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Levy M, Yatziv T, Levavi K, Yakov P, Pike A, Deater-Deckard K, Hadar A, Bar G, Froimovici M, Atzaba-Poria N. The association between maternal and child posttraumatic stress symptoms among families living in southern Israel: The buffering role of maternal executive functions. Stress Health 2024; 40:e3456. [PMID: 39116030 DOI: 10.1002/smi.3456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 07/11/2024] [Accepted: 07/23/2024] [Indexed: 08/10/2024]
Abstract
Posttraumatic stress disorder is a prolonged stress and anxiety response that occurs after exposure to a traumatic event. Research shows that both parental and child posttraumatic stress symptoms (PTSS) are correlated but parental executive functions (EFs) could buffer this link. EFs refers to a group of high-level cognitive processes that enable self-regulation of thoughts and actions to achieve goal-directed behaviours and can be of importance for both positive parenting interactions and effective coping skills for PTSS. Our study aimed to (1) examine the link between maternal and child PTSS and the moderating role of varying degrees of exposure to severe security threats context, and (2) to identify the moderating role of maternal EFs in this interaction, among families living in southern Israel. Our sample included 131 mothers in their second pregnancy and their firstborn children. Mothers performed computerised tasks to assess their EFs and they reported on their own and their child's PTSS. Results revealed a positive correlation between maternal PTSS and child PTSS. However, the link between maternal and child PTSS was moderated by maternal working memory updating abilities and threat context severity. Among mothers with lower updating capacities, the association between maternal and child symptoms was stronger under higher threat contexts; conversely, among mothers with higher maternal updating abilities, threat context did not modulate the link between maternal and child PTSS, suggesting a stress-buffering effect. Our study contributes to the growing literature on the significant role of parental EFs in the context of parent-child interactions.
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Affiliation(s)
- Michal Levy
- Department of Psychology, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Duet Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Tal Yatziv
- Department of Psychology, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Yale Child Study Center, School of Medicine, Yale University, New Haven, Connecticut, USA
| | - Kinneret Levavi
- Department of Psychology, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Duet Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Porat Yakov
- Department of Psychology, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Duet Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | - Alison Pike
- School of Psychology, University of Sussex, Brighton, UK
| | - Kirby Deater-Deckard
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | | | - Guy Bar
- Fertility and IVF Unit, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel
| | | | - Naama Atzaba-Poria
- Department of Psychology, Ben-Gurion University of the Negev, Be'er Sheva, Israel
- Duet Center, Ben-Gurion University of the Negev, Be'er Sheva, Israel
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Kerbage H, Elbejjani M, Bazzi O, El-Hage W, BouKhalil R, Corruble E, Purper-Ouakil D. 'We are all children of war': a qualitative inquiry into parenting following adolescents' recent traumatic exposure in a multiple crisis setting in Beirut, Lebanon. Eur J Psychotraumatol 2024; 15:2382650. [PMID: 39113651 PMCID: PMC11312994 DOI: 10.1080/20008066.2024.2382650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 07/08/2024] [Accepted: 07/09/2024] [Indexed: 08/11/2024] Open
Abstract
Background: Strong familial bonds are crucial to building resilience among youth exposed to traumatic events in socially adverse environments. Exploring parental experiences in the aftermath of adolescents' traumatic exposure in these settings would help tailor early interventions.Objective: We qualitatively explored experiences and perceived needs among parents of teenagers aged 11-16 years who were exposed in the last three months to a potentially traumatic event in Beirut, Lebanon.Method: We purposively sampled 28 parents of 24 adolescents meeting the inclusion criteria. Semi-structured interviews were conducted, and thematic analysis was applied combined with a grounded theory approach.Results: The most frequent traumatic event was direct exposure to the violent clashes that happened in Beirut on 14 October 2021. Parents identified that the recent event exacerbated pre-existing mental health difficulties caused by cumulative stress. They were reminded of their own war experiences and tended to reject the 'sick role' associated with trauma. A majority of participants viewed resilience as a fixed trait characteristic of the Lebanese and avoided communication with their children about traumatic memories, while a significant minority criticised resilience as a myth that added pressure on them and had more open communication about trauma. Parenting styles oscillated between controlling behaviours, warmth, and avoidance, which impacted the family dynamic. Despite adversity, most parents tried to cope through social connectedness, humour, and living day by day.Conclusions: Our findings hold implications for contextual adaptations of early posttraumatic interventions aimed at strengthening family support, such as addressing parental mental health; increasing awareness among first-line responders on parents' potential representations of trauma and resilience; addressing the issue of controlling parenting; and including a component in psychoeducation on traumatic stress that validates the impact of daily stressors on mental health while avoiding direct labelling. Further research is needed to validate the impact of these domains.
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Affiliation(s)
- Hala Kerbage
- Department of Child and Adolescent Psychiatry, Saint Eloi University Hospital, Montpellier, France
- Center for Epidemiology and Population Health (CESP), Paris-Saclay University, Paris, France
| | - Martine Elbejjani
- Clinical Research Institute, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ola Bazzi
- Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Wissam El-Hage
- CHRU de Tours, Regional Trauma Center CRP-CVL, Tours, France
- UMR 1253, iBraiN, University of Tours, INSERM, Tours, France
| | - Rami BouKhalil
- Saint-Joseph University; Hotel-Dieu de France Hospital, Beirut, Lebanon
| | - Emmanuelle Corruble
- CESP, MOODS Team, INSERM U1018, School of Medicine, Paris-Saclay University, Le Kremlin Bicêtre, France
- Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin Bicêtre, France
| | - Diane Purper-Ouakil
- Department of Child and Adolescent Psychiatry, Saint Eloi University Hospital, Montpellier, France
- Center for Epidemiology and Population Health (CESP), Paris-Saclay University, Paris, France
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Ayran G, Çevik Özdemir HN. Caregiver and parent-child relationship during COVID-19: The mediator role of anxiety and life satisfaction. Child Care Health Dev 2024; 50:e13247. [PMID: 38558179 DOI: 10.1111/cch.13247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 11/28/2023] [Accepted: 02/04/2024] [Indexed: 04/04/2024]
Abstract
AIM This research was conducted to evaluate the mediation effect of anxiety and life satisfaction on the relationship between Care burden and Parent Child Relationship in Turkish parents during the COVID-19 epidemic. METHODS The research was carried out with parents (221 women and 219 men) who have children between the ages of 6-18 living in Turkey. Data were collected in June-July 2021 using the demographic data form, "Care Burden Scale," "Pervasive Anxiety Disorder-7 Test," "Satisfaction with Life Scale," and "Parent Child Relationship Scale." Path analysis was used to analyse the relationships. In this study, structural equation modelling (SEM) was used to examine the path analysis. RESULTS It was found that the burden of care and anxiety of the parents and the parent-child conflict relationship were positively correlated and negatively correlated with the life satisfaction and parent-child closeness relationship (p < 0.05). Path model analyses revealed that the burden of care had a direct effect on anxiety and life satisfaction, and an indirect effect on the parent-child relationship, respectively. CONCLUSIONS It shows that parents' perceptions of how the COVID-19 pandemic is affecting their mental health have implications for parent and child well-being, with stronger relationships for low-income families. Anxiety and life satisfaction had a mediating effect between care burden and parent-child relationship. Given the demonstrable impact of COVID-19 on the parent-child relationship, this study may guide the planning of coping strategies and programmes focused on mental health.
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Affiliation(s)
- Gülsün Ayran
- Faculty of Health Sciences, Erzincan Binali Yıldırım University, Erzincan, Turkey
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Strøm IF, Wentzel-Larsen T, Stensland S, Dyb G, Stene LE. Health care needs, experiences, and satisfaction after terrorism: a longitudinal study of parents of survivors of the Utøya attack. BMC Health Serv Res 2024; 24:277. [PMID: 38454472 PMCID: PMC10921612 DOI: 10.1186/s12913-024-10592-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 01/11/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND There is scarce knowledge on the health care follow-up of parents of terror attack survivors. This study focused on the mothers and fathers of survivors and examined (1) their perceived health care needs relative to their psychological reactions, physical health problems (unmet health care needs), and adaptation to work; (2) whether sociodemographic characteristics, health problems and social support were associated with unmet health care needs; and (3) how unmet health care needs, sociodemographic characteristics, and experiences with health services associated with overall dissatisfaction during the health care follow-up. METHODS Interview and questionnaire data from three waves of the Utøya parent study were analyzed (n = 364). Chi-square tests and t- tests were used to compare unmet physical and psychological health care needs, sociodemographic factors and post-terror attack health reported by mothers and fathers. Logistic regression analyses were used to examine whether sociodemographic characteristics, unmet health care needs, and health care experiences were associated with overall dissatisfaction among mothers and fathers of the survivors during the health care follow-up. RESULTS Among the mothers, 43% reported unmet health care needs for psychological reactions, while 25% reported unmet health care needs for physical problems. Among the fathers, 36% reported unmet health care needs for psychological reactions, and 15% reported unmet health care needs for physical problems. Approximately 1 in 5 mothers and 1 in 10 fathers reported "very high/high" needs for adaptation to work. Poorer self-perceived health, higher levels of posttraumatic stress and anxiety/depression symptoms, and lower levels of social support were significantly associated with reported unmet psychological and physical health care needs in both mothers and fathers. Parents with unmet health care needs reported significantly lower satisfaction with the help services received compared to parents whose health care needs were met. Low accessibility of help services and not having enough time to talk and interact with health care practitioners were associated with overall dissatisfaction with the help received. CONCLUSIONS Our findings highlight that parents of terror-exposed adolescents are at risk of having unmet psychological and physical health care needs and thus need to be included in proactive outreach and health care follow-up programs in the aftermath of a terror attack.
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Affiliation(s)
- Ida Frugård Strøm
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway.
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway
- Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Oslo, Norway
| | - Synne Stensland
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway
- Research and Communication Unit for Musculoskeletal Health (FORMI), Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Grete Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Lise Eilin Stene
- Norwegian Centre for Violence and Traumatic Stress Studies, Pb 181 Nydalen, 0409, Oslo, Norway
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Kerbage H, Elbejjani M, El-Hage W, Purper-Ouakil D. 'Life should go on': a qualitative inquiry of parental reactions, experiences, and perceived needs following adolescents' recent traumatic exposure. Eur J Psychotraumatol 2024; 15:2299660. [PMID: 38285906 PMCID: PMC10826792 DOI: 10.1080/20008066.2023.2299660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 12/19/2023] [Indexed: 01/31/2024] Open
Abstract
Background: Parents have a significant role in supporting children who have been exposed to traumatic events. Little is known about parental experiences and needs in the wake of traumatic exposure, which could help in designing tailored early interventions.Objective: This qualitative study explored experiences, perceived needs, and factors impacting those needs being met, in parents of adolescents aged 11-16 years who had been exposed in the past 3 months to a potentially traumatic event, in the city of Montpellier, France.Method: We purposively sampled 34 parents of 25 adolescents aged 11-16 years meeting the inclusion criteria and used semi-structured in-depth interviews. Thematic analysis was applied using a multistage recursive coding process.Results: Parents lacked trauma-informed explanations to make sense of their child's reduced functioning. They experienced stigma attached to the victim label and were reluctant to seek help. School avoidance and lack of collaboration with schools were major obstacles experienced by parents. Parents trying to navigate conflicting needs fell into two distinct categories. Those who experienced distressing levels of shame and guilt tended to avoid discussing the traumatic event with their child, pressuring them to resume life as it was before, despite this perpetuating conflictual interactions. Others adapted by revisiting their beliefs that life should go on as it was before and by trying to come up with new functional routines, which improved their relationship with their child and helped them to restore a sense of agency and hope, but at the cost of questioning their parental role.Conclusions: Key domains of parental experiences could provide potential early intervention targets, such as psychoeducation on traumatic stress, representations about recovery and the victim status, parent-child communication, and involvement of schools and primary caregivers. Further research is needed to validate the impact of these domains in early post-traumatic interventions.
