Heavy burden of family financial stress from COVID on adolescent mental health

In a recent study published in The Lancet Regional Health – Americasjournal researchers examined the impact of financial stress related to the coronavirus disease 2019 (COVID-19) pandemic on the mental health of adolescents in the United States (US).

Study: COVID-19-related financial strain and adolescent mental health. Image credit: Astafjeva / Shutterstock

Background

In addition to the unprecedented increase in the death rate, the drastic social distancing and lockdown measures imposed by governments around the world have also led to a global economic crisis. Recent studies have shown various links between financial stress due to loss of income during the pandemic and depression and other mental health problems in adults.

Children and youth from families facing financial stress and socioeconomic constraints experience significant mental health problems, including behavioral and developmental disabilities. As they age, they are also more likely to develop social dysfunction and health problems. Additionally, other drastic changes related to the pandemic, such as isolation, closing schools and other areas where youth interact socially, and uncertainty about the future have also been linked to worsening youth mental health.

However, the specific impacts of pandemic-related financial stress, changes in family interactions, and factors such as parental mental health, family conflict, and quality of parenting on adolescent mental health have not been comprehensively explored.

About the research

In the current study, researchers used data from the Longitudinal Study of Adolescent Brain Cognitive Development (ABCD), which collected information from adolescent participants aged nine and ten in 21 US locations via online surveys before the start of the COVID-19 pandemic. The ABCD study also administered targeted surveys between May 2020 and 2021 to understand the impact of the COVID-19 pandemic on adolescents.

Two exposure measures were used to analyze the impact of pandemic-related financial stress—one was objective strain characterized by parent-reported pandemic-related household wage loss, and the other was subjective strain based on financial adolescent-reported stress. Objective strain was measured based on a binary (yes or no) response as to whether a household member had experienced wage loss since the start of the pandemic. Subjective stress was measured based on how often the adolescent worried that the family did not have enough money for basic necessities in the past week. Responses were on a scale of zero to four, with zero being “never” and four being “very often.”

Outcome measures were assessed using an eight-item sadness scale that assesses feelings of loneliness, sadness, inability to have fun, and despair on a scale of one to five, with one being “never” to five being “always.” The ABCD study surveys also contained questions that assessed substance use, such as alcohol, marijuana, and other drug use among participants.

Statistical analyzes included univariate comparisons between participants from families that experienced wage loss and those that maintained wages during the pandemic. In addition, longitudinal mediation analyzes were conducted to understand the mechanisms behind the impact of financial stress on adolescent mental health.

Results

The results reported a high prevalence (more than 70%) of financial stress due to lost wages during the COVID-19 pandemic, especially in low-income families. In addition, wage loss and resulting financial stress were associated with depressive symptoms among participants.

The association between financial stress and depression remained robust despite accounting for other environmental confounders. Additionally, factors that mediated the relationship between wage loss and youth depression were found at the family and individual levels, such as family conflict and financial stress. These results suggest that socioeconomic disadvantage may affect adolescent mental health through changes in parenting and home environments and the stress experienced by adolescents regarding their socioeconomic status.

The results of the study have two important clinical implications. The first emphasized the influence of social determinants on mental health. While the COVID-19 pandemic may make this connection more salient, it also highlights the broader connection between financial health and youth mental health. The second clinical finding suggests two targets for intervention to mitigate the mental health burden due to the pandemic—subjective financial stress and family conflict experienced by youth.

Conclusions

Overall, the results show that the economic crisis resulting from the global response to the COVID-19 pandemic has had a significant impact on adolescent mental health. In families experiencing wage loss, family conflict and youth financial stress were associated with depressive symptoms. The study discusses intervention strategies to mitigate the burden on youth mental health during periods of economic stress.

Journal reference:

  • Argabright, ST, Tran, KT, Visoki, E., DiDomenico, GE, Moore, TM, & Barzilay, R. (2022). COVID-19-related financial strain and adolescent mental health. The Lancet Regional Health – Americas100391. https://doi.org/10.1016/j.lana.2022.100391, https://www.sciencedirect.com/science/article/pii/S2667193X22002083

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