Cited by 1,157COVID-19 and Mental HealthMaternal Mental Health During Pregnancy and PostpartumAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

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Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: Clinical implications for U.S. young adult mental health

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Liu, Cindy H., Zhang, Emily, Wong, Ga Tin Fifi, Hyun, Sunah, Hahm, Hyeouk “Chris”·2020·Psychiatry Research

DOI 10.1016/j.psychres.2020.113172PMC PMC7263263

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Abstract

This study sought to identify factors associated with depression, anxiety, and PTSD symptomatology in U.S. young adults (18-30 years) during the COVID-19 pandemic. This cross-sectional online study assessed 898 participants from April 13, 2020 to May 19, 2020, approximately one month after the U.S. declared a state of emergency due to COVID-19 and prior to the initial lifting of restrictions across 50 U.S. states. Respondents reported high levels of depression (43.3%, PHQ-8 scores ≥ 10), high anxiety scores (45.4%, GAD-7 scores ≥ 10), and high levels of PTSD symptoms (31.8%, PCL-C scores ≥ 45). High levels of loneliness, high levels of COVID-19-specific worry, and low distress tolerance were significantly associated with clinical levels of depression, anxiety, and PTSD symptoms. Resilience was associated with low levels of depression and anxiety symptoms but not PTSD. Most respondents had high levels of social support; social support from family, but not from partner or peers, was associated with low levels of depression and PTSD. Compared to Whites, Asian Americans were less likely to report high levels across mental health symptoms, and Hispanic/Latinos were less likely to report high levels of anxiety. These factors provide initial guidance regarding the clinical management for COVID-19-related mental health problems.

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“Studies conducted in several countries have already shown that COVID-19 may cause stress, anxiety, and depression (Cortés-Álvarez et al., 2020; Liu et al., 2020; Solomou & Constantinidou, 2020).”
Background
Perceived stress and stress responses during COVID-19: The multiple mediating roles of coping style and resilience
Gao, Q., Xu, H., Zhang, C., Huang, D., Zhang, T., & Liu, T. (2022) · PLoS ONE · doi:10.1371/journal.pone.0279071 · Cited by 8
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“The COVID-19 pandemic is a powerful stressor with many negative mental health consequences (Liu et al., 2020; Satici et al., 2022).”
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Depression and anxiety among college students at Historically Black and Predominantly White universities during the COVID-19 pandemic: A cross-sectional study
Rajbhandari‐Thapa, J., Chiang, K. E., Lee, M. C., Treankler, A. S., Padilla, H. M., Vall, E. A., & Fedrick, M. (2023) · Journal of American College Health · doi:10.1080/07448481.2023.2230297 · Cited by 7
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Intergenerational Transmission of Trauma
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“Resilience has been associated with fewer depression and anxiety symptoms (Liu et al., 2020).”
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“Studies show that during the pandemic period, people experienced various psychological problems such as depression [5], post-traumatic stress disorder [6], sleep and anxiety disorders [7], and burnout syndrome [8].”
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Literature Review: Quarantine and Lockdown During Covid19 Outbreak Impact on Mental Health Problem
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Evidence on Resilient Initial Response to COVID-19 Pandemic Among Youth: Findings From the Prospective Study of Mental Health in Two European Countries
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Psychological Inflexibility Moderates Stress and Loneliness in Depression Among Indonesian College Students During the COVID-19 Pandemic
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“Feeling disengaged from social connection due to social distancing and isolation may make one feel lonely and vulnerable, especially among college students [27], [6], [28], [29].”
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Ung, M., Wan, K. Y. Y., Liu, S. Y., Choo, Y. J., Liew, N. S. W., Shang, Z. A., Khoo, S. S. H., Tay, W. X., Lin, R., & Yi, S. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19095636 · Cited by 6
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The effects of compulsory isolation measures during the COVID‐19 pandemic: The example of prison workers
Ayhan, F., Balsak, H., & Ayhan, V. (2022) · The International Journal of Health Planning and Management · doi:10.1002/hpm.3528 · Cited by 6
Social support against depression in young adults’ group during COVID-19 pandemic
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“An important role in mental health outcomes is attributed to such factors as: loneliness, personal coping strategies, resilience, dis - tress tolerance, and family support [4, 6–10].”
The association between psychological burden related to COVID-19 and addictive social media use: Testing the mediational role of anxious affect
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The Impact of COVID-19 on the Quality of Life and Happiness of Care Home Residents in Croatia: A Cross-Sectional Study
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“[39], older adults tend to have “better emotional regulation and well-being than younger adults”.”
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Pandemic-related life changes and adolescent initiation of cannabis and tobacco/nicotine use
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“…depression, and substance use (including cannabis and tobacco/nicotine use) among adults and adolescents (Berki & Pikó, 2021; Chaiton, Dubray, Kundu, & Schwartz, 2022; Liu et al., 2020; Papp & Kouros, 2021; Villanti et al., 2022; Czeisler et al., 2020; Rogers, Shepherd, Garey, & Zvolensky, 2020).”
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Sleep quality and mental health during COVID-19: the role of distress tolerance.
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“Sleep quality is associated with distress tolerance (Reitzel et al., 2017; Short et al., 2016), which predicted depressive and anxiety symptoms during the COVID-19 pandemic (Liu et al., 2020).”
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Evidence of higher suicidal ideation among young adults in Canada during the COVID-19 pandemic
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Is coronavirus pandemic‐related anxiety higher in children with chronic kidney disease than healthy children?
Erfidan, G., Özyurt, G., Çamlar, S. A., Şimşek, Ö. Ö., Başaran, C., Alaygut, D., Mutlubaş, F., & Demir, B. K. (2021) · Pediatrics International · doi:10.1111/ped.14887 · Cited by 6
“All rights reserved GAD 5 (1-14) ns 8 (1-12) ns ns”
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Post-Traumatic Stress Disorder and Alcohol Use Disorder During the COVID-19 Outbreak: Do Dissociation and Emotional Metacognitive Beliefs Mediate the Role of Emotion Dysregulation?
Rogier, G., Zobel, S., Rizzi, D., & Velotti, P. (2022) · Psychiatry Investigation · doi:10.30773/pi.2022.0013 · Cited by 5
Assessment of burnout level among clinical dental students during the COVID-19 pandemic
Korkmaz, C., Dikicier, S., & Atay, A. (2023) · BMC Medical Education · doi:10.1186/s12909-023-04729-9 · Cited by 6
“Liu et al. [42] stated that high perceived social support from family was associated with lower levels of depression and post-traumatic stress disorder.”
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Modeling emotional contagion in the COVID-19 pandemic: a complex network approach
Zhu, Y., Zhang, W., & Li, C. (2023) · PeerJ Computer Science · doi:10.7717/peerj-cs.1693 · Cited by 6
“With the onset of the COVID-19 pandemic, stress has been identified as a profound threat to public health, predisposing individuals to an array of negative emotional responses and thereby facilitating the development of mental health conditions such as depression and anxiety ( Liu et al., 2020 ).”
Background
The mental health of college students in the transition of post-pandemic era in Pampanga, Philippines: an input for psychoeducation programme
Estacio, R. D., Subida, M. D., Bagaforo, M. V., Abuyuan, M. C., Dionisio, N. Y., & Letso, S. C. (2023) · Asia Pacific Journal of Counselling and Psychotherapy · doi:10.1080/21507686.2023.2281430 · Cited by 6
“In the studies conducted by Munir (2022), Jungmin Lee et al. (2021), Wang et al. (2021), Lail et al. (2021), Esterwood and Saeed (2020), Islam et al. (2020), and Liu et al. (2020), the mental health of college learners has been examined.”
Background
Chemical synthesis of ZnO, CuO, MnO and FeO Nano adsorbent and their application in anionic reactive blue turquoise 71 dye (RB-71 dye) and real effluents remediation: Batch adsorption and column studies
Ghaffar, K., Munir, R., Younas, F., Muneer, A., Sardar, M. F., Albasher, G. I., & Noreen, S. (2024) · Journal of Dispersion Science and Technology · doi:10.1080/01932691.2024.2325388 · Cited by 6
Predictive modelling of stress, anxiety and depression: A network analysis and machine learning study
Ganai, U. J., Sachdev, S., & Bhushan, B. (2024) · British Journal of Clinical Psychology · doi:10.1111/bjc.12487 · Cited by 7
Vulnerability to COVID‐19–Related Disability: The Impact of Posttraumatic Stress Symptoms on Psychosocial Impairment During the Pandemic
Morabito, D. M., Bedford, C. E., Woller, S. J., & Schmidt, N. B. (2021) · Journal of Traumatic Stress · doi:10.1002/jts.22717 · Cited by 6
“…current research demonstrating the impact of the COVID–19 pandemic on mental health difficulties (e.g., Fitzpatrick et al., 2020; Lebel et al., 2020; Liu et al., 2020; Tang et al., 2020; Twenge & Joiner, 2020) as well as with findings from prior studies illustrating the association between…”
BackgroundResult
Impact of School Closures, Precipitated by COVID-19, on Weight and Weight-Related Risk Factors among Schoolteachers: A Cross-Sectional Study
Silverman, J. R., & Wang, B. Z. (2021) · Nutrients · doi:10.3390/nu13082723 · Cited by 7
KESEHATAN MENTAL PADA PENYINTAS COVID-19: A LITERATURE REVIEW
Wulan, N. L. N., & Keliat, B. A. (2021) · Jurnal Ilmu Kesehatan Bhakti Husada Health Sciences Journal · doi:10.34305/jikbh.v12i2.327 · Cited by 8

