The effects of social deprivation on adolescent development and mental health

"I Hate This": A Qualitative Analysis of Adolescents' Self-Reported Challenges During the COVID-19 Pandemic

PURPOSE

The COVID-19 pandemic presents unique challenges for adolescents because of disruptions in school and social life. We compiled a diverse group (36.8% nonwhite or multiracial) of high schoolers' open-ended responses to the question: "What are your three biggest challenges right now?" (N = 719 adolescents).

METHODS

Using open and axial coding, we identified N = 1,902 thematic units (M = 2.64, SD = .701) and 14 thematic categories, including mental health, physical health, family, friends, social connection and community, academics, missing important events, socioeconomic issues, routine, COVID rules and adjustment, contraction/exposure to COVID, technology, and future plans.

RESULTS

Adolescents most commonly reported challenges related to academics (23.7%) but also cited high numbers of challenges in mental (14.8%) and physical (13.2%) health and friend (11.4%) domains.

CONCLUSIONS

Efforts should focus on helping adolescents cultivate academic skills needed during school closures, providing mental/physical health resources and helping them navigate peer relationships-especially given ongoing remote education and social distancing due to the pandemic.

"I Hate This": A Qualitative Analysis of Adolescents' Self-Reported Challenges During the COVID-19 Pandemic

PURPOSE

The COVID-19 pandemic presents unique challenges for adolescents because of disruptions in school and social life. We compiled a diverse group (36.8% nonwhite or multiracial) of high schoolers' open-ended responses to the question: "What are your three biggest challenges right now?" (N = 719 adolescents).

METHODS

Using open and axial coding, we identified N = 1,902 thematic units (M = 2.64, SD = .701) and 14 thematic categories, including mental health, physical health, family, friends, social connection and community, academics, missing important events, socioeconomic issues, routine, COVID rules and adjustment, contraction/exposure to COVID, technology, and future plans.

RESULTS

Adolescents most commonly reported challenges related to academics (23.7%) but also cited high numbers of challenges in mental (14.8%) and physical (13.2%) health and friend (11.4%) domains.

CONCLUSIONS

Efforts should focus on helping adolescents cultivate academic skills needed during school closures, providing mental/physical health resources and helping them navigate peer relationships-especially given ongoing remote education and social distancing due to the pandemic.

Reopening schools safely in the face of COVID-19: Can cluster randomized trials help?

The COVID-19 pandemic has highlighted the challenges of evidence-based health policymaking, as critical precautionary decisions, such as school closures, had to be made urgently on the basis of little evidence. As primary and secondary schools once again close in the face of surging infections, there is an opportunity to rigorously study their reopening. School-aged children appear to be less affected by COVID-19 than adults, yet schools may drive community transmission of the virus. Given the impact of school closures on both education and the economy, schools cannot remain closed indefinitely. But when and how can they be reopened safely? We argue that a cluster randomized trial is a rigorous and ethical way to resolve these uncertainties. We discuss key scientific, ethical, and resource considerations both to inform trial design of school reopenings and to prompt discussion of the merits and feasibility of conducting such a trial.

Early Life Stress Predicts Depressive Symptoms in Adolescents During the COVID-19 Pandemic: The Mediating Role of Perceived Stress

BACKGROUND

Exposure to early life stress (ELS) is alarmingly prevalent and has been linked to the high rates of depression documented in adolescence. Researchers have theorized that ELS may increase adolescents' vulnerability or reactivity to the effects of subsequent stressors, placing them at higher risk for developing symptoms of depression.

METHODS

We tested this formulation in a longitudinal study by assessing levels of stress and depression during the COVID-19 pandemic in a sample of adolescents from the San Francisco Bay Area (N = 109; 43 male; ages 13-20 years) who had been characterized 3-7 years earlier (M = 5.06, SD = 0.86 years) with respect to exposure to ELS and symptoms of depression.

RESULTS

As expected, severity of ELS predicted levels of depressive symptoms during the pandemic [r(107) = 0.26, p = 0.006], which were higher in females than in males [t(107) = -3.56, p < 0.001]. Importantly, the association between ELS and depression was mediated by adolescents' reported levels of stress, even after controlling for demographic variables.

CONCLUSIONS

These findings underscore the importance of monitoring the mental health of vulnerable children and adolescents during this pandemic and targeting perceived stress in high-risk youth.

