVID-19.
Hypo hesis 4 (H4).
Adap a ion o change would be nega i ely co ela ed o men al heal h p oblems.
Hypo hesis 5 (H5).
The emo ional ac o o adap a ion o change would unc ion as a media o o
he e ec ha a se ing whe e he e a e COVID-19 posi i e cases has on one’s men al heal h.
2. Ma e ials and Me hods
2.1. Pa icipan s
Fo he selec ion o he sample in his c oss-sec ional s udy, he inclusion c i e ia
we e being o legal age and ha ing access o he in e ne . Those indi iduals who did no
answe all he ques ions o did so andomly we e disca ded. The e o e, pa icipa ion was
1688 adul s, o whom 528 we e disca ded due o incomple e o andom answe s. The
inal sample was comp ised o 1160 adul Spania ds aged 18 o 82 and a mean age o
38.29 (SD = 13.71).
O he o al sample, 30.1% (n= 349) we e men and 69.9% (n= 811) we e women, wi h
a mean o age o 41.16 (SD = 14.13) and 37.05 (SD = 13.34), espec i ely. O hese, 47%
(n= 545) did no ha e a s able pa ne and 53% (n= 615) did. Conce ning educa ion, 77% o
he sample had a highe educa ion (n= 893), and he es we e dis ibu ed be ween p ima y
(3.5%, n= 41) and seconda y (19.5%, n= 226) educa ion.
They we e asked i hey had been diagnosed as COVID-19 posi i e (1.6% o he sample
answe ed a i ma i ely, n= 19), and whe he he e any posi i e cases close o hem, o
which 31% (n= 360) said yes. Conce ning he pe cei ed economic impac om COVID-19,
J. Clin. Med. 2022,11, 1497 4 o 13
53.1% (n= 616) o he pa icipan s said li le o none, 24.1% (n= 281) somewha , and he
emaining 22.7% (n= 263) s a ed ha i had a ec ed hem qui e a lo o e y much.
2.2. Ins umen s
An ad hoc ques ionnai e was d a ed o collec pa icipan sociodemog aphic da a and
ma e s ela ed o ci cums ances ha ing o do wi h COVID-19 (pe cei ed economic impac ,
COVID-19 posi i e diagnosis o no , and whe he he e was a posi i e case close o hem).
Adap a ion o Change Ques ionnai e (ADAPTA-10) [
2
]. This ins umen consis s o
10 i ems answe ed on a i e-poin Like - ype scale ( om “no a all” o “ e y much”). I
p o ides a o al sco e on abili y o change, bu also in o ma ion on: (i) emo ional ac o ,
ela ed o anguish and dis ess ha may appea due o change, and (ii) cogni i e-beha io al
ac o , ela ed o he capaci y o con olling, managing, and ac ing in di e en si ua ions.
Reliabili y was
ω
= 0.83 and GLB = 0.90 o he o al sco e,
ω
= 0.85 and GLB = 0.87 o he
emo ional ac o and ω= 0.75 and GLB = 0.78 o he cogni i e-beha io al ac o .
Gene al Heal h Ques ionnai e (GHQ-28) [
50
], Spanish adap a ion alida ed by Lobo
e al. [
51
]. I consis s o 28 i ems wi h ou answe choices ha p o ide in o ma ion on he
soma ic symp oms, anxie y and insomnia, social dys unc ion, and dep ession subscales.
The Like scale co ec ion me hod was used, a ibu ing answe s co es om 0 o 3. In
ou case, ins umen eliabili y was
ω
= 0.93 and GLB = 0.94 o he comple e scale, and
o each o he subscales: soma ic symp oms (
ω
= 0.86; GLB = 0.89), anxie y/insomnia
(
ω
= 0.90; GLB = 0.95), social dys unc ion (
ω
= 0.81; GLB = 0.82), and dep ession (
ω
= 0.91;
GLB = 0.94).
2.3. P ocedu e
Da a we e collec ed in a CAWI (Compu e Aided Web In e iewing) su ey by snow-
ball sampling, om 1–12 May 2020. Pa icipa ion was olun a y and, be o e s a ing o
answe he ques ionnai e, essen ial in o ma ion abou he s udy was p o ided, as well
as pe sonal da a managemen and p ocessing ma e s. The pa icipan s ga e hei con-
sen by ma king a box designa ed o he pu pose, which hen ga e hem access o he
ques ionnai e.
Con ol ques ions we e dis ibu ed h oughou he es o de ec andom o incong u-
en answe s. This s udy was app o ed by he Uni e si y o Alme ía Bioe hics Commi ee
(UALBIO2020/032).
2.4. Da a Analysis
Fi s , o ind ou whe he he e we e any di e ences in capaci y o adap a ion o
change, he independen samples - es was applied, and he Cohen’s d[
52
] was es ima ed
o quan i y he e ec size. In addi ion, o es he ela ionships be ween a iables, Pea son’s
coe icien co ela ion analyses we e done.
As a s a egy o iden i ying p o iles by COVID-19 cha ac e is ics in he se ing, a
wo-s age clus e analysis was pe o med. To de e mine whe he he e we e any di e ences
be ween COVID-19 clus e s ela ed o he mean sco es on adap a ion o change, an ANOVA
wi h pos hoc co ec ion (Bon e oni) was calcula ed. Fo he size e ec , he
η2
and
ω2
we e
es ima ed.
Finally, di e en media ion analyses we e ca ied ou , aking as he p edic o (p esence
o a COVID-19 posi i e case nea by), as media o s he ac o s o adap a ion o change and,
as esul a iables, he heal h measu e subscales (soma ic symp oms, anxie y/insomnia,
social dys unc ion, and dep ession). JASP e sion 0.11.1 [
53
] based on la aan so wa e was
used o his [
54
]. The bias-co ec ed pe cen ile boo s ap con idence in e als me hod was
used, as sugges ed by Biesanz, Falk, and Sa alei [
55
]. Reliabili y was es ima ed wi h he
McDonald’s Omega and he G ea es Lowe Bound (GLB).
J. Clin. Med. 2022,11, 1497 5 o 13
3. Resul s
This sec ion may be di ided by subheadings. I should p o ide a concise and p ecise
desc ip ion o he expe imen al esul s, hei in e p e a ion, as well as he expe imen al
conclusions ha can be d awn.
3.1. Adap a ion o Change: Sociodemog aphic Va iables and COVID-19 in he Se ing
Fi s , age was ound o be posi i ely co ela ed wi h he emo ional ac o ( = 0.18;
p< 0.001; 95% CI 0.12, 0.23), he cogni i e-beha io al ac o ( = 0.17; p< 0.001; 95%
CI 0.11, 0.22), and he o al sco e on he adap a ion o change scale ( = 0.21; p< 0.001;
95% CI 0.15, 0.26).
Pa icipan sex was ound o ha e s a is ically signi ican di e ences in all he adap a-
ion measu es (Figu e 2). Speci ically, men had highe mean sco es on he emo ional ac o
(
(1158)
= 7.15; p< 0.001; d= 0.45), he cogni i e-beha io al ac o (
(1158)
= 2.12; p< 0.05;
d= 0.13), and also he o al adap a ion scale ( (1158) = 6.22; p< 0.001; d= 0.39).
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 5 o 13
change and, as esul a iables, he heal h measu e subscales (soma ic symp oms,
anxie y/insomnia, social dys unc ion, and dep ession). JASP e sion 0.11.1 [53] based on
la aan so wa e was used o his [54]. The bias-co ec ed pe cen ile boo s ap con idence
in e als me hod was used, as sugges ed by Biesanz, Falk, and Sa alei [55]. Reliabili y was
es ima ed wi h he McDonald’s Omega and he G ea es Lowe Bound (GLB).
3. Resul s
This sec ion may be di ided by subheadings. I should p o ide a concise and p ecise
desc ip ion o he expe imen al esul s, hei in e p e a ion, as well as he expe imen al
conclusions ha can be d awn.
3.1. Adap a ion o Change: Sociodemog aphic Va iables and COVID-19 in he Se ing
Fi s , age was ound o be posi i ely co ela ed wi h he emo ional ac o ( = 0.18; p
< 0.001; 95% CI 0.12, 0.23), he cogni i e-beha io al ac o ( = 0.17; p < 0.001; 95% CI 0.11,
0.22), and he o al sco e on he adap a ion o change scale ( = 0.21; p < 0.001; 95% CI 0.15,
0.26).
