{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,25]],"date-time":"2026-02-25T22:38:43Z","timestamp":1772059123618,"version":"3.50.1"},"reference-count":66,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T00:00:00Z","timestamp":1682985600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>In its early stage, the COVID-19 pandemic and the subsequent public health measures brought several challenges to people in general, with adolescents being one of the most affected groups. To assess the psychological reactions of Portuguese adolescents in that early phase of the COVID-19 pandemic, we conducted an online survey that was filled by a sample of 340 (67.6% female and 32.4% male) middle adolescents (aged 16 and 17 years). Using the Impact Event Scale-Revised and the Depression, Anxiety, and Stress Scale, we found that most participants reported a normal score for depression, anxiety, and stress. However, 47.1% reported some level of pandemic-related traumatic distress, and 25.6% reported high severity values. The girls\u2019 levels of depression, anxiety, stress, and traumatic distress were significantly higher than those of the boys. Regression models showed that gender, number of symptoms experienced in the past days, self-reported health status, and concern with family were significant predictors of these mental health indicators. Our findings underscore the need for future research on the long-term traumatic psychological impact of the COVID-19 pandemic in adolescents, and on the gender differences in this group. This will allow the development of strategies to identify and address at-risk adolescents, since the promotion of mental health and the prevention of pathology are imperative for the health of current and future generations.<\/jats:p>","DOI":"10.3390\/ijerph20095705","type":"journal-article","created":{"date-parts":[[2023,5,2]],"date-time":"2023-05-02T01:36:27Z","timestamp":1682991387000},"page":"5705","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Initial Psychological Reactions to COVID-19 of Middle Adolescents in Portugal"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7617-933X","authenticated-orcid":false,"given":"Rute","family":"Brites","sequence":"first","affiliation":[{"name":"Centro de Investiga\u00e7\u00e3o em Psicologia (CIP), da Universidade Aut\u00f3noma de Lisboa, 1169 Lisbon, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1204-7557","authenticated-orcid":false,"given":"Mauro","family":"Paulino","sequence":"additional","affiliation":[{"name":"Mind Institute of Clinical and Forensic Psychology, 1990 Lisbon, Portugal"},{"name":"Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), 3000 Coimbra, Portugal"}]},{"given":"Sofia","family":"Brissos","sequence":"additional","affiliation":[{"name":"Centro Hospitalar Psiqui\u00e1trico de Lisboa, 1749 Lisbon, Portugal"}]},{"given":"Sofia","family":"Gabriel","sequence":"additional","affiliation":[{"name":"Mind Institute of Clinical and Forensic Psychology, 1990 Lisbon, Portugal"}]},{"given":"Laura","family":"Alho","sequence":"additional","affiliation":[{"name":"Mind Institute of Clinical and Forensic Psychology, 1990 Lisbon, Portugal"}]},{"given":"M\u00e1rio R.","family":"Sim\u00f5es","sequence":"additional","affiliation":[{"name":"Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), 3000 Coimbra, Portugal"},{"name":"Faculdade de Psicologia e de Ci\u00eancias da Educa\u00e7\u00e3o, Universidade de Coimbra, 3000 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1399-6674","authenticated-orcid":false,"given":"Carlos F.","family":"Silva","sequence":"additional","affiliation":[{"name":"Departamento de Educa\u00e7\u00e3o e Psicologia, Universidade de Aveiro, 3810 Aveiro, Portugal"},{"name":"William James Center for Research, ISPA & University of Aveiro, 3810 Aveiro, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,2]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1080\/13548506.2020.1808236","article-title":"COVID-19 in Portugal: Exploring the immediate psychological impact on the general population","volume":"26","author":"Paulino","year":"2021","journal-title":"Psychol. Health Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1007\/s12519-020-00343-7","article-title":"Diagnosis, treatment, and prevention of 2019 novel coronavirus infection in children: Experts\u2019 consensus statement","volume":"16","author":"Shen","year":"2020","journal-title":"World J. Pediatr."