Changes in emotions and worries during the Covid-19 pandemic: an online-survey with children and adults with and without mental health conditions

Emotions and behaviours of child and adolescent psychiatric patients during the COVID-19 pandemic

BACKGROUND

Previous pandemics have had negative effects on mental health, but there are few data on children and adolescents who were receiving ongoing psychiatric treatment.

AIMS

To study changes in emotions and clinical state, and their predictors, during the COVID-19 pandemic in France.

METHOD

We administered (by interview) the baseline Youth Self-Report version of the CoRonavIruS Health Impact Survey v0.3 (CRISIS, French translation) to 123 adolescent patients and the Parent/Caregiver version to evaluate 99 child patients before and during the first 'lockdown'. For 139 of these patients who received ongoing treatment in our centre, treating physicians retrospectively completed longitudinal global ratings for five time periods, masked to CRISIS ratings.

RESULTS

The main outcome measure was the sum of eight mood state items, which formed a single factor in each age group. Overall, this score improved for each age group during the first lockdown. Clinician ratings modestly supported this result in patients without intellectual disability or autism spectrum disorder. Improvement of mood states was significantly associated with perceived improvement in family relationships in both age groups.

CONCLUSIONS

Consistent with previous studies of clinical cohorts, our patients had diverse responses during the pandemic. Several factors may have contributed to the finding of improvement in some individuals during the first lockdown, including the degree of family support or conflict, stress reduction owing to isolation, limitations of the outcome measures and/or possible selection bias. Ongoing treatment may have had a protective effect. Clinically, during crises additional support may be needed by families who experience increased conflict or who care for children with intellectual disability.

Emotions and worries during 1.5 years of the COVID-19 pandemic - how adults with and without mental health conditions coped with the crisis

BACKGROUND

During the COVID 19 pandemic, there were social restrictions with severe mental stress for a long time. Most studies on mental health consequences of the pandemic focused primarily on the beginning of the pandemic. The present study on families of patients or study participants of a child and adolescent psychiatry aimed to examine long-term profiles of emotions and worries in adults with and without mental health condition (mhc) during the first 1.5 years of the COVID-19 pandemic.

METHODS

We surveyed emotions and worries of 128 adults with (n = 32) and without (n = 96) pre-pandemic mhc over a 1.5-year study period from spring 2020 until summer/autumn 2021. Emotions and worries were captured at four time points: [i] pre-pandemic, [ii] spring 2020 (first lockdown was implemented), [iii] December 2020 (hard lockdown at Christmas time) and [iv] summer/autumn 2021 (considerable ease of regulations); [i] pre-pandemic and [iii] December 2020 were measured retrospectively). First, we run non-parametric tests to compare emotions and worries between adults with and without pre-pandemic mhc at the four time points. Next, we conducted latent profile analysis to identify subgroups from the total sample who share similar trajectories of emotions and worries. Finally, a logistic regression analysis was run to examine whether socio-demographic and psycho-social factors were related to identified trajectories of emotions and worries.

RESULTS

Adults without pre-pandemic mhc reported a strong worsening of emotions and worries at the beginning of the pandemic and a lower worsening during the course, while adults with pre-pandemic mhc reported a constant worsening of emotions and worries. The latent profile analysis revealed three profiles of adults who show either i) an adaption, ii) no adaption or iii) a continuous high condition. With increasing age, higher perceived stress and pre-pandemic mhc, the likelihood of an adaption was increased.

CONCLUSION

The results of the present study suggested that adults (both with and without pre-pandemic mhc) coped the crisis with different strategies and that most of them returned to their initial, pre-pandemic levels of emotions and worries when social restrictions were considerably eased or stopped.

Latinx LGBTQ Youth, COVID-19, and Psychological Well-Being: A Systematic Review

OBJECTIVE

As a result of the COVID-19 pandemic, Latinx youth report high rates of negative mental health outcomes such as anxiety and depression. Similarly, research with lesbian, gay, bisexual, transgender, and queer (LGBTQ) youth have documented increased negative mental health outcomes such as depression and anxiety as a result of the COVID-19 pandemic. However, the current literature has yet to systematically uncover the intersectional experiences of Latinx LGBTQ youth during this time.

METHOD

We conducted a systematic review to uncover the experiences of Latinx LGBTQ youth during the pandemic. Our systematic review resulted in 14 empirical studies that explored the challenges, stressors, and impact of the COVID-19 pandemic on Latinx LGBTQ youth.

RESULTS

Findings revealed that most studies include cisgender, gender binary, heterosexual, Latinx youth. Findings across studies include: (a) impact from school closures, (b) pandemic stressors, (c) impact from online media, (d) family and Latinx cultural values as a source of support and stress, and (e) the implementation and evaluation of interventions during the COVID-19 pandemic.

DISCUSSION

We provide recommendations for clinicians working with Latinx LGBTQ youth including expanding their knowledge about the impact of the COVID-19 pandemic on these communities, considering the experiences of Latinx LGBTQ youth as multifaceted, and considering the role of heterogeneity in the mental health of Latinx LGBTQ Youth.

Mental health during the COVID-19 pandemic in children and adolescents with ADHD: A systematic review of controlled longitudinal cohort studies

Prior studies reported mixed effects of the COVID-19 pandemic on the mental health of children and adolescents with ADHD, but they were mainly cross-sectional and without controls. To clarify the impact, we searched Web of Science, EMBASE, Medline, and PsychINFO until 18/11/2023 and conducted a systematic review of controlled longitudinal cohort studies (Prospero: CRD42022308166). The Newcastle-Ottawa scale was used to assess quality. We identified 6 studies. Worsening of mental health symptoms was more evident in ADHD or control group according to symptom considered and context. However, those with ADHD had more persistent elevated symptoms and remained an at-risk population. Sleep problems deteriorated more significantly in those with ADHD. Lower pre-COVID emotion regulation skills and greater rumination were associated with worse mental health outcomes, and longer screen time with poorer sleep. Quality was rated as low in most studies, mainly due to self-report outcome measures and no information on attrition rates. Despite these limitations, results suggest a predominantly negative impact on youths with ADHD and may guide clinical practice and policy.

