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Muhyie JH, Yayeh D, Kidanie SA, Metekia WA, Tilahun T. Synthesizing the impact of armed conflicts on food security, livelihoods and social dynamics in Amhara region, Ethiopia. BMC Nutr 2025; 11:29. [PMID: 39901262 PMCID: PMC11789359 DOI: 10.1186/s40795-025-01013-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Accepted: 01/21/2025] [Indexed: 02/05/2025] Open
Abstract
BACKGROUND Armed conflicts cause food insecurity and famine by triggering the disruption and destruction of food systems. The conflict that erupted in northern Ethiopia lasted from 2020 to 2022 and affected millions of people. This resulted in severe damage to the food security, livelihoods and social dynamics of communities in the Amhara region. OBJECTIVE This study synthesized the impact of the conflict in northern Ethiopia on food security, livelihoods and social dynamics livelihoods in there zones, South Wello, North Wello and North Shewa zones of the Amhara Region. The conflict management response and the scope of humanitarian assistance are also analyzed. METHODS The study used a qualitative case study design. Primary data were collected through semi-structured interviews, focus group discussions and observation. Data were collected from local authorities, representatives of displaced people, government and non-government officials who responded to the crisis and from the community members who were directly affected by the conflict. The primary data were supplemented by a review of reports from credible secondary sources. The research used thematic and narrative analysis techniques to synthesize the impact of armed conflicts on food security, livelihoods, and social dynamics in Amhara region, Ethiopia. RESULTS Over 5.5 million people found to be affected by acute food insecurity and over half a million people were internally displaced due to the Northern conflict. The monetary value of the damage caused by the armed conflict is estimated at $500 million, due to the damage to basic services and the loss of 14 million quintals of agricultural production. The conflict has disrupted food systems by damaging agricultural infrastructure, causing market distortions and causing food shortages. Livelihoods were threatened by the loss of jobs and the destruction of private and municipal property. The destruction of the basic infrastructure such as health, water and sanitation, agriculture and market institutions inevitably have lasting negative impacts on the overall productivity of the community. Communities' religious and traditional values, informal social networks are affected by the impact of armed conflict, complicating communities' reconstruction efforts. CONCLUSION AND RECOMMENDATION The northern armed conflict has significant negative impacts on the food security, livelihoods and social dynamics of people in the Amhara region. Recognizing the multiple impacts of conflict livelihoods in the region is a critical step in developing effective responses. Government, non-governmental organizations, and community-based institutions should play a crucial role in building community resilience and support post-conflict reconstruction efforts. Future studies can capitalize on this qualitative finding and could design a large scale assessment using quantified data to further provide evidence on post-conflict reconstruction efforts.
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Affiliation(s)
- Jemal Hassen Muhyie
- Centre for Food Security Studies, College of Development Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | - Desalegn Yayeh
- Centre for Food Security Studies, College of Development Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | | | | | - Temesgen Tilahun
- Centre for Food Security Studies, College of Development Studies, Addis Ababa University, Addis Ababa, Ethiopia
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Chan JK, Marzuki AA, Vafa S, Thanaraju A, Yap J, Chan XW, Harris HA, Todi K, Schaefer A. A systematic review on the relationship between socioeconomic conditions and emotional disorder symptoms during Covid-19: unearthing the potential role of economic concerns and financial strain. BMC Psychol 2024; 12:237. [PMID: 38671542 PMCID: PMC11046828 DOI: 10.1186/s40359-024-01715-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 04/07/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Covid-19 has disrupted the lives of many and resulted in high prevalence rates of mental disorders. Despite a vast amount of research into the social determinants of mental health during Covid-19, little is known about whether the results are consistent with the social gradient in mental health. Here we report a systematic review of studies that investigated how socioeconomic condition (SEC)-a multifaceted construct that measures a person's socioeconomic standing in society, using indicators such as education and income, predicts emotional health (depression and anxiety) risk during the pandemic. Furthermore, we