Associations between COVID-19-related family hardships/distress and children's Adverse Childhood Experiences during the pandemic: The Environmental influences on Child Health Outcomes (ECHO) program

Karen L Thierry; Christine W Hockett; Amy J Elliott; Adaeze C Wosu; Aruna Chandran; Courtney K Blackwell; Amy E Margolis; Margaret R Karagas; Carmen Velez Vega; Cristiane S Duarte; Carlos A Camargo Jr; Barry M Lester; Elisabeth C McGowan; Assiamira Ferrara; Thomas G O'Connor; Cindy T McEvoy; Alison E Hipwell; Leslie D Leve; Jody M Ganiban; Sarah S Comstock; Dana Dabelea; program collaborators for Environmental influences on Child Health Outcomes

doi:10.1016/j.chiabu.2023.106510

Associations between COVID-19-related family hardships/distress and children's Adverse Childhood Experiences during the pandemic: The Environmental influences on Child Health Outcomes (ECHO) program

Child Abuse Negl. 2023 Dec:146:106510. doi: 10.1016/j.chiabu.2023.106510. Epub 2023 Nov 1.

Authors

Karen L Thierry¹, Christine W Hockett², Amy J Elliott³, Adaeze C Wosu⁴, Aruna Chandran⁴, Courtney K Blackwell⁵, Amy E Margolis⁶, Margaret R Karagas⁷, Carmen Velez Vega⁸, Cristiane S Duarte⁹, Carlos A Camargo Jr¹⁰, Barry M Lester¹¹, Elisabeth C McGowan¹¹, Assiamira Ferrara¹², Thomas G O'Connor¹³, Cindy T McEvoy¹⁴, Alison E Hipwell¹⁵, Leslie D Leve¹⁶, Jody M Ganiban¹⁷, Sarah S Comstock¹⁸, Dana Dabelea¹⁹; program collaborators for Environmental influences on Child Health Outcomes

Affiliations

¹ Committee for Children, Seattle, WA, USA. Electronic address: kthierry@cfchildren.org.
² Department of Pediatrics, University of South Dakota School of Medicine, Vermillion, SD, USA; Avera Research Institute, Sioux Falls, SD, USA.
³ Avera Research Institute, Sioux Falls, SD, USA.
⁴ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
⁵ Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
⁶ Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
⁷ Dartmouth College, Geisel School of Medicine, Hanover, NH, USA.
⁸ Social Sciences Department, School of Public Health, University of Puerto Rico, San Juan, PR.
⁹ Columbia University Irving Medical Center - New York State Psychiatric Institute, New York, NY, USA.
¹⁰ Massachusetts General Hospital, Boston, MA, USA.
¹¹ Department of Pediatrics, Brown University, Providence, RI, USA.
¹² Kaiser Permanente Northern California Division of Research, Oakland, CA, USA.
¹³ Departments of Psychiatry, Psychology, Neuroscience and Obstetrics & Gynecology, University of Rochester, Rochester, NY, USA.
¹⁴ Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA.
¹⁵ Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
¹⁶ Department of Education, University of Oregon, Eugene, OR, USA.
¹⁷ Department of Psychological and Behavioral Sciences, The George Washington University, Washington, DC, USA.
¹⁸ Department of Food Science and Human Nutrition, Michigan State University, East Lansing, MI, USA.
¹⁹ University of Colorado Anschutz Medical Campus, Aurora, CO, USA.

PMID: 37922614
DOI: 10.1016/j.chiabu.2023.106510

Abstract

Background: Economic hardships imposed by the pandemic could have implications for children's experiences of adversity in the home, or Adverse Childhood Experiences (ACEs).

Objective: This observational cohort study examined associations between COVID-19-related hardships and distress (e.g., job loss, caregiver stress) and the cumulative number of child ACEs reported by caregivers during the pandemic (i.e., March 1, 2020-February 28, 2022).

Participants and setting: The study included children (N = 4345; median age = 6.0 years, interquartile range = 4-9 years) and their parents/caregivers who participated in the NIH-funded Environmental influences in Child Health Outcomes (ECHO) Program.

Methods: We described socio-demographic characteristics and pandemic-related family hardships/distress and cumulative child ACE scores reported during pre-pandemic and pandemic periods. We used negative binomial regression models to evaluate associations between pandemic-related family hardships and cumulative child ACE scores reported during the pandemic.

Results: Each caregiver-reported hardship/distress was associated with higher child ACE scores reported during the pandemic. After accounting for pre-pandemic child ACE scores, moderate and severe symptoms of pandemic-related traumatic stress among caregivers were associated with 108 % and 141 % higher child ACE scores reported during the pandemic, respectively, compared with no or low caregiver symptoms. In addition, finance-related stress during the pandemic was associated with 47 % higher child ACE scores. After adjusting for pre-pandemic child experiences of neglect, most sources of stress remained significantly associated with higher child ACE scores reported during the pandemic, particularly severe/very severe symptoms of pandemic-related traumatic stress among caregivers. Findings held for children with no known pre-pandemic ACEs.

Conclusions: This research suggests that caregivers experiencing financial hardships and those with severe pandemic-related traumatic stress may require additional support systems during stressful events.

Keywords: Adverse childhood experiences; COVID-19 pandemic; Child abuse & neglect; Family stress.

Publication types

Observational Study
Research Support, N.I.H., Extramural

MeSH terms

Adverse Childhood Experiences*
COVID-19* / epidemiology
Child
Child, Preschool
Cohort Studies
Humans
Outcome Assessment, Health Care
Pandemics

Abstract

Publication types

MeSH terms

Grants and funding