Initial Challenges of Caregiving During COVID-19: Caregiver Burden, Mental Health, and the Parent-Child Relationship

Translational Research on Caregiver Reading and Playing Behaviors: Evidence from an In Vivo Community-based Intervention throughout the COVID-19 Pandemic

This study provides a rigorous assessment of a community-based early child development (ECD) intervention to understand the drivers of caregivers' reading and playing practices in a low-resourced township in South Africa. Mentors visited 157 homes biweekly (2474 observations from 2019-21; children ages 0-5), completing surveys regarding caregiver behaviors and engagement. One hundred and fifty-seven caregivers (mostly Black, Zulu women) participated in the program during this time period and completed surveys biannually on their support system (modified version of the Multidimensional Scale of Perceived Support) and ECD beliefs (modified versions of the Parental Play Beliefs Scale and the Parent Opinion Survey). Longitudinal Hierarchical Linear Model revealed that several behaviors and beliefs significantly predicted positive parenting behaviors. Regression discontinuity plots suggest that positive parenting behaviors could continue and even improve following Covid-19 shutdowns, especially in homes with more intervention visits. This paper provides translational evidence on tangible ways interventions can engage caregivers in stimulating ECD behaviors.

Nurturing care during COVID-19: a rapid review of early evidence

OBJECTIVES

The COVID-19 pandemic has brought significant changes to family life, society and essential health and other services. A rapid review of evidence was conducted to examine emerging evidence on the effects of the pandemic on three components of nurturing care, including responsive caregiving, early learning, and safety and security.

DESIGN

Two academic databases, organisational websites and reference lists were searched for original studies published between 1 January and 25 October 2020. A single reviewer completed the study selection and data extraction with verification by a second reviewer.

INTERVENTIONS

We included studies with a complete methodology and reporting on quantitative or qualitative evidence related to nurturing care during the pandemic.

PRIMARY AND SECONDARY OUTCOME MEASURES

Studies reporting on outcomes related to responsive caregiving, early learning, and safety and security were included.

RESULTS

The search yielded 4410 citations in total, and 112 studies from over 30 countries met our eligibility criteria. The early evidence base is weighted towards studies in high-income countries, studies related to caregiver mental health and those using quantitative survey designs. Studies reveal issues of concern related to increases in parent and caregiver stress and mental health difficulties during the pandemic, which was linked to harsher and less warm or responsive parenting in some studies. A relatively large number of studies examined child safety and security and indicate a reduction in maltreatment referrals. Lastly, studies suggest that fathers' engagement in caregiving increased during the early phase of the pandemic, children's outdoor play and physical activity decreased (while screen time increased), and emergency room visits for child injuries decreased.

CONCLUSION

The results highlight key evidence gaps (ie, breastfeeding support and opportunities for early learning) and suggest the need for increased support and evidence-based interventions to ensure young children and other caregivers are supported and protected during the pandemic.

Parenting Stress During COVID-19 Lockdown: Correlates with Family and Child Factors

In response to the COVID-19, a 76-day city-wide strict lockdown was imposed in Wuhan, China. This study aimed to document the family’s psychological status during the lockdown and test the role of family functioning, children’s mental health, child-parent relationship as well as parenting time during pandemic on parenting stress. The results showed that nearly 18% of the children exhibited clinical-level mental health problems. The children’s mental health and child-parent conflict fully mediated general family functioning’s impact on parenting stress. The change in childcaring time moderated the effect of the children’s mental health problems and child-parent conflict on parenting stress. Findings indicated that, during COVID-19 lockdown, children’s mental health and child-parent conflict contributed to parenting stress. More childrearing time would reduce the impact of children’s mental health on parenting stress.

The Impact of COVID-19 on Anxiety and Worries for Families of Individuals with Special Education Needs and Disabilities in the UK

COVID-19 has affected people across the world. The current study examined anxiety and worries during the first UK national lockdown in March 2020. Parents (n = 402) reported on their own anxiety and worries as well as that of their son/daughter with Special Education Needs and Disabilities (SEND) and typically developing (TD) child (n = 186) at three time points. Although both groups showed increased anxiety across the three time points, levels of anxiety in the SEND group, but not the TD siblings, were predicted by awareness about COVID-19. In addition, worries differed between the groups showing that COVID-19 impacts the wellbeing of those with SEND differently to that of their TD siblings.

Family adjustment to COVID-19 lockdown in Italy: Parental stress, coparenting, and child externalizing behavior

Evidence of psychological distress in families during COVID-19 outbreak are arising. However, the perceived changes in psychological adjustment during home confinement with respect to the period before the pandemic have not been addressed yet. Moreover, little is known about the role of coparenting and specific COVID-19 contextual variables on parental stress and children's behavioral difficulties in the Italian context. Using a cross-sectional survey, we collected data on 841 Italian parents of children aged 3-11 years with typical development during the home confinement (20th April-18th May). We analyzed levels of parental stress, coparenting, and child externalizing behaviors before and during the home confinement. Additionally, hierarchical regressions were performed to investigate predictors of parental stress and child externalizing behaviors during the lockdown. Results showed that parental stress (especially in mothers) and child externalizing behaviors increased during the lockdown period. Coparenting was a strong predictor of parental stress, together with being a mother, younger child age, less time dedicated to the child, and scarce feasibility of remote working. Besides, child externalizing behaviors were predicted by male gender, less parental time dedicated to the child, higher parental stress, and child distance learning workload. Our findings indicate a negative impact of COVID-19 lockdown in both parents and children, suggesting that positive coparenting and time dedicated to children may help to reduce the detrimental effect of pandemic restrictions on family adjustment.

Associations of lockdown stringency and duration with Google searches for mental health terms during the COVID-19 pandemic: A nine-country study

OBJECTIVES

We examined the associations of lockdown stringency and duration with Google searches for four mental health concepts (i.e., "Anxiety," "Depression," "Suicide," "Mental Health") in nine countries (i.e., Hungary, India, Iran, Italy, Paraguay, Serbia, South Africa, Spain, Turkey) during the COVID-19 pandemic.

METHODS

We retrieved national-level data for each country from Google Trends and the Global Panel Database of Pandemic Policies. In our primary analysis, we used data from all countries to estimate a set of multilevel regression models examining associations of overall lockdown stringency and lockdown duration with relative search volumes for each mental health term. We repeated the models after replacing overall lockdown stringency with each of the lockdown stringency components.

RESULTS

A negative association was found between overall lockdown stringency and "Depression." Lockdown duration and the most stringent stay-at-home requirements were negatively associated with "Anxiety." Policies that recommended or required the cancelation of public events evidenced negative associations with "Depression," whereas associations between policies that required some or all levels of schooling to close and "Depression" were positive. Policies that recommended or required workplaces to close and those that enforced quarantines on non-citizens arriving from high-risk regions or closed borders entirely were negatively associated with "Suicide."

CONCLUSIONS

Lockdown duration and some lockdown policies during the COVID-19 pandemic were generally associated with significantly lower, rather than higher, Google searches for selected mental health terms. These findings could be used alongside other evidence to develop future lockdown strategies that are sensitive to mental health issues during public health crises.

A Pandemic Perspective: Analyzing the Impact of COVID-19 on Diabetes Management and Mood Through the Lens of Location and Family Conflict

PURPOSE

The purpose of this study was to examine the influence of COVID-19 on teens' diabetes management and mood and their association with family conflict.

METHODS

One hundred and nineteen teens ages 13 to 17 (M = 15.5 ± 1.3 years, 61.3% female, 57.1% non-Hispanic White) and 119 parents (83.2% female, 75.6% married, 63.9% non-Hispanic White) enrolled in an ongoing two-site randomized behavioral clinical trial. At baseline, dyads completed the Revised Diabetes Family Conflict scale and a survey measuring the impact of COVID-19 on teens' mood and diabetes management.

