Longitudinal Study Of Children Research Articles

Who develops chronic pain after an acute lower limb injury? A longitudinal study of children and adolescents.

Prevention of chronic pain is a major challenge in this area of clinical practice. To do this, we must be able to understand who is most at risk of developing chronic pain after an injury. In this study, we aimed to identify risk factors of chronic pain onset, disability, and pain interference after a lower limb musculoskeletal injury in children and adolescents between 8 to 16 years of age. We assessed biopsychosocial factors including age, sex, pubertal status, anxiety, depression, fear of pain, pain worry, adverse life events, and sleep in children. We also assessed risk factors in parents including parent anxiety, depression, parent pain catastrophising, and protective behaviours. Logistic and hierarchical linear regressions identified risk factors assessed immediately postinjury for outcomes assessed at 3 months postinjury. Fourteen percent (17/118 children) reported chronic pain 3 months after injury. There were significant between-group differences in children with and without chronic pain at baseline. Children with chronic pain reported higher pain intensity, disability, pain interference, child depression, fear of pain, and catastrophic thinking about their pain. Regressions showed child depression and fear of pain at baseline independently predicted chronic pain onset at 3 months, parent protectiveness predicted child pain interference at 3 months, and child depression, poor sleep, parent anxiety and pain catastrophising predicted disability. Most children recover after a lower limb injury, but a minority develop chronic pain predicted by important psychosocial risk factors, which could be addressed to prevent the onset of treatment-resistant chronic pain and disability.

Ambient PM2.5 and specific sources increase inflammatory cytokine responses to stimulators and reduce sensitivity to inhibitors

Ambient exposure to fine particulate matter (PM2.5) is associated with increased morbidity and mortality from multiple diseases. Recent observations suggest the hypothesis that trained immunity contributes to these risks, by demonstrating that ambient PM2.5 sensitizes innate immune cells to mount larger inflammatory response to subsequent bacterial stimuli. However, little is known about how general and durable this sensitization phenomenon is, and whether specific sources of PM2.5 are responsible. Here we consider these issues in a longitudinal study of children. The sample consisted of 277 children (mean age 13.92 years; 63.8% female; 38.4% Black; 32.2% Latinx) who completed baseline visits and were re-assessed two years later. Fasting whole blood was ex vivo incubated with 4 stimulating agents reflecting microbial and sterile triggers of inflammation, and with 2 inhibitory agents, followed by assays for IL-1β, IL-6, IL-8, and TNF-α. Blood also was assayed for 6 circulating biomarkers of low-grade inflammation: C-reactive protein, interleukin-6, -8, and -10, tumor necrosis factor-α, and soluble urokinase-type plasminogen activator receptor. Using machine learning, levels of 15 p.m.2.5 constituents were estimated for a 50 m grid around children's homes. Models were adjusted for age, sex, race, pubertal status, and household income. In cross-sectional analyses, higher neighborhood PM2.5 was associated with larger cytokine responses to the four stimulating agents. These associations were strongest for constituents released by motor vehicles and soil/crustal dust. In longitudinal analyses, residential PM2.5 was associated with declining sensitivity to inhibitory agents; this pattern was strongest for constituents from fuel/biomass combustion and motor vehicles. By contrast, PM2.5 constituents were not associated with the circulating biomarkers of low-grade inflammation. Overall, these findings suggest the possibility of a trained immunity scenario, where PM2.5 heightens inflammatory cytokine responses to multiple stimulators, and dampens sensitivity to inhibitors which counter-regulate these responses.

Preadolescent Suicidal Thoughts and Behaviors: An Intensive Longitudinal Study of Risk Factors

