NYU OPUS Vol. XII Issue I

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The Online Publication of Undergraduate Studies was initiated in 2010 by undergraduate students in the Department of Applied Psychology, NYU Steinhardt. The ideas and opinions contained in this publication solely reflect those of the authors and not New York University. All work is licensed under the Creative Commons Attribution Noncommercial No Derivative Works License.

To view a copy of this license, visit http://creativecommons.org

OPUS

Online Publication of Undergraduate Studies Volume XII Issue I | Spring 2021 Editors-in-Chief Olivia P. Russo Maya Metser Katie Mundt Reviews Janean Cuffee Anjali Mehta Gizem Kurtbolat

Layout & Design Directors Chloe Carlson Sydney Liang Grace Park

Proposals Samantha Ruggiero Vion He Julia Leschi

Faculty Mentor Dr. Adina R. Schick

Research Macarena Kruger & Joy Shen Ana Warner & Callie Hilgendorf

Special Thanks Erica Rodriguez Dr. Gigliana Melzi Department of Applied Psychology NYU Steinhardt

Cover Art Design Mel Pagliaro

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Contents 05

Letter from the Editors

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Reviews 07 Janean Cuffee Racial Discrimination and Anxiety in African American Adolescents 11 Anjali Mehta Midsommar: Cults, Conformity, and Obedience 15 Gizem Kurtbolat Effect of Media Literacy Education on American Adolescents’ Sexual Socialization

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Proposals 21 Samantha Ruggiero Remote Learning, Academic Self Efficacy, & Academic Performance of College Students During COVID-19 26 Vion He CBT-based Mental Health Apps’ Treatment Outcomes in Heterosexual and LBTQ+ College Students with Depression 30 Julia Leschi Family Support, Motivation for Change, and Treatment Entry of Individuals with Substance Use Disorders

35 Research 36 Macarena Kruger and Joy Shen COVID-19 and Parental Burnout Levels 43 Ana Warner and Callie Hilgendorf COVID-19 and LGBTQ+ Mental Health

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Biographies 4

Letter From the Editors New York University’s Applied Psychology Online Publication of Undergraduate Studies, also known as OPUS, was established in 2009. OPUS provides Applied Psychology undergraduate students with a forum for sharing their independent work. This publication is entirely written, edited, and designed by Applied Psychology undergraduates, and is one of the only undergraduate psychology journals in the United States.

We are thrilled to present our Spring 2021 issue this year. Specifically, the Spring 2021 issue reflects the clinical and research interests of our contributing writers and demonstrates a desire to understand the nuances of psychological phenomena in order to improve the lives of a range of groups, thus embodying the ethos of Applied Psychology.

Our issue this semester contains further explorations of psychological theories with real-world applications.

In the first section, “Reviews,” Janean Cuffee examines how racial discrimination impacts anxiety in AfricanAmerican adolescents. Anjali Mehta’s piece focuses on an Ari Aster film, Midsommar, drawing parallels between the cult depicted in the film and aspects of social psychology. In the final piece in this section, Gizem Kurtbolat investigates the impact of media literacy education on adolescents’ attitudes about sex.

The following section, “Proposals’’ includes Samantha Ruggiero’s research proposal about the effect of remote learning on college students’ academic self-efficacy during COVID-19. Vion He proposes a study to examine how CBT mobile apps affect the outcomes of treatments for depression in LGBTQ+ college students. Julia Leschi’s concluding proposal focuses on treatment entry motivation for people with substance use disorders.

The final section, “Research,” includes two qualitative studies examining effects of the COVID-19 pandemic on different populations. The first, by Macarena Kruger and Joy Shen, is a novel study about burnout levels among parents of young children during the pandemic. The final piece, by Ana Warner and Callie Hilgendorf, explores how the COVID-19 pandemic has exacerbated symptoms of anxiety in LGBTQ+ college students.

Thank you so much to our enthusiastic and talented writers for their scholarly contributions, as well as Sydney Liang, Grace Park, and Chloe Carlson, the OPUS administrative staff for their hard work and commitment to the journal. Additionally, we would like to acknowledge and thank Mel Pagliaro for contributing their artwork to be displayed on the cover of this issue. We are also grateful to Dr. Gigliana Melzi, the Director of Undergraduate Studies in Applied Psychology, and Erica Rodriguez, the OPUS advisor for their continuous support of OPUS. Finally, we would like to thank Dr. Adina Schick, our faculty mentor, for her guidance, wit, and dedication to OPUS, without which this issue would not be possible.

Best, OPUS Editors

Maya Metser

Olivia Russo

Katie Mundt

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REVIEWS

Racial Discrimination and Anxiety in African American Adolescents Janean Cuffee

Anxiety disorders are among the most prevalent psychiatric disorders affecting American adolescents, with nearly one-fifth of the population experiencing some form of anxiety before adulthood (Hazen et al., 2011). In general, anxiety disorders can include fear and excessive worry about health, social interactions, and everyday circumstances, which may result in feelings of irritability, fatigue, and restlessness, as well as difficulty concentrating and controlling one’s feelings (National Institute of Mental Health [NIMH], 2018). Moreover, symptoms of anxiety negatively influence overall well-being, self-esteem, and academic success which specifically impacts adolescents (Derdikman-Eiron et al., 2011). Research shows that not only are adolescents vulnerable to developing anxiety in response to life events, but also they struggle with developing strategies to manage additional stressors (Garnefki et al., 2002).

Race-related experiences, such as consistent exposure to racial discrimination, have been linked to the development of anxiety symptoms (Clark et al., 2004; Gaylord-Harden, Elmore et al., 2011). Specifically, African American adolescents are faced with the highest levels of racial discrimination in the United States, resulting in feelings of worthlessness, hopelessness, and, ultimately, anxiety disorders (Caughy et al., 2004; SandersPhillips, 2009). Notably, the impact of racial discrimination on African American adolescents differs depending on whether it is overt (i.e., unfair behaviors towards an individual based on their race; Dovidio & Gaertner 1986; Gaylord-Harden & Cunningham, 2009) or perceived (i.e., an individual’s perception and internalization of someone’s negative actions as being racially driven; Sellers & Shelton, 2003). Nonetheless, both perceived and overt racial discrimination negatively affect African American adolescents’ symptoms of anxiety (Assari et al., 2017; Clark et al., 2004). Furthermore, research shows that both the expression and exacerbation of symptoms of anxiety differ by gender (Assari et al., 2017; Brodish et al., 2011; Palapattu et al., 2006). Therefore, the current review explores the following research question: How does racial discrimination impact symptoms of anxiety in African American adolescents, and how might these symptoms differ by gender?

Overt Racial Discrimination Racial discrimination is an active and persistent stressor in African American adolescents’ lives; studies show that experiencing racial discrimination correlates to higher levels of anxiety symptoms (Berkel et al., 2008; Gaylord-Harden & Cunningham, 2009; Smith-Bynum et al., 2014). Overt racial discrimination encompasses blatant antipathy, endorsing derogatory stereotypes, and believing one group is inherently

inferior (Cortina, 2008). Exposure to overt racial discrimination at high levels may result in an increasingly sensitive neurological structure related to managing threats, which leads to anxiety symptoms (Gaylord-Harden, Elmore, et al., 2011). Adolescent experiences with overt racial discrimination result in heightened negative psychological stress responses, hypervigilance, an increase in unhealthy behaviors, and increased physiological stress responses (Himmelstein et al., 2015; Sellers et al., 2003).

As a result, African American adolescents, as compared to non-African American adolescents, are forced to address these additional stressors resulting from everyday racial discrimination, which worsens their symptoms of anxiety (Sellers et al., 2003).

In addition to symptoms of anxiety, overt racial discrimination further taxes African American adolescents’ sense of identity, by decreasing self-worth and sense of control, and increasing mistrust for others (Sanders-Phillips, 2009; Simons et al., 2002). African Americans’ racial discrimination experiences are correlated with heightened levels of anger, nervousness, and assumptions of social interactions as harassment, negatively impacting their mental health (Assari et al., 2017). Additionally, overt racial discrimination is internalized as oppression, which increases anxiety and impacts adolescents’ well-being and academic performance (Wong et al., 2003). Furthermore, discrimination from peers and teachers correlates to a decline in self assessment of academic ability, grades, and the value of academic tasks (Wong et al., 2003). As a result, increased symptoms of anxiety in African American adolescents, caused by the internalization of overt racial discrimination, hinder future success (Berkel et al., 2008; Derdikman‐Eiron et al., 2011).

Perceived Racial Discrimination Recent studies show that African American adolescents’ awareness of racism influences the expression of anxiety disorders (Hunter & Schmidt, 2010). Negative group perceptions of African Americans are internalized by African American adolescents, and, thus, increase their anxiety (Tajfel, 1974). Group perceptions, with regard to race, are defined by stereotypes of ethnic groups that create a general perception of an individual’s identity based on their appearance (Duck et al, 2000; Scharrer, 2002). Negative group perception (i.e., race) negatively affects adolescents’ self-perception, resulting in internal blame and an increase in vulnerability to anxiety (Gaylord-Harden & Cunningham, 2009; Taylor et al., 2012).

Increased levels of perceived racial discrimination, negative evaluations and criticism by others, and rejection Reviews | 7

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correlate to poor psychological health in adolescents (Clark et al., 1999; Taylor et al., 2012). African American adolescents who internalize these negative racial perceptions and foster antiBlack attitudes report higher levels of anxiety (Carter, 1991; Pyant & Yanico, 1991). Specifically, as these negative views are internalized they impact adolescents’ view of themselves, damaging self-esteem and self-worth, thus worsening symptoms of anxiety due to their inability to develop adequate coping mechanisms to manage racial discrimination stressors (Derdikman-Eiron et al., 2011; Garnefki et al., 2002; SandersPhillips, 2009). Therefore, perceived racial discrimination is a prevalent stressor in African American adolescent lives, exacerbating symptoms of anxiety (Smith-Bynum et al., 2014).

Gendered Racial Discrimination Further, the negative effects of overt racial discrimination on African American adolescents differ depending on gender (Assari, 2017; Brodish et al., 2011). While African American males experience significantly more exposure to overt racial discrimination, females reported significantly higher levels of anxiety due to increased internalization of racial discrimination; thus, overall, African American adolescent girls display higher levels of anxiety symptoms than adolescent boys (Gaylord Harden & Cunningham 2011; Palapattu et al., 2006; Voisin et al., 2011). In addition, females endorse significantly higher rates of somatic symptoms, such as stomachaches and fatigue, as a result of anxiety from overt discrimination (Derdikman-Eiron et al., 2011). Furthermore, the internalization of racial discrimination correlates to somatic symptoms as adolescents struggle with understanding the root of their symptoms and forming healthy coping mechanisms (Hazen et al., 2011). Additionally, the correlation between overt racial discrimination exposure and internalizing symptoms (e.g., self blame and negative self perception) is significantly higher in African American adolescent females than males (Fitzpatrick & Boldizar, 1993; Gaylord-Haden, Cunningham et al., 2011).

Similar to overt racial discrimination, perceived racial discrimination’s impact on anxiety in African American adolescents also varies by gender (Kessler et al., 1999; Sellers & Shelton, 2003). In contrast to overt discrimination, perceived racial discrimination has a more significant impact on male African American adolescents than females, as internalization from percieved discrimination significantly increases their symptoms of anxiety (Assari et al., 2017). Male adolescents who internalize negative racial perceptions exhibit high rates of behavior problems (e.g., substance use) as a result of their anxiety (Brodish et al., 2011; Nyborg & Curry, 2003). However, female adolescents who internalize negative racial perceptions resulting in anti-Black attitudes report higher physical symptoms of anxiety, such as fatigue and headaches (Pyant & Yanico, 1991). As a result, anxiety from perceived racial discrimination has more significant long-term negative effects for African American males as compared to females (Assari, 2017). Despite varying responses to perceived racial discrimination, however, 8 | Reviews

both adolescent males and females experience symptoms of anxiety (Derdikman‐Eiron et al., 2011).

Conclusion Past research highlights that African American adolescents are continuously exposed to high rates of discrimination, both overt and perceived, leading to increased symptoms of anxiety (Clark et al., 1999; Harrell, 2000; Soto et al., 2010; Williams et al., 1997), thus putting African American adolescents at greater risk for poor mental health outcomes (Sellers & Shelton, 2003; Soto et al., 2010). Given that racial discrimination impacts African American adolescents differently based on their gender, future research should explore what factors contribute to females’ increased anxiety as a result of their lived experiences, as well as explore why males exposed to the same life factors, at higher rates, demonstrate lower rates of anxiety and symptoms. Further, research should also explore why male African American adolescents exhibit higher rates of anxiety due to perceived racial discrimination as opposed to overt racial discrimination.

Additionally, research should explore the connection between the psychological effects of discrimination and violence in African American adolescents to learn how to mitigate violence correlated to anxiety.

Future studies should seek to understand the causal relation between discrimination, negative perceptions, and anxiety, with gender as a moderator. Factors such as sensitivity, normalization, and level of exposure may play a role in the differences across gender. Understanding the differences between the effects of perceived and overt racial discrimination, in addition to the difference between gender and symptoms of anxiety induced by racial discrimination, will help create interventions for African American adolescents of any gender identity that are struggling with anxiety as a result of racial discrimination. Overall, exploring the various psychological impacts of discrimination on African American adolescents will allow for effective mental health counseling for these individuals.

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Palapattu, A., Kingery, J., & Ginsburg, G. (2006). Gender role

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Sellers, R., & Shelton, J. (2003). The role of racial identity in

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Tajfel, H. (1974). Social identity and intergroup behaviour.

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Midsommar:: Cults, Conformity, and Obedience Midsommar Anjali Mehta

Told against the backdrop of a trip to a secluded Swedish town, Ari Aster’s film Midsommar is a twisted tale of grief, belonging, and community centered around a tragically orphaned woman’s pain and desire for acceptance. A group of anthropology students visit a remote commune in Hälsingland, which quickly turns sinister as each student is murdered in gruesome, ritualistic killings (Andersson & Knudsen, 2019).

Midsommar is a film centered around a cult (i..e, a group with a shared commitment to an extreme ideology; Aster, 2019), known as the Hårga. The main character, Dani, finds a surrogate family and an empathic community within the Hårga. While the Hårga is a fictional cult, real cults exist worldwide, and their practices are not dissimilar to those of the Hårga. Cults exercise extreme social influence on individuals by systematically exploiting their basic human tendencies (e.g., making vulnerable people feel loved), in order to induce thought reform and behavior change, which can corrupt even the most ordinary of individuals (Hassan, 2000). Through the lens of a horror film, Midsommar terrifyingly depicts the rituals as a product of cults’ extreme social influence and psychological manipulation.

