ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2025
Long-COVID symptom burden and the experience of adversity: the importance of response-shift effects over 3 years of the pandemic.
Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Response shift-adjusted longitudinal assessment of patient-reported outcomes in older people living with HIV: a multilevel structural equation and Rasch analysis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- Exemplifying a measurement validation strategy for rare- and ultra-rare diseases: measuring what matters in alpha-mannosidosis.Orphanet journal of rare diseases · 2026Article
- Toward characterizing brain fog in long COVID: correlates and impact on measurement metrics.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026Article
- Cognitive appraisal processes and health: from bench to bedside.Frontiers in public health · 2026Review
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Authors and funding
3 authors.
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Abstract
BACKGROUND/
objectivesLong COVID is a long-term legacy of the global pandemic. This study aimed to illuminate how Long COVID impacts individuals, and how response-shift effects influence Long COVID's impact. Methodologically, it expands the application of longitudinal statistical methods to test a more dynamic investigation of psychosocial factors in health over time.
methodsThis quasi-experimental longitudinal cohort study collected data up to four times over 3 years of the COVID pandemic (May 2020 to April 2023). This study focused on 1151 participants divided into four Long-COVID Symptom Burden groups (Never Had COVID; Low, Medium, and High Long-COVID Symptom Burden). It examined COVID-specific outcomes: General Hardship, Healthcare Hardship, Worry, and Social Support. The Quality of Life Appraisal Profile
resultsNotable response-shift effects were revealed on all four COVID-specific outcomes, reflecting both direct and moderated response-shift effects. The experience of COVID-specific adversity was related to various appraisal processes but the nature of the relationship often varied by Long-COVID symptom burden. The appraisal processes that were most salient included patterns of emphasis related to getting used to and handling demands or recent changes, problem-solving goals, and comparing oneself to similar others. Individuals in the high Long-COVID Symptom-Burden Group were particularly highlighted in response-shift effects. The broad conclusions of both raw and multiplicity-adjusted results were similar. That is, there were notable reprioritization and reconceptualization response-shift effects for all outcomes, and notable but fewer recalibration response-shift effects.
conclusionsResponse-shift effects, measured via the direct assessment of cognitive-appraisal processes, were prominent in dealing with the COVID pandemic. The present study documented that COVID-specific adversity can be attenuated or exacerbated depending on individuals' patterns of emphasis, goals, and standards of comparison. The study's utilization of data collected at four time points over 3 years of the global pandemic provided a more comprehensive and far-reaching evaluation of response shift than earlier work. The theory-driven analytic methodology developed in the present work facilitated a more nuanced description of direct and moderated response-shift effects.
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