Profiles of positive changes in life outcomes over the COVID-19 pandemic in Chinese adolescents: the role of resilience and mental health consequence

The impact of the COVID-19 pandemic on the lives of the 2004 Pelotas (Brazil) birth cohort adolescents

Insights into the experiences of adolescents during the COVID-19 pandemic are crucial for understanding the extent of their impact and guiding future responses to similar challenging events. This study aims to describe the effects of the pandemic on different aspects of adolescents' lives and examine how they varied according to socioeconomic, family, and individual characteristics. We used data from a subsample of the 2004 Pelotas (Brazil) birth cohort to investigate the reported impacts of the COVID-19 pandemic on adolescents (N = 1,806; mean age = 17.41, range: 16.73-17.95). We investigated a range of issues and impacts caused by the pandemic and social distancing measures, considering their influence on various aspects of life. Additionally, we evaluated a spectrum of socioeconomic, family, and individual variables. Data were collected via in-person interviews from August to December 2021. Roughly 20% of adolescents have reported significant disruptions in their lives due to the COVID-19 pandemic. The effects of the pandemic were more pronounced among females, private school attendees, non-beneficiaries of the government cash transfer benefit (Brazil Assistance - Auxílio Brasil), and adolescents who reported having a regular or poor health status. Adolescents have shared a multitude of stressors and concerns directly linked to the pandemic, underscoring a notable trend of heightened impacts among female adolescents. The COVID-19 pandemic has had far-reaching consequences on various aspects of adolescents' daily lives. Recognizing the perspectives of adolescents in this challenging period is crucial for effectively addressing their needs in the post-pandemic society.

Child and adolescent mental health during the Covid-19 pandemic: an overview of key findings from a thematic series

BACKGROUND

The 2019 outbreak of COVID-19, a severe acute respiratory infection caused by the SARS-CoV-2 virus, triggered a global pandemic with far-reaching consequences. Societies worldwide felt the effects of the virus and pandemic related restrictive measures on their economies, healthcare systems, and social fabric. To curb the spread of COVID-19, numerous restrictive measures were implemented. This manuscript summarizes the findings published within the thematic series on Child Mental Health during the Covid-19 pandemic.

METHODS

Between May 2020 and June 2024 Child and Adolescent Psychiatry and Mental Health (CAPMH) issued a thematic series on "Child Mental Health during the Covid-19 pandemic." All manuscripts underwent a prescreening process by the Editor-in-Chief, including checks regarding the compliance with ethical standards compliance with the scope of the journal and the thematic series. Suitable manuscripts were then handled by one of the editors of the thematic series. All suitable manuscripts then underwent a peer review process that included at least two reviews. Different aspects of child and adolescent mental health as well as various aspects of the pandemic - in addition to their findings -were investigated, defined and discussed throughout the manuscripts within the series.

RESULTS

A total of 327 manuscripts were submitted and 85 manuscripts were published within the series. Manuscripts included qualitative and quantitative studies as well as systematic reviews. The manuscripts reported findings from 22 countries from all over the world and various populations. The studies covered the somatic and psychological impacts of the pandemic, including emotional and behavioral consequences, non-suicidal self-injury and suicidal behavior, threat and trauma, parent child separation, school closure and home schooling, physical activity and media use, psychiatric care, as well as digital resources and online therapy. Through its findings, the research also highlighted the multilayered impact the pandemic had, as well as the need to make targeted interventions and evidence-based interventions available to a large audience.

CONCLUSION

A broad range of literature in the series submitted from various countries around the world documented the profound impact of COVID-19 on child mental health. The findings can be used as a foundation for conceptualizing targeted programs to counteract the consequences, in addition to helping prepare systems in the event of similar incidents in the future.

Effects of the corona measures on the life of children and adolescents: Results of the German HBSC study 2022

Background

The containment measures of the COVID-19 pandemic have changed many people's daily lives. The study examines how children and adolescents assess the impact of the coronavirus measures on various areas of life.

