Mental health and its correlates among children and adolescents during COVID-19 school closure: The importance of parent-child discussion

[Infection epidemiological effects of school closures during the second COVID-19 pandemic wave-an exemplary analysis within a lower Bavarian region]

BACKGROUND

The rapid global spread of the SARS-CoV‑2 virus during the COVID-19 pandemic led to widespread non-pharmaceutical interventions, such as school closures, to curb infections. This study investigates the influence of school closures on the number of new infections to reduce the existing knowledge gap in this area.

METHODS

The effect of school closures starting on 16 December 2020, was quantified using COVID-19 infection data from the district and city of Landshut in Bavaria between November 2020 and January 2021. An interrupted time series (ITS) analysis was performed to analyze daily new infections among 6-18 year olds and the entire population in the region before and after the school closures using a negative binomial regression model.

RESULTS

The analysis showed that the trend of daily new COVID-19 infections among 6-18 year olds significantly decreased after the school closures (incidence rate ratio (IRR) 0.93; 95% confidence interval (CI): 0.89-0.96; p < 0.001). This was also true for the entire study population (IRR 0.95; 95% CI: 0.93-0.97; p < 0.001).

DISCUSSION

In the context of various concurrent measures to contain the COVID-19 pandemic, the study provides evidence for a significant association between school closures and reduced COVID-19 infections. By optimizing the existing incomplete evidence base on the role of school closures in pandemic control, this finding can support involved stakeholders and contribute to strengthening future approaches to pandemic prevention.

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.

Depression Takes a Toll on Academic Performance: Evidence from Rural Students in China

Purpose

Depression is a growing public health concern around the world. For adolescents, depression not only impedes healthy development, but is negatively associated with academic performance. The purpose of this paper is to examine the prevalence of adolescent depressive symptoms in a sample of rural primary and junior high school students. Additionally, we examine various factors to identify subgroups within the sample that may be more vulnerable to depression. Finally, we explore the extent to which depression correlates with academic performance and conduct a series of heterogeneity analyses.

Patients and Methods

We utilize cross-sectional data derived from 30 schools in underdeveloped regions of rural China encompassing primary and junior high school students (n = 1,609).

Results

We find a high prevalence of depression, with 23% and 9% of students experiencing general depression (depression score ≥ 14) and severe depression (depression score ≥ 21), respectively. Female gender, elevated stress and anxiety levels, boarding at school, exposure to bullying, and having depressed caregiver(s) are positively correlated with depressive symptoms, while high social support exhibits a negative association. Importantly, our analyses consistently show a significantly negative link between depression and academic performance, which is measured using standardized math tests. For instance, transitioning from a non-depressed state to a state of general depression (depression score ≥ 14) is linked to a decline of 0.348-0.406 standard deviations in math scores (p < 0.01). Heterogeneity analyses reveal that this adverse relationship is more pronounced for male students, boarding students, those with lower social support, individuals with more educated mothers, and those with lower family assets.

Conclusion

Our findings underscore the high prevalence of depression in rural schools and the detrimental impact on academic performance. We advocate for the implementation of policies aimed at reducing student depression, particularly within vulnerable populations and subgroups.

Prevalence and repercussions of stress and mental health issues on primary and middle school students: a bibliometric analysis

Objective

This study analyzes the presence and reverberations of stress, anxiety, and other mental health issues on primary and middle school students using bibliometric analysis. The aim of this study is to map the research landscape by statistically analyzing existing literature and identifying key themes, trends, and research hotspots in the domain of stress in students. This study also presents analysis related to top contributing countries, journals, authors, citations, and collaboration networks.

Method

A total of 1,335 publications from 1962 to 10 September 2023 were included in this study using the Web of Science, PubMed, and Scopus databases. The steps involved in the bibliometric study included data collection, cleaning, and various analyses such as performance analysis, citation analysis, and network analysis. Biblioshiny by RStudio and Microsoft Excel were used for bibliometric analysis to determine the collaboration between countries and authors and to explore keyword analysis and thematic evolution.

Results

The findings show that China and USA have contributed the highest number of publications. Frontiers in Psychology with 50 publications turns out to be the most prominent journal. The study presents the thematic evolution and the trend topics in this research domain. Some of the trend topics are stress, test anxiety, bullying, depression, cyberbullying, virtual reality, mathematics anxiety, childhood maltreatment and self-compassion, primary school, and middle school. The paper also highlights the prominent authors and their collaboration network.

Discussion

The study has highlighted the various reasons for stress and its potential repercussions on students. This information can be used to help parents, teachers, and the school administration to spot the most susceptible group of students who need immediate intervention to address various mental health issues. We see a gradual progress in the research areas being covered under this domain. More relevant areas of concern related to stress are being explored with time. With the technological advancement and the vast unmonitored internet usage (especially for primary and middle school students), the stress caused by cyberbullying and peer victimization has also become an important topic of research in later years.

Psychological strains after the crisis: evaluating separation anxiety among Iranian children and adolescents in the post-COVID-19 era

OBJECTIVES

The objective of this study was to specifically investigate Separation Anxiety Disorder (SAD), as one of the noteworthy disorders within the spectrum of anxiety disorders, among children and adolescents, after overcoming the crises caused by the Coronavirus Disease 2019 (COVID-19) pandemic. Efforts were also made to identify socio-demographic factors that could be associated with changes in SAD level and also to assess the effect of different constituting dimensions of SAD on the severity of this disorder.

METHODS

In this cross-sectional study, face-to-face interviews were conducted with the parents of 317 (7-13-year-old) Iranian students, who were selected through a multi-stage random sampling method in the city of Shiraz. During the interviews, socio-demographic data were collected, and subsequently, SAD symptoms and dimensions were assessed using the Separation Anxiety Assessment Scale (Parent Version) (SAAS-P) questionnaire. Later, employing the Partition Around Medoids (PAM) statistical method, the participants were categorized into two groups with low and high levels of SAD. Also, to understand the interaction between the different dimensions of SAD, the network analysis method was employed. Finally, univariate analysis and logistic regression were utilized, with a significance level of 0.05, to determine potential associating factors with the level of SAD.

RESULTS

The sample included 128 girls and 189 boys with a mean age of 9.63 ± 2.63 and 9.63 ± 1.95 years respectively. Based on the PAM method, 51.1% of the participants presented a high level of SAD. According to network analysis, it was demonstrated that the "fear of abandonment" dimension plays a central role in high levels of SAD. Based on logistic regression, female gender, age ≥ 10 years, parents' unacademic educational background, mother's employment, and child's history of physical/mental problems were significantly associated with the high level of SAD.

CONCLUSIONS

A considerable number of the participants in this study presented a high level of SAD with the "fear of abandonment" being a key influential dimension of elevated levels of this disorder. Maternal employment, female gender, child's history of health issues, and low parental education were identified as important contributors to the high SAD level. Considering these factors allows for more effective diagnostic and therapeutic interventions. However, the need for further studies remains crucial.

Caregiver and student perspectives on school services for students with traumatic brain injury during the COVID-19 pandemic

PURPOSE

This study aimed to identify unique challenges created by COVID-19 school closures for students with traumatic brain injury (TBI) and their families with relation to special education accommodations, therapy services, social support systems, and mental health complications.

METHODS

Forty-one caregivers and students participated in semi-structured, virtual interviews. Families had students in kindergarten through 12th grade who experienced a TBI prior to spring 2020 and were receiving support services at schools in Pennsylvania (US). Researchers used reflexive thematic analysis to identify themes across interviews.

RESULTS

Central themes encompassing the student- and caregiver-reported challenges and advantages of COVID-19 school closures were changes in [1] education delivery, special education services, and accommodations for children with TBI, and [2] social relationships for students with TBI and their caregivers.

CONCLUSION

COVID-19 and the transition to remote learning significantly impacted special education services and education received by students with TBI. Families in this study discussed both perceived obstacles to and advantages of remote learning in this population. As remote and asynchronous learning are now commonly integrated into the curriculum, research should clarify the facilitators and barriers for successful service provision for students with TBI.

SARS-CoV-2 seroprevalence and mental health of school staff: a cross-sectional study of schools from four areas of Montreal, Quebec in 2021

OBJECTIVES

To assess the seroprevalence of infection-acquired SARS-CoV-2 and the mental health of school/daycare staff in the months after reopening of schools in Montreal, Quebec (Canada) in the Fall of 2020 and whether these varied by school and participant characteristics.

DESIGN

A cross-sectional design based on a convenience sample of schools/daycares and staff was used as the originally planned longitudinal design was no longer feasible due to obstacles in recruitment, for example, teacher's strike.

