INTRODUCTION: The COVID-19 pandemic disrupted youths' interpersonal relationships, posing risks for internalizing distress. Yet, evidence remains limited beyond the early pandemic waves and with changing interpersonal contexts. This study examined trajectories of youth internalizing symptoms across five timepoints of the pandemic and associations with parental support and social interactions (in-person vs. virtual).
METHOD: Data were from the population-based COVID-19 Ontario Provincial Assessment and Tracking of Child and Family Health study in Canada. Youth (N = 176; 10-18 years; 51.4% girls, 43.5% boys) participated in up to five waves between January 2021 and December 2022. Linear mixed-effects models were conducted with internalizing symptoms as the outcome and age, gender, parental support, and in-person and virtual social interactions as predictors.
RESULTS: Girls (b = 0.21, p = 0.005), gender minority youth (b = 0.60, p < 0.001), and older youth (b = 0.07, p < 0.001) reported greater symptoms; girls showed steeper increases over time (b = 0.01, p = 0.006), reflecting widening gender disparities. Greater baseline parental support was associated with fewer symptoms (b = -0.33, p < 0.001), with a stable effect over time. In-person and virtual interactions were unrelated to symptoms at baseline; however, over time, more frequent in-person interactions were increasingly associated with fewer symptoms (b = -0.01, p = 0.005). Virtual interactions remained unrelated.
CONCLUSIONS: Internalizing symptoms increased modestly across the study period, with widening disparities for girls that extended well beyond periods of lockdown. In-person social interactions became increasingly protective, whereas parental support showed a stable protective association. Findings highlight the importance of gender-responsive supports and family relationships during prolonged disruption, and in-person connections as restriction ease.
