COVID-19 anxiety's influence on obsessive compulsive symptoms among African American young adults

Black/African American young adults experienced disproportionate pandemic burdens that may have amplified obsessive-compulsive (OC) symptoms. The current study tested whether COVID-19 anxiety (COV-A) related to OC symptoms directly and indirectly via psychological inflexibility (PI; or lower psychological flexibility, PF). A national sample of 591 Black/African American young adults (M_age = 23.6, SD = 3.4; 67.8% female) completed the Coronavirus Anxiety Scale (COV-A), the Acceptance and Action Questionnaire-II (PI), and the Dimensional Obsessive-Compulsive Scale (OC symptoms) between October 2020 and February 2022. Path analysis (Mplus 8.11) adjusted for age, gender, and socioeconomic status; indirect effects were bootstrapped (1000 draws). The path analysis model fit well (χ²[6] = 9.72, p = .14; RMSEA = 0.032, 90% CI [0.000,0.068]; CFI = 0.988; TLI = 0.976; SRMR = 0.024) and explained 40% of OC-symptom variance (R² = 0.40). Higher COV-A predicted greater OC symptoms (β = 0.471, SE = 0.033, p < .001) and greater PI (β = 0.232, SE = 0.047, p < .001); higher PI predicted greater OC symptoms (β = 0.327, SE = 0.040, p < .001). The indirect effect of COV-A on OC symptoms via PI was significant (β = 0.076, 95% CI [0.05,0.10], p < .001). Among Black/African American young adults, pandemic-specific anxiety was robustly associated with OC symptoms, partly through PI. Findings highlight the importance of considering pandemic-related stressors when assessing OC symptoms in Black young adults. Findings also underscore the importance of culturally responsive interventions that cultivate PF and address sociocultural stressors, such as COV-A, when treating Black young adults with OC symptoms.