The Pandemic and Psychosocial Development During Late Adolescence

Acknowledgments: This chapter is based on a presentation to the Pontifical Academy of Sciences, Casina Pio IV, Vatican City on February 28, 2022. We are grateful to Marcelo Suárez-Orozco, the organizer of this conference, for his helpful comments on this paper. We are also grateful to Heather Bell, Sika Berger, and Jean Ferguson for their helpful library research and to Joanna Olin for her feedback on the paper.

For people around the world, the impact of COVID-19 on our daily lives has been significant and profound. We have all suffered from the inability to plan in the face of uncertainty; from the intermittent need for isolation as we deal with new strains of the virus; from lost opportunities; and perhaps from loss of loved ones. As Rao and Fisher (2021, 739) have noted, “From a systems science perspective, global pandemics represent a ‘shock to the system’, affecting every aspect of society”.

In this paper, we review the research literature of the pandemic’s impact on psychosocial development during late adolescence. Adolescence denotes the time of life between childhood and young adulthood. Throughout most of human history – and in some societies today – puberty marks the end of childhood, whereby full-time work expectations and new family obligations emerge. In societies with formal schooling, delayed adulthood is the norm because children continue to be dependent on their parents while in school. Consequently, in most societies today adolescence has emerged as a relatively long phase of development, typically defined from ages 12 to 25, with late adolescence defined from ages 18 to 25. There is a growing consensus among researchers that adolescence “constitutes a critical intervention window, given the far-reaching physical, socio-emotional changes that occur” (GAGE 2017).

To understand the impact of COVID-19 on late adolescence, it is critical to begin with an understanding of the developmental changes this age group experiences as part of normal development. First, as Steinberg (2014, 15) has argued, neuroplasticity in the brain causes adolescents to be “more easily excited, emotionally aroused, and prone to getting angry or upset”. In other words, the ability to understand and manage emotions as well as behavior develops through late adolescence, which explains why risky behavior and mental health problems are more prevalent during this time of life. Second, Tambelli et al. (2021) have posited that the pandemic delayed normal psychosocial development because the evolutionary tasks that all adolescents face – identity development, autonomy and the reorganization of relationships with parents and peers – were disrupted by school closures and concomitant social isolation. Following the pandemic, especially when schools were closed, adolescents’ increasing need for autonomy was checked by parents who exerted control to ensure their children’s health and safety. Third, adolescence has been called “a sensitive period for the emergence of mental health disorders”, based on prevalence rates by age (Liu et al. 2022). Finally, we argue here that existential threats, like COVID-19, are deeply experienced by adolescents because their self regulation skills are still developing, compared with adults, thereby limiting their ability to cope in the face of significant stressors. For all these reasons, it follows that the impact of COVID-19 on psychosocial development might be especially acute during this stage of life.

Psychosocial development typically includes social cognition, perspective taking, adjustment, and mental health; much of the research on the effects of the pandemic has focused on adjustment and mental health. There is a robust research literature already documenting an increase in mental health problems following the onset of COVID-19. A review of 21 studies has demonstrated a clear link between the pandemic and mild to severe anxiety in children, adolescents and young adults (Stavridou et al. 2020). Further, according to a recent U.S. Surgeon General’s advisory (2021), there is burgeoning evidence that the pandemic has exacerbated the incidence of mental health problems, especially for vulnerable populations, including youth with disabilities, racial and ethnic minorities, LGBTQ+ youth, low-income youth, youth in rural areas, youth in immigrant households, youth involved with the child welfare or juvenile justice systems, and homeless youth. This is particularly troubling given that there was already a youth mental health crisis prior to the pandemic. The U.S. Surgeon General’s report summarizes U.S. survey data documenting the mental health crisis in recent years. For example, between 2009 and 2019, among high school students, the number of adolescents who reported depressive symptoms increased by 40 percent, while the number with serious suicidal ideation increased by 36 percent. Further, between 2011 and 2015, youth psychiatric visits to emergency departments for mental health symptoms increased by 28 percent.

The reasons for the increase in mental health problems is unclear, although the U.S. Surgeon General’s report suggests two possible causes. First, popular culture and social media may play a role because they can negatively influence an individual’s sense of self worth. Second, young people do not believe that there has been adequate progress on issues that will affect their future, such as climate change, racism and poverty. The threat of climate change is an existential one, given that the habitability of the planet is in doubt; as journalist Masha Gessen (2022) has observed, Gen Z is the first generation that believes it may be the last.

