Maternal mental health mediates the effects of pandemic-related stressors on adolescent psychopathology during COVID-19

Mental health and quality of life in children and adolescents during the COVID-19 pandemic: a systematic review of longitudinal studies

Background

The COVID-19 pandemic has significantly impacted the mental health of children and families, i.e., due to measures like social distancing and remote schooling. While previous research has shown negative effects on mental health and health-related quality of life (HRQoL), most studies have focused on pre-post comparisons in the early pandemic stages. This systematic review aims to examine longitudinal studies to understand the long-term impacts of the pandemic on children and adolescents.

Methods

This systematic review adhered to the PRISMA guidelines and was preregistered in the international prospective register of systematic reviews (Record ID: CRD42022336930). We systematically searched PubMed/MEDLINE, Web of Science, PsycINFO, PSYNDEX, and the WHO-COVID-19 database and included studies published up to August 30, 2022. Based on pre-defined eligibility criteria, longitudinal and prospective studies that assessed the mental health or quality of life of children or adolescents (0-19 years) in the general population over a longer time span (at two or more measurement points) during the COVID-19 pandemic were included in the review. The methodological quality of the included studies was assessed using an adapted version of the Effective Public Health Practice Project (EPHPP) checklist. Narrative data synthesis was used to summarize the findings.

Results

A total of 5,099 results were obtained from literature searches, with 4,935 excluded during title/abstract screening. After reviewing 163 full-text articles, 24 publications were included in the review. Sample sizes ranged between n = 86 and n = 34,038. The length of the investigated time periods and the number of assessment points, as well as outcomes, varied. The majority of studies were of moderate methodological quality. Mental health outcomes were more frequently studied compared to measures of HRQoL. The findings from these studies mostly suggest that children and adolescents experienced heightened mental health problems, specifically internalizing symptoms like anxiety and depression. Further, there was a decline in their overall HRQoL over the course of the COVID-19 pandemic that did not necessarily subside when lockdowns ended.

Conclusion

It is crucial to continue monitoring the mental health and well-being of children and adolescents following the pandemic to identify groups at risks and plan interventions. This should ideally be conducted by large systematic studies, using validated instruments, and encompassing representative samples to obtain reliable and comprehensive insights with the aim of improving youth mental health care.

The promotive and protective effects of parents' perceived changes during the COVID-19 pandemic on emotional well-being among U.S. households with young children: an investigation of family resilience processes

Introduction

The COVID-19 pandemic may constitute a traumatic event for families with young children due to its acute onset, the unpredictable and ubiquitous nature, and the highly distressing disruptions it caused in family lives. Despite the prevalent challenges such as material hardships, child care disruptions, and social isolation, some families evinced remarkable resilience in the face of this potentially traumatic event. This study examined domains of changes perceived by parents of young children that were consistent with the post-traumatic growth (PTG) model as factors that facilitate family resilience processes.

Methods

This study drew data from the RAPID project, a large ongoing national study that used frequent online surveys to examine the pandemic impact on U.S. households with young children. A subsample of 669 families was leveraged for the current investigation, including 8.07% Black, 9.57% Latino(a), 74.44% non-Latino(a) White families, and 7.92% households of other racial/ethnic backgrounds. In this subsample, 26.36% were below 200% federal poverty level.

Results

Approximately half of the parents reported moderate-to-large degrees of changes during the pandemic, and the most prevalent domain of change was appreciation of life, followed by personal strengths, new possibilities, improved relationships, and spiritual growth. Black and Latino(a) parents reported more changes in all five domains than White parents and more spiritual growth than parents of the other racial/ethnic groups. Moreover, parent-reported improved relationships were found to indirectly reduce young children's overall fussiness/defiance and fear/anxiety symptoms through reducing parents' emotional distress. Perceived changes in the new possibilities, personal strengths, and appreciation of life domains were found to serve as protective factors that buffered the indirect impacts of material hardship mean levels on child behavioral symptoms via mitigating parents' emotional distress.

