Stress-Related Growth in Adolescents Returning to School After COVID-19 School Closure

Authors: Lea Waters,1,*Kelly-Ann Allen,1,2 and Gökmen Arslan3,4

Abstract

The move to remote learning during COVID-19 has impacted billions of students. While research shows that school closure, and the pandemic more generally, has led to student distress, the possibility that these disruptions can also prompt growth in is a worthwhile question to investigate. The current study examined stress-related growth (SRG) in a sample of students returning to campus after a period of COVID-19 remote learning (n = 404, age = 13–18). The degree to which well-being skills were taught at school (i.e., positive education) before the COVID-19 outbreak and student levels of SRG upon returning to campus was tested via structural equation modeling. Positive reappraisal, emotional processing, and strengths use in students were examined as mediators. The model provided a good fit [χ2 = 5.37, df = 3, p = 0.146, RMSEA = 0.044 (90% CI = 0.00–0.10), SRMR = 0.012, CFI = 99, TLI = 0.99] with 56% of the variance in SRG explained. Positive education explained 15% of the variance in cognitive reappraisal, 7% in emotional processing, and 16% in student strengths use during remote learning. The results are discussed using a positive education paradigm with implications for teaching well-being skills at school to foster growth through adversity and assist in times of crisis.

Introduction

Novel coronavirus (COVID-19) spread rapidly across the globe in 2020, infecting more than 70 million people and causing more than 1.5 million deaths at the time of submitting this paper (December 8, 2020; World Health Organization, 2020a). The restrictions and disruptions stemming from this public health crisis have compromised the mental health of young people (Hawke et al., 2020UNICEF, 2020Yeasmin et al., 2020Zhou et al., 2020). A review assessing the mental health impact of COVID-19 on 6–21-year-olds (n = 51 articles) found levels of depression and anxiety ranging between 11.78 and 47.85% across China, the United States of America, Europe, and South America (Marques de Miranda et al., 2020). Researchers have also identified moderate levels of post-traumatic stress disorder (PTSD) in youth samples during the COVID-19 pandemic (Guo et al., 2020Liang et al., 2020Wang et al., 2020).

Adolescence is a critical life stage for identity formation (Allen and McKenzie, 2015Crocetti, 2017) where teenagers strive for mastery and autonomy (Featherman et al., 2019), individuate from their parents (Levpuscek, 2006), and gravitate toward their peer groups to have their social and esteem needs met (Allen and Loeb, 2015). The pandemic has drastically curtailed the conditions for teens to meet their developmental needs (Loades et al., 2020). Gou et al. (2020, p. 2) argue that adolescents are “more vulnerable than adults to mental health problems, in particular during a lockdown, because they are in a transition phase… with increasing importance of peers, and struggling with their often brittle self-esteem.”

In addition to the researching psychological distress arising from COVID-19, it is also important to identify positive outcomes that may arise through this pandemic. Dvorsky et al. (2020) caution that research focused only on distress may create a gap in knowledge about the resilience processes adopted by young people. In line with this, Bruining et al. (2020, p. 1) advocate for research to keep “an open scientific mind” and include “positive hypotheses.” Waters et al. (2021) argue that researching distress during COVID-19 need not come at the expense of investigating how people can be strengthened through the pandemic. Hawke et al. (2020), for example, found that more than 40% of their teen and early adult sample reported improved social relationships, greater self-reflection, and greater self-care.

Focusing on adolescents and adopting positive hypotheses, the current study will examine the degree to which a positive education intervention taught at school prior to the COVID-19 outbreak had an influence on three coping approaches during remote learning (i.e., positive reappraisal, emotional processing, and strengths use) and on student levels of stress-related growth (SRG) upon returning to school.