RESULTS

Parent- and teen-reported impacts of COVID-19 on diabetes management and teen mood were positively correlated. Higher levels of both parent- and teen-reported family conflict were associated with greater parent-reported impact of COVID-19 on diabetes management and teen mood. In addition, teen-reported impact of COVID-19 on their mood varied by geographical location but not population density.

CONCLUSIONS

COVID-19 influenced teen diabetes management and mood, and the impact of COVID-19 was related to diabetes-related family conflict and differed by geographic location. Findings lend support for mental health interventions targeting teens with T1DM affected by COVID-19 and monitoring the long-term effects of the pandemic.

The voices of parents in child protective services: A qualitative analysis of families' struggles with COVID-19

The pandemic of the Coronavirus disease 2019 (COVID-19) has affected children and families worldwide, disrupting their daily lives and well-being. A small-scale study involving 13 parents in Child Protective Services in Estonia was conducted using in-depth, semi-structured interviews to explore parents' experiences with COVID-19 and its impact on their families' well-being. The findings indicated that one of the areas most impacted by the COVID-19 pandemic was schooling, as the implementation of remote schooling often created tensions and conflicts at home. Parents reported regression in daily functioning, attributing this to the lack of supportive services during lockdown and additional distress resulting from increased workload at home and problems with balancing home and work life. Parents were exhausted by the various problems caused by the pandemic and questioned their ability to provide their children the support they needed. Discontinuation of services intensified existing challenges for both parents and children. Furthermore, a lack of trust in Child Protective Services was identified, serving as a barrier to asking for help in times of crisis.

Mental health of children with and without special healthcare needs and of their caregivers during COVID-19: a cross-sectional study

OBJECTIVE

To describe mental health outcomes and measures of pandemic burden of children with and without special healthcare needs, and their caregivers following the second wave of the COVID-19 pandemic in Germany.

DESIGN

This is the second of a sequential series of cross-sectional online surveys conducted among caregivers of children ≤18 years since the onset of the COVID-19 pandemic, administrated between 2 April 2021 and 31 July 2021.

MAIN OUTCOME MEASURES

Child and parental mental health were assessed using the Strengths and Difficulties Questionnaire and WHO-5 Well-being index. Children with Special Healthcare Needs (CSHCN) were identified using the CSHCN-Screener. Descriptive statistics, linear and hierarchical logistic regression modelling assessed associations between parent-reported child mental health problems and measures of pandemic burden, disease complexity, caregiver mental well-being and socioeconomic status.

RESULTS

521 participants were included in the final sample. There was a high prevalence of parent-reported mental health problems in n=302 (66.7%) children, particularly in CSHCN. Among caregivers, n=372 (72.5%) screened positive for depression. Logistic regression modelling showed a strong association of child mental health problems and disease complexity, parental mental well-being, increase in family conflict and inadequate social support.

CONCLUSIONS

Our study identifies CSHCN as a particularly vulnerable group in terms of mental health outcomes. Psychosocial factors were important predictors of parent-reported child mental health problems. Policy measures should consider the importance of social support systems for vulnerable children and their families, and aim to provide accessible mental health support for caregivers.

Additional burdens of family caregivers during the COVID-19 pandemic: A qualitative analysis of social media in Germany

Caregiving is associated with various burdens for family caregivers. The COVID‐19 pandemic and the protective measures implemented to restrict public life, such as social distancing and the closure of services and educational institutions, add further challenges. Little is known about how they are perceived by family caregivers. Based on an analysis of German social media posts, the aim of this study was to explore the additional strains family caregivers experience during the pandemic. The websites of three social media services were searched using the respective search engines provided by the websites. Data from a 10‐month period (March to December 2020) were identified and examined. A total of 237 publicly available posts were included in the analysis. Seven main categories were identified using a thematic approach: care and support, deterioration of the condition of the person being cared for, psychological challenges, financial challenges, infection control, access to protective equipment, and acknowledgement of family caregivers. Family caregivers are affected by additional burdens during the pandemic, which makes the development of support and relief services tailored to this population group necessary.

Association Among Mothers’ Loneliness, Cognitive Flexibility, and Children’s Social Competence: Moderated Mediating Effect of Mothers’ Perceived Impact of COVID-19 on Daily Lives

Objectives: The purpose of this study is to explore the association among mothers’ loneliness, cognitive flexibility, and children’s social competence, and examine the moderated mediating effect of mothers’ perceived impact of COVID-19 on daily lives on the relationships.Methods: Data were collected from 315 mothers having three-to-five-year-old children through an online survey. Preliminary analyses were conducted using descriptive statistics. In addition, the mediation, moderation, and moderated mediation effects were examined using the SPSS Process macro 3.5 and the analysis considered children’s age, sex, and birth order as covariates.Results: The findings can be summarized as follows: First, mothers’ loneliness had a significant negative effects on their cognitive flexibility and children’s social competence, and the partial mediation effect of mothers’ cognitive flexibility on the association between their loneliness and children’s social competence was significant. Second, mothers’ perceived impact of COVID-19 significantly moderated the effect of their loneliness on children’s social competence. Third, mothers’ perceived impact of COVID-19 also significantly moderated the effect of their cognitive flexibility on children’s social competence. Lastly, there was a significant moderated mediation effect of mothers’ perceived impact of COVID-19 on the relationship in which mothers’ loneliness affected children’s social competence mediated by their cognitive flexibility.Conclusion: These findings empirically confirmed the association among mothers’ loneliness, cognitive flexibility, and children’s social competence in a comprehensive framework, suggesting the importance of mothers’ emotional and cognitive factors in order to understand young children’s social competence in the current pandemic situations.

Risks and Protective Factors of Hispanic Families and Their Young Children during the COVID-19 Pandemic

This study examines the risk-related factors during the pandemic and protective factors that might reduce its effects on family functioning in a sample of 161 low-income Hispanic parents in the United States, recruited from an ongoing longitudinal intervention study. They were surveyed about family functioning six months into the pandemic. We focused on the associations between social (e.g., exposure to the virus) and economic (e.g., job loss) pandemic-related risks on parental stress, parenting, and children's socioemotional problems and skills, as well as the degree to which coparenting support, parents' positivity, economic support, and access to services and information mitigated (protected) the negative effects of these stressors on family functioning. We found that increases in economic risk were associated with more child competence skills, whereas increases in social risk were associated with less parental engagement. Positivity and economic support moderated the effects of economic risk on parental stress and engagement. These findings show that to intervene effectively with low-income Hispanic families, we need to strengthen and support the resources for coping with adversity.

Adult student perspectives toward housing during COVID-19

Precarious housing conditions are on the rise in many developing economies, which has resulted in increasing segmentation between population groups with different socioeconomic backgrounds, and in differentiated access to life chances. With the onset of the COVID-19 pandemic, and its subsequent lockdowns, the relation between learning and housing conditions has become crucial for understanding the adult student's learning experience and well-being. However, knowledge about this relation is limited. This study employs the concept of dwelling to investigate how housing-related precarities may impact upon experiences of students during COVID-19 induced stay-at-home orders. The study draws on fifteen in-depth interviews and a Zoom Video Conferencing (ZVC)-aided focus group in the Ashaiman Municipality in Ghana, to explore students' perspectives on precarious housing conditions, well-being and learning. Findings reveal that experiences of precarious housing conditions can be complicated and compromised in diverse ways related to quality learning environment, financial, and personal well-being. Through ZVC-aided focus groups, participants defined housing suitable for learning - not purely in academic terms but in relation to housing characteristics, the neighbourhood environment, the built environment, and the social relations of learning. The study finds that students perceive an array of economic, social and geographic barriers to learning and that these perspectives deserve attention in adult student housing policy debate.

