Associations Between COVID-19-related Family Hardships/distress and Children's Adverse Childhood Experiences During the Pandemic: The Environmental Influences on Child Health Outcomes (ECHO) Program

Overview

Journal Child Abuse Negl

Specialty Pediatrics

Date 2023 Nov 3

PMID 37922614

Authors

Karen L Thierry

Christine W Hockett

Amy J Elliott

Adaeze C Wosu

Aruna Chandran

Courtney K Blackwell

Amy E Margolis

Margaret R Karagas

Carmen Velez Vega

Cristiane S Duarte

Carlos A Camargo Jr

Barry M Lester

Elisabeth C McGowan

Assiamira Ferrara

Thomas G OConnor

Cindy T McEvoy

Alison E Hipwell

Leslie D Leve

Jody M Ganiban

Sarah S Comstock

Dana Dabelea

Affiliations

Soon will be listed here.

Abstract

Background: Economic hardships imposed by the pandemic could have implications for children's experiences of adversity in the home, or Adverse Childhood Experiences (ACEs).

Objective: This observational cohort study examined associations between COVID-19-related hardships and distress (e.g., job loss, caregiver stress) and the cumulative number of child ACEs reported by caregivers during the pandemic (i.e., March 1, 2020-February 28, 2022).

Participants And Setting: The study included children (N = 4345; median age = 6.0 years, interquartile range = 4-9 years) and their parents/caregivers who participated in the NIH-funded Environmental influences in Child Health Outcomes (ECHO) Program.

Methods: We described socio-demographic characteristics and pandemic-related family hardships/distress and cumulative child ACE scores reported during pre-pandemic and pandemic periods. We used negative binomial regression models to evaluate associations between pandemic-related family hardships and cumulative child ACE scores reported during the pandemic.

Results: Each caregiver-reported hardship/distress was associated with higher child ACE scores reported during the pandemic. After accounting for pre-pandemic child ACE scores, moderate and severe symptoms of pandemic-related traumatic stress among caregivers were associated with 108 % and 141 % higher child ACE scores reported during the pandemic, respectively, compared with no or low caregiver symptoms. In addition, finance-related stress during the pandemic was associated with 47 % higher child ACE scores. After adjusting for pre-pandemic child experiences of neglect, most sources of stress remained significantly associated with higher child ACE scores reported during the pandemic, particularly severe/very severe symptoms of pandemic-related traumatic stress among caregivers. Findings held for children with no known pre-pandemic ACEs.

Conclusions: This research suggests that caregivers experiencing financial hardships and those with severe pandemic-related traumatic stress may require additional support systems during stressful events.

Citing Articles

Adverse childhood experiences are associated with perceived cognitive difficulties among high school students in the United States.

Iverson I, Cook N, Iverson G Front Psychol. 2024; 15:1293013.

PMID: 38375116 PMC: 10875032. DOI: 10.3389/fpsyg.2024.1293013.

References

Spinelli M, Lionetti F, Pastore M, Fasolo M . Parents' Stress and Children's Psychological Problems in Families Facing the COVID-19 Outbreak in Italy. Front Psychol. 2020; 11:1713. PMC: 7350926. DOI: 10.3389/fpsyg.2020.01713. View

Kovler M, Ziegfeld S, Ryan L, Goldstein M, Gardner R, Garcia A . Increased proportion of physical child abuse injuries at a level I pediatric trauma center during the Covid-19 pandemic. Child Abuse Negl. 2020; 116(Pt 2):104756. PMC: 7518108. DOI: 10.1016/j.chiabu.2020.104756. View

Taylor C, Guterman N, Lee S, Rathouz P . Intimate partner violence, maternal stress, nativity, and risk for maternal maltreatment of young children. Am J Public Health. 2008; 99(1):175-83. PMC: 2636621. DOI: 10.2105/AJPH.2007.126722. View

Whelan E, OShea J, Hunt E, Dockray S . Evaluating measures of allostatic load in adolescents: A systematic review. Psychoneuroendocrinology. 2021; 131:105324. DOI: 10.1016/j.psyneuen.2021.105324. View

