Adolescent well-being amid the COVID-19 pandemic

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In this podcast, we talk to Dr. Thorhildur Halldórsdóttir, Assistant Professor at the Department of Psychology at Reykjavik University in Iceland and Director of the Icelandic Behavioural Genetics Centre.

The focus of this podcast is on the JCPP Advances paper, ‘Adolescent well-being amid the COVID-19 pandemic: Are girls struggling more than boys?’ (https://doi.org/10.1002/jcv2.12027).

Thorhildur sets the scene by providing a summary of the paper and highlighting the methodology used for her research, before sharing some of the key findings.

Thorhildur then defines the difference between active and passive social media use, before providing further insight into her finding that active social media use amongst boys and passive social media use amongst girls was associated with increased depressive symptoms.

Furthermore, Thorhildur also discusses the implications of her findings for professionals working with young people and their families, what policy makers should take from her findings, and what parents can do to mitigate the impact of the pandemic on their children’s mental health and wellbeing.

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Dr. Thorhildur Halldorsdottir
Dr. Thorhildur Halldórsdóttir

Dr. Thorhildur Halldórsdóttir received her PhD in Clinical Psychology under the mentorship of Thomas Ollendick, PhD at Virginia Tech. Her PhD focused on examining predictors and moderators of treatment outcomes in youth following empirically-supported psychosocial interventions. Upon graduating, Dr. Halldórsdóttir was a postdoctoral fellow at the Max Planck Institute of Psychiatry in Munich, Germany, with Elisabeth Binder, MD, PhD. Building on her background in developmental psychopathology, she studied gene-by-environment interactions shaping the risk for psychiatric symptoms and disorders across the developmental trajectory. Relocating back to Iceland, Dr. Halldórsdóttir was a postdoctoral fellow with Unnur Valdimarsdottir, PhD, at the University of Iceland where she gained more experience in interdisciplinary population-based studies. Dr. Halldórsdóttir is now an assistant professor at Reykjavik University. At the intersection of clinical psychology, behavioral genetics and epidemiology, Dr. Halldórsdóttir’s research focuses on understanding when and how genetic and environmental factors – in particular stress exposure – shape mental health outcomes in youth and young adults.

Transcript

[00:00:30.370] – Jo Carlowe: Welcome to a different type of In-Conversation podcast from the Association for Child and Adolescent Mental Health, ACAMH, where we will look at the paper ‘Adolescent well-being amid the COVID-19 pandemic: Are girls struggling more than boys?’, published in JCPP Advances. I’m Jo Carlowe a freelance journalist with a specialism in psychology, and I have with me Thora Halldórsdóttir, Assistant Professor at the Department of Psychology at Reykjavik University in Iceland and Director of the Icelandic Behavioural Genetics Centre. Thora is also the first author of the paper that we’ll be discussing today.

[00:01:09.460] If you’re a fan of our In-Conversation series, please subscribe on your preferred streaming platform. Let us know how we did with a rating or review and do share with friends and colleagues. Thora, welcome. Can you start with a brief introduction about yourself?

[00:01:23.800] – Dr. Thora Halldórsdóttir: Yes. Hi. So my name is Thorhildur Halldorsdottir, but I’m called Thora, so please do that throughout and it’s an absolute pleasure to be here and Jo, like you said, I’m an Assistant Professor at Reykjavik University, which is located in Iceland, and I’m also a licenced clinical psychologist.

[00:01:43.510] – Jo Carlowe: Thora, what prompted your interest in child and adolescent mental health?

[00:01:47.060] – Dr. Thora Halldórsdóttir: Well, I always knew that I wanted to work with people, so it just made sense when I enrolled in uni to study psychology and alongside my studies I always worked also with people throughout in different clinical settings. So I felt that just working with kids and adolescents suited me the best and it was the most fun and rewarding, and also through this experience in terms of the research, there’s just so much to do when it comes to the mental health of children and adolescents. So yeah, I was smitten with the field.