The Cult Experience: Susceptibility In order for cults to carry out their plans and spread their beliefs, they must recruit new members. Midsommar highlights how the basic human need of belonging can make ordinary people susceptible to cults. Due to a horrific incident resulting in the death of her entire family, Dani is launched into a state of despair driving her to seek comfort. Emotionally vulnerable, trapped in a codependent relationship with her partner without a reliable support system, Dani is susceptible to falling prey to the illusion of family. Given the uniquely vulnerable position Dani is in, which the Hårga honed in on to exert their influence, Dani is especially susceptible to the fall into the arms of somebody who could provide empathy and community (Curtis & Curtis, 1993).

In addition to her vulnerability, another major factor making Dani a person of interest to the Hårga is her gender (Rousselet et al., 2017). Women seem to be at the center of the Hårga’s mission and rituals. The May Queen, for example, is perhaps the most honorable position and is given specifically to a woman. The May Queen ritual is an annual rite for fertility to welcome the new harvesting season, as The May Queen symbolizes rebirth, the new season, and the beginning of the new cycle. In this highly respected position, the essence of the Hårga and its cult community is continued via the May Queen, who is taken to bless the harvest and animals for the continuation of the Hårga life cycle and the cult itself. Given that cults rely on

reproduction as a means of growing their population, women in the Hårga are symbols of sex, fertility, and continuation (Boeri, 2002). In Midsommar, reproduction is an emphasized practice that has its own rituals and its own method of practice, which is typical cult behavior, as they tend to be gendered and controlling (Boeri, 2002). For example, a female cult member, Maja, uses a “love spell” and performs a typical Hårga mating ritual with one of the male archeology students to impregnate herself and continue to populate the cult society. Real-life cults, such as the Children of God, forbid birth control, while others, such as the Fundamentalist Church of Latter-Day Saints, marry young girls to older men to have children (Stein, 2016). Cults will often “groom” their women and prepare them for sexual intercourse with their leaders (Boeri, 2002). In a cult, such as in the Hårga, women lose their bodily autonomy and are often used just as a method of maintaining fidelity.

The Cult Experience: Maintaining Membership Cults influence thoughts and behaviors as a way of manipulating people to remain in cults. Human behavior can be influenced in two ways: informational social influence (i.e., when people look to others for information on how to behave acceptably) and normative social influence (i.e., when people get along with others for the sake of social approval; Deutsch & Gerard, 1955). This type of social influence is a function of private acceptance of (i.e., a change in opinion) and public conformity (i.e., a change in behavior without a mental acceptance) to a group’s norms and beliefs (Cath, 2009). Specifically, since group norms of the Hårga deviate from widely accepted societal norms, when members are together their behavior is influenced via informational social influence, and they become more likely to act according to the Hårga’s group norms through successful deindividuation (Deutsch & Gerard, 1955). Contributing to both conformity and obedience is the concept of deindividuation (i.e., the loss of personal responsibility); thus, deindividuation reinforces a person’s adherence to group behavior, as their behaviors are affected by social influence (Postmes & Spears, 1998). In other words, when individuals no longer feel like individual entities but like a small part of a larger group, they feel less accountable and, thus, increasingly adhere to local group norms. When an individual is “following orders” of the cult, the individual does not feel responsible to carry the blame.

It becomes easier to do unpleasant things when people no longer need to take full responsibility (Prentice-Dunn & Rogers, 1982).

Even though horrific acts were carried out by individual members throughout the film, they did not feel the blame individually; this is typical in the deindividuation practices of Reviews | 11

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cults. Further, the Hårga extract their beliefs from the natural world, and leaders of the cult use these beliefs to justify their control over cult members’ lives. For instance, their concept of life is divided into a rigid cycle of life: birth, death, rebirth, and so on. The cult leaders use this knowledge to sacrifice members and entice members to take their own lives. In order to continue this belief, the Hårga relies on forms of social influence within the cult to maintain membership and carry out practices. Due to the Hårga’s efforts to maintain this cyclical balance, they live in isolation, cut off from the law, with their own rigid hierarchy and rules.

Another factor keeping people trapped in cults is the need to behave consistently with beliefs and commitments in order to avoid cognitive dissonance (i.e., internal conflict experienced when certain beliefs are not reflected in reality; Cialdini & Trost, 1998). In Midsommar, Dani makes the monumental decision to kill her boyfriend. During the last scene, when Dani is shown smiling, she has convinced herself that it was a good decision.

A study by Festinger et al. (1956) investigating cognitive dissonance and cult formation found that members developed a stronger belief when the cult’s prophecy failed, revealing how people had to find a way to cope psychologically with the failure.

Each compromise makes it more painful to admit the deception, keeping people trapped in cults (Lifton, 1989). In other words, the human tendency to justify actions and commitments protects self-perception. If cult members did question their cult practices, it would hurt their self-perception, essentially leading people to experience the psychological distress that results from cognitive dissonance. Justification for self-protection acts as a maladaptive way of coping that leads to illogical thinking, which is why perfectly rational people find themselves unable to rationally make decisions about a cult they are involved in, as it would create cognitive dissonance and thus damage their selfperception (Stein, 2016).

In addition, Social Impact Theory, which discusses the likelihood of responding to social influence, cites three key variables for social influence: strength (i.e., the importance of the group), immediacy (i.e., the physical proximity of the group), and number (i.e., how many people are in the cult versus on the side of the individual; Mullen, 1985). In Midsommar, Dani was constantly surrounded by many cult members (i.e., immediacy and number), and further the saliency of the Hårga into Dani’s life is significant (i.e., strength). The Hårga acted as an important aspect of Dani’s life from the psychedelic tea to her dressing in the same clothes as the cult members, ultimately the Hårga provided not only a community, but also a place Dani felt she belonged.

The Cult Experience: Comformity, Obedience, & Belonging A crucial factor contributing to the social influence of cult members is the concept of obedience to authority. Obedience to authority is closely connected to the principle of conformity (i.e., when faced with group norms, the majority of people 12 | Reviews

match attitudes, beliefs, and behaviors; Cath, 2009). Further, when people are uncertain in new surroundings, as was the case with Dani and her peers when they first arrived, they look to others (i.e., the existing cult members) for cues on how to behave (Zimbardo, 1997). Evidently, the existing cult members act according to their leader’s commands, and so Dani and her colleagues also obey the authority of the cult. Obeying authority figures is an essential factor of human nature, especially when the other people around are obeying authority figures as well, thus reinforcing the norm to obey authority (Cath, 2009). In Midsommar, obedience to authority is displayed at the very beginning of the film, where immediately upon their arrival, existing cult members feed Dani and her fellow travelers a psychedelic tea, which they do not know the contents of but consume without any questioning. Throughout the movie, Dani is seen obeying the norms of the cult and doing as she is directed: eating what they eat, dressing a certain way, and ultimately performing the May Queen rituals. Social influence in the form of obedience, conformity, and compliance are present in the cult experience. Specifically, Dani in the Hårga displays conformity to group social norms and compliance to cult behavior, and, thus, obedience to authority.

Compliance can be normative (i.e., without private acceptance and purely for social approval), leading normative social influence to be subtle, indirect, and outside of awareness (Cialdini & Goldstein, 2004). In Midsommar, compliance can be seen when Dani is selected as the May Queen after which she simply follows orders and performs whatever rituals cult members tell her to without fully understanding what she is doing. Another example of the establishment of a social group and conformity in Midsommar is the Hårga’s belief to maintain the cycle of seasons in order to ensure their own survival. Social groups (e.g., the Hårga) provide a lens through which individuals can view and understand the world (e.g., the cycle of seasons).

Groups establish social norms, both implicit and explicit, to define acceptable behavior. Cults are, ultimately, another type of social group, and many times, people succumb due to the innate human need to belong. In other words, people conform to the group’s expectations in order to be accepted. Under strong social pressure, individuals will give in and conform, even if this means doing something unethical (Nord, 1969).

Cults exploit peoples’ natural human tendencies to belong and conform, with the ultimate goal of carrying out the cult’s plans and spreading their beliefs. Given human beings’ strong and perhaps innate need to join social groups, coupled with Dani’s vulnerable state and situation, joining the Hårga provided both a sense of belonging and a sense of self. In being crowned May Queen, Dani finally found a sense of belonging and catharsis for her grief. Furthermore, giving Dani the role of May Queen reinforces her place in their community, as she found herself in the most powerful position. Dani managed to rise through the ranks and find both a support system and an identity within the cult community. In this way, Dani found a sense of identity and belonging with the Hårga through successfully fulfilling her

Midsommar: Cults, Conformity, and Obedience

need to belong through conforming with the cult.

Conclusion Midsommar’s portrayal of the Hårga showcases the power of extreme social influence, as cults exploit individuals’ natural inclinations to follow orders, mimic others, and protect self-esteem.Ultimately, Midsommar’s Hårga represents a very accurate depiction of cults in the real world. Many times, individuals, such as Dani, find themselves in a vulnerable position, struggling to comprehend the circumstances they are in (O’Reilly & Chatman, 1996). This can make an individual susceptible to fall prey to the psychological manipulation and social influence cults use to maintain membership. Through Dani’s uniquely vulnerable and susceptible position, she falls victim to becoming a member of the Hårga and comes to realize the power of empathy. She experiences how emotions are collectively felt by every member of the cult and is slowly shown what a real support system looks like as the community helps her express her emotions. By catering to humans’ innate need to belong, cults offer a sense of community and identity. When Dani blissfully smiles at the end of the movie, she has found the feeling of home and belongingness in the Hårga. Ultimately, Midsommar perfectly displays the enticing and believable illusion of warmth and community cults offer people.

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Effect of Media Literacy Education on American Adolescents’ Sexual Socialization Gizem Kurtbolat

Mass media plays a critical role in young people’s lives, as adolescents use mass media not only for entertainment and communication, but also as a source of information (Crone & Konjin, 2018). Information surrounding sex and relationships is particularly prevalent in mass media (L’Engle, 2006; Pinkleton et al., 2013). Thus, rather than talking to their parents, adolescents turn to the media for information about sex because it provides a more private and comfortable environment in which to consume such sensitive content (Brown & L’Engle, 2009). Unfortunately, however, the information adolescents receive from the media is not always accurate (L’Engle et al., 2006; Peter & Valkenburg, 2007). Many of the sources adolescents turn to, in order to learn more about sex and relationships, expose them to sexually explicit messages that lack factual information about sexual health and sexual responsibility, which can negatively affect their attitudes and expectations towards sexuality (American Academy of Pediatrics, 2010; Peter & Valkenburg, 2008; Vahedi et al., 2018; Ward, 2003). As adolescence is a period characterized by a spike in sexual curiosity and risk-taking behaviors, examining the explicit sexual content they consume, both passively and actively, is important to foster positive sexual socialization (i.e., a process in which adolescents learn and internalize attitudes, values, and knowledge about sexuality through integrating information from several different socializing agents; Randall & Langlais, 2019; Vahedi et al., 2018). Teaching adolescents skills to critically analyze the media messages they are exposed to could mitigate the media’s influence on sexual socialization and prevent the internalization of inaccurate messages (Scull et al., 2018; Vahedi et al., 2018). Through media literacy education (MLE), adolescents learn to analyze and decode information, which promotes a critical understanding of both print and electronic media (American Psychological Association [APA], 2010; Scull et al., 2014). Consequently, this review explored the question: How does media literacy education for adolescents in the US affect their sexual socialization?

Media’s Effect on Adolescents’ Sexual Socialization In the past decade, the media has become an increasingly powerful socializing agent in providing adolescents with information about sexuality (Rousseau et al., 2017). Adolescents are exposed to various verbal and visual portrayals of sex and relationships through mass media (Ward, 2003). For example, television shows targeted at adolescents contained more sexual content in comparison to shows targeted at adults (Strasburger, 2012). Frequent exposure to sexually explicit media has an effect on early sexual behavior, sexual norms, and sex-based behavioral expectations (Brown & L’Engle, 2009; Strasburger,

2012; Ward et al., 2014). For instance, frequent exposure to sex-based behavioral expectations, such as the portrayal of women as objects for sex and men as powerful aggressors, can influence an adolescent’s understanding of what is demanded of them sexually (Brown & L’Engle, 2009; Randall & Langlais, 2019). The effect of these behavioral expectations on adolescents is mediated through a concept called perceived realism (i.e., the degree to which the viewer believes the content they see on the media is a representation of what happens in the realworld; Bahk, 2001). Adolescents accept the incorrect messages about sexuality because frequent exposure to the same sexually explicit messages makes them seem accurate and representative of real-world instances (Austin, 2007; Peter & Valkenburg, 2006; Tian & Yoo, 2016).

An increase in perceived realism raises the likelihood of internalizing messages from the media (Austin, 2007; Peter & Valkenburg, 2006; Tian & Yoo, 2016). The internalization (i.e., unconscious mental process where the beliefs and attitudes of others are adopted as one’s own) of sexual messages has a direct impact on an adolescent’s attitudes toward romantic and sexual behavior (APA, n.d., internalization; Rousseau et al., 2017). The internalization and subsequent influence of media messages on attitudes and behavior can be explained through the script and super-peer theories (Strasburger, 2012). The script theory suggests that people form behavioral patterns, or scripts, based on the cultural norms they are exposed to; therefore, when adolescents are frequently exposed to hypersexualized content in the media, they start forming scripts of behaviors, attitudes, and norms according to the content they view in the media that will ultimately guide their social behavior (Maas et al., 2019; Randall & Langlais, 2019). The super-peer theory suggests that the media acts as a “super-peer” as it exerts a more powerful influence over adolescents than their own peers (Randall & Langlais, 2019; Strasburger, 2007, 2012). Thus, the scripts adolescents form based on the messages they receive from the media are as or more influential than the messages from their peers (Randall & Langlais, 2019; Strasburger, 2007, 2012). As media continues to become a more powerful and influential socializing agent for adolescents, it is imperative to interrupt the internalization of the hypersexualized messages portrayed to help create healthy attitudes and realistic expectations about sex.

Effect of Media Literacy Education on Sexual Socialization Due to the media’s role as a critical socializing agent and its consequential impact on adolescents’ sexual socialization, educators have conveyed the need for the incorporation of media literacy (i.e., learning skills and knowledge to access, evaluate, Reviews | 15

OPUS (2021) 12:1

and analyze media messages) in sex education (Aufderheide, 1993; Jeong et al., 2012; Pinkleton et al., 2013; Ward, 2003).

