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      Parent psychological distress and parent-child relationships two years into the COVID-19 pandemic: Results from a Canadian cross-sectional study

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          Abstract

          Background

          Mental health impacts of the COVID-19 pandemic have not been felt equally within populations. Parents with children living at home were early on identified as a population at heightened mental health risk, with concerns about the potential long-term impacts of the pandemic on parents’ mental health, family functioning, and children’s well-being. This study investigates impacts of the pandemic on parents’ psychological distress, contextual sources of distress, and associations with family functioning nearly two years into the pandemic.

          Methods and findings

          Data were drawn from a national cross-sectional survey of adults living in Canada in November and December 2021 that was representative by age, gender, household income, and region. Parents with children < 18 years old living at home (N = 553) reported their experiences of psychological distress, pandemic-related stressors, coping mechanisms, and family functioning (changes in parent-child interactions, children’s anxiety). Chi-square tests, logistic regression, and linear regression analyses examined sociodemographic inequities in parents’ levels of psychological distress, sources and mitigating mechanisms of distress, and associations between psychological distress and family functioning. Nearly two years into the pandemic, parents with children at home reported nearly double pre-pandemic population estimates of moderate to severe psychological distress. Psychological distress was more frequently reported among parents with pre-existing mental health conditions, disabilities, and financial stressors. Parents with greater psychological distress reported increases in negative parent–child interactions due to the pandemic and higher anxiety among their children.

          Conclusions

          This study identifies sustained negative impacts of the pandemic on parents’ mental health and family functioning in Canada nearly two years into the pandemic, despite high vaccine uptake and declining infection rates. Disparities in financial stress, social support structures, and pre-existing mental health were identified as underlying sources of psychological distress. These results highlight that meaningful responses to promote mental health among parents and families must address social and structural inequities.

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          Most cited references42

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          Mental health before and during the COVID-19 pandemic: a longitudinal probability sample survey of the UK population

          Summary Background The potential impact of the COVID-19 pandemic on population mental health is of increasing global concern. We examine changes in adult mental health in the UK population before and during the lockdown. Methods In this secondary analysis of a national, longitudinal cohort study, households that took part in Waves 8 or 9 of the UK Household Longitudinal Study (UKHLS) panel, including all members aged 16 or older in April, 2020, were invited to complete the COVID-19 web survey on April 23–30, 2020. Participants who were unable to make an informed decision as a result of incapacity, or who had unknown postal addresses or addresses abroad were excluded. Mental health was assessed using the 12-item General Health Questionnaire (GHQ-12). Repeated cross-sectional analyses were done to examine temporal trends. Fixed-effects regression models were fitted to identify within-person change compared with preceding trends. Findings Waves 6–9 of the UKHLS had 53 351 participants. Eligible participants for the COVID-19 web survey were from households that took part in Waves 8 or 9, and 17 452 (41·2%) of 42 330 eligible people participated in the web survey. Population prevalence of clinically significant levels of mental distress rose from 18·9% (95% CI 17·8–20·0) in 2018–19 to 27·3% (26·3–28·2) in April, 2020, one month into UK lockdown. Mean GHQ-12 score also increased over this time, from 11·5 (95% CI 11·3–11·6) in 2018–19, to 12·6 (12·5–12·8) in April, 2020. This was 0·48 (95% CI 0·07–0·90) points higher than expected when accounting for previous upward trends between 2014 and 2018. Comparing GHQ-12 scores within individuals, adjusting for time trends and significant predictors of change, increases were greatest in 18–24-year-olds (2·69 points, 95% CI 1·89–3·48), 25–34-year-olds (1·57, 0·96–2·18), women (0·92, 0·50–1·35), and people living with young children (1·45, 0·79–2·12). People employed before the pandemic also averaged a notable increase in GHQ-12 score (0·63, 95% CI 0·20–1·06). Interpretation By late April, 2020, mental health in the UK had deteriorated compared with pre-COVID-19 trends. Policies emphasising the needs of women, young people, and those with preschool aged children are likely to play an important part in preventing future mental illness. Funding None.
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            Risk and resilience in family well-being during the COVID-19 pandemic.