SETTING

Forty-nine schools/daycares in four Montreal neighbourhoods from March to October 2021.

PARTICIPANTS

Three-hundred and sixty-two participants completed both questionnaires and serology tests.

PRIMARY AND SECONDARY OUTCOME MEASURES

SARS-CoV-2 seroprevalence and prevalence of anxiety, depression, resilience and burnout/emotional exhaustion.

RESULTS

The seroprevalence estimate made representative to the Quebec population of educators was 8.6% (95% CI 5.2 to 13.0). The adjusted seroprevalence in high school was 20% that of elementary school (aRR=0.20, 95% CI 0.07 to 0.58). Thirty per cent of seropositive staff were exposed to a household member with confirmed COVID-19. Prevalence of high emotional exhaustion/burnout was 35%, 44% and 53% in daycare, elementary school and high school staff, respectively. However, moderate/severe anxiety and depression and low resilience did not exceed 18%. After adjusting for confounders, being very afraid of catching COVID-19 at school was associated with moderate-severe anxiety, moderate-severe depression and high emotional exhaustion (aRR=4.4, 95% CI 2.2 to 8.9; aRR=2.8, 95% CI 1.5 to 5.4; aRR=2.2, 95% CI 1.6 to 3.0, respectively).

CONCLUSION

The seroprevalence, anxiety and depression among school/daycare staff were comparable to the reported levels in the adult population of Quebec. The prevalence of emotional exhaustion/burnout was high across all school levels and exceeding the average across all occupations in the USA and in teachers in Germany.

Externalizing Behaviors/Violence Exposure and Suicide Among U.S. Adolescents

INTRODUCTION

This study examines associations between externalizing behaviors/violence exposure and suicidal behavior among U.S. high school students from 1991 to 2021.

METHODS

Data for this cross-sectional study were drawn from the Youth Risk Behavior Survey and the total sample contained data on 234,588 adolescents. Logistic regression models were used to assess the relationship between externalizing behaviors/violence exposure and suicidal behavior. To assess trends over time, models were then assessed for multiplicative interactions between externalizing behaviors/violence exposure and time by sex. State-level trends were also assessed. All analyses were conducted in 2024.

RESULTS

The prevalence of externalizing behaviors/violence exposure increased among youth with an injurious suicide attempt (ISA). Logistic regression models indicated statistically significant associations across suicidal behaviors with a higher magnitude of association observed among those with an ISA. For instance, compared to those who did not carry a gun, those who carried a gun had 6.32 (95% confidence interval: 4.78, 8.36) times the odds of ISA versus no attempt and 2.66 (95% confidence interval: 2.00, 3.53) times the odds of non-ISA versus no attempt. Stronger associations arose among male individuals. Among those with an ISA in 2021, state-level differences in weapon access emerged.

CONCLUSIONS

Adolescents with externalizing behaviors/violence exposure are at an increased risk of an ISA. The relationship varies over time and by sex. Culturally adaptive and structurally competent approaches to mental health and mechanisms to identify at-risk youth are imperative.

Predictors of loneliness among middle childhood and adolescence during the COVID-19 pandemic

Social contexts (e.g., family, friends) are important in predicting and preventing loneliness in middle childhood (MC) and adolescence; however, these social contexts were disrupted during the COVID-19 pandemic. Comparison of social context factors that may differentially contribute to loneliness at each developmental stage (MC vs. adolescence) during the COVID-19 pandemic have been overlooked. This study examined longitudinal predictors of loneliness, including social contexts and COVID-19 impact, within MC (8-12y) and adolescence (13-17y). Parents reported on demographic information, and their children completed surveys on COVID-19 impact, loneliness, and family functioning using the COVID-19 Exposure and Family Impact Survey (CEFIS), the NIH Toolbox Loneliness (Ages 8-17) measure, and the PROMIS Family Relationships Short Form 4a measure, respectively. Regression models examined time one (T1; May-June 2020) predictors of time two (T2; November 2020-January 2021) MC child (n=92, Mage=10.03) and adolescent (n=56, Mage=14.66) loneliness. For the MC child model, significant predictors of higher loneliness included worse family functioning as well as higher COVID-19 impact and lower family income. On the other hand, higher adolescent loneliness was significantly predicted by not having married/partnered parents and was marginally significantly predicted by higher COVID-19 impact. The regression model with the full sample and interaction terms revealed no significant interactions, but that lower family functioning and higher COVID-19 impact were significant predictors of higher loneliness. Lower family income and lower in-person communication were marginally significant predictors of higher loneliness in the combined interaction model. Lastly, further exploratory mediation analyses displayed that family functioning significantly mediated the relationship between COVID-19 impact and T2 loneliness only for MC children and the full sample. Results support future interventions focused on optimizing family functioning to help mitigate MC loneliness in the context of adversity, such as a global pandemic.

A bibliometric analysis of anxiety and depression among primary school students

Background

Rising anxiety and depression in primary school students adversely affect their development and academics, burdening families and schools. This trend necessitates urgent, focused research within this young demographic. This alarming trend calls for a systematic bibliometric analysis to develop effective preventative and remedial strategies.

Objectives

This study aims to identify and analyze the prevailing research hotspots and emerging trends concerning anxiety and depression in primary school students, thereby furnishing a foundational reference for future academic endeavors in this area.

Methods

This study uses the Web of Science (WOS) Core Collection database as the data source, focusing on literature published between 2013 and 2023 concerning anxiety and depression in primary school students. An initial search identified 1852 articles, which were then manually screened to exclude duplicates, conferences, announcements, and unrelated literature, resulting in 1791 relevant articles. The analysis, executed on December 31, 2023, employed CiteSpace and Vosviewer tools to assess various bibliometric indicators including authorship, country, institutional affiliations, publication trends, keyword frequency, and citation analysis.

Results

The analysis revealed a corpus of 1,791 English-language articles, with a discernible upward trend in publications over the decade. The USA and China were the leading countries in this field, with 482and 272 papers, respectively. The research predominantly addresses the etiological factors of anxiety and depression, various intervention strategies, and the comorbidities associated with these conditions in the target population. Key research focuses have been identified in areas such as suicidal thoughts, bullying in schools, the impact of COVID-19, mindfulness interventions, and anxiety related to mathematics. Future research is projected to increasingly focus on the effects of mathematics anxiety on the psychological and behavioral outcomes in students.

Conclusion

This study provides a critical visual and analytical overview of the key research areas and trends in the field of anxiety and depression among primary school students. It underscores the necessity of concentrating on the underlying causes and potential interventions. Such focused research is imperative for mitigating the mental health challenges faced by young students and enhancing their educational and developmental outcomes.

Instructional approach, sleep, and perceived academic well-being in adolescents during COVID-19: Evidence from the NESTED study

OBJECTIVES

At the peak of COVID-19, adolescent life was disrupted as schools adapted their instructional approaches such as online, in-person, or hybrid instruction. We and others have previously commented on how these shifts facilitated longer, later and (more developmentally appropriate) sleep. Here, we report how sleep contributed to associations between remote instruction and broader academic well-being (e.g., cognitive function, school connectedness, and stress).

METHODS

Adolescents from all 50 U.S. states (n = 4068) completed online self-report surveys in fall 2020. Instructional approach was operationalized from fully in-person instruction to fully asynchronous online education. Sleep parameters included sleep timing and duration, sleep disturbances, and sleep-related impairments. Perceived academic well-being was defined as cognitive function, school connectedness, and school-related stress. Sleep and perceived academic well-being are examined across instructional approaches, in their association, and in structural models.

RESULTS

Sleep and perceived academic well-being differed between hybrid and online instruction groups. Less variable or disturbed sleep was associated both with in-person instruction, and with positive outcomes in cognitive function, school connectedness, and stress domains. Sleep mediated a substantial portion of variance in perceived academic well-being attributable to instructional approach.

CONCLUSION

These data highlight the need to protect both healthy sleep and in-person instruction. Appropriate sleep timing and duration, fewer sleep disturbances and sleep-related impairments accounted for a substantial degree of variance in the association between remote instruction on academic outcomes. While many students experienced "lost learning" because of COVID-19, this study joins a broader discussion of ensuring developmentally appropriate school-start times to support both sleep and achievement.

