How anxious did you feel during lockdown? The roles resilience, living environment, and gender play on the level of anxiety state during pandemic isolation


In the unique context of the coronavirus disease 2019 (COVID-19) pandemic, researchers and clinicians alike drew attention to the risks involved by physical and social isolation for mental health. Factors like resilience, gender, urban/rural environment, or preexisting anxiety can impact anxious states produced by home forced isolation. Based on these, we assumed that: i) there are significant differences in the level of anxiety (state) during the pandemic, depending on the living area of the subjects; ii) gender plays a moderating role in the relationship between resilience and anxiety; and iii) anxiety (trait), experiential avoidance, resilience, and family connectedness, determine the level of anxiety (state). The MemoryLab team conducted the present study on 495 subjects (n=411 women, age between 18 and 65). Of these, 350 live in large and medium urban areas, 63 in small urban areas, and 82 in rural areas. As instruments, we used The State-Trait Anxiety Inventory (STAI 2.0), The Acceptance and Action Questionnaire 2 (AAQ-2), The Aggression Questionnaire (AQ), The Family Connectedness Questionnaire, and Connor-Davidson Resilience Scale 10 (CD-RISC-10), as well as the standard division of living areas according to community size. Data collection took place online during the spring peak of the pandemic. According to ANOVA analysis, people living in small urban areas have a higher level of anxiety. The difference is significant compared to those living in large and medium cities and villages. Gender has no moderating role in the relationship between resilience and the anxiety state. Also, experiential avoidance, anxiety (trait), and resilience play a significant role on the level of anxiety (state), measured during social isolation. The results could be an important indicator for understanding psychological mechanisms guiding interventions to support the communities effectively.



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Ajilore, O. (2020). Rural America is starting to feel the impact of the coronavirus. Center for American Progress. Available from:

American Psychological Association (APA). (2020). Psychological impact of COVID-19. Available from:

Bartik, A. W., Bertrand, M., Cullen, Z., Glaeser, E.L., Luca, M., & Stanton, C. (2020). The impact of COVID-19 on small business outcomes and expectations. Proceedings of the National Academy of Sciences of the United States of America, 117 (30), 17656-17666. doi: 10.1073/pnas.2006991117. DOI:

Bekker, M. H. J., & van Mens-Verhulst, J. (2007). Anxiety disorders: sex differences in prevalence, degree, and background, but gender-neutral treatment. Gender Medicine, 4(2), 178-193. doi: DOI:

Bennett, S. A. (1983). Patient perspective - psychological effects of barrier nursing isolation. Australian Nursing Journal, 12(10), 36-37.

Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: A revised measure of psychological inflexibility and experiential avoidance. Behaviour Therapy, 42, 676-688. doi: DOI:

Boulanger, J. L., Hayes, S. C., & Pistorello, J. (2010). Experiential avoidance as a functional contextual concept. In Kring, A.M., & Sloan, D.M. (Eds.), Emotion regulation, and psychopathology: A transdiagnostic approach to aetiology and treatment (pp. 107-136). New York, NY: The Guilford Press.

Campbell-Sills, L., Forde, D. R., & Stein, M. B. (2009). Demographic and childhood environmental predictors of resilience in a community sample. Journal of Psychiatric Research, 43(12), 1007-1012. doi: DOI:

Cao, W., Fang, Z., Hou, G., Han, M., Xu, X., Dong, J., & Zheng, J. (2020). The psychological impact of the COVID-19 epidemic on college students in China. Psychiatry Research, 112934. doi: DOI:

Chawla, N., & Ostafin, B. (2007). Experiential avoidance as a functional dimensional approach to psychopathology: An empirical review. Journal of clinical psychology, 63(9), 871-890. doi: DOI:

Chew, Q. H., Wei, K. C., Vasoo, S., Chua, H. C., & Sim, K. (2020). Narrative synthesis of psychological and coping responses towards emerging infectious disease outbreaks in the general population: practical considerations for the COVID-19 pandemic. Singapore medical journal, 61(7), 350-356. doi: DOI:

Cohen-Cline, H., Turkheimer, E., & Duncan, G. E. (2015). Access to green space, physical activity, and mental health: a twin study. Journal of Epidemiology and Community Health, 69(6), 523-529. doi: DOI:

