The Impact of the COVID-19 Pandemic on Child and Adolescent Mental Health: Risk and Resilience Factors

• In Event: Family functioning and child mental health in the COVID-19 pandemic: Implications for risk, resilience, and recovery

Abstract

Background and Objectives: Since the diagnosis of the first case of novel corona virus (COVID-19), countries around the globe have been confronted with the largest public health crisis in the last century. In an effort to control the spread of the virus and the rapidly rising death toll, governments have implemented physical distancing and stay-at-home orders that have not only resulted in social isolation, but also soaring levels of unemployment and pervasive threats to financial well-being. Although information about the adverse effects of the pandemic on adult mental health is growing, we have limited knowledge of how children and adolescents are being impacted. There is widespread speculation that the adverse influences will be pervasive, but factors that augment or protect from the multidimensional influences of the pandemic on emotional development and mental health are poorly understood.

Methods: Mental health symptoms were assessed in two prospective longitudinal cohorts during a COVID-related state-wide stay at home order in Southern California. In Cohort 1, depressive symptoms were assessed in 169 preschool children (mean age 4.1 years) with the Preschool Feelings Checklist. Mothers (46% Latinx) also reported on externalizing behaviors with the Strengths & Difficulties Questionnaire. To assess the role of environmental factors in child mental health we examined household income, food insecurity, parental essential worker status and loss of parental job, as well as family routines. In Cohort 2 the impact of the pandemic on depressive symptoms was determined by comparing symptoms from a pre-covid assessment to symptoms during the pandemic with the Children’s Depression Inventory in a sample of 208 adolescents (mean age 16.8 years). We also investigated whether health behaviors (sleep and physical activity), media use, and social relationships predicted COVID-related depressive symptoms.

Results: In both cohorts, mental health symptoms were elevated compared to pre-pandemic levels and in the adolescent sample, these elevations were more pronounced among girls (Figure 1). In Cohort 1, in which 61 percent of families’ incomes were below the living wage and 50% had at least one parent who was an essential worker, practice of family routines predicted better child mental health (Figure 2), and this protective effect persisted after covarying income, dual-parent status and food insecurity as well as maternal depression and stress. Among the adolescents in Cohort 2, for both boys and girls, more sleep disturbance, poorer quality peer relationships and loneliness were associated with a larger increase in depressive symptoms relative to pre-COVID levels.
Discussion: The COVID-19 pandemic is exacting a significant toll on the mental health of children and adolescents in the US. Specifically, this research suggests an increase in both internalizing and externalizing symptoms and among older youth, girls appear more vulnerable. Although mental health does appear to be suffering due to the pandemic and the long-term sequelae likely significant, there are resilience promoting factors identified here (e.g. family routines and social connections) that may have the potential to mitigate these adverse influences. Implications for future research and clinical practice will be discussed.

Authors

• Laura Glynn, Chapman University
  Presenting Author

• Sabrina R. Liu, University of California Irvine Conte Center
  Non-Presenting Author

• Joan L Luby, Washington University in St. Louis
  Non-Presenting Author

• Curt Sandman, University of California, Irvine
  Non-Presenting Author

• Tallie Z Baram, UC Irvine
  Non-Presenting Author

• Elysia Davis, University of Denver
  Non-Presenting Author