Psychological distress across 2 years of the COVID-19 pandemic differs by age and by race/ethnicity.

Abstract

The COVID-19 pandemic profoundly impacted mental health, with psychological distress varying across age and racial/ethnic groups. This study examined trajectories of five distress measures-symptoms of posttraumatic stress (PTS), anxiety, depression, anger, and somatization-over the first 2 years of the pandemic, adjusting for prepandemic mental health. Participants in a nationally representative, probability-based U.S. sample (N = 4,298, age range: 18-97 years) completed four online surveys from March 2020 to June 2022. Multilevel models revealed that symptom levels and changes over time varied by age group across outcomes. Across time, PTS and anxiety symptoms declined for most age groups at different rates, F(6, 85,660) = 6.21, p < .001. Younger adults initially reported higher PTS symptom levels at Wave 1, Bs = 0.10-0.14, p < .001, but levels converged across age groups by Wave 4. Rates of anxiety symptoms were similar across age groups at Wave 4 except for older adults, who reported significantly lower levels. Depressive symptoms and anger increased in the initial waves but declined by Wave 4, Bs = -0.25-0.02, p < .001. For all participants, somatization increased after Wave 1, B = -0.30, p < .001, and never returned to initial levels, B = -0.04, p < .001. Additionally, somatization was the only symptom with similar levels across age groups at each wave. Across race/ethnicity, Hispanic adults reported higher distress and less decline over time. Findings highlight distinct symptom trajectories across the pandemic, with generally lower distress levels among the oldest adults.