1
|
Ettman CK, Badillo-Goicoechea E, Stuart EA. Financial strain, schooling modality and mental health of US adults living with children during the COVID-19 pandemic. J Epidemiol Community Health 2024:jech-2023-221672. [PMID: 39019489 DOI: 10.1136/jech-2023-221672] [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: 11/27/2023] [Accepted: 06/09/2024] [Indexed: 07/19/2024]
Abstract
BACKGROUND The COVID-19 pandemic upended contexts for families; relatively little work has studied the influence of rapidly changing contexts on the mental health of parents. We aimed to assess the relation between financial strain and schooling modality with the mental health of adults living with school-age children across the pandemic. METHODS Using a large, national sample from the COVID-19 Trends and Impact Surveys (N=1 485 072 responses from November 2020 through June 2022), we used weighted multiple logistic regression with interactions for school semester to estimate changes in the association of frequent feelings of depression and anxiety, respectively, with financial strain and schooling modality, controlling for demographics and state, across time. RESULTS In all time periods, financial strain was associated with reporting frequent feelings of depression and anxiety, respectively. The association grew over time (p<0.001) from adjusted OR (aOR) 2.25 (95% CI 2.19, 2.32)/aOR 2.63 (95% CI 2.54, 2.73) in Autumn 2020 to aOR 3.11 (95% CI 3.01, 3.22)/aOR 3.79 (95% CI 3.64, 3.95) in Spring 2022. Living with children in fully online versus in-person schooling was associated with frequent feelings of anxiety and depression symptoms in all time periods, and increased from aOR 1.08 (1.05, 1.11)/aOR 1.06 (1.02, 1.10) in Autumn 2020 to aOR 1.20 (1.10, 1.32)/aOR 1.28 (1.16, 1.42) in Spring 2022. CONCLUSION Associations between financial strain and online-only schooling with poor mental health increased during the COVID-19 pandemic. Policies to support parents in the face of external stressors, such as economic instability and school closures, may improve overall population mental health.
Collapse
Affiliation(s)
- Catherine K Ettman
- Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Elena Badillo-Goicoechea
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Elizabeth A Stuart
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| |
Collapse
|
2
|
Gowans L, Ritchie T, Rogers MA, Jiang Y, Climie EA, Mah JWT, Corkum P, Krause A, Parvanova M. The Association Between the Impact of COVID-19 and Internalizing Problems Among Children and Adolescents with ADHD: The Moderating Role of Parental Anxiety. Child Psychiatry Hum Dev 2024:10.1007/s10578-024-01732-z. [PMID: 38992329 DOI: 10.1007/s10578-024-01732-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/17/2024] [Indexed: 07/13/2024]
Abstract
Previous research has identified an increase in internalizing problems during the COVID-19 pandemic in children and adolescents with attention-deficit/hyperactivity disorder (ADHD). Additionally, it has been observed that parents of children with ADHD had elevated levels of anxiety during the pandemic. The current study aimed to longitudinally assess whether the impact of COVID-19 was associated with internalizing problems in children and adolescents with ADHD during the middle (Time 1-Spring 2021 [T1]) and end (Time 2-Fall/Winter 2022 [T2]) of the pandemic, and whether parental anxiety moderated this relationship over time. Canadian parents of youth with ADHD (aged 3-18 years old) completed online questionnaires assessing their child's depression and anxiety symptoms, their own anxiety symptoms, and the pandemic's impact on their child, both at T1 (N = 278) and T2 (N = 89). The results indicated that the impact of COVID-19 on children at T1 was a unique predictor of child internalizing problems at T1 but not at T2. While parental anxiety did not moderate this association cross-sectionally, it was a significant moderator longitudinally. More specifically, low parental anxiety at T1 positively moderated the association between the COVID-19 impact on children at T1 and child internalizing problems at T2. The results highlight the importance of providing on-going psychological support for children and adolescents with ADHD and emphasize the need to aid parents in effectively supporting their children during the process of pandemic recovery.
Collapse
Affiliation(s)
- Lauren Gowans
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| | - Tessa Ritchie
- Department of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Maria A Rogers
- Department of Psychology, Carleton University, Ottawa, ON, Canada.
