Poster #25 - “We are flexible in adapting to new challenges”: Family resilience and child behavior problems during COVID-19

• In Event: Poster Session 06

Abstract

Introduction
Children’s mental health has declined since the COVID-19 pandemic (Racine, et al., 2020) including an increase in aggressive behaviors and other externalizing problems (Feinberg et al, 2022). The pandemic has also intensified other forms of social disruption and structural violence disproportionately affecting low-income families of color (Loades et al., 2020; Brooks et al., 2020). Researchers are just beginning to identify family processes that may buffer against the negative effects of COVID-19-related stress (Browne et al., 2020) and family resilience has emerged as an important protective factor (Prime et al., 2020). This study aims to investigate the unique family resilience processes used by families during the COVID-19 pandemic, and their potential buffering effect on internalizing and externalizing problems in children. We hypothesize that (1) children’s exposure to COVID-19 related life stressors will be associated with increases in internalizing and externalizing problems, and (2) an interaction between COVID-related stress and family resilience, such that high levels of family resilience will buffer the hypothesized association between stress and externalizing problems.

Methods
Participants included 89 mother-child dyads recruited from community agencies serving low-income families who were oversampled for violence exposure. Caregivers predominantly self-identified as Black or African American (84%) and children were preschool-aged (M= 51.56 months; SD= 9.18). Participants were re-contacted approximately three years later to participate in a remote COVID-19 follow up study when children were in elementary school (M=7.75 years old; SD = 1.42). Parents reported on exposure to COVID-19-related stressors, on child internalizing and externalizing behaviors, and on family resilience. All analyses used linear regression with bootstrapping using Hayes’ PROCESS macro (2013) to adjust for non-normality. Covariates included child age, sex, maternal education level, depressive symptoms, and a count of parent-reported traumatic life events.

Results
A significant interaction effect was observed between COVID-19 exposure and overall family resilience in predicting child externalizing problems (see Fig. 1; estimate= -0.27 [-0.49, -0.05], p=0.02). Analysis of simple slopes revealed that COVID-19 exposure and child externalizing problems were positively associated at low levels of family resilience (estimate= 0.55 [0.24, 0.87], p<0.001). However, at high levels of family resilience, the association between COVID-19 exposure and child externalizing problems was no longer significant, suggesting that family resilience acted as a buffer against COVID-19 exposure by stabilizing behavior problems (estimate= 0.10 [-.22, 0.43], p=0.53). Similar patterns were observed when testing the individual Walsh (2015) family resilience subscales (family belief systems, organizational patterns, and communication processes) as moderators between COVID-19 and externalizing problems. In the models examining internalizing problems, there were no significant main effects or interaction effects of COVID-19 exposure with any of the indices of family resilience.

Discussion
Taken together, these results highlight the buffering effects of family resilience in the context of the COVID-19 pandemic, but only for child externalizing and not internalizing problems. These results align with prior research suggesting family resilience processes can act as protective factors in contexts of environmental stress. Results have implications for clinical practice with families experiencing chronic stress related to the pandemic.

Authors

• Renee Lamoreau, Tulane University
  Presenting Author

• Allison Pequet, Tulane University

• Anna Wilson, Tulane University

• Kavya Subramaniam, Tulane University

• Sarah A.O. Gray, Tulane University