Almost 2 years into the COVID-19 pandemic: an update on parental stress, parent mental health, and the occurrence of child maltreatment

Increased parental stress, poorer mental health, and an increase in the occurrence of child maltreatment (CM) have been reported in earlier phases of the COVID-19 pandemic. However, data from later phases of the pandemic are not yet available. We conducted a cross-sectional, representative survey among 1087 parents (48.8% female; mean age 41.72 years, SD = 9.15) in Germany in December 2021. Data were compared to a previous representative sample, assessed in August 2020 (N = 1024), and to normative scores of the outcome measures. Predictors for the occurrence of CM were analyzed by logistic regression. Pandemic-related stress and general stress were higher and physical and mental health were poorer in the December 2021 sample than in the August 2020 sample. Occurrence rates of CM varied between 5 and 56%. Verbal emotional abuse (n = 607, 56%), witnessing domestic violence (n = 446, 41%), and emotional neglect (n = 435, 40%) were most frequently reported. For these subtypes, parental risk for alcohol abuse (OR 2.1-2.7) and parental recent experience of violence (OR 2.1-5.1) were the strongest predictors. Across all subtypes of CM, parents reporting child maltreatment showed poorer scores on all stress outcomes, with medium-large-effect sizes. Results confirm a high burden within the families, almost 2 years into the pandemic. Occurrence rates of a broad spectrum of CM subtypes raise further concerns for the well-being of children. Family-oriented intervention efforts are needed to stabilize families and provide targeted support. Longitudinal studies are needed for a description of families at risk for poorer outcomes.

[Patterns of social behavior among informal workers during extreme events: lessons from social life during the Covid-19 pandemic in Lima, Peru.]

This study analyzes changes in social life during the pandemic and the early stages of the post-pandemic period within a population characterized by high levels of informality in Lima, particularly the textile district of Gamarra, encompassing 89,123 people. A qualitative approach was adopted, based on 62 semi-structured interviews with garment manufacturers, in-store traders, and street vendors. Two distinct moments could be identified: a) experiences confronting the shock induced by the Covid-19 pandemic; and b) experiences of reconfiguring work and daily life, alongside strategies adopted by the population. In conclusion, the study suggests that some elements of daily life acquired during the Covid-19 pandemic may carry over into the future, inducing society to place greater emphasis on preventive measures against emerging risks, including behaviors related to hygiene and health, fostering closer family ties, increased utilization of digitalization and hybrid work models, and the cultivation of enhanced social capital.

Psychosocial Outcomes in Autistic Children Before and During the COVID-19 Pandemic

Studies on the impact of the COVID-19 pandemic on autistic children's psychosocial outcomes have shown mixed results. In the current study we aimed to gain a better insight into the effect of the COVID-19 pandemic by comparing psychosocial outcomes collected pre-pandemic with data collected during the pandemic. We used the Strengths and Difficulties Questionnaire (SDQ) to examine change over time in psychosocial outcomes of autistic children from pre-pandemic (T0) to lockdown I (T1) and lockdown II (T2) in the Netherlands. We expected a deterioration in psychosocial outcomes. There were 224 participants in T0 and T1, of which 141 also participated in T2. The results showed a surprising improvement in psychosocial outcomes from T0 to T1. Special education and female gender were associated with increased difficulties over time, while higher age was associated with decreased difficulties. At the subdomain level we found that emotional problems remained stable, while hyperactivity, conduct problems, and peer problems decreased, and prosocial behavior increased. Attending special education predicted increased peer problems over time, while higher age predicted both decreased conduct problems and increased prosocial behavior over time. The COVID-19 pandemic may have temporarily improved the fit between the psychosocial needs and the environment for children with autism in the Netherlands.

Understanding Differential Stress and Mental Health Reactions to COVID-19-Related Events

The effects of the pandemic on mental health can be studied through different variables, such as the number of COVID-19 stressors, the stressor types, and the stress responses. Understanding the sources of mental strain is crucial for developing effective interventions. The present study analyzed the relationship between these COVID-19-related variables and positive and negative mental health. A cross-sectional study was conducted with 666 individuals from the Portuguese general population, mostly females (65.5%) between 16-93 years old. They completed self-report measures regarding the number of COVID-19 stressors, the stressor types, the stress responses (IES-R), and positive (MHC-SF) and negative mental health (BSI-18). The results demonstrated that a higher number of COVID-19-experienced stressors and more stress responses were related to worse mental health. Regarding stressor types, experiences not related to the COVID-19 infection (e.g., tension at home) presented the largest effects on mental health. The strongest predictor was the stress responses for negative (β = 0.50) and positive mental health (β = -0.17). The predictors explained more about negative mental health than positive. These findings support the idea that individual appraisals play a crucial role in mental health.

COVID-19 Vaccine Hesitancy: A Global Public Health and Risk Modelling Framework Using an Environmental Deep Neural Network, Sentiment Classification with Text Mining and Emotional Reactions from COVID-19 Vaccination Tweets

Popular social media platforms, such as Twitter, have become an excellent source of information with their swift information dissemination. Individuals with different backgrounds convey their opinions through social media platforms. Consequently, these platforms have become a profound instrument for collecting enormous datasets. We believe that compiling, organizing, exploring, and analyzing data from social media platforms, such as Twitter, can offer various perspectives to public health organizations and decision makers in identifying factors that contribute to vaccine hesitancy. In this study, public tweets were downloaded daily from Tweeter using the Tweeter API. Before performing computation, the tweets were preprocessed and labeled. Vocabulary normalization was based on stemming and lemmatization. The NRCLexicon technique was deployed to convert the tweets into ten classes: positive sentiment, negative sentiment, and eight basic emotions (joy, trust, fear, surprise, anticipation, anger, disgust, and sadness). t-test was used to check the statistical significance of the relationships among the basic emotions. Our analysis shows that the p-values of joy-sadness, trust-disgust, fear-anger, surprise-anticipation, and negative-positive relations are close to zero. Finally, neural network architectures, including 1DCNN, LSTM, Multiple-Layer Perceptron, and BERT, were trained and tested in a COVID-19 multi-classification of sentiments and emotions (positive, negative, joy, sadness, trust, disgust, fear, anger, surprise, and anticipation). Our experiment attained an accuracy of 88.6% for 1DCNN at 1744 s, 89.93% accuracy for LSTM at 27,597 s, while MLP achieved an accuracy of 84.78% at 203 s. The study results show that the BERT model performed the best, with an accuracy of 96.71% at 8429 s.

