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Physically isolated but socially connected: Psychological adjustment and stress among adolescents during the initial COVID-19 crisis

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Abstract and Figures

We are facing an unprecedented time during the COVID-19 pandemic. Measures have been taken to reduce the spread of the virus, including school closures and widespread lockdowns. Physical isolation combined with economic instability, fear of infection, and uncertainty for the future has had a profound impact on global mental health. For adolescents, the effects of this stress may be heightened due to important developmental characteristics. Canadian adolescents (n = 1,054; Mage = 16.68, SD = 0.78) completed online surveys and responded to questions on stress surrounding the COVID-19 crisis, feelings of loneliness and depression, as well as time spent with family, virtually with friends, doing schoolwork, using social media, and engaging in physical activity. Results showed that adolescents are very concerned about the COVID-19 crisis and are particularly worried about schooling and peer relationships. COVID-19 stress was related to more loneliness and more depression, especially for adolescents who spend more time on social media. Beyond COVID-19 stress, more time connecting to friends virtually during the pandemic was related to greater depression, but family time and schoolwork was related to less depression. For adolescents with depressive symptoms, it may be important to monitor the supportiveness of online relationships. Results show promising avenues to stave off loneliness, as time with family, time connecting to friends, as well as physical activity were related to lower loneliness, beyond COVID-19 stress. These results shed light on the implications of the COVID-19 pandemic for adolescents and document possible pathways to ameliorate negative effects.
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Physically Isolated but Socially Connected: Psychological Adjustment and
Stress Among Adolescents During the Initial COVID-19 Crisis
Wendy E. Ellis
King’s University College at Western University
Tara M. Dumas
Huron University College at Western University
Lindsey M. Forbes
Western University and London, Ontario, Canada
We are facing an unprecedented time during the COVID-19 pandemic. Measures have been taken to
reduce the spread of the virus, including school closures and widespread lockdowns. Physical isolation
combined with economic instability, fear of infection, and uncertainty for the future has had a profound
impact on global mental health. For adolescents, the effects of this stress may be heightened due to
important developmental characteristics. Canadian adolescents (n1,054; M
age
16.68, SD 0.78)
completed online surveys and responded to questions on stress surrounding the COVID-19 crisis, feelings
of loneliness and depression, as well as time spent with family, virtually with friends, doing schoolwork,
using social media, and engaging in physical activity. Results showed that adolescents are very concerned
about the COVID-19 crisis and are particularly worried about schooling and peer relationships.
COVID-19 stress was related to more loneliness and more depression, especially for adolescents who
spend more time on social media. Beyond COVID-19 stress, more time connecting to friends virtually
during the pandemic was related to greater depression, but family time and schoolwork was related to less
depression. For adolescents with depressive symptoms, it may be important to monitor the supportiveness
of online relationships. Results show promising avenues to stave off loneliness, as time with family, time
connecting to friends, as well as physical activity were related to lower loneliness, beyond COVID-19
stress. These results shed light on the implications of the COVID-19 pandemic for adolescents and
document possible pathways to ameliorate negative effects.
Public Significance Statement
Adolescents are concerned about the COVID-19 crisis and their pandemic stress is related to
heightened depression and loneliness. However, time with family, time connecting virtually to
friends, as well as physical activity were related to less loneliness during the initial COVID-19 crisis.
On the contrary, although more time on social media and virtually connecting to friends was related
to more reported depression, time engaging with family was related to less reported depression.
Keywords: adolescents, depression, loneliness, COVID-19, social media
On March 11, 2020, the World Health Organization (www.who
.int) declared the COVID-19 outbreak a global pandemic and
many areas of North America (and across the world) began to
close schools and businesses, among other measures intended to
prevent the spread of the virus. At the same time, many regions
declared states of emergency and implicated strict public health
measures, effectively putting cities under lockdown. This physical
isolation combined with economic instability, fear of infection,
and stress surrounding the uncertainty of the future has had a
profound impact on global mental health, making research in this
area a top priority (Brooks et al., 2020;Holmes et al., 2020). For
adolescents, the effects of this stress may be heightened (Findlay
& Arim, 2020) due to their increased desire for autonomy and peer
connection (Brown & Larson, 2009), which are both hindered
when they are forced to physically distance from friends and
remain home. Further, adolescents are faced with underdeveloped
XWendy E. Ellis, Department of Psychology, King’s University Col-
lege at Western University; Tara M. Dumas, Department of Psychology,
Huron University College at Western University; XLindsey M. Forbes,
Department of Psychology, Western University, and Independent Practice,
London, Ontario, Canada.
We are grateful to the Social Sciences and Humanities Research Council of
Canada for funding parts of this study (Insight Development Grant; principal
investigator: Tara M. Dumas). We would also like to thank the undergraduate
students in Tara M. Dumas’ and Wendy E. Ellis’ research lab for their help in
providing quick feedback on our survey and in participant recruitment.
Correspondence concerning this article should be addressed to Wendy E.
Ellis, Department of Psychology, King’s University College at Western Uni-
versity, 266 Epworth Avenue, London, ON N6A 2M3, Canada. E-mail:
wendy.ellis@uwo.ca
Canadian Journal of Behavioural Science /
Revue canadienne des sciences du comportement
ISSN: 0008-400X 2020, Vol. 52, No. 3, 177–187
© 2020 Canadian Psychological Association http://dx.doi.org/10.1037/cbs0000215
177
cognitive mechanisms that inhibit self-regulation (Albert, Chein,
& Steinberg, 2013) and an increase in mental health issues during
this developmental stage (Lewinsohn, Clarke, Seeley, & Rohde,
1994). Additionally, school closures have a widespread impact on
adolescents’ academic development and access to mental health
services (Golberstein, Wen, & Miller, 2020). Many agencies have
put forth best practices to protect mental health during the pan-
demic. Among others, there are recommendations for staying
socially connected through virtual interactions, limiting news con-
sumption, and maintaining regular physical activity during the
crisis (e.g., Canadian Mental Health Association, 2020;Canadian
Psychological Association, 2020). However, the adherence to and
effects of these behaviours is uncertain. The goal of the present
study was to examine the stress associated with the initial
COVID-19 crisis among adolescents and measure the relationship
between their reported daily behaviours including social media
use, virtual communications with friends, time with family, time
completing schoolwork, and physical activity on reported feelings
of psychological distress (i.e., depression and loneliness).
Adolescence is a time of heightened motivation for peer affili-
ation (Brown & Larson, 2009). Peer groups provide an important
context for social and emotional support and have a significant
impact on the socialization of a range of behaviours (Ellis &
Zarbatany, 2017). However, during a time of social isolation,
physical peer interactions are invariably removed. Concerns about
maintaining close connections to friends and the consequences of
isolation for social status and peer belonging may be especially
prominent for adolescents. On top of this, adolescents likely ex-
perience the same stressors as adults during the pandemic, includ-
ing being fearful for their own and loved ones’ safety, financial
concerns, and uncertainty that may result in heightened feelings of
loneliness and depression (Wang et al., 2020). Loneliness and
depression have profound effects on academic achievement
(Verboom, Sijtsema, Verhulst, Penninx, & Ormel, 2014), risk-
taking behaviours (Keenan-Miller, Hammen, & Brennan, 2007),
interpersonal relationships and mortality (Holt-Lunstad, Smith, Baker,
Harris, & Stephenson, 2015). The adolescent time period also marks
a vulnerable time for the onset of mental illness including depression,
particularly among girls (Lewinsohn et al., 1994). Further, serious
mental distress has increased considerably among Canadian youth
(Abi-Jaoude, Naylor, & Pignatiello, 2020). Thus, it is vital to attend to
adolescents’ well-being during this crisis.
Online interactions are a major component of the social land-
scape of teens around the globe and reaching out to friends through
virtual means is not unprecedented. Between 83%-87% of Cana-
dian youth Ages 15–17 own their own smart phone and 86% of
Canadian teens visit social media sites daily (Media Smarts, 2014;
Statistics Canada, 2018). Major sociodevelopmental milestones
are reinforced via social media by seeking social validation and
feedback from others (Dumas, Maxwell-Smith, Davis, & Giulietti,
2017). At present, there are mixed findings about the role of social
media and screen time on adolescent adjustment and parents may
be concerned about increased use during the pandemic. The addi-
tion of online schooling may also call into question the ability of
teens to balance their use of technology. In a sample of Canadian
teens, screen time of all kinds was associated with increased
depression and anxiety (Maras et al., 2015). Still, some studies
have found little evidence for negative effects of screen time on
adolescent adjustment (Orben & Przybylski, 2019), and others
have shown that every hour leads to increases in depressive symp-
tom (Boers, Afzali, Newton, & Conrod, 2019). Social media use,
in particular, has been associated with greater well-being, but also
more negative feelings due to upward social comparison (Radovic,
Gmelin, Stein, & Miller, 2017). During the initial COVID-19
crisis, adolescents’ social and academic lives were almost exclu-
sively virtual, likely leading to a marked increase in screen time
and social media use. Recent research suggests that maintaining
online social connections is important for mental health outcomes
during the COVID-19 quarantine (Pancani, Marinucci, Aureli, &
Riva, 2020). However, it is also known that excessive media
consumption during times of crisis may be a concern for elevated
stress and anxiety (Garfin, Silver, & Holman, 2020). During the
initial COVID-19 crisis, it is uncertain how adolescents are using
technology to connect to peers, how they are using social media,
the extent to which they are monitoring the latest news, or how
much time they are devoting to schoolwork, yet these behaviours
will likely play a role in dealing with pandemic-related stress.
