The Mental Health Effects of the COVID-19 Pandemic on Children and Adolescents: Risk and Protective Factors

Objective: The restrictions to contain the coronavirus disease 2019 (COVID-19) pandemic have led to considerable social isolation, posing significant threats to mental health worldwide. The preventive lockdowns may be especially difficult for children and adolescents, who rely extensively on their daily routines and peer connections for stability and optimal development. However, there is a dearth of longitudinal research examining the mental health and daily life impact of the pandemic among children and adolescents. This study addresses this gap by examining the influence of the COVID-19 pandemic on children and adolescents' mental health and well-being, and potential risk and protective moderators of mental health change. Method: In the present study, 1,537 Israeli children and adolescents (M-age = 13.97; 52% girls) completed a battery of questionnaires in September 2019; before the COVID-19 outbreak and immediately after an 8-week lockdown period when schools reopened in May 2020. Results: A repeated measures multivariant analysis of variance (MANOVA) revealed significantly greater anxiety, depression, and panic symptoms, increases in video game, Internet and TV screen time use, and decreases in positive emotions, life satisfaction, social media use, and peer support during the pandemic. Participants with higher baseline mental health symptoms showed greater symptoms after the lockdown period. Perceived social support and consistent daily routines were found to act as significant protective factors against symptomatology. Conclusions: The results highlight the significant mental health consequences of the pandemic on children and adolescents, and substantiate the significant parents' and peers' roles in children's and adolescents' coping during this global pandemic. Clinical Impact Statement The study highlights the significant mental health burden during the coronavirus disease 2019 (COVID-19) pandemic on children and adolescents, in terms of greater anxiety, depression, and panic symptoms, increases in screen time use, and decreases in subjective well-being and peer support. In addition, the study demonstrates that peer and family support and regularity of daily routines during the pandemic lockdown period moderated the effects of the pandemic on changes in mental health. The study emphasizes the need to provide resilience-promoting interventions to children during the pandemic, and underscore the importance of creating supportive and organized home and school environments that support mental health.