1
|
Park JL, McArthur BA, Plamondon A, Hewitt JMA, Racine N, McDonald S, Tough S, Madigan S. The course of children's mental health symptoms during and beyond the COVID-19 pandemic. Psychol Med 2024:1-12. [PMID: 39247941 DOI: 10.1017/s0033291724001491] [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] [Indexed: 09/10/2024]
Abstract
BACKGROUND The COVID-19 pandemic is associated with increases in child mental health problems, but the persistence of these changes in the post-pandemic era remains uncertain. Additionally, it is unclear whether changes in mental health problems during the pandemic exceed the anticipated increases as children age. This study controls for the linear effect of age in 1399 children, investigating the course of child-reported anxiety, depression, hyperactivity, and inattention symptoms during and after the pandemic, and identifies risk and protective factors that predict these mental health trajectories. METHODS Children (51% male; ages 9-11 at the first timepoint) provided mental health ratings at three pandemic timepoints (July-August 2020; March-April 2021; November 2021-January 2022) and one post-pandemic timepoint (January-July 2023). Mothers reported pre-pandemic mental health (2017-2019) and socio-demographic factors. Children reported socio-demographic factors, risk (e.g. screen time, sleep), and resilience (e.g. optimism) factors during the first timepoint. RESULTS Average mental health symptoms increased over time, with more children exceeding clinical cut-offs for poor mental health at each subsequent pandemic timepoint. Growth curve modeling, adjusting for age-related effects, revealed a curvilinear course of mental health symptoms across all domains. Examination of risk and protective factors revealed that pre-existing mental health symptoms and optimism were associated with the course of symptoms. CONCLUSIONS After considering age effects, children's mental health follows a curvilinear pattern over time, suggesting an initial decline followed by a rising trend in symptoms post-COVID. These findings underscore the continued need for additional resources and timely, evidence-based mental health prevention and intervention for children.
Collapse
Affiliation(s)
- Joanne L Park
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Department of Psychology, Mount Royal University, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Brae Anne McArthur
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - André Plamondon
- Département des fondements et pratiques en éducation, Université Laval, QC, Canada
| | - Jackson M A Hewitt
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| | - Nicole Racine
- School of Psychology, Faculty of Social Sciences, University of Ottawa, Ottawa, ON, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Sheila McDonald
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Suzanne Tough
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Department of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Sheri Madigan
- Department of Psychology, University of Calgary, Calgary, AB, Canada
- Alberta Children's Hospital Research Institute, Calgary, AB, Canada
| |
Collapse
|
2
|
Tsai CS, Wang LJ, Hsiao RC, Yen CF, Lin CY. Psychological distress and related factors among caregivers of children with attention-deficit/hyperactivity disorder during the COVID-19 pandemic. Eur Child Adolesc Psychiatry 2024; 33:1197-1200. [PMID: 37162587 PMCID: PMC10170437 DOI: 10.1007/s00787-023-02220-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 04/27/2023] [Indexed: 05/11/2023]
Abstract
The present study examined the relationships of caregiver factors (including caregivers' age, sex and educational year), child-family interactions (caregivers' difficulties in managing children's protective behaviors against COVID-19, learning and daily performance, children's conflict with elders and siblings, and parenting styles), and children's factors (attention-deficit/hyperactivity disorder [ADHD] and oppositional defiant disorder [ODD] symptoms) with psychological distress of the caregivers of children with ADHD in the COVID-19 pandemic. This study recruited 252 caregivers of children with ADHD to participate and complete a questionnaire collecting their psychological distress in the COVID-19 pandemic, demographics, difficulties in managing children's protective behaviors against COVID-19, learning and daily performance, and parenting styles as well as children's conflict with elders and siblings, and the ADHD and ODD symptoms. Hierarchical regression models were constructed to examine the factors related to psychological distress among caregivers. Factors across caregiver, child, and child-family interaction dimensions, including children's conflict levels with elders and siblings, inattention symptoms, and caregivers' difficulties in managing children's protective behaviors against COVID-19, learning and daily performance, female sex, and younger age were significantly associated with psychological distress among caregivers in various hierarchical regression models. Health professionals should take the relevant factors identified in this study when developing an intervention to relieve caregivers' psychological distress in the COVID-19 pandemic.
Collapse
Affiliation(s)
- Ching-Shu Tsai
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Liang-Jen Wang
- Department of Child and Adolescent Psychiatry, Chang Gung Memorial Hospital, Kaohsiung Medical Center, Kaohsiung, Taiwan
- School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Ray C Hsiao
- Department of Psychiatry, Seattle Children's, Seattle, WA, USA
- Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Washington, Seattle, WA, USA
| | - Cheng-Fang Yen
- Department of Psychiatry, School of Medicine College of Medicine, Kaohsiung Medical University, 100 Tzyou 1St Road, Kaohsiung, 80703, Taiwan.
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
- College of Professional Studies, National Pingtung University of Science and Technology, Pingtung, Taiwan.
| | - Chung-Ying Lin
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 1 University Rd, Tainan, 70101, Taiwan.