Although most adolescents had been physically isolated from
peers, family time undoubtedly increased during stay at home
directives. The critical role of parents in adolescent adjustment has
been documented from multifaceted theoretical standpoints, in-
cluding enduring attachment relationships, parenting styles and the
overall quality and time spent in parent– child interactions (Collins
& Laursen, 2004;Pinquart, 2017). Importantly, parent communi-
cation shows consistent protective effects, as evidenced by the role
that family dinners play in positive adolescent development
(Fulkerson et al., 2006). During times of crisis, parents can both
exacerbate and buffer the influence of stressful experiences on
adolescent mental health (Collins & Laursen, 2004;Platt, Wil-
liams, & Ginsburg, 2016). Parents and siblings offered some of the
only in-person psychological support and companionship during
the physical distancing lockdown. As such, the amount of time that
adolescents spent in the family context may offset effects of the
pandemic on adolescents’ mental health (Manczak, Ordaz, Singh,
Goyer, & Gotlib, 2019) and families have been frequently encour-
aged to cherish their time together (Canadian Psychological As-
sociation, 2020). However, parents are feeling increased stress
about COVID-19 events themselves, which, in line with the family
stress model (Conger, Rueter, & Conger, 2000), may have a
negative influence on adolescent adjustment via poorer parenting
practices and parent– child relationship conflict. Indeed, parents
reported more conflict and harsh discipline with their children
during the initial crisis (Lee & Ward, 2020).
Finally, a common recommendation among mental health pro-
fessionals is to stay active, even while being isolated inside. Aside
from enhancing immune system functioning (Nieman & Wentz,
2019), exercise is a widely accepted stress management tool. It has
been shown to protect against the negative emotional conse-
quences of stress and promote positive changes to the ability to
cope with stress (Stults-Kolehmainen & Sinha, 2014). Physical
activity participation is also increasingly linked to improved men-
tal health and cognitive functioning (Weinberg & Gould, 2015).
During adolescence, physical activity steadily decreases (Guthold,
Stevens, Riley, & Bull, 2018), coinciding with the average age for
onset of mental health problems (Eime et al., 2016). Worldwide,
81% of youth Aged 11–17 years are insufficiently physically
active, with few meeting the recommended exercise guidelines of
60 min of moderate-vigorous physical activity per day (Guthold et
178 ELLIS, DUMAS, AND FORBES
al., 2018). With schools, sport teams, recreation centers and local
gyms closed during the initial COVID-19 crisis, maintaining reg-
ular physical activity was even more challenging for adolescents.
However, there is solid evidence that exercise can be used as a
targeted treatment/prevention strategy among youth to promote
mental health more generally, with effects on a wide-range of
affective outcomes (Bell, Audrey, Gunnell, Cooper, & Campbell,
2019).
In sum, the goal of the present study was to examine the
relationships between psychological adjustment and reported
stress associated with the initial COVID-19 crisis. Survey data was
collected from over 1,000 Canadian high school students during
the fourth and fifth weeks of physical distancing and school
closures. Adolescents completed measures of depression, loneli-
ness, and their stress due to COVID-19-related fear and physical
distancing. They further reported on the frequency of their behav-
iours including social media use (both before and during the
pandemic), news consumption, time spent interacting with friends
online, time spent interacting with family, time completing school-
work, and physical activity. It was expected that time with friends,
time with family, and physical activity would relate to positive
adjustment beyond COVID-19 stress. Social media use, news
consumption, and time spent completing schoolwork were exam-
ined as exploratory predictors of adjustment, beyond COVID-19
stress. Reported daily behaviours, as well as gender and age, were
also examined as moderators of COVID-19 stress to identify
potential patterns of exacerbation or mitigation on mental health.
Method
Participants
A total of 1,316 adolescent high school students completed the
survey. Data from 262 participants were removed because these
individuals failed to correctly complete one or both of two vali-
dation questions (e.g., “To respond to this question, please select
strongly agree/strongly disagree”). Our final sample consisted of
1,054 participants Aged 14 –18 years (M
age
16.68, SD 0.78;
76.4% female, 21.9% male, 1.2% other, including nonbinary and
gender fluid and 0.6% who indicated they preferred not to answer).
The grade distribution consisted of 28 (2.7%) Grade 9s (89.3%
female), 137 (13.0%) Grade 10s (69.3% female), 370 (35.1%)
Grade 11s (77.0% female), and 519 (49.2%) Grade 12s (77.1%
female). The majority of participants identified as White/European
(65.7%), followed by Asian (15.3%), Black North American/
African (3.9%), Latino (3.1%), and 11.0% identified as another
ethnicity. Further, 0.9% of participants indicated they preferred not
to answer this question. Finally, 67.6% of participants reported that
they were living and self-isolating with two parents, 14.6% with
their mother only, 2.7% with their father only, 7.3% with a parent
and stepparent, 5.9% equally in their mother and father’s separate
homes, 0.9% with grandparents, 0.6% in foster care, and 0.4%
with siblings only.
Recruitment Procedure
Ethics approval was obtained by the authors’ university ethics
board. Participant recruitment and survey completion occurred
between April 4 –16, 2020, approximately three weeks after sec-
ondary schools in Ontario, Canada closed due to the COVID-19
pandemic. An advertisement was posted to our research lab’s
Instagram page and advertised to adolescent users using Insta-
gram’s promotion feature for 5 days (which resulted in over 80%
of the data being collected during that time frame). The advertise-
ment communicated that we were looking for 16 –18-year-olds
from the province of Ontario, to complete a study on their social
media use and adjustment during the COVID-19 pandemic. Study
reimbursement included entry into a draw to win one of 20 $50 gift
cards or AirPods. We did not recruit teens younger than 16-years
of age in this way due to the logistical issues of having to secure
online parental consent. We further emailed the advertisement and
survey link to a group of adolescents (n155, 14 –18 years of
age) who were enrolled in a longitudinal study for our research
group. Participants were provided with a letter of information and
provided informed consent prior to completing the 15-min online
survey.
Measures
COVID-19 stress. Items were designed to assess fear about
the spread of COVID-19 and the possibility of being infected, as
well as specific adolescent concerns that may result from physical
distancing. A total of eight items (Table 1; e.g., “How likely is it
that you could become infected with the COVID-19 virus?”; “To
what extent are you worried about how the COVID-19 crisis will
impact your school year?”) were measured on a 4-point scale,
Table 1
Percentages and Frequency of Responses to COVID-19 Stress Questions
Items
%(n)
Not at all
A little
or somewhat Very much
1. To what extent are you worried about how COVID-19 will impact your school year? 3.2 (33) 25.1 (265) 71.7 (756)
2. To what extent are you worried about how COVID-19 will impact your own and your family’s finances? 6.3 (66) 57.5 (604) 36.2 (382)
3. To what extent are you worried about how COVID-19 will impact your ability to keep up your reputation? 26.8 (281) 60.1 (633) 13.1 (138)
4. To what extent are you worried about how COVID-19 will impact you feeling connected to your friends? 3.5 (36) 56.3 (590) 40.5 (427)
5. To what extent are you concerned about the COVID-19 crisis? 2.7 (28) 54.2 (573) 43.1 (453)
6. How likely is it that you could become infected with the COVID-19 virus? 14.3 (151) 78.6 (827) 7.1 (75)
7. How likely is it that someone you know could become infected with the COVID-19 virus? 4.3 (45) 64.2 (676) 31.5 (332)
8. If you did become infected with COVID-19, to what extent are you concerned that you will be severely ill? 17.5 (187) 63.9 (669) 18.6 (195)
Note. “A little” and “somewhat” were given as separate options, but combined here.
179
ADOLESCENT ADJUSTMENT DURING COVID-19
ranging from 1 (not at all)to4(very much). Items asking about the
fear of infection were taken from the Swine Flu Anxiety Scale
(Wheaton, Abramowitz, Berman, Fabricant, & Olatunji, 2012).
Items were averaged to yield a score for COVID-19 stress (␣⫽
.60) McDonald’s omega was also computed (␻⫽.60). The aver-
age interitem correlation was .14.
