


































Global Research in Higher Education 
ISSN 2576-196X (Print) ISSN 2576-1951 (Online) 

Vol. 4, No. 4, 2021 

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1 

 

Original Paper 

College Students’ Well-being during the COVID-19 Pandemic: 

A Systematic Review of the Literature 

Michaela Q. Iglesia
1*

 & Ming-Tsan Lu
2
 

1
 University of Texas Rio Grande Valley, School of Medicine, Edinburg, TX 78539, USA  

2
 University of Texas Rio Grande Valley, Department of Teaching and Learning, Edinburg, TX 78539, 

USA 

*
 Michaela Q. Iglesia, E-mail: michaela.iglesia01@utrgv.edu 

 

Received: June 10, 2021      Accepted: August 9, 2021     Online Published: November 29, 2021 

doi:10.22158/grhe.v4n4p1              URL: http://dx.doi.org/10.22158/grhe.v4n4p1 

 

Abstract 

Studies have shown increased levels of distress during the coronavirus disease-19 (COVID-19) 

pandemic, and college students are becoming more recognized as a vulnerable population. This 

narrative systematic review aims to synthesize the current understanding of mental health, lifestyle, 

and socioeconomic impacts that the pandemic had on college students in the United States. A search 

was conducted on PubMed, PsycInfo, and Web of Science. A total of 34 observational studies were 

included which examined aspects of college students’ health and experiences during the COVID-19 

pandemic in the United States. A great deal of students was shown to experience a moderate level of 

stress and subsyndromal depression and anxiety in the early months of the COVID-19 pandemic. 

Several risk and protective factors have been characterized. Students experienced various academic, 

financial, and housing disruptions. Studies have highlighted the need for institutional support to reduce 

the adverse psychological impact of the pandemic. There is a need for further large-scale research to 

assess the scope of COVID-19-related biopsychosocial impact, especially in vulnerable populations 

such as racial/ethnic and sexual/gender minorities. 

Keywords 

mental health, COVID-19, college students, psychological, depression, anxiety 

 

 

 

 

 



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1. Introduction 

The coronavirus disease-2019 (COVID-19) pandemic abruptly changed people’s daily routines and 

continues to affect how people live across the globe. Self-care includes various behaviors, such as 

healthy eating, exercise, relaxation, social connection, spirituality. Many of these aspects have been 

affected by restrictions and changes instated during the COVID-19 pandemic that may have prevented 

people from practicing their usual health-related behaviors or added a substantial amount of 

uncertainty. 

Several studies have been conducted across the globe to study mental health in young adults (18-29 

years old) and college students. The current understanding is that young adults are suffering from 

relatively high rates of perceived stress and that symptoms of depression and anxiety are common 

psychological reactions to the pandemic (Rajkumar, 2020; Xiong et al., 2020). At baseline, the college 

student population is particularly vulnerable to stress due to concerns related to academic performance, 

finances, interpersonal relationships, and post-graduation plans (Beiter et al., 2015). Psychosocial 

challenges are therefore compounded when faced with public health emergencies.  

There is a growing volume of literature available on this topic. It is important to evaluate the current 

evidence and determine trends in results to inform future research and interventions. The purpose of the 

study is to identify manifestations of psychological distress among college students, common coping 

behaviors, and challenges to managing self-care. The current review was designed to summarize the 

existing literature addressing health concerns among college students during the COVID-19 pandemic. 

Limitations to the existing literature should be addressed in future research. To our knowledge, this is 

the first review of the literature on this topic in this population to date.  

 

2. Method 

This article is a narrative review of the existing literature on mental health symptoms and behaviors 

during the COVID-19 pandemic.  

2.1 Information Sources & Eligibility Criteria 

Three online databases (PubMed, American Psychological Association PsychInfo, and Web of 

Sciences) were searched for relevant articles. Studies were included if they were observational in 

nature (cross-sectional, cohort, ecological), examined college students older than 18 years of age in the 

United States, and available in English language. They had to include information on aspects of 

well-being, such as stress, anxiety, depression, or health-related behaviors. 

2.2 Search Methodology 

A literature search was conducted with the search terms: ―college students‖ or ―university students‖ 

and ―mental health‖ or ―health‖ or ―stress‖ or ―depression‖ and ―pandemic‖ or ―covid-19‖ or 

―coronavirus‖. The search was filtered such that only results available in English from 2020 to 2021 

were included. If possible, a location filter for the United States was applied. 



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2.3 Study Selection & Data Collection 

After initial review, studies were screened by title and abstract to determine potential relevance. The 

full-text articles determined to be relevant were assessed for inclusion in the review. Data were taken 

directly from articles. No contact was made with authors of the publications to obtain raw data or 

confirm results. 

 

3. Result 

Well-being is multifactorial and can be approached from various disciplines. Therefore, there is a wide 

variety of study designs, analytical processes, and assessed outcomes. It is important to summarize this 

information from the breadth of sources available. Due to the heterogeneity of study designs, including 

assessment scales used, it was decided not to conduct a formal meta-analysis at this time. A narrative 

review was conducted to analyze the various methods used, categorize salient themes, and summarize 

the current literature. 

3.1 Study Selection 

Results from study selection are shown in the study flow diagram in Figure 1. On the initial search, 134 

studies were identified. Duplicates (n=32) were removed. Titles and abstracts of 101 articles were 

screened to confirm the location of study. International studies and studies taking place outside the 

United States were excluded, resulting in exclusion of 40 articles. Full-text articles were then retrieved 

and assessed for eligibility. Only original research papers were included; letters to the editor (n=3), 

editorials or commentary related to mental health (n=11), and reviews (n=3) were excluded. 12 articles 

were also excluded based on sample characteristics (n=4; e.g., sample not limited to college students) 

and subject matter (n=8; e.g., therapeutic interventions). The remaining 34 publications are included in 

this review. Characteristics of each study, including design, location, sample, and findings are shown in 

Appendix A.  



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Records identified from: 
PubMed (n = 43) 
APA PsychInfo (n = 19) 
Web Of Science (n = 72) 

Records removed before 
screening: 

Duplicate records removed  
(n = 32) 

Records screened 
(n = 101) 

Records manually excluded due 
to location outside of United 
States (n = 40) 

Reports sought for retrieval 
(n = 64) 

Reports not retrieved 
(n = 1) 

Reports assessed for eligibility 
(n = 63) Reports excluded: 

Incorrect article type (n = 17) 
Lack of relevance (n = 8) 
Sample not limited to college 
students (n = 4) 

Studies included in review 
(n = 34) 

Identification of studies via databases 

 

Figure 1. Study PRISMA Flow Diagram 

 

3.2 Study Characteristics 

3.2.1 Sample Characteristics 

The number of subjects in the studies included ranged from 49 to 5,547, with an average of 766. 25 

studies took place at one institution alone. Many of these institutions are located in the South (n=11) 

and Northeast (n=9) regions of the country. Two studies were conducted across more than one 

institution (Browning et al., 2021; Eden et al., 2020). Six studies recruited nationwide samples via 

social media, such as Facebook and Instagram (Cohen et al., 2020; Conrad et al., 2021; Firkey et al., 

2021; Gonzales et al., 2020; Hoyt et al., 2021; Melcher et al., 2021).
 

All studies recruited full-time students and were typically open to all programs of study and both 

undergraduate and graduate levels. One study included examined only social work students (Lawrence 

et al., 2021). Articles on students in other health professions, such as medicine, nursing, and pharmacy, 

were typically commentaries or took place outside of the United States and were therefore excluded. 



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Percentage of female participants ranged from 42.4%
 
(Eden et al., 2020) to 93%

 
(Kibbey et al., 2021) 

with an average of 67.96%. 

3.2.2 Study Designs 

All 34 studies were observational in design. The majority of studies (n=24) were cross-sectional, with 

data collection between the months of March and August 2020. 11 studies were longitudinal in design 

(Copeland et al., 2021; Fruehwirth et al., 2021; Haft & Zhou, 2021; Hoyt et al., 2021; Huckins et al., 

2020; Kleiman et al., 2020; Krendl, 2021; Maher et al., 2021; Melcher et al., 2021; Rettew et al., 2021; 

Wang et al., 2020). Of these, eight studies included baseline data from before the COVID-19 outbreak 

was classified as a pandemic by the World Health Organization in March 2020 (Copeland et al., 2020; 

Fruehwirth et al., 2021; Haft & Zhou, 2021; Huckins et al., 2020; Krendl, 2021; Maher et al., 2021; 

Zhang et al., 2020). Of the longitudinal studies, six utilized surveys alone (Fruehwirth et al., 2021; Haft 

& Zhou, 2021; Hoyt et al., 2021; Krendl, 2021; Maher et al., 2021; Wang et al., 2020) and five utilized 

Ecological Momentary Assessments (EMA) (Copeland et al., 2021; Huckins et al., 2020, Kleiman et al., 

2020; Melcher et al., 2021; Rettew et al., 2021). EMAs involved repeated sampling of behaviors and 

experiences in real time. These required access to a mobile application on a smartphone through which 

participants could answer daily questions and researchers could collect anonymized data. Response 

rates of longitudinal studies ranged from 30.6% to 100%, with an average of 73.53% follow-up. 

Overall, two surveys included an interview component that was conducted virtually (Melcher et al., 

2021; Son et al., 2020). 

Most survey questionnaires (n=29) included at least one standard validated scale to assess for 

symptoms of depression or anxiety or experiences of stress. Other survey questions addressed other 

aspects of student experiences such as stress-reducing behaviors, socioeconomic and academic 

disruptions, and COVID-19-related concerns. Likert scales were used more often than open-ended free 

response answer formats.  

3.2.3 Commonly Used Measures 

Commonly used measures included in surveys were analyzed and are summarized below.  

Patient Health Questionnaire. Depressive symptoms were assessed by eight studies using long forms 

of the Patient Health Questionnaire (PHQ) (Conrad et al., 2021; Fruehwirth et al., 2021; Krendl, 2021; 

Lawrence et al., 2021; Lechner et al., 2020; Melcher et al., 2021; Wang et al., 2020; Zhang et al., 2020). 