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Affiliation(s)
- Hala Kerbage
- Department of Child and Adolescent Psychiatry, Saint-Eloi University Hospital, Montpellier, France
- Center for Epidemiology and Population Health (CESP) INSERM U1018, Developmental Psychiatry Team, Paris-Saclay University, Paris, France
| | - Martine Elbejjani
- Clinical Research Institute, Department of Internal Medicine, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Wissam El-Hage
- UMR 1253, iBrain, University of Tours, INSERM, Tours, France
| | - Diane Purper-Ouakil
- Department of Child and Adolescent Psychiatry, Saint-Eloi University Hospital, Montpellier, France
- Center for Epidemiology and Population Health (CESP) INSERM U1018, Developmental Psychiatry Team, Paris-Saclay University, Paris, France
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Kw K, Yk K, Jh K. Associations between Parental Factors and Children's Screen Time During the COVID-19 Pandemic in South Korea. Child Psychiatry Hum Dev 2023; 54:1749-1758. [PMID: 35622302 PMCID: PMC9135994 DOI: 10.1007/s10578-022-01366-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/08/2021] [Revised: 04/20/2022] [Accepted: 04/23/2022] [Indexed: 02/05/2023]
Abstract
This study investigated how parental depression, parental self-care, family conflict, and parental fear of COVID-19 are associated with children's screen time during the COVID-19 pandemic. Data were collected online among South Korean families, resulting in 246 parents (59% fathers) with children between 6 and 12 years of age. Path analysis and multi-group structural equation modelling of fathers and mothers were conducted. Parent's fear of COVID-19 was positively associated with parental depression. Parent's fear of COVID-19 and parental depression were negatively related to parental self-care, which was negatively linked to family conflict. Family conflict was positively associated with children's screen time. The relationships between parental factors and children's screen time were different for mothers and fathers. Our results show that multiple family dynamics interact with children's screen time, emphasizing the need to look beyond parenting practices in understanding the effects of COVID-19 pandemic on children's screen time.
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Affiliation(s)
- Kim Kw
- School of Social Sciences, Humanities, and Arts, University of California, Merced, USA
| | - Koh Yk
- Department of Economics, Columbia University, New York, USA
| | - Kim Jh
- Institute for Economic and Social Research, Jinan University, 601 West Huangpu Road, 510632, Guangzhou, China.
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Sanchez BEL, Klein CC, Tremblay M, Rastogi M, Corcoran F, Barnett ML. Adapting to Unprecedented Times: Community Clinician Modifications to Parent-Child Interaction Therapy during COVID-19. EVIDENCE-BASED PRACTICE IN CHILD AND ADOLESCENT MENTAL HEALTH 2023; 8:348-363. [PMID: 37981955 PMCID: PMC10656036 DOI: 10.1080/23794925.2023.2238741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
Parent-Child Interaction Therapy (PCIT) is an evidence-based practice that effectively prevents and treats child disruptive behaviors and child physical maltreatment and reduces parenting stress. PCIT was adapted for telehealth delivery, internet-delivered PCIT (iPCIT), before the COVID-19 pandemic but was not widely implemented until the rapid transition to telehealth during stay-at-home orders. To understand how clinicians adapted PCIT during COVID-19, we followed up on a previous study investigating community clinician adaptations of PCIT pre-COVID-19 using the Lau et al. (2017) Augmenting and Reducing Framework. Clinicians (N = 179) who responded to the follow-up survey and reported delivering PCIT remotely completed a quantitative measure of adaptations at both time points (Fall 2019; Summer 2020) to assess how adaptations to PCIT changed following lockdown measures. Clinicians (n = 135) also provided qualitative descriptions of adaptations made early in the COVID-19 pandemic. Clinicians in the full sample were 74.3% Non-Hispanic White and 14% Latinx. Most clinicians had a master's degree (66.5%), were licensed (80.4%), and were PCIT-certified (70.4%). Paired samples t-tests showed that clinicians reported similar levels of augmenting t(179) = -0.09, p=.926) and reducing adaptations t(179) = -0.77, p=.442) at both time points. Unlike quantitative findings, qualitative findings indicated that clinicians described engaging in many types of adaptations in response to the pandemic. Clinicians discussed engaging in augmenting adaptations by extending treatment length and integrating other practices into treatment. Clinicians also discussed engaging in reducing adaptations. Implications and future directions will be discussed.
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Grigoropoulos I. Difficulties Imposed on the Parent-Child Relationship Due to the COVID-19 Pandemic. JOURNAL OF FAMILY ISSUES 2023; 44:1971-1983. [PMID: 37337599 PMCID: PMC10271812 DOI: 10.1177/0192513x211067527] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/21/2023]
Abstract
The present study tested whether emotionally burdened parents due to the COVID-19 pandemic might appraise their relationship with their children more negatively. The current cross-sectional study was circulated through social media. A total of 265 respondents took part in the study. Multiple linear regression analysis was used to examine the association between predictor variables and the parent-child relationship. This study's results report that older fathers with higher levels of COVID-19 related fear are more likely to appraise negatively their relationship with their children. Therefore, this study suggests the need for family-level strategies to address better the psychological aspects related to the pandemic outbreak.
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Affiliation(s)
- Iraklis Grigoropoulos
- Early Childhood Education and Care Department, International Hellenic University, Thessaloniki, Greece
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Lengua LJ, Stavish CM, Green LM, Shimomaeda L, Thompson SF, Calhoun R, Moini N, Smith MR. Pre-COVID-19 predictors of low-income women's COVID-19 appraisal, coping, and changes in mental health during the pandemic. JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 51:2098-2116. [PMID: 36776019 DOI: 10.1002/jcop.23012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 06/14/2023]
Abstract
Study examined predictors and mental health consequences of appraisal (threat, support satisfaction) and coping (active, avoidant) in a sample of low-income women during coronavirus disease 2019 (COVID-19). Pre-COVID-19 contextual risk and individual resources and COVID-19-specific risk factors were examined as predictors of COVID-19 appraisal and coping, which, in turn, were tested as predictors of changes in depression and anxiety across the pandemic. Pre-COVID-19 resilience predicted more active coping, whereas pre-COVID-19 anxiety and depression predicted more avoidant coping and lower support satisfaction, respectively. Increases in anxiety were predicted by lower pre-COVID-19 self-compassion and higher concurrent threat appraisal and avoidant coping. Increases in depression were related to lower pre-COVID-19 self-compassion, active coping and support satisfaction, and higher COVID-19 hardships and health risk. Findings highlight contextual and individual factors and processes that contribute to mental health problems in a vulnerable population during community-level stressors, with implications for prevention and intervention.
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Affiliation(s)
- Liliana J Lengua
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Caitlin M Stavish
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Lindsey M Green
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Lisa Shimomaeda
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | | | - Rebecca Calhoun
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Natasha Moini
- Department of Psychology, University of Washington, Seattle, Washington, USA
| | - Michele R Smith
- Department of Psychology, University of Washington, Seattle, Washington, USA
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Parental psychosocial factors predicting adolescents' psychological adjustment during the surging and remission periods of COVID-19 in China: A longitudinal study. J Affect Disord 2023; 320:57-64. [PMID: 36183815 PMCID: PMC9525891 DOI: 10.1016/j.jad.2022.09.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 09/25/2022] [Accepted: 09/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Parents play a critical role in adolescents' psychological adjustment, especially in stress response. Few studies have investigated parental impact on adolescents' psychological adjustment in the pandemic. The longitudinal study examined how parental psychosocial factors at the surging period of the pandemic (T1) in China predicted adolescents' anxiety and depression concurrently and at the remission periods three (T2) and six months (T3) later. METHODS Middle and high school students and their parents from three schools in Shanghai, China, completed online surveys on March 10, 2020 (T1), June 16, 2020 (T2), and Sep 25, 2020 (T3). Adolescents' anxiety/depression levels were assessed by matching self- and parent-reports at T1, T2, T3, and parents reported their psychological state (emotion and psychopathology), pandemic response (appraisal and coping), and perceived social support (PSS) at T1. RESULTS Parental positive/negative emotions, anxiety, depression, control-appraisal, forward- and trauma-focus coping style and PSS were all significantly related to their children's anxiety/depression at T1. All factors, except coping style, predicted adolescents' anxiety/depression at T2 and T3, even after controlling for T1 adjustment levels. Parental positive emotion and depression had the strongest impact on adolescents' adjustment. LIMITATIONS Some participants didn't complete the surveys at later time points, and the participants were only recruited in Shanghai. CONCLUSIONS The study found that parents' psychosocial factors played a pivotal role on adolescents' psychological adjustment during COVID-19, highlighting the need to provide help to parents who were suffering from potential psychological distress.
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Bolbocean C, Rhidenour KB, McCormack M, Suter B, Holder JL. Resilience, and positive parenting in parents of children with syndromic autism and intellectual disability. Evidence from the impact of the COVID-19 pandemic on family's quality of life and parent-child relationships. Autism Res 2022; 15:2381-2398. [PMID: 36196501 PMCID: PMC10092377 DOI: 10.1002/aur.2825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/09/2022] [Indexed: 12/15/2022]
Abstract
Family quality of life (FQoL) outcomes collected during the first year of COVID-19 has been combined with 2018 data to estimate the outbreak's impact on parental outcomes on a sample of 230 families with syndromic autistic children and those with intellectual disabilities (IDs). Despite challenges imposed by the COVID-19 outbreak, our study found that FQoL outcomes reported by participating parents during the first year of COVID-19 appears to be similar to ratings from a prepandemic study of families with the same conditions. Parents of children in our sample generally displayed a stable functioning trajectory as measured by the validated FQoL instrument. Across syndromic autistic groups considered, families reported that their relationships with their children were positive. Our findings provide evidence of families' resilience which might explain the presence of positive parent-child interactions during COVID-19. Exploring mechanisms which would explain how families with autistic and ID children confront, manage disruptive experiences, and buffer COVID-19 induced stress is a fruitful direction for future research.
