Study finds state restrictions not the cause of early COVID-19 pandemic distress

Exposure to virus media coverage and personal experience, not state restrictions, were the culprit of worsening mental health at the beginning of the COVID-19 pandemic, a study found.

Noting that stay-at-home orders and social distancing, once feared to create a “parallel mental health crisis,” did not have as damaging an impact as many assumed, Rebecca R. Thompson, PhD, a postdoctoral scholar in the department of psychological science at the University of California, Irvine, and colleagues said the exact science of psychological responses associated with the pandemic remain unknown, as prior studies produced potential bias and inconclusive results.

“Thus, the extent to which strict mitigation measures are associated with psychological outcomes is still an open question, particularly in the United States, where mitigation policies varied dramatically by state over the course of the pandemic,” they wrote.

Thompson and colleagues analyzed data on 6,514 participants from the NORC AmeriSpeak Panel, which the researchers described as a probability-based panel of U.S. households. The participants completed surveys from March 18, 2020, to April 18, 2020, and Sept. 9, 2020, to Oct. 16, 2020. Their mean age was 47 years, and 52% were women.

The researchers used three measures to analyze associations between mental health and the pandemic: dependent measures, state-level independent measures and person-level independent variables.

The outcomes used for dependent measures included distress, loneliness and traumatic stress symptoms (TSS). Participants were asked about the frequency in which they had each within the last week.

For the two additional variables, participants answered questions regarding the amount of time they spent consuming COVID-19-related media, how many people they knew who got sick from COVID-19, whether they knew someone who died from COVID-19 and whether they got personally sick from COVID-19.

The researchers found that state-wide restriction indicators — state-level policy stringency and COVID-19 case and mortality rates — were not associated with psychological outcomes.

Meanwhile, all psychological outcomes were “strongly correlated” with one another, and personal experiences with COVID-19 were linked to all three outcomes, Thompson and colleagues noted.

“Having been sick with COVID-19 oneself was most strongly associated with psychological symptoms, followed by personally knowing someone who had died from COVID-19 and knowing more people who had been sick with COVID-19,” they wrote.

Thompson and colleagues found that age was negatively associated with distress, loneliness and TSS, with older age groups reporting fewer symptoms than those aged 18 to 29 years. Women were also more likely to show more symptoms than men, while non-Hispanic Black participants reported less global stress and TSS than Hispanic and white participants.

The researchers noted that the findings extend previous work in several ways, such as examining psychological implications of the general populace, not just those hospitalized with severe COVID-19.

Additionally, identifying knowing someone who died of COVID-19 as a predictor of distress “supports prior research on the association between bereavement and the stress response including psychological distress and addresses the general dearth of empirical data on the psychological impact of COVID-19-related bereavement or knowing someone sick with COVID-19,” Thompson and colleagues wrote.

The researchers concluded that understanding person-level psychological implications is critical to building large-scale public health emergency responses.

“We would encourage the public to take heed of such measures to limit the potential detrimental psychological outcomes that accompany sickness and loss,” they said.

References:

• Thompson R, et al. Health Psychol. 2022;doi:10.1037/hea0001233.
• Statewide pandemic restrictions not related to psychological distress. https://www.apa.org/news/press/releases/2022/10/pandemic-restrictions-psychological-distress. Published Oct. 17, 2022. Accessed Oct. 20, 2022.