Effect of vicarious discrimination on race-based stress symptoms among Asian American young adults during the COVID-19 pandemic.

OBJECTIVE: The COVID-19 pandemic has led to a rise in anti-Asian hate crimes in the United States. Previous work has established that experiencing racism increases one's dysfunctional anxiety and avoidance actions-key symptoms of race-based stress symptoms. However, the psychological impact of vicarious, or secondhand, discrimination (witnessing racism targeting one's own race group) remains less understood. METHOD: We tested the hypothesis that higher reported vicarious discrimination would be associated with higher levels of race-based stress symptoms reported by Asian American young adults (n = 135) during the pandemic using a cross-sectional analysis of the COVID-19 Adult Resilience Experiences Study (CARES). Starting in April 2020, CARES assessed sociodemographic characteristics and key psychometric scales in young adults through three waves of online surveys. RESULTS: Our multiple regression analysis showed vicarious discrimination significantly predicted race-based stress symptoms, even after controlling for direct discrimination (p < .01). This association remained significant after controlling for age, gender, subjective childhood family social status, and preexisting psychiatric disorders (p < .01). Our results demonstrate that regardless of the effect that direct discrimination might have on race-based stress symptoms, witnessing discrimination against members of one's own racial group is significantly associated with increased race-based stress symptoms (b = 2.68, p < .01). Social media was the most common source of vicarious discrimination, with one out of three participants in our sample reporting nearly daily exposure. CONCLUSION: Providers should intentionally create a space within the therapeutic setting to discuss the effects of vicarious discrimination. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Posttraumatic growth as a moderator between pandemic-related distress and mental health symptoms in U.S. young adults.

OBJECTIVE: Compared to other age groups, young adults are at risk of suffering COVID-19 pandemic-related psychological problems. Prior research suggests that such adverse events (like the pandemic) can initiate adaptive psychological changes, referred to as posttraumatic growth (PTG); however, limited studies have examined the moderating role of PTG among young adults in the United States with regard to COVID-19-related distress. Thus, this study examines whether pandemic-related distress has a differential effect on young adults' mental health symptoms based on varying levels of PTG. METHOD: Using the data from 661 participants who completed all three waves of the CARES study (T1: April-August 2020; T2: September 2020-March 2021; T3: April-May 2021), a moderator analysis was performed using the PROCESS Macro to determine the moderating effect of PTG. RESULTS: In our data, higher levels of PTG buffered the effects of pandemic-related distress from 2020 on depressive symptoms in 2021; PTG did not show a moderating effect with anxiety as an outcome. CONCLUSIONS: Understanding the moderating role of PTG would help to further understand the mental health trajectories of young adults in the United States who are particularly distressed by the pandemic. Our findings suggest the importance of further exploring contributors to PTG for young adults, particularly among those who have experienced high levels of pandemic-related distress to date. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Youth Suicide During the First Year of the COVID-19 Pandemic.

OBJECTIVE: To identify potential differential changes in youth suicide deaths associated with the coronavirus disease (COVID-19) pandemic to better inform suicide prevention strategies. METHODS: This cross-sectional study analyzed national suicide data for US youth aged 5 to 24 years from 2015 to 2020. Annual and monthly numbers of suicides were extracted overall and by sex, age, race and ethnicity, and method. Expected suicides were modeled from the trend in monthly deaths before COVID-19 (January 1, 2015-February 29, 2020), by using interrupted time-series analyses with quasi-Poisson regression. Rate ratios (RR) and corresponding 95% confidence intervals (CI) were used to compare expected and observed suicides during the first 10 months of COVID-19 (March 1, 2020-December 31, 2020). RESULTS: Among 5568 identified youth suicides during the 2020 pandemic, 4408 (79.2%) were male, 1009 (18.1%) Hispanic, 170 (3.3%) non-Hispanic American Indian/Alaska Native, 262 (4.7%) Asian/Pacific Islander, 801 (14.4%) Black, and 3321 (59.6%) white. There was a significant increase in overall observed versus expected youth suicides during the COVID-19 pandemic (RR = 1.04, 95% CI = 1.01-1.07), equivalent to an estimated 212 excess deaths. Demographic subgroups including males (RR = 1.05, 95% CI = 1.02-1.08), youth aged 5 to 12 years (RR = 1.20, 95% CI = 1.03-1.41) and 18 to 24 years (RR =1.05, 95% CI = 1.02-1.08), non-Hispanic AI/AN youth (RR = 1.20, 95% CI = 1.03-1.39), Black youth (RR = 1.20, 95% CI = 1.12-1.29), and youth who died by firearms (RR = 1.14, 95% CI = 1.10-1.19) experienced significantly more suicides than expected. CONCLUSIONS: Suicide deaths among US youth increased during COVID-19, with substantial variation by sex, age, race and ethnicity, and suicide method. Suicide prevention strategies must be tailored to better address disparities in youth suicide risk.

