Mothers' and Children's Mental Health During the COVID-19 Pandemic Lockdown: The Mediating Role of Parenting Stress.

The present study, carried out during the first peak of the COVID-19 outbreak in Italy, aimed at investigating the mental health of mothers and children during the nationwide lockdown. More specifically, the study investigated children's depression and mothers' individual distress and parenting stress, in comparison with normative samples. The mediating effect of mothers' parenting stress on the relationship between mothers' individual distress and children's depression was also explored. Finally, the study analyzed whether children's biological sex and age moderated the structural paths of the proposed model. A sample of 206 Italian mothers and their children completed an online survey. Mothers were administered self-report questionnaires investigating individual distress and parenting stress; children completed a standardized measure of depression. Mothers' individual distress and parenting stress and children's depression were higher than those recorded for the normative samples. Mothers' parenting stress was found to mediate the association between mothers' individual distress and children's depression. With respect to children, neither biological sex nor age emerged as significant moderators of this association, highlighting that the proposed model was robust and invariant. During the current and future pandemics, public health services should support parents-and particularly mothers-in reducing individual distress and parenting stress, as these are associated with children's depression.

COVID-19 and home confinement: A study on fathers, father-child relationships and child adjustment.

BACKGROUND: The purpose of this study was to explore fathers' adjustment and father-child relationships during the first peak of the coronavirus disease 2019 (COVID-19) outbreak (April 2020). More particularly, the study analysed paternal perceptions of changes concerning familial economic conditions and children's psychological difficulties (viz., emotional problems and hyperactivity) during the lockdown produced by the current pandemic. Furthermore, we investigated the following correlates of fathers' parenting stress: socio-demographic condition, paternal individual stress, anxiety, depression and changes in the father-child relationship during the outbreak. METHODS: A total of 102 fathers (mean age = 41.60 years; SD = 11.54) with minor children were recruited through an online survey and reported data about their socio-economic condition, anxiety, and depressive levels, parenting stress, offspring's adjustment, and changes in their relationship with their children. RESULTS: As for the economic conditions, participants were equally distributed between those who did not perceive changes and those who perceived a worsening. With regard to changes in the child's psychological difficulties, results showed that levels of children's emotional problems and inattention/hyperactivity had significantly increased during the lockdown period. A multiple linear regression analysis highlighted that the principal predictor of paternal parenting stress was living in the regions most affected by the COVID-19 pandemic, followed by high levels of paternal anxiety symptomatology and high levels of worsening of the relationship with the child during the pandemic. CONCLUSIONS: Overall, our study suggests to consider the effects of COVID-19 on fathers as well, as they have been rather overlooked by previous research that has mainly focused on mothers, and to plan specific interventions able to also take them into account.

Psychological Adjustment of Healthcare Workers in Italy during the COVID-19 Pandemic: Differences in Stress, Anxiety, Depression, Burnout, Secondary Trauma, and Compassion Satisfaction between Frontline and Non-Frontline Professionals.

Emergency situations have been associated with negative psychological adjustment outcomes in healthcare professionals, although studies on the impact of the Coronavirus Disease 2019 (COVID-19) pandemic amongst Italian health workers are limited. The main aim of this study was to investigate the psychological adjustment of healthcare professionals during the peak of the COVID-19 pandemic, evaluating differences according to working or not with patients affected by COVID-19 and in areas with a more severe spread of this pandemic. Healthcare professionals' attitudes toward psychological support were analyzed. The levels of anxiety, depression, psychological stress, and professional quality of life (compassion satisfaction, burnout, and compassion fatigue) and attitudes toward psychological support were measured among 627 Italian healthcare workers (mean age = 40.55 years; SD = 11.49; range: 27-72). Significantly higher levels of stress, burnout, secondary trauma, anxiety, and depression were observed among professionals working with COVID-19 patients. Higher levels of stress and burnout and lower levels of compassion satisfaction were detected in professionals working in areas with higher rates of contagion. No interaction effects were found between working (or not) with patients affected by COVID-19 and working (or not) in areas with a more severe diffusion of this pandemic. Finally, in the group of professionals who worked with COVID-19 patients, the percentage of professionals who thought to ask for psychological support was twice that of the group that did not work with COVID-19 patients. The overall findings indicate that the mental health of frontline healthcare workers requires further consideration and that targeted prevention and intervention programs are necessary.

