Americans’ COVID-19 stress, coping, and adherence to CDC guidelines
Open accessAbstract
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.
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During the initial lockdown period, American adults commonly dealt with stress through distraction, active coping, and seeking emotional support.
“Research conducted during the initial lockdown period found that American adults commonly dealt with stress through distraction, active coping, and seeking emotional support [31]”
From Gender Differences in Coping and Psychological Adaptation during the COVID-19 Pandemic (2023) · cites this paper as [31]
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“Beliefs about the negative and constraining effect of public health measures partly reflected the anxiety and stress that resulted from adhering to these restrictive prevention mandates that people might or might not identify with [1,92] and the broader negative pandemic impacts that were widely experienced across lif…”
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“Thirdly, family dynamics have been influenced by the COVID-19 pandemic (Brooks et al., 2020; Park et al., 2020).”
Emotional exhaustion among the South Korean workforce before and after COVID‐19
Hwang, H., Hur, W., & Shin, Y. (2020) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1111/papt.12309 · Cited by 63 · see citing works
Modeling pandemic depression and anxiety: The mediational role of core beliefs and meaning making
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Measuring Cumulative Stressfulness: Psychometric Properties of the COVID-19 Stressors Scale
Tambling, R. R., Russell, B. S., Park, C. L., Fendrich, M., Hutchinson, M., Horton, A. L., & Tomkunas, A. J. (2020) · Health Education & Behavior · doi:10.1177/1090198120979912 · Cited by 58 · see citing works
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Hollands, L., Haensse, L., & Lin‐Hi, N. (2023) · The Journal of Applied Behavioral Science · doi:10.1177/00218863231165785 · Cited by 81 · see citing works
“This fi nding is consistent with prior research on females experiencing more stress during the COVID-19 crisis (e.g., Hwang et al., 2021; Park et al., 2020).”
Gignac, M., Shahidi, F., Jetha, A., Kristman, V., Bowring, J., Cameron, J., Tonima, S., & Ibrahim, S. (2021) · Disability and Health Journal · doi:10.1016/j.dhjo.2021.101161 · Cited by 44 · see citing works
Strengths-based actions to enhance wellbeing in the time of COVID-19
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Real versus illusory personal growth in response to COVID-19 pandemic stressors
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The Impact of the COVID-19 Pandemic on Genitourinary Cancer Care: Re-envisioning the Future
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“Social distancing has contributed to significant mental health issues including stress, loss of motivation, loss of meaning, and loss of self-worth [94,95].”
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Impact of COVID-19 First Wave on Psychological and Psychosocial Dimensions: A Systematic Review
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“Higher levels of stress were associated with: loss of job/education [89,309], having to go out to work [187], having an acquaintance infected with COVID-19 [89,187,247], likelihood of contracting the virus [310], more hygiene behaviors [247,256,310], history of stressful situations [187], medical problems [74,187], ri…”
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“These differences may reflect increased uptake of prevention behaviors among women, compared to a sample of both men and women; this is consistent with findings that female gender is associated with adherence to prevention behaviors [16].”
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Delgado-Gallegos, J. L., Padilla-Rivas, G. R., Zúñiga-Violante, E., Avilés-Rodríguez, G. J., Arellanos-Soto, D., Gastelum-Arias, L. J., Franco-Villareal, H., Cosío-León, M. D. L. Á., Romo-Cárdenas, G. S., Moreno‐Treviño, M. G., et al. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.728690 · Cited by 51 · see citing works
Daily Stress Processes in a Pandemic: The Effects of Worry, Age, and Affect
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“Additionally, between individuals, the most reported COVID-19-related stressor was news exposure (Park et al., 2020; Whitehead & Torossian, 2020).”
BackgroundInfluentialLillie, H. M., Chernichky-Karcher, S. M., & Venetis, M. K. (2021) · Journal of Social and Personal Relationships · doi:10.1177/02654075211009302 · Cited by 48 · see citing works
“Researchers and health professionals expressed concern about the relational impacts of social distancing, particularly for couples whose marriages may be strained from being confined together (Galea et al., 2020; Park et al., 2020; Restubog et al., 2020).”
BackgroundBrain volumetric changes in the general population following the COVID-19 outbreak and lockdown
Salomon, T., Cohen, A., Barazany, D., Ben-Zvi, G., Botvinik‐Nezer, R., Gera, R., Oren, S., Roll, D., Rozic, G., Saliy, A., et al. (2021) · NeuroImage · doi:10.1016/j.neuroimage.2021.118311 · Cited by 48 · see citing works
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“…sources of reward such as social interaction, physical activity, leisure activities, hobbies, work and school pursuits, while simultaneously experiencing drastic increases in stress and uncertainty related to the well-being of themselves, their loved ones, and their community (Park et al., 2020).”
BackgroundThe COVID-19 pandemic in Italy: Depressive symptoms immediately before and after the first lockdown
Medda, E., Toccaceli, V., Gigantesco, A., Picardi, A., Fagnani, C., & Stazi, M. A. (2021) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.10.129 · Cited by 46 · see citing works
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Young Adults Underestimate How Well Peers Adhere to COVID-19 Preventive Behavioral Guidelines
Graupensperger, S. A., Lee, C. M., & Larimer, M. E. (2021) · The Journal of Primary Prevention · doi:10.1007/s10935-021-00633-4 · Cited by 44 · see citing works
Masks, Gloves, and the COVID-19 Pandemic: Rapid Assessment of Public Behaviors in the United States
Khubchandani, J., Saiki, D., & Kandiah, J. (2020) · Epidemiologia · doi:10.3390/epidemiologia1010004 · Cited by 43 · see citing works
“Unfortunately, according to preliminary reports, men have a higher risk of mortality from COVID-19, and deaths of younger individuals are not uncommon [17,18].”
