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Risk and Protective Factors for Prospective Changes in Adolescent Mental Health during the COVID-19 Pandemic

Risk and Protective Factors for Prospective Changes in Adolescent Mental Health during the... The restrictions put in place to contain the COVID-19 virus have led to widespread social isolation, impacting mental health worldwide. These restrictions may be particularly difficult for adolescents, who rely heavily on their peer connections for emotional support. However, there has been no longitudinal research examining the psychological impact of the COVID-19 pandemic among adolescents. This study addresses this gap by investigating the impact of the COVID-19 pandemic on adolescents’ mental health, and moderators of change, as well as assessing the factors perceived as causing the most distress. Two hundred and forty eight adolescents (M = 14.4; 51% girls; 81.8% Caucasian) were surveyed over two time points; in age the 12 months leading up to the COVID-19 outbreak (T1), and again two months following the implementation of government restrictions and online learning (T2). Online surveys assessed depressive symptoms, anxiety, and life satisfaction at T1 and T2, and participants’ schooling, peer and family relationships, social connection, media exposure, COVID-19 related stress, and adherence to government stay-at-home directives at T2 only. In line with predictions, adolescents experienced significant increases in depressive symptoms and anxiety, and a significant decrease in life satisfaction from T1 to T2, which was particularly pronounced among girls. Moderation analyses revealed that COVID-19 related worries, online learning difficulties, and increased conflict with parents predicted increases in mental health problems from T1 to T2, whereas adherence to stay-at-home orders and feeling socially connected during the COVID-19 lockdown protected against poor mental health. This study provides initial longitudinal evidence for the decline of adolescent’s mental health during the COVID-19 pandemic. The results suggest that adolescents are more concerned about the government restrictions designed to contain the spread of the virus, than the virus itself, and that those concerns are associated with increased anxiety and depressive symptoms, and decreased life satisfaction. ● ● ● ● ● Keywords Adolescence COVID-19 Depressive symptoms Anxiety Life satisfaction Longitudinal Introduction these restrictions have been challenging for people of all ages, they may be particularly difficult for adolescents, who The COVID-19 pandemic has swept through the globe at this developmental stage rely heavily on their peer con- quickly and indiscriminately. Government restrictions put nections for emotional support and social development in place to slow the spread of the virus have led to wide- (Ellis and Zarbatany 2017). As orders to stay at home and spread social isolation, which can have profound con- socially distance from others impedes most peer interaction, sequences for mental health (Brooks et al. 2020). While it is important to examine the impact that this is having on adolescents’ mental health, especially given the strong associations between interpersonal stress and the onset of emotional difficulties among adolescents (Rapee et al. * Natasha R. Magson 2019). However, to date there is no longitudinal research Natasha.Magson@mq.edu.au examining the psychological impact of the COVID-19 pandemic among adolescents, and what is known is limited Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia by retrospective reports of perceived mental health changes (e.g., Hawke et al. 2020). The current study addressed this School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia gap by examining changes in adolescent mental health 1234567890();,: 1234567890();,: Journal of Youth and Adolescence within a longitudinal framework that included baseline online, spending most of their time indoors and are physi- measures of adolescents’ mental health before the COVID- cally separated from their peers, means they may be at an 19 pandemic, and a second measure two months following increased risk of developing psychological problems during the implementation of government restrictions and online the COVID-19 global pandemic. learning. Previous COVID-19 Studies Increased Vulnerability during Adolescence Whilst it may take years, and many studies, to fully To appreciate the importance of examining the effects of the understand the sequelae of the COVID-19 pandemic, prior COVID-19 pandemic on adolescent mental health, one must research shows a consistent link between the pandemic and first understand the pertinent developmental changes that mental health. Importantly, existing research highlights a occur during adolescence that may make this a particularly number of COVID-19 related factors (e.g., government distressing time. Adolescence has often been labeled by restrictions, media exposure, etc.) that may influence these developmental theorists as a period of storm and stress associations. As the current study explores these factors in (Casey et al. 2010). This is due in part, to the physical and conjunction with prospective changes in mental health, the chemical changes occurring in the brain from early ado- existing research is reviewed here briefly to demonstrate the lescence, which result in a ‘neural mismatch’ whereby association between COVID-19 and mental health, and to emotionality is heightened in response to real and/or per- highlight any relevant influencing factors. ceived stressors (Bailen et al. 2019), yet the self-regulatory Previous studies with adults consistently point to the system required to manage these emotions remains largely detrimental impact of COVID-19 on the mental health of underdeveloped until early adulthood (Somerville et al. individuals. For example, research conducted among 1210 2010). Another defining characteristic of adolescence is the respondents during the early stages of the crisis in China marked increase in social sensitivity and the importance of found that more than half (53.8%) rated the negative impact peers (Somerville 2013). As adolescents strive for inde- of the COVID-19 pandemic on their psychological health as pendence from their parents, the time spent with peers moderate to severe (Wang et al. 2020). A second study in increases dramatically, and for the first time, friends rather China reported COVID-19 related increases in generalized than parents become the primary source of interaction and anxiety, which were found to be more pronounced in influence (Meuwese et al. 2017). However, the increased younger people (<35 years) compared to older age groups social sensitivity that emerges during adolescence also (Huang and Zhao 2020). A meta-analysis of 13 studies of means that peer relationships can be a major source of mental health among healthcare workers found that almost a conflict, rejection, and interpersonal stress (Somerville quarter exhibited elevated COVID-19 related symptoms of 2013). During adolescence, acceptance and rejection by anxiety (23.2%) and depression (22.8%), and more than a peers is used to guide behaviors, shape self-concept and third (38.9%) experienced problems with insomnia (Pappa gauge self-worth (Connell and Wellborn 1991). Thus, et al. 2020). negative peer interactions during this important develop- To date, few studies have evaluated the impact of the mental window can lead to poor self-concept, a low sense of pandemic on mental health in adolescents. One study sur- worth, and subsequent increases in symptoms of anxiety veyed 1738 Chinese participants at two time points fol- and depression, whereas positive peer relationships can lowing the commencement of the pandemic and found no provide social and emotional support, which are known to significant changes across time in depression, anxiety and protect against the risk of both depression and anxiety (La stress over the study period (Wang et al. 2020). However, Greca and Harrison 2005). there was some indication that younger people (aged 12–21 The increases in interpersonal stress, coupled with years) perceived the impact of COVID-19 to be greater than heightened emotional reactivity and low emotion-regula- older adults (aged 50–59 years). Beliefs about the ease of tion, can place adolescents at a greater risk of developing virus transmission and increased media exposure to health many common forms of psychopathology including gen- information about COVID-19 were significantly associated eralized anxiety, eating disorders, depression, and social with depression and/or anxiety at both time points. In anxiety (Rapee et al. 2019). In fact, this particular subset of contrast, taking precautionary measures to avoid transmis- internalizing disorders has previously been referred to as sion (e.g., regular handwashing), complying with the stay- “disorders of adolescence” due to their typical median onset at-home orders, and low perceived likelihood of contracting age of 13 to 19 years (Rapee et al. 2019). Collectively, the and dying from COVID-19 were all found to be protective. developmental characteristics of adolescence, the typical In a study focused on youth, retrospective reports of age of onset for these social emotional disorders, and the mental health symptoms three months prior to the pandemic fact that adolescents have been conducting their schooling were compared to those three weeks into the pandemic Journal of Youth and Adolescence among 622 Canadian adolescents and young adults (Hawke Interestingly none of the studies reviewed above investigated et al. 2020). Participants perceived reductions in their whether mental health outcomes during the COVID-19 pan- mental health across the period, particularly in depression/ demic differed by sex, which is surprising considering the well- low mood and anxiety. Another study also found high established sex differences in the prevalence and severity of levels of depression and anxiety in Chinese adolescents depression and anxiety (Rose and Rudolph 2006). Hence, during the peak of the pandemic, although lower levels research examining sex differences in adolescents’ responses to were reported among males and youth that regularly COVID-19 and its associated restrictions is needed to address engaged in exercise (Chen et al. 2020). Finally, a survey of this gap. Finally, as depression and anxiety are known to 1054 Canadian adolescents (M = 16.68) found that ado- increase, and life satisfaction to decrease, from early adolescence age lescents were most concerned about the impact on their onward (Goldbeck et al. 2007; Rapee et al. 2019), it is important schooling, followed by general concerns about the COVID- to ensure that any potential prospective changes in mental health 19 crisis, and not feeling connected to friends (Ellis et al. symptoms during COVID-19 are not simply due to age effects. 2020). Further, COVID-19 related concerns, spending less However to date, developmental differences in COVID-19 time on schoolwork and more time with friends was posi- responses have not been examined in adolescent samples. tively associated with depression, whereas spending more time with family was negatively associated. COVID-19 related concerns were also positively associated with lone- The Current Study liness, while spending more time with family and friends, and engaging in more physical activity, was negatively Taken together, the above research provides consistent associated. Social media use moderated the association evidence that the COVID-19 crisis may be having a sig- between COVID-19 concerns and depression, with those nificant impact on the psychological health of adolescents reporting high levels of social media use also reporting the across the globe. However, all of these studies have relied most depression. on respondents indicating the perceived impact of COVID- 19 on their current mental health. Only longitudinal studies Potential Risk and Protective Moderating Factors that include a baseline measure before COVID-19 can truly detect changes in mental health related to the pandemic, The cross-sectional research cited above points to a number of although there has been no such research to date. To address factors that may be important for examining the association this gap, the primary purpose of the current research was to between adolescent mental health and COVID-19 long- determine the effect of the pandemic and the government- itudinally. Namely age, gender, media exposure, family imposed restrictions associated with the response to conflict, changes to schooling, adherence to restrictions, and COVID-19 on the emotional health of adolescents. The first levels of social connection have all been implicated as aim was to identify which factors were viewed by adoles- potential moderators within the existing research. As previous cents as producing the greatest COVID-19 related distress. research has demonstrated that adolescents were particularly It was hypothesized that not being able to see and spend concerned about feeling socially disconnected from their time with friends, and concerns about moving to online friends, and that COVID-19 related worries along with less learning, would cause adolescents the most distress. The time on schooling were significantly associated with depres- second aim was to prospectively investigate the impact of sion cross-sectionally (Ellis et al. 2020), it is possible that the COVID-19 pandemic on changes in adolescent anxiety, social connectedness, COVID-19 related concerns, and dis- depressive symptoms, and life satisfaction. It was antici- ruptions to schooling may predict change from pre-pandemic pated that from T1 (pre-pandemic) to T2 (during the pan- to intra-pandemic levels of depression, anxiety and life demic) adolescents would report an increase in symptoms of satisfaction. Further, as a prior two-wave study found that anxiety and depression, and a decrease in overall life increased exposure to media reports about COVID-19 was satisfaction. The third aim was to ascertain which factors significantly associated with increases in anxiety and during the pandemic served to decrease or increase the risk depression, whereas complying with the stay at home rules of experiencing adjustment difficulties two months after the was protective (Wang et al. 2020), it is important to examine pandemic began and whether there were any age or sex these associations longitudinally. Considering the substantial differences evident. It was predicted that disruptions to amount of time adolescents spend on social media, it may also schooling, COVID-19 related distress, family conflict, and be important to examine the effect of exposure to COVID-19 frequent media exposure during the pandemic, would serve related media reports via social media, particularly as prior to increase the risk of mental health problems, whereas has found that increased social media use during the pan- feeling socially connected and adhering to COVID-19 demic was associated with increased adolescent depression related restrictions during the lockdown would decrease the and anxiety (Ellis et al. 2020). risk of mental health problems two months into the Journal of Youth and Adolescence pandemic. As depression and anxiety are more prevalent in scores ranged from 0 to 26 with higher scores indicating more girls than in boys, it was expected that any changes depressive symptoms. The reliability of the measure was good in mental health symptoms from T1 to T2 would be stronger in the current sample (α= 0.91 at T1 and 0.93 at T2). in girls compared to boys, and if the predicted increases in mental health problems from T1 to T2 are simply due to Life satisfaction developmental maturation, it was expected older adoles- cents would report greater increases in symptoms of The Student’s Life Satisfaction Scale (SLSS; Huebner 1994) depression and anxiety, and greater decreases in life satis- is a 9-item self-report measure of global life satisfaction for faction, than younger adolescents. young people. Adolescent participants were required to indi- cate their level of agreement with a statement (e.g., “My life is going well”) on a 7-point Likert scale ranging from 1 Methods (strongly disagree) to 7 (strongly agree). After reverse coding the two negatively worded items, item scores were averaged Participants to provide a mean score ranging from 1 to 7, with higher scores indicating greater life satisfaction. The Cronbach’s Participants in the current study were part of the larger alphas in the current study were high (α= 0.91 at T1 and 0.92 longitudinal Risks to Adolescent Wellbeing Project (the at T2). RAW Project) who have been completing online ques- tionnaires annually for the past four years. Participants in COVID-19 related distress the study resided in an urban area of New South Wales (NSW) Australia, and the majority of participating families This 18-item measure assessing