COVID-19 pandemic may have increased mental health issues within families

April 13, 2021

Science Daily/Penn State

When the COVID-19 pandemic hit in early 2020, many families found themselves suddenly isolated together at home. A year later, new research has linked this period with a variety of large, detrimental effects on individuals' and families' well-being and functioning.

The study -- led by Penn State researchers -- found that in the first months of the pandemic, parents reported that their children were experiencing much higher levels of "internalizing" problems like depression and anxiety, and "externalizing" problems such as disruptive and aggressive behavior, than before the pandemic. Parents also reported that they themselves were experiencing much higher levels of depression and lower levels of coparenting quality with their partners.

Mark Feinberg, research professor of health and human development at Penn State, said the results -- recently published in the journal Family Process -- give insight into just how devastating periods of family and social stress can be for parents and children, and how important a good coparenting relationship can be for family well-being.

"Stress in general -- whether daily hassles or acute, crisis-driven stress -- typically leads to greater conflict and hostility in family relationships," Feinberg said. "If parents can support each other in these situations, the evidence from past research indicates that they will be able to be more patient and more supportive with their children, rather than becoming more harsh and angry."

Feinberg added that understanding what can help parents maintain positive parenting practices, such as a positive coparenting relationship, is key for helping protect children during future crises -- whether those crises are pandemics, economic shocks or natural disasters.

While cross-sectional studies have suggested there has been a negative impact of the pandemic on families, the researchers said this study is one of the first to measure just how much these factors have changed within families before and after the pandemic hit.

According to the researchers, previous research has found that periods of financial stress, such as the Great Depression and the 2008 recession, have led to higher levels of parent stress, mental health problems and interparental conflict, which can all lead to more harsh, and even abusive, parenting.

When the COVID-19 pandemic hit, Feinberg said it led to not only financial stress within families, but also problems related to being isolated together, issues managing work and childcare, and general fear related to the sudden health threat that was poorly understood.

"When the pandemic hit, like many people, I was very anxious and worried," Feinberg said. "I saw the tensions and difficulties my daughter and I were having being home together 24/7. So, when I realized that our existing studies and samples of families gave us an opportunity to learn something about how families would cope during the crisis, my team and I moved into action."

For the study, the researchers used data from 129 families, which included 122 mothers and 84 fathers, with an average of 2.3 children per family. The parents answered an online questionnaire that asked them about their depressive symptoms, anxiety, the quality of their relationship with their coparent, and externalizing and internalizing behavior they observed in their children, among other measures.

Because the participants were part of a longer study measuring these factors over prior years, the researchers already had data on these parents and children from before the pandemic.

The researchers found that parents were 2.4 times more likely to report "clinically significant" high levels of depression after the pandemic hit than before. They were also 2.5 times and 4 times more likely to report externalizing and internalizing problems, respectively, in their children at levels high enough that professional help might be needed.

Feinberg said that while it makes sense that families would experience these difficulties, he was shocked at the magnitude of the declines in well-being.

"The size of these changes are considered very large in our field and are rarely seen," Feinberg said. "We saw not just overall shifts, but greater numbers of parents and children who were in the clinical range for depression and behavior problems, which means they were likely struggling with a diagnosable disorder and would benefit from treatment."

Feinberg put the size of the declines in parent and child well-being in perspective by pointing out that the increase in parents' levels of depressive symptoms in the first months of the pandemic was about twice as large as the average benefit of antidepressants.

The researchers said that as the risk of future pandemics and natural disasters increases with the effects of climate change, so will the likelihood of families facing stressful conditions again in the future

"Getting ready for these types of crises could include helping families prepare -- not just by stocking up on supplies, but also by improving family resiliency and psychological coping resources," Feinberg said. "In my view, that means providing the kinds of family prevention programs we've been developing and testing at the Prevention Research Center for the past 20 years."

For example, Feinberg explained that their research shows that the Family Foundations program helps new parents develop stronger capacities for cooperation and support in their relationship with each other as coparents, which is a key dimension of family resiliency.

Feinberg said future research will examine whether families who went through Family Foundations or other programs were more resilient, maintained better family relationships, and experienced smaller declines in mental health during the pandemic.

Jacqueline Mogle, Jin-Kyung Lee, Samantha L. Tornello, Michelle L. Hostetler, Joseph A. Cifelli and Sunhye Bai, all at Penn State; and Emily Hotez, University of California, also participated in this work.