Daily COVID-19 Stressor Effects on Children's Mental Health Depend on Pre-pandemic Peer Victimization and Resting Respiratory Sinus Arrhythmia

Children's risk of poorer mental health due to the COVID-19 pandemic may depend on risk and protective factors heading into the pandemic. This study examined same-day associations between COVID-19 stressors and children's mental health using a daily diary design across 14 days, and considered the moderating roles of pre-pandemic peer victimization experiences and resting respiratory sinus arrhythmia (RSA; an indicator of cardiac regulatory capacity). Forty-nine Canadian children aged 8-13 years (Mage = 10.69, 29 girls) participated in the final wave of a longitudinal study just prior to the pandemic and a daily diary extension during the pandemic (N = 686 pandemic measurement occasions). Multilevel modeling indicated that children had poorer mental health on days when they experienced a COVID-19 stressor (e.g., virtual academic difficulties, social isolation). A three-way interaction indicated that this association was stronger for those with higher pre-pandemic peer victimization experiences and lower pre-pandemic resting RSA; however, highly victimized children with higher resting RSA did not experience poorer mental health on days with COVID-19 stressors. Findings offer preliminary insights into the preceding risk and protective factors for children's mental health amidst major subsequent stress.

Factors associated with an increased risk of anxiety among adolescents during the COVID-19 lockdown in the French Grand Est area

The COVID-19 pandemic has impacted adolescent mental health worldwide. The current study aims to assess the feelings of French adolescents and the factors related to anxiety among these adolescents during the first lockdown due to COVID-19. A sample of 284 French adolescents from the Grand Est region aged 12-18 years completed an online survey evaluating their pandemic-related anxiety symptoms, behaviors, and feelings regarding the contingent strategies of lockdown that were taken and their living and learning conditions, family relationships, and social support. The Generalized Anxiety Disorder Scale (GAD-6) was used to assess anxiety. Data on parents' mental health status were also collected. A word cloud was generated to visualize respondents' feelings according to word use frequency. Cross-sectional analysis with linear regression was performed to identify the factors associated with a higher level of anxiety in adolescents. Higher anxiety scale scores were observed among females than among males (β = 1.2; P = 0.0005), among adolescents experiencing conflicts at home (β = 0.9; P = 0.03) and difficulties in isolation (β = 1.1; P = 0.02) than among those who did not report any difficulty, and among those working less than 2 h a day (β = 1.1; P = 0.003) than among those working more. Anxiety scale scores were lower in adolescents with higher family social support (β = -0.66; P < 0.001) and those with parents with no anxiety (β = -2.28; P < 0.001), lower anxiety (β = -1.38; P = 0.018), and higher mental health-related quality of life (β = -0.04; P = 0.03). These findings suggest a need to support interventions targeting parents' anxiety, develop strategies to increase family support, and establish consistent work schedules for children.

The burden and its determinants of mental health distress among adolescents dwelling in Africa: a systematic review and meta-analysis

BACKGROUND

Adolescent mental health issues are emerging as a significant public health concern across many low- and middle-income countries, particularly in Africa. This study aims to evaluate the aggregated prevalence and contributing risk factors of mental health distress among adolescents in Africa.

METHODOLOGY

A comprehensive search of PubMed, PsycINFO, Web of Science, Google Scholar, and HINARI databases was conducted to identify relevant articles on the prevalence and risk factors associated with mental health distress among African adolescents, published up to December 2023. The quality of the selected studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. Heterogeneity among the studies was evaluated using the I² statistical test. Potential publication bias was assessed through a funnel plot and Egger's statistical test. This systematic review was registered with PROSPERO under reference number CRD42023494665.

RESULTS

Eighteen studies encompassing data from 37,016 adolescents were included in the analysis. The overall prevalence of mental health distress among adolescents in Africa was found to be 27.34% (95% CI: 23.18-31.50). The occurrence of mental health distress is observed in older adolescents at a prevalence of 29.44% (95% CI: 23.26-35.66) and in younger adolescents at 24.73% (95% CI: 11.96-37.51). Significant risk factors identified included bullying victimization, with an odds ratio (POR) of 1.30 (95% CI: 1.16, 1.46), and experiencing hunger, with an odds ratio (POR) of 2.10 (95% CI: 1.13, 3.91).

CONCLUSION

The findings indicate a high prevalence of mental health distress among adolescents in Africa, highlighting the widespread impact on this demographic. These results underscore the urgent need for targeted interventions to prevent and address mental health distress among adolescents. Further research on a global scale is essential to develop effective prevention and treatment strategies tailored to this age group.

Physical activity and mental health trends in Korean adolescents: Analyzing the impact of the COVID-19 pandemic from 2018 to 2022

Objective

Mental health significantly affects the physical and emotional development of adolescents. The aim of the current study was to examine how physical activity (PA) and mental health among Korean adolescents changed before and after the start of the COVID-19 pandemic.

Methods

We used comparative cross-sectional methods, gathering information from the Korea Disease Control and Prevention Agency databases and conducting Chi-square testing and correlation analysis for evaluation.

Results

The findings indicate that before and during the pandemic, participation in both moderate- and high-intensity PA, as well as strength training, mitigated stress, depression, and suicidal ideation. Furthermore, the findings confirm the beneficial effects of various physical activities on mental well-being.

Conclusions

These insights emphasize the vital role of regular PA in improving mental health among adolescents, particularly during a health crisis such as the pandemic.

The COVID-19 Experience in Adolescents: Emotional and Behavioral Recall at the End of the Pandemic

The COVID-19 pandemic and the resulting lockdown countermeasure may have significantly affected adolescents' physical and mental health. This study aims to assess adolescents' recollections of this period, also analyzing their current weight status along with factors they traced back to the epidemic phase and their current sports practice. A survey among 233 Italian adolescents aged 12.4 ± 0.9 years was conducted in October 2023. To achieve the research objectives, a new questionnaire was developed: the COVID-19 AdolesceNt/chilDren Lockdown Experience questionnaire (CANDLE). The new questionnaire was employed to gather data on the adolescents' recollections of the lockdown situation they experienced. The stature and weight of participants were measured directly. The results indicated that middle schoolers remember both positive and negative experiences of the lockdown: the change perceived as the most positive was spending more time with family, while social detachment from peers represents the most negative aspect. According to multivariate regression analysis, certain behaviors they assumed during the lockdown, such as comfort food consumption in boys and sleeping disturbances in girls, in addition to their current sports practice, affected their actual Body Mass Index. This study supports the evidence that changes caused by the COVID-19 lockdown affected adolescents' physical and mental health, albeit with sex differences.

Engagement, Mental Health, and Substance Use Under In-Person or Remote School Instruction During the COVID-19 Pandemic

BACKGROUND

Adolescents' school engagement, mental health, and substance use have been major concerns during the COVID-19 pandemic, particularly given disruptions to school instruction. We examined how the instructional setting was associated with academic and health-related outcomes within an adolescent cohort followed during the pandemic.

METHODS

During 3 semi-annual follow-up surveys, adolescents (N = 1066 students; 2242 observations) from 8 California high schools responded to items measuring academic self-efficacy, school connectedness, internalizing and externalizing problems, and use of substances. Separate generalized estimating equation models predicted outcomes based on the instructional setting.

RESULTS

Relative to in-person instruction, students in remote instruction reported lower academic self-efficacy (Beta: -0.11; 95% confidence interval [CI]: -0.22, -0.01) and school connectedness (Beta: -0.37; 95% CI: -0.48, -0.25), greater odds of past 30-day internalizing problems (AOR: 1.46; 95% CI: 1.09, 1.95), externalizing problems (AOR: 1.36; 95% CI: 1.02, 1.82), and cigarette, cigar, smokeless tobacco, or hookah use (AOR: 2.50; 95% CI: 1.06, 5.91), but lower odds of past 30-day e-cigarette use (AOR: 0.50; 95% CI: 0.30, 0.86).

CONCLUSIONS

Multiple adverse outcomes related to school engagement, mental health, and substance use were associated with remote instruction. To reduce such impacts under future emergencies, schools should rely sparingly on remote instruction and provide appropriate supportive resources.

