Impact of the COVID-19 pandemic on children with and without affective dysregulation and their families

A-K Treier^{1

2}, V Holas^{3

4}, A Görtz-Dorten^{3

4}, F Frenk^{3

4}, C Goldbeck^{3

4}, K Mücke^{3

4}, C Hanisch⁵, A Ritschel⁵, V Roessner⁶, J Rothe⁶, U Ravens-Sieberer⁷, A Kaman⁷, T Banaschewski⁸, D Brandeis^{8

9

10

11}, P-M Aggensteiner⁸, M Kölch^{12

13}, A Daunke¹², M Döpfner^{3

4}; ADOPT Consortium

Affiliations

¹ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University Cologne, Cologne, Germany. anne-katrin.treier@uk-koeln.de.
² School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. anne-katrin.treier@uk-koeln.de.
³ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University Cologne, Cologne, Germany.
⁴ School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁵ Faculty of Human Sciences, University of Cologne, Cologne, Germany.
⁶ Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany.
⁷ Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics & Research Unit Child Public Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁸ Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
⁹ Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zürich, Zurich, Switzerland.
¹⁰ Zürich Center for Integrative Human Physiology, University of Zürich, Zurich, Switzerland.
¹¹ Neuroscience Center Zürich, University and ETH Zürich, Zurich, Switzerland.
¹² Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany.
¹³ Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.

PMID: 36385660
PMCID: PMC9668221
DOI: 10.1007/s00787-022-02106-3

Clinical Trial

Impact of the COVID-19 pandemic on children with and without affective dysregulation and their families

A-K Treier et al. Eur Child Adolesc Psychiatry. 2023 Jun.

. 2023 Jun;32(6):951-961.

doi: 10.1007/s00787-022-02106-3. Epub 2022 Nov 16.

Authors

Affiliations

¹ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University Cologne, Cologne, Germany. anne-katrin.treier@uk-koeln.de.
² School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany. anne-katrin.treier@uk-koeln.de.
³ Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University Cologne, Cologne, Germany.
⁴ School for Child and Adolescent Cognitive Behavior Therapy (AKiP), Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
⁵ Faculty of Human Sciences, University of Cologne, Cologne, Germany.
⁶ Department of Child and Adolescent Psychiatry and Psychotherapy, TU Dresden, Dresden, Germany.
⁷ Department of Child and Adolescent Psychiatry, Psychotherapy, and Psychosomatics & Research Unit Child Public Health, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
⁸ Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany.
⁹ Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zürich, Zurich, Switzerland.
¹⁰ Zürich Center for Integrative Human Physiology, University of Zürich, Zurich, Switzerland.
¹¹ Neuroscience Center Zürich, University and ETH Zürich, Zurich, Switzerland.
¹² Department of Child and Adolescent Psychiatry, Neurology, Psychosomatics, and Psychotherapy, University Medical Center Rostock, Rostock, Germany.
¹³ Department of Child and Adolescent Psychiatry/Psychotherapy, University of Ulm, Ulm, Germany.

PMID: 36385660
PMCID: PMC9668221
DOI: 10.1007/s00787-022-02106-3

Abstract

Analyzing COVID-19-related stress in children with affective dysregulation (AD) seems especially interesting, as these children typically show heightened reactivity to potential stressors and an increased use of maladaptive emotion regulation strategies. Children in out-of-home care often show similar characteristics to those with AD. Since COVID-19 has led to interruptions in psychotherapy for children with mental health problems and to potentially reduced resources to implement treatment strategies in daily life in families or in out-of-home care, these children might show a particularly strong increase in stress levels. In this study, 512 families of children without AD and 269 families of children with AD reported on COVID-19-related stress. The sample comprised screened community, clinical, and out-of-home care samples. Sociodemographic factors, characteristics of child and caregiver before the pandemic, and perceived change in external conditions due to the pandemic were examined as potential risk or protective factors. Interestingly, only small differences emerged between families of children with and without AD or between subsamples: families of children with AD and families in out-of-home care were affected slightly more, but in few domains. Improvements and deteriorations in treatment-related effects balanced each other out. Overall, the most stable and strongest risk factor for COVID-19-related stress was perceived negative change in external conditions-particularly family conditions and leisure options. Additionally, caregiver characteristics emerged as risk factors across most models. Actions to support families during the pandemic should, therefore, facilitate external conditions and focus on caregiver characteristic to reduce familial COVID-19-related stress. Trial registration: German Clinical Trials Register (DRKS), ADOPT Online: DRKS00014963 registered 27 June 2018, ADOPT Treatment: DRKS00013317 registered 27 September 2018, ADOPT Institution: DRKS00014581 registered 04 July 2018.