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
- Department of Public Health, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
- Biostatistics Consulting Center, College of Medicine, National Cheng Kung University Hospital, National Cheng Kung University, Tainan, Taiwan.
| |
Collapse
|
3
|
Rask CU, Duholm CS, Poulsen CM, Rimvall MK, Wright KD. Annual Research Review: Health anxiety in children and adolescents-developmental aspects and cross-generational influences. J Child Psychol Psychiatry 2024; 65:413-430. [PMID: 37909255 DOI: 10.1111/jcpp.13912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/14/2023] [Indexed: 11/03/2023]
Abstract
Health anxiety involves excessive worries about one's health along with beliefs one has an illness or may contract a serious disease. Concerning evidence suggests that health anxiety is on the rise in society, possibly further fueled by the COVID-19 pandemic. Recent classification systems acknowledge that impairing health-related worries and beliefs can emerge in early childhood with significant levels of symptoms persisting throughout childhood, and possibly continuous with diagnostic considerations in adulthood. This narrative review summarizes recent research advances in health anxiety in children and adolescents, focusing on various developmental aspects of health anxiety and related concepts in youths. Findings suggest that health anxiety symptoms in young age groups are associated with impairment, distress, and increased healthcare use, as well as substantial comorbidity with mainly other emotional problems and disorders. Furthermore, longitudinal studies suggest that childhood health anxiety can persist across adolescence, perhaps with links to chronic courses in adulthood. The growing literature was further reviewed, thus extending our understanding of early risk factors, including the potential role of exposure to serious illness and transgenerational transmission of health anxiety. Learning more about developmental trajectories will be highly relevant to inform strategies for early detection and prevention. While modified cognitive behavioral therapies in adults are successful in treating health anxiety, specific interventions have not yet been tested in youths. Given substantial overlaps with other psychopathology, it could be important to develop and explore more transdiagnostic and scalable approaches that take advantage of common factors in psychotherapy, while also including a wider perspective on potential familiar maladaptive illness cognitions and behaviors.
Collapse
Affiliation(s)
- Charlotte Ulrikka Rask
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Charlotte Steen Duholm
- Department of Child and Adolescent Psychiatry, Aarhus University Hospital Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - Martin Køster Rimvall
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital - Psychiatry Region Zealand, Roskilde, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
| | - Kristi D Wright
- Department of Psychology, University of Regina, Regina, SK, Canada
| |
Collapse
|
4
|
Stoddard J, Reynolds E, Paris R, Haller SP, Johnson SB, Zik J, Elliotte E, Maru M, Jaffe AL, Mallidi A, Smith AR, Hernandez RG, Volk HE, Brotman MA, Kaufman J. The Coronavirus Impact Scale: Construction, Validation, and Comparisons in Diverse Clinical Samples. JAACAP OPEN 2023; 1:48-59. [PMID: 37359142 PMCID: PMC10010775 DOI: 10.1016/j.jaacop.2023.03.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/07/2023] [Indexed: 06/12/2023]
Abstract
Objective This report is of the construction and initial psychometric properties of the Coronavirus Impact Scale in multiple large and diverse samples of families with children and adolescents. The scale was established to capture the impact of the coronavirus pandemic during its first wave. Differences in impact between samples and internal structure within samples were assessed. Method A total of 572 caregivers of children and adolescents or expecting mothers in diverse clinical and research settings completed the Coronavirus Impact Scale. Samples differed in regard to developmental stage, background, inpatient/outpatient status, and primary research or clinical setting. Model free methods were used to measure the scale's internal structure and to determine a scoring method. Differences between samples in specific item responses were measured by multivariate ordinal regression. Results The Coronavirus Impact Scale demonstrated good internal consistency in a variety of clinical and research populations. Across the groups studied, single, immigrant, predominantly Latinx mothers of young children reported the greatest impact of the pandemic, with noteworthy effects on food access and finances reported. Individuals receiving outpatient or inpatient care reported greater impacts on health care access. Elevated scores on the Coronavirus Impact Scale were positively associated with measures of caregiver anxiety and both caregiver- and child-reported stress at a moderate effect size. Conclusion The Coronavirus Impact Scale is a publicly available scale with adequate psychometric properties for use in measuring the impact of the coronavirus pandemic in diverse populations.