COVID-19 related distress in the RAW Project are Caucasian (81.8%), speak English was specifically developed for the current research (items as a first language (96.4%), and have previously reported a listed in Fig. 1). Adolescents were required to indicate how middle to high socioeconomic status (79.2%). Of the 467 distressed they were about each item listed on a 10-point adolescents invited to participate in the COVID-19 survey, scale ranging from 1 (not at all distressed) to 10 (extremely 248 (53%) returned completed responses and thus com- distressed). Item scores were averaged to provide a mean prised the current sample. At the time the COVID-19 survey score ranging from 1 to 10 with higher scores indicating was completed, the adolescents were aged 13 to 16 years greater COVID-19 related distress. The Cronbach’s alpha (M = 14.4, SD = 0.5), with almost equal numbers of boys for the new scale was 0.91. age (n = 122) and girls (n = 126) participating. Disruption to schooling Measures To understand the impact of COVID-19 on schooling four Generalized anxiety items were developed to assess: format of school atten- dance, difficulties during online learning, motivation to The Generalized Anxiety subscale (e.g., “I worry about complete school work, and impact on education. Specifi- things”)ofthe Spence Children’s Anxiety Scale (SCAS-C; cally, adolescents were asked if they were (a) attending Spence 1998) was used to measure self-reported symptoms of school in-person; (b) learning online only; or (c) partici- anxiety. Adolescents were required to indicate how often they pating in a mix of in-person and online schooling. For those experienced each symptom on a 4-point Likert scale ranging learning online, an additional yes or no question was asked: from 0 (never) to 3 (always). The total scores for the Gen- “Have you had any difficulties switching to online learn- eralized Anxiety subscale ranged from 0 to 18 with higher ing?”, and if yes, an open-ended question followed asking scores indicating greater anxiety. The Cronbach’s alphas in the for details of their difficulties. The self-perceived impact of current study were acceptable (α=0.86 at T1 and0.87atT2). online learning and COVID-19 on education was measured using two questions, “Do you think your education is suf- Depressive symptoms fering due to online schooling?” and “Do you think your education is suffering due to the disruptions from COVID- The Short Mood and Feelings Questionnaire—Child Version 19?”, rated on a 4-point scale from 1 (not at all) to 4 (a great (SMFQ-C; Angold et al. 1995) is a 13-item self-report measure deal). The two questions were highly correlated (r = 0.758, used to assess symptoms of depression in children and ado- p < 0.001) so a mean of the two scores was calculated with lescents. Participants were required to indicate how true each higher scores indicating a larger impact on schooling. A statement was for them over the past 2 weeks on a 3-point single-item question was used to measure the change in Likert scale ranging from 0 (not true) to 2 (always true). Total students’ motivation to complete school work (i.e., Journal of Youth and Adolescence COVID-19 Related Distress disagree) to 6 (strongly agree). Item scores were averaged to Not being able to see my friends provide a mean score ranging from 1 to 6, with higher Friend or family dying from COVID-19 scores indicating greater social connectedness. The Cron- Friend or family getting very ill from COVID-19 Friend or family catching COVID-19 bach’s alpha value in the current study was high (α = 0.91). No participation in extra curricular activties Not being able to attend social events Not being able to travel/holiday Adherence to COVID-19 Australian government stay-at- My education Not being able to go to school home directive The family money situation Not being able to see extended family Australia's economy At the time T2 data was collected, laws in Australia were in The world economy Having to return to school place to help minimize the spread of COVID-19. Residents of Losing my job the state New South Wales were asked to stay at home unless Getting very sick from COVID-19 Catching COVID-19 they were going to work or school, obtaining food or other Dying from COVID-19 essential goods and services, exercising, or seeking medical 0123456789 10 care. To assess adherence to this stay-at-home directive, Fig. 1 Factors contributing to COVID-19 related distress among adolescents were asked how often they had left their home for adolescents. Rated on a scale of 0 (not at all distressed) to 10 (extre- mely distressed) reasons other than those listed above, responding on a 5-point scale from 0 (I have only left my home for the reasons listed above) to 4 (more than 10 times). “Compared to how motivated you usually are to do school work, how motivated do you feel now to do your school Procedure work?”) rated on a 3-point scale (1 = much less motivated, 2 = about the same, 3 = much more motivated). The parents of all adolescents currently enrolled in the RAW Project were sent information about the COVID-19 study and a Media exposure link to the T2 online survey. Parents who consented to their child participating, then shared the link with their child who One question assessed their exposure to traditional news assented online prior to beginning the survey. Participants were media (i.e., “On average, how often to you read/watch asked to complete the survey within two weeks of receiving the media reports about COVID-19 each day?”) and a second initial email, after which the survey was closed. The World question assessed social media related exposure (i.e., “On Health Organization declared COVID-19 a pandemic on average, how often do you read posts about COVID-19 on March 11, 2020. The T1 data used for the current study was social media each day?”). Both items were rated on a 6- collected online throughout 2019 as part of the larger RAW point scale from 1 (not at all) to 6 (five times or more). Project (thus prior to the COVID-19 pandemic), and the T2 data was collected between May 5th and May 14th 2020, Interpersonal conflict approximately two months after the Australian government had imposed the stay-at-home orders and schools had moved to The current study developed four self-report item to assess online learning. change in interpersonal conflict between adolescents and their mothers, fathers, siblings, and friends due to the Data Analysis COVID-19 social distancing rules and stay at home restrictions (e.g., “Do you feel you are having more or fewer Distribution and descriptive statistics were obtained through disagreements/arguments with your father?”). Adolescents SPSS (v26; IBM Corp. 2019). To determine whether levels of responded on a 5-point Likert scale ranging from 1 (we depressive symptoms, anxiety, and life satisfaction significantly have argued much less) to 5 (we have argued much more), increased or decreased in the period before the pandemic began thus higher scores indicated greater interpersonal conflict. and two months into the pandemic, a paired samples t-test in SPSS was conducted. Potential moderators of the change in Social connectedness mental health scores before and during COVID-19 were examined in SPSS using Model 2 in the MEMORE macro The Social Connectedness Scale (SCS; Lee and Robbins (Montoya and Hayes 2017), which is specifically designed to 1995) is a measure of how emotionally distant or connected assess moderation in two instance repeated measures research a respondent feels with those close to them, and society designs (Montoya 2019). This procedure computes a pre-post more broadly. Adolescents were required to indicate their difference score and then determines whether the moderator of level of agreement with eight statements (e.g., “I feel distant interest predicts that difference (Judd et al. 2001;Kenny 2018). from people”) on a 6-point scale, ranging from 1 (strongly For all non-dichotomous moderators, significant interactions Journal of Youth and Adolescence Table 1 Means and standard Males Females Total sample deviations for key study variables for male, female, and Mean SD Mean SD Mean SD Skew Kurtosis total sample Generalized anxiety T1 3.63 3.13 5.55 4.05 4.60 3.74 1.13 1.12 Generalized anxiety T2 3.64 3.16 6.52 4.31 5.10 4.05 0.72 −0.01 Depressive symptoms T1 2.81 3.18 4.77 5.00 3.81 4.31 1.57 2.21 Depressive symptoms T2 4.02 4.76 8.16 6.46 6.12 6.04 1.09 0.41 Life satisfaction T1 5.65 0.87 5.50 1.09 5.57 0.99 −0.81 0.29 Life satisfaction T2 5.23 1.10 4.81 1.14 5.01 1.14 −0.52 −0.25 COVID-19 distress T2 3.22 1.48 3.70 1.47 3.46 1.49 0.50 −0.27 Impact on education T2 2.10 0.79 2.10 0.74 2.10 0.76 0.90 0.72 Motivation to study T2 1.66 0.68 1.57 0.67 1.62 0.68 0.64 −0.67 Traditional media exposure T2 2.10 1.16 1.85 0.90 1.97 1.04 1.72 3.76 Social media exposure T2 2.26 1.48 2.25 1.38 2.26 1.42 1.32 1.10 Conflict—mother T2 3.05 0.97 2.86 1.08 2.95 1.03 −0.14 −0.07 Conflict—father T2 3.13 0.95 2.95 1.09 3.04 1.03 −0.28 −0.03 Conflict—siblings T2 3.43 0.99 3.40 1.11 3.41 1.05 −0.48 −0.13 Conflict—friends T2 2.31 0.94 2.30 1.07 2.30 1.00 −0.01 −1.10 Social disconnection T2 2.56 1.08 3.26 1.38 2.92 1.29 0.57 −0.18 Stay at home adherence T2 1.52 0.76 1.44 0.64 1.48 0.70 1.40 1.54 were probed at 1 SD above and below the mean. Data coverage variables were significantly correlated within and between for T1 and T2 mental health variables was 99.6% to 100%, time points in the predicted direction. COVID-19 related respectively. All other variables contained less than 1% missing distress and feeling socially disconnected from others were data with the exception of the family conflict variables which most strongly related to all mental health symptoms, as well had a “not applicable option” for family members not living as being significantly associated with viewing posts about within the same household. This resulted in non-responses of COVID-19 on social media, less motivation to study, a 3.2% for mother, 9.7% for father, and 7.7% for siblings. Due to greater perceived negative impact on schooling, and greater the small percentage of missing data, all analyses were con- conflict with siblings. ducted using pairwise deletion. Adolescents Distress during COVID-19 Results Addressing the first aim concerning what is causing ado- lescents the most distress, Fig. 1 shows that adolescents Preliminary Results reported low to moderate levels of COVID-19 related stress across the 18 items assessed. As predicted, the most dis- Descriptive statistics (for total sample, and boys and girls tressing issue for adolescents during this time was not being separately) and correlations between key variables are dis- able to see their friends, closely followed by a friend or played in Tables 1 and 2. As shown in Table 1, most family member contracting and getting very sick and/or variables were normally distributed with no obvious dying from COVID-19. Also high on adolescents’ lists of skewedness (−0.81 to 1.72), although the kurtosis of values concerns was the inability to participate in their normal of depressive symptoms at T1 (2.21) and exposure to tra- extra-curricular activities (e.g., sports, dance, music lessons ditional media at T2 (3.76) fell slightly above the recom- etc.) or attend social events. In contrast, they reported very mended values of plus or minus two (Gravetter et al. 2020). little concern about contracting, getting ill or dying from As expected, on average girls reported more symptoms of COVID-19 themselves. depression and anxiety at both time points, whereas boys reported more familial conflict during the lockdown period. Overall Changes in Mental Health Boys and girls were more similar on average levels of life satisfaction, exposure to COVID-19 related media, and To address the second aim relating to changes in mental attitudes toward the impact of COVID-19 on their school- health prior to and during the pandemic, the results of the ing. The correlations in Table 2 show that all mental health paired samples t-tests showed significant increases in Journal of Youth and Adolescence Table 2 Bivariate correlations between key study variables 1234567 89 10 11 12 13 14 15 16 17 1. Generalized Anx T1 1 2. Generalized Anx T2 0.61*** 1 3. Depressive symptoms T1 0.54*** 0.35*** 1 4. Depressive symptoms T2 0.41*** 0.67*** 0.41*** 1 5. Life satisfaction T1 −0.43*** −0.30*** −0.56*** −0.49*** 1 6. Life satisfaction T2 −0.34*** −0.45*** −0.33*** −0.67*** 0.64*** 1 7. COVID-19 distress T2 0.35*** 0.43*** 0.26*** 0.36*** −0.23*** −0.32*** 1 8. Motivation to study −0.07 −0.04 −0.06 −0.16* 0.17** 0.19** −0.17** 1 9. Impact on education T2 0.21** 0.21** 0.23*** 0.28*** −0.19** −0.20** 0.32***−0.46*** 1 10. Trad media exposure T2 0.08 −0.04 0.09 −0.05 −0.01 0.01 0.17** 0.10 −0.01 1 11. Social media 0.17** 0.14* 0.22** 0.19** −0.18** −0.13* 0.16* 0.00 0.11 0.44***1 exposure T2 12. Conflict—mother T2 0.08 0.03 0.09 0.16* −0.20** −0.28*** 0.03 −0.10 0.10 0.06 0.08 1 13. Conflict—father T2 0.01 0.08 0.05 0.21** −0.08 −0.20** 0.06 −0.13* 0.14* 0.11 0.15* 0.59*** 1 14. Conflict—siblings T2 0.16* 0.13* 0.18** 0.12 −0.11 −0.15* 0.22** 0.03 −0.01 0.09 0.11 0.26*** 0.19**1 15. Conflict—friends T2 0.01 0.06 0.05 0.05 −0.07 −0.14* 0.01 −0.09 0.00 −0.04 0.03 0.19** 0.17* 0.06 1 16. Disconnectedness T2 0.33*** 0.47*** 0.35*** 0.62*** −0.39*** −0.49*** 0.34***−0.19** 0.19** 0.01 0.23*** 0.15* 0.17* 0.17* 0.06 1 17. Stay home −0.07 −0.04 0.00 0.01 0.01 −0.11 −0.03 −0.04 0.15* 0.04 0.04 −0.01 −0.02 0.06 0.07 −0.10 1 adherence T2 T1 time 1, T2 time 2, Anx anxiety, Trad traditional, Stay at home adherence adherence to government stay at home directives *p < 0.05; **p < 0.01; ***p < 0.001 Journal of Youth and Adolescence adolescents’ symptoms of depression, (t(1, 247) = 6.26, p < 0.001, d = 0.15), and anxiety, (t(1, 244) = 5.26, p < 0.001, d = 0.40), and a significant decrease in life satisfaction, (t(1, 244) = −5.26, p < 0.001, d = 0.61) from T1 (before the pandemic) to T2 (2 months into the pandemic). Potential Moderating Factors To address the third aim of the research, the results for each of the potential moderating factors examined are presented below. To aid interpretation, the statistical results of all moderating analyses are summarized in Table 3 and described in text below. Sex Sex of the youth significantly moderated the change scores in depressive symptoms, with results indicating that although there were significant increases in depressive symptoms from T1 to T2 for both boys and girls, this effect was more pronounced in girls. This result was replicated for changes in anxiety, with girls again showing the largest increases in symptoms from T1 to T2. Finally, sex sig- nificantly moderated the change in life satisfaction from T1 to T2 with girls showing the greatest decrease. Age Age did not moderate change in depressive symptoms, anxiety, or life satisfaction from T1 to T2. COVID-19 related distress Levels of distress associated with the COVID-19 pandemic significantly moderated change scores in depressive symp- toms, anxiety, and life satisfaction from T1 to T2. Specifi- cally, adolescents with high and moderate levels of COVID- 19 related distress experienced significantly greater increa- ses in anxiety and depressive symptoms, and significantly greater decreases in life satisfaction, over time than those with low levels of COVID-19 related distress. Disruption to schooling The most commonly reported problems when learning online were related to technology problems, not under- standing the learning materials, being unable to ask the teacher to explain the work, and problems with motivation. Results showed that switching to learning exclusively online had no significant effect on levels of depressive symptoms, anxiety, or life satisfaction. However, experi- encing the abovementioned difficulties with online learning did significantly moderate change in depressive symptoms, Table 3 Results of the moderation analysis: test of factors that moderate changes in mental health from T1 to T2 Moderator Depression Anxiety Life satisfaction 2 2 2 FR b t (df) p F R b t (df) p F R b t (df) p Sex 9.00 0.035 2.18 6.64 (246) 0.003 4.19 0.017 2.18 1.81 (246) 0.041 5.16 0.021 −0.26 −2.27 (245) 0.024 Age 0.89 0.000 −0.17 −0.30 (246) 0.766 1.72 0.007 −0.45 −1.31 (246) 0.191 0.80 0.003 0.08 0.89 (245) 0.372 COVID-19 distress 9.00 0.031 3.34 6.47 (246) <0.001 4.18 0.017 0.30 2.05 (246) 0.042 5.56 0.022 −0.09 2.36 (245) 0.019 Learning online 0.01 0.000 0.11 0.11 (246) 0.914 0.23 0.001 0.29 0.48 (246) 0.631 1.89 0.008 0.22 1.38 (245) 0.170 Difficulties online 4.53 0.018 3.48 5.26 (244) <0.001 2.47 0.010 0.75 1.57 (244) 0.118 0.16 0.001 −0.05 −0.41 (243) 0.685 Educational impact 3.85 0.016 0.96 1.96 (244) 0.051 0.06 0.000 0.07 0.25 (244) 0.908 0.49 0.001 −0.05 −0.70 (243) 0.485 Motivation to study 3.76 0.015 −1.06 −1.94 (246) 0.053 0.25 0.001 0.16 0.50 (246) 0.615 0.81 0.003 0.08 0.90 (245) 0.370 Traditional media 3.42 0.014 −0.65 −1.85 (246) 0.066 4.51 0.018 −0.05 −2.12 (246) 0.035 0.11 0.000 0.02 0.33 (245) 0.740 Social media 0.34 0.001 0.15 0.58 (246) 0.562 0.03 0.000 −0.03 −0.18 (246) 0.857 0.18 0.001 0.02 0.43 (245) 0.671 Conflict—father 7.46 0.033 1.01 2.73 (222) 0.007 1.24 0.006 0.26 1.11 (222) 0.267 5.38 0.024 −0.14 −2.32 (221) 0.021 Conflict—mother 2.49 0.010 0.58 1.59 (238) 0.116 0.58 0.002 −0.17 −0.76 (238) 0.447 4.07 0.017 −0.12 −2.02 (237) 0.045 Conflict—sibling 0.04 0.000 −0.07 −0.21 (227) 0.838 0.11 0.000 −0.07 0.75 (227) 0.747 0.88 0.004 −0.06 −0.94 (226) 0.348 Conflict—friend 0.08 0.000 0.11 0.29 (210) 0.774 0.88 0.004 0.23 0.94 (210) 0.349 1.69 0.008 −0.09 −1.30 (209) 0.195 Social disconnection 42.06 0.146 −0.95 5.41 (245) <0.001 10.27 0.040 −0.54 −3.20 (246) <0.001 9.31 0.037 0.14 3.05 (245) 0.003 Stay home adherence 0.01 0.000 0.04 0.08 (246) 0.935 0.25 0.001 0.16 0.50 (246) 0.620 5.08 0.020 −0.19 −2.25 (245) 0.025 Significant p values are bolded to aid interpretation Journal of Youth and Adolescence with those who experienced problems reporting sig- significantly more life satisfaction from T1 to T2 than those nificantly more depressive symptoms during COVID-19, feeling socially disconnected during the lockdown period. compared to those who experienced no problems with online learning. Online learning difficulties did not moder- Adherence to COVID-19 government restrictions ate changes in anxiety or life satisfaction from T1 to T2. Participants’ perceptions that their education was suffering Adherence to the government’s stay at home directive had during the COVID-19 lockdown had no significant effect on no significant effect on changes in depressive symptoms or change scores in depressive symptoms, anxiety or life anxiety, however, those reporting greater adherence to the satisfaction. Finally, differences in motivation to engage in stay at home rules reported lower declines in life satisfac- school work before and during the COVID-19 pandemic tion from T1 to T2 compared to those who continued to had no significant effect on changes in depressive symp- leave their homes more frequently. toms, anxiety or life satisfaction. Media exposure Discussion Frequency of exposure to traditional media reports (i.e., The COVID-19 pandemic has had a significant impact on television, newspaper) about COVID-19 had no significant the lives of millions around the world. Government mea- effect on change in depressive symptoms, but there was a sures put in place to contain the virus have physically and significant moderating effect on changes in anxiety. Results socially isolated adolescents from their friends, extended showed those reporting high levels of traditional media family, and other social support networks, leaving many exposure had significantly greater decreases in anxiety from feeling socially isolated, and consequently, at an increased T1 to T2 than those reporting low exposure. Frequency of risk of psychological disorder. However, to date, there has exposure to COVID-19 traditional media reports had no been no longitudinal research examining how the pandemic significant effect on changes in life satisfaction. The fre- has impacted adolescents’ mental health despite decades of quency of reading posts about COVID-19 on social media research demonstrating the potential lifelong risks asso- had no significant effect on changes in depressive symp- ciated with prolonged interpersonal stress and social isola- toms, anxiety or life satisfaction. tion during the adolescent years (e.g., Loades et al. 2020). Further, research has not yet examined which demographic Interpersonal conflict and COVID-19 related factors serve to increase or decrease adolescent mental health symptoms over time. The current Increased conflict with siblings, friends and mothers had no study addressed these research gaps by conducting a long- significant interaction effect on depressive symptoms, itudinal investigation into the effect the COVID-19 virus however, increased conflict with fathers during COVID-19 and its associated restrictions are having on adolescents’ significantly moderated change in depressive symptoms mental health, as well as identifying some of the critical from T1 to T2. Those experiencing an increase in conflict impacts and life changes associated with the pandemic. with their fathers reported more depressive symptoms at T2 Potential moderators of change in mental health symptoms than those that did not. Levels of interpersonal conflict with were also investigated including age, sex, disruptions to siblings, friends, mothers or fathers did not moderate schooling, COVID-19 related distress, family conflict, change scores in anxiety. Interpersonal conflict with both media exposure, social connection, and adherence to mothers and fathers significantly moderated changes in life COVID-19 related restrictions. satisfaction with those reporting greater conflict with their mother and father also reporting larger declines in life Negative Emotionality satisfaction than those with low parental conflict. Inter- personal conflict with siblings and friends had no effect on As predicted, the results showed that adolescents’ mental changes in life satisfaction. health had slightly deteriorated compared to pre-pandemic levels and a number of pandemic-related factors were Social connectedness related to those changes. When interpreting the results, it must be kept in mind that, although mental health measures Feeling socially connected during the COVID-19 lockdown were taken on two occasions, potential moderators were period significantly moderated changes in depressive only measured once and therefore, the results are unable to symptoms, anxiety and life satisfaction. Those perceiving indicate the direction of relationships. high levels of social connection during COVID-19 reported The pre-pandemic to intra-pandemic increase in depres- significantly fewer depressive symptoms and anxiety, and sive symptoms and anxiety, and decrease in life satisfaction Journal of Youth and Adolescence found in the current study is generally consistent with adolescents’ greatest concern during the COVID-19 lock- previous retrospective and cross-sectional studies in both down was not being able to see their friends. In fact, all adult and adolescent samples, which have reported per- items mentioning friends or social connection were rated ceived increases in depression, anxiety, and loneliness due higher than any of the other COVID-19 related worries. to the effects of COVID-19 (Chen et al. 2020; Wang et al. Signifying the possibility of developmental differences, 2020; Ellis et al. 2020). The current study strengthens and these findings contrast with research in adults, as adults builds upon this literature by demonstrating that living with expressed the greatest concern over family members con- the restrictions and concerns surrounding COVID-19 are tracting COVID-19 (Wang et al. 2020). The present results related to not only increases in emotional distress but also also showed that feeling socially disconnected during the with decreases in life satisfaction. More importantly, the pandemic was associated with higher levels of anxiety and prospective collection of these data allows stronger con- depressive symptoms and lower levels of life satisfaction. clusions to be drawn, that go beyond the perceived attri- The importance of feeling socially connected during the butions of participants. Interestingly, while significant pandemic has been demonstrated previously when it was decrements in adolescent mental health were demonstrated found that adolescents left alone at home all day reported prospectively, the size of these effects were quite modest, significantly higher levels of depression and anxiety than with changes ranging from 0.2 to 0.6 standard deviations. those who were accompanied by a parent or relative (Chen Clearly a large proportion of adolescents are coping well et al. 2020). As the current results cannot indicate the causal with the impact of the pandemic, at least in the early stages, direction, it is equally plausible that emotional distress leads and most are showing minimal negative impact. to social disconnection or that social disconnection leads to greater emotional distress. If the latter direction is demon- Gender and Age Differences strated in future research, it might suggest that organizing to have a parent or relative work from home during such The finding that girls are experiencing greater declines in stressful times, may help in mitigating the risks for anxiety mental health than boys during the COVID-19 crisis may and depression, as long as it does not result in greater not only reflect the well-established literature highlighting familial conflict. sex differences in internalizing problems (e.g., Rose and About a quarter of the adolescents surveyed reported that Rudolph 2006), but also that girls are more likely than boys conflict with their parents had increased during the lock- to rely on their social networks for support when dealing down period, which was associated with decreases in life with significant life stressors (Tamres et al. 2002). Thus, the satisfaction; and increased conflict with fathers was asso- move to online schooling and the restrictions placed on ciated with more depressive symptoms. This increase in social interaction may effectively impede adolescent girls parental conflict and decrease in mental health may reflect a from employing their most commonly used coping strategy. developmental discrepancy between adolescents’ inherent Although this suggestion would need to be formally tested, drive to connect with peers and seek greater autonomy from the current findings suggest that it may be particularly their parents (Somerville 2013), while at the same time important to encourage adolescent girls to connect with being ordered to stay at home and physically distance from their friendship groups via safe means, so they can continue their friends. This possibility is further supported by the to access their much-needed social support systems during finding that although half of the current sample reported an the COVID-19 crisis. Previous research has also shown that increase in conflict with their siblings, this was not asso- the prevalence of internalizing disorders increases from ciated with changes to their mental health during the lock- early to mid-adolescence (Goldbeck et al. 2007). However, down period. the current study did not find any moderating effect of age, suggesting that the observed increase in mental health Educational Concerns symptoms from T1 to T2 cannot be simply explained by these developmental differences, and may instead be due to The current results also indicated that adolescents were not the changing social, educational and economic climate as a overly concerned with the impact that COVID-19 was result of COVID-19. having on their education, nor was this related to any of the mental health outcomes examined. These findings are Social Connection and Familial Conflict inconsistent with previous work which found that one of adolescents’ most pressing COVID-19 related worries was Consistent with developmental theory stressing the impor- the detriment to their education (Ellis et al. 2020). This may tance of peer relationships and social interaction during be because the earlier research was carried out immediately adolescence (Meuwese et al. 2017), and previous findings following the switch to online learning whereas the current (Ellis et al. 2020), the current results revealed that study assessed concerns two months after the initial change, Journal of Youth and Adolescence providing students with the opportunity to adapt and settle alleviating uncertainty and concern about its impact. As the into their new learning environment. It may also be due to rate of transmission and positive cases were fairly low in the younger age of the current cohort relative to those in the Australia at the time of the survey, it would be interesting to earlier study, most of whom were in senior school—a time investigate the role of media exposure further by looking at when grades are important in determining acceptance into relationships with adolescent mental health in countries university and future occupational opportunities. Although, experiencing high rates of transmission and infection, and there was no association between mental health problems comparing the findings to those in the current study. and moving to online learning, the current study did find The media also communicates important health infor- that experiencing difficulties during online learning was mation, which may serve to give adolescents a sense of associated with an increase in depressive symptoms from control over what they need to do to avoid contracting the T1 to T2. The most commonly reported difficulties were virus, which may also reduce anxiety. Indeed, the current related to technology problems, not understanding the study found those who adhered more closely to government learning materials, being unable to ask the teacher ques- stay-at-home orders reported fewer mental health problems tions, and problems with motivation. All of these difficulties than those who frequently defied them. This is consistent could be relatively easily addressed should online learning with previous research which also found an association be continued long-term (e.g., providing a platform to ask between that taking precautionary measures (e.g., staying at teachers questions during the lesson rather than having to home, wearing a mask) to avoid contracting the virus and wait for an email response), and implementing these chan- lower levels of depression and anxiety (Wang et al. 2020). ges may mitigate the increased risk for depressive symp- As with all of the current results, the casual relationship toms if the causal direction of this association does go from may flow in either direction. On the one hand, these results learning difficulties to depression. may suggest that disseminating health information and encouraging adherence to government advice through the Media Exposure media may be an effective way of not only reducing the spread of COVID-19, but also in stabilizing levels of gen- Contrary to expectations, high exposure to traditional media eralized anxiety. On the other hand, the results may suggest reports about COVID-19 had a negative relationship with that young people who become more distressed by the changes in generalized anxiety levels, and no significant effects of COVID-19, may be at greater risk to break effect on changes in life satisfaction or depressive symp- socially-described precautions, and in turn, may jeopardize toms. Although there is no clear explanation for the con- their and others’ health. tradictory findings between the current and previous studies, some research suggests that associations between media Limitations and Future Directions exposure and internalizing distress are nuanced (Wang et al. 2020). A recent study in China found that although greater The current study has a number of strengths and limitations. depression and anxiety were associated with exposure to First, this study overcomes many of the limitations of pre- radio reports around COVID-19, the same effect was not vious research by employing a longitudinal design to allow found in relation to television and internet reports (Wang determination of change in mental health symptoms before et al. 2020). These findings are broadly consistent with and during the COVID-19 pandemic. However, despite the those found in the current study in that social media posts longitudinal data collection on mental health, it is not about COVID-19 were not associated with changes in possible to attribute any changes specifically to the effects mental health, whereas reading and watching media reports of COVID-19 as there was no comparison condition. were positively related to good mental health. Similarly, the time two mental health measures and While the direction of these associations cannot be COVID-19 related factors were assessed concurrently, so determined from the current results, they are consistent with while it was possible to ascertain that these factors were a suggestion that changes in anxiety led to differences in associated with increases or decreases in mental health, the media exposure. Specifically, due to the established links direction of those associations cannot be determined. between avoidant coping and anxiety (Richardson et al. Employing alternative methods such as ecological in press), it might be logical to interpret that young people momentary assessment or daily diaries may help to clarify who became more anxious during the COVID-19 period the temporal ordering between social, educational, and avoided exposure to mainstream media reports. On the other emotional experiences during the pandemic and adoles- hand, it is possible that watching and reading news reports cents’ mental health. Further, the data were all self-report about the virus