Table 1.
Methodological characteristics of the included studies and quality appraisal.
| References | Country | Period of data collection | Study designa | Participants | Outcome measuresb | Relevant findings | Study appraisalc | |
|---|---|---|---|---|---|---|---|---|
| Total sample n (% females) | M (sd); age range | |||||||
| Quantitative studies | ||||||||
| Andrés et al. (2022) | Argentina | n.s. | Quantitative; cross-sectional; non-probabilistic sampling (i.e., snowball); online survey; parent/caregiver-report. |
Total sample n = 1,205 (51.5% females). Sub-sample 6–8 yo n = 286 (% gender n.s.). Sub-sample 9–11 yo n = 297 (% gender n.s.). |
Total sample M(sd) = n.s.; Age range = 3–18 yo. Sub-sample 6–8 yo M(sd) = n.s.; Age range = 6–8 yo. Sub-sample 9–11 yo M(sd) = n.s.; Age range = 9–11 yo. |
(1) Child Behavior CheckList (Achenbach and Rescorla, 2014): child' internalizing and externalizing symptoms; Positive and Negative Affect Schedule for Children (Positive Affect Subscale; Laurent et al., 1999): child' positive affect. (3) State-trait Anxiety Inventory (Spielberger et al., 1999): parent' anxiety; Beck Depression Inventory-II (Beck et al., 1996): parent' depression; Positive and Negative Affect Schedule (López-Gómez et al., 2015): parent' affectivity; Ad hoc measure: parent' concerns and worry on COVID-19 infection. |
RQ1 Children aged 6–8 years showed a high level of internalizing (anxiety-depression) and externalizing (impulsivity-inattention; aggression-irritability) symptoms. Children aged 9–11 years showed internalizing (anxiety-depression) and externalizing (aggression-irritability) symptoms. RQ2 Total sample Females > males: internalizing (anxiety and depression symptoms) symptoms; Males > females: externalizing (aggression and irritability) symptoms: Sub-sample 8–9 yo Males > females: dependence-withdrawal. |
Medium |
| Dodd et al. (2022) | Ireland, UK | Irish sample April 3–April 26, 2020 UK sample April 4–April 15, 2020 |
Sub-sample Irish Quantitative; cross-sectional; non-probabilistic sampling (i.e., snowball); online survey; parent-report. Sub-sample UK Quantitative; cross-sectional; probabilistic sampling; online survey; parent-report. |
Sub-sample Irish (Study 1) n = 427 (45% females). Sub-sample UK (Study 2) n = 1,919 (49% females). |
Sub-sample Irish (Study 1) M(sd) = 8.02 (1.98) yo; Age range = 5–11 yo. Sub-sample UK (Study 2) M(sd) = 8.45 (1.99) yo; Age range = 5–11 yo. |
Irish and UK samples (1) Strength and Difficulties Questionnaire (Goodman, 2003; Tobia and Marzocchi, 2018): child' internalizing and externalizing symptoms; Positive and Negative Affect Schedule for Children-P (Ebesutani et al., 2012): child' emotional functioning. (2) Children's Play Scale (Dodd et al., 2021): child' play. (3) Kessler-6 (Kessler et al., 2002): parent' distress. |
RQ1 Irish and UK sample Child' internalizing symptoms were negatively associated with play activities; furthermore, low levels of child' internalizing symptoms were associated with low parent' distress levels. No significant associations between considered variables and child externalizing symptoms were found. RQ2 No significant gender differences in internalizing and externalizing symptoms were found. Females > males: positive affect. RQ3 The more child play activities involved the more positive effects. |
Irish sample: High UK sample: High |
| Lionetti et al. (2022) | Italy |
T1: January, 2020 T2: April, 2020 |
Quantitative; longitudinal; non-probabilistic sampling (convenience); online survey; parent-report. | n = 94 (55% females). | M(sd) = 9.08 (0.56) yo; Age range: 8–10 yo. | T1 (1) Pediatric Symptoms Checklist (Gardner et al., 1999): child' externalizing symptoms. (2) HSC scale (Pluess et al., 2018): child' environmental sensitivity. T2 (1) Pediatric Symptoms Checklist (Gardner et al., 1999): child' externalizing symptoms; (2) Closeness Scale of the Parent-Child Relationship Scale (Pianta, 1992): quality of parent-child relationship. |
RQ1 Sensitive children showed more internalizing symptoms during the pandemic than before. RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. RQ4 A close parent-child relationship moderated the impact of time on child' externalizing symptoms. Furthermore, the close parent-child relationship leads sensitive children to show decreased internalizing symptoms during the pandemic. |
Low |
| Liu et al. (2022) | China | April 23–May 7, 2020. | Quantitative; cross-sectional; non-probabilistic sampling (convenience); online survey; self-report. |
Total sample n = 4,852 (51.5% females). Sub-sample 10–12 yo n = 1,524 (49.5% females). |
Total sample M(sd) = 13.80 (2.38) yo; Age range = 10–18 yo. Sub-sample 10–12 yo M(sd) = 10.96 (0.82) yo; Age range = 10–12 yo. |
(1) Chinese version of Self-Rating Depression Scale (Zung, 1965): child' depressive symptoms; Chinese version of Self-Rating Anxiety Scale (Zung, 1971): child' anxiety symptoms. (2) Chinese Internet Addiction Scale-Revised (Chen et al., 2003): child' internet addiction; Chinese version of Athens Insomnia Scale (Soldatos et al., 2000; Chiang et al., 2009): child' insomnia; Chinese version of Utrecht Work Engagement Scale for Students (Schaufeli and Salanova, 2007; Fang et al., 2008): child' academic engagement. |