Influence of the Sanitary, Economic, and Social Crisis of COVID-19 on the Emotional State of Dentistry in Galicia (Spain)

The main objective of this research was to analyze the economic, social, and emotional repercussions among Galician dentists (Spain) as a consequence of the COVID-19 pandemic. A survey was filled out by 347 professionals. After verifying the survey's reliability using Cronbach's alpha = 0.84, the professional activity and emotional state of the participants were assessed based on aspects related to their personal and family data. The economic impact of the pandemic was considerable, and all participants experienced a decrease in income. In total, 72% of the participants considered that working with personal protective equipment (PPE) made their clinical activities difficult, and 60% expressed concern about being infected during their professional practice. Among the professionals, women (p = 0.005), and separated, divorced, or single professionals (p = 0.003) were the most strongly affected. Separated or divorced professionals were the group that most frequently raised the need to make a radical change in their lives. Finally, it was observed that the emotional consequences varied substantially in the lives of these professionals, mainly among female dentists (p = 0.010), separated and divorced men (p = 0.000), and those with fewer years of professional practice (p = 0.021). The COVID-19 pandemic had an economic impact, due to the decrease in the number of patients and hours of attention, as well as an emotional impact, mostly expressed in the form of sleep disorders and stress. The most vulnerable professionals were women and professionals with fewer years of experience.

Changes in mental health in the German child and adolescent population during the COVID-19 pandemic - Results of a rapid review

Background

This rapid review examines changes in the mental health of the German child and adolescent population during the COVID-19 pandemic.

Methods

The basis are 39 publications, which were identified by means of systematic literature search (until 19.11.2021) and manual search. The databases of the included publications were systematized with regard to their representativeness for the general population, and the indicators used were categorized with regard to the depicted constructs and their reliability.

Results

The large majority of the studies took place at the beginning of the pandemic until the summer plateau 2020. Representative studies mainly reported high levels of pandemic-related stress, increases in mental health problems, and negative impacts on the quality of life. Non-representative studies showed mixed results. Vulnerable groups could only be identified to a limited extent. Both routine and care-related data showed declines in the outpatient and inpatient service utilisation during the various waves of the pandemic followed by catch-up effects. Children and adolescents turned out to be more vulnerable during the pandemic compared to adults, but their stress levels varied with the waves of the pandemic and the related containment measures.

Conclusions

A future forward-looking crisis and pandemic management requires a close-knit and continuous surveillance of the mental health of children as well as an improved identification of risk groups.

Mental distress and virtual mental health resource use amid the COVID-19 pandemic: Findings from a cross-sectional study in Canada

Objective

This paper characterizes levels of mental distress among adults living in Canada amid the COVID-19 pandemic and examines the extent of virtual mental health resource use, including reasons for non-use, among adults with moderate to severe distress.

Methods

Data are drawn from a cross-sectional monitoring survey (29 November to 7 December 2021) on the mental health of adults (N  =  3030) in Canada during the pandemic. Levels of mental distress were assessed using the Kessler Psychological Distress Scale. Descriptive statistics were used to examine virtual mental health resource use among participants with moderate to severe distress, including self-reported reasons for non-use.

Results

Levels of mental distress were classified as none to low (48.8% of participants), moderate (36.6%), and severe (14.6%). Virtual mental health resource use was endorsed by 14.2% of participants with moderate distress and 32% of those with severe distress. Participants with moderate to severe distress reported a range of reasons for not using virtual mental health resources, including not feeling as though they needed help (37.4%), not thinking the supports would be helpful (26.2%), and preferring in-person supports (23.4%), among other reasons.

Conclusions

This study identified a high burden of mental distress among adults in Canada during the COVID-19 pandemic alongside an apparent mismatch between actual and perceived need for support, including through virtual mental health resources. Findings on virtual mental health resource use, and reasons for non-use, offer directions for mental health promotion and health communication related to mental health literacy and the awareness and appropriateness of virtual mental health resources.

Emotional response patterns, mental health, and structural vulnerability during the COVID-19 pandemic in Canada: a latent class analysis

BACKGROUND

The COVID-19 pandemic has contributed to increases in negative emotions such as fear, worry, and loneliness, as well as changes in positive emotions, including calmness and hopefulness. Alongside these complex emotional changes has been an inequitable worsening of population mental health, with many people experiencing suicidal ideation and using substances to cope. This study examines how patterns of co-occurring positive and negative emotions relate to structural vulnerability and mental health amid the pandemic.

METHODS

Data are drawn from a cross-sectional monitoring survey (January 22-28, 2021) on the mental health of adults in Canada during the pandemic. Latent class analysis was used to group participants (N = 3009) by emotional response pattern types. Descriptive statistics, bivariate cross-tabulations, and multivariable logistic regression were used to characterize each class while quantifying associations with suicidal ideation and increased use of substances to cope.

RESULTS

A four-class model was identified as the best fit in this latent class analysis. This included the most at-risk Class 1 (15.6%; high negative emotions, low positive emotions), the mixed-risk Class 2 (7.1%; high negative emotions, high positive emotions), the norm/reference Class 3 (50.5%; moderate negative emotions, low positive emotions), and the most protected Class 4 (26.8% low negative emotions, high positive emotions). The most at-risk class disproportionately included people who were younger, with lower incomes, and with pre-existing mental health conditions. They were most likely to report not coping well (48.5%), deteriorated mental health (84.2%), suicidal ideation (21.5%), and increased use of substances to cope (27.2%). Compared to the norm/reference class, being in the most at-risk class was associated with suicidal ideation (OR = 2.84; 95% CI = 2.12, 3.80) and increased use of substances to cope (OR = 4.64; 95% CI = 3.19, 6.75).

CONCLUSIONS

This study identified that adults experiencing structural vulnerabilities were disproportionately represented in a latent class characterized by high negative emotions and low positive emotions amid the COVID-19 pandemic in Canada. Membership in this class was associated with higher risk for adverse mental health outcomes, including suicidal ideation and increased use of substances to cope. Tailored population-level responses are needed to promote positive coping and redress mental health inequities throughout the pandemic and beyond.

Feasibility of a secondary school-based mental health intervention: Reprezents' On The Level

AIMS

There is a need for innovative school-based mental health interventions to promote good mental health, healthy coping strategies, and engagement with support services. Consequently, Reprezent, a youth development organization, with mental health professionals and young people co-developed an online mental health intervention show, On The Level (OTL). This study assessed the acceptability and feasibility of delivering OTL to young people (aged 11-18 years) in 36 secondary schools across London and Essex, UK.

