Family Functioning and the Pandemic: How Do Parental Perceived Social Support and Mental Health Contribute to Family Health?

BACKGROUND: The COVID-19 pandemic and the quarantine measures implemented have profoundly impacted parents and families. The stress and uncertainty generated by the COVID-19 virus, as well as the disruption of routines and social relationships, have weakened both individual and family health and functioning. OBJECTIVE: The present research is part of a larger study that aims to understand, with a family systems theory, the longitudinal effects of the COVID-19 pandemic on school-aged children, adolescents, and their parents. More specifically, this paper aims to investigate parents' experience of the first months of the pandemic as a predictor of perceived social support, parental ill-being (aggregate score of well-established poor psychological functioning indicators), parental satisfaction, and family functioning. METHOD: During the first lockdown (April-May 2020), 203 parents of school-aged children living in Quebec completed an online questionnaire. RESULTS: Path analysis indicates that the impact of COVID-19 and health preoccupation due to COVID-19 are both positively associated with individual parental ill-being, which in turn detracts from family functioning and parental satisfaction. Furthermore, perceptions about positive effects of the pandemic are negatively associated with parental ill-being, and positively with perceived social support, which in turn significantly contributes to family functioning and parental satisfaction. CONCLUSION: The findings highlight the importance of adopting a systemic perspective to best understand the effects of the pandemic and the social and health measures on individuals, families, and systems, as well as to better support parents and family health through periods of uncertainty.

The role of perceived social support on pregnant women's mental health during the COVID-19 pandemic.

PURPOSE: The present study aimed at investigating which sources of social support best account for pregnant women's levels of psychological distress and mental well-being during the COVID-19 pandemic. METHODS: 274 Italian and Canadian expectant mothers completed an online-based survey including measures of perceived social support (from family, significant other and friends), state anxiety, depressive symptoms, and satisfaction with life. Correlation analyses and amultivariate analysis of covariance were performed to explore how social support from different sources was related to depressive symptoms, state anxiety and satisfaction with life. RESULTS: Different sources of social support contributed to explaining women's psychological distress and mental well-being. Social support both from family and friends was significantly related to women's state anxiety and depressive symptoms. Social support from friends was specifically related to women's satisfaction with life. CONCLUSION: Our findings endorse the crucial role of perceived social support as a protective factor for pregnant women's mental health. In the context of the COVID-19 pandemic, our results suggest that support from family seems important in preventing psychological distress, whereas support from friends is also associated with mental well-being. These results may help designing future interventions aimed at improving women's perinatal mental health in life-threatening conditions.

The COVID-19 Pandemic and Quality of Life: Experiences Contributing to and Harming the Well-Being of Canadian Children and Adolescents.

The pandemic's restrictive measures such as lockdowns, social distancing, and the wearing of masks transformed young people's daily lives and brought up major concerns regarding children's and adolescents' well-being. This longitudinal mixed study aims to identify how different experiences contributed to children's and adolescents' well-being through different stages of the pandemic. The sample comprises 149 Canadian youth from Quebec who shared their experiences of the COVID-19 pandemic. Children and adolescents were met virtually for semi-directed interviews about their well-being at three measurement time (T1: May 2020 lockdown, T2: July 2020 progressive reopening, and T3: beginning of the second wave). At T3, they also completed a questionnaire measuring their quality of life. Our findings indicated that 22% reported a low level of well-being (N: 32), 66% a normal level of well-being (N: 90), and 18% a high level of well-being (N: 27). The comparative thematic analysis of the discourse of these three groups allows us to identify experiences that are favorable and unfavorable to the well-being of young people and to distinguish two configurations of interactions between children and their environment over the first year of the pandemic, namely that of young people who report a high level of well-being and that of those who report a worrying level of well-being. Results highlight the importance of activities, relationships, support, and representations of children and adolescents for their well-being in the pandemic context. Interventions and social measures to better support their well-being are discussed.

Perceived Paternal Involvement, Relationship Satisfaction, Mothers' Mental Health and Parenting Stress: A Multi-Sample Path Analysis.

Research has demonstrated the short- and long-term impacts of maternal mental health and well-being on children's emotional and behavioral outcomes. It is thus important to better understand the antecedents of maternal depression and stress. The aim of this study was to determine whether the contribution of perceived paternal involvement to account for mothers' depression and parental stress was mediated by relationship factors such as parenting alliance and dyadic adjustment. A second aim was to determine whether these relationships hold equally true in mothers of infants and young toddlers (0-24 months) and mothers of older children (25 months and older). Cross-sectional data were collected from 447 mothers. Mothers reported on their perceptions of paternal involvement with childcare responsibilities, dyadic adjustment, parenting alliance, parenting stress, and depression. Multi-sample path modeling analyses were conducted. Results revealed that perceived paternal involvement was positively related to both dyadic adjustment and parental alliance, that parenting alliance was negatively related to all three subscales of parenting stress and mothers' depression but that dyadic adjustment was negatively related to parenting distress (one subscale of parenting stress) and mothers' depression. Results from the multi-sample analyses indicated that the pattern of relationships was the same in the two groups, but that the model was not invariant. The most notable difference was that parenting alliance did not significantly account for depression in the mothers of younger children. Correlates of maternal mental health and well-being identified in this study could be useful when designing psychological interventions for mothers and fathers.

Impacts of online and group perinatal education: a mixed methods study protocol for the optimization of perinatal health services.

