Coping with COVID-19: Predictors and Mediators of Anxiety and Depression during the Pandemic

The COVID-19 pandemic has led to increased levels of anxiety and depression worldwide. The current study examined predictors of anxiety and depression as well as longitudinal changes in distress at two times points during the pandemic in the United States. We also looked at disparities between White and Non-White participants. We found Non-White participants scored higher on all dependent measures than White participants in May 2020, indicating greater distress. Further, significant depression predictors for the whole sample were COVID-19 diagnosis, previous depression, and younger age, and health anxiety predictors were previous anxiety diagnosis and no COVID-19 diagnosis. Avoidant coping predicted state anxiety and depression; more time spent watching or reading COVID-19 related news predicted all three outcome variables; intolerance of uncertainty predicted state anxiety and health anxiety, and looming cognitive style predicted health anxiety. Spiritual well-being significantly mitigated all three types of symptoms. Finally, we found differences in predictors between White and non-White participants, such that for all three dependent measures there were more significant predictors for White participants, however there was substantial overlap in predictors. We further examined the impact of cognitive vulnerability factors and avoidant coping on anxiety and depression longitudinally. After testing for temporal directionality between looming cognitive style and intolerance of uncertainty, we found the best model fit and a significant serial mediation for looming cognitive style at time one leading to increased intolerance of uncertainty at time two leading to more avoidant coping resulting in increased anxiety and depression at time two. Depression scores significantly increased over time and moderation analyses revealed that when people had lower levels of depression at time one and used less avoidant coping, they had significantly less symptoms at time two; and when people had higher levels of depression at time one and used less approach coping, they had significantly higher levels of depression at time two. Results suggest a novel model in conceptualizing anxiety and depression during the pandemic, namely highlighting looming cognitive style as an underlying cognitive vulnerability factor and the impact of coping on distress. Further implications include understanding predictors and mitigating factors of psychological symptoms during COVID-19 to inform psychological treatment of depression and anxiety. Moreover, understanding the differences in predictors of anxiety and depression in White versus Non-White groups in creating treatment plans.