METHODS

OTL was delivered online as part of the school curriculum, in classrooms at timepoint 1 (T1, 50 min). Follow-up data was collected at timepoint 2 (T2) 4-6 weeks later, during a 20-min OTL review show. For interactive OTL elements and data collection participants logged into an online survey. Measures of acceptability and engagement, mental health and well-being outcomes and intervention evaluation were taken at T1 and T2. We also assessed the feasibility of implementing the OTL intervention in secondary schools.

RESULTS

10,315 participants received the intervention (T1) and 3369 attended the follow-up session (T2), this high attrition, and potential selection bias, was due to only 30% of schools being able to take part in T2. Rates of acceptability were high among young people and school staff. At T1, 88% found OTL engaging, and 84% felt more confident they had the tools to help them better manage stress and anxiety. At T2, 66% viewed mental health in a more positive way, and 71% had better understanding of how to maintain good mental health. Rates of engagement with mental health tools and services were good, and significant reduction in levels of stress were found 4-6 weeks after the OTL show (T2). The low mental health and well-being indices reported by the school children at baseline strongly support the need and use for a mental health intervention such as OTL in secondary schools.

CONCLUSION

These findings indicated good feasibility and acceptability of OTL intervention and support the delivery of the OTL mental health intervention at UK-based secondary schools to educate young people about mental health and well-being and give them the necessary tools to support their mental health.

How has the COVID-19 pandemic affected young people?-Mapping knowledge structure and research framework by scientometric analysis

Since the outbreak of COVID-19, there has been a large body of literature focusing on the relationship between the COVID-19 pandemic and young people. The purpose of this study is to explore the current research status and the specific mechanism of COVID-19's effects on young people based on related literature. This paper mainly used VOS viewer and CiteSpace software to conduct a scientometric analysis of 5,077 publications retrieved from the Web of Science database. The results show that the main contributors to the field were mainly from North America and Europe, and the trend of research focus was from shallow to deep. The five main research areas in the field were summarized by keyword clustering analysis as follows: lifestyle changes due to lockdown; changes in stress and emotions; psychological illness and trauma; risk perception and practice toward the epidemic; interventions and social support. Finally, they were linked by four pathways to form a framework that integrates the relationships between the five domains and between elements within each of them, revealing the mechanism of COVID-19's effect on young people. In addition, less studied but promising elements are also presented in the framework, such as research on special groups (disadvantaged socioeconomic groups and sexual minority youth) and extreme suicidal tendencies that deserve our further attention.

Statistical and clustering validation analysis of primary students' learning outcomes and self-awareness of information and technical online security problems at a post-pandemic time

The authors decided to investigate the impact of the pandemic period and the resulting limitations in Polish primary school online security education. The first part of the study investigates the impact of the COVID-19 pandemic on students' educational learning outcomes in information and Internet security. The study has been performed via a student-oriented survey of 20 questions. The statistical analysis confirms the significant difference before and after the pandemic in several questions at most. Nevertheless, this justifies the statement that pandemics had a positive impact on post-pandemic Internet-related security education. The second part of the study has been focused on students' perception and self-awareness of cyberspace problems. For this purpose, the authors used novel majority-based decision fusion clustering validation methods. The revealed results illustrate the positive tendency toward the students' self-awareness and self-confidence of online security problems and e-threats before, during and after the challenging pandemic period. Moreover, the presented validation methods show the appealing performance in educational data analysis, and therefore, the authors recommended these methods as a preprocessing step that helps to explore the intrinsic data structures or students' behaviors and as a postprocessing step to predict learning outcomes in different educational environments.

Pandemic-Related Social Disruption and Well-Being in Pediatric Gastrointestinal Diseases

OBJECTIVE

The coronavirus disease 2019 (COVID-19) pandemic has impacted everyone, but there are few data regarding how the pandemic has influenced the lives of children with gastrointestinal (GI) conditions. This cross-sectional study assessed pandemic-related social disruption (PRSD) in children with inflammatory bowel disease (IBD), celiac disease (CD), and irritable bowel syndrome (IBS), and the potential buffering effect of the parent-child relationship.

METHODS

A survey completed between September and December 2020 asked 146 children (ages 8-17) diagnosed with IBD (n = 44), CD (n = 81), or IBS (n = 51) and 185 parents how the pandemic has contributed to social disruption (i.e., financial stability, COVID-19 exposure, school changes, GI needs, and isolation) and their social-emotional well-being. Structural equation modeling was used to examine the role of social disruption on well-being, and the moderating effect of the parent-child relationship.

RESULTS

Increased social disruption predicted worse parent, β = 0.24, p = .02, and child well-being, β = 0.38, p < .01. The parent-child relationship moderated the relationship between parent and child well-being, β = 0.21, p = .03. Strong parent-child relationships predicted a positive association between parent and child well-being, β = 0.23, p = .003, whereas medium, β = 0.09, p = .14, and poor, β = -0.06, p = .52, relationships did not.

CONCLUSIONS

PRSD negatively impacted the well-being of children with GI conditions, and the parent-child relationship moderated this relationship. These findings are relevant to pediatric psychologists treating the physical and mental health needs of children with GI conditions and their parents.

Brief report of protective factors associated with family and parental well-being during the COVID-19 pandemic in an outpatient child and adolescent psychiatric clinic

Families of children with mental health challenges may have been particularly vulnerable to emotional distress during the COVID-19 pandemic. This cross-sectional study surveyed 81 parents of children ages 6–17 years receiving mental health treatment in an outpatient clinic during the pandemic. We sought to characterize the impact of the pandemic on family relationships and parental well-being. Additionally, regression and ANCOVA models examined associations between four potentially protective factors—parents’ psychological resilience, perceived social support, positive family experiences during the pandemic, and children’s use of cognitive or behavioral coping strategies—with family relationships and parental well-being. Findings suggest that families of children with mental health conditions experienced remarkable challenges to family relationships, parental well-being, and parents’ perceived capacity to support their children’s mental health. Nearly 80% of parents reported a negative impact of the pandemic on their own well-being, and 60% reported reduced ability to support their children’s mental health. Simultaneously, protective factors appeared to mitigate the negative impact of the pandemic. Particularly, support within the family (e.g., co-parenting) and from external sources (e.g., mental health services) were associated with better self-reported well-being for parents and their capacity to support their children. Children’s use of coping tools, likely enhanced by mental health treatment, was also positively related to better family relationships and parental ability to support children with mental health challenges. Our findings highlight the need for enhancing supports for families at multiple levels including individual skill-building, family-based/parenting support, and community-based support.