BACKGROUND: Prenatal education is a core component of perinatal care and services provided by health institutions. Whereas group prenatal education is the most common educational model, some health institutions have opted to implement online prenatal education to address accessibility issues as well as the evolving needs of future parents. Various studies have shown that prenatal education can be effective in acquisition of knowledge on labour and delivery, reducing psychological distress and maximising father's involvement. However, these results may depend on educational material, organization, format and content. Furthermore, the effectiveness of online prenatal education compared to group prenatal education remains unclear in the literature. This project aims to evaluate the impacts of group prenatal education and online prenatal education on health determinants and users' health status, as well as on networks of perinatal educational services maintained with community-based partners. METHODS: This multipronged mixed methods study uses a collaborative research approach to integrate and mobilize knowledge throughout the process. It consists of: 1) a prospective cohort study with quantitative data collection and qualitative interviews with future and new parents; and 2) a multiple case study integrating documentary sources and interviews with stakeholders involved in the implementation of perinatal information service networks and collaborations with community partners. Perinatal health indicators and determinants will be compared between prenatal education groups (group prenatal education and online prenatal education) and standard care without these prenatal education services (control group). DISCUSSION: This study will provide knowledge about the impact of online prenatal education as a new technological service delivery model compared to traditional group prenatal education. Indicators related to the complementarity of these interventions and those available in community settings will refine our understanding of regional perinatal services networks. Results will assist decision-making regarding service organization and delivery models of prenatal education services. PROTOCOL VERSION: Version 1 (February 9 2018).

Cortisol and blood pressure levels decreased in fathers during the first hour of skin-to-skin contact with their premature babies.

AIM: Premature birth is an extremely stressful experience. In 2013 to 2014, we explored the physiological stress responses of fathers during their first skin-to-skin contact (SSC) with their new baby. METHODS: We recruited 49 fathers whose partners had given birth to a premature baby of up to 33 weeks and three days. The study, in the neonatal intensive care unit (NICU) of a Quebec hospital, measured the physiological stress responses of the fathers before and after they first experienced SSC with their new baby. Cortisol levels and blood pressure were measured, and a generalised estimating equation was used for the data analysis. RESULTS: The fathers' cortisol levels decreased from 10.55 nmol/L, with a 95% confidence interval (95% CI) of 9.61-11.59 at the beginning of the experiment to 8.26 nmol/L (95% CI: 7.51-9.07) after 75 minutes. Meanwhile, their systolic blood pressure decreased from 135.16 mmHg (95% CI: 130-140) to 125.25 mmHg (95% CI: 121-129). CONCLUSION: Fathers who held their baby in SSC for the first time showed a significant reduction in physiological stress responses. Our findings support hospital practices that enable fathers to experience their first intimate contact with their newborn infant in the NICU.

Women's depressive symptoms during the transition to motherhood: the role of competence, relatedness, and autonomy.

This study investigates the longitudinal pattern of reciprocal relations between mothers' perceived satisfaction of their needs for competence, relatedness, and autonomy and depressive symptoms during the transition to motherhood. Participants were 331 women assessed during their pregnancy and two and five months after delivery. Results based on structural equation modeling provide some support for the effect of perceived needs satisfaction on subsequent depressive symptoms during the postpartum period. In addition, it appears that prior postpartum depressive symptoms account for subsequent psychological needs satisfaction. Discussion centers on the theoretical, methodological, and practical implications of the results.

Maternal self-efficacy and hostile-reactive parenting from infancy to toddlerhood.

A longitudinal study of maternal self-efficacy (SE) and hostile-reactive parenting (HRP) was conducted with a community sample of 1836 mothers. Mothers completed questionnaires when their child was 4.5, 16.6 and 28.5 months of age. Maternal SE showed little change, whereas HRP sharply increased from 4.5 to 28.5 months. Structural equation models suggest these initially correlated variables did not influence each other over time, but rather became increasingly independent. Three distinct developmental trajectories were fitted for both maternal SE and HRP. In contrast to the overall portrait of stability, 12.6% of mothers followed a trajectory of declining SE. Likewise, 12.1% of mothers showed initially high and sharply increasing HRP. Few mothers (3.1%) simultaneously followed both of these trajectories, yet overall, SE and HRP trajectories were modestly associated (tau(b)=-.23, p<.0001). Failure to support the expected reciprocal influences between SE and HRP over time, as well as maternal and child contributions to early manifestations of maternal HRP and their evolution are discussed.

Validation of a short version of the maternal behavior Q-set applied to a brief video record of mother-infant interaction.

A 25 item version of the maternal behavior Q-set (MBQS) was validated with 40 adolescent mother-infant dyads. Observations were made from 10 min play interactions when infants were 10 months old. Results show that the short MBQS is reliable (r(i)=.94), is related to assessments using the full MBQS at 6 months (r=.35), to cognitive development at 10 and 15 months (r=.48), and attachment security at 15 months (r=.34), indicating appropriate psychometric characteristics.

A longitudinal twin study of the genetic and environmental etiology of maternal hostile-reactive behavior during infancy and toddlerhood.

Children's negative characteristics are thought to be a factor in evoking hostile parenting responses. This can result in genotype/environment correlations (rGE) in which children's heritable traits influence the parenting they experience. We did genetic analyses on 292 mothers' self-reported hostile-reactive behaviors toward each of their twins at 5, 18 and 30 months. Finding heritability for a parenting behavior analyzed as a child phenotype is evidence of rGE correlation. The heritability of maternal behavior was modest (29% at 5 months, 0% at 18 months, and 25% at 30 months) and longitudinal analyses indicated that genetic factors at 5 and 30 months were uncorrelated. Common environment factors, probably reflecting characteristics of the mothers, were the main source of variance at the three ages and were highly correlated through time. We concluded that children's heritable characteristics evoked maternal negative response at specific times, but were not responsible for the stability of maternal hostility from infancy to toddlerhood.