| | - Yuanyuan Jiang
- Department of Educational & Counselling Psychology, and Special Education, University of British Columbia, University Endowment Lands, British Columbia, Canada
| | - Emma A Climie
- Department of Psychology, University of Calgary, Calgary, AB, Canada
| | - Janet W T Mah
- Department of Psychiatry, University of British Columbia, University Endowment Lands, British Columbia, Canada
| | - Penny Corkum
- Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Amanda Krause
- Department of Psychology, University of Ottawa, Ottawa, ON, Canada
| | - Marina Parvanova
- Department of Psychology, Carleton University, Ottawa, ON, Canada
| |
Collapse
|
3
|
Guo J, Guo S, Huang N, Fu M, Zhang B, Wang Y, Ma S, Wang X, Riem MME. Parental and Adolescents' Anxiety during the COVID-19 Outbreak in Rural China: The role of Parent-child Communication. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2024; 17:657-669. [PMID: 38938941 PMCID: PMC11199451 DOI: 10.1007/s40653-023-00609-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/19/2023] [Indexed: 06/29/2024]
Abstract
Purpose It has been suggested that the intergenerational transmission of anxiety may be an important contributor to the high prevalence of anxiety in adolescents. The objectives of this study are to examine whether and how parental anxiety is related to adolescent's anxiety and to explore the associations of parental anxiety and parent-child communication with adolescents' anxiety across different grades. Methods The current survey was conducted online from February 8th to February 27th, 2020.The questionnaires were distributed and retrieved through a web-based platform. A total of 6196 Chinese rural adolescents from grade seven to twelve (age ranging from 11 to 18 years old) were included. Results In this study, parental anxiety was significantly associated with higher adolescent anxiety (β = 0.14, p < 0.001) and this association was statically strongest at grade twelve. Besides, children with problematic parent-child communication related to COVID-19 reported elevated anxiety (β = 0.05, p < 0.01). In contrast, effective parent-child communication about COVID-19 mitigated the level of anxiety transmitted from parent to child (β = -0.04, p < 0.05). Conclusions During the COVID-19 epidemic, parents' anxiety was related to adolescents' anxiety. In addition, parent-child communication plays a moderating role in the above relationship. These findings emphasize the importance of implementing more psycho-education programs that specifically target parents' emotion regulation and effective communication abilities to ameliorate the psychopathological symptoms of parents and their children. Supplementary Information The online version contains supplementary material available at 10.1007/s40653-023-00609-y.
Collapse
Affiliation(s)
- Jing Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, 100191 China
| | - Sijia Guo
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, 100191 China
| | - Ning Huang
- Department of Health Policy and Management, School of Public Health, Peking University, Beijing, 100191 China
| | - Mingqi Fu
- School of Public Management, Central South University, Changsha, 410082 PR China
| | - Bo Zhang
- Department of Neurology and ICCTR Biostatistics and Research Design Center, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115 USA
| | - Yiqing Wang
- Department of Public Administration, Beijing City University, Beijing, 100083 China
| | - Shuang Ma
- School of Management, Beijing University of Chinese Medicine, Beijing, 100029 China
| | - Xiaohua Wang
- School of Social Development and Public Policy, Beijing Normal University, Beijing, 100875 China
| | - Madelon M. E. Riem
- Behavioral Science Institute, Radboud University, Nijmegen, The Netherlands
| |
Collapse
|
4
|
|
5
|
Fazel M, Soneson E. Current evidence and opportunities in child and adolescent public mental health: a research review. J Child Psychol Psychiatry 2023; 64:1699-1719. [PMID: 37771261 DOI: 10.1111/jcpp.13889] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND A public mental health lens is increasingly required to better understand the complex and multifactorial influences of interpersonal, community and institutional systems on the mental health of children and adolescents. METHODS This research review (1) provides an overview of public mental health and proposes a new interactional schema that can guide research and practice, (2) summarises recent evidence on public mental health interventions for children and adolescents, (3) highlights current challenges for this population that might benefit from additional attention and (4) discusses methodological and conceptual hurdles and proposes potential solutions. RESULTS In our evidence review, a broad range of universal, selective and indicated interventions with a variety of targets, mechanisms and settings were identified, some of which (most notably parenting programmes and various school-based interventions) have demonstrated small-to-modest positive effects. Few, however, have achieved sustained mental health improvements. CONCLUSIONS There is an opportunity to re-think how public mental health interventions are designed, evaluated and implemented. Deliberate design, encompassing careful consideration of the aims and population-level impacts of interventions, complemented by measurement that embraces complexity through more in-depth characterisation, or 'phenotyping', of interpersonal and environmental elements is needed. Opportunities to improve child and adolescent mental health outcomes are gaining unprecedented momentum. Innovative new methodology, heightened public awareness, institutional interest and supportive funding can enable enhanced study of public mental health that does not shy away from complexity.
Collapse
Affiliation(s)
- Mina Fazel
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Emma Soneson
- Department of Psychiatry, University of Oxford, Oxford, UK
| |
Collapse
|
6
|
Francis-Oliviero F, Loubières C, Grové C, Marinucci A, Shankland R, Salamon R, Perez E, Garancher L, Galera C, Gaillard E, Orri M, González-Caballero JL, Montagni I. Improving Children's Mental Health Literacy Through the Cocreation of an Intervention and Scale Validation: Protocol for the CHILD-Mental Health Literacy Research Study. JMIR Res Protoc 2023; 12:e51096. [PMID: 37796588 PMCID: PMC10587813 DOI: 10.2196/51096] [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: 07/24/2023] [Revised: 07/31/2023] [Accepted: 08/01/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Children's mental health is a public health priority, with 1 in 5 European children younger than 12 years having a behavioral, developmental, or psychological disorder. Mental health literacy (MHL) is a modifiable determinant of mental health, promoting psychological well-being and reducing mental health problems. Despite its significance, no interventions or scales currently exist for increasing and measuring MHL in this population. OBJECTIVE This study has dual objectives: (1) cocreating and evaluating an intervention on children's MHL, and (2) developing and validating a scale that measures children's MHL. METHODS Our study focuses on children aged 9-11 years attending primary school classes in various settings, including urban and rural areas, and priority education zones within a French department. Using a participatory research approach, we will conduct workshops involving children, parents, teachers, and 1 artist to cocreate an intervention comprising multiple tools (eg, a pedagogical kit and videos). This intervention will undergo initial evaluation in 4 classes through observations, interviews, and satisfaction questionnaires to assess its viability. Concurrently, the artist will collaborate with children to create the initial version of the CHILD-MHL scale, which will then be administered to 300 children. Psychometric analyses will validate the scale. Subsequently, we will conduct a cluster randomized controlled trial involving a minimum of 20 classes, using the CHILD-MHL scale scores as the primary end point to evaluate the intervention's efficacy. Additional interviews will complement this mixed methods evaluation. Both the intervention and the scale are grounded in the Child-Focused MHL model. RESULTS The first tool of the intervention is the pedagogical kit Le Jardin du Dedans, supported by the public organization Psycom Santé Mentale Info and endorsed by UNICEF (United Nations Children's Fund) France. The second tool is a handbook by the Pan American Health Organization and the World Health Organization, which is addressed to teachers to sensitize them to children's mental health problems. The third is a 5-page supplementary leaflet produced by the nongovernmental organization The Ink Link, which teaches children the notion of MHL. Finally, we produced 56 items of the MHL Scale and listed existing education policies for children's mental health. CONCLUSIONS After its robust evaluation, the intervention could be extended to several schools in France. The scale will be the first in the world to measure children's MHL. It will be used not only to evaluate interventions but also to provide data for decision makers to include MHL in all educational policies. Both the intervention and the scale could be translated into other languages. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/51096.
Collapse
Affiliation(s)
- Florence Francis-Oliviero
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
- Pôle de santé publique, Service d'Information Médicale, Centre Hospitalier Universitaire de Bordeaux, Bordeaux, France
| | | | - Christine Grové
- School of Curriculum Teaching & Inclusive Education, Monash University, Clayton, Australia
- Fulbright Association, Science, Technology, Engineering and Mathematics College, Health and Biomedical Sciences, Royal Melbourne Institute of Technology, Canberra, Australia
| | - Alexandra Marinucci
- School of Educational Psychology & Counselling, Monash University, Clayton, Australia
| | - Rebecca Shankland
- Laboratory Développement, Individu, Processus, Handicap, Éducation, Department of Psychology, Education and Vulnerabilities, Université Lumière Lyon 2, Lyon, France
| | - Réda Salamon
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
| | | | | | - Cédric Galera
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
- Charles Perrens Hospital, Bordeaux, France
| | - Elsa Gaillard
- Institute of Global Health, University of Geneva, Geneva, Switzerland
| | - Massimiliano Orri
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montréal, QC, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, School of Population and Global Health, McGill University, Montréal, QC, Canada
| | | | - Ilaria Montagni
- Bordeaux Population Health Research Center, Institut national de la santé et de la recherche médicale U1219, University of Bordeaux, Bordeaux, France
| |
Collapse
|
7
|
Maternal mental-health treatment moderates the association between psychological distress and harsh parenting: A prospective cohort study. PLoS One 2023; 18:e0282108. [PMID: 36827255 PMCID: PMC9955607 DOI: 10.1371/journal.pone.0282108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 02/08/2023] [Indexed: 02/25/2023] Open
Abstract
OBJECTIVE Parental psychological distress (depression, anxiety) is detrimental to child mental health. A key reason for this is that depressed and anxious parents are at risk of engaging in more negative, reactive and harsh parenting. While treatment for psychological distress has a long history of success in adults, less is known about how treatment for parental psychological distress may positively influence parenting behaviours, particularly in the general population. We examined the moderating role of mothers receiving treatment for depression or anxiety on the longitudinal relationship between maternal psychological distress and the development of harsh parenting (smacking and shouting) across early childhood (ages 3 to 7). METHOD Using prospective data from 16,131 families participating in the UK's Millennium Cohort Study, we conducted moderator analysis within a multilevel repeated measures model to test whether receiving treatment for mental health problems could protect mothers with high psychological distress from engaging in harsh parenting. RESULTS In each wave, about 7% of mothers reported undergoing treatment for depression or anxiety at that time. Maternal psychological distress was associated with increased use of harsh parenting and that, adjusting for psychological distress, receiving psychological treatment was related to decreased use of harsh parenting. Importantly, receiving psychological treatment buffered the negative effect of psychological distress on harsh parenting. CONCLUSION In early-to-middle childhood, mental health treatment may help mothers with depression or anxiety to be less harsh toward their children, thereby benefiting their child's psychological adjustment.
Collapse
|