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Affiliation(s)
- Corneliu Bolbocean
- The Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | | | - Maria McCormack
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas, USA.,Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Bernhard Suter
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas, USA.,Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
| | - Jimmy Lloyd Holder
- Jan and Dan Duncan Neurological Research Institute, Texas Children's Hospital, Houston, Texas, USA.,Division of Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA
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Lengua LJ, Thompson SF, Kim SG, Rosen ML, Rodman A, Kasparek S, Mayes M, Zalewski M, Meltzoff A, McLaughlin KA. Maternal mental health mediates the effects of pandemic-related stressors on adolescent psychopathology during COVID-19. J Child Psychol Psychiatry 2022; 63:1544-1552. [PMID: 35318671 PMCID: PMC9115007 DOI: 10.1111/jcpp.13610] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/25/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND This study examined whether COVID-19-related maternal mental health changes contributed to changes in adolescent psychopathology. METHODS A community sample of 226 adolescents (12 years old before COVID-19) and their mothers were asked to complete COVID-19 surveys early in the pandemic (April-May 2020, adolescents 14 years) and approximately 6 months later (November 2020-January 2021). Surveys assessed pandemic-related stressors (health, financial, social, school, environment) and mental health. RESULTS Lower pre-pandemic family income-to-needs ratio was associated with higher pre-pandemic maternal mental health symptoms (anxiety, depression) and adolescent internalizing and externalizing problems, and with experiencing more pandemic-related stressors. Pandemic-related stressors predicted increases in maternal mental health symptoms, but not adolescent symptoms when other variables were covaried. Higher maternal mental health symptoms predicted concurrent increases in adolescent internalizing and externalizing. Maternal mental health mediated the effects of pre-pandemic income and pandemic-related stressors on adolescent internalizing and externalizing problems. CONCLUSIONS Results indicate that adolescent mental health is closely tied to maternal mental health during community-level stressors such as COVID-19, and that pre-existing family economic context and adolescent symptoms increase risk for elevations in symptoms of psychopathology.
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Affiliation(s)
- Liliana J Lengua
- Psychology Department, University of Washington, Seattle, WA, USA
| | | | | | | | | | | | - Makeda Mayes
- Psychology Department, University of Washington, Seattle, WA, USA
| | | | - Andrew Meltzoff
- Psychology Department, University of Washington, Seattle, WA, USA
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13
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Fisk E, Russell B. Patterns of Stress and Wellbeing Among Families Enrolled in Early Head Start/Head Start During COVID-19. Matern Child Health J 2022; 26:2370-2376. [PMID: 36350437 PMCID: PMC9644384 DOI: 10.1007/s10995-022-03523-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 05/26/2022] [Accepted: 09/08/2022] [Indexed: 11/10/2022]
Abstract
The COVID-19 pandemic disproportionately affected low-income families in the U.S., particularly those with young children (Kalluri et al., 2021). This longitudinal study describes the resources, stress, and health and wellbeing of low-income families enrolled in an Early Head Start/Head Start program for two cumulative program years before and during the height of the COVID-19 pandemic. We found having more resources (higher income, higher education levels, full time employment) prior to the onset of COVID-19 was correlated with better wellbeing and lower stress throughout the pandemic. Implications and directions for future research include understanding the specific types of supports that programs like EHS/HS provided during COVID-19 and how families benefitted from them.
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Affiliation(s)
- Eleanor Fisk
- Department of Human Development and Family Sciences, University of Connecticut, 348 Mansfield Road, U-1058, CT 06269-1058, Storrs, U.S
| | - Beth Russell
- Department of Human Development and Family Sciences and Center for Applied Research in Human Development, University of Connecticut, Storrs, U.S
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14
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Calhoun CD, Stone KJ, Cobb AR, Patterson MW, Danielson CK, Bendezú JJ. The Role of Social Support in Coping with Psychological Trauma: An Integrated Biopsychosocial Model for Posttraumatic Stress Recovery. Psychiatr Q 2022; 93:949-970. [PMID: 36199000 PMCID: PMC9534006 DOI: 10.1007/s11126-022-10003-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 11/29/2022]
Abstract
This theoretical review proposes an integrated biopsychosocial model for stress recovery, highlighting the interconnectedness of intra- and interpersonal coping processes. The proposed model is conceptually derived from prior research examining interpersonal dynamics in the context of stressor-related disorders, and it highlights interconnections between relational partner dynamics, perceived self-efficacy, self-discovery, and biological stress responsivity during posttraumatic recovery. Intra- and interpersonal processes are discussed in the context of pre-, peri-, and post-trauma stress vulnerability as ongoing transactions occurring within the individual and between the individual and their environment. The importance of adopting an integrated model for future traumatic stress research is discussed. Potential applications of the model to behavioral interventions are also reviewed, noting the need for more detailed assessments of relational dynamics and therapeutic change mechanisms to determine how relational partners can most effectively contribute to stress recovery.
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Affiliation(s)
- Casey D Calhoun
- Department of Psychology and Neuroscience, University of North Carolina, 235 E. Cameron Avenue, CB 3270, Chapel Hill, NC, 27599, USA.
| | - Katie J Stone
- Division of Clinical Behavioral Neuroscience, University of Minnesota, Masonic Institute for the Developing Brain, Minneapolis, MN, USA
| | - Adam R Cobb
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Department of Psychology, The University of Texas at Austin, Austin, TX, USA
| | - Megan W Patterson
- Anschutz Medical Campus, Department of Psychiatry, University of Colorado, Aurora, CO, USA
| | - Carla Kmett Danielson
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Jason José Bendezú
- Institute of Child Development, University of Minnesota, Minneapolis, MN, USA
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15
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Cesur S, Topcu MT, Kalcıoğlu MT. Psychosocial Impact of the COVID-19 Pandemic on Children With Cochlear Implants and Their Parents/Family Members. Am J Audiol 2022; 31:1232-1246. [DOI: 10.1044/2022_aja-22-00031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Purpose:
The purpose of this study was to describe hearing health care and education experiences of children with cochlear implants (CIs) during the COVID-19 pandemic and the potential psychosocial effects of the pandemic on these children and their parents/family members.
Method:
The study used a cross-sectional survey design. The study sample comprised two groups, namely, parents/family members of children with CIs (study group,
n
= 70,
M
age
= 44.6 ± 12.4 years) and parents/family members of children with normal hearing (control group,
n
= 58,
M
age
= 43.8 ± 11.5 years). Parents/family members completed the Perceived Stress Scale (PSS), the Coronavirus Anxiety Scale (CAS), and the Family Perspective Profile form, as well as the Demographic Information form.
Results:
The PSS scores of the study group were higher than those of the control group (
p
= .001). However, there was no statistically significant difference between groups in the CAS scores (
p
= .896). According to the Family Perspective Profile form, almost half of the parents/family members of children with CIs reported that their children experienced difficulties in education and hearing health care services during the pandemic and showed some changes in their attitudes and behaviors.
Conclusions:
During the pandemic, the stress levels of parents/family members of children with CIs were higher than parents/family members of children with normal hearing. In addition to the challenges posed by the pandemic, the difficulties that parents/family members of children with CIs experience in meeting their children's additional needs related to accessing education and hearing health care services may have contributed to increased stress levels.
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Affiliation(s)
- Sıdıka Cesur
- Department of Audiology, Faculty of Health Sciences, Istanbul Medeniyet University, Turkey
| | - Merve Torun Topcu
- Department of Audiology, Faculty of Health Sciences, Istanbul Medeniyet University, Turkey
| | - Mahmut Tayyar Kalcıoğlu
- Department of Otorhinolaryngology–Head and Neck Surgery, Faculty of Medicine, Istanbul Medeniyet University, Turkey
- Goztepe Prof. Dr. Suleyman Yalcin City Hospital, Istanbul, Turkey
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16
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Nomura S, Endo K, Omori T, Kisugi N. Changes in parental involvement and perceptions in parents of young children during the COVID-19 pandemic: A cross-sectional observational study in Japan. Glob Health Med 2022; 4:166-173. [PMID: 35855065 DOI: 10.35772/ghm.2022.01003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 03/12/2022] [Accepted: 03/25/2022] [Indexed: 11/08/2022]
Abstract
This study aimed to clarify changes in parental involvement with their children and parental perceptions related to parenting in both fathers and mothers of young children during the coronavirus disease 2019 (COVID-19) pandemic. A cross-sectional observational design was used. Data were collected using a web-based questionnaire from 28 fathers and 115 mothers between October 1 and November 30, 2020. Parents answered questions regarding themselves, basic sociodemographic variables, perceived changes in involvement with their children, the presence or absence of abusive behavior (e.g., violence toward children), and parental perceptions related to parenting. Many parents indicated that they did not experience major changes in their involvement or perceptions compared to before the COVID-19 pandemic. Half of the fathers considered themselves to be in more physical contact or communication with their children; there was a significant difference between fathers and mothers regarding eating meals with their children (p = 0.00). Fathers felt tired due to parenting (35.7%) or a lack of free time (42.9%) during the COVID-19 pandemic. While significantly more mothers than fathers responded that their partners took care of their children (p = 0.03), significantly greater number of mothers than fathers also reported feeling overburdened (p = 0.00). Family support workers should help fathers maintain involvement with their young children without high stress levels and support mothers to reduce their heavy burden of parenting continuously. This would contribute to young childrens growth and development despite a public health crisis.
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Affiliation(s)
- Satomi Nomura
- Department of Child Nursing, National College of Nursing, Japan, Tokyo, Japan
| | - Kazue Endo
- Department of Child Nursing, National College of Nursing, Japan, Tokyo, Japan
| | | | - Namiko Kisugi
- Department of Child Nursing, National College of Nursing, Japan, Tokyo, Japan
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17
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Alonzo D, Popescu M, Zubaroglu Ioannides P. Mental health impact of the Covid-19 pandemic on parents in high-risk, low income communities. Int J Soc Psychiatry 2022; 68:575-581. [PMID: 33517821 PMCID: PMC7862916 DOI: 10.1177/0020764021991896] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
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.
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Affiliation(s)
- Dana Alonzo
- Graduate School of Social Service, Fordham University, West Harrison, NY, USA
| | - Marciana Popescu
- Graduate School of Social Service, Fordham University, West Harrison, NY, USA
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18
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Kerbage H, Bazzi O, El Hage W, Corruble E, Purper-Ouakil D. Early Interventions to Prevent Post-Traumatic Stress Disorder in Youth after Exposure to a Potentially Traumatic Event: A Scoping Review. Healthcare (Basel) 2022; 10:healthcare10050818. [PMID: 35627955 PMCID: PMC9141228 DOI: 10.3390/healthcare10050818] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 04/19/2022] [Accepted: 04/25/2022] [Indexed: 12/04/2022] Open
Abstract
The worldwide occurrence of potentially traumatic events (PTEs) in the life of children is highly frequent. We aimed to identify studies on early mental health interventions implemented within three months of the child/adolescent’s exposure to a PTE, with the aim of reducing acute post-traumatic symptoms, decreasing long term PTSD, and improving the child’s adjustment after a PTE exposure. The search was performed in PubMed and EMBASE databases resulting in twenty-seven articles meeting our inclusion criteria. Most non-pharmacological interventions evaluated had in common two complementary components: psychoeducation content for both children and parents normalizing early post-traumatic responses while identifying post-traumatic symptoms; and coping strategies to deal with post-traumatic symptoms. Most of these interventions studied yielded positive results on outcomes with a decrease in post-traumatic, anxiety, and depressive symptoms. However, negative results were noted when traumatic events were still ongoing (war, political violence) as well as when there was no or little parental involvement. This study informs areas for future PTSD prevention research and raises awareness of the importance of psychoeducation and coping skills building in both youth and their parents in the aftermath of a traumatic event, to strengthen family support and prevent the occurrence of enduring post-traumatic symptoms.
