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Okayama S, Minihan S, Andrews JL, Daniels S, Grunewald K, Richards M, Wang W, Hasan Y, Schweizer S. Intolerance of uncertainty and psychological flexibility as predictors of mental health from adolescence to old age. Soc Psychiatry Psychiatr Epidemiol 2024; 59:2361-2368. [PMID: 38981933 DOI: 10.1007/s00127-024-02724-z] [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: 01/15/2024] [Accepted: 06/24/2024] [Indexed: 07/11/2024]
Abstract
PURPOSE The COVID-19 pandemic brought with it significant social, economic and health uncertainties. These were proposed to impact young people more compared to adults, leading adolescents to report more mental health problems during the pandemic. The current study examined whether differences in cognitive risk (tolerance of uncertainty) and protective (psychological flexibility) factors accounted for age-related differences in depression and anxiety. METHODS These associations were investigated in the COVID-19 Risks Across the Lifespan (CORAL) cohort (N = 2280, 11-89 years). RESULTS The results showed that adolescents experienced greater intolerance of uncertainty and lower psychological flexibility compared to adults and older adults. Tolerance of uncertainty did not account for age-related differences in depression or anxiety. However, psychological flexibility conferred more protective advantage for anxiety in adults compared to adolescents. CONCLUSION The observed age-related differences in risk and protective factors advance our understanding of developmental vulnerabilities to depression and anxiety. Implications for mental health interventions in the context of future pandemics are discussed.
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Affiliation(s)
- Sakiko Okayama
- Department of Psychology, University of New South Wales, Kensington, Sydney, Australia
| | - Savannah Minihan
- Department of Psychology, University of New South Wales, Kensington, Sydney, Australia
| | - Jack L Andrews
- Department of Psychology, University of New South Wales, Kensington, Sydney, Australia
| | - Sarah Daniels
- Department of Psychology, University of New South Wales, Kensington, Sydney, Australia
| | - Karina Grunewald
- Department of Psychology, University of New South Wales, Kensington, Sydney, Australia
| | - Matthew Richards
- Department of Psychology, University of New South Wales, Kensington, Sydney, Australia
| | - Weike Wang
- Department of Psychology, University of New South Wales, Kensington, Sydney, Australia
| | - Yasmin Hasan
- Department of Psychology, University of New South Wales, Kensington, Sydney, Australia
| | - Susanne Schweizer
- Department of Psychology, University of New South Wales, Kensington, Sydney, Australia.
- University of Cambridge, Cambridge, UK.
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Han Y, Huang J, Chung RYN. Pre-COVID-19 cognitive social capital trajectories and peri-COVID-19 depression in China, 2014-2020: A longitudinal study. J Affect Disord 2024:S0165-0327(24)01786-5. [PMID: 39461372 DOI: 10.1016/j.jad.2024.10.106] [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: 04/24/2024] [Revised: 09/27/2024] [Accepted: 10/20/2024] [Indexed: 10/29/2024]
Abstract
BACKGROUND Social capital is dynamic; however, little is known about the association of its dynamics with peri-pandemic health. We examined the longitudinal association of pre-COVID-19 cognitive social capital trajectories with peri-COVID-19 depressive symptoms and the moderating effect of province-level COVID-19 severity on the association in China. METHODS We employed four-wave data from China Family Panel Studies between 2014 and 2020. Depressive symptoms in 2020 were measured by the 8-item Center for Epidemiological Studies-Depression Scale. Pre-COVID-19 cognitive social capital from 2014 to 2018 included dichotomized (high/low) generalized trust, trust in neighbors, trust in local government officials, and reciprocity, each of which included five trajectories: persistently low, decreased, fluctuated, increased, and persistently high. Province-level COVID-19 severity in 2020 was a factor score constructed by the number of provincial COVID-19 cases and deaths. We conducted mixed-effects linear regression to answer our research question. RESULTS Persistently low generalized trust (β: 0.46; 95 % CI: 0.15,0.78), persistently low (β: 0.57; 95 % CI: 0.22, 0.92), decreased (β: 0.36; 95 % CI: 0.07, 0.65) and increased (β: 0.40; 95 % CI: 0.12, 0.68) trust in neighbors, and persistently low (β: 0.39; 95 % CI: 0.02, 0.77) and decreased (β: 0.68; 95 % CI: 0.38, 0.97) reciprocity, compared with their persistently high trajectories, were associated with a higher level of peri-COVID-19 depressive symptoms. We did not find robust evidence to support the moderating effect of province-level COVID-19 severity. CONCLUSIONS Long-term strategies to increase cognitive social capital and prevent cognitive social capital decline are needed to protect mental health against a pandemic.
