A longitudinal investigation of psychological distress in children during COVID-19: the role of socio-emotional vulnerability

Abstract

Background Although the COVID-19 pandemic has increased the incidence of distress in youth, some children show increased resilience, emphasizing the need to better understand the predictors of distress in youth. Objective This longitudinal study aimed to assess the combined impact of known socio-emotional predictors of stress-related psychopathology, namely anxiety sensitivity, anxiety trait, intolerance to uncertainty, and rumination, on COVID-related distress in healthy youth. Method A total of 92 parent-child dyads that previously participated in a laboratory-based experiment assessing observational fear learning in families between 2017 and 2019 (T0) were recontacted. Of them, 84 children aged between 9 and 14 agreed to participate. They completed online questionnaires in June 2020 (T1), September 2020 (T2), December 2020 (T3), and March 2021 (T4). Participants were free of mental illness at T0 and T1. To create a socio-emotional composite score (SECS), we measured anxiety sensitivity (Childhood Anxiety Sensitivity Index) at T0, trait anxiety (Trait subscale of the State-Trait Anxiety Inventory for Children (STAI-C)), intolerance to uncertainty (Intolerance of Uncertainty Scale for Children), and trait rumination (Children’s Response Style Scale) at T1 and created a weighted z-score. To assess symptoms of anxiety, post-traumatic stress (PTS), and depression in reaction to COVID-19, participants completed the State subscale of the STAI-C, the Children’s Revised Impact of Event Scale, and the Children’s Depression Inventory at T1–T4. Three general linear models were run with sex, age group (9–11 and 12+ years old), and SECS as predictors. Results Analyses revealed a SECS*Time interaction, with higher SECS predicting elevated anxiety symptoms at T1 and T4, and elevated PTS symptoms at T1 and T2. Conclusion These results suggest that healthy youth endorsing high levels of socio-emotional vulnerability to psychopathology have a higher risk of suffering from anxiety and PTS, but not depressive symptoms, in the year following a major stressor.

Pre-pandemic socio-emotional vulnerability, internalizing and externalizing symptoms predict changes in hair cortisol concentrations in reaction to the COVID-19 pandemic in children

“…For the said study, parent-child dyads were recruited through advertisements on social media and posters in the surroundings of our research centre. Among the parents of the 92 children that were contacted, 84 (91.3%) children (42 girls and 42 boys) agreed to participate in this follow-up (T1) which intended to 1) assess distress longitudinally between June 2020 and March 2021 ( Raymond et al, 2022 ) and; 2) assess HCC in reaction to the COVID-19 pandemic (see Fig. 1 for timeline overview).…”

“…These scores were then averaged for each participant to provide a composite score. This score was referred to as the socio-emotional composite score (SECS; see Raymond et al (2022) ) for further details).…”

“…For instance, compared to younger children and boys, adolescent girls have an increased risk of presenting elevated depression and anxiety symptoms (for a meta-analysis, see Ma et al, 2021 ). A longitudinal study conducted by our research group showed that youth presenting elevated pre-pandemic socio-emotional vulnerability displayed an increase and maintenance of anxiety and post-traumatic symptoms when faced with the pandemic ( Raymond et al, 2022 ). Yet, it remains unclear whether the adverse life event of the pandemic was able to “get under the skin” and affect the biological stress system of these children.…”

“…Furthermore, although these factors tend to correlate amongst each other, studies tend to assess their individual predictive value on HPA axis activity rather than their combined contribution ( Boelen et al, 2010 , Cox et al, 2001 , Hensley and Varela, 2008 , Muris et al, 2001 ). Recently, our research group demonstrated the combined contribution of these factors in the prediction of anxiety and post-traumatic symptoms in reaction to COVID-19 in youth ( Raymond et al, 2022 ). The integration of these predictors could provide a more global portrait of the contribution that socio-emotional vulnerability plays on HPA functioning in children.…”

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“…Racine et al [ 4 ] estimated that, globally, during the first year of the pandemic, 25% of children and adolescents suffered from depression and 20% suffered from anxiety—rates that doubled those of the pre-pandemic era. Additionally, Raymond et al [ 5 ] detected symptoms of post-traumatic stress and anxiety in young people with socio-emotional vulnerability during the pandemic, noting that females and adolescents showed the most symptoms, relative to males and children.…”