The mental burden of stay-at-home order extensions during COVID-19

Abstract

This study evaluates the psychological impact of stay-at-home extension orders during COVID-19 and its relationship with individuals' expectations on the duration of the extensions. An online survey was administered to 1259 US adult residents to measure symptoms of post-traumatic stress disorder (PTSD), anxiety and stress induced by different stay-at-home order extensions using hypothetical length scenarios. We find that individuals exposed to two 2-week order extensions exhibit higher levels of stress and anxiety compared to those exposed to a single 4-week extension. We also find that subjects with longer expected extensions exhibit more signs of psychological damage than those with shorter expected extensions. Furthermore, we find that the negative psychological consequences of providing two shorter extensions is observed only among subjects with extension expectations of four weeks or less. Our results demonstrate that people's expectations affect the level of psychological damage caused by lockdown mandates. Our findings suggest that whenever lockdown extensions are necessary, reduced psychological distress may be possible by implementing a one-time restriction, rather than extending multiple smaller extensions perhaps due to manipulation of personal expectations.

Figure 1

Experimental procedure. *The psychological tests were measured after each 2-week extension in the Two extensions treatment, i.e., at 6-week stay-at-home order and 8-week order.

Figure 2

Psychological total scores by treatment. (A) PSS-10 total score by treatment. (B) IES-R total score by treatment. (C) GAD-7 total score by treatment. Notes: ***p < 0.01, **p < 0.05, and *p < 0.10; mean comparisons are performed between treatments and the No extension baseline using t-tests; scores for the Two extension treatment correspond to those elicited after the second 2-week extension.

Figure 3

Psychological total scores by expectation category. (A) PSS-10 total score by expectation category. (B) IES-R total score by expectation category. (C) GAD-7 total score by expectation category. ***p < 0.01, **p < 0.05, and *p < 0.10; mean comparisons between two categories are performed using t-tests; scores for the Two extension treatment correspond to those elicited after the second 2-week extension.