Understanding the impact of the COVID-19 pandemic on stress, mood, and substance use among young adults in the greater Minneapolis-St. Paul area: Findings from project EAT

Rationale: There is a need to understand how the ongoing COVID-19 pandemic has affected the mental and behavioral health of young adults in the U.S. Objective: This study used quantitative and qualitative survey data to identify young adults at highest risk for psychological distress during the U.S. outbreak of COVID-19 and to further understand how the pandemic has impacted their stress, mood, and substance use. Methods: Participants were 670 young adult cohort members (ages 21-29) of the population-based longitudinal study EAT 2010-2018 who participated in the C-EAT study (COVID-19 Eating and Activity over Time). Results: Among the sample, 84% (n = 561) reported pandemic-related changes to their mood or stress and 33% (n = 221) reported changes to their substance use. Linear regression analyses identified several meaningful risk factors for higher psychological distress during the pandemic, including female gender, White race, higher pre pandemic depressive symptoms and perceived stress, and lower pre-pandemic stress management ability. A thematic analysis further identified five major themes related to changes in stress and mood following the COVID-19 outbreak describing specific emotional reactions, stress related to the direct impact of the pandemic as well as interpersonal connectedness and economic factors, and strategies for managing stress. In addition, two major themes were identified related to substance use during the pandemic detailing specific changes in and motivations for substance use. Conclusions: These findings underscore the need to develop effective, scalable, and rapidly deployable public health resources that target the stressors commonly experienced among young adults to improve their psychological wellbeing during this pandemic.