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      Rumination as a Mechanism of the Longitudinal Association Between COVID-19-Related Stress and Internalizing Symptoms in Adolescents

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          Abstract

          The current prospective longitudinal study evaluated brooding rumination as an intervening mechanism of the association between COVID-19-related stress and internalizing symptoms during the first year of the pandemic. Attention-deficit/hyperactivity disorder (ADHD) status and adolescent sex were tested as moderators of the indirect effect. Adolescents with and without ADHD ( N = 238; M age = 16.74) completed rating scales of COVID-19 stress and both adolescents and parents completed ratings scales of internalizing symptoms in May/June 2020 (T1). In October/November 2020 (T2), adolescents reported on their brooding rumination. Adolescents and parents reported on internalizing symptoms again in March/April 2021 (T3). Covariates included participant characteristics and baseline symptoms. T1 self-reported COVID-19-related stress was associated with increased T3 self-reported anxiety ( ab = 0.10), self-reported depression ( ab = 0.07), and parent-reported depression ( ab = 0.09) via T2 brooding rumination. The indirect effect did not differ for adolescents with and without ADHD or for female and male adolescents. Brooding rumination may be one mechanism to target to promote the mental health adjustment of adolescents during periods of high stress of the COVID-19 pandemic and future stressors.

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          Rapid Systematic Review: The Impact of Social Isolation and Loneliness on the Mental Health of Children and Adolescents in the Context of COVID-19

          Maria Loades, Eleanor Chatburn, Nina Higson-Sweeney … (2020)
          Objective Disease containment of COVID-19 has necessitated widespread social isolation. We aimed to establish what is known about how loneliness and disease containment measures impact on the mental health in children and adolescents. Method For this rapid review, we searched MEDLINE, PSYCHINFO, and Web of Science for articles published between 01/01/1946 and 03/29/2020. 20% of articles were double screened using pre-defined criteria and 20% of data was double extracted for quality assurance. Results 83 articles (80 studies) met inclusion criteria. Of these, 63 studies reported on the impact of social isolation and loneliness on the mental health of previously healthy children and adolescents (n=51,576; mean age 15.3) 61 studies were observational; 18 were longitudinal and 43 cross sectional studies assessing self-reported loneliness in healthy children and adolescents. One of these studies was a retrospective investigation after a pandemic. Two studies evaluated interventions. Studies had a high risk of bias although longitudinal studies were of better methodological quality. Social isolation and loneliness increased the risk of depression, and possibly anxiety at the time loneliness was measured and between 0.25 to 9 years later. Duration of loneliness was more strongly correlated with mental health symptoms than intensity of loneliness. Conclusion Children and adolescents are probably more likely to experience high rates of depression and probably anxiety during and after enforced isolation ends. This may increase as enforced isolation continues. Clinical services should offer preventative support and early intervention where possible and be prepared for an increase in mental health problems.
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            Responses to depression and their effects on the duration of depressive episodes.

            Susan Nolen-Hoeksema (1991)
            I propose that the ways people respond to their own symptoms of depression influence the duration of these symptoms. People who engage in ruminative responses to depression, focusing on their symptoms and the possible causes and consequences of their symptoms, will show longer depressions than people who take action to distract themselves from their symptoms. Ruminative responses prolong depression because they allow the depressed mood to negatively bias thinking and interfere with instrumental behavior and problem-solving. Laboratory and field studies directly testing this theory have supported its predictions. I discuss how response styles can explain the greater likelihood of depression in women than men. Then I intergrate this response styles theory with studies of coping with discrete events. The response styles theory is compared to other theories of the duration of depression. Finally, I suggest what may help a depressed person to stop engaging in ruminative responses and how response styles for depression may develop.
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              Risk and Protective Factors for Prospective Changes in Adolescent Mental Health during the COVID-19 Pandemic

