A bar graph that shows the Chapman University National COVID-19 and Mental Health Survey findings on the perceptions of how COVID-19 has influenced mental health in the past week. Courtesy of Chapman University

The Chapman University National COVID-19 and Mental Health Survey provides an in-depth look at the experiences of 4,149 adults living in the United States. The study asked questions about how the COVID-19 pandemic is impacting people's mental health, physical health, romantic relationships and encounters of prejudice and discrimination.

What Are the Effects of COVID-19 on Mental Health and Behaviors?

Conducted at the end of April 2020, survey findings revealed that most people are staying home more than normal (89%), and the majority reported feeling more stressed (61%), nervous, anxious, or on edge (60%), and feeling down, depressed, or hopeless (45%) than normal due to the effects of the COVID-19 pandemic. People attributed the changes in their health behaviors to the pandemic, with about one-third reporting eating more because of stress (37%), eating more junk food (41%) and getting less exercise (35%).

"As a nation, we have focused a lot of attention on the physical health risks of COVID-19 and not nearly as much on the mental health," said David Frederick, PhD, an associate professor of health psychology who led an all-Chapman team of researchers to conduct this study at the height of the pandemic. "We know from past research that natural disasters, epidemics and chronic stressors all harm our mental health, but what we're experiencing now is radically different than any of those previous experiences. The scale is so much larger."

The data also shows that essential workers like grocery store clerks, delivery personnel and restaurant employees are facing even worse mental and physical health problems. People in these occupations, where they are currently exposed to many people during the day, report more loneliness, anxiety, depression, negative emotions, negative health symptoms in the past week and more flu-like symptoms in the past month.

About half of respondents are "very concerned" about catching COVID-19 (54%), but about 42% believe their chances of catching the coronavirus are very low. Surprisingly, essential workers did not differ from other people in their concerns about catching COVID-19. Similar results were found for people who identified as being in a "frontline" job, such as healthcare professionals and police officers, where they did not perceive greater overall risks to COVID-19.

How is COVID-19 Affecting Romantic Relationships?

A snapshot of how people's romantic and sex lives were changing during the pandemic was analyzed from 2,702 survey participants who reported being in a long-term relationship. Sixty-four percent (64%) are spending more time with their partner, and the average couple snuggled four times and said "I love you" six times during the past week. Additionally, about one-fourth reported having fewer arguments with their partner in the past week (24%) while one-fourth reported having more arguments than normal (25%).

"Most people are spending more time with their romantic partner. For some couples, the silver lining is that they are getting to connect with their partner. For others, staying home together allows little stressors to build and blow up which then promotes conflict over existing disagreements," Frederick said.

A subset of people reported wanting to have sex more often with their partner (31%), versus only 22% who want sex less often than normal. Only 19% of the survey participants are having sex more often.

"Some couples are experiencing a disconnect sexually -- this is not surprising. One partner may want to have sex while the other partner is not interested at the moment," said co-investigator Amy Moors, PhD, assistant professor of psychology at Chapman and research fellow at The Kinsey Institute. "Anxiety and stress regarding health, finances, and a host of other thoughts that consume our cognitive energy can make it challenging to feel in the mood."

Among Ethnic Minorities, Do They Perceive Prejudice or Discrimination Related to Their Ethnicity and COVID-19?

The survey asked ethnic minorities to think about their experiences since the COVID-19 pandemic started and if they had experienced any incidents that they think were motivated specifically by connections between their ethnicity and COVID-19.

Thirty-two percent of Asian Americans and 38% of Chinese Americans reported at least one incident of racism. One-fourth of the Chinese Americans surveyed say they have experienced three or more racist incidents (25%). These include rude comments, feeling unwelcome, being told to "go back" to their country, or being physically threatened.

Black Americans, who have been hardest hit as a group by COVID-19, were next most likely to report at least one incident (26%) and three or more incidents (21%).

Among both Blacks and Asians, experiencing more racist incidents was linked to greater stress, loneliness, anxiety, depression, negative emotions and number of health symptoms in the past week.

"I am troubled by these findings," said Jason Douglas, PhD, assistant professor of public health at Chapman and one of the researchers on the study. "We need clear and consistent messaging to indicate that viral pandemics do not stem from our ethnocultural minority communities. Rather, residents living in disadvantaged, ethnocultural minority communities are at greater risk for COVID-19 related morbidity and mortality due to longstanding systemic inequities that unfairly limit access to health-protective resources."

How Are People Coping with the COVID-19 Pandemic?

The most frequently used coping strategy was distraction through activities such as exercising, gardening, or watching television (69%). About half of people reported trying to find meaning in the experience by looking for something good in what was happening (48%). Thirty-six percent said that they have received comfort and understanding from someone, while 31% said that they found comfort in their religion or spiritual beliefs.

"How people cope in times of stress is very important," said Brooke Jenkins, Ph.D., assistant professor of health psychology at Chapman and one of the study's authors. "When stress is more outside of our control, techniques like distraction and reappraisal are beneficial. For example, if you feel that you have to stay home and that is outside of your control, then engaging in distracting activities like TV, gardening and exercise can be quite helpful."

For stress that seems more controllable, Jenkins recommends engaging in active coping. "For example, if you feel that you can actively reduce your risk of exposure to COVID-19, then getting advice from others and taking action to improve your situation will likely be helpful," she said.

The researchers saw that people who "took action to make their situation better" and who "looked for something good in what is happening" reported as having the best mental health. In contrast, people who gave up trying to deal with it, used drugs or alcohol, or said things to let unpleasant feelings escape tended to have worse mental health.

"The pandemic is creating many different stresses for people, there is no single strategy that will be optimal for coping with all of them," said Tara Gruenewald, PhD, associate professor of psychology at Chapman and project co-investigator. "A good rule of thumb is to gravitate toward those forms of healthy stress management you normally engage in, whether that is exercise, a good book, a favorite hobby, meditation or connecting with others. Of course, being safe and avoiding infection means we have to alter the way we engage in these activities, but the important thing is to make time to do them."

Methodology

The survey was conducted online through Amazon's Mechanical Turk. The survey asked participants to think about the effect that the COVID-19 pandemic has had on their lives within the past week. Only the 4,149 participants who passed standard data quality checks were analyzed. The study uses a national dataset from all 50 states, but the sample is not nationally representative. The sample included adults age 18 and older with the average age being 39. The survey was listed as the "Personal Attitudes and Experiences Study" to draw in a wide range of participants.

In addition to principal investigator David Frederick, the co-investigators of the study include Laura Glynn, Tara Gruenewald, David Pincus, Julia Boehm, Amy Moors, Brooke Jenkins, Vincent Berardi, Georgiana Bostean, Jo Armour Smith, Jason Douglas, and Jennifer Robinette from Chapman University Center for Excellence in Biopsychosocial Approaches to Health.

The study was funded by a grant from the Kay Family Foundation. The Chapman University National COVID-19 and Mental Health Survey continues as the authors recruit additional participants and follow current respondents over time. Those who are interested in completing the survey can do so online and will be entered into a lottery for a $250 stipend: https://www.surveymonkey.com/r/PAESsurveySM

For the full report and infographics, visit chapman.edu/mentalhealthsurvey.

Source: Chapman University