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Alexandrova-Karamanova A, Lauri Korajlija A, Halama P, Baban A. Long-Term Post-COVID-19 Health and Psychosocial Effects and Coping Resources Among Survivors of Severe and Critical COVID-19 in Central and Eastern Europe: Protocol for an International Qualitative Study. JMIR Res Protoc 2024; 13:e57596. [PMID: 39348673 DOI: 10.2196/57596] [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: 02/20/2024] [Revised: 05/22/2024] [Accepted: 08/22/2024] [Indexed: 10/02/2024] Open
Abstract
BACKGROUND There is a strong need to determine pandemic and postpandemic challenges and effects at the individual, family, community, and societal levels. Post-COVID-19 health and psychosocial effects have long-lasting impacts on the physical and mental health and quality of life of a large proportion of survivors, especially survivors of severe and critical COVID-19, extending beyond the end of the pandemic. While research has mostly focused on the negative short- and long-term effects of COVID-19, few studies have examined the positive effects of the pandemic, such as posttraumatic growth. It is essential to study both negative and positive long-term post-COVID-19 effects and to acknowledge the role of the resources available to the individual to cope with stress and trauma. This knowledge is especially needed in understudied regions hit hard by the pandemic, such as the region of Central and Eastern Europe. A qualitative approach could provide unique insights into the subjective perspectives of survivors on their experiences with severe COVID-19 disease and its lingering impact on their lives. OBJECTIVE The aim of the study is to qualitatively explore the experiences of adult survivors of severe or critical COVID-19 throughout the acute and postacute period in 5 Central and Eastern European countries (Bulgaria, Slovakia, Croatia, Romania, and Poland); gain insight into negative (post-COVID-19 condition and quality of life) and positive (posttraumatic growth) long-term post-COVID effects; and understand the role of survivors' personal, social, and other coping resources and local sociocultural context and epidemic-related situations. METHODS This is a qualitative thematic analysis study with an experiential reflexive perspective and inductive orientation. The analytical approach involves 2-stage data analysis: national analyses in stage 1 and international analysis in stage 2. Data are collected from adult survivors of severe and critical COVID-19 through in-depth semistructured interviews conducted in the period after hospital discharge. RESULTS As of the publication of this paper, data collection is complete. The total international sample includes 151 survivors of severe and critical COVID-19: Bulgaria (n=33, 21.8%), Slovakia (n=30, 19.9%), Croatia (n=30, 19.9%), Romania (n=30, 19.9%), and Poland (n=28, 18.5%). National-level qualitative thematic analysis is currently underway, and several papers based on national results have been published. Cross-national analysis has started in 2024. The results will be submitted for publication in the third and fourth quarters of 2024. CONCLUSIONS This research emphasizes the importance of a deeper understanding of the ongoing health and psychosocial challenges survivors face and what helps them cope with these challenges and, in some cases, thrive. It has implications for informing holistic care and improving the health and psychosocial outcomes of survivors of COVID-19 and will be crucial for evaluating the overall impact and multifaceted implications of the pandemic and for informing future pandemic preparedness. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/57596.
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Affiliation(s)
- Anna Alexandrova-Karamanova
- Department of Psychology, Institute for Population and Human Studies, Bulgarian Academy of Sciences, Sofia, Bulgaria
| | - Anita Lauri Korajlija
- Department of Psychology, Faculty of Humanities and Social Sciences, University of Zagreb, Zagreb, Croatia
| | - Peter Halama
- Centre of Social and Psychological Sciences, Slovak Academy of Sciences, Bratislava, Slovakia
| | - Adriana Baban
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
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Yang X, Lawrence AJ, Harrison P, Liu Y, Chen L, Wang C, Yan C, Zahn R. Positive effects of the COVID-19 pandemic on depression and anxiety in Chinese adolescents. Eur Child Adolesc Psychiatry 2024; 33:1551-1561. [PMID: 37486386 PMCID: PMC11098867 DOI: 10.1007/s00787-023-02263-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: 02/13/2023] [Accepted: 07/13/2023] [Indexed: 07/25/2023]
Abstract
The potential impact on mental health of home schooling and social isolation due to COVID-19 lockdowns has led to widespread concern, particularly for adolescents. However, studies including pre-pandemic data from longitudinal cohorts with an assessment of the longer-term impact of the Covid-19 pandemic beyond the first months of 2020 are scarce. This longitudinal study of 1534 adolescents attending a secondary school in Hunan province investigated self-reported symptoms of anxiety and depression using two validated scales (Screen for Child Anxiety Related Disorders, Child Mood and Feelings Questionnaire) at six time points before, during, and after the 2020 national lockdown restrictions in China. Perceived COVID-related stress was assessed by an author-developed scale at two timepoints during the lockdown. We investigated trends in symptoms over time with a fixed effects model and multiple imputations of missing data. Counter to our expectations, depressive and anxiety symptoms were reduced during the 2020 lockdown relative to pre-lockdown (depression: b = - 3.37, SE = 0.345, Cohen's d = - 0.25, p < 0.0001; anxiety: b = - 4.55, SE = 0.382, Cohen's d = - 0.30, p < 0.0001). Symptoms remained significantly reduced even after lockdown restrictions eased. Higher symptom levels during lockdown were associated with greater self-reported COVID-related stress (depression: b = 0.11, SE = 0.026, p < 0.0001; anxiety: b = 0.11, SE = 0.036, p < 0.0001). Although COVID-related stresses correlated with higher levels of anxiety and depression, the lockdown period was associated with improved symptom levels in the adolescents taking part in our study. School closures may have improved the mental health of adolescents in China. We speculate this beneficial effect of lockdown can be explained by the adverse effects of attending school itself such as exposure to bullying and achievement pressures.
