IMPORTANCE: Documenting Americans' stress responses to an unprecedented pandemic and their degree of adherence to CDC guidelines is essential for mental health interventions and policy-making. OBJECTIVE: To provide the first snapshot of immediate impact of COVID-19 on Americans' stress, coping, and guideline adherence. DESIGN: Data were collected from an online workers' platform for survey research (Amazon's Mechanical Turk) from April 7 to 9, 2020. The current data represents the baseline of a longitudinal study. Best practices for ensuring high-quality data were employed. PARTICIPANTS: Individuals who are 18 years of age or older, living in the USA, and English-speaking were eligible for the study. Of 1086 unique responses, 1015 completed responses are included. SETTING: Population-based. MAIN OUTCOMES: Exposure to and stressfulness of COVID-19 stressors, coping strategies, and adherence to CDC guidelines. RESULTS: The sample was 53.9% women (n = 547), with an average age of 38.9 years (SD = 13.50, range = 18-88), most of whom were White (n = 836, 82.4%), non-Hispanic (n = 929, 91.5%), and straight/heterosexual (n = 895, 88.2%); 40% were currently married (n = 407), and 21.6% (n = 219) were caregivers. About half (50.5%) endorsed having at least "mostly" enough money to meet their needs. Respondents' locations across the USA ranged from 18.5% in the Northeast to 37.8% in the South. The most commonly experienced stressors were reading/hearing about the severity and contagiousness of COVID-19, uncertainty about length of quarantine and social distancing requirements, and changes to social and daily personal care routines. Financial concerns were rated most stressful. Younger age, female gender, and caregiver status increased risk for stressor exposure and greater degree of stressfulness. The most frequently reported strategies to manage stress were distraction, active coping, and seeking emotional social support. CDC guideline adherence was generally high, but several key social distancing and hygiene behaviors showed suboptimal adherence, particularly for men and younger adults. CONCLUSIONS AND RELEVANCE: Americans have high COVID-19 stress exposure and some demographic subgroups appear particularly vulnerable to stress effects. Subgroups less likely to adhere to CDC guidelines may benefit from targeted information campaigns. these findings may guide mental health interventions and inform policy-making regarding implications of specific public health measures.
Objective:The rapid emergence of the coronavirus disease 2019 (COVID-19) pandemic in the United States has dramatically altered daily life and taken a toll on Americans' physical, mental, social, and financial well-being. Based on previous widespread disasters, future high prevalence of short-and long-term adverse mental health consequences are anticipated. Studies of COVID-19 outside the United States indicated moderately high levels of distress, but we have little information regarding Americans' distress nor the factors associated with relative distress or adjustment during this unprecedented time. This study represents the first national view of Americans' distress during the massive disruption of COVID-19 and identifies levels of stress exposure, protective psychosocial resources, and coping strategies. Method: Data were collected April 7-9, 2020 from an online platform, using best practices for ensuring high-quality data; 1,015 completed respondents are included ([53.9%] women; average age ϭ 38.9 years; mostly White [82.4%] and non-Hispanic [91.5%]). Respondents' locations ranged across the United States, from 18.5% in the Northeast to 37.8% in the South. Results: Fairly high levels of stress exposure and peritraumatic and general distress (depression, anxiety, and stress) were reported. Emotion regulation skills along with active and distraction coping emerged as the strongest predictors of lower distress levels. Conclusions: These results identify potential targets for online mental health interventions-focusing on engaging in adaptive emotion regulation and coping (e.g., through telehealth mental health first aid)-during the pandemic to offset the likely rise in distress over the months ahead. Clinical Impact StatementThese findings on stress exposure and distress of Americans early in the pandemic highlight psychosocial resources and coping strategies potentially useful to interventionists seeking to mitigate the immediate adverse mental health effects of the pandemic and to potentially dampen long-term sequelae. This information may also be useful to policymakers preparing for the demands of increased mental health services in the months and years ahead.
