The coronavirus disease (COVID-19) has been posing a significant threat to public health worldwide since the end of 2019. The World Health Organization (WHO) declared the disease a pandemic, and owing to the spread of variants, rigorous and prolonged social distancing practices have been imposed across nations. COVID-19 not only causes concerns regarding infection among individuals and those around them, but the implementation of social distancing rules has introduced tight restrictions on many activities, such as those related to work, leisure, school, social gatherings, and religious activities (Ko, 2020; Orsolini et al., 2020). Schools have been closed and school-age children are having to stay home due to strict social distancing measures in response to COVID-19, further aggravating parents’ burden of educating and parenting their children at home (Wang et al., 2020). As a result, many people have been suffering from fear of infection as well as psychological distress, such as frustration over job loss, financial hardship, and depression and helplessness due to alienation and social distancing (Wang et al., 2020). This study was conducted from November 2020 to July 2021. Until the beginning of the study, Korea had effectively controlled the spread of the infection with a strong Korean quarantine (which is called K-Quarantine just like K-POP). However, the K-Quarantine was loosened as COVID-19 prolonged. This led to the third wave of the virus infections in November 2020 (The Korea Herald, 2020). It took more than 80 days for the country to see its virus caseload increase from 20,000 to 30,000. However, it only took 20 days for the country to add another 10,000 cases after its tally surpassed 30,000 in November 2020. Unlike the first and second waves, the cluster infection continued in an unspecified group. Consequently, social distancing was strengthened, such as only take-out possible at cafes, and “Corona Red,” that is, anger and frustration, grew beyond “Corona Blue.”

Novel infectious diseases are known to induce extreme, uncontrollable, and extensive distress beyond routine levels of stress (Main et al., 2011). People who contracted severe acute respiratory syndrome (SARS) in 2003 and survived have been reported to experience an array of mental health problems since their recovery (Cheng, 2004; Mak et al., 2009; Wing and Leung, 2012). Further, more than 65% of patients who contracted Middle East Respiratory Syndrome (MERS) in 2015 were reported to have suffered from depression, anxiety, and sleep disorders as well as posttraumatic stress symptoms even 12 months after recovery (Shin et al., 2019). According to the survey of MERS victims conducted by Lee et al. (2016), more than 90% of the Korean population felt a fear of infection for themselves and their families, and the majority of the population suffered from emotional distress. In particular, restrictions on leaving their houses increased people’s distress. Parents of young children were at 1.8 times the risk of developing a fear of infection (Nickell et al., 2004).

What factors serve as a buffer against the adverse effects of COVID-19-related restrictions and concerns on mental health? In this study, we focus on posttraumatic growth (PTG), a coping mechanism developed following trauma experienced in the past, in examining receptive attitudes and flexible responses to stressful situations related to COVID-19. The term PTG refers to the phenomenon in which humans mature and show positive changes as they encounter various crises and adversities (Tedeschi and Calhoun, 1996). People with high PTG are expected to engage in committed action, whereby they accept their situation when faced with challenges in life, establish goals commensurate with their values, and move forward, step by step, to achieve those goals (Hayes, 2004).

Until the 1990s, psychological studies were primarily focused on examining the vulnerabilities, pathological symptoms, and treatments to reduce trauma in victims (Janoff-Bulman, 1992; Foa and Riggs, 1993; Keh and Choi, 1993; Ahn, 2005). With criticism of the limited, pathological perspectives on trauma, more scientific and systematic studies on the positive impact of trauma on our lives, that is, the PTG phenomenon, began being conducted since the 1990s (Joseph et al., 1993; Tedeschi and Calhoun, 1996). People who have experience PTG have not only found significant meaning to life but also strive to live life commensurate with their values (Triplett et al., 2012; Groleau et al., 2013; Im, 2017). Furthermore, people who have achieved tremendous growth following a traumatic loss have been reported to have broadened perspectives and become highly receptive to the finiteness of life and painful emotions, such as sorrow (Im, 2013). In other words, PTG is anticipated to contribute to preserving mental health by lowering the risk of progressing to a psychopathological condition by promoting the reception of discomfort and concerns caused by limitations in stressful situations, such as falling prey to COVID-19 and encouraging individuals to commit to activities that they value. For instance, Cui et al. (2021) reported that COVID-19 ward nurses experienced PTG through psychological interventions, and it is speculated that PTG enables nurses to handle high-intensity work with a positive psychological attitude by improving self-control and relieving negative emotions (Rodríguez-Rey et al., 2019; Wu et al., 2020).

