Effects of exposure to pandemic-related stressors on anxiety and mood difficulty during versus before the COVID-19 pandemic in United States Army soldiers and veterans.

Military personnel are routinely involved in pandemic relief efforts, placing them at risk of increased exposure to pandemic-related stressors. Although ample research suggests 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. The Army Study to Assess Risk and Resilience in Servicemembers (STARRS) Longitudinal Study screened for 30-day prevalence of major depressive episode, generalized anxiety disorder, post-traumatic stress disorder, and panic attack among n=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 those observed in civilian samples (RR=1.28-1.40). Greatest increases occurred among women, Blacks, Hispanics, those of lower socio-economic status, and Regular Army soldiers relative to 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 socio-demographics and Army career characteristics with difficulty RR. No significant interactions were found between pandemic-related stressors and either baseline difficulty prevalence, socio-demographics or Army career characteristics predicting difficulty RR. Results suggest military personnel may experience pandemic-related decrements in mental health comparable to those observed in civilian samples, with largest changes among personnel with greater socioeconomic vulnerability and/or greatest exposure to pandemic-related stress. Findings emphasize the importance of ensuring accessibility of appropriate supports for military personnel during pandemic conditions.