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“, 2020), high psychological distress (Wang et al., 2020; Park et al., 2020), financial stress (Chakraborty & Chatterjee, 2020), and depression and anxiety (Madani et al.”
Alschuler, K. N., Roberts, M. K., Herring, T. E., & Ehde, D. M. (2020) · Multiple Sclerosis and Related Disorders · doi:10.1016/j.msard.2020.102618 · Cited by 42 · see citing works
“, 2020) and the admission that fears of the severity and contagiousness of COVID-19 is the most common COVID-19 associated stressor in a general population sample (Park et al., 2020), it may be the case that individuals are primed to experience increased distress when evidence of the threat is more apparent.”
Noone, C., Warner, N. Z., Byrne, M., Durand, H., Lavoie, K., McGuire, B. E., McSharry, J., Meade, O., Morrissey, E. C., Molloy, G. J., et al. (2021) · Health Psychology Review · doi:10.1080/17437199.2021.1934062 · Cited by 40 · see citing works
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“One American study surveyed the types of coping that 1086 Americans employed to manage stressors online in early April 2020 and encouraged frequent use of emotional support-seeking strategies (Park et al., 2020).”
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“the COVID-19 pandemic, American adults most often dealt with stress through distraction, active coping, and seeking emotional support.(23) Acceptance, humor, and planning were the three most common strategies used by adults in Greece.”
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“Previous studies have shown that the concern of contracting the disease or death is a major source of concern to many people during the pandemic [13, 16].”
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Work Performance, Mood and Sleep Alterations in Home Office Workers during the COVID-19 Pandemic
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“Introduction The sudden burst of the COVID-19 pandemic and the subsequent preventive measures, such as quarantine, social isolation, partial or total lockdown, not only have dramatically transformed everyday life, with a massive impact on physical, mental, social, and financial welfare of the population [1] but they h…”
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“It seems that these concerns have gone beyond the current locality to become a global concern, creating fear and anxiety among people from all walks of life (Lin, Hu, Alias, & Wong, 2020; Park et al., 2020; Zandifar & Badrfam, 2020).”
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What predicts adherence to COVID-19 government guidelines? Longitudinal analyses of 51,000 UK adultsPreprint
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“Overall, adherence to the three TRBs was high, confirming the findings from other studies (Coroiu et al., 2020; Park et al., 2020).”
Sexual and Gender Minority Young Adult Coping Disparities During the COVID-19 Pandemic
Krueger, E. A., Barrington‐Trimis, J. L., Unger, J. B., & Leventhal, A. M. (2021) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2021.07.021 · Cited by 37 · see citing works
“, increased substance use, social disengagement, decreases in exercise) [18,19].”
Short‐term impacts of COVID‐19 on family caregivers: Emotion regulation, coping, and mental health
Russell, B. S., Hutchison, M., Park, C. L., Fendrich, M., & Finkelstein‐Fox, L. (2021) · Journal of Clinical Psychology · doi:10.1002/jclp.23228 · Cited by 34 · see citing works
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“J Risk Uncertain [Internet] 1997;14(3):235–57.”
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“2020), which are felt particularly keenly for those currently caring for children in their homes (Park et al. 2020; Pew Research Center 2020; Russell et al. 2020; Tambling et al. 2020).”
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“Regarding caregivers, disruptions to routines and access to supports during COVID-19 may result in additional burden and stress.(17,18) The extent of the impact of COVID-19 on access to rehabilitation therapies for children with motor impairment, and the subsequent impact on child and caregiver physical and mental hea…”
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- Authors
- Park, C. L., Russell, B. S., Fendrich, M., Finkelstein-Fox, L., Hutchison, M., & Becker, J.
- Affiliations
- University of Connecticut (US)
- Corresponding author
- Park, Crystal L.
- Venue
- Journal of General Internal Medicine
- Published
- 2020-05-29
- Volume
- 35
- Issue
- 8
- Pages
- 2296-2303
- ISSN
- 0884-8734 (ISSN-L)
- 1525-1497
- PMC
- PMC7259430
- OpenAlex
- W3031875368
- Cited by
- 728
- References
- 26
- Citations by year
- 2026: 10 · 2025: 31 · 2024: 74 · 2023: 120 · 2022: 219 · 2021: 224 · 2020: 49 · 2015: 1
- FWCI
- 61.25
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of General Internal Medicine (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (1R34AA027455)
- Topics
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Social Sciences › Sociology and Political Science › COVID-19 Prevention and Impact
- Social Sciences › Communication › Communication and COVID-19 Impact
- Keywords
- COVID-19 pandemic, psychological stress, coping strategies, social distancing, hygiene practices, financial stress, caregiver burden, gender differences, age differences, social support, mental health
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Adaptation, Psychological, Adult, Centers for Disease Control and Prevention, U.S., Female, Humans, Male, Mental Health, Pneumonia, Viral, Public Health, Surveys and Questionnaires, Stress, Psychological, United States, Guidelines as Topic, Coronavirus Infections, Disease Transmission, Infectious, Guideline Adherence, Pandemics
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