Dramatic increases in rates of suicidal thoughts and behaviors (STBs) among youth highlight the need to pinpoint early risk factors. This study used intensive longitudinal sampling to assess what the concurrent associations were between risk factors and STB status, how proximal changes in risk factors were related to STB status, and how risk factors prospectively predicted changes in STB status in a preadolescent sample enriched for early childhood psychopathology. A total of 192 participants were included from the Parent-Child Interaction Therapy-Emotional Development (PCIT-ED) Study, a longitudinal study of children with and without preschool depression. Participants 7 to 12 years of age completed a diagnostic interview, followed by 12 months of intensive longitudinal sampling, assessing experiences of suicidal ideation and 11 psychosocial variables with known links to STBs in adolescents and adults. Preadolescents with STB history (high-risk) received surveys weekly, and those without STB history (lower-risk) received surveys monthly. Female sex, elevated depressive symptoms, greater use of expressive suppression and rumination, emotional clarity, and perceived burdensomeness were uniquely concurrently associated with the likelihood of STB endorsement. Within the high-risk group, (1) increases in depression, expressive suppression, rumination, and perceived burdensomeness, and decreases in positive affect from weekt to weekt+1 were associated with a higher likelihood of a positive STB status at weekt+1; and (2) higher expressive suppression, perceived burdensomeness, and caregiver criticism and conflict at weekt compared to participants' mean levels prospectively predicted increases in the likelihood of a positive STB report from weekt to weekt+1. Psychosocial factors influencing STBs in adolescents and adults also affect preadolescents in day-to-day life. Expressive suppression and perceived burdensomeness consistently emerged as novel risk indicators and potential targets for treatment. In addition, increases in depression, rumination, and caregiver criticism and conflict, as well as decreases in positive affect, might prompt heightened STB screening and assessments for preadolescents with a history of STBs.

Theoretical analysis of the problem of developing personal resilience

Military operations on the territory of Ukraine have a devastating impact on the entire population of the state. Daily shelling, participation in combat, loss of loved ones, and the experience of prolonged stressful situations affect all areas of the population's life and, in particular, their psychological and mental health. An important task of modern psychological science is to explore ways to develop constructive ways to overcome stressful situations and develop personal resilience and counteract difficult life circumstances.In recent years, the study of the problem of resilience as the ability to resist life's difficulties has been actively developing. The study of this problem helps to solve many problems of practical psychology, since the development of resilience and the ability to resist stressful situations is a necessary component of the personality in wartime.The article presents a theoretical generalization of scientific approaches to the study of the concept of resilience. The main directions in the study of resilience of foreign and domestic authors are revealed. Various factors and determinants that influence the development of resilience as a process of resistance to stress are analyzed. The historical dynamics of understanding and studying the concept of resilience and the study of the development of personality resilience are presented.Based on the results of the theoretical analysis, we can distinguish the following scientific generalizations of the concept of resilience: it has a dynamic nature and biological basis, is an important prerequisite for successful adaptation and development of the individual, can be considered in social, biological or psychological aspects, its development depends not on the living conditions of a person, but on his/her perception of life difficulties, during the emergence of difficult living conditions, as well as in the process of experiencing life difficulties, a person is capable of post-traumatic growth and resilience.There are four stages in the study of the concept of resilience:1. Identification of signs based on longitudinal studies of children's defensive functions.2. Identification of the process. During this stage, the focus of the study changes from defensive factors to consideration of human resilience processes.3. The third stage is based on the first and second, it actively considers resilience as a mechanism that leads to positive human adaptation in adverse conditions.4. The fourth stage was caused by the development of technologies that allowed to study resilience more qualitatively with the help of psychodiagnostic tools.It has been established that resilience is an individual ability to counteract and find constructive methods of overcoming stressful situations, an important prerequisite for mental adaptation and personality development. Resilience depends on the influence of external (social) factors and individual psychological factors.

Error-monitoring: A predictor of future reading skills? A 3-year longitudinal study in children

Investigation of the factors explaining individual differences in the acquisition of expert reading skills has become of particular interest these last decades. Non-verbal abilities, such as visual attention and executive functions play an important role in reading acquisition. Among those non-verbal factors, error-monitoring, which allows one to detect one's own errors and to avoid repeating them in the future, has been reported to be impaired in dyslexic readers. The present three-year longitudinal study aims at determining whether error-monitoring efficiency evaluated before and during reading instruction could improve the explanation of reading skills. To do so, 85 children will be followed from the last year of kindergarten to the second grade. The classic predictors of reading will be assessed at each grade level. Error-monitoring indices in domain-general and reading-related contexts will be derived from EMG data recorded during a Simon task in kindergarten and during both a Simon and a lexical decision tasks in the first and second grades. Findings concerning the role of error-monitoring on reading skills are expected to have an important impact on reading instruction to prevent reading difficulties in at-risk children and improve remediation to help children with reading difficulties.

Gross motor coordination in relation to weight status: a longitudinal study in children and pre-adolescents.

