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Zani B, Luckett B, Thurman TR. COVID-19 pandemic stressors, familial discord, and anxiety among adolescents living with HIV in South Africa: pathways to non-adherence. AIDS Care 2024; 36:137-144. [PMID: 38301123 DOI: 10.1080/09540121.2024.2308025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024]
Abstract
Adolescents living with HIV (ALHIV) have poorer adherence to antiretroviral treatment (ART). This study investigates the interconnectivity of stressors induced by the COVID-19 pandemic, anxiety and family dynamics on adolescents' adherence to ART. A telephone survey was conducted among 196 South African ALHIV previously enrolled in support groups. Generalized structural equations modeling was used to understand how pandemic-related stressors affected ART adherence. Respondents reported experiencing life stressors since the implementation of COVID-19 restrictions, including doing worse at school (32%), loss of household income (44%) and less food available (38%). Forty-two percent reported greater verbal aggression from adults at home and 60% experienced anxiety. The structural equations model demonstrated a direct path from experiencing life stressors to increased verbal aggression from caregivers, which led to anxiety and ultimately, poorer ART adherence. Each stressor experienced increased the odds of experiencing verbal aggression by 51% (OR=1.51, 95%CI=1.14-2.00) which, in turn, increased the odds of having anxiety four-fold (OR=4.1, 95%C =2.16-7.76). Anxiety was associated with a 74% reduction in the odds of being fully ART adherent (OR=0.26, 95%CI=0.08-0.81). COVID-19-induced stressors exacerbated the mental and physical vulnerability of ALHIV. Findings elucidate how both discord at home and anxiety can result in poorer ART adherence.
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Affiliation(s)
- Babalwa Zani
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
| | - Brian Luckett
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
- School of Public Health and Tropical Medicine, Department of International Health and Sustainable Development, Tulane University, New Orleans, LA, USA
| | - Tonya R Thurman
- Tulane International, Cape Town, South Africa
- Highly Vulnerable Children Research Center, Cape Town, South Africa
- School of Public Health and Tropical Medicine, Department of International Health and Sustainable Development, Tulane University, New Orleans, LA, USA
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Chaffee BW, Cheng J, Couch ET, Halpern-Felsher B. Engagement, Mental Health, and Substance Use Under In-Person or Remote School Instruction During the COVID-19 Pandemic. THE JOURNAL OF SCHOOL HEALTH 2024; 94:501-508. [PMID: 38086782 PMCID: PMC11088987 DOI: 10.1111/josh.13418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/02/2023] [Accepted: 11/13/2023] [Indexed: 05/14/2024]
Abstract
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.
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Affiliation(s)
- Benjamin W. Chaffee
- Center for Tobacco Control Research and Education, University of California San Francisco, 707 Parnassus Avenue, D3214 - Box 0758, San Francisco, CA 94143
| | - Jing Cheng
- Center for Tobacco Control Research and Education, University of California San Francisco, 707 Parnassus Avenue, D3214 - Box 0758, San Francisco, CA 94143
| | - Elizabeth T. Couch
- Center for Tobacco Control Research and Education, University of California San Francisco, 707 Parnassus Avenue, D3214 - Box 0758, San Francisco, CA 94143
| | - Bonnie Halpern-Felsher
- Division of Adolescent Medicine, Stanford University, 770 Welch Road Suite 100, Stanford, CA 94304
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Feng W, Zhao L, Ge Z, Zhao X, Li T, Zhu Q. Association between physical activity and adolescent mental health in the post COVID-19: The chain mediating effect of self-esteem and social anxiety. PLoS One 2024; 19:e0301617. [PMID: 38758776 PMCID: PMC11101116 DOI: 10.1371/journal.pone.0301617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/19/2024] [Indexed: 05/19/2024] Open
Abstract
BACKGROUND In order to gain a deeper understanding of the relationship between physical activity and adolescent mental health in the post COVID-19 pandemic era, self-esteem and social anxiety were used as mediating variables to explore the potential mechanisms by which physical activity affects adolescent mental health. METHODS The study used the HELP-II Health Promoting Lifestyle Scale, the SPIN Social Phobia Scale, the Self-Esteem Scale, and the 10-item Kessler Psychological Distress Scale to administer questionnaires to 400 Chinese secondary school students, and SPSS 26.0 and PROCESS 3.3 were used to process the data. RESULTS The findings showed that (1) physical activity was significantly and positively associated with mental health; (2) self-esteem and social anxiety played a fully mediating role between physical activity and adolescent mental health respectively; (3) self-esteem and social anxiety played a chain mediating role between physical activity and adolescent mental health. CONCLUSION This study reveals the relationship and influencing mechanism between physical activity and adolescent mental health in the post COVID-19 pandemic era. Appropriate interventions for physical activity, self-esteem, and social anxiety may be beneficial to adolescent mental health. The protective role of self-esteem in adolescent mental health should be the focus of future studies, and further investigations into the association between the COVID-19 and adolescent mental health are warranted.
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Affiliation(s)
- Wanxuan Feng
- School of Physical Education, Shandong University, Lixia District, Jinan City, Shandong Province, China
| | - Liangyu Zhao
- School of Physical Education, Shandong University, Lixia District, Jinan City, Shandong Province, China
| | - Zhang Ge
- School of Physical Education, Shandong University, Lixia District, Jinan City, Shandong Province, China
| | - Xiuhan Zhao
- School of Physical Education, Shandong University, Lixia District, Jinan City, Shandong Province, China
| | - Tuojian Li
- School of Physical Education, Shandong University, Lixia District, Jinan City, Shandong Province, China
| | - Qiying Zhu
- School of Physical Education, Shandong University, Lixia District, Jinan City, Shandong Province, China
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Michael SL, Li J, Sliwa S, Cornett K, Hertz M. Association Between Adolescent Self-Reported Physical Activity Behaviors and Feeling Close to People at School During the COVID-19 Pandemic. Am J Lifestyle Med 2024; 18:364-375. [PMID: 38737878 PMCID: PMC9941458 DOI: 10.1177/15598276231157324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024] Open
Abstract
The disruption of school operations and routines caused by the COVID-19 pandemic affected students' physical and emotional well-being. Providing physical activity opportunities in schools can encourage students to positively engage with each other. Using a nationally representative sample of U.S. high school students from the Adolescent Behaviors and Experiences Survey (January to June 2021), we examined the association between physical activity behaviors and feeling close to people at school using sex-stratified and race/ethnicity-stratified multiple linear regressions models. Participating in team sports, being more physically active, and attending physical education (PE) during an average week were all associated with higher levels of feeling close to people at school, with variation by sex and race/ethnicity. These associations were also significant when the physical activity behavior variables were categorized to reflect national recommendations. Daily physical activity (i.e., ≥60 minutes all 7 days), daily PE (i.e., attended all 5 days), and the number of Comprehensive School Physical Activity Program (CSPAP) components implemented were associated with higher levels of feeling close to people at school. These findings suggest that opportunities for physical activity before, during, and after school are associated with increased levels of feeling close to people at school during crises like COVID-19.
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Affiliation(s)
- Shannon L. Michael
- Division of Population, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jingjing Li
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Sarah Sliwa
- Division of Population, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kelly Cornett
- Division of Population, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Marci Hertz
- Division of Adolescent and School Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Oblath R, Dayal R, Loubeau JK, Lejeune J, Sikov J, Savage M, Posse C, Jain S, Zolli N, Baul TD, Ladino V, Ji C, Kabrt J, Sidky L, Rabin M, Kim DY, Kobayashi I, Murphy JM, Garg A, Spencer AE. Trajectories and correlates of mental health among urban, school-age children during the COVID-19 pandemic: a longitudinal study. Child Adolesc Psychiatry Ment Health 2024; 18:32. [PMID: 38486248 PMCID: PMC10941406 DOI: 10.1186/s13034-024-00712-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 01/25/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic posed numerous obstacles to psychosocial wellbeing for children. We conducted a longitudinal study to evaluate child mental health and social risks during the pandemic. METHODS Participants were 172 caregivers of children aged 6-11 years old who attended well child visits within 6 months before pandemic onset at an urban safety net hospital in the US. Prepandemic data was extracted from the electronic medical record, and surveys were administered at three time points between August 2020 and July 2021. We measured mental health symptoms with the Pediatric Symptom Checklist-17, social risks (e.g., food and housing insecurity) with the THRIVE questionnaire, and school modality (in-person, hybrid, remote). RESULTS Compared to pre-pandemic, children had significantly higher PSC-17 total scores (overall mental health symptoms) and THRIVE total scores (total burden of social risks) at all three mid-pandemic waves. Using longitudinal mixed models accounting for time, social risks, and school modality, both social risks (B = 0.37, SE = 0.14, p < 0.01) and school modality were significantly associated with PSC-17 scores (B = - 1.95, SE = 0.63, p < 0.01). Children attending in-person school had fewer mental health symptoms than those attending remote or hybrid school. CONCLUSION Mental health symptoms and social risks remained significantly higher fifteen months after the onset of the COVID-19 pandemic compared to prepandemic. In-person attendance at school appeared protective against persistently elevated mental health symptoms.
