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. 2021 Oct:304:114146.
doi: 10.1016/j.psychres.2021.114146. Epub 2021 Aug 14.

Are the kids really alright? Impact of COVID-19 on mental health in a majority Black American sample of schoolchildren

Amanpreet Bhogal  1 , Breanna Borg  1 , Tanja Jovanovic  2 , Hilary A Marusak  3
Affiliations

Are the kids really alright? Impact of COVID-19 on mental health in a majority Black American sample of schoolchildren

Amanpreet Bhogal et al. Psychiatry Res. 2021 Oct.

Abstract

Children from historically disadvantaged groups (racial minorities, lower socioeconomic status [SES]) may be particularly susceptible to mental health consequences during the COVID-19 pandemic. We examined the impact of the pandemic, including mental health symptoms and COVID-19-related fears and behaviors, in a sample of majority Black American (72%) children (n=64, ages 7-10, 24 female) from an urban area with high infection rates. Children completed a mental health screening form prior to the pandemic (October 2019) and at two time points during the pandemic (May, August 2020). We examined the impact of SES on mental health changes over time, COVID-19 fears and behaviors, and perceived impact of the pandemic. We also tested whether baseline mental health predicted the impact of COVID-19. Children's fears of illness increased over time, and these effects were independent of race and SES. However, lower SES children reported more fears about social distancing during the pandemic as compared to higher SES children. Lower SES children also reported more internalizing symptoms at baseline, which decreased in this group following stay-at-home orders. Results highlight the need to reduce the risk of persistent fear and mitigate the mental health consequences among vulnerable pediatric populations during and after the pandemic.

Keywords: COVID-19; Child; Fear; Mental health; Physical distancing.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Fig 1
Fig. 1
Indirect exposure to the coronavirus is associated with greater protective behaviors during the pandemic. There was a significant main effect of indirect exposure (i.e., knowing someone who died from the coronavirus) on Behaviors (*p < .05, main effect of exposure). Behaviors reported using the Fear of Illness and Virus Evaluation (FIVE) questionnaire. Possible scores for the FIVE Behaviors subscale range from 14–50. SES was controlled for in statistical analyses. Error bars represent standard error.
Fig 2
Fig. 2
Children's Fears of Illness (a) and Fears about Social Distancing (b) reported two- and five-months following COVID-19-related school shutdowns in the US. A: There was a significant main effect of time for Fears of Illness such that fears increased over time during the pandemic (*p < .05, main effect of time). B: For Fears about Social Distancing, there was a significant main effect of socioeconomic status (SES), such that lower SES youth reported greater fear than higher SES youth (*p < .05, main effect of SES). Fear reported using the Fear of Illness and Virus Evaluation (FIVE) questionnaire. Possible scores for the Fears of Illness and Fears about Social Distancing subscales range from 8–32 or 10–40, respectively. Parent education was used as the marker of SES. Analyses used SES coded on an ordinal scale; split by low (i.e., some college or below) vs. high SES groups (i.e., two-year college degree or above) for display purposes only. Error bars represent standard error.
Fig 3
Fig. 3
Change in internalizing (a) and externalizing (b) symptoms over time, by socioeconomic status (SES). A: Overall, there was a significant main effect of time and a time x SES interaction for internalizing symptoms, which was driven by a decrease in internalizing symptoms between baseline and May, particularly in lower SES youth. B: There were no effects of time, SES, or time x SES interactions for externalizing symptoms (see text). Symptoms measured using the Pediatric Symptom Checklist (PSC). Parent education was used as the marker of SES. Analyses used SES coded on an ordinal scale; split by low (i.e., some college or below) vs. high SES groups (i.e., two-year college degree or above) for display purposes only. Error bars represent standard error.
Fig 4
Fig. 4
Correlations between FIVE scores and internalizing and externalizing symptoms in children. COVID-19-Related Behaviors are negatively correlated with internalizing (Panel A) and externalizing symptoms (Panel B) during May 2020. Perceived Impact is positively correlated with internalizing symptoms during August 2020 (May 2020).*p < .05, Pearson bivariate correlation.
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