Affect and mental health across the lifespan during a year of the COVID-19 pandemic: The role of emotion regulation strategies and mental flexibility.

During the COVID-19 pandemic, there has been a rise in common mental health problems compared to prepandemic levels, especially in young people. Understanding the factors that place young people at risk is critical to guide the response to increased mental health problems. Here we examine whether age-related differences in mental flexibility and frequency of use of emotion regulation strategies partially account for the poorer affect and increased mental health problems reported by younger people during the pandemic. Participants (N = 2,367; 11-100 years) from Australia, the UK, and US were surveyed thrice at 3-month intervals between May 2020 and April 2021. Participants completed measures of emotion regulation, mental flexibility, affect, and mental health. Younger age was associated with less positive (b = 0.008, p < .001) and more negative (b = -0.015, p < .001) affect across the first year of the pandemic. Maladaptive emotion regulation partially accounted for age-related variance in negative affect (ß = -0.013, p = .020), whereby younger age was associated with more frequent use of maladaptive emotion regulation strategies, which, in turn, was associated with more negative affect at our third assessment point. More frequent use of adaptive emotion regulation strategies, and in turn, changes in negative affect from our first to our third assessment, partially accounted for age-related variance in mental health problems (ß = 0.007, p = .023). Our findings add to the growing literature demonstrating the vulnerability of younger people during the COVID-19 pandemic and suggest that emotion regulation may be a promising target for intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The effect of intolerance of uncertainty on anxiety and depression, and their symptom networks, during the COVID-19 pandemic.

Individuals vary in their ability to tolerate uncertainty. High intolerance of uncertainty (the tendency to react negatively to uncertain situations) is a known risk factor for mental health problems. In the current study we examined the degree to which intolerance of uncertainty predicted depression and anxiety symptoms and their interrelations across the first year of the COVID-19 pandemic. We examined these associations across three time points (May 2020 - April 2021) in an international sample of adults (N = 2087, Mean age = 41.13) from three countries (UK, USA, Australia) with varying degrees of COVID-19 risk. We found that individuals with high and moderate levels of intolerance of uncertainty reported reductions in depression and anxiety symptoms over time. However, symptom levels remained significantly elevated compared to individuals with low intolerance of uncertainty. Individuals with low intolerance of uncertainty had low and stable levels of depression and anxiety across the course of the study. Network analyses further revealed that the relationships between depression and anxiety symptoms became stronger over time among individuals with high intolerance of uncertainty and identified that feeling afraid showed the strongest association with intolerance of uncertainty. Our findings are consistent with previous work identifying intolerance of uncertainty as an important risk factor for mental health problems, especially in times marked by actual health, economic and social uncertainty. The results highlight the need to explore ways to foster resilience among individuals who struggle to tolerate uncertainty, as ongoing and future geopolitical, climate and health threats will likely lead to continued exposure to significant uncertainty.

Social and cognitive vulnerability to COVID-19-related stress in pregnancy: A case-matched-control study of antenatal mental health.

Emerging evidence shows that compared to pre-pandemic norms pregnant women report significant increases in clinical levels of depressive and anxiety symptoms during COVID-19. This pre-registered study examined cognitive and social vulnerability factors for poor mental health in pregnancy during COVID-19. Understanding vulnerability profiles is key to identifying women at risk for deteriorating peripartum mental health. N = 742 pregnant women and N = 742 age and country-matched controls from the COVID-19 Risks Across the Lifespan Study were included. Using a case-match control design allowed us to explore whether the cognitive vulnerability profiles would differ between pregnant and non-pregnant women. The findings showed that COVID-19-related stress was associated with heightened levels of depression and anxiety during pregnancy. Its impact was greatest in women with cognitive (i.e., higher intolerance of uncertainty and tendency to worry) and social (i.e., higher level of self-reported loneliness) vulnerabilities. Importantly, our data show that the mental health impacts of the pandemic were greater in pregnant women compared to women who were not pregnant, especially those with cognitive and social vulnerabilities. The results highlight the urgent need to prioritize mental health care for pregnant women to mitigate the impact of COVID-19-related stress on women's postpartum mental health and their infants' well-being.

Social determinants of mental health during a year of the COVID-19 pandemic.

Belonging is a basic human need, with social isolation signaling a threat to biological fitness. Sensitivity to ostracism varies across individuals and the lifespan, peaking in adolescence. Government-imposed restrictions upon social interactions during COVID-19 may therefore be particularly detrimental to young people and those most sensitive to ostracism. Participants (N = 2367; 89.95% female, 11-100 years) from three countries with differing levels of government restrictions (Australia, UK, and USA) were surveyed thrice at three-month intervals (May 2020 - April 2021). Young people, and those living under the tightest government restrictions, reported the worst mental health, with these inequalities in mental health remaining constant throughout the study period. Further dissection of these results revealed that young people high on social rejection sensitivity reported the most mental health problems at the final assessment. These findings help account for the greater impact of enforced social isolation on young people's mental health, and open novel avenues for intervention.

Tracking Mental Wellbeing of Dutch Adolescents During the First Year of the COVID-19 Lockdown: A Longitudinal Study.

