Interactions between early-life adversity, pandemic stress, and social support on psychiatric disorders in a nationally representative sample of Canadian adults

PurposeThis study examined how pre-existing early-life adversity (ELA) and current social support interacted with COVID-specific pandemic stressors in relation to risk of psychiatric disorders in a nationally-representative sample of Canadian adults.MethodsParticipants (n = 9,409) were from the Mental Health and Access to Care Survey, a cross-sectional survey of Canadian adults during later stages of the COVID pandemic (March to July 2022). Measures included pandemic stressors (Statistics Canada), ELA (Childhood Experiences of Violence Questionnaire), social support (Social Provisions Scale), and past 12-month psychiatric problems (WHO-CIDI). Statistical analyses included two-step logistic regression models adjusted for covariates and weighted for complex survey design.ResultsHigher odds of psychiatric problems were predicted by ELA (aOR = 1.24 [1.15–1.35]-aOR = 1.53 [1.39–1.69] across psychiatric disorders) and pandemic stress (aOR = 1.18 [1.12–1.25]-aOR = 1.32 [1.26–1.39] across psychiatric disorders). Significant interactions between ELA and pandemic stress for depression (aOR = 0.96 [0.93–0.98]) suggested an attenuated effect of pandemic stress at higher levels of ELA. Social support was associated with reduced psychiatric problems (aOR = 0.88 [0.86–0.91]-aOR = 0.97 [0.94–0.99]), while pandemic stress was associated with increased psychiatric problems (aOR = 1.20 [1.15–1.26]-aOR = 1.33 [1.27–1.40]). An interaction between social support and pandemic stress for suicidality (aOR = 1.02 [1.01–1.03]) indicated that higher levels of social support were associated with increased odds of suicidality in the presence of pandemic stress, though the effect was small and of questionable clinical significance.ConclusionELA and pandemic stress increased psychiatric disorder likelihood, while social support was protective. However, interactions indicate nuanced relationships in mental health risk during the pandemic.