Association of children’s behavioral changes and parent–child relationship with parental anxiety under confinement during COVID-19 pandemic: a cross-sectional study

Abstract

Abstract Objective Coronavirus Disease-19 (COVID-19) has become a global pandemic, and mental health of children and parents are affected by confinement in home. Since the outbreak of COVID-19 is still global pandemic currently, it is important to examine how the changes of children’s behaviors and parent–child relationship affect parental anxiety during this difficult time. Methods A cross-sectional online investigation was conducted with snowball sampling to collect the information about the behavioral changes of children and the anxiety of parents from February 23 to March 3, 2020. 642 participants who had children aged 3–17 years included in this study. Information about behavioral change of children was reported by parents with a questionnaire, parental anxiety was assessed with Self-rating Anxiety Scale (SAS, Chinese Version). Results Among children’s behaviors, decreased time of outdoor activity was associated with a lower odds of parental anxiety, with an adjusted odds ratios (ORs) of 0.31 (95% CI, 0.11–0.87). Parents’ satisfaction with children's behaviors was associated with a lower odds of parental anxiety (ORs, 0.13; 95% CI, 0.05–0.35). In addition, we observed a significant association of worse behavioral performance and worse family relationship with anxiety among parents with the adjusted ORs of 2.78 (95% CI, 1.35–5.73), and 2.67 (95% CI, 1.13–6.32), respectively. Conclusion Under COVID-19 outbreak in China, changes in children’s behavioral and family relationship were associated with parental anxiety. Our finding suggested that family mental health support and promotion should consider the children’s behavioral regulation and parent–child relationship as essential components.

Keywords

• COVID-19 pandemic
• Confinement
• Children’s lifestyle changes
• Parent–child attachment
• Parental anxiety