Pa icipan sex was ound o ha e s a is ically signi ican di e ences in all he
adap a ion measu es (Figu e 2). Speci ically, men had highe mean sco es on he
emo ional ac o (
(1158)
= 7.15; p < 0.001; d = 0.45), he cogni i e-beha io al ac o (
(1158)
=
2.12; p < 0.05; d = 0.13), and also he o al adap a ion scale (
(1158)
= 6.22; p < 0.001; d = 0.39).
Figu e 2. Adap a ion o change by sex, desc ip i e plo s.
F om he pe spec i e o he sen imen al si ua ion (pa ne /no pa ne ) a he ime
da a we e collec ed, di e ences we e ound o he emo ional ac o (
(1158)
= −2.37; p < 0.01;
d = −0.14), he cogni i e-beha io al ac o (
(1158)
= −4.30; p < 0.001; d = −0.25), and he o al
adap a ion scale sco e (
(1158)
= −3.76; p < 0.001; d = −0.22), whe e hose who had a pa ne
sco ed highe (EM: M = 16.60, SD = 4.58; CB: M = 19.79, SD = 2.73; To al: M = 35.86, SD =
6.04) han hose who did no (EM: M = 15.40, SD = 4.97; CB: M = 19.02, SD = 3.36; To al: M
= 34.42, SD = 6.97).
The da a on educa ion did no back any signi ican associa ion wi h he o al sco e in
adap a ion o change ( = 0.02; p = 0.467), he emo ional ac o s ( = 0.01; p = 0.802), o
cogni i e-beha io al ac o s ( = 0.03; p = 0.247).
F om ano he pe spec i e, based on he clus e analysis, he pa icipan s we e
classi ied by hei answe s o he ques ions: “Ha e you been diagnosed as COVID-19
Figu e 2. Adap a ion o change by sex, desc ip i e plo s.
F om he pe spec i e o he sen imen al si ua ion (pa ne /no pa ne ) a he ime da a
we e collec ed, di e ences we e ound o he emo ional ac o (
(1158)
=
−
2.37; p< 0.01;
d=
−
0.14), he cogni i e-beha io al ac o (
(1158)
=
−
4.30; p< 0.001; d=
−
0.25), and he
o al adap a ion scale sco e (
(1158)
=
−
3.76; p< 0.001; d=
−
0.22), whe e hose who had a
pa ne sco ed highe (EM: M= 16.60, SD = 4.58; CB: M= 19.79, SD = 2.73; To al: M= 35.86,
SD = 6.04) han hose who did no (EM: M= 15.40, SD = 4.97; CB: M= 19.02, SD = 3.36;
To al: M= 34.42, SD = 6.97).
The da a on educa ion did no back any signi ican associa ion wi h he o al sco e
in adap a ion o change ( = 0.02; p= 0.467), he emo ional ac o s ( = 0.01; p= 0.802), o
cogni i e-beha io al ac o s ( = 0.03; p= 0.247).
F om ano he pe spec i e, based on he clus e analysis, he pa icipan s we e classi ied
by hei answe s o he ques ions: “Ha e you been diagnosed as COVID-19 posi i e?” and
“Do you ha e o ha e you had someone COVID-19 posi i e close o you?”. This esul ed
in h ee clus e s: Clus e 1 (C1), which was he mos nume ous (68.6%, n= 796), collec ed
hose who had no been diagnosed as COVID-19 posi i e no had any posi i e case nea
hem; Clus e 2 (C2) wi h 29.7% (n= 345) o he sample included hose who had no been
diagnosed posi i e bu said he e was some posi i e case nea hem; and, inally, Clus e 3

J. Clin. Med. 2022,11, 1497 6 o 13
(C3), he smalles (1.6%, n= 19), con ained hose who had been diagnosed as COVID-19
posi i e and also had a case in hei se ing.
Table 1shows he esul s ound om he compa ison o means in adap a ion and he
analysis o a iance, by a COVID-19 clus e .
Table 1. Adap a ion o change by a COVID-19 clus e , desc ip i e s a is ics, and ANOVA.
Emo ional Fac o
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 6 o 13
posi i e?” and “Do you ha e o ha e you had someone COVID-19 posi i e close o you?”
This esul ed in h ee clus e s: Clus e 1 (C1), which was he mos nume ous (68.6%, n =
796), collec ed hose who had no been diagnosed as COVID-19 posi i e no had any
posi i e case nea hem; Clus e 2 (C2) wi h 29.7% (n = 345) o he sample included hose
who had no been diagnosed posi i e bu said he e was some posi i e case nea hem;
and, inally, Clus e 3 (C3), he smalles (1.6%, n = 19), con ained hose who had been
diagnosed as COVID-19 posi i e and also had a case in hei se ing.
Table 1 shows he esul s ound om he compa ison o means in adap a ion and he
analysis o a iance, by a COVID-19 clus e .
Table 1. Adap a ion o change by a COVID-19 clus e , desc ip i e s a is ics, and ANOVA.
Emo ional Fac o
n M SD
Clús e 1
796 15.98 4.77
Clús e 2
345 15.38 4.74
Clús e 3
19 12.78 4.52
F = 5.67; p < 0.01 (η² = 0.010, ω² = 0.008)
Cogni i e-Beha io al Fac o
n M SD
Clús e 1 796 19.44 3.15
Clús e 2 345 19.47 2.83
Clús e 3 19 18.21 3.32
F = 1.55; p = 0.212
To al ADAPTA-10
n M SD
Clús e 1 796 35.43 6.56
Clús e 2 345 34.85 6.36
Clús e 3 19 31.00 6.80
F = 4.93; p < 0.01 (η
2
= 0.008, ω
2
= 0.007)
The mean sco es di e ed by clus e o he emo ional ac o and o al adap a ion
sco e. In he emo ional ac o , he pos hoc es s showed ha he signi ican di e ences
ound we e speci ically in he C1–C3 compa ison, whe e C1 has a signi ican ly highe
mean sco e (c1 > c3
MD
= 3.19; 95% CI 0.60–5.78). Fo he o al adap a ion sco e, he
di e ences we e in he c1–c3 (c1 > c3
MD
= 4.43; 95% CI 0.88–7.98) and c2–c3 (c2 > c3
MD
=
3.85; 95% CI 0.25–7.45) compa isons. Finally, ega ding he pe cei ed economic impac
due o he COVID-19 pandemic, nega i e co ela ions we e ound wi h he emo ional
ac o ( = −0.18; p < 0.001; 95% CI −0.24, −0.13), and wi h he o al on adap a ion o change
( = −0.14; p < 0.001; 95% CI −0.20, −0.08). No signi ican associa ion was ound be ween
he pe cei ed economic impac and he cogni i e-beha io al ac o ( = −0.01; p = 0.606).
3.2. Adap a ion o Change and Heal h
Table 2 shows he co ela ion ma ix be ween he ac o s and o al sco e on he
ADAPTA-10 adap a ion o change ques ionnai e and he di e en GHQ-28 subscales.
Bo h ac o s (emo ional and cogni i e-beha io al) and o al sco e in adap a ion showed
nega i e co ela ions wi h he p esence o heal h p oblems: soma ic symp oms,
anxie y/insomnia, social dys unc ion, and dep ession.
Table 2. Adap a ion o change and heal h. Pea son co ela ions.
n M SD
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 6 o 13
posi i e?” and “Do you ha e o ha e you had someone COVID-19 posi i e close o you?”
This esul ed in h ee clus e s: Clus e 1 (C1), which was he mos nume ous (68.6%, n =
796), collec ed hose who had no been diagnosed as COVID-19 posi i e no had any
posi i e case nea hem; Clus e 2 (C2) wi h 29.7% (n = 345) o he sample included hose
who had no been diagnosed posi i e bu said he e was some posi i e case nea hem;
and, inally, Clus e 3 (C3), he smalles (1.6%, n = 19), con ained hose who had been
diagnosed as COVID-19 posi i e and also had a case in hei se ing.
Table 1 shows he esul s ound om he compa ison o means in adap a ion and he
analysis o a iance, by a COVID-19 clus e .
Table 1. Adap a ion o change by a COVID-19 clus e , desc ip i e s a is ics, and ANOVA.