Social media use. Participants were asked to report on how
many hours per day, on average, they spent using social media
platforms (e.g., Instagram, Snapchat, TikTok, Facebook) both: (a)
in the 6 months before the COVID-19 crisis, and (b) in the past 3
weeks since the COVID-19 crisis. A total of eight response options
were provided (less than 10 min, 10 –30 min, 31– 60 min, 1–2 hr,
2–3 hr, 3–5 hr, 5–10 hr, to more than 10 hr).
Time in daily activities. A scale was created to measure how
participants have been spending their days during the crisis. Par-
ticipants were asked to think about the past 3 weeks since the
COVID-19 crisis and report, on average, how much time they
spent on different activities (Table 2). A total of seven response
options were provided (none, 30 min or less, 1 hr, 1–2 hr, 2– 4 hr,
4 6 hr, 6 or more hours). The family video chat item and family
activities item were combined. The friend video chat and friend
texting items were also combined. Participants were also asked to
indicate if they were working in an essential role (e.g., grocery
store), with a yes/no response.
Depression. The six-item depression subscale of the Brief
Symptom Inventory (BSI) was used to measure depression (Dero-
gatis & Melisaratos, 1983). Participants were asked to think about
the past 7 days and rank how they felt (e.g., “feeling hopeless
about the future”) on a 5-point scale ranging from 1 (not at all)to
5(extremely). Items were averaged to create a single index, with
higher scores indicating higher responses across items (␣⫽0.88).
The BSI is appropriate for adolescents over age 13, with strong
psychometric properties and convergence to other measures of
depression (Derogatis, 1975).
Loneliness. The revised UCLA Loneliness Scale was used to
measure participant loneliness (Hays & DiMatteo, 1987). Partici-
pants were asked to respond to eight items (e.g., “I lack compan-
ionship”; “I feel isolated from others”) on a 4-point scale ranging
from 1 (never)to4(often). Items were averaged to create a total
score with higher scores indicating greater feelings of loneliness
(␣⫽.81). This scale was designed and tested for use among
college students (Hays & DiMatteo, 1987) and derived from the
widely used long-form UCLA Loneliness Scale (Russell, Peplau,
& Ferguson, 1978).
Physical activity. Self-reported physical activity was assessed
using the Godin Leisure-Time Exercise Questionnaire (Godin,
2011). Participants were asked to report how often they did three
types of exercise (strenuous, moderate, mild) for more than 15 min
during the last 7 days. Examples were provided for each category
of exercise (e.g., running, fast walking, easy walking). A calcula-
tion was used to compute the Godin scale score (Godin, 2011). The
times reported per week were multiplied by 9 for strenuous exer-
cise, 5 for moderate exercise, and 3 for mild exercise and then
added together to a total score. This score was used as an index of
physical activity. This is a widely used scale to assess activity level
and has been validated among adolescents, showing high test–
retest reliability and validity (Zelener & Schneider, 2016).
Results
Descriptive Data
A frequency table was computed to show participants’ level of
stress associated with the COVID-19 crisis (see Table 1). Seventy-
two percent of teens reported being “very” concerned with how the
COVID-19 crisis will impact their school year. Regarding infec-
tivity, 78.5% responded to the question “How likely is it that you
could become infected with the COVID-19 virus?” with “a little”
or “somewhat.” Given the low interitem correlations for this scale,
the correlations between depression and loneliness with all eight
items on the scale were also tested. All items were significantly
correlated with depression (rrange .12–.25, ps.01), and
seven of the eight items were significantly correlated with loneli-
ness (rrange .10 –.26, ps.01).
Table 2 summarizes the time adolescents reported in various
activities during the initial COVID-19 crisis. Table 3 summarizes
the frequency of reported social media use and shows increased
use from before COVID-19 to after COVID-19. The largest re-
sponse category in the 6 months prior to the crisis was 2–3 hr per
day (31.1%), while the largest response category for the 3 weeks
after the crisis began was 5–10 hr (35.4%).
Many participants reported no physical activity in each category
over the past 7 days, particularly for intense exercise (40.0% for
strenuous activity, 21.3% for moderate exercise, and 12.9% for
light exercise). On average, participants reported engaging in 15 or
more minutes of strenuous activity 1.93 times, moderate exercise
2.70 times, and mild exercise 3.47 times over the course of the last
week.
Although the depression score used in the regression models
was calculated using the average response score across items, an
additional score was calculated to determine the number of symp-
toms participants were experiencing. A positive symptom total was
Table 2
Reported Time in Daily Activities Since the COVID-19 Crisis
%(n)
Reported activity None 30 min or less 1 hr or less 1–2 hr 2– 6 hr 6 or more hours
Watching or reading news on COVID-19 10.8 (114) 58.3 (613) 17.0 (179) 8.8 (93) 4.2 (45) .8 (8)
Activities with family 16.3 (171) 20.1 (212) 24.4 (257) 23.3 (246) 14.4 (152) 1.5 (15)
Video chat with family 60.1 (632) 27.7 (292) 6.3 (66) 3.3 (34) 2.6 (27) 0
Video chat with friend 18.2 (192) 24.5 (258) 14.8 (156) 15.5 (163) 21.9 (230) 5.1 (54)
Texting friends 1.4 (15) 14.1 (149) 15.7 (165) 20.8 (219) 34.4 (362) 13.6 (143)
School work 9.9 (104) 13.6 (143) 14.8 (156) 24.5 (258) 35.0 (368) 2.3 (24)
180 ELLIS, DUMAS, AND FORBES
created by summing the six items with nonzero responses
(Derogatis & Melisaratos, 1983). Only 2% (n21) reported no
symptoms across the six items, while 28% (n301) reported
symptoms across all items. For the item “thoughts of ending your
life”, 67.6% (n712) responded with “not at all,” while 17.5%
(n184) responded with either “moderately,” “quite a bit,” or
“extremely.” A comparison to previous research shows 5.8% of
Canadian youth (Ages 15–24) reported suicidal thoughts during
the past year and 14% over their lifetime (Statistics Canada, 2012).
Demographic Analyses
To examine age and grade differences in study variables a 2
(gender) 4 (grade) multivariate analysis of variance was com-
puted. No significant differences were found for grade. However,
there was a main effect of gender F(2, 1019) 3.45, p.001, d
.05, which indicated that females reported higher depression (M
2.85, SE .06 vs. M2.26 SE .15), loneliness (M2.64,
SE .03 vs. M2.50, SE .09), COVID-19 stress (M2.92,
SE .03 vs. M2.69, SE .06), and social media use since the
COVID-19 crisis (M6.30, SE .08 vs. M5.68, SE .20)
compared to males.
The impact of working in the community was also measured,
with 16.2% of participants working in an “essential role.” Three
independent ttests examined COVID-19 stress, depression, and
loneliness between those working and not working. COVID-19
stress was higher among the participants working in the commu-
nity (M3.02, SE .40 vs. M2.89, SE .41, t
(1049)
3.85,
p.001). No differences were found for depression and loneli-
ness.
Correlations
A correlation table was computed to show the intercorrelations
between the main variables in the present study (Table 4). As
expected, there were small to moderate correlations between
COVID-19 stress, depression and loneliness. Physical activity was
related to less loneliness and depression, and more time with
family. COVID-19 news consumption was related to higher
COVID-19 stress but not loneliness or depression. Greater social
media use both before and after the COVID-19 crisis was related
to higher depression, but not loneliness.
Regression Analysis Examining Predictors of
Loneliness and Depression
Two hierarchical regression analyses were used to test the
relationships between predictor variables and depression and lone-
liness. For each regression analysis, the following predictor vari-
ables were entered simultaneously: gender, age, COVID-19 stress,
social media use before COVID-19 and after COVID-19, family
time, friend time, news consumption, time on schoolwork, physi-
cal activity, two-way interactions between COVID-19 stress and
other variables, and interactions related to age and gender. One
significant two-way interaction was found for each regression, and
all other nonsignificant interaction terms were subsequently re-
moved from the models to promote statistical power and parsi-
mony (West, Welch, & Galecki, 2014). Simple slope analyses
were conducted to determine whether the slopes representing each
relationship were significantly different from zero at low (1SD),
average, and high levels (1SD;Hayes & Matthes, 2009). Given
the high correlation between before and after COVID-19 social
media use, tests to see if the data met the assumption of collinearity
indicated that multicollinearity was not a concern (with a range of
tolerance .76 –.88, and a range of variance inflation factor
1.13–1.31 across the regression models).