Methods

Overall, N = 6,475 students (11 - 15 years) in Germany took part in the representative 'Health Behavior in School-aged Children (HBSC)' study in 2022. Logistic regressions were performed to investigate the relationships between the perceived impact of the coronavirus measures on various areas of their lives by age, gender and family wealth.

Results

Two years after the onset of the pandemic, children and adolescents reported both, positive and negative effects of the coronavirus measures. About a half of those surveyed perceived positive effects regarding social relationships. In contrast, approximately one in three respondents reported a deterioration in mental health and school performance. In particular, 11-year-olds, boys and wealthy students reported more often positive effects.

Conclusions

The positive effects of the pandemic on the lives of children and adolescents in individual areas and the resilience (resistance) that is emerging here, as well as the results on more negative assessments of adolescents, girls and respondents with lower family wealth, can be used as a starting point for a needs-oriented and target group-specific health promotion in times of crisis. Future research should focus on the pandemic's long-term effects on young people's development.

The Impact of Adverse Childhood Experiences on the Development of Adolescent Risk-Taking: The Mediating Effect of Self-Control and Moderating Effect of Genetic Variations

Risk-taking is a concerning yet prevalent issue during adolescence and can be life-threatening. Examining its etiological sources and evolving pathways helps inform strategies to mitigate adolescents' risk-taking behavior. Studies have found that unfavorable environmental factors, such as adverse childhood experiences (ACEs), are associated with momentary levels of risk-taking in adolescents, but little is known about whether ACEs shape the developmental trajectory of risk-taking. Even less research has investigated the underlying mechanisms. Drawing on the self-regulation theory, this study examined the associations between ACEs and the developmental trajectory of adolescent risk-taking. Moreover, it also explored self-control as a mediator and genetic variations as a moderator from a "gene × environment" approach. Participants were 564 Chinese adolescents (48.40% males, Mage = 14.20 years, SD = 1.52). Adolescents reported their ACEs and self-control at T1 and risk-taking three times, with a six-month interval between each time point. Adolescents' saliva was collected at T1 for genetic extraction, and polygenetic index was created based on the gene-by-environment interaction between SNPs and ACEs for self-control via the leave-one-out machine learning approach. Findings of latent growth modeling revealed that adolescents' risk-taking decreased over time. ACEs were directly and indirectly through self-control associated with high initial levels of, and a rapid decrease in, risk-taking, especially for those with a higher polygenetic index compared to those with a lower polygenetic index. Theoretically, these results suggest a tripartite model of adolescent risk-taking, such that risk-taking is the combined function of adverse experiences in early years, low self-control, and carriage of sensitive genes. Practically, intervention strategies should reduce childhood adversities, build up self-control, and consider the potential impacts of genetic plasticity.

The changing association between pandemic-related stressors and child and adolescent mental health during the waning phase of the COVID-19 pandemic

This study examined the relation between pandemic-related stressors and mental health among young people (YP) in India during two time points in the waning phase of the pandemic. We use data from two cross-sectional waves of over 20,000 YP aged 5-19 in February 2022, during the peak of the Omicron wave, and October 2022, during a reduction in infections and easing of restrictions. COVID illness/death in the family's social network, current lockdown stringency, and significant change in household income were examined in relation to adult respondents' reports of YP internalizing symptoms. Internalizing symptoms declined slightly from February to October 2022. COVID-19 illness/death in the family's network was generally associated with more internalizing symptoms. Higher lockdown stringency was associated with lower levels of internalizing symptoms. YP in households with increases in income tended to have more internalizing symptoms. Many associations were driven by older adolescents and were stronger during the earlier (Feb-2022) than later (Oct-2022) data collection time-points. The findings illustrate the importance of anchoring results within a study's specific geographic context, including concurrent events during the study period. Importantly, findings that may initially seem counterintuitive ultimately illuminate the dynamic and complex processes underlying child and adolescent mental health.

