Epigenetic Impacts of COVID-19 Pandemic Chronic Stress on Youth: A Prospective Investigation of DNA methylation

The COVID-19 pandemic has introduced severe economic and social hardships contributing to rising rates of mental health problems in youth. Described as a "ticking time bomb", youth mental health problems have negative consequences for lifelong dysfunction affecting educational achievement, relationship success, work attainment and income. COVID-19 stressors may impact youth mental health by 'getting under the skin' and becoming engrained in child biology. To test this hypothesis, we propose quantifying an epigenetic mark called DNA methylation from child cheek swabs collected serendipitously just prior to the onset of the COVID-19 pandemic for comparison with samples we propose to collect approximately 2 years later. Our analysis first involves the creation of a pandemic stress score representing how much stress each child faced by combining stress measures from child and parent reports at the level of the youth (e.g., infection risks to child and friends), family (e.g., parental conflict), and community (loss of in-person schooling) and validating those scores with concurrent assessments of child mental health (i.e., depression, anxiety). Second, we will test whether pandemic stress scores relate to shifts in biological DNA methylation patterns pre- to 2 years post-pandemic onset, and whether shifts relate to youth mental health outcomes 2 years post-pandemic onset. We will also test whether pandemic stress is related to 'biological age', a DNA methylation-based gauge of biological aging that is relevant for long-term health outcomes. We will do each analysis separately for males and females to identify sex-specific stress pathways, given literature showing sex differences in both stress experiences and mental health outcomes. Findings will inform how pandemic stress from economic strain and social restrictions gets under the skin to affect youth mental health and what biological factors put some children at greater risk than others for mental health consequences.