Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, VA, USA.
Children's National Hospital, George Washington University, Washington, DC, USA.
J Child Psychol Psychiatry. 2021 Sep;62(9):1132-1139. doi: 10.1111/jcpp.13382. Epub 2021 Feb 4.
The impact of chronic stressors like the COVID-19 pandemic is likely to be magnified in adolescents with pre-existing mental health risk, such as attention-deficit/hyperactivity disorder (ADHD). This study examined changes in and predictors of adolescent mental health from before to during the COVID-19 pandemic in the Southeastern and Midwestern United States.
Participants include 238 adolescents (132 males; ages 15-17; 118 with ADHD). Parents and adolescents provided ratings of mental health symptoms shortly before the COVID-19 pandemic and in spring and summer 2020.
Adolescents on average experienced an increase in depression, anxiety, sluggish cognitive tempo, inattentive, and oppositional/defiant symptoms from pre-COVID-19 to spring 2020; however, with the exception of inattention, these symptoms decreased from spring to summer 2020. Adolescents with ADHD were more likely than adolescents without ADHD to experience an increase in inattentive, hyperactive/impulsive, and oppositional/defiant symptoms. Adolescents with poorer pre-COVID-19 emotion regulation abilities were at-risk for experiencing increases in all mental health symptoms relative to adolescents with better pre-COVID-19 emotion regulation abilities. Interactive risk based on ADHD status and pre-COVID-19 emotion regulation abilities was found for inattention and hyperactivity/impulsivity, such that adolescents with ADHD and poor pre-COVID-19 emotion regulation displayed the highest symptomatology across timepoints. Lower family income related to increases in inattention but higher family income related to increases in oppositional/defiant symptoms.
The early observed increases in adolescent mental health symptoms during the COVID-19 pandemic do not on average appear to be sustained following the lift of stay-at-home orders, though studies evaluating mental health across longer periods of time are needed. Emotion dysregulation and ADHD increase risk for sustained negative mental health functioning and highlight the need for interventions for these populations during chronic stressors. Results and clinical implications should be considered within the context of our predominately White, middle class sample.
在新冠疫情这样的慢性应激源下，原本就有心理健康风险的青少年，比如患有注意力缺陷多动障碍（ADHD）的青少年，其心理健康受到的影响可能会被放大。本研究在美国东南部和中西部，调查了青少年在新冠疫情前和疫情期间心理健康状况的变化及其预测因素。
参与者包括 238 名青少年（男性 132 名；年龄 15-17 岁；118 名患有 ADHD）。家长和青少年在新冠疫情前和 2020 年春季和夏季，对心理健康症状进行了评估。
青少年的抑郁、焦虑、认知迟钝、注意力不集中和对立/反抗症状，平均而言，从新冠疫情前到 2020 年春季有所增加；然而，除了注意力不集中，这些症状从春季到夏季有所下降。与没有 ADHD 的青少年相比，患有 ADHD 的青少年更有可能出现注意力不集中、多动/冲动和对立/反抗症状增加。与新冠疫情前情绪调节能力较好的青少年相比，情绪调节能力较差的青少年更容易出现所有心理健康症状的增加。基于 ADHD 状态和新冠疫情前情绪调节能力的交互风险，发现了注意力不集中和多动/冲动的情况，即 ADHD 合并新冠疫情前情绪调节能力差的青少年，在所有时间点的症状最严重。较低的家庭收入与注意力不集中的增加有关，而较高的家庭收入与对立/反抗症状的增加有关。
在新冠疫情期间，青少年心理健康症状的早期观察到的增加，在居家令解除后平均来看似乎并未持续，但需要研究评估更长时间的心理健康状况。情绪失调和 ADHD 增加了持续负面心理健康功能的风险，强调了在慢性应激源下，这些人群需要进行干预。结果和临床意义应在我们以白人、中产阶级为主的样本背景下进行考虑。
