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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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“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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Family Well‐Being During the COVID‐19 Pandemic: The Risks of Financial Insecurity and Coping
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“1 3 coping strategies, and seeking emotional social support (Park et al., 2020) are predictors of low levels of distress caused by COVID-19.”
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“In addition to the already discussed strategies, distraction can also be helpful as a coping strategy, especially in situations of low control (Park et al., 2020).”
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The moderating effects of nostalgia on mood and optimism during the COVID-19 pandemic
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Guse, J., Heinen, I., Mohr, S., & Bergelt, C. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.734264 · Cited by 22
Crowe, S., & Sarma, K. M. (2022) · BMC Pregnancy and Childbirth · doi:10.1186/s12884-022-04579-1 · Cited by 33
Qin, N., Shi, S., Ma, G., Li, X., Duan, Y., Shen, Z., Luo, A., & Zhong, Z. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2021.776829 · Cited by 24
“(24) found that the female, elder residents in good health condition will take precautions more frequently, which may be attributed to a higher level of cognition, a more precautious attitude toward COVID-19 as well as better compliance of the IPC guidance for those residents (25, 26).”
BackgroundYukhymenko–Lescroart, M. A. (2022) · Journal of College Student Retention Research Theory & Practice · doi:10.1177/15210251221100415 · Cited by 26
“Yet, the COVID-19 pandemic has caused significant disruption to academic, occupational, and interpersonal functioning, having a negative impact on many aspects of mental health and well-being in the adult population (e.g., Aristovnik et al., 2020; Van Bavel et al., 2020; Park et al., 2020).”
Psychometric properties of the Turkish version of the COVID-19 Impact Scale in university students
Yıldırım, M., & Şanlı, M. E. (2023) · Journal of School and Educational Psychology · doi:10.47602/josep.v3i1.34 · Cited by 22
Ames-Guerrero, R. J., Barreda-Parra, A., Cahua, J. C. H., & Banaszak‐Holl, J. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03326-8 · Cited by 40
“This has some minor fluctuations in North America, where women are more likely to report strategies that focus on passive behaviors such as distraction, religion, and less humor [58].”
BackgroundCOVID-19 health behaviors in a sexual minority sample: The impact of internalized stigma.
Solomon, D. T., Morey, K. E., Williams, C. J., Grist, C. L., & Malesky, L. A. (2021) · Psychology of Sexual Orientation and Gender Diversity · doi:10.1037/sgd0000466 · Cited by 23
Cosgrove, K., & Wharton, C. M. (2021) · Nutrients · doi:10.3390/nu13062097 · Cited by 21
“For example, individuals worldwide have been experiencing high levels of stress due to factors associated with the pandemic, such as fear of contracting COVID-19, employment loss, and lack of socialization [14].”
BackgroundResultWhat makes Dutch youth comply with preventive COVID‐19 measures? An explorative study
Koning, N., Hagedoorn, N., Stams, G. J. J. M., Assink, M., & van Dam, L. (2021) · Journal of Community Psychology · doi:10.1002/jcop.22651 · Cited by 19
“There is also empirical evidence showing that youth do not comply with social distancing measures as much as adults (e.g., Cohen et al., 2020; Park et al., 2020), due to their relatively strong desire for social connections (Muellerer et al. 2021).”
BackgroundItalia, S., Costa, C., Briguglio, G., Mento, C., Muscatello, M. R. A., Alibrandi, A., Filon, F. L., Spatari, G., Teodoro, M., & Fenga, C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph182312466 · Cited by 21
“Following the application of the statistical model, in group N we only found a sociodemographic characteristic, age > 40 y, as a predictor of Acceptance; in fact, age could be considered as a protective characteristic against the development of stress and a greater individual experience may orientate coping to the ado…”
MethodLee, D.-G., Kim, J.-G., Park, B., & Shin, W.-S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19116675 · Cited by 22
“the daily life of people around the world has changed, and it has had a significant impact on physical, mental, social, and economic well-being [7].”
BackgroundCOVID-19 Stress and Sexual Identities
Manning, W. D., & Dush, C. M. K. (2022) · Socius Sociological Research for a Dynamic World · doi:10.1177/23780231221105376 · Cited by 21
Boullion, A., Linde-Krieger, L. B., Doan, S. N., & Yates, T. M. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1216502 · Cited by 35
“In addition to global grieving over lost lives, efforts to prevent the spread of COVID-19 (e.g., isolation, remote learning; Park et al., 2020) negatively impacted mental health (Hertz-Palmor et al.”
BackgroundLandy, J. F., Shigeto, A., Laxman, D. J., & Scheier, L. M. (2022) · BMC Public Health · doi:10.1186/s12889-022-13161-5 · Cited by 24
“The spate of recent studies that examined compliance with public health recommendations has generally not done so within a stress-coping framework [18, 33, 34].”
BackgroundStaying Home, Distancing, and Face Masks: COVID-19 Prevention among U.S. Women in The COPE Study
Anderson, K. M., & Stockman, J. K. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18010180 · Cited by 20
“adults wore face masks in public, though 87% physically distanced [5].”
BackgroundElliott, J., & Pfeifer, G. (2022) · Aging & Mental Health · doi:10.1080/13607863.2022.2026878 · Cited by 20
Yu, C. C., Tou, N. X., & Low, J. A. (2022) · BMC Public Health · doi:10.1186/s12889-022-12857-y · Cited by 26
“Life is hard”: How the COVID-19 pandemic affected daily stressors of women
Purvis, R. S., Ayers, B. L., Rowland, B., Moore, R. A., Hallgren, E., & McElfish, P. A. (2022) · Dialogues in Health · doi:10.1016/j.dialog.2022.100018 · Cited by 23
“These fi ndings provide important nuanced insight on participant experiences that support the national trends related to COVID-19 stressors documented in the US population [1,2,9,12].”