The National Institute of Child Health and Development and The Huck Institutes of the Life Sciences at Penn State helped support this research.

https://www.sciencedaily.com/releases/2021/04/210412142720.htm

People with less body response to stress task had more PTSD signs after COVID-19 began

Study findings surprised researchers, who had expected the reverse, researcher says

August 31, 2020

Science Daily/Baylor University

People who did not have a large heart rate response to a stress task surprised researchers later -- after the onset of the COVID-19 pandemic -- when they showed more symptoms of post-traumatic stress disorder related to the crisis than others who also did the stress task and COVID-19 stress ratings.

Researchers had anticipated that the reverse would be true -- that those with higher heart rate reactions to the stress task would experience more distress related to COVID-19. Previous work shows individuals with a PTSD have higher responses to stress. But very few studies have examined heart rate responses to acute stress before the onset of a traumatic event, researchers said.

"The study shows that diminished biological arousal -- how the body responds when it is exposed to something startling or stressful -- before a global pandemic may predict PTSD symptoms related to the event," said principal investigator Annie T. Ginty, Ph.D., assistant professor of psychology and neuroscience at Baylor University.

The biological reactions were measured by blood pressure and heart rate, said co-author Danielle Young, Psy.D., research coordinator in the Baylor Behavioral Medicine Lab.

The study, published in the journal Psychosomatic Medicine, grew out of an ongoing study of undergraduate students at Baylor University.

"The research also showed that some college students were experiencing distress related to the pandemic in its earliest stages, even when social distancing was just beginning," Ginty said.

In the study's first phase, with 120 participants, researchers measured their resting heart rate and blood pressure before and during a standard acute psychological stress test. They asked students to do mental math, rather than writing down figures or using a calculator, and give the scorers verbal responses. In a four-minute test, they were asked to add consecutive single-digit numbers while remembering the most recent and adding it to the next number presented. They did this while being videotaped with a scorer present and looking at themselves in a mirror.

"The standard acute psychological stress task is meant to increase levels of stress by including requirements of cognitive effort, social evaluation, self-evaluation and competition," Ginty said. "The task substantially increases heart rate and feelings of stress."

The study's first phase, which ended in February 2020, was done in Central Texas. After the pandemic's onset, researchers launched a second phase between March 26 and April 5, sending participants a follow-up questionnaire about COVID-19. The participants were in 22 states after early campus closure due to COVID-19. When asked, none had tested positive for COVID-19 and 87.5 percent were living in a city/state with a "shelter in place" order.

The questionnaire included standard items used to measure PTSD symptoms of intrusion (dreaming about the event and having trouble staying asleep), hyperarousal (irritability and having trouble concentrating) and avoidance (trying not to think or talk about the event) in the seven days before they responded to the questionnaire.

The findings are in line with a previous study of soldiers, which showed that a lower response of cortisol -- the primary stress hormone -- to an acute psychological stress task before deployment predicted greater PTSD symptoms post deployment.

The present study supports growing evidence that lower biological arousal in response to psychological stress may be bad for health outcomes, particularly mental health outcomes. The findings support Ginty's previous work, which demonstrated that lower arousal to acute stress is associated with higher levels of perceived stress -- meaning that people rate their environment as more stressful.

Previous work also has shown that higher levels of biological arousal may be associated with developing PTSD symptoms. But those studies used what are considered passive tasks -- such as hearing loud bursts of noise. Lower biological responses to stress tasks that require participants to actively engage in the task may be a unique biomarker for mental health outcomes.

Ginty said that future research should aim for more comprehensive measures of biological reactivity and include a lifetime history of traumatic event exposure. However, the current study did account for childhood trauma and diagnosis of a mental health condition before the pandemic's onset.

"Since findings suggest that individuals with diminished arousal to active stress may be at greater risk for negative mental health outcomes, it could be helpful to offer preventive treatment or resources to them at the early stages of stress or trauma exposure," Ginty said.

https://www.sciencedaily.com/releases/2020/08/200831165700.htm

How Americans are coping with COVID-19 stress

June 1, 2020

Science Daily/University of Connecticut

Almost overnight, the rapid emergence of the COVID-19 pandemic in the United States and subsequent state and federal prevention measures dramatically altered daily behavior. A new study provides the first snapshot of the immediate impact of COVID-19 on Americans' stress levels, coping strategies, and adherence to public health guidelin

Several months into the pandemic, most Americans are familiar with the physical toll COVID-19 takes on those who contract it. But what about the mental and emotional implications of stress caused by the pandemic itself?

A new study by researchers from the University of Connecticut provides the first snapshot of the immediate impact of COVID-19 on Americans' stress levels, coping strategies, and adherence to public health guidelines.

For the study, which was published in the Journal of General Internal Medicine, the team surveyed over 1,000 English-speaking individuals, 18 years of age or older, living in the United States. Responses were collected in early April 2020, giving the researchers a unique view of how Americans are handling their new reality.

"Almost overnight, the rapid emergence of the COVID-19 pandemic in the United States and subsequent state and federal prevention measures dramatically altered daily behavior," says Crystal Park, professor of in the Department of Psychological Sciences. "This unique, early study and our planned future work will let us see how Americans navigate all of these changes, and how their response to this stress evolves over time."

In the study, the UConn researchers present baseline data on COVID-19-related stressors in three categories: stress related to the virus itself, stress related to changes in daily routines caused by the pandemic, and financial or resource-related stress. These measures allowed them to examine the circumstance-specific stressors of COVID-19 rather than global stress that could have other causes.

Based on previous work during SARS outbreaks and the early months of the COVID-19 pandemic, the researchers created an assessment of 23 COVID-19 stressors and their degree of stressfulness. The survey showed that Americans have high stress exposure from COVID-19, and that some demographic groups appear particularly vulnerable to stress effects. Reading or hearing about the severity and contagiousness of COVID-19 was the most common stressor, with almost 97% of survey respondents experiencing it. Uncertainty about the duration of social distancing requirements and changes to social and daily personal care routines also ranked high on the list of stressors with between 80% and 88% of those surveyed experiencing them.

While fears related to the virus itself were the most common, the survey showed that respondents were more acutely concerned about the financial consequences caused by the pandemic. Of the stressors experienced, respondents ranked loss of job security or income as the most stressful, followed by risk of a loved one's illness.

The researchers also looked at the methods Americans reported using to cope with these stressors. Distraction, seeking emotional social support, and active coping were the most commonly reported strategies. Younger participants, sexual minorities, and those with greater financial instability generally reported greater use of less helpful strategies, including substance use, behavioral disengagement, and humor.

Because of the unprecedented nature of the COVID-19 pandemic, the researchers say it's hard to determine which strategies will be healthy for managing stress over the weeks and months ahead.

"Distraction or avoidance is usually considered to be an unproductive coping strategy for most challenging situations and can lead to negative outcomes," says Beth Russell, associate professor of Human Development and Family Sciences and director of the Center for Applied Research in Human Development (CARHD). "But in this instance where people don't have much control over making the disease itself better, we can do small things to help ourselves and others -- seek connections through telemediated emotional support, for example -- and find ways to let the time pass. We'll see in the long run how those strategies help people's mental health."

The survey also showed very high rates of compliance with social distancing and federal Centers for Disease Control and Prevention (CDC) guidelines. Approximately 95% of respondents avoided eating out at bars or restaurants and visiting nursing homes, although these behaviors are likely impacted by policies enacted at the state and municipal levels. Almost 90% of respondents had stopped discretionary travel and were keeping the recommended six-feet distance from others. Approximately 75% of respondents reported adhering to CDC guidelines related to hygiene, like avoiding touching their faces and regularly cleaning and disinfecting surfaces. Some of the reported behaviors showed a potentially worrisome lack of adherence to critical CDC guidelines though, particularly for men and younger adults.

The role demographics play in stress, coping, and adherence to guidelines will be the focus of future studies by the team. Those results will be important for clinicians and policymakers as they develop the most effective health interventions to stem the anticipated long-term mental health impacts, they say.

"As we focus on developing treatments and vaccines, it is critical that we also understand the social aspects of this virus," says Michael Fendrich, associate dean for research in UConn's School of Social Work and co-author of the paper. "Understanding how Americans experience and respond to COVID-19 stressors and how this varies by socio-demographic characteristics can help to more effectively target prevention measures across various groups."

The team is continuing to monitor Americans' response to stress from the COVID-19 pandemic in future longitudinal waves of this study, which they hope will inform effective health behavior interventions to stop its spread.

https://www.sciencedaily.com/releases/2020/06/200601134607.htm