COVID-19 Pandemic Experiences and Symptoms of Pandemic-Associated Traumatic Stress Among Mothers in the US

Abstract

ImportanceThe primary outcomes of the COVID-19 pandemic on the mental health of women with children remain largely unknown.ObjectivesTo identify and describe clusters of mothers of children participating in the Environmental influences on Child Health Outcomes (ECHO) Program that characterize pandemic-associated hardships, coping mechanisms, and behaviors, and to evaluate associations between pandemic-associated hardships, coping strategies, and behavior changes with pandemic-associated traumatic stress symptoms.Design, Setting, and ParticipantsThis multicenter cohort study investigated experiences during the COVID-19 pandemic between April 2020 and August 2021 among maternal caregivers of children participating in the ECHO Program. Data from self-identified mothers of ECHO-enrolled children from 62 US cohorts were included in analyses. Data were analyzed from November 2021 to July 2022.ExposuresThe primary exposures were pandemic-associated changes in mothers’ health, health care utilization, work and finances, coping strategies, and health-associated behaviors. Exposures were assessed via a self-reported questionnaire designed by ECHO investigators.Main Outcomes and MeasuresThe primary outcome was the total symptoms score of pandemic-associated traumatic stress (PTS), defined as the number of items endorsed at least sometimes or more frequently, from a 10-item self-report measure.ResultsThe study surveyed 11 473 mothers (mean [SD] age, 37.8 [7.4] years; 342 American Indian [2.98%], 378 Asian [3.29%], 1701 Black [14.83%], and 7195 White [62.71%]; 2184 with Hispanic/Latina ethnicity [19.04%]) and identified 2 clusters that best characterized their COVID-19 pandemic experiences—one characterized by higher life disruptions (eg, to work and health care), higher social isolation, more coping behaviors to mitigate the outcomes of the pandemic, and more changes to their health behavior routines (high change [1031 mothers]) and the other characterized by lower changes (low change [3061 mothers]). The high change cluster was more socioeconomically advantaged and reported higher PTS (mean [SD] number of symptoms, 3.72 [2.44] vs 2.51 [2.47]). Across both clusters, higher pandemic-associated hardships, coping mechanisms, and behavior changes were associated with higher PTS, and these associations were greater in the low change cluster.Conclusions and RelevanceIn this study of more than 11 000 US mothers, associations between socioeconomic factors, stressful life events, and mental health sequelae were complex. Accordingly, programs, policies, and practices targeting mental health during public health crises such as the COVID-19 pandemic should consider the range and configuration of hardships in designing the most effective interventions to mitigate long-term outcomes.

Assessment of Psychosocial and Neonatal Risk Factors for Trajectories of Behavioral Dysregulation Among Young Children From 18 to 72 Months of Age

“…Risk and protective factors identified here can be ascertained prenatally, at birth, and prior to postnatal discharge to the home community to individualize family supports. 71 , 72 When initiated earlier, behavioral and emotional interventions are more effective, 73 , 74 , 75 , 76 , 77 with potential to prevent escalation among children with borderline symptoms. Toward the goal of disrupting persisting dysregulation and facilitating resilience, the cumulative risks and behavioral indicators identified inform best practices and future research.…”

Role of pandemic‐related experiences and maternal psychological distress in maternal rejection

“…Many studies have indicated that MPD has increased since the beginning of the COVID-19 pandemic (Adams et al, 2021;Eales et al, 2021;Kerr et al, 2022;Marchetti et al, 2020;Spinelli et al, 2020). However, recent findings show that some mothers are less affected by the negative consequences of the pandemic, and they have a more developed sense of parenting (Bastain et al, 2022;Xiao, 2024). Given that not all mothers are equally affected by the challenges posed by the pandemic, it is important to further investigate factors that might lead to individual differences in MPD during the pandemic.…”

“…In addition, the change in the level of psychological distress varies across individuals. A large‐scale cohort study conducted with almost 12,000 mothers from the United States revealed maternal profiles of high and low change in psychological distress levels during the pandemic (Bastain et al, 2022). Although some mothers adapted easily to the new living conditions and enjoyed spending more time with their children, other mothers experienced elevated levels of psychological distress (Calarco et al, 2020).…”

Changes in the Well-Being of Foreign Language Speaking Migrant Mothers Living in Finland during the Initial Stage of the COVID-19 Pandemic

“…The diversity of the effects of the COVID-19 pandemic across different social categories has been covered more in North American research. In their study, Bastain et al (2022) found that, while more changes in everyday life caused by the pandemic and higher PTS were reported by socioeconomically advantaged respondents, the association between PTS and higher pandemic-associated hardships, coping mechanisms, and behavioral changes was greater in the less socioeconomically advantaged cluster. In a Canadian study, Hirani and Wagner (2022) showed that refugee mothers were at a high risk of experiencing add-on stressors due to isolation, difficulty in accessing health care, COVID-19-related restrictions in hospitals, limited follow-up care, limited social support, financial difficulties, and compromised nutrition.…”