[00:02:19.790] – Jo Carlowe: As a clinical and translational scientist, you aim to advance understanding of the environmental and genetic factors that contribute to psychopathology in youth with the goal of developing effective preventative and treatment interventions. Can you say more about how you go about translating research into practice?

[00:02:40.360] – Dr. Thora Halldórsdóttir: This is something that I’m very passionate about because we know that there are both environmental and genetic factors that contribute to mental health problems, but it’s really not until recently that we actually have the technology to look into the combination of the two to figure out how they shape an individual’s mental health. So it’s actually a very exciting time to be part of this venture because it’s pretty novel. So with increased knowledge on what contributes to mental health problems down the line, devise more targeted and individualised interventions based on both then environmental and genetic factors.

[00:03:14.930] But at present, the research being conducted within this realm, so both my work and that of others is really focused on just laying the foundation. So we’re not there yet in terms of developing specifically the personalised and individualised treatment interventions, but I think we will be in the near future. Hopefully.

[00:03:32.890] – Jo Carlowe: Great. Thora, let’s turn now to the paper, ‘Adolescent well-being amid the COVID-19 pandemic: Are girls struggling more than boys?’. Can you give us a summary of the paper? What did you look at?

[00:03:46.130] – Dr. Thora Halldórsdóttir: So this is a paper that is a follow up on our study which we conducted recently where we compared so mental health problems of 13 to 18 year olds here in Iceland. In that paper we had nationwide ratings of depressive symptoms and mental wellbeing, and we found that adolescents between the ages of 16 to 18 years old and girls reported specifically an increase in these mental health problems. So that’s why we wanted to follow up on that and dig deeper into why that is? What is it about the COVID-19 pandemic and its restrictions that have this effect?

[00:04:19.950] So in this paper we asked specifically 16-year-olds a range of questions about their mental health, how they felt that the pandemic influenced their global wellbeing. So we asked about academic performance and peer and family relationships, but also physical and mental health, and then the hope was that we could use these findings based on their perceptions to help us identify areas quite quickly in terms of where they were struggling and that would then also further spur research into this field and potentially inform policymaking too.

[00:04:52.480] – Jo Carlowe: Right. We’ll touch on that in a while. Can you say anything about the methodology that you used for the research?

[00:04:58.840] – Dr. Thora Halldórsdóttir: The participants were a subset of a larger cohort called the Life Course Study, which is a longitudinal population based study on youth who were born in 2004 here in Iceland. So in this study we added to the data collection by administering social surveys and this was done during the third wave of the Covid-19 pandemic here in Iceland, which was the largest until the most recent wave, of course, but we had considerable governmental restrictions during that time and that was a peak basically during the third wave.

[00:05:32.810] So participants were between the ages of 16 to 17 years old. So they were an interesting time also in their development because they had just transitioned from elementary school to secondary school, and because of the restrictions most of them were doing online studying or in the job sector for the first time.

[00:05:54.650] – Jo Carlowe: Can you share some of the key findings from your research?

[00:05:58.270] – Dr. Thora Halldórsdóttir: Yeah, like in our previous paper we found that girls reported higher depressive symptoms than boys, and they also reported that overall the pandemic had a greater and more global effect on their wellbeing. So, for instance, they said that it had negatively affected their day-to-day life, academic performance, peer relationships, as well as physical and mental health more so than boys. Although boys did also say that the pandemic had negatively affected them as well, just not to the same degree.

[00:06:33.610] – Jo Carlowe: As you’ve just described girls reported greater negative impact during the pandemic with depressive symptoms above and beyond the expected nationwide scores. Thora, how do you account for this gender difference?

