Falling Behind and Feeling Bad: Unmet Expectations and Mental Health during the Transition to Adulthood

2021 ◽  
pp. 215686932199189
Author(s):  
Elizabeth Culatta ◽  
Jody Clay-Warner

How do perceived expectations of what it means to be an adult affect mental health? We draw from life course and social psychological literature to argue that falling behind perceived expectations for reaching markers of adulthood is associated with depression and anxiety. We test predictions with data from an original sample of more than five hundred 18- to 29-year-olds in the United States. Consistent with predictions, we find a positive relationship between falling behind expectations and both anxiety and depression even while controlling for own expectations about the accomplishment of markers of adulthood. In particular, we find that falling behind perceived expectations of peers regarding markers of adulthood is associated with anxiety and that falling behind perceived expectations of parents and society regarding markers of adulthood is associated with depressive symptoms.

2021 ◽  
Author(s):  
Adrian Aguilera ◽  
Rosa Hernandez-Ramos ◽  
Alein Yaritza Haro ◽  
Claire Elizabeth Boone ◽  
Tiffany Luo ◽  
...  

BACKGROUND Social distancing and stay-at-home orders are critical interventions to slow down person-to-person transmission of COVID-19. While these societal changes help to contain the pandemic, they also have unintended negative consequences, including anxiety and depression. We developed StayWell, a daily skills-based SMS text messaging program, to mitigate COVID-19 related depression and anxiety symptoms among people who speak English and Spanish in the United States. OBJECTIVE This paper describes the changes in the anxiety and depression levels of participants in the StayWell program after 60 days of exposure to skills-based SMS text messages. METHODS We used self-administered, empirically supported web-based questionnaires to assess the demographic and clinical characteristics of StayWell participants. Anxiety and depression were measured using the 2-item Generalized Anxiety Disorder (GAD-2) scale and the 8-item Patient Health Quesstionanire-8 (PHQ-8) scale at baseline and 60-day timepoints. We used paired t-tests to detect the change in PHQ-8 and GAD-2 scores from baseline to follow-up measured 60 days later. RESULTS The analytic sample includes 193 participants who completed both the baseline and 60-day exit questionnaires. At the 60-day time point, there were statistically significant reductions in both PHQ-8 and GAD-2 scores from baseline. We found an average reduction of -1.72 (95% CI: -2.35, -1.09) in PHQ-8 scores and -0.48 (95% CI: -0.71, -0.25) in GAD-2 scores. This translated to an 18.5% and 17.2% reduction in mean PHQ-8 scores and GAD-2, respectively. CONCLUSIONS StayWell is a low-intensity, cost-effective, and accessible population-level mental health intervention. Participation in StayWell focused on COVID-19 mental health coping skills and was related to improved depression and anxiety symptoms. In addition to improvements in outcomes, we found high levels of engagement during the 60-day intervention period. Text messaging interventions could serve as an important public health tool for disseminating strategies to manage mental health. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT04473599 INTERNATIONAL REGISTERED REPORT RR2-10.2196/23592


2021 ◽  
Author(s):  
Roy H. Perlis ◽  
Jon Green ◽  
Matthew D Simonson ◽  
David Lazer ◽  
Matthew Baum ◽  
...  

With rapid progress toward vaccination in the United States along with falling COVID-19 case rates and a reopening economy, federal and state leaders speak optimistically about a return to normalcy this summer. But as cases diminish, have the unprecedented rates of depression and anxiety documented in our reports, and in other US surveys, also begun to normalize? On the one hand, as a recent New York Times op-ed notes, people in general are remarkably resilient. And in our prior work we showed that depression and anxiety were tied closely to economic stress; as the economy improves, we might expect mental health to improve as well. On the other hand, the impact of a year of COVID-19 quarantine and fear of illness – perhaps compounded by political and societal turmoil – might not resolve so readily.In this report, we characterize rates of depression, anxiety, and sleep disturbance, as we have done on a regular basis since May 2020. We used a standard screening measure drawn from primary care, the Patient Health Questionnaire-9 (PHQ-9), which asks about the symptoms of major depression, as well as 2 items that ask about anxiety (the Generalized Anxiety Disorder-2, or GAD-2). We define major depression as a score on the PHQ-9 of 10 or greater, or moderate depression, often the point at which an individual would be referred for treatment. Sleep disruption and thoughts of suicide are defined based on items on the PHQ-9.