Parents and Children During the COVID-19 Lockdown: The Influence of Parenting Distress and Parenting Self-Efficacy on Children's Emotional Well-Being.

On March 10, 2020, Italy went into lockdown due to the Coronavirus Disease-19 (COVID-19) pandemic. The World Health Organization highlighted how the lockdown had negative consequences on psychological well-being, especially for children. The present study aimed to investigate parental correlates of children's emotion regulation during the COVID-19 lockdown. Within the Social Cognitive Theory framework, a path model in which parenting self-efficacy and parental regulatory emotional self-efficacy mediated the relationship between parents' psychological distress and both children's emotional regulation, and children's lability/negativity, was investigated. A total of 277 parents of children aged from 6 to 13 years completed an online survey that assessed their psychological distress, regulatory emotional self-efficacy, and parenting self-efficacy. Parents reported also children's emotional regulation and lability/negativity. A structural equation model (SEM) using MPLUS 8.3 was tested. Results showed that the hypothesized model exhibited excellent fit, chi-square (83) = 140.40, p < 0.01, RMSEA = 0.05, CFI = 0.97, TLI = 0.96, SRMR = 0.04. The influences of parents' psychological distress and parents' regulatory emotional self-efficacy on children's emotional regulation and lability/negativity were mediated by parenting self-efficacy. The mediation model was invariant across children's biological sex and age, and geographical residence area (high risk vs. low risk for COVID-19). Results suggested how parents' beliefs to be competent in managing parental tasks might be a protective factor for their children's emotional well-being. Implications for intervention programs are discussed.

Psychological effects of the COVID-2019 pandemic: Perceived stress and coping strategies among healthcare professionals.

Starting from China, the coronavirus disease (COVID-19) contagion spread unexpectedly and quickly all over the world, particularly affecting Italy. In the early stages of the epidemic, healthcare professionals have been in the front-line to manage the infection. The current study aimed to analyse the impact of COVID-19 outbreak on healthcare professionals and to detect some risk and protective factors of their distress levels, with regard to socio-demographic variables, direct exposure to COVID-19 and the coping strategies used to deal with stress. The data were collected during the peak of the infection. A total of 595 healthcare professionals enrolled in the study and completed the measures of socio-demographical and professional data, perceived stress (PSS) and coping strategies (COPE- NVI-25). Overall, we found that a positive attitude towards the stressful situation was the main protective factor, while female gender, seeking social support, avoidance strategies and working with COVID-19 patients were risk factors. Economic status, problem solving ability and turning to religion were not associated with stress levels. This study, one of the first on this topic, highlighted the main coping strategies used by healthcare professionals in facing the highly stressful situation caused by the pandemic.

Mothers' Depression, Anxiety, and Mental Representations After Preterm Birth: A Study During the Infant's Hospitalization in a Neonatal Intensive Care Unit.

Aim: This paper aimed to explore psychological functioning and mental representations in mothers of preterm infants during the child's hospitalization in a Neonatal intensive care unit (NICU). Methods: A sample including 62 mothers of premature infants (gestational age < 37 weeks) was recruited in a NICU. According to the gestational age at the time of delivery, we considered two groups: Group A included mothers whose children were born before 32 weeks of pregnancy; Group B included mothers whose children were born at or after 32 weeks of pregnancy. Within one week of childbirth, mothers were administered two self-report questionnaires: the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). When their infants' medical conditions became stable, the Clinical Interview for Parents of High-Risk Infants (CLIP) was administered to mothers. Results: The results showed high levels of depression and anxiety in both groups of mothers, with higher state anxiety scores in Group A than Group B. Besides, a series of hierarchical regression analyses were conducted with STAI, EPDS, and gestational age as predictors on the CLIP scores. Results indicated that EPDS scores predicted CLIP scores on parental self-image, support system, and readiness for discharge (p < 0.001); moreover, the interaction among depression, anxiety, and gestational age predicted the CLIP dimension of feeling of mutual recognition (p < 0.005). Conclusions: These findings suggested that a premature birth and the child's hospitalization might exert a negative effect on the mothers' emotional state, their perception of parental self-image and, consequently, the early bond with the child-independent from the infants' gestational age at the time of the preterm delivery. The data underlined the importance of involving NICU nurses and clinicians in order to optimize the care for mothers immediately after the preterm birth and during the infant's hospitalization, taking into account psychological needs of mothers of both very preterm and moderately preterm infants.

Relationship with Parents, Emotion Regulation, and Callous-Unemotional Traits in Adolescents' Internet Addiction.

