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Associations between parent-child relationship, and children's externalizing and internalizing symptoms, and lifestyle behaviors in China during the COVID-19 epidemic.

ABSTRACT: To investigate associations between parent-child relationships, children's externalizing and internalizing symptoms, and lifestyle responses to the COVID-19 epidemic, we conducted an online survey of a random, representative sample of residents with children aged 3-17 years during mid-March 2020 in Wuhan and Shanghai, China. A total of 1655 parents and children were surveyed with a response rate of 80.1% in the survey. During the epidemic, the frequency of children enquiring about the epidemic (AOR = 1.46, 95% CI: 1.04, 2.06), parents explaining the epidemic to them (AOR = 2.87, 95% CI: 1.80, 4.58), parents expressing negative emotions in front of them (AOR = 2.62; 95% CI = 2.08-3.30), and parents with more irritable attitudes (AOR = 1.93; 95% CI = 1.33-2.81) were significantly associated with children's externalizing symptoms. For internalizing symptoms, significant associations were found with worse parent-child closeness (AOR = 2.93; 95% CI = 1.80-4.79), the frequency of parents expressing negative emotions in front of them (AOR = 2.64; 95% CI = 1.68, 4.12), and more irritable attitudes (AOR = 2.24; 95% CI = 1.42-3.55). We also found that each indicator of parent-child relationships had the significantly similar associations with children's lifestyle behaviors. These findings suggest that improving parents' attitudes towards their children and parent-child closeness during the epidemic, especially among parents with lower educational levels, are important to ensure the wellbeing of children.

SUBMITTER: Du F

PROVIDER: S-EPMC8642441 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:The development of child mental health problems has been associated with experiences of adversity and dysregulation of stress response systems; however, past research has largely focused on externalizing or internalizing problems (rather than their co-occurrence) and single physiological systems in high-risk adolescent samples. The present study examined whether cumulative family adversity, functioning in the hypothalamic-pituitary-adrenal axis (i.e., cortisol) and the parasympathetic nervous system (i.e., respiratory sinus arrhythmia [RSA]), and their interactions, predicted trajectories of co-occurring externalizing and internalizing problems among young children. Participants included 338 socioeconomically and racially diverse children (M age = 5.32 years, SD = .32; male = 51.8%) from a community sample. Family adversity (assessed with six measures) and child daily cortisol output and resting RSA were assessed in kindergarten. Parents, teachers, and children reported on children's externalizing and internalizing psychopathology up to three times from kindergarten to grade 1. Latent class growth analyses identified stable trajectories of externalizing and internalizing psychopathology. Trajectories were combined to create groups: co-occurring externalizing and internalizing (13.1%), externalizing-only (14.0%), internalizing-only (11.3%), and low problems (61.3%). Family adversity and resting RSA significantly positively predicted co-occurring group membership. Tests for interactions showed adversity did not significantly interact with physiological indicators to predict group membership. However, the two physiological systems interacted, such that higher and lower daily cortisol predicted internalizing group membership for children with lower and higher resting RSA, respectively. Findings support the importance of considering family context and multiple physiological systems to inform understanding of the development of mental health problems, and their co-occurrence, in early childhood.

Dataset Information

Associations between parent-child relationship, and children's externalizing and internalizing symptoms, and lifestyle behaviors in China during the COVID-19 epidemic.

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