Association between Familism and Mental Health in College Adolescents during the COVID-19 Pandemic

Familism, also known in the literature as allocentrism, is the cultural propensity of a society to place the family at the center of its value system. Adherence to this value has been related to less depressive symptomatology in young people;however, these results are not conclusive, since it has also been found that the influence of familism on depressive symptoms is more indirect than direct. This study aimed to explore the direct relationships between familism (allocentrism and idiocentrism) and mental health (depression, anxiety, and stress). Methodologically, the study had a non-experimental, cross-sectional, descriptive, and correlational design. A sample of 451 Chilean university students responded to an instrument composed of the subscales allocentrism, idiocentrism, depression, anxiety, and stress during the COVID-19 pandemic. The results showed that family allocentrism was positively and significantly associated with depression (γ = 0.112, p < 0.05), anxiety (γ = 0.209, p < 0.001), and stress (γ = 0.212, p < 0.001), and family idiocentrism was negatively and significantly linked with depression (γ = −0.392, p < 0.001), anxiety (γ = −0.368, p < 0.001), and stress (γ = −0.408, p < 0.001). These findings contribute to supporting actions to reduce negative symptomatology and promote greater well-being in university students.

Association between Familism and Mental Health in College Adolescents during the COVID-19 Pandemic.

Familism, also known in the literature as allocentrism, is the cultural propensity of a society to place the family at the center of its value system. Adherence to this value has been related to less depressive symptomatology in young people; however, these results are not conclusive, since it has also been found that the influence of familism on depressive symptoms is more indirect than direct. This study aimed to explore the direct relationships between familism (allocentrism and idiocentrism) and mental health (depression, anxiety, and stress). Methodologically, the study had a non-experimental, cross-sectional, descriptive, and correlational design. A sample of 451 Chilean university students responded to an instrument composed of the subscales allocentrism, idiocentrism, depression, anxiety, and stress during the COVID-19 pandemic. The results showed that family allocentrism was positively and significantly associated with depression (γ = 0.112, p < 0.05), anxiety (γ = 0.209, p < 0.001), and stress (γ = 0.212, p < 0.001), and family idiocentrism was negatively and significantly linked with depression (γ = -0.392, p < 0.001), anxiety (γ = -0.368, p < 0.001), and stress (γ = -0.408, p < 0.001). These findings contribute to supporting actions to reduce negative symptomatology and promote greater well-being in university students.

Possible Stress-Neuroendocrine System-Psychological Symptoms Relationship in Pregnant Women during the COVID-19 Pandemic.

The COVID-19 pandemic induced long-term damages that weigh on the national health systems of various countries in terms of support and care. This review aimed to highlight the mental health impact of the COVID-19 pandemic in pregnant women. We first report data on the immune system physiopathology and the main viral infections in pregnancy, including COVID-19. Then, the attention is focused on the main factors that affect the mental health of pregnant women during the COVID-19 pandemic, such as (1) the fear of being infected and transmitting the infection to the fetus, (2) the cancellation of checkups and pre-child courses, and (3) confinement and the inability to have close friends or a partner at the time of delivery or in the first days after delivery, as well as family tensions. Because of all this, pregnant women find themselves in a stressful condition independent of the pregnancy, and thus experience anxiety, depression, insomnia, hostility, delirium, and an alteration of the mother-baby relationship. Several studies have shown an involvement of the hypothalamic-pituitary-adrenal axis and the hypothalamic-pituitary-thyroid axis in response to the pandemic. We propose a possible involvement of the neuroendocrine system as a mediator of the psychological symptoms of pregnant women induced by COVID-19-related stress.

COVID-19: Psychological symptoms and coping strategies in preschoolers, schoolchildren, and adolescents.

The present study aimed to compare psychological symptoms and coping strategies in 1480 preschoolers, schoolchildren, and adolescents during home confinement due to COVID-19. We enrolled parents from Italy, Portugal, and Spain who completed a survey between the second and fourth week of lockdown. The results showed that preschoolers displayed more sleeping difficulties, temper tantrums, and dependency while adolescents' reactions were more related to COVID-19 worries and uncertainty. Schoolchildren showed more difficulty in concentrating. Adolescent girls showed higher anxiety levels than schoolchildren boys. Schoolchildren relied more on emotion-oriented strategies, which were linked to increased internalizing and externalizing symptoms in all ages. Task-oriented strategies, regardless of the child's age, work best to cope with stress. Our findings provide information for professionals and parents about children's most common and adaptive coping strategies according to age. Furthermore, they contribute to the early detection of long-term psychological maladjustment in children.