Oral microbiota dysbiosis alters chronic restraint stress-induced depression-like behaviors by modulating host metabolism

Studies have shown that the microbiota-gut-brain axis is highly correlated with the pathogenesis of depression in humans. However, whether independent oral microbiome that do not depend on gut microbes could affect the progression of depression in human beings remains unclear, neither does the presence and underlying mechanisms of the microbiota-oral-brain axis in the development of the condition. Hence this study that encompasses clinical and animal experiments aims at investigating the correlation between oral microbiota and the onset of depression via mediating the microbiota-oral-brain axis. We compared the oral microbial compositions and metabolomes of 87 patients with depressive symptoms versus 70 healthy controls. We found that the oral microbial and metabolic signatures were significantly different between the two groups. Significantly, germ-free (GF) mice transplanted with saliva from mice exposing to chronic restraint stress (CRS) displayed depression-like behavior and oral microbial dysbiosis. This was characterized by a significant differential abundance of bacterial species, including the enrichment of Pseudomonas, Pasteurellaceae, and Muribacter, as well as the depletion of Streptococcus. Metabolomic analysis showed the alternation of metabolites in the plasma of CRS-exposed GF mice, especially Eicosapentaenoic Acid. Furthermore, oral and gut barrier dysfunction caused by CRS-induced oral microbiota dysbiosis may be associated with increased blood-brain barrier permeability. Pseudomonas aeruginosa supplementation exacerbated depression-like behavior, while Eicosapentaenoic Acid treatment conferred protection against depression-like states in mice. These results suggest that oral microbiome and metabolic function dysbiosis may be relevant to the pathogenesis and pathophysiology of depression. The proposed microbiota-oral-brain axis provides a new way and targets for us to study the pathogenesis of depression.

Coping methods of college students with different personality traits when facing COVID-19 from the anxiety psychology perspective

Objective

Based on a survey of anxiety among college students during the epidemic, this study takes anxiety as an example to study the coping methods of college students with different personality traits. Thus predicting the behavioral tendencies of college students and proposing some appropriate suggestions for the current psychological education work of college students. Method: The study was carried out during the large-scale outbreak of the COVID-19 epidemic, and the investigation lasted one month. Using the Self Rating Anxiety Scale (SAS), Eysenck Personality Questionnaire Simplified Chinese Version (EPQ-RSC), and Trait Coping Style Scale (TCSQ), an online questionnaire survey was conducted on 932 college students to analyze the mutual effects of different grades, genders, personality traits, coping methods, and other factors.

Results

The research found that there was a significant gender difference in negative coping methods and anxiety among college students. Grade differences: In the comparative study of personality traits, there are gender differences in introversion and concealment dimensions and grade differences in neuroticism and concealment dimensions. There is a pairwise correlation between personality traits, coping methods, and anxiety. There is a significant positive correlation between the dimensions of psychoticism, neuroticism and anxiety; There is a significant negative correlation between introversion, concealment, and anxiety. Positive coping methods are significantly negatively correlated with anxiety, while negative coping methods are significantly positively correlated with anxiety. The positive coping style is significantly negatively correlated with the dimensions of psychoticism and neuroticism and positively correlated with the dimensions of introversion, introversion, and concealment; Negative coping methods are significantly positively correlated with the dimensions of psychoticism and neuroticism and negatively correlated with the dimensions of introversion, introversion, and concealment.

Conclusion

The research results indicate that the mental health issues of college students need to be taken seriously to prevent the spread of anxiety.

Unveiling Coronasomnia: Pandemic Stress and Sleep Problems During the COVID-19 Outbreak

The COVID-19 pandemic posed an unprecedented challenge to public well-being, necessitating an examination of its health impact. This review discusses the relationship between pandemic-induced stressors and individual sleep patterns and quality. The pandemic stressors include lockdown or physical distancing measures, direct virus exposure, and the dissemination of misinformation and disinformation. The pandemic led to delayed sleep-wake cycles, except for healthcare professionals, and worsened sleep quality. The prevalence of insomnia was higher for women due to pre-existing conditions and susceptibility stressors such as lockdown stress and family responsibilities. Healthcare professionals, who experienced worsened work conditions during the pandemic, reported higher rates of insomnia and sleep difficulties due to infection anxiety and post-traumatic stress from direct virus exposure. For the general population, stress stemmed from social isolation under lockdown and overwhelming false information available online, resulting in sleep problems. Taken together, the findings highlight the importance of promoting social interactions, providing psychological support services, and caution in navigating health information. In summary, this review underscores the need for individual- and group-centered approaches in ongoing research and interventions to address pandemic-related stress and sleep issues during COVID-19.

Can a web application foster emotional competence in children and adolescents? The case of PandHEMOT®

The COVID-19 pandemic has had many traumatic consequences for the physical and psychological functioning of children and adolescents. Internet-based interventions can reach a large audience and be a potentially powerful resource for promoting well-being among young people. We tested the efficacy of the web application PandHEMOT®, developed ad hoc for increasing knowledge about pandemics, emotions, and emotion regulation. We involved a sample of 147 Italian third and seventh graders. The sample was assigned to an experimental (participating in the training) and a waitlist condition (who participated following a waitlist design). All the participants completed pretest and posttest measures. The intervention was structured into three units. The training took place between November and December 2021. Generalized linear mixed models and linear mixed models revealed that knowledge about pandemics, emotions, emotion regulation, and metacognitive awareness increased for the experimental condition. Moreover, adolescents performed better than children. The findings supported the efficacy of an Internet-based training for increasing children and adolescents' resilience, according to the standards of evidence-based research.

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.

The impact of COVID-19 on the peer relationships of adolescents around the world: A rapid systematic review

The main objective of this rapid systematic review was to examine how the COVID-19 pandemic impacted peer relationships for adolescents (10-25 years of age) around the globe. We focused on four indices of peer relationships: (1) loneliness, (2) social connectedness, (3) social support, and (4) social media use. In addition, we examined gender and age differences. Four databases (APA PsychInfo, PubMed, Scopus, and Web of Science) were searched for articles published from January 2020 to November 2022. A total of 96 studies (cross-sectional: n = 66, longitudinal: n = 30, quantitative: n = 67, qualitative: n = 12, mixed-methods: n = 17) met our inclusion criteria (empirical observational studies with data on at least one of the indices of interest, cross-sectional data on COVID-19-related experiences or longitudinal data collected during the pandemic, age range of 10-25 years, typically developing adolescents). We extracted data and conducted a narrative synthesis. Findings suggest that COVID-19 disruptions negatively impacted peer relationships for youth. Most studies reported either an increase in loneliness over the course of the pandemic or a positive association between loneliness and COVID-19-related experiences. Similar findings were observed for increased social media use as a means of continued communication and connection. Fewer studies focused on social support but those that did reported a decrease or negative association with COVID-19-related experiences. Lastly, findings suggest a mixed impact on social connectedness, which might be due to the strengthening of closer ties and weakening of more distant relationships. Results for gender differences were mixed, and a systematic comparison of differences across ages was not possible. The heterogeneity in measures of COVID-19-related experiences as well as timing of data collection prevented a more nuanced examination of short and more long-term impacts.

Knowledge, Attitudes and Practices Toward Physical Literacy Among the College Students During COVID-19 School Closure

Purpose

To investigate the knowledge, attitudes and practices (KAP) among college students toward physical literacy during COVID-19 school closure.

Patients and Methods

This web-based cross-sectional study was conducted between December 9th, 2022 and December 24th, 2022 among college students during COVID-19 school closure. A self-designed questionnaire was developed to collect demographic information of the college students, and assess their KAP toward physical literacy.

Results

A total of 969 students were recruited, with mean age of 18.73±0.97 years. The majority were male (54.70%), urban residents (78.02%), majoring in engineering (58.00%), and having exercise habits (61.09%). The mean KAP scores were 6.57±0.95, 32.63±4.07, and 27.06±7.23, respectively. Positive associations were identified between knowledge and attitude (OR = 2.01, 95% CI: 1.52-2.66, P < 0.001), and between attitude and practice (OR = 1.17, 95% CI: 1.12-1.22, P < 0.001). A bachelor's degree and being in the sophomore year were positively associated with knowledge (OR = 1.51-4.05, all P < 0.05). Urban residence and being in the sophomore year were negatively associated with attitude (OR = 0.43-0.59, all P < 0.05), while having daily exercise habits showed the opposite trend (OR = 1.85, 95% CI: 1.33-2.57, P < 0.001). Father's education level of high school and technical secondary school (OR = 0.58, 95% CI: 0.37-0.93, P = 0.023) and having daily exercise habits (OR = 3.88, 95% CI: 2.72-5.55, P < 0.001) were associated with practice.

Conclusion

College students had sufficient knowledge, moderate attitudes and negative practices towards physical literacy during COVID-19 school closure. The findings hold significant potential for developing educational programs, fostering healthier lifestyles and promoting mental well-being among college students during public health outbreaks.

