Resilience and the Role of Depressed and Anxious Mood in the Relationship Between Perceived Social Isolation and Perceived Sleep Quality During the COVID-19 Pandemic

Background: The aim of the study was to examine the mediating role of depressed and anxious mood in the relationship between perceived social isolation and perceived sleep quality during the COVID-19 pandemic. We also aimed to investigate the moderating role of psychological resilience in this mediation. Methods: A cross-sectional study of adults (18+ years old) was conducted using an online, multi-language, international survey between March 31 and May 15, 2020. Simple and moderated mediation analyses were performed using the PROCESS macro for SPSS, with perceived social isolation as an independent variable, change in perceived sleep quality (during vs. before the COVID-19 pandemic) as a dependent variable, depressed and anxious mood (Patient Health Questionnaire-4, PHQ-4) as a mediator, and resilience (Brief Resilience Scale, BRS) as a moderator. Results: A convenience sample of 3816 participants (2692 = female) from 94 countries (47.4% USA) met criteria for inclusion in the analyses. Results showed that depressed and anxious mood mediated the relationship between perceived social isolation and change in perceived sleep quality. This mediation was moderated by resilience; the indirect effect of perceived social isolation on change in perceived sleep quality through depressed and anxious mood decreased as the level of resilience increased (index of moderated mediation = 0.008, SE = 0.003, 95%CI [0.001; 0.014]). Conclusions: The study findings indicate benefits of psychological resilience in buffering negative effects of perceived isolation, suggesting potential benefits of developing targeted strategies to enhance resilience during times of significant crises.