Psychological Distress and Heavy Alcohol Consumption Among U.S. Young Women During the COVID-19 Pandemic.

INTRODUCTION: The predictors of heavy drinking among U.S. young women during the coronavirus disease 2019 (COVID-19) pandemic are not well-examined. This study aims to determine the prospective relationship between COVID-19 psychological distress and heavy alcohol use among U.S. young adult women. DESIGN: This study used the COVID-19 Adult Resilience Experiences Study (CARES) data collected from April 13, 2020, to August 31, 2020 (T1) and September 21, 2020, to March 15, 2021 (T2). Among the young adults (ages 18-30) who participated in both surveys, a total of 684 identified as women (including transgender women) were included in the analysis. Three or more drinks as a typical intake were defined as heavy drinking. Psychological distress in T1 was measured using scores for financial stress, COVID-19-related worry, and COVID-19-related grief. A series of logistic regression analyses were performed to identify risk factors associated with young women's heavy drinking during the pandemic. RESULTS: Twenty-two and one-half percent of young women reported heavy drinking in a typical intake. After controlling for covariates, women who reported high levels of COVID-19-related grief were more likely to report heavy drinking (odds ratio, 1.06; 95% confidence interval [CI], 1.01-1.13; p < .05). Those with high levels of COVID-19-related worry were less likely to report drinking heavily (odds ratio, 0.90; 95% confidence interval, 0.85-0.97; p < .01). CONCLUSIONS: Those who suffer from a deeper sense of COVID-19-related grief are particularly at risk of heavy drinking and should be targeted for outreach and clinical intervention. Further research is necessary to determine the long-term impacts of the pandemic on heavy drinking among young women and should include a more comprehensive assessment of psychological distress.

Psychological Distress and Heavy Alcohol Consumption Among U.S. Young Women During the COVID-19 Pandemic

Objectives The predictors of heavy drinking among U.S. young women during the COVID-19 pandemic are not well examined. This study aims to determine the prospective relationship between COVID-19 psychological distress and heavy alcohol use among U.S. young adult women. Design This study used the CARES (COVID-19 Adult Resilience Experiences Study) data collected April 13, 2020 - August 31, 2020 (T1) and September 21, 2020 - March 15, 2021 (T2). Among the young adults (ages 18-30) who participated in both surveys, a total of 684 identified as women (including transgender women) were included in the analysis. Three or more drinks as a typical intake were defined as heavy drinking. Psychological distress in T1 was measured using scores for financial stress, COVID-19-related worry, and COVID-19-related grief. A series of logistic regression analyses were performed to identify risk factors associated with young women’s heavy drinking during the pandemic. Results 22.5% of young women reported heavy drinking in a typical intake. After controlling for covariates, women who reported high levels of COVID-19-related grief were more likely to report heavy drinking (OR=1.06, CI: 1.01-1.13, p<0.05). Those with high levels of COVID-19-related worry were less likely to report drinking heavily (OR=0.90, CI: 0.85-0.97, p<0.01). Conclusion Those who suffer from a deeper sense of COVID-19-related grief are particularly at risk of heavy drinking and should be targeted for outreach and clinical intervention. Further research is necessary to determine the long-term impacts of the pandemic on heavy drinking among young women and should include a more comprehensive assessment of psychological distress.

Learning about discrimination during childhood: Implications for racial trauma among Asians and Asian Americans during the pandemic.