A meta-analysis of the prevalence of depressive and anxiety symptoms in children and adolescents following the onset of the pandemic, conducted by Racine et al. (2021), documents that the increase in anxiety and depression is a global problem. They identified 29 articles that met the criteria for their study: 16 from East Asia, 4 from Europe, 6 from North America, 2 from Central America and South America, and 1 from the Middle East. From a public health perspective, their results are quite concerning: 1 in 4 youth experienced depression, and 1 in 5 experienced anxiety. These estimates of mental health problems are double those of comparable estimates prior to the pandemic. Further, older adolescents had higher levels of depression, which is consistent with the hypothesis that the risk of mental illness is higher during late adolescence than during other times of life. Consistent with other studies, rates of depression and anxiety were higher in girls, perhaps because girls are more likely to report mental health problems or, as the authors suggest, because gender inequity increases stress. Taken together, these public health studies document a worldwide mental health problem among adolescents and emerging adults that necessitates better policies and practices, grounded in evidence.

Risk and Protection

As a next step, we need to consider why the pandemic disrupted adolescent psychosocial development; in other words, how did the experience of adolescents during the pandemic differ from the experience of adolescents prior to the pandemic, and why did these differences pose a threat to psychosocial development? Developmental theory and research inform our review, especially work on risk and protective factors in development. These factors are typically considered within an ecological system, whereby the individual is embedded within nested contexts, such as family, peers, schools, and community (Bronfenbrenner and Morris 2006). As Browne et al. (2021) have argued, the direction of effects generally flows from a distal variable like COVID-19 to a proximal variable, defined as what an individual experiences, to an outcome variable, in this case a measure of psychosocial development. A fuller understanding of the impact of COVID-19 necessitates an understanding of proximal variables – or mechanisms – associated with the consequences of COVID-19 for adolescents, especially home confinement and school closure.

COVID-19 is likely a risk factor with a pervasive impact across ecological contexts. A salient feature of COVID-19 is that nearly everyone around the world experienced an abrupt change to their daily lives to some degree. Further differentiating COVID-19 from many other risk factors is the fact that it poses an existential threat: people have died from this virus and will continue to do so. In this way, COVID-19 may operate like other events that Masten (2021) has defined as “catastrophic”, for example mass casualties, war and terror, famine, and climate change. Clearly, catastrophic events can have a wide-ranging negative impact on the development of adolescents. COVID-19 shares two important qualities of these catastrophic events, specifically, it affects populations and can result in death. Fear of death emerges in early adolescence, as individuals contemplate the possibility of non-existence for the first time, and continues throughout adulthood, as individuals develop coping mechanisms for this knowledge.

From a methodological perspective, it is not possible to isolate the impact of COVID-19 from other factors, because all developmental outcomes are the product of multiple influences: genetic predispositions, the environment, and the correlation and interaction between the two. In other words, it is difficult to disentangle the myriad effects on any given behavior. Nevertheless, longitudinal research can often provide the strongest evidence of environmental influence.The best data is derived from longitudinal studies, whereby a change in experience, for example an environmental indicator before and after the onset of COVID-19, is associated with a change in a measure of psychosocial development. Other research can be informative as well, especially when researchers control for other indicators of experience in an attempt to isolate the effect of COVID-19. Further, consistency across studies can provide compelling evidence of the salience of a specific risk or protective factor. From a public health perspective, the identification of risk and protective factors can point the way to prevention and intervention efforts.

Family

We begin with a review of research on the family because we agree with Weeland, Keijsers, and Branje (2021, 1559) that “Of all the influences on the development of children and adolescents, the family system is among the most proximal and important ones”. During the pandemic, families experienced disruption in their routines, given that many parents were working remotely. As a result, it is likely that many parents had fewer psychological resources, such as time, attention and patience, resulting in family relationships – between parents, between siblings, and between parents and children – that were more hostile and less sensitive than pre-pandemic (Browne et al. 2021). At the same time, parents served as a source of comfort during the pandemic (Weeland, Keijsers, and Branje 2021). Thus, parenting behaviors could confer both risk and protection during the pandemic, with the overall quality of parent-child relationships varying significantly across families.

Older adolescents, especially those in college, may have experienced lockdown solo or in small peer groups or pods; however, many returned to the family home and community from which they had been building their independence and autonomy. Some adolescents, especially girls, returned to responsibilities for caregiving, household operations and supporting younger siblings with remote learning. Like many aspects of the pandemic, the forced return to the family home carried disproportionate impacts for some populations. For example, sexual and gender minorities, some of whom were able to live openly and authentically upon leaving home, faced family hostility and rejection under lockdown (Salerno et al. 2020). The inability to explore gender identity and same-sex relationships is likely to carry developmental impacts beyond the immediate crisis.

