Family functioning as a moderator in the relation between perceived stress and psychotic-like experiences among adolescents during COVID-19

Abstract

Background The COVID-19 pandemic has increased psychological stress among adolescents, and the relation between perceived stress (PS) and psychotic-like experiences (PLEs) has been well-established. However, little is known about the role of family functioning (FF) in this relation, especially when adolescents experienced the extended lockdown period with family members. Methods A total of 4807 adolescents completed this retrospective paper-and-pencil survey after school reopening between May 14th and June 6th, 2020 in Hunan Province, China. We measured PS with the Perceived stress scale (PSS-10), PLEs with the eight positive items from Community Assessment of Psychic Experiences (CAPE-8), and FF with the Family APGAR scale. We conducted subgroup analysis based on three FF levels (good, moderate, and poor) determined by previous studies. Finally, correlation and moderation analysis were performed to detect the effect of FF in the relation between PS and PLEs after adjusting for demographic variables. Results Adolescents with poor FF had higher levels of PS and higher prevalence of PLEs compared to those with good FF (both p < 0.001). FF was negatively associated with both PS ( r = −0.34, p < 0.001) and PLEs ( r = −0.29, p < 0.001). Higher FF significantly attenuated the effect of PS on PLEs after adjusting for sex and age (effect = −0.011, bootstrap 95% CI -0.018, −0.005). Conclusion Our findings indicate that well-functioned family could protect against stress-induced PLEs among adolescents during this crisis. Thus family system could be an early interventional target for distressing psychotic-like experiences in youngsters.

Need Satisfaction and Depressive Symptoms Among University Students in Hong Kong During the COVID-19 Pandemic: Moderating Effects of Positive Youth Development Attributes

“…Concerning Research Question 4, we found that PYD attributes indexed by the three measures were negatively related to depressive symptoms. Generally speaking, the findings are in line with the PYD literature demonstrating the protective effects of PYD attributes, including belief about adversity, emotional competence, and family functioning, on adolescents' overall development (32) and mental health under the COVID-19 (41,74). These findings are also consistent with the theoretical proposition that developmental assets such as PYD attributes promote holistic youth development such as positive mental health (75).…”

“…Besides "internal assets" indexed by resilience and psychosocial competence, "external asset" defined by family functioning also protects individual family members (39). There are research findings showing that family functioning was positively related to the mental health of young people under the pandemic (40)(41)(42).…”

The COVID-19 Pandemic and Adolescents’ Psychological Distress: A Multinational Cross-Sectional Study

“…Among students who participated during the COVID-19 pandemic, this study found that female adolescents scored significantly higher on the psychoticism measure. Another study by [ 50 ], found that adolescents who were more stressed displayed more psychotic-like experiences during the pandemic. Furthermore, good family functioning, such as adaptation, partnership, growth, affection, and resolution, were protective factors against psychotic-like experiences.…”

Association Between Wisdom and Psychotic-Like Experiences in the General Population: A Cross-Sectional Study

“…PROCESS for Windows was used to build a moderation model ( 43 ). Bootstrap inference with 5,000 samples and heteroskedasticity-consistent standard error estimator (HC4) were adopted considering the violation of normal distribution, which was in accordance with our previous study ( 44 ). IBM SPSS 24.0 for Windows ( 45 ) was used for other statistical analyses.…”