10.2196/22817 ◽  
2020 ◽  
Vol 22 (9) ◽  
pp. e22817 ◽  
Author(s):  
Xiaomei Wang ◽  
Sudeep Hegde ◽  
Changwon Son ◽  
Bruce Keller ◽  
Alec Smith ◽  
...  

Background Evidence suggests that the COVID-19 pandemic has generally increased levels of stress and depression among the public. However, the impact on college students in the United States has not been well-documented. Objective This paper surveys the mental health status and severity of depression and anxiety of college students in a large university system in the United States during the COVID-19 pandemic. Methods An online survey was conducted among undergraduate and graduate students recruited from Texas A&M University via email. The survey consisted of two standardized scales—the Patient Health Questionnaire-9 and the General Anxiety Disorder-7—for depression and anxiety, and additional multiple-choice and open-ended questions regarding stressors and coping mechanisms specific to COVID-19. Results Among the 2031 participants, 48.14% (n=960) showed a moderate-to-severe level of depression, 38.48% (n=775) showed a moderate-to-severe level of anxiety, and 18.04% (n=366) had suicidal thoughts. A majority of participants (n=1443, 71.26%) indicated that their stress/anxiety levels had increased during the pandemic. Less than half of the participants (n=882, 43.25%) indicated that they were able to cope adequately with the stress related to the current situation. Conclusions The proportion of respondents showing depression, anxiety, and/or suicidal thoughts is alarming. Respondents reported academic-, health-, and lifestyle-related concerns caused by the pandemic. Given the unexpected length and severity of the outbreak, these concerns need to be further understood and addressed.


2019 ◽  
Author(s):  
John Hellen Keller

According to the Anxiety and Depression Association of America (ADAA), “Anxiety disorders are the most common mental illness in the U.S., affecting 40 million adults in the United States age 18 and older, or 18.1% of the population every year.”Although anxiety and depression are separate conditions, many people who suffer with depression also have anxiety or vice versa. The ADAA states, “Nearly one-half of those diagnosed with depression are also diagnosed with an anxiety disorder.” A Psychology Today article also points out the fact that researchers and doctors have been shifting toward a new conclusion about the disorders, stating, “Depression and anxiety are not two disorders that coexist. They are two faces of one disorder.”


2021 ◽  
pp. 002087282096342
Author(s):  
Sherinah Saasa ◽  
David Okech ◽  
Yoon Joon Choi ◽  
Larry Nackerud ◽  
Tenesha Littleton

This study examined the effects of social exclusion (socio-cultural and structural-economic exclusion) on the mental health and social well-being of African immigrants in the United States ( N = 409). We found that social exclusion increased depression and anxiety symptoms, decreased societal trust, increased subjective isolation, and increased worries about one’s safety among African immigrants. The results further indicated strong negative effects of discrimination on mental health and social well-being. The findings highlight the need for social work interventions that target discrimination and structural exclusionary mechanisms in efforts to improve the mental health and social well-being of African immigrants in the United States.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Anastasia Shuster ◽  
Madeline O’Brien ◽  
Yi Luo ◽  
Laura A. Berner ◽  
Ofer Perl ◽  
...  

AbstractCrises such as the COVID-19 pandemic are known to exacerbate depression and anxiety, though their temporal trajectories remain under-investigated. The present study aims to investigate fluctuations in depression and anxiety using the COVID-19 pandemic as a model crisis. A total of 1512 adults living in the United States enrolled in this online study beginning April 2, 2020 and were assessed weekly for 10 weeks (until June 4, 2020). We measured depression and anxiety using the Zung Self-Rating Depression scale and State-Trait Anxiety Inventory (state subscale), respectively, along with demographic and COVID-related surveys. Linear mixed-effects models were used to examine factors contributing to longitudinal changes in depression and anxiety. We found that depression and anxiety levels were high in early April, but declined over time. Being female, younger age, lower-income, and previous psychiatric diagnosis correlated with higher overall levels of anxiety and depression; being married additionally correlated with lower overall levels of depression, but not anxiety. Importantly, worsening of COVID-related economic impact and increase in projected pandemic duration exacerbated both depression and anxiety over time. Finally, increasing levels of informedness correlated with decreasing levels of depression, while increased COVID-19 severity (i.e., 7-day change in cases) and social media use were positively associated with anxiety over time. These findings not only provide evidence for overall emotional adaptation during the initial weeks of the pandemic, but also provide insight into overlapping, yet distinct, factors contributing to depression and anxiety throughout the first wave of the pandemic.


