N EW R E S E A R C H

Impact of COVID-19 Pandemic on College Student

Mental Health and Wellness
William E. Copeland, PhD, Ellen McGinnis, PhD, Yang Bai, PhD, Zoe Adams, BS,
Hilary Nardone, BS, Vinay Devadanam, BA, Jeffrey Rettew, PhD, Jim J. Hudziak, MD

Objective: To test the impact of the coronavirus disease 2019 (COVID) pandemic on the emotions, behavior, and wellness behaviors of first-year
college students.
Method: A total of 675 first-year university students completed a full assessment of behavioral and emotional functioning at the beginning of the
spring semester 2020. Of these, 576 completed the same assessment at the end of the spring semester, 600 completed at least 1 item from a COVID-
related survey after the onset of COVID pandemic, and 485 completed nightly surveys of mood and wellness behaviors on a regular basis before and
after the onset of the COVID crisis.
Results: Externalizing problems (mean ¼ 0.19, 95% CI ¼ 0.06 to 0.33, p ¼ .004) and attention problems (mean ¼ 0.60, 95% CI ¼ 0.40 to
0.80, p < .001) increased after the onset of COVID, but not internalizing symptoms (mean ¼ 0.18, 95% CI ¼ 0.1 to 0.38, p ¼ .06). Students who
were enrolled in a campus wellness program were less affected by COVID in terms of internalizing symptoms (b ¼ 0.40, SE ¼ 0.21, p ¼ .055) and
attention problems (b ¼ 0.59, SE ¼ 0.21, p ¼ .005) than those who were not in the wellness program. Nightly surveys of both mood (b ¼ 0.10,
SE ¼ 0.03, p ¼ .003) and daily wellness behaviors (b ¼ 0.06, SE ¼ 0.03, p ¼ .036), but not stress (b ¼ 0.02, SE ¼ 0.03, p ¼ .58), were negatively
affected by the COVID crisis. The overall magnitude of these COVID-related changes were modest but persistent across the rest of the semester and
different from patterns observed in a prior year.
Conclusion: COVID and associated educational/governmental mitigation strategies had a modest but persistent impact on mood and wellness be-
haviors of first-year university students. Colleges should prepare to address the continued mental health impacts of the pandemic.
Key words: adolescence, COVID-19, young adulthood, wellness, substance use, college behavior change
J Am Acad Child Adolesc Psychiatry 2021;60(1):134–141.

he novel coronavirus disease 2019 (COVID-19) effects of the pandemic and the resulting mitigation stra-
T emerged in Wuhan, China, in December 2019.1
By January 20, 2020 the first confirmed case was
identified in the United States in Washington State, and the
tegies on the emotional health and wellness of first-year
university students.
There are a number of additional reasons why students
first death was reported on February 29. By early March, in particular may be at risk. Many undergraduate students
most states had identified cases, and by mid-March state- faced this disruption without a familiar routine and support
wide school closures and stay-at-home orders were to provide a sense of stability and coherence.4 More
announced in many states. The rapid pandemic progression generally, late adolescence is a period of neuro-
and the associated mitigation strategies up-ended millions of developmental risk due to a developmental mismatch be-
lives within weeks of the virus arriving in the United States. tween mature subcortical regions (eg, nucleus accumbens,
Early data from China suggest that the outbreak, as well as amygdala) associated with reward seeking and the experi-
unprecedented government response, have had profound ence of emotions and still-developing regulatory prefrontal
psychological impact on the general public.2,3 Many uni- cortical regions.5,6 This mismatch sets the stage for poorly
versity and college students were displaced from their dor- regulated risk taking and emotional functioning.7,8 The
mitories and peer groups, required to leave campus risks are especially salient for college students, most of
immediately—in many cases, without their belongings— whom also experience a precipitous decrease in adult scaf-
and expected to continue their academic work as usual, folding and parental supervision and support. Not surpris-
remotely. The aim of the analysis is to understand the ingly, Cao et al.9 demonstrated that nearly one-fourth

134 www.jaacap.org Journal of the American Academy of Child & Adolescent Psychiatry
Volume 60 / Number 1 / January 2021
 IMPACT OF COVID ON COLLEGE STUDENTS

