Perceived stress, worries and changes in interpersonal relationships during the COVID-19 pandemic: Psychopathological and cognitive precursors in a 10-year youth cohort

Aims: to investigate if mental disorders and cognitive performance are associated with interpersonal behaviours and negative emotions among youth during the COVID-19 pandemic. Method(s): This work is part of the Brazilian High-Risk Cohort for Mental Conditions (BHRC), which included 6-12 years-old children at baseline (Year 2010) who participated in an online COVID-19 wave (N = 1.144). Outcomes were factor socres from specifc sections of the international Coronavirus Health and Impact Survey (relationship changes, stress, and concerns related to COVID-19). A structured interview (DAWBA, DSM-IV) assessed externalizing and internalizing disorders. Cognitive predictors were IQ and executive function assessed at baseline. We used Generalized Linear Models adjusting for sex and socioeconomic variables. First, higher IQ (B = 0.0032;t = 2.714;p = .006) and any internalizing disorder prior to the pandemic (B = 0.0902;t = 2.228;p = .026) were associated with higher perceived stress during the pandemic. Second, any externalizing disorder (B = -0.1449;t = -2.066;p = .039) was linked with lower levels of COVID-19-related worries, whilst higher performance in executive function tasks was associated with higher levels (B = 0.1803;t = 4.796;p = .001). Third, higher IQ was linked with negative changes in interpersonal relationships (B = -0.0007;t = -3.371;p = .0007). Conclusion(s): This study showed that lifetime externalizing and internalizing disorders, in addition to cognitive variables at lifetime externalizing and internalizing disorders, in addition to cognitive variables at an early age, were associated with distinct mental health outcomes during the COVID-19 pandemic.

High screen time and internalizing and externalizing behaviours among children aged 3 to 14 years during the COVID-19 pandemic in France.

Children's screen time increased as a result of the COVID-19 pandemic. In the summer of 2021, we explored the association between high screen time over a period of one year since May 2020 and behavioural problems among children and adolescents. The data were derived from the French EpiCov cohort study, collected in spring 2020, autumn 2020, and spring 2021. Participants (N = 1089) responded to online or telephone interviews about one of their children aged 3 to 14 years. Screen time was categorized as high if the daily mean screen time exceeded recommendations at each collection time. The Strengths and Difficulties Questionnaire (SDQ) was completed by parents to identify internalizing (emotional or peer problems) and externalizing (conduct problems or hyperactivity/inattention) behaviours in their children. Among the 1,089 children, 561 (51.5%) were girls, the average age was 8.6 years (SD 3.7). Internalizing behaviours: High screen time was not associated with internalizing behaviours (OR [95% CI] 1.20 [0.90-1.59]) or emotional symptoms (1.00 [0.71-1.41]) while it was associated with peer problems (1.42 [1.04-1.95]). Externalizing behaviours: High screen time was associated with externalizing problems (1.63 [1.01-2.63]) and conduct problems (1.91 [1.15-3.22]) only among older children aged 11 to 14 years. No association with hyperactivity/inattention was found. In a French cohort, exploration of persistent high screen time in the first year of the pandemic and behaviour difficulties in Summer 2021 resulted in mixed findings according to behaviour's type and children's age. These mixed findings warrant further investigation into screen type and leisure/school screen use to enhance future pandemic responses appropriate for children.

Quaranteens: Prepandemic relationship quality and changes in adolescent internalizing problems during the COVID-19 pandemic.

This preregistered longitudinal study examined changes in adolescents' depressive and anxiety symptoms before and during the COVID-19 pandemic using latent additive piece-wise growth models. It also assessed whether support from and conflict with mothers, fathers, siblings, and best friends explained heterogeneity in change patterns. One hundred and ninety-two Dutch adolescents (Mean age: 14.3 years; 68.8% female) completed online biweekly questionnaires for a year (November 2019-October 2020), consisting of a prepandemic, lockdown, and reopening phase. Depressive symptoms increased following the lockdown and decreased upon reopening. Anxiety symptoms showed an immediate decrease followed by a gradual increase in the reopening phase. Prepandemic family and best friend support and conflict did not explain heterogeneity in depressive and anxiety symptoms during the COVID-19 pandemic.