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Affiliation(s)
- Hala Kerbage
- Department of Child and Adolescent Psychiatry, Saint Eloi University Hospital, 34090 Montpellier, France
- Center for Epidemiology and Population Health (CESP), INSERM U1018, Developmental Psychiatry Team, Paris-Saclay University, Villejuif CEDEX, 94807 Paris, France
- Correspondence: ; Tel.: +33601819449
| | - Ola Bazzi
- Faculty of Health Sciences, American University of Beirut, Beirut 1107 2020, Lebanon;
| | - Wissam El Hage
- Center of Clinical Investigation iBrain 1253, University of Tours, 37032 Tours, France;
| | - Emmanuelle Corruble
- CESP, MOODS Team, INSERM U1018, School of Medicine, Paris-Saclay University, Kremlin Bicetre, 94275 Paris, France;
- Department of Psychiatry, Paris-Saclay University Hospital, Kremlin Bicetre, 94275 Paris, France;
| | - Diane Purper-Ouakil
- Department of Psychiatry, Paris-Saclay University Hospital, Kremlin Bicetre, 94275 Paris, France;
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19
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Tchimtchoua Tamo AR. Children academic stress, mothers’ anxiety and Mother-Child relationship during COVID-19 in China. Health Care Women Int 2022:1-15. [PMID: 35452351 DOI: 10.1080/07399332.2022.2037602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
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.
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20
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Russell BS, Tomkunas AJ, Hutchison M, Tambling RR, Horton AL. The Protective Role of Parent Resilience on Mental Health and the Parent-Child Relationship During COVID-19. Child Psychiatry Hum Dev 2022; 53:183-196. [PMID: 34533667 PMCID: PMC8447807 DOI: 10.1007/s10578-021-01243-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2021] [Indexed: 12/24/2022]
Abstract
The COVID-19 pandemic is linked to particularly potent psychological effects for children and their caregivers while families adjust to new daily routines for work, education, and self-care. Longitudinal associations are presented from a national sample of 271 parents (mean age = 35.29 years, 48.5% female) on resilience, mental health and stress indicators, and parenting outcomes. Multigroup path model results indicate significant associations between resilience and parent stress or parent perceived child stress initiates a sequence of significant linkages to parent depression, followed by caregiver burden and parent-child relationship quality. This final set of linkages between depression and both parenting outcomes were significantly stronger for men, who also reported higher rates of perceived child stress. Results suggest that fathers' depression symptoms and associated spill-over to perceived child stress is producing stronger effects on their parenting experiences than effects reported by mothers.
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Affiliation(s)
- Beth S Russell
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA.
| | - Alexandria J Tomkunas
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA
| | - Morica Hutchison
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA
| | - Rachel R Tambling
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA
| | - Abagail L Horton
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Rd. U-1058, Storrs, CT, 06269, USA
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21
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He Y, Ortiz R, Kishton R, Wood J, Fingerman M, Jacobs L, Sinko L. In their own words: Child and adolescent perceptions of caregiver stress during early COVID-19. CHILD ABUSE & NEGLECT 2022; 124:105452. [PMID: 34954423 PMCID: PMC8692067 DOI: 10.1016/j.chiabu.2021.105452] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 11/26/2021] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has exacerbated multiple stressors for caregivers of children in the United States, raising concern for increased family conflict, harsh parenting, and child maltreatment. Little is known regarding children's perceptions and experiences of caregiver stress during the COVID-19 pandemic. OBJECTIVE To examine how children and adolescents identify and experience caregiver stress during the early COVID-19 pandemic. METHODS We analyzed 105 de-identified helpline text and online chat transcripts from children under age 18 who submitted inquiries to the Childhelp National Child Abuse Hotline from March to June of 2020, with COVID-19 as a presenting issue. Inductive, thematic analysis was used to identify how child helpline users: 1) perceived and experienced drivers of caregiver stress and 2) used words to describe manifestations of caregiver stress during the COVID-19 pandemic. RESULTS Children experienced multiple drivers of caregiver stress during COVID-19, including intrapersonal (e.g. caregiver health concerns), interpersonal (e.g. parental discord, perceived dislike of child), and extrapersonal (e.g. financial insecurity, sheltering in place) stressors. Regardless of the driver, caregivers' stress was internalized by children. "Anger," "control," and "blame" were most commonly used to label manifestations of caregiver stress, which were often externalizing behaviors, including yelling, name calling, and blaming of others. CONCLUSION In text and online chat inquiries to a national child helpline during the COVID-19 pandemic, children described multiple drivers of caregiver stress, often feeling as though they were to blame. Providers serving children should address household stress spillover effects by including caregivers and directly acknowledging children's concerns using their own words.
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Affiliation(s)
- Yuan He
- University of Pennsylvania Perelman School of Medicine, National Clinician Scholars Program, United States of America; The Children's Hospital of Philadelphia, PolicyLab and Department of Pediatrics, United States of America; Leonard Davis Institute of Health Economics, University of Pennsylvania, United States of America.
| | - Robin Ortiz
- University of Pennsylvania Perelman School of Medicine, National Clinician Scholars Program, United States of America; The Children's Hospital of Philadelphia, PolicyLab and Department of Pediatrics, United States of America; Leonard Davis Institute of Health Economics, University of Pennsylvania, United States of America
| | - Rachel Kishton
- University of Pennsylvania Perelman School of Medicine, National Clinician Scholars Program, United States of America; Leonard Davis Institute of Health Economics, University of Pennsylvania, United States of America; University of Pennsylvania Perelman School of Medicine, Department of Family Medicine and Community Health, United States of America
| | - Joanne Wood
- University of Pennsylvania Perelman School of Medicine, National Clinician Scholars Program, United States of America; The Children's Hospital of Philadelphia, PolicyLab and Department of Pediatrics, United States of America; Leonard Davis Institute of Health Economics, University of Pennsylvania, United States of America
| | | | - Larel Jacobs
- Childhelp National Child Abuse Hotline, United States of America
| | - Laura Sinko
- University of Pennsylvania Perelman School of Medicine, National Clinician Scholars Program, United States of America; Leonard Davis Institute of Health Economics, University of Pennsylvania, United States of America; Temple University College of Public Health, Department of Nursing, United States of America
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22
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Associations between parent-child relationship, and children's externalizing and internalizing symptoms, and lifestyle behaviors in China during the COVID-19 epidemic. Sci Rep 2021; 11:23375. [PMID: 34862415 PMCID: PMC8642441 DOI: 10.1038/s41598-021-02672-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 11/19/2021] [Indexed: 11/30/2022] Open
Abstract
To investigate associations between parent–child relationships, children’s externalizing and internalizing symptoms, and lifestyle responses to the COVID-19 epidemic, we conducted an online survey of a random, representative sample of residents with children aged 3–17 years during mid-March 2020 in Wuhan and Shanghai, China. A total of 1655 parents and children were surveyed with a response rate of 80.1% in the survey. During the epidemic, the frequency of children enquiring about the epidemic (AOR = 1.46, 95% CI: 1.04, 2.06), parents explaining the epidemic to them (AOR = 2.87, 95% CI: 1.80, 4.58), parents expressing negative emotions in front of them (AOR = 2.62; 95% CI = 2.08–3.30), and parents with more irritable attitudes (AOR = 1.93; 95% CI = 1.33–2.81) were significantly associated with children’s externalizing symptoms. For internalizing symptoms, significant associations were found with worse parent–child closeness (AOR = 2.93; 95% CI = 1.80–4.79), the frequency of parents expressing negative emotions in front of them (AOR = 2.64; 95% CI = 1.68, 4.12), and more irritable attitudes (AOR = 2.24; 95% CI = 1.42–3.55). We also found that each indicator of parent–child relationships had the significantly similar associations with children’s lifestyle behaviors. These findings suggest that improving parents’ attitudes towards their children and parent–child closeness during the epidemic, especially among parents with lower educational levels, are important to ensure the wellbeing of children.
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23
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Kerr ML, Rasmussen HF, Fanning KA, Braaten SM. Parenting During COVID-19: A Study of Parents' Experiences Across Gender and Income Levels. FAMILY RELATIONS 2021; 70:1327-1342. [PMID: 34548726 PMCID: PMC8444790 DOI: 10.1111/fare.12571] [Citation(s) in RCA: 61] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 02/15/2021] [Accepted: 03/07/2021] [Indexed: 05/07/2023]
Abstract
Objective This study describes parenting experiences at the beginning of the COVID-19 pandemic and examines differences across parent gender and family income level. Background The COVID-19 pandemic had unprecedented impacts on families. Many parents faced employment changes, including job loss, reduced pay, and working remotely, while simultaneously experiencing increased childcare responsibilities due to school and childcare closures. Research is needed to document the ongoing impact of these changes on parents and families. Method An online convenience sample of parents (N = 1,009) reported on their parenting experiences during the beginning of the COVID-19 pandemic (April 2020) in an online survey. Results Parents reported high levels of depression, anxiety, and parental burnout. Further, many parents reported increased negative emotions, such as anger and worry, while simultaneously feeling closer to their children and offering more comfort and soothing. Differences across gender and income levels are presented. Conclusion These results align with other emerging findings of increased impacts to mental health and well-being for parents and children and document the disproportionate effects on women and low-income families. Implications Implications include needing additional support (e.g., financial, caregiving) for parents and families as we continue to face the impacts and consequences of COVID-19.
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24
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Barnett ML, Sigal M, Green Rosas Y, Corcoran F, Rastogi M, Jent JF. Therapist Experiences and Attitudes About Implementing Internet-Delivered Parent-Child Interaction Therapy During COVID-19. COGNITIVE AND BEHAVIORAL PRACTICE 2021; 28:630-641. [PMID: 33994769 PMCID: PMC8112899 DOI: 10.1016/j.cbpra.2021.03.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Accepted: 03/19/2021] [Indexed: 12/01/2022]
Abstract
It has been widely recognized that access to mental health treatment is imperative to address current and long-term stressors for children and parents during COVID-19. Internet-delivered Parent-Child Interaction Therapy (iPCIT, previously referred to as I-PCIT) is a strong model for remote service delivery during social distancing restrictions due to its empirical base. However, this treatment modality was not widely implemented before COVID-19, likely due to barriers to providing telehealth services. This mixed methods study conducted a follow-up survey to gather therapist experiences (N = 223) in delivering iPCIT during COVID-19, including qualitative data on the benefits and challenges to delivering iPCIT. The vast majority of therapists (82%) indicated that they transitioned to deliver PCIT via telehealth in response to COVID-19. PCIT caseloads decreased slightly from the first survey to the COVID-19 follow-up survey, but the racial and ethnic composition of caseloads were not significantly different between the two surveys. Of the 183 therapists who transitioned to deliver PCIT via telehealth, 82% expressed interest in continuing to provide iPCIT following the COVID-19 pandemic. Reported benefits of iPCIT included decreased barriers to access and the ability to practice skills within the naturalistic home environment. Challenges to iPCIT were primarily issues with technology as well as other logistical barriers, which could limit engagement for some families. Findings from this study may be beneficial in improving future implementation of iPCIT during and post-COVID-19.
