Effects of psychological distress and life satisfaction on COVID-related traumatic stress : An international, cross-sectional study

Background
This study examines the individual impacts of psychological distress (i.e., depression and anxiety) and life satisfaction on COVID-related traumatic stress in an international sample of heterosexual versus LGBQ+ adults.

Method
Between July and August 2020, a cross-sectional electronic survey (n = 2482) was launched in five countries (India, Italy, Saudi Arabia, Spain, and United States) assessing sociodemographic characteristics as well as psychological, behavioral, and social factors related to health outcomes during the COVID-19 pandemic.

Results
Significant differences between LGBQ+ participants and heterosexual participants were found for depression (p < .001) and anxiety (p < .001). Depression was associated with COVID-related traumatic stress among heterosexual participants (p < .001) but not LGBQ+ participants. Both anxiety (p < .001) and life satisfaction (p = .003) were also associated with COVID-related traumatic stress in both groups. Hierarchical regression models demonstrated significant effects of COVID-related traumatic stress for adults outside the United States (p < .001); less than full-time employment (p = .012); and for greater levels of anxiety, depression, and life satisfaction, respectively (all ps < .001).

Limitations
Given the stigma of being LGBQ+ that remains in many countries, participants in may have been reluctant to identify as a sexual minority and therefore indicated a heterosexual sexual orientation.

Conclusion
The impact of sexual minority stress among LGBQ+ may play a role in COVID-related post-traumatic stress. Large-scale global disasters such as pandemics, contribute to disparities in psychological distress among LGBQ+ individual, however, sociodemographic factors such as country and urbanicity may play mediating or moderating roles.