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Methods: We launched the CARES 2020 Project (COVID-19 Adult Resilience Experiences Study, www.cares2020.com) to track the health and well-being of young adults in the U.S. across multiple time points in 2020 and 2021. This longitudinal project assesses depression, anxiety, and PTSD symptomatology, and psychological experiences including distress tolerance, resilience, social support, and loneliness among young adults (18-30 years). An online survey (April 13, 2020 to April 24, 2020), approximately one month after the U.S. declared a state of emergency due to COVID-19. Participants were recruited through social media, emails, and word of mouths. Outcomes were assessed through standardized self-reported measures of depression (PHQ-8), anxiety (GAD-7), and PTSD (PCL-C) symptomatology.
Results: Out of 898 respondents, the majority were women (75.9%) and the average age was 24.7 years. The majority of respondents were scored with high loneliness (57.5%), low resilience (77.5%), and low distress tolerance (78.4%). The majority of respondents reported having high levels of social support (family, partners, peer, and instrumental). Among the sample, 35.2% had high levels of depression (PHQ-8 scores > 10), 36.6% had high anxiety scores (GAD-7 scores > 10), and 43.3% had high levels of PTSD symptoms (PCL-C scores > 45). Predictors that were significantly (p<.05) associated with clinical levels of depression, anxiety, and PTSD symptoms after adjustments for age, gender, race, and income included loneliness (OR range = 1.72 – 2.12), COVID-19-specific worries (OR range = 3.75 - 5.07), and distress tolerance (OR range = 0.14 – 0.45). Those who reported having high levels of instrumental support were more likely to score above the clinical cutoff for anxiety, but less likely to score above the clinical cutoff for PTSD (OR = 1.7, CI = 1.2 - 2.5 and OR = 0.2, CI = 0.1 - 0.3 respectively). No associations were obtained between support from partners and friends with any of the three outcomes.
Conclusions and Implications:
During the first month of the COVID-19 pandemic, one in three US young adults reported clinical cut-off symptoms of depression, anxiety, and PTSD. New evidence signifies that those with higher levels of loneliness and COVID-19 worries, and lower distress tolerance were more likely to fall within the clinical range for depression, anxiety, and PTSD.
Our newly developed COVID-19 worries measure uniquely predicted mental health symptoms, underscoring how the specific features of this pandemic give rise to acute stress. The stress resulting from lifestyle changes due to features of COVID-19 itself may lead to greater mental health concerns distinct from the endorsement of other risks. While closer examination is required to understand the psychometric properties of this measure, the six items in our measure were reliable and may be useful to other research studies during this pandemic.