Changes in Internalizing Symptoms During the COVID-19 Pandemic in a Transdiagnostic Sample of Youth: Exploring Mediators and Predictors

Child Psychiatry Hum Dev. 2024 Feb;55(1):206-218. doi: 10.1007/s10578-022-01382-z. Epub 2022 Jul 6.

Abstract

The COVID-19 pandemic is a chronically stressful event, particularly for youth. Here, we examine (i) changes in mood and anxiety symtpoms, (ii) pandemic-related stress as a mediator of change in symptoms, and (ii) threat processing biases as a predictor of increased anxiety during the pandemic. A clinically well-characterized sample of 81 youth ages 8-18 years (M = 13.8 years, SD = 2.65; 40.7% female) including youth with affective and/or behavioral psychiatric diagnoses and youth without psychopathology completed pre- and during pandemic assessments of anxiety and depression and COVID-related stress. Forty-six youth also completed a threat processing fMRI task pre-pandemic. Anxiety and depression significantly increased during the pandemic (all ps < 0.05). Significant symptom change was partially mediated by pandemic stress and worries. Increased prefrontal activity in response to neutral faces pre-pandemic was associated with more intense parent-reported anxiety during the pandemic (all Fs(1.95,81.86) > 14.44, ps < 0.001). The present work extends existing knowledge on the mediating role of psychological stress on symptoms of anxiety and depression in youth.

Trial registration: ClinicalTrials.gov NCT00006177 NCT00025935 NCT00018057 NCT02531893.

Keywords: Anxiety; Children and adolescence; Depression; Stress; Threat bias; fMRI.

Publication types

  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Anxiety / diagnosis
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology
  • Anxiety Disorders / psychology
  • COVID-19*
  • Depression / diagnosis
  • Depression / epidemiology
  • Depression / psychology
  • Female
  • Humans
  • Male
  • Pandemics*
  • Psychopathology

Associated data

  • ClinicalTrials.gov/NCT00006177
  • ClinicalTrials.gov/NCT00025935
  • ClinicalTrials.gov/NCT00018057
  • ClinicalTrials.gov/NCT02531893