Corrigendum: Coping Behaviors and Psychological Disturbances in Youth Affected by the COVID-19 Health Crisis.

[This corrects the article DOI: 10.3389/fpsyg.2021.565657.].

The Impact of Parental Stress on Italian Adolescents' Internalizing Symptoms during the COVID-19 Pandemic: A Longitudinal Study.

The challenges and consequences of COVID-19 imposed massive changes in adolescents' daily routines (e.g., school closures, home confinement, and social distancing rules), which impacted their mental health. This longitudinal study aimed to better understand the changes in adolescents' internalizing symptoms and the underlying mechanisms of parental stress due to COVID-19. We asked 1053 parents of adolescents to complete an online survey during the second and fifth weeks and at the end of home confinement (i.e., four weeks later). Results showed that parents reported their adolescents' anxiety and depression symptoms were more severe at Time 2 than at the first administration. Anxiety symptoms slightly decreased at Time 3, while there was no significant change in depression symptoms. Moreover, parents' expressive suppression mediated the association between parental stress and adolescents' anxiety and depression symptoms, respectively. The findings suggest that as restriction increased, adolescents' anxiety and depression became more severe. Moreover, due to the link between parental stress and adolescents' internalizing disorders helping families to cope with the distress due to the pandemic may have a positive impact on parents, the child, and the family as a whole (i.e., the family climate).

Psychological Symptoms in Italian, Spanish and Portuguese Youth During the COVID-19 Health Crisis: A Longitudinal Study.

Aiming to slow down the spread of the COVID-19, a lockdown was declared in the first term of 2020 in many European countries, applying different restrictions measures. Although the psychological effects of home confinement in children have been described, there is a lack of longitudinal research examining the impact of the confinement over time. The present study analyzes the evolution of the psychological wellbeing of children and adolescents from three European countries with different restrictions. Parents of 624 Italian, Spanish, and Portuguese children and adolescents aged 3 to 18 years old completed the "Impact Scale of COVID-19 and Home Confinement on Children and Adolescents" two, five, and eight weeks after the lockdown. Results show a different pattern for each country. Children from Italy, the first European country that applied a lockdown, were better adapted than Spanish and Portuguese children the first two weeks after confinement but they were more psychologically impacted by home confinement at the eight-week assessment. Portuguese children, who followed a general duty of home confinement, were the best adapted to the situation, with no significant differences over time. A significant change was found in anxiety symptoms in Spanish children, with a decrease at the last assessment. Findings suggest that long confinements and hard restrictions affect children, so prevention measures should be applied during confinements to prevent psychological problems in children.

Coping Behaviors and Psychological Disturbances in Youth Affected by the COVID-19 Health Crisis.

The COVID-19 pandemic and the quarantine undergone by children in many countries is a stressful situation about which little is known to date. Children and adolescents' behaviors to cope with home confinement may be associated with their emotional welfare. The objectives of this study were: (1) to examine the coping strategies used out by children and adolescents during the COVID-19 health crisis, (2) to analyze the differences in these behaviors in three countries, and (3) to examine the relationship between different coping modalities and adaptation. Participants were 1,480 parents of children aged 3-18 years from three European countries (n Spain = 431, n Italy = 712, and n Portugal = 355). The children's mean age was 9.15 years (SD = 4.27). Parents completed an online survey providing information on symptoms and coping behaviors observed in their children. The most frequent coping strategies were accepting what is happening (58.9%), collaborating with quarantine social activities (e.g., drawings on the windows, supportive applauses) (35.9%), acting as if nothing is happening (35.5%), highlighting the advantages of being at home (35.1%), and not appearing to be worried about what is happening (30.1%). Compared to Italian and Spanish children, Portuguese children used a sense of humor more frequently when their parents talked about the situation. Acting as if nothing was happening, collaborating with social activities, and seeking comfort from others were more likely in Spanish children than in children from the other countries. Compared to Portuguese and Spanish children, Italian children did not seem worried about what was happening. Overall, an emotional-oriented coping style was directly correlated with a greater presence of anxious symptoms, as well as to mood, sleep, behavioral, and cognitive alterations. Task-oriented and avoidance-oriented styles were related to better psychological adaptation (considered a low presence of psychological symptoms). Results also show that unaffected children or children with a lower level of impact were more likely to use strategies based on a positive focus on the situation. This study provides interesting data on the strategies to be promoted by parents to cope with the COVID-19 health crisis in children.

Parent and Child's Negative Emotions During COVID-19: The Moderating Role of Parental Attachment Style.