According to the PTG model recently established by Tedeschi and Calhoun (Tedeschi et al., 2018), trauma dismantles one’s basic assumptions of the world and causes suffering, but it eventually serves as an “engine” of growth (Choi, 2014; Triplett et al., 2012; Eom and Cho, 2016). Individuals engage in automatic and intrusive rumination immediately after suffering from trauma, but at some point after the traumatic episode, they re-evaluate the meaning of adversity and begin to introspect, looking back (Taku et al., 2008).

Although limited in number, studies have substantiated that PTG is a real phenomenon and it serves as a protective factor against burnout. Taku (2014) proved that PTG protects surgeons against burnout. Even physicians with low social support, a factor of resilience, were found to experience maladjustment, such as depersonalization and achieve greater personal accomplishments, if they experienced significant PTG (Taku, 2014). Gibbons et al. (2011) reported that burnout is negatively associated with growth in social workers. Thus, we examined whether PTG is indeed a protective factor that reduces individuals’ levels of depression and anxiety due to COVID-19 and increases their committed action.

COVID-19 has inflicted intense psychological suffering on healthcare providers. Yang et al. (2020) reported that 85.4% of frontline nurses sustained stress responses, such as somatization and compulsive symptoms, and moderate or severe psychological suffering. They are consistently exposed to infection risk during work and consequently required to be separated from their families, which makes it difficult for them to receive familial support when in need. Korean studies have examined the suffering of nurses—healthcare providers who must deal with patients in closed spaces for prolonged periods. Park (2018) reported that stress in nurses is aggravated by their having to remain in an isolation ward with a patient while wearing personal protection equipment for more than 90 min at a time and having to perform tasks, such as cleaning, in addition to nursing work due to the closed access to isolation wards for non-qualified personnel. High job stress and accumulated fatigue in such circumstances lead to burnout (Salari et al., 2020; Jeong, 2021). Similarly, COVID-19-related restrictions and concerns are believed to induce depression and anxiety.

Social restrictions and concerns pertinent to COVID-19 may thwart value-based committed action by reducing individuals’ vigor and causing a sense of isolation. Committed action is conceptualized as that being a result of “free choice and voluntariness from intrinsic motivation” (Wilson and DuFrene, 2009), and voluntariness and freedom not only increase vigor by providing reinforcements, such as pleasure, but also contribute to psychological wellbeing by conserving energy through self-regulatory control (Wilson and Sandoz, 2008). If individuals cannot adopt engagement response commensurate with their values due to restrictions, such as those imposed during the COVID-19 pandemic, the risk for persistence or exacerbation of depression is elevated (Zettler, 2007; Wilson et al., 2010). Moreover, some argue that individuals who are overwhelmed by anxiety lose their values and cannot live an engaged life because their views become limited to simply focusing on the imminent threat (Eifert and Forsyth, 2005). An engaged, pleasant, and meaningful life, is one aspect of happiness proposed by Seligman (2002).

On the other hand, restrictions and concerns pertinent to COVID-19 may actually promote committed action. Committed action refers to discovering values and living life in accordance with those values, and this is similar to the discovery of meaning in life. Although few studies have substantiated the relationship between committed action and COVID-19, many studies that investigated the association between meaning in life and COVID-19 observed that individuals discover life to be more meaningful during the COVID-19 pandemic than before it. In other words, amid the demands to restructure daily lives during the COVID-pandemic, people are likely to think about the meaning of their lives more than before and engage in relevant activities (De Jong et al., 2020; Eisenbeck et al., 2021), and it has been reported that people have discovered more meaning in life (Yang et al., 2021). Thus, it is necessary to explore the impact of COVID-19-related restrictions and concerns on committed action.

To secure ecological validity, this study used a diary method, a type of Ecological Moment Assessment (EMA). Diary research is advantageous as it (1) considers naturalistic settings compared to a cross-sectional study design, (2) avoids possible retroactive contamination by investigating ongoing experiences, (3) considers fluctuation among individuals, such as personality, mood, and behavior, while a cross-sectional study considers variables as a fixed value, and (4) examines person–situation interaction considering the contextual effect of individual characteristics (Shiffman et al., 2008; Ohly et al., 2010; Iida et al., 2012).

The degree of mood, such as feelings like anxiety and depression, or the degree of activity, such as commitment action measured in this study, is typically a variable that fluctuates according to daily experiences (e.g., Hankin et al., 2005; Starr and Davila, 2012). In addition, as described above, it was assumed that the level of depression, anxiety, and commitment behavior would fluctuate in response to the level of COVID-19-related restrictions and concerns. The diary method was thought as appropriate to dynamically examine the interaction between changes in levels of depression, anxiety, and commitment behavior according to COVID-19-related restrictions and concerns (within factor) and PTG (between factor).

