Impact of the COVID-19 pandemic on children with and without affective dysregulation and their families

Research output: Contribution to journalResearch articleContributedpeer-review


  • A. K. Treier - , University of Cologne (Author)
  • V. Holas - , University of Cologne (Author)
  • A. Görtz-Dorten - , University of Cologne (Author)
  • F. Frenk - , University of Cologne (Author)
  • C. Goldbeck - , University of Cologne (Author)
  • C. Hanisch - , University of Cologne (Author)
  • K. Mücke - , University of Cologne (Author)
  • A. Ritschel - , University of Cologne (Author)
  • V. Roessner - , Department of Child and Adolescent Psychiatry and Psychotherapy (Author)
  • J. Rothe - , Department of Child and Adolescent Psychiatry and Psychotherapy (Author)
  • U. Ravens-Sieberer - , University Hospital Hamburg Eppendorf (Author)
  • A. Kaman - , University Hospital Hamburg Eppendorf (Author)
  • T. Banaschewski - , Heidelberg University  (Author)
  • D. Brandeis - , Heidelberg University , University of Zurich, ETH Zurich (Author)
  • P. M. Aggensteiner - , Heidelberg University  (Author)
  • M. Kölch - , University of Rostock, Ulm University (Author)
  • A. Daunke - , University of Rostock (Author)
  • M. Döpfner - , University of Cologne (Author)
  • for the ADOPT Consortium - (Author)


Analyzing COVID-19-related stress in children with affective dysregulation (AD) seems especially interesting, as these children typically show heightened reactivity to potential stressors and an increased use of maladaptive emotion regulation strategies. Children in out-of-home care often show similar characteristics to those with AD. Since COVID-19 has led to interruptions in psychotherapy for children with mental health problems and to potentially reduced resources to implement treatment strategies in daily life in families or in out-of-home care, these children might show a particularly strong increase in stress levels. In this study, 512 families of children without AD and 269 families of children with AD reported on COVID-19-related stress. The sample comprised screened community, clinical, and out-of-home care samples. Sociodemographic factors, characteristics of child and caregiver before the pandemic, and perceived change in external conditions due to the pandemic were examined as potential risk or protective factors. Interestingly, only small differences emerged between families of children with and without AD or between subsamples: families of children with AD and families in out-of-home care were affected slightly more, but in few domains. Improvements and deteriorations in treatment-related effects balanced each other out. Overall, the most stable and strongest risk factor for COVID-19-related stress was perceived negative change in external conditions—particularly family conditions and leisure options. Additionally, caregiver characteristics emerged as risk factors across most models. Actions to support families during the pandemic should, therefore, facilitate external conditions and focus on caregiver characteristic to reduce familial COVID-19-related stress. Trial registration: German Clinical Trials Register (DRKS), ADOPT Online: DRKS00014963 registered 27 June 2018, ADOPT Treatment: DRKS00013317 registered 27 September 2018, ADOPT Institution: DRKS00014581 registered 04 July 2018.


Original languageEnglish
Pages (from-to)1-11
Number of pages11
JournalEuropean Child and Adolescent Psychiatry
Publication statusPublished - 2023

External IDs

Mendeley 62e5f6a9-1381-3ee4-a80b-209e15c0cb18
PubMed 36385660
ORCID /0000-0001-9445-0958/work/142239403


Sustainable Development Goals


  • Affective dysregulation, Children and adolescents, COVID-19, Risk factors, Stress