(24.9%) of college students were found to be experiencing students to make healthier decisions.15 This program in-
anxiety due to the COVID outbreak in China. Gender did volves educational and residential components to provide
not significantly impact COVID-related anxiety; however, students access to and education about different wellness
living with parents, and having a steady family income, were behaviors. Students are expected to live by a code that re-
protective against anxiety. Although only 0.55% of the quires that they do not possess alcohol, drugs, or para-
sample had an acquaintance or relative infected with phernalia in their dormitories, thereby promoting a
COVID, this personal connection was significantly pre- substance-free environment. It was hypothesized that stu-
dictive of the level of student anxiety. dents in this program may display fewer adverse effects of
The speed with which the pandemic has developed, the the COVID-related disruptions.
extent of the governmental and educational mitigation
strategies, and the ongoing nature of the threat make this a METHOD
unique experience. The closest comparisons for university Sample
and college students are the effects of natural disasters such This study is a subsample of a larger, ongoing student
as a hurricane or an earthquake. These events are collective, emotional health and wellness study at the University of
disruptive, and may pose an ongoing threat to safety. Vermont (Figure S1, available online). Eligible participants
Commonly observed effects of such experiences include for the larger study had to be full-time, first-year UVM
anxiety, depression, and stress,10-12 but also low academic undergraduates, aged 18 to 25 years, with an iPhone 5 or
motivation.13 The perceived level of personal disruption of newer (for app compatibility). All participants completed an
the event was closely tied to worse psychological out- informed consent approved by the UVM institutional re-
comes.12 It is not at all clear whether students’ responses to view board. A total of 675 students completed a full
COVID will follow a pattern similar to that observed with assessment of behavioral and emotional functioning at the
natural disasters such as Hurricane Katrina. Furthermore, beginning of the spring semester in 2020. Of these, 576
most studies of responses to collective events have infor- completed the same assessment at the end of the spring
mation only on the students’ responses after the events, and semester after the onset of COVID, 600 completed at least
thus are limited in their ability to inform how much 1 item from a COVID-related survey, and 485 completed
functioning has changed from before the event. We found nightly surveys of mood and wellness behaviors on a regular
only 1 such study that had information on students from basis both before and after the onset of the COVID crisis.
before the disaster, in which the investigators found that About 67% of participants were enrolled in the UVM
posttraumatic stressrelated symptoms significantly Wellness Environment (WE) program.
increased after an earthquake and continued to remain
significantly elevated at 7 weeks after the earthquake.14 To
Assessment
disentangle the effects of the event from the individual risk
COVID Survey. An additional questionnaire was added to
requires an experimental design in which individuals were
end of the spring semester assessment in spring 2020 to
sampled before the events.
evaluate students’ response to the COVID pandemic.16 The
In Vermont, the president of the University of Vermont
survey was developed after the onset of the COVID crisis to
(UVM) announced that the school would be shifting to
characterize an individual’s response to the crisis. The sur-
remote learning indefinitely as of Wednesday, March 11, and
vey’s items measured students’ confidence in the state/fed-
a stay-at-home order was instituted for the state by Governor
eral government’s response to and handling of the
Scott on March 24. These announcements also occurred in
pandemic, their hopefulness that the crisis would be
the midst of an ongoing study of student emotional health
resolved and whether they had a good outlook for their
and wellness. This provided a natural experiment with which
future, whether they knew someone who became ill or died
to understand the effects of COVID and associated mitigation
of the COVID virus, and the level of disruption that the
strategies on changes in individual emotional health and
pandemic had on their daily life. The full text of this survey,
wellness behaviors. It was hypothesized that the onset of
including survey questions and response options, is pro-
COVID and associated residential and educational disrup-
vided in Table S1, available online.
tions would be associated with decreased emotional health and
lower levels of wellness behavior. In-Depth Assessments. All participants completed 3 self-
Finally, a significant portion of the students in the study report survey batteries through the RedCap platform at
were enrolled in the UVM Wellness Environment (WE) the beginning of the fall semester, the beginning of the
program, a program created by Dr. Hudziak to support spring, semester and the end of the spring semester.
students in the transition to college and to encourage Although a number of measures were included, this study
Journal of the American Academy of Child & Adolescent Psychiatry www.jaacap.org 135
Volume 60 / Number 1 / January 2021
COPELAND et al.

