Impact of preschool attendance, parental stress, and parental mental health on internalizing and externalizing problems during COVID-19 lockdown measures in preschool children

Abstract

Background Internalizing problems are common in young children, often persist into adulthood, and increase the likelihood for subsequent psychiatric disorders. Problematic attachment, parental mental health problems, and stress are risk factors for the development of internalizing problems. COVID-19 lockdown measures have resulted in additional parental burden and especially their impact on preschool children has rarely been investigated as of now. The current study examined the impact of sustained preschool attendance, parental stress, and parental mental health on internalizing and externalizing problems during COVID-19 lockdown measures in a sample of preschool children in Germany. Methods and findings N = 128 parents of preschool children filled out a one-time online survey about children’s internalizing problems, externalizing problems, and attachment for three time points: before a nation-wide lockdown (T1), during the most difficult time of the lockdown (T2) and after the lockdown (T3). Additionally, parents answered questions about their own depressive and anxious symptomatology for the three time points and parental stress for T1 and T2. Linear-mixed effect models were computed to predict children’s internalizing / externalizing behavior. Preschool children showed a significant increase in internalizing and externalizing problems over time, highest at T2 with small decreases at T3. Parental depressive and anxious symptomatology increased significantly from T1 to T2, but also remained high at T3. Parental stress levels were comparable to community samples at T1, but attained average values reported for at-risk families at T2. Linear-mixed effect models identified higher parental stress, parental anxiety, attachment problems, parental education, and less preschool attendance as significant predictors for internalizing and externalizing problems in preschoolers with more specific associations shown in separate models. A limitation is the retrospective assessment for the times T1 and T2. Conclusions Preschool children’s mental health is strongly and negatively influenced by the ongoing COVID-19 pandemic and its lockdown measures. Sustained preschool attendance may serve as a protective factor.

Parenting young children during COVID-19: Parenting stress trajectories, parental mental health, and child problem behaviors.

“…Parental mental health symptoms at the beginning of the pandemic had direct effects on higher levels of child problem behaviors. This supports previous literature that found maternal depressive symptoms (Gordon-Hacker et al, 2023) and maternal anxiety symptoms (Jarvers et al, 2023) are linked to later emotional and behavioral problems in children. Parents struggling with more pandemic-related stressors likely face increased mental health symptoms, and thus find sensitive and responsive parenting more challenging.…”

Behavioral and Sleep Disorders in Children and Adolescents following COVID-19 Disease: A Case-Control Study

“…In the 6-18-year-old subgroup, anxiety (n = 74, 28%), depression (n = 51, 19%), somatic problems (n = 43, 16%), attention problems (n = 20, 8%), oppositional problems (n = 16, 6 %), and conducted (n = 6, 2%) were the most prevalent disorders [44]. In the research by Jarvers et al, internalizing and externalizing problems significantly increased with time in preschoolers, peaking during the lockdown and only slightly declining after the lockdown [45]. Schmidt et al found that, among 5823 children, from 2.2% to 9.9% reported emotional and behavioral issues that were beyond the clinical cut-off.…”

COVID-19 Pandemic: 1-Year Follow-Up in Children and Adolescents with Neuropsychiatric Disorders

“…Since the comparison between Time 0 and Time 1 was analyzed in one of our previous studies [33], we present here the results of the comparison between Time 1 and Time 2 in order to monitor symptoms after one year of the pandemic. While there are many studies comparing the mental health status of Italian neuropsychiatric patients before and during the first lockdown [3,19,22,30,39], to the best of our knowledge, our study is the first that has attempted to assess the long-term effects of the COVID-19 lockdown on mental health. Our sample included 369 patients and their families (Tables 1 and 2), aged between 2-18 years, with the following neuropsychiatric diagnoses: autism spectrum disorder (n = 110), epilepsy (n = 90), specific learning disorders (n = 40), intellectual disability (n = 33), communication disorders (n = 29), attention deficit/hyperactivity disorder (n = 21), behavioral disorders (n = 16), anxiety disorders (n = 15), and mood disorders (n = 15).…”