Gross Motor Coordination (GMC) is crucial for the adequate development of motor competence. Our purpose in this semi-longitudinal study was to evaluate the influence of BMI on GMC in children and pre-adolescents of both sexes, across school years (classes). We evaluated 117 subjects (aged 8-13 years) belonging to three different cohorts for 4 consecutive years, providing data over 6 years (classes). GMC was assessed through the Körperkoordinationstest für Kinder (KTK) test. Class and weight status effects were then evaluated by dividing the subjects into a normal weight group and an overweight group based on their weight status. A significant increase across classes was found for BMI (p < 0.001) and KTK raw score (p < 0.001) and a decrease was found for KTK normalized score (MQ) (p = 0.043). Significantly lower MQ values were found for girls. Absolute GMC increased across the years and there was no difference between boys and girls. Correlations between GMC scores and BMI were negative and significant in 5 of 6 classes. It was confirmed that overweight subjects had lower MQ and RAW values than normal-weight subjects, with no class-by-weight status interaction. The level of competence and its development are strictly dependent on weight status during childhood and pre-adolescence. The present investigation suggests that the adequate development of GMC requires not only targeted physical education programs but also the promotion of healthy habits aimed at maintaining a normal weight status during childhood and pre-adolescence.

Evolution of Youth's Mental Health and Quality of Life during the COVID-19 Pandemic in South Tyrol, Italy: Comparison of Two Representative Surveys.

The coronavirus disease 2019 pandemic has led to an increase in youth mental health problems worldwide. Studies have revealed substantial variation in the incidence of these problems across different regions. Longitudinal studies of children and adolescents in Italy are lacking. This study aimed to investigate the development of health-related quality of life (HRQoL) and mental health in Northern Italy by comparing surveys conducted in June 2021 and in March 2022. A representative, large cross-sectional, online survey investigated HRQoL, psychosomatic complaints, and symptoms of anxiety and depression among 5159 and 6675 children and adolescents in 2021 and 2022, respectively, using the KIDSCREEN-10 index, HBSC symptom checklist, SCARED, CES-DC, and PHQ-2 instruments. Statistical analyses included a multivariate linear regression analysis. Baseline characteristics showed significant differences in demographic variables between the two surveys. Girls and their parents reported a significantly lower HRQoL in 2021 than in 2022. Psychosomatic complaints differed significantly between sexes, and the results showed no decrease in psychosomatic complaints, anxiety, or depression between 2021 and 2022. Predictors of HRQoL, anxiety, depressive symptoms, and psychosomatic complaints in 2022 differed from those in 2021. The characteristics of the 2021 pandemic, including lockdowns and home schooling, may have contributed to the differences between the two surveys. As most pandemic restrictions ended in 2022, the results confirm the need for measures to improve the mental and physical health of children and adolescents after the pandemic.

Contact with parents from childhood to adulthood – a longitudinal study of children in kinship care and non-kinship care

ABSTRACT Previous research on parental contact for children in foster care shows that contact frequency is significantly related to parent’s gender and placement type. Yet very few studies have explored the impact of gender and type of placement on parental contact over time. Based on longitudinal quantitative data from kinship care and non-kinship care placements in Norway, we analyse contact between children and their birth parents at three timepoints: childhood, adolescence, and adulthood. The study shows different contact patterns for children’s contact with mothers and fathers. For most of the children, the possibility of contact with the mother was established from the first timepoint and contact occurred rather frequently throughout childhood, adolescence, and adulthood. Regular contact between fathers and children in childhood, on the other hand, was less common, and this could develop in different directions: either towards children coming into contact with their father later in life or not at all. From a longitudinal perspective, we can say that the most significant changes evolved around children’s contact with their fathers, while contact with mothers was more stable.

Association between Types of Screen Time and Weight Status during the COVID-19 Pandemic: A Longitudinal Study in Children and Adolescents.

This study aimed to investigate the changes in distinct types of screen time and explore their longitudinal association with children and adolescents' weight status. A two-wave longitudinal study was conducted among 2228 children and adolescents (6-19 years) in Shanghai, China, before and during the pandemic. Recreational screen time (watching TV/videos, online gaming, using social media, and browsing webpages), educational screen time (online homework and online class), and BMI were measured using a self-reported questionnaire. Mixed-effects models were constructed to assess the associations between screen time and weight status. The prevalence of overweight and obesity was 20.5% and 10.2% at baseline, respectively. Both recreational and educational screen time increased significantly over two months. While recreational screen time was found to be a risk factor for obesity, it was not the case for educational screen use. Specifically, adolescents who spent more time watching TV/videos had a higher obesity risk (OR = 1.576). No significant associations were found in children. Overweight and obesity were prevalent among children and adolescents in China. Reducing screen-based activities is a promising strategy to prevent unhealthy weight gain in Chinese children and adolescents, while it is necessary to consider the content and distinguish between educational and recreational screen use.

