Parental Burnout and Child Maltreatment During the COVID-19 Pandemic

Professionals' Perspectives on the Effects of the COVID-19 Pandemic among Child and Adolescent Victims of Domestic Violence Living in the Portuguese Residential Foster Care System

The COVID-19 pandemic had several negative impacts on child and adolescent victims of domestic violence, especially on those who lived in the residential foster care system. The main goal of the present study was to understand these negative impacts through the perspectives of professionals in Portuguese residential foster care structures using both individual interviews and an online survey. One hundred and three professionals aged between 22 and 64 years (M = 38.39; SD = 8.34) participated in the online survey (86 females and 17 males). Of those, seven professionals, four females and three males aged between 29 and 49 years (M = 38.43, SD = 7.50), were also interviewed. According to the participants, the conditions imposed by the COVID-19 pandemic contributed adversely not only to the increase in domestic violence against children and adolescents but also to the aggravation of the conditions children and adolescents living in the Portuguese residential foster care system were exposed to, namely concerning family relationships, access to resources and services, and institutional dynamics. The results suggest the necessity to develop standard procedures to cope with pandemic situations in the residential foster care system.

Parental Burnout, Quality of Life, and Pregnancy During COVID-19

Background: Parents may be at greater risk to experience parental burnout after experiencing challenges during the COVID-19 pandemic. Given the unique experiences of parents with young children during the first two years of the pandemic, this study explored the relationship between parental burnout, quality of life (QOL), and perceived threat of COVID-19 among a sample of adults who parented at least one child under the age of five. Method: A brief survey was conducted through convenience sampling (N = 48) and included the Brief Parental Burnout Scale, The QOL Scale, and a perceived COVID threat scale. Results: Logistic regression analysis found that pregnancy was a significant predictor of burnout risk even after controlling other effects on burnout risk. Conclusion: Findings suggest that the pandemic negatively impacted parental burnout and pregnancy during the first 2 years of the pandemic increased risk for burnout. Awareness is important for appropriate assessment and intervention by clinicians.

Brief Report: The Impact of COVID-19 on Parental Stress and Learning Challenges for Chinese Children with SpLD

The pandemic induced a radical shift to online learning with increased parental involvement. This study investigates the challenges that students with specific learning difficulties (SpLD) encountered during the pandemic and the mediating role of parental stress. A total of 294 parents of children with SpLD (mean age = 10.6; SD = 1.5) were recruited. Parents reported concerns over their children's difficulties maintaining learning routines, lack of suitable environment for online classes, and ineffective remote learning. Results of mediation analysis showed that online learning challenges, SpLD symptoms, and emotional and behavioral difficulties positively predicted parental stress. In turn, parental stress negatively predicted children's self-esteem and family quality of life. The study implies that parents of children with SpLD need both psychological and technical support under suspension of face-to-face teaching.

Structural Inequities in Self-compassion and Parental Burnout

Objectives

When parenting-related stressors and coping resources are chronically imbalanced, there is risk of parental burnout, and consequent negative impact on parent and child wellbeing. The objective of this study was to determine the relations between structural and social determinants of health inequities, self-compassion (a theoretically indicated coping practice), and parental burnout during the COVID-19 pandemic.

Method

Participants were parents (n = 2324) with at least one child aged 4-17 in the household recruited from NORC's AmeriSpeak Panel (a probability-based panel providing coverage of 97% of the US household population). Parents completed an online or telephone questionnaire in English or Spanish in December 2020. Structural equation modeling was used to test a system of relations between income, race and ethnicity, parental burnout, and parent and child mental health. Indirect effects and moderation by self-compassion were also tested.

Results

On average, parents experienced symptoms of burnout several days per week. Symptoms were the most frequent among parents with the least income, as well as female-identified and Asian parents. More self-compassion was associated with less parental burnout, and fewer parent and child mental health difficulties. Black and Hispanic parents were more self-compassionate compared to white parents, helping to explain similar levels of parental burnout and relatively better mental health outcomes, despite comparatively more stressors.

Conclusions

Self-compassion is a potentially promising target for interventions aiming to address parental burnout; however, such efforts must not detract from critical structural changes to reduce parenting stressors, particularly those impacting parents experiencing systemic racism and other forms of socioeconomic disadvantage.

Preregistration

This study is not preregistered.

Supplementary Information

The online version contains supplementary material available at 10.1007/s12671-023-02104-9.

Investigating the mediating effect of anxiety and fear of a third wave of COVID-19 among students in South India

The COVID-19 pandemic, which is a global health emergency, has potentiality had a serious impact on students' mental health. An online cross-sectional survey design that included 534 senior year college students from South India revealed a significant and direct positive effect of the fear of a third wave of COVID-19 on academic anxiety which in turn showed a significant and direct positive effect on COVID-19 burnout. Academic anxiety was also found to mediate the relationship between the fear of a third wave of COVID-19 and subsequent cases of burnout. The study suggested measures to be taken by policy makers for the broader interest and wellbeing of student communities. Managerial implications, limitations and future studies were also examined in the paper.

Child Maltreatment During COVID-19: Key Conclusions and Future Directions Based on a Systematic Literature Review

The COVID-19 pandemic has had a far-ranging impact. As societies struggled to minimize infection, questions arose regarding the consequences for children. Initial research reported the urgent need for child protective services worldwide to adapt existing policies and practices to protect children from maltreatment during this time, which is the rationale for the current systematic literature review. This review examined studies published in peer-reviewed journals from March 2020 to October 2020 on child maltreatment (CM) in the context of COVID-19. Twenty-five manuscripts met the inclusion criteria and were predominantly from the United States, with three international studies. The majority of the studies included CM reports during COVID-19 based on official data. The results clearly demonstrated an increased risk for children alongside a worrisome international decrease in CM reports. Only two studies addressed interventions during the pandemic. The current review highlights that, along with the obligation of scholars to advance the protection of children during COVID-19, there is much that is unknown. Future studies should examine the impact of the pandemic on children and their surrounding systems as well as child protective services' responses, which face enormous challenges during a pandemic. An additional conclusion is that, since children were not identified as a health risk group during the pandemic, their protection rights may have been jeopardized. Furthermore, the variance identified in the policies of different countries pinpoints the urgent need to establish an international protocol for protecting children from maltreatment during COVID-19, a protocol that will hopefully be a basis for policymakers worldwide.

The monthly incidence of abusive head trauma, inflicted skeletal trauma, and unexplained skin lesion in children in six French university hospitals during the COVID-19 pandemic

INTRODUCTION

The COVID-19 pandemic was a stressful period. Lockdowns may have added to parental difficulty leading to an increase in violence. This study aimed to compare the monthly incidence of high suspicion of child physical abuse before and during the COVID-19 pandemic.

MATERIAL

We have retrospectively reviewed imaging examinations of children having a skeletal X-ray examination in six university hospitals with high suspicion of abusive head traumatism (AHT), inflicted skeletal trauma (IST) and unexplained skin lesions (USL) between March 2020 and June 2021 and compared with the similar period from 2018 to 2019. The monthly incidence of the different physical maltreatment was analyzed using a QuasiPoisson regression model.

RESULTS

We included 178 children (n = 127 boys, 71.3 %), 110 during the pandemic period, median age 5 months. AHT was diagnosed in 91 children, 55 had inflicted skeletal trauma (IST) and 46 had unexplained skin lesions (USL). Among the 91 patients with AHT, 86 had a subdural hematoma (95.6 %) and 40 had bridging veins thrombosis (44 %). The ophthalmological examination performed on 89 children (97.9 %) revealed retinal hemorrhages in 57 children (89.8 %). The incidence of AHT doubled during the months of COVID-19 lockdowns (rate ratio = 2; 95 % CI [1.1; 3.6], p = 0.03). No difference in monthly incidence was observed for IST and USL groups.