The effects of the COVID ‐19 pandemic on French‐Canadian adolescents' academic motivation: A follow‐up study

We previously shared results suggesting that the academic motivation of a sample of French‐Canadian adolescents remained stable from few weeks before the first wave to the second wave of the COVID‐19 pandemic. We here examine if this pattern persisted using data collected at a third time point.

Social context effects on emotional language: The influence of the COVID-19 pandemic on the emotional evaluation of words

The COVID-19 pandemic has altered our routines, our conversations, the specific social contexts in which we hear or use certain words, and potentially, the representation of the words related to the disease and its consequences. Here we investigated whether the effects of the pandemic have changed the representation of the affective features of COVID-19-related words. To this aim, we collected new ratings of valence (from unpleasant to pleasant) and arousal (from calm to activated) dimensions for COVID-19-related words (e.g., hospital) and COVID-19-unrelated words (e.g., whale). Subsequently, we compared these scores with those from databases that reported ratings for the same pool of words before the pandemic. Our results showed significant changes in arousal for COVID-19-related words but not unrelated words, thus revealing that the pandemic social context modified their affective representation. These findings support the flexibility of emotional representations and the malleability and dynamicity of the mental lexicon as a function of contextual factors.

Mental Health Inequities Amid the COVID-19 Pandemic: Findings From Three Rounds of a Cross-Sectional Monitoring Survey of Canadian Adults

Objectives: Adverse mental health impacts of the COVID-19 pandemic are well documented; however, there remains limited data detailing trends in mental health at different points in time and across population sub-groups most impacted. This paper draws on data from three rounds of a nationally representative cross-sectional monitoring survey to characterize the mental health impacts of COVID-19 on adults living in Canada (N = 9,061).

Methods: Descriptive statistics were used to examine the mental health impacts of the pandemic using a range of self-reported measures. Multivariate logistic regression models were then used to quantify the independent risks of experiencing adverse mental health outcomes for priority population sub-groups, adjusting for age, gender, and survey round.

Results: Data illustrate significant disparities in the mental health consequences of the pandemic, with inequitable impacts for sub-groups who experience structural vulnerability related to pre-existing mental health conditions, disability, LGBTQ2+ identity, and Indigenous identity.

Conclusion: There is immediate need for population-based approaches to support mental health in Canada and globally. Approaches should attend to the root causes of mental health inequities through promotion and prevention, in addition to treatment.

Health-related quality of life, health literacy and COVID-19-related worries of 16- to 17-year-old adolescents and parents one year into the pandemic: a cross-sectional study

Background

The uncertain and challenging situation caused by the COVID-19 pandemic affects adolescents and their parents in an exceptional way. More knowledge of health-related quality of life (HRQoL), health literacy (HL) and COVID-19-related worries in adolescents and parents 1 year into the pandemic is needed. The present study aimed to describe HRQoL, HL and COVID-19-related worries of 16- to 17-year-old adolescents and parents of adolescents. Further, to assess the strength of associations between gender, HL, COVID-19-related worries and HRQoL.

Methods

A cross-sectional study involving 215 adolescents and 320 parents was conducted, exploring HRQoL, HL, COVID-19-related worries and sociodemographic variables. KIDSCREEN-10 and RAND-36 were used to measure HRQoL. Data were analyzed using bivariate methods, multiple linear regression and robust regression.

Results

Adolescents’ HRQoL was notably lower compared to previous Norwegian studies and European norms. Parents’ HRQoL was comparable to Norwegian norms. Adolescents and parents reported moderate-to-high HL and high degrees of COVID-19-related worries. Females reported significantly lower HRQoL and more worries compared to males. In adolescents, higher HL was significantly associated with higher HRQoL. COVID-19-related worries were not significantly associated with HRQoL. In parents, higher HL in the “understand health information” domain was significantly associated with higher HRQoL for mental well-being (mental component sum scores [MCS]) and with lower HRQoL for physical well-being (physical component sum scores [PCS]). Being worried a lot about infecting others and about family/friends becoming sick was significantly associated with higher MCS and lower MCS, respectively. COVID-19-related worries were not significantly associated with PCS.

Conclusions

Our results indicate that the pandemic has a major negative impact on adolescents’ HRQoL. Parents’ HRQoL remained unchanged and comparable to previous studies. Our study demonstrates that HL, gender and COVID-19-related worries are significantly associated with adolescents’ and parents’ HRQoL, indicating that efforts aimed at increasing their HL might indirectly affect their HRQoL as well and that gender-specific interventions or strategies could be beneficial.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13737-1.

Child, adolescent, and parent mental health in general population during a year of COVID-19 pandemic in belgium: a cross-sectional study

BACKGROUND

This study aims to evaluate the mental health status of children, adolescents and their parents during the first year of COVID-19 pandemic in Belgium.

METHOD

Analysis compared results before and during the second national lockdown, which started on November 2nd 2020. A cross-sectional online survey was conducted between May 2020 and April 2021.

RESULTS

Two hundred and eighteen adults and 273 children fully completed the survey. Almost one in five children (17.9%) presented moderate-to-severe scores of depression. Adolescents presented a higher level of depression than children (p = 0.007). The rate of moderate-to-severe depression scores (10.8% to 21%, p = 0.007) and internalized symptoms increased during the second lockdown (p < 0.001). Parents' depression (p < 0.001) and anxiety (p = 0.027) levels also increased during the second lockdown. Logistic regression showed that the use of psychotropic medication in parents and parents' depression scores were risk factors for children to have worse depression scores.

CONCLUSION

The second lockdown appears to worsen the effects of the pandemic on children's and parents' mental health. There is a need to implement specific interventions targeting both children/adolescents and their parents to support them during lockdown periods and improve mental health outcomes.

Challenges of children and adolescents with attention-deficit/hyperactivity disorder during the COVID-19 pandemic

OBJECTIVE

We aimed to understand the challenging effect of the pandemic on children and adolescents with ADHD.

METHODS

100 children and adolescents with ADHD aged 7-18 years were included in the study. They were evaluated in terms of internet addiction diagnostic criteria. Symptom severity was assessed using the CBCL, CPRS, and SNAP-IV.

RESULTS

We found that 42% spent less time outdoors, and 26% spent more time watching TV. 57% had increased internet use and 28% were diagnosed as having internet addiction. There was a significant difference in terms of symptom severity between the groups depending on whether the children took part in sports activity before the pandemic.

