A Comparison of Mental-Health Outcomes in the United States and Italy at Different Levels of Cumulative COVID-19 Prevalence

How does the prevalence of COVID-19 affect people’s mental health? In a preregistered study (N = 857), we sought to answer this question by comparing demographically matched samples in four regions in the United States and Italy with different levels of cumulative COVID-19 prevalence. No main effect of prevalence emerged. Rather, prevalence region had opposite effects, depending on the country. New York City participants (high prevalence) reported more general distress, posttraumatic-stress-disorder (PTSD) symptoms, and COVID-19 worry than San Francisco (low prevalence). Conversely, Campania participants (low prevalence) reported more general distress, PTSD symptoms, and COVID-19 worry than Lombardy (high prevalence). Consistent with these patterns, we found that COVID-19 worry was more strongly linked with general distress and PTSD symptoms in New York City than San Francisco, whereas COVID-19 worry was more strongly linked with PTSD in Campania than Lombardy. In exploratory analyses, media exposure predicted and mapped on to geographic variation in mental-health outcomes.