plays an important role in building young and thus are subject to bias that may not align with more people’s confidence in the public health measures imple- objective assessments of mental health and behaviors. To mented to contain the spread of infection, effectively address this limitation, future research could incorporate Journal of Youth and Adolescence parent and teacher reports of adolescents’ adjustment during engage students during their online classes, and ensuring the COVID-19 pandemic. Finally, the sample used in the students have access to adequate technology may help current study was relatively small and demographically overcome some of these most common problems, and as a restricted. The sample was predominately of Caucasian consequence, reduce depressive symptoms associated with ethnicity and included participants within a restricted age online learning difficulties. range, and perhaps most importantly for a study of the impacts of COVID-19, data were collected within a single country (Australia) and it cannot be ensured that the results Conclusion are generalizable to adolescents from other countries that differed widely in rates of infection and severity of Due to the recency of the COVID-19 pandemic, there is government-imposed restrictions. very limited research on its psychological consequences, and no research examining the prospective impact of the Implications virus, and its related restrictions, on the emotional health of adolescents. Thus, this research contributes to the existing While keeping these limitations in mind, several speculative literature by demonstrating longitudinal declines in the implications can be suggested. First, although it is difficult mental health of adolescents, especially among girls, when to disentangle whether the changes in mental health found comparing pre-pandemic to intra-pandemic levels. The in the current study are the direct result of anxieties around current study contributes further by identifying which contracting the virus, or the restrictions put in place to COVID-19 related factors served to increase or decrease the contain it, the current results suggest the latter. Adolescents’ risk of adolescents developing mental health problems concerns around catching and becoming ill from the virus during the pandemic. Specifically, COVID-19 related wor- were relatively low whereas difficulties adjusting to the new ries, difficulties with online learning, and increased family restrictions placed on social activities and schooling as a conflict were associated with greater psychological mal- result of COVID-19 moderated changes in mental health. adjustment. In contrast, greater exposure to traditional Therefore, finding new ways to help adolescents adapt and media, adherence to government restrictions, and feeling cope with the changes to their social and physical envir- socially connected with others was associated with less onment is essential. Ensuring that adolescents, particularly distress. Consistent with theory highlighting the importance girls, maintain their peer relationships seems especially of peers during the adolescent period, the results showed important, and both parents and teachers should encourage that adolescents’ greatest concerns during the COVID-19 social engagement whenever and however possible, within crisis were around the disruption to their social interactions the confines of government and health guidelines. and activities, whereas concerns around contracting or In addition, since early changes in symptoms of psy- getting ill from the virus were very low. This suggests that it chopathology may serve as an antecedent for the onset of is the restrictions put in place to reduce the spread of the chronic mental illness, it is important for parents and school virus, rather than the virus itself, that is causing adolescents staff to monitor young people for elevated emotional dis- the most distress. As social isolation, interpersonal stress, tress and to guide them into early intervention and treatment and mental health problems during adolescence can be a programs where necessary. It is also recommended that precursor for mental health problems across the lifespan, parents and teachers create positive and supportive home parents and teachers are encouraged to assist adolescents in and learning environments, both of which have previously finding ways to maintain their social networks, monitor been shown to lower levels of internalizing distress in young people for signs of emotional distress, provide adolescents even when isolated physically from peers (Ellis positive and supportive home and learning environments, et al. 2020; Manczak et al. 2019). and engage with mental health professionals early. Finally, Finally, and encouragingly, learning exclusively online as research on the mental health impact of COVID-19 is still did not appear to impact adolescents’ mental health, in its infancy, more longitudinal research is needed to gain a whereas difficulties encountered during online learning did. greater understanding of the long term implications of this This demonstrates that adolescents can be resilient and pandemic on the emotional wellbeing of young people. adaptive when needed, as long as they are equipped with the necessary tools and support they require. Most of the online Acknowledgements The authors extend their gratitude to the many research assistants on the RAW project for carrying out the extensive learning difficulties reported were modifiable and related to data collection required for this project and the interns who assisted in problems concerning technology, the understanding of the coding of the data sets. learning materials, and being unable to ask the teacher for clarification. Implementing regular question and answer Author’s Contributions N.R.M. conceived of the study, prepared the sessions throughout each lesson, finding creative ways to study materials, analyzed the results, and drafted the manuscript; Journal of Youth and Adolescence J.Y.A.F. helped with the development of the study materials, the Ellis, W. E., Dumas, T. M., & Forbes, L. M. (2020). Physically iso- coordination of the data collection, and assisted with the data analysis; lated but socially connected: psychological adjustment and stress R.M.R. participated in the study design and helped draft the manu- among adolescents during the initial COVID-19 crisis. Canadian script; C.E.R. helped design the study and draft the manuscript; E.L.O. Journal of Behavioural Science/Revue Canadienne des Sciences helped design the study materials, prepare the data, and draft the du Comportement, 52(3), 177. manuscript; and J.F. helped design the study materials and draft the Ellis, W. E., & Zarbatany, L. (2017). Understanding processes of peer manuscript. All authors have read and approved the submitted clique influence in late childhood and early adolescence. Child manuscript. Development Perspectives, 11(4), 227–232. Goldbeck, L., Schmitz, T. G., Besier, T., Herschbach, P., & Henrich, G. (2007). Life satisfaction decreases during adolescence. Quality Funding The Australian Research Council funded this research (grant of Life Research, 16(6), 969–979. number FL150100096). Gravetter, F., Wallnau, L., Forzano, L., & Witnauer, J. (2020). Essentials of statistics for the behavioral sciences (10 ed.). New Data Sharing and Declaration The datasets generated and/or analyzed York: Cengage Learning. during the current study are not publicly available but are available Hawke, L. D., Barbic, S. P., Voineskos, A., Szatmari, P., Cleverley, from the corresponding author upon reasonable request. K., Hayes, E., … Cheung, A. (2020). Impacts of COVID-19 on Youth Mental Health, Substance Use, and Well-being: A Rapid Compliance with Ethical Standards Survey of Clinical and Community Samples. The Canadian Journal of Psychiatry, 65(10), 701–709. https://doi.org/10.1177/ Conflict of Interest The authors declare that they have no conflict of Huang, Y., & Zhao, N. (2020). Generalized anxiety disorder, depressive interest. symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Research, 288 Ethical Approval All procedures performed in studies involving (112954). https://doi.org/10.1016/j.psychres.2020.112954. human participants were in accordance with the ethical standards of Huebner, E. S. (1994). Preliminary development and validation of a the institutional and/or national research committee and with the 1964 multidimensional life satisfaction scale for children. Psychologi- Helsinki declaration and its later amendments or comparable ethical cal Assessment, 6(2), 149. standards. IBM Corp. (2019). IBM SPSS statistics software: SPSS statistics V26. Armonk, NY: IBM Corp. Informed Consent Informed consent was obtained from all parents of Judd, C. M., Kenny, D. A., & McClelland, G. H. (2001). Estimating youth participating in the study, and informed assent was obtained and testing mediation and moderation in within-subject designs. from all adolescents. Psychological Methods, 6(2), 115. Kenny, D. A. (2018). Moderator variables: introduction. http://davida Publisher’s note Springer Nature remains neutral with regard to kenny.net/cm/moderation.htm. jurisdictional claims in published maps and institutional affiliations. La Greca, A. M., & Harrison, H. M. (2005). Adolescent peer relations, friendships, and romantic relationships: do they predict social anxiety and depression? Journal of Clinical Child & Adolescent Psychology, 34(1), 49–61. https://doi.org/10.1207/s15374424jccp3401_5. References Lee, R. M., & Robbins, S. B. (1995). Measuring belongingness: the social connectedness and the social assurance scales. Journal of Angold, A., Costello, E. J., & Messer, S. C. (1995). Development of a Counseling Psychology, 42(2), 232. short questionnaire for use in epidemiological studies of depres- Loades, M. E., Chatburn, E., Higson-Sweeney, N., Reynolds, S., sion in children and adolescents. International Journal of Meth- Shafran, R., Brigden, A., & Crawley, E. (2020). Rapid systematic ods in Psychiatric Research, 5, 237–249. review: the impact of social isolation and loneliness on the mental Bailen, N. H., Green, L. M., & Thompson, R. J. (2019). Understanding health of children and adolescents in the context of COVID-19. emotion in adolescents: a review of emotional frequency, inten- Journal of the American Academy of Child and Adolescent sity, instability, and clarity. Emotion Review, 11(1), 63–73. Psychiatry, S0890-8567(0820), 30337–30333. https://doi.org/10. Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, 1016/j.jaac.2020.05.009. S., Greenberg, N., & Rubin, G. J. (2020). The psychological Manczak, E. M., Ordaz, S. J., Singh, M. K., Goyer, M. S., & Gotlib, I. impact of quarantine and how to reduce it: rapid review of the H. (2019). Time spent with parents predicts change in depressive evidence. The Lancet, 395(10227), 912–920. https://doi.org/10. symptoms in adolescents with major depressive disorder. Journal 1016/S0140-6736(20)30460-8. of Abnormal Child Psychology, 47(8), 1401–1408. https://doi. Casey, B. J., Jones, R. M., Levita, L., Libby, V., Pattwell, S. S., org/10.1007/s10802-019-00526-5. Ruberry, E. J., & Somerville, L. H. (2010). The storm and stress Meuwese, R., Cillessen, A. H. N., & Güroğlu, B. (2017). Friends in of adolescence: insights from human imaging and mouse genet- high places: a dyadic perspective on peer status as predictor of ics. Developmental psychobiology, 52(3), 225–235. https://doi. friendship quality and the mediating role of empathy and proso- org/10.1002/dev.20447. cial behavior. Social Development, 26(3), 503–519. https://doi. Chen, F., Zheng, D., Liu, J., Gong, Y., Guan, Z., & Lou, D. (2020). org/10.1111/sode.12213. Depression and anxiety among adolescents during COVID-19: a Montoya, A. K. (2019). Moderation analysis in two-instance repeated cross-sectional study. Brain, Behavior, and Immunity, 88,36–38. measures designs: probing methods and multiple moderator https://doi.org/10.1016/j.bbi.2020.05.061. models. Behavior Research Methods, 51(1), 61–82. https://doi. Connell, J. P., & Wellborn, J. G. (1991). Competence, autonomy, and org/10.3758/s13428-018-1088-6. relatedness: a motivational analysis of self-system Montoya, A. K., & Hayes, A. F. (2017). Two-condition within-parti- processes. In Self processes and development. (pp. 43–77). cipant statistical mediation analysis: a path-analytic framework. Hillsdale, NJ, US: Lawrence Erlbaum Associates, Inc. Psychological Methods, 22(1), 6. Journal of Youth and Adolescence interests include peer influences on adolescent mental health and the Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., impact of peer victimization and weight stigma on adolescent & Katsaounou, P. (2020). Prevalence of depression, anxiety, and wellbeing. insomnia among healthcare workers during the COVID-19 pan- demic: a systematic review and meta-analysis. Brain, Behavior, and Immunity, 88, 901–907. https://doi.org/10.1016/j.bbi.2020. 05.026. Justin Y. A. Freeman is a project officer at in the Department of Rapee, R. M., Oar, E. L., Johnco, C. J., Forbes, M. K., Fardouly, J., Psychology at Macquarie University. He has extensive experience Magson, N. R., & Richardson, C. E. (2019). Adolescent devel- running large scale longitudinal projects with adolescents and their opment and risk for the onset of social-emotional disorders: a families, and has a strong interest in adolescent mental health and review and conceptual model. Behaviour Research and Therapy, associated influencing factors. 123, 103501. https://doi.org/10.1016/j.brat.2019.103501. Richardson, C. E., Magson, N. R., Fardouly, J., Oar, E. L., Forbes, M. K., Johnco, C. J., & Rapee, R. M. (2020). Longitudinal asso- Ronald M. Rapee is a Distinguished Professor at the Centre for ciations between coping strategies and psychopathology in pre- Emotional Health, Macquarie University, Australia. His research adolescence. Journal of Youth and Adolescence. (in press). specializes in mental health, especially in anxiety and related disorders Rose, A. J., & Rudolph, K. D. (2006). A review of sex differences in across the lifespan and he is best known for his theoretical models of peer relationship processes: potential trade-offs for the emotional the development of anxiety disorders as well as for his creation of and behavioral development of girls and boys. Psychological empirically validated intervention programs. Bulletin, 132(1), 98. Somerville, L. H. (2013). The teenage brain: sensitivity to social evaluation. Current Directions in Psychological Science, 22(2), 121–127. Somerville, L. H., Jones, R. M., & Casey, B. (2010). A time of change: Cele E. Richardson is a Lecturer in the School of Psychological behavioral and neural correlates of adolescent sensitivity to Science and Centre for Sleep Science at The University of Western appetitive and aversive environmental cues. Brain and Cognition, Australia. Cele is also an honorary lecturer at the Centre for Emotional 72(1), 124–133. Health, Macquarie University and her research interests include Spence, S. H. (1998). A measure of anxiety symptoms among chil- adolescent sleep and mental health. dren. Behaviour Research and Therapy, 36(5), 545–566. Tamres, L. K., Janicki, D., & Helgeson, V. S. (2002). Sex differences in coping behavior: a meta-analytic review and an examination of relative coping. Personality and Social Psychology Review, 6(1), 2–30. https://doi.org/10.1207/s15327957pspr0601_1. Ella L. Oar is a Postdoctoral Research Fellow at the Centre for Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. Emotional Health, Macquarie University, Australia. Her research aims (2020). Immediate psychological responses and associated factors to better understand the factors underlying the development of anxiety during the initial stage of the 2019 coronavirus disease (COVID- and obsessive-compulsive disorders in addition to enhancing treatment 19) epidemic among the general population in China. Interna- outcomes and access for youth who suffer from these debilitating tional Journal of Environmental Research and Public Health, 17 conditions. (5), 1729. Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., … Sharma, V. K. (2020). A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behavior, and Immunity. Jasmine Fardouly is a Postdoctoral Research Fellow at the Centre for Emotional Health, Macquarie University, Australia. Her research interests include social influences on the mental health of young Natasha R. Magson is a Postdoctoral Research Fellow at the Centre people, particularly the influence of social media use. for Emotional Health, Macquarie University, Australia. Her research http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Youth and Adolescence Pubmed Central

Risk and Protective Factors for Prospective Changes in Adolescent Mental Health during the COVID-19 Pandemic

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Pubmed Central
