The COVID-19 pandemic has caused unprecedented changes in the lives of 1.6 billion children and adolescents. First non-representative studies from China, India, Brazil, the US, Spain, Italy, and ...Germany pointed to a negative mental health impact. The current study is the first nationwide representative study to investigate the impact of the COVID-19 pandemic on health-related quality of life (HRQoL) and mental health of children and adolescents in Germany from the perspective of children themselves. A representative online survey was conducted among n = 1586 families with 7- to 17-year-old children and adolescents between May 26 and June 10. The survey included internationally established and validated instruments for measuring HRQoL (KIDSCREEN-10), mental health problems (SDQ), anxiety (SCARED), and depression (CES-DC). Results were compared with data from the nationwide, longitudinal, representative BELLA cohort study (n = 1556) conducted in Germany before the pandemic. Two-thirds of the children and adolescents reported being highly burdened by the COVID-19 pandemic. They experienced significantly lower HRQoL (40.2% vs. 15.3%), more mental health problems (17.8% vs. 9.9%) and higher anxiety levels (24.1% vs. 14.9%) than before the pandemic. Children with low socioeconomic status, migration background and limited living space were affected significantly more. Health promotion and prevention strategies need to be implemented to maintain children’s and adolescents’ mental health, improve their HRQoL, and mitigate the burden caused by COVID-19, particularly for children who are most at risk. (Orig.).
Background
The COVID-19 pandemic has disrupted the lives of children and adolescents worldwide. The German COPSY study is among the first population-based longitudinal studies to examine the mental ...health impact of the pandemic. The objective of the study was to assess changes in health-related quality of life (HRQoL) and mental health in children and adolescents and to identify the associated risk and resource factors during the pandemic.
Methods
A nationwide longitudinal survey was conducted with two waves during the pandemic (May/June 2020 and December 2020/January 2021). In total,
n
= 1923 children and adolescents aged 7 to 17 years and their parents participated (retention rate from wave 1 to wave 2: 85%). The self-report and parent-proxy surveys assessed HRQoL (KIDSCREEN-10), mental health problems (SDQ with the subscales emotional problems, conduct problems, hyperactivity, and peer problems), anxiety (SCARED), depressive symptoms (CES-DC, PHQ-2) and psychosomatic complaints (HBSC-SCL). Mixed model panel regression analyses were conducted to examine longitudinal changes in mental health and to identify risk and resource factors.
Results
The HRQoL of children and adolescents decreased during the pandemic, and emotional problems, peer-related mental health problems, anxiety, depressive and psychosomatic symptoms increased over time, however the change in global mental health problems from wave 1 to wave 2 was not significant, and some changes were negligible. Socially disadvantaged children and children of mentally burdened parents were at particular risk of impaired mental health, while female gender and older age were associated with fewer mental health problems. A positive family climate and social support supported the mental health of children and adolescents during the pandemic.
Discussion
Health promotion, prevention and intervention strategies could support children and adolescents in coping with the pandemic and protect and maintain their mental health.
Poor mental health affects adolescent development and is associated with health and social outcomes in later life. The current study uses cross-sectional data to explore the understudied aspects of ...peer relationships as a predictor of depressive symptom severity of adolescents in Germany.
Data from the German BELLA study were analyzed. We focused on the most recent measurement point of the BELLA study and analyzed data of 446 adolescents (aged 14-17 years). Peer relationship was measured using four items from the internationally established Patient-Reported Outcome Measurement Information System (PROMIS). Depressive symptoms were assessed via seven items of the German version of the Centre for Epidemiological Studies Short Depression Scale (CES-D). Hierarchical linear regression models were computed to explore the association between depressive symptoms and peer relationships. Hierarchical linear regression models served to determine the added predictive effects of each aspect of peer relationships.
The regression model showed that 22% of the variance of the severity of depressive symptoms could be explained by the quality of adolescents' peer relationships (
(1,444) = 125.65,
< 0.001). Peer acceptance has the most substantial unique contribution to peer relationship as a predictor of depressive symptom severity (Change in
= 0.05; Change in
= 27.01,
< 0.001). The gender-specific analysis shows different trends for boys and girls.
The quality of peer relationships is a significant predictor of adolescents' depressive symptoms severity. Improved peer acceptance, dependability, and ease of making new friends are significantly associated with reduced depression symptoms for Germany's adolescent population.
Abstract
Background
The Symptom Checklist (SCL) developed by the Health Behaviour in School-aged Children (HBSC) study is a non-clinical measure of psychosomatic complaints (e.g., headache and ...feeling low) that has been used in numerous studies. Several studies have investigated the psychometric characteristics of this scale; however, some psychometric properties remain unclear, among them especially a) dimensionality, b) adequacy of the Graded Response Model (GRM), and c) measurement invariance across countries.