Child Disruptions, Remote Learning, and Parent Mental Health during the COVID-19 Pandemic

New York City (NYC) was an epicenter of the COVID-19 pandemic, which resulted in broad economic, social, and emotional consequences in the lives of individuals. The current study examined associations between pandemic-related stressors and adverse mental health symptoms among NYC parents/caregivers. Community-based participatory research was used to develop a survey, and logistic regression models were utilized to assess associations between factors including disruptions in child routines and remote learning, and parent-reported symptoms of stress, anxiety, depression, and post-traumatic stress disorder (PTSD). Some 91.0% of parents reported stress and 41.2, 26.6, and 33.7% reported symptoms of anxiety, depression, and PTSD, respectively. Most parents (87.6%) reported cancellation of at least one child activity. Of the parents, 60.3% reported that their children participated in remote learning and the majority (70.3%) reported feeling overwhelmed by it. Having more cancelled child activities was associated with higher odds of reported mental health symptoms, with not being able to play outside associated with higher odds of anxiety (1.80 (1.26, 2.58), p = 0.001), depression (1.93 (1.29, 2.91), p = 0.002), PTSD (1.64 (1.13, 2.39), p = 0.009), and stress (2.34 (1.27, 4.44), p = 0.008). Feeling overwhelmed by remote learning was also associated with higher odds of all four outcomes. Pre-existing mental illness, lower resilience scores, and lower socioeconomic status emerged as additional factors associated with symptoms of mental illness. These findings highlight the importance of resources to minimize adverse psychological effects among vulnerable families.

Motherhood in Academia during the COVID-19 Pandemic: An International Online Photovoice Study Addressing Issues of Equity and Inclusion in Higher Education

Combining motherhood and academic work in higher education has been discussed for decades with the pandemic further exposing the inequalities. This crisis has significantly impacted the daily life of mothers in academia as they devote more time to keep their careers on track, produce papers, and take on other parenting and schooling responsibilities. This paper employs photovoice as an online methodology to document the real-life experiences of 68 women from nine countries who work and parent children in the sudden transition to remote working and learning environments. By explaining the photographs from their perspective, the participants in this study were able to capture their lived experiences, discuss working from home while guiding children in online learning, and create suggestions for ways academic institutions can alleviate gender inequality. The article explores the critical issues of academic work and childrearing drawing international attention to address issues of equity and inclusion in higher education among researchers, policymakers, and institutions.

A cross-sectional investigation of psychosocial stress factors in German families with children aged 0-3 years during the COVID-19 pandemic: initial results of the CoronabaBY study

BACKGROUND

Psychosocial stress during the COVID-19 pandemic is increasing particularly in parents. Although being specifically vulnerable to negative environmental exposures, research on psychosocial stress factors in infants' and toddlers' families during the pandemic is so far sparse. The CoronabaBY study investigates the perceived pandemic burden, parenting stress and parent and child mental health problems in families with children aged 0-3 years in Bavaria, Southern Germany. Further, the relationships between these psychosocial stressors are examined and sociodemographic characteristics that may be predictive of these factors will be explored.

METHODS

Participants were cross-sectionally surveyed via smartphone app. Standardized questionnaires on perceived pandemic burden, parenting stress, parental symptoms of depression and anxiety, infants' crying, sleeping and feeding problems or toddlers' emotional and behavioral problems were applied.

RESULTS

N = 991 parents (Mage = 33.7 years, SD = 4.5; 93.7% mothers, 91.5% born in Germany) with infants (n = 554; Mage = 5.9 months, SD = 3.0) or toddlers (n = 435; Mage = 25.9 months, SD = 6.5) participated in the first half-year of 2021. Sixty-five percent of the parents perceived a high pandemic burden, 37.7% experienced parenting stress and 24.1% showed affective symptoms (anxiety: 30.1%, depression: 18.5%). Feeding problems, crying/ sleeping problems and multiple regulatory problems were found in 34.8%, 26.2% and 13.5% of the infants, respectively. Amongst toddlers, 8.5% showed noticeable behavior and emotional problems. Children`s mental health problems correlated moderately with parenting stress and parental affective symptoms and weakly with perceived pandemic burden. A lower financial status, higher parental education and increasing child age were significant but weak predictors for higher parenting stress, affective symptoms and higher psychological problems in children.

CONCLUSIONS

A majority of the surveyed families with infants and toddlers experience the pandemic as stressful. The main challenges are parental affective symptoms and limited resources for childcare due to parenting stress. Overall, infants and toddlers show similar levels of mental health problems when being compared to pre-pandemic studies, but staggered detrimental effects on children`s mental health might occur if the stressful conditions persist. This is already indicated by correlations between parental and child psychosocial stress factors.

Trauma-Directed Interaction (TDI): An Adaptation to Parent-Child Interaction Therapy for Families with a History of Trauma

Parent-Child Interaction Therapy (PCIT) is one of the strongest evidence-based treatments available for young children and their families. Research has supported the use of PCIT for children with a history of trauma; however, the treatment does not directly address trauma in the child. PCIT is a dyadic treatment; yet, the impact of the carer’s trauma on the carer-child relationship is not assessed or incorporated into treatment. For these reasons, therapists, families, agencies, and funders tend to view PCIT as a trauma treatment with skepticism. PCIT therapists who currently address trauma within the intervention do so without a standardized approach. Trauma-Directed Interaction (TDI) is an adaptation developed to directly address these concerns. TDI maintains the key elements and theoretical underpinnings of PCIT while adding sessions to cover psychoeducation about trauma, carer response to a child’s trauma reactions (SAFE skills), and coping skills to aid both the child and the carer to manage trauma activators (COPE skills). The TDI module creates a consistent strategy for PCIT therapists to address trauma, thus allowing research and replication which will advance the dual fields of PCIT and family trauma. The theoretical conceptualization of TDI is presented along with next steps in its evaluation.

Family Thriving During COVID-19 and the Benefits for Children's Well-Being

Although the COVID-19 pandemic has raised deserved concern regarding adverse impacts on parents' and children's mental health, regulations like "sheltering-in-place" may have afforded parents novel opportunities to foster positive family connections, thereby bolstering well-being. Using latent profile analysis (LPA), we (a) distinguished family thriving during shelter-in-place (May-June 2020) from other patterns of family functioning, (b) tested potential predictors of family functioning profiles, and (c) examined if family thriving predicted subsequent child adjustment (September-October 2020). 449 parents in two-parent U.S. families with children aged 2-18 years completed online surveys assessing (a) parent-child relationship quality, parents' positive psychological adjustment, children's emotional well-being, and parenting efficacy and satisfaction as family functioning indicators, (b) financial, marital, parental psychosocial assets, and child (age, gender, and temperament) predictors of family functioning, and (c) child adjustment. LPA identified four family functioning profiles: Thriving, Managing, Struggling, and Distressed. Thriving families evinced higher scores on all functioning indicators. Logistic regressions revealed that parents in Thriving families reported significantly lower financial anxiety, less dissatisfaction with partner's help, less child emotionality, and greater use of cognitive reappraisal, as well as more positive child adjustment in Fall 2020. These findings underscore the multidimensional nature of coping and well-being during COVID-19. Utilizing these levers to promote mental health in families languishing during comparable future crises could promote resilience, thereby protecting children's well-being.

The COV-ED Survey: exploring the impact of learning and teaching from home on parent/carers' and teachers' mental health and wellbeing during COVID-19 lockdown

BACKGROUND

Following the emergence of COVID-19 in the UK, on March 18^th 2020 the majority of schools in England closed and families and teachers were tasked with providing educational support for children and adolescents within the home environment. Little is known, however, regarding the impact of remote teaching and learning on the mental wellbeing of parents/carers and teaching staff.

METHODS

The Coronavirus Education (COV-ED) online survey explored the practicalities of learning and teaching from home for 329 parents/carers and 117 teachers of 11-15 year old adolescents in England, during June/July 2020, and the associated impact on their mental wellbeing. Participants were recruited through schools and via University of Warwick social media channels. Data was analysed using a series of Multiple Linear and Multivariate Regressions.