[00:06:47.780] – Dr. Thora Halldórsdóttir: This was something that we really wanted to dive into, so we looked at it in the paper. So we looked specifically at behavioural changes by gender during the pandemic, and then we ran analysis to see if that was associated with depressive symptoms, and we found that for girls, increased passive social media use and decreased communication with family. So via phone or social media was associated with higher depressive symptoms. So there were behavioural changes that contributed to that and then other potential reasons were, for example, that the social restrictions may have limited girls in their ability to rely on social networks for emotional support.

[00:07:31.060] Another reason also is that just gender differences in how girls and boys communicate during this time. So research has shown that girls tend to co-ruminate more than boys, so their conversation might get stuck on that things are difficult and in these difficult times rather than move on to something more positive or just more neutral in general.

[00:07:56.190] – Jo Carlowe: In the paper I noticed it states that active social media use amongst boys and passive social media use amongst girls were associated with increased depressive symptoms. I’m really keen for you to elaborate on that finding. I’m also thinking it might be useful just to quickly define the difference between active and passive social media use.

[00:08:17.780] – Dr. Thora Halldórsdóttir: So active social media use is when the adolescent is actually using the medium to contact, so it’s an active participant. It’s sending messages and engaging actively. Whereas passive is more so looking at the profiles of friends and others and so on, so not truly engaging in the medium. We found that girls when they were engaging in the passive form of social media engagement that was associated with higher depressive symptoms, which is perhaps not surprising, and that’s something that parents can also be mindful of and making sure that their daughters are actually active in social media usage there.

[00:08:57.380] But with the boys, it actually was a bit of a surprise that the active social media use there was associated with higher depressive symptoms. The effect wasn’t that strong actually in this paper, and it could be a by-product of boys to some extent being under represented here, but I think this is definitely an area for further research, and if this is replicated then we need to figure out what is it about active social media use that differs, or how are girls and boys using or actively engaging within social media in different ways contributing to potential differences in this way?

[00:09:37.660] – Jo Carlowe: Do you have any feeling about why it might be the case?

[00:09:40.420] – Dr. Thora Halldórsdóttir: I’m not actually sure. It was very interesting because my hunch would have been if they are active, then that would decrease depressive symptoms but that doesn’t seem to be the case, but maybe like I said, they’re just using it differently than girls because online gaming with others was associated with decreased depressive symptoms. I’m not sure. It might have to do something with fear of missing out potentially or that they are more passive in general than they think they are. Yeah, I think this is just something that needs to be looked at further.

[00:10:16.770] – Jo Carlowe: Yeah, it would be interesting to see how it unfolds. Thora, what are the implications of your findings overall for professionals working with young people and their families?

[00:10:27.340] – Dr. Thora Halldórsdóttir: Well, first of all, the findings are quite clear and in line with other findings that mental health problems are on the rise during the pandemic and especially among girls, but it also suggests that there are ways to promote good mental health among youth during these strange times. So it’s clear that adolescence, whether it’s a boy or a girl, they need to be encouraged to be socially engaged. So it’s important to view social restrictions and quarantine as more physical distancing rather than social distancing, and another thing that professionals really need to be mindful of is that the family makes a big difference here.

[00:11:04.540] So one of the findings was that adolescents actually enjoyed the increased time with their family. So if they have a supportive and good family that could be a great protective factor, but one thing that we didn’t look at specifically in this paper, but research is coming out is that, of course, for families who have greater conflict this could be a greater risk factor that mental health professionals should be wary of and help families with during these times.

[00:11:30.540] – Jo Carlowe: Thora what message should policymakers take from your findings?

[00:11:34.890] – Dr. Thora Halldórsdóttir: Well, the findings highlight that adolescents are vulnerable to mental health problems during the pandemic. So the message is to policy makers that we need to potentially consider prevention efforts to circumvent a mental health pandemic in the wake of this pandemic, like some researchers have warned might happen, but there are also ways to help adolescence. For instance, one key factor here to increase their social engagement is to keep schools open if at all possible. Of course, it has to be safe and we’re actually very lucky here in Iceland that this is something that we can be mindful of.

