Table 3. Children’s Mental Health by COVID-19 Impact, Physical Activity, and Screen Time in a Weighted Multivariable Modela.
| Measure | SDQ total difficulties | SDQ symptoms | ||||
|---|---|---|---|---|---|---|
| Externalizing | Internalizing | |||||
| β (95% CI) | P value | β (95% CI) | P value | β (95% CI) | P value | |
| Children aged 6-10 y | ||||||
| COVID-19 total impact scoreb | 0.6 (0.3 to 0.9) | <.001 | 0.3 (0.1 to 0.5) | .006 | 0.3 (0.2 to 0.5) | <.001 |
| Physical activity, d/wk | ||||||
| 0 | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| 1-6 | −0.8 (−2.7 to 1.2) | .44 | −0.9 (−2.2 to 0.3) | .15 | 0.2 (−0.9 to 1.2) | .76 |
| 7 | −2.4 (−4.6 to −0.2) | .04 | −2.0 (−3.4 to −0.6) | .006 | −0.4 (−1.6 to 0.8) | .53 |
| Screen time | 0.3 (0.1 to 0.5) | .01 | 0.1 (0.0 to 0.3) | .05 | 0.1 (0.0 to 0.3) | .02 |
| Prior anxiety and/or depression | ||||||
| None | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| 1 Condition | −0.8 (−2.9 to 1.4) | .50 | −0.9 (−2.3 to 0.5) | .19 | 0.2 (−1.0 to 1.4) | .75 |
| Both conditions | −0.3 (−3.2 to 2.6) | .85 | −1.0 (−2.8 to 0.9) | .31 | 0.7 (−0.9 to 2.2) | .4 |
| Prior ADHD and/or behavioral problem | ||||||
| None | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| 1 Condition | 5.6 (3.7 to 7.5) | <.001 | 4.0 (2.8 to 5.2) | <.001 | 1.6 (0.6 to 2.6) | .003 |
| Both conditions | 7.2 (5.0 to 9.3) | <.001 | 4.4 (3.0 to 5.8) | <.001 | 2.8 (1.6 to 3.9) | <.001 |
| Children aged 11-17 y | ||||||
| COVID-19 total impact scoreb | 0.4 (0.0 to 0.7) | .03 | 0.3 (0.1 to 0.5) | .01 | 0.1 (−0.1 to 0.3) | .25 |
| Physical activity, d/wk | ||||||
| 0 | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| 1-6 | −3.5 (−5.3 to −1.8) | <.001 | −1.5 (−2.5 to −0.4) | .006 | −2.1 (−3.0 to −1.1) | <.001 |
| 7 | −3.6 (−5.8 to −1.4) | .002 | −1.3 (−2.6 to −0.0) | .04 | −2.3 (−3.5 to −1.1) | <.001 |
| Screen time | 0.4 (0.2 to 0.6) | <.001 | 0.2 (0.1 to 0.4) | <.001 | 0.1 (0.0 to 0.3) | .01 |
| Prior anxiety and/or depression | ||||||
| None | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| 1 Condition | 3.5 (2.0 to 5.1) | <.001 | 1.1 (0.2 to 2.0) | .02 | 2.5 (1.6 to 3.3) | <.001 |
| Both conditions | 4.8 (2.9 to 6.7) | <.001 | 0.9 (−0.2 to 2.0) | .12 | 3.8 (2.8 to 4.9) | <.001 |
| Prior ADHD and/or behavioral problem | ||||||
| None | 1 [Reference] | NA | 1 [Reference] | NA | 1 [Reference] | NA |
| 1 Condition | 1.9 (0.3 to 3.6) | .02 | 1.8 (0.8 to 2.8) | <.001 | 0.1 (−0.8 to 1.0) | .78 |
| Both conditions | 3.1 (1.1 to 5.1) | .003 | 3.0 (1.8 to 4.2) | <.001 | 0.01 (−1.1 to 1.1) | .99 |
Abbreviations: ADHD, attention-deficit/hyperactivity disorder; NA, not applicable; SDQ, Strengths and Difficulties Questionnaire.
a
All models adjusted for child age, sex, race and ethnicity, parent educational attainment, parent born outside the US, school status, and parent Patient Health Questionnaire for Depression and Anxiety scores.
b
Scores range from 0 to 9, with higher scores indicating greater impact of the COVID-19 pandemic on the family.