Coping with COVID-19: Longitudinal Impact of the Pandemic on Adjustment and Links with Coping for Adolescents with and without ADHD

Abstract

Understanding factors that foster resilience and buffer against the negative psychological impact of COVID-19 is critical to inform efforts to promote adjustment, reduce risk, and improve care, particularly for adolescents with neurodevelopmental disorders. This prospective longitudinal study addresses this gap by investigating the impact of the COVID-19 pandemic on adolescents' mental health and substance use, and by assessing specific positive coping strategies among adolescents with and without attention-deficit/hyperactivity disorder (ADHD). Using multi-group autoregressive cross-lagged path models, the present study explored the reciprocal influence of positive coping behaviors on multiple adjustment outcomes including mental health symptoms, substance use, stress, and worry. Participants included 238 adolescents (132 male participants; ages 15-17; 118 with ADHD). Parents provided ratings of adolescent routines, and adolescents provided ratings of coping behaviors and psychological adjustment in spring (May/June), summer (July/August), and fall (October/November) 2020. All models included the effects of adjustment at the prior timepoint as well as relevant covariates including adolescent race, ethnicity, sex, medication status, and family income. Adolescents with ADHD were at greater risk for experiencing increases in mental health symptoms and substance use throughout the pandemic, relative to adolescents without ADHD. The use of positive coping strategies and adolescent routines buffered against increases in substance use and mental health problems for adolescents with ADHD. These findings have important clinical and public policy relevance for parents, schools, and employers who may aim to prioritize keeping schedules as consistent as possible to promote healthy adjustment.

Predicting Parental Mental Health During COVID-19: Economic Pressure, COVID-19 Stress, and Coping Strategies

“…With the announcement of the pandemic, parents reported increased stress during the initial months of COVID-19 and the subsequent academic school year (Sonnenschein et al, 2021). The combination of economic stress and parenting stress during COVID-19 can influence the mental health of families in relatively short time spans, as suggested in prior research (Evans et al, 2020;Dvorsky et al, 2021). As families attempt to address the increased stressors affecting their daily lives, it becomes essential to gather proximal timely reporting of family functioning to understand changes in family mental health.…”

“…Parents reported their experiences of stress related to COVID-19 using the COVID-19 Stress Scale (Ladouceur, 2020). This scale examines the effects of COVID-19 on adolescents and through parental report, and research has supported their effectiveness in doing so (Dvorsky et al, 2021;Styck et al, 2021). Parents rated their stress about COVID-19 on four items asking, "How worried have you been about…" including, "Your physical health being influenced by COVID-19," and, "Friends or family being infected," with scores ranging from 0 (not at all) to 5 (extremely).…”

Prospective examination of psychological trauma among adolescents during the COVID-19 pandemic.

“…It is possible that the unique circumstances brought on by the COVID-19 pandemic (e.g., less social interactions, more flexibility in learning) may have actually resulted in some positive outcomes for adolescents with ADHD (e.g., less bullying, less demand on sitting and attending for extended periods of time; 7 Chawla et al, 2021;McFayden et al, 2021) and thus somewhat less psychological stress for these adolescents. Another potential explanation for why adolescents with ADHD are not displaying higher psychological trauma symptoms during the pandemic is that there they are worrying less about the pandemic than adolescents without ADHD (i.e., are less likely to experience worries about themselves, family, or friends being infected or about their physical or mental/emotional health being negatively impacted by COVID-19; Dvorsky et al, 2022).…”

Rumination as a Mechanism of the Longitudinal Association Between COVID-19-Related Stress and Internalizing Symptoms in Adolescents

“…Adolescents have encountered many disruptions as a result of the COVID-19 pandemic, including ongoing fears of infection, multiple school closures and transitions to and from virtual learning, disrupted social activities, family financial insecurity, and increased household stress [5]. As these changes have interfered with autonomy and peer connectedness in adolescence, an already vulnerable developmental period of increased mental health difficulties [5,8], heightened rates of depression and anxiety symptoms during the COVID-19 pandemic are unsurprising [2,5,6,9]. COVID-19-related stressors, such as family stress, inconsistent schedules, and online schooling difficulties, have been specifically linked to greater mental health symptoms [7,10,11].…”

“…Although many adolescents are at increased risk for the negative impact of COVID-19 stress as documented above, adolescents with pre-existing mental health and neurodevelopmental conditions represent a vulnerable group. Specifically, adolescents with attention-deficit/hyperactivity disorder (ADHD) have well-documented adjustment challenges during the COVID-19 pandemic and increased rates of internalizing comorbidity [8,25]. For instance, adolescents with ADHD may be more negatively impacted by the reduction in structured routines, in-person social relationships, and experience increased emotional distress.…”