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Affiliation(s)
- Rachel Oblath
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, MA, USA
- BEST Partnership for Behavioral Health, Racial, and Social Justice, Boston, MA, USA
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Rohan Dayal
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- School of Public Health, Boston University, Boston, MA, USA
| | | | - Julia Lejeune
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Jennifer Sikov
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- Department of Psychology, College of Arts, Sciences, and Education, Florida International University, FL, Miami, USA
| | - Meera Savage
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Catalina Posse
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Sonal Jain
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- Department of Psychiatry & Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Nicole Zolli
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Tithi D Baul
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston Medical Center, Boston, MA, USA
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Valeria Ladino
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Chelsea Ji
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Jessica Kabrt
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Lillian Sidky
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Megan Rabin
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Do Yoon Kim
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
| | - Imme Kobayashi
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA
- New York University Grossman School of Medicine, NY, New York City, USA
| | - J Michael Murphy
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Arvin Garg
- Department of Pediatrics, Child Health Equity Center, University of Massachusetts Chan Medical School, Worcester, MA, USA
- University of Massachusetts Memorial Children's Medical Center, Worcester, MA, USA
| | - Andrea E Spencer
- Department of Psychiatry, Boston Medical Center, Boston, MA, USA.
- Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E Chicago Ave, Chicago, IL, 60611, USA.
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, IL, Chicago, USA.
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Raney JH, Weinstein S, Ganson KT, Testa A, Jackson DB, Pantell M, Glidden DV, Brindis CD, Nagata JM. Mental Well-Being Among Adversity-Exposed Adolescents During the COVID-19 Pandemic. JAMA Netw Open 2024; 7:e242076. [PMID: 38477919 PMCID: PMC10938185 DOI: 10.1001/jamanetworkopen.2024.2076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 01/22/2024] [Indexed: 03/14/2024] Open
Abstract
Importance Further research is needed to understand factors associated with well-being during the COVID-19 pandemic among adolescents who have experienced adverse childhood experiences (ACEs). Objective To explore factors associated with improved mental health during the COVID-19 pandemic among adolescents who have experienced ACEs. Design, Setting, and Participants This cross-sectional study used data from the baseline (2016-2018) and sixth (March 2021) COVID Rapid Response Research (RRR) surveys of the Adolescent Brain Cognitive Development study, which includes 21 sites across the US. Adolescents aged 11 to 15 years who completed the COVID RRR mental health measures were included. Data analyses were conducted from June to August 2023. Exposures School-based factors (eg, in-person school) and 8 coping behaviors (eg, exercise). Main Outcomes and Measures The primary outcomes were adolescent-reported positive affect (PA) and perceived stress (PS). Adolescents were stratified by no ACEs, low-to-intermediate ACEs (1-3), and high ACEs (≥4). Linear regressions estimated associations between factors and mental health, adjusting for potential confounders. Unstandardized beta coefficients (B) were compared with equality of coefficients tests. Results The 4515 adolescents in this study (mean [SD] age, 13.3 [0.88] years; 51% [95% CI, 50% to 53%] female) were racially and ethnically diverse (American Indian/Alaska Native, 2% [95% CI, 2% to 3%]; Asian, 8% [95% CI, 7% to 9%]; Black, 11% [95% CI, 10% to 12%]; Latino or Hispanic, 17% [95% CI, 15% to 18%]; White, 61% [95% CI, 60% to 63%]; other, 1% [95% CI, 0% to 2%]). For youths with high ACEs, caring for one's body (PA B = 4.02 [95% CI, 1.39 to 6.66]; PS B = -0.92 [95% CI, -1.84 to 0.00]), exercising (PA B = 3.19 [95% CI, 0.46 to 5.92]; PS B = -1.41 [95% CI, -2.40 to -0.43]), and engaging in healthy behaviors (PA B = 4.07 [95% CI, 1.28 to 6.84]; PS B = -1.01 [95% CI, -1.98 to -0.05]) were associated with higher PA and lower PS scores. In-person schooling had a greater impact on PA scores for youths with high ACEs (B = 5.55 [95% CI, 2.08 to 9.01]) than youths with low-to-intermediate ACEs (B = 1.27 [95% CI, 0.27 to 2.27]). Conclusions and Relevance These findings suggest that in-person schooling and several coping behaviors (caring for one's body, exercising, and engaging in healthy behaviors) were associated with significantly higher PA and lower PS during the COVID-19 pandemic among adolescents with high ACEs. Adolescents with high ACEs demonstrated especially greater mental health scores when they reported in-person schooling. Future studies should build on these findings to identify clinical and school-based mental health protective factors for adolescents with high ACE risk.
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Affiliation(s)
- Julia H. Raney
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco
| | | | - Kyle T. Ganson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
| | - Alexander Testa
- Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston
| | - Dylan B. Jackson
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Matthew Pantell
- Division of Hospital Medicine, Department of Pediatrics, University of California, San Francisco
| | - David V. Glidden
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Claire D. Brindis
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco
- Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
| | - Jason M. Nagata
- Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco
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Madhanagopal N, Ahmad A, Hu YH, Olango G, Molla M. Mental Health Symptoms and Service Use in Depressed and Anxious Minors at the Onset of COVID-19 in a County Clinic Serving a Predominantly Hispanic Population. Cureus 2024; 16:e55160. [PMID: 38558688 PMCID: PMC10979717 DOI: 10.7759/cureus.55160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2024] [Indexed: 04/04/2024] Open
Abstract
OBJECTIVE The study's primary aim was to compare the utilization rates of services by minors with depression/anxiety in a county mental health clinic before (from December 1, 2019, to March 15, 2020) and during the COVID-19 pandemic (from March 16 to June 30, 2020). The secondary aim was to study demographics and psychiatric symptomatology. METHODS Service utilization rates were estimated. Univariate and multivariate logistic regression was used to identify significant predictors of worsening psychiatric symptoms, anxiety, and change in the frequency of therapy between the pre-COVID-19 period and the COVID-19 period. RESULTS Service utilization rates increased during the pandemic period. During the pandemic, the presence of mood symptoms, suicidal ideation, and relationship conflicts predicted worsening psychiatric symptoms. In addition, the presence of preexisting sleep problems and physical health issues that continued during COVID-19 exhibited correlations with worsening psychiatric symptoms during COVID-19. COVID-related stressors and physical health issues were associated with anxiety; suicidal ideation predicted a change in the frequency of therapy. CONCLUSIONS Prospective studies to recognize risk factors for worsening mental health in minors with psychiatric illness during a crisis are warranted to identify and allocate services to the high-risk groups.
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Affiliation(s)
- Nandhini Madhanagopal
- Psychiatry, Child and Adolescent Psychiatry, Kern Medical, Kern Behavioral Health & Recovery Services, UCLA-Kern Child & Adolescent Psychiatry Fellowship Program, Bakersfield, USA
| | - Ammar Ahmad
- Psychiatry, Child and Adolescent Psychiatry, Kern Medical, Kern Behavioral Health & Recovery Services, UCLA-Kern Child & Adolescent Psychiatry Fellowship Program, Bakersfield, USA
| | - Yu-Hsi Hu
- Psychiatry, Child and Adolescent Psychiatry, Veterans Administration, Palo Alto, USA
| | - Garth Olango
- Psychiatry, Child and Adolescent Psychiatry, Kern Medical, Kern Behavioral Health & Recovery Services, UCLA-Kern Child & Adolescent Psychiatry Fellowship Program, Bakersfield, USA
| | - Mohammed Molla
- Psychiatry, Child and Adolescent Psychiatry, Kern Medical, Kern Behavioral Health & Recovery Services, UCLA-Kern Child & Adolescent Psychiatry Fellowship Program, Bakersfield, USA
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8
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Kiss O, Qu Z, Müller-Oehring EM, Baker FC, Mirzasoleiman B. Sleep, brain systems, and persistent stress in early adolescents during COVID-19: Insights from the ABCD study. J Affect Disord 2024; 346:234-241. [PMID: 37944709 PMCID: PMC10842722 DOI: 10.1016/j.jad.2023.10.158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
PURPOSE The first year of the COVID-19 pandemic constituted a major life stress event for many adolescents, associated with disrupted school, behaviors, social networks, and health concerns. However, pandemic-related stress was not equivalent for everyone and could have been influenced by pre-pandemic factors including brain structure and sleep, which both undergo substantial development during adolescence. Here, we analyzed clusters of perceived stress levels across the pandemic and determined developmentally relevant pre-pandemic risk factors in brain structure and sleep of persistently high stress during the first year of the COVID-19 pandemic. METHODS We investigated longitudinal changes in perceived stress at six timepoints across the first year of the pandemic (May 2020-March 2021) in 5559 adolescents (50 % female; age range: 11-14 years) in the United States (U.S.) participating in the Adolescent Brain Cognitive Development (ABCD) study. In 3141 of these adolescents, we fitted machine learning models to identify the most important pre-pandemic predictors from structural MRI brain measures and self-reported sleep data that were associated with persistently high stress across the first year of the pandemic. RESULTS Patterns of perceived stress levels varied across the pandemic, with 5 % reporting persistently high stress. Our classifiers accurately detected persistently high stress (AUC > 0.7). Pre-pandemic brain structure, specifically cortical volume in temporal regions, and cortical thickness in multiple parietal and occipital regions, predicted persistent stress. Pre-pandemic sleep difficulties and short sleep duration were also strong predictors of persistent stress, along with more advanced pubertal stage. CONCLUSIONS Adolescents showed variable stress responses during the first year of the COVID-19 pandemic, and some reported persistently high stress across the whole first year. Vulnerability to persistent stress was evident in several brain structural and self-reported sleep measures, collected before the pandemic, suggesting the relevance of other pre-existing individual factors beyond pandemic-related factors, for persistently high stress responses.