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Affiliation(s)
- Yang Han
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Junjie Huang
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Roger Yat-Nork Chung
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China; Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong, China; Centre for Bioethics, The Chinese University of Hong Kong, Hong Kong, China.
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Orozco A, Thomas A, Raggatt M, Scott N, Eddy S, Douglass C, Wright CJC, Spelman T, Lim MSC. Coping with COVID-19: a prospective cohort study on young Australians' anxiety and depression symptoms from 2020-2021. Arch Public Health 2024; 82:166. [PMID: 39327590 PMCID: PMC11426065 DOI: 10.1186/s13690-024-01397-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 09/10/2024] [Indexed: 09/28/2024] Open
Abstract
BACKGROUND Studies have shown that the coronavirus (COVID-19) pandemic negatively impacted the mental health of young Australians. However, there is limited longitudinal research exploring how individual factors and COVID-19 related public-health restrictions influenced mental health in young people over the acute phase of the COVID-19 pandemic. This study aimed to identify risk and protective factors associated with changes in individual symptoms of anxiety and depression among young Australians during the COVID-19 pandemic. METHODS This prospective cohort study collected data on anxiety and depression symptoms of young Australians aged 15-29 years old using the Depression, Anxiety and Stress Scale short form (DASS-21). We delivered four online questionnaires from April 2020 to August 2021 at intervals of 3, 6, and 12 months after the initial survey. We implemented linear mixed-effects regression models to determine the association among demographic, socioeconomic, lifestyle and COVID-19 public health restrictions related factors and the severity of anxiety and depression symptoms over time. RESULTS Analyses included 1936 young Australians eligible at baseline. There was a slight increase in DASS-21 anxiety mean scores from timepoint 3 to timepoint 4. DASS-21 depression scores showed slight fluctuations across timepoints with the highest mean score observed in timepoint 2. Factors associated with increases in anxiety and depression severity symptoms included LGBTQIA + identity, financial insecurity both before and during the pandemic, higher levels of loneliness, withdrawal or deferral of studies, spending more time on social media, and difficulties to sleep. Risk factors for only depression symptoms include unemployment during COVID-19 pandemic and being in lockdown. Living with someone was a protective factor for both anxiety and depression symptoms, pre-COVID-19 unemployment for depression symptoms, and older age and unemployment during the pandemic for anxiety symptoms. CONCLUSION These findings indicate that during the first year of the pandemic in Australia, there were significant changes in young people's mental health which were associated with multiple demographic, socioeconomic, lifestyle, and lockdown factors. Hence, in future public health crises, we suggest more inclusive guidelines that involve young people in their development and implementation ensuring that their unique perspectives and needs are adequately considered.
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Affiliation(s)
- Ana Orozco
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
- Monash School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Alexander Thomas
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
| | - Michelle Raggatt
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
- Monash School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Nick Scott
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
| | - Sarah Eddy
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
| | - Caitlin Douglass
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Cassandra J C Wright
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
- Menzies School of Health Research, Darwin, Australia
- Centre for Alcohol Policy Research, Melbourne, Australia
| | - Tim Spelman
- Disease Elimination Program, Burnet Institute, Melbourne, Australia
| | - Megan S C Lim
- Disease Elimination Program, Burnet Institute, Melbourne, Australia.
