Life Interrupted: Family Routines Buffer Stress during the COVID-19 Pandemic

Adoption of certain behavioral and social routines that organize and structure the home environment may help families navigate the challenges presented by the COVID-19 pandemic. The current cross-sectional study aimed to assess family routines prior to and during the COVID-19 pandemic and examine associations with individual and family well-being. Using a national sample, 300 caregivers of children ages 6-18 were surveyed using Amazon Mechanical Turk platform during the first three months of COVID-19 pandemic in the United States. Caregivers reported on family demographics, COVID-19-related stress, engagement in family routines (prior to and during the COVID-19 pandemic), stress mindset, self-efficacy, and family resiliency. Overall, families reported engaging in fewer routines during the COVID-19 pandemic compared to prior to the pandemic. COVID-19-related stress was highest in low-income families, families of healthcare workers, and among caregivers who had experienced the COVID-19 virus. Moreover, COVID-19-related stress was negatively related to self-efficacy, positively related to an enhancing stress mindset, and negatively related to family resilience. Engagement in family routines buffered relations between COVID-19-related stress and family resilience, such that COVID-19-related stress was not associated with lower family resilience among families that engaged in high levels of family routines. Results suggest that family routines were challenging to maintain in the context of the COVID-19 pandemic, but were associated with better individual and family well-being during this period of acute health, economic, and social stress.

     

The effects of COVID-19 stressors and family life on anxiety and depression one-year into the COVID-19 pandemic

The purpose of this study was to examine the effects of Coronavirus (COVID-19)-related stressors and family health on adult anxiety and depressive symptoms 1 year into the pandemic. The sample consisted of 442 adults living in the United States who were recruited via Amazon Mechanical Turk. Data were analyzed using multiple logistic regression. Results indicated that compared to a sample 1 month into the pandemic, participants in the current sample reported worse family health and increases in both positive and negative perceptions of the pandemic on family life and routines. COVID-19 stressors and perceived negative effects of the pandemic on family life increased the odds for moderate-to-severe depression and anxiety while having more family health resources decreased the odds for depression and anxiety symptoms. Participants reported lower odds for worse depression and anxiety since the beginning of the pandemic when they reported more positive family meaning due to the pandemic. The results suggest a need to consider the impact of family life on mental health in pandemics and other disasters.     

Pandémie de COVID-19 : attachement,anxiété, régulation émotionnelle et stratégies de coping chez les enfants d’âge scolaire

IntroductionAn impact of the COVID-19 pandemic on the emotions and behaviors of children has been found in several studies. However, this impact is not found in all studies. Attachment could be linked to different reactions and levels of anxiety.ObjectiveThe main aim of this study was to analyze the links between children's insecure attachment and variables related to anxiety, emotional and behavioral management of children during the pandemic.MethodStudy participants (n = 83 parents and their child aged 6 to 12) completed anonymously online questionnaires assessing attachment insecurity, state-anxiety, coping strategies and emotional regulation. They also answered socio-demographic questions related to their context of life and experience of the pandemic.ResultsState-anxiety is significantly related to children's emotional dysregulation but not to emotion-oriented coping strategy. Significant links were observed between attachment insecurity on the one hand, and children's state-anxiety, emotion-oriented coping strategy and children's emotional dysregulation on the other hand. Emotional dysregulation mediates the link between disorganized attachment and state anxiety.ConclusionThe links between attachment insecurity and children's state-anxiety on the one hand, and the emotion-oriented coping strategy on the other hand highlight the importance of taking individual and interactional factors into account in children's socio-emotional manifestations during the COVID-19 pandemic.     

Links between rational and irrational beliefs,trait anxiety and fear of COVID 19

IntroductionOur beliefs and knowledge influence the way we act, react, or adapt to an aversive situation such as the current COVID-19 pandemic. The purpose of this study is to explore factors that may influence perceived fear of COVID-19.MethodologyThree hundred and forty-two people from the general population participated in this study. The participants completed an online anamnestic questionnaire that included questions regarding feelings of vulnerability to illness, fear of COVID-19, rational and irrational beliefs about COVID-19, and trait anxiety.ResultsA stepwise regression analysis showed that trait anxiety, irrational and rational beliefs, and having comorbidities linked to severe forms of the disease were associated with perceived vulnerability concerning health and fear of COVID-19.DiscussionThis study seems to underline the importance of pre-existing vulnerabilities that were exacerbated during the pandemic.     

Parents’ Perceived Impact of the Societal Lockdown of COVID-19 on Family Well-Being and on the Emotional and Behavioral State of Walloon Belgian Children Aged 4 to 13 Years: An Exploratory Study

This exploratory study assessed parents’ perceptions of the emotional and behavioral impacts of the COVID-19 lockdown on their children. The total sample included 749 children, aged 4 to 13 years old (353 girls, 396 boys); 524 parents took part. The emotional and behavioral changes observed during the societal lockdown, family coexistence, the impact of COVID-19 on family well-being, and the frequency of social contacts before and during this lockdown were investigated. Results show that the most frequently reported difficulties were worry, agitation, anxiety, sadness, loneliness, nervousness, arguing, anger, frustration, boredom, irritability, behavioral problems, and laziness. Family coexistence declined significantly during this lockdown, and parents mentioned that COVID-19 had an impact on family well-being. Various ordinal logistic regressions showed that family coexistence, children’s nervousness due to COVID-19, the impact of COVID-19 on family well-being, age, and social contacts before and during this lockdown seemed to explain the various emotional and behavioral changes observed in children during the societal lockdown. These results are discussed and recommendations are made.     

Self-regulation in early childhood: the interplay between family risk,temperament and teacher–child interactions

Abstract

This study investigates the interplay between family risk and the quality of classroom interactions and their impact on self-regulation skills in two groups of children—children from socioeconomically disadvantaged backgrounds (at-risk) and non-risk children. Participants included 485 children (N = 93 classrooms)—233 (N = 47 classrooms) of which were from socioeconomically disadvantaged areas. Temperament was measured using teacher report. Trained observers rated classroom quality via live observations of a typical preschool day. Behavioral regulation was assessed using direct measures and emotional regulation was assessed using a teacher report. Analyses using multiple group structural equation modeling showed that at-risk children had lower levels of cool behavior regulation than non-risk children. In addition, classroom quality was positively linked to cool behavioral self-regulation. Moderating effects were additionally found between family risk and classroom quality on both hot behavioral regulation and emotional regulation. Classroom quality served as a protective factor for children exposed to more risk factors. Results showed complex associations between individual characteristics, classroom quality, and family risk, indicating a need to further explore the interplay among these variables.     

Mediation of Mothers’ Anxiety and Parenting in Children’s Behavior Problems during COVID-19

The outbreak of COVID-19 is affecting the lives of millions of families around the world. The current study was carried out in Israel, following the pandemic’s initial outbreak and during the resulting enforced quarantine, confining parents and children to their homes. A sample of 141 Israeli mothers with at least one child between the ages of 3 and 12 (M?=?6.92, SD?=?2.55) participated as volunteers. About half the sample (50.7%) consisted of girls. Most mothers were cohabiting with a spouse (93%). Mothers completed online questionnaires about their perceptions about the health and economic threats of COVID-19, availability of social support, their anxiety symptoms, hostile/coercive and supportive/engaged parenting behavior, and their children’s behavior problems. Results showed expected significant associations between the mothers’ reports about having little social support, their anxiety symptoms, hostile/coercive and supportive/engaged parenting behavior, and children’s externalizing problems. Likewise, expected significant associations were found between mothers’ perceptions about the health and economic threats of COVID-19, their anxiety symptoms, hostile/coercive parenting behavior, and children’s internalizing and externalizing problems. Importantly, maternal anxiety and hostile/coercive parenting behavior mediated the associations between lack of support, negative perceptions about the health and economic threats of COVID-19, and children’s behavior problems. These findings stress the importance of mothers’ mental health and parenting behaviors for children’s socioemotional adaptation in the context of COVID-19. Implications of the findings for family interventions intended to help parents and children at this time are suggested.

     

Social connectedness,mindfulness, and coping as protective factors during the COVID-19 pandemic

The COVID-19 pandemic has had an unprecedented psychological impact, revealing immense emotional disturbances among the general population. This study examined the extent to which social connectedness, dispositional mindfulness, and coping moderate symptoms of anxiety and depression in 1242 adults under the same government-issued COVID-19 stay-at-home mandate. Participants completed measures of anxiety, depression, dispositional mindfulness, social connectedness, and coping, and regression analyses were used to examine associations and interaction effects. Results indicated that social connectedness and dispositional mindfulness were associated with reduced symptoms. For individuals living with a partner, decreased mindfulness and avoidant coping were associated with anxious symptoms. In households with children, overutilization of approach coping served to increase symptoms of depression. Results indicate the importance of considering social connectedness, mindfulness, and coping in counseling to enhance factors serving to protect clients during a public health crisis. Implications for professional counselors and areas of future research are discussed.     