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Affiliation(s)
- Xinhua Yang
- Changning Mental Health Center, 299 Xiehe Road, Changning District, Shanghai, 200335, China.
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Andrew J Lawrence
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Phillippa Harrison
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Yanlong Liu
- The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
| | - Liangliang Chen
- Changning Mental Health Center, 299 Xiehe Road, Changning District, Shanghai, 200335, China
| | - Chenglei Wang
- Changning Mental Health Center, 299 Xiehe Road, Changning District, Shanghai, 200335, China
| | - Chao Yan
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Roland Zahn
- Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Maruyama JM, Tovo-Rodrigues L, Santos IS, Murray J, Matijasevich A. Adolescent Mental Health Before and During COVID-19: Longitudinal Evidence From the 2004 Pelotas Birth Cohort in Brazil. J Adolesc Health 2024; 74:729-738. [PMID: 38310505 DOI: 10.1016/j.jadohealth.2023.10.016] [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] [Received: 03/12/2023] [Revised: 09/22/2023] [Accepted: 10/11/2023] [Indexed: 02/05/2024]
Abstract
PURPOSE There is great interest in examining the consequences of the COVID-19 pandemic on adolescent mental health, but most studies were conducted in high-income countries. The identification of overall effects and protective factors is essential to understand the determinants of mental wellbeing in contexts of stress. We aimed to study changes in adolescent mental health during the pandemic and the risk and protective factors associated with these changes in a Brazilian birth cohort. METHODS One thousand nine hundred forty nine adolescents from the 2004 Pelotas Birth Cohort were assessed prepandemic (T1, November 2019 to March 2020, mean age 15.69 years) and mid-pandemic (T2, August to December 2021, mean age 17.41 years). Mental health was assessed using the Strengths and Difficulties Questionnaire. Prepandemic and pandemic-related predictors were examined as predictors of change in multivariate latent change scores models. RESULTS There was a mean increase in adolescent total mental health difficulties (M = 1.071, p < .001), hyperactivity/inattention (M = 0.208, p < .001), emotion symptoms (M = 0.409, p < .001), and peer problems (M = 0.434, p < .001) during the pandemic. This increase was associated with several negative family context variables, including harsh parenting and maternal depressive symptoms at T2. Higher emotion regulation levels protected against increases in adolescent mental health difficulties related to the COVID-19 pandemic. DISCUSSION Family-context variables emerged as important risk factors for the deterioration of adolescent mental health during the COVID-19 pandemic. Interventions promoting emotion regulation strategies are a promising approach to protecting adolescent wellbeing in periods of stress.
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Affiliation(s)
- Jessica Mayumi Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil.
