Mindset and perceived parental support of autonomy safeguard adolescents' autonomous motivation during COVID-19 home-based learning

Healthcare utilization and costs of singaporean youth with symptoms of depression and anxiety: results from a 2022 web panel

BACKGROUND

There is evidence that the prevalence of depression and anxiety among youth is increasing and that these factors contribute to high healthcare costs and poor school performance. The goal of this study is to provide up-to-date estimates of the prevalence and economic burden of depression and anxiety among youth in Singapore.

METHODS

Using an existing web panel, 991 parents filled out the PHQ-4 screener on behalf of 1,515 youth. 104 of these parents whose children (ages 4 to 21) had symptoms consistent with depression or anxiety filled out a full survey with questions on mental health symptoms, school absences, school performance, and healthcare utilization. The survey was fielded between April and June 2022. Publicly available prices were used to estimate the cost associated with the observed rates of health service use.

FINDINGS

Based on parental responses, 11.7% (95% CI:10.2 - 13.5%) of youth had symptoms consistent with depression and 12.8% (95% CI:11.2 - 14.6%) had symptoms consistent with anxiety. In total, 16.2% (95% CI:14.5 - 18.3%) were reported to have symptoms consistent with at least one of these conditions. These youths missed an average of 190 (95% CI: 126-254) hours of school per year due to their mental health conditions and parents reported that school and daily activities performance was significantly degraded. Per capita annual healthcare costs averaged S$10,250 (95% CI: 7,150-13,350), with 64% of youth receiving emergency or inpatient services. In aggregate, annual costs associated with these conditions were estimated to be S$1.2 billion (95% CI:S$1.1bn - S$1.4bn).

INTERPRETATION

Even with significant potential for underreporting, these results reveal concerning rates of Singaporean youth with symptoms consistent with depression or anxiety, many of whom remain untreated. Results also reveal the short-term economic burden caused by these symptoms and hint at longer-term consequences resulting from poor school performance. This study should represent a call to action for Singapore to address poor mental health among youth.

Coping styles mediate the relation between mindset and academic resilience in adolescents during the COVID-19 pandemic: a randomized controlled trial

The COVID-19 pandemic negatively impacted adolescent mental health on a global scale. However, many students were resilient during this crisis, despite exposure to COVID-related stressors. We aimed to study the protective effects of growth mindset on school-related resilience during the COVID-19 pandemic, and the mediating effects of coping styles. The two-year follow-up of an ongoing Randomized Controlled Trial, involving a growth mindset and control intervention, took place during the pandemic. We measured growth mindset, school burnout symptoms, COVID-19-specific stressor exposure, coping styles, and calculated a resilience score (corrected for pre-pandemic school burnout symptoms). Mediation analyses were performed in the total sample (N = 261), and exploratory in the intervention subsamples, to test whether the associations between mindset and resilience were mediated by coping styles. Growth-mindset students were more resilient during the pandemic and used less maladaptive and more adaptive (acceptance) coping styles. Coping mediated the relation between mindset and resilience in the total sample (both coping styles), and growth mindset intervention subsample (maladaptive coping). We found unique evidence for the beneficial effects of growth mindset on school-related resilience during the pandemic, and the mediating effect of coping styles as explanatory mechanism. This work contributes to a growing literature that shows positive effects of growth mindset on mental health.