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      Examining Children and adolescent mental health trajectories during the COVID‐19 pandemic: Findings from a year of the Co‐SPACE study

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          Abstract

          Background

          A major concern throughout the COVID‐19 pandemic has been on young people's experiences with mental health. In this study we mapped children and adolescents' mental health trajectories over 13 months of the pandemic and examine whether family, peer, and individual‐level factors were associated with trajectory membership.

          Methods

          This study focuses on a sub‐sample from the Co‐SPACE study of 3322 children and adolescents (aged 4–16 years) for whom parents completed a survey at Time 0 and at least one follow‐up survey between March 2020 and May 2021. We used growth mixture models to examine trajectories in emotional, conduct, and hyperactivity/inattention difficulties using the Strengths and Difficulties Questionnaire and multinomial logistic regression models to estimate factors associated with individual trajectory membership.

          Results

          The average trend in young people's mental health appeared to follow changes in national guidelines regarding the pandemic. Distinct trends in GMM models highlighting individual differences showed that a 5‐trajectory model best explained the changes in emotional problems whilst 4‐trajectory models best explained variation in hyperactivity/inattention and conduct problems. While most young people followed low stable (62%–85%) or moderate stable (28%) symptom trajectories, 14%–31% experienced very high, high stable or increasing mental health difficulties. Young people following high stable trajectories were more likely to have special educational needs and/or neurodevelopmental disorders, parents reporting higher levels of distress and parent‐child conflict, and were less likely to have at least one close friend.

          Conclusions

          Most young people adapted well and experienced low stable symptoms, but nearly one third experienced high stable or increasing mental health difficulties. Young people with complex needs and parents with higher psychological distress were particularly vulnerable to high stable problems while those with positive peer relationships were less vulnerable. This study offers insight into potential factors that can be addressed using targeted interventions to improve the wellbeing of parents and young people in the event of future lockdowns and school closures.

          Abstract

          This study used data from the Co‐Space Study to examine children and adolescents' mental health trajectories over 13 months of the pandemic and whether family, peer, and individual‐level factors were associated with trajectory membership. We found that most young people adapted well and experienced low stable symptoms, but nearly one third experienced high stable or increasing mental health difficulties. Young people with complex needs and parents with higher psychological distress were particularly vulnerable to high mental health difficulties while those with positive peer relationships were less vulnerable. This study offers insight into potential factors that can be addressed using targeted interventions to improve the wellbeing of parents and young people in the event of future lockdowns and school closures.

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          Most cited references53

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          Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives

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            Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population

            Summary Background The potential impact of the COVID-19 pandemic on population mental health is of increasing global concern. We examine changes in adult mental health in the UK population before and during the lockdown. Methods In this secondary analysis of a national, longitudinal cohort study, households that took part in Waves 8 or 9 of the UK Household Longitudinal Study (UKHLS) panel, including all members aged 16 or older in April, 2020, were invited to complete the COVID-19 web survey on April 23–30, 2020. Participants who were unable to make an informed decision as a result of incapacity, or who had unknown postal addresses or addresses abroad were excluded. Mental health was assessed using the 12-item General Health Questionnaire (GHQ-12). Repeated cross-sectional analyses were done to examine temporal trends. Fixed-effects regression models were fitted to identify within-person change compared with preceding trends. Findings Waves 6–9 of the UKHLS had 53 351 participants. Eligible participants for the COVID-19 web survey were from households that took part in Waves 8 or 9, and 17 452 (41·2%) of 42 330 eligible people participated in the web survey. Population prevalence of clinically significant levels of mental distress rose from 18·9% (95% CI 17·8–20·0) in 2018–19 to 27·3% (26·3–28·2) in April, 2020, one month into UK lockdown. Mean GHQ-12 score also increased over this time, from 11·5 (95% CI 11·3–11·6) in 2018–19, to 12·6 (12·5–12·8) in April, 2020. This was 0·48 (95% CI 0·07–0·90) points higher than expected when accounting for previous upward trends between 2014 and 2018. Comparing GHQ-12 scores within individuals, adjusting for time trends and significant predictors of change, increases were greatest in 18–24-year-olds (2·69 points, 95% CI 1·89–3·48), 25–34-year-olds (1·57, 0·96–2·18), women (0·92, 0·50–1·35), and people living with young children (1·45, 0·79–2·12). People employed before the pandemic also averaged a notable increase in GHQ-12 score (0·63, 95% CI 0·20–1·06). Interpretation By late April, 2020, mental health in the UK had deteriorated compared with pre-COVID-19 trends. Policies emphasising the needs of women, young people, and those with preschool aged children are likely to play an important part in preventing future mental illness. Funding None.
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              The Strengths and Difficulties Questionnaire: A Research Note

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                Author and article information

                Contributors
                cathy.creswell@psych.ox.ac.uk
                Journal
                JCPP Adv
                JCPP Adv
                10.1002/(ISSN)2692-9384
                JCV2
                JCPP Advances
                John Wiley and Sons Inc. (Hoboken )
                2692-9384
                18 March 2023
                June 2023
                : 3
                : 2 ( doiID: 10.1002/jcv2.v3.2 )
                : e12153
                Affiliations
                [ 1 ] Department of Experimental Psychology University of Oxford Oxford UK
                [ 2 ] Department of Psychiatry University of Oxford Oxford UK
                [ 3 ] School of Psychology and Clinical Language Sciences University of Reading Reading UK
                [ 4 ] Centre for Longitudinal Studies and MRC Unit for Lifelong Health and Ageing University College London London UK
                Author notes
                [*] [* ] Correspondence

                Cathy Creswell, Departments of Experimental Psychology and Psychiatry, University of Oxford, Anna Watts Building, Oxford, OX2 6GG, UK.

                Email: cathy.creswell@ 123456psych.ox.ac.uk

                Author information
                https://orcid.org/0000-0002-5023-1726
                https://orcid.org/0000-0001-5645-3875
                https://orcid.org/0000-0002-7501-4111
                https://orcid.org/0000-0002-2739-6215
                https://orcid.org/0000-0003-1889-0956
                Article
                JCV212153
                10.1002/jcv2.12153
                10519733
                37753152
                30e628c2-2c07-4bf1-acf2-503a78130747
                © 2023 The Authors. JCPP Advances published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 November 2022
                : 10 February 2023
                Page count
                Figures: 5, Tables: 3, Pages: 13, Words: 9331
                Funding
                Funded by: Calleva Foundation , doi 10.13039/100015662;
                Funded by: National Institute for Health and Care Research , doi 10.13039/501100000272;
                Funded by: NIHR Applied Research Collaboration Oxford and Thames Valley
                Funded by: The Westminster Foundation
                Funded by: Economic and Social Research Council , doi 10.13039/501100000269;
                Award ID: ES/V004034/1
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                June 2023
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.3.4 mode:remove_FC converted:25.09.2023

                adolescents,children,mental health,pandemic,wellbeing
                adolescents, children, mental health, pandemic, wellbeing

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