OBJECTIVE: Although the COVID-19 pandemic has led to a sharp rise in anti-Asian hate crimes, limited data exist on racial trauma and its effects on Asian Americans. The current study investigated how racial discrimination and parental ethnic-racial socialization (cultural socialization, preparation for bias, and promotion of mistrust) were associated with racial trauma among Asian Americans in young adulthood. Increased cultural socialization and preparation for bias in childhood were hypothesized to be associated with lower levels of racial trauma, whereas increased racial discrimination and promotion of mistrust were hypothesized to predict higher levels of racial trauma. METHODS: Based on a retrospective report of young adults during the COVID-19 pandemic, this longitudinal nationwide study within the United States examined 133 Asian and Asian American young adults ages 18-30 who participated in an online survey regarding ethnic identity, childhood ethnic-racial socialization practices, racial discrimination-related experiences, and racial trauma. RESULTS: Lifetime discrimination, but not COVID-19-related discrimination, was associated with higher levels of racial trauma. Greater levels of preparation for bias during childhood predicted lower levels of racial trauma in young adulthood. Contrary to the hypothesis, greater levels of cultural socialization predicted higher levels of racial trauma. Promotion of mistrust was not associated with later racial trauma outcomes. CONCLUSION: The current study underscores the long-term impacts of parent-child discussions about racism (i.e., preparation for bias) to address racial trauma in young adulthood. Future research should further examine cultural socialization to determine its effects on racial trauma among Asian Americans.

Concerns about the social climate, finances, and COVID-19 risk on depression and anxiety: An analysis on U.S. young adults across two waves.

Concerns regarding contracting COVID-19 and finances may be risks to mental health during the COVID-19 pandemic. Social climate concerns may be another risk, given U.S. protests taking place during this period. We tested the hypothesis that concerns about COVID-19 risk, finances, and social climate would predict clinically significant levels of depression, anxiety, and comorbid depression and anxiety in young adults. A total of 782 U.S. young adults (18-30 years), initially recruited through convenience sampling (social media, email listservs), completed online surveys at Wave 1 (April-August 2020) and Wave 2 (September 2020-March 2021). The primary outcomes included scoring above the cut off for depressive (PHQ-8 ≥ 10) or anxiety symptoms (GAD ≥10). Approximately 41% reported depression and 47% reported anxiety at Wave 1; rates did not differ at Wave 2. Individuals with greater financial concerns were 14% more likely to score high on depressive symptoms; those with COVID-19 risk concerns and social climate concerns were 21% and 54% more likely, respectively, to score high on generalized anxiety. Those with social climate and financial concerns were 52% and 15% more likely, respectively, to score high on comorbid depressive and anxiety symptoms. Analyses controlled for Wave 1 symptoms. We provide evidence highlighting the roles of social climate and COVID-19 risk concerns on anxiety, and financial concerns on depression in young adults. Public health campaigns should acknowledge broader societal issues that have taken place as a source of mental health distress, beyond those driven by the pandemic (e.g., isolation and lockdowns).

Experiences of COVID-19-related anti-Asian discrimination and affective reactions in a multiple race sample of U.S. young adults.

BACKGROUND: Little remains known about both Asian and Asian American (A/AA) and non-Asian young adults' experiences and affective reactions regarding COVID-19 anti-Asian discrimination. To our knowledge, this is the first study that explores the nature and impact of COVID-19 anti-Asian discrimination within a multi-racial sample. METHODS: This study uses qualitative open-ended responses from a sub-sample of Wave I of the COVID-19 Adult Resilience Experiences Study (CARES) data collected between March to September 2020. Thematic analysis was used to explore two open-ended questions: "Are there experiences we missed in the survey so far that you wish to describe?" and "What are your thoughts about the current social climate?" The data analysis for this study focused on 113 discrimination or racism-related comments. RESULTS: A total of 1331 young adults completed an online survey of which 611 provided comments; a multi-racial sample of 95 individuals (65.3% non-Asians, 24.7% A/AA) contributed 113 COVID-19 anti-Asian discrimination or racism-related comments. Two overarching themes were: types of discrimination (societal, interpersonal, intrapersonal) and affective reactions to discrimination (fear, anxiety/distress, hopelessness/depression, and avoidance). Not only did both A/AA and non-Asian participants report witnessing or hearing reports of anti-Asian discrimination, but both groups described having negative affective reactions to anti-Asian discrimination. CONCLUSION: Anti-Asian discrimination in the face of COVID may be more widespread than initial reports indicate. Our finding suggests that anti-Asian discrimination is a societal illness that impacts all populations in the U.S. This calls for cross-racial coalitions and solidarity in the fight against discrimination and racism.

Health-related quality of life among US young adults during the COVID-19 pandemic: Psychiatric symptoms and emotional experiences to target within clinical practice.