La sexualité pendant la pandémie COVID-19 – de l’importance d’Internet

Le coronavirus est une maladie infectieuse qui a affecté de nombreux pays. Pour les couples, les contacts physiques ont diminué et la vie sexuelle en a été altérée. Une sexualité sans risque implique de savoir comment éviter la transmission du virus. La distance physique crée de l’irritabilité, de la peur, et menace la vie sexuelle : il est raisonnable pour un couple vivant sous le même toit d’avoir des relations sexuelles sauf si l’un d’entre eux présentent un risque d’infection. Tous les couples confinés séparément n’ont pas nécessairement envie d’avoir des relations sexuelles en ligne et pour les personnes qui ne sont pas en couple, il est difficile de s’engager dans des relations sexuelles récréatives. En dépit de cela, la pandémie permet d’envisager une nouvelle intimité sexuelle utilisant des sex toys et de la technologie. L’utilisation d’internet pour maintenir une activité sexuelle active semble avoir été une excellente alternative pour pallier la distance physique entre les partenaires. Le conseil le plus couramment donné aux membres de couples confinés seuls était de maintenir un contact électronique constant pour atténuer la nostalgie et compenser le manque d’activité sexuelle. Ceci entraîna l’essor des sextos, des rencontres par webcam ou des appels téléphoniques érotiques contribuant à la désinhibition des couples. L’utilisation de la webcam, associée à l’utilisation de sex toys, permet également d’enrichir le répertoire sexuel. La pratique du sexe en ligne avec le partenaire stable ne vivant pas sous le même toit a aidé certaines personnes à maintenir leur désir et à le satisfaire et préserver celui-ci intact en vue de la fin de la pandémie. L’objectif de ce travail est de passer en revue les données disponibles sur la sexualité pendant les pandémies COVID-19 et de fournir des recommandations pour aider la population à vivre et préserver sa sexualité dans cette période critique.

Mental Distress and Its Contributing Factors Among Young People During the First Wave of COVID-19: A Belgian Survey Study

Background: The outbreak of the COVID-19 pandemic in 2020 and its associated measures led to high levels of mental distress in the general population. Previous research indicated that young people are especially vulnerable for a wide range of mental health problems during the pandemic, but little is known about the mechanisms. This study examined mental distress and its contributing factors among young Belgian people. Methods: An online survey was widely distributed in Belgium during the first wave of COVID-19 in March, and 16-25-year-olds were selected as a subsample. Mental distress was assessed using the 12-item General Health Questionnaire (GHQ-12), and a threshold of ≥4 was used to discriminate mental distress cases from non-cases. Bivariate and multivariable logistic regression analyses were performed to evaluate possible predictors of mental distress, including demographics, chronic condition, history of mental health problems, social support, exposure to COVID-19, and several changes in everyday activities. Results: A total of 2,008 respondents were included, of which the majority was female (78.09%) and student (66.82%). The results indicate that about two thirds (65.49%) experienced mental distress. In the multivariable regression model, significant (p < 0.01) predictors of mental distress were female gender (OR = 1.78), low social support (OR = 2.17), loneliness (OR = 5.17), a small (OR = 1.63), or large (OR = 3.08) increase in social media use, a small (OR = 1.63) or large (OR = 2.17) decrease in going out for drinks or food, and a decrease in doing home activities (OR = 2.72). Conclusion: Young people experience high levels of mental distress during the COVID-19 pandemic. Our findings indicate that mental distress was highest among women, those experiencing loneliness or low social support and those whose usual everyday life is most affected. The psychological needs of young people, such as the need for peer interaction, should be more recognized and supported.

Legal and Ethical Issues Regarding Minors in the Italian Coronavirus Flu Emergency

On February 21, 2020, Italy became one of the countries hit by an epidemic of the new coronavirus that causes "severe acute respiratory syndrome coronavirus 2" (SARS-CoV-2). Even a month before that, however, the Italian government began issuing a series of decrees and ordinances aimed at the containment of the virus in Italy, the first of them on January 25, 2020. The COVID 19 infection has been faced as an epidemic through measures to enforce a high degree of isolation. These regulations hold for minors, as well, with consequent difficulties for this age group. While at the moment young people appear to be the least vulnerable to the severe complications of COVID 19, the psychological problems that may be brought on by pandemic-related restrictions should be taken into serious consideration.

Quality of life and occupational performance of children with cancer in the era of the COVID-19 pandemic in terms of rehabilitation

PURPOSE

This study was designed to determine the changes in the quality of life (QOL) and occupational performance of children with cancer and to examine their rehabilitation needs during the pandemic period in Turkey.

METHODS

60 children with cancer and their families participated in the study. The first and second assessments were carried out in April and September 2020, respectively. The pediatric quality of life inventory parent proxy-report was used to evaluate the QOL, and the Canadian occupational performance measurement was used to evaluate children's occupational performance and satisfaction. A qualitative interview was planned to determine the impact of the pandemic on children with cancer alongside their families and therefore determining the rehabilitation needs of the children.

RESULTS

While there is no statistically significant change in the pain-related conditions of the children in the first six months of the pandemic (p > 0.05), procedural and treatment anxieties of the children increased during the treatment. Their QOL including cognitive state, perceived physical appearance and communication skills also showed a statistically significant decrease (p < 0.05). Both the occupational performance and satisfaction scores decreased significantly, covering the pre-pandemic and pandemic era (p < 0.01). In the qualitative interview parents expressed their children's need for physical, psychological and social participation support. Also, they emphasized the need for time management.