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25
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Parental Internalizing Psychopathology and PTSD in Offspring after the 2012 Earthquake in Italy. CHILDREN-BASEL 2021; 8:children8100930. [PMID: 34682196 PMCID: PMC8535087 DOI: 10.3390/children8100930] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/19/2021] [Revised: 10/13/2021] [Accepted: 10/15/2021] [Indexed: 11/16/2022]
Abstract
Post-traumatic stress disorder (PTSD) is common in youths after earthquakes, with parental psychopathology among the most significant predictors. This study investigated the contribution and the interactional effects of parental internalizing psychopathology, the severity of exposure to the earthquake, and past traumatic events to predict PTSD in offspring, also testing the reverse pattern. Two years after the 2012 earthquake in Italy, 843 children and adolescents (9-15 years) living in two differently affected areas were administered a questionnaire on traumatic exposure and the UCLA PTSD Reaction Index. Anxiety, depression, and somatization were assessed in 1162 parents through the SCL-90-R. General linear model showed that, for offspring in the high-impact area, predictors of PTSD were earthquake exposure, past trauma, and parental internalizing symptoms, taken individually. An interaction between earthquake exposure and parental depression or anxiety (not somatization) was also found. In the low-impact area, youth PTSD was only predicted by earthquake exposure. The reverse pattern was significant, with parental psychopathology explained by offspring PTSD. Overall, findings support the association between parental and offspring psychopathology after natural disasters, emphasizing the importance of environmental factors in this relationship. Although further research is needed, these results should be carefully considered when developing mental health interventions.
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26
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Avery AR, Tsang S, Seto EYW, Duncan GE. Differences in Stress and Anxiety Among Women With and Without Children in the Household During the Early Months of the COVID-19 Pandemic. Front Public Health 2021; 9:688462. [PMID: 34540782 PMCID: PMC8440851 DOI: 10.3389/fpubh.2021.688462] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 08/09/2021] [Indexed: 11/16/2022] Open
Abstract
The COVID-19 pandemic and resulting lockdowns have had a disproportionate impact on parents of children under 18, particularly women. Mandatory school closures and loss of childcare resulted in parents balancing work, teaching, and childcare needs. A number of studies have examined changes in mental health of parents, but to date no studies have compared the differences in stress and anxiety levels between women with and without children in the United States. Adult women from the Washington State Twin Registry (WSTR) (N = 1,014, pair N = 529) and mothers of twin children enrolled in the WSTR (N = 147) completed an online survey examining several health-related behaviors and outcomes and their self-reported changes due to COVID-19. We conducted two studies to examine the impact of children on stress and anxiety levels among women. In study 1, we assessed whether women living in households with children under the age of 18 have higher levels of stress and anxiety than those without children in their household. We found that perceived stress levels did not differ between women with and without children in the household, but anxiety levels were higher among women living with children than those without. In study 2, we assessed whether the correlation between children in the household and stress/anxiety is accounted for by non-random genetic and environmental selection effects, causal processes, or both using a sample of adult female twins. We found that the presence of children in the household was associated with higher levels of stress and anxiety. However, this association is confounded by genetic and shared environmental factors. Our findings highlight the need to provide supporting resources to women living with children in the household during and after the COVID-19 pandemic.
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Affiliation(s)
- Ally R. Avery
- Department of Nutrition and Exercise Physiology, Washington State University, Spokane, WA, United States
| | - Siny Tsang
- Department of Nutrition and Exercise Physiology, Washington State University, Spokane, WA, United States
| | - Edmund Y. W. Seto
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
| | - Glen E. Duncan
- Department of Nutrition and Exercise Physiology, Washington State University, Spokane, WA, United States
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Russell BS, Hutchison M, Park CL, Fendrich M, Finkelstein-Fox L. Short-term impacts of COVID-19 on family caregivers: Emotion regulation, coping, and mental health. J Clin Psychol 2021; 78:357-374. [PMID: 34331773 PMCID: PMC8427037 DOI: 10.1002/jclp.23228] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/19/2021] [Accepted: 07/20/2021] [Indexed: 12/14/2022]
Abstract
Background The negative mental health impact of coronavirus disease 2019‐related stressors may be heightened for those caring for children, who bear responsibity for their welfare during disasters. Aim Based on the Transactional Model of Stress and Coping, we inquired whether caregivers' emotion regulation and coping behavior were associated with posttraumatic stress symptoms (PTSS). Materials & Methods Data were collected through a national online survey in April 2020, and again 60 days later. Results:Of the 801 longitudinal cases, 176 (63.6% female; mean age = 33.5) reported caring for minors in their homes during the pandemic. Over 20% of caregivers experienced clinically concerning PTSS, rates higher than their noncaregiving counterparts. Regression analysis indicates caregivers' baseline mental health symptoms and emotion regulation predicted PTSS 60 days later. Discussion Implications for needed parenting supports among families experiencing traumatic stress are provided. Conclusion Anxiety symptoms at baseline were the most significant and consistent contributor to all models and were significantly higher among those with clinically concerning levels of PTSS suggesting a clear intervention target.
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Affiliation(s)
- Beth S Russell
- Department of Human Development & Family Sciences, Storrs, Connecticut, USA
| | - Morica Hutchison
- Department of Human Development & Family Sciences, Storrs, Connecticut, USA
| | - Crystal L Park
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
| | - Michael Fendrich
- School of Social Work, University of Connecticut, Storrs, Connecticut, USA
| | - Lucy Finkelstein-Fox
- Department of Psychological Sciences, University of Connecticut, Storrs, Connecticut, USA
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The Association between Child and Parent Psychiatric Disorders in Families Exposed to Flood and/or Dioxin. Behav Sci (Basel) 2021; 11:bs11040046. [PMID: 33915718 PMCID: PMC8066693 DOI: 10.3390/bs11040046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/05/2021] [Accepted: 03/26/2021] [Indexed: 01/27/2023] Open
Abstract
Associations of disaster mental health sequelae between children and their parents have been demonstrated, but not using full diagnostic assessment. This study examined children and their parents after a series of disasters in 1982 to investigate associations of their psychiatric outcomes. Members of 169 families exposed to floods and/or dioxin or no disaster were assessed in 1986–1987 with structured diagnostic interviews. This vintage dataset collected several decades ago provides new information to this field because of the methodological rigor that is unparalleled in this literature. Disaster-related PTSD and incident postdisaster disorders in children were associated, respectively with disaster-related PTSD and incident postdisaster disorders in the chief caregiver and mother. More flood-only than dioxin-only exposed parents reported great harm by the disaster, but neither children nor parents in these two groups differed in incident psychiatric disorders. Although this study did not determine the direction of causal influences, its findings suggest that clinicians working with disaster-exposed families should work with children and adult members together, as their mental health outcomes may be intertwined.
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Tambling R, Russell B, Tomkunas A, Horton A, Hutchison M. Factors Contributing to Parents' Psychological and Medical Help Seeking During the COVID-19 Global Pandemic. FAMILY & COMMUNITY HEALTH 2021; 44:87-98. [PMID: 33565782 DOI: 10.1097/fch.0000000000000298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The COVID-19 pandemic and related quarantine orders will impact the mental health of millions of individuals in the United States. Mental health difficulties, including depression, anxiety, traumatic stress, and other negative mental health sequelae are likely and likely to persist. These challenges will require response from the psychotherapeutic and medical community that addresses the mental health needs of the population. Using binary logistic regression (n = 322 at time 1, and n = 189 at time 2), researchers in the present study examined promotive factors related to having sought medical or behavioral health treatment during a 30-day period in the midst of the COVID-19 pandemic in the United States. Approximately 10% of the sample indicated having sought either type of help. Results from the binary logistic regressions indicated those who sought counseling or medical help were those who reported increased depression symptoms at time 1. The likelihood of help seeking was heightened for those who reported greater caregiving burden, highlighting the need to consider the availability of services for those caring for children during this community-wide crisis.
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Affiliation(s)
- Rachel Tambling
- Department of Human Development & Family Sciences, University of Connecticut, Storrs
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Lorenzo NE, Zeytinoglu S, Morales S, Listokin J, Almas AN, Degnan KA, Henderson H, Chronis-Tuscano A, Fox NA. Transactional Associations Between Parent and Late Adolescent Internalizing Symptoms During the COVID-19 Pandemic: The Moderating Role of Avoidant Coping. J Youth Adolesc 2021; 50:459-469. [PMID: 33495969 PMCID: PMC7833445 DOI: 10.1007/s10964-020-01374-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 12/04/2020] [Indexed: 02/07/2023]
Abstract
Extensive research has demonstrated the transactional nature of parent-child psychopathology, with limited studies examining these effects during late adolescence and none, to our knowledge, longitudinally during the COVID-19 pandemic. The current study examined the cross-lagged effects of parent and adolescent internalizing symptoms during the COVID-19 pandemic and the moderating role of avoidant coping. A sample of 291 adolescents (Agemean = 18.27; 53% female; 61% White) and their parents rated their own anxiety and depressive symptoms and coping during the first two months following stay-at-home orders during the COVID-19 pandemic. Parent internalizing symptoms at the first assessment predicted adolescent internalizing symptoms at the second assessment. Adolescent avoidant coping style moderated this effect of parent internalizing symptoms on adolescent internalizing symptoms in the subsequent month, such that parent internalizing symptoms predicted child internalizing symptoms only among adolescents with moderate to high rates of avoidant coping. Follow-up analyses indicated different patterns when examining depressive and anxiety symptoms separately. The results highlight complex family dynamics between adolescents and their parents and begin to differentiate how individual characteristics impact the response to a significant life event such as the COVID-19 pandemic.
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Affiliation(s)
- Nicole E Lorenzo
- University of Maryland, 3942 Campus Drive, College Park, MD, 20742, USA.
| | - Selin Zeytinoglu
- University of Maryland, 3942 Campus Drive, College Park, MD, 20742, USA
| | - Santiago Morales
- University of Maryland, 3942 Campus Drive, College Park, MD, 20742, USA
| | - Jamie Listokin
- University of Maryland, 3942 Campus Drive, College Park, MD, 20742, USA
| | - Alisa N Almas
- University of British Columbia, 2206 East Mall, Vancouver, BC, V6T 1Z3, Canada
| | - Kathryn A Degnan
- Catholic University, 620 Michigan Ave., N.E., Washington, DC, 20064, USA
| | - Heather Henderson
- Waterloo University, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada
| | | | - Nathan A Fox
- University of Maryland, 3942 Campus Drive, College Park, MD, 20742, USA
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Tambling RR, Tomkunas AJ, Russell BS, Horton AL, Hutchison M. Thematic Analysis of Parent-Child Conversations About COVID-19: "Playing It Safe". JOURNAL OF CHILD AND FAMILY STUDIES 2021; 30:325-337. [PMID: 33456294 PMCID: PMC7798006 DOI: 10.1007/s10826-020-01889-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 05/10/2023]
Abstract
Caregivers have primary responsibility for teaching their children self-protective behaviors, including those behaviors recommended by the Center for Disease Control (CDC) to prevent the spread of COVID-19. Parents have an important role in scaffolding adherence to the CDC recommendations and in managing stress and regulate their emotions to adaptively cope during uncertain times like those facing communities nationwide. The present study is a qualitative, thematic analysis of parent-reported (n = 210; 64.8% female; average age = 39.33; 14.3% ethnic/racial minority) interactions with children (focal child age: 25.2% birth to 5 years old, 36.7% 6 to 11 years old, 37.6% 12 to 18 years old) about topics associated to COVID-19-related viral transmission suppression guidelines and stress/coping behaviors. Themes included discussions about personal and social hygiene, and parent reported sources of child stress, and child stress management efforts. Findings from our thematic analysis indicate parents are motivated to make scaffolding personal hygiene fun and engaging, signaling a positive, developmentally appropriate native approach to their role as sources of coping socialization. These findings also underscore the importance of providing information to parents in ways that can be translated to children in developmentally appropriate conversations about viral transmission suppression activities and stress management during disasters.
