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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

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          Abstract

          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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          Most cited references38

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          The psychological impact of the COVID-19 epidemic on college students in China

          Highlights • Methods of guiding students to effectively and appropriately regulate their emotions during public health emergencies and avoid losses caused by crisis events have become an urgent problem for colleges and universities. Therefore, we investigated and analyzed the mental health status of college students during the epidemic for the following purposes. (1) To evaluate the mental situation of college students during the epidemic; (2) to provide a theoretical basis for psychological interventions with college students; and (3) to provide a basis for the promulgation of national and governmental policies.
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            A Longitudinal Study on the Mental Health of General Population during the COVID-19 Epidemic in China

            Highlights • A significant reduction in psychological impact 4 weeks after COVID outbreak. • The mean scores of respondents in both surveys were above PTSD cut-offs. • Female gender, physical symptoms associated with a higher psychological impact. • Hand hygiene, mask-wearing & confidence in doctors reduced psychological impact. • Online trauma-focused psychotherapy may be helpful to public during COVID-19.
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              • Article: not found

              Epidemic of COVID-19 in China and associated Psychological Problems

              Highlights • There are higher rate of anxiety, depression, alcohol use disorder, and lower mental wellbeing during the COVID-19 epidemic. • Depression and alcohol use disorder were higher among people from Hubei than other provinces. • Non-significant gender differences in anxiety, depression, and mental wellbeing. • Young people, aged 21–40 years old, were psychologically more vulnerable position during the COVID-19 epidemic.
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                Author and article information

                Contributors
                rbreaux@vt.edu
                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
                04 February 2021
                : 10.1111/jcpp.13382
                Affiliations
                [ 1 ] Department of Psychology Virginia Polytechnic Institute and State University Blacksburg VA USA
                [ 2 ] Children’s National Hospital George Washington University Washington DC USA
                [ 3 ] Division of Behavioral Medicine and Clinical Psychology Cincinnati Children’s Hospital Medical Center Cincinnati OH USA
                [ 4 ] Department of Psychology Virginia Commonwealth University Richmond VA USA
                [ 5 ] Department of Pediatrics University of Cincinnati College of Medicine Cincinnati OH USA
                Author notes
                [*] [* ] Correspondence

                Rosanna Breaux, Department of Psychology, Virginia Polytechnic Institute and State University, 460 Turner St. NW, Suite 207, Blacksburg, VA 24060, USA; Email: rbreaux@ 123456vt.edu

                Author information
                https://orcid.org/0000-0001-5500-6950
                https://orcid.org/0000-0001-9046-5183
                Article
                JCPP13382
                10.1111/jcpp.13382
                8014657
                33543486
                5c2818b6-fe1c-427a-a8a8-ac3defb49088
                © 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.

                History
                : 08 December 2020
                Page count
                Figures: 1, Tables: 3, Pages: 8, Words: 14403
                Funding
                Funded by: Institute of Education Sciences , open-funder-registry 10.13039/100005246;
                Award ID: IES ‐ R305A160126
                Funded by: Cincinnati Children’s Research Foundation
                Funded by: Virginia Tech COVID‐19 Rapid Response Seed Grant
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                corrected-proof
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.0.1 mode:remove_FC converted:01.04.2021

                Clinical Psychology & Psychiatry
                novel coronavirus,covid‐19,adolescence,mental health,emotion regulation,attention‐deficit/hyperactivity disorder,psychopathology

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