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Affiliation(s)
- Orsolya Kiss
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA.
| | - Zihan Qu
- Electrical and Computer Engineering Department, University of California Los Angeles, 420 Westwood Plaza, Los Angeles, CA 90095, USA
| | - Eva M Müller-Oehring
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Rd., Stanford, CA 94305, USA
| | - Fiona C Baker
- Center for Health Sciences, SRI International, 333 Ravenswood Ave, Menlo Park, CA 94025, USA; Brain Function Research Group, School of Physiology, University of the Witwatersrand, Johannesburg, South Africa
| | - Baharan Mirzasoleiman
- Computer Science Department, University of California Los Angeles, 404 Westwood Plaza, Los Angeles, CA 90095, USA
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Campbell CE, Cotter DL, Bottenhorn KL, Burnor E, Ahmadi H, Gauderman WJ, Cardenas-Iniguez C, Hackman D, McConnell R, Berhane K, Schwartz J, Chen JC, Herting MM. Air pollution and age-dependent changes in emotional behavior across early adolescence in the U.S. ENVIRONMENTAL RESEARCH 2024; 240:117390. [PMID: 37866541 PMCID: PMC10842841 DOI: 10.1016/j.envres.2023.117390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 08/24/2023] [Accepted: 10/11/2023] [Indexed: 10/24/2023]
Abstract
Recent studies have linked air pollution to increased risk for behavioral problems during development, albeit with inconsistent findings. Additional longitudinal studies are needed that consider how emotional behaviors may be affected when exposure coincides with the transition to adolescence - a vulnerable time for developing mental health difficulties. This study investigates if annual average PM2.5 and NO2 exposure at ages 9-10 years moderates age-related changes in internalizing and externalizing behaviors over a 2-year follow-up period in a large, nationwide U.S. sample of participants from the Adolescent Brain Cognitive Development (ABCD) Study®. Air pollution exposure was estimated based on the residential address of each participant using an ensemble-based modeling approach. Caregivers answered questions from the Child Behavior Checklist (CBCL) at the baseline, 1-year follow-up, and 2-year follow-up visits, for a total of 3 waves of data; from the CBCL we obtained scores on internalizing and externalizing problems plus 5 syndrome scales (anxious/depressed, withdrawn/depressed, rule-breaking behavior, aggressive behavior, and attention problems). Zero-inflated negative binomial models were used to examine both the main effect of age as well as the interaction of age with each pollutant on behavior while adjusting for various socioeconomic and demographic characteristics. Against our hypothesis, there was no evidence that greater air pollution exposure was related to more behavioral problems with age over time.
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Affiliation(s)
- Claire E Campbell
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, 90089-2520, USA
| | - Devyn L Cotter
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Neuroscience Graduate Program, University of Southern California, Los Angeles, CA, 90089-2520, USA
| | - Katherine L Bottenhorn
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Department of Psychology, Florida International University, Miami, FL, USA
| | - Elisabeth Burnor
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Hedyeh Ahmadi
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - W James Gauderman
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Carlos Cardenas-Iniguez
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Daniel Hackman
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, 90089, USA
| | - Rob McConnell
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Kiros Berhane
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, 10032, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Jiu-Chiuan Chen
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles, CA, 90063, USA
| | - Megan M Herting
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA; Children's Hospital Los Angeles, Los Angeles, CA, 90027, USA.
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10
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Wang MT, Scanlon CL, Del Toro J, Qin X. Adolescent psychological adjustment and social supports during pandemic-onset remote learning: A national multi-wave daily-diary study. Dev Psychopathol 2023; 35:2533-2550. [PMID: 37655613 DOI: 10.1017/s0954579423001049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
In spring 2020, U.S. schools universally transitioned to online learning due to the COVID-19 pandemic's onset, thus creating a natural experiment for examining adolescents' risk and resilience during an ongoing school crisis response. This longitudinal study used a daily-diary approach to investigate the role of social support in the link between remote learning and psychological well-being across 64 days among a national sample of adolescents (n = 744; 42% Black, 36% White, 22% Other ethnicity/race; 41% boys; 72% eligible for free/reduced-priced lunch; Mage=14.60, SDage=1.71, age-range = 12-17 years). On days when youth attended remote learning, they reported lower daily positive affect, more daily stress, and higher parent social support. There were no significant differences in the effect of remote learning on affect or stress by race or economic status. On days when youth experienced more parent support, they reported lower daily stress and negative affect and higher daily positive affect. On days when youth experienced more peer support, they reported higher daily positive affect. Overall, the study highlights the impact of pandemic-onset remote learning on adolescents' psychological well-being and emphasizes the need for future research on school crisis contingency planning to address these challenges.
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Affiliation(s)
| | | | | | - Xu Qin
- University of Pittsburgh, Pittsburgh, PA, USA
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11
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Santana de Lima E, Preece C, Potter K, Goddard E, Edbrooke-Childs J, Hobbs T, Fonagy P. A community-based approach to identifying and prioritising young people's mental health needs in their local communities. RESEARCH INVOLVEMENT AND ENGAGEMENT 2023; 9:104. [PMID: 37996912 PMCID: PMC10666450 DOI: 10.1186/s40900-023-00510-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 10/24/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Identifying locally relevant and agreed-upon priorities for improving young people's mental health, aligned with social and environmental factors, is essential for benefiting target communities. This paper describes a participatory approach to engage young people and professionals in identifying such priorities, whilst considering the social determinants related to them. METHODS We utilised a community-based participatory approach to support young people and professionals in identifying, reviewing, refining, and prioritising, locally relevant opportunity areas that are crucial for understanding and addressing social determinants of young people's mental health. We adopted a flexible five-stage process, which enabled greater reflection and adaptation in response to young people's and professionals' feedback and reflections. RESULTS Over seven months, we engaged with young people and professionals in Northern Devon, (a rural area in southwest England), involving over 290 individuals to identify locally relevant priorities for supporting young people's mental health. Three priorities were identified for subsequent exploration using co-design approaches: (1) identity and belonging; (2) mental health awareness and literacy; and (3) diverse opportunities (for education, employment and leisure). The engagements suggested that designing initiatives and strategies in these areas could contribute to improvements in young people's mental health. CONCLUSION Young people in Northern Devon prioritised three themes for the next phase of the Kailo Programme-mental health literacy, access to diverse careers and employment opportunities, and identity and belonging within their communities. Rural communities face unique barriers associated with these issues, related to less diverse populations, lack of access to reliable and affordable transport and local industries, and seasonal working. The perceived neglect by authorities towards rural young people has resulted in a lack of activities and opportunities catering to their specific needs, compared to urban areas. Although the government has recognised the need to address these disparities, community members suggest that there is still more work to be done.
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Affiliation(s)
- Ediane Santana de Lima
- Dartington Service Design Lab, Buckfastleigh, UK
- Dartington Service Design Lab, Bristol, UK
| | - Cristina Preece
- Dartington Service Design Lab, Buckfastleigh, UK
- Dartington Service Design Lab, Hereford, UK
| | - Katie Potter
- Dartington Service Design Lab, Buckfastleigh, UK
- Dartington Service Design Lab, Stoke Gabriel, UK
| | - Ellen Goddard
- Dartington Service Design Lab, Buckfastleigh, UK
- Dartington Service Design Lab, Bangor, UK
| | | | - Tim Hobbs
- Dartington Service Design Lab, Buckfastleigh, UK
- Dartington Service Design Lab, Totnes, UK
| | - Peter Fonagy
- University College London (UCL), London, UK
- Division of Psychology and Language Sciences at University College London (UCL), London, UK
- Anna Freud National Centre for Children and Families, London, UK
- Child and Family Programme at the Menninger Department of Psychiatry and Behavioural Sciences at Baylor College of Medicine, London, UK
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12
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Hinoveanu D, Anastasiu DM, Citu C, Crisan DC, Popa ZL, Nicolae N, Dumitru C, Neda-Stepan O, Fericean RM, Stelea L. Mental Health and Contraceptive Knowledge in High Schoolers: Comparing Remote and In-Person Learning during COVID-19. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1876. [PMID: 37893594 PMCID: PMC10608468 DOI: 10.3390/medicina59101876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 10/16/2023] [Accepted: 10/20/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: In response to the COVID-19 pandemic's effects on education, this study delves into the behavioral, mental health, and sexual education characteristics of high school students during 2020-2021 and 2022-2023. Materials and Methods: We evaluated a variety of factors, including substance use, academic performance, sexual activities, mental health support, pandemic-related anxiety levels, and quality of life indicators using standardized instruments such as the SF-36, GAD-7, and WHOQOL-BREF. Furthermore, we addressed specific questions concerning contraception and sexual education during this period. Results: The questionnaires were filled in by 44 students in 2020-2021 and 41 students in 2022-2023. Significant findings included a noteworthy increase in COVID-19 vaccination rates, from 18.2% in 2020-2021 to 39.0% in 2022-2023 (p = 0.033), enhanced perceptions of mental health support during remote learning, from 7.1% to 20.0% (p = 0.044), and a rise in students partaking in reproductive health discussions from 10.7% to 25.0% (p = 0.046). Additionally, there was a marked decline in anxiety regarding the transition back to in-person learning (p = 0.048). Health surveys, such as the SF-36, signaled improvements in both physical and mental health over the years (p = 0.046 and p = 0.019, respectively), while the GAD-7 scores depicted a considerable reduction in anxiety symptoms (p = 0.038). The WHOQOL-BREF results also highlighted a significant uptick in students' mental well-being in 2022-2023 (p = 0.039). Conclusions: As the COVID-19 pandemic ended, high school students exhibited shifts in behavior, health, and education over four academic years, particularly in areas of contraceptive knowledge and mental health outcomes. The pronounced enhancements in vaccination rates, perceptions of mental health support, participation in health conversations, and overall mental wellness emphasize the adaptability and resilience of students in these tumultuous periods, and a general increase in contraceptive knowledge and quality of life during the end of the pandemic.