Although the content in media literacy education (MLE) varies from program to program, the main goal is to give adolescents the tools they need to deconstruct media messages and increase their awareness of how media messages are produced so they can become active interpreters rather than passive consumers (APA, 2010; Austin et al., 2015; Pinkleton et al., 2013; Scull et al., 2018; Ward et al., 2014). MLE programs are developed based on the Media Interpretation Process (MIP) model, which suggests that the extent of a media product’s potential influence is based on the heuristics (i.e., cognitive tools that individuals develop based on their past experiences) individuals apply to the message (Austin, 2007; Kupersmidt et al., 2010; Scull et al., 2014; Vahedi et al., 2018). Furthermore, the model suggests that level of identification with the media message predicts the type of outcome (e.g., good or bad) they expect from engaging in the behavior, which, in turn, reliably predicts what behavior the individual will engage in (Austin, 2007; Scull et al., 2014).

Through raising awareness of how media messages are produced and presented, educators hope to increase adolescents’ likelihood of reassessing the accuracy of these messages, ultimately decreasing the extent to which they are internalized (Austin et al., 2015; Pinkleton et al., 2013; Scull et al., 2018; Ward et al., 2014). One key component of MLE focuses on the improvement of adolescents’ logic-based decision-making skills, in order to improve their critical thinking capabilities, to help combat the glamorized sexual content (Pinkleton et al., 2012). MLE provides students with critical thinking skills (i.e., deconstructing media messages) to combat the influence of carefully designed media messages by thoroughly evaluating the source and intention behind the message (Austin et al., 2015; Kupersmidt et al., 2010; Vahedi et al., 2018).

MLE programs aim to change media-related outcomes in a variety of ways (Jeong et al., 2013). MLE programs seek to support knowledge outcomes by increasing an individual’s understanding of how the media uses techniques to create more persuasive content through the use of emotive words, for example (Hobbs & Frost, 2003). In addition to knowing how media messages and content are created, MLE programs also aim to help adolescents understand how this process impacts their beliefs and thoughts, in the hope of making them more skeptical and cautious about the sources behind the messages or content they will see, hear, or read (Austin et al., 2005; Jeong et al., 2013). Lastly, the programs help explain to adolescents that although the messages they view are portrayed as examples of the real world, in actuality much of the content shared in media is not an accurate portrayal of reality (Austin et al., 2007; Jeong et al., 2012).

In addition, MLE programs aim to change behaviorrelated outcomes through attitudes, beliefs, and norms (Jeong et al., 2012). MLE programs tend to focus on improving critical thinking skills in order to influence behavior, making behavior a distal outcome (i.e., not directly affected by the intervention; 16 | Reviews

the persuasive techniques used to create media content) and what they need to pay attention to (i.e., the source behind the media content) so that they can evaluate and question the content (Kupersmidt et al., 2010; Pinkleton et al., 2012). The expectation, then, is that these skills will lead to a change in behavior (Jeong et al., 2012). In fact, past research has found that MLE programs decrease the likelihood of adolescents engaging in risky or unhealthy sexual behaviors (Austin et al., 2005). For example, participation in MLE programs led adolescents to develop negative attitudes and beliefs to risky sexual behaviors, such as not using a condom (Austin et al., 2007).

Furthermore, MLE programs decrease adolescents’ perceived realism of sexual content and increase their skepticism towards media messages (Scull et al., 2018). Adolescents who participate in these programs are more likely to consider delaying becoming sexually active, and are less likely to think having sex will make them cool (Pinkleton et al., 2008; Scull et al., 2018). MLE provides adolescents with media-related critical thinking skills, increasing their skepticism and getting them to question their previous beliefs about sexual socialization.

However, whether or not they change their behavior is not clear (Bulger & Davison, 2018; Vahedi et al., 2018). Notably, the skills adolescents learn in MLE have an impact on their logic-based decision-making mechanisms, but not affect-based decision-making mechanisms. This is exemplified by the fact that adolescents who participate in MLE understand that the depictions of sexual behavior in the media are fictional and glamorized, but they still find the portrayals of sexual content desirable (Pinkleton et al., 2013; Scull et al., 2018). However, this is only problematic if adolescents start associating the desirable message with what occurs in real life. If the adolescent is able to recognize that the content was fictionalized to attract the audience’s attention, they will be less likely to trust the misleading message and portrayal of sex (Austin et al., 2015). Ultimately, adolescents who participate in MLE programs are less likely to be influenced by the unrealistic and inconsequential portrayal of sexual behavior in the media because they have the skills to critically question and evaluate the media messages they are exposed to (Pinkleton et al., 2013).

Conclusion MLE acts as a tool to promote media literacy by providing adolescents with the skills to deconstruct media messages, increasing their likelihood to make healthy decisions and have realistic expectations about sex (Austin et al., 2015; Brown, 2008a, 2008b; Pinkleton et al., 2013; Ward et al., 2014). Research shows that the media literacy skills adolescents learned in MLE programs were retained after the program had ended (Vahedi et al., 2018). Retention of these skills ensures that when exposed to sexual content in the media, adolescents will be properly equipped to critically analyze sexuality in media messages before trusting and internalizing their positive and nonconsequential depictions (Randall & Langlais, 2020; Vahedi et al., 2018).

The MLE programs examined in this review are provided

Media Literacy Education and Adolescents’ Sexual Socializaiton

as part of sex education or health education curricula. MLE is intertwined with the topics that are covered in these classes, focusing on sex and other risky behaviors such as drinking and smoking (Pinkleton et al., 2012; Vahedi et al., 2018). The main purpose of these classes is to increase adolescents’ knowledge about unhealthy or risky behaviors, but the addition of MLE increases adolescents’ understanding of how and why these behaviors are portrayed in the media. Additionally, research has shown an increase in the efficacy of MLE on sexual socialization when combined with sex education or health education classess, since the curricala act as guides for what needs to be covered in the media (Scull et al., 2014; Vahedi et al., 2018).

Future research should examine the long-term effects of MLE programs, specifically the extent to which adolescents retain the knowledge and skills from the programs (Pinkleton et al., 2015; Vahedi et al., 2018). While there is evidence of retention of the information learned, how long it remains effective is not clear. Future studies should also explore changes in actual behavior, since currently studies measure behavioral change based on behavioral intentions (e.g., I will use condoms; Pinkleton et al., 2008; Scull et al., 2018). Finally, greater priority should be placed on funding evidence-based MLE programs (Bulger & Davison, 2018; Vahedi et al., 2018). While there is growing support for MLE programs to be included in school curricula, there is no tangible evidence of any effort to accomplish this (Bulger & Davison, 2018). Focusing on MLE in both practice and research can help with the creation of strong, evidence-based programs, (Pinkleton et al., 2012; Scull et al., 2014; Scull et al., 2018; Ward, 2003), to help limit the impact of misinformation on adolescents’ development.

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PROPOSALS

Remote Learning, Academic Self-Efficacy, & Academic Performance of College Students During COVID-19 Samantha Ruggiero

Since March 2020, the COVID-19 pandemic has upended the day-to-day lives of individuals around the world, particularly students. As a result of the pandemic, remote learning rapidly became commonplace for students of all ages across international borders (Gillis & Krull, 2020; Miller, 2021). While remote learning was considered essential to protect public health during the beginning and middle stages of the pandemic, the widespread transition to this learning system was fraught with challenges for college students, administrators, and professors.

Research suggests that many students were dissatisfied with the quality of their remote courses and faced difficulties in maintaining engagement and motivation with course materials (Gillis & Krull, 2020; Miller, 2021), potentially decreasing their levels of academic self-efficacy. As academic self-efficacy is integral to academic performance, the current proposal seeks to investigate the impact of remote learning on college students’ academic self-efficacy and academic performance during the COVID-19 pandemic.

The Challenges of Remote Learning During COVID-19 The abrupt shift to remote learning resulted in a variety of obstacles for college students; remote learning led to a collective decline in students’ course satisfaction levels dropping from 87% pre-pandemic to 59% after the transition to remote learning (Miller, 2021). Findings of one study suggest that only 55% of students found live-Zoom lectures to be effective, with only 36% reporting the lectures to be enjoyable (Gillis & Krull, 2020). Moreover, 42% of college students cited staying motivated while taking classes remotely as a challenge (Miller, 2021). Furthermore, half of college students reported facing technical difficulties that disrupted their access to remote learning resources, which further compounded the obstacles associated with remote learning (Gillis & Krull, 2020). In another study, a majority of college students reported concerns about their academic performance during COVID-19 (Son et al., 2020). These findings demonstrate that many students did not feel able to perform at their full academic potential during the COVID-19 pandemic.

Due to the rapid nature of the emergency switch to remote learning during the pandemic, universities struggled to deliver high-quality education to college students (Johnson et al., 2020). For many professors, teaching remotely was an uncharted endeavor; in one national study, over half of college administrators and professors reported that increasing support for students during the transition to remote learning was a high priority to them, indicating a demand for resources to have better-supported college students during the pandemic

(Johnson et al., 2020). Yet, 64% of professors reported having no previous remote teaching experience before the transition to remote learning (Johnson et al., 2020). Furthermore, as of June 2020, only 47% of college and university presidents felt confident in their attempts to train less-experienced faculty members in using remote teaching technologies, and only 55% believed that they were able to uphold high academic standards through remote learning (Miller, 2021). It is, thus, evident that not only have students felt as if the quality of their education was compromised due to the transition to remote learning, but that university administrators and professors did not feel entirely equipped to prepare students to succeed while engaging with remote learning.

Academic Self-Efficacy and Academic Performance When exploring online academic learning, it is important to consider the ways in which academic self-efficacy impacts academic performance. Academic self-efficacy, or one’s confidence in their ability to achieve desired academic outcomes (Sharma & Nasa, 2014), has been reported to have a significant and positive relation with academic performance (Honicke & Broadbent, 2016; Sharma & Nasa, 2014; Zajacova et al., 2005). Much of the extant literature in this area emphasizes the importance of academic self-efficacy in the learning process and in predicting academic performance (Honicke & Broadbent, 2016; Schunk & Pajares, 2002; Sharma & Nasa, 2014; Zajacova et al., 2005). In particular, academic self-efficacy has been observed to sustain the initiation and completion of academic goals (Schunk & Pajares, 2002). Research supports that high academic self-efficacy is associated with increased motivation towards academic goal persistence, which is an essential component of academic success (Schunk & Pajares, 2002).

The relation between academic self-efficacy and academic performance might be cyclical, such that mastery experiences (i.e., experiences in which the desired outcome is achieved) serve as a source of academic self-efficacy (Bandura, 1994). This means that experiences of academic success, such as getting exceptional grades, may reinforce high levels of academic self-efficacy in students (Bandura, 1994). This hypothesis has been supported by the finding that academic self-efficacy and academic performance are more strongly correlated in new college students at the end of the semester compared to the beginning of the semester, as students accumulate mastery experiences over the course of the semester (Gore Jr., 2006). In another study (Chemers et al., 2001), past academic achievement (i.e., high school GPA) was shown to influence levels of academic self-efficacy in first-year college students, further exhibiting how Proposals | 21

OPUS (2021) 12:1

academic mastery experiences can impact levels of academic self-efficacy.

The COVID-19 pandemic and the widespread shift to remote learning resulted in a decrease in student motivation and a widespread negative outlook on remote learning (Miller, 2021), which might negatively impact students’ levels of academic self-efficacy. In turn, the influence of remote learning during the COVID-19 pandemic on academic self-efficacy levels might negatively impact students’ academic performance (Miller, 2021).

Proposed Study The reliance on remote learning during the COVID-19 pandemic has led to concerns about a potential decrease in academic self-efficacy (Alemany-Arrebola et al., 2020; Rohmani & Andriani, 2021). While several studies have explored the challenges of remote learning during the COVID-19 pandemic (e.g., Gillis & Krull, 2020; Johnson et al., 2020; Miller et al., 2020; Son et al., 2020), there has been a lack of literature investigating the relation between the remote learning, academic self-efficacy, and the academic performance of college students during the COVID-19 pandemic. The current proposal thus seeks to address the following research question: How does remote learning impact the academic self-efficacy and academic performance of college students during the COVID-19 pandemic?

Proposed Method Participants Random sampling will be used to obtain a sampling pool of 1,000 undergraduate students from across all Title IV degreegranting institutions in the United States to produce a diverse and generalizable sample. To qualify for this proposed study, participants must be between the ages of 18 and 24 years old, speak fluent English, and have been enrolled in remote classes for at least one semester during the pandemic. In addition, participants must have finalized their choice of major to be eligible for this proposed study, so that academic performance can be measured in relation to each participant’s major area of study. The study will aim to recruit a gender diverse sample of participants.

Procedure

Participants who qualify and consent to participate in the study will complete a Qualtrics form regarding their participation in remote courses (e.g., semesters enrolled in remote classes; fully remote or hybrid; number of courses completed). Participants will then complete the Academic SelfEfficacy Scale (Kunnathodi & Ashraf, 2007). The scale includes 20 positive (e.g., “Irrespective of the subject, I am competent in learning”) and 20 negative (e.g., “Often I fail to comprehend the actual meaning of what I study”) statements relating to academic self-efficacy, which participants respond on a 5-point Likert scale (Kunnathodi & Ashraf, 2007). Following the measure guidelines, composite scores ranging from 40 to 200 22 | Proposals

will be calculated and included in the analyses. The scale has high validity and reliability, with a test-retest coefficient of .85 and split-half reliability of .90 (Gafoor & Ashraf, 2007).

Participants will then be asked to provide information regarding their academic performance, including 1) the number of classes they took related to their major area of study in during the semester(s) they were enrolled in remote courses, 2) an objective report of their grades in these courses, and 3) responses to an adjusted version of the Pearlin Mastery Scale (Pearlin & Schooler, 1978), to capture their academic performance from the participants’ perspectives. The Pearlin Mastery Scale is typically used to measure the level of control participants feel that they have over important life outcomes (Pearlin & Schooler, 1978).

The scale has seven items to measure a sense of mastery, to which participants respond on a 4-point Likert scale (Pearlin & Schooler, 1978), and has a high Cronbach’s alpha (i.e., .89), and statistically significant convergent, predictive, and discriminant validity (Edwards et al., 2000). The scale is scored on a range between 7 and 28, with higher scores indicating a higher sense of mastery (Pearlin & Schooler, 1978). For this study, participants will be asked to frame their responses to the scale in terms of the classes related to their major. For instance, the item “There is really no way I can solve some of the problems I have” (Pearlin & Schooler, 1978) will be changed to “There was really no way I could solve some of the problems I had in online classes related to my major,” (Pearlin & Schooler, 1978) and so on. Items in the original scale using the term “life” will be replaced with the phrase “classes related to my major.” Item analysis will be run to ensure that the adapted measure has strong internal reliability.