examined which classes of SEC indicators would best predict symptoms of emotional disorders. METHODS Following PRISMA guidelines, we conducted search over six databases, including Scopus, PubMed, etc., between November 4, 2021 and November 11, 2021 for studies that investigated how SEC indicators predict emotional health risks during Covid-19, after obtaining approval from PROSPERO (ID: CRD42021288508). Using Covidence as the platform, 362 articles (324 cross-sectional/repeated cross-sectional and 38 longitudinal) were included in this review according to the eligibility criteria. We categorized SEC indicators into 'actual versus perceived' and 'static versus fluid' classes to explore their differential effects on emotional health. RESULTS Out of the 1479 SEC indicators used in these 362 studies, our results showed that 43.68% of the SEC indicators showed 'expected' results (i.e., higher SEC predicting better emotional health outcomes); 51.86% reported non-significant results and 4.46% reported the reverse. Economic concerns (67.16% expected results) and financial strains (64.16%) emerged as the best predictors while education (26.85%) and living conditions (30.14%) were the worst. CONCLUSIONS This review summarizes how different SEC indicators influenced emotional health risks across 98 countries, with a total of 5,677,007 participants, ranging from high to low-income countries. Our findings showed that not all SEC indicators were strongly predictive of emotional health risks. In fact, over half of the SEC indicators studied showed a null effect. We found that perceived and fluid SEC indicators, particularly economic concerns and financial strain could best predict depressive and anxiety symptoms. These findings have implications for policymakers to further understand how different SEC classes affect mental health during a pandemic in order to tackle associated social issues effectively.
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Affiliation(s)
- Jee Kei Chan
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia.
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia.
- Sunway University Malaysia, Room: 4-4-11, Jalan Lagoon Selatan, Bandar Sunway, Petaling Jaya, 47500, Selangor, Malaysia.
| | - Aleya A Marzuki
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Samira Vafa
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Arjun Thanaraju
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Jie Yap
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Xiou Wen Chan
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Hanis Atasha Harris
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Khushi Todi
- Department of Psychology, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
| | - Alexandre Schaefer
- Department of Psychology, Sunway University Malaysia, Jalan Universiti, No 5, 47500, Bandar Sunway, Petaling Jaya, Selangor Darul Ehsan, Malaysia
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Abbass K, Basit A, Niazi AAK, Mufti R, Zahid N, Qazi TF. Evaluating the social outcomes of COVID-19 pandemic: empirical evidence from Pakistan. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:61466-61478. [PMID: 35306646 PMCID: PMC8934127 DOI: 10.1007/s11356-022-19628-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 03/05/2022] [Indexed: 05/10/2023]
Abstract
The study aims to assess and analyze the social outcomes of the COVID-19 pandemic. The study uses the discourse of comprehensive literature review to identify the outcomes, Interpretive Structural Modeling (ISM) for developing a structural model and Matrices' Impacts Cruise's Multiplication Appliquée a UN Classement (MICMAC) for analysis, classification of societal outcomes, and corroboration of results of ISM. Data from fifteen experts was collected through a survey questionnaire. As a result of the literature review, a list of sixteen outcomes was generated and verified by a panel of experts. Results of ISM revealed that the outcomes, namely, "emotional instability," "mental health self-harm," loneliness reduced recreational activities, obesity, and "increased screen time" come at the top of the model; therefore, they are less vital outcomes, whereas the most significant outcome which is at the bottom of the model is "employment instability"; hence it has a major impact on the society. The remaining outcomes fall in the middle of the model, so they have a moderate-severe impact. Results of MICMAC validate the findings of ISM. Overall findings of the study reveal that "employment instability" is the crucial social outcome of the COVID-19 pandemic. It is an original attempt based on real-time data, which is helpful for society at large, researchers, the international community, and policymakers because this study provides a lot of new information about the phenomenon. The study includes understanding society at large, policymakers, and researchers by illustrating the complex relations and simplifying the connections among a wide range of social outcomes of COVID-19.
