Social determinants of mental health during a year of the COVID-19 pandemic

Minihan, Savannah; Orben, Amy; Songco, Annabel; Fox, Elaine; Ladouceur, Cecile D.; Mewton, Louise; Moulds, Michelle L.; Pfeifer, Jennifer H.; Harmelen, Anne‐Laura van; Schweizer, Susanne

doi:10.1017/s0954579422000396

Cited by 15 publications

(16 citation statements)

References 82 publications

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“…The following measures were included in the present study. The full list of measures included in the CORAL study at T1 has been reported by Minihan et al 12…”

Section: Methodsmentioning

confidence: 99%

Association of Antenatal COVID-19–Related Stress With Postpartum Maternal Mental Health and Negative Affectivity in Infants

et al. 2023

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ImportanceAntenatal stress is a significant risk factor for poor postpartum mental health. The association of pandemic-related stress with postpartum outcomes among mothers and infants is, however, less well understood.ObjectiveTo examine the association of antenatal COVID-19–related stress with postpartum maternal mental health and infant outcomes.Design, Setting, and ParticipantsThis cohort study was conducted among 318 participants in the COVID-19 Risks Across the Lifespan study, which took place in Australia, the UK, and the US. Eligible participants reported being pregnant at the first assessment wave between May 5 and September 30, 2020, and completed a follow-up assessment between October 28, 2021, and April 24, 2022.Main Outcomes and MeasuresCOVID-19–related stress was assessed with the Pandemic Anxiety Scale (score range, 0-4, with higher scores indicating greater COVID-19–related stress). The 8-item Patient Health Questionnaire (score range, 0-3, with higher scores indicating more frequent symptoms of depression) was used to measure maternal depression at each time point, and the 7-item General Anxiety Disorder scale (score range, 0-3, with higher scores indicating more frequent symptoms of anxiety) was used to measure generalized anxiety at each time point. At follow-up, postpartum distress was assessed with the 10-item Postpartum Distress Measure (score range, 0-3, with higher scores indicating greater postpartum distress), and infant outcomes (negative and positive affectivity and orienting behavior) were captured with the Infant Behavior Questionnaire (score range, 1-7, with higher scores indicating that the infant exhibited that affect/behavior more frequently).ResultsThe study included 318 women (mean [SD] age, 32.0 [4.6] years) from Australia (88 [28%]), the US (94 [30%]), and the UK (136 [43%]). Antenatal COVID-19–related stress was significantly associated with maternal postpartum distress (β = 0.40 [95% CI, 0.28-0.53]), depression (β = 0.32 [95% CI, 0.23-0.41]), and generalized anxiety (β = 0.35 [95% CI, 0.26-0.44]), as well as infant negative affectivity (β = 0.45 [95% CI, 0.14-0.76]). The findings remained consistent across a range of sensitivity analyses.Conclusions and RelevanceThe findings of this cohort study suggest that targeting pandemic-related stressors in the antenatal period may improve maternal and infant outcomes. Pregnant individuals should be classified as a vulnerable group during pandemics and should be considered a public health priority, not only in terms of physical health but also mental health.

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“…The following measures were included in the present study. The full list of measures included in the CORAL study at T1 has been reported by Minihan et al 12…”

Section: Methodsmentioning

confidence: 99%

Association of Antenatal COVID-19–Related Stress With Postpartum Maternal Mental Health and Negative Affectivity in Infants

et al. 2023

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“…Only the measures relevant to the present study are described below (for the full list of measures see 18 ).…”

Section: Methodsmentioning

confidence: 99%

“…A further source of stress introduced by the pandemic, beyond health and economic uncertainty, are social distancing measures implemented to reduce the spread of COVID-19 18 . These measures have limited access to, and social contact with healthcare providers, as well as social support from relatives and friends for all 19 and may have been particularly detrimental to the wellbeing of pregnant women.…”