We know that positive psychosocial development is associated with relationship quality with parents, especially as indicated by parental warmth, as well as by parental support of emerging autonomy. A study of adolescents and their parents in the Netherlands pre and post lockdown revealed several provocative findings (Bülow et al. 2021). First, parents established new rules to protect their children’s health during the early stages of the lockdown, thereby limiting autonomy; however, most adolescents believed that the new rules, such as not seeing friends who might expose them to the virus, were legitimate. Second, there was great heterogeneity among families, such that family functioning varied greatly. Preexisting characteristics of family relationships predicted whether families thrived during the pandemic. Families characterized by greater warmth and less conflict before lockdown fared better than other families. In the words of the researchers, “Oftentimes, the poor get poorer and the rich get richer” (Bülow et al. 2021, 1593).

Several longitudinal studies from a variety of countries have yielded a fairly consistent pattern concerning the impact of the pandemic on parents and their adolescent children. Measures of poor family functioning, such as family chaos or disruption of family life, were associated with negative child and adolescent outcomes, including greater internalizing or externalizing of problems, anxiety, depression, anger, and argumentativeness. Importantly, these same studies demonstrated that some parent and child behaviors moderated this association – we say importantly because these moderators signal possible family interventions. In one of the stronger methodological studies, Skinner et al. (2021) studied families in five countries – Italy, the Philippines, Sweden,Thailand, and the United States – to assess moderators of association between disruptions caused by the pandemic and changes in young adults’ adjustment. Adolescent adjustment was assessed when they were 17 years of age, pre-pandemic, and again three years later, during the pandemic. Higher levels of family disruption were associated with increases in adolescent internalizing and externalizing behaviors over time – convincing evidence of the negative impact of the pandemic on mental health. These associations were attenuated by three behaviors assessed prior to the pandemic: higher levels of youth disclosure, more supportive parenting, and lower levels of destructive adolescent-parent conflict. These three moderators offer directions for family interventions that are likely to be successful in reducing adolescent mental health problems.

Similarly, using a two-way longitudinal design, with subjects assessed one week before school reopenings and three months later, Qu et al. (2021) found that, in a sample of Chinese adolescents, parent-child conflict moderated the association between psychological stress more generally and psychological distress following the return to school; return-to-school stress was only associated with psychological distress in families with higher levels of parent-child conflict. A number of potential family moderator variables have been identified in other studies. In a different study of Chinese youth, parent involvement during the pandemic alleviated stress in their children, thereby serving as a protective factor (Ding et al. 2022). And, a study in New Zealand identified partner support and cooperative co-parenting as predictors of positive parenting (McRae et al. 2021).

Child moderators have also been identified (Donker, Mastrotheodoros and Branje 2021). Tambelli et al. (2021) hypothesized that self regulation would mitigate the association between security to parents and distress due to COVID-19. To test their hypothesis, they used social media to recruit a sample of 454 late adolescents during the second wave of COVID-19 in Italy. Participants completed an anonymous survey about the quality of their attachment to parents and their ability to process their emotions. Because the findings are not longitudinal, it is difficult to link them to COVID-19 per se; still, we know that late adolescents experienced heightened distress during the pandemic, providing the conditions to assess the activation of parent-child attachment. As predicted, reported attachment to mothers was linked with lower levels of distress. Importantly, this association was mediated by an index of self regulation, specifically a measure of one’s ability to recognize and describe one’s own emotions. Similarly, a study of 5,503 Chinese youth found that self-control mediated the association between insecurity and well-being during the pandemic (Wen et al. 2021). These findings are consistent with Steinberg’s (2014) view that self regulation is a key indicator of adolescent mental health.
Individuals infected by COVID-19 prior to the availability of vaccines experienced particular trauma, as did members of their families who worried about the health of loved ones as well as themselves. Early in the pandemic, historian and filmmaker Alexandra Zapruder collected diary entries from adolescents about their experiences (Zapruder 2020). As part of this project, an 18-year-old with COVID-19 wrote vividly about her experience living at home while ill:

I was ill until proven healthy. My mother left me small foods laid on paper plates
on the stairs, running away as I came out.
A date, some almonds, a sweet potato stabbed through with a fork.
I despised her for being so
scared of me, for crying
to the doctor ‘If she comes down
I will feel panicked’. I did not come down. I stayed still for six days,
four of which I did not get out
of bed. My father texted me
from downstairs, saying that
he missed me.

This poem captures poignantly the ways in which the COVID-19 pandemic heightened adolescents’ experiences of isolation, even with the support of caring parents.

Peers

Engagement with peers plays a central role in adolescents’ psychosocial development, because the influence of peers gradually exceeds that of parents, as emerging adults begin to distance themselves from family to achieve greater autonomy. Teens are acutely sensitive to the need for social interactions, and they seek increasing time with peers outside the home (Lam, McHale, and Crouter 2014), as they expand their capacities to form friendships and intimate relationships (Orben, Tomova, and Blakemore 2021). Social distancing and confinement measures, imposed in response to the pandemic, undermined adolescents’ typical social-emotional development by decreasing time spent with peers and increasing time in the presence of family, especially parents who exerted more controls.