BACKGROUND: The current study aimed to determine the role of psychological experiences during the COVID-19 pandemic (depression, anxiety, loneliness, and COVID-19-related grief and worry) on young adult physical and mental health functioning as measured by health-related quality of life (HRQoL). METHODS: Using hierarchical multiple regression analyses, this cross-sectional study examined psychological predictors of physical and mental health functioning among young adults (age 18 to 30 years) from April 13 to September 5, 2020. RESULTS: Pre-existing depression diagnoses (beta = -0.124, P < .001), current depression symptoms (beta = -0.298, P < .001), and COVID-19-related worry (beta = -0.142, P < .001) significantly predicted poorer physical health functioning. Current depression and anxiety symptoms (beta = -0.342 and beta = -0.268), loneliness (beta = -0.135), and COVID-19-related grief (beta = -0.180) predicted lower self-reported mental health functioning (P < .001). Black (beta = -0.072) and Hispanic/Latinx participants (beta = -0.082) were more likely to indicate poorer physical health functioning (P < .01) relative to White participants, whereas women reported poorer mental health relative to men (beta = -0.047, P < .05). CONCLUSIONS: This study identifies potential negative impacts of pandemic-related psychological experiences for young adults' health during the COVID-19 pandemic. There is a need to consider mental health symptomatology, COVID-19-related experiences, race, and gender when designing efforts to address long-term implications on health.

Perceived COVID-19-related anti-Asian discrimination predicts post traumatic stress disorder symptoms among Asian and Asian American young adults.

OBJECTIVE: This study investigates the prevalence of COVID-19-related discrimination and the extent to which COVID-19-related discrimination is associated with mental health symptoms among Asians and Asian American (A/AA) young adults during the first three months of the COVID-19 pandemic. METHODS: We used data from the COVID-19 Adult Resilience Experiences Study (CARES), a cross-sectional online survey conducted in the U.S. Out of 1,001 respondents, 211 A/AA young adults were analyzed for this study. RESULTS: Sixty-eight percent of A/AA young adults reported that they or their family have experienced COVID-19-related discrimination and approximately 15% of respondents reported verbal or physical assaults. After controlling for covariates including predisposing factors, lifetime discrimination, and pre-existing mental health diagnoses, COVID-19-related discrimination was significantly associated with an increased level of symptoms of posttraumatic stress disorder (PTSD), but not of anxiety or depression. Our study results suggest that COVID-19-related discrimination may contribute to PTSD symptoms among A/AA young adults. LIMITATIONS: This was cross-sectional data which was collected through online and self-report rather than clinical evaluation. CONCLUSION: This finding adds greater urgency to develop and implement policy- and individual-level interventions to reduce race-based discrimination among A/AA.

Psychosocial correlates of posttraumatic growth among U.S. young adults during the COVID-19 pandemic.

Given the prolonged nature of the COVID-19 pandemic, the purpose of this study was to examine the association between posttraumatic growth (PTG) among young adults during the COVID-19 pandemic and their psychosocial characteristics, specifically: distress tolerance; resilience; family connectedness; depression, anxiety, and PTSD symptoms; and COVID-19-related worry. The study utilized data from 805 U.S. young adults (18-30 years) who completed online surveys during the COVID-19 pandemic across two waves (April-August 2020 and September 2020-March 2021). Overall, young adults reported low PTG scores. PTSD symptoms and COVID-19-related worry significantly predicted higher levels of PTG, while their depression symptoms predicted lower levels of PTG. Resilience and family connectedness significantly predicted higher levels of PTG, and distress tolerance significantly predicted lower levels of PTG after accounting for sociodemographic characteristics and negative influential factors. Compared to Whites, Asians were less likely to report PTG. In general, young adults have not perceived personal growth from the pandemic; however, young adults with certain psychosocial factors appear to be predisposed to such PTG. This study highlights the importance of exploring and elucidating the potential positive trajectories following the adversity of the COVID-19 pandemic.

Psychiatric impacts of the COVID-19 global pandemic on U.S. sexual and gender minority young adults.

The COVID-19 pandemic has caused unprecedented isolation and mental health effects; few studies have characterized this in sexual and gender (SGM) minority young people, a particularly vulnerable population. This cross-sectional study sought to analyze the mental health outcomes of SGM young people (18-30 years) during the early stages of the pandemic in the United States (April 13-June 18, 2020) and to explore how factors related to SGM identity impact mental health, such as lifetime discrimination, family support, and pre-existing mental health conditions. An online survey collected socio-demographic information and assessed for both mental health (depression (PHQ-8), anxiety (GAD-7), PTSD (PCL-C)) and COVID-19-related outcomes (COVID-19-related worries and COVID-19-related grief). Out of 981 participants, 320 (32.6%) identified as SGM. SGM had significantly higher levels of depression and PTSD symptoms as well as COVID-19-related worries and grief than non-SGM, even after controlling for family support, lifetime discrimination, and pre-existing mental health diagnoses. These findings suggest that not only has the COVID-19 pandemic disproportionately impacted SGM mental health, but that minority stress factors cannot fully explain this impact. Thus, clinicians and societal stakeholders (schools, employers, policymakers) must think beyond traditional minority stress factors (family support, discrimination) and pre-pandemic disparities to support this vulnerable population as the pandemic progresses.

