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We analyzed seven waves of nationwide web-based surveys conducted in Japan between June 2020 and December 2022 (approximately 1,000 participants per wave) to examine long-term trends in depression, anxiety, and stress and their associations with self-evaluative traits. DASS-21 scores were significantly elevated during the initial emergency phase (June 2020) and declined substantially thereafter (Kruskal\u2013Wallis tests, all\n                    <jats:italic>p<\/jats:italic>\n                    &lt; .001). However, distributional analyses indicated that a subgroup of individuals remained persistently distressed despite overall population-level improvement. Decision-tree\u2013based variable-importance analyses identified the impostor phenomenon as the strongest contributor to depression, anxiety, and stress, followed by self-esteem. For anxiety, survey timing showed the strongest linear association, whereas non-linear models consistently highlighted self-evaluative variables as dominant predictors. These findings indicate that prolonged societal crises are associated with divergent mental-health adaptation patterns. Psychological self-evaluation factors, particularly impostor feelings and low self-esteem, may play a central role in persistent distress beyond demographic and social-network factors.\n                  <\/jats:p>","DOI":"10.1038\/s41598-026-53289-7","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T10:03:04Z","timestamp":1779184984000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Divergent trajectories of psychological distress during the prolonged COVID-19 pandemic in Japan"],"prefix":"10.1038","volume":"16","author":[{"given":"Junko","family":"Okuyama","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuji","family":"Seto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Okuyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Fukuda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinichi","family":"Egawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumihiko","family":"Imamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"53289_CR1","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.euroneuro.2021.10.864","volume":"55","author":"M Manchia","year":"2022","unstructured":"Manchia, M. et al. 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