Arranged cohabitation among Chinese Muslims

While modern family-related ideas and behaviors have become more widely accepted in contemporary China, Chinese Muslim minorities continue to hold on to traditional religious practices. Surprisingly, data from our survey conducted in Gansu province in China's northwestern borderlands reveal that Muslims of the Hui and Dongxiang ethnicities reported much higher rates of cohabitation experience than the secular majority Han. Based on follow-up qualitative interviews, we found the answer to lie in the interplay between the highly interventionist Chinese state and the robust cultural resilience of local Islamic communities. While the state maintains a high minimum legal age of marriage, the early marriage norm remains strong in Chinese Muslim communities, where religion constitutes an alternative and often more powerful source of legitimacy-at least in the private sphere of life. Using the 2000 census data, we further show that women in almost all 10 Muslim ethnic groups have higher percentages of underage births and premarital births than Han women, both nationally and in the northwest where most Chinese Muslims live. As the once-outlawed behavior of cohabitation became more socially acceptable during the reform and opening-up era, young Muslim Chinese often found themselves in "arranged cohabitations" as de facto marriages formed at younger-than-legal ages. In doing so, Chinese Muslim communities have reinvented the meaning of cohabitation. Rather than liberal intimate relationship based on individual autonomy, cohabitation has served as a coping strategy by which Islamic patriarchs circumvent the Chinese state's aggressive regulations aimed at "modernizing" the Muslim family.

Avoidant Parent-Child Communication About COVID-19: A Longitudinal Investigation of Associations with Youth Adjustment Across the First 6 Months of the Pandemic

In the aftermath of discrete disasters, how families discuss the event has been linked with child well-being. There is less understanding, however, of how family communication affects adjustment to a protracted and ongoing public health crisis such as the COVID-19 pandemic. The present research leveraged a large longitudinal sample of families (N = 1884) across the United States and Canada to investigate factors that predicted family communication styles (active versus avoidant communication) about the COVID-19 pandemic and examined the longitudinal sequelae of mental health outcomes for youth associated with different family communication styles. Parents of youth between 5 to 17 years old completed surveys about their own mental health, their child's mental health, and family communication about the COVID-19 pandemic at two time points 6 months apart. Overall, findings indicated that poorer parental mental health was related to greater use of avoidant communication, and avoidant communication styles were associated with poorer youth mental health over time. Findings suggest potential perils of avoidant family communication about ongoing threats and can help identify families at risk of negative mental health outcomes.

Impact of the COVID-19 pandemic on perceived changes in responsibilities for adult caregivers who support children and youth in Ontario, Canada

BACKGROUND

The COVID-19 pandemic has created long-lasting changes in caregiving responsibilities, including but not limited to increased demands, loss of support, worsening mental and physical health, and increased financial worries. There is currently limited evidence regarding factors associated with perceived changes in caregiving responsibilities.

AIMS

This observational study aimed to investigate factors (sociodemographic characteristics of caregivers and mental health and/or addiction concerns of the caregiver and their youth) that predict perceived negative changes in caregiving responsibilities among adult caregivers (aged 18+ years) of children and youth (aged 0-25 years) in Ontario, Canada, during the COVID-19 pandemic.

METHOD

Data were collected from 1381 caregivers of children and youth between January and March of 2022 through a representative cross-sectional survey completed online. Logistic regression was conducted to determine predictors contributing to perceived negative changes in caregiving responsibilities.

RESULTS

Among the sociodemographic characteristics, only ethnicity significantly predicted outcome. Higher caregiver strain (odds ratio [OR] = 10.567, 95% CI = 6.614-16.882, P < 0.001), worsened personal mental health (OR = 1.945, 95% CI = 1.474-2.567, P < 0.001), a greater number of children/youth cared for per caregiver (OR = 1.368, 95% CI = 1.180-1.587, P < 0.001), dissatisfaction with the availability of social supports (OR = 1.768, 95% CI = 1.297-2.409, P < 0.001) and negative changes in mental well-being in at least one child/youth (OR = 2.277, 95% CI = 1.660-3.123, P < 0.001) predicted negative changes in caregiving responsibilities.

CONCLUSION

These results support further exploration of the implications of negative perceptions of caregiving responsibilities and what processes might be implemented to improve these perceptions and the outcomes.

What our children lost and gained at the time of school closure during the Covid-19 pandemic: a study on psychological distress, behavioural concerns and protective factors of resilience among preschool children in Kerala, India

BACKGROUND

The pandemic has put at risk the social and emotional development of children on account of the paucity of arenas for social interaction. This study from Kerala, India was conducted to assess the resilience factors, behavioural concerns, psychological distress symptoms among the children aged 3 to 5 years. We also tried to look into the lost opportunities that could have aided the social and emotional development of children like peer interaction, child care hours.

METHODS

The cross-sectional study was conducted among the children aged 3 to 5 years. A total of 535 children attending the immunisation clinics were enrolled by consecutive sampling. Devereux Early Childhood Assessment P2 (DECA P2) questionnaire was used to assess the levels of resilient factors and behavioural concerns in the study population.

RESULTS

We observed a high proportion of children in the area of need category of protective factors under DECA P2. The proportion of children falling under area of concern was 64.5%, 49%, 68.4% for attachment/relationship, self-regulation, and initiative respectively. 24.9% study subjects have a behavioural concern score that puts them in the area of need category. The logistic regression model we created identified 'Male Gender,' 'Mothers could spend only less time for child care' and 'electronic devices used as pacifier' as significant predictors for belonging to Area of need Behavioural Concerns T score category.

CONCLUSION

A large proportion of children aged between 3 to 5 years with reported behavioural concerns and lack of protective factors for socioemotional development. This can be attributed partly to the ongoing pandemic and its associated restrictions. The increased child care hours invested by parents or grandparents could have sized down the full impact that the pandemic would have had on the socio emotional development of the child. Increased time spent using electronic devices coupled with dwindled opportunities for interaction with peers have been notable challenges.

Cross-Sectional and Descriptive Study on the Challenges and Awareness of Hispanic Parents Regarding Their Adolescents' Mental Health during the COVID-19 Pandemic

Research has shown that during the COVID-19 pandemic, approximately 20% of children and adolescents in the United States experienced mental health issues that became a significant social concern. However, recent studies have demonstrated that the majority of adolescents maintain positive emotions despite the crisis. This cross-sectional and descriptive study delves into the emotional states of adolescents during the pandemic, considering the viewpoints of both adolescents and their parents, with a specific focus on Hispanic adolescents. Survey results revealed that most adolescents reported positive and happy moods. However, a percentage of adolescents experienced worry, significant changes in feelings, and loneliness as a result of the physical and social isolation associated with virtual learning. Unfortunately, most surveyed Hispanic parents did not adequately recognize their adolescents' mood changes well. This lack of awareness, caused by factors such as an insufficient understanding about the importance of adolescent mental health, cultural reasons, language barriers, low education, unstable jobs, and more, could lead to missed opportunities for timely mental health interventions. This study seeks to provide a comprehensive discussion on the mental health of adolescents, while also advocating for the emotional wellbeing of Hispanic adolescents.

The Silver Lining of Posttraumatic Growth around the Dark Side of the COVID-19 Pandemic: A School-Based Intervention with Mindfulness and Character Strengths Practices among Children

The theory of posttraumatic growth (PTG) proposes that from life difficulties positive changes can happen, such as deepened personal relationships and an awareness of new possibilities in life. PTG can occur naturally or can be facilitated. This study aimed to promote PTG through a school-based intervention of eight sessions of 45 min each with mindfulness and character strengths practices (the so-called "The exploration of happiness during the COVID-19 pandemic"). The study conducted assessments at baseline, post-intervention, and follow-up (i.e., one month after the intervention). The post-intervention results showed that the participants in the intervention group experienced an improvement in PTG, well-being, mindfulness, strengths use, and PTS symptoms compared to the children in the control group. Furthermore, these positive changes were sustained at follow-up. The findings of this study highlight that mindfulness-based strengths practices can increase positive outcomes (i.e., well-being, posttraumatic growth) and reduce negative psychological symptoms (PTS) among children. The implications for theory and practice are discussed, and detailed appendices for practitioners are provided.

Consequences of the Covid-19 pandemic in children and adolescents with attention deficit hyperactivity disorder - a systematic review

OBJECTIVE

In this systematic review (SR), the authors aimed to identify the possible impact of the social restriction imposed by the Coronavirus Disease-19 (COVID-19) pandemic on children/adolescents with Attention Deficit Hyperactivity Disorder (ADHD).

DATA SOURCES

This SR was registered on PROSPERO CRD42021255569. Eligible articles were selected from PubMed, Embase, and LILACS, according to the following characteristics: ADHD patients < 18 years old, exposed to the COVID-19 pandemic, and the outcomes, medications, relationships, sleep, media use, remote learning, and comorbidities such as depression/sadness, inattention, anxiety, and irritability/aggressiveness. Newcastle-Ottawa Scale (NOS) for cohort, cross-sectional and case-control studies was used to assess methodological quality and the risk of bias.