The 9-item PHQ (PHQ-9) is widely used in primary care settings to screen for depression and has 

demonstrated very good internal consistency with a Cronbach alpha of 0.89 (Kroenke et al., 2001).
 

Participants were asked to rate on a 4-point Likert scale how often they experienced depressive 

symptoms over the past two weeks. Of these studies, five utilized the full 9-item questionnaire, while 

three used the 8-item version, which omits the item regarding suicidal ideation. Possible scores range 

from 0 to 27. Scores from 5 to 9, 10 to 14, 15 to 19, and 20 to 27 indicate mild, moderate, moderately 

severe, and severe depression, respectively. 



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Generalized Anxiety Disorder Scale. Anxiety symptoms were assessed by ten studies using the 

7-item Generalized Anxiety Disorder Scale (GAD-7) (Biber et al., 2020; Conrad et al., 2021; 

Fruehwirth et al., 2021; Hoyt et al., 2021; Krendl, 2021; Lawrence et al., 2021; Lechner et al., 2020; 

Melcher et al., 2021; Wang et al., 2020; Zhang et al., 2020).
 
This questionnaire is used in primary care 

settings to screen for generalized anxiety disorder and has demonstrated excellent internal consistency 

with a Cronbach alpha of 0.92 (Son et al., 2020). Participants were asked to rate on a 4-point Likert 

scale how often they experienced anxiety symptoms over the past two weeks. Possible scores range 

from 0 to 21. Scores from 6 to 10, 11 to 15, and 16 to 21 indicate mild, moderate, and severe anxiety, 

respectively. 

The PHQ-4 is a shorter 4-item screening tool that comprises of two screening questions from each of 

the previous scales. The PHQ-4 was used by three studies (Eden et al., 2020; Haliwa et al., 2021; Hoyt 

et al., 2021). 

Perceived Stress Scale. Levels of stress were assessed by nine studies using the Perceived Stress Scale 

(PSS) (Eden et al., 2020; Hathaway et al., 2021; Hoyt et al., 2021; Kecojevic et al., 2020; Krendl, 2021; 

Melcher et al., 2021; Son et al., 2020; Trammell et al., 2021; Zhen et al., 2021). The 10-item PSS 

(PSS-10) has demonstrated good internal consistency with a Cronbach alpha of 0.84-0.85 in college 

student samples as well as good validity with a positive correlation with scores on life event scales 

(Cohen et al., 1983). Participants were asked to rate on a 5-point Likert scale how often they felt or 

thought a certain way in the past month. Items numbered 4, 5, 7, and 8 were reverse scored. Possible 

scores range from 0 to 40. PSS does not have official score cutoffs for classification of severity, but 

higher scores indicate a higher level of perceived stress.  

Other scales were administered relatively frequently. The Multidimensional Scale of Perceived Social 

Support was used by four studies to assess for perceived support from family, friends, and significant 

others (Fruehwirth et al., 2021; Haliwa et al., 2021; Hathaway et al., 2021). The Depression Anxiety 

and Stress Scale is a widely used screening tool that was administered in three studies, only one of 

which supplemented it with PHQ and GAD (Haliwa et al., 2021; Kibbey et al., 2021; Melcher et al., 

2021). The Brief Resilience Scale was used by three studies to measure resiliency (Eden et al., 2020; 

Fruehwirth et al., 2021; Hunt et al., 2021). The University of California, Los Angeles Loneliness Scale 

was used by three studies that characterizes how much a person feels socially disconnected from others 

(Conrad et al., 2021; Krendl, 2021; Melcher et al., 2021).
 

3.3 Thematic Analysis 

Four broad themes were identified across the 34 publications and were used to organize the review: (a) 

mental health in the general student population, (b) mental health in specific subgroups, (c) 

health-related behaviors, and (d) socioeconomic implications. 

 

 



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3.3.1 Mental Health in the General Student Population 

Review of titles, abstracts, and methods revealed that 14 studies investigated mental health as the 

primary research topic, with the objective to determine the severity of psychological distress and its 

manifestations as symptoms of depression or anxiety.  

Almost all 14 publications showed that students overall were experiencing high levels of distress in the 

early stages of the pandemic. The frequency of students expressing increased levels of stress ranged 

from 14.6% (Browning et al., 2021) to as high as 71% (Son et al., 2020; Wang et al., 2020). Average 

PSS10 scores ranged from 18.8(4.9) (Son et al., 2020) to 30.26(6.41) (Krendl, 2021), indicating at least 

a moderate level of perceived stress. Two longitudinal studies taking place from January to May 2020 

showed that stress levels were the same (Copeland et al., 2021)
 
or lower (Rettew et al., 2021) during 

the start of the pandemic as compared to the months prior. Another longitudinal study showed that 

overall stress levels were particularly high in April 2020 and slightly declined in July 2020 (Hoyt et al., 

2021). 

Six studies collected qualitative descriptions of stressors (Browning et al., 2021; Hoyt et al., 2021; 

Jones et al., 2021; Lawrence et al., 2021; Molock & Parchem, 2021; Son et al., 2020). Common 

stressors that students experienced included fear and worry about their own or family members’ risks 

of being infected with COVID-19, difficulty concentrating, decreased social interactions, concerns 

regarding academic plans or performance, and concerns about obtaining basic needs (Browning et al., 

2021; Jones et al., 2021; Son et al., 2020). Students have described changes to their daily life pertaining 

to their general behaviors and financial and living situations during school closures. Anecdotal samples 

included in articles highlighted the complexity of cumulative stressors such as loss of employment, 

lack of assistance for tuition, housing insecurity, caretaking responsibilities, class workload, and 

changes to or loss of access to mental health services and peer support (Hoyt et al., 2021). 

Risk factors for stress were investigated in several studies through exploratory analysis. Females were 

found to be associated with greater perceived stress (Browning et al., 2021; Hathaway et al., 2021; 

Hoyt et al., 2021; Jones et al., 2021; Kecojevic et al., 2020; Kibbey et al., 2021). Students from lower 

socioeconomic status reported higher perceived stress and anxiety in the first months of the national 

public health emergency (Browning et al., 2021; Haliwa et al., 2021; Hoyt et al., 2021). However, one 

longitudinal study continuing into the summer of 2020 found no statistically significant changes in 

perceived stress or anxiety by race/ethnicity or income level (Hoyt et al., 2021). High risk of distress 

was also associated with knowing someone infected with COVID-19, personally experiencing 

respiratory viral symptoms or a greater perceived risk of contracting COVID-19 ((Browning et al., 

2021; Haliwa et al., 2021; Kibbey et al., 2021; Trammell et al., 2021). A pre-existing psychiatric 

diagnosis was significantly associated with experiencing more symptoms of depression, anxiety, and 

post-traumatic stress disorder (Cohen et al., 2020). 

 



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Protective factors for psychological health were investigated as well. Higher levels of mindfulness and 

social support were identified as protective factors for mental health in terms of reporting less 

perceived stress, greater happiness, and greater life satisfaction (Haliwa et al., 2021; Szkody et al., 

2020; Zhen et al., 2021). Personality traits were also found to contribute to the ability to cope with 

major stressful events. For example, extraversion was negatively associated with mood indices but 

positively associated with engagement in healthy activities (Rettew et al., 2021). 

Stress was associated with worse mental health outcomes during the pandemic. Symptoms of 

depression and anxiety were universally reported at high rates. Among all publications, PHQ scores 

ranged from 6.22 (Fruehwirth et al., 2021) to 9.44 (Lechner et al., 2020), and GAD scores ranged from 

5.41 (Fruehwirth et al., 2021) to 10.49 (Hoyt et al., 2021) in the early stages of the pandemic. Four 

longitudinal studies demonstrated an increase in these scores as the pandemic initially progressed 

(Fruehwirth et al., 2021; Krendl, 2021; Lawrence et al., 2021; Zhang et al., 2020). The frequency of 

anxiety symptoms was positively correlated with the daily number of new cases and deaths due to 

COVID-19 in April and May 2020 (Huckins et al., 2020; Kleiman et al., 2020).  

3.3.2 Mental Health in Specific Subgroups 

Five publications focused on specific subgroups regarding demographics such as race/ethnicity and 

sexual/gender identity as the primary research topic (Gonzales et al., 2020; Haft & Zhou, 2021; Hunt et 

al., 2021; Molock & Parchem, 2021; Trammell et al., 2021).
 
 

Three studies examined racial or ethnic minorities (Haft & Zhou, 2021; Molock & Parchem, 2021; 

Trammell et al., 2021). A cross-sectional survey of undergraduate students of color enrolled in a 

diversity mentorship program highlighted that these students endured disruptive changes in finances, 

living situation, academic performance, education plans, and career goals (Molock & Parchem, 2021). 

One study found no statistically significant ethnic/racial differences in perceived stress, perceived 

COVID-19-related depression, health-related behaviors, or overall COVID-19 mental health impacts 

(Trammell et al., 2021). In this study, however, Hispanic/Latinx and Asian students perceived higher 

COVID-19-related threat and held more negative health beliefs than White students; Latinx students 

reported higher financial and resource impact scores than White students; and Asian students were 

significantly more likely than White students to report witnessing or experiencing discrimination. 

One study found that relatively few participants, most of which identified as Asian, reported 

experiencing racial discrimination in April 2020 (Cohen et al., 2020). When surveying ethnically 

diverse students, the majority of these individuals personally experienced or witnessed discrimination 

against individuals of Asian descent followed by Black descent (Molock & Parchem, 2021). A 

longitudinal study of Chinese students in California revealed higher perceived discrimination and 

anxiety during the pandemic when compared to prior to the pandemic (Haft & Zhou, 2021). After 

controlling for overall media exposure, the relationship between the pandemic and perceived 

discrimination was partially mediated by exposure to media that negatively portrayed Chinese 



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individuals. These are notable findings, as one study found that Asian students experienced higher 

levels of psychological impact compared to White students (Browning et al., 2021). On the contrary, 

another study found that Asian students reported fewer anxiety symptoms than White students (Hoyt et 

al., 2021). 

