Although the negative impacts of COVID-19 pose significant challenges and distress, there is considerable variability in how youth have been impacted by the pandemic (Roy et al., 2021). The social disruption including interruption of school routines, stay-at-home orders, social distancing, and prolonged stress associated with COVID-19 likely intensifies adjustment difficulties in adolescents, leading to significant short- and long-term mental health concerns. Growing evidence supports the profound early impact of the COVID-19 pandemic on adolescent well-being and mental health functioning (Magson et al., 2020 Racine et al., 2020). These findings have important clinical and public policy relevance for parents, schools, and employers who may aim to prioritize keeping schedules as consistent as possible to promote healthy adjustment.

The use of positive coping strategies and adolescent routines buffered against increases in substance use and mental health problems for adolescents with ADHD. Adolescents with ADHD were at greater risk for experiencing increases in mental health symptoms and substance use throughout the pandemic, relative to adolescents without ADHD. All models included the effects of adjustment at the prior timepoint as well as relevant covariates including adolescent race, ethnicity, sex, medication status, and family income.

Parents provided ratings of adolescent routines, and adolescents provided ratings of coping behaviors and psychological adjustment in spring (May/June), summer (July/August), and fall (October/November) 2020. Participants included 238 adolescents (132 male participants ages 15–17 118 with ADHD). Using multi-group autoregressive cross-lagged path models, the present study explored the reciprocal influence of positive coping behaviors on multiple adjustment outcomes including mental health symptoms, substance use, stress, and worry. This prospective longitudinal study addresses this gap by investigating the impact of the COVID-19 pandemic on adolescents’ mental health and substance use, and by assessing specific positive coping strategies among adolescents with and without attention-deficit/hyperactivity disorder (ADHD). Understanding factors that foster resilience and buffer against the negative psychological impact of COVID-19 is critical to inform efforts to promote adjustment, reduce risk, and improve care, particularly for adolescents with neurodevelopmental disorders.

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