Author(s):  
Wändi Bruine de Bruin

Abstract Objectives Theories of aging posit that older adult age is associated with less negative emotions, but few studies have examined age differences at times of novel challenges. As COVID-19 spread in the United States, this study therefore aimed to examine age differences in risk perceptions, anxiety, and depression. Method In March 2020, a nationally representative address-based sample of 6,666 U.S. adults assessed their perceived risk of getting COVID-19, dying if getting it, getting quarantined, losing their job (if currently working), and running out of money. They completed a mental health assessment for anxiety and depression. Demographic variables and precrisis depression diagnosis had previously been reported. Results In regression analyses controlling for demographic variables and survey date, older adult age was associated with perceiving larger risks of dying if getting COVID-19, but with perceiving less risk of getting COVID-19, getting quarantined, or running out of money, as well as less depression and anxiety. Findings held after additionally controlling for precrisis reports of depression diagnosis. Discussion With the exception of perceived infection-fatality risk, U.S. adults who were relatively older appeared to have a more optimistic outlook and better mental health during the early stages of the pandemic. Interventions may be needed to help people of all ages maintain realistic perceptions of the risks, while also managing depression and anxiety during the COVID-19 crisis. Implications for risk communication and mental health interventions are discussed.


Author(s):  
Xiaomei Wang ◽  
Sudeep Hegde ◽  
Changwon Son ◽  
Bruce Keller ◽  
Alec Smith ◽  
...  

BACKGROUND Evidence suggests that the COVID-19 pandemic has generally increased levels of stress and depression among the public. However, the impact on college students in the United States has not been well-documented. OBJECTIVE This paper surveys the mental health status and severity of depression and anxiety of college students in a large university system in the United States during the COVID-19 pandemic. METHODS An online survey was conducted among undergraduate and graduate students recruited from Texas A&M University via email. The survey consisted of two standardized scales—the Patient Health Questionnaire-9 and the General Anxiety Disorder-7—for depression and anxiety, and additional multiple-choice and open-ended questions regarding stressors and coping mechanisms specific to COVID-19. RESULTS Among the 2031 participants, 48.14% (n=960) showed a moderate-to-severe level of depression, 38.48% (n=775) showed a moderate-to-severe level of anxiety, and 18.04% (n=366) had suicidal thoughts. A majority of participants (n=1443, 71.26%) indicated that their stress/anxiety levels had increased during the pandemic. Less than half of the participants (n=882, 43.25%) indicated that they were able to cope adequately with the stress related to the current situation. CONCLUSIONS The proportion of respondents showing depression, anxiety, and/or suicidal thoughts is alarming. Respondents reported academic-, health-, and lifestyle-related concerns caused by the pandemic. Given the unexpected length and severity of the outbreak, these concerns need to be further understood and addressed.


2021 ◽  
Author(s):  
Dara H Sorkin ◽  
Emily A Janio ◽  
Elizabeth V Eikey ◽  
Margaret Schneider ◽  
Katelyn Davis ◽  
...  