CONCLUSION

A significant increase in AHT was observed during the months with lockdowns and curfews during the COVID-19 pandemic. This highlights the need for developing a national strategy to prevent physical abuse in children in this context.

Caregivers' Experiences During the COVID-19 Pandemic and Their Children's Behavior

The COVID-19 pandemic has financial and emotional impacts on families. We explored how caregivers' financial strain and mental health are associated with changes in their young children's behavior during the pandemic. We additionally considered whether having a sense of purpose moderated these associations. Caregivers (n = 300) in the emergency department of a children's hospital were surveyed anonymously about changes to their employment (e.g., reduced/increased hours and job loss), ability to pay for expenses and whether their child's behavior had changed. Aligned with the Family Stress Model, caregivers' financial strain was associated with poor mental health, inconsistent sleep routines, and changes in children's problematic and prosocial behaviors. A sense of purpose buffered some of these relationships. Families are differently affected by the pandemic and our findings underscore the need for supporting caregivers' mental health and connecting them with resources.

COVID-19 impacts and adolescent suicide: The mediating roles of child abuse and mental health conditions

BACKGROUND

Considerable research has established the harmful impacts of the COVID-19 pandemic on children's and adolescents' health and well-being. However, the literature has been constrained by studies using less representative samples, hindering the generalization of the findings.

OBJECTIVE

This study aimed to investigate the associations of employment disruption and school closures during the pandemic with suicidal ideation and behavior in children and adolescents-and to consider the potential mediating effects of child psychological and physical abuse and subsequent mental health conditions.

PARTICIPANTS AND SETTING

This study used the Adolescent Behaviors and Experiences data (n = 4692) - a nationally representative survey administered by the CDC of the United States from January to June 2021.

METHODS

Logistic regression models were conducted to investigate the associations. A series of multiple mediation models were performed.

RESULTS

School closures directly reduced child psychological and physical abuse and suicidal ideation and behavior. Employment disruption did not directly predict suicidal ideation and behavior but primarily through child abuse. Mental health's mediation role was significant in the associations between child psychological abuse and suicidal ideation and behavior, but no evidence suggested the same mediating pattern for the physical abuse-suicidal ideation and behavior relationship. Within the covariates, sexual orientation was the most consistent and highest risk factor.

CONCLUSIONS

This study contributes to current knowledge on disaster impact, child abuse, and suicidal ideation and behavior, and it can also provide policy and intervention awareness for social workers.

Applying a family stress model to understand U.S. families' patterns of stress, media use, and child behavior during the COVID-19 pandemic

The COVID-19 pandemic has greatly altered family life, and research among adults and families is finding increases in financial stress, mental health problems, screen time, parental conflict, and child behavior problems. Given these patterns, we sought to replicate these findings with a younger and largely non-white sample and consider how these constructs might relate to each other by using the Family Stress Model. From surveys of 247 predominately Latine mothers and fathers of children under 4 years in the U.S., we found that financial strain was related to children's media exposure and use, largely through impacts on parents' mental health and coparenting relationship. Interestingly, only use of television in the background and during mealtimes were associated with increases in children's behavior problems. Such findings better capture how stress may operate in a family system and offer a way to counsel parents about healthier media habits for children.

Lessons Learned-The Impact of the Third Wave of the COVID-19 Pandemic on German Waldorf Parents' Support Needs and Their Rating of Children's Health-Related Quality of Life: A Cross-Sectional Online Survey

BACKGROUND

COVID-19-related lockdowns and homeschooling have imposed a substantial burden on school-aged children and parents. Waldorf education is a reform-educational concept. Little is known about the situation of German Waldorf families under pandemic conditions.

METHODS

A cross-sectional, online, parent-proxy survey was conducted regarding the third pandemic wave. The primary outcome was parents' support needs, assessed with questions from the German COPSY (COVID-19 and PSYchological Health) study; the secondary outcome was children's HRQoL (KIDSCREEN-10, proxy version).

RESULTS

We analyzed questionnaires from 431 parents of 511 Waldorf students aged 7 to 17 years. While 70.8% of Waldorf parents (WPs) reported a general need for support in dealing with their children, 59.9% of COPSY parents (CPs) indicated this need. WPs' support needs in dealing with their children's academic demands were similar to CPs' needs but relatively higher in terms of dealing with emotions and moods, behavior, and relationships within the family. WPs sought support mainly from school and teachers (65.6%). Support needs were high, although WPs rated their children's HRQoL higher than CPs.

CONCLUSIONS

Our results underline the substantial pandemic-related burden on families across school types. WPs participating in this survey gave evidence that supports should focus on academic demands as well as psychosocial issues.

Evaluating the impact of Hazelwood mine fire event on students' educational development with Bayesian interrupted time-series hierarchical meta-regression

BACKGROUND

Environmental disasters such as wildfires, floods and droughts can introduce significant interruptions and trauma to impacted communities. Children and young people can be disproportionately affected with additional educational disruptions. However, evaluating the impact of disasters is challenging due to difficulties in establishing studies and recruitment post-disasters.

OBJECTIVES

We aimed to (1) develop a Bayesian model using aggregated school-level data to evaluate the impact of environmental disasters on academic achievement and (2) evaluate the impact of the 2014 Hazelwood mine fire (a six-week fire event in Australia).

METHODS

Bayesian hierarchical meta-regression was developed to evaluate the impact of the mine fire using easily accessible aggregated school-level data from the standardised National Assessment Program-Literacy and Numeracy (NAPLAN) test. NAPLAN results and school characteristics (2008-2018) from 69 primary/secondary schools with different levels of mine fire-related smoke exposure were used to estimate the impact of the event. Using an interrupted time series design, the model estimated immediate effects and post-interruption trend differences with full Bayesian statistical inference.

RESULTS

Major academic interruptions across NAPLAN domains were evident in high exposure schools in the year post-mine fire (greatest interruption in Writing: 11.09 [95%CI: 3.16-18.93], lowest interruption in Reading: 8.34 [95%CI: 1.07-15.51]). The interruption was comparable to a four to a five-month delay in educational attainment and had not fully recovered after several years.

CONCLUSION

Considerable academic delays were found as a result of a mine fire, highlighting the need to provide educational and community-based supports in response to future events. Importantly, this work provides a statistical method using readily available aggregated data to assess the educational impacts in response to other environmental disasters.

From parental issues of job and finance to child well-being and maltreatment: A systematic review of the pandemic-related spillover effect

BACKGROUND

Covid-19 pandemic jeopardized family well-being at the population level internationally. Pandemic-related job/financial difficulties in parents have a spillover effect on their child's well-being and issues of child maltreatment.

OBJECTIVE

The current review sought to systematically summarize and analyze this pandemic-related spillover effect.

PARTICIPANTS AND SETTINGS

In the home setting, participants involved 11,100 adolescents, 9144 parents/caregivers, and another 7927 parent-children dyads.

METHODS

An extensive literature search in 13 electronic databases was conducted. A total 21 eligible papers published from 2020 to 2022 were included for further thematic analysis.

RESULTS

A significant positive relationship between the pandemic-related spillover effect from parental job or financial issues to child maltreatment and child's mental/behavioral issues was established. The internal mechanisms demonstrated that this relationship was intermediated or moderated by the interactions of parental mental health issues, parenting practice, and family relationships. Families with particular factors may be more vulnerable and sensitive to the spillover effect during the pandemic. The work-from-home arrangement was found as positively related to enhanced parenting warmth and parent-child relationship in some cases who had relatively high familial social-economic status.