A number of studies have documented young adults’ isolation from peers during the early days of the pandemic. Data from a longitudinal study in the Netherlands (Bülow et al. 2021) found that 14- and 15-year-olds who, prior to the pandemic, had spent 14.5 hours a week in face-to-face contact with friends, experienced strong declines in peer socialization opportunities under lockdown, with their in-person peer contacts shrinking to just four hours weekly. And, while digital connection filled part of that gap, the authors argue that adolescents “missed important opportunities to obtain support and comfort from friends and romantic partners, in circumstances when these social resources were needed most” (Keijsers and Bülow 2021, 119).

Isolation affected college and university students as well. A study of undergraduates in Switzerland compared students’ social networks – such as friendships, social supports, and study groups – during lockdown with those of pre-pandemic cohorts. Elmer, Mepham, and Stadtfeld (2020) found a decline in the social networks of undergraduates during the pandemic compared with other groups prior to the pandemic. Social networks were associated with positive social interaction and emotional support. Not surprisingly, the decline in social networks was associated with increases in undergraduates’ anxiety, stress and depression. In fall 2020, while students studied remotely, Smith College, where we both work, administered a survey to assess students’ mental health and sense of engagement with the college community. Students’ open-ended responses included statements such as these three: I miss bumping into people at meals and chatting; I miss hanging out with people; and I feel so deeply isolated from my friends. These kinds of statements suggest the need for rich qualitative data to inform the true impact of the confinement necessitated by the pandemic.

One qualitative study of U.S. adolescents identified three themes from open-ended responses to a survey: social disconnection and inadequacy of virtual means of communication; interconnection of daily routines, social life, and mental health; and a sense of missing out on key experiences (Velez, Hahn, and Troyer 2022). Written comments demonstrate convincingly that the participants were well aware of and could speak to the impact of the pandemic on their lives. One 16-year-old boy noted, “I kind of need to go out and hang out with friends. I know everyone faces what their social life is like in different ways, but high school is supposed to be the time I find out what I am and what kind of person I want to be and I can’t really do that when I’m stuck inside”. This participant understands the psychosocial task of identity development and the fact that his progress may be delayed by the conditions associated with the pandemic. Another adolescent wrote, “The current situation has me feeling isolated and alone. My mental health has definitely taken a toll, and depressive, harmful thoughts have measurably increased. My grades have plummeted”. This participant understands the profound impact of isolation on mental health as well as academic progress.

In some studies, however, reduced time with peers and increased time with family appeared to confer protective effects, by buffering adolescents from the negative influences of peers. The protective effects were particularly salient for emerging adults. In a diary study of social interactions before and during the pandemic, researchers found that the lockdown was associated with a decrease in negative interactions with friends, for example bullying behavior and fighting (Gadassi Polack et al. 2021). Similarly, a study of adolescent psychosocial functioning in Sweden showed that isolation from peers due to remote schooling reduced incidents of victimization, a phenomenon that the researchers linked to the fact that such activity often originates in a face-to-face context before continuing online (Kapetanovic et al. 2021).

The influence of social media and digital connectivity on adolescence, especially during the pandemic, is complex. Adolescents utilized social media for their education, entertainment, information, and social contact. Some of the developmental consequences of social deprivation on adolescent development and mental health can be addressed by expanding conventional ideas of what it means to be connected. As Orben, Tomova, and Blakemore (2021, 637) explain, “Digitally-mediated interactions challenge our traditional conceptualisations of what socialising entails as they can be asynchronous, click based, or audio-video reliant. These means of interaction raise the possibility that digitalised social contact can mitigate the potentially harmful effects of physical distancing in young people”. While this seems likely to be true, Salmela-Aro and Motti-Stefanidi (2022) offer a more nuanced perspective that media use can be adaptive or maladaptive, depending on the developmental stage of the individual, the type and extent of use, and individual characteristics of the adolescent. Digital connection clearly posed risks for some groups of adolescents during the pandemic. Many students experience cyberbullying, with one study reporting that 17 percent of 12-17-year-olds in Austria have experienced this at least once (Strohmeier and Gradinger, 2022). Some groups may be particularly vulnerable based on their identity alone. In one U.S. sample, students of color who posted or shared publications about racial issues and racial justice during the pandemic were more likely to be exposed to social media discrimination, which in turn was associated with depression and drug use (Tao and Fisher 2021). It is important to highlight that most studies of adolescent social media usage during the pandemic reported associations with depression (Liu et al. 2022).