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Affiliation(s)
- Denisa Hinoveanu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (D.C.C.); (N.N.); (C.D.); (L.S.)
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (O.N.-S.); (R.M.F.)
| | - Doru Mihai Anastasiu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (D.C.C.); (N.N.); (C.D.); (L.S.)
| | - Cosmin Citu
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (D.C.C.); (N.N.); (C.D.); (L.S.)
| | - Doru Ciprian Crisan
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (D.C.C.); (N.N.); (C.D.); (L.S.)
| | - Zoran Laurentiu Popa
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (D.C.C.); (N.N.); (C.D.); (L.S.)
| | - Nicoleta Nicolae
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (D.C.C.); (N.N.); (C.D.); (L.S.)
| | - Catalin Dumitru
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (D.C.C.); (N.N.); (C.D.); (L.S.)
| | - Oana Neda-Stepan
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (O.N.-S.); (R.M.F.)
- Department VIII—Neurosciences, Discipline of Psychiatry, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania
| | - Roxana Manuela Fericean
- Doctoral School, “Victor Babes” University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania; (O.N.-S.); (R.M.F.)
- Department of Infectious Diseases, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania
| | - Lavinia Stelea
- Department of Obstetrics and Gynecology, “Victor Babes” University of Medicine and Pharmacy Timisoara, 300041 Timisoara, Romania; (D.H.); (D.M.A.); (C.C.); (D.C.C.); (N.N.); (C.D.); (L.S.)
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13
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Irani S, Chang C, Morrison L, Waselewski M, Chang T. Youth experiences with and perspectives on long covid. BMC Public Health 2023; 23:2059. [PMID: 37864192 PMCID: PMC10588061 DOI: 10.1186/s12889-023-16899-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 10/04/2023] [Indexed: 10/22/2023] Open
Abstract
BACKGROUND Research on the long-term effects of COVID-19 infection is ongoing, and the psychological and physical impacts of Long Covid on youth is poorly understood. To assess these impacts, we surveyed youth regarding their experiences with, and perspectives on, the long-term effects of COVID-19. METHODS We conducted a nationwide text message survey of youth ages 14-24 years in the United States. The survey asked four open ended questions regarding their experiences and perceptions regarding the long-term effects of COVID-19. Qualitative data was analyzed independently by three investigators using thematic analysis. Prevalence of codes were summarized using descriptive statistics. RESULTS Among 1150 participants, 991 responded to at least one survey question (response rate 86.1%). The vast majority of our sample had COVID-19 or knew someone who did (75%), and approximately one third (32%) of youth indicated that they knew someone who had experienced symptoms consistent with Long Covid. Many youth (50%) reported worry and concern about Long Covid even if they, or someone they knew, did not have Long Covid. Among youth who were not concerned about Long Covid, the most commonly reported reasons were having received the vaccine (29%) and not having a prior COVID-19 infection (24%). CONCLUSIONS Our findings suggest that among younger populations, there is significant concern regarding the long-term effects of COVID-19. Vaccination campaigns and youth-centered public health communication about Long Covid may not only reduce COVID-19 transmission, but also alleviate worries and concerns about Long Covid among youth.
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Affiliation(s)
- Sarosh Irani
- University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Claire Chang
- University of Michigan Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Leigh Morrison
- Department of Family Medicine, University of Michigan, 2800 Plymouth Rd Bldg 14, Room G128, Ann Arbor, MI, 48109, USA
| | - Marika Waselewski
- Department of Family Medicine, University of Michigan, 2800 Plymouth Rd Bldg 14, Room G128, Ann Arbor, MI, 48109, USA
| | - Tammy Chang
- Department of Family Medicine, University of Michigan, 2800 Plymouth Rd Bldg 14, Room G128, Ann Arbor, MI, 48109, USA.
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
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14
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Tsai YH, Janssen TWP, Vu TV, Meeter M, van Atteveldt NM, Jansen BRJ, Magis-Weinberg L. Trajectories of early adolescents' perceptions of school motivation and effort during the pandemic in Perú: A four time point longitudinal observational study. Acta Psychol (Amst) 2023; 239:103984. [PMID: 37523830 DOI: 10.1016/j.actpsy.2023.103984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 06/18/2023] [Accepted: 07/05/2023] [Indexed: 08/02/2023] Open
Abstract
In this longitudinal, observational study, following 883 adolescents (aged 11-15 years, grades 6th - 8th) we tracked changes in perceived school motivation and effort across four time points during the two years of remote education in Perú as a consequence of COVID-19 (retrospective reports before the pandemic, May 2020, July 2021, and November 2021). Compared to before the pandemic, levels of perceived school motivation and effort dropped sharply in May 2020 and continued to decrease across 2 years. Perceived school motivation was positively associated with perceived school effort at almost all time points. Furthermore, students with lower levels of perceived school motivation had a steeper decline in perceived school effort. In a subsample of 380 students in 8th grade, perceived school effort in July 2021 predicted objective math performance in November 2021. Our findings suggest that COVID-19 has further compounded decreases in subjective and objective indices of school engagement and performance that are typically observed in early adolescence. Our results from a large sample of low- to middle-class Peruvian adolescents highlight the experiences of youth in a country that had particularly long school closures, and that is under-represented in the literature.
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Affiliation(s)
- Yi-Heng Tsai
- Department of Psychology, National Taiwan University, Taiwan
| | - Tieme W P Janssen
- LEARN! Research Institute, Vrije Universiteit Amsterdam, the Netherlands; Section Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Science, Vrije Universiteit Amsterdam, the Netherlands
| | - Tuong-Van Vu
- LEARN! Research Institute, Vrije Universiteit Amsterdam, the Netherlands; Section Clinical, Neuro and Developmental Psychology, Faculty of Behavioral and Movement Science, Vrije Universiteit Amsterdam, the Netherlands
| | - Martijn Meeter
- LEARN! Research Institute, Vrije Universiteit Amsterdam, the Netherlands; Department of Educational and Family Studies, Vrije Universiteit Amsterdam, the Netherlands
| | - Nienke M van Atteveldt
- LEARN! Research Institute, Vrije Universiteit Amsterdam, the Netherlands; Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Brenda R J Jansen
- Department of Developmental Psychology, University of Amsterdam, the Netherlands
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15
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Claussen AH, Dimitrov LV, Bhupalam S, Wheaton AG, Danielson ML. Short Sleep Duration: Children's Mental, Behavioral, and Developmental Disorders and Demographic, Neighborhood, and Family Context in a Nationally Representative Sample, 2016-2019. Prev Chronic Dis 2023; 20:E58. [PMID: 37441755 PMCID: PMC10364829 DOI: 10.5888/pcd20.220408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023] Open
Abstract
INTRODUCTION Many children and adolescents experience insufficient sleep, which poses risks for their short- and long-term health and development. This study examined the concurrent associations of contextual factors, including child, demographic, neighborhood, and family factors, with short sleep duration. METHODS We combined data on children aged 3 to 17 years from the 2016-2019 National Survey of Children's Health (N = 112,925) to examine the association of parent-reported child short sleep duration (ages 3-5 y, <10 h; 6-12 y, <9 h; 13-17 y, <8 h) with mental, behavioral, and developmental disorders (MBDDs); selected physical health conditions; and demographic, neighborhood, and family factors. RESULTS Overall, 34.7% of children experienced short sleep duration. The prevalence was highest among children aged 6 to 12 years (37.5%); children from racial and ethnic minority groups, especially non-Hispanic Black children (50.0%); children from low-income households (44.9%); children with an MBDD (39.6%); children experiencing negative neighborhood factors (poor conditions and lack of safety, support, and amenities, 36.5%); and family factors such as inconsistent bedtime (57.3%), poor parental mental (47.5%) and physical health (46.0%), and adverse childhood experiences (44.1%). The associations between sleep and demographic, neighborhood, and family factors, and MBDD remained significant after controlling for all other factors. CONCLUSION This study identified several individual, family, and community factors that may contribute to children's short sleep duration and can be targeted to improve healthy development, particularly among children with an MBDD, from households with low socioeconomic status, or from racial and ethnic minority groups who are at increased risk for short sleep duration.
