PTSD impacts from COVID-19 on family caregivers

• In Event: Poster Session 07
  In Poster Session: PS 07 Topic - Solicited Content: COVID-19 Related

Abstract

Periods of uncertainty, anxiety, and changes in routine with an indeterminant endpoint - characteristics of the quarantines enacted during the spread of novel diseases like COVID-19 - are stressful experiences and may be particularly salient for families with children (Brooks et al., 2020; Carleton, 2016; Cluver et al., 2020; Sweeny, 2018). As with all segments of the population, responses to stressors for caregivers include anxiety and depression; attempts to cope with the symptoms of this distress have well-documented implications for psychiatric diagnoses, including post traumatic stress disorder. The mental health sequalae of pandemics and other disasters are extensive and can lead to prolonged periods of distress (Baral & Bhagawati, 2019; Galea & Coffey, 2018; North, 2016). Given high levels ambiguity and limited opportunities for control during COVID-19, caregivers are at risk of stress saturation and burnout; those with pre-existing emotion regulation difficulties are at elevated risk of psychopathology during prolonged stress (Maslach et al., 2001). Evidence suggests that compared to their non-caregiving counterparts, caregviers experience more acute negative disaster responses (Fussell & Lowe, 2014), which may heighten anxiety and posttraumatic stress (Kerns, et al., 2014; Maeda & Oe, 2017). Thus the COVID-19 pandemic is an instance of traumatic stress, creating prolonged pathogenic conditions for families (Horesh & Brown, 2020).
The current study examined longitudinal patterns of caregivers’ mental health from a national sample surveyed online. We assess linkages between coping and mental health indicators over a 60-day period immediately following the first peak of US COVID-19 infections (Dong & Gardner, 2020). Participants include 176 (63.6% female; mean age = 33.5, see Table 1) caregivers with children younger than 18 living in their home during the pandemic. Results indicated 35 (19.9%) caregivers scored above the Impact of Event Scale (IES; Creamer et al., 2003) clinical cutoff for PTSD at 60 days, 23 (65.7%) of whom were female. Caregivers who scored above this cutoff reported significantly higher rates of COVID-specific stressors (ts ranging -5.54 to -3.36, p<.01), and increased use of substances, behavioral disengagement, and active coping strategies (ts ranging from -2.86 to -4.38, p<.01). Linear stepwise regressions indicate significant predictions of the 3 IES forms of psychological distress: Intrusion (Adj. R2 = 0.513, F(8, 130) = 19.16, p<.01), avoidance (Adj. R2 = 0.358, F(7, 134) = 12.23, p<.01) and hyperarousal psychological (Adj. R2 = 0.508, F(8, 131) = 18.97, p<.01). Across all 3 models (see Table 2), baseline anxiety predicted distress, while depression symptoms, COVID-related stress appraisals, and emotion dysregulation had significant impacts for some but not all types of distress. Post-hoc analyses indicating group differences between caregivers and their non-partnered counterparts are presented.
As fatigue and the emotional strains of quarantine increase over time, the energy caregivers have to sustain high-levels of protective preventative behaviors while modeling active and adaptive coping strategies will be crucial. Additionally, resources that offer parenting guides for managing stress and maintaining positive parent-child interactions during COVID-19 are necessary to bolster coping resources for caregivers and their children (particularly mothers, who evidenced greater rates of PTSD).

Authors

• Beth S Russell, University of Connecticut
  Presenting Author

• Morica Hutchison, University of Connecticut
  Non-Presenting Author

• Michael Fendrich, University of Connecticut
  Non-Presenting Author

• Crystal L. Park, University of Connecticut
  Non-Presenting Author