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Affiliation(s)
- R. R. Tambling
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT 06269-1058 USA
| | - A. J. Tomkunas
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT 06269-1058 USA
| | - B. S. Russell
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT 06269-1058 USA
| | - A. L. Horton
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT 06269-1058 USA
| | - M. Hutchison
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT 06269-1058 USA
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Arshad M, Mughal MK, Giallo R, Kingston D. Predictors of child resilience in a community-based cohort facing flood as natural disaster. BMC Psychiatry 2020; 20:543. [PMID: 33213409 PMCID: PMC7678269 DOI: 10.1186/s12888-020-02944-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 11/07/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Natural disasters are unpredictable and uncontrollable events that usually induce significant level of stress and social disruption in afflicted individuals. The consequences are formidable, affecting lifetime health and economic prosperity. Among natural disasters, floods are the most common causes and tend to have the highest economic burden. The aim of this study was to examine factors associated with child resilience in the face of the natural disaster experienced by the city of Calgary, Alberta, Canada during its unprecedented flood of 2013. METHODS The current study was conducted in a community-based cohort situated in the city of Calgary. The participants were recruited out of the All Our Families longitudinal cohort within the Cummings School of Medicine at the University of Calgary. Of the total 1711 people contacted, 469 people consented and completed questionnaire. Of those 469 who consented to be part of the study, 467 were eligible to be included for analysis. A flood impact questionnaire was delivered 6 months after the 2013 flood in families whose children were an average of 3 years old. Mother reported questionnaires were used to assess child resilience. The study included maternal data on a range of factors including socio-demographic, history of mental health, relationship with the partner and social support. Child related data were also incorporated into the study, and variables included delivery mode, child sex, and child age at the time of disaster. RESULTS Child resilience was best predicted by mother's age and social support, and by child gender, the child's externalizing and internalizing behaviors and the Rothbart temperament scale: effortful control. Furthermore, this study revealed that children who were more exposed to the flood events, showed higher resilience compared to the children who were less or not exposed. CONCLUSIONS These findings highlight the risk and protective factors that predict child resilience and suggest that mother reported questionnaire are useful tools to assess child resilience amidst early life adversity.
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Affiliation(s)
- Muhammad Arshad
- grid.22072.350000 0004 1936 7697Faculty of Nursing, University of Calgary, Calgary, Alberta Canada ,Center for Genomics and Systems Biology, New York University, Abu Dhabi, United Arab Emirates
| | - Muhammad Kashif Mughal
- grid.22072.350000 0004 1936 7697Faculty of Nursing, University of Calgary, Calgary, Alberta Canada
| | - Rebecca Giallo
- Murdoch Childrens Research Institute, The Royal Children’s Hospital, Parkville, Victoria Australia
| | - Dawn Kingston
- Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada.
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Bountress KE, Gilmore AK, Metzger IW, Aggen SH, Tomko RL, Danielson CK, Williamson V, Vladmirov V, Ruggiero K, Amstadter AB. Impact of disaster exposure severity: Cascading effects across parental distress, adolescent PTSD symptoms, as well as parent-child conflict and communication. Soc Sci Med 2020; 264:113293. [PMID: 32858492 PMCID: PMC7689632 DOI: 10.1016/j.socscimed.2020.113293] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 07/16/2020] [Accepted: 08/11/2020] [Indexed: 10/23/2022]
Abstract
RATIONALE Natural disasters are common and have potentially deleterious impacts on individuals, as well as on the relationships among family members (Adams et al., 2015; Paul, 2015). Additionally, caregiver-, offspring-, and family-level outcomes are often correlated following disaster. OBJECTIVE Thus, longitudinal work is needed to clarify the prospective associations among such constructs following severe disasters. METHOD The current study included 1,271 adolescents and investigated whether disaster exposure impacted adolescent posttraumatic stress disorder (PTSD) symptoms, parent distress, and family parent-child conflict and communication, as well as whether/how these factors influenced one another over time. This study used a dynamic cascade model and included adolescents (ages 12-17) and caregivers present for tornadoes in Missouri and Alabama in 2011. These participants were part of a larger study involving a web-based intervention. RESULTS Over and above covariates (i.e., adolescent age, gender, race, treatment, prior trauma, adolescent alcohol use and depressive symptoms, and household income), families who experienced greater severity of disaster exposure had adolescents who reported more baseline PTSD symptoms and caregivers who reported more distress at baseline. CONCLUSIONS Providing tangible resources (e.g., housing, food, transportation, essential possessions) to families post-disaster may reduce parent distress and adolescent PTSD symptoms. Additionally, reducing adolescent PTSD symptoms may prospectively improve relationships between parents and adolescents.
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Affiliation(s)
- Kaitlin E Bountress
- Virginia Institute for Psychiatry and Behavioral Genetics, Virginia Commonwealth University, United States.
| | - Amanda K Gilmore
- Mark Chaffin Center for Healthy Development and Department of Health Policy & Behavioral Sciences, School of Public Health, Georgia State University, United States
| | - Isha W Metzger
- University of Georgia, Department of Psychology, United States
| | - Steven H Aggen
- Virginia Institute for Psychiatry and Behavioral Genetics, Virginia Commonwealth University, United States
| | - Rachel L Tomko
- Addiction Sciences Division, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States
| | - Carla Kmett Danielson
- National Crime Victim Research & Treatment Center (NCVC), Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, United States
| | - Vernell Williamson
- Virginia Institute for Psychiatry and Behavioral Genetics, Virginia Commonwealth University, United States
| | - Vladimir Vladmirov
- Virginia Institute for Psychiatry and Behavioral Genetics, Virginia Commonwealth University, United States
| | - Kenneth Ruggiero
- College of Nursing, Medical University of South Carolina, United States
| | - Ananda B Amstadter
- Virginia Institute for Psychiatry and Behavioral Genetics, Virginia Commonwealth University, United States
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Russell BS, Hutchison M, Tambling R, Tomkunas AJ, Horton AL. Initial Challenges of Caregiving During COVID-19: Caregiver Burden, Mental Health, and the Parent-Child Relationship. Child Psychiatry Hum Dev 2020; 51:671-682. [PMID: 32749568 PMCID: PMC7398861 DOI: 10.1007/s10578-020-01037-x] [Citation(s) in RCA: 356] [Impact Index Per Article: 89.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Research confirms that the mental health burdens following community-wide disasters are extensive, with pervasive impacts noted in individuals and families. It is clear that child disaster outcomes are worst among children of highly distressed caregivers, or those caregivers who experience their own negative mental health outcomes from the disaster. The current study used path analysis to examine concurrent patterns of parents' (n = 420) experience from a national sample during the early months of the U.S. COVID-19 pandemic. The results of a multi-group path analysis, organized by parent gender, indicate good fit to the data [X2(10) = 159.04, p < .01]. Results indicate significant linkages between parents' caregiver burden, mental health, and perceptions of children's stress; these in turn are significantly linked to child-parent closeness and conflict, indicating possible spillover effects for depressed parents and compensatory effects for anxious parents. The impact of millions of families sheltering in place during the COVID-19 pandemic for an undefined period of time may lead to unprecedented impacts on individuals' mental health with unknown impacts on child-parent relationships. These impacts may be heightened for families whose caregivers experience increased mental health symptoms, as was the case for fathers in the current sample.
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Affiliation(s)
- B S Russell
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT, 06269-1058, USA.
| | - M Hutchison
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT, 06269-1058, USA
| | - R Tambling
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT, 06269-1058, USA
| | - A J Tomkunas
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT, 06269-1058, USA
| | - A L Horton
- Department of Human Development & Family Sciences, University of Connecticut, 348 Mansfield Road, Unit 1058, Storrs, CT, 06269-1058, USA
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Chen XY, Chen J, Shi X, Jiang M, Li Y, Zhou Y, Ran M, Lai Y, Wang T, Fan F, Liu X, Chan CLW. Trajectories of maternal symptoms of posttraumatic stress disorder predict long-term mental health of children following the Wenchuan earthquake in China: A 10-year follow-up study. J Affect Disord 2020; 266:201-206. [PMID: 32056877 DOI: 10.1016/j.jad.2020.01.084] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Revised: 01/16/2020] [Accepted: 01/20/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Maternal psychopathology can be an important factor associated with psychological adjustment of children. However, there is limited research on long-term impacts of maternal posttraumatic stress disorder (PTSD) on children's mental health. This study examined how PTSD trajectories of women exposed to the 2008 Wenchuan earthquake in China predicted their children's mental health symptoms 10 years after the earthquake. METHODS 410 dyads of mothers and their adolescent children who exposed to the Wenchuan earthquake were investigated at 12 and 18 months post-earthquake. While the mothers completed measures of earthquake exposure and PTSD symptoms, the children completed measures of earthquake exposure, PTSD, depression and anxiety symptoms. In the 10-year follow up, 257 out of the 410 children completed measures of PTSD, depression and anxiety symptoms. Data were analyzed using linear regression. RESULTS Four trajectories of maternal PTSD symptoms were identified: (a) chronic (9.5%); (b) resilient (66.3%); (c) delayed (7.6%); and (d) recovery (16.6%); More importantly, the findings demonstrated that children whose mothers experienced chronic PTSD reported higher level of PTSD and anxiety symptoms 10 years after the earthquake. LIMITATIONS Only two waves of maternal PTSD were collected, self-reported tools other than clinical reviews were used to collect data, and a significant proportion of participants did not respond at the 10-year follow-up. CONCLUSIONS This study identified maternal PTSD trajectories following the Wenchuan earthquake. Chronic PTSD symptoms in mothers were associated with increased risk of children's PTSD and anxiety 10 years after the earthquake.
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Affiliation(s)
- Xiao-Yan Chen
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China
| | - Jieling Chen
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong, China
| | - Xuliang Shi
- College of Education, Hebei University, Hebei, China
| | - Min Jiang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China
| | - Yuanyuan Li
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China
| | - Ya Zhou
- Department of Psychology, Lund University, 221 00 Lund, Sweden
| | - Maosheng Ran
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
| | - Yuan Lai
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China
| | - Tong Wang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China
| | - Fang Fan
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China.
| | - Xianchen Liu
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Shipai Road, Guangzhou 510631, Guangdong, China
| | - Cecilia Lai Wan Chan
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China
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Symes L, McFarlane J, Maddoux J, Fredland N. Evaluating an Intergenerational Model to Explain the Path From Violence Against Mothers to Child Behavior and Academic Outcomes. Violence Against Women 2019; 26:730-749. [PMID: 31032712 DOI: 10.1177/1077801219841444] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
An intergenerational model to explain the long-term effect of partner violence against mothers on child behavior was evaluated 48 months after 278 mothers first sought safe shelter or justice services. Twelve percent reported recent abuse, and six mothers reported severe or extreme danger. Self-efficacy (-.58, p < .05), social support (-28, p < .05), and financial support (-.25) were inversely associated with mental health concerns. Higher maternal mental health concerns (.55, p < .05) and child witnessing abuse (.70, p < .05) were associated with child behavioral problems. Child behavioral problems were inversely associated with child academic functioning (-.22, p < .05). To improve child outcomes, interventions that establish safety for mothers and children and promote maternal mental health are needed.