For depression (Table 5), the model was significant, F(11,
1039) 25.24, p.01. The model showed that gender was a
significant predictor (␤⫽.15, t5.15, p.001), with girls
having higher depressive levels. COVID-19 stress was a signifi-
Table 3
Reported Social Media Use Before and After the COVID-19 Crisis
%(n)
Reported use Less than 30 min Between 30 min–2 hr 2–3 hr 3–5 hr 5–10 hr More than 10 hr
Social media use before 3.8 (40) 33.1 (349) 31.1 (328) 21.7 (229) 8.2 (86) 2.0 (21)
Social media use after 1.2 (13) 9.8 (43) 11.8 (124) 29.7 (313) 35.4 (372) 12.1 (127)
Table 4
Correlations Between Predictor and Outcome Variables
Variable 1 2 3 4 5 6 7 8 9
1. Loneliness
2. Depression .53
ⴱⴱ
3. COVID19-Stress .28
.36
4. Physical activity .12
ⴱⴱ
.08
.03
5. Family time .12
ⴱⴱ
.09
ⴱⴱ
.05 .21
ⴱⴱ
6. Friend time .11
ⴱⴱ
.189
ⴱⴱ
.08
ⴱⴱ
.03 .09
7. Watching news .04 .06 .23
ⴱⴱ
.06
.11
ⴱⴱ
.11
ⴱⴱ
8. School work .06
.05 .06
.11
.15
.04 .08
9. Social media before .04 .14
ⴱⴱ
.05 .04 .05 .31
ⴱⴱ
.03 .08
10. Social media use after .04 .24
ⴱⴱ
.15
ⴱⴱ
.05 .06
.42
ⴱⴱ
.11
ⴱⴱ
.06 .70
ⴱⴱ
p.05.
ⴱⴱ
p.01.
181
ADOLESCENT ADJUSTMENT DURING COVID-19
cant predictor of depression, (␤⫽.33, t11.49, p.001), as was
more social media time after the COVID-19 crisis (␤⫽.12, t
2.89, p.01), more time with friends (␤⫽.11, t3.69, p
.001) and less time with family (␤⫽⫺.09, t⫽⫺3.24, p.001),
and less time on schoolwork (␤⫽⫺.06, t⫽⫺1.98, p.05). The
interaction between COVID-19 stress and social media use was
also significant, ␤⫽.07, t2.59, p.01. The R
2
for this model
was .21, which yielded an effect size of f
2
.27. Overall, 21% of
the variance in depression was predicted with this model and a
medium effect size was evident (Cohen, 1988).
The simple slopes analysis was tested at 1SD of the mean of
COVID-19 stress. The analysis revealed that the relationship be-
tween COVID-19 stress and depression was strongest among
adolescents who reported the highest social media use after the
pandemic (B.96, SE .02, p.001), as compared to adoles-
cents with lower (B.66, SE .09, p.001) and average use
(B.78, SE .70, p.001; Figure 1). The regions of signifi-
cance for social media use as a moderator of COVID-19 stress
showed a cutoff of 2.32, indicating that adolescents who scored
greater than 3 SD below the mean had a significant association
between COVID-19 stress and depression.
For loneliness (see Table 5), the regression model was signifi-
cant, F(11, 1038) 15.14, p.001. An examination of the
predictors indicated that gender was a significant predictor (␤⫽
.08, t2.70, p.001), with girls experiencing more loneliness.
COVID-19 stress was a significant positive predictor of greater
loneliness, ␤⫽.29, t9.46, p.001. More time with family
(␤⫽⫺.09, t⫽⫺3.02, p.001) and friends (␤⫽⫺.13,
t⫽⫺4.15, p.001) and more physical activity (␤⫽⫺.09,
t⫽⫺3.05, p.001) were also significant predictors of less
loneliness. The interaction between COVID-19 stress and physical
activity was significant, ␤⫽.04, t2.96, p.01. The R
2
for this
model was .14, which produced an effect size of f
2
.16. Overall,
14% of the variance in loneliness was predicted with this regres-
sion model and a medium effect size was evident (Cohen, 1988).
The simple slopes analysis was tested at 1SD of the mean of
COVID-19 stress. The relationship between COVID-19 stress and
loneliness was strongest among adolescents with high and average
physical activity (B.54, SE .06, p.001, B.39, SE .04,
p.001), as compared to low (B.29, SE .06, p.001;
Figure 2). The figure shows little difference between groups at
high levels of stress. The regions of significance for activity level
as a moderator of COVID-19 stress showed that adolescents at all
activity levels had a significant association between COVID-19
stress and loneliness.
Discussion
Results show that adolescents’ concerns about the COVID-19
crisis are troubling, with 43% saying they are “very concerned”
about the pandemic. As a whole, adolescents’ stress about
COVID-19 was significantly related to poorer adjustment, includ-
ing more reported depression and greater loneliness. Adolescents
also reported spending substantially more time on social media
after the start of the COVID-19 crisis than they did before the
crisis, with 48% spending more than 5 hr per day since school
closure. Importantly, adolescents’ reported behaviours during the
Table 5
Hierarchical Regressions Predicting Depression and Loneliness
From COVID-19 Stress, Social Media Use, Social Connections,
School Work, and Physical Activity
Variable BSEtvalue (p)R
2
Depression model
Age .04 .04 .03 1.12 (.26)
Gender .29 .06 .15 5.15 (.00)
COVID-19 stress .82 .07 .33 11.49 (.00)
Social media use before .01 .03 .01 .24 (.80)
Social media use after .10 .03 .12 2.89 (.01)
Family time .05 .02 .09 3.24 (.00)
Friend time .04 .01 .11 3.65 (.00)
Physical activity .00 .00 .04 1.52 (.12)
News coverage .03 .02 .06 1.02 (.30)
School work .04 .02 .06 1.98 (.048)
Stress Physical Activity .12 .05 .07 2.59 (.01)
21.3%
Loneliness model
Age .01 .02 .01 .25 (.80)
Gender .10 .04 .08 2.70 (.01)
COVID-19 stress .42 .04 .29 9.46 (.00)
Social media use before .03 .02 .05 1.30 (.19)
Social media use after .01 .02 .10 .39 (.70)
Family time .03 .01 .09 3.02 (.00)
Friend time .03 .01 .13 4.15 (.00)
Physical activity .00 .00 .09 3.05 (.00)
News coverage .02 .01 .00 .09 (.93)
School work .02 .01 .06 1.97 (.05)
Stress Physical Activity .04 .00 .09 2.96 (.01)
14.0%
p.05.
p.01.
1
1.5
2
2.5
3
3.5
4
Depression
Low COVID-19 Stress (-1 SD) High COVID-19 Stress ( +1 SD)
Low Social Media Average Social Media High Social Media
Figure 1. Interaction between social media use and COVID-19 stress on
reported depression.
2
2.2
2.4
2.6
2.8
3
Loneliness
Low COVID-19 Stress (-1 SD) High COVID-19 Stress ( +1 SD)
Low Acvity Average Acvity High Acvity
Figure 2. Interaction between physical activity and COVID-19 stress on
reported loneliness.
182 ELLIS, DUMAS, AND FORBES
initial weeks of the crisis were significantly related to adjustment
beyond COVID-19 stress, and in some cases moderated the rela-
tionship between stress and adjustment.
The impact of the COVID-19 crisis has been felt on a global
level (Wang et al., 2020), and adolescents are no exception. They
reported being concerned about family finances and infection for
themselves and loved ones. Adolescents also had unique concerns
about their schooling, friendships, and reputations. High school
seniors, for example, may have been thinking ahead to the uncer-
tainty of college and university acceptance and grieving the loss of
important milestone events, like graduation. Further, adolescents
who reported watching or reading more COVID-19 news, who
spent more time on social media, and who reported working in the
community reported even greater COVID-19 stress. Given this
high level of concern in the adolescent population, finding ways to
lessen the effects on depressive symptoms and loneliness is essen-
tial for avoiding chronic mental illness.
At-home isolation for adolescents is vastly different than their
day-to-day lives in classrooms and schools and the effects of these
circumstances is worrisome. Nevertheless, adolescents appear to
be heeding advice by reaching out to friends though virtual means,
with many teens indicating they spent between 1 to 2 hr texting
with friends (50%) and similar times in online video chats with
friends (40%) each day. Although social media use is nearly
universal among youth (95% of teens reported at least 30 min per
day), results showed a substantial increase in the time spent using
a variety of social media platforms (e.g., Instagram, Snapchat,
TikTok,) during the initial call to stay at home. Shockingly, over
12% of adolescents reported using social media more than 10 hrs
a day. Mixed results for these virtual social connections and time
on social media were found. Analyses showed virtual time with
friends related to higher depression but lower loneliness, beyond
reported COVID-19 stress. It was also found that social media use
during the initial crisis was related to higher depression but was
unrelated to loneliness. These results are in line with other research
showing varying outcomes for screen time and social media con-
sumption (e.g., Orben & Przybylski, 2019). Thus, rather than only
examining time, we must look closely at what adolescents are
doing online.
