Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Effects of pandemic-related stressors on anxiety and mood difficulty during versus before the COVID-19 pandemic in US Army soldiers and veterans

Nature Mental Health volume 3, pages 1191–1201 (2025)Cite this article

Subjects

Abstract

Military personnel are routinely involved in pandemic relief efforts, placing them at risk of increased exposure to pandemic-related stressors. Although ample research suggests that exposure to pandemic-related stressors contributed to decrements in mental health among civilians during the COVID-19 pandemic, limited work has examined whether these patterns were also salient in military populations. Here we report data on The Army Study to Assess Risk and Resilience in Servicemembers (STARRS) Longitudinal Study, which screened for 30-day prevalence of major depressive episode, generalized anxiety disorder, post-traumatic stress disorder and panic attack among 10,206 US Army soldiers and veterans before (2018–2019) and then again during (2020–2022) the COVID-19 pandemic. Statistically significant increases were found in prevalence, with relative risk (RR) comparable to that observed in civilian samples (RR 1.28–1.40). The greatest increases were observed among women, Black and Hispanic individuals, those of lower socioeconomic status and Regular Army soldiers compared with reservists and those separated from service. Exposures to pandemic-related stressors, although associated with significantly increased mental health difficulty (RR 1.06–1.17), did not explain associations of sociodemographics and Army career characteristics with difficulty RR. No significant interactions were found between pandemic-related stressors and either baseline difficulty prevalence, sociodemographics or Army career characteristics predicting difficulty RR. Results suggest that military personnel may experience pandemic-related declines in mental health similar to those observed in civilian populations, with the largest changes occurring among individuals with greater socioeconomic vulnerability and/or higher exposure to pandemic-related stress. Findings emphasize the importance of ensuring accessibility to appropriate support for military personnel during pandemic conditions.

Access through your institution
Buy or subscribe

This is a preview of subscription content, access via your institution

Access options

Access through your institution

Buy this article

  • Purchase on SpringerLink
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

Data availability

STARRS-LS Wave 1, Wave 2 and Wave 3 data, as well as data from the earlier Army STARRS New Soldier Study, All Army Study and Pre and Post Deployment studies, are available through the Inter-university Consortium for Political and Social Research (ICPSR) at the University of Michigan (https://www.icpsr.umich.edu/web/ICPSR/studies/35197). STARRS-LS and Army STARRS data are restricted from general dissemination, meaning that a confidential data use agreement must be established before access. Researchers interested in gaining access to the data can submit their applications via ICPSR’s online Restricted Contracting System. Guidelines for applying for access to this data can be found under the data and documentation tab at the above URL. The STARRS Historical Administrative Data Study data are not available for public release.

Code availability

Code used to produce the statistical output is available via GitHub at https://github.com/kingme5005/COVID_ls2_ls3. Because the data used in this study are not publicly available and require DoD clearance to access, we cannot post the source code used to read in the Army administrative data (which requires DoD clearance) and create the 2,000+ variables used in this analysis.

References

  1. Cavicchioli, M. et al. What will be the impact of the Covid-19 quarantine on psychological distress? Considerations based on a systematic review of pandemic outbreaks. Healthcare 9, 101 (2021).

    PubMed  PubMed Central  Google Scholar 

  2. Chu, I. Y., Alam, P., Larson, H. J. & Lin, L. Social consequences of mass quarantine during epidemics: a systematic review with implications for the COVID-19 response. J. Travel Med. 27, taaa192 (2020).

    PubMed  PubMed Central  Google Scholar 

  3. Shah, K. et al. Focus on mental health during the coronavirus (COVID-19) pandemic: applying learnings from the past outbreaks. Cureus 12, e7405 (2020).

    PubMed  PubMed Central  Google Scholar 

  4. Goldmann, E. & Galea, S. Mental health consequences of disasters. Annu. Rev. Public Health 35, 169–183 (2014).

    PubMed  Google Scholar 

  5. Galea, S., Merchant, R. M. & Lurie, N. The mental health consequences of COVID-19 and physical distancing: the need for prevention and early intervention. JAMA Intern. Med. 180, 817–818 (2020).

