COVID-19 stressors and symptoms of anxiety and depression in a community sample of children and adolescents.

BACKGROUND: The COVID-19 public health crisis has created abrupt and unparalleled disruptions to the daily lives of children and adolescents across the world, placing them at significant risk for developing symptoms of anxiety and depression. METHOD: The current study used two data collection periods to determine which types of COVID-19-related stressors were associated with the greatest risk of anxiety and depression symptoms in a community sample of children and adolescents in the United States (U.S.) from May-August 2020 (T1) to February-April 2021 (T2). Seventy-nine youth (ages 10-17; M = 13.41, SD = 2.10; 54.4% female) completed a battery of online standardized questionnaires about COVID-19 stress and psychiatric symptoms at T1 and 56 of these also participated at T2. RESULTS: The majority of children and adolescents reported experiencing the COVID-19-related stressors in multiple domains including daily routines, interpersonal relationships, education, finances, and health. A substantial proportion of the sample reported clinical levels of depression and anxiety symptoms at both T1 and T2. Multiple linear regression analyses revealed that, controlling for T1 anxiety and depression symptoms, T2 interpersonal stressors were significantly associated with elevated depression and anxiety scores at T2. CONCLUSIONS: The findings highlight the salience of social connection for children and adolescents, and may also underscore the risk associated with lockdown restrictions, social distancing, and school closures during the pandemic.

Coping with COVID-19 stress: Associations with depression and anxiety in a diverse sample of U.S. adults.

The COVID-19 pandemic has brought unprecedented levels of stress to individuals in the U.S. and throughout the world. These high stress levels place individuals at risk for symptoms of anxiety, depression, and other psychiatric disorders. The current study applies a control-based model of coping to contribute to the development of evidence-based interventions to promote resilience. Data were collected online from April 22 through July 12, 2020. Data from two samples of U. S. community adults who completed an online battery of standardized questionnaires were combined (N = 709). More than a quarter reported moderate to severe levels of depression symptoms, and more than one-fifth reported moderate to severe levels of anxiety symptoms; symptom levels were higher among adults who reported more COVID-19-related stress. As hypothesized, multiple regression analyses indicated that greater use of primary and secondary control coping was associated with lower symptom levels, whereas greater use of disengagement coping was associated with higher symptom levels, above and beyond the association of stress with symptoms. Race and ethnicity emerged as important moderators of these associations, indicating that what constitutes adaptive coping varies according to characteristics of the individual. Implications for public health policy and clinical practice are discussed. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12144-021-02444-6.

Sleep quality and COVID-19-related stress in relation to mental health symptoms among Israeli and U.S. adults.

OBJECTIVES: The COVID-19 virus has resulted not only in high rates of morbidity and mortality across the globe, but in widespread mental health problems and sleep disruption, likely as a result of pandemic-related stressors. The current study examines associations among COVID-related stress, sleep quality, and mental health. DESIGN: Cross-sectional data were collected via online surveys in May 2020. PARTICIPANTS: were 2541 community adults ages 18-70 from Israel (N = 1969) and the U.S. (N = 572). MEASUREMENT: Participants completed measures of COVID-related stress, sleep quality, and symptoms of anxiety, depression and adjustment disorder. RESULTS: Participants reported high rates of depression and anxiety symptoms, adjustment difficulties, and poor sleep quality. In both countries, COVID-related stressors were associated with both anxiety and depression, and these associations were mediated by sleep disturbances. CONCLUSIONS: These results support the role of sleep in mental health difficulties. Widespread, accessible, evidence-based interventions are urgently needed to improve health and mental health and to promote resilience in preparation for future global crises.

Comparison of two approaches to prevention of mental health problems in college students: Enhancing coping and executive function skills.

OBJECTIVE: College students face a significant number of stressors, increasing risk for internalizing and externalizing psychopathology. The current study examines two promising avenues of intervention aimed to reduce stress and prevent psychopathology in this population: a coping skills group and a cognitive training program. PARTICIPANTS: 62 undergraduate students from two universities were recruited from 2013 to 2015. METHODS: Students were randomized to a 6-week coping skills group or cognitive training program and completed measures of stress, coping, executive function, and symptoms of anxiety, depression and Attention-Deficit Hyperactivity Disorder (ADHD) at pre- and post-intervention. RESULTS: Participants in both conditions reported significant decreases in social stress, executive function difficulties, and anxiety symptoms post-intervention. Students in the cognitive program improved significantly more on measures of behavior regulation and ADHD symptoms compared to the coping group at post-intervention. CONCLUSIONS: Brief stress management interventions targeting coping and executive function may benefit college students at risk for psychopathology.

College students coping with interpersonal stress: Examining a control-based model of coping.

OBJECTIVE: The ways that college students cope with stress, particularly interpersonal stress, may be a critical factor in determining which students are at risk for impairing mental health disorders. Using a control-based model of coping, the present study examined associations between interpersonal stress, coping strategies, and symptoms. PARTICIPANTS: A total of 135 undergraduate students from 2 universities. METHODS: Interpersonal stress, coping strategies, depression, anxiety, and somatization were assessed via self-report. RESULTS: Students reporting more interpersonal stress reported more depression, anxiety, and somatization, and they reported less use of engagement coping strategies and greater use of disengagement coping strategies. Engagement coping strategies accounted for a significant portion of the association between interpersonal stress and mental health symptoms. Unexpectedly, coping strategies did not moderate the association between stress and mental health symptoms. CONCLUSION: Interventions designed to improve students' coping strategies may be an effective way to reduce mental health problems on college campuses.

