Abstract
Background
Through the COVID-19 pandemic, the series of lockdowns and sustained restrictions on face-to-face contacts were seen as particularly damaging to children, considering the importance of social interactions to their wellbeing and development. The effects could have been even more deleterious to primary-school-aged children as a more vulnerable group (Adegboye et al., 2021). This study assessed specific disorder symptoms of pupils in primary years 4-6 in relation to their COVID-related stress at home and evaluations of school’s COVID protocol for reopening, during the final stage of the 2021 Spring lockdown in England. The stage of lockdown is relevant as studies have reported differing levels of stress before school-return (Achterberg et al., 2021). We also aimed to examine group (age, gender and learning mode) differences in symptom-reporting, home-stress, and school-protocol evaluations, where the existing research also reports a range of vulnerabilities (Adegboye et al., 2021; Chen et al., 2021; Pizarro‑Ruiz & Ordóñez‑Camblor, 2021).
Method
A sample of 145 junior-school pupils (76 girls, 69 boys; Mage=120.45, SD=10.09, in months), from a commuter town outside London, participated through online meetings with their Pupil Mentor (second author) within the final three weeks before returning to school. Ninety-seven were learning at home exclusively, while 48 attended face-to-face schooling up to three days per week due to their parents being keyworkers. Over 90 per cent of participants had at least one sibling up to a maximum of four.
The 47-item Revised Child Anxiety and Depression scales (RCADs; Chorpita et al., 2000) were used for children to report symptoms for generalized anxiety (GAD), major depression (MDD), panic disorder (PD), social phobia (SP), obsessive-compulsive disorder (OCD) and separation anxiety (SAD). Twelve additional questions were devised for children to report perceived COVID-related stress at home and their evaluations of home-learning and of the planned COVID-protocol for school reopening.
Results
Between-groups comparisons found that, symptoms of all disorders, except SAD, increased with either or both of age in months or/and number of siblings. Controlling for these factors, a gender effect was still seen across all RCADs and home-stress, with girls scoring higher than boys did. An interaction with learning mode was found for SAD and OCD; within the home-learning majority subsample, girls scored higher than boys, but within the face-to-face schooling group the two sexes did not differ. Those with face-to-face schooling scored higher on school-protocol evaluations and lower on home-learning satisfaction.
Hierarchical regression models confirmed that (female) gender was an individual predictor of symptomatology for all disorders, and so was (higher) age for most disorders, while learning mode (with face-to-face) contributed to MDD. Both COVID-related home-stress and school-protocol evaluations independently predicted symptom-reporting of all disorders; relative to other predictors, home-stress contributed the most to SP, while school-protocol evaluations contributed the most to GAD and MDD.
Discussion
In terms of group differences, the increase in symptoms with age is in line with some existing research (Chen et al., 2020; Pizarro-Ruiz & Ordóñez‑Camblor, 2021) showing an increase in vulnerabilities and self-reflections on mental health towards adolescence. The relevance of number of siblings to certain disorders suggests that staying in prolonged confinement with others may aggravate specific symptoms. The gender differences are in line with much of the literature regarding girls’ vulnerabilities (Achterberg et al., 2021). The interactions involving learning mode can mean that their vulnerabilities for some symptoms may worsen after home confinement (e.g., OCD behaviours) or near school-return (e.g., separation issues).
The finding that children who were offspring of keyworkers scored higher on MDD reflects research showing having close relatives in high-risk jobs contributes to depressive symptoms (Chen et al. 2020), while their higher satisfaction with school-protocol might indicate greater appreciation for collective health measures due to having direct experience with these.
The differential contributions of home-stress and school-protocol evaluations to symptom-reporting suggest that, while home confinement may particularly affect children’s ability to deal with social situations, schools’ COVID-related policy and provisions have the potential to counter anxiety and depressive symptoms widely reported during lockdowns.
Despite the cross-sectional design, limited sample and focus on internalised disorders, this is one of a minority of studies conducted during the lockdown that enabled younger children to report their symptoms directly. With regular administrations, and combined with improved communications between school and families, these assessments have practice implications for promoting pupils’ wellbeing and preparedness for school-returns through the monitoring of vulnerabilities, stressors and symptoms during closures.
References
Achterberg, M., Dobbelaar, S., Boer, O. D., & Crone, E. A. (2021). Perceived stress as mediator for longitudinal effects of the COVID‑19 lockdown on wellbeing of parents and children. Scientific Reports, 11, 2971.
Adegboye, D., Williams, F., Collishaw, S., Shelton, K., Langley, K., Hobson, C., Burley, D., & van Goozen, S. (2021). Understanding why the COVID‐19 pandemic‐related lockdown increases mental health difficulties in vulnerable young children. Journal of Child Psychology & Psychiatry, 1, e12005. https://doi.org/10.1111/jcv2.12005
Chen, S., Cheng, Z., & Wu, J. (2020). Risk factors for adolescents’ mental health during the COVID-19 pandemic: a comparison between Wuhan and other urban areas in China. Globalization & Health, 16:96. https://doi.org/10.1186/s12992-020-00627-7
Chorpita, B. F., Yim, L., Moffitt, C., Umemoto, L. A., & Francis, S. E. (2000). Assessment of symptoms of DSM-IV anxiety and depression in children: A revised child anxiety and depression scale. Behaviour Research & Therapy, 38(8), 835-855.
