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Children and COVID-19 Research Library

UNICEF Innocenti's curated library of COVID-19 + Children research

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Crisis response and suicidal patterns in U.S. youth before and during COVID-19: a latent class analysis

Jennifer D. Runkle; Shrikanth Yadav; Kurt Michael (et al.)

Published: January 2022   Journal: Journal of Adolescent Health

This study characterized the unobserved patterns in crisis response among youth in the U.S. from March to December 2020 and determined the characteristics of vulnerable subgroups who were at increased risk for suicide due to the pandemic. A latent class analysis of crisis support-seeking from a national text-based crisis platform, (n = 179,497, aged 24 years or younger) for 11 crisis concerns (e.g., depression, anxiety/stress, suicidal thoughts, isolation, abuse, bereavement, relationships) was performed on three study periods: (1) January 2017 to December 2020, (2) prepandemic: 1 January 2017 to 12 March 2020, and (3) pandemic: 13 March to 20 December 2020. Demographic characteristics (age, race/ethnicity, sexual orientation, and gender identity) were used as predictors for class membership using the three-step method.

Effect of subjective economic status during the COVID-19 pandemic on depressive symptoms and suicidal ideation among South Korean adolescents

Jong Min Han; Hyunjong Song

Published: December 2021   Journal: Psychology Research and Behavior Management
This study identified the relationships between perceived household economic status and household economic downturn due to COVID-19 and adolescent depressive symptoms and suicidal ideation. Participants for this study were extracted from the 13th Korea Youth Risk Behavior Web-Based Survey, conducted from August to November 2020. The participants comprised 54,948 middle and high school students selected by stratified random cluster sampling.
Comparison of stress and suicide-related behaviors among Korean youths before and during the COVID-19 pandemic

So Young Kim; Hye-Rim Kim; Bumjung Park (et al.)

Published: December 2021   Journal: JAMA Network Open

The COVID-19 pandemic has had a substantial psychological effect on young people. A quantitative assessment of the association between the pandemic and stress and suicidality in youths is needed. This study aims to investigate the association of the COVID-19 pandemic with self-reported stress and suicide-related behaviors in youths. This cross-sectional study used data from the the Korea Youth Risk Behavior Web-based Survey (KYRBWS) conducted in 2019 and 2020 with youths aged 12 to 18 years. Statistical analysis was performed from January to February 2021.

Inter-parental conflict’s persistent effects on adolescent psychological distress, adjustment issues, and suicidal ideation during the COVID-19 lockdown

Iqra Mushtaque; Muhammad Rizwan; Mazhar Abbas (et al.)

Published: December 2021   Journal: OMEGA - Journal of Death and Dying
The current study sought to ascertain the impact of inter-parent conflicts on teenage psychological distress, social and academic adjustment and examine the suicide ideation during the COVID-19. The results found to be alarming as 22% of the individuals displayed suicidal tendencies, with 9% having attempted suicide once, 4.6% having tried suicide twice, and 11% stating that they were likely to do so again. Therefore, the media and the government might host awareness programs and counseling initiatives to promote mental health and prevent suicidal behavior. Moreover, parents may be educated on community level, about the effect of inter-parental arguments on the mental health of their children.
Child suicide rates during the COVID-19 pandemic in England

David Odd; Tom Williams; Louis Appleby (et al.)

Published: December 2021   Journal: Journal of Affective Disorders Reports

There is concern about the impact of COVID-19, and the control measures to prevent the spread, on children's mental health. The aim of this work was to identify if there had been a rise of childhood suicide during the COVID pandemic. Using data from England's National Child Mortality Database (NCMD) the characteristics and rates of children dying of suicide between April and December 2020 were compared with those in 2019. In a subset (1st January to 17th May 2020) further characteristics and possible contributing factors were obtained.

The effect of cyberbullying, abuse, and screen time on non-suicidal self-injury among adolescents during the pandemic: a perspective from the mediating role of stress

Tjhin Wiguna; Kusuma Minayati; Fransiska Kaligis (et al.)