Discussion This proposed study has implications for college students, administrators, and professors at universities across the United States. This proposed study can serve as a platform to reflect the attitudes college students have had towards remote learning during the COVID-19 pandemic, as well as their levels of academic self-efficacy during this time. In turn, such insights can inform university administrators and professors of students’ academic performance and levels of academic self-efficacy during what was a prolonged period of remote learning. University administrators and professors can serve as an important resource and source of support for students during difficult times, especially amid a pandemic (Zhai & Du, 2020).

Thus, the proposed study can serve as an important resource to prompt university administrators and professors to monitor the academic self-efficacy of students and provide a space in which high academic self-efficacy and success are attainable if a transition to remote learning returns. Thus, this study could be essential in determining the teaching styles, resources, and levels of support provided to students by universities during any future experiences with remote learning.

Further research might explore how remote learning impacts a diverse population of college students across the United States. One way to expand on the current proposal

Remote Learning, Academic Self-Efficacy, & Academic Performance

is to explore how academic self-efficacy and remote learning, as well as academic self-efficacy and academic performance during remote learning, differ amongst types of Title IV degreegranting institutions attended. Furthermore, future research might explore how the relationships between the variables differ by demographics such as gender, sexuality, socioeconomic status, race, and ethnicity. COVID-19 has impacted certain racial and ethnic minority groups disproportionately in terms of health and quality-of-life (CDC, 2020), and students with lower socioeconomic statuses may lack access to the technological resources needed to succeed in a remote learning environment, with the procurement and distribution of resources for students varying across universities. In addition, college students with mental health disorders and learning difficulties may be more susceptible to difficulties in remote learning than other students.

Therefore, research regarding the disparities between samples that vary in demographics and neurodiversity could provide more insight into which students require the most support from their professors and administrators to maintain academic success.

The COVID-19 pandemic disrupted the lives of many individuals across the world. This unparalleled time proved to be particularly difficult for college students who were required to attend classes virtually and balance other life activities. Thus, this proposed study can provide insight into how the pandemic and subsequent transition to remote learning impacted the past academic self-efficacy and academic performance of college students. By gaining valuable metrics regarding the relationships between these variables, university administrators and professors can be more equipped to provide college students with engaging and supportive learning environments over remote platforms in the future. Such insight may allow universities to provide more opportunities for all students to succeed during stable and turbulent times alike.

Proposals | 23

OPUS (2021) 12:1 References Alemany-Arrebola, I., Rojas-Ruiz, G., Granda-Vera, J., &

Mingorance-Estrada, A.C. (2020). Influence of

COVID-19 on the perception of academic self-efficacy,

state anxiety, and trait anxiety in college students.

Frontiers in Psychology. Advance online publication.

Centers for Disease Control and Prevention (CDC). (2020, July). Health equity considerations and racial and

ethnic minority groups. Centers for Disease Control

and Prevention. Retrieved from https://www.cdc. gov/coronavirus/2019-ncov/community/health equity/race-ethnicity.html Chemers, M.M., Hu, L., & Garcia, B.F. (2001). Academic self efficacy and first-year college student performance and adjustment. Journal of Educational Psychology, 93(1), 55-64.

College Board. (n.d.). How to convert your GPA to a 4.0 scale.

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and validity of a self-efficacy instrument specific to

sickle cell disease. Behaviour Research and Therapy, 38(9), 951-963.

Gillis, A., & Krull, L.M. (2020). COVID-19 Remote learning

transition in spring 2020: Class structures, student

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Gore Jr., P.A. (2006). Academic self-efficacy as a predictor of

college outcomes: Two incremental validity studies.

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self-efficacy on academic performance: A systematic review. Educational Research Review, 17, 63-84.

Johnson, N., Veletsianos, G., & Seaman, J. (2020). U.S. faculty

and administrators’ experiences and approaches in

the early weeks of the COVID-19 pandemic. Online

Learning, 24(2), 6-21.

Kunnathodi, A. G., & Ashraf, P. M. (2007). Academic self efficacy scale.

Pearlin, L. I., & Schooler, C. (1978). The structure of coping.

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Online education trends. Education Data. Retrieved

from https://educationdata.org/online-education statistics Rohmani, N., & Andriani, R. (2021). Correlation between

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Schunk, D. H., & Pajares, F. (2002). The development of academic self-efficacy. In A. Wigfield & J. S. Eccles (Eds.),

Development of Achievement Motivation (pp. 15–31).

Academic Press.

Sharma, H., & Nasa, G. (2014). Academic self efficacy: A reliable

predictor of educational performances. British Journal

of Education, 2(3), 57-64. ISSN: 2054-6351 Son, C., Hegde, S., Smith, A., Wang, X., & Sasangohar, F. (2020).

Effects of COVID-19 on college students’ mental health

in the United States: interview survey study. Journal of

Medical Internet Research, 22(9), 1-22.

Zajacova, A., Lynch, S. M., & Espenshade, T. J. (2005). Self efficacy, stress, and academic success in college.

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Zhai, Y. & Du, X. (2020). Addressing collegiate mental health

amid COVID-19 pandemic. Psychiatry Research, 288.

CBT-based Mental Health App Treatment Outcomes for Heterosexual and LGBTQ+ College Students With Depression Vion He

The percent of college students in the United States suffering from depression has increased, rising from 25% in 2007 to 30% in 2017 (Lipson et al., 2019). Among college students, LGBTQ+ individuals experience even higher levels of depression than their heterosexual peers, suggesting that they may be more in need of mental health services (Backhaus et al., 2019; Dunbar et al., 2017). Despite their increased need for mental health services, LGBTQ+ young people often encounter unique barriers that prevent them from accessing or benefiting from such services, including concerns about cost and confidentiality (Brown et al., 2015; Sanchez et al., 2009), fear of harassment (Brown et al., 2015), fear of letting their family members know about their gender or sexual orientation (Williams & Chapman, 2011), and skepticism about the inclusivity of services (Williams & Chapman, 2011).

Recent studies suggest that some of these barriers might be addressed via mental health mobile applications, interventions delivered through smartphones to promote users’ mental health (Rozbroj et al., 2015). Such health tools consist of psychoeducation and therapeutic exercises designed for different psychological disorders, such as depression (Hollis et al., 2016). Although these applications have not been specifically tested on LGBTQ+ students, their efficacy in reducing depressive symptoms in other populations is supported by research (e.g., Firth et al., 2017; Mohr et al., 2017). Compared to in-person services, mobile mental health apps are less expensive, easier to use, and often self-directed, which provide individuals with more control over their treatment (Rozbroj et al., 2015). Among the many types of mental health apps, those using cognitivebehavioral therapy (CBT) are the most common (PorrasSegovia et al., 2020). CBT is a type of psychotherapy based on the premise that mental illness stems from maladaptive cognitive and behavioral patterns, and it treats psychological problems by changing these patterns (Beck, 1970; Ellis, 1962). There is a large body of literature supporting the efficacy of CBT in treating depression because it identifies negative beliefs that lead to depression and replaces them with positive ways of thinking (Charkhandeh et al., 2016; Driessen & Hollon, 2010; Hofmann et al., 2012). When administered through mobile apps, CBT treats depression by guiding people to identify and challenge their negative thinking patterns, track thoughts and feelings, and engage in mood-improving exercises (Stawarz et al., 2018).

Users complete homework activities, practice different coping skills, and work towards greater wellbeing (Stawarz et al., 2018).

Many CBT-based apps have yielded positive results on reducing

depressive symptoms, especially among the college student population (Broglia et al., 2019; Bruehlman-Senecal et al., 2020; McCloud et al., 2020).

Despite the encouraging results of CBT-based apps, little is known about whether LGBTQ+ college students will benefit from them as much as their heterosexual peers. As sexual minorities, LGBTQ+ people often experience unique stressors related to their sexual identity, such as coming out, discrimination, and stigma, which have been associated with higher levels of depression (Meyer, 2003). As such, depression apps designed for the general population might not be inclusive enough to effectively address these LGBTQ-related stressors.

Specifically, previous research has found that the majority of digital interventions tend to assume users to be heterosexual (e.g., use pictures of heterosexual relationships to describe marriage; Rozbroj et al., 2014). By adopting these assumptions, they overlook that LGBTQ+ people are experiencing unique stress because of their identity, thereby failing to address relevant topics (e.g., coming out) in the intervention (Rozbroj et al., 2014). This exclusion can lead to inappropriate treatment of LGBTQ+ youth, which contributes to a poor experience and feelings of alienation and distrust of services (Rozbroj et al., 2014). As a result, LGBTQ+ youth may delay seeking help in the future, which allows symptoms to worsen and leads to poorer health outcomes (Elliott et al., 2015; Kilicaslan & Petrakis, 2019).

In short, if CBT-based health apps fail to account for LGBTQ+ experiences and stressors, they may not be efficacious, and even be detrimental, for LGBTQ+ people with mental health problems. Nonetheless, if CBT-based apps are found to be effective for LGBTQ+ youth, they have the potential to facilitate easier access to mental health care for this population (Rozbroj et al., 2015). Because LGBTQ+ youth already have a tendency to seek mental health information and support online, they may be more receptive to and benefit from the apps (Lucassen et al., 2018; Rozbroj et al., 2015). In order to assess these concerns, this study proposes to answer the following question: How do CBTbased mental health apps affect depression treatment outcomes in LGBTQ+ college students compared with heterosexual students?

Proposed Method Participants The study will recruit 180 U.S. college students diagnosed with depression, evenly distributed across racial and ethnic backgrounds. Half of them will be individuals who identify as Proposals | 25

OPUS (2021) 12:1

heterosexual, and the other half will identify as LGBTQ+. To be eligible, students must be at least 18 years old, have a smartphone or a tablet with internet access, and exhibit at least a mild level of depression, as measured by the 9-item Patient Health Questionnaire (PHQ-9) (Kroenke et al., 2001). Individuals who are using SSRI(s) at the time of recruitment will be excluded, as the effects of antidepressants on depression may interfere with the study outcomes. Individuals with suicidal ideations within the month prior to recruitment will also be excluded, due to participant safety and ethical considerations. Instead, they will be directly referred to professional psychological services.

Procedure As a first step, participants will complete a demographic survey and a PHQ-9 assessment (Kroenke et al., 2001) to determine their depression level. Those who score 5 or higher, indicating at least a mild level of depression, will be randomly assigned to one of the two groups: (a) doing activities on the SuperBetter app or (b) doing activities on the MoodKit app.

The participants will further be separated into heterosexual and LGBTQ+ students, resulting in four groups total. Both apps have demonstrated a significantly positive impact on alleviating depression in randomized controlled trials in a largely heterosexual sample (Bakker et al., 2018; Roepke et al., 2015). Because the two apps have different emphases when approaching depression, including both in this study can help compare results and distinguish between features that contribute to the efficacy of the intervention. SuperBetter is a game-based app that helps build resilience and improve mental health by helping individuals build self-esteem and self-acceptance through activities such as “hugging yourself ” and “writing down things you feel grateful for” (Roepke et al., 2015). Participants assigned to this group will be instructed to complete a To-Do List every day with seven activities of their choice. MoodKit is an app that focuses on mood self-management. It contains four main tools: mood-improving activities, a thought checker, a mood tracker, and a journal (Dahne et al., 2019). Participants assigned to this group will be instructed to record their mood and complete at least three mood-improving activities every day and use the journal and the thought checker as needed. After two months, all participants will be assessed again for depression.

Researchers will also assess their depression levels three months after the intervention to see if there is any lasting effect.

Measures Demographic form. A demographic form will be administered to collect information on participants’ age, gender, sexual identity, race, academic standing, use of professional mental health services (e.g., therapy or life coaching) and antidepressants, suicide ideations, Internet access, use of electronic devices, and technical difficulties if any.

Depression. Depression will be assessed using the PHQ9 (Kroenke & Spitzer, 2001), a self-report scale that measures depression and its severity. The PHQ-9 consists of nine items on 26 | Proposals

a four-point Likert Scale, eight of which measure the frequency of symptoms from not at all to nearly every day, and one of which measures the extent of difficulty these symptoms cause in everyday life, from not difficult at all to extremely difficult. The PHQ-9 has been shown to be a reliable depression assessment tool with a Cronbach’s alpha of approximately 0.86 (Kroenke et al., 2001), and validity has been established, especially in the college student population (Keum et al., 2018; Kroenke & Spitzer, 2001).

Data Analysis Plan A repeated measures analysis of co-variance (ANCOVA) will be conducted to help determine if there are significant differences in treatment outcomes between the four groups, using the mean differences in PHQ-9 scores before the intervention, immediately after, and three months later, controlling for covariates (e.g., the use of mental health services). If there are differences, post-hoc tests will be used to determine which group yields the best result.

Discussion The proposed study seeks to examine whether there are differences in treatment outcomes of CBT-based mental health apps on depression in LGBTQ+ and heterosexual students.

While mental health apps have the potential to improve access to mental health care for LGBTQ+ youth, not much is known about whether they are effective in addressing the needs of this population (Schueller et al., 2019). This study might contribute to a theoretical understanding of whether sexual identity (identifying as a LGBTQ+ or not) moderates the apps’ effects on depression.

Given the potential of mobile mental health in increasing LGBTQ+ youth’s service utilization rate (Rozbroj et al., 2015; Schueller et al., 2019), this study might enhance our understanding of the impact of these apps on treating depression in LGBTQ+ college students. It will help elucidate whether there is a need to improve such apps or develop more apps, to better meet their needs. Future research might examine and compare the impact of other types of mental health apps to determine the optimal treatment approach, as well as expand the measures of depression beyond self-report measures, so as to avoid the results may be subject to response bias. Future research might also examine and compare the impact of other types of mental health apps to determine the optimal treatment approach, as well as expand the measures of depression beyond self-report measures, so as to avoid response bias. Moreover, the outcomes of this study can be especially helpful in the context of the current COVID-19 pandemic. As LGBTQ+ youth are experiencing a heavier mental health burden and increased demand for services due to limited resources and support available, CBT-based apps may have potential to serve this population in the aftermath of the pandemic (Moore et al., 2021; Salerno et al., 2020).

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Health & social work, 36(3), 197-206.

Family Support, Motivation for Change, and Treatment Entry of Individuals with Substance Use Disorders Julia E. Leschi

Substance abuse is a public health crisis, with around 20 million adults in the United States struggling with a substance use disorder in 2017 (Substance Abuse and Mental Health Services Administration [SAMHSA], 2018). One of the major issues hindering substance abuse recovery is that too few people enter treatment (Cunningham et al., 1993; Kessler et al., 2001; Wang et al., 2004). Of those who do, there is often a treatment delay of at least a decade after identification of the substance use problem, and many do not complete treatment (Cunningham et al., 1993; Kessler et al., 2001; Wang et al., 2004). Research has identified motivation to change as one of the most reliable indicators of treatment readiness and engagement (De Leon et al., 1999; Heather et al., 1993; Hiller et al., 2002). Motivation to change evolves in five stages: pre-contemplation, contemplation, preparation, action, and maintenance (Prochaska & Diclemente, 1984). Where a patient is situated on this continuum at treatment entry has been linked to treatment outcomes and dropout rates (DiClemente et al., 2004; Heather et al., 1993; Klag et al., 2010; Simpson et al., 2002; Simpson et al., 1993). Thus, learning more about the factors leading to an increase in motivation to change is an important step in trying to improve the success of substance abuse treatment.

