Psychological effects of COVID-19 on parenting and maternal-fetal mental health

The Pandemics of Mass Destruction: A Comparative Analysis of HIV/AIDS and Coronavirus (COVID-19)

Historically, humanity has suffered and endured deadly pandemics of varying mortality rates. Irrefutably, research shows that the outbreak of pandemics is flooded by mythical and fallacious information among the public, hence stifling the prevention, treatment, and management of diseases. This paper focused on comparing selected aspects of the two pandemics, that is, HIV/AIDS and Coronavirus. This comparative analysis is important for drawing informative lessons for effective response and management of pandemics in the future. Through a literature review analysis, the paper established that both pandemics have more similarities than distinctions. The etiology and epidemiology of the diseases assume a similar cascading trajectory; the public health information about the diseases is characterized by myths, conspiracy theories, illusions, and delusions from the public. The myths associated with pandemics prevail around causation, disease transmission, and cure. The pandemics present economic paradoxes, though arguably the negatives outdo the positives. There is a need for the governments and international health custodians to be richly prepared for the pandemics in the future. This implies having special budgetary allocations for possible pandemic outbreaks, investing in vaccine development and disease surveillance, and training and skilling personnel in all social-health-related sectors.

The negative association of the SARS-CoV-2 pandemic with the health of mother and child considering maternal childhood maltreatment

BACKGROUND

Social distancing strategies during the SARS-CoV-2 pandemic have left families facing a variety of different constraints. Especially in this stressful time, children need a stable parental home to prevent developmental consequences. Additional risk factors such as maternal childhood maltreatment (CM) may affect mother's psychosomatic health and children's physical well-being in this period.

OBJECTIVE

It was aimed to analyze the associations between maternal CM, mother's mental health, and children's physical complaints during the SARS-CoV-2-pandemic.

METHOD

Mothers of a well-documented birth cohort from a longitudinal study were included in this study. Psychosomatic health was assessed with the PHQ-D and children's physical health with the GBB-KJ during the pandemic. N = 159 mothers completed the online survey. To describe the maternal CM, data from a longitudinal survey were used.

RESULTS

The calculation of three mediation analyses demonstrate that maternal depression symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.07, p = .13), somatic symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.07, p = .13) and psychosomatic symptoms (c-path: β = 0.10, p = .02; c'-path: β = 0.06, p = .19) fully mediate the relationship between CM and children's physical health complaints.

CONCLUSIONS

Maternal CM experiences seem to be one relevant risk factor during the pandemic and seem to influence the way in which parents deal with stressful situations and increase the risk for depressive symptoms. The present results highlight the importance to provide individually adjusted assistance to help the families to get through the pandemic.

Negative effects of the SARS-CoV-2 pandemic: The interlinking of maternal attachment representation, coping strategies, parental behavior, and the child's mental health

For more than two years, young families have been confronted with a large number of restrictions and following burdens as a result of the SARS-CoV-2 pandemic. In fact, it became evident, that the current circumstances are particularly stressful for child's mental health. With regard to the child's mental health in times of a pandemic, additional factors within the family, such as maternal attachment representations as well as coping strategies and parental behavior, may play an important role. This study aims to investigate the interplay of maternal attachment representation, coping strategies, parental behavior and child's mental health during the SARS-CoV-2 pandemic. In this longitudinal study, previously collected data regarding maternal attachment representation and newly attained data from the SARS-CoV-2-pandemic-assesment (lack of coping strategies, children's mental health and parental behavior) were combined and analyzed. The data were collected in an online survey since beginning of the pandemic, including N = 73 mothers. A path model was calculated in form of multiple linear regression. A path model could be confirmed, which indicates that insecure maternal attachment representation predicts lack of coping strategies during the pandemic [b = 5.55, 95%-CI = (4.51; 6.55), p = 0.001]. Furthermore, lack of coping strategies predicts harmful parental behavior during the pandemic [b = -0.77, 95%-CI = (-1.27; -0.21), p = 0.007], which in turn predicts children's mental health problems, namely behavioral problems [b = -0.08, 95%-CI = (-0.14; -0.01), p = 0.027]. Presence of short-time work and decrease in income since beginning of the pandemic were used as control variables. This means that since the pandemic mothers with insecure attachment representation have an increased risk of having only a few coping mechanisms available, leading to harmful parental behaviors and ultimately affecting the mental health of their children. In conclusion, the pandemic could potentially have a particularly negative influence on mothers with an insecure attachment type and therefore on their children. Therefore, tailored interventions for families should be offered that both focus on the different types of mental health problems in children and support parents in their coping skills.

