{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,9]],"date-time":"2026-07-09T13:48:49Z","timestamp":1783604929349,"version":"3.55.0"},"reference-count":60,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T00:00:00Z","timestamp":1758153600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000738","name":"U.S. Department of Veterans Affairs","doi-asserted-by":"publisher","award":["#I01RX000304"],"award-info":[{"award-number":["#I01RX000304"]}],"id":[{"id":"10.13039\/100000738","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Stress and Health"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Emotion regulation, or the ways in which individuals respond to or modulate their emotional experience, is critical when responding to distressing life circumstances. However, less is known about response to prolonged stressful situations. The present study seeks to understand how trait emotion regulation contributes to poorer mental health and more substance use during a prolonged chronic stress event, the coronavirus 19 (COVID\u201019) pandemic. A sample of 188 post\u20109\/11 veterans who were part of an ongoing longitudinal study of post\u2010deployment functioning participated in the present observational prospective cohort study. Veterans (29.25% women) completed online assessments of substance use and mental health at four time points over an 8\u2010month period. Measures of trait emotion regulation and flexibility were taken approximately 2\u00a0years before and pre\u2010pandemic mood was rated at baseline of the COVID\u201019 specific study. We also considered current, COVID\u2010related distress, social media, and sleep as mediators. There was little uniform change in mental health or substance use over the course of the study; however, considerable variability was observed, with some individuals experiencing worsening mental health or increased substance use. Greater COVID\u2010related distress, but not sleep quantity or media use, contributed to poorer mental health and more substance use. There were indirect effects of trait emotion regulation and distress on alcohol, mental health, and sedative use through COVID\u2010related distress. No effects were observed for emotional flexibility as a predictor or cigarette use as an outcome. Overall, results point to no uniform change in mental health or substance use as a consequence of the COVID\u201019 pandemic and subsequent mitigation measures. Instead, this highlights the contribution of multiple individual factors for mental health and substance use. Considerations for future research and implications for care during chronically stressful times are discussed.<\/jats:p>","DOI":"10.1002\/smi.70102","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T12:20:12Z","timestamp":1758198012000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Trait Emotion Regulation as a Predictor of Mental Health and Substance Use During a Period of Chronic Stress: A Longitudinal Analysis of US Veterans"],"prefix":"10.1002","volume":"41","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5436-7081","authenticated-orcid":false,"given":"Yvette Z.","family":"Szabo","sequence":"first","affiliation":[{"name":"Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans  Waco Texas USA"},{"name":"Central Texas Veterans Healthcare System  Temple Texas USA"},{"name":"Department of Psychology California State University Los Angeles  Los Angeles California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Crystal","family":"Lantrip","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans  Waco Texas USA"},{"name":"Central Texas Veterans Healthcare System  Temple Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"McGuire","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans  Waco Texas USA"},{"name":"Central Texas Veterans Healthcare System  Temple Texas USA"},{"name":"Department of Psychology and Counseling The University of Texas at Tyler  Tyler Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John David","family":"Coppin","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans  Waco Texas USA"},{"name":"Central Texas Veterans Healthcare System  Temple Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corina","family":"Mendoza","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans  Waco Texas USA"},{"name":"Central Texas Veterans Healthcare System  Temple Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzannah","family":"Creech","sequence":"additional","affiliation":[{"name":"Department of Veterans Affairs VISN 17 Center of Excellence for Research on Returning War Veterans  Waco Texas USA"},{"name":"Central Texas Veterans Healthcare System  Temple Texas USA"},{"name":"University of Texas at Austin Medical Center  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,9,18]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1037\/adb0000796"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.768132"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10862\u2010015\u20109514\u2010x"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.0956\u20107976.2004.00705.x"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1037\/ser0000233"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/16506073.2020.1861084"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.18637\/jss.v080.i01"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1037\/pas0000231"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2019.106035"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468\u20102667(20)30088\u20108"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleh.2021.02.006"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.30849\/ripijp.v54i2.1335"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyab090"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1037\/a0030259"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010022\u201023612\u2010z"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.577639"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.47602\/jpsp.v4i2.225"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0239698"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.02.033"},{"key":"e_1_2_8_21_1","first-page":"3","volume-title":"Handbook of Emotion Regulation","author":"Gross J. 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