“My Entire World Stopped”: College Students’ Psychosocial and Academic Frustrations during the COVID-19 Pandemic

The COVID-19 pandemic disrupted normalcy for college attending young adults which resulted in a loss of the campus environment and classroom setting. This change in setting may interfere with a student’s personal and academic wellbeing. This study used an online survey to evaluate college students’ academic and psychosocial frustrations during the COVID-19 pandemic. Data were collected from March–April 2020 at a land-grant university in the Appalachian region. Data were available from 2643 undergraduate and graduate students. There was a 65.8% and 15.7% increase in the number of students who reported their learning and health as fair, poor, or very poor after the COVID-19 pandemic, respectively. Qualitative responses were coded and 8 themes and 24 subthemes emerged. College students expressed frustrations regarding technology, classwork, research, family, social, emotional, behavioral, and financial aspects of life. These results can be used by higher education administration, faculty, and staff when planning for online courses. Ensuring that student frustrations and barriers to success are recognized and considered may help prevent students departing from higher education during this time.

     

L’évolution des facteurs prédictifs de la détresse psychologique des étudiants en contexte de Covid-19 : un modèle d’équation structurelle exploratoire

IntroductionStudents are at risk for mental health issues due to the COVID-19 pandemic. The implementation of lockdowns as a means to curb the spread of the disease have had an impact on this population, as observed in many international studies. However, few studies have investigated the longitudinal impact of COVID-19 lockdowns on students’ mental health.ObjectiveWe explored the relation between individual characteristics of students, context of life, difficulties in emotion regulation and psychological distress over the first two lockdowns in France during the COVID-19 pandemic.Methodology160 university students (90% female, mean of 24 years old) responded to an online questionnaire at three times points: once during the first lockdown during the COVID-19 pandemic in march 2020, a second time after this lockdown and a third time during the second lockdown. Difficulties in emotion regulation, psychological distress, acute stress, academic concerns, financial resources, and exchanges with professors were measured.ResultsAn exploratory structural equations model was developed to investigate the factors related to psychological distress (χ² = 1459.18, df = 1064, CFI = 0.910, RMSEA = 0.049, SRMR = 0.068). During both lockdowns, psychological distress was explained by academic concerns and lack of emotional clarity and acceptance. An indirect and negative significant relation was identified between financial difficulties, lack of exchanges with professors during the first lockdown, emotion clarity and experienced psychological distress during the second lockdown. Repeated measures ANOVAs identified high levels of acute stress during both lockdowns and a diminution during the deconfinement indicating an impact of sanitary measures on student's mental health.ConclusionCoherently with the Bruchon-Sweiser translational model of stress, emotion regulation capacities seem to have a central and moderating role in the experience of the pandemic for students. They would benefit greatly from appropriate therapeutic interventions in this pandemic situation and in general.     

Parental Buffering of Stress in the Time of COVID-19: Family-Level Factors May Moderate the Association Between Pandemic-Related Stress and Youth Symptomatology

Nearly all families in the United States were exposed to varying degrees of stress related to the COVID-19 pandemic during the spring of 2020. Building on previous research documenting the pernicious effects of stress on youth mental health, we aimed to test the effects of exposure to COVID-19-related stress on youth symptomatology. Further, in light of evidence suggesting that parents play an important role in buffering children from environmental stress, we assessed how specific parental behaviors (i.e., parental emotion socialization, maintenance of home routines, and availability to discuss the pandemic with child) contributed to effective parental buffering of the impact of pandemic-related stress on children’s symptomatology. Conversely, we tested whether parental anxiety-related symptomatology and parenting stress exacerbated the effect of children’s exposure to pandemic-related stress on children’s symptomatology. Results suggest that parents who engaged in relatively higher levels of emotion coaching of children’s negative emotions and who maintained more stable home routines during the pandemic were more effectively able to buffer the effects of pandemic-related stress on children’s symptomatology. Parents who reported higher levels of parenting stress and anxiety-related symptomatology were less likely to effectively buffer stress. Though interpretation of the findings is limited due to sole reliance on parental report and the cross-sectional study design due to the constraints of collecting data during a global pandemic, findings underscore the importance of assessing family-level factors when considering the impact of stressors on children’s symptomatology and highlight the need to support parents during global events that place families under significant stress.

     

Elementary School Students’ Subjective Well-Being Before and During the COVID-19 Pandemic: A Longitudinal Study

First empirical results indicate that the COVID-19 pandemic has a negative impact on adolescents’ and adults’ subjective well-being. In the present study we focus on the subjective well-being of elementary school children before and after the first pandemic-related school lockdown and examine if possible declines in subjective well-being are especially pronounced for some groups, considering socio-economic status, migration background, and gender as moderators. We tested N?=?425 elementary school students (mean age: M?=?8.19; SD?=?1.04) longitudinally with four measurement points (three before the school lockdown and one after) regarding their general life satisfaction, mood, and domain satisfaction regarding peers, family, and school. Piecewise growth curve models revealed a significant decline in positive mood and in satisfaction with the family. Decline in life satisfaction and satisfaction with peers nearly missed significance. The investigated moderators had no impact on the changes in subjective well-being. We conclude that the pandemic had detrimental effects on young children’s subjective well-being.

     

Differential Effects of Child Difficulties on Family Burdens across Diagnostic Groups

Children with neurodevelopmental disorders, such as attention deficit hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and intellectual disability (ID), have a variety of difficulties that can place considerable strain on their families. This study investigated the nature of family burdens (i.e., financial burden, need for respite, need for counseling, work changes, and care hours) by examining the effects of child characteristics (i.e., age, gender, and severity of condition), family characteristics (i.e., parent role, education, income, and number of children), and child difficulties (i.e., behavioral, adaptive, emotional, social, learning, and communicative). With representative survey data from parents of children with ADHD (n?=?8252), ASD (n?=?1448), or ID (n?=?949), ranging in age from 2 to 17 years old, we used Χ ², binary logistic regression, linear regression, and univariate analyses to answer our research questions. We found that parents of children with ADHD, ASD, and ID experienced different types and amounts of burdens, families of younger children experienced more burden than those of older children, and families with more income or more children experienced fewer burdens. Adaptive and behavioral difficulties had the greatest relative impact on families. Diagnosis moderated almost all of the relationships between child difficulties and family burden. Overall, these results suggest that providing services and supports that are tailored to the specific needs of each child and family will be necessary for enhancing quality of life.     

Positive Public Health Ethics: Toward Flourishing and Resilient Communities and Individuals

Abstract

The COVID-19 pandemic is a global contagion of unprecedented proportions and health, economic, and social consequences. As with many health problems, its impact is uneven. This article argues the COVID-19 pandemic is a global health injustice due to moral failures of national governments and international organizations to prepare for, prevent and control it. Global and national health communities had a moral obligation to act in accordance with the current state of knowledge of pandemic preparedness. This obligation—a positive duty to develop and implement systems to reduce threats to and safeguard individuals’ and, communities’ abilities to flourish—stems from theories of global health justice and governance. The COVID-19 pandemic revealed and amplified the fragility and deficiencies in our global and domestic health institutions and systems. Moving forward, positive public health ethics is needed to set ethical standards for building and operating robust public health systems for resilient individuals and communities.     

COVID-19 Pandemic: Applying a Multisystemic Lens

The COVID-19 pandemic has a pervasive effect on all aspects of family life. We can distinguish the collective societal and community effects of the global pandemic and the risk and disease impact for individuals and families. This paper draws on Rolland’s Family Systems-Illness (FSI) model to describe some of the unique challenges through a multisystemic lens. Highlighting the pattern of psychosocial issues of COVID-19 over time, discussion emphasizes the evolving interplay of larger systems public health pandemic challenges and mitigation strategies with individual and family processes. The paper addresses issues of coping with myriad Covid-19 uncertainties in the initial crisis wave and evolving phases of the pandemic in the context of individual and family development, pre-existing illness or disability, and racial and socio-economic disparities. The discussion offers recommendations for timely family oriented consultation and psychoeducation, and for healthcare clinician self-care.     

Socioeconomic Status,Emotional/Behavioral Difficulties,and Social Competence among Preschool Children in Japan

Socioeconomic status (SES) is an important contextual factor influencing children’s development. However, there have been limited attempts to examine either the impact of relative poverty on child development or the relationships between specific SES indicators and mental health domains. This study elucidates these relationships in Japanese preschool children who experience high levels of relative poverty. Participants were 3218 Japanese children aged 5–6 years. Their mothers completed self-report questionnaires on SES indicators and the Strengths and Difficulties Questionnaire to measure emotional/behavioral problems. Children’s teachers evaluated children’s social competence using the Social Skills Questionnaire for Preschoolers. Each SES indicator had an inverse relationship with all emotional/behavioral problem domains in the univariate analysis. In the multivariate analysis, lower family income consistently predicted higher scores on all emotional/behavioral problem domains, whereas lower maternal and paternal education levels independently predicted higher scores in specific domains. Each SES indicator had positive relationships with all social competence dimensions in the univariate analysis. Higher family income consistently predicted higher social competence in the multivariate analysis. However, paternal education level only predicted self-control, and maternal education did not predict social competence. Family income and parental education levels were significant independent predictors of emotional/behavioral problems and social competence. Thus, this study suggests that SES does affect child outcomes in a country where there is a high level of relative poverty and underscores the importance of assessing income and education status separately in order to identify their potentially unique associations with development among preschool children.     

Involving Families in Change

Summary

In this article, a range of matters are considered that have to do with involvement of families with children with severe behavioral and emotional disorders in change. Family participation on education and system change is reviewed, while principles of family participation are enumerated.     

Les couples mis à l’épreuve du confinement de la crise Covid

ObjectivesThe COVID-19 pandemic resulted in strict containment. The isolation and anxietyinducing nature of the situation had an impact on the mental health of individuals. Our study examines the intimacy of individuals confined with or without their partners during this period and explores the risk factors and resources available to them.MethodologyWe distributed an online questionnaire during the first lockdown (April 2020). In total, 1985 adults (80.3% female; M = 34.27, SD = 14.96) participated in the study. Several validated scales assessed life context, mental health, substance use (alcohol and cannabis), intolerance of uncertainty and intimacy in the couple. Participants described their experiences through open-ended questions.ResultsOur results indicate that couples who lived in separate households during confinement (n = 453 or 22.8% of our sample) were more depressed, more anxious and more intolerant of uncertainty. Through a thematic analysis, we found that couples who were confined together were more likely to report an improvement in the quality of their emotional and sexual life than couples separated by confinement. However, restriction of available space, reorganisation of work and leisure activities and relationships with children emerged as potential stressors.ConclusionThe intimate partner can be a form of support for stress during containment and supports resilience in a pandemic crisis.     

Parent–Child Relationships and the COVID-19 Pandemic: An Exploratory Qualitative Study with Parents in Early,Middle, and Late Adulthood

The impact of the COVID-19 pandemic on families is currently unknown. Parents and children have experienced a variety of changes as public health interventions have been implemented to slow the spread of the virus. The current exploratory qualitative study recruited parents (n?=?365) in early (ages 20–34), middle (ages 35–64), and late (ages 65 and older) adulthood to understand how the early weeks of the pandemic influenced their parent–child relationships. Participants completed an online survey between March 21 and 31, 2020. Three themes emerged through qualitative content analysis: (1) relational steadiness, (2) navigating COVID-19 challenges in relationships, and (3) relational enhancement.

     

Intolerance of Uncertainty and Health-Related Anxiety in Youth amid the COVID-19 Pandemic: Understanding and Weathering the Continuing Storm

The COVID-19 pandemic is a public health crisis that continues to impact individuals worldwide. While children may be less susceptible to severe medical complications, they are nonetheless vulnerable to stress and anxiety associated with the pandemic. However, current understanding of psychological functioning and potential strategies to mitigate distress amid a pandemic is naturally limited. Consequently, this article is an attempt to fill that gap. Existing literature on pandemics, health-related anxieties, intolerance of uncertainty, and psychopathological sequelae is summarized within the context of the COVID-19 outbreak. Conclusions from the empirical data and emerging theoretical models are reviewed and synthesized. Finally, several potentially engaging and effective examples of developmentally appropriate interventions targeting intolerance of uncertainty and health-related anxieties in pediatric patients during the peri- and post-pandemic periods are described.