CONCLUSIONS

Children and adolescents with ADHD have experienced challenges in many areas, especially internet use in the pandemic. The positive long-term effects of exercise in children with ADHD are thought to be protective in terms of symptom management during the COVID-19 pandemic.

Health and health inequalities impact assessment for non-clinical measures to control COVID-19 in the Basque Country and Navarre (Spain)

This article describes the results of a health and health inequalities impact assessment of the COVID-19 pandemic control measures in the regions of the Basque Country and Navarre in Spain. A literature review was conducted on Pubmed and Web of Science (WoS) databases, in addition to individual semi-structured interviews and focus groups with experts, key informants and different profiles of citizens. A wide variety of social determinants of health have been affected by the measures, which included individual health-related behaviors, service disruption in formal care, educational settings, and health care provision. These changes have particularly affected certain population groups including children and adolescents, older people, those with health conditions and disabilities together with caregivers, women, as well as people with low levels of education, income, and resources. In future scenarios it will be necessary to pay attention to the potential impacts of policy responses on health inequalities to avoid an increase in existing health gaps.

Pathways from self-disclosure to medical coping strategy among adolescents with moderate and major depression during the COVID-19 pandemic: A mediation of self-efficacy

BACKGROUND

The prevalence of adolescent depression in China during the COVID-19 pandemic is increasing. Self-disclosing depressive emotions could help release stress. Self-disclosure, which is a prerequisite for self-efficacy, can directly contribute to people's psychological health, and depression and the choice of coping strategy are determined by the level of self-efficacy perceived.

PURPOSE

We aimed to discuss the relationship between self-efficacy, self-disclosure, and medical coping strategy. Further, we explore the mediation effect of self-efficacy on the influence of self-disclosure on medical coping strategies in adolescents with depression.

METHODS

A total of 585 patients aged 11-24 years with moderate and major depression were recruited. All the assessments were completed on the second day after admission, including the General Self-Efficacy Scale (GSE), Distress Disclosure Index (DDI), and Medical Coping Modes Questionnaire (MCMQ). Pearson correlation was performed to explore the relationships of these variables. The bootstrap analysis was used to conduct to assess the mediation effects.

RESULTS

Both direct and indirect effects of self-disclosure on medical coping strategy were found. As predicted, self-efficacy partially mediated the relationship between self-disclosure and medical coping strategy (b = 0.0385, 95% CI: 0.0244-0.0538 for Confrontation; b = -0.0466, 95%CI: -0.0651 to -0.0296 for Resignation), respectively. The effect size for Confrontation and Resignation was 0.2659 and 0.2485, respectively.

CONCLUSION

Self-efficacy played a partial mediating role in the effect of self-disclosure on medical coping strategies for adolescent depression during the COVID-19 pandemic, and the use of a positive self-disclosure mechanism may be anticipated to promote improved self-efficacy and the use of active coping strategies.

Companion Animals and Adolescent Stress and Adaptive Coping During the COVID-19 Pandemic

The COVID-19 pandemic has resulted in significant social disruptions for youth caused by lockdowns, school closures, and a lack of in-person social interactions. Companion animals are prevalent in US households and may provide a source of emotional support and motivation for youth to engage in adaptive coping behaviors during social challenges. The goals of this study were to assess if dog owners, non-dog pet owners, and non-pet owners differed in stress levels, positive affect, and use of adaptive coping strategies such as increased time outdoors, regular walking, and healthy behaviors. This study used data collected during the COVID-19 pandemic from the Adolescent Brain Cognitive Development^SM (ABCD) Study, a large, nationally representative dataset of American youth. In a cross-sectional sample of 6,069 adolescents, there were significant, but small, relationships between owning a non-dog pet and lower levels of positive affect, and both dog owners and non-dog pet owners reported higher perceived stress compared with non-pet owners. Dog ownership was associated with higher odds of using healthy coping strategies compared with non-pet owners, but this relationship was not significant when controlling for demographic variables. Dog owners reported higher odds of having a walking routine and spending time outdoors compared with non-pet owners. Overall, the results suggest no buffering effect of pet ownership on youth mental wellbeing, but dog ownership is associated with some healthy coping behaviors linked to walking.

Worries About COVID-19 and Adolescents' Mental Health and Life Satisfaction: The Role of Sociodemographics and Social Support

Worries related to the COVID-19 pandemic are associated with mental health problems and reduced life satisfaction. However, the association between different types of worries about COVID-19 and adolescent mental health is unclear. Moreover, there is a lack of information about whether certain groups of adolescents are more vulnerable to the adverse effects of worries and how social support may moderate these effects. Adolescents (N = 12,686) completed a survey during the lockdown in spring 2020 in Oslo, Norway (37% response rate, 56.4% girls). The results showed that adolescent worries could be categorized into worries related to infection and those related to the general negative effects of the pandemic. Multivariate regression analyses showed that both types of worries were negatively related to positive affect and life satisfaction and positively related to depressive symptoms. Interaction analyses indicated that some associations with positive affect and depressive symptoms were stronger among adolescents with non-migrant backgrounds, higher family SES, and high reported levels of social support and physical contact during the pandemic. The findings suggest that COVID-19 worries may have negative effects on mental health and inform strategies to increase tailored psychological interventions to mitigate the effect of worry on adolescents' mental health and life satisfaction.

Effect of online counselling on emotional outcomes during the COVID‐19 pandemic: An innovative group intervention for university students using the Brain Wave Modulation Technique

Young people's mental health problems are a matter of concern during the COVID‐19 pandemic. Counselling services for university students by means of telemental support can help them to deal with psychological issues that they may be facing due to the pandemic. The present study investigated the effects of four once‐weekly online counselling sessions based on a mind‐body technique (the Brain Wave Modulation Technique; BWM‐T) on enhancing positive affect and on reducing negative affect and anxiety in a sample of 54 university students (96.3% females; M_age = 21.31 years, SD = 2.09). An experimental design was conducted: the participants were randomly assigned to the intervention group, which received 15 min of a guided online BWM‐T session, or to the control group, which watched a 15‐min video on how to sustain their psychological well‐being. The results of a two‐factor mixed‐design analysis of variance (ANOVA) showed that the participants in the intervention group reported a significant increase in positive affect and a decrease in negative affect over time compared to those in the control group. They also reported a slight decrease in state anxiety compared to the control group, although this was just short of statistical significance. The information provided by this study, regarding emotional outcomes among university students after four brief online counselling sessions, suggests that such interventions could be an effective and sustainable way to reinforce young people's mental health during the COVID‐19 pandemic, as well as later in their university careers and adult lives.