CONCLUSIONS

During the COVID-19 pandemic, the QOL and occupational performance level of children with cancer decreased significantly. Holistic rehabilitation approaches complying with pandemic conditions are likely to benefit these children.

Health-Related Quality of Life in Italian Adolescents During Covid-19 Outbreak

Coronavirus disease 2019 (COVID-19) outbreak represented an experience of social isolation potentially leading to changes in the health quality of life. The aim of this study is to investigate the health-related quality of life during quarantine in early adolescents. Data were collected from 1,289 adolescents (mean age, 12.5; male, 622), at the beginning of the school year (September 2019, Standard Condition, SC) as part of the AVATAR project and during Phase 1 of the Italian lockdown (mid-late April 2020) (COVID-19 Quarantine, CQ) using an online questionnaire. In the CQ period, with respect to SC, adolescents showed lower perception in the dimensions, such as psychological (p = 0.001), physical well-being (p = 0.001), mood/emotion (p = 0.008), autonomy (p = 0.001), and financial resources (p = 0.018). Relationship with the family (p = 0.021) and peers (p = 0.001), as well as the perception of bullying (p = 0.001) were reduced. In lifestyle, adolescents developed higher adherence to the Mediterranean diet (p = 0.001). Adolescents living in the village had greater reduction in both autonomy (p = 0.002) and peer relationships (p = 0.002). Moreover, the perception of physical well-being was lower in those living in the city instead of those living in the countryside (p = 0.03), in an apartment instead of a detached house (p = 0.002), and in those who did not have green space (p = 0.001). Gender effect emerged for the psychological (p = 0.007) and physical well-being (p = 0.001), mood/emotion (p = 0.001), and self-perception (p = 0.001). The study showed that health-related quality of life during quarantine changed in its psychosocial dimensions, from mood and self-esteem to social relationships, helping to define the educational policies at multiple points in the promotion process of health.

Mood Variability Among Early Adolescents in Times of Social Constraints: A Daily Diary Study During the COVID-19 Pandemic

The COVID-19 pandemic and associated governmental regulations have drastically changed the daily social lives of children, adolescents, and adults. Changes in the social context may particularly affect children who are in the transition to adolescents (henceforth referred to as early adolescents) as adolescence is a crucial period for peer interactions and development of independence and autonomy. Yet, the impact of the pandemic and associated governmental regulations on early adolescents' emotional well-being has yet to be clarified. In the current study, we explored daily fluctuations in mood in 54 early adolescents (M _age = 11.07) during the first few months (April 2020-June 2020) of the COVID-19 pandemic. Moreover, the role of parents and peers on adolescents' mood variability was investigated. Adolescents rated their mood (i.e., happiness, anger, sadness, anxiety) and peer interactions once a day during four separate weeks across different weeks of containment measures in the Netherlands. Moreover, adolescents reported on their experienced attachment to parents and peers and internalizing problems during baseline and the final measurement, respectively. Results showed relatively stable levels of mood during the first few months of the COVID-19 pandemic. However, individual differences in mood variability during the first assessment week were negatively associated with the experienced level of attachment to both parents and peers. Moreover, heightened levels of mood variability did not mediate the link between attachment and internalizing problems. Lastly, the quality of offline contact, but not online contact, was negatively related to adolescents' mood variability. Overall, this study suggests that mood of early adolescents did not heavily fluctuated across the first few months of the COVID-19 pandemic. Our findings add to the growing body of literature aiming to understand how adolescent's life are affected by the COVID-19 crisis and illustrates that social connectedness to parents or peers may facilitate resilience to distress and daily mood fluctuation in early adolescents.

A Brain Capital Grand Strategy: toward economic reimagination

‘I have not found among my possessions anything which I hold more dear than, or value so much as, my knowledge of the actions of great people, acquired by long experience in contemporary affairs, and a continual study of antiquity.’ The Prince, Machiavelli

Sexuality during the COVID-19 pandemic: The importance of Internet

Coronavirus is an infectious disease that has affected many countries, changing daily life. For many individuals, sexual activity has decreased, physical contact within couples has been reduced. Obviously, to maintain a safe sex life, it is essential to know how to avoid the virus transmission. Distance creates irritability, fear, anxiety, endangering sexual life: it is reasonable to have sex between cohabiting partners unless one or both are at risk of infection. Despite this, the pandemic allows us to think of new sexual intimacies mediated by sextoys and technology. Not all distant couples are willing to have sex online, and it is difficult for singles to engage in casual sexual relations, so after the pandemic there will be many couples who will have to remodel and many singles who will seek a partner. Using the Internet to maintain active sexual activity appeared to be an excellent alternative to diminish the distance between partners or to increase online knowledge. The most common advice for separated couples was to maintain constant digital contact to alleviate nostalgia and lack. This was the springboard to use sexting, meeting via webcam or making a hot call that make the couple more uninhibited. Using the webcam, also sometimes with the possibility to use sex toys, could create also the opportunity to enrich the future sexual repertoire. Practicing online sex with the stable partner far from home has helped some to keep their desire active and to satisfy it in order to be able to realize it once the pandemic has ended. The purpose of this narrative review of available evidence on sexuality during COVID-19 pandemics is to provide recommendations to help people facing their sexual life in this critical period.

