Abstract
BACKGROUND: College students' mental health may be disproportionally affected by the COVID-19 pandemic because of the abrupt shift off campus and subsequent loss of a social network and potential long-term impact on job prospects. OBJECTIVE: We sought to assess the nature of COVID-19's mental health impact among a sample of undergraduates who were experiencing the pandemic as it occurred in real time. METHODS: In total, 140 college students completed smartphone-based ecological momentary assessments of anxiety and optimism related to COVID-19 and other generic mental health variables 6 times daily. RESULTS: Participants completed >23,750 surveys. Overall, >75% of these surveys indicated at least some level of anxiety about COVID-19. On average, the proportion of responses each day at the highest levels of anxiety about COVID-19 was 7 times greater than the proportion of responses at the highest levels of non-COVID-19-specific anxiety. Structural change analyses indicated a significant downward trend in COVID-19 anxiety after the first week of June, but even at the lowest point, >15% of the participants in the sample still reported high levels of COVID-19 anxiety each day. Participants felt more anxious about COVID-19 on days when the number of new cases and deaths due to COVID-19 were higher. When participants felt anxious about COVID-19, they also felt sad, anxious (in general), and had a greater desire to drink and use drugs. Participants felt more optimistic about COVID-19 when they received more support from others and from their university. CONCLUSIONS: This study demonstrated the widespread mental health impact that COVID-19 has had on college students.