(PS5-21) COVID-19 and Changes in Youth-reported Transdiagnostic Mechanisms of Anxiety Disorders

Background:

The COVID-19 pandemic has exacerbated mental health (MH) issues globally, serving as a catalyst for a rise in anxiety and related disorders. To better understand trends in MH conditions, however, it is imperative to assess the pandemic’s effects on transdiagnostic mechanisms of emotional disorders that contribute to their development and maintenance. Anxiety sensitivity (AS), distress intolerance (DI), and intolerance of uncertainty (IU) are three such mechanisms; yet, studies are limited, mixed in terms of their trajectories during COVID-19, and primarily focused on adult populations (Katz, 2022; Yang et al., 2023). The current study aimed to assess changes in youth-reported AS, DI, and IU from pre- to post-pandemic to help identify treatment targets in the context of ongoing increases in emotional disorders among youth. 

Method:  

Sociodemographic, Child Anxiety Sensitivity Index (CASI), Distress Intolerance Index-Youth Report (DII-Y), and Intolerance of Uncertainty Scale for Children (IUSC) questionnaire data were collected from patients seen at a university-based youth anxiety clinic between December 6th, 2018-May 22nd, 2023. The time frame was trichotomized into the following: pre-pandemic (12/6/2018-3/15/2020), during pandemic (3/16/2020-9/1/2021), and post-pandemic (9/2/2021-5/22/23) based on the clinic’s COVID-19 closure period and the time of school reopenings in the region. Kruskal-Wallis H tests assessed changes in CASI, DII-Y, and IUSC scores as a function of pandemic periods. Bonferroni corrections were applied to post-hoc comparisons. 

Results:  

A total of 158 patients aged 10-17 (M=13.17) completed the questionnaires within the analytic time period. Most  (n=109; 69%) were female. Median IUSC scores were significantly different across the pandemic periods (H[2]= 10.70, p=.005), such that pre-pandemic scores (Mdn=49) were significantly lower than during- and post-pandemic (both Mdn=64, p=.005). Similarly, there were significant differences in median CASI scores by pandemic category (H[2]=8.28, p=.016) with the same pattern of significantly higher scores during- and post-pandemic (both Mdn=30) relative to pre-pandemic (Mdn=26, p=.019). DII-Y scores also changed significantly by pandemic category (H[2]=10.02, p=.007), with the highest median score associated with the during-pandemic period (Mdn=23) compared to pre-pandemic (Mdn=16) and post-pandemic (Mdn=22). Further analyses revealed that girls had a continual rise in symptomatology while boys showed a decline post-pandemic.

Conclusion

Findings highlight the continued effect of the pandemic on youths’ ability to tolerate uncertainty, distress, and physiological sensations of anxiety. As the clinical field moves towards identifying and targeting shared mechanisms of emotional disorders, the current study indicates that clinically anxious youth may need greater support managing symptoms of AS, DI, and IU following the pandemic. These notable increases from pre- to during and post-pandemic may suggest an ever-important need to focus treatment on shared mechanisms rather than disorder-specific targets, given the continuing upward trend in youth anxiety and depressive disorders.