    PubMed  Google Scholar 

  6. Pfefferbaum, B. & North, C. S. Mental health and the Covid-19 pandemic. N. Engl. J. Med. 383, 510–512 (2020).

    PubMed  Google Scholar 

  7. Twenge, J. M. & Joiner, T. E. Mental distress among U.S. adults during the COVID-19 pandemic. J. Clin. Psychol. 76, 2170–2182 (2020).

    PubMed  PubMed Central  Google Scholar 

  8. Czeisler, M. et al. Mental health, substance use, and suicidal ideation during the COVID-19 pandemic—United States, June 24–30, 2020.Morb. Mortal. Wkly. Rep. 69, 1049–1057 (2020).

    Google Scholar 

  9. Daly, M., Sutin, A. R. & Robinson, E. Depression reported by US adults in 2017–2018 and March and April 2020. J. Affect. Disord. 278, 131–135 (2021).

    PubMed  Google Scholar 

  10. Ettman, C. K. et al. Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic. JAMA Netw. Open 3, e2019686 (2020).

    PubMed  PubMed Central  Google Scholar 

  11. McGinty, E. E., Presskreischer, R., Han, H. & Barry, C. L. Psychological distress and loneliness reported by US adults in 2018 and April 2020. JAMA 324, 93–94 (2020).

    PubMed  PubMed Central  Google Scholar 

  12. Twenge, J. M., McAllister, C. & Joiner, T. E. Anxiety and depressive symptoms in U.S. Census Bureau assessments of adults: trends from 2019 to fall 2020 across demographic groups. J. Anxiety Disord. 83, 102455 (2021).

    PubMed  Google Scholar 

  13. Kessler, R. C. et al. Estimated prevalence of and factors associated with clinically significant anxiety and depression among US adults during the first year of the COVID-19 pandemic. JAMA Netw. Open 5, e2217223 (2022).

    PubMed  PubMed Central  Google Scholar 

  14. Blendermann, M., Ebalu, T. I., Obisie-Orlu, I. C., Fried, E. I. & Hallion, L. S. A narrative systematic review of changes in mental health symptoms from before to during the COVID-19 pandemic. Psychol. Med. 54, 43–66 (2024).

    PubMed  Google Scholar 

  15. Robinson, E., Sutin, A. R., Daly, M. & Jones, A. A systematic review and meta-analysis of longitudinal cohort studies comparing mental health before versus during the COVID-19 pandemic in 2020. J. Affect. Disord. 296, 567–576 (2022).

    PubMed  Google Scholar 

  16. Santomauro, D. F. et al. Global prevalence and burden of depressive and anxiety disorders in 204 countries and territories in 2020 due to the COVID-19 pandemic. Lancet 398, 1700–1712 (2021).

    Google Scholar 

  17. Sun, Y. et al. Comparison of mental health symptoms before and during the covid-19 pandemic: evidence from a systematic review and meta-analysis of 134 cohorts. Br. Med. J. 380, e074224 (2023).

    Google Scholar 

  18. Witteveen, A. B. et al. COVID-19 and common mental health symptoms in the early phase of the pandemic: an umbrella review of the evidence. PLoS Med. 20, e1004206 (2023).

    PubMed  PubMed Central  Google Scholar 

  19. Bonanno, G. A., Brewin, C. R., Kaniasty, K. & Greca, A. M. Weighing the costs of disaster: consequences, risks, and resilience in individuals, families, and communities. Psychol. Sci. Public Interest 11, 1–49 (2010).

    PubMed  Google Scholar 

  20. North, C. S. & Pfefferbaum, B. Mental health response to community disasters: a systematic review. JAMA 310, 507–518 (2013).

    PubMed  Google Scholar 

  21. Kessler, R. C. et al. Changes in prevalence of mental illness among US adults during compared with before the COVID-19 pandemic. Psychiatr. Clin. North Am. 45, 1–28 (2022).

