Child Traumatic Stress and COVID-19: The Impact of the Pandemic on a Clinical Sample of Children in Trauma Treatment.

Given the scope and duration of the COVID-19 pandemic, it is not surprising that research has documented negative effects to youth's mental health. Yet, there is negligible research on the impact of the pandemic among clinical samples of youth receiving treatment for pre-existing trauma exposure and symptoms. The current study investigates COVID-19 as an index trauma, and if prior traumatic stress scores mediate the relationship between pandemic-related exposure and subsequent traumatic stress. METHODS: This is a study of 130 youth ages 7-18 receiving trauma treatment at an academic medical center. The University of California Los Angeles Post-traumatic Stress Disorder-Reaction Index (UCLA-PTSD-RI) was completed by all youth during intake as part of routine data collection. From April, 2020 to March, 2022 the UCLA Brief COVID-19 Screen for Child/Adolescent PTSD was also administered to assess trauma exposures and symptoms specifically-related to the pandemic experience. Univariate and bivariate analyses were conducted on all variables of interest to describe response patterns cross-sectionally and longitudinally; a mediational analysis was used to determine if prior trauma symptoms mediate the relationship between COVID-19 exposure and response. Additionally, interviews were conducted with youth using a series of open-ended questions about their perceptions of safety, threat and coping related to the pandemic. RESULTS: A quarter of the sample reported COVID-19 related exposures that would meet Criterion A for PTSD. Participants whose UCLA-COVID scores that exceeded the clinical cutoff had lower scores on two items measuring social support. There was no evidence of full or partial mediation. Responses to interview questions revealed low levels of threat reactivity, perceptions of no to little impact, positive changes, varying opinions on social isolation, some evidence of inaccurate messaging and adaptive coping using strategies learned in treatment. IMPLICATIONS: The findings broaden our understanding of the impact of COVID-19 on vulnerable children and provide insight into how prior trauma history and the provision of evidence-based trauma treatment impact a youth's response to pandemic conditions.

The impact of COVID-19 and experiences of secondary traumatic stress and burnout.

OBJECTIVE: This study examines the relationships between multiple COVID-19 related stressors and experiences of secondary traumatic stress (STS) and burnout (BO). METHOD: This sample (N = 550) of professionals and caregivers from a foster care system in the United States completed an online survey regarding their experiences of COVID-19 related stress in multiple domains (disruptions in routines, income/employment, food access, medical/mental health care access, access to social support, worries about COVID, family conflict/violence, and COVID diagnoses). The survey also included established measures of STS and BO. RESULTS: A subset of COVID-19 stressors was found to account for 27.4% of the variance in STS and 24.7% of the variance in BO scores in regression analyses. Significant correlates for STS included worries about COVID, family conflict/violence and food access, while only worries about COVID and family conflict/violence were significant in the model testing BO. Part of the sample (N = 64) had participated in a related 2019 study of STS and BO and were included in comparison analyses of these conditions before and during the COVID-19 pandemic. Results for T1 and T2 comparisons yielded significant increases in STS related symptoms of intrusion and alterations in cognitions and mood, with differences in total STS scores trending toward significance. No significant differences were found in BO scores. CONCLUSIONS: These findings and associated implications are discussed for groups of caregivers and helping professionals with preexisting high levels of indirect trauma exposure in a pandemic context. This study provides some guidance on how to identify those at risk for increased distress in their helping roles and considerations for implementing support strategies during a pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Foster care during the COVID-19 pandemic: A qualitative analysis of caregiver and professional experiences.

BACKGROUND: Research is needed to facilitate better understanding of how different groups have been impacted by COVID-19, especially those in already strained service systems such as foster care. These inquiries will support further response, recovery and preparedness efforts. OBJECTIVE: This qualitative study addressed how professionals and caregivers in foster care described being affected by COVID-19 in order to support future research and planning for foster care systems in this pandemic context. PARTICIPANTS AND SETTING: A sample of foster parents and foster care professionals (N = 357) from a mostly rural, southeastern state in the U.S. participated in the study. METHODS: Qualitative analysis was conducted of 357 open-ended responses regarding the impact of COVID-19 from a survey distributed in August 2020. RESULTS: The coding process resulted in the identification of 15 distinct themes: Isolation & Loss of Social Support, Work Changes/Stressors, School Issues, Childcare Issues, No Impact/Positive Changes, Financial Problems, Fear of Contagion, Negative Child Welfare Impacts, Mental Health Problems/Stress, Loss of Faith/Trust & Societal Frustrations, Health & Mental Healthcare Access Issues, PPE & Testing Issues, Grief & Loss, and Marital Problems. Secondary impacts rather than direct physiologic effects of the virus were primarily reported. CONCLUSIONS: This study underscores the various challenges facing foster care systems, and how the pandemic context is exacerbating many of these issues. Further research is needed to ensure the implementation of adequately complex and nuanced responses that target needs and avoid creating further problems for foster care.