Building connections through play: Influences on children's connected talk with peers.

Effective reciprocal communication is a vital component in forming and maintaining social relationships. Peer social play may provide a particularly important context for communicative skill development, as sophisticated negotiation and exchange are required to coordinate play. We focus on connectedness, a property of conversation referring to the topical relation between speakers' turns, to understand how partners coordinate ideas to build a shared play experience. The present study uses a longitudinal secondary analysis approach to drive forward our understanding of the individual and shared influences that contribute to connectedness during peer social play. Using data from a three-wave, longitudinal study of children's play and social relationships during the first 3 years of school in the United Kingdom (https://osf.io/3p4q8/), we coded connectedness from transcripts of video observations of 148 children playing in pairs at wave three (mean age 6.79 years) and model individual differences in language ability, theory of mind, and emotion comprehension from all three waves as potential predictors of connectedness. Our results show substantial dyadic effects on connectedness, but individual differences in socio-cognitive measures were not significant predictors of connectedness. These findings indicate the importance of dyadic and partner effects in children's social interactions and implicate the dyad as an essential focus for future research.

Is There a Role for Imaging Youth at Risk of Atherosclerosis?

Cardiovascular (CV) risk factors such as dyslipidemia, hypertension, diabetes, and obesity are associated with an increased risk for CV events in adults. Noninvasive measures of vascular health are associated with these CV events and can potentially help risk stratify children with CV risk factors. The purpose of this review is to summarize recent literature regarding vascular health in children with cardiovascular risk factors. Adverse changes in pulse wave velocity, pulse wave analysis, arterial distensibility, and carotid intima-media thickness are seen in children with CV risk factors supporting potential utility in risk stratification. Assessing vascular health in children can be challenging due to growth-related changes in vasculature, multiple assessment modalities, and differences in normative data. Vascular health assessment in children with cardiovascular risk factors can be a valuable tool for risk stratification and help identify opportunities for early intervention. Future areas of research include increasing normative data, improving conversion of data between different modalities, and increasing longitudinal studies in children linking childhood risk factors to adult CV outcomes.

Factors related to retention in a longitudinal study of infants at familial risk for autism.

Reporting retention data is critical to determining the soundness of a study's conclusions (internal validity) and broader generalizability (external validity). Although selective attrition can lead to overestimates of effects, biased conclusions, or overly expansive generalizations, retention rates are not reported in many longitudinal studies. We examined multiple child- and family-level factors potentially associated with retention in a longitudinal study of younger siblings of children with autism spectrum disorder (ASD; n=304) or typical development (n=163). The sample was followed from the first year of life to 36months of age, for up to 7 visits. Of the 467 infant siblings who were consented and participated in at least one research visit, 397 (85.0%) were retained to study completion at 36months. Retention rates did not differ by familial risk group (ASD-risk vs. Low-risk), sex, race, ethnicity, age at enrollment, number of children in the family, maternal employment, marital status, or parent concerns about the child at enrollment. A stepwise regression model identified 4 variables that, together, provided the most parsimonious predictive model of study retention: maternal education, maternal age at child's birth, travel distance to the study site, and diagnostic outcome classification at the final study visit. The retained and not-retained groups did not differ on most demographic and clinical variables, suggesting few threats to internal and external validity. The significantly higher rate of retention of children diagnosed with ASD (95%) than typically developing children (83%) may, however, present biases when studying recurrence risk. We conclude by describing engagement and tracking methods that can be used to maximize retention in longitudinal studies of children at risk of ASD.

Airway remodeling heterogeneity in asthma and its relationship to disease outcomes.