Families can play an important role in helping loved ones pursue treatment. Research has found that family support plays a considerable role in preventing substance use and in supporting recovering users following treatment (Dishion et al., 2003; Kumpfer et al., 2003). Expressed concern from one’s social network has also been found to greatly increase the likelihood of someone committing to treatment, reinforcing the impact family and friends can have on someone’s desire and ability to change (Pollini et al., 2006; Rapp et al., 2007). These findings all point towards the importance of families in tackling substance use issues, yet few studies have directly explored the association between family support and treatment entry.

Community Reinforcement and Family Training (CRAFT; Meyers & Wolfe, 2004), an intervention program highlighting the use of positive reinforcement from family members (referred to as Concerned Significant Others [CSO]) to get loved ones (referred to as Individual Patients [IP]) into treatment, has shown great promise in recent years (Brigham et al., 2014; Meyers et al., 2002; Roozen et al., 2010). CRAFT is a behavioral intervention aiming to both improve the CSO’s wellbeing and promote the IP’s treatment entry by transforming the IP’s environment (Kirby et al., 2017; Meyers et al., 2011). This happens through changes in the CSO’s communication, the use of positive reinforcement for sober behaviors, and a reduction of the CSO interfering with the consequences of substance use, among others (Meyers et al.,

2011). CRAFT has been shown to be significantly more effective at engaging treatment-resistant loved ones than traditional approaches taught in Al-Anon Family Groups, a popular 12step program for family members and loved ones of substance abusers, which encourages family members to detach from their loved ones and accept their powerlessness in the face of the loved one’s illness (Brigham et al., 2014; Meyers et al., 2002; Roozen et al., 2010). The mechanisms through which CRAFT functions have scarcely been researched, but existing studies suggest that family support and motivation to change could play a significant mediating role (Dishion et al., 2003; Kumpfer et al., 2003; Meyers et al., 2011), since the CRAFT approach depends on the IP having a relationship with their family, and aims to push the IP to seek treatment of their own volition.

The association between family support, motivation to change, and treatment entry must be further researched so that families can further help the recovery of their loved ones.

Hence, this study proposes to address the following research questions: What are the differential effects of CRAFT and Al-Anon on family support and motivation to change for individuals struggling with substance use disorders? To what extent is the effect of CRAFT (vs. Al-Anon) on SUD treatment entry mediated by levels of family support and motivation to change?

Proposed Method Participants The proposed study will include 300 substance-abusing individuals and their CSOs. All participants will be over 18 years old. CSOs should be a direct relative, spouse, or cohabitating romantic partner of the IP who is in regular contact with the IP. Participating substance users will fit the diagnostic criteria for a DSM-V Substance Use Disorder and not be in therapy or receiving pharmaceutical treatment for addiction. The sample will aim to be as representative of the general population as possible in terms of gender, education level, socioeconomic status, race and ethnicity.

Procedure Participating CSOs and IPs will be recruited through flyers inviting family members of treatment-resistant substance abusers to participate in a six-month long treatment program, posted in community spaces of towns located in counties with high rates of drug use, as well as on Facebook groups for loved ones of substance abusers. In order to only include CSOs of treatmentresistant IPs, CSOs will be asked their IP’s hypothetical reaction to being asked to enter treatment. CSOs will be excluded if Proposals | 29

OPUS (2021) 12:1

they answer that the IP would already be interested and open to treatment. Participating CSOs will be randomly assigned to either CRAFT, an approach that seeks to transform the IP’s behavior through the family, or Al-Anon therapy, focused on detaching the family from the IP. When their family members commit to the program, IPs will fill out demographics and baseline measures of family support (Multidimensional Scale of Perceived Social Support, or MSPSS), motivation to change (Stages of Change Readiness and Treatment Eagerness Scale, or SOCRATES-8), severity of substance use (Drug Abuse Screening Test, or DAST) and psychological wellbeing to account for variation in depression and anxiety at baseline (Depression and Anxiety Stress Scale, or DASS-21).

The CRAFT group will meet once a week for six months with a licensed therapist trained in CRAFT who will teach them the primary components of CRAFT: how to identify a loved one’s triggers to use substances, positive communication strategies and reinforcement strategies, identifying appropriate times and ways to suggest treatment, and self-care practices (Kirby et al., 2017). The Al-Anon group will meet at the same frequency with a licensed counselor with a 12-step orientation reflecting Al-Anon’s philosophy. For both groups, if at any point the IP expresses desire to enter treatment, researchers will schedule the IP’s intake session within the next 72 hours, at which point the IP will once again fill out the baseline measures.

Entering treatment is operationalized as having completed the intake measures and attended at least three individual treatment sessions. If the IP never expresses interest in treatment, they will fill out the measures again at the end of the study.

Referrals to local mental health providers will be shared with all participants so that they may continue or begin to receive therapy after termination of the study. Information about open support groups and psychoeducation materials on substance use disorders will also be available.

Measures Drug Abuse Screening Test (DAST). The DAST is a 28item self-report measure for drug use. Research has established the DAST’s high internal reliability (α = .92). Validity was assessed by correlating the DAST with documented frequency of drug use in the last year (p < .05; Skinner, 1982).

Depression and Anxiety Stress Scale - Short Form (DASS-21). The DASS-21 is a 21-item instrument comprised of three reliable subscales measuring depression (α = .88), anxiety (α = .82), and stress (α = .90). The composite score (i.e., combining each of the subscales scores) has also been found to have strong s reliability (α = .93; Lovibond & Lovibond, 1995).

The DASS-21 dimensions are correlated (all ps < .01) to the appropriate Positive Negative Affect Schedule (PANAS; Watson et al., 1988) dimensions, demonstrating high construct validity.

Multidimensional Scale of Perceived Social Support (MSPSS). The MSPSS is a 12-item self-report instrument assessing perceived social support from family, friends, and significant others on a seven point Likert-type scale from “Very 30 | Proposals

Strongly Disagree” to “Very Strongly Agree.” Research has found the MSPSS has good internal reliability (α = .88), and moderate construct validity, with the scale being significantly correlated to depression (r = -.25, p < .01; Zimet el al., 1988).

Stages of Change Readiness and Treatment Eagerness Scale (SOCRATES-8). The SOCRATES-8 is a 19-item instrument used to assess change readiness and treatment eagerness in substance users (Miller & Tonigan, 1996). It is scored on a five point Likert scale from “Strongly Disagree” to “Strongly Agree”, and is composed of three dimensions of Recognition, Ambivalence, and Taking Steps. Miller and Tonnigan (1996) found the internal reliability of the SOCRATES-8 to range from 0.85–0.95 for Recognition; 0.60–0.88 for Ambivalence; and 0.83–0.96 for Taking Steps (as cited in Abiola et al., 2015).

Data Analytic Plan Two regressions will be run to explore whether participation in CRAFT leads to greater changes in perceived family support and motivation to change than Al-Anon (IV: experimental condition; DVs: family support, motivation to change). Baron and Kenny’s (1986) approach will then be followed to test the mediation hypotheses. We will use a logistic regression to show whether CRAFT is correlated with treatment entry status (C pathway), and a linear regression to show whether CRAFT is correlated with family support/motivation to change (A pathway). Then, both CRAFT and family support/motivation to change will be entered as predictors in a last logistic regression to see if the total effect of CRAFT on treatment entry diminishes when controlling for family support/motivation to change (B and C’ pathways). Sobel’s tests will be run to establish if the mediation effects are significant. Covariates (i.e., demographics, depression and anxiety levels, baseline severity of substance use) will be controlled for throughout.

Discussion Although there is a great deal of research assessing CRAFT’s rates of successful treatment engagement compared to other popular programs for families of substance abusers (Meyers et al., 2011), there are no published studies investigating the steps through which CRAFT is effective. Hence, the proposed study would help fill a gap in the literature. However, this study will be limited by certain selection factors. Indeed, IPs who volunteer to participate in this research study may already be more motivated to change, and therefore to enter treatment, than the general population of substance users. This threatens the study’s external reliability and the generalizability of the findings.

Furthermore, the least motivated study participants are more likely to drop out before the end of the study, which could skew the results. Assessing motivation to change levels at baseline will enable partial control for this. Additionally, this study should be adapted to look specifically at group and family-oriented populations, such as Hispanic/Latinx or East-Asian individuals (Corrigan & Lee, 202; Sabogal et al., 1987; Villatoro et al., 2014).

These different family dynamics could make CRAFT even more

Family Support, Motivation for Change, and Treatment Entry

effective, or, on the contrary, more difficult to implement. It is important to investigate if interventions research has deemed successful in the past remain so across ethnic groups.

Understanding how family support and motivation for change influence the efficacy of CRAFT could help improve other interventions’s success rates for treatment entry, strengthening other programs aimed at getting substance abusers to commit to treatment. Demonstrating the importance of family support in relation to treatment entry has implications for research to explore how it could play a role in other treatment modalities, building upon the literature that has explored family support as a tool for addiction prevention or maintaining recovery (Dishion et al., 2003; Kumpfer et al., 2003; Pollini et al., 2006; Rapp et al., 2007). Identifying mediators can also make CRAFT more cost-effective and, therefore, more broadly accessible to the millions of individuals struggling with addiction and their families suffering by proxy, lightening the burden of care.

Proposals | 31

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RESEARCH

COVID-19 and Parental Burnout Levels Joy Shen and Macarena Kruger

The COVID-19 pandemic has created significant shifts in people’s everyday lives (Brown et al., 2020; Prime et al., 2020).

Social restrictions and business downfalls negatively impacted adults’ and children’s mental health (Centers for Disease Control and Prevention [CDC], 2020). Indeed, many adults lost their jobs (Karpman et al., 2020; Nicola et al., 2020), and almost all children globally transitioned to online learning (Golberstein et al., 2020). With these transitions, many parents needed to take on a new role of teacher or school facilitator for their children at home (Prime et al., 2020). These added roles and responsibilities might have increased parental burnout levels. While parental stress is common and not usually detrimental to parents’ well-being (Griffith, 2020), burnout is indicated by extreme exhaustion, a feeling of distance from the family structure or child (e.g., being less responsive to their child or emotionally disengaged), and a sense of inadequacy or ineffectiveness in their parenting role (Griffith, 2020; Mikolajczak et al., 2018; Roskam et al., 2017). Extant research on parenting and burnout has examined emotional burnout in parents (e.g., Le Vigouroux et al., 2017; Mikolajczak et al., 2018), including in parents who homeschool their children (e.g., Lois, 2006). However, less is known about whether this burnout is different amongst caregivers who were forced to adopt teaching roles at home.

Further, given the recency of COVID-19, research has not yet fully examined the effects of the pandemic on parenting.

There are a few studies that have examined the pandemic in relation to higher parental stress levels and an increase in child maltreatment rates (e.g., Brown et al., 2020; Campbell, 2020).

However, they fail to acknowledge other parental mental health aspects, such as burnout levels, as a result of the pandemic.

Parental Burnout in Parents With Young Children Parental burnout is a significant problem, because it leads to sleep difficulties, marital conflict, and child rearing practices that could have a detrimental impact on children’s development (Mikolajczak et al., 2018). Specifically in the United States, parental burnout rates are alarming; approximately 3.5 million parents experience burnout (Mikolajczak et al., 2019). Children’s ages and the number of children in the household are key factors that play a role in parental burnout levels (Le Vigouroux & Scola, 2018). Indeed, young children (i.e., from birth to 6 years old) require more supervision and attention from their parents compared with their older counterparts (Le Vigouroux & Scola, 2018; Mikolajczak et al., 2018). For instance, parents play a key role in their young children’s development of healthy habits (e.g., limited time watching TV), as well as in the promotion of practices that foster childrens’ early skills (e.g., book reading;

Olson et al., 2004).

In addition to factors at home, burnout levels may be impacted by external circumstances, such as unexpected events (Le Vigouroux et al. 2017) and social expectations for raising young children (Borelli et al., 2017; Meeussen & Van Laar, 2018; Roskam et al., 2017). For example, due to women’s increasing participation in the workplace, it may be harder for mothers to attend to their children’s demands, and these difficulties might be compounded by the social pressure that is placed on parents, specifically on mothers to be warm, present, and engaged (Meeussen & Van Laar, 2018; Roskam et al., 2017). Accordingly, mothers tend to experience greater parental burnout levels than fathers. Furthermore, parents’ socioeconomic status and their financial positions play a key role (Sorkkila & Aunola, 2020), especially when dealing with unexpected financial responsibilities (e.g., increase in rent and/or medical bills). If parents are not financially stable, finances become a constant stressor, and prolonged exposure to stressors leads to burnout (Lebert-Charron et al., 2018; Meeussen & Van Laar, 2018; Roskam & Mikolajczak, 2020).

Despite all the challenges that parents face, there are also protective factors which prevent parents from experiencing the negative effects of potential high stress (Sorkkila & Aunola, 2020). One of the most beneficial protective factors is to make time for self-care practices (e.g., practice self-compassion and self-acceptance; Sorkkila & Aunola, 2020). Another effective strategy is to perceive control over challenging situations, which consequently helps parents develop higher emotion regulation to cope with burnout (Brown et al., 2020; Dijkstra & Homan, 2016). In terms of family support, parental agreement when parenting children has also shown to help minimize the effects of burnout (Gérain & Zech, 2018; Mikolajczak et al., 2018).

Homeschooling, COVID-19, and Burnout Parents who homeschool their children face unique challenges with balancing roles, and, thus, tend to experience greater burnout levels (Baker, 2019). Both their teaching and parenting roles are psychologically, physically, and cognitively demanding (Boyle et al., 1995; Friedman, 2003). Parents who take on the role of an educator at home may experience role strain, a common factor leading to burnout (Baker, 2019; Lois, 2006). Role strain may be exacerbated by role ambiguity (i.e., uncertainty about the expectations of a role) or role conflict (i.e., when there are multiple roles to fill, and they interfere with one another; Lois, 2006; Papastylianou et al., 2009). Juggling a career alongside parenting and teaching might contribute to even greater role strain (Green & Hoover-Dempsey, 2007).

Research | 35

OPUS (2021) 12:1

These role strains are often exacerbated if parents lack adequate resources and/or social support (Friedman, 2003; Lois, 2006).