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1177\/1059840520988548","article-title":"Predictors of Depression and Anxiety Among Senior High School Students During COVID-19 Pandemic: The Context of Home Quarantine and Online Education","volume":"37","author":"AlAzzam","year":"2021","journal-title":"J. Sch. Nurs."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"24059","DOI":"10.1038\/s41598-021-02021-8","article-title":"The impact of sleep, physical activity, and sedentary behaviour on symptoms of depression and anxiety before and during the COVID-19 pandemic in a sample of South African participants","volume":"11","author":"Lewis","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Serafim, A.P., Dur\u00e3es, R.S., Rocca, C.C., Gon\u00e7alves, P.D., Saffi, F., Cappellozza, A., Paulino, M., Dumas-Diniz, R., Brissos, S., and Brites, R. (2021). Exploratory study on the psychological impact of COVID-19 on the general Brazilian population. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0245868"},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Simegn, W., Dagnew, B., Yeshaw, Y., Yitayih, S., Woldegerima, B., and Dagne, H. (2021). Depression, anxiety, stress and their associated factors among Ethiopian University students during an early stage of COVID-19 pandemic: An online-based cross-sectional survey. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0251670"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1186\/s41983-021-00377-2","article-title":"A study of anxiety, depression, and stress symptoms among Fayoum medical students during COVID-19 lockdown, Egypt","volume":"57","author":"Soltan","year":"2021","journal-title":"Egypt J. Neurol. Psychiatry Neurosurg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1016\/S0140-6736(20)30460-8","article-title":"The psychological impact of quarantine and how to reduce it: Rapid review of the evidence","volume":"395","author":"Brooks","year":"2020","journal-title":"Lancet"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"112934","DOI":"10.1016\/j.psychres.2020.112934","article-title":"The psychological impact of the COVID-19 epidemic on college students in China","volume":"287","author":"Cao","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_10","first-page":"jrm00063","article-title":"Long-term clinical outcomes in survivors of severe acute respiratory syndrome and Middle East respiratory syndrome coronavirus outbreaks after hospitalisation or ICU admission: A systematic review and meta-analysis","volume":"52","author":"Ahmed","year":"2020","journal-title":"J. Rehabil. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1355","DOI":"10.1016\/j.psyneuen.2009.04.006","article-title":"Emotion regulation and cortisol reactivity to a social-evaluative speech task","volume":"34","author":"Lam","year":"2009","journal-title":"Psychoneuroendocrinology"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.genhosppsych.2009.03.001","article-title":"Long-term psychiatric morbidities among SARS survivors","volume":"31","author":"Mak","year":"2009","journal-title":"Gen. Hosp. Psychiatry"},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Forte, G., Favieri, F., Tambelli, R., and Casagrande, M. (2020). COVID-19 pandemic in the italian population: Validation of a post-traumatic stress disorder questionnaire and prevalence of PTSD symptomatology. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17114151"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1016\/j.jpsychires.2020.11.033","article-title":"Association of PTSD with COVID-19 testing and infection in the Veterans Health Administration","volume":"143","author":"Haderlein","year":"2021","journal-title":"J. Psychiatry Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1037\/tra0000592","article-title":"Traumatic stress in the age of COVID-19: A call to close critical gaps and adapt to new realities","volume":"12","author":"Horesh","year":"2020","journal-title":"Psychol. Trauma Theory Res. Pract. Policy"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1016\/j.jad.2021.09.052","article-title":"Anxiety, depression, and PTSD symptoms among high school students in China in response to the COVID-19 pandemic and lockdown","volume":"296","author":"Cao","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.jad.2021.09.090","article-title":"Physical and mental health impact of COVID-19 on children, adolescents, and their families: The Collaborative Outcomes study on Health and Functioning during Infection Times-Children and Adolescents (COH-FIT-C&A)","volume":"299","author":"Solmi","year":"2022","journal-title":"J. Affect. Disord."