Authors: Liu, C. H., Zhang, E., Wong, G. T. F., Hyun, S., & Hahm, H. “.
Affiliations: Boston University (US)
Corresponding author: Liu, Cindy H.
ORCID: Liu, Cindy H.
Hyun, Sunah
Hahm, Hyeouk “Chris”
Venue: Psychiatry Research
Publisher: Elsevier BV
Published: 2020-08
Volume: 290
Pages: 113172
ISSN: 0165-1781 (ISSN-L)
DOI: 10.1016/j.psychres.2020.113172
PMC: PMC7263263
OpenAlex: W3030361728
Cited by: 1,157
References: 48
Citations by year: 2026: 27 · 2025: 92 · 2024: 130 · 2023: 226 · 2022: 316 · 2021: 300 · 2020: 64
FWCI: 90.67
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
www.elsevier.com/legal/tdmrep-license (tdm)
www.elsevier.com/open-access/userlicense/1.0/ (am, 308 d)
Locations: Psychiatry Research (acceptedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Institutes of Health
National Science Foundation
Topics: Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords: COVID-19 pandemic, depression, anxiety, post-traumatic stress disorder, young adults, loneliness, distress tolerance, resilience, social support, family social support, racial and ethnic differences, mental health
MeSH terms: Patient Health Questionnaire, Betacoronavirus, COVID-19, SARS-CoV-2, Adolescent, Adult, Anxiety, Cross-Sectional Studies, Depression, Female, Humans, Loneliness, Male, Pneumonia, Viral, Quarantine, Social Support, Stress Disorders, Post-Traumatic, United States, Coronavirus Infections, Young Adult, Pandemics

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Factors associated with depression, anxiety, and PTSD symptomatology during the COVID-19 pandemic: Clinical implications for U.S. young adult mental health

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