| | | | - Iná S Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Joseph Murray
- Human Development and Violence Research Centre, Federal University of Pelotas, Pelotas, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
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Maruyama JM, Tovo-Rodrigues L, Santos IS, Murray J, Matijasevich A. Changes and predictors of adolescent emotion regulation, self-esteem, and locus of control during the COVID-19 pandemic: 2004 Pelotas Birth Cohort. REVISTA BRASILEIRA DE PSIQUIATRIA (SAO PAULO, BRAZIL : 1999) 2023; 45:389-396. [PMID: 37400138 PMCID: PMC10894627 DOI: 10.47626/1516-4446-2023-3169] [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: 04/18/2023] [Accepted: 06/25/2023] [Indexed: 07/05/2023]
Abstract
OBJECTIVES There is growing interest in examining the impacts of the coronavirus disease 2019 (COVID-19) pandemic on adolescent socioemotional development. This study aimed to examine changes in adolescent emotion regulation (ER), self-esteem (SE), and locus of control (LoC) from before to during the pandemic in a Brazilian birth cohort, and to investigate the variables associated with changes in those socioemotional competences. METHODS 1,949 adolescents from the 2004 Pelotas Birth Cohort were assessed before (T1, November 2019 to March 2020) and during (T2, August to December 2021) the COVID-19 pandemic (mean ages [SD] = 15.69 [0.19] and 17.41 [0.26], respectively). Adolescents' socioemotional competences were assessed, including ER, SE, and LoC. Sociodemographic, pre-pandemic, and pandemic-related correlates were examined as predictors of change. Multivariate latent change score models were used in the analyses. RESULTS There were significant mean increases in adolescents' ER and SE (mean ER = 1.918, p < 0.001; mean SE = 1.561, p = 0.001) and a significant mean decrease (towards internalization) in LoC levels (MLoC = -0.497, p < 0.01) during the pandemic. Factors that predicted a lower competency increase included family conflicts, harsh parenting, and maternal depressive symptoms during the pandemic. CONCLUSION Despite the stress imposed by the COVID-19 pandemic, the adolescents of this cohort showed positive development in their socioemotional competences. Family-related factors emerged as important predictors of adolescent socioemotional adjustment during the study period.
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Affiliation(s)
- Jessica Mayumi Maruyama
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Luciana Tovo-Rodrigues
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Iná S. Santos
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Joseph Murray
- Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Alicia Matijasevich
- Departamento de Medicina Preventiva, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil
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Ju YJ, Kim W, Lee SY. Public perception of the appropriateness of COVID-19 management strategies and level of disturbances in daily activities: A focus on educational level. PLoS One 2023; 18:e0287143. [PMID: 37294776 PMCID: PMC10256230 DOI: 10.1371/journal.pone.0287143] [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: 01/26/2023] [Accepted: 05/31/2023] [Indexed: 06/11/2023] Open
Abstract
BACKGROUND This study investigated the association between public perception of the appropriateness of management strategies implemented during the COVID-19 pandemic and the level of disturbances in daily activities reported by the general population. METHODS This cross-sectional study used Korea Community Health Survey conducted from August to November 2020. Public perception of COVID-19 management strategies included those implemented by the government (central, city or provincial, and administrative districts), the mass media, regional medical institutions, and neighbors. The subjective level of disturbances in daily activities was measured using a 0-100 numeric rating scale developed by Korea Disease Control and Prevention Agency. Multivariable linear regression analysis was used. A subgroup analysis was conducted based on education level. RESULTS The present study analyzed 211,353 participants. Compared to individuals who perceived that the management strategies implemented during the pandemic was 'highly appropriate,' those who reported 'mediocre appropriateness' (β: -1.96, p-value: <0.001) or 'low appropriateness' (β: -3.60, p-value: 0.010) reported higher levels of subjective disturbances. The appropriateness of measures implemented by the mass media was associated with levels of subjective disturbances felt by individuals of lower education with statistical significance, whereas that applied by the mass media and the government were important in those with higher education. CONCLUSIONS The findings suggest the importance of public perception of management strategies when implementing containment policies and minimizing its disturbances on daily lives is essential.
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Affiliation(s)
- Yeong Jun Ju
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon-si, Gyeonggi-do, Republic of Korea
| | - Woorim Kim
- Division of Cancer Control & Policy, National Cancer Control Institute, National Cancer Center, Goyang-si, Gyeonggi-do, Republic of Korea
| | - Soon Young Lee
- Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon-si, Gyeonggi-do, Republic of Korea
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Bui HN, Duong CD, Nguyen VQ, Vu NX, Ha ST, Le TT, Vu TN. Utilizing the theory of planned behavior to predict COVID-19 vaccination intention: A structural equational modeling approach. Heliyon 2023; 9:e17418. [PMID: 37366521 PMCID: PMC10275777 DOI: 10.1016/j.heliyon.2023.e17418] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/09/2023] [Accepted: 06/16/2023] [Indexed: 06/28/2023] Open
Abstract
It is essential to achieve herd immunity in order to control the COVID-19 pandemic, and this requires a high level of vaccination rate. Despite the importance of vaccination, hesitancy and unwillingness in receiving the COVID-19 vaccine still exists. It is therefore crucial to comprehend the intentions of adults regarding COVID-19 vaccination, which is beneficial for establishing community immunity and an efficient future pandemic response. An online survey was administered to 2722 adults in Vietnam. Cronbach's alpha, exploratory factor analysis (EFA), and confirmatory factor analysis (CFA) were used to test the reliability and validity of the developed scales. Then, structural equational modeling (SEM) was employed to test correlations. This study found that favorable attitudes toward COVID-19 vaccines played the most important role in shaping adults' intention to receive these vaccines, followed by perceived behavioral control, perceived benefits of COVID-19 vaccines, and subjective norms. Concurrently, all three core dimensions of the theory of planned behavior mediated the link between the perceived benefits of COVID-19 vaccines and the intention to receive them. Also, there were significant differences between males and females in the way they formed this intention. The findings of this study offer valuable guidance for practitioners on how to encourage adults to receive COVID-19 vaccinations, as well as how to limit the transmission of the COVID-19 virus.