BACKGROUND Accompanying the rising rates of reported mental distress during the COVID-19 pandemic has been a reported increase in the use of digital technologies to manage health generally, and mental health more specifically. OBJECTIVE The objective of this study was to systematically examine whether there was a COVID-19 pandemic–related increase in the self-reported use of digital mental health tools and other technologies to manage mental health. METHODS We analyzed results from a survey of 5907 individuals in the United States using Amazon Mechanical Turk (MTurk); the survey was administered during 4 week-long periods in 2020 and survey respondents were from all 50 states and Washington DC. The first set of analyses employed two different logistic regression models to estimate the likelihood of having symptoms indicative of clinical depression and anxiety, respectively, as a function of the rate of COVID-19 cases per 10 people and survey time point. The second set employed seven different logistic regression models to estimate the likelihood of using seven different types of digital mental health tools and other technologies to manage one’s mental health, as a function of symptoms indicative of clinical depression and anxiety, rate of COVID-19 cases per 10 people, and survey time point. These models also examined potential interactions between symptoms of clinical depression and anxiety, respectively, and rate of COVID-19 cases. All models controlled for respondent sociodemographic characteristics and state fixed effects. RESULTS Higher COVID-19 case rates were associated with a significantly greater likelihood of reporting symptoms of depression (odds ratio [OR] 2.06, 95% CI 1.27-3.35), but not anxiety (OR 1.21, 95% CI 0.77-1.88). Survey time point, a proxy for time, was associated with a greater likelihood of reporting clinically meaningful symptoms of depression and anxiety (OR 1.19, 95% CI 1.12-1.27 and OR 1.12, 95% CI 1.05-1.19, respectively). Reported symptoms of depression and anxiety were associated with a greater likelihood of using each type of technology. Higher COVID-19 case rates were associated with a significantly greater likelihood of using mental health forums, websites, or apps (OR 2.70, 95% CI 1.49-4.88), and other health forums, websites, or apps (OR 2.60, 95% CI 1.55-4.34). Time was associated with increased odds of reported use of mental health forums, websites, or apps (OR 1.20, 95% CI 1.11-1.30), phone-based or text-based crisis lines (OR 1.20, 95% CI 1.10-1.31), and online, computer, or console gaming/video gaming (OR 1.12, 95% CI 1.05-1.19). Interactions between COVID-19 case rate and mental health symptoms were not significantly associated with any of the technology types. CONCLUSIONS Findings suggested increased use of digital mental health tools and other technologies over time during the early stages of the COVID-19 pandemic. As such, additional effort is urgently needed to consider the quality of these products, either by ensuring users have access to evidence-based and evidence-informed technologies and/or by providing them with the skills to make informed decisions around their potential efficacy.


2021 ◽  
Author(s):  
Dante Mack ◽  
Alex DaSilva ◽  
Courtney Rogers ◽  
Elin Hedlund ◽  
Eilis Murphy ◽  
...  

BACKGROUND Since late 2019, the lives of people across the globe have been disrupted by COVID-19. Millions of people have become infected; billions have been continually asked or required by local and national governments to change their behavioral patterns. Previous research on the COVID-19 pandemic suggests that it is associated with large-scale behavioral and mental health changes, but few studies have been able to track these changes with frequent, near real-time sampling or compare these changes to previous years of data for the same individuals. OBJECTIVE By combining mobile phone sensing and self-reported mental health data in a cohort of college-aged students enrolled in a longitudinal study, we seek to understand the behavioral and mental health impacts associated with the pandemic, measured by search term interest in "coronavirus" and "covid fatigue" across the United States. METHODS Behaviors such as the number of locations visited, distance traveled, duration of phone usage, number of phone unlocks, sleep duration, and sedentary time were measured using the StudentLife mobile smartphone sensing app. Depression and anxiety were assessed using weekly self-reported Ecological Momentary Assessments (EMAs), including the Patient Health Questionnaire-4 (PHQ-4). Participants were 217 undergraduate students. Differences in behaviors and self-reported mental health collected during the Spring 2020 term, as compared to previous terms in the same cohort, were modeled using mixed linear models. RESULTS Linear mixed models observed differences in phone usage, sleep, sedentary time and the number of locations visited associated with the COVID-19 pandemic. In further models, these behaviors were strongly associated with increased interest in covid fatigue. When mental health metrics (e.g., depression and anxiety) were added to the previous measures (week of term, number of locations visited, phone usage, sedentary time), both anxiety and depression (_P_<.001) were significantly associated with interest in covid fatigue. Notably, these behavioral and mental health changes are consistent with those observed around the initial implementation of COVID-19 lockdowns in the spring of 2020 [@Huckins2020]. CONCLUSIONS In the initial lockdown phase of the COVID-19 pandemic, people spent more time on their phones, were more sedentary, visited fewer locations, and exhibited increased symptoms of anxiety and depression. As the pandemic persisted through the spring, people continued to exhibit very similar changes in both mental health and behaviors. Though unsurprising, understanding these large-scale shifts in mental health and behaviors is critical in disrupting the negative consequences to mental health during the ongoing pandemic. INTERNATIONAL REGISTERED REPORT RR2-https://doi.org/10.31234/osf.io/8yt4x


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