Mental Health Is a Family Affair—Systematic Review and Meta-Analysis on the Associations between Mental Health Problems in Parents and Children during the COVID-19 Pandemic
Abstract
:1. Introduction
- (1)
- Are parental mental health problems prior to the COVID-19 pandemic associated with child mental health outcomes during the COVID-19 pandemic?
- (2)
- Are current parental mental health symptoms associated with child mental health outcomes during the COVID-19 pandemic?
- (3)
- Are parents’ general stress levels associated with child mental health outcomes during the COVID-19 pandemic?
- (4)
- Is parenting stress associated with child mental health outcomes during the COVID-19 pandemic?
2. Methods
2.1. Literature Search
2.2. Study Selection
2.3. Data Extraction
2.4. Risk of Bias
2.5. Systematic Synthesis and Statistical Analysis
3. Results
3.1. Research Question 1: Are Parental Mental Health Problems Prior to the COVID-19 Pandemic Associated with Child Mental Health Outcomes during the COVID-19 Pandemic?
3.2. Research Question 2: Are Current Parental Mental Health Symptoms Associated with Child Mental Health Outcomes during the COVID-19 Pandemic?
3.3. Research Question 3: Are Parents’ General Stress Levels Associated with Child Mental Health Outcomes during the COVID-19 Pandemic?
3.4. Research Question 4: Is Parenting Stress Associated with Child Mental Health Outcomes during the COVID-19 Pandemic?
4. Discussion
4.1. Limitations
4.2. Implications for Research and Practice
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Research Question | Parental Variable | Child Outcome | Meta-Analytic Results | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
k | o | r | 95% CI | z | p-Value | Q | I2 | T2 | Fail-Safe N | |||
1. Are parental mental health problems prior to the COVID-19 pandemic associated with child mental health outcomes during the COVID-19 pandemic? | Psy-pathol | Psy-pathol | 2 | 351 | 0.23 | (−0.85; 0.94) | 1.96 | 0.30 | 4.65, p = 0.03 | 78.5% | 0.022 | |
Psy-pathol | Int symp | 4 | 754 | 0.18 | (−0.07; 0.40) | 2.28 | 0.11 | 13.30, p < 0.01 | 77.4% | 0.019 | ||
Psy-pathol | Dep symp | 2 | 403 | 0.16 | (−0.29; 0.56) | 4.53 | 0.14 | 0.53, p = 0.47 | 0.0% | 0 | ||
Psy-pathol | Anx symp | 2 | 403 | 0.09 | (−0.03; 0.21) | 9.61 | 0.07 | 0.04, p = 0.85 | 0.0% | 0 | ||
Psy-pathol | Ext symp | 2 | 351 | 0.23 | (−0.49; 0.76) | 3.87 | 0.16 | 1.25, p = 0.26 | 20.2% | 0.002 | ||
Dep symp | Psy-pathol | 2 | 188 | 0.29 | (−0.73; 0.91) | 3.04 | 0.20 | 1.65, p = 0.20 | 39.5% | 0.007 | ||
Dep symp | Int symp | 3 | 334 | 0.19 | (0.11; 0.28) | 9.65 | 0.01 | 0.27, p = 0.87 | 0.0% | 0 | 12 | |
Dep symp | Dep symp | 3 | 582 | 0.23 | (−0.10; 0.51) | 3.03 | 0.09 | 4.51, p = 0.10 | 55.6% | 0.009 | ||
Dep symp | Ext symp | 2 | 188 | 0.20 | (−0.37; 0.67) | 4.38 | 0.14 | 0.40, p = 0.53 | 0.0% | 0 | ||