The Grow It! app-longitudinal changes in adolescent well-being during the COVID-19 pandemic: a proof-of-concept study.

Adolescent mental health and well-being have been adversely impacted by the COVID-19 pandemic. In this preregistered longitudinal study, we evaluated whether adolescents' well-being improved after playing the multiplayer serious game app Grow It! During the first lockdown (May-June 2020), 1282 Dutch adolescents played the Grow It! app (age = 16.67, SD = 3.07, 68% girls). During the second lockdown (December-May 2020 onwards), an independent cohort of 1871 adolescents participated (age = 18.66, SD = 3.70, 81% girls). Adolescents answered online questionnaires regarding affective and cognitive well-being, depressive symptoms, anxiety, and impact of COVID-19 at baseline. Three to six weeks later, the baseline questionnaire was repeated and user experience questions were asked (N = 462 and N = 733 for the first and second cohort). In both cohorts, affective and cognitive well-being increased after playing the Grow It! app (t = - 6.806, p < 0.001; t = - 6.77, p < 0.001; t = - 6.12, p < 0.001; t = - 5.93, p < 0.001; Cohen's d range 0.20-0.32). At the individual level, 41-53% of the adolescents increased in their affective or cognitive well-being. Adolescents with higher risk profiles (i.e., more depressive symptoms, lower atmosphere at home, and more COVID-19 impact) improved more strongly in their well-being. Positive user evaluations and app engagement were unrelated to changes in affective and cognitive well-being. This proof-of-concept study tentatively suggests that Grow It! supported adolescents during the pandemic.

Testing an integrated dimensional model of adverse childhood experiences: Associations with COVID-19 outcomes.

BACKGROUND: Adverse childhood experiences (ACEs) are a salient risk factor for a myriad of negative outcomes. Extant theoretical and empirical models traditionally quantify the impact of ACEs using cumulative representations. Recent conceptualizations challenge this framework and theorize that the types of ACEs children are exposed to differentially impacts their future functioning. OBJECTIVE: The current study tested an integrated ACEs model using parent-report of child ACEs across four aims: (1) characterize heterogeneity in child ACEs using a latent class analysis (LCA); (2) examine mean level class differences in COVID specific and COVID non-specific environmental factors (i.e., COVID impact, ineffective parenting, effective parenting) and internalizing and externalizing problems during the COVID pandemic; (3) test interactions between COVID impact and ACEs classes in predicting outcomes, and (4) compare a cumulative risk approach to a class membership approach. PARTICIPANTS AND SETTING: A nationally representative sample of U.S. parents (N = 796; 51.8 % fathers, M age = 38.87 years, 60.3 % Non-Hispanic White) completed a cross-sectional survey about themselves and one child (5-16 years old) between February-April 2021. METHOD: Measures of child's ACEs history, COVID impact, effective and ineffective parenting, and children's internalizing and externalizing problems were completed by parents. RESULTS: A LCA demonstrated three distinct classes of ACEs reflecting low-risk, trauma-risk, and environmental-risk classes. In general, the trauma-risk class had more negative COVID-19 outcomes than the other classes (small to large effect sizes). CONCLUSIONS: The classes differentially related to outcomes, providing support for dimensions of ACEs and emphasizing the distinct types of ACEs.

Peer victimization, schooling format, and adolescent internalizing symptoms during the COVID-19 pandemic: Between- and within-person associations across ninth grade.