Emo ional Fac o
n M SD
Clús e 1
796 15.98 4.77
Clús e 2
345 15.38 4.74
Clús e 3
19 12.78 4.52
F = 5.67; p < 0.01 (η² = 0.010, ω² = 0.008)
Cogni i e-Beha io al Fac o
n M SD
Clús e 1 796 19.44 3.15
Clús e 2 345 19.47 2.83
Clús e 3 19 18.21 3.32
F = 1.55; p = 0.212
To al ADAPTA-10
n M SD
Clús e 1 796 35.43 6.56
Clús e 2 345 34.85 6.36
Clús e 3 19 31.00 6.80
F = 4.93; p < 0.01 (η
2
= 0.008, ω
2
= 0.007)
The mean sco es di e ed by clus e o he emo ional ac o and o al adap a ion
sco e. In he emo ional ac o , he pos hoc es s showed ha he signi ican di e ences
ound we e speci ically in he C1–C3 compa ison, whe e C1 has a signi ican ly highe
mean sco e (c1 > c3
MD
= 3.19; 95% CI 0.60–5.78). Fo he o al adap a ion sco e, he
di e ences we e in he c1–c3 (c1 > c3
MD
= 4.43; 95% CI 0.88–7.98) and c2–c3 (c2 > c3
MD
=
3.85; 95% CI 0.25–7.45) compa isons. Finally, ega ding he pe cei ed economic impac
due o he COVID-19 pandemic, nega i e co ela ions we e ound wi h he emo ional
ac o ( = −0.18; p < 0.001; 95% CI −0.24, −0.13), and wi h he o al on adap a ion o change
( = −0.14; p < 0.001; 95% CI −0.20, −0.08). No signi ican associa ion was ound be ween
he pe cei ed economic impac and he cogni i e-beha io al ac o ( = −0.01; p = 0.606).
3.2. Adap a ion o Change and Heal h
Table 2 shows he co ela ion ma ix be ween he ac o s and o al sco e on he
ADAPTA-10 adap a ion o change ques ionnai e and he di e en GHQ-28 subscales.
Bo h ac o s (emo ional and cogni i e-beha io al) and o al sco e in adap a ion showed
nega i e co ela ions wi h he p esence o heal h p oblems: soma ic symp oms,
anxie y/insomnia, social dys unc ion, and dep ession.
Table 2. Adap a ion o change and heal h. Pea son co ela ions.
Clús e 1 796 15.98 4.77
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 6 o 13
posi i e?” and “Do you ha e o ha e you had someone COVID-19 posi i e close o you?”
This esul ed in h ee clus e s: Clus e 1 (C1), which was he mos nume ous (68.6%, n =
796), collec ed hose who had no been diagnosed as COVID-19 posi i e no had any
posi i e case nea hem; Clus e 2 (C2) wi h 29.7% (n = 345) o he sample included hose
who had no been diagnosed posi i e bu said he e was some posi i e case nea hem;
and, inally, Clus e 3 (C3), he smalles (1.6%, n = 19), con ained hose who had been
diagnosed as COVID-19 posi i e and also had a case in hei se ing.
Table 1 shows he esul s ound om he compa ison o means in adap a ion and he
analysis o a iance, by a COVID-19 clus e .
Table 1. Adap a ion o change by a COVID-19 clus e , desc ip i e s a is ics, and ANOVA.
Emo ional Fac o
n M SD
Clús e 1
796 15.98 4.77
Clús e 2
345 15.38 4.74
Clús e 3
19 12.78 4.52
F = 5.67; p < 0.01 (η² = 0.010, ω² = 0.008)
Cogni i e-Beha io al Fac o
n M SD
Clús e 1 796 19.44 3.15
Clús e 2 345 19.47 2.83
Clús e 3 19 18.21 3.32
F = 1.55; p = 0.212
To al ADAPTA-10
n M SD
Clús e 1 796 35.43 6.56
Clús e 2 345 34.85 6.36
Clús e 3 19 31.00 6.80
F = 4.93; p < 0.01 (η
2
= 0.008, ω
2
= 0.007)
The mean sco es di e ed by clus e o he emo ional ac o and o al adap a ion
sco e. In he emo ional ac o , he pos hoc es s showed ha he signi ican di e ences
ound we e speci ically in he C1–C3 compa ison, whe e C1 has a signi ican ly highe
mean sco e (c1 > c3
MD
= 3.19; 95% CI 0.60–5.78). Fo he o al adap a ion sco e, he
di e ences we e in he c1–c3 (c1 > c3
MD
= 4.43; 95% CI 0.88–7.98) and c2–c3 (c2 > c3
MD
=
3.85; 95% CI 0.25–7.45) compa isons. Finally, ega ding he pe cei ed economic impac
due o he COVID-19 pandemic, nega i e co ela ions we e ound wi h he emo ional
ac o ( = −0.18; p < 0.001; 95% CI −0.24, −0.13), and wi h he o al on adap a ion o change
( = −0.14; p < 0.001; 95% CI −0.20, −0.08). No signi ican associa ion was ound be ween
he pe cei ed economic impac and he cogni i e-beha io al ac o ( = −0.01; p = 0.606).
3.2. Adap a ion o Change and Heal h
Table 2 shows he co ela ion ma ix be ween he ac o s and o al sco e on he
ADAPTA-10 adap a ion o change ques ionnai e and he di e en GHQ-28 subscales.
Bo h ac o s (emo ional and cogni i e-beha io al) and o al sco e in adap a ion showed
nega i e co ela ions wi h he p esence o heal h p oblems: soma ic symp oms,
anxie y/insomnia, social dys unc ion, and dep ession.
Table 2. Adap a ion o change and heal h. Pea son co ela ions.
Clús e 2 345 15.38 4.74
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 6 o 13
posi i e?” and “Do you ha e o ha e you had someone COVID-19 posi i e close o you?”
This esul ed in h ee clus e s: Clus e 1 (C1), which was he mos nume ous (68.6%, n =
796), collec ed hose who had no been diagnosed as COVID-19 posi i e no had any
posi i e case nea hem; Clus e 2 (C2) wi h 29.7% (n = 345) o he sample included hose
who had no been diagnosed posi i e bu said he e was some posi i e case nea hem;
and, inally, Clus e 3 (C3), he smalles (1.6%, n = 19), con ained hose who had been
diagnosed as COVID-19 posi i e and also had a case in hei se ing.
Table 1 shows he esul s ound om he compa ison o means in adap a ion and he
analysis o a iance, by a COVID-19 clus e .
Table 1. Adap a ion o change by a COVID-19 clus e , desc ip i e s a is ics, and ANOVA.
Emo ional Fac o
n M SD
Clús e 1
796 15.98 4.77
Clús e 2
345 15.38 4.74
Clús e 3
19 12.78 4.52
F = 5.67; p < 0.01 (η² = 0.010, ω² = 0.008)
Cogni i e-Beha io al Fac o
n M SD
Clús e 1 796 19.44 3.15
Clús e 2 345 19.47 2.83
Clús e 3 19 18.21 3.32
F = 1.55; p = 0.212
To al ADAPTA-10
n M SD
Clús e 1 796 35.43 6.56
Clús e 2 345 34.85 6.36
Clús e 3 19 31.00 6.80
F = 4.93; p < 0.01 (η
2
= 0.008, ω
2
= 0.007)
The mean sco es di e ed by clus e o he emo ional ac o and o al adap a ion
sco e. In he emo ional ac o , he pos hoc es s showed ha he signi ican di e ences
ound we e speci ically in he C1–C3 compa ison, whe e C1 has a signi ican ly highe
mean sco e (c1 > c3
MD
= 3.19; 95% CI 0.60–5.78). Fo he o al adap a ion sco e, he
di e ences we e in he c1–c3 (c1 > c3
MD
= 4.43; 95% CI 0.88–7.98) and c2–c3 (c2 > c3
MD
=
3.85; 95% CI 0.25–7.45) compa isons. Finally, ega ding he pe cei ed economic impac
due o he COVID-19 pandemic, nega i e co ela ions we e ound wi h he emo ional
ac o ( = −0.18; p < 0.001; 95% CI −0.24, −0.13), and wi h he o al on adap a ion o change
( = −0.14; p < 0.001; 95% CI −0.20, −0.08). No signi ican associa ion was ound be ween
he pe cei ed economic impac and he cogni i e-beha io al ac o ( = −0.01; p = 0.606).
