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Pre-Pandemic Generalized Anxiety is Linked to Anxiety During COVID-19: The Moderating Role of Coping

Wed, April 7, 3:15 to 4:15pm EDT (3:15 to 4:15pm EDT), Virtual

Abstract

The COVID-19 pandemic has led to concerning increases in anxiety in the US, implicating a need to understand the factors that contribute to this elevated anxiety (Barzilay et al., 2020). Previous research suggests that adolescents with high levels of generalized anxiety symptoms may be particularly vulnerable to experiencing heightened anxiety during stressful life events such as the pandemic (Francis, et al., 2012; McLaughlin & Hatzenbuehler, 2009). How adolescent populations cope with stressful situations (e.g., sudden schedule changes, closures) may moderate this effect of pre-pandemic generalized anxiety on increased levels of anxiety during the pandemic. Specifically, children with greater pre-pandemic anxiety who rely heavily on avoidant coping strategies (e.g., alcohol use, disengagement) may be at risk for elevated anxiety during the pandemic given that they would not directly address the source of their concern. On the other hand, positive coping strategies (e.g., cognitive reframing) may protect adolescents with pre-pandemic anxiety from experiencing elevated levels of anxiety during the pandemic. In the current study, we examined the moderating roles of avoidant coping and positive coping in the relation between generalized pre-pandemic and anxiety during the COVID-19 pandemic.
Participants (N=291, 54% female) were part of a larger longitudinal study. Generalized anxiety at age 15 was assessed via adolescent self-report on the Screen for Child Anxiety Related Disorders (Birmaher,1999; SCARED). Anxiety during COVID-19 was assessed via the Generalized Anxiety Disorder-7 (GAD-7) Scale twice during the COVID-19 pandemic: during the stay-at-home orders (T1) and at the start of gradual reopening (Spitzer, 2006; T2). Coping behaviors were assessed at age 18 via Brief-COPE at the first assessment during the COVID-19 pandemic (Carver,1997; T1). Positive coping behaviors including active coping and acceptance; and avoidant coping behaviors including self-blame and denial, were separated into subscales and summed.
A path model was conducted. As shown in Figure 1, pre-pandemic generalized anxiety positively predicted anxiety during COVID-19 T2 controlling for anxiety at T1. Coping behaviors did not predict anxiety during COVID-19. However, the relation between pre-pandemic generalized anxiety and anxiety during COVID-19 was moderated by avoidant coping, such that pre-pandemic anxiety positively predicted anxiety during COVID-19 among those who engaged in high or moderate levels of avoidant coping. As seen in Figure 2, for those who engaged in low levels of avoidant coping, pre-COVID anxiety did not predict anxiety during the pandemic. In contrast, positive coping did not moderate the relation between 15-year generalized anxiety and anxiety during COVID-19 (β =-0.077, p=.112).
Our findings suggest that not all adolescents with heightened generalized anxiety before the COVID-19 pandemic experience elevated anxiety during the pandemic. Adolescents with elevated anxiety before COVID-19 who engage in moderate or high levels of avoidant coping are particularly at risk for experiencing elevated anxiety during the pandemic. Interventions should aim to reduce the use of avoidant coping strategies in those who experienced anxiety before the pandemic. Future research could examine which specific avoidant coping behaviors most strongly contributed to this moderation to fine tune intervention strategies.

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