From the Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia.
Epidemiology. 2025 Jan 1;36(1):28-39. doi: 10.1097/EDE.0000000000001798. Epub 2024 Oct 22.
"Positive epidemiology" emphasizes strengths and assets that protect the health of populations. Positive mental health refers to a range of social and emotional capabilities that may support adaptation to challenging circumstances. We examine the role of positive mental health in promoting adolescent health during the crisis phase of the COVID-19 pandemic.
We used four long-running Australian and UK longitudinal cohorts: Childhood to Adolescence Transition Study (CATS; analyzed N = 809; Australia); Longitudinal Study of Australian Children (LSAC) - Baby (analyzed N =1,534) and Kindergarten (analyzed N = 1,300) cohorts; Millennium Cohort Study (MCS; analyzed N = 2,490; United Kingdom). Measures included prepandemic exposure: positive mental health (parent reported, 13-15 years) including regulating emotions, interacting well with peers, and caring for others; and pandemic outcomes: psychological distress, life satisfaction, and sleep and alcohol use outside of recommendations (16-21 years; 2020). We used a two-stage meta-analysis to estimate associations between positive mental health and outcomes across cohorts, accounting for potential confounders.
Estimates suggest meaningful effects of positive mental health on psychosocial outcomes during the pandemic, including lower risk of psychological distress (risk ratio [RR] = 0.83, 95% confidence interval [CI] = 0.71, 0.97) and higher life satisfaction (RR = 1.1, 95% CI = 1.0, 1.2). The estimated effects for health behaviors were smaller in magnitude (sleep: RR = 0.95, 95% CI = 0.86, 1.1; alcohol use: RR = 0.97, 95% CI = 0.85, 1.1).
Our results are consistent with the hypothesis that adolescents' positive mental health supports better psychosocial outcomes during challenges such as the COVID-19 pandemic, but the relevance for health behaviors is less clear. These findings reinforce the value of extending evidence to include positive health states and assets.
“积极流行病学”强调了保护人群健康的优势和能力。积极的心理健康是指一系列社会和情感能力，这些能力可能有助于适应具有挑战性的环境。我们研究了积极心理健康在促进青少年在 COVID-19 大流行的危机阶段的健康方面所起的作用。
我们使用了四个澳大利亚和英国的长期纵向队列：青少年过渡期研究（CATS；分析 N = 809；澳大利亚）；澳大利亚儿童纵向研究（LSAC）-婴儿（分析 N = 1534）和幼儿园（分析 N = 1300）队列；千禧年队列研究（MCS；分析 N = 2490；英国）。测量包括大流行前的暴露：积极的心理健康（父母报告，13-15 岁），包括调节情绪、与同龄人良好互动和关心他人；以及大流行的结果：心理困扰、生活满意度和睡眠和饮酒超出建议（16-21 岁；2020 年）。我们使用两阶段荟萃分析来估计跨队列积极心理健康与结果之间的关联，考虑到潜在的混杂因素。
研究结果表明，积极的心理健康对大流行期间的心理社会结果有显著影响，包括降低心理困扰的风险（风险比 [RR] = 0.83，95%置信区间 [CI] = 0.71，0.97）和提高生活满意度（RR = 1.1，95% CI = 1.0，1.2）。健康行为的估计效果较小（睡眠：RR = 0.95，95% CI = 0.86，1.1；饮酒：RR = 0.97，95% CI = 0.85，1.1）。
我们的结果与假设一致，即青少年的积极心理健康有助于在 COVID-19 等挑战中获得更好的心理社会结果，但对健康行为的相关性不太明确。这些发现加强了将证据扩展到包括积极健康状态和资产的价值。
