COVID-19 Unmasked: trajectories, risk and protective factors for mental health outcomes in young Australian children during the first year of the COVID-19 pandemic

Abstract

OBJECTIVE: Emerging evidence suggests a negative impact of COVID-19 on children's mental health. The aims of this study were to examine trajectories of mental health in children younger than 6 years as well as risk and protective factors during the first year of the pandemic. METHOD: In a prospective, longitudinal online study, data were collected on N = 837 children aged 1 to 5 years in Australia between May and July 2020 and after 3, 6 and 12 months, with n = 257 participating at all 4 timepoints. Individual trajectories ofanxiety, anger/irritability, depressive symptoms and sleep disturbance were analysed using latent growth mixture modelling. RESULTS: The results showed that 1 in 4 children experienced moderate to severe symptoms in each problem domain. The overall means for depressive symptoms, anger/irritability, and sleep disturbance decreased while anxiety increased over time. For most outcomes, two individual trajectories were identified: moderate/high-decreasing (26-29%) andlow-increasing. Important predictors were negative COVID-19 related impact on daily life, caregiver distress, lower child positive affect and self-regulation. CONCLUSIONS: The current results highlight that the pandemic indirectly affected young children's mental health, especially in the presence of risk factors such as caregiver distress and poor child self-regulation skills.

What is already known about this topic: Previous studies with children and adolescents have indicated an increase in mental health difficulties, especially anxiety, in the first year of the pandemic.There are few longitudinal studies mostly using group means in within-pandemic data of mental health difficulties in young children.It is likely that children follow different trajectories depending on individual coping capacities, experiences, and relationships with their parents and within their families. What this topic adds: This is the first study focusing on individual trajectories of mental health in Australian children younger than 6 years during the first year of the pandemic.This study indicated that 1 in 4 children younger than 6 years experienced moderate to severe mental health symptoms with increasing overall mean scores for depressive symptoms, anger/irritability, and sleep disturbance and decreasing anxiety over time.Negative COVID-19 impact on daily life, caregiver distress and child difficulties in self-regulation were significant predictors of moderate to high trajectories of child mental health difficulties.

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