Social media and smartphone app use predicts maintenance of physical activity during Covid-19 enforced isolation in psychiatric outpatients

There is growing concern that the social and physical distancing measures implemented in response to the Covid-19 pandemic may negatively impact health in other areas, via both decreased physical activity and increased social isolation. Here, we investigated whether increased engagement with digital social tools may help mitigate effects of enforced isolation on physical activity and mood, in a naturalistic study of at-risk individuals. Passively sensed smartphone app use and actigraphy data were collected from a group of psychiatric outpatients before and during imposition of strict Covid-19 lockdown measures. Data were analysed using Gaussian graphical models: a form of network analysis which gives insight into the predictive relationships between measures across timepoints. Within-individuals, we found evidence of a positive predictive path between digital social engagement, general smartphone use, and physical activity-selectively under lockdown conditions (N = 127 individual users, M = 6201 daily observations). Further, we observed a positive relationship between social media use and total daily steps across individuals during (but not prior to) lockdown. Although there are important limitations on the validity of drawing causal conclusions from observational data, a plausible explanation for our findings is that, during lockdown, individuals use their smartphones to access social support, which may help guard against negative effects of in-person social deprivation and other pandemic-related stress. Importantly, passive monitoring of smartphone app usage is low burden and non-intrusive. Given appropriate consent, this could help identify people who are failing to engage in usual patterns of digital social interaction, providing a route to early intervention.

A Mobile Serious Game About the Pandemic (COVID-19 - Did You Know?): Design and Evaluation Study

Background

No treatment for COVID-19 is yet available; therefore, providing access to information about SARS-CoV-2, the transmission route of the virus, and ways to prevent the spread of infection is a critical sanitary measure worldwide. Serious games have advantages in the dissemination of reliable information during the pandemic; they can provide qualified content while offering interactivity to the user, and they have great reach over the internet.

Objective

This study aimed to develop a serious game with the purpose of providing science-based information on the prevention of COVID-19 and personal care during the pandemic while assessing players’ knowledge about COVID-19–related topics.

Methods

The study was conducted with the interdisciplinary collaboration of specialists in health sciences, computing, and design at the Federal University of Minas Gerais, Brazil. The health recommendations were grouped into six thematic blocks, presented in a quiz format. The software languages were based on the progressive web app development methodology with the Ionic framework, JavaScript, HTML5, cascading style sheets, and TypeScript (Angular). Open data reports of how users interact with the serious game were obtained using the Google Analytics application programming interface. The visual identity, logo, infographics, and icons were carefully developed by considering a selection of colors, typography, sounds, and images that are suitable for young audiences. Cards with cartoon characters were introduced at the end of each thematic topic to interact with the player, reinforcing their correct answers or alerting them to the need to learn more about the disease. The players’ performance was assessed by the rate of incorrect and correct answers and analyzed by linear correlation coefficient over 7 weeks. The agile SCRUM development methodology enabled quick and daily interactions of developers through a webchat and sequential team meetings.

Results

The game “COVID-19–Did You Know?” was made available for free on a public university website on April 1, 2020. The game had been accessed 17,571 times as of September 2020. Dissemination actions such as reports on social media and television showed a temporal correspondence with the access number. The players’ error rate in the topic “Mask” showed a negative trend (r=–.83; P=.01) over the weeks of follow-up. The other topics showed no significant trend over the weeks.

Conclusions

The gamification strategy for health education content on the theme of COVID-19 reached a young audience, which is considered to be a priority in the strategy of orientation toward social distancing. Specific educational reinforcement measures were proposed and implemented based on the players’ performance. The improvement in the users’ performance on the topic about the use of masks may reflect an increase in information about or adherence to mask use over time.

Impact of COVID-19 on adolescents’ mental health: a systematic review

Background

The impact of COVID-19 towards psychology and mental health is anticipated to be significant and may affect the population disproportionately, especially adolescent as the vulnerable category. We aimed to analyze the impact of COVID-19 towards adolescents’ mental health.