SUMMARY OF FINDINGS

Of the 222 articles identified, 27 were included, with information on 7,235 patients. Most studies (n = 22) were cross-sectional and received a mean NOS 4.63/10 followed by longitudinal (n = 4) with 3.75/8 points and case-control (n = 1), with 3/9 points. The pandemic affected patients' access to treatment, behavior, and sleep. Difficulties in remote learning and increased use of social media were described, as well as significant and positive changes in relationships with family and peers.

CONCLUSION

Although the studies were heterogeneous, they indicated that the pandemic-related issues experienced by patients with ADHD were mostly manifested affecting their behavior and sleep patterns.

Parent-Child Communication Incongruence in Pediatric Healthcare

Parents play a key role in providing children with health-related information and emotional support. This communication occurs both in their homes and in pediatric healthcare environments, such as hospitals, outpatient clinics, and primary care offices. Often, this occurs within situations entailing heightened stress for both the parent and the child. There is considerable research within the communication literature regarding the nature of both verbal and nonverbal communication, along with the way in which these communication modalities are either similar (i.e., congruent) or dissimilar (i.e., incongruent) to one another. However, less is known about communication congruency/incongruency, specifically in parent-child relationships, or within healthcare environments. In this narrative review, we explore the concept of verbal and nonverbal communication incongruence, specifically within the context of parent-child communication in a pediatric healthcare setting. We present an overview of verbal and nonverbal communication and propose the Communication Incongruence Model to encapsulate how verbal and nonverbal communication streams are used and synthesized by parents and children. We discuss the nature and possible reasons for parental communication incongruence within pediatric settings, along with the consequences of incongruent communication. Finally, we suggest a number of hypotheses derived from the model that can be tested empirically and used to guide future research directions and influence potential clinical applications.

The Effect of Psychological Distress on Adolescents' Academic Engagement: The Roles of Social-Emotional Competence and Teachers' Caring Behavior

Purpose

The relationship between psychological distress (PD) and academic engagement (AE) in adolescents is widely recognized. However, there is a lack of research on the mechanisms behind this correlation, especially in COVID-19 pandemic policy liberalization. This study proposed a moderated mediation model to determine the mediating role of social-emotional competence (SEC) between PD and AE and the moderating role of teachers' caring behavior (TCB).

Patients and methods

The moderated mediation model was tested by PROCESS macro developed based on SPSS with Chinese adolescents aged 13-18 years (n = 8625; male 50.5%) as survey respondents. Multiple scales, including the 6-item Kessler PD Scale, SEC Scale, TCB Scale, and AE Scale, were used in this test.

Results

Adolescent PD negatively predicted AE. In addition, SEC partially mediated the relationship between adolescent PD and AE. TCB moderated the direct and indirect relationships between PD and AE, which mitigated the negative effect of PD on AE and enhanced the positive effect of SEC on AE.

Conclusion

Adolescent SEC and TCB are essential in mediating PD and AE. This study provided instructions for schools and teachers to intervene in adolescents' PD and academic problems, such as improving SEC and engaging in TCB in an adequate and timely manner. In addition, these findings provided vital references for adolescent mental health interventions in future large-scale public health events.

School and class closures and adolescent mental health during the second and later waves of the COVID-19 pandemic in Finland: a repeated cross-sectional study

BACKGROUND

Since the start of the COVID-19 pandemic, several studies have shown deterioration of adolescents' mental health when comparing periods before and after the start of the pandemic when there were national school closures. Less is known of the following waves with more variation in school closures and their duration. We study here, if variation in school or class closures was related to adolescents' mental health, if the duration mattered, and if the relationships were gender sensitive.

METHODS

All comprehensive schools in Finland were invited to participate. Students (grades 7-9, age 13-16 years) answered digitally in November-December 2020 (n = 41,041) and April-May 2021 (n = 28,501). The responses were given anonymously. Mental health was measured by daily health complaints and moderate/severe anxiety (GAD-7, only in 2021). School and class closures were combined to a variable (yes/no). The duration of a closure was analysed in weeks. Logistic regression analysis was used.

RESULTS

In 2020, 14% of pupils reported a school closure and 33% in 2021. The gender-adjusted odds for daily health complaints were higher among those with the school or class closure compared to those without (OR = 1.2 (1.1-1.3) in 2020; OR = 1.3 (1.2-1.3) in 2021). For anxiety, the corresponding OR was 1.3 (1.2-1.4). Girls had higher odds for both measures than boys and the non-binary gender had the highest. A one-week increase in the duration of closure had a small effect on daily health complaints OR = 1.05 (1.02-1.09) in 2020; OR = 1.05 (1.02-1.08) in 2021) and anxiety OR = 1.05 (1.01-1.08). Gender differences in the associations of the school or class closure with mental health were negligible.

CONCLUSIONS

A specific negative influence of school or class closures on adolescents' mental health was seen when comparing those who had school/class closure and those who did not during the further waves of the pandemic. The duration of closure had a small effect, too. The non-binary gender had lowest mental health, but the influence of school closure on mental health was mainly similar between the genders. School closures are one of the factors in adolescents' mental health, but not the only one.

Comparison of primary school teachers' stress responses between pre-pandemic and pandemic periods: a large-scale nationwide survey in Japan

A schoolteacher's job is considered one of the most stressful occupations globally. The coronavirus disease 2019 pandemic has posed further challenges for schoolteachers. This study aimed to examine the effects of the pandemic on primary school teachers' stress responses in Japan. We analyzed the data from a nationwide survey of public-school teachers conducted between June 2019 and December 2021. The total numbers of participants were 65,968 in 2019, 72,248 in 2020, and 75,435 in 2021. Working hours and perceived main stressors as well as stress response scores were assessed. Contrary to expectations, the results showed that the stress response scores among primary school teachers did not increase in the first year of the pandemic. Rather, the stress response scores and the proportion of high-stress teachers significantly decreased from the pre-pandemic year (2019) to the first year of the pandemic (2020). However, the stress response scores showed a rising trend in the second year of the pandemic (2021). Participants' working hours decreased from 2019 to 2021. The findings in relation to teachers' main stressors matched these trends. Continuous monitoring of teachers' stress levels is required both during and after the pandemic.

Evaluation of vaccine rollout strategies for emerging infectious diseases: A model-based approach including protection attitudes

Vaccine allocation strategies become crucial during vaccine shortages, especially in the face of potential outbreaks of new infectious diseases, as witnessed during the COVID-19 pandemic. To address this, a specialized compartmental model is created, which simulates an emerging infectious disease similar to COVID-19. This model divides the population into different age groups and is used to compare various vaccine prioritisation approaches, aiming to minimize the total number of fatalities. The model is an improvement upon previous ones as it incorporates essential behavioural factors and is adapted to account for the protective effects of vaccination against both disease infection and transmission. It takes into account human behaviors such as mask-wearing and social distancing by utilizing specific parameters related to self-protection, awareness levels, and the frequency of daily person-to-person interactions within each age group. Furthermore, a novel method for dynamic vaccine prioritisation was introduced in this study. This approach is model-independent and relies on the dynamic R number. It is the first time such a method has been developed, offering a decision-making approach that is not tied to any specific model. This innovation provides a flexible and adaptable strategy for determining vaccine priorities based on real-time data and the current state of the outbreak. Our findings reveal crucial insights into vaccine allocation strategies. When the daily rollout rates are fast (0.75% or higher) and children are eligible for vaccination, prioritising groups with high daily person-to-person interactions can lead to substantial reductions in total fatalities (up to approximately 40% lower). On the other hand, if rollout rates are slower and overall vaccination coverage is high, focusing on vaccinating elders emerges as the most effective strategy, resulting in up to approximately 10% fewer fatalities. However, the scenario changes significantly when children are not eligible for vaccination, as they constitute a highly interactive population group. In this case, the differences between priority strategies become smaller. With fast daily rollout rates, prioritisation based on interactions achieves only a 7% reduction in total fatalities, while a slower rollout with vaccination of elders first leads to an approximately 11% reduction in fatalities compared to the scenario where children are eligible for vaccination. The impact of behavioural parameters is equally critical. When the self-protection levels exercised by the population are low, it significantly affects the optimal vaccine prioritisation strategy to be followed, making it essential to consider behavioural factors in decision-making.