Female and sexual/gender minority individuals were shown to be at highest risk for increases in 

depression and anxiety across longitudinal studies (Fruehwirth et al., 2021). Two studies focused on 

members of the lesbian, gay, bisexual, transgender, queer, and/or questioning (LGBTQ) community 

(Gonzales et al., 2020; Hunt et al., 2021). Both studies found that nonbinary individuals reported higher 

psychological distress than binary individuals. Almost half of LGBTQ college students (45.7%) 

reported having families that do not support or know of their LGBTQ identity, and these students were 

more likely to experience frequent distress when compared with students who reported having 

supportive families (Gonzales et al., 2020). The majority of these respondents (58.5%) indicated that 

they would be able to receive mental health care if needed. However, 12.8% of respondents indicated 

that stay-at-home orders prevented their ability to receive mental health care services. 

3.3.3 Health-related Behaviors 

Behavior changes in response to the pandemic were found to be pervasive throughout the studies. 

Students almost universally adopted public health recommendations of physical distancing, regular 

hand hygiene, and face protection (Cohen et al., 2020; Kecojevic et al., 2020; Szkody et al., 2020). In 

qualitative sections of cross-sectional surveys, students mentioned several coping strategies such as 

ignoring the news, using other media, turning to social support, drinking alcohol, meditating, and 

engaging in physical exercise (Browning et al., 2021; Son et al., 2020). Physical activity was positively 

associated with positive affect during COVID-19 stay-at-home orders (Maher et al., 2021). Two 

longitudinal studies found that students were more sedentary as the outbreak progressed during the 

Spring 2020 semester (Huckins et al., 2020; Maher et al., 2021). Though, one cross-sectional study 

found that moderate-to-vigorous physical activity did not significantly decrease among social work 

students during the pandemic (Lawrence et al., 2021). 

Four studies revealed students had poorer sleep quality during the pandemic (Firkey et al., 2021; Maher 

et al., 2021; Melcher et al., 2021; Tasso et al., 2021). Two studies reported that students were getting 

fewer hours of sleep (Copeland et al., 2021; Son et al., 2020), and one study found no difference in 

hours of sleep across the Spring 2020 semester (Huckins et al., 2020).
 

Although college students have recently shown higher rates of disordered eating behaviors as compared 

to the general population (Rodgers et al., 2020), change in eating patterns during the pandemic was not 

studied extensively in the included articles. Few studies highlighted examples such as inconsistent 

eating, increased or decreased appetite, and emotional eating (Son et al., 2020; Wang et al., 2020). 

 

 



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Four studies examined screen time and use of media as a coping tool (Browning et al., 2021; Eden et al., 

2020, Kecojevic et al., 2020; Zhen et al., 2021). The intensity of anxiety was associated with spending 

more than one hour per day searching for information on COVID-19 in April 2020 (Kecojevic et al., 

2020). Depression and anxiety were positively correlated with screen time (Browning et al., 2021; 

Lawrence et al., 2021; Wang et al., 2020)
 
and use of media

 
(Eden et al., 2020). Results from one study 

suggested that spending two or more hours outdoors daily was associated with lower levels of 

psychological impact and eight or more hours of screen time daily was associated with higher levels of 

psychological impact (Browning et al., 2021). However, one study suggested that some media coping 

strategies were associated with positive affect, positive mental health, and flourishing (Eden et al., 

2020). Both anxiety and depression were significantly associated with COVID-19-related news. 

Increased phone use and decreased physical activity were associated with fluctuations in COVID-19 

news reporting (Huckins et al., 2020).
 

The amount and frequency of alcohol consumption was found to increase during the first month of the 

pandemic in four studies (Eden et al., 2020; Firkey et al., 2021; Jones et al., 2021; Lechner et al., 2020). 

The number of reported depressive and anxiety symptoms was positively correlated with alcohol 

consumption, whereas the level of perceived social support was negatively correlated with alcohol 

consumption (Lechner et al., 2020). One study found that feelings of COVID-19-related anxiety were 

associated with a greater desire to drink alcohol and use drugs (Kleiman et al., 2020), and two found 

that students reported increases in use of recreational drugs such as cannabis (Firkey et al., 2021; Jones 

et al., 2021). Yet, one study reported that alcohol consumption did not significantly increase among 

social work students (Lawrence et al., 2021). 

3.3.4 Socioeconomic Implications 

Several studies focused on the psychosocial impact of the pandemic on areas such as disruptions in 

income, housing, food security, and academic experiences. A considerable portion of students reported 

a reduction in household income (Cohen et al., 2020; Firkey et al., 2021; Hoyt et al., 2021; Jones et al., 

2021; Owens et al., 2020; Son et al., 2020). Open-ended responses further revealed concerns about 

expenses for food, rent, tuition, and medical expenses (Hoyt et al., 2021; Jones et al., 2021; Son et al., 

2020). Many students relocated in response to campus closures. A substantial number of students 

changed their living situation, with many moving in with parents (Conrad et al., 2021; Jones et al., 

2021; Tasso et al., 2021). The majority of students reported living with parents during initial 

stay-at-home orders (Cohen et al., 2020; Conrad et al., 2021; Lawrence et al., 2021; Son et al., 2020; 

Szkody et al., 2020; Tasso et al., 2021; Zhen et al., 2021). 

Three studies screened for food insecurity (Jones et al., 2021; Maher et al., 2021; Owens et al., 2020). 

Two cross-sectional surveys highlighted that one-third to one-half of students experiencing food 

insecurity (Jones et al., 2021; Owens et al., 2020). One longitudinal study revealed no significant 

change in food security during the first two months of pandemic when compared to food security over 



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the preceding year (Maher et al., 2021). Identification as a racial/ethnic minority or single parent, 

change in living situation, or loss of employment during the global outbreak were strongly associated 

with food insecurity (Owens et al., 2020). Moreover, strong predictors of anxiety or depression 

included high levels of food and housing insecurity (Jones et al., 2021). 

Lastly, organizational changes during the pandemic had consequences on academic progress and added 

uncertainty about career prospects. No objective measures of academic performance or enrollment have 

been used; however, students have consistently reported increased concerns about difficulty 

concentrating on course work and dissatisfaction with changes to the learning environment (Kecojevic 

et al., 2020; Son et al., 2020; Wang et al., 2020). College students indicated some level of fear and 

worry about their academic progress and future career plans (Cohen et al., 2020; Lawrence et al., 2021; 

Melcher et al., 2021; Rettew et al., 2021). For example, summer internships and other opportunities to 

gain work experience were cancelled, thereby limiting professional development during these times 

(Molock & Parchem, 2021; Son et al., 2020). It is currently unclear to what extent these consequences 

will affect young adults entering the workforce. 

 

4. Discussion 

4.1 Summary of the Evidence 

The purpose of this review is to summarize the current understanding of well-being in college students 

during the COVID-19 pandemic. With school closures and stay-at-home orders, students have had to 

adapt to new environments, such as virtual classes and meetings and different living situations. 

National and regional studies across the United States have examined the mental health burden among 

students in higher education. Thematic analysis revealed several emerging themes from challenges that 

students face and their attempts to cope with hardships. 

Students endured employment losses, housing changes, and difficulty meeting basic needs on top of the 

transition to online learning. Generally, a great deal of students was shown to experience a moderate 

level of stress as soon as American institutions started addressing the outbreak. Common stressors 

included social isolation, fear of becoming infected with COVID-19, financial strain, and uncertainty 

about the future. Only two longitudinal studies showed a decline or no change in perceived distress 

across the Spring 2020 semester, the academic term disrupted by abrupt changes to course delivery, 

campus services, and lockdowns (Copeland et al., 2021; Rettew et al., 2021). One study showed a 

marginal decline in stress levels into the summer months (Hoyt et al., 2021). As of yet, no other trends 

have been reported in later months.  

The average severity of depression or anxiety experienced in samples that measured PHQ or GAD 

scales were classified as mild. While this may be interpreted as subclinical depression or anxiety, these 

average scores indicate poor psychological health at the community level that may be addressed with 

institutional support and interventions. Of course, recommendations should be tailored to each 



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individual, and those with clinically severe psychiatric conditions may benefit from seeking 

professional treatment. The increased need for mental health services suggests that universities should 

seek ways to increase access to these services for their students. 

Several studies found increased severity of stress and psychiatric symptoms in females and LGTBQ 

individuals. However, females were overrepresented in several samples, and this imbalance may skew 

analyses. There is mixed evidence on racial/ethnic disparities in mental health burden, and researchers 

sought to examine these nuances in different ways. While some aspects of psychological responses to 

the pandemic may have been universal
 
(Trammell et al., 2021), racial discrimination and financial 

impact was more likely to be reported among certain racial/ethnic groups. In particular, Asian, Black, 

and Latinx groups were emotionally affected by current events regarding anti-Asian and anti-Black 

violence (Cohen et al., 2020; Molock & Parchem, 2021). 

Behavior changes varied across studies. Variations in mental health and behaviors, including screen 

time and use of media, fluctuated with the dynamic situation of the pandemic (Browning et al., 2021; 

Eden et al., 2020; Huckins et al., 2020; Kecojevic et al., 2020; Lawrence et al., 2021; Wang et al., 

2020).
 
Changes in physical activity were mixed across studies and may be owed to the fact that these 

activities largely depend on the home environment, available facilities, personal preferences, and 

concerns for health safety. Given that many students changed their living situation while schools and 

businesses were not physically operating, students were driven to seek safe, alternate avenues for 

physical activity. Lack of motivation, a common symptom of depression, may contribute to reduced 

physical activity as well. Students reported poor quality of sleep (Firkey et al., 2021; Maher et al., 2021; 

Melcher et al., 2021; Tasso et al., 2021) and altered eating habits (Son et al., 2020; Wang et al., 2020) 

during the pandemic. Disturbances in sleep and eating patterns are also common symptoms of 

depression, but these may also be affected by external factors such as housing and food insecurity.
 

