Genetic predisposition, perceived threat and burden, and sex differences in changes in anxiety symptoms across the COVID-19 pandemic

Abstract Several meta-analyses have shown that the COVID-19 crisis and the efforts to contain the virus have had a significant impact on mental health, leading to an increase in anxiety-related symptoms, especially in the first phase of the pandemic. The present paper aimed to investigate the development of anxiety symptoms throughout the course of the pandemic in a non-clinical sample. Using longitudinal data from the German TwinLife panel, the study investigates how stressor-related perceptions of threat and burden mediated the development of anxiety symptoms while acknowledging individuals’ genetic susceptibility to developing anxiety symptoms, as well as sex differences. The study expands the understanding of pandemic-specific processes by incorporating pre-pandemic anxiety levels. Anxiety symptoms remained remarkably stable during the pandemic in relation to pre-pandemic anxiety levels, underscoring the relevance of pre-pandemic differences in anxiety as pandemic risk factors. Genetic predispositions explained differences in initial anxiety levels and in perceived threat and burden, but not in anxiety change over time, which calls for research on the environmental factors through which these predispositions are realized. Females showed higher initial anxiety, and perceived threat and burden mediated changes in anxiety significantly only in females. Whether these sex differences in mediation reflect distinct mechanisms remains to be tested in future studies.