{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T01:54:49Z","timestamp":1790042089958,"version":"4.0.1"},"reference-count":120,"publisher":"American Medical Association (AMA)","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi230113-4\"><jats:title>Importance<\/jats:title><jats:p>The adverse effects of COVID-19 containment policies disrupting child mental health and sleep have been debated. However, few current estimates correct biases of these potential effects.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230113-5\"><jats:title>Objectives<\/jats:title><jats:p>To determine whether financial and school disruptions related to COVID-19 containment policies and unemployment rates were separately associated with perceived stress, sadness, positive affect, COVID-19\u2013related worry, and sleep.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230113-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cohort study was based on the Adolescent Brain Cognitive Development Study COVID-19 Rapid Response Release and used data collected 5 times between May and December 2020. Indexes of state-level COVID-19 policies (restrictive, supportive) and county-level unemployment rates were used to plausibly address confounding biases through 2-stage limited information maximum likelihood instrumental variables analyses. Data from 6030 US children aged 10 to 13 years were included. Data analysis was conducted from May 2021 to January 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230113-7\"><jats:title>Exposures<\/jats:title><jats:p>Policy-induced financial disruptions (lost wages or work due to COVID-19 economic impact); policy-induced school disruptions (switches to online or partial in-person schooling).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230113-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Perceived stress scale, National Institutes of Health (NIH)\u2013Toolbox sadness, NIH-Toolbox positive affect, COVID-19\u2013related worry, and sleep (latency, inertia, duration).<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230113-9\"><jats:title>Results<\/jats:title><jats:p>In this study, 6030 children were included in the mental health sample (weighted median [IQR] age, 13 [12-13] years; 2947 [48.9%] females, 273 [4.5%] Asian children, 461 [7.6%] Black children, 1167 [19.4%] Hispanic children, 3783 [62.7%] White children, 347 [5.7%] children of other or multiracial ethnicity). After imputing missing data, experiencing financial disruption was associated with a 205.2% [95% CI, 52.9%-509.0%] increase in stress, a 112.1% [95% CI, 22.2%-268.1%] increase in sadness, 32.9% [95% CI, 3.5%-53.4%] decrease in positive affect, and a 73.9 [95% CI, 13.2-134.7] percentage-point increase in moderate-to-extreme COVID-19\u2013related worry. There was no association between school disruption and mental health. Neither school disruption nor financial disruption were associated with sleep.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi230113-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>To our knowledge, this study presents the first bias-corrected estimates linking COVID-19 policy-related financial disruptions with child mental health outcomes. School disruptions did not affect indices of children\u2019s mental health. These findings suggest public policy should consider the economic impact on families due to pandemic containment measures, in part to protect child mental health until vaccines and antiviral drugs become available.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2023.2716","type":"journal-article","created":{"date-parts":[[2023,3,13]],"date-time":"2023-03-13T15:02:34Z","timestamp":1678719754000},"page":"e232716","source":"Crossref","is-referenced-by-count":22,"title":["COVID-19 Policies, Pandemic Disruptions, and Changes in Child Mental Health and Sleep in the United States"],"prefix":"10.1001","volume":"6","author":[{"given":"Yunyu","family":"Xiao","sequence":"first","affiliation":[{"name":"Weill Cornell Medicine, NewYork Presbyterian, Department of Population Health Sciences, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy T.","family":"Brown","sequence":"additional","affiliation":[{"name":"School of Public Health, University of California, Berkeley"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lonnie R.","family":"Snowden","sequence":"additional","affiliation":[{"name":"School of Public Health, University of California, Berkeley"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julian Chun-Chung","family":"Chow","sequence":"additional","affiliation":[{"name":"School of Social Welfare, University of California, Berkeley"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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