    PubMed  Google Scholar 

  22. Yavorsky, J. E., Qian, Y. & Sargent, A. C. in Working in America (ed. Wharton, A.) 305–317 (Routledge, 2022).

  23. Hagerty, S. L. & Williams, L. M. Moral injury, traumatic stress, and threats to core human needs in health-care workers: the COVID-19 pandemic as a dehumanizing experience. Clin. Psychol. Sci. 10, 1060–1082 (2022).

    Google Scholar 

  24. Magesh, S. et al. Disparities in COVID-19 outcomes by race, ethnicity, and socioeconomic status: a systematic-review and meta-analysis. JAMA Netw. Open 4, e2134147 (2021).

    PubMed  PubMed Central  Google Scholar 

  25. ElTohamy, A. et al. Testing positive, losing a loved one, and financial hardship: real-world impacts of COVID-19 on US college student distress. J. Affect. Disord. 314, 357–364 (2022).

    PubMed  PubMed Central  Google Scholar 

  26. Coley, R. L., Carey, N., Baum, C. F. & Hawkins, S. S. COVID-19-related stressors and mental health disorders among US adults. Public Health Rep. 137, 1217–1226 (2022).

    PubMed  PubMed Central  Google Scholar 

  27. Kapucu, N. The role of the military in disaster response in the US. Eur. J. Econ. Pol. Stud. 4, 7–33 (2011).

    Google Scholar 

  28. Davis, T. et al. Quantitative analysis of United States National Guard COVID-19 disaster relief activities April–June 2020. Disaster Med. Public Health Prep. 17, e562 (2023).

    PubMed  Google Scholar 

  29. Powell, T., Billiot, S., Muller, J., Elzey, K. & Brandon, A. The cost of caring: psychological adjustment of health-care volunteers during the COVID-19 pandemic. Traumatology 28, 383 (2022).

    Google Scholar 

  30. Baker, M. D., Southard, M. A., Beymer, M. R. & Riviere, L. A. National Guard service members decedent recovery and processing operations during the COVID-19 pandemic in New York City. Mil. Psychol. 35, 431–439 (2023).

    PubMed  PubMed Central  Google Scholar 

  31. Gomez, S. A. Q. et al. Impact of the COVID-19 pandemic on army families: household finances, familial experiences, and soldiers’ behavioral health. Mil. Psychol. 35, 420–430 (2023).

    PubMed  Google Scholar 

  32. Mitchell, N. A., McCauley, M., O’Brien, D. & Wilson, C. E. Mental health and resilience in the Irish defense forces during the COVID-19 global pandemic. Mil. Psychol. 35, 383–393 (2023).

    PubMed  Google Scholar 

  33. Fischer, I. C., Na, P. J., Harpaz-Rotem, I., Krystal, J. H. & Pietrzak, R. H. Characterization of mental health in US Veterans before, during, and 2 years after the onset of the COVID-19 pandemic. JAMA Netw. Open 6, e230463 (2023).

    PubMed  PubMed Central  Google Scholar 

  34. Hill, M. L. et al. Mental health impact of the COVID-19 pandemic in U.S. military veterans: a population-based, prospective cohort study. Psychol. Med. 53, 945–956 (2023).

    PubMed  Google Scholar 

  35. Marquardt, C. A. et al. Evaluating resilience in response to COVID-19 pandemic stressors among veteran mental health outpatients. J. Psychopathol Clin. Sci. 132, 26–37 (2023).

    PubMed  Google Scholar 

  36. Na, P. J. et al. military veterans during the COVID-19 pandemic: a nationally representative, prospective cohort study. J. Psychiatr. Res. 151, 546–553 (2022).

    PubMed  PubMed Central  Google Scholar 

  37. McCaslin, S. E., Bramlett, D., Juhasz, K., Mackintosh, M. & Springer, S. in Positive Psychological Approaches to Disaster (ed. Schulenberg, S. E.) 61–79 (Springer, 2020).

  38. Ursano, R. J. et al. The Army study to assess risk and resilience in servicemembers (Army STARRS). Psychiatry 77, 107–119 (2014).