Main body

A systematic search was conducted from Cochrane, Google Scholar, Scielo, and PubMed. Inclusion criteria included all types of studies which observed the effect of COVID-19 and its related causes, such as lockdown, on adolescents’ mental health. All studies were assessed for its level of evidence according to Oxford 2011 criteria and Newcastle Ottawa Scale (NOS). Three studies (Seçer and Ulaş, Int J Ment Health Addict: 1–14, 2020; Zhou et al., Eur Child Adolesc Psychiatry 29:749–58, 2020; Qu et al., Lancet: 1–17, 2020) showed that COVID-19 was a risk factor for mental health problems in adolescents while Oosterhoff et al. (J Adolesc Health 67: 179–185, 2020) showed that adolescents who preferred to stay at home during this pandemic reported less anxiety and depressive symptoms

Conclusion

COVID-19 has been found to be associated with mental health changes in adolescents which meant management of COVID-19 should also focus on mental health as well.

Impact of COVID-19 lockdown in children with neurological disorders in Italy

Background

The costs and benefits of full lockdown measures are debated. Neurologically impaired children are a vulnerable population with specific needs in terms of protection against infection and access to health services.

Objectives

We investigated the effects of lockdown on the health of children with neurological disorders and on their access to care during lockdown.

Methods

Data from 514 children (282 males – 232 females) were collected through physician-administered interviews to investigate: the occurrence of viral-like physical symptoms, the correlation between the risk of developing such symptoms and several demographic and clinical variables, the occurrence of any worsening of the children's neurological conditions during lockdown, and their access to care services during this period.

Results

49.1% experienced at least one symptom during the study period, but no child developed severe complications. The prevalence of symptoms was significantly lower during lockdown than during the previous two months. The underlying neurological condition worsened in 11.5% of the patients. Children who regularly left the home during lockdown were greater risk of exhibiting symptoms. During lockdown, 67.7% had a specialist appointment cancelled, 52.6% contacted their paediatrician, and 30.9% contacted their child neuropsychiatrist. Among patients who usually receive rehabilitation, 49.5% continued remotely.

Conclusion

Lockdown protected children from infections. Telemedicine and telerehabilitation constituted a valid alternative for the care and treatment of these children, but they should not become a widespread and definitive model of care. COVID-19 and other emergency response plans must take into account the specific needs of children with disabilities.

Establishing a Theory-Based Multi-Level Approach for Primary Prevention of Mental Disorders in Young People

The increasing prevalence of mental health disorders and psychosocial distress among young people exceeds the capacity of mental health services. Social and systemic factors determine mental health as much as individual factors. To determine how best to address multi-level risk factors, we must first understand the distribution of risk. Previously, we have used psychometric methods applied to two epidemiologically-principled samples of people aged 14-24 to establish a robust, latent common mental distress (CMD) factor of depression and anxiety normally distributed across the population. This was linearly associated with suicidal thoughts and non-suicidal self-harm such that effective interventions to reduce CMD across the whole population could have a greater total benefit than those that focus on the minority with the most severe scores. In a randomised trial of mindfulness interventions in university students (the Mindful Student Study), we demonstrated a population-shift effect whereby the intervention group appeared resilient to a universal stressor. Given these findings, and in light of the COVID-19 pandemic, we argue that population-based interventions to reduce CMD are urgently required. To target all types of mental health determinants, these interventions must be multi-level. Careful design and evaluation, interdisciplinary work, and extensive local stakeholder involvement are crucial for these interventions to be effective.

Social Media Use and Monitoring for Adolescents With Depression and Implications for the COVID-19 Pandemic: Qualitative Study of Parent and Child Perspectives

BACKGROUND

Although youth report many positive experiences with social media (SM) use in their daily lives, adolescents with depression are more vulnerable to the risks of SM use than adolescents without depression. Parents protect adolescents with depression from the risks of SM use by monitoring their child's SM activity; however, this comes into conflict with the adolescent's need for autonomy in their web-based communication. The implications of SM use and monitoring for adolescents with depression and their parents are of particular relevance to the COVID-19 pandemic, as rates of SM use have increased in response to physical distancing measures.

OBJECTIVE

This study aims to explore parent and child perspectives regarding the use and function of SM in the daily lives of adolescents with depression and parents' perceptions of and experience with monitoring their child's SM use.

METHODS

We conducted qualitative interviews with adolescents with depression (n=23) and one parent of each adolescent (n=23) between July 2013 and September 2014. The adolescents were patients seeking treatment for depression in Pittsburgh, Pennsylvania. Data analysis included dyadic analysis of the adolescents' and parents' perspectives and qualitative descriptions of individual parent interviews to explore their experiences with SM use and monitoring. The construct of parental knowledge and factors hypothesized to contribute to parental knowledge, including adolescent disclosure, parental solicitation, and parental control, were used to guide the codebook and dyadic data analysis.