focuses on results from the Brief Problem Monitor from the RESULTS
beginning and end of the spring semester. The Brief Sample descriptive statistics including gender, ethnicity, and
Problem Monitor (BPM/18-59) was introduced by year in college were also collected on all participants, as well
Achenbach et al.17 A survey of 18 items, the BPM is as the follow-up samples (Table 1). The sample has a racial/
intended to evaluate internalizing, attention, and external- ethnic composition similar to that of the UVM student
izing problems in adults 18 to 59 years of age. Each of the body, but a higher percentage of female students.
18 items appears on the Adult Self Report (ASR) and the
Adult Behavior Checklist. It has been determined that COVID survey
BPM/18-59 can serve as an alternative or supplement to the All participants were sent a COVID-specific survey as part
ASR, particularly when frequent and brief assessments are of their end-of-the-year survey. This survey was completed
needed. by 600 of the study participants, or 88.9% of the partici-
Ecological Momentary Assessments. All participants in pants who completed the assessment at the beginning of the
the study were asked to download an app to complete daily spring semester (n ¼ 675). Participants who completed the
surveys across the school year.18 The daily survey was open COVID survey were not different from those that did not
from 7 pm to 11:59 pm every evening, and prompted in terms of gender, ethnicity, age, involvement in the
participants to report on 21 health- and wellness-related wellness program, or SSS.
behaviors from the day. Five wellness items (ie, minutes Figure 1a and 1b provide the responses of the stu-
of exercise, minutes of screen time, nutritional quality of dents to the survey items. The majority of students
meals, hours of sleep, and amount of water consumed), and (68.4%; n ¼ 384) reported that they were not confident
the 2 mood-scale items (mood, stress) from the spring se- in the government’s handling of COVID. Older stu-
mester are the focus of this analysis. The 5 wellness items dents, just among first-year students, and those in the
were each dichotomized to indicate absence (0) or presence wellness program were more likely to report confidence
(1) of healthy choices and summed to form a cumulative in the government (p ¼ .008 and p ¼ .05, respectively).
wellness index. The full text of this survey, including survey At the same time, 86.3% of students (n ¼ 490) were
questions, response options, and cut-off values, is provided hopeful that COVID would be resolved. Such optimism
in Table S2, available online. was not related to gender, ethnicity, SSS, or involvement
in the wellness program. Almost all students (95.8%;
Statistical Analyses n ¼ 536) reported compliance with governmental rules
Descriptive statistics for demographic variables included and suggestions for conduct during the pandemic. Fe-
age, involvement in the wellness program, gender, ethnicity, male students were slightly more likely to report
and subjective social status (SSS). A c2 test was conducted compliance than male students (96.5% versus 93.3%,
to examine the sample distribution in these demographic p ¼ 0.01). The majority of students (75.2%; n ¼ 425)
characteristics. The descriptive statistics of responses to the found this compliance with governmental rules and
COVID survey were summarized, and the response differ- suggestions easy. This ease of compliance was not asso-
ence in demographic variables mentioned above was tested. ciated with gender, ethnicity, SSS, or involvement in the
Change scores of pre- and post-COVID BPM were calcu- wellness program.
lated, and the difference in participants with or without In terms of the impact on their lives, 23.8% of the
wellness program involvement was tested. All analyses of the students (n ¼ 136) knew someone who had tested positive
daily surveys had to account for repeated, correlated ob- for COVID, and 2.4% (n ¼ 14) knew someone who had
servations within individuals. Correlation matrices were died of COVID. No group of students was more likely to
introduced to account for within-subject correlations using report knowing someone who had tested positive for or died
general estimating equations implemented in SAS PROC of COVID. Finally, students reported how disruptive
GENMOD, with an autoregressive covariance structure. In COVID had been to them personally on a 10-point scale,
this approach, participant ID is introduced as a cluster ranging from “not at all disruptive” to “extremely disrup-
(class) variable. Robust variance estimates (ie, sandwich-type tive.” The mean level of disruptiveness was 7.8 (SD ¼ 2.1),
estimates) adjusted the standard errors of the parameter with 87.3% reporting a score of 6 or greater. This is not
estimates for the within-person nesting of observations. All surprising, as all students were affected by shifting to remote
analyses were conducted with SAS 9.4 software (SAS learning and by the shutdown of the university campus.
Institute, Cary, NC).19 The a value for significance testing The level of disruptiveness was higher for younger students
was set at .05 for hypothesis testing. and those who were not involved in the wellness program.

