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Westrupp EM, Bennett C, Berkowitz T, Youssef GJ, Toumbourou JW, Tucker R, Andrews FJ, Evans S, Teague SJ, Karantzas GC, Melvin GM, Olsson C, Macdonald JA, Greenwood CJ, Mikocka-Walus A, Hutchinson D, Fuller-Tyszkiewicz M, Stokes MA, Olive L, Wood AG, McGillivray JA, Sciberras E. Child, parent, and family mental health and functioning in Australia during COVID-19: comparison to pre-pandemic data. Eur Child Adolesc Psychiatry 2023; 32:317-330. [PMID: 34417875 PMCID: PMC8379590 DOI: 10.1007/s00787-021-01861-z] [Citation(s) in RCA: 54] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 08/13/2021] [Indexed: 02/07/2023]
Abstract
The COVID-19 pandemic presents significant risks to population mental health. Despite evidence of detrimental effects for adults, there has been limited examination of the impact of COVID-19 on parents and children specifically. We aim to examine patterns of parent and child (0-18 years) mental health, parent substance use, couple conflict, parenting practices, and family functioning during COVID-19, compared to pre-pandemic data, and to identify families most at risk of poor outcomes according to pre-existing demographic and individual factors, and COVID-19 stressors. Participants were Australian mothers (81%) and fathers aged 18 years and over who were parents of a child 0-18 years (N = 2365). Parents completed an online self-report survey during 'stage three' COVID-19 restrictions in April 2020. Data were compared to pre-pandemic data from four Australian population-based cohorts. Compared to pre-pandemic estimates, during the pandemic period parents reported higher rates of parent depression, anxiety, and stress (Cohen's d = 0.26-0.81, all p < 0.001), higher parenting irritability (d = 0.17-0.46, all p < 0.001), lower family positive expressiveness (d = - 0.18, p < 0.001), and higher alcohol consumption (22% vs 12% drinking four or more days per week, p < 0.001). In multivariable analyses, we consistently found that younger parent age, increased financial deprivation, pre-existing parent and child physical and mental health conditions, COVID-19 psychological and environmental stressors, and housing dissatisfaction were associated with worse parent and child functioning and more strained family relationships. Our data suggest wide-ranging, detrimental family impacts associated with the COVID-19 pandemic; and support policy actions to assist families with financial supports, leave entitlements, and social housing.
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Affiliation(s)
- E M Westrupp
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia.
- Department of Paediatrics, University of Melbourne, Victoria, Australia.
- Judith Lumley Centre, La Trobe University, Victoria, Australia.
| | - C Bennett
- Judith Lumley Centre, La Trobe University, Victoria, Australia
| | - T Berkowitz
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - G J Youssef
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Murdoch Children's Research Institute, Victoria, Australia
| | - J W Toumbourou
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - R Tucker
- Deakin HOME Research Hub, Victoria, Australia
| | - F J Andrews
- Deakin HOME Research Hub, Victoria, Australia
| | - S Evans
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - S J Teague
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - G C Karantzas
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - G M Melvin
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Centre for Educational Development Research and Appraisal, University of Warwick, Coventry, UK
| | - C Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Department of Paediatrics, University of Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Victoria, Australia
| | - J A Macdonald
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Department of Paediatrics, University of Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Victoria, Australia
| | - C J Greenwood
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - A Mikocka-Walus
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - D Hutchinson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Murdoch Children's Research Institute, Victoria, Australia
- The National Drug and Alcohol Research Centre, University of Sydney, New South Wales, Australia
| | - M Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - M A Stokes
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - L Olive
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- IMPACT Institute, School of Medicine, Faculty of Health, Deakin University, Victoria, Australia
| | - A G Wood
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- College of Health and Life Sciences, Aston University, Birmingham, UK
| | - J A McGillivray
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
| | - E Sciberras
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, 221 Burwood Highway, Geelong, VIC, 3216, Australia
- Department of Paediatrics, University of Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Victoria, Australia
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Thapar A, Livingston LA, Eyre O, Riglin L. Practitioner Review: Attention-deficit hyperactivity disorder and autism spectrum disorder - the importance of depression. J Child Psychol Psychiatry 2023; 64:4-15. [PMID: 35972029 PMCID: PMC10087979 DOI: 10.1111/jcpp.13678] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/13/2022] [Indexed: 11/30/2022]
Abstract
Young people with neurodevelopmental disorders, such as attention-deficit hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), show high rates of mental health problems, of which depression is one of the most common. Given that depression in ASD and ADHD is linked with a range of poor outcomes, knowledge of how clinicians should assess, identify and treat depression in the context of these neurodevelopmental disorders is much needed. Here, we give an overview of the latest research on depression in young people with ADHD and ASD, including possible mechanisms underlying the link between ADHD/ASD and depression, as well as the presentation, assessment and treatment of depression in these neurodevelopmental disorders. We discuss the implications for clinicians and make recommendations for critical future research in this area.