Comisia Națională pentru Statistică și Prognoză (CNSP) [National Board of Strategy and Prognosis]. (2019). Proiecţia principalilor indicatori economico-sociali în PROFIL TERITORIAL până în 2023. Available from:

Connor, K. M., & Zhang, W. (2006). Resilience: Determinants, measurement, and treatment responsiveness. CNS spectrums, 11(S12), 5-12. doi: DOI:

Cowling, B. J., Ng, D. M. W., Ip, D. K. M., Liao, Q., Lam, W. W. T., Wu, J. T., Lau, J. T. F., Griffiths, S. M., & Fielding, R. (2010). Community psychological and behavioural responses through the first wave of the 2009 influenza A(H1N1) pandemic in Hong Kong. The Journal of Infectious Diseases, 202(6), 867-876. doi: DOI:

de Vries, S., Verheij, R. A., Groenewegen, P. P., & Spreeuwenberg, P. (2003). Natural Environments-Healthy Environments? An Exploratory Analysis of the Relationship between Greenspace and Health. Environment and Planning A: Economy and Space, 35(10), 1717-1731. doi: DOI:

Douglas, M., Katikireddi, S. V., Taulbut, M., McKee, M., & Mc-Cartney, G. (2020). Mitigating the wider health effects of COVID-19 pandemic response. British Medical Journal, 369, 1-6. doi: DOI:

Eisenberg, M. E., & Resnick, M. D. (2006). Suicidality among Gay, Lesbian, and Bisexual Youth: The Role of Protective Factors. Journal of Adolescent Health, 39(5), 662-668. doi: DOI:

Fledderus, M., Bohlmeijer, E. T., & Pieterse, M. E. (2010). Does experiential avoidance mediate the effects of maladaptive coping styles on psychopathology and mental health? Behaviour Modification, 34(6), 503-519. doi: DOI:

Haddadi, P., & Besharat, M. A. (2010). Resilience, vulnerability, and mental health. Procedia - Social and Behavioral Sciences, 5, 639-642. doi: DOI:

Hankin, B.L., Mermelstein, R., & Roesch, L. (2007). Sex differences in adolescent depression: stress exposure and reactivity models. Child Development, 78(1). doi: .2007.00997.x

Hardway, C., & Fuligni, A. J. (2006). Dimensions of family connectedness among adolescents with Mexican, Chinese, and European backgrounds. Developmental Psychology, 42(6), 1246-1258. doi: DOI:

Hegberg, N. J., & Tone, E. B. (2015). Physical activity and stress resilience: Considering those at-risk for developing mental health problems. Mental Health and Physical Activity, 8, 1-7. doi: DOI:

Hesketh, T., & Ding, Q. J. (2005). Anxiety and depression in adolescents in urban and rural China. Psychological Reports, 96(2), 435-444. doi: DOI:

Hettema, J. M., Neale, M. C., & Kenneth S., & Kendler, K. S. (2001). A review and meta-analysis of the genetic epidemiology of anxiety disorders. The American Journal of Psychiatry, 158(10), 1568-1578. doi: DOI:

Huang, Y., & Zhao, N. (2020). Generalized anxiety disorder, depressive symptoms, and sleep quality during the COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Research, 112954. doi: DOI:

Iglesias, M. E. L., de Bengoa Vallejo, R. B., Salvadores Fuentes, P. (2010). The relationship between experiential avoidance and burnout syndrome in critical care nurses: A cross-sectional questionnaire survey. International Journal of Nursing Studies, 47(1), 30-37. doi: DOI:

INS (National Institute of Statistics). (2020). Starea economică şi socială a României 2017 şi 2018 - Date statistice. Available from:

Jacobson, K. C., & Rowe, D. C. (1999). Genetic and environmental influences on the relationships between family connectedness, school connectedness, and adolescent depressed mood: Sex differences. Developmental Psychology, 35(4), 926-939. doi: DOI:

James, P., Hart, J. E., Banay, R. F., & Laden, F. (2016). Exposure to greenness and mortality in a nationwide prospective cohort study of women. Environmental health perspectives, 124(9), 1344-1352. doi: DOI:

Lamond, A. J., Depp, C. A., Allison, M., Langer, R., Reichstadt, J., Moore, D. J. (2008). Measurement and predictors of resilience among community-dwelling older women. Journal of Psychiatric Research, 43(2), 148-154. doi: 10.1016/j.jpsychires.2008.03.007 DOI:

Law 351/ 6.07.2001. Available from:

Leal, P. C., Goes, T. C., da Silva, L. C. F., & Teixeira-Silva, F. (2017). Trait vs state anxiety in different threatening situations. Trends in Psychiatry and Psychotherapy, 39(3), 147-157. doi: DOI:

Lister, R. G. (1990). Ethologically-based animal models of anxiety disorders. Pharmacology & Therapeutics, 46(3), 321-340. doi: DOI:

Luo, M., Guo, L., Yu, M., Jiang, W., & Wang, H. (2020). The psychological and mental impact of coronavirus disease 2019 (COVID-19) on medical staff and general public - A systematic review and meta-analysis. Psychiatry Research, 291, 113190. doi: DOI:

Madhav, N., Oppenheim, B., Gallivan, M., Mulembakani, P., Rubin, E., & Wolfe, N. (2017). Chapter 17. Pandemics: risks, impacts, and mitigation. In: Jamison, D. T., Gelband, H., Horton S, Jha, P., Laxminarayan, R., Mock, G. N. & Nugent, R. (Eds). Disease control priorities: improving health and reducing poverty. 3rd edition. The International Bank for Reconstruction and Development/The World Bank. doi: DOI:

Mahoney, C. T., Segal, D. L., & Coolidge, F. L. (2015). Anxiety sensitivity, experiential avoidance, and mindfulness among younger and older adults: age differences in risk factors for anxiety symptoms. The International Journal of Aging and Human Development, 81(4), 217-240. doi: DOI:

Malaquias, S., Crespo, C., & Francisco, R. (2015). How do adolescents benefit from family rituals? Links to social connectedness, depression, and anxiety. Journal of Child and Family Studies, 24(10), 3009-3017. doi: DOI:

McKee-Ryan, F., Song, Z., Wanberg, C. R., & Kinicki, A. J. (2005). Psychological and physical well-being during unemployment: a meta-analytic study. Journal of Applied Psychology, 90(1), 53. doi: DOI:

McKenzie, K., Murray, A., & Booth, T. (2013). Do urban environments increase the risk of anxiety, depression, and psychosis? An epidemiological study. Journal of affective disorders, 150(3), 1019-1024. DOI:

Min, J. A., Lee, N. B., Lee, C. U., Lee, C., & Chae, J. H. (2012). Low trait anxiety, high resilience, and their interaction as possible predictors for treatment response in patients with depression. Journal of affective disorders, 137(1-3), 61-69. doi: DOI:

Minnesota Student Survey (2004). Available from:

Moghanibashi-Mansourieh, A. (2020). Assessing the anxiety level of Iranian general population during the COVID-19 outbreak. Asian Journal of Psychiatry, 51, 1-5. doi: DOI:

Pagel, J. I., & Choukèr, A. (2016). Effects of isolation and confinement on humans-implications for manned space explorations. Journal of Applied Physiology, 120 (12), 1449-1457. doi: DOI:

Roya, A. (2017). Mediating role of interpersonal problems in the relationship between experiential avoidance with depression and anxiety. Journal of Applied Psychology, 4(40), 523-542.

Sanad, H. M. (2019). Stress and anxiety among junior nursing students during the initial clinical Training: a descriptive study at college of health sciences. American Journal of Nursing Research, 7(6), 995-999. doi: 10.12691/ajnr-7-6-13

Saviola, F., Pappaianni, E., Monti, A., Gregucci, A., Jovicich, J., & De Pisapia, N. (2020). Trait and state anxiety are mapped differently in the human brain. Scientific Reports, 10(1). doi: DOI:

Savitsky, B., Findling, Y., Ereli, A., & Hendel, T. (2020). Anxiety and coping strategies among nursing students during the COVID-19 pandemic. Nurse Education in Practice, 102809. doi: DOI:

Schiele, M. A., & Domschke, K. (2018). Epigenetics at the crossroads between genes, environment and resilience in anxiety disorders. Genes, Brain and Behavior, 17, 1-15. doi: DOI:

Shi, R., Zhang, S., Zhang, Q., Fu, S., Wang, Z. (2016). Experienial avoidance mediates the association between emotion regulation abilities and loneliness. PLoS One, 11(12):e0168536. doi: DOI:

Southwick, S. M., Vythilingam, M., & Charney, D. S. (2005). The psychobiology of depression and resilience to stress: implications for prevention and treatment. Annual Review of Clinical Psychology, 1, 255-291. doi: DOI:

Spielberger, C. D. (1983). State-Trait Anxiety Inventory for Adults (STAI-AD). doi: DOI:

Sylvester, C. M., Corbetta, M., Raichle, M. E., Rodebaugh, T., Schlaggar, B. L., Sheline, Y. I., Zorumski, C. F., & Lenze, E. J. (2012). Functional network dysfunction in anxiety and anxiety disorders. Trends in Neuroscience, 35(9), 527-535. doi: DOI:

Taquet., M., Luciano, S., Geddes, J. R., & Harrison, P. J. (2020). Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA. The Lancet - Psychiatry. doi: S2215-0366(20)30462-4 DOI:

Thompson, C. W., Roe, J., Aspinall, P., Mitchell, R., Clow, A., & Miller, D. (2012). More green space is linked to less stress in deprived communities: Evidence from salivary cortisol patterns. Landscape and urban planning, 105(3), 221-229. doi: DOI:

To, K. K. W., Hung, I. F. N., Ip, J. D., Chu, A. W. H., Chan, W. M., Tam, A. R., Fong, C. H. Y., Yuan, S., Tsoi, H. W., Ng, A. C. K., Lee, L. L. Y., Wan, P., Tso, E., Wing-Kin To, W. K., Tsang, D., Chan, K. Y., Huang, J. D., Kok, K. H., Cheng, V. C. C., Yuen, K. Y. (2020). COVID-19 reinfection by a phylogenetically distinct SARS-coronavirus-2 strain confirmed by whole-genome sequencing. Clinical Infectious Diseases [published online ahead of print, 2020 Aug 25], ciaa1275. doi: DOI:

Verheij, R. A. (1996). Explaining urban-rural variations in health: A review of interactions between individual and environment. Social Science & Medicine, 42(60), 923-935. doi: DOI:

Wainer, J., & Chesters, J. (2000). Rural mental health: neither romanticism nor despair. The Australian Journal of Rural Health, 8, 141-147. doi: DOI:

Walters, K., Breeze, E., Wilkinson, P., Price, G. M., Bulpitt, C. J., & Fletcher, A. (2004). Local area deprivation and urbanrural differences in anxiety and depression among people older than 75 years in Britain. American Journal of Public Health, 94(10), 1768-1774. doi: DOI:

Ward, D. (2000). Infection control: reducing the psychologicalveffects of isolation. British Journal of Nursing, 9(3), 162-170. doi: DOI:

Wheaton, M. G., Deacon, B. J., McGrath, P. B., Berman, N. C., & Abramowitz, J. S. (2012). Dimensions of anxiety sensitivity in the anxiety disorders: Evaluation of the ASI-3. Journal of Anxiety Disorders, 26(3), 401-408. doi: DOI:

White, M. P., Alcock, I., Wheeler, B. W., & Depledge, M. H. (2013). Would you be happier living in a greener urban area? A fixed-effects analysis of panel data. Psychological Science, 24(6), 920-928. doi: DOI:

Zerbe M. B., Parkerson, S. G., & Spitzer, T. (1994). Laminar airflow versus reverse isolation: nurses’ assessments of moods, behavior, and activity levels in patients receiving bone marrow transplants. Oncology Nursing Forum, 21(3), 565-568. doi:

Zhang, M., Zhang, J., Zhang, F., Zhang, L., & Feng, D. (2018). Prevalence of psychological distress and the effects of resilience and perceived social support among Chinese college students: Does gender make a difference? Psychiatry Research, 267, 409-413. doi: DOI:

Special section COVID-19
Anxiety state and trait, resilience, living environment, gender, family connectedness.
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How to Cite
Rotărescu, V. S., Matei, D. B., Mircea, I. A., Mirescu, A. M., Nedelescu, B. G., Nedelea, D. G., Raluca Neagu, A. N., Necșulescu, A. G., Oteșanu, G. A., & Tudor, L. C. (2021). How anxious did you feel during lockdown? The roles resilience, living environment, and gender play on the level of anxiety state during pandemic isolation. Research in Psychotherapy: Psychopathology, Process and Outcome, 23(3).