For More Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8174561/

US case series study in children study looking at association of myocarditis with the Pfizer-BioNTech COVID-19 vaccine

Authors: byUK Science Media Centre|Published onAugust 10, 2021: Prof Peter Openshaw

In this case series, 15 cases of myocarditis are described from a single paediatric referral centre in May, June and July 2021.  Each had been given the Pfizer mRNA vaccine between 1 and 6 days prior to diagnosis; children were aged 12-18 years.  In addition to chest pain, most had fever and muscle pain with evidence of inflammation of the heart muscle evident on tests.  All cases were relatively mild and most resolved completely without treatment.  All but one case was male, and most were after the 2nd dose.

The problem with case series of this type is the lack of comparison groups.  How many cases of myocarditis might be seen in normal children, or those given other vaccines (including those that are not for COVID), or in teenagers infected with SARS-CoV-2?

As the authors note, myocarditis does happen after other vaccines.  The estimated rate (62.8 cases per million) makes this a rare event.  To put this in context, the authors point out that COVID-19 vaccination in males aged 12 to 29 years would prevent 11,000 COVID-19 cases, 560 hospitalizations, 138 intensive care unit admissions and 6 deaths compared with 39 to 47 expected case of myocarditis, if the link with the vaccine is causal.

In another recent study that has not yet been peer-reviewed (https://www.medrxiv.org/content/10.1101/2021.07.23.21260998v1), the authors estimated that males aged 12 to 17 were most likely to develop myocarditis within three months of catching covid-19, at a rate of about 450 cases per million infections.  Mendel Singer at Case Western Reserve University in Ohio (an author on this study) said: “If you’re focused on heart inflammation, the safer bet is to take the vaccine.”  The calculations on which this statement is based are still under discussion, but my view that teenagers should be considered for vaccination is not changed by this new publication.

For More Information: https://covidvaccinehub.org/articles/us-case-series-study-in-children-study-looking-at-association-of-myocarditis-with-the-pfizer-biontech-covid-19-vaccine

Psychological Impact of COVID-19 on Children and Adolescents: A Systematic Review

Authors: Nishtha Chawla,1Ashlyn Tom,1Mahadev Singh Sen,1 and Rajesh Sagar1

Abstract

Background and aims:

The outbreak of COVID-19 led to a significant psychological impact on individuals, particularly those belonging to vulnerable groups. This study aimed to synthesize literature on the psychological impact of COVID-19 among children and adolescents.

Methods:

Electronic search engines were used to identify studies till March 2021 that reported symptoms of psychological origin in children and adolescents. Information was extracted using a predefined template, and qualitative analysis was conducted using STROBE.

Results:

One hundred and two relevant papers were identified. Most of the studies were conducted online or telephonically. The study designs were primarily single group cross-sectional, though a few prospective/retrospective designs were also identified. Studies assessing emotional distress showed variable levels of anxiety and depressive symptoms in the study population, with greater severity of anxiety symptoms among females and older adolescents. Reduced physical activity; delayed sleep time; increased sleep duration, screen time, internet use, and sedentary habits, poor quality of life were other notable findings, often correlating with anxiety/depression. Efforts to address bias, discussion on generalizability of their results, and sample size calculation were not reported in most studies.

Conclusion:

Psychological impact on children/adolescents is significant, either due to the fear of the illness or social isolation related to COVID-19. One may focus on improving sleep habits and physical activity and regulating internet use for maintaining psychological well-being.

For More Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8327877/

Evaluation of the safety of mRNA-Moderna in adolescents

Authors: Killian Meara

The vaccine demonstrated an acceptable safety profile in the adolescent population.

A recent study conducted by investigators from the pharmaceutical and biotechnology company, Moderna, has found that their COVID-19 vaccine, mRNA-1273, was both safe and efficacious in preventing COVID-19 in adolescents.

Results from the study were published in The New England Journal of Medicine.

The incidence of COVID-19 in adolescents between the ages of 12 and 17 years was 900 per 100,000 during the time period of April and June of 2021. The aim of the study was to evaluate the safety, efficacy and immunogenicity of the Moderna vaccine in that population.

