Gender differences in affective reactivity to COVID-related daily stressors in mood and anxiety disorders: A six-month intensive longitudinal study

Gender differences in stress processes can contribute to the disparities in the prevalence of psychiatric disorders between women and men. However, gender differences in daily stress processes, particularly during the COVID-19 pandemic, among mental health clinical populations is yet to be explored. Our goal is to determine gender differences in daily stress processes related to the COVID-19 pandemic. This was an intensive longitudinal cohort study of outpatients with mood and anxiety disorders conducted from January 2021 to May 2023. Daily diary data consisting of self-reported daily positive and negative affect were collected across 8 consecutive days, each month, for a maximum period of 6 consecutive months. Multilevel modeling was implemented. Thirty-one women and 18 men (mean 41years [SD = 15]) completed 1,711 surveys over an average of 4.98 months. Multilevel models showed that women exhibited heightened affective reactivity to COVID-19 daily stressors. On days with an increased number of COVID-19 daily stressors, women experienced a decrease in positive affect (b = -0.08, SE = 0.03, P = 0.007), but not men. At the person-level, a greater number of COVID-19 daily stressors was associated with higher negative affect (b = 0.28, SE = 0.08, P < 0.001) only among women. In this novel, intensive longitudinal cohort study, women and men with mood and anxiety disorders did not differ in the frequency of COVID-19-related daily stressors. However, women were affectively more responsive to these stressors. Gender, therefore, may inform patterns of stress response in daily affective reactivity to COVID-19 stressors, which in turn, may inform stress-related treatment interventions.