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Affiliation(s)
- Angelika H Claussen
- Centers for Disease Control and Prevention, National Center on Birth Defects and Disabilities, Division of Human Development and Disability, Atlanta, Georgia
- Centers for Disease Control and Prevention, 4770 Buford Hwy, S106-4, Atlanta, GA 30341-3717
| | - Lina V Dimitrov
- Centers for Disease Control and Prevention, National Center on Birth Defects and Disabilities, Division of Human Development and Disability, Atlanta, Georgia
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Sivapriya Bhupalam
- Centers for Disease Control and Prevention, National Center on Birth Defects and Disabilities, Division of Human Development and Disability, Atlanta, Georgia
- Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee
| | - Anne G Wheaton
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Atlanta, Georgia
| | - Melissa L Danielson
- Centers for Disease Control and Prevention, National Center on Birth Defects and Disabilities, Division of Human Development and Disability, Atlanta, Georgia
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16
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Campbell CE, Cotter DL, Bottenhorn KL, Burnor E, Ahmadi H, Gauderman WJ, Cardenas-Iniguez C, Hackman D, McConnell R, Berhane K, Schwartz J, Chen JC, Herting MM. Air pollution and emotional behavior in adolescents across the U.S. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.19.23288834. [PMID: 37162908 PMCID: PMC10168412 DOI: 10.1101/2023.04.19.23288834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Recent studies have linked air pollution to increased risk for behavioral problems during development, albeit with inconsistent findings. Additional longitudinal studies are needed that consider how emotional behaviors may be affected when exposure coincides with the transition to adolescence - a vulnerable time for developing mental health difficulties. This study examines how annual average PM2.5 and NO2 exposure at ages 9-10 years relates to internalizing and externalizing behaviors over a 2-year follow-up period in a large, nationwide U.S. sample of participants from the Adolescent Brain Cognitive Development (ABCD) Study®. Air pollution exposure was estimated based on the residential address of each participant using an ensemble-based modeling approach. Caregivers answered questions from the Child Behavior Checklist (CBCL) at baseline and annually for two follow-up sessions for a total of 3 waves of data; from the CBCL we obtained scores on internalizing and externalizing problems plus 5 syndrome scales (anxious/depressed, withdrawn/depressed, rule-breaking behavior, aggressive behavior, and attention problems). Zero-inflated negative binomial models were used to examine both the main effect of age as well as the interaction of age with each pollutant on behavior while adjusting for various socioeconomic and demographic characteristics. Overall, the pollution effects moderated the main effects of age with higher levels of PM2.5 and NO2 leading to an even greater likelihood of having no behavioral problems (i.e., score of zero) with age over time, as well as fewer problems when problems are present as the child ages. Albeit this was on the order equal to or less than a 1-point change. Thus, one year of annual exposure at 9-10 years is linked with very small change in emotional behaviors in early adolescence, which may be of little clinical relevance.
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Affiliation(s)
- Claire E Campbell
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
- Neuroscience Graduate Program, University of Southern California, Los Angeles, California, USA 90089-2520
| | - Devyn L Cotter
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
- Neuroscience Graduate Program, University of Southern California, Los Angeles, California, USA 90089-2520
| | - Katherine L Bottenhorn
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
- Department of Psychology, Florida International University, Miami, FL, USA
| | - Elisabeth Burnor
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Hedyeh Ahmadi
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - W James Gauderman
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Carlos Cardenas-Iniguez
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Daniel Hackman
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA 90089
| | - Rob McConnell
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
| | - Kiros Berhane
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Jiu-Chiuan Chen
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
- Department of Neurology, Keck School of Medicine of University of Southern California, Los Angeles, CA 90063, USA
| | - Megan M Herting
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, USA
- Children's Hospital Los Angeles, Los Angeles, CA 90027, USA
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17
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Auger N, Low N, Chadi N, Israël M, Steiger H, Lewin A, Ayoub A, Healy-Profitós J, Luu TM. Suicide Attempts in Children Aged 10-14 Years During the First Year of the COVID-19 Pandemic. J Adolesc Health 2023; 72:899-905. [PMID: 36870902 PMCID: PMC9980433 DOI: 10.1016/j.jadohealth.2023.01.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 12/22/2022] [Accepted: 01/21/2023] [Indexed: 03/06/2023]
Abstract
PURPOSE To determine if suicide attempts increased during the first year of the pandemic among young adolescents in Quebec, Canada. METHODS We analyzed children aged 10-14 years who were hospitalized for a suicide attempt between January 2000 and March 2021. We calculated age-specific and sex-specific suicide attempt rates and the proportion of hospitalizations for suicide attempts before and during the pandemic and compared rates with patients aged 15-19 years. We used interrupted time series regression to measure changes in rates during the first (March 2020 to August 2020) and second (September 2020 to March 2021) waves and difference-in-difference analysis to determine if the pandemic had a greater impact on girls than boys. RESULTS Suicide attempt rates decreased for children aged 10-14 years during the first wave. However, rates increased sharply during the second wave for girls, without changing for boys. Girls aged 10-14 years had an excess of 5.1 suicide attempts per 10,000 at the start of wave 2, with rates continuing to increase by 0.6 per 10,000 every month thereafter. Compared with the prepandemic period, the increase in the proportion of girls aged 10-14 years hospitalized for a suicide attempt was 2.2% greater than that of boys during wave 2. The pattern seen in girls aged 10-14 years was not present in girls aged 15-19 years. DISCUSSION Hospitalizations for suicide attempts among girls aged 10-14 years increased considerably during the second wave of the pandemic, compared with boys and older girls. Young adolescent girls may benefit from screening and targeted interventions to address suicidal behavior.
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Affiliation(s)
- Nathalie Auger
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, Quebec, Canada; Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada.
| | - Nancy Low
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Nicholas Chadi
- Department of Pediatrics, Sainte-Justine Hospital, Montreal, Quebec, Canada
| | - Mimi Israël
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Howard Steiger
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Antoine Lewin
- Department of Obstetrics and Gynecology, University of Sherbrooke, Sherbrooke, Quebec, Canada; Medical Affairs and Innovation, Héma-Québec, Montreal, Quebec, Canada
| | - Aimina Ayoub
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Jessica Healy-Profitós
- Health Innovation and Evaluation Hub, University of Montreal Hospital Research Centre, Montreal, Quebec, Canada; Bureau d'information et d'études en santé des populations, Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Thuy Mai Luu
- Department of Pediatrics, Sainte-Justine Hospital, Montreal, Quebec, Canada
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18
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Gonzalez MR, Brown SA, Pelham WE, Bodison SC, McCabe C, Baker FC, Baskin‐Sommers A, Dick AS, Dowling GJ, Gebreselassie S, Guillaume M, Marshall AT, Sheth C, Sowell ER, Van Rinsveld A, Tapert SF. Family Well-Being During the COVID-19 Pandemic: The Risks of Financial Insecurity and Coping. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2023; 33:43-58. [PMID: 35748113 PMCID: PMC9349420 DOI: 10.1111/jora.12776] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
During the COVID-19 pandemic, families have experienced unprecedented financial and social disruptions. We studied the impact of preexisting psychosocial factors and pandemic-related financial and social disruptions in relation to family well-being among N = 4091 adolescents and parents during early summer 2020, participating in the Adolescent Brain Cognitive DevelopmentSM Study. Poorer family well-being was linked to prepandemic psychosocial and financial adversity and was associated with pandemic-related material hardship and social disruptions to routines. Parental alcohol use increased risk for worsening of family relationships, while a greater endorsement of coping strategies was mainly associated with overall better family well-being. Financial and mental health support may be critical for family well-being during and after a widespread crisis, such as the COVID-19 pandemic.