The ongoing, phase 2-3, placebo-controlled trial randomly assigned healthy adolescents between the ages of 12 and 17 in a 2:1 ratio to receive 2 doses of the vaccine or a placebo, 28 days apart.

The trial included 3,732 participants, of which 2,489 received the therapy and 1,243 received the placebo.

The primary objective was to evaluate the safety of mRNA-1273 in adolescents as compared to that in young adults between the ages of 18 to 25 years. The secondary objectives included an evaluation of the efficacy in preventing either symptomatic or asymptomatic disease.

Findings from the study demonstrated that the most commonly reported adverse reactions in the vaccine group were injection site pain, headache and fatigue. The most commonly reported adverse reactions in the placebo group were similar and no serious adverse events were noted in either group.

Mean ratio of pseudovirus neutralizing antibody titers in the adolescents relative to the young adults was 1.08, with the absolute difference in serologic response being 0.2 percentage points.

There were no reported cases of COVID-19 with an onset of 14 days after the second injection in the vaccine group and 4 cases reported in the placebo group.

“The mRNA-1273 vaccine had an acceptable safety profile in adolescents,” the authors wrote. “The immune response was similar to that in young adults, and the vaccine was efficacious in preventing COVID-19.”

For More Information: https://www.contagionlive.com/view/how-soon-covid-19-vaccine-booster-doses-available-us

Individual differences in adolescent mental health during COVID-19: The importance of peer relationship quality

By DocWire News Featured Reading -August 11, 2021

Neuron. 2021 Aug 9:S0896-6273(21)00571-7. doi: 10.1016/j.neuron.2021.07.027. Online ahead of print.

ABSTRACT

Lockdowns and school closures deprive adolescents of typical social interactions. In this NeuroView, we explore how the quality of existing peer relationships might moderate-both positively and negatively-the impact of these restrictions on adolescent mental health, and we highlight the importance of individual differences.

For More Information: https://www.docwirenews.com/abstracts/individual-differences-in-adolescent-mental-health-during-covid-19-the-importance-of-peer-relationship-quality/

Stress-Related Growth in Adolescents Returning to School After COVID-19 School Closure

Authors: Lea Waters1*Kelly-Ann Allen1,2 and Gökmen Arslan3,4

The move to remote learning during COVID-19 has impacted billions of students. While research shows that school closure, and the pandemic more generally, has led to student distress, the possibility that these disruptions can also prompt growth in is a worthwhile question to investigate. The current study examined stress-related growth (SRG) in a sample of students returning to campus after a period of COVID-19 remote learning (n = 404, age = 13–18). The degree to which well-being skills were taught at school (i.e., positive education) before the COVID-19 outbreak and student levels of SRG upon returning to campus was tested via structural equation modeling. Positive reappraisal, emotional processing, and strengths use in students were examined as mediators. The model provided a good fit [χ2 = 5.37, df = 3, p = 0.146, RMSEA = 0.044 (90% CI = 0.00–0.10), SRMR = 0.012, CFI = 99, TLI = 0.99] with 56% of the variance in SRG explained. Positive education explained 15% of the variance in cognitive reappraisal, 7% in emotional processing, and 16% in student strengths use during remote learning. The results are discussed using a positive education paradigm with implications for teaching well-being skills at school to foster growth through adversity and assist in times of crisis.

Introduction

Novel coronavirus (COVID-19) spread rapidly across the globe in 2020, infecting more than 70 million people and causing more than 1.5 million deaths at the time of submitting this paper (December 8, 2020; World Health Organization, 2020a). The restrictions and disruptions stemming from this public health crisis have compromised the mental health of young people (Hawke et al., 2020UNICEF, 2020Yeasmin et al., 2020Zhou et al., 2020). A review assessing the mental health impact of COVID-19 on 6–21-year-olds (n = 51 articles) found levels of depression and anxiety ranging between 11.78 and 47.85% across China, the United States of America, Europe, and South America (Marques de Miranda et al., 2020). Researchers have also identified moderate levels of post-traumatic stress disorder (PTSD) in youth samples during the COVID-19 pandemic (Guo et al., 2020Liang et al., 2020Wang et al., 2020).

