The Longitudinal Association between COVID-19 Stress and Adolescents' Diurnal Cortisol: The Mediating Effects of Parental Anxiety and Behaviors

During the COVID-19 pandemic, studies revealed increased mental health problems and psychological distress in adolescents. However, few studies have examined the impact of COVID-19-related stress on youth’s hypothalamic-pituitary-adrenal (HPA) axis functioning, a critical stress-response system. Here, we conducted a longitudinal study to address this gap by investigating the association between COVID-19 stress and adolescent HPA activity from a family perspective.Adolescents (n=121, Mage =10.02) and their parents were recruited in Hubei Province, China. The COVID-19 stress, parental anxiety, and parenting behaviors were assessed in parents. Adolescents' diurnal cortisol were assessed 4 months later. Serial mediation analyses showed that high COVID-19 stress reported by parents was associated with lower diurnal cortisol levels in children, mediated by higher parental anxiety and indifference sequentially, but the mediating effect of parental caring was not found. The results highlight the devastating effects of negative parental behaviors in adolescents' HPA axis during COVID-19. Reducing parental anxiety levels and negative parental behaviors may be effective interventions during a pandemic to protect adolescents' mental health.