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Affiliation(s)
- Kashif Abbass
- School of Economics and Management, Nanjing University of Science and Technology, Nanjing, 210094 China
- Riphah School of Business and Management, Riphah International University Lahore, Raiwind Campus, Lahore, Pakistan
| | - Abdul Basit
- Lahore Institute of Science and Technology, Lahore, Pakistan
| | - Abdul Aziz Khan Niazi
- Institute of Business and Management, University of Engineering and Technology, Lahore, Pakistan
| | - Ramish Mufti
- Lahore Institute of Science and Technology, Lahore, Pakistan
| | - Nauman Zahid
- Lahore Institute of Science and Technology, Lahore, Pakistan
| | - Tehmina Fiaz Qazi
- Hailey College of Banking and Finance, University of the Punjab, Lahore, Pakistan
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Tang Y, Shao Y, He T, Wang Y, Hinshaw SP, Lin X. Latent profiles of adolescents' relationships with parents and siblings: Associations with emotional and behavioral responses during the COVID-19 pandemic. CURRENT PSYCHOLOGY 2022; 42:1-12. [PMID: 36540694 PMCID: PMC9756743 DOI: 10.1007/s12144-022-03959-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/30/2022] [Indexed: 12/23/2022]
Abstract
The purpose of this study is to identify the latent profiles of Chinese adolescents' family (parent-adolescent and sibling) relationships prior to and during the COVID-19 pandemic, as well as associations between those profiles and adolescents' emotional and behavioral responses. A total of 2,305 adolescents from China aged between 10 and 18 years completed measures of parent-adolescent relationships, sibling relationships, and emotional and behavioral responses during the pandemic. Four profiles of family relationships were identified via latent profile analysis and categorized as Cohesive-Decline, Mild-Decline, Conflictual-Stable, and Indifferent-Stable. Adolescents with a Conflictual-Stable profile reported more emotional and behavioral responses compared to the other profiles. In contrast, adolescents with a Cohesive-Decline profile exhibited fewer emotional responses compared to the other profiles. Adolescents with a Mild-Decline profile had fewer emotional responses than those with an Indifferent-Stable profile. These results shed light on the patterns and consequences of family relationships during the COVID-19 pandemic and have substantial implications for interventions involving family relationships in the context of regular epidemic prevention and control.
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Affiliation(s)
- Yingying Tang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875 China
| | - Yingmiao Shao
- Faculty of Psychology, Beijing Normal University, Beijing, 100875 China
| | - Ting He
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875 China
| | - Yulong Wang
- Department of Psychology, Hunan Normal University, Changsha, 410081 China
| | - Stephen P. Hinshaw
- Department of Psychology, University of California, Berkeley, CA 94720 USA
| | - Xiuyun Lin
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, 100875 China
- Beijing Key Laboratory of Applied Experimental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
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Saemi E, Nobari H, Badicu G, Ghazizadeh H, Pashabadi A, Imani F, Clemente FM, Silva AF, Afrash S. The impact of COVID-19 pandemic restrictions on physical activity and mental health status of Iranian people. BMC Sports Sci Med Rehabil 2022; 14:186. [PMID: 36309739 PMCID: PMC9617045 DOI: 10.1186/s13102-022-00584-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 10/21/2022] [Indexed: 12/03/2022]
Abstract
Background Coronavirus-19 (COVID-19) is a highly contagious disease caused by acute respiratory syndrome that can negatively impact physical activity as well as mental health of people in the world. Since Iran is one of the countries deeply affected by the COVID-19 pandemic, therefore, the aim of this study was to investigate the impact of the COVID-19 pandemic restrictions on physical activity behaviours, as well as on mental health indicators among Iranian people.
Methods In this cross-sectional study, 335 participants were included (155 males, mean age = 30.06 ± 14.58 years). Participants were selected through the convenience sampling from different parts of Iran mainly through virtual social networks and filled out an electronic questionnaire in the form of Google Form online survey measuring physical activity behaviours (The International Physical Activity Questionnaire; IPAQ; Short Form) and two mental health indicators–self-esteem (Rosenberg self-esteem scale) and social physical anxiety (7-items social physique anxiety scale). The questionnaires were provided to the participants in the spring of 2021 for 15 days and they were asked to answer it in two periods before the outbreak of coronavirus (winter 2020) and the period during the outbreak of coronavirus (spring 2021). Results The results showed that participants reported significant differences from before to during the pandemic in all three variables of physical activity (significant decreases), self-esteem (significant decreases), and social physical anxiety (significant increases) regardless of participants’ gender. The results of correlation test between changes in physical activity and changes in mental health indicators showed that COVID-19 pandemic negatively impacted self-esteem and social physical anxiety. However, we have not found any significant association of physical activity’s change with social physical anxiety or self-esteem’s changes before and during the pandemic. Conclusions The findings of the present study indicate a detrimental effect of the COVID-19 pandemic on the physical activity and mental health among Iranian people. Public policies aiming to buffer the negative impact on COVID-19 Iranians’ health are urgently needed.