Adolescence is a critical life stage for identity formation (Allen and McKenzie, 2015Crocetti, 2017) where teenagers strive for mastery and autonomy (Featherman et al., 2019), individuate from their parents (Levpuscek, 2006), and gravitate toward their peer groups to have their social and esteem needs met (Allen and Loeb, 2015). The pandemic has drastically curtailed the conditions for teens to meet their developmental needs (Loades et al., 2020). Gou et al. (2020, p. 2) argue that adolescents are “more vulnerable than adults to mental health problems, in particular during a lockdown, because they are in a transition phase… with increasing importance of peers, and struggling with their often brittle self-esteem.”

In addition to the researching psychological distress arising from COVID-19, it is also important to identify positive outcomes that may arise through this pandemic. Dvorsky et al. (2020) caution that research focused only on distress may create a gap in knowledge about the resilience processes adopted by young people. In line with this, Bruining et al. (2020, p. 1) advocate for research to keep “an open scientific mind” and include “positive hypotheses.” Waters et al. (2021) argue that researching distress during COVID-19 need not come at the expense of investigating how people can be strengthened through the pandemic. Hawke et al. (2020), for example, found that more than 40% of their teen and early adult sample reported improved social relationships, greater self-reflection, and greater self-care.

Focusing on adolescents and adopting positive hypotheses, the current study will examine the degree to which a positive education intervention taught at school prior to the COVID-19 outbreak had an influence on three coping approaches during remote learning (i.e., positive reappraisal, emotional processing, and strengths use) and on student levels of stress-related growth (SRG) upon returning to school.

For More Information: https://www.frontiersin.org/articles/10.3389/fpsyg.2021.643443/full

Long covid: Damage to multiple organs presents in young, low risk patients

Authors: Gareth Iacobucci BMJ 2020; 371 doi: https://doi.org/10.1136/bmj.m4470 (Published 17 November 2020)Cite this as: BMJ 2020;371:m4470

Young, low risk patients with ongoing symptoms of covid-19 had signs of damage to multiple organs four months after initially being infected, a preprint study has suggested.1

Initial data from 201 patients suggest that almost 70% had impairments in one or more organs four months after their initial symptoms of SARS-CoV-2 infection.

The results emerged as the NHS announced plans to establish a network of more than 40 long covid specialist clinics across England this month to help patients with long term symptoms of infection.

The prospective Coverscan study examined the impact of long covid (persistent symptoms three months post infection) across multiple organs in low risk people who are relatively young and had no major underlying health problems. Assessment was done using results from magnetic resonance image scans, blood tests, and online questionnaires.

The research has not yet been peer reviewed and could not establish a causal link between organ impairment and infection. But the authors said the results had “implications not only for [the] burden of long covid but also public health approaches which have assumed low risk in young people with no comorbidities.”

The study enrolled participants at two UK sites in Oxford and London between April and August 2020. Two hundred and one individuals (mean age 44 (standard deviation 11.0) years) completed assessments after SARS-CoV-2 infection a median of 140 days after initial symptoms.

Participants were eligible if they tested positive for SARS-CoV-2 by random polymerase chain reaction swab (n=62), a positive antibody test (n=63), or had typical symptoms and were determined to have covid-19 by two independent clinicians (n=73).

The prevalence of pre-existing conditions was low (obesity: 20%, hypertension: 6%, diabetes: 2%, heart disease: 4%), and less than a fifth (18%) of individuals had been hospitalised with covid-19.

The most commonly reported ongoing symptoms—regardless of hospitalization status—were fatigue (98%), muscle ache (88%), shortness of breath (87%), and headache (83%). There was evidence of mild organ impairment in the heart (32% of patients), lungs (33%), kidneys (12%), liver (10%), pancreas (17%), and spleen (6%).

For More Information: https://www.bmj.com/content/371/bmj.m4470