RESULTS

Despite coping well with the challenges of remote learning, a third of teachers reported below average mental wellbeing on the Warwick-Edinburgh Mental Wellbeing Scale. Multivariate regression revealed that wellbeing was associated with access to resources and confidence to teach from home. Almost half of parents/carers surveyed reported below average wellbeing. Multivariate regression revealed that poor wellbeing was more common in those who were also working from home and who lacked support for their own mental health. Concerns about their child's mental health and lack of access to electronic devices and workspace were also significantly associated with the mental wellbeing of parents/carers.

CONCLUSIONS

Whilst young people's mental health and wellbeing has, and continues to be a national priority, the mental health and wellbeing of the families and teachers supporting them has not previously been explored. Our survey population was of predominantly white British heritage, female and living in the West Midlands UK, therefore, findings should be treated with caution. Findings provide a snapshot of factors that may be of significance to families and schools in supporting the mental wellbeing of those tasked with learning from home. They will help i) increase knowledge and awareness with regard to future support of families and teachers during similar crises; ii) enable the design and development of practical solutions in the delivery of remote teaching and learning; and, iii) help address the mental wellbeing needs of those tasked with supporting adolescents.

Caregiver decision-making on young child schooling/care in the face of COVID-19: The influence of child, caregiver, and systemic factors

In March 2020, U.S. schools and daycares largely shut down to manage the novel COVID-19 pandemic. As the country made efforts to reopen the economy, American parents faced difficult decisions regarding returning to work and securing schooling and care for their young children. During the summer and fall of 2020, caregivers (N = 1655) of children (N = 2408; ages 0 - 12 years) completed questionnaires assessing their decision-making process regarding their children's daycare or schooling situation. A mixed method approach (i.e., qualitative, quantitative assessments) was utilized. Outcomes indicated three main themes that impacted caregivers' choices: child factors, caregiver factors, and systemic factors. Caregivers experienced high levels of stress while worrying about their child's and family's health, job responsibilities, and risk of COVID-19 infection rates in their areas. Continued assessment of families and children during this time is warranted.

A latent profile analysis of the COVID-19 Stressors Scale

OBJECTIVE

Research from the early months of the SARS-Cov-2 (COVID-19) pandemic identifies many COVID-related stressors, including fears of infection, disruptions to work/learning and daily self-care routines, and lack of access to reliable information and resources. Measuring the complex, ongoing nature of the stressors related to COVID-19 is of great practical utility, as is investigating how people may differently respond to stressors. The objective of the present study was to identify the possible profiles of COVID-19-related stressors using a recently developed measure, the COVID-19 Stressors Scale.

METHOD

The present study sampled individuals from Amazon Mechanical Turk (MTurk; n = 1,530) and examined the COVID-19 Stressors Scale with a latent profile analysis.

RESULTS

Using a latent profile analysis, three profiles of COVID-19-related stressors were identified, Moderate Disruption Distress, High Disruption Distress, and Identity and Role Strain.

CONCLUSIONS

Based on the results of the study, the authors encourage researchers to differentiate types of stressors profiles of individual experiences COVID-19 or future pandemics. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Mental health impact of the Covid-19 pandemic on parents in high-risk, low income communities

BACKGROUND

COVID-19 has spread across the globe, resulting in significant changes in virtually every aspect of life. Mitigation efforts, like shelter-in-place orders, have taken a particular toll on parents who have had to navigate disruptions in work and/or school schedules. Research from high-income countries demonstrates increased parental anxiety, stress, depression, and burnout resulting from the pandemic. It is unclear if these outcomes are the same for parents in high-risk communities in low-income countries where pre-pandemic conditions were deleterious. This study addresses this gap and examines the mental health impact of the pandemic on parents in high-risk communities in Guatemala.

METHODS

A total of 330 individuals from 11 districts in Guatemala participated in the study and were assessed for sociodemographic characteristics and mental health impairment. Chi-squares were conducted for bivariate analysis. Multivariate analysis was conducted using binary logistic regression.

RESULTS

Bivariate analysis revealed differences between groups on burnout, with parents more often reporting feelings of burnout than nonparents (p < .001). Binary regression demonstrated that non-parents were 70% less likely to endorse feelings of stress as compared to parents (OR = .285; p = .014).

CONCLUSION

Our findings underscore the importance of identifying the unique mental health impact of the COVID 19 pandemic on parents in high-risk communities. In high-risk communities, parental stress is a pressing problem that, if unaddressed, has the potential to result in even greater psychological distress and child maltreatment. Training community healthcare providers to assess and address parental stress can lead to increased community capacity and the development of a community-based network to serve as a first line of support for parents and their children.

COVID-19 Vaccination and Mental Health: A Difference-In-Difference Analysis of the Understanding America Study

INTRODUCTION

Mental health problems increased during the COVID-19 pandemic. The knowledge that one is less at risk after being vaccinated may alleviate distress, but this hypothesis remains unexplored. This study tests whether psychological distress declined in those vaccinated against COVID-19 in the U.S. and whether changes in anticipatory fears mediated any association.

METHODS

A nationally representative cohort of U.S. adults (N=8,090) in the Understanding America Study were interviewed regularly from March 2020 to June 2021 (28 waves). Difference-in-differences regression tested whether vaccination reduced distress (Patient Health Questionnaire 4 scores), with mediation analysis used to identify potential mechanisms, including perceived risks of infection, hospitalization, and death.

RESULTS

Vaccination was associated with a 0.04-SD decline in distress (95% CI= -0.07, -0.02). Vaccination was associated with a 7.77-percentage point reduction in perceived risk of infection (95% CI= -8.62, -6.92), a 6.91-point reduction in perceived risk of hospitalization (95% CI= -7.72, -6.10), and a 4.68-point reduction in perceived risk of death (95% CI= -5.32, -4.04). Including risk perceptions decreased the vaccination-distress association by 25%. Event study models suggest that vaccinated and never vaccinated respondents followed similar Patient Health Questionnaire 4 trends before vaccination, diverging significantly after vaccination. Analyses were robust to individual and wave fixed effects and time-varying controls. The effect of vaccination on distress varied by race/ethnicity, with the largest declines observed among American Indian and Alaska Native individuals (β= -0.20, p<0.05, 95% CI= -0.36, -0.03).

CONCLUSIONS

COVID-19 vaccination was associated with declines in distress and perceived risks of infection, hospitalization, and death. Vaccination campaigns could promote these additional benefits of receiving the COVID-19 vaccine.

A Preliminary Study of COVID-19-related Stressors, Parenting Stress, and Parental Psychological Well-being Among Parents of School-age Children

The COVID-19 pandemic has had substantial health, social, and economic effects on families. Consequent lockdowns and school closures heightened the burden on parents of school-age children. Many parents, while working from home, had to care for their children with restricted access to caregiver resources and to support their children's education through homeschooling or remote learning provided by their schools. These duties created challenges and pressures on parents. Using online survey data collected from 197 parents of school-age (Prek-12) children during the first three months of the COVID-19 pandemic in the U.S., this preliminary study examined the relations among COVID-19-related stressors, including fear of COVID-19 and problems associated with school closures, parenting stress, and parental psychological well-being. Fear of COVID-19 and various issues associated with school closures were related to parenting stress and parental well-being. Parents with less instrumental and emotional support reported higher levels of parenting stress and lower levels of psychological well-being. The results of hierarchical multiple regressions revealed that parenting stress was the strongest predictor of parental psychological distress. Social support was associated with parental well-being but did not mediate the relation between parenting stress and parental well-being. The findings suggest that parenting stress during the COVID-19 lockdowns might take a toll on the mental health of parents of school-age children. Parents of school-age children need multiple layers of support, including targeted support addressing stressors related to school closures and parenting under quarantine.

