Direct and indirect effects of dorsolateral prefrontal cortex and emotion regulation strategy use on mental health during Covid-19
Background. Covid-19 and associated restrictions have been linked to negative mental health outcomes across the globe. Cognitive emotion regulation strategies constitute means to mitigating negative affect and are associated with prefrontal and limbic brain regions. Methods. Variations in cognitive emotion regulation strategy use, anxiety and depression in 43 adults (31♀, average age=35.14±9.20y) and emotional and behavioral problems in 26 children (10♀, average age=10.69±2.52y) were tested seven times following Covid-19 onset (March-December 2020). Relationships between pre-pandemic brain structure, use of cognitive emotion regulation strategies and mental well-being were tested using multiple regression and mediation models. Results. Covid-19 and associated restrictions were linked to heightened, but varying levels of anxiety and depression across 2020. While adaptive strategies were most employed, maladaptive strategies explained the highest variation in negative mental health outcomes (i.e., anxiety and depression). Adaptive strategies had a positive, maladaptive strategies a negative effect, however, this direction varied for some strategies when considering long-term effects. Emotion regulation strategy use mediated the association between pre-pandemic brain structure (i.e., cortical thickness) in right dorsolateral prefrontal cortex and well-being, with prefrontal-amygdala coupling as a possible driving factor. Additionally, early well-being measures were crucial for later well-being. Conclusion. Our findings support the use of early intervention strategies for mental health consequences due to the pandemic. Due to substantial personal and societal costs associated with mental health disorders, such as anxiety and depression, an early identification of risk factors for the development and treatment response are of utmost importance.