The current longitudinal study examined how between-person (BP) differences and within-person (WP) fluctuations in adolescents' peer victimization and schooling format across ninth grade related to changes in their internalizing symptoms during the COVID-19 pandemic. Participants were 388 adolescents (61% female; Mage = 14.02) who completed three online surveys, administered 3 months apart, from November 2020 to May 2021. Multilevel modeling revealed BP (time-invariant) and WP (time-varying) effects of peer victimization and school instructional format (i.e., in-person; hybrid; online) on internalizing symptoms while accounting for potentially confounding demographic (e.g., gender) and contextual (e.g., COVID-19 positivity rates) factors. Results indicated that adolescents who experienced higher overall levels of peer victimization across the school year, compared to those who experienced lower victimization, reported more severe internalizing symptoms. Whereas relative WP increases in peer victimization predicted corresponding increases in adolescents' depressive and somatic symptoms regardless of schooling format, WP increases in peer victimization only predicted elevated anxiety during months when students attended fully in-person, but not online, school. Adolescents who spent a greater proportion of their school year attending online school also reported less peer victimization across the year. Findings highlight WP fluctuations in the effects of peer victimization on internalizing and contextual variations depending on schooling format.

The Risk-Taking and Self-Harm Inventory for Adolescents: Validation of the Italian Version (RTSHIA-I).

The aim of the present paper is to establish the factorial validity and reliability of the Risk-Taking and Self-Harm Inventory for Adolescents (RTSHIA), proposed by Vrouva and colleagues in 2010, in an Italian sample. The RTSHIA measures both Risk-Taking and Self-Harm behavior in adolescents. We administered the scale to a total of 1292 Italian adolescents from 9th to 12th grade; to verify the validity of the scale, we also assessed emotion regulation and psychopathological traits. The exploratory factor analysis (EFA) (N = 638) and the confirmatory factor analysis (CFA) (N = 660) confirmed the original two-factor structure of the RTSHIA (Risk-Taking and Self-Harm). The only differences in the Italian version of the RTSHIA (RTSHIA-I) were that one item was moved from the original Risk-Taking factor to the Italian Self-Harm factor, and another item that was not included in the original RTSHIA is now part of the Risk-Taking factor in the Italian version. The reliability of the RTSHIA-I is also confirmed, and both factors correlate with emotion regulation and externalizing/internalizing traits. Our results suggest that the RTSHIA-I is a useful tool for assessing Risk-Taking and Self-Harm behaviors in Italian adolescents, and the correlational patterns indicate that these behaviors may be related to difficulties in mentalization skills.

Pathways to Children's Behavioral Problems during the COVID-19 Pandemic: Fathers' Parenting Stress and Parenting Approaches.

Although the family stress model theoretically focuses on the roles of both mothers and fathers as predictors of children's outcomes, studies generally have focused on mothers. The pandemic has brought additional burdens to parents' daily functioning, including fathers' involvement in childcare. The current study aimed to examine the contributions of fathers' parenting stress and parenting approaches to their children's behavior problems during the COVID-19 pandemic. Particularly, we examined the indirect effects of parenting stress on children's behavior problems via parenting practices. The participants were 155 fathers (Mage = 36.87, SD = 5.11) and their children (71 girls, 84 boys; Mage = 59.52, SD = 14.98) from Turkish contexts. The fathers reported their parenting stress, approaches, and children's behavioral problems. The results from the path analysis showed that parenting stress predicted children's internalizing and externalizing behaviors. Parenting stress also predicted severe punishment and obedience as parts of the parenting approach. Finally, parenting stress was indirectly related to children's externalizing behaviors via the punishment-based parenting approach of fathers. The findings of the current study highlighted the importance of examining the roles of fathers during the COVID-19 pandemic. Intervention programs targeting reducing fathers' parenting stress and negative parenting approaches would also be beneficial for reducing children's behavioral problems.

Pre-existing parental stress and youth internalizing symptoms predict parent-reported COVID-related stress in military families

Understanding the extent to which youth and families experienced COVID-related stress requires accounting for prior levels of stress and other associated factors. This is especially important for military families, which experience unique stressors and may be reluctant to seek outside help. In this prospective study, we examined the role of pre-pandemic family factors in predicting parent and youth stress during the COVID-19 pandemic. Participants were 234 families with at least one active-duty parent and a 3rd or 5th-grade child. Findings revealed that preexisting factors predicted youth and family COVID-related stress. Specifically, heightened pre-pandemic parental stress and youth internalizing symptoms were significant predictors of COVID-related stress. Implications for mental health professionals and other organizations supporting military parents and families during the COVID-19 pandemic as well as other times of upheaval are discussed. © 2023 Division 19 (Society for Military Psychology) of the American Psychological Association.

