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The COVID-19 pandemic has affected daily stressors, coping and suicidal ideation among psychiatrically hospitalized youth, according to a presentation at the Anxiety and Depression Association of America annual conference.
“Suddenly, some of the things that kids might typically do to manage stress might be restricted or no longer available to them, so COVID-19 could have pretty dramatic impacts on how kids are able to access different skills that maybe they typically would use in the face of stress,” Alexandra H. Bettis, PhD, assistant professor in the department of psychiatry and behavioral sciences at Vanderbilt University Medical Center, said during the presentation.
In the current study, Bettis and colleagues sought to shed light on experiences of teens psychiatrically hospitalized during the pandemic, as well as to assess links between COVID-19-specific stress and coping, daily functioning and suicidal ideation. They analyzed data of 107 individuals aged 11 to 18 years who were admitted to the Bradley Hospital Adolescent Psychiatric Inpatient Unit between March 13, 2020, and July 19, 2020. A total of 66.4% of participants were non-Hispanic, 53.2% were white, 13% were Black or African American, 1.9% were American Indian and Alaska Native, 16.8% reported multiple races/ethnicities and 14% self-identified as having other racial/ethnic backgrounds. Further, 47.7% were women, 43.9% were men, 5.6% were genderqueer/gender non-conforming/gender fluid, 1.9% were transgender male and 0.9% preferred not to answer. The researchers’ assessed the following experiences participants had before hospitalization: COVID-19-related emotions, such as feeling sad, lonely, bored, anxious, guilty, uncertain, angry or relaxed; COVID-19-related stressors, including a list of stressful events relevant to adolescents; COVID-19 coping, such as social engagement, effortful distraction, relaxation and avoidance/disengagement strategies; perceived effectiveness of coping, such as the question, “How helpful have these coping strategies been to deal with the effects of COVID-19?”; and changes in functioning, which included assessment of 12 domains, rated as no change, improved or worsened functioning. Further, the researchers employed the Self-Perceived Flexible Coping with Stress Scale and the Suicidal Ideation Questionnaire-Jr.
Results showed COVID-19 affected participants’ daily functioning, with 44% reporting a negative impact, 6% a positive impact, 4% an equally positive and negative impact and 46% as no impact. Mean emotion rating scores demonstrated a general trend of moderate to moderately high levels of negative emotions linked to the COVID-19 pandemic, with loneliness and boredom being the highest. The researchers noted that, for mean coping and stress scores, distraction and disengagement were significantly higher than relaxation and social engagement. Social media or television use, sleeping or isolating from others and wishing things were different were the most common coping strategies. Being unable to leave home, being cut off from others and worrying about someone participants cared about getting COVID-19 were the most common stressors. Those who used disengagement coping to cope with the pandemic reported higher levels of suicidal ideation, and these individuals were more likely to report feeling that their coping strategies were ineffective.
“When we think about these kids who are really vulnerable to experiencing psychiatric problems, it’s important that we focus on helping them to identify engagement-focused strategies to manage stress in the context of COVID-19,” Bettis said.
Bettis A, et al. Coping with COVID-19: Identifying transdiagnostic and modifiable risk and resilience factors among adolescents. Presented at: The Anxiety and Depression Association of America Annual Conference; Mar. 18-19, 2021 (virtual meeting).