Maternidade em tempos de pandemia de Covid-19: o que nos revelam as mães atendidas em um hospital de referência

A pandemia de Covid-19 afetou todas as esferas da nossa vida. Mulheres no período perinatal têm necessidades únicas, demandando diretrizes de saúde e segurança devido aos riscos do isolamento social. Objetivou-se conhecer a vivência de mulheres na gestação ou puerpério no contexto da pandemia durante atendimento em hospital de referência. Estudo qualitativo pautado em referenciais da integralidade do cuidado e cotidiano. Participaram 18 mulheres, gestantes e puérperas. Três temas emergiram: repercussões na gestação e puerpério; repercussões na vida prática; e estratégias de enfrentamento criadas pelas mulheres. Os relatos desvelam diferentes repercussões da pandemia na vida das mulheres e de suas famílias, bem como estratégias e cuidados usados para mitigar os efeitos adversos. Sugere-se o direcionamento de medidas preventivas e políticas públicas que priorizem mulheres grávidas e puérperas, reconhecendo e acolhendo questões subjetivas envolvidas nesse momento na vida da mulher.

Barriers to telemedicine among physicians in epilepsy care during the COVID-19 pandemic: A national-level cross-sectional survey in Japan

OBJECTIVE

This study aimed to investigate the factors affecting the unwillingness of physicians involved in epilepsy care to continue telemedicine during the coronavirus disease 2019 (COVID-19) pandemic in Japan.

METHOD

This was a national-level cross-sectional survey initiated by Japan Young Epilepsy Section (YES-Japan) which is a national chapter of The Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES). We asked physicians who conducted telemedicine in patients with epilepsy (PWE) during the COVID-19 pandemic at four clinics and 21 hospitals specializing in epilepsy care in Japan from March 1 to April 30, 2021. The following data were collected: (1) participant profile, (2) characteristics of PWE treated by telemedicine, and (3) contents and environmental factors of telemedicine. Statistically significant variables (p < 0.05) in the univariate analysis were analyzed in a multivariate binary logistic regression model to detect the independently associated factors with the unwillingness to continue telemedicine.

RESULT

Among the 115 respondents (response rate: 64%), 89 were included in the final analysis. Of them, 60 (67.4%) were willing to continue telemedicine, and 29 (32.6%) were unwilling. In the univariate binary logistic regression analysis, age (Odds ratio [OR] = 1.84, 95% confidence interval [CI] 1.10-3.09, p = 0.02), psychiatrist (OR = 5.88, 95% CI 2.15-16.08, p = 0.001), hospital (OR = 0.10, 95% CI 0.01-0.94, p = 0.04), the number of COVID-19 risk factors in the participant (OR = 2.88, 95% CI 1.46-5.69, p = 0.002), the number of COVID-19 risk factors in the cohabitants (OR = 2.52, 95% CI 1.05-6.01, p = 0.04), COVID-19 epidemic area (OR = 4.37, 95% CI 1.18-16.20, p = 0.03), consultation time during telemedicine (OR = 2.51, 95% CI 1.32-4.76, p = 0.005), workload due to telemedicine (OR = 4.17, 95% CI 2.11-8.24, p < 0.001) were statistically significant. In the multivariate binary logistic regression analysis, workload due to telemedicine (OR = 4.93, 95% CI 1.96-12.35) was independently associated with the unwillingness to continue telemedicine.

