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Psychological impacts from COVID-19 among university students: Risk factors across seven states in the United States

Open access
Browning, Matthew H. E. M., Larson, Lincoln R., Sharaievska, Iryna, Rigolon, Alessandro, McAnirlin, Olivia, Mullenbach, Lauren, Cloutier, Scott, Vu, Tue M., Thomsen, Jennifer, Reigner, Nathan, Metcalf, Elizabeth Covelli, D'Antonio, Ashley, Helbich, Marco, Bratman, Gregory N., Alvarez, Hector Olvera·2021·PLOS ONE
DOI 10.1371/journal.pone.0245327PMC PMC7790395
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Abstract

Background: University students are increasingly recognized as a vulnerable population, suffering from higher levels of anxiety, depression, substance abuse, and disordered eating compared to the general population. Therefore, when the nature of their educational experience radically changes—such as sheltering in place during the COVID-19 pandemic—the burden on the mental health of this vulnerable population is amplified. The objectives of this study are to 1) identify the array of psychological impacts COVID-19 has on students, 2) develop profiles to characterize students' anticipated levels of psychological impact during the pandemic, and 3) evaluate potential sociodemographic, lifestyle-related, and awareness of people infected with COVID-19 risk factors that could make students more likely to experience these impacts. Methods: Cross-sectional data were collected through web-based questionnaires from seven U.S. universities. Representative and convenience sampling was used to invite students to complete the questionnaires in mid-March to early-May 2020, when most coronavirus-related sheltering in place orders were in effect. We received 2,534 completed responses, of which 61% were from women, 79% from non-Hispanic Whites, and 20% from graduate students. Results: Exploratory factor analysis on close-ended responses resulted in two latent constructs, which we used to identify profiles of students with latent profile analysis, including high (45% of sample), moderate (40%), and low (14%) levels of psychological impact. Bivariate associations showed students who were women, were non-Hispanic Asian, in fair/poor health, of below-average relative family income, or who knew someone infected with COVID-19 experienced higher levels of psychological impact. Students who were non-Hispanic White, above-average social class, spent at least two hours outside, or less than eight hours on electronic screens were likely to experience lower levels of psychological impact. Multivariate modeling (mixed-effects logistic regression) showed that being a woman, having fair/poor general health status, being 18 to 24 years old, spending 8 or more hours on screens daily, and knowing someone infected predicted higher levels of psychological impact when risk factors were considered simultaneously. Conclusion: Inadequate efforts to recognize and address college students’ mental health challenges, especially during a pandemic, could have long-term consequences on their health and education.

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Crossref · 10.1371/journal.pone.0245327

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Fig 1 COVID-19 psychological impact profiles derived from z-scores of eight items reduced to two factors using data from college students across the United States (n = 2,534). Means and standard errors shown.
Fig 1 COVID-19 psychological impact profiles derived from z-scores of eight items reduced to two factors using data from college students across the United States (n = 2,534). Means and standard errors shown.CC BY · PubMed Central
Fig 2 Sociodemographic (a), lifestyle (b), and COVID-19 victim awareness (c) risk factors associated with high, moderate, and low psychological impact profiles for students across the United States. Residuals from Pearson's chi-squared tests depict likelihood of profile membership based on risk factor. Only significant factors (p < .05) are reported. Reference groups include men; over 32 age; other race/ethnicity; average/above average SES (social class and relative family income); good/very good/excellent general health; less than 2 hours of time outdoors; less than 8 hours of screen time; and not knowing someone infected (COVID-19).
Fig 2 Sociodemographic (a), lifestyle (b), and COVID-19 victim awareness (c) risk factors associated with high, moderate, and low psychological impact profiles for students across the United States. Residuals from Pearson's chi-squared tests depict likelihood of profile membership based on risk factor. Only significant factors (p < .05) are reported. Reference groups include men; over 32 age; other race/ethnicity; average/above average SES (social class and relative family income); good/very good/excellent general health; less than 2 hours of time outdoors; less than 8 hours of screen time; and not knowing someone infected (COVID-19).CC BY · PubMed Central

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Research works printed but not linked: 4

  1. ME Loades, 2020, J Am Acad Child Adolesc Psychiatry, 1
  2. Centers for Disease Control and Prevention, 2018, Healthy Days Core Module: HRQOL-14 Measure, 1
  3. J Nash, 2014, Stress and diabetes: The use of “worry time” as a way of managing stress, Journal of Diabetes Nursing, 18, 329
  4. S Galea, 2020, The mental health consequences of COVID-19 and physical distancing, 180, 817

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Metadata

Authors
Browning, M. H. E. M., Larson, L. R., Sharaievska, I., Rigolon, A., McAnirlin, O., Mullenbach, L., Cloutier, S., Vu, T. M., Thomsen, J., Reigner, N., Metcalf, E. C., D'Antonio, A., Helbich, M., Bratman, G. N., & Alvarez, H. O.
Affiliations
  • Clemson University (US)
  • North Carolina State University (US)
  • University of Utah (US)
  • Arizona State University (US)
  • University of Montana (US)
  • Pennsylvania State University (US)
  • Utrecht University (NL)
  • University of Washington (US)
Corresponding author
Browning, Matthew H. E. M.
ORCID
Venue
PLOS ONE
Publisher
Public Library of Science (PLoS)
Published
2021-01-07
Volume
16
Issue
1
Pages
e0245327
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0245327
PMC
PMC7790395
OpenAlex
W3118613563
Cited by
888
References
125
Citations by year
2026: 23 · 2025: 71 · 2024: 133 · 2023: 222 · 2022: 279 · 2021: 159
FWCI
135.73
Type
journal article
Language
en
Update notices
correction (2022-08-26)
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • TigerPrints (Clemson University) (submittedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
Topics
  • Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
  • Social Sciences › Psychology › Developmental and Educational Psychology › Student Stress and Coping
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords
COVID-19 pandemic, university students, student mental health, psychological impact, risk factors, anxiety, depression, substance abuse, disordered eating, sheltering in place, sociodemographic factors, health status, screen time, latent profiles, gender differences
MeSH terms
Social Factors, COVID-19, Adult, Cross-Sectional Studies, Female, Humans, Male, Mental Health, Middle Aged, Risk Factors, Students, United States, Universities, Young Adult

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