3.2. Adap a ion o Change and Heal h
Table 2 shows he co ela ion ma ix be ween he ac o s and o al sco e on he
ADAPTA-10 adap a ion o change ques ionnai e and he di e en GHQ-28 subscales.
Bo h ac o s (emo ional and cogni i e-beha io al) and o al sco e in adap a ion showed
nega i e co ela ions wi h he p esence o heal h p oblems: soma ic symp oms,
anxie y/insomnia, social dys unc ion, and dep ession.
Table 2. Adap a ion o change and heal h. Pea son co ela ions.
Clús e 3 19 12.78 4.52
F= 5.67; p< 0.01 (η2= 0.010, ω2= 0.008)
Cogni i e-Beha io al Fac o
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 6 o 13
posi i e?” and “Do you ha e o ha e you had someone COVID-19 posi i e close o you?”
This esul ed in h ee clus e s: Clus e 1 (C1), which was he mos nume ous (68.6%, n =
796), collec ed hose who had no been diagnosed as COVID-19 posi i e no had any
posi i e case nea hem; Clus e 2 (C2) wi h 29.7% (n = 345) o he sample included hose
who had no been diagnosed posi i e bu said he e was some posi i e case nea hem;
and, inally, Clus e 3 (C3), he smalles (1.6%, n = 19), con ained hose who had been
diagnosed as COVID-19 posi i e and also had a case in hei se ing.
Table 1 shows he esul s ound om he compa ison o means in adap a ion and he
analysis o a iance, by a COVID-19 clus e .
Table 1. Adap a ion o change by a COVID-19 clus e , desc ip i e s a is ics, and ANOVA.
Emo ional Fac o
n M SD
Clús e 1
796 15.98 4.77
Clús e 2
345 15.38 4.74
Clús e 3
19 12.78 4.52
F = 5.67; p < 0.01 (η² = 0.010, ω² = 0.008)
Cogni i e-Beha io al Fac o
n M SD
Clús e 1 796 19.44 3.15
Clús e 2 345 19.47 2.83
Clús e 3 19 18.21 3.32
F = 1.55; p = 0.212
To al ADAPTA-10
n M SD
Clús e 1 796 35.43 6.56
Clús e 2 345 34.85 6.36
Clús e 3 19 31.00 6.80
F = 4.93; p < 0.01 (η
2
= 0.008, ω
2
= 0.007)
The mean sco es di e ed by clus e o he emo ional ac o and o al adap a ion
sco e. In he emo ional ac o , he pos hoc es s showed ha he signi ican di e ences
ound we e speci ically in he C1–C3 compa ison, whe e C1 has a signi ican ly highe
mean sco e (c1 > c3
MD
= 3.19; 95% CI 0.60–5.78). Fo he o al adap a ion sco e, he
di e ences we e in he c1–c3 (c1 > c3
MD
= 4.43; 95% CI 0.88–7.98) and c2–c3 (c2 > c3
MD
=
3.85; 95% CI 0.25–7.45) compa isons. Finally, ega ding he pe cei ed economic impac
due o he COVID-19 pandemic, nega i e co ela ions we e ound wi h he emo ional
ac o ( = −0.18; p < 0.001; 95% CI −0.24, −0.13), and wi h he o al on adap a ion o change
( = −0.14; p < 0.001; 95% CI −0.20, −0.08). No signi ican associa ion was ound be ween
he pe cei ed economic impac and he cogni i e-beha io al ac o ( = −0.01; p = 0.606).
3.2. Adap a ion o Change and Heal h
Table 2 shows he co ela ion ma ix be ween he ac o s and o al sco e on he
ADAPTA-10 adap a ion o change ques ionnai e and he di e en GHQ-28 subscales.
Bo h ac o s (emo ional and cogni i e-beha io al) and o al sco e in adap a ion showed
nega i e co ela ions wi h he p esence o heal h p oblems: soma ic symp oms,
anxie y/insomnia, social dys unc ion, and dep ession.
Table 2. Adap a ion o change and heal h. Pea son co ela ions.
n M SD
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 6 o 13
posi i e?” and “Do you ha e o ha e you had someone COVID-19 posi i e close o you?”
This esul ed in h ee clus e s: Clus e 1 (C1), which was he mos nume ous (68.6%, n =
796), collec ed hose who had no been diagnosed as COVID-19 posi i e no had any
posi i e case nea hem; Clus e 2 (C2) wi h 29.7% (n = 345) o he sample included hose
who had no been diagnosed posi i e bu said he e was some posi i e case nea hem;
and, inally, Clus e 3 (C3), he smalles (1.6%, n = 19), con ained hose who had been
diagnosed as COVID-19 posi i e and also had a case in hei se ing.
Table 1 shows he esul s ound om he compa ison o means in adap a ion and he
analysis o a iance, by a COVID-19 clus e .
Table 1. Adap a ion o change by a COVID-19 clus e , desc ip i e s a is ics, and ANOVA.
Emo ional Fac o
n M SD
Clús e 1
796 15.98 4.77
Clús e 2
345 15.38 4.74
Clús e 3
19 12.78 4.52
F = 5.67; p < 0.01 (η² = 0.010, ω² = 0.008)
Cogni i e-Beha io al Fac o
n M SD
Clús e 1 796 19.44 3.15
Clús e 2 345 19.47 2.83
Clús e 3 19 18.21 3.32
F = 1.55; p = 0.212
To al ADAPTA-10
n M SD
Clús e 1 796 35.43 6.56
Clús e 2 345 34.85 6.36
Clús e 3 19 31.00 6.80
F = 4.93; p < 0.01 (η
2
= 0.008, ω
2
= 0.007)
The mean sco es di e ed by clus e o he emo ional ac o and o al adap a ion
sco e. In he emo ional ac o , he pos hoc es s showed ha he signi ican di e ences
ound we e speci ically in he C1–C3 compa ison, whe e C1 has a signi ican ly highe
mean sco e (c1 > c3
MD
= 3.19; 95% CI 0.60–5.78). Fo he o al adap a ion sco e, he
di e ences we e in he c1–c3 (c1 > c3
MD
= 4.43; 95% CI 0.88–7.98) and c2–c3 (c2 > c3
MD
=
3.85; 95% CI 0.25–7.45) compa isons. Finally, ega ding he pe cei ed economic impac
due o he COVID-19 pandemic, nega i e co ela ions we e ound wi h he emo ional
ac o ( = −0.18; p < 0.001; 95% CI −0.24, −0.13), and wi h he o al on adap a ion o change
( = −0.14; p < 0.001; 95% CI −0.20, −0.08). No signi ican associa ion was ound be ween
he pe cei ed economic impac and he cogni i e-beha io al ac o ( = −0.01; p = 0.606).
3.2. Adap a ion o Change and Heal h
Table 2 shows he co ela ion ma ix be ween he ac o s and o al sco e on he
ADAPTA-10 adap a ion o change ques ionnai e and he di e en GHQ-28 subscales.
Bo h ac o s (emo ional and cogni i e-beha io al) and o al sco e in adap a ion showed
nega i e co ela ions wi h he p esence o heal h p oblems: soma ic symp oms,
anxie y/insomnia, social dys unc ion, and dep ession.
Table 2. Adap a ion o change and heal h. Pea son co ela ions.
Clús e 1 796 19.44 3.15
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 6 o 13
posi i e?” and “Do you ha e o ha e you had someone COVID-19 posi i e close o you?”
This esul ed in h ee clus e s: Clus e 1 (C1), which was he mos nume ous (68.6%, n =
796), collec ed hose who had no been diagnosed as COVID-19 posi i e no had any
posi i e case nea hem; Clus e 2 (C2) wi h 29.7% (n = 345) o he sample included hose
who had no been diagnosed posi i e bu said he e was some posi i e case nea hem;
and, inally, Clus e 3 (C3), he smalles (1.6%, n = 19), con ained hose who had been
diagnosed as COVID-19 posi i e and also had a case in hei se ing.
Table 1 shows he esul s ound om he compa ison o means in adap a ion and he
analysis o a iance, by a COVID-19 clus e .
Table 1. Adap a ion o change by a COVID-19 clus e , desc ip i e s a is ics, and ANOVA.