              Natasha R. Magson, Justin Freeman, Ronald M. Rapee … (2020)
              The restrictions put in place to contain the COVID-19 virus have led to widespread social isolation, impacting mental health worldwide. These restrictions may be particularly difficult for adolescents, who rely heavily on their peer connections for emotional support. However, there has been no longitudinal research examining the psychological impact of the COVID-19 pandemic among adolescents. This study addresses this gap by investigating the impact of the COVID-19 pandemic on adolescents’ mental health, and moderators of change, as well as assessing the factors perceived as causing the most distress. Two hundred and forty eight adolescents (M age  = 14.4; 51% girls; 81.8% Caucasian) were surveyed over two time points; in the 12 months leading up to the COVID-19 outbreak (T1), and again two months following the implementation of government restrictions and online learning (T2). Online surveys assessed depressive symptoms, anxiety, and life satisfaction at T1 and T2, and participants’ schooling, peer and family relationships, social connection, media exposure, COVID-19 related stress, and adherence to government stay-at-home directives at T2 only. In line with predictions, adolescents experienced significant increases in depressive symptoms and anxiety, and a significant decrease in life satisfaction from T1 to T2, which was particularly pronounced among girls. Moderation analyses revealed that COVID-19 related worries, online learning difficulties, and increased conflict with parents predicted increases in mental health problems from T1 to T2, whereas adherence to stay-at-home orders and feeling socially connected during the COVID-19 lockdown protected against poor mental health. This study provides initial longitudinal evidence for the decline of adolescent’s mental health during the COVID-19 pandemic. The results suggest that adolescents are more concerned about the government restrictions designed to contain the spread of the virus, than the virus itself, and that those concerns are associated with increased anxiety and depressive symptoms, and decreased life satisfaction.
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                Author and article information

                Contributors
                Joseph W. Fredrick:
                ORCID: https://orcid.org/0000-0003-4617-8552
                joseph.fredrick@cchmc.org
                Journal
                Journal ID (nlm-ta): Child Psychiatry Hum Dev
                Journal ID (iso-abbrev): Child Psychiatry Hum Dev
                Title: Child Psychiatry and Human Development
                Publisher: Springer US (New York )
                ISSN (Print): 0009-398X
                ISSN (Electronic): 1573-3327
                Publication date (Electronic): 8 September 2022
                Pages: 1-10
                Affiliations
                [1 ]GRID grid.239573.9, ISNI 0000 0000 9025 8099, Division of Behavioral Medicine and Clinical Psychology, , Cincinnati Children’s Hospital Medical Center, ; 3333 Burnet Avenue, Cincinnati, OH 45229 USA
                [2 ]GRID grid.24827.3b, ISNI 0000 0001 2179 9593, Department of Pediatrics, , University of Cincinnati College of Medicine, ; Cincinnati, OH USA
                [3 ]GRID grid.224260.0, ISNI 0000 0004 0458 8737, Department of Psychology, , Virginia Commonwealth University, ; Richmond, VA USA
                [4 ]GRID grid.239560.b, ISNI 0000 0004 0482 1586, Division of Psychology and Behavioral Health, Children’s National Hospital, , Center for Translational Research, ; Washington, DC USA
                [5 ]GRID grid.253615.6, ISNI 0000 0004 1936 9510, Department of Psychiatry & Behavioral Sciences, Department of Pediatrics, , The George Washington University School of Medicine and Health Sciences, ; Washington, DC USA
                [6 ]GRID grid.438526.e, ISNI 0000 0001 0694 4940, Department of Psychology, , Virginia Polytechnic Institute and State University, ; Blacksburg, VA USA
                Author information
                https://orcid.org/0000-0003-4617-8552
                https://orcid.org/0000-0003-0169-2793
                https://orcid.org/0000-0002-3790-1334
                https://orcid.org/0000-0001-5500-6950
                https://orcid.org/0000-0001-9046-5183
                Article
                Publisher ID: 1435
                DOI: 10.1007/s10578-022-01435-3
                PMC ID: 9458302
                PubMed ID: 36076118
                SO-VID: 551f9af8-6565-4ea2-aee5-7cab8ebf4f5a
                Copyright © © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022, Springer Nature or its licensor holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
                License:

                This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.

                History
                Date accepted : 31 August 2022
                Funding
                Funded by: FundRef http://dx.doi.org/10.13039/100005246, Institute of Education Sciences;
                Award ID: R305A160126
                Award Recipient :
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: covid-19,stress,rumination,depression,anxiety,adolescence
                Data availability:
                ScienceOpen disciplines: Clinical Psychology & Psychiatry
                Keywords: covid-19, stress, rumination, depression, anxiety, adolescence

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