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Crum KI, Cornacchio D, Coxe S, Green JG, Comer JS. A latent profile analysis of co-occurring youth posttraumatic stress and conduct problems following community trauma. JOURNAL OF CHILD AND FAMILY STUDIES 2018; 27:3638-3649. [PMID: 31824130 PMCID: PMC6904109 DOI: 10.1007/s10826-018-1205-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Although most research with youth exposed to violent manmade disasters has focused on internalizing problems, recent work suggests conduct problems (CPs) may also manifest in exposed youth. However, the extent to which youth postevent CPs present independently, versus co-present in conjunction with PTSD symptoms, remains unclear. The present study examined PTS and CP symptom profiles among affected Boston-area youth following the 2013 Boston Marathon bombing. This study used latent profile analysis to identify distinct PTS and CP symptom profiles among Boston-area youth ages 4-19 years (N=344) affected by the Boston Marathon bombing events. PTS and CPs were measured using the UCLA-PTSD-RI and the SDQ parent reports, respectively. Analyses identified 3 distinct profiles: presentations characterized by (a) low PTS, low CPs, (b) moderate PTS, low CPs, and (c) high PTS, elevated CPs. The profile characterized by the highest PTS was the only profile with elevated CPs; hyperarousal and emotional numbing/avoidance symptoms showed the greatest distinguishing properties among profiles with and without elevated CP. Types of traumatic exposure experienced by youth were differentially associated with profiles. Specifically, direct (but not relational) exposure distinguished youth classified in the profile showing elevated CPs. Findings suggest interventions following violent manmade disasters may do well to incorporate CP modules when working with youth showing the greatest hyperarousal and emotional numbing, and/or who have directly witnessed the most violence.
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Affiliation(s)
- Kathleen I Crum
- Medical University of South Carolina, Department of Psychiatry and Behavioral Sciences, National Crime Victims Research and Treatment Center; 67 President St, MSC 861, Charleston, SC 29414
| | | | - Stefany Coxe
- Florida International University, Department of Psychology, Miami, FL
| | | | - Jonathan S Comer
- Florida International University, Department of Psychology, Miami, FL
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Parent-Reported Child Reactions to the September 11, 2001 World Trade Center Attacks (New York USA) in Relation to Parent Post-Disaster Psychopathology Three Years After the Event. Prehosp Disaster Med 2018; 33:558-564. [PMID: 30295206 DOI: 10.1017/s1049023x18000869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
IntroductionParents are a primary support for children following disasters, even though they face numerous challenges in addressing the physical and social consequences of an event. Parents who are directly exposed to a disaster and those who develop psychiatric disorders post-event are likely to be especially challenged and may be limited in their ability to support their children. This Brief Report describes a pilot study of survivors of the September 11, 2001 World Trade Center (New York USA) attacks who reported their own psychosocial consequences and the reactions of their children three years post-event.HypothesesThe primary hypothesis of the study was that children's September 11th reactions would be associated with their parents' psychiatric status. Secondary hypotheses were that the children's disaster reactions would be associated with direct exposure to the disaster in children and/or their parents, parent-child separation due to the disaster, and disaster-related school absence. METHODS Approximately three years after the 2001 World Trade Center attacks, 116 parents recruited from disaster-affected or disaster-related organizations were assessed using structured diagnostic interviews and queried about their children's (188 youths, aged three to 17 years at the time of the attacks) posttraumatic stress symptoms and behavioral changes. RESULTS Almost one-half of the parents had a post-disaster psychiatric disorder, including major depression in 27% and disaster-related posttraumatic stress disorder (PTSD) in 11%. More than three-fourths of the children had at least one disaster-related posttraumatic stress symptom, and more than one-half experienced at least one post-disaster behavior change. A minority of the children were reported to have increased school behavior problems or a decline in their grades. Key correlates of children's disaster-related posttraumatic stress symptoms and post-disaster behavior changes were parent-child separation due to the disaster and parental post-disaster psychiatric disorders. CONCLUSION Because parents provide primary caretaking and support for children post-disaster, addressing the needs of parents is critical to their ability to assist their children. Reducing parents' symptoms should increase their emotional availability and enhance their ability to address the needs of their children. Given the challenges in providing disaster interventions directly to children, especially when resources are limited, addressing parent psychopathology and distress (even in the absence of focusing on children's symptoms) may benefit children. PfefferbaumB, SimicZ, NorthCS. Parent-reported child reactions to the September 11, 2001, World Trade Center attacks (New York USA) in relation to parent post-disaster psychopathology three years after the event. Prehosp Disaster Med. 2018;33(5):558-564.
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Wisner B, Paton D, Alisic E, Eastwood O, Shreve C, Fordham M. Communication With Children and Families About Disaster: Reviewing Multi-disciplinary Literature 2015-2017. Curr Psychiatry Rep 2018; 20:73. [PMID: 30094701 DOI: 10.1007/s11920-018-0942-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
PURPOSE OF REVIEW To identify strategies for communicating with youth and children pre- and post-disaster in the context of a broader survey of child participation in disaster risk reduction as well as methods for communication with children. RECENT FINDINGS Youth and children are capable of peer and community education and activism concerning disaster issues and such participation benefits the young actors. Family and sibling support are important in easing the impact of trauma on children. Contemporary forms of psychological first aid appear to do no harm and in line with current evidence. Generally, more evidence from evaluations is necessary to guide the development of communication strategies. Children are growing up in increasingly urban environments with less contact with nature and greater reliance on techno-social systems. Thus, young people may misunderstand natural hazards. Schools and conscious parenting can play important roles in building understanding and psychological resilience.
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Affiliation(s)
| | | | - Eva Alisic
- University of Melbourne, Melbourne, Australia
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Lee MS, Bhang SY. Assessment Tools for the Mental Health of School-Aged Children and Adolescents Exposed to Disaster: A Systematic Review (1988-2015). Soa Chongsonyon Chongsin Uihak 2018; 29:88-100. [PMID: 32595301 PMCID: PMC7289459 DOI: 10.5765/jkacap.180002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Revised: 04/03/2018] [Accepted: 04/24/2018] [Indexed: 11/05/2022] Open
Abstract
Objectives In this study, we aimed to conduct a systematic review of studies investigating psychosocial factors affecting children exposed to disasters. Methods In total, 140 studies were retrieved. The studies were published from 1988 to 2015. A systematic review was performed using the PRISMA guidelines. MEDLINE, EMBASE, Cochrane Central, Web of Science, PsycINFO, PubMed, and Google Scholar were searched. Each database was searched using the following terms: 'Child,' 'Adolescent,' 'Youth,' 'Disaster,' 'Posttraumatic,' 'Psychosocial,' 'Assessment,' 'Evaluation,' and 'Screening.' The identified studies were subjected to data extraction and appraisal. Results The database search identified 713 articles. Based on the titles and abstracts, the full texts of 118 articles were obtained. The findings of this review can be used as a basis for the design of a psychosocial evaluation tool for disaster preparedness. Conclusion Given the paramount importance of post-disaster evaluation and the weaknesses of current disaster evaluation tools, the need to develop valid and reliable tools and psychometric evaluations cannot be overstated. Our findings provide current evidence supporting various assessments in children, who are very vulnerable psychologically following disasters.
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Affiliation(s)
- Mi-Sun Lee
- Department of Psychiatry, Eulji University Hospital, Seoul, Korea
| | - Soo-Young Bhang
- Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Seoul, Korea
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Salloum A, Johnco C, Smyth KM, Murphy TK, Storch EA. Co-Occurring Posttraumatic Stress Disorder and Depression Among Young Children. Child Psychiatry Hum Dev 2018; 49:452-459. [PMID: 29052121 DOI: 10.1007/s10578-017-0764-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The purpose of this study was to examine differences in: (1) mental health emotional and behavioral problems between young children experiencing PTSD with and without MDD; (2) the incidence of caregiver PTSD and MDD between children with PTSD ± MDD; and (3) the number of traumatic events and interpersonal versus non-interpersonal nature of trauma events among children whose parents sought child trauma-focused treatment. Sixty-six caregivers of children aged 3-7 with PTSD completed semi-structured interviews regarding caregiver and child diagnoses, and caregivers completed self-report measures regarding child symptomatology. Results indicated that young children with PTSD + MDD had significantly higher internalizing symptoms, dissociative symptoms, and posttraumatic stress severity than those without comorbid MDD. There were no significant group differences in the incidence of caregiver PTSD or MDD, or the number or types of traumatic events. Future research to understand the unique contributors to the etiology of MDD in the context of PTSD among young children is needed.
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Affiliation(s)
- Alison Salloum
- School of Social Work, College of Behavioral and Community Sciences, University of South Florida, 13301 Bruce B. Downs Blvd., MHC 1400, Tampa, FL, 33612-3870, USA.
- Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA.
| | - Carly Johnco
- Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, NSW, Australia
| | - Kristin M Smyth
- Department of Social Work, Western Carolina University, Cullowhee, NC, USA
| | - Tanya K Murphy
- Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA
- Department of Psychiatry & Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
- All Children's Hospital - Johns Hopkins Medicine, St. Petersburg, FL, USA
| | - Eric A Storch
- Department of Pediatrics, University of South Florida, St. Petersburg, FL, USA
- Department of Psychiatry & Behavioral Neurosciences, University of South Florida, Tampa, FL, USA
- All Children's Hospital - Johns Hopkins Medicine, St. Petersburg, FL, USA
- Rogers Behavioral Health, Tampa, FL, USA
- Department of Health Policy and Management, University of South Florida, Tampa, FL, USA
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Shi X, Zhou Y, Geng F, Li Y, Zhou J, Lei B, Chen S, Chen X, Fan F. Posttraumatic stress disorder symptoms in parents and adolescents after the Wenchuan earthquake: A longitudinal actor-partner interdependence model. J Affect Disord 2018; 226:301-306. [PMID: 29028591 DOI: 10.1016/j.jad.2017.10.011] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 09/26/2017] [Accepted: 10/01/2017] [Indexed: 01/06/2023]
Abstract
BACKGROUND Previous research has examined the association between parents' and children's posttraumatic stress disorder symptoms (PTSS) after a variety of traumatic events. However, longitudinal parent-child dyadic studies are scarce. METHODS Independent self-reports were collected from parent-adolescent dyads (n = 688) after the 2008 Wenchuan earthquake. Adolescents (Mean = 15.22 years; 61.63% female) and one of their parents (Mean = 41.04 years; 58.14% female) each reported on their PTSS at 12 (T12m) and 18 months (T18m) following the earthquake. Longitudinal actor-partner interdependence models (APIMs) were used to examine PTSS within dyads. RESULTS The prevalence rates of probable PTSD at T12m and T18m were 18.90% and 11.92% in adolescents; as well as 22.09% and 15.12% in parents, showing a significant decline over time. After adjusted for earthquake exposure, both maternal and paternal PTSS at T12m prospectively predicted adolescent girls' and boys' PTSS at T18m (mother to daughter: β = 0.13; mother to son: β = 0.17; father to daughter: β = 0.17; father to son: β = 0.33), while adolescent girls' and boys' PTSS at T12m only predicted maternal PTSS at T18m (daughter to mother: β = 0.20; son to mother: β = 0.20), but not paternal PTSS at T18m. LIMITATIONS Self-reported measures other than clinical reviews were used to collect data. CONCLUSIONS This study highlights the mutual impacts of adolescent and parental (especially maternal) PTSS after a disaster. Psychological prevention and intervention for adolescent disaster survivors should adopt a whole family approach.