    PubMed  Google Scholar 

  39. Avdiu, B. & Nayyar, G. When face-to-face interactions become an occupational hazard: jobs in the time of COVID-19. Econ. Lett. 197, 109648 (2020).

    Google Scholar 

  40. Burch, A. E. & Jacobs, M. COVID-19, police violence, and educational disruption: the differential experience of anxiety for racial and ethnic households. J. Racial Ethn. Health Disparities 9, 2533–2550 (2022).

    PubMed  Google Scholar 

  41. Thomeer, M. B., Moody, M. D. & Yahirun, J. Racial and ethnic disparities in mental health and mental health care during the COVID-19 pandemic. J. Racial Ethn. Health Disparities 10, 961–976 (2023).

    PubMed  Google Scholar 

  42. Cretney, R. M. Local responses to disaster: the value of community led post disaster response action in a resilience framework. Disaster Prev. Manage. 25, 27–40 (2016).

    Google Scholar 

  43. Jacobs, G. A., Gray, B. L., Erickson, S. E., Gonzalez, E. D. & Quevillon, R. P. Disaster mental health and community-based psychological first aid: concepts and education/training. J. Clin. Psychol. 72, 1307–1317 (2016).

    PubMed  Google Scholar 

  44. Southwick, S. M., Satodiya, R. & Pietrzak, R. H. Disaster mental health and positive psychology: an afterward to the special issue. J. Clin. Psychol. 72, 1364–1368 (2016).

    PubMed  Google Scholar 

  45. Mancini, A. D. When acute adversity improves psychological health: a social-contextual framework. Psychol. Rev. 126, 486–505 (2019).

    PubMed  Google Scholar 

  46. Mancini, A. D., Westphal, M. & Griffin, P. Outside the eye of the storm: can moderate hurricane exposure improve social, psychological, and attachment functioning? Pers. Soc. Psychol. Bull. 47, 1722–1734 (2021).

    PubMed  Google Scholar 

  47. Salanti, G. et al. Changes in the prevalence of mental health problems during the first year of the pandemic: a systematic review and dose-response meta-analysis. BMJ Ment. Health 27, e301018 (2024).

    PubMed  PubMed Central  Google Scholar 

  48. Al Maqbali, M., Alsayed, A., Hughes, C., Hacker, E. & Dickens, G. L. Stress, anxiety, depression and sleep disturbance among healthcare professional during the COVID-19 pandemic: an umbrella review of 72 meta-analyses. PLoS ONE 19, e0302597 (2024).

    PubMed  PubMed Central  Google Scholar 

  49. Donnelly, W. M. et al. The United States Army and the Covid-19 Pandemic (United States Army, 2021); https://history.army.mil/Publications/Publications-Catalog/The-United-States-Army-and-the-COVID-19-Pandemic/

  50. Naifeh, J. A. et al. The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS): progress toward understanding suicide among soldiers. Mol. Psychiatry 24, 34–48 (2019).

    PubMed  Google Scholar 

  51. Heeringa, S. G. et al. Field procedures in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Int. J. Methods Psychiatr. Res. 22, 276–287 (2013).

    PubMed  PubMed Central  Google Scholar 

  52. Kessler, R. C. et al. Design of the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Int. J. Methods Psychiatr. Res. 22, 267–275 (2013).

    PubMed  PubMed Central  Google Scholar 

  53. Stanley, I. H. et al. Predicting suicide attempts among U.S. Army soldiers after leaving active duty using information available before leaving active duty: Results from the Study to Assess Risk and Resilience in Servicemembers-Longitudinal Study (STARRS-LS). Mol. Psychiatry 27, 1631–1639 (2022).

    PubMed  PubMed Central  Google Scholar 

  54. Kessler, R. C. et al. Response bias, weighting adjustments, and design effects in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Int. J. Methods Psychiatr. Res. 22, 288–302 (2013).

    PubMed  PubMed Central  Google Scholar 

  55. Kessler, R. C. & Ustün, T. B. The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int. J. Methods Psychiatr. Res. 13, 93–121 (2004).

