Examining enduring effects of COVID-19 on college students' internalizing and externalizing problems: A four-year longitudinal analysis.

ABSTRACT

BACKGROUND: College students' mental health has been a vital concern for researchers, policymakers, administrators, and educators since before the pandemic, and it is crucial to identify the extent to which the pandemic affected college students' mental health. METHODS: The current study utilized data repeatedly collected over more than four years (2017-2022) from N = 355 students enrolled at a large public research university in the Midwestern US. The data collection period coincided with the COVID-19 pandemic's onset, facilitating systematic examination of whether and how college students' trajectories (i.e., level and slopes) of depressive symptoms, social anxiety, general disinhibition, callous aggression, and problematic alcohol use changed as the pandemic progressed. Across seven waves, surveys assessed multiple outcome and predictor domains. Multilevel growth curve modeling was used to analyze all outcomes. RESULTS: Depression symptoms peaked mid-pandemic, whereas social anxiety first declined then continued rising. General disinhibition and callous aggression showed non-significant changes in trajectories. Problematic alcohol use decreased continuously with no significant pandemic-associated effects in the best-fitting model. LIMITATIONS: An important limitation is reliance on a sample from a single campus utilizing self-reported, non-clinical assessments. Another important limitation is the lack of location information from participants during the acute COVID-19 phase. CONCLUSIONS: Reported longitudinal analyses expand upon findings from previous limited repeated-measures and cross-sectional studies. In terms of clinical significance, some of the most harmful COVID-19 effects to mental health may be long-lasting and cumulative, making them difficult to detect in shorter-term or cross-sectional studies. Altogether, findings demonstrate complex changes in students' mental health that may have ongoing effects on well-being during key developmental stages.