Clearly peer interactions – or lack thereof – during the pandemic provided both risk and protection.This conclusion mirrors what we saw with respect to parenting behavior during the pandemic. Thus, to gain a complete picture of psychosocial development during adolescence, we need to assess a full range of predictive behaviors – from positive to negative – with respect to adolescents’ relationships with significant people like parents and peers. Facile conclusions about a given risk or protective factor are likely to be wrong.
Schools

School closures associated with the pandemic have affected more than 1.6 billion learners worldwide (UNESCO 2021). The decision to close schools changed the lives of students in dramatic ways. Teachers taught their students using a variety of online platforms, sometimes synchronously and sometimes asynchronously. Adolescents without access to computers and/or internet connectivity were ill-equipped for learning during the pandemic, which exacerbated the so-called digital divide between less- and more-affluent students within and across countries. Some students, especially girls and young women, had to set aside academics to take on caregiving responsibilities for younger siblings while their parents were working remotely. Moreover, some students lost critical services provided by schools during the pandemic, for example tutoring and extracurricular activities, as well as health interventions ranging from free or subsidized meals to mental health counseling. The lack of in-person instruction resulted in learning loss as well as disengagement with learning for most students of all ages, across all cultures (Reimers 2022).

International studies reveal striking differences in adolescents’ schooling experiences during the early phase of the pandemic. A UNESCO (2020) study of 33 countries in Latin America and the Caribbean revealed the extent to which education was disrupted in these countries compared with Organisation for Economic Co-operation and Development (OECD) countries. Only four of the 33 countries studied provided live classes, while 18 provided asynchronous learning and 23 broadcast lessons via television and radio. Given the mode of delivery, it was challenging to monitor and assess student learning. Some countries, like Mexico, canceled end-of-year assessments. Not surprisingly, low-income students were less likely to have access to technology, although adolescents were generally more likely to have access to the internet and mobile devices compared with primary school children. Unfortunately, students with learning differences did not receive the services they would have had in an in-person school context. Finally, there was inadequate training and support for teachers to adapt their instruction to virtual platforms. In some countries, like Chile, teachers relied on learning guides and homework for students to complete independently.

Rajmil et al. (2021) identified 22 peer-reviewed studies on school closure, which involved participants who represented 15 countries, with a focus on changes in outcomes following school closure. Four studies ex-amined indexes of mental health. There was some evidence linking school closure with increases in depression and anxiety as well as a decrease in life satisfaction, with a greater effect for girls. The findings linking school closure with suicidal ideation were mixed. The authors discuss several possible mechanisms to explain the link between school closure and depression. As reported by other researchers cited here, children and adolescents were more socially isolated, which can amplify personal vulnerabilities and/or result in a lack of social support from friends. In addition, several studies reported a decrease in physical activity, often linked with depression, during school closures.

Many studies reported a greater impact of COVID-19 on adolescent girls compared with boys, perhaps because girls were more affected by the social isolation that accompanied the pandemic. This gender difference is clear in a longitudinal study of 175 adolescents whose mothers were originally recruited during pregnancy (Liu et al. 2021). There were no sex differences in self-reported depressive symptoms before the pandemic; however, after the lockdown, girls showed an increase in depression within the first seven weeks, an increase that was maintained over the next six months. In contrast, boys did not report increases initially, but did report increasing levels over time. For both boys and girls, mean levels of depression exceeded the average for non-pandemic populations.The authors attribute higher depression to higher stress experienced during the pandemic, especially during the onset of the pandemic when stresses included their fear of infection, concerns about the health of their loved ones, disruption of their plans, missed rites of passage, and loss of interpersonal relationships.

A study of university students in the U.S. examined the impact of COVID-19 on study-related stress, which they define as stress related to coursework, procrastination and study/life balance (Keyserlingk et al. 2021). Participants experienced not only online learning but also a change in residence, given that they were required to leave their dormitories. Generally, high levels of ambiguity and low perceived controllability leads to stress, so it is likely that COVID-19 would be associated with higher stress levels. Students completed a survey in February 2020, before there were any cases of COVID-19 on campus, and completed the same survey again in April, May and June of the same semester. There were three main findings: there was an increase in study stress following the onset of the pandemic; self regulation mitigated the increase in stress, thereby serving as a protective factor; and pre-existing psychological distress was associated with larger increases in study-related stress, thereby serving as a risk factor.

In another study, parent involvement in distance learning resulted in stress for adults and their adolescent children. Schmidt et al. (2021) conducted a 21-day diary study in Germany with 562 highly-educated parents, mostly mothers. On average, parents in the study had two children, where the older child was an adolescent. When the children were working on school tasks or when parental involvement was required for their children’s learning, parents reported more negative parent-child interactions as well as lower parent and child positive affect. This finding is consistent with pre-pandemic research on the stress associated with parental involvement with homework.

