Maternal mental health in response to the COVID-19 pandemic: Risk, protective, and moderating factors

• In Event: Longitudinal Studies of Risk for and Resilience against Psychopathology during the COVID-19 Pandemic

Abstract

Stress, adversity and mental health problems are often pronounced and stable in families experiencing economic disadvantage (e.g. Dunn et al., 2011). The global COVID-19 pandemic poses an extreme and societally disproportionate burden on these families (e.g. Holmes Jr. et al., 2020; Fortuna et al., 2020), potentially exacerbating the effects of economic disadvantage and its associated risk on mental health. The current study examines risk and protective factors that may predict pandemic changes to maternal mental health symptoms or moderate the effects of pre-pandemic and pandemic risks on maternal mental health. Specifically, this study examined active and avoidant coping (Brief Coping Scale; Carver 1997), threat appraisal (Maladaptive Beliefs Scale; Vogt et al, 2012), self-compassion (Self-Compassion Scale; Neff 2003), mindfulness (Five Factor Mindfulness Questionnaire; Baer et al., 2006), and social support (Social Support Questionnaire; Sarason et al., 1987) as putative moderators of Pre-COVID-19 Risk (a cumulative index of low income, financial insecurity, adolescent parenthood, low maternal education, and ACEs) and COVID-19 Health Risk (being in poor health, themselves/their child experiencing symptoms, in contact with someone with symptoms, having knowledge of someone who has tested positive or died, etc.) on maternal anxiety (GAD-7) and depression (CES-D). Participant were mothers (N = 202) living in a low-income context (<200% poverty) who previously enrolled in a study evaluating their mental health and well-being during their first pregnancy and early postpartum period. Mothers reported on their anxiety, depression, mindfulness, and self-compassion when their children were 4-6 months old. Mothers completed an online survey in April 2020 (a time that coincided with a local stay at home order) to report current mental health, appraisal, and coping, and social support. In addition, they provided information on their COVID-19 Contextual Risk (a cumulative index of having no medical insurance, changes to their employment, income, and childcare, as well as housing risks) and COVID-19 Health Risk (above). Pre-COVID-19 Risk did not predict changes in maternal mental health from before to during the pandemic nor did concurrent social support. In contrast, mother’s COVID-19 Health Risk and COVID-19 Contextual Risk predicted greater increases in mental health symptoms. Additionally, prior levels of self-compassion predicted decreases, and threat appraisal, avoidant coping and mindfulness predicted increases in maternal mental health symptoms from before to during the pandemic. For both symptoms of depression and anxiety, threat appraisal moderated the effects of pre-pandemic risk such that at higher levels of threat appraisal, preexisting risk predicted increases in mental health symptoms more strongly than at lower levels of threat. Findings highlight promotable qualities (e.g. self-compassion, active coping) that have protective effects on mental health, even when co-occurring with profound stress and hardship. Further, while current experiences of COVID-19 specific contextual risk have a direct effect on symptoms, there is an interaction effect of prior risk on adjustment: individuals high in threat appraisals who have significant histories at disadvantage appear at particular risk during the pandemic.

Authors

• Stephanie F Thompson, University of Washington
  Presenting Author

• Becca Calhoun, University Of Washington
  Non-Presenting Author

• Lisa Shimomaeda, University of Washington
  Non-Presenting Author

• Michele R Smith, University of Washington
  Non-Presenting Author

• Liliana J Lengua, University of Washington
  Non-Presenting Author