Assessing the health, social, educational and economic impact of the COVID-19 pandemic on adolescents in low- and middle-income countries: a rapid review of the literature

COVID-19 has caused profound health, social, educational and economic devastation around the world, especially among the lives of adolescents in low- and middle-income countries. This paper looks at a wide array of outcomes impacting adolescents' daily lives including health (mental, physical, sexual and reproductive health, vaccine perceptions and overlap between these topics), social relationships (family and peer), education and socio-economic disparities. Both scientific and grey literature between December 2019 and February 2022 were sought from PubMed, Google Scholar and organisations conducting research among adolescents, and coded. A total of 89 articles were included, 73% of which were peer-reviewed; 37% of the articles were from WHO's Western Pacific region; 62% of the articles were cross-sectional; 75% were quantitative. Three major topics emerged in more than half the articles: mental health (72%), education (61%) and socio-economic ramifications (55%). However, there were regional differences in topics and many of them overlapped. The results indicate that, where there has been research, almost all findings have been linked to worse mental health during the pandemic. Overall, remote education was seen as a negative experience. The ramification of school closures on future aspirations, in particular early school leaving, highlights the importance of prioritising education during future pandemics based on the situation within the country. Gender and other disparities have made marginalised adolescents vulnerable to the economic ramifications of containment measures. Given the risks identified, there is a pressing need to put adolescents at the centre of establishing priorities for their health agenda for post-pandemic recovery.

Social and Psychological Effects of COVID-19 Pandemic on Adolescents' and Young Adults' Mental Health: A Cross-Cultural Mediation Study

The ongoing pandemic has dramatically disrupted daily life, increasing the risk of developing psychiatric disorders and poor mental wellbeing. The compound effects of social, political and psychological stressors have increased psychological symptoms among adolescents and young people, with worries about COVID-19 playing a central role in the clinical course of their mental health problems caused by the pandemic. The aim of this cross-cultural study was to examine the social psychological effects of COVID-19 on adolescents' and young people's mental health and wellbeing in Ibero-American population. Participants involved 6,283 adolescents and young adults from five different Spanish-Speaking countries (83.7% female) aged between 12 and 30 years (M = 18.79; SD = 3.48). Participants completed the Worries about COVID-19 and its Consequences Scale (W-COV), the Satisfaction with Life Scale (SWLS), and the Depression, Anxiety and Stress Scale (DASS-21). Descriptive analyses, multivariate ANOVAs and Pearson correlations were performed, as well as Structural Equation Modelling (SEM) testing a mediational model. The results indicate cross-cultural difference in COVID-19 related worries, emotional symptoms and life satisfaction. Results from SEM confirmed the overall indirect effects of COVID-19 cases, political response and participants' conditions during lockdown on depression, anxiety, stress and life satisfaction mediated by COVID-19 related worries. These findings suggest that the social psychological factors underlying psychological symptoms could be partly explained by increased worries about COVID-19 and its personal, social, economic and political consequences, which may offer guidance to policy makers and health services for safeguarding youth mental well-being.

Impact of the COVID-19 pandemic on the psychological well-being of adolescents by gender identity

OBJECTIVE

To describe the impact of the COVID-19 pandemic on the psychological well-being of adolescents in Catalan schools by gender identity, and to compare coping strategies adopted to manage the health crisis and their relationship with the self-perceived impact of COVID-19 on mental health.

METHOD

Cross-sectional study in educational centres that includes 1171 adolescents over 15 years old from October to November 2021. Multivariate logistic regression models were built to evaluate the association between coping strategies with self-perceived impact of the pandemic on mental health.

RESULTS

A greater proportion of girls perceived a worsening in mental health than boys due to COVID-19 (36.9% and 17.8%, respectively). The main emotions reported for both girls and boys were worry and boredom. The study found an association between positive coping strategies with less adverse mental health among girls, whereas unhealthy habits were associated with a higher probability of declaring worsening of mental health for both girls and boys.

CONCLUSIONS

This study demonstrated the negative impact of the COVID-19 pandemic on psychological well-being in adolescents and a clearly worse impact on girls. It is important to keep monitoring the medium- and long-term secondary impacts of the pandemic on mental health outcomes of adolescents and to gather information that can improve services for the development of healthy coping strategies during health crises like COVID-19, which include gender perspective.

Psychometric properties of the Depression, Anxiety, and Stress Scale (DASS-21) among different Chinese populations: A cross-sectional and longitudinal analysis

Given that there is limited evidence concerning the psychometric properties of DASS-21 when applied to primary school students, the present study undertook a comprehensive exploration of the psychometric evidence supporting the use of the DASS-21 within this demographic. The research comprised three studies. In Study 1, the basic psychometric properties of internal consistency and construct validity were examined. A total of 3138 primary school students from three provinces in mainland China participated. The internal reliability of the overall scale was 0.93, and for all the subscales, it was higher than 0.80. Construct validity was partially supported. Both exploratory and confirmatory factor analyses upheld the factorial validity of the original three-factor structure. While convergent validity was established, the results showed unsatisfactory discriminant validity. The bifactor model showed that DASS-21 raw scores predominantly indicated the general factor, evidenced by the high explained common variance and omega-hierarchical values. However, the contributions from the three specific factors were minimal, with their omega hierarchical values all below 0.15. In Study 2, a longitudinal design was adopted, tracking 1366 primary school students from Southwest China over a three-month interval. The results further confirmed that the DASS-21 exhibited scalar time-invariance. The latent mean analysis showed that there were no statistically significant differences in the latent means of depression, anxiety, and stress between Time 1 and Time 2. In Study 3, which included 364 college students and 483 enterprise workers, the results demonstrated that the DASS-21 had measurement invariance across different populations. The latent mean analysis further confirmed that, in terms of the latent mean of all three subscales, both college students and enterprise workers had significantly higher scores than primary school students. Overall, the findings indicated that the DASS-21 is a suitable tool for screening schoolchildren for general psychological distress, but it is not suitable for discerning distinct negative mood state disorders.

Anxiety in Children and Adolescents in the Covid-19 Pandemic: A Systematic Review

The aim of this study was; to define the anxiety and anxiety-related factors experienced by children/adolescents during the Covid-19 pandemic on a global scale. Study data were collected between 15.04.2021 and 30.04.2021 by using keywords (child, children, adolescents, adolescents, mental health, anxiety, anxiety and stress) in Turkish and English. The data sources of this study are PubMed, Web of Science, and Google Scholar t. As a result of the evaluations, a total of n=6185 articles were reached from all databases. After the evaluation of the full texts, the study was completed with n=31 articles. Eleven of the articles evaluated in this study were published in China. The anxiety prevalence of children and adolescents varies between 1.84-45.0%. As a result of the evaluated studies; It has been observed that women, those with chronic-psychiatric diseases, those who are older, separated from family members, migrant children and adolescents are more likely to experience anxiety. Some of the anxiety symptoms of children and adolescents are nervousness, irritability, anxiety, and suicidal ideation. In conclusion, anxiety levels and anxiety-related factors of children and adolescents living in various countries of the world during the Covid-19 pandemic were determined.

Relationship between household financial debt and depressive symptoms: a longitudinal study in China

OBJECTIVES

To examine the impacts of household financial debt on depressive symptoms and its possible mediating mechanisms.

DESIGN

A nationally representative longitudinal study using the ordinary least squares regression model, fixed-effects model, and instrumental variable approach to explore the relationship between household financial debt and depressive symptoms and further using structural equation models and the Bootstrap method to analyse the mediating effects.

SETTING

The China Family Panel Studies (CFPS) database.

PARTICIPANTS

Three waves of longitudinal data in 2012, 2016, and 2018 from CFPS were used. A total of 103,247 individuals over the age of 18 were included in our study sample.

OUTCOME MEASURES

Depression symptoms were assessed using an eight-item version of the Center for Epidemiologic Studies Depression Scale (CES-D8). We summed these eight items to conduct a depressive symptoms index to measure depressive symptoms.

RESULTS

Among the sample, 35.3% of the households have financial debt, 49.7% of the sample are male, 73.2% of them have rural hukou, and the average age was 46.6. Regression results showed that household financial debt had a negative effect on depressive symptoms (β=0.655, 95% CI 0.602 to 0.707, p<0.01). This result remained robust after using instrumental variables with fixed effects (β=0.483, 95% CI 0.311 to 0.656, p<0.01). Household financial debt could affect depressive symptoms through mediating variables such as working pressure (p<0.05) and life happiness (p<0.01).

CONCLUSION

Our study showed that household indebtedness in China had a negative effect on depressive symptoms. Also, we found some mediating mechanisms for this effect, which might help provide new guidance for psychological interventions to promote the mental health of indebted residents.

