{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T02:47:51Z","timestamp":1782355671273,"version":"3.54.5"},"reference-count":25,"publisher":"Public Library of Science (PLoS)","issue":"9","license":[{"start":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T00:00:00Z","timestamp":1664496000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"\nIntroduction<\/jats:title>\nNational mental health surveys have demonstrated increased stress and depressive symptoms among high-school students during the first year of the COVID-19 pandemic, but objective measures of anxiety after the first year of the pandemic are lacking.<\/jats:p>\n<\/jats:sec>\n\nMethods<\/jats:title>\nA 25-question survey including demographics, the Generalized Anxiety Disorder-7 scale (GAD-7) a validated self-administered tool to evaluate anxiety severity, and questions on achievement goals and future aspirations was designed by investigators. Over a 2-month period, all students from grade 9\u201312 in a single high-school (n = 546) were invited to complete an online survey after electronic parental consent and student assent. Bi-variate and chi-square analyses examined demographic differences in anxiety scores and the impact on outcomes; qualitative analyses examined related themes from open-ended questions.<\/jats:p>\n<\/jats:sec>\n\nResults<\/jats:title>\nIn total, 155\/546 (28%) completed the survey. Among students with binary gender classifications, 54\/149 (36%) had GAD-7 scores in the moderate or severe anxiety range (scores\u226510), with a greater proportion among females than males (47% vs 21%, P<0.001). Compared to students with GAD-7<10, those with \u2265 10 were more likely to strongly agree that the pandemic changed them significantly (51% vs 28%, p = 0.05), made them mature faster (44% vs 16%, p = 0.004), and affected their personal growth negatively (16% vs 6%, p = 0.004). Prominent themes that emerged from open-ended responses on regrets during the pandemic included missing out on school social or sports events, missing out being with friends, and attending family events or vacations.<\/jats:p>\n<\/jats:sec>\n\nConclusion<\/jats:title>\nIn this survey of high school students conducted 2 years after the onset of COVID-19 in the United States, 47% of females and 21% of males reported moderate or severe anxiety symptoms as assessed by the GAD-7. Whether heightened anxiety results in functional deficits is still uncertain, but resources for assessment and treatment should be prioritized.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0275292","type":"journal-article","created":{"date-parts":[[2022,9,30]],"date-time":"2022-09-30T17:47:54Z","timestamp":1664560074000},"page":"e0275292","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":13,"title":["Persistent anxiety among high school students: Survey results from the second year of the COVID pandemic"],"prefix":"10.1371","volume":"17","author":[{"given":"Olivia","family":"Yin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nadia","family":"Parikka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Ma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philip","family":"Kreniske","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1978-7638","authenticated-orcid":true,"given":"Claude A.","family":"Mellins","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,9,30]]},"reference":[{"key":"pone.0275292.ref001","doi-asserted-by":"crossref","first-page":"113599","DOI":"10.1016\/j.psychres.2020.113599","article-title":"Prevalence of symptoms of depression, anxiety, insomnia, posttraumatic stress disorder, and psychological distress among populations affected by the COVID-19 pandemic: A systematic review and meta-analysis","volume":"295","author":"JM Cenat","year":"2021","journal-title":"Psychiatry Res."},{"issue":"3","key":"pone.0275292.ref002","doi-asserted-by":"crossref","first-page":"16","DOI":"10.15585\/mmwr.su7103a3","article-title":"Mental Health, Suicidality, and Connectedness Among High School Students During the COVID-19 Pandemic\u2014Adolescent Behaviors and Experiences Survey, United States, January-June 2021.","volume":"71","author":"SE Jones","year":"2022","journal-title":"MMWR Suppl"},{"key":"pone.0275292.ref003","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1196\/annals.1308.001","article-title":"Adolescent brain development: a period of vulnerabilities and opportunities. 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