RQ1 Depression and insomnia, as well as anxiety and insomnia mediated the relationship between problematic internet use and academic engagement. The indirect effects of Internet risk on academic engagement through depression and insomnia in middle and late adolescence were stronger than those in early adolescence; the direct effect in early adolescence was stronger than that in middle adolescence. RQ2 Females > males: internalizing (depression, anxiety) symptoms; Females > males: insomnia. RQ3 The older, female, and non-only children were significantly correlated with higher levels of internalizing (depression, anxiety and insomnia) symptoms. |
High |
| Martiny et al. (2022) | Norway | June 8–July 3, 2020 | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent and child -report. | n = 87 (51.7% females) | M(sd) = 9.66 (1.77) yo; Age range = 6-13 yo. | (1) How I feel Questionnaire, used with children as young as 8 years of age (Walden et al., 2003): child' internalizing symptoms. (2) Ad hoc measure: child' COVID-19 attitudes; KIDSCREEN-10 (Haraldstad et al., 2006; Ravens-Sieberer et al., 2006): child' wellbeing. (3) World Health Organization Index (Topp et al., 2015): parent' wellbeing; Ad hoc measure: parent' stress because of the reopening. |
RQ1 Results show that high levels of child' wellbeing and positive emotions were associated with child' positive attitude toward the COVID-19. RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. RQ4 Living with one parent was associated with low child' wellbeing; mother' wellbeing was associated with child' wellbeing and child' negative emotions. |
Low |
| Morelli et al. (2022) | Italy | April, 2020 | Quantitative; cross-sectional; non-probabilistic sampling (convenience); online survey; parent-report. | n = 277 (52% females). | M(sd) = 9.66 (2.29) yo; Age range = 6–13 yo. | (1) Emotion Regulation Checklist (Molina et al., 2014): child' emotions regulation. (2) Ad hoc measure: familiar risks related to the family situation during the lockdown, risks related to the COVID-19 pandemic, child' exposure to news related to COVID-19. (3) Modified version of the Television Mediation Scale (Valkenburg et al., 1999): parental mediation of children' exposure to news related to the COVID-19 pandemic. |
RQ1 Results show an increase in anxiety and sadness in children. High level of child' emotion regulation and low level of lability/negativity were associated with parental active mediation style; low level of child' lability/negativity was associated with the parental restrictive style; child' lower emotion regulation was associated with parental social co-viewing style. RQ2 No significant gender differences in internalizing and externalizing symptoms were found. RQ3 Early adolescents show a lower level of emotion regulation than younger children. |
Medium |
| Oliveira et al. (2022) | Portugal | June–July, 2020 | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-report. | n = 110 (50% females). | M(sd) = 9.09 (0.80) yo; Age range = 7–10 yo. | (1) Strength and Difficulties Questionnaire (Goodman, 2003): child' internalizing and externalizing symptoms. (2) KIDSCREEN-10 Index (Ravens-Sieberer et al., 2014): child' quality of life; Q25 Questionnaire (Oliveira et al., 2019): child' daily activities. |
RQ1 Internalizing symptoms were positively correlated with domestic chores and negatively with play. Externalizing symptoms were positively correlated with gaming and negatively with creative leisure and play. Level of engagement in physical activities was positively correlated with psychological and social wellbeing and negatively with internalizing and externalizing symptoms. RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. Males > females: physically active; Females > males: engaged in play and social activities. RQ3 There is evidence of high levels of sedentary behavior (time spent on the screen) and low levels of play and recreation, particularly among socioeconomically vulnerable children. |
Low |
| Penner et al. (2022) | USA | February 2–April 4, 2021 |
Quantitative; cross-sectional; non-probabilistic sampling (quota); online survey; parent-reported. |
Total sample n = 796 (42.1% females). Sub-sample 5–8 yo n = n.s. (% gender distribution n.s.). Sub-sample 9–12 yo n = n.s. (% gender distribution n.s.). |
Total sample M(sd) = 10.35 (3.16) yo; Age range = 5–16 yo. Sub-sample 5–8 yo M(sd) = n.s.; Age range = 5–8 yo. Sub-sample 9–12 yo M(sd) = n.s.; Age range = 9–12 yo. |