Caregivers' Difficulty in Managing Smartphone Use of Children with Attention-Deficit/Hyperactivity Disorder during the COVID-19 Pandemic: Relationships with Caregiver and Children Factors

This study examined the difficulty encountered by caregivers of children with attention-deficit/hyperactivity disorder (ADHD) in managing children’s smartphone use during the coronavirus disease 2019 (COVID-19) pandemic and the caregiver- and children-related factors that influence this difficulty. In total, 252 caregivers of children with ADHD were recruited into this study. The caregivers completed a research questionnaire to provide data regarding the difficulty they encountered in managing the smartphone use of children during the COVID-19 pandemic, their general mental health and parenting styles, and the ADHD and oppositional defiant disorder (ODD) symptoms of the children they are caring for. The results indicated that almost 45% of the caregivers of children with ADHD sometimes or often found it difficult to manage the smartphone use of children with ADHD during the COVID-19 pandemic. For the caregivers, a short duration of education, poor general mental health, unaffectionate/uncaring and overprotective parenting styles, older children, and inattention and ODD symptoms were significantly associated with increased difficulty in managing their children’s smartphone use during the COVID-19 pandemic. On the basis of the relevant factors identified in this study, an intervention should be developed to enhance the skills of caregivers of children with ADHD with respect to the management of children’s smartphone use during the COVID-19 pandemic.

Children academic stress, mothers’ anxiety and Mother-Child relationship during COVID-19 in China

In this study, the researcher aims to examine and provide some knowledge of COVID-19 impact on mother-child relationship, children perceived academic stress and mothers' anxiety among families in mainland China (N = 1512). The researcher confirms that mental health symptoms resulting from Covid-19 are significant, with extensive impacts on mothers' anxieties, children's academic stress, and mother-child conflict and closeness. The researcher also show significant link between students' tremendous academic stress and students completing their final grade. The author highlights the need for health policies to expand families' psychological well-being especially in crisis time.

"Did You Bring It Home with You?" A Qualitative Investigation of the Impacts of the COVID-19 Pandemic on Victorian Frontline Healthcare Workers and Their Families

Concerns regarding the physical and mental health impacts of frontline healthcare roles during the COVID-19 pandemic have been well documented, but the impacts on family functioning remain unclear. This study provides a unique contribution to the literature by considering the impacts of the COVID-19 pandemic on frontline healthcare workers and their families. Thirty-nine frontline healthcare workers from Victoria, Australia, who were parents to at least one child under 18 were interviewed. Data were analysed using reflexive thematic analysis. Five superordinate and 14 subordinate themes were identified. Themes included more family time during lockdowns, but at a cost; changes in family responsibilities and routines; managing increased demands; healthcare workers hypervigilance and fear of bringing COVID-19 home to their family members; ways in which families worked to “get through it”. While efforts have been made by many healthcare organisations to support their workers during this challenging time, the changes in family functioning observed by participants suggest that more could be done for this vulnerable cohort, particularly with respect to family support.

Caregivers' perceived changes in engaged time with preschool-aged children during COVID-19: Familial correlates and relations to children's learning behavior and emotional distress

The COVID-19 pandemic and its resulting containment measures have forced many children and their caregivers around the world to spend unprecedented amounts of time at home. Based on a sample of 764 households with preschool-aged children in Wuhan, China, where the pandemic began, this study examined how primary caregivers perceived changes in the amount of time spent engaging with their children (i.e., engaged time) from the start of the pandemic and whether these changes were associated with children's learning behavior and emotional distress. The results showed that primary caregivers generally perceived increases in the amount of engaged time spent on indoor activities with their children but decreases in the amount of engaged time spent playing with their children outdoors. A bigger family size and greater loss of family income during the pandemic were associated with bigger perceived increases in caregivers' engaged time spent on indoor activities, whilst a higher level of parental education was associated with bigger perceived decreases in engaged time spent playing with children outdoors. The family's poorer physical health and higher levels of chaos during the pandemic were related to smaller perceived increases in caregivers' engaged time spent on educational activities. Finally, although bigger perceived increases in caregivers' indoor engaged time (e.g., time spent on educational activities) were associated with higher levels of positive learning behavior and fewer symptoms of anxiety and withdrawal in the children, bigger perceived decreases in outdoor play time were associated with fewer symptoms of anxiety and withdrawal. These findings offer valuable insights into caregivers' allocation of engaged time with their preschool-aged children during the COVID-19 pandemic.

Maternal Anxiety Symptoms and Chinese Adolescents' Mental Health During the COVID-19 Pandemic: The Protective Role of Adolescents' Self-Compassion

The COVID-19 outbreak triggered dramatic changes to family life. Parents, especially mothers, were found to experience more psychological distress during the pandemic, which may have had an impact on their children's mental health. The primary goal of this study was to examine the potential protective role of adolescents' self-compassion in the relationship between maternal anxiety and adolescents' mental health during the COVID-19 pandemic. Participants included 5,720 adolescents (48.9% girls; M age = 11.60, SD age = 1.36) and their mothers from Zhengzhou city, Henan province, in Mainland China. Adolescents reported their level of self-compassion, PTSD symptoms, and negative affect during the COVID-19 pandemic. Mothers reported their own anxiety symptoms and their children's depression and anxiety symptoms. Results indicated that older female adolescents reported higher levels of PTSD symptoms and negative affect and lower levels of self-compassion than their counterparts. Maternal anxiety during the COVID-19 pandemic was consistently positively associated with adolescents' psychological maladjustment. These associations were buffered by adolescents' self-compassion. Specifically, adolescents with higher levels of self-compassion were found to be less psychologically affected by their mothers' anxiety during the COVID-19 pandemic. Findings highlighted the possibility of improving adolescents' mental health through fostering their self-compassion during the COVID-19 pandemic.

The COVID-19 Pandemic as a Threat Multiplier for Childhood Health Disparities: Evidence from St. Louis, MO

The COVID-19 pandemic has highlighted socioeconomic and racial health disparities in the USA. In this study, we examined the COVID-19 pandemic as a threat multiplier for childhood health disparities by evaluating health behavior changes among urban St. Louis, MO, children (ages 6-14) during the COVID-19 pandemic. From 27 October to 10 December 2020, 122 parents/guardians reported on their children's health behaviors (Eating, Sleeping, Physical activity, Time outside, Time with friends in-person, Time with friends remotely, Time using media for educational proposes, Time using media for non-educational proposes, and Social connectedness) prior to and during the COVID-19 pandemic. We ran K-means cluster analyses to identify distinct health behavior cluster profiles. Relative risks were determined to evaluate behavioral differences between the two clusters. Two distinct cluster profiles were identified: a High Impact profile (n = 49) and a Moderate Impact profile (n = 73). Children in the High Impact cluster had a greater risk of being diagnosed with COVID-19, developed worsened eating habits (RR = 2.10; 95% CI = 1.50-2.93), spent less time sleeping, and spent less time outdoors (RR = 1.55; 95% CI = 1.03-2.43) than the Moderate Impact cluster. The High Impact cluster was more likely to include Black children and children from single-adult households than the Moderate Impact cluster (both p < 0.05). Our findings suggest that the COVID-19 pandemic may be a threat multiplier for childhood health disparities. Further research is needed to better understand the long-term effects of the COVID-19 pandemic on children's health.

Age differences in the association between loneliness and anxiety symptoms during the COVID-19 pandemic

Loneliness and associated mental health problems are of particular concern during the COVID-19 pandemic due to physical distancing and lockdown restrictions. Loneliness is most common among young adults and women during the pandemic, but it is unclear if the association between loneliness and mental health problems, notably anxiety, is strongest in these groups. The objective of this study was to examine whether the association between loneliness and anxiety differed by age and/or gender during the pandemic. We analyzed data from a multi-wave national online survey of Canadians aged 18+ years from May 2020 to March 2021 (n = 7,021). Multivariable modified least-squares regression was used to examine whether the association between loneliness and moderate to severe anxiety symptoms (GAD-7 10+) differed by age and/or gender on the additive scale, controlling for socio-demographic factors, depression, hopefulness, and survey wave. Age significantly moderated the association between loneliness and anxiety symptoms while gender did not. Loneliness was associated with anxiety symptoms for all age groups, but the association was not as strong among those aged 70+ years compared to other age groups. Evidence-based loneliness interventions that target younger adults are needed to mitigate the mental health effects of infectious disease events such as COVID-19.