In the present study, we used a short-term longitudinal design to examine the moderating effect of PTG by collecting data on mental health-related parameters (depression, anxiety, and committed action) at several time points to ensure higher reliability of data than that measured at a single point. We established the following hypotheses: First, PTG moderates the effect of COVID-19-related restrictions and concerns on depression. Second, PTG moderates the effect of COVID-19-related restrictions and concerns on anxiety. Third, PTG moderates the effect of COVID-19-related restrictions and concerns on committed action.

This study aimed to investigate how PTG acted as a buffer against the psychological impact of the restrictions and concerns related to COVID-19 using a short-term longitudinal design. More specifically, we analyzed whether people with high PTG exhibited a lower level of anxiety and depression in relation to the restrictions and concerns pertinent to COVID-19 and how PTG influenced their level of committed action. The key findings were as follows.

First, on an average, depression and anxiety were not associated with COVID-19-related restrictions and concerns. Second, committed action increased with increasing COVID-19-related restrictions and concerns. In other words, people with greater COVID-19-related restrictions and concerns actually lived their lives more commensurate with their values. Third, individuals who achieved greater levels of PTG were less depressed and less anxious. Fourth, individuals who achieved greater levels of PTG engaged in more committed action.

Contrary to our expectation that COVID-19-related restrictions and concerns would adversely impact mental health, COVID-19-related restrictions and concerns were not significantly associated with depression and anxiety. Previous studies and media coverage of infectious disease disasters have shown that quarantine experience triggers acute stress responses, such as anxiety, irritation, insomnia, and reduced concentration in healthcare workers (Bai et al., 2004), and that a suspension of routine activities and severed social interactions aggravated loneliness and frustration (Orsolini et al., 2020). Thus, we expected that people with greater actual or perceived COVID-19-related restrictions and concerns would show a higher level of depression and anxiety, but we did not observe a statistically significant association between the two. We propose a few reasons for this result. First, while social distancing practices also have negative repercussions, they can induce positive changes depending on individuals’ personality traits. For example, people who have difficulty with face-to-face activities and interactions due to tendencies, such as high avoidance might actually benefit from social distancing in terms of their mental health and life, as it ensures an adequate amount of time alone. In particular, one characteristic feature of Korean social culture is frequent mandatory corporate dinners and group activities, and the prohibition of such activities during the pandemic might have been welcomed by these individuals. However, this is a unique phenomenon observed in the strongly collectivist Korean society, so subsequent studies should compare the impact of restrictions provoked by COVID-19 on individuals’ lives and mental health. Another reason may be that this study was conducted 1 year after the outbreak of COVID-19 and, therefore, many people became accustomed to the changes in their lives due to social distancing. For this reason, it is possible that their perceived inconveniences from social distancing measures were considerably reduced regardless of COVID-19-related restrictions and concerns. In conclusion, our results suggest that the impact of COVID-19-related restrictions and concerns on people’s lives may be quite complex, depending on individuals’ traits and the time of observation.

Following this, we discuss the increased rate of committed action with increasing COVID-19-related restrictions and concerns. First, this may be attributable to the sufficient time secured for a committed action because people have strictly adhered to social distancing practices, such as avoiding social gatherings, due to COVID-19-related restrictions and concerns. Although this topic has not been exactly studied in the literature, a Dutch study reported that people have been engaging in more online leisure activities at home as well as traditional outdoor solo sport activities, such as hiking and running, since the implementation of social distancing norms due to COVID-19 (van Leeuwen et al., 2020), suggesting that people are finding more time to spend on solo leisure activities.

These results can be interpreted in relation to the result that men and childlessness were identified as the predictors of committed action according to COVID-19-related restrictions and concerns. In Korea, the duration of household labor, including caregiving labor, is 3.6 times higher among women than men (Park and Cho, 2020). Childless individuals or men spend less time on household chores or parenting compared to their parents or female counterparts, respectively. Thus, they have relatively more spare time and be more relaxed psychologically to commit to an engaged life in line with their values.

In addition to having more time to live an engaged life, people might have also been given the opportunity to reflect on and reestablish their values and practice them. An Italian study that surveyed the impact of COVID-19 on the meaning in life during a lockdown and performed a cluster analysis observed that rearranging personal priorities was one of the four key factors (Venuleo et al., 2020). Some argued that meaning can be restructured (De Jong et al., 2020) and engagement in meaningful activities increased during the process whereby daily lives were dismantled by COVID-19 are, subsequently, reestablished (Eisenbeck et al., 2021). In a three-month longitudinal study conducted in China, meaning making about negative events increased, which in turn resulted in reduced psychological distress during the COVID-19 pandemic (Yang et al., 2021), and a four-day short-term longitudinal study reported that people with a higher understanding of the meaning of life were less stressed about COVID-19 (Trzebiński et al., 2020). In light of these studies, it is possible that people have rearranged their lives’ priorities to focus on those activities that they had been postponing and pursue meaningfulness in life when given enough time alone.