Discussion

These findings shed light on resilience processes of a family system in a large-scale, disruptive, and stressful socio-historical event such as the COVID-19 pandemic. The five PTG domains could inform therapeutic and intervention practices in the face of future similar events. Importantly, these findings and the evinced family resilience should not negate the urgent needs of policy and program efforts to address material hardships, financial instabilities, and race/ethnicity-based structural inequalities for families of young children.

Empirical support for a model of risk and resilience in children and families during COVID-19: A systematic review & narrative synthesis

BACKGROUND.

The COVID-19 Family Disruption Model (FDM) describes the cascading effects of pandemic-related social disruptions on child and family psychosocial functioning. The current systematic review assesses the empirical support for the model.

METHODS.

Study eligibility: 1) children between 2-18 years (and/or their caregivers); 2) a quantitative longitudinal design; 3) published findings during the first 2.5 years of COVID-19; 4) an assessment of caregiver and/or family functioning; 5) an assessment of child internalizing, externalizing, or positive adjustment; and 6) an examination of a COVID-19 FDM pathway. Following a search of PsycINFO and MEDLINE in August 2022, screening, full-text assessments, and data extraction were completed by two reviewers. Study quality was examined using an adapted NIH risk-of- bias tool.

RESULTS.

Findings from 47 studies were summarized using descriptive statistics, tables, and a narrative synthesis. There is emerging support for bidirectional pathways linking caregiver-child functioning and family-child functioning, particularly for child internalizing problems. Quality assessments indicated issues with attrition and power justification.

DISCUSSION.

We provide a critical summary of the empirical support for the model, highlighting themes related to family systems theory and risk/resilience. We outline future directions for research on child and family well-being during COVID-19. Systematic review registration. PROSPERO [CRD42022327191].

Factors associated with mental health symptoms among UK autistic children and young people and their parents during the COVID-19 pandemic

LAY ABSTRACT

What is already known about the topic: The COVID-19 pandemic and the associated restrictions impacted all of society. There is emerging evidence showing a range of impacts on autistic children and young people and their families. Further research that looks at how individuals coped during the pandemic while considering how they were doing before the pandemic is needed.What this paper adds: This article explores whether how well autistic youth were doing before the pandemic influenced how they coped during the pandemic. It also looked at how well their parents were doing during the pandemic and whether any pre-pandemic factors influenced how they coped. Samples of both primary-school-aged autistic children and autistic teenagers and their parents were surveyed to answer these questions. More engagement and enjoyment in education provision during the pandemic and getting outside more were linked with better child and parental mental health during the pandemic. More attention deficit hyperactivity disorder before the pandemic was linked with more attention deficit hyperactivity disorder and behavioural problems during the pandemic in primary-school-aged autistic children, and more emotional problems during the pandemic in autistic teenagers. Parents with more mental health problems during the pandemic had more mental health problems before the pandemic.Implications for practice, research or policy: Encouraging engagement and enjoyment in education and promoting physical exercise are key intervention targets. Ensuring access to attention deficit hyperactivity disorder medication and support is important, especially if this is managed jointly across school and home.

Pre-pandemic brain structure and function and adolescent psychopathology during the COVID-19 pandemic

The COVID-19 pandemic has presented unprecedented challenges for youths and families, dramatically increasing exposure to stressors and stress-related psychopathology. Increasing work has leveraged pre-pandemic neuroimaging data to predict adolescent psychopathology and stress responses during the pandemic, with a particular focus on internalizing symptoms. We review this recent literature on pre-pandemic brain structure and function and adolescent internalizing psychopathology during the pandemic. At present, existing studies have not consistently identified specific alterations in brain structure and function that predict anxiety or depressive symptoms during the pandemic. In contrast, exposure to stress and adversity before and during the pandemic as well as access to peer and family support have emerged as consistent and reliable predictors of youth mental health during the pandemic.

