How shifting mindsets after catastrophes can promote mental and physical health

Catastrophes, by definition, are devastating, but they can often be catalysts for lasting, positive change – and if people can adopt that perspective, they may see some real benefits, a Stanford-led study suggests.

In a randomized, controlled trial, a one-hour intervention was given to a group of adults designed to shift their mindset, or core beliefs and assumptions, about having lived through a catastrophe like the COVID-19 pandemic, with the goal of seeing growth opportunities in the experience.

Those who received the intervention showed lower levels of depression three months later compared to a control group. Blood tests also revealed lower levels of C-reactive protein, an inflammatory marker linked to chronic stress and disease. The findings were reported in the journal Brain, Behavior, and Immunity.

As much as we might wish to live untouched by trauma or catastrophe, the reality is that few of us are spared from such struggle. The study was inspired by our desire to help people reflect on their experience of the pandemic with an eye on how it could help them grow."

Alia Crum, study's senior author and associate professor of psychology in theStanford School of Humanities and Sciences

A balanced view

Crum's team from the Stanford Mind & Body Lab and their colleagues conducted the study from October 2022 to February 2023 with two groups of adult participants. The control group viewed a series of videos with information about different phases of the COVID-19 pandemic and answered questions to test their knowledge. The intervention group viewed a series of videos showing that mindsets can be powerful drivers of health and well-being.

These videos also highlighted evidence that people often grow in characteristic ways as a result of living through catastrophic experiences such as the COVID-19 pandemic. Common areas of growth include developing a greater appreciation for life, increasing resilience, strengthening interpersonal relationships, deepening one's spiritual faith, and pursuing new opportunities that would not have otherwise been possible.

After viewing the videos, the intervention group participants were asked to reflect in writing on their current mindsets about the long-term impact of the pandemic and potential areas of growth they could pursue in their own lives.

Cultivating a mindset is not the same as blind positive thinking, the researchers emphasized, and participants were not asked to ignore the pandemic's negative impacts.

"We tried to be very nuanced and balanced but also bring in the genuine, research-based evidence that there are specific positive changes that a lot of people do go through when they live through something like the pandemic," said Jesse Barrera, the study's co-first author and former lab manager of the Mind & Body Lab.

In fact, previous research from Crum's team revealed that people who saw the pandemic as a major catastrophe in early 2020 were actually more likely to also see it as holding some opportunities. This insight informed the intervention in the current study.

The researchers themselves also found an opportunity from the pandemic experience. They had to conduct their study remotely, which led to a new design where participants viewed the videos at home and mailed in dried blood spot samples for testing.

"In a lot of ways, the methodology that we came up with for this study was actually only an opportunity because of COVID-19," said Lexi Straube, a Stanford medical student and co-first author. "This approach opens the door for more accessible strategies that can reach people during future public health crises or in communities that don't have access to traditional clinical trials."

Hope after catastrophe

More research is needed to replicate the findings with different groups of people, but the results provide hope for anyone who has experienced a challenging or traumatic life event, Crum said.

"We would have liked to avoid the COVID-19 pandemic, but it came regardless," she said. "In the post-pandemic era, we face a choice: We can let it recede into memory, leaving us depleted and disillusioned, or we can choose to look back, learn from it, and grow – both personally and collectively."

Additional Stanford co-authors include Zoë Huml, Mind & Body Lab research coordinator; recent doctoral graduate Sean R. Zion; current doctoral student Kris M. Evans; and postdoctoral scholar Chiara Gasteiger in the Department of Psychology in the School of Humanities and Sciences. Other co-authors on the study include researchers from Boston College; the University of Auckland, New Zealand; the University of California, Los Angeles; and the University of Pennsylvania.

This research received support from the Robert Wood Johnson Foundation and the California Initiative to Advance Precision Medicine.