While at-home learning exacerbated parental stress, it is important to note that parents held varying views about schooling for their children. In a recent essay, Astor (2022) noted, “Some parents whose children are learning remotely are upset that they aren’t in school in person. Some whose children are learning in person are upset that they cannot be remote. Many are torturously ambivalent, trying to claw good solutions out of situations that offer none”. Holmes (2022) and others have argued that it is foolhardy to view schooling during the pandemic with an either/or or win/lose frame, with academic success and socialization on one side and risk of infection on the other. Specifically, for some students of color in the U.S., the pivot to remote learning necessitated by the pandemic conferred some benefits, for example it closed, to some extent, the digital divide, through the provision of computing devices and connectivity; reduced academic losses associat- ed with disproportionate suspensions for students of color; and provided more opportunities for conferences with teachers for parents with difficult job schedules. Further, Holmes (2022) as well as Gilbert et al. (2020) have urged school opening advocates to consider their recommendations in a broader context with consideration of racial identity; there are good reasons for parents of color in the U.S., specifically Black and Latino parents, to be reluctant to send their children to school, especially given the well-docu- mented inferiority of public schools for students of color.

Disparities in economic and social circumstances tended to predict whether an adolescent would continue with schooling following school closures. A multi-modal study of adolescents’ access to education during COVID-19 in Bangladesh, Ethiopia and Jordan found that poverty reduced school persistence and increased drop-out rates, especially among girls and young women (Jones et al. 2021). Data from Sub-Saharan Africa also suggests a disproportionate risk for girls (Kwauk, Schmidt, and Ganju 2021). Although younger girls returned to schools when they reopened at rates equal to or better than boys, this was not true for adolescent girls. Economic precarity exacerbated by the pandemic often sent adolescent girls into the workplace – or into transactional sex work – either to support their families or because families no longer had the resources for school fees. A Brookings Institute survey of 4,000 adolescents in Kenya found that boys were twice as likely to return to the classroom when schools reopened as were girls (Kwauk, Schmidt, and Ganju 2021). This same survey revealed that adolescent girls in eastern Africa reported higher levels of anxiety, compared with boys, about their learning loss, their need for remedial education, and the prospect of repeating a grade at an age older than their peers. In study after study, girls fared worse than boys during the pandemic.

The effect of remote instruction and modified educational methods on adolescents’ school performance and learning retention varied widely across countries. A systematic review of 42 studies – mostly in Europe, Asia and the U.S. – found that secondary students had sufficient facility with technology, which enabled them to learn fairly autonomously; nonetheless, the academic performance of most children suffered, especially children with neurodevelopmental disorders and those in need of special education more generally (Panagouli et al. 2021). Thus, we must consider individual differences among children when examining the effects of the pandemic. Going forward, it will be important to consider how and whether differences in learning outcomes during the pandemic are mediated by psychosocial development, which seems likely from a cumulative risk perspective.
Community

Although there are studies of the impact of the pandemic across countries, most do not consider measures of how the pandemic was experienced as a function of a country’s customs and values. Further, there are few studies of communities within a given culture beyond assessment of socio-economic status.Yet, we know from sociological and anthropological literature that cultural practices greatly influence families, peers, and schooling and, therefore, should be considered in the development of policy initiatives, social support programs, and public health interventions.

Two studies illustrate the importance of examining communities within a given country. One is the experience of indigenous young adults at tribal colleges in the U.S. One-third of Native American college students are single parents living in multigenerational households earning well below the poverty line; most are first generation college students carrying sig-nificant responsibilities for family, extended family, and the greater tribal community. Many are high school dropouts seeking a General Equivalency Degree (GED); more than 60 percent require developmental support in math and 45 percent in reading to be prepared for college level work (Yarlott 2020).

The advent of the pandemic exacerbated existing stressors on Native American students and families. A 2020 survey of students at 13 tribal colleges conducted by the American Indian Higher Education Consortium (AIHEC 2021) found that 24 percent of those who had been able to meet their mental health needs prior to the onset of the pandemic were unable to do so; this builds on 15 percent who had been unable to meet those needs pre-pandemic (Redden 2021). Native communities have suffered pandemic-related deaths at 1.8 times the number for non-Hispanic Whites (Arrazola et al. 2020), leading to an increased demand for grief counseling, especially in light of the fact that COVID-19 isolation protocols precluded collective bereavement rituals. Amid multiple challenges – poverty, homelessness, food insecurity, insufficient technology access – tribal college leaders identified supporting students with mental health issues as one of their biggest challenges (Redden 2021).