Effects on children of treating their mothers' depression: results of a 12-month follow-up.

OBJECTIVE: This study used a controlled research design to examine the effects on children of treating their mothers' depression and of remission of the mothers' depression. METHOD: The sample consisted of 60 low-income women with major depression, who were predominantly from minority racial-ethnic groups, and their children ages four to 11. Women were randomly assigned to receive one of two active treatments (medication or cognitive-behavioral therapy) or a referral to existing community services. The mothers' depression was assessed by self-report on the Hamilton Depression Rating Scale, and the children's symptoms and adaptive skills were assessed by their mothers at baseline and six-month and 12-month follow-ups with the Behavior Assessment System for Children. RESULTS: Mixed-effects random intercept and random slope repeated-measures analyses using an intent-to-treat approach indicated that active treatment of mothers did not result in improvement in their children's behavior problems or adaptive skills. However, at both the six- and the 12-month follow-ups, children of mothers whose depression had remitted, regardless of treatment assignment, had significantly fewer behavior problems than children whose mothers remained depressed. CONCLUSIONS: The results support the need to expand access to, and support participation in, depression treatment among low-income women from minority racial-ethnic groups. Although treatment alone of this undertreated population was not associated with improvement in children's outcomes, it is a necessary first step to prevent psychopathology among offspring of depressed parents.

Test-order effects: a measure of verbal memory influences performance on a measure of verbal fluency.

In neuropsychological assessment, the impact of completing one measure on the performance of a second measure is often unknown. The current study examined the effect of a list-learning measure, the California Verbal Learning Test-Second Edition (CVLT-II), on a verbal fluency measure, the Delis-Kaplan Executive Functioning System Verbal Fluency subtest, when completed in a battery of tests. These tests were chosen because stimuli from the CVLT-II can function as responses for Verbal Fluency. Twenty-eight individuals seeking psychoeducational evaluation were randomly assigned to one of two test orders: the CVLT-II followed by Verbal Fluency, or the reverse order. Consistent with hypotheses, individuals who completed the CVLT-II first used more words from this task as responses on the various Verbal Fluency tasks, t(26) = 2.84, p = .009. In addition, they obtained higher raw scores and scaled scores on Category Fluency: t(26) = 3.01, p = .006, and t(26) = 2.53, p = .018, respectively. Surprisingly, the larger number of words produced on Category Fluency exceeded the number of CVLT-II words used as responses. These results suggest that clinicians should consider the order of administration when using these measures, and they indicate a need for further investigation of order effects.

Mental health of children of low-income depressed mothers: influences of parenting, family environment, and raters.

OBJECTIVE: This study examined the association of maternal depression with the emotional and behavioral problems and adaptive skills of four- to ten-year-old children as rated by their mothers, fathers, and teachers. METHODS: Eighty-four mothers had major depressive disorder, and 49 did not. They were predominantly African American or Latino and lived in low-income, urban communities. Mothers, fathers, and teachers reported on children's emotional and behavioral problems and adaptive functioning. Parenting behavior and family stress were examined as potential mediators, and generalized estimating equations were used to test mediation and to account for discrepancies in reports by different raters. RESULTS: According to the combined reports, children of mothers with depression had significantly poorer adaptive skills than children of sociodemographically similar mothers without depression; according to the reports of mothers and fathers, these children also had more emotional and behavioral problems. The quality of mothers' parenting mediated these associations, but measured family stressors did not. CONCLUSIONS: This study contributes to the scientific literature by demonstrating the effects of raters and testing mediators of maternal depression in low-income African-American and Latino families. It demonstrated that mothers, fathers, and teachers observed worse functioning among children of mothers with depression than without depression, although reporters' perspectives varied somewhat. The impact of maternal depression over and above that of poverty suggests the importance of developing and funding services to address the needs of affected families.

Childhood functional status, family stressors, and psychosocial adjustment among school-aged children with disabilities in the United States.

BACKGROUND: During the last 30 years, several studies have indicated that children with disabilities are at increased risk for emotional and behavioral morbidity. Population-based studies are needed to understand the relationship between functional status, family stressors, and the psychosocial adjustment of children with disabilities. METHODS: Using data from the 1994 and 1995 National Health Interview Surveys, Disability Supplement, this study examines the associations between children's functional status, family stressors, and the psychosocial adjustment of school-aged children with disabilities. RESULTS: Regression analyses indicate that children's functional impairments in the areas of communication or learning, poor maternal health and mental health, family burden, and poverty are significantly and positively associated with psychosocial maladjustment among children with disabilities. CONCLUSIONS: Children's functional activity limitations and family stressors are significant correlates of psychosocial adjustment among children with disabilities. These data indicate a need for routine screening for mental health problems among children with disabilities, as well as a family-oriented approach to their medical care.