{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:19:08Z","timestamp":1789755548192,"version":"4.0.1"},"reference-count":68,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T00:00:00Z","timestamp":1672876800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["RF 50087\u20132021\u20130309-S9"],"award-info":[{"award-number":["RF 50087\u20132021\u20130309-S9"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"NHLBI","doi-asserted-by":"publisher","award":["20\u2013312\u20130217571\u201366102L"],"award-info":[{"award-number":["20\u2013312\u20130217571\u201366102L"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>This population-based study investigated gender differences in the use of coping strategies and their relationship to anxiety symptoms during the initial COVID-19 lockdown period in the United States. A national online survey was administered between 13 April 2020 and 8 June 2020. The study sample comprised 1673 respondents (66% women). Overall, 46% reported high levels of anxiety, and women experienced significantly (p &lt; 0.001) higher levels of anxiety than men. Women were significantly (p &lt; 0.05) more likely to use acceptance, self-distraction, positive reframing, and emotional support than men. Significant interactions between gender and coping strategies were also identified. Women engaging in high (+1SD) vs. low (\u22121SD) levels of active coping were not found to have significantly different anxiety levels. In contrast, men reported higher levels of anxiety when they engaged in high levels of active coping and lower levels of anxiety when they engaged in low levels of active coping (b2 = 0.88, t = 3.33, p = 0.001). Additionally, women engaging in high levels of acceptance and positive reframing reported significantly lower anxiety levels than when engag-ing in low levels of acceptance (b1 = \u22121.03, t = \u22124.58, p &lt; 0.001) and positive reframing (b1 = \u22120.72, t = \u22123.95, p &lt; 0.001). No significant associations between acceptance and positive reframing levels and anxiety levels were found with men. Overall, these findings extend our understanding of the nature of gender differences in stress responsivity during periods of high psychological distress and can inform the development of mental health interventions to respond to the COVID-19 pandemic and future infectious disease outbreaks.<\/jats:p>","DOI":"10.3390\/ijerph20020993","type":"journal-article","created":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T06:11:51Z","timestamp":1672899111000},"page":"993","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":87,"title":["Gender Differences in Coping and Psychological Adaptation during the COVID-19 Pandemic"],"prefix":"10.3390","volume":"20","author":[{"given":"Rosann","family":"Cholankeril","sequence":"first","affiliation":[{"name":"Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, TX 77030, USA"},{"name":"MPH@GW, Milken Institute School of Public Health, George Washington University, Washington, DC 20052, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9577-5308","authenticated-orcid":false,"given":"Ellen","family":"Xiang","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4549-9111","authenticated-orcid":false,"given":"Hoda","family":"Badr","sequence":"additional","affiliation":[{"name":"Department of Medicine, Section of Epidemiology and Population Science, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,5]]},"reference":[{"key":"ref_1","first-page":"157","article-title":"WHO Declares COVID-19 a Pandemic","volume":"91","author":"Cucinotta","year":"2020","journal-title":"Acta Bio-Med. 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