Emo ional Fac o
n M SD
Clús e 1
796 15.98 4.77
Clús e 2
345 15.38 4.74
Clús e 3
19 12.78 4.52
F = 5.67; p < 0.01 (η² = 0.010, ω² = 0.008)
Cogni i e-Beha io al Fac o
n M SD
Clús e 1 796 19.44 3.15
Clús e 2 345 19.47 2.83
Clús e 3 19 18.21 3.32
F = 1.55; p = 0.212
To al ADAPTA-10
n M SD
Clús e 1 796 35.43 6.56
Clús e 2 345 34.85 6.36
Clús e 3 19 31.00 6.80
F = 4.93; p < 0.01 (η
2
= 0.008, ω
2
= 0.007)
The mean sco es di e ed by clus e o he emo ional ac o and o al adap a ion
sco e. In he emo ional ac o , he pos hoc es s showed ha he signi ican di e ences
ound we e speci ically in he C1–C3 compa ison, whe e C1 has a signi ican ly highe
mean sco e (c1 > c3
MD
= 3.19; 95% CI 0.60–5.78). Fo he o al adap a ion sco e, he
di e ences we e in he c1–c3 (c1 > c3
MD
= 4.43; 95% CI 0.88–7.98) and c2–c3 (c2 > c3
MD
=
3.85; 95% CI 0.25–7.45) compa isons. Finally, ega ding he pe cei ed economic impac
due o he COVID-19 pandemic, nega i e co ela ions we e ound wi h he emo ional
ac o ( = −0.18; p < 0.001; 95% CI −0.24, −0.13), and wi h he o al on adap a ion o change
( = −0.14; p < 0.001; 95% CI −0.20, −0.08). No signi ican associa ion was ound be ween
he pe cei ed economic impac and he cogni i e-beha io al ac o ( = −0.01; p = 0.606).
3.2. Adap a ion o Change and Heal h
Table 2 shows he co ela ion ma ix be ween he ac o s and o al sco e on he
ADAPTA-10 adap a ion o change ques ionnai e and he di e en GHQ-28 subscales.
Bo h ac o s (emo ional and cogni i e-beha io al) and o al sco e in adap a ion showed
nega i e co ela ions wi h he p esence o heal h p oblems: soma ic symp oms,
anxie y/insomnia, social dys unc ion, and dep ession.
Table 2. Adap a ion o change and heal h. Pea son co ela ions.
Clús e 2 345 19.47 2.83
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 6 o 13
posi i e?” and “Do you ha e o ha e you had someone COVID-19 posi i e close o you?”
This esul ed in h ee clus e s: Clus e 1 (C1), which was he mos nume ous (68.6%, n =
796), collec ed hose who had no been diagnosed as COVID-19 posi i e no had any
posi i e case nea hem; Clus e 2 (C2) wi h 29.7% (n = 345) o he sample included hose
who had no been diagnosed posi i e bu said he e was some posi i e case nea hem;
and, inally, Clus e 3 (C3), he smalles (1.6%, n = 19), con ained hose who had been
diagnosed as COVID-19 posi i e and also had a case in hei se ing.
Table 1 shows he esul s ound om he compa ison o means in adap a ion and he
analysis o a iance, by a COVID-19 clus e .
Table 1. Adap a ion o change by a COVID-19 clus e , desc ip i e s a is ics, and ANOVA.
Emo ional Fac o
n M SD
Clús e 1
796 15.98 4.77
Clús e 2
345 15.38 4.74
Clús e 3
19 12.78 4.52
F = 5.67; p < 0.01 (η² = 0.010, ω² = 0.008)
Cogni i e-Beha io al Fac o
n M SD
Clús e 1 796 19.44 3.15
Clús e 2 345 19.47 2.83
Clús e 3 19 18.21 3.32
F = 1.55; p = 0.212
To al ADAPTA-10
n M SD
Clús e 1 796 35.43 6.56
Clús e 2 345 34.85 6.36
Clús e 3 19 31.00 6.80
F = 4.93; p < 0.01 (η
2
= 0.008, ω
2
= 0.007)
The mean sco es di e ed by clus e o he emo ional ac o and o al adap a ion
sco e. In he emo ional ac o , he pos hoc es s showed ha he signi ican di e ences
ound we e speci ically in he C1–C3 compa ison, whe e C1 has a signi ican ly highe
mean sco e (c1 > c3
MD
= 3.19; 95% CI 0.60–5.78). Fo he o al adap a ion sco e, he
di e ences we e in he c1–c3 (c1 > c3
MD
= 4.43; 95% CI 0.88–7.98) and c2–c3 (c2 > c3
MD
=
3.85; 95% CI 0.25–7.45) compa isons. Finally, ega ding he pe cei ed economic impac
due o he COVID-19 pandemic, nega i e co ela ions we e ound wi h he emo ional
ac o ( = −0.18; p < 0.001; 95% CI −0.24, −0.13), and wi h he o al on adap a ion o change
( = −0.14; p < 0.001; 95% CI −0.20, −0.08). No signi ican associa ion was ound be ween
he pe cei ed economic impac and he cogni i e-beha io al ac o ( = −0.01; p = 0.606).
3.2. Adap a ion o Change and Heal h
Table 2 shows he co ela ion ma ix be ween he ac o s and o al sco e on he
ADAPTA-10 adap a ion o change ques ionnai e and he di e en GHQ-28 subscales.
Bo h ac o s (emo ional and cogni i e-beha io al) and o al sco e in adap a ion showed
nega i e co ela ions wi h he p esence o heal h p oblems: soma ic symp oms,
anxie y/insomnia, social dys unc ion, and dep ession.
Table 2. Adap a ion o change and heal h. Pea son co ela ions.
Clús e 3 19 18.21 3.32
F= 1.55; p= 0.212
To al ADAPTA-10
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 6 o 13
posi i e?” and “Do you ha e o ha e you had someone COVID-19 posi i e close o you?”
This esul ed in h ee clus e s: Clus e 1 (C1), which was he mos nume ous (68.6%, n =
796), collec ed hose who had no been diagnosed as COVID-19 posi i e no had any
posi i e case nea hem; Clus e 2 (C2) wi h 29.7% (n = 345) o he sample included hose
who had no been diagnosed posi i e bu said he e was some posi i e case nea hem;
and, inally, Clus e 3 (C3), he smalles (1.6%, n = 19), con ained hose who had been
diagnosed as COVID-19 posi i e and also had a case in hei se ing.
Table 1 shows he esul s ound om he compa ison o means in adap a ion and he
analysis o a iance, by a COVID-19 clus e .
Table 1. Adap a ion o change by a COVID-19 clus e , desc ip i e s a is ics, and ANOVA.
Emo ional Fac o
n M SD
Clús e 1
796 15.98 4.77
Clús e 2
345 15.38 4.74
Clús e 3
19 12.78 4.52
F = 5.67; p < 0.01 (η² = 0.010, ω² = 0.008)
Cogni i e-Beha io al Fac o
n M SD
Clús e 1 796 19.44 3.15
Clús e 2 345 19.47 2.83
Clús e 3 19 18.21 3.32
F = 1.55; p = 0.212
To al ADAPTA-10
n M SD
Clús e 1 796 35.43 6.56
Clús e 2 345 34.85 6.36
Clús e 3 19 31.00 6.80
F = 4.93; p < 0.01 (η
2
= 0.008, ω
2
= 0.007)
The mean sco es di e ed by clus e o he emo ional ac o and o al adap a ion
sco e. In he emo ional ac o , he pos hoc es s showed ha he signi ican di e ences
ound we e speci ically in he C1–C3 compa ison, whe e C1 has a signi ican ly highe
mean sco e (c1 > c3
MD
= 3.19; 95% CI 0.60–5.78). Fo he o al adap a ion sco e, he
di e ences we e in he c1–c3 (c1 > c3
MD
= 4.43; 95% CI 0.88–7.98) and c2–c3 (c2 > c3
MD
=
3.85; 95% CI 0.25–7.45) compa isons. Finally, ega ding he pe cei ed economic impac
due o he COVID-19 pandemic, nega i e co ela ions we e ound wi h he emo ional
ac o ( = −0.18; p < 0.001; 95% CI −0.24, −0.13), and wi h he o al on adap a ion o change
( = −0.14; p < 0.001; 95% CI −0.20, −0.08). No signi ican associa ion was ound be ween
he pe cei ed economic impac and he cogni i e-beha io al ac o ( = −0.01; p = 0.606).
3.2. Adap a ion o Change and Heal h
Table 2 shows he co ela ion ma ix be ween he ac o s and o al sco e on he
ADAPTA-10 adap a ion o change ques ionnai e and he di e en GHQ-28 subscales.