CONCLUSIONS

Findings of current review provided the evidences from empirical data. During the Covid-19 pandemic, spillover effect from parental job/financial issues significantly influenced the child well-being and family functioning. Future efforts for intervention/service design should be made to enhance familial protective factors and support those families with vulnerable factors.

The Impact of Helping Children with Distance Learning During COVID-19 on U.S. Parents' Alcohol Consumption

We examined the impact of distance learning-related parental stress due to COVID-19 on parental alcohol consumption using an online survey in May 2020 with a convenience sample of U.S. adults. This article focuses on the 361 parents who had children under the age of 18 living with them. Seventy-eight percent had children who were engaged in distance learning; 59% reported being stressed because they were not sure how to help their children with distance learning. Stressed parents reported consuming significantly more alcohol and binge drinking more often than parents who were not stressed by distance learning. We hope that public health professionals can use our findings to better target alcohol prevention programs aimed at parents to reduce parental stress, and hopefully, parental alcohol consumption.

Empathy and parenthood: The moderating role of maternal trait empathy on parental burnout

The ability to empathize with others enables us to effectively interact with each other and may have specifically evolved to support parental roles and caregiving. The relationship between parenting and trait empathy is little understood as previous research focused on empathy exclusively in the context of parenting, for example parental sensitivity. Here we aimed to understand how trait empathy may moderate the association between child's negative emotionality and parental burnout. Two cohorts were examined (1) parents of infants (10-18 months old; N = 203) and (2) parents of children (3-10 years old, N = 201). Parents filled out a battery of online questionnaires assessing maternal empathy, parental burnout and child temperament. We found that the relationship between higher levels of negative emotionality and parental burnout is moderated by specific aspects of maternal emotional empathy. Our findings suggest that maternal emotional empathy acts as a buffer against parental burnout when faced with a child's characteristics that incur higher parental demands.

Psychosocial Stressors and Maternal Mental Health in the U.S. During the First Wave of the COVID-19 Pandemic: A Cross-Sectional Analysis

OBJECTIVES

The COVID pandemic has had widespread impacts on maternal mental health. This research aims to examine the relationship between psychosocial stressors and symptoms of depression and anxiety and the extent to which emotional support or resilient coping moderates the relationship between psychosocial stressors and maternal mental health during the first wave of the COVID pandemic.

METHODS

This analysis includes data collected in October and November 2020 from a geographically and sociodemographically diverse sample of 776 mothers in the U.S. with children ≤ 18 years of age. Log binomial models were used to estimate the association between moderate or severe symptoms of anxiety and depression and psychosocial stressors.

RESULTS

Symptoms of moderate or severe anxiety and depression were reported by 37.5% and 37.6% of participants, respectively. Moderate (aRR 2.76 [95% CI 1.87, 4.07]) and high (aRR 4.95 [95% CI 3.40, 7.20]) levels of perceived stress were associated with greater risk of moderate or severe anxiety symptoms. Moderate and high levels of parental burnout were also associated with greater prevalence of moderate or severe anxiety symptoms in multivariable models. Results were similar when examining the relationship among stress, parental burnout, and depressive symptoms. Neither resilient coping nor social support modified the relationship between psychosocial stressors and mental health.

CONCLUSIONS FOR PRACTICE

Evidence-based strategies to reduce stress and parental burnout and improve the mental health of mothers are urgently needed. Strategies focused on bolstering coping and social support may be insufficient to improve maternal mental health during acute public health emergencies.

Exploring the lived experiences of women with children during COVID-19: Maternal stress and coping mechanisms

This paper presents the results of a qualitative study of mothers' lived experiences during the COVID-19 lockdown in the United States. An analysis of open-ended interviews with 44 mothers who had children ages zero-to-five identified two main themes: (1) increased stress among mothers; and (2) resilience through the use of coping mechanisms. The findings indicate that the COVID-19 pandemic has led to higher stress among mothers due to issues of work-family life balance, family and children's needs, decision-making about getting sick, concerns for children's development, and lack of clarity from government officials. Mothers described using a variety of problem-focused and emotion-focused methods to cope with this stress. The lived experiences of mothers during the pandemic highlights the need for innovations in childcare modalities, paid leave policies to relieve stress, and strengthening whole family processes and resilience through the use of coping mechanisms.

Home, but Left Alone: Time at Home and Child Abuse and Neglect During COVID-19

We use high-frequency mobile phone movement data and quick-release administrative data from Georgia to examine how time at home during the COVID-19 pandemic is related to child maltreatment referrals. Findings show that referrals plummeted by 58% relative to previous years, driven by fewer referrals from education personnel. After this initial decline, however, each 15 minutes at home was associated with an increase in referrals of material neglect by 3.5% and supervisory neglect by 1%. Our results describe how children have fared during the initial wave of the pandemic, and the results have long-term implications for child development and well-being.

Violence and sexual abuse rates before and during the Covid-19 pandemic: A prospective population-based study on Norwegian youth

BACKGROUND

Considerable concern is raised as to whether the pandemic has led to an increase in violence and sexual abuse against children.

OBJECTIVE

The present study objective is to provide rates of violence and sexual abuse against adolescents the year before the pandemic compared to one year into the pandemic.

PARTICIPANTS AND SETTING

Two samples of Norwegian 12-16-year-olds were approached. A representative pre-pandemic sample of 9240 adolescents (M age (SD) = 14.11(0.88), and a sample recruited one year into the pandemic resulting in 3540 responses (M age (SD) = 14.5 (0.96)).

METHODS

An online survey was administered during school hours including established measures of violence and sexual abuse exposure. Sociodemographic characteristics were assessed.

RESULTS

There was 1.4 percentage point increase in sexual abuse by an adult, and a 3.9 percentage point decrease in psychological violence by a parent during the pandemic compared to the year before the pandemic. Otherwise, violence and sexual abuse rates remained stable across these two time periods. Risk factors for violence and sexual abuse were amplified during the pandemic.

CONCLUSION

Norway, a high-income welfare state, imposed measures to counteract the burden of the pandemic mitigation actions for adolescents. This might partly explain the absence of the feared increase in violence towards adolescents. The disproportionate risk for violence and sexual abuse for some groups of adolescents is however concerning, and should be followed up over time.

Social support profiles correlate with depressive symptoms among Chinese parents during the COVID-19 pandemic: A latent profile analysis

This study explored pandemic-related social support profiles and investigated their relationships with depressive symptoms among Chinese parents during the COVID-19 pandemic. The hypotheses were evaluated in an online cross-sectional survey of 1286 parents. Latent profile analysis identified two profiles of received social support (isolated and integrated support). Three convergent profiles (high, moderate, and low support) and one divergent profile were found in perceived social support. The results revealed that the distribution of age, region, income and educational level varied across these profiles. Only the "high" (β = -0.11, p < 0.01) and "divergent" (β = -0.12, p < 0.01) profiles of perceived social support were negatively associated with parents' depressive symptoms. These findings highlight the importance of developing better-targeted intervention programs aimed at optimizing the allocation and improving the quantity and quality of supportive resources for parents.

The prevalences, changes, and related factors of child maltreatment during the COVID-19 pandemic: A systematic review

BACKGROUND

The impact of the COVID-19 pandemic has been extensive and drastic during the twenty-first century. The increasing phenomenon of child maltreatment during the pandemic is a significant public health concern.

OBJECTIVE

This study is the first systematic review to analyze and summarize the prevalence rates, risk factors, and protective factors related to child maltreatment during the COVID-19 pandemic.

