Combining natural language processing with patient-reported outcome measures scores to investigate the association of pandemic regulations with anxiety in children
Abstract
The COVID-19 pandemic and the governmental regulations taken during the pandemic have been associated with the experienced anxiety of children. However, there is a gap in research that explains how and which regulations were associated with higher anxiety. In this study we combine quantitative and qualitative data through structural topic modelling (STM) and sentiment analysis. Children and adolescents (N = 3,821, aged 8–18 years old) completed an open-ended question; “ How are the corona-regulations for you? ”, and the PROMIS Anxiety questionnaire, bi-annually from April 2020 until March 2023 (7 measurement occasions). This yielded 7,605 open-ended responses, of which 6,672 contained anxiety, which was classified as (sub)clinical for PROMIS T-scores > 50.8. We applied STM to the open-ended responses to identify relevant topics, using dichotomized Anxiety as covariate. We used sentiment analysis to assess the affective state of responses and obtain polarity scores for each response (ranging from − 1 (negative) to + 1 (positive)). We identified the topics of importance to children during the pandemic and assessed the affective state of these responses per topic in the whole sample and split by presence of (sub)clinical anxiety. Eight topics emerged: (1) Adaptation/Resilience, (2) Distress, (3) Adherence to social distancing, (4) Limited social and family contact (5) Restrictions in activities/boredom, (6) Future perspectives, (7) Homebound (school closures), and (8) Lack of celebratory events. Compared to their peers, children with (sub)clinical anxiety reported significantly more negative sentiment, particularly regarding adaptation/resilience (-0.19 vs. -0.10, Cohen’s D = 0.24) and distress due to lockdown (-0.06 vs. 0.02, Cohen’s D = 0.20). They also expressed stronger emotional language when discussing these topics. We successfully identified topics relating to the governmental regulations that are associated with (sub)clinical anxiety during the COVID-19 pandemic. This study shows that children with (sub)clinical anxiety scores described the pandemic period and regulations slightly more negatively, which may indicate that they have more problems with coping and adapting to lockdown measures.
Authors 11
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Michiel A. J. Luijten corresponding
Amsterdam Public Health · Amsterdam University Medical Centers · Amsterdam Reproduction Development · Vrije Universiteit Amsterdam · University of Amsterdam · Amsterdam UMC Location Vrije Universiteit Amsterdam
Affiliation as printed
Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
Amsterdam Public Health, Methodology, Amsterdam, Netherlands
Amsterdam Reproduction and Development, Child Development, Amsterdam, The Netherlands
Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Epidemiology and Data Science, Amsterdam, The Netherlands
Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC Location University of Amsterdam, Emma Children’s Hospital, Meibergdreef 9, Postbox 22660, 1100 AD, Amsterdam, The Netherlands
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Affiliation as printed
Health Data Intelligence and Life Sciences, Oracle, Austin, TX, USA
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Affiliation as printed
Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
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Amsterdam Public Health · Amsterdam Reproduction Development · University of Amsterdam
Affiliation as printed
Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
Amsterdam Reproduction and Development, Child Development, Amsterdam, The Netherlands
Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC Location University of Amsterdam, Emma Children’s Hospital, Meibergdreef 9, Postbox 22660, 1100 AD, Amsterdam, The Netherlands
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Amsterdam Public Health · Levvel · University of Amsterdam
Affiliation as printed
Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC Location University of Amsterdam, Emma Children’s Hospital, Meibergdreef 9, Postbox 22660, 1100 AD, Amsterdam, The Netherlands
Levvel, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
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Leiden University Medical Center
Affiliation as printed
LUMC Curium – Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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Affiliation as printed
Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Leiden University Medical Center
Affiliation as printed
LUMC Curium – Child and Adolescent Psychiatry, Leiden University Medical Center, Leiden, The Netherlands
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University Medical Center Groningen · University of Groningen · Karakter
Affiliation as printed
Department of Biomedical Sciences and Systems, Cognitive Neurosciences, University of Groningen, University Medical Center Groningen (UMCG), Groningen, The Netherlands
Karakter Child and Adolescent Psychiatry University Centre, Nijmegen, The Netherlands
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Amsterdam Public Health · Amsterdam Reproduction Development · University of Amsterdam
Affiliation as printed
Amsterdam Public Health, Mental Health, Amsterdam, The Netherlands
Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
Amsterdam Reproduction and Development, Child Development, Amsterdam, The Netherlands
Child and Adolescent Psychiatry & Psychosocial Care, Amsterdam UMC Location University of Amsterdam, Emma Children’s Hospital, Meibergdreef 9, Postbox 22660, 1100 AD, Amsterdam, The Netherlands