Psychological well-being in times of COVID-19: Associated factors and levels in the general population

The COVID-19 pandemic and living under social distancing restrictions have been hypothesized to impact well-being and mental health in the general population. This study investigated the general Norwegian adult population's well-being after implementing and lifting strict social distancing restrictions. The study was conducted through digital surveys; during the implementation of strict social distancing restrictions in March 2020 (T1) and 3 months later, when the preponderance of strict distancing restrictions was discontinued (T2). Well-being was measured at T2. Four thousand nine hundred twenty-one individuals participated, and a sensitivity analysis was conducted to ensure that the sample reflects the true Norwegian adult population. Hierarchical regression analyses show that contemporaneous employment status and positive metacognitions at T2 were associated with higher well-being. Negative metacognitions and the use of unhelpful coping strategies at T2 had a contemporaneous association with lower mental well-being. Negative metacognitions at T1 were associated with lower well-being scores, while positive metacognitions at T1 were positively associated with higher well-being. An indirect association between social distancing and lower well-being was found through heightened depressive symptoms. These results contribute to understanding how social distancing restrictions relate to general well-being, which may further contribute to designing proper strategies to strengthen mental health and well-being during challenging and unavoidable societal conditions.publishedVersio

Psychiatric symptoms in COVID-19-positive individuals in the general population: Trajectories of depression, anxiety, and insomnia

The present study investigates differences in the trajectories of anxiety, depression, and sleep problems among infected versus non-infected case-controlled individuals. Patients who tested positive for COVID-19 were selected from a representative sample in Norway (N > 10,000). In total, 126 of these individuals were infected during the project period, and this group was analyzed at T5 (May 2021). Of these positive cases, those who had completed both PHQ-9 and GAD-7 at all three measurement points were selected for longitudinal analysis using multilevel modeling. There was a significant difference at T5 between those who had tested positive for COVID-19 and matched controls. Anxiety and depression were reduced among those who tested positive, but there were no differences in trajectory when compared to matched controls. Limitations include the use of self-report measures and the assessment of symptoms at a time when strict virus mitigation protocols were in place. The present findings indicate that individuals who test positive for COVID-19 exhibit higher levels of depressive symptoms after restrictions are lifted. However, comparison of anxiety and depression symptom trajectories with matched controls reveals that both groups exhibited stable or slightly decreased symptoms.publishedVersio

Daily Dynamics of Parental Mental Health: Investigating Depressive Symptoms and Negative Parental Experiences

Background: Investigating psychopathological processes and how these are connected to psychiatric symptoms is important to understand how disorder states emerge and are maintained over time. Focusing on within-person relationships between variables further allows investigation of how these relations on average unfold within individuals. Methods: This preregistered intensive longitudinal study investigates connections between depressive symptoms, psychopathological processes, and negative parental experiences. Daily observations from 1036 parents were retrieved from two 40-day periods during the COVID-19 pandemic. The data was modelled using multilevel dynamic network analysis, unveiling across-day associations and contemporaneous interactions within the same time window. Results: On an across-day basis, helplessness was strongly interwoven with and predictive of the cognitive-affective features of depression and the other psychopathological processes. Being overwhelmed by the parental role (parenting stress) and emotionally drained as a parent (parental burnout) reciprocally reinforced each other from one day to the next, indicating how these components can manifest as a vicious loop over time. Finally, depressive symptomatology and negative parental experiences displayed within-day connections, with emotion regulation difficulties being connected to all parental components. Conclusions: The findings suggest that vicious cycles between helplessness and worthlessness predict the prolonged experience of depressed states in parents and that elevations in parenting stress and parental burnout reinforce each other over time