Perfectionism and internalized symptoms in university students: The mediating and moderating role of perceived social support

Psychological health among students was an important issue even before the Covid-19 crisis. University students are exposed to high levels of psychological stress. Among the dimensions studied with student psychological well-being, perfectionism is increasingly explored in the literature. While perfectionism can be adaptive, it can also be a source of vulnerability to stress when expectations and aspirations exceed the student's resources. Furthermore, the literature has repeatedly shown the role of social support in good psychological health. The present study investigates the mediating and moderating effects of social support on the relationship between perfectionism (self-oriented and socially prescribed) and internalizing symptoms (anxiety and depression) in university students. Longitudinal data were collected at three measurement times among 60 undergraduate students from the University of Montreal. First, correlational analyses showed that socially prescribed perfectionism was related to anxiety symptoms at Time 1 and Time 3, as well as to depressive symptoms at Time 1. Second, perceived social support was negatively associated with anxiety and depressive symptoms. Linear regression analyses did not show that self-oriented perfectionism and socially prescribed perfectionism are associated with increased anxiety and depressive symptoms over time. Third, mediation analyses fail to show that social support mediates the relationship between perfectionism and students' internalized symptoms. Finally, moderation analyses fail to confirm the role of social support as a moderator of the relationship between perfectionism and symptoms of anxiety and depression. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (French) La sante psychologique etudiante constituait deja un enjeu important avant meme l'avenement de la crise liee a la Covid-19. Les etudiants universitaires sont exposes a des niveaux de stress psychologique eleves. Parmi les dimensions etudiees en lien avec le bien-etre psychologique etudiant, le perfectionnisme est de plus en plus explore dans la litterature. Bien que le perfectionnisme puisse etre adaptatif, il peut aussi constituer un facteur de vulnerabilite au stress lorsque les attentes et les aspirations depassent les ressources de l'etudiant. Par ailleurs, la litterature a montre a plusieurs reprises le role du soutien social pour une bonne sante psychologique. La presente etude porte sur les effets mediateur et moderateur du soutien social sur la relation entre le perfectionnisme (oriente vers soi et prescrit socialement) et les symptomes interiorises (anxiete et depression) chez des etudiants universitaires. Des donnees longitudinales ont ete recueillies a trois temps de mesure aupres de 60 etudiants au baccalaureat a l'Universite de Montreal. Dans un premier temps, les analyses correlationnelles ont montre que le perfectionnisme prescrit socialement est lie aux symptomes anxieux au temps 1 et au temps 3, ainsi qu'aux symptomes depressifs au temps 1. Le soutien social percu est associe negativement aux symptomes anxieux et depressifs. Des analyses de regression lineaire n'ont pas montre que le perfectionnisme oriente vers soi et le perfectionnisme prescrit socialement sont associes a une augmentation des symptomes anxieux et depressifs a travers le temps. Des analyses de mediation ne permettent pas de montrer que le soutien social joue un role mediateur sur la relation entre le perfectionnisme et les symptomes interiorises des etudiants. Enfin, des analyses de moderation ne permettent pas de confirmer le role du soutien social comme moderateur du lien entre le perfectionnisme et les symptomes d'anxiete et de depression. (PsycInfo Database Record (c) 2023 APA, all rights reserved) Impact Statement (French) Plusieurs etudes ont montre que les etudiants universitaires presentent des niveaux eleves de detresse psychologique (anxiete et depression);Le perfectionnisme est associe a des niveaux eleves de detresse psychologique chez les etudiants universitaires, surtout le perfectionnisme prescrit socialement (qui provient des autres);Les etudiants qui beneficient d'un bon soutien social montrent moins de symptomes de depression et d'anxiete. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Examining links between social withdrawal subtypes and internalizing problems among Italian primary school children