To support students’ mental health needs, Native colleges deployed resources across a number of dimensions, including everyday basic needs. Interventions included emergency funds for food, utilities, and car payments; expanded access to laptops, mobile phones and wifi connectivity; as well as the resources that technology enables such as tele-health services and remote mental health counseling (Weissman 2021). In this community context and across a range of others, economic supports and access to services through technology hold the potential to serve as protective factors during late adolescent development.

The experience of refugee and migrant youth reveals a different pandemic experience, requiring different supports and services. By United Nations criteria, there are more than 56 million migrant children and youth around the world, many unaccompanied by adults and/or separated from parents. Displaced from their families and countries of origin and severed from a collective cultural environment, these populations experience significant precarity of all sorts; as a result, adolescents face risks for psychosocial and developmental impacts, even in the absence of a global health crisis.

Not surprisingly, during the COVID-19 pandemic, migrant and refugee youth struggled across multiple dimensions. They struggled to maintain school attendance and lagged in academic progress, particularly with regard to language learning in their unfamiliar community contexts. Opportunities to form social connections – already hindered by language limitations as well as migrant youths’ vulnerability to sexual and labor exploitation – were further constrained by the lockdown.

As part of the Gender and Adolescence: Global Evidence (GAGE 2017) study, a team of British, American and Bangladeshi researchers conducted telephone surveys of Rohingya adolescents living in migrant camps and in nearby host communities in Bangladesh. The surveys, conducted from May to June 2020, elicited quantitative and qualitative data across a range of areas, including education and psychosocial well-being. Respondents’ reported rates of moderate to severe depression (4.4 percent), lower than expected in comparison to 2019WHO figures showing that 10-20 percent of adolescents around the world experience mental illness.The researchers attribute the low depression prevalence in their sample to underreporting of symptoms as well as to normalizing “extreme disadvantage” (Guglielmi et al. 2020). The relatively low rates of depression were also belied by the qualitative responses. For example, a 15-year-old respondent in the study reported, “I have to be alone all the time, which makes me sad. I am losing myself for all these disturbances and troubles”.

Pandemic impacts on displaced girls and young women, who are already disproportionately confined to domestic spaces, have been significant. They have been even less likely than their male counterparts to leave home or circulate with others under COVID-19 (Guglielmi et al. 2020). Lockdown limited their access to information, learning and social development. Relatedly, the reduced presence of humanitarian workers in refugee camps due to COVID-19 has raised concerns for girls’ increased vulnerability to child marriage (Guglielmi et al. 2020).

For adolescents from middle-class families in countries with developed economies, the picture is far more positive. As the world struggled to cope with the pandemic, Grütter and Buchmann (2021), researchers from Switzerland, developed profiles of 20-year-olds with respect to solidarity, defined as “mutually beneficial individual-context relation”, which they view as adaptive developmental regulation for any community. Given that the pandemic necessitated strong restrictions on our social lives as well as health behaviors like the use of masks, both to promote the public good, solidarity appears to be an important new construct.The researchers chose to study adolescents because this age group has been identified as a source of virus transmission, given their robust social lives. They identified three profiles: low solidarity (23 percent of the sample), average (54 percent of the sample), and high (23 percent of the sample). Those in the high group were more likely to engage in adaptive behaviors, for example self isolation, mask wearing and volunteering to help others. The high group also reported higher levels of concern for others’ health. In this longitudinal study, measures of social trust and sympathy at age 12 predicted solidarity at age 20. Grütter and Buchmann argue that these findings may inform interventions to prepare future generations to contribute to the common good as we face other global crises.

In a U.S. study, Coulombe and Yates (2022) discuss the importance of providing children and adolescents with motivation for other-oriented behavior, and they argue that secure attachment provides the foundation for this. In their study, secure attachment with parents at age 12 promoted not only prosocial and health protective behaviors, but also adolescent mental health.They argue persuasively that “interventions to promote the wellbeing of adolescents (and others) during this global crisis should consider the quality of parent-adolescent relationships with regard to children’s felt security and safety therein” (Coulombe and Yates 2022, 68).Taken together, these two studies suggest that interventions should focus on socio-cognitive skills, especially perspective taking, which leads to concern for others within the community. Although young people are shaped by context and community, under the right circumstances, they, in turn, can shape their community for the better.