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Xiao Y, Brown TT, Snowden LR, Chow JCC, Mann JJ. COVID-19 Policies, Pandemic Disruptions, and Changes in Child Mental Health and Sleep in the United States. JAMA Netw Open 2023; 6:e232716. [PMID: 36912834 DOI: 10.1001/jamanetworkopen.2023.2716] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/14/2023] Open
Abstract
IMPORTANCE The adverse effects of COVID-19 containment policies disrupting child mental health and sleep have been debated. However, few current estimates correct biases of these potential effects. OBJECTIVES To determine whether financial and school disruptions related to COVID-19 containment policies and unemployment rates were separately associated with perceived stress, sadness, positive affect, COVID-19-related worry, and sleep. DESIGN, SETTING, AND PARTICIPANTS This cohort study was based on the Adolescent Brain Cognitive Development Study COVID-19 Rapid Response Release and used data collected 5 times between May and December 2020. Indexes of state-level COVID-19 policies (restrictive, supportive) and county-level unemployment rates were used to plausibly address confounding biases through 2-stage limited information maximum likelihood instrumental variables analyses. Data from 6030 US children aged 10 to 13 years were included. Data analysis was conducted from May 2021 to January 2023. EXPOSURES Policy-induced financial disruptions (lost wages or work due to COVID-19 economic impact); policy-induced school disruptions (switches to online or partial in-person schooling). MAIN OUTCOMES AND MEASURES Perceived stress scale, National Institutes of Health (NIH)-Toolbox sadness, NIH-Toolbox positive affect, COVID-19-related worry, and sleep (latency, inertia, duration). RESULTS In this study, 6030 children were included in the mental health sample (weighted median [IQR] age, 13 [12-13] years; 2947 [48.9%] females, 273 [4.5%] Asian children, 461 [7.6%] Black children, 1167 [19.4%] Hispanic children, 3783 [62.7%] White children, 347 [5.7%] children of other or multiracial ethnicity). After imputing missing data, experiencing financial disruption was associated with a 205.2% [95% CI, 52.9%-509.0%] increase in stress, a 112.1% [95% CI, 22.2%-268.1%] increase in sadness, 32.9% [95% CI, 3.5%-53.4%] decrease in positive affect, and a 73.9 [95% CI, 13.2-134.7] percentage-point increase in moderate-to-extreme COVID-19-related worry. There was no association between school disruption and mental health. Neither school disruption nor financial disruption were associated with sleep. CONCLUSIONS AND RELEVANCE To our knowledge, this study presents the first bias-corrected estimates linking COVID-19 policy-related financial disruptions with child mental health outcomes. School disruptions did not affect indices of children's mental health. These findings suggest public policy should consider the economic impact on families due to pandemic containment measures, in part to protect child mental health until vaccines and antiviral drugs become available.
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Affiliation(s)
- Yunyu Xiao
- Weill Cornell Medicine, NewYork Presbyterian, Department of Population Health Sciences, New York
| | | | | | | | - J John Mann
- Departments of Psychiatry and Radiology, Columbia University Irving Medical Center, Columbia University, New York
- Division of Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York
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Fung H, Yeo BTT, Chen C, Lo JC, Chee MWL, Ong JL. Adherence to 24-Hour Movement Recommendations and Health Indicators in Early Adolescence: Cross-Sectional and Longitudinal Associations in the Adolescent Brain Cognitive Development Study. J Adolesc Health 2023; 72:460-470. [PMID: 36528521 DOI: 10.1016/j.jadohealth.2022.10.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 09/12/2022] [Accepted: 10/13/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE Adherence to 24-hour movement guidelines of ≥60 minutes of physical activity, ≤2 hours of screen time, and 9-11 hours of sleep has been shown to benefit cognitive, physical, and psychosocial health in children and young adolescents aged 5-13 years. However, these findings have mostly been based on cross-sectional studies or relatively small samples and the associations between adherence to guidelines and brain structure remain to be evaluated. METHODS Data from the Adolescent Brain Cognitive Development℠ (ABCD) study of 10,574 early adolescents aged 9-14 years from September 2016 to January 2021 were used to examine whether adherence to 24-hour movement guidelines benefits cognition (general cognitive ability, executive function, and learning/memory assessed by the National Institutes of Health Toolbox neurocognitive battery), body mass index, psychosocial health (internalizing, externalizing, and total problems from the parent-reported Child Behavior Checklist), and magnetic resonance imaging-derived brain morphometric measures at baseline (T1), ∼2 years later (T2), and longitudinally from T1 to T2 (T2-T1). Multivariable linear mixed models were used, with adjustments for sociodemographic confounders. Time elapsed and T1 outcome measures were also controlled for in longitudinal models. RESULTS Better cognitive scores, fewer behavioral problems, lower adiposity levels, and greater gray matter volumes were observed in those who met both sleep and screen time recommendations compared to those who met none. Longitudinal follow-up further supports these findings; participants who met both recommendations at T1 and T2 evidenced better outcome measures than those who met none. DISCUSSION These findings support consideration of integrated rather than isolated movement recommendations across the day in early adolescence for better cognitive, physical and psychosocial health. Although the associations between physical activity and health indicators were less consistent in this study, the significant findings from sleep and screen time demonstrate the importance of considering movement recommendations in an integrated rather than isolated manner for adolescent health. It is recommended that movement behaviors be simultaneously targeted for better developmental outcomes.
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Affiliation(s)
- Hoki Fung
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Meditation Research Group, Center for Depression, Anxiety, and Stress Research, McLean Hospital, Belmont, Massachusetts
| | - B T Thomas Yeo
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Electrical and Computer Engineering, National University of Singapore, Singapore; Centre for Translational Magnetic Resonance Research, Yong Loo Lin School of Medicine, Singapore; N.1 Institute for Health & Institute for Digital Medicine, National University of Singapore, Singapore; Integrative Sciences and Engineering Programme (ISEP), National University of Singapore, Singapore; Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts
| | - Christina Chen
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - June C Lo
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Michael W L Chee
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ju Lynn Ong
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Grelle K, Shrestha N, Ximenes M, Perrotte J, Cordaro M, Deason RG, Howard K. The Generation Gap Revisited: Generational Differences in Mental Health, Maladaptive Coping Behaviors, and Pandemic-Related Concerns During the Initial COVID-19 Pandemic. JOURNAL OF ADULT DEVELOPMENT 2023; 30:1-12. [PMID: 36811122 PMCID: PMC9934502 DOI: 10.1007/s10804-023-09442-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 02/18/2023]
Abstract
The purpose of this study was to assess differences in mental health symptoms, pandemic-related concerns, and maladaptive coping behaviors among adults in the United States across generations during the initial period of the COVID-19 pandemic. A social media campaign was used to recruit 2696 U.S. individuals to participate in an online survey in April 2020, assessing various validated psychosocial factors, including major depressive disorder, generalized anxiety disorder (GAD), perceived stress, loneliness, quality of life, and fatigue, along with pandemic-specific concerns and changes in alcohol use and substance use. Participants were grouped based on generation status (Gen Z, Millennial, Gen X, and Baby Boomer) and statistical comparisons were conducted based on demographics, psychosocial factors, pandemic-related concerns, and substance use. During the initial period of the COVID-19 pandemic, the younger cohorts (Gen Z and Millennials) rated significantly worse on mental health indices, including major depression, GAD, perceived stress, loneliness, quality of life, and fatigue. Further, the participants in the Gen Z and Millennial generational groups exhibited greater increase in maladaptive coping with substance use, specifically alcohol use and increased use of sleep aids. Our results indicate that during the initial period of the COVID-19 pandemic, members of the Gen Z and Millennial generational cohorts were considered a psychologically vulnerable population due to their mental health and maladaptive coping behaviors. Improving access to mental health resources during early stages of a pandemic is an emerging public health concern.
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Affiliation(s)
- Kaitlin Grelle
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Neha Shrestha
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Megan Ximenes
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Jessica Perrotte
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Millie Cordaro
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Rebecca G. Deason
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
| | - Krista Howard
- Department of Psychology, Texas State University, 601 University Drive, San Marcos, TX 78666 USA
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22
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Liu SR, Davis EP, Palma AM, Stern HS, Sandman CA, Glynn LM. Experiences of COVID-19-Related Racism and Impact on Depression Trajectories Among Racially/Ethnically Minoritized Adolescents. J Adolesc Health 2023; 72:885-891. [PMID: 36788046 PMCID: PMC9922380 DOI: 10.1016/j.jadohealth.2022.12.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 12/15/2022] [Accepted: 12/17/2022] [Indexed: 02/16/2023]
Abstract
PURPOSE In 2020, racially/ethnically minoritized (REMD) youth faced the "dual pandemics" of COVID-19 and racism, both significant stressors with potential for adverse mental health effects. The current study tested whether short- and long-term trajectories of depressive symptoms from before to during the COVID-19 pandemic differed between REMD adolescents who did and did not endorse exposure to COVID-19-era-related racism (i.e., racism stemming from conditions created or exacerbated by the COVID-19 pandemic). METHODS A community sample of 100 REMD adolescents enrolled in an ongoing longitudinal study of mental health was assessed before and during the COVID-19 pandemic. Participants were 51% girls, mean age = 16, standard deviation = 2.7, and identified as Latinx/Hispanic (48%), Multiethnic (34%), Asian American (12%), and Black (6%). RESULTS REMD adolescents' depressive symptoms were elevated during the COVID-19 pandemic compared to pre-pandemic levels, and increases were more pronounced over time for those who endorsed exposure to COVID-19-era-related racism. In general, Asian American participants endorsed racism experiences at the highest rates compared to others, including being called names (42%), people acting suspicious around them (33%), and being verbally threatened (17%). Additionally, more than half of Black and Asian American participants reported worry about experiencing racism related to the COVID-19 pandemic, even if they had not experienced it to date. DISCUSSION REMD adolescents are at increased risk for depressive symptoms related to converging stressors stemming from the COVID-19 pandemic and pandemic-related racism, which has the potential to widen racial/ethnic mental health disparities faced by the REMD youth.