Use of alcohol and recreational drugs was shown to increase in five of six studies (Eden et al., 2020; 

Firkey et al., 2021; Jones et al., 2021; Kleiman et al., 2020; Lawrence et al., 2021; Lechner et al., 2020). 

One disadvantage is that these results were typically collected in cross-sectional studies, which lack an 

objective baseline, but one study was able to record self-reports of substance use in real time via EMAs 

(Kleiman et al., 2020). Under-reporting is a concern for self-reporting of drug use (Bone et al., 2016). 

There is not enough evidence to conclude long-term implications of these behavior changes, however 

the current literature captures an intricate account of the student experience at the beginning of the 

public health emergency. 

Most studies were launched at 4-year universities, so community college students may not have been 

represented heavily. Study design varied greatly as well, particularly in terms of survey measures of 

demographics, psychological health, and behaviors. Scales are useful in quantifying attitudes, 

maximizing response rate, and ensuring consistency in data reporting. Quantification allows for 

rigorous statistical analysis to test several hypotheses. Open questions may be more time-consuming 



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and reduce rates of survey completion. However, free responses have provided a more complex and 

human narrative of student experiences. All studies relied on self-reported data and could be 

susceptible to recall bias. EMAs have the advantage of frequent sampling over time, which can 

minimize recall bias and maximize validity by capturing data in real time (Shiffman et al., 2008). 

EMAs require smartphone compatibility, and caution must be taken to ensure data privacy. 

4.2 Limitations 

Limitations apply to this review. Inclusion criteria were relatively liberal to capture the wide 

perspective of available literature in the United States; specifically, a quality assessment tool was not 

used. Preliminary articles were not included, and the current study may not have captured latest 

research on data from the later stages of the outbreak. Substantial heterogeneity of methods (i.e., 

assessment tools, primary outcomes measured, data analysis) and data reporting was noted across the 

included studies. Authors of publications were not contacted for raw data or confirmation of results. All 

articles relied on self-reported data, thereby increasing the risk of recall bias, particularly in 

cross-sectional studies and assessments using large retrospective timeframes.  

Owing to the breadth of the chosen research topic, many factors were not assessed in depth in this 

review, including somatic manifestations of stress (i.e., headaches, change in bowel habits), caretaking 

responsibilities, first-generation college student status, and domestic violence. These are important 

physiologic and socioeconomic characteristics to consider in future research. Other demographic 

features, such as city of residence and year in program of study, were not analyzed in the review. 

In the current review, quantitative synthesis was not conducted, and study findings were summarized in 

a narrative fashion. As with observational studies generally, causality cannot be concluded from studies 

included in this review. Lastly, overrepresentation of female and White students was noted in several 

studies, introducing concern for sampling bias and indicating that presented findings may not be 

representative of the real collegiate population. Large population-based studies may suffer from 

ecological fallacy, and inferences about individuals cannot be made based on aggregate data. 

 

5. Conclusions 

College students in the United States have experienced a great deal of biopsychosocial stress during the 

era of COVID-19. There is concern for a ―dual pandemic‖ pertaining to mental health and social 

isolation. The volume of literature on well-being in young adults during these times is expanding 

globally from various disciplines. University students are becoming increasingly recognized as a 

vulnerable subpopulation suffering from high rates of depression, anxiety, and substance use. These 

conditions are all risk factors for suicide and should be taken seriously. 

The mental health burden of American collegiate is extensive, certain subgroups are vulnerable to 

greater impact, students have changed their behaviors in many ways, and the pandemic has impacted 

student’s financial and living situations. Some demographic subgroups (e.g., sexual/gender and 



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racial/ethnic minorities, and low socioeconomic status) experienced greater hardships than others. For 

some, the university setting provides access to various resources, including food, stable housing, access 

to online learning technology, work experience, and peer support. 

Changes brought about by the COVID-19 pandemic affected all aspects of social determinants of 

health: economic stability, community and social context, neighborhood and built environment, health 

care, and education. Studies have enumerated factors such as loneliness, distress tolerance, and family 

support as potential risk and protective factors for psychological health outcomes. 

Studies have highlighted the need for tangible institutional support, including tuition relief and greater 

access and affordability of mental health services, particularly for vulnerable populations, to reduce the 

adverse psychological impact of the COVID-19 pandemic. Universities may consider offering more 

targeted services or utilizing mobile health technology in order to promote healthy stress coping 

techniques.  

Studies included in the review took place in the spring and summer of 2020, with the latest data 

collection ending in August 2020. As COVID-19 vaccinations become more widely available, it will be 

helpful to assess how vaccination status affects mental health and behaviors as well. As the pandemic 

continues to evolve, ongoing psychological and economic effects of the pandemic should continue to 

be monitored. There is a need for more high-quality large-scale longitudinal studies that examine 

differences in mental health outcomes based on risk factors such as racial/ethnic and sexual/gender 

identity as well as socioeconomic status. More consistent survey measures, particularly highly 

validated quantitative assessments of psychosocial profiles, should be utilized.  

The long-term impact of COVID-19-related stress on physical health may take months to years to 

become fully apparent. Chronic distress has been associated with an increased risk of chronic diseases 

such as hypertension, diabetes, and cardiovascular disease. Early detection of these problems at the 

population level is essential to optimizing management, identifying disparities, and informing health 

promotion and disease prevention strategies. Health care systems and educational institutions should be 

prepared to address socioeconomic impacts beyond the immediate academic terms. 

 

References 

Beiter, R., Nash, R., McCrady, M., Rhoades, D., Linscomb, M., Clarahan, M., & Sammut, S. (2015). 

The prevalence and correlates of depression, anxiety, and stress in a sample of college students. 

Journal of affective disorders, 173, 90-96. https://doi.org/10.1016/j.jad.2014.10.054 

Biber, D. D., Melton, B., & Czech, D. R. (2020). The impact of COVID-19 on college anxiety, 

optimism, gratitude, and course satisfaction. Journal of American college health: J of ACH, 1-6. 

https://doi.org/10.1080/07448481.2020.1842424 

 

 

https://doi.org/10.1016/j.jad.2014.10.054
https://doi.org/10.1080/07448481.2020.1842424


www.scholink.org/ojs/index.php/grhe            Global Research in Higher Education                  Vol. 4, No. 4, 2021 

15 
Published by SCHOLINK INC. 

 

Bone, C., Gelberg, L., Vahidi, M., Leake, B., Yacenda-Murphy, J., & Andersen, R. M. (2016). 

Under-reporting of Risky Drug Use among Primary Care Patients in Federally Qualified Health 

Centers. Journal of addiction medicine, 10(6), 387-394. 

https://doi.org/10.1097/ADM.0000000000000246 

Browning, M., Larson, L. R., Sharaievska, I., Rigolon, A., McAnirlin, O., Mullenbach, L., Cloutier, S., 

Vu, T. M., Thomsen, J., Reigner, N., Metcalf, E. C., D’Antonio, A., Helbich, M., Bratman, G. N., 

& Alvarez, H. O. (2021). Psychological impacts from COVID-19 among university students: Risk 

factors across seven states in the United States. PloS one, 16(1), e0245327. 

https://doi.org/10.1371/journal.pone.0245327 

Cohen, A. K., Hoyt, L. T., & Dull, B. (2020). A Descriptive Study of COVID-19-Related Experiences 

and Perspectives of a National Sample of College Students in Spring 2020. The Journal of 

adolescent health: Official publication of the Society for Adolescent Medicine, 67(3), 369-375. 

https://doi.org/10.1016/j.jadohealth.2020.06.009 

Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of 

health and social behavior, 24(4), 385-396. https://doi.org/10.2307/2136404 

Conrad, R. C., Hahm, H. C., Koire, A., Pinder-Amaker, S., & Liu, C. H. (2021). College student mental 

health risks during the COVID-19 pandemic: Implications of campus relocation. Journal of 

psychiatric research, 136, 117-126. https://doi.org/10.1016/j.jpsychires.2021.01.054 

Copeland, W. E., McGinnis, E., Bai, Y., Adams, Z., Nardone, H., Devadanam, V., Rettew, J., & 

Hudziak, J. J. (2021). Impact of COVID-19 Pandemic on College Student Mental Health and 

Wellness. Journal of the American Academy of Child and Adolescent Psychiatry, 60(1), 134-141. 

https://doi.org/10.1016/j.jaac.2020.08.466 

Eden, A. L., Johnson, B. K., Reinecke, L., & Grady, S. M. (2020). Media for Coping during COVID-19 

Social Distancing: Stress, Anxiety, and Psychological Well-Being. Frontiers in psychology, 11, 

577639. https://doi.org/10.3389/fpsyg.2020.577639 

Firkey, M. K., Sheinfil, A. Z., & Woolf-King, S. E. (2021). Substance use, sexual behavior, and general 

well-being of U.S. college students during the COVID-19 pandemic: A brief report. Journal of 

American college health: J of ACH, 1-7. https://doi.org/10.1080/07448481.2020.1869750 

Fruehwirth, J. C., Biswas, S., & Perreira, K. M. (2021). The Covid-19 pandemic and mental health of 

first-year college students: Examining the effect of Covid-19 stressors using longitudinal data. 