Psychiatric distress in family caregivers of patients with COVID-19

PURPOSE

Many COVID-19 patients with low to moderate disease severity were cared for at home by family members. Caring for relatives with COVID-19 could have a psychiatric disorder for informal caregivers. Therefore, this study aimed to investigate the psychiatric disorders of family caregivers of relatives with COVID-19, in Iran.

METHODS

This online survey was conducted with 350 family caregivers over 18 years from April to July 2020, which was guided by the STROBE checklist. The study survey consisted of socio-demographic items, 7-items fear of COVID-19 scale, and a 21-item version of the depression, anxiety, and stress scales.

RESULTS

The mean (standard deviation) scores for depression, anxiety, and stress were 20 (0.40), 19.52 (0.39), and 19.72 (0.35), respectively, moreover for fear of COVID-19 was 20.33 (0.43). Of all family caregivers, 77.75%, 75%, and 80% had depression, anxiety, and stress, respectively. Sixty-nine percent of caregivers had fear with moderate to high severity. Being younger, married, having a health-related occupation, not exercising, and high monthly salary were significant predictors of the total score of depression, anxiety, and stress scale (P < 0.05). Further, being married, having a health-related occupation, and not exercising, having comorbidity, high income, and being younger were independent predictors of fear of COVID-19 (P < 0.05). Only 32% and 33% of the variance of total depression, anxiety, and stress, and fear of COVID-19 scores were predicted by the studied variables (p < 0.001).

CONCLUSION

Our study demonstrated the high prevalence of psychiatric disorders in family caregivers, which requires swift and comprehensive attention from authorities.

School Closures During Social Lockdown and Mental Health, Health Behaviors, and Well-being Among Children and Adolescents During the First COVID-19 Wave: A Systematic Review

IMPORTANCE

School closures as part of broader social lockdown measures during the COVID-19 pandemic may be associated with the health and well-being of children and adolescents.

OBJECTIVE

To review published reports on the association of school closures during broader social lockdown with mental health, health behaviors, and well-being in children and adolescents aged 0 to 19 years, excluding associations with transmission of infection.

EVIDENCE REVIEW

Eleven databases were searched from inception to September 2020, and machine learning was applied for screening articles. A total of 16 817 records were screened, 151 were reviewed in full text, and 36 studies were included. Quality assessment was tailored to study type. A narrative synthesis of results was undertaken because data did not allow meta-analysis.

FINDINGS

A total of 36 studies from 11 countries were identified, involving a total of 79 781 children and adolescents and 18 028 parents, which occurred during the first wave of the COVID-19 pandemic (February to July 2020). All evaluated school closure as part of broader social lockdown during the first COVID-19 wave, and the duration of school closure ranged from 1 week to 3 months. Of those, 9 (25%) were longitudinal pre-post studies, 5 (14%) were cohort, 21 (58%) were cross-sectional, and 1 (3%) was a modeling study. Thirteen studies (36%) were high quality, 17 (47%) were medium quality, and 6 (17%) were low quality. Twenty-three studies (64%) were published, 8 (22%) were online reports, and 5 (14%) were preprints. Twenty-five studies (69%) concerning mental health identified associations across emotional, behavioral, and restlessness/inattention problems; 18% to 60% of children and adolescents scored above risk thresholds for distress, particularly anxiety and depressive symptoms, and 2 studies reported no significant association with suicide. Three studies reported that child protection referrals were lower than expected number of referrals originating in schools. Three studies suggested higher screen time usage, 2 studies reported greater social media use, and 6 studies reported lower physical activity. Studies on sleep (10 studies) and diet (5 studies) provided inconclusive evidence on harms.

CONCLUSIONS AND RELEVANCE

In this narrative synthesis of reports from the first wave of the COVID-19 pandemic, studies of short-term school closures as part of social lockdown measures reported adverse mental health symptoms and health behaviors among children and adolescents. Associations between school closure and health outcomes and behaviors could not be separated from broader lockdown measures.

Belastungen, positive Veränderungen und Ressourcen von Familien in der COVID-19-Pandemie

Zusammenfassung. Theoretischer Hintergrund: Die Maßnahmen zur Eindämmung der COVID-19-Pandemie stellten Familien vor Herausforderungen. Es fehlt an Studien, welche die umfassende Vielfalt der subjektiven Erfahrungen abbilden. Fragestellung: Ziel ist, Belastungen, positive Veränderungen und Ressourcen in Familien zu erfassen. Methode: 4 967 Eltern (87.6 % weiblich, 86.7 % mit Hochschulreife) minderjähriger Kinder (0 – 17 Jahre) nahmen an einer Online-Erhebung im August 2020 teil. Belastungen, positive Veränderungen und Ressourcen während der Pandemie wurden durch offene Fragen erfasst. Auf Basis der Freitextantworten wurde ein Kategoriensystem entwickelt und ausgewertet. Ergebnisse: Die Vereinbarkeit von Beruf und Privatleben (12 %), Sorgen um die Entwicklung der Pandemie (11 %) und eingeschränkte Betreuung und schulische Bildung (9 %) wurden am häufigsten als Belastungen genannt. Positive Veränderungen waren vermehrte Wertschätzung, Dankbarkeit und neue Einstellungen (16 %), engere Beziehungen innerhalb der Familie (13 %) und mehr Zeit mit Menschen (11 %). Wichtige Ressourcen für Familien waren das soziale Miteinander innerhalb der Familie (19 %) und positive Aktivitäten (13 %). Diskussion und Schlussfolgerung: Ansatzpunkte für familienzentrierte Präventionsmaßnahmen sind die Offenhaltung von Betreuungseinrichtungen, eine Flexibilisierung der Arbeitssituation, eine fortlaufende Aufklärung über notwendige Maßnahmen, Stärkung digitaler Unterstützungsangebote einschließlich der Verbesserung der Medienkompetenz, die Ermöglichung von Freizeitaktivitäten, sowie die Verbesserung psychosozialer Unterstützungsmaßnahmen.

The impact of workplace safety and customer misbehavior on supermarket workers' stress and psychological distress during the COVID-19 pandemic

Purpose

Essential frontline workers in the retail sector face increased exposure risks to coronavirus disease 2019 (COVID-19) due to frequent interactions with the general public. Often these interactions are fraught with controversies over public safety protocols. The purpose of this study is to examine the impacts of frontline workers' perceptions of workplace safety and customer misbehaviors on their stress and psychological distress to inform managing workplace health and safety during public health crises.

Design/methodology/approach

The authors conducted an online survey of 3,344 supermarket workers in the state of Arizona (US) during the state's first COVID-19 pandemic wave in July 2020. Measures included mental health distress, and perceptions of workplace safety and customer behaviors. The authors utilized a mixed-methods approach combining multiple regression analyses with qualitative analyses of open-ended comments.

Findings

Workers reported high rates of stress and psychological distress. Increases in mental health morbidity were correlated with perceptions of being unsafe in the workplace and concerns about negative customer encounters. Qualitative analyses reveal frustration with management's efforts to reduce risks intertwined with feelings of being unsafe and vulnerable to threatening customer encounters.

Practical implications

The findings highlight the need to provide and enforce clear safety guidelines, including how to manage potential hostile customer interactions, to promote positive health workplace management during a pandemic.

Originality/value

This study is among the first to assess the COVID-19 pandemic's impact on the mental health of non-health care frontline essential workers and presents novel insights regarding perceived customer misbehavior and need for management support and guidance in a public health crisis.

