Purpose Adolescence is characterized by dramatic physical, social, and emotional changes, making teens particularly vulnerable to the mental health effects of the COVID-19 pandemic. This longitudinal study identifies young adolescents who are most vulnerable to the psychological toll of the pandemic and provides insights to inform strategies to help adolescents cope better in times of crisis. Methods A data-driven approach was applied to a longitudinal, demographically diverse cohort of more than 3,000 young adolescents (10–14 years) participating in the ongoing Adolescent Brain Cognitive Development Study in the United States, including multiple prepandemic visits and three assessments during the COVID-19 pandemic (May–August 2020). We fitted machine learning models and provided a comprehensive list of predictors of psychological distress in individuals. Results Positive affect, stress, anxiety, and depressive symptoms were accurately detected with our classifiers. Female sex and prepandemic internalizing symptoms and sleep problems were strong predictors of psychological distress. Parent- and youth-reported pandemic-related psychosocial factors, including poorer quality and functioning of family relationships, more screen time, and witnessing discrimination in relation to the pandemic further predicted youth distress. However, better social support, regular physical activities, coping strategies, and healthy behaviors predicted better emotional well-being. Conclusions Findings highlight the importance of social connectedness and healthy behaviors, such as sleep and physical activity, as buffering factors against the deleterious effects of the pandemic on adolescents' mental health. They also point to the need for greater attention toward coping strategies that help the most vulnerable adolescents, particularly girls and those with prepandemic psychological problems.

Introduction Sleep disturbances frequently emerge during adolescence amongst profound, normative, sleep maturation and biopsychosocial changes. Factors like stress, worry or rumination may make falling asleep and maintaining sleep more difficult. Here, we evaluate the efficacy of a novel intervention based on virtual reality (VR) and slow breathing to promote bedtime relaxation and facilitate sleep in high-school adolescents. Methods Twenty-nine 16-18 year-old adolescents with (N=9, 6 girls) and without (N=20, 11 girls) sleep difficulties underwent two counterbalanced in-lab relaxation and baseline polysomnography (PSG) nights. For the relaxation condition, immediately preceding bedtime, participants were engaged in slow diaphragmatic breathing (to promote physiological downregulation) whilst passively experiencing a relaxation immersive VR environment, designed to promote cognitive relaxation/distraction (20min). On the baseline night, participants engaged in quiet activities (e.g., reading a book) before bedtime (20min). Results The VR intervention resulted in a significant immediate increase in perceived relaxation and reduced worry (p<0.05). Also, heart rate dropped (~5bpm) in the pre-to-post intervention (p<0.05), while no significant change in heart rate was evident before and after the time spent in quiet activities on the baseline night. PSG-defined sleep onset latency was shorter (~6min reduction) and sleep efficiency was greater (~3% increase) on the VR relaxation night compared to the baseline night (p<0.05). In addition, baseline sleep onset latency was related to the magnitude of the baseline-to-relaxation reduction in sleep onset latency in participants (R2=0.70; p<0.01). There was no apparent difference in responses to the VR intervention between adolescents with or without insomnia. Conclusion Our data highlight the potential for combining cognitive relaxation/distraction strategies, using immersive VR technology and physiological downregulation, to promote bedtime relaxation and improve overall sleep quality in adolescents. Further research is needed to evaluate the feasibility and effectiveness of such interventions over time. Support National Heart, Lung and Blood Institute (NHLBI) R01HL139652 (to MdZ)

Introduction Racism negatively affects children’s health, behavior, and relationships. Current literature focuses on associations between perceived discrimination and daytime behaviors in children and adolescents, with less known about associations with sleep behavior, an essential aspect on health during development. Racial/ethnic minorities, including Hispanic/Latinx youth, are at increased risk of sleep problems, along with mental health issues. Here, we examined the relationship between perceived discrimination and sleep and behavioral problems, and the potential role of familial cultural heritage connectedness as a mediator, in Hispanic/Latinx adolescents in the Adolescent Brain Cognitive Development (ABCD) Study®. Methods Data were analyzed from 1,213 Hispanic/Latinx adolescents (Mean age =11.89 years, range: 10-14 years, 48.22% female), collected as part of the ongoing ABCD Study® from the 2nd year follow up. Sleep was assessed with a question about having trouble falling or staying asleep in the past two weeks from the Kiddie Schedule for Affective Disorders and Schizophrenia (KSADS-5) (youth-report). Participants completed the Perceived Discrimination scale, an 11-item self-report about racial/ethnic perceived discrimination in the past year from teachers, peers, and other adults. Cultural heritage connectedness was gathered from the Vancouver Index of Acculturation (caregiver-report). Internalizing and externalizing behaviors were assessed using the Child Behavior Checklist (caregiver-report). Regression models examined associations between perceived discrimination and sleep behavior and externalizing/internalizing behavior, considering age, socio-demographic characteristics, parental education, and familial immigration status. Results Perceived discrimination correlated with more sleep problems (p< 0.01), with a stronger effect in female than male participants (p< 0.01). Perceived discrimination was also associated with internalizing and externalizing behaviors (p< 0.01). Connectedness to cultural heritage partially mediated the association between perceived discrimination and externalizing behaviors (p< 0.01), but not with sleep problems or internalizing behaviors. Conclusion Results show perceived discrimination is associated with sleep problems in Hispanic/Latinx adolescents, with a stronger relationship in female participants. Future investigation of links between perceived discrimination and health outcomes, including sleep and behaviors, is needed using longitudinal data and youth self-reports of the Vancouver Index of Acculturation, rather than caregiver reports to further investigate the potential role of cultural connectedness is these relationships. Support (if any) NIH U01DA041022