Spreading rapidly across the United States beginning in the spring of 2020, the coronavirus disease 2019 (COVID-19) pandemic radically disrupted Americans' lives. Previous studies of community-wide disasters suggested people are fairly resilient and identified resources and strategies that promote that resilience. Yet, the COVID-19 pandemic is in some ways unique, with high levels of uncertainty, evolving implications and restrictions, and varied and uneven impacts. How resilient were Americans as the pandemic progressed? What psychosocial resources and coping strategies facilitated adjustment as the country moved into a summer of uneven reopenings and reclosures? Data from a national sample of 674 Americans were gathered at the height of early lockdowns and peaking infections in mid-April, 2020, and again, 5 and 10 weeks later. The study aimed to determine levels and sources of distress and to identify the resources and coping efforts that promoted or impeded resilience. Early levels of distress diminished to some extent over subsequent months while levels of wellbeing were comparable with usual norms, suggesting a largely resilient response. COVID-19-related stress exposure also decreased gradually over time. Older age, higher levels of mindfulness and social support, and meaning focused coping predicted better adjustment, reflecting resilience, while avoidance coping was particularly unhelpful. In models predicting change over time, approach-oriented coping (i.e., active coping, meaning-focused coping, and seeking social support) was minimally predictive of subsequent adjustment. Given the unique and ongoing circumstances presented by COVID-19, specific interventions targeting psychosocial resources and coping identified here may help to promote resilience as the pandemic continues to unfold.
Dispositional mindfulness is often linked to higher positive affect and lower negative affect, and coping with stress has been hypothesized to mediate these links. However, few studies have explicitly tested the ways in which stress appraisals, coping strategies, or coping flexibility (i.e., fit of coping to controllability appraisals) uniquely relate to mindfulness and well-being. Drawing on a stress and coping framework, the present study tested the degree to which (a) lower stress appraisals mediate mindfulness' effects on daily positive and negative affect; (b) daily coping mediates mindfulness' impact on daily positive and negative affect, above and beyond the effects of stress appraisals; and (c) coping flexibility mediates mindfulness' impact on positive and negative affect, above and beyond the effects of stress appraisals and average daily coping. Participants were 157 undergraduate students (mean age = 17.81; 79% women), completing daily diary questionnaires regarding stress appraisals, coping, and affect for 1 week. Results demonstrate that lower average stress appraisals mediated 19% of mindfulness' effects on negative affect; further, average use of some "mindful" emotion-focused coping strategies (i.e., non-self-blame and acceptance) independently mediated 3%-13% of mindfulness' effects on positive and negative affect. Although mindfulness was associated with greater "fit" of problem-focused versus acceptance coping to high controllability appraisals, coping flexibility did not appear to mediate mindfulness' effects on either positive or negative affect. Thus, mindfulness-based stress management interventions may be most effective by promoting mindful coping to complement, rather than replace, problem-focused coping. (PsycINFO Database Record
Background The negative mental health impact of coronavirus disease 2019‐related stressors may be heightened for those caring for children, who bear responsibity for their welfare during disasters. Aim Based on the Transactional Model of Stress and Coping, we inquired whether caregivers' emotion regulation and coping behavior were associated with posttraumatic stress symptoms (PTSS). Materials & Methods Data were collected through a national online survey in April 2020, and again 60 days later. Results: Of the 801 longitudinal cases, 176 (63.6% female; mean age = 33.5) reported caring for minors in their homes during the pandemic. Over 20% of caregivers experienced clinically concerning PTSS, rates higher than their noncaregiving counterparts. Regression analysis indicates caregivers' baseline mental health symptoms and emotion regulation predicted PTSS 60 days later. Discussion Implications for needed parenting supports among families experiencing traumatic stress are provided. Conclusion Anxiety symptoms at baseline were the most significant and consistent contributor to all models and were significantly higher among those with clinically concerning levels of PTSS suggesting a clear intervention target.
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