Harnessing Virtual Mom Power: Process and Outcomes of a Pilot Telehealth Adaptation of a Multifamily, Attachment-Based Intervention

Objective

The COVID-19 pandemic and mitigation strategies amplified racial and income-based health disparities, profoundly shifted family life, and altered delivery systems for support services. We report pilot data from a telehealth adaptation of Mom Power, an evidence-based, attachment-informed multifamily preventive intervention (clinicaltrials.gov: de-identified).

Method

Virtual Mom Power (VMP), adapted for economically marginalized, predominantly Black mothers and their young children (n = 9) was implemented in New Orleans, an early COVID-19 hotspot with an entrenched history of structural racism and trauma. We outline our approach to adaptation of curriculum and service delivery, using a trauma-informed lens.

Results

Maternal reports of maternal and child functioning from pre to post were consistent with improvements in maternal depressive and posttraumatic stress symptoms and child competence, comparable to outcomes from in-person trials. Feasibility and acceptability data were strong.

Discussion

Preliminary results and reflections on process suggest that telehealth service delivery of a multifamily preventive intervention, with attention to decreasing barriers to online access and consideration of culture and context, facilitated engagement while maintaining fidelity and effects on intervention targets. Future research using larger samples, randomized controlled design, and multi-method assessment should continue to guide dissemination of reflective, group-based telehealth parenting programs.

Implications of the COVID-19 Pandemic on Children and Adolescents: Cognitive and Emotional Representations

The present research investigated children and adolescents' explicit and spontaneous representation of the COVID-19 pandemic and their related emotions, cognitions, and coping strategies. We explored the self-reported protective factors and coping mechanisms, in addition to similar attributional emotional experiences, i.e., the ways participants evaluated others' pandemic experiences. Our sample consisted of 155 children and adolescents aged 10 to 13 (M = 10.70, SD = 0.85, 56.1% females). We designed a 12-item survey and analyzed our data using both qualitative and quantitative methods. Our findings suggested that most children and adolescents associated masks with the thought of the novel coronavirus, and the most frequently associated emotion was sadness (45.2%), followed by fear (17.4%). Generally, participants reported a medium level of perceived adverse effects of the pandemic, mainly because their regular physical school classes moved to the online setting. We also found a significant association between children's self-reported levels of harmful effects of the pandemic and perceived adverse effects on their families. Most participants expressed their dissatisfaction concerning online school classes, primarily due to poor online interaction. In our sample, the children and adolescents reported positive thoughts and family relationships as their primary coping mechanisms during the pandemic, suggesting similar perceived coping mechanisms in the others around them. Finally, more than half of the participants considered that the COVID-19 pandemic had no positive effects, while 40% considered the increased time spent with their families the primary positive consequences following the COVID-19 health crisis. Results are discussed regarding their implications concerning healthcare, social, and educational policies.

Psychodrama with persons with dementia on zoom: Proof of concept

COVID-19 pandemic and subsequent lockdowns created a global public health crisis generating mental health problems including social isolation, stress, and anxiety especially for persons with dementia and their carers. This article reports on the use of digital technology to maintain social connectivity via a virtual group session that focused on the topic of "what is home." Participants in this session included 16 day-care center clients representing an immigrant community identified with mild to moderate cognitive impairment. A trained psychodrama therapist conducted the virtual group meeting based on five key techniques: spectrogram, role reversal, doubling, mirroring, and soliloquy. The NVivo software was used for the qualitative analysis of the transcribed video recording to identify key themes based on grounded theory methodology. Zooming from home, clients engaged in significant social interaction. Findings of the NVivo analysis identified the following themes of "what is home": Emotions and home, Home is family, Home is community, and Reminiscence (with objects and traditions). Findings suggest that digital interactive technologies, like Zoom, enhance social connectivity thus mitigating the negative impact of social isolation for persons with dementia especially during pandemic lockdowns. Our pilot findings based on virtual group meetings from home demonstrate that participants can express significant emotive capacity and enhanced connectivity with one another despite a diagnosis of mild to moderate dementia. While larger studies are needed to confirm these findings, we suggest that this methodology may be used to support persons with dementia not only in times of pandemics but also as an addition to other community and home care services. Changes in reimbursement policies to include these innovative home services may be helpful in building more resilient communities for the more highly vulnerable populations.

Trajectories of alcohol use and problems during the COVID-19 pandemic: The role of social stressors and drinking motives for men and women

INTRODUCTION

Increased alcohol use coinciding with onset of the COVID-19 pandemic, particularly among women, has been documented among U.S. adults. This study examines trajectories of alcohol use and alcohol problems over a 9-month period during the pandemic, the extent to which these trajectories are predicted by social stress and drinking motives, and whether results differ for women and men.

METHODS

Data come from three online surveys of a nationally representative sample of U.S. adults ages 30-80 conducted in May-July 2020, October-November 2020, and March 2021. The analytic sample consists of N = 1118 who initially reported any past year alcohol use. The early-COVID survey assessed demographics, social stressors, and drinking motives. All three surveys assessed average drinks per day in past month and drinking-related problems.

RESULTS

Alcohol use declined for men, but remained stable for women. Alcohol problems increased for both sexes, especially for men. Level of alcohol use was associated with loneliness and social demands for men, and drinking motives for both sexes, with changes in use related to loneliness and social demands for men. Level of alcohol problems was associated with loneliness for women and drinking motives for both sexes, with changes in problems related to drinking motives for women. Interactions of social stress with drinking motives were not found.

CONCLUSIONS

Sex differences in alcohol use and alcohol problems during the pandemic-as well as their associations with indicators of social stress and drinking motives-highlight the importance of tailoring prevention and treatment efforts for men and women.

COVID-19 Life Events Spill-Over on Family Functioning and Adolescent Adjustment

We examined US parent and youth perceptions of how life events, both positive and negative, associated with COVID-19 resulted in changes in family and youth functioning. Families (n = 105, 80% white, 48% male, and 87% mothers) completed surveys during the pandemic (May to July 2020) and 3 years prior (for youth ages M = 10.6, SD = 1.17 and M = 13.6, SD = 1.19). Declines in youth, though not parent, report of open family communication, parental support, and family satisfaction were found. Declines were associated with various domains of pandemic-related stress in parent report, though positive life events served as buffers. Pre-pandemic family functioning also predicted pandemic stress. Spillover effects in turn impacted youth functioning. The current findings shed light on how experiences of the pandemic are linked with family functioning and have implications for how to support families during this time.

Anxiety Levels and Changes in Health and Hygiene Behaviors in Mothers of Children with Asthma in Early COVID-19 Lockdown in Turkey

Objective: The restrictions imposed by the coronavirus disease 2019 (COVID-19) pandemic have caused significant changes in people's lives. This study aimed to investigate anxiety levels and changes in health and hygiene behaviors in mothers of children with asthma in early COVID-19 lockdown in Turkey. Materials and Methods: This study was a cross-sectional survey conducted on children with asthma, 6 to 11 years of age, between June 1 and 30, 2020, in Turkey. A sociodemographic data form, health and hygiene behavior form, childhood asthma control test, and state-trait anxiety inventory were administered to the mothers of the children. Results: The asthma group included 123 children (Female: 39.0%) and median age, interquartile range (IQR) [minimum-maximum]: 8.0 (6) [6-12] years; the control group included 88 children (Female: 47.7%) median age, IQR [minimum-maximum]: 8.0 (7) [5-12] years. Increased hygiene behaviors and high compliance with social isolation measures were recorded in the early lockdown, with no difference between the groups. Before the pandemic, the most frequently used cleaning products were general-purpose cleaners. During the early lockdown, however, the most frequently used product was disinfectants and was similar in both groups. In both groups, the rate of using nutritional supplements increased during the pandemic period, but the rate was higher in children with asthma both before and during the early lockdown (P < 0.001). The anxiety levels of the mothers in asthma and control groups were similar. Conclusion: This study is the first in Turkey demonstrating that, in mothers of children with asthma, lifestyle changes related to health and hygiene and anxiety levels are similar to those of other children and their mothers during the early lockdown period of COVID-19 pandemic.

