Table of Contents

Acknowledgments…………………………………………………………………………..……..3

Abstract……………………………………………………………………………………………4

Introduction………………………………………………………………………………………..5

Methods…………………………………………………………………………………………..10

Results…………………………………………………………………………………………....14

Discussion………………………………………………………………………………………..20

Acknowledgments

I would like to express my gratitude to my thesis director, Dr. Nicole Zarrett, my second reader

Dr. Jongho Moon, and the entire Connect Lab team for taking me on as a research assistant with

their impactful study. The mentorship I have received throughout my undergraduate career from

these individuals has allowed me to complete this honors thesis, graduate in three years, and

apply to medical school with valuable experiences. I would also like to thank the Honors College

for giving me the opportunity to graduate from their esteemed program as well as my parents for

Abstract

pandemic and negative mental health outcomes in younger populations. This paper examines the

impact of the COVID-19 pandemic on the mental health of those younger than 25 years of age,

specifically focusing on students. It will investigate how various factors of the pandemic have

affected people and how they have coped with psychological distress induced by the pandemic.

Through a review of scientific data and scholarly literature, the impacts of the pandemic on

caused about half of the global workforce’s livelihoods to be at risk, the deaths of hundreds of

thousands of people, and the disruption of everyone’s normal routine (WHO, 2020b.) The

pandemic has affected every aspect of life and has been detrimental to the mental health of

college students. Thus it is important that people learn from the experience so we are better

equipped to handle future mental health issues. Studying how a life-altering event like a global

and impact all aspects of well-being. They can also shape a person’s perception of the world and

themselves. The stress associated with life-altering events can lead to acute and chronic mental

health issues. For many adolescents and young adults, the COVID-19 pandemic is their first or at

the very least most significant life-altering event. The brains of people aged 0 to 25 are still

developing and the mental trauma caused by this pandemic could have lifelong consequences

(CDC, 2020.) Young adults and adolescents have missed many significant life events, had a

break in the continuity of education, and been socially isolated during critical stages of cognitive

development.

immensely affects cognitive development and physical health. The overall mental well-being of

an individual determines how they deal with stress, interact with others, and make important

decisions (MentalHealth.gov.) Adolescents and young adults depend greatly on peers for social

development and emotional support. The social isolation forced by COVID-19 has inhibited

normal peer to peer interaction and thus led to the loss of support systems. Mental health has

suffered as a result of this isolation. According to a study in the Journal of Youth and

Adolescence, adolescents have suffered significant decreases in life satisfaction and increased

anxiety and depressed symptoms (Magson et al., 2021.) Younger generations are the future of the

range from substance abuse to self-harm. Some people have experience coping with life-altering

events but many adolescents and young adults had to deal with significant stress for the first time

during the pandemic. The coping mechanisms and strategies utilized by younger generations to

deal with COVID-19 induced stress will be monumental in shaping how they handle future stress

and decision making.

Many people faced mental health issues due to the pandemic. During the pandemic, the number

of adults suffering from symptoms of anxiety or depression increased from one in ten to four in

ten adults (Panchal et al., 2020.) This is a significant increase and it is alarming that the number

can quadruple so quickly. The pandemic shocked most people when it reached America and most

people were not mentally prepared to have their lives completely disrupted. College students

experienced a lot of stress and mental health issues before the pandemic. One in five college

students experienced a mental health disorder before the pandemic (Zhai & Du, 2020.) These

statistics have increased due to COVID-19. 44% of college students reported symptoms of

depression and anxiety in 2021. 30% reported feeling more depressed in 2021 than previous

years (Mayo Clinic, 2021.) The added stress from COVID-19 only exacerbated the mental health

issues that college students experience. In a survey conducted at Texas A&M, many students

Freshmen especially rely on their first-year experience to meet new people and form new support

groups. Students expect to socialize with their peers and it is almost necessary in order to

succeed in school. Research has shown that adolescents have experienced higher levels of

anxiety and depression during the pandemic than before the pandemic. The same study found

that adolescents were more concerned about restrictions associated with the pandemic than the

virus itself (Magson et al., 2021.). Having peers to relate to and reach out to for support can

reduce stress. The pandemic greatly changed the educational experience for students of all ages

and made it harder to make connections at school. Elementary school through college is a

significant time in many people's lives where they make lifelong connections, learn impactful

lessons, and mature into productive members of society. It is imperative that the factors causing

mental health issues in younger generations are understood so intervention strategies can be

implemented.

students stems from negative news about the pandemic, restrictions that isolate them, increased

job and food insecurity, and disruption in the continuity of their education. Educational and

government mitigation strategies have had persistent negative effects on the mental wellness of

students (Copeland et al., 2021.) At the beginning of the pandemic, governments acted quickly to

It is also necessary for people to destigmatize mental health problems so they are talked about

more freely and people can get help easier. Although a population’s psychological reaction to a

disease outbreak shapes the spread and stress associated with the disease, insufficient resources

are provided by governments to manage mental health during this pandemic (Cullen et al., 2020.)