When adolescents connect with peer groups online, interactions
are likely to mimic in person dynamics. In group chats, there is a
real possibility of ostracism, social aggression and even cyberbul-
lying (Meter & Bauman, 2015). More time in these virtual group
settings may amplify existing interpersonal struggles. Even when
communicating with close friends, there is the danger of corumi-
nation, which involves excessive discussion of problems and
heightened focus on negative emotions among friends (Rose,
2002). It has been documented that, especially for girls, close
friendships can sometimes have a paradoxical effect, both increas-
ing feelings of friendship quality and connection but simultane-
ously leading to increased depression through corumination (Rose,
2002;Rose, Carlson, & Waller, 2007). When dealing with high
levels of stress and uncertainty, conversations among adolescents
may ruminate on negative feelings and unintentionally escalate
these concerns. Further, depressed teens may interact differently
with their peers than less depressed teens. Given the correlational
data used in the present study, the direction of these relationships
is uncertain. Nonetheless, connecting to peers is crucial for ado-
lescents and virtual connections should be encouraged, especially
because these connections may help alleviate loneliness. However,
it is also necessary to consider preexisting peer dynamics and teach
youth to be mindful about having supportive peer interactions.
The findings about time on social media are also noteworthy, as
greater time was related to higher depressive symptoms. This is
consistent with other research highlighting the possible positives
and inherent dangers of social media, often due to upward social
comparison or envy (Radovic et al., 2017;Vogel, Rose, Roberts, &
Eckles, 2014). Adolescents are likely to see images of others who
may seemingly be less impacted by social isolation. In addition,
although news coverage was not significantly related to adjustment
(and low rates were reported overall), pandemic-related news is
found on most social media platforms. Moreover, COVID-19 news
on social media tends to be exaggerated and misleading (Nielsen,
Fletcher, Newman, Brennen, & Howard, 2020). The more moder-
ate time on social media before stay-at-home orders were in effect
was not related to adjustment, again suggesting the necessity to
consider how teens are using social media. For example, different
outcomes are predicted by passive versus active social media use
(Frison & Eggermont, 2016). An exacerbating relationship of
social media use on depression was also evident in the present
study. Adolescents who experienced the most COVID-19 stress
and reported high levels of social media use also had the highest
reported level of depression. Indeed, teens with depression may
self-select negative information (e.g., by “following” certain peo-
ple or pages) to reinforce negative mood over time (Boers et al.,
2019). As such, it may be wise for parents to monitor usage of
social media, at least for more at-risk adolescents. A productive
approach to dealing with these issues involves open discussions in
a developmentally appropriate manner, in the context of supportive
relationships rather than strict bans and limits (Baldry, Sorrentino,
& Farrington, 2019). Talking to adolescents about mindful media
consumption and granting them the agency to self-regulate may
help keep healthy routines in place in both the short and long term.
Interestingly, teens were also spending a significant amount of
time completing schoolwork (62% reported more than 1 hr per
day), and this time was related to lower reported depression.
Although school engagement has been shown to predict less de-
pression (Pate, Maras, Whitney, & Bradshaw, 2017), it is also
possible that depressed mood hindered adolescents’ motivation to
continue with schooling at home (Garvik, Idsoe, & Bru, 2014).
Follow-up data will be needed to determine directional effects.
A key finding in this study was that time with family was
consistently related to better mental health. More time interacting
with parents and siblings face-to-face and family via video mes-
saging was related to less loneliness and less depression. Social
support is an important buffer in the face of other risk factors,
particularly in the lives of adolescents (Collins & Laursen, 2004).
In fact, time with parents independently predicts lower levels of
depression among depressed adolescents over time (Manczak et
al., 2019), suggesting even parent proximity (e.g., working side by
side) may signal the availability of support to teens. No doubt, time
with family may have been difficult during the initial COVID-19
crisis, yet 36% of teens reported spending less than 30 min a day
with family members. This is somewhat concerning, given ado-
lescents’ lack of other social connections at this time. Parents,
more than friends, have the ability to address teens’ concerns in a
healthy manner and to create positive, adaptive experiences even
during social isolation. Siblings may also offer additional support
183
ADOLESCENT ADJUSTMENT DURING COVID-19
during times of crisis (Volling, 2003). Balancing family time with
work and online education remains a challenging process during
the COVID-19 pandemic.
Current results also reflect extremely low rates of activity, well
below the recommended 60 min per day of moderate-vigorous
exercise for teens. This is not surprising, given the levels of
inactivity among Canadian youth (Statistics Canada, 2017) and the
impact of initial physical distancing on factors that are positively
linked to activity among adolescents (e.g., involvement in school/
community recreational activities, peers’ activity level, and ab-
sence of depression; Sirard et al., 2013;Higgins, Gaul, Gibbons, &
Van Gyn, 2003). However, results showed that physical activity
was related to lower loneliness, beyond the prediction of
COVID-19 stress and the other daily activity variables. There was
also a small but significant correlation between physical activity
and lower depression. Thus, there may be some protection offered
from staying physically active. This is in line with research show-
ing similar protective effects of exercise on subsequent emotional
problems (Bell et al., 2019). Notably, a significant moderating
effect was also found between COVID-19 stress and physical
activity. At lower levels of stress, greater physical activity was
related to lower reported loneliness. At higher levels of stress,
there was no relationship between loneliness and exercise. Higher
COVID-19 stress may significantly interfere with exercise rou-
tines, as higher objective (i.e., life events) and subjective stress is
related to reduced physical activity (Stults-Kolehmainen & Sinha,
2014). Further, as a whole, our sample showed low levels of
activity and high levels of stress. This creates a reinforcing circular
relationship between stress and activity that is problematic for
many individuals. Yet, family members may play a role in inter-
rupting this cycle. The positive correlation between physical ac-
tivity and time with family suggests there could be an additive
effect when exercising with family members to alleviate loneli-
ness.
Despite the important implications of these findings, this study
is not without limitations. First, a one-time survey was completed
after the first 3 weeks of the physical distancing and stay- at-home
directives, potentially before routines of home school and other
behaviours were firmly in place. Yet, it is likely that mental health
concerns will remain in the face of this ongoing pandemic. More
research will be needed as this crisis continues to unfold to track
longitudinal changes, as well as other predictors of adjustment. At
present, the direction of the relationships noted in this study are
unclear. For example, preexisting depressive symptoms may result
in different behaviours during isolation. Additionally, effect sizes
were in the medium range and much of the variance in the
adjustment variables was unaccounted for. To better understand
how adolescents’ daily experiences during the pandemic relate to
adjustment, as well as to tease apart the directional ordering of
relationships, it may be useful for future research to adopt a daily
diary approach. Past research, for instance, demonstrates that ad-
olescents’ corumination with friends predicts within-day worsen-
ing of depression (White & Shih, 2012) and daily variations in peer
and parent support predicts changes in adolescents’ feelings of
connectedness with others (Schacter & Margolin, 2019). Thus, this
type of methodology has the potential to offer a rich understanding
of the fluctuations in adolescent adjustment during social isolation.
Second, results examining virtual social connections also as-
sumes that teens are listening to public health guidelines and are
not seeing friends. In a recent report (Dumas, Ellis, & Litt, in
press), it was found that a subgroup of adolescents were still in
physical contact with their friends despite lockdowns. The impli-
cations of adherence to physical distancing guidelines may have
implications for social support and mental health.
Third, the present results may be an overestimate of social
media use due to our recruitment procedures. As a result, it is
unclear how these results generalise to adolescents who may be
less frequent consumers. Similarly, this data was collected from a
Canadian sample of mid-to-late adolescents that was primarily
female and Caucasian and results may differ by adolescent stage,
gender, geographic region and culture. We had a much greater
representation of females (76.4% of the sample) than males and we
may have lacked statistical power to detect gender differences or
make accurate conclusions for males.
Finally, our scale of COVID-19 stress may not be a reliable way
to measure this construct, given the low internal consistency.
Although items were independently correlated with adjustment,
the correlations between items was low. As this pandemic unfolds,
more work may be needed refine questions to accurately reflect
stress and anxiety about the coronavirus among adolescents.
In conclusion, the goal of this study was to examine stress
associated with the initial COVID-19 crisis and the role of recom-
mended coping strategies on mental health indicators among mid-
to-late adolescents. Given the uncertainty about school environ-
ments during the COVID-19 crisis and possible long-term use of
physical distancing measures, these results highlight important
considerations for parents and mental health practitioners. This
study shows the important role of family connections to potentially
buffer negative outcomes. In addition, time with family and vir-
tually connecting to friends, as well as greater physical activity all
related to lower loneliness, beyond COVID-19 stress levels. In
short, there may be some good options for reducing loneliness
during times of physical distancing. On the contrary, social media
use appears to relate to greater depression as does more frequent
virtual time with friends. It is important to be mindful of the nature
of adolescents’ peer interactions and levels of social media con-
sumption. For teens already struggling with depression and feeling
stressed about the pandemic, existing virtual connections may not
offer enough support. Instead, assistance from parents, and espe-
cially mental health professionals, might be necessary. These
results shed light on far-reaching concerns about the possibility of
global mental health crisis on the heels of the COVID-19 pan-
demic.