Many parents, even former school teachers who end up in a homeschooling role, feel a sense of inadequacy or insecurity surrounding their abilities to teach, causing more stress and exhaustion (Brissie et al., 1988; Friedman, 2003; Lois, 2006; Papastylianou et al., 2009). This sense of inadequacy is often exacerbated due to parents’ deep emotional commitment to the children, especially if their child lacks motivation or is failing to meet expectations (Baker, 2019; Lois, 2006).

Most research on homeschooling has focused on parents who made the decision to transition to homeschooling due to religious, moral or protective reasons; less is understood about parents who are forced to take on a similar role (Baker, 2019). The COVID-19 outbreak led many parents to take on homeschooling roles due to the closing of schools and transition to remote learning (“COVID-19 Educational Disruption,” 2020). While children continued to follow curricula set by their teachers at school, young children needed their parents to aid them in the unfamiliar online learning format. This transition not only altered children’s everyday lives, but also family dynamics as a whole, and especially the role of parents at home (Brown et al., 2020). Research shows that parents in the U.S. reported to be more stressed during the COVID-19 pandemic compared with their non-parent counterparts and have attributed their main stressors to their parenting roles and transition to online learning (American Psychological Association [APA], 2020). Over the course of the pandemic, parents have reported having less emotional support and higher levels of stress due to financial struggles and health concerns leading to increased parental burnout (Center for Translational Neuroscience, 2020). Although, to date, there has been very little research surrounding the pandemic and its mental health implications, many parents have expressed this sense of stress and burnout through mediums like social media and popular journals. For example, Grose (2020) conducted an interview for The New York Times with Paige Posladek, a pregnant woman and mother of two children who are two and four years old.

Posladek explained a sense of stagnancy and a failure to move forward because she feels overwhelmed and does not have time for herself. One of the few studies addressing parental burnout during COVID-19 (Mousavi, 2020) found that other parents are experiencing higher levels of parental burnout citing new stressors such as uncertainty, lack of control, and helplessness, confirming anecdotal evidence from parents with young children.

Current Study Parental burnout is a feeling of extreme exhaustion due to high levels of stress and a mismatch between responsibilities and available resources, which includes a sense of disconnection with parents’ family and/or children (Griffith, 2020; Mikolajczak et al., 2018; Roskam et al., 2017). Past research has found that parenting young children can be very rewarding, yet challenging 36 | Research

at times (Le Vigouroux et al. 2017; Mikolajczak et al., 2018), with additional difficulties on parents who homeschool their children (Baker, 2019). Research on the recent COVID-19 pandemic has begun to shed light on changing family routines and increased stress (“COVID-19 Educational Disruption”, 2020; Grose, 2020).

However, little is known about the effect of a teaching role at home on burnout for parents who are forced to take on this role.

Furthermore, minimal work has focused on the relation between COVID-19 and parental burnout levels. Thus, this study aimed to fill these gaps through the following research question: How has the COVID-19 pandemic impacted burnout in parents with young children?

Method Participants Ten parents of young children in New York City were interviewed (N = 10) via Zoom. Nine participants identified as cis-women, and one identified as cis-man. Most of them (N = 8) identified as White, whereas one participant identified as Hispanic or Latino and one participant identified as Black or African American. Parents’ ages ranged from 29 to 43 years old.

All parents were married except for one who was divorced. All of them reported obtaining at least a Bachelor’s degree; four reported obtaining a professional or Master’s degree, and five parents reported obtaining a doctorate degree. The majority (N = 6) reported having one child and the remaining four parents reported having two children. Ten of the children were female and four were male; their ages ranged from 7 months to 10 years old (M = 3.26, SD = 2.62).

Procedure In October and November of 2020, participants were interviewed by one of the authors via Zoom. The interview protocol was created based on findings in the extant literature; a trial interview was conducted to see which questions were relevant, and the interview questions were then revised accordingly. The interviews were semi-structured, including questions such as “In what ways did your child/children need more support or supervision for their schooling from home?”

However, follow-up questions were also asked throughout the interviews for clarification. During the interviews, both the participants and the interviewers had their cameras on.

All the interviews were conducted in English, and they were approximately 30-35 minutes long.

Transcription and Coding All interviews were transcribed using Trint software. The coding scheme emerged from the data based on a grounded theory approach (Glaser & Strauss, 1967). To establish reliability, each researcher coded the same interview, compared codes, and clarified the discrepancies. Once reliability was achieved, each transcript was read by one of the researchers twice and coded for main themes and specific codes that emerged from the data. The interviews were coded at the turn level, such that researchers

COVID-19 and Parental Burnout Levels

coded each time the participant spoke (i.e., each turn speaking).

Although the same code could not be assigned multiple times within a turn, codes were not mutually exclusive. Therefore, if a statement within one turn qualified for multiple codes, researchers double coded them. This decision was made in order to capture participants’ experiences in a nuanced way.

Final Codes From the conducted interviews, two main themes emerged that gave insight into how the COVID-19 pandemic has affected burnout in parents. Although none of the parents in our sample experienced burnout in accordance with the definition, most of them experienced added stress. We will explore two themes that emerged: (a) contributors and (b) preventative factors to stress. Within those themes, specific codes (i.e., stressors, social support, roles, silver linings, self care, childcare) were developed and analyzed. See Table 1 for specific codes and definitions.

Results Contributors Results show variability among each participant’s experiences. Nevertheless, the “stressors” theme emerged in all ten interviews. All participants mentioned that the COVID-19 pandemic has brought additional stressors into their lives.

Within this main theme, work/schooling, time management, and parenting were the most prevalent sources of stress.

Work and schooling. ‘Work/schooling’ came up 32 times across all the interviews. Four participants stated how they had more responsibilities and more things to do since COVID-19 hit. They were doing most of the household tasks “and then also school work, getting things done, making sure that I’m on top of everything, and I am on track, and everything… it’s hard sometimes.” In addition, two participants mentioned how they have always been overwhelmed due to workload, but how now it was even more stressful: “My work day is never sufficient, and that’s always the case. Now it’s worse...” and “so I felt like work became busier.”

Time management. Often co-occurring with work and school stress, “time management” stress came up 29 times. Most parents were very explicit when they talked about problems with time management, with statements such as “you know, it’s hard to manage time: home work, teaching and lots of meetings. It’s like this the whole week.” Along these lines, some parents reported being exhausted due to the great amount of energy they invest in their responsibilities. One mother referred to it as follows: “at the end of the week you’re like, wow, how did I actually survive that week?” In addition, two of them specifically talked about how their schedules were shaped based on their children’s needs. One of them said that her “workday was extended and sort of built around her [daughter’s] schedule.” Another mother explained what a typical day looks like for her: “I wake up at 7:00 and I prepare everything that [my daughter] needs to be able to do work at home. So that means creating a schedule, a reminder,

so she has a little notepad that I put down to remind her when she has Zoom meetings...” which takes a lot of time.

Increase in parenting. Finally, “an increase in parenting stress” came up 22 times. All participants except one brought up this idea. They mentioned that spending most of the time with their children at home was challenging. Parenting sometimes interferes with their work and with their professional responsibilities because now “there’s lots of different disruptions.”

For example, one of the mothers talked about how when she “was in meetings particularly, there was a push and pull. My daughter… doesn’t quite understand that when I’m working, I can’t be entertaining her.” Another parent mentioned how irritating it was to ask her child about her homework and getting a response such as “I don’t want to do it, I’m only doing it because I have to,” causing tension in their parent-child relationship.

Roles. The second most prevalent theme after stress was “roles.” Within this theme, the two most prevalent specific codes were “more roles” and “took on a teacher role.” For instance, eight out of the ten participants reported taking ‘more roles’ as a result of the pandemic. One of them mentioned that he was “working, making dinner and taking care of the three year old who needs attention.” The specific code called ‘took on a teacher role’ was also a trend among parents’ responses. Fifty percent of the participants reported taking on a teacher role, and it came up 11 times across those five interviews. The only father participating in this study said that he felt an additional burden because he now listens to his daughter’s Zoom classes, so that if her daughter did not understand something, he could help her based on what the teacher said. So he was “teaching now” and that “a lot of the teaching is falling on [him].” Most parents talked about how they struggled when their children needed to do homework, and how “that kind of negotiation adds stress.”

Parents whose children had not yet entered the school system, also reported that their children’s education and development are main stressors. For instance, one mother who has a toddler was worried about the lack of social interactions her daughter had, and expressed the following: “I worry about her social isolation... not really knowing, you know, how to engage with other kids her age, so I do not know if I should have her in like half day programs.” Only three parents reported experiencing the specific code called ‘role ambiguity’.

Preventative factors Financial stability. In addition to adjusting to the pandemic over time, many parents discussed several factors that helped them cope with and prevent burnout even during the early transition. For parents participating in the current study, one major factor that helped to prevent burnout was financial stability. Out of the ten participants, eight had obtained a graduate degree (either master’s or doctorate). During the interviews, no parent had reported stressors stemming from financial instability or loss of occupation, and some even explained that their incomes had not changed, allowing them to either move to a larger home, or continue to pay for childcare.

Research | 37

OPUS (2021) 12:1

In realizing the difficulties in living in a small apartment, one participant reported that her family “moved to New Jersey over the summer because [they] needed more space,” a larger home where her children would have space to do schoolwork while she worked from home. Moving to a larger space allowed for this family to have more privacy for work and combat some of the stressors of working from home. This ability to move reflected how good financial standing could prevent stressors for some families during COVID-19.

Silver linings. Changes in parents’ schedules and work was another helpful factor. Within the “silver lining” theme, one of the most commonly cited codes was the lack of commuting. In describing their routines pre-COVID, several parents noted that a main stressor during those months was due to their commute to and from work. One parent reported, “the most stressful part… was the commute… it takes me about two hours, one way to get to [work].” Fifty percent of the sample used the lack of a commute as an example for any decrease in stress levels. So while all of the participants discussed increased stress levels due to parenting and time management, this aspect of stress from pre-COVID was no longer there.

Social support. Lastly, one last preventative factor that helped parents cope with the increased stress due to COVID-19 was social support. Seven out of ten of our participants reported an increase in social support, despite the fact that they were not able to see people in person anymore, because frequent Zoom calling or FaceTiming friends and family led to more contact.

One participant stated, “I feel like in a lot of ways, FaceTime has allowed for more intimate connections with supporters…

[Before], we would not call that much. We would text a lot. And now we FaceTime. Much more than we ever called each other.”

Another participant noted the increase of contact by stating, “So we’re able to talk to [family] more and face time with them more because everyone’s home, whereas before we never really were able to.” Through these reports, it was clear that many participants felt that they had support from family, friends and colleagues because everyone was experiencing the pandemic, leading to a “we’re all in this together” mentality.

Discussion The present qualitative study examined the impact of COVID-19 on parental burnout levels. Existing literature indicates that the COVID-19 pandemic has brought unexpected changes (Prime et al., 2020) and significant stress in 2020 (Klaiber et al., 2020). In line with these findings, the current study showed that many parents experienced an increase in parenting stress caused by taking on more roles at home, increased work stress, and less time. Yet, although most research, to date, examining COVID-19 and family-related factors only report negative implications (e.g., Brown et al., 2020; Power, 2020; Russell et al., 2020), this study also found positive outcomes of the pandemic.

These included a lack of commuting, which was a source of stress pre-COVID-19, as well as increased social support due to the immediacy of technology and video calls.

38 | Research

Based on the operationalization of parental burnout proposed in past research (e.g., Griffith, 2020; Mikolajczak & Roskam, 2020; Roskam et al.,2017), parents in this particular sample did not experience high parental burnout levels in the aftermath of the pandemic. Parents reported experiencing more stress compared to their pre-COVID-19 stress levels and having a general feeling of exhaustion in some cases, but none of them reported experiencing a feeling of distance from their family structure and/or children. Rather, one parent explicitly mentioned how he is trying to emotionally support his daughter as much as possible, while others even reported feeling closer to their children. Furthermore, none reported a sense of ineffectiveness in their parenting role or experiencing role ambiguity. Thus, although certain symptoms of parental burnout such as increased stress were experienced, no parent reported facing all aspects of parental burnout.

Past research suggests that protective factors such as financial stability (Sorkkila & Aunola, 2020) and social support (Gérain & Zech, 2018; Mikolajczak et al., 2018) might help prevent parents from experiencing high burnout levels. In the current study, all participants had at least a Bachelor’s degree, and all of them reported having a stable job or a spouse with a stable job. Financial stability and income typically also come with health insurance, and access to safe housing and transportation, all crucial elements to navigating a pandemic.

During this time, many businesses closed down and many people were laid off from their jobs, creating financial instability and turmoil for many families (Karpman et al., 2020; Nicola et al., 2020). Anecdotal reports of extreme exhaustion and parental burnout in the media came from families who were struggling financially to support their families during the pandemic, on top of all of the stressors the participants in this study experienced (“COVID-19 Educational Disruption”, 2020; Gross, 2020).

Indeed, participants in the current study did not report financial instability or marital conflict, and thus, they relied on those protective factors.

Another discrepancy between past research and the current findings is that previous studies suggest that parents who have less time for themselves, as well as less time to meet their responsibilities, tend to experience higher parental burnout levels (e.g., Griffith, 2020; Mikolajczak et al., 2019).

Nevertheless, participants did not report this to be the case.

All of the participants expressed concerns regarding time management, as well as having less time to engage in self-care practices. However, they did not meet all the parental burnout criteria, according to the definition of parental burnout that was adopted for the purpose of this study.

Findings of the current study should be interpreted with caution, as this qualitative investigation was a limited exploration of ten participants. Future research should explore this area of study using a qualitative approach with a larger sample size or using quantitative measures to investigate levels of burnout over time in the aftermath of the pandemic. Moreover, incorporating quantitative measures, such as the MBI or the

COVID-19 and Parental Burnout Levels

Parental Burnout Assessment, might be more objective ways of capturing this variable, and might allow for the inclusion of larger samples (Maslach & Jackson, 1981; Roskam et al., 2018). Furthermore, due to convenience sampling, the sample was rather homogenous, as it included mostly white, highly educated, financially stable mothers, and, therefore, was not able to provide information on a variety of parents living through the pandemic. Because there was only one father, researchers were unable to gain a comprehensive understanding of gender roles in parental burnout due to COVID-19. The sample was all relatively high SES, as well, which is not representative of the population at large. Although this information helped in understanding factors contributing to or protecting against stress, it did not describe the struggles middle class and low income families might be experiencing during this difficult time. Despite these limitations, however, the current study provides valuable insight into the impact of COVID-19 on parental mental health through a preliminary investigation of how parents are coping and managing with young kids in the house.

Findings show that protective factors have the ability to prevent parents of young children from experiencing high burnout levels (Le Vigouroux et al., 2017). Parents reported high stress and anxiety levels due to external and unexpected circumstances like COVID-19 (Le Vigouroux et al., 2017).