Parental burnout during the COVID-19 pandemic

Increased and long-term parental stress related to one's parental role can lead to parental burnout. In the early phase of the COVID-19 pandemic, families experienced intensified pressure due to the government-initiated contact restrictions applied to prevent the spread of the virus in the population. This study investigates the risk factors and predictors of parental burnout in a large sample of parents (N = 1488) during the COVID-19 pandemic in Norway. Demographic and psychosocial factors were assessed at two timepoints: at the beginning of the pandemic outbreak in March 2020 (T1) and at 3 months follow-up (T2). A hierarchical regression analysis was applied to identify the factors that contribute to parental burnout at T2. Parental burnout was additionally explored across subgroups. Findings revealed that younger age was associated with more parental burnout. Concurrent (T2) use of unhelpful coping strategies, insomnia symptoms, parental stress, and less parental satisfaction was significantly associated with the presence of greater parental burnout (T2). Additionally, parental stress and satisfaction measured in the earliest phase of the pandemic (T1) were associated with parental burnout 3 months later (T2) over and above concurrent parental stress/satisfaction. Unemployed parents and individuals with a mental health condition were identified as subgroups with substantially heightened levels of parental burnout

Feelings of Worthlessness Links Depressive Symptoms and Parental Stress: A Network Analysis during the COVID-19 Pandemic

Background. The prevalent co-occurrence between parental stress and depression has been established prior to and during the COVID-19 pandemic outbreak. However, no studies to date have identified the connections through which these symptom domains interact with each other to emerge into a complex and detrimental mental health state, along with the plausible mechanistic variables that may play key roles in maintaining parental stress and depression. The aim of this research is to uncover these interactions in a period where parents experience heightened demands and stress because of the strict social distancing protocols. Methods: Network analysis is utilized to examine parental stress and depressive symptoms during the COVID-19 pandemic in a large cross-sectional study (N = 2,868) of parents. Two graphical Gaussian graphical network models were estimated, one in which only parental stress and depression symptoms were included, and another in which several mechanistic variables were added. Results: Expected influence and bridge expected influence revealed that feeling worthless was the most influential node in the symptoms network and bridged the two psychological states. Among the mechanistic variables, worry and rumination was specifically relevant in the depressive cluster of symptoms, and self-criticism was connected to both constructs. Conclusion: The study displays that the co-occurrence of parental stress and depression has specific pathways, was manifested through feelings of worthlessness, and has specific patterns of connection to important mechanisms of psychopathology. The results are of utility when aiming to avoid the constellation of co-occurring parental stress and depressive symptoms during the pandemic

Parenting in a pandemic: Parental stress, anxiety and depression among parents during the government-Initiated physical distancing measures following the first wave of COVID-19

Drawing on the tenets of family stress theory, the aim of this study is to examine parents' perceived stress, symptoms of anxiety, depression, and associated risk- and protective factors across demographic subgroups during in the first wave of the COVID-19 pandemic. Norwegian parents (N = 2868; 79.5% mothers) with >1 child under 18 years of age completed an online survey two weeks after the implementation of government-initiated distancing measures. The survey includes measures of COVID-related risk factors (parental stress, burnout, depression, anxiety, anger of parents towards children, difficulty working from home, and positive beliefs about worry) and protective factors (self-efficacy and social support). Mothers, parents living with more than one child, and parents with a psychiatric diagnosis reported greater levels of parental stress, more burnout, and more anger towards their children, as well as less social support. Almost 25% of the parents reported anxiety and depression that are clinically significant. Parents who followed distancing measures reported significantly higher distress. Anger of parents towards children explains 41% of the variation in parental stress. These findings indicate that parents have experienced symptoms of deteriorated mental health due to the COVID- 19 pandemic, including parental stress, anxiety, and depression. The study presents practical implications for meso- and macro-level policymaking and offers support to further the potential aims of public health and clinical interventions. Future studies to monitor long-term aversive mental health outcomes among parents are warranted

Mechanisms of Parental Stress During and After the COVID-19 Lockdown: A two-wave longitudinal study