Bo h ac o s (emo ional and cogni i e-beha io al) and o al sco e in adap a ion showed
nega i e co ela ions wi h he p esence o heal h p oblems: soma ic symp oms,
anxie y/insomnia, social dys unc ion, and dep ession.
Table 2. Adap a ion o change and heal h. Pea son co ela ions.
n M SD
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 6 o 13
posi i e?” and “Do you ha e o ha e you had someone COVID-19 posi i e close o you?”
This esul ed in h ee clus e s: Clus e 1 (C1), which was he mos nume ous (68.6%, n =
796), collec ed hose who had no been diagnosed as COVID-19 posi i e no had any
posi i e case nea hem; Clus e 2 (C2) wi h 29.7% (n = 345) o he sample included hose
who had no been diagnosed posi i e bu said he e was some posi i e case nea hem;
and, inally, Clus e 3 (C3), he smalles (1.6%, n = 19), con ained hose who had been
diagnosed as COVID-19 posi i e and also had a case in hei se ing.
Table 1 shows he esul s ound om he compa ison o means in adap a ion and he
analysis o a iance, by a COVID-19 clus e .
Table 1. Adap a ion o change by a COVID-19 clus e , desc ip i e s a is ics, and ANOVA.
Emo ional Fac o
n M SD
Clús e 1
796 15.98 4.77
Clús e 2
345 15.38 4.74
Clús e 3
19 12.78 4.52
F = 5.67; p < 0.01 (η² = 0.010, ω² = 0.008)
Cogni i e-Beha io al Fac o
n M SD
Clús e 1 796 19.44 3.15
Clús e 2 345 19.47 2.83
Clús e 3 19 18.21 3.32
F = 1.55; p = 0.212
To al ADAPTA-10
n M SD
Clús e 1 796 35.43 6.56
Clús e 2 345 34.85 6.36
Clús e 3 19 31.00 6.80
F = 4.93; p < 0.01 (η
2
= 0.008, ω
2
= 0.007)
The mean sco es di e ed by clus e o he emo ional ac o and o al adap a ion
sco e. In he emo ional ac o , he pos hoc es s showed ha he signi ican di e ences
ound we e speci ically in he C1–C3 compa ison, whe e C1 has a signi ican ly highe
mean sco e (c1 > c3
MD
= 3.19; 95% CI 0.60–5.78). Fo he o al adap a ion sco e, he
di e ences we e in he c1–c3 (c1 > c3
MD
= 4.43; 95% CI 0.88–7.98) and c2–c3 (c2 > c3
MD
=
3.85; 95% CI 0.25–7.45) compa isons. Finally, ega ding he pe cei ed economic impac
due o he COVID-19 pandemic, nega i e co ela ions we e ound wi h he emo ional
ac o ( = −0.18; p < 0.001; 95% CI −0.24, −0.13), and wi h he o al on adap a ion o change
( = −0.14; p < 0.001; 95% CI −0.20, −0.08). No signi ican associa ion was ound be ween
he pe cei ed economic impac and he cogni i e-beha io al ac o ( = −0.01; p = 0.606).
3.2. Adap a ion o Change and Heal h
Table 2 shows he co ela ion ma ix be ween he ac o s and o al sco e on he
ADAPTA-10 adap a ion o change ques ionnai e and he di e en GHQ-28 subscales.
Bo h ac o s (emo ional and cogni i e-beha io al) and o al sco e in adap a ion showed
nega i e co ela ions wi h he p esence o heal h p oblems: soma ic symp oms,
anxie y/insomnia, social dys unc ion, and dep ession.
Table 2. Adap a ion o change and heal h. Pea son co ela ions.
Clús e 1 796 35.43 6.56
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 6 o 13
posi i e?” and “Do you ha e o ha e you had someone COVID-19 posi i e close o you?”
This esul ed in h ee clus e s: Clus e 1 (C1), which was he mos nume ous (68.6%, n =
796), collec ed hose who had no been diagnosed as COVID-19 posi i e no had any
posi i e case nea hem; Clus e 2 (C2) wi h 29.7% (n = 345) o he sample included hose
who had no been diagnosed posi i e bu said he e was some posi i e case nea hem;
and, inally, Clus e 3 (C3), he smalles (1.6%, n = 19), con ained hose who had been
diagnosed as COVID-19 posi i e and also had a case in hei se ing.
Table 1 shows he esul s ound om he compa ison o means in adap a ion and he
analysis o a iance, by a COVID-19 clus e .
Table 1. Adap a ion o change by a COVID-19 clus e , desc ip i e s a is ics, and ANOVA.
Emo ional Fac o
n M SD
Clús e 1
796 15.98 4.77
Clús e 2
345 15.38 4.74
Clús e 3
19 12.78 4.52
F = 5.67; p < 0.01 (η² = 0.010, ω² = 0.008)
Cogni i e-Beha io al Fac o
n M SD
Clús e 1 796 19.44 3.15
Clús e 2 345 19.47 2.83
Clús e 3 19 18.21 3.32
F = 1.55; p = 0.212
To al ADAPTA-10
n M SD
Clús e 1 796 35.43 6.56
Clús e 2 345 34.85 6.36
Clús e 3 19 31.00 6.80
F = 4.93; p < 0.01 (η
2
= 0.008, ω
2
= 0.007)
The mean sco es di e ed by clus e o he emo ional ac o and o al adap a ion
sco e. In he emo ional ac o , he pos hoc es s showed ha he signi ican di e ences
ound we e speci ically in he C1–C3 compa ison, whe e C1 has a signi ican ly highe
mean sco e (c1 > c3
MD
= 3.19; 95% CI 0.60–5.78). Fo he o al adap a ion sco e, he
di e ences we e in he c1–c3 (c1 > c3
MD
= 4.43; 95% CI 0.88–7.98) and c2–c3 (c2 > c3
MD
=
3.85; 95% CI 0.25–7.45) compa isons. Finally, ega ding he pe cei ed economic impac
due o he COVID-19 pandemic, nega i e co ela ions we e ound wi h he emo ional
ac o ( = −0.18; p < 0.001; 95% CI −0.24, −0.13), and wi h he o al on adap a ion o change
( = −0.14; p < 0.001; 95% CI −0.20, −0.08). No signi ican associa ion was ound be ween
he pe cei ed economic impac and he cogni i e-beha io al ac o ( = −0.01; p = 0.606).
3.2. Adap a ion o Change and Heal h
Table 2 shows he co ela ion ma ix be ween he ac o s and o al sco e on he
ADAPTA-10 adap a ion o change ques ionnai e and he di e en GHQ-28 subscales.
Bo h ac o s (emo ional and cogni i e-beha io al) and o al sco e in adap a ion showed
nega i e co ela ions wi h he p esence o heal h p oblems: soma ic symp oms,
anxie y/insomnia, social dys unc ion, and dep ession.
Table 2. Adap a ion o change and heal h. Pea son co ela ions.
Clús e 2 345 34.85 6.36
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 6 o 13
posi i e?” and “Do you ha e o ha e you had someone COVID-19 posi i e close o you?”
This esul ed in h ee clus e s: Clus e 1 (C1), which was he mos nume ous (68.6%, n =
796), collec ed hose who had no been diagnosed as COVID-19 posi i e no had any
posi i e case nea hem; Clus e 2 (C2) wi h 29.7% (n = 345) o he sample included hose
who had no been diagnosed posi i e bu said he e was some posi i e case nea hem;
and, inally, Clus e 3 (C3), he smalles (1.6%, n = 19), con ained hose who had been
diagnosed as COVID-19 posi i e and also had a case in hei se ing.
Table 1 shows he esul s ound om he compa ison o means in adap a ion and he
analysis o a iance, by a COVID-19 clus e .
Table 1. Adap a ion o change by a COVID-19 clus e , desc ip i e s a is ics, and ANOVA.
