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During the COVID-19 pandemic, youth have been learning and socializing remotely which has likely impacted their social connectedness, an important part of wellness. Different types of social connectedness (family, friends, school, community) may have differential associations with adolescent mental health. The experiences of LGBTQ+ adolescents, who are already at higher risk of adverse mental health outcomes, is important to understand. We describe perceived changes in anxiety/depression, the association of 4 types of social connectedness to anxiety/depression, and comparisons between cisgender heterosexual (CH) and LGBTQ+ adolescents during the pandemic.
Methods
Participants (n = 36) ages 13-18 were recruited through a primary care clinic in NYC using convenience sampling. Social connectedness was measured using a modified version of the Social Connectedness Scale, with sub-scales for family, friends, school, and community. Subscale scores range from 0 (no connectedness) to 4 (high connectedness). Depression was measured using the PHQ-9; anxiety by the GAD-7. Adolescents reported how their levels of anxiety and depression had changed from pre-pandemic to present (0 = stayed the same/decreased, 1 = increased). Logistic regression was conducted to examine associations between different types of social connectedness and anxiety and depression. Comparisons between groups (LGBTQ+ vs. CH) were assessed using Wilcoxon rank-sum tests and Fisher’s exact tests.
Results
Over half of the 36 adolescents reported experiencing more anxiety (53%) and depression (53%) during the pandemic. Twenty-eight percent of adolescents currently met criteria for clinically significant anxiety, and 31% met criteria for minor/major depression. When comparing groups, LGBTQ+ adolescents (n = 8) were more likely to meet criteria for anxiety on the GAD-7 (63% vs. 18%, p = 0.02) and were marginally more likely to meet criteria for minor/major depression on the PHQ-9 (63% vs. 23%, p = 0.079). In the overall sample, higher levels of family and friend connectedness were associated with being less likely to meet clinically significant criteria for anxiety (family OR = 0.30, 95% CI = 0.09-0.97, p = 0.04; friend OR = 0.19, 95% CI = 0.045-0.66, p = 0.009) and depression (friend OR = 0.28, 95% CI = 0.08-0.90, p = 0.03). Additionally, LGBTQ+ adolescents on average reported significantly lower family connectedness (M = 2.82 vs. M = 3.56, p = 0.01) compared to CH, with no differences in other types of connectedness between groups.
Conclusions/Implications
Over half of adolescents reported an increase in anxiety or depression during the pandemic. Greater social connectedness with family and friends was associated with less anxiety/depression, possibly because they provided a buffering impact or because less anxious/depressed adolescents were better able to connect to others. Understanding the role (or lack thereof) of school and community connectedness on anxiety/depression is worthy of further study. LGBTQ+ adolescents were more likely to meet criteria for clinically significant anxiety and depression and report lower family connectedness than CH adolescents. Addressing the long-term impact of the pandemic on the mental health of all adolescents requires further attention, and it is critical that the specific vulnerabilities of LGBTQ+ youth be included in those efforts.