Background: In the unpredictable times of the ongoing global coronavirus disease (COVID-19), parents worldwide are affected by stressors and strains that follow in the wake of the government-initiated distancing protocols. Objective: In a two‐wave longitudinal survey, we examined levels of parental perceived stress and symptoms of anxiety and depression among a sample of parents at two time points; in the midst of the strictest government-initiated physical distancing protocols following the onset of the COVID-19 pandemic (T1, N = 2868) and three months after the protocols discontinued (T2, n = 1489). Further, we investigated the levels of parental stress, anxiety, and depression relative to perceived relationship quality and anger aimed at child(ren) at the two time points, including subgroups based on age, sex, cultural background, civil status, education level, number of children in household, employment status, and pre-existing psychiatric diagnosis. Methods and findings: Parents were asked to fill out a set of validated questionnaires on the two measurement occasions. As expected, the findings indicate that the high levels of parental stress significantly decreased from T1 to T2, indicating that the cumulative stressors that parent’s experiences during distancing protocols declined as a function of the phaseout of the protocols. The decrease of perceived parental stress at the two time points, was accompanied by a significant decrease in symptoms of both depression and anxiety among the participating parents. Symptoms meeting the clinical cut-off for depression (23.0%) and generalized anxiety disorder (23.3%) were reported among participating parents at T1, compared to 16.8% and 13.8% respectively at T2. Reduction in depression and angry at child(ren) from T1 to T2 were further associated with a reduction in perceived parental stress. In addition, relationship quality and angry at child(ren) at T1 predicted change in parental stress. Conclusions: The findings underline some of the negative psychological impact of physical distancing protocols on parent’s health and well-being. Parents who are facing physical distancing and remaining at home with their children may be particularly vulnerable to parental stress, anxiety and depression. Uncovering the nature of how these constructs are associated to parents and families facing social crisis, such as the ongoing pandemic, can contribute to design relevant interventions to reduce parental stress and strengthen parental coping and resilience. Keywords: COVID-19 lockdown, parental stress, anxiety, depression, social distancing

Feelings of Worthlessness Links Depressive Symptoms and Parental Stress: A Network Analysis During the COVID-19 Pandemic

The prevalent co-occurrence between parental stress and depression has been previously established prior to and during the COVID-19 pandemic outbreak. However, no studies to date have identified the connections through which these symptom domains interact with each other to emerge into a complex and detrimental mental health state, along with the plausible mechanistic variables that may play key roles in maintaining parental stress and depression. The aim of this research is to uncover these interactions in a period where parents experience heighted demands and stress as a consequence of the strict social distancing protocols. Network analysis is utilized to examine parental stress and depressive symptoms during the COVID-19 pandemic in a large cross-sectional study (N = 2868) of parents. Two graphical Gaussian graphical network models were estimated, one in which only parental stress and depression symptoms were included, and another in which several mechanistic variables were added. Expected influence and bridge expected influence revealed that feeling worthless was the most influential node in the symptoms network and bridged the two psychological states. Among the mechanistic variables, worry and rumination was specifically relevant in the depressive cluster of symptoms, and self-criticism was connected to both constructs. The study display that the co-occurrence of parental stress and depression have specific pathways, were manifested through feelings of worthlessness, and have specific patterns of connection to important mechanisms of psychopathology. The results are of utility when aiming to avoid the constellation of co-occurring parental stress and depressive symptoms during the pandemic

Feelings of Worthlessness Links Depressive Symptoms and Parental Stress: A Network Analysis during the COVID-19 Pandemic

Background The prevalent co-occurrence between parental stress and depression has been established prior to and during the COVID-19 pandemic outbreak. However, no studies to date have identified the connections through which these symptom domains interact with each other to emerge into a complex and detrimental mental health state, along with the plausible mechanistic variables that may play key roles in maintaining parental stress and depression. The aim of this research is to uncover these interactions in a period where parents experience heightened demands and stress because of the strict social distancing protocols. Methods Network analysis is utilized to examine parental stress and depressive symptoms during the COVID-19 pandemic in a large cross-sectional study (N = 2,868) of parents. Two graphical Gaussian graphical network models were estimated, one in which only parental stress and depression symptoms were included, and another in which several mechanistic variables were added. Results Expected influence and bridge expected influence revealed that feeling worthless was the most influential node in the symptoms network and bridged the two psychological states. Among the mechanistic variables, worry and rumination was specifically relevant in the depressive cluster of symptoms, and self-criticism was connected to both constructs. Conclusion The study displays that the co-occurrence of parental stress and depression has specific pathways, was manifested through feelings of worthlessness, and has specific patterns of connection to important mechanisms of psychopathology. The results are of utility when aiming to avoid the constellation of co-occurring parental stress and depressive symptoms during the pandemic