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Affiliation(s)
| | | | - Van Quang Nguyen
- College of Economics, Technology and Fisheries, Viet Nam
- TIMAS - Thang Long University, Hanoi, Viet Nam
| | | | - Son Tung Ha
- National Economics University, Hanoi, Viet Nam
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Zdravkovic A, Goldstein AL. Optimists and Realists: A Latent Class Analysis of Students Graduating from High School during COVID-19 and Impacts on Affect and Well-Being. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20032120. [PMID: 36767487 PMCID: PMC9915344 DOI: 10.3390/ijerph20032120] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/11/2023] [Accepted: 01/17/2023] [Indexed: 05/13/2023]
Abstract
The Novel Coronavirus Disease (COVID-19) pandemic has had profound effects on physical and mental health worldwide. Students transitioning out of high school were uniquely impacted at the onset of the pandemic, having missed the opportunity to properly mark the end of their final year in the K-12 school system. The adverse effects of this loss on this population are still unknown. The purpose of the current study was to examine stress, wellbeing, and affect in a sample of 168 students (N = 168; Mage = 17.0, SD = 0.46; 60% female; 40% male) who were completing their final year of high school during the early stages of the pandemic when emergency stay-at-home orders were in place. Participants completed an online survey assessing the impact of COVID-19 on their life satisfaction (pre-COVID19, during COVID-19, and anticipated five years from now), stress, positive affect, and negative affect. Latent class analysis (LCA) was used to create classes of participants based on their responses to the pandemic. A two-subgroup solution provided the best model for the life satisfaction outcome variable. Subgroup 1, optimists, comprised 24% (N = 40) of the sample and reported high life satisfaction ratings one year prior to COVID-19 and a slight decrease in life satisfaction during COVID-19, and they anticipated an increase in life satisfaction 5 years from now. This group was characterized by low stress, low negative affect, and high positive affect during the pandemic. Subgroup 2, realists, comprised 76% of the population (N = 128) and experienced similarly high retrospective ratings of pre-COVID life satisfaction but a larger decrease in life satisfaction during the pandemic and a smaller increase in five years. The realist group was characterized by low positive affect, high stress, and high negative affect during the pandemic. The findings suggest that during the pandemic, certain subsamples of adolescents had greater difficulty in managing this transitional period and experienced changes in mood and well-being (i.e., affect, stress) as compared to other adolescents (i.e., optimists). Future research should investigate the characteristics and coping mechanisms that are instrumental for increasing life satisfaction and positive affect while lowering stress in this population.
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Xu M, Tian R, Fu C, Li J, Bi D, Wang Y. The impact of family function on post-traumatic reactions of Chinese adolescents infected with COVID-19: a latent profile study. Front Public Health 2023; 11:1153820. [PMID: 37213623 PMCID: PMC10192572 DOI: 10.3389/fpubh.2023.1153820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/11/2023] [Indexed: 05/23/2023] Open
Abstract
Background Since the end of 2019, Corona Virus Disease 2019, also known as COVID-19, has broken out in various countries. However, the change of China's COVID-19 prevention and control policy and the sharp increase in the number of infected people are making the teenagers have post-traumatic reactions. Negative post-traumatic reactions include: post-traumatic stress disorder (PTSD), depression, anxiety. Positive post-traumatic reaction mainly refers to post-traumatic growth (PTG). The purpose of this study is to explore the post-traumatic reaction, which refers to PTSD, depression, anxiety and the co-occurrence pattern of growth after trauma and to further explore the influence of family function on different categories of Post-traumatic Reactions. Methods Latent profile analysis (LPA) was used to explore the co-occurrence of PTSD, depression, anxiety, and PTG. Multiple logistics regression was used to analyze the influence of family function on different categories of post-traumatic response. Results There were three categories of post-traumatic reactions in adolescents infected with COVID-19 adolescents infected with COVID-19, namely: growth class, struggling class, and pain class. Multivariate Logistic regression showed that the growth class and struggling class were affected by problem solving and behavior control in family function, while the growth class and pain class were affected by problem solving, roles, behavior control, and general functioning. Multiple logistic regression showed that the growth class and struggling class were affected by problem solving and roles. Conclusions The findings of this study provide evidence for the identification of high-risk individuals and the provision of effective interventions in clinical practice, as well as the influence of family functioning on the different categories of PTSD among adolescents infected with COVID-19.