College student mental health risks during the COVID-19 pandemic: Implications of campus relocation.

PURPOSE: During the COVID-19 pandemic, many universities evacuated their campuses, requiring students to vacate on campus residences. The psychological outcomes of students who relocated during the pandemic remains unknown. We examined mandated relocation experiences related to self-reported worry, grief, loneliness, and depressive, generalized anxiety, and post-traumatic stress disorder (PTSD) symptoms among college students during the COVID-19 pandemic. METHODS: We analyzed cross-sectional survey data obtained from April 9 to August 4, 2020 on 791 young adults (ages 18-30 years) who were enrolled at a U.S. university. The CARES 2020 Project (COVID-19 Adult Resilience Experiences Study) is an online survey of young adults' mental health during the COVID-19 pandemic. Recruitment relied on snowball sampling. Participants were asked if they were required to relocate from campus and among those who did, their experiences in moving. COVID-19-related worry and grief, loneliness, and depressive, anxiety, and PTSD symptoms were assessed. RESULTS: Approximately one-third of students reported being mandated to relocate. Students mandated to relocate reported more COVID-19-related grief, loneliness, and generalized anxiety symptoms compared to those who did not even after controlling for the severity level of local COVID-19 outbreaks. Students who had to leave behind valuable personal belongings reported more COVID-19-related worries, grief, and depressive, generalized anxiety, and PTSD symptoms. CONCLUSIONS: Students who were mandated to relocate reported worse psychological outcomes compared to students who were not mandated to relocate. Our findings have implications for addressing the psychological impact of evacuating college campuses during public health emergencies and other disasters.

Psychological correlates of poor sleep quality among U.S. young adults during the COVID-19 pandemic.

OBJECTIVE: Uncertainty due to the COVID-19 pandemic may result in problematic sleep that can lead to negative effects on overall health. This unprecedented and stressful time can be even more detrimental for young adults with pre-existing mental health conditions. The purpose of this study is to investigate potential risk factors (i.e., current mental health symptoms, and COVID-19-related grief and worry) on sleep quality of U.S. young adults during the initial months of the global pandemic. METHOD: This cross-sectional study examined 908 young adults in the weeks following the declaration of the coronavirus pandemic as a national emergency by the United States. A series of hierarchical multiple regression analyses examined depression, anxiety, and PTSD, as well as COVID-19-related grief and worry as predictors of young adults' sleep quality. RESULTS: Young adults experienced high rates of sleep problems during the first two months (April to May 2020) of the pandemic. Depressive and anxiety symptoms appear to be predictors of sleep quality regardless of any pre-existing diagnosis. Furthermore, high levels of PTSD symptoms and COVID-19-related worry were associated with young adults' poor sleep. CONCLUSIONS: Our findings point to possible psychological factors that uniquely explain young adults' poor sleep quality during the COVID-19 pandemic in the U.S. This study shed new light on how the COVID-19 pandemic might affect the sleep behaviors of young adults without a pre-existing mental health diagnosis. Implications for supporting young adults sleep and well-being during the pandemic are addressed.

Priorities for addressing the impact of the COVID-19 pandemic on college student mental health.

The COVID-19 pandemic has already produced profound impacts on college students, with unprecedented directives for student relocation from their college campuses and dormitories mid-semester and coursework that took place through virtual learning. The current disruptions and anticipated potential long-term changes call for immediate prioritization regarding next steps for addressing college mental health and well-being. This viewpoint article highlights two urgent priorities for addressing current college mental health needs: the development of strategies for ensuring mental health service access, and intentional outreach to college students with special circumstances. The current crisis also represents an opportunity for campus administrators, mental health professionals, researchers, and policymakers to leverage innovative models of care as well as identity-related student assets, strengths, and resilience-promoting factors to support students' eventual return to campus and to respond more effectively to future massive disruptions.

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

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.