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Affiliation(s)
- Sabrina R. Liu
- Department of Human Development, California State University, San Marcos, California,Address correspondence to: Sabrina R. Liu, Ph.D., Department of Human Development, College of Education, Health, and Human Services, California State University San Marcos, 333 S Twin Oaks Valley Rd, San Marcos, CA, 92096
| | - Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, Colorado,Department of Pediatrics, University of California, Irvine, Irvine, California
| | | | - Hal S. Stern
- Department of Statistics, University of California, Irvine, Bren Hall, Irvine, California
| | - Curt A. Sandman
- Department of Psychiatry & Human Behavior, University of California, Irvine, Orange, California
| | - Laura M. Glynn
- Department of Psychology, Chapman University, One University Drive, Orange, California
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23
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Adolescents' Time During the First Year of the COVID-19 Pandemic: Evidence From the American Time Use Survey. J Adolesc Health 2023; 72:295-299. [PMID: 36216677 PMCID: PMC9546725 DOI: 10.1016/j.jadohealth.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 08/12/2022] [Accepted: 08/17/2022] [Indexed: 11/12/2022]
Abstract
PURPOSE The aim of this study is to examine where and with whom adolescents spent time during the first months of the COVID-19 pandemic compared to 2019. METHODS Time diary data from the May 2019 to December 2020 waves of the American Time Use Survey were used to examine trends in where and with whom a sample of individuals aged 15-18 years (N = 437) spent their time. RESULTS Only 13% of adolescents spent any time at school on a given day during the pandemic (May-December 2020), compared to 36% in the same period in 2019. Average time with friends decreased by 28%. Over the 7.5-month period, this amounts to an average of 204 fewer hours/34 fewer days in school and 86 fewer hours with friends. Time spent sleeping or sleepless did not change. DISCUSSION Time at school and with friends decreased substantially during the first months of the pandemic.
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24
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Gervais C, Côté I, Lampron-deSouza S, Barrette F, Tourigny S, Pierce T, Lafantaisie V. The COVID-19 Pandemic and Quality of Life: Experiences Contributing to and Harming the Well-Being of Canadian Children and Adolescents. INTERNATIONAL JOURNAL ON CHILD MALTREATMENT : RESEARCH, POLICY AND PRACTICE 2022; 6:1-23. [PMID: 36531795 PMCID: PMC9734348 DOI: 10.1007/s42448-022-00141-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/24/2022] [Indexed: 12/12/2022]
Abstract
The pandemic's restrictive measures such as lockdowns, social distancing, and the wearing of masks transformed young people's daily lives and brought up major concerns regarding children's and adolescents' well-being. This longitudinal mixed study aims to identify how different experiences contributed to children's and adolescents' well-being through different stages of the pandemic. The sample comprises 149 Canadian youth from Quebec who shared their experiences of the COVID-19 pandemic. Children and adolescents were met virtually for semi-directed interviews about their well-being at three measurement time (T1: May 2020 lockdown, T2: July 2020 progressive reopening, and T3: beginning of the second wave). At T3, they also completed a questionnaire measuring their quality of life. Our findings indicated that 22% reported a low level of well-being (N: 32), 66% a normal level of well-being (N: 90), and 18% a high level of well-being (N: 27). The comparative thematic analysis of the discourse of these three groups allows us to identify experiences that are favorable and unfavorable to the well-being of young people and to distinguish two configurations of interactions between children and their environment over the first year of the pandemic, namely that of young people who report a high level of well-being and that of those who report a worrying level of well-being. Results highlight the importance of activities, relationships, support, and representations of children and adolescents for their well-being in the pandemic context. Interventions and social measures to better support their well-being are discussed.
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Affiliation(s)
- Christine Gervais
- Nursing Department, Université du Québec en Outaouais, 5 Rue Saint-Joseph, Saint-Jérôme, Québec J7Z 0B7 Canada
| | - Isabel Côté
- Social Work Department, Université du Québec en Outaouais, 283 Boulevard Alexandre-Taché, C.P. 1250, Succursale Hull, Gatineau, Québec J8X 3X7 Canada
| | - Sophie Lampron-deSouza
- School of Psychoeducation, Université de Montréal, 90 Av, Vincent-d’Indy, Montréal, Québec H2V 2S9 Canada
| | - Flavy Barrette
- Social Work Department, Université du Québec en Outaouais, 283 Boulevard Alexandre-Taché, C.P. 1250, Succursale Hull, Gatineau, Québec J8X 3X7 Canada
| | - Sarah Tourigny
- Psychoeducation and Psychology Department, Université du Québec en Outaouais, 5 Rue Saint-Joseph, Saint-Jérôme, Québec J7Z 0B7 Canada
| | - Tamarha Pierce
- School of Psychology, Université Laval, 2325, Rue Des Bibliothèques, Québec, G1V 0A6 Canada
| | - Vicky Lafantaisie
- Psychoeducation and Psychology Department, Université du Québec en Outaouais, 5 Rue Saint-Joseph, Saint-Jérôme, Québec J7Z 0B7 Canada
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25
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COVID-19-related financial strain and adolescent mental health. LANCET REGIONAL HEALTH. AMERICAS 2022; 16:100391. [PMID: 36405885 PMCID: PMC9664255 DOI: 10.1016/j.lana.2022.100391] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/14/2022] [Accepted: 10/19/2022] [Indexed: 11/17/2022]
Abstract
Background The COVID-19 pandemic and associated responses have induced a host of crises worldwide, including an economic recession and a global mental health crisis. The specific effects of recession on youth mental health are understudied. We aimed to examine the mechanisms by which pandemic-related financial strain may affect mental health in a diverse sample of American adolescents. Methods We analyzed data from the Adolescent Brain Cognitive Development Study (ABCD Study®), a large, longitudinal study of diverse US adolescents which collected data before and during the pandemic (N = 9,720, mean age 12.9 years, 18.2% Black). Linear mixed-effects models tested associations of financial strain (parent-reported household wage loss and youth-reported financial stress) with depressive symptomatology over time, covarying for multiple confounders including pre-pandemic socioeconomic status and psychopathology, and pandemic-related environmental factors. Longitudinal mediation analyses examined potential mechanisms leading from wage loss to youth mental health. Findings Financial strain was highly prevalent, especially among low-income participants, with >70% of the total sample reporting lost wages. Both wage loss and subjective financial stress were associated with depressive symptomatology over time (Estimate = 0.04, P = 0.014; Estimate = 0.17, P < 0.001; respectively). The association between financial stress and depressive symptomatology was robust to the addition of multiple environmental confounders (Estimate = 0.16, P < 0.001). Both family-level (family conflict) and individual-level (financial stress) factors mediated the relationship between wage loss and depressive symptomatology. Interpretation The financial effects of COVID-19 (and worldwide responses to it) have taken a significant toll on youth mental health. In families that lost wages, youth-reported financial stress and familial factors mediated the relationship between wage loss and mental health over time. Findings highlight financial stress as a key driver of youth mental health burden and identify familial factors as critical targets for intervention to mitigate mental health risks in periods of economic crises. Funding This study was supported by the National Institute of Mental Health [grant numbers K23MH120437 (RB), R01MH117014 (TMM)]; the Lifespan Brain Institute of Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania.
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Burns RD, Armstrong JA. Associations of connectedness and parental behaviors with adolescent physical activity and mental health during COVID-19: A mediation analysis using the 2021 adolescent behaviors and experiences survey. Prev Med 2022; 164:107299. [PMID: 36228874 PMCID: PMC9550276 DOI: 10.1016/j.ypmed.2022.107299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 10/03/2022] [Accepted: 10/06/2022] [Indexed: 12/03/2022]
Abstract
The purpose of this study was to examine the associations of connectedness and parental behaviors with adolescent physical activity (PA) and mental health during COVID-19. Participants were a representative sample of US high school students who completed the 2021 Adolescent Behaviors and Experiences Survey (ABES; N = 7705; 50.4% female). ABES was completed online during the spring of 2021 and data were analyzed during the spring of 2022. Independent variables were items asking about perceived school and virtual connectedness, parental emotional abuse, and parental monitoring. Latent variables represented both PA and mental health. Two weighted structural equation models tested the associations between connectedness, parental behaviors, and mental health mediated through PA (Model 1) and between connectedness, parental behaviors, and PA mediated through mental health (Model 2) with indirect effect confidence intervals obtained using Monte Carlo simulations. School connectedness directly associated with better mental health in Model 1 (β = 0.17, p < 0.001) and with higher PA in Model 2 (β = 0.19, p < 0.001) while virtual connectedness directly associated with higher PA in Model 2 (β = 0.08, p < 0.001). Parental emotional abuse directly associated with poorer mental health in Model 1 (β = -0.43, p < 0.001). Standardized indirect effects to better mental health mediated through higher PA were observed for school connectedness (IE = 0.017, p < 0.001) and virtual connectedness (IE = 0.007, p < 0.001) and indirect effects to lower PA mediated through poorer mental health were observed for parental emotional abuse (IE = -0.050, p < 0.001). Perceptions of school and virtual connectedness and parental emotional abuse both directly and indirectly impacted adolescent PA and mental health during the COVID-19 pandemic.