The lack of institutional support typically leads people to look for social support however

restrictions and isolation mostly prevent this.

stress can cause substance abuse, suicidal ideation, or mental health issues (CDC, 2021.) Surveys

have shown that interventions and prevention strategies are urgently needed to address the

mental health issues of students (Son et al., 2020.) Another factor is that difficulty focusing on

academic work has caused high levels of depression in students (Kecojevic et al., 2020.)

COVID-19 also worsened inequalities for students of color and put their academic success at risk

(Lederer et al., 2020.) This is a major concern because the pandemic is life-altering for everyone,

but students of color have been affected worse. This only further highlights inequalities in our

country and systems. Institutional support for equity is needed to reduce inequalities. No one

should have their academic success threatened because of something out of their control. Having

one’s academic success put at risk only adds to the stress of an already stressful pandemic. The

better prepare students to deal with future stressors they may face. The social benefit of

understanding the relationship between the pandemic and mental health is that more emphasis

can be put on good mental health practices. In the long term understanding how life-altering

events impact mental health is important because people can be better mentally prepared for the

next life-altering event.

socializing, forced to learn virtually, and had more stress added to an already stressful time. This

begs the question: Are schools doing enough for the mental health of students? Educational

institutions had to follow state restrictions and create their own restrictions to physically protect

the well-being of students and faculty. All of these restrictions had to be created rapidly to reduce

the spread of the virus. This forced students to social distance, isolate themselves, and wear a

mask almost everywhere. These times made people realize how much they value being able to

see someone’s entire face. Many schools were effective in reducing the transmission of the virus

in their student and faculty populations. However, with the reduction of spreading the virus being

the primary concern, many did not consider how the restrictions would affect mental health.

Methods

underserved students. Participants were randomized to two levels of intervention, a staff-based

social development physical activity program or a generalized after school program health

curriculum control, over a 10-month time period (16-week intervention, 6 month followup.) The

study builds upon pre-existing after school programs at elementary and middle schools serving

underserved youth. The intervention team implements a tailored social and physical activity

curriculum to randomly selected after school programs along with delivering surveys to students.

The goal of this research is to effectively prevent obesity in underserved youth. The program is

delivered in a rural-suburban area of the southeastern United States.

Association and collects precise data about college students’ holistic health. The survey is

positive for loneliness (range 6-9.) Participants’ mean psychological well-being score was 43.89

on the Diener Flourishing Scale – Psychological Well-Being (PWB) score (range is 8-56.) The

standard deviation was 8.84. Participants’ of the Fall 2019 NCHA mean psychological

well-being score was 46.72. Higher scores reflect a higher level of psychological well-being.

Participants’ mean resilience score was 5.95 on the Connor-Davison Resilience Scale

(CD-RISC2) score (range is 0-8.) Higher scores reflect greater resilience. The standard deviation

was 1.57. Participants’ of the Fall 2019 NCHA had a similar mean resilience score of 5.94.

score (range is 3-18), 28.5% of participants had a positive suicidal screening (range 7-18.) The

mean was 5.44 and the standard deviation was 3.16. 25.1% of Fall 2019 NCHA participants had

a positive suicidal screening (range 7-18.) The suicide attempt question found that 2.3% of

undergraduate students surveyed (2.7% men, 2% women, and 5.6 % trans/gender

non-conforming) indicated they had attempted suicide within the last 12 months. 2.7 % of

college students surveyed on the Fall 2019 NCHA (3 % male and 2.4 % female) indicated they

had attempted suicide within the last 12 months.

participants experienced high stress, 48.2% experienced moderate stress, 17.1% experienced low

stress, and 1.2% experienced no stress over the previous 30 days. The perceived level of stress

question on the Fall 2019 NCHA found that 27.9% of participants experienced high stress,

48.6% experienced moderate stress, 21.8% experienced low stress, and 1.7% experienced no

stress over the previous 30 days. As seen in Figures 4 and 5, participants of the Spring 2021

National College Health Assessment were stressed by a wide range of issues during the

pandemic. Students had the greatest problems with procrastination (78.6%), personal appearance

(56.9), and academics (56.1.) Students had the least problems with hazing (1%), cyberbullying

(3.9%), and bullying (5.8%.) 6% of students reported no problems with the listed stressors, 6.7%