Long-Term Post-COVID-19 Health and Psychosocial Effects and Coping Resources Among Survivors of Severe and Critical COVID-19 in Central and Eastern Europe: Protocol for an International Qualitative Study

BACKGROUND

There is a strong need to determine pandemic and postpandemic challenges and effects at the individual, family, community, and societal levels. Post-COVID-19 health and psychosocial effects have long-lasting impacts on the physical and mental health and quality of life of a large proportion of survivors, especially survivors of severe and critical COVID-19, extending beyond the end of the pandemic. While research has mostly focused on the negative short- and long-term effects of COVID-19, few studies have examined the positive effects of the pandemic, such as posttraumatic growth. It is essential to study both negative and positive long-term post-COVID-19 effects and to acknowledge the role of the resources available to the individual to cope with stress and trauma. This knowledge is especially needed in understudied regions hit hard by the pandemic, such as the region of Central and Eastern Europe. A qualitative approach could provide unique insights into the subjective perspectives of survivors on their experiences with severe COVID-19 disease and its lingering impact on their lives.

OBJECTIVE

The aim of the study is to qualitatively explore the experiences of adult survivors of severe or critical COVID-19 throughout the acute and postacute period in 5 Central and Eastern European countries (Bulgaria, Slovakia, Croatia, Romania, and Poland); gain insight into negative (post-COVID-19 condition and quality of life) and positive (posttraumatic growth) long-term post-COVID effects; and understand the role of survivors' personal, social, and other coping resources and local sociocultural context and epidemic-related situations.

METHODS

This is a qualitative thematic analysis study with an experiential reflexive perspective and inductive orientation. The analytical approach involves 2-stage data analysis: national analyses in stage 1 and international analysis in stage 2. Data are collected from adult survivors of severe and critical COVID-19 through in-depth semistructured interviews conducted in the period after hospital discharge.

RESULTS

As of the publication of this paper, data collection is complete. The total international sample includes 151 survivors of severe and critical COVID-19: Bulgaria (n=33, 21.8%), Slovakia (n=30, 19.9%), Croatia (n=30, 19.9%), Romania (n=30, 19.9%), and Poland (n=28, 18.5%). National-level qualitative thematic analysis is currently underway, and several papers based on national results have been published. Cross-national analysis has started in 2024. The results will be submitted for publication in the third and fourth quarters of 2024.

CONCLUSIONS

This research emphasizes the importance of a deeper understanding of the ongoing health and psychosocial challenges survivors face and what helps them cope with these challenges and, in some cases, thrive. It has implications for informing holistic care and improving the health and psychosocial outcomes of survivors of COVID-19 and will be crucial for evaluating the overall impact and multifaceted implications of the pandemic and for informing future pandemic preparedness.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/57596.

Positive effects of the COVID-19 pandemic on depression and anxiety in Chinese adolescents

The potential impact on mental health of home schooling and social isolation due to COVID-19 lockdowns has led to widespread concern, particularly for adolescents. However, studies including pre-pandemic data from longitudinal cohorts with an assessment of the longer-term impact of the Covid-19 pandemic beyond the first months of 2020 are scarce. This longitudinal study of 1534 adolescents attending a secondary school in Hunan province investigated self-reported symptoms of anxiety and depression using two validated scales (Screen for Child Anxiety Related Disorders, Child Mood and Feelings Questionnaire) at six time points before, during, and after the 2020 national lockdown restrictions in China. Perceived COVID-related stress was assessed by an author-developed scale at two timepoints during the lockdown. We investigated trends in symptoms over time with a fixed effects model and multiple imputations of missing data. Counter to our expectations, depressive and anxiety symptoms were reduced during the 2020 lockdown relative to pre-lockdown (depression: b = - 3.37, SE = 0.345, Cohen's d = - 0.25, p < 0.0001; anxiety: b = - 4.55, SE = 0.382, Cohen's d = - 0.30, p < 0.0001). Symptoms remained significantly reduced even after lockdown restrictions eased. Higher symptom levels during lockdown were associated with greater self-reported COVID-related stress (depression: b = 0.11, SE = 0.026, p < 0.0001; anxiety: b = 0.11, SE = 0.036, p < 0.0001). Although COVID-related stresses correlated with higher levels of anxiety and depression, the lockdown period was associated with improved symptom levels in the adolescents taking part in our study. School closures may have improved the mental health of adolescents in China. We speculate this beneficial effect of lockdown can be explained by the adverse effects of attending school itself such as exposure to bullying and achievement pressures.