Résumé
Nous nous trouvons, avec la pandémie de COVID-19, dans une
situation sans précédent. Des mesures ont été prises pour réduire la
propagation du virus, notamment des fermetures d’établissements
scolaires et des confinements a
`grande échelle. L’isolement phy-
sique, combiné a
`l’instabilité économique, a
`la crainte de
l’infection et a
`l’incertitude quant a
`l’avenir, a eu de profondes
répercussions sur la santé mentale globale. Chez les adolescents,
les effets de ce stress peuvent être exacerbés en raison des carac-
téristiques importantes du développement. Des adolescents cana-
diens (n1 054; M
age
16,68, écart-type 0,78) ont répondu
a
`un sondage en ligne comportant des questions sur le stress dû a
`
la crise de la COVID-19, le sentiment de solitude et de dépression,
184 ELLIS, DUMAS, AND FORBES
ainsi que le temps passé avec la famille ou les amis (virtuellement),
ainsi que le temps consacré aux devoirs, aux médias sociaux et a
`
l’activité physique. Les résultats ont démontré que les adolescents
sont très préoccupés par la crise de la COVID-19, et qu’ils sont
particulièrement inquiets par rapport a
`leurs études et aux relations
avec leurs pairs. Le stress dû a
`la COVID-19 était lié a
`une plus
grande solitude et a
`la hausse des cas de dépression, en particulier
chez les adolescents qui passent plus de temps sur les médias
sociaux. Outre le stress dû a
`la COVID-19, le fait de passer plus de
temps en contact virtuel avec ses amis durant la pandémie était lié
a
`une hausse des cas de dépression, tandis que le temps passé en
famille ou consacré aux devoirs était lié a
`une incidence moindre
de la dépression. Dans le cas des adolescents souffrant de
symptômes de dépression, il pourrait être important de surveiller le
niveau de soutien fourni par les relations en ligne. Les résultats
laissent entrevoir des pistes prometteuses pour prévenir la solitude.
Notamment, le temps en famille, le temps consacré aux contacts
avec les amis, ainsi que l’activité physique étaient liés a
`une
diminution de la solitude dans le contexte du stress lié a
`la
COVID-19. Ces résultats permettent de mieux comprendre les
répercussions de la pandémie de COVID-19 sur les adolescents et
font état de possibles voies d’intervention pour atténuer les con-
séquences négatives.
Mots-clés : adolescents, dépression, solitude, COVID-19, médias
sociaux.
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Received May 7, 2020
Revision received June 8, 2020
Accepted June 9, 2020
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187
ADOLESCENT ADJUSTMENT DURING COVID-19
... Although these precautions are deemed necessary, scholars worry that distance schooling [4], along with social distancing [5], could have adverse impacts on adolescents' psychosocial functioning [3]. Indeed, adolescents, particularly high-school seniors, have reported experiencing distress and concern about the future due to being away from school and peers [6]. Other studies have shown that school closures can be linked to decreased physical activity, sleep problems, a less healthy diet, and increased screen time [7,8], which can sometimes lead to mental health problems, including depression [9]. ...
... These results are important given that adolescence is a time of important biopsychosocial changes [13], making adolescents a vulnerable group during times of crisis [3]. We hypothesized (a) that adolescents would report an increase in substance use and victimization [3], more conflicts or quality time spent with parents [19], less time spent with peers [6], and poorer everyday life and mental health [9]; (b) that particularly girls [11,12] would be subject to poorer psychosocial functioning during COVID-19; and (c) although some studies have shown mixed results [11], that adolescents who are engaged in distance schooling [7,8] would report poorer psychosocial functioning during COVID-19. Given the paucity of research on adolescent perceptions of the restrictions during COVID-19, no specific hypotheses regarding adolescents' thoughts and behaviors around the COVID-19 outbreak were made. ...
... This particularly seemed to be the case for girls and for adolescents who have had distance schooling during COVID-19 crisis. These results corroborate the findings from other studies showing that female gender [11] and distance schooling [6] are important risk factors during the time of crisis, such as a pandemic. Indeed, adolescents' school context was suddenly reduced to distance education at home and less social support from teachers and peers. ...
Article
Full-text available
What effect the outbreak of the COVID-19 pandemic has had on adolescents’ psychosocial functioning is currently unknown. Using the data of 1767 (50.2% female and 49.8 male) adolescents in Sweden, we discuss adolescents’ thoughts and behaviors around the COVID-19 outbreak, as well as reported changes in substance use, everyday life, relations, victimization, and mental health during the outbreak. Results showed that (a) the majority of adolescents have been complying with regulations from the government; (b) although most adolescents did not report changes in their psychosocial functioning, a critical number reported more substance use, conflict with parents, less time spent with peers, and poorer control over their everyday life; and (c) the majority of adolescents have experienced less victimization, yet poorer mental health, during the COVID-19 outbreak. Adolescent girls and adolescents in distance schooling were likely to report negative changes in their psychosocial functioning during the COVID-19 outbreak. Based on these findings, we suggest that society should pay close attention to changes in adolescents’ psychosocial functioning during times of crisis.
... Such policies that encourage protective behaviors such as social distancing have been found to be effective in reducing the spread of COVID-19 [6]. Many of these social distancing measures, such as school closures and the subsequent transition to online learning, greatly affect adolescents, and researchers have found that the continued spread of COVID-19 has many deleterious effects on adolescents' mental, physical, and socioemotional health [7][8][9][10][11][12][13]. Therefore, it is of interest to examine the extent to which adolescents engage in protective behaviors against the spread of COVID-19, such as staying home and being more diligent about hygiene, and what determinants influence such behaviors, so that the spread of COVID-19 may be reduced [14]. ...
... Emerging research has shown that since the COVID-19 pandemic emerged, adolescents are at increased risk for various mental and physical health issues [7,10,11,13,15,16]. In a longitudinal study of adolescents in Shanghai, China conducted from January to March 2020, adolescents' physical activity decreased significantly, from an average of 540 min per week to 105 min per week [13]. ...
... Adolescents are also at increased risk for negative mental health outcomes since the beginning of the COVID-19 pandemic [10,11,15]. A review of the preliminary literature indicated an increased risk of posttraumatic stress disorder, depressive and anxiety symptoms among adolescents since the pandemic emerged [11]. ...
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Middle school students are of particular interest when examining the impact of the COVID-19 pandemic because they are in a formative period for socioemotional development, and because they are not as mature as adults, making them more vulnerable to the effects of the current pandemic. This study seeks to examine determinants of protective behavior changes since COVID-19 among middle school students. Participants were recruited through an official online flatform used by public schools. The final sample included 328 middle school students in South Korea. A multiple linear regression was conducted to explore what factors influence protective behavior changes since COVID-19. Gender and health status were associated with protective behavior changes since COVID-19. Family satisfaction was positively associated with protective behavior changes. Levels of sanitation since COVID-19 and perceptions regarding the risk of COVID-19 were significantly related to protective behavior changes. This study suggests to consider three factors–individual, family, and environmental—in order to prevent middle school students from contracting and spreading the virus.
... Therefore studies have looked into technologies to measure public mental health by mining social media data [3,15,32]. Recent studies suggested that COVID social distancing caused loneliness and other mental health challenges to many who stayed at home [36,45], especially the young adults [16,22]. However, the use of video-sharing for supporting mental health during disasters is under-explored [47]. ...
... For creators who mentioned COVID-19 more, their videos showed homelife or chat with the audience. SHWM videos didn't intensively mention COVID because YouTubers felt discussing this stressor in the video would negatively impact viewers' mental states and wellbeing [16]. ...
... For example, Twitter enhanced public situational awareness [61]; Facebook was a source of community and official information [5,11]; and Reddit was used for risk perception and speculation [23]. However, more exposure to the overwhelming COVID-19 news via social media caused negative mental states such as stress and depression [16,22]. Prior works on social media and disaster mental health mainly examined media's roles in mental health surveillance [32] offering mental health service [27], and enhancing community ties [49]. ...
Conference Paper
Full-text available
Loneliness threatens public mental wellbeing during COVID-19. In response, YouTube creators participated in the #StayHome #WithMe movement (SHWM) and made myriad videos for people experiencing loneliness or boredom at home. User-shared videos generate parasocial attachment and virtual connectedness. However, there is limited knowledge of how creators contributed videos during disasters to provide social provisions as disaster-relief. Grounded on Weiss's loneliness theory, this work analyzed 1488 SHWM videos to examine video sharing as a pathway to social provisions. Findings suggested that skill and knowledge sharing, entertaining arts, homelife activities, live chatting, and gameplay were the most popular video styles. YouTubers utilized parasocial relationships to form a space for staying away from the disaster. SHWM YouTubers provided friend-like, mentor-like, and family-like provisions through videos in different styles. Family-like provisions led to the highest overall viewer engagement. Based on the findings, design implications for supporting viewers' mental wellbeing in disasters are discussed.
... Therefore studies have looked into technologies to measure public mental health by mining social media data [3,15,32]. Recent studies suggested that social distancing caused loneliness and other mental health challenges to many who stayed at home [36,45], especially the young adults [16,22]. However, the use of video-sharing for supporting mental health during disasters is under-explored [47]. ...