    PubMed  Google Scholar 

  56. Blevins, C. A., Weathers, F. W., Davis, M. T., Witte, T. K. & Domino, J. L. The posttraumatic stress disorder checklist for DSM-5 (PCL-5): development and initial psychometric evaluation. J. Trauma. Stress 28, 489–498 (2015).

    PubMed  Google Scholar 

  57. Kessler, R. C. et al. Clinical reappraisal of the Composite International Diagnostic Interview Screening Scales (CIDI-SC) in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS). Int. J. Methods Psychiatr. Res. 22, 303–321 (2013).

    PubMed  PubMed Central  Google Scholar 

  58. Holmberg, M. J. & Andersen, L. W. Estimating risk ratios and risk differences: alternatives to odds ratios. JAMA 324, 1098–1099 (2020).

    PubMed  Google Scholar 

  59. Marginal Means, Adjusted Predictions, and Marginal Effects (STATACorp, 2022); https://www.stata.com/features/overview/marginal-analysis/

  60. Benjamini, Y. & Yekutieli, D. False discovery rate–adjusted multiple confidence intervals for selected parameters. J. Am. Stat. Assoc. 100, 71–81 (2005).

    Google Scholar 

  61. von Elm, E. et al. The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. J. Clin. Epidemiol. 61, 344–349 (2008).

    Google Scholar 

  62. SAS ®Software 9.4 (SAS Institute, 2013).

Download references

Acknowledgements

The Army STARRS Team consists of Co-Principal Investigators: R.J.U. (Uniformed Services University) and M.B.S. (University of California San Diego and VA San Diego Healthcare System). Site Principal Investigators: J.R.W. (University of Michigan) and R.C.K. (Harvard Medical School). Army scientific consultant/liaison: K. Cox (Office of the Assistant Secretary of the Army (Manpower and Reserve Affairs). Other team members: P. A. Aliaga (Uniformed Services University); D. M. Benedek (Uniformed Services University); L. Campbell-Sills (University of California San Diego); C. S. Fullerton (Uniformed Services University); N. Gebler (University of Michigan); M. House (University of Michigan); P. E. Hurwitz (Uniformed Services University); S. Jain (University of California San Diego); T.-C. Kao (Uniformed Services University); L. Lewandowski-Romps (University of Michigan); A. Luedtke (University of Washington and Fred Hutchinson Cancer Research Center); H. Herberman Mash (Uniformed Services University); J. A. Naifeh (Uniformed Services University); M. K. Nock (Harvard University); N. Hani Zainal (Harvard Medical School); N.A.S. (Harvard Medical School); and A. M. Zaslavsky (Harvard Medical School). Army STARRS was sponsored by the Department of the Army and funded under cooperative agreement number U01MH087981 (2009–2015) with the National Institute of Mental Health (NIMH). Subsequently, STARRS-LS was sponsored and funded by the Department of Defense (USUHS grant number HU0001-15-2-0004). E.R.E. was supported in part by the US Department of Veterans Affairs, Clinical Sciences Research and Development Service (CSR&D) VA-STARRS Researcher-in-Residence Program (Project SPR-002-24F). The contents are solely the responsibility of the authors and do not necessarily represent the views of the NIMH, the Department of the Army, the Department of Defense or the Department of Veteran Affairs.

Author information

Authors and Affiliations

  1. Department of Health Care Policy, Harvard Medical School, Boston, MA, USA

    Ronald C. Kessler, Sarah M. Gildea, Andrew J. King, Howard Liu, Maria V. Petukhova & Nancy A. Sampson

  2. US Army Public Health Center, Aberdeen Proving Ground, Aberdeen, MD, USA

    Amy M. Millikan-Bell

  3. Department of Veteran Affairs, VISN 2 MIRECC, Bronx, NY, USA

    Emily R. Edwards

  4. Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Emily R. Edwards

  5. Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA

    Hannah N. Ziobrowski

  6. Institute for Social Research, University of Michigan, Ann Arbor, MI, USA

    James R. Wagner

  7. Department of Psychiatry, University of California San Diego, La Jolla, CA, USA

    Murray B. Stein

  8. Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, CA, USA

    Murray B. Stein

  9. Psychiatry Service, VA San Diego Healthcare System, San Diego, CA, USA

    Murray B. Stein

  10. Department of Psychiatry, Center for the Study of Traumatic Stress, Uniformed Services University of the Health Sciences, Bethesda, MD, USA