136 www.jaacap.org Journal of the American Academy of Child & Adolescent Psychiatry
Volume 60 / Number 1 / January 2021
 IMPACT OF COVID ON COLLEGE STUDENTS

Changes in Emotional and Behavioral Functioning improved internalizing symptoms (b ¼ 0.40, SE ¼ 0.21,
Participants completed the Brief Problem Monitor to assess p ¼ .055) and less deteriorating attention over the spring
emotional and behavioral functioning at the beginning of semester as compared to students who were not in WE (b ¼
the spring semester before COVID and at the end of the 0.59, SE ¼ 0.21, p ¼ .005). Although there were no dif-
spring semester. Of the 675 students who completed the ferences between these groups’ scores at baseline on any
BPM at the beginning of the spring, 576 completed the BPM scale, WE students had lower attention problems
BPM at the end of the year (85.3%). There were no dif- scores at the end of the semester (b ¼ 0.94, SE ¼ 0.25, p <
ferences in attrition by sex, ethnicity, age, WE status, or SSS .001), and a similar trend was seen for internalizing prob-
(Table 1). lems (b ¼ 0.44, SE ¼ 0.25, p ¼ .07). Finally, the more
The BPM produces scales for internalizing problems, disruption that students experienced related to COVID, the
attention problems, and externalizing problems. From the greater the increase in their internalizing symptoms
beginning of the spring to the end of the spring, there were (b ¼ 0.13, SE ¼ 0.05, p ¼ .004).
modest improvements in internalizing symptoms (mean ¼
0.18, 95% CI ¼ 0.1 to 0.38, p ¼ .06) but decrements in Changes in Daily Mood, Stress, and Wellness
externalizing problems (mean ¼ 0.19, 95% CI ¼ 0.06 Five-minute, nightly ecological momentary assessments
to 0.33, p ¼ .004) and attention problems (mean ¼ 0.60, were completed by participants throughout the spring se-
95% CI ¼ 0.40 to 0.80, p < .001). Moderation of mester before and after the onset of COVID, providing a
COVID-related differences in BPM scales were also tested high-resolution picture of potential changes in mood, stress,
in relation to age, WE involvement, gender, ethnicity, and and wellness behaviors. In total, 485 first-year students
SSS. Only WE involvement moderated changes in BPM completed 50% of the nightly surveys across the spring
scale scores (Figure 2). The WE students experienced semester, or 71.8% of those completing the beginning of

TABLE 1 Descriptive Information About First-Year College Sample

Beginning of
spring sample End of spring EMA sample
(n ¼ 675) sample (n ¼ 576) (n ¼ 485)
Characteristic n % n % p n % p
Gendera
Female 500 74.1 435 75.5 .32 367 75.8 .34
Male 172 25.5 139 24.1 117 24.2
WE status
WE 453 67.1 386 67.0 .87 328 67.6 .95
Non-WE 222 32.9 190 33.0 157 32.4
Ethnicity
African American 5 0.7 2 0.3 .62 2 0.4 .77
Asian 28 4.2 20 3.5 17 3.5
White/Caucasian 604 89.5 523 90.8 439 90.5
Latina/Latino 20 3.0 16 2.8 13 2.7
Other 15 2.2 17 2.9 14 2.9
Age, y
18 618 91.4 532 92.0 .76 447 92.2 .17
19 51 7.6 39 6.8 35 7.2
20 4 0.6 4 0.7 3 0.6
21 2 0.3 2 0.4 0 0.0
SES
1-4 46 6.9 36 6.3 .56 29 6.0 .52
5-7 445 66.3 387 67.4 324 66.9
8-10 180 26.8 151 26.3 131 27.1

Note: EMA ¼ ecological momentary assessments; SES ¼ socioeconomic status; WE ¼ involvement in wellness program.
a
A small number of students identified as other than male or female.

