Pathways of association between disordered eating in adolescence and mental health outcomes in young adulthood during the COVID-19 pandemic.

OBJECTIVES: The COVID-19 pandemic has been associated with increased mental health problems. We investigated (1) associations between disordered eating in adolescence and mental health problems after one year of the pandemic and (2) the mechanisms explaining associations. METHOD: We analyzed data from a population-based birth cohort in Quebec, Canada (557 males and 759 females). High and low levels of disordered eating symptom trajectories were previously estimated (age 12, 15, 17, and 20 years). Anxiety, depression, non-suicidal self-injury, and suicidal ideation were assessed at 23 years (March-June 2021). Putative mediators included loneliness and social media use (age 22 years, July-August 2020). Analyses controlled for mental health and socio-economic status at age 10-12 years and were conducted for males and females separately. RESULTS: Females in the high-level disordered eating symptom trajectory were at increased risk for non-suicidal self-injury (OR 1.60; 95% CI 1.02-2.52) and suicidal ideation (2.16; 1.31-3.57), whereas males were at increased risk for severe anxiety (2.49; CI 1.11-5.58). Males and females in the high-level trajectory were more likely to report severe depression (2.26; 1.14-5.92 and 2.15, 1.36-3.38 respectively). Among females, associations were partially explained (17-35%) by loneliness during the first 4 months of the pandemic. CONCLUSION: Young adults who experienced disordered eating as adolescents were at increased risk of mental health problems during the pandemic. Loneliness partially mediated the effect, suggesting that pandemic mitigation resulting in increased social isolation may have exacerbated mental health problems among women with a history of disordered eating.

RéSUMé: OBJECTIFS: La pandémie de COVID-19 a été associée à une augmentation des problèmes de santé mentale. Nous avons investigué 1) les associations entre les problèmes de comportement alimentaire à l'adolescence et les problèmes de santé mentale après un an de pandémie et 2) les mécanismes expliquant les associations. MéTHODE: Nous avons analysé les données d'une cohorte de naissance basée sur la population au Québec, Canada (557 hommes et 759 femmes). Nous avons utilisé des trajectoires précédemment estimées indicatives d'un haut et bas niveau de problèmes alimentaires (à l'âge de 12, 15, 17 et 20 ans). L'anxiété, la dépression, l'automutilation et les idées suicidaires ont été évaluées à 23 ans (mars à juin 2021). Les médiateurs putatifs incluaient la solitude et l'utilisation des réseaux sociaux (à l'âge de 22 ans, juillet à août 2020). Les analyses contrôlaient la santé mentale et le statut socio-économique à l'âge de 10 à 12 ans et ont été menées séparément pour les hommes et les femmes. RéSULTATS: Les femmes dans la trajectoire des problèmes alimentaires élevés présentaient un risque accru d'automutilation non-suicidaire (OR 1,60; IC à 95 % 1,02-2,52) et d'idées suicidaires (2,16; 1,31-3,57), tandis que les hommes présentaient un risque accru d'anxiété sévère (2,49; IC 1,11-5,58). Les hommes et les femmes de la trajectoire élevée étaient plus susceptibles de déclarer une dépression grave (2,26; 1,14-5,92 et 2,15; 1,36-3,38, respectivement). Chez les femmes, les associations s'expliquaient en partie (17-35 %) par la solitude durant les 4 premiers mois de la pandémie. CONCLUSION: Les jeunes adultes ayant connu des problèmes de comportement alimentaire à l'adolescence couraient un risque accru de problèmes de santé mentale pendant la pandémie. La solitude a partiellement atténué l'effet, suggérant que l'isolation accrue entrainée par la pandémie peut avoir exacerbé les problèmes de santé mentale chez les femmes ayant des antécédents de problèmes de comportement alimentaire.

Protocol for the Open Sky School: a two-arm clustered randomized controlled trial to test the effectiveness of a nature-based intervention on mental health of elementary school children.