Section: Social Vulnerability To Covid-19-related Stressmentioning

confidence: 99%

“…Participants were eligible for the larger CORAL study if they were: fluent in English; lived in Australia, the UK or USA; over 11 years of age; had no neurological or developmental condition or history of a traumatic brain injury; responded to no more than 1 attention check item incorrectly (the survey included a total of 5 attention check items that were designed to ensure that participants were reading questionnaire items attentively); and were capable of providing informed consent 18 . For the present study, only eligible female participants at time 1 were included in the analyses based on their pregnancy status in a screening questionnaire within the survey.…”

Section: Participantsmentioning

confidence: 99%

“…Therefore, the loneliness items, interactions items and social support items were modelled as three separate latent variables 18 . The measurement models of loneliness (CFI = 0.87, TLI = 0.85, RMSEA = 0.11, SRMR = 0.06) and social support (CFI = 1, TLI = 1, RMSEA = 0, SRMR = 0) demonstrated an adequate fit to the data.…”

Section: Social Risk Factor Scorementioning

confidence: 99%

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Social and Cognitive Vulnerability to COVID-19-Related Stress in Pregnancy: A Case-Matched-Control Study of Antenatal Mental Health

Songco¹,

Minihan²,

Fox³

et al. 2023

Preprint

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Emerging evidence shows that compared to pre-pandemic norms pregnant women report significant increases in clinical levels of depressive and anxiety symptoms during COVID-19. This pre-registered study examined cognitive and social vulnerability factors for poor mental health in pregnancy during COVID-19. Understanding vulnerability profiles is key to identifying women at risk for deteriorating peripartum mental health. N=742 pregnant women and N=742 age and country-matched controls from the COVID-19 Risks Across the Lifespan Study were included. Using a case-match control design allowed us to explore whether the cognitive vulnerability profiles would differ between pregnant and non-pregnant women. The findings showed that COVID-19-related stress was associated with heightened levels of depression and anxiety during pregnancy. Its impact was greatest in women with cognitive (i.e., higher intolerance of uncertainty and tendency to worry) and social (i.e., higher level of self-reported loneliness) vulnerabilities. Importantly, our data show that the mental health impacts of the pandemic were greater in pregnant women compared to women who were not pregnant, especially those with cognitive and social vulnerabilities. The results highlight the urgent need to prioritise mental health care for pregnant women to mitigate the impact of COVID-19-related stress on women’s postpartum mental health and their infants’ well-being.

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Intolerance of uncertainty and psychological flexibility as predictors of mental health from adolescence to old age

Okayama,

Minihan,

Andrews

et al. 2024

Soc Psychiatry Psychiatr Epidemiol

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Purpose The COVID-19 pandemic brought with it significant social, economic and health uncertainties. These were proposed to impact young people more compared to adults, leading adolescents to report more mental health problems during the pandemic. The current study examined whether differences in cognitive risk (tolerance of uncertainty) and protective (psychological flexibility) factors accounted for age-related differences in depression and anxiety. Methods These associations were investigated in the COVID-19 Risks Across the Lifespan (CORAL) cohort (N = 2280, 11–89 years). Results The results showed that adolescents experienced greater intolerance of uncertainty and lower psychological flexibility compared to adults and older adults. Tolerance of uncertainty did not account for age-related differences in depression or anxiety. However, psychological flexibility conferred more protective advantage for anxiety in adults compared to adolescents. Conclusion The observed age-related differences in risk and protective factors advance our understanding of developmental vulnerabilities to depression and anxiety. Implications for mental health interventions in the context of future pandemics are discussed.

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Social determinants of mental health during a year of the COVID-19 pandemic

Cited by 15 publications

References 82 publications

Association of Antenatal COVID-19–Related Stress With Postpartum Maternal Mental Health and Negative Affectivity in Infants

Association of Antenatal COVID-19–Related Stress With Postpartum Maternal Mental Health and Negative Affectivity in Infants

Social and Cognitive Vulnerability to COVID-19-Related Stress in Pregnancy: A Case-Matched-Control Study of Antenatal Mental Health

Intolerance of uncertainty and psychological flexibility as predictors of mental health from adolescence to old age

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