            The COVID-19 pandemic poses an acute threat to the well-being of children and families due to challenges related to social disruption such as financial insecurity, caregiving burden, and confinement-related stress (e.g., crowding, changes to structure, and routine). The consequences of these difficulties are likely to be longstanding, in part because of the ways in which contextual risk permeates the structures and processes of family systems. The current article draws from pertinent literature across topic areas of acute crises and long-term, cumulative risk to illustrate the multitude of ways in which the well-being of children and families may be at risk during COVID-19. The presented conceptual framework is based on systemic models of human development and family functioning and links social disruption due to COVID-19 to child adjustment through a cascading process involving caregiver well-being and family processes (i.e., organization, communication, and beliefs). An illustration of the centrality of family processes in buffering against risk in the context of COVID-19, as well as promoting resilience through shared family beliefs and close relationships, is provided. Finally, clinical and research implications are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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              Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19 : A Meta-analysis

              Emerging research suggests that the global prevalence of child and adolescent mental illness has increased considerably during COVID-19. However, substantial variability in prevalence rates have been reported across the literature.
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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: MethodologyRole: SupervisionRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Formal analysisRole: MethodologyRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – original draftRole: Writing – review & editing
                Role: ConceptualizationRole: MethodologyRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Writing – review & editing
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: Writing – review & editing
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                PLOS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                17 October 2023
                2023
                17 October 2023
                : 18
                : 10
                : e0292670
                Affiliations
                [1 ] Children’s Health Policy Centre, Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
                [2 ] Human Early Learning Partnership, School of Population and Public Health, University of British Columbia, Vancouver, Canada
                [3 ] Centre for Advancing Health Outcomes, Providence Health Care Research Institute, Vancouver, British Columbia, Canada
                [4 ] School of Nursing, University of British Columbia, Vancouver, Canada
                [5 ] School of Population and Public Health, University of British Columbia, Vancouver, Canada
                University of Central Florida, UNITED STATES
                Author notes

                Competing Interests: CGR reports receiving personal fees from the University of British Columbia during the conduct of this study. All other authors report no competing interests. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                Author information
                https://orcid.org/0000-0002-4508-2463
                https://orcid.org/0000-0002-7868-564X
                Article
                PONE-D-23-00797
                10.1371/journal.pone.0292670
                10581480
                37847679
                aa18c700-0665-4018-bf27-c10429918217
                © 2023 Thomson et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 10 January 2023
                : 26 September 2023
                Page count
                Figures: 0, Tables: 3, Pages: 14
                Funding
                Funded by: Canadian Mental Health Association
                Award Recipient :
                The Canadian Mental Health Association (CMHA) funded survey data collection through national polling vendor, Maru/Matchbox. Collaborators from CMHA also contributed to the survey development. CMHA had no further role in the study design, data collection, data analysis, or interpretation.
                Categories
                Research Article
                Medicine and Health Sciences
                Epidemiology
                Pandemics
                People and Places
                Population Groupings
                Age Groups
                Children
                People and Places
                Population Groupings
                Families
                Children
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Psychological Stress
                Biology and Life Sciences
                Psychology
                Psychological Stress
                Social Sciences
                Psychology
                Psychological Stress
                Biology and Life Sciences
                Psychology
                Social Sciences
                Psychology
                Biology and Life Sciences
                Psychology
                Emotions
                Anxiety
                Social Sciences
                Psychology
                Emotions
                Anxiety
                Medicine and Health Sciences
                Medical Conditions
                Infectious Diseases
                Viral Diseases
                Covid 19
                Biology and Life Sciences
                Psychology
                Social Psychology
                Social Sciences
                Psychology
                Social Psychology
                Custom metadata
                There are ethical restrictions that do not allow for the data to be made publicly available. Participants consented to the data being stored in a password protected database on Canadian-hosted servers only; the consent form did not include where or how open access data would be stored or associated risks of opening access to the data. The dataset for this study is available upon researcher request for the purpose of replicating the study findings. Please contact Michele Wiens, Senior Manager, Knowledge Management and Privacy & Ethics Officer at the Human Early Learning Partnership, University of British Columbia: privacy@ 123456help.ubc.ca .
                COVID-19

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