The COVID-19 pandemic presents significant risks to the mental health and wellbeing of families. This study aimed to examine: (1) patterns of parent and child (0–18 years) mental health, parent substance use, couple conflict, parenting practices, and family functioning during COVID-19 compared to pre-pandemic data; and (2) associations between parent, child, and family outcomes during the pandemic and both pre-existing risk factors and COVID-19 stressors. Participants were Australian mothers (81%) and fathers aged 18 years and over who were parents of a child 0–18 years (N=2,365). Parents completed an online self-report survey assessing mental health, substance use, couple conflict, parenting, and family functioning during ‘stage three’ COVID-19 restrictions in April 2020. Data were compared to pre-pandemic data from four Australian population-based cohorts. Compared to pre-pandemic estimates, during the pandemic period parents reported higher rates of parent mental health symptoms (Cohen’s d=0.26-.81, all p<.001), higher parenting irritability (d=0.17-.46, all p<.001), lower family positive expressiveness (d=-0.18, p<.001), and higher alcohol consumption (22% vs 12% drinking four or more days per week, p<.001). In multivariable analyses, pre-existing financial deprivation and COVID-19 stressors were associated with greater severity in parent and child mental health symptoms, parent emotion dysregulation, parenting irritability, couple conflict and family positive/negative expressiveness. Parents and children with pre-existing mental health conditions had elevated difficulties during the pandemic across most domains. Our data suggest wide-ranging, detrimental family impacts associated with the COVID-19 pandemic; and support policy actions to assist families with financial supports, leave entitlements, and social housing.

Introduction: The multi-system symptoms accompanying acute and post-treatment Lyme disease syndrome pose a challenge for time-limited assessment. The General Symptom Questionnaire (GSQ-30) was developed to fill the need for a brief patient-reported measure of multi-system symptom burden. In this study we assess the psychometric properties and sensitivity to change of the GSQ-30.Materials and Methods: 342 adult participants comprised 4 diagnostic groups: Lyme disease (post-treatment Lyme disease syndrome, n = 124; erythema migrans, n = 94); depression, n = 36; traumatic brain injury, n = 51; healthy, n = 37. Participants were recruited from clinical research facilities in Massachusetts, Maryland, and New York. Validation measures for the GSQ-30 included the Patient Health Questionnaire-4 for depression and anxiety, visual analog scales for fatigue and pain, the Sheehan Disability Scale for functional impairment, and one global health question. To assess sensitivity to change, 53 patients with erythema migrans completed the GSQ-30 before treatment and 6 months after 3 weeks of treatment with doxycycline.Results: The GSQ-30 demonstrated excellent internal consistency (Cronbach α = 0.95). The factor structure reflects four core domains: pain/fatigue, neuropsychiatric, neurologic, and viral-like symptoms. Symptom burden was significantly associated with depression (rs = 0.60), anxiety (rs = 0.55), pain (rs = 0.75), fatigue (rs = 0.77), functional impairment (rs = 0.79), and general health (rs = −0.58). The GSQ-30 detected significant change in symptom burden before and after antibiotic therapy; this change correlated with change in functional impairment. The GSQ-30 total score significantly differed for erythema migrans vs. three other groups (post-treatment Lyme disease syndrome, depression, healthy controls). The GSQ-30 total scores for traumatic brain injury and depression were not significantly different from post-treatment Lyme disease syndrome.Conclusions and Relevance: The GSQ-30 is a valid and reliable instrument to assess symptom burden among patients with acute and post-treatment Lyme disease syndrome and is sensitive in the detection of change after treatment among patients with erythema migrans. The GSQ-30 should prove useful in clinical and research settings to assess multi-system symptom burden and to monitor change over time. The GSQ-30 may also prove useful in future precision medicine studies as a clinical measure to correlate with disease-relevant biomarkers.

Mentalization is proposed to underlie the disturbed interpersonal relatedness that is a hallmark of borderline personality disorder (BPD). Despite growing evidence of BPD in adolescents, studies examining mentalization in relation to adolescent BPD have remained limited. Given contradictory findings of this relationship, particularly with adults, further research of mentalization in adolescents with BPD is warranted. The current study further clarifies the nature of mentalizing impairments, related to BPD, by examining different aspects of mentalization between adolescents with BPD (n = 26) and a group of healthy controls (n = 25). Findings support studies that suggest that mentalization may be an important treatment target, influencing BPD symptoms and interpersonal functioning in adolescents with BPD. They also support the importance of examining mentalizing abilities in relation to varying levels of complexity, interpersonal contexts, and levels of arousal. Limitations and further research are discussed.

No abstract

Childhood experiences of emotional invalidation are commonly reported by adults with borderline personality disorder (BPD). This study aimed to compare perceptions of emotional invalidation between adolescents with and adolescents without BPD, and their primary caregivers. Participants were 51 adolescents subdivided into a clinical group of 26 adolescents with BPD and a community-control group of 25 adolescents, each with their primary caregivers. To examine perceptions of invalidation, adolescents and caregivers completed parallel reports assessing caregiver responses to adolescents' negative emotions. Adolescents with BPD reported more punitive and less supportive responses to their negative emotions than their caregivers. In the control group, by contrast, differences between caregiver and adolescent reports were due to caregivers rating themselves more harshly than did adolescents. Findings demonstrated that adolescents with BPD perceived their caregivers to be relatively less supportive and more invalidating than did adolescents without BPD. Results highlight the importance of adolescents' subjective experiences of caregiving to enduring borderline psychopathology.

No abstract

The transition to parenthood represents one of the greatest potential stressors that the romantic couple relationship will experience. This chapter examines the role of individual vulnerability factors, environmental stressors, individual psychological responses, and couple relationship functioning in negatively impacting the maintenance and quality of the couple bond within the context of parenthood. We propose and then structure a summary of the current research evidence around a conceptual model of relationship maintenance that integrates an evolutionary psychology perspective—namely, attachment theory—to complement other relationship science and developmental perspectives. We show that individual differences in adult attachment are associated with relationship functioning (i.e., levels of support and conflict between partners), which, in turn, predict relationship outcomes related to the maintenance of romantic relationships (i.e., couple relationship quality and dissolution), and that the environmental stressors in and around parenthood can exacerbate these associations. Specifically, we highlight research showing that attachment insecurity (i.e., higher levels of attachment anxiety and avoidance) is associated with poorer relationship functioning and outcomes.

No abstract