Association of Discrimination Experiences with Rapid Subsequent Changes in Anxiety and Depressive Symptoms in U.S. Adults During the COVID-19 Pandemic

This study explores how discrimination experiences during the COVID-19 pandemic relate to anxiety and depressive symptoms in U.S. adults. Using a national representative intensive longitudinal survey, the study evaluates rapid subsequent changes in anxiety and depression when individuals undergo heightened discrimination beyond their usual experiences. The study used 23 survey timepoints, primarily with 2-week intervals, from the Understanding America Study (n=8,198). Time-varying and time-lagged associations between discrimination experiences and anxiety and depression were modeled using multi-level logistic random-effect repeated-measures regression models. The results showed that discrimination experiences were associated with moderate-to-severe anxiety and depressive symptoms, as well as more than one comorbid psychological distress symptom (adjusted Odds Ratios [AORs]=1.10 to 1.13). The association remained significant regardless of inter-individual differences in exposure to discrimination. Non-Hispanic Blacks, Asians, and other race/ethnicities exhibited stronger associations between discrimination and psychological distress (AORs=1.63 to 1.93) compared to Hispanic and White respondents (AORs=1.13 to 1.25). Our findings suggest that individuals experience a rapid deterioration in their emotional well-being when subjected to heightened levels of discrimination beyond their typical experiences.