2. Are current parental mental health symptoms associated with child mental health outcomes during the COVID-19 pandemic? | Psy-pathol | Psy-pathol | 25 | 11,883 | 0.36 | (0.31; 0.42) | 12.26 | <0.001 | 226.39, p < 0.001 | 89.4% | 0.020 | 12,464 |
Psy-pathol | Int symp | 23 | 14,348 | 0.36 | (0.30; 0.42) | 10.90 | <0.001 | 213.80, p < 0.001 | 89.7% | 0.023 | 11,478 | |
Psy-pathol | Dep symp | 8 | 6540 | 0.27 | (0.16; 0.37) | 5.93 | <0.001 | 57.00, p < 0.001 | 87.7% | 0.014 | 1076 | |
Psy-pathol | Anx symp | 7 | 6018 | 0.27 | (0.19; 0.34) | 8.26 | <0.001 | 25.15, p < 0.001 | 76.1% | 0.006 | 823 | |
Psy-pathol | Ext symp | 18 | 9103 | 0.32 | (0.24; 0.38) | 8.84 | <0.001 | 151.49, p < 0.001 | 88.8% | 0.021 | 5140 | |
Psy-pathol | Gen stress | 5 | 1214 | 0.31 | (−0.01; 0.57) | 2.71 | 0.053 | 67.76, p < 0.001 | 94.1% | 0.065 | ||
Dep symp | Psy-pathol | 18 | 5692 | 0.39 | (0.32; 0.44) | 12.26 | <0.001 | 100.62, p < 0.001 | 83.1% | 0.015 | 4935 | |
Dep symp | Int symp | 16 | 8357 | 0.28 | (0.24; 0.33) | 12.89 | <0.001 | 35.01, p < 0.01 | 57.2% | 0.004 | 2751 | |
Dep symp | Dep symp | 11 | 14,958 | 0.27 | (0.17; 0.37) | 5.75 | <0.001 | 196.72, p < 0.001 | 94.9% | 0.023 | 2075 | |
Dep symp | Anx symp | 8 | 6275 | 0.25 | (0.21; 0.30) | 11.96 | <0.001 | 14.33, p < 0.05 | 51.1% | 0.002 | 856 | |
Dep symp | Ext symp | 13 | 4018 | 0.27 | (0.22; 0.33) | 10.62 | <0.001 | 22.26, p = 0.03 | 46.1% | 0.003 | 1194 | |
Dep symp | Gen stress | 3 | 923 | 0.39 | (−0.47; 0.87) | 1.90 | 0.20 | 71.37, p < 0.001 | 97.2% | 0.130 | ||
Anx symp | Psy-pathol | 12 | 4110 | 0.31 | (0.25; 0.38) | 9.89 | <0.001 | 43.49, p < 0.001 | 74.7% | 0.008 | 1535 | |
Anx symp | Int symp | 15 | 14,571 | 0.30 | (0.23; 0.36) | 9.85 | <0.001 | 152.43, p < 0.001 | 90.8% | 0.010 | 5098 | |
Anx symp | Dep symp | 6 | 5613 | 0.22 | (0.08; 0.35) | 4.07 | <0.01 | 41.34, p < 0.001 | 87.9% | 0.015 | 481 | |
Anx symp | Anx symp | 9 | 6549 | 0.26 | (0.20; 0.33) | 8.91 | <0.001 | 36.32, p < 0.001 | 78.0% | 0.006 | 1138 | |
Anx symp | Ext symp | 9 | 3517 | 0.23 | (0.17; 0.28) | 8.80 | <0.001 | 18.32, p = 0.02 | 56.3% | 0.004 | 510 | |
Anx symp | Gen stress | 3 | 923 | 0.33 | (−0.41; 0.81) | 1.91 | 0.20 | 34.72, p < 0.001 | 94.2% | 0.088 | ||
3. Are parents’ general stress levels associated with child mental health outcomes during the COVID-19 pandemic? | Gen stress | Psy-pathol | 20 | 38,991 | 0.34 | (0.29, 0.39) | 13.24 | <0.001 | 433.74, p < 0.001 | 95.6% | 0.012 | 18,997 |
Gen stress | Int symp | 21 | 40,084 | 0.31 | (0.27, 0.35) | 14.37 | <0.001 | 87.39, p < 0.001 | 77.1% | 0.007 | 12,548 | |
Gen stress | Dep symp | 10 | 5243 | 0.30 | (0.21; 0.39) | 7.39 | <0.001 | 50.19, p < 0.001 | 82.1% | 0.014 | 1510 | |
Gen stress | Anx symp | 8 | 4913 | 0.32 | (0.22; 0.41) | 7.33 | <0.001 | 29.68, p < 0.001 | 76.4% | 0.012 | 1124 | |