CONCLUSION

This national-level cross-sectional survey found that workload due to telemedicine among physicians involved in epilepsy care was independently associated with the unwillingness to continue telemedicine.

Risk factors for psychological distress in electroencephalography technicians during the COVID-19 pandemic: A national-level cross-sectional survey in Japan

OBJECTIVE

To identify the risk factors for psychological distress in electroencephalography (EEG) technicians during the coronavirus disease 2019 (COVID-19) pandemic.

METHOD

In this national-level cross-sectional survey initiated by Japan Young Epilepsy Section (YES-Japan), which is a national chapter of The Young Epilepsy Section of the International League Against Epilepsy (ILAE-YES), a questionnaire was administered to 173 technicians engaged in EEG at four clinics specializing in epilepsy care and 20 hospitals accredited as (quasi-) epilepsy centers or epilepsy training facilities in Japan from March 1 to April 30, 2021. We collected data on participants' profiles, information about work, and psychological distress outcome measurements, such as the K-6 and Tokyo Metropolitan Distress Scale for Pandemic (TMDP). Linear regression analysis was used to identify the risk factors for psychological distress. Factors that were significantly associated with psychological distress in the univariate analysis were subjected to multivariate analysis.

RESULTS

Among the 142 respondents (response rate: 82%), 128 were included in the final analysis. As many as 35.2% of EEG technicians have been under psychological distress. In multivariate linear regression analysis for K-6, female sex, examination for patients (suspected) with COVID-19, and change in salary or bonus were independent associated factors for psychological distress. Contrastingly, in multivariate linear regression analysis for TMDP, female sex, presence of cohabitants who had to be separated from the respondent due to this pandemic, and change in salary or bonus were independent associated factors for psychological distress.

CONCLUSION

We successfully identified the risk factors associated with psychological distress in EEG technicians during the COVID-19 pandemic. Our results may help in understanding the psychological stress in EEG technicians during the COVID-19 pandemic and improving the work environment, which is necessary to maintain the mental health of EEG technicians.

Maternal attachment representation, the risk of increased depressive symptoms and the influence on children's mental health during the SARS-CoV-2-pandemic

The social distancing measures and the related closure of education institutions have confronted young families, in particular, with various challenges. Additional risk factors such as an insecure or even unresolved maternal attachment representation may affect mental health of mothers and their children in times of increased stress such as during the ongoing pandemic. We aimed to analyze the interplay between maternal attachment representation and mother's and children's mental health before and during the SARS-CoV-2-pandemic. 91 mothers completed a "SARS-CoV-2 pandemic survey" examining the pandemic-related stress of their families including their own depressive symptomology and their children's mental health. Our mediation analysis demonstrates that the mothers' depressive symptomology significantly and fully mediated the relationship between maternal attachment representations and children's mental health during the pandemic. In contrast, the indirect effect of the maternal attachment representation on children's mental health before the pandemic through the depressive symptoms experienced by the mothers before the pandemic did not reach significance alongside the total and direct effect. The quality of the maternal attachment representation, promoted by childhood maltreatment, seems to be one relevant risk factor for the mothers' and children's mental health during a stressful time like a pandemic. The risk for mothers to develop depressive symptoms in times of a pandemic is significantly influenced by their current representation of previous attachment experiences. In addition, the mental well-being of mothers showed a considerable influence on the children's mental health during a pandemic. The results underline the necessity to consider unique needs of family members and to offer specific support in the current crisis focusing on attachment issues.

