Research

During the winter break, we talked to some of our friends about the perceived changes in our mental status during COVID-19. Their responses caught our attention, making us realize a large number of teenagers are suffering from mental challenges during the hard time.

We decided to conduct an in-depth research on "how COVID-19 affected the mental wellbeing of teenagers in China" by doing interviews, literature reviews, and applying sociological theories to explain the phenomenon.

A summary of our research

Interview:
What did most of our peers say about sources of mental stress during COVID-19?

We reached out to

Concerns about academic performance:

"Studying required a lot more efforts and self-discipline during COVID-19.

I couldn't control the amount of time and frequency I spent looking at my cell phone and social media.
There was a painful feeling of watching myself fall."

Family relationships:

"At the beginning of the COVID-19 period, my relationship with my family was sometimes not pleasant.
My need for privacy, especially when I was having online courses, was often the reason why conflicts occur between me and my family members."

Changes in interpersonal relatioinships:

"When I was quarantined at home, I suddenly lost my enthusiasm for talking to my friends. I wanted to (talk to them) but sometimes I felt helpless, like there was nothing to say, nothing to talk about, and they didn't always reply in time as well actually."

In general, we all agreed that the changes in our lives have resulted in frequent negative emotions, including anxiety, loneliness, and fear. Our rapid changes of emotions, perceptions and expectations of the future also resulted in increasing amount of doubt and distress.

Although we have entered the "post-pandemic era", many of the problems still persist.

For example, the 'social isolation' has reduced our social enthusiasm and our contact with many friends and relatives. Unfortunately, these interpersonal distances can hardly be fully repaired after the pandemic. Some people even "get used" to the feeling of isolation and reduce their normal social interactions. Another example is that people who experience separation during the pandemic are more likely to have anxiety problems and to experience a persistent sense of loss of family and friends.

Literature review:
1. Survey on the psychological condition of high school students in Wuhan during the epidemic
Liu Yanling, Guo Cheng,2020 (excerpt)

Student mental health status during the outbreak was alerting:

In 2020, a study tested the psychological level of 2,133 students from a secondary school in Wuhan, the site of the outbreak. The conclusions were realistic. The majority of students had good mental health, 26.5% had mild mental health problems, 5.2% had moderate mental health problems and, in addition, 34 students in the survey had more severe mental health problems.

-Stress sources increased: fear of being infected, frightening news on social media, and the actual toll on health coming with infection...

-Dramatic changes in life style: online learning, more social media and electronic devise, disrupted daily schedules

-Less time ourdoors and reduced opportunities to play sports and workout

-Increased time spent with family members, more likely for conflicts within families to occur; parents suffering from financial stress during pandemic, bringing more tension at home

-Sabotaged social supporting system: weaker bond with school, teachers, and friends, more likely to feel helpless whestruggling with stress and depressive mood

-Less medical resources distributed to mental health support, those who need help or are suffering from mental illnesses may failto fail to find professional help

3. The Psychological Impact of the COVID-19 Pandemic on Teenagers in China

Caiyun Zhang , Maolin Ye (2020)

Our sample comprised 493 junior high school students (male = 239, mean age = 13.93 years) and 532 high school students (male = 289, mean age = 17.08 years). Resilience and positive coping were protective factors for the occurrence of depressive, anxiety, and stress symptoms in junior high and high school students (p < .05). Positive coping was a protective factor for trauma-related distress in junior high school students (p < .05). Negative coping is a risk factor for depression, anxiety, stress symptoms, and trauma-related distress in junior high and high school students (p < .05).

During the COVID-19 pandemic in China, more than one fifth of junior high and high school students' mental health was affected. Our findings suggested that resilience and positive coping lead to better psychological and mental health status among students. In contrast, negative coping is a risk factor for mental health.

