UNSTRUCTURED Background: College students’ mental health may be disproportionally affected by the COVID-19 pandemic because of the abrupt shift off campus and subsequent loss of a social network and potential long-term impact on job prospects. We sought to assess the nature of COVID-19’s mental health impact of among a sample of undergraduates who were experiencing the pandemic, as it occurred in real-time. Methods: 140 college students completed 6x daily smartphone-based ecological momentary assessment (EMA) of anxiety and optimism related to COVID-19 as well as other generic mental health variables. Results: Participants completed >23,750 surveys, >75% of which indicated at least some level of anxiety about COVID-19. On average, the proportion of responses each day at the highest levels of anxiety about COVID-19 was 7 times greater than the proportion of responses at the highest levels of non-specific anxiety. Structural change analyses indicated a significant downward trend in COVID-19 anxiety after the first week of June, but even at the lowest point, >15% of the sample still endorsed high levels of COVID-19 anxiety each day. Participants felt more anxious about COVID-19 on days when the number of new cases and deaths due to COVID-19 were higher. When participants felt anxious about COVID-19, they also felt sad, anxious (in general), and had a greater desire to drink and use drugs. Participants felt more optimistic about COVID-19 when they received more support from others and from their university. Conclusion: This study demonstrated the wide-spread mental health impact that COVID-19 has on college students.
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