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Affiliation(s)
- Esmaeel Saemi
- Department of Motor Behavior and Sport Psychology, Faculty of Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz, 6135783151, Iran.
| | - Hadi Nobari
- Department of Exercise Physiology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, 56199-11367, Iran. .,Faculty of Sport Sciences, University of Extremadura, 10003, Cáceres, Spain. .,Department of Physical Education and Special Motricity, Faculty of Physical Education and Mountain Sports, Transilvania University of Braşov, 500068, Braşov, Romania.
| | - Georgian Badicu
- Department of Physical Education and Special Motricity, Faculty of Physical Education and Mountain Sports, Transilvania University of Braşov, 500068, Braşov, Romania
| | - Habibollah Ghazizadeh
- Department of Motor Behavior and Sport Psychology, Faculty of Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz, 6135783151, Iran
| | - Ali Pashabadi
- Department of Motor Behavior, Faculty of Sport Sciences, Kharazmi University, Tehran, 1571914911, Iran
| | - Fatemeh Imani
- Department of Sport Biological Sciences, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, 1983969411, Iran
| | - Filipe Manuel Clemente
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun'Álvares, 4900-347, Viana do Castelo, Portugal
| | - Ana Filipa Silva
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun'Álvares, 4900-347, Viana do Castelo, Portugal
| | - Sana Afrash
- Department of Motor Behavior and Sport Psychology, Faculty of Sport Sciences, Shahid Chamran University of Ahvaz, Ahvaz, 6135783151, Iran
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Kang S, Jeong Y, Park EH, Hwang SS. The Impact of Household Economic Deterioration Caused by the COVID-19 Pandemic and Socioeconomic Status on Suicidal Behaviors in Adolescents: A Cross-sectional Study Using 2020 Korea Youth Risk Behavior Web-based Survey Data. J Prev Med Public Health 2022; 55:455-463. [PMID: 36229908 PMCID: PMC9561140 DOI: 10.3961/jpmph.22.241] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 08/19/2022] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Economic hardship has a serious impact on adolescents' mental health. The financial impact of the coronavirus disease 2019 (COVID-19) pandemic was more severe for low-income families, and this also impacted adolescents. This study aimed to examine the associations of economic deterioration (ED) caused by the COVID-19 pandemic and low socioeconomic status (SES) with adolescents' suicidal behaviors. METHODS This study analyzed data from the 2020 Korea Youth Risk Behavior Web-based Survey, which included 54 948 middle and high school students. Odds ratios (ORs) of suicidal ideation, suicidal planning, and suicide attempts related to ED and SES were calculated using multivariable logistic regression. We calculated relative excess risks due to interaction to assess additive interactions. RESULTS The ORs for suicidal ideation, suicidal planning, and suicide attempts related to combined severe ED and low SES were 3.64 (95% confidence interval [CI], 3.13 to 4.23), 3.88 (95% CI, 3.09 to 4.88), and 4.27 (95% CI, 3.21 to 5.69), respectively. CONCLUSIONS ED and low SES were significantly associated with suicidal behaviors in adolescents. Although no significant additive interaction was found, the ORs related to suicidal ideation, suicidal planning, and suicide attempts were highest among adolescents from low-income families with severe ED. Special attention is needed for this group, considering the increased impact of economic inequality due to the COVID-19 pandemic.
