Predictors of mental health in healthcare workers during the COVID-19 pandemic: The role of experiential avoidance, emotion regulation and resilience

Aims: This study explores the mediational role of resilience, experiential avoidance and emotion regulation in the levels of anxiety, depression and posttraumatic stress disorder (PTSD) of healthcare workers during the COVID-19 pandemic. Additionally, we explored the association of such levels with personal and professional variables. Design: Cross-sectional study. Methods: Healthcare professionals working in Spain (N = 786) were recruited following a snowball approach in November and December 2021. Resilience, emotion regulation, experiential avoidance, depression, anxiety, PTSD and work-related variables were measured. Mean differences and correlations were computed, and a path analysis with latent variables (PALV) model was tested. Results: In total, 18.8% of the sample scored above the cut-off score for depression, 24.6% for anxiety and 36.4% for PTSD. Higher resilience and lower experiential avoidance and expression suppression were correlated with better mental health. The PALV model explained 42%-53% of mental health outcomes. Experiential avoidance showed the greatest explanatory power and mediated the impact that stressors had on mental health. Some work-related variables correlated with greater psychological impact. These factors encompassed being a nurse, feeling that their job remained stressful and had not yet returned to its pre-pandemic state and having interacted with individuals facing economic difficulties due to the pandemic, and those who had lost their lives to COVID-19. Conclusion: Healthcare workers showed high levels of psychological impact during the COVID-19 pandemic. Such impact was predicted from some work-stress variables and the reliance on maladaptive strategies such as experiential avoidance and expressive suppression. Impact: Training healthcare professionals to use coping strategies incompatible with experiential avoidance may improve their mental health. Additionally, better working conditions are fundamental for reducing the impact of critical situations on healthcare workers' mental health. Patient or Public Contribution: No patient or public contribution.