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s13034-020-00329-3","article-title":"Challenges and burden of the Coronavirus 2019 (COVID-19) pandemic for child and adolescent mental health: A narrative review to highlight clinical and research needs in the acute phase and the long return to normality","volume":"14","author":"Fegert","year":"2020","journal-title":"Child Adolesc. Psychiatry Ment. Health"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"226","DOI":"10.23736\/S0026-4946.20.05887-9","article-title":"Impact of COVID-19 on children: Special focus on the psychosocial aspect","volume":"72","author":"Ghosh","year":"2020","journal-title":"Minerva Pediatr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"113429","DOI":"10.1016\/j.psychres.2020.113429","article-title":"Impact of COVID-19 and lockdown on mental health of children and adolescents: A narrative review with recommendations","volume":"293","author":"Singh","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"434","DOI":"10.17105\/SPR45-4.434-457","article-title":"Conceptualizing High School Students\u2019 Mental Health Through a Dual-Factor Model","volume":"45","author":"Suldo","year":"2016","journal-title":"Sch. Psychol. Rev."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1037\/amp0000838","article-title":"The mental health implications of COVID-19 for adolescents: Follow-up of a four-wave longitudinal study during the pandemic","volume":"77","author":"Hancock","year":"2022","journal-title":"Am. Psychol."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Powell, T., Wegmann, K.M., and Backode, E. (2021). Coping and post-traumatic stress in children and adolescents after an acute onset disaster: A systematic review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18094865"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1111\/camh.12405","article-title":"Debate: COVID-19 and psychological well-being of children and adolescents in Italy","volume":"25","author":"Caffo","year":"2020","journal-title":"Child Adolesc. Ment. Health"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.jadohealth.2021.10.006","article-title":"Communicating With and Supporting Youth Diagnosed With COVID-19: A Trauma-Informed Care Approach","volume":"70","author":"Mirman","year":"2022","journal-title":"J. Adolesc. Health"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1016\/j.jaac.2020.05.009","article-title":"Rapid systematic review: The impact of social isolation and loneliness on the mental health of children and adolescents in the context of COVID-19","volume":"59","author":"Loades","year":"2020","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Jones, E.A.K., Mitra, A.K., and Bhuiyan, A.R. (2021). Impact of COVID-19 on mental health in adolescents: A systematic review. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18052470"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1016\/j.jadohealth.2022.05.025","article-title":"The Impact of the COVID-19 pandemic on adolescent mental health and substance use","volume":"71","author":"Temple","year":"2022","journal-title":"J. Adolesc. Health"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1007\/s10964-020-01332-9","article-title":"Risk and protective factors for prospective changes in adolescent mental health during the COVID-19 pandemic","volume":"50","author":"Magson","year":"2021","journal-title":"J. Youth Adolesc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.bbi.2020.05.061","article-title":"Depression and anxiety among adolescents during COVID-19: A cross-sectional study","volume":"88","author":"Chen","year":"2020","journal-title":"Brain Behav. Immun."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"348","DOI":"10.5209\/rev_SJOP.2012.v15.n1.37341","article-title":"Anxiety, depression and coping: CDI, MASC and CRI-Y for screening purposes in schools","volume":"15","author":"Matos","year":"2012","journal-title":"Span. J. Psychol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"514","DOI":"10.1016\/j.jadohealth.2020.07.001","article-title":"The effect of social support on mental health in Chinese adolescents during the outbreak of COVID-19","volume":"67","author":"Qi","year":"2020","journal-title":"J. Adolesc. Health"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1007\/s00787-020-01541-4","article-title":"Prevalence and socio-demographic correlates of psychological health problems in Chinese adolescents during the outbreak of COVID-19","volume":"29","author":"Zhou","year":"2020","journal-title":"Eur. Child Adolesc. Psychiatry"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.jadohealth.2021.04.005","article-title":"COVID-19 and adolescent mental health in the United Kingdom","volume":"69","author":"Hu","year":"2021","journal-title":"J. Adolesc. Health"},{"key":"ref_35","unstructured":"World Health Organization (2023, April 23). Fact Sheet: Mental Health of Adolescents, Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/adolescent-mental-health."