Prevalence of and risk factors for depressive and anxiety symptoms in a large sample of Chinese adolescents in the post-COVID-19 era

BACKGROUND

Depressive and anxiety symptoms are widespread among adolescents today, creating a large social problem. However, few previous studies have addressed depression and anxiety among adolescents in Chinese cohorts. The aim of this study was to evaluate the prevalence of and risk factors for depressive and anxiety symptoms among Chinese middle school adolescent students in the post-COVID-19 era.

METHODS

A total of 22,380 middle school students from Jiangsu Province were surveyed online, and their general demographic data were collected. The Patient Health Questionnaire-9 (PHQ-9) was used to assess depressive symptoms, and the seven-item Generalized Anxiety Disorder (GAD-7) scale was used to measure anxiety symptoms.

RESULTS

Of these participants (aged 12-17 years), 25.6% had depressive symptoms, 26.9% had anxiety symptoms, and 20.6% had a combination of depression and anxiety symptoms. The prevalence of depressive symptoms was higher in female adolescents (27.6%) than in male adolescents (23.7%; χ² = 45.479, P = 0.000), and the proportion with anxiety symptoms was higher among female adolescents (28.6%) than among male adolescents (25.4%; χ² = 29.390, P = 0.000). Furthermore, binary logistic regression analysis showed that gender, region, and parental relationship were significantly associated with depressive symptoms among adolescents, while age, gender, region, and parental relationship were significantly associated with anxiety symptoms.

CONCLUSIONS

Our findings demonstrated that the prevalence of reported depressive and anxiety symptoms in Chinese adolescents are high. Female gender, urban region, and poor parental relationship may be risk factors for depressive and anxiety symptoms. Furthermore, policy makers, schools, and families need to pay more attention to the psychological health of adolescents, develop response plans and take early intervention measures to reduce the prevalence of adolescent depression and anxiety.

Increase in the Diagnosis and Severity of Presentation of Pediatric Type 1 and Type 2 Diabetes during the COVID-19 Pandemic

INTRODUCTION

The impact of the COVID-19 pandemic on the incidence of pediatric type 1 (T1D) and type 2 diabetes (T2D) and severity of presentation at diagnosis is unclear.

METHODS

A retrospective comparison of 737 youth diagnosed with T1D and T2D during the initial 12 months of the COVID-19 pandemic and in the preceding 2 years was conducted at a pediatric tertiary care center.

RESULTS

Incident cases of T1D rose from 152 to 158 in the 2 years before the pandemic (3.9% increase) to 182 cases during the pandemic (15.2% increase). The prevalence of diabetic ketoacidosis (DKA) at T1D diagnosis increased over 3 years (41.4%, 51.9%, and 57.7%, p = 0.003); severe DKA increased during the pandemic as compared to the 2 years before (16.8% vs. 28%, p = 0.004). Although there was no difference in the mean hemoglobin A1c (HbA1c) between racial and ethnic groups at T1D diagnosis in the 2-years pre-pandemic (p = 0.31), during the pandemic HbA1c at T1D diagnosis was higher in non-Hispanic Black (NHB) youth (11.3 ± 1.4%, non-Hispanic White 10.5 ± 1.6%, Latinx 10.8 ± 1.5%, p = 0.01). Incident cases of T2D decreased from 54 to 50 cases (7.4% decrease) over the 2-years pre-pandemic and increased 182% during the pandemic (n = 141, 1.45 cases/month, p < 0.001). As compared to the 2-years pre-pandemic, cases increased most among NHB youth (56.7% vs. 76.6%, p = 0.001) and males (40.4% vs. 58.9%, p = 0.005). Cases of DKA (5.8% vs. 23.4%, p < 0.001) and hyperosmolar DKA (0 vs. 9.2%, p = 0.001) increased among youth with T2D during the pandemic.

CONCLUSIONS

During the pandemic, the incidence and severity of presentation of T1D increased modestly, while incident cases of T2D increased 182%, with a nearly 6-fold increase in DKA and nearly a 10% incidence of hyperosmolar DKA. NHB youth were disproportionately impacted, raising concern about worsening of pre-existing health disparities during and after the pandemic.

Impact of the COVID-19 Pandemic on the Mental Health of Adolescent Students in Daegu, Korea

BACKGROUND

In February 2020, as coronavirus disease 2019 (COVID-19) spread rapidly in Daegu, South Korea, students in that region experienced many emotional difficulties. In this study, we analyzed the stress and emotional crisis experienced by students during the COVID-19 pandemic, its causative factors, and the factors that affect negative emotions.

METHODS

We identified the demographic information related to the experiences of unbearable stress and emotional crisis and their causal factors at three points in time: before the pandemic, during its peak, and at the time of the survey (2-3 months after the peak). In addition, we analyzed the factors related to depression and anxiety experienced by students during the COVID-19 pandemic. The Korean version of the Patient Health Questionnaire 9 and the Korean version of the Generalized Anxiety Disorder 7 was used to assess for depressive and anxiety symptoms in the subject students, respectively.

RESULTS

A total of 8,177 students participated in the analysis, with 4,072 boys (49.8%), 4,105 girls (50.2%), and 4,463 middle school students (54.6%) and 3,177 high school students (45.4%). The percentage of students who experienced unbearable stress was 9% before the COVID-19 pandemic, increased to 16% at the peak of the COVID-19 pandemic, then decreased to 12.7% at the time of the survey. Stress was experienced more by girls (18.1% versus 13.8% in boys; χ² = 28.159, P < 0.001) and high school students (19.0% versus 13.5% in middle school students; χ² = 45.437, P < 0.001). Overall, 7.6% experienced emotional crises during the COVID-19 pandemic, which was more prevalent in girls (10.1% versus 5.2% in boys; χ² = 71.025, P < 0.001) and in high school students (8.8% versus 6.7% in middle school students; χ² = 12.996, P < 0.001). Depression and anxiety was seen in 19.8% and 12.3% of students during the COVID-19 pandemic, respectively. The risk factors for depression and anxiety included unbearable stress before the COVID-19 pandemic (P < 0.001), mental health (P = 0.044), and age (P = 0.040), whereas resilience was identified as a protective factor for depression and anxiety (P = 0.001).

