Emotional distress in young adults during the COVID-19 pandemic: evidence of risk and resilience from a longitudinal cohort study

Lilly Shanahan, Annekatrin Steinhoff, Laura Bechtiger, Aja L Murray, Amy Nivette, Urs Hepp, Denis Ribeaud, Manuel Eisner, Lilly Shanahan, Annekatrin Steinhoff, Laura Bechtiger, Aja L Murray, Amy Nivette, Urs Hepp, Denis Ribeaud, Manuel Eisner

Abstract

Background: The coronavirus disease 2019 (COVID-19) pandemic and associated lockdown could be considered a 'perfect storm' for increases in emotional distress. Such increases can only be identified by studies that use data collected before and during the pandemic. Longitudinal data are also needed to examine (1) the roles of previous distress and stressors in emotional distress during the pandemic and (2) how COVID-19-related stressors and coping strategies are associated with emotional distress when pre-pandemic distress is accounted for.

Methods: Data came from a cohort study (N = 768). Emotional distress (perceived stress, internalizing symptoms, and anger), COVID-19-related stressors, and coping strategies were measured during the pandemic/lockdown when participants were aged 22. Previous distress and stressors were measured before COVID-19 (at age 20).

Results: On average, participants showed increased levels of perceived stress and anger (but not internalizing symptoms) during the pandemic compared to before. Pre-COVID-19 emotional distress was the strongest predictor of during-pandemic emotional distress, followed by during-pandemic economic and psychosocial stressors (e.g. lifestyle and economic disruptions) and hopelessness, and pre-pandemic social stressors (e.g. bullying victimization and stressful life events). Most health risks to self or loved ones due to COVID-19 were not uniquely associated with emotional distress in final models. Coping strategies associated with reduced distress included keeping a daily routine, physical activity, and positive reappraisal/reframing.

Conclusions: In our community sample, pre-pandemic distress, secondary consequences of the pandemic (e.g. lifestyle and economic disruptions), and pre-pandemic social stressors were more consistently associated with young adults' emotional distress than COVID-19-related health risk exposures.

Keywords: COVID-19; distress; mental health; resilience; stress; young adults.

Conflict of interest statement

The authors have no conflicts of interest to report.

Figures

Fig. 1.
Fig. 1.
Associations of sociodemographic and risk variables with levels of emotional distress during the COVID-19 pandemic/lockdown. Models that used stressors and health risks as predictors were adjusted for all sociodemographic variables. Risk factors were entered one at a time (i.e. a separate model for each risk factor). Standardized regression coefficients (β) and 95% confidence intervals (CIs) were applied. For exact coefficients, CIs, and p values, see online Supplementary Table S3.
Fig. 2.
Fig. 2.
Associations of sociodemographic and risk variables with changes in emotional distress from the pre-pandemic to the during-pandemic/lockdown assessment (i.e. adjusted for pre-pandemic distress). Models that used stressors and health risks as predictors were adjusted for all sociodemographic variables. Risk factors were each entered one at a time (i.e. a separate model for each risk factor). Standardized regression coefficients (β) and 95% CIs were applied. For exact coefficients, CIs, and p values, see online Supplementary Table S4.

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