Parenting-Related Exhaustion During the Italian COVID-19 Lockdown

Daniela Marchetti, PHD; Lilybeth Fontanesi, PHD; Cristina Mazza, PSYD; Serena Di Giandomenico, PSYD; Paolo Roma, PHD; Maria Cristina Verrocchio, PSYD

Disclosures

J Pediatr Psychol. 2020;45(10):1114-1123. 

In This Article

Abstract and Introduction

Abstract

Objective: Worldwide, the coronavirus disease 2019 (COVID-19) pandemic has generated significant worry, uncertainty, anxiety, sadness, and loneliness. In Italy, these effects have been particularly pronounced. While research on the COVID-19 outbreak has mainly focused on the clinical features of infected patients and the psychological impact on the general population and health professionals, no investigation has yet assessed the psychological impact of the pandemic on parents. In the present research, we conducted a web-based survey of Italian parents to examine the prevalence of parenting-related exhaustion—and to identify its associated risk and protective factors—4 weeks into the lockdown.

Methods: A total of 1,226 parents provided their consent to participate in the study and completed a demographic questionnaire, information relating to particular COVID-19 experiences, and measures of emotional exhaustion, parental resilience, social connections, and psychological distress during the lockdown.

Results: Seventeen percent of our sample experienced significant parenting-related exhaustion, with mothers more severely affected. Multiple regression analyses showed that greater parenting-related exhaustion was predicted by psychological distress, lower parental resilience, motherhood, fewer perceived social connections, and being single, as well as having a child with special needs, having a large number of children, and having younger children.

Conclusion: The findings add further support to the call for preventive programs to support parents throughout the COVID-19 pandemic. Mental health professionals and social workers should be warned of the effects of lockdown and social distancing on parenting and, consequently, the well-being of children.

Introduction

The World Health Organization declared the outbreak of coronavirus disease 2019 (COVID-19) a pandemic on March 1, 2020.1 Prior to this, in Italy, a series of restrictions of increasing severity began on February 23, 2020, with the first lockdown initiated in the Codogno area (Lombardy, northern Italy), which recorded the first case of COVID-19 in Italy (Lazzerini & Putoto, 2020). As the virus spread rapidly throughout the country, the Italian government gradually imposed more stringent measures, leading to the national lockdown imposed on March 11, involving the closure of schools, social and recreational venues (cinemas, theaters, cultural centers), and shops (except for those selling staple goods); a ban on sporting events, funerals, and all other assemblages (Lazzerini & Putoto, 2020); and new rules involving social distancing and home working. As a result of these measures to control the spread of the virus, the Italian public has suffered a massive burden.

Research on both historical outbreaks (e.g., of severe acute respiratory syndrome) and the current COVID-19 outbreak has demonstrated a wide-ranging psychological impact on noninfected community members (Huang & Zhao, 2020; Leung, 2003; Rubin et al., 2010; Sim, 2010; Van Bortel et al., 2016). Specifically, some studies have revealed an increase in parental stress and the presence of Post-Traumatic Stress Disorder (PTSD) symptoms in parents and children after a prolonged period of forced lockdown (Brooks et al., 2020; Sprang & Silman, 2013).

Worldwide, the COVID-19 epidemic is producing uncertainty about the future, anxiety, fear, sadness, and loneliness among individuals, especially with regard to health and finances. At the family level, parents are being called to cope with the additional stress and emotional difficulties caused by school closures and children's confinement at home (Fegert et al., 2020; Halvorsen et al., 2020). Furthermore, research suggests that, during the first months of the pandemic, both mothers and fathers demonstrated more safety behaviors than did nonparents; thus, parental status seems to comprise a risk factor for fear and anxiety, especially with respect to children's safety (Lauri Korajlija & Jokic-Begic, 2020). Finally, a recent investigation showed that the health risks and fear connected to COVID-19 influence parents' levels of stress and, as a consequence, children's well-being (Spinelli et al., 2020).