Collapse
Affiliation(s)
- Joel Stoddard
- University of Colorado, Anschutz Medical Campus, Aurora, Colorado, and Children's Hospital Colorado, Aurora, Colorado
| | | | - Ruth Paris
- Boston University School of Social Work, Boston, Massachusetts
| | - Simone P Haller
- National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Sara B Johnson
- Johns Hopkins School of Medicine, Baltimore
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jodi Zik
- University of Colorado, Anschutz Medical Campus, Aurora, Colorado, and Children's Hospital Colorado, Aurora, Colorado
| | - Eliza Elliotte
- University of Colorado, Anschutz Medical Campus, Aurora, Colorado, and Children's Hospital Colorado, Aurora, Colorado
| | - Mihoko Maru
- Boston University School of Social Work, Boston, Massachusetts
| | - Allison L Jaffe
- National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Ajitha Mallidi
- National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Ashley R Smith
- National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Raquel G Hernandez
- Johns Hopkins School of Medicine, Baltimore
- Johns Hopkins All Children's Center for Pediatric Health Equity Research, St. Petersburg, Florida
| | - Heather E Volk
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Melissa A Brotman
- National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Joan Kaufman
- Johns Hopkins School of Medicine, Baltimore
- Center for Child and Family Traumatic Stress, Kennedy Krieger Institute, Baltimore, Maryland
| |
Collapse
|
5
|
Cortese S, Solmi M, Correll CU. Commentary: The impact of Covid-19 on psychopathology in children and young people worldwide - reflections on Newlove-Delgado et al. (2023). J Child Psychol Psychiatry 2023; 64:641-644. [PMID: 36786395 DOI: 10.1111/jcpp.13765] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2023] [Indexed: 02/15/2023]
Abstract
In the past 3 years, since the beginning of the Covid-19 pandemic, there has been an impressive flourishing body of publications on the impact of the pandemic and related restrictions on the mental health of children and young people. It was about time for a rigorous quantitative evidence synthesis of this large body of research. Newlove-Delgado et al. (J Child Psychol Psychiatry, 2022) took on this challenge by completing a systematic review with meta-analysis of epidemiological studies on the impact of Covid-19 on psychopathology in children and adolescents, featured in the 2023 Annual Research Review series of the Journal. Overall, this meta-analysis shows that the relationship between mental health and Covid-19 pandemic in children and adolescents is complex and, as such, it ought to be addressed by studies using rigorous methods and advanced analytic strategies. Collectively, as a field, we should and could do better with regards to the scope and quality of the studies in this area.
Collapse
Affiliation(s)
- Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK.,Solent NHS Trust, Southampton, UK.,Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK.,Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA
| | - Marco Solmi
- Centre for Innovation in Mental Health, School of Psychology, University of Southampton, Southampton, UK.,Department of Psychiatry, University of Ottawa, Ottawa, ON, Canada.,Department of Mental Health, The Ottawa Hospital, Ottawa, ON, Canada.,School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.,Ottawa Hospital Research Institute (OHRI), Clinical Epidemiology Program, University of Ottawa, Ottawa, ON, Canada.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.,Division of Psychiatry Research, Northwell Health, The Zucker Hillside Hospital, New York, NY, USA.,Department of Psychiatry and Molecular Medicine, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York, NY, USA
| |
Collapse
|
6
|
Newlove‐Delgado T, Russell AE, Mathews F, Cross L, Bryant E, Gudka R, Ukoumunne OC, Ford TJ. Annual Research Review: The impact of Covid-19 on psychopathology in children and young people worldwide: systematic review of studies with pre- and within-pandemic data. J Child Psychol Psychiatry 2023; 64:611-640. [PMID: 36421049 PMCID: PMC10952503 DOI: 10.1111/jcpp.13716] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/02/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND The high volume and pace of research has posed challenges to researchers, policymakers and practitioners wanting to understand the overall impact of the pandemic on children and young people's mental health. We aimed to search for and review the evidence from epidemiological studies to answer the question: how has mental health changed in the general population of children and young people? METHODS Four databases (Medline, CINAHL, EMBASE and PsychINFO) were searched in October 2021, with searches updated in February 2022. We aimed to identify studies of children or adolescents with a mean age of 18 years or younger at baseline, that reported change on a validated mental health measure from prepandemic to during the pandemic. Abstracts and full texts were double-screened against inclusion criteria and quality assessed using a risk of bias tool. Studies were narratively synthesised, and meta-analyses were performed where studies were sufficiently similar. RESULTS 6917 records were identified, and 51 studies included in the review. Only four studies had a rating of high quality. Studies were highly diverse in terms of design, setting, timing in relation to the pandemic, population, length of follow-up and choice of measure. Methodological heterogeneity limited the potential to conduct meta-analyses across studies. Whilst the evidence suggested a slight deterioration on some measures, overall, the findings were mixed, with no clear pattern emerging. CONCLUSIONS Our findings highlight the need for a more harmonised approach to research in this field. Despite the sometimes-inconsistent results of our included studies, the evidence supports existing concerns about the impact of Covid-19 on children's mental health and on services for this group, given that even small changes can have a significant impact on provision at population level. Children and young people must be prioritised in pandemic recovery, and explicitly considered in planning for any future pandemic response.
Collapse
Affiliation(s)
| | | | - Frances Mathews
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Lauren Cross
- Department of PsychiatryUniversity of CambridgeCambridgeUK
| | - Eleanor Bryant
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Rebecca Gudka
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
| | - Obioha C. Ukoumunne
- University of Exeter Medical SchoolUniversity of ExeterExeterUK
- NIHR Applied Research Collaboration South West Peninsula (PenARC)ExeterUK
| | - Tamsin J. Ford
- Department of PsychiatryUniversity of CambridgeCambridgeUK
| |
Collapse
|