However, results demonstrate the importance of social support and economic stability in preventing stress and inform policy to prevent disproportionate levels of burnout in parents based on family income and access to resources. Despite being able to afford childcare, some parents participating in this study still commented that it was expensive. Thus, this study provides evidence for policymakers to incorporate more accessible childcare policies in New York City. This study also lays the foundations for future research to investigate the negative long term repercussions of high parental stress not only on parents but also on their children. For instance, future longitudinal research should examine the relation between children who had parents with high levels of stress and future personality disorders during adolescence. Although more studies are required to further explore this field, qualitative research like the present study is a first step to inform researchers and practitioners of the issues that families face during unprecedented times.

Research | 39

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Research | 41

COVID-19 and LGBTQ+ Mental Health Ana Warner & Callie Hilgendorf

With the onset of the COVID-19 pandemic, many public health officials expressed a serious concern regarding the ramifications for mental health (Hasan & Bao, 2020). In fact, preliminary findings on the lack of educational opportunities and the rise in social isolation and partner violence reveal troubling trends in the already burdening effects of the COVID-19 pandemic on both physical and mental health (Goodman & Epstein, 2020; Wang et al., 2020). The intensity of COVID-19 in the United States has had a profound effect on the mental health of various communities, including lesbian, gay, bisexual, transgender, and queer (LGBTQ+) college students (Meyer, 2013). Prior to the pandemic, LGBTQ+ individuals were more vulnerable to experiencing negative mental health outcomes, specifically anxiety, in comparison to their heterosexual peers (Price-Feeney et al., 2020 & Russell & Fish, 2016). LGBTQ+ young adults have endured suffering, social isolation, job insecurity, and a tremendous amount of community loss during the COVID-19 pandemic (Gonzales et al., 2020; Konnoth, 2020).

These experiences may be unique to people in the LGBTQ+ community, as compared to their heterosexual counterparts, because they may also face housing and job discrimination, live with people who are not supportive of their identities, and may generally rely on in-person, queer, community support systems (Jackson, 2017). To add to these already high-stress situations, many college students have had to make the difficult and abrupt transition to online learning with little support (Perz et al., 2020). Yet, there is limited research that addresses the ways in which LGBTQ+ college students have experienced anxiety from the pandemic.

COVID-19 Effects on College Communities The COVID-19 pandemic has led to dramatic and undeniable losses worldwide, particularly for college-aged students (World Health Organization, 2020). With the continuing rise of COVID-19 cases, many universities shut down or shifted to fully remote learning (Grether et al., 2020; Perz et al., 2020). Due to campus closings, many students abruptly moved off-campus, which, in turn, caused many to lose their jobs and endure significant financial loss (Hoyt et al., 2020; Perz et al., 2020). This is in addition to the challenges regarding food, housing, and financial insecurity that many college students experienced prior to the pandemic (Owens et al., 2020).

The logistical and mental strain on college-aged students brought on by the pandemic challenged many to adapt to social, physical, and mental isolation (Wang et al., 2020). Recent research has indicated that college students have been coping with high 42 | Research

amounts of stress and anxiety related to academic performance, physical risk of themselves or a loved one contracting the virus, study habits, social habits, remote learning experiences, current labor market participation, and expectations about future employment or further degrees (Aucejo et al., 2020; Chen et al., 2020; Perz et al., 2020). Specifically, the pandemic led to many students to withdraw from classes and even delay graduation because of uncertainty surrounding future educational plans and the current unemployment climate in the United States (Aurcejo et al., 2020). Additionally, students indicated a decrease in hours committed to scholarly activities, resulting in an overall decrease in academic performance (Aurcejo et al., 2020).

Each of these factors contribute to a general concern that an already existing mental health crisis is likely to become exacerbated due to handling of the COVID-19 pandemic (Hasan & Bao, 2020; Perz et al., 2020). According to the 2019 Annual Report of the Center for Collegiate Mental Health, anxiety was the most reported issue amongst college-aged students and has increased since the beginning of the pandemic (Wang et al., 2020). Research has found that those who indicated an increase in stress frequently cited five main reasons: academics (i.e., grades, delayed graduation, and remote learning), general uncertainty, health related concerns, finances, and social isolation (Wang et al., 2020). As social distancing protocols and the closure of public spaces continue, researchers have presented evidence that individuals, particularly young adults, experienced significant levels of anxiety and stress while in quarantine (Salari et al., 2020), and students have felt unable to adequately cope with their stress during this difficult time (Wang et al., 2020).

Yet, there is a clear gap in the support these students have been receiving, and universities need to take action to better support the mental health of their students (Wang et al., 2020).

LGBTQ+ College Students and Anxiety Academic interest in the wellbeing of LGBTQ+ students is relatively new (Leider, 2012). Until the early 2000s, the research published regarding LGBTQ+ college students was mostly concerned with anti-LGBTQ+ attitudes, as opposed to the experiences of LGBTQ+ students (Leider, 2012). Today there is a growing body of research working to address mental health concerns, such as anxiety, in the LGBTQ+ community (Leider, 2012; Ottenritter, 2012). One meta-analysis showed a pattern of lower rates of anxiety amongst heterosexual people as compared to their LGBTQ+ peers, even when controlling for other predictors of mental health complications (e.g., people who are HIV positive or experiencing housing insecurity), especially on college campuses (Meyer, 2013). Researchers have generally

COVID-19 and LGBTQ+ Mental Health

come to believe that this may be a result of LGBTQ+ identifying individuals experiencing microaggressions, overt aggressions, identity confusion, and internalized homophobia (Meyer, 2013; Ross et al., 2018).

College campuses also have the potential to improve mental health outcomes for LGBTQ+ students. When LGBTQ+ individuals have safe community-oriented queer spaces to process impactful events in their lives, they perceive less social isolation and are met with more wholly advantageous coping strategies (Jackson, 2017). Community building and consistent access to these different support networks are crucial for LGBTQ+ students to manage anxieties surrounding their identities and life experiences, so that they can fully commit themselves to flourishing during their time in school and beyond (Leider, 2012; Ottenritter, 2012). Given the nature of collegiate institutions, LGBTQ+ populations, compared to their heterosexual peers, are more likely to experience mental health disparities which may have been exacerbated since the COVID-19 pandemic (Salerno et al., 2020).

Current Study There is currently very little research available that seeks to understand the connection between anxiety in LGBTQ+ college students and the COVID-19 pandemic (Meyer, 2013; Ross et al., 2018; Seelman et al., 2017). While it is understandable that this research is not widely available yet due to the recency of the pandemic and the number of subpopulations affected by it, it is especially important to look at LGBTQ+ college students, because they are already at a higher risk of anxiety than their peers (Meyer, 2013; Salerno et al., 2020). Additionally, by focusing on this community, research can strive to discover trends in LGBTQ+ college students’ experiences with anxiety and prevent them from becoming more prevalent in the future.

Experience with anxiety, in this case, will focus on symptoms (e.g., panic attacks, increased heart rate, feelings of being out of control, etc.), access to support systems, and environmental factors. This qualitative study, thus, explored the following research question: How has the COVID-19 pandemic affected the experience of anxiety in LGBTQ+ college students?

Method Participants Fourteen LGBTQ+ identifying students from New York University (NYU), recruited via social media, class forums, and word of mouth, participated in the study. Participants were told they must identify as part of the LGBTQ+ community and be currently enrolled at NYU to be eligible for the study.

Students were also given the opportunity to request a specific interviewer to reduce response biases and encourage more open responses. All respondents (N=14) identified as one or more of the following racial/ethnic identities: White (47.1%), Black (17.6%), Latine (23.5%), and Asian (11.8%), and one or more of the following LGBTQ+ identities: lesbian (24%), gay (16%), bisexual (12%), transgender (8%), pansexual (4%), queer (36%).

The following gender identities were also represented: cisgender female (62.5%), transgender (12.5%), and nonbinary (25%) with differing combinations of she/her (62.5%), they/them (31.3%), and he/him pronouns (6.3%).

Procedure This study was conducted via 20-minute semi-structured Zoom interviews where participants were asked to report demographic information such as pronouns, gender identity, LGBTQ+ identity, ethnicity, age, and year in college. For questions such as gender identity, LGBTQ+ identity, and ethnicity, participants were not given options to choose and were encouraged to list any and all terms that they identify with.

Participants were also asked questions about their experiences since the beginning of the COVID-19 pandemic and anxiety.

The questions about the participants’ experiences with anxiety and COVID-19 can be found in Appendix A. Results All interviews were recorded and then transcribed by the interviewers. Researchers used the principles of grounded theory to code the semi-structured interviews, by coding 21% of the transcripts and discussing and defining common themes related to the research question (Chun Tie et al., 2019). The codes that were generated based on the emergent themes are: anxiety surrounding routine (anxiety linked to changes in everyday life and uncertainties as a result of COVID-19), anxiety surrounding uncertainty (anxiety linked to unforeseen changes in previously secure long-term environments such as employment, housing, and community), social isolation (a decrease in daily interpersonal interactions and ultimate feelings of detachment from their communities), lack of normality (reported feelings of continued distress and inability to adjust comfortability into the world as affected by COVID-19), and less mental capacity (a lack of self-reported cognitive capabilities to perform everyday responsibilities such as homework, attending class or work, and personal maintenance).

Analysis of the data highlighted that 34% percent of participants indicated they were experiencing “anxiety surrounding uncertainty” over the past month. This included anxiety about relocating, changes in employment, and financial instability. Additionally, 13 out of the 14 participants indicated they were struggling with changes in everyday life, as well as “anxiety surrounding changes in routine” as a result of COVID-19. These changes included a shift to online learning due to COVID-19, adjusting to different workloads in employment or unemployment, moving locations during the pandemic, and shifting daily activities to a more indoor environment. Eightysix percent of the participants reported that they were lacking a sense of normality in their daily interpersonal interactions. This included participants feeling equipped to adjust to a reorganized change in normality, and professors failing to recognize student accommodations due to COVID-19 related issues.

Throughout the pandemic, community engagement (e.g., Research | 43

OPUS (2021) 12:1

through roommates, family, family-friends, or colleagues) has been a source of both reduced anxiety (21.4%) and increased anxiety (57.1%) for participants. Some specific examples of reduced anxiety that participants noted included a decrease in social anxiety given that social interactions decreased, and connecting with friends and family has switched to virtual communication. Out of the total responses, 13% of participants expressed that they had been experiencing “social isolation” through separation from their respective communities due to COVID-19. Potential causes for increases in anxiety levels that stem from “social isolation” include: living alone in an apartment, abrupt separation, limited social interactions, partner separation, contraction anxiety between partners, and NYU community seperation. Of the 14 interviews conducted, nine participants indicated that they were experiencing feelings of social isolation.

All 14 participants indicated at least once that they were struggling with less mental capacity to perform everyday responsibilities including homework, attending class or work, and personal hygiene or self-care. These experiences of anxiety focus specifically on the symptoms our population of study encounters. There was a noticeable trend in the participants’ quantity and quality of sleep; out of the 11 participants who chose to disclose their symptoms, six identified insomnia, or restlessness, as a significant source of their anxiety. These sleep disruptions totaled to 55% of the symptoms reported by the participants.

Another heavily represented symptom included trouble eating and nausea; five out of fourteen, or 35.7%, of participants expressed this manifestation of anxiety. Among the three participants who disclosed a medical diagnosis of Obsessive Compulsive Disorder (OCD,) two indicated that their obsessive thoughts or repetitive compulsions have increased because of an increase in anxiety related to COVID-19. Other common symptoms of anxiety that were expressed by our participants include: headaches, fidgeting, anxiety attacks (i.e., tightness in the chest, feeling an inability to breathe, and trouble thinking clearly), and dissociation from the present moment. Participants commonly reported struggling with one or more combinations of dissociation, lack of motivation, trouble focusing, and fatigue as symptoms of their anxiety. These symptoms combined with feelings of uncertainty, dramatic changes in routine, and intrusive thoughts and behaviors make it difficult to perform everyday tasks such as attending work and school and maintaining physical and mental hygiene. Some participants specifically said that they must be more strategic with planning their days around their available mental capacities. They also stated that they have had to significantly adjust their daily routines by increasing alone time, minimizing time on the computer, and scheduling daily outings.

Another aspect that was highlighted during the semistructured interviews is that having access to mental health services is important for LGBTQ+ college students during the pandemic. Although it was not part of the formal interview 44 | Research

questions, access to medication and counseling services came up organically in many conversations with the participants. Only five participants mentioned that they were taking medication to help manage their feelings and symptoms of anxiety and/ or regularly seeing a mental health professional during the pandemic. In each of those cases, students reported a decrease in symptoms of anxiety and general improvement in their dayto-day lives.

Discussion This study aimed to address the gaps in the literature surrounding the experiences of anxiety that LGBTQ+ college students face throughout the COVID-19 pandemic. The findings support past research by highlighting the anxiety experienced by LGBTQ+ college students (Goodman & Epstein, 2020; Meyer, 2013). One of the most common shared experiences from the participants was related to new or heightened stressors that have been increasingly difficult to manage since the pandemic.

Specifically, individuals are forced to resume their lives with academics and work, but with less perceived mental capacity.

Participants commonly reported struggling with one or more combinations of dissociation, lack of motivation, trouble focusing, and fatigue as symptoms of their anxiety. These symptoms combined with feelings of uncertainty, dramatic changes in routine, and intrusive thoughts and behaviors make it difficult to perform everyday tasks such as attending work and school and maintaining physical and mental hygiene.

Another aspect which has appeared to contribute to how LGBTQ+ students are re-prioritizing their available time and energy is their individual engagement in their classes. The rise of COVID-19 has created or heightened anxiety surrounding uncertainty with employment, finances, and housing amongst students and thus impacts individuals’ motivation and ability to be engaged in their coursework which is consistent with previous literature (Aucejo et al., 2020; Chen et al., 2020; Perz et al., 2020;). One student specifically mentioned that, “online school is not fun or easy, especially with professors who are not trained to teach online and when everything else in the world is a mess.” When participants were asked about how they were able to adjust their priorities and maintain engagement in school and work, every response mentioned the impact of their professors’ attitudes and/or policies in some way. Based on the findings, it appears that the attitudes of professors are impactful to LGBTQ+ students’ experiences with anxiety during COVID-19, which could be beneficial to take into account when planning lessons, deadlines, and general class structure in the future to better support students during this time.

