The prefrontal cortex in a pandemic: Restoring functions with system-, family-, and individual-focused interventions.

Abstract

The COVID-19 pandemic is an unanticipated and uncontrollable chronic stressor that is detrimental to the mental and behavioral health of children and families, particularly those from disadvantaged and marginalized backgrounds. Chronic stress impairs a myriad of prefrontal cortical functions, important for coping with the COVID-19 pandemic, and has consequences on dyadic parent-child functioning. Informed by neuroscience and clinical evidence, sensitive parenting is a vital avenue of intervention that buffers against the toxic effects of COVID-19 on parent-child mental health. In the context of the COVID-19 pandemic, we first discuss the neurobiological, psychological, and behavioral mechanisms behind exacerbated mental health risks in families. We then highlight the role of sensitive parenting as a buffer against stressrelated mental health problems, and conclude with recommendations for systemic-, family-, and individual-interventions to most effectively address stress-related mental health problems and their impact on children and families during the COVID-19 pandemic. Public Significance StatementThis review examines the neurobiological mechanisms underlying exacerbated mental health risks in disadvantaged and marginalized families during the COVID-19 pandemic, and potential interventions. The chronic stress of COVID-19 impacts various prefrontal cortical functions that are critical for adaptive emotion regulation, mentalizing, and coping skills in children and their caregivers. These functions can be restored by systemic policies that address long-standing structural racism and mental health inequities, as well as family-and individual-level interventions that aim to reduce stress and promote sensitive caregiving.

Chronic stress and turnover intention of resident physicians after experiencing COVID-19

“…However, it is not difficult to understand the high proportion of stress perception among resident physicians. The outbreak of COVID-19 has been described as an important source of chronic stress, and medical workers bear the brunt of great pressure during COVID-19 [ 8 , 27 ]. For resident physicians, the pandemic has also led to direct changes in work and professional training [ 52 ].…”

“…Worse still, COVID-19 had affected the medical system and brought unprecedented challenges to medical personnel [ 24 – 26 ]. The persistent COVID-19 had been described as a widespread chronic stressor that affects people and all social strata around the world [ 8 , 27 , 28 ]. In this serious public health problem, resident physicians have to contact patients with COVID-19 directly [ 29 ].…”

Screening of prenatal depression and anxiety among antenatal women and their association with fear of Coronavirus disease during the COVID-19 pandemic in Coastal Karnataka, India

“…Chronic stress impairs the prefrontal cortical functions, which are very important for coping up with the consequences of the COVID-19 pandemic. 25 Screening for perinatal depression and anxiety should be considered a priority during an international public health crisis like the COVID-19 pandemic. In any public health emergency, feelings of uncertainty, fear, and stigmatization are common and may act as help-seeking barriers to appropriate mental health interventions.…”

Weaponizing Clinical Mental Health in Family Justice Courts: Ethical and Legal Minefields

“…The risk for children from parental conflict was (and is) exacerbated during the COVID-19 pandemic, with additional stress, emotional dysregulation, and cognitive impairments, coupled with the loss of school, nutrition, mental health, kinship care, and special education services as protective factors or safe harbors (Arnsten et al, 2021;Hails, 2021;McEwen & Prescott, 2022). Concomitantly, the COVID-19 pandemic has exposed the consequences of decades of drift into state judicial systems where families or the state file lawsuits-and all forms of litigation begin with a lawsuit-to resolve disputes that parents cannot settle privately.…”