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COPELAND et al.

FIGURE 1 Descriptive Results of COVID Survey Items

Note: Descriptive results from the items on the COVID survey administered at the end of the spring semester. (a) First 4 items related to the government response and
individual compliance. (b) Disruptiveness of COVID to the student’s life personally. Please note color figures are available online.

the spring assessment. Those who routinely completed the students were informed that on-campus instruction would
daily surveys were not different in terms of gender, race/ be discontinued for the remainder of the spring semester.
ethnicity, age, WE status, or SSS from those who did not. Each of these outcomes has been standardized to allow for
Figure 3 displays the weekly survey values for overall comparison of all items on a single figure. There are 2
mood, stress, and an index of 5 wellness behaviors. The patterns. The first is similar for overall mood (in blue) and
vertical line indicates the week of spring break, when the the wellness index (in orange), in which levels drop in the 2

FIGURE 2 Changes in Brief Problem Monitor (BPM) Scale Scores After COVID Onset

Note: Displays changes in scores on different Brief Problem Monitor scales from the beginning of the spring semester before COVID to the end of the spring semester.
Please note color figures are available online.
*p < .05.

138 www.jaacap.org Journal of the American Academy of Child & Adolescent Psychiatry
Volume 60 / Number 1 / January 2021
 IMPACT OF COVID ON COLLEGE STUDENTS

FIGURE 3 Nightly Survey Results Across Spring Semester

Note: Result from nightly ecological momentary assessments throughout the spring semester. Vertical dashed line indicates spring break when on-campus learning was
suspended. Please note color figures are available online.

to 3 weeks after spring break and then remain relatively Both mood and wellness changes were associated with how
steady through the end of the semester. This is consistent personally disruptive the crisis was for the student (mood:
with a COVID-related drop in overall mood and wellness b ¼ 0.03, SE ¼ 0.01, p ¼ .02, and wellness: b ¼ 0.02,
behavior. Follow-up analyses on the wellness index indi- SE¼0.01, p ¼ .12, respectively). There was little evidence
cated drops in each of the 5 behaviors after COVID, of additional vulnerable groups for the overall wellness in-
including exercise minutes, nutritional quality, sleep, and dex. In the case of mood, there was trend-level associations
hydration coupled with increases in screen time. The second for both gender and WE status (b ¼ 0.10, SE ¼ 0.06, p ¼
pattern is for stress level (higher indicates more stress), in .09, and b ¼ 0.09, SE ¼ 0.05, p ¼ .08, respectively), in
which the levels vary throughout the semester with no which the drop in mood was somewhat greater in female
change from before to after COVID. students and those not enrolled in the wellness program.
It is plausible that the observed change in mood and
wellness behaviors is not uncommon after spring break. To
test for this pattern, we analyzed UVM nightly survey data DISCUSSION
from spring 2018 for mood and wellness behavior (stress In addition to concerns for the health of oneself and loved
was not assessed that semester). In both cases, there was a ones, college students faced an interruption in their spring
significant difference, but in the direction of improved semester, in which on-campus learning and residential living
mood and wellness behavior after spring break. were suspended. This study leverages an ongoing study of
Finally, we tested whether particular groups of students college life that was begun before COVID to study the
were vulnerable or resilient to the COVID-related changes. impact of this disruption on emotional and behavioral

Journal of the American Academy of Child & Adolescent Psychiatry www.jaacap.org 139
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COPELAND et al.

functioning. Despite subjective reports that the crisis was was associated with improved internalizing problems and
highly disruptive and that there was limited confidence in mitigated attention problem increases across COVID-
the government’s handling of the crisis, these students (1) related changes compared to college as usual students.
remained hopeful for the future and (2) reported very high The WE program is a neuroscience-inspired, incentivized
levels of compliance with governmental laws and behavioral change program that involves residential,
suggestions. educational, and digital interventions to promote wellness
There were persistent negative effects on students’ behaviors in a university setting.15 This program provided a
behavioral and emotional functioning, particularly measure of resilience in the face of COVID. It is not
externalizing and attention problems. These findings possible to clarify which aspect of the intervention was
are consistent with those in students who have experi- helpful, whether it be wellness practices themselves, the
enced natural disasters overall; but, notably, internal- sense of community/social network,12,20 or students’ pre-
izing symptoms did not decline here as has been seen in existing interest in health promotion.
prior work.10-12 Also, students in the wellness program This study was designed to provide a fine-grained
were less affected by COVID in terms of internalizing picture of college life across the school year at UVM,
symptoms and attention problems. The nightly survey but not to assess response to a pandemic such as COVID.
results of mood, stress, and daily wellness behaviors The analysis completed is post hoc, but capitalizes on
told a complementary story. Although these responses ongoing data collection to address these aims. The study
were highly stable within individuals, both mood and was focused only on first-year college students at a single
wellness behaviors were negatively affected by COVID. university. The racial/ethnic composition of the sample is
The overall magnitude of these COVID-related changes similar to the UVM student body, but underrepresents
was modest but persistent across the rest of the se- nonwhite students as compared to the national average for
mester and differed from patterns observed in a colleges. Students were also required to have an IPhone 5.
prior year. It is not clear whether the findings here will apply to
One apparent inconsistency in our results was in the university students with different socio-demographic pro-
way in which stress levels were unaffected in the same files. Participation rates were high for a study with this
daily survey that identified decreases in mood and wellness type of intensive follow-up, but it is still possible that
behaviors. Why should stress and mood levels vary those who completed 50% or more of all daily surveys
differently? Here, our explanations rely more on conjecture differed in ways not measured from participants who did
than empirical data. One potential explanation lies in the not complete daily surveys regularly.
return of students to home from living on campus. The As universities prepare for the coming academic year,
transition from home to college has been identified as a many are anticipating COVID-related adjustments,
significant social and academic stressor for many. The including on-campus social distancing and/or remote
transition back home may, in turn, reduce the social stress learning. Our study found that similar changes in spring
of first-year college life. Academic stress may also have 2020 resulted in modest but persistent psychological im-
been minimized. After COVID, instructors at the Uni- pacts. The greater the perceived disruption by COVID,
versity of Vermont were instructed to make additional the greater the impact. This disruption may increase for
accommodations to students, students were allowed to students as their families struggle with the economic
shift to pass/fail status, and the amount of instruction time conditions of the continued pandemic. Students, and
decreased in many cases. Together, these 2 factors may particularly first-year students, may be in need of more
have mitigated any overall increase in stress. At the same institutional support than ever. In the face of similar
time, the pandemic and its uncertainty, isolation, and challenges, other studies have suggested positive attitude
economic/health effects may be responsible for decreased and availability of faculty,21 and reduction of uncertainty
mood and wellness behaviors. Regardless of the interpre- via transparency of institutional information.9,21-23 These
tation, these finding provide some evidence that closely suggestions seem reasonable. Our study also supports 2
related constructs of mood and stress are distinct and additional measures. If school are tracking health symp-
distinguishable in the context of the complexities of a toms, and most are, they also should take the opportunity
pandemic and its effects. to track emotional health; and if they have detailed pro-
In this study, there appears to be an advantage, albeit tocols for supporting physical health, similar protocols
small, to being a part of the UVM WE learning commu- should be in place to support mental health. Finally, there
nity. Considering similar baseline scores, WE enrollment is an increasing role for college programs, such as the

140 www.jaacap.org Journal of the American Academy of Child & Adolescent Psychiatry
Volume 60 / Number 1 / January 2021
 IMPACT OF COVID ON COLLEGE STUDENTS

UVM wellness program, that increase the sense of com- Writing e review and editing: Copeland, McGinnis, Bai, Adams, Nardone,
munity within the student body and may aid in student Rettew, Hudziak

resilience in the face of future deviations from and ORCID

William E. Copeland, PhD: https://orcid.org/0000-0002-1348-7781
ongoing disruptions to typical college life. Ellen McGinnis, PhD: https://orcid.org/0000-0001-8566-2289
Zoe Adams, BS: https://orcid.org/0000-0001-6913-3352
Jeffrey Rettew, PhD: https://orcid.org/0000-0002-4238-5979
Accepted October 13, 2020. Jim J. Hudziak, MD: https://orcid.org/0000-0001-9653-758X

