Mediation-Moderation Links Between Mothers’ Anxiety and Mentalization and Children’s Behavior Problems Before and During COVID-19

• In Event: Poster Session 08
  In Poster Session: PS 08 Topic - Solicited Content: COVID-19 Related

Abstract

 The outbreak of COVID-19 has been marked by high levels of anxiety among adults and increases in young children’s fears, regression, clinginess and behavior problems.
 Young children’s responses to external threats are mediated through their primary caregivers’ emotional reactions, particularly their anxiety.
 Maternal mentalization is evident in the mother’s proclivity to “get into her child’s shoes” and is considered an asset that helps the mother assess the impact of negative events on the child.
Objectives:
• To compare reports of maternal anxiety and child behavior problems among mothers assessed before COVID-19 and a comparable group of mothers assessed shortly after the pandemic outbreak.
• To examine whether maternal anxiety mediates and mentalization moderates the association between COVID-19 group status and child behavior problems.
Hypotheses:
1. Mothers in the COVID-19 group will report more anxiety symptoms (H1a) and more children’s internalizing and externalizing problems (H1b), compared to mothers in the PreCOVID-19 group.
2. COVID-19 group status will be linked with the child’s externalizing (H2a) and internalizing (H2b) problems. These associations will be mediated by the mother’s anxiety and moderated by the mother’s mentalization skills. Specifically, the direct and mediated links via the mother’s anxiety will be the strongest for mothers with weak mentalization. For mothers with strong mentalization skills, these associations will be weaker.

Method: A sample of Israeli mothers (N = 148) with a child 3-6 years of age (M = 4.18, SD = .88) participated. The sample consisted of (1) a COVID-19 group (N=60), recruited during the first wave of the pandemic’s outbreak; (2) a PreCOVID-19 group (N=88) of similar background, recruited prior to the pandemic. Mothers in the two groups reported on their anxiety symptoms (BSI) and the targeted child’s behavior problems (CBCL). Maternal mentalization was assessed with the Mind-Mindedness interview.

Results: Mothers in the COVID-19 group reported significantly higher levels of anxiety (H1a) and children’s internalizing and externalizing problems (H1b) compared to the PreCOVID-19 group (see table 1).
The models predicting children’s externalizing (F (5, 141) = 16.97, p < .001 R2 = .38) and internalizing (F (5, 141) = 10.85, p < .001 R2 = .36) problems were significant. Mothers’ anxiety partially mediated the links between the COVID-19 group status and the children’s externalizing (H2a) and internalizing (H2b) problems. Mothers’ mentalization moderated the direct and indirect links, but only in the case of children’s externalizing problems (see figure 1). Specifically, the strongest mediation effect was found when the mothers had weak mentalization skills. In contrast, there was no mediation link when the mothers had strong mentalization.

Conclusions: The findings indicate that COVID-19 is associated with heightened maternal anxiety and increases in children’s internalizing and externalizing problems. High maternal anxiety, which is associated with the pandemic, appears to be a major factor which is linked with the increased risk in children’s behavior problems. Maternal mentalization can help mothers appreciate and modulate the potentially overwhelming impact of their anxiety on their children. Thus, supporting parents and enhancing their mentalization skills are important treatment targets, particularly during COVID-19.

Authors

• Daphna G. Dollberg, Academic College of Tel Aviv Yaffo
  Presenting Author

• Keren Hanetz- Gamliel, Academic Collage of Tel Aviv Yaffo
  Non-Presenting Author

• Sigal Levy, The Academic College of Tel Aviv Yaffo
  Non-Presenting Author