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Which anxious adolescents are most impacted by the COVID-19 pandemic?

Fri, April 9, 4:30 to 5:30pm EDT (4:30 to 5:30pm EDT), Virtual

Abstract

The COVID-19 pandemic has created significant disruptions in individuals’ lives, resulting in increased stress, worries, and anxiety among many, especially young adults (Czeisler et al., 2020). Some adolescents, however, may be more vulnerable to mental health problems during this period. Thus, identifying individuals who are at greatest risk for elevated anxiety and understanding psychological processes that explain the changes in anxiety during the pandemic will inform intervention efforts. Although pre-COVID anxiety problems are likely to predict worries and anxiety during the pandemic, no study has examined if different subtypes of anxiety predict distinct trajectories of worry, stress, and anxiety during the COVID-19 pandemic. For instance, adolescents high in social anxiety may be less worried and anxious about some of the initial disruptions from COVID-19 (e.g., reductions in in-person social interactions), whereas adolescents high in generalized anxiety may be more worried and anxious. Here, we examine if specific forms of anxiety (social anxiety vs. generalized anxiety) predict distinct trajectories of anxiety and COVID-related worries during three initial months of the pandemic. Moreover, we examine the trajectories in perceived stress as a mechanism that explains the relation between pre-COVID anxiety and worries and anxiety during the pandemic.
Participants were part of a larger longitudinal study (N=291). In adolescence (Meanage=15yrs; n= 194), participants and their parents completed the Screen for Child Anxiety Related Disorders and a structured diagnostic interview. To create robust measures of generalized and social anxiety, we created latent factors that included clinical diagnosis, child, and parent reports of anxiety. In young adulthood (Meanage=18yrs; Rangeage=16-19yrs) during three consecutive months of the pandemic, participants reported on their anxiety, perceived stress, and COVID-related worries (e.g., having to stay home, getting sick, or not having enough resources). These assessments occurred approximately one month after the implementation of and during the stay-at-home orders (T1; n=158), after gradual reopening began (T2; n=155), and after reopening occurred (T3; n=143). Growth curve analyses were used to characterize linear trajectories of anxiety, COVID-related worries, and perceived stress.
On average, anxiety and COVID-related worries decreased as the stay at home orders were lifted and reopening gradually occurred and/or families adapted to the restrictions, indicating that participants experienced greater anxiety and worries initially. In a model including both anxiety subtypes (Figure 1), generalized anxiety predicted greater initial levels of anxiety and COVID-related worries, but greater decreases in anxiety across time, whereas social anxiety predicted lower initial levels of anxiety and COVID-related worries, but relative increases in anxiety across time. Furthermore, mediation analyses revealed that the relations between 15-year anxiety subtypes (social and generalized) and COVID-related anxiety/worries during the pandemic were mediated by the intercept or slope of participants’ perceived stress, respectively (Figure 2).
Together these results suggest that not all children high in anxiety experienced elevated anxiety during pandemic, such that adolescents high in social anxiety appeared to experience less anxiety, especially as compared to individuals high in generalized anxiety. Results highlight the importance of considering pre-COVID predictors of response to the pandemic and its associated restrictions (e.g., stay-at-home orders).

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