The severe restrictions put in place to mitigate the spread of the corona virus dramatically changed adolescents’ lives during the COVID-19 pandemic. Several large-scale research efforts have found that adolescents’ psychosocial well-being deteriorated during the pandemic and that the decline was the strongest among the most vulnerable groups1,2. However, less is known about adolescents’ situation after restrictions had been lifted and life had seemingly returned to normal. In particular, there is little research on whether adolescents’ psychosocial well-being quickly returned to pre-pandemic levels after restrictions were removed, or whether the pandemic had ‘scarring effects’, reducing well-being even after it had been declared overcome. In this study, we address this issue by using nationwide, large-scale, repeated cross-sectional data from more than 500,000 adolescents in Norway who were assessed on key psychosocial aspects before the COVID-19 outbreak, during the pandemic and after all restrictions were lifted in Norway in the spring of 2022. We examine whether psychosocial changes related to the pandemic at the population level reversed when restrictions were lifted and whether social inequalities returned to pre-pandemic levels.
Studies on the immediate effects of the COVID-19 pandemic and pandemic-related restrictions have found that adolescent mental health and well-being declined in comparison to pre-pandemic levels1–5. However, we know little about whether the pandemic had lasting effects on adolescents’ psychosocial well-being even after all restrictions were lifted. Research from the field of economics shows that economic crises have substantial and persistent negative effects on young people in a variety of important future life outcomes, including earnings, physical health, life satisfaction, drug use and criminal behaviour6–9. These prolonged negative effects, which are difficult to explain by short-lived labour market shocks, have been termed ‘scarring effects’. They refer to situations in which those who are exposed to a recession in young age experience lasting disadvantage in later life, often years after the recession has ended. Even though economic research on scarring effects has mainly focused on young adults entering the labour market, scarring mechanisms may also apply to younger age groups during the COVID-19 pandemic because of widespread school closures and negative effects on family finances10. Econometric modelling indicates that COVID-19 school closures may indeed have scarring effects of welfare loss for children and possible effects on lifetime earnings11. However, there are not as yet any large-scale studies available comparing psychosocial well-being among adolescents before, during and after the COVID-19 pandemic.
In this article, we examine potential scarring effects in the domains of social relationships, mental health, substance use, physical activity, screen time and future life expectations. By doing so, we extend a previous study by our research team that examined changes during the pandemic1. Concerning social relationships, theoretical accounts have posited that physical distancing and school closures may have longstanding negative effects on family life and social relationships12. However, a recent study by our research group did not find any substantial declines in satisfaction with relationships to parents and peers during the pandemic1, whereas a Dutch study showed small increases in peer relationship problems at the beginning of the pandemic, but no subsequent changes in later pandemic phases13. Concerning mental health, several studies have found increasing rates of depressive symptoms during the pandemic1–3, 5. Findings are somewhat mixed when examining related constructs, such as loneliness; one study found a significant increase in adolescent loneliness during the pandemic14, whereas another did not1.
A recent review based on 49 studies revealed a general decline in the prevalence of adolescent substance use during the pandemic, with reductions in the use of alcohol, tobacco and cannabis15. This decline has been explained by the fact that restrictions during the pandemic led to fewer opportunities for accessing and using substances15. Concerning physical activity and sedentary behaviour, a review has shown that most studies reported reduced physical activity and increased screen time among children and adolescents16. Moreover, a Dutch study found that physical activity decreased and screen time increased among children not only during school lockdowns, but also afterwards17. These findings may indicate that child and adolescent activity patterns underwent prolonged changes even after the most severe restrictions were lifted.
Finally, the pandemic may have had lasting effects on adolescents’ expectations of their future opportunities in life. Results from our research group pointed to less optimistic future life expectations during the pandemic than before1. These expectations may remain low also afterwards, given that the pandemic and its consequences may have fundamentally shaken adolescents’ belief in a safe and controllable world. In sum, studies have indicated adverse changes to a variety of psychosocial factors among adolescents, besides of in the domain of substance use; however, little is known about whether such changes are sustained after pandemic restrictions have been lifted and adolescents’ lives have seemingly returned to normal. The present study aims at examining this issue.
Recent research has revealed that the pandemic disproportionately affected disadvantaged adolescents in a variety of life domains and thereby widened social disparities during the time of the pandemic1. Research on scarring effects has shown that even years after a period of downturn, economic recessions have disproportionally large negative effects on vulnerable groups—such as people with low education and low household incomes—in a variety of life domains, including income, health, life satisfaction, obesity and substance use6,8,18. It seems plausible to assume then, that also the scarring effects of the pandemic are unevenly distributed. For example, the pandemic was accompanied by an economic downturn that disproportionately affected families with low socioeconomic resources, particularly at the beginning of the pandemic19. Moreover, the severe pandemic-related restrictions, including school closures and suspension of organized youth activities, led to interruptions in adolescents’ academic and social lives. Disadvantaged families may have found these interruptions the most difficult to compensate for20 and therefore, a negative influence on adolescents from these backgrounds may have persisted after restrictions were lifted.
The pandemic may also have had differential effects according to regional socioeconomic characteristics. People in marginalized areas with higher levels of social inequality may have suffered more from consequences of the pandemic than people from other areas. This notion is supported by analyses showing that residents in deprived areas in the UK were economically more vulnerable to the effects of the pandemic than those living in less deprived areas21. We follow this line of research by examining whether adolescents from lower socioeconomic backgrounds experienced more negative changes during and after the pandemic than other adolescents did. We also examine whether living in municipalities characterized by few socioeconomic resources and high levels of inequality was related to more adverse changes, both during and after the pandemic.
In Norway, restrictions aimed at mitigating the COVID-19 pandemic were similar to those in other European countries, with a severe lockdown introduced on 12 March, 2020, including closures of schools, suspension of most organized leisure activities and the implementation of strict physical distancing measures. Junior and senior high schools reopened on 11 May, 2020, but with restrictions in place such as smaller class sizes, physical distancing and in part digital schooling. Other regulatory measures were maintained and continuously adapted to account for changing levels of infection risk. Most restrictions were removed on 1 February, 2022, with the final remaining restrictions lifted on 12 February, including all physical distancing measures, face mask requirements and regulatory procedures for the isolation and quarantine of people with COVID-19 infections. Moreover, on February,12, 2022, the Norwegian prime minister announced that ‘the COVID-19 pandemic no longer is a great threat to most of us’ and that ‘we can return to normal everyday life’22.
To sum up, research has shown that adolescents reported declines in psychosocial well-being in several domains during the COVID-19 pandemic. Further, disadvantaged adolescents showed larger adverse changes during the pandemic than other adolescents did. However, we know little about whether such adverse changes and exacerbated social inequalities were sustained beyond the immediate period of the pandemic. In line with economic research on scarring effects, we hypothesized that adverse changes in psychosocial well-being during the pandemic may have lasted even after all pandemic-related restrictions were lifted. Likewise, we expected that increased social inequalities would be sustained beyond the pandemic period.
To address these issues, we used nationwide Norwegian survey data from 2014 to 2022 (N = 576,082; ages 13–18) to examine psychosocial outcomes in adolescents before the pandemic, during the pandemic in 2021 and after all restrictions in Norway were lifted in the spring of 2022. We applied multilevel societal growth models to examine changes in levels of psychosocial well-being in different life domains relative to long-term trends. Moreover, and with particular interest, we examined whether social inequalities in psychosocial well-being were reduced in the spring of 2022 after they had increased considerably during the first year of the pandemic1. We further investigated whether more adverse changes during and after the pandemic were observed in areas in Norway with greater socioeconomic challenges.