Adolescent Mental Health Before and During COVID-19: Longitudinal Evidence From the 2004 Pelotas Birth Cohort in Brazil

PURPOSE

There is great interest in examining the consequences of the COVID-19 pandemic on adolescent mental health, but most studies were conducted in high-income countries. The identification of overall effects and protective factors is essential to understand the determinants of mental wellbeing in contexts of stress. We aimed to study changes in adolescent mental health during the pandemic and the risk and protective factors associated with these changes in a Brazilian birth cohort.

METHODS

One thousand nine hundred forty nine adolescents from the 2004 Pelotas Birth Cohort were assessed prepandemic (T1, November 2019 to March 2020, mean age 15.69 years) and mid-pandemic (T2, August to December 2021, mean age 17.41 years). Mental health was assessed using the Strengths and Difficulties Questionnaire. Prepandemic and pandemic-related predictors were examined as predictors of change in multivariate latent change scores models.

RESULTS

There was a mean increase in adolescent total mental health difficulties (M = 1.071, p < .001), hyperactivity/inattention (M = 0.208, p < .001), emotion symptoms (M = 0.409, p < .001), and peer problems (M = 0.434, p < .001) during the pandemic. This increase was associated with several negative family context variables, including harsh parenting and maternal depressive symptoms at T2. Higher emotion regulation levels protected against increases in adolescent mental health difficulties related to the COVID-19 pandemic.

DISCUSSION

Family-context variables emerged as important risk factors for the deterioration of adolescent mental health during the COVID-19 pandemic. Interventions promoting emotion regulation strategies are a promising approach to protecting adolescent wellbeing in periods of stress.

Changes and predictors of adolescent emotion regulation, self-esteem, and locus of control during the COVID-19 pandemic: 2004 Pelotas Birth Cohort

OBJECTIVES

There is growing interest in examining the impacts of the coronavirus disease 2019 (COVID-19) pandemic on adolescent socioemotional development. This study aimed to examine changes in adolescent emotion regulation (ER), self-esteem (SE), and locus of control (LoC) from before to during the pandemic in a Brazilian birth cohort, and to investigate the variables associated with changes in those socioemotional competences.

METHODS

1,949 adolescents from the 2004 Pelotas Birth Cohort were assessed before (T1, November 2019 to March 2020) and during (T2, August to December 2021) the COVID-19 pandemic (mean ages [SD] = 15.69 [0.19] and 17.41 [0.26], respectively). Adolescents' socioemotional competences were assessed, including ER, SE, and LoC. Sociodemographic, pre-pandemic, and pandemic-related correlates were examined as predictors of change. Multivariate latent change score models were used in the analyses.

RESULTS

There were significant mean increases in adolescents' ER and SE (mean ER = 1.918, p < 0.001; mean SE = 1.561, p = 0.001) and a significant mean decrease (towards internalization) in LoC levels (MLoC = -0.497, p < 0.01) during the pandemic. Factors that predicted a lower competency increase included family conflicts, harsh parenting, and maternal depressive symptoms during the pandemic.

CONCLUSION

Despite the stress imposed by the COVID-19 pandemic, the adolescents of this cohort showed positive development in their socioemotional competences. Family-related factors emerged as important predictors of adolescent socioemotional adjustment during the study period.

