Anxiety-Symptom Severity and Implicit and Explicit Self-as-Anxious Associations in a Large Online Sample of U.S. Adults: Trends From 2011 to 2022

Abstract

Some studies have suggested a rise in anxiety prevalence and severity over the past decade, particularly among emerging adults, whereas others have reported stable rates. In this preregistered study, we examine trends in anxiety-symptom severity and explicit (self-reported) and implicit (using the Brief Implicit Association Test) associations about the self as anxious versus calm. Using continuous cross-sectional data from 99,973 U.S. adults who visited the Project Implicit Health website between 2011 and 2022, we compared trends in anxiety outcomes between emerging adults (ages 18–25) and adults ages 26+, including during the COVID-19 pandemic. Contrary to hypotheses, average anxiety severity and strength of implicit/explicit self-as-anxious associations did not spike at the start of the pandemic, and rates of change did not significantly differ by age from 2011 to 2020 except for explicit, nonrelative self-as-anxious ratings. Instead, anxiety mostly remained stable; emerging adults exhibited consistently higher anxiety-symptom severity and stronger implicit/explicit self-as-anxious associations than adults ages 26+.