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Affiliation(s)
- Sanggu Kang
- Department of Preventive Medicine, Graduate School of Public Health, Seoul National University, Seoul,
Korea
| | - Yeri Jeong
- Department of Preventive Medicine, Graduate School of Public Health, Seoul National University, Seoul,
Korea
| | - Eun Hye Park
- Graduate School of Public Health, Seoul National University, Seoul,
Korea
| | - Seung-sik Hwang
- Department of Preventive Medicine, Graduate School of Public Health, Seoul National University, Seoul,
Korea
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Chang B, Hou J. The Association Between Perceived Risk of COVID-19, Psychological Distress, and Internet Addiction in College Students: An Application of Stress Process Model. Front Psychol 2022; 13:898203. [PMID: 35795419 PMCID: PMC9252417 DOI: 10.3389/fpsyg.2022.898203] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 05/19/2022] [Indexed: 01/28/2023] Open
Abstract
The closed-off management of the university during coronavirus disease 2019 (COVID-19) may be associated with an elevated odds of psychological and behavioral issues among college students. We aimed to use the stress-process model to explore the potential mechanisms for this phenomenon. A total of 924 college students were recruited via posters, peer referrals, and class attendance. Among them, 82 (9%) were probable depression, 190 (20.8%) were probable anxiety, and 69 (7.5%) were internet addiction. Parallel mediation was used to test this theoretical model. For personal resources, the perceived risk of COVID-19 was positively associated with psychological distress via negative coping style (β = 0.051) and internet addiction via negative coping style or self-esteem (β = 0.023 for negative coping style, β = 0.015 for self-esteem). For social resources, the perceived risk of COVID-19 was positively associated with psychological distress and internet addiction via roommate relationships (β = 0.19 for psychological distress, β = 0.046 for internet addiction). Negative coping styles and roommate relationships are possible psychological mechanisms linking the perceived risk of COVID-19, psychological distress, and internet addiction.
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Affiliation(s)
- Biru Chang
- School of Preschool Education, Xi’an University, Xi’an, China
| | - Jianhua Hou
- Department of Social and Behavioural Sciences, City University of Hong Kong, Kowloon, Hong Kong SAR, China
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Windarwati HD, Lestari R, Supianto AA, Wicaksono SA, Ati NAL, Kusumawati MW, Humayya A, Ekawati D. A narrative review into the impact of COVID-19 pandemic on senior high school adolescent mental health. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2022; 35:206-217. [PMID: 35199403 PMCID: PMC9114999 DOI: 10.1111/jcap.12370] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 01/08/2022] [Accepted: 02/13/2022] [Indexed: 12/25/2022]
Abstract
Problem High school teenagers are facing significant challenges during the COVID‐19 pandemic. Teenagers are at risk of experiencing physical, mental, and social health problems due to the COVID‐19 pandemic. This narrative review aims to explore the impact of COVID‐19 on the emergence of mental health problems in high school adolescents. Methods This study employed a narrative review method. We conducted a systematic search using PRISMA on three databases: Medline, PubMed, and ScienceDirect. A total of 40 articles met the inclusion and exclusion criteria set based on the research objectives. Findings The study uncovered that high school adolescents had an increased risk of experiencing mental health problems, namely psychological distress, worry, loneliness, anxiety, depression, traumatic symptoms, other psychological disorders, suicide risk, sleep disorders, and psychosocial functioning. Anxiety, depression, and psychological stress were the most discussed mental health problems among high school adolescents during the COVID‐19 pandemic. Conclusions There is a need for efforts to identify health problems and intervene in mental health problems early in high school adolescents. Schools, mental health workers, and the government (e.g., policy stakeholders) need to implement the recommendations given as a follow‐up effort for mental health services for high school youth.
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Affiliation(s)
- Heni D Windarwati
- Department of Mental Health Nursing, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Retno Lestari
- Department of Mental Health Nursing, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Ahmad A Supianto
- Faculty of Computer Science, Universitas Brawijaya, Malang, Indonesia
| | | | - Niken A L Ati
- Department of Research, Saintek Medika Nusantara, Jombang Regency, Indonesia
| | - Mira W Kusumawati
- Department of Mental Health Nursing, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Atin Humayya
- Department of Mental Health Nursing, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
| | - Dessy Ekawati
- Department of Mental Health Nursing, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia
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