Methods
Data from 229,906 adolescents aged 11, 13 and 15 from 46 countries that participated in the 2018 HBSC survey were analyzed. Adolescents were selected using representative sampling and surveyed by questionnaire in the classroom. Dimensionality was investigated using exploratory graph analysis. In addition, we investigated whether the GRM provided an adequate description of the data. Reliability over the latent variable continuum and differential test functioning across countries were also examined.
Results
Exploratory graph analyses showed that SCL can be considered as one-dimensional in 16 countries. However, a comparison of the unidimensional with a post-hoc bifactor GRM showed that deviation from a hypothesized one-dimensional structure was negligible in most countries. Multigroup invariance analyses supported configural and metric invariance, but not scalar invariance across 32 countries. Alignment analysis showed non-invariance especially for the items irritability, feeling nervous/bad temper and feeling low.
Conclusion
HBSC-SCL appears to represent a consistent and reliable unidimensional instrument across most countries. This bodes well for population health analyses that rely on this scale as an early indicator of mental health status.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Disordered eating is highly prevalent among children and adolescents. Since the outbreak of the COVID-19 pandemic, hospitalizations due to eating disorders have peaked and overweight has risen. The ...aim of this study was to determine differences in the prevalence of eating disorder symptoms among children and adolescents in Germany before and after the onset of the COVID-19 pandemic and to identify associated factors.
Eating disorder symptoms and associated factors were examined in a sample of
= 1,001 participants of the nationwide population-based COPSY study in autumn 2021. Standardized and validated instruments were used to survey 11-17-year-olds along with a respective parent. To identify differences in prevalence rates, logistic regression was used to compare results with data from
= 997 participants of the prepandemic BELLA study. Multiple logistic regression analyses were performed to examine associations with relevant factors in the pandemic COPSY sample.
Eating disorder symptoms were reported by 17.18% of females and 15.08% of males in the COPSY study. Prevalence rates were lower overall in the COPSY sample compared to before the pandemic. Male gender, anxiety, and depressive symptoms were associated with increased odds for eating disorder symptoms in the pandemic.
The pandemic underscores the importance of further research, but also prevention and intervention programs that address disordered eating in children and adolescents, with a focus on age - and gender-specific differences and developments. In addition, screening instruments for eating disorder symptoms in youths need to be adapted and validated.
Antisocial behaviour is a common phenomenon in childhood and adolescence. Information on psychosocial risk and resource factors for antisocial behaviour are important for planning targeted prevention ...and early intervention programs. The current study explores risk and resource factors of antisocial behaviour in children and adolescents based on population-based longitudinal data.
We analysed longitudinal data from the German BELLA study (n = 1145; 11 to 17 year-olds) measured at three measurement points covering two years. Latent growth analysis, linear regression models and structural equation modelling were used to explore cross-sectional and longitudinal data.
Based on baseline data, we found that stronger self-efficacy and worse family climate were each related to stronger antisocial behaviour. Longitudinal data revealed that more severe parental mental health problems, worse family climate at baseline, deteriorating family climate over time, and more social support were each associated with increasing antisocial behaviour over time. We further found a moderating effect for family climate.
Our study provides important exploratory results on psychosocial risk, resource and protective factors in the context of antisocial behaviour in children and adolescents, which need confirmation by future research. Our exploratory results point in the direction that family-based interventions for antisocial behavior in children and adolescents may benefit from considering the family climate.
Physical activity is central to health, beginning in childhood and adolescence, and regular monitoring provides important information for strategic decisions on promoting physical activity in ...Germany.
The current survey cycle of the Health Behaviour in School-aged Children (HBSC) study gives an insight into the prevalence of the indicators daily recommended physical activity, high and low physical activity, and sporting activity among students aged between 11 and 15 for 2022. In addition, the data is compared to the survey cycles of the 2009/10, 2013/14, and 2017/18 school years and analysed over time.
The results of the current survey cycle show that 10.8 % of girls, 20.9 % of boys, and 12.4 % of gender diverse adolescents fulfil the daily physical activity recommendation. There are also major gender-specific differences for the other indicators. The group of gender diverse adolescents needs to be analysed further. The changes over time between 2009/10 and 2022 are relatively small. While girls' physical activity habits decreased slightly for the various indicators between 2009/10 and 2022, boys' prevalence remained relatively stable over the same period.
Overall, in part due to the effects of the various COVID-19 lockdowns, the need for effective and population-based measures to promote physical activity in childhood and adolescence remains high.
Background
Mental health during the COVID-19 pandemic is of particularly high relevance. Especially for children and adolescents, the pandemic and its restrictions represent a significant burden. The ...present study aims to identify risks and resources for depressive symptoms and anxiety in children and adolescents during the pandemic in Germany.
