Long-term effects of the COVID-19 pandemic on children’s mental health in the ABCD study cohort

The purpose of this study was to investigate the impact of the COVID-19 pandemic on children’s mental health and the impact of parental involvement during the pandemic. We used long-term observational data from a large sample of ABCD studies. A total of 4885 children were analyzed in the study, adjusted for PMQ scores, and analyzed for changes in CBCL scores before and after the onset of the pandemic. suggests that it has a negative impact. We also found that the degree of child-parent involvement and parenting style impacted children’s mental health, even in the face of a pandemic. For each, interpret the results obtained below.

First, we hypothesized that the COVID-19 pandemic would exacerbate children’s mental health problems over time. The results of this study support our hypothesis. An emotional problem exacerbated by this pandemic was depression.The findings are consistent with previous research, showing that depressive symptoms in children are exacerbated by the COVID-19 pandemic^{30,31,32,33,34,35}as in adults^35,36,37However, withdrawn/depressive behaviors went from a pre-pandemic average of 53.4 ± 5.7 to 53.7 ± 5.9 since the start of the pandemic, a change of only 0.3. Moreover, these values ​​are within the normal range before and during the COVID-19 pandemic. The exacerbation of children’s depressive tendencies was statistically significant, but the magnitude of exacerbation was clinically minor. Therefore, caution should be exercised in interpreting these results. Second, this change was similar for attention, which was clinically slightly worse. Mean values ​​for attention problems went from 53.4 ± 5.4 pre-pandemic to 53.6 ± 5.6 after the start of the pandemic.Interestingly, the results of our study did not reveal any effects on anxiety or physical ill health. I am^38,39Instead, it reportedly reduced emotional problems in children aged 11-16 in the UK.³⁸A longitudinal study of about 1000 children in the UK reported a significant reduction in anxiety overall.³⁹These results are consistent with our findings that the COVID-19 pandemic does not affect children’s anxiety. Moreover, our findings showed that children’s behavioral problems were not affected by the pandemic. This result is consistent with the results of an online cross-sectional study of her 1264 children (aged 2–6 years) and their caregivers from her two primary schools in Hubei, China.⁴⁰Thus, mental health issues such as anxiety and behavioral problems common in children appeared to be largely unaffected by the pandemic.

In addition, we investigated whether there were differences in mental health changes between children who already experienced severe symptoms before the pandemic and those who did not. Interestingly, all mental health symptoms improved significantly during the pandemic, even when mental health symptoms were severe at first. This improvement trend may be a regression to the mean. Therefore, it should be interpreted with caution. Nonetheless, the findings may indicate that children who initially had interpersonal problems moved away from the community, had fewer interpersonal problems, and had improved mental health. . Previous studies have reported that children perceive home isolation positively rather than negatively, which reduces psychological distress and increases life satisfaction.⁴¹In contrast, children who did not cross the cutoff pre-pandemic had worse mental health during the pandemic, with the exception of rule-breaking behavior.The interaction between lifestyle changes and the psychosocial stress of staying at home may exacerbate the negative effects on children’s mental health.³⁹. however, t– CBCL had a maximum score of less than 1 point. Considering that, t– If the scores are in the normal range, it’s possible that the pandemic had little effect on children whose mental health was initially stable.Most children are functioning at the same or better levels since the pandemic and are satisfied with their current living conditions⁴¹.

We then tested the hypothesis that parental involvement acts as a protective factor for children’s mental health, even during a pandemic. Parental involvement had a positive impact on children’s mental health, emotional and behavioral aspects. In particular, frequent parent-child conversations and higher parental understanding of the child’s condition decreased rule violations, and when such involvement was weaker, the child’s depression and aggressive behavior increased. A cross-sectional study of 1655 parents and children in China found that parental attitudes and intimacy with children were positively correlated with children’s mental and behavioral health.^{twenty one}These results are consistent with our research showing that parenting styles have a significant impact on children’s mental health.Our study is a large longitudinal study of children living in the United States, which has the highest number of COVID-19 cases⁴²To our knowledge, this is the first time that parental involvement has been shown to affect the mental health of children in the United States. increase.Early detection and care of children’s mental health problems can prevent them from getting worse⁴³The findings may indicate that parents and caregivers influence children’s mental health.

In particular, analysis of each PMQ subitem shows that when children communicate clearly with their parents about their school plans and activities with their peers, they commit less rule violations. In contrast, less disclosure is associated with increased depression. In other words, you may need to communicate frequently and fully about your daily life, not just the negative aspects.Frequent conversations about pandemics and expressions of unpleasant emotions affect children’s externalizing and internalizing symptoms⁴⁴Rumination was positively associated with depressive symptoms in children aged 9 and 12⁴⁵Those who were less optimistic about the start of the pandemic had a higher risk of depressive symptoms than those who were not⁴⁶Encouraging parents to communicate more fully with their children and consider positive aspects may therefore prevent deterioration of mental health during the pandemic.

Although our findings greatly benefit this research area, our study has limitations. First, we set March 1, 2020 as the start date of his COVID-19 pandemic, and analyzed subjects who agreed to provide follow-up data for his third year after March 1, 2020. However, the period from March 1, 2020 to the actual date of data acquisition will vary by subject. That is, the impact of the pandemic period at the time of data collection was not taken into account. Also, whether there were various restrictions such as lockdowns and social interactions during these periods may vary depending on where you live. The impact of the pandemic on children’s mental health may be different during the early stages of the pandemic than during its progression and recovery. In the future, it may be necessary to consider the accumulation of chronological data, including that mechanism. Next, we examined whether there was a difference between participants with and without year 3 data. Those with no 3-year data were found to have slightly higher CBCL scores. Therefore, if the analysis included people who withdrew from the study, there may have been some improvement in overall children’s mental health. We investigated mental health and used child assessments to explore the extent of parental involvement. In the future, both child and parent reports should be included to ensure data accuracy.

In conclusion, the results of this study indicate that the COVID-19 pandemic may slightly exacerbate depression and attention problems in children. On the other hand, if mental health symptoms were severe before the pandemic, all mental health symptoms improved during the crisis. Moreover, even during the global public health crisis caused by COVID-19, positive parent-child relationships have a protective impact on the mental health of US adolescents. Therefore, increasing parent-child involvement is important for children’s overall mental health, even during the COVID-19 pandemic.