In a recent study published in The Lancet Regional Health – The AmericasJournal researchers examined the impact of financial stresses related to the coronavirus disease 2019 (COVID-19) pandemic on the mental health of adolescents in the United States (US).
Apart from the unprecedented increase in deaths, the severe social distancing measures and lockdowns imposed by governments around the world have also led to a global economic crisis. Recent studies have shown distinct associations between financial stress caused by lost income during the pandemic and depression and other mental health problems in adults.
Children and youth from families facing significant financial stress and social and economic constraints suffer from mental health problems, including behavioral and developmental disabilities. As they get older, they are more likely to develop social dysfunction and health problems. In addition, other drastic changes associated with the pandemic such as isolation, school closures and other areas in which young people interact socially, and uncertainty about the future have also been associated with declining mental health in young people.
However, the specific effects of pandemic-related financial stresses, changes in family interactions, and factors such as parents’ mental health, intra-family conflict, and parenting quality on adolescent mental health have not been comprehensively investigated.
In this study, the researchers used data from the Longitudinal Study of Adolescent Brain Cognitive Development (ABCD), which was collecting information from teenage participants ages nine to 10 across 21 locations in the United States through online surveys before the onset of the COVID-19 pandemic. Study ABCD also administered targeted surveys between May 2020 and 2021 to understand the impact of the COVID-19 pandemic on adolescents.
Two measures of exposure were used to analyze the impact of financial stress related to the pandemic – one was objective, parent-reported stress of pandemic-related wage loss in the household, and the other was subjective stress based on financial stress reported by adolescents. Objective stress was measured based on a binary response (yes or no) to whether a household member had experienced loss of wages since the start of the pandemic. Subjective stress was measured based on how often the teen had worried that the family did not have enough money for necessities in the past week. The answers were on a scale of zero to four, with zero denoting “never” and four “very often”.
Outcome measures were assessed on an eight-item sadness scale which analyzed feelings of loneliness, sadness, inability to enjoy, and hopelessness on a scale of one to five, with one indicating “never” to five indicating “always”. The ABCD Study surveys also contained questions that assessed substance use, such as alcohol, marijuana, and other drug use among the participants.
Statistical analyzes included univariate comparisons between participants from families who experienced loss of wages and those who kept their wages during the pandemic. Furthermore, longitudinal mediation analyzes were conducted to understand the mechanisms underlying the impact of financial stress on adolescent mental health.
Findings reported a high prevalence (over 70%) of financial stress due to lost wages during the COVID-19 pandemic, especially in low-income households. Moreover, lost wages and the resulting financial stress were associated with depressive symptoms among the participants.
The association between financial stress and depression remained strong despite accounting for other environmental confounders. In addition, factors that mediated the association between loss of wages and depression in young adults were found at both the family and individual levels, such as family conflict and financial stress. These findings indicated that socioeconomic disadvantages can affect adolescent mental health through changes in parenting, the home environment, and stress experienced by adolescents about their socioeconomic status.
The results of the study have two important clinical implications. The first highlighted the impact of social determinants on mental health. While the COVID-19 pandemic may have made this relationship more prominent, it also points to the broader link between financial status and mental health in young people. The second clinical implication suggested two goals for intervention to mitigate the mental health burden caused by the pandemic—subjective financial stress and family conflict experienced by young people.
Overall, the results indicated that the economic crisis that resulted from the global response to the COVID-19 pandemic had a significant impact on adolescent mental health. In families that experienced loss of wages, family conflicts and financial stress in young adults were associated with depressive symptoms. The study discussed intervention strategies to reduce the mental health burden of young people during periods of economic stress.
- Argabright ST, Tran KT, Visoki E, DiDomenico G.E., Moore T.M., & Barzilay R. (2022). Financial stress related to COVID-19 and adolescent mental health. The Lancet Regional Health – The Americas100391. https://doi.org/10.1016/j.lana.2022.100391And the https://www.sciencedirect.com/science/article/pii/S2667193X22002083