Did Children Interact With Their Personified Objects During the COVID-19 Pandemic?

Although previous studies revealed the characteristics of children with imaginary companions, the characteristics of children alone could not explain why some children create and interact with imaginary companions. The current cross-sectional study examined the impact of the situational factors, decreased opportunities to meet and play with real playmate due to the COVID-19 pandemic, on the prevalence of imaginary companions. Five hundred sixty caregivers of children aged 2-9 years (half of them were girls) were asked whether their children currently had imaginary companions (personified objects and invisible friends) before (September 2019) and during the pandemic (April 2020). The logistic regression model showed that only the prevalence of personified objects increased during the pandemic, OR = 2.01, 95%CI [1.34, 3.00], even when potential variables were controlled. The results suggest that children more frequently played with their personified objects during the pandemic compared to before the pandemic.

COVID-19 Life Events Spill-Over on Family Functioning and Adolescent Adjustment

We examined US parent and youth perceptions of how life events, both positive and negative, associated with COVID-19 resulted in changes in family and youth functioning. Families (n = 105, 80% white, 48% male, and 87% mothers) completed surveys during the pandemic (May to July 2020) and 3 years prior (for youth ages M = 10.6, SD = 1.17 and M = 13.6, SD = 1.19). Declines in youth, though not parent, report of open family communication, parental support, and family satisfaction were found. Declines were associated with various domains of pandemic-related stress in parent report, though positive life events served as buffers. Pre-pandemic family functioning also predicted pandemic stress. Spillover effects in turn impacted youth functioning. The current findings shed light on how experiences of the pandemic are linked with family functioning and have implications for how to support families during this time.

Understanding the unpaid work roles amongst households, during COVID-19

Background

Worldwide, the COVID-19 pandemic has had a rapid disruption on work, social activities and family life. Pre-pandemic norms suggested that women spend more time in unpaid work roles and with childcare, while men spend more time in paid work roles. This study aims to understand: 1) the distribution of unpaid work roles within households, and 2) if there are certain factors that explain the unpaid work roles within a household during the pandemic.

Methods

This study used a cross-sectional survey of people across the globe, during the pandemic. The survey, administered through a virtual platform of Qualtrics, consisted of the following sections: (a) consent, (b) location and job description (c) marital status and household numbers (d) age, sex, and gender (e) unpaid work roles and family responsibilities. Descriptive statistics and percentages were reported for all the data regarding the study variables. A multivariable regression model was used to understand which factors may explain the changes in unpaid work roles recalling before and during the pandemic

Results

This survey was completed by 1847 participants. The mean age was 30 years old (standard deviation of 13.3). The majority of participants identified themselves as women (76.0%) and single (62.1%). The multivariable linear regression indicated that marital status (single, common-law, married, divorced), higher number of household members (1-8,12), older age, higher number of dependent children, and gender (female) were positive and significant predictors of baseline changes in unpaid work role scores, explaining 50% of the variance (R² = 0.50).

Discussion

All households experienced a significant increase in the amount of unpaid work roles during the pandemic. However, older women who were in a relationship and experienced additional household members such as dependent children or sick older adults, were faced with more changes in unpaid work roles during COVID-19, than other individuals.

Associations of household structure and presence of children in the household with mental distress during the early stages of the U.S. COVID-19 pandemic

PURPOSE

The objectives of the current study were to (1) assess associations between household structure (i.e., living with spouse compared to living alone, with children, or with a spouse and children), presence of children, and mental distress in April 2020 and change in mental distress (between April and August 2020); and (2) determine whether these associations are moderated by income or sex.

PARTICIPANTS

A total of 2,214 adults aged 25-55 from the April and August 2020 waves of the Understanding America study were included in the analytic sample.

STUDY METHOD

Multivariable, survey-weighted linear regression models were used to examine associations between explanatory variables (i.e., household structure and number of children) and outcome variables (mental distress in April and change in mental distress), measured via the Patient Health Questionnaire (PHQ)-4.

RESULTS

In adjusted models, each additional child under the age of 12 was associated with lower mental distress in April 2020 (β = -.30, p = .002). Having children aged 13 to 18 and household structure were not significantly associated with mental distress. In interaction models, living with children only was associated with decreased mental distress among individuals reporting low income (interaction β = -1.28, p = .016) but not high income. Similarly, living with children only was associated with decreased mental distress in females (interaction β = -1.09, p = .025) but not males.

CONCLUSION

This study supports prior literature that demonstrates the positive association of child rearing with psychological well-being and suggests that these benefits may be present even under stay-at-home orders in the early stages of the U.S. COVID-19 pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Caregiver experiences with accessing sickle cell care and the use of telemedicine

BACKGROUND

Sickle cell disease (SCD) is associated with a wide range of complications. However, a multitude of barriers prevent SCD patients from receiving adequate healthcare, including difficulties with transportation and lack of provider knowledge about disease sequelae. Importantly, studies have demonstrated the benefits of telemedicine in addressing barriers to healthcare. While previous studies have identified barriers to care through quantitative methods, few studies have explored barriers which affect the pediatric SCD patient population in the Midwest, wherein the geographical landscape can prohibit healthcare access. Furthermore, few studies have established acceptability of telemedicine among caregivers and patients with SCD.

METHODS

This study aims to increase understanding of barriers to care and perceptions of telemedicine by caregivers of pediatric SCD patients in a medically under-resourced area in the Midwest. Researchers conducted semi-structured interviews with caregivers of children with SCD. The interviews were audio-recorded and transcribed. Thematic analyses were performed.

RESULTS

Researchers interviewed 16 caregivers of 15 children with SCD. Thematic analyses of the interview transcripts revealed four broad themes regarding caregiver burden/stress, both facilitators and barriers to SCD healthcare, and general thoughts on the acceptability/usefulness of telemedicine.

CONCLUSION

This qualitative study describes common burdens faced by caregivers of SCD, barriers to and facilitators of SCD care in the Midwest, and caregiver perceptions of the usefulness and efficacy of telemedicine for SCD care.

Parental Mediation of COVID-19 News and Children's Emotion Regulation during Lockdown

The COVID-19 outbreak resulted in a large amount of emotionally charged messaging that is believed to have a tremendous psychological impact, particularly on children and early adolescents. The present study examined the relationships between children's exposure to COVID-19 news, children's emotional responses to the news, parental styles of mediating COVID-19 news, and children's emotional functioning during the COVID-19 lockdown in Italy in April 2020. An online survey was completed by 277 parents (Mage = 43.36; SDage = 4.76; mothers = 89.5%) with children aged 6 to 13 years. Regression analyses showed that the parental active mediation style was associated with higher emotion regulation and lower lability/negativity, whereas the restrictive style was associated with higher lability/negativity and the social coviewing style was associated with lower emotion regulation. The results provide evidence for how adults using an active style can mediate messages to reduce children's emotional difficulties during events with high emotional involvement.

Exploring American Parents' Lived Experiences During the COVID-19 Pandemic: Ramifications for Well-Being

OBJECTIVE

The objective of this study was to document the direct impact of the COVID-19 pandemic on parents and families in the United States.

METHODS

Parents' experiences during the pandemic were examined using an online survey (N = 564) collected during May and June 2020.

RESULTS

Parents reported experiencing a high frequency of COVID-19-related events (e.g., job loss and health concerns) and impact on their lives. Parents' experiences with COVID-19, as well as self-reported perceived increase in home labor, experiences with assisting children with remote schooling, and work-life conflict were all significantly associated with higher levels of parental role overload. COVID-19-related events and impact, as well as parental role overload, significantly predicted parents' anxiety and depression, even after controlling for demographic factors.

CONCLUSIONS

The findings suggest the importance of providing support for parents and families through direct services and public policy changes.