BACKGROUND: The impact of chronic stressors like the COVID-19 pandemic is likely to be magnified in adolescents with pre-existing mental health risk, such as attention-deficit/hyperactivity disorder (ADHD). This study examined changes in and predictors of adolescent mental health from before to during the COVID-19 pandemic in the Southeastern and Midwestern United States .
METHODS: Participants include 238 adolescents (132 males; ages 15-17; 118 with ADHD). Parents and adolescents provided ratings of mental health symptoms shortly before the COVID-19 pandemic and in spring and summer 2020 .
RESULTS: Adolescents on average experienced an increase in depression, anxiety, sluggish cognitive tempo, inattentive, and oppositional/defiant symptoms from pre-COVID-19 to spring 2020; however, with the exception of inattention, these symptoms decreased from spring to summer 2020 . Adolescents with ADHD were more likely than adolescents without ADHD to experience an increase in inattentive, hyperactive/impulsive, and oppositional/defiant symptoms . Adolescents with poorer pre-COVID-19 emotion regulation abilities were at-risk for experiencing increases in all mental health symptoms relative to adolescents with better pre-COVID-19 emotion regulation abilities . Interactive risk based on ADHD status and pre-COVID-19 emotion regulation abilities was found for inattention and hyperactivity/impulsivity, such that adolescents with ADHD and poor pre-COVID-19 emotion regulation displayed the highest symptomatology across timepoints . Lower family income related to increases in inattention but higher family income related to increases in oppositional/defiant symptoms .
CONCLUSIONS: The early observed increases in adolescent mental health symptoms during the COVID-19 pandemic do not on average appear to be sustained following the lift of stay-at-home orders, though studies evaluating mental health across longer periods of time are needed . Emotion dysregulation and ADHD increase risk for sustained negative mental health functioning and highlight the need for interventions for these populations during chronic stressors . Results and clinical implications should be considered within the context of our predominately White, middle class sample.