METHODS

Four electronic databases (PubMed, Web of Science, Scopus, Embase) were systematically searched. Some potential studies were also identified from the reference lists of previously included articles. The quality of the included studies was assessed by the National Institutes of Health (NIH) Quality Assessment Tool and Critical Appraisal Skills Program (CASP) Quality Assessment Tool.

RESULTS

A total of 35 articles were included in the analysis, with 16 having prevalence information and 22 having factor information. Sixteen studies were conducted in the US, the other 17 studies were from 12 countries, and only two studies contained mixed countries. The prevalences of child maltreatment during the pandemic varied widely in different types and measurements. The pandemic rates of physical abuse, psychological abuse, neglect, and sexual abuse were 0.1 %-71.2 %, and 4.9 %-61.8 %, 7.3 %-40 % and 1.4 %-19.5 %, respectively. There was a decline in allegations of child maltreatment and an increase in severe cases of child maltreatment during the COVID-19 pandemic. Lockdown measures and their side effects were the main risk factors contributing to child maltreatment.

CONCLUSIONS

This review calls for targeted measures to prevent child maltreatment during the COVID-19 pandemic and current and future lockdowns and more future replication studies conducted in countries other than the US.

Trends in Pediatric Head and Facial Trauma During the COVID-19 Pandemic

INTRODUCTION

The effect of physical-distancing policies and school closures on pediatric health has been a topic of major concern in the United States during the coronavirus disease 2019 (COVID-19) pandemic. The objective of this study was to assess the immediate impact of these public policies on patterns of head and facial trauma in the pediatric population.

MATERIALS AND METHOD

The Pediatric Health Information System (PHIS) was queried to identify patient encounters at 46 children's hospitals across the United States in 2016-2020. Encounters were included if resultant in ICD-10 diagnosis for head or facial trauma in a child under 18 between April 1 and June 30 in 2020 (first COVID-19 school closures) and during the same period in the previous 4 years (for comparison).

RESULTS

A total of 170,832 patient encounters for pediatric head and facial trauma were recorded during the study period, including 28,030 (16.4%) in 2020 and 142,802 (83.6%) in 2016-2019. Patient encounters declined significantly in 2020 among children of all age groups relative to previous years. Relative reductions were greatest in children aged 11 to 17 (middle/high school) and 6 to 10 (elementary school), at -34.6% (95% confidence interval: -23.6%, -44%; P <0.001) and -27.7% (95% confidence interval: -18.4%, -36%; P <0.001). Variation in relative reductions by race/ethnicity, sex, and rural/urban status were not statistically significant.

CONCLUSIONS

Physical-distancing policies and school closures at the start of the COVID-19 pandemic correlated with significant reductions in pediatric head and facial trauma patient encounters. As in-person activities resume, reductions in head and facial trauma during the pandemic may indicate a range of possible preventable injuries in the future.

Real-Time Mental Health Crisis Response in the United States to COVID-19

Background: Data are scarce on assessing the impact of the COVID-19 pandemic on young people. Aim: To examine changes in crisis text patterns in the United States during the pandemic compared to the prepandemic period. Method: Nonintrusive data from a national digital crisis texting platform were analyzed using an interrupted time series design. Poisson regression with repeated-measures examined help-seeking patterns for stress, anxiety, depression, suicidal thoughts, and other mental health concerns in the pandemic (March 13 to July 20, 2020) compared to the prepandemic period (March 13 to July 20, 2019). Results: An abrupt increase in national crisis response texts occurred during the pandemic for stress and anxiety, substance abuse, bereavement, isolation, and abuse compared to the prepandemic period. Similar trends of excess texts for isolation and abuse were reported among children (relative risk [RR]_abuse: 1.16, CI: 1.03, 1.31; RR_isolation: 1.15, CI: 1.09, 1.21) and adolescents (RR_abuse: 1.17, CI: 1.11, 1.24; RR_isolation: 1.08, CI: 1.05, 1.11), bereavement among Black (RR: 1.31, CI: 1.12, 1.54) and Hispanic (RR: 1.28, CI: 1.10, 1.49) texters, and isolation and bereavement in female (RR_isolation: 1.09, CI: 1.06, 1.11; RR_bereavement: 1.21, CI: 1.13, 1.28) or nonconforming youth (RR_isolation: 1.19, CI: 1.08, 1.32; RR_bereavement: 1.50, CI: 1.08, 2.09) texters. Conversely, the risks of reporting bullying, depression, relationship issues, and suicidal thoughts as reasons for texting were significantly lower during COVID-19. Limitations: Results may underestimate crisis support-seeking in some groups because demographic data were not captured on all texters. Conclusion: Findings illuminated the real-time crisis response of young people across the United States and can inform more responsive interventions to alleviate the mental health consequences brought on by the COVID-19 pandemic.

Increased severity of abusive head trauma during the first year of the COVID-19 pandemic

BACKGROUND

Abusive head trauma (AHT) is the leading cause of death from physical abuse in children. Reports regarding the impact of the COVID-19 pandemic on rates and severity of AHT are limited and with conflicting results.

OBJECTIVE

To determine the number and clinical characteristics of AHT cases presenting to a pediatric tertiary care center during the first year of the COVID-19 pandemic compared to the two prior years.

PARTICIPANTS AND SETTING

We performed a retrospective cohort study of patients <5 years old diagnosed with AHT at a single pediatric tertiary care center over a three-year period.

METHODS

Data were obtained for the pandemic year and two years before, including demographics, length of stay, physical and retinal examination findings, radiologic studies, electroencephalogram results, and mortality.

RESULTS

There were 27 cases of AHT during the first year of the pandemic and 55 during the two pre-pandemic years. Length of stay was similar for the two cohorts. The mortality rate was higher during the pandemic (29.6 % vs. 3.6 %; p < .01), as were the proportion of patients with retinal hemorrhages (84.6 % vs. 41.5 %; p < .01) and abnormal cervical spine imaging (52.6 % vs. 21.2 %; p = .02). There were no differences in age, sex, race, abnormalities on dermatological exam, skeletal surveys, and electroencephalograms.

CONCLUSIONS

We did not observe an increase in the number of patients with AHT during the pandemic but did see an increase in mortality, patients with retinal hemorrhages, and patients with abnormalities on cervical spine imaging. These data suggest a higher severity of AHT presenting to a pediatric tertiary care center during the pandemic.

The impact of the COVID-19 pandemic on the mental health of families dealing with attention-deficit hyperactivity disorder

BACKGROUND

The COVID-19 pandemic uprooted regular routines forcing many children to learn from home, requiring many adults to work from home, and cutting families off from support outside the home. Public health restrictions associated with the pandemic caused widespread psychological distress including depression and anxiety, increased fear, panic, and stress. These trends are particularly concerning for families raising neuroatypical children such as those with Attention-Deficit Hyperactivity Disorder (ADHD), as these children are already more likely than their typically developing peers to experience comorbid mental health issues, and to experience greater distress when required to stay indoors. Families with children who have ADHD are also at greater risk for experiencing heightened familial stress due to the challenges associated with managing ADHD behavioural symptoms, greater parental discord and divorce, and greater financial difficulties compared to other families. The current study engaged families comprised of at least one child diagnosed with ADHD to elucidate 1) the unique ways that the COVID-19 pandemic affected their mental health and 2) the specific barriers these families faced to maintaining optimal mental wellbeing.

METHODS AND FINDINGS

A total of 33 participants (15 parent-child dyads) engaged in virtual interviews. Content analysis revealed that the most frequently identified mental health effects for families were increased child anxiety and disconnectedness, as well as deteriorating parental mental health. The most frequently identified barriers to maintaining optimal mental wellbeing were lack of routine, lack of social interaction and social supports, and uncertainty and fear.

CONCLUSIONS

Findings underscore areas of need during times of large-scale social isolation, specifically for families with children who have ADHD. This work contributes to a growing body of research aimed at creating safeguards to support mental wellbeing for vulnerable families during times of crisis.

The Mental Health of Emerging Adults: Hostile Home Environments and COVID-19

Purpose

Due to shifts in societal and educational expectations alongside the COVID-19 pandemic, many emerging adults live with their family of origin for extended periods of time. Little is known about patterns of parent-perpetrated maltreatment in emerging adulthood. Therefore, this study evaluates the relation between forms of parent-perpetrated maltreatment, including economic abuse, and COVID stress, on symptoms of depression, anxiety, and traumatic stress.

Method

423 emerging adults who were enrolled in college in the United States in March of 2020 were recruited via MTurk to complete an online survey. An age-related COVID questionnaire and six empirically validated measures assess levels of COVID-19 exposure, lifetime maltreatment, economic abuse, and mental health status.

Results

13.0% of participants reported maltreatment that most recently occurred over the age of 18 in their household of origin. Mean COVID stress level was found to be significantly higher in the Maltreated Over 18 group compared to the Never Maltreated group (t(345) = -3.03, p = 0.003), and in the Maltreated Under 18 group compared to the Never Maltreated group (t(346) = -3.20, p = 0.002). In accounting for the contribution of demographic variables, maltreatment chronicity, economic abuse, and COVID stress, our model predicted 38.6% of variance in depression symptoms, 37.2% of variance in anxiety symptoms, and 42.9% of variance in traumatic stress.

Conclusions

Findings indicate need for increased maltreatment screenings within the emerging adult population and calls for age-specific interventions to address the mental health disparities experienced by emerging adults with maltreatment histories.

Parental burnout and resilience intervention among Chinese parents during the COVID-19 pandemic

INTRODUCTION

Parental burnout is a mental state that combines long-term stress and depression with an overwhelming feeling of parental pressure.

METHODS

In Study 1, we conducted a web-based survey of 390 Chinese parents (75.1% mothers) with children aged 1-18 years old (Mean age = 9.05 years, SD = 5.098) to examine the parental burnout during the COVID-19 global pandemic and to identify associated factors during the national lockdown. In Study 2, eight weeks of resilience intervention was administered to 20 parents to compare parental resilience and parental burnout before and after the intervention.

RESULTS

The correlational study showed that greater parental burnout occurred in parents with the lower educational levels and in parents of school-age children. The risk factors of parental burnout included household burden and children's interference with work; while protective factors included living materials, family atmosphere, and parent-child meeting frequency. The intervention study showed the effectiveness of meditation intervention in resilience and parental burnout, suggesting that meditation training can effectively increase parental resilience and reduce parental burnout.

DISCUSSION

These findings demonstrate the risk and protective factors associated with parental burnout during the COVID-19 lockdown and highlight the positive role of meditation in mitigating parental burnout.

Dyadic associations between COVID-19-related stress and mental well-being among parents and children in Hong Kong: An actor-partner interdependence model approach

The spread of COVID-19 and its subsequent social distancing policies have profoundly impacted the lives of parents and children. Prolonged exposure to parenting-related responsibilities and heightened levels of family conflict under stay-at-home orders coupled with reduced access to support systems and resources have rendered parents and children more prone to stress and mental health difficulties. Drawing on a transactional model of parent-child interactions, the present study applied an actor-partner interdependence model approach to examine the transactional relationship between COVID-19-related stress and mental well-being among parents and children. Data from 109 Chinese parent-child dyads in Hong Kong were included in the study. Parents and their 8- to 10-year-old children completed a questionnaire on COVID-19-related stress, parent-child relationships, and mental well-being. The results showed that 53.2% and 30.3% of the parents and children, respectively, showed poor mental well-being, indicating possible emotional problems. Both actor and partner effects of parent COVID-19-related stress were found. Parent COVID-19-related stress was indirectly related to lower levels of parent and child mental well-being, through the mediation of parent-child conflict. To facilitate psychological adjustment following the COVID-19 outbreak, effective family-based mental health and parenting interventions are needed to promote family cohesion and alleviate stress-induced psychological symptoms. Even in the time of social distancing, telepsychotherapy and other online non-psychotherapeutic interventions can serve as a valid alternative for parents and children who experience excessive distress. Implications for psychological services, family-friendly policies, and social protection measures are also discussed.

Intervention of Physical Activity for University Students with Anxiety and Depression during the COVID-19 Pandemic Prevention and Control Period: A Systematic Review and Meta-Analysis

(1) Background: Although physical activity has been widely recognized as an effective way to improve anxiety and depression, we lack a systematic summary of research on improving anxiety and depression during the COVID-19 pandemic. The study aims to systematically analyze how physical activity impacts on this situation in college students during COVID-19. (2) Methods: Both Chinese and English databases (PubMed the Cochrane Library, EMBASE, Web of Science, Scopus, Chinese National Knowledge Infrastructure, Wanfang) were analyzed. All the randomized controlled trials (RCTs) about physical activity intervention for this were included. We received eight eligible RCT experiments before the retrieval time (4 October 2022) in the meta-analysis. (3) Results: Physical activity benefits for college students with significant anxiety were (SMD = -0.50; 95% CI = -0.83 to -0.17; I² = 84%; p < 0.001; Z = 2.98;) and depression (SMD = -0.62; 95% CI = -0.99 to -0.25; I² = 80.7%; p < 0.001; Z = 3.27). Subgroup analyses showed physical activity of different intensities significantly impacted on improving college students' depression and anxiety, but physical activity of 6 < 9 Mets intensity had a greater effect on anxiety than on depression. Interventions of eight weeks or less performed better than those of over eight weeks while interventions less than four times per week had a significant effect on improving the situation. The overall effect of a single intervention of 30 min was more effective than one of over 60 min. (4) Conclusion: Physical activities can effectively improve the situation of anxiety and depression for college students during the COVID-19 pandemic. However, a higher quality RCT experiment is needed to prove it.

COVID-19 burnout, resilience, and psychological distress among Chinese college students

Background

Since the outbreak of coronavirus disease 2019 (COVID-19), Chinese college students have spent 3 years dealing with infection prevention. Some students have undergone quarantine due to the detection of new variants of COVID-19 and the rise in cases. This study examines pandemic-related isolation and its psychological impact on Chinese college students and explores the relationships among COVID-19 burnout, resilience, and psychological distress in Chinese college students during the pandemic.

Methods

The COVID-19 Burnout Scale, the Connor-Davidson Resilience Scale, and the Brief Symptom Inventory were used to investigate 388 college students from Nanjing City, China. All participants were enrolled in university after 2019, and they participated in the survey voluntarily via the Internet. Participants were divided into two groups (isolated group vs. non-isolated group) based on whether or not they had been isolated.

Results

(1) Significantly lower scores were found for all factors in the isolated group; (2) COVID-19 burnout significantly negatively predicted resilience and significantly positively predicted psychological distress (anxiety, depression, and somatization symptoms), while resilience significantly negatively predicted psychological distress; and (3) Resilience mediated the relationship between COVID-19 burnout and psychological distress.

Conclusion

Isolation is a risk factor for psychological distress related to COVID-19. Resilience can buffer psychological distress and help improve Chinese college students' wellbeing during the COVID-19 pandemic.

The conditional effect of family resilience on family quality of life during the Covid-19 pandemic

Introduction: The Covid-19 pandemic has brought unprecedented challenges, both economically and psychologically, to most families across the world. Yet, little study has been done on this topic in Indonesia, even after the second year of the pandemic. This study examines how the Covid-19 economic impact and parental stress are related to the family quality of life (FQOL) and how the relation is moderated by family resilience. Methods: To this end, we employed previously tested measures to assess the level of parental stress, family resilience and FQOL. Especially for the latter, we modified the measure, developed by Beach Center on Disability, by including only four domains (i.e., family interaction, parenting, emotional well-being, and material well-being) to adjust to our research context. Results: Based on 169 participants, our confirmatory factor analysis (CFA) displays that all employed measures in the study are valid and reliable. Our regression analysis shows that there are significant direct relations of parental stress & family resilience with FQOL. However, we find that family resilience only positively moderates the relation between the Covid-19 economic impact and FQOL but not the relation between parental stress and FOQL; indicating that high family resilience can only buffer the effect of economic impact on FQOL. Discussion: This study presents a view on how the Covid-19 pandemic affects the way families live and hence, their quality of life. In addition, the findings suggest the importance of family relationship and support in times of crisis, not limited to the Covid-19 pandemic.

The conditional effect of family resilience on family quality of life during the Covid-19 pandemic

Introduction This study examines how the Covid-19 economic impact and parental stress are moderated by family resilience to relate to the family quality of life (FQOL). Methods We modify the measure of FQOL, developed by Beach Center on Disability, by including only four domains (i.e., family interaction, parenting, emotional well-being, and material well-being) to adjust to our research context. Results Based on 169 participants, our CFA displays that all employed measures in the study are valid and reliable. Our regression analysis shows that there are significant direct relations of parental stress & family resilience with family quality of life. However, we find that family resilience only positively moderates the relation between the Covid-19 economic impact and family quality of life. Discussion This study presents a view on how the Covid-19 pandemic affects the way families live and hence, their quality of life.

The conditional effect of family resilience on family quality of life during the Covid-19 pandemic

Introduction: The Covid-19 pandemic has brought unprecedented challenges, both economically and psychologically, to most families across the world. Yet, little study has been done on this topic in Indonesia, even after the second year of the pandemic. This study examines how the Covid-19 economic impact and parental stress are related to the family quality of life (FQOL) and how the relation is moderated by family resilience. Methods: To this end, we employed previously tested measures to assess the level of parental stress, family resilience and FQOL. Especially for the latter, we modified the measure, developed by Beach Center on Disability, by including only four domains (i.e., family interaction, parenting, emotional well-being, and material well-being) to adjust to our research context. Results: Based on 169 participants, our CFA displays that all employed measures in the study are valid and reliable. Our regression analysis shows that there are significant direct relations of parental stress & family resilience with family quality of life. However, we find that family resilience only positively moderates the relation between the Covid-19 economic impact and family quality of life. Discussion: This study presents a view on how the Covid-19 pandemic affects the way families live and hence, their quality of life. In addition, the findings suggest the importance of family relationship and support in times of crisis, not limited to the Covid-19 pandemic.

Online ACT Matrix Parent Training for Japanese-Speaking Mothers with Distress in the United States

Cultural stigma, shame, self-concealment, and language and socio-economic barriers often keep Asian immigrant parents and children away from mental and behavioral services in the United States. Research shows that increased levels of parent distress suggest a negative impact on parenting practices and correlate child-maltreatment. Therefore, this study aimed to test one functionally contextual strategy to address such issues. The current study evaluated the effects of an online Acceptance and Commitment Training (ACT) Matrix for Japanese-speaking mothers living the United States. A nonconcurrent multiple baseline single-subject design across four mothers was used to assess the effect of ACT Matrix on value-driven behaviors, parental engagement (session attendance and daily assignment completion), parental distress, and psychological flexibility. The study consisted of a baseline, treatment (three ACT Matrix treatment sessions adapted from the six-step protocol), maintenance, and follow-up phases. A visual analysis reporting level, trend, variability, immediacy of change and overlap was used to identify a functional relation between the treatment and observable overt behaviors of value-driven behaviors and daily assignment completion. In addition, a non-overlap of all pairs was used to measure effect sizes for these behaviors. For psychological flexibility and parental distress, we used the reliable change index to assess whether clinically significant improvement occurred or not. The results revealed that the online ACT Matrix parent training program was effective in improving all four dependent variables. Mothers reported that the training was culturally sensitive, effective, and acceptable. The details of findings and the implications for future research as preventive science are discussed.

A qualitative examination of the mental health impact of Covid-19 in marginalized communities in Guatemala: The Covid Care Calls survey

BACKGROUND

The mental health impact of Covid-19 from the perspective of individuals experiencing psychological distress during lockdown period in marginalized, high-risk communities remains underinvestigated.

AIMS

This study aims to identify key factors related to psychological distress resulting from the Covid-19 pandemic across highly vulnerable districts in Guatemala.

METHODS

The Covid Care Calls (CCC) survey was administered to households in 11 districts in Guatemala to gather information about medical, mental health, and psychosocial status during the lockdown period; provide referral for care; and disseminate information on evidence-based protective measures to stem the spread of the virus. The 330 individuals participated the survey. Conventional content analysis was used to analyze survey data.

RESULTS

Most commonly reported mental health issues since the start of the pandemic were anxiety (46%), stress (36%), and exacerbation of pre-Covid-19 mental health conditions (19%). Depression and burnout were equally reported by 12% of participants. Only 2% reported issues with safety in the home. Concerns about catching the virus and economic worries were the most commonly reported sources of psychological distress.

CONCLUSION

Results of this study indicate a high prevalence of anxiety, stress, and increased prior mental health symptoms resulting from the onset of the Covid-19 pandemic in low-income, high-risk communities across Guatemala. Efforts focused on enhancing coping strategies as well as psychoeducation to address stigma and increase help-seeking for depression are particularly important.

The emotional neglect potentials of nurses working in the COVID-19 service towards their children: A qualitative study

PURPOSE

This study aims to examine in depth the potential child emotional neglect behaviors of nurses working in the COVID-19 service, and their feelings, thoughts, and experiences regarding the causes and effects on their children.

DESIGN AND METHODS

The study was designed as a qualitative study based on a descriptive phenomenological approach. A purposeful sample of service providers (N = 22) in the COVID-19 clinics of the region's largest hospital in northeast Turkey in terms of education and patient care were recruited for the study. The data were collected through semi-structured interviews using the individual in-depth face-to-face interview method. The interviews were audio-recorded, transcribed verbatim, and analyzed with Braun and Clarke's thematic analysis method. The research was reported by following Consolidated criteria for reporting qualitative research-COREQ.

RESULTS

The findings enabled the identification of four unique themes expressed by the participants: parent-child interaction, social impact, physiological impact, and psychological impact. The first theme consists of adversely affected time nurses spent with their children, decreased physical contact, and communication problems; the second theme includes nurses' and their children's social isolation and social stigma; the third theme includes a change in eating habits and daily activities; the fourth theme includes fear of losing parents and emotional change.

CONCLUSIONS AND PRACTICE IMPLICATIONS

To prevent the increased emotional neglect potential due to the COVID-19 pandemic, it is necessary to regulate the working conditions of parents who are nursing professionals and support the parent/child emotionally and psychologically.

Psychometric Properties of the New Working Parent Burnout Scale

INTRODUCTION

Parental burnout is an underrecognized condition with adverse consequences for parents and children. The objective of this study was to determine the psychometric properties of a new scale, the Working Parent Burnout Scale, and a concurrent one-item assessment.

METHOD

A cross-sectional survey was conducted. The sample included parents (N = 1,285) living with children < 18 years. Content, face, construct, and predictive validity and reliability were established.

RESULTS

Cronbach α was 0.90 with the elimination of item four on the scale. All factor loadings were > 0.40. The one-factor model was supported by confirmatory factor analysis. The Pearson r correlation was 0.59 for the total score on the original 10-item burnout scale (item 4 excluded) and the one-item assessment.

DISCUSSION

These are the first known scales to measure working parent burnout. By better identifying parental burnout, preventive and interventional approaches can be initiated to enhance parent and child outcomes.

Effects of Mindful Emotion Regulation on Parents' Loneliness and Social Support: A Longitudinal Study During the COVID-19 Pandemic in the United States

The COVID-19 pandemic has introduced unprecedented challenges and demands for parents or caregivers of children who experienced disruptions in social support and feelings of isolation. Mindful emotion regulation may be a resilient factor for parents' psychosocial outcomes. Mindful emotion regulation refers to individuals' inherent capacities to regulate emotions mindfully, i.e., through paying attention to one's experiences in the present moment nonjudgmentally. Based on the theoretical and empirical literature associating mindful emotion regulation with loneliness and perceived social support, the current study tested the effects of mindful emotion regulation on later changes in perceived social support and loneliness in U.S. parents during the pandemic. Participants were 147 parents/caregivers who were living with at least one child or adolescent in their household during the pandemic in the USA. Data were collected from a national online sample at four time points: baseline (April 7-21, 2020), 30-, 60-, and 90-days later. Results of longitudinal mediational structural equation modeling showed that mindful emotion regulation was directly associated with increased perceived social support and decreased loneliness. Moreover, mindful emotion regulation was also associated with perceived social support indirectly through its effects on loneliness. Focusing on the needs of parents is important for promoting family and child wellbeing to ameliorate negative health consequences. More research is needed to elucidate whether and how mindful emotion regulation may be beneficial for parents in the social relationship domain.

Faith-Based Community Members, Family, and COVID-19: The Role of Family Cohesion, Social Support, and Spiritual Support on Quality of Life, Depression, and COVID-19-Prevention Behaviors

This study examined relationships between family cohesion, social support/spiritual support, and quality of life and depression among faith-based community members during the 2020 COVID-19 restrictions. Drawing upon the buffering model of social support and family cohesion as theoretical frameworks, the authors examined these factors in a survey of 551 faith-based community members between March 2020 and June 2020. Family cohesion had a direct and indirect effect (mediated by overall social support and spiritual support on quality of life). Moreover, family cohesion only had a direct effect on depression (e.g., not mediated by overall social support or spiritual support). Greater family cohesion and overall social support were predictive of increased COVID-19-prevention behaviors, while spiritual support was predictive of reduced COVID-19-prevention behaviors.

Children's age matters: Parental burnout in Chilean families during the COVID-19 pandemic

For families all over the world, going through a pandemic has presented a number of challenges. In particular, social distancing measures involving the closure of schools and day care centers, as well as increasing work hours at home, made parents face very demanding situations. However, we know little about whether parents' burnout levels are influenced by the age of their children. This study sought to determine whether levels of parental burnout (PB) are higher in families with at least one child under the age of four than in families with older children (5 to 18 years). The second goal was to explore whether having children under 4 years of age moderates the relationship between parental cooperation and PB. A cross-sectional study was conducted with a sample of 651 participants (525 mothers and 126 fathers) since May 18th until August 27th, 2020. The main results showed that child age is a predictor of PB. Besides, having a child aged 0-4 years old moderates the relationship between parental cooperation and PB. Finally, it was found that in cases where there was at least one child under 4 years of age in the family, with one of the partners who worked remotely, the respondent's PB rose by 7.9 points. The implications of these results with respect to the consideration of children's ages in the different parental scenarios were discussed.

Child maltreatment and management of pediatric patients during COVID-19 pandemic: Knowledge, awareness, and attitudes among students of medicine and surgery. A survey-based analysis

Purpose of the study

To assess perception, awareness, and attitudes regarding the medico-legal relevance of child maltreatment and management of pediatric patients during the COVID-19 pandemic in a cohort of medicine and surgery students, with a particular focus on child safety and maltreatment.

Methods

A cross-sectional, web-based survey was conducted through an anonymous questionnaire on the personal websites of Università Cattolica del Sacro Cuore medical students.

Results

The study included 1,166 participants, the majority of whom were experienced with child maltreatment and defensive medicine; only a small percentage was aware of the government's efforts to prevent child maltreatment and safeguard vaccination physicians. Moreover, there was no agreement on the use of telemedicine for non-serious pediatric patients or on the consequences it might have on their health. Finally, the detrimental impacts of lockdown on children's mental health are a major worry.

Conclusions

Knowledge of these themes is mainly implemented by deepening these concepts during the undergraduate studies since a high level of knowledge on child maltreatment and on the management of COVID-19 pandemic was significantly associated with clinical years of course. Specific seminars analyzing telemedicine and legislative protections concerning minors and those concerning vaccination doctors should be included in the study plan to raise awareness these concepts.

The role of parental conflict in predicting adolescent depression symptoms during the COVID-19 pandemic: A longitudinal study

The present study was designed to investigate the association and the underlying mechanism between parental conflict and adolescent depression during the COVID-19 pandemic. In a longitudinal study, a total of 655 Chinese adolescents ranging from 13 to 16 years old completed a three-wave survey (W1, W2, W3) via a survey website. The data was collected three times: March 15-20, 2020 (W1, the outbreak period of the COVID-19 pandemic in Mainland China), June 20-25, 2020 (W2, the trough stage), and December 15-20, 2020 (W3, six months after the trough stage). The SPSS 16.0 software was used to investigate the relationships among study variables. The findings showed that a double-hump effect was found for depression detection among adolescents during the pandemic, with depression rates in W1 (26.9%) and W3 (29%) were higher than that in W2 (21.9%). The parental conflict subscales of content and resolution had a greater impact on adolescent adjustment than other subscales. The parental conflict had direct and indirect impacts (through reducing family support and increasing burdensomeness) on adolescent depression symptoms in W3. It was concluded that when the COVID-19 pandemic was in a trough curve for more than six months, adolescent adjustment was significantly impacted by the pandemic, and parental conflict was an important risk factor in predicting individual adjustment. Therefore, family intervention is recommended when improving adolescent adjustment during the COVID-19 pandemic.

The silent crisis of child abuse in the COVID-19 pandemic: A scoping review

Background and Aims

The global outbreak of COVID-19 has become an international concern. The lives of children are severely affected by COVID-19 pandemic. There is evidence of a pandemic impact on violence against children. This scoping review study aimed to investigate the effects of the COVID-19 pandemic on child abuse.

Methods

We searched PubMed, Scopus, and Web of Science databases to retrieve related studies. Regarding the recent incident of COVID-19, the articles were reviewed from 2019 to June 1, 2021. The terms Child abuse and COVID-19 were used in the precise search technique of each database. The search techniques were created to work with any scientific database that used the keywords given.

Results

In the initial search of scientific databases, 568 articles were retrieved. After applying the inclusion and exclusion criteria during the screening process, 16 papers were included in the scoping review. Twelve articles have mentioned the increase of physical, psychological, and neglect types of abuse. However, sexual violence has not been reported in any of the articles. Four articles reported a reduction in the incidence of child abuse.

Conclusion

During the COVID-19 pandemic, a crisis occurred in the form of an upsurge in violence toward children, since limits made to diminish the virus, in general, increased the danger to children. Numerous factors such as stress, poverty, financial situation, history of violence, school closures, and lack of contact with support organizations contribute to this phenomenon. Social action and support needed is the right of every child in need in this critical situation.

