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There is a need to understand how the ongoing COVID-19 pandemic has affected the mental and behavioral health of young adults in the U.S. This study used quantitative and qualitative survey data to identify young adults at highest risk for psychological distress during the U.S. outbreak of COVID-19 and to further understand how the pandemic has impacted their stress, mood, and substance use. Participants were 670 young adult cohort members (ages 21-29) of the population-based longitudinal study EAT 2010-2018 who participated in the C-EAT