The study aimed to explore links between social withdrawal subtypes and internalizing problems among children during the COVID-19 pandemic. Participants were N = 748 children (387 girls) aged 7–11 years (M = 8.91, SD = 1.07) attending primary schools in Italy. Children completed an online questionnaire assessing subtypes of social withdrawal (i.e., shyness, social avoidance, unsociability) and indices of internalizing problems (i.e., social anxiety, loneliness, depression). Among the results, shyness was positively associated with social anxiety, depression, and loneliness. Unsociability was related to depression but not to social anxiety and loneliness. Social avoidance was positively related to loneliness and depression (particularly among older children) and negatively associated with social anxiety (particularly among boys). Results are also discussed in terms of the implications of the different subtypes of social withdrawal in late childhood and early adolescence.

Interactive Relationship between Mentalization, Epistemic Trust, Emotion Dysregulation and Psychopathology Risk: An Exploration in Non-Clinical Adolescents

Introduction: Mentalization is the ability to interpret one's own behaviour, as well as the behaviours of others, as caused by intentional inner mental states. It has been theoretically linked to resilience;indeed, thinking about actions in terms of mental states enables people to manage both everyday problems. Under the umbrella of mentalizing theory, growing interest has recently emerged in the concept of Epistemic Trust. Epistemic Trust is defined as the ability to evaluate incoming information from the social world as accurate, reliable, and relevant. The opening of Epistemic Trust allows the individual to assimilate information into existing knowledge domains. Recently, Luyten et al. (2020) theorized that complex trauma might disrupt the development of the capacity for epistemic Trust. Campbell et al. (2021) highlighted the mediating role of epistemic mistrust (i.e., the rigid suspiciousness toward incoming knowledge) and epistemic credulity (i.e., the inability to discriminate between trustworthy and untrustworthy information) in the association between childhood adverse experiences and psychopathological outcomes. In addition, focusing on adolescent inpatients, Orme et al. (2019) found negative associations between epistemic Trust and borderline traits. During the COVID-19 lockdown was found a protective role of Mentalization and epistemic Trust in contrast to dysregulation and perceived stress in adolescence (Locati et al., 2022). Thus, it is possible to hypothesize that both mentalizing capacity and epistemic Trust play protective roles in reducing the risk of developing psychopathology, but further evidence of these associations is needed. This study aims to investigate the relationship between mentalizing and stress, exploring how challenging circumstances interact with adolescent mentalizing capacity. This study sought to examine how Mentalization and epistemic trust were recruited in regulating and coping with emotional distress and psychopathological diseases by non-clinical adolescents. Method(s): Participants were 482 non-clinical adolescents (204 Males e 278 Females), aged between 12 and 19 years (M=15,59, DS=2,05). Adolescents were assessed using the Reflective Functioning Questionnaire for Youth, Epistemic Trust Mistrust Credulity Questionnaire, Difficulties in Emotion Regulation Scale and Youth Self Report. By means of ANOVA we test the effect of age on Mentalization and epistemic Trust (Trust, Mistrust and Credulity). We hypothesized to find a positive effect on Mentalization, but not on epistemic Trust. We performed a network analysis in order to explore the relationship between Mentalization and epistemic trust (Trust, Mistrust and Credulity), psychopathology (internalizing and externalizing), emotion dysregulation and age. Result(s): Developmental trends reveal a positive effect of age on Mentalization, Trust and Mistrust, but not on Credulity. Network analysis showed that both Trust and Mentalization are negatively associated with emotion dysregulation and externalizing problems. In addition, Trust is linked with Mentalization. On the other hand, Mistrust is positive associated with Dysregulation and Psychopathology (internalizing and externalizing problems), while Credulity is positive association only with emotion dysregulation. Conclusion(s): First, these findings underline the presence of a developmental dynamic that involves not only Mentalization but also Epistemic Trust in its Trust and Mistrust domains. These findings suggest the idea of epistemic Trust as a developmental construct that may be negotiated in the relationship with the social context, that in adolescence became challenging from the childhood phase. Nevertheless, Credulity domain may represent a different trend, maybe already defined during infancy. Moreover, these findings suggest that trust and the capacity to mentalize contrast emotional dysregulation. However, robust levels of epistemic Trust and Mentalization may have acted as protective factors that buffered psychopathology risk. Network analysis confirms the rel tionship between mistrust and credulity and psychopathological risks and emotion dysregulation, with a stronger effect of Mistrust on both internalizing and externalizing symptoms and a hidden effect of Credulity on emotion dysregulation. These findings may inform clinical treatment and prevention in adolescence, confirming the resilient role of Trust and Mentalization in contrast to externalizing behaviour risk. On the other hand, Mistrust may reveal a critical maintenance factor of internalizing behaviour problems.

