Psychological Responses to U.S. Statewide Restrictions and COVID-19 Exposures: A Longitudinal Study

• Published in: Health psychology 2022-11, Vol.41 (11), p.817-825
• Main Authors: Thompson, Rebecca R., Jones, Nickolas M., Freeman, Apphia M., Holman, E. Alison, Garfin, Dana Rose, Silver, Roxane Cohen
• Format: Article
• Language: English
• Subjects: Adult; Coronaviruses; COVID-19; Distress; Female; Human; Humans; Loneliness; Loneliness - psychology; Longitudinal Studies; Male; Mass Media; Mitigation; Pandemics; Policy Making; Polls & surveys; Posttraumatic Stress; Psychological distress; Public health; Responses; Statistical Samples; Surveys and Questionnaires; Symptoms; Traumatic stress; United States - epidemiology
• ISSN: 0278-6133; 1930-7810
• DOI: 10.1037/hea0001233

Objective: The COVID-19 pandemic has generated debate as to whether community-level behavioral restrictions are worth the emotional costs of such restrictions. Using a longitudinal design, we juxtaposed the relative impacts of state-level restrictions and case counts with person-level direct and media-based exposures on distress, loneliness, and traumatic stress symptoms (TSS) during the COVID-19 pandemic in the United States. Method: From March 18, 2020 to April 18, 2020 and September 9, 2020 to October 16, 2020, a representative probability sample of U.S. adults (N = 5,594) completed surveys of their psychological responses and personal direct and media-based exposures to the COVID-19 pandemic. Survey data were merged with publicly available data on the stringency of state-level mitigation policies (e.g., school/business closures) during this period and longitudinal case/death counts for each state. Results: Three multilevel models (outcomes: distress, loneliness, TSS) were constructed. Measurements of dependent variables (Level 1) were nested within respondents (Level 2) who were nested within states (Level 3). State-level mitigation, cases, or deaths were not associated with any dependent variables (all p's > .05). However, person-level exposures, including having contracted COVID-19 oneself (distress b = .22, p < .001; loneliness b = .13, p = .03; TSS b = .18, p = .001), knowing others who were sick (distress b = .04, p < .001; loneliness b = .02, p < .001; TSS b = .05, p < .001) or died (distress b = .10, p = .001; loneliness b = .10, p = .003; TSS b = .16, p < .001), and exposure to pandemic-related media (distress b = .12, p < .001; loneliness b = .09, p < .001; TSS b = .16, p < .001), were positively associated with outcomes. Conclusions: Personal exposures to COVID-19 are more strongly associated with psychological outcomes than statewide mitigations levied to stop disease spread. Results may inform public health response planning for future disease outbreaks.