The aim of this study was to investigate the associations of relationship with parents, emotion regulation, and callous-unemotional traits with Internet addiction in a community sample of adolescents. Self-report measures of relationship with parents (both mothers and fathers), emotion regulation (in its two dimensions: cognitive reappraisal and expressive suppression), callous- unemotional traits (in its three dimensions: callousness, uncaring, and unemotional), and Internet addiction were completed by 743 adolescents aged 10 to 21 years. Results showed that a low perceived maternal availability, high cognitive reappraisal, and high callousness appeared to be predictors of Internet addiction. The implications of these findings are then discussed.

Male factor infertility and lack of openness about infertility as risk factors for depressive symptoms in males undergoing assisted reproductive technology treatment in Italy.

OBJECTIVE: To investigate the association between male factor infertility and openness to discussing assisted reproductive technology (ART) treatment with levels of depression among men undergoing infertility treatment. DESIGN: Cross-sectional. SETTING: Not applicable. PATIENT(S): Three hundred forty participants (170 men and their partners) undergoing ART treatments. INTERVENTION(S): Administration of a set of questionnaires. MAIN OUTCOME MEASURE(S): Depressive symptoms were detected by means of the Zung Depression Self-Rating Scale. Participants' willingness to share their infertility treatment experience with other people was assessed by means of self-report questionnaires. RESULT(S): In this study, 51.8% of males chose not to discuss their ART treatments with people other than their partner. In addition, the decision to discuss or not discuss the ART treatments with others was significantly associated with men's depressive symptoms. Male factor infertility was significantly associated with depression when considered together with the decision not to discuss ART treatments with others. A general disposition characterized by a lack of openness with others seemed to be a significant predictor of depression. CONCLUSION(S): There is a need for routine fertility care to pay greater attention to men's emotional needs. Before commencing reproductive treatment, male patients may benefit from undergoing routine screening for variables (i.e., male factor infertility and openness to others about ART) that may affect their risk of depression.

Depressive Symptoms, Self-Esteem and Perceived Parent-Child Relationship in Early Adolescence.

AIMS: Early adolescence represents a critical developmental period both from a psychological and a psychopathological point of view. During this period, one of the most common disorders that frequently arise is represented by depression, that tends to become chronic and may produce many subsequent psychosocial impairments. The present study aimed to analyze characteristics of depressive symptoms in an Italian sample of early adolescents, and to explore their connections with self-esteem levels and perceived maternal and paternal emotional availability. METHODS: 594 adolescents (50% females) with a mean age of 12.11 years (SD = 0.98) were administered the Children's Depression Inventory, the Rosenberg Self-Esteem Scale, and the maternal and the paternal forms of the Lum Emotional Availability of Parents. RESULTS: Findings highlighted a slightly higher, though not statistically significant, level of depressive symptoms in girls than in boys. Regression analysis showed that, as far as predictors of depression, self-esteem was the most relevant one, followed by maternal and paternal emotional availability. CONCLUSION: Our results strongly suggested to plan intervention programs aimed at monitoring early adolescents' self-esteem and supporting relationship with both parents, in order to prevent the emergence of depressive symptoms.

The experience of premature birth for fathers: the application of the Clinical Interview for Parents of High-Risk Infants (CLIP) to an Italian sample.

AIM: The study explored fathers' experience of premature birth during the hospitalization of their infants, analyzing levels of depressive and anxiety symptoms as compared with mothers. Moreover the Italian version of the Clinical Interview for Parents of High-Risk Infant (CLIP) was tested through confirmatory factor analysis. METHODS: Couples of parents (N = 64) of preterm infants (gestational age < 37 weeks) were administered a socio-demographic questionnaire, the Edinburgh Postnatal Depression Scale, the State-Trait Anxiety Inventory and the CLIP after the admission to the Neonatal Intensive Care Unit (NICU). RESULTS: Significant levels of anxiety and depressive symptoms and high percentages of subjects above the corresponding risk thresholds were found among fathers and mothers with higher scores among the latters. Confirmatory factor analysis of the CLIP showed an adequate structure, with better fit for mothers than for fathers. CONCLUSION: RESULTS highlighted the importance for nurses and clinicians working in the NICU to consider not only the maternal difficulties but also the paternal ones, even if these are often more hidden and silent. In addition the CLIP may be considered an useful interview for research and clinical purposes to be used with parents of high-risk infants.