PloS one, 16(3), e0247999. https://doi.org/10.1371/journal.pone.0247999 

Gonzales, G., Loret de Mola, E., Gavulic, K. A., McKay, T., & Purcell, C. (2020). Mental Health 

Needs among Lesbian, Gay, Bisexual, and Transgender College Students during the COVID-19 

Pandemic. The Journal of adolescent health: Official publication of the Society for Adolescent 

Medicine, 67(5), 645-648. https://doi.org/10.1016/j.jadohealth.2020.08.006 

 

https://doi.org/10.1097/ADM.0000000000000246
https://doi.org/10.1371/journal.pone.0245327
https://doi.org/10.1016/j.jadohealth.2020.06.009
https://doi.org/10.2307/2136404
https://doi.org/10.1016/j.jpsychires.2021.01.054
https://doi.org/10.1016/j.jaac.2020.08.466
https://doi.org/10.3389/fpsyg.2020.577639
https://doi.org/10.1080/07448481.2020.1869750
https://doi.org/10.1371/journal.pone.0247999
https://doi.org/10.1016/j.jadohealth.2020.08.006


www.scholink.org/ojs/index.php/grhe            Global Research in Higher Education                  Vol. 4, No. 4, 2021 

16 
Published by SCHOLINK INC. 

 

Haft, S. L., & Zhou, Q. (2021). An outbreak of xenophobia: Perceived discrimination and anxiety in 

Chinese American college students before and during the COVID-19 pandemic. International 

journal of psychology: Journal international de psychologie, 56(4), 522-531. 

https://doi.org/10.1002/ijop.12740 

Haliwa, I., Spalding, R., Smith, K., Chappell, A., & Strough, J. (2021). Risk and protective factors for 

college students’ psychological health during the COVID-19 pandemic. Journal of American 

college health: J of ACH, 1-5. https://doi.org/10.1080/07448481.2020.1863413 

Hathaway, E. D., Peyer, K. L., & Doyle, K. A. (2021). A first look at perceived stress in southeastern 

university students during the COVID-19 pandemic. Journal of American college health: J of 

ACH, 1-4. https://doi.org/10.1080/07448481.2021.1895809 

Hoyt, L. T., Cohen, A. K., Dull, B., Maker Castro, E., & Yazdani, N. (2021). ―Constant Stress Has 

Become the New Normal‖: Stress and Anxiety Inequalities Among U.S. College Students in the 

Time of COVID-19. The Journal of adolescent health: Official publication of the Society for 

Adolescent Medicine, 68(2), 270-276. https://doi.org/10.1016/j.jadohealth.2020.10.030 

Huckins, J. F., daSilva, A. W., Wang, W., Hedlund, E., Rogers, C., Nepal, S. K., Wu, J., Obuchi, M., 

Murphy, E. I., Meyer, M. L., Wagner, D. D., Holtzheimer, P. E., & Campbell, A. T. (2020). 

Mental Health and Behavior of College Students during the Early Phases of the COVID-19 

Pandemic: Longitudinal Smartphone and Ecological Momentary Assessment Study. Journal of 

medical Internet research, 22(6), e20185. https://doi.org/10.2196/20185 

Hunt, C., Gibson, G. C., Vander Horst, A., Cleveland, K. A., Wawrosch, C., Granot, M., Kuhn, T., 

Woolverton, C. J., & Hughes, J. W. (2021). Gender diverse college students exhibit higher 

psychological distress than male and female peers during the novel coronavirus (COVID-19) 

pandemic. Psychology of Sexual Orientation and Gender Diversity, 8(2), 238-244. 

https://doi.org/10.1037/sgd0000461 

Jones, H. E., Manze, M., Ngo, V., Lamberson, P., & Freudenberg, N. (2021). The Impact of the 

COVID-19 Pandemic on College Students’ Health and Financial Stability in New York City: 

Findings from a Population-Based Sample of City University of New York (CUNY) Students. 

Journal of urban health: Bulletin of the New York Academy of Medicine, 98(2), 187-196. 

https://doi.org/10.1007/s11524-020-00506-x 

Kecojevic, A., Basch, C. H., Sullivan, M., & Davi, N. K. (2020). The impact of the COVID-19 

epidemic on mental health of undergraduate students in New Jersey, cross-sectional study. PloS 

one, 15(9), e0239696. https://doi.org/10.1371/journal.pone.0239696 

Kibbey, M. M., Fedorenko, E. J., & Farris, S. G. (2021). Anxiety, depression, and health anxiety in 

undergraduate students living in initial US outbreak ―hotspot‖ during COVID-19 pandemic. 

Cognitive behaviour therapy, 50(5), 409-421. https://doi.org/10.1080/16506073.2020.1853805 

 

https://doi.org/10.1002/ijop.12740
https://doi.org/10.1080/07448481.2020.1863413
https://doi.org/10.1080/07448481.2021.1895809
https://doi.org/10.1016/j.jadohealth.2020.10.030
https://doi.org/10.2196/20185
https://doi.org/10.1037/sgd0000461
https://doi.org/10.1007/s11524-020-00506-x
https://doi.org/10.1371/journal.pone.0239696
https://doi.org/10.1080/16506073.2020.1853805


www.scholink.org/ojs/index.php/grhe            Global Research in Higher Education                  Vol. 4, No. 4, 2021 

17 
Published by SCHOLINK INC. 

 

Kleiman, E. M., Yeager, A. L., Grove, J. L., Kellerman, J. K., & Kim, J. S. (2020). Real-time Mental 

Health Impact of the COVID-19 Pandemic on College Students: Ecological Momentary 

Assessment Study. JMIR mental health, 7(12), e24815. https://doi.org/10.2196/24815 

Krendl, A. C. (2021). Changes in stress predict worse mental health outcomes for college students than 

does loneliness; evidence from the COVID-19 pandemic. Journal of American college health: J of 

ACH, 1-4. https://doi.org/10.1080/07448481.2021.1887198 

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: Validity of a brief depression 

severity measure. Journal of general internal medicine, 16(9), 606-613. 

https://doi.org/10.1046/j.1525-1497.2001.016009606.x 

Lawrence, S. A., Garcia, J., Stewart, C., & Rodriguez, C. (2021). The mental and behavioral health 

impact of COVID-19 stay at home orders on social work students. Journal of social work 

education, 1-15. https://doi.org/10.1080/02615479.2021.1883582 

Lechner, W. V., Laurene, K. R., Patel, S., Anderson, M., Grega, C., & Kenne, D. R. (2020). Changes in 

alcohol use as a function of psychological distress and social support following COVID-19 related 

University closings. Addictive behaviors, 110, 106527. 

https://doi.org/10.1016/j.addbeh.2020.106527 

Maher, J. P., Hevel, D. J., Reifsteck, E. J., & Drollette, E. S. (2021). Physical activity is positively 

associated with college students’ positive affect regardless of stressful life events during the 

COVID-19 pandemic. Psychology of sport and exercise, 52, 101826. 

https://doi.org/10.1016/j.psychsport.2020.101826 

Melcher, J., Lavoie, J., Hays, R., D’Mello, R., Rauseo-Ricupero, N., Camacho, E., Rodriguez-Villa, E., 

Wisniewski, H., Lagan, S., Vaidyam, A., & Torous, J. (2021). Digital phenotyping of student 

mental health during COVID-19: An observational study of 100 college students. Journal of 

American college health: J of ACH, 1-13. https://doi.org/10.1080/07448481.2021.1905650 

Molock, S. D., & Parchem, B. (2021). The impact of COVID-19 on college students from communities 

of color. Journal of American college health: J of ACH, 1-7. 

https://doi.org/10.1080/07448481.2020.1865380 

Owens, M. R., Brito-Silva, F., Kirkland, T., Moore, C. E., Davis, K. E., Patterson, M. A., Miketinas, D. 

C., & Tucker, W. J. (2020). Prevalence and Social Determinants of Food Insecurity among 

College Students during the COVID-19 Pandemic. Nutrients, 12(9), 2515. 

https://doi.org/10.3390/nu12092515 

Rajkumar, R. P. (2020). COVID-19 and mental health: A review of the existing literature. Asian 

journal of psychiatry, 52, 102066. https://doi.org/10.1016/j.ajp.2020.102066 

Rettew, D. C., McGinnis, E. W., Copeland, W., Nardone, H. Y., Bai, Y., Rettew, J., Devadenam, V., & 

Hudziak, J. J. (2021). Personality trait predictors of adjustment during the COVID pandemic 

among college students. PloS one, 16(3), e0248895. https://doi.org/10.1371/journal.pone.0248895 

https://doi.org/10.2196/24815
https://doi.org/10.1080/07448481.2021.1887198
https://doi.org/10.1046/j.1525-1497.2001.016009606.x
https://doi.org/10.1080/02615479.2021.1883582
https://doi.org/10.1016/j.addbeh.2020.106527
https://doi.org/10.1016/j.psychsport.2020.101826
https://doi.org/10.1080/07448481.2021.1905650
https://doi.org/10.1080/07448481.2020.1865380
https://doi.org/10.3390/nu12092515
https://doi.org/10.1016/j.ajp.2020.102066
https://doi.org/10.1371/journal.pone.0248895


www.scholink.org/ojs/index.php/grhe            Global Research in Higher Education                  Vol. 4, No. 4, 2021 

18 
Published by SCHOLINK INC. 

 

Rodgers, R. F., Lombardo, C., Cerolini, S., Franko, D. L., Omori, M., Fuller‐Tyszkiewicz, M., 

Linardon, J., Courtet, P., & Guillaume, S. (2020). The impact of the COVID‐19 pandemic on 

eating Disorder risk and symptoms. International Journal of Eating Disorders, 53(7), 1166-1170. 

https://doi.org/10.1002/eat.23318 

Shiffman, S., Stone, A. A., & Hufford, M. R. (2008). Ecological momentary assessment. Annual review 

of clinical psychology, 4, 1-32. https://doi.org/10.1146/annurev.clinpsy.3.022806.091415 

Son, C., Hegde, S., Smith, A., Wang, X., & Sasangohar, F. (2020). Effects of COVID-19 on College 

Students’ Mental Health in the United States: Interview Survey Study. Journal of medical Internet 

research, 22(9), e21279. https://doi.org/10.2196/21279 

Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing 

generalized anxiety disorder: The GAD-7. Archives of internal medicine, 166(10), 1092-1097. 

https://doi.org/10.1001/archinte.166.10.1092 

Szkody, E., Stearns, M., Stanhope, L., & McKinney, C. (2020). Stress-Buffering Role of Social 

Support during COVID-19. Family process, 10.1111/famp.12618. 

https://doi.org/10.1111/famp.12618 

Tasso, A. F., Hisli Sahin, N., & San Roman, G. J. (2021). COVID-19 disruption on college students: 

Academic and socioemotional implications. Psychological trauma: Theory, research, practice and 

policy, 13(1), 9-15. https://doi.org/10.1037/tra0000996 

Trammell, J. P., Joseph, N. T., & Harriger, J. A. (2021). Racial and ethnic minority disparities in 

COVID-19 related health, health beliefs and behaviors, and well-being among students. Journal of 

American college health: J of ACH, 1-7. https://doi.org/10.1080/07448481.2021.1890606 

Wang, X., Hegde, S., Son, C., Keller, B., Smith, A., & Sasangohar, F. (2020). Investigating Mental 

Health of US College Students during the COVID-19 Pandemic: Cross-Sectional Survey Study. 

