Now, Stanford University psychologists have found that mindsets formed about COVID-19 early on – within the first 10 days of the World Health Organization (WHO) declaring the disease a global pandemic – influenced emotions and health behaviors, ultimately affecting well-being months down the line. The results stem from a study of more than 5,000 American adults surveyed at three specific points in time: the beginning of the pandemic, six weeks later, and again at the six-month mark. The findings will be published in an upcoming issue of the journal Social Science & Medicine.

“We had long thought that mindsets are formed in the midst of uncertainty,” said Alia Crum, an associate professor of psychology in Stanford’s School of Humanities and Sciences and senior author on the paper. “So this current event, as unfortunate as it was, was the moment to study mindsets.”

Making up your mind

The researchers identified three mindsets that people could adopt:

  • Catastrophe mindset: The COVID-19 pandemic is a global catastrophe that is wreaking havoc on our society.
  • Manageable mindset: The COVID-19 pandemic can be managed so that people in our society can live life as normal.
  • Opportunity mindset: The COVID-19 pandemic can be an opportunity for our society to make positive changes.

Crum’s group at Stanford, called the Stanford Mind & Body Lab, had studied these mindsets before.

“It really came from existing work that we were doing on illness mindsets,” said study lead author Sean Zion, who conducted the research as a PhD student in Crum’s lab. “Since we had this work, and we knew that these mindsets were important, we adapted them to fit with the context of the COVID-19 pandemic.”

Prior to the pandemic, Zion was studying how mindsets formed when patients are diagnosed with chronic illnesses affect their health and well-being later on. The lab’s previous research found the catastrophe mindset to be generally maladaptive – patients with this mindset generally reported greater levels of depression and anxiety and were less able to perform standard physical and social tasks, like running errands. The manageable and opportunity mindsets, conversely, tended to be adaptive, with patients reporting the opposite traits.

To find out if mindsets formed early in the pandemic predict similar outcomes, Zion and his colleagues launched an online questionnaire through a social media campaign. This happened to coincide with the day the WHO designated COVID-19 as a global pandemic.

“We were one of the first non-medical teams at Stanford to mobilize research to study the pandemic,” Crum said. “As psychologists, this was our way of jumping in to try and help understand COVID-19 and support people.”

The initial survey asked how much a person agreed with each of the three mindsets, and it also queried their mood, physical health, quality of life, eating and sleeping behaviors, and abidance by the Centers for Disease Control’s COVID-19 guidelines. Subsequent questionnaires sent out six weeks and six months later were largely the same but contained slight modifications in response to ever-evolving information about COVID-19.

In all, more than 5,000 American adults responded to the surveys at all three time points.

Nuanced viewpoints

The goal of the project was not to characterize the mindsets of Americans, Crum explained. Rather, the research team wanted to explore the relationships between mindsets and behaviors, emotions, and well-being.

On this score, the team found that the catastrophe mindset led to more negative emotions and less adaptive behaviors, while the opportunity mindset led to more positive emotions and more adaptive behaviors.

Those who adopted a catastrophe mindset reported worse well-being and higher levels of negative feelings, engagement in unhealthy behaviors, and experiences of isolation and meaninglessness on the last survey. Agreement with the opportunity mindset, however, led to better well-being, more positive mood, more experiences of growth and connection, and fewer experiences of isolation and meaninglessness. The majority of the research participants’ views aligned with one of these two mindsets.

The manageable mindset brought about more complex outcomes: It was adaptive on the individual level but maladaptive on the societal level.

“The manageable mindset helped individuals in terms of their level of mental health or their level of positive affect. It’s adaptive at the individual level to not engage with something that’s scary and uncertain, like a pandemic,” Zion explained. “But collectively, it was also decreasing the behaviors we all needed to do – things like staying home, social distancing, and wearing masks.”

For some people, Crum said, the manageable mindset may have led them to deny the seriousness of the COVID-19 pandemic.

Furthermore, the scientists found that many participants viewed the pandemic as both a catastrophe and an opportunity – something they had not seen when studying mindsets in illness.

“In many ways, the pandemic did feel like a catastrophe,” Zion said. “But it also opened some new doors, some possibilities for slowing down, for reconnecting with family, for maybe rethinking career choices or how much you’re prioritizing work versus family.”

Learning new approaches

One caveat of the study is that the majority of survey-takers were white educated women, so the responses are not representative of the American population. This was likely due to the recruitment method – more white educated women tended to click on the research team’s social media advertisements. While the study’s analyses controlled for demographic factors, the researchers are working to understand the mindsets of more diverse samples of people.

Now, the team is examining how early mindsets about COVID-19 impact individuals at a fourth time point: two years into the pandemic.

Things have changed drastically since the study’s last survey was administered in September 2020: Vaccines are now available, COVID-19 variants have spawned waves of infection, and people are growing even wearier of living with the virus. With this two-year check in, Zion and his colleagues are exploring how early mindsets influence vaccine hesitancy and likelihood of catching COVID-19.

Mindsets, however, are just one piece of the puzzle, Crum explained. Personal experiences and circumstances during the pandemic, like the loss of a loved one and access to health care, also play a role in health and well-being.

As society learns to live with COVID-19, the researchers are designing and testing interventions to help people adopt useful mindsets for post-pandemic life. Zion explained that health care has a long history of trying to improve health and well-being outcomes through brute-force changes to people’s behaviors.

Instead, altering mindsets and core beliefs may be a better way to produce desired results.

“We aim to help people acknowledge that the pandemic was a catastrophe, while also recognizing and realizing the opportunities it could open for people to make changes on individual and societal levels,” Crum said. “These opportunities begin with one’s mindset.”

Additional Stanford co-authors of this research include graduate students Kengthsagn Louis and Kari Leibowitz, former postdoctoral scholar Lauren Heathcote, and former research coordinator Rina Horii. Crum is also a member of Stanford Bio-X and the Maternal & Child Health Research Institute.

This research was funded by a grant from the Robert Wood Johnson Foundation.

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