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© Springer Science+Business Media, LLC, part of Springer Nature 2020
ISSN
0047-2891
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1573-6601
DOI
10.1007/s10964-020-01332-9
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Abstract

The restrictions put in place to contain the COVID-19 virus have led to widespread social isolation, impacting mental health worldwide. These restrictions may be particularly difficult for adolescents, who rely heavily on their peer connections for emotional support. However, there has been no longitudinal research examining the psychological impact of the COVID-19 pandemic among adolescents. This study addresses this gap by investigating the impact of the COVID-19 pandemic on adolescents’ mental health, and moderators of change, as well as assessing the factors perceived as causing the most distress. Two hundred and forty eight adolescents (M = 14.4; 51% girls; 81.8% Caucasian) were surveyed over two time points; in age the 12 months leading up to the COVID-19 outbreak (T1), and again two months following the implementation of government restrictions and online learning (T2). Online surveys assessed depressive symptoms, anxiety, and life satisfaction at T1 and T2, and participants’ schooling, peer and family relationships, social connection, media exposure, COVID-19 related stress, and adherence to government stay-at-home directives at T2 only. In line with predictions, adolescents experienced significant increases in depressive symptoms and anxiety, and a significant decrease in life satisfaction from T1 to T2, which was particularly pronounced among girls. Moderation analyses revealed that COVID-19 related worries, online learning difficulties, and increased conflict with parents predicted increases in mental health problems from T1 to T2, whereas adherence to stay-at-home orders and feeling socially connected during the COVID-19 lockdown protected against poor mental health. This study provides initial longitudinal evidence for the decline of adolescent’s mental health during the COVID-19 pandemic. The results suggest that adolescents are more concerned about the government restrictions designed to contain the spread of the virus, than the virus itself, and that those concerns are associated with increased anxiety and depressive symptoms, and decreased life satisfaction. ● ● ● ● ● Keywords Adolescence COVID-19 Depressive symptoms Anxiety Life satisfaction Longitudinal Introduction these restrictions have been challenging for people of all ages, they may be particularly difficult for adolescents, who The COVID-19 pandemic has swept through the globe at this developmental stage rely heavily on their peer con- quickly and indiscriminately. Government restrictions put nections for emotional support and social development in place to slow the spread of the virus have led to wide- (Ellis and Zarbatany 2017). As orders to stay at home and spread social isolation, which can have profound con- socially distance from others impedes most peer interaction, sequences for mental health (Brooks et al. 2020). While it is important to examine the impact that this is having on adolescents’ mental health, especially given the strong associations between interpersonal stress and the onset of emotional difficulties among adolescents (Rapee et al. * Natasha R. Magson 2019). However, to date there is no longitudinal research Natasha.Magson@mq.edu.au examining the psychological impact of the COVID-19 pandemic among adolescents, and what is known is limited Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, New South Wales, Australia by retrospective reports of perceived mental health changes (e.g., Hawke et al. 2020). The current study addressed this School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia gap by examining changes in adolescent mental health 1234567890();,: 1234567890();,: Journal of Youth and Adolescence within a longitudinal framework that included baseline online, spending most of their time indoors and are physi- measures of adolescents’ mental health before the COVID- cally separated from their peers, means they may be at an 19 pandemic, and a second measure two months following increased risk of developing psychological problems during the implementation of government restrictions and online the COVID-19 global pandemic. learning. Previous COVID-19 Studies Increased Vulnerability during Adolescence Whilst it may take years, and many studies, to fully To appreciate the importance of examining the effects of the understand the sequelae of the COVID-19 pandemic, prior COVID-19 pandemic on adolescent mental health, one must research shows a consistent link between the pandemic and first understand the pertinent developmental changes that mental health. Importantly, existing research highlights a occur during adolescence that may make this a particularly number of COVID-19 related factors (e.g., government distressing time. Adolescence has often been labeled by restrictions, media exposure, etc.) that may influence these developmental theorists as a period of storm and stress associations. As the current study explores these factors in (Casey et al. 2010). This is due in part, to the physical and conjunction with prospective changes in mental health, the chemical changes occurring in the brain from early ado- existing research is reviewed here briefly to demonstrate the lescence, which result in a ‘neural mismatch’ whereby association between COVID-19 and mental health, and to emotionality is heightened in response to real and/or per- highlight any relevant influencing factors. ceived stressors (Bailen et al. 2019), yet the self-regulatory Previous studies with adults consistently point to the system required to manage these emotions remains largely detrimental impact of COVID-19 on the mental health of underdeveloped until early adulthood (Somerville et al. individuals. For example, research conducted among 1210 2010). Another defining characteristic of adolescence is the respondents during the early stages of the crisis in China marked increase in social sensitivity and the importance of found that more than half (53.8%) rated the negative impact peers (Somerville 2013). As adolescents strive for inde- of the COVID-19 pandemic on their psychological health as pendence from their parents, the time spent with peers moderate to severe (Wang et al. 2020). A second study in increases dramatically, and for the first time, friends rather China reported COVID-19 related increases in generalized than parents become the primary source of interaction and anxiety, which were found to be more pronounced in influence (Meuwese et al. 2017). However, the increased younger people (<35 years) compared to older age groups social sensitivity that emerges during adolescence also (Huang and Zhao 2020). A meta-analysis of 13 studies of means that peer relationships can be a major source of mental health among healthcare workers found that almost a conflict, rejection, and interpersonal stress (Somerville quarter exhibited elevated COVID-19 related symptoms of 2013). During adolescence, acceptance and rejection by anxiety (23.2%) and depression (22.8%), and more than a peers is used to guide behaviors, shape self-concept and third (38.9%) experienced problems with insomnia (Pappa gauge self-worth (Connell and Wellborn 1991). Thus, et al. 2020). negative peer interactions during this important develop- To date, few studies have evaluated the impact of the mental window can lead to poor self-concept, a low sense of pandemic on mental health in adolescents. One study sur- worth, and subsequent increases in symptoms of anxiety veyed 1738 Chinese participants at two time points fol- and depression, whereas positive peer relationships can lowing the commencement of the pandemic and found no provide social and emotional support, which are known to significant changes across time in depression, anxiety and protect against the risk of both depression and anxiety (La stress over the study period (Wang et al. 2020). However, Greca and Harrison 2005). there was some indication that younger people (aged 12–21 The increases in interpersonal stress, coupled with years) perceived the impact of COVID-19 to be greater than heightened emotional reactivity and low emotion-regula- older adults (aged 50–59 years). Beliefs about the ease of tion, can place adolescents at a greater risk of developing virus transmission and increased media exposure to health many common forms of psychopathology including gen- information about COVID-19 were significantly associated eralized anxiety, eating disorders, depression, and social with depression and/or anxiety at both time points. In anxiety (Rapee et al. 2019). In fact, this particular subset of contrast, taking precautionary measures to avoid transmis- internalizing disorders has previously been referred to as sion (e.g., regular handwashing), complying with the stay- “disorders of adolescence” due to their typical median onset at-home orders, and low perceived likelihood of contracting age of 13 to 19 years (Rapee et al. 2019). Collectively, the and dying from COVID-19 were all found to be protective. developmental characteristics of adolescence, the typical In a study focused on youth, retrospective reports of age of onset for these social emotional disorders, and the mental health symptoms three months prior to the pandemic fact that adolescents have been conducting their schooling were compared to those three weeks into the pandemic Journal of Youth and Adolescence among 622 Canadian adolescents and young adults (Hawke Interestingly none of the studies reviewed above investigated et al. 2020). Participants perceived reductions in their whether mental health outcomes during the COVID-19 pan- mental health across the period, particularly in depression/ demic differed by sex, which is surprising considering the well- low mood and anxiety. Another study also found high established sex differences in the prevalence and severity of levels of depression and anxiety in Chinese adolescents depression and anxiety (Rose and Rudolph 2006). Hence, during the peak of the pandemic, although lower levels research examining sex differences in adolescents’ responses to were reported among males and youth that regularly COVID-19 and its associated restrictions is needed to address engaged in exercise (Chen et al. 2020). Finally, a survey of this gap. Finally, as depression and anxiety are known to 1054 Canadian adolescents (M = 16.68) found that ado- increase, and life satisfaction to decrease, from early adolescence age lescents were most concerned about the impact on their onward (Goldbeck et al. 2007; Rapee et al. 2019), it is important schooling, followed by general concerns about the COVID- to ensure that any potential prospective changes in mental health 19 crisis, and not feeling connected to friends (Ellis et al. symptoms during COVID-19 are not simply due to age effects. 2020). Further, COVID-19 related concerns, spending less However to date, developmental differences in COVID-19 time on schoolwork and more time with friends was posi- responses have not been examined in adolescent samples. tively associated with depression, whereas spending more time with family was negatively associated. COVID-19 related concerns were also positively associated with lone- The Current Study liness, while spending more time with family and friends, and engaging in more physical activity, was negatively Taken together, the above research provides consistent associated. Social media use moderated the association evidence that the COVID-19 crisis may be having a sig- between COVID-19 concerns and depression, with those nificant impact on the psychological health of adolescents reporting high levels of social media use also reporting the across the globe. However, all of these studies have relied most depression. on respondents indicating the perceived impact of COVID- 19 on their current mental health. Only longitudinal studies Potential Risk and Protective Moderating Factors that include a baseline measure before COVID-19 can truly detect changes in mental health related to the pandemic, The cross-sectional research cited above points to a number of although there has been no such research to date. To address factors that may be important for examining the association this gap, the primary purpose of the current research was to between adolescent mental health and COVID-19 long- determine the effect of the pandemic and the government- itudinally. Namely age, gender, media exposure, family imposed restrictions associated with the response to conflict, changes to schooling, adherence to restrictions, and COVID-19 on the emotional health of adolescents. The first levels of social connection have all been implicated as aim was to identify which factors were viewed by adoles- potential moderators within the existing research. As previous cents as producing the greatest COVID-19 related distress. research has demonstrated that adolescents were particularly It was hypothesized that not being able to see and spend concerned about feeling socially disconnected from their time with friends, and concerns about moving to online friends, and that COVID-19 related worries along with less learning, would cause adolescents the most distress. The time on schooling were significantly associated with depres- second aim was to prospectively investigate the impact of sion cross-sectionally (Ellis et al. 2020), it is possible that the COVID-19 pandemic on changes in adolescent anxiety, social connectedness, COVID-19 related concerns, and dis- depressive symptoms, and life satisfaction. It was antici- ruptions to schooling may predict change from pre-pandemic pated that from T1 (pre-pandemic) to T2 (during the pan- to intra-pandemic levels of depression, anxiety and life demic) adolescents would report an increase in symptoms of satisfaction. Further, as a prior two-wave study found that anxiety and depression, and a decrease in overall life increased exposure to media reports about COVID-19 was satisfaction. The third aim was to ascertain which factors significantly associated with increases in anxiety and during the pandemic served to decrease or increase the risk depression, whereas complying with the stay at home rules of experiencing adjustment difficulties two months after the was protective (Wang et al. 2020), it is important to examine pandemic began and whether there were any age or sex these associations longitudinally. Considering the substantial differences evident. It was predicted that disruptions to amount of time adolescents spend on social media, it may also schooling, COVID-19 related distress, family conflict, and be important to examine the effect of exposure to COVID-19 frequent media exposure during the pandemic, would serve related media reports via social media, particularly as prior to increase the risk of mental health problems, whereas has found that increased social media use during the pan- feeling socially connected and adhering to COVID-19 demic was associated with increased adolescent depression related restrictions during the lockdown would decrease the and anxiety (Ellis et al. 2020). risk of mental health problems two months into the Journal of Youth and Adolescence pandemic. As depression and anxiety are more prevalent in scores ranged from 0 to 26 with higher scores indicating more girls than in boys, it was expected that any changes depressive symptoms. The reliability of the measure was good in mental health symptoms from T1 to T2 would be stronger in the current sample (α= 0.91 at T1 and 0.93 at T2). in girls compared to boys, and if the predicted increases in mental health problems from T1 to T2 are simply due to Life satisfaction developmental maturation, it was expected older adoles- cents would report greater increases in symptoms of The Student’s Life Satisfaction Scale (SLSS; Huebner 1994) depression and anxiety, and greater decreases in life satis- is a 9-item self-report measure of global life satisfaction for faction, than younger adolescents. young people. Adolescent participants were required to indi- cate their level of agreement with a statement (e.g., “My life is going well”) on a 7-point Likert scale ranging from 1 Methods (strongly disagree) to 7 (strongly agree). After reverse coding the two negatively worded items, item scores were averaged Participants to provide a mean score ranging from 1 to 7, with higher scores indicating greater life satisfaction. The Cronbach’s Participants in the current study were part of the larger alphas in the current study were high (α= 0.91 at T1 and 0.92 longitudinal Risks to Adolescent Wellbeing Project (the at T2). RAW Project) who have been completing online ques- tionnaires annually for the past four years. Participants in COVID-19 related distress the study resided in an urban area of New South Wales (NSW) Australia, and the majority of participating families This 18-item measure