Objective: Traumatic stress symptoms increase the risk for mental health problems. We examine patterns of COVID-19-related changes in youth and family experiences (material hardships, behavior change, coping strategies), how these patterns vary with sociodemographic factors, and how COVID-19-related experiences associate with youth pandemic-related traumatic stress (PTS) symptoms.

Method: K-means clustering examined patterns of pandemic-related experiences in Environmental influences on Child Health Outcomes data (April 2020-August 2021; N = 9,139; 48% female), a demographically and regionally diverse sample. Clusters were characterized by sociodemographic factors measured pre-pandemic. Sparse partial least squares regression evaluated associations between cluster parameters and youth PTS symptoms in two samples (children [<13 years-old, n = 1,293]; adolescents [≥13 years-old], n = 1,272).

Results: Clustering replicated in the child and adolescent samples. One cluster reported more (HiChange) and one reported less (LoChange) pandemic-related change. The LoChange (versus HiChange) group included more Black individuals, single-parent households, and had lower income and education. PTS Scale scores were more associated with the youth's own versus the parent/caregiver's experiences. Nonetheless, across all youth, a report of "no change" in parent/caregiver behavior was associated with lower youth PTS Scale scores. For all children, lower PTS Scale scores are associated with the parent/caregiver being able to isolate. Use of coping strategies was not associated with lowered scores. Higher scores are associated with changes in youth health behaviors (e.g. eating, exercise, time outside), health care access, and increased media use.

Conclusion: Results provide information for public health guidance, which can minimize youth PTS symptoms now and in future health disasters: stability in health behaviors, access to healthcare, and ability to isolate are paramount.