},{"key":"ref_36","unstructured":"Wilson, J.P., and Keane, T.M. (1997). Assessing Psychological Trauma and PTSD, Guilford Press."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1590\/1982-02752017000200006","article-title":"Avalia\u00e7\u00e3o do impacto de acontecimentos traum\u00e1ticos na adolesc\u00eancia: Valida\u00e7\u00e3o da Impact of Event Scale-Revised","volume":"34","author":"Cunha","year":"2017","journal-title":"Estudos de Psicologia (Campinas)"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/0005-7967(94)00075-U","article-title":"The structure of negative emotional states: Comparison of the depression anxiety stress scales (DASS) with the Beck depression and anxiety inventories","volume":"33","author":"Lovibond","year":"1995","journal-title":"Behav. Res. Ther."},{"key":"ref_39","first-page":"229","article-title":"Contribui\u00e7\u00e3o para o estudo da adapta\u00e7\u00e3o portuguesa das escalas de ansiedade, depress\u00e3o e stress (EADS) de 21 itens de Lovibond e Lovibond","volume":"V","author":"Honrado","year":"2004","journal-title":"Psicol. Sa\u00fade E Doen\u00e7as"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2325","DOI":"10.1007\/s11136-019-02177-x","article-title":"Systematic review of the measurement properties of the Depression Anxiety Stress Scales-21 by applying updated COSMIN methodology","volume":"28","author":"Lee","year":"2019","journal-title":"Qual. Life Res."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1002\/jts.22469","article-title":"Alternative models of DSM-5 posttraumatic stress disorder in Portuguese adolescents exposed to trauma and childhood adversity","volume":"32","author":"Morgado","year":"2019","journal-title":"J. Trauma. Stress"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1007\/s11126-020-09744-3","article-title":"The effect of COVID-19 on youth mental health","volume":"91","author":"Liang","year":"2020","journal-title":"Psychiatr. Q."},{"key":"ref_43","doi-asserted-by":"crossref","unstructured":"Gu, X., Obrenovic, B., and Fu, W. (2023). Empirical Study on Social Media Exposure and Fear as Drivers of Anxiety and Depression during the COVID-19 Pandemic. Sustainability, 15.","DOI":"10.3390\/su15065312"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"113108","DOI":"10.1016\/j.psychres.2020.113108","article-title":"Psychological effects of the COVID-19 outbreak and lockdown among students and workers of a Spanish university","volume":"290","author":"Irurtia","year":"2020","journal-title":"Psychiatry Res."},{"key":"ref_45","first-page":"77","article-title":"Structure of anxiety associated with COVID-19 pandemic: The online survey results","volume":"3","author":"Sorokin","year":"2020","journal-title":"Bull. Russ. State Med. Univ."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.jadohealth.2020.06.009","article-title":"A Descriptive study of COVID-19\u2013related experiences and perspectives of a national sample of college students in spring 2020","volume":"67","author":"Cohen","year":"2020","journal-title":"J. Adolesc. Health"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"1168","DOI":"10.3389\/fpsyg.2020.01168","article-title":"The Impact of COVID-19 on Anxiety in Chinese University Students","volume":"22","author":"Wang","year":"2020","journal-title":"Front. Psychol."},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Mu\u00f1oz-Fern\u00e1ndez, N., and Rodr\u00edguez-Meirinhos, A. (2021). Adolescents\u2019 Concerns, Routines, Peer Activities, Frustration, and Optimism in the Time of COVID-19 Confinement in Spain. J. Clin. Med., 10.","DOI":"10.3390\/jcm10040798"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1037\/a0032359","article-title":"On psychological growth and vulnerability: Basic psychological need satisfaction and need frustration as a unifying principle","volume":"23","author":"Vansteenkiste","year":"2013","journal-title":"J. Psychother. Integr."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C.S., and Ho, R.C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 Coronavirus Disease (COVID-19) epidemic among the general population in China. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17051729"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1177\/0004867414533834","article-title":"Are child and adolescent mental health problems increasing in the 21st century? A systematic review","volume":"48","author":"Bor","year":"2014","journal-title":"Aust. N. Z. J. Psychiatry"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.jad.2020.06.029","article-title":"An investigation of mental health status of children and adolescents in China during the outbreak of COVID-19","volume":"275","author":"Duan","year":"2020","journal-title":"J. Affect. Disord."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"783","DOI":"10.1037\/bul0000102","article-title":"Gender differences in depression in representative national samples: Meta-analyses of diagnoses and symptoms","volume":"143","author":"Salk","year":"2017","journal-title":"Psychol. Bull."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1080\/23812346.2020.1745411","article-title":"Opinions from the epicenter: An online survey of university students in Wuhan amidst the COVID-19 outbreak1","volume":"5","author":"Yang","year":"2020","journal-title":"J. Chin. Gov."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s13052-020-00833-4","article-title":"The psycho-social effects of COVID-19 on Italian adolescents\u2019 attitudes and behaviors","volume":"46","author":"Buzzi","year":"2020","journal-title":"Ital. J. Pediatr."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1016\/j.jpeds.2020.03.013","article-title":"Behavioral and emotional disorders in children during the COVID-19 epidemic","volume":"221","author":"Jiao","year":"2020","journal-title":"J. Pediatr."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Xie, X., Xue, Q., Zhou, Y., Zhu, K., Liu, Q., Zhang, J., and Song, R. (2020). Mental health status among children in home confinement during the coronavirus disease 2019 outbreak in Hubei Province, China. JAMA Pediatr.","DOI":"10.1001\/jamapediatrics.2020.1619"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1016\/S2352-4642(20)30096-1","article-title":"Mental health considerations for children quarantined because of COVID-19","volume":"4","author":"Liu","year":"2020","journal-title":"Lancet Child Adolesc. Health"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"e993003","DOI":"10.3389\/fpsyg.2022.993003","article-title":"COVID anxiety and its predictors among Slovak adolescents","volume":"13","author":"Jozefiakova","year":"2022","journal-title":"Front. Psychol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1001\/jamapediatrics.2021.2482","article-title":"Global prevalence of depressive and anxiety symptoms in children and adolescents during COVID-19: A meta-analysis","volume":"175","author":"Racine","year":"2021","journal-title":"JAMA Pediatr."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"e203221","DOI":"10.1001\/jamanetworkopen.2020.3221","article-title":"Longitudinal Assessment of Mental Health Disorders and Comorbidities Across 4 Decades Among Participants in the Dunedin Birth Cohort Study","volume":"3","author":"Caspi","year":"2020","journal-title":"JAMA Netw. Open"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1038\/nrn2513","article-title":"Why do many psychiatric disorders emerge during adolescence?","volume":"9","author":"Paus","year":"2008","journal-title":"Nat. Rev. Neurosci."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"1032700","DOI":"10.3389\/fpsyt.2022.1032700","article-title":"The impacts of academic stress on college students\u2019 problematic smartphone use and Internet gaming disorder under the background of neijuan: Hierarchical regressions with mediational analysis on escape and coping motives","volume":"5","author":"Gu","year":"2023","journal-title":"Front. Psychiatry"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1037\/cap0000254","article-title":"The psychological impact of COVID-19 in Canada: Effects of social isolation during the initial response","volume":"62","author":"Best","year":"2021","journal-title":"Can. Psychol.\/Psychol. Can."},{"key":"ref_65","first-page":"1","article-title":"The fear of COVID-19 scale: Development and initial validation","volume":"20","author":"Ahorsu","year":"2020","journal-title":"Int. J. Ment. Health Addict."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"110347","DOI":"10.1016\/j.paid.2020.110347","article-title":"Positivity explains how COVID-19 perceived risk increases death distress and reduces happiness","volume":"168","year":"2021","journal-title":"Personal. Individ. 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