Dr. Bai is with the University of Utah, Salt Lake City. Drs. Copeland, McGinnis, The authors thank the participants themselves for being part of the study
Rettew, Nardone, Hudziak, and Devadanam are with the University of Vermont, during a difficult time.
Burlington. Ms. Adams is with Happy Corp, Atlanta, Georgia. Disclosure: Dr. Copeland has received research support from the National
The work presented here was supported by a research grant from the Conrad Institute of Mental Health, the National Institute on Drug Abuse, and the
Hilton Foundation. The funding source had no involvement in the study Eunice Kennedy Shriver National Institute of Child Health and Human Devel-
design, data collection, analysis and interpretation of data, writing of the opment. Dr. Hudziak has received research grants from the Conrad N. Hilton
report, or the decision to submit the article for publication. Foundation and Apple Corps and has been a scientific consultant to Happy
Corp. Drs. McGinnis, Bai, Rettew, Mss. Adams and Nardone, and Mr. Deva-
Author Contributions danam have reported no biomedical financial interests or potential conflicts of
Conceptualization: Hudziak interest.
Data curation: Bai, Adams, Nardone, Devadanam
Formal analysis: Copeland, Bai Correspondence to William E. Copeland, PhD, Vermont Center for Children,
Funding acquisition: Hudziak Youth, and Families, Department of Psychiatry, University of Vermont College
Investigation: Devadanam, Rettew, Hudziak of Medicine, Box 3454, 1 South Prospect Street, MS 446AR6, Burlington, VT
Methodology: Rettew, Hudziak 05401; e-mail: [email protected]
Project administration: Adams, Nardone, Devadanam 0890-8567/$36.00/ª2020 American Academy of Child and Adolescent
Resources: Devadanam, Rettew, Hudziak Psychiatry
Supervision: Copeland, Hudziak
Writing e original draft: Copeland, McGinnis, Bai, Nardone https://doi.org/10.1016/j.jaac.2020.08.466

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COPELAND et al.

FIGURE S1 Ascertainment Figure for Sample

Note: UVM ¼ University of Vermont.

141.e1 www.jaacap.org Journal of the American Academy of Child & Adolescent Psychiatry
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 IMPACT OF COVID ON COLLEGE STUDENTS

TABLE S1 COVID-19 Survey Items TABLE S2 Ecological Momentary Assessment Items

Question Response scale Question Response scale

I am confident the government Strongly disagree, somewhat How was your day? 0e10
is handling the COVID-19 disagree, somewhat agree, How was your stress level today? 0e10
response in the best manner strongly agree Wellness
possible How many minutes did you exercise? 0e180
I am hopeful that the COVID-19 Strongly disagree, somewhat How many minutes have you practiced 0e120
virus will resolve over time disagree, somewhat agree, mindfulness?
and I have a good outlook strongly agree How many minutes did you play an 0e120
toward the future instrument or sing today?
I complied with the rules and Strongly disagree, somewhat How would you describe the nutritional Poor,
suggestions of the disagree, somewhat agree, quality of your meals/snacks today? Average, Good
government and health care strongly agree How many hours of sleep did you get? 0e14
system to remain at home to How many glasses of water did you have 0e12
try to contain the virus today?
I found it easy to comply with Strongly disagree, somewhat
the rules and suggestions of disagree, somewhat agree,
the government and health strongly agree
care system to remain at
home to try to contain the
virus.
Do you have a close friend or Yes, No
loved one who has tested
positive for the COVID-19
virus?
This may be a difficult question, Yes, No
but has someone close to
you lost their life due to the
COVID-19 virus?
Please describe your Free type
relationship with this person
(aunt, uncle, parent,
neighbor, etc)
Please rate how much the 1L10
COVID-19 outbreak has been
disruptive to you personally.
Think about your daily
routines, work, and family life.

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