[00:12:11.260] So we placed more restrictions on the borders, rather than closing schools. So this is something that would really promote good mental health for adolescents, but another strategy is, of course, to provide education on the potential risks so that parents are mindful of what’s going on with their adolescents and encourage them then to engage in behaviours that promote good health rather than those that could potentially promote poor mental health.

[00:12:39.280] – Jo Carlowe: Well, let’s focus on parents. Is there anything they can do to mitigate the impact of the pandemic on their children’s mental health and wellbeing?

[00:12:47.710] – Dr. Thora Halldórsdóttir: They, first of all need to be mindful that mental health problems may increase during this time, so it’s good to be alert and notice any drastic changes in their child’s mood, and based on our findings there are several things that they could do to try to hopefully and promote good mental health during this difficult time. So, for example, encourage adolescent girls to engage actively via social media outlets like we were just talking about, rather than scrolling down Instagram or just receiving messages on Snapchat or something like that. The parents should encourage them, actually to initiate the conversation, to be part of it rather than a passive observer.

[00:13:28.340] The same would apply for boys to some extent, but within a different realm. So for online gaming parents should encourage their boys to make sure that their friends are involved too, so they get some social interaction through it too.

[00:13:42.010] – Jo Carlowe: Thora, is there anything else in the paper that you’d like to highlight?

[00:13:45.150] – Dr. Thora Halldórsdóttir: Understandably we tend to focus on the negatives associated with the pandemic, which is, of course, like I said, very understandable but in this paper we also wanted to see if there were any positive aspects that we could focus on to try to promote good mental health, and like we touched upon earlier, there seems to be some degree of actually the increased time with family promoting good mental health and of course, that has to be a supportive and good environment to be in but this is something that girls specifically noted that they enjoyed spending more time with their family.

[00:14:20.480] And another area that the boys specifically focused on was that they actually enjoyed having less structure in their routine. They enjoyed being able to sleep more and so on.

[00:14:31.890] – Jo Carlowe: Are you planning some follow up research that you can share with us?

[00:14:35.790] – Dr. Thora Halldórsdóttir: So we are continuing to collect data on mental health outcomes of adolescents, so we will continue to track the life course participants, and we tend to do that twice more. So once yearly, and we want to see if this increase in mental health problems is temporary just during the height of the pandemic, or if these effects are more permanent. So this is definitely something that needs to be looked at in great detail because of the implications of it. Then we’re also focusing on more so longitudinal risk and protective factors and then dissecting who is at particular risk for mental health problems during this time versus who is more resilient because that also has implications for stress research in general.

[00:15:20.410] – Jo Carlowe: Thora, is there anything else in the pipeline for you that you’d like to mention?

[00:15:24.140] – Dr. Thora Halldórsdóttir: So I’m fortunate to be involved in many exciting projects, primarily focusing on improving the mental health of children and adolescents. This is an area like I mentioned earlier that there’s a lot of potential to increase our understanding and really contribute to some good here, so enough to do.

[00:15:42.670] – Jo Carlowe: It sounds like it, and finally, what is your take home message for those listening to our conversation?

[00:15:49.270] – Dr. Thora Halldórsdóttir: The take home would probably be that, yes, there is evidence that mental health problems are on the rise among adolescents during the pandemic and they’ve actually been on the rise for several years now, but it’s been even more exacerbated by the pandemic. So we need to be wary of that. We need to figure out what we can do to circumvent this and there are obviously some areas that we target to try to promote good mental health among adolescents.

[00:16:19.900] – Jo Carlowe: Thank you ever so much. Great. Thank you, Thora. For more details on Thora Halldorsdottir, please visit the ACAMH website www.acamh.org and Twitter at @acamh. ACAMH is spelt A-C-A-M-H and don’t forget to follow us on iTunes or your preferred streaming platform and let us know if you enjoyed the podcast with a rating or review and do share with friends and colleagues.

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