Mental Health and Behavior of College Students During the Early Phases of the COVID-19 Pandemic: Longitudinal Smartphone and Ecological Momentary Assessment Study

Abstract

Background The vast majority of people worldwide have been impacted by coronavirus disease (COVID-19). In addition to the millions of individuals who have been infected with the disease, billions of individuals have been asked or required by local and national governments to change their behavioral patterns. Previous research on epidemics or traumatic events suggests that this can lead to profound behavioral and mental health changes; however, researchers are rarely able to track these changes with frequent, near-real-time sampling or compare their findings to previous years of data for the same individuals. Objective By combining mobile phone sensing and self-reported mental health data among college students who have been participating in a longitudinal study for the past 2 years, we sought to answer two overarching questions. First, have the behaviors and mental health of the participants changed in response to the COVID-19 pandemic compared to previous time periods? Second, are these behavior and mental health changes associated with the relative news coverage of COVID-19 in the US media? Methods Behaviors such as the number of locations visited, distance traveled, duration of phone usage, number of phone unlocks, sleep duration, and sedentary time were measured using the StudentLife smartphone sensing app. Depression and anxiety were assessed using weekly self-reported ecological momentary assessments of the Patient Health Questionnaire-4. The participants were 217 undergraduate students, with 178 (82.0%) students providing data during the Winter 2020 term. Differences in behaviors and self-reported mental health collected during the Winter 2020 term compared to previous terms in the same cohort were modeled using mixed linear models. Results During the first academic term impacted by COVID-19 (Winter 2020), individuals were more sedentary and reported increased anxiety and depression symptoms ( P <.001) relative to previous academic terms and subsequent academic breaks. Interactions between the Winter 2020 term and the week of the academic term (linear and quadratic) were significant. In a mixed linear model, phone usage, number of locations visited, and week of the term were strongly associated with increased amount of COVID-19–related news. When mental health metrics (eg, depression and anxiety) were added to the previous measures (week of term, number of locations visited, and phone usage), both anxiety ( P <.001) and depression ( P =.03) were significantly associated with COVID-19–related news. Conclusions Compared with prior academic terms, individuals in the Winter 2020 term were more sedentary, anxious, and depressed. A wide variety of behaviors, including increased phone usage, decreased physical activity, and fewer locations visited, were associated with fluctuations in COVID-19 news repo...

Changes in Depression and Physical Activity Among College Students on a Diverse Campus After a COVID-19 Stay-at-Home Order

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“…They also reported increases in anxiety and depression, and academic performance suffering due to mental health concerns [12]. These results are consistent with ndings by Huckins and colleagues, who found that U.S. college students exhibited greater anxiety and depression and increased sedentary behavior in the rst few months of the COVID-19 pandemic [14]. Because of the major stressors associated with COVID-19, such as the imposition of unfamiliar public health measures, potential nancial losses, and the reality of life in a pandemic, there will likely be an uptick in psychiatric illness in the general population [15].…”

Loneliness, Mental Health, and Substance Use among US Young Adults during COVID-19

“…In the face of global concern about the mental health effects of COVID-19, specifically in adolescents and young adults (Fegert et al 2020), few studies have sought to document and characterize loneliness and mental health wellbeing and problems in the young adult population. To date, only anxiety, post-traumatic stress disorder, and depression have been documented among college students in China and the US (Cao et al 2020;Chang, Yuan, and Wang 2020;Huckins et al 2020). Recent reports on loneliness during COVID-19 have yielded controversial results, and differences between subpopulations evaluated (Killgore et al 2020;Luchetti et al 2020;Sutin, Luchetti, and Terracciano 2020).…”

Depression, Anxiety and Stress Symptomatology among Swedish University Students Before and During the COVID-19 Pandemic: A Cohort Study.

“…However, most studies included in the review were cross-sectional and it is therefore challenging to determine how mental health status evolved in the early months of the pandemic. For university students speci cally, there are some studies indicating short-term increases in depression and anxiety during COVID-19 [5,6], while others have found no changes [7]. Moreover, it is plausible that the mental health impact of the pandemic differs between regions and countries, as well as between sub-groups within populations.…”