A longitudinal study on depression and anxiety among Chinese adolescents in the late phase of the COVID-19 pandemic: The trajectories, antecedents, and outcomes

During the COVID-19 pandemic, all age groups' mental health has substantially declined. Compared to other age groups, the impact of the COVID-19 pandemic on adolescent mental health problems was more salient, particularly on depression and anxiety. Previous studies, which were primarily conducted during the phase of COVID-19 pandemic, have mainly covered the first and second phases of COVID-19-related prevention and containment in China, without adequate attention being paid to the third and fourth phases of COVID-19- related prevention and containment in China. Currently, there are three competing hypotheses for the longitudinal trajectories of depression and anxiety among Chinese adolescents in the post-COVID era, making the construction of the mental health monitoring system and the mental health service system for adolescents in China "blind spots". Based on developmental contextualism and three- dimensional theoretical framework of mental health change, the present study thus investigated the developmental trajectories of depression and anxiety among adolescents, as well as the potential antecedent (psychological resilience) and outcome (prosocial tendency) of such trajectories in the late phase of the COVID-19 pandemic in China. In this study, 1170 adolescents in Shandong province were assessed at three time points with a six- month interval (Time 1 = May 2021; Time 2 = November 2021; Time 3 = May 2022) from the normalization period of the pandemic through self-report questionnaires. The adolescents completed Center for Epidemiologic Studies Depression Scale and Self-Rating Anxiety Scale during the three measurements. Furthermore, all adolescents completed the Connor-Davidson Resilience Scale at Time 1 and Prosocial Tendencies Measure at Time 3. Attrition analyses, common method bias analyses, and descriptive statistics were analyzed by SPSS software. The trajectories of depression and anxiety, as well as their associated antecedent (i.e., psychological resilience) and outcome (i.e., prosocial tendency) were further analyzed via latent growth curve models using Mplus software. According to the results of the latent growth curve models, adolescents' depression and anxiety levels tended to decline. The higher the level of depression and anxiety at Time 1, the slower the decline over time. Furthermore, psychological resilience at Time 1 negatively predicted initial levels of depression and anxiety but positively predicted the decreasing speed of depression and anxiety trajectories. Concerning the outcomes, we found that the initial level and speed of depression trajectories significantly and negatively predicted the levels of prosocial tendency at Time 3. Regarding the anxiety trajectory, its intercept factor negatively predicted prosocial tendency at Time 3, but its slope factor's predictive effect was non-significant. Finally, multi-group analyses revealed that both boys and girls showed declining trends in depression and anxiety over time, while girls scored significantly higher on depression and anxiety initially than boys. In conclusion, this research found that the changes in mental health (particularly depression and anxiety problems) among Chinese adolescents in the late phase of the COVID-19 pandemic were developing well, which provides empirical evidence for better construction of adolescent mental health service systems in China.