(1) Strength and Difficulties Questionnaire (Goodman, 2003): child' internalizing and externalizing symptoms. (2) Child Routines Inventory (Daily Living Routines subscale; Sytsma et al., 2001): child' daily routines; Part 1 (Exposures) of the COVID-19 Exposure and Family Impact Survey (Kazak et al., 2021): family COVID-19 exposure. (3) Short Forms of the Patient- Reported Outcomes Measurement Information System (PROMIS)-Depression and PROMIS-Anxiety (Pilkonis et al., 2011): parent' current depressive and anxiety symptoms; Short form of the Alabama Parenting Questionnaire (Elgar et al., 2007): parenting behaviors; Multidimensional Assessment of Parenting Scale (Hostility and Supportiveness subscales; Parent and Forehand, 2017): affective aspects of parenting; Parenting Sense of Competence Scale (Efficacy subscale; Johnston and Mash, 2010): parenting cognitions. |
RQ1 For internalizing and externalizing symptoms, indirect associations occurred through increased parental hostility and inconsistent discipline and decreased parental routines and support. A negative correlation was found between child' internalizing symptoms and levels of positive reinforcement, daily routine, parental support and parental self-efficacy. A negative correlation was found between child' externalizing symptoms and levels of positive reinforcement, daily routine, parental support and parental self-efficacy. RQ2 No gender differences in internalizing and externalizing symptoms were found. RQ4 A positive correlation was found between high levels of inconsistent discipline, poor supervision and parental hostility. |
Medium |
| Ravens-Sieberer et al. (2022) | Germany | May 26–June 10, 2020 | Quantitative; cross-sectional; non-probabilistic sampling (convenience); online survey; parent–report (sub-sample 7–10 yo); self-report (sub-sample 11–13 yo). |
Total sample n = 1,586 (50% females). Sub-sample 7–10 yo n = 546 (% gender distribution n.s.). Sub-sample 11–13 yo n = 351 (% gender distribution n.s.). |
Total sample M(sd) = 12.25 (3.30) yo; Age range = 7–17 yo. Sub-sample 7–10 yo M(sd) = n.s.; Age range = 7–10 yo; Sub-sample 10–13 yo M(sd) = n.s.; Age range = 10–13 yo. |
(1) Strength and Difficulties Questionnaire (Goodman, 2003): child' internalizing and externalizing symptoms; Selected items from the German version of the Center for Epidemiological Studies Depression Scale (Barkmann et al., 2008): child' depression symptoms; Screen for Child Anxiety Related Disorders (Birmaher et al., 1999): child' anxiety symptoms. (2) Ad hoc measure: child' burden of the pandemic; KIDSCREEN-10 Index (Ravens-Sieberer et al., 2014): child' quality of life; HBSC symptom check-list (Haugland et al., 2001): child' psychosomatic complaints. |
RQ1 During the pandemic, children experienced high levels of anxiety, hyperactivity symptoms and peer problems. RQ2 Males > females: internalizing and externalizing symptoms. Females > males: externalizing symptoms (only for peer problems subscale). RQ3 During the pandemic, children experienced lower health-related quality of life than before the pandemic. |
Medium |
| Sun et al. (2022) | USA |
T1 Spring, 2019 T2 Spring, 2020 |
Quantitative; longitudinal; non-probabilistic sampling (convenience); T1: data were collected at school; T2: data were collected online. | n = 247 (47% females) | M(sd) = 8.13 (0.46 yo); Age range = 7–9 yo. | T1 (1) Teacher-Child Rating Scale (Perkins and Hightower, 2002): child' pre-pandemic social-emotional skills. T2 (1) Pediatric Emotional Distress Scale (three subscales; Saylor et al., 1999): child' internalizing and externalizing symptoms. (3) Center for the Epidemiological Studies of Depression Short Form (Björgvinsson et al., 2013): parent' depression symptoms; Generalized Anxiety Disorder 7- Item Scale (Spitzer et al., 2006; Löwe et al., 2008): parent' anxiety symptoms; UCLA Loneliness Scale version 3 (Russell, 1996): parent' loneliness; Brief Resilience Scale (Smith et al., 2008): parent' resilience. |
RQ1 Results show that at the beginning of the pandemic, parents reported more children' externalizing symptoms than internalizing ones. Ability in relationships with peers before the pandemic predicted the child' internalizing and externalizing symptoms at pandemic onset. Child' externalizing symptoms were predicted by parental distress. RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. |
Low |
| Andrés-Romero et al. (2021) | Spain | Started in the third week of confinement until the sixth week (3 weeks) | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-report. |
Total sample n = 1,555 (53.18% females). Sub-sample 6–11 yo n = 353 (% gender distribution n.s.). |
Total sample M(sd) = n.s.; Age range = 3–18 yo. Sub-sample 6–11 yo M(sd) = n.s.; Age range = 6–11 yo. |
(1) Strength and Difficulties Questionnaire (Goodman, 2003): child' internalizing and externalizing symptoms. (2) Ad hoc measure: child' habits of everyday living. (3) Parental Stress Scale (Oronoz Artola et al., 2007): parent' stress; Resilience Scale (Wagnild, 2009): parent' resilience. |
RQ1 High parental resilience levels were associated with low child' difficulties in terms of internalizing and externalizing symptoms. RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. RQ3 Parents perceive a change in their child' habits and psychological difficulties. |
Medium |