Relationship between mental health diagnoses and COVID-19 test positivity, hospitalization, and mortality in Southeast Wisconsin.

BACKGROUND: There is a paucity of literature on the relationship between pre-existing mental health conditions and coronavirus disease-2019 (COVID-19) outcomes. The aim was to examine the association between pre-existing mental health diagnosis and COVID-19 outcomes (positive screen, hospitalization, mortality). METHODS: Electronic medical record data for 30 976 adults tested for COVID-19 between March 2020 and 10th July 2020 was analyzed. COVID-19 outcomes included positive screen, hospitalization among screened positive, and mortality among screened positive and hospitalized. Primary independent variable, mental health disorders, was based on ICD-10 codes categorized as bipolar, internalizing, externalizing, and psychoses. Descriptive statistics were calculated, unadjusted and adjusted logistic regression and Cox proportional hazard models were used to investigate the relationship between each mental health disorder and COVID-19 outcomes. RESULTS: Adults with externalizing (odds ratio (OR) 0.67, 95%CI 0.57-0.79) and internalizing disorders (OR 0.78, 95% CI 0.70-0.88) had lower odds of having a positive COVID-19 test in fully adjusted models. Adults with bipolar disorder had significantly higher odds of hospitalization in fully adjusted models (OR 4.27, 95% CI 2.06-8.86), and odds of hospitalization were significantly higher among those with externalizing disorders after adjusting for demographics (OR 1.71, 95% CI 1.23-2.38). Mortality was significantly higher in the fully adjusted model for patients with bipolar disorder (hazard ratio 2.67, 95% CI 1.07-6.67). CONCLUSIONS: Adults with mental health disorders, while less likely to test positive for COVID-19, were more likely to be hospitalized and to die in the hospital. Study results suggest the importance of developing interventions that incorporate elements designed to address smoking cessation, nutrition and physical activity counseling and other needs specific to this population to improve COVID-19 outcomes.

Siblings in lockdown: International evidence for birth order effects on child adjustment in the Covid19 pandemic

Supportive family relationships may mitigate the impact of the Covid19 pandemic on young children's adjustment, but existing work is limited by its focus on within-country variation and parental influences. Addressing these gaps, and drawing on reported buffering effects of older siblings on child mental health (Lawson and Mace, 2010), the current international study examined whether child adjustment problems were, on average, elevated by the pandemic and whether this buffering effect of older siblings would be maintained. In the first wave of the Covid19 pandemic (April to July 2020), 2516 parents of 3- to 8-year-old children living in Australia, China, Italy, Sweden, United Kingdom, and United States of America—six countries with contrasting governmental responses to the pandemic—completed an online survey about family experiences and relationships and child adjustment, as indexed by ratings on the Strengths and Difficulties Questionnaire (SDQ: R. Goodman, 1997). As expected, child SDQ total difficulty scores were elevated in all sites except Sweden (which notably did not enforce mass school closures). Compared to children without siblings, children with one or more older siblings showed fewer adjustment problems. Children from lone-parent households displayed more adjustment problems, as did those whose parents reported increased sibling conflict. Finally, child adjustment problems were negatively associated with family socio-economic status, but positively related to the indices of Covid-19 family disruption and government stringency. We discuss these findings in relation to existing work on asymmetric effects of older versus younger siblings, and siblings as sources of support. © 2023 The Authors. Social Development published by John Wiley & Sons Ltd.