- Monash School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
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Wilbrecht L, Davidow JY. Goal-directed learning in adolescence: neurocognitive development and contextual influences. Nat Rev Neurosci 2024; 25:176-194. [PMID: 38263216 DOI: 10.1038/s41583-023-00783-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2023] [Indexed: 01/25/2024]
Abstract
Adolescence is a time during which we transition to independence, explore new activities and begin pursuit of major life goals. Goal-directed learning, in which we learn to perform actions that enable us to obtain desired outcomes, is central to many of these processes. Currently, our understanding of goal-directed learning in adolescence is itself in a state of transition, with the scientific community grappling with inconsistent results. When we examine metrics of goal-directed learning through the second decade of life, we find that many studies agree there are steady gains in performance in the teenage years, but others report that adolescent goal-directed learning is already adult-like, and some find adolescents can outperform adults. To explain the current variability in results, sophisticated experimental designs are being applied to test learning in different contexts. There is also increasing recognition that individuals of different ages and in different states will draw on different neurocognitive systems to support goal-directed learning. Through adoption of more nuanced approaches, we can be better prepared to recognize and harness adolescent strengths and to decipher the purpose (or goals) of adolescence itself.
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Affiliation(s)
- Linda Wilbrecht
- Department of Psychology, University of California, Berkeley, CA, USA.
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA.
| | - Juliet Y Davidow
- Department of Psychology, Northeastern University, Boston, MA, USA.
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Minihan S, Songco A, Fox E, Ladouceur CD, Mewton L, Moulds M, Pfeifer JH, Van Harmelen AL, Schweizer S. Affect and mental health across the lifespan during a year of the COVID-19 pandemic: The role of emotion regulation strategies and mental flexibility. Emotion 2024; 24:67-80. [PMID: 37199936 PMCID: PMC11064816 DOI: 10.1037/emo0001238] [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: 08/02/2022] [Revised: 02/06/2023] [Accepted: 02/16/2023] [Indexed: 05/19/2023]
Abstract
During the COVID-19 pandemic, there has been a rise in common mental health problems compared to prepandemic levels, especially in young people. Understanding the factors that place young people at risk is critical to guide the response to increased mental health problems. Here we examine whether age-related differences in mental flexibility and frequency of use of emotion regulation strategies partially account for the poorer affect and increased mental health problems reported by younger people during the pandemic. Participants (N = 2,367; 11-100 years) from Australia, the UK, and US were surveyed thrice at 3-month intervals between May 2020 and April 2021. Participants completed measures of emotion regulation, mental flexibility, affect, and mental health. Younger age was associated with less positive (b = 0.008, p < .001) and more negative (b = -0.015, p < .001) affect across the first year of the pandemic. Maladaptive emotion regulation partially accounted for age-related variance in negative affect (β = -0.013, p = .020), whereby younger age was associated with more frequent use of maladaptive emotion regulation strategies, which, in turn, was associated with more negative affect at our third assessment point. More frequent use of adaptive emotion regulation strategies, and in turn, changes in negative affect from our first to our third assessment, partially accounted for age-related variance in mental health problems (β = 0.007, p = .023). Our findings add to the growing literature demonstrating the vulnerability of younger people during the COVID-19 pandemic and suggest that emotion regulation may be a promising target for intervention. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
| | | | - Elaine Fox
- School of Psychology, University of Adelaide
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Schweizer S, Lawson RP, Blakemore SJ. Uncertainty as a driver of the youth mental health crisis. Curr Opin Psychol 2023; 53:101657. [PMID: 37517166 DOI: 10.1016/j.copsyc.2023.101657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Revised: 06/29/2023] [Accepted: 06/30/2023] [Indexed: 08/01/2023]
Abstract
Mental health problems in young people have been on the rise for over a decade, with that trend accelerating during the pandemic. This review proposes that the catalyst effect of the pandemic offers insights into a key driver of increases in youth depression and anxiety: greater uncertainty. Uncertainty about many aspects of everyday life, including social connections, education, job security and health, increased during the pandemic, and this coincided with increasing rates of depression and anxiety. Lab-based developmental cognitive and clinical neuroscience research on tolerance of uncertainty and adolescent mental health shows that when adolescents fail to show age-typical tolerance of uncertainty, they are at greater risk of mental health problems. Avenues for future research to understand and promote tolerance of uncertainty in adolescents are proposed.
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Affiliation(s)
- Susanne Schweizer
- University of New South Wales, Australia; University of Cambridge, United Kingdom.