| Balayar and Langlais (2022) | USA | n.s. | Quantitative; cross-sectional [comparison before (retrospective) and during pandemic]; non-probabilistic sampling (snowball); online survey; parent-report. | n = 80 (50% females). | M(sd) = 8.7 (6.67) yo; Age range = 8–13 yo. | (1) Ad hoc measure: child' internalizing and externalizing symptoms. (2) Ad hoc measure: child' learning performance and psychosocial activities before and during the pandemic. (3) Depression, anxiety, stress scale (Henry and Crawford, 2005): parent' distress. |
RQ1 Internalizing symptoms (withdrawn, anxious, depressed, and stressed) were significantly poorer during the pandemic than before. Regarding the externalizing symptoms, no significant differences before and during the pandemic were found. RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. RQ3 Children' learning attainment during the pandemic was significantly predicted by externalizing symptoms. |
Low |
| Bate et al. (2021) | USA | March 31–May 15, 2020 | Quantitative study; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-report. | n = 158 (43% females). | M(sd) = 8.73 (2.01) yo; Age range = 6–12 yo. | (1) Pediatric Symptoms Checklist (Jellinek et al., 1999): child' internalizing and externalizing symptoms; Child Revised Impact of Event Scale-13 (Perrin et al., 2005): child' trauma-related symptoms. (2) Child-parent relationship scale (Pianta, 1992): parent-child relationship quality. (3) Ad hoc measure: COVID-19 impact on parent; Patient Health Questionnaire (Spitzer et al., 1999): parent' emotional health; Impact of Events Scale -Revised (Weiss, 2007): parent' evaluation of own distress caused by traumatic events. |
RQ1 Child' internalizing and externalizing symptoms were positively predicted by parent' emotional problems. RQ2 Females > males: internalizing symptoms; Males > females: externalizing symptoms. RQ4 The more conflictual parent-child relationship, the more the child' internalizing symptoms. |
Low |
| Bianco et al. (2021) | Italy | April 1–May 4, 2020 | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-report. | n = 305 (49.5% females). |
Females M(sd) = 10.58 (2.3) yo; Males M(sd) = 10.01 (2.4) yo; Age range = 6–13 yo. |
(1) Child Behavior CheckList 6–18 years (Achenbach and Rescorla, 2014): child' internalizing and externalizing symptoms. (3) Ad hoc measure: COVID-19 exposure: parental exposure to COVID-19; Depression Anxiety Stress Scale−21 (Fonagy et al., 2016): parent' distress; Reflective Functioning Questionnaire (Fonagy et al., 2016): parent' reflective function. |
RQ1 Child Internalizing symptoms (anxious/depressed) was associated with high maternal distress level and hypermentalization; child externalizing (attention problems, aggressive behavior) symptoms, were associated with high maternal distress level and hypermentalization. Child internalizing (anxious/depressed) symptoms and externalizing (attention problems, aggressive behavior) symptoms were associated with maternal exposure to COVID-19 infection. RQ2 Females > males: internalizing (anxiety and depression symptoms) symptoms. |
High |
| Cellini et al. (2021) | Italy | April 1–April 9, 2020 | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-report. | n = 299 (46% females). | M(sd) = 7.96 (1.36) yo; Age range = 6–10 yo. | (1) Strength and Difficulties Questionnaire (Goodman, 2003): child' internalizing and externalizing symptoms. (2) Sleep Disturbance Scale for Children (Bruni et al., 1996): child' quality of sleep; Three items from Porcelli et al. (2018) and one item from Zakay (2014): child' time perception. (3) Pittsburgh Sleep Quality Index (Curcio et al., 2013): mother' quality of sleep; Subjective Time Questionnaire (Mioni et al., 2020): mother' perception of time; Strength and Difficulties Questionnaire−18+ (Goodman, 2003): parent' internalizing and externalizing symptoms (self-reported); Difficulties in Emotion Regulation (Giromini et al., 2012): parent' difficulties in emotional regulation. |
RQ1 Results show an increase in three areas: (1) child' emotional symptoms; (2) child' conduct; (3) child' hyperactivity/inattention. RQ2 Males > females: hyperactivity-inattention, felt more bored; Females > males: poorer sleep. RQ3; RQ4 Low quality of sleep, children increasing boredom and the mother' emotional problems predicted children's emotional symptoms. |
High |
| Khoury et al. (2021) | Canada | T0: 2016–2018; T1: May–November, 2020 | Quantitative; longitudinal; non-probabilistic sampling (convenience); online survey; parent-report. | n = 68 (47.1% females). | M(sd) = 7.87 (0.75) yo; Age range = 7–9 yo. | (1) Brief Problem Monitor-Parent form for ages 6–18 years (Achenbach and Rescorla, 2014): child' externalizing symptoms. (2) Parent Behavior Inventory (Lovejoy et al., 1999): mother' behaviors over the past month; Center for Epidemiologic Studies Depression Scale (Andresen et al., 1994): mother' depressive symptoms over the past week; Generalized Anxiety Disorder-7 (Spitzer et al., 2006): mother' anxiety symptoms over the past 2 weeks; Perceived Stress Scale (Cohen, 1998): mother' experiences of stress over the past month. |