    Robert J. Ursano

Authors
  1. Ronald C. Kessler
    View author publications

    Search author on:PubMed Google Scholar

  2. Amy M. Millikan-Bell
    View author publications

    Search author on:PubMed Google Scholar

  3. Emily R. Edwards
    View author publications

    Search author on:PubMed Google Scholar

  4. Sarah M. Gildea
    View author publications

    Search author on:PubMed Google Scholar

  5. Andrew J. King
    View author publications

    Search author on:PubMed Google Scholar

  6. Howard Liu
    View author publications

    Search author on:PubMed Google Scholar

  7. Maria V. Petukhova
    View author publications

    Search author on:PubMed Google Scholar

  8. Nancy A. Sampson
    View author publications

    Search author on:PubMed Google Scholar

  9. Hannah N. Ziobrowski
    View author publications

    Search author on:PubMed Google Scholar

  10. James R. Wagner
    View author publications

    Search author on:PubMed Google Scholar

  11. Murray B. Stein
    View author publications

    Search author on:PubMed Google Scholar

  12. Robert J. Ursano
    View author publications

    Search author on:PubMed Google Scholar

Contributions

R.C.K. and A.M.M.-B.: concept and design. R.C.K., A.M.M.-B., E.R.E., A.J.K., H.L., M.V.P., N.A.S., H.N.Z., J.R.W., M.B.S. and R.J.U.: acquisition, analysis or interpretation of data. R.C.K., A.M.M.-B. and E.R.E.: drafting of the manuscript. A.J.K., H.L. and M.V.P.: statistical analysis. R.C.K., M.B.S. and R.J.U.: obtained funding. R.C.K., A.M.M.-B., S.M.G., N.A.S., J.R.W., M.B.S. and R.J.U.: technical, administrative or material support. R.C.K., A.M.M.-B. and N.A.S.: supervision. All authors: critical revision of the manuscript for important intellectual content and approved final version for submission.

Corresponding author

Correspondence to Ronald C. Kessler.

Ethics declarations

Competing interests

In the past 3 years, R.C.K. was a consultant for Cambridge Health Alliance, Canandaigua VA Medical Center, Child Mind Institute, Holmusk, Massachusetts General Hospital, Partners Healthcare, Inc., RallyPoint Networks, Inc., Sage Therapeutics and University of North Carolina. He has stock options in Cerebral Inc., Mirah, PYM (Prepare Your Mind), Roga Sciences and Verisense Health. In the past 3 years, M.B.S. received consulting income from Actelion, Acadia Pharmaceuticals, Aptinyx, atai Life Sciences, Boehringer Ingelheim, Bionomics, BioXcel Therapeutics, Clexio, EmpowerPharm, Engrail Therapeutics, GW Pharmaceuticals, Janssen, Jazz Pharmaceuticals and Roche/Genentech. He has stock options in Oxeia Biopharmaceuticals and EpiVario. He is paid for his editorial work on Biological Psychiatry (Deputy Editor) and UpToDate (Co-Editor-in-Chief for Psychiatry). The other authors declare no competing interests.

Peer review

Peer review information

Nature Mental Health thanks Sebastian Trautmann and the other, anonymous, reviewer(s) for their contribution to the peer review of this work.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kessler, R.C., Millikan-Bell, A.M., Edwards, E.R. et al. Effects of pandemic-related stressors on anxiety and mood difficulty during versus before the COVID-19 pandemic in US Army soldiers and veterans. Nat. Mental Health 3, 1191–1201 (2025). https://doi.org/10.1038/s44220-025-00505-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue date:

  • DOI: https://doi.org/10.1038/s44220-025-00505-4

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing