Coping During COVID-19: Uncovering the Relationship between Executive Control, Amygdala Reactivity and Coping in Psychiatric Patients

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The ability to successfully cope with stressful experiences is an important predictor of resilience and mental health outcomes. Therefore, when confronted with stressors such as the COVID-19 pandemic, coping represents an essential skill for individuals with psychiatric disorders. Psychiatric patients commonly demonstrate deficits in executive control (EC) and increased reactivity of the amygdala to emotional information, which might separately or jointly compromise their coping abilities. However, particularly in light of psychiatric comorbidity, the relationship between EC, amygdala reactivity, and coping in psychiatric patients remains unclear. Therefore, in a naturalistic cohort of psychiatric patients (N = 88) and a healthy control group (N = 49), we examined the association between EC and coping in daily life and in response to the COVID-19 pandemic. Additionally, we explored whether this relation was mediated by amygdala reactivity to emotional information on a neural level. Using a self-report measure of EC and a spatial working memory (SWM) task, we found that only subjective EC was associated with a higher positive appraisal style and positive reappraisal of the COVID-19 pandemic across patients and controls. Moreover, while discovering as association between SWM performance and right amygdala reactivity, the relation between EC and coping was not mediated by amygdala reactivity. Therefore, further research exploring how EC and amygdala reactivity tie into coping is required. These findings underscore the relevance of subjective EC deficits as a transdiagnostic predictor of coping and reappraisal skills. Targeting EC deficits and reappraisal skills could represent promising pathways to increasing resilience across psychiatric disorders in the future. Keywords: coping, resilience, executive control, amygdala reactivity, psychiatry, COVID-19
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