The moderating effect of PTG, which was the focus of our study, was confirmed. In other words, regardless of COVID-19-related restrictions and concerns, depression and anxiety decreased on average with increasing PTG, and people who achieved greater PTG demonstrated a higher baseline level of committed action. These results suggest that PTG positively contributes to psychological health and protects against psychological distress. We experience growth in a variety of areas through crises and adversities (Tedeschi et al., 2018). In particular, personal growth, referring to the awareness of one’s potential and resilience, enhancement of their ability to cope with difficulties, and greater confidence, can be considered a factor that helps individuals protect themselves and respond flexibly to the confusion and fear around the COVID-19 pandemic. Several studies have reported that PTG is negatively correlated with psychological distress (Powell et al., 2003), and it has also been reported that PTG is negatively associated with depression and anxiety among SARS survivors (Cheng et al., 2006). In fact, PTG has also been reported to be negatively associated with psychological distress in frontline healthcare workers who battle against the COVID-19 pandemic (Cui et al., 2021). In particular, Korea adopted the most rigorous social distancing measures in response to the COVID-19 pandemic among countries worldwide (Kim et al., 2021), and it is speculated that mature emotional regulation achieved by PTG lowered the risk of progressing to psychopathologies, such as depression and anxiety, and contributed to individuals’ commitment to activities they value. The protective effects of PTG against burnout (Taku, 2014) can also be understood in line with our findings. Committed action refers to discovering values and living a life in line with these values. This is closely linked to the discovery of meaning in life. While few studies have investigated the association between committed action and PTG, many studies have supported the positive association between meaning in life and PTG (Triplett et al., 2012; Groleau et al., 2013; Im, 2017). Further, Im (2017) reported that life satisfaction increases with increasing agreement between one’s life and its meaning. Taken together, people who have achieved PTG are able to discover meaning in life better and realize their values through committed action.

This study had several limitations. First, the total duration of data collection was only 12 days; therefore, subsequent studies should ensure a sufficient duration of study to retest the hypothesis. To examine individual reactions to various phases of COVID-19 more dynamically, we think it would have been nice to measure them over a longer period of more than 6 months. Second, because of the COVID-19 situation, the online survey was the most realistic method of collecting data; however, it did not guarantee sufficient representation of the sample. In order to secure representation, an online research company with a large-scale national research panel was selected, and the ratio of demographic characteristics, such as gender and age, was tried to be maintained similar to the actual one, but offline surveys will be needed for more representative sampling. Third, the path through which COVID-19-related restrictions and concerns increases committed action needed to be explored further. In particular, studies should examine the increase in committed action through the mediation of leisure time. Fourth, other types of measurement for anxiety and depression should be taken. It is possible that we could not accurately measure the emotional changes resulting from COVID-19 because these measurements do not change over a short period of time. The instrument we used to measure COVID-19-related restrictions and concerns was a three-item scale developed by a Korean developer (Ko, 2020). COVID-19-related restrictions and concerns were not significantly associated with depression and anxiety in our study, and this may be due to the small number of items in the scale. We suggest that better instruments to measure the COVID-19-related restrictions and concerns which have enough items and higher reliability should be developed for further study.

Despite these limitations, this study has several methodological strengths and implications. First, in contrast to the predominant use of cross-sectional designs to study the association between PTG, psychological health, and meaning in life, we collected data based on daily life experiences using the diary method, which enhanced the ecological validity of our study. Second, we applied multilevel modeling to measure dynamic person-situation interactions. By analyzing the interaction of PTG with COVID-19-related restrictions and concerns, we were able to more thoroughly examine individuals’ behavioral patterns during the COVID-19 pandemic.

COVID-19-related restrictions and concerns would adversely impact mental health. COVID-19-related restrictions and concerns were not significantly associated with depression and anxiety, but with the increased rate of committed action. We proposed a few possible reasons, such as social distancing practices, can induce positive changes depending on individuals’ personality traits or cultural context. And this study is an empirical one that evaluated the contribution of PTG in dealing with infectious disease disasters, where our findings provide evidence supporting the fact that qualitative changes attained by overcoming a crisis in life are beneficial for coping with future crises in and maintaining a high quality of life.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

The studies involving human participants were reviewed and approved by institutional review board of Hallym University. The patients/participants provided their written informed consent to participate in this study.

SI and SP jointly participated in conceptualization, data collection, and statistical analysis. In draft writing, SP and SI jointly wrote the first draft on Introduction, Discussion, Method, and Results. Afterward, the authors reviewed and edited the draft together, and approved the final draft.

This research was supported by the Hallym University Research Fund, 2018 (HRF-201809-002).

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.