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Affiliation(s)
- Xuliang Shi
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China; Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, China
| | - Ya Zhou
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China; Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, China
| | - Fulei Geng
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China; Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, China
| | - Yuanyuan Li
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China; Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, China
| | - Jieying Zhou
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China; Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, China
| | - Binbin Lei
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China; Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, China
| | - Siyi Chen
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China; Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, China
| | - Xiaoyan Chen
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China; Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, China
| | - Fang Fan
- School of Psychology and Center for Studies of Psychological Application, South China Normal University, Guangzhou, China; Key Laboratory of Mental Health and Cognitive Science of Guangdong Province, Guangzhou, China.
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Children's Mental Health in the Context of Terrorist Attacks, Ongoing Threats, and Possibilities of Future Terrorism. Curr Psychiatry Rep 2016; 18:79. [PMID: 27423458 DOI: 10.1007/s11920-016-0722-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Over the past two decades, the field has witnessed tremendous advances in our understanding of terrorism and its impacts on affected youth. It is now well established that a significant proportion of exposed youth show elevated PTSD symptoms in the months following a terrorist attack. In more recent years, research has expanded beyond confirming our understanding of the association between direct terrorism exposure and child PTSD symptoms by elucidating (a) links between terrorism exposure and non-PTSD clinical outcomes (e.g., externalizing problems, substance use), (b) individual differences associated with divergent patterns of risk and resilience, (c) the clinical correlates of media-based contact with terrorism, (d) clinical outcomes associated with exposure to recurrent terrorist attacks, and (e) exposure to extended contexts of uncertainty and the possibilities of future terrorism. Researchers studying the effects of terrorism and political violence on youth have increasingly examined a much broader range of regions in the world, affording needed opportunities to consider the generalizability of prior findings to youth living in different political contexts, in less developed regions of the world, and/or in regions with different rates of recurrent terrorism. In order to understand and, in turn, best meet the clinical needs of the majority of terrorism-affected youth across the globe, more targeted research on exposed youth is needed in developing regions of the world and regions enduring more recurrent terrorist attacks.
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Comer JS, DeSerisy M, Green JG. Caregiver-reports of Internet Exposure and Posttraumatic Stress Among Boston-Area Youth Following the 2013 Marathon Bombing. ACTA ACUST UNITED AC 2016; 1:86-102. [PMID: 28770253 DOI: 10.1080/23794925.2016.1203737] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Although practitioners and researchers have considered children's television-based terrorism exposure, Internet-based exposure has not been sufficiently examined. We examined the scope and correlates of children's Internet-based exposure following the Boston Marathon bombing among Boston-area youth (N=460; 4-19 years), and the potential moderating role of age. Further exploratory analyses examined patterns of caregiver attempts to regulate child Internet exposure. Caregivers reported on child Internet-based and direct exposure to traumatic bombing-related events, and youth posttraumatic stress (PTS). Online youth consumed on average over two daily hours of Internet coverage, and roughly one-third consumed over three daily hours of coverage. Internet exposure was particularly high among children over 12. Greater Internet-based exposure was associated with PTS, and 12-15 year olds were particularly vulnerable. Further exploratory analyses found that although most caregivers reported believing media exposure can cause children further trauma, a considerable proportion of caregivers made no attempt to restrict or regulate their child's Internet-based exposure. These findings help practitioners clarify forms of indirect exposure that can place youth at risk following terrorism. Future work is needed to examine the important roles caregivers play as media regulators and as promoters of child coping and media literacy following terrorism.
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Affiliation(s)
- Jonathan S Comer
- Mental Health Interventions and Technology (MINT) Program, Florida International University, Miami, FL, USA
| | - Mariah DeSerisy
- Department of Psychology, Fordham University, New York, NY, USA
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Abstract
There is widespread support for the hypothesis that, post-disaster, children's mental health is impacted--at least in part--via the impact on parents, parenting, parent-child interactions, and the family environment. To some degree, the enthusiasm with which this hypothesis is held outstrips the evidence examining it. The current paper critically evaluates the empirical evidence for this hypothesis and concludes that although limited (both in terms of number of existing studies and methodological flaws), the extant literature indicates some parent-related variables, as well as some aspects of the family environment are likely to constitute risk or protective factors for children. Given that parenting is modifiable, it is proposed that the identified parent- and family-related factors represent important therapeutic targets, and a universal post-disaster parenting intervention (Disaster Recovery Triple P) is described.
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Thoresen S, Jensen TK, Wentzel-Larsen T, Dyb G. Parents of terror victims. A longitudinal study of parental mental health following the 2011 terrorist attack on Utøya Island. J Anxiety Disord 2016; 38:47-54. [PMID: 26812593 DOI: 10.1016/j.janxdis.2016.01.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Revised: 01/07/2016] [Accepted: 01/08/2016] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Little is known about parents' health following their children's exposure to trauma. We investigated the mental health of parents of young terrorist survivors and assessed parental distress and guilt as potential predictors of mental health. METHOD Mothers and fathers (N=531) participated in two study waves 4-5 and 14-15 months after the shooting. Posttraumatic stress reactions (PTSS) and anxiety/depression were compared with age- and gender-adjusted expected scores that were calculated from a concurrent population study. Mixed effects models investigated the associations between parental distress, parental guilt, and mental health. RESULTS Parents' level of anxiety/depression was three times higher and PTSS was five times higher than that of the general population. Parental distress and guilt about their child's traumatic experience contributed uniquely to symptoms at both time points. CONCLUSIONS Parents of traumatized youth constitute a vulnerable group that has been overlooked in the literature. Intervention strategies following trauma should include both survivors and their parents.
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Affiliation(s)
- Siri Thoresen
- Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugvn 1-3, 5th floor, 0408 Oslo, Norway.
| | - Tine K Jensen
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Harald Schjelderup House, Forskningsveien 3A, 0373 Oslo, Norway; Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugvn 1-3, 5th floor, 0408 Oslo, Norway.
| | - Tore Wentzel-Larsen
- Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugvn 1-3, 5th floor, 0408 Oslo, Norway; Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, Gullhaugveien 1-3, 0484 Oslo, Norway.
| | - Grete Dyb
- Norwegian Centre for Violence and Traumatic Stress Studies, Gullhaugvn 1-3, 5th floor, 0408 Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Kirkeveien 166, 0450 Oslo, Norway.
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Crum KI, Cornacchio D, Coxe S, Greif Green J, Comer JS. Conduct Problems Among Boston-Area Youth Following the 2013 Marathon Bombing: The Moderating Role of Prior Violent Crime Exposure. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 46:343-352. [PMID: 26630365 DOI: 10.1080/15374416.2015.1077450] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A large body of work documents the heavy mental health burden of youth exposure to disasters, but the majority of this research has focused on posttraumatic stress and internalizing symptoms. Less is known about associations between disaster exposure and children's conduct problems (CPs), or variables that may moderate such relationships. Given well-documented links between CPs and children's exposure to community violence, youth with greater prior community violence exposure through residence in high-crime areas may be particularly vulnerable to the impacts of disaster exposure on CPs. We surveyed Boston-area caregivers (N = 460) in the first 6 months following the 2013 Marathon bombing on their children's event-related exposures, as well as CPs. To estimate prior violent crime exposure, children's neighborhoods were assigned corresponding violent crime rates obtained from the Federal Bureau of Investigation's uniform crime reporting statistics. Almost 1 in 6 Boston-area children assessed in this convenience sample showed clinically elevated CPs in the aftermath of the Boston Marathon bombing and subsequent manhunt. Prior violent crime exposure significantly moderated the link between children's manhunt exposure (but not bombing exposure) and child CPs. Manhunt exposure was related to increased CPs among children living in areas with high and medium (but not low) levels of prior violent crime. Children living in neighborhoods characterized by violent crime may be at particularly increased risk for developing CPs after violent manmade disasters. As most postdisaster child intervention efforts focus on posttraumatic stress, efforts are needed to develop programs targeting child CPs, particularly for youth dwelling in violent neighborhoods.
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Affiliation(s)
- Kathleen I Crum
- a Department of Psychology , Florida International University
| | | | - Stefany Coxe
- a Department of Psychology , Florida International University
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Carpenter AL, Elkins RM, Kerns C, Chou T, Greif Green J, Comer JS. Event-Related Household Discussions Following the Boston Marathon Bombing and Associated Posttraumatic Stress Among Area Youth. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 46:331-342. [PMID: 26538213 DOI: 10.1080/15374416.2015.1063432] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Despite research documenting the scope of disaster-related posttraumatic stress (PTS) in youth, less is known about how family processes immediately postdisaster might associate with child outcomes. The 2013 Boston Marathon bombing affords a unique opportunity to assess links between immediate family discussions about community trauma and child mental health outcomes. The present study examined associations between attack-related household discussions and child PTS among Boston-area youth ages 4 to 19 following the Marathon bombing (N = 460). Caregivers completed surveys 2 to 6 months postattack about immediate household discussions about the events, child exposure to potentially traumatic attack-related experiences, and child PTS. During the Marathon bombing and manhunt, there was considerable heterogeneity in household discussions across area families, and several discussion items were differentially predictive of variability in children's PTS. Specifically, after controlling for children's direct exposure to the potentially traumatic attack/manhunt events, children showed lower PTS when it was their caregivers who informed them about the attack and manhunt, and when their caregivers expressed confidence in their safety and discussed their own feelings about the manhunt with their child. Children showed higher PTS when their caregivers did not discuss the events in front of them, asked others to avoid discussing the events in front of them, and expressed concern at the time that their child might not be safe. Child age and traumatic attack/manhunt exposure moderated several links between household discussions and child PTS. Findings underscore the importance of family communication and caregiver modeling during times of community threat and uncertainty.
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Affiliation(s)
| | | | - Caroline Kerns
- a Center for Anxiety and Related Disorders , Boston University
| | - Tommy Chou
- b Center for Children and Families , Florida International University
| | | | - Jonathan S Comer
- b Center for Children and Families , Florida International University
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La Greca AM, Comer JS, Lai BS. Commentary: Key Issues, Concluding Thoughts, and Future Directions for the Study of Trauma and Child Health. J Pediatr Psychol 2015; 41:149-58. [PMID: 26416828 DOI: 10.1093/jpepsy/jsv088] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2015] [Accepted: 08/18/2015] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | - Betty S Lai
- Division of Epidemiology and Biostatistics, School of Public Health, Georgia State University
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Perceptions of Trauma and Loss among Children and Adolescents Exposed to Disasters a Mixed-Methods Study. CURRENT PSYCHOLOGY 2015. [DOI: 10.1007/s12144-015-9348-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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