RESULTS

Dyadic analyses showed that parents and their children disagreed on the use and function of SM in the daily lives of adolescents with depression, with adolescents viewing SM as a forum for honest expression of their emotions, whereas parents felt that their children's posts were inconsequential and interfered with the adolescents' lives. Furthermore, parents reported using a wide range of strategies to gain knowledge of their child's SM use to monitor their safety on SM, including direct solicitation and indirect solicitation, such as keeping the child's passwords, asking friends or siblings about their child's SM use, and restricting SM behavior and access to devices.

CONCLUSIONS

Clinicians should support adolescents with depression and their parents in finding common ground for an effective and acceptable monitoring approach. Resources are provided for clinicians navigating conversations about SM use and monitoring with adolescents with depression and their parents during the COVID-19 pandemic.

Commensal microbe-derived propionic acid mediates juvenile social isolation-induced social deficits and anxiety-like behaviors

Social experiences during early life are thought to be critical for proper social and emotional development. Conversely, social insults during development causes long-lasting behavioral abnormalities later in life. However, how juvenile social deprivation influences social and emotional behaviors remains poorly understood. Here, we show that juvenile social isolation induces a shift in microbial ecology that negatively impacts social and emotional behaviors in adulthood. These behavioral changes, which occur during this critical period are transferable to antibiotic pre-treated mice by fecal microbiota transplant. In addition, juvenile social isolation decreases the expression of oxytocin receptor (OXTR) in the medial prefrontal cortex (mPFC), and increases the amounts of fecal propionic acid (PA), a short-chain fatty acid derived from gut micobiota. Accordingly, infusion with an OXTR antagonist (OXTR-A, l-368,899) specifically in the mPFC or supplementation of PA both can cause social deficits and anxiety-like behaviors in group housed mice. Collectively, our findings reveal that juvenile social experience regulates prefrontal cortical OXTR expression through gut microbiota-produced PA and that is essential for normal social and emotional behaviors, thus providing a cellular and molecular context to understand the consequences of juvenile social deprivation.

Ranking the effectiveness of worldwide COVID-19 government interventions

Assessing the effectiveness of non-pharmaceutical interventions (NPIs) to mitigate the spread of SARS-CoV-2 is critical to inform future preparedness response plans. Here we quantify the impact of 6,068 hierarchically coded NPIs implemented in 79 territories on the effective reproduction number, R_t, of COVID-19. We propose a modelling approach that combines four computational techniques merging statistical, inference and artificial intelligence tools. We validate our findings with two external datasets recording 42,151 additional NPIs from 226 countries. Our results indicate that a suitable combination of NPIs is necessary to curb the spread of the virus. Less disruptive and costly NPIs can be as effective as more intrusive, drastic, ones (for example, a national lockdown). Using country-specific 'what-if' scenarios, we assess how the effectiveness of NPIs depends on the local context such as timing of their adoption, opening the way for forecasting the effectiveness of future interventions.

Young people's views on their role in the COVID-19 pandemic and society's recovery from it

OBJECTIVE

There has been little formal exploration of how young people see their role in the COVID-19 pandemic.

DESIGN/SETTING

Focus-group discussion with 15 Children's Hospital Young People's Forum members (23/5) to explore their perspective on the impact of COVID-19 on both their lives and those of their community, on school closures, and the role they wished to play in society's recovery from the pandemic. Audio recordings were transcribed verbatim using NVivo Software and analysed using an inductive thematic analysis approach.

OUTCOME

Four major themes identified: (1) Awareness of pandemic's impact on others: participants showed mature awareness of the effects on broader society, especially the elderly, socially disadvantaged and parents. (2) Perceived impact on their own lives: principal concerns were the educational and practical repercussions of school closures and social isolation, including effects on educational prospects. (3) Views about school reopening: young people understood the broader rationale for school reopening and were generally positive about it, but expressed concerned about their safety and that of others. (4) Communication issues: a need for clear, concise, understandable information readily accessible for young people was expressed. Up to now, they felt passive recipients rather than participants.

CONCLUSION

Young people were concerned about their future, their family and broader society, consistent with a high level of moral development. They want to be active participants in social recovery, including concepts around return to school but require appropriate information and a means by which their voices can be heard. The alternative suggested roles as pawns or pathfinders were discounted.