Leslie E, Wilson R . Sheltering in place and domestic violence: Evidence from calls for service during COVID-19. J Public Econ. 2020; 189:104241. PMC: 7377795. DOI: 10.1016/j.jpubeco.2020.104241. View

Krieger N . Refiguring "race": epidemiology, racialized biology, and biological expressions of race relations. Int J Health Serv. 2000; 30(1):211-6. DOI: 10.2190/672J-1PPF-K6QT-9N7U. View

Hooper M, Napoles A, Perez-Stable E . COVID-19 and Racial/Ethnic Disparities. JAMA. 2020; 323(24):2466-2467. PMC: 9310097. DOI: 10.1001/jama.2020.8598. View

Gilbert L, Breiding M, Merrick M, Thompson W, Ford D, Dhingra S . Childhood adversity and adult chronic disease: an update from ten states and the District of Columbia, 2010. Am J Prev Med. 2014; 48(3):345-9. DOI: 10.1016/j.amepre.2014.09.006. View

Cappa C, Jijon I . COVID-19 and violence against children: A review of early studies. Child Abuse Negl. 2021; 116(Pt 2):105053. PMC: 9754317. DOI: 10.1016/j.chiabu.2021.105053. View

10.

McGuigan W, Pratt C . The predictive impact of domestic violence on three types of child maltreatment. Child Abuse Negl. 2001; 25(7):869-83. DOI: 10.1016/s0145-2134(01)00244-7. View

11.

Lawson M, Piel M, Simon M . Child Maltreatment during the COVID-19 Pandemic: Consequences of Parental Job Loss on Psychological and Physical Abuse Towards Children. Child Abuse Negl. 2020; 110(Pt 2):104709. PMC: 7472978. DOI: 10.1016/j.chiabu.2020.104709. View

12.

Gardner W, Mulvey E, SHAW E . Regression analyses of counts and rates: Poisson, overdispersed Poisson, and negative binomial models. Psychol Bull. 1995; 118(3):392-404. DOI: 10.1037/0033-2909.118.3.392. View

13.

Johnson M, Skjerdingstad N, Ebrahimi O, Hoffart A, Johnson S . 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. Stress Health. 2021; 38(4):637-652. DOI: 10.1002/smi.3120. View

14.

Windham A, Rosenberg L, Fuddy L, McFarlane E, Sia C, Duggan A . Risk of mother-reported child abuse in the first 3 years of life. Child Abuse Negl. 2004; 28(6):645-67. DOI: 10.1016/j.chiabu.2004.01.003. View

15.

Newland R, Crnic K, Cox M, Mills-Koonce W . The family model stress and maternal psychological symptoms: mediated pathways from economic hardship to parenting. J Fam Psychol. 2013; 27(1):96-105. PMC: 8011847. DOI: 10.1037/a0031112. View

16.

Brown S, Doom J, Lechuga-Pena S, Watamura S, Koppels T . Stress and parenting during the global COVID-19 pandemic. Child Abuse Negl. 2020; 110(Pt 2):104699. PMC: 7440155. DOI: 10.1016/j.chiabu.2020.104699. View

17.

Bryant D, Oo M, Damian A . The rise of adverse childhood experiences during the COVID-19 pandemic. Psychol Trauma. 2020; 12(S1):S193-S194. DOI: 10.1037/tra0000711. View

18.

Blackwell C, Mansolf M, Sherlock P, Ganiban J, Hofheimer J, Barone C . Youth Well-being During the COVID-19 Pandemic. Pediatrics. 2022; 149(4). PMC: 9169239. DOI: 10.1542/peds.2021-054754. View

19.

Giano Z, Wheeler D, Hubach R . The frequencies and disparities of adverse childhood experiences in the U.S. BMC Public Health. 2020; 20(1):1327. PMC: 7488299. DOI: 10.1186/s12889-020-09411-z. View

20.

Iruka I, LaForett D, Odom E . Examining the validity of the family investment and stress models and relationship to children's school readiness across five cultural groups. J Fam Psychol. 2012; 26(3):359-70. DOI: 10.1037/a0028290. View