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      Editorial: Do lockdowns scar? Three putative mechanisms through which COVID‐19 mitigation policies could cause long‐term harm to young people's mental health

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          Abstract

          The use of lockdown to slow the spread of COVID‐19 has been unprecedented in its scale, scope and duration despite early predictions that such a measure would have a negative impact on the mental health and well‐being of many young people and their families. From a developmental psychopathology perspective both direct and indirect effects of lockdown‐related harms to young people’s mental health were predictable: Direct effects, for instance, being due to the negative psychological impact of social isolation and confinement on children; Indirect effects being exerted via negative impacts on family and parent mental health and wellbeing. That these effects would vary from person‐to‐person was also predicted from this perspective; with vulnerable individuals with pre‐existing conditions and those living in high‐risk settings being at particular risk. The presumption has been that such negative effects, if they do occur, would be time limited and that everything would return to normal once lockdowns ended. But this is not necessarily the case. In this editorial we ask whether lockdowns could have long‐term effects on young people's mental health and then briefly outline three putative mechanisms through which such long‐term effects might occur.

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          Risk and resilience in family well-being during the COVID-19 pandemic.

          The COVID-19 pandemic poses an acute threat to the well-being of children and families due to challenges related to social disruption such as financial insecurity, caregiving burden, and confinement-related stress (e.g., crowding, changes to structure, and routine). The consequences of these difficulties are likely to be longstanding, in part because of the ways in which contextual risk permeates the structures and processes of family systems. The current article draws from pertinent literature across topic areas of acute crises and long-term, cumulative risk to illustrate the multitude of ways in which the well-being of children and families may be at risk during COVID-19. The presented conceptual framework is based on systemic models of human development and family functioning and links social disruption due to COVID-19 to child adjustment through a cascading process involving caregiver well-being and family processes (i.e., organization, communication, and beliefs). An illustration of the centrality of family processes in buffering against risk in the context of COVID-19, as well as promoting resilience through shared family beliefs and close relationships, is provided. Finally, clinical and research implications are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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            Relationships between poverty and psychopathology: a natural experiment.

            Social causation (adversity and stress) vs social selection (downward mobility from familial liability to mental illness) are competing theories about the origins of mental illness. To test the role of social selection vs social causation of childhood psychopathology using a natural experiment. Quasi-experimental, longitudinal study. A representative population sample of 1420 rural children aged 9 to 13 years at intake were given annual psychiatric assessments for 8 years (1993-2000). One quarter of the sample were American Indian, and the remaining were predominantly white. Halfway through the study, a casino opening on the Indian reservation gave every American Indian an income supplement that increased annually. This increase moved 14% of study families out of poverty, while 53% remained poor, and 32% were never poor. Incomes of non-Indian families were unaffected. Levels of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, psychiatric symptoms in the never-poor, persistently poor, and ex-poor children were compared for the 4 years before and after the casino opened. Before the casino opened, the persistently poor and ex-poor children had more psychiatric symptoms (4.38 and 4.28, respectively) than the never-poor children (2.75), but after the opening levels among the ex-poor fell to those of the never-poor children, while levels among those who were persistently poor remained high (odds ratio, 1.50; 95% confidence interval, 1.08-2.09; and odds ratio, 0.91; 95% confidence interval, 0.77-1.07, respectively). The effect was specific to symptoms of conduct and oppositional defiant disorders. Anxiety and depression symptoms were unaffected. Similar results were found in non-Indian children whose families moved out of poverty during the same period. An income intervention that moved families out of poverty for reasons that cannot be ascribed to family characteristics had a major effect on some types of children's psychiatric disorders, but not on others. Results support a social causation explanation for conduct and oppositional disorder, but not for anxiety or depression.
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              Prospective impact of COVID‐19 on mental health functioning in adolescents with and without ADHD: protective role of emotion regulation abilities

              Background The impact of chronic stressors like the COVID‐19 pandemic is likely to be magnified in adolescents with pre‐existing mental health risk, such as attention‐deficit/hyperactivity disorder (ADHD). This study examined changes in and predictors of adolescent mental health from before to during the COVID‐19 pandemic in the Southeastern and Midwestern United States. Methods Participants include 238 adolescents (132 males; ages 15–17; 118 with ADHD). Parents and adolescents provided ratings of mental health symptoms shortly before the COVID‐19 pandemic and in spring and summer 2020. Results Adolescents on average experienced an increase in depression, anxiety, sluggish cognitive tempo, inattentive, and oppositional/defiant symptoms from pre‐COVID‐19 to spring 2020; however, with the exception of inattention, these symptoms decreased from spring to summer 2020. Adolescents with ADHD were more likely than adolescents without ADHD to experience an increase in inattentive, hyperactive/impulsive, and oppositional/defiant symptoms. Adolescents with poorer pre‐COVID‐19 emotion regulation abilities were at‐risk for experiencing increases in all mental health symptoms relative to adolescents with better pre‐COVID‐19 emotion regulation abilities. Interactive risk based on ADHD status and pre‐COVID‐19 emotion regulation abilities was found for inattention and hyperactivity/impulsivity, such that adolescents with ADHD and poor pre‐COVID‐19 emotion regulation displayed the highest symptomatology across timepoints. Lower family income related to increases in inattention but higher family income related to increases in oppositional/defiant symptoms. Conclusions The early observed increases in adolescent mental health symptoms during the COVID‐19 pandemic do not on average appear to be sustained following the lift of stay‐at‐home orders, though studies evaluating mental health across longer periods of time are needed. Emotion dysregulation and ADHD increase risk for sustained negative mental health functioning and highlight the need for interventions for these populations during chronic stressors. Results and clinical implications should be considered within the context of our predominately White, middle class sample.
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                Author and article information

                Contributors
                edmund.sonuga-barke@kcl.ac.uk
                Journal
                J Child Psychol Psychiatry
                J Child Psychol Psychiatry
                10.1111/(ISSN)1469-7610
                JCPP
                Journal of Child Psychology and Psychiatry, and Allied Disciplines
                John Wiley and Sons Inc. (Hoboken )
                0021-9630
                1469-7610
                22 November 2021
                December 2021
                22 November 2021
                : 62
                : 12 ( doiID: 10.1111/jcpp.v62.12 )
                : 1375-1378
                Affiliations
                [ 1 ] School of Psychiatry Institute of Psychology, Psychiatry and Neuroscience King's College London London UK
                [ 2 ] Department of Child & Adolescent Psychiatry University of Aarhus Aarhus Denmark
                [ 3 ] Research Department of Clinical, Educational and Health Psychology University College London London UK
                Author notes
                [*] [* ] Correspondence

                Edmund Sonuga‐Barke, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AF, UK; Email: edmund.sonuga-barke@ 123456kcl.ac.uk

                Article
                JCPP13537
                10.1111/jcpp.13537
                9011706
                34806768
                28efad66-b68c-41fc-bf88-e44ccb43326f
                © 2021 Association for Child and Adolescent Mental Health.

                This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency.

                Page count
                Figures: 0, Tables: 0, Pages: 4, Words: 2696
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                Editorial
                Editorial
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                2.0
                December 2021
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.1.4 mode:remove_FC converted:15.04.2022

                Clinical Psychology & Psychiatry
                Clinical Psychology & Psychiatry

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