Journal of medical Internet research, 22(9), e22817. https://doi.org/10.2196/22817 

Xiong, J., Lipsitz, O., Nasri, F., Lui, L., Gill, H., Phan, L., Chen-Li, D., Iacobucci, M., Ho, R., Majeed, 

A., & McIntyre, R. S. (2020). Impact of COVID-19 pandemic on mental health in the general 

population: A systematic review. Journal of affective disorders, 277, 55-64. 

https://doi.org/10.1016/j.jad.2020.08.001 

Zhang, B., Zaman, A., Silenzio, V., Kautz, H., & Hoque, E. (2020). The Relationships of Deteriorating 

Depression and Anxiety with Longitudinal Behavioral Changes in Google and YouTube Use 

During COVID-19: Observational Study. JMIR mental health, 7(11), e24012. 

https://doi.org/10.2196/24012 

Zhen, L., Nan, Y., & Pham, B. (2021). College students coping with covid-19: Stress-buffering effects 

of self-disclosure on social media and parental support. Communication Research Reports, 38(1), 

23-31. https://doi.org/10.1080/08824096.2020.1870445 

https://doi.org/10.1002/eat.23318
https://doi.org/10.1146/annurev.clinpsy.3.022806.091415
https://doi.org/10.2196/21279
https://doi.org/10.1001/archinte.166.10.1092
https://doi.org/10.1111/famp.12618
https://doi.org/10.1037/tra0000996
https://doi.org/10.1080/07448481.2021.1890606
https://doi.org/10.2196/22817
https://doi.org/10.1016/j.jad.2020.08.001
https://doi.org/10.2196/24012
https://doi.org/10.1080/08824096.2020.1870445


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Appendix 

Appendix A. Study Characteristics 

Study Summary of Findings Design (Dates 
of Data 

Collection) 

Location Measures Demographics 

Biber et 
al., 

2020* 

There was a negative correlation 
between anxiety and optimism 

(r=-0.36), gratitude (r=-0.12), and 
perceived effectiveness of academic 

instruction (r=- 0.11). Average GAD7 
score of all respondents was 6.96(6.27). 

Students with higher GAD7 scores 
perceived lower effectiveness of 

institutional response to COVID-19 
when compared to mildly or moderately 
anxious respondents [F(2,1516)=10.60, 

p<0.001].  

Cross-sectional, 
Survey (April 

2020) 

GA GAD7, Revised Life 
Orientation Test, 

Gratitude 
Questionnaire 6. 
Questions about 

perceived instructional 
response 

N=1640. 60.3% 
female. 61.4% 

White, 24.7%   Black 

Brownin
g et al., 
2021 

In open-ended responses, respondents 
reported symptoms of depression 
(27.3%) and anxiety (17.4%) and 

perceptions of stress (14.6%). Bivariate 
associations showed students who were 
female, were Asian, in fair/poor health, 

of below-average relative family 
income, or who knew someone infected 

with COVID-19 experienced higher 
levels of psychological impact. Students 
who were White, higher socioeconomic 
status, spent at least two hours outside, 
or less than eight hours on electronic 

screens were likely to experience lower 
levels of psychological impact. 

Multivariate modeling showed that 
being a female, having fair/poor general 
health status, spending 8 or more hours 
on screens daily, and knowing someone 

infected predicted higher levels of 
psychological impact when risk factors 

were considered simultaneously. 

Cross-sectional, 
Survey (March- 

May 2020) 

Various (7 
universities) 

Positive and Negative 
Affect Schedule, Penn 

State Worry 
Questionnaire. 

Questions about 
behaviors 

N=2534. 61% 
female. 79% 
White. 20% 

graduate 

Cohen et 
al., 2020 

Personal experiences and attitudes 
regarding COVID-19 during February 

through April 2020 were  surveyed. 35% 
of respondents had experienced any 

COVID-19-related symptoms, less than 
5% had gotten tested. Participants were 
more stressed about the disease's health 

implications for their family and 
American society than for themselves. 

Cross-sectional, 
Survey (April 

2020) 

Various 
(nationwide) 

Questions about 
COVID-19 
symptoms, 

socioeconomic 
impacts 

N=725. 60.7% 
female. 63.2% 

White, 8% Black, 
13.9% Hispanic, 

24.3% API 



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Conrad 
et al., 
2021 

33.38% of respondents reported being 
mandated to relocate. 86.4% reported 
living with parents/guardians. Total 
average PHQ8 score was 9.28(5.65). 

Total average of GAD7 score was 
9.47(5.63). After controlling for the 
severity level of local COVID-19 

outbreaks, respondents who relocated 
reported greater COVID-19-related 

grief, loneliness, and anxiety 
symptoms, compared to respondents 
who did not relocate. Gender diverse 
individuals were more likely to report 

depressive, anxiety, and PTSD 
symptoms compared to men (p<0.05). 
A pre-existing psychiatric diagnosis 

was significantly associated with 
depressive, anxiety, and PTSD 

symptoms (p<0.001). 

Cross-sectional, 
Survey (April- 
August 2020) 

Various 
(nationwide) 

COVID-related 
worry, COVID- 

related grief, UCLA 
Loneliness Scale, 

PHQ8, GAD7, PTSD 
Checklist—Civilian 

Version, Distress 
Tolerance Scale, 

Connor-Davidson 
Resilience Scale. 
Questions about 
relocation and 
socioeconomic 

impacts 

N=791. 82.2% 
female, mean age 

23.07(3.18). 59.7% 
White, 4.8% Black, 

5.8% Hispanic, 
21.0% Asian. 

61.9% 
undergraduate 

Copeland 
et al., 
2021 

Daily mood (β=-0.1, p=0.003) and 
health-related behaviors (β=-0.06, 

p=0.036) were negatively affected by 
the pandemic, but stress (β=0.02, 

p=0.58) was not. The overall magnitude 
of these changes were modest but 
persistent across the Spring 2020 

semester and differed from patterns 
observed in a prior year. Externalizing 

and attention problems increased during 
the pandemic, but not internalizing 
symptoms. Students enrolled in a 
wellness program reported less 

internalizing and attention problems 
compared to those not enrolled in a 
wellness program. The majority of 

respondents (68.4%) reported they were 
not confident in the government’s 

response to the pandemic. 

Longitudinal, 
Survey, EMA 
(January-May 

2020) 

VT Brief Problem 
Monitor, Questions 
about COVID-19 

perceptions, mood, 
stress levels, wellness 

index based on 
exercise, nutrition, 
sleep, hydration, 

screen time 

N=675, 576. 74.1% 
female. 89.5% 

White, 0.7% Black, 
3% Hispanic, 4.2% 

Asian 

Eden et 
al., 2020 

Anxiety was associated with increased 
use of media (p<0.05). Stress was 

associated with more hedonic (p<0.05) 
and less eudemonic (p<0.05) media use. 

Avoidant coping was associated with 
poorer mental health, whereas humor 

coping was associated with better 
mental health. Resilience positively 

moderated the effect of stress on 
problem-focused, avoidant, reframing, 

and humor coping. 

Cross-sectional, 
Survey (March- 

April 2020) 

Various (MI, 
FL) 

PSS14, Brief COPE, 
Basic Psychological 
Need Satisfaction, 

Life Orientation Scale, 
Hope Scale, Brief 
Resilience Scale, 

Scale of Positive and 
Negative Experience, 

Flourishing Scale, 
Mental health 

subscale of SF36 

N=425. 68.5% 
female, mean age 

20.19(2.18). 78.1% 
White, 8.5% Black, 

11.5% Hispanic, 
12.7% Asian 

Firkey et 
al., 2021* 

Most students reported a decrease in 
quality of life (71.7%), an increase in 
levels of anxiety (63.7%), concerns 
with meeting basic resource needs 
(53.8%), and a decrease in sexual 

activity (57.5%). 26.9% and 15.1% of 
students reported increases in alcohol 

and cannabis use, respectively. 

Cross-sectional, 
Survey (May- 

July 2020) 

Various 
(nationwide) 

Pandemic Stress 
Index, AUDIT-C. 
Questions about 

COVID-19 beliefs, 
behaviors 

N=212. 50.5% 
female, mean age 
22, 70.8% White 



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Fruehwir
th et al., 

2021 

Prevalence of moderate to severe 
depression increased from 21.5% in 

Fall 2019 to 31.7% in Spring-Summer 
2020 (p<0.001). Prevalence of 

moderate to severe anxiety increased 
from 18.1% to 25.3% (p<0.05). White, 

female, and sexual/gender minority 
students were at highest risk for 

increases in anxiety symptoms. Black, 
female and sexual/gender minority 

students were at highest risk of 
increases in depression. Loss of work 

and COVID-19 diagnosis or 
hospitalization of oneself, family 

members, or friends were not associated 
with increases in depression or anxiety 

symptoms. 