Figure 4. Spring 2021 NCHA Young Adult Causes of Perceived Stress

Figure 5. Spring 2021 NCHA Young Adult Perceived Level of Distress by Cause

pandemic and negative mental health outcomes in younger populations. The data shows that the

youth surveyed as part of the Connect Through PLAY study were 49.1% more or much more

stressed during the pandemic than before the pandemic. The leading causes of additional stress

during the pandemic for Connect Through PLAY participants were missing friends/feeling lonely

(49.1%), stress about schoolwork (47.2%), and worrying about their own health (35.8%) The

pandemic than before. Across the younger generations surveyed it appears that academics are the

most common factor during the pandemic that induced stress. This may be due to all participants

of both surveys being students. Other potential variables that could increase academic related

stress are the break in the continuity of education, forced switch to online learning, and reduced

social interactions at academic institutions.

undergraduate students from before the pandemic (Fall 2019) to during the pandemic (Spring

2021.) The NCHA results showed an increase in serious psychological distress, loneliness,

self-harm, suicidal screening scores, perceived high stress, and a decrease in psychological

well-being in undergraduate students. This coincides with data from the Connect Through PLAY

survey that found participants were more stressed during the pandemic than before. The NCHA

trend of increased mental health issues from 2019 to 2021 aligns with data from secondary

sources as well that have found increased mental health problems due to COVID-19 (Kumar et

al., 2021.)

meta-analysis of 29 studies which found that across the globe during the pandemic, the

prevalence of depression and anxiety symptoms doubled in youth and adolescents (Racine et al.,

coping mechanisms could be one reason for increased stress and mental health issues during the

pandemic, especially in younger generations who heavily rely on social interactions for

development. Studies have shown that adolescents have significantly lower cognitive coping

strategies than adults (Garnefski et al., 2002.) This could lead to the pandemic having greater

effects on the mental health of younger people compared to adults due to reduced cognitive

development.

Through PLAY participants. This was interesting because previous studies have shown that

increased physical activity is correlated with a decrease in stress (Kim et al., 2019.) The different

results found with the Connect Through PLAY participants could be due to the smaller sample

size. There is a significant relationship between screen time and stress in participants of the

Connect Through PLAY study. Students who spent more time on smartphones, computers, and

consoles during the pandemic reported experiencing more stress during the pandemic. This is

interesting because students were inadvertently required to have more screen time each day due

to COVID-19 forcing online learning and limiting in-person interactions. People were forced to

work, attend school, interact, and find leisure through virtual means which greatly increased

screen time. Previous studies have found that increased screen time is associated with increased

sedentary time, poor sleep, and exacerbation of mental health problems (Nagata et al., 2020.)

Increasing physical activity has been shown to improve physical self-perception and self-esteem

(Lubans et al., 2016.) Returning to the normal state before the pandemic should naturally reduce

some stress by removing most pandemic-related stressors. In order to be better prepared for the

psychological side effects of life altering events, it is imperative that government and academic

institutions have better mental health infrastructure in place. Mental health problems must be

destigmatized in order to increase mental health conversations and reduce feelings of isolation by

those impacted. Greater resources for mental health and decreased stigma around the issue will

reduce the negative psychological effects of life altering events.

stressful events by giving them wisdom and a framework for how they internally and externally

handle stressful times. People who utilized healthy coping mechanisms during the pandemic will

have the best experiences to draw from when facing future stressors in life. Those that engaged

in unhealthy coping mechanisms will not have good experiences from the pandemic to draw

from which could lead them down a negative developmental course. Due to this, it is important

that greater access to mental health resources is provided so that individuals who struggled

mechanisms thus increasing social interaction and destigmatizing mental health issues.

are still being assessed and further research needs to be done into how the pandemic has affected

people. In future research, it will be useful to survey individuals to determine if the evaluation of

their perceived level of stress during the pandemic changes over time as they gain more

experiences. The evaluation of perceived stress during the pandemic may change as people

experience other stressors. This information would be useful to determine how the perception of

stress changes over time. Other useful future research includes how people feel the pandemic

prepared them for stressful events later in life to assess if the life altering experience of living

through a pandemic taught them how to cope with stress. This information could provide support

for the value or consequences of experiencing stressful situations early in life. The pandemic

may have caused people to mature faster and develop healthy or unhealthy coping mechanisms

that they will utilize later in life. I hope more research is done on the pandemic and mental health

to destigmatize mental health issues and increase support for greater mental health infrastructure.

Table 1. Demographics of Connect Through Play Survey Sample

Table 2. Demographics of Spring 2021 National College Health Assessment Sample

American College Health Association. (n.d.). Do you have a comprehensive picture of Your

Amsalem, D., Dixon, L. B., & Neria, Y. (2021). The coronavirus disease 2019 (COVID-19)

Centers for Disease Control and Prevention. (2021, January 22). Mental Health and Coping

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