A novel extended approach under hesitant fuzzy sets to design a framework for assessing the key challenges of digital health interventions adoption during the COVID-19 outbreak

In recent years, Digital Technologies (DTs) are becoming an inseparable part of human lives. Thus, many scholars have conducted research to develop new tools and applications. Processing information, usually in the form of binary code, is the main task in DTs, which is happening through many devices, including computers, smartphones, robots, and applications. Surprisingly, the role of DTs has been highlighted in people's life due to the COVID-19 pandemic. There are several different challenges to implement and intervene in DTs during the COVID-19 outbreak; therefore, the present study extended a new fuzzy approach under Hesitant Fuzzy Set (HFS) approach using Stepwise Weight Assessment Ratio Analysis (SWARA) and Weighted Aggregated Sum Product Assessment (WASPAS) method to evaluate and rank the critical challenges of DTs intervention to control the COVID-19 outbreak. In this regard, a comprehensive survey using literature and in-depth interviews have been carried out to identify the challenges under the SWOT (Strengths, Weaknesses, Opportunities, Threats) framework. Moreover, the SWARA procedure is applied to analyze and assess the challenges to DTs intervention during the COVID-19 outbreak, and the WASPAS approach is utilized to rank the DTs under hesitant fuzzy sets. Further, to demonstrate the efficacy and practicability of the developed framework, an illustrative case study has been analyzed. The results of this study found that Health Information Systems (HIS) was ranked as the first factor among other factors followed by a lack of digital knowledge, digital stratification, economic interventions, lack of reliable data, and cost inefficiency In conclusion, to confirm the steadiness and strength of the proposed framework, the obtained outputs are compared with other methods.

How evolutionary behavioural sciences can help us understand behaviour in a pandemic

The COVID-19 pandemic has brought science into the public eye and to the attention of governments more than ever before. Much of this attention is on work in epidemiology, virology and public health, with most behavioural advice in public health focusing squarely on 'proximate' determinants of behaviour. While epidemiological models are powerful tools to predict the spread of disease when human behaviour is stable, most do not incorporate behavioural change. The evolutionary basis of our preferences and the cultural evolutionary dynamics of our beliefs drive behavioural change, so understanding these evolutionary processes can help inform individual and government decision-making in the face of a pandemic. Lay summary: The COVID-19 pandemic has brought behavioural sciences into the public eye: Without vaccinations, stopping the spread of the virus must rely on behaviour change by limiting contact between people. On the face of it, "stop seeing people" sounds simple. In practice, this is hard. Here we outline how an evolutionary perspective on behaviour change can provide additional insights. Evolutionary theory postulates that our psychology and behaviour did not evolve to maximize our health or that of others. Instead, individuals are expected to act to maximise their inclusive fitness (i.e, spreading our genes) - which can lead to a conflict between behaviours that are in the best interests for the individual, and behaviours that stop the spread of the virus. By examining the ultimate explanations of behaviour related to pandemic-management (such as behavioural compliance and social distancing), we conclude that "good of the group" arguments and "one size fits all" policies are unlikely to encourage behaviour change over the long-term. Sustained behaviour change to keep pandemics at bay is much more likely to emerge from environmental change, so governments and policy makers may need to facilitate significant social change - such as improving life experiences for disadvantaged groups.

Brain structure correlates of expected social threat and reward

Prospection (mentally simulating future events) generates emotionally-charged mental images that guide social decision-making. Positive and negative social expectancies-imagining new social interactions to be rewarding versus threatening-are core components of social approach and avoidance motivation, respectively. Interindividual differences in such positive and negative future-related cognitions may be underpinned by distinct neuroanatomical substrates. Here, we asked 100 healthy adults to vividly imagine themselves in a novel self-relevant event that was ambiguous with regards to possible social acceptance or rejection. During this task we measured participants' expectancies for social reward (anticipated feelings of social connection) or threat (anticipated feelings of rejection). On a separate day they underwent structural MRI; voxel-based morphometry was used to explore the relation between social reward and threat expectancies and regional grey matter volumes (rGMV). Increased rGMV in key default-network regions involved in prospection, socio-emotional cognition, and subjective valuation, including ventromedial prefrontal cortex, correlated with both higher social reward and lower social threat expectancies. In contrast, social threat expectancies uniquely correlated with rGMV of regions involved in social attention (posterior superior temporal sulcus, pSTS) and interoception (somatosensory cortex). These findings provide novel insight into the neurobiology of future-oriented cognitive-affective processes critical to adaptive social functioning.

Rationale, Relevance, and Limits of Stress-Induced Psychopathology in Rodents as Models for Psychiatry Research: An Introductory Overview

Emotional and cognitive information processing represent higher-order brain functions. They require coordinated interaction of specialized brain areas via a complex spatial and temporal equilibrium among neuronal cell-autonomous, circuitry, and network mechanisms. The delicate balance can be corrupted by stressful experiences, increasing the risk of developing psychopathologies in vulnerable individuals. Neuropsychiatric disorders affect twenty percent of the western world population, but therapies are still not effective for some patients. Elusive knowledge of molecular pathomechanisms and scarcity of objective biomarkers in humans present complex challenges, while the adoption of rodent models helps to improve our understanding of disease correlate and aids the search for novel pharmacological targets. Stress administration represents a strategy to induce, trace, and modify molecular and behavioral endophenotypes of mood disorders in animals. However, a mouse or rat model will only display one or a few endophenotypes of a specific human psychopathology, which cannot be in any case recapitulated as a whole. To override this issue, shared criteria have been adopted to deconstruct neuropsychiatric disorders, i.e., depression, into specific behavioral aspects, and inherent neurobiological substrates, also recognizable in lower mammals. In this work, we provide a rationale for rodent models of stress administration. In particular, comparing each rodent model with a real-life human traumatic experience, we intend to suggest an introductive guide to better comprehend and interpret these paradigms.

