Resilience, COVID-19-related stress, anxiety and depression during the pandemic in a large population enriched for healthcare providers

Ran Barzilay, Tyler M. Moore, David M. Greenberg, Grace E. DiDomenico, Lily A. Brown, Lauren K. White, Ruben C. Gur, Raquel E. Gur

Research output: Contribution to journalArticlepeer-review

328 Scopus citations


COVID-19 pandemic is a global calamity posing an unprecedented opportunity to study resilience. We developed a brief resilience survey probing self-reliance, emotion-regulation, interpersonal-relationship patterns and neighborhood-environment, and applied it online during the acute COVID-19 outbreak (April 6–15, 2020), on a crowdsourcing research website ( advertised through social media. We evaluated level of stress (worries) regarding COVID-19: (1) contracting, (2) dying from, (3) currently having, (4) family member contracting, (5) unknowingly infecting others with (6) experiencing significant financial burden following. Anxiety (GAD7) and depression (PHQ2) were measured. Totally, 3042 participants (n = 1964 females, age range 18–79, mean age = 39) completed the resilience and COVID-19-related stress survey and 1350 of them (mean age = 41, SD = 13; n = 997 females) completed GAD7 and PHQ2. Participants significantly endorsed more distress about family contracting COVID-19 (48.5%) and unknowingly infecting others (36%), than getting COVID-19 themselves (19.9%), p < 0.0005 covarying for demographics and proxy COVID-19 exposures like getting tested and knowing infected individuals. Patterns of COVID-19 related worries, rates of anxiety (GAD7 > 10, 22.2%) and depression (PHQ2 > 2, 16.1%) did not differ between healthcare providers and non-healthcare providers. Higher resilience scores were associated with lower COVID-19 related worries (main effect F1,3054 = 134.9; p < 0.00001, covarying for confounders). Increase in 1 SD on resilience score was associated with reduced rate of anxiety (65%) and depression (69%), across healthcare and non-healthcare professionals. Findings provide empirical evidence on mental health associated with COVID-19 outbreak in a large convenience sample, setting a stage for longitudinal studies evaluating mental health trajectories following COVID-19 pandemic.

Original languageEnglish
Article number291
JournalTranslational Psychiatry
Issue number1
StatePublished - 1 Dec 2020

Bibliographical note

Funding Information:
We thank participants of for their contribution to data generation. This study was supported by the National Institute of Mental Health (NIMH) grants K23-MH120437 (RB), R01-MH119219 (REG, RCG), R01-MH117014 (RCG), and the Lifespan Brain Institute of Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania. DMG was funded in part by the Zuckerman STEM Leadership Program. The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the paper; and decision to submit the paper for publication. The authors thank Sigal Barzilay for her help with the Hebrew translation of the survey.

Publisher Copyright:
© 2020, The Author(s).


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