Ecological-Systems Contributors to Internalizing Symptoms in a US Sample of Adolescents During the COVID-19 Pandemic

ABSTRACT

Objective

Internalizing problems are common in adolescence and increased substantially during the COVID-19 pandemic. Although rates of anxiety and depression have since improved, the general increase in the prevalence of mental health problems and disruptions to mental health services during the COVID-19 pandemic has resulted in huge gaps in care. Although research has primarily focused on proximal correlates of internalizing problems, a growing literature suggests that factors outside youths’ immediate microsystems are equally crucial for their mental well-being. Thus, it is important to investigate multisystemic correlates of internalizing problems to inform individual and community-based interventions to address the current mental health burden.

Method

Leveraging secondary data from a nationally diverse U.S. sample of 2,954 adolescents (ages 13–16), we examined the associations between factors at multiple levels of youths’ ecologies – spanning indicators of threat and deprivation – and their depression and anxiety symptoms during the COVID-19 pandemic. Furthermore, in follow-up exploratory analyses, we examined if these associations differed by adolescents’ racial/ethnic groups.

Results

Consistent with socioecological models, we found that indicators of threat and deprivation in the adolescents’ immediate home and more distal neighborhood environments were associated with depression and anxiety symptoms. The patterns of associations were similar across racial/ethnic groups in multigroup structural equation models. Additionally, we found that mean levels of internalizing symptoms and socioecological predictors significantly differed across racial/ethnic groups.

Conclusion

These findings have important implications for understanding multi-level contributors to adolescent mental health, which may inform research, practice, and policy.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Supplementary data

Supplemental material for this article can be accessed online at https://doi.org/10.1080/15374416.2023.2246556

Notes

¹ We recognize the use of “Asian American” to be a limitation given it does not acknowledge many subgroup differences across the continent of Asia. Similar to the other racial/ethnic groups in this manuscript, we recognize that this broad grouping of people creates a false narrative of a monolith and does not recognize cultural and linguistic differences among people.

² In this manuscript, we use the term Hispanic/Latine/Latinx to describe people of Spanish (origin in Spain), Central and South American (including the Caribbean) descent, of which there is a complicated political and linguistic history. Latinx and Latine has been used as gender-inclusive terms, but the “x” or “e” ending is not a Spanish language ending, and many consider it an Anglicized version of the root word, which has masculine (o) and feminine (a) ends depending on the reference category.

³ We have capitalized the names of all racial groups to be consistent with linguistic standards (i.e., capitalizations of proper nouns). We recognize the shift from using the racial group “White” with a capital “W” given its ties to White Supremacy. We acknowledge the history of White Supremacy and will specifically name White Supremacy in contexts where it is appropriate to differentiate it from “White” as a racial category, as White Supremacy is more indicative of a system, rather than an individual or group of people, that disproportionately hurts people of color in the US. Furthermore, the differentiation between “White” and “White Supremacy” also helps to differentiate the evolution of what was/is considered “White” in the United States (i.e., people of Italian, Jewish, Arab descent, etc.) from a White Supremacist system on which the country was built to disadvantage groups of people.

Additional information

Funding

This work was supported by the NIH Office of the Director [DP5OD028123].