The unfolding COVID-19 pandemic: A probability-based, nationally representative study of mental health in the United States

Abstract

The COVID-19 (coronavirus disease 2019) pandemic is a collective stressor unfolding over time; yet, rigorous empirical studies addressing its mental health consequences among large probability-based national samples are rare. Between 18 March and 18 April 2020, as illness and death escalated in the United States, we assessed acute stress, depressive symptoms, and direct, community, and media-based exposures to COVID-19 in three consecutive representative samples from the U.S. probability-based nationally representative NORC AmeriSpeak panel across three 10-day periods (total N = 6514). Acute stress and depressive symptoms increased significantly over time as COVID-19 deaths increased across the United States. Preexisting mental and physical health diagnoses, daily COVID-19-related media exposure, conflicting COVID-19 information in media, and secondary stressors were all associated with acute stress and depressive symptoms. Results have implications for targeting public health interventions and risk communication efforts to promote community resilience as the pandemic waxes and wanes over time.

Fig. 1. Study design for examining early psychological responses to the COVID-19 pandemic in three consecutive probability-based, nationally representative cohorts in the United States.

Fig. 2. Mean pandemic-related acute stress response and depressive symptoms across cohorts (N = 6514).

*P < 0.05; **P < 0.01; ***P < 0.001. Values represent raw mean scores for each cohort. Range for acute stress: 1 to 5; range for depressive symptoms: 0 to 4.