Materials and Methods
Self-reported data from the first wave of the longitudinal COVID-19 and Psychological Health (COPSY) study were used to investigate risks and resources among
n
= 811 children and adolescents aged 11–17 years. Depressive symptoms and anxiety were measured at the first follow-up 6 months later. Multivariate linear regression analyses were performed to investigate the effects of risks and resources on depressive symptoms and anxiety.
Results
Parental depressive symptoms predicted depressive symptoms and anxiety in children and adolescents 6 months later. Female gender was identified as a risk factor for anxiety during the pandemic. None of the potential resources were associated with depressive symptoms or anxiety at the follow-up.
Conclusion
The findings provide evidence of risk factors for depressive symptoms and anxiety during the COVID-19 pandemic. Children and adolescents who face risk factors need to be identified early and monitored during the pandemic. Family-based intervention programs are needed to help vulnerable children and adolescents cope with the challenges of the pandemic.
For the past three years, the German longitudinal COPSY (
) study has monitored changes in health-related quality of life (HRQoL) and the mental health of children and adolescents during the COVID-19 ...pandemic.
A nationwide, population-based survey was conducted in May-June 2020 (W1), December 2020-January 2021 (W2), September-October 2021 (W3), February 2022 (W4), and September-October 2022 (W5). In total,
= 2,471 children and adolescents aged 7-17 years (
= 1,673 aged 11-17 years with self-reports) were assessed using internationally established and validated measures of HRQoL (KIDSCREEN-10), mental health problems (SDQ), anxiety (SCARED), depressive symptoms (CES-DC, PHQ-2), psychosomatic complaints (HBSC-SCL), and fear about the future (DFS-K). Findings were compared to prepandemic population-based data.
While the prevalence of low HRQoL increased from 15% prepandemic to 48% at W2, it improved to 27% at W5. Similarly, overall mental health problems rose from 18% prepandemic to W1 through W2 (30-31%), and since then slowly declined (W3: 27%, W4: 29%, W5: 23%). Anxiety doubled from 15% prepandemic to 30% in W2 and declined to 25% (W5) since then. Depressive symptoms increased from 15%/10% (CES-DC/PHQ-2) prepandemic to 24%/15% in W2, and slowly decreased to 14%/9% in W5. Psychosomatic complaints are across all waves still on the rise. 32-44% of the youth expressed fears related to other current crises.
Mental health of the youth improved in year 3 of the pandemic, but is still lower than before the pandemic.
Abstract Background Children with affective dysregulation (AD) show an excessive reactivity to emotionally positive or negative stimuli, typically manifesting in chronic irritability, severe temper ...tantrums, and sudden mood swings. AD shows a large overlap with externalizing and internalizing disorders. Given its transdiagnostic nature, AD cannot be reliably and validly captured only by diagnostic categories such as disruptive mood dysregulation disorder (DMDD). Therefore, this study aimed to evaluate two semi-structured clinical interviews—one for parents and one for children. Methods Both interviews were developed based on existing measures that capture particular aspects of AD. We analyzed internal consistencies and interrater agreement to evaluate their reliability. Furthermore, we analyzed factor loadings in an exploratory factor analysis, differences in interview scores between children with and without co-occurring internalizing and externalizing disorders, and associations with other measures of AD and of AD-related constructs. The evaluation was performed in a screened community sample of children aged 8–12 years ( n = 445). Interrater reliability was additionally analyzed in an outpatient sample of children aged 8–12 years ( n = 27). Results Overall, internal consistency was acceptable to good. In both samples, we found moderate to excellent interrater reliability on a dimensional level. Interrater agreement for the dichotomous diagnosis DMDD was substantial to perfect. In the exploratory factor analysis, almost all factor loadings were acceptable. Children with a diagnosis of disruptive disorder, attention-deficit/hyperactivity disorder, or any disorder (disruptive disorder, attention-deficit/hyperactivity disorder, and depressive disorder) showed higher scores on the DADYS interviews than children without these disorders. The correlation analyses revealed the strongest associations with other measures of AD and measures of AD-specific functional impairment. Moreover, we found moderate to very large associations with internalizing and externalizing symptoms and moderate to large associations with emotion regulation strategies and health-related quality of life. Conclusions The analyses of internal consistency and interrater agreement support the reliability of both clinical interviews. Furthermore, exploratory factor analysis, discriminant analyses, and correlation analyses support the interviews’ factorial, discriminant, concurrent, convergent, and divergent validity. The interviews might thus contribute to the reliable and valid identification of children with AD and the assessment of treatment responses. Trial registration ADOPT Online: German Clinical Trials Register (DRKS) DRKS00014963. Registered 27 June 2018.
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