RQ1 The results show an increase in internalizing and externalizing symptoms during the pandemic than before. Child' externalizing symptoms were associated with parental hostility; child' internalizing symptoms were associated with maternal anxiety. RQ2 No significant gender differences in internalizing and externalizing symptoms were found. |
Low |
| Li and Zhou (2021) | China | February 28–March 5, 2020 | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-report. |
Total sample n = 892 (47% females). Sub-sample 5–8 yo n = 647 (46% females). Sub-sample 9–13 yo n = 245 (51% females). |
Total sample M(sd) = n.s.; Age range = 5–13 yo. Sub sample 5–8 yo M(sd) = 6.19 (0.99) yo; Age range = 5–8 yo; Sub-sample 9–13 yo M(sd) = 10.81 (1.40) yo; Age range = 9–13 yo. |
(1) Spence Children's Anxiety Scale-Parent Version (Spence, 1999): child' internalizing symptoms; Early School Behavior Rating Scale (Caldwell and Pianta, 1991): child' externalizing symptoms. (2) Ad hoc measure: Family-Based Disaster Education Scale: disaster education provided by parents to their children during COVID-19. (3) Parental Worry Scale (Fisak et al., 2012): parent' worry in relation to their children during COVID-19. |
RQ1 Child' internalizing and externalizing symptoms were associated with parental worry. RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. RQ4 For the schoolchildren group only, fewer internalizing symptoms were associated with disaster-based education. |
High |
| Liu et al. (2021) | China | February 25–March 8, 2020 | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-report. |
Total sample n = 1,264 (44% females). Sub-sample Huangshi n = 790 (% gender distribution n.s). Sub-sample Wuhan N = 474 (% gender distribution n.s). |
Total sample M(sd) = 9.81 (1.44) yo; Age range = 7–12 yo. Sub-sample Huangshi M(sd) = n.s.; Age range = 7–12 yo. Sub-sample Wuhan M(sd) = n.s.; Age range = 7–12 yo. |
(1) Strength and Difficulties Questionnaire (Du et al., 2008): child' internalizing and externalizing symptoms. (3) Self-Rating Anxiety Scale (Zung, 1971): parent' anxiety symptoms. |
RQ1 Children in Wuhan had more externalizing symptoms (problems with peers) and general difficulties than children in Huangshi. Children aged 10–12 yo had more externalizing symptoms in terms of problems with peers than children aged 7–9 yo. Children aged 7–9 yo had more externalizing symptoms in terms of problems in prosocial behaviors than children aged 10–12 yo. RQ2 Females > males: externalizing symptoms (peer problems). RQ4 Parental anxiety was associated with emotional symptoms in children. |
Low |
| Mariani Wigley et al. (2021) | Italy | May 18–June 4, 2020 | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-report. | n = 158 (53% females). | M(sd) = 8.88 (1.41) yo; Age range = 6–11 yo. | (1) Ad hoc measure: child' internalizing and externalizing symptoms (stress-related behaviors, e.g., nervousness and irritability, difficulty falling asleep). (2) Child and Youth Resilience Measure-Revised (Personal Resilience subscale of the Person Most Knowledgeable version; Jefferies et al., 2019): child' individual resources. (3) COPEWithME questionnaire (developed in the study): parental teaching of resilient behaviors in children; Italian version of the Connor-Davidson Resilience Scale (Connor and Davidson, 2003): parent' resilience. |
RQ1 Results show an increase in all child' stress-related behaviors (e.g., nervousness and irritability; difficulty falling asleep) investigated. RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. RQ4 The greater was parental resilience, the better were the strategies used by parents to teach the child to manage stressful situations. |
Low |
| Orgilés Amorós et al. (2021) | Italy; Spain; Portugal. | Seven weeks after the lockdown (15 days). | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-report. |
Total sample n = 515 (46% females). Sub-sample 6–12 yo n = 233 (gender distribution n.s.). |
Total sample M(sd) = 8.98 (4.29) yo; Age range = 5–18 yo. Sub-sample 6–12 yo M(sd) = n.s.; Age range = 6–12 yo. |
(1) Spence Children's Anxiety Scale-Parent Version (Spence, 1999): child' anxiety symptoms; Short Mood and Feelings Questionnaire-Parent Version (Angold et al., 1995): child' depressive symptoms. (2) Ad hoc measure: parent' stress due to the COVID-19 situation. |
RQ1 The results show a high level of anxiety and depression in Spain. Italian children were more likely to present internalizing symptoms (depressive symptoms) than the Portuguese children. Internalizing symptoms (anxiety and depressive symptoms) were more likely in children whose parents reported higher levels of stress. RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. |
Low |