Longitudinal, 
Survey (October 
2019-July 2020) 

NC PHQ8, GAD7, Brief 
Resilience Scale, 

MSPSS. Questions 
about COVID-19 

stressors, 
socioeconomic 

impacts 

N=966, 419. Mean 
age 18.9(0.1), 

61.6% White, 6.7% 
Black, 18.1% API, 

8.4% Hispanic 

Gonzales 
et al., 
2020 

The majority of respondents reported 
experiencing depressive symptoms 

(60.4%) anxiety symptoms (65%) and 
frequent distress (61%). Compared to 
cisgender men, transgender students 

were much more likely to report 
frequent distress (aOR=3.41, CI 1.31, 

8.86). 45.7% of LGBT college students 
have immediate families that do not 

support or know of their LGBT identity. 
LGBT students with unsupportive 

families were more likely to experience 
frequent distress (aOR=1.83, CI 1.13, 

2.95). 

Cross-sectional, 
Survey (April- 

June 2020) 

Various 
(nationwide) 

PHQ4. Questions 
about LGBT 
experiences, 

socioeconomic 
impacts, barriers to 
mental health care 

N=477. 25.2% 
nonbinary, 42.4% 
female, mean age 

20.7, 61.2% White, 
9.2% Black, 13.2% 

Hispanic, 13.8% 
API 

Haft & 
Zhou, 
2021* 

Chinese students were surveyed in 
Fall 2019 with a 47.76% follow-up 

response rate in Spring 2020. 
Respondents reported higher 

perceived discrimination and anxiety 
during the pandemic when compared 
to prior to the pandemic. Mediation 

analyses suggested that negative 
Chinese media exposure partly 

accounted for the group difference in 
perceived discrimination. 

Longitudinal, 
Survey 

(September 
2019-March 

2020) 

CA Everyday 
Discrimination Scale, 

Beck Anxiety 
Inventory 

N=134, 64. 55.6% 
female, mean age 

20.01(1.31), 100% 
Asian 

Haliwa et 
al., 2021* 

Greater perceived risk of contracting 
COVID-19 was associated with 
greater depression, anxiety, and 

perceived stress. Greater mindfulness 
and social support were identified as 
protective factors for psychological 

health. 

Cross-sectional, 
Survey 

(March-May 2020) 

WV DASS, MSPSS, 
Cognitive and Affective 

Mindfulness Scale 
Revised, Subjective 

Happiness Scale, 
Satisfaction with Life 

Scale, Questions about 
COVID-19 awareness 

and worries 

N=251. 82.22% 
female, mean age 

19.62(1.55), 
89.69% White 

Hathawa
y et al., 
2021* 

Undergraduate student respondents 
reported an average PSS10 score of 

21.31(7.54). Females reported higher 
PSS10 scores compared to males 

(Z=4.89, p<0.01). 

Cross-sectional, 
Survey (July- 
August 2020) 

TN PSS10 retrospectively 
―at the end of Spring 

2020‖ 

N=312. 74.7% 
female. 88% 

White, 3.2% Black, 
2.9% Asian 



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Hoyt et 
al., 2021 

Levels of anxiety and perceived stress 
were higher in April than in July 2020. 
Average GAD7 scores decreased from 

10.49(5.95) to 9.85(6.04). Average 
PSS10 scores decreased from 

22.72(9.00) to 20.36(8.06). Black and 
mixed race/ethnicity individuals were 

the only groups to show increased 
anxiety from April to July. Women 

reported worse well-being compared 
with men. Gender diverse and sexual 

minority youths reported worse 
outcomes than their cisgender 

heterosexual peers at both time points. 
Qualitative data illustrates 
educational, economic, and 

environmental stressors. 

Longitudinal, 
Survey (April- July 

2020) 

Various 
(nationwide) 

PSS10, GAD7. 
Questions about 

socioeconomic impacts 

N=707. 61% 
female, mean age 
20.0(1.3). 54.3% 

White, 5.2% Black, 
8.9% Hispanic, 
20.4% Asian, 
10.1% mixed 

Huckins 
et al., 
2020 

Both anxiety (p<0.001) and 
depression (p=0.03) were 

significantly associated with 
COVID-19–related news. Compared 
with prior academic terms, students 
were more sedentary, anxious, and 

depressed when the pandemic started. 
Increased phone usage, decreased 

physical activity, and fewer locations 
visited, were associated with 

fluctuations in COVID-19 news 
reporting. 

Longitudinal, 
EMA 

(January-March 
2020) 

NH PHQ4. Smartphone 
sensing data on 

sedentary time, sleep, 
location, and phone 

usage 

N=217, 178. 68% 
female. 

Race/ethnicity not 
collected 

Hunt et 
al., 2021* 

Gender diverse individuals reported 
higher psychological distress 

(M=12.33, SD=6.04, p<0.0001) and 
lower psychological resilience 

(M=2.88, SD=0.93, p<0.001) than 
nonbinary individuals. Cohen’s d 

comparing gender diverse individuals 
to male and female individuals was 

0.66 and 0.70 for resilience and 
distress, respectively. 48.2% of gender 

diverse individuals were above the 
cutoff for severe psychological 

distress. 

Cross-sectional, 
Survey (March- 

April 2020) 

OH Brief Resilience Scale, 
Kessler Psychological 

Distress Scale. 
Perceived COVID- 19 

risk 

N=5547 14.96% 
nonbinary (n=83, 

comparisons 
matched with 83 
male and female) 

Jones et 
al., 2021* 

54.5% of respondents reported 
experiencing anxiety and/or depression, 

with 43.2% reporting anxiety and 
42.2% reporting depression in April 
2020. 49.0% reported an increased 

need for mental health services. 81.1% 
reported loss of household income and 
49.8% reported worries about losing 

housing. High levels of food (aPR=1.4, 
CI 1.2, 1.6) and housing (aPR=1.3, CI 
1.2, 1.4) insecurity were the strongest 
predictors of anxiety or depression. 

Cross-sectional, 
Survey (April 

2020) 

NY CDC Health-related 
Quality of Life 

Healthy Days Core 
Module, PHQ4, 

USDA Food Security 
Survey. Questions 
about COVID-19 

symptoms, 
socioeconomic 

impacts 

N=2282. 57.9% 
female. 23% 

White, 24.9%, 
Black, 29.4% 

Hispanic 



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Kecojevi
c et al., 
2020 

Students reported several difficulties 
and high levels of perceived distress 
with a total average PSS10 score of 
20.6(7.3). High levels of depression 
were associated with difficulties in 

focusing on academic work and 
employment losses. High levels of 

anxiety were more likely to be reported 
by upperclassmen and those who spent 
more than one hour per day searching 

for information on COVID-19. 
Difficulty focusing on academic work 
was associated with higher levels of 

somatization. Respondents with higher 
perceived stress were more likely to be 

female, unable to focus on academic 
work, and report difficulties obtaining 

medications and cleaning supplies. 

Cross-sectional, 
Survey (April 

2020) 

NJ PSS10, Brief 
Symptom Inventory. 

Questions about 
knowledge of 

COVID-19, behaviors, 
socioeconomic impacts 

N=162. 71% 
female, mean age 

20.4(2.9). 37% 
White, 25.3% 
Black, 26.5% 

Hispanic, 7.4% 
Asian 

Kibbey 
et al., 
2021 

46.0% of respondents reported 
experiencing elevated psychological 

distress, with reports of anxiety 
(30.3%) and depression (25.4%). High 

risk of distress was associated with 
female sex, a COVID-19 case in the 

immediate social network, underlying 
medical conditions, and recent 
experience of 3 or more viral 

symptoms. 

Cross-sectional, 
Survey (April-May 

2020) 

NJ DASS, Short Health 
Anxiety Inventory. 

Questions about 
COVID-19 stressors, 

medical history 
checklist 

N=641. 72.7% 
female, mean age 
20.1(2.11). 49% 

White, 6.6% Black, 
15.1% Hispanic, 

31.9% Asian 

Kleiman 
et al., 
2020 

78.5% of respondents indicated at least 
some level of anxiety about COVID-19. 
Structural change analyses indicated a 
downward trend in COVID-19-related 

anxiety after the first week of June 
2020, with more than 15% of 

participants reporting high levels of 
anxiety at the lowest points. Anxiety 
was correlated with daily number of 

new cases and death due to COVID-19. 
Reportings of anxiety were associated 
with a greater desire to drink and use 

drugs. Optimism about COVID-19 was 
associated with receiving support from 

others and from their university. 

Longitudinal, 
EMA (April-May 

2020) 

NJ Questions about affect, 
knowledge/ awareness 

about COVID-19 

N=140. 77.6% 
female, mean age 

19.98(1.61). 
48.59% White, 
7.04% Black, 
36.62% API 

Krendl 
AC, 

2021* 

Prior to the pandemic, stress mediated 
the positive relationships between 

loneliness and depression (β=0.45). 
44% of respondents indicated that they 

had previously sought mental health 
treatment. During the pandemic, mental 
health outcomes, stress, and loneliness 
increased. PHQ8 scores increased from 
5.85(5.09) to 8.91(5.42) (p=0.009), and 

GAD7 scores increased from 
6.41(5.14) to 8.91(6.23) (p=0.034). 

PSS10 scores increased from 
26.62(6.49) to 30.26(6.41) (p=0.02). 

Stress (b>0.38, p<0.05), but not 
loneliness, was associated with worse 

mental health outcomes during the 
pandemic. 

Longitudinal, 
Survey (October 

2019-March 
2020) 

IN PHQ8, GAD7, PSS10, 
UCLA Loneliness Scale 

N=111, 34. 54.96% 
female, mean age 

19.09(1.38). 100% 
White 



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Lawrenc
e et al., 
2021* 

There was a statistically significant 
increase in depression and anxiety 

scores in May through July 2020 when 
compared to retrospective 

self-reporting of scores for February 
2020. Average PHQ9 increased from 

3.63 to 9.10 (p<0.0001). Average 
GAD7 increased from 4.03 to 9.11 
(p<0.0001). There was a significant 
increase in screen time during the 

pandemic (p<0.0001). Alcohol 
consumption did not significantly 

increase during the pandemic (p=0.06) 
and moderate-to-vigorous physical 

activity did not significantly decrease 
during the pandemic (p=0.21). 