Public perception of the appropriateness of COVID-19 management strategies and level of disturbances in daily activities: A focus on educational level

BACKGROUND

This study investigated the association between public perception of the appropriateness of management strategies implemented during the COVID-19 pandemic and the level of disturbances in daily activities reported by the general population.

METHODS

This cross-sectional study used Korea Community Health Survey conducted from August to November 2020. Public perception of COVID-19 management strategies included those implemented by the government (central, city or provincial, and administrative districts), the mass media, regional medical institutions, and neighbors. The subjective level of disturbances in daily activities was measured using a 0-100 numeric rating scale developed by Korea Disease Control and Prevention Agency. Multivariable linear regression analysis was used. A subgroup analysis was conducted based on education level.

RESULTS

The present study analyzed 211,353 participants. Compared to individuals who perceived that the management strategies implemented during the pandemic was 'highly appropriate,' those who reported 'mediocre appropriateness' (β: -1.96, p-value: <0.001) or 'low appropriateness' (β: -3.60, p-value: 0.010) reported higher levels of subjective disturbances. The appropriateness of measures implemented by the mass media was associated with levels of subjective disturbances felt by individuals of lower education with statistical significance, whereas that applied by the mass media and the government were important in those with higher education.

CONCLUSIONS

The findings suggest the importance of public perception of management strategies when implementing containment policies and minimizing its disturbances on daily lives is essential.

Utilizing the theory of planned behavior to predict COVID-19 vaccination intention: A structural equational modeling approach

It is essential to achieve herd immunity in order to control the COVID-19 pandemic, and this requires a high level of vaccination rate. Despite the importance of vaccination, hesitancy and unwillingness in receiving the COVID-19 vaccine still exists. It is therefore crucial to comprehend the intentions of adults regarding COVID-19 vaccination, which is beneficial for establishing community immunity and an efficient future pandemic response. An online survey was administered to 2722 adults in Vietnam. Cronbach's alpha, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were used to test the reliability and validity of the developed scales. Then, structural equational modeling (SEM) was employed to test correlations. This study found that favorable attitudes toward COVID-19 vaccines played the most important role in shaping adults' intention to receive these vaccines, followed by perceived behavioral control, perceived benefits of COVID-19 vaccines, and subjective norms. Concurrently, all three core dimensions of the theory of planned behavior mediated the link between the perceived benefits of COVID-19 vaccines and the intention to receive them. Also, there were significant differences between males and females in the way they formed this intention. The findings of this study offer valuable guidance for practitioners on how to encourage adults to receive COVID-19 vaccinations, as well as how to limit the transmission of the COVID-19 virus.

Optimists and Realists: A Latent Class Analysis of Students Graduating from High School during COVID-19 and Impacts on Affect and Well-Being

The Novel Coronavirus Disease (COVID-19) pandemic has had profound effects on physical and mental health worldwide. Students transitioning out of high school were uniquely impacted at the onset of the pandemic, having missed the opportunity to properly mark the end of their final year in the K-12 school system. The adverse effects of this loss on this population are still unknown. The purpose of the current study was to examine stress, wellbeing, and affect in a sample of 168 students (N = 168; Mage = 17.0, SD = 0.46; 60% female; 40% male) who were completing their final year of high school during the early stages of the pandemic when emergency stay-at-home orders were in place. Participants completed an online survey assessing the impact of COVID-19 on their life satisfaction (pre-COVID19, during COVID-19, and anticipated five years from now), stress, positive affect, and negative affect. Latent class analysis (LCA) was used to create classes of participants based on their responses to the pandemic. A two-subgroup solution provided the best model for the life satisfaction outcome variable. Subgroup 1, optimists, comprised 24% (N = 40) of the sample and reported high life satisfaction ratings one year prior to COVID-19 and a slight decrease in life satisfaction during COVID-19, and they anticipated an increase in life satisfaction 5 years from now. This group was characterized by low stress, low negative affect, and high positive affect during the pandemic. Subgroup 2, realists, comprised 76% of the population (N = 128) and experienced similarly high retrospective ratings of pre-COVID life satisfaction but a larger decrease in life satisfaction during the pandemic and a smaller increase in five years. The realist group was characterized by low positive affect, high stress, and high negative affect during the pandemic. The findings suggest that during the pandemic, certain subsamples of adolescents had greater difficulty in managing this transitional period and experienced changes in mood and well-being (i.e., affect, stress) as compared to other adolescents (i.e., optimists). Future research should investigate the characteristics and coping mechanisms that are instrumental for increasing life satisfaction and positive affect while lowering stress in this population.