4. The impact of the COVID-19 pandemic on adolescent mental health: a natural experiment

Rosie Mansfield （2022）

Despite widespread concern about the impact of COVID-19 on adolescent mental health, there remains limited empirical evidence that can causally attribute changes to the pandemic. The current study aimed to overcome existing methodological limitations by exploiting a serendipitously occurring natural experiment within two ongoing, multi-phase cluster randomized controlled trials. Depressive symptoms (primary outcome), externalizing difficulties and life satisfaction (secondary outcomes) were assessed at baseline (phase 1 [pre-COVID-19 group]: September - October 2018, phase 2 [COVID-19 group]: September - October 2019) and 1-year follow-up (pre-COVID-19 group: January - March 2020, COVID-19 group: February - April 2021). Participants in phase 1 (N = 6419) acted as controls. In phase 2, participants (N = 5031) were exposed to the COVID-19 pandemic between the baseline and follow-up assessments providing a natural experimental design. The primary analysis used a random intercept linear multivariable regression model with phase (exposure to the COVID-19 pandemic) included as the key predictor while controlling for baseline scores and individual and school-level covariates. Depressive symptoms were higher and life satisfaction scores lower in the group exposed to the COVID-19 pandemic. Had the COVID-19 pandemic not occurred, we estimate that there would be 6% fewer adolescents with high depressive symptoms. No effect of exposure to the pandemic on externalizing difficulties was found. Exploratory analyses to examine subgroup differences in impacts suggest that the negative impact of the COVID-19 pandemic on adolescent mental health may have been greater for females than males. Given the widespread concern over rising adolescent mental health difficulties prior to the pandemic, this paper quantifies the additional impacts of the pandemic. A properly resourced, multi-level, multi-sector public health approach for improving adolescent mental health is necessary

2. Reasons why COVID-19 would negatively affect teenagers' mental health

Sociological theories to explain the causal relationship

The study of mental health issues in terms of the division of labor and social integration was once considered nonsense. However, as early as the end of the 19th century, French sociologist E. Durkheim’s Suicide: A Study in Sociology began to explain individual mental health problems from a sociological perspective. He criticized the psychological view of suicide by pointing out that suicide is no individual act, but primarily a social phenomenon, caused by the breaking or transformation of important social bonds in an individual's life and the degree of social integration as a whole.

Now, more than a hundred years after Durkheim, the development of sociology has made us realize that mental health issues are not only caused by the patient's weak psychological ability to cope with stress, but also by the social reality and circumstances surrounding the individual, which, in our case, is the pandemic. The pandemic has not only disrupted our ‘normal’ lives but has also created a rupture in every part of our social being. Therefore, we will analyze the impact of the COVID-19 pandemic on adolescent mental health from three major sociological frameworks: structural functionalism, conflict theory, and symbolic interactionism.

1. structural functionalism: The two most important social institutions in which socialization takes place in students' lives are education and family (Horton & Hunt, 1985). And during the epidemic, both changed.
Education: the shift from offline to online instruction: research shows that 72% of students believe that online instruction is more inefficient than offline instruction. Another 88% of students believe that online testing should not be conducted because of the digital divide between students due to different economic levels. Long hours of online instruction also make peer interpersonal interactions difficult and distant, blocking the socialization process of adolescents.
Family: The increase in home time makes adolescents spend more time with their parents, leading to a surge in friction between the views of some adolescents and their parents and increasing dissatisfaction with family members.

2. Conflict theory: Online teaching is a way to maintain social stratification, i.e., to maintain inequality between different social classes through a positive correlation between online teaching-related resources and family economic levels. Increased social inequality and declining family economic status can lead to psychological problems in adolescents.

3. Symbolic interaction theory: Symbols are signs that refer to certain imagery or meaning. During the epidemic, symbolic interactions such as words, expressions, and gestures were significantly reduced. The symbolic interaction theory argues that the individual self is formed through symbolic interaction and communication with society, but online teaching and the creation of isolation zones hinder the process of symbolic interaction, thus leading to a lack of meaning and preventing the interaction between the primary and the secondary self, and possibly even the absence of the secondary self due to unclear social expectations.