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Trajectories of emotional and behavioral problems in young children during the COVID-19 pandemic: A longitudinal

Markus A Landolt1,2, Noëmi Ruther2, Nathan L Strebel2

  • 1Department of Psychosomatics and Psychiatry, Children's Research Center, University Children`s Hospital Zurich, University of Zurich, Zurich, Switzerland.

PLOS Mental Health
|February 9, 2026
PubMed

Insights

A significant minority of young children faced emotional and behavioral issues during the COVID-19 pandemic. Parental mental health and child worries were key predictors of these persistent problems.

Area of Science:

  • Child Psychology
  • Mental Health Research
  • Epidemiology

Background:

  • The COVID-19 pandemic significantly impacted children's mental health globally.
  • Pre-existing research indicated potential increases in emotional and behavioral problems among children during crises.
  • Understanding longitudinal trajectories is crucial for effective intervention.

Purpose of the Study:

  • To explore emotional and behavioral problem trajectories in young children (1-6 years) during the COVID-19 pandemic.
  • To identify predictors of these trajectories, including parental mental health and child worries.
  • To assess the prevalence of clinically significant problems compared to normative data.

Main Methods:

  • Longitudinal study with four assessment points (April 2020-May 2021).
  • Anonymous online surveys completed by 527-888 parents in Austria, Germany, and Switzerland.
  • Utilized Child Behavior Checklist (CBCL/1.5-5) for emotional and behavioral problems; assessed sociodemographics, COVID-19 exposure, child worries, and parental mental health.

Main Results:

  • Prevalence of clinically significant behavioral problems ranged from 4.2% to 11.5%, exceeding the normative 2%.
  • Latent class growth analyses revealed stable high-symptom trajectories for anxiety, affective, and oppositional-defiant problems (13.1%-15.6% of sample).
  • Parental mental health (anxiety, depression) and child worries significantly predicted high symptom trajectories; female sex predicted high affective problems.

Conclusions:

  • A notable minority of young children experienced persistent elevated emotional and behavioral problems during the pandemic's first year.
  • Parental mental health and children's worries are critical factors influencing these trajectories.
  • Findings highlight the need for targeted interventions and support for parental mental health to mitigate pandemic-related adverse effects on child mental health.

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