Identity also seemed to play a role in the reported experiences of anxiety in this study. One person went as far as to mention that “some of [their] anxiety is specifically because [they] are LGBTQ+ and exist during the COVID-19 pandemic.” This feeling seemed to resonate in a few respondents who mentioned having to move out of their own spaces on or around campus and moving in with family or friends for extended periods of time in

COVID-19 and LGBTQ+ Mental Health

early 2020. Experiences ranged from not being able to engage in meaningful discussions with like-minded individuals about their lives or identities to entirely having to act as though they were not part of the LGBTQ+ community, which correspond to increased feelings of anxiety surrounding routine, anxiety surrounding uncertainty, social isolation, lack of normality, and less mental capacity based on the study’s coding measures. When LGBTQ+ college students are living through these experiences, it impacts their ability to perform at work and school as well as their ability to adequately take care of themselves. In order to address the ramifications of these experiences, it is especially important for institutions such as businesses, universities, and community organizations to prioritize the accessibility of a variety of mental health services (e.g., counseling, medication, etc.), as well as creating community support to re-engage young people in dialogue and action that empowers them in their identities. Organizations should also seek to utilize avenues that allow the individual to maintain their security within their living environment such as having e-book clubs, pen pals, and virtual affinity groups. It is important that research is able to center LGBTQ+ people to address existing disparities in mental health outcomes and prevent these from becoming exacerbated as a result of COVID-19.

students are currently facing has a positive impact on the amount of attention this topic receives in psychology research.

Future studies can address some of the limitations of this study in order to develope a more well-rounded understanding of how to support different LGBTQ+ communities. By highlighting the need for more anxiety-related mental health support for the LGBTQ+ community, further research can also expand to other mental health conditions that are prevalent in adolescents’ lives. As the pandemic progressively becomes under control, it is important to continue to support vulnerable communities.

Limitations and Future Directions The researchers chose to identify patterns in experiences with anxiety amongst LGBTQ+ students at New York University in order to get the most representative sample for this context.

With the resources available, if the study had included other universities there may not have been enough representation from any one place to get an accurate depiction of students’ experiences. Future research might explore how the experiences of LGBTQ+ identifying students at other universities are the same or different so that administrators and other stakeholders can adequately support their students.

Aside from universities, one aspect that was often touched on in this study was respondent’s experiences with finances and employment. No participants discussed the level of support and communication that they received from their employers during the pandemic. Given that many of the participants mentioned being employed at some point before or during the pandemic, it may also be beneficial for future research to explore how LGBTQ+ individuals’ employment has been affected by the pandemic to better address potential financial discrepancies and discern how employers can best support their employees during this time. Additionally, it is common for people with anxiety to experience other mental health complications at the same time, such as depression and phobias (Kaufman & Charney 2020; Last et al., 1987). This study did not examine comorbidities of anxiety, but in order to get a more holistic understanding of the needs and experiences of LGBTQ+ individuals during COVID-19 future qualitative research should investigate intersectional mental health concerns as well.

Shedding-light on the experience of anxiety that college Research | 45

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OPUS (2021) 12:1

Appendix A LGBTQ+ College Student Semi-Structured Interview Protocol (2020) Demographic Questions What is your name?

What is your age?

What is your gender identity?

What pronouns do you use?

What is your ethnicity? Please list any and all terms that apply.

What term or terms best describe your LGBTQ+ identity? Please list any and all that apply.

What year in college are you?

Anxiety and Experience Questions After NYU announced that it was going to be online for the remainder of the spring semester, did you experience any other major changes in your life (e.g.: housing, employment, community, etc.)?

If yes, what kind of changes and to what extent did it impact your life?

Have you ever been diagnosed with anxiety?

Have you been experiencing anxiety throughout the last month?

If yes, what kind of symptoms have you been noticing?

Do you feel that this is representative of what you have experienced throughout the pandemic?

How is it the same/different?

Why do you think that is?

Do you feel that your anxiety has more to do with potentially contracting COVID-19 or more to do with changes in your life and environment due to COVID-19? Both? Neither?

48 | Research

BIOGRAPHIES

Olivia P. Russo (she/her) Editor-in-Chief op496@nyu.edu

Olivia is a senior in the Applied Psychology program, double majoring in Gender & Sexuality Studies. She is passionate about bridging psychology and gender & sexuality, evident by her research interests and experience. She is currently a research assistant on Dr. Yoshikawa’s Gender and Sexuality Alliance Research Consortium (GSARC), where she is involved on two smaller projects: the Principal Interview Study, exploring school principals’ experiences with the LGBTQIA+ community, and the Dissemination Efforts team, creating resources for high-school GSAs based on previous GSARC research. Upon graduation, Olivia is pursuing a Master of Arts at NYU Steinhardt in Counseling for Mental Health and Wellness, with an advanced certificate in LGBTQ Eduation, Health, and Social Services.

Maya Metser (she/her) maya.metser@nyu.edu

Editor-in-Chief

Maya is a senior in the Applied Psychology program. She is currently pursuing an Honors thesis under the mentorship of Dr. Natalie H. Brito at the ISLAND Lab, where she is exploring the effects of mother-infant heart rate synchrony on infant attention outcomes. In the past, she was an advocate for the ROSES research team and a research assistant at the SCAN Lab, a fetal neuroimaging lab. Moving forward, she hopes to bridge her passion for neuroscience, education, and juvenile justice reform to make early environments better support positive development. Lastly, Maya hosts a podcast called Psych Mic that explores the lives and career paths of industry leaders who use psychology to make an impact in the world. Psych Mic highlights psychology’s versatile applications and provides practical advice about opportunities in the field.

Katie Mundt (she/her) kvm256@nyu.edu

Editor-in-Chief

Katie is a fall graduate of the Global Public Health/Applied Psychology program. She is interested in improving community health through a psychological lens, applying the skills and theories from psychology to health research and policy reform. She worked at NYU Langone on the Smoke-Free Housing Project, which evaluated the effectiveness of a smoke-free policy in NYC public housing developments. Currently, she works as a research assistant for the RISE lab and has helped develop a grant-awarded research proposal for the Social Perception Action & Motivation (SPAM) lab, which examined how the media’s portrayal of the COVID-19 pandemic impacts perception and subsequent behavior. She recently accepted a Service Coordinator position with ComPsych, an employee assistance program headquartered in Chicago, IL. Biographies | 50

Chloe Carlson (She/Her) Layout and Design Director cec747@nyu.edu

Chloe is a sophomore in Applied Psychology with a strong interest in the effects of media on the mind. While pursuing a minor in Media, Culture, and Communication, she hopes to assist in the creation of more psychology related media in order to raise mental health awareness and educate others.

Sydney Liang (she/her) Layout and Design Director

syl569@nyu.edu

Sydney is a junior in the Applied Psychology program with a minor in Media, Culture, and Communication. She is currently a research assistant at Play and Language Lab, which examines how children interact with their environment as well as how social and cultural factors influence children’s development. Previously, she has interned at various organizations ranging from nonprofits to multinational companies. She plans on continuing to explore various career paths which highlight the intersection between psychology, research, and communication before pursuing higher education.

Grace Park (she/her) Layout and Design Director hjp332@nyu.edu

Grace is a junior in Applied Psychology minoring in Nutrition and Dietetics. She is interested in raising awareness of mental health in minority communities and hopes to help such populations by providing culturally competent care. Grace will be working as a research assistant for The Listening Project which aims to train middle school students and teachers in a semi-structured method of interviewing with the goal of enhancing listening skills, empathy, trust, academic engagement and achievement. The Listening Project works to disrupt stereotypes and build relationships across differences. Grace ultimately hopes to complete her masters at NYU in Counseling for Mental Health and Wellness.

51 | Biographies

Janean Cuffee (she/her)

Anjali Mehta (she/her)

Janean is a senior in the Applied Psychology program double minoring in Sociology and History. She is also a member of the varsity women’s basketball team at NYU. She is interested in equal educational opportunities across socioeconomic backgrounds and the mental health impacts of childhood trauma. In the past, she has worked with under-resourced youth in her internship at Harlem Children’s Zone and fellowship at Uncommon Schools. Currently, she is an Assistant Lab Manager for the RISE Lab that works to advance and improve the lives of marginalized populations. Additionally, she is the founder of BLAC (Black Latinx Athlete Coalition), a space meant to provide comfort to minority athletes that may not always feel at home in a PWI. After graduation, Janean will be a middle school teacher at a charter school in Brooklyn in the Uncommon Schools Organization.

Anjali Mehta is a junior at NYU, getting a B.S. in Applied Psychology with a minor in Philosophy, and an M.A. in Mental Health Counseling. Anjali works at the Mindful Education Lab, where she is currently investigating the overlap between cognitive neuropsychology and meditation, specifically by researching attention and technology. Her research interests also include selfknowledge, violence, and PTSD, specifically from military trauma and sexual abuse. Outside of NYU, Anjali is a certified advanced yoga instructor, yoga therapist, and MBSR coach and has also delivered a TEDx talk on the “Power of Breath.” Though she has more than five years of experience as a yoga instructor, Anjali intends to earn a Ph.D. in Clinical Psychology and ultimately to become a practicing psychotherapist, in order to investigate the inner workings of the mind. Her career plans may include serving in the Singapore Military as a Clinical Psychologist.

Contributing Writer

Contributing Writer

Biographies | 52

Gizem Kurtbolat (she/her)

Samantha Ruggiero (she/her)

Gizem is a senior in the Applied Psychology program. She is interested in working with children and adolescents and raising mental health awareness among this population. In the past she has volunteered at school for children with Autism as a classroom volunteer. Currently she is an intern at Ramapo for Children, working on creating content on school climate and researching for reports and articles that can be useful resources for schools. In addition she volunteers as a tutor at Econnected, a non-profit organization that supports English Language Learners with their English and Math skills. After graduation, she would like to gain more experience working with children and adolescents in clinical settings to work towards becoming a child and adolescent psychologist.

Samantha is a senior in the Applied Psychology program with a minor in Public Policy and Management. Her research interests include the ways in which social inequality impacts individuals in the workplace. In the past, Samantha has interned in a variety of professional settings, including in schools, research labs, non-profits, and start-ups.

Currently, Samantha is working as a Research Assistant in Dr. Rezarta Bilali’s Social Inequality and Intergroup Conflict Lab. Specifically, she is working on projects that are centered on evaluating the ways in which social movement organizations and mainstream media outlets portray historical narratives and their various components. She is also working on a code-writing project to analyze data from a study that measured participant perceptions of the Women’s March. Upon graduation, Samantha will be continuing her post-baccalaureate education at New York University in the Master of IndustrialOrganizational Psychology program.

Contributing Writer

53 | Biographies

Contributing Writer

Vion He (she/her)

Julia Leschi (she/her)

Vion is a junior in the Applied Psychology program with a minor in BEMT (Business of Entertainment, Media and Technology). She is interested in improving mental health literacy and increasing access to psychological services for marginalized populations, particularly the LGBTQIA+ community. As a research assistant at Families and Children Experiencing Success (FACES) Lab, she focuses on examining the effectiveness of parenttargeted interventions for children with behavioral challenges (e.g., ADHD) and their families, as well as parental engagement in treatment. In addition, she volunteers at the College Prep Academy program at NYU Metro Center, where she delivers group coaching services to high school students on topics including college planning, careers, and mental health. While planning to explore career path possibilities, she hopes to dedicate herself to providing mental health care and treatment to minority populations in the future.

Julia is a senior in the Applied Psychology program minoring in Public Health. She is interested in applying a psychological lens to public health and policy issues. In the past, she worked as a clinical assistant at a substance use clinic in Midtown Manhattan. She is currently working as the Associate Director of Research at the Empower Lab, a clinical research and advocacy lab working to further gender equity through scientific approaches to issues of gender-based violence.

There, she is conducting a qualitative exploration of sugar dating practices on college campuses, and studying the health needs of human trafficking survivors and asylum seekers. In the future, she hopes to put her research skills in service of policy reform and community work before continuing her education.

Contributing Writer

Contributing Writer

Biographies | 54

Macarena Kruger (she/her)

Joy Shen (she/her)

Macarena is a senior in the Applied Psychology undergraduate program. She is also a member of the varsity women’s tennis team at NYU and a research assistant at NYU-LFELD (Latino Family Engagement and Language Development).

Specifically, she works for the MEAL project, which focuses on examining Latine children’s development and math skills learning in the United States. Throughout the Spring semester, Macarena has been coding data collected on mother-child semi-naturalistic interactions. She is currently writing “Math heroes biographies” in Spanish for third graders. The main purpose of the project is for low-income Latine children to learn about the lives of people of color who have been successful and to make an explicit connection between their professions and the use of math. Macarena is also working on her Honors thesis under the mentorship of Dr. Gigliana Melzi., exploring Mexican-heritage mothers’ relative importance given to children’s academic and socio-emotional skills and their book sharing practices.

Joy is a recent graduate of the Applied Psychology undergraduate program. During her time at NYU, Joy was involved in research in Dr. Brito’s ISLAND Lab, where she worked with families and explored infant development. Currently, Joy works as a research assistant at the Cognitive and Behavioral Consultants, a mental health facility, where she works on various program and treatment evaluations to manage and track patient’s progress. Her projects focus on implementing DBT in schools, overseeing intensive DBT and CBT programs, and conducting qualitative studies on program dropout. Ultimately, she hopes to work with a diverse population to help promote equity in mental health treatment and to focus on the incarceration system. Outside of school, Joy spends her free time skateboarding, painting, and baking. In the fall, Joy will begin her PsyD program at Yeshiva University’s Ferkauf Graduate School of Psychology, where she will train to practice psychotherapy and broaden her research.

Contributing Writer

55 | Biographies

Contributing Writer

Ana Warner (she/her)

Callie Hilgendorf (she/her)

Ana is a senior double majoring in the Applied Psychology and Global Public Health programs.

She is interested in expanding healthcare access and education with LGBTQ+ and BIPOC populations, especially amongst students. She is currently exploring these interests as an HRTP Intern at the NYC Department of Health and Mental Hygiene and a research assistant in the Gender and Sexuality Alliance Research Consortium (GSARC) at NYU under the direction of Dr. Yoshikawa. In the future, she hopes to combine her passions for public health policy and psychology to expand mental health access, education, and autonomy for young people.

Callie is a senior double majoring in Global Public Health and Applied Psychology. She is interested in actively engaging within communities to combat oppressive systems and how mental health trauma is experienced and pathologized by stigma. She is currently working as a research assistant in the Project for the Advancement of our Common Humanity Listening Project (PACH): The Listening Project at NYU under the direction of Dr. Yoshikawa and Dr. Way. She also holds a leadership position with the NYU chapter of Peer Health Exchange (PHE), a non-profit organization focusing on improving health equity and advocacy outreach for adolescents. Upon graduation, Callie will be pursuing a Master of Public Health at Columbia University in the Sociomedical Sciences and a certificate in Population Mental Health.

Contributing Writer

Contributing Writer

Biographies | 56