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Affiliation(s)
- Ryan D Burns
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA.
| | - Jason A Armstrong
- Department of Health and Kinesiology, University of Utah, Salt Lake City, UT, USA
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Furstova J, Kascakova N, Sigmundova D, Zidkova R, Tavel P, Badura P. Perceived stress of adolescents during the COVID-19 lockdown: Bayesian multilevel modeling of the Czech HBSC lockdown survey. Front Psychol 2022; 13:964313. [PMID: 36248520 PMCID: PMC9558731 DOI: 10.3389/fpsyg.2022.964313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 08/23/2022] [Indexed: 11/24/2022] Open
Abstract
Objective Long-term isolation, including lockdowns and quarantines, may have a distressing effect on anyone experiencing it. Adolescent brain architecture is very sensitive to environmental adversities, and the mental health development of adolescents may be particularly vulnerable during the pandemic era. In order to better understand the triggers for perceived adolescent stress (PSS) during the COVID-19 lockdown, the present study aimed to assess the effects of social well-being and changes in time use during the lockdown, as well as the family COVID experience of adolescents. Methods The sample for this study comprised n = 3,440 adolescents (54.2% girls; mean age = 13.5 ± 1.6 years). Bayesian correlations between PSS, health and well-being variables were assessed. PSS was then modeled as an outcome variable in a series of nested Bayesian multilevel regression models. Results The negative impact of the COVID-19 lockdown was more apparent in girls. PSS was moderately correlated with adolescent health and well-being. The strongest predictor of higher level of PSS was frequent feeling of loneliness. On the contrary, lower level of PSS was most associated with having someone to talk to. Conclusion Long-term social isolation of adolescents could be harmful to their mental health. Psychological coping strategies to prevent the consequences of social isolation and development of mental health problems should be promoted on the individual, family, and even community level.
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Affiliation(s)
- Jana Furstova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czechia
- *Correspondence: Jana Furstova,
| | - Natalia Kascakova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czechia
- Psychiatric-Psychotherapeutic Outpatient Clinic, Pro Mente Sana, Bratislava, Slovakia
| | - Dagmar Sigmundova
- Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czechia
| | - Radka Zidkova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czechia
| | - Peter Tavel
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czechia
| | - Petr Badura
- Faculty of Physical Culture, Palacky University Olomouc, Olomouc, Czechia
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Zhao Q, Wang K, Kiss O, Yuksel D, de Zambotti M, Clark DB, Goldston DB, Nooner KB, Brown SA, Tapert SF, Thompson WK, Nagel BJ, Pfefferbaum A, Sullivan EV, Pohl KM, Baker FC. Earlier Bedtime and Effective Coping Skills Predict a Return to Low-Risk of Depression in Young Adults during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191610300. [PMID: 36011934 PMCID: PMC9408272 DOI: 10.3390/ijerph191610300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 08/13/2022] [Accepted: 08/15/2022] [Indexed: 05/24/2023]
Abstract
To determine the persistent effects of the pandemic on mental health in young adults, we categorized depressive symptom trajectories and sought factors that promoted a reduction in depressive symptoms in high-risk individuals. Specifically, longitudinal analysis investigated changes in the risk for depression before and during the pandemic until December 2021 in 399 young adults (57% female; age range: 22.8 ± 2.6 years) in the United States (U.S.) participating in the National Consortium on Alcohol and NeuroDevelopment in Adolescence (NCANDA) study. The Center for Epidemiologic Studies Depression Scale (CES-D-10) was administered multiple times before and during the pandemic. A score ≥10 identified individuals at high-risk for depression. Self-reported sleep behavior, substance use, and coping skills at the start of the pandemic were assessed as predictors for returning to low-risk levels while controlling for demographic factors. The analysis identified four trajectory groups regarding depression risk, with 38% being at low-risk pre-pandemic through 2021, 14% showing persistent high-risk pre-pandemic through 2021, and the remainder converting to high-risk either in June 2020 (30%) or later (18%). Of those who became high-risk in June 2020, 51% were no longer at high-risk in 2021. Logistic regression revealed that earlier bedtime and, for the older participants (mid to late twenties), better coping skills were associated with this declining risk. Results indicate divergence in trajectories of depressive symptoms, with a considerable number of young adults developing persistent depressive symptoms. Healthy sleep behavior and specific coping skills have the potential to promote remittance from depressive symptoms in the context of the pandemic.
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Affiliation(s)
- Qingyu Zhao
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA
| | - Kevin Wang
- Department of Computer Science, Stanford University, Stanford, CA 94305, USA
| | - Orsolya Kiss
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Dilara Yuksel
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | | | - Duncan B. Clark
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15260, USA
| | - David B. Goldston
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC 27708, USA
| | - Kate B. Nooner
- Department of Psychology, University of North Carolina Wilmington, Wilmington, NC 28403, USA
| | - Sandra A. Brown
- Department of Psychiatry, University of California, San Diego, CA 92093, USA
| | - Susan F. Tapert
- Department of Psychiatry, University of California, San Diego, CA 92093, USA
| | - Wesley K. Thompson
- Population Neuroscience and Genetics Lab, University of California, San Diego, CA 92093, USA
- Department of Radiology, University of California, San Diego, CA 92093, USA
| | - Bonnie J. Nagel
- Departments of Psychiatry and Behavioral Neuroscience, Oregon Health & Science University, Portland, OR 97239, USA
| | - Adolf Pfefferbaum
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Edith V. Sullivan
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Kilian M. Pohl
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94304, USA
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
| | - Fiona C. Baker
- Center for Health Sciences, SRI International, Menlo Park, CA 94025, USA
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Zhi JC, Pei F, Zhang SW, Huang ML, Zhao MY, Wang Y. [Psychological and behavioral problems in children and adolescents during the coronavirus disease 2019 epidemic: a Scoping review]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2022; 24:728-735. [PMID: 35894185 PMCID: PMC9336617 DOI: 10.7499/j.issn.1008-8830.2204187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To investigate the psychological and behavioral problems and related influencing factors in children and adolescents during the coronavirus disease 2019 (COVID-19) epidemic. METHODS China National Knowledge Infrastructure, Wanfang Data, PubMed, and Web of Science were searched using the method of subject search for articles published up to March 31, 2022, and related data were extracted for Scoping review. RESULTS A total of 3 951 articles were retrieved, and 35 articles from 12 countries were finally included. Most of the articles were from the journals related to pediatrics, psychiatry, psychology, and epidemiology, and cross-sectional survey was the most commonly used research method. Psychological and behavioral problems in children and adolescents mainly included depression/anxiety/stress, sleep disorder, internet behavior problems, traumatic stress disorder, and self-injury/suicide. Influencing factors were analyzed from the three aspects of socio-demographic characteristics, changes in living habits, and ways of coping with COVID-19. CONCLUSIONS During the COVID-19 epidemic, the psychological and behavioral problems of children and adolescents in China and overseas are severe. In the future, further investigation and research can be carried out based on relevant influencing factors to improve the psychological and behavioral problems.
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Affiliation(s)
| | - Fei Pei
- Rehabilitation Center, Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang 150001, China
| | | | | | - Ming-Yue Zhao
- Rehabilitation Center, Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang 150001, China
| | - Yan Wang
- Rehabilitation Center, Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin, Heilongjiang 150001, China
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Ford CA. The Journal of Adolescent Health's Editor-in-Chief's Annual Reflection: A Year of Endurance and Looking Toward the Future. J Adolesc Health 2022; 71:1-3. [PMID: 35718386 PMCID: PMC9212740 DOI: 10.1016/j.jadohealth.2022.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 04/14/2022] [Indexed: 11/24/2022]
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Kim S, Champion KE, Gardner LA, Teesson M, Newton NC, Gainsbury SM. The directionality of anxiety and gaming disorder: An exploratory analysis of longitudinal data from an Australian youth population. Front Psychiatry 2022; 13:1043490. [PMID: 36405898 PMCID: PMC9672463 DOI: 10.3389/fpsyt.2022.1043490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022] Open
Abstract
Gaming activities among adolescents have increased during the COVID-19 pandemic, bringing with it a growing concern for the potential harms of excessive gaming and its risk factors. Anxiety is frequently linked with gaming disorder, but studies investigating this association were mostly cross-sectional in design. Longitudinal studies that explore risk factors associated with gaming disorder are sparse and the trajectories of gaming disorder remain unclear. To address this paucity, the present study analyzed a large longitudinal dataset with a 12-month follow-up of 4,968 Australian adolescents (ages 13-14) during the pandemic. Logistic regression and multiple regression analyses were conducted to investigate the temporal relationships between anxiety, gaming frequency, the amount of money spent within video games, and gaming disorder. Prevalence rates for gaming disorder in adolescents aged 13 and 14 were 15 and 16%, respectively. The regression models indicated a bidirectional relationship between anxiety and gaming disorder symptoms, where higher levels of anxiety were associated with higher levels of gaming disorder 12 months later and vice versa. The study also found that the interaction between anxiety and higher gaming frequency could predict gaming disorder symptoms. Overall, the findings suggest that young adolescents may be more vulnerable to developing gaming disorder and highlight the importance of addressing the interactions between risk factors and gaming disorder in treatment approaches.
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Affiliation(s)
- Seungyeon Kim
- Brain and Mind Centre, School of Psychology, The University of Sydney, Sydney, NSW, Australia
| | - Katrina E Champion
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Lauren A Gardner
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Nicola C Newton
- The Matilda Centre for Research in Mental Health and Substance Use, The University of Sydney, Sydney, NSW, Australia
| | - Sally M Gainsbury
- Brain and Mind Centre, School of Psychology, The University of Sydney, Sydney, NSW, Australia
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