The interplay between maternal childhood maltreatment, parental coping strategies as well as endangered parenting behavior during the current SARS-CoV-2 pandemic

The SARS-CoV-2-pandemic is associated different challenges, especially for families. The disruption and challenges require parents to develop strategies to cope with the current situation. One factor that may influence how parents deal with pandemic-associated stressors are experiences of parental childhood maltreatment (CM), which represent a high risk of engaging in endangered parenting. A decisive candidate for the connection between parental CM and the transgenerational transmission could be the parental ability to employ coping strategies. Mothers of a well-documented birth cohort for investigating the pathways leading to resilience or vulnerability in the transgenerational transmission of CM were imbedded in an online “SARS-CoV-2 pandemic survey” assessing maternal ability for coping strategies and the dimension of endangered maternal parenting behavior. 91 mothers completed the online survey. To describe the maternal CM, data from a longitudinal survey were used. Our mediation analysis shows a significant positive relationship between the sum of maternal CM experiences, lack of coping strategies and endangered parenting behavior. This suggests a partial mediation of the association between CM and endangered parenting behavior as the direct effect remained significant when the maternal lack of coping strategies was included as the mediator. Parental CM is a risk factor for coping with stressful situation as well as for endangered parenting behavior. The ability to deal with stress seems to have a significant influence on the context of a possible transgenerational transmission of CM. The results underline the need to consider the unique needs of families with children and to support them as to how to overcome the current crisis.

Mothers' daily perceived stress influences their children's mental health during SARS-CoV-2-pandemic-an online survey

BACKGROUND

The current situation caused by the SARS-CoV-2-pandemic is associated with serious losses for everyone and has been affecting social life, politics, the economy and the media worldwide. Preventive isolation and social distancing strategies have confronted families with a large number of different challenges. The current epidemic and quarantine restrictions have a verifiable influence on the emotional and social development of children and adolescents. During this ongoing situation children of parents, who already were mentally stressed, seem particularly at risk.

OBJECTIVE

We aimed to assess the role of maternal daily perceived stress on children's mental health during the SARS-CoV-2-pandemic.

METHODS

An online "SARS-CoV-2-pandemic survey" was developed to assess children's mental health since the beginning of the SARS-CoV-2 pandemic. To describe maternal perceived everyday stress, data from a longitudinal survey was utilized. Our survey includes elements and versions of the Childhood Trauma Questionnaire, the Strengths and Difficulties Questionnaire and the Perceived Stress Scale. We furthermore collected socio-demographic data. Due to our limited dependent variables we applied Tobit models for estimation.

RESULTS

We found a positive and significant effect of the maternal perceived everyday stress on children's emotional problems during the pandemic. Furthermore, results provide empirical evidence for an increase of the children's hyperactivity level dependent on the mother's perceived stress before the SARS-COV-2 crisis. We could not find significant effects for the relationship between mother's perceived everyday stress and the children's behavioral problems.

CONCLUSIONS

Analyses illustrate the effects on children's mental distress during everyday life in the SARS-CoV-2 pandemic. Future research needs to identify influencing factors with regard to political, economic and social restrictions, in order to prevent children's mental health problems.

Psychoeducational Challenges in Spanish Children With Dyslexia and Their Parents' Stress During the COVID-19 Pandemic

Background

Research during 2020 has been rapidly attending to the impact of COVID-19 on various dimensions of wellbeing (e.g., physical, psychological, lifestyle and routines) on adults and children around the world. However, less attention has focused on the psychoeducational impact on children and their families. To our knowledge, no currently available studies have looked specifically at the impact of COVID-19 on students with dyslexia and their families. Research on this topic is needed to offer greater support for this population of students and their families.

Objective

The main objective of this paper is to examine the psychoeducational impact of the required COVID-19 quarantine in Spain among children with dyslexia and their families.

Method

A sample of 32 children with dyslexia and their mothers participated in this study.

Measures

Children and adolescents with dyslexia and their mother completed several measures before the required national quarantine in Spain and again during the quarantine. Children completed measures of depression, state anxiety, reading activity, and reading motivation. Mothers provided demographic information and completed measures related to students’ emotional and behavioral difficulties as well as parenting stress, parental distress, and a questionnaire about educational problems during quarantine.