assessing COVID-19 related distress in the RAW Project are Caucasian (81.8%), speak English was specifically developed for the current research (items as a first language (96.4%), and have previously reported a listed in Fig. 1). Adolescents were required to indicate how middle to high socioeconomic status (79.2%). Of the 467 distressed they were about each item listed on a 10-point adolescents invited to participate in the COVID-19 survey, scale ranging from 1 (not at all distressed) to 10 (extremely 248 (53%) returned completed responses and thus com- distressed). Item scores were averaged to provide a mean prised the current sample. At the time the COVID-19 survey score ranging from 1 to 10 with higher scores indicating was completed, the adolescents were aged 13 to 16 years greater COVID-19 related distress. The Cronbach’s alpha (M = 14.4, SD = 0.5), with almost equal numbers of boys for the new scale was 0.91. age (n = 122) and girls (n = 126) participating. Disruption to schooling Measures To understand the impact of COVID-19 on schooling four Generalized anxiety items were developed to assess: format of school atten- dance, difficulties during online learning, motivation to The Generalized Anxiety subscale (e.g., “I worry about complete school work, and impact on education. Specifi- things”)ofthe Spence Children’s Anxiety Scale (SCAS-C; cally, adolescents were asked if they were (a) attending Spence 1998) was used to measure self-reported symptoms of school in-person; (b) learning online only; or (c) partici- anxiety. Adolescents were required to indicate how often they pating in a mix of in-person and online schooling. For those experienced each symptom on a 4-point Likert scale ranging learning online, an additional yes or no question was asked: from 0 (never) to 3 (always). The total scores for the Gen- “Have you had any difficulties switching to online learn- eralized Anxiety subscale ranged from 0 to 18 with higher ing?”, and if yes, an open-ended question followed asking scores indicating greater anxiety. The Cronbach’s alphas in the for details of their difficulties. The self-perceived impact of current study were acceptable (α=0.86 at T1 and0.87atT2). online learning and COVID-19 on education was measured using two questions, “Do you think your education is suf- Depressive symptoms fering due to online schooling?” and “Do you think your education is suffering due to the disruptions from COVID- The Short Mood and Feelings Questionnaire—Child Version 19?”, rated on a 4-point scale from 1 (not at all) to 4 (a great (SMFQ-C; Angold et al. 1995) is a 13-item self-report measure deal). The two questions were highly correlated (r = 0.758, used to assess symptoms of depression in children and ado- p < 0.001) so a mean of the two scores was calculated with lescents. Participants were required to indicate how true each higher scores indicating a larger impact on schooling. A statement was for them over the past 2 weeks on a 3-point single-item question was used to measure the change in Likert scale ranging from 0 (not true) to 2 (always true). Total students’ motivation to complete school work (i.e., Journal of Youth and Adolescence COVID-19 Related Distress disagree) to 6 (strongly agree). Item scores were averaged to Not being able to see my friends provide a mean score ranging from 1 to 6, with higher Friend or family dying from COVID-19 scores indicating greater social connectedness. The Cron- Friend or family getting very ill from COVID-19 Friend or family catching COVID-19 bach’s alpha value in the current study was high (α = 0.91). No participation in extra curricular activties Not being able to attend social events Not being able to travel/holiday Adherence to COVID-19 Australian government stay-at- My education Not being able to go to school home directive The family money situation Not being able to see extended family Australia's economy At the time T2 data was collected, laws in Australia were in The world economy Having to return to school place to help minimize the spread of COVID-19. Residents of Losing my job the state New South Wales were asked to stay at home unless Getting very sick from COVID-19 Catching COVID-19 they were going to work or school, obtaining food or other Dying from COVID-19 essential goods and services, exercising, or seeking medical 0123456789 10 care. To assess adherence to this stay-at-home directive, Fig. 1 Factors contributing to COVID-19 related distress among adolescents were asked how often they had left their home for adolescents. Rated on a scale of 0 (not at all distressed) to 10 (extre- mely distressed) reasons other than those listed above, responding on a 5-point scale from 0 (I have only left my home for the reasons listed above) to 4 (more than 10 times). “Compared to how motivated you usually are to do school work, how motivated do you feel now to do your school Procedure work?”) rated on a 3-point scale (1 = much less motivated, 2 = about the same, 3 = much more motivated). The parents of all adolescents currently enrolled in the RAW Project were sent information about the COVID-19 study and a Media exposure link to the T2 online survey. Parents who consented to their child participating, then shared the link with their child who One question assessed their exposure to traditional news assented online prior to beginning the survey. Participants were media (i.e., “On average, how often to you read/watch asked to complete the survey within two weeks of receiving the media reports about COVID-19 each day?”) and a second initial email, after which the survey was closed. The World question assessed social media related exposure (i.e., “On Health Organization declared COVID-19 a pandemic on average, how often do you read posts about COVID-19 on March 11, 2020. The T1 data used for the current study was social media each day?”). Both items were rated on a 6- collected online throughout 2019 as part of the larger RAW point scale from 1 (not at all) to 6 (five times or more). Project (thus prior to the COVID-19 pandemic), and the T2 data was collected between May 5th and May 14th 2020, Interpersonal conflict approximately two months after the Australian government had imposed the stay-at-home orders and schools had moved to The current study developed four self-report item to assess online learning. change in interpersonal conflict between adolescents and their mothers, fathers, siblings, and friends due to the Data Analysis COVID-19 social distancing rules and stay at home restrictions (e.g., “Do you feel you are having more or fewer Distribution and descriptive statistics were obtained through disagreements/arguments with your father?”). Adolescents SPSS (v26; IBM Corp. 2019). To determine whether levels of responded on a 5-point Likert scale ranging from 1 (we depressive symptoms, anxiety, and life satisfaction significantly have argued much less) to 5 (we have argued much more), increased or decreased in the period before the pandemic began thus higher scores indicated greater interpersonal conflict. and two months into the pandemic, a paired samples t-test in SPSS was conducted. Potential moderators of the change in Social connectedness mental health scores before and during COVID-19 were examined in SPSS using Model 2 in the MEMORE macro The Social Connectedness Scale (SCS; Lee and Robbins (Montoya and Hayes 2017), which is specifically designed to 1995) is a measure of how emotionally distant or connected assess moderation in two instance repeated measures research a respondent feels with those close to them, and society designs (Montoya 2019). This procedure computes a pre-post more broadly. Adolescents were required to indicate their difference score and then determines whether the moderator of level of agreement with eight statements (e.g., “I feel distant interest predicts that difference (Judd et al. 2001;Kenny 2018). from people”) on a 6-point scale, ranging from 1 (strongly For all non-dichotomous moderators, significant interactions Journal of Youth and Adolescence Table 1 Means and standard Males Females Total sample deviations for key study variables for male, female, and Mean SD Mean SD Mean SD Skew Kurtosis total sample Generalized anxiety T1 3.63 3.13 5.55 4.05 4.60 3.74 1.13 1.12 Generalized anxiety T2 3.64 3.16 6.52 4.31 5.10 4.05 0.72 −0.01 Depressive symptoms T1 2.81 3.18 4.77 5.00 3.81 4.31 1.57 2.21 Depressive symptoms T2 4.02 4.76 8.16 6.46 6.12 6.04 1.09 0.41 Life satisfaction T1 5.65 0.87 5.50 1.09 5.57 0.99 −0.81 0.29 Life satisfaction T2 5.23 1.10 4.81 1.14 5.01 1.14 −0.52 −0.25 COVID-19 distress T2 3.22 1.48 3.70 1.47 3.46 1.49 0.50 −0.27 Impact on education T2 2.10 0.79 2.10 0.74 2.10 0.76 0.90 0.72 Motivation to study T2 1.66 0.68 1.57 0.67 1.62 0.68 0.64 −0.67 Traditional media exposure T2 2.10 1.16 1.85 0.90 1.97 1.04 1.72 3.76 Social media exposure T2 2.26 1.48 2.25 1.38 2.26 1.42 1.32 1.10 Conflict—mother T2 3.05 0.97 2.86 1.08 2.95 1.03 −0.14 −0.07 Conflict—father T2 3.13 0.95 2.95 1.09 3.04 1.03 −0.28 −0.03 Conflict—siblings T2 3.43 0.99 3.40 1.11 3.41 1.05 −0.48 −0.13 Conflict—friends T2 2.31 0.94 2.30 1.07 2.30 1.00 −0.01 −1.10 Social disconnection T2 2.56 1.08 3.26 1.38 2.92 1.29 0.57 −0.18 Stay at home adherence T2 1.52 0.76 1.44 0.64 1.48 0.70 1.40 1.54 were probed at 1 SD above and below the mean. Data coverage variables were significantly correlated within and between for T1 and T2 mental health variables was 99.6% to 100%, time points in the predicted direction. COVID-19 related respectively. All other variables contained less than 1% missing distress and feeling socially disconnected from others were data with the exception of the family conflict variables which most strongly related to all mental health symptoms, as well had a “not applicable option” for family members not living as being significantly associated with viewing posts about within the same household. This resulted in non-responses of COVID-19 on social media, less motivation to study, a 3.2% for mother, 9.7% for father, and 7.7% for siblings. Due to greater perceived negative impact on schooling, and greater the small percentage of missing data, all analyses were con- conflict with siblings. ducted using pairwise deletion. Adolescents Distress during COVID-19 Results Addressing the first aim concerning what is causing ado- lescents the most distress, Fig. 1 shows that adolescents Preliminary Results reported low to moderate levels of COVID-19 related stress across the 18 items assessed. As predicted, the most dis- Descriptive statistics (for total sample, and boys and girls tressing issue for adolescents during this time was not being separately) and correlations between key variables are dis- able to see their friends, closely followed by a friend or played in Tables 1 and 2. As shown in Table 1, most family member contracting and getting very sick and/or variables were normally distributed with no obvious dying from COVID-19. Also high on adolescents’ lists of skewedness (−0.81 to 1.72), although the kurtosis of values concerns was the inability to participate in their normal of depressive symptoms at T1 (2.21) and exposure to tra- extra-curricular activities (e.g., sports, dance, music lessons ditional media at T2 (3.76) fell slightly above the recom- etc.) or attend social events. In contrast, they reported very mended values of plus or minus two (Gravetter et al. 2020). little concern about contracting, getting ill or dying from As expected, on average girls reported more symptoms of COVID-19 themselves. depression and anxiety at both time points, whereas boys reported more familial conflict during the lockdown period. Overall Changes in Mental Health Boys and girls were more similar on average levels of life satisfaction, exposure to COVID-19 related media, and To address the second aim relating to changes in mental attitudes toward the impact of COVID-19 on their school- health prior to and during the pandemic, the results of the ing. The correlations in Table 2 show that all mental health paired samples t-tests showed significant increases in Journal of Youth and Adolescence Table 2 Bivariate correlations between key study variables 1234567 89 10 11 12 13 14 15 16 17 1. Generalized Anx T1 1 2. Generalized Anx T2 0.61*** 1 3. Depressive symptoms T1 0.54*** 0.35*** 1 4. Depressive symptoms T2 0.41*** 0.67*** 0.41*** 1 5. Life satisfaction T1 −0.43*** −0.30*** −0.56*** −0.49*** 1 6. Life satisfaction T2 −0.34*** −0.45*** −0.33*** −0.67*** 0.64*** 1 7. COVID-19 distress T2 0.35*** 0.43*** 0.26*** 0.36*** −0.23*** −0.32*** 1 8. Motivation to study −0.07 −0.04 −0.06 −0.16* 0.17** 0.19** −0.17** 1 9. Impact on education T2 0.21** 0.21** 0.23*** 0.28*** −0.19** −0.20** 0.32***−0.46*** 1 10. Trad media exposure T2 0.08 −0.04 0.09 −0.05 −0.01 0.01 0.17** 0.10 −0.01 1 11. Social media 0.17** 0.14* 0.22** 0.19** −0.18** −0.13* 0.16* 0.00 0.11 0.44***1 exposure T2 12. Conflict—mother T2 0.08 0.03 0.09 0.16* −0.20** −0.28*** 0.03 −0.10 0.10 0.06 0.08 1 13. Conflict—father T2 0.01 0.08 0.05 0.21** −0.08 −0.20** 0.06 −0.13* 0.14* 0.11 0.15* 0.59*** 1 14. Conflict—siblings T2 0.16* 0.13* 0.18** 0.12 −0.11 −0.15* 0.22** 0.03 −0.01 0.09 0.11 0.26*** 0.19**1 15. Conflict—friends T2 0.01 0.06 0.05 0.05 −0.07 −0.14* 0.01 −0.09 0.00 −0.04 0.03 0.19** 0.17* 0.06 1 16. Disconnectedness T2 0.33*** 0.47*** 0.35*** 0.62*** −0.39*** −0.49*** 0.34***−0.19** 0.19** 0.01 0.23*** 0.15* 0.17* 0.17* 0.06 1 17. Stay home −0.07 −0.04 0.00 0.01 0.01 −0.11 −0.03 −0.04 0.15* 0.04 0.04 −0.01 −0.02 0.06 0.07 −0.10 1 adherence T2 T1 time 1, T2 time 2, Anx anxiety, Trad traditional, Stay at home adherence adherence to government stay at home directives *p < 0.05; **p < 0.01; ***p < 0.001 Journal of Youth and Adolescence adolescents’ symptoms of depression, (t(1, 247) = 6.26, p < 0.001, d = 0.15), and anxiety, (t(1, 244) = 5.26, p < 0.001, d = 0.40), and a significant decrease in life satisfaction, (t(1, 244) = −5.26, p < 0.001, d = 0.61) from T1 (before the pandemic) to T2 (2 months into the pandemic). Potential Moderating Factors To address the third aim of the research, the results for each of the potential moderating factors examined are presented below. To aid interpretation, the statistical results of all moderating analyses are summarized in Table 3 and described in text below. Sex Sex of the youth significantly moderated the change scores in depressive symptoms, with results indicating that although there were significant increases in depressive symptoms from T1 to T2 for both boys and girls, this effect was more pronounced in girls. This result was replicated for changes in anxiety, with girls again showing the largest increases in symptoms from T1 to T2. Finally, sex sig- nificantly moderated the change in life satisfaction from T1 to T2 with girls showing the greatest decrease. Age Age did not moderate change in depressive symptoms, anxiety, or life satisfaction from T1 to T2. COVID-19 related distress Levels of distress associated with the COVID-19 pandemic significantly moderated change scores in depressive symp- toms, anxiety, and life satisfaction from T1 to T2. Specifi- cally, adolescents with high and moderate levels of COVID- 19 related distress experienced significantly greater increa- ses in anxiety and depressive symptoms, and significantly greater decreases in life satisfaction, over time than those with low levels of COVID-19 related distress. Disruption to schooling The most commonly reported problems when learning online were related to technology problems, not under- standing the learning materials, being unable to ask the teacher to explain the work, and problems with motivation. Results showed that switching to learning exclusively online had no significant effect on levels of depressive symptoms, anxiety, or life satisfaction. However, experi- encing the abovementioned difficulties with online learning did significantly moderate change in depressive symptoms, Table 3 Results of the moderation analysis: test of factors that moderate changes in mental health from T1 to T2 Moderator Depression Anxiety Life satisfaction 2 2 2 FR b t (df) p F R b t (df) p F R b t (df) p Sex 9.00 0.035 2.18 6.64 (246) 0.003 4.19 0.017 2.18 1.81 (246) 0.041 5.16 0.021 −0.26 −2.27 (245) 0.024 Age 0.89 0.000 −0.17 −0.30 (246) 0.766 1.72 0.007 −0.45 −1.31 (246) 0.191 0.80 0.003 0.08 0.89 (245) 0.372 COVID-19 distress 9.00 0.031 3.34 6.47 (246) <0.001 4.18 0.017 0.30 2.05 (246) 0.042 5.56 0.022 −0.09 2.36 (245) 0.019 Learning online 0.01 0.000 0.11 0.11 (246) 0.914 0.23 0.001 0.29 0.48 (246) 0.631 1.89 0.008 0.22 1.38 (245) 0.170 Difficulties online 4.53 0.018 3.48 5.26 (244) <0.001 2.47 0.010 0.75 1.57 (244) 0.118 0.16 0.001 −0.05 −0.41 (243) 0.685 Educational impact 3.85 0.016 0.96 1.96 (244) 0.051 0.06 0.000 0.07 0.25 (244) 0.908 0.49 0.001 −0.05 −0.70 (243) 0.485 Motivation to study 3.76 0.015 −1.06 −1.94 (246) 0.053 0.25 0.001 0.16 0.50 (246) 0.615 0.81 0.003 0.08 0.90 (245) 0.370 Traditional media 3.42 0.014 −0.65 −1.85 (246) 0.066 4.51 