Keywords: Affective dysregulation; COVID-19; Children and adolescents; Risk factors; Stress.

PubMed Disclaimer

Conflict of interest statement

AGD receives royalties from publishing companies as an author of books and treatment manuals on child behavioral therapy and assessment manuals, including the treatment manuals evaluated in this trial. TB served in an advisory or consultancy role for ADHS digital, Infectopharm, Lundbeck, Medice, Neurim Pharmaceuticals, Oberberg GmbH, Roche, and Takeda. He received conference support or speaker’s fees from Medice and Takeda. He received royalities from Hogrefe, Kohlhammer, CIP Medien, Oxford University Press; the present work is unrelated to these relationships. CH receives royalties from a publishing company as the author of a treatment manual. MK receives royalties from publishing companies as an author of books. He served as PI or CI in clinical trials of Lundbeck, Pascoe, and Janssen-Cilag. He received grants from the BMBF, BMFSFJ, BZgA and Bundeswehr. He served as scientific advisor for Janssen. The present work is unrelated to the above grants and relationships. MD receives royalties from publishing companies as an author of books and treatment manuals on child behavioral therapy and of assessment manuals published by Beltz, Elsevier, Enke, Guilford, Hogrefe, Huber, Kohlhammer, Schattauer, Springer, and Wiley. He receives income as a consultant for Child Behavior Therapy at the National Association of Statutory Health Insurance Physicians. He also receives consulting income and research support from Lilly, Medice, Takeda, and eyelevel GmbH. DB served as an unpaid scientific advisor for an EU-funded neurofeedback trial unrelated to the present work. All other authors declare no conflict of interest.

References

1. World Health Organization Europe (2022) Coronavirus disease (COVID-19) pandemic: Overview. https://www.who.int/europe/emergencies/situations/covid-19
1. Paschke K, Arnaud N, Austermann MI, Thomasius R. Risk factors for prospective increase in psychological stress during COVID-19 lockdown in a representative sample of adolescents and their parents. BJPsych Open. 2021;7(3):e94. doi: 10.1192/bjo.2021.49. - DOI - PMC - PubMed
1. Ravens-Sieberer U, Kaman A, Otto C, Adedeji A, Napp AK, Becker M, Blanck-Stellmacher U, Loffler C, Schlack R, Holling H, Devine J, Erhart M, Hurrelmann K. Seelische Gesundheit und psychische Belastungen von Kindern und Jugendlichen in der ersten Welle der COVID-19-Pandemie—Ergebnisse der COPSY-Studie. Bundesgesundheitsbl. 2021 doi: 10.1007/s00103-021-03291-3. - DOI - PMC - PubMed
1. Tang S, Xiang M, Cheung T, Xiang YT. Mental health and its correlates among children and adolescents during COVID-19 school closure: the importance of parent-child discussion. J Affect Disord. 2021;279:353–360. doi: 10.1016/j.jad.2020.10.016. - DOI - PMC - PubMed
1. Calvano C, Engelke L, Di Bella J, Kindermann J, Renneberg B, Winter SM. Families in the COVID-19 pandemic: parental stress, parent mental health and the occurrence of adverse childhood experiences-results of a representative survey in Germany. Eur Child Adolesc Psychiatry. 2021 doi: 10.1007/s00787-021-01739-0. - DOI - PMC - PubMed

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Impact of the COVID-19 pandemic on children with and without affective dysregulation and their families

Affiliations

Impact of the COVID-19 pandemic on children with and without affective dysregulation and their families

Authors

Affiliations

Abstract

Conflict of interest statement

References

Publication types

MeSH terms

Associated data

Grants and funding

LinkOut - more resources

Full Text Sources

Medical