The experience of the COVID-19 pandemic for families of infants involved with Child Protection Services for maltreatment concerns

The COVID-19 pandemic and associated physical distancing restrictions have exacerbated social, economic and health disadvantage within our communities. With increases in mental health difficulties and family violence already being seen, there is concern that the risk of child maltreatment risk may also be increased. The current study aimed to explore the experience of the COVID-19 pandemic for families identified to be at risk of child maltreatment in Victoria, Australia. Understanding the experiences of the pandemic for families already at risk is essential in identifying how to best support vulnerable parents and young children during this challenging time. Interviews were conducted with 11 parents currently involved with Child Protection Services, and nine clinicians working within a child and family health services, supporting clients with child protection involvement. Parents and clinicians described a range of pandemic related stressors including employment and financial stress, worry about infection and changes to service access. In addition, parents with children in out of home care discussed decreased access to their children resulting from physical distancing restrictions. Parents and clinicians perceived the pandemic to be having a negative impact on parent mental health, parenting stress and isolation. Although parents raised minimal concerns about the impact of the pandemic on child well-being, clinicians expressed concerns about the rise in risk factors for child maltreatment. Parents discussed a range of coping strategies which they perceived to be helpful during the pandemic, and clinicians and parents described the need for additional mental health support and support to access basic needs. The study highlights the importance of ensuring at risk families have access to parenting and mental health support throughout the pandemic and the importance of ensuring children within at-risk families are sighted and their safety assessed.

Love in the time of COVID-19: A systematic mapping review of empirical research on romantic relationships one year into the COVID-19 pandemic

The COVID-19 pandemic has affected nearly every area of daily life, including romantic relationships. With the pandemic still ongoing, this study reviewed the existing scholarly literature to document the status of empirical research on how COVID-19 has affected couples during its first year. Studies were identified through searching five databases as well as sources of gray literature. Overall, 42 studies on committed romantic relationships during the first year of the pandemic were identified. The mapping process revealed four main themes: (1) relationship quality; (2) sexuality; (3) couple daily adjustment; and (4) intimate partner violence. The findings suggest that the way romantic relationships were affected by the pandemic depends on a variety of demographic, individual, and couple-level factors. Implications include a call for both the development of evidence-based interventions that consider the current findings and further research to continue exploring the clinical implications of future findings to promote healthy intimate relationships during the ongoing global pandemic.

The COVID-19 pandemic, mask-wearing, and emotion recognition during late-childhood

Face masks are an effective and important tool to prevent the spread of COVID-19, including among children. However, occluding parts of the face can impact emotion recognition, which is fundamental to effective social interactions. Social distancing, stress, and changes to routines because of the pandemic have also altered the social landscape of children, with implications for social development. To better understand how social input and context impact emotion recognition, the current study investigated emotion recognition in children (7-12 years old, N = 131) using images of both masked and unmasked emotional faces. We also assessed a subsample of participants ("pre-pandemic subsample," n = 35) who had completed the same emotion recognition task with unmasked faces before and during the pandemic. Masking of faces was related to worse emotion recognition, with more pronounced effects for happy, sad, and fearful faces than angry and neutral faces. Masking was more strongly related to emotion recognition among children whose families reported greater social disruption in response to the pandemic. Finally, in the pre-pandemic subsample, emotion recognition of sad faces was lower during versus before the pandemic relative to other emotions. Together, findings show that occluding face parts and the broader social context (i.e., global pandemic) both impact emotion-relevant judgments in school-aged children.

Impact of the COVID-19 Pandemic on Pediatric Emergency Medicine: A Systematic Review

(1) Background and Objectives: The COVID-19 pandemic has considerably affected clinical systems, especially the emergency department (ED). A decreased number of pediatric patients and changes in disease patterns at the ED have been noted in recent research. This study investigates the real effect of the pandemic on the pediatric ED comprehensively by performing a systematic review of relevant published articles. (2) Materials and Methods: A systematic review was conducted based on a predesigned protocol. We searched PubMed and EMBASE databases for relevant articles published until 30 November 2021. Two independent reviewers extracted data by using a customized form, and any conflicts were resolved through discussion with another independent reviewer. The aggregated data were summarized and analyzed. (3) Results: A total of 25 articles discussing the impact of COVID-19 on pediatric emergencies were included after full-text evaluation. Geographic distribution analysis indicated that the majority of studies from the European continent were conducted in Italy (32%, 8/25), whereas the majority of the studies from North America were conducted in the United States (24%, 6/25). The majority of the studies included a study period of less than 6 months and mostly focused on the first half of 2020. All of the articles revealed a decline in the number of pediatric patients in the ED (100%, 25/25), and most articles mentioned a decline in infectious disease cases (56%, 14/25) and trauma cases (52%, 13/25). (4) Conclusions: The COVID-19 pandemic resulted in a decline in the number of pediatric patients in the ED, especially in the low-acuity patient group. Medical behavior changes, anti-epidemic policies, increased telemedicine use, and family financial hardship were possible factors. A decline in common pediatric infectious diseases and pediatric trauma cases was noted. Researchers should focus on potential child abuse and mental health problems during the pandemic.

Parents' perceptions of children's emotional well-being during spring 2020 COVID-19 restrictions: A qualitative study with parents of young children in England

BACKGROUND

During COVID-19 restrictions in England in spring 2020, early years settings for young children were closed to all but a small percentage of families, social contact was limited and play areas in parks were closed. Concerns were raised about the impact of these restrictions on young children's emotional well-being. The aim of this study was to explore parents' perceptions of young children's emotional well-being during these COVID-19 restrictions.

METHODS

We interviewed 20 parents of children 3-4 years due to begin school in England in September 2020. Interviews were conducted via telephone (n = 18) and video call (n = 2), audio-recorded and transcribed verbatim. Interviews focused on childcare arrangements, children's behaviour and transition to school. A sample of transcripts were coded line by line to create a coding framework, which was subsequently applied to the remaining transcripts. Coded data were then analysed using a nurture lens to develop themes and further understanding.

RESULTS

Participants were predominantly mothers (n = 16), White British (n = 10) and educated to degree level (n = 13), with half the sample living in the highest deprivation quintile in England (n = 10). Five were single parents. Three themes developed from nurturing principles were identified: creating age-appropriate explanations, understanding children's behaviour and concerns about school transition. Parents reported that their children's emotional well-being was impacted and described attempts to support their young children while looking ahead to their transition to primary school.

CONCLUSIONS

This study is one of the first to examine in-depth perceptions of COVID-19 restrictions on young children's emotional well-being. The longer term impacts are not yet understood. Although young children may be unable to understand in detail what the virus is, they undoubtedly experience the disruption it brings to their lives. The well-being of families and children needs to be nurtured as they recover from the effects of the pandemic to allow them to thrive.

Support for Families During COVID-19 in Spain: The iCygnus Online Tool for Parents

On March 14, 2020 one of the strictest confinements in Europe was imposed on the citizens of Spain. The online tool for parents, iCygnus, was designed to reduce the psychological impact generated by the pandemic on the child population (2-12 years of age) through automatic recommendations to parents based on individual responses about their parenting styles and their child's characteristics. The profiles of the 710 families indicate a higher prevalence of internalizing and externalizing behavior problems in children, as well as a relationship between punitive parenting in families where the parents lost their jobs due to the coronavirus disease (COVID-19). The usefulness of the help offered by iCygnus was evaluated after 6 weeks, and almost 80% of the families indicated that they used the recommendations and that they helped them in their relationship with their children.