| Rajabi et al. (2021) | Iran | n.s. | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-report. | n = 1,182 (44.5% females). | M(sd) = 7.18 (2.02) yo; Age range = 5–11 yo. | (1) Strengths and Difficulties Questionnaire–Parent version (Goodman, 2003): child' internalizing and externalizing symptoms; The International Positive and Negative Affect Schedule Short Form (Thompson, 2007): child' positive and negative affect. (2) Children's Play Scale (Dodd et al., 2021): child' time spent playing. |
RQ1 Results show a significant negative correlation between mental health difficulties (internalizing and externalizing symptoms and positive and negative affect) and time spent playing. RQ2 Total sample Males > females: negative affect; Females > males: positive affect. Sub-sample 5–10 yo Males > females: Strength and Difficulties Questionnaire total score, emotional symptoms, hyperactivity/inattention subscales; Females > males: prosocial behavior subscale. Sub-sample 8–11 yo Males > females: emotional symptoms, hyperactivity/inattention, conduct problems, general problems subscales. Females > males: problems with peers and prosocial behavior subscales. RQ3 During COVID-19 children spent more time playing in the home setting and less time playing outdoors. |
High |
| Scaini et al. (2021) | Italy | n. s. | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-reported. | n = 158 (52% females). | M(sd) = 7.4 (1.8) yo; Age range = 5–10 yo. | (1) Strength and Difficulties Questionnaire (Goodman, 2003): child' internalizing and externalizing symptoms. (2) The Child and Youth Resilience Measure—Person Most Knowledgeable version (Ungar and Liebenberg, 2011): child' resilience; Junior Temperament and Character Inventory (Luby et al., 1999; Italian Version by Andriola et al., 2012): child' temperament and character. |
RQ1 Child' externalizing symptoms were associated with low levels of persistence and reward dependence; internalizing symptoms were more likely among children with high harm avoidance and low persistence. RQ2 No significant gender differences in internalizing and externalizing symptoms were found. RQ3 High levels of resilience were associated with high levels of persistence and reward dependence. |
Low |
| Vira and Skoog (2021) | Sweden | T1: October 2019–January, 2020; T2: November 2020–February, 2021. |
Quantitative; longitudinal; non-probabilistic sampling (convenience); T1: data were collected at school; T2: data were collected via online survey; self-report. |
N = 849 (51.83% females). |
T1 M(sd) = 10 (0.03) yo; Age range = 9–11 yo. T2 M(sd) = 11 (0.05) yo; Age range = 10–12 yo. |
(1) Strengths and Difficulties Questionnaire (subscale of emotional problems; Lundh et al., 2008): child' internalizing symptoms. (2) The Children's Hope Scale (Snyder et al., 1997): child' sense of hope; Ad hoc measure: Children's Self-Efficacy Scale: child' ability to be assertive and expressive; The Single-Item Self-Esteem Scale (SISE; Robins et al., 2001): child' self-esteem; Perceived Social Support (parents, close friends and teacher subscales; Malecki and Elliott, 1999): child' perceived social support; Ad hoc measure: child' school and class wellbeing. |
RQ1 There were no significant differences in children' internalizing symptoms between T1 and T2. RQ2 No significant gender differences in internalizing and externalizing symptoms were found. RQ3 The results show a decrease in all factors assessed, in particular, children' perceived low support from teachers and class; low school wellbeing and self-esteem. |
Medium |
| Wang et al. (2021a) | China | June 26–July 6, 2020 | Quantitative; cross-sectional; probabilistic sampling (cluster method); online survey; parent-report. | N = 6,017 (45.4% females). | M(sd) = n.s.; Age range = 5–13 yo. | (1) Strength and Difficulties Questionnaire (Goodman, 2003): child' internalizing and externalizing symptoms. (2) Ad hoc measure: child' knowledge and precaution levels regarding COVID-19. (3) Depression Anxiety Stress Scale (Henry and Crawford, 2005): parent' distress; Ad hoc measure: parent' knowledge and precaution levels regarding COVID-19. |
RQ1 Few child' emotional and behavioral symptoms were associated with increased knowledge and precautions regarding COVID-19 pandemic. Child' internalizing and externalizing symptoms were associated with parent' distress. RQ2 Males > females: Strength and Difficulties Questionnaire total score. |
High |
| Wang et al. (2021c) | China | May 20–July 20, 2020 | Quantitative; cross-sectional; probabilistic sampling (cluster method); online survey; parent-report. |
Total sample n = 12,186 (47.8% females). Sub-sample Wuhan 6–11 yo n = n.s. (% gender distribution n.s.). Sub-sample outside Wuhan 6–11 yo n = n.s. (% gender distribution n.s.). |
Total sample M(sd) = n.s.; Age range = 6–11 yo. Sub-sample Wuhan 6–11 yo M(sd) = 9.3 (1.43) yo; Age range = 6–11 yo. Sub-sample outside Wuhan 6–11 yo M(sd) = 9.1 (1.33); Age range = 6–11 yo. |
(1) Child Behavior CheckList (Achenbach and Rescorla, 2014): child' internalizing and externalizing symptoms. (2) Ad hoc measure: psychosocial impact of pandemic on child. |
RQ1 Children from Wuhan reported higher levels of schizoid and depression than children from outside Wuhan. RQ2 No significant gender differences in internalizing and externalizing symptoms were found. |
