COVID‐related distress, mental health, and substance use in adolescents and young adults

Abstract

Background This study examined the impact of COVID‐related disruptions on mental health and substance use in young people residing in a state with an initially lower COVID burden and earlier reopening of in‐person learning than other states. Methods Data come from Waves 3 (Fall 2019) and 4 (Fall 2020) of the Policy and Communication Evaluation (PACE) Vermont, an online cohort study of adolescents (ages 12–17) and young adults (ages 18–25). Participants in Wave 4 (212 adolescents; 662 young adults) completed items on COVID‐related stressors, the impact of the pandemic on their substance use, brief mental health scales, and past 30‐day substance use. Analyses examined correlational and longitudinal relationships between COVID‐related stressors, mental health symptoms, and substance use. Results More than 60% of participants noted negative effects of the pandemic on their physical, emotional, and social well‐being, with greater impacts of COVID‐related stressors in young adults than adolescents. There were significant increases in depressive (OR 1.31, 95% CI 1.03, 1.66) and anxiety symptoms (OR 1.34; 95% CI 1.10, 1.64) in young adults between Fall 2019 and Fall 2020. Higher overall COVID Impact scores were associated with higher odds of depressive and anxiety symptoms, as well as past 30‐day electronic vapor product use, in adjusted cross‐sectional and longitudinal models. Conclusions Robust associations between COVID‐related distress, mental health, and substance use outcomes in young people signal the opportunity to increase evidence‐based interventions while adding novel approaches to minimize longer‐term harms of the pandemic on mental health in adolescents and young adults.

Persistent anxiety among high school students: Survey results from the second year of the COVID pandemic

“…Participants are asked how often they were bothered by each of the following symptoms during the last 2 weeks with a 4-point scale ranging from "not at all" (0 points) to "nearly every day" (3 points): feeling nervous, anxious or on edge; not being able to stop or control worrying; worrying too much about different things; trouble relaxing; being so restless that it is hard to sit still; becoming easily annoyed or irritable; feeling afraid as if something awful might happen. The total score indicates the level of anxious symptoms ranging from minimal/no anxiety (0-4), mild (5-9), moderate (10)(11)(12)(13)(14) and severe (�15).…”

“…Demographic data were collected, including current grade (9)(10)(11)(12), gender (female, male, transgender man, transgender woman, non-binary, other), race (American Indian or Alaska Native, Asian, Black or African American, Hispanic or Latino, Native Hawaiian or other Pacific Islander, other), whether attending school by hybrid or remote learning, and COVID-19 vaccination status (none, partial or full series).…”

“…socioeconomically diverse students at 2 semi-rural public high schools in Georgia in 2020 and found that 25% of students were worried about the COVID-19 pandemic and a negative financial impact, with a similar gender difference in girls versus boys (29% vs 16%, p<0.0001) [13]. The Policy and Communication Evaluation (PACE) Vermont is an online cohort study of 212 adolescents (ages 12-17) and 662 young adults (ages 18-25) that completed questionnaires in the Fall of 2019 and 2020, before and after the onset of the COVID-19 pandemic [12]. The prevalence of anxiety symptoms measured by the GAD-2 increased from 24.3% to 28.4% among adolescents after COVID-19, similar to the increase from 35.3% to 42.3% observed among young adults [12].…”

“…The Policy and Communication Evaluation (PACE) Vermont is an online cohort study of 212 adolescents (ages 12-17) and 662 young adults (ages 18-25) that completed questionnaires in the Fall of 2019 and 2020, before and after the onset of the COVID-19 pandemic [12]. The prevalence of anxiety symptoms measured by the GAD-2 increased from 24.3% to 28.4% among adolescents after COVID-19, similar to the increase from 35.3% to 42.3% observed among young adults [12]. In our study, 36% of high school students had moderate/severe anxiety by GAD-7, which is slightly higher than the prevalence in aforementioned high school studies, and similar to the prevalence among college students in the Healthy Minds Survey.…”

“…The Adolescent Behaviors and Experiences Survey and COVID Experiences Survey both assessed level of stress, symptoms of depression and consideration of suicide among high school students but did not specifically include an evaluation of anxiety [2,11]. Several smaller published surveys of mental health among adolescent high school students in the United States included assessments of anxiety, although not all of them included validated measures of anxiety or examined the consequences of heightened anxiety [12,13]. In addition, all were performed in 2020, during the first wave of the infection.…”