Affective Mechanisms of Risk and Resilience to Stress from the COVID-19 Pandemic

• In Event: Poster Session 01
  In Poster Session: PS 01 Topic - Solicited Content: COVID-19 Related

Abstract

Background: Adolescence is a period of increased risk for internalizing problems, and experiencing stressful life events increases that risk. The COVID-19 pandemic is a major source of stress in the lives of adolescents across the world, but the health, economic, and social impacts of the pandemic and lockdowns vary between individuals. Individual differences in emotion functioning and underlying brain structure and function may influence how vulnerable adolescents are to the mental health impacts of these stressors. Understanding the characteristics that convey risk or resilience to internalizing problems during the COVID-19 pandemic may aid in the mitigation of the consequences of this near universal stressor as well as adolescents’ stressful experiences in general.

Methods: Participants were drawn from a study of neurobiological mechanisms of risk and resilience in children 11-12 years (n = 183). At this initial visit, they reported on the frequency of their engagement in rumination, internalizing problems, and participated in an fMRI scan to assess amygdala response during passive viewing of fearful and neutral faces. From this sample, 151 youths (68 female, mean age = 14.39, SD = .47) and a caregiver participated in an online remote follow-up visit in April or May of 2020, where they and their parent reported on the stressors they experienced as a result of the COVID-19 pandemic, and they reported on their use of cognitive reappraisal and expressive suppression, and symptoms of internalizing problems. We calculated a sum score of COVID-related stress based on dichotomized exposure to stressors specific to the pandemic in the following domains: health stressors, financial stressors, social stressors, school, crowding.

Results: Adolescents who experienced more COVID-related stressors reported higher levels of internalizing problems (ß= .451, p<.001). Youth who reported more frequent use of rumination at baseline, reported more internalizing problems during the COVID pandemic (ß= .186, p=.046). Lower use of cognitive reappraisal (ß= -.365, p<.001) and greater use of expressive suppression (ß= .284, p<.001) reported during the COVID pandemic were significantly associated with higher concurrent internalizing problems. Greater use of expressive suppression significantly moderated the positive association between COVID-related stress and internalizing problems (ß= .161, p=.019). COVID-related stress was more strongly associated with internalizing problems among youth who used expressive suppression more. Lower left amygdala activation to fearful compared to neutral faces at the baseline visit was associated with more internalizing problems during the COVID pandemic (ß= -.210, p=.011) and significantly moderated the association between COVID-related stress and internalizing problems (ß= -.194, p=.011), such that COVID-related stress was significantly associated with internalizing problems among youth with low to mean amygdala reactivity, but not among youth with high amygdala reactivity to fearful vs. neutral faces.

Conclusion: These results demonstrate that cumulative exposure to stressors associated with the COVID-19 pandemic contribute to internalizing problems in adolescents, and that individual differences in emotional reactivity and regulation can exacerbate or mitigate this association. In particular, engaging in less expressive suppression, and greater amygdala reactivity to fearful compared to neutral faces protect against the effects of COVID-related stress on internalizing problems.

Authors

• David G Weissman, Harvard University
  Presenting Author

• Alexandra M Rodman, Harvard University
  Non-Presenting Author

• Steven Kasparek, Harvard University
  Non-Presenting Author

• Maya L. Rosen, Harvard University
  Non-Presenting Author

• Margaret A. Sheridan, University of North Carolina at Chapel Hill
  Non-Presenting Author

• Katie McLaughlin, Harvard University
  Non-Presenting Author