Listen to us! The psychosocial impact of COVID-19 on adolescents - A mixed-methods study

COVID-19对青少年心理健康、教育程度和未来前景的持续影响令人高度关注。我们拟议研究的目的是，随着艾滋病大流行的展开以及长期社会和经济后果的出现，了解青少年的经历。青少年可能特别容易受到COVID-19的不良影响，因为这是发展精神病理学的风险增加的时期（费尔柴尔德2011，Paus et al 2008），也是建立个人身份/独立性的关键时期。在此期间，同伴关系尤为重要（Albarello et al 2018，Hay & Ashman 2003，Steinberg & Morris 2001）。因此，青少年的正常发育过程可能会受到COVID-19疫情的干扰。尽管如此，对逆境的反应存在个体差异，因此并非所有暴露于相同压力源的个体都会受到不良影响或心理健康受损（Cicchetti 2010），有些人对逆境的反应比预期的要好，这种现象被称为“韧性”（Galatzer-Levy et al 2018，Masten 2011，Yule et al 2019）。本研究旨在探索哪些因素（例如，性别、种族、社会经济地位、家庭功能、决策能力）决定了这一流行病对青少年的影响。这项工作的基础是在一年多前建立的，当时我们进行了一项在线调查，以检查COVID-19对13-24岁年轻人的影响（n = 2002，按年龄，种族和贫困指数分层），作为COVID-19研究联盟研究（C19 PRC，https：//osf.io/v2zur/wiki/home/）的一部分。我们的研究结果揭示了青少年在大流行对其心理健康的影响方面面临的独特挑战，并强调了目前尚未解决的关键因素的重要性，例如，年轻人的社会和心理调整以及制定健康行为的困难（Levita等人，2020 a，Levita等人，2020 b）。由于缺乏资源，这项研究没有包括对年轻人本身在这一流行病中的生活经历进行跟踪或进一步探讨。因此，我们现在的目标是在这项工作的基础上，丰富自我报告的数据，更准确地描述青少年的心理健康和幸福感，通过一年后从我们最初的队列中跟踪13-16岁的代表性子样本。为此，我们将（1）与参与者进行定性的个人访谈（虚拟）。这是一种更个性化的研究形式，有助于更好地探索和了解参与者的意见、行为和经历，并且在关于COVID-19对青少年影响的研究中一直缺失（例如，战神等人2021，Copeland等人2021，Hawes等人2021）。(2)我们将从在线调查中收集心理健康，幸福感和弹性指数。(3)我们将使用简短的智能手机任务捕捉决策指数，这些指数可以提供一种准确的方法（不太容易产生偏见）来衡量情绪如何影响这些年轻人做出风险决策的方式。我们的团队已经证明这些任务可以预测成年人的焦虑症状和实时COVID-19健康行为（包括社交距离遵守）（Lloyd et al 2020）。这项工作既及时又紧迫，因为学生们在最近的封锁之后已经返回学校，我们希望捕捉他们最近的封锁经历和他们目前返回学校的经历。这段时间是在下一学年开始前的关键时间点捕获数据的最后机会。在迅速变化的背景下，这项工作将帮助决策者从年轻人的角度了解哪些年轻人群体需要支持，以帮助他们的福祉;他们何时需要支持，以及他们希望从循证研究中获得什么样的支持。

The continued impact of COVID-19 on adolescent mental health, educational attainment and future prospects is of great concern. The aim of our proposed study is to capture the experiences of adolescents as the pandemic unfolds and longer-term societal and economic consequences emerge. Adolescents may be of particular risk for adverse effects due to COVID-19 as this is a period of increased risk for developing psychopathology (Fairchild 2011, Paus et al 2008), as well as a crucial time for establishing personal identity/independence. During this period, peer relationships are especially important (Albarello et al 2018, Hay & Ashman 2003, Steinberg & Morris 2001). Hence, the normal developmental processes of adolescence are likely to be disrupted by the COVID-19 pandemic. Nonetheless, there are individual differences in responses to adversity so that not all individuals exposed to the same stressors will experience adverse effects or impaired mental health (Cicchetti 2010) and some exhibit better-than-expected responses to adversity, a phenomenon known as 'resilience' (Galatzer-Levy et al 2018, Masten 2011, Yule et al 2019). This study has been designed to explore which factors (e.g., gender, ethnicity, socioeconomic status, family function, decision-making abilities) determine the impact of the pandemic on young adolescents. The basis for this work was established just over a year ago when we conducted an online survey to examine the impact of Covid-19 on young people aged 13-24 (n = 2002, stratified by age, ethnicity and deprivation index) as part of the COVID-19 Research Consortium Study (C19PRC, https://osf.io/v2zur/wiki/home/). Our findings revealed unique challenges faced by younger adolescents in terms of the impact of the pandemic on their mental health and highlighted the importance of key factors that are not currently being addressed, e.g., young people's social and psychological adjustment and difficulty in enacting health behaviours (Levita et al 2020a, Levita et al 2020b). Due to a lack of resources, this study did not include follow-ups or further exploration of the lived experience of the pandemic from young people themselves. Consequently, our objective is now to build on this work and enrich the self-report data to more accurately profile the mental health and well-being of adolescents, by following a representative sub-sample aged 13-16 from our original cohort one year on. To that end, we will (1) conduct qualitative individual personal interviews (virtually) with participants. This is a more personal form of research that helps to better explore and understand participants' opinions, behaviour, and experiences and has been missing from research on the Impact of COVID-19 on young adolescents (e.g., Ares et al 2021, Copeland et al 2021, Hawes et al 2021). (2) We will gather mental health, well-being, and resilience indices from an online survey. (3) We will capture, using short smartphone tasks, decision-making indices, that can provide an accurate way (less prone to bias) to gauge how mood affects the way these young people make decisions about risk. These tasks have been shown by our team to predict anxiety symptoms and real-time COVID-19 health behaviours (including social distancing adherence) in adults (Lloyd et al 2020). This work is both timely and urgent, as pupils have now returned to school following the latest lockdown, and we wish to capture both their recent experiences of the lockdown and their current experiences of returning to school. This time period is the last opportunity to capture data at a critical time point before the start of the next school year. In a rapidly changing context, this work will help policy makers understand, from young people's perspective, which groups of young people need support to aid their well-being; when they need support and what kind of support they would like, from evidence-based research.