**3. Results**

#### *3.1. Changes within Each Group*

Did mean levels of psychological distress change significantly from Time 1 to Time 2, and differently by groups?

Changes on mental health and well-being measures for the total cohort (*n* = 231), and then within each ACE group (No ACE (*n* = 75); Low ACE (*n* = 110); and High ACE (*n* = 46)) from Time 1 to Time 2 were examined. As seen in Table 1, there were no significant changes in mean scores for Depression, Anxiety, or Stress for those with No ACE over time, as measured by the DASS-21. However, those with Low ACE scores had significant increases in all areas of psychological distress from Time 1 to Time 2— Depression (t(109) = 5.60, *p* < 0.001, d = 0.53), Anxiety (t(109) = 2.18, *p* = 0.032, d = 0.21) and Stress (t(109) = 4.60, *p* < 0.001, d = 0.44). Furthermore, individuals with High ACE had a significant increase in Depression scores (t(45) = 3.29, *p* = 0.002, d = 0.49). In terms of relative change, repeated measure ANOVA revealed a significant group-by-time interaction effect (F (2228) = 3.68, *p* = 0.027) for Depression. A one-way ANOVA revealed no significant differences in depression scores between groups at Time 1 (F (2228) = 0.036, *p* = 0.964) but significant differences between groups at Time 2 (F (2228) = 3.11 *p* = 0.046). Planned contrasts (Dunnet T) to test the hypothesis that those with No ACE would score lower than those with ACEs in the analysis, indicated that the increase in Depression scores in the No ACE group (*M* = 5.93, SD = 4.77) was significantly lower (*p* < 0.05) than the corresponding changes within the Low ACE (*M* = 7.75, SD = 5.48) and High ACE groups (*M* = 7.87, SD = 5.68).

When Anxiety was considered within the repeated measure ANOVA, there was no significant group-by-time interaction effect (F (2228) = 2.35, *p* = 0.098) for anxiety. One-way ANOVAs revealed no significant differences in scores at Time 1 or Time 2 between groups (*p* > 0.05).

A final repeated measure ANOVA revealed a significant group-by-time interaction effect (F (2228) = 4.27, *p* = 0.015) for Stress. A one-way ANOVA revealed no significant differences in stress scores between groups at Time 1 (F (2228) = 0.025, *p* = 0.975) but revealed significant differences at Time 2 (F (2228) = 3.21, *p* = 0.042, partial *n*<sup>2</sup> = 0.027). Planned contrasts indicated that the increase in stress scores for those with No ACE (*M* = 6.69, SD = 5.01) was significantly lower (*p* = 0.011) than those with Low ACE (*M* = 8.61, SD = 8.61) but not significantly lower (*p*= 0.168) than those with High ACE scores (*M* = 7.87, SD = 4.60).

Interestingly, there was no significant change within any group on mean levels of COVID-19 specific illness perception over time, as measured by the BIPQ.

Did mean levels of wellbeing change significantly from Time 1 to Time 2 and differently for groups?

Mean levels of wellbeing decreased significantly for all groups over time—the whole sample (*p* < 0.001, d = 0.367); those with No ACE (*p* < 0.001, d = 0.266); those with Low ACE (*p* < 0.001. d = 0.404); and those with High ACE (*p* < 0.001, d = 0.452). In contrast, there were no significant changes, positively or negatively, within any group when comparing gratitude over time.


Note: M = Mean; SD = standard deviation; *p* = significance value; d = Cohen's d; bolded = significant < 0.05.