Asthma affects an estimated 262 million people worldwide and caused over 461,000 deaths in 2019. The disease is characterized by chronic airway inflammation, reversible bronchoconstriction, and airway remodeling. Longitudinal studies have shown that current treatments for asthma (inhaled bronchodilators and corticosteroids) can reduce the frequency of exacerbations, but do not modify disease outcomes over time. Further, longitudinal studies in children to adulthood have shown that these treatments do not improve asthma severity or fixed airflow obstruction over time. In asthma, fixed airflow obstruction is caused by remodeling of the airway wall, but such airway remodeling also significantly contributes to airway closure during bronchoconstriction in acute asthmatic episodes. The goal of the current review is to understand what is known about the heterogeneity of airway remodeling in asthma and how this contributes to the disease process. We provide an overview of the existing knowledge on airway remodeling features observed in asthma, including loss of epithelial integrity, mucous cell metaplasia, extracellular matrix remodeling in both the airways and vessels, angiogenesis, and increased smooth muscle mass. While such studies have provided extensive knowledge on different aspects of airway remodeling, they have relied on biopsy sampling or pathological assessment of lungs from fatal asthma patients, which have limitations for understanding airway heterogeneity and the entire asthma syndrome. To further understand the heterogeneity of airway remodeling in asthma, we highlight the potential of in vivo imaging tools such as computed tomography and magnetic resonance imaging. Such volumetric imaging tools provide the opportunity to assess the heterogeneity of airway remodeling within the whole lung and have led to the novel identification of heterogenous gas trapping and mucus plugging as important predictors of patient outcomes. Lastly, we summarize the current knowledge of modification of airway remodeling with available asthma therapeutics to highlight the need for future studies that use in vivo imaging tools to assess airway remodeling outcomes.

Educational bilingualism: Reflections on a longitudinal study of children's cognitive and linguistic development

Our longitudinal study examined the cognitive and linguistic development of bilingually-educated, yet monolingually-raised, Spanish children, exploring (a) whether bilingual education procured a bilingual advantage, (b) whether greater L2 exposure was key to producing it, and (c) how development proceeded over time.We compared three groups of children in Years 1 and 2 of primary education in Spain: one attending monolingual education (MON), and two attending English-Spanish bilingual education, where one group received higher exposure (HiEx) and the other lower exposure (LoEx) to English. Children were tested in their schools on attention and L1 and L2 vocabulary skills, as well as several background measures.Across both years, the groups differed in their English vocabulary: HiEx outperformed LoEx and MON (p < 0.001), and LoEx outperformed MON (p = 0.02) but there were no differences in the children's L1 vocabulary scores. After one year of schooling, bilingually-educated children scored higher than MON on certain cognitive skills (interference suppression, p < 0.001; response inhibition, p = 0.02) but these differences did not materialise after a second year. The present paper combines these results from our two previously published studies with other current literature on educational bilingualism into a discussion on how future work on this population could progress.

Staging the bipolar disorders: Are early stages too early a stage for intervention?

Staging the bipolar disorders: Are early stages too early a stage for intervention?

Bone Mineral Density and Vascular Calcification in Children and Young Adults With CKD 4 to 5 or on Dialysis

Older adults with chronic kidney disease (CKD) can have low bone mineral density (BMD) with concurrent vascular calcification. Mineral accrual by the growing skeleton may protect young people with CKD from extraosseous calcification. Our hypothesis was that children and young adults with increasing BMD do not develop vascular calcification. This was a multicenter longitudinal study in children and young people (5-30 years) with CKD stages 4 to 5 or on dialysis. BMD was assessed by tibial peripheral quantitative computed tomography (pQCT) and lumbar spine dual-energy X-ray absorptiometry (DXA). The following cardiovascular imaging tests were undertaken: cardiac computed tomography for coronary artery calcification (CAC), ultrasound for carotid intima media thickness z-score (cIMTz), pulse wave velocity z-score (PWVz), and carotid distensibility for arterial stiffness. All measures are presented as age-adjusted and sex-adjusted z-scores. One hundred participants (median age 13.82 years) were assessed at baseline and 57 followed up after a median of 1.45 years. Trabecular BMD z-score (TrabBMDz) decreased (P= 0.01), and there was a nonsignificant decrease in cortical BMD z-score (CortBMDz) (P= 0.09). Median cIMTz and PWVz showed nonsignificant increase (P= 0.23 and P= 0.19, respectively). The annualized increase in TrabBMDz (ΔTrabBMDz) was an independent predictor of cIMTz increase (R 2= 0.48, β= 0.40, P= 0.03). Young people who demonstrated statural growth (n= 33) had lower ΔTrabBMDz and also attenuated vascular changes compared with those with static growth (n= 24). This hypothesis-generating study suggests that children and young adults with CKD or on dialysis may develop vascular calcification even as their BMD increases. A presumed buffering capacity of the growing skeleton may offer some protection against extraosseous calcification.

Michael Rutter (1933-2021).