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Affiliation(s)
- Anita Thapar
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Lucy A Livingston
- Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Olga Eyre
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Lucy Riglin
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University School of Medicine, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
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Westrupp EM, Greenwood CJ, Fuller-Tyszkiewicz M, Olsson CA, Sciberras E, Mikocka-Walus A, Melvin GA, Evans S, Stokes MA, Wood AG, Karantzas GC, Macdonald JA, Toumbourou JW, Teague SJ, Fernando JW, Berkowitz TS, Ling M, Youssef GJ. Parent and child mental health trajectories April 2020 to May 2021: Strict lockdown versus no lockdown in Australia. Aust N Z J Psychiatry 2022; 56:1491-1502. [PMID: 34930045 DOI: 10.1177/00048674211065365] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To control a second-wave COVID-19 outbreak, the state of Victoria in Australia experienced one of the world's first long and strict lockdowns over July-October 2020, while the rest of Australia experienced 'COVID-normal' with minimal restrictions. We (1) investigate trajectories of parent/child mental health outcomes in Victoria vs non-Victoria and (2) identify baseline demographic, individual and COVID-19-related factors associated with mental health trajectories. METHODS Online community sample of 2004 Australian parents with rapid repeated assessment over 14 time-points over April 2020 to May 2021. Measures assessed parent mental health (Depression, Anxiety and Stress Scales-21), child depression symptoms (13-item Short Mood and Feelings Questionnaire) and child anxiety symptoms (four items from Brief Spence Children's Anxiety Scale). RESULTS Mental health trajectories shadowed COVID-19 infection rates. Victorians reported a peak in mental health symptoms at the time of the second-wave lockdown compared to other states. Key baseline predictors, including parent and child loneliness (standardized regression coefficient [β] = 0.09-0.46), parent/child diagnoses (β = 0.07-0.21), couple conflict (β = 0.07-0.18) and COVID-19 stressors, such as worry/concern about COVID-19, illness and loss of job (β = 0.12-0.15), predicted elevated trajectories. Effects of predictors on parent and child mental health trajectories are illustrated in an online interactive app for readers (https://lingtax.shinyapps.io/CPAS_trend/). CONCLUSION Our findings provide evidence of worse trajectories of parent and child mental health symptoms at a time coinciding with a second COVID-19 outbreak involving strict lockdown in Victoria, compared to non-locked states in Australia. We identified several baseline factors that may be useful in detecting high-risk families who are likely to require additional support early on in future lockdowns.
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Affiliation(s)
- Elizabeth M Westrupp
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Judith Lumley Centre, La Trobe University, Burwood, VIC, Australia
| | - Christopher J Greenwood
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Craig A Olsson
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Emma Sciberras
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - Antonina Mikocka-Walus
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Glenn A Melvin
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Centre for Educational Development, Appraisal and Research, University of Warwick, Coventry, UK
| | - Subhadra Evans
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Mark A Stokes
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Amanda G Wood
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,College of Health and Life Sciences, Aston University, Birmingham, UK
| | - Gery C Karantzas
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Jacqui A Macdonald
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia.,Department of Paediatrics, The University of Melbourne, Melbourne, VIC, Australia
| | - John W Toumbourou
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Samantha J Teague
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Julian W Fernando
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Tomer S Berkowitz
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - Mathew Ling
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia
| | - George J Youssef
- School of Psychology Deakin University Geelong Australia.,Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Burwood, VIC, Australia.,Murdoch Children's Research Institute, Melbourne, VIC, Australia
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Li Q, Guo L, Zhang S, Wang W, Li W, Chen X, Shi J, Lu C, McIntyre RS. The relationship between childhood emotional abuse and depressive symptoms among Chinese college students: The multiple mediating effects of emotional and behavioral problems. J Affect Disord 2021; 288:129-135. [PMID: 33878646 DOI: 10.1016/j.jad.2021.03.074] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/22/2021] [Accepted: 03/24/2021] [Indexed: 01/16/2023]
Abstract
BACKGROUND This study aims to explore the mediational effects of emotional and behavioral problems on the association between childhood emotional abuse and depressive symptoms among college students. METHODS Data were drawn from 60 universities from 10 provinces in China (n=30,374). Information about childhood maltreatment, depressive symptoms, emotional and behavioral problems were gathered through the Childhood Trauma Questionnaire-Short Form (CTQ-SF), the Center for Epidemiologic Studies Depression Scale (CES-D) and the Strengths and Difficulties Questionnaire (SDQ), respectively. Univariable and multivariable logistic regression models and mediating models were used. RESULTS After controlling for demographic factors, childhood emotional abuse was the strongest risk factor for depressive symptoms (adjusted odds ratio (aOR)=2.54, 95%CI=2.27-2.85). The relationship between childhood emotional abuse and depressive symptoms was partially mediated by emotional and behavioral problems with 68.7% total indirect effect. Among the 5 identified subtypes of emotional and behavioral problems, the mediating effects of emotional problems (57.3%) and hyperactivity (28.6%) were higher than peer problems (7.8%) and prosocial behavior (3.6%). Conduct problems did not show a significant mediating effect (p>0.05). LIMITATIONS The cross-sectional design is limited to make inferences about causality. CONCLUSIONS Childhood emotional abuse was strongly associated with depressive symptoms in college students. Of the five identified subtypes of emotional and behavioral problems, four subtypes mediated the relationship between childhood emotional abuse and depressive symptoms, including emotional problems, hyperactivity, peer problems and prosocial behavior.
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Affiliation(s)
- Qian Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Lan Guo
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Sheng Zhang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Wanxin Wang
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Wenyan Li
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Xiaoliang Chen
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Jingman Shi
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China
| | - Ciyong Lu
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou 510080, People's Republic of China.
| | - Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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