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

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.