Risk Factors for Pediatric Anxiety Disorders.

This review summarizes risk factors for developing anxiety disorders in children and adolescents. A surfeit of risk factors, including temperament, family environment (eg, parenting style), environmental exposures (eg, particulate matter), and cognitive factors (eg, threat bias), increases the risk of anxiety in children. These risk factors can significantly impact the trajectory of pediatric anxiety disorders. The impact of severe acute respiratory syndrome coronavirus 2 infection on anxiety disorders in children is discussed in addition to its public health implications. Identifying risk factors for pediatric anxiety disorders creates a scaffold for the development of prevention strategies and for reducing anxiety-related disability.

Mental Health and Physical Complaints of German Children and Adolescents before and during the COVID-19 Pandemic: A Repeated Cross-Sectional Study.

The potential impact of the COVID-19 pandemic on young people's mental and physical health is of increasing concern. We examined the levels of internalizing and externalizing problem behavior and physical complaints before and during the COVID-19 pandemic in Germany. Data came from a repeated cross-sectional study on child and youth health in schools in Germany. Assessments took place from November to February each year. Two data collections were conducted before the COVID-19 pandemic in 2018-2019 and in 2019-2020. Collections during the pandemic took place in 2020-2021 and 2021-2022. A total of 63,249 data observations were included in the analyses. Multilevel analyses were used to examine temporal trends in mean emotional problems (e.g., often unhappy, downhearted), hyperactivity-inattention (e.g., constantly fidgeting or squirming), conduct problems (e.g., fights with other children), and physical complaints. Models were adjusted for age, gender, school type, socioeconomic status, and sensation seeking. During the COVID-19 pandemic, children and adolescents in Germany experienced an increase in emotional problems from the pre-pandemic cohort 2019-2020 to the pandemic cohort 2021-2022 (ß = 0.56, 95% CI (0.51-0.62)) and, over the course of the pandemic, reported elevated levels of physical complaints (ß = 0.19, 95% CI (0.16-0.21)). Findings of increased emotional problems and physical complaints after the two years of the pandemic support the ongoing demand for low-threshold health promotion and prevention and the need for further monitoring of young people's health in Germany.

Gender and Racial/Ethnic Disparities in Undergraduate and Graduate Students' Mental Health and Treatment Use Amid the COVID-19 Pandemic.

The COVID-19 pandemic has negatively impacted numerous people?s mental health and created new barriers to services. To address the unknown effects of the pandemic on accessibility and equality issues in mental health care, this study aimed to investigate gender and racial/ethnic disparities in mental health and treatment use in undergraduate and graduate students amid the COVID-19 pandemic. The study was conducted based on a largescale online survey (N = 1,415) administered during the weeks following a pandemic-related university-wide campus closure in March 2020. We focused on the gender and racial disparities in current internalizing symptomatology and treatment use. Our results showed that in the initial period of the pandemic, students identified as cis women (p < .001), non-binary/genderqueer (p < .001), or Hispanic/Latinx (p = .002) reported higher internalizing problem severity (aggregated from depression, generalized anxiety, intolerance of uncertainty, and COVID-19-related stress symptoms) compared to their privileged counterparts. Additionally, Asian (p < .001) and multiracial students (p = .002) reported less treatment use than White students while controlling for internalizing problem severity. Further, internalizing problem severity was associated with increased treatment use only in cisgender, non-Hispanic/Latinx White students (pcis man = 0.040, pcis woman < 0.001). However, this relationship was negative in cis-gender Asian students (pcis man = 0.025, pcis woman = 0.016) and nonsignificant in other marginalized demographic groups. The findings revealed unique mental health challenges faced by different demographic groups and served as a call that specific actions to enhance mental health equity, such as continued mental health support for students with marginalized gender identities, additional COVID-related mental and practical support for Hispanic/Latinx students and promotion of mental health awareness, access, and trust in non-White, especially Asian, students are desperately needed.

The impact of the COVID-19 pandemic on psychiatric emergency consultations in adolescents.