InfluentialKia, H., Rutherford, L. L., Jackson, R., Grigorovich, A., Ricote, C. L., Scheim, A. I., & Bauer, G. R. (2022) · BMC Public Health · doi:10.1186/s12889-022-13684-x · Cited by 20
Berg, J. A., Woods, N. F., Shaver, J. L. F., & Kostas-Polston, E. A. (2022) · Nursing Outlook · doi:10.1016/j.outlook.2022.05.001 · Cited by 20
Upadhyay, P., Narayanan, S., Khera, T., Kelly, L., Mathur, P. A., Shanker, A., Novack, L., Pérez-Robles, R., Hoffman, K. A., Sadhasivam, S. K., et al. (2022) · Frontiers in Public Health · doi:10.3389/fpubh.2022.813664 · Cited by 21
“In fact, the US Centers for Disease Control has emphasized the importance of managing stress during the pandemic time and avoiding maladaptive behaviors to cope with stress and anxiety (9).”
BackgroundPrime, H., Wade, M., & Browne, D. T. (2022) · Adversity and Resilience Science · doi:10.1007/s42844-022-00077-7 · Cited by 21
“We focus on caregivers of school-aged children, as they have experienced elevated levels of pandemic-related stress and its sequalae as compared to adults without children (Gadermann et al., 2021; Park et al., 2020; Pierce et al., 2020; Wamser-Nanney et al., 2021).”
BackgroundCoronavirus Disease 2019 (COVID-19)–Related Stress and Menstrual Changes
Anto‐Ocrah, M., Valachovic, T., Chen, M. J., Tiffany, K., DeSplinter, L., Kaukeinen, K. A., Glantz, J. C., & Hollenbach, S. J. (2022) · Obstetrics and Gynecology · doi:10.1097/aog.0000000000005010 · Cited by 20
Goins, R. T., Anderson, E. L., Minick, H., & Daniels, H. (2021) · Frontiers in Public Health · doi:10.3389/fpubh.2021.660536 · Cited by 19
Brouzos, A., Vassilopoulos, S. P., Stavrou, V., Baourda, V. C., Tassi, C., & Brouzou, K. O. (2021) · Journal of Technology in Behavioral Science · doi:10.1007/s41347-021-00216-4 · Cited by 19
Peritraumatic Distress during the COVID-19 Pandemic in Seoul, South Korea
Yoon, H., You, M., & Shon, C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18094689 · Cited by 18
“Psychiatric symptoms that include psychological reactions similar to those in China have also been reported in many other countries, including Italy [22], Spain [23], the USA [24,25], Australia [26], and Israel [27].”
InfluentialAdherence to COVID-19 mitigation measures: The role of sociodemographic and personality factors
Turk, E., Čelik, T., Smrdu, M., Šet, J., Kuder, A., Gregorič, M., & Kralj‐Fišer, S. (2021) · Current Psychology · doi:10.1007/s12144-021-02051-5 · Cited by 19
Morales-Vives, F., Dueñas, J.-M., Ferrando, P. J., Vigil‐Colet, A., & Varea, M. D. (2022) · PLoS ONE · doi:10.1371/journal.pone.0262698 · Cited by 19
“[4] shows that in the United States the measures with the highest levels of non-compliance are hand washing and social distancing.”
BackgroundResultInfluentialOnline education in Covid-19: Limitations and improvements
Jindal, M., Bajal, E., Singh, P., Diwakar, M., Arya, C., & Sharma, K. (2021) · IEEE Uttar Pradesh Section International Conference on Electrical, Electronics and Computer Engineering (UPCON) · doi:10.1109/upcon52273.2021.9667605 · Cited by 19
Nia, H. S., She, L., Kaur, H., Boyle, C., Fomani, F. K., Hoseinzadeh, E., Kohestani, D., & Rahmatpour, P. (2022) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2022.851212 · Cited by 19
“Stress caused by the pandemic was found to be higher in women (9, 37, 42), younger people (58), those with poor sleeping habits (37, 58, 59), support caregivers, and other minority and disadvantaged groups (60) as they have lower compliance with prevention behavior and/or have less adaptive coping strategies, leading…”
BackgroundReligiousness in the first year of COVID-19: A systematic review of empirical research
David, A. B., Park, C. L., Awao, S., Vega, S., Zuckerman, M. S., White, T. F., & Hanna, D. C. (2022) · Current Research in Ecological and Social Psychology · doi:10.1016/j.cresp.2022.100075 · Cited by 21
Self-citationZhang, Y., Guo, X., Su, Y., Yaya Hamadou Koura, H., Wang, N., & Song, W. (2023) · Humanities and Social Sciences Communications · doi:10.1057/s41599-023-02201-z · Cited by 19
Assessing patient risk from cancer and COVID-19: Managing patient distress
Klaassen, Z. W. A., & Wallis, C. J. D. (2021) · Urologic Oncology Seminars and Original Investigations · doi:10.1016/j.urolonc.2021.01.023 · Cited by 19
“Social distancing during the pandemic is contributing to mental health distress, loss of motivation, and loss of self-worth [12].”
BackgroundImpacts of the COVID-19 Pandemic on Communication and Healthcare Access for Adults With Hearing Loss
Wilson, H. L., Crouch, J. B., Schuh, M. R., Shinn, J. B., & Bush, M. L. (2021) · Otology & Neurotology · doi:10.1097/mao.0000000000003203 · Cited by 19
Rotenberg, S., Oreper, J. S., Bar, Y., Davids-Brumer, N., Arbel, I., & DAWSON, D. R. (2021) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s0714980821000465 · Cited by 20
Metadata
- 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
- 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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