Emotional adaptation during a crisis: decline in anxiety and depression after the initial weeks of COVID-19 in the United States
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Abstract
Crises such as the COVID-19 pandemic are known to exacerbate depression and anxiety, though their temporal trajectories remain under-investigated. The present study aims to investigate fluctuations in depression and anxiety using the COVID-19 pandemic as a model crisis. A total of 1512 adults living in the United States enrolled in this online study beginning April 2, 2020 and were assessed weekly for 10 weeks (until June 4, 2020). We measured depression and anxiety using the Zung Self-Rating Depression scale and State-Trait Anxiety Inventory (state subscale), respectively, along with demographic and COVID-related surveys. Linear mixed-effects models were used to examine factors contributing to longitudinal changes in depression and anxiety. We found that depression and anxiety levels were high in early April, but declined over time. Being female, younger age, lower-income, and previous psychiatric diagnosis correlated with higher overall levels of anxiety and depression; being married additionally correlated with lower overall levels of depression, but not anxiety. Importantly, worsening of COVID-related economic impact and increase in projected pandemic duration exacerbated both depression and anxiety over time. Finally, increasing levels of informedness correlated with decreasing levels of depression, while increased COVID-19 severity (i.e., 7-day change in cases) and social media use were positively associated with anxiety over time. These findings not only provide evidence for overall emotional adaptation during the initial weeks of the pandemic, but also provide insight into overlapping, yet distinct, factors contributing to depression and anxiety throughout the first wave of the pandemic.
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SciScore for 10.1101/2020.12.23.20248773: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: Participants provided informed consent via an online form.
IRB: The Institutional Review Board of the Icahn School of Medicine at Mount Sinai determined this research to be exempt following review.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable The final sample included 537 participants who successfully completed all 10 weeks of data collection (252 females (47%), mean age 36.91±13.68, from 48 states) and passed all data quality checks (Figure 2A). Table 2: Resources
Software and Algorithms Sentences Resources To identify variables relating to depression and anxiety, we conducted two mixed-effect linear … SciScore for 10.1101/2020.12.23.20248773: (What is this?)
Please note, not all rigor criteria are appropriate for all manuscripts.
Table 1: Rigor
Institutional Review Board Statement Consent: Participants provided informed consent via an online form.
IRB: The Institutional Review Board of the Icahn School of Medicine at Mount Sinai determined this research to be exempt following review.Randomization not detected. Blinding not detected. Power Analysis not detected. Sex as a biological variable The final sample included 537 participants who successfully completed all 10 weeks of data collection (252 females (47%), mean age 36.91±13.68, from 48 states) and passed all data quality checks (Figure 2A). Table 2: Resources
Software and Algorithms Sentences Resources To identify variables relating to depression and anxiety, we conducted two mixed-effect linear regressions: Depression (or anxiety) ∼ 1 + age + sex + race + income + diagnosis + age:time + sex:time + race:time + income:time + diagnosis:time + time + COVID19_severity + activity + economic_impact + informedness + social_media + COVID19_future + (1 + age:time + sex:time + race:time + income:time + diagnosis:time + time + COVID19_severity + activity + economic_impact + informedness + social_media + COVID19_future | participant) All analyses were carried out using MATLAB 2018b. MATLABsuggested: (MATLAB, RRID:SCR_001622)Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).
Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:There are two main limitations of the present study. First, no baseline scores for self-reported depression or anxiety could be established due to the unexpected nature of the COVID-19 pandemic and time needed to set up the study. To address this, we compared our scores with previously-reported mean community scores of the same depression and anxiety measures. We found that anxiety and depression both began at higher levels than previously reported community averages - though not significantly so for depression - and decreased to meet these averages by week three of data collection. The second limitation of our study is its correlational nature: with the exception of demographic information and the effects of time and seven-day change of COVID-19 cases, causation in either direction cannot be ascribed to the results of our mixed-effects models. For example, while our findings included an association between increased social media use and exacerbated anxiety scores, this could be explained either by social media content driving anxiety or by the likelihood that an individual with increased anxiety would monitor social media more closely. Likewise, negative economic impact could contribute to depression, but increased depression could also render an individual unable to work. Thus, more research is needed to establish the precise relationships between mental health symptomatology and COVID-19. Taken together, our findings provide important evidence supporting human resilience a...
Results from TrialIdentifier: No clinical trial numbers were referenced.
Results from Barzooka: We did not find any issues relating to the usage of bar graphs.
Results from JetFighter: We did not find any issues relating to colormaps.
Results from rtransparent:- Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
- Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
- No protocol registration statement was detected.
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