Mental Health Is a Family Affair-Systematic Review and Meta-Analysis on the Associations between Mental Health Problems in Parents and Children during the COVID-19 Pandemic

As a multidimensional and universal stressor, the COVID-19 pandemic negatively affected the mental health of children, adolescents, and adults worldwide. In particular, families faced numerous restrictions and challenges. From the literature, it is well known that parental mental health problems and child mental health outcomes are associated. Hence, this review aims to summarize the current research on the associations of parental mental health symptoms and child mental health outcomes during the COVID-19 pandemic. We conducted a systematic literature search in Web of Science (all databases) and identified 431 records, of which 83 articles with data of over 80,000 families were included in 38 meta-analyses. A total of 25 meta-analyses resulted in significant small to medium associations between parental mental health symptoms and child mental health outcomes (r = 0.19 to 0.46, p < 0.05). The largest effects were observed for the associations of parenting stress and child mental health outcomes. A dysfunctional parent-child interaction has been identified as a key mechanism for the transmission of mental disorders. Thus, specific parenting interventions are needed to foster healthy parent-child interactions, to promote the mental health of families, and to reduce the negative impacts of the COVID-19 pandemic.

Family functioning buffers the consequences of the COVID-19 pandemic for children's quality of life and loneliness

COVID-19 resulted in mass quarantine measures early in the pandemic. This disruption of daily life widened inequities and made children one of the most vulnerable populations during the crisis. This national, cross-sectional "COVID-Kids" study collected data from almost 500 parent-child dyads using standardized measures to better understand the effects of COVID exposure and impact on children's quality of life and loneliness. Data were collected via social media from May to July 2020. According to parent proxy and child self-report, United States children experienced worse quality of life (p < 0.0001; d = 0.45 and 0.53) and greater child-reported loneliness (p < 0.0001) when compared to normative, healthy samples (i.e., children who do not have a chronic medical condition). Older children (r = 0.16, p = 0.001) and female children (r = 0.11, p = 0.02) reported greater loneliness. Higher child-reported family functioning scores were associated with better quality of life (r = 0.36, p < 0.0001) and less loneliness (r = -0.49, p < 0.0001). Moderated mediation analyses indicated the indirect effect of parent COVID impact on the association between COVID exposure and child quality of life was weaker in the context of better family functioning. Results of this study raise concern for the short-and long-term sequelae of the pandemic on the physical and mental health of children. Healthcare providers and researchers must find new and innovative ways to protect the well-being of children. Strengthening family functioning may buffer the effects of the pandemic and improve overall quality of life in our "COVID Kids."

Parental psychosocial factors predicting adolescents' psychological adjustment during the surging and remission periods of COVID-19 in China: A longitudinal study

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.

Editorial: The critical need to assess pubertal development in studies of child and adolescent psychopathology

Nearly all developmental studies of youth psychopathology assess the effects of age on risk factor-youth outcomes, yet very few examine the effects of pubertal development on developmental trajectories. Growing evidence underscores the importance of both stages of puberty (adrenarche and gonadarche) in risk for psychopathology and the need to consider these developmental stages as predictors and moderators of mental health outcomes and trajectories. The purpose of this Editorial is to provide examples of this evidence and highlight gaps in our literature base as well as opportunities for future research.

Child, adolescent, and parent mental health in general population during a year of COVID-19 pandemic in belgium: a cross-sectional study

BACKGROUND

This study aims to evaluate the mental health status of children, adolescents and their parents during the first year of COVID-19 pandemic in Belgium.

METHOD

Analysis compared results before and during the second national lockdown, which started on November 2nd 2020. A cross-sectional online survey was conducted between May 2020 and April 2021.

RESULTS

Two hundred and eighteen adults and 273 children fully completed the survey. Almost one in five children (17.9%) presented moderate-to-severe scores of depression. Adolescents presented a higher level of depression than children (p = 0.007). The rate of moderate-to-severe depression scores (10.8% to 21%, p = 0.007) and internalized symptoms increased during the second lockdown (p < 0.001). Parents' depression (p < 0.001) and anxiety (p = 0.027) levels also increased during the second lockdown. Logistic regression showed that the use of psychotropic medication in parents and parents' depression scores were risk factors for children to have worse depression scores.

CONCLUSION

The second lockdown appears to worsen the effects of the pandemic on children's and parents' mental health. There is a need to implement specific interventions targeting both children/adolescents and their parents to support them during lockdown periods and improve mental health outcomes.