CONCLUSION

Students in Daegu experienced lots of mental difficulties since the COVID-19 pandemic. It will be necessary to improve stress management and resilience to improve students' mental health in disasters such as the COVID-19 pandemic.

[Burden in parents of school-aged children during different phases of the COVID-19 pandemic in Germany: an analysis within the COVID-19 snapshot monitoring (COSMO) study]

BACKGROUND

Parents face a variety of personal challenges during the COVID-19 pandemic, while simultaneously being confronted with additional, school-related pandemic containment measures.

OBJECTIVES

To investigate burden in parents of school-aged children across different phases of the COVID-19 pandemic in Germany and to identify particularly affected subgroups.

METHODS

The COSMO project is a repetitive cross-sectional survey monitoring the psychosocial situation of the population in Germany during the pandemic with a sample size of approximately n = 1000 respondents per survey wave. A quantitative analysis of COSMO data was conducted using closed survey questions on the item "burden" as the main outcome, and, if applicable, on parenthood-associated burden from March 2020 until January 2021.

RESULTS

During the first COVID-19 wave, parents of school-aged children were significantly more burdened compared to the general study population. However, burden decreased significantly from March/April to June 2020. During the second COVID-19 wave in January 2021, burden was homogeneously high across all groups. Single parenthood, a low household income, having a chronic health condition, a COVID-19 infection and a migration background were associated with higher burden, although none of these factors was consistently significant across the survey waves. Mothers reported to be more affected by parenthood-related burden than fathers.

CONCLUSIONS

School measures for infection control have to be weighed carefully against the psychological impact on parental burden with subsequent negative impact on the family system. An English full-text version of this article is available at SpringerLink as Supplementary Information.

New realities for Polish primary school informatics education affected by COVID-19

In the paper, the authors discuss the first research effort to explore the transition from traditional teaching into distance teaching in Polish primary schools enforced by COVID-19. The first research question was addressed to primary school students and was dedicated to furnishing them with ICT equipment for crisis-prompted distance informatics learning. According to the obtained results, almost all Polish students during the pandemic have a technical opportunity to participate in distance learning and to use digital devices to develop their digital competences. Hence the second research question was addressed to the experts, demystifies whether the accessibility and the availability of ICTs could increase students' informatics learning outcomes in out-of-school primary education settings. The obtained results reveal the significant importance of out-of-school informatics education in pandemic time. Moreover, in the first wave of pandemic, distance informatics education had the same or similar effect as if students learn informatics by themselves, without school lessons and teachers' support. The obtained results should strengthen teachers and school leaders in making informed decisions during the shift into distance informatics education. Also, by investigating participants' informatics learning outcomes and teacher preparedness and choices when implementing distance education, authors hope that the study may be helpful for policy-makers with the progressive changes in education and government support for informatics, especially in Poland, in making informed decisions to aid the transition into distance education as well as developing preparedness plans for future pandemics.

Real-Time Infoveillance of Moroccan Social Media Users' Sentiments towards the COVID-19 Pandemic and Its Management

The impact of COVID-19 on socio-economic fronts, public health related aspects and human interactions is undeniable. Amidst the social distancing protocols and the stay-at-home regulations imposed in several countries, citizens took to social media to cope with the emotional turmoil of the pandemic and respond to government issued regulations. In order to uncover the collective emotional response of Moroccan citizens to this pandemic and its effects, we use topic modeling to identify the most dominant COVID-19 related topics of interest amongst Moroccan social media users and sentiment/emotion analysis to gain insights into their reactions to various impactful events. The collected data consists of COVID-19 related comments posted on Twitter, Facebook and Youtube and on the websites of two popular online news outlets in Morocco (Hespress and Hibapress) throughout the year 2020. The comments are expressed in Moroccan Dialect (MD) or Modern Standard Arabic (MSA). To perform topic modeling and sentiment classification, we built a first Universal Language Model for the Moroccan Dialect (MD-ULM) using available corpora, which we have fine-tuned using our COVID-19 dataset. We show that our method significantly outperforms classical machine learning classification methods in Topic Modeling, Emotion Recognition and Polar Sentiment Analysis. To provide real-time infoveillance of these sentiments, we developed an online platform to automate the execution of the different processes, and in particular regular data collection. This platform is meant to be a decision-making assistance tool for COVID-19 mitigation and management in Morocco.

The Comparative Estimation of Primary Students' Programming Outcomes Based on Traditional and Distance Out-of-School Extracurricular Informatics Education in Electronics Courses during the Challenging COVID-19 Period

The authors decided to investigate the impact of the lockdown period and the resulting limitations in informatics education, especially programming, in out-of-school electronics courses using traditional and distance learning modes in primary school COVID-19 pandemic settings. Two extracurricular courses were held successively; the first electronics course was performed in a traditional out-of-school learning mode using Arduino kits, while the other was held using the TinkerCad circuits virtual environment in distance learning mode. A structured questionnaire was administered to students to map their knowledge of programming. The questionnaire consists of three emotional dimensions: enjoyment, satisfaction and motivation. The fourth dimension was dedicated to the students' programming outcomes. Three emotional dimensions were addressed to primary school students, while the fourth dimension was addressed to the tutors' observations toward the students' programming outcomes. The obtained results revealed that learning modes have no significant impact on students perceiving the programming issues. However, three emotional dimensions revealed a significant difference in the students' enjoyment, satisfaction and motivation in favor of the traditional learning mode. Our findings are of particular interest in light of possible crisis-prompted distance education in the future but can also serve to inform government institutions and policymakers seeking to develop effective concepts for successful distance learning.

Experiences of children (ages 6-12) during COVID-19 pandemic from mothers' perspectives

PURPOSE

This study evaluated the experiences of children between ages 6 and 12 based on their mothers' perspectives during the COVID-19 pandemic.

METHODS

Ten mothers living in Ankara, Turkey with children in the aforementioned age range, participated in this study. Data were collected through focus group interview with a qualitative phenomenological approach followed by thematic data analysis.

FINDINGS

Three categories were obtained relating to the pandemic, including negative effects, positive effects, and the resultant needs and expectations of parents.

CONCLUSION

The findings show that the pandemic has significantly affected children in psychological, social, developmental, and academic realms. Therefore, it is necessary to plan interventions with a multidisciplinary approach to increase children's physical and psychosocial health, minimizing children's level of negative influences.