Gen stress | Ext symp | 17 | 36,844 | 0.31 | (0.27, 0.35) | 17.37 | <0.001 | 161.94, p < 0.001 | 90.1% | 0.004 | 10,637 | |
Gen stress | Gen stress | 13 | 4110 | 0.29 | (0.18, 0.39) | 5.49 | <0.001 | 139.59, p < 0.001 | 91.4% | 0.033 | 1659 | |
4. Is parenting stress associated with child mental health outcomes during the COVID-19 pandemic? | Par stress | Psy-pathol | 9 | 4213 | 0.44 | (0.33, 0.54) | 8.32 | <0.001 | 43.82, p < 0.001 | 81.7% | 0.020 | 2387 |
Par stress | Int symp | 7 | 3307 | 0.46 | (0.26, 0.63) | 5.18 | <0.01 | 95.89, p < 0.001 | 93.7% | 0.059 | 1315 | |
Par stress | Dep symp | 2 | 251 | 0.36 | (−0.95; 0.99) | 2.16 | 0.28 | 4.30, p = 0.04 | 76.7% | 0.047 | ||
Par stress | Ext symp | 8 | 4079 | 0.45 | (0.39, 0.50) | 16.37 | <0.001 | 15.83, p = 0.03 | 55.8% | 0.002 | 2354 | |
Par stress | Gen stress | 2 | 1682 | 0.51 | (−0.12, 0.85) | 10.38 | 0.06 | 3.67, p = 0.06 | 72.8% | 0.004 |
Child Variables (all during the COVID-19 pandemic) | |||||||
Psychopathology | Internalizing symptoms | Depressive symptoms | Anxiety symptoms | Externalizing symptoms | General stress | ||
Parental variables | (1) Prior to the COVID-19 pandemic | ||||||
Depressive symptoms | 0.19 | ||||||
(2) During the COVID-19 pandemic | |||||||
Psychopathology | 0.36 | 0.36 | 0.27 | 0.27 | 0.32 | ||
Depressive symptoms | 0.39 | 0.28 | 0.27 | 0.25 | 0.27 | ||
Anxiety symptoms | 0.31 | 0.30 | 0.22 | 0.26 | 0.23 | ||
General stress | 0.34 | 0.31 | 0.30 | 0.32 | 0.31 | 0.29 | |
Parenting stress | 0.44 | 0.46 | 0.45 |
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Stracke, M.; Heinzl, M.; Müller, A.D.; Gilbert, K.; Thorup, A.A.E.; Paul, J.L.; Christiansen, H. Mental Health Is a Family Affair—Systematic Review and Meta-Analysis on the Associations between Mental Health Problems in Parents and Children during the COVID-19 Pandemic. Int. J. Environ. Res. Public Health 2023, 20, 4485. https://doi.org/10.3390/ijerph20054485
Stracke M, Heinzl M, Müller AD, Gilbert K, Thorup AAE, Paul JL, Christiansen H. Mental Health Is a Family Affair—Systematic Review and Meta-Analysis on the Associations between Mental Health Problems in Parents and Children during the COVID-19 Pandemic. International Journal of Environmental Research and Public Health. 2023; 20(5):4485. https://doi.org/10.3390/ijerph20054485
Chicago/Turabian StyleStracke, Markus, Miriam Heinzl, Anne Dorothee Müller, Kristin Gilbert, Anne Amalie Elgaard Thorup, Jean Lillian Paul, and Hanna Christiansen. 2023. "Mental Health Is a Family Affair—Systematic Review and Meta-Analysis on the Associations between Mental Health Problems in Parents and Children during the COVID-19 Pandemic" International Journal of Environmental Research and Public Health 20, no. 5: 4485. https://doi.org/10.3390/ijerph20054485