High |
| Wang et al. (2021b) | China | June 26–July 6, 2020 | Quantitative; cross-sectional; probabilistic sampling (cluster method); online survey; parent-report. | n = 6,017 (% gender distribution n.s.). | M(sd) = n.s. Age range = 5–13 yo. | (1) Strength and Difficulties Questionnaire (Stone et al., 2010): child' internalizing and externalizing symptoms. (2) Ad hoc measure: child' psychological stressors, daily activities, social interactions. |
RQ1 The prevalence of externalizing symptoms (low prosocial behavior) was 17.85%. RQ2 Males > females: Strength and Difficulties Questionnaire total score. RQ3 Time used in homework and computer games was positively related to child' mental health problems; child' physical exercises were negatively related to frequency of communication with others. |
Medium |
| Duan et al. (2020) | China | n.s. | Quantitative; cross-sectional; non-probabilistic sampling (convenience); online survey; self-report. |
Total sample n = 3,613 (49.85% females). Sub-sample 7–12 yo n = 359 (% gender distribution n.s) |
Total sample M(sd) = n.s.; Age range = 7–18 yo. Sub-sample 7–12 yo M(sd) = n.s.; Age range = 7–12 yo. |
(1) Chinese Version of Spence Child Anxiety Scale (Zhao et al., 2012): child' anxiety symptoms; The Child Depression Inventory (Kovacs and Beck, 1977): child' depression symptoms. (2) Ad hoc measure: COVID-19 related questions (e.g., degree of concerns, implementation of control measures); Short Version of Smartphone Addiction Scale (Kwon et al., 2013) and Internet Addiction Scale from DSM-IV-TR (American Psychiatric Association, 2000): child' smartphone addiction; Coping Style Scale (Chen et al., 2000): child' coping strategies. |
RQ1 The results show above-threshold results for depressive symptoms. RQ2 Females > males: internalizing (anxiety symptoms) symptoms. RQ3 The results show above-threshold results for internet addiction. The more time spent on the Internet, the higher the level of depressive symptoms. |
Medium |
| Liang et al. (2020) | Italy | March 26–April 12, 2020 | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-report. | n = 1,074 (48% females) | M(sd) = 8.99 (1.97) yo; Age range = 6–12 yo. | (1) Impact Scale of the COVID-19 and home confinement on children and adolescents (Orgilés et al., 2020): child' internalizing and externalizing symptoms. (2) 11 items included the three dimensions proposed by Parker and Endler (Parker and Endler, 1992): child' coping strategies. |
RQ1 The results show that children from Northern Italy were scared and they had greater fear of death than children from Central Italy. No significant differences regarding internalizing and externalizing symptoms between children from Northern and Central Italy were found. RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. RQ3 Regarding coping strategies, children from Northern Italy used emotion-oriented coping strategies, while children from Central Italy used task-oriented coping strategies. |
Medium |
| Morelli et al. (2020) | Italy | April, 2020 | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-report. | n = 233 (52% females). | M(sd) = 9.66 (2.29) yo; Age range = 6–13 yo. | (1) Emotion Regulation Checklist (Molina et al., 2014): child' emotions regulations. (2) Ad hoc measure: familiar risks related to the family situation during the COVID-19 pandemic. (3) Perceived Stress Scale (Cohen et al., 1983); Italian validation by Mondo et al. (2021): parent' distress; Regulatory Emotional Self-Efficacy Scale (Caprara et al., 2013): parental belief to be able to manage with their negative emotions; Parenting Self-Agency Measures (Dumka et al., 1996; Baiocco et al., 2017): parental belief to be able to manage with daily parental demands. |
RQ1 Parental self-efficacy mediated the relationship between the influences of parent' psychological distress and parent' emotional regulatory self-efficacy on children' emotional regulation and lability/negativity. RQ2 No significant gender differences in internalizing and externalizing symptoms were found. |
Medium |
| Petrocchi et al. (2020) | Italy | April 1–May 4, 2020 | Quantitative; cross-sectional; non-probabilistic sampling (snowball); online survey; parent-report. | n = 144 (43% females). | M(sd) = 7.54 (1.6) yo; Age range = 5–10 yo. | (1) Ad hoc measure: child' internalizing symptoms (emotional responses); Ad hoc measure: child' adaptive behaviors. (2) Ad hoc measure: mother' exposure to COVID-19. (3) Depression Anxiety Stress Scale-−21 (Fonagy et al., 2016): mother' distress; Coping Scale (Hamby et al., 2015): mother' coping strategies. |
RQ1 Child' internalizing symptoms (negative emotions) were associated with high maternal distress and low maternal coping strategies. RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. RQ4 Mothers exposed to COVID-19 infection showed high distress levels and more coping strategies than mothers not exposed to virus infection. |
Medium |
| Qualitative studies | ||||||||