Associations between pre-pandemic authoritative parenting, pandemic stressors, and children's depression and anxiety at the initial stage of the COVID-19 pandemic

Large-scale changes due to the Novel Coronavirus (COVID-19) pandemic negatively affected children's mental health. Prior research suggests that children's mental health problems during the pandemic may have been concurrently attenuated by an authoritative parenting style and exacerbated by family stress. However, there is a gap in the literature investigating these mechanisms and whether pre-pandemic authoritative parenting had a lasting positive influence on children's mental health while they were exposed to pandemic-related family stressors. The current study begins to fill this gap by investigating these unique relationships in a sample of 106 4-8 year old children (51% female). Before the pandemic, caregivers completed questionnaires on their parenting style and their children's depression and anxiety symptoms. Shortly after the onset of COVID-19's stay-at-home mandate, parents answered questionnaires about their children's depression and anxiety symptoms and pandemic-related family stressors. Child depression and anxiety symptom severity increased. Higher levels of pandemic-related family stress were associated with increases only in child anxiety scores. Further, greater endorsement of a pre-pandemic authoritative parenting style was associated with smaller changes only in child depression scores. Study findings elucidate unique and complex associations between young children's anxiety and depression symptoms severity and pre-pandemic parenting and pandemic-related family stressors.

Impact of COVID-19 Pandemic on Children's Fundamental Motor Skills: A Study for the Taiwanese Preschoolers Teachers

The outbreak of the COVID-19 pandemic has resulted in reduced opportunities for children to engage in fundamental motor skills [FMS]. This prolonged inactivity and restriction of play can have serious consequences for children's physical and mental health. The purpose of this study was to explore teaching strategies during the pandemic, whether there were differences in children's motor development, and the differences in the implementation of physical movement courses before and during the pandemic from the perspective of preschool teachers. This study was a retrospective study using an internet survey, and participants comprised 2337 preschool teachers. The statistical methodology of this study included descriptive statistics, the dependent t-test, and the independent t-test. The results showed that regardless of the time, frequency, activity intensity, and frequency of outdoor courses, the results from before the pandemic was better than those taken during the pandemic. Only the "frequency of implementing physical movement courses indoors every week" had not been affected by the pandemic. This study also obtained the performance of "children's fitness", "overall performance of physical movement ability", "stability movement skills", "locomotor movement skills", and "manipulative movement skills". All were better before the pandemic than during the pandemic. During the COVID-19 pandemic, mixed-age classes performed better than same-age classes in terms of frequency, time, intensity, outdoor course implementation, and physical fitness. Public schools performed better than private schools in terms of frequency, time, intensity, outdoor course implementation, and fundamental motor skills performance. Private schools implemented physical movement courses indoors every week, which was more than public schools. Excepting the frequency of implementing physical movement courses indoors every week, fewer than schools with five classes performed better than those who had more than schools with six classes. Finally, rural schools were better than urban schools in the implementation of outdoor courses and fundamental motor skills performance. Therefore, we suggest that in response to the pandemic, teachers should further improve their professionalism and use diversified teaching methods, and guide students to be willing to learn and improve their skill performance.

Changes in physical activity level of adolescents and its relationship with mental health during regular COVID-19 prevention and control

PURPOSE

This study aimed to analyze the impact of regular prevention and control of COVID-19 on the physical activity level (PAL) of adolescents and the relationship between PAL and mental health.

METHODS

Using the convenience sampling method, two stages of the on-site cross-sectional investigation were conducted in 11 middle schools in Guiyang City in China. There were 1132 participants who completed the Physical Activity Questionnaire for old children (PAQ-C) in October 2020, and 1503 participants who completed the PAQ-C and Mental Health Inventory of Middle-school students (MMHI-60) in October 2021. All participants reported their demographic data. Descriptive, quantitative statistics were used for data analysis. One-way ANOVA was used to explore associations between PAL and mental health.

RESULTS

The results of statistical analysis showed a gradual yearly increase in the PAL of teenagers, and the PAL of male junior middle school students has a significant increase (p < .05); while that of adolescents in Grade 10 significantly decreased (p < .001). There is a statistically significant correlation between adolescents' mental health (except for anxiety) and PAL (p < .05). The overall abnormal rate of mental health was 27.9%; The PAL and the total mean score of mental health had a negative correlation (p < .001). There was a significant difference between mental health scores and corresponding PAL (p < .001). Furthermore, there are statistically significant differences in scores of mental health factors corresponding to varying PAL among junior high school students and male students (p < .05).

CONCLUSIONS

The regular epidemic prevention and control measures had significant adverse effects on the PAL of girls and high school adolescents, especially Grade 10 adolescents. Improving adolescents' PAL can promote their mental health. Interventions based on PAL slightly lower than the level recommended in the physical activity guidelines can bring significant mental health effects.

Subjective well-being and school engagement before versus during the COVID-19 pandemic: What good are positive emotions?

The present study overcomes the limited empirical evidence on the association between well-being and school engagement in times of adversity by exploiting available data from two large and comparable samples of eighth graders; one obtained prior to the COVID-19 pandemic and the second obtained during the pandemic. Results suggest that adolescents were less engaged with their learning context during the pandemic, as well as lower in positive and negative affect, but slightly more satisfied with life. Through SEM we found a stronger positive association between positive affect and school engagement in the COVID-19 group compared with the pre-COVID-19 group. This finding highlights the important role of positive affect in supporting better academic functioning in the aftermath of a global crisis.

Psychological Toll of the COVID-19 Pandemic: An In-Depth Exploration of Anxiety, Depression, and Insomnia and the Influence of Quarantine Measures on Daily Life

The COVID-19 pandemic, on a global scale, has prompted multifaceted challenges, including a notable psychological toll on the general population. This study uses mixed-method approach for a nuanced exploration of these experiences. Using a phenomenological strategy, qualitative responses from 999 participants were analyzed regarding their pandemic-induced anxiety and the influence of quarantine measures on their lives. Quantitative measures, including the revised Impact of Event Scale (IES-R), patient health questionnaire-9 (PHQ-9), the seven-item generalized anxiety disorder assessment (GAD-7), and Insomnia Severity Index (ISI), were used to quantify trauma, depression, anxiety, and insomnia attributed to COVID-19. Partial least squares structural equation modeling (PLS-SEM) was utilized for quantitative data analysis. The anxiety-related responses were mainly clustered into four themes: life threats, support shortage, economic consequences, and disruptions to family and social life. Subthemes that addressed the perceived effects encapsulated disruptions to academic and professional lives, familial and social relationships, psychopathological stress, and movement limitations. The findings from quantitative analysis revealed the significant associations between COVID-19-related trauma and symptoms of anxiety, depression, and insomnia, as indicated by coefficients exceeding 0.10 (all z-values > 1.96; p-values < 0.05). In conclusion, the findings underscore COVID-19's role in escalating anxiety, influenced by various factors, and its disruptive effects on daily life due to quarantine measures. The strong associations between the pandemic and the symptoms of depression, anxiety, and insomnia underscore the urgency of comprehensive psychological and public health interventions to alleviate these impacts.

Perceived Quality of Life and Life Satisfaction: Does the Role of Gender, Age, Skills, and Psychological Factors Remain Relevant after the COVID-19 Pandemic?

BACKGROUND

After two years of psychological, physical, social, economic, environmental, and societal challenges, this paper examines the psychological health and well-being of Portuguese students based on their socioemotional skills (SSES), positive youth development (PYD), depression, anxiety, and stress (DASS), as well as the relationship between these variables and their influence on perceived quality of life and life satisfaction.

METHODS

This study examined 3235 students from lower to upper secondary, half of whom were female (M = 14.46 ± 1.883 years old). Using SPSS software, descriptive statistics were determined for all variables; mean differences between age and gender were found using ANOVA and the post hoc Scheffe test. Linear regressions with the Enter method were used to study how to predict perceived quality of life and satisfaction with life.

RESULTS

Males had scores indicating more SSES|optimism, emotional control, resilience, confidence, sociability, creativity, energy, a sense of belonging to school, and PYD. Girls had better skills for cooperating and relating to teachers but more test anxiety and DASS. Younger adolescents had better psychological health, greater skills, and a better perception of quality of life and life satisfaction when compared to older adolescents. Age, gender, SSES, PYD, and the DASS variables can explain 69% of the variance in life satisfaction, while these variables can explain 60.5% of the variance in perceived quality of life.

CONCLUSIONS

These results point to the relevance of SSES for psychological health and well-being, suggesting that interventions should focus on promoting these variables, paying special attention to female gender and age-related challenges.