Beyond the Pandemic Prism: Influence of COVID-19 Priming on Assessments of Child Mental Health

The influence of survey framing and priming on reported outcomes is a critical yet underexplored issue in mental health research, particularly during the COVID-19 pandemic. This study compared routinely assessed reports of child wellbeing and behavioural problems with reports framed around the pandemic using identical instruments. We analysed data from two large Dutch cohorts—the general-population Netherlands Twin Register (N = 6,593) and the clinical DREAMS cohort (N = 4,180)—collected between March 2020 and March 2023. Linear mixed model analyses revealed when surveys explicitly referenced COVID-19, parents reported significantly lower wellbeing (mean difference: −0.60) and higher internalizing (mean difference: +0.41) and externalizing problems (+0.25), compared to regular surveys. These framing effects were larger than differences between early- and post-pandemic periods and were strongest for internalizing symptoms. The findings suggest that crisis-oriented survey framing can prime respondents to report more negative outcomes, even with neutral item content. This has important implications for the design and interpretation of mental health assessments during public health emergencies. Accurate monitoring of child mental health trends requires attention to methodological biases such as framing effects, especially when comparing data across contexts or over time.