| Aras Kemer (2022) | Turkey | n.s. | Qualitative; cross-sectional; non-probabilistic sampling (snowball); online survey; self-reported. | n = 9 (66% females). | M(sd) = n.s.; Age range = 7–10 yo. | (1) Ad hoc measure: child' anxiety evaluated via drawings and interviews. |
RQ1 Drawings and interviews revealed internalizing symptoms (anxiety, negative emotions). RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. RQ3 Results showed limited knowledge of the COVID-19 pandemic in children. |
High |
| Cortés-García et al. (2021) | USA | May, 2020 | Qualitative; cross-sectional; probabilistic sampling (random); online focus group; self-report. |
Total sample n = 17 (52.9% females). Sub-sample 10–12 yo n = 9 (44.44% females). |
Total sample M(sd) = n.s; Age range = 10–14 yo. Sub-sample 10–12 yo M(sd) = n.s; Age range = 10–12 yo. |
(1) Ad hoc measure: semi-structured interview about child' emotional responses and coping strategies during pandemic. |
RQ1 The results were mixed. On the one hand, children experienced positive feelings such as happiness (spending more time with parents, more free time and to play), on the other hand, children experienced negative feelings such as loneliness, sadness, boredom and fear (due to lack of socialization with friends and other family members). RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. RQ3, RQ4 Other revealed themes were perception of racism, perception of economic impact and information related to COVID-19, quality of relationships in the family, use of coping strategies. |
High |
| Idoiaga et al. (2020) | Spain | March 30–April 13, 2020 | Qualitative; cross-sectional; non-probabilistic sampling (convenience); online open-ended questions; self-report. |
Total sample n = 228 (52.21% females). Sub-sample 3–12 yo n = n.s. (% gender distribution n.s.). |
Total sample M(sd) = 7.14 (2.57) yo; Age range = 3–12; Sub-sample 3–12 yo M(sd) = n.s. Age range = 6–12 yo. |
(1)Ad hoc measure: open-ended questions about child' social and emotional representation of COVID-19. |
RQ1 Results were mixed. On the one hand, they say they are bored, angry, overwhelmed, tired and even lonely because they have to stay at home without being able to go out. On the other hand, they also say they are happy and cheerful in the family. RQ2 No gender differences in internalizing and externalizing symptoms were evaluated. RQ3 Parents identified sibling relationship as particularly positive. Also, a disturbed sleep routine is reported. |
Low |
| Mixed study | ||||||||
| Wenter et al. (2022) | Austria |
T1: March/April, 2020 T2: December 2020/ January, 2021 T3: June/July, 2021 T4: December 2021/ January 2022. |
Mixed study (convergent design); longitudinal; non-probabilistic sampling (convenience); online survey; parent-report. |
Total sample n = 2.691 (48.8% females). Sub-sample 7–13 yo n = 1,740 (49.8% females). |
Total sample M(sd) = n.s.; Age range = 3–13 yo. Sub-sample 7–13 yo M(sd) = 9.6 (1.9) yo; Age range = 7–13 yo. |
(1) Child and Adolescent Trauma screen—caregiver report (Sachser et al., 2017): child' risk of post-traumatic stress disorder (Quantitative study); Child Behavior CheckList (Achenbach and Rescorla, 2014): child' internalizing and externalizing symptoms (Quantitative study); Kiddy-KINDL (Ravens-Sieberer and Bullinger, 2000): child' quality of life (Quantitative study). (2) Ad hoc measure: parent' evaluation of child exposure to COVID-19 infection (Quantitative study); Ad hoc measure: parent' evaluation of child' threat experience of COVID-19 (Quantitative study). (3) Ad hoc open-ended questions: parent description on the positive effects related to the COVID-19 pandemic (Qualitative study). |
RQ1 Quantitative results: Data collected during the T4 wave showed a clinical classification of internalizing (emotional reactivity, anxious/depressed; somatic complaints; withdrawn/depressed) and externalizing (aggressive behaviors) symptoms. Qualitative results: Thematic analysis showed that the themes were: importance of intra- and extra-familiar relationships; new competence and experiences; values and virtues; use of time; and family strengths. RQ2 Males > females: externalizing (aggressive behaviors) symptoms. RQ3 Threat experience increased internalizing and externalizing symptoms, post-traumatic symptoms, and low quality of life. |
Medium |
aStudy design (Qualitative vs. quantitative vs. mixed study) (cross-sectional vs. longitudinal); sampling strategy; data collection strategy (online vs. face-to-face); respondent (parent- vs. self-report).
bMeasures: (1) measure(s) administered to evaluate the child' internalizing/externalizing symptoms; (2) measure(s) administered to evaluate other(s) child' psychological factor(s); (3) measure(s) administered to evaluate parent(s) psychological factor(s).
cStudy appraisal: * and ** = low; *** = medium; **** and ***** = high.
n.s, not specified.
* and ** mean that the quality of the paper is low; *** means that the quality of the paper is medium; **** and ***** mean that the quality of the paper is high.