Bivariate analyses showed a positive 
association between depression and 

anxiety with screen time and the 
transition to virtual classes. 

Cross-sectional, 
Survey 

(May-July 2020) 

FL PHQ9, GAD7, Godin 
Leisure Time Exercise, 

AUDIT-C 

N=88. 93% female, 
mean age 

29(10.01), 61% 
White, 20% 

Hispanic. 100% 
social work 

students 

Lechner 
et al., 
2020 

Amount and frequency of alcohol 
consumption increased during the first 

month of the pandemic. Greater 
number of depressive and anxiety 

symptoms were associated with 
increases in alcohol consumption 
compared to students with fewer 
symptoms. Students with greater 

perceived social support reported less 
alcohol consumption. 

Cross-sectional, 
Survey (March 

2020) 

OH Timeline Follow- Back 
Interview, PHQ9, 
GAD7, MSPSS 

N=1958. 79.97% 
female, mean age 

24.94(7.65). 
86.41% White 

Maher et 
al., 2021 

Students exhibited significant 
reduction in physical activity, positive 
affect, and sleep quality, as well as an 

increase in negative affect during 
stay-at-home orders. Physical activity 
was positively associated with positive 
affect during COVID-19 stay-at-home 

orders (β=0.01, p=0.01). 

Longitudinal, 
Survey 

(January-May 
2020) 

NC Social Readjustment 
Rating Scale, Positive 
and Negative Affect 

Schedule, International 
Physical Activity 

Questionnaire, PSQI, 
US Household Food 

Security Survey 
Module, Social 

Readjustment Rating 
Scale 

N=107. 66% 
female, mean age 

21.7(2.6). 54% 
White, 35.5% 
Black, 12.1%, 
Hispanic, 4.7% 

Asian 

Melcher 
et al., 
2021* 

In-app daily mood assessments were 
strongly correlated with their 

corresponding gold standard clinical 
assessments. Total average PHQ9 was 
8.58(5.33). Total average GAD7 was 

6.50(5.03). Total PSS10 was 
21.00(3.48). Sleep variance among 

students was correlated to depression 
scores (p=0.28) and stress scores 

(p=0.27) 

Longitudinal, 
EMA, Interview 

(May-August 
2020) 

Various 
(nationwide) 

DASS, PHQ9, GAD7, 
PSS10, UCLA 

Loneliness Scale, 
PSQI, Hamilton 

Depression Rating 
Scale, Flourishing 

Scale, Social 
Interaction Anxiety 

Scale, Social 
Functioning Scale, 

Health survey, 
Questions about 

COVID-19 
symptoms, clinical 
global impression. 

Smartphone sensing 
data about screen 

time, location 

N=100. 75% 
female, mean age 
20.3. 63% White, 

4% Black, 3% 
Hispanic, 20% 

Asian 



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Molock 
& 

Parchem, 
2021* 

Ethnically diverse students were 
surveyed. Respondents reported 

disruptive changes in finances (54%), 
living situation (35%), academic 

performance (46%), educational plans 
(49%), and career goals (36%). 

Psychological challenges included 
stress (41%), anxiety (33%), and 

depression (18%). 

Cross-sectional, 
Survey (June 

2020) 

DC Questions about 
socioeconomic 

impacts, behaviors 

N=193. 49% 
female, mean age 
20.52. 46% Black, 

18% Hispanic, 21% 
Asian 

Owens et 
al., 2020 

34.5% of respondents were classified 
as food insecure within the last 30 days. 

Strong predictors of food insecurity 
include change in living situation 
(OR=2.70, CI 2.47, 2.96), being 

furloughed (OR=3.22, CI 2.86, 3.64), 
being laid off (OR=4.07, CI 3.55, 

4.66), or losing part-time work 
(OR=5.73, CI 5.09, 6.46) during the 

pandemic. 

Cross-sectional, 
Survey (May- June 

2020) 

TX Food sufficiency 
screener, USDA Food 

Security Survey. 
Questions about 

financial and housing 
situation 

N=651. 88% 
female. 40% 

White, 18% Black, 
27% Hispanic, 11% 

Asian. 62% 
undergraduate 

Rettew et 
al., 2021 

Indices of mood (β=-0.09, p<0.001) and 
health-related behaviors (β=-0.07, 
p<0.001) declined during the study 
period and stress levels decreased 
(β=-.04, p=.006). Higher levels of 
extraversion were associated with 

decreases in mood indices (β=-0.07, 
p<0.001), whereas lower levels of 

extraversion were associated with slight 
increases in mood indices. Personality 
traits can contribute to ability to cope 

with major stressful events. 

Longitudinal, 
Survey, EMA 
(January-May 

2020) 

VT Big Five Inventory. 
Questions about mood 
and behaviors (daily 

ratings) 

N=484. 76% 
female, mean age 
18.08(0.3). >90% 

White 

Son et 
al., 2020 

71% of respondents reported increased 
stress and anxiety during the pandemic. 

Total average PSS10 score was 
18.8(4.9). Common stressors include 

fear and worry about their health and of 
loved ones (91%), difficulty 

concentrating (89%), decreased social 
interaction due to physical distancing 

(86%), and increased concerns on 
academic performance (82%). 

Participants have adopted a variety of 
coping strategies. A vast majority of 

participants who indicated an increase 
in stress and anxiety (93%) reported that 

they had not used school counseling 
services during the pandemic. 

Cross-sectional, 
Interview (April 

2020) 

TX PSS10. Questions 
about coping 

mechanisms, health- 
related concerns, 

academic and 
socioeconomic 

impacts, barriers to 
mental health care 

N=195. 57% 
female, mean age 

20.7(1.7). 
Race/ethnicity not 

collected 

Szkody 
et al., 
2021* 

Respondents reported social distancing 
or isolating for an average of 

17.59(13.93) days. When accounting 
for length of time in self-isolation, 

perceived social support buffered the 
connection between COVID-19-related 

worries and psychological health. 

Cross-sectional, 
Survey 

MS MSPSS, Inventory of 
Socially Supportive 
Behaviors, WHO 
Quality of Life 

Instrument 

N=405.65% 
female. 46.3% 
White, 11.1% 

Black, 0.5% Asian 



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Tasso et 
al., 2021 

There was a positive relationship 
between academic frustrations and 

mental health symptoms. Worries about 
becoming infected with COVID-19 

were positively correlated with mental 
health symptoms and negatively 

correlated with trust in the government. 

Cross-sectional, 
Survey 

NJ Questions about 
COVID-19 stressors, 
perceived academic 

frustration, perceived 
mental health 

symptoms 

N=257. 75% 
female 

Trammel
l et al., 
2021* 

15.2% of respondents reported either 
being diagnosed with COVID-19 or 

experiencing viral symptoms, and there 
were no racial/ethnic disparities in this 

health outcome. Hispanic and Asian 
students experienced higher 

COVID-19-related threat and negative 
beliefs than White students. Total 

average PSS10 score was 28.59(8.45). 
35% of respondents reported 

experiencing depressive symptoms, but 
there were no racial/ethnic differences 

in mental health symptoms or 
health-related behaviors. 

Cross-sectional, 
Survey (May 

2020) 

CA PSS14, Brief Illness 
Perception 

Questionnaire, Social 
Psychological 

Measurements of 
COVID-19, 

Epidemic-Pandemic 
Impacts Inventory 

N=403. 74% 
female, mean age 

20.4(1.5). 65% 
White, 6% Black, 

10% Hispanic, 19% 
Asian. 100% 

undergraduate 

Wang et 
al., 2020 

48.14% of respondents reported 
moderate-to-severe depression, 38.48% 

reported moderate-to-severe anxiety, 
and 18.04% reported suicidal ideation. 
71.26% of respondents indicated their 

stress levels increased during the 
pandemic. 43.25% reported being able 

to cope adequately. 

Cross-sectional, 
Survey 

TX PHQ9, GAD7. 
Questions about 

COVID-19 stressors, 
behaviors, barriers to 

mental health care 

N=2031. 61.64% 
female, mean age 

22.8(5.52), 30.53% 
graduate. 

Race/ethnicity not 
collected 

Zhang et 
al., 2020 

49% and 53%of respondents reported 
an increase in PHQ9 and GAD7, 

respectively, over the course of the 
study. Greater late- night online activity 
volumes were positively correlated with 

increasing depression (r ranging 
between 0.32 and 0.75, p<0.04) and 

anxiety levels (r ranging between 0.39 
and 0.74, p<0.006). 

Longitudinal, 
Survey 

(January-May 
2020) 

NY PHQ9, GAD7, 
Google/YouTube search 

activities 

N=49. 61% female 

Zhen et 
al., 2021 

77.8% of respondents reported 
currently living with parents. 

Self-disclosure on social media 
(β=-0.13, p<0.05) and support from 

parents (β=-0.15, p<0.05) moderated 
levels of stress experienced by students. 

Cross-sectional, 
Survey (April 

2020) 

CA PSS adapted to 
COVID-19, Medical 

Outcomes Study Social 
Support Survey. 
Questions about 
socioeconomic 

impacts, behaviors 
with media 

N=215. 79% 
female, mean age 

20.5 

*Denotes pre-print, non-peer-reviewed article.  

CDC=Centers for Disease Control and Prevention; UCLA=University of California, Los Angeles; 

USDA=United States Department of Agriculture; WHO=World Health Organization.  

AUDIT-C=Alcohol Use Disorders Identification Test-Concise; DASS=Depression Anxiety and Stress 

Scale; GAD=Generalized Anxiety Disorder; MSPSS=Multidimensional Scale of Perceived Social 

Support; PHQ=Patient Health Questionnaire; PSS=Perceived Stress Scale; PSQI=Pittsburgh Sleep 

Quality Index. CI=confidence interval. 


