Psychological responses to U.S. statewide restrictions and COVID-19 exposures: A longitudinal study

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.

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.

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.

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. (PsycInfo Database Record (c) 2022 APA, all rights reserved).