0.018 −0.05 −2.12 (246) 0.035 0.11 0.000 0.02 0.33 (245) 0.740 Social media 0.34 0.001 0.15 0.58 (246) 0.562 0.03 0.000 −0.03 −0.18 (246) 0.857 0.18 0.001 0.02 0.43 (245) 0.671 Conflict—father 7.46 0.033 1.01 2.73 (222) 0.007 1.24 0.006 0.26 1.11 (222) 0.267 5.38 0.024 −0.14 −2.32 (221) 0.021 Conflict—mother 2.49 0.010 0.58 1.59 (238) 0.116 0.58 0.002 −0.17 −0.76 (238) 0.447 4.07 0.017 −0.12 −2.02 (237) 0.045 Conflict—sibling 0.04 0.000 −0.07 −0.21 (227) 0.838 0.11 0.000 −0.07 0.75 (227) 0.747 0.88 0.004 −0.06 −0.94 (226) 0.348 Conflict—friend 0.08 0.000 0.11 0.29 (210) 0.774 0.88 0.004 0.23 0.94 (210) 0.349 1.69 0.008 −0.09 −1.30 (209) 0.195 Social disconnection 42.06 0.146 −0.95 5.41 (245) <0.001 10.27 0.040 −0.54 −3.20 (246) <0.001 9.31 0.037 0.14 3.05 (245) 0.003 Stay home adherence 0.01 0.000 0.04 0.08 (246) 0.935 0.25 0.001 0.16 0.50 (246) 0.620 5.08 0.020 −0.19 −2.25 (245) 0.025 Significant p values are bolded to aid interpretation Journal of Youth and Adolescence with those who experienced problems reporting sig- significantly more life satisfaction from T1 to T2 than those nificantly more depressive symptoms during COVID-19, feeling socially disconnected during the lockdown period. compared to those who experienced no problems with online learning. Online learning difficulties did not moder- Adherence to COVID-19 government restrictions ate changes in anxiety or life satisfaction from T1 to T2. Participants’ perceptions that their education was suffering Adherence to the government’s stay at home directive had during the COVID-19 lockdown had no significant effect on no significant effect on changes in depressive symptoms or change scores in depressive symptoms, anxiety or life anxiety, however, those reporting greater adherence to the satisfaction. Finally, differences in motivation to engage in stay at home rules reported lower declines in life satisfac- school work before and during the COVID-19 pandemic tion from T1 to T2 compared to those who continued to had no significant effect on changes in depressive symp- leave their homes more frequently. toms, anxiety or life satisfaction. Media exposure Discussion Frequency of exposure to traditional media reports (i.e., The COVID-19 pandemic has had a significant impact on television, newspaper) about COVID-19 had no significant the lives of millions around the world. Government mea- effect on change in depressive symptoms, but there was a sures put in place to contain the virus have physically and significant moderating effect on changes in anxiety. Results socially isolated adolescents from their friends, extended showed those reporting high levels of traditional media family, and other social support networks, leaving many exposure had significantly greater decreases in anxiety from feeling socially isolated, and consequently, at an increased T1 to T2 than those reporting low exposure. Frequency of risk of psychological disorder. However, to date, there has exposure to COVID-19 traditional media reports had no been no longitudinal research examining how the pandemic significant effect on changes in life satisfaction. The fre- has impacted adolescents’ mental health despite decades of quency of reading posts about COVID-19 on social media research demonstrating the potential lifelong risks asso- had no significant effect on changes in depressive symp- ciated with prolonged interpersonal stress and social isola- toms, anxiety or life satisfaction. tion during the adolescent years (e.g., Loades et al. 2020). Further, research has not yet examined which demographic Interpersonal conflict and COVID-19 related factors serve to increase or decrease adolescent mental health symptoms over time. The current Increased conflict with siblings, friends and mothers had no study addressed these research gaps by conducting a long- significant interaction effect on depressive symptoms, itudinal investigation into the effect the COVID-19 virus however, increased conflict with fathers during COVID-19 and its associated restrictions are having on adolescents’ significantly moderated change in depressive symptoms mental health, as well as identifying some of the critical from T1 to T2. Those experiencing an increase in conflict impacts and life changes associated with the pandemic. with their fathers reported more depressive symptoms at T2 Potential moderators of change in mental health symptoms than those that did not. Levels of interpersonal conflict with were also investigated including age, sex, disruptions to siblings, friends, mothers or fathers did not moderate schooling, COVID-19 related distress, family conflict, change scores in anxiety. Interpersonal conflict with both media exposure, social connection, and adherence to mothers and fathers significantly moderated changes in life COVID-19 related restrictions. satisfaction with those reporting greater conflict with their mother and father also reporting larger declines in life Negative Emotionality satisfaction than those with low parental conflict. Inter- personal conflict with siblings and friends had no effect on As predicted, the results showed that adolescents’ mental changes in life satisfaction. health had slightly deteriorated compared to pre-pandemic levels and a number of pandemic-related factors were Social connectedness related to those changes. When interpreting the results, it must be kept in mind that, although mental health measures Feeling socially connected during the COVID-19 lockdown were taken on two occasions, potential moderators were period significantly moderated changes in depressive only measured once and therefore, the results are unable to symptoms, anxiety and life satisfaction. Those perceiving indicate the direction of relationships. high levels of social connection during COVID-19 reported The pre-pandemic to intra-pandemic increase in depres- significantly fewer depressive symptoms and anxiety, and sive symptoms and anxiety, and decrease in life satisfaction Journal of Youth and Adolescence found in the current study is generally consistent with adolescents’ greatest concern during the COVID-19 lock- previous retrospective and cross-sectional studies in both down was not being able to see their friends. In fact, all adult and adolescent samples, which have reported per- items mentioning friends or social connection were rated ceived increases in depression, anxiety, and loneliness due higher than any of the other COVID-19 related worries. to the effects of COVID-19 (Chen et al. 2020; Wang et al. Signifying the possibility of developmental differences, 2020; Ellis et al. 2020). The current study strengthens and these findings contrast with research in adults, as adults builds upon this literature by demonstrating that living with expressed the greatest concern over family members con- the restrictions and concerns surrounding COVID-19 are tracting COVID-19 (Wang et al. 2020). The present results related to not only increases in emotional distress but also also showed that feeling socially disconnected during the with decreases in life satisfaction. More importantly, the pandemic was associated with higher levels of anxiety and prospective collection of these data allows stronger con- depressive symptoms and lower levels of life satisfaction. clusions to be drawn, that go beyond the perceived attri- The importance of feeling socially connected during the butions of participants. Interestingly, while significant pandemic has been demonstrated previously when it was decrements in adolescent mental health were demonstrated found that adolescents left alone at home all day reported prospectively, the size of these effects were quite modest, significantly higher levels of depression and anxiety than with changes ranging from 0.2 to 0.6 standard deviations. those who were accompanied by a parent or relative (Chen Clearly a large proportion of adolescents are coping well et al. 2020). As the current results cannot indicate the causal with the impact of the pandemic, at least in the early stages, direction, it is equally plausible that emotional distress leads and most are showing minimal negative impact. to social disconnection or that social disconnection leads to greater emotional distress. If the latter direction is demon- Gender and Age Differences strated in future research, it might suggest that organizing to have a parent or relative work from home during such The finding that girls are experiencing greater declines in stressful times, may help in mitigating the risks for anxiety mental health than boys during the COVID-19 crisis may and depression, as long as it does not result in greater not only reflect the well-established literature highlighting familial conflict. sex differences in internalizing problems (e.g., Rose and About a quarter of the adolescents surveyed reported that Rudolph 2006), but also that girls are more likely than boys conflict with their parents had increased during the lock- to rely on their social networks for support when dealing down period, which was associated with decreases in life with significant life stressors (Tamres et al. 2002). Thus, the satisfaction; and increased conflict with fathers was asso- move to online schooling and the restrictions placed on ciated with more depressive symptoms. This increase in social interaction may effectively impede adolescent girls parental conflict and decrease in mental health may reflect a from employing their most commonly used coping strategy. developmental discrepancy between adolescents’ inherent Although this suggestion would need to be formally tested, drive to connect with peers and seek greater autonomy from the current findings suggest that it may be particularly their parents (Somerville 2013), while at the same time important to encourage adolescent girls to connect with being ordered to stay at home and physically distance from their friendship groups via safe means, so they can continue their friends. This possibility is further supported by the to access their much-needed social support systems during finding that although half of the current sample reported an the COVID-19 crisis. Previous research has also shown that increase in conflict with their siblings, this was not asso- the prevalence of internalizing disorders increases from ciated with changes to their mental health during the lock- early to mid-adolescence (Goldbeck et al. 2007). However, down period. the current study did not find any moderating effect of age, suggesting that the observed increase in mental health Educational Concerns symptoms from T1 to T2 cannot be simply explained by these developmental differences, and may instead be due to The current results also indicated that adolescents were not the changing social, educational and economic climate as a overly concerned with the impact that COVID-19 was result of COVID-19. having on their education, nor was this related to any of the mental health outcomes examined. These findings are Social Connection and Familial Conflict inconsistent with previous work which found that one of adolescents’ most pressing COVID-19 related worries was Consistent with developmental theory stressing the impor- the detriment to their education (Ellis et al. 2020). This may tance of peer relationships and social interaction during be because the earlier research was carried out immediately adolescence (Meuwese et al. 2017), and previous findings following the switch to online learning whereas the current (Ellis et al. 2020), the current results revealed that study assessed concerns two months after the initial change, Journal of Youth and Adolescence providing students with the opportunity to adapt and settle alleviating uncertainty and concern about its impact. As the into their new learning environment. It may also be due to rate of transmission and positive cases were fairly low in the younger age of the current cohort relative to those in the Australia at the time of the survey, it would be interesting to earlier study, most of whom were in senior school—a time investigate the role of media exposure further by looking at when grades are important in determining acceptance into relationships with adolescent mental health in countries university and future occupational opportunities. Although, experiencing high rates of transmission and infection, and there was no association between mental health problems comparing the findings to those in the current study. and moving to online learning, the current study did find The media also communicates important health infor- that experiencing difficulties during online learning was mation, which may serve to give adolescents a sense of associated with an increase in depressive symptoms from control over what they need to do to avoid contracting the T1 to T2. The most commonly reported difficulties were virus, which may also reduce anxiety. Indeed, the current related to technology problems, not understanding the study found those who adhered more closely to government learning materials, being unable to ask the teacher ques- stay-at-home orders reported fewer mental health problems tions, and problems with motivation. All of these difficulties than those who frequently defied them. This is consistent could be relatively easily addressed should online learning with previous research which also found an association be continued long-term (e.g., providing a platform to ask between that taking precautionary measures (e.g., staying at teachers questions during the lesson rather than having to home, wearing a mask) to avoid contracting the virus and wait for an email response), and implementing these chan- lower levels of depression and anxiety (Wang et al. 2020). ges may mitigate the increased risk for depressive symp- As with all of the current results, the casual relationship toms if the causal direction of this association does go from may flow in either direction. On the one hand, these results learning difficulties to depression. may suggest that disseminating health information and encouraging adherence to government advice through the Media Exposure media may be an effective way of not only reducing the spread of COVID-19, but also in stabilizing levels of gen- Contrary to expectations, high exposure to traditional media eralized anxiety. On the other hand, the results may suggest reports about COVID-19 had a negative relationship with that young people who become more distressed by the changes in generalized anxiety levels, and no significant effects of COVID-19, may be at greater risk to break effect on changes in life satisfaction or depressive symp- socially-described precautions, and in turn, may jeopardize toms. Although there is no clear explanation for the con- their and others’ health. tradictory findings between the current and previous studies, some research suggests that associations between media Limitations and Future Directions exposure and internalizing distress are nuanced (Wang et al. 2020). A recent study in China found that although greater The current study has a number of strengths and limitations. depression and anxiety were associated with exposure to First, this study overcomes many of the limitations of pre- radio reports around COVID-19, the same effect was not vious research by employing a longitudinal design to allow found in relation to television and internet reports (Wang determination of change in mental health symptoms before et al. 2020). These findings are broadly consistent with and during the COVID-19 pandemic. However, despite the those found in the current study in that social media posts longitudinal data collection on mental health, it is not about COVID-19 were not associated with changes in possible to attribute any changes specifically to the effects mental health, whereas reading and watching media reports of COVID-19 as there was no comparison condition. were positively related to good mental health. Similarly, the time two mental health measures and While the direction of these associations cannot be COVID-19 related factors were assessed concurrently, so determined from the current results, they are consistent with while it was possible to ascertain that these factors were a suggestion that changes in anxiety led to differences in associated with increases or decreases in mental health, the media exposure. Specifically, due to the established links direction of those associations cannot be determined. between avoidant coping and anxiety (Richardson et al. Employing alternative methods such as ecological in press), it might be logical to interpret that young people momentary assessment or daily diaries may help to clarify who became more anxious during the COVID-19 period the temporal ordering between social, educational, and avoided exposure to mainstream media reports. On the other emotional experiences during the pandemic and adoles- hand, it is possible that watching and reading news reports cents’ mental health. Further, the data were all self-report about