Parent and Child Mental Health Symptom Trajectories April-October 2020: Second-Wave Strict Lockdown Compared to COVID-Normal in Australia

Background: To control a second-wave COVID-19 outbreak, the state of Victoria in Australia experienced one of the world’s first long and strict lockdowns over July-October 2020, while the rest of Australia experienced ‘COVID-normal’ with minimal restrictions. We (1) investigate trajectories of parent/child mental health outcomes; and (2) identify baseline demographic, individual, and COVID-19-related factors associated with mental health trajectories. Methods: Online community sample of 1,877 Australian parents with rapid repeated assessment over 10 time-points over April-October, 2020. Measures assessed parent mental health (Depression, Anxiety and Stress Scales-21); child depression symptoms (13-item Short Mood and Feelings Questionnaire); and child anxiety symptoms (four-items from Brief Spence Children’s Anxiety Scale). Results: Mental health trajectories shadowed COVID infection rates. Victorians reported a large peak in mental health symptoms at the time of the second-wave lockdown compared to other states. Key baseline predictors, including parent and child loneliness (standardised regression coefficient [β]=·09-·39), parent/child diagnoses (β=·11-·22), couple conflict (β=·09-·19), and COVID-19 stressors, such as worry/concern about COVID, illness, and loss of job (β=·07-·22), predicted elevated trajectories. Effects of predictors on parent and child mental health trajectories are illustrated in an online interactive app for readers (https://lingtax.shinyapps.io/CPAS_trend/). Conclusion and Relevance: Our findings provide evidence of worse trajectories of parent and child mental health symptoms associated with strict, sustained, COVID-19 lockdown in Victoria, compared to non-locked states in the rest of Australia. We identified several baseline factors that may be useful in detecting high risk families who are likely to require additional support early on in future lockdowns. Funding Statement: EW, AMW, & GK were supported by Deakin Faculty of Health Mid-Career Fellowships. ES was supported by an NHMRC Career Development Fellowship (1110688) and a veski Inspiring Women’s Fellowship. Declaration of Interests: The authors declare that they have no conflict of interest. Ethics Approval Statement: This study uses data from ten time-points of the COVID-19 Pandemic Adjustment Survey (CPAS),22 an online community sample of 2,365 Australian parents of a child 0-18 years, investigating the impact of the COVID-19 crisis on Australian families. CPAS was approved by the Deakin University Human Ethics Advisory Group (HEAG-H 52_2020). Participants were recruited via paid and unpaid social media advertisements over 8-28th April, 2020, during the first-wave national lockdown in Australia, and were followed over ten time-points until the 5th October 2020.