Emo ional Fac o
n M SD
Clús e 1
796 15.98 4.77
Clús e 2
345 15.38 4.74
Clús e 3
19 12.78 4.52
F = 5.67; p < 0.01 (η² = 0.010, ω² = 0.008)
Cogni i e-Beha io al Fac o
n M SD
Clús e 1 796 19.44 3.15
Clús e 2 345 19.47 2.83
Clús e 3 19 18.21 3.32
F = 1.55; p = 0.212
To al ADAPTA-10
n M SD
Clús e 1 796 35.43 6.56
Clús e 2 345 34.85 6.36
Clús e 3 19 31.00 6.80
F = 4.93; p < 0.01 (η
2
= 0.008, ω
2
= 0.007)
The mean sco es di e ed by clus e o he emo ional ac o and o al adap a ion
sco e. In he emo ional ac o , he pos hoc es s showed ha he signi ican di e ences
ound we e speci ically in he C1–C3 compa ison, whe e C1 has a signi ican ly highe
mean sco e (c1 > c3
MD
= 3.19; 95% CI 0.60–5.78). Fo he o al adap a ion sco e, he
di e ences we e in he c1–c3 (c1 > c3
MD
= 4.43; 95% CI 0.88–7.98) and c2–c3 (c2 > c3
MD
=
3.85; 95% CI 0.25–7.45) compa isons. Finally, ega ding he pe cei ed economic impac
due o he COVID-19 pandemic, nega i e co ela ions we e ound wi h he emo ional
ac o ( = −0.18; p < 0.001; 95% CI −0.24, −0.13), and wi h he o al on adap a ion o change
( = −0.14; p < 0.001; 95% CI −0.20, −0.08). No signi ican associa ion was ound be ween
he pe cei ed economic impac and he cogni i e-beha io al ac o ( = −0.01; p = 0.606).
3.2. Adap a ion o Change and Heal h
Table 2 shows he co ela ion ma ix be ween he ac o s and o al sco e on he
ADAPTA-10 adap a ion o change ques ionnai e and he di e en GHQ-28 subscales.
Bo h ac o s (emo ional and cogni i e-beha io al) and o al sco e in adap a ion showed
nega i e co ela ions wi h he p esence o heal h p oblems: soma ic symp oms,
anxie y/insomnia, social dys unc ion, and dep ession.
Table 2. Adap a ion o change and heal h. Pea son co ela ions.
Clús e 3 19 31.00 6.80
F= 4.93; p< 0.01 (η2= 0.008, ω2= 0.007)
The mean sco es di e ed by clus e o he emo ional ac o and o al adap a ion sco e.
In he emo ional ac o , he pos hoc es s showed ha he signi ican di e ences ound
we e speci ically in he C1–C3 compa ison, whe e C1 has a signi ican ly highe mean sco e
(c1 > c3
MD
= 3.19; 95% CI 0.60–5.78). Fo he o al adap a ion sco e, he di e ences we e in
he c1–c3 (c1 > c3
MD
= 4.43; 95% CI 0.88–7.98) and c2–c3 (c2 > c3
MD
= 3.85; 95% CI 0.25–7.45)
compa isons. Finally, ega ding he pe cei ed economic impac due o he COVID-19
pandemic, nega i e co ela ions we e ound wi h he emo ional ac o ( =
−
0.18; p< 0.001;
95% CI
−
0.24,
−
0.13), and wi h he o al on adap a ion o change ( =
−
0.14; p< 0.001; 95%
CI
−
0.20,
−
0.08). No signi ican associa ion was ound be ween he pe cei ed economic
impac and he cogni i e-beha io al ac o ( =−0.01; p= 0.606).
3.2. Adap a ion o Change and Heal h
Table 2shows he co ela ion ma ix be ween he ac o s and o al sco e on he
ADAPTA-10 adap a ion o change ques ionnai e and he di e en GHQ-28 subscales. Bo h
ac o s (emo ional and cogni i e-beha io al) and o al sco e in adap a ion showed nega i e
co ela ions wi h he p esence o heal h p oblems: soma ic symp oms, anxie y/insomnia,
social dys unc ion, and dep ession.
J. Clin. Med. 2022,11, 1497 7 o 13
Table 2. Adap a ion o change and heal h. Pea son co ela ions.
GHQ-SS GHQ-AI GHQ-SD GHQ-D
Emo ional ac o
Pea son’s −0.617 *** −0.792 *** −0.491 *** −0.551 ***
p- alue <0.001 <0.001 <0.001 <0.001
Uppe 95% CI −0.580 −0.770 −0.446 −0.509
Lowe 95% CI −0.651 −0.813 −0.534 −0.590
Cogni i e-Beha io al ac o
Pea son’s −0.261 *** −0.311 *** −0.330 *** −0.391 ***
p- alue <0.001 <0.001 <0.001 <0.001
Uppe 95% CI −0.206 −0.258 −0.278 −0.341
Lowe 95% CI −0.314 −0.362 −0.381 −0.439
To al ADAPTA-10
Pea son’s −0.574 *** −0.725 *** −0.515 *** −0.587 ***
p- alue <0.001 <0.001 <0.001 <0.001
Uppe 95% CI −0.534 −0.697 −0.471 −0.548
Lowe 95% CI −0.611 −0.752 −0.556 −0.623
No e. GHQ-SS = Soma ic symp oms, GHQ-AI = Anxie y/insomnia, GHQ-SD = Social dys unc ion, GHQ-
D = Dep ession. *** p< 0.001.
A media ion analysis was compu ed (Figu e 3) o check he media ing ole o he
capaci y o adap ing o change, and, in bo h cases, he p edic o was p esence o some
close COVID-19 posi i e case, and he GHQ-28 dimensions we e he ou pu a iables.
J. Clin. Med. 2022, 11, x FOR PEER REVIEW 7 o 13
GHQ-SS GHQ-AI GHQ-SD GHQ-D
Emo ional ac o
Pea son’s −0.617 *** −0.792 *** −0.491 *** −0.551 ***
p- alue <0.001 <0.001 <0.001 <0.001
Uppe 95% CI −0.580 −0.770 −0.446 −0.509
Lowe 95% CI −0.651 −0.813 −0.534 −0.590
Cogni i e-Beha io al ac o
Pea son’s −0.261 *** −0.311 *** −0.330 *** −0.391 ***
p- alue <0.001 <0.001 <0.001 <0.001
Uppe 95% CI −0.206 −0.258 −0.278 −0.341
Lowe 95% CI −0.314 −0.362 −0.381 −0.439
To al ADAPTA-10
Pea son’s −0.574 *** −0.725 *** −0.515 *** −0.587 ***
p- alue <0.001 <0.001 <0.001 <0.001
Uppe 95% CI −0.534 −0.697 −0.471 −0.548
Lowe 95% CI −0.611 −0.752 −0.556 −0.623
No e. GHQ-SS = Soma ic symp oms, GHQ-AI = Anxie y/insomnia, GHQ-SD = Social dys unc ion,
GHQ-D = Dep ession. *** p < 0.001.
A media ion analysis was compu ed (Figu e 3) o check he media ing ole o he
capaci y o adap ing o change, and, in bo h cases, he p edic o was p esence o some
close COVID-19 posi i e case, and he GHQ-28 dimensions we e he ou pu a iables.
Figu e 3. Hypo hesized media ion model.
As shown in Table 3, he e was a signi ican di ec e ec o close COVID-19 posi i e
cases on he p esence o soma ic symp oms. Inso a as he indi ec e ec s, he emo ional
ac o o adap a ion o change was a signi ican media o in he ela ionship be ween close
COVID-19 posi i e cases and he ou heal h subscales. The o al e ec s we e signi ican
o he ou pu a iables: soma ic symp oms, anxie y/insomnia, social dys unc ion, and
dep ession.
Figu e 3. Hypo hesized media ion model.
As shown in Table 3, he e was a signi ican di ec e ec o close COVID-19 posi i e
cases on he p esence o soma ic symp oms. Inso a as he indi ec e ec s, he emo ional
ac o o adap a ion o change was a signi ican media o in he ela ionship be ween
close COVID-19 posi i e cases and he ou heal h subscales. The o al e ec s we e signi i-
can o he ou pu a iables: soma ic symp oms, anxie y/insomnia, social dys unc ion,
and dep ession.
J. Clin. Med. 2022,11, 1497 8 o 13
Table 3. Di ec , indi ec , and o al e ec s.
Di ec E ec s
95% CI
Es ima e S d.
E o z-Value pLowe Uppe
COVID-19 posi i e
cases in en i onmen
→GHQ-SS 0.228 0.050 4.611 <0.001 0.120 0.330
→GHQ-AI 0.068 0.039 1.744 0.081 −0.011 0.139
→GHQ-SD −0.001 0.054 −0.019 0.984 −0.106 0.106
→GHQ-D 0.061 0.051 1.187 0.235 −0.034 0.179
Indi ec E ec s
95% CI
Es ima e S d.