PURPOSE: Adolescents might be susceptible to the effects of the COVID-19 lockdown. We assessed changes in mental wellbeing throughout the first year of the pandemic and compared these with prepandemic levels. METHODS: This five-wave prospective study among Dutch adolescents aged 12-17 years used data collected before the pandemic (n = 224) (T0), in May (T1), July (T2), and October 2020 (T3), and in February 2021 (T4). Generalized estimating equations were used to assess the association between stringency of the lockdown with mental wellbeing. RESULTS: Adolescents had a lower life satisfaction during the first full lockdown (T1) [adjusted ß: -0.36, 95% confidence interval (CI): -0.58 to -0.13], during the partial lockdown (T3) (adjusted ß: -0.37, 95% CI: -0.63 to -0.12), and during the second full lockdown (T4) (adjusted ß: -0.79, 95% CI: -1.07 to -0.52) compared to before the pandemic (T0). Adolescents reported more internalizing symptoms during only the second full lockdown (T4) (adjusted ß: 2.58, 95% CI: 0.41-4.75). During the pandemic [at T1 (adjusted ß: 0.29, 95% CI: 0.20-0.38), T2 (adjusted ß: 0.36, 95% CI: 0.26-0.46), T3 (adjusted ß: 0.33, 95% CI: 0.22-0.45), and T4 (adjusted ß: 0.20, 95% CI: 0.07-0.34)], adolescents reported a better psychosomatic health, partly attributable to less trouble falling asleep (p < .01). DISCUSSION: The COVID-19 lockdown measures have had both a negative and positive impact on mental wellbeing of Dutch adolescents. However, mental wellbeing was most impacted during the second full lockdown compared to before the pandemic.

Gender-Specific Changes in Life Satisfaction After the COVID-19-Related Lockdown in Dutch Adolescents: A Longitudinal Study.

PURPOSE: The purposes of this study were to assess whether mental well-being has changed after introduction of the lockdown measures compared with that before, whether this change differs between boys and girls, and whether this change is associated with COVID-19-related concerns. METHODS: This is a two-wave prospective study among Dutch adolescents using data collected up to one year before the COVID-19 pandemic (n = 224) and 5-8 weeks after the first introduction of lockdown measures (n = 158). Mental well-being was assessed by three indicators: life satisfaction, internalizing symptoms, and psychosomatic health. General linear model repeated-measures analysis of variance was used to assess whether mental well-being has changed and if this differed by sex. Univariate linear regressions were used to assess associations between COVID-19-related concerns and a change in mental well-being. RESULTS: Life satisfaction decreased (η2p = .079, p < .001), but no change in internalizing symptoms was observed (η2p = .014, p = .14), and psychosomatic health increased (η2p = .194, p < .001) after the introduction of lockdown measures. Boys scored significantly better on all mental health indicators compared with girls at baseline and follow-up. However, boys' life satisfaction significantly decreased at the follow-up (η2p = .038, p = .015), whereas girls' life satisfaction did not change. Concerns about COVID-19 were significantly associated with a lower life satisfaction and more internalizing symptoms. CONCLUSIONS: Adolescents', especially boys', life satisfaction decreased during the lockdown. They reported no change in internalizing symptoms and an improved psychosomatic health. Adolescents' mental well-being is expected to vary during the COVID-19 pandemic and should continue to be monitored.

REACT study protocol: resilience after the COVID-19 threat (REACT) in adolescents.

INTRODUCTION: COVID-19-related social isolation and stress may have significant mental health effects, including post-traumatic stress, anxiety and depression. These factors are thought to disproportionately affect populations at risk of psychopathology, such as adolescents with a history of childhood adversity (CA). Therefore, examining which factors may buffer the impact of COVID-19-related stress and isolation in vulnerable adolescents is critical. The Resilience After the COVID-19 Threat (REACT) study assesses whether emotion regulation capacity, inflammation and neuroimmune responses to stress induced in the laboratory prior to the pandemic predict responses to COVID-19-related social isolation and stress in adolescents with CA. We aim to elucidate the mechanisms that enable vulnerable adolescents to maintain or regain good mental health when confronted with COVID-19. METHODS AND ANALYSIS: We recruited 79 adolescents aged 16-26 with CA experiences from the Resilience After Individual Stress Exposure study in which we assessed emotion regulation, neural and immune stress responses to an acute stress task. Our sample completed questionnaires at the start of the UK lockdown ('baseline'; April 2020) and three (July 2020) and 6 months later (October 2020) providing crucial longitudinal information across phases of the pandemic progression and government response. The questionnaires assess (1) mental health, (2) number and severity of life events, (3) physical health, (4) stress perception and (5) loneliness and friendship support. We will use multilevel modelling to examine whether individual differences at baseline are associated with responses to COVID-19-related social isolation and stress. ETHICS AND DISSEMINATION: This study has been approved by the Cambridge Psychology Research Ethics Committee (PRE.2020.037). Results of the REACT study will be disseminated in publications in scientific peer-reviewed journals, presentations at scientific conferences and meetings, publications and presentations for the general public, and through social media.