Published: November 2021   Journal: Frontiers in Psychiatry
Adolescence is often a period of turmoil. The COVID-19 pandemic has increased adolescents' difficulty due to mental health consequences that may affect their developmental milestones. This study constructed and empirically tested a theoretical model of three predictive factors (cyberbullying, abuse, and screen time) and stress as the mediating factor in adolescent non-suicidal self-injury (NSSI). Structural equation model (SEM) analysis was applied to investigate stress as a mediating factor in the relationship between adolescent NSSI and cyberbullying, abuse, and screen time. This cross-sectional study used a “crowdsourcing” sample collection method to recruit 464 adolescents aged 11–17 years who were administered a questionnaire comprising scales on cyberbullying, abuse, screen time, stress, and NSSI. All scales had construct reliabilities ranging from 0.759 to 0.958. SEM statistical analysis was performed using Lisrel version 8.8 (Scientific Software International, USA) for Windows (Microsoft Corporation, Redmond, WA, USA). The mean (± SD) age of the cohort was 14.61 ± 1.65 years, and consisted of 66.7% females. Secondary high school was the highest educational background (58%).
Temporal trends in suicide attempts among children in the decade before and during the COVID-19 pandemic in Paris, France

Anthony Cousien; Eric Acquaviva; Solen Kernéis (et al.)

Published: October 2021   Journal: JAMA Network Open

Recent studies have reported a deterioration in children’s mental health since the start of the COVID-19 pandemic in 2020, with an increase in anxiety and mood disorders. Rates of suicide ideation and suicide attempts among children were also higher when COVID-19–related stressors were heightened in 2020. This study aimed to better assess temporal trends in suicide attempts among children while adjusting for annual and seasonal fluctuations. It conducted a cross-sectional study of surveillance data collected over the past 10 years at the Robert Debré Hospital in Paris, France, which is one of the largest pediatric centers in Europe.

Young people’s mental health is finally getting the attention it needs
Published: October 2021   Journal: Nature

Worldwide, at least 13% of people between the ages of 10 and 19 live with a diagnosed mental-health disorder, according to the latest State of the World’s Children report, published this week by the United Nations children’s charity UNICEF. It’s the first time in the organization’s history that this flagship report has tackled the challenges in and opportunities for preventing and treating mental-health problems among young people. It reveals that adolescent mental health is highly complex, understudied — and underfunded. These findings are echoed in a parallel collection of review articles published this week in a number of Springer Nature journals. Anxiety and depression constitute more than 40% of mental-health disorders among young people (those aged 10–19). UNICEF also reports that, worldwide, suicide is the fourth most-common cause of death (after road injuries, tuberculosis and interpersonal violence) among adolescents (aged 15–19). In eastern Europe and central Asia, suicide is the leading cause of death for young people in that age group — and it’s the second-highest cause in western Europe and North America.

Emergency department encounters among youth with suicidal thoughts or behaviors during the COVID-19 pandemic

Kathryn K. Ridout; Mubarika Alavi; Samuel J. Ridout (et al.)

Published: September 2021   Journal: JAMA Psychiatry

Population-level reports of suicide-related emergency department (ED) encounters among youth during the COVID-19 pandemic are lacking, along with youth characteristics and preexisting psychiatric service use. This study aims to characterize population-level and relative change in suicide-related ED encounters among youth during the COVID-19 pandemic compared with 2019. This cross-sectional study evaluated ED encounters in 2019 and 2020 at Kaiser Permanente Northern California—a large, integrated, community-based health system. Youth aged 5 to 17 years who presented to the ED with suicidal thoughts or behaviors were included.

Peer connectedness and pre-existing social reward processing predicts U.S. adolescent girls’ suicidal ideation during COVID-19

Emily A. Hutchinson; Jennifer S. Silk; Stefanie L. Sequeira (et al.)

Published: August 2021   Journal: Journal of Research on Adolescence
There is major concern about the impact of the COVID-19 pandemic on adolescent suicidal ideation (SI) and peer relationships. This study investigated (1) rates of SI and (2) the extent to which peer connectedness and pre-existing neural activation to social reward predicted SI during the initial stay-at-home orders of the pandemic (April–May 2020) in a longitudinal sample of adolescent girls (N = 93; Mage = 15.06; 69% White non-Hispanic). Daily diary and fMRI methods were used to assess peer connectedness and neural activation to social reward, respectively. Nearly 40% of girls endorsed SI during the initial stay-at-home orders. Greater peer connectedness and neural responsivity to anticipated social reward were associated with a reduced odds of SI during the pandemic among girls.
COVID-19-specific suicidal thoughts and behaviors in psychiatrically hospitalized adolescents

Taylor A. Burke; Alexandra H. Bettis; Anastacia Kudinova (et al.)