Pizarro‑Ruiz, J. P., & Ordóñez‑Camblor, N. (2021). Effects of Covid‑19 confinement on the mental health of children and adolescents in Spain. Scientific Reports, 11:11713. https://doi.org/10.1038/s41598-021-91299-9
Through the COVID-19 pandemic, the series of lockdowns and sustained restrictions on face-to-face contacts were seen as particularly damaging to children, considering the importance of social interactions to their wellbeing and development. The effects could have been even more deleterious to primary-school-aged children as a more vulnerable group (Adegboye et al., 2021). This study assessed specific disorder symptoms of pupils in primary years 4-6 in relation to their COVID-related stress at home and evaluations of school’s COVID protocol for reopening, during the final stage of the 2021 Spring lockdown in England. The stage of lockdown is relevant as studies have reported differing levels of stress before school-return (Achterberg et al., 2021). We also aimed to examine group (age, gender and learning mode) differences in symptom-reporting, home-stress, and school-protocol evaluations, where the existing research also reports a range of vulnerabilities (Adegboye et al., 2021; Chen et al., 2021; Pizarro‑Ruiz & Ordóñez‑Camblor, 2021).
Method
A sample of 145 junior-school pupils (76 girls, 69 boys; Mage=120.45, SD=10.09, in months), from a commuter town outside London, participated through online meetings with their Pupil Mentor (second author) within the final three weeks before returning to school. Ninety-seven were learning at home exclusively, while 48 attended face-to-face schooling up to three days per week due to their parents being keyworkers. Over 90 per cent of participants had at least one sibling up to a maximum of four.
The 47-item Revised Child Anxiety and Depression scales (RCADs; Chorpita et al., 2000) were used for children to report symptoms for generalized anxiety (GAD), major depression (MDD), panic disorder (PD), social phobia (SP), obsessive-compulsive disorder (OCD) and separation anxiety (SAD). Twelve additional questions were devised for children to report perceived COVID-related stress at home and their evaluations of home-learning and of the planned COVID-protocol for school reopening.
Results
Between-groups comparisons found that, symptoms of all disorders, except SAD, increased with either or both of age in months or/and number of siblings. Controlling for these factors, a gender effect was still seen across all RCADs and home-stress, with girls scoring higher than boys did. An interaction with learning mode was found for SAD and OCD; within the home-learning majority subsample, girls scored higher than boys, but within the face-to-face schooling group the two sexes did not differ. Those with face-to-face schooling scored higher on school-protocol evaluations and lower on home-learning satisfaction.
Hierarchical regression models confirmed that (female) gender was an individual predictor of symptomatology for all disorders, and so was (higher) age for most disorders, while learning mode (with face-to-face) contributed to MDD. Both COVID-related home-stress and school-protocol evaluations independently predicted symptom-reporting of all disorders; relative to other predictors, home-stress contributed the most to SP, while school-protocol evaluations contributed the most to GAD and MDD.
Discussion
In terms of group differences, the increase in symptoms with age is in line with some existing research (Chen et al., 2020; Pizarro-Ruiz & Ordóñez‑Camblor, 2021) showing an increase in vulnerabilities and self-reflections on mental health towards adolescence. The relevance of number of siblings to certain disorders suggests that staying in prolonged confinement with others may aggravate specific symptoms. The gender differences are in line with much of the literature regarding girls’ vulnerabilities (Achterberg et al., 2021). The interactions involving learning mode can mean that their vulnerabilities for some symptoms may worsen after home confinement (e.g., OCD behaviours) or near school-return (e.g., separation issues).
The finding that children who were offspring of keyworkers scored higher on MDD reflects research showing having close relatives in high-risk jobs contributes to depressive symptoms (Chen et al. 2020), while their higher satisfaction with school-protocol might indicate greater appreciation for collective health measures due to having direct experience with these.
The differential contributions of home-stress and school-protocol evaluations to symptom-reporting suggest that, while home confinement may particularly affect children’s ability to deal with social situations, schools’ COVID-related policy and provisions have the potential to counter anxiety and depressive symptoms widely reported during lockdowns.
Despite the cross-sectional design, limited sample and focus on internalised disorders, this is one of a minority of studies conducted during the lockdown that enabled younger children to report their symptoms directly. With regular administrations, and combined with improved communications between school and families, these assessments have practice implications for promoting pupils’ wellbeing and preparedness for school-returns through the monitoring of vulnerabilities, stressors and symptoms during closures.
References
Achterberg, M., Dobbelaar, S., Boer, O. D., & Crone, E. A. (2021). Perceived stress as mediator for longitudinal effects of the COVID‑19 lockdown on wellbeing of parents and children. Scientific Reports, 11, 2971.
Adegboye, D., Williams, F., Collishaw, S., Shelton, K., Langley, K., Hobson, C., Burley, D., & van Goozen, S. (2021). Understanding why the COVID‐19 pandemic‐related lockdown increases mental health difficulties in vulnerable young children. Journal of Child Psychology & Psychiatry, 1, e12005. https://doi.org/10.1111/jcv2.12005
Chen, S., Cheng, Z., & Wu, J. (2020). Risk factors for adolescents’ mental health during the COVID-19 pandemic: a comparison between Wuhan and other urban areas in China. Globalization & Health, 16:96. https://doi.org/10.1186/s12992-020-00627-7
Chorpita, B. F., Yim, L., Moffitt, C., Umemoto, L. A., & Francis, S. E. (2000). Assessment of symptoms of DSM-IV anxiety and depression in children: A revised child anxiety and depression scale. Behaviour Research & Therapy, 38(8), 835-855.
Pizarro‑Ruiz, J. P., & Ordóñez‑Camblor, N. (2021). Effects of Covid‑19 confinement on the mental health of children and adolescents in Spain. Scientific Reports, 11:11713. https://doi.org/10.1038/s41598-021-91299-9
| Original language | English |
|---|---|
| Publication status | Published - 13 Sept 2023 |