Widespread COVID-19 disease prevention and containment procedures have resulted in major shifts in family dynamics. Virtual educational and professional obligations have required the reconfiguration of homes, new systems for engaging with relatives, and in some circumstances, new tensions.
A recent study conducted by Mark E. Feinberg and colleagues published in Family Process compares various features of family functioning before and during the pandemic in people in the United States to provide some insight into how these families were impacted.
“This is the first study of which we are aware that examined the magnitude of change in parent, child, and family mental health and adjustment from before to the pandemic period,” they write. “By examining within-individual change, our approach overcomes major methodological weaknesses in other reports. Our results provide evidence of a large deterioration in parent and child mental and behavioral health during the first months of the pandemic.”
Around this time last year, widespread concerns surrounding the mental health implications of the COVID-19 pandemic began to receive heavy media coverage. The effects of lockdown and containment measures vary based on diverse contextual factors (e.g., monetary and social resources). They have resulted in particularly detrimental consequences for young people and adults who were already struggling pre-pandemic. Health risks, limited access to opportunities for work, housing, and food insecurity, as well as social stressors, are among the pandemic-related challenges that continue to impact many families on a global scale.
To claim that COVID-19 precautions have been altogether harmful to mental health would be inaccurate, however. Some studies have captured affordances such as increased access to opportunities historically challenged by proximity and mobility, flexibility for students to work according to their own preferred schedules outside the confines of a standards school day, and in some circumstances, increased family connections.
The picture painted by the available research to date isn’t one of a mental health tsunami initially forecasted by some but rather a landscape of nuanced impacts complicating sweeping generalizations.
Feinberg and the team endeavored to explore the impact of the COVID-19 pandemic on family wellbeing in a sample of families all living in the United States. According to the authors, prior research has been limited by the lack of sensitive instruments to detect changes in mental health, different participant samples used in pre-and post-assessments, and cross-sectional as opposed to longitudinal designs. Among the unique qualities of the current study is its focus on family units instead of individual-level areas of impact alone.
“To quantify the impact of the COVID-19 pandemic and public health interventions on parent and child mental health and family relationships, we examined change in individual and family functioning in a sample of parents enrolled in a prevention trial; we examined change before the pandemic (2017–2019) when children were an average of 7 years old to the first months after the imposition of widespread public health interventions in the United States.”
208 family units engaged in the study included cohabitating mother and father dyads with only one child each. All had initially been recruited as part of the Family Foundations randomized trial and had later been contacted with the opportunity to participate in questionnaires regarding adjustment during the pandemic. Of note, parents reported both the parent and child outcomes accounted for in Feinberg and colleagues’ analysis.
Items included in the online questionnaire accounted for parental depressive symptoms, parental anxiety, co-parenting relationship quality, child internalizing and externalizing behavioral concerns, parenting quality, and household income and education. Pre- and post-pandemic trends were compared using hierarchical linear modeling (HLM) across three levels: time, individual data, and family unit data.
“We found large deteriorations from before the pandemic to the first months of the pandemic in child internalizing and externalizing problems and parent depression, and a moderate decline in co-parenting quality,” the researchers report. “Smaller changes were found for parent anxiety and parenting quality. Mothers and families with lower levels of income were at particular risk for deterioration in well-being.”
Results indicated “striking” shifts in parent-reported depressive symptoms and child externalizing and internalizing behavioral concerns, as well as substantial deterioration in parent anxiety and overall family relationship quality.
Interestingly, parents who reported fewer depressive symptoms pre-pandemic experienced more substantial increases in depression during the pandemic. Household income was found to significantly moderate the magnitude of deterioration of parenting quality. Lower family income was associated with more substantial declines in self-reported parenting quality during the pandemic.
Among the limitations to Feinberg and team’s study is its predominately White participant sample, compromising the representativeness of results. Other studies indicated that severe health and wellbeing consequences had been experienced by Latinx, Native American, and Black individuals in the United States at disproportionally high rates. Exclusive reliance on parent reports and the homogeneity of families represented in the study also represent limitations. Results may also have been skewed by questions not necessarily designed to highlight areas of resilience.
The authors suggest that their findings point to the need for family-level interventions promoting resilience, coping skills, mood management, and co-parenting skills. Additionally, moderators of severe consequences indicate a need for systems-level relief initiatives to reduce the burdens of the pandemic disproportionately experienced by those with limited economic resources.
“As ongoing, intertwined family conflict and mental health problems are difficult to interrupt, a ‘scarring’ phenomenon could lead to entrenched, long-term psychological and family relationship difficulties. Assisting families in recovering from the pandemic period may require multi-component, inter-disciplinary approaches by schools, counselors, mental health clinicians, pediatricians, family service agencies, faith-based congregations, and youth-serving recreational and athletic organizations.”
Feinberg, M. E., Mogle, J., Lee, J. K., Tornello, S. L., Hostetler, M. L., Cifelli, J. A., Bai, S., & Hotez, E. (2021). Impact of the COVID‐19 pandemic on parent, child, and family functioning. Family Process. https://doi.org/10.1111/famp.12649 (Link)