In February 2020, the coronavirus disease 2019 (COVID-19) appeared and spread rapidly in Italy. With the health emergency and social isolation, parents started spending more time with their children, and they might have experienced greater distress. Attachment style is considered as an effective emotion regulation strategy in the parent-child relationship. However, few empirical studies have addressed this issue. Based on attachment theory, this study aimed to find parental attachment style as a candidate to moderate the relation between parents' negative emotions and their perceptions of their children's negative emotions related to COVID-19. Parents (Mage = 42.55 ± 6.56, 88.2% female) of 838 Italian children and adolescents aged 3 to 18 years participated in an online survey. Results showed that parents with a fearful attachment style had significantly higher negative emotions when facing COVID-19 than those with other attachment styles. Moreover, parents with a dismissing attachment style perceived fewer negative emotions in their children than parents with fearful and preoccupied styles. At last, higher parents' negative emotions were associated with greater perception of children's negative emotions only in parents classified as secure and fearful. These findings suggest that parents with dismissing and fearful attachment styles and their children may be at higher risk during the COVID-19 pandemic and they should be given long-term attention.

"Ripple effect": Psychological responses and coping strategies of Italian children in different COVID-19 severity areas

COVID-19 has affected learning and the outdoor activities of more than 862 million children or adolescents worldwide. This study investigated the mental health of Italian children and explored their psychological response and coping strategies in different COVID-19 epidemic severity areas, with the aims of alleviating the impacts of COVID-19, promoting targeted intervention, and reducing the risk of future psychological problems. 1074 parents of children aged 6 to 12 years old participated in an ad-hoc online survey. Among them, 40.3% were from the high-risk areas in the North, and 59.7% were from the medium/low-risk areas in the center of Italy. The results showed that, compared to the children in medium- or low-risk areas, children in the North scored significantly higher for symptoms of anxiety, moods, and cognitive changes, showing a "ripple effect" trend. Moreover, children in the northern areas used fewer task-oriented strategies and more emotion- and avoidance-oriented strategies than those in the central areas. Specifically, children in the northern areas were more likely to show acceptance and seek affection from others, while those in the central areas used more humor when their parents talked about quarantine or coronavirus. These findings provide relevant evidence and a reference point for crisis management in children's mental health. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Abstract (Spanish) El COVID-19 ha afectado el aprendizaje y las actividades al aire libre de mas de 862 millones de ninos o adolescentes en todo el mundo. Este estudio investigo la salud mental de los ninos italianos y exploro su respuesta psicologica y las estrategias de afrontamiento en diferentes areas de gravedad de la epidemia de COVID-19, con el objetivo de aliviar los impactos de la misma, promover la intervencion especifica y reducir el riesgo de futuros problemas psicologicos. 1074 padres de ninos entre 6 a 12 anos de edad participaron en una encuesta ad-hoc online. De ellos, el 40,3% procedian de las zonas de alto riesgo del norte y el 59,7% de las zonas de riesgo medio/bajo del centro de Italia. Los resultados mostraron que, en comparacion con los ninos de las areas de riesgo medio o bajo, los ninos del norte obtuvieron una puntuacion significativamente mas alta en cuanto a los sintomas de ansiedad, cambios cognitivos y de estado de animo, mostrando una tendencia de "efecto domino". Ademas, los ninos de las zonas del norte utilizaron menos estrategias orientadas a las tareas y mas estrategias orientadas a las emociones - y la evitacion - que los de las zonas centrales. Concretamente, los ninos de las zonas del norte eran mas propensos a mostrar aceptacion y a buscar el afecto de los demas, mientras que los de las zonas centrales usaban mas el humor cuando sus padres hablaban de la cuarentena o del coronavirus. Estos hallazgos proporcionan evidencia relevante y un punto de referencia para el manejo de crisis en la salud mental de los ninos. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Anxiety and Depressive Symptoms in Children and Adolescents during COVID-19 Pandemic: A Transcultural Approach.

BACKGROUND: Despite being necessary to delay the spread of COVID-19, home confinement could have affected the emotional well-being of children and adolescents. Knowing which variables are involved in anxiety and depressive symptoms could help to prevent young people's psychological problems related to lockdown as early as possible. This cross-sectional study aims to examine anxiety and depressive symptomatology in Italian, Spanish, and Portuguese children and adolescents in order to determine which variables are related to poorer well-being during the pandemic. METHOD: The parents of 515 children, aged 3-18 years old, completed an online survey. Children's anxiety symptoms were assessed using the Spence Children's Anxiety Scale-Parent Version, and depressive symptoms were measured with the Short Mood and Feelings Questionnaire-Parent Version. RESULTS: We found differences in anxiety and depression between countries, with higher anxiety scores in Spanish children, and higher depression scores in Spanish and Italian children compared to the Portuguese. Anxiety and depressive symptoms were more likely in children whose parents reported higher levels of stress. CONCLUSIONS: These findings are discussed in the light of detecting and supporting affected children as early as possible.