BACKGROUND: There is growing evidence that the COVID-19 pandemic, and its associated social distancing measures, affect adolescents' mental health. We wanted to examine whether and how the number and characteristics of adolescents' psychiatric emergency presentations have changed throughout the pandemic. METHODS: We extracted data from the records of 977 psychiatric emergency consultations of adolescents aged 12- 19 who had been referred to the mobile psychiatric emergency services in Rotterdam, the Netherlands between January 1st 2018 and January1st 2022. Demographic, contextual, and clinical characteristics were recorded. Time-series-analyses were performed using quasi-Poisson Generalized Linear Model to examine the effect of the first and second COVID-19 lockdown on the number of psychiatric emergency consultations, and to explore differences between boys and girls and internalizing versus externalizing problems. RESULTS: The number of psychiatric emergency consultations regarding adolescents increased over time: from about 13 per month in 2018 to about 29 per month in 2021. During the COVID-19 pandemic, the increase was tempered. In the second wave a pronounced increase of psychiatric emergencies among adolescents with internalizing problems but not with externalizing problems was found. CONCLUSION: Despite the reported increase of mental health problems in adolescents during the COVID-19 pandemic, we did find a smaller increase in psychiatric emergency consultations in this group then would be expected considering the overall trend. Besides changes in help-seeking and access to care, a possible explanation may be that a calmer, more orderly existence, or more parental supervision led to less psychiatric emergency situations in this age group. In the second wave the number of emergency consultations increased especially among girls with internalizing problems. While there has been a particular fall in emergency referrals of adolescents with externalizing problems since the start of the pandemic it is still too early to know whether this is a structural phenomenon. It would be important to elucidate whether the changes in emergency referrals reflect a true change in prevalence of urgent internalizing and externalizing problems in adolescents during the pandemic or a problem related to access to care.

Longitudinal Relations Between Emotion Regulation and Internalizing Symptoms in Emerging Adults During the Covid-19 Pandemic.

Background: Maladaptive and adaptive emotion regulation are putative risk and protective factors for depression and anxiety, but most prior research does not differentiate within-person effects from between-person individual differences. The current study does so during the early part of the Covid-19 pandemic when internalizing symptoms were high. Methods: A sample of emerging adult undergraduate students (N = 154) completed online questionnaires bi-weekly on depression, anxiety, and emotion regulation across eight weeks during the early days of the Covid-19 pandemic (April 2nd to June 27th, 2020). Results: Depression demonstrated significantly positive between-person correlations with overall maladaptive emotion regulation, catastrophizing, and self-blame, and negative correlations with overall adaptive emotion regulation and reappraisal. Anxiety demonstrated significantly positive between-person correlations with overall maladaptive emotion regulation, rumination, and catastrophizing, and a negative correlation with reappraisal. After controlling for these between-person associations, however, there were generally no within-person associations between emotion regulation and internalizing symptoms. Conclusions: Emotion regulation and internalizing symptoms might be temporally stable individual differences that cooccur with one another as opposed to having a more dynamic relation. Alternatively, these dynamic mechanisms might operate over much shorter or longer periods compared to the two-week time lag in the current study. Supplementary Information: The online version contains supplementary material available at 10.1007/s10608-023-10366-9.

Students' Perceptions of COVID-19 Stress and Internalizing Problems: Is Social Support a Buffer?

The current study investigated the associations among student perceptions of COVID-19 stress, internalizing problems, and school social support (teacher and classmate support) and how these relations differed across elementary/middle and high school students. Based on data from 526 4th- through 12th-grade students from a school district in the Northeast, we found that COVID-19-related stress was significantly related to internalizing problems for all students, regardless of grade level. We also found that teacher social support, but not classmate social support, buffered the positive relation between COVID-19 stress and internalizing problems. The results of the current study have implications for school psychologists, counselors, social workers, and other educators in alleviating COVID-19-related stress in students and associated symptoms of internalizing problems in students. As the pandemic unwinds, future research should examine the long-term impacts of the COVID-19 pandemic, especially for students with marginalized identities, and how teacher and/or peer support may play a role in buffering these stressors for students.