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).

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.

COVID-19-related direct and vicarious racial discrimination: Associations with psychological distress among U.S. college students.

BACKGROUND: The COVID-19 pandemic has been accompanied by a myriad of racist incidents targeting minorities in the U.S. Young adults are susceptible to direct and vicarious (indirect) pandemic-related racial discrimination. We sought to examine associations between both types of discrimination experiences and psychological distress among college students across different racial groups. METHODS: We analyzed self-reported data from 64,041 undergraduate students from the Spring 2021 American College Health Association-National College Health Assessment. Logistic regression examined odds of severe distress based on self-reported exposure to direct and vicarious racial discrimination. RESULTS: Even after controlling for sociodemographic characteristics and prior mental health diagnoses, there was a significant association between direct discrimination and distress among Asian (AOR: 1.3, p < 0.001), Hispanic (AOR: 1.6, p < 0.001), and Multiracial (AOR: 1.4, p < 0.001) students. Vicarious discrimination was significantly associated with distress among White (AOR: 1.4, p < 0.001), Asian (AOR: 1.4, p < 0.001), Hispanic (AOR: 1.5, p < 0.001), and Multiracial (AOR: 1.3, p < 0.001) students. Further analysis considering distress as a continuous measure revealed a significant association between vicarious discrimination and distress for Black participants (ß = 0.9, p < 0.001). LIMITATIONS: Self-reported variables are susceptible to recall bias. Minority racial group analyses may be underpowered. CONCLUSIONS: Our findings reveal an overall link between both direct and vicarious racial discrimination and distress across several racial groups. Further studies should examine effective mental health interventions and anti-racism initiatives to support students who have experienced direct or vicarious discrimination due to COVID-19.

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.

Racial and socioeconomic status differences in stress, posttraumatic growth, and mental health in an older adult cohort during the COVID-19 pandemic.

Background: The COVID-19 pandemic has disproportionately impacted the most vulnerable and widened the health disparity gap in both physical and mental well-being. Consequentially, it is vital to understand how to best support elderly individuals, particularly Black Americans and people of low socioeconomic status, in navigating stressful situations during the COVID-19 pandemic and beyond. The aim of this study was to investigate perceived levels of stress, posttraumatic growth, coping strategies, socioeconomic status, and mental health between Black and non-Hispanic, White older adults, the majority over the age of 70. Additionally, we investigated which variables, if any, were associated with posttraumatic growth in these populations. Methods: One hundred seventy-six community dwelling older adults (mean age = 76.30 ±8.94), part of two observational studies (The Harvard Aging Brain Study and Instrumental Activities of Daily Living Study) in Massachusetts, US, were included in this cross-sectional study. The survey, conducted from March 23, 2021 to May 13, 2021, measured perceived stress, behavioral coping strategies, posttraumatic growth, and mental health during the COVID-19 pandemic. We investigated associations with post-traumatic growth in a multiple linear regression model and examined their differences by race with t-tests, Wilcoxon rank-sum tests, and Fisher's exact tests. A second multiple linear regression model was used to examine which coping strategies were associated with posttraumatic growth. Findings: Our results indicated no significant difference between the groups in terms of mental health or stress. However, Black participants showed significantly greater posttraumatic growth compared to non-Hispanic, White participants. Additionally, the coping strategies of religion and positive reframing were found to be significantly associated with posttraumatic growth. Furthermore, even with the effects of stress and coping strategies controlled for, race remained significantly associated with posttraumatic growth. Interpretation: The COVID-19 pandemic has differentially impacted Black and non-Hispanic White older adults. These results may help encourage further analysis on geriatric psychiatry as well as understanding how cultural values and adaptations impact posttraumatic growth and mental health in diverse populations. Funding: The Harvard Aging Brain Study (HABS) has been funded by NIH-NIA P01 AG036694 (PI: Reisa Sperling). The IADL study is funded by the National Institute on Aging (R01 AG053184, PI: Gad A. Marshall).

Testing positive, losing a loved one, and financial hardship: Real-world impacts of COVID-19 on US college student distress.