Anxiety Severity, Perceived Risk of COVID-19 and Individual Functioning in Emerging Adults Facing the Pandemic.

The COVID-19 pandemic is showing a strong impact on people in terms of uncertainty and instability it has caused in different areas of daily life. Uncertainty and instability are also emotions that characterize emerging adulthood (EA). They generate worries about the present and the future and are a source of anxiety that impacts negatively on personal and interpersonal functioning. Anxiety seems a central effect of the pandemic and recent studies have suggested that it is linked to COVID-19 risk perception. In the present study, a sample of 1045 Italian emerging adults was collected: (1) to assess anxiety severity and perceived risk related to COVID-19 and their association and (2) to compare general health and protective factors such as attitudes about security, relationships, self-esteem, and self-efficacy across anxiety severity and perceived risk categories. The findings of this study highlighted that anxiety severity categories were distributed homogeneously across the sample and that half of the participants referred to moderate-severe anxiety. A series of analysis of variances and post hoc comparisons showed that general health and all protective factors decreased according to anxiety severity. They were higher in participants with high perceived risk, with the exception of self-efficacy. Given the challenging features of the pandemic and EA, it is crucial to monitor anxiety severity in order to prevent last longing effects on mental and physical health, as well as keeping emerging adults informed about the risks related to the pandemic. Intervention and supportive programs based on improving self-esteem and self-efficacy, as well as confidence in relationships, should be offered to emerging adults over the long term, beyond the current outbreak.

Psychological Symptoms and Behavioral Changes in Children and Adolescents During the Early Phase of COVID-19 Quarantine in Three European Countries.

The coronavirus disease (COVID-19) pandemic forced the home confinement of the majority of population around the world, including a significant number of children and adolescents, for several weeks in 2020. Negative psychological effects have been identified in adults, but research about the impact of this type of social distancing measure on children and adolescents is scarce. The present study aimed to describe and compare the immediate psychological and behavioral symptoms associated with COVID-19 quarantine in children and adolescents from three southern European countries with different levels of restrictions (Italy, Spain, and Portugal). Parents of 1,480 children and adolescents (52.8% boys) between 3 and 18 years old (M = 9.15, SD = 4.27) participated in the study. An online survey using snowball sampling techniques was conducted during 15 days between March and April 2020, representing the early phase of the quarantine associated with COVID-19 outbreak. Parents answered questionnaires about sociodemographic data, housing conditions, immediate psychological responses during quarantine (e.g., anxiety, mood, sleep, and behavioral alterations), patterns of use of screens, daily physical activity, and sleep hours before and during the quarantine. The results revealed an increase in children's psychological and behavioral symptoms, increased screen-time, reduced physical activity, and more sleep hours/night. Italian children presented less psychological and behavioral symptoms compared with Portuguese and Spanish children. In general, hierarchical multiple regressions revealed that having an outdoor exit in the house (e.g., garden, terrace) contributed to lower levels of psychological and behavioral symptomatology. Future studies are needed to identify family and individual variables that can better predict children and adolescents' well-being during and after quarantine. Recommendations for families and implications for practice are discussed.

Immediate Psychological Effects of the COVID-19 Quarantine in Youth From Italy and Spain.

The COVID-19 quarantine has affected more than 860 million children and adolescents worldwide, but to date, no study has been developed within Western countries to examine the psychological impact on their lives. The present study aims to examine for the first time the emotional impact of the quarantine on children and adolescents from Italy and Spain, two of the countries most affected by COVID-19. Participants were 1,143 parents of Italian and Spanish children aged 3 to 18 years who completed a survey providing information about how the quarantine affects their children and themselves, compared to before the home confinement. Results show that 85.7% of the parents perceived changes in their children's emotional state and behaviors during the quarantine. The most frequent symptoms were difficulty concentrating (76.6%), boredom (52%), irritability (39%), restlessness (38.8%), nervousness (38%), feelings of loneliness (31.3%), uneasiness (30.4%), and worries (30.1%). Spanish parents reported more symptoms than Italians. As expected, children of both countries used monitors more frequently, spent less time doing physical activity, and slept more hours during the quarantine. Furthermore, when family coexistence during quarantine became more difficult, the situation was more serious, and the level of stress was higher, parents tended to report more emotional problems in their children. The quarantine impacts considerably on Italian and Spanish youth, reinforcing the need to detect children with problems as early as possible to improve their psychological well-being.