A daily diary study on adolescents' mood, empathy, and prosocial behavior during the COVID-19 pandemic

Adolescence is a formative phase for social development. The COVID-19 pandemic and associated regulations have led to many changes in adolescents' lives, including limited opportunities for social interactions. The current exploratory study investigated the effect of the first weeks of COVID-19 pandemic lockdown on Dutch adolescents' (N = 53 with attrition, N = 36 without attrition) mood, empathy, and prosocial behavior. Longitudinal analyses comparing pre-pandemic measures to a three-week peri-pandemic daily diary study showed (i) decreases in empathic concern, opportunities for prosocial actions, and tension, (ii) stable levels of social value orientation, altruism, and dire prosociality, and (iii) increased levels of perspective-taking and vigor during the first weeks of lockdown. Second, this study investigated peri-pandemic effects of familiarity, need, and deservedness on giving behavior. To this end, we utilized novel hypothetical Dictator Games with ecologically valid targets associated with the COVID-19 pandemic. Adolescents showed higher levels of giving to a friend (a familiar other, about 51% of the total share), a doctor in a hospital (deserving target, 78%), and individuals with COVID-19 or a poor immune system (targets in need, 69 and 63%, respectively) compared to an unfamiliar peer (39%) This suggests that during the pandemic need and deservedness had a greater influence on adolescent giving than familiarity. Overall, this study demonstrates detrimental effects of the first weeks of lockdown on adolescents' empathic concern and opportunities for prosocial actions, which are important predictors of healthy socio-emotional development. However, adolescents also showed marked resilience and a willingness to benefit others as a result of the lockdown, as evidenced by improved perspective-taking and mood, and high sensitivity to need and deservedness in giving to others.

Coping, fostering resilience, and driving care innovation for autistic people and their families during the COVID-19 pandemic and beyond

The new coronavirus disease (COVID-19) pandemic is changing how society operates. Environmental changes, disrupted routines, and reduced access to services and social networks will have a unique impact on autistic individuals and their families and will contribute to significant deterioration in some. Access to support is crucial to address vulnerability factors, guide adjustments in home environments, and apply mitigation strategies to improve coping. The current crisis highlights that our regular care systems are not sufficient to meet the needs of the autism communities. In many parts of the world, people have shifted to online school and increased use of remote delivery of healthcare and autism supports. Access to these services needs to be increased to mitigate the negative impact of COVID-19 and future epidemics/pandemics. The rapid expansion in the use of telehealth platforms can have a positive impact on both care and research. It can help to address key priorities for the autism communities including long waitlists for assessment and care, access to services in remote locations, and restricted hours of service. However, system-level changes are urgently needed to ensure equitable access and flexible care models, especially for families and individuals who are socioeconomically disadvantaged. COVID-19 mandates the use of technology to support a broader range of care options and better meet the diverse needs of autistic people and their families. It behooves us to use this crisis as an opportunity to foster resilience not only for a given individual or their family, but also the system: to drive enduring and autism-friendly changes in healthcare, social systems, and the broader socio-ecological contexts.

Coping, fostering resilience, and driving care innovation for autistic people and their families during the COVID-19 pandemic and beyond

The new coronavirus disease (COVID-19) pandemic is changing how society operates. Environmental changes, disrupted routines, and reduced access to services and social networks will have a unique impact on autistic individuals and their families and will contribute to significant deterioration in some. Access to support is crucial to address vulnerability factors, guide adjustments in home environments, and apply mitigation strategies to improve coping. The current crisis highlights that our regular care systems are not sufficient to meet the needs of the autism communities. In many parts of the world, people have shifted to online school and increased use of remote delivery of healthcare and autism supports. Access to these services needs to be increased to mitigate the negative impact of COVID-19 and future epidemics/pandemics. The rapid expansion in the use of telehealth platforms can have a positive impact on both care and research. It can help to address key priorities for the autism communities including long waitlists for assessment and care, access to services in remote locations, and restricted hours of service. However, system-level changes are urgently needed to ensure equitable access and flexible care models, especially for families and individuals who are socioeconomically disadvantaged. COVID-19 mandates the use of technology to support a broader range of care options and better meet the diverse needs of autistic people and their families. It behooves us to use this crisis as an opportunity to foster resilience not only for a given individual or their family, but also the system: to drive enduring and autism-friendly changes in healthcare, social systems, and the broader socio-ecological contexts.