Conclusion

Adolescents today will be defined as the COVID-19 generation, and the full effects of the pandemic on their lives may not be clear for years to come.Yet, in just two and a half years, the scientific community has produced timely and valuable information about the impact of COVID-19 on adolescent psychosocial development. There is consistent evidence that mental health outcomes, such as anxiety and depression, increased dramatically across the world following the COVID-19 pandemic. The question is why. The consequences of COVID-19 were many, including remote work for parents and school closures for children. These two structural changes led to profound differences in adolescents’ lived experiences. In this review, we have identified processes associated with these structural changes that influenced adolescent psychosocial development:

• In the family context, indicators of experience like parent-adolescent conflict and restriction of adolescent autonomy were shown to be risk factors for psychosocial development while other indicators like parental warmth were shown to be protective;
• In the peer context, the pandemic necessitated a decrease in peer interaction, which was associated with decreased social support and increased stress, as well as with decreased victimization and bullying. Like parents, peers offered both risks and protections for adolescents.
• In the school context, school closures led to disengagement from school, learning loss, decrease in services associated with school and, as a result, increased stress for students across the world.
• In the community context, we assume that customs and values matter, and we know that there are great differences in adolescent experience within cultures and countries. Still, there is very little research to date. A new line of research suggests that adolescent interventions that promote solidarity, or concern for community, may help address the impact of a community crisis like COVID-19.

If there is one major conclusion from the extant research, it is this: relationship closeness buffered children from the negative impact of COVID-19. This is hardly surprising, given the existing developmental literature on parent-child attachment, parenting quality, peer interaction and support as well as research on risk and protection. A second key finding is that self regulation appears to help both parents and children navigate catastrophic events. People who can self regulate reflect on their emotions and can manage their behaviors and reactions as a result. In doing so, they learn more effectively and have better social relationships. In the context of COVID-19, self regulation mitigated the negative impact of this powerful stressor, as demonstrated across numerous studies.

Taken together, these findings are consistent with a cumulative adversity model or stress exacerbation perspective, identified by Repetti, Taylor, and Seeman (2002) in their comprehensive review of the literature on risk and protective factors. The more risk, the more vulnerability for the developing adolescent; however, protective factors can mitigate risk. Further, risks can both create vulnerability in adolescents or exacerbate genetic predispositions that are associated with vulnerability. Going forward, it will be critical to consider the impact of COVID-19 in light of individual differences among adolescents with the goal of providing tailored prevention and intervention programs in partnership with families, schools and communities.

Despite what the research community has learned, our knowledge of the impact of existential risks, like COVID-19, is just emerging. Only longitudinal research will allow us to understand both the directionality, timing and persistence of the impact of the pandemic as well as the developmental trajectory for given outcomes. As Masten (2021, 1749) has noted, “As conditions improve and adaptive systems are restored or mobilized, most people improve to normative functioning, although there can be lifelong consequences of severe and prolonged trauma and related deprivation, illnesses, or injuries”. Conditions in some countries and communities are improving throughout the world, which is encouraging; however, we need to prevent prolonged trauma for individuals within communities that continue to experience high rates of illness and death.

As a global community, we need to advocate for funding to conduct multi-site, longitudinal studies representative of populations within and across countries.Too often, researchers must rely on convenience samples that typically are not representative of populations with respect to demographic indicators such as education level, income and race. Further, research on the impact of COVID-19 must prioritize vulnerable groups, because there is ample evidence that COVID-19 disproportionately affects adolescents already at risk. Also, as this review demonstrated again and again, girls were more vulnerable to the effects of COVID-19 with respect to mental health, perhaps because of the additional family burdens they incurred during lockdown.

As we all know, we cannot await future research to act. How do we mitigate the impact of the pandemic on adolescents? From the extant literature on mental health, we know that prevention is critical. Educating the public on wellness strategies is a good first step, for example the importance of investing in healthy relationships, practicing techniques to manage stress, taking care of our bodies, and being intentional about social media and video games (U.S. Surgeon General’s Advisory 2021). Some studies have identified specific behaviors that decrease stress, for example keeping a journal, physical activity and exercise, and positive reappraisal and reframing of one’s circumstances; regarding the latter, some adolescents saw the lockdown as an opportunity to decelerate their lives (Shanahan et al. 2022). Parents, physicians and teachers have critical roles to play as well – parent education will promote warm, trusting relationships with children and adolescents; physician education will promote mental health screening during visits with patients; and teacher education will promote individualized instruction in a caring, supportive environment. Of course, sometimes prevention is not enough, especially for vulnerable people. For this reason, we need to be mindful about the importance of intervention, that is, mental health services, when needed.

The pandemic has revealed, once again, the unequal social systems, discrimination, marginalization and violence that are endemic in our globalized contemporary world (Velez, Taylor, and Power 2022). The need to recommit to the United Nations Sustainable Development Goals – especially the goal of good health and well being – has never been more clear. Children and adolescents deserve nothing less than universal access to prevention and intervention services, that is effective mental health care and wellness programs.

^1. Corresponding Author: Kathleen McCartney, Smith College, College Hall, Northampton, MA 01063 USA, kmccartney@smith.edu

 

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