Italy is among the countries that have been most severely affected by COVID-19. Accordingly, many Italian parents are observing negative changes in their children's emotional states and routines during the lockdown. In particular, Italian families are dealing with children's increased use of technology and the effect of this on their sleeping patterns, due to their greater time spent at home; to this, they refer moderated levels of stress (Orgilés et al., 2020). Italian parents also report problems of irritability, intolerance of rules, nervousness about the pandemic, and regressive symptoms in their children (Pisano et al., 2020). Finally, parents of children with pre-existing psychological and behavioral difficulties are reporting problems managing their children at home over this extended period, especially when also striving to fulfill daily personal/professional responsibilities (Colizzi et al., 2020; de Girolamo et al., 2020).

While flexible and adapted parents may experience the current limitations on place and time as an opportunity to spend more quality time with their family, for others, the lockdown is threatening to disrupt family cohesion and individual well-being by raising unresolved conflicts and difficulties to the surface (Fegert et al., 2020). For instance, there are mounting data that the social exclusion of the family due to COVID-19 represents an important risk for the escalation of child abuse, family violence, and neglect (Roje Đapić et al., 2020).

Social isolation, unstable finances, and psychological distress have been found to be connected to higher levels of parental stress, especially during the COVID-19 pandemic (Griffith, 2020). Parental stress is a risk factor for negative mental health outcomes among both parents and children (Bøe et al., 2018; Conger et al., 1992; Masarik & Conger, 2017; Sobolewski & Amato, 2005). Indeed, due to the COVID-19 epidemic, many national and international institutions have advised that children and their families are in a state of emergency (Cluver et al., 2020). Protracted parental stress and a lack of resilience in parents can produce overwhelming exhaustion—defined as feelings of being overextended and depleted of one's emotional and physical resources. Exhaustion is an aspect of parental burnout, which results from prolonged exposure to parental stress (Mikolajczak, et al., 2018). Parental burnout can be connected to daily tasks involving children, such as managing children's time, homework, and chores; it may also be related to critical stressors, such as child illness or adolescent law infringement, or chronic stressors, such as children's mental or behavioral disorders. It is composed of three main dimensions: the abovementioned emotional exhaustion, emotional distancing, and a sense of low/no parental achievement (Roskam et al., 2017). Parenting-related exhaustion can lead to a belief that parenting requires too much engagement; parents may feel too tired to spend time with their children and this may generate emotional distancing and/or a general lack of involvement in their children's lives (Mikolajczak et al., 2018). The literature shows that parents' stress response is more significant than stressors, themselves, in predicting parents'—and subsequently children's—psychological well-being (e.g., Crnic & Low, 2002).

Nevertheless, research on the mental health effects of the COVID-19 outbreak has focused mainly on the general population and health professionals and, to a lesser extent, parents; no investigation has explored parents' emotional exhaustion related to the COVID-19 lockdown. In the present study, we administered a web-based cross-sectional survey of Italian parents to examine the prevalence of parenting-related exhaustion—and to identify its risk and protective factors—4 weeks into the COVID-19 lockdown.

Based on previous research on parental stress and the consequences of the COVID-19 lockdown on mental health (Griffith, 2020; Spinelli et al., 2020), we hypothesized that three main factors may contribute to the alarming levels of parenting-related exhaustion during the lockdown: (a) pre-existing conditions relating to gender, age, education, and children (e.g., number of children, children with cognitive or physical disabilities [special needs]); (b) COVID-19 experiences, which were theorized to be risk factors (i.e., living in a highly infected area, spending the lockdown with others vs. alone with children, working during the lockdown, infected loved ones, losses); and (c) psychological variables, which were theorized to be protective factors (i.e., social support, parental resilience, psychological well-being). Higher levels of parenting-related exhaustion were hypothesized to be linked to pre-existing stress, negative COVID-19 experiences (i.e., losses, infected loved ones, isolation), and a poor psychological condition (i.e., lack of support/resilience, higher psychological distress).

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