Memorializes Michael (Mike) Rutter (1933-2021), widely known as "the father of child psychiatry." Mike was just as much revered as a child psychologist as he was as a child psychiatrist. From the beginning of his career, at the Institute of Psychiatry in London in the 1960s, where he remained until his death, Mike not only engaged with psychological theories and research but also made unparalleled contributions to our understanding of children's mental health problems. What was remarkable about Mike was that he made foundational contributions in so many areas of developmental psychology, including, but not limited to, the impact of maternal separation on children, the influence of families and schools, the psychological consequences of extreme deprivation, genetic and environmental influences on autism, longitudinal studies of children's mental health, and risk and resilience. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Association between developmental defects of enamel and early childhood caries in children under 6 years old: A systematic review and meta-analysis.

Early childhood caries (ECC) are an oral health problem worldwide in children under 6 years of age. This disease of rapid development has a multifactorial etiology, and one of the possible risk factors is developmental defects of enamel (DDE), such as hypoplasia and opacities. The aim of this systematic review was to evaluate the association between DDE and ECC in children under 6 years of age. An electronic search was conducted until March 2022 using Medline (PubMed), Scopus, Science-Direct, LILACS, Web of Science, Cochrane Library, EBSCO-Host, EMBASE, and Google Scholar and complemented with a manual search, with no restrictions on language or date of publication. Longitudinal studies of children under 6 years of age with primary dentition were included. A total of 1158 studies were found, of which 651 records were reviewed by title and abstract, and 24 articles were selected for full-text evaluation. Finally, nine studies that met the selection criteria were included in the qualitative synthesis. Study quality and certainty were assessed using the Newcastle-Ottawa scale and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. Three cohort studies of good quality were included in the meta-analysis. A risk associated with DDE (RR = 1.94; 95% CI: 1.52–2.49) and a risk associated with enamel hypoplasia (RR = 5.45; 95% CI: 1.84–16.14) were found. The results for diffuse opacity (RR = 1.21; 95% CI: 0.18–8.15) and demarcated opacity (RR = 1.26; 95% CI: 0.43–3.65) were not significant. GRADE analysis presented low and very low certainty of evidence. It was concluded that there is an association between DDE and ECC. However, the results should be interpreted with caution because of the limitations of the study.The protocol for this study has been registered in PROSPERO under identification number CRD42021238919.

A Longitudinal Study of Children’s Perceived Usability: Methodology and Measurements

This study examines longitudinal changes in children’s perceived usability based on two aspects. First, we developed a child-friendly usability questionnaire, which used cartoons to express the questionnaire response options. This approach provides an easy-to-understand five-point scale and a filling process using magnetic blocks, which together lead to highly reliable results. Additionally, we designed a longitudinal study to investigate the children’s perceived usability according to two measurement methods (immediate and retrospective). The children’s usability increased with longer durations of usage (i.e., increased repetitions of exercises). The short-term retrospective assessments depended on the most recent experience, whereas the long-term retrospective assessments were generally more positive.

Association of Changes of lifestyle behaviors before and during the COVID-19 pandemic with mental health: a longitudinal study in children and adolescents

BackgroundWe examined the prospective associations of changes in lifestyle behaviors before/during the COVID-19 pandemic, namely physical activity and screen time, with mental health. Furthermore, the impacts of physical activity and screen time on mental health during the pandemic were examined cross-sectionally.MethodsA two-wave longitudinal study was conducted among 2423 children and adolescents in Shanghai, China. Lifestyle behavior variables (physical activity and screen time) and psychological variables (depressive symptoms, anxiety, and stress) were measured using a self-reported questionnaire in January and March 2020. A series of multivariable logistic regressions were performed to examine the associations between changes in lifestyle behaviors in two waves and psychological problems. The combined associations of physical activity and screen time with psychological problems were also explored using the second wave data.ResultsCompared to students with persistently short screen time before and during the COVID-19 pandemic, those with prolonged screen time (OR = 1·36 for depression, OR = 1·48 for anxiety) and those with persistently long screen time (OR = 1·70 for depression, OR = 2·13 for anxiety) reported a higher risk of psychological symptoms. The association between changes in physical activity and psychological symptoms was not statistically significant after adjustment for demographic factors, socioeconomic status, and screen time. During the COVID-19 pandemic, engaging in longer screen time (OR = 1·44 for depression, OR = 1·55 for anxiety) was associated with worsened psychological conditions, while engaging in increased physical activity (OR = 0·58 for depression, OR = 0·66 for anxiety) was associated with better psychological conditions.ConclusionsOur study suggests that promoting physical activity and limiting leisure screen time during the COVID-19 pandemic are important to prevent and mitigate psychological problems in children and adolescents. Therefore, effective interventions targeting lifestyle behaviors are needed to protect children and adolescents’ physical and mental health.