E o z-Value pLowe Uppe
COVID-19 posi i e
cases in en i onmen
→EM →GHQ-SS 0.089 0.038 2.375 0.018 0.018 0.165
→CB →GHQ-SS 5.229 ×10−40.003 0.166 0.868 −0.006 0.009
→EM →GHQ-AI 0.118 0.049 2.383 0.017 0.025 0.215
→CB →GHQ-AI 3.567 ×10−40.002 0.166 0.868 −0.004 0.007
→EM →GHQ-SD 0.065 0.027 2.361 0.018 0.013 0.120
→CB →GHQ-SD 0.002 0.011 0.166 0.868 −0.020 0.024
→EM →GHQ-D 0.071 0.030 2.367 0.018 0.014 0.132
→CB →GHQ-D 0.002 0.014 0.166 0.868 −0.025 0.029
To al E ec s
95% CI
Es ima e S d.
E o z-Value pLowe Uppe
COVID-19 posi i e
cases in en i onmen
→GHQ-SS 0.318 0.063 5.073 <0.001 0.178 0.442
→GHQ-AI 0.185 0.063 2.934 0.003 0.063 0.297
→GHQ-SD 0.065 0.063 1.033 0.302 −0.057 0.193
→GHQ-D 0.134 0.063 2.120 0.034 0.002 0.260
No e. EM = Emo ional ac o , CB = Cogni i e-Beha io al ac o , GHQ-SS = Soma ic symp oms, GHQ-AI = Anx-
ie y/insomnia, GHQ-SD = Social dys unc ion, GHQ-D = Dep ession. (No e. Del a me hod s anda d e o s,
bias-co ec ed pe cen ile boo s ap con idence in e als).
4. Discussion
This s udy analyzed he emo ional and cogni i e dimensions ha make up he capaci y
o adap ing o change du ing a h ea such as COVID-19 and i s possible ela ionship o
pe cei ed heal h.
Fi s , di e ences we e ound in adap a ion o change by sex. Men had highe sco es
han women, bo h in he emo ional and cogni i e-beha io al ac o s and in gene al adap a-
ion o change [
2
]. These da a a e in ag eemen wi h wha has been epo ed p e iously
in he li e a u e, whe e men ha e a be e capaci y o adap ing o ad e se e en s and
si ua ions [28], and a lowe le el o ulne abili y o h ea s such as COVID-19 [8].
Wi h ega d o he second hypo hesis o his s udy, he esul s showed an e ec o age
on he capaci y o adap ing o change. Olde indi iduals had a be e sco e on emo ional,
cogni i e-beha io al, and gene al adap a ion, indica ing be e capaci y o adap ing o
he s ess ul si ua ion ha COVID-19 ep esen s. These da a we e associa ed wi h olde
indi iduals who had mo e expe ience, highe esilience, and cohe ence in hei coping
s uc u es in un o eseen e en s [
29
,
30
]. Mo eo e , olde indi iduals ha e a wide , mo e
consolida ed con ac ne wo k [
41
], which could enable hem o adap be e o ce ain
ad e se e en s [20,31,42], such as COVID-19 and he ac ions aken o i s con ol [6,7,9].
Analysis o he economic impac pe cei ed by he popula ion as a ibu able o COVID-
19 showed a ela ionship be ween his conce n and emo ional ac o s and gene al adap a ion
o he changing si ua ion gene a ed by he disease, while no ela ionship was ound wi h
he cogni i e-beha io al ac o s. Loss o one’s job o lowe pu chasing powe diminish he
s anda d o li ing and sa is ac ion [
27
], causing al e a ions in one’s beha io al le el and
e en less abili y o ole a e change [
26
]. Loss o economic esou ces is also associa ed wi h
J. Clin. Med. 2022,11, 1497 9 o 13
he gene a ion o a eeling o loneliness and being abandoned [
9
], anxie y, i i abili y, and
dep ession [13,16,17].
I was also obse ed ha hose who had a s able pa ne no only had highe sco es in
o al adap a ion, bu also highe emo ional and cogni i e le els. Ha ing a s able couple
posi i ely in luences he capaci y o adap a ion o ad e se e en s, which ag ees wi h
wha has been desc ibed by o he au ho s who ha e indica ed ha main aining a s able
pa ne inc eases wellbeing [
27
] and p o ides emo ional and social suppo [
56
] e en in
ca as ophic e en s.
Howe e , he le el o educa ion o he pa icipan s was no ela ed o adap i e capaci y
in e en s such as he COVID-19 pandemic, a esul which does no ag ee wi h hose p e i-
ously published, whe e he le el o educa ion was impo an o esilience and p epa a ion
o esis ing ca as ophic e en s, inding ha hose who had a highe educa ion we e be e
p epa ed han hose wi h a lowe le el o educa ion [35].
Finally, he appea ance o COVID-19 posi i e cases in one’s close se ing was ound
o be associa ed wi h a lowe capaci y o adap ing o he changes gene a ed and he
appea ance o mo e p e alence o heal h diso de s. Close COVID-19 posi i e cases cause a
s ess ul si ua ion [
7
,
9
], which could lead o unce ain y and eeling symp oms compa ible
wi h COVID-19, which could hen cause al e a ions in beha io [
21
–
23
], anxie y [
19
], and
dep ession because he pe cei ed dange o onesel o one’s amily canno be managed [
39
].
Conce ning he ela ionship be ween he capaci y o adap ing o change and men al
heal h, a signi ican nega i e ela ionship was ound be ween adap a ion o change, he
emo ional and cogni i e ac o s, and heal h. Thus, indi iduals who had a g ea e capaci y
o adap ing o change, bo h in i s cogni i e and emo ional ace s, in gene al, sco ed lowe
in all he symp oms: soma ic, anxie y/insomnia, dep ession, and social dys unc ion [
50
,
51
].
O he s udies ha e ound ha capaci y o emo ional managemen is ela ed o be e capac-
i y o adap ing o changing si ua ions [33,46,47], while, on he con a y, dep essi e s a es
ha could a ise in si ua ions o ex eme s ess ha e been ela ed nega i ely o success ul
coping o be e capaci y o adap ing o new si ua ions [
24
], and wo se psychological
wellbeing [
48
,
49
]. The esul s o o he s udies also insis on he impo ance o being able o
depend on a wide social suppo ne wo k o cope mo e success ully wi h s ess ul si ua ions
and ein o ce he capaci y o indi idual esis ance [
20
,
31
,
42
]. In b ie , a be e capaci y o
managing emo ions and imp o emen in capaci y o adap ing o si ua ions ha gene a e
unce ain y [22,34] lead o be e pe cei ed heal h.
This s udy also made an in-dep h analysis o he p o ec i e e ec ha capaci y o
adap ing o change exe s on he ela ionship be ween se ings wi h a COVID-19 posi i e
case and men al heal h. The impo ance o he p o ec i e ole exe ed by he emo ional
ac o o capaci y o change was shown, con i ming ou las esea ch hypo hesis. These
indings ein o ce he need o lea n o manage emo ions, especially anxie y and dis ess,
which can appea in esponse o change, o con ibu e o wellbeing, eco e y, and gene al
heal h in se ings wi h COVID-19 posi i e cases.
4.1. P ac ical Implica ions
Ou esul s show ha he men al heal h o he popula ion may be a ec ed by a se ing
wi h posi i e COVID-19 cases. In his scena io, e ec i e emo ional coping is undamen al
o p e en psychological symp oms associa ed wi h a pandemic. We also ound da a
sugges ing ha i is ha des o young people and women o adap o changes de i ed om
su oundings wi h posi i e COVID-19 cases. In o ma ion on such isk p o iles p o ides an
ad an age o making he igh decisions on p e en i e ac ion o imp o ing wellbeing
and men al heal h.
Any ini ia i e di ec ed a imp o ing he capaci y o adap a ion o change has posi i e
consequences o p o ec ing public men al heal h. The e o e, he da a de i ed om his
s udy ha e impo an p ac ical implica ions o decision-making on he design o in e -
en ions o he gene al public. In his line o ac ion, agen s o social change (communi y
social se ices, heal hca e pe sonnel, educa o s, and so o h) could bene i om hese