Results

Major findings showed that during quarantine, children with dyslexia had increased levels of depression and anxiety symptoms, and parents perceived their children as having more emotional symptoms, hyperactivity-inattention, and conduct problems. During quarantine, children and adolescents with dyslexia also showed less reading activity and less reading motivation. Parents also reported significantly more stress, during quarantine compared to pre-quarantine conditions. Some demographic and psychological variables predicted children’s state anxiety as well parental stress. The questionnaire related to impacts of quarantine also revealed several important findings. For example, nearly all parents of children with dyslexia reported (a) difficulties in establishing study routines, (b) that the quarantine negatively affected their child’s learning, and (c) that they did not receive sufficient help from teachers on how to support their child’s learning. Additionally, the vast majority of the parents were very worried about the child’s learning and school success, the child’s motivation and interest in reading, the child’s peer relations, and the professional skills of the child’s teacher.

Conclusion

This study offers a preliminary investigation into this topic and elucidates several psychoeducational challenges that children with dyslexia and their families have experienced during the quarantine in Spain. Study findings highlight the need to provide immediate support for children with dyslexia and emphasizes the importance of developing prevention programs to mitigate any future negative impacts of COVID-19 on children with dyslexia and their parents.

Consequences of the COVID-19 pandemic on the postpartum course: Lessons learnt from a large-scale comparative study in a teaching hospital

Objective

To evaluate the consequences of COVID‐19 pandemic restrictions on the postpartum course.

Methods

A retrospective cross‐sectional study compared women who gave birth between March and April 2020 (first wave), between July to September 2020 (second wave), and a matched historical cohort throughout 2017–2019 (groups A, B, and C, respectively). Primary outcomes were postpartum length of stay (LOS), presentations to the emergency department (ED), and readmissions 30 days or longer after discharge. Following Bonferroni correction, p < 0.016 was considered statistically significant.

Results

In total, 3377 women were included: 640, 914, and 1823 in groups A, B, and C, respectively. LOS after birth (both vaginal and cesarean) was shorter in groups A and B compared to the control group (2.28 ± 1.01 and 2.25 ± 0.93 vs 2.55 ± 1.10 days, p < 0.001). Rates of ED presentations 30 days after discharge were higher in groups C and B compared to group A (6.63% and 6.45% vs 3.12%, p = 0.006). Rates of readmissions 30 days after discharge were 0.78%, 1.42%, and 1.09% (groups A, B, and C, respectively), demonstrating no statistical difference (p = 0.408).

Conclusion

During the COVID‐19 pandemic, there was a reduction or no change in rates of ED presentations and readmissions, despite the shortened LOS after delivery. A shift in policy regarding the postpartum LOS could be considered.

Length of stay after delivery was shortened during the COVID‐19 pandemic without a surge in postpartum presentations to the emergency department or rates of readmission.

Parenting-Related Exhaustion During the Italian COVID-19 Lockdown

OBJECTIVE

Worldwide, the coronavirus disease 2019 (COVID-19) pandemic has generated significant worry, uncertainty, anxiety, sadness, and loneliness. In Italy, these effects have been particularly pronounced. While research on the COVID-19 outbreak has mainly focused on the clinical features of infected patients and the psychological impact on the general population and health professionals, no investigation has yet assessed the psychological impact of the pandemic on parents. In the present research, we conducted a web-based survey of Italian parents to examine the prevalence of parenting-related exhaustion-and to identify its associated risk and protective factors-4 weeks into the lockdown.

METHODS

A total of 1,226 parents provided their consent to participate in the study and completed a demographic questionnaire, information relating to particular COVID-19 experiences, and measures of emotional exhaustion, parental resilience, social connections, and psychological distress during the lockdown.

RESULTS

Seventeen percent of our sample experienced significant parenting-related exhaustion, with mothers more severely affected. Multiple regression analyses showed that greater parenting-related exhaustion was predicted by psychological distress, lower parental resilience, motherhood, fewer perceived social connections, and being single, as well as having a child with special needs, having a large number of children, and having younger children.

CONCLUSION

The findings add further support to the call for preventive programs to support parents throughout the COVID-19 pandemic. Mental health professionals and social workers should be warned of the effects of lockdown and social distancing on parenting and, consequently, the well-being of children.