Published: August 2021   Journal: Child Psychiatry & Human Development
This study examined the presence and correlates of COVID-specific suicidal thoughts and behaviors (i.e., thoughts of or engaging in intentional COVID-19 exposure with associated suicidal intent) among psychiatrically hospitalized adolescents. Adolescents (N = 143) completed study measures as part of the standard intake process between March 13th and August 14th, 2020. Participants answered questionnaires assessing COVID-specific passive and active suicidal ideation (SI) and suicidal behavior, as well as COVID-related stressors and emotions, and public health guidance compliance. Findings highlights that COVID-specific SI is common in high-risk youth. COVID-specific SI was associated with COVID-19-related negative emotions, elevated stress, and decreased public health guidance compliance.
Implementing and adapting the SAFETY treatment for suicidal youth: the incubator model, telehealth, and the Covid-19 pandemic

Jennifer Hughes; Joan R. Asarnow

Published: August 2021   Journal: Cognitive and Behavioral Practice
The Safe Alternatives for Teens and Youth (SAFETY) treatment was developed to decrease the risk of repeat suicidal and self-harm behavior in youth presenting with elevated suicide risk. This paper uses case illustrations to demonstrate the SAFETY treatment, building upon the companion paper describing our “incubator” treatment development model and process (Asarnow et al., 2021). As illustrated in the second case illustration, the incubator model approach was particularly useful during the COVID-19 pandemic switch to telehealth. SAFETY specifically targets suicide and self-harm risk reduction using an individually tailored principle-guided approach, grounded in a case conceptualization that identifies cognitive-behavioral processes and reactions that contribute to increased suicide attempt risk and explains the youth’s suicidal/self-harm behavior within the context of his or her broader social systems. The SAFETY treatment has been tested in two treatment development trials, and results support the efficacy of SAFETY for preventing suicide attempts in adolescents presenting with recent self-harm.
COVID-19 related daily stressors, coping, and suicidal ideation in psychiatrically hospitalized youth

Anastacia Y. Kudinova; Alexandra H. Bettis; Elizabeth C. Thompson (et al.)

Published: July 2021   Journal: Child & Youth Care Forum

Given reports of the adverse effects of COVID-19 on adolescent mental health, it is critical to understand how it impacts psychiatrically hospitalized youth who may be particularly vulnerable to its effects. This study aimed to advance our understanding of high-risk adolescents’ experiences of COVID-19, including COVID-19-related stress, changes in daily functioning, and coping as they relate to suicidal ideation (SI).

The changes of suicidal ideation status among young people in Hong Kong during COVID-19: a longitudinal survey

Shimin Zhua; Yanqiong Zhuang; Paul Lee

Published: July 2021   Journal: Journal of Affective Disorders

Pandemics affect the physical and mental well-being of all potentially at-risk young people globally. This longitudinal study examines changes of suicidal ideation status among adolescents during COVID-19. A follow-up after nine-months of a school-based survey among 1,491 secondary school students was conducted during COVID-19. Psychological well-being, psychological factors, family support, and COVID-19-related experiences were examined.

Stressful events and adolescents’ suicidal ideation during the COVID-19 epidemic: A moderated mediation model of depression and parental educational involvement

Gang Cheng; Jia Liu; Yiying Yang (et al.)

Published: May 2021   Journal: Children and Youth Services Review
This study examined the association between stressful events and adolescents’ suicidal ideation and determined the roles of depression as a mediator and parental educational involvement as a moderator during the COVID-19 epidemic. Survey data from a sample of 1595 Chinese adolescents and their parents were subjected to path analysis. The results indicated that stressful events of the COVID-19 epidemic were significantly positively associated with adolescents’ suicidal ideation, and this association was mediated by depression. In addition, adolescents’ parental educational involvement significantly moderated the path from depression to suicidal ideation.
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UNICEF Innocenti's Children and COVID-19 Library is a database collecting research from around the world on COVID-19 and its impacts on children and adolescents.


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UNICEF Innocenti is mobilizing a rapid research response in line with UNICEF’s global response to the COVID-19 crisis. The initiatives we’ve begun will provide the broad range of evidence needed to inform our work to scale up rapid assessment, develop urgent mitigating strategies in programming and advocacy, and preparation of interventions to respond to the medium and longer-term consequences of the COVID-19 crisis. The research projects cover a rapid review of evidence, education analysis, and social and economic policies.