The relationship between anxiety, health, and potential stressors among adults in the United States during the COVID-19 pandemic

  1. Angela M Parcesepe
  2. McKaylee Robertson
  3. Amanda Berry
  4. Andrew Maroko
  5. Rebecca Zimba
  6. Christian Grov
  7. Drew Westmoreland
  8. Sarah Kulkarni
  9. Madhura Rane
  10. William Salgado-You
  11. Chloe Mirzayi
  12. Levi Waldron
  13. Denis Nash

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Abstract

Objective

To estimate the prevalence of anxiety symptoms and the association between moderate or severe anxiety symptoms and health and potential stressors among adults in the U.S. during the COVID-19 pandemic

Methods

This analysis includes data from 5,250 adults in the Communities, Households and SARS/CoV-2 Epidemiology (CHASING) COVID Cohort Study surveyed in April 2020. Poisson models were used to estimate the association between moderate or severe anxiety symptoms and health and potential stressors among U.S. adults during the COVID-19 pandemic.

Results

Greater than one-third (35%) of participants reported moderate or severe anxiety symptoms. Having lost income due to COVID-19 (adjusted prevalence ratio [aPR] 1.27 (95% CI 1.16, 1.30), having recent COVID-like symptoms (aPR 1.17 (95% CI 1.05, 1,31), and having been previously diagnosed with depression (aPR 1.49, (95% CI 1.35, 1.64) were positively associated with anxiety symptoms.

Conclusions

Anxiety symptoms were common among adults in the U.S. during the COVID-19 pandemic. Strategies to screen and treat individuals at increased risk of anxiety, such as individuals experiencing financial hardship and individuals with prior diagnoses of depression, should be developed and implemented.

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  1. ScreenIT

    SciScore for 10.1101/2020.10.30.20221440: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: This study was approved by the Institutional Review Board at the City University of New York Graduate School of Public Health.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your code and data.

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This cross-sectional study has several limitations. The sample was recruited online or by referral and is not nationally representative of the adult population of the U.S. As such, findings cannot be generalized to the adult population of the U.S. Second, the directionality of relationships reported cannot be ascertained. In addition, all data were captured via self-report. Anxiety symptoms appear to be elevated among adults in the U.S. during the COVID-19 pandemic. Longitudinal research to examine the persistence of anxiety symptoms among adults in the U.S. during and after the COVID-19 pandemic is needed. Such research can elucidate to what extent anxiety symptoms persist throughout different phases of the COVID-19 pandemic and its aftermath. Anxiety symptoms may diminish during the COVID-19 pandemic as individuals become more accustomed to social distancing measures. Alternately, anxiety symptoms may persist or worsen in response to national or local trajectories in COVID-19 cases, the easing or continuation of social distancing protocols, a worsening economic climate, or continued uncertainty. Strategies to screen and treat individuals at increased risk of anxiety, such as those experiencing financial hardship or with depression, should be developed and implemented. Evidence-based pharmacological and psychological interventions to treat anxiety, such as cognitive-behavioral therapy, should be implemented and scaled up for digital delivery throughout the U.S, particularly ...

    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.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.10.30.20221440 on medRxiv