The impact of family function on post-traumatic reactions of Chinese adolescents infected with COVID-19: a latent profile study

Background

Since the end of 2019, Corona Virus Disease 2019, also known as COVID-19, has broken out in various countries. However, the change of China's COVID-19 prevention and control policy and the sharp increase in the number of infected people are making the teenagers have post-traumatic reactions. Negative post-traumatic reactions include: post-traumatic stress disorder (PTSD), depression, anxiety. Positive post-traumatic reaction mainly refers to post-traumatic growth (PTG). The purpose of this study is to explore the post-traumatic reaction, which refers to PTSD, depression, anxiety and the co-occurrence pattern of growth after trauma and to further explore the influence of family function on different categories of Post-traumatic Reactions.

Methods

Latent profile analysis (LPA) was used to explore the co-occurrence of PTSD, depression, anxiety, and PTG. Multiple logistics regression was used to analyze the influence of family function on different categories of post-traumatic response.

Results

There were three categories of post-traumatic reactions in adolescents infected with COVID-19 adolescents infected with COVID-19, namely: growth class, struggling class, and pain class. Multivariate Logistic regression showed that the growth class and struggling class were affected by problem solving and behavior control in family function, while the growth class and pain class were affected by problem solving, roles, behavior control, and general functioning. Multiple logistic regression showed that the growth class and struggling class were affected by problem solving and roles.

Conclusions

The findings of this study provide evidence for the identification of high-risk individuals and the provision of effective interventions in clinical practice, as well as the influence of family functioning on the different categories of PTSD among adolescents infected with COVID-19.

Resilience, well-being and informal and formal support in multi-problem families during the Covid-19 pandemic

BACKGROUND

The Covid-19 pandemic may have had negative effects on youth and parental mental health, especially in high-risk populations such as multi-problem families (i.e., families that experience problems in multiple domains, such as mental health and social network problems). Using one to four assessments during all phases of the Covid-19 pandemic up until January 2022, we examined the associations between pandemic-related stress and mental health (resilience and well-being) of youth and parents from multi-problem families. We also investigated whether experienced informal (i.e., youth informal mentoring) and formal support (i.e., therapist support) served as protective factors in this association.

METHODS

A total of 92 youth aged 10-19 years (46.7% girls; mean age 16.00 years) and 78 parents (79.5% female; mean age 47.17 years) filled in one to four questionnaires between March 2020 and January 2022. Multi-level analyses were conducted to account for the nested structure of the data.

RESULTS

For youth, pandemic-related stress was associated with lower well-being, but not with resilience. Perceived support from both mentors and therapists was positively associated with youth mental health. Furthermore, high perceived therapist support protected youth from the negative effect of pandemic-related stress on resilience. For parents, pandemic-related stress was not related to mental health, irrespective of therapist support. Yet, therapist support was directly and positively associated with parental mental health.

CONCLUSIONS

Youth from multi-problem families who experience pandemic-related stress are at risk of (elevated) mental health problems during the pandemic, specifically if they have no or weak therapist support. The mental health of parents, however, was minimally affected by pandemic-related stress, indicating strength and flexibility. Youth and parents who experienced support during the pandemic reported higher levels of resilience and well-being, demonstrating the importance of support for individuals' mental health during stressful times such as a pandemic.