... For example, Twitter enhanced public situational awareness [61]; Facebook was a source of community and official information [5,11]; and Reddit was used for risk perception and speculation [23]. However, more exposure to the overwhelming COVID-19 news via social media caused negative mental states such as stress and depression [16,22]. Prior works on social media and disaster mental health mainly examined media's roles in mental health surveillance [32] offering mental health service [27], and enhancing community ties [49]. ...
... The prolonged social distancing and overwhelming COVID information put people, especially young adults, at risk for increased loneliness and depression [16,22]. SHWM movement indicates new design opportunities for using video sharing to mitigate the loneliness and stress caused by disaster information. ...
Preprint
Loneliness threatens public mental wellbeing during COVID-19. In response, YouTube creators participated in the #StayHome #WithMe movement (SHWM) and made myriad videos for people experiencing loneliness or boredom at home. User-shared videos generate parasocial attachment and virtual connectedness. However, there is limited knowledge of how creators contributed videos during disasters to provide social provisions as disaster-relief. Grounded on Weiss's loneliness theory, this work analyzed 1488 SHWM videos to examine video sharing as a pathway to social provisions. Findings suggested that skill and knowledge sharing, entertaining arts, homelife activities, live chatting, and gameplay were the most popular video styles. YouTubers utilized parasocial relationships to form a space for staying away from the disaster. SHWM YouTubers provided friend-like, mentor-like, and family-like provisions through videos in different styles. Family-like provisions led to the highest overall viewer engagement. Based on the findings, design implications for supporting viewers' mental wellbeing in disasters are discussed.
... Children and adolescents have also had their own challenges, including the closure of schools and universities, resulting in significant disruption to daily routines and leisure, examination postponement and graduation cancellations [15,16]. Closure of recreation facilities, national parks and playgrounds have had the unintended consequences of a reduction in physical activity and increase in sedentary lifestyle and obesity, exposing the population to an increased risk of developing or deteriorating existing chronic health conditions such as diabetes mellitus and hypertension [17]. ...
Article
Full-text available
Mental health and emotional responses to the effects of COVID-19 lockdown in sub-Saharan Africa (SSA) are of serious public health concern and may negatively affect the mental health status of people. Hence, this study assessed the prevalence of mental health symptoms as well as emotional reactions among sub-Saharan Africans (SSAs) and associated factors among SSAs during the COVID-19 lockdown period. This was a web-based cross-sectional study on mental health and emotional features from 2005 respondents in seven SSA countries. This study was conducted between 17 April and 17 May 2020 corresponding to the lockdown period in most SSA countries. Respondents aged 18 years and above and the self-reported symptoms were feeling anxious, being worried, angry, bored and frustrated. These were the main outcomes and were treated as dichotomous variables. Univariate and multivariate logistic regression analyses were used to identify the factors associated with these symptoms. We found that over half (52.2%) of the participants reported any of the mental health symptoms and the prevalence of feeling bored was 70.5% followed by feeling anxious (59.1%), being worried (57.5%), frustrated (51.5%) and angry (22.3%) during the COVID-19 pandemic. Multivariate analysis revealed that males, those aged >28 years, those who lived in Central and Southern Africa, those who were not married, the unemployed, those living with more than six persons in a household, had higher odds of mental health and emotional symptoms. Similarly, people who perceived low risk of contracting the infection, and those who thought the pandemic would not continue after the lockdown had higher odds of mental health and emotional symptoms. Health care workers had lower odds for feeling angry than non-healthcare workers. During the COVID-19 lockdown periods in SSA, about one in two participants reported mental health and emotional symptoms. Public health measures can be effectively used to identify target groups for prevention and treatment of mental health and emotional symptoms. Such interventions should be an integral component of SSA governments’ response and recovery strategies of any future pandemic.
... Children and adolescents have also had their own challenges, including the closure of schools and universities, resulting in significant disruption to daily routines and leisure, examination postponement and graduation cancellations [15,16]. Closure of recreation facilities, national parks and playgrounds have had the unintended consequences of a reduction in physical activity and increase in sedentary lifestyle and obesity, exposing the population to an increased risk of developing or deteriorating existing chronic health conditions such as diabetes mellitus and hypertension [17]. ...
Preprint
Full-text available
Mental health and emotional responses to the effects of COVID-19 lockdown in sub-Saharan Africa (SSA) are of serious public health concern and may negatively affect the mental health status of people. Hence, this study assessed the prevalence of mental health symptoms as well as emotional reactions among sub-Saharan Africans (SSAs) and associated factors among SSAs during the COVID-19 lockdown period. This was a web-based cross-sectional, a study on mental health and emotional features from 2005 respondents in seven SSA countries. This study was conducted between April 27 and May 17, 2020 corresponding to the lockdown period in most SSA countries. Respondents aged 18 years and above and the self-reported symptoms were feeling anxious, being worried, angry, bored and frustrated. These were the main outcomes and were treated as dichotomous variables. Univariate and multivariate logistic regression analyses were used to identify the factors associated with these symptoms. We found that over half (52.2%) of the participants reported any of the mental health symptoms in SSA and the prevalence of feeling bored was 70.5% followed by feeling anxious (59.1%), being worried (57.5%), frustrated (51.5%) and angry (22.3%) during the COVID-19 pandemic. Multivariate analysis revealed that males, those aged >28 years, Central and Southern Africans, those who were not married, the unemployed, those living with more than six persons in a household, had higher odds of mental health and emotional symptoms. Similarly, people who perceived low risk of contracting the infection, and those who thought the pandemic would not continue after the lockdown had higher odds of mental health and emotional symptoms. Health care workers had lower odds for feeling angry than non-healthcare workers. During COVID-19 lockdown periods in SSA, about one in two participants reported mental health and emotional symptoms. Public health measures can be effectively used to identify target groups for prevention and treatment of mental health and emotional symptoms. Such interventions should be an integral component of SSA governments’ response and recovery strategies of any future pandemic.
... These results confirm that online interaction, including on social media, can enhance social connections and provide psychological support for nursing students (Bavel et al., 2020;Doré, Morris, Burr, Picard, & Ochsner, 2017). It should be noted, however, that passive use of social media (e.g., lurking or monitoring others without direct engagement) can be a concern, and studies have found that students who spent prolonged time using social media for social interaction while physically isolated were at risk for depression (Ellis, Dumas, & Forbes, 2020;Verduyn et al., 2015). Nursing educators may wish to discuss the findings of Ellis et al. and Verduyn et al. with their students to help any students who may be at risk for depression to identify their own problematic patterns of behavior and seek appropriate help. ...
Article
The COVID-19 outbreak has profoundly changed daily life and the ways in which students learn and interact. This study explores the nature and content of tweets posted by students enrolled in nursing programs (hereafter nursing students) in the United Kingdom, the United States, and South Korea during the COVID-19 pandemic between March 4 and April 7, 2020. A total of 8,856 tweets from the Twitter accounts of 95 self-identified nursing students were included in our qualitative analysis. The findings revealed five categories of tweet content: (1) reactions to COVID-19, (2) everyday life, (3) role as a student, (4) social connection, and (5) sociopolitical issues. Students shared concerns about the impact of COVID-19 on their education, discussed their experiences as nursing students, tweeted details of their daily lives, and sought social connections for support as well as for information sharing. The findings of this study can inform nurse educators to better understand their students' responses to and sentiments about the COVID-19 pandemic. Nurse educators should incorporate this understanding into curricula for pandemic preparedness and response efforts.
... Reasonably, a great deal of the initial studies on the effect of pandemic and social isolation on children and adolescents focused on the risk factors that such an emergency condition could produce on the youth's psychological well-being (Spinelli, Lionetti, Pastore & Fasolo, 2020;Wang, Zhang, Zhao, Zhang & Jiang, 2020). Nevertheless, since the beginning it was emerging the need to focus not only on the risk factors but also on children's and adolescents' capabilities to cope with the new situation (Ellis, Dumas & Forbes, 2020). As it usually happens, research was done on children and adolescents rather than with them (Crivello, Camfield & Woodhead, 2009). ...
Article
Full-text available
The article presents the preliminary analysis of Italian children’s diaries during the COVID-19 lockdown. The outbreak of the disease has posed great challenges to people’s daily lives and often children’s perspectives have been overlooked. We conducted a diary study with 28 pre-adolescents in the North–East of Italy to grasp their first-person perspective on this extraordinary event. We considered a number of relevant examples that are representative of their ideas, opinions and thoughts on the pandemic phases, family life, and education. Diaries are used as ecocultural qualitative methods able to illustrate the dynamics of children’s experiences and their sense-making, and to provide useful insights for educators.
