*3.2. Mediational Analysis*

Does ACE exposure have a perpetuating effect on psychological symptoms during periods of prolonged stress, and is psychological flexibility protective and a mediator of this relationship?

Mediational analyses with psychological flexibility as a mediator of the relationship between ACE (predictor) and psychological distress (DASS-21 scales) at Time 2 (outcome) were carried out. Bivariate correlations are reported in Table 2. Results from the mediational analyses are illustrated in Figure 1. In all the mediation models ACE was not a significant predictor of Psychological Flexibility (Path a), b = −0.03, t (228) = −0.22, *p* = 0.83. Psychological Flexibility was a significant strong negative predictor of all three outcomes of psychological symptoms (path b)—depression, b = −0.69, t (228) = −11.78, *p* < 0.001; anxiety, b = −0.52, t (228) = −10.72, *p* < 0.001; stress, b = −0.63, t (228) = −10.63, *p* < 0.001. ACE was a significant positive predictor of outcomes for depression and anxiety (path c) depression b = 0.35, t (228) = 2.21, *p* = 0.03; anxiety, b = 0.31, t (228) = 2.45, *p* = 0.01 but not for stress—b = 0.24, t (228) = 1.52, *p* = 0.13. There was no significant relationship between cumulative ACE scores, and the outcome on Psychological Flexibility (Path a). However, Psychological Flexibility was a significantly positive strong predictor of wellbeing (Path b), b = 1.34 t (228) = 13.34, *p* < 0.001, and ACE was a significant negative predictor of wellbeing (path c), b = −0.58, t (228) = −2.02, *p* = 0.04.

**Table 2.** Bivariate correlations among variables for mediation analysis.


Note: \* *p* < 0.05; \*\* *p* < 0.01; \*\*\* *p* < 0.001.

742

 on

indicate a

non-significant

 mediation effect, with filled (black) arrows indicating a significant relationship.

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 arrows

#### **4. Discussion**

The objective of this study was to investigate the longitudinal profile of psychological wellbeing and distress, during the COVID-19 pandemic, to investigate whether a history of self-reported ACE related to a person's wellbeing during the COVID-19 pandemic. The anticipated decrease in mental health and wellbeing due to COVID-19 will likely peak in the mid and post-pandemic phases and persist for years to come [4,22,65]. This longitudinal study investigated mental health and wellbeing changes from the beginning of the pandemic (March 2020) and again approximately ten months into the pandemic (January 2021), with a specific interest in the response profile and self-reported stress of people who had experienced ACE, compared to those without. This study hypothesized that psychological distress would increase over time for those with ACE, relative to the control population (those with no ACE). In addition, it was hypothesized that those with No ACE would have significantly lower distress at Time 2 compared to those with ACE, based on the stress sensitization hypothesis. Finally, this study also aimed to investigate whether self-reported Psychological Flexibility was a protective mediating factor on psychological distress, wellbeing, and the ACE-Distress relationship. Recent findings related to COVID-19 and historical research show that the mental health fallout from COVID-19 will disproportionately impact those already vulnerable in society [65–68]. This study supports previous research showing that those who have experienced ACE report greater psychological distress over time during the current COVID-19 pandemic [25,26,32,36].