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Affiliation(s)
- Mingtu Xu
- Department of Mental Health, First Affiliated Hospital of Jilin University, Changchun, China
| | - Runhui Tian
- Department of Mental Health, First Affiliated Hospital of Jilin University, Changchun, China
- *Correspondence: Runhui Tian
| | - Cong Fu
- Department of Mental Health, First Affiliated Hospital of Jilin University, Changchun, China
| | - Jingyang Li
- Department of Mental Health, First Affiliated Hospital of Jilin University, Changchun, China
| | - Dingyu Bi
- Department of Politics and Education, Jilin Experimental Middle School, Changchun, China
| | - Yan Wang
- Affiliated Middle School of Jilin University, Changchun, China
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Koper N, Creemers HE, van Dam L, Stams GJJM, Branje S. Resilience, well-being and informal and formal support in multi-problem families during the Covid-19 pandemic. Child Adolesc Psychiatry Ment Health 2022; 16:103. [PMID: 36536396 PMCID: PMC9762621 DOI: 10.1186/s13034-022-00542-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 12/02/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The Covid-19 pandemic may have had negative effects on youth and parental mental health, especially in high-risk populations such as multi-problem families (i.e., families that experience problems in multiple domains, such as mental health and social network problems). Using one to four assessments during all phases of the Covid-19 pandemic up until January 2022, we examined the associations between pandemic-related stress and mental health (resilience and well-being) of youth and parents from multi-problem families. We also investigated whether experienced informal (i.e., youth informal mentoring) and formal support (i.e., therapist support) served as protective factors in this association. METHODS A total of 92 youth aged 10-19 years (46.7% girls; mean age 16.00 years) and 78 parents (79.5% female; mean age 47.17 years) filled in one to four questionnaires between March 2020 and January 2022. Multi-level analyses were conducted to account for the nested structure of the data. RESULTS For youth, pandemic-related stress was associated with lower well-being, but not with resilience. Perceived support from both mentors and therapists was positively associated with youth mental health. Furthermore, high perceived therapist support protected youth from the negative effect of pandemic-related stress on resilience. For parents, pandemic-related stress was not related to mental health, irrespective of therapist support. Yet, therapist support was directly and positively associated with parental mental health. CONCLUSIONS Youth from multi-problem families who experience pandemic-related stress are at risk of (elevated) mental health problems during the pandemic, specifically if they have no or weak therapist support. The mental health of parents, however, was minimally affected by pandemic-related stress, indicating strength and flexibility. Youth and parents who experienced support during the pandemic reported higher levels of resilience and well-being, demonstrating the importance of support for individuals' mental health during stressful times such as a pandemic.
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Affiliation(s)
- Natasha Koper
- Department of Youth and Family, Utrecht University, PO box 80140, 3508TC, Utrecht, The Netherlands. .,Department of Forensic Child and Youth Care Sciences, University of Amsterdam, Amsterdam, The Netherlands. .,YIM Foundation, Amersfoort, The Netherlands.
| | - Hanneke E. Creemers
- grid.7177.60000000084992262Department of Forensic Child and Youth Care Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Levi van Dam
- grid.7177.60000000084992262Department of Forensic Child and Youth Care Sciences, University of Amsterdam, Amsterdam, The Netherlands ,YIM Foundation, Amersfoort, The Netherlands ,grid.491096.3Levvel Youth and Family Care, Amsterdam, The Netherlands
| | - Geert Jan J. M. Stams
- grid.7177.60000000084992262Department of Forensic Child and Youth Care Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Susan Branje
- grid.5477.10000000120346234Department of Youth and Family, Utrecht University, PO box 80140, 3508TC Utrecht, The Netherlands
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