... These findings suggest that the stress associated with lockdown (e.g., less social contact, cancellation of events and extra-curricular activities, changed routine) may be associated with poorer mental health in children with ADHD. Although this is the first study to our knowledge that has examined the association between child COVID-19 stress and functioning in children with ADHD, this finding is consistent with studies linking COVID-19-related risk factors (e.g., time spent thinking about COVID-19, perceived negative impact of COVID-19) to higher levels of mental health difficulties in children (Xie et al., 2020), adolescents (Ellis et al., 2020), and adults in the general population (Guo et al., 2020;Huang & Zhao, 2020;Li et al., 2020;Liu et al., 2020;Ustun, 2020). ...
Article
Full-text available
Objective To examine the impact of COVID-19 restrictions among children with attention-deficit/hyperactivity disorder (ADHD). Methods Parents of 213 Australian children (5–17 years) with ADHD completed a survey in May 2020 when COVID-19 restrictions were in place (i.e., requiring citizens to stay at home except for essential reasons). Results Compared to pre-pandemic, children had less exercise (Odds Ratio (OR) = 0.4; 95% CI 0.3–0.6), less outdoor time (OR = 0.4; 95% 0.3–0.6), and less enjoyment in activities (OR = 6.5; 95% CI 4.0–10.4), while television (OR = 4.0; 95% CI 2.5–6.5), social media (OR = 2.4; 95% CI 1.3–4.5), gaming (OR = 2.0; 95% CI 1.3–3.0), sad/depressed mood (OR = 1.8; 95% CI 1.2–2.8), and loneliness (OR = 3.6; 95% CI 2.3–5.5) were increased. Child stress about COVID-19 restrictions was associated with poorer functioning across most domains. Most parents (64%) reported positive changes for their child including more family time. Conclusions COVID-19 restrictions were associated with both negative and positive impacts among children with ADHD.
Article
Full-text available
Aims. Even though child psychology researches related to a pandemic are extensive, the knowledge of practitioners about interventions and practices is still very limited. The complete novelty of such an epidemic situation in Europe, the diversity of terminology and methods are factors that make results hard to interpret. Therefore, the current study aims to give an overview of the psychological literature of the family aspects of the Covid-19 pandemic. Methods. A search was executed in four databases (Science Direct, Medline, Scopus, Google Scholar) using the following keywords: pandemic, Covid 19, family, children, adolescents, anxiety, depression. Our review focuses only on English language literature. Results. The majority of the articles focus on non-pathological phenomena and draws attention to the behavior of healthy populations (increase in internet use, the decline of concentration). Methods were dominated by online surveys. These surveys were mainly constructed ad-hoc and they preferred to address parents. Direct child investigations are underrepresented, but several suggestions were formulated for their optimal functioning. Conclusion:. Researches focusing on psychopathology emphasize the growth in the prevalence of disorders. However, other researches are needed to explore the psychodynamics of the pandemic on the family level. Our study aimed to contribute to the field by summarizing the main findings, suggestions, and interventions hoping that it might be a useful tool for practitioners and reduce the territory of the unknown.
Article
Full-text available
The 2019 novel coronavirus (COVID-2019) has led to a serious outbreak of often severe respiratory disease, which originated in China and has quickly become a global pandemic, with far-reaching consequences that are unprecedented in the modern era. As public health officials seek to contain the virus and mitigate the deleterious effects on worldwide population health, a related threat has emerged: global media exposure to the crisis. We review research suggesting that repeated media exposure to community crisis can lead to increased anxiety, heightened stress responses that can lead to downstream effects on health, and misplaced health-protective and help-seeking behaviors that can overburden health care facilities and tax available resources. We draw from work on previous public health crises (i.e., Ebola and H1N1 outbreaks) and other collective trauma (e.g., terrorist attacks) where media coverage of events had unintended consequences for those at relatively low risk for direct exposure, leading to potentially severe public health repercussions. We conclude with recommendations for individuals, researchers, and public health officials with respect to receiving and providing effective communications during a public health crisis. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
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The notion that digital-screen engagement decreases adolescent well-being has become a recurring feature in public, political, and scientific conversation. The current level of psychological evidence, however, is far removed from the certainty voiced by many commentators. There is little clear-cut evidence that screen time decreases adolescent well-being, and most psychological results are based on single-country, exploratory studies that rely on inaccurate but popular self-report measures of digital-screen engagement. In this study, which encompassed three nationally representative large-scale data sets from Ireland, the United States, and the United Kingdom (N = 17,247 after data exclusions) and included time-use-diary measures of digital-screen engagement, we used both exploratory and confirmatory study designs to introduce methodological and analytical improvements to a growing psychological research area. We found little evidence for substantial negative associations between digital-screen engagement—measured throughout the day or particularly before bedtime—and adolescent well-being.
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Purpose The overarching goal of this study was to provide key information on how adolescents' substance use has changed since the corona virus disease (COVID)-19 pandemic, in addition to key contexts and correlates of substance use during social distancing. Methods Canadian adolescents (n = 1,054, Mage = 16.68, standard deviation = .78) completed an online survey, in which they reported on their frequency of alcohol use, binge drinking, cannabis use, and vaping in the 3 weeks before and directly after social distancing practices had taken effect. Results For most substances, the percentage of users decreased; however, the frequency of both alcohol and cannabis use increased. Although the greatest percentage of adolescents was engaging in solitary substance use (49.3%), many were still using substances with peers via technology (31.6%) and, shockingly, even face to face (23.6%). Concerns for how social distancing would affect peer reputation was a significant predictor of face-to-face substance use with friends among adolescents with low self-reported popularity, and a significant predictor of solitary substance use among average and high popularity teens. Finally, adjustment predictors, including depression and fear of the infectivity of COVID-19, predicted using solitary substance use during the pandemic. Conclusions Our results provide preliminary evidence that adolescent substance use, including that which occurs face to face with peers, thereby putting adolescents at risk for contracting COVID-19, may be of particular concern during the pandemic. Further, solitary adolescent substance use during the pandemic, which is associated with poorer mental health and coping, may also be a notable concern worthy of further investigation.
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This article examines the self-perceived mental and physical health of Canadians during the COVID-19 pandemic and reports differences between women and men and for different age groups. https://www150.statcan.gc.ca/n1/pub/45-28-0001/2020001/article/00003-eng.htm
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Countries are tackling the spread of the COVID-19 pandemic imposing people to social isolate. However, this measure carries risks for people's mental health. This study evaluated the psychological repercussions of isolation in 1006 Italians locked down. Although varying for the regional spread-rate of the contagion, results showed that the length of isolation and the inadequacy of the physical space where people were isolated worsened mental health (e.g., depression). Offline and online social contacts could buffer the adverse effects of social restrictions. However, when offline contacts are limited, online contacts can protect mental health from isolation. The findings inform about the downsides of the massive social isolation imposed by COVID-19 spread, highlighting risk factors and resources to account for in the implementation of such isolation measures.
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Importance Increases in screen time have been found to be associated with increases in depressive symptoms. However, longitudinal studies are lacking. Objective To repeatedly measure the association between screen time and depression to test 3 explanatory hypotheses: displacement, upward social comparison, and reinforcing spirals. Design, Setting, and Participants This secondary analysis used data from a randomized clinical trial assessing the 4-year efficacy of a personality-targeted drug and alcohol prevention intervention. This study assessed screen time and depression throughout 4 years, using an annual survey in a sample of adolescents who entered the seventh grade in 31 schools in the Greater Montreal area. Data were collected from September 2012 to September 2018. Analysis began and ended in December 2018. Main Outcomes and Measures Independent variables were social media, television, video gaming, and computer use. Symptoms of depression was the outcome, measured using the Brief Symptoms Inventory. Exercise and self-esteem were assessed to test displacement and upward social comparison hypothesis. Results A total of 3826 adolescents (1798 girls [47%]; mean [SD] age, 12.7 [0.5] years) were included. In general, depression symptoms increased yearly (year 1 mean [SD], 4.29 [5.10] points; year 4 mean [SD], 5.45 [5.93] points). Multilevel models, which included random intercepts at the school and individual level estimated between-person and within-person associations between screen time and depression. Significant between-person associations showed that for every increased hour spent using social media, adolescents showed a 0.64-unit increase in depressive symptoms (95% CI, 0.32-0.51). Similar between-level associations were reported for computer use (0.69; 95% CI, 0.47-0.91). Significant within-person associations revealed that a further 1-hour increase in social media use in a given year was associated with a further 0.41-unit increase in depressive symptoms in that same year. A similar within-person association was found for television (0.18; 95% CI, 0.09-0.27). Significant between-person and within-person associations between screen time and exercise and self-esteem supported upward social comparison and not displacement hypothesis. Furthermore, a significant interaction between the between-person and within-person associations concerning social media and self-esteem supported reinforcing spirals hypothesis. Conclusions and Relevance Time-varying associations between social media, television, and depression were found, which appeared to be more explained by upward social comparison and reinforcing spirals hypotheses than by the displacement hypothesis. Both screen time modes should be taken into account when developing preventive measures and when advising parents.