When it comes to worrying about the COVID-19 pandemic, a new study demonstrates that people are more concerned about whether their family members could contract the virus or if they are unknowingly spreading the virus themselves than they are with contracting it. The study, conducted by researchers from the Lifespan Brain Institute (LiBI) of Children's Hospital of Philadelphia (CHOP) and the Perelman School of Medicine at the University of Pennsylvania, also shows how increased resilience is able to reduce rates of anxiety and depression during the pandemic.

The findings were published online today by the journal Translational Psychiatry.

The COVID-19 pandemic has affected not only people's physical health, but also their mental health. Coping with these mental effects requires resilience, the ability to adapt in the face of adversity. Given the rapid spread of COVID-19 around the globe, the researchers at LiBI saw an opportunity to study resilience in the midst of a single global adversity.

In April, soon after stay-at-home measures were issued, the researchers launched an online survey at covid19resilience.org to study stress and resiliency during the COVID-19 pandemic. The survey measured six potential sources of stress during the pandemic: contracting the virus; dying from the virus; currently having the virus; having a family member contract the virus; unknowingly infecting others; and experiencing a significant financial burden.

The study involved 3,042 participants from the United States and Israel, ranging in age from 18 to 79. Most were living in locations with active stay-at-home orders at the time of the survey, and approximately 20% of those taking the survey were healthcare workers. Once they completed the questionnaire, participants' responses were measured for anxiety and depression. Of those who participated, distress about family members contracting the virus (48.5%) and unknowingly infecting others (36%) outweighed distress associated with contracting the virus themselves (19.9%). Rates of anxiety (22.2%) and depression (16.1%) were not significantly different between health care workers and non-health care workers.

"The opportunity to study mental resilience during this pandemic is unprecedented," said Ran Barzilay, MD, Ph.D., lead author, child and adolescent psychiatrist at CHOP, and Assistant Professor at LiBI. "Our frontline health care workers are acutely aware of the mental health challenges facing everyone right now, so there is an urgent need to quantify the effects of resilience and determine how future studies might guide us toward improving mental health under these changing circumstances."

Respondents with higher resilience scores had lower COVID-19-related worries, as well as a reduced rate of anxiety (65%) and depression (69%) across both health care workers and non-health care workers.

"Based on our study, it appears that people are more worried about others than themselves when reporting their COVID-19 related concerns, but encouragingly, resilience helps reduce these worries, as well as anxiety and depression," said Raquel Gur, MD, Ph.D., Professor of Psychiatry at the University of Pennsylvania and the director of LiBI. "As we get a better grasp of what constitutes resilience in people during COVID-19, we hope that soon we will be able to inform interventions that can enhance resilience, thereby mitigating the adverse effects of COVID-19 on mental health."

The survey website not only provided data to researchers, but also supplied unique information to participants, who immediately received personalized feedback upon completing the survey, including a resilience profile.

"We received many responses from participants telling us that they liked the interactive nature of the survey," said Dr. Barzilay. "Some of them explicitly said that they found the personalized feedback to be useful during these stressful times."

The researchers are continuing to gather information from the survey as the pandemic unfolds. The survey has already been translated to Spanish, French and Hebrew, and the researchers hope to collect data around the globe. So far more than 7,000 people have taken the survey, and the research team hopes to collect data over time that will shed light on the long-term effects of the COVID-19 high-stress environment.