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Branje S. The impact of the COVID-19 pandemic on adolescent mental health across the world. Curr Opin Psychol 2023; 53:101665. [PMID: 37562339 DOI: 10.1016/j.copsyc.2023.101665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 08/12/2023]
Abstract
The global impact of the COVID-19 pandemic on adolescents has been substantial. The current review aimed to summarize the existing literature on the impact of the pandemic on mental health during adolescence, with a specific focus on longitudinal studies. The findings from these studies indicated that many adolescents experienced increased mental health problems, especially those who were already vulnerable prior to the pandemic. Several preexisting factors, such as socioeconomic background and gender, and pandemic-related factors, such as perceived stress and restrictive measures, were identified that contribute to interindividual differences in how adolescents were affected by the pandemic. However, it is crucial to interpret these changes in the context of the ongoing trend of increasing mental health problems among youth over the past decades.
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Affiliation(s)
- Susan Branje
- Faculty of Social and Behavioural Sciences, Utrecht University, the Netherlands.
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Schweizer S, Andrews JL, Grunewald K, Kumle L. Association of Antenatal COVID-19-Related Stress With Postpartum Maternal Mental Health and Negative Affectivity in Infants. JAMA Netw Open 2023; 6:e232969. [PMID: 36917108 PMCID: PMC10015313 DOI: 10.1001/jamanetworkopen.2023.2969] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/15/2023] Open
Abstract
IMPORTANCE Antenatal stress is a significant risk factor for poor postpartum mental health. The association of pandemic-related stress with postpartum outcomes among mothers and infants is, however, less well understood. OBJECTIVE To examine the association of antenatal COVID-19-related stress with postpartum maternal mental health and infant outcomes. DESIGN, SETTING, AND PARTICIPANTS This cohort study was conducted among 318 participants in the COVID-19 Risks Across the Lifespan study, which took place in Australia, the UK, and the US. Eligible participants reported being pregnant at the first assessment wave between May 5 and September 30, 2020, and completed a follow-up assessment between October 28, 2021, and April 24, 2022. MAIN OUTCOMES AND MEASURES COVID-19-related stress was assessed with the Pandemic Anxiety Scale (score range, 0-4, with higher scores indicating greater COVID-19-related stress). The 8-item Patient Health Questionnaire (score range, 0-3, with higher scores indicating more frequent symptoms of depression) was used to measure maternal depression at each time point, and the 7-item General Anxiety Disorder scale (score range, 0-3, with higher scores indicating more frequent symptoms of anxiety) was used to measure generalized anxiety at each time point. At follow-up, postpartum distress was assessed with the 10-item Postpartum Distress Measure (score range, 0-3, with higher scores indicating greater postpartum distress), and infant outcomes (negative and positive affectivity and orienting behavior) were captured with the Infant Behavior Questionnaire (score range, 1-7, with higher scores indicating that the infant exhibited that affect/behavior more frequently). RESULTS The study included 318 women (mean [SD] age, 32.0 [4.6] years) from Australia (88 [28%]), the US (94 [30%]), and the UK (136 [43%]). Antenatal COVID-19-related stress was significantly associated with maternal postpartum distress (β = 0.40 [95% CI, 0.28-0.53]), depression (β = 0.32 [95% CI, 0.23-0.41]), and generalized anxiety (β = 0.35 [95% CI, 0.26-0.44]), as well as infant negative affectivity (β = 0.45 [95% CI, 0.14-0.76]). The findings remained consistent across a range of sensitivity analyses. CONCLUSIONS AND RELEVANCE The findings of this cohort study suggest that targeting pandemic-related stressors in the antenatal period may improve maternal and infant outcomes. Pregnant individuals should be classified as a vulnerable group during pandemics and should be considered a public health priority, not only in terms of physical health but also mental health.
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Affiliation(s)
- Susanne Schweizer
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- School of Psychology, University of New South Wales, Kensington, New South Wales, Australia
| | - Jack L. Andrews
- School of Psychology, University of New South Wales, Kensington, New South Wales, Australia
| | - Karina Grunewald
- School of Psychology, University of New South Wales, Kensington, New South Wales, Australia
| | - Levi Kumle
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
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Does pressure to gain social media attention have consequences for adolescents’ friendship closeness and mental health? A longitudinal examination of within-person cross-lagged relations. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
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