BACKGROUND: The COVID-19 pandemic has taken a particularly heavy toll on U.S. college students. In addition to facing academic-related stress and social pressures, these individuals are now increasingly susceptible to experiences such as contracting the virus, losing loved ones to COVID-19, or facing financial hardship due to the pandemic. The effects of such personal, pandemic-related experiences on young adult mental health - and the inherent racial disparities within these outcomes - remain largely understudied. METHODS: We analyzed 65,568 undergraduate students from the Spring 2021 American College Health Association-National College Health Assessment (ACHA-NCHA). RESULTS: The rates of the aforementioned COVID-19-related stressors were unevenly distributed across racial groups. A logistic regression analysis to identify predictors of moderate and serious psychological distress revealed that participants who had experienced the death of a loved one had 1.14 times greater odds of developing psychological distress (p < 0.0001). Those who experienced financial hardship had an odds ratio of 1.78 (p < 0.0001). Surprisingly, testing positive for COVID-19 was associated with an odds ratio of 0.82 of psychological distress (p < 0.0001). LIMITATIONS: Self-reported measures are susceptible to recall bias and misinterpretation. Exposure and outcome variables were measured simultaneously in this cross-sectional study which limits inference on causality. CONCLUSIONS: Financial burdens and bereavement are especially impactful stressors among college students during the pandemic, whereas contracting COVID-19 seemingly exhibits less impact on distress levels. When addressing student wellbeing, institutions should consider prioritizing the implementation of resources to support individuals affected by pandemic-related financial and familial losses.

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).

Prenatal distress during the COVID-19 pandemic: clinical and research implications.

PURPOSE: The objective of this study was to identify risk and protective factors related to general prenatal distress and COVID-19-specific prenatal distress to inform intervention targets among women pregnant during the COVID-19 pandemic. METHODS: The study relied on data obtained from U.S. pregnant women (N = 701) who participated in the Perinatal Experiences and COVID-19 Effects (PEACE) Study from May 21 to October 3, 2020. The present cross-sectional study examined the potential risk and protective factors associated with different features of prenatal distress among U.S. pregnant women during the COVID-19 pandemic. RESULTS: Approximately two-thirds of expectant mothers indicated being more stressed about going to the hospital because of COVID-19. Generalized anxiety and PTSD were associated with higher levels of general and COVID-19-specific prenatal distress. Depression symptoms were associated with higher general prenatal distress. Higher levels of distress tolerance were associated with lower levels of general prenatal distress (B = - 0.192, p < .001) and COVID-19-specific prenatal distress (B = - 0.089, p < .05). Higher levels of instrumental social support were marginally associated with lower COVID-19-specific prenatal distress (B = - 0.140, p < 0.1). CONCLUSION: Findings draw attention to prenatal distress experiences during the COVID-19 pandemic, including new types of distress arising from the pandemic itself. Women might benefit from the introduction of interventions such as mindfulness-based or relaxation therapy. Coverage of responsibilities and financial assistance is particularly needed during the COVID-19 pandemic. Limitations include a majority White and high socioeconomic sample. These findings provide specificity regarding potential targets for addressing prenatal distress.

Psychological risks to mother-infant bonding during the COVID-19 pandemic.

BACKGROUND: The purpose of this study was to examine the association between mental health symptoms, along with psychological experiences and coronavirus disease 2019 (COVID-19) related concerns, and self-reported maternal-infant bonding experiences of postpartum women. METHODS: Using data collected from May 19 to August 17, 2020, this cross-sectional online study assessed 429 women to better understand the impact of the COVID-19 pandemic on women during the postpartum period. Enrolled respondents were asked to participate in a 30-45-min online survey about COVID-19-related experiences, pregnancy, stress, and well-being. RESULTS: Postpartum women's depressive symptoms were related to lower quality maternal-infant bonding, but the anxiety symptoms were not associated with bonding. Maternal self-efficacy, but not social support, was associated with mothers' higher quality of maternal-infant bonding. COVID-19-related grief was significantly associated with lower quality bonding. On the other hand, COVID-19-related health worries were associated with higher quality of maternal-infant bonding. CONCLUSIONS: We describe potential psychological risk factors to maternal-infant bonding among postpartum women during the pandemic period. To best support the medical and psychological well-being of the mothers and infants, enhanced interdisciplinary partnerships among perinatal healthcare professionals involved in primary and/or specialty care is needed. IMPACT: Unique COVID-19-related health and grief concerns exist, with implications for maternal-infant bonding. Depression but not anxiety is associated with lower maternal-infant bonding. Caregiving confidence, but not social support, is associated with higher maternal-infant bonding. It is critical to screen for postpartum depression and COVID-19-related grief during maternal follow-up and pediatric visits. Study findings inform and prioritize pediatric interventions toward enhancing maternal-infant bonding during the COVID-19 era.

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.

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.

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.

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.