the virus plays an important role in building young and thus are subject to bias that may not align with more people’s confidence in the public health measures imple- objective assessments of mental health and behaviors. To mented to contain the spread of infection, effectively address this limitation, future research could incorporate Journal of Youth and Adolescence parent and teacher reports of adolescents’ adjustment during engage students during their online classes, and ensuring the COVID-19 pandemic. Finally, the sample used in the students have access to adequate technology may help current study was relatively small and demographically overcome some of these most common problems, and as a restricted. The sample was predominately of Caucasian consequence, reduce depressive symptoms associated with ethnicity and included participants within a restricted age online learning difficulties. range, and perhaps most importantly for a study of the impacts of COVID-19, data were collected within a single country (Australia) and it cannot be ensured that the results Conclusion are generalizable to adolescents from other countries that differed widely in rates of infection and severity of Due to the recency of the COVID-19 pandemic, there is government-imposed restrictions. very limited research on its psychological consequences, and no research examining the prospective impact of the Implications virus, and its related restrictions, on the emotional health of adolescents. Thus, this research contributes to the existing While keeping these limitations in mind, several speculative literature by demonstrating longitudinal declines in the implications can be suggested. First, although it is difficult mental health of adolescents, especially among girls, when to disentangle whether the changes in mental health found comparing pre-pandemic to intra-pandemic levels. The in the current study are the direct result of anxieties around current study contributes further by identifying which contracting the virus, or the restrictions put in place to COVID-19 related factors served to increase or decrease the contain it, the current results suggest the latter. Adolescents’ risk of adolescents developing mental health problems concerns around catching and becoming ill from the virus during the pandemic. Specifically, COVID-19 related wor- were relatively low whereas difficulties adjusting to the new ries, difficulties with online learning, and increased family restrictions placed on social activities and schooling as a conflict were associated with greater psychological mal- result of COVID-19 moderated changes in mental health. adjustment. In contrast, greater exposure to traditional Therefore, finding new ways to help adolescents adapt and media, adherence to government restrictions, and feeling cope with the changes to their social and physical envir- socially connected with others was associated with less onment is essential. Ensuring that adolescents, particularly distress. Consistent with theory highlighting the importance girls, maintain their peer relationships seems especially of peers during the adolescent period, the results showed important, and both parents and teachers should encourage that adolescents’ greatest concerns during the COVID-19 social engagement whenever and however possible, within crisis were around the disruption to their social interactions the confines of government and health guidelines. and activities, whereas concerns around contracting or In addition, since early changes in symptoms of psy- getting ill from the virus were very low. This suggests that it chopathology may serve as an antecedent for the onset of is the restrictions put in place to reduce the spread of the chronic mental illness, it is important for parents and school virus, rather than the virus itself, that is causing adolescents staff to monitor young people for elevated emotional dis- the most distress. As social isolation, interpersonal stress, tress and to guide them into early intervention and treatment and mental health problems during adolescence can be a programs where necessary. It is also recommended that precursor for mental health problems across the lifespan, parents and teachers create positive and supportive home parents and teachers are encouraged to assist adolescents in and learning environments, both of which have previously finding ways to maintain their social networks, monitor been shown to lower levels of internalizing distress in young people for signs of emotional distress, provide adolescents even when isolated physically from peers (Ellis positive and supportive home and learning environments, et al. 2020; Manczak et al. 2019). and engage with mental health professionals early. Finally, Finally, and encouragingly, learning exclusively online as research on the mental health impact of COVID-19 is still did not appear to impact adolescents’ mental health, in its infancy, more longitudinal research is needed to gain a whereas difficulties encountered during online learning did. greater understanding of the long term implications of this This demonstrates that adolescents can be resilient and pandemic on the emotional wellbeing of young people. adaptive when needed, as long as they are equipped with the necessary tools and support they require. Most of the online Acknowledgements The authors extend their gratitude to the many research assistants on the RAW project for carrying out the extensive learning difficulties reported were modifiable and related to data collection required for this project and the interns who assisted in problems concerning technology, the understanding of the coding of the data sets. learning materials, and being unable to ask the teacher for clarification. Implementing regular question and answer Author’s Contributions N.R.M. conceived of the study, prepared the sessions throughout each lesson, finding creative ways to study materials, analyzed the results, and drafted the manuscript; Journal of Youth and Adolescence J.Y.A.F. helped with the development of the study materials, the Ellis, W. E., Dumas, T. M., & Forbes, L. M. (2020). Physically iso- coordination of the data collection, and assisted with the data analysis; lated but socially connected: psychological adjustment and stress R.M.R. participated in the study design and helped draft the manu- among adolescents during the initial COVID-19 crisis. Canadian script; C.E.R. helped design the study and draft the manuscript; E.L.O. Journal of Behavioural Science/Revue Canadienne des Sciences helped design the study materials, prepare the data, and draft the du Comportement, 52(3), 177. manuscript; and J.F. helped design the study materials and draft the Ellis, W. E., & Zarbatany, L. (2017). Understanding processes of peer manuscript. All authors have read and approved the submitted clique influence in late childhood and early adolescence. Child manuscript. Development Perspectives, 11(4), 227–232. Goldbeck, L., Schmitz, T. G., Besier, T., Herschbach, P., & Henrich, G. (2007). Life satisfaction decreases during adolescence. Quality Funding The Australian Research Council funded this research (grant of Life Research, 16(6), 969–979. number FL150100096). Gravetter, F., Wallnau, L., Forzano, L., & Witnauer, J. (2020). Essentials of statistics for the behavioral sciences (10 ed.). New Data Sharing and Declaration The datasets generated and/or analyzed York: Cengage Learning. during the current study are not publicly available but are available Hawke, L. D., Barbic, S. P., Voineskos, A., Szatmari, P., Cleverley, from the corresponding author upon reasonable request. K., Hayes, E., … Cheung, A. (2020). Impacts of COVID-19 on Youth Mental Health, Substance Use, and Well-being: A Rapid Compliance with Ethical Standards Survey of Clinical and Community Samples. The Canadian Journal of Psychiatry, 65(10), 701–709. https://doi.org/10.1177/ Conflict of Interest The authors declare that they have no conflict of Huang, Y., & Zhao, N. (2020). Generalized anxiety disorder, depressive interest. symptoms and sleep quality during COVID-19 outbreak in China: a web-based cross-sectional survey. Psychiatry Research, 288 Ethical Approval All procedures performed in studies involving (112954). https://doi.org/10.1016/j.psychres.2020.112954. human participants were in accordance with the ethical standards of Huebner, E. S. (1994). Preliminary development and validation of a the institutional and/or national research committee and with the 1964 multidimensional life satisfaction scale for children. Psychologi- Helsinki declaration and its later amendments or comparable ethical cal Assessment, 6(2), 149. standards. IBM Corp. (2019). IBM SPSS statistics software: SPSS statistics V26. Armonk, NY: IBM Corp. Informed Consent Informed consent was obtained from all parents of Judd, C. M., Kenny, D. A., & McClelland, G. H. (2001). Estimating youth participating in the study, and informed assent was obtained and testing mediation and moderation in within-subject designs. from all adolescents. Psychological Methods, 6(2), 115. Kenny, D. A. (2018). Moderator variables: introduction. http://davida Publisher’s note Springer Nature remains neutral with regard to kenny.net/cm/moderation.htm. jurisdictional claims in published maps and institutional affiliations. La Greca, A. M., & Harrison, H. M. (2005). Adolescent peer relations, friendships, and romantic relationships: do they predict social anxiety and depression? Journal of Clinical Child & Adolescent Psychology, 34(1), 49–61. https://doi.org/10.1207/s15374424jccp3401_5. References Lee, R. M., & Robbins, S. B. (1995). Measuring belongingness: the social connectedness and the social assurance scales. Journal of Angold, A., Costello, E. J., & Messer, S. C. (1995). Development of a Counseling Psychology, 42(2), 232. short questionnaire for use in epidemiological studies of depres- Loades, M. E., Chatburn, E., Higson-Sweeney, N., Reynolds, S., sion in children and adolescents. International Journal of Meth- Shafran, R., Brigden, A., & Crawley, E. (2020). Rapid systematic ods in Psychiatric Research, 5, 237–249. review: the impact of social isolation and loneliness on the mental Bailen, N. H., Green, L. M., & Thompson, R. J. (2019). Understanding health of children and adolescents in the context of COVID-19. emotion in adolescents: a review of emotional frequency, inten- Journal of the American Academy of Child and Adolescent sity, instability, and clarity. Emotion Review, 11(1), 63–73. Psychiatry, S0890-8567(0820), 30337–30333. https://doi.org/10. Brooks, S. K., Webster, R. K., Smith, L. E., Woodland, L., Wessely, 1016/j.jaac.2020.05.009. S., Greenberg, N., & Rubin, G. J. (2020). The psychological Manczak, E. M., Ordaz, S. J., Singh, M. K., Goyer, M. S., & Gotlib, I. impact of quarantine and how to reduce it: rapid review of the H. (2019). Time spent with parents predicts change in depressive evidence. The Lancet, 395(10227), 912–920. https://doi.org/10. symptoms in adolescents with major depressive disorder. Journal 1016/S0140-6736(20)30460-8. of Abnormal Child Psychology, 47(8), 1401–1408. https://doi. Casey, B. J., Jones, R. M., Levita, L., Libby, V., Pattwell, S. S., org/10.1007/s10802-019-00526-5. Ruberry, E. J., & Somerville, L. H. (2010). The storm and stress Meuwese, R., Cillessen, A. H. N., & Güroğlu, B. (2017). Friends in of adolescence: insights from human imaging and mouse genet- high places: a dyadic perspective on peer status as predictor of ics. Developmental psychobiology, 52(3), 225–235. https://doi. friendship quality and the mediating role of empathy and proso- org/10.1002/dev.20447. cial behavior. Social Development, 26(3), 503–519. https://doi. Chen, F., Zheng, D., Liu, J., Gong, Y., Guan, Z., & Lou, D. (2020). org/10.1111/sode.12213. Depression and anxiety among adolescents during COVID-19: a Montoya, A. K. (2019). Moderation analysis in two-instance repeated cross-sectional study. Brain, Behavior, and Immunity, 88,36–38. measures designs: probing methods and multiple moderator https://doi.org/10.1016/j.bbi.2020.05.061. models. Behavior Research Methods, 51(1), 61–82. https://doi. Connell, J. P., & Wellborn, J. G. (1991). Competence, autonomy, and org/10.3758/s13428-018-1088-6. relatedness: a motivational analysis of self-system Montoya, A. K., & Hayes, A. F. (2017). Two-condition within-parti- processes. In Self processes and development. (pp. 43–77). cipant statistical mediation analysis: a path-analytic framework. Hillsdale, NJ, US: Lawrence Erlbaum Associates, Inc. Psychological Methods, 22(1), 6. Journal of Youth and Adolescence interests include peer influences on adolescent mental health and the Pappa, S., Ntella, V., Giannakas, T., Giannakoulis, V. G., Papoutsi, E., impact of peer victimization and weight stigma on adolescent & Katsaounou, P. (2020). Prevalence of depression, anxiety, and wellbeing. insomnia among healthcare workers during the COVID-19 pan- demic: a systematic review and meta-analysis. Brain, Behavior, and Immunity, 88, 901–907. https://doi.org/10.1016/j.bbi.2020. 05.026. Justin Y. A. Freeman is a project officer at in the Department of Rapee, R. M., Oar, E. L., Johnco, C. J., Forbes, M. K., Fardouly, J., Psychology at Macquarie University. He has extensive experience Magson, N. R., & Richardson, C. E. (2019). Adolescent devel- running large scale longitudinal projects with adolescents and their opment and risk for the onset of social-emotional disorders: a families, and has a strong interest in adolescent mental health and review and conceptual model. Behaviour Research and Therapy, associated influencing factors. 123, 103501. https://doi.org/10.1016/j.brat.2019.103501. Richardson, C. E., Magson, N. R., Fardouly, J., Oar, E. L., Forbes, M. K., Johnco, C. J., & Rapee, R. M. (2020). Longitudinal asso- Ronald M. Rapee is a Distinguished Professor at the Centre for ciations between coping strategies and psychopathology in pre- Emotional Health, Macquarie University, Australia. His research adolescence. Journal of Youth and Adolescence. (in press). specializes in mental health, especially in anxiety and related disorders Rose, A. J., & Rudolph, K. D. (2006). A review of sex differences in across the lifespan and he is best known for his theoretical models of peer relationship processes: potential trade-offs for the emotional the development of anxiety disorders as well as for his creation of and behavioral development of girls and boys. Psychological empirically validated intervention programs. Bulletin, 132(1), 98. Somerville, L. H. (2013). The teenage brain: sensitivity to social evaluation. Current Directions in Psychological Science, 22(2), 121–127. Somerville, L. H., Jones, R. M., & Casey, B. (2010). A time of change: Cele E. Richardson is a Lecturer in the School of Psychological behavioral and neural correlates of adolescent sensitivity to Science and Centre for Sleep Science at The University of Western appetitive and aversive environmental cues. Brain and Cognition, Australia. Cele is also an honorary lecturer at the Centre for Emotional 72(1), 124–133. Health, Macquarie University and her research interests include Spence, S. H. (1998). A measure of anxiety symptoms among chil- adolescent sleep and mental health. dren. Behaviour Research and Therapy, 36(5), 545–566. Tamres, L. K., Janicki, D., & Helgeson, V. S. (2002). Sex differences in coping behavior: a meta-analytic review and an examination of relative coping. Personality and Social Psychology Review, 6(1), 2–30. https://doi.org/10.1207/s15327957pspr0601_1. Ella L. Oar is a Postdoctoral Research Fellow at the Centre for Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C. S., & Ho, R. C. Emotional Health, Macquarie University, Australia. Her research aims (2020). Immediate psychological responses and associated factors to better understand the factors underlying the development of anxiety during the initial stage of the 2019 coronavirus disease (COVID- and obsessive-compulsive disorders in addition to enhancing treatment 19) epidemic among the general population in China. Interna- outcomes and access for youth who suffer from these debilitating tional Journal of Environmental Research and Public Health, 17 conditions. (5), 1729. Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., McIntyre, R. S., … Sharma, V. K. (2020). A longitudinal study on the mental health of general population during the COVID-19 epidemic in China. Brain, Behavior, and Immunity. Jasmine Fardouly is a Postdoctoral Research Fellow at the Centre for Emotional Health, Macquarie University, Australia. Her research interests include social influences on the mental health of young Natasha R. Magson is a Postdoctoral Research Fellow at the Centre people, particularly the influence of social media use. for Emotional Health, Macquarie University, Australia. Her research

Journal

Journal of Youth and AdolescencePubmed Central

Published: Oct 27, 2020

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