Mental Health Profiles in a Sample of Moroccan High School Students: Comparison Before and During the COVID-19 Pandemic

BACKGROUND

Adolescent high school students may be particularly susceptible to suffering from the effect of isolation, physical distancing restrictions, and school closures imposed during the COVID-19 (Corona Virus Disease 2019) pandemic. Given the biological and psychological changes that occur during this period of development, adolescents' experiences of these pandemic measures could significantly threaten their mental health and cause long-term consequences.

AIM

The main objectives of the study were to determine the impact of confinement because of the COVID-19 pandemic restrictions on the psychological distress of Moroccan adolescents and identify the risk and protective factors that could influence their mental health.

METHODS

The participants in this study were Moroccan high school students who were recruited at two different times-before the COVID-19 pandemic (350 students, mean age: 16.55 years; 53.71% female; data collected in 2014/2015) and after the announcement of the pandemic (457 students, mean age: 16.84; 64.1% female; data collected in 2020). Students responded to an anonymous survey that included several validated instruments, such as the Brief Symptom Inventory and the Godin-Shephard Leisure-Time Physical Activity questionary, and elicited information about the students' psychosocial environment, gender, and age. The scores on the Brief Symptom Inventory dimensions from the pre-pandemic period and during 2020 were compared. A comparison between the scores of the two genders of the 2020 sample was also carried out. In addition, binary regression analysis was performed to predict the associations between gender, frequency of physical activity, the presence of the number of negative psychosocial factors, and those dimensions of the Brief Symptom Inventory that significantly changed between the samples.

RESULTS

Female students reported higher psychological distress than male students in both data collection periods. During the COVID-19 pandemic, students scored significantly (p < 0.001) higher in depression and paranoid ideation, and they scored significantly (p = 0.01) lower in hostility and anxiety compared with the pre-pandemic period. Female gender and the experience of physical or psychological abuse significantly increased the risk of reporting higher scores in depression and paranoid ideation symptoms during 2020. Moderate and frequent physical activities were significantly and negatively associated with depression (p = 0.003 and p = 0.004; respectively).

CONCLUSIONS

This study confirms the stressful impact of the COVID-19 pandemic on Moroccan high school students, who reported more symptoms of depression and paranoid ideation compared with the pre-COVID-19 period. Female students reported higher psychological distress than male students did. The experience of physical /psychological abuse during the pandemic worsened mental health, while moderate/frequent physical activity improved it.

Youth experiencing transitional and temporary homelessness: A pilot study

Homeless youth represent a vulnerable and understudied population, particularly those among them who are hidden, experiencing transitional or temporary homelessness. Little research focuses on this group, including the methods and settings to identify and tailor interventions to their circumstances. Given the immediate risks and possible transition to chronic homelessness, their identification is critical for prevention and intervention efforts. This exploratory pilot study investigated transitional and temporary homelessness among youth. The study demonstrated the ability to identify such participants. Twenty participants completed a survey that measured demographics, behavioral risk factors, and the Brief Symptom Inventory (BSI; Derogatis, 1993). Reports of relationships with parents varied. They included positive maternal relationships, but also concerns about intrafamilial conflict. While frequent change of schools was reported, generally positive feelings toward school were expressed. Social relationships suggest limited exposure to other homeless youth. Some substance abuse was noted, possibly at lower rates than expected for hard drugs. The BSI results are suggestive of health concerns. The study demonstrated that it is possible to capture children experiencing transitional or temporary homelessness in alternative school settings. It is essential that efforts be made to identify them and provide early supports toward preventing chronic homelessness.

Evaluating the Responsiveness to Therapeutic Change with Routine Outcome Monitoring: A Comparison of the Symptom Questionnaire-48 (SQ-48) with the Brief Symptom Inventory (BSI) and the Outcome Questionnaire-45 (OQ-45)

Assessment of psychological distress is important, because it may help to monitor treatment effects and predict treatment outcomes. We previously developed the 48-item Symptom Questionnaire (SQ-48) as a public domain self-report psychological distress instrument and showed good internal consistency as well as good convergent and divergent validity among clinical and non-clinical samples. The present study, conducted among psychiatric outpatients in a routine clinical setting, describes additional psychometric properties of the SQ-48. The primary focus is on responsiveness to therapeutic change, which to date has been rarely examined within psychiatry or clinical psychology. Since a questionnaire should also be stable when no clinically important change occurs, we also examined test-retest reliability within a test-retest design before treatment (n = 43). A pre-treatment/post-treatment design was used for responsiveness to therapeutic change, comparing the SQ-48 with two internationally widely used instruments: the Brief Symptom Inventory (n = 97) and the Outcome Questionnaire-45 (n = 109). The results showed that the SQ-48 has excellent test-retest reliability and good responsiveness to therapeutic change, without significant differences between the questionnaires in terms of responsiveness. In sum, the SQ-48 is a psychometrically sound public domain self-report instrument that can be used for routine outcome monitoring, as a benchmark tool or for research purposes. Copyright © 2015 John Wiley & Sons, Ltd. Key Practitioner Message The SQ-48 is developed as a public domain self-report questionnaire, in line with growing efforts to develop clinical instruments that are free of charge. The SQ-48 has excellent test-retest reliability and good responsiveness to therapeutic change or patient progress. There were no significant differences in terms of responsiveness between the SQ-48 and BSI or OQ-45. The SQ-48 can be used as a routine evaluation outcome measure for quality assurance in clinical practice. Providing feedback on patient progress via outcome measures could contribute to the enhancement of treatment outcomes.

Bifactor structural model of symptom checklists: SCL-90-R and Brief Symptom Inventory (BSI) in a non-clinical community sample

The Derogatis symptom checklist (SCL-90-R) and its short version, the Brief Symptom Inventory (BSI), are widely used instruments, despite the fact that their factor structures were not clearly confirmed. The goals of this research were to compare four measurement models of these instruments including one-factor, nine-factor, a second-ordered factor model and a bifactor model, in addition to testing the gender difference in symptom factors in a community sample. SCL-90-R was assessed in a large community survey which included 2710 adults who represent the population of Hungary. Statistical analyses included a series of confirmatory factor analyses and multiple indicator multiple cause (MIMIC modeling). The responses to items were treated as ordinal scales. The analysis revealed that the bifactor model yielded the closest fit in both the full SCL-90-R and BSI; however the nine-factor model also had an acceptable level of fit. As for the gender differences, women scored higher on global severity, somatization, obsession-compulsion, interpersonal sensitivity, depression and anxiety factors. Men scored higher on hostility and psychoticism. The bifactor model of symptom checklist supports the concept of global symptom severity and specific symptom factors. Global symptom severity explains the large correlations between symptom factors.