BACKGROUND: This article outlines the protocol for a trial to test the effectiveness of a nature-based intervention called Open Sky School to reduce mental health problems among elementary school children. Experimental studies show that contact with nature (e.g. walks in parks) improve mental health. A growing number of teachers have been applying outdoor education within the regular school curriculum and evidence suggests that such teaching methods could improve students' mental health but a randomized controlled trial has never been conducted. METHODS: A two-arm clustered randomized controlled trial will be conducted in elementary schools across Québec, Canada. Following informed consent by teachers, parents and students, schools will be randomly assigned 1:1 to the intervention or the control group with a total of 2500 5-6th grade students and 100 teachers expected to participate. The intervention will take place outdoors in a green-space (2 h per week for 12 weeks) and include a toolkit of 30 activities to foster well-being (e.g. mindfulness) and academic competencies (e.g. mathematics). Questionnaires will be administered to teachers and students before, immediately after and 3 months after the intervention. The primary outcome will be reductions of mental health problems in children from pre-to-post test (Social Behavior Questionnaire: self and teacher reports). Secondary outcomes include depression, positive and negative affect, nature connectedness, and pro-environmental behaviors among children. We will explore, immediate benefits on teacher's well-being and positive and negative affect and sustained benefits among students at 3 months follow-up. For the primary outcome, we will explore moderators including child's sex, child's disability status, the green-space of neighbourhoods, the school's socio-economic position and teacher's experience. DISCUSSION: In conducting the first randomized controlled trial of the Open Sky School, our results could provide empirical evidence on the effectiveness of nature-based interventions in reducing mental health problems among elementary school children. TRIAL REGISTRATION: This study was registered with clinicaltrials.gov: NCT05662436 on December 22, 2022.

Parental loneliness, parental stress and child mental health during the COVID-19 pandemic: Variations by cumulative socioeconomic risk.

Background: The COVID-19 pandemic has raised concerns about parent and child mental health, especially within disadvantaged families. However, little is known about how parental stress and loneliness during the pandemic influenced their children and no studies have investigated if these associations could vary by socioeconomic status. Methods: In July to September 2021, a large representative sample of parents (N = 4,524) in Québec (Canada) reported on aspects of their own mental health and that of their 9-10 year old child. Outcome variables were child externalizing and internalizing symptoms. Exposure variables were changes in parental loneliness and parental stress since the onset of the pandemic. The moderator variable was cumulative socioeconomic risk. Multiple linear regression analyses were executed and adjusted for confounding factors. Results: Child internalizing symptoms were associated with higher levels of parental stress (ß = 0.14, p<.001) and loneliness (ß = 0.23, p<.001). Child externalizing symptoms were also associated with parental stress (ß = 0.13, p<.001) and loneliness (ß = 0.18, p<.001). Most of these associations were stronger within the most disadvantaged households. Limitations: The cross-sectional design does not allow interpretations about causality. Conclusions: Increases in parental stress and loneliness since the onset of the COVID-19 pandemic would be detrimental to parent and child mental health. As these issues were amplified within families experiencing more socioeconomic adversities, our results can inform public policy to support families in times of crisis and direct resources to those most in need.

Disrupting times in the wake of the pandemic: Dispositional time attitudes, time perception and temporal focus.

Introduction: The COVID-19 pandemic has majorly disrupted many aspects of people's lives, provoking psychosocial distress among students. People's positive and negative attitudes towards the past, present and future were a dispositional pre-COVID-19 reality. Faced with a pandemic, people have reported disruptions in the speed of passing time. People can shift their attention more towards the past, present or future when major changes in society occur. These aspects of psychological time would be key to understanding the quality of psychosocial adjustment to the pandemic. We hypothesized that dispositional time attitudes impact psychosocial distress because they would trigger situational changes in our time perception and temporal focus. Methods: One hundred and forty-four university students in Uruguay responded to self-report questionnaires online while in-person classes were cancelled. Students reported on shifts in temporal focus, changes in time awareness and dispositional time attitudes. Reactive psychological, social and learning environment distress were reported. Results: Students reported substantial changes in time perception and temporal focus. A correlation matrix showed significant relationships between time attitudes, focus and awareness. For example, psychological distress was correlated with negative time attitudes, slower passage of time, boredom, blurred sense of time and shifting focus to the past. Mediation models were derived. The indirect effect of time attitudes on psychological distress was significant through past focus. Discussion: Dispositional time attitudes would impact students' capacity to cope with the pandemic. Situational shifts in temporal focus and perception were prevalent and can be viewed as temporal coping mechanisms in the wake of powerful societal change. Our mediation models showed that those with negative time attitudes experienced more psychological distress because they shifted their attention to the past. Future directions for research and practical implications are discussed.

School readiness losses during the COVID-19 outbreak. A comparison of two cohorts of young children.

The COVID-19 context has created the most severe disruption to education systems in recent history. Its impact on child development was estimated comparing two cohorts of 4- to 6-year-old Uruguayan children: control (n = 34,355, 48.87% girls) and COVID cohort (n = 30,158, 48.95% girls) assessed between 2018 and 2020 in three waves, by a routinely administered school readiness instrument in public preschools. Ethnicity information is not available. For the COVID cohort, losses were observed in Motor and Cognitive development, Attitudes towards learning, and Internalizing behavior (range 0.13 - 0.27 SD). Losses were less pronounced among children from higher socioeconomic schools. These results extend the literature on the consequences of the pandemic on learning and early child development.